The Role of Auditory Feedback in Guiding Upper Extremity Movements

Stroke is one of the leading causes of disability, with an estimated prevalence of 50,000 cases per year in Canada. Less than half of stroke patients regain use of their arm and hand. There is currently no intervention regime that is the gold standard, despite the variety of therapeutic techniques used to treat the upper extremity post-stroke. The use of external feedback to improve motor learning is a technique that has been less studied but shows promise. Therefore, the purpose of this proof of principle study it to test whether different auditory feedback frequencies can facilitate reaching ability in people with stroke. In addition brain scans will be collected that will enable us to determine how stroke severity may impact on one's ability to improve with this technique.

We hypothesize that patients who receive less feedback (50% alternate) will have enhanced learning relative to the patients who receive more feedback (100%).

Inclusion Criteria:

• Unilateral first time MCA ischemic stroke
• Stroke patients should have some movement of shoulder/elbow (no movement of hand - e.g. hand, fingers - is OK)
• > 2 months post
• between 30-85 years

Exclusion Criteria:

• prior stroke
• severe comprehension (or cognitive) deficit that compromises informed consent or understanding of instructions
• contraindications to MRI (e.g. claustrophobia, metal implants)
• neurodegenerative or psychiatric disease
• apraxia
• auditory deficits that would impair testing
• prior musculoskeletal injury to back or upper extremity (including shoulder subluxation from stroke)
• skin conditions that would preclude taping of goniometers