[Abstract Title]. - Society for Neuroscience

Disclosures: S.N. Kukke , None; T.D. Sanger, None.
Poster
276. Voluntary Movement: Stroke, Damage, or Disease
Time: Sunday, November 16, 2008, 1:00 pm - 5:00 pm
Program#/Poster#: 276.8/KK18
Topic: D.17.a. Kinematics and muscle activity
Support: Department of Occupational Therapy Scholarship Advancement Award
Title: Comparison of kinematic reaching patterns of stroke survivors completing Rhythmic
Auditory-Motor Entrainment versus Constraint-Induced Therapy
Authors: *C. L. MASSIE 1 , M. MALCOLM 1 , M. THAUT 2 ;
1 Occup. Therapy, 2 Ctr. for Biomed. Res. in Music, Colorado State Univ., Fort Collins, CO
Abstract: Background: In recent years, principles of motor control, motor learning, and
sensorimotor facilitation have provided the foundation for conceptual shifts in upper-extremity
stroke rehabilitation. Constraint-Induced Therapy (CIT) and Rhythmic Auditory Stimulation
(RAS) are two prominent new approaches to stroke rehabilitation showing strong potential in
clinical outcome studies. Both techniques, however, address motor recovery in very different
ways - CIT by forced-use to reverse learned non-use of the hemiparetic arm, RAS by accessing
sensory codes and feedforward/feedback mechanisms. Whereas CIT drives primarily quantitative
motor activity by forced use of the affected side, RAS is based on facilitation of qualitative
motor control in the hemiparetic limb. This project compares stroke-affected reaching kinematics
of participants completing either CIT or RAS training.
Methods: Ten stroke survivors completed 2 weeks of CIT incorporating massed practice of
functionally-based reaching tasks 6 hours daily. Six stroke survivors completed 2 weeks of RAS
training 3 hours daily. During RAS, participants reached in time with a metronome beat between
an array of target locations on a template. During kinematic data collection (pre and posttest),
participants were instructed to reach back and forth with their hemiparetic arm between two
targets. Kinematic measures included: 1) segmental contribution of shoulder, elbow, and trunk;
2) shoulder abduction ROM; 3) movement time.
Results: Following CIT, participants used significantly more shoulder flexion (p=.034, d=1.22)
to reach but the amount of elbow extension (p=.22) and compensatory trunk movement (p=.67)
did not change. Participants also used significantly more shoulder abduction following CIT
(p=.018, d=0.30). Following RAS, participants used significantly more shoulder flexion (p=.004,
d=0.61) and significantly less trunk movement during reach (p=.032, d=0.9). Compensatory
shoulder abduction significantly decreased (p