Does Provision of Extrinsic Feedback Result in Improved Motor Learning in the Upper Limb Poststroke? A Systematic Review of the Evidence
- 27 October 2009
- journal article
- review article
- Published by SAGE Publications in Neurorehabilitation and Neural Repair
- Vol. 24 (2), 113-124
- https://doi.org/10.1177/1545968309349941
Abstract
Background. Recovery of the upper limb (UL) after a stroke occurs well into the chronic stage. Stroke survivors can benefit from adaptive plasticity to improve UL movement through motor relearning. The provision of feedback has been shown to decrease the use of compensatory UL movement patterns. However, the effectiveness of feedback in improving UL motor recovery after a stroke has not yet been systematically reviewed. Objective.The objective of this review was to systematically examine the role of extrinsic feedback on implicit motor learning after stroke, focusing on UL movement and functional recovery. Results. The authors retrieved 9 studies that examined the role of feedback on UL motor recovery. Of these, 6 were randomized controlled trials (RCTs), 1 was a single-subject design, 1 was a pre—post design, and 1 was a cohort study. The studies were rated on the basis of Sackett’s levels of evidence and PEDro (Physiotherapy Evidence Database) scores for RCTs. Levels of evidence were limited (level 2b) for UL motor learning of the less-affected extremity and strong (level 1a) for the more-affected extremity. Discussion and conclusions. The results suggest that people with stroke may be capable of using extrinsic feedback for implicit motor learning and improving UL motor recovery. Emergent questions regarding the advantages of using different media for feedback delivery and the optimal type and schedule of feedback to enhance motor learning in patient populations still need to be addressed.Keywords
This publication has 44 references indexed in Scilit:
- What Do Motor “Recovery” and “Compensation” Mean in Patients Following Stroke?Neurorehabilitation and Neural Repair, 2008
- The effect of the GENTLE/s robot-mediated therapy system on arm function after strokeClinical Rehabilitation, 2008
- Repetitive Transcranial Magnetic Stimulation as an Adjunct to Constraint-Induced TherapyAmerican Journal of Physical Medicine & Rehabilitation, 2007
- Effect of Constraint-Induced Movement Therapy on Upper Extremity Function 3 to 9 Months After StrokeJama-Journal Of The American Medical Association, 2006
- Feedback and Cognition in Arm Motor Skill Reacquisition After StrokeStroke, 2006
- Task-Specific Training With Trunk Restraint on Arm Recovery in StrokeStroke, 2006
- Distinguishable Brain Activation Networks for Short- and Long-Term Motor Skill LearningJournal of Neurophysiology, 2005
- Providing Explicit Information Disrupts Implicit Motor Learning After Basal Ganglia StrokeLearning & Memory, 2004
- Comparison of changes in upper and lower extremity impairments and disabilities after strokeInternational Journal of Rehabilitation Research, 2003
- Quality of Life Among Stroke Survivors Evaluated 1 Year After StrokeStroke, 2000