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01.12.2017 | Research | Ausgabe 1/2017 Open Access

Journal of NeuroEngineering and Rehabilitation 1/2017

Nonlinear mixed-effects model reveals a distinction between learning and performance in intensive reach training post-stroke

Zeitschrift:
Journal of NeuroEngineering and Rehabilitation > Ausgabe 1/2017
Autoren:
Hyeshin Park, Nicolas Schweighofer

Abstract

Background

We recently showed that individuals with chronic stroke who completed two sessions of intensive unassisted arm reach training exhibited improvements in movement times up to one month post-training. Here, we study whether changes in movement times during training can predict long-term changes.

Methods

Sixteen participants with chronic stroke and ten non-disabled age-matched participants performed two sessions of reach training with 600 movements per session. Movement time data during training were fitted to a nonlinear mixed-effects model consisting of a decreasing exponential term to model improvements of performance due to learning and an increasing linear term to model worsening of performance due to activity-dependent fatigability and/or other factors unrelated to learning.

Results

For non-disabled age-matched participants, movement times gradually decreased overall during training and overall changes in movement times during training predicted long-term changes. In contrast, for participants post-stroke, movement times often worsened near the end of training. As a result, overall changes in movement times during training did not predict long-term changes in movement times in the stroke group. However, improvements in movement times due to training, as estimated by the exponential term of the model, predicted long-term changes in movement times.

Conclusion

Participants post-stroke showed a distinction between learning and performance in unassisted intensive arm reach training. Despite worsening of performance in later trials, extended training was beneficial for long-term gains.
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