Grant: Project Grant

Stroke affects many Canadians, leadings to persistent problems moving the arm and hand effectively. While exercise is important, we still do not know what type of exercise leads to the best possible recovery of movement. Traditional treatments that take a 'one-size-fits-all' approach do not lead to full arm and hand recovery and the societal burden of arm movement problems after stroke remains high. This study will investigate the effects of a new exercise approach to retrain arm and hand movement. The new approach builds on basic scientific knowledge about how movement is controlled that has already shown promise in previous research. The novel feature of this training is that it tailors practice to the individual's specific movement problem. We previously tested this approach for only one part of the arm. In the present research, we expand this approach for movements of the whole arm. We think that this new exercise approach will be also be better than just generalized exercise. Another novel feature is that we will identify the mechanisms by which movement improves and relate them to the amount of damage in the nervous system caused by the stroke. People who suffered a recent stroke will be divided into two groups. Both groups will practice 160 reaches/day for 10 days spaced over 3 weeks. One group will practice reaching objects placed within their range of possible arm movement, determined before each session. The other group will practice the same tasks but objects will be placed randomly without accounting for the individual's specific ability. We will measure the effects of practice in each group before, right after, and after a delay to see how long effects last after training and relate changes to the individual's specific brain lesion. This will allow us to find out which individuals may obtain the best possible recovery of their arm and hand movements and help form guidelines to create more effective treatment programs for people living with stroke.