Minimal forced use without constraint stimulates spontaneous use of the impaired upper extremity following motor cortex injury

Warren G Darling; Marc A Pizzimenti; Diane L Rotella; Stephanie M Hynes; Jizhi Ge; Kimberly S Stilwell-Morecraft; Tyler Vanadurongvan; David W McNeal; Kathryn M Solon-Cline; Robert J Morecraft

doi:10.1007/s00221-010-2157-y

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Minimal forced use without constraint stimulates spontaneous use of the impaired upper extremity following motor cortex injury

Journal article

Peer reviewed

Minimal forced use without constraint stimulates spontaneous use of the impaired upper extremity following motor cortex injury

Warren G Darling, Marc A Pizzimenti, Diane L Rotella, Stephanie M Hynes, Jizhi Ge, Kimberly S Stilwell-Morecraft, Tyler Vanadurongvan, David W McNeal, Kathryn M Solon-Cline and Robert J Morecraft

Experimental brain research, Vol.202(3), pp.529-542

01/28/2010

DOI: 10.1007/s00221-010-2157-y

PMCID: PMC3650615

PMID: 20107980

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Abstract

The purpose of this study was to determine if recovery of neurologically impaired hand function following isolated motor cortex injury would occur without constraint of the non-impaired limb, and without daily forced use of the impaired limb. Nine monkeys ( Macaca mulatta ) received neurosurgical lesions of various extents to arm representations of motor cortex in the hemisphere contralateral to the preferred hand. After the lesion, no physical constraints were placed on the ipsilesional arm/hand and motor testing was carried out weekly with a maximum of 40 attempts in two fine motor tasks that required use of the contralesional hand for successful food acquisition. These motor tests were the only “forced use” of the contralesional hand. We also tested regularly for spontaneous use of the contralesional hand in a fine motor task in which either hand could be used for successful performance. This minimal intervention was sufficient to induce recovery of the contralesional hand to such a functional level that eight of the monkeys chose to use that hand on some trials when either hand could be used. Percentage use of the contralesional hand (in the task when either hand could be used) varied considerably among monkeys and was not related to lesion volume or recovery of motor skill. These data demonstrate a remarkable capacity for recovery of spontaneous use of the impaired hand following localized frontal lobe lesions. Clinically, these observations underscore the importance of therapeutic intervention to inhibit the induction of the learned nonuse phenomenon after neurological injury.

Brain injury

Dexterity

Hand

Motor recovery

Therapeutic intervention

Details

Title: Subtitle: Minimal forced use without constraint stimulates spontaneous use of the impaired upper extremity following motor cortex injury
Creators: Warren G Darling - University of Iowa
Marc A Pizzimenti - University of Iowa
Diane L Rotella - University of Iowa
Stephanie M Hynes - University of Iowa
Jizhi Ge - University of South Dakota
Kimberly S Stilwell-Morecraft - University of South Dakota
Tyler Vanadurongvan - University of South Dakota
David W McNeal - University of South Dakota
Kathryn M Solon-Cline - University of South Dakota
Robert J Morecraft - University of South Dakota
Resource Type: Journal article
Publication Details: Experimental brain research, Vol.202(3), pp.529-542
DOI: 10.1007/s00221-010-2157-y
PMID: 20107980
PMCID: PMC3650615
NLM abbreviation: Exp Brain Res
ISSN: 0014-4819
eISSN: 1432-1106
Grant note: R01 NS046367 || NS / National Institute of Neurological Disorders and Stroke : NINDS
Language: English
Date published: 01/28/2010
Academic Unit: Anatomy and Cell Biology; Physical Therapy and Rehabilitation Science; Health, Sport, and Human Physiology
Record Identifier: 9984259392102771

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