title: Motor strategies and bilateral transfer in sensorimotor learning of patients with subacute stroke and healthy subjects. A randomized controlled trial.
abstract: BACKGROUND
  Bilateral transfer, i.e. the capacity to transfer from one to the other hand a learned motor skill, may help the recovery of upper limb functions after stroke.
  
  
  OBJECTIVE
  To investigate the motor strategies at the basis of sensorimotor learning involved in bilateral transfer.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Neurorehabilitation Hospital.
  
  
  METHODS
  Eighty right-handed participants (65 ± 13 years old): 40 patients with subacute stroke, 40 control healthy subjects.
  
  
  METHODS
  Subjects performed the 9 hole-peg-test twice in an order defined by random allocation: first with low and then with high skilled hand (LS-HS) or the reverse (HS-LS). Time spent to complete the test and filling sequence were recorded, together with maximum pinch force (assessed using a dynamometer), upper limb functioning (Motricity Index), spasticity (modified Ashworth Scale), limb dominance (Edinburgh Handeness Inventory).
  
  
  RESULTS
  As expected, in patients, the performance was found related to the residual pinch force (P<0.001), upper limb motricity (P=0.006) and side of hemiparesis (P=0.016). The performances of all subjects improved more in HS-LS than in LS-HS subgroups (P=0.043). The strategy adopted in the first trial influenced the velocity in the second one (P=0.030).
  
  
  CONCLUSIONS
  Bilateral transfer was observed from high to low skilled hand. Learning was not due to a mere sequence repetition, but on a strategy chosen on the basis of the previous performance.
  
  
  CONCLUSIONS
  The affected hand of patients with subacute stroke may benefit from sensorimotor learning occurred with the un-affected hand.
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy. m.iosa@hsantalucia.it
authors.forename: M
authors.initials: M
authors.lastname: Iosa
authors.forename: G
authors.initials: G
authors.lastname: Morone
authors.forename: M R
authors.initials: MR
authors.lastname: Ragaglini
authors.forename: A
authors.initials: A
authors.lastname: Fusco
authors.forename: S
authors.initials: S
authors.lastname: Paolucci
mesh_terms: D000368:Aged; D056228:Feedback, Sensory; D005260:Female; D018737:Hand Strength; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000502:physiology