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Optimal therapy for recovery after a stroke

Stroke affects over 1 million Europeans every year and survivors often have problems with arm function. Current motor therapy is expensive and relatively ineffective.
Optimal therapy for recovery after a stroke
Researchers with the MARS (Modeling arm recovery after stroke) project have developed a multiple timescale model of arm function recovery. For post-stroke rehabilitation, they constructed a personalised motor trainer to optimise arm function long term after a stroke.

Data was collected from 30 healthy individuals and 12 post-stroke patients on motor learning and recovery at hand- and arm-joint levels. 'Synergies', or abnormal couplings, between joints frequently developed after stroke were studied in particular. This information is important as stroke patients recover very well in the task/hand space domain, but still use abnormal compensatory movements at joint level.

A newly developed way to separate hand-related joint movements from articulations that do not affect the hand enabled analysis of these synergies. Subsequently, they found that motor training in the subacute phase after a stroke gave improvements in three different time constants: within session, over days and across weeks. Moreover, within session improvement is linked with long-term recovery.

Using optimal control theory, the researchers have also devised a new scheduling programme that maximises predicted long-term gains from multiple motor tasks in healthy subjects. Motor adaptation is the result of fast as well as slow processes and long-term memory is achieved from slow processes.

Based on this, the optimal schedule determined the sequence of tasks that maximised long-term retention of all tasks. The programme has been tested to determine duration, task difficulty and interfering conditions.

For the future, testing should validate the individual predictive models of recovery and optimise the motor training schedules for long-term recovery after a stroke. The impact of this research will affect patients, clinicians and the insurance industry.

Related information


Stroke, arm function, arm recovery, hand, motor training
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