Motor learning and stroke: implications for rehabilitation

Rehabilitation following stroke aims to optimise function through various means. With regards to movement-related difficulties, whether increased function is achieved as a result of reducing impairment or via compensatory strategies, the ability to learn is critical to the process. Given this importance, it is surprising how little is known about how brain damage as a result of stroke affects the ability of patients to relearn movement, and those charged with delivering rehabilitation services have very limited information about how best to guide the process. Findings from more basic research into learning and memory have demonstrated a clear dichotomy between mechanisms underpinning the learning of movements that are most commonly referred to as either explicit or implicit. Explicit learning refers to a situation where learning is directed by prior knowledge (e.g. verbal instructions) and one is consciously aware of what is being learned. Implicit learning refers to a situation where sustained improved performance results simply through repetition of tasks with no conscious awareness of how this has been achieved. This project will explore implicit and explicit mechanisms of learning following stroke using two established methods for measuring outcome; the serial response time task and visuo-motor adaptation. This experimental work will initially be directed by the hypothesis that attentional capacity (known to be variable following stroke) is a key determinant in understanding optimal approaches to motor learning following stroke.

Related reading
Boyd, L. A. and C. J. Winstein (2003). "Impact of explicit information on implicit motor-sequence learning following middle cerebral artery stroke." Phys.Ther. 83(11): 976-989.
Mazzoni, P. and J. W. Krakauer (2006). "An implicit plan overrides an explicit strategy during visuomotor adaptation." J Neurosci 26(14): 3642-3645.