Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke
Stroke continues to be a leading cause of disability. Basic neurorehabilitation research is necessary to inform the neuropathophysiology of impaired motor control, and to develop targeted interventions with potential to remediate disability post-stroke. Despite knowledge gained from basic research s...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-04-01
|
Series: | Frontiers in Human Neuroscience |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2021.644335/full |
id |
doaj-2dad8bdca5b1499f9e82058ca03c492e |
---|---|
record_format |
Article |
spelling |
doaj-2dad8bdca5b1499f9e82058ca03c492e2021-04-20T06:00:31ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612021-04-011510.3389/fnhum.2021.644335644335Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-StrokeNatalia Sánchez0Carolee J. Winstein1Carolee J. Winstein2Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United StatesDivision of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United StatesDepartment of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United StatesStroke continues to be a leading cause of disability. Basic neurorehabilitation research is necessary to inform the neuropathophysiology of impaired motor control, and to develop targeted interventions with potential to remediate disability post-stroke. Despite knowledge gained from basic research studies, the effectiveness of research-based interventions for reducing motor impairment has been no greater than standard of practice interventions. In this perspective, we offer suggestions for overcoming translational barriers integral to experimental design, to augment traditional protocols, and re-route the rehabilitation trajectory toward recovery and away from compensation. First, we suggest that researchers consider modifying task practice schedules to focus on key aspects of movement quality, while minimizing the appearance of compensatory behaviors. Second, we suggest that researchers supplement primary outcome measures with secondary measures that capture emerging maladaptive compensations at other segments or joints. Third, we offer suggestions about how to maximize participant engagement, self-direction, and motivation, by embedding the task into a meaningful context, a strategy more likely to enable goal-action coupling, associated with improved neuro-motor control and learning. Finally, we remind the reader that motor impairment post-stroke is a multidimensional problem that involves central and peripheral sensorimotor systems, likely influenced by chronicity of stroke. Thus, stroke chronicity should be given special consideration for both participant recruitment and subsequent data analyses. We hope that future research endeavors will consider these suggestions in the design of the next generation of intervention studies in neurorehabilitation, to improve translation of research advances to improved participation and quality of life for stroke survivors.https://www.frontiersin.org/articles/10.3389/fnhum.2021.644335/fullstrokeneurorehabilitationrecoverycompensationimpairment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natalia Sánchez Carolee J. Winstein Carolee J. Winstein |
spellingShingle |
Natalia Sánchez Carolee J. Winstein Carolee J. Winstein Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke Frontiers in Human Neuroscience stroke neurorehabilitation recovery compensation impairment |
author_facet |
Natalia Sánchez Carolee J. Winstein Carolee J. Winstein |
author_sort |
Natalia Sánchez |
title |
Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke |
title_short |
Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke |
title_full |
Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke |
title_fullStr |
Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke |
title_full_unstemmed |
Lost in Translation: Simple Steps in Experimental Design of Neurorehabilitation-Based Research Interventions to Promote Motor Recovery Post-Stroke |
title_sort |
lost in translation: simple steps in experimental design of neurorehabilitation-based research interventions to promote motor recovery post-stroke |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Human Neuroscience |
issn |
1662-5161 |
publishDate |
2021-04-01 |
description |
Stroke continues to be a leading cause of disability. Basic neurorehabilitation research is necessary to inform the neuropathophysiology of impaired motor control, and to develop targeted interventions with potential to remediate disability post-stroke. Despite knowledge gained from basic research studies, the effectiveness of research-based interventions for reducing motor impairment has been no greater than standard of practice interventions. In this perspective, we offer suggestions for overcoming translational barriers integral to experimental design, to augment traditional protocols, and re-route the rehabilitation trajectory toward recovery and away from compensation. First, we suggest that researchers consider modifying task practice schedules to focus on key aspects of movement quality, while minimizing the appearance of compensatory behaviors. Second, we suggest that researchers supplement primary outcome measures with secondary measures that capture emerging maladaptive compensations at other segments or joints. Third, we offer suggestions about how to maximize participant engagement, self-direction, and motivation, by embedding the task into a meaningful context, a strategy more likely to enable goal-action coupling, associated with improved neuro-motor control and learning. Finally, we remind the reader that motor impairment post-stroke is a multidimensional problem that involves central and peripheral sensorimotor systems, likely influenced by chronicity of stroke. Thus, stroke chronicity should be given special consideration for both participant recruitment and subsequent data analyses. We hope that future research endeavors will consider these suggestions in the design of the next generation of intervention studies in neurorehabilitation, to improve translation of research advances to improved participation and quality of life for stroke survivors. |
topic |
stroke neurorehabilitation recovery compensation impairment |
url |
https://www.frontiersin.org/articles/10.3389/fnhum.2021.644335/full |
work_keys_str_mv |
AT nataliasanchez lostintranslationsimplestepsinexperimentaldesignofneurorehabilitationbasedresearchinterventionstopromotemotorrecoverypoststroke AT caroleejwinstein lostintranslationsimplestepsinexperimentaldesignofneurorehabilitationbasedresearchinterventionstopromotemotorrecoverypoststroke AT caroleejwinstein lostintranslationsimplestepsinexperimentaldesignofneurorehabilitationbasedresearchinterventionstopromotemotorrecoverypoststroke |
_version_ |
1721518598601572352 |