Nicolas Schweighofer博士 講演会(2017年6月7日,東京大学柏キャンパス)


演者: Professor Nicolas Schweighofer
(USC, United States)

日時: 6/7(水曜日) 4:00 pm – 5:30 pm
場所: 東京大学柏キャンパス総合研究棟570室

Virtuous and vicious cycle between arm use and performance post-stroke

Although spontaneous use of the more-affected upper extremity after stroke is an important determinant
of participation and quality of life, a number of patients exhibit decreases in use following
rehabilitative therapy. Our general hypothesis that there exists a threshold for function of the paretic arm
and hand after therapy. If function is above this threshold, spontaneous use will increase in the months
following therapy. In contrast, if function is below this threshold, spontaneous use will decrease. A
previous “qualitative” neuro-computational model predicted that if the dose of therapy is sufficient to
bring performance above a certain threshold, training can be stopped. Computer simulations are presented
showing how changes in arm use following therapy depend on a performance threshold. This prediction was tested
by reanalyzing the data from the extremity constraint-induced therapy evaluation (EXCITE) trial,
phase III randomized controlled trial in which participants received constraint-induced movement
therapy for 2 weeks and were tested both 1 week and 1 year after therapy. Next, we present a “quantitative”
model, with parameters fitted to longitudinal data of individual patients recovering from stroke, that allow
us to estimate the effect of therapy on the time-varying interactions between arm function and use. Finally, we
will present recent data from both non-disabled and post-stroke individuals that suggest that expected
movement duration, expected effort, and expected task success all influence arm choice.