'Use It and Improve It or Lose It' Axiom Substantiated by Paper on Arm Function After Stroke
"Use it and improve it, or lose it" is an axiom of motor therapy-physical therapy that relates to the muscles that induce movement-for people recovering from a stroke. Yet the interactions between arm function and use in people who have had a stroke are still poorly understood. Paper to be published in leading journal of computational biology
- (1888PressRelease) November 23, 2011 - "Use it and improve it, or lose it" is an axiom of motor therapy-physical therapy that relates to the muscles that induce movement-for people recovering from a stroke. Yet the interactions between arm function and use in people who have had a stroke are still poorly understood.
A paper that explores these interactions, coauthored by two faculty members of the USC Division of Biokinesiology and Physical Therapy-Dr. Nicholas Schweighofer, associate professor, and Dr. Carolee J. Winstein, professor-has been accepted for publication in PLoS Computational Biology, the leading journal of computational biology.
"Use it and improve it or lose it: Interactions between arm function and use in humans post-stroke" describes how the research team developed a model of stroke recovery using data from EXCITE clinical trial participants who had received constraint-induced movement therapy (CIMT)-physical therapy that improves stroke patients' arm function by restraining the use of the non-affected arm and increasing the use of the affected arm. (EXCITE-Extremity Constraint-Induced Therapy Evaluation-was a single-blind, randomized, multisite clinical trial involving 222 stroke patients, conducted at seven U.S. academic institutions between 2001 and 2006.)
The authors looked at arm-function data for a two-year period, starting three months or more after the clinical trial participants had their stroke. After systematically comparing their model with other models that either did or did not include interactions between arm function and use, the authors concluded that the data substantiated the "use it or lose it" axiom.
In addition, by comparing the model parameters before and after the CIMT intervention one year later, the researchers found that an increase in patients' confidence in using the arm during therapy appeared to positively affect recovery after therapy.
The authors' long-term goal is to develop and validate a method based on such models, to allow clinicians and patients to make informed decisions about treatment and potentially determine the critical dose of motor therapy for individual patients.
The paper's other coauthors are Yukikazu Hidaka, a computer science PhD student in the USC Viterbi School of Engineering; Cheol E. Han, Brain and Cognitive Sciences, Seoul National University; and Steven L. Wolf, Department of Rehabilitation Medicine, Emory University, principal investigator of the EXCITE trial.
Computational biology involves the development and application of theory and data analysis, mathematical modeling, and computational simulation techniques to the study of biological and behavioral systems.
PLoS Computational Biology, a peer-reviewed open-access journal published by the Public Library of Science, presents research articles of exceptional significance that further our understanding of living systems at all scales-from molecules and cells to patient populations and ecosystems-through the application of computational methods.
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