The importance of memory traces of motor efferent discharges for learning skilled movements

Visual motor rehabilitation in children with cerebral palsy

Cerebral palsied (CP) children were given intensive visuo-oculomotor training in order to improve their visuo-oculomotor control, using children's films as a visual stimulus. A comparative study was conducted on a group of normal children of the same age. Results showed that training does improve visuo-oculomotor system control as illustrated by (1) a marked increase in smooth pursuit precision and maximum velocity, (2) an improvement of saccadic movement precision and stability, and (3) a shortening of the saccadic reaction time. The highest performance was observed under conditions in which the child pointed at and followed the visuo-acoustic target with his arm extended.

Some factors influencing the outcome of stroke rehabilitation

The eventual outcome of a stroke patient's rehabilitation may depend as much upon his experiences following the stroke as upon the actual brain damage. Positive factorsinfluencing rehabilitation include the early stimulation of the body orienting mechanism in upright positions; the prevention of the development of spasticity; the therapist's understanding of the factors involved in learning a motor skill; the ability to analyse an everyday activity and find its missing or abnormal components an understanding of the current hypotheses about the effect of stimution upon the recovering brain. Negative factorsinclude a tendency to be obsessed with techniques of treatment rather than with a detailed analysis of the patient's problems; the perpetuation of certain 'myths' such as proximal to distal recovery of function, and practising movement in a neuro-developmental sequence despite the maturity of the adult patient's brain; a failure to understand the different physiological and behavioural mechanisms underlying apparently similar problems which leads to lack of cortical drive being confused with muscle weakness; the expectations of the therapist who expects a stroke patient will become spastic, will not recover functional use of his upper limb, and will need a quadripod stick in order not to fall over.

Experimental analysis of EMG feedback in treating dystonia

Recent clinical reports have suggested that electromyographic feedback offers promise as a palliative therapy for neuromuscular disorders. This study utilized a single-subject experimental analysis to evaluate the effects of EMG feedback training on a 20-year-old man with adult-onset idiopathic dystonia to achieve control of orofacial dysfunctions. Feedback training produced reductions in levels and variability of tension in facial and forearm muscles, as measured by EMG. Reliable blind observations of facial control indicated that feedback training enabled the patient to produce normal facial relaxation in extraclinical environments.

The perception of passive joint-movements by cerebral-palsied children

Luce's choice theory provided the psychophysical basis for investigating the ability of cerebral-palsied children to detect passive movement of the elbow joint. The method included testing "yes" responses when the forearm was moved, and "false-alarm" responses of "yes" when no arm movement had occurred. The children were tested with their eyes closed. The results showed that, in general, the children with spastic cerebral palsy had no deficits, or only very minor ones, in passive movement sensation. In contrast, the athetoid children had considerable deficits. It is suggested that the athetoid child is affected by a continuous barrage of irrelevant proprioceptive information and so finds difficulty in discriminating any particular proprioceptive cue.