Unilateral strength training with and without a mirror to improve motor function after stroke: Past, present, and future
Article type: Research Article
Authors: Monaghan, Kennetha; b; * | Simpson, Danielb | Ehrensberger, Monikab | Zult, Tjerkc
Affiliations: [a] Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland | [b] Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Institute of Technology (IT) Sligo, Ireland | [c] Vision and Eye Research Unit, School of Medicine, Anglia Ruskin University, Cambridge, UK | [d] Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Correspondence: [*] Corresponding author: Dr Kenneth Monaghan, Director, Clinical Health and Nutrition Centre (CHANCE), Neuroplasticity Research Group, School of Science, Institute of Technology (IT) Sligo, Ireland. Tel.: +353 719155222; E-mail: Monaghan.kenneth@itsligo.ie.
Abstract: Unilateral resistance training not only strengthens muscles on the trained side but also the homologous muscles on the untrained side. This phenomenon is called cross-education and was first observed in 1894. Since then, many studies have been conducted in neurologically intact persons but the potential of cross-education for people with unilateral orthopaedic and neurological impairments remains largely unexplored. In this commentary, we highlight the potential of cross-education in the rehabilitation after stroke. Current clinical practice in stroke rehabilitation is to train the more-affected side but people with a severe hemiparesis are often not able to train this side due to muscle weakness and limited range of motion. Resistance training of the less-affected side might be a great tool to improve muscle strength and motor function of the more-affected side. Mirror therapy, where a mirror reflection of the less-affected side creates the illusion that the more affected side is exercising, could even further augment these cross-education benefits. Three functional networks (i.e., attentional resources, the mirror-neuron system, and the motor network) play a role in cross-education with and without a mirror and induce neuroplasticity in the brain that can help people who have had a stroke in their recovery. The use of inter-limb mechanisms in the rehabilitation from unilateral impairments has to be exploited further and should be incorporated in the standard protocols for neurologic and musculoskeletal rehabilitation.
Keywords: Rehabilitation, cross-education, strength training, musculoskeletal injury, neurological impairment, muscle weakness
DOI: 10.3233/PPR-170104
Journal: Physiotherapy Practice and Research, vol. 39, no. 1, pp. 1-4, 2018
Mirror Therapy combined with Strength Training in Stroke Patients.
What is it about?
The article discusses the history of 'Cross-education of strengthening', and 'Mirror Therapy' neuroplasticity principles.
Why is it important?
It is currently unknown if the combination of Cross-education of strengthening combined with Mirror Therapy is effective in rehabilitation with chronic stroke patients.
Resources
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Press release
‘I can walk for 50m without stopping. I feel on top of the world now’
Patient Testimony following Mirror Therapy + Cross-education of strengthening post stroke.
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Press release
Mirror Therapy Helping Stroke Patients to Recover Strength
Patient Testimony regarding Mirrror Therapy + Cross-education of Strengthening Post Stroke
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Press release
Stroke of Innovation
Award of Research Money from Northwest Stroke Volunteer Group Ltd
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Url
Dr Kenneth Monaghan, IT Sligo Staff Profile
Dr Kenneth Monaghan, IT Sligo Staff Profile
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Press release
'Second lease of life' Face to face with Researchers at IT Sligo
Press release about IT Sligo Neuroplasticity Research Group.