Motor learning and movement performance: older versus younger adults

Introduction: Motor skills play an important role during life span, and older adults need to learn or relearn these skills. The purpose of this study was to investigate how aging affects induction of improved movement performance by motor training

Methods: Serial Reaction Time Test [SRTT] was used to assess movement performance during 8 blocks of motor training. Participants were tested in two separate dates, 48 hours apart. First session included 8 blocks of training [blocks 1-8] and second session comprised 2 blocks [blocks 9, 10]

Results: Analyses of data showed that reaction times in both online and offline learning were significantly shorter in older adults compared to younger adults [P<0.001]. Young adults demonstrated both online and offline learning [P<0.001], but older adults only showed online learning [P<0.001] without offline learning [P=0.24]

Discussion: The result of the current study provides evidence that the healthy older adults are able to improve their performance with practice and learn motor skill successfully in the form of online learning

Effect of rTMS with Rehabilitation on Hand Function and Corticomotor Excitability in Sub-Acute Stroke

Objectives: Stroke is the leading cause of long-term disability. Hand motor impairment resulting from chronic stroke may have extensive physical, psychological, economical, and social implications despite available rehabilitative treatments. The best time to start treatment for stroke is in sub-acute period. Repetitive Transcranial Magnetic Stimulation [rTMS] is a method of stimulating and augmenting the neurophysiology of the motor cortex in order to promote the neuroplastic changes that are associated with motor recovery. The purpose of this study was to compare the effects of repetitive transcranial magnetic stimulation protocols plus routine rehabilitation on hand motor functions and hand corticomotor excitability in stroke patients with hemiplegia with pure routine rehabilitation programs.

Methods: This study was a randomized clinical trial which was performed on 24 patients with hemiplegia who were randomly divided in to three groups: received high frequency rTMS, received rehabilitation program with low frequency rTMSl, who were given only routine rehabilitation programs. The treatment was performed for 10 sessions, three times pre-post test and follow-up about neurophysiological contralesional hemisphere evaluations using record of MEP wave indices by single pulse TMS, and assessing functional wolf test and hand grip power of disabled hand by dynamometer.

Results: The results demonstrated that the rest MEP threshold reduction in experimental group which received high frequency magnetic stimulation was not statistically significant [P=0.387]. There was significant reduction for active MEP threshold in the within group [P=0.031]. Also there were statistically significant between obtained results from WOLF test and grip test.

Discussion: According to the results, it seems that Hf rTMS combined with routine physiotherapy can significantly improve hand functions and brain neurophysiology via specifically increase of contralesional corticomotor excitability in sever stroke patients. It indicated the role of neuroplasticity in nonlesioned hemisphere; but the hypothesis of movement improvement related cognitive balance can't be eliminated by exploring powerful approved effect of Hf rTMS on mood regulation.

[Effect of slow stroke back massage [SSBM] on shoulder pain and hand function in patients with stroke]

Shoulder pain is a consequence of hemiplegia among patients with stroke. It makes patient to be dependent to others in their daily living activities. This study aimed to determine the effect of the slow stroke back massage [SSBM] on shoulder pain and hand function among patients with stroke. In this semi-experimental study, 34 patients were recruited among from 70 patients who reffered to rehabilitation center in 2010, according to the inclusion criteria. Participants were randomly allocated into two groups of control and experiment. In the intervention group, the SSBM was implemented for 10 minutes through seven consecutive sessions. Shoulder pain and hand function were measured using the visual pain scale [Visual Analog Scale], and the researcher-made "affected hand function in ADL" instrument, respectively. The measurement was done before and 24 hours after the last session of the intervention. Data were analyzed using descriptive and inferential statistical tests [independent t-test and paired t-test]. At baseline, the mean scores of shoulder pain were 8.4 in both experimental and control groups [P=0.999]. After the intervention, the mean scores of shoulder pain were 1.13 and 8.40 in experimental and control groups, respectively [P<0.001]. At baseline, the mean scores of hand function were 7.46 and 8.93 in the experimental and control groups, respectively [P=0.752]. After the intervention, the mean scores of hand function reached 9.13 and 8.6 in the experimental and control groups, respectively [P=0.918]. According to the results of the study, applying the SSBM as a treatment procedure and care plan by health care providers can be considered as an effective intervention to prevent or reduce shoulder pain and consequently to improve motor function of affected hand in patients with hemiplegia after stroke