A First Step Toward the Operationalization of the Learned Non-Use Phenomenon: A Delphi Study.

Background: The negative discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms.

Objective: Albeit the LNU phenomenon is generally accepted to exist, currently, no transdisciplinary definition exists. Furthermore, although therapeutic approaches are implemented in clinical practice targeting LNU, no standardized diagnostic routine is described in the available literature.

Effects of a predefined mini-trampoline training programme on balance, mobility and activities of daily living after stroke: a randomized controlled pilot study.

Objective: To investigate the effects of a predefined mini-trampoline therapy programme for increasing postural control, mobility and the ability to perform activities of daily living after stroke.

Design: Randomized non-blinded controlled pilot study.

Setting: Neurological rehabilitation hospital.

Improved walking ability and reduced therapeutic stress with an electromechanical gait device.

Objective: To evaluate the effectiveness of repetitive locomotor training using a newly developed electromechanical gait device compared with treadmill training/gait training with respect to patient's ambulatory motor outcome, necessary personnel resources, and discomfort experienced by therapists and patients.

Methods: Randomized, controlled, cross-over trial. Sixteen non-ambulatory patients after stroke, severe brain or spinal cord injury sequentially received 2 kinds of gait training.

Gait training with the newly developed 'LokoHelp'-system is feasible for non-ambulatory patients after stroke, spinal cord and brain injury. A feasibility study.

Primary Objective: To evaluate the feasibility of using a newly developed electromechanical gait device (LokoHelp) for locomotion training in neurological patients with impaired walking ability with respect to training effects and patients' and therapists' efforts and discomfort.

Methods And Procedures: design: Case series. setting: A neurological rehabilitation centre for children, adolescents and young adults.

Application of the CIT concept in the clinical environment: hurdles, practicalities, and clinical benefits.

Basic neuroscience research on brain plasticity, motor learning, and recovery has stimulated new concepts in motor rehabilitation. Combined with the development of methodological goal standards in clinical outcome research, these findings have effectuated the introduction of a double-paradigm shift in physical rehabilitation: (a) the move toward evidence-based procedures and disablement models for the assessment of clinical outcome and (b) the introduction of training-based concepts that are theoretically founded in learning theory. A major drive for new interventions has further come from recent findings on the adaptive capacities of neural networks and their linkage to perception, performance, and long-term recovery.

Intensive training in chronic upper limb hemiparesis does not increase spasticity or synergies.

The authors assessed whether intensive training increases spasticity and leads to the development of "pathologic movement patterns," a concern often raised by Bobath-trained therapists. The authors used a baseline-control repeated-measures test to study 29 patients with chronic upper limb hemiparesis who received daily shaping training. Their results suggest that training has no adverse effects on muscle tone and movement quality.

Motor-improvement following intensive training in low-functioning chronic hemiparesis.

Constraint-induced movement therapy can improve chronic hemiparesis, but this technique has proven difficult to transfer into clinical practice. The authors studied the benefits of a modified regimen designed to be applicable in the clinical environment. Affected arm movements were trained for 90 min/d for 3 weeks using the learning principle "shaping.

Neurobehavioral aspects of recovery: assessment of the learned nonuse phenomenon in hemiparetic adolescents.

Objective: To test the learned nonuse assumption of constraint-induced movement therapy (CIMT), through behavioral assessment, that residual movement abilities are not used to their fullest extent in persons with chronic hemiparesis.

Design: Repeated-measures cohort design.

Setting: Rehabilitation clinic in southwest Germany.