Cooperative Hand Movements and their Potential for Stroke Rehabilitation

Abstract

Eating, washing and dressing oneself are just a few examples of upper limb tasks we perform every day with little effort. For people suffering from a stroke, these tasks can become challenging due to sensorimotor impairments of the upper limb. Consequently, providing efficient and evidence based therapeutic strategies is crucial to improve their quality of life and independence. Cooperative, object-oriented hand movements underlie an enhanced neural coupling of the upper limbs reflected in a strong bilateral neural organization including enhanced bilateral muscle reflexes and sensory processing after unilateral nerve stimulation. This neural characteristic is partly preserved in stroke survivors indicating that tracts of the non-affected hemisphere are strongly involved in the control of the affected arm. A training of cooperative hand movements based on this neural behaviour might be promising for a better sensorimotor recovery of the upper limb. Still, not much is known about the neural control of these movements and no therapy approach focussing on these movements is currently available. Thus, the aim of this thesis was to get a more profound understanding of the sensorimotor control underlying cooperative hand movements and to evaluate their potential for stroke rehabilitation.