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Assignment 6

1970’s is very essential period for the USC Division of Biokinesiology and Physical Therapy as a pioneer of Physical Therapy education paradigm. Especially, 1971 was a landmark year for the USC Division of Biokinesiology and Physical Therapy [1] . In this year, the division moved to Rancho Los Amigos Hospital in Downey to initiate a new paradigm in U.S. rehabilitation medicine. Also, USC established a master’s degree in clinical physical therapy including clinical fellows in this year. 1975 is also another turning point of the division. First, Helen Hislop, who intensively devoted to develop the entry-level graduate Physical Therapy program, appointed the chair of the division[2] . In this year, final B. S. class graduated and all physical therapy graduate degrees changed from M. A. to M. S. 1978 is also an important year for the division history when it comes to the division established the first physical therapy Ph. D. program in the nation, and accepted three Ph. D. students. Dr. Perry, who was a director of the Pathokinesiology lab at Rancho and an exceptional expert of gait analysis and polio, tremendously contributed to the development of Ph. D. program in physical therapy at USC, and improved the quality of physical therapy research[3] .


Assignment 5

Figure 8. Velocity profile of a goal-directed arm reaching movement

My research interest is motor control and motor learning of individuals after stroke. So I want to write some paragraphs related to my research interest. Thus, I am going to write a paragraph about neuroplasticity.

I would propose subsections of neuroplasticity in principles section. First section is about research papers which lead to the transition of neurorehabilitation paradigm. One example of these articles is the paper published by Nudo et al. (1996) [4]. I would write how these papers influence the neurorehabilitation paradigm related to neuroplasticity. Also, I am going to write a paragraph related to motor learning paradigm of neurorehabilitation. I will explain about the motor learning perspective of functional recovery after stroke, and will describe the EXCITE trial [5] which is a multi-center randomized controlled trial using motor learning paradigm of functional recovery after stroke.

I am going to generate 3-5 graphical contents. First figure will be a graph showing the relation between neuroplasticity and performance improvement (or behavioral changes). Second figure is going to be related to the rehabilitative training effect on neuroplasticity after stroke. This figure would be adapted from Nudo et al. (1996) [6]. Also, I will use one or two figures related to neuroimaging such as fMRI or TMS which illustrate the neuroplasticity after training.

Assignment 4

Figure 1. The publication trend of motor learning area related to motor recovery after stroke
Figure 2. The publication trend of motor learning studies using fMRI
Figure 3. The publication trend of motor learning studies using TMS
Figure 4. The publication trend of stroke rehabilitation
Figure 5. The publication trend of motor learning
Figure 6. The publication trend of fMRI
Figure 7. The publication trend of TMS

Assignment 3

Although research in 'Motor Learning' and 'Stroke Rehabilitation' started growing in 1990, the use of motor learning concept in stroke rehabilitation started growing in 2000. So I assumed that there are two main factors which influence the increase in the amount of studies in motor learning after stroke.

First, there were few key research papers which open the door for this area. Nudo et al. (1996) [7] suggested that functional reorganization occurs in the motor cortex of adult monkeys after a focal ischemic brain injury when the monkeys went through physical training. After this paper was published, many studies in neurologic rehabilitation domain focused on the neuroplasticity after stroke. Also, Krakauer (2006)[8] published a nice review paper about the relationship between motor learning and functional recovery after stroke. Before these papers were published, most of rehabilitation treatment for individuals after stroke was related to reducing spasticity and improving range of motion. On the other hand, the concept of rehabilitation treatment for post-stroke individuals changed to more active training to facilitate neuroplasticity and skill acquisition after these papers published. These two key papers opened a new research paradigm in neurorehabilitation. I researched the citation number of these papers, and the number of citation of these papers are about 47 and 24 per year respectively. Also, most of research papers related to motor learning after stroke cited these two papers. In addition to these two papers, there is one more paper which contribute to the motor learning paradigm in functional recovery after stroke: The EXCITE trial[9]. In this study, the authors also focused on the motor learning aspect of motor recovery after stroke, and this article has been cited by a number of research articles. The number of citation of this paper is about 72 per year after it is published in 2006. This paper is the first paper which applied the motor learning paradigm in motor recovery in clinical settings. Thus, these papers start shifting paradigm of motor recovery after stroke, and it leads to motor learning paradigm in stroke recovery.

Second, emerging new technology in neuroimage could be a possible reason why the motor learning after stroke area is growing. Neuroimaging techniques such as function Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS) allow to explore the brain, and help to research the changes in the brain after rehabilitative training for individuals after stroke. These neuroimaging techniques have been used since early 1990's, but researchers started using these techniques more for motor learning study in the early 2000's. I researched with these keywords about the number of papers published. First I searched with 'fMRI and Motor Learning' from web of science to understand the trend of motor learning studies with fMRI. Also, I searched with 'TMS and Motor Learning'. The trends in publication of 'fMRI and Motor Learning' and 'TMS and Motor Learning' is quite similar, and these trends are also similar to the trend in 'Motor Learning after Stroke' study area. Thus, I could say that the emerging technology in neuroimaging techniques may contribute to the increase in the number of study in motor learning after stroke.

References

  1. ^ "USC BKN&PT InMotion" (PDF).
  2. ^ "USC HSC News" (PDF).
  3. ^ "Rancho Los Amigos Pathokinesiology Laboratory Researchers".
  4. ^ Nudo, RJ (1996 Jun 21). "Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct". Science (New York, N.Y.). 272 (5269): 1791–4. PMID 8650578. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  5. ^ Wolf, SL (2006 Nov 1). "Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial". JAMA : the journal of the American Medical Association. 296 (17): 2095–104. PMID 17077374. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  6. ^ Nudo, RJ (1996 Jun 21). "Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct". Science (New York, N.Y.). 272 (5269): 1791–4. PMID 8650578. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  7. ^ Nudo, RJ (1996 Jun 21). "Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct". Science (New York, N.Y.). 272 (5269): 1791–4. PMID 8650578. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  8. ^ Krakauer, JW (2006 Feb). "Motor learning: its relevance to stroke recovery and neurorehabilitation". Current opinion in neurology. 19 (1): 84–90. PMID 16415682. {{cite journal}}: Check date values in: |date= (help)
  9. ^ Wolf, SL (2006 Nov 1). "Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial". JAMA : the journal of the American Medical Association. 296 (17): 2095–104. PMID 17077374. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)