Stage I Reaching & Grasping Award Winner: Volker Dietz


Summary:

After spinal cord injury, today’s rehabilitation of arm/hand function is focused on the training of uni-manual reach and grasp movements. On the basis of our recent research results we suggest that training of cooperative movements of both arms/hands is more successful for the outcome of hand function after a stroke not only for bi-manual but also for reach and grasp movements. 

This assumption is based on the knowledge that such cooperative tasks are a) under a specific control, i.e. the neural-coupling of both hands and, b) because in such tasks movement performance each of both hands becomes supported not only by the contralateral hemisphere, but also via uncrossed pathways by the ipsilateral hemisphere. The aim of the project is a) the technical implementation of this physiological knowledge into rehabilitation and, b) the proof of concept of the effectiveness of this novel therapeutical approach for the restoration of hand function in SCI patients. The goal is to re-establish the mechanism of neural coupling in movement control. Cooperative hand movements represent essential motor tasks in daily life activities (e.g. opening a bottle, dress oneself, cutting bread and all of them rely on this task-specific neural control. 

However, it is also expected that reach and grasp movements become improved after a stroke because of the influence of both hemispheres, i.e. also of the undamaged one, on the recovery of hand function.- Currently a prototype of the device allows the performance and assessment of cooperative hand movements for research purposes. For a training study the device will be reconstructed to allow the performance of a number of daily life activities requiring cooperative movements and to provide a corresponding virtual reality training program including feedback information about performance. The ‘cooperative’ training approach is assumed to represent a promising basis to achieve stronger beneficial effects for the restoration of uni-and bimanual functional hand movements in chronic SCI patients compared to the conventional hand therapy.

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