Rubio Ballester, BelénNirme, JensDuarte Oller, EstherCuxart, AmparRodriguez, SusanaVerschure, Paul F. M. J.Duff, Armin2015-11-032015-11-032015Rubio Ballester B, Nirme J, Duarte E, Cuxart A, Rodriguez S5, Verschure P. et al. The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients. J Neuroeng Rehabil. 2015 Jun 9;12:50. doi: 10.1186/s12984-015-0039-z.1743-0003http://hdl.handle.net/10230/24986BACKGROUND: Stroke-induced impairments result from both primary and secondary causes, i.e. damage to the brain and the acquired non-use of the impaired limbs. Indeed, stroke patients often under-utilize their paretic limb despite sufficient residual motor function. We hypothesize that acquired non-use can be overcome by reinforcement-based training strategies. METHODS: Hemiparetic stroke patients (n = 20, 11 males, 9 right-sided hemiparesis) were asked to reach targets appearing in either the real world or in a virtual environment. Sessions were divided into 3 phases: baseline, intervention and washout. During the intervention the movement of the virtual representation of the patients' paretic limb was amplified towards the target. RESULTS: We found that the probability of using the paretic limb during washout was significantly higher in comparison to baseline. Patients showed generalization of these results by displaying a more substantial workspace in real world task. These gains correlated with changes in effector selection patterns. CONCLUSIONS: The amplification of the movement of the paretic limb in a virtual environment promotes the use of the paretic limb in stroke patients. Our findings indicate that reinforcement-based therapies may be an effective approach for counteracting learned non-use and may modulate motor performance in the real world.application/pdfeng© 2015 Rubio Ballester et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:///ncreativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Infart cerebralinfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s12984-015-0039-zinfo:eu-repo/semantics/openAccess