Investigations of physical therapy interventions to enhance movement recovery in people after stroke: Development and design of a novel intervention embedding Functional Strength Training within a motor learning context

Mares, Kathryn (2013) Investigations of physical therapy interventions to enhance movement recovery in people after stroke: Development and design of a novel intervention embedding Functional Strength Training within a motor learning context. Doctoral thesis, University of East Anglia.

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Abstract

Stroke is the largest cause of adult disability in the UK and stroke survivors commonly present with a partial or complete loss of movement. Physical therapy interventions as part of movement rehabilitation after stroke aim to facilitate a return to participation in activities of daily living. It has been proposed that the processes that underpin both movement recovery following stroke and motor learning are the same. By embedding physical therapies within a motor learning context it is possible that the effects of the therapy could be enhanced. Yet the application of motor learning principles within the field of movement rehabilitation after stroke is fragmented and supported by evidence of their application in studies with healthy volunteers. This thesis aims to carry out a systematic review of the evidence for the effectiveness of the application of motor learning principles in movement rehabilitation after stroke and to combine this with findings from a feasibility study of Functional Strength Training. These findings will be used to design a novel intervention embedding FST within a motor learning context. Organisation and synthesis of the systematic review was guided by the development of a motor learning framework. Interpretation of the findings from the review showed some evidence in favour of the application of motor learning
principles. A phase II randomised controlled trial of FST to the upper limb and lower limb in people within six months and five years after stroke showed evidence of feasibility for both interventions but indicated efficacy of the upper limb intervention only (p=0.046). These findings were combined to inform the design and delivery of a novel intervention, testing for proof of concept for this intervention is now required. This thesis suggests an alternative approach to the development of physical therapy interventions after stroke, however consensus for this needs to be achieved.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Rehabilitation Sciences (former - to 2014)
Depositing User:	Stacey Armes
Date Deposited:	03 Mar 2015 10:12
Last Modified:	03 Mar 2015 10:26
URI:	https://ueaeprints.uea.ac.uk/id/eprint/52519
DOI:

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