The generalization of motor recovery after stroke: Assessment within and outside the training workspace

Stroke patients exhibit a reduced ability or incapacity to selectively activate muscle fibres and consequently motor performance is impaired. The best behavioural outcomes after stroke are associated with the greatest return of brain function toward the normal state of organization. Besides traditional physical therapy, task oriented repetitive movements can help patients recover motor function, improve motor coordination, learn new motor strategies and avoid secondary complications, as many studies using robot-aided therapy attest. The goal of the present study was to verify the transfer of motor skills from trained to untrained tasks in chronic stroke subjects. We investigated to what extent there is generalization of motor recovery in chronic stroke subjects for point-to-point movements executed within and outside the workspace in which they were previously trained. Our results suggest that while the generalization of motor recovery is good for new point-to-point movements executed within the training workspace, there is little generalization for point-to-point movements outside. This calls for varied therapy practice to promote improvement in activity of daily living.