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Abstract:
The ability to train or retrain subjects in use of a hand is
important in health and disease--e.g., stroke patients, surgeons,
athletes, repetitive motion syndrome prophylaxis by using both
hands. Also, effective training procedures allow study of the
neural primary and backup systems subserving movement. We have
performed a prospective, cross-over trial comparing mirror therapy
(Proc. Roy. Soc. B 263: 377-386) and constraint induced therapy (J
Rehab Res Dev 36: 237-251). After ten weeks of training (15
minutes, 1-2x/day; four weeks, two week vacation, then cross-over
and four more weeks) twelve of fifteen colleagues of one of us (CL)
(ages 14-15) had handwriting with their non-dominant handwriting
closely approaching the quality of their dominant hand; two others
had also substantially improved. A larger trial is needed to
confirm this result, differentiate between the two methods, and
make sure that results are not too sensitive to subjects' ages.
Appreciation that healthy subjects can rapidly improve
functionality in their non-dominant hand might allow subjects to
alternate hand use during tasks to avoid repetitive motion injuries
and to "prehabilitate" as insurance against neurologic disease. The
neural correlates of training can be more easily studied (e.g., by
PET or fMRI) in healthy subjects, than neurologic patients.
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