Arm Ability Training (AAT) Promotes Dexterity Recovery After a Stroke—a Review of Its Design, Clinical Effectiveness, and the Neurobiology of the Actions

Frontiers in Neurology, 2018 · DOI: 10.3389/fneur.2018.01082 · Published: December 11, 2018

Neurology Neuroplasticity Neurorehabilitation

Simple Explanation

Arm Ability Training (AAT) is designed for stroke patients with mild to moderate arm weakness, focusing on improving dexterity, which involves various sensorimotor skills. AAT involves repetitive training of sensorimotor abilities at the individual's performance limit, incorporating different difficulty levels and feedback to enhance motor learning. Studies show AAT improves dexterity and reduces disability in stroke patients. It also induces sensorimotor learning, engaging different brain areas at different training stages.

Study Duration

Not specified

Participants

Stroke patients with mild to moderate arm paresis

Evidence Level

Review of randomized controlled trials and experimental studies

Key Findings

1
AAT is clinically effective in promoting dexterity recovery and reducing focal disability in stroke patients with mild to moderate arm paresis.
2
AAT induces substantial sensorimotor learning in healthy subjects, strengthening various arm and hand abilities.
3
Training-induced plasticity involves cortical sensorimotor network areas early in training, with subcortical structures becoming more involved with prolonged training.

Research Summary

The Arm Ability Training (AAT) is specifically designed for individuals with brain injuries causing mild to moderate arm weakness and reduced dexterity, addressing sensorimotor efficiency across various arm abilities. Clinical trials have demonstrated AAT's effectiveness in improving sensorimotor efficiency and ADL-like arm activities, proving superior to conventional therapy. Neurobiological studies show AAT induces motor learning, engaging distributed cortico-subcortical networks and promoting functional reorganization in brain networks.

Practical Implications

Targeted Rehabilitation

AAT offers a tailored approach for stroke patients with specific motor control deficits.

Enhanced Motor Learning

The design of AAT incorporates principles that promote effective motor skill acquisition and retention.

Neuroplasticity Insights

AAT provides a model for understanding brain reorganization and recovery mechanisms after stroke.

Study Limitations

1
Limited number of participants in RCTs testing AAT's effectiveness.
2
Evidence primarily generated during the subacute phase of stroke and inpatient rehabilitation.
3
Lack of evidence for AAT's acceptability and effectiveness in the chronic stage and in ambulatory settings.

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