Education Center

Moving Beyond the Motor System: Other Factors Influencing Neurorehabilitation After Stroke: A CSM 2021 Presentation

Recorded On: 01/11/2022

After stroke, physical therapists aim to improve movement and quality of life through interventions targeting upper extremity function and mobility. In doing so, we often perform measures of body structure and function (e.g., strength and range of motion assessments) as well as measures of activity (e.g., Six Minute Walk Test and Wolf Motor Function Test) that are specific to physical function. While these assessments are critical to developing an appropriate plan of care, there are factors outside the motor system that impact how well patients respond to our interventions. In this presentation we will discuss current evidence examining how 1) sensation, 2) cognition, 3) self-efficacy, and 4) environmental factors impact the response to rehabilitation interventions and patient recovery. We will discuss how gathering information about factors beyond the motor system may impact clinical care and how it can be used to improve patient outcomes.

Learning Objectives:

1. Discuss the implications of 1) sensation/proprioception, 2) cognition, 3) self-efficacy, and 4) the environment on post stroke rehabilitation and recovery.
2. Identify potential assessment tools for each of these 4 non-motor factors that impact post stroke rehabilitation/recovery.
3. Understand potential adjustments to rehabilitation interventions due to the role of these 4 non-motor factors in post-stroke rehabilitation/recovery.

Course Recorded January 2022

Jennifer Semrau

PhD

Jennifer Semrau, PhD is currently an Assistant Professor in the Department of Kinesiology and Applied Physiology at the University of Delaware. She received her PhD in Neuroscience from Washington University in 2011 and completed her post-doctoral training at the University of Calgary with Sean Dukelow, MD, PhD. Her work has focused on the developmcent and implementation of robotic measurements for sensorimotor control after stroke, particularly proprioception. Currently, her research program at UD focuses on developing robotic tools to assess sensorimotor integration and learning after stroke, which the overarching goal of developing targeted, patient-need driven, robotic tools for rehabilitation. She has received several awards for her work, including the 2015 Canadian Stroke Congress Co-Chairs’ Award for Impact, and her work is currently funded through the National Science Foundation. Her work has been published in leading journals in the fields of neuroscience and neurorehabilitation including Stroke, Cortex, Neurorehabilitation and Neural Repair, and Journal of NeuroEngineering and Rehabilitation. She is currently an Associate Editor for the Journal of NeuroEngineering and Rehabilitation.

Darcy Reisman

PT, PhD

Darcy Reisman, PT, PhD is Professor and Chairperson in the Department of Physical Therapy and Professor in the Biomechanics and Movement Science Program at the University of Delaware (UD). She has been a Physical Therapist for over 25 years. Dr. Reisman received her PhD from the University of Delaware in 2003 and completed post-doctoral training at the Kennedy Krieger Institute/Johns Hopkins School of Medicine. She is faculty in both the UD- Johns Hopkins Neurologic Physical Therapy Residency and UD Geriatric Physical Therapy Residency programs. The overall goal of Dr. Reisman’s research is to develop scientifically-based therapies to advance physical rehabilitation and recovery after stroke. Dr. Reisman’s research has been continuously funded for the past 15 years through federal agencies and foundations including the American Heart Association and the National Institutes of Health. She has more than 100 peer-reviewed publications and is an Associate Editor and Editorial Board Member for some of the top rehabilitation journals.

Allison Miller

PT, DPT, NCS

Allison Miller, PT, DPT, NCS is currently a PhD student with Dr. Darcy Reisman in the Biomechanics and Movement Science Program at the University of Delaware. Allison received her DPT degree from the University of Connecticut in 2013. She then completed the Kessler Institute for Rehabilitation Residency in Neurologic Physical Therapy in 2016 and obtained her NCS in 2017. Dr. Miller’s research interests involve understanding factors that influence walking activity in those post stroke. Her research has been funded by the Foundation for Physical Therapy Research.

Margaret French

PT, DPT, PhD, NCS

Margaret French, PT, DPT, PhD, NCS is currently a postdoctoral fellow with Dr. Preeti Raghavan in the Department of Physical Medicine and Rehabilitation at the Johns Hopkins University. She completed her PhD in Biomechanics and Movement Science at the University of Delaware in 2021. Prior to obtaining her PhD, she completed the University of Delaware/Johns Hopkins Neurological Physical Therapy Residency and subsequently practiced as an outpatient neurologic physical therapist. Dr. French’s research interests include understanding variability in post stroke recovery in order to develop more effective, targeted rehabilitation interventions. Her work has been funded by the Foundation for Physical Therapy Research and the National Institutes of Health.

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Moving Beyond the Motor System: Other Factors Influencing Neurorehabilitation after Stroke
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Open to view video. After stroke, physical therapists aim to improve movement and quality of life through interventions targeting upper extremity function and mobility. In doing so, we often perform measures of body structure and function (e.g., strength and range of motion assessments) as well as measures of activity (e.g., Six Minute Walk Test and Wolf Motor Function Test) that are specific to physical function.
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