Directions in retraining reaching

Despite the growing amount of movement science and professional literature, rehabilitation for stroke is commonly based instead on accepted practice or custom. Therefore, this review article was undertaken to further the development of a sound theoretical background for intervention with stroke patients. We first report the key findings from the literature concerned with normal reaching, then discuss evidence relevant to training reaching after stroke. The review finishes with an extraction of those clinical implications that have the firmest scientific evidence at present. In this way, scientifically based directions for retraining reaching and for research in this area are provided. Current research indicates that effective training strategies are likely to include voluntary activation of whole movements with meaningful goals, and sufficient practice to achieve skill learning. Practice should be varied to suit different environmental contexts and the inclusion of strategies such as using electromyographic biofeedback, bilateral movements and constraining the unaffected arm is beneficial