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An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping.

E Taub1,J E Crago1,L D Burgio1,T E Groomes1,E W Cook 3rd1,S C DeLuca1,N E Miller1
1Psychology Department, University of Alabama at Birmingham 35294.
PMCID: PMC1334416  PMID:8169577

Abstract

A new approach to the rehabilitation of movement, based primarily on the principles of operant conditioning, was derived from research with deafferented monkeys. The analysis suggests that a certain proportion of excess motor disability after certain types of injury involves a learned suppression of movement and may be termed learned nonuse. Learned nonuse can be overcome by changing the contingencies of reinforcement so that they strongly favor use of an affected upper extremity in the chronic postinjury situation. The techniques employed here involved 2 weeks of restricting movement of the opposite (unaffected) extremity and training of the affected limb. Initial work with humans has been with chronic stroke patients for whom the approach has yielded large improvements in motor ability and functional independence. We report here preliminary data suggesting that shaping with verbal feedback further enhances the motor recovery.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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