The carrot and the stick seem to enhance motor learning in patients with stroke

Reinforcement enhances the rate of motor learning in patients with stroke

Each year five million people are left permanently disabled by stroke.1 Identifying novel approaches to address their impairments is an important challenge. In their JNNP paper, Quattrocchi et al show that both reward-based and punishment-based feedbacks enhance the rate of motor learning following stroke2. Patients who trained with this additional feedback learnt to adapt their movements to counteract a robot-induced force field faster than those who received neutral feedback. Patients who had learnt under the reward or punishment conditions were also faster to adapt their movements when exposed to a similar perturbation on a subsequent day. These results suggest that reinforcement can have lasting beneficial effects on the rate of motor learning after stroke.

Rehabilitation is an arduous process. Developing approaches to enhance the efficiency of rehabilitation should result in direct benefits to patients, in turn leading...

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