Reinvestment and movement disruption following stroke

Abstract

Background. Disruption of the automaticity of movement execution is commonly experienced by people with stroke and may result from the person consciously attempting to control the mechanics of his or her movements. This act of turning one's attention in toward the mechanics of an action is referred to as "reinvestment." Objectives. This study aimed to explore the hypothesis that people with stroke have a greater propensity for reinvestment than the nondisabled population and to examine the relationship between reinvestment, functional impairment from stroke, and aspects of rehabilitation. Methods. A cross-sectional questionnaire survey was used. A total of 148 people with stroke and 148 nondisabled adults completed the Movement Specific Reinvestment Scale. Correlational and multiple regression analyses were conducted to examine the relationship between functional impairment and various potential predictors. Results. Compared with controls, people with stroke had a greater propensity for reinvestment. Conscious motor processing and time spent in rehabilitation were significant predictors of functional impairment following stroke. Conclusions. The association between functional impairment, propensity for reinvestment, and time spent in rehabilitation indicates that exclusive reliance on conscious motor processing strategies in the rehabilitation setting may be an impediment to regaining functional independence. There is a need to develop motor learning strategies for rehabilitation that restrain the propensity for reinvestment. © 2009 The American Society of Neurorehabilitation.