The Build and Application of a Storm and Flood Standard Data Model of a Damage Prediction Map

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Understanding the Effects of Movement-Based Priming on Neuroplasticity and Motor Control in Stroke

The purpose of this dissertation was to examine the effects of movement-based priming on neuroplasticity and motor control in stroke survivors. Specifically, this dissertation examined whether movement-based priming using the paretic or non-paretic lower limb enhanced corticomotor activity and paretic lower limb motor control in stroke survivors. The rationale for this dissertation derived from the recent impactful perspective suggesting that people with mild stroke impairment may improve paretic limb motor recovery utilizing the interhemispheric competition model (facilitating the lesioned motor cortex) while people with severe stroke may benefit from the vicariation model (facilitating the non-lesioned motor cortex). We first investigated the effects of movement-based priming using the paretic lower limb with gaming technology on corticomotor excitability of the paretic TA and paretic ankle motor control in people with chronic stroke. We demonstrated that the short-term paretic limb movement priming increased corticomotor excitability of the paretic TA, however the ankle motor control did not change. This study establishes the use of paretic limb movement of the lower limb as a priming approach in relatively less impaired chronic stroke survivors. Also, we examined the effects of movement-based priming using the non-paretic lower limb on neurophysiological outcomes and paretic ankle motor control in severely impaired stroke survivors. We found that the contralateral corticomotor excitability of the non-paretic TA increased after non-paretic skill- and strength-based movement priming. Ipsilateral connectivity from the non-lesioned hemisphere to the paretic TA and TCI from the non-lesioned to lesioned hemisphere increased after skill priming while strength priming did not show any changes for ipsilateral connectivity and TCI. Also, reaction time of the paretic TA improved after skill and strength priming tasks using the non-paretic limb. The study finding suggests the non-paretic lower limb movements as an alternative cortical priming approach for those with severe impairment in the paretic limb and enhances our understanding on the role of non-lesioned M1 to promote lower limb neuroplasticity and motor recovery in severe stroke. Findings from this dissertation may provide useful information to develop targeted rehabilitation approaches for individuals post stroke with different impairment levels