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Learned Nonuse: What Happens When Survivors Neglect Their Affected Side

Doctor testing stroke patient's arm for learned nonuse

Learned nonuse occurs when an individual suppresses the use of their affected limb, often after a stroke has impaired movement on that side. If the condition persists, it can lead to muscle atrophy and loss of motor and sensory function.

Since this condition can progressively worsen function, it is important to learn ways to avoid it. This article will help you better understand what learned non-use is and how to prevent it.

What Is Learned Nonuse?

Learned nonuse typically occurs as a result of hemiparesis, which involves weakness on one side of the body. To compensate, the stroke survivor will often use their unaffected side for most activities.

Unfortunately, by not using their affected side, their function on that side will deteriorate until it is effectively paralyzed. Therapists refer to this as learned nonuse.

If a stroke survivor’s non-dominant side is affected, learned nonuse can become more problematic. Most people are right-side dominant. When a stroke weakens the left (non-dominant) side of the body, it’s easier for patients to subconsciously avoid using the left side, slipping into patterns that promote learned nonuse.

There’s actually a name for this phenomenon: unilateral neglect. This refers to a condition wherein a stroke survivor loses awareness of their affected side. Unilateral neglect can occur on the right or left, but left-side neglect is more common. With left neglect, the person does not make a conscious decision to only use their right hand, they simply do not even recall their left side exists.

However, no matter the cause of learned nonuse, the end result is the same: decreased motor and sensory functions.

How to Prevent and Treat Learned Nonuse

therapist helping stroke patient with arm exercises to prevent learned nonuse

The best way to prevent learned nonuse after a stroke is to treat the underlying cause. You can do this by activating the brain’s neuroplasticity.

Neuroplasticity refers to the brain’s ability to reorganize neural pathways in response to repetitive practice. This enables the brain to transfer functions previously controlled by damaged areas to other, healthy regions.

After a stroke, the neural connections between the brain and muscles can become weakened or destroyed. This explains why a patient might lose strength in their hand following their stroke. Engaging the brain’s neuroplasticity allows a person to rebuild those neural connections and regain control of their muscles.

However, stroke patients can face a difficult dilemma here. Neuroplasticity is primarily activated through intensive exercise, but exercising your affected arm is almost impossible if you have learned nonuse.

Fortunately, therapists have devised an effective treatment to address this problem.

Using Constraint-Induced Movement Therapy to Reverse Nonuse

therapist teaching stroke patient how to do CIMT exercises

Constraint-induced movement therapy (CIMT) is an intervention designed to prevent and treat learned nonuse after stroke. It involves the application of behavioral-analytic techniques to motor deficits. Specifically, it works by forcing the stroke survivor to activate their neglected arm by constraining their unaffected arm.

The hope is that by exercising the affected arm, neuroplasticity will kick in and the person will regain full function. To constrain the unaffected arm, a therapist might have you wear a mitt to prevent you from using your hand. This forces you to use your weaker hand.

For CIMT to have its intended effect, patients must practice it more than once or twice a week. Because the goal is to activate neuroplasticity, you will need to use your affected arm as often as possible. That’s why many therapists instruct their patients to continue wearing a mitt on their strong arm for up to 90% of their waking hours, even at home.

However, wearing a restraint alone for an extended period does not enhance the treatment results, according to one pilot study. Rather, patients must engage in functional, intensive exercise as well.

This is where home exercise programs like Flint Rehab’s FitMi really shine. It encourages patients to exercise on a regular basis. Because of this functional, intensive exercise, patients with hemiplegia or hemiparesis are often able to regain mobility.

All this goes to show, that when you use your affected side, the brain will respond and improve the affected side. As the therapy saying goes: “use it to improve it!”

Overcoming Learned Nonuse After Stroke

Learned nonuse is a serious but common secondary effect of stroke. Fortunately, it is treatable.

The key to preventing learned nonuse is to move (and try to functionally use) your affected side at least a bit every day. This will engage neuroplasticity and help rebuild the neural connections to your muscles.

If learned nonuse has already set in, constraint-induced movement therapy can help. Talk to your physical or occupational therapist for more information on CIMT and for specific exercises you can try at home.

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You’re on a Roll! See how Jerry is regaining movement with FitMi home therapy

5 stars

My husband is getting better and better!

“My name is Monica Davis but the person who is using the FitMi is my husband, Jerry. I first came across FitMi on Facebook. I pondered it for nearly a year. In that time, he had PT, OT and Speech therapy, as well as vision therapy.

I got a little more serious about ordering the FitMi when that all ended 7 months after his stroke. I wish I hadn’t waited to order it. He enjoys it and it is quite a workout!

He loves it when he levels up and gets WOO HOOs! It is a wonderful product! His stroke has affected his left side. Quick medical attention, therapy and FitMi have helped him tremendously!”

Monica & Jerry’s review of FitMi home therapy

What are these “WOO HOOs” about?

FitMi is like your own personal therapist encouraging you to accomplish the high repetition of exercise needed to improve.

When you beat your high score or unlock a new exercise, FitMi provides a little “woo hoo!” as auditory feedback. It’s oddly satisfying and helps motivate you to keep up the great work.

In Jerry’s photo below, you can see him with the FitMi pucks below his feet for one of the leg exercises:

FitMi is beloved by survivors and used in America’s top rehab clinics

Many therapists recommend using FitMi at home between outpatient therapy visits and they are amazed by how much faster patients improve when using it.

It’s no surprise why over 14,000 OTs voted for FitMi as “Best of Show” at the annual AOTA conference; and why the #1 rehabilitation hospital in America, Shirley Ryan Ability Lab, uses FitMi with their patients.

This award-winning home therapy device is the perfect way to continue recovery from home. Read more stories and reviews by clicking the button below:

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