When healthy people learn new movements, this skill is stored in the brain by new connections formed between neurones involved in movement. New methods of brain stimulation (such as transcranial magnetic stimulation, TMS) can interact with these connections and affect how well people learn. If certain types of TMS are given before training on a task, subjects learn the task better/faster than they would do normally.
After a stroke, physical therapy helps patients to improve their movement, and improvements are due to changes in the connections between neurones. There is some evidence that TMS can improve or accelerate recovery after stroke. This study asks whether TMS can be used to improve shoulder/upper-arm function. These muscles are controlled by both sides of the brain, so should we give TMS to the undamaged of the brain, or to the damaged side? Will we get better improvement of arm reaching if we try to shift limb control to the undamaged side of the brain?
We will test this by asking whether TMS of the undamaged side, (not the damaged side) of the brain improves the response to physical training of shoulder/upper arm function, 3-6 months after their stroke. While upper arm movements in the affected arm are controlled by both sides of the brain, can we obtain the best improvement by giving TMS to the undamaged side?