Rehabilitation programme to promote task relearning and generalisation after stroke : a review of literature

Background and Purpose: The relearning of functional skills following a stroke is an essential part of the rehabilitation process. Rehabilitation post stroke may facilitate an individual to return to independent living. However, the skills learnt during this process do not necessarily transfer to the skills required for daily functioning. This review addresses the issue of generalisation of skills learnt by discussing the connectionist model. Summary of Review: Connectionism models how the human brain functions and stipulates that the units in an input layer feed their activations forward to the units in the hidden layer for interpretation and then to the output layer for execution. These units are connected and distributed in a connectionist network. The activation of clusters of units in retrained tasks will provide signals to other different but connected tasks that have not been retrained. Adopting the concept of the connectionist model, the relearning of tasks after brain damage enhances the relearnt skills by transferring them to other tasks that share similar units within the same connectionist network, resulting in generalisation. Research evidence has shown that the strategies of self-regulation and mental imagery further enhance the relearning and generalisation of skills among people with brain damage. By identifying a list of daily tasks that fall within a connectionist network and the appropriate use of training strategies, the skills developed during the rehabilitation process could lead to effective task generalisation to suit the needs of independent living and community re-integration of the individual. Conclusions: The Connectionist Model provides a theoretical base for developing evidence-based interventions throughout the acute, rehabilitation and community phases. The Connectionist Model is the theory by which the cognitive skills learned to perform one particular behaviour, or skill, are transferable to executing other similar skills or beahviours without specifically relearning those skills or behaviours.