Nonlinear mixed-effects model reveals a distinction between learning and performance in intensive reach training post-stroke.

Only 16 people with chronic stroke and mild to moderate impairment, plus 10 controls, were analysed, so it does not show what happens in more severely impaired or earlier stroke. This was a re-analysis of existing data, not a new treatment trial, and it did not test whether using the model changes patient outcomes. The worsening during training was not measured directly as fatigue or strength loss, so the fatigue-like term may include attention, motivation, or other factors. The model accounted for only 37% of the one-month differences in the stroke group, and 51% when one participant who did not improve was excluded. All participants had to reach targets quickly within fixed accuracy requirements, so speed-accuracy trade-offs and other clinical tasks were not examined.

Funding is listed as National Science Foundation, National Institutes of Health, and MC-IIF. No author conflict-of-interest declaration is provided in the supplied text.

Do not stop intensive reach training because movement times worsen during a session. In 16 people with chronic stroke, overall performance change during training did not predict one-month gains, and many participants were better at delayed testing than at the end of training.