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This review presents the results of studies carried out in our laboratory that aim to investigate, through functional magnetic resonance imaging (fMRI), the brain plasticity associated with motor sequence learning, defined as our ability to integrate simple stereotyped movements into a single motor representation. Following a brief description of Doyon and colleagues' model (2002, 2005, 2009) of motor skill learning that has guided this work, we then describe the functional changes that occur at the different (rapid, slow, automatization) acquisition phases, and propose specific roles that the putamen, the cerebellum and their motor-related cortical areas, play in this form of motor behavior. Finally, we put forward evidence that post-training, non-REM sleep (and spindles in Stage 2 sleep, in particular) contributes to the consolidation of a motor sequence memory trace, and that increased activity within the striatum and/or the hippocampus mediates this mnemonic process.

The task-oriented approach incorporating treadmill walking for retraining gait early after stroke has contributed to promote locomotor recovery. To augment practice, training strategies such as mental practice and training in virtual environments are proposed. While the former offers more practice with less physical exertion, the latter allows safe practice in a variety of challenging environments. Work is under way to assess whether these new strategies can further enhance locomotor recovery.

Caregivers are often ill-equipped to cope with repeated verbal and physical aggression by geriatric residents with cognitive deficits. Cooperation from other members of the health care team is rarely automatic and there is little adherence to established interventions. This article offers valuable insights on patient care to caregivers who work with aggressive individuals in geriatric settings. With the consensual approach, nursing assistants and attendants who are assigned to these patients daily are able to participate in the problem-solving process. They help design the approach and willingly become stakeholders in the actions presented by the patient care plans. By the end of the process they are able to view the aggressive person as someone worthy of attention and love, rather than a disruptive element to be endured.

Functional analysis is a research process that links problem behavior, its surrounding elements and the resulting consequences. The goal of this study was to decrease repetitive shouting of an elderly patient diagnosed with Alzheimer-like dementia. The analysis provided the following data: BEHAVIORS: Repetitive shouting by the patient lasting 80-115 seconds per 30 minutes during specific times of the day--accompanied by licking of the lips to moisten them. Environmental factors: Constant loud noise in the patient's room; the use of loud voices by staff and visitors; familiar objects out of the patient's reach. Individual factors: Diagnosis of the patient's blindness and auditory hypersensitivity; side-effects of psychotropic medications; a lack of social activities; inactivity because of the patient being bedridden 22 hours per day and the use of restraints when positioned in a chair., Surrounding Elements: The patients was isolated in a private room; psychotropic medication was increased; staff and other patients were less disrupted and the number of visitors to the patient was decreased., Consequences: The above data enabled the formulation of four hypotheses (with specific interventions for each) that assisted staff in planning the patient's care for a 10-day period; a reduction of anxiety; a reduction in discomfort; sensory hypostimulation; verbal hypostimulation. Following the application of these interventions for a 10-day period, a second set of data was gathered and the results showed a decrease in shouting by 40 per cent in the morning and 51 per cent in the afternoon.(ABSTRACT TRUNCATED AT 250 WORDS)