Archives of physical medicine and rehabilitation · 2007
Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke.
СтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаResearch Support, N.I.H., IntramuralПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Celnik Pablo, Hummel Friedhelm, Harris-Love Michelle, Wolk Rebecca, Cohen Leonardo G
Аннотация
OBJECTIVE: To test the hypothesis that somatosensory stimulation would enhance the effects of training functional hand tasks immediately after practice and 1 day later in chronic subcortical stroke patients.
DESIGN: Single-blinded and randomized, crossover study.
SETTING: Human research laboratory.
PARTICIPANTS: Nine chronic subcortical stroke patients.
INTERVENTIONS: Three separate sessions of motor training preceded by (1) synchronous peripheral nerve stimulation (PNS), (2) no stimulation, or (3) asynchronous PNS.
MAIN OUTCOME MEASURES: Time to complete the Jebsen-Taylor Hand Function Test (JTHFT time) and corticomotor excitability tested with transcranial magnetic stimulation.
RESULTS: After familiarization practice, during which all patients reached a performance plateau, training under the effects of PNS reduced JTHFT time by 10% beyond the post-familiarization plateau. This behavioral gain was accompanied by a specific reduction in GABAergically mediated intracortical inhibition in the motor cortex. These findings were not observed after similar practice under the influence of no stimulation or asynchronous PNS sessions.
CONCLUSIONS: Somatosensory stimulation may enhance the training of functional hand tasks in patients with chronic stroke, possibly through modulation of intracortical GABAergic pathways.
DESIGN: Single-blinded and randomized, crossover study.
SETTING: Human research laboratory.
PARTICIPANTS: Nine chronic subcortical stroke patients.
INTERVENTIONS: Three separate sessions of motor training preceded by (1) synchronous peripheral nerve stimulation (PNS), (2) no stimulation, or (3) asynchronous PNS.
MAIN OUTCOME MEASURES: Time to complete the Jebsen-Taylor Hand Function Test (JTHFT time) and corticomotor excitability tested with transcranial magnetic stimulation.
RESULTS: After familiarization practice, during which all patients reached a performance plateau, training under the effects of PNS reduced JTHFT time by 10% beyond the post-familiarization plateau. This behavioral gain was accompanied by a specific reduction in GABAergically mediated intracortical inhibition in the motor cortex. These findings were not observed after similar practice under the influence of no stimulation or asynchronous PNS sessions.
CONCLUSIONS: Somatosensory stimulation may enhance the training of functional hand tasks in patients with chronic stroke, possibly through modulation of intracortical GABAergic pathways.
Предметные рубрики MeSH
AdultAgedBrain MappingCerebral InfarctionCombined Modality TherapyCross-Over StudiesDominance, CerebralElectromyographyEvoked Potentials, MotorFemaleFingersHandHemiplegiaHumansMaleMedian NerveMiddle AgedMotor CortexMotor SkillsMotor Skills DisordersMuscle, SkeletalNeurologic ExaminationPhysical Therapy ModalitiesPyramidal TractsReaction TimeRecruitment, NeurophysiologicalSingle-Blind MethodSomatosensory CortexSynaptic TransmissionTranscranial Magnetic StimulationTranscutaneous Electric Nerve StimulationUlnar Nerve