Pohl P S, Luchies C W, Stoker-Yates J, Duncan P W
Department of Physical Therapy Education and Center on Aging, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7601, USA.
Neurorehabil Neural Repair. 2000;14(1):33-41. doi: 10.1177/154596830001400104.
Motor control deficits in the upper extremity (UE) ipsilateral to the side of brain damage persist after stroke, but it is not known if the presence of these deficits is related to impairment of the contralateral UE. The purpose of this study was to investigate whether motor deficits are present in the ipsilateral UE when contralateral UE impairment is mild in adults with chronic stroke. Right-handed adults (10 controls, 10 right stroke, 10 left stroke) performed rapid continuous aiming movements to small and large targets. Using kinematic analysis, temporal measures of the movement were defined, including movement time (MT) and the three components of MT: acceleration, deceleration, and dwell time (i.e., time on target). Participants with right stroke had prolonged MT only with the left UE, primarily due to longer dwell times. Participants with left stroke had prolonged MT with both UEs as a result of longer dwell times. The results indicate that control deficits of the ipsilateral UE are evident in individuals with left but not right brain damage who have minimal impairment of the contralateral UE. These findings are consistent with the role of the left hemisphere in the control of both UEs.
脑卒中后，脑损伤一侧上肢（UE）的运动控制缺陷依然存在，但目前尚不清楚这些缺陷的存在是否与对侧上肢的功能受损有关。本研究旨在调查慢性脑卒中成年患者对侧上肢轻度受损时，同侧上肢是否存在运动缺陷。右利手成年人（10名对照组、10名右侧脑卒中患者、10名左侧脑卒中患者）对大小不同的目标进行快速连续瞄准动作。通过运动学分析，定义了运动的时间指标，包括运动时间（MT）以及MT的三个组成部分：加速时间、减速时间和停留时间（即目标上的时间）。右侧脑卒中患者仅左侧上肢的MT延长，主要原因是停留时间更长。左侧脑卒中患者两侧上肢的MT均延长，原因也是停留时间更长。结果表明，在对侧上肢仅有轻微损伤的情况下，左侧而非右侧脑损伤个体的同侧上肢存在明显的控制缺陷。这些发现与左半球在两侧上肢控制中的作用一致。
