Ribbers Gerard M, Mulder Theo, Geurts Alexander C, den Otter Rob A
Rehabilitation Center Rijndam and Institute of Rehabilitation of the Erasmus University Center Rotterdam, The Netherlands.
Arch Phys Med Rehabil. 2002 Jan;83(1):81-5. doi: 10.1053/apmr.2002.27331.
To test whether central motor processing can be impaired in chronic reflex sympathetic dystrophy (RSD).
Experimental 2-group analysis.
Tertiary care center in the Netherlands.
Five patients with stage 3 RSD of the left forearm, free of symptoms and complaints in the right forearm; and 10 healthy control subjects.
On a digitizer, RSD patients and controls had to draw 3 sequences of graphemes of different complexity with their (unaffected) dominant right hand. The drawing tracks were segmented in time periods between points of velocity minima of the pen tip.
Mean velocity, coefficients of variation of both length and movement time per segment, and mean intersegmental pausing time were calculated for each sequence.
A repeated-measures analysis of variance by using the multivariate method yielded a 35% lower mean velocity (F(1,13) = 5.83, P =.031), a 110% larger segment length variability (F(1,13) = 9.72, P =.008) and a 60% larger variability of movement time per segment (F(1,13) = 5.78, P =.032) in RSD patients. No group difference was found for intersegmental pausing time or any interaction effect with the type of task.
Patients with chronic RSD have a normal ability to preprogram sequential movements of their unaffected hand; but with impaired temporospatial coding and movement execution. We concluded that cortical mechanisms may be involved in motor impairments in patients with chronic RSD.
测试慢性反射性交感神经营养不良（RSD）患者的中枢运动处理功能是否受损。
两组实验分析。
荷兰的三级护理中心。
5例左前臂为3期RSD患者，右前臂无症状及不适；10名健康对照者。
在数字化仪上，RSD患者和对照者要用其（未受影响的）优势右手绘制3组不同复杂度的字素序列。绘图轨迹按笔尖速度最小值点之间的时间段进行分割。
计算每组序列的平均速度、每段长度和运动时间的变异系数以及平均段间停顿时间。
采用多变量方法进行重复测量方差分析，结果显示RSD患者的平均速度降低了35%（F(1,13) = 5.83，P =.031），段长变异性增加了110%（F(1,13) = 9.72，P =.008），每段运动时间的变异性增加了60%（F(1,13) = 5.78，P =.032）。段间停顿时间或与任务类型的任何交互效应在两组之间均未发现差异。
慢性RSD患者未受影响手的连续运动预编程能力正常；但颞空间编码和运动执行受损。我们得出结论，皮质机制可能参与慢性RSD患者的运动障碍。
