Boyd Lara A, Winstein Carolee J
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, 3056 Robinson, Mail Stop 2002, 3901 Rainbow Blvd, Kansas City, KS 66160-7601, USA.
Phys Ther. 2003 Nov;83(11):976-89.
Recovery of motor skills following stroke is supported, in part, by the implicit memory system. However, attempts to guide learning commonly use explicit instructions concerning "how to" perform a movement task. The purpose of this work was to systematically investigate the impact of explicit information (EI) on implicit motor-sequence learning using the ipsilesional arm in people with damage in the middle cerebral artery (MCA) distribution.
Ten people with unilateral stroke in the MCA distribution affecting the sensorimotor cortical areas and 10 people with no known pathology or impairment (control participants) were randomly divided into 2 groups. One group was provided with EI and one group was not (EI and No-EI groups, respectively) as the participants practiced an implicit motor-sequencing task over 3 days, with a retention test on day 4.
A 3-way interaction demonstrated that, across days of practice, EI had opposite effects on implicit motor-sequence performance for the 2 groups. Post hoc tests confirmed that EI facilitated the performance of the control participants in the EI group but interfered with the performance of the participants with stroke in the EI group. This interference effect persisted, and was evident during the retention test in the participants with stroke in the EI group.
Explicit information was detrimental for implicit motor-sequence learning following MCA stroke. Rehabilitation outcomes may benefit from consideration of stroke location when determining the degree to which EI can augment implicit motor skill learning.
中风后运动技能的恢复部分受到内隐记忆系统的支持。然而，引导学习的尝试通常使用关于“如何”执行运动任务的明确指令。这项研究的目的是系统地调查明确信息（EI）对大脑中动脉（MCA）分布区受损患者患侧手臂内隐运动序列学习的影响。
10名MCA分布区单侧中风且影响感觉运动皮层区域的患者和10名无已知病理或损伤的人（对照参与者）被随机分为两组。一组在参与者进行为期3天的内隐运动序列任务练习时提供EI，另一组不提供（分别为EI组和无EI组），并在第4天进行留存测试。
三因素交互作用表明，在整个练习过程中，EI对两组的内隐运动序列表现有相反的影响。事后检验证实，EI促进了EI组对照参与者的表现，但干扰了EI组中风患者的表现。这种干扰效应持续存在，并且在EI组中风患者的留存测试中很明显。
明确信息对MCA中风后的内隐运动序列学习有害。在确定EI可以增强内隐运动技能学习的程度时，考虑中风位置可能有益于康复结果。
