Mihaltchev P, Archambault P S, Feldman A G, Levin M F
Centre for Interdisciplinary Research in Rehabilitation (CRIR), Institut de réadaptation de Montréal, 6300 Darlington, Montreal, Quebec H3S 2J4, Canada.
Exp Brain Res. 2005 Jun;163(4):468-86. doi: 10.1007/s00221-004-2202-9. Epub 2005 Feb 3.
It has been suggested that multijoint movements result from the specification of a referent configuration of the body. The activity of muscles and forces required for movements emerge depending on the difference between the actual and referent body configurations. We identified the referent arm configurations specified by the nervous system to bring the arm to the target position both in healthy individuals and in those with arm motor paresis due to stroke. From an initial position of the right arm, subjects matched a force equivalent to 30% of their maximal voluntary force in that position. The external force, produced at the handle of a double-joint manipulandum by two torque motors, pulled the hand to the left (165 degrees ) or pushed it to the right (0 degrees ). For both the initial conditions, three directions of the final force (0 degrees , +20 degrees , and -20 degrees ) with respect to the direction of the initial force were used. Subjects were instructed not to intervene when the load was unexpectedly partially or completely removed. Both groups of subjects produced similar responses to unloading of the double-joint arm system. Partial removal of the load resulted in distinct final hand positions associated with unique shoulder-elbow configurations and joint torques. The net static torque at each joint before and after unloading was represented as a function of the two joint angles describing a planar surface or invariant characteristic in 3D torque/angle coordinates. For each initial condition, the referent arm configuration was identified as the combination of elbow and shoulder angles at which the net torques at the two joints were zero. These configurations were different for different initial conditions. The identification of the referent configuration was possible for all healthy participants and for most individuals with hemiparesis suggesting that they preserved the ability to adapt their central commands-the referent arm configurations-to accommodate changes in external load conditions. Despite the preservation of the basic response patterns, individuals with stroke damage had a more restricted range of hand trajectories following unloading, an increased instability around the final endpoint position, altered patterns of elbow and shoulder muscle coactivation, and differences in the dispersion of referent configurations in elbow-shoulder joint space compared to healthy individuals. Moreover, 4 out of 12 individuals with hemiparesis were unable to specify referent configurations of the arm in a consistent way. It is suggested that problems in the specification of the referent configuration may be responsible for the inability of some individuals with stroke to produce coordinated multijoint movements. The present work adds three findings to the motor control literature concerning stroke: non-significant torque/angle relationships in some subjects, narrower range of referent arm configurations, and instability about the final position. This is the first demonstration of the feasibility of the concept of the referent configuration for the double-joint muscle-reflex system and the ability of some individuals with stroke to produce task-specific adjustments of this configuration.
有人提出,多关节运动源于身体参考构型的设定。运动所需的肌肉活动和力量取决于实际身体构型与参考身体构型之间的差异。我们确定了神经系统为使手臂到达目标位置而设定的参考手臂构型,研究对象包括健康个体以及因中风导致手臂运动性麻痹的患者。从右臂的初始位置开始,受试者匹配相当于该位置最大自主力量30%的力。由两个扭矩电机在双关节操作器手柄处产生的外力,将手向左拉(165度)或向右推(0度)。对于这两种初始条件,使用了相对于初始力方向的三个最终力方向(0度、+20度和 -20度)。受试者被指示在负载意外部分或完全移除时不要干预。两组受试者对双关节手臂系统卸载的反应相似。负载的部分移除导致与独特的肩肘构型和关节扭矩相关的不同最终手部位置。卸载前后每个关节的净静态扭矩表示为描述平面表面的两个关节角度的函数,或三维扭矩/角度坐标中的不变特征。对于每种初始条件,参考手臂构型被确定为两个关节净扭矩为零的肘角和肩角的组合。这些构型因不同的初始条件而不同。对于所有健康参与者以及大多数偏瘫患者来说,都能够确定参考构型,这表明他们保留了调整其中心指令——参考手臂构型——以适应外部负载条件变化的能力。尽管保留了基本的反应模式,但与健康个体相比,中风损伤患者在卸载后手轨迹的范围更受限,最终端点位置周围的不稳定性增加,肘和肩肌肉共同激活模式改变,以及参考构型在肘 - 肩关节空间中的分散存在差异。此外,12名偏瘫患者中有4人无法以一致的方式确定手臂的参考构型。有人认为,参考构型设定方面的问题可能是一些中风患者无法产生协调多关节运动的原因。目前的研究为关于中风的运动控制文献增添了三项发现:一些受试者中扭矩/角度关系不显著、参考手臂构型范围更窄以及最终位置的不稳定性。这是首次证明双关节肌肉反射系统参考构型概念的可行性,以及一些中风患者对该构型进行特定任务调整的能力。