Geurts A C, Mulder T W, Nienhuis B, Rijken R A
Department of Research and Development, St. Maartenskliniek, Nijmegen, The Netherlands.
Arch Phys Med Rehabil. 1991 Dec;72(13):1059-64.
Postural control in persons with lower limb amputation was studied using a cognitive approach to motor learning. The aim of this study was to show that an important characteristic of the central reorganization process after a lower limb amputation is the gradually decreasing need of attentional resources to perform a motor task. A dual-task procedure was developed to estimate the level of automaticity of a quiet, upright standing task. The effect of a concurrent attention-demanding task (Stroop task) on the efficiency of balance control was determined using force-platform measurements at the start and the end of the rehabilitation process. In contrast with a control group, the amputation group showed interference effects on body sway caused by the concurrent task both at the start (p less than .05) and, less severe, at the end of rehabilitation (p less than .05). Improvement of balance control was significant only for the dual-task condition (p less than .05). The results corroborated the hypothesis that dual tasks give information about the restoration of automaticity of postural control as an essential characteristic of the central reorganization process in persons with lower limb amputation. The role of dual-task procedures as a useful approach to skill assessment is discussed.
采用运动学习的认知方法对下肢截肢患者的姿势控制进行了研究。本研究的目的是表明下肢截肢后中枢重组过程的一个重要特征是执行运动任务时对注意力资源的需求逐渐减少。开发了一种双任务程序来评估安静直立站立任务的自动化水平。在康复过程开始和结束时，使用力平台测量来确定同时进行的注意力需求任务（斯特鲁普任务）对平衡控制效率的影响。与对照组相比，截肢组在康复开始时（p小于0.05）以及康复结束时（p小于0.05，程度较轻）都显示出由同时进行的任务对身体摇摆产生的干扰效应。仅在双任务条件下平衡控制的改善具有显著性（p小于0.05）。结果证实了这样的假设，即双任务为姿势控制自动化的恢复提供了信息，这是下肢截肢患者中枢重组过程的一个基本特征。讨论了双任务程序作为技能评估有用方法的作用。
