Raghavan Preeti
Department of Rehabilitation Medicine, Box 1240, The Mount Sinai Medical Center, 1 Gustave L. Levy Place, New York, NY 10029, USA.
Curr Treat Options Cardiovasc Med. 2007 Jun;9(3):221-8. doi: 10.1007/s11936-007-0016-3.
Hand motor impairments may be viewed as 1) a deficit in motor execution, resulting from weakness, spasticity, and abnormal muscle synergies, and/or 2) a deficit in higher-order processes, such as motor planning and motor learning, which lead to poorly formed sensorimotor associations that lead to impaired motor control. Although weakness and spasticity impede motor execution, strengthening and tone reduction represent simplistic solutions to the deficit in motor control after stroke. Deficits in hand motor control are better appreciated by examining the coordination of fingertip forces and movements during natural movements, and suggest that impairments in motor learning and planning are fundamental impediments to motor recovery following stroke. However, despite an explosion in the number of therapeutic protocols based on the principles of motor learning, little is known about the types of motor learning impairment that occur after stroke and how lesion location may influence motor relearning.
1）运动执行方面的缺陷，由无力、痉挛和异常肌肉协同作用导致；和/或2）高阶过程的缺陷，如运动规划和运动学习，这会导致感觉运动关联形成不佳，进而导致运动控制受损。尽管无力和痉挛会妨碍运动执行，但增强力量和降低肌张力只是解决中风后运动控制缺陷的简单方法。通过检查自然运动过程中指尖力量和运动的协调性，可以更好地理解手部运动控制的缺陷，这表明运动学习和规划方面的损伤是中风后运动恢复的根本障碍。然而，尽管基于运动学习原则的治疗方案数量激增，但对于中风后发生的运动学习损伤类型以及病变位置如何影响运动再学习，人们知之甚少。
