Malcolm Matthew P, Massie Crystal, Thaut Michael
Department of Occupational Therapy, NeuroRehabilitation Research Laboratory, Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, Colorado, USA.
Top Stroke Rehabil. 2009 Jan-Feb;16(1):69-79. doi: 10.1310/tsr1601-69.
Recovery of skilled upper limb movement remains a critical focus of rehabilitation in individuals post stroke. Conventional treatments, however, have demonstrated limited capability to produce substantial improvements in poststroke quality of movement. Recently, rhythmic auditory stimulation (RAS) has emerged as efficacious in improving and normalizing limb movements in neurologically impaired populations. This pilot study examined changes in pre- to post-RAS reach kinematics and functional outcomes in survivors of stroke.
Five individuals in the chronic poststroke phase participated in a 2-week program of RAS training. Kinematic reaching variables were trunk, shoulder, and elbow segment contribution; movement time; and reach velocity. Functional outcomes were the Wolf Motor Function Test, Motor Activity Log, and Fugl-Meyer Assessment.
Post-RAS assessment of reaching kinematics revealed a significant (p < .05) decrease in compensatory trunk movement, increase in shoulder flexion, and a slight increase in elbow extension. Movement time and velocity significantly improved post RAS. Significant gains were observed on all functional assessments.
Post RAS, participants demonstrated substantial decreases in compensatory reaching movements. These changes in motor control strategy were paralleled by gains in functional abilities, suggesting that reduced reliance on compensatory movements may translate to improved performance of daily activities.
恢复熟练的上肢运动仍然是中风后个体康复的关键重点。然而，传统治疗方法在改善中风后运动质量方面的能力有限。最近，节律性听觉刺激（RAS）已被证明对改善神经功能受损人群的肢体运动并使其正常化有效。这项初步研究调查了中风幸存者在接受RAS前后的伸手运动学变化和功能结果。
五名处于中风后慢性期的个体参加了为期两周的RAS训练计划。运动学伸手变量包括躯干、肩部和肘部节段的贡献；运动时间；以及伸手速度。功能结果通过沃尔夫运动功能测试、运动活动日志和Fugl-Meyer评估来衡量。
RAS后对伸手运动学的评估显示，代偿性躯干运动显著减少（p < .05），肩部屈曲增加，肘部伸展略有增加。RAS后运动时间和速度显著改善。在所有功能评估中均观察到显著改善。
RAS后，参与者的代偿性伸手运动显著减少。这些运动控制策略的变化与功能能力的提高同时出现，表明减少对代偿性运动的依赖可能转化为日常活动表现的改善。
