Alberts Jay L, Wolf Steven L
Department of Biomedical Engineering, Center for Neurological Restoration, Cleveland Clinic, Cleveland FES Center, Ohio, USA.
Top Stroke Rehabil. 2009 Jul-Aug;16(4):223-36. doi: 10.1310/tsr1604-223.
Stroke is the leading cause of severe, long-term disability among older adults in the United States. Unimanual motor performance of the hemiparetic limb is clearly compromised, and these declines are well documented. An often overlooked aspect of motor function for patients with stroke is the effect of unilateral motor dysfunction on bimanual motor activities. Diminished bimanual function resulting from upper extremity hemiparesis necessarily limits the patient's daily functioning. In this review we describe a bimanual dexterity task that replicates many daily activities and outline how kinetic analysis of this task may provide insight into diminished bimanual function of patients with stroke and how these variables may be useful in assessing level of recovery and rate of motor recovery associated with behavioral interventions intended to improve upper extremity function. It is argued that the use of objective kinetic measures to quantify hand function may facilitate the clinical adoption of behavioral interventions for stroke, such as constraint-induced movement therapy and other repetitive task practice-based interventions.
中风是美国老年人严重长期残疾的主要原因。偏瘫肢体的单手运动表现明显受损，这些下降情况有充分记录。中风患者运动功能中一个常被忽视的方面是单侧运动功能障碍对双手运动活动的影响。上肢偏瘫导致的双手功能减退必然会限制患者的日常功能。在本综述中，我们描述了一项模仿许多日常活动的双手灵巧性任务，并概述了对该任务的动力学分析如何能深入了解中风患者双手功能减退的情况，以及这些变量如何有助于评估与旨在改善上肢功能的行为干预相关的恢复水平和运动恢复率。有人认为，使用客观的动力学测量来量化手部功能可能会促进中风行为干预措施在临床上的应用，如强制性运动疗法和其他基于重复任务练习 的干预措施。
