School of Medicine, Université Catholique de Louvain, Brussels, Belgium.
Neurorehabil Neural Repair. 2010 May;24(4):318-27. doi: 10.1177/1545968309353327. Epub 2009 Dec 3.
Grasping an object between the thumb and index finger requires precise coordination between grip force (GF) and tangential load force (LF), which is impaired in children with congenital hemiplegia (CH). This study aimed to determine the respective contributions of predictive and reactive control in the impaired precision grip of 12 children with CH between 10 and 16 years of age when compared with age- and gender-matched controls.
The load of a handheld object was increased rapidly by generating an impact through the drop of a mass attached to the object. The drop was triggered by the participant (predictive conditions) or unexpectedly by the examiner (reactive conditions). In both conditions, participants aimed to prevent the object from falling. Both hands of children with CH and controls were tested.
During our task, no differences in the GF levels were observed between paretic, nonparetic, and control hands. Under predictive conditions, the temporal variables related to the GF were preserved before impact in children with CH but altered after impact. Under reactive conditions, the reactive delays were longer in the paretic hand. Predictive and reactive control were preserved on the nonparetic hand.
Deficits were observed in both predictive and reactive control for the paretic hand. The predictive control exists but is altered after the impact, suggesting an inability to anticipate the consequences of a dynamic perturbation. The authors suggest that the abilities of the nonparetic side could be used in neurorehabilitation to improve motor control of the paretic side.
拇指和食指之间的物体抓取需要握持力（GF）和切向负载力（LF）之间的精确协调，而患有先天性偏瘫（CH）的儿童会受到影响。本研究旨在确定 12 名 10 至 16 岁患有 CH 的儿童与年龄和性别匹配的对照组相比，在受损的精确抓握中，预测性和反应性控制各自的贡献。
通过使附在物体上的质量下降来产生冲击，快速增加手持物体的负载。下降由参与者触发（预测条件）或由检查者意外触发（反应条件）。在两种情况下，参与者都旨在防止物体掉落。CH 儿童和对照组的双手均接受测试。
在我们的任务中，在冲击前，CH 儿童的患侧、非患侧和对照组的 GF 水平没有差异。在预测条件下，与 GF 相关的时间变量在冲击前在 CH 儿童中得到保留，但在冲击后发生了变化。在反应条件下，患侧的反应延迟时间更长。非患侧的预测和反应控制得到保留。
患侧的预测和反应控制均存在缺陷。预测控制存在，但在冲击后发生了改变，这表明无法预测动态扰动的后果。作者建议可以利用非患侧的能力来改善对患侧的运动控制，从而在神经康复中进行应用。
