Shepherd Center, Crawford Research Institute, Atlanta, GA 30309, USA.
PM R. 2010 Dec;2(12 Suppl 2):S279-85. doi: 10.1016/j.pmrj.2010.10.004.
Persons with tetraplegia resulting from a cervical spinal cord injury believe that increasing upper limb (UL) function will improve their quality of life. Various lines of evidence demonstrate that persons with incomplete tetraplegia have the potential for improvements in both neural plasticity and function of the arms and hands. Therefore treatment to improve UL function in persons with incomplete tetraplegia should focus on improving motor control, not just compensation for the paralysis and sensory loss that follows a spinal cord injury. This article highlights the principles that underlie the facilitation of neural plasticity and functional changes: intensity, repeated practice, attention, and somatosensory augmentation. Evidence is presented for the application of these principles through the use of activity-based interventions in persons with tetraplegia and the hypothesis is proposed that the use of activity-based interventions will lead to greater, more beneficial neural plasticity as well as gains in UL function, in persons with incomplete tetraplegia.
截瘫患者认为，上肢功能的提高将改善他们的生活质量。各种证据表明，不完全性截瘫患者上肢和手部具有神经可塑性和功能改善的潜力。因此，改善不完全性截瘫患者上肢功能的治疗应侧重于改善运动控制，而不仅仅是补偿脊髓损伤后的瘫痪和感觉丧失。本文重点介绍了促进神经可塑性和功能变化的原则：强度、重复练习、注意力和躯体感觉增强。通过在截瘫患者中使用基于活动的干预措施来证明这些原则的应用，并提出假设，即使用基于活动的干预措施将导致不完全性截瘫患者产生更大、更有益的神经可塑性以及上肢功能的提高。
