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动作减缓:不完全性脊髓损伤后恢复良好的受试者存在反应时间缺陷。

Slowed down: response time deficits in well-recovered subjects with incomplete spinal cord injury.

机构信息

Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland; Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland; Pediatric Rehab Research Group, Rehabilitation Center, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.

出版信息

Arch Phys Med Rehabil. 2013 Oct;94(10):2020-6. doi: 10.1016/j.apmr.2013.04.002. Epub 2013 Apr 18.

Abstract

OBJECTIVE

To quantify remaining motor deficits in well-recovered subjects with incomplete spinal cord injury.

DESIGN

Case-control study.

SETTING

Spinal cord injury center of a university hospital.

PARTICIPANTS

Out of a volunteer sample, we recruited 15 subjects with incomplete paraplegia (mean age, 50y; 67% men; neurologic level from T4 to L4; mean time since injury, 6.3y) and close-to-normal walking pattern. They were compared with 15 age- and sex-matched controls.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Response time and its 4 subparts, processing time, conduction time, motor time, and movement time. These were assessed with an electromyogram-supported lower-limb response time task and single-pulse transcranial magnetic stimulation to measure the motor-evoked potential latency of the M. tibialis anterior. In addition, participants were tested for lower-extremity muscle strength, gait capacity, visual acuity, and upper-extremity response time.

RESULTS

Well-recovered subjects with incomplete paraplegia still suffered from deficits in conduction and movement time, whereas their processing and motor times were essentially normal. In addition, these patients showed delayed movement times of the upper limb, even if their injury was located in the thoracic or lumbar region.

CONCLUSIONS

Well-recovered patients with incomplete paraplegia still experience difficulties with quick and accurate movements. Furthermore, combining transcranial magnetic stimulation, electromyogram, and a response time task proved useful for investigating deficits in executing fast and accurate movements.

摘要

目的

量化不完全性脊髓损伤后恢复良好的患者的残留运动缺陷。

设计

病例对照研究。

地点

大学医院脊髓损伤中心。

参与者

在志愿者样本中,我们招募了 15 名不完全性截瘫患者(平均年龄 50 岁;67%为男性;神经损伤水平为 T4 至 L4;平均受伤时间为 6.3 年),且具有接近正常的步行模式。他们与 15 名年龄和性别匹配的对照组进行比较。

干预措施

不适用。

主要观察指标

反应时间及其 4 个子部分,即处理时间、传导时间、运动时间和运动时间。通过肌电图支持的下肢反应时间任务和单脉冲经颅磁刺激来测量胫骨前肌的运动诱发电位潜伏期来评估这些指标。此外,还对下肢肌肉力量、步态能力、视力和上肢反应时间进行了测试。

结果

不完全性截瘫且恢复良好的患者仍存在传导和运动时间的缺陷,而他们的处理时间和运动时间基本正常。此外,即使损伤位于胸段或腰段,这些患者的上肢运动时间也会延迟。

结论

不完全性截瘫且恢复良好的患者在快速准确运动方面仍存在困难。此外,结合经颅磁刺激、肌电图和反应时间任务,可用于研究快速准确运动执行方面的缺陷。

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