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右侧大脑损伤患者的双重任务姿势控制。

Dual-tasking postural control in patients with right brain damage.

机构信息

Service de Rééducation et de Réadaptation Fonctionnelle, Clinique Les Trois Soleils, Boissise le Roi, France.

出版信息

Gait Posture. 2014 Jan;39(1):188-93. doi: 10.1016/j.gaitpost.2013.07.002. Epub 2013 Jul 31.

Abstract

The control of dual-tasking effects is a daily challenge in stroke neurorehabilitation. It maybe one of the reasons why there is poor functional prognosis after a stroke in the right hemisphere, which plays a dominant role in posture control. The purpose of this study was to explore cognitive motor interference in right brain-lesioned and healthy subjects maintaining a standing position while performing three different tasks: a control task, a simple attentional task and a complex attentional task. We measured the sway area of the subjects on a force platform, including the center of pressure and its displacements. Results showed that stroke patients presented a reduced postural sway compared to healthy subjects, who were able to maintain their posture while performing a concomitant attentional task in the same dual-tasking conditions. Moreover, in both groups, the postural sway decreased with the increase in attentional load from cognitive tasks. We also noticed that the stability of stroke patients in dual-tasking conditions increased together with the weight-bearing rightward deviation, especially when the attentional load of the cognitive tasks and lower limb motor impairments were high. These results suggest that stroke patients and healthy subjects adopt a similar postural regulation pattern aimed at maintaining stability in dual-tasking conditions involving a static standing position and different attention-related cognitive tasks. Our results indicate that attention processes might facilitate static postural control.

摘要

在脑卒中神经康复中,双重任务效应的控制是一项日常挑战。这可能是右半球脑卒中后功能预后较差的原因之一,因为右半球在姿势控制中起着主导作用。本研究旨在探讨认知运动干扰对右脑损伤患者和健康受试者在进行三种不同任务(控制任务、简单注意力任务和复杂注意力任务)时保持站立姿势的影响。我们通过力平台测量了受试者的姿势摆动面积,包括压力中心及其位移。结果表明,与健康受试者相比,脑卒中患者的姿势摆动幅度减小,而健康受试者在相同的双重任务条件下能够执行伴随的注意力任务。此外,在两组中,随着认知任务注意力负荷的增加,姿势摆动幅度减小。我们还注意到,在双重任务条件下,脑卒中患者的稳定性随着承重向右偏差的增加而增加,尤其是当认知任务的注意力负荷和下肢运动障碍较高时。这些结果表明,脑卒中患者和健康受试者在涉及静态站立和不同注意力相关认知任务的双重任务条件下采用了类似的姿势调节模式,旨在维持稳定性。我们的研究结果表明,注意力过程可能有助于静态姿势控制。

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