Department of Occupational Therapy, College of Alternative Medicine, Jeonju University, Hyoja-dong 3-ga, Wansan-gu, Jeonju-si, Jeollabuk-do, Republic of Korea.
Department of Occupational Therapy, College of Health Science, Yonsei University, Heungup-myun, Wonju-si, Kangwon-do, Republic of Korea.
NeuroRehabilitation. 2014;34(2):277-86. doi: 10.3233/NRE-131040.
Stroke patients have major problems with impaired upper-extremity function. Unfortunately, many patients do not experience a full recovery from movement deficits in the upper extremities.
The purpose of this study was to compare the effectiveness of inter-limb learning transfer (ILT) to the contralateral upper limb after both hemisphere-specific and -unspecific ipsilateral upper limb training for stroke patients with hemiparesis.
Twenty-four stroke patients with hemiparesis participated. The hemisphere-specific training group performed reaching movements in a customized training setting in which non-dominant limb training participants began from a single starting location and proceeded to one of three target locations (1S3T condition); the dominant limb training participants started from one of three starting locations and proceeded to a single target location (3S1T condition). The hemisphere-unspecific training group performed these movements starting under reverse-start and target conditions.
The non-dominant to dominant limb transfer, the hemisphere-specific training group performance time decreased significantly as compared with the pre-training session (p < 0.05). Also, the isolation contraction ratio was decreased significantly from that of the pre-training session in the biceps brachii muscles and increased significantly in the upper trapezius muscles (p < 0.05). And, dominant to non-dominant limb transfer in the hemisphere-specific training group significantly increased RMS amplitudes from the pre-training session in the biceps brachii and triceps muscles (p < 0.05). Also, the isolation contraction ratio was increased significantly from that of the pre-training session in the biceps brachii muscles and decreased significantly in the upper trapezius muscles (p < 0.05). However, the hemisphere-unspecific training group showed no significant differences in inter-limb learning transfer (ILT).
The transfer of hemisphere-specific training from one arm to the other had a more positive influence on functional recovery than did hemisphere-unspecific training for patients with stroke and hemiparesis.
中风患者上肢功能受损严重。不幸的是，许多患者上肢运动功能障碍并未完全恢复。
本研究旨在比较半球特异性和非特异性同侧上肢训练后，通过肢体间学习转移（ILT）对偏瘫中风患者的上肢的有效性。
共有 24 名偏瘫中风患者参与了本研究。在半球特异性训练组中，患者在定制的训练环境中进行上肢伸展运动，非优势侧肢体训练的参与者从一个起始位置开始，并移动到三个目标位置之一（1S3T 条件）；优势侧肢体训练的参与者从三个起始位置之一开始，移动到一个目标位置（3S1T 条件）。在半球非特异性训练组中，参与者在反向起始和目标条件下进行这些运动。
与训练前相比，非优势侧到优势侧的肢体转移，半球特异性训练组的运动时间显著减少（p < 0.05）。此外，肱二头肌的孤立收缩比率从训练前显著降低，而上斜方肌的收缩比率显著增加（p < 0.05）。而且，在半球特异性训练组中，从训练前相比，优势侧到非优势侧的肢体转移使肱二头肌和肱三头肌的均方根振幅显著增加（p < 0.05）。此外，肱二头肌的孤立收缩比率从训练前显著增加，而上斜方肌的收缩比率显著降低（p < 0.05）。然而，半球非特异性训练组在肢体间学习转移（ILT）方面没有显示出显著差异。
与非特异性半球训练相比，偏瘫中风患者的半球特异性训练从一只手臂转移到另一只手臂对功能恢复有更积极的影响。
