Yen Sheng-Che, Landry Jill M, Wu Ming
Department of Physical Therapy, Bouve College of Health Sciences, Northeastern University, Boston, MA.
J Rehabil Res Dev. 2013;50(9):1187-200. doi: 10.1682/JRRD.2012.09.0175.
Studies in arm motor adaptation suggest that introducing small errors during the adaptation period may lead to a longer retention of the aftereffect than introducing large errors. However, it is unclear whether this notion can be generalized to locomotor adaptation in patients with incomplete spinal cord injury (SCI). We hypothesized that a smaller error size may lead to longer retention of the aftereffect in patients with SCI. We recruited 12 subjects with incomplete SCI for this study. They were instructed to walk on a treadmill while light-, medium-, and heavy-resistance loads were applied to the right ankle to perturb leg swing. Each of the three resistance-load conditions were specific to the subject and determined by each subject's maximum voluntary contraction of the hip flexors. We observed that subjects tended to make larger errors when the resistance-load condition was greater. Following resistance load release, subjects showed an aftereffect consisting of an increase in stride length. Further, the aftereffect was retained longer in the medium-resistance load condition than in the heavy- and light-resistance load conditions. This finding suggests that a patient-specific resistance load may be needed to facilitate retention of locomotor adaptation in patients with incomplete SCI.
上肢运动适应性研究表明,在适应期引入小误差可能比引入大误差导致后效应的保留时间更长。然而,尚不清楚这一概念是否能推广到不完全性脊髓损伤(SCI)患者的运动适应性中。我们假设较小的误差大小可能导致SCI患者后效应的保留时间更长。我们招募了12名不完全性SCI患者参与本研究。他们被要求在跑步机上行走,同时对右脚踝施加轻、中、重阻力负荷以干扰腿部摆动。三种阻力负荷条件中的每一种都针对个体,由每个受试者髋屈肌的最大自主收缩力决定。我们观察到,当阻力负荷条件增加时,受试者往往会产生更大的误差。在阻力负荷解除后,受试者表现出步幅增加的后效应。此外,中阻力负荷条件下的后效应保留时间比重阻力和轻阻力负荷条件下更长。这一发现表明,可能需要针对患者的阻力负荷来促进不完全性SCI患者运动适应性的保留。