Department of Physical Therapy Education and Center on Aging, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7601, USA.
Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
NeuroRehabilitation. 1997;9(1):57-69. doi: 10.3233/NRE-1997-9106.
There is substantial evidence to indicate that sensory-motor control of the ipsilesional upper extremity (UE) in adults after unilateral stroke is abnormal. Some of the sensory-motor deficits differ as a function of the side of the cerebral lesion. Rapid movements of the ipsilesional UE that require precise timing and sequencing are more affected in individuals with lesions in the left hemisphere. In contrast, ipsilesional movements that have constrained spatial requirements are more affected in those with lesions in the right hemisphere. Ipsilesional UE coordination of discrete tasks may be normal, but the coordination of continuous tasks is affected in adults with left stroke. Sensation in the ipsilesional UE appears to be unaffected, or minimally affected after stroke. Strength deficits have been demonstrated in the ipsilesional UE, but primarily in those with right sided lesions. Ipsilesional performance deficits are revealed in clinical tests of function that use time to completion as the measure of success. Ipsilesional performance deficits may reflect motor control deficits that are masked on the contralateral side by hemiplegia and hemisensory loss. Interventions that focus on specific motor control deficits, such as speed of sensory-motor processing, through practice with the ipsilesional UE, may result in functional improvements in both limbs.
有大量证据表明，成年人单侧卒中后对健侧上肢（UE）的感觉运动控制是异常的。一些感觉运动缺陷的差异与大脑损伤的侧别有关。需要精确计时和顺序的健侧 UE 的快速运动在左半球损伤的个体中受影响更大。相比之下，空间要求受限的健侧运动在右半球损伤的个体中受影响更大。离散任务的健侧 UE 协调性可能正常，但左卒中成年人的连续任务协调性受影响。卒中后健侧 UE 的感觉似乎不受影响，或受影响很小。在健侧 UE 中已经证明存在力量缺陷，但主要在右侧病变的个体中。在使用完成时间作为成功衡量标准的功能临床测试中，揭示了健侧表现缺陷。健侧表现缺陷可能反映了由偏瘫和半感觉缺失在对侧掩盖的运动控制缺陷。通过使用健侧 UE 进行练习，针对特定运动控制缺陷（如感觉运动处理速度）的干预措施可能会导致四肢的功能改善。
