Program in Human Movement Science, Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7135, USA.
Center for the study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA Department of Physical and Occupational Therapy, Duke University Medical Center, Durham, NC, USA.
NeuroRehabilitation. 1997;9(1):71-87. doi: 10.3233/NRE-1997-9107.
Our purpose was to identify impairments in movement control for subjects with left and right brain lesions using a kinematic analysis of the trajectory of a stylus during an upper limb tapping task. We hypothesized that subjects with left cerebrovascular accident (LCVA) would have bilateral deficits in programming while subjects with right cerebrovascular accident (RCVA) would only have deficits in the limb contralateral to the lesion.
Data were collected from 11 subjects with LCVA, 11 with RCVA, and 22 non-disabled subjects who were age and gender-matched to subjects with left or RCVA. Subjects were videotaped performing a Fitts tapping task on a single 3-inch target with each hand. The stylus movement was digitized at 60 Hz and data were calculated for each tap cycle and averaged across each 10-s trial. We examined differences in the kinematic variables of cycle frequency, amplitude, symmetry in up and down velocity, symmetry in timing of up and down velocity, and temporal phases of acceleration and deceleration for up and down directions of the tap cycle. Multivariate analyses were performed on four dependent kinematic variables, and univariate ANOVAs were conducted for the differences in phases between stroke and non-disabled limbs.
Subject with LCVA showed lower frequencies, and asymmetrical velocity and timing ratio in both 'uninvolved' and 'involved' limbs compared to non-disabled subjects. Subjects with RCVA showed similar impairments for the 'involved' limb only.
Left hemisphere lesions create bilateral impairments in programming movement reversals. Right hemisphere lesions produced deficits only for the limb contralateral to the lesion. Strategies used by the subjects with LCVA may be-related to the need for subjects to use feedback to perform this rapid continuous sequencing task. Suggestions for rehabilitation are presented.
我们的目的是通过分析上肢叩击任务中触笔轨迹的运动学，来识别左、右脑损伤患者的运动控制障碍。我们假设，左侧脑卒中（LCVA）患者在编程方面会存在双侧缺陷，而右侧脑卒中（RCVA）患者仅会在与病变侧相对的肢体上存在缺陷。
从 11 名 LCVA 患者、11 名 RCVA 患者和 22 名非残疾患者中收集数据，这些患者与 LCVA 或 RCVA 患者的年龄和性别相匹配。患者使用每个手在单个 3 英寸的目标上进行 Fitts 叩击任务。触笔运动以 60Hz 数字化，并为每个叩击周期计算数据，并在每个 10 秒的试验中平均。我们检查了在周期频率、振幅、上下速度对称性、上下速度定时对称性、以及叩击周期上下方向的加速度和减速的时间相位等运动学变量上的差异。对四个依赖运动学变量进行了多元分析，并对卒中侧和非卒中侧肢体之间相位的差异进行了单变量方差分析。
与非残疾患者相比，LCVA 患者在“未受累”和“受累”肢体中表现出较低的频率、不对称的速度和定时比。RCVA 患者仅在“受累”肢体中表现出类似的缺陷。
左半球损伤会导致双侧编程运动反转障碍。右半球损伤仅导致与病变相对的肢体出现缺陷。LCVA 患者使用的策略可能与患者需要使用反馈来执行这种快速连续序列任务有关。提出了康复建议。
