School of Engineering, Sun Yat-sen University, Guangzhou, PR China.
J Neuroeng Rehabil. 2014 May 11;11:84. doi: 10.1186/1743-0003-11-84.
The aim of this study is to investigate quantitative outcome measurements of hand motor performance for subjects after mild to moderate stroke using grip control tasks and characterize abnormal flexion synergy of upper extremities after stroke.
A customized dynamometer with force sensors was used to measure grip force and calculate rotation torque during the sub-maximal grip control tasks. The paretic and nonpartic sides of eleven subjects after stroke and the dominant sides of ten healthy persons were tested. Their maximal voluntary grip force was measured and used to set sub-maximal grip control tasks at three different target force levels. Force control ability was characterized by the maximal grip force, mean force percentage, coefficient of variation (CV), target deviation ratio (TDR), and rotation torque ratio (RTR). The motor impairments of subjects after stroke were also evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE) and Wolf Motor Function Test (WMFT).
Maximal grip force of the paretic side was significantly reduced as compared to the nonparetic side and the healthy group, while the difference of maximal grip force between the nonparetic side and the healthy group was not significant. TDR and RTR increased for all three groups with increasing target force level. There were significant differences of CV, TDR and RTR between the paretic side and the healthy group at all the force levels. CV, TDR and RTR showed significant negative correlations with FMA-UE and WMFT at 50% of maximum grip force.
This study designed a customized dynamometer together with an innovative measurement, RTR, to investigate the hand motor performance of subjects after mild to moderate stroke during force control tasks. And stroke-induced abnormal flexion synergy of wrist and finger muscles could be characterized by RTR. This study also identified a set of kinetic parameters which can be applied to quantitatively assess the hand motor function of subjects after mild to moderate stroke.
本研究旨在通过握力控制任务调查轻度至中度脑卒中患者手部运动表现的定量测量指标，并描述脑卒中后上肢异常屈肌协同现象。
使用带有力传感器的定制测力计来测量握力并计算在次最大握力控制任务中的旋转扭矩。我们测试了 11 名脑卒中患者的患侧和健侧以及 10 名健康人的优势侧。测量了他们的最大自主握力，并用于在三个不同目标力水平设置次最大握力控制任务。力控制能力的特征包括最大握力、平均力百分比、变异系数 (CV)、目标偏差比 (TDR) 和旋转扭矩比 (RTR)。脑卒中患者的运动障碍也使用上肢 Fugl-Meyer 评估 (FMA-UE) 和 Wolf 运动功能测试 (WMFT) 进行评估。
与健侧和健康组相比，患侧的最大握力明显降低，而健侧与健康组之间的最大握力差异不显著。随着目标力水平的增加，所有三组的 TDR 和 RTR 均增加。在所有力水平下，患侧与健康组之间的 CV、TDR 和 RTR 均存在显著差异。在最大握力的 50%时，CV、TDR 和 RTR 与 FMA-UE 和 WMFT 呈显著负相关。
本研究设计了一种定制测力计和一种创新的测量方法 RTR，以研究轻度至中度脑卒中患者在力控制任务中的手部运动表现。并且可以通过 RTR 来描述脑卒中引起的腕部和手指肌肉的异常屈肌协同现象。本研究还确定了一组动力学参数，可用于定量评估轻度至中度脑卒中患者的手部运动功能。
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