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上肢固定:一种与中风后运动康复相关的神经可塑性模型。

Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation.

作者信息

Furlan Leonardo, Conforto Adriana Bastos, Cohen Leonardo G, Sterr Annette

机构信息

School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.

Neurology Clinical Division, Clinics Hospital, São Paulo University, Avenida Dr. Enéas C. Aguiar 255/5084, 05403-010 São Paulo, SP, Brazil; Instituto de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Avenida Albert Einstein 627/701, 05601-901 São Paulo, SP, Brazil.

出版信息

Neural Plast. 2016;2016:8176217. doi: 10.1155/2016/8176217. Epub 2015 Dec 30.

Abstract

Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well.

摘要

我们对偏瘫性中风后发生的神经可塑性的理解取得了进展,这有助于形成中风后运动恢复的理论。反过来,这些理论为当代治疗中风后运动缺陷(如上肢偏瘫)的运动康复策略奠定了基础。然而,一个相对的缺点是,一般来说,这些策略最适合功能相对较高的中风幸存者的恢复情况,因此不容易转化为对那些患有低功能上肢偏瘫、残余功能较差的个体的益处。对于这些个体,目前需要替代的运动康复策略。在本文中,我们将回顾针对健康成年人类和动物进行的上肢固定研究。然后,我们将讨论这些研究的结果如何能够启发建立一个神经可塑性模型,该模型可能与中风后运动康复的背景特别相关。例如,正如将要阐述的那样,这样的模型可以有助于开发治疗中风后上肢偏瘫的替代运动康复策略。还将讨论这些固定研究的结果对当代运动康复策略的影响,并提供该领域未来研究的展望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d93/4710952/71b43c532b04/NP2016-8176217.001.jpg

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