Kantak Shailesh S, Zahedi Nazaneen, McGrath Robert L
Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, PA; Department of Physical Therapy, Arcadia University, Glenside, PA.
Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, PA.
Arch Phys Med Rehabil. 2016 May;97(5):798-806. doi: 10.1016/j.apmr.2016.01.020. Epub 2016 Feb 10.
To determine (1) bimanual coordination deficits in patients with stroke using 3-dimensional kinematic analyses as they perform naturalistic tasks requiring collaborative interaction of the 2 arms; and (2) whether bimanual coordination deficits are related to clinical measures of sensorimotor impairments and unimanual performance of the paretic arm.
Case-control study.
Rehabilitation hospital research institute.
Participants (N=24) were patients with unilateral chronic stroke (n=14) and age-matched controls (n=10).
Not applicable.
Temporal coordination between the 2 hands as participants performed (1) a symmetric task: reach to pick up a box using both hands; and (2) an asymmetric task: open a drawer with 1 hand to press a button inside with the other hand.
During the symmetric task, patients and controls showed preserved temporal coupling while transporting the hands to the box. However, on reaching the box, patients demonstrated an impaired ability to cooperatively interact their 2 arms for an efficient pickup. This led to significantly longer pickup times compared with controls. Pickup time positively correlated with proprioceptive deficits of the paretic arm. During the asymmetric task, patients had a longer time delay between drawer opening and button pressing movements than controls. The deficits in asymmetric coordination did not significantly correlate with sensorimotor impairments or unimanual paretic arm performance.
Bimanual coordination was impaired in patients poststroke during symmetric and asymmetric bimanual tasks that required cooperative interaction between the 2 arms. While the proprioceptive system contributes to symmetric cooperative coordination, commonly tested measures of paretic arm impairment or performance, or both, do not strongly predict deficits in bimanual coordination.
（1）使用三维运动学分析确定中风患者在执行需要双臂协同互动的自然任务时的双手协调缺陷；（2）双手协调缺陷是否与感觉运动障碍的临床指标以及患侧手臂的单手运动表现相关。
病例对照研究。
康复医院研究机构。
参与者（N = 24）为单侧慢性中风患者（n = 14）和年龄匹配的对照组（n = 10）。
不适用。
参与者执行（1）对称任务：用双手伸手拿起一个盒子；以及（2）不对称任务：用一只手打开抽屉，用另一只手按下里面的按钮时，双手之间的时间协调情况。
在对称任务中，患者和对照组在将手移向盒子的过程中显示出保留的时间耦合。然而，在到达盒子时，患者表现出双臂协同互动以有效拿起物品的能力受损。这导致与对照组相比拿起物品的时间明显更长。拿起物品的时间与患侧手臂的本体感觉缺陷呈正相关。在不对称任务中，患者在打开抽屉和按下按钮动作之间的时间延迟比对照组更长。不对称协调缺陷与感觉运动障碍或患侧手臂单手运动表现没有显著相关性。
中风患者在需要双臂协同互动的对称和不对称双手任务中双手协调受损。虽然本体感觉系统有助于对称协同协调，但通常测试的患侧手臂损伤或运动表现指标，或两者，都不能强烈预测双手协调缺陷。
