Park Hyeshin, Schweighofer Nicolas
Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
J Neuroeng Rehabil. 2017 Mar 17;14(1):21. doi: 10.1186/s12984-017-0233-2.
We recently showed that individuals with chronic stroke who completed two sessions of intensive unassisted arm reach training exhibited improvements in movement times up to one month post-training. Here, we study whether changes in movement times during training can predict long-term changes.
Sixteen participants with chronic stroke and ten non-disabled age-matched participants performed two sessions of reach training with 600 movements per session. Movement time data during training were fitted to a nonlinear mixed-effects model consisting of a decreasing exponential term to model improvements of performance due to learning and an increasing linear term to model worsening of performance due to activity-dependent fatigability and/or other factors unrelated to learning.
For non-disabled age-matched participants, movement times gradually decreased overall during training and overall changes in movement times during training predicted long-term changes. In contrast, for participants post-stroke, movement times often worsened near the end of training. As a result, overall changes in movement times during training did not predict long-term changes in movement times in the stroke group. However, improvements in movement times due to training, as estimated by the exponential term of the model, predicted long-term changes in movement times.
Participants post-stroke showed a distinction between learning and performance in unassisted intensive arm reach training. Despite worsening of performance in later trials, extended training was beneficial for long-term gains.
我们最近发现，完成两期强化无辅助手臂伸展训练的慢性中风患者在训练后长达一个月的时间里运动时间有所改善。在此，我们研究训练期间运动时间的变化是否能预测长期变化。
16名慢性中风患者和10名年龄匹配的非残疾参与者进行了两期伸展训练，每期600次动作。训练期间的运动时间数据被拟合到一个非线性混合效应模型中，该模型由一个递减指数项（用于模拟因学习导致的表现改善）和一个递增线性项（用于模拟因活动依赖性疲劳和/或其他与学习无关的因素导致的表现恶化）组成。
对于年龄匹配的非残疾参与者，训练期间运动时间总体上逐渐减少，训练期间运动时间的总体变化预测了长期变化。相比之下，对于中风后参与者，运动时间在训练接近尾声时往往会变差。因此，训练期间运动时间的总体变化并不能预测中风组运动时间的长期变化。然而，由模型的指数项估计的训练导致的运动时间改善预测了运动时间的长期变化。
中风后参与者在无辅助强化手臂伸展训练中表现出学习与表现之间的差异。尽管后期试验中表现变差，但延长训练对长期收益有益。
