Maguire Clare C, Sieben Judith M, De Bie Robert A
a Department of Physiotherapy, BZG Bildungszentrum Gesundheit Basel-Stadt , Munchenstein , Switzerland.
b Health Division , Bern University of Applied Science , Bern , Switzerland.
Physiother Theory Pract. 2019 Jan;35(1):1-14. doi: 10.1080/09593985.2018.1434579. Epub 2018 Feb 5.
Current knowledge of neural and neuromuscular processes controlling gait and movement as well as an understanding of how these mechanisms change following stroke is an important basis for the development of effective rehabilitation interventions. To support the translation of findings from basic research into useful treatments in clinical practice, up-to-date neuroscience should be presented in forms accessible to all members of the multidisciplinary team. In this review we discuss aspects of cortical control of gait and movement, muscle synergies as a way of translating cortical commands into specific muscle activity and as an efficient means of reducing neural and musculoskeletal redundancy. We discuss how these mechanisms change following stroke, potential consequences for gait rehabilitation, and the prescription and use of walking-aids as well as areas requiring further research.
目前关于控制步态和运动的神经及神经肌肉过程的知识,以及对这些机制在中风后如何变化的理解,是开发有效康复干预措施的重要基础。为了支持将基础研究结果转化为临床实践中的有用治疗方法,最新的神经科学应以多学科团队所有成员都能理解的形式呈现。在本综述中,我们讨论了皮质对步态和运动的控制、肌肉协同作用,肌肉协同作用是将皮质指令转化为特定肌肉活动的一种方式,也是减少神经和肌肉骨骼冗余的有效手段。我们讨论了这些机制在中风后如何变化、对步态康复的潜在影响、助行器的处方和使用,以及需要进一步研究的领域。