Patel Prakruti, Kaingade Sarthak R, Wilcox Anthony, Lodha Neha
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.
Neurosci Lett. 2020 Jun 11;729:135015. doi: 10.1016/j.neulet.2020.135015. Epub 2020 Apr 30.
High-functioning stroke survivors with mild to moderate motor impairments show greater functional autonomy in activities of daily living, and often return to work or prior activities. Increased functional independence necessitates dexterous use of hands to execute tasks such as typing, using a phone, and driving. Despite the absence of any pronounced motor impairments, high-functioning individuals with stroke report challenges in performing skilled manual tasks. Two prominent motor deficits that limit functional performance after stroke are decline in strength and force control. Here, we quantify the deficits in fine motor dexterity in high-functioning stroke survivors and determine the relative contribution of strength and force control to fine motor dexterity.
Fifteen high-functioning participants with stroke (upper-limb Fugl-Meyer score ≥43/66) and 15 controls performed following tasks with the paretic and non-dominant hands respectively: i) Nine-hole peg pest, ii) maximum voluntary contraction and iii) dynamic force tracking with isometric finger flexion.
High-functioning stroke participants required greater time to complete the pegboard task, showed reduced finger strength, and increased force variability relative to the controls. Importantly, the time to complete pegboard task in high-functioning stroke participants was explained by finger force variability, not strength.
High-functioning stroke survivors show persistent deficits in fine motor dexterity, finger strength, and force control. The ability to modulate forces (control) contributes to fine motor dexterity in high-functioning stroke survivors. Interventions to improve fine motor dexterity in these individuals should include the assessment and training of force control.
患有轻度至中度运动障碍的高功能中风幸存者在日常生活活动中表现出更大的功能自主性，并且常常能够重返工作岗位或继续之前的活动。功能独立性的增强需要灵活运用双手来执行诸如打字、使用电话和驾驶等任务。尽管没有明显的运动障碍，但患有中风的高功能个体在执行熟练的手动任务时仍面临挑战。中风后限制功能表现的两个突出运动缺陷是力量下降和力控制能力下降。在此，我们对高功能中风幸存者的精细运动灵巧性缺陷进行量化，并确定力量和力控制对精细运动灵巧性的相对贡献。
15名高功能中风参与者（上肢Fugl-Meyer评分≥43/66）和15名对照组分别用患侧手和非优势手执行以下任务：i）九孔插板测试，ii）最大自主收缩，以及iii）等长手指屈曲的动态力跟踪。
与对照组相比，高功能中风参与者完成插板任务所需时间更长，手指力量降低，力变异性增加。重要的是，高功能中风参与者完成插板任务的时间是由手指力变异性而非力量来解释的。
高功能中风幸存者在精细运动灵巧性、手指力量和力控制方面存在持续缺陷。调节力量（控制）的能力有助于高功能中风幸存者的精细运动灵巧性。改善这些个体精细运动灵巧性的干预措施应包括力控制的评估和训练。
