Carvalho Débora B, Freitas Sandra M S F, Alencar Flavia A D, Silva Maria Liliane, Alouche Sandra R
Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo - UNICID, Rua Cesário Galeno, 448/475 - Tatuapé, São Paulo, SP, 03071-000, Brazil.
School of Physical Therapy, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil.
Exp Brain Res. 2020 Oct;238(10):2323-2331. doi: 10.1007/s00221-020-05897-6. Epub 2020 Jul 31.
Aiming movements of the upper limbs can be classified either as discrete, or reciprocal, or cyclic. The control of these movements after a stroke can be affected. The aim of this experimental, cross-sectional study was to characterize the performance of these movements after the right and left hemisphere chronic stroke. Thirty-six individuals aged between 40 and 70 years, right-handed, were allocated into three groups (control, right stroke, and left stroke). Participants were asked to perform aiming movements on a tablet. Individuals after stroke performed the tasks only with their ipsilesional limb, while the control group performed movements with both limbs. The reaction and movement times, peak velocity, and the variability and error of the endpoint were analyzed. Individuals after stroke presented a worse performance in all movement classes as expected, but differently depending on the damaged hemisphere. Participants with right hemisphere damage showed larger endpoint errors, while those with left hemisphere damage had longer reaction and movement times. Both differences were seen consistently in discrete and reciprocal, but not in cyclic movements. Cyclic movements presented shorter latencies, were faster, and showed greater endpoint errors when compared to discrete and reciprocal movements. These results suggest that stroke affects differently the performance of discrete and reciprocal movements according to the hemisphere lesion side, but not in cyclic movements. Different levels of motor control among the three classes of movements by the nervous system may justify these results.
上肢的指向运动可分为离散型、交互型或循环型。中风后这些运动的控制可能会受到影响。本实验性横断面研究的目的是描述右半球和左半球慢性中风后这些运动的表现。36名年龄在40至70岁之间的右利手个体被分为三组（对照组、右中风组和左中风组）。参与者被要求在平板电脑上进行指向运动。中风后的个体仅用患侧肢体执行任务，而对照组用双上肢进行运动。分析了反应时间、运动时间、峰值速度以及终点的变异性和误差。正如预期的那样，中风后的个体在所有运动类型中的表现都较差，但因受损半球的不同而有所差异。右半球受损的参与者表现出更大的终点误差，而左半球受损的参与者反应时间和运动时间更长。这两种差异在离散型和交互型运动中均持续存在，但在循环型运动中未出现。与离散型和交互型运动相比，循环型运动的潜伏期更短、速度更快且终点误差更大。这些结果表明，中风根据半球病变侧不同程度地影响离散型和交互型运动的表现，但对循环型运动无此影响。神经系统对这三类运动的不同水平的运动控制可能解释了这些结果。
