Liepert Joachim, Stürner Jana, Büsching Imke, Sehle Aida, Schoenfeld Mircea A
Department of Neurorehabilitation, Kliniken Schmieder, Zum Tafelholz 8, 78476 Allensbach, Germany.
Rehaklinik Bellikon, Bellikon, Switzerland.
BMC Sports Sci Med Rehabil. 2020 Oct 22;12:66. doi: 10.1186/s13102-020-00212-w. eCollection 2020.
Motor imagery training might be helpful in stroke rehabilitation. This study explored if a single session of motor imagery (MI) training induces performance changes in mental chronometry (MC), motor execution, or changes of motor excitability.
Subacute stroke patients ( = 33) participated in two training sessions. The order was randomized. One training consisted of a mental chronometry task, the other training was a hand identification task, each lasting 30 min. Before and after the training session, the Box and Block Test (BBT) was fully executed and also performed as a mental version which served as a measure of MC. A subgroup analysis based on the presence of sensory deficits was performed. Patients were allocated to three groups (no sensory deficits, moderate sensory deficits, severe sensory deficits). Motor excitability was measured by transcranial magnetic stimulation (TMS) pre and post training. Amplitudes of motor evoked potentials at rest and during pre-innervation as well as the duration of cortical silent period were measured in the affected and the non-affected hand.
Pre-post differences of MC showed an improved MC after the MI training, whereas MC was worse after the hand identification training. Motor execution of the BBT was significantly improved after mental chronometry training but not after hand identification task training. Patients with severe sensory deficits performed significantly inferior in BBT execution and MC abilities prior to the training session compared to patients without sensory deficits or with moderate sensory deficits. However, pre-post differences of MC were similar in the 3 groups. TMS results were not different between pre and post training but showed significant differences between affected and unaffected side.
Even a single training session can modulate MC abilities and BBT motor execution in a task-specific way. Severe sensory deficits are associated with poorer motor performance and poorer MC ability, but do not have a negative impact on training-associated changes of mental chronometry. Studies with longer treatment periods should explore if the observed changes can further be expanded.
DRKS, DRKS00020355, registered March 9th, 2020, retrospectively registered.
运动想象训练可能有助于中风康复。本研究探讨单次运动想象（MI）训练是否会引起心理计时（MC）、运动执行方面的表现变化或运动兴奋性的改变。
33例亚急性中风患者参加了两次训练 sessions。顺序是随机的。一次训练包括心理计时任务，另一次训练是手部识别任务，每次持续30分钟。在训练 session 前后，完整执行箱块测试（BBT），并以心理版本进行，作为 MC 的一种测量方法。基于感觉缺陷的存在进行了亚组分析。患者被分为三组（无感觉缺陷、中度感觉缺陷、重度感觉缺陷）。在训练前后通过经颅磁刺激（TMS）测量运动兴奋性。测量患侧和非患侧手在静息和预激活期间的运动诱发电位幅度以及皮质静息期的持续时间。
MC 的前后差异显示，MI 训练后 MC 有所改善，而手部识别训练后 MC 更差。心理计时训练后 BBT 的运动执行有显著改善，但手部识别任务训练后没有。与无感觉缺陷或中度感觉缺陷的患者相比，重度感觉缺陷的患者在训练 session 前的 BBT 执行和 MC 能力明显较差。然而，三组 MC 的前后差异相似。TMS 结果在训练前后没有差异，但在患侧和未患侧之间存在显著差异。
即使是单次训练 session 也可以以任务特定的方式调节 MC 能力和 BBT 运动执行。严重感觉缺陷与较差的运动表现和较差的 MC 能力相关，但对心理计时的训练相关变化没有负面影响。更长治疗期的研究应探讨观察到的变化是否可以进一步扩大。
DRKS，DRKS00020355，于2020年3月9日注册，追溯注册。
