Mizrachi Nama, Bar-Haim Simona, Treger Iuly, Melzer Itshak
Physical Therapy Department, Faculty of Health Sciences, Recanati School of Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva 84417, Israel.
The BGU Adi-Negev Translational Laboratory, Merhavim Regional Council, Ofakim 80300, Israel.
Brain Sci. 2023 Feb 3;13(2):264. doi: 10.3390/brainsci13020264.
Persons with chronic stroke (PwCS) have a decreased ability to ambulate and walk independently. We aimed to investigate the differences between the motor adaptation process for two different perturbation methods: split-belt treadmill walking and unilaterally applied resistance to the swing leg during walking. Twenty-two PwCS undergo split-belt treadmill walking and unilaterally applied resistance to the swing leg during walking, each one week apart. The test included three phases: the baseline period, the early-adaptation period and the late-adaptation period, as well as the early-de-adaptation period and the late-de-adaptation period. The average step length, swing duration, double-limb support duration, and coefficient of variance (CV) of these parameters were measured. During the split-belt treadmill walking, PwCS showed an adaptation of double-limb support duration symmetry ( = 0.004), specifically a trend between baseline versus early-adaptation ( = 0.07) and an after-effect (late-adaptation compare to early-de-adaptation, = 0.09). In unilaterally applied resistance to the swing leg during walking, PwCS showed lower swing phase duration CV, in the adaptation period (baseline compare to adaptation, = 0.006), and a trend toward increased variability of gait in the de-adaptation period compare to the adaptation periods ( = 0.099). The rate of adaptation and de-adaptation were alike between the two perturbation methods. Our findings show that the learning process happening in the central nervous system of PwCS may be dependent on the nature of the perturbation (mechanical resistance vs. split-belt) and that PwCS are able to adapt to two types of errors.
慢性中风患者（PwCS）独立行走和移动的能力下降。我们旨在研究两种不同扰动方法的运动适应过程之间的差异：分带式跑步机行走和行走过程中对摆动腿单侧施加阻力。22名慢性中风患者分别进行分带式跑步机行走和行走过程中对摆动腿单侧施加阻力，每次间隔一周。测试包括三个阶段：基线期、早期适应期和晚期适应期，以及早期去适应期和晚期去适应期。测量这些参数的平均步长、摆动持续时间、双支撑持续时间和变异系数（CV）。在分带式跑步机行走过程中，慢性中风患者表现出双支撑持续时间对称性的适应（P = 0.004），具体表现为基线与早期适应之间的趋势（P = 0.07）以及后效应（晚期适应与早期去适应相比，P = 0.09）。在行走过程中对摆动腿单侧施加阻力时，慢性中风患者在适应期表现出较低的摆动期持续时间CV（基线与适应相比，P = 0.006），并且与适应期相比，去适应期步态变异性增加的趋势（P = 0.099）。两种扰动方法之间的适应和去适应速率相似。我们的研究结果表明，慢性中风患者中枢神经系统中发生的学习过程可能取决于扰动的性质（机械阻力与分带），并且慢性中风患者能够适应两种类型的误差。
