Lim Hyosok, Yan Shijun, Dee Weena, Pech Velarie, Hameeduddin Iram, Roth Elliot J, Rymer William Z, Wu Ming
Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA.
Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
Eur J Neurosci. 2024 Sep;60(6):5249-5265. doi: 10.1111/ejn.16507. Epub 2024 Aug 14.
Motor interference, where new skill acquisition disrupts the performance of a previously learned skill, is a critical yet underexplored factor in gait rehabilitation post-stroke. This study investigates the interference effects of two different practice schedules, applying interleaved (ABA condition) and intermittent (A-A condition) pulling force to the pelvis during treadmill walking, on lateral pelvis shifting towards the paretic leg in individuals with stroke. Task A involved applying resistive pelvis force (pulling towards the non-paretic side), and Task B applied assistive force (pulling towards the paretic side) at the stance phase of the paretic leg during walking. Sixteen individuals with chronic stroke were tested for gait pattern changes, including lateral pelvis shifting and spatiotemporal gait parameters, and neurophysiological changes, including muscle activity in the paretic leg and beta band absolute power in the lesioned cortical areas. A-A condition demonstrated increased lateral pelvis shifting towards the paretic side, extended paretic stance time and longer non-paretic step length after force release while ABA condition did not show any changes. These changes in gait pattern after A-A condition were accompanied by increased muscle activities of the ankle plantarflexors, and hip adductors/abductors. A-A condition demonstrated greater changes in beta band power in the sensorimotor regions compared to ABA condition. These findings suggest that while walking practice with external force to the pelvis can improve lateral pelvis shifting towards the paretic leg post-stroke, practicing a new pelvis shifting task in close succession may hinder the performance of a previously obtained lateral pelvis shifting pattern during walking.
运动干扰是指新技能的习得会干扰先前所学技能的表现，这是中风后步态康复中一个关键但尚未充分探索的因素。本研究调查了两种不同练习方案的干扰效果，即在跑步机行走过程中对骨盆施加交错式（ABA条件）和间歇性（A-A条件）拉力，对中风患者向患侧腿侧方骨盆移位的影响。任务A包括在行走过程中对患侧腿的支撑期施加抵抗性骨盆力（拉向非患侧），任务B施加辅助力（拉向患侧）。对16名慢性中风患者进行了步态模式变化测试，包括侧方骨盆移位和时空步态参数，以及神经生理学变化测试，包括患侧腿的肌肉活动和受损皮质区域的β波段绝对功率。A-A条件下，在力释放后，向患侧的侧方骨盆移位增加，患侧支撑时间延长，非患侧步长变长，而ABA条件下未显示任何变化。A-A条件下这些步态模式的变化伴随着踝关节跖屈肌、髋内收肌/外展肌肌肉活动的增加。与ABA条件相比，A-A条件下感觉运动区域的β波段功率变化更大。这些发现表明，虽然在骨盆上施加外力进行行走练习可以改善中风后患侧腿的侧方骨盆移位，但连续练习新的骨盆移位任务可能会阻碍在行走过程中先前获得的侧方骨盆移位模式的表现。
