Preserved motor skill learning in acute stroke patients
Preserved motor skill learning in acute stroke patients
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DOI：
10.1007/s13760-020-01304-7
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发表时间：
2020-04-01
影响因子：
2.7
通讯作者：
Vandermeeren, Yves
中科院分区：
文献类型：
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作者：
Baguma, Marius;Doost, Maral Yeganeh;Vandermeeren, Yves
急性中风期间的恢复是动态的，但在此恢复期间麻痹上肢（UL）是否能获得新的运动技能尚不清楚。澄清这个未知是重要的，因为神经康复在很大程度上依赖于运动学习。目的是调查在急性中风期间，患者是否通过麻痹UL实现了运动技能学习和保持。在连续3天（D1-D3），14名患者与他们的麻痹UL练习，运动技能学习任务与速度/准确性权衡（SAT）。学习指数（LI）用于量化与基线相比的标准化SAT变化。通过另一项无SAT限制的任务（EASY）、握力（GF）和方块测试（BBT）量化自发运动恢复。在患者中，TBI改善98% +/- 66.2（平均值+/- SD）。这一改善与年轻健康个体（n = 30）的改善相似，后者连续3天（83.8% +/- 58.8%）接受略微不同的方案训练。在两组中均观察到SAT增益泛化到未经训练的电路。从D1到D3，卒中患者在EASY上的表现有所改善，而GF和BBT的变化是异质的。在急性中风期间，患者保留了SAT增益的运动技能与轻瘫UL学习的方式类似的健康人。这些结果表明，急性卒中患者获得的运动技能学习和保持超过了由自发恢复解释的轻瘫UL改善。
Recovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor learning. The aim was to investigate whether, during acute stroke, patients achieved motor skill learning and retention with the paretic UL. Over 3 consecutive days (D1-D3), 14 patients practiced with their paretic UL the CIRCUIT, a motor skill learning task with a speed/accuracy trade-off (SAT). A Learning Index (LI) was used to quantify normalised SAT changes in comparison with baseline. Spontaneous motor recovery was quantified by another task without SAT constraint (EASY), by grip force (GF), and the Box and Blocks test (BBT). In patients, CIRCUIT LI improved 98% +/- 66.2 (mean +/- SD). This improvement was similar to that of young healthy individuals (n = 30) who trained with a slightly different protocol for 3 consecutive days (83.8% +/- 58.8%). Generalisation of SAT gains to an untrained circuit was observed in both groups. From D1 to D3, stroke patients improved their performance on EASY, while changes in GF and BBT were heterogeneous. During acute stroke, patients retained SAT gains for a motor skill learned with the paretic UL in a manner similar to that of healthy individuals. These results demonstrate acute stroke patients achieved motor skill learning and retention that exceeded paretic UL improvements explained by spontaneous recovery.