Vibration training after chronic spinal cord injury: Evidence for persistent segmental plasticity.
Vibration training after chronic spinal cord injury: Evidence for persistent segmental plasticity.
复制标题
慢性脊髓损伤后的振动训练：持续节段可塑性的证据。
DOI：
10.1016/j.neulet.2017.03.019
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发表时间：
2017
影响因子：
2.5
通讯作者：
Shields,RichardK
中科院分区：
文献类型：
--
作者：
Yen,Chu-Ling;McHenry,ColleenL;Petrie,MichaelA;Dudley-Javoroski,Shauna;Shields,RichardK
H反射成对脉冲抑制在SCI后的第一年内逐渐消失，这一过程被认为反映了正常下行（皮层）抑制消失后节段性中间神经元的重组。这种重组随着不自主痉挛和痉挛状态的发展而及时变化。本研究的目的是确定长期振动训练是否可以启动慢性完全性SCI患者H反射双脉冲抑制的恢复。五名SCI患者在轮椅上接受每周两次的振动训练（30 Hz，0.6g）。对侧肢体作为受试者内对照。配对脉冲H-反射之前，期间和之后的振动会议。未经训练的肢体H反射抑制值与以前报告的慢性SCI值相当。相比之下，所有5名参与者的训练肢体显示抑郁值在先前报告的急性SCI和非SCI H反射抑郁范围内。肢体之间的平均差异为34.98%（p = 0.016）。H反射抑制恢复的证据表明，即使对于长期SCI的人来说，可塑性仍然存在于节段性反射通路中。因此，与痉挛临床表现相关的脊髓网络可能在长期SCI后保持适应性可塑性。这项研究的结果表明，振动训练可能持有承诺作为一种抗痉挛康复干预。
H-reflex paired-pulse depression is gradually lost within the first year post-SCI, a process believed to reflect reorganization of segmental interneurons after the loss of normal descending (cortical) inhibition. This reorganization co-varies in time with the development of involuntary spasms and spasticity. The purpose of this study is to determine whether long-term vibration training may initiate the return of H-reflex paired-pulse depression in individuals with chronic, complete SCI. Five men with SCI received twice-weekly vibration training (30 Hz, 0.6g) to one lower limb while seated in a wheelchair. The contra-lateral limb served as a within-subject control. Paired-pulse H-reflexes were obtained before, during, and after a session of vibration. Untrained limb H-reflex depression values were comparable to chronic SCI values from previous reports. In contrast, the trained limbs of all 5 participants showed depression values that were within the range of previously-reported Acute SCI and Non-SCI H-reflex depression. The average difference between limbs was 34.98% (p = 0.016). This evidence for the return of H-reflex depression suggests that even for people with long-standing SCI, plasticity persists in segmental reflex pathways. The spinal networks involved with the clinical manifestation of spasticity may thus retain adaptive plasticity after long-term SCI. The results of this study indicate that vibration training may hold promise as an anti-spasticity rehabilitation intervention.