Interlimb influences on paretic leg function in poststroke hemiparesis
Interlimb influences on paretic leg function in poststroke hemiparesis
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DOI：
10.1152/jn.00963.2004
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发表时间：
2005-05-01
影响因子：
2.5
通讯作者：
Patten, C
中科院分区：
文献类型：
--
作者：
Kautz, SA;Patten, C
中风后，麻痹性下肢运动障碍通常被视为单侧控制缺陷。然而，许多控制正常腿部功能的神经回路是双侧组织的，以在双腿中产生协调的、特定任务的活动。因此，作为对侧损伤神经控制过程的结果，在双侧下肢任务期间，麻痹腿运动模式的产生可能实质上受到非麻痹腿感觉运动状态的影响。因此，我们研究了在机械等效的双侧和单侧任务中是否观察到不同的麻痹腿运动模式，如果是这样，非麻痹腿参与是否改善或加剧了麻痹腿协调缺陷。一个踏板装置，机械解耦的腿被用来呈现科目越来越复杂的双向和单向运动任务：等距力的产生，离散运动，和踏板。收集了21名慢性卒中后轻偏瘫患者和11名年龄相仿的对照组的双侧肌电图和足力数据。在等长力量的产生和离散运动，非瘫痪腿的影响，瘫痪腿协调是相似的，没有显着不同的控制interlimbs的影响。然而，在双边踩踏板，interlimbs的影响不同于控制，使瘫痪腿协调赤字加剧。在踏板运动，抑制interlimb的影响类似于观察到的等距和离散运动可能会发生在控制，但可能会中断轻偏瘫。我们认为，耦合的模式产生之间的两条腿可能会导致更大的，虽然更受损，麻痹腿运动输出在双边踩踏板比在单边踩踏板。
After stroke, paretic leg motor impairment is typically viewed as a unilateral control deficit. However, much of the neural circuitry controlling normal leg function is organized bilaterally to produce coordinated, task-specific activity in the two legs. Thus, as a result of contralesional neural control processes, paretic leg motor pattern generation may be substantially influenced by the nonparetic leg sensorimotor state during bilateral lower limb tasks. Accordingly, we investigated whether different paretic leg motor patterns are observed during mechanically equivalent bilateral and unilateral tasks and, if so, whether nonparetic leg participation improved or exacerbated paretic leg coordination deficits. A pedaling apparatus that mechanically decoupled the legs was used to present subjects with increasingly complex bi- and unilateral motor tasks: isometric force generation, discrete movement, and pedaling. Bilateral electromyographic and pedal force data were collected from 21 persons with chronic poststroke hemiparesis and 11 similarly aged controls. During isometric force generation and discrete movements, nonparetic leg influences on paretic leg coordination were similar and not markedly different from interlimb influences in controls. In bilateral pedaling, however, interlimb influences differed from controls such that paretic leg coordination deficits were exacerbated. During pedaling movements, the suppression of interlimb influences similar to those observed in isometric and discrete movement may occur in controls but may be disrupted in hemiparesis. We suggest that the coupling of pattern generation between the two legs may result in greater, albeit more impaired, paretic leg motor output during bilateral pedaling than during unilateral pedaling.