Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke.
Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke.
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DOI：
10.1177/1545968315606990
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发表时间：
2016-07
影响因子：
4.2
通讯作者：
Schweighofer N
中科院分区：
文献类型：
--
作者：
Park H;Kim S;Winstein CJ;Gordon J;Schweighofer N
先前的研究表明，多次REACH训练可以长期改善中风后患者的运动时间和平稳性。然而，这种长期的训练方案往往很难在实际的临床环境中实施。在这里，我们评估了16名慢性卒中患者和轻中度损伤患者的短期强化REACH训练的长期和泛化效果。参与者进行了两次无人协助的强化REACH训练，每次600个动作，并在每个动作后显示基于表现的反馈。参与者的躯干被皮带绑住，以避免补偿性运动。训练使运动时间(平均20.4%)和运动流畅度(平均22.7%)有显著和持久的改善(1个月)。最大的改善发生在最初运动障碍最大的人身上。此外，培训导致对未经培训的目标进行概括，这在1天和1个月的保持测试中持续存在。最后，盒子和区块测试从基线到1个月的保留测试有了显著的改善(平均23%)。因此，短时间和高强度的REACH训练可以为慢性中风和轻度至中度损伤的患者带来普遍和持久的好处。
Previous studies have shown that multiple sessions of reach training lead to long-term improvements in movement time and smoothness in individuals post-stroke. Yet, such long-term training regimens are often difficult to implement in actual clinical settings. Here, we evaluated the long-term and generalization effects of short-duration and intensive reach training in 16 individuals with chronic stroke and mild to moderate impairments. Participants performed two sessions of unassisted intensive reach training, with 600 movements per session, and with display of performance-based feedback after each movement. The participants’ trunks were restrained with a belt to avoid compensatory movements. Training resulted in significant and durable (1-month) improvements in movement time (20.4% on average) and movement smoothness (22.7% on average). The largest improvements occurred in individuals with the largest initial motor impairments. In addition, training induced generalization to non-trained targets, which persisted in 1-day and in 1-month retention tests. Finally, there was a significant improvement in the Box and Block test from baseline to 1-month retention test (23% on average). Thus, short-duration and intensive reach training can lead to generalized and durable benefits in individuals with chronic stroke and mild to moderate impairments.