Enhanced error facilitates motor learning in weight shift and increases use of the paretic leg during walking at chronic stage after stroke.
Enhanced error facilitates motor learning in weight shift and increases use of the paretic leg during walking at chronic stage after stroke.
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DOI：
10.1007/s00221-021-06202-9
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发表时间：
2021-11
影响因子：
2
通讯作者：
Wu M
中科院分区：
文献类型：
--
作者：
Park SH;Hsu CJ;Dee W;Roth EJ;Rymer WZ;Wu M
本研究的目的是确定在中风幸存者中，在瘫痪腿的站立阶段，向非瘫痪侧施加横向骨盆拉力是否会增强瘫痪腿的强制使用，并增加中风幸存者的体重向瘫痪侧的转移。 11 名慢性中风幸存者参加了两次实验，其中包括 1）应用“骨盆阻力”或“骨盆辅助”的跑步机行走和 2）地面行走。在跑步机行走过程中，在瘫痪腿的站立阶段向非瘫痪侧施加横向拉力以实现“骨盆阻力”条件，或者在瘫痪腿的站立阶段向瘫痪侧施加“骨盆辅助”条件。力释放后，与“骨盆辅助”条件相比，“骨盆阻力”条件对髋部 ABD、ADD 和 SOL 的肌肉激活有更大的增强，并且对偏瘫侧的侧向重量转移有更大的改善（P<0.03）。这种侧向重量转移的改善与髋部 ABD 和 ADD 的肌肉激活增强相关（R2=0.67，P=0.01）。在跑步机行走 10 分钟后测量时，骨盆阻力状况还改善了地面行走速度和站立相位对称性（P=0.004）。总之，施加骨盆阻力来增加误差信号可能会促进体重向偏瘫侧转移的运动学习，并增强慢性中风幸存者对偏瘫腿的使用。这项研究的结果可用于开发一种干预方法来改善中风幸存者的行走能力。
The purpose of this study was to determine whether the application of lateral pelvis pulling force toward the non-paretic side during the stance phase of the paretic leg would enhance forced use of the paretic leg and increase weight shift toward the paretic side in stroke survivors. Eleven chronic stroke survivors participated in two experimental sessions, which consisted of 1) treadmill walking with the application of “pelvis resistance” or “pelvis assistance” and 2) overground walking. During the treadmill walking, the laterally pulling force was applied during the stance phase of the paretic leg toward the non-paretic side for the “pelvis resistance” condition or toward the paretic side for the “pelvis assistance” condition during the stance phase of the paretic leg. After force release, the “pelvis resistance” condition exhibited greater enhancement in muscle activation of hip ABD, ADD, and SOL and greater improvement in lateral weight shift toward the paretic side, compared with the effect of the “pelvis assistance” condition (P<0.03). This improved lateral weight shift was associated with the enhanced muscle activation of hip ABD and ADD (R2=0.67, P=0.01). The pelvis resistance condition also improved overground walking speed and stance phase symmetry when measured 10-min after the treadmill walking (P=0.004). In conclusion, applying pelvis resistance forces to increase error signals may facilitate motor learning of weight shift toward the paretic side and enhance use of the paretic leg in chronic stroke survivors. Results from this study may be utilized to develop an intervention approach to improve walking in stroke survivors.
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影响因子：
2.5
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