Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke
Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke
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DOI：
10.1016/j.apmr.2007.08.001
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发表时间：
2007-11-01
影响因子：
4.3
通讯作者：
Cohen, Leonardo G.
中科院分区：
文献类型：
--
作者：
Celnik, Pablo;Hummel, Friedhelm;Cohen, Leonardo G.
首页--期刊主要分类--期刊细介绍--期刊题录与文摘--期刊详细文摘内容躯体感觉刺激增强慢性中风患者训练功能性手任务的效果。Arch Phys Med Rehabil 2007；88：1369-76.目的：检验躯体感觉刺激对慢性皮质下卒中患者训练后即刻和第一天后的手功能训练的效果的假设。设计：单盲、随机、交叉研究。地点：人类研究实验室。参与者：9名慢性皮质下卒中患者。干预：在训练前进行三次单独的运动训练：(1)同步周围神经刺激(PNS)，(2)无刺激，(3)异步PNS。主要结果：完成Jebsen-Taylor手功能测试(JTHFT时间)的时间和皮质运动兴奋性用经颅磁刺激测试在此期间，所有患者都达到了表现平台期，在三七总皂甙的作用下进行训练，使JTHFT的时间减少了10%，超出了熟悉后的平台期。伴随着这种行为获得的是GABA气体介导的运动皮质内抑制的特定减少。结论：体感刺激可能通过调节皮质内GABA能通路，增强慢性卒中患者功能性手任务的训练。
Celnik P, Hummel F, Harris-Love M, Wolk R, Cohen LG. Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke. Arch Phys Med Rehabil 2007;88:1369-76.Objective: To test the hypothesis that somatosensory stimulation would enhance the effects of training functional hand tasks immediately after practice and I day later in chronic subcortical stroke patients.Design: Single-blinded and randomized, crossover study.Setting: Human research laboratory.Participants: Nine chronic subcortical stroke patients.Interventions: Three separate sessions of motor training preceded by (1) synchronous peripheral nerve stimulation (PNS), (2) no stimulation, or (3) asynchronous PNS.Main Outcome Measures: Time to complete the Jebsen-Taylor Hand Function Test (JTHFT time) and corticomotor excitability tested with transcranial magnetic stimulation.Results: After familiarization practice, during which all patients reached a performance plateau, training under the effects of PNS reduced JTHFT time by 10% beyond the post-familiarization plateau. This behavioral gain was accompanied by a specific reduction in GABAergically mediated intracortical inhibition in the motor cortex. These findings were not observed after similar practice under the influence of no stimulation or asynchronous PNS sessions.Conclusions: Somatosensory stimulation may enhance the training of functional hand tasks in patients with chronic stroke, possibly through modulation of intracortical GABAergic pathways.