Does exposure to startle impact voluntary reaching movements in individuals with severe-to-moderate stroke?
Does exposure to startle impact voluntary reaching movements in individuals with severe-to-moderate stroke?
复制标题
DOI：
10.1007/s00221-020-06005-4
复制
发表时间：
2021-03
影响因子：
2
通讯作者：
Honeycutt CF
中科院分区：
文献类型：
--
作者：
Rahimi M;Swann Z;Honeycutt CF
当中风患者的运动是由惊人的声刺激（SAS）引起时，到达运动更快，更远，并且直接远离身体。然而，这些惊吓引起的运动也会引起与任务不相称的屈肌活动，这引起了人们的关注，即长期暴露于惊吓也可能会在自愿引起的运动中引起高度的屈肌活动。本研究的目的是评估惊吓暴露对中重度脑卒中患者点对点接触时自主运动的影响。我们假设惊吓暴露会增加屈肌中任务不适当的活动，这将与较差的自愿开始到达性能（例如距离，位移和最终准确性降低）有关。11例中重度脑卒中患者（ufm = 8-41/66, MAS = 0-4/4）进行了自愿点对点接触，其中1/3的试验由SAS诱导。我们使用肌电图测量肱桡肌（BR）、肱二头肌（BIC）、肱三头肌外侧头（TRI）、胸肌（PEC）、前三角肌（AD）和后三角肌（PD）的活动。与我们的假设相反，暴露于惊吓并没有增加异常屈曲，而是肘关节屈肌和肩部水平内收肌的拮抗剂活性降低，这表明异常的屈肌/伸肌共同收缩减少了。屈曲度的减少导致在训练结束时，到达距离增加（增加18.2%），运动开始（加快8.6%）和最终准确度（提高16.1%）。这项研究提供了第一个证据，表明在iwS中暴露于惊吓不会对自主运动产生负面影响；此外，暴露可以通过减少异常屈曲活动来改善意志激活的伸展运动。
When movements of individuals with stroke (iwS) are elicited by startling acoustic stimulus (SAS), reaching movements are faster, further, and directed away from the body. However, these startle-evoked movements also elicit task-inappropriate flexor activity, raising concerns that chronic exposure to startle might also induce heightened flexor activity during voluntarily elicited movement. The objective of this study is to evaluate the impact of startle exposure on voluntary movements during point-to-point reaching in individuals with moderate and severe stroke. We hypothesize that startle exposure will increase task-inappropriate activity in flexor muscles, which will be associated with worse voluntarily initiated reaching performance (e.g. decreased distance, displacement, and final accuracy). Eleven individuals with moderate-to-severe stroke (UEFM = 8–41/66 and MAS = 0–4/4) performed voluntary point-to-point reaching with 1/3 of trials elicited by an SAS. We used electromyography to measure activity in brachioradialis (BR), biceps (BIC), triceps lateral head (TRI), pectoralis (PEC), anterior deltoid (AD), and posterior deltoid (PD). Conversely to our hypothesis, exposure to startle did not increase abnormal flexion but rather antagonist activity in the elbow flexors and shoulder horizontal adductors decreased, suggesting that abnormal flexor/extensor co-contraction was reduced. This reduction of flexion led to increased reaching distance (18.2% farther), movement onset (8.6% faster), and final accuracy (16.1% more accurate) by the end of the session. This study offers the first evidence that exposure to startle in iwS does not negatively impact voluntary movement; moreover, exposure may improve volitionally activated reaching movements by decreasing abnormal flexion activity.
登录
查看更多内容
影响因子：
5.1
作者：
Ellis MD;Lan Y;Yao J;Dewald JP
通讯作者：
Dewald JP
影响因子：
1.4
作者：
Carlsen, AN;Chua, R;Franks, IM
通讯作者：
Franks, IM
影响因子：
4.7
作者：
Castellote, J. M.;Valls-Sole, J.
通讯作者：
Valls-Sole, J.
DOI：
10.1016/s0003-9993(99)90225-3
发表时间：
1999-07-01
影响因子：
4.3
作者：
Beer, RF;Given, JD;Dewald, JPA
通讯作者：
Dewald, JPA
影响因子：
2.5
作者：
Ellis, Michael D.;Drogos, Justin;Dewald, Julius P. A.
通讯作者：
Dewald, Julius P. A.