Mixed slip-trip perturbation training for improving reactive responses in people with chronic stroke
Mixed slip-trip perturbation training for improving reactive responses in people with chronic stroke
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DOI：
10.1152/jn.00671.2019
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发表时间：
2020-07-01
影响因子：
2.5
通讯作者：
Bhatt, Tanvi
中科院分区：
文献类型：
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作者：
Dusane, Shamali;Bhatt, Tanvi
本研究确定了混合（滑倒和绊倒样姿态扰动）训练对慢性中风（PwCS）患者反应性反应的影响，并检查了他们对高强度扰动posttraining（缩放）的反应性反应的调制。12个PwCS暴露于连续块的基于milly-based滑动和旅行样扰动和混合姿态扰动。高强度的试验提供后块和后混合训练。检查姿势稳定性[质心位置（CoMP）和速度（CoMV）]、代偿步长、步数和躯干角度。PwCS表现出CoM的前向定位，增加步长，减少代偿性步数（P < 0.05）。类似旅行的阻滞训练导致步数、步长和躯干角度减少（P < 0.05），但CoMP保持不变（P < 0.05）。在混合训练中，滑动样扰动的步长减少而不是增加，但在旅行样扰动中观察到步长和躯干角度持续减少（P < 0.05）;然而，CoMP和步数两者均保持不变。对于两种扰动，较高强度试验与最后一次区组试验相比无变化。后混合块，更高的强度试验表明，增加只在步数上的旅行样扰动。在阻滞后和混合后高强度试验之间，仅注意到滑动样扰动的步数增加和步长减少。与滑和绊倒样的立场扰动块训练可以提高反应PWCS之间的反应。虽然混合扰动训练继续改善跳闸引起的适应，以前的滑引起的自适应变化没有保持和进一步的滑适应没有看到。PwCS显示了反应性反应postblock和postmixed training.NEW & NOTEWORTHY块扰动训练的部分缩放导致了良好的反应性反应的发展，以抵消慢性中风患者中基于milling，slip样和trip样的站立扰动。在混合块，以前获得的自适应变化的反应性反应，从滑块训练没有保持，可能是由于干扰提供的跳闸块。相反，在旅行样的扰动，旅行块诱导的适应保持，并继续显示出进一步的改善。我们的研究结果可能为设计有效的混合扰动训练范式以抵消两种相反的扰动类型提供未来的方向。
This study determined the effect of mixed (slip- and trip-like stance perturbation) training on reactive responses in people with chronic stroke (PwCS) and examined modulation of their reactive responses on higher intensity perturbation sposttraining (scaling). Twelve PwCS were exposed to consecutive blocks of treadmill-based slip-like and trip-like perturbations and mixed-stance perturbations. A higher intensity trial was provided postblock and postmixed training. Postural stability [center-of-mass position (CoMP) and velocity (CoMV)], compensatory step length, step count, and trunk angle were examined. PwCS demonstrated an anterior positioning of the CoM, increased step length, and reduced compensatory step count with slip-like block training (P < 0.05). Trip-like block training resulted in reductions in step count, step length, and trunk angle (P < 0.05); however, CoMP remained unchanged (P < 0.05). With mixed training, there was a decrease rather than an increase in step length for slip-like perturbations but a continued decrease in step length and trunk angle was seen on trip-like perturbations (P < 0.05); however, CoMP and step count remained unchanged for both. For both perturbations, the higher intensity trials demonstrated no change from the last block trial. Postmixed block, the higher intensity trial demonstrated an increase only in step count on trip-like perturbation. Between postblock and postmixed higher intensity trials, an increase in step count and decrease in step length was noted only for slip-like perturbations. Block training with slip- and trip-like stance perturbations can enhance reactive responses among PwCS. Although mixed perturbation training continued to improve trip-induced adaptation, prior slip-induced adaptive changes were not maintained and further slip-adaptation was not seen. PwCS demonstrated partial scaling of reactive responses postblock and postmixed training.NEW & NOTEWORTHY Block perturbation training led to development of favorable reactive responses to counteract treadmill-based, slip-like and trip-like stance perturbations among people with chronic stroke. During mixed block, previously acquired adaptive changes in reactive responses from slip-block training were not maintained, probably due to interference offered by trip block. Instead, on trip-like perturbations, trip block-induced adaptation was maintained and continued to show further improvement. Our findings might provide future direction for designing effective mixed perturbation training paradigms to counteract both opposing perturbation types.