Effect of sensory discrimination training on structure and function in patients with focal hand dystonia: A case series
Effect of sensory discrimination training on structure and function in patients with focal hand dystonia: A case series
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DOI：
10.1016/s0003-9993(03)00276-4
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发表时间：
2003-10-01
影响因子：
4.3
通讯作者：
McKenzie, L
中科院分区：
文献类型：
--
作者：
Byl, NN;Nagajaran, S;McKenzie, L
目的：观察基于神经可塑性原理的感觉运动训练对局灶性手肌张力障碍患者的治疗效果。设计：3名左手局灶性手肌张力障碍患者的病例系列，与年龄匹配的规范对照进行比较。单位：门诊。参与者：三个连续的临床患者-有局灶性手肌张力障碍的音乐家-描述了重复练习和演奏的历史（2名女性，年龄分别为23岁和35岁；1名男性，年龄为24岁）。干预：受试者被要求停止执行导致异常运动的任务，参加健康计划（有氧运动，姿势练习，压力徒手使用），并进行监督，参加，个性化，重复的感觉运动训练活动，每周至少一次，持续12周，每天在家中加强。主要结果测量：记录躯体感觉手部表征、目标特异性手部控制和临床功能的标准测试。结果：在患侧方面，3名被试手体感表现平均提高86.8%，目标特异性表现平均提高117%，精细运动技能平均提高23.9%，感觉辨别能力平均提高22.7%，肌肉骨骼技能平均提高31.9%，独立性平均提高32.3%。所有3名受试者在90%的子测试中提高了10%或更多，在50%的子测试中提高了20%。结论：有重复性手用史的局灶性手肌张力障碍患者可通过符合神经适应原则的个体化感觉运动训练改善皮质体感觉反应和临床运动功能。
Objective: To measure the effects of sensorimotor training based on the principles of neuroplasticity for patients with focal hand dystonia.Design: Case series of 3 subjects with focal hand dystonia of the left hand, compared with age-matched normative controls.Setting: Outpatient clinic.Participants: Three consecutive clinic patients-musicians with focal hand dystonia-who described a history of repetitive practice and performance (2 women; ages, 23y and 35y; 1 man; age, 24y).Intervention: Subjects were asked to stop performing the tasks that caused the abnormal movements, to participate in a wellness program (aerobics, postural exercises, stress free hand use), and to carry out supervised, attended, individualized, repetitive sensorimotor training activities at least once week for 12 weeks and reinforced daily at home.Main Outcome Measures: Standard tests documenting somatosensory hand representation, target-specific hand control, and clinical function.Results: On the affected side, the 3 subjects improved an average of 86.8% on somatosensory hand representation, 117% on target-specific performance, 23.9% on fine motor skills, 22.7% on sensory discrimination, 31.9% on musculoskeletal skills, and 32.3% on independence. All 3 subjects improved 10% or more on 90% of the subtests with 20% improvement on 50% of the subtests.Conclusion: Individuals with focal hand dystonia who have a history of repetitive hand use can improve cortical somatosensory responses and clinical motor function after individualized sensorimotor training consistent with the principles of neural adaptation.