Shoulder abduction-induced reductions in reaching work area following hemiparetic stroke: neuroscientific implications
Shoulder abduction-induced reductions in reaching work area following hemiparetic stroke: neuroscientific implications
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DOI：
10.1007/s00221-007-1029-6
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发表时间：
2007-11-01
影响因子：
2
通讯作者：
Dewald, Julius P. A.
中科院分区：
文献类型：
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作者：
Sukal, Theresa M.;Ellis, Michael D.;Dewald, Julius P. A.
假设脑卒中相关的皮质脊髓和皮质延髓通路的丧失导致剩余神经基质（如球脊髓通路）的使用增加，因为脑卒中患者需要产生更大的自主肩外展扭矩。使用手臂协调训练3-D（ACT（3D））设备测量了18名中风患者肩外展对上肢活动范围（工作区）的影响。该机器人系统能够在受试者尝试到达时量化运动学，同时产生各种水平的主动肩外展扭矩。我们提供的数据表明，肘关节屈曲的异常耦合的增量增加，导致有效工作面积减少，作为主动肢体支撑的功能，在麻痹肢体的肩外展水平更高。肩/肘耦合异常表达的逐渐增加可以解释为对间接皮质-延髓脊髓连接的逐渐依赖，这些连接在卒中诱导的脑损伤后仍存在于个体中。
A stroke-related loss of corticospinal and corticobulbar pathways is postulated to result in an increased use of remaining neural substrates such as bulbospinal pathways as individuals with stroke are required to generate greater volitional shoulder abduction torques. The effect of shoulder abduction on upper extremity reaching range of motion (work area) was measured in 18 individuals with stroke using the Arm Coordination Training 3-D (ACT(3D)) device. This robotic system is capable of quantifying movement kinematics when a subject attempts to reach while simultaneously generating various levels of active shoulder abduction torque. We have provided data demonstrating an incremental increase of abnormal coupling of elbow flexion for greater levels of shoulder abduction in the paretic limb that results in a reduction in available work area as a function of active limb support. The progressive increase in the expression of abnormal shoulder/elbow coupling can be explained by a progressive reliance on the indirect cortico-bulbospinal connections that remain in individuals following a stroke-induced brain injury.