Shoulder and hand displacements during hitting, reaching, and grasping movements in hemiparetic cerebral palsy.
Shoulder and hand displacements during hitting, reaching, and grasping movements in hemiparetic cerebral palsy.
复制标题
偏瘫脑瘫患者击打、伸手和抓握动作时肩部和手部的移位。
DOI：
10.1123/mcj.5.2.166
复制
发表时间：
2001
期刊：
影响因子：
1.1
通讯作者：
Bert Steenbergen
中科院分区：
文献类型：
--
作者：
Edwin Van Thiel;Bert Steenbergen
在这项研究中，我们检查了患有偏瘫性脑瘫的年轻人在击球、伸手和抓握运动中肩膀移位的程度和时间。参与者对不同大小的目标和物体进行单手和双手的手臂运动。假设由于躯干平移和旋转导致的肩部移位是受影响手臂关节活动度降低的成功适应性反应，在肩部移位变化的情况下，手部移位的流畅性预计将保持不变，健康参与者的情况也是如此。结果指向了这个方向。关于肩关节移位的时间，先前的研究表明，偏瘫运动的特征是不一致的运动时间模式——也就是说，在不同的试验中，肩关节和手关节移位的时间是不同的。因此，手部和同侧肩膀位移之间的运动开始的异步的受试者内部变异性预计在受损侧比在未受损侧更大。这一预测没有得到证实，这对之前的结论提出了挑战。此外，我们还检查了手和肩膀的峰值速度不同步。与开始非同步性相反，峰值非同步性在击中和到达任务之间以及在击中和抓取任务之间存在差异。在伸手和抓握任务上，手与手之间也存在显著差异。同样，与未受损的手相比，受损手的（峰值速度）不同步的可变性并没有显著增加。结果表明，偏瘫参与者能够灵活地招募和排序成功完成任务所需的各种程度的受损侧的自由，尽管在不同的大小和排序不同。
In this study, we examined the degree and timing of shoulder displacements during hitting, reaching, and grasping movements performed by young adults with hemiparetic cerebral palsy. The participants performed unimanual and bimanual arm movements towards targets and objects of different sizes. On the basis of the assumption that shoulder displacement due to trunk translation and rotation is a successful adaptive reaction to reduced joint mobility in the affected arm, the fluency of hand displacements was expected to remain invariant under variations of shoulder displacement as is also the case in healthy participants. The results point in this direction. With respect to the timing of shoulder displacement, prior research suggested that hemiparetic movements can be characterized by inconsistent motion-timing patterns-that is, the timing of the of shoulder and hand-displacement onsets varied between trials. Therefore, the within-subject variability of the movement-onset asynchrony between hand and ipsilateral shoulder displacement was expected to be larger on the impaired side than on the unimpaired side. This prediction was not confirmed, which challenges these earlier conclusions. Additionally, we also examined the peak-velocity asynchrony of the hand and shoulder. Contrary to the onset asynchrony, the peak asynchrony varied between the hitting and reaching task and between the hitting and grasping task. For the reaching and grasping tasks, there were also significant differences between hands. Again, variability of the (peak-velocity) asynchrony was not significantly increased when comparing the impaired hand with the unimpaired hand. The results suggests that the hemiparetic participants were capable of flexibly recruiting and sequencing the various degrees of freedom of their impaired side required for successful task completion, albeit in different magnitudes and sequenced differently.