Comparison of finger tracking versus simple movement training via telerehabilitation to alter hand function and cortical reorganization after stroke
Comparison of finger tracking versus simple movement training via telerehabilitation to alter hand function and cortical reorganization after stroke
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DOI：
10.1177/1545968306292381
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发表时间：
2007-05-01
影响因子：
4.2
通讯作者：
Lewis, Scott M.
中科院分区：
文献类型：
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作者：
Carey, James R.;Durfee, William K.;Lewis, Scott M.
目标。比较两种远程康复训练策略，重复跟踪运动与重复简单运动，以促进脑重组和手功能的恢复。方法：研究方法。20名慢性中风患者和10度自愿伸指的受试者被随机分配接受1800次远程康复试验，为期2周，要么接受计算机化的跟踪训练(跟踪组)，涉及到时间空间加工，以达到准确性；要么接受不考虑准确性的运动训练(移动组)。在运动训练之后，运动组交叉接受另外两周的跟踪训练。通过Box and Block测试、Jebsen Taylor测试和手指活动范围测量行为变化，并在fMRI期间使用手指跟踪激活范例。结果。Track组在所有4项行为测试中都有显著改善；Move组在Box、Block和Jebsen Taylor测试中有所改善。在Box and Block和Jebsen Taylor测试中，轨迹组的改进没有超过移动组。大脑重组的一致群体模式并不明显。MOVE组在交叉后没有显示出进一步的显著改善。结论。远程康复治疗可能在改善慢性中风患者的运动能力方面有效。然而，加强跟踪训练以加强学习，并不比相同数量的随机动作的练习产生明显的优势。两周的训练可能不足以证明行为优势和相关的大脑重组。
Objective. To compare 2 telerehabilitation training strategies, repetitive tracking movements versus repetitive simple movements, to promote brain reorganization and recovery of hand function. Methods. Twenty subjects with chronic stroke and 10 degrees of voluntary finger extension were randomly assigned to receive 1800 telerehabilitation trials over 2 weeks of either computerized tracking training (track group) with the affected finger and wrist involving temporospatial processing to achieve accuracy or movement training (move group) with no attention to accuracy. Following movement training, the move group crossed over to receive an additional 2 weeks of tracking training. Behavioral changes were measured with the Box and Block test, Jebsen Taylor test, and finger range of motion, along with a finger-tracking activation paradigm during fMRI. Results. The track group showed significant improvement in all 4 behavioral tests; the move group improved in the Box and Block and Jebsen Taylor tests. The improvement for the track group in the Box and Block and Jebsen Taylor tests did not surpass that for the move group. A consistent group pattern of brain reorganization was not evident. The move group, after crossing over, did not show further significant improvements. Conclusion. Telerehabilitation may be effective in improving performance in subjects with chronic stroke. Tracking training with reinforcement to enhance learning, however, did not produce a clear advantage over the same amount of practice of random movements. Two weeks of training may be insufficient to demonstrate a behavioral advantage and associated brain reorganization.