Exercise-mediated locomotor recovery and lower-limb neuroplasticity after stroke
Exercise-mediated locomotor recovery and lower-limb neuroplasticity after stroke
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DOI：
10.1682/jrrd.2007.02.0034
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发表时间：
2008-01-01
影响因子：
--
通讯作者：
Luft, Andreas R.
中科院分区：
文献类型：
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作者：
Forrester, Larry W.;Wheaton, Lewis A.;Luft, Andreas R.
中风后数月内运动恢复平台的假设受到了新的运动学习康复疗法的挑战。下肢踏车（TM）运动的使用已有效地改善偏瘫步态功能。在这篇综述中，我们提供了一个基本原理，跑步机运动作为刺激中风后的运动再学习。最近的研究使用神经影像学和神经生理学的措施表明，中枢神经系统（CNS）对下肢运动控制和步态的影响。与上肢的研究一样，有证据表明，下肢可以引起快速短暂的CNS可塑性。短期轻瘫腿运动后观察到的这种效果表明TM运动的运动学习的潜在机制。初步干预研究提供的证据表明，长期TM运动可以介导CNS可塑性，这与改善步态功能有关。关键的需求是确定TM治疗的最佳时机和强度，以最大限度地提高可塑性和学习效果。
Assumptions that motor recovery plateaus within months after stroke are being challenged by advances in novel motor-learing-based rehabilitation therapies. The use of lower-limb treadmill (TM) exercise has been effective in improving hemiparetic gait function. In this review, we provide a rationale for treadmill exercise as stimulus for locomotor relearning after stroke. Recent studies using neuroimaging and neurophysiological measures demonstrate central nervous system (CNS) influences on lower-limb motor control and gait. As with studies of upper limbs, evidence shows that rapid transient CNS plasticity can be elicited in the lower limb. Such effects observed after short-term paretic leg exercises suggest potential mechanisms for motor learning with TM exercise. Initial intervention studies provide evidence that long-term TM exercise can mediate CNS plasticity, which is associated with improved gait function. Critical needs are to determine the optimal timing and intensities of TM therapy to maximize plasticity and learning effects.