Increased motor variability facilitates motor learning in weight shift toward the paretic side during walking in individuals post-stroke.
Increased motor variability facilitates motor learning in weight shift toward the paretic side during walking in individuals post-stroke.
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运动变异性的增加有助于中风后个体在行走过程中重心向麻痹侧转移的运动学习。
DOI：
10.1111/ejn.15212
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Wu,Ming
中科院分区：
文献类型：
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作者：
Park,SeoungHoon;Hsu,Chao-Jung;Lin,Jui-Te;Dee,Weena;Roth,ElliotJ;Rymer,WilliamZ;Wu,Ming
本研究的目的是确定中风幸存者行走时向麻痹侧施加“变化”或恒定的骨盆辅助力是否会在短期内改善向麻痹侧的体重转移。12名中风后患者（60.4±6.2岁，步态速度：0.53±0.19 m/s）在两种条件下（变化与恒定）进行了测试。每种情况都在一个单独的阶段进行，包括：(a)无辅助力的跑步机行走1分钟（基线），骨盆向左侧辅助行走9分钟（适应），然后再无辅助力行走1分钟（适应后），以及(b)地上行走。在“变化”条件下，力的大小在预定量的30%到100%之间随机变化。在突变条件下，力的大小保持在预定量的100%不变。从基线到适应后后期，受试者在体重向轻瘫侧移动（p< 0.01）和轻瘫腿的足底屈肌和髋内收肌的肌肉活动（p= 0.02）方面表现出比恒定条件下更大的改善。基线时骨盆峰值位移的运动变异性与变化条件（R2= 0.64,p= 0.01）和恒定条件（R2= 0.39,p= 0.03）训练后体重向轻侧移动的改善相关。这些发现表明，通过应用不同的骨盆辅助引起的运动变异性的增加，可能促进中风后个体行走时体重转移和步态对称的运动学习。
The purpose of this study was to determine whether applying “varied” versus constant pelvis assistance force mediolaterally toward the paretic side of stroke survivors during walking would result in short‐term improvement in weight shift toward the paretic side. Twelve individuals post‐stroke (60.4 ± 6.2 years; gait speed: 0.53 ± 0.19 m/s) were tested under two conditions (varied vs. constant). Each condition was conducted in a single separate session, which consisted of (a) treadmill walking with no assistance force for 1 min (baseline), pelvis assistance toward the paretic side for 9 min (adaptation), and then no force for additional 1 min (post‐adaptation), and (b) overground walking. In the “varied” condition, the magnitude of force was randomly changed across steps between 30% and 100% of the predetermined amount. In the abrupt condition, the magnitude of force was kept constant at 100% of the predetermined amount. Participants exhibited greater improvements in weight shift toward the paretic side (p< 0.01) and in muscle activity of plantar flexors and hip adductors of the paretic leg (p= 0.02) from baseline to late post‐adaptation period for the varied condition than for the constant condition. Motor variability of the peak pelvis displacement at baseline was correlated with improvement in weight shift toward the paretic side after training for the varied (R2= 0.64,p= 0.01) and the constant condition (R2= 0.39,p= 0.03). These findings suggest that increased motor variability, induced by applying the varied pelvis assistance, may facilitate motor learning in weight shift and gait symmetry during walking in individuals post‐stroke.