Rehabilitating Strength Perception After Stroke

描述（由申请人提供）：这项R03申请研究了中风后觉醒减少对力量和平衡的感知是如何改变的。在美国，中风每年影响60万患者。一半的中风患者对肢体力量的感知可能会发生改变。三分之一的中风患者在中风康复期间跌倒。摔倒与力量和平衡的改变有关。本研究的长期目标是通过治疗阻碍治疗进展并导致并发症的觉醒相关缺陷来改善卒中康复的结果。虽然右脑卒中后的忽视综合征已知与觉醒和感知改变有关，但本项目旨在表明力量和平衡感知改变比忽视更常见，即使在没有被忽视的患者中，觉醒缺陷也会使康复变得复杂。目的我将通过展示它们与功能限制的关系来验证改变的力量和平衡感知的结构。Aim II将通过使用热量刺激暂时增加中风患者的觉醒来测试觉醒改变、感知和功能之间的联系。Aim III研究在康复后3个月，对热刺激有反应能力的患者是否比无反应能力的患者有更好的功能结局。本研究旨在为使用觉醒增强药物治疗脑卒中患者康复期间知觉缺陷的药理学研究奠定基础。

DESCRIPTION (provided by applicant): This R03 application examines how perception of strength and balance is altered by decreased arousal following stroke. Stroke affects 600,000 patients annually in the United States. Perception of limb strength may be altered in half of all stroke patients. One-third of all stroke patients fall during stroke rehabilitation. Falling is related to altered strength and balance. The long term goal of this study is to improve the outcome of stroke rehabilitation by treating arousal-related deficits that impede progress in therapy and lead to complications. Whereas the neglect syndrome following right hemisphere stroke is known to be associated with altered arousal and perception, this project aims to show that altered perception of strength and balance is much more common than neglect and that rehabilitation is complicated by deficits in arousal even in patients without neglect. Aim I will validate the constructs of altered strength and balance perception by demonstrating their relationship to functional limitations. Aim II will test the link between altered arousal, perception and function by using caloric stimulation to temporarily increase arousal in stroke patients. Aim III examines whether patients with the capacity to respond to caloric stimulation have better functional outcomes three months after rehabilitation than those who do not. This research is intended to lay the ground-work for pharmacological studies that use arousal-enhancing medications to treat perceptual deficits in stroke patients during rehabilitation. This proposal aims to improve public health in the US by rehabilitating altered perception of contralateral limb strength following stroke. Altered perception of strength may be a significant contributor to poor participation and frustration in rehabilitation therapy and it increases the risk of orthopedic injury due to falls. Stroke affects 600,000 patients annually in the United States. Half of all stroke patients in rehabilitation may have altered strength perception. There is no pharmacological treatment at the present time.