Sensory Re-Education of the Hand after Stroke by Yekutiel Margaret in 2001
http://nnr.sagepub.com/content/26/7/881.abstract?etoc
Abstract
Background. Previous studies demonstrated a
posterior shift of activation toward the primary sensory cortex (S1)
following stroke; however,
any relationship between this posterior shift and
clinical outcome measures for the affected hand function were unclear. Objective. The authors investigated the possible role of S1 in motor recovery. Methods.
Assuming that previous studies examined inhomogeneous groups of
patients, the authors selected participants with chronic
stroke who had moderate hand paresis, normal
sensory examination and somatosensory-evoked potentials, and no lesion
within
the S1, thalamus, or brain stem. Constraint-induced
movement therapy (CIMT) was used to train the impaired hand. To relate
fMRI (functional MRI) activation changes from
baseline to post-CIMT, a correlation analysis was performed with changes
of
the Wolf Motor Function Test (WMFT) as a test for
the hand function. Results. A close relationship was found between increases in hand function and peak changes in activation within the ipsilesional
S1. With a better outcome, greater increases in activation within the S1 were evident (P < .03; r = 0.73). Conclusion.
In selected patients, the sensory network influences training-induced
motor gains. This predictive knowledge of plasticity
when applying CIMT may suggest strategies to
enhance the effect of therapy, such as the addition of electrical
stimulation
to enhance S1 excitability.
No comments:
Post a Comment