학술논문
Task Oriented Training Activities Post Stroke Will Produce Measurable Alterations in Brain Plasticity Concurrent with Skill Improvement.
Document Type
Academic Journal
Author
Rungseethanakul S; Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.; Tretriluxana J; Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.; Piriyaprasarth P; Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.; Pakaprot N; Faculty of Medicine Siriraj Hospital, Mahidol University, Wang Lang, Thailand.; Jitaree K; Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.; Tretriluxana S; Department of Electronics Engineering, School of Engineering, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand.; Danoff JV; Department of Exercise and Nutrition Science, George Washington University, Washington, DC, USA.
Source
Publisher: Taylor & Francis Country of Publication: England NLM ID: 9439750 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1945-5119 (Electronic) Linking ISSN: 10749357 NLM ISO Abbreviation: Top Stroke Rehabil Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Task-oriented training with upper extremity (UE) skilled movements has been established as a method to regain function post stroke. Although improved UE function has been shown after this type of therapy, there is minimal evidence that brain plasticity is associated with this training. The accelerated skill acquisition program (ASAP) is an example of an approach for promoting UE function using targeting movements.
Objective: To investigate the effects of a single 2-hour session of ASAP in individuals with stroke on measures of brain plasticity as represented by corticospinal excitability (CE) and determine associations with reach-to-grasp (RTG) performance.
Methods: Eighteen post-acute stroke patients were randomized to two groups. Experimental group (n = 9) underwent ASAP for 2 hours, while the control group (n = 9) received dose equivalent usual and customary care. Both groups were evaluated for CE and RTG performance prior to the session and then four times after training: immediately, 1 day, 6 days, and 12 days.
Results: Significant alterations in CE were found in the peak-to-peak of Motor Evoked Potential amplitude of elbow and wrist extensor muscles in the lesioned hemisphere. The experimental group also demonstrated improved execution (shortened total movement time, TMT), feed-forward mechanism (deceleration time, DT) and planning (lengthened relative time to maximum hand aperture, RTApmax) compared to the control group.
Conclusion: Alterations in brain plasticity occur concurrently with improvements in RTG performance in post-acute stroke patients with mild impairment after a single 2-hour session of task-oriented training and persist for at least 12 days.
Objective: To investigate the effects of a single 2-hour session of ASAP in individuals with stroke on measures of brain plasticity as represented by corticospinal excitability (CE) and determine associations with reach-to-grasp (RTG) performance.
Methods: Eighteen post-acute stroke patients were randomized to two groups. Experimental group (n = 9) underwent ASAP for 2 hours, while the control group (n = 9) received dose equivalent usual and customary care. Both groups were evaluated for CE and RTG performance prior to the session and then four times after training: immediately, 1 day, 6 days, and 12 days.
Results: Significant alterations in CE were found in the peak-to-peak of Motor Evoked Potential amplitude of elbow and wrist extensor muscles in the lesioned hemisphere. The experimental group also demonstrated improved execution (shortened total movement time, TMT), feed-forward mechanism (deceleration time, DT) and planning (lengthened relative time to maximum hand aperture, RTApmax) compared to the control group.
Conclusion: Alterations in brain plasticity occur concurrently with improvements in RTG performance in post-acute stroke patients with mild impairment after a single 2-hour session of task-oriented training and persist for at least 12 days.