Training of isometric force tracking to improve motor control of the wrist after incomplete spinal cord injury: a case study.

Autor: Bisson JA; Department of Physical Therapy and Rehabilitation Science, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA., Dupre JR; Department of Physical Therapy and Rehabilitation Science, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA., DeJong SL; Department of Physical Therapy and Rehabilitation Science, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Jazyk: angličtina
Zdroj: Physiotherapy theory and practice [Physiother Theory Pract] 2023 Aug 03; Vol. 39 (8), pp. 1777-1788. Date of Electronic Publication: 2022 Mar 14.
DOI: 10.1080/09593985.2022.2049405
Abstrakt: Objective: Upper limb function is a high priority for people with cervical spinal cord injury (SCI). This case report describes an application of technology to activate spared neural pathways and improve wrist motor control.
Case Description: A 73-year-old man with chronic incomplete C5 SCI completed 24 training sessions over 92 days. Each session included 2 maximal contractions, 6 test trials, and 10 training trials of a visuomotor force tracking task. The participant attempted to match a sinusoidal target force curve, using isometric wrist flexor and extensor contractions. Electromyography (EMG) and force signals were recorded.
Outcomes: Errors were elevated initially and improved with training, similarly during extension and flexion phases of the force tracking task. Improvement in both phases was associated with greater flexor activation in flexion phases and greater extensor relaxation in flexion phases. Errors were not related to EMG modulation during the extensor phases. Small improvements in active range of motion, grip force, spasticity, touch sensation, and corticospinal excitability were also observed.
Conclusions: Motor skill training improved motor control after incomplete SCI, within the range of residual force production capacity. Performance gains were associated with specific adjustments in muscle activation and relaxation, and increased corticospinal excitability.
Databáze: MEDLINE
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