Nonparetic Arm Force Does Not Overinhibit the Paretic Arm in Chronic Poststroke Hemiparesis
| Autor: | Erick Tarula, Sungyoung Auh, Leonardo G. Cohen, Michael A. Dimyan, Monica A. Perez, Matthew Wilson |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Article Physical medicine and rehabilitation Hand strength Task Performance and Analysis medicine Humans Contraindication Stroke Aged Retrospective Studies Paresis Aged 80 and over Hand Strength Rehabilitation Motor Cortex Stroke Rehabilitation Recovery of Function Middle Aged medicine.disease Exercise Therapy Transcranial magnetic stimulation Treatment Outcome Hemiparesis medicine.anatomical_structure Motor Skills Chronic Disease Arm Physical therapy Female medicine.symptom Primary motor cortex Psychology Follow-Up Studies Motor cortex |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 95:849-856 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2013.12.023 |
| Popis: | Objective To determine whether nonparetic arm force overinhibits the paretic arm in patients with chronic unilateral poststroke hemiparesis. Design Case-control neurophysiological and behavioral study of patients with chronic stroke. Setting Research institution. Participants Eighty-six referred patients were screened to enroll 9 participants (N=9) with a >6 month history of 1 unilateral ischemic infarct that resulted in arm hemiparesis with residual ability to produce 1Nm of wrist flexion torque and without contraindication to transcranial magnetic stimulation. Eight age- and handedness-matched healthy volunteers without neurologic diagnosis were studied for comparison. Interventions Not applicable. Main Outcome Measure Change in interhemispheric inhibition targeting the ipsilesional primary motor cortex (M1) during nonparetic arm force. We hypothesized that interhemispheric inhibition would increase more in healthy controls than in patients with hemiparesis. Results Healthy age-matched controls had significantly greater increases in inhibition from their active to resting M1 than patients with stroke from their active contralesional to resting ipsilesional M1 in the same scenario (20%±7% vs −1%±4%, F 1,12 =6.61, P =.025). Patients with greater increases in contralesional to ipsilesional inhibition were better performers on the 9-hole peg test of paretic arm function. Conclusions Our findings reveal that producing force with the nonparetic arm does not necessarily overinhibit the paretic arm. Though our study is limited in generalizability by the small sample size, we found that greater active contralesional to resting ipsilesional M1 inhibition was related with better recovery in this subset of patients with chronic poststroke. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|