Rest the brain to learn new gait patterns after stroke.

IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Journal of NeuroEngineering and Rehabilitation Pub Date : 2024-10-29 DOI:10.1186/s12984-024-01494-8
Chandramouli Krishnan, Thomas E Augenstein, Edward S Claflin, Courtney R Hemsley, Edward P Washabaugh, Rajiv Ranganathan
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Abstract

Background: The ability to relearn a lost skill is critical to motor recovery after a stroke. Previous studies indicate that stroke typically affects the processes underlying motor control and execution but not the learning of those skills. However, these studies could be confounded by the presence of significant motor impairments. Furthermore, prior research involving the upper extremity indicates that stroke survivors have an advantage in offline motor learning when compared with controls. However, this has not been examined using motor acuity tasks (i.e., tasks focusing on the quality of executed actions) that have direct functional relevance to rehabilitation.

Objective: Investigate how stroke affects leg motor skill learning during walking in stroke survivors.

Methods: Twenty-five participants (10 stroke; 15 controls) were recruited for this prospective, case-control study. Participants learned a novel foot-trajectory tracking task on two consecutive days while walking on a treadmill. The task necessitated greater hip and knee flexion during the swing phase of the gait. Online learning was measured by comparing tracking error at the beginning and end of each practice session, offline (rest-driven) learning was measured by comparing the end of the first practice session to the beginning of the second, and retention was measured by comparing the beginning of the first practice session to the beginning of the second. Online learning, offline learning, and retention were compared between the stroke survivors and uninjured controls.

Results: Stroke survivors improved their tracking performance on the first day (p = 0.033); however, the amount of learning in stroke survivors was lower in comparison with the control group on both days (p ≤ 0.05). Interestingly, stroke survivors showed higher offline learning gains when compared with uninjured controls (p = 0.011).

Conclusions: Even stroke survivors with no perceivable motor impairments have difficulty acquiring new motor skills related to walking, which may be related to the underlying neural damage caused at the time of stroke. Furthermore, stroke survivors may require longer training with adequate rest to acquire new motor skills.

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让大脑休息,以便在中风后学习新的步态。
背景:重新学习失去的技能的能力对中风后的运动恢复至关重要。以往的研究表明,中风通常会影响运动控制和执行的基础过程,但不会影响这些技能的学习。然而,这些研究可能因存在明显的运动障碍而受到混淆。此外,先前涉及上肢的研究表明,与对照组相比,中风幸存者在离线运动学习方面具有优势。但是,还没有使用与康复有直接功能相关性的运动敏锐度任务(即侧重于执行动作质量的任务)对这一点进行研究:调查中风如何影响中风幸存者在行走过程中的腿部运动技能学习:这项前瞻性病例对照研究招募了 25 名参与者(10 名中风患者;15 名对照组患者)。参与者连续两天在跑步机上行走时学习一项新颖的脚部轨迹跟踪任务。这项任务要求参与者在步态的摆动阶段加大髋关节和膝关节的屈曲幅度。在线学习通过比较每次练习开始和结束时的跟踪误差进行测量,离线(休息驱动)学习通过比较第一次练习结束和第二次练习开始时的跟踪误差进行测量,而保持则通过比较第一次练习开始和第二次练习开始时的跟踪误差进行测量。比较了中风幸存者和未受伤对照组的在线学习、离线学习和保持率:结果:中风幸存者在第一天的追踪表现有所改善(p = 0.033);然而,与对照组相比,中风幸存者两天的学习量都较低(p ≤ 0.05)。有趣的是,与未受伤的对照组相比,中风幸存者的离线学习收益更高(p = 0.011):结论:即使没有明显运动障碍的中风幸存者也很难获得与行走相关的新运动技能,这可能与中风时造成的潜在神经损伤有关。此外,中风幸存者可能需要更长时间的训练和充分的休息才能掌握新的运动技能。
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来源期刊
Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation 工程技术-工程:生物医学
CiteScore
9.60
自引率
3.90%
发文量
122
审稿时长
24 months
期刊介绍: Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.
期刊最新文献
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