Sensorimotor Training Induced Neural Reorganization After Stroke: A Case Series
Identifieur interne : 001861 ( Main/Exploration ); précédent : 001860; suivant : 001862Sensorimotor Training Induced Neural Reorganization After Stroke: A Case Series
Auteurs : Travis Bird ; Seongjin Choi ; Lindsay Goodman ; Petra Schmalbrock ; Deborah S. Nichols-LarsenSource :
- Journal of neurologic physical therapy : JNPT [ 1557-0576 ] ; 2013.
English descriptors
- KwdEn :
- Aged, Brain (pathology), Brain (physiopathology), Diffusion Magnetic Resonance Imaging (instrumentation), Diffusion Magnetic Resonance Imaging (methods), Discrimination (Psychology) (physiology), Exercise Test (utilization), Female, Humans, Magnetic Resonance Imaging (instrumentation), Magnetic Resonance Imaging (methods), Male, Middle Aged, Movement Disorders (etiology), Movement Disorders (rehabilitation), Neuronal Plasticity (physiology), Neuropsychological Tests, Physical Therapy Modalities, Pilot Projects, Psychomotor Performance (physiology), Sensation Disorders (etiology), Sensation Disorders (rehabilitation), Severity of Illness Index, Stroke (complications), Stroke (rehabilitation), Touch Perception (physiology), Treatment Outcome, Upper Extremity (physiopathology).
- MESH :
- complications : Stroke.
- etiology : Movement Disorders, Sensation Disorders.
- instrumentation : Diffusion Magnetic Resonance Imaging, Magnetic Resonance Imaging.
- methods : Diffusion Magnetic Resonance Imaging, Magnetic Resonance Imaging.
- pathology : Brain.
- physiology : Discrimination (Psychology), Neuronal Plasticity, Psychomotor Performance, Touch Perception.
- physiopathology : Brain, Upper Extremity.
- rehabilitation : Movement Disorders, Sensation Disorders, Stroke.
- utilization : Exercise Test.
- Aged, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Physical Therapy Modalities, Pilot Projects, Severity of Illness Index, Treatment Outcome.
Abstract
Impaired hand function decreases quality of life after stroke. The purpose of this study was to pilot a novel two-week upper extremity sensorimotor training program. This case series describes the training program and highlights outcome measures used for documenting behavioral change and neural reorganization.
Sensorimotor evaluation identified behavioral changes, activity induced neural reorganization was examined using sensory fMRI, diffusion tensor tractography, and brain volume measurement. Participant 1 was a 75-year-old right-handed man one year post right hemisphere stroke with severe sensory impairment across domains in his left hand, he reported limited left hand/arm use. Participant 2 was a 63-year-old right-handed woman who had experienced a left hemisphere stroke 9 months earlier resulting in mild sensory impairment across domains in her right hand, as well as mild motor deficit.
Participants trained 4 hours per day, 5 days per week for two weeks. Training tasks required sensory discrimination of temperature, weights, textures, shapes and objects in the context of active exploration with the involved hand. Random multi-modal feedback was used.
Both participants had improved scores on the Wolf Motor Function Test after training. Participant 1 had no measureable change in sensory function, while Participant 2 improved in touch perception, proprioception and haptic performance. Sensory fMRI suggested neural reorganization in both participants; Participant 1 had a small increase in brain volume, while superior thalamic radiation white matter connectivity was unchanged in either participant.
Participating in sensorimotor training focused on sensory discrimination during manual manipulation was feasible for both participants. Future research to determine efficacy and identify optimal measures of sensory function and neural reorganization is recommended. Video Abstract available (see
Url:
DOI: 10.1097/NPT.0b013e318283de0d
PubMed: 23399924
PubMed Central: 3726277
Affiliations:
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Le document en format XML
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<author><name sortKey="Bird, Travis" sort="Bird, Travis" uniqKey="Bird T" first="Travis" last="Bird">Travis Bird</name>
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<author><name sortKey="Choi, Seongjin" sort="Choi, Seongjin" uniqKey="Choi S" first="Seongjin" last="Choi">Seongjin Choi</name>
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<author><name sortKey="Goodman, Lindsay" sort="Goodman, Lindsay" uniqKey="Goodman L" first="Lindsay" last="Goodman">Lindsay Goodman</name>
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<author><name sortKey="Schmalbrock, Petra" sort="Schmalbrock, Petra" uniqKey="Schmalbrock P" first="Petra" last="Schmalbrock">Petra Schmalbrock</name>
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<author><name sortKey="Nichols Larsen, Deborah S" sort="Nichols Larsen, Deborah S" uniqKey="Nichols Larsen D" first="Deborah S." last="Nichols-Larsen">Deborah S. Nichols-Larsen</name>
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<author><name sortKey="Choi, Seongjin" sort="Choi, Seongjin" uniqKey="Choi S" first="Seongjin" last="Choi">Seongjin Choi</name>
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<author><name sortKey="Goodman, Lindsay" sort="Goodman, Lindsay" uniqKey="Goodman L" first="Lindsay" last="Goodman">Lindsay Goodman</name>
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<author><name sortKey="Schmalbrock, Petra" sort="Schmalbrock, Petra" uniqKey="Schmalbrock P" first="Petra" last="Schmalbrock">Petra Schmalbrock</name>
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<author><name sortKey="Nichols Larsen, Deborah S" sort="Nichols Larsen, Deborah S" uniqKey="Nichols Larsen D" first="Deborah S." last="Nichols-Larsen">Deborah S. Nichols-Larsen</name>
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<series><title level="j">Journal of neurologic physical therapy : JNPT</title>
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<term>Diffusion Magnetic Resonance Imaging (instrumentation)</term>
<term>Diffusion Magnetic Resonance Imaging (methods)</term>
<term>Discrimination (Psychology) (physiology)</term>
<term>Exercise Test (utilization)</term>
<term>Female</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging (instrumentation)</term>
<term>Magnetic Resonance Imaging (methods)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Movement Disorders (etiology)</term>
<term>Movement Disorders (rehabilitation)</term>
<term>Neuronal Plasticity (physiology)</term>
<term>Neuropsychological Tests</term>
<term>Physical Therapy Modalities</term>
<term>Pilot Projects</term>
<term>Psychomotor Performance (physiology)</term>
<term>Sensation Disorders (etiology)</term>
<term>Sensation Disorders (rehabilitation)</term>
<term>Severity of Illness Index</term>
<term>Stroke (complications)</term>
<term>Stroke (rehabilitation)</term>
<term>Touch Perception (physiology)</term>
<term>Treatment Outcome</term>
<term>Upper Extremity (physiopathology)</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Stroke</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Movement Disorders</term>
<term>Sensation Disorders</term>
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<term>Magnetic Resonance Imaging</term>
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<term>Psychomotor Performance</term>
<term>Touch Perception</term>
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<term>Upper Extremity</term>
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<term>Sensation Disorders</term>
<term>Stroke</term>
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<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
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<term>Pilot Projects</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background and Purpose</title>
<p id="P1">Impaired hand function decreases quality of life after stroke. The purpose of this study was to pilot a novel two-week upper extremity sensorimotor training program. This case series describes the training program and highlights outcome measures used for documenting behavioral change and neural reorganization.</p>
</sec>
<sec id="S2"><title>Case Description</title>
<p id="P2">Sensorimotor evaluation identified behavioral changes, activity induced neural reorganization was examined using sensory fMRI, diffusion tensor tractography, and brain volume measurement. Participant 1 was a 75-year-old right-handed man one year post right hemisphere stroke with severe sensory impairment across domains in his left hand, he reported limited left hand/arm use. Participant 2 was a 63-year-old right-handed woman who had experienced a left hemisphere stroke 9 months earlier resulting in mild sensory impairment across domains in her right hand, as well as mild motor deficit.</p>
</sec>
<sec id="S3"><title>Intervention</title>
<p id="P3">Participants trained 4 hours per day, 5 days per week for two weeks. Training tasks required sensory discrimination of temperature, weights, textures, shapes and objects in the context of active exploration with the involved hand. Random multi-modal feedback was used.</p>
</sec>
<sec id="S4"><title>Outcomes</title>
<p id="P4">Both participants had improved scores on the Wolf Motor Function Test after training. Participant 1 had no measureable change in sensory function, while Participant 2 improved in touch perception, proprioception and haptic performance. Sensory fMRI suggested neural reorganization in both participants; Participant 1 had a small increase in brain volume, while superior thalamic radiation white matter connectivity was unchanged in either participant.</p>
</sec>
<sec id="S5"><title>Discussion/Summary</title>
<p id="P5">Participating in sensorimotor training focused on sensory discrimination during manual manipulation was feasible for both participants. Future research to determine efficacy and identify optimal measures of sensory function and neural reorganization is recommended. Video Abstract available (see <xref rid="SD2" ref-type="supplementary-material">Video, Supplemental Digital Content 1</xref>
) for more insights from the authors.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Bird, Travis" sort="Bird, Travis" uniqKey="Bird T" first="Travis" last="Bird">Travis Bird</name>
<name sortKey="Choi, Seongjin" sort="Choi, Seongjin" uniqKey="Choi S" first="Seongjin" last="Choi">Seongjin Choi</name>
<name sortKey="Goodman, Lindsay" sort="Goodman, Lindsay" uniqKey="Goodman L" first="Lindsay" last="Goodman">Lindsay Goodman</name>
<name sortKey="Nichols Larsen, Deborah S" sort="Nichols Larsen, Deborah S" uniqKey="Nichols Larsen D" first="Deborah S." last="Nichols-Larsen">Deborah S. Nichols-Larsen</name>
<name sortKey="Schmalbrock, Petra" sort="Schmalbrock, Petra" uniqKey="Schmalbrock P" first="Petra" last="Schmalbrock">Petra Schmalbrock</name>
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