Sensorimotor Training Induced Neural Reorganization After Stroke: A Case Series
Identifieur interne : 001018 ( Pmc/Checkpoint ); précédent : 001017; suivant : 001019Sensorimotor 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.
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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<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>
</author>
<author><name sortKey="Goodman, Lindsay" sort="Goodman, Lindsay" uniqKey="Goodman L" first="Lindsay" last="Goodman">Lindsay Goodman</name>
</author>
<author><name sortKey="Schmalbrock, Petra" sort="Schmalbrock, Petra" uniqKey="Schmalbrock P" first="Petra" last="Schmalbrock">Petra Schmalbrock</name>
</author>
<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="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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<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>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101193365</journal-id>
<journal-id journal-id-type="pubmed-jr-id">32636</journal-id>
<journal-id journal-id-type="nlm-ta">J Neurol Phys Ther</journal-id>
<journal-id journal-id-type="iso-abbrev">J Neurol Phys Ther</journal-id>
<journal-title-group><journal-title>Journal of neurologic physical therapy : JNPT</journal-title>
</journal-title-group>
<issn pub-type="ppub">1557-0576</issn>
<issn pub-type="epub">1557-0584</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23399924</article-id>
<article-id pub-id-type="pmc">3726277</article-id>
<article-id pub-id-type="doi">10.1097/NPT.0b013e318283de0d</article-id>
<article-id pub-id-type="manuscript">NIHMS437675</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Sensorimotor Training Induced Neural Reorganization After Stroke: A Case Series</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bird</surname>
<given-names>Travis</given-names>
</name>
<degrees>PT, DPT</degrees>
<aff id="A1">Physical Therapist, Good Samaritan Hospital, Dayton, OH</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Choi</surname>
<given-names>Seongjin</given-names>
</name>
<degrees>PhD</degrees>
<aff id="A2">Post-Doctoral Researcher, Radiology, College of Medicine, The Ohio State University, Columbus, OH</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Goodman</surname>
<given-names>Lindsay</given-names>
</name>
<degrees>PT, DPT, GCS</degrees>
<aff id="A3">Physical Therapist and Geriatric Residency Mentor at Home Care by Blackstone, Columbus, OH</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schmalbrock</surname>
<given-names>Petra</given-names>
</name>
<degrees>PhD</degrees>
<aff id="A4">Associate Professor of Radiology, The Ohio State University, Columbus, OH</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Nichols-Larsen</surname>
<given-names>Deborah S.</given-names>
</name>
<degrees>PT, PhD</degrees>
<aff id="A5">Director, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH</aff>
</contrib>
</contrib-group>
<author-notes><corresp id="FN1">Corresponding: Alexandra L. Borstad PhD, PT, NCS, Graduate Research Assistant, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, Phone: 614-395-1708, <email>Borstad.2@osu.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>18</day>
<month>3</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>3</month>
<year>2014</year>
</pub-date>
<volume>37</volume>
<issue>1</issue>
<fpage>27</fpage>
<lpage>36</lpage>
<abstract><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>
</abstract>
<funding-group><award-group><funding-source country="United States">National Center for Research Resources : NCRR</funding-source>
<award-id>TL1 RR025753 || RR</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<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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