學院 |
醫學院 |
系所 |
職能治療學系 |
題名 |
Reactive postural control deficits
in patients with posterior parietal cortex lesions following stroke and the
effects of auditory cueing |
作者 |
Lin, Y-H., Tang, P-F.*, Wang,
Y-H., Eng, J-J., Lin, K-C.,
Lu, L., Jeng, J-S., & Chen, S-C. |
期刊名稱 |
American Journal of Physical
Medicine & Rehabilitation
(SCI 期刊) |
發表日期 |
2014 |
著作性質 |
原著 |
語文 |
英文 |
關鍵字 |
Stroke,
Posterior Parietal Cortex, Posture, Cues |
摘要 |
Objective: The purpose of this study was to investigate the ways in which
stroke-induced posterior parietal cortex (PPC) lesions affect reactive
postural responses and whether providing auditory cues modulates these
responses. Design: Seventeen hemiparetic patients following stroke, nine with PPC
lesions (PPCLesion) and eight with intact PPCs (PPCSpared), and nine
age-matched healthy adults completed a lateral-pull perturbation experiment
under non-cued and cued conditions. The activation rates of the gluteus
medius muscle ipsilateral (GMi) and contralateral (GMc) to the pull
direction, the rates of occurrence of three types of GM activation patterns,
and the GMi contraction latency were investigated. Results: In
non-cued pulls towards the paretic side, of the three groups, the PPCLesion
group exhibited the lowest activation rate (56%) of the GMi (P <
0.05), which is the primary postural muscle involved in this task, and the
highest rate of occurrence (33%) of the GMc-activation-only pattern (P <
0.05), which is a compensatory activation pattern. In contrast, in cued pulls
towards the paretic side, the PPCLesion group were able to increase the
activation rate of the GMi to a level (81%) such that there became no
significant differences in activation rate of the GMi among the three groups
(P > 0.05). However, there were no significant differences in the
GM activation patterns and GMi contraction latency between the non-cued and
cued conditions for the the PPCLesion group (P > 0.05). Conclusions: The PPCLesion patients had greater
deficits in recruiting paretic muscles and were more likely to use the
compensatory muscle activation pattern for postural reactions than the
PPCSpared patients, suggesting that PPC is part of the neural circuitry
involved in reactive postural control in response to lateral perturbations.
The auditory cueing used in this study, however, did not significantly modify
the muscle activation patterns in PPCLesion patients. More research is needed
to explore the type and structure of cueing that could effectively improve
patterns and speed of 26 postural responses in these patients. |