Functional MRI evidence of cortical reorganization in upper-limb stroke hemiplegia treated with constraint-induced movement therapy.
Am J Phys Med Rehabil
; 80(1): 4-12, 2001 Jan.
Article
em En
| MEDLINE
| ID: mdl-11138954
ABSTRACT
OBJECTIVE:
The purpose of this pilot study was to test constraint-induced movement therapy for chronic upper-limb stroke hemiparesis and to investigate the neural correlates of recovery with functional magnetic resonance imaging (MRI) in two subjects. Both subjects had been discharged from traditional therapy because no further improvement was anticipated.DESIGN:
Constraint-induced movement therapy consisted of 6 hr of daily upper-limb training for 2 wk; a restrictive mitt was worn on the nonparetic limb during waking hours. Functional MRI was performed on a 1.5-T MRI with echo-planar imaging; at the same time, the subjects attempted sequential finger-tapping.RESULTS:
Compared with baseline, performance time improved an average of 24% immediately after training and also continued to improve up to 33% 3 mo after training. Lift, grip strength, and Motor Activity Log scores likewise improved. Initially, on functional MRI, subject 1 activated scattered regions in the ipsilateral posterior parietal and occipital cortices. Subject 2 showed almost no areas of significant activation. After training, subject 1 showed activity bordering the lesion, bilateral activation in the association motor cortices, and ipsilateral activation in the primary motor cortex. Subject 2 showed activation near the lesion site.CONCLUSION:
Constraint-induced movement therapy produced significant functional improvement and resulted in plasticity as demonstrated by functional MRI.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
/
Acidente Vascular Cerebral
/
Terapia por Exercício
/
Reabilitação do Acidente Vascular Cerebral
/
Hemiplegia
/
Córtex Motor
/
Plasticidade Neuronal
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Phys Med Rehabil
Ano de publicação:
2001
Tipo de documento:
Article