中风后的健侧上肢问题

The study of sensory motor in the ipsilesional upper extremity after stroke

大量证据表明 ,成年人中风后大脑损伤的同侧上肢感觉运动控制也出现异常。一些感觉运动缺损因脑损伤侧的功能不同而异 ,需要精确时序性的快速运动在左半球损伤的患者中对同侧上肢的影响大 ,相反在右半球损伤的患者中对有空间运动需要的同侧上肢影响较大 ,左侧中风的成年人同侧上肢的分离协调动作是正常的 ,但是连续协调动作则异常。中风后同侧上肢的感觉不受影响或仅受轻微影响 ,损伤同侧上肢有肌力缺陷 ,主要表现在右侧半球损伤患者 ,在要求一定时间完成的床功能检查中 ,见损伤同侧操作不能按时完成 ,这种操作缺陷可以反映损伤同侧的运动控制缺陷 ,这种缺陷往往被对侧偏瘫和偏身感觉丧失掩盖 ,集中于特殊运动控制缺陷的干预措施有助于双上肢的功能改善。

There is substantial evidence to indicate that sensory motor control of the ipsilesional upper exremity in adults after unilateral stroke is abnormal.Some of the sensory motor deficits as a function of the side of the cerbral lesion.Rapid movment of the ipsilesional UE that require precise timing and sequencing are more affected in individuals with lessions in the hemisphere.In contrast,ipsilesional movements that have cootrained spatial requirements are more affected in those with lesions in the right hemisphere.Ipsilesional UE covrdination of discrete tasks may be normal,but the coordination of continuos tasks is affected in adults with left stroke.sensation in the ipsilesional UE appears to be unaffected,or minimally affected after stroke.Strength defictits have been demonstrated in the ipsilesional UE,but premarily in those with right sided lesions.Ipsilesional performance deficits are revealed in clinical tests of function that use time to completion as the measure of success.Ipsilesional performance deficits may reflect motor control deicits that are masked on the contralatoral side by hemiplegia and hemisensory loss.Interventions that focus on specific motor control deficits,such as speed of sensory motor processing,through practice with the ipsilesional UE,may result in functional improvements in both limbs.