J Rehabilitation Med 2004 ; 36: 117–123
EFFECTS OF PASSIVE-ACTIVE MOVEMENT TRAINING ON UPPER LIMB MOTOR FUNCTION AND CORTICAL ACTIVATION IN CHRONIC PATIENTS WITH STROKE: A PILOT STUDY
Pa°vel Lindberg,1,2,3 Christina Schmitz,2 Hans Forssberg,2 Margareta Engardt3,4 and Jo¨rgen Borg1
From the 1Department of Neuroscience, Rehabilitation Medicine, Uppsala University Hospital, Uppsala, 2Neuropediatrics, Department of Woman and Child Health, Karolinska Institutet, Stockholm, 3Rehabilitation Medicine, Danderyd Hospital AB, Stockholm and 4Neurotec Department, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
Objective: To explore how repetitive passive-active movement training effects upper limb motor function and cortical activation in patients with stroke.
Design: Single-group treatment trial with baseline comparisons.
Patients: Ten chronic patients with stroke with paresis of the upper limb.
Methods: Assessments were performed during a 4-week baseline period before and once after 4 weeks of training using the Motor Assessment Scale of the upper limb, Nine Hole Peg Test, goniometer for range of movement and the modified Ashworth scale for muscle tone. Two patients underwent functional magnetic resonance imaging pre- and post-training. The treatment consisted of daily sessions of repeated functional reaching and grasping movements guided passively and attempted actively during 4 weeks.
Results: The group improved in range of motion and Motor Assessment Scale scores. Subjects reported improvements in a variety of daily tasks requiring the use of the affected upper limb. Increases in cortical activation in prefrontal and sensorimotor areas were observed in parallel with improvements of upper limb motor function in the 2 patients scanned.
Conclusion: The 4-week training programme improved hand motor function and ability. Cortical activation on functional magnetic resonance imaging changed in parallel suggesting reorganization of areas related to movements of the paretic limb.
Key words: stroke, upper limb, motor function, movement training, fMRI, cortical reorganization.
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Effects of Passive-Active Movement Training on Upper Limb Motor Function and Cortical Activation In Chronic Patients with Stroke_A Pilot Study