Cortical reorganization induced by body weight-supported treadmill training in patients with hemiparesis of different stroke durations.

摘要

OBJECTIVE: To investigate corticomotor changes induced by body weight-supported treadmill training (BWSTT) in patients with short or long poststroke duration. DESIGN: Single-blinded and randomized controlled trial. SETTING: Neurologic physical therapy research laboratory. PARTICIPANTS: Hemiparesis patients (N=18) whose motor-evoked potentials could be induced participated in this study. Subjects in each hemiparesis postonset of short (<6 mo) or long (>12 mo) duration group were randomly assigned to either the control or experimental group. INTERVENTIONS: Subjects in the experimental groups participated in BWSTT for 4 weeks. Those in the control groups received the general exercise program. MAIN OUTCOME MEASURES: The primary outcomes were motor threshold and map size of the abductor hallucis muscle in the ipsilesional hemisphere. The secondary outcome was Fugl-Meyer Assessment. Outcome measures were blindly assessed before and after completing the 4 weeks of training. RESULTS: The 4-week BWSTT resulted in a decrease of motor threshold and an increase of map size in subjects with hemiparesis of short duration, whereas only the expansion of the map size was noted in subjects with hemiparesis of long duration. Improvement of motor control occurred in subjects with hemiparesis of both short and long duration after BWSTT. CONCLUSIONS: The BWSTT results in similar improvement in motor control but different patterns of treatment-induced cortical reorganization in subjects with different poststroke durations.