Article

Préhension -
Abstract : Intensive task-oriented training such as constraint-induced movement
therapy (CIMT) is thought to engage motor learning and decision-making processes,
including anticipatory action planning. OBJECTIVE: To identify the effects of
CIMT on anticipatory hand posture selection and movement time for task-specific
reach-to-grasp performance. METHODS: Subacute and chronic poststroke participants
were recruited into CIMT (n = 10) or non-CIMT (n = 10) groups. Arm and hand
functions were assessed before and after 2 weeks with the Wolf Motor Function
Test (WMFT), Motor Activity Log (MAL), and a unique skilled reach-to-grasp task
designed to test anticipatory hand posture selection. The reach-to-grasp tasks
included power and precision grasping in 2 conditions achieved optimally with
either a pronated (low difficulty) or supinated (high difficulty) hand posture.
Outcome measures included success rate, frequency of optimal strategy selection,
and movement time. RESULTS: Between-group comparisons revealed a significant
treatment effect for WMFT and MAL scores. The CIMT group showed larger gains in
success rate, optimal posture selection (precision grasp only), and faster
movement times for the supinated conditions. CONCLUSION: Together, a faster
movement time and greater frequency of optimal hand posture selection in the more
difficult task condition highlights a set of novel findings.
These results
provide evidence for training-induced improvements in upper-extremity function
that support neurobehavioral recovery more than compensation. Although these
findings are preliminary in view of the small sample size, the authors suggest
that they may be useful to design and power larger-scale studies to further the
understanding of the fundamental mechanisms induced by task-oriented training
interventions in neurorehabilitation.

Langue : ANGLAIS