Article

Motor deficits after a stroke are thought to be compounded by the
development of asymmetric interhemispheric inhibition. Bilateral priming was
developed to rebalance this asymmetry and thus improve therapy efficacy.This study investigated the effect of bilateral priming before
Wii-based Movement Therapy to improve rehabilitation after stroke. METHODS: Ten
patients who had suffered a stroke (age, 23-77 years; 3-123 months after stroke)
underwent a 14-day program of Wii-based Movement Therapy for upper limb
rehabilitation. Formal Wii-based Movement Therapy sessions were immediately
preceded by 15 minutes of bilateral priming, whereby active flexion-extension of
the less affected wrist drove mirror-symmetric passive movements of the more
affected wrist through a custom device. Functional movement was assessed at weeks
0 (before therapy), 3 (after therapy), and 28 (follow-up) using the Wolf Motor
Function Test (WMFT), upper limb Fugl-Meyer Assessment (FMA), upper limb range of
motion, and Motor Activity Log (MAL). Case-matched controls were patients who had
suffered a stroke who received Wii-based Movement Therapy but not bilateral
priming. RESULTS: Upper limb functional ability improved for both groups on all
measures tested. Posttherapy improvement on the FMA for primed patients was twice
that of the unprimed patients (37.3% vs 14.6%, respectively) and was
significantly better maintained at 28 weeks (P = .02). Improvements on the WMFT
and MAL were similar for both groups, but the pattern of change in range of
motion was strikingly different. CONCLUSIONS:
Bilateral priming before Wii-based
Movement Therapy led to a greater magnitude and retention of improvement compared
to control, especially measured with the FMA. These data suggest that bilateral
priming can enhance the efficacy of Wii-based Movement Therapy, particularly for
patients with low motor function after a stroke.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS