Article

Knowledge of how damage to brain regions and pathways affects central
nervous system control of coordination of reach-to-grasp (RTG) following stroke
may not be sufficiently used in existing treatment interventions or in research
that assesses their effectiveness. OBJECTIVE: To review current knowledge of
motor control of coordination of RTG and discuss the extent to which this
information is being used in research evaluating treatment interventions. METHOD:
This review (1) summarizes the current knowledge of motor control of RTG
coordination in healthy individuals, including speculative models and structures
of the brain identified as being involved; (2) summarizes evidence of RTG
coordination deficits in people with stroke; (3) evaluates current interventions
directed at retraining coordination of RTG, including a review of the extent to
which these interventions are based on putative neurobiological mechanisms and
reports on their effectiveness; and (4) recommends directions for research on
treatment interventions for coordination of RTG. RESULTS: Functional
task-specific therapy, electrical stimulation, and robot or computerized training
were identified as treatments targeted at improving coordination of RTG. However,
none of the studies reporting the effect of these interventions related results
to individual brain regions affected, and neurobiological mechanisms underlying
improved performance were only minimally discussed. CONCLUSIONS: Research on
treatment interventions for coordination of RTG needs to combine measures of
interruption to brain networks and how remaining intact neural tissue and
networks respond to therapy with measures of spatiotemporal motor control and
upper-limb function to gain a fuller understanding of treatment effects and their
mechanisms.

Langue : ANGLAIS