Priming for Improved Hand Strength in Persons with Chronic Tetraplegia: A Comparison of Priming-Augmented Functional Task Practice, Priming Alone, and Conventional Exercise Training.

摘要: Many everyday tasks cannot be accomplished without adequate grip strength, and corticomotor drive to the spinal motoneurons is a key determinant of strength. In persons with tetraplegia, damage pathways limits transmission signals from motor cortex motoneurons. Corticomotor priming, which increases descending drive, should increase corticospinal through remaining resulting in increased Since somatosensory cortices share reciprocal connections, priming may also have potential influence function. The purpose this study was assess changes (precision, power) force tactile sensation associated two different approaches conventional training approach, determine whether baseline values can predict responsiveness training. Participants chronic (> 1 year) tetraplegia (n=49), were randomized one approaches: functional task practice plus peripheral nerve stimulation (FTP+PNSS) or alone (PNSS), exercise (CET). To excitability predictive training, subset participants we assessed pre-intervention thenar muscles. trained 2hrs daily, 5 days/week for 4 weeks. Thirty-seven completed study. Following intervention, significant improvements precision observed both stronger weaker hand FTP+PNSS group (effect size: 0.51, p=0.04 0.54, p=0.03; respectively), weak PNSS CET p=0.03 0.75, p=0.02; respectively). No power scores any group. Across all groups, as measured by change correlated force. Change strength measures excitability. These findings indicate that had greatest on hand, however improved hand. Responsiveness corticospinal.