Effects of Stroke Lesions and Timing of Rehabilitation on the Compensatory Movement Patterns During Stroke Recovery

초록

Objectives The aims of this study were to distinguish between behavioral compensation and behavioral recovery and to determine the role of stroke lesions and the optimal timing of rehabilitation in true recovery. Design Single pellet reaching test has been performed to analyze both quantitative and qualitative measures of forelimb function in a stroke animal model with lesions in the motor cortex, somatosensory cortex, or sensorimotor cortex. The four gestures of compensatory movement patterns that comprised a reach were head lift, limb withdrawal, pellet chasing, and phantom grasp. Results Functional recovery improved in all the stroke groups after rehabilitation (P < 0.001). However, the compensatory movement patterns of the motor cortex and somatosensory cortex stroke groups initially increased and subsequently decreased (P = 0.0054), whereas those of the sensorimotor cortex stroke group increased and persisted (P = 0.0063). In the sensorimotor cortex stroke group, compensatory movement patterns significantly decreased when training was initiated 5 and 14 days after stroke (P = 0.0083, P = 0.0226, respectively), while they increased and persisted when training was initiated 1 day after stroke. Conclusions These findings suggest that true recovery by task-specific training after stroke depends, probably, on the lesion size and the timing of rehabilitation.

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