Affiliations: [a] Department of Physical Therapy, Graduate School of Rehabilitation Therapy, Institute of Health Science, Yonsei University College of Health Science, Wonju, Republic of Korea | [b] Department of Occupational Therapy, Kaya University College of Health Science, Goryeong, Republic of Korea | [c] Department of Rehabilitation Science, Graduate School, Daegu University, Taegu, Republic of Korea | [d] Department of Physical Medicine and Rehabilitation, Yonsei University of College of Medicine, Wonju, Republic of Korea | [e] Department of Department of Biochemistry and Molecular Biology, Yeungnam University College of Medicine, Taegu, Republic of Korea | [f] Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Taegu, Republic of Korea
Correspondence:
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Address for correspondence: Sung Ho Jang, MD, MS, Associate Professor, Department of Physical Medicine & Rehabilitation, School of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Taegu 705-717, South Korea. Tel.: +83 53 620 3269; Fax: +83 53 620 3269; E-mail: strokerehab@hanmail.net
Abstract: Objectives:We tried to examine whether visual biofeedback tracking training (VBTT) can improve both the gait performance and cortical activation pattern in chronic stroke patients. Design:We enrolled 10 chronic hemiparetic patients with stroke(mean age 46.3 ± 5.19 years). The patients were randomly assigned to the training group (5 patients) or the control group (5 patients). VBTT was to follow the PC-generated sine waves with the knee joint electrogoniometer, and the two sine waves should appear as close to overlapping as possible on the PC monitor. The training was performed for 39 minutes/day, 5 days/week, for 4 weeks. Pre-training and post-training accuracy of tracking, functional status of gait, and functional MRI (fMRI) were measured. fMRI was performed at 1.5 T in parallel with timed knee flexion-extension movements at a fixed rate. Results:The accuracy of the tracking performance, walking speed, and motor scale for gait improved in the training group. Primary sensorimotor cortex (SM1) cortical activation shifted significantly from the unaffected to the affected hemisphere in the training group. Conclusions:We demonstrated that cortical activation changes occurred with gait function improvement in chronic stroke patients throughout the 4-week VBTT program. It seems that the cortical reorganization was induced by VBTT.
Keywords: Functional MRI, gait, stroke, cortical reorganization, tracking training
