Cortical activation changes induced by visual biofeedback tracking training in chronic stroke patients.
OBJECTIVE
We tried to examine whether visual biofeedback tracking training (VBTT) can improve both the gait performance and cortical activation pattern in chronic stroke patients.


METHODS
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.
Department of Physical Therapy, Graduate School of Rehabilitation Therapy, Institute of Health Science, Yonsei University College of Health Science, Wonju, Republic of Korea.
Sang-Hyun
SH
Cho
Hwa-Kyung
HK
Shin
Yong-Hyun
YH
Kwon
Mi Young
MY
Lee
Young-Hee
YH
Lee
Chu-Hee
CH
Lee
Dong Suk
DS
Yang
Sung-Ho
SH
Jang
D000328:Adult; D001676:Biofeedback, Psychology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D011597:Psychomotor Performance; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation