| Summary: | 碩士 === 高雄醫學大學 === 醫學系神經學科碩士班 === 102 === Background and purposes: Leg cycling motion training is commonly used to facilitate the functional recovery of the lower extremity in patients with stroke. However, studies investigating the relationships between the functional recovery of the lower extremity in patients with stroke and cortical activations are limited. This study aimed to explore the relationships between the functional recovery of the lower extremity in patients with stroke and cortical activation patterns after a cycling training.
Methods: This study recruited patients with chronic stroke to undergo a leg cycling motion training five times a week for 4 weeks. Functional recovery was evaluated with the Lower Extremity subscale of the Fugl-Meyer Assessment (LE-FMA), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10MWT) at baseline (pre-training) and after the four-week training (post-training). In addition, the affected and non-affected ankle dorsi-flexion paradigm based on the functional MRI (fMRI) were done in order to analyze the cortical activation patterns and the activation balance between the two hemispheres using the weighted Lateralization Index (wLI) in the primary sensorimotor cortex (SMC) and the supplemental motor area (SMA) before and after the cycling training.
Results: After the cycling training, the LE-FMA score of five subjects improved from 25.20±2.86 to 29±2.55, and the 6MWT (walking endurance) improved from 254.47±50.01 meters to 276.65±52.27 meters, and the 10MWT improved from 13.48±3.11 seconds to 11.50±2.17 seconds. After the cycling training, three subjects demonstrated bilateral activation patterns and the other two showed contralateral activation patterns in the SMC during the affected ankle dorsi-flexion paradigm. In addition, there were no specific patters in the SMA.
Discussion and Conclusion: This study demonstrated the activation pattern in the SMC was bilateral or contralateral activations, while no specific pattern in the SMA, after the cycling training. Future studies with more subjects and follow-ups are suggested to fully explore the relationship between functional recovery of lower extremity and the cortical activation after cycling training.
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