Hand function in congenital and acquired hemiparesis : physiology and pathology from tactile perception to motor control
(2009)
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Details
- Authors
- Supervisors
- Thonnard, Jean-Louis
- Abstract
- (en) Skilled hand movements are controlled by peripheral and central components of the Nervous System. Some of these components can be impaired in congenital and acquired hemiparesis. A complete evaluation of hand impairments enables to identify the perturbed component(s).This should help to adapt therapies according to concrete scientific evidence, with the aim of improving patients’ functions at typical daily activities. Systematic and rigorous evaluation of upper limb and hand impairments could also help to properly quantify the progress made by patients and the efficiency of treatment. Therefore, an investigation of the different levels of impairment that could perturb motor control is worthwhile. Chapter I investigates the tactile perception in normal and pathological subjects using a tactile spatial resolution test. First, the validation of a clinical procedure used to measure tactile spatial resolution is made. The development of tactile spatial resolution through childhood is then considered using a sample of 222 healthy children. Finally, in a third section, the tactile spatial resolution of children and adults with chronic brain lesions is investigated. The relationship between tactile spatial resolution and digital dexterity is also examined. Chapter II describes the central control of hand movements and presents data on both the predictive and reactive control mechanisms that are used during performance of an impulsive loading task, i.e. a rapid increase in load. In the first section, we study the nature of the grip force (GF) increase that arises after impulsive loading under self-triggered conditions in 30 healthy adult subjects. Since we intended to study these mechanisms in children suffering from brain lesions, we investigate both predictive and reactive mechanisms of control throughout childhood, in order to dissociate age effects and impairments. In the third and fourth sections, the predictive and reactive controls are studied in children with CH and in stroke patients. Chapter III investigates the relationship between corticospinal tract degeneration and motor deficits in the hands of children with CH. Finally, we discuss the results of the different chapters, their implications for neurorehabilitation and the perspectives for future research.
- Affiliations
Citations
Bleyenheuft, Y. (2009). Hand function in congenital and acquired hemiparesis : physiology and pathology from tactile perception to motor control. https://hdl.handle.net/2078.5/54078