Background. Patients with an upper limb motor impairment are likely to develop wrist hyper-resistance during the first months post stroke. The time course of wrist hyper-resistance in terms of neural and biomechanical components, and their interaction with motor recovery, is poorly understood. Objective. To investigate the time course of neural and biomechanical components of wrist hyper-resistance in relation to upper limb motor recovery in the first 6 months post stroke. Methods. Neural (NC), biomechanical elastic (EC), and viscous (VC) components of wrist hyper-resistance (NeuroFlexor device), and upper limb motor recovery (Fugl-Meyer upper extremity scale [FM-UE]), were assessed in 17 patients within 3 weeks and at 5, 12, and 26 weeks post stroke. Patients were stratified according to the presence of voluntary finger extension (VFE) at baseline. Time course of wrist hyper-resistance components and assumed interaction effects were analyzed using linear mixed models. Results. On average, patients without VFE at baseline (n = 8) showed a significant increase in NC, EC, and VC, and an increase in FM-UE from 13 to 26 points within the first 6 months post stroke. A significant increase in NC within 5 weeks preceded a significant increase in EC between weeks 12 and 26. Patients with VFE at baseline (n = 9) showed, on average, no significant increase in components from baseline to 6 months whereas FM-UE scores improved from 38 to 60 points. Conclusion. Our findings suggest that the development of neural and biomechanical wrist hyper-resistance components in patients with severe baseline motor deficits is determined by lack of spontaneous neurobiological recovery early post stroke.

中文翻译：

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腕部超阻与中风后早期上肢运动恢复相关的时间进程

背景。有上肢运动障碍的患者在中风后的头几个月很可能会出现腕部高阻力。就神经和生物力学组件而言，腕部超阻力的时间过程及其与运动恢复的相互作用知之甚少。目标。研究与中风后前 6 个月中上肢运动恢复相关的腕部超阻的神经和生物力学成分的时间过程。方法。在 17 名受试者中评估了腕部超阻（NeuroFlexor 装置）和上肢运动恢复（Fugl-Meyer 上肢量表 [FM-UE]）的神经 (NC)、生物力学弹性 (EC) 和粘性 (VC) 分量中风后 3 周内和 5、12 和 26 周的患者。根据基线时是否存在自主手指伸展 (VFE) 对患者进行分层。使用线性混合模型分析手腕超电阻组件的时间进程和假设的交互作用。结果。平均而言，在基线时没有 VFE 的患者（n = 8）显示出 NC、EC 和 VC 的显着增加，并且在卒中后的前 6 个月内 FM-UE 从 13 点增加到 26 点。在第 12 周和第 26 周之间 EC 显着增加之前 5 周内 NC 显着增加。 基线时有 VFE 的患者（n = 9）显示，平均而言，从基线到 6 个月，成分没有显着增加，而 FM-UE 评分从 38 分提高到 60 分。结论。