Early phases of the grip-lift cycle were prolonged (related to grasp preparation), but a later phase was not affected (related to object lifting). Terminal movement time was increased in the initial examination only. The peak velocity of reaching-to grasp was decreased, and patients tended to segment the movement. Patients were still handicapped in the picking-up test if deprived from vision even after discharge from the rehabilitation unit. Clinical scores revealed an early recovery of dexterity within 2 months in most of the patients and the performance in the pegboard and pickingup tests also recovered early. Pegboard and picking-up tests, a reach-to grasp movement and lifting of a small, instrumented object were assessed early after coma and during rehabilitation in 21 patients.
STEREOLOGY EICH MANUAL
Our aim was to quantify manual dexterity and to gain further insights in force coordination. Deuschl, Universitätsklinik Kiel (Kiel, D) Patients suffering from traumatic brain injury (TBI) often show severe disturbances of motor control, especially of dexterity, although the underlying mechanisms remained unclear. 245 Rehabilitation of hand functions after brain trauma. This might represent a more general control strategy when the output of motor commands is suboptimal. The patients produced uneconomically elevated grip forces during both stationary and dynamic tasks. Conclusion: The patients yield preserved capabilities in basic tasks but seem to be increasingly impaired in more complex tasks. When both patients held the instrumented object (GF) stationary and subsequently performed cyclic movements with increasing speed-levels, they produced greater grip forces than the control subjects during both tasks (up to 100 % increased) and grip force was not well coordinated with the load in the movement-task. In handwriting (CS) both patients were slowed writing a test sentence and also showed clear deficits during isolated sub-movements which are part of normal writing. On the elementary control level (FCA) both patients showed an age-related normal maximum finger force, but doing fast force changes both showed slowness and decoordinated force production in the affected hand. Results: We analysed two patients (both male, 24 and 22 years, right hand affected, right handed) with head trauma after car accident and two healthy sex- and age-matched control subjects. Functional force control: To analyse grip force during daily object manipulation we used an instrumented hand-held object supplied with force and acceleration sensors (device GF). Handwriting: To analyse more complex capabilities we measured handwriting movements using a digitising tablet (device CS). Methods: Elementary finger force and movement control: For the examination of basic abilities/disorders of finger force control we measured maximum grip force and fast force changes in a precision grip (device FCA) sensory function was assessed by resistance to perturbation (device FS). This is why we analysed and quantified sensory motor performance as well as the severity of functional deficits using the following methods. So far correlation of primary traumatic insult and fine motor control deficits have not been described in more detail. Incidence of head trauma is thus followed by hand function deficits in about 40 % of all cases including plegia and paresis. Marquardt, Neuropsycholgie Krankenhaus München Bogenhausen on behalf of the Entwicklungsgruppe Klinische Neuropsychologie/DFG-Graduiertenkolleg Neurotraumatologie und Neuropsycholgische Rehabilitation GRK 688 Introduction: After head trauma via fall or car accident most patients show deficits concerning motor coordination and sensory motor control even if gross force remains. 244 Analysis of fine motor control deficits following head trauma. The activity of the nondominant hemisphere may be integrated into the cerebral network subserving language processing following ischemic stroke of the languagedominant hemisphere. This study provides neurophysiological evidence that the nondominant hemisphere is involved in the process of recovery from post-stroke aphasia. Thus, the changes in the excitability in the hand area of both motor cortices were language related. Mouth movements had no effect on hand motor cortex excitability.
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