An explorative, cross-sectional study into abnormal muscular coupling during reach in chronic stroke patients
AuthorPrange, GB; Jannink, MJA; Stienen, AHA; van der Kooij, H; IJzerman, MJ; Hermens, HJ
Source TitleJournal of NeuroEngineering and Rehabilitation
PublisherBIOMED CENTRAL LTD
University of Melbourne Author/sIJzerman, Maarten
AffiliationMelbourne School of Population and Global Health
Document TypeJournal Article
CitationsPrange, G. B., Jannink, M. J. A., Stienen, A. H. A., van der Kooij, H., IJzerman, M. J. & Hermens, H. J. (2010). An explorative, cross-sectional study into abnormal muscular coupling during reach in chronic stroke patients. JOURNAL OF NEUROENGINEERING AND REHABILITATION, 7 (1), https://doi.org/10.1186/1743-0003-7-14.
Access StatusOpen Access
BACKGROUND: In many stroke patients arm function is limited, which can be related to an abnormal coupling between shoulder and elbow joints. The extent to which this can be translated to activities of daily life (ADL), in terms of muscle activation during ADL-like movements, is rather unknown. Therefore, the present study examined the occurrence of abnormal coupling on functional, ADL-like reaching movements of chronic stroke patients by comparison with healthy persons. METHODS: Upward multi-joint reaching movements (20 repetitions at a self-selected speed to resemble ADL) were compared in two conditions: once facilitated by arm weight compensation and once resisted to provoke a potential abnormal coupling. Changes in movement performance (joint angles) and muscle activation (amplitude of activity and co-activation) between conditions were compared between healthy persons and stroke patients using a repeated measures ANOVA. RESULTS: The present study showed slight changes in joint excursion and muscle activation of stroke patients due to shoulder elevation resistance during functional reach. Remarkably, in healthy persons similar changes were observed. Even the results of a sub-group of the more impaired stroke patients did not point to an abnormal coupling between shoulder elevation and elbow flexion during functional reach. CONCLUSIONS: The present findings suggest that in mildly and moderately affected chronic stroke patients ADL-like arm movements are not substantially affected by abnormal synergistic coupling. In this case, it is implied that other major contributors to limitations in functional use of the arm should be identified and targeted individually in rehabilitation, to improve use of the arm in activities of daily living.
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