Impaired afferent control in patients with spastic hemiplegia at different recovery stages: Contribution to gait disorder

El-Abd, M. A. R.; Ibrahim, Ibrahim K.

doi:10.1016/0003-9993(94)90035-3

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…Kamper et al (2002) reported contralesional deficits in movement velocity, smoothness, linearity and direction. Although earlier studies that examined deficits, such as weakness and spasticity, attributed contralesional impairments to reduced agonist (El-Abd et al, 1993;Fellows et al, 1994) and antagonist muscle activation (McLellan et al, 1985;El-Abd et al, 1993), hyperactive reflexes (Mizrahi and Angel, 1979), peripheral disturbances, such as changes in tissue properties (Dietz et al, 1991;Given et al, 1995), or the presence of abnormal synergies (Bourbonnais et al, 1989;Dewald et al, 1995); more recent studies that also address coordination deficits are beginning to identify inadequacies in movement planning (Beer et al, 2000;Kusoffsky et al, 2001) as a potential source of these problems. Our results agree with these studies that a deficit in predictive control mechanisms gives rise to coordination deficits post-stroke.…”

Section: Discussionmentioning

confidence: 99%

Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms

Mani

Mutha

Przybyla

et al. 2013

Brain

134

108

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We have proposed a model of motor lateralization, in which the left and right hemispheres are specialized for different aspects of motor control: the left hemisphere for predicting and accounting for limb dynamics and the right hemisphere for stabilizing limb position through impedance control mechanisms. Our previous studies, demonstrating different motor deficits in the ipsilesional arm of stroke patients with left or right hemisphere damage, provided a critical test of our model. However, motor deficits after stroke are most prominent on the contralesional side. Post-stroke rehabilitation has also, naturally, focused on improving contralesional arm impairment and function. Understanding whether contralesional motor deficits differ depending on the hemisphere of damage is, therefore, of vital importance for assessing the impact of brain damage on function and also for designing rehabilitation interventions specific to laterality of damage. We, therefore, asked whether motor deficits in the contralesional arm of unilateral stroke patients reflect hemisphere-dependent control mechanisms. Because our model of lateralization predicts that contralesional deficits will differ depending on the hemisphere of damage, this study also served as an essential assessment of our model. Stroke patients with mild to moderate hemiparesis in either the left or right arm because of contralateral stroke and healthy control subjects performed targeted multi-joint reaching movements in different directions. As predicted, our results indicated a double dissociation; although left hemisphere damage was associated with greater errors in trajectory curvature and movement direction, errors in movement extent were greatest after right hemisphere damage. Thus, our results provide the first demonstration of hemisphere specific motor control deficits in the contralesional arm of stroke patients. Our results also suggest that it is critical to consider the differential deficits induced by right or left hemisphere lesions to enhance post-stroke rehabilitation interventions.

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Section: Discussionmentioning

confidence: 99%

Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms

Mani

Mutha

Przybyla

et al. 2013

Brain

134

108

View full text Add to dashboard Cite

show abstract

“…Moreover, sensory deficits are associated with the degree of weakness and the degree of stroke severity related to mobility, independence in activities of daily living, and recovery (De Haart et al, 2004;Lin, 2005). Addressing sensory deficits that accompany muscle weakness may improve impaired processing of afferent signals which in turn may contribute to improved muscle activation, gait patterns, and responses to perturbation during gait and stance (El-Abd & Ibrahim, 1994).…”

Section: Correlation Between Muscle Variables and Functional Performancementioning

confidence: 99%

Functional recovery and muscle properties after stroke: a preleminary longitudinal study

Horstman¹,

Haan²,

Konijnenbelt³

et al. 2012

Rehabilitation Medicine

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Reflexes From the Superficial Peroneal Nerve During Walking in Stroke Subjects

Zehr

Fujita

Stein

1998

Journal of Neurophysiology

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The function of ipsilateral cutaneous reflexes was studied with short trains of stimuli presented pseudorandomly to the superficial peroneal nerve (SP; innervates the top of the foot) during treadmill walking in neurologically intact (NI) subjects and subjects who had had a stroke. Ankle and knee joint angles together with electromyograms (EMG) of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG), vastus lateralis (VL), and biceps femoris (BF) muscles were recorded. Net reflex EMG and kinematic responses to stimulation were quantified in each of the 16 parts of the step cycle and responses compared between the stroke and NI subjects. Stimulation strongly suppressed extensor muscles throughout stance in the stroke subjects. TA muscle showed a significant suppression during swing phase that was correlated with reduced ankle dorsiflexion in both stroke and NI subjects. BF reflexes were facilitatory during parts of swing and VL reflexes were suppressive throughout stance in the stroke subjects. There was a significant correlation between BF facilitation and knee flexion during swing, which was stronger in NI subjects. We conclude that only part of the stumble correction to foot dorsum electrical stimulation observed in NI subjects is maintained after stroke, and that new, suppressive responses are seen.

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Impaired afferent control in patients with spastic hemiplegia at different recovery stages: Contribution to gait disorder

Cited by 5 publications

References 22 publications

Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms

Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms

Functional recovery and muscle properties after stroke: a preleminary longitudinal study

Reflexes From the Superficial Peroneal Nerve During Walking in Stroke Subjects

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