Patellar tendon vibration reduces the increased facilitation from quadriceps to soleus in post-stroke hemiparetic individuals

Maupas, Eric; Dyer, Joseph-Omer; Melo, Sibele de Andrade; Forget, Robert

doi:10.1016/j.rehab.2017.03.008

Cited by 4 publications

(4 citation statements)

References 47 publications

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“…The primary focus has been on the magnitude of heteronymous excitation because excessive excitation could contribute to the abnormal Q and SOL coactivation frequently observed in stroke survivors during walking (3). In support of this premise, one research group observed abnormally increased heteronymous excitation in persons with stroke from Q onto the SOL Hre ex (4) and ongoing tonic SOL EMG (5,7). In contrast, the present study found that femoral nerve elicited heteronymous excitation measured as change in tonic SOL EMG was not greater in the paretic compared to the nonparetic or age-matched control limbs.…”

Section: Discussionsupporting

confidence: 75%

“…Lower limb heteronymous re exes can in uence motor coordination because excitatory and inhibitory feedback from a muscle can increase and decrease motor output of other muscles (8-12, 15, 17, 18, 25, 31, 33, 34). Therefore, abnormal lower limb motor coordination such as Q and SOL coactivation frequently observed after stroke during walking could arise, in part, from alterations to the strength of excitatory and inhibitory heteronymous feedback (4)(5)(6)(7)13). This study examined whether persons with stroke exhibit sensorimotor impairments in heteronymous excitation and inhibition from Q onto SOL, and whether heteronymous re ex magnitudes are related to lower limb motor impairment, walking speed, and dynamic balance.…”

Section: Discussionmentioning

confidence: 99%

“…Recent ndings suggest altered heteronymous re ex pathways may contribute to abnormal Q and SOL coactivation (4)(5)(6)(7). Heteronymous re exes can contribute to lower limb muscle coactivation because excitatory length and inhibitory force-dependent feedback from Q can increase and decrease SOL motor output (8-12).…”

Section: Introductionmentioning

confidence: 99%

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Heteronymous feedback from quadriceps onto soleus in stroke survivors

Cuadra,

Wolf,

Lyle

2024

Preprint

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Background: Recent findings suggest increased excitatory heteronymous feedback from quadriceps onto soleus may contribute to abnormal coactivation of knee and ankle extensors after stroke. However, there is lack of consensus on whether persons post-stroke exhibit altered heteronymous reflexes and, when present, the origin of increased excitation (i.e. increased excitation alone and/or decreased inhibition). This study examined heteronymous excitation and inhibition from quadriceps onto soleus in paretic, nonparetic, and age-matched control limbs to determine whether increased excitation was due to excitatory and/or reduced inhibitory reflex circuits. A secondary purpose was to examine whether heteronymous reflex magnitudes were related to clinical measures of lower limb recovery, walking-speed, and dynamic balance. Methods: Heteronymous excitation and inhibition from quadriceps onto soleus were examined in fourteen persons post-stroke and fourteen age-matched unimpaired participants. Heteronymous feedback was elicited by femoral nerve and quadriceps muscle stimulation in separate trials while participants tonically activated soleus at 20% max. Fugl-Myer assessment of lower extremity, 10-meter walk test, and Mini-BESTest were assessed in stroke survivors. Results: Heteronymous excitation and inhibition onsets, durations, and magnitudes were not different between paretic, nonparetic or age-matched unimpaired limbs. Quadriceps stimulation elicited excitation that was half the magnitude of femoral nerve stimulation. Femoral nerve elicited paretic limb heteronymous excitation was positively correlated with walking speed but did not reach significance because only a subset of paretic limbs exhibited excitation (n = 8, Spearman r = 0.69, P = 0.058). Conclusions: Heteronymous feedback from quadriceps onto soleus assessed in a seated posture was not impaired in persons post-stroke. Despite being unable to identify whether reduced inhibition contributes to abnormal excitation reported in prior studies, our results indicate quadriceps stimulation may allow a better estimate of heteronymous inhibition in those that exhibit exaggerated excitation. Heteronymous excitation magnitude in the paretic limb was positively correlated with self-selected walking speed suggesting paretic limb excitation at the higher end of a normal range may facilitate walking ability after stroke. Future studies are needed to identify whether heteronymous feedback from Q onto SOL is altered after stroke in upright postures and during motor tasks as a necessary next step to identify mechanisms underlying motor impairment.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Heteronymous feedback from quadriceps onto soleus in stroke survivors

Cuadra,

Wolf,

Lyle

2024

Preprint

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“…8,9 In addition, a clinical study has shown that the vibration applied to the sole of the foot of patient after stroke has a positive effect on balance improvement, 10 and another study has shown that patellar tendon vibration can reduce pathological extensor synergy after stroke. 11 However, it is difficult to compare the effects of vibration on the human body through the results of previous studies, because the vibration characteristics (such as the type, frequency, and intensity) used in each study are different. Therefore, a quantitative standard for the effect of vibration stimulus is needed, and it can be found through the change of Mu rhythm activity according to vibratory stimulus.…”

Section: Introductionmentioning

confidence: 99%

Derivation of local vibratory stimulus for stair climbing based on Mu rhythm

Kwak

Kim

et al. 2019

Advances in Mechanical Engineering

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The purpose of this study was to derive the local vibration that the sensorimotor area responds sensitively and to investigate changes in muscle activity of the lower limb when the vibratory stimulus was applied during the stair climbing. The electroencephalogram was measured when vibratory stimulus was applied to each tendon and changes in Mu rhythm activity were analyzed. A specific vibration frequency was selected through the results of the Mu rhythm analysis, and the specific vibratory conditions were set by combining the tendon site, vibration intensity, and frequencies. These vibratory conditions were applied simultaneously with the electromyogram measurement during the stair climbing. As a result, we confirm the specific vibration frequencies in each tendon. Also, we infer that there is a sensitive vibratory stimulus for each tendon. Moreover, the specific vibratory stimulus activates the sensorimotor area and elicits an increase in the muscle activity. This result means that specific vibration frequency and stimulation site should be considered in rehabilitation therapy that used the local vibratory stimulus. Also, local vibratory stimulus can be used to assist in stair climbing.

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