Reliability of elbow stretch reflex assessment in chronic post-stroke hemiparesis

Condliffe, Elizabeth G.; Clark, David J.; Patten, Carolynn

doi:10.1016/j.clinph.2005.02.030

Cited by 44 publications

(30 citation statements)

References 38 publications

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“…Increased motor output fluctuations restricted the ability of an individual to exert a steady trajectory [37] or move upper extremity accurately to the target [38]. In reverse, a pervious study reported that improvements in muscle strength would improve force control ability after strength training of upper extremities for poststroke patients [39]. …”

Section: Discussionmentioning

confidence: 99%

Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks

Yan

et al. 2014

J NeuroEngineering Rehabil

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BackgroundThe aim of this study is to investigate quantitative outcome measurements of hand motor performance for subjects after mild to moderate stroke using grip control tasks and characterize abnormal flexion synergy of upper extremities after stroke.MethodsA customized dynamometer with force sensors was used to measure grip force and calculate rotation torque during the sub-maximal grip control tasks. The paretic and nonpartic sides of eleven subjects after stroke and the dominant sides of ten healthy persons were tested. Their maximal voluntary grip force was measured and used to set sub-maximal grip control tasks at three different target force levels. Force control ability was characterized by the maximal grip force, mean force percentage, coefficient of variation (CV), target deviation ratio (TDR), and rotation torque ratio (RTR). The motor impairments of subjects after stroke were also evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE) and Wolf Motor Function Test (WMFT).ResultsMaximal grip force of the paretic side was significantly reduced as compared to the nonparetic side and the healthy group, while the difference of maximal grip force between the nonparetic side and the healthy group was not significant. TDR and RTR increased for all three groups with increasing target force level. There were significant differences of CV, TDR and RTR between the paretic side and the healthy group at all the force levels. CV, TDR and RTR showed significant negative correlations with FMA-UE and WMFT at 50% of maximum grip force.ConclusionsThis study designed a customized dynamometer together with an innovative measurement, RTR, to investigate the hand motor performance of subjects after mild to moderate stroke during force control tasks. And stroke-induced abnormal flexion synergy of wrist and finger muscles could be characterized by RTR. This study also identified a set of kinetic parameters which can be applied to quantitatively assess the hand motor function of subjects after mild to moderate stroke.

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Section: Discussionmentioning

confidence: 99%

Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks

Yan

et al. 2014

J NeuroEngineering Rehabil

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“…Spasticity, the typically measured component of hypertonicity, is most commonly measured with the Modified Ashworth Scale 131,132 ; however, its validity and interrater reliability have been questioned. 131,132 Other spasticity measures exist in the research literature (eg, Condliffe et al 133 ), but their clinical feasibility remains an issue, and there are limitations in the number of joints that can be assessed. An additional concern with motor tests that evaluate body structure and function issues is that although several assessments have established psychometric properties, the item structure of many tests is still being evaluated.…”

Section: Icf Dimensions Across the Inpatient-to-chronic Care Contmentioning

confidence: 99%

“…An additional concern with motor tests that evaluate body structure and function issues is that although several assessments have established psychometric properties, the item structure of many tests is still being evaluated. 43,44,133,134 Whatever tests are chosen, it is further recommended that clinicians obtain not only training to establish administration and scoring consistency, but also over time, routine retraining to ensure they maintain this consistency.…”

Section: Icf Dimensions Across the Inpatient-to-chronic Care Contmentioning

confidence: 99%

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Miller¹,

Murray²,

Richards³

et al. 2010

Stroke

675

412

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“…Gains in proprioceptive feedback, regulated through stretch reflex pathways, are significantly enhanced, as evidenced by greater muscle activity in response to limb movement [5], but it is not clear how altered stretch reflexes contribute to impaired muscle coordination during active control of limb mechanics poststroke. Investigations quantifying reflex function have primarily focused on passive, single joint conditions [6]. Although these studies are useful for characterizing the abnormal state of spastic muscles, their results make it difficult to fully appreciate their functional relevance under more natural multijoint conditions, relevant to control of arm posture.…”

Section: Introductionmentioning

confidence: 99%

Altered multijoint reflex coordination is indicative of motor impairment level following stroke

Trumbower

Ravichandran

Krutky

et al. 2008

2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Following stroke, individuals often are unable to activate their elbow and shoulder muscles independently. There is growing evidence that altered reflex pathways may contribute to these abnormal patterns of activation or muscle synergies. Most studies investigating reflex function following stroke have examined only individual joints at rest. Thus, the purpose of this study was to quantify multijoint reflex contributions to the stereotyped muscle synergies commonly observed following stroke. We hypothesized that the patterns of reflex coordination mirror the abnormal muscle coactivity patterns previously reported for voluntary activation. 10 chronic stroke and 8 agematched control subjects participated. Reflexes were elicited by perturbing the arm with a 3 degree of freedom robot while subjects exerted voluntary forces at the elbow and shoulder. The force conditions tested were selected to assess the influence of gravity and the influence of joint torque generation without gravity on reflex coordination. Reflex magnitude was quantified by the average rectified electromyogram, recorded from 8 muscles that span the elbow and shoulder. Patterns of reflex coordination were quantified using independent components analysis. Results show significant reflex coupling between elbow flexor and shoulder abductor-extensor muscles in stroke patients during isolated elbow and shoulder torque generation and during active arm support against gravity. Identified patterns of stretch reflex coordination were consistent with the stereotyped voluntary flexion synergy, suggesting reflex pathways contribute to abnormal muscle coordination following stroke.

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Reliability of elbow stretch reflex assessment in chronic post-stroke hemiparesis

Cited by 44 publications

References 38 publications

Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks

Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Altered multijoint reflex coordination is indicative of motor impairment level following stroke

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