Triceps denervation as a predictor of elbow flexion contractures in C5 and C6 tetraplegia

Bryden, Anne M.; Kilgore, Kevin L.; Lind, Benjamin; Yu, David

doi:10.1016/j.apmr.2004.01.042

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…45,52 Elbow extension ranged from 0 to 2. 46,47 The mean wrist flexion was 1.5. 45 The mean motor score of the five key muscles of both upper extremities was 19 or 20 out of 50.…”

Section: Resultsmentioning

confidence: 98%

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Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

et al. 2006

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Study design: Review of publications. Objective: To assess the level of physical capacity (peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Methods: Pubmed (Medline) search of publications from 1980 onwards. Studies were systematically assessed. Weighted means were calculated for baseline values. Results: In tetraplegia, the weighted mean for peak oxygen uptake was 0.89 l/min for the wheelchair exercise test (WCE) and 0.87 l/min for arm-cranking or hand-cycling (ACE). The peak power output was 26 W (WCE) and 40 W (ACE). In paraplegia, the peak oxygen uptake was 2.10 l/min (WCE) and 1.51 l/min (ACE), whereas the peak power output was 74 W (ACE) and 85 W (WCE). In paraplegia, muscle strength of the upper extremity and respiratory function were comparable to that in the able-bodied population. In tetraplegia muscle strength varied greatly, and respiratory function was reduced to 55-59% of the predicted values for an age-, gender-and height-matched able-bodied population. Conclusions: Physical capacity is reduced and varies in SCI. The variation between results is caused by population and methodological differences. Standardized measurement of physical capacity is needed to further develop comparative values for clinical practice and rehabilitation research.

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“…45,52 Elbow extension ranged from 0 to 2. 46,47 The mean wrist flexion was 1.5. 45 The mean motor score of the five key muscles of both upper extremities was 19 or 20 out of 50.…”

Section: Resultsmentioning

confidence: 98%

“…48 Elbow flexion ranged from a grade 2 to 5. [45][46][47]49,52 Wrist extension ranged from 3.3 to 4. 45,52 Elbow extension ranged from 0 to 2.…”

Section: Resultsmentioning

confidence: 99%

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

et al. 2006

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“…26 The modified Brunstron and Dennem grading scale was applied in three studies. 85,97,101 This method evaluates, through MMT, not only isolated muscles, but also active movement. 102 It also uses a six-point scale, with half point between the grades in the modified version.…”

Section: Resultsmentioning

confidence: 99%

“…102 It also uses a six-point scale, with half point between the grades in the modified version. 85,97,101 The OXFORD scale for the assessment of muscle strength was identified in one study. 100 Unspecified scales with scoring from 0 to 5 were used in three studies.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Muscle Strength in Medullar Injury: A Literature Review

et al. 2017

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Objective: To identify the tools used to evaluate muscle strength in subjects with spinal cord injury in both clinical practice and scientific research. Methods: Initially, the literature review was carried out to identify the tools used in scientific research. The search was conducted in the following databases: Virtual Health Library (VHL), Pedro, and PubMed. Studies published between 1990 and 2016 were considered and selected, depicting an evaluation of muscle strength as an endpoint or for characterization of the sample. Next, a survey was carried out with physiotherapists to identify the instruments used for evaluation in clinical practice, and the degree of satisfaction of professionals with respect to them. Results: 495 studies were found; 93 were included for qualitative evaluation. In the studies, we verified the use of manual muscle test with different graduation systems, isokinetic dynamometer, hand-held dynamometer, and manual dynamometer. In clinical practice, the manual muscle test using the motor score recommended by the American Spinal Cord Injury Association was the most used method, despite the limitations highlighted by the physiotherapists interviewed. Conclusion: In scientific research, there is great variation in the methods and tools used to evaluate muscle strength in individuals with spinal cord injury, differently from clinical practice. The tools available and currently used have important limitations, which were highlighted by the professionals interviewed. No instrument depicts direct relationship of muscle strength and functionality of the subject. There is no consensus as to the best method for assessing muscle strength in spinal cord injury, and new instruments are needed that are specific for use in this population.

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“…4 In this report, we present experimental evidence for the second and less obvious phenomenon; namely, that the preferential, focal denervation of the cervical spinal cord segments immediately caudal to the lesion site causes permanent paresis of their myotomes, as it occurs in the human TB after cervical SCI. 3,10,58 We chose C6 hemisection as an optimal model for testing our hypothesis, because this lesion spares the supraspinal and cervical propriospinal innervation of the spinal MN nuclei controlling elbow flexors and shoulder flexors and extensors, 37 thus allowing sufficient foreleg protraction during the stride swing phase and providing proximal mechanical stability for body support and foreleg retraction during the stance phase. Consequently, the rat actively used the foreleg and manifested deficits related to inactivation of elbow extensors and wrist flexors.…”

Section: Permanent Segmental Deficits After Scimentioning

confidence: 99%

Dynamic Motor Compensations with Permanent, Focal Loss of Forelimb Force after Cervical Spinal Cord Injury

López-Dolado

Lucas‐Osma²,

Collazos‐Castro³

2013

Journal of Neurotrauma

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Incomplete cervical lesion is the most common type of human spinal cord injury (SCI) and causes permanent paresis of arm muscles, a phenomenon still incompletely understood in physiopathological and neuroanatomical terms. We performed spinal cord hemisection in adult rats at the caudal part of the segment C6, just rostral to the bulk of triceps brachii motoneurons, and analyzed the forces and kinematics of locomotion up to 4 months postlesion to determine the nature of motor function loss and recovery. A dramatic (50%), immediate and permanent loss of extensor force occurred in the forelimb but not in the hind limb of the injured side, accompanied by elbow and wrist kinematic impairments and early adaptations of whole-body movements that initially compensated the balance but changed continuously over the follow-up period to allow effective locomotion. Overuse of both contralateral legs and ipsilateral hind leg was evidenced since 5 days postlesion. Ipsilateral foreleg deficits resulted mainly from interruption of axons that innervate the spinal cord segments caudal to the lesion, because chronic loss (about 35%) of synapses was detected at C7 while only 14% of triceps braquii motoneurons died, as assessed by synaptophysin immunohistochemistry and retrograde neural tracing, respectively. We also found a large pool of propriospinal neurons projecting from C2-C5 to C7 in normal rats, with topographical features similar to the propriospinal premotoneuronal system of cats and primates. Thus, concurrent axotomy at C6 of brain descending axons and cervical propriospinal axons likely hampered spontaneous recovery of the focal neurological impairments.

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Triceps denervation as a predictor of elbow flexion contractures in C5 and C6 tetraplegia

Cited by 34 publications

References 23 publications

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

Evaluation of Muscle Strength in Medullar Injury: A Literature Review

Dynamic Motor Compensations with Permanent, Focal Loss of Forelimb Force after Cervical Spinal Cord Injury

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