![]() Overactive spinal motor neurons are sensitive to the obscured signals from the remaining pyramidal tract or extrapyramidal pathway ( 7), such as the reticular spinal tract ( 8), activating the muscles to participate in the synergistic movements ( 9). It is generally believed that decreased descending inhibitory signals or an imbalance between the inhibitory and excitatory descending signals after stroke leads to an increase in the excitability of spinal motor neurons. The synergistic movements are partially voluntary yet not completely under control ( 5, 6). It is difficult to break upper limbs' synergic pattern and to induce isolated movement with practical value ( 4). A considerable number of patients have chronic hemiplegia in the affected upper limb, characterized by synergistic movements ( 3). Hemiplegia is the most common sequela of a stroke and the leading cause of disability ( 1, 2). ![]() The difference in muscle activation based on spinal cord segments may be the reason for the stereotyped joint movement of upper limb flexion synergy. However, the standardized activation of both FCR and FCU in stroke patients was significantly lower than that in healthy controls.Ĭonclusion: After stroke, the activation of the distal muscles of the upper limb decreased significantly regardless of the difference of spinal cord segments while the activation of the proximal muscles innervated by the same spinal cord segment (C5-C6) dominating the elbow flexion showed higher activation during flexion synergy. ![]() Similarly, there was no significant difference in normalized activation between FCR and FCU in healthy controls, and the same is true for stroke patients. Results: There was no difference between the PC and PS's normalized activation in healthy controls while the PC's normalized activation was higher than PS in stroke patients during elbow flexion. The comparison of the activation of the same muscle between patients and healthy controls was undertaken after standardization based on the activation of the biceps brachii in elbow flexion. In each muscle pair, one muscle was innervated by the same spinal cord segment (C5-C6), dominating the elbow flexion and the other was not. Sternocostal part of the pectoralis major, PS Flexor carpi radialis, FCR vs. The study compared normalized activation of two pairs of muscles that could cause similar joint movement but which dominated different spinal cord segments (clavicular part of the pectoralis major, PC vs. Methods: Surface electromyography (sEMG) signals were collected during elbow flexion in stroke patients and healthy controls. Abnormal flexor synergy in both hip and knee joints (score 1 or 2) on the Fugl-Meyer Assessment Lower Extremity section II: Volitional movement within synergies (Fugl-Meyer et al.Objective: This study examined the activation difference of muscles innervated by cervical cord 5-6 (C5-C6) and cervical cord 8- thoracic cord 1 (C8-T1) in upper limb flexion synergy after stroke.Able to walk with or without an assistive device for 7 m independently.Time post-stroke between 6 months and 3 years.Heart rate (HR) will be monitored continuously using a fingertip pulse monitor to ensure the maximum training HR is no more than 75% of the subject's HR Reserve. With feet strapped to the pedals, the participant will be asked to activate the hip, knee, and ankle flexors simultaneously when the pedal is moving up and then relax. The bike pedals are moving backward at a preset speed regardless of user effort. Their lower limb muscle function and walking performance will be assessed at baseline (2 to 3 times within the 2 weeks prior to starting the training), at the end of training, and 4 weeks later.Įach subject will perform biking exercises under supervision, 2-3 times per week for 4 weeks (30 minutes each). Ten participants with chronic stroke will be recruited. Therefore, it is the intent of this exploratory study to find out whether an exercise training program focusing on lower limb flexors can improve lower limb motor function late after stroke. Many previous studies have focused on strengthening the lower limb muscles that support the body in standing and walking (the so-called anti-gravity extensor muscles) but the training targeting the lower limb flexors has rarely been emphasized in stroke rehabilitation. ![]() It is known that the muscles that flex the hip, knee, and ankle joints are responsible for bringing the leg up and forward during walking and for a successful recovery from a slip or trip. Why Should I Register and Submit Results?. ![]()
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