Distribution of weakness in the upper and lower limbs post-stroke

Tyson, Sarah; Chillala, Jay; Hanley, Marie; Selley, Andrea; Tallis, Raymond

doi:10.1080/09638280500301584

Cited by 25 publications

(16 citation statements)

References 24 publications

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“…Weakness may affect all muscle groups of the upper limb, or may be selective, affecting some muscle groups more than others. Large inter-subject differences exist in the pattern of muscle weakness across muscle groups, but research has shown that no consistent proximal-to-distal gradient or greater extensor relative to flexor weakness exists (Mercier and Bourbonnais 2004; Tyson, Chillala et al 2006). While the absolute strength in any particular muscle group has not shown to predict function, the rate of change of force development in wrist extensor and handgrip strength (Renner, Bungert-Kahl et al 2009) are good predictors of upper limb function.…”

Section: Learned Nonusementioning

confidence: 99%

Upper Limb Motor Impairment After Stroke

Raghavan

2015

Physical Medicine and Rehabilitation Clinics of North America

283

198

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Synopsis Understanding upper limb impairment after stroke is essential to planning therapeutic efforts to restore function. However determining which upper limb impairment to treat and how is complex for two reasons: 1) the impairments are not static, i.e. as motor recovery proceeds, the type and nature of the impairments may change; therefore the treatment needs to evolve to target the impairment contributing to dysfunction at a given point in time. 2) multiple impairments may be present simultaneously, i.e., a patient may present with weakness of the arm and hand immediately after a stroke, which may not have resolved when spasticity sets in a few weeks or months later; hence there may be a layering of impairments over time making it difficult to decide what to treat first. The most useful way to understand how impairments contribute to upper limb dysfunction may be to examine them from the perspective of their functional consequences. There are three main functional consequences of impairments on upper limb function are: (1) learned nonuse, (2) learned bad-use, and (3) forgetting as determined by behavioral analysis of tasks. The impairments that contribute to each of these functional limitations are described.

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Section: Learned Nonusementioning

confidence: 99%

Upper Limb Motor Impairment After Stroke

Raghavan

2015

Physical Medicine and Rehabilitation Clinics of North America

283

198

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“…Sensorimotor deficits in the upper limb, such as weakness (Bourbonnais & Vanden Noven, 1989;Dewald & Beer, 2001;Tyson, Chillala, Hanley, Selley, & Tallis, 2006), decreased speed of movement (Trombly, 1992), decreased angular excursion and impaired temporal coordination of the joints (Cirstea & Levin, 2000;Levin, 1996), impaired upper-limb and trunk coordination (Cirstea & Levin, 2000;Michaelsen, Luta, Roby-Brami, & Levin, 2001), and impaired hand function (Lang, Wagner, Edwards, Sahrmann, & Dromerick, 2006;Welmer, Holmqvist, & Sommerfeld, 2008), may limit the ability to use the affected upper extremity to perform various tasks.…”

mentioning

confidence: 99%

Use of Mental Practice to Improve Upper-Limb Recovery After Stroke: A Systematic Review

Nilsen

Gillen

Gordon

2010

The American Journal of Occupational Therapy

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OBJECTIVE. We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke. METHOD. We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements. RESULTS. Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery. CONCLUSION. When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance.

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“…HSP on movement is a predictor of poor functional outcome (Pong et al, 2012;Roy, Sands, Hills, Harrison, & Marshall, 1995) while poor motor recovery has been associated with presence of HSP (Pong et al, 2012;Smith, 2012). Immobility of the upper limb due to paralysis or weakness (Ada et al, 2003;Tyson, Chillala, Hanley, Selley, & Tallis, 2006) and changes in muscle control and adaptive changes in muscle length post-stroke (Ada et al, 2003;Kalichman & Ratmansky, 2011) and inwards/outwards (medio-laterally). The mobility of the glenohumeral joint together with joint instability puts it at risk of musculoskeletal complications post-stroke (Shepherd & Carr, 1998).…”

Section: Adey-wakelingmentioning

confidence: 99%

Tracking changes in glenohumeral joint position in acute post-stroke hemiparetic patients: an observational study

Choolun

Kuys

Bisset

2016

Disability and Rehabilitation

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Minimal changes in glenohumeral joint positioning occurs early post-stroke. Clinicians should consider changes in glenohumeral joint position for both non- and hemiparetic sides during the early rehabilitation phase following stroke. Implications for rehabilitation Changes occur in glenohumeral joint centre of rotation (GHJC) position between hemiparetic and non-hemiparetic sides early in people with mild stroke. Clinicians need to be aware of early GHJC positional changes. Early GHJC positional changes may contribute to the development of hemiparetic shoulder pain (HSP), anterior humeral subluxation and glenohumeral joint impingement. Clinicians should employ current best practice guidelines which promote safe positioning and handling of the upper limb to minimise subluxation forces and potential trauma to the passive restraints of the shoulder in the acute phase following stroke, to reduce the possibility of glenohumeral subluxation in the short term.

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Distribution of weakness in the upper and lower limbs post-stroke

Cited by 25 publications

References 24 publications

Upper Limb Motor Impairment After Stroke

Upper Limb Motor Impairment After Stroke

Use of Mental Practice to Improve Upper-Limb Recovery After Stroke: A Systematic Review

Tracking changes in glenohumeral joint position in acute post-stroke hemiparetic patients: an observational study

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