Impairment of voluntary control of finger motion following stroke: Role of inappropriate muscle coactivation

Kamper, Derek G.; Rymer, William Z.

doi:10.1002/mus.1054

Cited by 191 publications

(129 citation statements)

References 28 publications

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“…finger flexor muscles and increased resting flexor muscle tone (Kamper et al 2003). Our findings build on this earlier work by quantifying the amount of finger and thumb extension recovery after stroke.…”

Section: Limited Recovery Of Digit Extensionsupporting

confidence: 79%

“…The inability to extend the digits is primarily due to a limited ability to activate the finger and thumb extensor muscles (Kamper and Rymer 2001;Kamper et al 2003Kamper et al , 2006. Historically, there has been little success in improving finger and thumb extension capabilities with targeted rehabilitation techniques (Trombly et al 1986).…”

Section: Introductionmentioning

confidence: 99%

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Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Lang¹,

DeJong²,

Beebe³

2009

Journal of Neurophysiology

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Lang CE, DeJong SL, Beebe JA. Recovery of thumb and finger extension and its relation to grasp performance after stroke. J Neurophysiol 102: 451-459, 2009. First published May 20, 2009 doi:10.1152/jn.91310.2008. This study investigated how the ability to extend the fingers and thumb recovers early after stroke and how the ability to extend all of the digits affects grasping performance. We studied 24 hemiparetic patients at 3 and 13 wk post stroke. At each visit, we tested the subjects' ability to actively extend all five digits of their contralesional, affected hand against gravity and to perform a grasp movement with the same hand. Three-dimensional motion analysis captured: 1) maximal voluntary extension excursion of each digit and 2) grasp performance variables of movement time, peak aperture, peak aperture rate, and aperture path ratio. We found that finger and thumb extension improved from 3 to 13 wk, with average improvements ranging from 12 to 19°across the five digits. Grasp performance improved on two of the four variables measured. Peak apertures and peak aperture rates improved from 3 to 13 wk, but self-selected movement time and aperture path ratio did not. Stepwise multiple regression models showed that the majority of variance in grasp performance at 13 wk could be predicted by the ability to extend the index or middle finger at 3 wk, plus the change in the ability to extend the index finger from 3 to 13 wk. R 2 values ranged from 0.55 to 0.89. Our data indicate that the amount of recovery in finger and thumb extension and grasping is small from 3 to 13 wk post stroke. In people with relatively pure motor hemiparesis, one important factor underlying deficits in hand shaping during grasping is the inability to extend the fingers and thumb. Without sufficient volitional control of finger and thumb extension, successful grasping of objects will not occur.

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Section: Limited Recovery Of Digit Extensionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Lang¹,

DeJong²,

Beebe³

2009

Journal of Neurophysiology

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“…As such, possibly via reciprocal inhibition mechanisms, the breathing-controlled ES (BreEStim) could avoid excessive finger flexor-extensor coactivation problems in stroke patients (Kamper and Rymer 2001) and, in turn, lead to reduction of flexor hypertonia. Similar to this idea, ES, when combined with motor point block for antagonist muscles (hybrid FES therapy), has shown greater functional improvement and spasticity reduction than used alone for stroke rehabilitation (Hara et al 2000).…”

Section: Potential Clinical Applicationsmentioning

confidence: 99%

Voluntary Breathing Influences Corticospinal Excitability of Nonrespiratory Finger Muscles

Rymer

2011

Journal of Neurophysiology

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Li S, Rymer WZ. Voluntary breathing influences corticospinal excitability of nonrespiratory finger muscles. J Neurophysiol 105: 512-521, 2011. First published December 15, 2010 doi:10.1152/jn.00946.2010. The present study aimed to investigate neurophysiologic mechanisms mediating the newly discovered phenomenon of respiratory-motor interactions and to explore its potential clinical application for motor recovery. First, young and healthy subjects were instructed to breathe normally (NORM); to exhale (OUT) or inhale (IN) as fast as possible in a self-paced manner; or to voluntarily hold breath (HOLD). In experiment 1 (n ϭ 14), transcranial magnetic stimulation (TMS) was applied during 10% maximal voluntary contraction (MVC) finger flexion force production or at rest. The motor-evoked potentials (MEPs) were recorded from flexor digitorum superficialis (FDS), extensor digitorum communis (EDC), and abductor digiti minimi (ADM) muscles. Similarly, in experiment 2 (n ϭ 11), electrical stimulation (ES) was applied to FDS or EDC during the described four breathing conditions while subjects maintained 10%MVC of finger flexion or extension and at rest. In the exploratory clinical experiments (experiment 3), four patients with chronic neurological disorders (three strokes, one traumatic brain injury) received a 30-min session of breathing-controlled ES to the impaired EDC. In experiment 1, the EDC MEP magnitudes increased significantly during IN and OUT at both 10%MVC and rest; the FDS MEPs were enhanced only at 10%MVC, whereas the ADM MEP increased only during OUT, compared with NORM for both at rest and 10%MVC. No difference was found between NORM and HOLD for all three muscles. In experiment 2, when FDS was stimulated, force response was enhanced during both IN and OUT, but only at 10%MVC. When EDC was stimulated, force response increased at both 10%MVC and rest, only during IN, but not OUT. The averaged response latency was 83 ms for the finger extensors and 79 ms for the finger flexors. After a 30-min intervention of ES to EDC triggered by forced inspiration in experiment 3, we observed a significant reduction in finger flexor spasticity. The spasticity reduction lasted for Ն4 wk in all four patients. TMS and ES data, collectively, support the phenomenon that there is an overall respiration-related enhancement on the motor system, with a strong inspiration-finger extension coupling during voluntary breathing. As such, breathing-controlled electrical stimulation (i.e., stimulation to finger extensors delivered during the voluntary inspiratory phase) could be applied for enhancing finger extension strength and finger flexor spasticity reduction in poststroke patients.

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“…Reducing co-contraction can thus lead to reduction in metabolic cost of movement (Huang, Kram, & Ahmed, 2012). The reduction of muscle cocontraction is postulated to reduce spasticity (Kamper & Rymer, 2001) and thus it has been a target for rehabilitative programs (Wright, Rymer, & Slutzky, 2014).…”

Section: Muscle Co-contraction In Motor Deficitsmentioning

confidence: 99%

Muscle co-contraction patterns in robot-mediated force field learning to guide specific muscle group training

Pizzamiglio

Desowska

Shojaii

et al. 2017

NRE

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Impairment of voluntary control of finger motion following stroke: Role of inappropriate muscle coactivation

Cited by 191 publications

References 28 publications

Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Voluntary Breathing Influences Corticospinal Excitability of Nonrespiratory Finger Muscles

Muscle co-contraction patterns in robot-mediated force field learning to guide specific muscle group training

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