Measurement of synergy and spasticity during functional movement of the post-stoke hemiplegic upper limb

Ohn, Suk Hooh; Yoo, Woo‐Kyoung; Kim, Deog Young; Ahn, Seungho; Jung, Bora; Choi, Ikjun; Lee, Nam Jae; Jung, Kwang‐Ik

doi:10.1016/j.jelekin.2012.10.001

Cited by 29 publications

(26 citation statements)

References 34 publications

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“…It has been emphasized that EMG is the most appropriate method to measure motor function, because it has high clinical significance [9−13, 15, 16, 20]. Integral EMG (IEMG) [14] and co-contraction ratio (CCR) [16] have been suggested to determine the co-contraction ratio between muscles. In recent years, partially linear decomposition methods, such principal component analysis (PCA), linear independent component analysis (ICA) [21,22], and nonnegative matrix factorization (NMF) [23], are often used to investigate the relation between cortical activation (electroencephalography) and movement (EMG).…”

Section: Discussionmentioning

confidence: 99%

“…Because motor impairment in the upper extremity is the most frequent stroke complication, therapists make considerable efforts to target abnormal muscle activities. Furthermore, the present study proposes a promising method to objectively assess hemiplegic upper extremities to avoid unreliable assessments, such as the FM score, as pointed out by [16] Despite these facts, such subjective assessment methods are the most widely used in clinical settings [19,25]. Although these clinical assessments are very useful to roughly estimate motor disorders, they cannot clarify multiple muscle activities in detail.…”

Section: Discussionmentioning

confidence: 99%

“…These approaches identified the relation of the muscle groups affected by a stroke during typical synergy patterns (e.g., co-contraction) [15,16], but the characteristics of specific muscles remain unclear. It is important to clarify this point to enable physical and occupational therapists to target specific muscles when treating post-stroke patients for unstable reaching movements.…”

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confidence: 99%

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Analysis of reaching movements in stroke patients using average variability of electromyogram value

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Analysis of reaching movements in stroke patients using average variability of electromyogram value

et al. 2017

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“…16 Furthermore, spasticity patterns may differ according to whether a lesion occurs in the brain or at the level of the spinal cord. 17 For example, muscle synergy and spasticity induce distinctive and complex movement patterns in individuals with stroke primarily characterized by spastic hemiplegic posturing , 18 whereas extensor spasms, flexor withdrawal spasms and clonus are frequently reported in SCI. 19 Different patterns can impact the functional sequelae of the spasticity, 19 and consideration of these patterns may improve the dosing, goal setting and outcome measures selected to examine the effects of spasticity treatment.…”

Section: Introductionmentioning

confidence: 99%

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

2015

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Study design: Systematic review. Objectives: To systematically review the literature on chemodenervation with botulinum toxin (BoNT) or phenol/alcohol for treatment of limb spasticity following spinal cord injury (SCI). Setting: British Columbia, Canada. Methods: EMBASE, MEDLINE, CINAHL, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched for English language studies published up until March 2014. Studies were assessed for eligibility and quality by two independent reviewers. Results: No controlled trials were identified. A total of 19 studies were included: 9 involving BoNT and 10 involving phenol/alcohol. Owing to the clinically diverse nature of the studies, meta-analysis was deemed inappropriate. The studies produced level 4 and level 5 evidence that chemodenervation with BoNT or alcohol/phenol can lead to improvement in outcome measurements classified in the body structure and function, as well as activity domains of the International Classification of Functioning, Disability and Health framework. The Modified Ashworth Scale (MAS) was the most commonly used outcome measure. All six studies on BoNT and three of the four studies on phenol/alcohol measuring MAS reported a decrease in at least one point. An improvement in MAS was not always associated with improvement in function. The effect of phenol/alcohol has the potential to last beyond 6 months; study follow-up did not occur beyond this time point. Conclusion Chemodenervation with BoNT or phenol/alcohol may improve spasticity and function in individuals with SCI. However, there is a lack of high-quality evidence and further research is needed to confirm the efficacy of these interventions.

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“…However, it has been demonstrated that during rehabilitation the affected limb develops undesired compensatory strategies [3]. Thus, it is essential to understand healthy motor-control to avoid detrimental rehabilitation and guide a correct therapy design [4].…”

Section: Introductionmentioning

confidence: 99%

Synergy analysis as a tool to design and assess an effective stroke rehabilitation

Urra

Casals

Jané

2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-The poor rehabilitation success rate, including the cases of ineffective and detrimental adaptations, make stroke a leading cause of disability. Thus, it is essential to recognize the mechanisms driving healthy motor recovery to improve such rate. Stroke alters the Synergy Architecture (SA), the modular muscle control system. So SA analysis may constitute a powerful tool to design and assess rehabilitation procedures. However, current impairment scales do not consider the patient's neuromuscular state. To gain insights into this hypothesis, we recorded multiple myoelectric signals from upper-limb muscles, in healthy subjects, while executing a set of common rehabilitation exercises. We found that SA reveals optimized motor control strategies and the positive effects of the use of visual feedback (VF) on motor control. Furthermore we demonstrate that the right and left arm's SA share the basic structure within the same subject, so we propose using the unaffected limb's SA as a reference motion pattern to be reached through rehabilitation.

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Measurement of synergy and spasticity during functional movement of the post-stoke hemiplegic upper limb

Cited by 29 publications

References 34 publications

Analysis of reaching movements in stroke patients using average variability of electromyogram value

Analysis of reaching movements in stroke patients using average variability of electromyogram value

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

Synergy analysis as a tool to design and assess an effective stroke rehabilitation

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