scholarly journals Increased shoulder abduction loads decreases volitional finger extension in individuals with chronic stroke: Preliminary findings

2014 ◽  
Author(s):  
Yiyun Lan ◽  
Jun Yao ◽  
Jules Dewald
Keyword(s):  
Chronic Stroke ◽  
Shoulder Abduction ◽  
Finger Extension

Clinical findings in C5-C6 and C5-C7 root palsies with brachial plexus traction lesions

2012 ◽  
Vol 38 (3) ◽  
pp. 237-241 ◽  
Author(s):  
J. A. Bertelli ◽  
M. F. Ghizoni
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Elbow Flexion ◽  
Clinical Findings ◽  
Hand Strength ◽  
Shoulder Abduction ◽  
Finger Extension ◽  
Root Injury ◽  
Flexion Extension

Stretch injuries of the C5-C7 roots of the brachial plexus traditionally have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. Based on current myotome maps we hypothesized that, as far as motion is concerned, palsies involving C5-C6 and C5-C7 root injuries should be similar. In 38 patients with upper-type palsies of the brachial plexus, we examined for correlations between clinical findings and root injury level, as documented by CT tomomyeloscan. Contrary to commonly held beliefs, C5-C7 root injuries were not associated with loss of extension of the elbow, wrist, thumb, or fingers, but residual hand strength was much lower with C5-C7 vs C5-C6 lesions.

*Poster 63: Presence of Finger Extension and Shoulder Abduction Within 72 Hours Poststroke Predicts Functional Recovery

2010 ◽  
Vol 91 (10) ◽  
pp. e24
Author(s):  
Erwin van Wegen ◽  
Rinske Nijland ◽  
Janne Veerbeek ◽  
Barbara Harmeling–van der Wel ◽  
Gert Kwakkel
Keyword(s):  
Functional Recovery ◽  
Shoulder Abduction ◽  
Finger Extension

scholarly journals Presence of Finger Extension and Shoulder Abduction Within 72 Hours After Stroke Predicts Functional Recovery

Stroke ◽  
2010 ◽  
Vol 41 (4) ◽  
pp. 745-750 ◽  
Author(s):  
Rinske H.M. Nijland ◽  
Erwin E.H. van Wegen ◽  
Barbara C. Harmeling-van der Wel ◽  
Gert Kwakkel
Keyword(s):  
Functional Recovery ◽  
Shoulder Abduction ◽  
Finger Extension

Bimanual force control strategies in chronic stroke: Finger extension versus power grip

2012 ◽  
Vol 50 (11) ◽  
pp. 2536-2545 ◽  
Author(s):  
Neha Lodha ◽  
Carolynn Patten ◽  
Stephen A. Coombes ◽  
James H. Cauraugh
Keyword(s):  
Force Control ◽  
Control Strategies ◽  
Chronic Stroke ◽  
Power Grip ◽  
Finger Extension

scholarly journals Coupling of shoulder joint torques in individuals with chronic stroke mirrors controls, with additional non-load-dependent negative effects in a combined-torque task

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Joseph V. Kopke ◽  
Levi J. Hargrove ◽  
Michael D. Ellis
Keyword(s):  
Task Performance ◽  
Internal Rotation ◽  
Dual Task ◽  
External Rotation ◽  
Load Level ◽  
Chronic Stroke ◽  
Shoulder Abduction ◽  
Dual Tasks ◽  
Joint Torques ◽  
Co Activation

Abstract Background After stroke, motor control is often negatively affected, leaving survivors with less muscle strength and coordination, increased tone, and abnormal synergies (coupled joint movements) in their affected upper extremity. Humeral internal and external rotation have been included in definitions of abnormal synergy but have yet to be studied in-depth. Objective Determine the ability to generate internal and external rotation torque under different shoulder abduction and adduction loads in persons with chronic stroke (paretic and non-paretic arm) and uninjured controls. Methods 24 participants, 12 with impairments after stroke and 12 controls, completed this study. A robotic device controlled abduction and adduction loading to 0, 25, and 50% of maximum strength in each direction. Once established against the vertical load, each participant generated maximum internal and external rotation torque in a dual-task paradigm. Four linear mixed-effects models tested the effect of group (control, non-paretic, and paretic), load (0, 25, 50% adduction or abduction), and their interaction on task performance; one model was created for each combination of dual-task directions (external or internal rotation during abduction or adduction). The protocol was then modeled using OpenSim to understand and explain the role of biomechanical (muscle action) constraints on task performance. Results Group was significant in all task combinations. Paretic arms were less able to generate internal and external rotation during abduction and adduction, respectively. There was a significant effect of load in three of four load/task combinations for all groups. Load-level and group interactions were not significant, indicating that abduction and adduction loading affected each group in a similar manner. OpenSim musculoskeletal modeling mirrored the experimental results of control and non-paretic arms and also, when adjusted for weakness, paretic arm performance. Simulations incorporating increased co-activation mirrored the drop in performance observed across all dual-tasks in paretic arms. Conclusion Common biomechanical constraints (muscle actions) explain limitations in external and internal rotation strength during adduction and abduction dual-tasks, respectively. Additional non-load-dependent effects such as increased antagonist co-activation (hypertonia) may cause the observed decreased performance in individuals with stroke. The inclusion of external rotation in flexion synergy and of internal rotation in extension synergy may be over-simplifications.

Abstract TP147: Quantitative Measures of Strength and Synergy Differentiate Individuals With Chronic Stroke With and Without Clinically Detectable Elbow Contracture

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Grace C Bellinger ◽  
Michael D Ellis
Keyword(s):  
Quantitative Measure ◽  
Chronic Stroke ◽  
Future Research ◽  
Emg Activity ◽  
Shoulder Abduction ◽  
Joint Control ◽  
Elbow Extension ◽  
Unaffected Side ◽  
Elbow Contracture ◽  
Flexion Synergy

Many individuals with chronic stroke demonstrate contracture of the elbow flexors. The development of contracture may be attributable to underlying impairments such as weakness, flexion synergy, and hyperactive reflexes. This study explored differences in motor impairment and function between 17 individuals with clinically detectable elbow flexor contracture and 17 individuals with full passive range of motion. The groups did not differ in age (61.61 ± 7.99, 55.06 ± 12.48, p = 0.078), years post-stroke (12.92 ± 9.34, 10.60 ± 7.16, p = 0.423), or Fugl-Meyer Motor Assessment score (FMA, 26.35 ± 5.86, 26.47 ± 8.70, p = 0.963). The passive range limitation in the contracture group was 3 to 36° (11.65 ± 8.30°). Kinetics, kinematics, and EMG were used to quantify four motor impairments and reaching function. Shoulder abduction and elbow extension strength were measured isometrically and normalized to the unaffected side. Flexion synergy was quantified as a force-based measure assessing independent joint control. Flexor spasticity was quantified while reaching at 50% of maximum shoulder abduction as the change in biceps EMG from reach onset to peak angular velocity, normalized by maximal EMG activity. Reaching function was defined as maximum reaching distance against gravity and normalized by target distance (-10° of full extension). The groups differed in elbow extension strength (Contracture, 0.315 ± 0.129; No contracture, 0.559 ± 0.153; p < 0.001) and flexion synergy (0.146 ± 0.186, 0.397 ± 0.229, p = 0.009). The groups did not differ in shoulder abduction strength (0.500 ± 0.174, 0.615 ± 0.199, p = 0.080), flexor spasticity (0.079 ± 0.090, 0.056 ± 0.115, p = 0.523), or reaching function (0.501 ± 0.391, 0.714 ± 0.296, p = 0.082). The findings of this study suggest a relationship between elbow contracture and the concurrent presence of elbow extension weakness and flexion synergy. The quantitative measure of reaching function will likely differentiate individuals with and without contracture if the assessment is modified so that the standardized reaching target is located at 0° of elbow extension (normal range). Future research should use quantitative metrics to further explore the temporal recovery of impairments in order to prevent the development of contracture.

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