scholarly journals Phase-dependent deficits during reach-to-grasp after human spinal cord injury

2018 ◽  
Vol 119 (1) ◽  
pp. 251-261 ◽  
Author(s):  
Yuming Lei ◽  
Monica A. Perez
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Muscle Activation ◽  
Cervical Spinal Cord ◽  
Sensory Function ◽  
Movement Duration ◽  
Functional Impairments ◽  
Reach To Grasp ◽  
Cord Injury ◽  
Opening And Closing

Most cervical spinal cord injuries result in asymmetrical functional impairments in hand and arm function. However, the extent to which reach-to-grasp movements are affected in humans with incomplete cervical spinal cord injury (SCI) remains poorly understood. Using kinematics and electromyographic (EMG) recordings in hand and arm muscles we studied the different phases of unilateral self-paced reach-to-grasp movements (arm acceleration, hand opening and closing) to a small cylinder in the more and less affected arms of individuals with cervical SCI and in age-matched controls. We found that SCI subjects showed prolonged movement duration in both arms during arm acceleration, and hand opening and closing compared with controls. Notably, the more affected arm showed an additional increase in movement duration at the time to close the hand compared with the less affected arm. Also, the time at which the index finger and thumb contacted the object and the variability of finger movement trajectory were increased in the more compared with the less affected arm of SCI participants. Participants with prolonged movement duration during hand closing were those with more pronounced deficits in sensory function. The muscle activation ratio between the first dorsal interosseous and abductor pollicis brevis muscles decreased during hand closing in the more compared with the less affected arm of SCI participants. Our results suggest that deficits in movement kinematics during reach-to-grasp movements are more pronounced at the time to close the hand in the more affected arm of SCI participants, likely related to deficits in EMG muscle activation and sensory function. NEW & NOTEWORTHY Humans with cervical spinal cord injury usually present asymmetrical functional impairments in hand and arm function. Here, we demonstrate for the first time that deficits in movement kinematics during reaching and grasping movements are more pronounced at the time to close the hand in the more affected arm of spinal cord injury. We suggest that this is in part related to deficits in muscle activation ratios between hand muscles and a decrease in sensory function.

scholarly journals Bilateral reach-to-grasp movement asymmetries after human spinal cord injury

2016 ◽  
Vol 115 (1) ◽  
pp. 157-167 ◽  
Author(s):  
Finnegan J. Calabro ◽  
Monica A. Perez
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Emg Activity ◽  
Small Object ◽  
Functional Impairments ◽  
Reach To Grasp ◽  
Control Subjects ◽  
Cord Injury ◽  
Opening And Closing ◽  
Hand Opening

Cervical spinal cord injury (SCI) in humans typically damages both sides of the spinal cord, resulting in asymmetric functional impairments in the arms. Despite this well-accepted notion and the growing emphasis on the use of bimanual training strategies, how movement of one arm affects the motion of the contralateral arm after SCI remains unknown. Using kinematics and multichannel electromyographic (EMG) recordings we studied unilateral and bilateral reach-to-grasp movements to a small and a large cylinder in individuals with asymmetric arm impairments due to cervical SCI and age-matched control subjects. We found that the stronger arm of SCI subjects showed movement durations longer than control subjects during bilateral compared with unilateral trials. Specifically, movement duration was prolonged when opening and closing the hand when reaching for a large and a small object, respectively, accompanied by deficient activation of finger flexor and extensor muscles. In subjects with SCI interlimb coordination was reduced compared with control subjects, and individuals with lesser coordination between hands were those who showed prolonged times to open the hand. Although the weaker arm showed movement durations during bilateral compared with unilateral trials that were proportional to controls, the stronger arm was excessively delayed during bilateral reaching. Altogether, our findings demonstrate that during bilateral reach-to-grasp movements the more impaired arm has detrimental effects on hand opening and closing of the less impaired arm and that they are related, at least in part, to deficient control of EMG activity of hand muscles. We suggest that hand opening might provide a time to drive bimanual coordination adjustments after human SCI.

scholarly journals High-frequency epidural stimulation across the respiratory cycle evokes phrenic short-term potentiation after incomplete cervical spinal cord injury

2017 ◽  
Vol 118 (4) ◽  
pp. 2344-2357 ◽  
Author(s):  
Elisa J. Gonzalez-Rothi ◽  
Kristi A. Streeter ◽  
Marie H. Hanna ◽  
Anna C. Stamas ◽  
Paul J. Reier ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
High Frequency ◽  
Muscle Activation ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Burst Frequency ◽  
Epidural Stimulation ◽  
Term Potentiation ◽  
Cord Injury

C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of “crossed spinal” synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high-frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60 s, and currents ranged from 100 to 1,000 µA. Bilateral phrenic nerve activity and ipsilateral hypoglossal (XII) nerve activity were recorded before and after HF-ES. Higher T2 stimulus currents potentiated ipsilateral phasic inspiratory activity at both 2 and 12 wk post-C2Hx, whereas higher stimulus currents delivered at C4 potentiated ipsilateral phasic phrenic activity only at 12 wk ( P = 0.028). Meanwhile, tonic output in the ipsilateral phrenic nerve reached 500% of baseline values at the high currents with no difference between 2 and 12 wk. HF-ES did not trigger inspiratory burst-frequency changes. Similar responses occurred following T2 HF-ES. Increases in contralateral phrenic and XII nerve output were induced by C4 and T2 HF-ES at higher currents, but the relative magnitude of these changes was small compared with the ipsilateral phrenic response. We conclude that following incomplete cervical spinal cord injury, HF-ES of the ventrolateral midcervical or thoracic spinal cord can potentiate efferent phrenic motor output with little impact on inspiratory burst frequency. However, the substantial increases in tonic output indicate that the uninterrupted 60-s stimulation paradigm used is unlikely to be useful for respiratory muscle activation after spinal injury. NEW & NOTEWORTHY Previous studies reported that high-frequency epidural stimulation (HF-ES) activates the diaphragm following acute spinal transection. This study examined HF-ES and phrenic motor output following subacute and chronic incomplete cervical spinal cord injury. Short-term potentiation of phrenic bursting following HF-ES illustrates the potential for spinal stimulation to induce respiratory neuroplasticity. Increased tonic phrenic output indicates that alternatives to the continuous stimulation paradigm used in this study will be required for respiratory muscle activation after spinal cord injury.

scholarly journals Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury

2015 ◽  
Vol 9 ◽  
Author(s):  
Sébastien Mateo ◽  
Franck Di Rienzo ◽  
Vance Bergeron ◽  
Aymeric Guillot ◽  
Christian Collet ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Imagery ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Reach To Grasp ◽  
Cord Injury

scholarly journals Time-Dependent Discrepancies between Assessments of Sensory Function after Incomplete Cervical Spinal Cord Injury

2017 ◽  
Vol 34 (9) ◽  
pp. 1778-1786 ◽  
Author(s):  
Richard A. Macklin ◽  
Jihye Bae ◽  
Melanie Orell ◽  
Kim D. Anderson ◽  
Peter H. Ellaway ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Sensory Function ◽  
Time Dependent ◽  
Cord Injury

scholarly journals The effect of task symmetry on bimanual reach-to-grasp movements after cervical spinal cord injury

2018 ◽  
Vol 236 (11) ◽  
pp. 3101-3111
Author(s):  
Laura Britten ◽  
R. O. Coats ◽  
R. M. Ichiyama ◽  
W. Raza ◽  
F. Jamil ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Reach To Grasp ◽  
Cord Injury

scholarly journals Upper Limb Robotic Rehabilitation for Patients With Cervical Spinal Cord Injury: A Comprehensive Review

2021 ◽  
Author(s):  
Giovanni Morone ◽  
Alessandro De Sire ◽  
Alex Martino Cinnera ◽  
Matteo Paci ◽  
Luca Perrero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cochrane Library ◽  
Functional Impairments ◽  
Robotic Assisted ◽  
Study Results ◽  
Cord Injury

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results; therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.

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