scholarly journals Startle Increases the Incidence of Anticipatory Muscle Activations but Does Not Change the Task-Specific Muscle Onset for Patients After Subacute Stroke

2022 ◽  
Vol 12 ◽  
Author(s):  
Nan Xia ◽  
Chang He ◽  
Yang-An Li ◽  
Minghui Gu ◽  
Zejian Chen ◽  
...  
Keyword(s):  
Stroke Survivors ◽  
Onset Latency ◽  
Reaching Tasks ◽  
Stroke Population ◽  
Subacute Stroke ◽  
Anterior Deltoid ◽  
Specific Muscle ◽  
Muscle Activations ◽  
Lower Trapezius ◽  
Post Hoc

Objectives: To demonstrate the task-specificities of anticipatory muscle activations (AMAs) among different forward-reaching tasks and to explore the StartleReact Effect (SE) on AMAs in occurrence proportions, AMA onset latency or amplitude within these tasks in both healthy and stroke population.Methods: Ten healthy and ten stroke subjects were recruited. Participants were asked to complete the three forward-reaching tasks (reaching, reaching to grasp a ball or cup) on the left and right hand, respectively, with two different starting signals (warning-Go, 80 dB and warning-startle, 114 dB). The surface electromyography of anterior deltoid (AD), flexor carpi radialis (FCR), and extensor carpi radialis (ECR) on the moving side was recorded together with signals from bilateral sternocleidomastoid muscles (SCM), lower trapezius (LT), latissimus dorsi (LD), and tibialis anterior (TA). Proportions of valid trials, the incidence of SE, AMA incidence of each muscle, and their onset latency and amplitude were involved in analyses. The differences of these variables across different move sides (healthy, non-paretic, and paretic), normal or startle conditions, and the three tasks were explored. The ECR AMA onset was selected to further explore the SE on the incidence of AMAs.Results: Comparisons between move sides revealed a widespread AMA dysfunction in subacute stroke survivors, which was manifested as lower AMA onset incidence, changed onset latency, and smaller amplitude of AMAs in bilateral muscles. However, a significant effect of different tasks was only observed in AMA onset latency of muscle ECR (F = 3.56, p = 0.03, η2p = 0.011), but the significance disappeared in the subsequent analysis of the stroke subjects only (p > 0.05). Moreover, the following post-hoc comparison indicated significant early AMA onsets of ECR in task cup when comparing with reach (p < 0.01). For different stimuli conditions, a significance was only revealed on shortened premotor reaction time under startle for all participants (F = 60.68, p < 0.001, ηp2 = 0.056). Furthermore, stroke survivors had a significantly lower incidence of SE than healthy subjects under startle (p < 0.01). But all performed a higher incidence of ECR AMA onset (p < 0.05) than with normal signal. In addition, the incidence of ECR AMAs of both non-paretic and paretic sides could be increased significantly via startle (p ≤ 0.02).Conclusions: Healthy people have task-specific AMAs of muscle ECR when they perform forward-reaching tasks with different hand manipulations. However, this task-specific adjustment is lost in subacute stroke survivors. SE can improve the incidence of AMAs for all subjects in the forward-reaching tasks involving precision manipulations, but not change AMA onset latency and amplitude.

Abstract P851: Embracing Virtual Connection: An Innovative Systemwide Approach to Support Groups

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Carly J Rossi ◽  
Nicole Westensee ◽  
Dienst Elizabeth ◽  
Danielle Hagedorn ◽  
Julie Schafer ◽  
...  
Keyword(s):  
Support Groups ◽  
Support Group ◽  
High Risk Patient ◽  
Stroke Survivors ◽  
Group Leaders ◽  
Caregiver Support ◽  
Stroke Population ◽  
Virtual Platform ◽  
Problem Solve ◽  
Virtual Support

Background: Following a statewide stay-at-home order, Centura Stroke Support Group meetings were postponed indefinitely due to our high-risk patient population. Throughout the organization, stroke coordinators and support group leaders recognized the importance of community and continued support for the stroke population. The objective was to develop a creative survivor & caregiver support offering following social distancing guidelines given the Covid-19 restrictions, while collaborating & expanding opportunities for stroke support across the Centura system. Purpose: We hypothesized that we could successfully support stroke survivors & caregivers through a virtual platform during the pandemic & improve accessibility regardless of participant location or transportation. Methods: Group leaders assessed stroke survivors & caregivers ongoing needs through weekly outreach identifying the importance of the support group and a need for continued group access during the Covid-19 pandemic. Attendee’s indicated an interest in virtual support & a willingness to learn the required virtual platform. Leaders collaborated across the system to organize efforts in reaching survivors & caregivers at each hospital while sharing group curriculum & education systemwide; thus, allowing groups to meet at different times and increasing overall accessibility. Facilitators worked with individuals to problem solve potential issues navigating a virtual format. Results: The virtual format successfully provided support from the comfort & safety of home. Attendance increased in comparison to an in-person format. When asked about preference for an in-person setting only vs. a combination of in-person & virtual format, 80% selected a combination format. Working together across the system, stroke coordinators & group facilitators benefitted from a broader range of resources and connected the greater stroke community across Colorado. Conclusion: Regardless of future restrictions, hospitals should consider virtual support groups to increase accessibility for survivors & caregivers. There are benefits of the virtual platform which expand access to support by reducing barriers such as community availability and transportation.

scholarly journals β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke

2020 ◽  
Vol 34 (5) ◽  
pp. 450-462 ◽  
Author(s):  
Chih-Wei Tang ◽  
Fu-Jung Hsiao ◽  
Po-Lei Lee ◽  
Yun-An Tsai ◽  
Ya-Fang Hsu ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Hand Movement ◽  
Stroke Recovery ◽  
Stroke Survivors ◽  
Healthy Controls ◽  
Functional Changes ◽  
Post Stroke ◽  
Subacute Stroke

Background. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. Methods. First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. Results. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. The peak amplitudes of ipsilesional β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke. Conclusions. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.

scholarly journals Alterations in upper limb muscle synergy structure in chronic stroke survivors

2013 ◽  
Vol 109 (3) ◽  
pp. 768-781 ◽  
Author(s):  
Jinsook Roh ◽  
William Z. Rymer ◽  
Eric J. Perreault ◽  
Seng Bum Yoo ◽  
Randall F. Beer
Keyword(s):  
Muscle Activation ◽  
Isometric Force ◽  
Muscle Synergy ◽  
Muscle Synergies ◽  
Stroke Survivors ◽  
Activation Patterns ◽  
Force Matching ◽  
Muscle Activation Patterns ◽  
Anterior Deltoid ◽  
Arm Function

Previous studies in neurologically intact subjects have shown that motor coordination can be described by task-dependent combinations of a few muscle synergies, defined here as a fixed pattern of activation across a set of muscles. Arm function in severely impaired stroke survivors is characterized by stereotypical postural and movement patterns involving the shoulder and elbow. Accordingly, we hypothesized that muscle synergy composition is altered in severely impaired stroke survivors. Using an isometric force matching protocol, we examined the spatial activation patterns of elbow and shoulder muscles in the affected arm of 10 stroke survivors (Fugl-Meyer <25/66) and in both arms of six age-matched controls. Underlying muscle synergies were identified using non-negative matrix factorization. In both groups, muscle activation patterns could be reconstructed by combinations of a few muscle synergies (typically 4). We did not find abnormal coupling of shoulder and elbow muscles within individual muscle synergies. In stroke survivors, as in controls, two of the synergies were comprised of isolated activation of the elbow flexors and extensors. However, muscle synergies involving proximal muscles exhibited consistent alterations following stroke. Unlike controls, the anterior deltoid was coactivated with medial and posterior deltoids within the shoulder abductor/extensor synergy and the shoulder adductor/flexor synergy in stroke was dominated by activation of pectoralis major, with limited anterior deltoid activation. Recruitment of the altered shoulder muscle synergies was strongly associated with abnormal task performance. Overall, our results suggest that an impaired control of the individual deltoid heads may contribute to poststroke deficits in arm function.

Scapula Muscle Activations During Overhead Throwing Holds

2016 ◽  
Vol 21 (3) ◽  
pp. 42-46 ◽  
Author(s):  
Gretchen Oliver ◽  
Lisa Henning ◽  
Hillary Plummer
Keyword(s):  
Surface Electromyography ◽  
Serratus Anterior ◽  
Upper Trapezius ◽  
Overhead Throwing ◽  
Muscle Activations ◽  
Lower Trapezius

The purpose of this study was to examine activations of selected scapular stabilizing musculature while performing an overhead throw with a hold (not releasing the ball) in two different throwing positions—standing with a crow hop and kneeling on the ipsilateral knee. Surface electromyography was used to examine activations of throwing side lower trapezius (LT), middle trapezius (MT), serratus anterior (SA), and upper trapezius (UT). Muscle activations were recorded while performing the overhead throw with holds while in two throwing positions. MANOVA results revealed no significant differences between the two throwing conditions and muscle activations of LT, MT, SA, and UT: F(8,124) = .804, p = .600; Wilks’s Λ = .904, partial η2 = .049. Although no significant differences were observed in the scapular stabilizers between the two conditions, moderate (21–50% MVIC) to high (> 50% MVIC) activations of each muscle were present, indicating that nonrelease throws may be beneficial for scapular stabilization in throwers.

scholarly journals Efficacy of bilateral lower limb training over unilateral to re-educate balance and walking in post stroke survivors: a protocol for randomized clinical trial

2021 ◽  
Author(s):  
Pallavi Harjpal ◽  
Mohd Irshad Qureshi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lower Limb ◽  
Stroke Survivors ◽  
Clinical Trial Registry ◽  
Post Stroke ◽  
Subacute Stroke ◽  
Bilateral Training ◽  
Bilateral Lower Limb ◽  
Group B

Abstract Background: Stroke is the leading cause of global morbidity and a major contributor to disability. According to the National Stroke Association, as many as 9 out of 10 stroke survivors have some degree of paralysis immediately after the stroke. Aim is to evaluate the level to which the bilateral lower limb training compared to unilateral alone, reinforces the lower limb functional recovery in the subjects with sub-acute stroke.Methods: The participants (n=40) with subacute stroke will be included in assessor blinded, randomized clinical trial. Participants will be categorized into 2 groups after performing baseline assessments and equal randomization. The participants in Group A will receive only training to the affected side, and those in the Group B will receive bilateral training. We will be evaluating the improvement in lower limb function by balance and walking along with gait parameters.Discussion: Findings of the study will provide further insight into the effectiveness of bilateral training over unilateral in post stroke survivors. If this study is proved to be effective it will improve the balance and gait impairments in post stroke patients.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033621.

scholarly journals Volitional Preemptive Abdominal Contraction and Upper Extremity Muscle Latencies During D1 Flexion and Scaption Shoulder Exercises

2018 ◽  
Vol 53 (12) ◽  
pp. 1181-1189 ◽  
Author(s):  
Ramonica Scott ◽  
Hyung Suk Yang ◽  
C. Roger James ◽  
Steven F. Sawyer ◽  
Phillip S. Sizer
Keyword(s):  
Serratus Anterior ◽  
Movement Initiation ◽  
Open Chain ◽  
Cross Sectional ◽  
Upper Trapezius ◽  
Shoulder Muscle ◽  
Onset Timing ◽  
Asymptomatic Volunteers ◽  
Anterior Deltoid ◽  
Lower Trapezius

Context The abdominal-bracing maneuver, a volitional preemptive abdominal contraction (VPAC) strategy, is commonly used during resisted shoulder exercises. How VPAC affects shoulder-muscle function during resisted shoulder exercise is unknown. Objective To identify the effects of VPAC on selected parascapular and glenohumeral muscles during specific shoulder exercises with or without resistance. Design Cross-sectional study. Setting Clinical biomechanics research laboratory. Patients or Other Participants Twenty-two asymptomatic volunteers between 18 and 40 years of age. Intervention(s) Participants performed arm elevation in scaption and D1 shoulder-flexion (D1F) patterns with and without resistance and VPAC. Main Outcome Measure(s) Electromyography was used to test the muscle-contraction amplitudes and onset timing of the anterior deltoid, posterior deltoid, upper trapezius, lower trapezius, and serratus anterior. Muscle-response amplitudes were quantified using root mean square electromyography. Shoulder-muscle relative-onset timing was quantified in reference to kinematic elbow-movement initiation. Results The VPAC increased serratus anterior amplitude during D1F (P &lt; .001) and scaption (P &lt; .001) and upper trapezius amplitude (P &lt; .001) in scaption. All muscle amplitudes increased with resistance. The VPAC decreased muscle-onset latencies for the anterior deltoid (P &lt; .001), posterior deltoid (P = .008), upper trapezius (P = .001), lower trapezius (P = .006), and serratus anterior (P = .001) during D1F. In addition, the VPAC decreased muscle-onset latencies for the anterior deltoid (P &lt; .001), posterior deltoid (P = .007), upper trapezius (P &lt; .001), lower trapezius (P &lt; .001), and serratus anterior (P &lt; .001) during scaption. Conclusions The VPAC affected only the parascapular muscles that had the greatest scapular-stabilizing roles during the specific open chain movement we tested. It decreased latencies in all muscles. These neuromuscular changes may enhance the stability of the shoulder during D1F and scaption exercises.

scholarly journals Assessment of Utilization of Rehabilitation Services among Stroke Survivors

2018 ◽  
Vol 09 (04) ◽  
pp. 461-467 ◽  
Author(s):  
Chandel Mahak ◽  
Nagi Manisha ◽  
Ghai Sandhya ◽  
Khurana Dheeraj ◽  
Manju Dhandapani ◽  
...  
Keyword(s):  
Daily Living ◽  
Health Workers ◽  
Tertiary Care ◽  
Rehabilitation Services ◽  
Stroke Survivors ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Factors Affecting ◽  
Stroke Population ◽  
Common Problems

ABSTRACT Background: Rehabilitation is probably one of the most important phases of recovery for many stroke survivors. The current study was conducted with the objective to assess the utilization of rehabilitation services and factors affecting nonutilization of rehabilitation services among the stroke survivors. Materials and Methods: The current study was carried out in the Neuro Outpatient Department of a tertiary care hospital in India. It was a descriptive study. Consecutive 55 stroke survivors who had met the inclusion and exclusion criteria were recruited in this study. Self-structured rehabilitation tool was used to collect the data. Results: Data were analyzed using the descriptive and inferential statistics. Majority of the patients comprised 70.9% of males and 29.1% of females. Among participants, 70.90% were aware about rehabilitation, 67% were utilizing rehabilitation services, whereas 33% were not utilizing rehabilitation services. In the current study, certain reasons were found behind not utilizing rehabilitation services. There were 83.3% of participants who had lack of awareness about rehabilitation services and 61.1% of participants who had no availability of rehabilitation services. Only 45.5% of rural inhabitants were utilizing rehabilitation services as compared to 81.2% of urban inhabitants and 83.23% of suburban inhabitants. Conclusion: Rehabilitation is of utmost importance. Hemiparesis, difficulty in performing activity of daily living, difficulty in performing social activities, and difficulty in reasoning were the most common problems faced by people suffering stroke after discharge from the hospital. There was lack of awareness and utilization of rehabilitation services by patients among Indian stroke population. Hence, health workers have an immense role in educating, motivating, and ensuring that rehabilitation services in rural inhabitants.

Comparison of Diagonal Shoulder Exercises With and Without Visual Trace

2015 ◽  
Vol 20 (1) ◽  
pp. 52-56
Author(s):  
Jwa-jun Kim ◽  
So-youn Ann ◽  
Se-yeon Park
Keyword(s):  
Repeated Measures ◽  
Muscle Activation ◽  
Outcome Measure ◽  
Specific Pattern ◽  
Repeated Measure ◽  
Serratus Anterior ◽  
Additional Advantage ◽  
Main Outcome Measure ◽  
Anterior Deltoid ◽  
Lower Trapezius

Objectives:The aim of this study was to investigate the effects of visual trace on shoulder muscle activation during diagonal pattern of exercises. Sixteen healthy male participants volunteered to participate.Design:Repeated-measure design.Setting:Laboratory setting.Participants:Sixteen physically active male participants volunteered to participate.Intervention:Five muscles of the shoulder were investigated during standing performance of diagonal shoulder exercises with and without visual trace. Two patterns of the diagonal exercises were used: diagonal 1 flexion (D1F) and diagonal 2 fexion (D2F). Two-way repeated measures analysis of variance was used, with factors being the presence of visual trace and exercise variations.Main Outcome Measure:Electromyography (EMG).Results:The average muscle activity values of the lower trapezius and anterior deltoid were higher with the D2F compared with the D1F (P < .05). The visual trace effect was observed within the serratus anterior, with values significantly greater in exercise with visual trace (P < .05). There was a significant increase of the lower trapezius during the exercise with the visual trace condition compared with the exercise without visual trace, which was only observed during D2F (P < .05).Conclusions:Present results suggest that the D2F exercise pattern is effective for activating lower trapezius and anterior deltoid muscles. The visual trace condition has the additional advantage of activating the scapulothoracic muscle activities depending on the specific pattern of diagonal shoulder exercise.

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