Alterations in intermuscular coordination underlying isokinetic exercise after a stroke and their implications on neurorehabilitation.
Alterations in intermuscular coordination underlying isokinetic exercise after a stroke and their implications on neurorehabilitation.
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DOI：
10.1186/s12984-021-00900-9
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发表时间：
2021-07-03
影响因子：
5.1
通讯作者：
Park HS
中科院分区：
文献类型：
--
作者：
Park JH;Shin JH;Lee H;Roh J;Park HS
肌肉间协调异常限制了受中风影响的上肢的运动能力。通过评估不同生物力学任务约束下患肢的肌肉间协调性，可以分析中风对运动控制的影响，从而开发基于肌肉间协调性的康复策略。在这项研究中，我们研究了在等速运动中中风后上肢肌肉间的协调性。招募了16名慢性中风幸存者和8名神经学完好的个体。当参与者在三维空间中进行等速上肢运动时，测量了肩部和肘部肌肉的终点力和肌电活动。中风幸存者和对照组参与者的肌肉间协调性以肌肉协同作用的形式进行量化。然后，我们比较了两组之间的肌肉协同作用和终点力的数量、组成和激活系数。研究肌肉协同效应的改变与运动损伤程度的相关性。中风组和对照组分别观察到四块和五块肌肉协同作用。两组之间肌肉协同作用的构成是相似的，除了中风组三角肌的三个头部被共同激活并形成一个协同作用，而在对照组这些肌肉形成两个协同作用。当两组之间的肌肉协同效应的数量匹配时，两组的肌肉协同效应的组成相似。另外，中风后协同激活系数的调节也发生了改变。运动障碍的严重程度与卒中后协同效应与平均控制协同效应的相似性呈负相关。受中风影响的上肢似乎模块化了肩部和肘部肌肉的激活，其方式与神经功能正常的个体在等速运动中的方式相当相似。与自由(即无约束)运动相比，包括等速约束在内的生物力学约束下的运动可能独立地促进卒中幸存者肌肉协同作用的激活。我们假设了生物力学约束对肌肉间协调性的影响，并提出了一种可能的基于肌肉间协调性的康复方案，该方案在整个康复过程中提供适合受训者的生物力学约束。
Abnormal intermuscular coordination limits the motor capability of stroke-affected upper limbs. By evaluating the intermuscular coordination in the affected limb under various biomechanical task constraints, the impact of a stroke on motor control can be analyzed and intermuscular coordination-based rehabilitation strategies can be developed. In this study, we investigated upper limb intermuscular coordination after a stroke during isokinetic movements. Sixteen chronic stroke survivors and eight neurologically intact individuals were recruited. End-point forces and electromyographic activities of the shoulder and elbow muscles were measured while the participants performed isokinetic upper limb movements in a three-dimensional space. Intermuscular coordination of the stroke survivors and the control participants was quantified in the form of muscle synergies. Then, we compared the number, composition, and activation coefficients of muscle synergies and the end-point force between the groups. The correlation between the alteration of muscle synergies and the level of motor impairment was investigated. Four and five muscle synergies in the stroke and control groups were observed, respectively. The composition of muscle synergies was comparable between the groups, except that the three heads of the deltoid muscle were co-activated and formed one synergy in the stroke group, whereas those muscles formed two synergies in the control group. When the number of muscle synergies between the groups matched, the comparable composition of muscle synergies was observed in both groups. Alternatively, the modulation of synergy activation coefficients was altered after a stroke. The severity of motor impairments was negatively correlated with the similarity of the post-stroke synergies with respect to the mean control synergies. Stroke-affected upper limbs seemed to modularize the activation of the shoulder and elbow muscles in a fairly similar way to that of neurologically intact individuals during isokinetic movements. Compared with free (i.e., unconstrained) movement, exercise under biomechanical constraints including the isokinetic constraint might promote the activation of muscle synergies independently in stroke survivors. We postulated the effect of biomechanical constraints on the intermuscular coordination and suggested a possible intermuscular coordination-based rehabilitation protocol that provides the biomechanical constraint appropriate to a trainee throughout the progress of rehabilitation.
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影响因子：
5.3
作者：
d'Avella, Andrea;Portone, Alessandro;Lacquaniti, Francesco
通讯作者：
Lacquaniti, Francesco
影响因子：
5.1
作者：
Ellis MD;Lan Y;Yao J;Dewald JP
通讯作者：
Dewald JP
DOI：
10.1016/j.apmr.2007.07.016
发表时间：
2007-10-01
影响因子：
4.3
作者：
Chang, Jyh-Jong;Tung, Wen-Lin;Su, Fong-Chin
通讯作者：
Su, Fong-Chin
影响因子：
2.5
作者：
Sin, Minki;Kim, Won-Seok;Paik, Nam-Jong
通讯作者：
Paik, Nam-Jong
DOI：
10.1016/s0003-9993(99)90225-3
发表时间：
1999-07-01
影响因子：
4.3
作者：
Beer, RF;Given, JD;Dewald, JPA
通讯作者：
Dewald, JPA