Activation of elbow extensors during passive stretch of flexors in patients with post-stroke spasticity
Activation of elbow extensors during passive stretch of flexors in patients with post-stroke spasticity
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DOI：
10.1016/j.clinph.2018.07.007
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发表时间：
2018-10-01
影响因子：
4.7
通讯作者：
Feldman, Anatol G.
中科院分区：
文献类型：
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作者：
Levin, Mindy F.;Solomon, John M.;Feldman, Anatol G.
目的：中风后，肘屈肌和肘伸肌的强直性牵张反射阈值（TSRT）调节缺陷导致特定关节范围的痉挛。阈值失调也可能导致其他缺陷，如被动缩短肌肉的异常激活。目标是表征激活缩短肘伸肌在被动肘屈肌伸展中风的个人，并确定其关系上肢运动immortality.Methods：33名参与者与单侧中风参加。以不同速度拉伸被动肘屈肌，测量肘屈肌的TSRT。肌电图反应记录从拉伸激动剂（二头肌）和缩短拮抗剂（三头肌）muscles.Results：三头肌激活在被动二头肌拉伸发生在所有，但4名参与者同时，之前或之后二头肌激活发作。肱二头肌和肱三头肌的激活起始和持续时间随着拉伸速度的增加而减少。肱二头肌TSRT和肱三头肌激活幅度与感觉运动障碍无关，但更高的卒中慢性化倾向于与更高的肱二头肌TSRT相关（r = 0.406，p = 0.041）。结论：中风可能会导致相互抑制的限制和过度的激动剂-拮抗剂共激活，这可能是由于两个肌肉群TSRT调节的缺陷。意义：由于相互抑制和共激活是正常运动控制的基础，在设计干预措施以增加屈肌和伸肌TSRT的调节范围以促进上肢功能恢复时应考虑它们的合作作用。(C)2018国际临床神经生理学联合会。Elsevier B. V.出版，保留所有权利。
Objectives: Deficits in regulation of tonic stretch reflex thresholds (TSRTs) after stroke occur in elbow flexors and extensors leading to spasticity in specific joint ranges. Threshold deregulation may also be responsible for other deficits such as abnormal activation of passively shortening muscles. Goals were to characterize activation of shortening elbow extensors during passive elbow flexor stretch in individuals with stroke, and identify its relationship to upper-limb motor impairment.Methods: Thirty-three participants with unilateral stroke participated. TSRTs in elbow flexors were measured by stretching passive elbow flexors at different velocities. EMG responses were recorded from stretched agonist (biceps) and shortened antagonist (triceps) muscles.Results: Triceps activation during passive biceps stretch occurred in all but 4 participants simultaneously with, before or after biceps activation onset. Biceps and triceps activation onsets and durations decreased with stretch velocity. Biceps TSRT and triceps activation magnitude did not correlate with sensorimotor impairment but greater stroke chronicity tended to be related to higher biceps TSRTs (r = 0.406, p = 0.041).Conclusions: Stroke may result in both limitations in reciprocal inhibition and excessive agonist-antagonist co-activation, likely from deficits in TSRT modulation in both muscle groups.Significance: Since both reciprocal inhibition and co-activation are fundamental to normal motor control, their cooperative action should be considered in designing interventions to increase the ranges of regulation of TSRTs in flexors and extensors to enhance upper limb functional recovery. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.