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      The surface electromyography analysis of the non-plegic upper limb of hemiplegic subjects Translated title: Análise da eletromiografia de superfície do membro superior não plégico de hemiplégicos

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          Abstract

          Many authors have studied physical and functional changes in individuals post-stroke, but there are few studies that assess changes in the non-plegic side of hemiplegic subjects. This study aimed to compare the electromyographic activity in the forearm muscles of spastic patients and clinically healthy individuals, to determine if there is difference between the non-plegic side of hemiplegics and the dominant member of normal individuals. 22 hemiplegic subjects and 15 clinically healthy subjects were submitted to electromyography of the flexor and extensor carpi ulnaris muscles during wrist flexion and extension. The flexor muscles activation of stroke group (average 464.6 u.n) was significantly higher than the same muscles in control group (mean: 106.3 u.n.) during the wrist flexion, what shows that the non affected side does not present activation in the standart of normality found in the control group.

          Translated abstract

          Muitos autores estudaram as modificações funcionais e físicas em indivíduos pós-acidente vascular cerebral; porém, poucos estudos avaliam alterações no hemicorpo não plégico de indivíduos hemiplégicos. O objetivo deste estudo foi comparar a atividade eletromiográfica nos músculos do antebraço de pacientes espásticos e indivíduos clinicamente saudáveis, para averiguar se há diferença entre o lado não plégico de indivíduos hemiplégicos e o lado dominante de indivíduos clinicamente saudáveis. 22 indivíduos hemiplégicos e 15 clinicamente saudáveis foram submetidos à eletromiografia dos músculos flexor e extensor ulnar do carpo durante a flexão e extensão do punho. A ativação dos músculos flexores dos hemiplégicos (média: 464,6 u.n), foi significantemente maior que nos indivíduos do grupo controle (média: 106,3 u.n) durante o movimento de flexão do punho, o que demonstra que o hemicorpo não acometido dos pacientes estudados não apresenta o comportamento padrão de normalidade encontrado no grupo controle.

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          Most cited references25

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          How can corticospinal tract neurons contribute to ipsilateral movements? A question with implications for recovery of motor functions.

          In this review, the authors discuss some recent findings that bear on the issue of recovery of function after corticospinal tract lesions. Conventionally the corticospinal tract is considered to be a crossed pathway, in keeping with the clinical findings that damage to one hemisphere, for example, in stroke, leads to a contralateral paresis and, if the lesion is large, a paralysis. However, there has been great interest in the possibility of compensatory recovery of function using the undamaged hemisphere. There are several substrates for this including ipsilaterally descending corticospinal fibers and bilaterally operating neuronal networks. Recent studies provide important evidence bearing on both of these issues. In particular, they reveal networks of neurons interconnecting two sides of the gray matter at both brainstem and spinal levels, as well as intrahemispheric transcallosal connections. These may form "detour circuits" for recovery of function, and here the authors will consider some possibilities for exploiting these networks for motor control, even though their analysis is still at an early stage.
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            Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis.

            Bilateral movement training is being increasingly used as a post-stroke motor rehabilitation protocol. The contemporary emphasis on evidence-based medicine warrants a prospective meta-analysis to determine the overall effectiveness of rehabilitating with bilateral movements. After searching reference lists of bilateral motor recovery articles as well as PubMed and Cochrane databases, 11 stroke rehabilitation studies qualified for this systematic review. An essential requirement for inclusion was that the bilateral training protocols involved either functional tasks or repetitive arm movements. Each study had one of three common arm and hand functional outcome measures: Fugl-Meyer, Box and Block, and kinematic performance. The fixed effects model primary meta-analysis revealed an overall effect size (ES=0.732, S.D.=0.13). These findings indicate that bilateral movement training was beneficial for improving motor recovery post-stroke. Moreover, a fail-safe analysis indicated that 48 null effects would be necessary to lower the mean effect size to an insignificant level. These meta-analysis findings indicate that bilateral movements alone or in combination with auxiliary sensory feedback are effective stroke rehabilitation protocols during the sub-acute and chronic phases of recovery.
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              Performance of the 'unaffected' upper extremity of elderly stroke patients.

              The main objective of this study was to compare the sensorimotor performance of the unaffected upper extremity (UE) of elderly stroke patients with that of healthy elderly people. The group of stroke patients was composed of 43 hemiplegic/paretic subjects who had had a cerebrovascular accident at least 6 months earlier. They were > or = 60 years old, were right-handed before the stroke, had visual perception within normal limits, and showed no major cognitive impairments. A group of 43 healthy subjects matched for dominance, age, and sex was used for comparison. The main parameters of the performance of the unaffected UE of the stroke subjects and of the same side of the healthy subjects were measured with valid, reliable instruments. Some variables potentially related to the unaffected UE were also measured: affected UE motor function, functional independence, length of time since the stroke, self-perceived health status, activity level, and hand anthropometry. Statistical analyses showed significant deficits in the unaffected UE of hemiplegic/paretic subjects compared with normal subjects with regard to the following parameters: gross manual dexterity, fine manual dexterity, motor coordination, global performance, and kinesthesia (P < .01 to P < .0001). No significant clinical or statistical difference was found for grip strength (P < .81), static and moving two-point discrimination (P = .21 and P = .12), or touch/pressure threshold (P < .91). Many factors (frequency of use of the unaffected hand, sensorimotor interaction tasks, severity of the deficits in corticifugal projections, and deficits in postural stabilization) could interact to provide the clinical picture obtained in the present study.
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                Author and article information

                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )
                0004-282X
                1678-4227
                August 2010
                : 68
                : 4
                : 562-566
                Affiliations
                [01] Presidente Prudente SP orgnameUniversity Estadual Paulista orgdiv1FCT orgdiv2Laboratory of Physical Therapy Applied to Human Movement Brazil
                [02] São Carlos SP orgnameUniversity of São Paulo orgdiv1Post-Graduation Program Interunits Bioingeneering Brazil
                Article
                S0004-282X2010000400016 S0004-282X(10)06800416
                a48e3b1f-8242-4bfd-a599-66e9aad92dfc

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 October 2009
                : 04 January 2010
                : 14 January 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 5
                Product

                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Articles

                espasticidade muscular,eletromiografia de superfície,hemiplegia,muscle spasticity,surface electromyography

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