scholarly journals Sustained involuntary muscle activity in cerebral palsy and stroke: same symptom, diverse mechanisms

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Christian Riis Forman ◽  
Christian Svane ◽  
Christina Kruuse ◽  
Jean-Michel Gracies ◽  
Jens Bo Nielsen ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Muscle Activity ◽  
Surface Emg ◽  
Passive Movement ◽  
Gamma Band ◽  
Involuntary Muscle ◽  
Extended Position ◽  
Cross Correlation Analysis ◽  
Stroke Group ◽  
Spinal Stretch Reflex

Abstract Individuals with lesions of central motor pathways frequently suffer from sustained involuntary muscle activity. This symptom shares clinical characteristics with dystonia but is observable in individuals classified as spastic. The term spastic dystonia has been introduced, although the underlying mechanisms of involuntary activity are not clarified and vary between individuals depending on the disorder. This study aimed to investigate the nature and pathophysiology of sustained involuntary muscle activity in adults with cerebral palsy and stroke. Seventeen adults with cerebral palsy (Gross Motor Function Classification System I–V), 8 adults with chronic stroke and 14 control individuals participated in the study. All individuals with cerebral palsy or stroke showed increased resistance to passive movement with Modified Ashworth Scale >1. Two-minute surface EMG recordings were obtained from the biceps muscle during attempted rest in three positions of the elbow joint; a maximally flexed position, a 90-degree position and a maximally extended position. Cross-correlation analysis of sustained involuntary muscle activity from individuals with cerebral palsy and stroke, and recordings of voluntary isometric contractions from control individuals were performed to examine common synaptic drive. In total, 13 out of 17 individuals with cerebral palsy and all 8 individuals with stroke contained sustained involuntary muscle activity. In individuals with cerebral palsy, the level of muscle activity was not affected by the joint position. In individuals with stroke, the level of muscle activity significantly (P < 0.05) increased from the flexed position to the 90 degree and extended position. Cumulant density function indicated significant short-term synchronization of motor unit activities in all recordings. All groups exhibited significant coherence in the alpha (6–15 Hz), beta (16–35 Hz) and early gamma band (36–60 Hz). The cerebral palsy group had lower alpha band coherence estimates, but higher gamma band coherence estimates compared with the stroke group. Individuals with increased resistance to passive movement due to cerebral palsy or stroke frequently suffer sustained involuntary muscle activity, which cannot exclusively be described by spasticity. The sustained involuntary muscle activity in both groups originated from a common synaptic input to the motor neuron pool, but the generating mechanisms could differ between groups. In cerebral palsy it seemed to originate more from central mechanisms, whereas peripheral mechanisms likely play a larger role in stroke. The sustained involuntary muscle activity should not be treated simply like the spinal stretch reflex mediated symptom of spasticity and should not either be treated identically in both groups.

scholarly journals Monitoring Involuntary Muscle Activity in Acute Patients with Upper Motor Neuron Lesion by Wearable Sensors: A Feasibility Study

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3120
Author(s):  
Andrea Merlo ◽  
Maria Giulia Montecchi ◽  
Francesco Lombardi ◽  
Xhejsi Vata ◽  
Aurora Musi ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Biceps Brachii ◽  
Wearable Sensors ◽  
Surface Emg ◽  
Motor Unit Action Potential ◽  
Involuntary Muscle ◽  
Neurological Patients ◽  
Huge Impact ◽  
Motor Unit Action ◽  
Acute Rehabilitation

Sustained involuntary muscle activity (IMA) is a highly disabling and not completely understood phenomenon that occurs after a central nervous system lesion. We tested the feasibility of in-field IMA measuring at an acute rehabilitation ward. We used wearable probes for single differential surface EMG (sEMG), inclusive of a 3D accelerometer, onboard memory and remote control. We collected 429 h of data from the biceps brachii of 10 patients with arm plegia. Data quality was first verified in the time and frequency domains. Next, IMA was automatically identified based on the steady presence of motor unit action potential (MUAP) trains at rest. Feasibility was excellent in terms of prep time and burden to the clinical staff. A total of 350.5 h of data (81.7%) were reliable. IMA was found in 85.9 h (25%). This was often present in the form of exceedingly long-lasting trains of one or a few MUAPs, with differences among patients and variability, both within and between days in terms of IMA duration, root mean square (RMS) and peak-to-peak amplitude. Our results proved the feasibility of using wearable probes for single differential sEMG to identify and quantify IMA in plegic muscles of bedridden acute neurological patients. Our results also suggest the need for long-lasting acquisitions to properly characterize IMA. The possibility of easily assessing IMA in acute inpatients can have a huge impact on the management of their postures, physiotherapy and treatments.

scholarly journals Small amounts of involuntary muscle activity reduce passive joint range of motion

2019 ◽  
Vol 127 (1) ◽  
pp. 229-234 ◽  
Author(s):  
Joanna Diong ◽  
Simon C. Gandevia ◽  
David Nguyen ◽  
Yanni Foo ◽  
Cecilia Kastre ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Soleus Muscle ◽  
Muscle Activity ◽  
Random Order ◽  
Passive Movement ◽  
Ankle Dorsiflexion ◽  
Passive Joint ◽  
Joint Range Of Motion ◽  
Involuntary Muscle ◽  
Joint Range

When assessing passive joint range of motion in neurological conditions, concomitant involuntary muscle activity is generally regarded small enough to ignore. This assumption is untested. If false, many clinical and laboratory studies that rely on these assessments may be in error. We determined to what extent small amounts of involuntary muscle activity limit passive range of motion in 30 able-bodied adults. Subjects were seated with the knee flexed 90° and the ankle in neutral, and predicted maximal plantarflexion torque was determined using twitch interpolation. Next, with the knee flexed 90° or fully extended, the soleus muscle was continuously electrically stimulated to generate 1, 2.5, 5, 7.5, and 10% of predicted maximal torque, in random order, while the ankle was passively dorsiflexed to a torque of 9 N·m by a blinded investigator. A trial without stimulation was also performed. Ankle dorsiflexion torque-angle curves were obtained at each percent of predicted maximal torque. On average (mean, 95% confidence interval), each 1% increase in plantarflexion torque decreases ankle range of motion by 2.4° (2.0 to 2.7°; knee flexed 90°) and 2.3° (2.0 to 2.5°; knee fully extended). Thus 5% of involuntary plantarflexion torque, the amount usually considered small enough to ignore, decreases dorsiflexion range of motion by ~12°. Our results indicate that even small amounts of involuntary muscle activity will bias measures of passive range and hinder the differential diagnosis and treatment of neural and nonneural mechanisms of contracture. NEW & NOTEWORTHY The soleus muscle in able-bodied adults was tetanically stimulated while the ankle was passively dorsiflexed. Each 1% increase in involuntary plantarflexion torque at the ankle decreases the range of passive movement into dorsiflexion by >2°. Thus the range of ankle dorsiflexion decreases by ~12° when involuntary plantarflexion torque is 5% of maximum, a torque that is usually ignored. Thus very small amounts of involuntary muscle activity substantially limit passive joint range of motion.

scholarly journals Identifying bidirectional total and non-linear information flow in functional corticomuscular coupling during a dorsiflexion task: a pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tie Liang ◽  
Qingyu Zhang ◽  
Xiaoguang Liu ◽  
Bin Dong ◽  
Xiuling Liu ◽  
...  
Keyword(s):  
Time Series ◽  
Information Flow ◽  
Gamma Band ◽  
Motor Dysfunction ◽  
Beta Band ◽  
Short Time Series ◽  
Information Interaction ◽  
Stroke Group ◽  
Short Time ◽  
Maximal Information Coefficient

Abstract Background The key challenge to constructing functional corticomuscular coupling (FCMC) is to accurately identify the direction and strength of the information flow between scalp electroencephalography (EEG) and surface electromyography (SEMG). Traditional TE and TDMI methods have difficulty in identifying the information interaction for short time series as they tend to rely on long and stable data, so we propose a time-delayed maximal information coefficient (TDMIC) method. With this method, we aim to investigate the directional specificity of bidirectional total and nonlinear information flow on FCMC, and to explore the neural mechanisms underlying motor dysfunction in stroke patients. Methods We introduced a time-delayed parameter in the maximal information coefficient to capture the direction of information interaction between two time series. We employed the linear and non-linear system model based on short data to verify the validity of our algorithm. We then used the TDMIC method to study the characteristics of total and nonlinear information flow in FCMC during a dorsiflexion task for healthy controls and stroke patients. Results The simulation results showed that the TDMIC method can better detect the direction of information interaction compared with TE and TDMI methods. For healthy controls, the beta band (14–30 Hz) had higher information flow in FCMC than the gamma band (31–45 Hz). Furthermore, the beta-band total and nonlinear information flow in the descending direction (EEG to EMG) was significantly higher than that in the ascending direction (EMG to EEG), whereas in the gamma band the ascending direction had significantly higher information flow than the descending direction. Additionally, we found that the strong bidirectional information flow mainly acted on Cz, C3, CP3, P3 and CPz. Compared to controls, both the beta-and gamma-band bidirectional total and nonlinear information flows of the stroke group were significantly weaker. There is no significant difference in the direction of beta- and gamma-band information flow in stroke group. Conclusions The proposed method could effectively identify the information interaction between short time series. According to our experiment, the beta band mainly passes downward motor control information while the gamma band features upward sensory feedback information delivery. Our observation demonstrate that the center and contralateral sensorimotor cortex play a major role in lower limb motor control. The study further demonstrates that brain damage caused by stroke disrupts the bidirectional information interaction between cortex and effector muscles in the sensorimotor system, leading to motor dysfunction.

Antagonist thigh-muscle activity in 6-to-8-year-old children assessed by surface EMG during walking

2017 ◽  
Author(s):  
Francesco Di Nardo ◽  
Annachiara Strazza ◽  
Alessandro Mengarelli ◽  
Serena Ercolani ◽  
Laura Burattini ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Surface Emg ◽  
Thigh Muscle

Wavelet spectra of surface EMG during gait in children with di- and tetraplegic spastic cerebral palsy

2015 ◽  
Vol 42 ◽  
pp. S8-S9
Author(s):  
K. Bracht-Schweizer ◽  
J. Romkes ◽  
B. Göpfert ◽  
R. Brunner ◽  
E. Rutz
Keyword(s):  
Cerebral Palsy ◽  
Surface Emg ◽  
Spastic Cerebral Palsy ◽  
Wavelet Spectra

Deficits in anticipatory inhibition of postural muscle activity associated with load release while standing in individuals with spastic diplegic cerebral palsy

2013 ◽  
Vol 109 (8) ◽  
pp. 1996-2006 ◽  
Author(s):  
Hidehito Tomita ◽  
Yoshiki Fukaya ◽  
Kenji Totsuka ◽  
Yuri Tsukahara
Keyword(s):  
Cerebral Palsy ◽  
Lower Limb ◽  
Muscle Activity ◽  
Erector Spinae ◽  
Lower Limbs ◽  
Control Group ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Postural Muscle ◽  
Load Release

This study aimed to determine whether individuals with spastic diplegic cerebral palsy (SDCP) have deficits in anticipatory inhibition of postural muscle activity. Nine individuals with SDCP (SDCP group, 3 female and 6 male, 13–24 yr of age) and nine age- and sex-matched individuals without disability (control group) participated in this study. Participants stood on a force platform, which was used to measure the position of the center of pressure (CoP), while holding a light or heavy load in front of their bodies. They then released the load by abducting both shoulders. Surface electromyograms were recorded from the rectus abdominis, erector spinae (ES), rectus femoris (RF), medial hamstring (MH), tibialis anterior (TA), and gastrocnemius (GcM) muscles. In the control group, anticipatory inhibition before load release and load-related modulation of the inhibition were observed in all the dorsal muscles recorded (ES, MH, and GcM). In the SDCP group, similar results were obtained in the trunk muscle (ES) but not in the lower limb muscles (MH and GcM), although individual differences were seen, especially in MH. Anticipatory activation of the ventral lower limb muscles (RF and TA) and load-related modulation of the activation were observed in both participant groups. CoP path length during load release was longer in the SDCP group than in the control group. The present findings suggest that individuals with SDCP exhibit deficits in anticipatory inhibition of postural muscles at the dorsal part of the lower limbs, which is likely to result in a larger disturbance of postural equilibrium.

Developing an Active Ankle Foot Orthosis Based on Shape Memory Alloy Actuators

2007 ◽  
Author(s):  
Ehsan Tarkesh ◽  
Mohammad H. Elahinia ◽  
Mohamed Samir Hefzy
Keyword(s):  
Multiple Sclerosis ◽  
Cerebral Palsy ◽  
Shape Memory Alloy ◽  
Shape Memory ◽  
Muscle Activity ◽  
Heel Strike ◽  
Drop Foot ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

This paper is on development of an active ankle foot orthosis (AAFO). This device will fill the gap in the existing research aimed at helping patients with drop foot muscle deficiencies as well as rehabilitation activities. Drop foot patients are unable to lift their foot because of reduced or no muscle activity around the ankle. The major causes of drop foot are severing of the nerve, stroke, cerebral palsy and multiple sclerosis. There are two common complications from drop foot. First, the patient cannot control the falling of their foot after heel strike, so that it slaps the ground on every step. The second complication is the inability to clear the toe during swing. This causes the patients to drag their toe on the ground throughout the swing.

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