scholarly journals Gait Performance and Lower-Limb Muscle Strength Improved in Both Upper-Limb and Lower-Limb Isokinetic Training Programs in Individuals with Chronic Stroke

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Marie-Hélène Milot ◽  
Sylvie Nadeau ◽  
Denis Gravel ◽  
Daniel Bourbonnais
Keyword(s):  
Training Program ◽  
Upper Limb ◽  
Lower Limb ◽  
Gait Speed ◽  
Chronic Stroke ◽  
Control Group ◽  
Positive Power ◽  
Gait Performance ◽  
Lower Limb Muscles ◽  
Limb Muscles

Background. Limited improvement in gait performance has been noted after training despite a significant increase in strength of the affected lower-limb muscles after stroke. A mismatch between the training program and the requirements of gait could explain this finding. Objective. To compare the impact of a training program, matching the requirements of the muscle groups involved in the energy generation of gait, to a control intervention, on gait performance and strength. Methods. 30 individuals with chronic stroke were randomly assigned into two groups (n = 15), each training three times/week for six weeks. The experimental group trained the affected plantarflexors, hip flexors, and extensors, while the control group trained the upper-limb muscles. Baseline and posttraining values of gait speed, positive power (muscles’ concentric action during gait), and strength were retained and compared between groups. Results. After training, both groups showed a similar and significant increase in gait speed, positive power of the hip muscles, and plantarflexors strength. Conclusion. A training program targeting the lower-limb muscles involved in the energy generation of gait did not lead to a greater improvement in gait performance and strength than a training program of the upper-limb muscles. Attending the training sessions might have been a sufficient stimulus to generate gains in the control group.

Validity of Skeletal Muscle Ultrasound in Assessment of Suspected Limb Girdle Muscular Dystrophy Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rasha M Ibrahim ◽  
Haitham M Hamdy ◽  
Amr A Mohammed ◽  
Ahmed M Elsadek ◽  
Ahmed M Bassiouny ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Upper Limb ◽  
Lower Limb ◽  
Limb Girdle Muscular Dystrophy ◽  
Ultrasound Images ◽  
General Electric ◽  
Cross Sectional ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Muscle Ultrasound

Abstract Background Limb-girdle muscular dystrophies (LGMDs) are a clinically and genetically heterogeneous group of disorders characterized by progressive muscle weakness and degenerative muscle changes. Studies have shown that ultrasound can be useful both for diagnosis and follow-up of LGMDs patients. Objectives This study aims to measure the sensitivity and the specificity of muscle ultrasound in assessment of suspected limb girdle muscular dystrophy patients. Subjects and Methods This cross-sectional descriptive study was conducted on Fifty-five patients with suspected LGMD from neuromuscular unit, myology clinic, Ain Shams University hospitals and eight healthy subjects. Age was above 2 years. Both sexes were included in the study. They underwent real-time B-mode ultrasonography performed with using Logiq p9 General Electric ultrasound machine and General Electric 7-11.5 MHZ linear array ultrasound probe. All ultrasound images have been obtained and scored by a single examiner and muscle echo intensity was visually graded semiquantitative according to Heckmatt's scale. The examiner was blinded to the muscle biopsy results and clinical evaluations. Results Statistical analysis revealed that the diagnostic performance of muscle US (Heckmatt’s score) in LGMD is most sensitive when calculated in all examined upper limb and lower limb muscles, followed by lower limb muscles alone. US of upper limb was found to be the least sensitive. Conclusions Muscle ultrasound is a practical and reproducible and valid tool that can be used in assessment of suspected LGMD patients.

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.

Cortical Control of Human Motoneuron Firing During Isometric Contraction

1997 ◽  
Vol 77 (6) ◽  
pp. 3401-3405 ◽  
Author(s):  
Stephan Salenius ◽  
Karin Portin ◽  
Matti Kajola ◽  
Riitta Salmelin ◽  
Riitta Hari
Keyword(s):  
Motor Cortex ◽  
Upper Limb ◽  
Isometric Contraction ◽  
Lower Limb ◽  
Biceps Brachii ◽  
Cortical Control ◽  
Lower Limb Muscles ◽  
Cortical Rhythms ◽  
Motor Unit Firing ◽  
Limb Muscles

Salenius, Stephan, Karin Portin, Matti Kajola, Riitta Salmelin, and Riitta Hari. Cortical control of human motoneuron firing during isometric contraction. J. Neurophysiol. 77: 3401–3405, 1997. We recorded whole scalp magnetoencephalographic (MEG) signals simultaneously with the surface electromyogram from upper and lower limb muscles of six healthy right-handed adults during voluntary isometric contraction. The 15- to 33-Hz MEG signals, originating from the anterior bank of the central sulcus, i.e., the primary motor cortex, were coherent with motor unit firing in all subjects and for all muscles. The coherent cortical rhythms originated in the hand motor area for upper limb muscles (1st dorsal interosseus, extensor indicis proprius, and biceps brachii) and close to the foot area for lower limb muscles (flexor hallucis brevis). The sites of origin corresponding to different upper limb muscles did not differ significantly. The cortical signals preceded motor unit firing by 12–53 ms. The lags were shortest for the biceps brachii and increased systematically with increasing corticomuscular distance. We suggest that the motor cortex drives the spinal motoneuronal pool during sustained contractions, with the observed cortical rhythmic activity influencing the timing of efferent commands. The cortical rhythms could be related to motor binding, but the rhythmic output may also serve to optimize motor cortex output during isometric contractions.

scholarly journals Muscle perfusion of posterior trunk and lower-limb muscles at rest and during upper-limb exercise in spinal cord-injured and able-bodied individuals

Spinal Cord ◽  
2012 ◽  
Vol 50 (11) ◽  
pp. 822-826 ◽  
Author(s):  
A Zafeiridis ◽  
A V Vasiliadis ◽  
A Doumas ◽  
N Galanis ◽  
T Christoforidis ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Upper Limb ◽  
Lower Limb ◽  
Muscle Perfusion ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Posterior Trunk ◽  
Spinal Cord Injured ◽  
Limb Exercise

scholarly journals Gait Improvement in Chronic Stroke Survivors by Using an Innovative Gait Training Machine: A Randomized Controlled Trial

2021 ◽  
Vol 19 (1) ◽  
pp. 224
Author(s):  
Patcharee Kooncumchoo ◽  
Phuwarin Namdaeng ◽  
Somrudee Hanmanop ◽  
Bunyong Rungroungdouyboon ◽  
Kultida Klarod ◽  
...  
Keyword(s):  
Lower Limb ◽  
Gait Training ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Control Group ◽  
Walk Test ◽  
Limb Function ◽  
Gait Performance ◽  
Bonferroni Test ◽  
Lower Limb Function

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl–Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.

scholarly journals The Effect of Virtual Reality-Based Therapy on Improving Upper Limb Functions in Individuals With Stroke: A Randomized Control Trial

2021 ◽  
Vol 13 ◽  
Author(s):  
Ehab Mohamed Abd El-Kafy ◽  
Mansour Abdullah Alshehri ◽  
Amir Abdel-Raouf El-Fiky ◽  
Mohamad Abdelhamid Guermazi
Keyword(s):  
Virtual Reality ◽  
Training Program ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Incidence ◽  
Functional Training ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Background: Stroke is a common cause of motor disability. The recovery of upper limb after stroke is poor, with few stroke survivors regaining some functional use of the affected upper limb. This is further complicated by the fact that the prolonged rehabilitation is accompanied by multiple challenges in using and identifying meaningful and motivated treatment tasks that may be adapted and graded to facilitate the rehabilitation program. Virtual reality-based therapy is one of the most innovative approaches in rehabilitation technology and virtual reality systems can provide enhanced feedback to promote motor learning in individuals with neurological or musculoskeletal diseases.Purpose: This study investigated the effect of virtual reality-based therapy on improving upper limb functions in individuals with chronic stroke.Methods: Forty Saudi individuals with chronic stroke (6–24 months following stroke incidence) and degree of spasticity ranged between 1, 1 + and 2 according to Modified Ashworth Scale were included in this study. Participants were randomly assigned into two groups, experimental and control, with the experimental group undertaking a conventional 1-h functional training program, followed by another hour of virtual reality-based therapy using Armeo Spring equipment and the control group received 2 h of a conventional functional training program. The treatment program was conducted three times per week for three successive months. The change in the scores of Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), WMFT-Time (time required to complete the test) and Hand Grip Strength (HGS) were recorded at baseline and after completion of the treatment. Parametric (paired and unpaired t-tests) non-parametric (Wilcoxon and Mann–Whitney tests) statistical tests were used to identify the differences within and between groups (experimental group and control group) and evaluation times (pre- and immediately post-treatment).Results: Both groups showed significant differences (all, P < 0.05) in all measured variables after 3 months of the treatment. Individuals with stoke in the experimental group had a better improvement in ARAT (P < 0.01), WMFT (P < 0.01) and WMFT-Time (P < 0.01) scores after completion of the treatment compared to the control group. No significant difference in HGS scores was detected between groups after completion of the treatment (P = 0.252).Conclusion: The use of combined treatment of virtual reality-based therapy and conventional functional training program is more effective for improving upper limb functions in individuals with chronic stroke than the use of the conventional program alone.

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