http://www.jneuroengrehab.com/content/10/1/103/abstract
- † Equal contributors
Journal of NeuroEngineering and Rehabilitation 2013, 10:103 doi:10.1186/1743-0003-10-103
Published: 5 October 2013
Published: 5 October 2013
Abstract
Background
After a stroke, patients show significant modifications of neural control of movement,
such as abnormal muscle co-activation, and reduced selectivity and modulation of muscle
activity. Nonetheless, results reported in literature do not allow to unequivocally
explain whether and, in case, how a cerebrovascular accident affects muscle synergies
underlying the control of the upper limb. These discrepancies suggest that a complete
understanding of the modular re-organization of muscle activity due to a stroke is
still lacking. This pilot study aimed at investigating the effects of the conjunction
between the natural ongoing of the pathology and the intense robot-mediated treatment
on muscle synergies of the paretic upper limb of subacute post-stroke patients.
Methods
Six subacute patients, homogenous with respect to the age and the time elapsed from
the trauma, and ten healthy age-matched subjects were enrolled. The protocol consisted
in achieving planar movement of the upper limb while handling the end-effector of
a robotic platform. Patients underwent 6 weeks long treatment while clinical scores,
kinematics of the end-effector and muscle activity were recorded. Then we verified
whether muscle coordination underlying the motor task was significantly affected by
the cerebrovascular accident and how muscle synergies were modified along the treatment.
Results
Results show that although muscle synergies in subacute stroke patients were qualitatively
comparable to those of healthy subjects, those underlying the movement of the shoulder
can reflect the functional deficit induced by the pathology. Moreover, the improvement
of motor performance due to the treatment was achieved in conjunction with slight
modifications of muscle synergies. In this regard, modifications of muscle synergies
appeared to be influenced by the different recovering mechanisms across patients presumably
due to the heterogeneity of lesions, sides and location of the accident.
Conclusions
The results support the hypothesis that muscle synergies reflect the injury of the
cerebrovascular accident and could document the effects of the functional recovery
due to a suitable and customized treatment. Therefore, they open up new possibilities
for the development of more effective neuro-rehabilitation protocols.
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