Abstract
BACKGROUND:
Weight
support of the arm (WS) can be used in stroke rehabilitation to
facilitate upper limb therapy, but the neurophysiological effects of
this technique are not well understood. While an overall reduction in
muscle activity is expected, the mechanism by which WS may alter the
expression of muscle synergies has not been examined until now. We
explored the neurophysiological effect of WS on the selectivity of
biceps brachii (BB) activation in healthy adults.
METHODS:
Thirteen
participants completed counterbalanced movement tasks in a repeated
measures design. Three levels of WS (0, 45, and 90 % of full support)
were provided to the arm using a commercial device (Saebo Mobile Arm
Support). At each level of WS, participants maintained a flexed shoulder
posture while performing rhythmic isometric elbow flexion (BB agonist)
or forearm pronation (BB antagonist). Single-pulse transcranial magnetic
stimulation of primary motor cortex was used to elicit motor-evoked
potentials (MEPs) in BB 100-300 ms before muscle contraction. Baseline
muscle activity and MEP amplitude were the primary dependent measures.
Effects of movement TASK and SUPPORT LEVEL were statistically analyzed
using linear mixed effects models.
RESULTS:
As
expected, with increased support tonic activity was reduced across all
muscles. This effect was greatest in the anti-gravity muscle anterior
deltoid, and evident in biceps brachii and pronator teres as well. For
BB MEP amplitude, TASK and SUPPORT LEVEL, interacted such that for elbow
flexion, MEP amplitudes were smaller with incrementally greater WS
whereas, for forearm pronation MEP amplitudes were smaller only at high
WS.
CONCLUSIONS:
Weight
support of the arm influences corticomotor selectivity of biceps
brachii. WS may impact coordination independently of a global reduction
in muscle activity. The amount of supportive force applied to the arm
influences the neuromechanical control profile for the limb. These
findings may inform the application of WS in upper limb stroke
rehabilitation.
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