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Muacevic A, Adler JR, Varma A, Sharma NS, Vagha JD, Naqvi WM, Besekar S. Pediatric Patients With Hemiplegia: A Systematic Review of a Randomized Controlled Trial. Cureus 2023; 15:e34074. [PMID: 36843815 PMCID: PMC9946895 DOI: 10.7759/cureus.34074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 01/24/2023] Open
Abstract
Hemiplegia is the medical term for paralysis of one side of the body. It results in muscular wasting on the affected side, impairs gait, reduces motor abilities, and causes instability and a loss of grasping capacity. The patient's quality of life is impacted by hemiplegia because it impairs brain and spinal cord functions. Consequently, a range of therapeutic options, including physical therapy, medical health management, and other multidisciplinary care, are accessible. The effects of treatments on juvenile patients with hemiplegia who are participating in a randomized controlled trial (RCT) are examined in this systematic review. Using the Boolean operator "AND," the research process entailed searching for keywords like "Hemiplegia" and "Pediatrics." Based on the inclusion and exclusion criteria, a total of six RCTs were included in the study. According to the study's findings, hemiplegic patients benefited from Kinesio taping (KT), botulinum toxin type-A (BoNT-A), hyaluronic acid injections, and bimanual treatment.
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Micheletti J, Andersen L, Machado A, Lopes J, Souto L, Pastre C. Reliability of shoulder abduction muscle endurance measured using isokinetic dynamometry. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bohannon RW. Isokinetic testing of muscle strength of older individuals post-stroke: An integrative review. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-201146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Estrada-Bonilla YC, Castro de Souza-Tomé PA, Faturi FM, Mendes-Zambetta R, Lepesteur-Gianlorenço AC, Croti G, Jones TA, Russo TL. Compensatory neuromuscular junction adaptations of forelimb muscles in focal cortical ischemia in rats. Brain Behav 2020; 10:e01472. [PMID: 32004425 PMCID: PMC7066338 DOI: 10.1002/brb3.1472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/17/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Upper limb movements are affected frequently by brain ischemia (BI). Mechanisms involved in recovery and compensatory movements have developed several studies. However, less attention is given to skeletal muscles, where neuromuscular junction (NMJ) has an important role on muscle tropism and functional performance. METHODS Animals were divided into two groups: control (C) and BI. Then, animals were skilled to perform single-pellet retrieval task, following these procedures: habituation, shaping, and single-pellet retrieval task. BI was induced using stereotaxic surgery in order to apply endothelin-1 in motor cortex, representative of movements of dominant paw. Reaching task performance was evaluated by single-pellet retrieval task 1 day before BI induction, 4 and 15 days after BI induction. After that, biceps, triceps, fingers flexor, and extensor muscles were extracted. NMJ was assessed in morphometric characteristics (total area, total perimeter, and feret). Muscle fiber cross-sectional area and connective tissue percentage were also evaluated for characterization. Student's t test was used for comparisons between C and BI groups. Tau Kendall's correlation was applied among variables from BI group. RESULTS An increase in all NMJ morphometric parameters, as well as increase of atrophy and fibrosis in BI group compared with C. There was a high level of direct correlation between mean values of NMJ morphometry with percentage of success in reaching task in BI group. CONCLUSION Brain ischemia-induced NMJ compensatory expansion, muscle atrophy, and fibrosis in forelimb muscles that are related to reaching performance.
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Affiliation(s)
- Yisel Carolina Estrada-Bonilla
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil.,Body, Subjetct and Education Research Group, Physical Culture, Sports and Recreation, Saint Thomas University, Bogotá, DC, Colombia
| | - Paula Aiello Castro de Souza-Tomé
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
| | - Fernanda María Faturi
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
| | - Rafaella Mendes-Zambetta
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
| | - Anna Carolyna Lepesteur-Gianlorenço
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
| | - Gabrielle Croti
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
| | - Theresa A Jones
- Department of Psychology, Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
| | - Thiago Luiz Russo
- Physiotherapy Deparment - (DFisio), Laboratorio de Pesquisa em Fisioterapia Neurológica - LaFiN, Federal University of São Carlos, São Carlos, Brazil
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Mirror Movements are Linked to Executive Control in Healthy and Brain-injured Adults. Neuroscience 2018; 379:246-256. [DOI: 10.1016/j.neuroscience.2018.03.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 11/20/2022]
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Bilateral changes in 3-D scapular kinematics in individuals with chronic stroke. Clin Biomech (Bristol, Avon) 2017; 47:79-86. [PMID: 28618310 DOI: 10.1016/j.clinbiomech.2017.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Stroke can lead to altered scapular motion that may limit the ability to perform activities of daily living. The aims were to evaluate scapular kinematics of individuals with chronic stroke and the correlation with paretic arm function. METHODS Scapular kinematics was assessed in thirty-four individuals (Chronic stroke=17; controls=17) during arm elevation and lowering in scapular and self-selected planes, and during hair combing. The use of the paretic arm to perform activities of daily living was assessed by the Motor Activity Log (MAL-30). Scapular kinematics was compared among paretic and non-paretic arms, and controls. Correlation between scapular kinematics and MAL-30 was also verified. FINDINGS Paretic and non-paretic arms showed increased scapular internal rotation (p<0.05) during arm lowering in the scapular plane, and during arm elevation and lowering in the self-selected plane compared to controls. Increased internal rotation (p<0.05) was also found in the paretic arm during hair combing compared to controls. Increased scapular anterior tilt (p<0.05) was observed in the paretic arm during arm elevation while performing the activity of hair combing and during arm elevation and lowering in the scapular and self-selected planes compared to controls. The non-paretic arm showed increased anterior tilt (p<0.05) during arm elevation and lowering in self-selected plane compared to controls. No difference in scapular upward rotation among neither arms, nor correlation between scapular kinematics and MAL-30 were found (p>0.05). INTERPRETATION Individuals with chronic stroke showed bilateral scapular kinematics alterations. However, these alterations are not correlated with paretic arm function.
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Kristensen OH, Stenager E, Dalgas U. Muscle Strength and Poststroke Hemiplegia: A Systematic Review of Muscle Strength Assessment and Muscle Strength Impairment. Arch Phys Med Rehabil 2017; 98:368-380. [DOI: 10.1016/j.apmr.2016.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/26/2016] [Indexed: 12/17/2022]
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Santos GL, García-Salazar LF, Souza MB, Oliveira AB, Camargo PR, Russo TL. Torque steadiness and muscle activation are bilaterally impaired during shoulder abduction and flexion in chronic post-stroke subjects. J Electromyogr Kinesiol 2016; 30:151-60. [PMID: 27451360 DOI: 10.1016/j.jelekin.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To characterize sensorimotor control and muscle activation in the shoulder of chronic hemiparetic during abduction and flexion in maximal and submaximal isometric contractions. Furthermore, to correlate submaximal sensorimotor control with motor impairment and degree of shoulder subluxation. METHODS Thirteen chronic hemiparetic post-stroke age-gender matched with healthy were included. Isometric torques were assessed using a dynamometer. Electromyographic activity of the anterior and middle deltoid, upper trapezius, pectoralis major and serratus anterior muscles were collected. Variables were calculated for torque: peak, time to target, standard deviation (SD), coefficient of variation (CV), and standard error (RMSE); for muscle activity: maximum and minimum values, range and coefficient of activation. Motor impairment was determined by Fugl-Meyer and shoulder subluxation was measured with a caliper. RESULTS Paretic and non-paretic limbs reduced peak and muscle activation during maximal isometric contraction. Paretic limb generated lower force when compared with non-paretic and control. Paretic and non-paretic presented higher values of SD, CV, RMSE, and CV for prime mover muscles and minimum values for all muscles during steadiness. No correlation was found between sensorimotor control, motor impairment and shoulder subluxation. CONCLUSION Chronic hemiparetic presented bilateral deficits in sensorimotor and muscle control during maximal and submaximal shoulder abduction and flexion.
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Affiliation(s)
- Gabriela Lopes Santos
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Luisa Fernanda García-Salazar
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Physical Therapy Program, School of Medicine and Health Science, University of Rosario, Bogotá, D.C., Colombia
| | - Matheus Bragança Souza
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Beatriz Oliveira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Paula Rezende Camargo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Thiago Luiz Russo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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De Baets L, Van Deun S, Monari D, Jaspers E. Three-dimensional kinematics of the scapula and trunk, and associated scapular muscle timing in individuals with stroke. Hum Mov Sci 2016; 48:82-90. [PMID: 27155342 DOI: 10.1016/j.humov.2016.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 04/27/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
Poor scapulothoracic control is a risk for developing shoulder pathology, but has received little attention so far in individuals with stroke (IwS). Trunk and scapular kinematics and surface muscle activity were measured in 15 healthy controls and 18 IwS during a low and high forward flexion (FF). Group-differences in trunk and scapular kinematics were assessed during low and high FF using a t-test (independent samples). Differences in muscle onset and offset time relative to movement start (both FF tasks) were determined using a mixed model taking into account the different groups and muscles. Recruitment patterns per group and task were described based on significant differences between muscles. In IwS, earlier lower trapezius and late infraspinatus offset were found during low FF, as well as a later onset and earlier offset of serratus anterior. For low FF, significantly more trunk axial rotation was found in IwS during both elevation and lowering. During high FF, IwS showed significantly less scapular posterior tilt during elevation and more scapular lateral rotation during lowering. IwS demonstrated adaptive muscle timing with earlier initiation and late inactivation of lower trapezius and infraspinatus, possibly to compensate for a late activation and early deactivation of the serratus anterior and to establish as such the correct pattern of scapulothoracic movement.
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Affiliation(s)
- Liesbet De Baets
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, 3590 Diepenbeek, Belgium.
| | - Sara Van Deun
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, 3590 Diepenbeek, Belgium
| | - Davide Monari
- CMAL Clinical Motion Analysis Laboratory, University Hospital Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, ETH Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
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Dos Santos GL, Salazar LFG, Lazarin AC, de Russo TL. Joint position sense is bilaterally reduced for shoulder abduction and flexion in chronic hemiparetic individuals. Top Stroke Rehabil 2015; 22:271-80. [PMID: 26258452 DOI: 10.1179/1074935714z.0000000014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The stroke is the leading cause of adult disability in the world. One of the main complaints of individuals post-stroke refers to the loss of function of the upper limb, as evidenced during the performance of activities of daily living. This difficulty may be related to an important component of sensorimotor control, joint position sense, a submodality of proprioception. OBJECTIVES To investigate whether the proprioception of both shoulders of chronic hemiparetic patients is altered during abduction and flexion. METHODS Thirteen subjects with chronic hemiparesis due to ischemic stroke and 13 healthy subjects matched for gender and age was included. The joint sense position was assessed using a dynamometer. Absolute error for shoulder abduction and flexion at the 30 and 60° was calculated. RESULTS No difference was found between the paretic and non-paretic limbs in movements at both 30 and 60°. Higher values of absolute error for both paretic and non-paretic limbs compared to the control were observed during abduction at 30 and at 60°. CONCLUSIONS Chronic ischemic post-stroke patients have bilateral proprioceptive deficits in the shoulder during abduction and flexion. But these deficits are dependent on the movement performed and the angle tested. The results demonstrate the need to include bilateral exercises and/or visual feedback in the rehabilitation program.
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Nascimento LR, Teixeira-Salmela LF, Polese JC, Ada L, Faria CDCM, Laurentino GEC. Strength deficits of the shoulder complex during isokinetic testing in people with chronic stroke. Braz J Phys Ther 2014; 18:268-75. [PMID: 25003280 PMCID: PMC4183497 DOI: 10.1590/bjpt-rbf.2014.0030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/11/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To examine the strength deficits of the shoulder complex after stroke and to characterize the pattern of weakness according to type of movement and type of isokinetic parameter. METHOD Twelve chronic stroke survivors and 12 age-matched healthy controls had their shoulder strength measured using a Biodex isokinetic dynamometer. Concentric measures of peak torque and work during shoulder movements were obtained in random order at speeds of 60°/s for both groups and sides. Type of movement was defined as scapulothoracic (protraction and retraction), glenohumeral (shoulder internal and external rotation) or combined (shoulder flexion and extension). Type of isokinetic parameter was defined as maximum (peak torque) or sustained (work). Strength deficits were calculated using the control group as reference. RESULTS The average strength deficit for the paretic upper limb was 52% for peak torque and 56% for work. Decreases observed in the non-paretic shoulder were 21% and 22%, respectively. Strength deficit of the scapulothoracic muscles was similar to the glenohumeral muscles, with a mean difference of 6% (95% CI -5 to 17). Ability to sustain torque throughout a given range of motion was decreased as much as the peak torque, with a mean difference of 4% (95% CI -2 to 10). CONCLUSIONS The findings suggest that people after stroke might benefit from strengthening exercises directed at the paretic scapulothoracic muscles in addition to exercises of arm elevation. Clinicians should also prescribe different exercises to improve the ability to generate force and the ability to sustain the torque during a specific range of motion.
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Affiliation(s)
- Lucas R Nascimento
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Luci F Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Janaine C Polese
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Louise Ada
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Christina D C M Faria
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Glória E C Laurentino
- Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, PE, Brazil
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