1
|
Onursal Kilinç Ö, Kilinç M, Ayvat E, Düzgün I, Özçakar L. Effects of scapulo-humeral training on ultrasonographic and clinical evaluations in stroke: a randomized controlled trial. Top Stroke Rehabil 2024; 31:501-512. [PMID: 38194359 DOI: 10.1080/10749357.2024.2302720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND After stroke, the effects of focused scapulo-humeral training with simultaneous assessment of the changes in shoulder subluxation, related muscle thicknesses and upper limb performance have not been studied in the literature. OBJECTIVES This study aimed to investigate the effects of an 8-week scapulo-humeral training program in addition to conventional rehabilitation on upper extremity/trunk functions, shoulder pain, and sonographic measurements of the shoulder joint and periscapular muscles. METHODS Thirty stroke individuals were randomly separated into two groups as Group I-scapulo-humeral training (5F/10 M) and Group II - control (5F/10 M). Conventional rehabilitation program was applied to both groups, and a scapulo-humeral training exercise protocol was added for the scapulo-humeral group. All the treatments were applied for 1 hour/day, 3 days/week, 8 weeks. Clinical evaluations were made using the Fugl Meyer Assessment-Upper Extremity(FMA-UE), Action Research Arm Test(ARAT), ABILHAND, Visual Analog Scale, and Trunk Impairment Scale(TIS). Ultrasound was used to measure serratus anterior/lower trapezius muscle thicknesses, and acromion-greater tubercule/acromio-humeral distances. RESULTS FMA-UE, ARAT, ABILHAND and TIS scores increased in both groups, with greater increases in most parameters in the scapulo-humeral training group. Shoulder pain decreased only in the scapulo-humeral training group. Subacromial distances were decreased on the paretic side, and muscle thicknesses increased on both sides in the scapulo-humeral training group, and in the control group, only serratus anterior muscle thickness increased on the paretic side (p < 0.05 for all). CONCLUSIONS Additional scapulo-humeral exercises to conventional rehabilitation was seen to improve upper extremity/trunk performance and shoulder pain, and to increase scapula stabilizer muscle thicknesses in stroke individuals with mild-moderate upper extremity disability.
Collapse
Affiliation(s)
- Özge Onursal Kilinç
- Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey
| | - Muhammed Kilinç
- Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey
| | - Ender Ayvat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey
| | - Irem Düzgün
- Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe Universitesi Tip Fakultesi, Ankara, Turkey
| |
Collapse
|
2
|
Borges H, de Freitas S, Liebano R, Alouche S. Hemiplegic shoulder pain affects ipsilesional aiming movements after stroke: a cross-sectional study. Physiother Theory Pract 2024; 40:241-252. [PMID: 36062585 DOI: 10.1080/09593985.2022.2118004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/23/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hemiplegic shoulder pain (HSP) is common after stroke. The pain perception may exacerbate changes in the motor behavior of the ipsi-lesional upper limb, contributing to the functional decline of an individual's motor performance. OBJECTIVE This study evaluates the influence of pain perception on the aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke. METHODS A cross-sectional study was conducted with 41 participants divided into three groups: 1) stroke with contralesional shoulder pain ≥ 3 by the Visual Numerical Pain Scale (SPSG; n = 13); 2) stroke no shoulder pain (nSPSG; n = 14); and 3) healthy control (CTG; n = 14) matched by sex and age. Individuals with stroke were matched for the severity of sensorimotor impairment by the Fugl-Meyer upper limb subscale and the injured hemisphere side. Stroke groups performed aiming movements with the ipsilesional upper limb and the CTG with the corresponding limb using a pen tip on the sensitive surface of a digitizing tablet. Performance across groups was compared by one-way analysis of variance, considering the time since injury as a covariate. The planning and execution variables of the movement trajectory were analyzed, and the significance was set at 5%. RESULTS Trajectories of the SPSG were slower (p = .010; η2 = 0.22), were less smooth (p = .002; η2 = 0.30), had more directional error (p = .002; η2 = 0.28), and were less accurate (p = .034; η2 = 0.17) than the CTG. The nSPSG and CTG showed similar performance. CONCLUSIONS The perception of pain impairs aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke.
Collapse
Affiliation(s)
- Heloise Borges
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- School of Physiotherapy, Centro Universitário Nossa Senhora do Patrocínio, Itú, Brazil
| | - Sandra de Freitas
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Richard Liebano
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (Ufscar), São Carlos/SP, Brazil
| | - Sandra Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Pandian S, Arya KN, Kumar V, Joshi AK. Synergy-Based Motor Therapy Inducing Favorable Changes in Motor Function Components among Poststroke Subjects: A Single-Group Study. J Neurosci Rural Pract 2022; 13:261-269. [PMID: 35694074 PMCID: PMC9187400 DOI: 10.1055/s-0042-1743458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background
Synergy is an outcome of multiple muscles acting in a synchronized pattern, controlled by the central nervous system. After brain insult, a set of deviated movement pattern emerges in the affected limb. The methods to train synchronization of muscles may diminish the deviated movement augmenting neuromotor control. The purpose of this investigation was to develop a synergy-based motor therapy (SBMT) protocol for the paretic upper limb in poststroke subjects. Further, the feasibility and effectiveness of the program was evaluated. .
Methods
The design was Pretest–posttest single-group assessor-blinded trial. Department of occupational therapy of a national institute for persons with physical disabilities was the study site. There were 40 study subjects (23 men, ranging from 40 to 60 years, 18 subjects with hemorrhagic cerebrovascular accident, and > 6 months after the accident) exhibiting motor paresis of half side of the body. SBMT is a stage-specific regime based on the linkage between the deviated and usual muscle action. SBMT items were selected considering the strength and magnitude of the deviated motor components. The movement linkages were utilized to dissociate strong coupled components; for instance, forearm pronation-supination with elbow 90-degree flexion. Fugl-Meyer Assessment (upper extremity) (FMA-UE), Wolf Motor Function Test (WMFT), and Barthel Index (BI) were applied to quantify the motor status, motor functional ability of the upper extremity, and self-care activities, respectively.
Results
All the enrolled subjects could perform their corresponding SBMT sessions. Posttreatment, FMA-UE improved significantly (
p
< 0.001) from mean of 26.30 (standard deviation [SD] 15.02) to 35.20 (SD 17.64). Similarly, the WMFT both time (in seconds) and quality also positively improved significantly (
p
< .001) from mean of 76.77 (SD 54.73) to 64.07 (SD 56.99) and 1.34 (SD 1.06) to 1.87 (SD 1.34), respectively. BI improved from 79.88 (SD 17.07) to 92.62 (SD 21.2) after the intervention (
p
< 0.001).
Conclusion
SBMT protocol was a feasible and effective intervention to facilitate motor function components in chronic hemiparetic subjects. The regime could be considered as a potential intervention for stroke rehabilitation. Further trials and use of sophisticated measures are recommended to authenticate the outcome of this investigation.
Clinical Trial Registration
Clinical Trial Registry of India as CTRI/2017/10/010162 on October 23, 2017 (retrospectively).
Collapse
Affiliation(s)
- Shanta Pandian
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Kamal Narayan Arya
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Vikas Kumar
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Akshay Kumar Joshi
- Department of Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| |
Collapse
|
4
|
Ijiri T, Urabe Y, Maeda N, Sasadai J, Suzuki T. Shoulder muscle activation during scapular protraction exercise with arm rotation. J Back Musculoskelet Rehabil 2022; 35:75-83. [PMID: 34092591 DOI: 10.3233/bmr-200180] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The role of the serratus anterior is to maintain scapular stability. To strengthen this muscle, scapular protraction exercises are typically performed. Although the angle of arm rotation leads to changes in shoulder muscle activation, the arm rotation position is not normally determined. OBJECTIVE To investigate if scapular muscle activations were changed by combining arm external rotation during scapular protraction exercises. METHODS Thirty-four healthy men were enrolled in this study. Participants were instructed to perform scapular protraction exercises at 90∘ and 120∘ of shoulder flexion while in the standing and supine positions. Two different arm rotation angles were used: the thumb-up position (neutral position) and the maximum arm external rotation (ER) position. The percentages of maximum voluntary contractions (%MVCs) were measured, and %MVCs in the neutral and arm ER positions were compared. RESULTS Muscle activities of the middle serratus anterior (MSA) and lower serratus anterior (LSA) in the arm ER position were significantly higher than those in the neutral position during all tasks. The highest MSA and LSA positions were observed with the arm ER position of 120∘ while standing. CONCLUSIONS Scapular protraction exercises with arm ER resulted in a higher serratus anterior activity.
Collapse
Affiliation(s)
- Tomohito Ijiri
- Department of Rehabilitation, Kiba Hospital, Medical Corporation, Juzankai, Osaka, Japan.,Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junpei Sasadai
- Sports Medical Center, Japan Institute of Sport Sciences, Tokyo, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, Osaka, Japan
| |
Collapse
|
5
|
Chiu YH, Chang KV, Wu WT, Hsu PC, Özçakar L. Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis. Pharmaceuticals (Basel) 2021; 14:ph14080788. [PMID: 34451885 PMCID: PMC8401803 DOI: 10.3390/ph14080788] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 01/13/2023] Open
Abstract
Hemiplegic shoulder pain (HSP) hampers post-stroke functional recovery and is not well managed with conservative treatments. This systematic review aimed to examine the various injection therapies for HSP and investigate their effectiveness at different time points. The protocol of this meta-analysis was registered on INPLASY with a registration number of INPLASY202180010. PubMed, EMBASE, and Scopus were searched from their inception to 4 August 2021 for the clinical studies investigating comparative effectiveness of different injection regimens for treating hemiplegic shoulder pain in patients with stroke. The primary outcome was the weighted mean difference (WMD) on the visual analog scale (VAS) of pain reduction in the fourth-week and between the fourth and twenty-fourth weeks. Ranking probabilities of the WMD for each treatment were obtained using simulations. Seventeen studies with 595 participants were included. The network meta-analysis showed that at the fourth-week, intra-muscular botulinum toxin (BoNT) injections and suprascapular nerve blocks (SSNB) were superior to a placebo, with WMDs of 1.55 (95% CI, 0.09 to 3.01) and 1.44 (95% CI, 0.07 to 2.80), respectively. SSNB possessed the highest probability (53.3%) and appeared to be the best treatment in the fourth-week, followed by intra-muscular BoNT injections (42.6%). Intramuscular BoNT injections were better than the placebo, with a WMD of 1.57 (95% CI, 0.30 to 2.84) between the 4th and 24th weeks. Intramuscular BoNT injections had the highest probability (79.8%) as the best treatment between the 4th and 24th weeks. SSNB was likely to rank first in relieving HSP at the fourth post-treatment week, whereas intra-muscular BoNT injections had the highest probability to achieve the best treatment effectiveness in the post-injection period between the fourth and twenty-fourth weeks. However, as some of the included studies used a non-randomized controlled design, more randomized controlled trials are needed in the future to validate and better understand the short- and long-term efficacy of different injection therapies for management of HSP.
Collapse
Affiliation(s)
- Yi-Hsiang Chiu
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan;
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei 11600, Taiwan
- Correspondence:
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
| | - Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey;
| |
Collapse
|
6
|
Kotoshiba S, Urabe Y, Hara M, Fujisawa M, Sumida R, Aramaki K, Sasadai J, Maeda N. The infraspinatus muscle activity during pitching motion in baseball players with shoulder instability. JSES Int 2021; 5:512-518. [PMID: 34136863 PMCID: PMC8178609 DOI: 10.1016/j.jseint.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Shoulder microinstability is often overlooked, which can be problematic, especially in overhead athletes. The slipping phenomenon is defined as posterior or lateral sliding of the humeral head in an elevated arm. When the shoulder is close to the end range of stability, the infraspinatus is highly activated and keeps the shoulder in the glenoid cavity. This study aimed to examine the characteristic physical function and infraspinatus activity during the pitching motion in baseball pitchers with shoulder instability. Methods Twenty-one male baseball pitchers participated and were divided into 2 groups based on radiograph findings at zero position: slipped (group S) and nonslipped (group N) groups. Physical function using Hara test and infraspinatus muscle activity during pitching were evaluated. Results The infraspinatus muscle activity during the acceleration phase was significantly greater in group S (59.5 ± 33.0%MVC) than in group N (33.0 ± 16.9%MVC) (P < .05). Positive rate of the Hara test in group S was significantly high in the loose test and elbow push test. Conclusions This study shows that baseball pitchers with slipping phenomenon have capsular laxity and scapular instability that indicate high infraspinatus muscle activity during the acceleration phase. Therefore, repetitive pitching with hyperactivity of the infraspinatus on the slipping shoulder may cause fatigue and dysfunction.
Collapse
Affiliation(s)
- Somu Kotoshiba
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masafumi Hara
- Hara Baseball Medical Institute, Hisatsune Hospital, Fukuoka, Japan.,Department of Orthopedic Surgery, Hisatsune Hospital, Fukuoka, Japan
| | - Motoyuki Fujisawa
- Hara Baseball Medical Institute, Hisatsune Hospital, Fukuoka, Japan.,Department of Orthopedic Surgery, Hisatsune Hospital, Fukuoka, Japan
| | - Ryohei Sumida
- Department of Rehabilitation, Hisatsune Hospital, Fukuoka, Japan
| | - Kei Aramaki
- Department of Rehabilitation, Hisatsune Hospital, Fukuoka, Japan
| | - Junpei Sasadai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
7
|
Essers JMN, Murgia A, Peters AA, Janssen MMHP, Meijer K. Recommendations for studies on dynamic arm support devices in people with neuromuscular disorders: a scoping review with expert-based discussion. Disabil Rehabil Assist Technol 2020; 17:487-500. [PMID: 32981390 DOI: 10.1080/17483107.2020.1806937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Neuromuscular disorders are characterised by muscle weakness that limits upper extremity mobility, but can be alleviated with dynamic arm support devices. Current research highlights the importance and difficulties of evidence-based recommendations for device development. We aim to provide research recommendations primarily concerning upper extremity body functions, and secondarily activity and participation, environmental and personal factors. METHODS Evidence was synthesised from literature, ongoing studies, and expert opinions and tabulated within a framework based on a combination of the International Classification of Functioning, Disability and Health (ICF) model and contextual constructs. RESULTS Current literature mostly investigated the motor capacity of muscle function, joint mobility, and upper body functionality, and a few studies also addressed the impact on activity and participation. In addition, experts considered knowledge on device utilisation in the daily environment and characterising the beneficiaries better as important. Knowledge gaps showed that ICF model components and contextual constructs should be better integrated and more actively included in future research. CONCLUSIONS It is recommended to, first, integrate multiple ICF model components and contextual constructs within one study design. Second, include the influence of environmental and personal factors when developing and deploying a device. Third, include short-term and long-term measurements to monitor adaptations over time. Finally, include user satisfaction as guidance to evaluate the device effectiveness.IMPLICATIONS ON REHABILITATIONSynthesized evidence will support future research and development of dynamic arm supports.Tabulated evidence stresses the importance of integrating ICF model components and contextual constructs to fill the knowledge gaps.Presented knowledge gaps and proposed steps guide the set up of future studies on dynamic arm supports.
Collapse
Affiliation(s)
- J M N Essers
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - A Murgia
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A A Peters
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M M H P Janssen
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Meijer
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
8
|
The effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2020. [DOI: 10.1186/s43161-020-00004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Post-stroke scapular dyskinesia is a predisposing factor for the affection of motor and somatosensory functions of the hemiparetic upper extremity.
Objective
The purpose of the study was to investigate the effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity.
Subjects and methods
Sixty patients with spasticity post-stroke participated in this study. The patients were assigned to one of the two groups as determined by the lateral scapular slide test (LSST) using the palpation meter (PALM); group A with scapular dyskinesia and group B stroke patients without scapular dyskinesia. The scapular position was determined by a measurement of scapular balance angle (SBA), and the upper extremity sensorimotor function was evaluated using Fugl-Meyer Assessment upper extremity (FMAUE) scale. The scapular balance angle and Fugl-Meyer upper extremity scores were compared between groups.
Results
There was a significant increase in the scapular balance angle of group A compared with that of group B (p < 0.001). Also, there was a significant decrease in sensory and motor functions of group A as measured by Fugl-Meyer upper extremity compared with that of group B (p < 0.001).
Conclusion
Scapular dyskinesia had a significant effect on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity. Management of scapular dyskinesia should be emphasized in the rehabilitation program for stroke patients with spasticity.
Collapse
|
9
|
Simon-Martinez C, Mailleux L, Jaspers E, Ortibus E, Desloovere K, Klingels K, Feys H. Effects of combining constraint-induced movement therapy and action-observation training on upper limb kinematics in children with unilateral cerebral palsy: a randomized controlled trial. Sci Rep 2020; 10:10421. [PMID: 32591590 PMCID: PMC7320002 DOI: 10.1038/s41598-020-67427-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 05/26/2020] [Indexed: 11/15/2022] Open
Abstract
Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP in a randomized controlled trial. Thirty-six children with uCP completed an UL kinematic and clinical evaluation after participating in a 9-day mCIMT camp wearing a splint for 6 h/day. The experimental group (mCIMT + AOT, n = 20) received 15 h of AOT, i.e. video-observation and execution of unimanual tasks. The control group (mCIMT + placebo, n = 16) watched biological-motion free videos and executed the same tasks. We examined changes in motor control (movement duration, peak velocity, time-to-peak velocity, and trajectory straightness) and kinematic movement patterns (using Statistical Parametric Mapping) during the execution of three unimanual, relevant tasks before the intervention, after and at 6 months follow-up. Adding AOT to mCIMT mainly affected movement duration during reaching, whereas little benefit is seen on UL movement patterns. mCIMT, with or without AOT, improved peak velocity and trajectory straightness, and proximal movement patterns. Clinical and kinematic improvements are poorly related. Although there seem to be limited benefits of AOT to CIMT on UL kinematics, our results support the inclusion of kinematics to capture changes in motor control and movement patterns of the proximal joints.
Collapse
Affiliation(s)
- Cristina Simon-Martinez
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium. .,Information Systems Institute, University of Applied Sciences Western Switzerland (HES-SO Valais), Sierre, Switzerland.
| | - Lisa Mailleux
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium.,Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| |
Collapse
|
10
|
Ijiri T, Urabe Y, Maeda N, Sasadai J, Suzuki T. Comparative study of the differences in shoulder muscle activation according to arm rotation angle. Hum Mov Sci 2020; 69:102567. [PMID: 31989947 DOI: 10.1016/j.humov.2019.102567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Scapular muscle exercise is important for patients with shoulder disorders. Distal variance leads to changes in shoulder muscle activation. Here, we aimed to determine whether scapular muscle activation is affected by different arm rotation angles. METHODS Overall, 30 healthy men participated in this study. The subjects were asked to keep their arms at 120 degrees of shoulder flexion while holding a 1.0-kg dumbbell in palms down (pronation) and palms up (supination) positions. Electromyography was used to measure anterior, middle, posterior deltoid, serratus anterior, upper, and lower trapezius muscle activation during the task. The muscle activations of each shoulder were compared between the pronation and supination positions. RESULTS Anterior deltoid and serratus anterior activations were significantly higher in supination than in pronation (p < .05). Alternatively, posterior deltoid and lower trapezius muscles were significantly more activated in pronation than in supination (p < .05). CONCLUSION Scapular muscle activation changed with arm rotation angle. Arm rotation angle should be assessed to estimate scapular muscle activation during exercise and motion analysis in clinical practice.
Collapse
Affiliation(s)
- Tomohito Ijiri
- Department of Rehabilitation, Kiba Hospital, Medical Corporation, Juzankai 4-2-8, Iwata, Higashiosaka, Osaka 578-0941, Japan; Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Junpei Sasadai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Sciences, 2-11-1, Wakaba, Kumatori, Sennan county, Osaka 590-0482, Japan
| |
Collapse
|
11
|
Lennon O, Logeswaran K, Mistry S, Moore T, Severini G, Cornall C, O'Sullivan C, McCarthy Persson U. Effect of the Triceps Brachii Facilitation Technique on Scapulohumeral Muscle Activation during Reach and Point in a Healthy Population. Physiother Can 2019; 71:309-318. [PMID: 31762541 DOI: 10.3138/ptc-2018-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Neurodevelopmental techniques are commonly used in upper limb rehabilitation, but little evidence supports the facilitation techniques associated with this concept. This exploratory study determined whether a facilitation technique at the triceps muscle affected scapulothoracic muscle activity during reach in healthy participants compared with self-selected posture and reach. The secondary aim was to determine whether muscle activation levels differed between the facilitation technique and the optimized posture or guided movement. We also hypothesized that activity in the scapular stabilizers (lower trapezius [LT] and serratus anterior [SA]) would be increased during the facilitated movement than in the other conditions. Methods: The study included 17 healthy participants (aged 20-70 y). Surface electromyography recorded muscle activity in the upper trapezius (UT), middle trapezius (MT), and LT muscles and in the SA, middle deltoid (MD), and triceps during five performance conditions. We used Friedman's test to explore differences in muscle activity across conditions and Bonferroni's post hoc test to explore the differences between conditions. Results: The facilitation technique produced decreased activity in the SA, MD, and triceps muscles (p < 0.01) compared with the self-executed control condition. Compared with optimized posture with independent reach, facilitated movement again produced similar reductions in MD and triceps activity, with decreased LT activity also noted (p < 0.01). Lower activity levels were noted during facilitation than during manual guidance, with or without optimized posture, in the UT, MT, (p < 0.01), SA, and MD muscles (p < 0.05). Conclusions: Triceps facilitation did not increase scapular stability activity, but the activity levels in several other muscle groups (SA, MD, and triceps) were reduced during triceps facilitation compared with optimized posture or guided movement. Detailed analysis of this technique, including co-registered kinematic data and timing of muscle onset, is needed.
Collapse
Affiliation(s)
- Olive Lennon
- School of Public Health, Physiotherapy and Sports Science
| | | | - Srushti Mistry
- School of Public Health, Physiotherapy and Sports Science
| | - Tara Moore
- School of Public Health, Physiotherapy and Sports Science
| | - Giacomo Severini
- School of Electrical and Electronic Engineering, University College
| | | | | | | |
Collapse
|
12
|
Cuesta-Gómez A, Carratalá-Tejada M, Molina-Rueda F, Miangolarra-Page JC. Functional electrical stimulation improves reaching movement in the shoulder and elbow muscles of stroke patients: A three-dimensional motion analysis. Restor Neurol Neurosci 2019; 37:231-238. [PMID: 31177249 DOI: 10.3233/rnn-180884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recovery of motor function following stroke is essential to restore adequate functionality. The use of functional electrical stimulation (FES) technology as a neuroprosthesis to enhance the motor function of the UL, and thus facilitate the performance of ADL, could lead to a stroke patient's greater activity and participation in daily life. OBJECTIVE The aim of the present study was to establish whether the application of FES in patients who have suffered a stroke with UL motor impairment is able to modify and facilitate their reaching patterns, measured by a three-dimensional motion capture system. METHODS 20 patients with chronic stroke participated in this study. For muscle stimulation, the electrical stimulator Compex® was used. Motion analysis was performed using the VICON Motion System®. Joint movements of the thorax, shoulder and elbow were analyzed in the sagittal plane, during the reaching movement under two different conditions of stimulation: FES condition and placebo condition. RESULTS Differences between FES condition and placebo condition were observed. In the FES condition it was recorded: an increased shoulder flexion and elbow extension in the reaching movement. CONCLUSIONS Functional electrical stimulation improved reaching movement in stroke patients with upper limb impairment.
Collapse
Affiliation(s)
- Alicia Cuesta-Gómez
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | - María Carratalá-Tejada
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | - Francisco Molina-Rueda
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | - Juan Carlos Miangolarra-Page
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain.,Chair of Rehabilitation and Physical Medicine, Fuenlabrada University Hospital, Madrid, Spain
| |
Collapse
|
13
|
Wang Q, Timmermans A, Chen W, Jia J, Ding L, Xiong L, Rong J, Markopoulos P. Stroke Patients' Acceptance of a Smart Garment for Supporting Upper Extremity Rehabilitation. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 6:2101009. [PMID: 30519515 PMCID: PMC6276725 DOI: 10.1109/jtehm.2018.2853549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/10/2018] [Accepted: 04/07/2018] [Indexed: 11/09/2022]
Abstract
The objective is to evaluate to which extent that Zishi a garment equipped with sensors that can support posture monitoring can be used in upper extremity rehabilitation training of stroke patients. Seventeen stroke survivors (mean age: 55 years old, SD =13.5) were recruited in three hospitals in Shanghai. Patients performed 4 tasks (analytical shoulder flexion, functional shoulder flexion placing a cooking pot, analytical flexion in the scapular plane, and functional flexion in the scapular plane placing a bottle of water) with guided feedback on a tablet that was provided through inertial sensors embedded in the Zishi system at the scapula and the thoracic spine region. After performing the training tasks, patients completed four questionnaires for assessing their motivation, their acceptance of the system, its credibility, and usability. The study participants were highly motivated to train with Zishi and the system was rated high usability, while the subjects had moderate confidence with technology supported training in comparison with the training with therapists. The patients respond positively to using Zishi to support rehabilitation training in a clinical setting. Further developments need to address more on engaging and adaptive feedback. This paper paves the way for larger scale effectiveness studies.
Collapse
Affiliation(s)
- Qi Wang
- College of Design and InnovationTongji UniversityShanghai200092China.,Industrial Design DepartmentEindhoven University of Technology5612AZEindhovenThe Netherlands
| | - Annick Timmermans
- BIOMED Biomedical Research Institute, University of HasseltBE3500DiepenbeekBelgium
| | - Wei Chen
- Center for Intelligent Medical Electronics, School of Information Science and TechnologyFudan UniversityShanghai200433China
| | - Jie Jia
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghai200040China.,National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghai200040China
| | - Li Ding
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghai200040China
| | - Li Xiong
- Shanghai First Rehabilitation HospitalShanghai200090China
| | - Jifeng Rong
- Shanghai First Rehabilitation HospitalShanghai200090China
| | - Panos Markopoulos
- Industrial Design DepartmentEindhoven University of Technology5612AZEindhovenThe Netherlands
| |
Collapse
|
14
|
Santos GL, Russo TL, Nieuwenhuys A, Monari D, Desloovere K. Kinematic Analysis of a Drinking Task in Chronic Hemiparetic Patients Using Features Analysis and Statistical Parametric Mapping. Arch Phys Med Rehabil 2017; 99:501-511.e4. [PMID: 28939425 DOI: 10.1016/j.apmr.2017.08.479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/06/2017] [Accepted: 08/16/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare sitting posture and movement strategies between chronic hemiparetic and healthy subjects while performing a drinking task, using statistical parametric mapping (SPM) and feature analysis. DESIGN Cross-sectional study. SETTING A university physical therapy department. PARTICIPANTS Participants (N=26) consisted of chronic hemiparetic (n=13) and healthy individuals (n=13) matched for sex and age. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The drinking task was divided into phases: reaching, transporting the glass to mouth, transporting the glass to table, and returning to initial position. An SPM 2-sample t test was used to compare the entire kinematic waveforms of different joint angles (trunk, scapulothoracic, humerothoracic, elbow). Joint angles at the beginning and end of the motion, movement time, peak velocity timing, trajectory deviation, normalized integrated jerk, and range of motion were extracted from the motion data. Group differences for these parameters were analyzed using independent t tests. RESULTS At the static posture and beginning of the reaching phase, patients showed a shoulder position more deviated from the midline and externally rotated with increased scapula protraction, medial rotation, anterior tilting, trunk anterior flexion and inclination to the paretic side. Altered spatiotemporal variables throughout the task were found in all phases, except for the returning phase. Patients returned to a similar posture as the task onset, except for the scapula, which was normalized after the reaching phase. CONCLUSIONS Chronic hemiparetic subjects showed more deviations in the proximal joints during seated posture and reaching. However, the scapular movement drew nearer to the healthy individuals' patterns after the first phase, showing an interesting point to consider in rehabilitation programs.
Collapse
Affiliation(s)
- Gabriela Lopes Santos
- Laboratory of Neurological Physiotherapy Research, Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Thiago Luiz Russo
- Laboratory of Neurological Physiotherapy Research, Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Angela Nieuwenhuys
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, CERM, University Hospital Pellenberg, Pellenberg, Belgium
| | - Davide Monari
- Clinical Motion Analysis Laboratory, CERM, University Hospital Pellenberg, Pellenberg, Belgium; Department of Mechanical Engineering, Faculty of Engineering, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, CERM, University Hospital Pellenberg, Pellenberg, Belgium
| |
Collapse
|
15
|
Motor Control Training for the Shoulder with Smart Garments. SENSORS 2017; 17:s17071687. [PMID: 28737670 PMCID: PMC5539564 DOI: 10.3390/s17071687] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 11/17/2022]
Abstract
Wearable technologies for posture monitoring and posture correction are emerging as a way to support and enhance physical therapy treatment, e.g., for motor control training in neurological disorders or for treating musculoskeletal disorders, such as shoulder, neck, or lower back pain. Among the various technological options for posture monitoring, wearable systems offer potential advantages regarding mobility, use in different contexts and sustained tracking in daily life. We describe the design of a smart garment named Zishi to monitor compensatory movements and evaluate its applicability for shoulder motor control training in a clinical setting. Five physiotherapists and eight patients with musculoskeletal shoulder pain participated in the study. The attitudes of patients and therapists towards the system were measured using standardized survey instruments. The results indicate that patients and their therapists consider Zishi a credible aid for rehabilitation and patients expect it will help towards their recovery. The system was perceived as highly usable and patients were motivated to train with the system. Future research efforts on the improvement of the customization of feedback location and modality, and on the evaluation of Zishi as support for motor learning in shoulder patients, should be made.
Collapse
|
16
|
Cuesta-Gómez A, Molina-Rueda F, Carratala-Tejada M, Imatz-Ojanguren E, Torricelli D, Miangolarra-Page JC. The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study. Front Neurol 2017; 8:186. [PMID: 28539911 PMCID: PMC5423909 DOI: 10.3389/fneur.2017.00186] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/18/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL) muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES) is used to activate the paretic muscles using short-duration electrical pulses. Objective To evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems. Design A cross-sectional study was carried out. Setting The VICON Motion System® was used to conduct motion analysis. Participants Twenty-one patients with chronic stroke. Intervention The Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition. Main outcome measures We analyzed the joint kinematics (trunk, shoulder, and elbow) from the starting position until the affected hand reached the glass. Results Participants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions. Conclusion The application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.
Collapse
Affiliation(s)
- Alicia Cuesta-Gómez
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | - Francisco Molina-Rueda
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | - Maria Carratala-Tejada
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | | | | | - Juan Carlos Miangolarra-Page
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain.,Chair of Rehabilitation and Physical Medicine, Fuenlabrada University Hospital, Madrid, Spain
| |
Collapse
|
17
|
dos Santos GL, Souza MB, Desloovere K, Russo TL. Elastic Tape Improved Shoulder Joint Position Sense in Chronic Hemiparetic Subjects: A Randomized Sham-Controlled Crossover Study. PLoS One 2017; 12:e0170368. [PMID: 28099472 PMCID: PMC5242462 DOI: 10.1371/journal.pone.0170368] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 01/04/2017] [Indexed: 11/26/2022] Open
Abstract
Background Elastic tape has been widely used in clinical practice in order to improve upper limb (UL) sensibility. However, there is little evidence that supports this type of intervention in stroke patients. Objective To verify the effect of elastic tape, applied to the paretic shoulder, on joint position sense (JPS) during abduction and flexion in subjects with chronic hemiparesis compared to sham tape (non-elastic tape). Furthermore, to verify if this potential effect is correlated to shoulder subluxation measurements and sensorimotor impairment. Methods A crossover and sham-controlled study was conducted with post-stroke patients who were randomly allocated into two groups: 1) those who received Sham Tape (ST) first and after one month they received Elastic Tape (ET); 2) those who received Elastic Tape (ET) first and after one month they received Sham Tape (ST). The JPS was evaluated using a dynamometer. The absolute error for shoulder abduction and flexion at 30° and 60° was calculated. Sensorimotor impairment was determined by Fugl-Meyer, and shoulder subluxation was measured using a caliper. Results Thirteen hemiparetic subjects (average time since stroke 75.23 months) participated in the study. At baseline (before interventions), the groups were not different for abduction at 30° (p = 0.805; p = 0.951), and 60° (p = 0.509; p = 0.799), or flexion at 30° (p = 0.872; p = 0.897) and 60° (p = 0.853; p = 0.970). For the ET group, differences between pre and post-elastic tape for abduction at 30° (p<0.010) and 60° (p<0.010), and flexion at 30° p<0.010) and 60° (p<0.010) were observed. For the ST group, differences were also observed between pre and post-elastic tape for abduction at 30° (p<0.010) and 60° (p<0.010), and flexion at 30° (p<0.010,) and 60° (p<0.010). Potential effects were only correlated with shoulder subluxation during abduction at 30° (p = 0.001, r = -0.92) and 60° (p = 0.020, r = -0.75). Conclusion Elastic tape improved shoulder JPS of subjects with chronic hemiparesis regardless of the level of UL sensorimotor impairment. However, this improvement was influenced by the subluxation degree at abduction.
Collapse
Affiliation(s)
- Gabriela Lopes dos Santos
- Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
- * E-mail: (GLS); (TLR)
| | - Matheus Bragança Souza
- Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory (CERM), University Hospital Pellenberg, Pellenberg, Belgium
| | - Thiago Luiz Russo
- Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
- * E-mail: (GLS); (TLR)
| |
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
De Baets L, Jaspers E, Van Deun S. Scapulohumeral control after stroke: A preliminary study of the test-retest reliability and discriminative validity of a clinical scapular protocol (ClinScaP). NeuroRehabilitation 2016; 38:359-70. [PMID: 27061164 DOI: 10.3233/nre-161327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinical scapulohumeral tests are lacking post-stroke. OBJECTIVE To test reliability and discriminant validity of clinical scapulohumeral assessments post-stroke. METHODS Following tests were assessed in 57 individuals with stroke (IwS) (subdivided in a low, moderate, high proximal arm function (PAF) group) and 15 healthy controls: (1) Observation of tilting/winging; (2) shoulder girdle position tests (pectoralis minor index, acromial index, scapular distance test); (3) scapular lateral rotation measurement; (4) maximal humeral elevation and (5) medial rotation test were executed. 15 IwS were measured twice by the same assessor to determine test-retest reliability. Differences between controls and IwS and between IwS with different levels of PAF were assessed. RESULTS ICCs were very high for all tests (>0.80), except the pectoralis minor index (0.66). Weighted Kappas were high for observation and the medial rotation test (>0.70). Group differences were found for observation, lateral rotation and humeral elevation. IwS compared to controls, and IwS with lower compared to higher PAF generally showed increased lateral rotation (p < .01); decreased maximal active humeral elevation (p < .001); and more often tilting and winging (p < .05). CONCLUSIONS The use of these tests in clinical settings will allow for identification of altered scapular characteristics, which will enhance treatment planning for PAF post-stroke.
Collapse
Affiliation(s)
- Liesbet De Baets
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - Sara Van Deun
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
20
|
|