Spasticity pp 123-138 | Cite as
Factors Underlying Abnormal Posture and Movement in Spastic Hemiparesis
Abstract
Hemiparetic stroke is accompanied by abnormalities of muscle tone (identified as spastic hypertonia), weakness for voluntary movement, and disturbances of muscular coordination. The first two disturbances, i.e., spasticity and weakness, are the most visible and the most intensively studied, yet the disturbance of muscular coordination is often the most incapacitating, and the least well understood. For example, it is widely known that in many subjects disturbances of voluntary movement may be masked by abnormalities of muscle tone and/or concurrent muscular weakness. Yet when these physical signs are treated effectively, or when they resolve spontaneously, the resulting incoordination and motor impairment is still severe. It is therefore likely that in many hemiparetic stroke subjects, neither increases in muscle tone nor muscular weakness are the primary sources of movement dysfunction or of their global disability.
Keywords
Elbow Flexor Polar Plot Contralateral Limb Stroke Subject Impaired LimbPreview
Unable to display preview. Download preview PDF.
References
- Brunnstrom S (1970) Movement therapy in hemiplegia. Harper and Row, New YorkGoogle Scholar
- Buchanan TS, Almdale DPJ, Lewis JL, Rymer WZ (1986) Characteristics of synergic relations during isometric contractions of human elbow muscles. J Neurophysiol 56:1225–1241PubMedGoogle Scholar
- Buchanan TS, Moniz MJ, Dewald JPA, Rymer WZ (1993) A biomechanical analysis of individual muscle forces about the wrist joint during isometric tasks. J Biomech (in press)Google Scholar
- Dewald JPA, Buchanan TS, Rovai GP, Rymer WZ (1989) Control of muscle activation during the maintenance of arm postures in the spastic hemiparetic subject. Soc Neurosci Abstr 15:693Google Scholar
- Dewald JPA, Pope PS, Given JD, McGuire JR, Rymer WZ (1992a) Evidence for abnormal coactivation patterns in hemiparetic stroke subjects. ACRM/AAPM&R Abstr, p 138Google Scholar
- Dewald JPA, McGuire JR, Rymer WZ (1992b) Evidence for flexor reflex alterations in hemiparetic stroke subjects. Soc Neurosci Abstr 18:1410Google Scholar
- Flanders M, Soechting JF (1990) Arm muscle activation for static forces in three-dimensional space. J Neurophysiol 64:1818–1837PubMedGoogle Scholar
- Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S (1975) The post-stroke hemiplegic patient. I. A method for evaluation of physical performance. Scand J Rehabil Med 7:13–31PubMedGoogle Scholar
- Holmqvist B, Lundberg A (1961) Differential supraspinal control of synaptic actions evoked by volleys in the flexion reflex afferents in alpha motoneurons. Acta Physiol Scand 54:1–51Google Scholar
- Kuypers HGJM (1964) The descending pathways to the spinal cord, their anatomy and function. In: Eccles JG, Schade J (eds) Organization of the spinal cord. Elsevier, New York, pp 178–200CrossRefGoogle Scholar
- Kuypers HGJM (1981) Anatomy of the descending pathways. In: Brookhart JM, Mountcastle VB (eds) Handbook of physiology, sect 1, vol 2, part 1. American Physiological Society, Bethesda, pp 597–666Google Scholar
- McPherson JM (1988a) Strategies that simplify the control of quadrupedal stance. I. Forces at the ground. J Neurophysiol 60:204–217Google Scholar
- McPherson JM (1988b) Strategies that simplify the control of quadrupedal stance. II. Electromyographic activity. J Neurophysiol 60:218–231Google Scholar
- Shahani BT, Young RR (1971) Human flexor reflexes. J Neurol Neurosurg Psychiatry 34: 616–627PubMedCrossRefGoogle Scholar
- Twitchell TE (1951) The restoration of motor function following hemiplegia in man. Brain 74:443–480PubMedCrossRefGoogle Scholar
- Wilson VJ, Yosida M (1969) Comparison of effects of stimulation of Deiters’ nucleus and medial longitudinal fasciculus on neck, forelimb, and hindlimb smotoneurons. J Neurophysiol 32:743–758PubMedGoogle Scholar