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Impaired Coordination and Recruitment of Muscle Agonists, But Not Abnormal Synergies or Co-contraction, Have a Significant Effect on Motor Impairments After Stroke

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Health and Medicine

Part of the book series: Advances in Experimental Medicine and Biology ((CLEXBI,volume 1279))

Abstract

Movement synergies, muscle co-contraction, and decreased motor drive to muscle agonists were suggested to be major factors in motor impairments after stroke. The purpose of this study was to investigate the major muscle mechanisms contributing to motor impairment after stroke. Twelve healthy and 13 post-stroke patients participated in this observational study. Both groups participated in a single experimental session, performing hand pointing movements in multiple directions, during which EMG was assessed. Additionally, the patients underwent the Fugl-Meyer assessment. A set of features from the electromyography (EMG) signal and co-contraction ratios were used to compare the capacity to modulate the muscle activity between the two groups of participants. A correlation analysis was applied between the Euclidian distances of each target and the Fugl-Meyer scoring assessment in the post-stroke patients. We found that impaired modulation of muscle activity in post-stroke patients was characterized by significantly increased Euclidian distances between the EMG features of different target directions and by a higher variability between muscle activation compared to healthy subjects. Impaired capacity to modulate muscle activity significantly correlated with the impairment status. In conclusion, impaired motor performance post-stroke systematic disturbance in the control signal to limb muscles, which manifests as decreased capacity to modulate muscle activity, rather than co-contraction of muscle antagonists or stereotyped movement patterns.

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Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Review Board of the Bait-Balev Rehabilitation Center in Nesher, Israel, and it was registered at ClinicalTrials.gov#NCT03063151.

Informed Consent

Informed consent was obtained from all individual participants included in the study. In addition, the subject presented in the photo of Fig. 2 gave written informed consent permitting the reproduction of his body in both electronic and printed versions of the article.

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Authors and Affiliations

  1. Department of Medical Neurobiology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Sharon Israely

  2. Department of Physical Therapy, University of Haifa, Haifa, Israel

    Gerry Leisman & Eli Carmeli

  3. National Institute for Brain and Rehabilitation Sciences-Israel, Nazareth, Israel

    Gerry Leisman

  4. Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Universidad de Ciencias Médicas de la Habana, Havana, Cuba

    Gerry Leisman

Authors
  1. Sharon Israely
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  2. Gerry Leisman
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  3. Eli Carmeli
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Corresponding author

Correspondence to Gerry Leisman .

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Editors and Affiliations

  1. Opole Medical School, Warsaw, Poland

    Mieczyslaw Pokorski

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Israely, S., Leisman, G., Carmeli, E. (2020). Impaired Coordination and Recruitment of Muscle Agonists, But Not Abnormal Synergies or Co-contraction, Have a Significant Effect on Motor Impairments After Stroke. In: Pokorski, M. (eds) Health and Medicine. Advances in Experimental Medicine and Biology(), vol 1279. Springer, Cham. https://doi.org/10.1007/5584_2020_528

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