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Quantitative features of the stretch response of extrinsic finger muscles in hemiparetic stroke

Quantitative features of the stretch response of extrinsic finger muscles in hemiparetic stroke,10.1002/(SICI)1097-4598(200006)23:6<954::AID-MUS17>3.0

Quantitative features of the stretch response of extrinsic finger muscles in hemiparetic stroke   (Citations: 23)
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Despite its potential importance in hand dysfunction, spas- ticity in the finger muscles following stroke has not been well described. To explore this area, we assessed the role of finger flexor spasticity, along with that of passive mechanical forces, in resisting finger movement in 13 chronic stroke subjects. Subjects were tested with a device that stretched the ex- trinsic finger muscles through imposed rotation of the metacarpophalangeal (MCP) joints. Both maintained and constant-velocity stretches were im- posed. For the constant-velocity stretches, eight of the 13 stroke subjects exhibited strong stretch reflexes, as determined by electromyography and net work. The net work of this reflex response, calculated from the integral of the torque-angle plots, increased proportionally with increasing velocity, indicating a contribution from flexor muscle spasticity. Conversely, nine of the 13 stroke subjects did not possess distinctly greater passive, mechanical resistance to MCP rotation than control subjects. While extensor spasticity was not observed, stretch of the extrinsic finger flexors also produced some reflex activity in the finger extensors concomitant with reflex excitation of the flexors. These findings suggest that resistance to muscle stretching follow- ing stoke is mediated primarily by neurological rather than biomechanical disturbances, although changes in muscle fiber length may exaggerate the resistance.
Journal: Muscle & Nerve - MUSCLE NERVE , vol. 23, no. 6, pp. 954-961, 2000
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    • ...However, deficit in hand opening has been documented also in stroke subjects who didn’t present with increased passive resistance [33], suggesting that anomalies in neurological control play a major role in reducing finger joints motion...
    • ...[33,34]. The other two aspects are excessive co-contraction of flexors and extensors [5,35] and weakness of extensor muscles, presumably caused by a reduction in the activation of spinal segmental neurons [36]...
    • ...Considering that spasticity of finger extensors was rarely observed in stroke subjects [33], impairment in hand closing could be ascribed to flexors weakness well documented in literature [5,36]...

    Ilaria Carpinellaet al. Multi-finger coordination in healthy subjects and stroke patients: a m...

    • ...Kamper et al. examined the torque required to extend hypertonic finger joints and found a nearly linear relationship between metacarpophalangeal (MCP) joint extension angle and applied extension torque [16], [17]...
    • ...The HandSOME design uses elastic cords as springs to assist with finger and thumb extension, and provide assistance profiles that emulate the torque versus extension angle profiles for passive movement reported by Kamper et al. [17]...

    Elizabeth B. Brokawet al. Hand Spring Operated Movement Enhancer (HandSOME): A Portable, Passive...

    • ...For stroke patients, finger extension is much harder than flexion [22]...

    HyunKi Inet al. Jointless structure and under-actuation mechanism for compact hand exo...

    • ...While muscle atrophy (Scelsi et al. 1984) and contracture (O’Dwyer et al. 1996) could play a role in causing impairment in finger force coordination, neural factors may best account for finger impairment in persons with hemiparetic stroke (Kamper and Rymer 2000; Kamper et al. 2003)...

    Na Jin Seoet al. Altered digit force direction during pinch grip following stroke

    • ...Evidence indicates that hypertonia in finger flexor muscles [6] and weakness in...
    • ...This approach directly counters muscle tone, one of the neural mechanisms shown to impede hand extension [6]...

    Christopher N Schabowskyet al. Development and pilot testing of HEXORR: Hand EXOskeleton Rehabilitati...

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