Relation between abnormal patterns of muscle activation and response to common peroneal nerve stimulation in hemiplegia.
نویسندگان
چکیده
OBJECTIVE To investigate the relation between response to common peroneal nerve stimulation, timed to the swing phase of walking, and abnormal ankle movement and muscle activation patterns. METHOD Eighteen patients who took part had a drop foot and had had a stroke at least 6 months before the study Twelve age matched normal subjects were also studied. Response to stimulation was measured by changes in the speed and effort of walking when the stimulator was used. Speed was measured over 10 m and effort by the physiological cost index. Abnormal ankle movement and muscle activation were measured in a rig by ability to follow a tracking signal moving sinusoidally at either 1 or 2 Hz, resistance to passive movement, and EMG activity during both passive and active movements. Indices were derived to define EMG response to passive stretch, coactivation, and ability to activate muscles appropriately during active movement RESULTS Different mechanisms underlying the drop foot were seen. Results showed that patients who had poor control of ankle movement and spasticity, demonstrated by stretch reflex and coactivation, were more likely to respond well to stimulation. Those with mechanical resistance to passive movement and with normal muscle activation responded less well. CONCLUSIONS The results support the hypothesis that stimulation of the common peroneal nerve to elicit a contraction of the anterior tibial muscles also inhibits the antagonist calf muscles. The technique used may be useful in directing physiotherapy by indicating the underlying cause of the drop foot.
منابع مشابه
Effects of Functional Electrical Stimulation on Gait in Cerebral Palsy
Several authors have reported functional and therapeutic benefits after the application of electrical stimulation to children with neurological disorders (1-3). A functional movement can be induced by electrical neuromuscular stimulation of the paralysed muscles with intact excitability of their peripheral innervation. A long-term use of electrical neuromuscular stimulation can strengthen the w...
متن کاملAppearance of reciprocal facilitation of ankle extensors from ankle flexors in patients with stroke or spinal cord injury.
The purpose of the present study was to investigate the pathophysiological role of reciprocal facilitation between antagonistic motoneuron pools in spasticity. The soleus H-reflex was conditioned by prior stimulation of the peroneal nerve in 15 healthy subjects, six hemiplegic patients and 11 spinal cord injured (SCI) patients. The hemiplegic patients were tested from soon after the onset of he...
متن کاملSelective Stimulation of the Common Peroneal Nerve for Hemiplegia: Long-Term Clinical Follow-up
We present the results of seven-year clinical follow-up in correction of drop-foot in one of three hemiplegic patients with Implantable Gait Corrector (IGC) for stimulation of the common peroneal nerve (CPN). Selective stimulation of muscles tibialis anterior (TA) and the peroneus brevis (PB) that contribute to strong dorsal flexion and moderate eversion of the foot was achieved with a monopola...
متن کاملA Rare Anatomical Variation of Sciatic Nerve and its Relationship with Piriformis Muscle
Sciatic nerve is the thickest nerve of the body which is formed by ventral branches of L4, L5, S1, S2 and S3 of spinal nerves as a part of sacral plexus in pelvis. It leaves the pelvis via the greater sciatic foramen below piriformis muscle and descends between the greater trochanter and ischial tuberosity, along the back of the thigh and dividing into the tibial and common peroneal (fibular) n...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of neurology, neurosurgery, and psychiatry
دوره 69 3 شماره
صفحات -
تاریخ انتشار 2000