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Brain Advance Access originally published online on October 3, 2006
Brain 2007 130(1):159-169; doi:10.1093/brain/awl278
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© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Exaggerated interlimb neural coupling following stroke

Tiffany L. Kline1,2, Brian D. Schmit1,2 and Derek G. Kamper2,3

1 Neuromechanics Laboratory, Marquette University Milwaukee, WI 2 Sensory Motor Performance Program, Rehabilitation Institute of Chicago Chicago, IL, USA 3 Department of Biomedical Engineering, Illinois Institute of Chicago Chicago, IL, USA

Correspondence to: Derek Kamper, PhD, Rehabilitation Institute of Chicago, 345 E Superior Street, Room 1406, Chicago, IL 60611, USA E-mail: d-kamper{at}northwestern.edu

The patterns of interlimb coupling were examined in 10 stroke survivors with chronic hand impairment. In particular, the potential roles of postural state and motor tasks in promoting the flexed posture of the upper extremity were assessed. Through the use of electromyography analysis, joint angle measurements and a novel biomechanical apparatus to perturb the digits of the hand into extension, measurements of muscle activity and joint position were compared during multiple postural states, locomotion and voluntary muscle activity. The results demonstrated a significant increase in flexion of the digits (P < 0.001) and elbow (P < 0.005), during walking as compared with standing, sitting or laying supine. These results were indicative of an overall excessive activation coupling between the upper and lower extremities after stroke. Indeed both voluntary finger flexion and voluntary leg extension produced significant activity in the other impaired extremity, leg and arm, respectively, in the stroke as compared with the control subjects. Thus, rectus femoris in the impaired leg was active during finger flexion of the impaired hand in the stroke survivors and all four tested muscles in the impaired arm were active during extension of the legs (P < 0.05). These findings suggest an interlimb coupling related to active motor tasks, contributing to an upper extremity flexion bias following stroke.

Key Words: hemiparesis; stroke; posture; hand; muscle activity

Abbreviations: BIC, biceps; EDC, extensor digitorum communis; EMG, electromyography; FDS, flexor digitorum superficialis; MCP, metacarpophalangeal; PIP, proximal interphalangeal; TRIC, triceps

Received March 20, 2006. Revised August 25, 2006. Accepted August 28, 2006.


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