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Cited by 192Stroke Rehabilitation and RecoveryMotor Control and AdaptationMuscle activation and electromyography studies

Anticipatory postural adjustment in selected trunk muscles in poststroke hemiparetic patients

Dickstein, Ruth, Shefi, Sara, Marcovitz, Emanuel, Villa, Yael·2004·Archives of Physical Medicine and Rehabilitation
DOI 10.1016/j.apmr.2003.05.011
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Abstract

Objectives To study electromyographic characteristics of anticipatory postural adjustment in axial and lateral, posterior and anterior trunk muscles during the performance of upper-and lower-limb flexion tasks, in subjects with hemiparesis after stroke and to determine the relationship between anticipatory activity and subjects' motor and functional status.Design A nonrandomized control study.Setting Geriatric rehabilitation center in Israel.Participants Fifty poststroke hemiparetic patients and 30 healthy control subjects.Intervention Electromyographic activity of the lumbar erector spinae and of the latissimus dorsi muscles was recorded bilaterally during flexion of either arm and from the 2 rectus abdominis and obliquus externus muscles during flexion of either hip.Main outcome measures Muscles' onset latency, cross-correlation values between the temporal activation profile of corresponding pairs and between ipsilateral muscular pairs, symmetry in activation magnitude of corresponding muscles, and relation between electromyographic activity and motor and functional performance Results Onset latencies of trunk muscles were partially delayed in the patients with longest hindrance displayed by the erector spinae ipsilateral to the flexing arm (P<.04). Temporal synchronization between pertinent muscular pairs was lower in the patients than in the healthy subjects, with significant group differences (P<.05 or lower) in the correlations between ipsilateral pairs of trunk muscles. Activation of the corresponding lateral trunk muscles in the patients was significantly less symmetrical than in the controls (P<.03 or lower) because of reduced activity on the paretic body side, especially on flexing of the paretic limbs. Conversely, in the controls as well as on the nonparetic side of the patients, limb flexion was associated with increased activity in the ipsilateral lateral trunk muscle. The erector spinae muscle in both groups and on both sides was more active on the contralateral side than on the ipsilateral side to the flexing arm. The reduced activity level in trunk muscles on the paretic body side was associated with deficiencies in motor and functional abilities.Conclusions Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in the reduced activity level of the lateral trunk muscles, in delayed onset, and in reduced synchronization between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

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  • The asymmetrical stance in hemiparesis may be necessary to compensate for muscle weakness, delayed muscle activation, synergistic-dependent activation patterns of muscles, and perceptual deficits.

    “This finding suggests that the asymmetrical stance in hemiparesis may be necessary to compensate for muscle weakness, 67,68 delayed muscle activation, 66,69 synergistic-dependent activation patterns of mus-cles, 70 and perceptual deficits.71,72”

    From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [67]

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Authors
Dickstein, R., Shefi, S., Marcovitz, E., & Villa, Y.
Affiliations
Tel Aviv University (IL)
Venue
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier BV
Published
2004-02
Volume
85
Issue
2
Pages
261-267
ISSN
0003-9993 (ISSN-L)
DOI
10.1016/j.apmr.2003.05.011
OpenAlex
W2066313862
Cited by
192
References
35
Citations by year
2026: 7 · 2025: 2 · 2024: 8 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 14 · 2019: 9 · 2018: 11 · 2017: 17 · 2016: 15 · 2015: 22 · 2014: 11 · 2013: 10 · 2012: 10
FWCI
3.39
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Archives of Physical Medicine and Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
  • Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
Keywords
anticipatory postural adjustments, post-stroke hemiparesis, trunk muscles, electromyography, erector spinae, latissimus dorsi, rectus abdominis, external oblique, limb flexion, onset latency, stroke rehabilitation
MeSH terms
Abdominal Muscles, Stroke Rehabilitation, Adaptation, Physiological, Aged, Arm, Electromyography, Female, Hip Joint, Humans, Male, Muscle Contraction, Paresis, Posture, Case-Control Studies, Muscle, Skeletal, Stroke

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