Sensorimotor control is bilaterally altered for shoulder abduction and flexion in chronic hemiparetic individuals

Título traducido de la contribución: El control sensoriomotor se altera bilateralmente para la abducción y flexión del hombro en individuos con hemiparesia crónica.

Gabriela Lopes Santos, Luisa Fernanda Garcia Salazar, Ana Beatriz Oliveira, Ana Carolina Lazarin, G.C Zanca, S.T Matiello, Thiago Luiz Russo

Resultado de la investigación: Contribución a RevistaArtículo

Resumen

Introducción y objetivo: El control sensomotor adecuado del hombro es necesario para realizar las funciones de las extremidades superiores [[1],[2]] y puede identificarse como la capacidad de generar y modular las fuerzas de forma efectiva durante las contracciones musculares, al mismo tiempo que se ajusta a un nivel de fuerza determinado[3]. Sin embargo, las estrategias sensomotrices del hombro en sujetos hemiparéticos crónicos siguen siendo poco claras en la literatura, porque son relevantes para apoyar el tratamiento de la neurorehabilitación. Objetivos: El objetivo del estudio fue evaluar el control sensomotor del hombro y la fuerza muscular máxima del hombro durante la abducción isométrica y la flexión en sujetos con hemiparesia crónica. Pacientes/materiales y métodos: Trece individuos con hemiparesia crónica por accidente cerebrovascular isquémico y trece sujetos sanos coincidieron por sexo y edad. Se midió el par máximo (PT) y la estabilidad del par durante la abducción isométrica y la flexión del hombro a 45° de rango de movimiento utilizando el dinamómetro Biodex System III. La desviación estándar (DE) y el coeficiente de variación (CV) se midieron a partir del ensayo de estabilidad. La diferencia entre las extremidades dominantes y no dominantes en ambos movimientos (flexión y abducción) se realizó utilizando Anova Two-Way. Como no se encontraron diferencias entre los miembros dominantes y no dominantes para todas las variables, se realizó un grupo de datos. La diferencia entre los miembros de control, paréticos y no paréticos para la DS y la CV se realizó utilizando la prueba de Kruskall Wallis después de Mann-Whitney considerando un nivel de significación de 0,017, debido al ajuste de Bonferroni. Para la variable PT, se realizó Anova Two-Way, considerando un nivel de significación de 0,05. Resultados: Tanto las extremidades paréticas como las no paréticas redujeron la fisioterapia en comparación con el control (parético - déficit por flexión: 50.27% y secuestro: 56,56%; no parético - déficit por flexión: 84.01%; y secuestro: 71.49%). El TP del miembro parético fue inferior al no parético (p < 0,05). No se encontraron diferencias entre los miembros paréticos y no paréticos en ambos movimientos para todas las variables de estabilidad (p > 0,05), pero fueron mayores en comparación con el miembro control (p < 0,05). Durante la abducción, se observaron valores más altos de CV y SD en las extremidades paréticas y no parásitas que durante la flexión del hombro. Discusión y conclusiones: El control sensomotor se altera bilateralmente en individuos hemiparéticos, según el movimiento realizado. Así, los resultados demuestran la necesidad de incluir intervenciones en el programa de rehabilitación que incluyan, por ejemplo, ejercicios bilaterales de extremidades superiores, fortalecimiento muscular, ejercicios con retroalimentación visual y entrenamiento en tareas manuales funcionales, como alcanzar movimientos.
Idioma originalEnglish (US)
Páginas (desde-hasta)590-590
Número de páginas1
PublicaciónGait and Posture
DOI
EstadoPublished - dic 2015

Huella dactilar

Extremities
Torque
Upper Extremity
Social Adjustment
Sensory Feedback
Aptitude
Muscle Strength
Paresis
Muscle Contraction
Articular Range of Motion
Healthy Volunteers
Rehabilitation
Stroke
Muscles

Citar esto

Santos, Gabriela Lopes ; Garcia Salazar, Luisa Fernanda ; Oliveira, Ana Beatriz ; Lazarin, Ana Carolina ; Zanca, G.C ; Matiello, S.T ; Russo, Thiago Luiz. / Sensorimotor control is bilaterally altered for shoulder abduction and flexion in chronic hemiparetic individuals. En: Gait and Posture. 2015 ; pp. 590-590.
@article{0b49adceb47b40f199b5691e29612eb4,
title = "Sensorimotor control is bilaterally altered for shoulder abduction and flexion in chronic hemiparetic individuals",
abstract = "Introduction and aim: The appropriate sensorimotor control of shoulder is required for performing functions of upper extremity [[1], [2]] and can be identified as the ability to generate and modulate forces effectively during muscle contractions while matching a given force level [3]. Nevertheless, the sensorimotor strategies of shoulder in chronic hemiparetic subjects remain unclear on the literature, because they are relevant to support neurorehabilitation management.Aims: The aim of the study was to evaluate shoulder sensorimotor control and maximal shoulder muscle strength during isometric abduction and flexion in chronic hemiparetic subjects.Patients/materials and methods: Thirteen individuals with chronic hemiparesis due to ischemic stroke and thirteen healthy subjects matched for gender and age. Peak torque (PT) and torque steadiness was measured during isometric abduction and flexion of shoulder at 45° of range of motion using Biodex System III dynamometer. Standard deviation (SD) and coefficient of variation (CV) were measured from the steadiness trial. Difference between dominant and non dominant limbs in both movements (flexion and abduction) was performed using Anova Two-Way. As no differences were found between dominant and non dominant limbs for all the variables, a pool of data was performed. Difference between control, paretic and nonparetic limbs for the SD and CV was performed using Kruskall Wallis Test following Mann-Whitney considering a significance level of 0.017, due to Bonferroni adjustment. For PT variable, Anova Two-Way, considering a significance level of 0.05, was performed.Results: Both paretic and non paretic limbs reduced PT compared to control (paretic - deficit for flexion: 50.27{\%} and abduction: 56.56{\%}; non paretic - deficit for flexion: 84.01{\%}; and abduction: 71.49{\%}). Paretic limb PT was lower than non paretic one (p < 0.05). No difference was found between the paretic and nonparetic limbs in both movements for all variables of steadiness (p > 0.05), but they were higher when compared to control limb (p < 0.05). During abduction, higher values of CV and SD were observed in paretic and non-paretic limbs than during shoulder's flexion.Discussion and conclusions: The sensorimotor control is bilaterally altered in hemiparetic individuals, according the movement performed. Thus, the results demonstrate the need to include interventions in the rehabilitation program including, for example, bilateral upper extremity exercises, muscle strengthening, exercises with visual feedback, and functional manual tasks training, as reaching movements.",
author = "Santos, {Gabriela Lopes} and {Garcia Salazar}, {Luisa Fernanda} and Oliveira, {Ana Beatriz} and Lazarin, {Ana Carolina} and G.C Zanca and S.T Matiello and Russo, {Thiago Luiz}",
year = "2015",
month = "12",
doi = "https://doi.org/10.1016/j.gaitpost.2015.03.150",
language = "English (US)",
pages = "590--590",
journal = "Gait and Posture",
issn = "0966-6362",
publisher = "Elsevier",

}

Sensorimotor control is bilaterally altered for shoulder abduction and flexion in chronic hemiparetic individuals. / Santos, Gabriela Lopes; Garcia Salazar, Luisa Fernanda; Oliveira, Ana Beatriz; Lazarin, Ana Carolina; Zanca, G.C; Matiello, S.T; Russo, Thiago Luiz.

En: Gait and Posture, 12.2015, p. 590-590.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Sensorimotor control is bilaterally altered for shoulder abduction and flexion in chronic hemiparetic individuals

AU - Santos, Gabriela Lopes

AU - Garcia Salazar, Luisa Fernanda

AU - Oliveira, Ana Beatriz

AU - Lazarin, Ana Carolina

AU - Zanca, G.C

AU - Matiello, S.T

AU - Russo, Thiago Luiz

PY - 2015/12

Y1 - 2015/12

N2 - Introduction and aim: The appropriate sensorimotor control of shoulder is required for performing functions of upper extremity [[1], [2]] and can be identified as the ability to generate and modulate forces effectively during muscle contractions while matching a given force level [3]. Nevertheless, the sensorimotor strategies of shoulder in chronic hemiparetic subjects remain unclear on the literature, because they are relevant to support neurorehabilitation management.Aims: The aim of the study was to evaluate shoulder sensorimotor control and maximal shoulder muscle strength during isometric abduction and flexion in chronic hemiparetic subjects.Patients/materials and methods: Thirteen individuals with chronic hemiparesis due to ischemic stroke and thirteen healthy subjects matched for gender and age. Peak torque (PT) and torque steadiness was measured during isometric abduction and flexion of shoulder at 45° of range of motion using Biodex System III dynamometer. Standard deviation (SD) and coefficient of variation (CV) were measured from the steadiness trial. Difference between dominant and non dominant limbs in both movements (flexion and abduction) was performed using Anova Two-Way. As no differences were found between dominant and non dominant limbs for all the variables, a pool of data was performed. Difference between control, paretic and nonparetic limbs for the SD and CV was performed using Kruskall Wallis Test following Mann-Whitney considering a significance level of 0.017, due to Bonferroni adjustment. For PT variable, Anova Two-Way, considering a significance level of 0.05, was performed.Results: Both paretic and non paretic limbs reduced PT compared to control (paretic - deficit for flexion: 50.27% and abduction: 56.56%; non paretic - deficit for flexion: 84.01%; and abduction: 71.49%). Paretic limb PT was lower than non paretic one (p < 0.05). No difference was found between the paretic and nonparetic limbs in both movements for all variables of steadiness (p > 0.05), but they were higher when compared to control limb (p < 0.05). During abduction, higher values of CV and SD were observed in paretic and non-paretic limbs than during shoulder's flexion.Discussion and conclusions: The sensorimotor control is bilaterally altered in hemiparetic individuals, according the movement performed. Thus, the results demonstrate the need to include interventions in the rehabilitation program including, for example, bilateral upper extremity exercises, muscle strengthening, exercises with visual feedback, and functional manual tasks training, as reaching movements.

AB - Introduction and aim: The appropriate sensorimotor control of shoulder is required for performing functions of upper extremity [[1], [2]] and can be identified as the ability to generate and modulate forces effectively during muscle contractions while matching a given force level [3]. Nevertheless, the sensorimotor strategies of shoulder in chronic hemiparetic subjects remain unclear on the literature, because they are relevant to support neurorehabilitation management.Aims: The aim of the study was to evaluate shoulder sensorimotor control and maximal shoulder muscle strength during isometric abduction and flexion in chronic hemiparetic subjects.Patients/materials and methods: Thirteen individuals with chronic hemiparesis due to ischemic stroke and thirteen healthy subjects matched for gender and age. Peak torque (PT) and torque steadiness was measured during isometric abduction and flexion of shoulder at 45° of range of motion using Biodex System III dynamometer. Standard deviation (SD) and coefficient of variation (CV) were measured from the steadiness trial. Difference between dominant and non dominant limbs in both movements (flexion and abduction) was performed using Anova Two-Way. As no differences were found between dominant and non dominant limbs for all the variables, a pool of data was performed. Difference between control, paretic and nonparetic limbs for the SD and CV was performed using Kruskall Wallis Test following Mann-Whitney considering a significance level of 0.017, due to Bonferroni adjustment. For PT variable, Anova Two-Way, considering a significance level of 0.05, was performed.Results: Both paretic and non paretic limbs reduced PT compared to control (paretic - deficit for flexion: 50.27% and abduction: 56.56%; non paretic - deficit for flexion: 84.01%; and abduction: 71.49%). Paretic limb PT was lower than non paretic one (p < 0.05). No difference was found between the paretic and nonparetic limbs in both movements for all variables of steadiness (p > 0.05), but they were higher when compared to control limb (p < 0.05). During abduction, higher values of CV and SD were observed in paretic and non-paretic limbs than during shoulder's flexion.Discussion and conclusions: The sensorimotor control is bilaterally altered in hemiparetic individuals, according the movement performed. Thus, the results demonstrate the need to include interventions in the rehabilitation program including, for example, bilateral upper extremity exercises, muscle strengthening, exercises with visual feedback, and functional manual tasks training, as reaching movements.

U2 - https://doi.org/10.1016/j.gaitpost.2015.03.150

DO - https://doi.org/10.1016/j.gaitpost.2015.03.150

M3 - Article

SP - 590

EP - 590

JO - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

ER -