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Interactions in abnormal synergies between the upper and lower extremities in various phases of stroke: A cohort study.
Kim, Dongwon; Ko, Sung-Hwa; Han, Junhee; Kim, Young-Taek; Kim, Yun-Hee; Chang, Won Hyuk; Shin, Yong-Il.
Afiliación
  • Kim D; Shirley Ryan AbilityLab, Chicago, IL, USA.
  • Ko SH; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL.
  • Han J; Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL.
  • Kim YT; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Republic of Korea.
  • Kim YH; Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
  • Chang WH; Department of Statistics, Hallym University, Chuncheon-si, Republic of Korea.
  • Shin YI; Department of Preventive Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
medRxiv ; 2024 Feb 09.
Article en En | MEDLINE | ID: mdl-38370652
ABSTRACT

Objective:

The flexion synergy and extension synergy are a representative consequence of a stroke and appear in the upper extremity and lower extremity. Since the ipsilesional corticospinal tract (CST) is the most influential neural pathway for both extremities in motor execution, damage by a stroke to this tract could lead to similar motor pathological features (e.g., abnormal synergies) in both extremities. However less attention has been paid to the inter-limb correlations in the flexion synergy and extension synergy across different recovery phases of a stroke.

Methods:

In this study, we used results of the Fugl-Meyer assessment (FMA) to characterize those correlations in a total of 512 participants with hemiparesis post stroke from the acute phase to 1 year. The FMA provides indirect indicators of the degrees of the flexion synergy and extension synergy post stroke.

Results:

We found that generally, strong inter-limb correlations (r>0.65 with all p-values<0.0001) between the flexion synergy and extension synergy appeared in the acute-to-subacute phase (<90 days). But correlations of lower-extremity extension synergy with upper-extremity flexion synergy and extension synergy decreased (down to r=0.38) around 360 days after stroke (p<0.05).

Interpretation:

These results suggest that the preferential use of alternative neural pathways after damage by a stroke to the CST enhances inter-limb correlations between the flexion synergy and extension, however a recovery of the CST or/and the functional fragmentation (remodeling) of the alternative neural substrates in the chronic phase contribute to diversity in neural pathways in motor execution, eventually leading to reduced inter-limb correlations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: MedRxiv Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: MedRxiv Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos