Delay in Initiation and Termination of Tibialis Anterior Contraction in Lower-Limb Hemiparesis: Relationship to Lower-Limb Motor Impairment and Mobility
Abstract
Chae J, Quinn A, El-Hayek K, Santing J, Berezovski R, Harley M. Delay in initiation and termination of tibialis anterior contraction in lower-limb hemiparesis: relationship to lower-limb motor impairment and mobility.
Objective
To assess the relationship between delays in initiation and termination of tibialis anterior contraction in the hemiplegic lower limb and clinical measures of lower-limb motor impairment and mobility.
Design
Cross-sectional correlational study.
Setting
Outpatient rehabilitation clinic of an academic medical center.
Participants
Convenience sample of 22 chronic stroke survivors with lower-limb hemiparesis.
Interventions
Not applicable.
Main Outcome Measures
Delays in initiation and termination of tibialis anterior electromyographic activity during isometric contraction, lower-limb Fugl-Meyer Assessment (FMA), and Modified Emory Functional Ambulation Profile (mEFAP).
Results
The affected lower limb exhibited significantly longer delays in initiation and termination of tibialis anterior contraction relative to the unaffected limb. Delay in termination of 3-second tibialis anterior contraction of the affected limb correlated significantly with the FMA and mEFAP. However, delay in initiation of tibialis anterior contraction did not correlate with clinical measures.
Conclusions
Delay in termination of muscle activity in the hemiparetic lower limb may have important clinical implications, but delay in initiation did not correlate with clinical measures. Controlled, interventional trials are needed to demonstrate a cause and effect relationship.
aDepartment of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
bDepartment of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland, OH
cCleveland Functional Electrical Stimulation Center, Cleveland, OH
dDepartment of Physical Medicine and Rehabilitation, Leiden University, Leiden, The Netherlands.
Reprint requests to John Chae, MD, Physical Medicine and Rehabilitation and Biomedical Engineering, Case Western Reserve University, 2500 MetroHealth Dr, Cleveland, OH, 44109
Supported in part by the National Institutes of Health (grant no. R01HD39913).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT