Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 9 , Pages 1230-1234, September 2006

Delay in Initiation and Termination of Tibialis Anterior Contraction in Lower-Limb Hemiparesis: Relationship to Lower-Limb Motor Impairment and Mobility

  • John Chae, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
    • Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Cleveland, OH
    • Corresponding Author InformationReprint requests to John Chae, MD, Physical Medicine and Rehabilitation and Biomedical Engineering, Case Western Reserve University, 2500 MetroHealth Dr, Cleveland, OH, 44109
  • ,
  • Allison Quinn, BS

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Cleveland, OH
  • ,
  • Kevin El-Hayek, BA

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Cleveland, OH
  • ,
  • Jennifer Santing, MD

      Affiliations

    • Cleveland Functional Electrical Stimulation Center, Cleveland, OH
    • Department of Physical Medicine and Rehabilitation, Leiden University, Leiden, The Netherlands.
  • ,
  • Roman Berezovski, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
  • ,
  • Mary Harley, OTR

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Cleveland, OH

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.

Key Words:  Electromyography , Hemiparesis , Motor skills disorders , Rehabilitation

 

 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.

PII: S0003-9993(06)00438-2

doi:10.1016/j.apmr.2006.05.007

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 9 , Pages 1230-1234, September 2006