Abstract
Objective
To explore the interaction between postural stability and hand task on the corticospinal
excitability (CE) of upper extremity muscles and how it is affected by lesion location.
Design
Cross-sectional explorative survey.
Setting
Inpatient rehabilitation center.
Participants
Participants (N=81) were neurologically healthy subjects (volunteer sample, n=36)
and patients with stroke (convenience sample, n=45; mean time since stroke, 45d),
stratified according to lesion location: pure subcortical strokes (n=25) and strokes
with cortical involvement (n=20).
Interventions
Not applicable.
Main Outcome Measures
Motor-evoked potentials were recorded simultaneously from the first dorsal interosseus
(FDI) muscle and biceps brachii (BB) during rest and during low and forceful activation
of the FDI in 4 different postural positions (supine, sitting, sitting unsupported,
standing) and compared.
Results
Posture modulated CE of the FDI and BB during performance of a motor task but not
at rest. The influence of postural position on CE of the FDI depended on force demand
and lesion location: the control and subcortical stroke group demonstrated significantly
higher CE of the FDI when performing the forceful task in the supine and stable sitting
positions, respectively, compared with standing. In contrast, the cortical stroke
group exhibited significantly higher CE of the FDI when performing the low-force task
in a stable sitting position compared with standing.
Conclusions
Posture influences CE of the FDI and BB in healthy subjects and patients with stroke
differentially depending on hand task, but not at rest. A stable sitting posture increased
excitability of the FDI in patients with stroke. These findings imply that hand rehabilitation
protocols may be influenced by posture.
Keywords
List of abbreviations:
BB (biceps brachii), CE (corticospinal excitability), CMP (corticomotorneuronal pathway), FDI (first dorsal interosseus), MEP (motor-evoked potential), MVC (maximal voluntary contraction), TMS (transcranial magnetic stimulation)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The role of multiple contralesional motor areas for complex hand movements after internal capsular lesion.J Neurosci. 2006; 26: 6096-6102
- Motor system activation after subcortical stroke depends on corticospinal system integrity.Brain. 2006; 129: 809-819
- Cortical connectivity after subcortical stroke assessed with functional magnetic resonance imaging.Ann Neurol. 2008; 63: 236-246
- Dynamic functional reorganization of the motor execution network after stroke.Brain. 2010; 133: 1224-1238
- Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury.J Rehabil Med. 2003; 41: 7-10
- Reorganization of cerebral networks after stroke: new insights from neuroimaging with connectivity approaches.Brain. 2011; 134: 1264-1276
- Changes in propriospinally mediated excitation of upper limb motoneurones in stroke patients.Brain. 2003; 126: 988-1000
- Muscle representation in the macaque motor cortex: an anatomical perspective.Proc Natl Acad Sci U S A. 2006; 103: 8257-8262
- Cortical overlap of joint representations contributes to the loss of independent joint control following stroke.Neuroimage. 2009; 45: 490-499
- Coordination between posture and movement: interaction between postural and accuracy constraints.Exp Brain Res. 2006; 170: 255-264
- Cortical involvement in anticipatory postural reactions in man.Exp Brain Res. 2009; 193: 161-171
- Finger movements induced by transcranial magnetic stimulation change with hand posture, but not with coil position.Hum Brain Mapp. 1998; 6: 390-393
- Cortico-motoneuronal output to intrinsic hand muscles is differentially influenced by static changes in shoulder positions.Exp Brain Res. 2005; 164: 500-504
- Increase in corticospinal excitability of limb and trunk muscles according to maintenance of neck flexion.Neurosci Lett. 2009; 461: 235-239
- Posture-related modulations in motor cortical excitability of the proximal and distal arm muscles.Neurosci Lett. 2013; 533: 65-70
- Are muscular responses to magnetic brain stimulation in hemiparetic stroke patients influenced by variations in body, head and arm positions?.Eur J Phys Med Rehabil. 1994; 4: 201-204
- What do motor “recovery” and “compensation” mean in patients following stroke?.Neurorehabil Neural Repair. 2009; 23: 313-319
- Brain lesion size and location: effects on motor recovery and functional outcome in stroke patients.Arch Phys Med Rehabil. 2000; 81: 447-452
- Lesion location alters brain activation in chronically impaired stroke survivors.NeuroImage. 2004; 21: 924-935
- Motor strokes: the lesion location determines motor excitability changes.Stroke. 2005; 36: 2648-2653
- Modulation of brain plasticity in stroke: a novel model for neurorehabilitation.Nat Rev Neurol. 2014; 10: 597-608
- Intracortical excitability after repetitive hand movements is differentially affected in cortical versus subcortical strokes.J Clin Neurophysiol. 2009; 26: 348-357
- The assessment and analysis of handedness: the Edinburgh inventory.Neuropsychologia. 1971; 9: 97-113
- A safety screening questionnaire for transcranial magnetic stimulation [letter].Clin Neurophysiol. 2000; 112: 720
- Assessing motor impairment after stroke: a pilot reliability study.J Neurol Neurosurg Psychiatry. 1990; 53: 576-579
- Optimal focal transcranial magnetic activation of the human motor cortex: effects of coil orientation, shape of the induced current pulse, and stimulus intensity.J Clin Neurophysiol. 1992; 9: 132-136
- Applications of magnetic cortical stimulation.in: Deuschl G. Eisen A. Recommendations for the practice of clinical neurophysiology: guidelines of the International Federation of Clinical Physiology. Elsevier, Amsterdam1999: 171-185
- Task dependence of responses in first dorsal interosseous muscle to magnetic brain stimulation in man.J Physiol. 1993; 464: 361-378
- Progressive suppression of intracortical inhibition during graded isometric contraction of a hand muscle is not influenced by hand preference.Exp Brain Res. 2007; 177: 266-274
- The influence of hand posture on corticospinal excitability during motor imagery: a transcranial magnetic stimulation study.Cereb Cortex. 2004; 14: 1200-1206
- Differential modulation of intracortical inhibition in human motor cortex during selective activation of an intrinsic hand muscle.J Physiol. 2003; 550: 933-946
- Role of intracortical inhibition in selective hand muscle activation.J Neurophysiol. 2003; 89: 2014-2020
- Descending pathways in motor control.Annu Rev Neurosci. 2008; 31: 195-218
- The primate reticulospinal tract, hand function and functional recovery.J Physiol. 2011; 589: 5603-5612
- Circuits for skilled reaching and grasping.Annu Rev Neurosci. 2012; 35: 559-578
- Cortical and subcortical compensatory mechanisms after spinal cord injury in monkeys.Exp Neurol. 2012; 235: 152-161
- Cortical control of the primate hand. The 1992 G.L. Brown Prize Lecture.Exp Physiol. 1993; 78: 263-301
- Motor control: basic units of cortical output?.Curr Biol. 2004; 14: R353-R354
- Differential effects of high-frequency repetitive transcranial magnetic stimulation over ipsilesional primary motor cortex in cortical and subcortical middle cerebral artery stroke.Ann Neurol. 2009; 66: 298-309
- The effect of stroke on motor selectivity for force control in single- and multi-finger force production tasks.NeuroRehabilitation. 2014; 34: 429-435
- Exaggerated interlimb neural coupling following stroke.Brain. 2006; 130: 159-169
- Central compensation at short muscle range is differentially affected in cortical versus subcortical strokes.Stroke. 2006; 37: 2076-2080
- Influence of age and posture on spinal and corticospinal excitability.Exp Gerontol. 2015; 69: 62-69
- Corticomotor excitability of arm muscles modulates according to static position and orientation of the upper limb.Clin Neurophysiol. 2014; 125: 2046-2054
Article info
Publication history
Published online: January 24, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
