Article

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.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS