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The unoperated hand : the role of passive forces in hand function after tetraplegia
JOHANSON ME; MURRAY WM
HAND CLIN , 2002, vol. 18, n° 3, p. 391-398 Doc n°: 107703 Localisation : Documentation IRR Descripteurs : AE2 - PARAPLEGIE-TETRAPLEGIE, DD8 - MAIN-DOIGTS For the nonimpaired individual, hand function is a consequence of active muscle contractions orchestrated by the central nervous system. For example, thumb function is controlled by 10 distinct muscles. For most individuals with cervical spinal cord injury, none of the muscles controlling finger or thumb movement is controlled actively. As a result, passive forces must assume a critical role in functional use of the hand after tetraplegia. An injury involving the cervical level of the spinal cord paralyzes muscles in the forearm and hand, with the degree of residual motor function traditionally linked to the segmental level of injury. In the unoperated tetraplegic upper extremity, an individual uses the hand to interact with the environment by combining residual voluntary control of proximal muscles and joints with the very small passive forces produced by finger and thumb muscles. Most rehabilitation modalities aimed at improving hand function after tetraplegia exploit the passive properties of the upper extremity. Many approaches, including the wrist-driven tional electrical stimulation, attempt to strengthen the natural patterns of movement arising from the passive force-generating characteristics of the paralyzed hand muscles. Passive tension produced by noncontracting structures is used most effectively for hand function by individuals who can extend the wrist after injury. Langue : ANGLAIS Tiré à part : OUI Identifiant basis : 2003225784 |
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