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Relationship between maximum isometric joint moment and functional task performance in patients with brachial plexus injury

CROUCH DL; SANTAGO AC II; PLATE JF; LI Z; SAUL KR
GAIT POSTURE , 2016, vol. 44, p. 238-244
Doc n°: 179664
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.gaitpost.2015.12.038
Descripteurs : AC221 - PLEXUS BRACHIAL, DF22 - EXPLORATION EXAMENS BILANS - MARCHE

We evaluated whether subjects with brachial plexus injury (BPI) adapted their
movements to reduce the mechanical demand on their impaired upper extremity. In 6
subjects with unilateral BPI with C5 and C6 involvement, we measured bilateral
maximum isometric shoulder and elbow strength, and computed joint kinematics and
net muscle-generated joint moments during 7 unimanual functional tasks. Compared
to the unimpaired extremity, maximum strength in shoulder abduction, extension,
and external rotation was 60% (p=0.02), 49% (p=0.02), and 75% (p=0.02) lower,
respectively, on the impaired side. Significant kinematic and kinetic differences
were observed only when reaching to the back of the head. However, because of
substantially reduced strength in their impaired upper extremities, subjects used
a significantly higher percentage of their maximum strength during several tasks
and along several directions of movement. The peak percentage of maximal strength
subjects used across tasks was 32% (p=0.03) and 29% (p=0.03) more on their
impaired side in shoulder extension and external rotation, respectively. Subjects
had less reserve strength available for performing upper extremity tasks and,
therefore, may be less adaptive to strength declines due to injury progression
and normal aging. Quantitatively measuring maximal strength may help clinicians
ensure that patients maintain sufficient upper extremity strength to preserve
long-term functional ability.
CI - Copyright (c) 2015 Elsevier B.V. All rights reserved.

Langue : ANGLAIS

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