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Control of functional movements in healthy and post-stroke subjects: Role of neural interlimb coupling


Dietz, Volker; Schrafl-Altermatt, Miriam (2016). Control of functional movements in healthy and post-stroke subjects: Role of neural interlimb coupling. Clinical Neurophysiology, 127(5):2286-2293.

Abstract

In recent years it has become evident that, in a number of functional movements, synergistically acting limbs become task-specifically linked by a soft-wired 'neural coupling' mechanism (e.g. the legs during balancing, the arms and legs during gait and both arms during cooperative hand movements). Experimentally this mechanism became evident by the analysis of reflex responses as a marker for a neural coupling. It is reflected by the task-specific appearance of reflex EMG responses to non-noxious nerve stimulation, not only in muscles of the stimulated limb, but also, with same long latency, in muscles of meaningful coupled (contralateral) limb(s). After a stroke, nerve stimulation of the unaffected limb during such cooperative tasks is followed by EMG responses in muscles of the (contralateral) coupled affected limb, i.e. unaffected motor centres support synergistically acting movements of the paretic limb. In contrast, following stimulation of the affected limb, no contralateral responses appear due to defective processing of afferent input. As a consequence, it may be therapeutically possible to strengthen the influence of unaffected motor centres on the performance of affected limb movements through training of cooperative limb movements required during activities of daily living.

Abstract

In recent years it has become evident that, in a number of functional movements, synergistically acting limbs become task-specifically linked by a soft-wired 'neural coupling' mechanism (e.g. the legs during balancing, the arms and legs during gait and both arms during cooperative hand movements). Experimentally this mechanism became evident by the analysis of reflex responses as a marker for a neural coupling. It is reflected by the task-specific appearance of reflex EMG responses to non-noxious nerve stimulation, not only in muscles of the stimulated limb, but also, with same long latency, in muscles of meaningful coupled (contralateral) limb(s). After a stroke, nerve stimulation of the unaffected limb during such cooperative tasks is followed by EMG responses in muscles of the (contralateral) coupled affected limb, i.e. unaffected motor centres support synergistically acting movements of the paretic limb. In contrast, following stimulation of the affected limb, no contralateral responses appear due to defective processing of afferent input. As a consequence, it may be therapeutically possible to strengthen the influence of unaffected motor centres on the performance of affected limb movements through training of cooperative limb movements required during activities of daily living.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:May 2016
Deposited On:11 Nov 2016 08:22
Last Modified:12 Nov 2016 08:35
Publisher:Elsevier
ISSN:1388-2457
Publisher DOI:https://doi.org/10.1016/j.clinph.2016.02.014
PubMed ID:27072101

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