Bilateral early activity in the hip flexors associated with falls in stroke survivors: Preliminary evidence from laboratory-induced falls
| Autor: | Dmitrijs Celinskis, Mark D. Grabiner, Claire F. Honeycutt |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty medicine.medical_treatment Population Poison control Rectus femoris muscle Article 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Physiology (medical) Reflex Injury prevention medicine Humans Treadmill Muscle Skeletal education Postural Balance education.field_of_study Hip Rehabilitation business.industry Middle Aged Trunk Sensory Systems Stroke Neurology Physical therapy Accidental Falls Female Neurology (clinical) 0305 other medical science business 030217 neurology & neurosurgery Muscle Contraction |
| Zdroj: | Clinical Neurophysiology. 129:258-264 |
| ISSN: | 1388-2457 |
| DOI: | 10.1016/j.clinph.2017.11.005 |
| Popis: | Objective Falls are the most common and expensive medical complication following stroke. Hypermetric reflexes have been suggested to impact post-stroke balance but no study has evaluated reflex amplitudes under real conditions of falls in this population. Our objective was to quantify the early reflexive responses during falls induced in the laboratory. Methods Sixteen stroke survivors were exposed to posteriorly directed treadmill perturbations that required a forward step to maintain a balance. Perturbations differed in terms of treadmill translation displacement, velocity, and acceleration. EMG amplitudes were compared between Fall/Recovery trials, as well as Fallers/Non-Fallers at two different time windows: 50–75 and 75–100 ms. Results Sixteen of 86 trials resulted in falls by nine subjects (Fallers). While no differences were found between 50 and 75 ms, EMG amplitude in the paretic rectus femoris muscle was larger between 75 and 100 ms during Fall trials. Further, a bilateral increase in RF activity was seen in Fallers but not Non-Fallers. Interestingly, the bilateral increase was related to perturbation intensity (larger EMG activity with larger perturbations) in Fallers, but again not in Non-Fallers. Conclusions Heightened early recovery hip flexor activity between 75 and 100 ms is associated with falls and Fallers post-stroke. Significance Though requiring replication and expanded subject pools, these preliminary results reflect a possible clinically meaningful relationship between heightened reflexive responses and fall risk. Future work should evaluate the underlying mechanisms driving these heightened reflexes (e.g. stretch, startle) such that future rehabilitation techniques can address this abnormal response. |
| Databáze: | OpenAIRE |
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