DOI QR코드

DOI QR Code

Effects of Fatigue in the Non-paretic Plantarflexor on the Activities of the Lower Leg Muscles during Walking in Chronic Stroke Patients

만성 뇌졸중 환자의 비마비측 발바닥굽힘근 근피로가 보행 시 양측 하지 근육의 활성도에 미치는 영향

  • Lee, Jae-Woong (Department of Physical Therapy, Keunsol Hospital) ;
  • Koo, Hyun-Mo (Department of Physical Therapy, College of Science, Kyungsung University)
  • Received : 2019.06.06
  • Accepted : 2019.06.20
  • Published : 2019.08.31

Abstract

PURPOSE: The aim of this study was to obtain detailed and quantified data concerning the effects of plantarflexor fatigue induced to the non-paretic side on muscle activities of the bilateral lower extremities during walking in chronic stroke patients. METHODS: In this study, chronic stroke patients were evaluated for six months after the onset of stroke. To induce the non-paretic plantarflexor fatigue, 20 chronic stroke patients were asked to perform their given fatigue affecting assignments, which were presented in a forced contraction fatigue test method, until the range of motion of the plantarflexor was reduced to less than 50%. The muscle activities of the rectus femoris, tibialis anterior and gastrocnemius in the paretic and non-paretic lower extremities were measured using a wireless surface EMG before and after muscle fatigue induction. RESULTS: The findings showed that after plantarflexor fatigue was induced on the non-paretic side, a significant decrease in muscle activities of the rectus femoris on the paretic side was noted (p<.05). The muscle activities of the tibialis anterior and gastrocnemius were also observed to decrease, but, these results were not statistically significant (p>.05). In the non-paretic side, there was a significantly decrease in the muscle activities of the rectus femoris, tibialis anterior, and gastrocnemius (p<.05). CONCLUSION: These finding suggest that the muscle fatigue of the non-paretic plantarflexor affects not only the muscle activity of the ipsilateral lower extremity but also the muscles activity of the contralateral lower extremity. This highlights the necessity of performing exercise or training programs that do not cause muscle fatigue in clinical aspects.

Keywords

References

  1. Peurala SH, Airaksinen O, Jakala P, et al. Effects of intensive gait-oriented physiotherapy during early acute phase of stroke. J Rehabil R D. 2007;44(5):637-48. https://doi.org/10.1682/JRRD.2006.05.0039
  2. Braun SM, Beurskens AJ, van Kroonenburgh SM, et al. Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial. BMC Neurol. 2007;7(1):34. https://doi.org/10.1186/1471-2377-7-34
  3. O'Sullivan SB, Schmitz TJ. Physical rehabilitation. 5th edition. F.A Davis. 2007:705-6.
  4. Duncan PW, Horner RD, Reker DM, et al. Adherence to post acute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002;33(1):167-78. https://doi.org/10.1161/hs0102.101014
  5. Duncan PW, Zorowitz R, Bates B, et al. Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke. 2005;36(9):e100-43.
  6. Perry J. Gait analysis: normal and pathological function. Slack Inc. 1992;224-43.
  7. Stolze H, Klebe S, Zechlin C, et al. Falls in frequent neurological diseases. J of Neurol. 2004;251(1):79-84. https://doi.org/10.1007/s00415-004-0276-8
  8. Mauritz KH. Gait training in hemiplegia. Eur J Neurol. 2002;9(s1):23-9. https://doi.org/10.1046/j.1468-1331.2002.0090s1023.x
  9. Kirker KR, Luo Y, Nielson JH, et al. Glycosaminoglycan hydrogel films as bio-interactive dressings for wound healing. Biomaterials. 2002;23(17):3661-71. https://doi.org/10.1016/S0142-9612(02)00100-X
  10. Bohannon RW. Muscle strength and muscle training after stroke. J of Rehabil Med. 2007;39(1):14-20. https://doi.org/10.2340/16501977-0018
  11. Hachisuka K, Umezu Y, Ogata H. Disuse muscle atrophy of lower limbs in hemiplegic patients. Arch Phys Med Rehabil. 1997;78(1):13-8. https://doi.org/10.1016/S0003-9993(97)90003-4
  12. Patten C, Lexell J, Brown HE. Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy. J Rehabil R D. 2004;41(3):293-312. https://doi.org/10.1682/JRRD.2004.03.0293
  13. Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013;80(4):409-16. https://doi.org/10.1212/WNL.0b013e31827f07be
  14. McKevitt C, Fudge N, Redfern J, et al. Self-reported long-term needs after stroke. Stroke. 2011;42(5):1398-403. https://doi.org/10.1161/STROKEAHA.110.598839
  15. Horstman AM, Gerrits KH, Beltman MJ, et al. Instrinsic properties of the knee extensor muscles after subacute stroke. Arch Phys Med Rehabil. 2010;91(1):123-8. https://doi.org/10.1016/j.apmr.2009.09.008
  16. Docherty CL, Arnold BL, Zinder SM, et al. Relationship between two proprioceptive measures and stiffness at the ankle. J Electromyogr Kinesiol. 2004;14(3):317-24. https://doi.org/10.1016/S1050-6411(03)00035-X
  17. Sommerfeld DK, Eek EUB, Svensson AK, et al. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke. 2004;35(1):134-9. https://doi.org/10.1161/01.STR.0000105386.05173.5E
  18. Doix ACM, Lefevre F, Colson SS. Time course of the cross-over effect of fatigue on the contralateral muscle after unilateral exercise. PLOS ONE. 2013;8(5):e64910. https://doi.org/10.1371/journal.pone.0064910
  19. Shinohara M, Keenan KG, Enoka RM. Contralateral activity in a homologous hand muscle during voluntary contractions is greater in old adults. J Appl Physiol. 2003;94(3):966-74. https://doi.org/10.1152/japplphysiol.00836.2002
  20. Gefen A, Megido-Ravid M, Itzchak Y, et al. Analysis of muscular fatigue and foot stability during high-heeled gait. Gait & Posture. 2002;15(1):56-63. https://doi.org/10.1016/S0966-6362(01)00180-1
  21. Cheng AJ, Rice CL. Factors contributing to the fatiguerelated reduction in active dorsiflexion joint range of motion. Appl Physiol Nutr Metab. 2012;38(5):490-7. https://doi.org/10.1139/apnm-2012-0357
  22. Espinosa N, Brodsky JW, Maceira E. Metatarsalgia. J Am Acad Orthop Surg, 2010;18(8):474-85. https://doi.org/10.5435/00124635-201008000-00004
  23. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-74. https://doi.org/10.1016/S1050-6411(00)00027-4
  24. Hollis LL. Anatomy of exercise encyclopedia. Bloomsbury Publishing Plc. 2014;26-9.
  25. Criswell E. Cram's introduction to surface electromyography. Jones & Bartlett Publishers. 2010;49-50.
  26. Gentili R, Papaxanthis C, Pozzo T. Improvement and generalization of arm motor performance through motor imagery practice. Neuroscience. 2006;137(3):761-72. https://doi.org/10.1016/j.neuroscience.2005.10.013
  27. Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol. 1992;72(5):1631-48. https://doi.org/10.1152/jappl.1992.72.5.1631
  28. Hassanlouei H, Arendt-Nielsen L, Kersting UG, et al. Effect of exercise-induced fatigue on postural control of the knee. J Electromyogr Kinesiol. 2012;22(3):342-7. https://doi.org/10.1016/j.jelekin.2012.01.014
  29. Hughes AM, Freeman CT, Burridge JH, et al. Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke. J Electromyogr Kinesiol. 2010;20(3):465-76. https://doi.org/10.1016/j.jelekin.2009.08.001
  30. Carroll TJ, Herbert RD, Munn J, et al. Contralateral effects of unilateral strength training: evidence and possible mechanisms. J Appl Physiol. 2006;101(5):1514-22. https://doi.org/10.1152/japplphysiol.00531.2006
  31. Aranyi Z, Rosler KM. Effort-induced mirror movements. Experimental Brain Research. 2002;145(1):76-82. https://doi.org/10.1007/s00221-002-1101-1
  32. Rattey J, Martin PG, Kay D, et al. Contralateral muscle fatigue in human quadriceps muscle: evidence for a centrally mediated fatigue response and cross-over effect. Pflugers Archive-European J Physiol. 2006;452(2):199-207. https://doi.org/10.1007/s00424-005-0027-4
  33. Bodwell JA, Mahurin RK, Waddle S, et al. Age and features of movement influence motor overflow. J Am Geriatr Soc. 2003;51(12):1735-9. https://doi.org/10.1046/j.1532-5415.2003.51557.x
  34. Rees SS, Murphy AJ, Watsford ML, et al. Effects of proprioceptive neuromuscular facilitation stretching on stiffness and force-producing characteristics of the ankle in active women. J Strength Cond Res. 2007;21(2):572-7. https://doi.org/10.1519/R-20175.1
  35. Todd G, Petersen NT, Taylor JL, et al. The effect of a contralateral contraction on maximal voluntary activation and central fatigue in elbow flexor muscles. Experimental Brain Research. 2003;150(3):308-13. https://doi.org/10.1007/s00221-003-1379-7