Trunk compensatory strategies during arm elevation on poststroke patients
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1
Hospital Garcia de Orta, Portugal
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2
Escola Superior de Saude Egas Moniz, Portugal
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3
Universidade Tecnica de Lisboa, Faculdade de Motricidade Humana, Portugal
Background: Post-stroke patients shoulder rehabilitation involves some motor stimulus such as self-motion (SM); free-motion (FM) and conduced-motion (CM). But often patients use several motor strategies to overcome the incapacity to perform arm elevation movements. However, the hemiplegic shoulder rehabilitation strongly depends on the capability to identify trunk compensatory strategies that may influence the affected upper arm.
Objectives: To compare trunk 3D kinematics during three hemiplegic shoulder rehabilitation procedures: self- motion (SM); free-motion (FM) and conduced-motion (CM).
Methods: Humeral and thorax 3D kinematics were recorded in 10 post-stroke hemiplegic patients (♀=7; age:58,5±12,5 years; right hemiplegic=6) by means of an electromagnetic tracking device (Flock-of-Birds) in three different conditions of arm elevation: self-motion (SM); free-motion (FM) and conduced-motion (CM). Thorax position was recorded on the extreme amplitude of arm elevation and described by Euler angles as anterior flexion, lateral flexion and rotation, and compared in the three conditions of arm elevation using the Friedman test for paired samples (p<0.05).
Results: Trunk anterior flexion was higher during SM (15º ± 8º) compared with FM (3º ± 8º) and CM (-2º ± 8º) shows a slightly trunk extension, with statically significant differences in the three variants of arm elevation (p=0,000). Significant differences (p=0,000) were observed on trunk lateral flexion. Trunk right flexion (right hemiplegia) lowest value was registered in the SM condition. Both FM (11º ± 7º) and CM (9º ± 3º) showed intermediate values. Trunk left flexion (left hemiplegia) had significant differences (p=0.000) between SM (4º ± 7º) and the other two conditions, FM (13º ± 7º) and CM (8º ± 6º). Trunk rotation remains close to neutral position on CM (0º ± 6º) and significantly (p=0.000) lower values on SM (-3º ± 6º) and FM (-12º ± 12º). Conclusion and discussion: Trunk compensatory strategies were observed in the three variants of arm elevation. In CM the trunk showed stability, but only in respect to the rotation movement. To accomplish selective arm movement it’s necessary to keep the trunk still during arm elevation. We suggest a procedure like trunk restriction in the three axes of movement (flexion, lateral flexion and rotation). It is needed to identify which motor patterns are produced throughout specific therapeutic stimulus and to identify the related brain activation process.
Conference:
11th Meeting of the Portuguese Society for Neuroscience, Braga, Portugal, 4 Jun - 6 Jun, 2009.
Presentation Type:
Poster Presentation
Topic:
Abstracts
Citation:
Inacio
CA,
Sequeira
A,
Pinto
S and
Gil-Pascoal
A
(2009). Trunk compensatory strategies during arm elevation on poststroke patients.
Front. Neurosci.
Conference Abstract:
11th Meeting of the Portuguese Society for Neuroscience.
doi: 10.3389/conf.neuro.01.2009.11.072
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Received:
07 Aug 2009;
Published Online:
07 Aug 2009.
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Correspondence:
Cristina A Inacio, Hospital Garcia de Orta, Almada, Portugal, ana.cristina.inacio@iol.pt