Pamela A. Catlin

Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke

Background and Purpose— The Wolf Motor Function Test (WMFT) is a new time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This study addresses selected psychometric attributes of the WMFT applied to a chronic stroke population. Methods— Nineteen individuals after stroke and with intact cognition and sitting balance were age- and sex-matched with 19 individuals without impairment. Subjects performed the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) on 2 occasions (12 to 16 days apart), with scoring performed independently by 2 random raters. Results— The WMFT and FMA demonstrated agreement (P <0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different (P ≤0.05) from the more and less affected extremities of subjects after stroke. The FMA score for the more affected extremity of subjects after stroke was different (P ≤0.05) from the dominant and nondominant extremities. However, the FMA score for the less affected upper extremity of individuals after stroke was not different (P >0.05) from the dominant and nondominant extremities of individuals without impairment. The WMFT and FMA scores were related (P <0.02) for the more affected extremity in individuals after stroke. Conclusions— The interrater reliability, construct validity, and criterion validity of the WMFT, as used in these subject samples, are supported.

Contralateral and long latency effects of human biceps brachii stretch reflex conditioning

Results from previous studies on monkeys and human subjects have demonstrated that the biceps brachii spinal stretch reflex (SSR) can be operantly conditioned. The extent to which conditioning paradigms influence contralateral SSRs or longer latency responses in the same limb has not been examined. Nine subjects were given 10 training sessions to either increase or decrease the size of their biceps brachii SSR. Group changes were compared to the mean of six baseline (control) sessions. Both groups showed progressive SSR changes over the training sessions. Up-trained subjects increased their SSR responses by an average of 135.3% above baseline, with the last three sessions showing a 237.5% increase, while down-trained subjects reduced their average SSR responses by 43.4%, with a 52.7% reduction over the last three sessions. Ipsilateral longer latency responses showed average changes of 68.9% and-68.7% for up- and down-trainers, respectively. As in the case of SSRs, these responses changed progressively over sessions, with a 131.5% increase seen in the last three up-training sessions and an 82.4% reduction over the same period for down-trainers. Correlation coefficients between SSR and longer latency responses were high (R=0.90, up-trainers; R=0.87, down-trainers). Contralateral SSR and longer latency responses, measured in the absence of feedback and at least 10 min after ipsilateral conditioning, showed directional changes that were similar to the trained side, but their magnitudes were not as profound. Collectively, these data suggest that unilateral SSR conditioning affects spinal circuits controlling contralateral SSRs and influences longer latency responses.

Anatomical Partitioning of Three Human Forearm Muscles

Anatomical partitioning has been found in the human biceps brachii, extensor carpi radialis longus and flexor carpi radialis muscles. The purpose of this study was to determine if the human extensor carpi ulnaris, flexor carpi ulnaris and flexor digitorum profundus are anatomically partitioned. Evidence for or against anatomical partitioning was obtained by observation of the architectural and innervation characteristics of each of the investigated muscles. Twelve samples (11 were used for extensor carpi ulnaris) of each specific muscle type were harvested from perfused human cadavers. The architectural characteristics of tendinous boundaries, muscle fiber direction, and muscle fiber angle magnitude were observed, measured and documented. Microdissection technique was used to investigate the primary nerve branching pattern throughout each muscle. A primary nerve branch to a specific muscle region indicated possible partitioning by innervation. The extensor carpi ulnaris was found to have a variable number of primary nerve branches. The extensor carpi ulnaris may have four partitions by innervation alone or three congruent partitions by innervation and muscle fiber architecture. The nerve to the flexor carpi ulnaris clearly innervates two architectural partitions within the muscle. The innervation pattern to the flexor carpi ulnaris is congruent with muscle fiber architecture characteristics indicating consistent anatomical partitioning within the flexor carpi ulnaris. Two muscle nerves innervate the flexor digitorum profundus with branches innervating the medial and lateral regions of the muscle. Up to eight architectural partitions were found in a medial-to-lateral direction.

Decline in Spontaneous Activity of Group Aαβ Sensory Afferents After Sciatic Nerve Axotomy in Rat

Abstract Changes are observed in the strength of central synaptic transmission and the firing behavior of primary afferents damaged by peripheral nerve injury. To clarify the relationship between synaptic strength and amount of spontaneous activity, firing behavior was studied in adult, male Sprague–Dawley rats in which sciatic nerve afferents were axotomized. Intra-axonal recordings were taken from A α βafferents within 7 h (acute, n =309), at 3 days ( n =228), or at 10 days ( n =230) after sciatic nerve cut. The proportion of spontaneously discharging afferents fell from 22% in the acute group to ≤13% in chronic groups. Thus, neither the progressive decline in the strength of central synaptic transmission from cut primary afferents nor the altered sensation observed after nerve cut can be explained by chronic changes in spontaneous activity of cut A α /Aβ afferents.

THE LANDAU RÉACTION IN FULLTERM and PRÉTÉRM INFANTS AT FOUR MONTHS OF AGE

Twelve normal fullterm infants and 11 low‐risk preterm infants were assessed at four months of age. Assessments included a Three‐Component‐Scale for the Landau réaction, the Touwen Scale for the Landau réaction, the Bayley Scales of Infant Development Motor Scale, and the Movement Assessment of Infants Muscle Tone Scale. a statistically significant relationship was found between gestational age (preterm vs. fullterm birth) and scores on the hip and kicking subcomponents on the Three‐Component‐Scale for the Landau réaction, and also between gestational age at birth and scores on the summary of tone‐extremities and total risk score items on the Movement Assessment of Infants. Although preterm and fullterm infants may not show differences in scores on motor developmental level assessments, variations in postural réactions and muscle tone may be present at four months of age.

Up-Training Loading Responses in Older Adults

This randomized, experimental-control group, multiple-observation study examined the ability of older adults to use center of pressure feedback to up-train the vertical loading response (LR) and the impact that such training had on changes in clinical tests of balance. Eleven community ambulators, aged at least 65 years, with no recent history of falls were recruited by convenience sampling. Each group received 6 baseline sessions and 6 control/training sessions, followed by 1 posttest session. All sessions included visual cueing about stance equilibrium followed by 30 randomly timed dynamic, toes-up perturbations (8 degrees, 66 degrees per second). Training consisted of verbal instructions with visual and auditory feedback of a 225 msec response window to shape an increase in total LR following perturbations. Subjects in the experimental group demonstrated a tendency to decrease vertical loading relative to baseline regardless of visual and verbal feedback encouraging strategies to increase it. Specifically, the T3 or 150–225 msec component of the response window showed a decline from session 7 to session 12. Up-training, however, appears to cause a faster rate of rise to the maintenance window, but this event probably occurs too late to correct for a loss of balance. No correlation was found between change in load values and change in performance on clinical balance tests.

Verbetering van een verminderde beweeglijkheid in de elleboog bij hyperactiviteit in de antagonisten

Traditioneel behoort men bij de revalidatie van patienten met een abnormale mate van hyperactiviteit in spiergroepen eerst een zekere mate van relaxatie te bereiken, voordat de antagonisten aangespannen kunnen worden bij het maken van een effectieve beweging in een gewricht. Het doel van dit onderzoek was na te gaan welk effect het trainen van een zwakke M. triceps brachii heeft op de bewegingsuitslag in het ellebooggewricht, bij patienten met hyperactiviteit in de antagonist (= M. biceps brachii). De patienten die meededen aan het onderzoek hadden allen minimaal een jaar geleden een beroerte gehad.