Motor unit properties in the biceps brachii of chronic stroke patients assessed with high-density surface EMG

Motor unit (MU) properties of the biceps brachii and Fugl-Meyer score were assessed in stroke patients and healthy controls during passive and active elbow flexion and extension contractions. The level of motor recovery as assessed with the Fugl-Meyer score was correlated with the ratio of the size of the motor unit action potentials (MUAPs) at the affected side and the unaffected side. This ratio may reflect the extent to which reinnervation has occurred on the affected side. The RMS value of the MUAPs recruited during the stretch phase of the passive contractions was lower than the RMS value of MUAPs recruited during active contractions. This may indicate that only smaller MUs are affected by increased sensitivity to muscle stretch while a larger part of the MU pool can be recruited voluntarily.

[1]  B. Freriks,et al.  Development of recommendations for SEMG sensors and sensor placement procedures. , 2000, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[2]  D. Farina,et al.  The linear electrode array: a useful tool with many applications. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[3]  G Rau,et al.  From cell to movement: to what answers does EMG really contribute? , 2004, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[4]  Miklós Lukács,et al.  Electrophysiological signs of changes in motor units after ischaemic stroke , 2005, Clinical Neurophysiology.

[5]  Hermie J Hermens,et al.  Behaviour of motor unit action potential rate, estimated from surface EMG, as a measure of muscle activation level , 2006, Journal of NeuroEngineering and Rehabilitation.

[6]  G. Kraft,et al.  Recruitment and termination of electromyographic activity in the hemiparetic forearm. , 1988, Archives of physical medicine and rehabilitation.

[7]  M. J. Trotter,et al.  Co-contraction in the hemiparetic forearm: quantitative EMG evaluation. , 1988, Archives of physical medicine and rehabilitation.

[8]  B. Calancie,et al.  Recruitment order of motor units during the stretch reflex in man , 1984, Brain Research.

[9]  O. Goldkamp.  Electromyography and nerve conduction studies in 116 patients with hemiplegia. , 1967, Archives of physical medicine and rehabilitation.

[10]  E Henneman,et al.  Recruitment order of motoneurons in stretch reflexes is highly correlated with their axonal conduction velocity. , 1984, Journal of neurophysiology.

[11]  R. Merletti,et al.  Neck flexor muscle fatigue is side specific in patients with unilateral neck pain , 2004, European journal of pain.

[12]  H. Hermens,et al.  Motor unit action potential rate and motor unit action potential shape properties in subjects with work-related chronic pain , 2004, European Journal of Applied Physiology.

[13]  Gea Drost,et al.  Motor unit characteristics in healthy subjects and those with postpoliomyelitis syndrome: A high‐density surface EMG study , 2004, Muscle & nerve.

[14]  H. Hermens,et al.  Neurophysiological methods for the assessment of spasticity: The Hoffmann reflex, the tendon reflex, and the stretch reflex , 2005, Disability and rehabilitation.

[15]  W. Rymer,et al.  Abnormal muscle coactivation patterns during isometric torque generation at the elbow and shoulder in hemiparetic subjects. , 1995, Brain : a journal of neurology.

[16]  Richard W. Bohannon,et al.  Distribution of muscle strength impairments following stroke , 2000, Clinical rehabilitation.

[17]  G. Hansson,et al.  Influence of the subcutaneous fat layer, as measured by ultrasound, skinfold calipers and BMI, on the EMG amplitude , 2003, European Journal of Applied Physiology.

[18]  C. Disselhorst-Klug,et al.  Non-invasive approach of motor unit recording during muscle contractions in humans , 2000, European Journal of Applied Physiology.

[19]  Richard W. Bohannon,et al.  Interrater reliability of a modified Ashworth scale of muscle spasticity. , 1987, Physical therapy.

[20]  S. Chokroverty,et al.  Hemiplegic amyotrophy. Muscle and motor point biopsy study. , 1976, Archives of neurology.

[21]  S. Lotta,et al.  Hemiplegic atrophy , 2004, Acta Neuropathologica.

[22]  Dario Farina,et al.  A new method for the extraction and classification of single motor unit action potentials from surface EMG signals , 2004, Journal of Neuroscience Methods.

[23]  A. Pistorio,et al.  Myoelectric manifestations of muscle changes in stroke patients. , 2001, Archives of physical medicine and rehabilitation.

[24]  R. F. Mayer,et al.  Physiological alterations of motor units in hemiplegia , 1982, Journal of the Neurological Sciences.

[25]  J. Chae,et al.  Delay in initiation and termination of muscle contraction, motor impairment, and physical disability in upper limb hemiparesis , 2002, Muscle & nerve.

[26]  L. Arendt-Nielsen,et al.  The relationship between mean power frequency of the EMG spectrum and muscle fibre conduction velocity. , 1985, Electroencephalography and clinical neurophysiology.

[27]  F. Kueppers,et al.  Albumin Santa Ana: a new inherited variant. , 1969, Human heredity.

[28]  Dario Farina,et al.  Noninvasive estimation of motor unit conduction velocity distribution using linear electrode arrays , 2000, IEEE Transactions on Biomedical Engineering.

[29]  S. Andreassen,et al.  Muscle fibre conduction velocity in motor units of the human anterior tibial muscle: a new size principle parameter. , 1987, The Journal of physiology.

[30]  W. Engel,et al.  The histographic analysis of human muscle biopsies with regard to fiber types , 1969, Neurology.

[31]  Dario Farina,et al.  Influence of anatomical, physical, and detection-system parameters on surface EMG , 2002, Biological Cybernetics.

[32]  P Bawa,et al.  Voluntary and reflexive recruitment of flexor carpi radialis motor units in humans. , 1985, Journal of neurophysiology.

[33]  H. Hermens,et al.  Distinction between computer workers with and without work-related neck–shoulder complaints based on multiple surface EMG parameters , 2006 .

[34]  G Rau,et al.  Clinical application of a noninvasive multi-electrode array EMG for the recording of single motor unit activity. , 1993, Neuropediatrics.

[35]  Karin Roeleveld,et al.  What do we learn from motor unit action potentials in surface electromyography? , 2002, Muscle & nerve. Supplement.

[36]  Andreas Daffertshofer,et al.  Improving EMG-based muscle force estimation by using a high-density EMG grid and principal component analysis , 2006, IEEE Transactions on Biomedical Engineering.

[37]  H B Boom,et al.  The median frequency of the surface EMG power spectrum in relation to motor unit firing and action potential properties. , 1992, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[38]  A R Upton,et al.  Functional changes in motoneurones of hemiparetic patients , 1973, Journal of neurology, neurosurgery, and psychiatry.

[39]  M. Zwarts,et al.  Determinants of motor unit action potential duration , 1999, Clinical Neurophysiology.

[40]  L. Edström.  Selective changes in the sizes of red and white muscle fibres in upper motor lesions and Parkinsonism. , 1970, Journal of the neurological sciences.

[41]  D. Gravel,et al.  Characterization of global synkineses during hand grip in hemiparetic patients. , 1997, Archives of physical medicine and rehabilitation.

[42]  Naoichi Chino,et al.  The physiological functional loss of single thenar motor units in the stroke patients: when does it occur? Does it progress? , 2004, Clinical Neurophysiology.

[43]  A Cruz Martínez,et al.  Altered motor unit architecture in hemiparetic patients. A single fibre EMG study. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[44]  T. Cope,et al.  Stability of motor-unit force thresholds in the decerebrate cat. , 1997, Journal of neurophysiology.

[45]  J. Prather,et al.  Firing rate modulation of motoneurons activated by cutaneous and muscle receptor afferents in the decerebrate cat. , 2002, Journal of neurophysiology.

[46]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[47]  Gea Drost,et al.  Clinical applications of high-density surface EMG: a systematic review. , 2006, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[48]  W Z Rymer,et al.  Reorganization of flexion reflexes in the upper extremity of hemiparetic subjects , 1999, Muscle & nerve.

[49]  Dario Farina,et al.  Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[50]  P Girlanda,et al.  Muscle rearrangement in patients with hemiparesis after stroke: an electrophysiological and morphological study. , 1993, European neurology.

[51]  J. Chae,et al.  Muscle Weakness and Cocontraction in Upper Limb Hemiparesis: Relationship to Motor Impairment and Physical Disability , 2002, Neurorehabilitation and neural repair.

[52]  V. Dietz,et al.  Motor unit involvement in spastic paresis: Relationship between leg muscle activation and histochemistry , 1986, Journal of the Neurological Sciences.

[53]  D. Farina,et al.  Single motor unit analysis from spatially filtered surface electromyogram signals. Part 2: Conduction velocity estimation , 2003, Medical and Biological Engineering and Computing.

[54]  L.H. Lindstrom,et al.  Interpretation of myoelectric power spectra: A model and its applications , 1977, Proceedings of the IEEE.