Correlation of polyelectromyographic patterns and clinical upper motor neuron syndrome in hemiplegic stroke patients.
OBJECTIVE
To investigate the correlation between movement patterns, measured by polyelectromyography (PEMG), and clinical upper motor neuron (UMN) syndrome in stroke patients.


METHODS
PEMG patterns, recorded from pairs of flexor-extensor muscles during voluntary maneuvers, and motor outcomes were assessed approximately 1 month after stroke (early stage). Motor outcomes were reassessed 6 months later (late stage).


METHODS
Thirty-nine hemiplegic stroke patients and 18 healthy control subjects.


METHODS
Passive stretch reflexes (PSRs), Brunnstrom's stages, and walking ability.


RESULTS
Six PEMG patterns, varying from complete reciprocal to complete synchrony, were identified. Higher PEMG pattern scores were associated with better Brunnstrom's stages (r > .80), walking ability (r > .39), and some PSRs (r < -.37). PEMG patterns could separate patterns 1 and 2 from patterns 3 and 4 for patients with early Brunnstrom's stages 1 and 2. Patterns 1 and 2 (reduced agonist electromyographic activities) indicated weakness and resulted in the worst motor outcomes. Patterns 3 and 4 (cocontraction and coactivation) indicated spasticity and associated synergistic movements. Patients with patterns of 5 and 6 (reciprocal electromyographic activities) had more selective motor control.


CONCLUSIONS
PEMG patterns correlate with clinical UMN syndromes and may allow treatment strategy planning on the basis of underlying motor control, as well as the prediction of final motor outcomes soon after stroke, even in patients who cannot move their legs initially.
Chen
C L
CL
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taipei, Taiwan.
Wong
M K
MK
Chen
H C
HC
Cheng
P T
PT
Tang
F T
FT
D000368:Aged; D004576:Electromyography; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000503:physiopathology* / Q000534:rehabilitation*; D012026:Reflex, Stretch; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016138:Walking