title: Modifiability of abnormal isometric elbow and shoulder joint torque coupling after stroke.
abstract: Unlike individuals with mild stroke, individuals with severe stroke are constrained to stereotypical movement patterns attributed to abnormal coupling of shoulder abductors with elbow flexors, and shoulder adductors with elbow extensors. Whether abnormal muscle coactivation and associated joint torque patterns can be changed in this population is important to determine given that it bears on the development of effective rehabilitation interventions. Eight subjects participated in a protocol that was designed to reduce abnormal elbow/shoulder joint torque coupling by training them to generate combinations of isometric elbow and shoulder joint torques away from the constraining patterns. After training, subjects demonstrated a significant reduction in abnormal torque coupling and a subsequent significant increase in ability to generate torque patterns away from the abnormal pattern. We suggest the rapid time-course of these changes reflects a residual capacity of the central nervous system to adapt to a novel behavioral training environment.
authors.affiliation: Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Avenue, Suite 1100, Room 1159, Chicago, Illinois 60611, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ellis
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Holubar
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Acosta
authors.forename: Randall F
authors.initials: RF
authors.lastname: Beer
authors.forename: Julius P A
authors.initials: JP
authors.lastname: Dewald
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004551:Elbow Joint / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D026741:Physical Therapy Modalities / Q000639:trends; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012785:Shoulder Joint / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D019415:Torque; D016896:Treatment Outcome