title: Delay in initiation and termination of tibialis anterior contraction in lower-limb hemiparesis: relationship to lower-limb motor impairment and mobility.
abstract: OBJECTIVE
  To assess the relationship between delays in initiation and termination of tibialis anterior contraction in the hemiplegic lower limb and clinical measures of lower-limb motor impairment and mobility.
  
  
  METHODS
  Cross-sectional correlational study.
  
  
  METHODS
  Outpatient rehabilitation clinic of an academic medical center.
  
  
  METHODS
  Convenience sample of 22 chronic stroke survivors with lower-limb hemiparesis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Delays in initiation and termination of tibialis anterior electromyographic activity during isometric contraction, lower-limb Fugl-Meyer Assessment (FMA), and Modified Emory Functional Ambulation Profile (mEFAP).
  
  
  RESULTS
  The affected lower limb exhibited significantly longer delays in initiation and termination of tibialis anterior contraction relative to the unaffected limb. Delay in termination of 3-second tibialis anterior contraction of the affected limb correlated significantly with the FMA and mEFAP. However, delay in initiation of tibialis anterior contraction did not correlate with clinical measures.
  
  
  CONCLUSIONS
  Delay in termination of muscle activity in the hemiparetic lower limb may have important clinical implications, but delay in initiation did not correlate with clinical measures. Controlled, interventional trials are needed to demonstrate a cause and effect relationship.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA. Jchae@metrohealth.org
authors.forename: John
authors.initials: J
authors.lastname: Chae
authors.forename: Allison
authors.initials: A
authors.lastname: Quinn
authors.forename: Kevin
authors.initials: K
authors.lastname: El-Hayek
authors.forename: Jennifer
authors.initials: J
authors.lastname: Santing
authors.forename: Roman
authors.initials: R
authors.lastname: Berezovski
authors.forename: Mary
authors.initials: M
authors.lastname: Harley
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D007866:Leg; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors