title: Associated movements in hemiplegic limbs during yawning.
abstract: BACKGROUND
  Yawning is phylogenetically ancient and associated with a stereotyped behavioral pattern.
  
  
  OBJECTIVE
  To describe the pattern of associated movements observed in hemiplegic limbs during yawning and its relationship to gender, laterality of hemiplegia and muscle tone.
  
  
  METHODS
  An observational study was designed for 75 patients with newly detected anterior circulatory stroke due to ischemia or hemorrhage in the internal capsule region. The subjects were free from any arthropathy, autoimmune disease, muscular disorders and injury/deformity.
  
  
  RESULTS
  There were 48 males and 27 females, whose median ages were 48 and 47 years, respectively. The median yawning onset times after stroke in males and females were 36 and 38 h, respectively. Associated movements in hemiplegic limbs during yawning were minimal and observed in 59 hemiplegics (78.6%); significantly more were seen in males (83%) vs. females (70%), left-sided (94%) vs. right-sided hemiplegics (64%), those with hypotonia (87%) vs. hypertonia (61%), and in the upper limbs (91%) vs. lower limbs (83%)and proximal (72%) vs. distal joints (29%), irrespective of limb.
  
  
  CONCLUSIONS
  The appearance of associated movements in hemiplegic limbs indicates the return of ancestral function observed in quadrupeds. However, further studies are needed to ascertain the reasons for such variations and determine how to utilize these movements in rehabilitation programs.
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Meenakshisundaram
authors.forename: Ponniah
authors.initials: P
authors.lastname: Thirumalaikolundusubramanian
authors.forename: Olivier
authors.initials: O
authors.lastname: Walusinski
authors.forename: Arunachalam
authors.initials: A
authors.lastname: Muthusundari
authors.forename: Shah
authors.initials: S
authors.lastname: Sweni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001244:Association; D005121:Extremities / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006429:Hemiplegia / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D019370:Observation; D015000:Yawning / Q000502:physiology*