title: Motor recovery patterns in arm muscles: coupled bilateral training and neuromuscular stimulation.
abstract: BACKGROUND
  Neuromuscular stimulation coupled with bilateral movements facilitates functional motor recovery of the upper extremities post stroke. This study investigated electromyography activation patterns during training. The leading question asked: Do EMG activation patterns show rehabilitative effects of coupled bilateral movement training on wrist and fingers extension, elbow extension, and shoulder abduction?
  
  
  METHODS
  Twelve stroke volunteers completed nine hours of coupled bilateral movement training on three sets of joints in their arms. Neuromuscular stimulation on the impaired limb assisted wrist and fingers extension, elbow extension, and shoulder abduction. Mean activation level data were analyzed in a three-way completely within-subjects ANOVA (Training Day × Movement Type × Trial Block: 3 × 3 × 3).
  
  
  RESULTS
  The analysis revealed three important findings: (a) activation levels in Days 5 and 6 were significantly higher than Days 1 and 2, (b) muscle activation patterns increased across trial blocks, and (c) movements for the shoulder joint/girdle as well as wrist and fingers demonstrated higher activation than the elbow joint. Further analysis indicated that the muscle activation patterns for shoulder abduction were positively associated with force stabilization (ratio of good variability relative to bad variability) during bilateral force production.
  
  
  CONCLUSIONS
  The findings indicate that capability to increase muscle activity during the three joint movements was improved after training. There appears to be higher muscle activation in the primary proximal and distal muscles necessary for motor control improvement.
authors.forename: Nyeonju
authors.initials: N
authors.lastname: Kang
authors.forename: Jerelyne
authors.initials: J
authors.lastname: Idica
authors.forename: Bhullar
authors.initials: B
authors.lastname: Amitoj
authors.affiliation: Motor Behavior Laboratory, Applied Physiology and Kinesiology Department, University of Florida, Gainesville, FL 32611-8206, USA. cauraugh@ufl.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Cauraugh
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation
references.citation: Exp Brain Res. 2012 Mar;217(1):1-5
references.pmid: 22246105
references.citation: Clin Neurophysiol. 1999 Jul;110(7):1270-5
references.pmid: 10423192
references.citation: Exp Brain Res. 2006 Sep;174(1):86-94
references.pmid: 16575579
references.citation: J Rehabil Med. 2005 Mar;37(2):65-74
references.pmid: 15788340
references.citation: Acta Neurol Scand. 2003 May;107(5):369-81
references.pmid: 12713530
references.citation: Exerc Sport Sci Rev. 2002 Jan;30(1):26-31
references.pmid: 11800496
references.citation: Exp Brain Res. 2003 Nov;153(1):45-58
references.pmid: 12928761
references.citation: Clin Neurophysiol. 2010 Nov;121(11):1952-61
references.pmid: 20435515
references.citation: Source Code Biol Med. 2008 Dec 16;3:17
references.pmid: 19087314
references.citation: Clin Rehabil. 2011 Dec;25(12):1086-96
references.pmid: 21788265
references.citation: Exp Brain Res. 2009 Jul;196(4):483-96
references.pmid: 19504088
references.citation: Exp Brain Res. 2007 Nov;183(2):215-23
references.pmid: 17634933
references.citation: Exp Brain Res. 2014 Feb;232(2):503-13
references.pmid: 24212257
references.citation: J Nippon Med Sch. 2008 Feb;75(1):4-14
references.pmid: 18360073
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Neurophysiol. 2011 Nov;106(5):2546-56
references.pmid: 21832028
references.citation: Stroke. 2008 Sep;39(9):2477-84
references.pmid: 18635846
references.citation: Neurosci Lett. 2005 Jul 1-8;382(1-2):39-44
references.pmid: 15911118
references.citation: J Occup Rehabil. 2004 Dec;14(4):281-94
references.pmid: 15638258
references.citation: Restor Neurol Neurosci. 2009;27(1):17-25
references.pmid: 19164850
references.citation: J Neurophysiol. 1965 May;28:560-80
references.pmid: 14328454
references.citation: J Neurol Neurosurg Psychiatry. 2003 Nov;74(11):1562-6
references.pmid: 14617717
references.citation: J Neurol Sci. 2003 Mar 15;207(1-2):25-9
references.pmid: 12614927
references.citation: Clin Neurophysiol. 2008 Sep;119(9):2074-85
references.pmid: 18571981
references.citation: Am J Epidemiol. 1989 Jan;129(1):125-37
references.pmid: 2910056
references.citation: J Neurobiol. 1991 Jul;22(5):547-59
references.pmid: 1890428
references.citation: J Neurophysiol. 2009 Jul;102(1):451-9
references.pmid: 19458140
references.citation: Neurorehabil Neural Repair. 2009 Oct;23(8):862-9
references.pmid: 19454622
references.citation: Cerebrovasc Dis. 2008;25(1-2):115-21
references.pmid: 18073464
references.citation: Yale J Biol Med. 2012 Jun;85(2):201-15
references.pmid: 22737049
references.citation: Hum Mov Sci. 2010 Oct;29(5):853-70
references.pmid: 19926154
references.citation: Muscle Nerve. 1990 Dec;13(12):1133-45
references.pmid: 1702521
references.citation: J Neurophysiol. 1965 May;28(3):599-620
references.pmid: 5835487
references.citation: J Neurol Sci. 2003 Nov 15;215(1-2):13-9
references.pmid: 14568122