title: Restoration of Central Programmed Movement Pattern by Temporal Electrical Stimulation-Assisted Training in Patients with Spinal Cerebellar Atrophy.
abstract: Disrupted triphasic electromyography (EMG) patterns of agonist and antagonist muscle pairs during fast goal-directed movements have been found in patients with hypermetria. Since peripheral electrical stimulation (ES) and motor training may modulate motor cortical excitability through plasticity mechanisms, we aimed to investigate whether temporal ES-assisted movement training could influence premovement cortical excitability and alleviate hypermetria in patients with spinal cerebellar ataxia (SCA). The EMG of the agonist extensor carpi radialis muscle and antagonist flexor carpi radialis muscle, premovement motor evoked potentials (MEPs) of the flexor carpi radialis muscle, and the constant and variable errors of movements were assessed before and after 4 weeks of ES-assisted fast goal-directed wrist extension training in the training group and of general health education in the control group. After training, the premovement MEPs of the antagonist muscle were facilitated at 50 ms before the onset of movement. In addition, the EMG onset latency of the antagonist muscle shifted earlier and the constant error decreased significantly. In summary, temporal ES-assisted training alleviated hypermetria by restoring antagonist premovement and temporal triphasic EMG patterns in SCA patients. This technique may be applied to treat hypermetria in cerebellar disorders. (This trial is registered with NCT01983670.).
authors.affiliation: Department of Neurology and Neuroscience Research Center, Chang Gung Memorial Hospital, 5 Fusing Street, Kweishan, Taoyuan 333, Taiwan ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Ying-Zu
authors.initials: YZ
authors.lastname: Huang
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan ; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
authors.forename: Yao-Shun
authors.initials: YS
authors.lastname: Chang
authors.affiliation: Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan ; Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Miao-Ju
authors.initials: MJ
authors.lastname: Hsu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
authors.forename: Alice M K
authors.initials: AM
authors.lastname: Wong
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Ya-Ju
authors.initials: YJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D001284:Atrophy; D002524:Cerebellar Ataxia / Q000503:physiopathology / Q000628:therapy; D002531:Cerebellum / Q000473:pathology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography; D019054:Evoked Potentials, Motor; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D018482:Muscle, Skeletal / Q000294:innervation; D010806:Physical Education and Training; D011597:Psychomotor Performance; D011930:Reaction Time; D013116:Spinal Cord / Q000473:pathology*; D050781:Transcranial Magnetic Stimulation