PTOTCase-ControlJournal of neuroengineering and rehabilitation2021

Alterations in intermuscular coordination underlying isokinetic exercise after a stroke and their implications on neurorehabilitation.

Jeong-Ho Park, Joon-Ho Shin, Hangil Lee and 2 others

PMID 34217328

WHAT IT FOUND

During fixed-speed upper limb movements, stroke survivors generated weaker and less accurately directed forces, used fewer coordination patterns than controls, and more impaired participants showed more altered muscle activation.

Key findings

01Stroke survivors generated lower maximum end-point forces and force directions that deviated more from the intended movement across all movements.

02Stroke survivors used fewer average muscle synergies than controls, 4.38 versus 5.25, and deltoid-related shoulder muscles appeared together in a stroke synergy.

03Stroke survivors with more severe impairment showed more dissimilar muscle activation patterns from controls.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was small, with 16 stroke survivors and 8 controls, so the findings may not apply to all stroke populations. It did not test rehabilitation or follow patients over time, so it cannot show that fixed-speed training improves function. It measured only isokinetic movements with a constrained handle, not free movement or other task constraints, and compared its results with previous studies that used different participants and methods. Some EMG channels were removed for several participants, and only maximum force magnitude and force direction were analysed, not detailed force control. Stroke participants had to have upper limb mobility to perform the initial postures, so people who could not perform these movements were not included.

The easy way to misread this

Do not conclude that isokinetic training improves upper limb function. The study measured coordination during one task in 16 stroke survivors and 8 controls; it did not test a training programme or follow patients over time.

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