Abstract
The Brain Motor Control Assessment (BMCA) protocol is a surface electromyography (sEMG)-based measure of motor output from central nervous system during a variety of reflex and voluntary motor tasks performed under strictly controlled conditions. The aim of this study was to evaluate the BMCA protocol for upper limb with the addition of shoulder voluntary tasks. The voluntary response index (VRI) was calculated from quantitative analysis of sEMG data during defined voluntary movement in neurologically intact people for comparison with that of patients after neurological injuries. The BMCA protocol included one bilateral and 4 unilateral voluntary tasks at different joints of both arms. The VRI, measured from 19 neurologically intact participants, comprises the total muscle activity recorded for the voluntary motor task (magnitude). The calculated similarity index (SI) for each phase of each task show the similarity of “the distribution of activity across the recorded muscles” for that task in this group off participants. Results: The VRI magnitude values from right and left sides for different tasks showed no significant difference (ANOVA: FSide: 0.09, P = 0.77). Therefore these values were pooled before calculating SI. SI values were higher for tasks against gravity: elbow flexion (0.99±0.03), wrist flexion with palm up (0.98±0.03) and wrist extension with palm down (0.97±0.07). On the other hand, the SI values were the lowest for bilateral shoulder abduction (0.84±0.08) and shoulder adduction (0.84±0.08). Conclusion: To validate this index for clinical use, serial studies on patients with neurological impairments should be performed. Tasks involving movement against gravity may be more suitable in future BMCAs.
Highlights
The loss of upper limb function is one of the most significant and devastating losses after injuries to the central nervous system (CNS)
The results showed that the main effect of the ‘‘side’’ or the ‘‘gender’’ on the magnitudes of response vector (RV) for each phase of each unilateral task was not significant in neurologically intact participants (FTask: 17.1, P,0.0001; FSide: 0.09, P = 0.77; FGender: 1.64, P = 0.61) (Figure 2)
The values were combined from both sides to calculate the prototype response vector (PRV) for each task
Summary
The loss of upper limb function is one of the most significant and devastating losses after injuries to the central nervous system (CNS) (e.g. spinal cord injury, stroke, head injury). Numerous measures are readily available to clinicians for the evaluation of these functions after neurological injuries [4] e.g. Action Research Arm Test [5], Box and Blocks Test [6], Chedoke Arm and Hand Activity Inventory, Jebsen-Taylor Hand Function Test [7], Nine-Hole Peg Test [8], the Wolf Motor Function Test [9], the Motor Activity Log [10] or Arm Activity Measure [11] Many of these tests have been thoroughly evaluated for reliability and validity at multiple time points. Electrophysiological methods can complement the clinical evaluation by providing quantitative, objective data about the function of upper limb muscles; these techniques are not used routinely in clinical practice
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