Abstract
Upper extremity deformities and dysfunction are often the result of injury to the central nervous system. Upper motor neuron syndrome is a condition that arises as a result of the disruption of the upper motor neuron inhibitory pathways that frequently occurs in association with conditions such as traumatic brain injury, spinal cord injury, cerebral palsy, and cerebrovascular accident1. Damage to these pathways often leads to the constellation of symptoms that characterize this syndrome. Most notably, these symptoms include muscle weakness and diminished endurance as well as symptoms of hypertonicity, such as spasticity (muscle activation with a quick-stretch stimulus), rigidity (exaggerated response with a slow-stretch stimulus), dyssynergy or spastic co-contraction (antagonist co-activation alongside an agonist), and hyperreflexia. The presentation of this condition can be highly variable as any combination of these symptoms may be reported by the patient. The alteration of the muscular balance about the joints in the upper extremity often initially presents as a dynamic problem characterized by impaired motion. However, prolonged deformity may lead to the formation of contracture (fixed shortening)—a consequence that may impair the active or passive function of the affected limb. Patients with upper motor neuron syndrome often complain of pain. The reported prevalence of shoulder pain after a stroke has ranged from 24% to 84%2-5. The association between hemiplegia and shoulder pain is unclear, …
Published Version
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