Abstract
Effective control of trunk muscles is fundamental to perform most daily activities. Stroke affects this ability also when sitting, and the Modified Functional Reach Test is a simple clinical method to evaluate sitting balance. We characterize the upper body kinematics and muscular activity during this test. Fifteen chronic stroke survivors performed twice, in separate sessions, three repetitions of the test in forward and lateral directions with their ipsilesional arm. We focused our analysis on muscles of the trunk and of the contralesional, not moving, arm. The bilateral activations of latissimi dorsi, trapezii transversalis and oblique externus abdominis were left/right asymmetric, for both test directions, except for the obliquus externus abdominis in the frontal reaching. Stroke survivors had difficulty deactivating the contralesional muscles at the end of each trial, especially the trapezii trasversalis in the lateral direction. The contralesional, non-moving arm had muscular activations modulated according to the movement phases of the moving arm. Repeating the task led to better performance in terms of reaching distance, supported by an increased activation of the trunk muscles. The reaching distance correlated negatively with the time-up-and-go test score.
Highlights
Accepted: 24 December 2021Core stability and proper trunk muscle control are fundamental in most daily living activities, such as standing up, sitting down, walking and stabilizing distal limbs [1]
The surface electrodes were placed according to SENIAM guidelines [33] to bilaterally record the trunk muscles trapezius trasversalis (TrapT), latissimus dorsi (LD) and obliquus externus abdominis (OEA), and unilaterally record the contralesional arm muscles deltoideus posterior (Delt), sternal head of pectoral major (Pect), caput lungus of triceps brachii (Tric) and of biceps brachii (Bic)
We expected a correlation between the kinematic performance of the Modified Functional Reach Test (MFRT) and the clinical scores directly related to trunk control ability, such as the TIS and the Time Up and Go (TUG)
Summary
Core stability and proper trunk muscle control are fundamental in most daily living activities, such as standing up, sitting down, walking and stabilizing distal limbs [1]. The MFRT is a functional clinical assessment for evaluating the risk of fall and determining the limits of stability while sitting, focusing on the ability to shift the body weight maintaining the equilibrium in a self-initiated movement [19,20,21,22,23] It is widely used in clinical practice for both neurotypical individuals and heterogenous populations with sensorimotor deficits [19,20,21,22,23,24,25,26]. To the best of our knowledge, a kinematic and muscular characterization of MFRT, focusing on the upper body, is still missing, despite the fact that trunk muscles are fundamental for postural control during reaching movements Our work fills this gap, having the primary goal of characterizing the trunk and upper-body muscular activations as well as the kinematic performance of chronic stroke survivors engaging in the forward and lateral. We focused on the bilateral trunk muscles’ activations; on the muscular activity of the contralesional arm, not actively involved in the reaching movement; on the effects of the reaching movement repetition
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