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Motor Control in Patients with Incomplete Spinal Cord Injuries and Various Voluntary Movement Capabilities

Author(s): Shih-Wei Chou | Yu-Cheng Pei | Cheng-Hsiu Lai | Chia-Hua Kuo | Tieh-Cheng Fu | Wei-Hsien Hong

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 28;
Issue: 05;
Start page: 349;
Date: 2005;
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Keywords: motor control | spinal cord injury | stretch reflex | polyelectromyography.

Background: In this study, we attempted to verify the hypothesis that further improvementsin volitional movement of patients with a spinal cord injury woulddiminish and ultimately suppress the segmental responses, while enhancingthe supraspinal inhibitory influence.Methods: Eleven patients with an incomplete spinal cord injury and partial preservationof motor function (ASIS grades C and D) were recruited. Their lowerlimbs were evaluated using polyelectromyography (PEMG) during voluntarymovements, reinforcement maneuvers, tonic vibratory reflex, passive stretchreflex, irradiation of the passive stretch reflex (PSRirrad), and plantar reflexsuppression.Results: The reinforcement maneuver response, tonic vibratory response, passivestretch reflex, and PSRirrad were most active in limbs with partially preservedvolitional movement, but for which patients were still incapable oflifting their heel off the examination table. In contrast, plantar reflex suppressionwas strongest in limbs with partially preserved volitional movement, forwhich patients were capable of lifting the heel off the examination table.Conclusions: Supraspinal inhibitory effects were most active in those limbs which werecapable of lifting the heel off the examination table, compared to limbs withpartially preserved volitional activity but without visible movement or whichwere incapable of lifting the heel off the examination table. The capabilityfor volitional activity paralleled the supraspinal inhibitory effects.
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