BILATERAL MOTOR CORTICES ARE ACTIVATED PRECEDING VOLUNTARY MOVEMENT OF PARETIC ARM IN RECOVERED HEMIPARESIS
Jun-ichi Kitamura, Naoko Akiyama, Ano Oya, Keiho Tashima, Takahito Takeuchi (Nippon Medical School, Kawasaki, Japan)
Scalp-recorded movement-related cortical potentials preceding voluntary elbow flexion were studied in two hemiplegics 8 months after the stroke with unilateral lenticular and internal capsular vascular lesion sparing the cortex. Their motor recovery of the paretic arm remained in synergistic movement. NS' (Negative Slope) preceding voluntary unilateral elbow flexion of the intact arm showed a distinct preponderance over the contralateral precentral area, while NS' preceding the paretic arm movement was symmetrically large at the bilateral precentral areas. Synergistic elbow flexion of the paretic arm is associated with an activation of bilateral sensorimotor cortex, while isolated elbow flexion of the intact arm is associated with an activation of the contralateral sensorimotor cortex.
EFFECT OF CONTINUED STRETCHING IN PATIENTS WITH CEREBROVASCULAR DISEASES.
- H-REFLEX STUDY -
T. SUZUKI, Y. YASE, M. TANI, R. NABETA, S. DAIKUYA, H. HIROSE, S. NISHIGUCHI and T. FUJIWARA (Research Center of Neurological Diseases, Kansai College of Oriental Medicine, OSAKA, JAPAN)
Purpose: To investigate excitability of spinal neural function during stretching exercise in patients with cerebrovascular disease, H-reflex was analyzed before, during and after stretching.
Method: 10 hemiplegic patients with hypertonus and hyperreflex, mean age of 53.2 years were tested. 10 patients were separated into 3 groups in regard of muscle tonus and tendon reflex; slightly increased (3 patients), moderately increased (4 patients) and markedly increased group (3 patients). H-reflex before, during and after was recorded from the abductor pollicis brevis after stimulation of median nerve at the wrist. The method of stretching was following. We stretched the affected arm in shoulder joint abduction, elbow joint extension, wrist joint dorsi-flexion and finger extension for 1 min. H-reflex was analyzed for persistence, amplitude and amplitude ratio of H/M under these conditions.
Result: The persistence, amplitude and amplitude ratio of H/M during continued stretching were lower than those before and after in the patients with moderately increased muscle tonus. However in patients with slightly and markedly increased, results of H-reflex was same before, during and after continued stretching.
Conclusion: It is suggested that excitability of spinal neural function during 1 min. continued stretching was inhibited in the patients with moderately increased muscle tonus. And it is important to select the patient for neurological findings using continued stretching as one of treatments in rehabilitation medicine.