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Electrical stimulation-a mapping system for hand dysfunction in tetraplegia.

Ines Bersch1,2, Sabrina Koch-Borner3, Jan Fridén3,4

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Summary
This summary is machine-generated.

Electrical stimulation can identify upper motor neuron (UMN) or lower motor neuron (LMN) lesions affecting the tenodesis grasp in tetraplegia. This aids in optimizing hand function treatment.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Electrophysiology

Background:

  • The tenodesis grasp is crucial for hand function in individuals with tetraplegia.
  • Identifying upper motor neuron (UMN) and lower motor neuron (LMN) lesions is essential for effective treatment planning.
  • Understanding the motor point distribution and excitability of wrist and finger actuators is key.

Purpose of the Study:

  • To define the distribution of motor points and excitability of key wrist and finger actuators.
  • To detect UMN and LMN lesions influencing tenodesis grasp development in tetraplegia.
  • To evaluate electrical stimulation (ES) as a diagnostic tool for differentiating UMN/LMN lesions.

Main Methods:

  • Retrospective analysis of forearm muscle electrical stimulation (ES) in 32 tetraplegia patients (AIS A-D).
  • Standardized mapping and bilateral ES testing were used to differentiate UMN and LMN presence.
  • Patients underwent a consistent positioning schedule for testing.

Main Results:

  • Sixteen hands developed a tenodesis grasp, all associated with an LMN lesion of the M. extensor digitorum communis (EDC).
  • The frequency of tenodesis grasp differed significantly between groups with and without an intact reflex arc (p < 0.0001).
  • Seven patients developed bilateral tenodesis grasps, while others showed unilateral or no grasp development.

Conclusions:

  • Surface ES can serve as a diagnostic tool to detect UMN or LMN lesions impacting the tenodesis grasp.
  • Findings are crucial for selecting treatments to optimize tetraplegic hand function.
  • This diagnostic approach aids in personalized rehabilitation strategies for spinal cord injury patients.