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Lower extremity long-latency reflexes differentiate walking function after stroke.

Caitlin L Banks1,2,3, Virginia L Little3, Eric R Walker3

  • 1Biomechanics, Rehabilitation, and Integrative Neuroscience (BRaIN) Lab, Physical Medicine and Rehabilitation, UC Davis School of Medicine, 4860 Y Street, Suite 3850, Sacramento, CA, 95817-2307, USA.

Experimental Brain Research
|August 3, 2019
PubMed
Summary
This summary is machine-generated.

Understanding long-latency reflex (LLR) responses and antagonist motor-evoked responses after stroke can reveal walking impairments. This study differentiates stroke patients based on these neurophysiologic markers, offering insights into motor recovery.

Keywords:
Long-latency reflexReciprocal inhibitionStrokeTranscortical reflexWalking

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Motor Control

Background:

  • Walking impairment after stroke is common, but underlying neural mechanisms, particularly in plantarflexor power generation, remain unclear.
  • Understanding these mechanisms is crucial for targeted rehabilitation strategies.

Purpose of the Study:

  • To investigate the association between long-latency reflex (LLR) responses and dynamic facilitation of antagonist motor-evoked responses with walking function in individuals post-stroke.
  • To characterize neurophysiologic markers that differentiate stroke survivors with varying degrees of lower extremity motor impairment.

Main Methods:

  • Fourteen individuals with chronic post-stroke hemiparesis and thirteen healthy controls performed isometric and dynamic plantarflexion.
  • Transcranial magnetic stimulation (TMS) assessed supraspinal drive; LLR activity was measured during dynamic plantarflexion.
  • Participants were classified as LLR present (LLR+) or absent (LLR-).

Main Results:

  • LLR+ individuals post-stroke demonstrated better walking speeds and greater ankle plantarflexor power compared to LLR- individuals.
  • LLR- individuals exhibited exaggerated TMS responses and dysfunctional modulation of stretch reflexes and antagonist supraspinal drive.
  • Healthy controls and most post-stroke individuals exhibited LLRs, while a subset of five post-stroke individuals did not.

Conclusions:

  • The presence or absence of LLRs and abnormal antagonist motor-evoked responses can distinguish between different profiles of motor impairment after stroke.
  • These neurophysiologic markers provide clinically relevant information beyond standard behavioral assessments, aiding in understanding the heterogeneity of post-stroke motor deficits.
  • Findings suggest potential for personalized rehabilitation approaches based on individual neurophysiologic profiles.