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J Neurophysiol (July 1, 2009). doi:10.1152/jn.90950.2008
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90950.2008v1
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Submitted on August 21, 2008
Revised on June 23, 2009
Accepted on June 24, 2009

Modulation of stretch reflexes of the finger flexors by sensory feedback from the proximal upper limb post-stroke

Gilles Hoffmann1*, Derek G. Kamper1, Jennifer H. Kahn1, William Z. Rymer1, and Brian D Schmit2

1 Rehabilitation Institute of Chicago
2 Marquette University

* To whom correspondence should be addressed. E-mail: g-hoffman{at}northwestern.edu.

Neural coupling of proximal and distal upper limb segments may have functional implications in the recovery of hemiparesis after stroke. The goal of the present study was to investigate whether the stretch reflex response magnitude of spastic finger flexor muscles post-stroke is influenced by sensory input from the shoulder and the elbow and whether reflex coupling of muscles throughout the upper limb is altered in spastic stroke survivors. Through imposed extension of the metacarpophalangeal (MCP) joints, stretch of the relaxed finger flexors of the four fingers was imposed in ten relaxed stroke subjects under different conditions of proximal sensory input, namely static arm posture (three different shoulder/elbow postures) and electrical stimulation (surface stimulation of biceps brachii or triceps brachii, or none). Fast (300°/s) imposed stretch elicited stretch reflex flexion torque at the MCP joints and reflex electromyographic (EMG) activity in flexor digitorum superficialis. Both measures were greatest in an arm posture of 90° of elbow flexion and neutral shoulder position. Biceps stimulation resulted in greater MCP stretch reflex flexion torque. Fast imposed stretch also elicited reflex EMG activity in non-stretched heteronymous upper limb muscles, both proximal and distal. These results suggest that, in the spastic hemiparetic upper limb post-stroke, sensorimotor coupling of proximal and distal upper limb segments is involved in both the increased stretch reflex response of the finger flexors and an increased reflex coupling of heteronymous muscles. Both phenomena may be mediated through changes post-stroke in the spinal reflex circuits and/or in the descending influence of supraspinal pathways.







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