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Deficits in Spatial Threshold Control of Muscle Activation as a Window for Rehabilitation After Brain Injury

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Book cover Progress in Motor Control

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 826))

Abstract

Recovery of voluntary control of movement is the main goal of rehabilitation. Despite numerous studies aimed at identifying the most effective rehabilitation interventions, attempts to improve poststroke upper limb recovery remain disappointing: Sensorimotor deficits of the arm and hand persist in a large proportion of stroke survivors (up to 62 %). Indeed, efforts to improve upper limb recovery have been hampered by the lack of understanding of the neural mechanisms underlying spasticity, muscle weakness, and altered kinematic redundancy. Spasticity refers to the presence of hyperactive velocity-dependent stretch reflexes and is associated with disorders of upper motor neurons following central nervous system (CNS) injury such as stroke. Since it is associated with disruption of upper motor neuron function, those with spasticity typically also have weakness and decreased control of voluntary movements. Despite intensive research into these phenomena, the nature of the relationship and neural mechanisms underlying spasticity, weakness, and voluntary control remains unclear. This chapter will describe a new approach to the understanding of this relationship based on deficits in (1) the ability of the damaged CNS to control spatial thresholds (STs) of reflexes and (2) the residual capacity of corticospinal pathways to regulate STs across different regions of the arm workspace in poststroke subjects at rest and during voluntary movement. This approach is driven by recent evidence that, rather than directly specifying motor commands to muscles, the corticospinal system resets STs of reflexes to generate and control voluntary movement.

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  1. School of Physical and Occupational Therapy, McGill University, 3654 Promenade SirWilliam Osler, Montreal, QC, H3G 1Y5, Canada

    Mindy F. Levin

  2. Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital, Laval, QC, Canada

    Mindy F. Levin

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Levin, M. (2014). Deficits in Spatial Threshold Control of Muscle Activation as a Window for Rehabilitation After Brain Injury. In: Levin, M. (eds) Progress in Motor Control. Advances in Experimental Medicine and Biology, vol 826. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1338-1_14

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