Spasticity pp 319-332 | Cite as

Task-Dependent Spinal Inhibition in Spastic Hemiplegia

  • S. Miller
  • R. Plant
Conference paper

Abstract

In the spastic hemiplegia, which so frequently develops following stroke (Aho et al. 1980), voluntary control of the upper limb is impaired, leading to severe handicap in the performance of activities of daily living. The upper limb is held in a typical posture of retraction of the shoulder, medial rotation of the humerus, pronation of the forearm and flexion of the elbow, wrist and finger joints (Twitchell 1951; Bobath 1990; Carr and Shepherd 1990). In this posture increased tone is observed in several superficial muscles, particularly pectoralis major, biceps and the forearm flexors (Bobath 1990; Brunnstrom 1970; De Souza et al. 1980; Johnstone 1987). Attempts to make voluntary movements of the upper limb out of this posture are hampered by an inability to inhibit the increased tone of these muscles (e.g., Chan 1986; Musa 1986). This deficit of voluntary movement control illustrates a disorder of Sherrington’s principle of spinal reciprocal inhibition, in which activation of agonist muscles is normally accompanied by centrally generated inhibition, of antagonists (Sherrington 1906). In fact, when movement is initiated voluntarily, reciprocal inhibition of antagonist muscles occurs in advance of the activation of the agonist muscles (Symoyama and Tanaka 1974).

Keywords

Sine Hemiplegia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Aho K, Harmsen P, Hatano S, Marquardsen J, Smirnov VE, Strasser T (1980) Cerebrovascular disease in the community: results of a WHO collaborative study. Bull WTTO 58:113–130Google Scholar
  2. Ashby P, McCrea DA (1987) Neurophysiology of spinal spasticity. In: Davidoff RA (ed) Handbook of the spinal cord. Dekker, New York, pp 119–143Google Scholar
  3. Bobath B (1990) Adult hemiplegia: evaluation and treatment. Heinemann, LondonGoogle Scholar
  4. Brunnstrom S (1970) Movement therapy in hemiplegia. Harper and Row, New YorkGoogle Scholar
  5. Burke D (1985) Mechanisms underlying the tendon jerk and H-reflex. In: Delwaide PJ, Young RR (eds) Clinical neurophysiology in spasticity. Elsevier Amsterdam, pp 55–93Google Scholar
  6. Burke D, Hagbarth KE, Lofstedt L, Wallin BG (1976) The responses of muscle spindle endings to vibration in non-contracting muscles. J Physiol (Lond) 261:673–693Google Scholar
  7. Carr JH, Shepherd RB (1982) A motor relearning programme for stroke. Heinemann, LondonGoogle Scholar
  8. Carr JH, Shepherd RB (1990) A motor learning model for rehabilitation of the movement disabled. In: Ada L, Canning C (eds) Key issues in neurological physiotherapy. Butterworth and Heinemann, Oxford, pp 1–24Google Scholar
  9. Chan CWY (1986) Some techniques for the relief of spasticity and their physiological basis. Physiother Can 38:85–89Google Scholar
  10. Cheung Y (1984) The examination of human stretch reflexes: an engineering approach. PhD thesis, Newcastle upon Tyne UniversityHBKGoogle Scholar
  11. Cheung Y, Cozens A, Hammond GR, Miller S, Veitch ME (1983) Amplitude modulated pseudo-random excitation of stretch reflexes in arm and trunk muscles in normal subjects and stroke patients. J Physiol (Lond) 345:102PGoogle Scholar
  12. Crone C, Hultborn H, Jespersen B, Nielsen J (1987) Reciprocal la inhibition between ankle flexors and extensors in man. J Physiol (Lond) 389:163–185Google Scholar
  13. De Souza LH, Langton Hewer R, Miller S (1980) Assessment of recovery of arm control in hemiplegic stroke patients. I. Arm function tests. Int Rehabil Med 2:3–9Google Scholar
  14. Feldman AG, Orlovsky GM (1974) Activity of interneurones mediating reciprocal la inhibition during locomotion. Brain Res 84:181–194CrossRefGoogle Scholar
  15. Goff B (1972) The application of recent advances in neurophysiology to Miss Rood’s concept of neuromuscular facilitation. Physiotherapy 62(11):358–361Google Scholar
  16. Gordon J (1990) Disorders of motor control. In: Ada L, Canning C (eds) Key issues in neurological physiotherapy. Butterworth and Heinemann, Oxford, pp 25–50Google Scholar
  17. Hammond GR, Miller S, Robertson PM (1982) Central nervous control of arm movement in stroke patients. In: Sjolund B, Bjorklund A (eds) Brain stem control of spinal mechanisms. Elsevier North Holland, Amsterdam, pp 323–330 (Erik Fernstrom symposium 1)Google Scholar
  18. Hultborn H (1976) Transmission in the pathway of reciprocal la inhibition to motoneurones and its control during the tonic stretch reflex. In: Homma S (ed) Understanding the stretch reflex. Prog Brain Res 44:235–255Google Scholar
  19. Hultborn H, Jankowska E, Lindstrom S (1971) Recurrent inhibition from motor axon collaterals of transmission in the la inhibitory pathways to motoneurones. J Physiol (Lond) 215:591–612Google Scholar
  20. Lies JF (1986) Reciprocal inhibition during agonist and antagonist contraction. Exp Brain Res 62:212–214Google Scholar
  21. Johnson SW, Lynn PA, Miller S, Reed GAL (1977) Miniature skin mounted preamplifiers for measurement of surface electromyographic potentials. Med Biol Eng Comput 15:710–711PubMedCrossRefGoogle Scholar
  22. Johnstone M (1987) Restoration of motor function in the stroke patient. Churchill Livingstone, EdinburghGoogle Scholar
  23. Katz R, Penicaud A, Rossi A (1991) Reciprocal la inhibition between elbow flexors and extensors in the human. J Physiol (Lond) 437:269–286Google Scholar
  24. Musa I (1986) Recent findings on the neural control of locomotion: implications for the rehabilitation of gait. In: Banks M (ed) Stroke. Churchill Livingstone, Edinburgh, pp 79–89Google Scholar
  25. Pierrot-Deseilligny E, Mazieres L (1985) Spinal mechanisms underlying spasticity. In: Delwaide PJ, Young RR (eds) Clinical neurophysiology in spasticity. Elsevier, AmsterdamGoogle Scholar
  26. Plant RD, Miller S (1990) Short latency inhibitory reflexes in shoulder and trunk muscles in spastic hemiplegia. In: Berardelli A, Benecke R, Manfredi M, Marsden CD (eds) Motor disturbances II. Academic, London, pp 367–378Google Scholar
  27. Rood MS (1956) Neurophysiological mechanisms utilised in the treatment of neuromuscular dysfunction. Am J Occup Ther 4(l):220–225Google Scholar
  28. Rossi A, Mazzocchio R, Scarpini C (1988) Changes in la reciprocal inhibition from the peroneal nerve to the soleus alpha-motoneurons with different static body positions in man. Neurosci Lett 84:283–286PubMedCrossRefGoogle Scholar
  29. Sherrington CS (1906) The integrative action of the nervous system. Yale University Press, New Haven (Silliman Memorial Lectures)Google Scholar
  30. Symoyama M, Tanaka R (1974) Reciprocal la inhibition at the onset of voluntary movements in man. Brain Res 82:334–337CrossRefGoogle Scholar
  31. Tanaka R (1983) Reciprocal la inhibitory pathway in normal man and in patients with motor disorders. In: Desmedt JE (ed) Motor control mechanisms in health and disease. Raven, New YorkGoogle Scholar
  32. Tanji J, Taniguchi K (1976) Presetting excitability of the spinal la inhibitory pathway in relation to the direction of an intended movement. Neurosci Lett 3:321–327PubMedCrossRefGoogle Scholar
  33. Twitchell TE (1951) The restoration of motor function following hemiplegia in man. Brain 74:443–480PubMedCrossRefGoogle Scholar
  34. Yanasigawa N, Tanaka R, Ito Z (1976) Reciprocal la inhibition in spastic hemiplegia of man. Brain 99:555–574CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • S. Miller
    • 1
  • R. Plant
    • 2
  1. 1.Division of Clinical Neuroscience, The Medical SchoolThe University of Newcastle upon TyneNewcastle upon TyneUK
  2. 2.Institute of Health SciencesUniversity of Northumbria at NewcastleNewcastle upon TyneUK

Personalised recommendations