The Investigation of the Pre-movement Facilitation of Agonist-antagonist Muscles and the Effect of the Feedforward Rehabilitation in Individuals With Hypermetria

Study Overview
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Brief Summary
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In individuals with spino-cerebellar atrophy (SCA), the delayed onset of antagonist muscle firing has been reported to be the cause of hypermetria. Hypermetria is a common deficit in individuals with spino-cerebellar atrophy SCA when they perform ballistic goal-directed movement. Based on the previous studies, ballistic goal-directed movements are controlled by a triphasic pattern of agonistic and antagonistic muscle activation. The origin of the EMG pattern is a central program, whereas the delayed onset of antagonistic muscle firing has been reported to be the cause of hypermetria. To develop a therapy method, the difference in temporal pattern and intensity of supraspinal excitability of agonist and antagonist bursts between healthy adults and individuals with SCA when performing rapid and slow goal-directed movements should be further investigated. Traditional rehabilitations of individuals with cerebellum lesion were limited to improve the functional performance of movement. Since the deficits of the goal-directed movement are at pre-movement programming, only feedforward training will be possible to re-establish an appropriate program. Previous showed that peripheral stimulation resulted in a facilitation of motor cortex. Our group also found that this facilitation in individuals with SCA was similar to the ones without SCA. Therefore, it is possible to adjust the control pattern of supraspinal excitability of agonist and antagonist busts of SCA patient with passively providing electrical stimulation contains normal control pattern of healthy human. The present study sought to investigate the difference in temporal pattern and intensity of supraspinal excitability of agonist and antagonist bursts between healthy adults and individuals with SCA when performing rapid and slow goal-directed movements.

Conditions
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Spinocerebellar Atrophy (SCA)

Intervention / Treatment
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* Other: Temporal electrical stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of spinocerebellar ataxia

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: health group 1<br>Health subjects received 30 mins delay antagonist activation temporal ES. | Other: Temporal electrical stimulation<br> <br> |
| Experimental: SCA group 1<br>SCA subjects received four weeks temporal ES assisted home training program. | Other: Temporal electrical stimulation<br> <br> |
| No Intervention: health group 2<br>health subjects controlled group | |
| No Intervention: SCA group 2<br>SCA subjects controlled group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle evoked potential(MEP) | Measure of changes in MEP of flexor carpi radialis. | Baseline, 4 weeks. | 
| Electromyography(EMG) | Measure of changes in EMG of flexor carpi radialis and extensor carpi radialis. | Baseline, 4 weeks | 
| Movement error | Measure of changes in movement error during fast 30 degrees wrist extensions. | Baseline, 4weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pre-movement facilitation, Fast goal directed movement, Triphasic EMG pattern, Temporal electrical stimulation,, Spinocerebellar Ataxia