Antagonist Activation Measurement at the Ankle Using High-density and Bipolar Surface EMG in Chronic Hemiparesis

Study Overview
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Brief Summary
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In chronic hemiparesis, abnormal antagonist muscle activation in the paretic lower limb contributes to impair ambulation capacities. A biased estimate of antagonist muscle activation when using surface bipolar EMG compared with high-density (HD) EMG has been previously reported in healthy subjects. The present study compares muscles cocontraction at the paretic ankle estimated with a pair of and multi-channel surface EMG.

Detailed Description
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In chronic hemiparesis, gait velocity deficit is associated with a disturbed voluntary movement caused especially by inappropriate antagonist muscle activation. The present study investigates muscles cocontraction at the paretic ankle estimated with a pair of and multi-channel surface EMG (HD-EMG) in patients after stroke. HD-EMGs were collected from gastrocnemius medialis (GM), tibialis anterior (TA) and soleus (SO) during isometric contractions. From these EMGs the study asked whether bipolar and HD-EMGs provided comparable estimates of antagonist activation. Two active contraction levels (submaximal vs. maximal) and knee positions (flexed vs. extended) were assessed for each muscle. Notwithstanding the evidence of localized antagonist activation in the GM muscle of healthy subjects, hypothesizing equally localized antagonist activation in the paretic limb may not follow from the current literature. In virtue of evidence supporting the enlargement of motor unit territories in paretic and hyperactive muscles, it may be that stroke survivors have lost their ability to regionally and appropriately activate their muscle. In this case, bipolar and HD-EMG would be expected to provide comparable antagonist activation coefficients.

Official Title
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Antagonist Activation Measurement at the Ankle Using High-density and Bipolar Surface EMG in Chronic Hemiparesis

Conditions
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Stroke, Muscle Hypertonia, Spasticity, Muscle

Intervention / Treatment
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* Diagnostic Test: Electromyographic measurements


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: hemiparesis due to a non-evolutive central nervous system lesion time since lesion ≥ 6 months ability to walk 10 meters barefoot without any assistance cognitive abilities to understand the verbal instructions for the test according to the investigator's judgment absence of botulinum toxin injections within the last 3 months prior to enrolment Exclusion Criteria: botulinum toxin injections within the last 3 months prior to enrolment

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Electromyographic measurements|HD and bipolar EMG were assessed from gastrocnemius medialis (GM), soleus (SO) and tibialis anterior (TA) at seated position, ankle at 0°, during isometric submaximal effort and maximal effort, knee flexed (90°) and knee extended (0°)|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coefficient of ANtagonist activation | The Coefficient of ANtagonist activation of 3 muscles was calculated by the ratio between the root mean square amplitude during antagonist effort and maximal agonist effort for the same muscle. | 5 seconds |