Clinical trial NCT04181151: Investigation of Activation of Latissimus Dorsi Muscle Segments During Functional Reach Activity in Chronic Stroke Patients
Official title: Investigation of Activation of Latissimus Dorsi Muscle Segments During Functional Reach Activity in Chronic Stroke Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Stroke
Keywords: latissimus dorsi
stroke
electromyography
reaching activity
muscle activation
Lead sponsor: Hacettepe University
Sponsor class: OTHER
First posted: 2019-11-29
Enrollment: 12
Sex: ALL
Minimum age (years): 30
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Hacettepe University Neurological Rehabilitation Unit

Brief summary: Latissimus Dorsi (LD); Medial sacrum, lumbar vertebrae and lower thoracic vertebrae 10-12 lateral to the spinous processus. It is a fan-like wide muscle that connects to the inferior angle of the scapula and ribs, adheres to the anterior surface of the proximal humerus and continues with aponeurosis of the contralateral Gluteus Maximus below. The activation of the LD muscle during the functional reach activity, which we use most frequently in daily living activities, affects the upper extremity and trunk movements. Therefore it is important muscle that affects the quality of movement.

The study include individuals with stroke that diagnosed by the neurologist and include healthy subjects. During sitting activity, they will be required to reach three different distances in the sagittal and scapular plane: arm length, 125% of the arm length and end point where it can reach the modified functional reach test. During the activity, electromyography (EMG) activation of latissimus dorsi, anterior deltoid and erector spina muscles will be examined with electromyographic device.

Hypothesis originating from the investigation:

H1: Latissimus dorsi muscle segments show different activation during functional reach activity.

H2: Activation of latissimus dorsi muscle segments is affected by reaching direction during functional reach activity.

H3: Activation of latissimus dorsi muscle segments is affected by reaching distance during functional reach activity.

Detailed description: Measurements will be made during the sitting activity of the individuals included in the study. Individuals will be asked to reach midsternal height cups in two separate planes, sagittal and scapular, at arm's end, 125% of arm's distance and end point where it can reach according to modified functional reach test.

Muscle activation of latissimus dorsi, erector spina and anterior deltoid muscles will be measured by superficial electromyographic measurement. Muscle activation according to SENIAM for erector spina and anterior deltoid will be evaluated. For latissimus dorsi, activation will be measured in six segments separated according to anatomic dissection.

Reach activity will be performed 3 times on each side and at 1 minute intervals.

Eligibility criteria: Inclusion Criteria:

* diagnosed with stroke by a neurologist
* least 6 mounts after stroke
* Fugl Meyer Upper Extremity Motor Rating Scale with a value of 40 and above,
* independent sitting,
* Mini Mental Status Scale (MMSE)\> 24,
* 30-67 age.

Exclusion Criteria:

* neurodegenerative disease other than stroke
* presence of neglect
* presence of apraxia
* uncorrected visual impairment
* neuromusculoskeletal pathologies
* neck and shoulder pain lasting more than 3 months

Primary outcomes:
measure: Surface electromyographic measurement
timeFrame: 90 minutes
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Hacettepe University
state: Sıhhiye/ANKARA
Study officials:
affiliation: Hacettepe University
name: Tuba KAYA, R.A.
role: PRINCIPAL_INVESTIGATOR
affiliation: Hacettepe University
name: Sevil BİLGİN, Assoc. Prof.
role: STUDY_DIRECTOR
affiliation: Hacettepe University
name: Muhammed KILINÇ, Assoc. Prof.
role: STUDY_CHAIR
affiliation: Hacettepe University
name: Esra DÜLGER, R.A.
role: STUDY_CHAIR
References:
citation: Bogduk N, Johnson G, Spalding D. The morphology and biomechanics of latissimus dorsi. Clin Biomech (Bristol). 1998 Sep;13(6):377-385. doi: 10.1016/s0268-0033(98)00102-8.
citation: Dickstein R, Shefi S, Marcovitz E, Villa Y. Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients. Arch Phys Med Rehabil. 2004 Feb;85(2):261-7. doi: 10.1016/j.apmr.2003.05.011.
citation: Wickham JB, Brown JM. Muscles within muscles: the neuromotor control of intra-muscular segments. Eur J Appl Physiol Occup Physiol. 1998 Aug;78(3):219-25. doi: 10.1007/s004210050410.
citation: Brown JM, Wickham JB, McAndrew DJ, Huang XF. Muscles within muscles: Coordination of 19 muscle segments within three shoulder muscles during isometric motor tasks. J Electromyogr Kinesiol. 2007 Feb;17(1):57-73. doi: 10.1016/j.jelekin.2005.10.007. Epub 2006 Feb 2.
citation: Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000 Oct;10(5):361-74. doi: 10.1016/s1050-6411(00)00027-4.