Article

Post-stroke hemiparesis may manifest as asymmetric gait, poor balance,
and inefficient movement patterns. We investigated improvements in lower-limb
muscle activation and function during Wii-based Movement Therapy (WMT), a
rehabilitation program specifically targeting upper-limb motor-function. METHODS:
Electromyography (EMG) was recorded bilaterally from tibialis anterior (TA) in 20
stroke patients during a 14-day WMT program. EMG amplitude and burst duration
were analyzed during stereotypical movement sequences of WMT activities.
Functional movement ability was assessed pre- and post-therapy including 6-min
walk test (6MWT), stair-climbing speed, and Wolf Motor Function Test timed-tasks.
RESULTS: TA EMG burst duration during Wii-golf increased by 30% on the
more-affected side (p = 0.04) and decreased by 28% on the less-affected side.
Patients who did not step during Wii-tennis had a 16% decrease in more-affected
TA burst sum (p = 0.047) resulting in more symmetrical activation ratio at
late-therapy, with the ratio changing from 3.24 +/- 2.25 to 0.99 +/- 0.11 (p =
0.047). Six-minute walk and stair-climbing speed improved (p = 0.005 and 0.03,
respectively), as did upper-limb movement (p </= 0.001). CONCLUSION: This study
provides physiological evidence for lower-limb improvements with WMT. Different
patterns of muscle activation changes were evident across the WMT activities.
Despite the relatively good pre-therapy lower-limb function, muscle activation
and symmetry improved significantly with upper-limb WMT. Implications for
rehabilitation WMT is an upper-limb neurorehabilitation program that also
improves lower-limb motor-function. We report a shift towards more symmetrical
muscle activation of tibialis anterior on the more- and less-affected sides that
were reflected in increased distance walked during the 6MWT. The use of standing
during therapy not only improves lower-limb function but also permits larger and
more powerful upper-limb movements. Targeted upper-limb rehabilitation can also
significantly improve mobility and balance, whether dynamic or static, that
should reduce the risk of falls post-stroke.

Langue : ANGLAIS