Investigation of Upper Limb Kinematics and Corticospinal Pathway Activity Early After Stroke

Collins, Kathryn (2016) Investigation of Upper Limb Kinematics and Corticospinal Pathway Activity Early After Stroke. Doctoral thesis, University of East Anglia.

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Abstract

Abstract
Reach-to-grasp is an essential part of activities of daily living (ADL’s); despite rehabilitation reach-to-grasp often impaired after a stroke contributing to disability. Upper limb rehabilitation interventions need improvement. A deeper understanding of underlying kinematic characteristics and the neural correlates of movement can be achieved through neuro-biomechanical assessment. This would provide knowledge of the interaction of the nervous and musculoskeletal system, which may contribute to development of improved targeted upper limb interventions.
A systematic review and meta-analysis was conducted investigating the kinematic differences in reach-to-grasp between stroke survivors and neurologically intact adults. The results indicate stroke survivors consistently demonstrate different kinematics to neurologically intact adults during reach-to-grasp in the central and ipsilateral workspace. There was heterogeneity of the reach-to-grasp task, and included studies demonstrated unclear or high potential risk of bias.
A test-retest reliability study investigated transcranial magnetic stimulation (TMS) measures of corticospinal pathway excitability in the bilateral biceps, extensor carpi radialis (ECR), and abductor pollicis brevis (APB) in neurologically intact adults. The results demonstrate variable reliability; the lower end of the confidence interval was below acceptable reliability (ICC < 0.70) for many measures. The 95% confidence intervals (CI) and 95% limits of agreement (LOA) were wide, further indicating imprecision in measurement.
A test-retest reliability study investigated TMS measures of corticospinal pathway excitability in the bilateral biceps, ECR and APB in stroke survivors within three months after stroke. The results demonstrate variable reliability; and the lower end of the confidence interval was below the range of acceptable reliability (ICC < 0.70) for many measures. The 95% CI and 95% LOA were wide, further indicating imprecision in measurement.
Investigations into the variability of TMS measures in sub-acute stroke survivors and neurologically intact adults; as well as specificity of TMS measurement warrant future investigations to determine the use of TMS within these populations.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Rehabilitation Sciences (former - to 2014)
Depositing User:	Users 7376 not found.
Date Deposited:	22 Jun 2016 09:10
Last Modified:	22 Jun 2016 09:10
URI:	https://ueaeprints.uea.ac.uk/id/eprint/59448
DOI:

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