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Applying Stretch to Evoke Hyperreflexia in Spasticity Testing: Velocity vs. Acceleration

Lookup NU author(s): Dr Lizeth SlootORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© Copyright © 2021 Sloot, Weide, van der Krogt, Desloovere, Harlaar, Buizer and Bar-On. In neurological diseases, muscles often become hyper-resistant to stretch due to hyperreflexia, an exaggerated stretch reflex response that is considered to primarily depend on the muscle's stretch velocity. However, there is still limited understanding of how different biomechanical triggers applied during clinical tests evoke these reflex responses. We examined the effect of imposing a rotation with increasing velocity vs. increasing acceleration on triceps surae muscle repsonse in children with spastic paresis (SP) and compared the responses to those measured in typically developing (TD) children. A motor-operated ankle manipulator was used to apply different bell-shaped movement profiles, with three levels of maximum velocity (70, 110, and 150°/s) and three levels of maximum acceleration (500, 750, and 1,000°/s2). For each profile and both groups, we evaluated the amount of evoked triceps surae muscle activation. In SP, we evaluated two additional characteristics: the intensity of the response (peak EMG burst) and the time from movement initiation to onset of the EMG burst. As expected, the amount of evoked muscle activation was larger in SP compared to TD (all muscles: p < 0.001) and only sensitive to biomechanical triggers in SP. Further investigation of the responses in SP showed that peak EMG bursts increased in profiles with higher peak velocity (lateral gastrocnemius: p = 0.04), which was emphasized by fair correlations with increased velocity at EMG burst onset (all muscles: r > 0.33–0.36, p ≤ 0.008), but showed no significant effect for acceleration. However, the EMG burst was evoked faster with higher peak acceleration (all muscles p < 0.001) whereas it was delayed in profiles with higher peak velocity (medial gastrocnemius and soleus: p < 0.006). We conclude that while exaggerated response intensity (peak EMG burst) seems linked to stretch velocity, higher accelerations seem to evoke faster responses (time to EMG burst onset) in triceps surae muscles in SP. Understanding and controlling for the distinct effects of different biological triggers, including velocity, acceleration but also length and force of the applied movement, will contribute to the development of more precise clinical measurement tools. This is especially important when aiming to understand the role of hyperreflexia during functional movements where the biomechanical inputs are multiple and changing.


Publication metadata

Author(s): Sloot LH, Weide G, van der Krogt MM, Desloovere K, Harlaar J, Buizer AI, Bar-On L

Publication type: Article

Publication status: Published

Journal: Frontiers in Bioengineering and Biotechnology

Year: 2021

Volume: 8

Online publication date: 16/02/2021

Acceptance date: 29/12/2020

Date deposited: 20/02/2024

ISSN (electronic): 2296-4185

Publisher: Frontiers Media SA

URL: https://doi.org/10.3389/fbioe.2020.591004

DOI: 10.3389/fbioe.2020.591004


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Funding

Funder referenceFunder name
FWO-12R4215N
German Carl-Zeiss Foundation project HEIAGE
IWT-TBM 060799
KNAW Fund Medical Sciences (Ter Meulen Scholarship)
Netherlands Organization for Scientific Research
NWO-016.186.144
Research Foundation Flanders

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