Motor Impairment–Related Alterations in Biceps and Triceps Brachii Fascicle Lengths in Chronic Hemiparetic Stroke

Christa M. Nelson, Wendy M. Murray, Julius P.A. Dewald*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Poststroke deficits in upper extremity function occur during activities of daily living due to motor impairments of the paretic arm, including weakness and abnormal synergies, both of which result in altered use of the paretic arm. Over time, chronic disuse and a resultant flexed elbow posture may result in secondary changes in the musculoskeletal system that may limit use of the arm and impact functional mobility. This study utilized extended field-of-view ultrasound to measure fascicle lengths of the biceps (long head) and triceps (distal portion of the lateral head) brachii in order to investigate secondary alterations in muscles of the paretic elbow. Data were collected from both arms in 11 individuals with chronic hemiparetic stroke, with moderate to severe impairment as classified by the Fugl-Meyer assessment score. Across all participants, significantly shorter fascicles were observed in both biceps and triceps brachii (P <.0005) in the paretic limb under passive conditions. The shortening in paretic fascicle length relative to the nonparetic arm measured under passive conditions remained observable during active muscle contraction for the biceps but not for the triceps brachii. Finally, average fascicle length differences between arms were significantly correlated to impairment level, with more severely impaired participants showing greater shortening of paretic biceps fascicle length relative to changes seen in the triceps across all elbow positions (r = −0.82, P =.002). Characterization of this secondary adaptation is necessary to facilitate development of interventions designed to reduce or prevent the shortening from occurring in the acute stages of recovery poststroke.

Original languageEnglish (US)
Pages (from-to)799-809
Number of pages11
JournalNeurorehabilitation and Neural Repair
Volume32
Issue number9
DOIs
StatePublished - Sep 1 2018

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We would like to acknowledge funding from the American Heart Association (#14PRE20240022), Northwestern University terminal year fellowship, NIH-NIBIB (#T32EB009406), NIH R01 to Drs Dewald and Murray (#1R01HD084009-01A1), Northwestern University Department of Physical Therapy and Human Movement Sciences, and the Searle Funds of the Chicago Community Trust.

Keywords

  • fascicle length
  • muscle adaptation
  • muscle architecture
  • stroke
  • ultrasonography
  • upper extremity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Rehabilitation

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