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3-D scapular kinematics and eletromiography during arm elevation in chronic hemiparesis: implications for upper limb rehabilitation

Grant number: 14/00200-2
Support type:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): June 01, 2014
Effective date (End): September 11, 2017
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Tania de Fatima Salvini
Grantee:Maíra Carolina Lixandrão
Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
Associated scholarship(s):15/16744-4 - Comparing the efficacy of anodal transcranial direct current stimulation at two locations: EEG and TMS-Derived hotspot, BE.EP.DD

Abstract

Background: Scapula abnormal movement, deficits in scapulothoracic muscle activation and force generation post-stroke can impair the stabilization of proximal arm, limiting upper limb functional capacity and cause pain in the paretic shoulder. However, no detailed study has evaluated the different aspects associated with scapula abnormal movement post-stroke. Three-dimensional (3-D) kinematic analysis associated with electromyographic (EMG) examination during upper limb movement could allow identifying and evaluating the mechanisms that affect positioning and movements of scapula post-stroke, and make a proper diagnosis of shoulder movement deficits of these individuals. This study may contribute to new scientific evidence that underlie the rehabilitation of the upper limb post-stroke. Aims: To analyze the scapula kinematic pattern and the scapulothoracic muscle activation during upper limb elevation of post-stroke subjects compared to a control group. Correlate the possible changes in these variables with paretic upper limb functionality. Methods: A kinematic assessment of 25 chronic hemiparetic and 25 control subjects matched by age and sex, during upper limb elevation in the scapular plane and in a self-selected plane, according to the individual's ability. Simultaneously, EMG signals from upper and lower trapezius, serratus anterior, and anterior and middle deltoid muscles, considered essential to arm elevation and scapular kinematics will be collected. For functional assessment of hemiparetic subjects, Fugl-Meyer assessment scale and Motor Activity Log-Brazil (MAL) questionnaire will be used. Data analysis: The kinematic and EMG data during upper limb elevation will be analyzed and compared between groups and members. Will also be evaluated correlations between kinematic variables, EMG and functionality of the paretic upper limb. For statistical analysis tests of normality and homogeneity will be used and, according to the results, parametric and nonparamentric tests, with a significance level of 0.05 will be applied. (AU)