Motor Evoked Potential In The Rehabilitation Of Hemiplegic Patients

Abstract

Hemiparesis is the most common disability after stroke, affecting about 80% of patients acutely and more than 40% chronically.O) Voluntary movement control is typically impaired after a stroke. Movement control of the body on the contralateral side of the brain lesion proceeds through stages of recovery in which the sensory and motor function are often reestablished abnom1ally.(2)

In the upper extremity, after a period of flaccidity, a common course of recovery includes the development of uncontrolled flexion synergy. This pathological synergy· is observed in the hemiparetic limb during efforts to use the arm for functional tasks. Individuals with this uncontrolled flexion synergy have great difficulty isolating joint movements out of synergy.<2 3

As the months after stroke accumulate into years,

individuals accept the chronic motor problems and attempt to

cotnpensate for the losses.<2

Wolf et al (4

argued that individuals

with upper extremity motor problems display behaviors that indicate learned non-use. The affected arm is not used for any voluntary movements, whereas the unaffected arm attempts to execute all of the motor actions required for daily living