Caractérisation biomécanique et physiologique de la cocontraction spastique dans la parésie spastique

Abstract : Spastic cocontraction, an abnormalilty of motor command that is ubiquitous in the paretic population, is one of the most disabling forms of muscle overactivity, affecting voluntary movement in spastic paresis, in the upper limb as in walking. Elucidated as a misdirection of the descending central command, spastic cocontraction is an exaggerated antagonistic contraction triggered by voluntary agonist command, which creates an opposing torque able to reverse the desired movement. Often underestimated by both clinicians and researchers, the biomechanical and physiological underpinnings of the phenomenon have been poorly characterized. This work aimed to contribute to this characterization in subjects with spastic paresis. Our experiments included: a study of responsiveness of antagonist cocontraction to changes in central command (different levels of effort) or peripheral conditions (muscle relaxed and stretched) in static paradigms (isometric); quantification of spastic cocontraction in dynamic conditions (swing phase of gait); finally an evaluation of its sensitivity to a neuromuscular blocker (botulinum toxin). The results of this work should allow clinicians to better take the phenomenon into account in their assessment and management of patients. For the biomechanical engineer and the neurophysiologist, various tools are presented, using a range of dynamometric and electromyographic indices that we hope will facilitate further researches on the phenomenon of spastic cocontraction in particular and on spastic paresis in general.
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https://pastel.archives-ouvertes.fr/pastel-00913644
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Submitted on : Wednesday, December 4, 2013 - 10:45:56 AM
Last modification on : Friday, October 4, 2019 - 1:13:50 AM

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  • HAL Id : pastel-00913644, version 1

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Mariaconceta Vinti. Caractérisation biomécanique et physiologique de la cocontraction spastique dans la parésie spastique. Sciences de l'ingénieur [physics]. Arts et Métiers ParisTech, 2012. Français. ⟨NNT : 2012ENAM0047⟩. ⟨pastel-00913644⟩

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