Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Does Limited Dorsiflexion during Swing Phase in Hemiparesis Depend on Spasticity?

Maria Vinti
* ,
Mathias Blandeau
* ORCID logo ,
Hélène Pillet
,
Wafa Skalli
,
Philippe Decq
,
Andrea Merlo
,
Jean-Michel Gracies
,
Nicolas Bayle
,
Mouna Ghédira
,
Emilie Hutin
ORCID logo
Version 1 : Received: 16 February 2024 / Approved: 18 February 2024 / Online: 19 February 2024 (11:48:54 CET)

How to cite: Vinti, M.; Blandeau, M.; Pillet, H.; Skalli, W.; Decq, P.; Merlo, A.; Gracies, J.; Bayle, N.; Ghédira, M.; Hutin, E. Does Limited Dorsiflexion during Swing Phase in Hemiparesis Depend on Spasticity?. Preprints 2024, 2024020932. https://doi.org/10.20944/preprints202402.0932.v1 Vinti, M.; Blandeau, M.; Pillet, H.; Skalli, W.; Decq, P.; Merlo, A.; Gracies, J.; Bayle, N.; Ghédira, M.; Hutin, E. Does Limited Dorsiflexion during Swing Phase in Hemiparesis Depend on Spasticity?. Preprints 2024, 2024020932. https://doi.org/10.20944/preprints202402.0932.v1

Abstract

Plantar flexors (PF) spasticity is known to poorly correlate with active dorsiflexion (DF) impairment throughout the swing phase of hemiparetic gait. Spastic Cocontraction, instead, stemming from descending pathways, potentially misdirect antagonist PF activity opposing DF during swing. Electromyographic (EMG) recordings, while unable to differentiate between reflex-based and descending origins, may offer valuable insights into this distinction by exploring PF EMG activity after tibial nerve neurotomy (which eliminates PF spasticity). Eleven subjects with hemiparesis walking at comfortable velocity and 11 controls walking at comfortable and slow velocity, underwent kinematic and PF/DF EMG analysis. Five of the hemiparetic subjects underwent tibial neurotomy >1 year prior. We evaluated spasticity at rest (Tardieu scale), maximal ankle dorsiflexion, tibialis anterior agonist recruitment and gastrocnemius medialis and soleus cocontraction coefficients during swing. At slow velocity, controls (0.80±0.12 m/s) moved at a similar pace as hemiparetic subjects (0.73±0.37 m/s, NS). Hemiparetic subjects showed: (i) reduced ankle DF across swing (ii) increased PF cocontraction, including before any DF (iii) higher cocontraction despite absent spasticity in tibial neurotomy subjects (iv) higher tibialis anterior recruitment. Increased PF cocontraction occurs in the absence of spasticity or ankle DF despite higher agonist recruitment. Spastic cocontraction is a major factor limiting active DF at swing, unlike spasticity.

Keywords

Hemiparesis; Spastic cocontraction; Electromyography; Gastrocnemius; Soleus; Tibial nerve neurotomy

Subject

Biology and Life Sciences, Anatomy and Physiology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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