Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks

Cervical spinal cord injuries (cSCI) severely affect upper limb function, yet research on post-injury neuromotor abilities is limited. In response, we developed an assessment integrating clinical, kinematic and muscle activity measures. Twelve cSCI (C5-C7) and six unimpaired participants underwent a...

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Main Authors: Amy Bellitto, Alice de Luca, Simona Gamba, Luca Losio, Antonino Massone, Maura Casadio, Camilla Pierella
Format: Article
Language:English
Published: IEEE 2024-01-01
Series:IEEE Access
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Online Access:https://ieeexplore.ieee.org/document/10676964/
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author Amy Bellitto
Alice de Luca
Simona Gamba
Luca Losio
Antonino Massone
Maura Casadio
Camilla Pierella
author_facet Amy Bellitto
Alice de Luca
Simona Gamba
Luca Losio
Antonino Massone
Maura Casadio
Camilla Pierella
author_sort Amy Bellitto
collection DOAJ
description Cervical spinal cord injuries (cSCI) severely affect upper limb function, yet research on post-injury neuromotor abilities is limited. In response, we developed an assessment integrating clinical, kinematic and muscle activity measures. Twelve cSCI (C5-C7) and six unimpaired participants underwent a clinical (Range Of Motion and Manual Muscle tests) and an instrumented assessment. During the latter, bilateral upper body kinematics and muscle activity were recorded as participants performed a set of unilateral movements, i.e. reaching movements toward different heights-directions and an object transfer along an arch-shaped structure (arc task). Kinematics and neuromuscular indicators were analyzed following a two-tiered approach: comparing unimpaired and cSCI and differentiating more and less impaired arms within the cSCI cohort based on their ability to complete the arc task. Clinical tests revealed shoulder mobility and strength limitations in cSCI participants, with a significant weakness in elbow extension noted in more impaired arms. The instrumented assessment revealed reduced movement speed, smoothness and accuracy in the cSCI cohort, primarily due to weaknesses in the pectoralis muscle affecting contralateral movements and deltoids affecting ipsilateral movements. Muscle activations were detected in the non-moving arm of cSCI participants, particularly noticeable during movements toward greater heights or in a contralateral direction. The pronounced weakness in the pectoralis muscle of the more impaired cSCI arms explained the related ability to complete only 28% of the arc task. Our findings provide a thorough insight into changes in upper limb neuromotor function following cSCI, underscoring motor deficits and related alterations in bilateral muscle activity.
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spelling doaj-art-e2193cff4f3a4cc19dfbf169fad32e882025-08-20T02:12:30ZengIEEEIEEE Access2169-35362024-01-011213626313627910.1109/ACCESS.2024.345785710676964Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral TasksAmy Bellitto0https://orcid.org/0000-0002-5085-6689Alice de Luca1Simona Gamba2Luca Losio3Antonino Massone4Maura Casadio5https://orcid.org/0000-0003-2338-8995Camilla Pierella6Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, Genoa, ItalyDepartment of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, Genoa, ItalySpinal Cord Unit, Santa Corona Hospital, ASL 2 Savonese, Pietra Ligure, Savona, ItalySpinal Cord Unit, Santa Corona Hospital, ASL 2 Savonese, Pietra Ligure, Savona, ItalySpinal Cord Unit, Santa Corona Hospital, ASL 2 Savonese, Pietra Ligure, Savona, ItalyDepartment of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, Genoa, ItalyDepartment of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, Genoa, ItalyCervical spinal cord injuries (cSCI) severely affect upper limb function, yet research on post-injury neuromotor abilities is limited. In response, we developed an assessment integrating clinical, kinematic and muscle activity measures. Twelve cSCI (C5-C7) and six unimpaired participants underwent a clinical (Range Of Motion and Manual Muscle tests) and an instrumented assessment. During the latter, bilateral upper body kinematics and muscle activity were recorded as participants performed a set of unilateral movements, i.e. reaching movements toward different heights-directions and an object transfer along an arch-shaped structure (arc task). Kinematics and neuromuscular indicators were analyzed following a two-tiered approach: comparing unimpaired and cSCI and differentiating more and less impaired arms within the cSCI cohort based on their ability to complete the arc task. Clinical tests revealed shoulder mobility and strength limitations in cSCI participants, with a significant weakness in elbow extension noted in more impaired arms. The instrumented assessment revealed reduced movement speed, smoothness and accuracy in the cSCI cohort, primarily due to weaknesses in the pectoralis muscle affecting contralateral movements and deltoids affecting ipsilateral movements. Muscle activations were detected in the non-moving arm of cSCI participants, particularly noticeable during movements toward greater heights or in a contralateral direction. The pronounced weakness in the pectoralis muscle of the more impaired cSCI arms explained the related ability to complete only 28% of the arc task. Our findings provide a thorough insight into changes in upper limb neuromotor function following cSCI, underscoring motor deficits and related alterations in bilateral muscle activity.https://ieeexplore.ieee.org/document/10676964/Spinal cord injuryunilateral arm movementsurface electromyographymuscle synergiesspinal maps
spellingShingle Amy Bellitto
Alice de Luca
Simona Gamba
Luca Losio
Antonino Massone
Maura Casadio
Camilla Pierella
Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
IEEE Access
Spinal cord injury
unilateral arm movement
surface electromyography
muscle synergies
spinal maps
title Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
title_full Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
title_fullStr Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
title_full_unstemmed Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
title_short Neuromotor Changes After a Cervical Spinal Cord Injury: Bilateral Assessment of Unilateral Tasks
title_sort neuromotor changes after a cervical spinal cord injury bilateral assessment of unilateral tasks
topic Spinal cord injury
unilateral arm movement
surface electromyography
muscle synergies
spinal maps
url https://ieeexplore.ieee.org/document/10676964/
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