The pattern of EMG change by late therapy was complex and variable, with differences between patients with low compared to moderate or high motor-function levels. Clinical assessments improved over time (p < 0.01) with an effect of motor-function level (p < 0.001). Clinical assessments of upper limb motor-function pre- and post-therapy included the Wolf Motor Function Test, Fugl-Meyer Assessment and Motor Activity Log Quality of Movement scale. The area under the curve was calculated from EMG amplitude and movement duration. Patients were classified according to residual voluntary motor capacity with low, moderate, or high motor-function levels. Electromyography (EMG) was recorded from five upper limb muscles on the more-affected side of 24 patients during early and late therapy sessions of an intensive 14-day program of Wii-based Movement Therapy (WMT) and for a subset of 13 patients at 6-month follow-up. This study investigated changes in muscle activation patterns to understand therapy-induced improvements in motor-function in chronic stroke compared to clinical assessments and to identify the effect of motor-function level on muscle activation changes.
Poststroke weakness on the more-affected side may arise from reduced corticospinal drive, disuse muscle atrophy, spasticity, and abnormal coordination. Negin Hesam-Shariati, Terry Trinh, Angelica Thompson Butel, Christine T Shiner and Penelope A McNulty
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