İnmeli Bireylerde Fonksiyonel Hedef Varlığının Kas Aktivasyonu ve Hareket Yörüngeleri Üzerine Olan Etkilerinin İncelenmesi

Abstract

Investigation of the Effects of Functional Target Presence on Muscle Activation and Movement Patterns in Individuals with Stroke, Hacettepe University Graduate School of Health Sciences, Neurology Physiotheraphy Programme Master Of Science Thesis, Ankara, 2024. This research was planned to examine the effects of presence of a functional target added to shoulder elevation on muscle activations and movement trajectories in stroke patients. 18 patient with stroke whose mean age of 55.22±6.47 years and 14 healthy individuals whose mean age of 50.92±11.00 years were included. Upper extremity muscle tone was assessed with the Modified Ashwort Scale, cognitive status with the Standardized Mini Mental Test and upper extremity functional state with Fugl Meyer Upper Extremity Assessment. After the evaluations, the individuals were asked to raise their hands to the level of the prepared apparatus by first doing 60° and then 90° arm elevation in front of the prepared apparatus. At the same times, simultaneous electromyography measurements were taken from the upper trapezius (UT), anterior deltoid (AD), biceps brachii (BB) and triceps brachii (TB) muscles of the individuals while performing 60° shoulder elevation. Then, a water bottle was placed on the shelf system in front of them and the individuals were asked to raise their arms and reach for the bottle to drink the water and the measurement was repeated. The same procedure was repeated for 90° shoulder elevation. While the measurements were taken, kinematic analysis was performed simultaneously to track movement trajectories and analyze the angular velocity of the shoulder. As a result of the research, it was found that the activation onset times of the UT, AD ve BB muscles of stroke patients were shifted earlier, especially in the 90° shoulder elevation condition when the function was loaded, compared to the non-function condition (p<0,05). Compared to healthy individuals, it was found that the muscle activation levels of UT, AD and BB muscles were higher in 60° and 90° shoulder elevations; the contraction times of TB muscles in 60° shoulder elevation when there was no function, UT and BB muscles when there was no function and TB muscles when there was function in 90° elevation were later (p<0.05). The results of our study showed that the muscles in stroke patients started to contract earlier to approach normal under the condition of function loading and completed the activity with less effort in some muscles for the same activity. Functional loading of the movement has shown that the muscles participate in the movement with more normal timing and angular velocity, thus supporting that the preference of function-based exercise approaches will provide more patient gains.