Investigation of Activation of Latissimus Dorsi Muscle Segments During Functional Reach Activity in Chronic Stroke Patients

Latissimus Dorsi (LD); Medial sacrum, lumbar vertebrae and lower thoracic vertebrae 10-12 lateral to the spinous processus. It is a fan-like wide muscle that connects to the inferior angle of the scapula and ribs, adheres to the anterior surface of the proximal humerus and continues with aponeurosis of the contralateral Gluteus Maximus below. The activation of the LD muscle during the functional reach activity, which we use most frequently in daily living activities, affects the upper extremity and trunk movements. Therefore it is important muscle that affects the quality of movement.

The study include individuals with stroke that diagnosed by the neurologist and include healthy subjects. During sitting activity, they will be required to reach three different distances in the sagittal and scapular plane: arm length, 125% of the arm length and end point where it can reach the modified functional reach test. During the activity, electromyography (EMG) activation of latissimus dorsi, anterior deltoid and erector spina muscles will be examined with electromyographic device.

Hypothesis originating from the investigation:

H1: Latissimus dorsi muscle segments show different activation during functional reach activity.

H2: Activation of latissimus dorsi muscle segments is affected by reaching direction during functional reach activity.

H3: Activation of latissimus dorsi muscle segments is affected by reaching distance during functional reach activity.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Other: Electromyographic device

Detailed Description

Measurements will be made during the sitting activity of the individuals included in the study. Individuals will be asked to reach midsternal height cups in two separate planes, sagittal and scapular, at arm's end, 125% of arm's distance and end point where it can reach according to modified functional reach test.

Muscle activation of latissimus dorsi, erector spina and anterior deltoid muscles will be measured by superficial electromyographic measurement. Muscle activation according to SENIAM for erector spina and anterior deltoid will be evaluated. For latissimus dorsi, activation will be measured in six segments separated according to anatomic dissection.

Reach activity will be performed 3 times on each side and at 1 minute intervals.

• Study Type: Observational
• Enrollment (Actual): 12

Contacts and Locations

Study Locations

• Turkey
  • Sıhhiye/ANKARA
    • Ankara, Sıhhiye/ANKARA, Turkey
      • Hacettepe University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years to 60 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Hacettepe University Neurological Rehabilitation Unit

Description

Inclusion Criteria:

• diagnosed with stroke by a neurologist
• least 6 mounts after stroke
• Fugl Meyer Upper Extremity Motor Rating Scale with a value of 40 and above,
• independent sitting,
• Mini Mental Status Scale (MMSE)> 24,
• 30-67 age.

Exclusion Criteria:

• neurodegenerative disease other than stroke
• presence of neglect
• presence of apraxia
• uncorrected visual impairment
• neuromusculoskeletal pathologies
• neck and shoulder pain lasting more than 3 months

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Stroke patients	Other: Electromyographic device; An 8-channel surface EMG system (Noraxon Telemyo DTS system, Scottsdale, USA) will be used to measure signals from muscles during surface electromyography measurements.
Healthy Subjects	Other: Electromyographic device; An 8-channel surface EMG system (Noraxon Telemyo DTS system, Scottsdale, USA) will be used to measure signals from muscles during surface electromyography measurements.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Surface electromyographic measurement	Muscle activation measurement It is an 8-channel system for measuring signals come from muscles (Noraxon Telemyo DTS system, Scottsdale, USA).	90 minutes

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Principal Investigator: Tuba KAYA, R.A., Hacettepe University; Study Director: Sevil BİLGİN, Assoc. Prof., Hacettepe University; Study Chair: Muhammed KILINÇ, Assoc. Prof., Hacettepe University; Study Chair: Esra DÜLGER, R.A., Hacettepe University

Publications and helpful links

General Publications

• Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000 Oct;10(5):361-74. doi: 10.1016/s1050-6411(00)00027-4.
• Bogduk N, Johnson G, Spalding D. The morphology and biomechanics of latissimus dorsi. Clin Biomech (Bristol, Avon). 1998 Sep;13(6):377-385. doi: 10.1016/s0268-0033(98)00102-8.
• Dickstein R, Shefi S, Marcovitz E, Villa Y. Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients. Arch Phys Med Rehabil. 2004 Feb;85(2):261-7. doi: 10.1016/j.apmr.2003.05.011.
• Wickham JB, Brown JM. Muscles within muscles: the neuromotor control of intra-muscular segments. Eur J Appl Physiol Occup Physiol. 1998 Aug;78(3):219-25. doi: 10.1007/s004210050410.
• Brown JM, Wickham JB, McAndrew DJ, Huang XF. Muscles within muscles: Coordination of 19 muscle segments within three shoulder muscles during isometric motor tasks. J Electromyogr Kinesiol. 2007 Feb;17(1):57-73. doi: 10.1016/j.jelekin.2005.10.007. Epub 2006 Feb 2.

Helpful Links

• SENIAM

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2019
• Primary Completion (ACTUAL): August 7, 2019
• Study Completion (ACTUAL): December 29, 2020

Study Registration Dates

• First Submitted: November 25, 2019
• First Submitted That Met QC Criteria: November 27, 2019
• First Posted (ACTUAL): November 29, 2019

Study Record Updates

• Last Update Posted (ACTUAL): April 20, 2022
• Last Update Submitted That Met QC Criteria: April 13, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: stroke; electromyography; muscle activation; latissimus dorsi; reaching activity
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: Hacettepe U

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No