Relationship Of Associated Reactions In The Hemiplegic Arm And Leg With Spasticity

ABSTRACT

Background: Associated reactions may be observed in several neurological conditions involving upper motor neuron disorders and more frequently in hemiplegic extremities. The patient’s ability to control associated reactions is generally considered an index of their motor performance. The severity of spasticity and its relationship with the severity of associated reactions have not been explored much. Moreover, as many studies have not been made in the ankle, an attempt has also been made to study the associated reactions in the ankle, based on Brunnstrom’s assertion that in the lower limb, associated reactions are of the opposite type to the movement employed to evoke the response. Purpose of the Study The purpose of the study is to find the relationship between the severity of associated reactions and the severity of spasticity in the hemiplegic arm and leg, the relationship between the maximal voluntary force exertion and the associated reactions in the hemiplegic arm, and to find out which muscle group is over firing during contra lateral maximal voluntary force exertion in the hemiplegic arm and leg. Materials and Methods: A descriptive study design has been used in this study, with a sample of 20 hemiplegic subjects with post CVA duration from 1 – 3 years. The sample consisted of both right and left hemiplegics of age between 45 and 65 yrs., including both the ischaemic and haemorrhagic causes of lesion. The study on the relationship of associated reactions with spasticity was made on the 20 hemiplegic subjects in terms of electrical muscle activity and elbow and ankle movement in the paretic arm and leg using surface electromyography and clinical goniometry respectively. Results: There is considerable variability in the magnitude of associated reactions seen in patients with spasticity. The electrical activity of associated reactions is widespread among the flexors of elbow and wrist and is predominant in the dorsiflexors of ankle. The study also shows that there is considerable variability in the amplitude of associated reactions when correlated with the force exerted on the normal side. Conclusion: This study has the potential to be useful in the evaluation and treatments aimed at reducing associated reactions and spasticity in the hemiplegic patients.