Adaptations in motor control of the
upper extremities in subjects with tetraplegia
Yvonne Janssen-Potten, PhD (Researcher)
Henk Seelen, PhD (Project leader)
Cees Pons, MD (Project leader)
A
controllable arm and hand function is essential for the performance of
activities of daily living (ADL). Patients suffering from a thoracic or (low)
cervical SCI highly depend on the use of a wheelchair for their mobility
needs. When the arm-hand function (AHF) is impaired due to a cervical SCI
wheelchair mobility and ADL is jeopardised. Clinical rehabilitation of these
patients is focused on residual sensori-motor functions. In some cases
surgical muscle/tendon transpositions are carried out to improve functional
outcome. In effect new patterns of motor control have to be acquired by these
patients. The project aims at understanding the development of new patterns of
motor control in persons with tetraplegia during and after their active
clinical rehabilitation. Adaptations in motor control are studied during
standardized ADL tasks with electromyography. Insight in changes in muscle use
during task performance in tetraparetic persons may be used as ‘input’ to
better judge as well as to simulate and predict—through modelling (project
III) -, the mechanical loading and movement efficiency of the upper
extremities in these persons. This is relevant not only for persons who have
completed their active rehabilitation program, but also (and especially) for
patients who still receive therapy. Insight in changed muscle use and
mechanical 
loading and stress is also relevant to tetraparetic persons who are
eligible for surgical muscle transposition. Through modelling the mechanical
constraints may be assessed before surgery and a possible result of surgery
regarding changes in muscle function, co-ordination and improved ADL may be
predicted through simulation. Given the coherence between this and project III
data of both projects will be exchanged.
Research Questions
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To what extent can subjects with a tetraparesis based on a cervical SCI actively compensate the loss of muscle function in the shoulder girdle, arm and hand? (research phase B).
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How do new patterns of alternative muscle use for AHF develop during the active clinical rehabilitation phase of patients with a tetraparesis based on a cervical SCI? (research phase C).
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How do isolated muscle transpositions influence existing movement synergies of the shoulder-arm complex in patients with a tetraparesis based on a cervical SCI and what are the mechanical consequences of such surgical interventions on the loading / stress in the shoulder-arm complex? (research phase D + study III).
List of publications
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Assessment of upper extremity muscle function in persons with tetraplegia. Janssen-Potten YJM, Seelen HAM, Bongers-Janssen HM, Van der Woude LHV. J. Electromyograph. Kinesiol. 2007.
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Evaluation of upper extremity motor function tests in tetraplegics. Tuijl JH van, Janssen-Potten YJM, Seelen HAM, Spinal Cord 40, 51-64, 2002.
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