Muscle movement??

[duceno1]

I am not sure if this is the appropriate category to post this question, but I will ask none-the-less.

I am C4/5 complete, 9 yrs post...When I attempt to straighten my fingers, while there is no movement of the fingers and while I cannot visually see any muscle movement, it "feels" as if the muscles are straining, for lack of a better word. This does not occur elsewhere in the body, ie., when I attempt to wiggle my toes. What is the simplest "test" or method I can try to see if these are just mind games or in fact the muscles are attempting to work. This has been the case for years, I have just dismissed it as my mind playing tricks on me. Any suggestions?

[JimB]

well.... im a c6 but i have most my arm muscles. i have the same feelngs and am happy to say that with repeated trys i can now move my thumb, so dont give up it is possible those feelings can become movement.

"had a ball, atom bomb"

[-scott-]

i dunno. i'm c6/7 incomplete sensory, 4yrs post... if i attempt to move my legs, particularily my right one, i "feel" the same straining, yet see not even a flicker or twitch of movement. it's frustrating.

i've tried & tried, but to no avail. i just can't figure out the nervous system.

anyone else have any constructive input, i'd appreciate it http://sci.rutgers.edu/forum/images/smilies/wink.gif

[KDK513]

Have you tried electrical stimulation?

[bruce]

Have someone feel your finger extensor muscles when you try to straighten your fingers. The muscles are located on top of your forearm about two-thirds of the way from your wrist to your elbow. Looking at an anatomy book might help, because they can be hard to find. If there's a palpable contraction you're in there, and there should be if something is happening. The trick is finding it!

E-stimming the finger extensors is tricky. I met with an occupational therapist who taught me how to find the muscles and stim them and not the wrist extensors, which are all layered there on top of your forearm. It's inexact at best, and takes some trial and error each time you do it. He also hooked me to a crude EMG machine that could pick up the signals in the muscles, which also helped me figure what was going on.

I'm C6 incomplete, two years post. My left hand works, but my right doesn't do well. However, I can move my fingers together from straight through more than 90 degrees of bend. I have had a number of botox injections to loosen things up which has helped .. also an inexact science. A year ago I had no movement in the fingers, so I have made a lot of progress through e-stim, the botox, and simply trying to move them.

Good luck!

- Bruce

[Wise Young]

duceno, the standard way to maximize subliminal muscle activity of the type that you describe is biofeedback therapy.

Basically, in biofeedback therapy, you connect electrodes to record the muscle activity. You can have muscle activation that can be recorded with electrodes that may not show up in palpable or visible movement. Over the course of a biofeedback, you may be able to activate the muscle more or less. By being able to see the muscle activation, you can train yourself to strengthen that muscle activity until you get that activity as consistently as possible. By that time, you will find that your muscle activity will have a higher range. You set the criterion at a higher level and then train yourself to reach the upper limits of your range of activation. Over time, you can get back usable function for the muscle.

This is something that of course is best done under the guidance of an experience biofeedback therapist but it can be done at home. Biofeedback equipment is not particularly difficult or expensive. I don't really know the cost of such instruments but getting surface electromyograms is simple and easy to do.

Wise.

[jonsmom]

Our son Is 20 months post C4/5 complete SCI. In the last few months, he has started to be able to rotate his legs/ feet and pull his knees up 4 or more inches while laying on the standing table in the horizontal position or in bed. He is only able to do this 7 to 9 times, and then he is spent. In addition, at night while laying on his side he can pull his legs up 4 to 8 inches, only up and not down at this time. Does this sound like some recovery or just controlled spasticity? Any one out there with a similar condition?

[jonsmom]

Unlike some, our son has no feeling below the C-5 level, however as stated befor he can now move his legs a little and has some trunk control. Can recovery of muscle come ahead of feeling? In our son's case it appears to be such.

[betheny]

Movement can return before sensation and vice-versa.

[kilgore]

What, then, is learned non-use? I'm a C5 "complete". At about 6 months post, my right wrist flexor started to come back. I did exercises, e-stim, and biofeedback therapy until I plateaued somewhere less-than-functional. So it goes. Now it's almost 6 years, and I still occasionally "move" my toes or quadriceps without even a flicker. Sometimes, while half-awake, I'll clench a fist or rub my thumb and index finger together before realizing that my hard hand splints would prevent this.
So is this sort of "exercise" of any use? Could it be a slow means to a Christopher Reeve-type recovery that no one has had the tenacity to apply? Or maybe it would be a useful skill to have for when a real regeneration therapy occurs to help align the new axons.

[Wise Young]

jonsmom, I agree with betheny that motor recovery can occur without sensory recovery. He may well be getting some motor recovery... Can he feel the movement? Wise.

[Wise Young]

kilgore, the term "learned non-use" has been applied to paralysis of an arm after cutting of dorsal roots and arm movements in hemiplegic patients after a stroke. It has been loosely applied to the ambulation training to restore locomotion after spinal cord injury.

For many people who have a little bit of motor function of the type that you describe, biofeedback therapy may be useful to amplifying that. Likewise, for people who have some movement of their legs, ambulation training may restore their ability to step on a treadmill with some weight support.

There will of course be some people who may not respond to therapy and this is where the research is necessary to help define not only the people who would respond to training but what type of training is most suitable.

Wise.

[jonsmom]

DR. Young, Jon can not feel the movementon of his legs only when the E-stim unit is set on 40 and above, Same for his abs and middle back. To night Jon worked out on the standing table and pulled himself up from a 65% incline to virtical and back again stopping at 80% and 65% to the vertical. He was able to do 12 reps up and back and 20 from side to side. Jon is starting Project Walk on the 8th of April. We are hoping the thier program may continue with improvements.