Artificial feedforward as preparatory motor control in postictal hemiparesis.

One of the most important disturbances in spastic hemiparesis is the lack of reciprocal inhibition and the insufficient and inadequate preparatory programming of this inhibition. In 40 patients with postical hemiparesis some preparatory procedures foregoing the volitional movement attempt were assumed. The movement was extension of the wrist and the intended reciprocal inhibition was that in the wrist flexors. The procedures were extensor muscle vibration or electrostimulation which produce contraction of the wrist extensors and reciprocal inhibition in the wrist flexors. A conditioning has been attempted of these effects achieved at spinal level to the existing ipsilateral and spared contralateral cortical influences during a volitional extension of the wrist. In this way an artificial feedforward have been created, with favourable results in motor reeducation of wrist movements.