A neuro-orthopaedic approach to the management of common patterns of upper motoneuron dysfunction after brain injury

Abstract

This article describes a neuro-orthopacdic approach to the functional problems of patients with an upper motoneuron syndrome after acquired brain injury. Typical patterns of upper motoneuron deformity are diagnostically evaluated to identify which muscles contribute dynamically and statically to observed deformity and impaired motor control. Dynamic EMG, gait and motion analysis and diagnostic nerve blocks frequently provide detailed information about specific muscle groups that guide neuro-orthopaedic decision making. Based on such information, neuro-orthopaedic procedures are done to improve passive and active function by rebalancing muscle forces that cause deformity and dysfunction across joints and limb segments.