Physiological alterations of motor units in hemiplegia

Isometric contractions of single motor units in the first dorsal interosseous muscle were recorded with an intramuscular microstimulation technique in patients with short- or long-term hemiplegia and compared with controls. In the hemiplegic patients motor units could be classified as in controls, utilizing twitch contraction time and fatigue sensitivity, as FF (fast fatigable), FR (fast fatigue resistant) and S (slow fatigable). The mean twitch contraction time of fast-twitch but not slow-twitch units was slightly prolonged in patients with spastic hemiplegia and motor units, especially type S, tended to generate larger twitch tensions. A fourth type of motor unit, characterized by slow-twitch contraction times and increased fatigability (SF units), was recorded in long-term hemiplegia. The data demonstate that during long-term spastic hemiplegia in man some motor units develop increased fatigability and prolonged-twitch contraction times, reflecting the dynamic properties of muscle.