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The Info Arm and Leg Synergies are Different and the Same | Health News

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The Info Arm and Leg Synergies are Different and the Same | Health News

Arm and leg synergies seen after a stroke are different.  The hemiplegic (paralyzed) arm is dominated by the flexion synergy while the hemiplegic leg is dominated by the extension synergy. That means extensor muscles that straighten the knee and point the toes are strong while flexor muscles that bend the hip, knee, and ankle are weak.  Yet arm and leg synergies are the same because both make it difficult to move a single joint.  When clients who are synergy bound want to move a limb we have to move all the joints in the limb whether we want to or not.  

To point my toes I have to straighten my whole leg (photo on left).  To bend my ankle I have to bend my hip and knee (photo on right).  
 Problem #1: Two trips to the emergency room after bad falls were enough for me.  My weak hip and knee flexors do not lift my leg high enough to clear my toes as I take a step.  To make things worse my leg is mostly straight when I swing my leg to take a step so the extension synergy forces my toes to point       (top left photo).  Weakness and synergy produce foot drop which makes me stub my toes (photo on left).                              Solution #1: I faithfully wear my leg brace because it prevents falls. 
 
Problem #2: I am not interested in surviving rehab after a knee replacement.  The extension synergy makes my knee hyperextend (straighten) every time I take a step with my hemiplegic foot.  This abnormal movement can eventually damage my knee.  Unfortunately hamstring muscles on the back of my thigh (see pink line) are too weak to keep my knee from snapping into that dangerous position.
Solution #2: My leg brace keeps my knee slightly bent (see green line) when I take a step.  I faithfully wear my leg brace because it defers the need for knee surgery. 


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