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Spasticity and the influence of synergy begins to decline and the patient is able to move with less restrictions. The ease of these movements progresses from difficult to easy within this stage. 5: Spasticity continues to decline, and there is a greater ability for the patient to move freely from the synergy pattern.
Examples of common abnormal movement patterns include obligatory synergy patterns. These patterns can be described as the process of trying to perform isolated movement of a particular limb but triggering the use of other typically uninvolved muscles (when compared to normal movement) in order to achieve movement.
Obligatory synergy patterns are observed when a patient tries to make a minimal voluntary movement, or as a result of stimulated reflexes. [1] The flexion synergy for the upper extremity includes scapular retraction and elevation, shoulder abduction and external rotation, elbow flexion, forearm supination, and wrist and finger flexion. [1]
A functional muscle synergy is defined as a pattern of co-activation of muscles recruited by a single neural command signal. [18] One muscle can be part of multiple muscle synergies, and one synergy can activate multiple muscles. Synergies are learned, rather than being hardwired, like motor programs, and are organized in a task-dependent manner.
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The spinal cord executes rhythmical and sequential activation of muscles in locomotion. The central pattern generator (CPG) provides the basic locomotor rhythm and synergies by integrating commands from various sources that serve to initiate or modulate its output to meet the requirements of the environment.
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