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Central and peripheral contributions to neuromuscular fatigue in people with stroke

Abstract Objective: To evaluate the evidence for neuromuscular fatigue following stroke and to consider the implications of the findings for clinical practice and future research. Methods: A search of Ebsco Health and Ovid electronic search engines was undertaken using key search terms. In addition, the reference lists of pertinent articles were screened for other relevant articles. Results: A total of five relevant research papers were identified for review. Discussion: There is physiological evidence to suggest that changes in the development of neuromuscular fatigue are likely to occur in both the nervous system (central neuromuscular fatigue) and muscle (peripheral neuromuscular fatigue) following stroke. Based on the experimental research available it may be asserted that people with stroke fatigue differently from control participants, however, the source of these differences remains unclear. There are indications of a relative reduction in the amount of peripheral neuromuscular fatigue, and an increase in the amount of central neuromuscular fatigue, experienced by people following stroke. However, the validity of protocols for measuring fatigue in pathological populations can be questioned. Further elucidation of the presence, extent and cause of neuromuscular fatigue through experimental research, and consideration of neuromuscular fatigue during the rehabilitation process, is warranted.