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Biomedical subjects

Kevin P Granata

Publications and source records attributed to Kevin P Granata.

At least 19 recordsLinked to original sources

Role of reflex gain and reflex delay in spinal stability--a dynamic simulation.

The goal of this study was to investigate the role of reflex and reflex time delay in muscle recruitment and spinal stability. A dynamic biomechanical model of the musculoskeletal spine with reflex response was implemented to investigate the relationship between reflex gain, co-contraction, and stability in the spine. The first aim of the study was to investigate how reflex gain affected co-contraction predicted in the model. It was found that reflexes allowed the model to stabilize with less antagonistic co-contraction and hence lower metabolic power than when limited to intrinsic stiffness alone. In fact, without reflexes there was no feasible recruitment pattern that could maintain spinal stability when the torso was loaded with 200N external load. Reflex delay is manifest in the paraspinal muscles and represents the time from a perturbation to the onset of reflex activation. The second aim of the study was to investigate the relationship between reflex delay and the maximum tolerable reflex gain. The maximum acceptable upper bound on reflex gain decreased logarithmically with reflex delay. Thus, increased reflex delay and reduced reflex gain requires greater antagonistic co-contraction to maintain spinal stability. Results of this study may help understanding of how patients with retarded reflex delay utilize reflex for stability, and may explain why some patients preferentially recruit more intrinsic stiffness than healthy subjects.

Humans↗

Effect of augmented plantarflexion power on preferred walking speed and economy in young and older adults.

With age, loss of skeletal muscle mass (sarcopenia) results in decreased muscle strength and power. Decreased strength and power, in turn, are closely linked with declines in physical function. Preferred walking speed, a marker of physical function, is slower in older adults compared to young adults. Research suggests that older adults may walk slower as a consequence of decreased plantarflexor power at push-off. In this study, we hypothesized that providing additional plantarflexion (PF) power during push-off would (1) increase preferred walking speed, and (2) reduce metabolic cost of transport (MCOT), in young and older adults. PF power was augmented using powered ankle-foot orthoses (PAFOs). The PAFOs, which use pneumatic actuators to provide an additional PF moment, were based on a design by Ferris et al. [Ferris DP, Czerniecki JM, Hannaford B. An ankle-foot orthosis powered by artificial pneumatic muscles. J Appl Biomech 2005;21:189-97.]. Nine young (23.3+/-1.6 years) and seven older (74.6+/-6.6 years) adults participated. For the young adults, eight out of nine increased their preferred walking speed when push-off power was augmented (1.18+/-0.16 to 1.25+/-0.16m/s, p=0.03). A similar, but non-significant, trend in preferred walking speed was observed for the older adults. With augmented push-off power, MCOT for young adults decreased from 0.395+/-0.057 to 0.343+/-0.047 (p=0.008); indicating that the neuromuscular system was able to adapt to use external energy to reduce metabolic cost. Only three older adults were tested but MCOT values showed a similar trend. Augmenting PF power increases gait speed and reduces MCOT in young adults. Older adults may need a longer period to take advantage of additional push-off power.

Adult↗

Role of reflex dynamics in spinal stability: intrinsic muscle stiffness alone is insufficient for stability.

Spinal stability is related to both the intrinsic stiffness of active muscle as well as neuromuscular reflex response. However, existing analyses of spinal stability ignore the role of the reflex response, focusing solely on the intrinsic muscle stiffness associated with voluntary activation patterns in the torso musculature. The goal of this study was to empirically characterize the role of reflex components of spinal stability during voluntary trunk extension exertions. Pseudorandom position perturbations of the torso and associated driving forces were recorded in 11 healthy adults. Nonlinear systems-identification analyses of the measured data provided an estimate of total systems dynamics that explained 81% of the movement variability. Proportional intrinsic response was less than zero in more than 60% of the trials, e.g. mean value of P(INT) during the 20% maximum voluntary exertion trunk extension exertions -415+/-354N/m. The negative value indicated that the intrinsic muscle stiffness was not sufficient to stabilize the spine without reflex response. Reflexes accounted for 42% of the total stabilizing trunk stiffness. Both intrinsic and reflex components of stiffness increased significantly with trunk extension effort. Results reveal that reflex dynamics are a necessary component in the stabilizing control of spinal stability.

Humans↗

Stability of dynamic trunk movement.

STUDY DESIGN: Nonlinear systems analyses of trunk kinematics were performed to estimate control of dynamic stability during repetitive flexion and extension movements. OBJECTIVE: Determine whether movement pace and movement direction of dynamic trunk flexion and extension influence control of local dynamic stability. SUMMARY OF BACKGROUND DATA: Spinal stability has been previously characterized in static, but not in dynamic movements. Biomechanical models make inferences about static spinal stability, but existing analyses provide limited insight into stability of dynamic movement. Stability during dynamic movements can be estimated from Lyapunov analyses of empirical data. METHODS: There were 20 healthy subjects who performed repetitive trunk flexion and extension movements at 20 and 40 cycles per minute. Maximum Lyapunov exponents describing the expansion of the kinematic state-space were calculated from the measured trunk kinematics to estimate stability of the dynamic system. RESULTS: The complexity of torso movement dynamics required at least 5 embedded dimensions, which suggests that stability components of lumbar lordosis may be empirically measurable in addition to global stability of trunk dynamics. Repeated trajectories from fast paced movements diverged more quickly than slower movement, indicating that local dynamic stability is limited in fast movements. Movements in the midsagittal plane showed higher multidimensional kinematic divergence than asymmetric movements. CONCLUSION: Nonlinear dynamic systems analyses were successfully applied to empirically measured data, which were used to characterize the neuromuscular control of stability during repetitive dynamic trunk movements. Movement pace and movement direction influenced the control of spinal stability. These stability assessment techniques are recommended for improved workplace design and the clinical assessment of spinal stability in patients with low back pain.

Adult↗

The influence of gait speed on local dynamic stability of walking.

The focus of this study was to examine the role of walking velocity in stability during normal gait. Local dynamic stability was quantified through the use of maximum finite-time Lyapunov exponents, lambda(Max). These quantify the rate of attenuation of kinematic variability of joint angle data recorded as subjects walked on a motorized treadmill at 20%, 40%, 60%, and 80% of the Froude velocity. A monotonic trend between lambda(Max) and walking velocity was observed with smaller lambda(Max) at slower walking velocities. Smaller lambda(Max) indicates more stable walking dynamics. This trend was evident whether stride duration variability remained or was removed by time normalizing the data. This suggests that slower walking velocities lead to increases in stability. These results may reveal more detailed information on the behavior of the neuro-controller than variability-based analyses alone.

Acceleration↗

Disturbed paraspinal reflex following prolonged flexion-relaxation and recovery.

STUDY DESIGN: Repeated measures experimental study of the effect of flexion-relaxation, recovery, and gender on paraspinal reflex dynamics. OBJECTIVE: To determine the effect of prolonged flexion-relaxation and recovery time on reflex behavior in human subjects. SUMMARY OF BACKGROUND DATA: Prolonged spinal flexion has been shown to disturb the paraspinal reflex activity in both animals and human beings. Laxity in passive tissues of the spine from flexion strain may contribute to desensitization of mechanoreceptors. Animal studies indicate that recovery of reflexes may take up to several hours. Little is known about human paraspinal reflex behavior following flexion tasks or the recovery of reflex behavior following the flexion tasks. METHODS: A total of 25 subjects performed static flexion-relaxation tasks. Paraspinal muscle reflexes were recorded before and immediately after flexion-relaxation and after a recovery period. Reflexes were quantified from systems identification analyses of electromyographic response in relation to pseudorandom force disturbances applied to the trunk. RESULTS: Trunk angle measured during flexion-relaxation postures was significantly higher following static flexion-relaxation tasks (P < 0.001), indicating creep deformation of passive supporting structures in the trunk. Reflex response was diminished following flexion-relaxation (P < 0.029) and failed to recover to baseline levels during 16 minutes of recovery. CONCLUSION: Reduced reflex may indicate that the spine is less stable following prolonged flexion-relaxation and, therefore, susceptible to injury. The absence of recovery in reflex after a substantial time indicates that increased low back pain risk from flexion-relaxation may persist after the end of the flexion task.

Adult↗

Validity and reliability of a new in vivo ankle stiffness measurement device.

This investigation was designed to test the validity and reliability of a new measure of inversion/eversion ankle stiffness on a unique medial/lateral swaying cradle device utilizing a test/retest with comparison to a known standard. Ankle stiffness is essential to maintaining joint stability. Most ankle injuries occur via an inversion mechanism. To date, very little information is available regarding stiffness of the evertor muscles in the prevention of excessive inversion joint rotation. Transient oscillation data representing inversion/eversion stiffness was obtained in a bipedal weight-bearing stance with an upright posture. Using commercially available springs with stiffness of 4.80N/cm the measured value recorded by the cradle was 4.87N/cm. Mean active stiffness values of the ankle were 35.70Nm/cm (SD 9.45). The trial-to-trial reliability ICC (2,1) coefficient was 0.96 with an SEM of 2.05Nm/rad, and the day-to-day reliability ICC (2,k) coefficient was 0.93 and an SEM of 3.00Nm/rad. The results demonstrate that inversion/eversion ankle stiffness measures on this device are a valid, repeatable and consistent measure. This is relevant because the ability to accurately quantify inversion/eversion ankle stiffness will improve our understanding of biomechanical stability and factors that influence it. It will also enable identification of ankle injury risk factors that will lead to more efficient rehabilitation programs and injury prevention strategies.

Adult↗

Effect of lumbar extensor fatigue on paraspinal muscle reflexes.

Low back disorders are a frequent medical problem. Altered neuromuscular control of the spine has been associated with low back pain, and may contribute to its occurrence. The purpose of this study was to investigate the effect of lumbar extensor fatigue on reflex delay and amplitude in the paraspinal muscles. Ten healthy males (20-22 years of age) were subjected to an anteriorly-directed perturbation applied at the inferior margin of the scapulae while standing quietly before and after a lumbar extensor fatiguing protocol. The fatiguing protocol consisted of multiple sets of back extensions and intermittent isometric maximum voluntary contraction on a Roman chair for 14 min until 60% of unfatigued lumbar extensor MVC was reached. Reflexes were recorded from the paraspinal muscles at the level of L4. Results indicated the mean reflex delay was 60+/-18 ms and was not affected by fatigue (p=0.278). Reflex amplitude increased 36+/-32% with fatigue (p=0.017). The increase in reflex amplitude may reflect an attempt to compensate for losses in muscle force capacity with fatigue in order to maintain sufficient spinal stability. However, additional studies are necessary to investigate the mechanisms of this fatigue-related change in paraspinal reflex.

Adult↗

Passive mechanical properties of maturing extensor digitorum longus are not affected by lack of dystrophin.

Mechanical weakness of skeletal muscle is thought to contribute to onset and early progression of Duchenne muscular dystrophy, but this has not been systematically assessed. The purpose of this study was to determine in mice: (1) whether the passive mechanical properties of maturing dystrophic (mdx) muscles were different from control; and (2) if different, the time during maturation when these properties change. Prior to and following the overt onset of the dystrophic process (14-35 days), control and dystrophic extensor digitorum longus (EDL) muscles were subjected to two passive stretch protocols in vitro (5% strain at instantaneous and 1.5 L(0)/s strain rates). Force profiles were fit to a viscoelastic muscle model to determine stiffness and damping. The mdx and control EDL muscles exhibited similar passive mechanical properties at each age, suggesting a functional threshold for dystrophic muscle below which damage may be minimized. Determining this threshold may have important clinical implications for treatments of muscular dystrophy involving physical activity.

Animals↗

Co-contraction recruitment and spinal load during isometric trunk flexion and extension.

BACKGROUND: Pushing and pulling tasks account for 20% of occupational low-back injury claims. Primary torso muscle groups recruited during pushing tasks include rectus abdominis and the external obliques. However, analyses suggest that antagonistic co-contraction of the paraspinal muscles is necessary to stabilize the spine during flexion exertions. The study quantified co-contraction and spinal load differences during isometric flexion and extension exertions. The goal was to provide insight into the mechanisms requiring greater co-contraction during trunk flexion exertions compared to extension exertions. METHODS: Electromyographic (EMG) signals were recorded from the trunk muscles of healthy volunteers during isometric trunk flexion and extension exertions. A biomechanical model was implemented to estimate total muscle force from the measured EMG and trunk moment data. A similar model estimated the muscle forces necessary to achieve equilibrium while minimizing the sum of squared muscle forces. The difference in these forces represented co-contraction. Spinal load attributed to co-contraction was computed. RESULTS: Average co-contraction during flexion exertions was approximately twice the value of co-contraction during extension, i.e. 28% and 13% of total muscle forces respectively. Co-contraction accounted for up to 47% of the total spinal load during flexion exertions. Consequently, spinal compression during the flexion tasks was nearly 50% greater than during extension exertions despite similar levels of trunk moment. INTERPRETATION: Co-contraction must be considered when evaluating spinal load during pushing exertions. Results underscore the need to consider neuromuscular control of spinal stability when evaluating the biomechanical risks.

Adult↗

Active trunk stiffness increases with co-contraction.

Trunk dynamics, including stiffness, mass and damping were quantified during trunk extension exertions with and without voluntary recruitment of antagonistic co-contraction. The objective of this study was to empirically evaluate the influence of co-activation on trunk stiffness. Muscle activity associated with voluntary co-contraction has been shown to increase joint stiffness in the ankle and elbow. Although biomechanical models assume co-active recruitment causes increase trunk stiffness it has never been empirically demonstrated. Small trunk displacements invoked by pseudorandom force disturbances during trunk extension exertions were recorded from 17 subjects at two co-contraction conditions (minimal and maximal voluntary co-contraction recruitment). EMG data were recorded from eight trunk muscles as a baseline measure of co-activation. Increased EMG activity confirms that muscle recruitment patterns were different between the two co-contraction conditions. Trunk stiffness was determined from analyses of impulse response functions (IRFs) of trunk dynamics wherein the kinematics were represented as a second-order behavior. Trunk stiffness increased 37.8% (p < 0.004) from minimal to maximal co-activation. Results support the assumption used in published models of spine biomechanics that recruitment of trunk muscle co-contraction increases trunk stiffness thereby supporting conclusions from those models that co-contraction may contribute to spinal stability.

Back↗

Repeatability of surface EMG during gait in children.

Although mean amplitude and ON-OFF timing of muscle recruitment and electromyography (EMG) activation during gait is achieved by an age of six to eight years in normally developing children, recruitment dynamics illustrated by the shape of the EMG waveform may require continued developmental practice to achieve a stable pattern. Previous analyses have quantified the repeatability of the EMG waveform in adult subjects, but EMG variability for a pediatric population may be significantly different. The goal of this study was to quantify intra-session and inter-session variability in the phasic EMG waveform patterns from the lower limb muscles during self-selected speeds of walking in healthy-normal children for comparison with adult variability in gait EMG. The variance ratio quantifies the repeatability of the integrated EMG waveform shape in a group of normally-developing children. Results reveal that between-session EMG waveform variability were similar in adult and pediatric populations, but within-session variability for the children was approximately twice the published value for adults. Clinical implications of this pediatric EMG variability suggest cautious interpretation of data from limited trial samples or inter-session changes in performance of gait data.

Analysis of Variance↗

Effects of static flexion-relaxation on paraspinal reflex behavior.

BACKGROUND: Static trunk flexion working postures and disturbed trunk muscle reflexes are related to increased risk of low-back pain. Animal studies conclude that these factors may be related; passive tissue strain in spinal ligaments causes subsequent short-term changes in reflex. Although studies have documented changes in the myoelectric onset angle of flexion-relaxation following prolonged static flexion and cyclic flexion we could find no published evidence related to the human reflex response of the trunk extensor muscles following a period of static flexion-relaxation loading. METHODS: Eighteen subjects maintained static lumbar flexion for 15 min. Paraspinal muscle reflexes were elicited both before and after the flexion-relaxation protocol using pseudorandom stochastic force disturbances while recording EMG. Reflex gain was computed from the peak value of the impulse response function relating input force perturbation to EMG response using time-domain deconvolution analyses. FINDINGS: Reflexes showed a trend toward increased gain after the period of flexion-relaxation (P < 0.055) and were increased with trunk extension exertion (P < 0.021). Significant gender differences in reflex gain were observed (P < 0.01). INTERPRETATIONS: Occupational activities requiring extended periods of trunk flexion contribute to changes in reflex behavior of the paraspinal muscles. Results suggest potential mechanisms by which flexed posture work may contribute to low-back pain. Significant gender differences indicate risk analyses should consider personal factors when considering neuromuscular behavior.

Adaptation, Physiological↗

Trunk stiffness and dynamics during active extension exertions.

Spinal stability is related to the recruitment and control of active muscle stiffness. Stochastic system identification techniques were used to calculate the effective stiffness and dynamics of the trunk during active trunk extension exertions. Twenty-one healthy adult subjects (10 males, 11 females) wore a harness with a cable attached to a servomotor such that isotonic flexion preloads of 100, 135, and 170 N were applied at the T10 level of the trunk. A pseudorandom stochastic force sequence (bandwidth 0-10 Hz, amplitude +/-30 N) was superimposed on the preload causing small amplitude trunk movements. Nonparametric impulse response functions of trunk dynamics were computed and revealed that the system exhibited underdamped second-order behavior. Second-order trunk dynamics were determined by calculating the best least-squares fit to the IRF. The quality of the model was quantified by comparing estimated and observed displacement variance accounted for (VAF), and quality of the second-order fits was calculated as a percentage and referred to as fit accuracy. Mean VAF and fit accuracy were 87.8 +/- 4.0% and 96.0 +/- 4.3%, respectively, indicating that the model accurately represented active trunk kinematic response. The accuracy of the kinematic representation was not influenced by preload or gender. Mean effective stiffness was 2.78 +/- 0.96 N/mm and increased significantly with preload (p < 0.001), but did not vary with gender (p = 0.425). Mean effective damping was 314 +/- 72 Ns/m and effective trunk mass was 37.0 +/- 9.3 kg. We conclude that stochastic system identification techniques should be used to calculate effective trunk stiffness and dynamics.

Adult↗

Females recruit quadriceps faster than males at multiple knee flexion angles following a weight-bearing rotary perturbation.

OBJECTIVE: To compare the effect of knee angle on muscle response times and neuromuscular recruitment patterns between sexes following a perturbation in single leg stance at 10 degrees, 20 degrees, and 30 degrees. We hypothesized that response times would be faster at lesser knee flexion angles and that females would recruit their quadriceps faster than males at all angles. DESIGN: A repeated-measures design. SETTING: Motion analysis laboratory. PARTICIPANTS: Twenty (10 female; 10 male) healthy, recreationally active volunteers. INTERVENTIONS: A rotary perturbation in single leg stance. OUTCOME MEASUREMENTS: Response times of the medial and lateral quadriceps, hamstrings, and gastrocnemius. RESULTS: There was a trend toward faster response times for all muscles closer toward extension. A consistent neuromuscular recruitment pattern for both males and females was evident for each knee angle tested. Females, however, contracted their quadriceps faster than males at all knee flexion angles. CONCLUSIONS: Small changes in knee angle near extension do not alter muscle response times and hence neuromuscular recruitment patterns in males and females. Regardless of knee flexion angle, following a perturbation in single leg stance, females contract their quadriceps faster than males. CLINICAL RELEVANCE: Earlier contraction of the quadriceps in females may increase anterior tibial translation and hence anterior cruciate ligament strain, thereby heightening injury risk.

Adult↗

Gender differences in leg stiffness and stiffness recruitment strategy during two-legged hopping.

The authors compared leg stiffness (K(VERT)), muscle activation, and joint movement patterns between 11 men and 10 women during hopping. Physically active and healthy men and women performed continuous 2-legged hopping at their preferred rate and at 3.0 Hz. Compared with men, women demonstrated decreased K(VERT); however, after the authors normalized for body mass, gender differences in K(VERT) were eliminated. In comparison with men, women also demonstrated increased quadriceps and soleus activity, as well as greater quadriceps-to-hamstrings coactivation ratios. There were no significant gender differences for joint movement patterns (p>.05). The relationship between the observed gender differences in muscle recruitment and the increased risk of anterior cruciate ligament injury in women requires further study.

Adult↗

Seated postural control in adolescents with idiopathic scoliosis.

STUDY DESIGN: The center of pressure (COP) path in 14 adolescents with idiopathic scoliosis and 12 age-matched able-bodied adolescents was compared using traditional measures and a two-level decomposition. OBJECTIVES: To investigate whether asymmetries in the spines of children with idiopathic scoliosis are reflected in altered sway patterns in quiet sitting. SUMMARY OF BACKGROUND DATA: Previous studies have studied the sway of children with scoliosis while standing. However, the standing posture is typically controlled at the ankle joint. To date, there are no studies with this population of sitting sway, where the movement is controlled by the trunk muscles. METHODS: Traditional measures of the COP of the trunk were analyzed. The COP was also decomposed into an approximation of the center of mass path and deviations around this path. RESULTS: COP movement in sitting, reflecting the postural control of the spine, was decreased in adolescents with idiopathic scoliosis. Children with scoliosis had symmetric sitting COP trajectories and most measures were similar between the two groups. CONCLUSIONS: The results suggest a control strategy for maintaining a sitting posture that does not change with the development of scoliosis but does adapt by decreasing movement to maintain the trunk in a region where the it can remain "passively" stable.

Adolescent↗

Knee ligament behavior following a controlled loading protocol does not differ by menstrual cycle day.

BACKGROUND: Females experience a disproportionate number of anterior cruciate ligament injuries compared to males. Increased estradiol concentration has been suggested to alter ligament properties and strength. Determining whether the knee responds differently to an external load at various hormonal levels may be helpful in further explaining the gender disparity. METHODS: Estradiol, progesterone and testosterone were quantified at menses, near ovulation and at the mid-luteal phase. With one knee serving as the control limb and the other as the experimental limb, displacement at 134N and stiffness between 90 and 134N were recorded with a knee ligament arthrometer on both knees before and after a loading protocol. The protocol consisted of three, 3-min, posterior to anterior normalized loads directed to the posterior calf with a ligament testing device. FINDINGS: The loading protocol produced a measurable increase in displacement but not stiffness. Neither displacement nor stiffness measures however were affected by day of the menstrual cycle. No consistent relationships between hormonal concentrations and displacement or stiffness were evident. INTERPRETATION: Following a controlled, static external load, displacement and stiffness were not affected differently by day of the menstrual cycle.

Adolescent↗