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Damping actions of the neuromuscular system with inertial loads: human flexor pollicis longus muscle.

Our previous work in an animal model showed that neuromuscular damping properties help maintain limb posture by effectively dissipating mechanical energy arising from disturbances. The purpose of this study was to determine whether similar damping properties were expressed in intact, normal human muscles. To review briefly, when the reflexively active soleus muscle in a decerebrate cat is coupled to an inertial load, application of a force impulse to the load results in lightly damped oscillations. By calculating the logarithmic decrement in muscle velocity following the impulse (the decrement being related to the amount of energy dissipated from the inertia), we found that damping increased with oscillation amplitude, a nonlinear property. This nonlinearity represents an automatic compensation for larger perturbations. Our findings in parallel experiments on the interphalangeal joint of the human thumb were that the long thumb flexor, the flexor pollicis longus (FPL), displayed mechanical and reflex behavior closely comparable to that reported earlier for the cat soleus, despite differences in architectural and metabolic properties between these muscles. Specifically, by selecting experimental trials that did not include voluntary interventions, we observed amplitude-dependent differences in damping in which larger amplitude movements elicited larger damping than did smaller movements. In addition, even after accounting for amplitude-dependent differences in damping, damping was found to be larger in later cycles than in the first cycle. This nonlinearity indicates that both mechanical properties of muscle and reflex mechanisms are dependent on prior movement history. We propose that this history-dependent behavior arises from the effects of prior movement on stretch reflex gain, and these effects are mediated primarily via changes in muscle spindle properties. Recordings of electromyographic activity from the FPL, during the first and second cycles of oscillation supported this postulate of a reduced reflex gain following prior motion. The functional significance of these nonlinear damping properties is that during the initial muscle stretch, the stiffness is high, which helps to preserve the initial position (although at the expense of promoting oscillation). Subsequently, the ensuing increase in damping helps suppress continuing oscillation. This sequence of varying mechanical properties is broadly analogous to the features of a predictive, or feed-forward controller, designed to produce a response that initially maintains position, and subsequently dampens oscillations. These results show that the intrinsic properties of muscle and spinal reflexes automatically provide a complex time-varying response, appropriate for maintenance of stable limb posture.

Adult↗

Reflex and intrinsic changes induced by fatigue of human elbow extensor muscles.

Fatigue-induced changes in intrinsic and reflex properties of human elbow extensor muscles and the underlying mechanisms for fatigue compensation were investigated. The elbow joint was perturbed using small-amplitude and pseudorandom movement patterns while subjects maintained steady levels of mean joint extension torque. Intrinsic and reflex properties were identified simultaneously using a nonlinear delay differential equation model. Intrinsic joint properties were characterized by measures of joint stiffness, viscous damping, and limb inertia and reflex properties characterized by measures of dynamic and static reflex gains. Fatigue was induced using 15 min of intermittent voluntary isometric (submaximal) exercise, and a rest period of 10 min was taken to allow the fatigued muscles to recover from acute fatigue effects. Identical experimental and data analysis procedures were used before and after fatigue. Our findings were that after fatigue, joint stiffness was significantly reduced at higher torque levels, presumably reflecting the reduced force-generating capacity of fatigued muscles. Conversely, joint viscosity was increased after fatigue potentially because of the reduced crossbridge detachment rate and prolonged relaxation associated with intracellular acidosis accompanying fatigue. Static stretch reflex gain decreased significantly at higher torque levels after fatigue, indicating that the isometric fatiguing exercise might be associated with a preferential change in properties of spindle chain fibers and bag(2) fibers. For matched pre- and postfatigue torque levels, dynamic reflexes contributed relatively more torque after fatigue, displaying higher dynamic reflex gains and larger dynamic electromyographic responses elicited by the controlled small-amplitude position perturbations. These changes appear to counteract the fatigue-induced reductions in joint stiffness and static reflex gain. The compensatory responses could be partly due to the effects of increasing the number of active motoneurons innervating the fatiguing muscles. This shift in operating point gave rise to significant compensation for the loss of contractile force. The compensation could also be due to fusimotor adjustment, which could make the dynamic reflex gain much less sensitive to fatigue than intrinsic stiffness. In short, the reduced contribution from intrinsic stiffness to joint torque was compensated by increased contribution from dynamic stretch reflexes after fatigue.

Adult↗

Postural muscle dyscoordination in children with cerebral palsy.

The present paper gives an overview of the knowledge currently available on muscular dyscoordination underlying postural problems in children with cerebral palsy (CP). Such information is a prerequisite for developing successful therapeutic interventions in children with CP. Until now, three children with CP functioning at GMFCS (Gross Motor Function Classification System) level V have been documented. The children totally or partially lacked direction specificity in their postural adjustments and could not sit independently for more than 3 seconds. Some children functioning at GMFCS level IV have intact direction-specific adjustments, whereas others have problems in generating consistently direction-specific adjustments. Children at GMFCS levels I to III have an intact basic level of control but have difficulties in fine-tuning the degree of postural muscle contraction to the task-specific conditions, a dysfunction more prominently present in children with bilateral spastic CP than in children with spastic hemiplegia. The problems in the adaptation of the degree of muscle contraction might be the reason that children with CP, more often than typically developing children, show an excess of antagonistic coactivation during difficult balancing tasks and a preference for cranial-caudal recruitment during during reaching. This might imply that both stereotypies might be regarded as functional strategies to compensate for the dysfunctional capacity to modulate subtly postural activity.

Adaptation, Physiological↗

Effects of postural change of the shoulder on EMG reaction time of triceps brachii.

Postural dependence of electromyographic reaction time (EMG-RT) of triceps brachii in normal subjects was examined at neutral (N) and facilitating (F) positions. EMG-RT was faster at F than at N; moreover, the slower one's EMG-RT, the larger the difference of EMG-RTs. F position of arms causes the shifting of EMG-RT through two biasing systems. The action of one system arises from either arm and acts on both arms, as the facilitation and its intensity depend on one's EMG-RT. The other system arises from one arm, and facilitates the ipsilateral arm but inhibits the contralateral arm; its intensity is independent of one's EMG-RT. The amount of the shift is determined by the added contribution of those two actions.

Adolescent↗

Contraction-induced potentiation of human motor unit discharge and surface EMG activity.

In quadrupeds, an electrically induced, moderate to high intensity brief muscle contraction potentiates autogenetic excitation and leads to enhanced recruitment and/or tonic firing frequency of alpha-motor neurons. To determine if similar adaptations occur in humans, single motor units (SMUs) and surface electromyographic activity (EMG) were recorded from the right biceps brachii before and immediately after a 5-s 25% or 50% maximum voluntary contraction (MVC), while subjects held a handle (0-1% MVC) attached to a force transducer or maintained a 2% MVC for 30-60 s. Of 26 SMUs recorded, 15 increased, 4 decreased, and 7 showed no change in firing frequency (mean increase: 5 imp/s, P less than 0.01). Twelve SMUs had lower recruitment force thresholds after contraction. There was no significant treatment effect for the % MVC intensity. The postcontraction surface EMG power spectrum broadened, increased in amplitude, and contained a higher frequency component than the control contraction power spectrum. Changes in recruitment and/or frequency coding were reflected in the raw EMG records. Findings agree with previous reports in animals of contraction-induced potentiation of subsequent submaximal muscle contractions. Such acute adaptations in spinal neuromuscular pathways would function to optimize force output to a submaximal range of neural input frequencies.

Electromyography↗

Central and peripheral contributions to fatigue after electrostimulation training.

PURPOSE: We examined the effect of 4 (WK4) and 8 wk (WK8) of neuromuscular electrical stimulation (NMES) training on both endurance time and mechanisms contributing to task failure. METHODS: Ten males performed a fatiguing isometric contraction with the knee extensor muscles at 20% of maximal voluntary contraction (MVC) until exhaustion before (B), at WK4, and at WK8 of NMES training. The electromyographic (EMG) activity and muscle activation obtained under MVC were recorded before and after the fatiguing task to assess central fatigue. Torque and EMG responses obtained under electrically evoked contractions were examined before and after the fatiguing task to analyze peripheral fatigue. RESULTS: Knee extensor MVC torque increased significantly between B and WK4 (+16%), between WK4 and WK8 (+10%), and between B and WK8 (+26%), which meant that the average target torque sustained during the fatiguing contraction increased between the testing sessions. Endurance time decreased significantly over the three sessions (493+/-101 s at B, 408+/-159 s at WK4, and 338+/-126 s at WK8) despite a similar reduction in knee extensor MVC (approximately 25%). Negative correlations were found between endurance time absolute changes and target torque absolute gains. Average EMG activity of the knee extensor muscles was lower after training, but the mean rate of increase was similar over the three sessions. Single-twitch contractile properties were not affected by the task. CONCLUSION: We conclude that the endurance time was shorter after 4 and 8 wk of NMES training, and this was associated with higher absolute contraction intensity. Despite endurance time reduction, NMES training did not affect the amount of fatigue at exhaustion nor the central and peripheral contributions to fatigue.

Adult↗

Application of EMG signals for controlling exoskeleton robots.

Exoskeleton robots are mechanical constructions attached to human body parts, containing actuators for influencing human motion. One important application area for exoskeletons is human motion support, for example, for disabled people, including rehabilitation training, and for force enhancement in healthy subjects. This paper surveys two exoskeleton systems developed in our laboratory. The first system is a lower-extremity exoskeleton with one actuated degree of freedom in the knee joint. This system was designed for motion support in disabled people. The second system is an exoskeleton for a human hand with 16 actuated joints, four for each finger. This hand exoskeleton will be used in rehabilitation training after hand surgeries. The application of EMG signals for motion control is presented. An overview of the design and control methods, and first experimental results for the leg exoskeleton are reported.

Algorithms↗

Control of multifunctional prosthetic hands by processing the electromyographic signal.

The human hand is a complex system, with a large number of degrees of freedom (DoFs), sensors embedded in its structure, actuators and tendons, and a complex hierarchical control. Despite this complexity, the efforts required to the user to carry out the different movements is quite small (albeit after an appropriate and lengthy training). On the contray, prosthetic hands are just a pale replication of the natural hand, with significantly reduced grasping capabilities and no sensory information delivered back to the user. Several attempts have been carried out to develop multifunctional prosthetic devices controlled by electromyographic (EMG) signals (myoelectric hands), harness (kinematic hands), dimensional changes in residual muscles, and so forth, but none ofthese methods permits the "natural" control of more than two DoFs. This article presents a review of the traditional methods used to control artificial hands by means of EMG signal, in both the clinical and research contexts, and introduces what could be the future developments in the control strategy of these devices.

Algorithms↗

A bibliographical survey of bruxism with special emphasis on non-traditional treatment modalities.

After proposing a common-sense definition of bruxism, this partial review distills its various symptoms and consequences from the literature. That literature suggests that the splint-the most popular treatment modality-falls short in some respects. The research literature is even less sanguine about the efficacy of such other traditional therapies as sound alarms and stress reduction. Given the limited success of traditional approaches, and given, moreover, the high incidence of bruxism and its harmful consequences, clinicians may occasionally be interested in experimenting with non-intrusive, safe, less widely known, treatment modalities. To meet this need, this review-unlike all other reviews of the subject-focuses on such comparatively unpopular or recent approaches.

Bruxism↗

Articulatory drift in the speech of children with articulation and phonological disorders.

This study used electropalatography to identify articulatory drift in alveolar stops (/t/ and /d/) produced by 10 children with functional articulation and phonological disorders. Drift involves an abnormal change in place of articulation that occurs during stop closure. An index was used to measure drift, with higher values indicating greater drift. The results showed that drift was higher for children who produced undifferentiated gestures (articulations with increased tongue-palate contact). Drift is an important characteristic of articulation because it is believed to reflect impaired speech motor control. In addition, drift could explain some perceptually based speech errors that are frequently reported in functional disorders.

Adolescent↗

Evaluation and prediction of regenerative processes by quantitative analysis of the electromyographic response and biofeedback in peripheral nerve injuries.

The purpose of this study was to quantitatively and objectively evaluate and monitor regenerative processes in peripheral nerve lesions using a new electrophysiological method, and to develop and evaluate an electromyographic (EMG) biofeedback training programme for the rehabilitation of patients with such injuries. Five patients with traumatic unilateral brachial plexus injuries participated in the study longitudinally on a twice-weekly basis. The electrophysiological method was based on quantitative on-line analyses of the myoelectric signal from affected muscles of the upper limb. The biofeedback programme was developed and used to: (1) increase maximum voluntary centrally mediated neuromuscular activity; (2) dissociate desired and interfering neuromuscular activity; and (3) improve patient control over the neuromuscular activity. The electrophysiological results have differentiated clearly between muscles where regeneration can be assumed to be in progress and muscles where it is not in progress. This differentiation can be made prior to the occurrence of any observable contraction in muscle under study. The biofeedback training resulted in improved neuromuscular function in all patients.

Brachial Plexus↗

Intravaginal surface EMG probe design test for urinary incontinence patients.

Pelvic floor training is a well-established treatment for female urinary stress incontinence The purpose of this study was to test four different intravaginal surface electromyography (EMG) probes for biofeedback exercise and measurements. The study design was a comparison test. The study was accomplished in a referral on outpatient clinic. Participants were 9 urinary incontinent patients sent to physiotherapist for pelvic floor muscle exercise and 2 asymptomatic volunteers. The participants were asked to do pelvic floor contractions in supine position. The EMG activity of pelvic floor muscles was measured with four different types of intravaginal probes, and rectal pressure was measured simultaneously with a microtip catheter for controlling the pelvic floor muscle contraction force levels. Main outcome measure was the electrical activity of pelvic floor muscle contractions. The intraprobe correlation coefficients for comparing subsequent measurements ranged from 0.84-0.97, indicating adequate reliability. The results were affected by the location of the measuring electrodes, and the shape and size of the probes. No statistically significant differences were found between different probes. The compliance was best with L- shaped probe B and it gave highest mean EMG values so it was chosen for M- further development as a biofeedback-based home training system.

Adult↗