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Active stiffness of the ankle in response to inertial and elastic loads.

Effective stiffness of the musculoskeletal system was examined as a function of the characteristics of an external load. Thirteen healthy subjects provided active contraction of the ankle plantarflexion musculature in a neutral ankle posture to support an external load. Musculoskeletal stiffness was computed from kinetic data recorded in response to dorsiflexion/plantarflexion perturbations. Ankle dynamics were recorded while supporting external loads of 19 and 38 kg with and without antagonistic co-contraction. External loads were applied using pure gravitational mass. In separate trials external loads were applied from stretch of steel springs in parallel with the plantarflexion musculature that also provided added parallel stiffness to the system. Adding external stiffness of 4.9 and 8.1 kN/m surprisingly failed to significantly change the stiffness of the ankle-plus-spring system. This suggests contributions from intrinsic muscle stiffness and reflex stiffness declined in response to added external stiffness. This could not be explained by load magnitudes, ankle postures, or co-activation as these were similar between the inertial and elastic loading conditions. However, non-linear parametric analyses suggest mean intrinsic stiffness of 35.5 kN/m and reflex gain of 11.6 kN/m with a constant reflex delay of 70 ms accurately described the empirical results. The phase response between the mechanical dynamics of the musculoskeletal system and delayed neuromotor feedback combine to provide robust control of system behavior.

Acceleration↗

Statistical modelling of fatigue-related electromyographic median frequency characteristics of back and hip muscles during a standardized isometric back extension test.

The purpose of the present study was to evaluate which statistical model - linear, logarithmic, quadratic or exponential - best described the fatigue-related electromyographic (EMG) changes of back and hip muscles. Twenty healthy volunteers performed a modified Biering-Sorensen test. The EMG activity of the latissimus dorsi (LD), longissimus thoracis pars thoracis (LTT) and lumborum (LTL), iliocostalis lumborum pars thoracis (ILT) and lumborum (ILL), multifidus (MF), gluteus maximus (GM) and biceps femoris (BF) was measured bilaterally using surface electrodes. Higher R(2) values were found for the quadratic models (p<0.05 for all muscles), and lower R(2) values for the logarithmic models (p<0.05 for LTT, LTL, ILL, MF and GM). The exponential models generated higher R(2) values compared to the linear ones for the LTT, LTL and MF (all p<0.05). Further analyses revealed, however, that these models did not add useful additional information, and therefore would only increase the complexity. The findings of the current study validate the use of simple linear regression techniques when studying fatigue-related EMG median frequency characteristics of back and hip muscles during isometric contractions.

Adult↗

The effect of postural correction on muscle activation amplitudes recorded from the cervicobrachial region.

In clinical practice, postural correction is a common treatment approach for individuals with neck and shoulder pain. As chronic static muscle use is thought to be associated with the onset of some neck and shoulder pain syndromes, it is important to understand the impact a postural correction program might have on muscle activation amplitudes in the neck and shoulder regions. Normalized surface electromyographic data were recorded from the levator scapulae, upper trapezius, supraspinatus, posterior deltoid, masseter, rhomboid major, cervical erector spinae, and sternocleidomastoid muscles of the dominant side of each of eighteen healthy subjects. Subjects performed five repetitions of each of four seated typing postures (habitual, corrected, head-forward and slouched) and four standing postures (habitual, corrected, and head-forward and slouched). Repeated-measures analysis of variance models (alpha=0.05) revealed that in sitting postural correction tended to decreased the level of muscle activation required in all muscles studied during seated computer work, however this finding was not statistically significant. Corrected posture in sitting did, however produce a statistically significant reduction in muscle activity compared to forward head posture. Corrected posture in standing required more muscle activity than habitual or forward head posture in the majority of cervicobrachial and jaw muscles, suggesting that a graduated approach to postural correction exercises might be required in order to train the muscles to appropriately withstand the requirements of the task. A surprising finding was that muscle activity levels and postural changes had the largest impact on the masseter muscle, which demonstrated activation levels in the order of 20% maximum voluntary electrical activation.

Adult↗

Modifications of anticipatory postural adjustments in a rock climbing task: the effect of supporting wall inclination.

The aim of this study was to analyse the influence of initial postural constraint on the realisation of a leg release in a rock climbing task. Two conditions were tested: a vertical posture and an overhanging posture. The overhanging posture was characterised by a large sustentation base, which enhanced the mechanical possibilities of the system. Subjects had to release their right foot in both postural conditions. In the vertical posture, movement's effectuation was associated with anticipatory postural adjustments (APAs). In the overhanging posture, the movement was performed without APAs. The results indicated that APAs were modulated according to the possibilities of force creation of the system. Hence, the disappearance of APAs in the overhanging posture was explained by the efficiency of the system to create the impulse necessary to perform the task.

Adult↗

Effects of wrist position and contraction on wrist flexors H-reflex, and its functional implications.

In order to determine whether joint position exerts a powerful influence on length-tension regulation in multiarticulate wrist flexors, three wrist positions (neutral, flexion and extension) and four levels of flexor contraction [0%, 10%, 20% and 30% maximum voluntary contraction (MVC)] were manipulated. There were significant differences in H-reflex amplitudes according to wrist positions and levels of flexor contraction. H-reflex increased linearly as a function of contraction in all three wrist positions. H-reflex was consistently larger in the wrist flexion than in the wrist extension position. The strength of the relationship (omega2) indicated that wrist position had a greater effect on H-reflex than force of muscle contraction. The interaction between wrist flexors contraction and joint position was significant only in the wrist flexion position. Trend analysis showed that, in the wrist flexion position, a low level of contraction was sufficient to maximally facilitate the H-reflex; however, a quadratic component was seen at higher contraction levels. The above findings may reflect the length-tension relationship of the multiarticulate wrist flexors. Therefore, this paper will discuss the functional implications related to the larger H-reflex in flexion position and the depressed H-reflex in the wrist extension position.

Adaptation, Physiological↗

Postural muscle activity patterns during standing at rest and on an oscillating floor.

Postural muscle activity pattern was examined in the eyes-closed state after adequate adaptation to floor anteroposterior oscillation. Twenty-three subjects were grouped almost evenly according to dominance of anterior or posterior postural muscles in the trunk and thigh during quiet stance. In the posterior-dominant group, this dominance was maintained at every frequency in most subjects. In the anterior-dominant group, this dominance was maintained in most subjects at 0.1 and 0.5 Hz but changed to posterior dominance at 1.0 and 1.5 Hz in about half the subjects. Periodicity of muscle activity was evaluated by EMG amplitude spectrum at the floor oscillation frequency. Periodicity of posterior-dominant muscles in the trunk and thigh increased with increasing oscillatory frequency. In the trunk, the periodicity did not differ significantly between posterior-dominant and anterior-dominant groups. However, in the thigh, periodicity was significantly lower in the anterior-dominant muscles. This was considered to be caused by nonperiodic alternating action of the anterior and posterior muscles. In the lower leg, posterior dominance was observed in quiet stance and at all oscillation frequencies. Periodicity of soleus and gastrocnemius increased at higher frequencies and was higher in gastrocnemius than in soleus. The periodicity difference between both muscles decreased with increasing oscillation frequency.

Adolescent↗

Muscles within muscles: Coordination of 19 muscle segments within three shoulder muscles during isometric motor tasks.

The aim of the present study was to determine how the intra-muscular segments of three shoulder muscles were coordinated to produce isometric force impulses around the shoulder joint and how muscle segment coordination was influenced by changes in movement direction, mechanical line of action and moment arm (ma). Twenty male subjects (mean age 22 years; range 18-30 years) with no known history of shoulder pathologies, volunteered to participate in this experiment. Utilising an electromyographic technique, the timing and intensity of contraction within 19 muscle segments of three superficial shoulder muscles (Pectoralis Major, Deltoid and Latissimus Dorsi) were studied and compared during the production of rapid (e.g. approximately 400ms time to peak) isometric force impulses in four different movement directions of the shoulder joint (flexion, extension, abduction and adduction). The results of this investigation have suggested that the timing and intensity of each muscle segment's activation was coordinated across muscles and influenced by the muscle segment's moment arm and its mechanical line of action in relation to the intended direction of shoulder movement (e.g. flexion, extension, abduction or adduction). There was also evidence that motor unit task groups were formed for individual motor tasks which comprise motor units from both adjacent and distant muscles. It was also confirmed that for any particular motor task, individual muscle segments can be functionally classified as prime mover, synergist or antagonist - classifications which are flexible from one movement to the next.

Adaptation, Physiological↗

Adaptation of gait initiation in children with unilateral idiopathic clubfoot following conservative treatment.

Children with unilateral clubfoot (CF) treated conservatively have residual foot deformities and triceps surae m. atrophy. Using surface electromyography of tibialis anterior (TA), gastrocnemius (GA), and peroneus longus muscles, simultaneously with ground reaction forces recordings, the present work assesses the influence of this pathology on the gait initiation process. Ten children with CF and 10 healthy children were investigated. In children with CF, the velocity of the centre of gravity (CG) at the end of gait initiation did not differ from that of healthy children, because of adaptations of anticipation and execution phases. CG velocity at the end of anticipation was lower in children with CF than in healthy children when the swing foot was the affected one, indicating that propulsion was less efficient in this condition. It is shown that this resulted from alterations in anticipation duration, initial centre of pressure position and TA and PL excitations. Execution was shortened when support was provided by the pathological foot: the motor program was adapted to shorten the phase during which equilibrium control might be deficient. Biomechanical characteristics of the execution phase of children with CF did not depend on the swing foot. This indicated that the sound foot cannot be used as a control for accessing residual deficiencies.

Acceleration↗

Surface electromyography as a tool to assess the responses of car passengers to lateral accelerations. Part II: Objective comparison of vehicles.

The purpose of this study was to objectively assess the response of car passengers to lateral accelerations. Surface EMG signals were collected bilaterally from the cervical erector spinae (CES), latissimus dorsi (LD), erector spinae (ES), external oblique (EO), and vastus lateralis (VL) muscles of 10 subjects. Lateral acceleration was also recorded. Three chassis-seat configurations AA, BA and BB were tested, with the first letter denoting the chassis and the second the seat. SEMG signals were often contaminated by noise, and were, therefore, denoised using the methods explained in part I. Reciprocal phasic activity was observed for all muscles except for the EO, and the reaction of passengers to lateral accelerations was interpreted as a bust torsion. The RMS of EMG segments was used as an indication of muscle activity. Muscle activation of VL and ES were significantly affected by the configuration tested (p<0.05), with greater activation levels observed for the chassis A than for the chassis B. Such a finding implies that greater roll requires greater muscle activity, thus resulting in less comfortable vehicles. Therefore, SEMG can be used to provide an objective measure of discomfort in passengers subjected to lateral accelerations in a car seat.

Acceleration↗

Co-contraction of the pronator teres and extensor carpi radialis during wrist extension movements in humans.

In order to elucidate the functional significance of excitatory spinal reflex arcs (facilitation) between musculus (M.) pronator teres (PT) and M. extensor carpi radialis (ECR, longus: ECRL, brevis: ECRB) in humans, activities of the muscles were studied with electromyography (EMG) and electrical neuromuscular stimulation (ENS). In EMG study, activities of PT, ECRL, ECRB, and M. flexor carpi radialis during repetitive static (isometric) wrist extension and a series of a dynamic motion of wrist flexion/extension in the prone, semiprone, and supine positions of the forearm were recorded in 12 healthy human subjects. In the prone, semiprone, and supine positions, PT and ECR showed parallel activities during the static extension in all, eight, and eight subjects, respectively, and at the extension phase during the dynamic motion in all, eight and five subjects, respectively. These findings suggest that co-contraction of PT and ECR occurs during wrist extension movements at least with the prone forearm. The facilitation must be active during the co-contraction. In ENS study, ENS to PT was examined in 11 out of the 12 and that to ECRL was in the 12 subjects. Before ENS, the forearm was in the prone, semiprone, and supine positions. In all the subjects, ENS to PT induced a motion of forearm pronation to the maximum pronation. ENS to ECRL induced motions of wrist extension to the maximum extension and abduction (radial flexion) to 5-20 degrees of abduction regardless of the positions of the forearm. Moreover, it induced 30-80 degrees supination of the forearm from the prone position. Consequently, combined ENS to PT and ECRL resulted in motions of the extension and abduction while keeping the maximum pronation. These findings suggest that the co-contraction of PT and ECR during wrist extension movements occurs to prevent supinating the forearm. Forearm supination from the prone position should be added to one of the actions of ECRL.

Adult↗

Trunk muscle activation and associated lumbar spine joint shear forces under different levels of external forward force applied to the trunk.

High anterior intervertebral shear loads could cause low back injuries and therefore the neuromuscular system may actively counteract these forces. This study investigated whether, under constant moment loading relative to L3L4, an increased externally applied forward force on the trunk results in a shift in muscle activation towards the use of muscles with more backward directed lines of action, thereby reducing the increase in total joint shear force. Twelve participants isometrically resisted forward forces, applied at several locations on the trunk, while moments were held constant relative to L3L4. Surface EMG and lumbar curvature were measured, and an EMG-driven muscle model was used to calculate compression and shear forces at all lumbar intervertebral joints. Larger externally applied forward forces resulted in a flattening of the lumbar lordosis and a slightly more backward directed muscle force. Furthermore, the overall muscle activation increased. At the T12L1 to L3L4 joint, resulting joint shear forces remained small (less than 200N) because the average muscle force pulled backward relative to those joints. However, at the L5S1 joint the average muscle force pulled the trunk forward so that the increase in muscle force with increasing externally applied forward force caused a further rise in shear force (by 102.1N, SD=104.0N), resulting in a joint shear force of 1080.1N (SD=150.4N) at 50Nm moment loading. It is concluded that the response of the neuromuscular system to shear force challenges tends to increase rather than reduce the shear loading at the lumbar joint that is subjected to the highest shear forces.

Abdomen↗

Spinal loading during manual materials handling in a kneeling posture.

Stooped, restricted, kneeling, and other awkward postures adopted during manual materials handling have frequently been associated with LBP onset. However, lift assessment tools have focused on materials handling performed in an upright, or nearly upright standing posture. Unfortunately, many of the tools designed to analyze standing postures are not easily adapted to jobs requiring restricted postures. Therefore, the objective of this study was to evaluate spinal loading during manual materials handing in kneeling postures and determine if those loads can be predicted using simple regression. An EMG-driven biomechanical model, previously validated for upright lifting, was adapted for use in kneeling tasks. Subjects knelt under a 1.07m ceiling and lifted luggage of six weights (6.8, 10.9, 15.0, 19.1, 23.1 and, 27.2kgf) to one of four destination heights (0, 25.4, 53.3, 78.7cm). Spine loading was significantly affected by both destination height and load weight. Destination height increased compression, AP shear and lateral shear by an average of 14.5, 3.7 and 6.6N respectively per cm height increase. Load weight increased compression, AP shear and lateral shear by an average of 83.8, 27.0 and 13.1N respectively per kgf lifted. Regression equations were developed to predict peak spine loading using subject height, load weight and destination height with R(2) values of 0.62, 0.51 and 0.57 for compression, AP and lateral shear respectively.

Adult↗

Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations.

Much discussion exists about which is the most effective technique to improve spine stability. The purpose of this study was to evaluate the effectiveness of abdominal bracing and abdominal hollowing maneuvers to control spine motion and stability against rapid perturbations. Eleven healthy males were posteriorly loaded in different experimental conditions: resting with no knowledge of the perturbation timing; performing each of the stabilization maneuvers at 10%, 15% and 20% of internal oblique maximum voluntary contraction with no knowledge of the perturbation timing; and naturally coactivating the trunk muscles when perturbation timing was known. An EMG biofeedback system was used to control the pattern and intensity of abdominal coactivation. The muscular preactivation of seven trunk muscles (bilaterally registered), the applied force, and the torso muscular and kinematic responses to loading were measured; and the spine stability and compression were modeled. The hollowing maneuver was not effective for reducing the kinematic response to sudden perturbation. On the contrary, the bracing maneuver fostered torso cocontraction, reduced lumbar displacement, and increased trunk stability, but at the cost of increasing spinal compression. When the timing of the perturbation was known, the participants were able to stabilize the trunk while imposing smaller spine compressive loads.

Abdomen↗

Anticipation mechanism in body sway control and effect of muscle fatigue.

The aim of this work is to quantify the occurrence of an anticipatory mechanism in the control of quiet standing by measuring the lag between the myoelectric activity of the lateral gastrocnemius muscle and the stabilometric signal, as well as to determine the influence of the muscle fatigue on this process. Stabilometric and electromyographic (EMG) signals were synchronously collected from 22 subjects. Gastrocnemius fatigue was induced by a sustained plantar flexed posture until muscle failure. The data acquisition lasted for 120 s before and after the induced fatigue. After mean removal, the root mean square values of the EMG (RMS-EMG) were calculated for each 20 ms period. The normalized cross-correlation function was estimated to find the time delay between RMS-EMG and stabilometric signals. Anticipation values up to 1.62 s were found both before and after fatigue conditions (p<0.05), indicating that this mechanism plays an important role in body sway control. The fatigue caused a significant increase in the latency between the myoelectric activity of the gastrocnemius muscle and the movements of the center of pressure (p<0.05).

Adult↗

Quantification of intrinsic and reflexive properties during multijoint arm posture.

This study estimates intrinsic and reflexive properties of single- and two-joint muscles acting around the human shoulder, elbow and wrist joint during posture maintenance. External force disturbances were applied to the hand while subjects (n = 5) were instructed to minimize their hand displacement amplitude in a horizontal plane. To examine how the nervous system modifies intrinsic and reflexive muscle properties, we varied external damping, disturbance power and arm configuration. A new identification method is introduced to quantify a large set of model parameters describing intrinsic, activation and reflexive properties, the latter representing afferent feedback gains from muscle spindles and Golgi tendon organs. Consistent estimates were found for the gains of the different types of reflex pathways. The results showed that intrinsic visco-elasticity of shoulder muscles was minimal, whereas reflexive feedback was largest compared to the elbow and wrist joint. Intrinsic and reflexive properties of the two-joint shoulder-elbow muscles were larger than the two-joint elbow-wrist muscles. Contrasting to previous single-joint studies, the reflex gains did not vary with the experimental conditions. It is concluded that during redundant multijoint posture maintenance, the mechanical properties are efficiently controlled on the joint level and not on the endpoint level.

Adult↗

From trepidant abasia to motor network failure--gait disorders as a consequence of subcortical vascular encephalopathy (SVE): review of historical and contemporary concepts.

Gait disorders in progressive subcortical vascular encephalopathy (SVE) and their impact on the burden of disability in the growing elderly population are underrepresented in medical scientific literature. The absence of a clear framework for the diagnosis and classification for gait disorders on the basis of SVE has multiple reasons: (1) neither movement disorder specialists nor stroke specialists are truly familiar with this topic and feel responsible for its treatment, (2) the existing terminology lacks a clear concept and a consistent classification, and (3) only in recent years have large prospective trials started to address the natural course of SVE. This article reviews the classical descriptions of gait disturbances with preferential view to our present concept of SVE, and comments on historical and current nosology of gait disorders aiming to propose for a new classification.

Basal Ganglia Diseases↗

A threshold-based fall-detection algorithm using a bi-axial gyroscope sensor.

A threshold-based algorithm, to distinguish between Activities of Daily Living (ADL) and falls is described. A gyroscope based fall-detection sensor array is used. Using simulated-falls performed by young volunteers under supervised conditions onto crash mats and ADL performed by elderly subjects, the ability to discriminate between falls and ADL was achieved using a bi-axial gyroscope sensor mounted on the trunk, measuring pitch and roll angular velocities, and a threshold-based algorithm. Data analysis was performed using Matlab to determine the angular accelerations, angular velocities and changes in trunk angle recorded, during eight different fall and ADL types. Three thresholds were identified so that a fall could be distinguished from an ADL: if the resultant angular velocity is greater than 3.1 rads/s (Fall Threshold 1), the resultant angular acceleration is greater than 0.05 rads/s(2) (Fall Threshold 2), and the resultant change in trunk-angle is greater than 0.59 rad (Fall Threshold 3), a fall is detected. Results show that falls can be distinguished from ADL with 100% accuracy, for a total data set of 480 movements.

Accidental Falls↗

The effect of aging on postural stability: a cross sectional and longitudinal study.

AIMS OF THE STUDY: Only a good knowledge of the effects of age on postural stability allows differentiating between physiological aging and pathologies leading to its impairment. The aims of this study were to define the posturographic parameters which best reflected the effects of aging on postural stability and to determine the slope of postural stability impairment related to aging. PATIENTS AND METHODS: Postural stability of 50 normal volunteers aged 25-83 years (55.4) was studied with one Kistler force plate. Subjects were asked to stand for 30 s on two-legged stance, eyes open then closed. The center of pressure displacement (COPd) and velocities (COPv), in the antero-posterior (x) and the medio-lateral (z) axis, the sway axis, and the integral of COP displacement vs. time were computed. Eleven subjects were retested at 3 and 6 months to estimate the reliability of posturographic measurements. In addition, 28 subjects aged 25-83 years (60.2) were retested 2.2 years after their first posturographic assessment. RESULTS: COPxv best reflected postural stability impairment with aging. Closure of the eyes increased the variance of the results. This change was higher in subjects more than 60 years old: 0.019-0.157 cm2 s(-2) than in younger ones: 0.011-0.043 cm2 s(-2). Retesting at 3 and 6 months showed a reliability of 79%. According to the cross-sectional part of the study, the slope of postural stability impairment with aging was estimated at 0.0038 cm/s/year. These results were confirmed by the longitudinal part of the study, which showed that COPxv increased from 0.66-0.75 cm/s/year (P = 0.0001) (slope = 0.0041 cm/s/year). CONCLUSION: (1) Measurement of COPxv, on two-legged stance, is a simple and reliable way to assess postural stability. (2) Thanks to both a cross sectional and a longitudinal study, the rate of postural stability impairment due to aging was precisely estimated, which will be useful to help distinguishing between the part of postural stability impairment attributable to aging from the one due to neuro-degenerative diseases.

Adult↗