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Preparatory process for anticipatory postural adjustments: modulation of leg muscles reflex pathways during preparation for arm movements in standing man.

We have investigated, in 6 standing subjects, the time course of amplitude changes in the short latency (40-60 ms) and long latency (60-80 ms) reflex response components of gastrocnemius medialis (GM) and soleus (S) muscles during the preparatory period (time between a warning signal and a response signal) as a function of the precued direction (pull or push) of arm movement. Subjects maintained their standing posture by visual feedback during the 1.5 s preparatory period of a reaction time task. A warning signal gave advance information concerning the voluntary response to be performed which consisted of either a pull or push movement of the right arm. The excitability of the reflex pathways was evaluated by triggering a rapid rotation of the right ankle joint (dorsiflexion) applied randomly at 100, 300 or 500 ms before the response signal for arm movement. Statistical analysis of EMG amplitude (ANOVA) showed that preparatory effects were different for the two synergistic muscles with both short (spinal) and longer latency components of GM showing generalized facilitation and of S showing generalized inhibition. In addition, the longer latency, presumably supraspinal, component of the two muscles was differentially modulated according to directional advance information, showing relative facilitation for pull as compared to push trials. These reflex response modulations were emphasized in faster reaction time (RT) performers at the end of the preparatory period. It is concluded that postural preparatory processes are reflected at the spinal level in global effects and at the supraspinal level in directionally specific effects.

Adolescent↗

Accuracy of planar reaching movements. II. Systematic extent errors resulting from inertial anisotropy.

This study examines the source of direction-dependent errors in movement extent made by human subjects in a reaching task. As in the preceding study, subjects were to move a cursor on a digitizing tablet to targets displayed on a computer monitor. Movements were made without concurrent visual feedback of cursor position, but movement paths were displayed on the monitor after the completion of each movement. We first examined horizontal hand movements made at waist level with the upper arm in a vertical orientation. Targets were located at five distances and two directions (30 degrees and 150 degrees) from one of two initial positions. Trajectory shapes were stereotyped, and movements to more distant targets had larger accelerations and velocities. Comparison of movements in the two directions showed that in the 30 degrees direction responses were hypermetric, accelerations and velocities were larger, and movement times were shorter. Since movements in the 30 degrees direction required less motion of the upper arm than movements in the 150 degrees direction, we hypothesized that the differences in accuracy and acceleration reflected a failure to take into account the difference in total limb inertia in the two directions. To test this hypothesis we simulated the initial accelerations of a two-segment limb moving in the horizontal plane with the hand at shoulder level when a constant force was applied at the hand in each of 24 directions. We compared these simulated accelerations to ones produced by our subjects with their arms in the same position when they aimed movements to targets in the 24 directions and at equal distances from an initial position. The magnitudes of both simulated and actual accelerations were greatest in the two directions perpendicular to the forearm, where inertial resistance is least, and lowest for movements directed along the axis of the forearm. In all subjects, the directional variation in peak acceleration was similar to that predicted by the model and shifted in the same way when the initial position of the hand was displaced. The pattern of direction-dependent variations in initial acceleration did not depend on the speed of movement. It was also unchanged when subjects aimed their movements toward targets presented within the workspace on the tablet instead of on the computer monitor. These findings indicate that, in programming the magnitude of the initial force that will accelerate the hand, subjects do not fully compensate for direction dependent differences in inertial resistance.(ABSTRACT TRUNCATED AT 400 WORDS)

Acceleration↗

The relationship between control, kinematic and electromyographic variables in fast single-joint movements in humans.

Two versions of the hypothesis that discrete movements are produced by shifts in the system's equilibrium point are considered. The first suggests that shifts are monotonic and end near the peak velocity of movement, and the second presumes that they are nonmonotonic ("N-shaped") and proceed until the end of movement. The first version, in contrast to the second, predicts that movement time may be significantly reduced by opposing loads without changes in the control pattern. The purpose of the present study was to test the two hypotheses about the duration and shape of the shift in the equilibrium point based on their respective predictions concerning the effects of perturbations on kinematic and EMG patterns in fast elbow flexor movements. Subjects performed unopposed flexions of about 55-70 degrees (control trials) and, in random test trials, movements were opposed by spring-like loads generated by a torque motor. Subjects had no visual feedback and were instructed not to correct arm deflections in case of perturbations. After the end of the movement, the load was removed leading to a secondary movement to the same final position as that in control trials (equifinality). When the load was varied, the static arm positions before unloading and associated joint torques (ranging from 0 to 80-90% of maximum voluntary contraction) had a monotonic relationship. Test movements opposed by a high load (80-90% of maximal voluntary contraction) ended near the peak velocity of control movements. Phasic and tonic electromyographic patterns were load-dependent. In movements opposed by high loads, the first agonist burst was significantly prolonged and displayed a high level of tonic activity for as long as the load was maintained. In the same load conditions, the antagonist burst was suppressed during the dynamic and static phases of movement. The findings of suppression of the antagonist burst does not support the hypothesis of an N-shaped control signal. Equally, the substantial reduction in movement time by the introduction of an opposing load cannot be reconciled in this model. Instead, our data indicate that the shifts in the equilibrium point underlying fast flexor movements are of short duration, ending near the peak velocity of unopposed movement. This suggests that kinematic and electromyographic patterns represent a long-lasting oscillatory response of the system to the short-duration monotonic control pattern, external forces and proprioceptive feedback.

Adult↗

A matrix analysis for a conjugate vestibulo-ocular reflex.

The technique of matrix analysis is used to compare the connectivity between vestibular neurons and oculomotor neurons of the two eyes that would generate a conjugate vestibulo-ocular reflex (VOR). The technique shows that the connectivity is normally anatomically symmetric. The technique is also used to determine the types and loci of adaptation within the VOR that will maintain conjugacy. Adaptation is divided into 1) that evoked by changes in visual feedback, which requires VOR or system-specific changes and 2) that produced by changes in the canals or muscles, which requires deficit-specific adaptation. In the former case, the adaptation could best be achieved by an additive alteration of the vestibular-motoneuron projections. In the latter case, the appropriate adaptations would be serial, multiplicative changes, applied at the level of the vestibular neurons when the canals are at fault or at the level of the motoneurons of the eye whose muscles are impaired. The analysis thus suggests multiple loci of plasticity within the VOR, specialized for adapting to different deficits.

Adaptation, Physiological↗

Isovelocity investigation of the lengthening behaviour of the erector spinae muscles.

The purpose of this study was to investigate the force-velocity (F/v) relationship for the erector spinae muscles in submaximal activation movements, with particular attention to their response during lengthening movements and at lower shortening contraction velocities. Dynamic models that predict lower back muscle forces require reasonable representations of the modulating effect of instantaneous velocity. Ten males were observed performing trunk flexion and extension in the sagittal plane under constant load. Contraction velocities were measured as the first derivative from a devise sensitive to changes in spine curvature, and controlled by a visual feedback system while a constant load was applied through a chest harness. The erector spinae exhibited a yielding phenomenon which causes an abrupt drop in force during constant velocity stretching under constant, submaximal, stimulation. The findings were consistent with previous isovelocity muscle lengthening experiments. Yielding appeared dependent on the level of load/activation supporting the theory of a "state-variable" F/v relationship. The eccentric behaviour of the lower erectors (L3) seemed independent of velocity and length, while that of the upper erectors (T9) showed a dependence on length. At lower concentric velocities, concavity in torque-velocity curves was noted after a "threshold" velocity. The findings of this study strongly reinforce the notion that the F/v length relationship is not a continuous hyperbolic relationship during muscle shortening and that the commonly modelled force augmentation effect of lengthening is incorrect, at least for submaximal activation of the extensors of the lower back.

Adult↗

Instructed heart rate control in a high heart rate population.

Forty college students were selected from a large number of introductory psychology students on the basis of high heart rate during an initial screening session. Subjects were then contacted and participated in two additional sessions during which heart rate, respiration rate, and skin conductance measures were obtained. Each session consisted of a baseline period followed by five trial periods during which subjects attempted to control their heart rate or performed a visual tracking task. Subjects were randomly assigned to one of four groups. One group served as a control and monitored a visual feedback display driven by their own heart rate but received no instructions to decrease their heart rate. In contrast, the three heart rate control groups were instructed to decrease heart rate during the trial periods by utilizing a relaxation procedure, proportional biofeedback, or proportional biofeedback plus criterion information. No group differences were present during the baseline periods. During feedback trials, however, all the training groups differed from the control in heart rate but did not differ from each other. It is suggested that feedback displays may not facilitate heart rate reduction beyond the level achieved by instructing subjects to use a general relaxation procedure.

Attention↗

An experimental analysis of a program to reduce retail theft.

A program for elementary school-aged youth, designed for and implemented by a retail business, was evaluated. The program included visual instructions to youth, tokens (exchangeable for special prizes) for appropriate verbal behavior, visual feedback to youth, and rewards for reducing merchandise loss, all continued to a criterion level. A 54% reduction in losses of popular youth merchandise was achieved.

Child↗

Operant conditioning of skin resistance tonic levels.

The purpose of the current investigation was to determine whether increases and decreases in skin resistance tonic level could be controlled by individuals given discrete visual feedback of such activity. Thirty-six male undergraduate students served as subjects. They were assigned randomly in equal numbers to four groups; two of the groups received accurate feedback of skin resistance level changes and two received inaccurate feedback. The two accurate-feedback groups differed with respect to the order in which increases and decreases in skin resistance level were reinforced. Each noncontingent group was matched with one of the contingent groups in terms of reinforcement density. The results indicated that accurate feedback produced skin resistance level changes consistent with the type of reinforcement employed. However, operant control was not clearly sustained subsequent to a reversal in the type of tonic level change reinforced. Some problems related to the clinical application of skin resistance level training are discussed.

Conditioning, Operant↗

Electrophysiologic behavior modification of frontal EMG in cerebral-palsied children.

Four cerebral-palsied children participated in the following ABAB design: speech and motor pre-electrophysiologic behavior modification (EMB) evaluation; frontal EMG EMB, six weeks; speech and motor post-EBM evaluation; six weeks no training; speech and motor reevaluation; EMG EBM, four weeks; speech and motor evaluation. Auditory and visual feedback of frontal EMG was monitored by cumulative integration of frontal EMG voltage. The children were shaped by setting a cumulative voltage threshold (CVT). If the child's cumulative integrated frontal EMG voltage fell below the CVT at the end of each 60-sec epoch, a reward was automatically dispensed from a Universal Feeder. Frontal EMG decreased significantly over the initial twelve trials. Correspondingly, improvement was noted for the children in speech and motor skills. Follow-up six weeks later showed increased frontal EMG voltage and deterioration of speech and motor function. Reinstitution of frontal EMG EBM produced reacquisition of low frontal EMG and some recovery of speech and motor function. Collectively, these results indicate that frontal EMG EBM shows promise as an additional treatment modality in the habilitation of cerebral palsy children with spasticity.

Behavior Therapy↗

Highlights of the 13th International Symposium on Respiratory Psychophysiology held at the inaugural meeting of the International Society for the Advancement of Respiratory Psychophysiology.

This article presents a summary of selected events that highlighted the 13th International Symposium on Respiratory Psychophysiology held at the inaugural meeting of the International Society for the Advancement of Respiratory Psychophysiology, Saint Flour, France, 1994. The topic of basic and applied research includes summaries of presentations of research on (a) the control of breathing, (b) dyspnea, (c) dyspneic-fear, (d) hyperventilation (panic disorder, somatic changes, pain, fatigue, occupational stress, and strain), and (e) asthma. The topic of evaluation of treatment includes (a) a review of breathing retraining outcome studies and (b) a discussion of recent advances and continuing controversies regarding breathing patterns and breathing retraining. The topic of technical advances is provided by a description of a visual feedback device for pulmonary rehabilitation. The symposium banquet celebration was highlighted by an award ceremony in which L. C. Lum was recognized for his distinguished contributions to respiratory psychophysiology.

Humans↗

Slowed respiration training.

A method of slowed respiration rate (RR) training is described that uses visual feedback of the respiratory cycle. Subjects assigned to the slowed RR training procedure were compared with subjects assigned to either a traditional frontal electromyographic (EMG) biofeedback condition or a control condition where no feedback was presented. RR, frontal EMG, heart rate, digital temperature, and skin conductance level were monitored simultaneously. The results indicated that RR training was effective in reducing RR, that RR training had little systematic effect on the other physiological variables, and the frontal EMG procedure did not in itself reduce RR. The advantages of the current methodological approach and the importance of respiration training were discussed along with a literature review. The relationship between RR training and the complexities of respiratory phenomena was discussed, as well as ways that future research using this method may help clarify current issues within respiration training.

Adult↗

Can manometric parameters predict response to biofeedback therapy in fecal incontinence?

PURPOSE: Biofeedback therapy may improve fecal control in up to 50 percent to 92 percent of patients with fecal incontinence. Identification of favorable manometric parameters before biofeedback therapy may help in selection of patients suitable for such therapy. METHODS: Twenty-eight patients with fecal incontinence (idiopathic, 11; iatrogenic trauma, 8; obstetric trauma, 9) who underwent biofeedback therapy were studied to determine whether manometric parameters could predict the result of therapy. Biofeedback was given using a computer software program designed to strengthen the external anal sphincter with auditory and visual feedback. RESULTS: Thirteen patients (46.4 percent) achieved excellent results; eight patients (28.6 percent) had good results, but seven patients (24.5 percent) failed to improve after biofeedback therapy. Resting or squeeze anal canal pressure, pressure volume, sphincter length, sphincter fatigue rate, and cross-sectional asymmetry of the entire sphincter before biofeedback failed to reveal any statistically significant differences between responders and nonresponders. However, the cross-sectional asymmetry of the high-pressure zone within the sphincter at rest was greater in nonresponders than in responders (not improved, 25.8 percent; good result, 20.2 percent; excellent result, 15.4 percent; P < 0.07). This difference was even greater on squeeze (not improved, 21 percent; good result, 17.6 percent; excellent result, 13.2 percent; P < 0.04). The number of biofeedback sessions, response on bearing down, and quality of rectoanal excitatory reflex were not reliable indicators of outcome. No statistical difference was found in mean resting and squeeze pressures after biofeedback between responders and non-responders. CONCLUSIONS: Except for increased cross-sectional asymmetry in the high-pressure zone, which may be a forerunner of adverse outcome, manometric parameters before biofeedback do not predict response to biofeedback therapy. Improvement in continence may be independent of resting and squeeze pressures achieved after biofeedback therapy.

Adult↗

The effects of breathing pattern training on ventilatory function in patients with COPD.

The purpose of this study was to assess the effects of a particular breathing pattern training (BPT) on forced expiratory volume during the first second (FEV1) and forced vital capacity (FVC) in patients with chronic obstructive pulmonary disease (COPD). The subjects adjusted each breath to a target breath displayed on a video screen, by using visual feedback. This target was chosen in an individual sample recorded at rest. We used a randomized, controlled group design. Twenty patients with stable COPD, FEV1 less than 1.5 liters, undergoing a traditional rehabilitation program were randomly assigned to the BPT group or to the control group. Each BPT subject underwent 30-35 training sessions spread out over four weeks, in addition to the traditional program. FEV1 and FVC were performed before and after this program. ANOVAs showed that FEV1 and FVC significantly improved in BPT subjects, with a mean percent increase of 22% and 19%, respectively. Corresponding changes in controls were not significant. This study showed short-term increases in FEV1 and FVC in COPD patients practicing BPT in addition to respiratory rehabilitation, in comparison with controls. Further studies should incorporate outcome data to clarify the mechanisms and the duration of this effect.

Aged↗

Biofeedback training in patients with fecal incontinence.

PURPOSE: This study was undertaken to assess the functional results of biofeedback training in patients with fecal incontinence in relation to clinical presentation and anorectal manometry results. METHODS: Twenty-six consecutive patients with fecal incontinence were treated with biofeedback training using anorectal manometry pressure for visual feedback. Ten patients had passive incontinence only, six patients had urge incontinence, and ten patients had combined passive and urge incontinence. RESULTS: Patients with urge incontinence had a lower maximum voluntary contraction pressure (92+/-12 mmHg) and a lower maximum tolerable volume (78+/-13 ml) than patients with passive incontinence (140+/-43 mmHg and 166+/-73 ml). Twenty-two patients completed the treatment, five patients (23 percent) showed excellent improvement, nine patients (41 percent) had good results, and eight (36 percent) patients showed no improvement. At follow-up on average of 21 months after therapy, 41 percent of our patients reported continued improvement. The maximum tolerable volume was higher in those with excellent (140.4+/-6.8 ml) or good (156.3+/-6.64 ml) results of therapy than it was in those with poor results (88.5+/-2.5 ml). Greater asymmetry of the anal sphincter also correlated to poor results. CONCLUSION: Biofeedback therapy improved continence immediately after training and at follow-up after 21 months, but the initial results were better. The urge fecal incontinence seems to be related to function of the external anal sphincter and to the maximum tolerable volume. Low maximum tolerable volume and anal sphincter asymmetry were associated with a poor outcome of therapy.

Adult↗

Analysis of postural sway using entropy measures of signal complexity.

A stochastic complexity analysis is applied to centre-of-pressure (COP) time series, by using different complexity features, namely the spectral entropy, the approximate entropy, and the singular value decomposition spectrum entropy. A principal component analysis allows an estimate of the overall signal complexity in terms of the ensemble complexity score; the difference in values between open-eyes (OE) and closed-eyes (CE) trials is used for clustering purposes. In experiments on healthy young adults, the complexity of the mediolateral component is shown not to depend on the manipulation of vision. Conversely, the increase of the anteroposterior complexity in OE conditions can be statistically significant, leading to a functional division of the subjects into two groups: the Romberg ratios (RRs), namely the ratios of the CE measure to the OE measure, are: RR = 1.19 +/- 0.15 (group 1 subjects), and RR = 1.05 +/- 0.14 (group 2 subjects). Multivariate statistical techniques are applied to the complexity features and the parameters of a postural sway model recently proposed; the results suggest that the complexity change is the sign of information-generating behaviours of postural fluctuations, in the presence of a control strategy which aims at loosening long-range correlation and decreasing stochastic activity when visual feedback is allowed.

Adult↗

New instrumental set for the assessment of the hand functionality.

Hand motor deficits have been widely investigated, and several devices have been proposed for the selective and accurate study of specific hand motor tasks. Most studies have focused on the four, long fingers. The thumb function, although extremely important for the performance of most daily activities involving the hand, has scarcely been documented. A set of general-purpose, instrumental measuring devices has been designed and constructed at the authors' laboratory to measure and monitor the force each finger exerts separately, under isometric conditions, during pressing tasks. More generally, it is meant for the functional evaluation of the normal hand in different postures, but it also provides reliable measurements of the injured or deformed hand. The instrumental set is suitable for both biomechanical research and clinical applications. Effectively integrated with a visual feedback tool, it could be exploited in delivering and monitoring custom-designed rehabilitation programmes. The characteristics of the force transducers (range 0-100 N) were: inter-axis crosstalk < 4%; non-linearity < +/- 0.4% f.s.; hysteresis < 0.3% f.s.; overall accuracy +/- 1% f.s. The overall measurement system resolution was better than 0.1 N, and the keys response to the mechanical shock (acquired at 10 kHz) showed a resonance frequency of about 1 kHz. It was observed that the thumb contributed more than 30% of the overall pressing force.

Adult↗

Biofeedback gait training system for temporal and distance factors.

A biofeedback gait-training system has been developed which can deal with the gait problems of all subjects in any phase of rehabilitation: measurement, analysis, training and/or evaluation. The system is composed of a measuring walkway and a training walker. The walkway can measure all the temporal and distance factors of gait. The walker, with two parallel grasping bars and a CRT monitor, moves automatically with the aid of servo-motors. The system provides visual feedback for distance factors of gait and audio feedback for temporal factors. During the single-support phase the desired foot position for the next step and the supporting foot position are displayed on the CRT. The actual position of the foot placement is then overlaid for the double support duration that follows. A trainee learns to place the foot in such a way as to overlap the desired with the actual foot stamps on the CRT. The desired temporal factors are provided by buzzer tones. A trainee tries to shorten or elongate the duration of the respective phase of the gait cycle in accordance with the tone. Some experiments on normal subjects and on some with degenerative knee joints verified that the biofeedback signals were utilised effectively and that the walker was of value for improving pathological gait.

Adult↗

Non-invasive method to detect motor unit contractile properties and conduction velocity in human vastus lateralis muscle.

The contractile properties and conduction velocity of motor units are estimated by using surface array electrodes during voluntary isometric contractions of the human vastus lateralis muscle. The subjects develop and maintain sufficient force to steadily discharge a given motor unit, assisted by visual feedback from an oscilloscope. The torque curve developed around the knee joint is triggered by an individual motor unit and averaged. 31 motor units in five subjects are studied. The twitch tension detected ranges from 3 to 27 m Nm with a mean of 12.3 m Nm. The threshold force ranges from 1.88 to 10.12 Nm with a mean of 5.48 Nm, which is 3% of the maximal voluntary contraction. The rise time ranges from 56 to 106 ms with a mean of 83 ms. The mean value of conduction velocity is 4.64 m s-1. The twitch tension is positively correlated to the threshold force (r = 0.839, p < 0.01), but has no relation to the other parameters. It is concluded that the use of non-invasive surface array electrodes provides the contractile properties of motor units and muscle fibre conduction velocity during weak contractions.

Electromyography↗