Flexor Activity Research Articles

Neck Active Movements Assessment in Women with Episodic and Chronic Migraine.

We aimed to compare movement parameters and muscle activity during active cervical spine movements between women with episodic or chronic migraine and asymptomatic control. We also assessed the correlations between cervical movement measures with neck-related disability and kinesiophobia. Women with episodic (n = 27; EM) or chronic (n = 27; CM) migraine and headache-free controls (n = 27; CG) performed active cervical movements. Cervical range of motion, angular velocity, and percentage of muscular activation were calculated in a blinded fashion. Compared to CG, the EM and CM groups presented a reduced total range of motion (p < 0.05). Reduced mean angular velocity of cervical movement was also observed in both EM and CM compared to CG (p < 0.05). Total cervical range of motion and mean angular velocity showed weak correlations with disability (r = −0.25 and −0.30, respectively; p < 0.05) and weak-to-moderate correlations with kinesiophobia (r = −0.30 and −0.40, respectively; p < 0.05). No significant correlation was observed between headache features and total cervical range of motion or mean angular velocity (p > 0.05). No differences in the percentage of activation of both flexors and extensors cervical muscles during active neck movements were seen (p > 0.05). In conclusion, episodic and chronic migraines were associated with less mobility and less velocity of neck movements, without differences within muscle activity. Neck disability and kinesiophobia are negative and weakly associated with cervical movement.

Differential activation of psoas major and rectus femoris during active straight leg raise to end range

The purpose of this study was to investigate the activation of the hip flexor and abdominal muscles during an active straight leg raise (ASLR) to end range of hip flexion. Data were recorded from nine healthy men. Fine-wire electromyography (EMG) electrodes were inserted into psoas major (PM), and surface electrodes were placed over rectus femoris (RF), rectus abdominis, obliquus externus abdominis (OE), and obliquus internus abdominis/transversus abdominis (OI/TrA). EMG and kinematic data were obtained during concentric, hold (at end range) and eccentric phases of an ASLR. Concentric and eccentric movements were divided into three phases (early, mid, and late). Onsets of EMG relative to the onset of the ALSR movement and EMG amplitudes in each phase were compared between muscles. Onsets of the PM (–33 ± 245 ms) and RF (-3 ± 119 ms) EMG prior to leg elevation were significantly earlier than those of the OE and OI/TrA. PM EMG showed highest activation in the late concentric, hold, early eccentric phase, and was significantly higher than RF EMG. OI/TrA EMG was significantly greater in mid and late concentric, hold, and early eccentric phase than other phases. During the ASLR, unlike RF, PM EMG continues to increase towards the end range of hip flexion. Activation of OI/TrA muscle may be involved in control trunk and pelvic movement.

The single-leg heel raise does not predict maximal plantar flexion strength in healthy males and females.

IntroductionThe single-leg heel raise test (SLHR) is commonly used in clinical settings to approximate plantar flexor strength, yet this is neither validated nor supported physiologically. The purposes of this study were to: determine (1) associations between SLHR repetitions, maximal plantar flexor strength, and reductions in strength; and (2) whether sex differences exist in performance of the SLHR.MethodsTwenty-eight young, healthy participants (14 males,14 females, 19–30 years) performed repeated single-leg heel raises to task failure. Pre- and post-task measures included maximal voluntary isometric contractions (MVIC), and voluntary activation and contractile properties of the plantar flexor muscles, assessed using peripheral electrical stimulation of the tibial nerve. Surface electromyography was recorded for the medial and lateral gastrocnemius, soleus, and anterior tibialis muscles.ResultsThe SLHR resulted in 20.5% reductions in MVIC torque (p<0.001). However, the number of SLHR repetitions was not correlated with either the baseline MVIC (maximal strength; p = 0.979) or the reduction in MVIC following the SLHR (p = 0.23). There were no sex differences in either the number of SLHR repetitions (p = 0.14), baseline MVIC torque (p = 0.198), or the reduction of MVIC (p = 0.14). MVIC decline was positively associated with the reduction in voluntary activation (r = 0.841, p<0.001), but was not associated with the change in twitch amplitude (p = 0.597).ConclusionsThe SLHR was similar in young males and females yet was a poor predictor of maximal plantar flexor strength but evaluates performance fatigability of the lower extremity specific to dynamic contractions. The reduction in maximal strength at task failure was explained by reduced neural drive to the plantar flexor muscles in both males and females.Impact statementSLHR performance is not a clinical assessment of plantar flexor strength but assesses dynamic lower extremity fatigability that is similar in males and females. Alternate clinical measures for maximal plantar flexion strength need to be developed.

Agonist and antagonist activation at the ankle monitored along the swing phase in hemiparetic gait

BackgroundDescending command in hemiparesis is reduced to agonists and misdirected to antagonists. We monitored agonist and antagonist activation along the swing phase of gait, comparing paretic and non-paretic legs. MethodsForty-two adults with chronic hemiparesis underwent gait analysis with bilateral EMG from tibialis anterior, soleus and gastrocnemius medialis. We monitored ankle and knee positions, and coefficients of agonist activation in tibialis anterior and of antagonist activation in soleus and gastrocnemius medialis over the three thirds of swing phase. These coefficients were defined as the ratio of the root-mean-square EMG from one muscle over any period to the root-mean-square EMG from the same muscle over 100 ms of its maximal voluntary isometric contraction. FindingsAs against the non-paretic side, the paretic side showed lesser ankle dorsiflexion and knee flexion (P < 1.E−5), with higher coefficients of agonist activation in tibialis anterior (+100 ± 28%, P < 0.05), and of antagonist activation in soleus (+224 ± 41%, P < 0.05) and gastrocnemius medialis (+276 ± 49%, P < 0.05). On the paretic side, coefficient of agonist activation in tibialis anterior decreased from mid-swing on; coefficients of antagonist activation in soleus and gastrocnemius medialis increased and ankle dorsiflexion decreased in late swing (P < 0.05). InterpretationDuring the swing phase in hemiparesis, normalized tibialis anterior recruitment is higher on the paretic than on the non-paretic leg, failing to compensate for a marked increase in plantar flexor activation (cocontraction). The situation deteriorates along swing with a decrease in tibialis anterior recruitment in parallel with an increase in plantar flexor activation, both likely related to gastrocnemius stretch during knee re-extension.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT03119948

The role of load-dependent sensory input in the control of balance during gait in rats.

Locomotor activity requires fine balance control that strongly depends on the afferent input from the load receptors. Following hindlimb unloading (HU), the kinematic and EMG activity of the hindlimbs is known to change significantly. However, the effects of HU on the integrative control mechanisms of posture and locomotion are not clear. The goal of the present study was to evaluate the center of mass (CoM) dynamic stabilization and associated adaptive changes in the trunk and hindlimb muscle activity during locomotion after 7 days of HU. The EMG signals from the muscles of the low lumbar trunk [m. longissimus dorsi (VERT)] and the hind limb [m. tibialis anterior (TA), m. semitendinosus (ST), m. soleus (SOL)] were recorded together with the hindquarter kinematics during locomotion on a treadmill in six rats before and after HU. The CoM lateral shift in the step cycle significantly increased after HU and coincided with the enhanced activity of the VERT. The mean EMG of the TA and the ST flexor activity increased significantly with reduction of their burst duration. These data demonstrate the disturbances of body balance after HU that can influence the basic parameters of locomotor activity. The load-dependent mechanisms resulted in compensatory adjustments of flexor activity toward a faster gait strategy, such as a trot or gallop, which presumably have supraspinal origin. The neuronal underpinnings of these integrative posture and locomotion mechanisms and their possible reorganization after HU are discussed.

MBboard: Validity and Reliability of a New Tool Developed to Evaluate Specific Strength in Rock Climbers.

In the present study, we analysed the validity and reliability of a new tool designed to assist the measurement of maximal upper-limb strength in rock climbers in a specific way, named MBboard. The MBboard consists of an artificial small climbing hold affixed to a wooden board, which is connected to any cable-motion strength equipment to determine the maximum dynamic strength (MBboard-1RM). Ten male rock climbers (Rock Climbing Group, RCG = 10) and ten physically active men (Control Group, CG = 10) performed, on three separate occasions, a familiarization session with procedures adopted during MBboard-1RM testing and two experimental trials (i.e., test and retest) to determine the construct validity and reliability of the MBboard during unilateral seated cable row exercise. In the first trial, the electromyographic activity (EMG) was recorded from the flexor digitorum superficialis. The self-reported climbing ability was also recorded. The RCG had superior performance (i.e. 37.5%) and EMG activity (i.e. 51%) in MBboard-1RM testing when compared with the CG (p < 0.05). There was a significant correlation between the MBboard-1RM results and climbing ability (r > 0.72, p < 0.05). Intraclass correlation coefficient analysis revealed good reliability within trials (ICC > 0.79, p < 0.05). These findings suggest that the MBboard is a valid and reliable tool to assess rock climbing-specific maximal strength. The validity of MBboard-1RM appears to be related to the finger flexor muscles activation, probably reflecting the specific adaptations resulting from long-term practice of this sport discipline.

Expiratory abdominal muscle nerve is active at flexor phase, while inspiratory phrenic nerve is not active during locomotion evoked by 5-HT and NMDA in the neonatal rat

Abdominal muscles are involved in respiration and locomotion. In the isolated pons-spinal cord-rib attached preparation from neonatal rat, the phrenic nerve and abdominal muscles show inspiratory and expiratory activity, respectively. Using this preparation, we investigated whether the bath application of NMDA and 5-HT could evoke locomotor activities in the fourth cervical ventral root (C4VR), phrenic nerve, and abdominal muscle nerve (ilioinguinal nerve, IIG-n). We also observed rib and abdominal muscle movements visually. The phrenic nerve and C4VR showed inspiratory activity consistently under the control conditions, whereas IIG-n showed expiratory activity only at the beginning of the experiment. During the chemically-induced locomotion, both C4VR and IIG-n showed locomotor activity, and IIG-n in particular showed flexor activity. During the flexor activity, lateral bending of the rib cage to the recording site was observed. The phrenic nerve showed weak or no apparent locomotor activity. We concluded that the central pattern generator (CPG) for locomotion provides stronger excitatory synaptic inputs to C4 motoneurons innervating neck and shoulder muscles than the inputs to the phrenic motoneurons. Thus, the locomotor CPG provides a suitable amount of inputs to the functionally proper motoneurons. This preparation will be useful to explore how the respiratory and locomotor CPGs select proper motoneurons to give synaptic inputs and are coordinated with each other.

Compensatory Strategies Due to Knee Flexion Constraint during Gait of Non-Disabled Adults

Constraining knee flexion of non-disabled individuals could further our understanding regarding the importance of knee joint during gait, which is a common disturbance in individuals with gait impairment. In this study we investigated whether a mechanical constraint of knee flexion in non-disabled adults would lead to compensatory strategies. Eleven non-disabled male adults walked without and with an orthosis that permitted full extension and limited knee flexion up to either 45° or 30°. We analyzed the temporal organization of lower limb kinematics and electromyograms of the rectus femoris, vastus medialis and lateralis, tibialis anterior, semitendinosus, biceps femoris, and gastrocnemius medialis and lateralis. Non-disabled adults compensated for the reduced knee flexion by increasing hip and ankle joint excursions and ankle flexor activation amplitude. Also, these adults shortened pre-swing and lengthened swing duration in the constrained limb and increased the activity of bifunctional hip extensor and knee flexor muscles in the constrained limb in relation to the unconstrained limb. The use of an orthosis that limited knee flexion in non-disabled adults leaded to compensatory strategies in the temporal organization of joint excursions and muscle activations in the constrained limb. The compensatory effects were correlated with the extent of knee flexion constraint.

Effect of hindlimb unloading on recruitment of gastrocnemius medialis muscle during treadmill locomotion in rats.

After hindlimb unloading (HU), the adaptive changing of the rat step cycle duration, kinematics of the ankle and knee joints, and duration of one-joint ankle extensor m. soleus (SOL) activity are detected. However, how the activity of their synergist gastrocnemius medialis muscle (GM) changes in locomotion after HU remains unknown. GM is a two-joint muscle that produces both extension and flexion torques at the ankle and knee, respectively, regardless of the step cycle phase. The aim of our study was to assess changes in the flexor and extensor activity of GM and their influence on hindlimb kinematics after HU. The hindlimb kinematics, activity of GM, and SOL were evaluated, and semitendinosus muscle (ST) activity was registered in six Wistar rats in treadmill locomotion before and after HU. The mean EMG of the GM activity, which was co-active with ST burst activity, significantly increased after HU. The mean EMG of the GM activity, which was co-active with SOL activity, was unchanged after HU, but both SOL and GM bursts had a tendency to increase in duration. Hyperextension of the knee joint and the tendency to overextension of the ankle joint in the late of the stance phase were revealed after HU. The results show that the absence of weight bearing leads to an increase only in the flexor activity of GM and does not affect the extensor GM activity. Possible mechanisms of changes in GM activity and joint kinematics after HU are discussed.

Pilot evaluation of changes in motor control after wearable robotic resistance training in children with cerebral palsy

Cerebral palsy (CP) is characterized by deficits in motor function due to reduced neuromuscular control. We leveraged the guiding principles of motor learning theory to design a wearable robotic intervention intended to improve neuromuscular control of the ankle. The goal of this study was to determine the neuromuscular and biomechanical response to four weeks of exoskeleton ankle resistance therapy (exo-therapy) in children with CP. Five children with CP (12 – 17 years, GMFCS I – II, two diplegic and three hemiplegic, four males and one female) were recruited for ten 20-minute sessions of exo-therapy. Surface electromyography, three-dimensional kinematics, and metabolic data were collected at baseline and after training was complete. After completion of training and with no device on, participants walked with decreased co-contraction between the plantar flexors and dorsiflexors (-29 ± 11%, p = 0.02), a more typical plantar flexor activation profile (33 ± 13% stronger correlation to a typical soleus activation profile, p = 0.01), and increased neural control complexity (7 ± 3%, p < 0.01 measured via muscle synergy analysis). These improvements in neuromuscular control led to a more mechanically efficient gait pattern (58 ± 34%, p < 0.05) with a reduced metabolic cost of transport (-29 ± 15%, p = 0.02). The findings from this study suggest that ankle exoskeleton resistance therapy shows promise for rapidly improving neuromuscular control for children with CP, and may serve as a meaningful rehabilitative complement to common surgical procedures.

Evaluation of two upper-limb exoskeletons during overhead work: influence of exoskeleton design and load on muscular adaptations and balance regulation.

Overhead works (OHW) are identified as a major risk factor for shoulder musculoskeletal disorders. The use of upper-limb exoskeletons (EXOUL) is emerging to address these challenges. This research tested the influence of EXOUL design and load on the upper-limb and postural muscles activity, and on the balance control, during OHW. This study compared two passive EXOUL, notably differing by the level of assistive torque delivered. Both EXOUL was examined in two load conditions (2 vs. 8kg). Twenty-nine volunteers performed a static OHW for each condition. Both EXOUL led to similar reductions in shoulder flexor muscle activity (12.3 ± 7.8% of RMSREF), compared to without equipment (29.0 ± 14.2% RMSREF). Both EXOUL resulted in a reduction in the activity of shoulder (3.6 ± 3.2% RMSREF) and wrist (2.4 ± 1.7% RMSREF) extensor muscles (4.9 ± 3.9 and 5.9 ± 6.1% RMSREF, respectively). The use of EXOUL led to reductions in back muscle activity, depending on the exoskeleton design (in% RMSREF, 12.9 ± 9.4 for EXO1, 22.8 ± 12.6 for EXO2 and 32.0 ± 18.4 without equipment). Wearing EXOUL induced changes in balance regulation, depending on both exoskeleton design and load condition. The increase of assistive torque was not associated with an increase in EXOUL performance. However, the exoskeleton design (mass, balance, and assistive torque) has to be suitable for the load handled during static OHW to optimize the effects of using an EXOUL on the postural muscles.

Comparisons of muscle strength, size, and voluntary activation in pre- and post-pubescent males and females.

The purpose of this study was to compare measurements of muscle strength, size, and activation of the forearm flexors in pre- and post-pubescent males and females. Forty pre-pubescent (mean ± 95% confidence interval, age = 9.79 ± 0.35years, n = 10 males, n = 10 females) and post-pubescent (age = 17.23 ± 0.58years, n = 10 males, n = 10 females) youth participated. Subjects completed maximal voluntary isometric contractions (MVICs) of the forearm flexors, and submaximal isometric step muscle actions at 30, 50, and 70% of the peak MVIC. Percent voluntary activation (VA) was quantified during all isometric muscle actions. Forearm flexor (biceps brachii and brachialis) muscle cross-sectional area (CSA) was quantified from ultrasound images. MVIC strength was expressed in absolute terms and normalized to CSA. Post-pubertal males were 130% stronger, had 101% greater CSA, and 17% greater maximal VA than pre-pubertal males, while post-pubertal females were 72% stronger, had 54% greater CSA, and 23% greater maximal VA than pre-pubertal females. When MVIC strength was normalized to CSA, the post-pubertal males were still 15% stronger than the pre-pubertal males, while the post-pubertal females were only 12% stronger than the pre-pubertal females. The responses for VA across intensity reflected differences in muscle activation strategies between pre- and post-pubertal males and females. These results suggest that muscle size may account for a greater proportion of the growth and development-related differences in strength among males, while females may be more affected by changes in muscle activation. Regardless of sex, changes in muscle size and neuromuscular function influence strength increases during growth and development.

Wrist extensor muscle activity is less task-dependent than wrist flexor muscle activity while simultaneously performing moderate-to-high handgrip and wrist forces

The aim of this study was to characterize wrist extensor and flexor muscle activity during combinations of moderate-to-high handgrip and wrist forces that are similar to actions and intensities used in many workplace settings. Surface electromyography was recorded from three wrist flexors and three wrist extensors while participants performed simultaneous handgrip forces and wrist forces ranging in intensities from 15-60% of maximum. While the wrist flexors were highly task-dependent, in that their activity significantly changed between conditions, wrist extensor activity was consistently high throughout the experiment. Wrist joint co-contraction was also significantly higher when the wrist extensors were functioning as the antagonists. These findings suggest that the wrist extensors likely demonstrate consistently higher muscle activity during most tasks of the hand and wrist, which is likely the leading mechanism behind why they develop chronic overuse injuries more frequently than the wrist flexors. Practitioner Summary: This study was conducted to identify forearm muscle activity patterns that might help explain why the wrist extensors develop overuse injuries more frequently than the flexors. Results demonstrated that the wrist extensors are consistently, highly active during combined handgrip and wrist forces and exhibit no periods of low muscle activity.

Effects of a Tai Chi-Based Stroke Rehabilitation Program on Symptom Clusters, Physical and Cognitive Functions, and Quality of Life: A Randomized Feasibility Study.

Stroke survivors suffer from disease-associated symptoms. Tai Chi can be a beneficial approach to provide an adapted form of intervention to manage their symptoms. The study aimed to determine the effects of a Tai Chi-based stroke rehabilitation program on symptom clusters, physical and cognitive functions, and stroke-specific quality of life among stroke survivors in Korea. Thirty-four stroke survivors were randomly assigned to receive either the Tai Chi-based program or the stroke-symptom management program. The feasibility of the program and its effects on the outcomes were assessed at baseline, 3 months, and 6 months. Repeated measures ANOVA showed that most symptoms improved in both groups during the 6-month period, but swallowing-related symptoms improved significantly in the Tai Chi group. Based on the interaction effect, Tai Chi was more effective on flexor muscle strength, ambulation, and activities of daily living and cognitive function over 6 months than their counterparts. Among SS-QOL dimensions, the Tai Chi group showed significant improvements in the thinking and self-care dimensions. The Tai Chi-based stroke rehabilitation program was feasible and safely applicable to stroke survivors in the community settings. This program could improve symptoms, physical and cognitive function, leading to improvements in the self-care dimension of the SS-QOL among stroke survivors.

Comparison of Flatfoot on the Activities of Medial and Lateral Plantar Flexor Muscle During Heel Rising

Background: Flat feet can be identified by assessing the collapse of the medial longitudinal arch (MLA) and these conditions can trigger epidemiological changes in the feet. Many of previous studies compared the muscle activity of lower body in terms of intervention and dynamics to treat the structural defect of flat feet. However, few studies have investigated or analyzed the muscle activity of gastrocnemius muscle in the subjects with flat feet. Objects: This study investigated the differences in changes of medial and lateral plantar flexors in subjects with flat feet during bipedal heel-rise (BHR) task and analyzed the differences in muscle activity between two groups by measuring the electromyography (EMG) of abductor hallucis (AH), tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG). Methods: A total of Twenty one adult females participated in this experiment. Subjects were assigned to groups according to the navicular drop test. The task was applied to the leg, where the heel lifting action prevailed. The muscle activity of the medial and lateral feet plantar flexors was evaluated, and the % maximum voluntary isometric contractions (%MVIC) of these were compared. Results: For the difference between groups the muscle activity (%MVIC) of LG muscle was statistically significantly low in flat feet group compared to healthy feet group (flat feet: 64.57, healthy feet: 90.17; p < 0.05). Conclusion: The results of this study will contribute to identifying the muscle activities of medial and lateral feet plantar flexors among subjects with flat feet, which can cause abnormal epidemiological changes in the feet.

Effects of Plyometric and Balance Training on Neuromuscular Control of Recreational Athletes with Functional Ankle Instability: A Randomized Controlled Laboratory Study.

Plyometric exercise has been suggested for knee injury prevention in sports participation, but studies on ankle plyometric training are limited. This study aims to investigate the change of joint position sense and neuromuscular activity of the unstable ankle after six-week integrated balance/plyometric training and six-week plyometric training. Thirty recreational athletes with functional ankle instability were allocated into three groups: plyometric group (P) vs. plyometric integrated with balance training group (BP) vs. control group (C). Ankle joint position sense, integrated electromyography (EMG), and balance adjusting time during medial single-leg drop-landing tasks were measured before and after the training period. Following the six-week period, both training groups exhibited a lower absolute error in plantar flexion (P group: pre: 3.79° ± 1.98°, post: 2.20° ± 1.31°, p = 0.016; BP group: pre: 4.10° ± 1.87°, post: 2.94° ± 1.01°, p = 0.045), and the integrated group showed a lower absolute error in inversion angles (pre 2.24° ± 1.44° and post 1.48° ± 0.93°, p = 0.022), and an increased integrated EMG of ankle plantar flexors before landing. The plyometric group exhibited a higher integrated EMG of the tibialis anterior before and after landing (pre: 102.88 ± 20.93, post: 119.29 ± 38.33, p = 0.009 in post-landing) and a shorter adjusting time of the plantar flexor following landing as compared to the pre-training condition (pre: 2.85 ± 1.15 s, post: 1.87 ± 0.97 s, p = 0.006). In conclusion, both programs improved ankle joint position sense and muscle activation of the ankle plantar flexors during single-leg drop landing. The plyometric group showed a reduced adjusting time of the ankle plantar flexor following the impact from drop landing.

Patterns of whole-body muscle activations following vertical perturbations during standing and walking

BackgroundFalls commonly occur due to losses of balance associated with vertical body movements (e.g. reacting to uneven ground, street curbs). Research, however, has focused on horizontal perturbations, such as forward and backward translations of the standing surface. This study describes and compares muscle activation patterns following vertical and horizontal perturbations during standing and walking, and investigates the role of vision during standing postural responses.MethodsFourteen healthy participants (ten males; 27±4 years-old) responded to downward, upward, forward, and backward perturbations while standing and walking in a virtual reality (VR) facility containing a moveable platform with an embedded treadmill; participants were also exposed to visual perturbations in which only the virtual scenery moved. We collected bilateral surface electromyography (EMG) signals from 8 muscles (tibialis anterior, rectus femoris, rectus abdominis, external oblique, gastrocnemius, biceps femoris, paraspinals, deltoids). Parameters included onset latency, duration of activation, and activation magnitude. Standing perturbations comprised dynamic-camera (congruent), static-camera (incongruent) and eyes-closed sensory conditions. ANOVAs were used to compare the effects of perturbation direction and sensory condition across muscles.ResultsVertical perturbations induced longer onset latencies and shorter durations of activation with lower activation magnitudes in comparison to horizontal perturbations (p<0.0001). Downward perturbations while standing generated earlier activation of anterior muscles to facilitate flexion (for example, p=0.0005 and p=0.0021 when comparing the early activators, rectus femoris and tibialis anterior, to a late activator, the paraspinals), whereas upward perturbations generated earlier activation of posterior muscles to facilitate extension (for example, p<0.0001 and p=0.0004, when comparing the early activators, biceps femoris and gastrocnemius, to a late activator, the rectus abdominis). Static-camera conditions induced longer onset latencies (p=0.0085 and p<0.0001 compared to eyes-closed and dynamic-camera conditions, respectively), whereas eyes-closed conditions induced longer durations of activation (p=0.0001 and p=0.0008 compared to static-camera and dynamic-camera, respectively) and larger activation magnitudes. During walking, downward perturbations promptly activated contralateral trunk and deltoid muscles (e.g., p=0.0036 for contralateral deltoid versus a late activator, the ipsilateral tibialis anterior), and upward perturbations triggered early activation of trunk flexors (e.g., p=0.0308 for contralateral rectus abdominis versus a late activator, the ipsilateral gastrocnemius). Visual perturbations elicited muscle activation in 67.7% of trials.ConclusionOur results demonstrate that vertical (vs. horizontal) perturbations generate unique balance-correcting muscle activations, which were consistent with counteracting vertical body extension induced by downward perturbations and vertical body flexion induced by upward perturbations. Availability of visual input appears to affect response efficiency, and incongruent visual input can adversely affect response triggering. Our findings have clinical implications for the design of robotic exoskeletons (to ensure user safety in dynamic balance environments) and for perturbation-based balance and gait rehabilitation.

Increased motor variability facilitates motor learning in weight shift toward the paretic side during walking in individuals post-stroke.

The purpose of this study was to determine whether applying "varied" versus constant pelvis assistance force mediolaterally toward the paretic side of stroke survivors during walking would result in short-term improvement in weight shift toward the paretic side. Twelve individuals post-stroke (60.4±6.2years; gait speed: 0.53±0.19m/s) were tested under two conditions (varied vs. constant). Each condition was conducted in a single separate session, which consisted of (a) treadmill walking with no assistance force for 1min (baseline), pelvis assistance toward the paretic side for 9min (adaptation), and then no force for additional 1min (post-adaptation), and (b) overground walking. In the "varied" condition, the magnitude of force was randomly changed across steps between 30% and 100% of the predetermined amount. In the abrupt condition, the magnitude of force was kept constant at 100% of the predetermined amount. Participants exhibited greater improvements in weight shift toward the paretic side (p<0.01) and in muscle activity of plantar flexors and hip adductors of the paretic leg (p=0.02) from baseline to late post-adaptation period for the varied condition than for the constant condition. Motor variability of the peak pelvis displacement at baseline was correlated with improvement in weight shift toward the paretic side after training for the varied (R2 =0.64, p=0.01) and the constant condition (R2 =0.39, p=0.03). These findings suggest that increased motor variability, induced by applying the varied pelvis assistance, may facilitate motor learning in weight shift and gait symmetry during walking in individuals post-stroke.

Copers and Noncopers Use Different Landing Techniques to Limit Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction.

Background:At 1 year after anterior cruciate ligament reconstruction (ACLR), two-thirds of patients manage to return to sports (copers), whereas one-third of patients do not return to sports (noncopers). Copers and noncopers have different muscle activation patterns, and noncopers may not be able to control dynamic anterior tibial translation (ATTd) as well as copers.Purpose/Hypothesis:To investigate whether (1) there is a positive correlation between passive ATT (ATTp; ie, general joint laxity) and ATTd during jump landing, (2) whether ATTd is moderated by muscle activating patterns, and (3) whether there is a difference in moderating ATTd between copers and noncopers. We hypothesized that patients who have undergone ACLR compensate for ATTd by developing muscle strategies that are more effective in copers compared with noncopers.Study Design:Controlled laboratory study.Methods:A total of 40 patients who underwent unilateral ACLR performed 10 single-leg hops for distance with both legs. Lower body kinematic and kinetic data were measured using a motion-capture system, and ATTd was determined with an embedded method. Muscle activity was measured using electromyographic signals. Bilateral ATTp was measured using a KT-1000 arthrometer. In addition, the Beighton score was obtained.Results:There was no significant correlation between ATTp and ATTd in copers; however, there was a positive correlation between ATTp and ATTd in the operated knee of noncopers. There was a positive correlation between the Beighton score and ATTp as well as between the Beighton score and ATTd in both copers and noncopers in the operated knee. Copers showed a negative correlation between ATTd and gastrocnemius activity in their operated leg during landing. Noncopers showed a positive correlation between ATTd and knee flexion moment in their operated knee during landing.Conclusion:Copers used increased gastrocnemius activity to reduce ATTd, whereas noncopers moderated ATTd by generating a smaller knee flexion moment.Clinical Relevance:This study showed that copers used different landing techniques than noncopers. Patients who returned to sports after ACLR had sufficient plantar flexor activation to limit ATTd.

Series elasticity facilitates safe plantar flexor muscle-tendon shock absorption during perturbed human hopping.

In our everyday lives, we negotiate complex and unpredictable environments. Yet, much of our knowledge regarding locomotion has come from studies conducted under steady-state conditions. We have previously shown that humans rely on the ankle joint to absorb energy and recover from perturbations; however, the muscle-tendon unit (MTU) behaviour and motor control strategies that accompany these joint-level responses are not yet understood. In this study, we determined how neuromuscular control and plantar flexor MTU dynamics are modulated to maintain stability during unexpected vertical perturbations. Participants performed steady-state hopping and, at an unknown time, we elicited an unexpected perturbation via rapid removal of a platform. In addition to kinematics and kinetics, we measured gastrocnemius and soleus muscle activations using electromyography and in vivo fascicle dynamics using B-mode ultrasound. Here, we show that an unexpected drop in ground height introduces an automatic phase shift in the timing of plantar flexor muscle activity relative to MTU length changes. This altered timing initiates a cascade of responses including increased MTU and fascicle length changes and increased muscle forces which, when taken together, enables the plantar flexors to effectively dissipate energy. Our results also show another mechanism, whereby increased co-activation of the plantar- and dorsiflexors enables shortening of the plantar flexor fascicles prior to ground contact. This co-activation improves the capacity of the plantar flexors to rapidly absorb energy upon ground contact, and may also aid in the avoidance of potentially damaging muscle strains. Our study provides novel insight into how humans alter their neural control to modulate in vivo muscle-tendon interaction dynamics in response to unexpected perturbations. These data provide essential insight to help guide design of lower-limb assistive devices that can perform within varied and unpredictable environments.