Soleus Activity Research Articles

Kinetic changes of gait initiation in individuals with chronic ankle instability: A systematic review.

Gait initiation (GI) in individuals with chronic ankle instability (CAI) has shown differences in the center of pressure (COP) and muscular measures compared to healthy controls. Some studies reported that these alterations appeared when GI was with the affected leg, while others indicated that they occurred when GI was with the non-affected leg. This systematic review aimed to understand kinetic and muscular differences between individuals with CAI, healthy controls, and the affected and non-affected legs of individuals with CAI. PubMed, Science Direct, Web of Science, Google Scholar, and Scopus databases (1990-2023) were searched using the Population, Exposure, Comparator, and Outcome measure. The PRISMA guidelines were followed. The outcome measures were the peak and rate of COP displacement in the medial-lateral and anterior-posterior directions, and resultant plane during phases 1, 2, and 3 of COP trace during GI and the duration of each phase. The other measures included the onset time of the tibialis anterior and soleus muscle activity between individuals with CAI, healthy controls, and the affected and non-affected legs of the individuals with CAI. The studies' quality assessment was conducted based on the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Five studies were included in the final evaluation. The results of included studies showed, individuals with CAI spent less time during phases 1 and 2, as well as a shorter peak of COP displacement in the lateral direction during phase 1 compared to healthy controls, regardless of whether the GI was with the affected or non-affected leg. Individuals with CAI have probably adopted a strategy involving adjusting the peak of COP displacement to manage internal sway while in a single-leg stance. Overall, there was no comprehensive conclusion about differences between the two legs in individuals with CAI.

Acute effects of the short-foot exercise in runners with medial tibial stress syndrome: A quasi-experimental study

ObjectivesAnalyze whether there are immediate changes in peak soleus activation and peak hindfoot eversion after short-foot exercise (SFE) in runners with medial tibial stress syndrome (MTSS). Secondarily, establish differences in peak soleus activation and peak hindfoot eversion between asymptomatic individuals and those presenting MTSS. DesignQuasi-experimental study. SettingUniversity Laboratory. ParticipantsThirty-two runners participated: 16 with MTSS and 16 in the no-pain group (NPG). Main outcome measuresSoleus activation was measured using electromyography, and hindfoot eversion via 3D kinematic analysis. Participants performed SFE, and running data were collected at 9,12 and 15 km/h pre- and post-intervention. ResultsSFE reduced peak soleus activation at 9 (p = 0.017) and 15 km/h (p = 0.019) for the MTSS group and at 15 km/h (p < 0.001) for the NPG, suggesting improved neuromuscular efficiency and potentially reduced tibial stress. SFE did not significantly affect peak hindfoot eversion. Significant correlations were found between ankle dorsiflexion range of motion and muscle activation (r = 0.585 to 0.849, p < 0.05). These findings suggest SFE could improve neuromuscular efficiency and reduce tibial stress, and highlights ankle flexibility's role in muscle activation. ConclusionsSFE significantly reduces soleus activation, potentially improving neuromuscular efficiency and decreasing tibial stress.

Have a Little Heart (or Not): Highly Minimized Skeletal Muscle Regulatory Cassettes with Low or No Activity in the Heart.

Adeno-associated virus-mediated gene therapies for certain muscle disorders require regulatory cassettes that provide high-level, striated muscle-specific activity. However, cardiotoxicity has emerged as a serious concern in clinical trials for Duchenne muscular dystrophy and X-linked myotubular myopathy. While this may be caused by systemic inflammatory effects of the treatment, high transgene expression in the heart may also play a role. Thus, certain muscle disorders may require a modulated level of therapeutic expression in the heart, while others may not require any cardiac expression at all. Additionally, the size of some cargos requires regulatory cassettes to be small enough that large cDNAs and other therapeutic payloads can be accommodated. Thus, we have performed enhancer/promoter optimization to develop highly minimized regulatory cassettes that are active in skeletal muscles, with either low or no detectable activity in cardiac muscle. Our No-heart (NH) cassette is active in most skeletal muscles, but exhibits only very low activity in extensor digitorum longus (EDL), soleus, and diaphragm, and no activity in the heart. By contrast, our Have a Little Heart (HLH) cassette displays high activity in most skeletal muscles, comparable to the ∼800-bp CK8 cassette, with increased activity in EDL, soleus, and diaphragm, and low activity in the heart. Due to their small size, these cassettes can be used in therapeutic strategies with both flexible (e.g., antisense) and stringent (e.g., CRISPR/Cas or bicistronic) size limitations. Thus, our new cassettes may be useful for gene therapies of muscle disorders in which the need for low or almost no expression in cardiac muscle would outweigh the need for high levels of therapeutic product in certain skeletal muscles.

Molecular Signaling Effects behind the Spontaneous Soleus Muscle Activity Induced by 7-Day Rat Hindlimb Suspension.

The elimination of ground reaction force (support withdrawal) vastly affects slow postural muscles in terms of their regulation and structure. One of the effects of support withdrawal in this study was an immediate postural muscle inactivation, followed by the daily gradual development of spontaneous activity of the slow postural soleus muscle in response to rat hindlimb suspension to mimic space flight. The origin of this activity is somewhat akin to muscle spasticity after spinal cord injuries and is the result of KCC2 content decline in the spinal cord's motor neurons. However, the physiological consequences of unloading-induced spontaneous activity remain unexplored. We have conducted an experiment with the administration of a highly specific KCC2 activator during 7-day unloading. For this experiment, 32 male Wistar rats were divided into 4 groups: C+placebo, C+CLP-290 (100 mg/kg b w), 7HS+placebo, and 7HS+CLP-hindlimb-suspended group with CLP-290 administration (100 mg/kg b w). The soleus muscles of the animals were dissected and analyzed for several proteostasis- and metabolism-related parameters. CLP-290 administration to the unloaded animals led to the upregulation of AMPK downstream (p-ACC) and mTOR targets (p-p70S6k and p-4E-BP) and an enhanced PGC1alpha decrease vs. the 7HS group, but neither prevented nor enhanced atrophy of the soleus muscle or myofiber CSA.

A dynamic foot model for predictive simulations of human gait reveals causal relations between foot structure and whole-body mechanics.

The unique structure of the human foot is seen as a crucial adaptation for bipedalism. The foot's arched shape enables stiffening the foot to withstand high loads when pushing off, without compromising foot flexibility. Experimental studies demonstrated that manipulating foot stiffness has considerable effects on gait. In clinical practice, altered foot structure is associated with pathological gait. Yet, experimentally manipulating individual foot properties (e.g. arch height or tendon and ligament stiffness) is hard and therefore our understanding of how foot structure influences gait mechanics is still limited. Predictive simulations are a powerful tool to explore causal relationships between musculoskeletal properties and whole-body gait. However, musculoskeletal models used in three-dimensional predictive simulations assume a rigid foot arch, limiting their use for studying how foot structure influences three-dimensional gait mechanics. Here, we developed a four-segment foot model with a longitudinal arch for use in predictive simulations. We identified three properties of the ankle-foot complex that are important to capture ankle and knee kinematics, soleus activation, and ankle power of healthy adults: (1) compliant Achilles tendon, (2) stiff heel pad, (3) the ability to stiffen the foot. The latter requires sufficient arch height and contributions of plantar fascia, and intrinsic and extrinsic foot muscles. A reduced ability to stiffen the foot results in walking patterns with reduced push-off power. Simulations based on our model also captured the effects of walking with anaesthetised intrinsic foot muscles or an insole limiting arch compression. The ability to reproduce these different experiments indicates that our foot model captures the main mechanical properties of the foot. The presented four-segment foot model is a potentially powerful tool to study the relationship between foot properties and gait mechanics and energetics in health and disease.

Development and Validation of Robotic Ankle Exoskeleton With Parallel Nonlinear Elastic Actuator

Abstract This paper presents the development of a robotic ankle exoskeleton for human walking assistance. First, the biomechanical properties of a human ankle joint during walking are presented. Next, design of the robotic ankle exoskeleton is introduced. The exoskeleton is actuated by a novel parallel nonlinear elastic actuator. The cam-spring mechanism in the actuator can function as a parallel nonlinear spring with an adjustable stiffness, and the design of the cam profile curve is described. Additionally, an adaptive controller is proposed for the exoskeleton to generate a desired assistive torque according to the wearer's total weight. Finally, experiments are conducted to validate the effectiveness of the developed robotic ankle exoskeleton. The experimental results demonstrate that during a gait cycle, reductions of 42.7% and 40.1% of the peak and average currents of the driving motor in the actuator are observed, respectively, with the designed cam-spring mechanism. A peak assistive torque of 23.9 Nm can be provided for the wearers by the exoskeleton during walking. With the assistance provided by the exoskeleton, the average and peak soleus activities of the wearers during a gait cycle are decreased by 25.42% and 31.94%, respectively.

The influence of unstable surfaces on ankle muscle activation during functional exercises

BackgroundThe study aims to compare how 3 balance platform designs affect ankle muscle activation during various functional exercises, all performed on the dominant limb. MethodsFifteen healthy, active participants performed single-leg stance, single-leg squat, and forward lunge on BOSU® Ball, wobble board, stability trainer, and flat ground. Surface electromyography was used to measure Peroneus Longus, Tibialis Anterior, Gastrocnemius, and Soleus activation during these exercises on different platforms and flat ground. Repeated measures ANOVA with two factors (exercise and platform) were used for analysis. ResultsThere was a significant interaction between balance platforms and exercises (p < 0.05). Soleus displayed the highest activation amplitudes during the single leg stance and single leg squat on BOSU®, and peroneus longus displayed the greatest activation amplitudes during the forward lunge on BOSU® (p < 0.05). ConclusionsThe present study findings indicated that exercises conducted on a flexible platform resulted in greater muscle activation levels when compared to those executed on both a rigid platform and flat ground. Based on the level of ankle muscle activation in the current study, exercises for the ankle would progress from exercises on to a flat ground to on a BOSU® in order to achieve progressively greater ankle muscle activation. Level of evidenceLevel III.

Mechanical and signaling responses of unloaded rat soleus muscle to chronically elevated β-myosin activity

It has been reported that muscle functional unloading is accompanied by an increase in motoneuronal excitability despite the elimination of afferent input. Thus, we hypothesized that pharmacological potentiation of spontaneous contractile soleus muscle activity during hindlimb unloading could activate anabolic signaling pathways and prevent the loss of muscle mass and strength. To investigate these aspects and underlying molecular mechanisms, we used β-myosin allosteric effector Omecamtiv Mekarbil (OM). We found that OM partially prevented the loss of isometric strength and intrinsic stiffness of the soleus muscle after two weeks of disuse. Notably, OM was able to attenuate the unloading-induced decrease in the rate of muscle protein synthesis (MPS). At the same time, the use of drug neither prevented the reduction in the markers of translational capacity (18S and 28S rRNA) nor activation of the ubiquitin-proteosomal system, which is evidenced by a decrease in the cross-sectional area of fast and slow muscle fibers. These results suggest that chemically-induced increase in low-intensity spontaneous contractions of the soleus muscle during functional unloading creates prerequisites for protein synthesis. At the same time, it should be assumed that the use of OM is advisable with pharmacological drugs that inhibit the expression of ubiquitin ligases.

Effectiveness of functional or biomechanical bandages with athletic taping and kinesiotaping in subjects with chronic ankle instability: a systematic review and meta-analysis.

The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI). This review used PubMed, WoS, SCOPUS, and CINAHL following PRISMA and registering in Prospero. Main PICOS: (1) CAI; (2) intervention, functional/biomechanical bandages; (3) comparison, taping effect versus placebo/no taping, or another functional taping; (4) outcomes, improvement of CAI functionality (dynamic/static balance, ankle kinematic, perception, agility and motor control, endurance and strength; (5) experimental and preexperimental studies. The meta-analyses considered mean and s.d. of the results per variable; effect size (ES) of each study and for each type of intervention. Homogeneity (Q), heterogeneity (H 2 and I 2), and 95% CI were calculated. In total, 28 studies were selected. Significant differences were found for dynamic balance (66.66%) and static balance (87.5%), ankle kinematics (75.00%), perceptions (88.88%), plantar flexor strength (100%), muscle activity (66.6%), endurance (100%), functional performance (100%), and gait (66.6%). The main results of meta-analyses (eight studies) are as follows - h/M ratio soleus, ES: 0.080, 95% CI: -5.219-5.379; h/M ratio peroneus, ES: 0.070, 95% CI: -6.151-6.291; posteromedial KT, ES: 0.042 95% CI: -0.514-0.598; posteromedial-overall, ES: -0.006 95% CI: -1.071-0.819; mSEBT-KT, ES: 0.057 95% CI: -0.281-0.395; mSEBT-overall, ES: -0.035 95% CI: -0.190-0.590. All biomechanical or functional bandages, whether elastic or inelastic, applied in CAI were favorable, highlighting patient perception, dynamic and static balance, kinematics and agility and motor control, for its effectiveness and evidence. Thus, bandages increase ankle functionality. The meta-analyses found no statistical significance. Clinically, soleus muscle activity, h-reflex/M-responses using fibular reposition with rigid tape, and dynamic balance with combined kinesiotaping during the modified star excursion balance test and with the posteromedial direction found improvements. Level of evidence according to Scottish Intercollegiate Guidelines Network: 1+. Level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011: 1.

Immediate Effect of a Comprehensive Foot Mobility and Strengthening Treatment on Ankle Muscle Activation in Children with Spastic Diplegia

Foot mobility and strengthening treatment (FMST) is a routinely practiced management strategy in musculoskeletal rehabilitation to improve ankle and foot alignment and muscle function, which prevents joint deformities. The FMST may contribute to improvements in foot alignment and muscle function in children with cerebral palsy (CP). However, treatment influence on muscle imbalances and strength in children with spastic diplegic CP is not yet documented. The aim of the study was to determine the effect of FMST on tibialis anterior (TA), medial gastrocnemius (MG), peroneus longus (PL), and soleus muscle activity using electromyography (EMG) in children with spastic diplegic CP. Twenty children with spastic diplegia (mean age: 7.4 years) with GMFCS levels I, II and III were included in this pre and post-experimental (preliminary) study. Muscle activation of TA, MG, PL, and soleus was recorded using surface EMG in a standing position before and after providing the intervention. Muscle activation in RMS-EMG (mV) was calculated. Findings showed a significant increase in muscle activation of TA, MG, and PL in standing position following the intervention. The increase in soleus muscle activation in standing was not statistically significant. We hypothesized that FMST could alter the muscle recruitment pattern. Our findings showed immediate improvement in muscle activation after the intervention. Future studies should consider its carryover effect on motor performance and gait using functional outcomes.

Effects of ankle exoskeleton assistance and plantar pressure biofeedback on incline walking mechanics and muscle activity in cerebral palsy

Ankle dysfunction affects more than 50 % of people with cerebral palsy, resulting in atypical gait patterns that impede lifelong mobility. Incline walking requires increased lower limb effort and is a promising intervention that targets lower-limb extensor muscles. A concern when prescribing incline walking to people with gait deficits is that this exercise may be too challenging or reinforce unfavorable gait patterns. This study aims to investigate how ankle exoskeleton assistance and plantar pressure biofeedback would affect gait mechanics and muscle activity during incline walking in CP. We recruited twelve children and young adults with CP. Participants walked with ankle assistance alone, biofeedback alone, and the combination while we assessed ankle, knee, and hip mechanics, and plantar flexor and knee extensor activity. Compared to incline walking without assistance or biofeedback, ankle assistance alone reduced the peak biological ankle moment by 12 % (p < 0.001) and peak soleus activity by 8 % (p = 0.013); biofeedback alone increased the biological ankle moment (4 %, p = 0.037) and power (19 %, p = 0.012), and plantar flexor activities by 9 – 27 % (p ≤ 0.026); assistance-plus-biofeedback increased biological ankle and knee power by 34 % and 17 %, respectively (p ≤ 0.05). The results indicate that both ankle exoskeleton assistance and plantar pressure biofeedback can effectively modify lower limb mechanics and muscular effort during incline walking in CP. These techniques may help in establishing personalized gait training interventions by providing the ability to adjust intensity and biomechanical focus over time.

Audiovisual biofeedback amplifies plantarflexor adaptation during walking among children with cerebral palsy

BackgroundBiofeedback is a promising noninvasive strategy to enhance gait training among individuals with cerebral palsy (CP). Commonly, biofeedback systems are designed to guide movement correction using audio, visual, or sensorimotor (i.e., tactile or proprioceptive) cues, each of which has demonstrated measurable success in CP. However, it is currently unclear how the modality of biofeedback may influence user response which has significant implications if systems are to be consistently adopted into clinical care.MethodsIn this study, we evaluated the extent to which adolescents with CP (7M/1F; 14 [12.5,15.5] years) adapted their gait patterns during treadmill walking (6 min/modality) with audiovisual (AV), sensorimotor (SM), and combined AV + SM biofeedback before and after four acclimation sessions (20 min/session) and at a two-week follow-up. Both biofeedback systems were designed to target plantarflexor activity on the more-affected limb, as these muscles are commonly impaired in CP and impact walking function. SM biofeedback was administered using a resistive ankle exoskeleton and AV biofeedback displayed soleus activity from electromyography recordings during gait. At every visit, we measured the time-course response to each biofeedback modality to understand how the rate and magnitude of gait adaptation differed between modalities and following acclimation.ResultsParticipants significantly increased soleus activity from baseline using AV + SM (42.8% [15.1, 59.6]), AV (28.5% [19.2, 58.5]), and SM (10.3% [3.2, 15.2]) biofeedback, but the rate of soleus adaptation was faster using AV + SM biofeedback than either modality alone. Further, SM-only biofeedback produced small initial increases in plantarflexor activity, but these responses were transient within and across sessions (p > 0.11). Following multi-session acclimation and at the two-week follow-up, responses to AV and AV + SM biofeedback were maintained.ConclusionsThis study demonstrated that AV biofeedback was critical to increase plantarflexor engagement during walking, but that combining AV and SM modalities further amplified the rate of gait adaptation. Beyond improving our understanding of how individuals may differentially prioritize distinct forms of afferent information, outcomes from this study may inform the design and selection of biofeedback systems for use in clinical care.

In vivo human medial gastrocnemius fascicle behaviour and belly gear during submaximal eccentric contractions are not affected by concentric fatiguing exercise

Changes in muscle geometry and belly gearing during eccentric contractions influence fibre strain and susceptibility to muscle damage. They are modulated by the interaction between connective tissues and intracellular-intrafascicular fluid pressures and external pressures from neighbouring structures. Fatiguing exercise triggers fluid shifts (muscle swelling) and muscle activation changes that may influence these modulators. Our purpose was to measure medial gastrocnemius (MG) geometric changes in vivo during eccentric contractions before and after maximal concentric muscle work to test the hypothesis that fatigue would reduce fascicle rotation and muscle gear and provoke greater fascicle strain. Submaximal eccentric plantar flexor contractions at 40% and 60% of maximal eccentric torque were performed on an isokinetic dynamometer at 5°.s−1 before and immediately after the fatiguing exercise. MG fascicles and muscle–tendon junction were captured using ultrasonography during contractions, allowing quantification of geometric changes, whole-MG length, and belly gear (Δmuscle length/Δfascicle length). Triceps surae (TS) activation was estimated using surface electromyography and the distribution of activations between synergistic muscles was then determined. After exercise, concentric torque decreased ∼39% and resting muscle thickness increased by 4%, indicating muscle fatigue and swelling, respectively. While soleus (Sol) activation and the Sol/TS ratio increased, no changes in MG, MG/TS ratio or fascicle rotation during the contraction were detected. Thus, fascicle lengthening and belly gear remained unaltered. Changes in muscle thickness during contraction was also similar before and after exercise, suggesting that changes in muscle shape were relatively unaffected by the exercise. Consequently, the muscle maintained mechanical integrity after the fatiguing muscle work.

Speed-specific optimal contractile conditions of the human soleus muscle from slow to maximum running speed.

The soleus is the main muscle for propulsion during human running but its operating behavior across the spectrum of physiological running speeds is currently unknown. This study experimentally investigated the soleus muscle activation patterns and contractile conditions for force generation, power production and efficient work production (i.e. force-length potential, force-velocity potential, power-velocity potential and enthalpy efficiency) at seven running speeds (3.0 m s-1 to individual maximum). During submaximal running (3.0-6.0 m s-1), the soleus fascicles shortened close to optimal length and at a velocity close to the efficiency maximum, two contractile conditions for economical work production. At higher running speeds (7.0 m s-1 to maximum), the soleus muscle fascicles still operated near optimum length, yet the fascicle shortening velocity increased and shifted towards the optimum for mechanical power production with a simultaneous increase in muscle activation, providing evidence for three cumulative mechanisms to enhance mechanical power production. Using the experimentally determined force-length-velocity potentials and muscle activation as inputs in a Hill-type muscle model, a reduction in maximum soleus muscle force at speeds ≥7.0 m s-1 and a continuous increase in maximum mechanical power with speed were predicted. The reduction in soleus maximum force was associated with a reduced force-velocity potential. The increase in maximum power was explained by an enhancement of muscle activation and contractile conditions until 7.0 m s-1, but mainly by increased muscle activation at high to maximal running speed.

An optimization model of tractor clutch pedal design parameters based on lower limb biomechanical characteristics

The design of tractor pedal affects operator's comfort, working efficiency, and occupational health. To optimize tractor clutch pedal design parameters, we conducted a single-factor experiment and a response surface experiment based on a biomechanical model. The experimental indicators included the biomechanical loads of major activated muscles and joints of the lower limb, and the experimental factors comprised pedal-seat horizontal distance L, pedal-seat vertical distance H, and pedal spring stiffness k. The results indicate that L and H mainly influence the loads of semitendinosus and hip. Semitendinosus activity and hip torque first decreased and then increased with increasing L (or H), reaching the lowest level at 82 cm of L (or 42 cm of H). The increase in k led to gradual decreases in iliopsoas activity and increases in semitendinosus, rectus femoris, soleus activities, and ankle torque, as well as a first decreasing and then increasing trend of hip and knee torques. The overall biomechanical loads of the lower limb first declined and then grew with increasing L, H, and k. The optimal range of clutch pedal design parameters was calculated to be {(L, H, k) | 36≤L ≤ 40, 72≤H ≤ 76, 14≤k ≤ 22} when using the response surface method. Within this range, muscle activity and joint torque were reduced by 14.2% and 51.6%, respectively, indicating effective alleviation of the lower limb biomechanical loads. This study provides important implications for the biomechanical analysis of tractor operator-pedal interaction system and lays a foundation for improving the design and comfort of tractors.

Effects of jaw clenching and mental stress on persistent inward currents estimated by two different methods.

Spinal motoneuron firing depends greatly on persistent inward currents (PICs), which in turn are facilitated by the neuromodulators serotonin and noradrenaline. The aim of this study was to determine whether jaw clenching (JC) and mental stress (MS), which may increase neuromodulator release, facilitate PICs in human motoneurons. The paired motor unit (MU) technique was used to estimate PIC contribution to motoneuron firing. Surface electromyograms were collected using a 32-channel matrix on gastrocnemius medialis (GM) during voluntary, ramp, plantar flexor contractions. MU discharges were identified, and delta frequency (ΔF), a measure of recruitment-derecruitment hysteresis, was calculated. Additionally, another technique was used (VibStim) that evokes involuntary contractions that persist after cessation of combined Achilles tendon vibration and triceps surae neuromuscular electrical stimulation. VibStim measures of plantar flexor torque and soleus activity may reflect PIC activation. ΔF was not significantly altered by JC (p = .679, n = 18, 9 females) or MS (p = .147, n = 14, 5 females). However, all VibStim variables quantifying involuntary torque and muscle activity during and after vibration cessation were significantly increased in JC (p < .011, n = 20, 10 females) and some, but not all, increased in MS (p = .017-.05, n = 19, 10 females). JC and MS significantly increased the magnitude of involuntary contractions (VibStim) but had no effect on GM ΔF during voluntary contractions. Effects of increased neuromodulator release on PIC contribution to motoneuron firing might differ between synergists or be context dependent. Based on these data, the background level of voluntary contraction and, hence, both neuromodulation and ionotropic inputs could influence neuromodulatory PIC enhancement.

The Accuracy of Ankle Eccentric Torque Control Explains Dynamic Postural Control During the Y-Balance Test.

The Y-Balance Test (YBT), especially the posteromedial (PM) reach direction (PM-YBT), is able to identify dynamic postural control deficits in those who have ankle instability. However, there still exists a need to understand how sensorimotor function at the ankle explains the performance during the PM-YBT. The purpose of this study was to determine whether the ability to accurately control eccentric ankle torque explained PM-YBT performance. It was hypothesized that eccentric dorsiflexion/plantarflexion torque control would be positively related to the maximum reach distance (MRD) of PM-YBT. Cross-sectional study. Twelve healthy subjects performed the PM-YBT, maximum voluntary isometric contractions (MVIC) for both dorsiflexion and plantarflexion muscle strength, and then the torque control testing of the ankle. The torque control testing provided a target torque level on a screen in front of the subject and passive rotations of the ankle joint in the sagittal plane at 10 deg/sec between plantarflexion to dorsiflexion. Subjects were then instructed to eccentrically contract the dorsiflexors and plantar flexors to generate torque while the ankle joint rotated. The accuracy of torque control during eccentric dorsiflexion and plantarflexion by calculating absolute errors, the area between the target torque and the produced torque were evaluated. Tibialis anterior and soleus muscle activities were simultaneously recorded during testing. A step-wise linear regression model was used to determine the best model predicted the MRD of the PM-YBT (PM-MRD). A step-wise linear regression developed a model explaining only eccentric dorsiflexion torque control predicted higher PM-MRD score (R2 = 44%, F1,10 = 7.94, β = -0.67, p = 0.02). The accuracy of torque control during eccentric dorsiflexion predicts better performance in the PM-YBT. 3b.

Adaptations in Gait Mechanics When Walking in an Ankle Exoskeleton

Exoskeletons are robotic, brace-like devices that can apply assistive torques to joints, supplementing biological torques. For example, ankle exoskeletons are often designed to assist during the push-off phase of walking to reduce energy expenditure. However, the mechanism by which these exoskeletons reduce metabolic costs is often unclear due to complex human-machine interactions. Here, our purpose was to determine what lower-limb gait kinematic, kinetic, and muscle activity changes underly metabolic cost reductions during ankle exoskeleton-assisted walking. We had healthy participants (n=6) perform two, 12-minute walking trials, one without assistive torques applied (Exo Off) and one with assistive torques applied (Exo On). Participants walked on a force plate instrumented treadmill (Bertec) and were instrumented with optical motion capture (Qualisys) to measure lower-limb gait kinematics and kinetics using Opensim, electromyography (Delsys) to measure the muscle activity of nine lower-limb muscles of the dominant limb, and indirect calorimetry (Cosmed) to measure metabolic energy expenditure (Figure 1A). We aggregated the motion capture, electromyography, and metabolic data for a final analysis using custom scripts (Matlab). We found that metabolic energy expenditure was reduced by 9.52  1.25% (p=0.011; Figure 1B). This, however, did not coincide with any changes in biological ankle angle, torque, or power. However, there was a trending reduction in peak soleus activity (p=0.052). Surprisingly, we did find a reduction in knee power (p=7.3x10-3; Figure 1C) and an accompanying decrease in semitendinosus activity (p=5.9x10-3). Despite the exoskeleton acting at the ankle joint, we found the clearest benefits at the knee joint—highlighting that complex, multi-joint adaptations may underly cost savings. We are continuing data collection to increase our statistical power and better understand the mechanisms that underly exoskeleton assistance.

Chronic changes in muscle architecture and aponeurosis structure following calf muscle strain injuries.

Muscle strain injuries in the human calf muscles are frequent sports injuries with high recurrence. Potential structural and functional changes in the medial head of the musculus gastrocnemius (GM) and the associated aponeurosis are not well documented. To test whether a GM muscle strain injury affects muscle fascicle length, pennation angle, and the morphology of the deep aponeurosis at rest and during muscle contraction long time after the injury. Additionally, electromyography (EMG) of the GM and the soleus muscle during a unilateral heel rise was measured in the injured and uninjured calf. GM fascicle length, pennation angle, and aponeurosis thickness was analyzed on dynamic ultrasonography (US) recordings in 10 participants with a chronic calf strain. In addition, US images taken across the distal portion and mid-belly of the GM were analyzed at three different ankle positions. EMG recordings were obtained during a unilateral heel rise. The pennation angle of the injured distal GM was significantly larger compared to the uninjured GM in the contracted, but not the relaxed state. Pennation angle increased more in the injured compared to the uninjured GM during contraction. Fascicle length was shorter in the most distal portion of the injured GM. Fascicles at the distal portion of the injured GM showed a pronounced curvilinear shape as the muscle contracted and the aponeurosis was enlarged in the injured compared to the uninjured GM. The ratio between GM and soleus EMG activity showed a significantly higher relative soleus activity in the injured compared to the healthy calf. The greater change in pennation angle and curvilinear fascicle shape during contraction suggest that a long-term consequence after a muscle strain injury is that some muscle fibers at the distal GM are not actively engaged. The significantly enlarged aponeurosis indicates a substantial and long-lasting connective tissue involvement following strain injuries.

Elastic ankle exoskeletons influence soleus fascicle dynamics during unexpected perturbations

Spring-based passive ankle exoskeletons have been designed to emulate the energy conservation and power amplification roles of biological muscle–tendon units during locomotion. Yet, it remains unknown if similar assistive devices can serve the other elastomechanical role of biological muscle–tendon units — power attenuation. Here we explored the effect of bilateral passive ankle exoskeletons on neuromuscular control and muscle fascicle dynamics in the ankle plantarflexors during rapid, unexpected vertical perturbations. We recorded muscle activation and soleus fascicle length changes during hopping with and without exoskeleton assistance (0 and 76 Nm rad−1) on elevated platforms (20 cm), which were removed at an unknown time. Our results demonstrate that exoskeleton assistance leads to a reduction in soleus muscle activation, increases in fascicle length change and decreases in muscle forces during perturbed hopping. These changes have competing effects on the mechanics and energetics of lower limb muscles, likely limiting the capacity for series elastic tissues to absorb energy. As we strive towards the design of wearable assistive devices for everyday locomotion, information regarding real-time muscle–tendon behavior may enable tunable assistance that adapts to both the user and the environment.