Activation Of Multiple Muscles Research Articles

Referent Control of Side-to-Side Body-Weight Transfer During Standing and Stepping in Adults

Research suggests that locomotion may be primarily caused by shifting stable body balance from one location in the environment to another with subsequent rhythmical muscle activation by the central pattern generator (CPG), constituting a multi-level control system. All levels interact with environmental forces affected by proprioceptive and vestibular reflexes as well as vision. A similar multi-level control schema is likely used to shift body balance laterally when the body weight is rhythmically transferred from side-to-side. In order to do so, the system shifts a specific body posture in space. This body posture is referred to as the threshold or referent body posture, R, at which all muscles involved can be at rest but are activated depending on the deflection of the actual body posture, Q, from R. This concept has previously been investigated for forward and backward locomotion. The purpose of the present study was to verify if it was also applicable to locomotor tasks in other directions such as sidestepping. We predicted that during sidestepping, the actual and referent posture can transiently match each other bringing the activity of multiple muscles to a minimum. The existence of such minima was demonstrated in healthy adults performing three locomotor tasks involving shifts of the body weight from side-to-side thus further supporting the validity of the multi-level control scheme of locomotion.

Quantitative evaluation of motion compensation in post-stroke rehabilitation training based on muscle synergy.

Introduction: Stroke is the second leading cause of death globally and a primary factor contributing to disability. Unilateral limb motor impairment caused by stroke is the most common scenario. The bilateral movement pattern plays a crucial role in assisting stroke survivors on the affected side to relearn lost skills. However, motion compensation often lead to decreased coordination between the limbs on both sides. Furthermore, muscle fatigue resulting from imbalanced force exertion on both sides of the limbs can also impact the rehabilitation outcomes. Method: In this study, an assessment method based on muscle synergy indicators was proposed to objectively quantify the impact of motion compensation issues on rehabilitation outcomes. Muscle synergy describes the body's neuromuscular control mechanism, representing the coordinated activation of multiple muscles during movement. 8 post-stroke hemiplegia patients and 8 healthy subjects participated in this study. During hand-cycling tasks with different resistance levels, surface electromyography signals were synchronously collected from these participants before and after fatigue. Additionally, a simulated compensation experiment was set up for healthy participants to mimic various hemiparetic states observed in patients. Results and discussion: Synergy symmetry and synergy fusion were chosen as potential indicators for assessing motion compensation. The experimental results indicate significant differences in synergy symmetry and fusion levels between the healthy control group and the patient group (p ≤ 0.05), as well as between the healthy control group and the compensation group. Moreover, the analysis across different resistance levels showed no significant variations in the assessed indicators (p > 0.05), suggesting the utility of synergy symmetry and fusion indicators for the quantitative evaluation of compensation behaviors. Although muscle fatigue did not significantly alter the symmetry and fusion levels of bilateral synergies (p > 0.05), it did reduce the synergy repeatability across adjacent movement cycles, compromising movement stability and hindering patient recovery. Based on synergy symmetry and fusion indicators, the degree of bilateral motion compensation in patients can be quantitatively assessed, providing personalized recommendations for rehabilitation training and enhancing its effectiveness.

Postural balance disorders in sarcopenia based on surface electromyography

BackgroundSarcopenia is an intrinsic factor that leads to balance disorders and falls in older adults. However, the characterization of sarcopenia-related postural balance deficits remains unclear. AimsThis study aimed to explore the balance performance and postural control strategy in older adults with sarcopenia during static stance tasks using force platforms and surface electromyography. MethodsOlder adults with right-sided dominance were recruited, including 27 adults with sarcopenia and 27 healthy counterparts. Postural sway was measured with eyes open/closed on rigid/compliant surfaces. The time- and frequency-domain indexes of bilateral lower extremity muscle activity were simultaneously recorded. ResultsThe postural sway and activity of multiple lower extremity muscles in the sarcopenia group were increased (P < 0.05). The amplitude contribution ratio of the right tibialis anterior muscle (larger in sarcopenia), co-contraction ratio of right ankle dorsiflexion (smaller in sarcopenia), and mean power frequency and median frequency of the left gluteus maximus muscle (smaller in sarcopenia) had main effects of grouping (P < 0.001, η2p = 0.06–0.10). All of them had discrimination for sarcopenia (area under the curve = 0.639–0.657, P < 0.001) and were correlated with balance function measurement in sarcopenia (|rs| = 0.22–0.44, P < 0.05). ConclusionThe results of this study suggest that older adults with sarcopenia have decreased balance function and increased cost of electrophysiology. They were found to prefer the postural strategy of dominant ankle dorsiflexion and demonstrated overactivity of the dominant tibialis anterior muscles and fatigue vulnerability of the nondominant gluteus maximus. Improvements in these postural features may have balance benefits.

Identifying Referent Control Variables Underlying Goal-Directed Arm Movements.

The referent control theory (RCT) for action and perception is an advanced formulation of the equilibrium-point hypothesis. The RCT suggests that rather than directly specifying the desired motor outcome, the nervous system controls action and perception indirectly by setting the values of parameters of physical and physiological laws. This is done independently of values of kinematic and kinetic variables including electromyographic patterns describing the motor outcome. One such parameter-the threshold muscle length, λ, at which motoneurons of a given muscle begin to be recruited, has been identified experimentally. In RCT, a similar parameter, the referent arm position, R, has been defined for multiple arm muscles as the threshold arm position at which arm muscles can be quiescent but activated depending on the deflection of the actual arm position, Q, from R. Changes in R result in reciprocal changes in the activity of opposing muscle groups. We advanced the explanatory power of RCT by combining the usual biomechanical descriptions of motor actions with the identification of the timing of R underlying arm movements made with reversals in three directions and to three different extents. We found that in all movements, periods of minimization of the activity of multiple muscles could be identified at ∼61%-86% of the reaching extent in each direction. These electromyographic minimization periods reflect the spatial coordinates at which the R and Q overlap during the production of movements with reversals. The findings support the concept of the production of arm movement by shifting R.

Three-dimensional motion of the toes with simulated contraction of individual toe flexors and extensors: A cadaver study

BackgroundThe primary motion of the toes is flexion and extension. The motion results from activity of multiple muscles, and toe disorders may result from muscle dysfunction. The relationships of specific muscles related to toe function is underreported. The purpose of this study was to quantitatively evaluate three-dimensional toe motion resulting from specific muscle contraction using cadavers. MethodsThree-dimensional joint movements of the 1st, 2nd, and 5th toe were produced by applying traction of individual muscles using six Thiel-embalmed cadaver legs. The traction increments were 3 mm, 6 mm, and 9 mm, during which the angle of the distal bone with respect to the proximal bone of each toe joint was measured using a magnetic tracking system. ResultsAs tendon traction distance increased, the angular measure of the distal bone with respect to the proximal bone at each toe joint increased linearly and three-dimensionally. The flexor hallucis brevis significantly pronated and abducted the 1st toe compared to the extensor hallucis longus and brevis. The flexor digitorum brevis significantly supinated and adducted the 2nd toe compared to the flexor digitorum longus and quadratus plantae, while the extensor digitorum brevis demonstrated significant pronation and abduction compared to the extensor digitorum longus. ConclusionsThree intrinsic muscles produced significant toe motion in frontal and horizontal planes. Our results revealed that there was a proportional relationship between tendon excursion and joint angle, and an antagonistic relationship of muscles acting on the toes. These results can be considered regarding pathogenesis of toe disorders or deformity and regarding treatment such as exercise therapy or tendon transfer. Level of evidenceV, cadaveric study.

Reaction of human walking to transient block of vision: analysis in the context of indirect, referent control of motor actions.

Human locomotion may result from monotonic shifts in the referent position, R, of the body in the environment. R is also the spatial threshold at which muscles can be quiescent but are activated depending on the deflection of the current body configuration Q from R. Shifts in R are presumably accomplished with the participation of proprioceptive and visual feedback and responsible for transferring stable body balance (equilibrium) from one place in the environment to another, resulting in rhythmic activity of multiple muscles by a central pattern generator (CPG). We tested predictions of this two-level control scheme. In particular, in response to a transient block of vision during locomotion, the system can temporarily slow shifts in R. As a result, the phase of rhythmical movements of all four limbs will be changed for some time, even though the rhythm and other characteristics of locomotion will be fully restored after perturbation, a phenomenon called long-lasting phase resetting. Another prediction of the control scheme is that the activity of multiple muscles of each leg can be minimized reciprocally at specific phases of the gait cycle both in the presence and absence of vision. Speed of locomotion is related to the rate of shifts in the referent body position in the environment. Results confirmed that human locomotion is likely guided by feedforward shifts in the referent body location, with subsequent changes in the activity of multiple muscles by the CPG. Neural structures responsible for shifts in the referent body configuration causing locomotion are suggested.

Corticospinal interface to restore voluntary control of joint torque in a paralyzed forearm following spinal cord injury in non-human primates.

The corticospinal tract plays a major role in the control of voluntary limb movements, and its damage impedes voluntary limb control. We investigated the feasibility of closed-loop brain-controlled subdural spinal stimulation through a corticospinal interface for the modulation of wrist torque in the paralyzed forearm of monkeys with spinal cord injury at C4/C5. Subdural spinal stimulation of the preserved cervical enlargement activated multiple muscles on the paralyzed forearm and wrist torque in the range from flexion to ulnar-flexion. The magnitude of the evoked torque could be modulated by changing current intensity. We then employed the corticospinal interface designed to detect the firing rate of an arbitrarily selected "linked neuron" in the forearm territory of the primary motor cortex (M1) and convert it in real time to activity-contingent electrical stimulation of a spinal site caudal to the lesion. Linked neurons showed task-related activity that modulated the magnitude of the evoked torque and the activation of multiple muscles depending on the required torque. Unlinked neurons, which were independent of spinal stimulation and located in the vicinity of the linked neurons, exhibited task-related or -unrelated activity. Thus, monkeys were able to modulate the wrist torque of the paralyzed forearm by modulating the firing rate of M1 neurons including unlinked and linked neurons via the corticospinal interface. These results suggest that the corticospinal interface can replace the function of the corticospinal tract after spinal cord injury.

Muscle synergies of multidirectional postural control in astronauts on Earth after a long-term stay in space.

Movements of the human biological system have adapted to the physical environment under the 1-g gravitational force on Earth. However, the effects of microgravity in space on the underlying functional neuromuscular control behaviors remain poorly understood. Here, we aimed to elucidate the effects of prolonged exposure to a microgravity environment on the functional coordination of multiple muscle activities. The activities of 16 lower limb muscles of 5 astronauts who stayed in space for at least 3 mo were recorded while they maintained multidirectional postural control during bipedal standing. The coordinated activation patterns of groups of muscles, i.e., muscle synergies, were estimated from the muscle activation datasets using a factorization algorithm. The experiments were repeated a total of five times for each astronaut, once before and four times after spaceflight. The compositions of muscle synergies were altered, with a constant number of synergies, after long-term exposure to microgravity, and the extent of the changes was correlated with the increased velocity of postural sway. Furthermore, the muscle synergies extracted 3 mo after the return were similar in their activation profile but not in their muscle composition compared with those extracted in the preflight condition. These results suggest that the modularity in the neuromuscular system became reorganized to adapt to the microgravity environment and then possibly reoptimized to the new sensorimotor environment after the astronauts were reexposed to a gravitational force. It is expected that muscle synergies can be used as physiological markers of the status of astronauts with gravity-dependent change.NEW & NOTEWORTHY The human neuromuscular system has adapted to the gravitational environment on Earth. Here, we demonstrated that prolonged exposure to a microgravity environment in space changes the functional coordination of multiple muscle activities regarding multidirectional standing postural control. Furthermore, the amount of change led to a greater regulatory balancing activity needed for postural control immediately after returning to Earth and differences in muscular coordination before space flight and 3 mo after the return to Earth.

Detection of swallowing disorders with a multiple-channel surface electromyography sensor sheet

Background/purposeA sensor sheet comprising multiple electromyography electrodes that can be used to measure a series of multiple muscle activities related to swallowing was recently developed. In this study, we aimed to evaluate its utility in detecting swallowing disorders with a new method for the identification of muscle activity. Materials and methodsAll participants were evaluated by using the repetitive saliva swallowing test and modified water swallowing test and were classified accordingly into participants with (n = 21; mean age, 81.6 [standard deviation, 10.1] years) and those without (n = 41; mean age, 70.0 [8.4] years) dysphagia. The sheet contains four pairs of electrodes, and surface electromyography (sEMG) was performed on the suprahyoid (position A: upper front of the suprahyoid muscles; position B: bottom rear of the suprahyoid muscles) and infrahyoid (position C: above the infrahyoid muscles; position D: beneath the infrahyoid muscles) muscles while the participants swallowed liquid, thickened water, paste, and jelly. The sEMG findings, including the duration of swallowing waveforms and the delay in swallowing onset from position A to positions B, C, and D, were compared between the groups. ResultsThe duration of muscle activity differed between the groups in the infrahyoid muscles when jelly (Mann–Whitney U test; position C, P = 0.007 and position D, P = 0.018) and thickened water (position C, P = 0.033) were swallowed. ConclusionOur study demonstrates the utility of a novel sensor sheet developed for detecting swallowing disorders by using visual methods for identification of muscle activity.

Muscle Synergies in People With Chronic Ankle Instability During Anticipated and Unanticipated Landing-Cutting Tasks.

Although neuromuscular deficits in people with chronic ankle instability (CAI) have been identified, previous researchers have mostly investigated the activation of multiple muscles in isolation. Investigating muscle synergies in people with CAI would provide information about the coordination and control of neuromuscular activation strategies and could supply important information for understanding and rehabilitating neuromuscular deficits in this population. To assess and compare muscle synergies using nonnegative matrix factorization in people with CAI and healthy control individuals as they performed different landing-cutting tasks. Cross-sectional study. Laboratory. A total of 11 people with CAI (5 men, 6 women; age = 22 ± 3 years, height = 1.68 ± 0.11 m, mass = 69.0 ± 19.1 kg) and 11 people without CAI serving as a healthy control group (5 men, 6 women; age = 23 ± 4 years, height = 1.74 ± 0.11 m, mass = 66.8 ± 15.5 kg) participated. Muscle synergies were extracted from electromyography of the lateral gastrocnemius, medial gastrocnemius, fibularis longus, soleus, and tibialis anterior (TA) muscles during anticipated and unanticipated landing-cutting tasks. The number of synergies, activation coefficients, and muscle-specific weighting coefficients were compared between groups and across tasks. The number of muscle synergies was the same for each group and task. The CAI group exhibited greater TA weighting coefficients in synergy 1 than the control group (P = .02). In addition, both groups demonstrated greater fibularis longus (P = .03) weighting coefficients in synergy 2 during the unanticipated landing-cutting task than the anticipated landing-cutting task. These results suggest that, although both groups used neuromuscular control strategies of similar complexity or dimensionality to perform the landing-cutting tasks, the CAI group displayed different muscle-specific weightings characterized by greater emphasis on TA function in synergy 1, which may reflect an effort to increase joint stability to compensate for ankle instability.

Task- and Intensity-Dependent Modulation of Arm-Trunk Neural Interactions in the Corticospinal Pathway in Humans.

Most human movements require coordinated activation of multiple muscles. Although many studies reported associations between arm, leg, and trunk muscles during functional tasks, their neural interaction mechanisms still remain unclear. Therefore, the aim of our study was to investigate arm-trunk or arm-leg neural interactions in the corticospinal tract during different arm muscle contractions. Specifically, we examined corticospinal excitability of the erector spinae (ES; trunk extensor), rectus abdominis (RA; trunk flexor), and tibialis anterior (TA; leg) muscles while participants exerted: (1) wrist flexion and (2) wrist extension isometric contraction at various contraction intensity levels ranging from rest to 50% of maximal voluntary contraction (MVC) effort. Corticospinal excitability was assessed using motor evoked potentials (MEPs) elicited through motor cortex transcranial magnetic stimulation (TMS). Results showed that ES MEPs were facilitated even at low contractions (>5% MVC) during wrist flexion and extension, while stronger contractions (>25% MVC) were required to facilitate RA MEPs. The extent of facilitation of ES MEPs depended on contraction intensity of wrist extension, but not flexion. Moreover, TA MEPs were facilitated at low contractions (>5% MVC) during wrist flexion and extension, but contraction intensity dependence was only shown during stronger wrist extension contractions (>25% MVC). In conclusion, trunk extensor corticospinal excitability seems to depend on the task and the intensity of arm contraction, while this is not true for trunk flexor and leg muscles. Our study therefore demonstrated task- and intensity-dependent neural interactions of arm-trunk connections, which may underlie anatomic and/or functional substrates of these muscle pairs.

Modulation of spatial and temporal modules in lower limb muscle activations during walking with simulated reduced gravity

Gravity plays a crucial role in shaping patterned locomotor output to maintain dynamic stability during locomotion. The present study aimed to clarify the gravity-dependent regulation of modules that organize multiple muscle activities during walking in humans. Participants walked on a treadmill at seven speeds (1–6 km h−1 and a subject- and gravity-specific speed determined by the Froude number (Fr) corresponding to 0.25) while their body weight was partially supported by a lift to simulate walking with five levels of gravity conditions from 0.07 to 1 g. Modules, i.e., muscle-weighting vectors (spatial modules) and phase-dependent activation coefficients (temporal modules), were extracted from 12 lower-limb electromyographic (EMG) activities in each gravity (Fr ~ 0.25) using nonnegative matrix factorization. Additionally, a tensor decomposition model was fit to the EMG data to quantify variables depending on the gravity conditions and walking speed with prescribed spatial and temporal modules. The results demonstrated that muscle activity could be explained by four modules from 1 to 0.16 g and three modules at 0.07 g, and the modules were shared for both spatial and temporal components among the gravity conditions. The task-dependent variables of the modules acting on the supporting phase linearly decreased with decreasing gravity, whereas that of the module contributing to activation prior to foot contact showed nonlinear U-shaped modulation. Moreover, the profiles of the gravity-dependent modulation changed as a function of walking speed. In conclusion, reduced gravity walking was achieved by regulating the contribution of prescribed spatial and temporal coordination in muscle activities.

How to improve the muscle synergy analysis methodology?

Muscle synergy analysis is increasingly used in domains such as neurosciences, robotics, rehabilitation or sport sciences to analyze and better understand motor coordination. The analysis uses dimensionality reduction techniques to identify regularities in spatial, temporal or spatio-temporal patterns of multiple muscle activation. Recent studies have pointed out variability in outcomes associated with the different methodological options available and there was a need to clarify several aspects of the analysis methodology. While synergy analysis appears to be a robust technique, it remain a statistical tool and is, therefore, sensitive to the amount and quality of input data (EMGs). In particular, attention should be paid to EMG amplitude normalization, baseline noise removal or EMG filtering which may diminish or increase the signal-to-noise ratio of the EMG signal and could have major effects on synergy estimates. In order to robustly identify synergies, experiments should be performed so that the groups of muscles that would potentially form a synergy are activated with a sufficient level of activity, ensuring that the synergy subspace is fully explored. The concurrent use of various synergy formulations-spatial, temporal and spatio-temporal synergies- should be encouraged. The number of synergies represents either the dimension of the spatial structure or the number of independent temporal patterns, and we observed that these two aspects are often mixed in the analysis. To select a number, criteria based on noise estimates, reliability of analysis results, or functional outcomes of the synergies provide interesting substitutes to criteria solely based on variance thresholds.

Ketamine-induced neuromuscular reactivity is associated with aging in female rhesus macaques.

Rhesus macaques represent an important species for translational and pre-clinical research studies across a multitude of disease and injury models, including aging. Ketamine anesthesia is used in humans and non-human primates but may be associated with adverse effects, including neuromuscular reactions. The effects of aging on ketamine adverse effects is not well characterized. Urodynamic recordings and electromyography (EMG) studies were performed in aged (>20 years old) and adult (3.9–14.9 years old) female rhesus macaques under an equal and light plane of sedation by constant rate infusion (CRI) of ketamine. A total of 4 of 41 adult subjects (9.7%) showed clinical signs of ketamine-induced abnormal neuromuscular reactivity, whereas a larger portion of 14 of 26 aged subjects showed similar ketamine-induced neuromuscular reactivity (53.8%; P< 0.001). The ketamine CRI rate was 19.8±0.9 mg/kg/h in adults and lower in aged subjects at 16.5±1.4 mg/kg/h (P<0.05). The ketamine CRI rate was negatively correlated with age (r = -0.30, P<0.05, n = 64). The incidence of ketamine reactivity or CRI rate was not different between aged pre-and post-menopausal females. EMG recordings during neuromuscular reactivity showed coordinated activation of multiple muscles, suggesting a central nervous system (CNS) mechanism for ketamine-associated neuromuscular reactivity. The incidence of ketamine-induced neuromuscular reactivity is age related but not affected by the estrous cycle in female rhesus macaques. A coordinated activation of multiple muscles, innervated by different peripheral nerves, suggests that ketamine-induced neuromuscular reactivity originates in the CNS.

Dystrophin R16/17-syntrophin PDZ fusion protein restores sarcolemmal nNOS\u03bc

BackgroundLoss of sarcolemmal nNOSμ is a common manifestation in a wide variety of muscle diseases and contributes to the dysregulation of multiple muscle activities. Given the critical role sarcolemmal nNOSμ plays in muscle, restoration of sarcolemmal nNOSμ should be considered as an important therapeutic goal.MethodsnNOSμ is anchored to the sarcolemma by dystrophin spectrin-like repeats 16 and 17 (R16/17) and the syntrophin PDZ domain (Syn PDZ). To develop a strategy that can independently restore sarcolemmal nNOSμ, we engineered an R16/17-Syn PDZ fusion construct and tested whether this construct alone is sufficient to anchor nNOSμ to the sarcolemma in three different mouse models of Duchenne muscular dystrophy (DMD).ResultsMembrane-associated nNOSμ is completely lost in DMD. Adeno-associated virus (AAV)-mediated delivery of the R16/17-Syn PDZ fusion construct successfully restored sarcolemmal nNOSμ in all three models. Further, nNOS restoration was independent of the dystrophin-associated protein complex.ConclusionsOur results suggest that the R16/17-Syn PDZ fusion construct is sufficient to restore sarcolemmal nNOSμ in the dystrophin-null muscle.

Development of a multichannel current-EMG system for coherence modulation with visual biofeedback.

By means of biofeedback, neuromotor control can be modified. Recent biofeedback experiments have used the power of the electromyogram of one muscle in different frequency bands to control a two-dimensional cursor. However, the human body usually requires coherent activation of multiple muscles to achieve daily life tasks. Additionally, electromyography (EMG) instrumentation has remained the same for decades, and might not be the most suitable to measure coherent activations from pennated muscles according to recent experiments by von Tscharner and colleagues. In this study, we propose the development of a multichannel current-based EMG amplifier to use intermuscular coherence as the control feature of a visual biofeedback system. The system was used in a leg extension protocol to voluntarily increase intermuscular coherence between the vastii muscles. Results from ten subjects show that it is possible to increase intermuscular coherence through visual biofeedback. Such a system can have applications in endurance training and rehabilitation.

Vestibular and corticospinal control of human body orientation in the gravitational field.

Body orientation with respect to the direction of gravity changes when we lean forward from upright standing. We tested the hypothesis that during upright standing, the nervous system specifies the referent body orientation that defines spatial thresholds for activation of multiple muscles across the body. To intentionally lean the body forward, the system is postulated to transfer balance and stability to the leaned position by monotonically tilting the referent orientation, thus increasing the activation thresholds of ankle extensors and decreasing their activity. Consequently, the unbalanced gravitational torque would start to lean the body forward. With restretching, ankle extensors would be reactivated and generate increasing electromyographic (EMG) activity until the enhanced gravitational torque would be balanced at a new posture. As predicted, vestibular influences on motoneurons of ankle extensors evaluated by galvanic vestibular stimulation were smaller in the leaned compared with the upright position, despite higher tonic EMG activity. Defacilitation of vestibular influences was also observed during forward leaning when the EMG levels in the upright and leaned position were equalized by compensating the gravitational torque with a load. The vestibular system is involved in the active control of body orientation without directly specifying the motor outcome. Corticospinal influences originating from the primary motor cortex evaluated by transcranial magnetic stimulation remained similar at the two body postures. Thus, in contrast to the vestibular system, the corticospinal system maintains a similar descending facilitation of motoneurons of leg muscles at different body orientations. The study advances the understanding of how body orientation is controlled. NEW & NOTEWORTHY The brain changes the referent body orientation with respect to gravity to lean the body forward. Physiologically, this is achieved by shifts in spatial thresholds for activation of ankle muscles, which involves the vestibular system. Results advance the understanding of how the brain controls body orientation in the gravitational field. The study also extends previous evidence of empirical control of motor function, i.e., without the reliance on model-based computations and direct specification of motor outcome.

Sleeping tongue: current perspectives of genioglossus control in healthy individuals and patients with obstructive sleep apnea.

The focus of this review was on the genioglossus (GG) muscle and its role in maintaining upper airway patency in both healthy individuals and obstructive sleep apnea (OSA) patients. This review provided an overview of GG anatomy and GG control and function during both wakefulness and sleep in healthy individuals and in those with OSA. We reviewed evidence for the role of the GG in OSA pathogenesis and also highlighted abnormalities in GG morphology, responsiveness, tissue movement patterns and neurogenic control that may contribute to or result from OSA. We summarized the different methods for improving GG function and/or activity in OSA and their efficacy. In addition, we discussed the possibility that assessing the synergistic activation of multiple upper airway dilator muscles may provide greater insight into upper airway function and OSA pathogenesis, rather than assessing the GG in isolation.

Positive and Negative Covariation Mechanism of Multiple Muscle Activities During Human Walking

Positive and Negative Covariation Mechanism of Multiple Muscle Activities During Human Walking

Referent control of the orientation of posture and movement in the gravitational field.

This study addresses the question of how posture and movement are oriented with respect to the direction of gravity. It is suggested that neural control levels coordinate spatial thresholds at which multiple muscles begin to be activated to specify a referent body orientation (RO) at which muscle activity is minimized. Under the influence of gravity, the body is deflected from the RO to an actual orientation (AO) until the emerging muscle activity and forces begin to balance gravitational forces and maintain body stability. We assumed that (1) during quiet standing on differently tilted surfaces, the same RO and thus AO can be maintained by adjusting activation thresholds of ankle muscles according to the surface tilt angle; (2) intentional forward body leaning results from monotonic ramp-and-hold shifts in the RO; (3) rhythmic oscillation of the RO about the ankle joints during standing results in body swaying. At certain sway phases, the AO and RO may transiently overlap, resulting in minima in the activity of multiple muscles across the body. EMG kinematic patterns of the 3 tasks were recorded and explained based on the RO concept that implies that these patterns emerge due to referent control without being pre-programmed. We also confirmed the predicted occurrence of minima in the activity of multiple muscles at specific body configurations during swaying. Results re-affirm previous rejections of model-based computational theories of motor control. The role of different descending systems in the referent control of posture and movement in the gravitational field is considered.