Coactivation Of Antagonist Muscles Research Articles

Higher coactivations of lower limb muscles increase stability during walking on slippery ground in forward dynamics musculoskeletal simulation

The energy efficiency theory of human bipedal locomotion has been widely accepted as a neuro-musculoskeletal control method. However, coactivation of agonist and antagonist muscles in the lower limb has been observed during various limb movements, including walking. The emergence of this coactivation cannot be explained solely by the energy efficiency theory and remains a subject of debate. To shed light on this, we investigated the role of muscle coactivations in walking stability using a forward dynamics musculoskeletal simulation combined with neural-network-based gait controllers. Our study revealed that a gait controller with minimal muscle activations had a high probability of falls under challenging gait conditions such as slippery ground and uneven terrain. Lower limb muscle coactivations emerged in the process of gait controller training on slippery ground. Controllers with physiological coactivation levels demonstrated a significantly reduced probability of falls. Our results suggest that achieving stable walking requires muscle coactivations beyond the minimal level of muscle energy. This study implies that coactivations likely emerge to maintain gait stability under challenging conditions, and both coactivation and energy optimization of lower limb muscles should be considered when exploring the foundational control mechanisms of human walking.

Antagonist Coactivation of Muscles of Ankle and Thigh in Post-Stroke vs. Healthy Subjects during Sit-to-Stand Task

This study aims to analyse the coactivation of antagonist muscles of the thigh and ankle during the sit-to-stand task in post-stroke subjects, specifically during forward and antigravity sub-phases. A group of 18 healthy subjects and another with 18 subjects with a history of stroke participated voluntarily in this study. Bilateral surface electromyography (EMGs) of the soleus, gastrocnemius medialis, tibialis anterior, rectus femoris and biceps femoris muscles were collected synchronously with ground reaction forces (GRF) during the sit-to-stand task. The magnitude of electromyographic (EMG) activity was analysed during forward translation and antigravity sub-phases which were determined through GRF signals. The coactivation was calculated to quantify the degree of antagonist coactivation according to the role of the muscles during the task. Statistically significant values were found between antagonist coactivation on both sub-phases of the sit-to-stand task when comparing healthy and post-stroke subjects (healthy with ipsilesional (IPSI); healthy with contralesional (CONTRA); and healthy with IPSI and with CONTRA limbs) in all muscle pairs analysed (p < 0.01), except on thigh muscles (p > 0.05), in the antigravity sub-phase. When comparing IPSI with CONTRA sides in post-stroke subjects, no statistically significant differences were found. Increased values of antagonist coactivation were observed in post-stroke subjects compared to healthy subjects (both IPSI and CONTRA limb) in the two sub-phases analysed. The forward sub-phase CONTRA limb showed higher antagonist coactivation compared to IPSI, while in the antigravity sub-phase, IPSI antagonist coactivation was higher than in the CONTRA. In conclusion, post-stroke subjects presented an antagonist coactivation more dysfunctional at the ankle joint muscles compared to the thigh segment. So, it seems that the distal segment could express more accurately the central nervous system dysfunction in post-stroke subjects, despite the need for further studies to achieve a better spatiotemporal understanding of the variability on coactivation levels.

Mechanical disturbances applied by motorized ankle foot orthosis to adapt ankle muscles activation-A validation study.

Background: Reduced function of ankle muscles usually leads to impaired gait. Motorized ankle foot orthoses (MAFOs) have shown potential to improve neuromuscular control and increase volitional engagement of ankle muscles. In this study, we hypothesize that specific disturbances (adaptive resistance-based perturbations to the planned trajectory) applied by a MAFO can be used to adapt the activity of ankle muscles. The first goal of this exploratory study was to test and validate two different ankle disturbances based on plantarflexion and dorsiflexion resistance while training in standing still position. The second goal was to assess neuromuscular adaptation to these approaches, namely, in terms of individual muscle activation and co-activation of antagonists. Methods: Two ankle disturbances were tested in ten healthy subjects. For each subject, the dominant ankle followed a target trajectory while the contralateral leg was standing still: a) dorsiflexion torque during the first part of the trajectory (Stance Correlate disturbance-StC), and b) plantarflexion torque during the second part of the trajectory (Swing Correlate disturbance-SwC). Electromyography was recorded from the tibialis anterior (TAnt) and gastrocnemius medialis (GMed) during MAFO and treadmill (baseline) trials. Results: GMed (plantarflexor muscle) activation decreased in all subjects during the application of StC, indicating that dorsiflexion torque did not enhance GMed activity. On the other hand, TAnt (dorsiflexor muscle) activation increased when SwC was applied, indicating that plantarflexion torque succeeded in enhancing TAnt activation. For each disturbance paradigm, there was no antagonist muscle co-activation accompanying agonist muscle activity changes. Conclusion: We successfully tested novel ankle disturbance approaches that can be explored as potential resistance strategies in MAFO training. Results from SwC training warrant further investigation to promote specific motor recovery and learning of dorsiflexion in neural-impaired patients. This training can potentially be beneficial during intermediate phases of rehabilitation prior to overground exoskeleton-assisted walking. Decreased activation of GMed during StC might be attributed to the unloaded body weight in the ipsilateral side, which typically decreases activation of anti-gravity muscles. Neural adaptation to StC needs to be studied thoroughly in different postures in futures studies.

Child-Adult differences in antagonist muscle coactivation: A systematic review.

Antagonist coactivation is the simultaneous activation of agonist and antagonist muscles during a motor task. Age-related changes in coactivation may contribute to observed differences in muscle performance between children and adults. Our aim was to systematically summarize age-related differences in antagonist muscle coactivation during multi-joint dynamic and single-joint isometric and isokinetic contractions. Electronic databases were searched for peer-reviewed studies comparing coactivation in upper or lower extremity muscles between healthy children and adolescents/young adults. Of the 1083 studies initially identified, 25 met eligibility criteria. Thirteen studies examined multi-joint dynamic movements, 10 single-joint isometric contractions, and 2 single-joint isokinetic contractions. Of the studies investigating multi-joint dynamic contractions, 83% (11/13 studies) reported at least one significant age-related difference: In 84% (9/11 studies) coactivation was higher in children, whereas 16% (2/11 studies) reported higher coactivation in adults. Among single-joint contractions, only 25% (3/12 studies) reported significantly higher coactivation in children. Fifty six percent of studies examined females, with no clear sex-related differences. Child-adult differences in coactivation appear to be more prevalent during multi-joint dynamic contractions, where generally, coactivation is higher in children. When examining child-adult differences in muscle function, it is important to consider potential age-related differences in coactivation, specifically during multi-joint dynamic contractions.

Interaction between age and fatigue on antagonist muscle coactivation during an acute post-fatigue recovery phase.

This study investigated the age-related changes in antagonist muscle coactivation of the biceps femoris (BF) during an acute recovery period following a leg extensor fatiguing protocol. Twenty-three young (mean ± SD: age = 25.1 ± 3.0 years) and twenty-three old men (age = 71.5 ± 3.9 years) participated. Surface electromyography (sEMG) was recorded from the BF muscles for antagonist muscle coactivation. Testing involved participants performing leg extension isometric maximal voluntary contractions (MVCs) and isokinetic MVCs at 240°·s−1 at baseline (Pre) and again after the fatigue protocol at 0 (Post0), 7 (Post7), 15 (Post15), and 30 (Post30) minutes post fatigue. Root mean square (RMS) values were computed from the BF sEMG and were calculated as the first 200 ms from onset for the isometric (IsomCoact200ms) and dynamic isokinetic 240°·s−1 (DynCoact200ms) MVCs, and for the final 10° of the leg extension (DynCoact10°) on the isokinetic 240°·s−1 MVCs. Two-way ANOVAs [age group (young vs. old) × time (Pre vs. Post0 vs. Post7 vs. Post15 vs. Post30)] showed that DynCoact200ms had an effect for time (p = 0.018), with greater antagonist coactivation in Pre than Post0 (p = 0.009) and recovering by Post7 (p = 0.011) with no group differences. DynCoact10° had no age × time interaction (p = 0.070), but had a main effect for time (p = 0.020) with the Post0 being lower than the Pre. However, for this variable the young group showed a more severe Pre to Post0 fatigue decline (−45.9%) than the old group (−6.7%) indicating this may be a more sensitive variable for capturing age-related antagonist coactivation post-fatigue responses. Leg extensor fatigue affects some BF coactivation sEMG variables more than others, and any altered post-fatigue coactivation response recovers rapidly (<7 min) from baseline levels.

Hemisphere Asymmetry during Different Levels of Co-activation of Antagonist Muscles: a Transcranial Magnetic Stimulation Study

Contralateral and ipsilateral silent periods were recorded from first dorsal interosseous muscles of the dominant and the non-dominant hand in response to contralateral and ipsilateral transcranial magnetic stimulation (TMS) in twelve right-handed healthy volunteers during isometric index finger abduction and co-activation of antagonist muscles.&#x0D; In the dominant hand, contralateral silent period recorded during coactivation of antagonist muscles was significantly shorter than contralateral silent period recorded during isometric index finger abduction. In the nondominant hand, we did not find significant differences.&#x0D; In the dominant hand, ipsilateral silent period recorded during co-activation of antagonist muscles was significantly shorter than ipsilateral silent period recorded during isometric index finger abduction. In the non-dominant hand, we did not find significant differences.&#x0D; In conclusion, our main finding was the hemisphere asymmetry during co-activation of antagonist muscles. Both, contralateral and ipsilateral silent periods recorded from the dominant right hand were shorter in comparison to those recorded from the non-dominant hand. These findings illustrate the role of co-activation for the better and precise usage of the dominant hand.

Halo Sport Transcranial Direct Current Stimulation Improved Muscular Endurance Performance and Neuromuscular Efficiency During an Isometric Submaximal Fatiguing Elbow Flexion Task.

The present study examined the effects of transcranial direct current stimulation (tDCS) using Halo Sport on the time to exhaustion (TTE) in relation with muscle activities and corticomuscular coupling of agonist and antagonist muscles during a sustained isometric fatiguing contraction performed with the elbow flexors. Twenty healthy male college students were randomly assigned to tDCS group and control group. The two group participants performed two experimental sessions which consisted of pre-fatigue isometric maximal voluntary contraction (MVC), sustained submaximal voluntary contractions (30% maximal torque) performed to exhaustion, and post-fatigue MVC with the right elbow flexor muscles. Sham stimulation (90 s) and tDCS (20 min) were applied for control and tDCS group participants 20 min prior to the second session test, respectively. MVC strength in pre- and post-fatigue test, TTE, electroencephalogram (EEG), and electromyography (EMG) of biceps brachii (BB) and triceps brachii (TB) were recorded during the tests. It was found that tDCS using the Halo Sport device significantly increased TTE and thus improved muscular endurance performance. The improvement may be partly related to the improvement of neuromuscular efficiency as reflected by decrease of antagonistic muscle coactivation activities, which may be related to cortical originated central processing mechanism of neuromuscular activities.

Improving reaching with functional electrical stimulation by incorporating stiffness modulation

Objective. Intracortical recordings have now been combined with functional electrical stimulation (FES) of arm/hand muscles to demonstrate restoration of upper-limb function after spinal cord injury. However, for each desired limb position decoded from the brain, there are multiple combinations of muscle stimulation levels that can produce that position. The objective of this simulation study is to explore how modulating the amount of coactivation of antagonist muscles during FES can impact reaching performance and energy usage. Stiffening the limb by cocontracting antagonist muscles makes the limb more resistant to perturbation. Minimizing cocontraction saves energy and reduces fatigue. Approach. Prior demonstrations of reaching via FES used a fixed empirically-derived lookup table for each joint that defined the muscle stimulation levels that would position the limb at the desired joint angle decoded from the brain at each timestep. This study expands on that previous work by using simulations to: (a) test the feasibility of controlling arm reaching using a suite of lookup tables with varying levels of cocontraction instead of a single fixed lookup table for each joint, (b) optimize a simple function for automatically switching between these different cocontraction tables using only the desired kinematic information already being decoded from the brain, and (c) compare energy savings and movement performance when using the optimized function to automatically modulate cocontraction during reaching versus using the best fixed level of cocontraction. Main results. Our data suggests energy usage and/or movement performance can be significantly improved by dynamically modulating limb stiffness using our multi-table method and a simple function that determines cocontraction level based on decoded endpoint speed and its derivative. Significance. By demonstrating how modulating cocontraction can reduce energy usage while maintaining or even improving movement performance, this study makes brain-controlled FES a more viable option for restoration of reaching after paralysis.

Effect of power training on locomotion capacities in children with CP with GMFCS level III-V

Previously, we showed that prolonged reaction-time (RT) in older persons is related to increased antagonist muscle co-activation, occurring already before movement onset. Here, we studied whether a difference in temporal agonist and antagonist muscle activation exists between young and older persons during an RT-test. We studied Mm. Biceps (antagonist muscle) & Triceps (agonist muscle) Brachii activation time by sEMG in 60 young (26 ± 3 years) and 64 older (80 ± 6 years) community-dwelling subjects during a simple point-to-point RT-test (moving a finger using standardized elbow-extension from one pushbutton to another following a visual stimulus). RT was divided in pre-movement-time (PMT, time for stimulus processing) and movement-time (MT, time for motor response completion). Muscle activation time 1) following stimulus onset (PMAT) and 2) before movement onset (MAT) was calculated. PMAT for both muscles was significantly longer for the older subjects compared to the young (258 ± 53 ms versus 224 ± 37 ms, p = 0.042 for Biceps and 280 ± 70 ms versus 218 ± 43 ms for Triceps, p < 0.01). Longer agonist muscle PMAT was significantly related to worse PMT and RT in young (respectively r = 0.76 & r = 0.68, p < 0.001) and elderly (respectively r = 0.42 & r = 0.40, p = 0.001). In the older subjects we also found that the antagonist muscle activated significantly earlier than the agonist muscle (− 22 ± 55 ms, p = 0.003). We conclude that in older persons, besides the previously reported increased antagonist muscle co-activation, the muscle firing sequence is also profoundly altered. This is characterized by a delayed muscle activation following stimulus onset, and a significantly earlier recruitment of the antagonist muscle before movement onset.

Antagonist Muscle Co-Activation during Kettlebell Single Arm Swing Exercise

The purpose of this study was to determine the muscle activation and co-activation of selected muscles during the kettlebell single arm swing exercise. To the best of our knowledge, this is the first study investigating the muscle co-activation of a kettlebell single arm swing exercise. Nine volunteers participated in the present study (age: 22.6 ± 3.8 years; body mass: 80.4 ± 9.2 kg; height: 175.6 ± 7.5 cm). The electrical muscle activity of eight right agonist/antagonist muscles (AD/PD, ESL/RA, ESI/EO, and GM/RF) were recorded using a surface EMG system (Myon m320RX; Myon, Switzerland) and processed using the integrated EMG to calculate a co-activation index (CoI) for the ascending and descending phases. A significant effect of the ascending and descending phases on the muscles’ CoI was observed. Post hoc analyses showed that the co-activation was significantly higher in the descending phase compared to that in the ascending phase of AD/PD CoI (34.25 ± 18.03% and 24.75 ± 13.03%, p &lt; 0.001), ESL/RA CoI (34.97 ± 17.86% and 24.19 ± 10.32%, p &lt; 0.001), ESI/EO CoI (41.14 ± 10.72% and 30.87 ± 11.26%, p &lt; 0.001), and GM/RF CoI (27.49 ± 12.97% and 34.98 ± 14.97%, p &lt; 0.001). In conclusion, the co-activation of the shoulder muscles varies within the kettlebell single arm swing. The highest level of co-activation was observed in the descending phase of AD/PD and GM/RF CoI, and the lowest level of co-activation was observed during the descending phase, ESL/RA and ESI/EO CoI. In addition, the highest level of co-activation was observed in the ascending phase of ESL/RA and ESI/EO CoI, and the lowest level of co-activation was observed during the ascending phase, AD/PD and GM/RF CoI. The co-activation index could be a useful method for the interpretation of the shoulder and core muscles’ co-activity during a kettlebell single arm swing.

Recruitment Curves during Different Types of Muscle Activity in Non-dominant Hand: A Transcranial Magnetic Stimulation Study

Motor evoked potentials (MEPs) were recorded from first dorsal interosseous muscle of non-dominant hand in response to contralateral transcranial magnetic stimulation (TMS) in seven right-handed healthy volunteers during relaxed muscles (without electromyorgaphic activity and zero force production), isometric index finger abduction (20% of individual measured maximum voluntary contraction in direction of abduction) and co-activation of antagonist muscles (simultaneously activated antagonist muscles, matching level equal to 20% of individual measured maximum voluntary contraction in direction of abduction by increasing the angle stiffness without producing of external force). The excitability of motor cortex was assessed by the amplitudes of MEPs recorded in response to increasing stimulation intensity: 100%, 110%, 120%, 130%, 140% of individually measured motor threshold at relax. The aim of the present study was using the method of transcranial magnetic stimulation to investigate the effect of different types of muscle activity in non-dominant hand. The secondary purpose was to compare new collected data with our previous data about dominant hand. At non-dominant hand we found significant changes between relax condition and each of the two active motor tasks almost at all five investigated TMS intensities. Also, we found that MEP amplitudes during abduction were significantly bigger than MEP amplitudes during co-activation of antagonist muscles, both in non-dominant hand and in dominant hand. We observed changes between MEP amplitudes of non-dominant and dominant hand during the performance of the same motor task.

A Statistical Approach for the Assessment of Muscle Activation Patterns during Gait in Parkinson’s Disease

Recently, the statistical analysis of muscle activation patterns highlighted that not only one, but several activation patterns can be identified in the gait of healthy adults, with different occurrence. Although its potential, the application of this approach in pathological populations is still limited and specific implementation issues need to be addressed. This study aims at applying a statistical approach to analyze muscle activation patterns of gait in Parkinson’s Disease, integrating gait symmetry and co-activation. Surface electromyographic signal of tibialis anterior and gastrocnemius medialis were recorded during a 6-min walking test in 20 patients. Symmetry between right and left stride time series was verified, different activation patterns identified, and their occurrence (number and timing) quantified, as well as the co-activation of antagonist muscles. Gastrocnemius medialis presented five activation patterns (mean occurrence ranging from 2% to 43%) showing, with respect to healthy adults, the presence of a first shorted and delayed activation (between flat foot contact and push off, and in the final swing) and highlighting a new second region of anticipated activation (during early/mid swing). Tibialis anterior presented five activation patterns (mean occurrence ranging from 3% to 40%) highlighting absent or delayed activity at the beginning of the gait cycle, and generally shorter and anticipated activations during the swing phase with respect to healthy adults. Three regions of co-contraction were identified: from heel strike to mid-stance, from the pre- to initial swing, and during late swing. This study provided a novel insight in the analysis of muscle activation patterns in Parkinson’s Disease patients with respect to the literature, where unique, at times conflicting, average patterns were reported. The proposed integrated methodology is meant to be generalized for the analysis of muscle activation patterns in pathologic subjects.

Sex differences in soleus muscle H‐reflex and V‐wave excitability

What is the central question of this study? How do H-reflex and V-wave excitability compare between men and women engaging in similar levels of physical activity? What is the main finding and its importance? H-reflex excitability is lower in women than in men because of their greater level of antagonist co-activation during sustained plantar flexion isometric exercise. In addition, supraspinal drive is similar between men and women independently of their differences in H-reflex excitability and antagonist muscle co-activation. We compared H-reflex and V-wave excitability between men and women engaging in similar levels of physical activity. We also explored whether differences in antagonist muscle co-activation between sexes might partially explain sexual dimorphism in the excitability of the H-reflex and V-wave. Fifty-seven young participants were included (29 men: 21.7±2.3years; 28 women: 22.4±3.3years). Soleus M- and H-recruitment curves were constructed on a tonic background muscle activation. V-waves were elicited during maximal voluntary contraction (MVC). Besides being stronger than women, men achieved greater Hmax /Mmax values and presented a steeper slope of the ascending limb of the H-reflex recruitment curve (P<0.05). The current intensity required to elicit Hmax was lower for men (P<0.05). The co-activation of the tibialis anterior muscle during the sustained plantar flexions was greater in women (ratio between tibialis and soleus normalized EMG: 20.5 vs. 8.3%, P<0.05). Covariance analysis showed that sexual dimorphism in H-reflex excitability was dissipated when controlling for antagonist co-activation. V-wave normalized amplitude was similar between sexes even after controlling for the effects of Hmax /Mmax and antagonist co-activation as covariates. Thus, women exhibit lower H-reflex excitability than men and this is dependent on their higher level of antagonist muscle co-activation. While sex differences in antagonist co-activation persist during MVCs, this is not the case for V-wave normalized amplitude. Thus, although the efficacy of the transmission between Ia afferent fibres to α-motoneurons is lower in women because of a greater level of antagonist co-activation, our findings are consistent with similar supraspinal drive between sexes.

Muscle Fatigue Enhance Beta Band EMG-EMG Coupling of Antagonistic Muscles in Patients With Post-stroke Spasticity.

There is a significant influence of muscle fatigue on the coupling of antagonistic muscles while patients with post-stroke spasticity are characterized by abnormal antagonistic muscle coactivation activities. This study was designed to verify whether the coupling of antagonistic muscles in patients with post-stroke spasticity is influenced by muscle fatigue. Ten patients with chronic hemipare and spasticity and 12 healthy adults were recruited to participate in this study. Each participant performed a fatiguing isometric elbow flexion of the paretic side or right limb at 30% maximal voluntary contraction (MVC) level until exhaustion while surface electromyographic (sEMG) signals were collected from the biceps brachii (BB) and triceps brachii (TB) muscles during the sustained contraction. sEMG signals were divided into the first (minimal fatigue) and second halves (severe fatigue) of the contraction. The power and coherence between the sEMG signals of the BB and TB in the alpha (8–12 Hz), beta (15–35 Hz), and gamma (35–60 Hz) frequency bands associated with minimal fatigue and severe fatigue were calculated. The coactivation ratio of the antagonistic TB muscle was also determined during the sustained fatiguing contraction. The results demonstrated that there was a significant decrease in maximal torque during the post-fatigue contraction compared to that during the pre-fatigue contraction in both stroke and healthy group. In the stroke group, EMG-EMG coherence between the BB and TB in the alpha and beta frequency bands was significantly increased in severe fatigue compared to minimal fatigue, while coactivation of antagonistic muscle increased progressively during the sustained fatiguing contraction. In the healthy group, coactivation of the antagonistic muscle showed no significant changes during the fatiguing contraction and no significant coherence was found in the alpha, beta and gamma frequency bands between the first and second halves of the contraction. Therefore, the muscle fatigue significantly increases the coupling of antagonistic muscles in patients with post-stroke spasticity, which may be related to the increased common corticospinal drive from motor cortex to the antagonistic muscles. The increase in antagonistic muscle coupling induced by muscle fatigue may provide suggestions for the design of training program for patients with post-stroke spasticity.

Computational evidence for nonlinear feedforward modulation of fusimotor drive to antagonistic co-contracting muscles

The sensorimotor integration during unconstrained reaching movements in the presence of variable environmental forces remains poorly understood. The objective of this study was to quantify how much the primary afferent activity of muscle spindles can contribute to shaping muscle coactivation patterns during reaching movements with complex dynamics. To achieve this objective, we designed a virtual reality task that guided healthy human participants through a set of planar reaching movements with controlled kinematic and dynamic conditions that were accompanied by variable muscle co-contraction. Next, we approximated the Ia afferent activity using a phenomenological model of the muscle spindle and muscle lengths derived from a musculoskeletal model. The parameters of the spindle model were altered systematically to evaluate the effect of fusimotor drive on the shape of the temporal profile of afferent activity during movement. The experimental and simulated data were analyzed with hierarchical clustering. We found that the pattern of co-activation of agonistic and antagonistic muscles changed based on whether passive forces in each movement played assistive or resistive roles in limb dynamics. The reaching task with assistive limb dynamics was associated with the most muscle co-contraction. In contrast, the simulated Ia afferent profiles were not changing between tasks and they were largely reciprocal with homonymous muscle activity. Simulated physiological changes to the fusimotor drive were not sufficient to reproduce muscle co-contraction. These results largely rule out the static set and α-γ coactivation as the main types of fusimotor drive that transform the monosynaptic Ia afferent feedback into task-dependent co-contraction of antagonistic muscles. We speculate that another type of nonlinear transformation of Ia afferent signals that is independent of signals modulating the activity of α motoneurons is required for Ia afferent-based co-contraction. This transformation could either be applied through a complex nonlinear profile of fusimotor drive that is not yet experimentally observed or through presynaptic inhibition.

Spastic movement disorder: should we forget hyperexcitable stretch reflexes and start talking about inappropriate prediction of sensory consequences of movement?

Spastic movement disorder is characterized by reduced ability to selectively activate muscles with significant co-activation of antagonist muscles. It has traditionally been thought that hyperexcitable stretch reflexes have a central role in the pathophysiology and the clinical manifestations of the disorder. Here we argue that the main functional challenges for persons with spastic movement disorder are related to contractures, paresis, weak muscles and inappropriate central motor commands, whereas hyperexcitable reflexes play no or only an insignificant functional role. Co-activation of antagonist muscles and stiff posture and gait may rather be adaptations that aim to ensure joint and postural stability due to insufficient muscle strength. Aberrant (involuntary) muscle activity is likely related to an inadequate prediction of the sensory consequences of movement and a resulting impairment of muscle coordination. We argue that improvement of functional muscle strength and muscle coordination following central motor lesions may be achieved by optimizing integration of somatosensory information into central feedforward motor programs, whereas anti-spastic therapy that aims to reduce reflex activity may be less efficient. This opens for novel investigations into new treatment strategies that may improve functional control of movement and prevent reduced joint mobility in people with brain lesions.

Sex may influence motor phenotype in a novel rodent model of cerebral palsy

Cerebral palsy (CP) is the most common cause of childhood motor disability, manifesting most often as spasticity and/or dystonia. Spasticity and dystonia are often co-morbid clinically following severe injury at term gestation. Currently available animal CP models have not demonstrated or differentiated between these two motor phenotypes, limiting their clinical relevance. We sought to develop an animal CP model displaying objectively identifiable spasticity and dystonia. We exposed rat pups at post-natal day 7–8 (equivalent to human 37 post-conceptional weeks) to global hypoxia. Since spasticity and dystonia can be difficult to differentiate from each other in CP, objective electrophysiologic markers of motor phenotypes were assessed. Spasticity was inferred using an electrophysiologic measure of hyperreflexia: soleus Hoffman reflex suppression with 2 Hz tibial nerve stimulation. Dystonia was assessed during voluntary isometric hindlimb withdrawal at different levels of arousal by calculating tibialis anterior and triceps surae electromyographic co-activation as a surrogate of overflow muscle activity. Hypoxia affected spasticity and dystonia measures in a sex-dependent manner. Males had attenuated Hoffman reflex suppression suggestive of spasticity but no change in antagonist muscle co-activation. In contrast, females demonstrated increased co-activation suggestive of dystonia but no change in Hoffman reflex suppression. Therefore, there was an unexpected segregation of electrophysiologically-defined motor phenotypes based on sex with males predominantly demonstrating spasticity and females predominantly demonstrating dystonia. These results require human clinical confirmation but suggest that sex could play a critical role in the motor manifestations of neonatal brain injury.

Influence of Antagonistic Hamstring Coactivation on Measurement of Quadriceps Strength in Older Adults.

There is limited understanding of how antagonist muscle coactivation relates to measurement of strength in both individuals with and without knee osteoarthritis (KOA). This study sought to determine whether hamstring coactivation during a maximal quadriceps activation task attenuates net quadriceps strength. Cross-sectional cohort analysis was conducted using data from the 60-month visit of the Multicenter Osteoarthritis Study (MOST). Laboratory. A sample of 2328 community-dwelling MOST participants between the ages of 55 and 84 years, with or at elevated risk for KOA, completed the 60-month MOST follow-up visit. Of these, 1666 met inclusion criteria for the current study. Not applicable. Quadriceps strength; percentage of combined hamstring coactivation (HC), medial HC, and lateral HC. Quadriceps and hamstring strength were assessed using an isokinetic dynamometer. Surface electromyography was used to assess muscle activation patterns. General linear models, adjusted for age, BMI, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Kellgren-Lawrence (KL) grade and study site, modeled the relationship between antagonist hamstring coactivation and quadriceps strength. Men had significantly greater quadriceps strength (P < .001), history of knee injury (P < .001) and surgery (P = .002), and greater presence of varus malalignment (P < .001). Women had greater pain (P < .001) and proportion of KL grade ≥2 (P = .017). Gender-specific analyses revealed combined HC (P = .013) and lateral HC inversely associated with quadriceps strength in women (P = .023) but not in men (combined HC P = .320, lateral HC P = .755). A nonlinear association was detected between quadriceps strength and medial HC. Assessment of quartiles of medial HC revealed the third quartile had reduced quadriceps strength when compared to the lowest quartile of coactivation in both men and women. Hamstring coactivation attenuates measured quadriceps strength in women with or at elevated risk for KOA. II.

Badminton players show a lower coactivation and higher beta band intermuscular interactions of ankle antagonist muscles during isokinetic exercise.

Previous studies have suggested that skilled athletes may show a specific muscle activation pattern with a lower antagonist coactivation level. Based on the point, we hypothesize that the coupling of antagonistic muscles may be different between badminton players and non-skilled individuals during exercises. The current work was designed to verify the hypothesis. Ten male college students and eight male badminton players performed three maximal voluntary isometric contractions (MVC) and a set of three maximal concentric ankle dorsiflexion and plantar flexions at an angular velocity of 30°, 60°, 120°, and 180°/s. Surface electromyography (EMG) was recorded from the tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during the test. Normalized average EMG amplitude and phase synchronization index (PSI) between surface EMG of TA and LG were calculated. Antagonist muscle coactivation was significantly lower (from 22.1% ± 9.4 and 10.7% ± 3.7 at 30°/s to 22.4% ± 9.7 and 10.6% ± 2.5 at 180°/s for non-players and badminton playersgroup, respectively), and PSI in beta frequency band was significantly higher (from 0.42 ± 0.06 and 0.47 ± 0.15 at 30°/s to 0.35 ± 0.12 and 0.49 ± 0.14 at 180°/s) in the badminton player group compared with the non-player group during isokinetic ankle dorsiflexion contraction. No significant difference was found in antagonist muscle coactivation and PSI between two group subjects during ankle plantar flexion. The decrease of antagonist coactivation may indicate an optimal motor control style to increase the contraction efficiency, while the increase coupling of antagonistic muscles may help to ensure joint stability to compensate for the decrease of antagonist coactivation. Graphical abstract Significant difference of observed indexes between non-players and badminton players.

Neurostructural correlates of strength decrease following total knee arthroplasty: A systematic review of the literature with meta-analysis.

Recent literature suggests that alterations in both neural and structural components of the neuromuscular system are major determinants of knee extensor muscle weakness after total knee arthroplasty (TKA). Therefore, the goal of this study was to investigate the maximal voluntary strength (MVS), voluntary muscle activation (VMA), and the cross-sectional area (CSA) of the muscle, up to 33 months after the TKA. We searched relevant scientific databases and literature for outcomes of interest, including quadriceps MVS, VMA, and CSA. Ten studies met the inclusion criteria and involved a total of 289 patients. The quality of the studies was evaluated by Methodological Index for Non-Randomized Studies (MINORS). Results showed that quadriceps MVS markedly declines in the early postoperative period, after which it slowly and linearly recovers over time. However, the same phenomenon was not observed for VMA and CSA, which were not significantly altered after the TKA. Furthermore, a meta-regression analysis revealed that the change in VMA accounted for 39% of the relative change in quadriceps strength (R2=0.39; p=0.015) in the early postoperative period. Patients treated with TKA had considerable weakness of the quadriceps muscle, which was detectable up to 3 months after surgery. Although the change in VMA largely explains quadriceps weakness, this change and CSA differences were not significant, suggesting that other neural correlates, such as hamstrings coactivation, might alter quadriceps muscle function. Thus, more attention should be paid to address VMA failure and coactivation of antagonist muscles. More comprehensive rehabilitation approaches may be required to target the whole neural circuit controlling the motor action.