Motor Unit Control Research Articles

A Comparison of Motor Unit Control Strategies between Two Different Isometric Tasks.

Background: This study examined the motor unit (MU) control strategies for non-fatiguing isometric elbow flexion tasks at 40% and 70% maximal voluntary isometric contraction. Methods: Nineteen healthy individuals performed two submaximal tasks with similar torque levels: contracting against an immovable object (force task), and maintaining the elbow joint angle against an external load (position task). Surface electromyographic (EMG) signals were collected from the agonist and antagonist muscles. The signals from the agonist were decomposed into individual action potential trains. The linear regression analysis was used to examine the MU recruitment threshold (RT) versus mean firing rates (MFR), and RT versus derecruitment threshold (DT) relationships. Results: Both agonist and antagonist muscles’ EMG amplitudes did not differ between two tasks. The linear slopes of the MU RT versus MFR and RT versus DT relationships during the position task were more negative (p = 0.010) and more positive (p = 0.023), respectively, when compared to the force task. Conclusions: To produce a similar force output, the position task may rely less on the recruitment of relatively high-threshold MUs. Additionally, as the force output decreases, MUs tend to derecruit at a higher force level during the position task.

Compensatory adjustments in motor unit behavior during fatigue differ for younger versus older men.

The ability to maintain a submaximal force as a muscle fatigues is supplemented by compensatory adjustments in the nervous system's control of motor units. We sought to compare vastus lateralis motor unit recruitment and firing rate data for younger versus older men during isometric fatigue. Twelve younger (age = 25 ± 3years) and 12 older (75 ± 8years) men performed contractions of the knee extensors at 50% of maximal voluntary contraction force until exhaustion. Surface electromyographic (sEMG) signals were detected from the vastus lateralis. A sEMG signal decomposition algorithm was used to quantify the motor unit action potential (MUAP) amplitude, mean firing rates, and recruitment threshold of each motor unit. For the latter two variables, our analyses only included motor units that featured similar action potential amplitude throughout the protocol. There was no group difference for time to task failure (p = 0.362, d = 0.381). Both groups showed increases in MUAP amplitude [younger and older slopes = 0.0174 ± 0.0123 and 0.0073 ± 0.0123mV/contraction, respectively (p = 0.082, d = 0.710)], but the change was more linear for the younger men (mean r2 values = 0.565 and 0.455). Mean firing rates increased over time for the younger (p < 0.001), but not the older (p = 0.579), men. Similarly, recruitment thresholds decreased for younger men (p = 0.001). We propose that aging results in neuromuscular impairments that hinder older adults' ability to make compensatory adjustments in motor unit control during fatigue.

Vastus Lateralis Motor Unit Recruitment Thresholds Are Compressed towards Lower Forces in Older Men.

Aging results in adaptations which may affect the control of motor units. We sought to determine if younger and older men recruit motor units at similar force levels. Cross-sectional, between-subjects design. Controlled laboratory setting. Twelve younger (age = 25 ± 3 years) and twelve older (age = 75 ± 8 years) men. Participants performed isometric contractions of the dominant knee extensors at a force level corresponding to 50% maximal voluntary contraction (MVC). Bipolar surface electromyographic (EMG) signals were detected from the vastus lateralis. A surface EMG signal decomposition algorithm was used to quantify the recruitment threshold of each motor unit, which was defined as the force level corresponding to the first firing. Recruitment thresholds were expressed in both relative (% MVC) and absolute (N) terms. To further understand age-related differences in motor unit control, we examined the mean firing rate versus recruitment threshold relationship at steady force. MVC force was greater in younger men (p = 0.010, d = 1.15). Older men had lower median recruitment thresholds in both absolute (p = 0.005, d = 1.29) and relative (p = 0.001, d = 1.53) terms. The absolute recruitment threshold range was larger for younger men (p = 0.020; d = 1.02), though a smaller difference was noted in relative terms (p = 0.235, d = 0.50). These findings were complimented by a generally flatter slope (p = 0.070; d = 0.78) and lower y-intercept (p = 0.009; d = 1.17) of the mean firing rate versus recruitment threshold relationship in older men. Older men tend to recruit more motor units at lower force levels. We speculate that recruitment threshold compression may be a neural adaptation serving to compensate for lower motor unit firing rates and/or denervation and subsequent re-innervation in aged muscle.

The Influence of Contraction Types on the Relationship Between the Intended Force and the Actual Force

It has been demonstrated that the intended force (subjective estimation of force) does not always match to actual force without external feedback. The purpose of this study was to compare the influence of ballistic and tonic contractions on the relationship between the intended and actual force. Subjects produced isometric force at requested percentages of their MVC (20, 40, 60 and 80%) based on subjective estimation of force under two conditions (tonic and ballistic conditions). The tonic condition was to maintain force production, whereas the ballistic condition was to produce force as fast as possible. As a result, the actual force amplitude, the coefficient of variance and EMG amplitude were larger under the ballistic contraction compared with the tonic condition, even the same intended force levels. These results suggest that different motor unit activity and control systems in the ballistic and tonic contractions could alter the relationship between the intended force and the actual force.

Evidence of bilinearity in the relationship between rate of neuromuscular excitation and rate of force development

The purpose was to examine the relationship between the rate of neural excitation (rate of rise in the electromyogram, EMG) and the rate of isometric force development (RFD) to determine whether surface EMG measures can detect nonlinearity that is expected due to underlying motor unit discharge behavior and the summation of progressively larger motor unit potentials throughout recruitment. Due to interest in obtaining a change point, a bilinear model was hypothesized to provide the best fit of the EMG-RFD relationship compared to a linear model, exponential model and log-transformed data. 21 young adult participants performed isometric dorsiflexion contractions to 40% of their maximal voluntary contraction (MVC) force. Contractions were performed in RFD conditions ranging from slow (20 %MVC/s) to fast (peak volitional rate). The Akaike Information Criterion supported nonlinear best fit models in 16 of the 21 participants with the greatest overall support for the bilinear model (n = 13). The bilinear models indicated a mean change point at 204%MVC/s. The present data do not identify the specific motor unit control mechanisms at play and the influence of amplitude cancellation on the electromyogram must be carefully considered.

Human motor unit characteristics of the superior trapezius muscle with age-related comparisons.

Current understanding of human motor unit (MU) control and aging is mostly derived from hand and limb muscles that have spinal motor neuron innervations. The aim here was to characterize and test whether a muscle with a shared innervation supply from brainstem and spinal MU populations would demonstrate similar age-related adaptations as those reported for other muscles. In humans, the superior trapezius (ST) muscle acts to elevate and stabilize the scapula and has primary efferent supply from the spinal accessory nerve (cranial nerve XI) located in the brainstem. We compared electrophysiological properties obtained from intramuscular and surface recordings between 10 young (22-33 yr) and 10 old (77-88 yr) men at a range of voluntary isometric contraction intensities (from 15 to 100% of maximal efforts). The old group was 41% weaker with 43% lower MU discharge frequencies compared with the young (47.2 ± 9.6 Hz young and 26.7 ± 5.8 Hz old, P < 0.05) during maximal efforts. There was no difference in MU number estimation between age groups (228 ± 105 young and 209 ± 89 old, P = 0.33). Furthermore, there were no differences in needle detected near fiber (NF) stability parameters of jitter or jiggle. The old group had lower amplitude and smaller area of the stimulated compound muscle action potential and smaller NF MU potential area with higher NF counts. Thus, despite age-related ST weakness and lower MU discharge rates, there was minimal evidence of MU loss or compensatory reinnervation.NEW & NOTEWORTHY The human superior trapezius (ST) has shared spinal and brainstem motor neuron innervation providing a unique model to explore the impact of aging on motor unit (MU) properties. Although the ST showed higher MU discharge rates compared with most spinally innervated muscles, voluntary strength and mean MU rates were lower in old compared with young at all contraction intensities. There was no age-related difference in MU number estimates with minimal electrophysiological evidence of collateral reinnervation.

The Motor Unit Mean Firing Rate versus Recruitment Threshold Relationship is Unaffected by Short-Term Disuse

The loss of muscle strength during periods of disuse is rapid. Some investigators have postulated that these changes are due to neural, rather than muscular, adaptations. It is unclear, however, if short-term immobilization of the knee joint affects the voluntary control of motor units. PURPOSE: To determine whether the slope and y-intercept of the motor unit mean firing rate versus recruitment threshold relationship is altered by 72 hours of disuse. METHODS: Fifteen healthy females (mean ± SD age = 21 ± 2 years, body mass index [BMI] = 23.1 ± 2.3 kg/m2) voluntarily underwent left knee joint unloading via ambulating on crutches and use of a brace. The brace was worn at all times except during sleep, and compliance was confirmed via accelerometers secured around both ankles. Following two extensive familiarization sessions at the laboratory, testing was performed immediately prior to immobilization (PRE) and 72 hours later (POST). During both testing sessions, participants performed trapezoidal isometric contractions at a torque level corresponding to 50% of their maximal voluntary contraction (MVC). Participants were instructed to increase torque from 0 to 50% in five seconds, maintain 50% MVC for 15 seconds, and decrease torque from 50% to 0 in five seconds. Bipolar surface electromyographic (EMG) signals were recorded from the vastus lateralis. A surface EMG signal decomposition algorithm was used to calculate the mean firing rate (pulses per second [pps]) and recruitment threshold (% MVC) of each detected motor unit. Motor units with decomposition accuracy levels < 90% were discarded. Linear regression was then used to quantify the slope (pps/% MVC) and y-intercept (pps) of each relationship. RESULTS: Immobilization had no influence on the linear slope coefficient for the mean firing rate versus recruitment threshold relationship (PRE = -0.362 ± 0.127, POST = -0.399 ± 0.108 pps/%MVC; p = 0.413, d = 0.218). Similarly, no change in the y-intercept was observed (PRE = 23.2 ± 2.8, POST = 23.3 ± 4.0 pps; p = 0.972, d = 0.009) CONCLUSION: Our findings demonstrated that 72 hours of knee joint immobilization in healthy females had little influence on vastus lateralis motor unit control during submaximal contractions. Funding: The De Luca Foundation and the UCF Office of Research’s Advancement of Early Career Researchers program

Influence of age on motor control accuracy during static ramp contractions.

We investigated the influence of the ageing process on the performance of the motor control system accuracy during a challenging motor task throughout the analysis of force output oscillations. The force signal of the first dorsal interosseous during linearly varying static contraction, 0-100-0% of the maximal volitional abduction in 15s, was studied in 11 young and older adults. The relative error between the target and the actual force as well as several parameters of the force oscillations (corrections) were estimated. To understand the experimental results, we analyzed the force output generated by a set of computational simulations of a pool of motor units controlled by a proportional-integral-derivative system. Compared to young adults the older subjects presented larger errors and a lower number of corrections with longer duration and larger relative amplitude. The motor control system modelling varied the error update frequency (UF) of the controller (from 1 to 2.5Hz) as well as the range of contraction time (CT) of the recruited motor unit (30-90ms and 60-120ms reflecting young and old ranges, respectively). The simulation generated force profiles with parameters similar to experimental recordings in young (UF = 1.5; CT 30-90ms) and older (UF = 1; CT 60-120ms) adults. Interestingly, the results of the simulations suggested that the improvement in the error update frequency of the controller was not able to compensate for the contractile changes in the motor unit twitches. In conclusion, the peripheral contractile changes with age can influence motor unit control strategies and represent a crucial phenomenon in the generation of larger force oscillations in older adults.

Contribution from motor unit firing adaptations and muscle coactivation during fatigue

The control of motor unit firing behavior during fatigue is still debated in the literature. Most studies agree that the central nervous system increases the excitation to the motoneuron pool to compensate for decreased force contributions of individual motor units and sustain muscle force output during fatigue. However, some studies claim that motor units may decrease their firing rates despite increased excitation, contradicting the direct relationship between firing rates and excitation that governs the voluntary control of motor units. To investigate whether the control of motor units in fact changes with fatigue, we measured motor unit firing behavior during repeated contractions of the first dorsal interosseous (FDI) muscle while concurrently monitoring the activation of surrounding muscles, including the flexor carpi radialis, extensor carpi radialis, and pronator teres. Across all subjects, we observed an overall increase in FDI activation and motor unit firing rates by the end of the fatigue task. However, in some subjects we observed increases in FDI activation and motor unit firing rates only during the initial phase of the fatigue task, followed by subsequent decreases during the late phase of the fatigue task while the coactivation of surrounding muscles increased. These findings indicate that the strategy for sustaining force output may occasionally change, leading to increases in the relative activation of surrounding muscles while the excitation to the fatiguing muscle decreases. Importantly, irrespective of changes in the strategy for sustaining force output, the control properties regulating motor unit firing behavior remain unchanged during fatigue. NEW & NOTEWORTHY This work addresses sources of debate surrounding the manner in which motor unit firing behavior is controlled during fatigue. We found that decreases in the motor unit firing rates of the fatiguing muscle may occasionally be observed when the contribution of coactive muscles increases. Despite changes in the strategy employed to sustain the force output, the underlying control properties regulating motor unit firing behavior remain unchanged during muscle fatigue.

Relative contribution of different altered motor unit control to muscle weakness in stroke: a simulation study

Objective. Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach. Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level. We additionally expanded the original model to include a fatigue component, which variably decreased the output force with increasing length of contraction. Differences in the force output at both the peak and fatigued time points across different excitation levels were quantified and compared across different sets of MU parameters. Main results. Across the different simulation parameters, we found that the main driving factor of the reduced force output was due to the compressed range of MU recruitment. Recruitment compression caused a decrease in total force across all excitation levels. Additionally, a compression of the range of MU firing rates also demonstrated a decrease in the force output mainly at the higher excitation levels. Lastly, changes to the recruitment order of MUs appeared to minimally impact the force output. Significance. We found that altered control of MUs alone, as simulated in this study, can lead to a substantial reduction in muscle force generation in stroke survivors. These findings may provide valuable insight for both clinicians and researchers in prescribing and developing different types of therapies for the rehabilitation and restoration of lost strength after stroke.

Regionalization of the stretch reflex in the human vastus medialis

Regionalization of the stretch reflex, i.e. the notion that the activation of 1a afferents from a muscle region influences only the activation of motor units in the same region, has been demonstrated previously in animals but not in humans. Mechanical stretches applied to regions of vastus medialis as close as 10mm apart resulted in recruitment of motor units localized topographically with respect to the location of the mechanical stretch. Stretch reflexes are regionalized in the human vastus medialis. The human spinal cord has the neuromuscular circuitry to preferentially activate motoneurones innervating muscle fibres located in different regions of the vastus medialis. The localization of motor unit territories provides an anatomical basis to suggest that the CNS may have more independence in motor unit recruitment and control strategies than what was previously thought. In this study, we investigated whether the human spinal cord has the neuromuscular circuitry to independently activate motor units located in different regions of the vastus medialis. Mechanical taps were applied to multiple locations in the vastus medialis (VM) in nine healthy individuals. Regional responses within the muscle were observed using a grid of 5×13 surface EMG electrodes. The EMG amplitude was quantified for each channel, and a cluster of channels showing the largest activation was identified. The spatial location of the EMG response was quantified as the position of the channels in the cluster. In a subset of three participants, intramuscular recordings were performed simultaneously with the surface EMG recordings. Mechanical taps resulted in localized, discrete responses for each participant. The spatial location of the elicited responses was dependent on the location of the tap (P<0.001). Recordings with intramuscular electrodes confirmed the regional activation of the VM for different tap locations. Selective stimulation of 1a afferents localized in a region of the VM results in reflex recruitment of motor units in the same region. These findings suggest that the human spinal cord has the neuromuscular circuitry to modulate spatially the motoneuronal output to vastus medialis regions, which is a neuroanatomical prerequisite for regional activation.

Dysfunction of central control of breathing in amyotrophic lateral sclerosis.

Dysfunction in central control of breathing in some amyotrophic lateral sclerosis (ALS) patients is not adequately detected with standard evaluation for respiratory dysfunction. Nocturnal oximetry reveals periodic desaturations despite normal respiratory muscle movements. Continuous diaphragmatic electromyography has provided in vivo data consistent with impaired central control of diaphragm motor units. Current understanding of central control of breathing identifies the pre-Botzinger complex as the inspiratory rhythm generator. Animal models of pre-Botzinger complex neurodegeneration demonstrate rapid eye movement-related central sleep apneas progressing to loss of rapid eye movement sleep, also apparent in some ALS patients. Evidence supports the hypothesis that dysfunction in central control of breathing in some ALS patients may be related to pre-Botzinger complex degeneration. As the impact dysfunction of central control of breathing has on ALS becomes better defined the current standard of evaluating respiratory dysfunction in ALS patients may need updating. Muscle Nerve 56: 197-201, 2017.

The compensatory interaction between motor unit firing behavior and muscle force during fatigue.

Throughout the literature, different observations of motor unit firing behavior during muscle fatigue have been reported and explained with varieties of conjectures. The disagreement amongst previous studies has resulted, in part, from the limited number of available motor units and from the misleading practice of grouping motor unit data across different subjects, contractions, and force levels. To establish a more clear understanding of motor unit control during fatigue, we investigated the firing behavior of motor units from the vastus lateralis muscle of individual subjects during a fatigue protocol of repeated voluntary constant force isometric contractions. Surface electromyographic decomposition technology provided the firings of 1,890 motor unit firing trains. These data revealed that to sustain the contraction force as the muscle fatigued, the following occurred: 1) motor unit firing rates increased; 2) new motor units were recruited; and 3) motor unit recruitment thresholds decreased. Although the degree of these adaptations was subject specific, the behavior was consistent in all subjects. When we compared our empirical observations with those obtained from simulation, we found that the fatigue-induced changes in motor unit firing behavior can be explained by increasing excitation to the motoneuron pool that compensates for the fatigue-induced decrease in muscle force twitch reported in empirical studies. Yet, the fundamental motor unit control scheme remains invariant throughout the development of fatigue. These findings indicate that the central nervous system regulates motor unit firing behavior by adjusting the operating point of the excitation to the motoneuron pool to sustain the contraction force as the muscle fatigues.

Analysis of linear electrode array EMG for assessment of hemiparetic biceps brachii muscles.

This study presents a frequency analysis of surface electromyogram (EMG) signals acquired by a linear electrode array from the biceps brachii muscles bilaterally in 14 hemiparetic stroke subjects. For different levels of isometric contraction ranging from 10 to 80% of the maximum voluntary contraction (MVC), the power spectra of 19 bipolar surface EMG channels arranged proximally to distally along the muscle fibers were examined in both paretic and contralateral muscles. It was found that across all stroke subjects, the median frequency (MF) and the mean power frequency (MPF), averaged from different surface EMG channels, were significantly smaller in the paretic muscle compared to the contralateral muscle at each of the matched percent MVC contractions. The muscle fiber conduction velocity (MFCV) was significantly slower in the paretic muscle than in the contralateral muscle. No significant correlation between the averaged MF, MPF, or MFCV vs. torque was found in both paretic and contralateral muscles. However, there was a significant positive correlation between the global MFCV and MF. Examination of individual EMG channels showed that electrodes closest to the estimated muscle innervation zones produced surface EMG signals with significantly higher MF and MPF than more proximal or distal locations in both paretic and contralateral sides. These findings suggest complex central and peripheral neuromuscular alterations (such as selective loss of large motor units, disordered control of motor units, increased motor unit synchronization, and atrophy of muscle fibers, etc.) which can collectively influence the surface EMG signals. The frequency difference with regard to the innervation zone also confirms the relevance of electrode position in surface EMG analysis.

The effects of training status and muscle action on muscle activation of the vastus lateralis.

This study examined the electromyographic amplitude-force relationships for 5 (age = 19.20 ± 0.45 yrs) aerobically-trained, 5 (age = 25 ± 4.53 yrs) resistance-trained, and 5 (age = 21.20 ± 2.17 yrs) sedentary individuals. Participants performed an isometric trapezoidal muscle action at 60% maximal voluntary contraction of the leg extensors that included linearly increasing, steady force, and linearly decreasing muscle actions. Electromyography was recorded from the vastus lateralis. The b (slopes) and a (y-intercepts) terms were calculated from the natural log-transformed electromyographic amplitude-force relationships (linearly increasing and decreasing segments) for each participant. An average of the electromyographic amplitude was calculated for the entire steady force segment. The b terms for the resistance-trained (1.384 ± 0.261) were greater than the aerobically-trained (0.886 ± 0.130, P = 0.003) and sedentary (0.955 ± 0.105, P = 0.008) participants during the linearly increasing segment, whereas, there were no differences in b terms among training statuses for the linearly decreasing segment. The b terms for the resistance-trained were greater (P = 0.019) during the linearly increasing segment than decreasing segment (1.186 ± 0.181), however, the b terms for the aerobically-trained were lower (P = 0.017) during the linearly increasing than decreasing segment (1.054 ± 0.176). The a terms from the log-transformed electromyographic amplitude- force relationships and electromyographic amplitude during the steady force segment were not different among training statuses (P = 0.187, P = 0.910). The linearity of the electromyographic amplitude patterns of response (b terms) recording during increasing and decreasing muscle actions may provide insight on motor unit control strategy differences as a result of exercise training status and muscle action, however, the a terms of these patterns and electromyographic amplitude during a steady force contraction did not distinguish among training statuses.

Decomposition of surface EMG signals from cyclic dynamic contractions.

Over the past 3 decades, various algorithms used to decompose the electromyographic (EMG) signal into its constituent motor unit action potentials (MUAPs) have been reported. All are limited to decomposing EMG signals from isometric contraction. In this report, we describe a successful approach to decomposing the surface EMG (sEMG) signal collected from cyclic (repeated concentric and eccentric) dynamic contractions during flexion/extension of the elbow and during gait. The increased signal complexity introduced by the changing shapes of the MUAPs due to relative movement of the electrodes and the lengthening/shortening of muscle fibers was managed by an incremental approach to enhancing our established algorithm for decomposing sEMG signals obtained from isometric contractions. We used machine-learning algorithms and time-varying MUAP shape discrimination to decompose the sEMG signal from an increasingly challenging sequence of pseudostatic and dynamic contractions. The accuracy of the decomposition results was assessed by two verification methods that have been independently evaluated. The firing instances of the motor units had an accuracy of ∼90% with a MUAP train yield as high as 25. Preliminary observations from the performance of motor units during cyclic contractions indicate that during repetitive dynamic contractions, the control of motor units is governed by the same rules as those evidenced during isometric contractions. Modifications in the control properties of motoneuron firings reported by previous studies were not confirmed. Instead, our data demonstrate that the common drive and hierarchical recruitment of motor units are preserved during concentric and eccentric contractions.

Examination of Poststroke Alteration in Motor Unit Firing Behavior Using High-Density Surface EMG Decomposition.

Recent advances in high-density surface electromyogram (EMG) decomposition have made it a feasible task to discriminate single motor unit activity from surface EMG interference patterns, thus providing a noninvasive approach for examination of motor unit control properties. In the current study, we applied high-density surface EMG recording and decomposition techniques to assess motor unit firing behavior alterations poststroke. Surface EMG signals were collected using a 64-channel 2-D electrode array from the paretic and contralateral first dorsal interosseous (FDI) muscles of nine hemiparetic stroke subjects at different isometric discrete contraction levels between 2 to 10 N with a 2 N increment step. Motor unit firing rates were extracted through decomposition of the high-density surface EMG signals and compared between paretic and contralateral muscles. Across the nine tested subjects, paretic FDI muscles showed decreased motor unit firing rates compared with contralateral muscles at different contraction levels. Regression analysis indicated a linear relation between the mean motor unit firing rate and the muscle contraction level for both paretic and contralateral muscles (p < 0.001), with the former demonstrating a lower increment rate (0.32 pulses per second (pps)/N) compared with the latter (0.67 pps/N). The coefficient of variation (averaged over the contraction levels) of the motor unit firing rates for the paretic muscles (0.21 ± 0.012) was significantly higher than for the contralateral muscles (0.17 ± 0.014) (p < 0.05). This study provides direct evidence of motor unit firing behavior alterations poststroke using surface EMG, which can be an important factor contributing to hemiparetic muscle weakness.

Could motor unit control strategies be partially preserved after stroke?

There is considerable evidence on the impairments that a cerebral stroke will have down-stream of the stroke, i.e., in the spinal motoneuron and the muscle. Motor impairment following stroke has been documented as force production that is slow, weak, and lacking in precision (Garland et al., 2009) and is associated with difficulty in fully activating the muscle (Klein et al., 2013). Furthermore, in functional tasks such as standing balance and gait, there is evidence of deficits in intra-limb coordination of muscles even on the non-paretic side (Marigold and Eng, 2006; Raja et al., 2012). In this opinion paper, we will first briefly review the changes observed at the level of the motor unit (MU) after stroke and second reflect upon whether some changes in the intrinsic properties of motoneurons, typically considered to be maladaptive, might also reflect a positive adaptation that could assist in force production. Lastly, this paper will explore the control of MUs between limbs during standing balance and suggest that, while some impairment may exist, there remains the possibility of a preservation of fundamental motor control strategies after stroke that might be a target for rehabilitation.

Anomalous EMG-force relations during low-force isometric tasks in hemiparetic stroke survivors.

Hemispheric brain injury resulting from a stroke is often accompanied by muscle weakness in contralateral limbs. In neurologically intact subjects, appropriate motoneuronal recruitment and rate modulation are utilized to optimize muscle force production. In the present study, we sought to determine whether weakness in an affected hand muscle in stroke survivors is partially attributable to alterations in the control of muscle activation. Specifically, our goal was to characterize whether the surface EMG amplitude was systematically larger as a function of (low) force in paretic hand muscles as compared to contralateral muscles in the same subject. We tested a multifunctional muscle, the first dorsal interosseous (FDI), in multiple directions about the second metacarpophalangeal joint in ten hemiparetic and six neurologically intact subjects. In six of the ten stroke subjects, the EMG-force slope was significantly greater on the affected side as compared to the contralateral side, as well as compared to neurologically intact subjects. An unexpected set of results was a nonlinear relation between recorded EMG and generated force commonly observed in the paretic FDI, even at very low-force levels. We discuss possible experimental as well as physiological factors that may contribute to an increased EMG-force slope, concluding that changes in motor unit (MU) control are the most likely reasons for the observed changes.

Trunk motor variability in patients with non-specific chronic low back pain.

To identify and characterize trunk neuromuscular adaptations during muscle fatigue in patients with chronic low back pain (LBP) and healthy participants. Forty-six patients with non-specific chronic LBP and 23 healthy controls were asked to perform a trunk muscles fatigue protocol. Surface electromyography was recorded using two adhesive matrix of 64 electrodes applied bilaterally over the erector spinae. Pain score, kinesiophobia and physical disability were analyzed through different questionnaires. To characterize motor variability, dispersion of muscular activity center of gravity was computed. Motor variability between groups was compared using repeated-measures analyses of variance. Score of disability and kinesiophobia were significantly higher in patients with LBP. Results indicated a significant group effect characterized by an increased motor variability in the healthy group through the entire fatigue task on the left (p = 0.003) and right side (p = 0.048). Interestingly, increasing muscle fatigue led to increased motor variability in both groups (on both sides (p < 0.001) but with a greater increase in the healthy group. Muscle recruitment is altered in patients with chronic LBP in the presence of muscle fatigue. Consequently, these patients exhibit changes in muscle recruitment pattern and intensity (lower levels of motor variability) during sustained isometric contraction that may be attributed to variation in the control of motor units within and between muscles. However, patients with LBP are able to increase their motor variability over time but with a lower increase compared to healthy participants.