Extensor Activity Research Articles

Effect of integrated manual and verbal cueing on functional transfers in chronic stroke survivors: a randomized controlled study

Purpose The profession of physical therapy has historically relied on manual facilitation to improve motor control strategies and performance in persons rehabilitating from a stroke, yet there is insufficient evidence to support its use during functional task training. The purpose of this study was to determine the effects of integrated cueing (verbal and manual) and verbal cueing approaches during sit-to-stand training on midline alignment & muscle activation in chronic stroke survivors. Methods Twenty-one chronic right-brained stroke survivors with hemiplegia were randomly assigned to the Integrated Cueing or Verbal Only group and outcome measures were recorded using an 18-Camera Motion Capture System, force plates, and surface electromyography (EMG). Results Both groups demonstrated a significant improvement in symmetry toward the midline after thirty training repetitions. Significant improvements in muscle activation were found in two muscle groups on the affected side of the body in the Integrated Cueing group, gastrocnemius and rectus femoris. Conclusion Both the Verbal Only and Integrated Cueing groups made significant progress toward more symmetrical movement, yet more significant changes in the activation of hemiparetic extensor muscles were seen in the Integrated Cueing group. These findings support the use of manual cueing in movement activation and performance during the training of functional tasks. IMPLICATIONS FOR REHAB Physical therapists commonly use manual tactile cues to facilitate movement performance but there is currently insufficient evidence to support this use with stroke survivors. In a relatively small sample size, both verbal cues and integrated cues (verbal plus manual) improved symmetry during sit to stand in chronic right brain stroke survivors. Integrated cueing enhanced motor activation and performance during sit to stand better than verbal cues alone. Manual tactile cueing should be considered during functional task retraining.

Understanding gait alterations: trunk flexion and its effects on walking neuromechanics.

Evolutionary and functional adaptations of morphology and postural tone of the spine and trunk are intrinsically shaped by the field of gravity in which humans move. Gravity also significantly impacts the timing and levels of neuromuscular activation, particularly in foot-support interactions. During step-to-step transitions, the centre of mass velocity must be redirected from downwards to upwards. When walking upright, this redirection is initiated by the trailing leg, propelling the body forward and upward before foot contact of the leading leg, defined as an anticipated transition. In this study, we investigated the neuromechanical adjustments when walking with a bent posture. Twenty adults walked on an instrumented treadmill at 4 km h-1 under normal (upright) conditions and with varying degrees of anterior trunk flexion (10, 20, 30 and 40deg). We recorded lower-limb kinematics, ground reaction forces under each foot, and the electromyography activity of five lower-limb muscles. Our findings indicate that with increasing trunk flexion, there is a lack of these anticipatory step-to-step transitions, and the leading limb performs the redirection after the ground collision. Surprisingly, attenuating distal extensor muscle activity at the end of stance is one of the main impacts of trunk flexion. Our observations may help us to understand the physiological mechanisms and biomechanical regulations underlying our tendency towards an upright posture, as well as possible motor control disturbances in some diseases associated with trunk orientation problems.

Acute normobaric hypoxia causes a rightward shift in the torque-frequency relationship but has no effect on postactivation potentiation.

Low fractions of inspired oxygen ([Formula: see text]; i.e., hypoxia) affect aspects of skeletal muscle contractility in humans, but it remains unclear if postactivation potentiation (PAP) and the torque-frequency (T-F) relationship are altered. We investigated the effects of 2 (H2) and 4 (H4) h of normobaric hypoxia ([Formula: see text] = 0.11 ± 0.47) on the magnitude of PAP of the knee extensors and the T-F relationship of the dorsiflexors in 13 and 12 healthy participants, respectively. To assess PAP, a resting twitch was evoked via femoral nerve stimulation before and 2-300 s after a 10-s maximal voluntary contraction (MVC). A T-F relationship was obtained by stimulating the common fibular nerve with a single pulse and 1-s trains between 5 and 100 Hz. During hypoxia, peripheral oxygen saturation decreased by ∼18% from 98.0 ± 0.8% at baseline (P < 0.001). MVC force and voluntary activation (VA) of the knee extensors were lower than baseline throughout hypoxia (e.g., ∼8% and ∼5%, respectively, at H2; P ≤ 0.027); however, the magnitude of PAP was not altered by hypoxia (P ≥ 0.711). Surprisingly, PAP did increase with time across the control day (P ≤ 0.012). MVC torque and VA of the dorsiflexors were unaffected by hypoxia (P ≥ 0.127), but the estimated frequency required to evoke 50% of 100 Hz torque increased by ∼1.2 Hz at H2 (P ≤ 0.021). These results imply that 2 h of normobaric hypoxia were sufficient to 1) impair neural drive to the knee extensors but not the mechanism(s) responsible for PAP and 2) lead to a rightward shift of the T-F relationship for the dorsiflexors.NEW & NOTEWORTHY Postactivation potentiation of the knee extensors was unaffected by 4 h of normobaric hypoxia exposure but may be confounded by hypoxia-related impairments to the conditioning contraction. In the dorsiflexors, contractile rates increased in hypoxia, which led to a rightward shift of the torque-frequency relationship, such that a higher frequency was required to obtain 50% of maximal torque. These results expand our understanding of the acute effects of hypoxia on skeletal muscle function.

Effects of unstable load and unstable surface ontrunk muscles activation and postural control in healthy subjects

Exercise with an unstable load is considered a new training method to activate the core muscles. Research has shown consistency regarding an unstable surface but has not provided comprehensive findings about the effect of an unstable load. The study aimed to examine the impact of an unstable load and unstable surfaces on core muscle activation and postural control during lifting. Thirty-eight participants lifted a load equivalent to 10 % of their body weight under three conditions: a stable load on an unstable surface, a stable load on a stable surface, and an unstable load on a stable surface. The center of pressure (COP) displacement and electromyography activity of abdominal and back extensor muscles were measured during lifting. The results indicated that lifting on an unstable surface activated the lumbar erector spinae and multifidus muscles more than in a stable condition (P<0.05). However, there was no significant difference in the level of thoracic erector spinae muscle activity between the unstable load and unstable surface conditions. The stable condition increased activity in the internal oblique muscle (1.37 times) compared to the unstable conditions. The analysis of postural control revealed that lifting the load on an unstable surface significantly decreased COP displacement in the anteroposterior direction (P<0.05), while holding the load on the unstable surface significantly increased COP displacement in the anteroposterior direction compared to the other conditions. These findings could be valuable for future rehabilitation research, learning appropriate lifting techniques, and setting specific training goals in sports.

Effects of kinesio taping combined with upper extremity function training home program on upper limb function and self-efficacy in stroke patients: An experimental study.

The purpose of this study is to investigate the effects of kinesio taping and an upper extremity function home program on the upper extremity function and self-efficacy of stroke patients, and to present therapeutic evidence for home program intervention to improve upper extremity function. First, 53 stroke patients were randomly assigned to 2 groups: 26 experimental subjects and 27 controls. The experimental group performed kinesio taping on the dorsal part of the hand along with upper extremity functional training home program and the control group performed only upper extremity functional training home program. The intervention was conducted for a total of 30 sessions over 6 weeks. To evaluate changes in upper extremity function, wrist extensor muscle activation via the Surface Electromyography, the Chedoke Arm and Hand Activity Inventory-9 (CAHAI-9), and the motor activity log (including amount of use and quality of movement) were evaluated. In addition, the Self-Efficacy Scale (SES) was evaluated to examine the change in the self- efficacy of the study subjects. The experimental group participating in the kinesio taping and upper limb function home program showed a statistically significant improvement (P < .01) before and after the intervention in the Surface Electrography the Chedoke Arm and Hand Activity Inventory-9 evaluation item in the upper limb function change. The SES evaluation, a self-esteem evaluation, also showed a statistically significant improvement (P < .01) before and after the intervention. Chedoke Arm and Hand Activity Inventory-9, motor activity log (quality of movement), and SES evaluation showed statistically significant differences (P < .05) between the experimental and control groups. It was confirmed that the upper extremity function training home program performed in parallel with the kinesio taping technique had a positive effect on the recovery of upper extremity function and self-esteem in stroke patients. The kinesio taping technique provides stability to the wrist while performing a home program that patients can perform on their own at home and appears to improve upper extremity function more effectively than when performing the upper extremity function home program alone.

Improvisation and live accompaniment increase motor response and reward during a music playing task

Music provides a reward that can enhance learning and motivation in humans. While music is often combined with exercise to improve performance and upregulate mood, the relationship between music-induced reward and motor output is poorly understood. Here, we study music reward and motor output at the same time by capitalizing on music playing. Specifically, we investigate the effects of music improvisation and live accompaniment on motor, autonomic, and affective responses. Thirty adults performed a drumming task while (i) improvising or maintaining the beat and (ii) with live or recorded accompaniment. Motor response was characterized by acceleration of hand movements (accelerometry), wrist flexor and extensor muscle activation (electromyography), and the drum strike count (i.e., the number of drum strikes played). Autonomic arousal was measured by tonic response of electrodermal activity (EDA) and heart rate (HR). Affective responses were measured by a 12-item Likert scale. The combination of improvisation and live accompaniment, as compared to all other conditions, significantly increased acceleration of hand movements and muscle activation, as well as participant reports of reward during music playing. Improvisation, regardless of type of accompaniment, increased the drum strike count and autonomic arousal (including tonic EDA responses and several measures of HR), as well as participant reports of challenge. Importantly, increased motor response was associated with increased reward ratings during music improvisation, but not while participants were maintaining the beat. The increased motor responses achieved with improvisation and live accompaniment have important implications for enhancing dose of movement during exercise and physical rehabilitation.

Biomechanics‐based study of muscle activation under different driving conditions for Chinese percentiles

AbstractIn this paper, we determined the adjustment levels of the human–machine layout under the preferred driving posture for individuals with different body sizes. We also comparatively analyzed the maximum activation levels of various muscles under straight‐line driving and steering conditions. To increase the accuracy of the results, AnyBody biomechanics software was used to establish a human skeletal muscle mechanics model, which we analyzed for consistency with rig test results. The results showed that people with larger body sizes preferred a driving position with the seat reclined back. Steered driving was associated with a significant (p &lt; .05) increase in the maximum activation of the wrist extensors, serratus anterior, deltoid, and triceps brachii, which are the main force‐generating muscle groups for steered driving, compared with straight driving. Moreover, the measured and simulated results of maximum muscle activation were relatively consistent, with the error between them within a 15% margin. In summary, this study explored the relationship between different driving conditions and preferred driving postures from a biomechanical perspective. A combined experimental and simulation approach was adopted to ensure the reliability of the findings. The insights from this study can inform ergonomic considerations for the comfort and health of Chinese drivers with varying physical characteristics.

Improvements in motor control are associated with improved quality of life following an at-home muscle biofeedback program for chronic stroke.

Chronic stroke survivors with severe arm impairment have limited options for effective rehabilitation. High intensity, repetitive task practice (RTP) is known to improve upper limb function among stroke survivors who have some volitional muscle activation. However, clients without volitional movement of their arm are ineligible for RTP-based interventions and require hands-on facilitation from a clinician or robotic therapy to simulate task practice. Such approaches can be expensive, burdensome, and have marginal effects. Alternatively, supervised at-home telerehabilitation using muscle biofeedback may provide a more accessible, affordable, and effective rehabilitation option for stroke survivors with severe arm impairment, and could potentially help people with severe stroke regain enough volitional activation to be eligible for RTP-types of therapies. Feedback of muscle activity via electromyography (EMG) has been previously used with clients who have minimal or no movement to improve functional performance. Specifically, training to reduce unintended co-contractions of the impaired hand using EMG biofeedback may modestly improve motor control in people with limited movement. Importantly, these modest and covert functional changes may influence the perceived impact of stroke-related disability in daily life. In this manuscript, we examine whether physical changes following use of a portable EMG biofeedback system (Tele-REINVENT) for severe upper limb hemiparesis also relate to perceived quality of life improvements. Secondarily, we examined the effects of Tele-REINVENT, which uses EMG to quantify antagonistic muscle activity during movement attempt trials and transform individuated action into computer game control, on several different domains of stroke recovery. For this pilot study, nine stroke survivors (age = 37-73 years) with chronic impairment (Fugl-Meyer = 14-40/66) completed 30 1-hour sessions of home-based training, consisting of six weeks of gaming that reinforced wrist extensor muscle activity while attenuating coactivation of flexor muscles. To assess motor control and performance, we measured changes in active wrist ranges of motion, the Fugl-Meyer Assessment, and Action Research Arm Test. We also collected an EMG-based test of muscle control to examine more subtle changes. To examine changes in perceived quality of life, we utilized the Stroke Impact Scale along with participant feedback. Results from our pilot data suggest that 30 sessions of remote training can induce modest changes on clinical and functional assessments, showing a statistically significant improvement of active wrist ranges of motion at the group level, changes that could allow some people with severe stroke to be eligible for other therapeutic approaches, such as RTP. Additionally, changes in motor control were correlated with the perceived impact of stroke on participation and impairment after training. We also report changes in corticomuscular coherence, which showed a laterality change from the ipsilesional motor cortex towards the contralesional hemisphere during wrist extension attempts. Finally, all participants showed high adherence to the protocol and reported enjoying using the system. Overall, Tele-REINVENT represents a promising telerehabilitation intervention that might improve sensorimotor outcomes in severe chronic stroke, and that improving sensorimotor abilities even modestly may improve quality of life. We propose that Tele-REINVENT may be used as a precursor to help participants gain enough active movement to participate other occupational therapy interventions, such as RTP. Future work is needed to examine if home-based telerehabilitation to provide feedback of individuated muscle activity could increase meaningful rehabilitation accessibility and outcomes for underserved populations.

Surface electromyography analysis of ankle flexor and extensor activity under different standing stability levels.

Background: To observe the activation strategies of the ankle muscles using surface electromyography (sEMG) during single-leg standing (SLS) and both-leg standing (BLS) on flat ground (FG), soft mat (SM), and BOSU ball (BB) surfaces. Methods: Thirty healthy young adults participated in the study. The muscle activities of the tibialis anterior (TA) and gastrocnemius medial (GM) were measured on the three surfaces during SLS and BLS. Electromyographic evaluations of the TA and GM were recorded during maximum voluntary isometric contractions (MVIC). Muscle activation was evaluated using MVIC%, and muscle co-contraction was evaluated using the co-contraction index (CI). Results: A statistically significant increase was observed in the MVIC% of the TA, GM, and CI on the three surfaces during SLS compared to BLS, except for the comparison of CI on BB between SLS and BLS (t = -1.35, p = 0.19). The MVIC% of the TA and GM during SLS and BLS on BB was significantly increased in comparison with FG and SM. The CI during BLS on BB increased compared to FG (t = 3.19, p < 0.01) and SM (t = 4.64, p < 0.01). The CI during BLS on SM (t = -1.46, p = 0.15) decreased when compared to FG but without statistical significance. Conclusions: SLS and unstable surfaces can induce greater muscle activation, and SLS can have a greater influence on ankle muscles.

Anthropometric, neuromuscular, physiologic and training variables as determinants to laboratory cycling performance.

The goal of this study was to verify whether anthropometric, physiological and neuromuscular factors, as well as training characteristics, could predict cycling performance during maximal incremental and time-to-exhaustion tests. Twenty cyclists were evaluated: Anthropometric variables, knee extensor muscle activation and architecture, training history, and training volume were assessed. Second ventilatory threshold (VT<inf>2</inf>), maximal oxygen uptake (VO<inf>2MAX</inf>), and maximal power output (PO<inf>MAX</inf>) were assessed during the incremental test. Muscle architecture of the vastus lateralis (VL) and rectus femoris (RF) muscles was evaluated bilaterally to calculate the mean thighs' muscle thickness, pennation angle and fascicle length, at rest condition. After that, time-to-exhaustion test at PO<inf>MAX</inf> was performed. Muscle activation of the VL, RF and vastus medialis (VM) was evaluated of both legs. Cyclists' height (r2=0.37), experience time and training volume (r2=0.46) were predictors of PO<inf>MAX</inf> (P<0.02), while cadence (r2=0.30) was the only predictive variable for the time-to-exhaustion performance (P<0.01). These results suggest that training characteristics and experience are important when training for incremental cycling conditions, whereas cadence (and its determinant variables) should be looked at during maximal and exhaustive conditions.

Knee extensor electromyographic activity during different depths of squat exercise in strength training experienced adults: A Systematic Review

B ACKGROUND: Changes in range of motion during partial and deep squats can affect the electrical activity of the knee extensor muscles. There are results’ divergences between studies that evaluated the effects of deep and partial squats on the electrical activity of the knee extensor muscles. AIM: To systematically review the literature on the electromyographic activity of the knee extensor muscles during partial and deep squat exercises in subjects with strength training experience. METHOD: The search included MEDLINE (via Pubmed), Scielo, EMBASE, in addition to a manual search, until June 2023. Cross-sectional observational studies comparing partial squats (up to 90º of knee flexion) and deep squats (maximum knee flexion) that evaluated the electrical activation through surface electromyography in men and women with strength training experience were included. Methodological quality assessment was performed using the adapted Downs and Black tool, as suggested by the Cochrane Collaboration. RESULTS: Of the 636 articles identified, four studies were included. The included studies presented electromyographic values of the two squat variations. No difference was found in the activation of the rectus femoris, vastus medialis and vastus lateralis muscles between partial and deep squats. Regarding methodological quality, one study was classified as having moderate and the other three studies showing high methodological quality. CONCLUSION: The similarity in the knee extensors’ electromyographic activation between partial and deep squat exercises in men and women with strength training experience suggests that both exercises can be used for recruiting these muscles during physical fitness activities.

Biomechanical analysis of different back-supporting exoskeletons regarding musculoskeletal loading during lifting and holding

Industrial back support exoskeletons (BSEs) are a promising approach to addressing low back pain (LBP) which still affect a significant proportion of the workforce. They aim to reduce lumbar loading, the main biomechanical risk factor for LBP, by providing external support to the lumbar spine. The aim of this study was to determine the supporting effect of one active (A1) and two passive (P1 and P2) BSEs during different manual material handling tasks. Kinematic data and back muscle activity were collected from 12 subjects during dynamic lifting and static holding of 10 kg. Mean and peak L5/S1 extension moments, L5/S1 compression forces and muscle activation were included in the analysis. During dynamic lifting all BSEs reduced peak (12–26 %) and mean (4–17 %) extension moments and peak (10–22 %) and mean (4–15 %) compression forces in the lumbar spine. The peak (13–28 %) and mean (4–32 %) activity of the back extensor muscles was reduced accordingly. In the static holding task, analogous mean reductions for P1 and P2 of L5/S1 extension moments (12–20 %), compression forces (13–23 %) and muscular activity (16–23 %) were found. A1 showed a greater reduction during static holding for extension moments (46 %), compression forces (41 %) and muscular activity (54 %). This pronounced difference in the performance of the BSEs between tasks was attributed to the actuators used by the different BSEs.

Volume Transfer: A New Design Concept for Fabric‐Based Pneumatic Exosuits

The fabric‐based pneumatic exosuit is now a hot research topic because it is lighter and softer than traditional exoskeletons. Existing research focuses more on the mechanical properties of the exosuit (e.g., torque and speed), but less on its wearability (e.g., appearance and comfort). This work presents a new design concept for fabric‐based pneumatic exosuits: volume transfer, which means transferring the volume of pneumatic actuators beyond the garment's profile to the inside. This allows for a concealed appearance and a larger stress area while maintaining adequate torques. In order to verify this concept, a fabric‐based pneumatic exosuit is developed for knee extension assistance. Its profile is only 26 mm and its stress area wraps around almost half of the leg. A mathematical model and simulation is used to determine the parameters of the exosuit, avoiding multiple iterations of the prototype. Experiment results show that the exosuit can generate a torque of 7.6 Nm at a pressure of 90 kPa and produce a significant reduction in the electromyography activity of the knee extensor muscles. It is believed that volume transfer can be utilized prevalently in future fabric‐based pneumatic exosuit designs to achieve a significant improvement in wearability.

Age and gender differences in the perception and use of soft vs. rigid exoskeletons for manual material handling

We investigated age and gender differences in the perception and use of soft (Apex) vs. rigid (Paexo Back) passive back-support exoskeletons (BSE) for repetitive lifting and lowering. A gender-balanced sample of 20 young (18–30 years) and 16 old (45–60 years) individuals were recruited. In the first session, participants’ self-reported maximum acceptable load (MAL) was assessed using a psychophysical approach. Changes in muscle activity and kinematics due to BSE use in repetitive lifting/lowering tasks were also assessed. Overall, both BSEs increased MAL (by ∼7%), and reduced trunk extensor muscle activity across all groups (by ∼7–18%), compared to the control condition. Both BSEs promoted more squatting postures, increased quadriceps muscle activity (by ∼34%) and abdominal muscle activity during asymmetric tasks (by 5–20%). Some age and gender differences were significant, particularly for the trunk kinematics when using the Apex. Future work should include more diverse user groups in studying willingness to adopt BSEs and characterising their consequent effects on the body.

Impact of repetitive mouse clicking on forearm muscle fatigue and mouse aiming performance

Exercise induced performance fatigue has been shown to impair many aspects of fine motor function in the distal upper limb. However, most fatiguing protocols do not reflect the conditions experienced with computer use. The purpose of this study was to determine how a prolonged, low-force mouse clicking fatigue protocol impacts performance fatigue of the distal upper limb for gamers and non-gamers. Participants completed a total of 1 h of mouse clicking at 5 clicks per second. Muscle fatigue and performance were intermittently assessed. RMS amplitude increased for the forearm flexors throughout the fatigue protocol. Accuracy decreased following the first bout of clicking and returned to baseline values after 40-min. EDC and ECU displayed the greatest muscle activity while aiming, producing 11.4% and 12.9% of MVC, respectively. These findings indicate that mouse clicking may not result in performance fatigue, however, high levels of extensor activity may explain common injuries among gamers.

Optimizing Rehabilitation Outcomes for Stroke Survivors: The Impact of Speed and Slope Adjustments in Anti-Gravity Treadmill Training.

Background and Objectives: This study explored the efficacy of customized anti-gravity treadmill (AGT) training, with adjustments in speed and incline, on rehabilitation outcomes for stroke patients, focusing on knee extensor muscle strength, joint angle, balance ability, and activities of daily living (ADLs). Materials and Methods: In this study, 30 individuals diagnosed with a stroke were divided into three groups. Experimental group 1 (EG1) underwent training without changes to speed and incline, experimental group 2 (EG2) received training with an increased incline, and experimental group 3 (EG3) underwent training with increased speed. Initially, all participants received AGT training under uniform conditions for two weeks. Subsequently, from the third to the sixth week, each group underwent their specified training intervention. Evaluations were conducted before the intervention and six weeks post-intervention using a manual muscle strength tester for knee strength, TETRAX for balance ability, Dartfish software for analyzing knee angle, and the Korean version of the Modified Barthel Index (K-MBI) for assessing activities of daily living. Results: Within-group comparisons revealed that AGT training led to enhancements in muscle strength, balance ability, joint angle, and ADLs across all participant groups. Between-group analyses indicated that EG2, which underwent increased incline training, demonstrated significant improvements in muscle strength and balance ability over EG1. EG3 not only showed significant enhancements in muscle strength, joint angle, and ADLs when compared to EG1 but also surpassed EG2 in terms of knee strength improvement. Conclusions: In conclusion, the application of customized AGT training positively impacts the rehabilitation of stroke patients, underscoring the importance of selecting a treatment method tailored to the specific needs of each patient.

Voluntary activation of human knee extensors during isotonic shortening contractions.

The interpolated twitch technique (ITT) is often used to assess voluntary activation during isometric contractions; however, this may have limited relevance to dynamic contractions. Although the ITT has been applied to relatively slow isokinetic contractions (< 150°/s), it has received limited consideration during unconstrained velocity (i.e., isotonic) contractions, despite their relevance to natural movements. Here, we explored the ITT during isotonic knee extension contractions using a modified dynamometer. Young males (n = 6) and females (n = 4) performed isometric and isotonic knee extension contractions of sub-maximal and maximal intensities with doublet (150 Hz) muscle belly stimulations to assess voluntary activation. Following each voluntary isotonic contraction (velocity range ~ 35°/s to ~ 275°/s), resting potentiated doublets were evaluated during passive joint rotation at the same angular velocity achieved during voluntary efforts, to account for force-velocity characteristics. Correlations between voluntary activation and the proportion of maximal torque or power were evaluated for isometric and isotonic contractions, respectively. Isometric voluntary activation was strongly correlated with increasing torque output (r = 0.96, p < 0.001). Doublet torque during passive joint rotation displayed a hyperbolic relationship with increasing angular velocity (r = 0.98, p < 0.001). Isotonic voluntary activation was strongly correlated with increasing power output (r = 0.89, p < 0.001). During maximal effort contractions, no differences were observed in voluntary activation between isometric and isotonic conditions (89.4% vs. 89.2%, p = 0.904). The ITT is a valid approach to evaluate voluntary activation during an isotonic contraction using a modified dynamometer. Participants were able to achieve a similar high level of voluntary activation during isometric and isotonic contractions.

INSIGHTS INTO HUMAN LOCOMOTION STRATEGIES AND MOTOR LEARNING FOR AN AGEING POPULATION USING TRANSFER TESTING AND COUPLED SIMULATIONS

The elucidation of human locomotion strategies has potential applications in the prevention of sarcopenia and in the reduction of falls. Given the diverse biochemical, mechanical and functional age-related changes seen in the neuro-musculoskeletal system, the decline in motor function is difficult to study experimentally. In this study, we use transfer testing and coupled simulation strategies within a deep reinforcement learning environment to better understand the complex problem of motor control adaptation to age-related changes. Using transfer testing, a 3D musculoskeletal model is separately trained on parameters of the young adult model (Y) for either forward or backward falls after completing two steps forward, and tested using a 30% age-related reduction for all parameters (M_all). This strategy produces a backward fall for a forwardly trained simulation, showing potential sensitivity of these parameters to a given fall direction. Second, a coupled simulation solution is used to simulate recovery from falls by considering the center-of-mass position relative to the base of support. Results for the M_all trained model showed a longer simulation time and a greater vertical pelvis velocity with a maximal value of 4.26[Formula: see text]m/s. In particular, the results of the coupled simulations clearly show that both the young and M_all condition models respond with a step back and stronger leg extensor activations to propel the model forward to recover from the simulated fall. We developed a novel coupling between transfer testing and coupled simulation strategies to improve upon muscle models for characterizing muscle function, and also to begin testing different hypotheses, such as the strategy and force required to avoid a fall at different limits. This opens new avenues for precision rehabilitation with patient-specific muscle-driven recovery exercises.

Effect of Hindlimb Unloading on Hamstring Muscle Activity in Rats

Introduction: The changes in knee axial rotation play an important role in traumatic and non-traumatic knee disorders. It is known that support afferentation can affect the axial rotator muscles. The condition of innervation of the semitendinosus (ST) and biceps femoris posterior (BFp) has changed in non-terrestrial and terrestrial vertebrates in evolution; thus, we hypothesized this situation might be replayed by hindlimb unloading (HU). Methods: In the present study, the EMG activity of two hamstring muscles, m. ST and m. BFp, which are antagonists in axial rotation of the tibia, was examined before and after 7 days of HU. Results: During locomotion and swimming, the ST flexor burst activity increased in the stance-to-swing transition and in the retraction-protraction transition, respectively, while that of BFp remained unchanged. Both ST and BFp non-burst extensor activity increased during stepping and decreased during swimming. Conclusions: Our results show that (1) the flexor burst activity of ST and BFp depends differently on the load-dependent sensory input in the step cycle; (2) shift of the activity gradient towards ST in the stance-to-swing transition could produce excessive internal tibia torque, which can be used as an experimental model of non-traumatic musculoskeletal disorders; and (3) the mechanisms of activity of ST and BFp may be based on reciprocal activity of homologous muscles in primary tetrapodomorph and depend on the increased role of supraspinal control.

Gait analysis of a patient after femoral nerve and malignant soft tissue tumor resections: a case report

BackgroundMalignant femoral soft tissue tumors are occasionally resected together with the femoral nerves, but this can cause loss of knee extensor muscle activity. To the best of our knowledge, no previous reports have detailed the gait analysis of such cases in combination with electromyography. Herein, we report the gait analysis of a patient who underwent left groin synovial sarcoma and left femoral nerve resection 12 years ago.Case presentationWe analyzed the gait of a 38-year-old man who was able to walk unaided after the resection of a synovial sarcoma in the left groin together with the ipsilateral femoral nerve. The muscle activities of the affected medial (MH) and lateral hamstrings (LH), and lateral heads of the gastrocnemius (GL) were increased during 50–75% of the stance phase. The hip flexion angle of the affected limb was smaller, and the ankle plantar flexion angle of the affected limb was larger than that of the non-affected limb. This means that in the affected limb, the hip and ankle angles were adjusted to prevent knee collapse, and the MH, LH, and GL muscles contributed in the mid- and late-stance phases. Moreover, we found that the hamstring and gastrocnemius of the affected limb worked together to keep the ipsilateral knee extended in the mid-stance phase and slightly flexed in the late-stance phase.ConclusionsPatients capable of walking after femoral nerve resection may control their hamstrings and gastrocnemius muscles collaboratively to prevent ipsilateral knee collapse in the mid- and late-stance phases.