Force Steadiness Research Articles

Effects of Motor and Cognitive Dual-Task Demands on Ankle Dorsiflexor and Plantarflexor Force Control in Older Adults

ABSTRACT Background Force steadiness can be impaired under dual-task conditions in older adults. Since this impairment is attributed to their limited attentional resources, we hypothesized that the degree of cortical activity involved in muscle contraction would affect force steadiness under dual-task conditions. To test this hypothesis, based on the premise that dorsiflexion requires more cortical resources than plantarflexion, we compared the effects of additional motor and cognitive task demands on force steadiness between dorsiflexion and plantarflexion contractions in young and older adults. Method Eighteen young and eighteen older adults performed a force tracking task by applying either isometric dorsiflexion or plantarflexion force concurrently with and without (control) secondary upper-limb motor or cognitive task. Results Force steadiness was impaired by both secondary upper-limb motor and cognitive tasks for the dorsiflexors and plantarflexors in older adults. While force steadiness was impaired similarly by additional task demands regardless of the secondary task type for the dorsiflexors, the impairment effect was larger in the secondary cognitive than motor task for the plantarflexors. Conclusion The effects of dual-task demand on force steadiness could depend on the degree of cortical activity involved in muscle contraction in older adults.

Neuroplastic alterations in common synaptic inputs and synergistic motor unit clusters controlling the vastii muscles of individuals with ACL reconstruction.

This cross-sectional study aims to elucidate the neural mechanisms underlying the control of knee extension forces in individuals with anterior cruciate ligament reconstruction (ACLR). Eleven soccer players with ACLR and nine control players performed unilateral isometric knee extensions at 10% and 30% of their maximum voluntary force (MVF). Simultaneous recordings of high-density surface electromyography (HDEMG) and force output were conducted for each lower limb, and HDEMG data from the vastus lateralis (VL) and vastus medialis (VM) muscles were decomposed into individual motor unit spike trains. Force steadiness was estimated using the coefficient of variation of force. An intramuscular coherence analysis was adopted to estimate the common synaptic input (CSI) converging to each muscle. A factor analysis was applied to investigate the neural strategies underlying the control of synergistic motor neuron clusters, referred to as motor unit modes. Force steadiness was similar between lower limbs. However, motor neurons innervating the VL on the reconstructed side received a lower proportion of CSI at low-frequency bandwidths (<5 Hz) compared with the unaffected lower limbs (P < 0.01). Furthermore, the reconstructed side demonstrated a higher proportion of motor units associated with the neural input common to the synergistic muscle, as compared with the unaffected lower limbs (P < 0.01). These findings indicate that the VL muscle of reconstructed lower limbs contribute marginally to force steadiness and that a plastic rearrangement in synergistic clusters of motor units involved in the control of knee extension forces is evident following ACLR.NEW & NOTEWORTHY Chronic quadriceps dysfunction is common after anterior cruciate ligament reconstruction (ACLR). We investigated voluntary force control strategies by estimating common inputs to motor neurons innervating the vastii muscles. Our results showed attenuated common inputs to the vastus lateralis and plastic rearrangements in functional clusters of motor neurons modulating knee extension forces in the reconstructed limb. These findings suggest neuroplastic adjustments following ACLR that may occur to fine-tune the control of quadriceps forces.

Eversion Force Control and Neural Drive to the Peroneus Muscles in Male Collegiate Soccer Athletes With and Without Perceived Ankle Instability

OBJECTIVE: To investigate whether individuals with perceived ankle instability (PAI) exhibited lower force control capacity and higher neural drive variability during ankle eversion force control tests compared to individuals without PAI. DESIGN: Cross-sectional case-control study. METHODS: We included male collegiate soccer athletes with ( n = 16) and without PAI ( n = 11). Force steadiness and accuracy tests were performed at 10%, 30%, and 50% of maximal voluntary contraction. Neural drive to the peroneal muscles was calculated using high-density surface electromyography. We analyzed force error, force complexity, and force and neural drive variability. RESULTS: Eversion strength was higher in the PAI group (0.36 ± 0.1 N m/kg) ( P = .03). Force error (mean difference [MD], 0.05; 95% confidence interval [CI]: −0.31, 0.21), force complexity (approximate entropy) (MD, 0.08; 95% CI: − 0.34, 0.50), force (MD, 0.20; 95% CI: −1.77, 1.36), and neural drive (MD, 1.75; 95% CI: −2.48, 5.91) variability at 10% maximal voluntary contraction did not differ between groups ( P&gt;.05). There were no significant differences between groups in other intensities and variables ( P&gt;.05). CONCLUSION: Eversion force control and neural drive to the peroneal muscles in male collegiate soccer athletes with PAI did not differ from those in athletes without PAI. JOSPT Open 2024;2(4):315-321. Epub 15 July 2024. doi:10.2519/josptopen.2024.0360

Does pain influence control of muscle force? A systematic review and meta-analysis.

In the presence of pain, whether clinical or experimentally induced, individuals commonly show impairments in the control of muscle force (commonly known as force steadiness). In this systematic review and meta-analysis, we synthesized the available evidence on the influence of clinical and experimental pain on force steadiness. MEDLINE, EMBASE, PubMed, CINAHL Plus and Web of Science databases were searched from their inception to 19 December 2023, using MeSH terms and pre-selected keywords related to pain and force steadiness. Two independent reviewers screened studies for inclusion and assessed their methodological quality using a modified Newcastle-Ottawa risk of bias tool. In total, 32 studies (19 clinical pain and 13 experimental pain) were included. Meta-analyses revealed reduced force steadiness in the presence of clinical pain as measured by the coefficient of variation (CoV) and standard deviation (SD) of force (standardized mean difference; SMD = 0.80, 95% CI = 0.31-1.28 and SMD = 0.61, 95% CI = 0.11-1.11). These findings were supported by moderate and low strength of evidence respectively. In the presence of experimental pain, meta-analyses revealed reductions in force steadiness when measured by the CoV of force but not by the SD of force (SMD = 0.50, 95% CI = 0.01-0.99; and SMD = 0.44, 95% CI = -0.04 to 0.92), each supported by very low strength of evidence. This work demonstrates that pain, particularly clinical pain, impairs force steadiness. Such impairments likely have clinical relevance and could become targets for treatment when managing people experiencing musculoskeletal pain. This systematic review and meta-analyses enhances our understanding of motor impairments observed in people experiencing musculoskeletal pain. It underscores the significance of incorporating force steadiness assessment when managing individuals experiencing musculoskeletal pain. Additionally, it suggests that future research should explore the potential benefits of force steadiness training in alleviating patients' symptoms and enhancing their functional performance. This could potentially lead to the development of innovative therapeutic approaches for individuals suffering from musculoskeletal pain.

Distinct Neural Drives along the Semitendinosus Muscle.

Conflicting results have been reported on the functional role of the proximal and distal compartments of the semitendinosus (ST) muscle. This study compared the discharge characteristics of motor units (MUs) in the two compartments at three knee-joint angles (0°: long length, 45°: intermediate length, and 90°: short length). Twenty men (21.4 ± 2.3 years) performed steady isometric contractions with the knee flexors at four target forces: 10%, 20%, 40%, and 60% of maximum voluntary contraction (MVC). High-density electromyography (EMG) signals were recorded to examine the MU discharge characteristics in the two compartments. Measurements included recruitment threshold (RT), mean discharge rate (MDR), coefficient of variation for interspike interval (CoV for ISI), and the standard deviation of filtered cumulative spike train (SD of fCST). Additionally, the within- and between-compartment association of the neural drive was calculated. Analysis of variance indicated that maximal force, absolute EMG amplitude during the MVCs, and force steadiness (CoV for force) were greater at the longest muscle length than the other two lengths (P < 0.05). Linear mixed models showed that both RT and CoV for ISI were similar between compartments (P > 0.05) at each of the three knee-joint angles. However, MDR and the variability in neural drive were greater for the proximal than the distal compartment (P < 0.05). The between-compartment association in neural drive (fCST) was relatively low. There were distinct differences in motor unit discharge characteristics between the proximal and distal compartments of ST across its operating range of muscle lengths and each compartment received a relatively distinct neural drive. These findings emphasize the importance of recognizing differences in neural control of the ST compartments to guide related interventions and inform rehabilitation strategies.

Differential training benefits and motor unit remodeling in wrist force precision tasks following high and low load blood flow restriction exercises under volume-matched conditions

BackgroundBlood flow restriction (BFR) resistance training has demonstrated efficacy in promoting strength gains beneficial for rehabilitation. Yet, the distinct functional advantages of BFR strength training using high-load and low-load protocols remain unclear. This study explored the behavioral and neurophysiological mechanisms that explain the differing effects after volume-matched high-load and low-load BFR training.MethodsTwenty-eight healthy participants were randomly assigned to the high-load blood flow restriction (BFR-HL, n = 14) and low-load blood flow restriction (BFR-LL, n = 14) groups. They underwent 3 weeks of BFR training for isometric wrist extension at intensities of 25% or 75% of maximal voluntary contraction (MVC) with matched training volume. Pre- and post-tests included MVC and trapezoidal force-tracking tests (0–75%–0% MVC) with multi-channel surface electromyography (EMG) from the extensor digitorum.ResultsThe BFR-HL group exhibited a greater strength gain than that of the BFR-LL group after training (BFR_HL: 26.96 ± 16.33% vs. BFR_LL: 11.16 ± 15.34%)(p = 0.020). However, only the BFR-LL group showed improvement in force steadiness for tracking performance in the post-test (p = 0.004), indicated by a smaller normalized change in force fluctuations compared to the BFR-HL group (p = 0.048). After training, the BFR-HL group activated motor units (MUs) with higher recruitment thresholds (p < 0.001) and longer inter-spike intervals (p = 0.002), contrary to the BFR-LL group, who activated MUs with lower recruitment thresholds (p < 0.001) and shorter inter-spike intervals (p < 0.001) during force-tracking. The discharge variability (p < 0.003) and common drive index (p < 0.002) of MUs were consistently reduced with training for the two groups.ConclusionsBFR-HL training led to greater strength gains, while BFR-LL training better improved force precision control due to activation of MUs with lower recruitment thresholds and higher discharge rates.

Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness.

The purpose was to identify the variables that can explain the variance in the grooved pegboard times of older adults categorized as either fast or slow performers. Participants (n = 28; 60-83years) completed two experimental sessions, before and after 6 practice sessions of the grooved pegboard test. The 2 groups were identified based on average pegboard times during the practice sessions. Average pegboard time during practice was 73 ± 11s for the fast group and 85 ± 13s for the slow group. Explanatory variables for the pegboard times before and after practice were the durations of 4 peg-manipulation phases and 12 measures of force steadiness (coefficient of variation [CV] for force) during isometric contractions with the index finger abductor and wrist extensor muscles. Time to complete the grooved pegboard test after practice decreased by 25 ± 11% for the fast group and by 28 ± 10% for the slow group. Multiple regression models explained more of the variance in the pegboard times for the fast group before practice (Adjusted R2 = 0.85) than after practice (R2 = 0.51), whereas the variance explained for the slow group was similar before (Adjusted R2 = 0.67) and after (Adjusted R2 = 0.64) practice. The explanatory variables differed between before and after practice for the fast group but only slightly for the slow group. These findings indicate that performance-based stratification of older adults can identify unique adjustments in motor function that are independent of chronological age.

Sex disparities of human neuromuscular decline in older humans

AbstractFemales typically live longer than males but, paradoxically, spend a greater number of later years in poorer health. The neuromuscular system is a critical component of the progression to frailty, and motor unit (MU) characteristics differ by sex in healthy young individuals and may adapt to ageing in a sex‐specific manner due to divergent hormonal profiles. The purpose of this study was to investigate sex differences in vastus lateralis (VL) MU structure and function in early to late elderly humans. Intramuscular electromyography signals from 50 healthy older adults (M/F: 26/24) were collected from VL during standardized submaximal contractions and decomposed to quantify MU characteristics. Muscle size and neuromuscular performance were also measured. Females had higher MU firing rate (FR) than males (P = 0.025), with no difference in MU structure or neuromuscular junction transmission (NMJ) instability. All MU characteristics increased from low‐ to mid‐level contractions (P &lt; 0.05) without sex × level interactions. Females had smaller cross‐sectional area of VL, lower strength and poorer force steadiness (P &lt; 0.05). From early to late elderly, both sexes showed decreased neuromuscular function (P &lt; 0.05) without sex‐specific patterns. Higher VL MUFRs at normalized contraction levels previously observed in young are also apparent in old individuals, with no sex‐based difference of estimates of MU structure or NMJ transmission instability. From early to late elderly, the deterioration of neuromuscular function and MU characteristics did not differ between sexes, yet function was consistently greater in males. These parallel trajectories underscore the lower initial level for older females and may offer insights into identifying critical intervention periods. imageKey points Females generally exhibit an extended lifespan when compared to males, yet this is accompanied by a poorer healthspan and higher rates of frailty. In healthy young people, motor unit firing rate (MUFR) at normalized contraction intensities is widely reported to be higher in females than in age‐matched males. Here we show in 50 people that older females have higher MUFR than older males with little difference in other MU parameters. The trajectory of decline from early to late elderly does not differ between sexes, yet function is consistently lower in females. These findings highlight distinguishable sex disparities in some MU characteristics and neuromuscular function, and suggest early interventions are needed for females to prevent functional deterioration to reduce the ageing health–sex paradox.

Foot-dominance does not influence force variability during ankle dorsiflexion and foot adduction

ABSTRACT The aim of our study was to compare the force steadiness and the discharge characteristics of motor units in the tibialis anterior (TA) during ankle dorsiflexion and foot adduction produced by submaximal isometric contractions with the dominant and non-dominant foot. Fifteen young men performed maximal and submaximal contractions at five target forces with both legs, and motor unit activity in TA was recorded using high-density electromyography. Maximal force and the fluctuations in force during submaximal contractions were similar between the two legs (p > 0.05). Motor unit activity was characterized by measures of mean discharge rate (MDR), coefficient of variation for interspike interval (CoV for ISI), and standard deviation of the filtered cumulative spike train (SD of fCST). There were no statistically significant differences in motor unit activity between legs during ankle dorsiflexion. In contrast, the MDR and the CoV for ISI but not the SD of fCST, were greater for the non-dominant foot compared with the dominant foot during foot adduction. Nonetheless, these differences in motor unit activity were not sufficient to influence the force fluctuations during the submaximal contractions. These results indicate that control of the force produced by TA during the two actions was not influenced by limb dominance.

Muscle contractile properties directly influence shared synaptic inputs to spinal motor neurons.

Alpha band oscillations in shared synaptic inputs to the alpha motor neuron pool can be considered an involuntary source of noise that hinders precise voluntary force production. This study investigated the impact of changing muscle length on the shared synaptic oscillations to spinal motor neurons, particularly in the physiological tremor band. Fourteen healthy individuals performed low-level dorsiflexion contractions at ankle joint angles of 90° and 130°, while high-density surface electromyography (HDsEMG) was recorded from the tibialis anterior (TA). We decomposed the HDsEMG into motor units spike trains and calculated the motor units' coherence within the delta (1-5Hz), alpha (5-15Hz), and beta (15-35Hz) bands. Additionally, force steadiness and force spectral power within the tremor band were quantified. Results showed no significant differences in force steadiness between 90° and 130°. In contrast, alpha band oscillations in both synaptic inputs and force output decreased as the length of the TA was moved from shorter (90°) to longer (130°), with no changes in delta and beta bands. In a second set of experiments (10 participants), evoked twitches were recorded with the ankle joint at 90° and 130°, revealing longer twitch durations in the longer TA muscle length condition compared to the shorter. These experimental results, supported by a simple computational simulation, suggest that increasing muscle length enhances the muscle's low-pass filtering properties, influencing the oscillations generated by the Ia afferent feedback loop. Therefore, this study provides valuable insights into the interplay between muscle biomechanics and neural oscillations. KEY POINTS: We investigated whether changes in muscle length, achieved by changing joint position, could influence common synaptic oscillations to spinal motor neurons, particularly in the tremor band (5-15Hz). Our results demonstrate that changing muscle length from shorter to longer induces reductions in the magnitude of alpha band oscillations in common synaptic inputs. Importantly, these reductions were reflected in the oscillations of muscle force output within the alpha band. Longer twitch durations were observed in the longer muscle length condition compared to the shorter, suggesting that increasing muscle length enhances the muscle's low-pass filtering properties. Changes in the peripheral contractile properties of motor units due to changes in muscle length significantly influence the transmission of shared synaptic inputs into muscle force output. These findings prove the interplay between muscle mechanics and neural adaptations.

Integrative approach to understanding force (un)steadiness.

Integrative approach to understanding force (un)steadiness.

Multivariate approach to detect force steadiness.

Multivariate approach to detect force steadiness.

Last Word on Viewpoint: Rethinking force steadiness: a new perspective-Yank magnitude: a metric of unsteadiness during the constant isometric force task.

Last Word on Viewpoint: Rethinking force steadiness: a new perspective-Yank magnitude: a metric of unsteadiness during the constant isometric force task.

Why stick with Fourier analysis for force steadiness: a commentary.

Why stick with Fourier analysis for force steadiness: a commentary.

Influence of visual feedback and cognitive challenge on the age-related changes in force steadiness.

Force steadiness can be influenced by visual feedback as well as presence of a cognitive tasks and potentially differs with age and sex. This study determined the impact of altered visual feedback on force steadiness in the presence of a difficult cognitive challenge in young and older men and women. Forty-nine young (19-30yr; 25 women, 24 men) and 25 older (60-85yr; 15 women; 10 men) performed low force (5% of maximum) static contractions with the elbow flexor muscles in the presence and absence of a cognitive challenge (counting backwards by 13) either with low or high visual feedback gain. The cognitive challenge reduced force steadiness (increased force fluctuation amplitude) particularly in women (cognitive challenge × sex: P < 0.05) and older individuals (cognitive challenge × age: P < 0.05). Force steadiness improved with high-gain visual feedback compared with low-gain visual feedback (P < 0.01) for all groups (all interactions: P > 0.05). Manipulation of visual feedback had no influence on the reduced force steadiness in presence of the cognitive challenge for all groups (all P > 0.05). These findings indicate that older individuals and women have greater risk of impaired motor performance of the upper extremity if steadiness is required during a low-force static contraction. Manipulation of visual feedback had minimal effects on the reduced force steadiness in presence of a difficult cognitive challenge.

Corticospinal and spinal responses following a single session of lower limb motor skill and resistance training.

Prior studies suggest resistance exercise as a potential form of motor learning due to task-specific corticospinal responses observed in single sessions of motor skill and resistance training. While existing literature primarily focuses on upper limb muscles, revealing a task-dependent nature in eliciting corticospinal responses, our aim was to investigate such responses after a single session of lower limb motor skill and resistance training. Twelve participants engaged in a visuomotor force tracking task, self-paced knee extensions, and a control task. Corticospinal, spinal, and neuromuscular responses were measured using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS). Assessments occurred at baseline, immediately post, and at 30-min intervals over two hours. Force steadiness significantly improved in the visuomotor task (P < 0.001). Significant fixed-effects emerged between conditions for corticospinal excitability, corticospinal inhibition, and spinal excitability (all P < 0.001). Lower limb motor skill training resulted in a greater corticospinal excitability compared to resistance training (mean difference [MD] = 35%, P < 0.001) and control (MD; 37%, P < 0.001). Motor skill training resulted in a lower corticospinal inhibition compared to control (MD; - 10%, P < 0.001) and resistance training (MD; - 9%, P < 0.001). Spinal excitability was lower following motor skill training compared to control (MD; - 28%, P < 0.001). No significant fixed effect of Time or Time*Condition interactions were observed. Our findings highlight task-dependent corticospinal responses in lower limb motor skill training, offering insights for neurorehabilitation program design.

Short term effects of contralateral tendon vibration on motor unit discharge rate variability and force steadiness in people with Parkinson's disease.

Vibration of one limb affects motor performance of the contralateral limb, and this may have clinical implications for people with lateralized motor impairments through vibration-induced increase in cortical activation, descending neural drive, or spinal excitability. The objective of this study was to evaluate the effects of acute biceps brachii tendon vibration on force steadiness and motor unit activity in the contralateral limb of persons with Parkinson's disease. Ten participants with mild to moderate Parkinson's disease severity performed a ramp, hold and de-ramp isometric elbow flexion at 5% of maximum voluntary contraction with the more-affected arm while vibration was applied to the distal biceps brachii tendon on the contralateral, less-affected arm. Using intramuscular fine wire electrodes, 33 MUs in the biceps brachii were recorded across three conditions (baseline, vibration, and post-vibration). Motor unit recruitment & derecruitment thresholds, discharge rates & variability, and elbow flexion force steadiness were compared between conditions with and without vibration. Coefficient of variation of force and discharge rate variability decreased 37 and 17%, respectively in post-vibration compared with baseline and vibration conditions. Although the motor unit discharge rates did not differ between conditions the total number of motor units active at rest after de-ramp were fewer in the post-vibration condition. Contralateral tendon vibration reduces MU discharge rate variability and enhances force control on the more affected side in persons with Parkinson's disease.

Motor Unit Firing Properties During Force Control Task and Associations With Neurological Tests in Children.

The present study aimed to clarify the development of motor unit (MU) firing properties and the association between those neural properties and force steadiness (FS)/neurological tests in 6- to 12-year-old children. Fifty-eight school-aged children performed maximal voluntary knee extension contraction, a submaximal FS test at 10% of maximal voluntary knee extension contraction, knee extension reaction time to light stimulus test, and single-leg standing test, and data from 38 children who passed the criteria were subject to analysis. During the FS test, high-density surface electromyography was recorded from the vastus lateralis muscle to identify individual MU firing activity. FS was improved with an increase in age (r = -.540, P < .001). The MU firing rate (MUFR) was significantly decreased with an increase in age (r = -.343, P = .035). MUFR variability was not associated with age. Although there was no significant correlation between FS and MUFR, FS was significantly correlated with MUFR variability even after adjustment for the effect of age (r = .551, P = .002). Neither the reaction time nor the single-leg standing test was correlated with any MU firing properties. These findings suggest that MUFR variability makes an important contribution to precise force control in children but does not naturally develop with age.

Control of motor output during steady submaximal contractions is modulated by contraction history.

The purpose of the study was to investigate the influence of contraction history on force steadiness and the associated EMG activity during submaximal isometric contractions performed with the dorsiflexor muscles. The key feature of the protocol was a triangular ramp contraction performed in the middle of a steady contraction at a lower target force. The target force during the ramp contraction was 20% MVC greater than that during the steady contraction. Thirty-seven healthy individuals (21 men and 16 women) performed the submaximal tasks with the ankle dorsiflexors. Electromyography (EMG) signals were recorded from tibialis anterior with a pair of surface electrodes. The coefficient of variation for force was significantly greater during the second steady contraction compared with the first one at each of the seven target forces (p<0.015; d=0.38-0.92). Although the average applied force during the steady contractions before and after the triangular contraction was the same (p=0.563), the mean EMG amplitude for the steady contractions performed after the triangular contraction was significantly greater at each of the seven target forces (p<0.0001; d=0.44-0.68). Also, there were significant differences in mean EMG frequency between the steady contractions performed before and after the triangular contraction (p<0.01; d=0.13-0.82), except at 10 and 20% MVC force. The greater force fluctuations during a steady submaximal contraction after an intervening triangular contraction indicate a change in the discharge characteristics of the involved motor units.

More Variability in Tibialis Anterior Function during the Adduction of the Foot than Dorsiflexion of the Ankle.

The aim of the study was to compare maximal force, force steadiness, and the discharge characteristics of motor units in the tibialis anterior (TA) muscle during submaximal isometric contractions for ankle dorsiflexion and adduction of the foot. Nineteen active young adults performed maximal and submaximal isometric dorsiflexion and adduction contractions at five target forces (5%, 10%, 20%, 40%, and 60% maximal voluntary contraction [MVC]). The activity of motor units in TA was recorded by high-density EMG. The maximal force was similar between dorsiflexion and adduction, despite EMG amplitude for TA being greater ( P < 0.05) during dorsiflexion than adduction. Τhe coefficient of variation (CV) for force (force steadiness) during dorsiflexion was always less ( P < 0.05) than during adduction, except of 5% MVC force. No differences were observed for mean discharge rate; however, the regression between the changes in discharge rate relative to the change of force was significant for dorsiflexion ( R2 = 0.25, P < 0.05) but not for adduction. Discharge variability, however, was usually less during dorsiflexion. The CV for interspike interval was less ( P < 0.05) at 10%, 20%, and 40% MVC but greater at 60% MVC during dorsiflexion than adduction. Similarly, the SD values of the filtered cumulative spike train of the motor units in TA were less ( P < 0.05) at 5%, 10%, 20%, and 40% MVC during dorsiflexion than adduction. Although the mean discharge rate of motor units in TA was similar during foot adduction and ankle dorsiflexion, discharge variability was less during dorsiflexion resulting in less accurate performance of the steady adduction contractions. The neural drive to bifunctional muscles differs during their accessory function, which must be considered for training and rehabilitation interventions.