Soleus Electromyography Research Articles

EMG coherence of foot and ankle muscles increases with a postural challenge in men

BackgroundThe functional role of intrinsic foot muscles in the control of standing balance is often overlooked in rehabilitation, partly because the interactions with ankle muscles are poorly understood. Research questionHow does coactivation of Flexor Digitorum Brevis (FDB) and soleus (SOL) vary across standing tasks of increasing difficulty. MethodsPostural sway (Centre of Pressure, CoP) and the electromyographic (EMG) activity of FDB, SOL, Medial Gastrocnemius (MG) and Tibialis Anterior (TA) were measured during bipedal standing, tandem stance, one-legged balance, and standing on toes. Coherence of the rectified EMG signals for SOL and FDB in two bandwidths (0–5 and 10–20 Hz) was calculated as a coactivation index. Results and significanceThe CoP sway and the EMG activity of all muscles was greater (P<0.05) for the three difficult tasks. Significant coherence between the SOL and FDB EMG activity was found in both frequency regions: 0–5 and 10–20 Hz. The coherence integral increased with the difficulty of the postural task, especially in the 10–20 Hz band. The findings underscore the important role of FDB in the control of standing balance across tasks and its coactivation with SOL. Clinical recommendations to improve balance control need to consider the interaction between the plantar flexor and intrinsic-foot muscles.

Effects of Acute Sleep Deprivation on the Sequential Rate of Torque Development throughout the Force-Time Curve.

Objective The impact of sleep deprivation on the physiological determinants of explosive torque production remains poorly understood. We aimed at determining the acute effects of 24 hours of sleep deprivation on the sequential rate of torque development (RTD) obtained during plantar flexion through maximum voluntary isometric contraction (MVIC). Materials and Methods The study included 14 healthy-young adults (8 men and 6 women). The participants visited the laboratory on 2 different occasions: without and with 24 hours of sleep deprivation. In each session, the subjects were tested for RTD of the plantar flexors with concomitant recordings of the electromyographic (EMG) amplitude of the soleus over the following time intervals: 0 to 30, 30 to 50, 50 to 100, and 100 to 150 ms. Results Sleep deprivation did not affect peak RTD (without sleep deprivation: 283.3 ± 111.6 N.m.s -1 versus with sleep deprivation: 294.9 ± 99.2 N.m.s -1 ; p > 0.05) of plantar flexion. The sequential values of RTD, as well as the normalized amplitude of the soleus EMG, remained similar between both conditions (p > 0.05). Discussion In conclusion, we found that 24 hours of sleep deprivation do not affect muscle activation, nor explosive torque production throughout the torque-time curve. Thus, exercise performance and daily functionality in tasks involving rapid torque development might remain well preserved after 24 hours of acute sleep deprivation.

Effects of postural threat on the scaling of anticipatory postural adjustments in young and older adults.

The ability to scale anticipatory postural adjustments (APAs) according to the predicted size of the upcoming movement is reduced with aging. While age-related changes in central set may be one reason for this effect, an individual's emotional state might also contribute to changes in anticipatory postural control. Therefore, the purpose of this study was to determine whether an altered emotional state, as elicited through postural threat, alters the scaling of APAs during a handle pull movement in young and older adults. It was hypothesized that the presence of postural threat would lead to more homogenous APAs (i.e., less scaling of APAs) across a range of pulling forces. Young (n = 23) and older adults (n = 16) stood on top of a force plate that was mounted to a motorized platform. From this position, participants performed a series of handle pull trials without (no threat) or with (threat) the possibility of receiving a postural perturbation in the form of an unpredictable surface translation. Handle pulls were performed at force levels between 50 and 90% of maximum force. For each trial, the magnitude and timing of the APA were quantified from center of pressure (COP) recordings as well as electromyographic (EMG) activity of the soleus and medial gastrocnemius. The scaling of APAs with respect to force exertion was then determined through regression analyses and by comparing APAs during pulls of lower versus higher force. As evidenced by their smaller slope of the regression line between various dependent measures (i.e., COP velocity, soleus EMG onset latency, and soleus EMG amplitude) and the pulled forces, older adults demonstrated less scaling of APAs than the young. However, increases in arousal, anxiety and fear of falling due to postural threat, only minimally altered the scaling of APAs. Regardless of age, the slope of the regressions for none of the measures were affected by threat while only the soleus and medial gastrocnemius EMG onsets demonstrated significant force × threat interaction effects. These results suggest that the decreased ability to scale APAs with aging is unlikely to be due to changes in emotional state.

Chronic changes in muscle architecture and aponeurosis structure following calf muscle strain injuries.

Muscle strain injuries in the human calf muscles are frequent sports injuries with high recurrence. Potential structural and functional changes in the medial head of the musculus gastrocnemius (GM) and the associated aponeurosis are not well documented. To test whether a GM muscle strain injury affects muscle fascicle length, pennation angle, and the morphology of the deep aponeurosis at rest and during muscle contraction long time after the injury. Additionally, electromyography (EMG) of the GM and the soleus muscle during a unilateral heel rise was measured in the injured and uninjured calf. GM fascicle length, pennation angle, and aponeurosis thickness was analyzed on dynamic ultrasonography (US) recordings in 10 participants with a chronic calf strain. In addition, US images taken across the distal portion and mid-belly of the GM were analyzed at three different ankle positions. EMG recordings were obtained during a unilateral heel rise. The pennation angle of the injured distal GM was significantly larger compared to the uninjured GM in the contracted, but not the relaxed state. Pennation angle increased more in the injured compared to the uninjured GM during contraction. Fascicle length was shorter in the most distal portion of the injured GM. Fascicles at the distal portion of the injured GM showed a pronounced curvilinear shape as the muscle contracted and the aponeurosis was enlarged in the injured compared to the uninjured GM. The ratio between GM and soleus EMG activity showed a significantly higher relative soleus activity in the injured compared to the healthy calf. The greater change in pennation angle and curvilinear fascicle shape during contraction suggest that a long-term consequence after a muscle strain injury is that some muscle fibers at the distal GM are not actively engaged. The significantly enlarged aponeurosis indicates a substantial and long-lasting connective tissue involvement following strain injuries.

Effect of galvanic vestibular stimulation applied at the onset of stance on muscular activity and gait cycle duration in healthy individuals.

Locomotion requires the complex involvement of the spinal and supraspinal systems. So far, the role of vestibular input in gait has been assessed mainly with respect to gait stability. The noninvasive technique of galvanic vestibular stimulation (GVS) has been reported to decrease gait variability and increase gait speed, but the extent of its effect on spatiotemporal gait parameters is not fully known. Objective: Characterize vestibular responses during gait and determine the influence of GVS on cycle duration in healthy young participants. Methods: Fifteen right-handed individuals participated in the study. Electromyography (EMG) recordings of the bilateral soleus (SOL) and tibialis anterior muscles (TA) were performed. First, to determine stimulation intensity, an accelerometer placed on the vertex recorded the amplitude of the head tilts evoked by the GVS (1-4 mA, 200 ms) to establish a motor threshold (T). Second, while participants walked on a treadmill, GVS was applied at the onset of the stance phase during the treadmill gait with an intensity of 1 and 1.5 T with the cathode behind the right (RCathode) or left ear (LCathode). EMG traces were rectified, averaged (n = 30 stimuli), and analyzed. Latency, duration, and amplitude of vestibular responses as well as the mean duration of the gait cycles were measured. Results: GVS mainly induced long-latency responses in the right SOL, right TA and left TA. Only short-latency responses were triggered in the left SOL. Responses in the right SOL, left SOL and left TA were polarity dependent, being facilitatory with RCathode and inhibitory with LCathode, whereas responses in the right TA remained facilitatory regardless of the polarity. With the RCathode configuration, the stimulated cycle was prolonged compared with the control cycle at both 1 and 1.5 T, due to prolonged left SOL and TA EMG bursts, but no change was observed in right SOL and TA. With LCathode, GVS did not modify the cycle duration. Conclusion: During gait, a brief, low-intensity GVS pulse delivered at the right stance onset induced mainly long-latency polarity-dependent responses. Furthermore, a RCathode configuration increased the duration of the stimulated gait cycle by prolonging EMG activity on the anodic side. A similar approach could be explored to influence gait symmetry in individuals with neurological impairment.

Temporal modulation of H-reflex in young and older people: Acute effects during Achilles tendon vibration while standing.

Examining how timely is sensory input processed and regulated after a perturbation while standing, is a key element to understand postural control, especially in people with balance deficits, such as older adults. In this study, we investigated the age-related temporal modulations in spinal excitability, by measuring the soleus H-reflex within the first 250ms after switching on (V-ON) and off (V-OFF) a pair of vibrators, placed over the Achilles tendons. Twenty young (25.1±5.1yrs) and 16 older (71.8±6.1yrs) adults stood blindfolded, while 12-15s periods of Achilles tendon vibration (ATV) were applied with 20-24s intervals. Anterior/posterior center of pressure and electromyographic (EMG) responses [soleus (SOL) and tibialis anterior (TA)] were assessed whereas SOL H-reflex normalized to maximum M-wave (H/Mmax) and SOL EMG (H/SOL) were evaluated before ATV (Pre) and at 50, 100, 150, 200 and 250ms after the V-ON and V-OFF. Only in young adults the TA/SOL EMG ratio decreased 100 (p=0.032) and 150ms (p<0.001) after V-ON and the H/Mmax and H/SOL decreased 150-250ms after V-ON (p<0.001). At 50-250ms after V-OFF, H/Mmax was reduced compared to Pre values (p<0.001), with no differences between the age groups (p>0.05). H/SOL was decreased for the young adults (p<0.001) and remained reduced at least for the first 250ms after V-OFF. At 150ms after V-OFF, SOL/Mmax was decreased only for the older adults (p<0.001), whereas TA/SOL EMG gradually increased for both groups (p<0.001). When ATV is introduced while standing, the spinal excitability of older people is reduced later and to a lesser extent compared to young adults. Their limited capacity to down-regulate the "noisy" sensory input generated by ATV gives further evidence of a possible mechanism for their inefficient postural control.

Motor Unit Discharge Patterns in Response to Focal Tendon Vibration of the Lower Limb in Cats and Humans.

High-frequency vibration of the tendon provides potent activation of Ia afferents time-locked to the stimulation frequency and provides excitatory ionotropic activation of homonymous motor pools. In cats, the evoked motor unit discharge is constrained to discharge at integer multiples of the vibration frequency, resulting in a probability of discharge that is highly punctuated. Here we quantify the robustness of this punctuated response in the cat and evaluate whether it is present in the human. Soleus electromyography (EMG) was collected from eight cats using 64 channel electrodes during three modes of motoneuron activation. First, tendon vibration parameters were modified. Second, secondary reflex inputs are applied concurrently with tendon vibration. Third, the state of the spinal cord was altered through pharmacological or surgical manipulations. Analogous surface high-density EMG was collected from the lower leg of six humans during both vibration evoked and matched volitional contractions. Array EMG signals from both the cat and human were decomposed into corresponding motor unit action potential spike trains, and the punctuation in discharge was quantified. In the cat, regardless of vibration parameters, secondary synaptic drive, and state of spinal circuitry, focal tendon vibration evoked punctuated motor unit discharge. However, in the human lower limb, the vibration-evoked contractions do not produce punctuated motor unit discharge.

Resilience of visually guided weight shifting to a proprioceptive perturbation depends on the complexity of the guidance stimulus

BackgroundWhole-body tracking of visual motion cues is used in balance training to improve weight shifting ability in old age and sports. Research questionHow tracking of a complex (pink noise) and a periodic visual target motion during anteroposterior weight shifting affects postural and muscle responses to unilateral hip vibration. MethodsTwenty-six participants performed 160 anteroposterior weight shifting cycles while tracking the vertical motion of a visual target, concurrently receiving Center of Pressure (CoP) feedback. They were randomly divided to groups; (a) the Constant group tracked a visual target motion constructed by 3 sinusoids of different amplitude, and (b) the Pink group tracked a complex visual target motion constructed by a pink noise generation process. Between the 60th and the 120th cycle, vibration was applied to the right gluteus medius, introducing a sideways CoP deviation. CoP displacement and electromyographic (EMG) responses of soleus, tibialis anterior and peroneus longus were recorded and summarized in blocks of 3 cycles. ResultsSideways CoP deviation induced at the onset/offset of unilateral hip vibration was smaller for the Pink than the Constant group. The Pink group demonstrated greater tibialis anterior and peroneus longus EMG activity around the most anterior sway peak while soleus EMG was similar for the two groups. Both groups successfully coupled weight shifting amplitude to the target motion, but the Pink group tracked the target motion with a greater delay compared to the Constant group. SignificanceWhole body tracking of complex visual motions evokes perception-based action and increases ankle muscle co-activation making sway more resilient to a proprioceptive perturbation induced by unilateral hip vibration. Complex visual guidance motions should be considered when designing balance rehabilitation regimes, aiming at improving weight shifting ability and dynamic balance control.

Electromyographic responses to unexpected Achilles tendon vibration-induced perturbations during standing in young and older people.

This study aimed to investigate age-related differences in electromyographic (EMG) responses to unexpected Achilles tendon vibration (ATV) perturbations while standing blindfold. ATV with variable and random duration (12-15s) and rest periods (20-24s) was applied on 18 young and 16 older volunteers. The anterior/posterior center of pressure (CoP) and the soleus (SOL) and tibialis anterior (TA) EMG were analyzed for 1s before and 8s after the ATV onset and offset. ATV induced a posterior shift of CoP in both groups, with more pronounced shift in the older group. During ATV onset, the older group demonstrated less SOL and more TA EMG increase compared to the young group. During the first 0.5s of ATV offset, SOL EMG was decreased in both age groups, while TA showed a burst of EMG activity that was greater in the older group. No difference in the latencies of EMG peaks or valleys was observed between the groups. It is concluded that ATV induces greater posterior CoP shift in older adults, and they adopt a recovery strategy, characterized by a decreased SOL activation and an increased TA activation. These differences are possibly attributed to the increased fear of falling, decreased limits of stability and reduced capacity of older people to reweight their sensory inflow when proprioception is distorted.

Corticospinal modulation of vibration-induced H-reflex depression.

The purpose of this study was to examine corticospinal modulation of spinal reflex excitability, by determining the effect of transcranial magnetic stimulation (TMS) on soleus H-reflexes while they were almost completely suppressed by lower extremity vibration. In 15 healthy adults, a novel method of single-limb vibration (0.6g, 30Hz, 0.33mm displacement) was applied to the non-dominant leg. Soleus muscle responses were examined in six stimulation conditions: (1) H-reflex elicited by tibial nerve stimulation, (2) tibial nerve stimulation during vibration, (3) subthreshold TMS, (4) subthreshold TMS during vibration, (5) tibial nerve stimulation 10ms after a subthreshold TMS pulse, and (6) tibial nerve stimulation 10ms after a subthreshold TMS pulse, during vibration. With or without vibration, subthreshold TMS produced no motor evoked potentials and had no effect on soleus electromyography (p > 0.05). In the absence of vibration, H-reflex amplitudes were not affected by subthreshold TMS conditioning (median (md) 35, interquartile range (IQ) 18-56 vs. md 46, IQ 22-59% of the maximal M wave (Mmax), p > 0.05). During vibration, however, unconditioned H-reflexes were nearly abolished, and a TMS conditioning pulse increased the H-reflex more than fourfold (md 0.3, IQ 0.1-0.7 vs. md 2, IQ 0.9-5.0% of Mmax, p < 0.008). Limb vibration alone had no significant effect on corticospinal excitability. In the absence of vibration, a subthreshold TMS pulse did not influence the soleus H-reflex. During limb vibration, however, while the H-reflex was almost completely suppressed, a subthreshold TMS pulse partially restored the H-reflex. This disinhibition of the H-reflex by a corticospinal signal may represent a mechanism involved in the control of voluntary movement. Corticospinal signals that carry the descending motor command may also reduce presynaptic inhibition, temporarily increasing the impact of sensory inputs on motoneuron activation.

The tightening parameters of the vibratory devices modify their disturbing postural effects

The purpose was to specify the impact of two different forces exerted by vibratory devices on the Achilles tendon on postural balance. The postural balance of 13 participants was evaluated on a force platform in two 40 s bipedal stance conditions with closed eyes. Tendon vibrations (80 Hz) were triggered 10 s after the beginning of the postural evaluation and applied during 20 s. Two levels of the force exerted by the vibrators were calibrated using load cells to control the tightening parameters of the vibrators: a strong tightening (ST) condition at 45 N and a light tightening (LT) condition at 5 N. The soleus electromyographic (EMG) activity and the spatio-temporal parameters of displacement of the centre of foot pressure (COP) were analysed. To analyse the effects of the introduction, the adaptation and the end of the stimulation, non-parametric tests were used. The results indicated that the soleus EMG activity increased only in the ST condition. However, during the vibration the anteroposterior COP position was significantly more in a backward position in the LT condition. At the end of the vibration, COP parameters increased more in the LT condition than the ST condition. This study demonstrated that the effects of the vibration depended on the force exerted by the devices on the tendons. The ST increased the vibration effects on EMG activity through greater stimulating effects compared to the LT. However, the ST could also increase the ankle joint stiffness and/or somaesthetic sensory information, which attenuated the COP backward shift.

Alteration of H-reflex amplitude modulation is a marker of impaired postural responses in individuals with incomplete spinal cord injury.

Individuals with incomplete spinal cord injury (iSCI) show altered postural reactions leading to increased risk of falls. To investigate neural correlates underlying this deficit, we assessed the modulation pattern of the Soleus H-reflex in iSCI individuals following unexpected perturbations of a base of support. Ten men with iSCI (AIS D) and 8 age-matched controls (CTRL) stood on a force-platform randomly tilted forward or backward. The center of pressure (CoP) excursion, 95% confidence ellipse area and electromyographic (EMG) activity of the Soleus (SOL) and Tibialis Anterior (TA) muscles were analyzed. SOL H-reflex amplitude was assessed by stimulating the tibial nerve prior to and at 100, 150 and 200ms following perturbation onset. Although SOL and TA short-latency EMG responses were comparable in both groups, long-latency EMG responses occurred later in the iSCI group for both directions: during backward tilt, a decrease in H-reflex amplitude was observed at all stimulus timings post-tilt in CTRL, but only at 200ms in iSCI. The decrease in H-reflex amplitude was smaller in iSCI participants. During forward tilt, an increase in H-reflex amplitude was observed at 150 and 200ms in the CTRL group, but no increase was observed in the iSCI group. Decreased and delayed SOL H-reflex amplitude modulation in the iSCI group accompanied impaired balance control as assessed clinically with the Berg Balance Scale and biomechanically through CoP displacement. Overall, delayed and reduced spinal reflex processing may contribute to impaired balance control in people with iSCI.

Specific modulation of corticomuscular coherence during submaximal voluntary isometric, shortening and lengthening contractions

During voluntary contractions, corticomuscular coherence (CMC) is thought to reflect a mutual interaction between cortical and muscle oscillatory activities, respectively measured by electroencephalography (EEG) and electromyography (EMG). However, it remains unclear whether CMC modulation would depend on the contribution of neural mechanisms acting at the spinal level. To this purpose, modulations of CMC were compared during submaximal isometric, shortening and lengthening contractions of the soleus (SOL) and the medial gastrocnemius (MG) with a concurrent analysis of changes in spinal excitability that may be reduced during lengthening contractions. Submaximal contractions intensity was set at 50% of the maximal SOL EMG activity. CMC was computed in the time–frequency domain between the Cz EEG electrode signal and the unrectified SOL or MG EMG signal. Spinal excitability was quantified through normalized Hoffmann (H) reflex amplitude. The results indicate that beta-band CMC and normalized H-reflex were significantly lower in SOL during lengthening compared with isometric contractions, but were similar in MG for all three muscle contraction types. Collectively, these results highlight an effect of contraction type on beta-band CMC, although it may differ between agonist synergist muscles. These novel findings also provide new evidence that beta-band CMC modulation may involve spinal regulatory mechanisms.

Effects of intermittent claudication due to arterial disease on pain-free gait

IntroductionStudies of intermittent claudication gait report inconsistent outcomes. Changes in gait are often attributed to degradation of calf muscles, but causation has not been proven through real-time electromyographic data. Neither have effects of walking speed been fully considered. This study aimed to investigate the effect of intermittent claudication on kinematics, kinetics and muscle activity during pain-free gait. Methods18 able bodied individuals and 18 with intermittent claudication walked at their preferred speed while lower limb kinematic, kinetic and electromyography data were collected. FindingsPeople with intermittent claudication walk slower and with reduced step length. Internal ankle plantarflexion moment (P = 0.004, effect size = 0.96) and ankle power generation (P < 0.001, effect size = 1.36) in late stance were significantly reduced for individuals with intermittent claudication. Significant moment and power reductions at the knee and power reduction at hip occurred in early stance, with similar reductions in early and late stance for ground reaction forces. Peak electromyography of soleus activity was significantly reduced in late stance (P = 0.01, effect size = 1.1, n = 13). Effects were independent of walking speed. InterpretationReductions in ankle plantarflexion moments and power generation were consistent with reduced soleus electromyography activity and reduced peak vertical ground reaction forces during late stance. These effects are not due to a reduced walking speed. Changes in knee and hip function are also unrelated to walking speed. These outcomes provide a platform for the design and evaluation of interventions that seek to restore normal walking and improve pain-free walking distances for people with intermittent claudication.

Design of a Passive Gait-based Ankle-foot Exoskeleton with Self-adaptive Capability

Propulsion during push-off is the key to realizing human locomotion. Humans have evolved a way of walking with high energy utilization, but it can be further improved. Drawing inspiration from the muscle-tendon unit, a passive spring-actuated ankle-foot exoskeleton is designed to assist with human walking and to lengthen walking duration by mechanically enhancing walking efficiency. Detection of the gait events is realized using a smart clutch, which is designed to detect the contact states between the shoe sole and the ground, and automatically switch its working state. The engagement of a suspended spring behind the human calf muscles is hence controlled and is in synchrony with gait. The device is completely passive and contains no external power source. Energy is stored and returned passively using the clutch. In our walking trials, the soleus electromyography activity is reduced by as much as 72.2% when the proposed ankle-foot exoskeleton is worn on the human body. The influence of the exoskeleton on walking habits is also studied. The results show the potential use of the exoskeleton in humans’ daily life.

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy.

Individuals with neuromuscular impairment from conditions like cerebral palsy face reduced quality of life due to diminishing mobility and independence. Lower-limb exoskeletons have potential to aid mobility, yet few studies have investigated their use during over-ground walking - an exercise that may contribute to our understanding of potential benefit in free-living settings. The goal of this study was to determine the potential for adaptive plantar-flexor assistance from an untethered ankle exoskeleton to improve over-ground walking economy and speed. Six individuals with cerebral palsy completed three consecutive daily over-ground training sessions to acclimate to, and tune, assistance. During a final assessment visit, metabolic cost, walking speed, and soleus electromyography were collected for baseline, unpowered, low, training-tuned, and high assistance conditions. Compared to each participant's baseline condition, we observed a 3.9 ± 1.9% (p = 0.050) increase in walking speed and a 22.0 ± 4.5% (p = 0.002) reduction in soleus activity with training-tuned assistance; metabolic cost of transport was unchanged (p = 0.130). High assistance resulted in an 8.5 ± 4.0% (p = 0.042) reduction in metabolic cost of transport, a 6.3 ± 2.6% (p = 0.029) increase in walking speed, and a 25.0 ± 4.0% (p < 0.001) reduction in soleus activity. Improvement in exoskeleton-assisted walking economy was related to pre-training baseline walking speed ( [Formula: see text], p = 0.001); the slower and more impaired participants improved the most. Energy cost and preferred walking speed remained generally unchanged for the faster and less impaired participants. These findings demonstrate that powered ankle exoskeletons have the potential to improve mobility-related outcomes for some people with cerebral palsy.

Effect of functional electrical stimulation of the peroneal nerve on antagonist resistances measured during swing phase of gait in spastic paresis. A randomized, controlled study

In hemiparesis, functional electrical stimulation (FES) of the peroneal nerve aims to compensate for ankle dorsiflexor paresis in swing phase. The present prospective study compared the effects of gait training with FES vs. conventional therapy on plantar flexor overactivity. Twenty subjects with chronic hemiparesis (6 ± 4years post-lesion; mean ± SD) were randomized into two groups: FES (45 min/day of gait self-training using FES) and Control (CON, 3 × 45 min/week of conventional physiotherapy) for 10 weeks. Outcomes at Day 1 and Week 10 included comfortable speed barefoot gait analysis with gastrocnemius medialis (GM) and soleus (SO) electromyography, yielding:, walking speed; and, at the paretic ankle: maximal passive dorsiflexion during stance, maximal active dorsiflexion during swing, velocity of active dorsiflexion over early swing, coefficient of spastic cocontraction in GM and SO over the three thirds of swing (CSC, calculated by the ratio of the RMS of the electromyogram in the period of interest over the RMS of the electromyogram of the same muscle over 100 ms around its maximal voluntary contraction). Intra- and inter-group comparison used rank-ANOVAs. No difference was observed in walking speed changes (both groups pooled; D1, 0.73 ± 0.25 m/s, W10, 0.80 ± 0.30 m/s, ns) and in passive and active dorsiflexion amplitudes (ns). However, the velocity of active dorsiflexion increased in FES while it decreased in Controls (D1 vs. W10, FES, +5 ± 2°/s, P = 0.02; CON, −4 ± 1°/s, P = 0.04). In parallel, CSC GM in early swing tended to improve in FES only (FES, −41 ± 23%, P = 0.09; CON, −24 ± 89%, ns; between group difference ns). In chronic hemiparesis, FES, which focuses on agonist dorsiflexor stimulation during gait improves active dorsiflexion velocity in swing and may also be associated with reduction of plantar flexor spastic cocontraction. Further studies are required to confirm these findings and evaluate whether reciprocal inhibition toward plantar flexors may be restored by FES.

Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy.

Exaggerated sensory activity has been assumed to contribute to functional impairment following lesion of the central motor pathway. However, recent studies have suggested that sensory contribution to muscle activity during gait is reduced in stroke patients and children with cerebral palsy (CP). We investigated whether this also occurs in CP adults and whether daily treadmill training is accompanied by alterations in sensory contribution to muscle activity. Seventeen adults with CP and 12 uninjured individuals participated. The participants walked on a treadmill while a robotized ankle-foot orthosis applied unload perturbations at the ankle, thereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were obtained after 6 wk of gait training. We found that sensory contribution to soleus EMG activation was reduced in CP adults compared with uninjured adults. The lowest contribution of sensory feedback was found in participants with lowest maximal gait speed. This was related to increased ankle plantar flexor stiffness. Six weeks of gait training did not alter the contribution of sensory feedback. We conclude that exaggerated sensory activity is unlikely to contribute to impaired gait in CP adults, because sensory contribution to muscle activity during gait was reduced compared with in uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait so that a larger part of plantar flexor muscle activity must be generated by descending motor commands.NEW & NOTEWORTHY Findings suggest that adults with cerebral palsy have less contribution of sensory feedback to ongoing soleus muscle activation during push-off than uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait, and/or sensory feedback is less integrated with central motor commands in the activation of spinal motor neurons. Consequently, muscle activation must to a larger extent rely on descending drive, which is already decreased because of the cerebral lesion.

The effects of foot cooling on postural muscle responses to an unexpected loss of balance

The purpose of this study was to examine the role of foot sole somatosensory information during reactive postural control. Twenty young adults (22.0±1.4y) participated in this study. Baseline skin sensitivity from the foot sole was assessed using Semmes-Weinstein monofilaments. Postural muscle responses, in the form of electromyographic (EMG) onset latencies and amplitudes, were then obtained while participants recovered their balance while standing on a moveable platform that could translate in either the forward or backward direction. Following these baseline measures, the participant’s foot soles were immersed in a 0–2°C ice-water bath for 12min followed by a 3min re-immersion period. At the completion of foot cooling, foot sole sensitivity and postural muscle responses to the balance perturbations were re-assessed. Results indicated that the foot cooling protocol reduced foot sole sensitivity and remained reduced throughout the duration of the experiment (p<0.001). The reduction in foot sole somatosensation resulted in the soleus EMG onset latency being delayed by 3ms (p=0.041) and the soleus and medial gastrocnemius EMG amplitudes increasing by 14–23% (p=0.002–0.036) during the balance perturbation trials. While the magnitude of these results may suggest that foot cooling has a minor functional consequence on reactive postural control, it is likely that the results also reflect the ability of the central nervous system to rapidly adapt to situations with altered somatosensory feedback.

Patellar tendon vibration reduces the increased facilitation from quadriceps to soleus in post-stroke hemiparetic individuals

BackgroundStimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke. ObjectivesTo determine whether vibration of the quadriceps can modify the enhanced heteronymous facilitation of the soleus muscle observed in people with spastic stroke after femoral nerve stimulation and compare post-vibration effects on soleus facilitation in control and stroke individuals. MethodsModulation of voluntary soleus EMG activity induced by femoral nerve stimulation (2×motor threshold) was assessed before, during and after vibration of the patellar tendon in 10 healthy controls and 17 stroke participants. ResultsVoluntary soleus EMG activity was facilitated by femoral nerve stimulation in 4/10 (40%) controls and 11/17 (65%) stroke participants. The level of facilitation was greater in the stroke than control group. Vibration significantly reduced early heteronymous facilitation in both groups (50% of pre-vibration values). However, the delay in recovery of soleus facilitation after vibration was shorter for the stroke than control group. The control condition with the vibrator turned off had no effect on the modulation. ConclusionsPatellar tendon vibration can reduce the facilitation between knee and ankle extensors, which suggests effective presynaptic inhibition but decreased post-activation depression in the lower limb of people after chronic hemiparetic stroke. Further studies are warranted to determine whether such vibration could be used to reduce the abnormal extension synergy of knee and ankle extensors in people after hemiparetic stroke.