Trunk Coordination Research Articles

PARKİNSON HASTALARINDA FARKLI DENGE DURUMLARINA GÖRE GÖVDE KONTROLÜNÜN, EL FONKSİYONUNUN ve EL REAKSİYON ZAMANININ KARŞILAŞTIRILMASI

Objective
 This study aims to compare trunk control, manual dexterity,
 and reaction time according to different balance
 states in people with Parkinson's Disease (PwPD).
 Material and Method
 A total of 25 PwPD, 6 of whom were women, were
 included in the study. Individuals were divided into the
 Moderate-risk group (n=11) and the Low-risk group
 (n=14) according to the Berg Balance Scale (BBS)
 cut-off scores. To evaluate trunk control and functions,
 static and dynamic sitting balance were evaluated
 with the Trunk Impairment Scale (TIS), which
 consists of trunk coordination sub-parameters. Hand
 grip strength was measured with the Jamar hand dynamometer,
 manual dexterity was measured bilaterally
 with the Purdue Pegboard Test, and hand reaction
 time was measured bilaterally with the the Ruler Drop
 Test.
 Results
 When the groups were compared for trunk control,
 there was a significant difference in the dynamic sitting
 subparameter and the total score of the trunk impairment
 scale in favor of the low-risk group (p=0.030,
 p=0.005). However, there was no difference between
 the groups in static sitting and coordination sub-parameters
 (p=0.181, p=0.558). There was no difference
 between the groups in the grip strength, dexterity, and
 reaction time of both hands (p>0.05).
 Conclusion
 While the dynamic sitting balance and trunk impairment
 of the moderate-risk balance group was worse
 than the low-risk group, manual dexterity and reaction
 time were similar. Further studies are needed to
 examine manual dexterity for trunk and distal mobility,
 which play a key role in proximal stabilization and balance
 in PwPD.

A Two-Stage Real-Time Optimization Model of Arterial Signal Coordination Based on Reverse Causal-Effect Modeling Approach

The arterial signal coordination is an effective method to improve traffic operational efficiency and reduce vehicle delay. In this paper, a two-stage arterial signal coordination model under dynamic traffic demands is established, and the signal timing and offset are adjusted according to the dynamic traffic demands. The objective is to minimize the expected intersection delay and the overflow of the coordinated direction. In the first stage, a calculation model for intersection signal timing based on phase clearing reliability is proposed by the reverse causal-effect modeling approach, which can calculate the signal timing of each intersection in real time. In the second stage, an offset calculation model is established to achieve the goal of minimizing delay in the coordinated direction, which can calculate the offset of trunk coordination in real time. The concept of phase clearance reliability is introduced in the model, which can dynamically adjust the balance between the coordinated phase and the non-coordinated phase, thus taking the overall control efficiency of intersections into account. We then develop an algorithm to solve the problem and then apply the model and the solution algorithm to an arterial road with three intersections to investigate and compare its performance with the Allsop’s method and the Webster’s method. A comparison between the proposed coordinated two-stage logic and a coordinated actuated logic is also conducted in the case study to show the advantages and disadvantages.

Muscle synergy patterns as altered coordination strategies in individuals with chronic low back pain: a cross-sectional study

BackgroundChronic low back pain (CLBP) is a highly prevalent disease with poorly understood underlying mechanisms. In particular, altered trunk muscle coordination in response to specific trunk tasks remains largely unknown.MethodsWe investigated the muscle synergies during 11 trunk movement and stability tasks in 15 healthy individuals (8 females and 7 males, aged 21. 3 (20.1–22.8) ± 0.6 years) and in 15 CLBP participants (8 females and 7 males, aged 20. 9 (20.2–22.6) ± 0.7 years) by recording the surface electromyographic activities of 12 back and abdominal muscles (six muscles unilaterally). Non-negative matrix factorization was performed to extract the muscle synergies.ResultsWe found six trunk muscle synergies and temporal patterns in both groups. The high similarity of the trunk synergies and temporal patterns in the groups suggests that both groups share the common feature of the trunk coordination strategy. We also found that trunk synergies related to the lumbar erector spinae showed lower variability in the CLBP group. This may reflect the impaired back muscles that reshape the trunk synergies in the fixed structure of CLBP. Furthermore, the higher variability of trunk synergies in the other muscle regions such as in the latissimus dorsi and oblique externus, which were activated in trunk stability tasks in the CLBP group, represented more individual motor strategies when the trunk tasks were highly demanding.ConclusionOur work provides the first demonstration that individual modular organization is fine-tuned while preserving the overall structures of trunk synergies and temporal patterns in the presence of persistent CLBP.

The Effects of Trunk Impairment on Fatigue and Balance in Children with Cerebral Palsy.

Cerebral palsy (CP) involves trunk impairment, leading to decreased postural control that is an important contributor to problems maintaining daily activities without undue fatigue. Our aim in this research was to determine the effects of trunk impairment on fatigue and balance in children with hemiplegic CP. We included 65 ambulatory children with CP in this cross-sectional study, and we grouped them into those with greater trunk impairment (Group 1, n = 33) and lesser trunk impairment (Group 2, n = 32) according to their scores on the Trunk Imparment Scale (TIS). We assessed their fatique level using the Pediatric Quality of Life Inventory™ Version 4.0 Multidimensional Fatigue Scale (PedsQL-MFS), and their balance ability using the Pediatric Balance Scale (PBS). We found that the PedsQL-MFS parameters, except the general and cognitive fatigue scores, were significantly better for participants in Group 2 than in Group 1; however Group 2 showed significantly higher scores for balance ability than did Group 1 (p < .001). All of the TIS parameters were significantly correlated with sleep/rest fatigue, and PBS scores and trunk coordination were also significantly correlated with general fatigue (p = .013) and cognitive fatigue (p = .003) which are subparameters of the PedsQL-MFS and PBS (p < .001). However static balance was highly and negatively correlated with cognitive fatigue (p < .037).Increased trunk impairment contributed to the exacerbation of fatigue and balance problems in children with hemiplegic CP. Inadequate trunk control was associated with poor sleep and poor resting quality rather than perceived general and cognitive fatigue.

Variability of trunk muscle synergies underlying the multidirectional movements and stability trunk motor tasks in healthy individuals

Muscle synergy analysis is useful for investigating trunk coordination patterns based on the assumption that the central nervous system reduces the dimensionality of muscle activation to simplify movement. This study aimed to quantify the variability in trunk muscle synergy during various trunk motor tasks in healthy participants to provide reference data for evaluating trunk control strategies in patients and athletes. Sixteen healthy individuals performed 11 trunk movement and stability tasks with electromyography (EMG) recording of their spinal and abdominal muscles (6 bilaterally). Non-negative matrix factorization applied to the concatenated EMG of all tasks identified the five trunk muscle synergies (W) with their corresponding temporal patterns (C). The medians of within-cluster similarity defined by scalar products in W and rmax coefficient using the cross-correlation function in C were 0.73–0.86 and 0.64–0.75, respectively, while the inter-session similarities were 0.81–0.96 and 0.74–0.84, respectively. However, the lowest and highest values of both similarity indices were broad, reflecting the musculoskeletal system’s redundancy within and between participants. Furthermore, the significant differences in the degree of variability between the trunk synergies may represent the different neural features of synergy organization and strategies to overcome the various mechanical demands of a motor task.

Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia.

Impaired trunk control is common in neurological disorders; however, trunk control has not been examined in patients with cervical dystonia (CD). Therefore, the primary aim was to compare trunk control between patients with CD and healthy people. The secondary aim was to investigate the relationship between trunk control and balance, functional mobility, and disease severity in patients with CD. ]This cross-sectional study included 32 patients with CD and 32 healthy people. Trunk control was compared using the trunk impairment scale (TIS) that consists of three subscales: static sitting balance, dynamic sitting balance, and trunk coordination between two groups. Balance was assessed using Berg Balance Scale, four square step test, and one-leg stance test. The Timed Up and Go Test was measured to determine functional mobility. Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate disease severity.]></AbstractText> <AbstractText Label="RESULTS"><![CDATA[ Patients with CD demonstrated worse performance on the TIS-total with TIS-dynamic sitting subscale and TIS-trunk coordination subscale (p < 0.001, p < 0.001, and p < 0.001), except for TIS-static sitting subscale (p = 0.078) compared to healthy people. TIS-total scores had moderate to strong correlations with balance, functional mobility, and disease severity (range r between 0.786 and 0.536, p < 0.05 for all). There was no correlation between TIS-total scores and disease severity (p = 0.102). Patients with CD had impaired trunk control, especially in dynamic sitting balance and trunk coordination. Impaired trunk control was also associated with balance and functional mobility but not disease severity. These findings suggest that trunk control deficits should receive attention in the assessment and treatment of patients with CD.

On-Field Biomechanical Assessment of High and Low Dive in Competitive 16-Year-Old Goalkeepers through Wearable Sensors and Principal Component Analysis.

Diving saves are the main duty of football goalkeepers. Few biomechanical investigations of dive techniques have been conducted, none in a sport-specific environment. The present study investigated the characteristics of goalkeepers’ dive in preferred (PS) and non-preferred (nPS) side through an innovative wearables-plus-principal-component analysis (PCA) approach. Nineteen competitive academy goalkeepers (16.5 ± 3.0 years) performed a series of high and low dives on their PS and nPS. Dives were performed in a regular football goal on the pitch. Full-body kinematics were collected through 17 wearable inertial sensors (MTw Awinda, Xsens). PCA was conducted to reduce data dimensionality (input matrix 310,878 datapoints). PCA scores were extracted for each kinematic variable and compared between PS and nPS if their explained variability was >5%. In high dive, participants exhibited greater hip internal rotation and less trunk lateral tilt (p < 0.047, ES > 0.39) in PS than nPS. In low dives, players exhibited greater ipsilateral hip abduction dominance and lower trunk rotation (p < 0.037, ES > 0.40) in PS than nPS. When diving on their nPS, goalkeepers adopted sub-optimal patterns with less trunk coordination and limited explosiveness. An ecological testing through wearables and PCA might help coaches to inspect relevant diving characteristics and improve training effectiveness.

Effect of adding electrical muscle stimulation to trunk control changes in patients hemiparese post stroke

Hemiparesis post stroke often causes balance disorders due to changes in muscle tone, where these changes cause trunk control disorders that can affect static sitting balance, dynamic and trunk coordination. This study is a quasi-experiment with randomized pretest-posttest control group design, aiming to find out the effect of adding electrical muscle stimulation in weight shifting exercise exercises to changes in trunk control of hemiparese post stroke sufferers, carried out with Poly Physiotherapy RSKD. Dadi South Sulawesi Province with a sample of 24 people who fit the inclusion criteria, which were domesticated into 2 groups, namely the treatment group given electrical muscle stimulation and weight shifting exercise exercises and the control group given weight shifting exercises. Based on the wilcoxon test obtained the value of p = 0.002 for static and dynamic sitting balance, as well as the value p = 0.001 for coordination (treatment), and obtained a value of p = 0.002 for static sitting balance and coordination and a value of p = 0.001 for dynamic sitting balance (kontrol) , which means there is a significant influence on both sample groups on trunk control changes.

Task-specific fear influences abnormal trunk motor coordination in workers with chronic low back pain: a relative phase angle analysis of object-lifting

BackgroundPain-related fear influences impaired trunk movement (e.g., limited movement of range and velocity), but it is unclear how fear relates to trunk motor coordination (e.g., a more “in-phase” upper-lower trunk motion pattern). We conducted the present study to: (1) identify the motor coordination pattern of the in-phase upper-lower lumbar movements during the lifting, and (2) determine how pain-related fear is related to the trunk coordination pattern in workers with chronic low back pain (CLBP).MethodsWe examined 31 male workers with CLBP (CLBP group) and 20 healthy controls with no history of CLBP (HC group). The movement task was lifting a box, the weight of which was 10, 30%, or 50% of the subject’s body weight. We used a 3D motion capture system to calculate the mean absolute relative phase angle (MARP) angle as an index of coordination and the mean deviation phase (DP) as an index of variability. We used a numerical rating scale to assess the subjects’ task-specific fear.ResultsThe MARP angle during trunk extension movement in the 50% condition was significantly decreased in the CLBP group compared to the HCs; i.e., the upper lumbar movement was more in-phase with the lower lumbar movement. The hierarchical multiple regression analysis results demonstrated that a decreased MARP angle was associated with high task-specific fear.ConclusionsA more ‘in-phase’ upper-lower lumbar movement pattern was predicted by task-specific fear evoked when performing a work-related activity. Our findings suggest that an intervention for task-specific fear may be necessary to improve an individual’s impaired trunk motor coordination.

Margins of stability and trunk coordination during Nordic walking

Although it has already been demonstrated that Nordic walking has some peculiar biomechanical features with respect to walking, the effects on balance and trunk coordination are still unknown. Our aim here was to compare margins of stability, hip stabilizer muscle activation and scapular-pelvis coordination (mean and variability of continuous relative phase) between walking and two different pole walking techniques (observational design). Eleven Nordic walking instructors were asked to walk at 5.5 km·h−1 on a flat treadmill while 1) walking, 2) Nordic walking and 3) pole walking with just elbow flexion–extension motion allowed and constrained shoulder motion (elbow technique). The 3D movements of limbs and poles were measured by an optoelectronic motion capture system, and gluteus medius activation was measured through surface electromyography. Both techniques using poles show larger mediolateral margins of stability and similar anterior-posterior margins of stability in comparison with walking (p < 0.001). The larger mediolateral margin of stability using poles (conditions 2 and 3) is accompanied by greater trunk coordination stability (greater continuous relative phase variability) than walking. Although the Nordic walking (condition 2) technique results in a similar range of scapular and pelvis transverse rotation, the general pattern of scapular-pelvis coordination was temporally delayed by approximately 20% of the gait cycle in relation to other conditions (1 and 3). In conclusion, Nordic walking provides enhanced mediolateral support and coordination stability of trunk compared with walking, suggesting that it could be proposed as a safer exercise modality than walking.

The Relationship Between Pain-Related Threat and Motor Behavior in Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis.

Although pain-related fear and catastrophizing are predictors of disability in low back pain (LBP), their relationship with guarded motor behavior is unclear. The aim of this meta-analysis was to determine the relationship between pain-related threat (via pain-related fear and catastrophizing) and motor behavior during functional tasks in adults with LBP. This review followed PRISMA guidelines. MEDLINE, Embase, PsychINFO, and CINAHL databases were searched to April 2021. Included studies measured the association between pain-related fear or pain catastrophizing and motor behavior (spinal range of motion, trunk coordination and variability, muscle activity) during movement in adults with nonspecific LBP. Studies were excluded if participants were postsurgery or diagnosed with specific LBP. Two independent reviewers extracted all data. The Newcastle-Ottawa Scale was used to assess for risk of bias. Correlation coefficients were pooled using the random-effects model. Reduced spinal range of motion during flexion tasks was weakly related to pain-related fear (15 studies, r = -0.21, 95% CI = -0.31 to -0.11) and pain catastrophizing (7 studies, r = -0.24, 95% CI = -0.38 to -0.087). Pain-related fear was unrelated to spinal extension (3 studies, r = -0.16, 95% CI = -0.33 to 0.026). Greater trunk extensor muscle activity during bending was moderately related to pain-related fear (2 studies, r = -0.40, 95% CI = -0.55 to -0.23). Pain catastrophizing, but not fear, was related to higher trunk activity during gait (2 studies, r = 0.25, 95% CI = 0.063 to 0.42). Methodological differences and missing data limited robust syntheses of studies examining muscle activity, so these findings should be interpreted carefully. This study found a weak to moderate relationship between pain-related threat and guarded motor behavior during flexion-based tasks, but not consistently during other movements. These findings provide a jumping-off point for future clinical research to explore the advantages of integrated treatment strategies that target both psychological and motor behavior processes compared with traditional approaches.

Establishing the reliability of instrumented trunk impairment assessment methods to enable evidence-based classification in Para swimming

ABSTRACT This study examined the reliability of instrumented trunk assessment methods across two experiments to develop and improve evidence-based classification in Para swimming. Trunk coordination, range of motion (ROM), and strength were assessed in 38 non-disabled participants. Each test battery was completed on two occasions to determine inter-session reliability. Intra-session reliability was also determined in Experiment Two. Absolute agreement of two-way mixed intraclass correlation coefficients (ICC 3,1) was calculated to assess reliability. Standard errors of measurement (SEMs) were also reported to facilitate comparisons between different outcomes. Trunk coordination measures had low-to-moderate reliability (inter-session ICCs = 0.00–0.60; intra-session ICCs = 0.14–0.65) and variable SEMs (5–60%). Trunk ROM demonstrated moderate-to-excellent reliability (inter-session ICCs = 0.61–0.93; intra-session ICCs = 0.87–0.95) and good SEMs (<10%). Trunk strength measures demonstrated good-to-excellent reliability (ICCs = 0.87–0.98) and good SEMs (<10%). The strength values obtained for the load cell and hand-held dynamometer (HHD) were significantly different from each other with the HHD underestimating strength. Modifications provided in Experiment Two improved the reliability of strength and ROM assessments but did not improve coordination measures. Further research involving para swimmers is required to establish the validity of the methods.

Young adults with recurrent low back pain demonstrate altered trunk coordination during gait independent of pain status and attentional demands.

Pain influences both attention and motor behavior. We used a dual-task interference paradigm to investigate (1) alterations in attentional performance, (2) the ability to switch task prioritization, and (3) the effect of attentional demand on trunk coordination during narrow-based walking in and out of a painful episode in individuals with recurrent low back pain (LBP). We tested twenty young adults with LBP both in and out of a painful episode and compared them to twenty matched back-healthy individuals. Participants simultaneously performed a narrow step width matching task and an arithmetic task, with and without instructions to prioritize either task. A motion capture system was used to record kinematic data, and frontal plane trunk coordination was analyzed using vector coding on the thorax and pelvis angles. Single-task performance, dual-task effect, dual-task performance variability, task prioritization switch, and trunk coordination were analyzed using paired t tests or repeated measures two-way ANOVAs. Results indicated that active pain has a detrimental effect on attentional processes, indicated by poorer single-task performance and increased dual-task performance variability for individuals with recurrent LBP. Individuals with LBP, regardless of pain status, were able to switch task prioritization to a similar degree as their back-healthy counterparts. Compared to the control group, individuals with recurrent LBP exhibited a less in-phase, more pelvis-dominated trunk coordination during narrow-based walking, independent of pain status and regardless of attentional manipulations. Thus, altered trunk coordination in persons with LBP appears to be habitual, automatic, and persists beyond symptom duration.

Trunk-pelvic coordination during unstable sitting with varying task demand: A methodological study

Unstable sitting is used commonly to evaluate trunk postural control (TPC), typically via measures based on center-of-pressure (CoP) time series. However, these measures do not directly reflect underlying control/movement strategies. We quantified trunk-pelvis coordination during unstable sitting using vector coding (VC) and correlated such coordination with CoP-based outcomes across varying task demands. Thirteen uninjured individuals (11 male/2 female) sat on an unstable chair at four instability levels, in a random order, defined relative to the individual gravitational gradient (∇G): 100, 75, 60, and 45%∇G. VC assessed trunk-pelvic coordination, and coupling angles classified movements as: 1) anti-phase, 2) in-phase, 3) trunk-phase, or 4) pelvic-phase. With decreasing %∇G (i.e., increasing instability), we found: increased anti-phase movement in the sagittal and frontal planes; decreased in-phase movement in the sagittal and frontal planes; and increased in-phase and pelvic-phase movement in the transverse plane. In the sagittal and frontal planes, we observed significant weak-to-moderate correlations between anti-phase and in-phase movements (0.288 < |ρ| < 0.549). Correlations between CoP-based measures and pelvic-phase and trunk-phase movements were typically weak and/or non-significant (|ρ| < 0.318). VC techniques discriminated between levels of instability during unstable sitting, identifying in-phase coordination (stiffening strategy) at lower instability levels and anti-phase coordination at higher instability levels. Compared to CoP-based measures, trunk coordination outcomes during unstable sitting provide measures of TPC that more directly quantify underlying movement strategies. These results can also serve as a baseline for future work investigating populations with impaired TPC (e.g., individuals with low back pain or limb loss).

Eye–Head–Trunk Coordination While Walking and Turning in a Simulated Grocery Shopping Task

Previous studies argued that body turns are executed in an ordered sequence: the eyes turn first, followed by the head and then by the trunk. The purpose of this study was to find out whether this sequence holds even if body turns are not explicitly instructed, but nevertheless are necessary to reach an instructed distal goal. We asked participants to shop for grocery products in a simulated supermarket. To retrieve each product, they had to walk down and aisle, and then turn left or right into a corridor that led towards the target shelf. The need to make a turn was never mentioned by the experimenter, but it nevertheless was required in order to approach the target shelf. Main variables of interest were the delay between eye and head turns towards the target shelf, as well as the delay between head and trunk turns towards the target shelf. We found that both delays were consistently positive, and that their magnitude was near the top of the range reported in literature. We conclude that the ordered sequence of eye – then head – then trunk turns can be observed not only with a proximal, but also with a distal goal.

Can a simple clinical test demonstrate head-trunk coordination impairment in neck pain?

BackgroundSensorimotor impairment in neck pain sufferers is well established. Recent research has identified impairment in head and trunk co-ordination in this population. Presently, no clinically appropriate testing exists to quantify such impairment. ObjectiveTo determine if a simple and clinically relevant test of head-trunk co-ordination can identify dysfunction in neck pain subjects when compared to healthy controls. Study designCross-sectional observational study. MethodsThirty-one neck pain and 29 healthy control subjects were assessed using head- and chest-mounted lasers with a target positioned 90 cm away. Subjects were required to rotate the trunk at least 45° with the head laser to be kept as accurately as possible in the centre of the target while sitting and standing. Maximal deviation of the head to the left and right of the target's centre with each trunk movement was measured. ResultsThe neck pain group demonstrated significantly greater head deviation from the centre in all but one test direction (p= <0.03). Head deviation to the same side as trunk rotation was larger in the neck pain group for both sitting and standing (p= <0.01). No significant differences existed between testing in sitting and standing. ConclusionDifferences in trunk-head control exist in persons suffering from neck pain compared to healthy individuals, which can be demonstrated using simple equipment suggesting clinical utility of the measure. Performing the task in standing would seem most suitable as it can avoid influence by reduced thoracic mobility. Further research is required to establish the clinical suitability of this test.

Trunk coordination in people with low back pain during goal-directed repetitive sagittal trunk movements

Purpose: Repetitive sagittal trunk movements represent an occupational risk factor leading to cumulative trunk loading which can be associated with the development of low back pain (LBP) (Coenen et al., 2014). A possible mechanism causing an increased loading effect in LBP relates to impaired adaptation of speed control during goal-directed trunk movements (Zhou et al., 2016). This study explored trunk temporal coordination pattern during repetitive goal-directed sagittal trunk movements in LBP people compared to asymptomatic control.

A pilot study on the evaluation of eye, head, and trunk coordination in subjects with chronic whiplash during a target-tracking task - A driving context approach

BackgroundMotor vehicle accidents (MVA) are the most common causes of whiplash injuries. Difficulties with driving and changes in driving behavior are reported by subjects with chronic whiplash associated disorders (WAD). Proper eye and head coordination is required for driving tasks. Disturbances of eye and head coordination were found in these subjects with chronic WAD. ObjectivesThe objective of this pilot study is to evaluate eye, head and trunk coordination in subjects with chronic WAD due to MVA and healthy controls during a target-tracking task using a functionally oriented approach in the context of driving. DesignCross-sectional. MethodThe subjects performed target tracking tasks that reproduced eye and head movements required while driving. Head and trunk motion was captured using a motion capture system and eye movement was captured with an eye-tracker. Response time, time to target, and eye, head, and trunk contribution of movement were measured. Results/findingsSubjects with chronic WAD presented delayed response time and time to reach the targets with both eyes and head compared to the control group, and tended to compensate the lack of neck motion with increased eye motion. ConclusionsThis study shows indications of impairments of eye and head coordination in chronic WAD due to MVA when compared to healthy subjects. These alterations may have implications for driving safety.

Crossed activation of thoracic trunk motoneurons by medullary reticulospinal neurons.

Activation of contralateral muscles by supraspinal neurons, or crossed activation, is critical for bilateral coordination. Studies in mammals have focused on the neural circuits that mediate cross activation of limb muscles, but the neural circuits involved in crossed activation of trunk muscles are still poorly understood. In this study, we characterized functional connections between reticulospinal (RS) neurons in the medial and lateral regions of the medullary reticular formation (medMRF and latMRF) and contralateral trunk motoneurons (MNs) in the thoracic cord (T7 and T10 segments). To do this, we combined electrical microstimulation of the medMRF and latMRF and calcium imaging from single cells in an ex vivo brain stem-spinal cord preparation of neonatal mice. Our findings substantiate two spatially distinct RS pathways to contralateral trunk MNs. Both pathways originate in the latMRF and are midline crossing, one at the level of the spinal cord via excitatory descending commissural interneurons (reticulo-commissural pathway) and the other at the level of the brain stem (crossed RS pathway). Activation of these RS pathways may enable different patterns of bilateral trunk coordination. Possible implications for recovery of trunk function after stroke or spinal cord injury are discussed.NEW & NOTEWORTHY We identify two spatially distinct reticulospinal pathways for crossed activation of trunk motoneurons. Both pathways cross the midline, one at the level of the brain stem and the other at the level of the spinal cord via excitatory commissural interneurons. Jointly, these pathways provide new opportunities for repair interventions aimed at recovering trunk functions after stroke or spinal cord injury.

Effectiveness of Virtual Reality and Visual Feedback on Balance and Leg Function in Children with Cerebral Palsy

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it affects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.