Influence of gait speed on the control of mediolateral dynamic stability during gait initiation

This study investigated the influence of gait speed on the control of mediolateral dynamic stability during gait initiation. Thirteen healthy young adults initiated gait at three self-selected speeds: Slow, Normal and Fast. The results indicated that the duration of anticipatory postural adjustments (APA) decreased from Slow to Fast, i.e. the time allocated to propel the centre of mass (COM) towards the stance-leg side was shortened. Likely as an attempt at compensation, the peak of the anticipatory centre of pressure (COP) shift increased. However, COP compensation was not fully efficient since the results indicated that the mediolateral COM shift towards the stance-leg side at swing foot-off decreased with gait speed. Consequently, the COM shift towards the swing-leg side at swing heel-contact increased from Slow to Fast, indicating that the mediolateral COM fall during step execution increased as gait speed rose. However, this increased COM fall was compensated by greater step width so that the margin of stability (the distance between the base-of-support boundary and the mediolateral component of the “extrapolated centre of mass”) at heel-contact remained unchanged across the speed conditions. Furthermore, a positive correlation between the mediolateral extrapolated COM position at heel-contact and step width was found, indicating that the greater the mediolateral COM fall, the greater the step width. Globally, these results suggest that mediolateral APA and step width are modulated with gait speed so as to maintain equivalent mediolateral dynamical stability at the time of swing heel-contact.     

Effect of local and general fatiguing exercises on disturbed and static postural control

This study compared the effect of local and general fatiguing exercise on disturbed and static postural control performances. Surface electromyography and center of pressure signals were respectively recorded during self-initiated perturbation test and static postural stability test from 7 young male subjects. Local fatiguing exercise was performed using intermittent isometric knee extensions at the level of 40% of maximal voluntary torques. General fatiguing exercise was implemented with rowing ergometer at a speed of 200 ± 5 m/min. Results of disturbed postural tests showed no significant change of anticipatory postural adjustment (APAs) organizations in individual muscles following both fatiguing exercises, but observed larger APAs coactivations in trunk and dorsal muscle pairs following local than general fatiguing exercise, and larger compensatory postural adjustments (CPAs) coactivation in dorsal muscle pair after both fatiguing exercises. In addition, the results of static postural tests indicated efficient static postural stability accompanying the down-weighting of visual input and the up-weighting of vestibular/somatosensory component following both fatiguing exercises. These findings evidenced a general compensation in the central nervous system in response to the neuromuscular deficiencies induced by local fatiguing exercise and put forward the function of sensory recalibration in maintaining postural stability under fatigue conditions.     

Use of a backpack alters gait initiation of high school students

We assessed how backpack carriage influences the gait initiation (GI) process in high school students, who extensively use backpacks. GI involves different dynamics from gait itself, while the excessive use of backpacks can result in adverse effects. 117 high school students were evaluated in three experimental conditions: no backpack (NB), bilateral backpack (BB), and unilateral backpack (UB). Two force plates were used to acquire ground reaction forces (GRFs) and moments for each foot separately. Center of pressure (COP) scalar variables were extracted, and statistical parametric mapping analysis was performed over the entire COP/GRFs time series. GI anticipatory postural adjustments (APAs) were reduced and were faster in backpack conditions; medial–lateral COP excursion was smaller in this phase. The uneven distribution of the extra load in the UB condition led to a larger medial–lateral COP shift in the support-foot unloading phase, with a corresponding vertical GRF change that suggests a more pronounced unloading swing foot/loading support foot mechanism. The anterior–posterior GRFs were altered, but the COP was not. A possible explanation for these results may be the forward trunk lean and the center of mass proximity of the base of support boundary, which induced smaller and faster APA, increased swing foot/support foot weight transfer, and increased load transfer to the first step.     

Anticipatory postural adjustments during sitting reach movement in post-stroke subjects

The study assessed the effect of velocity of arm movement on anticipatory postural adjustments (APAs) generation in the contralateral and ipsilateral muscles of individuals with stroke in seating. Ten healthy and eight post-stroke subjects were studied in sitting. The task consisted in reaching an object placed at scapular plane and mid-sternum height at self-selected and fast velocities. Electromyography was recorded from anterior deltoid (AD), upper (UT) and lower trapezius (LT) and latissimus dorsi (LD). While kinematic analysis was used to assess peak velocity and trunk displacement. Differences were found between the timing of APAs on ipsi and contralateral LD and LT in both movement speeds and in ipsilateral UT during movement of the non-affected arm at a self-selected velocity. A delay on the contralateral LD to reach movement with the non-affected arm at fast velocity was also observed. The trunk displacement was greater in post-stroke subjects. Individuals with stroke demonstrated a delay of APAs in the muscles on both sides of the body compared to healthy subjects. The delay was observed during performance of the reaching task with the fast and self-selected velocity.     

Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand-to-sit in post-stroke vs. healthy subjects

Introduction. Sit-to-stand (SitTS) and stand-to-sit (StandTS) are very important functional tasks that become compromised in stroke patients. As in other voluntary movements, they require an adequate postural control (PC) involving the generation of anticipatory postural adjustments (APAs). In order to give clues for more efficient and directed rehabilitation programs, a deeper knowledge about APAs during challenging and daily life movements is essential.

Purpose. To analyze the activation timing of tibialis anterior (TA) and soleus (SOL) muscles during SitTS and StandTS in healthy subjects and in post-stroke patients.

Methods. Two groups participated in this study: one composed of ten healthy subjects and the other by ten subjects with a history of stroke and increased H-reflex. Electromyographic activity (EMGa) of SOL and TA was analyzed during SitTS and StandTS in the ipsilateral (IPSI) and the contralateral (CONTRA) limb to the side lesion in stroke subjects, and in one limb in healthy subjects. A force plate was used to identify the movement onset.

Results. In both sequences, in the stroke group SOL activation timing occurred prior to movement onset, contrary to the pattern observed in the healthy subjects. Statistically significant differences were found in SOL activation timings between each lower limb of the stroke and healthy groups, but no significant differences were found between the IPSI and the CONTRA limb. The TA activation timing seems to be delayed in the CONTRA limb when compared to the healthy subjects and showed a better organization of TA timing activation in StandTS when compared to SitTS.

Conclusion. Compared to healthy subjects, APAs seem to be altered in both limbs of the post-stroke subjects, with the SOL activation timing being anticipated in both SitTS and StandTS.     

Rhythmic movement and rhythmic auditory cues enhance anticipatory postural adjustment of gait initiation

Abstract

The purpose of this study was to determine whether the rhythmic movements or cues enhance the anticipatory postural adjustment (APA) of gait initiation. Healthy humans initiated gait in response to an auditory start cue (third cue). A first auditory cue was given 8?s before the start cue, and a second auditory cue was given 3?s before the start cue. The participants performed the rhythmic medio-lateral weight shift (ML-WS session), rhythmic anterior-posterior weight shift (AP-WS session), or rhythmic arm swing (arm swing session) in the time between the first and second cues. In the rhythmic cues session, rhythmic auditory cues with a frequency of 1?Hz were given in this time. In the stationary session, the participants maintained stationary stance in this time. The APA and initial step movement preceded by those rhythmic movements or cues were compared with those in the stationary session. The temporal characteristics of the initial step movement of the gait initiation were not changed by the rhythmic movements or cues. The medio-lateral displacement of the APA in the ML-WS and arm swing sessions was significantly greater than that in the stationary session. The anterior–posterior displacement of the APA in the rhythmic cues and arm swing sessions was significantly greater than that in the stationary session. Taken together, the rhythmic movements and cues enhance the APA of gait initiation. The present finding may be a clue or motive for the future investigation for using rhythmic movements or cues as the preparatory activity to enlarge the small APA of gait initiation in the patients with Parkinson’s disease.     

Anticipatory postural adjustments in children with hemiplegia and diplegia

Anticipatory postural adjustments (APAs) play an important role in the performance of many activities requiring the maintenance of standing posture. However, little is known about if and how children with cerebral palsy (CP) generate APAs. Two groups of children with CP (hemiplegia and diplegia) and a group of children with typical motor development performed arm flexion and extension movements while standing on a force platform. Electromyographic activity of six trunk and leg muscles and displacement of center of pressure (COP) were recorded. Children with CP were able to generate anticipatory postural adjustments and produce directionally specific APAs and COP displacements similar to those described in adults and typically developing children. However, children with diplegia were unable to generate APAs of the same magnitude as children with typical development and hemiplegia and had higher baseline muscle activity prior to movement. In children with diplegia, COP was posteriorly displaced and peak acceleration was smaller during bilateral extension compared to children with hemiplegia. The outcomes of the study highlight the role of APAs in the control of posture of children with CP and point out the similarities and differences in anticipatory control in children with diplegia and hemiplegia. These differences may foster ideas for treatment strategies to enhance APAs in children with CP.     

Muscular fatigue during repeated isokinetic shoulder forward flexions in young females

Peak torque, work, mean power and electromyographic (EMG) activity were recorded for each of 150 repeated isokinetic maximal shoulder flexions (45 degrees-90 degrees) in 23 healthy females. From the EMG signals of trapezius, deltoid, infraspinatus and biceps brachii the mean power frequency and the signal amplitude were determined in real time. The mechanical output showed a steep decrease during the first 40 contractions, followed by a plateau maintained until the end. In all muscles, except the biceps brachii, significant decreases in mean power frequency occurred during the first 40 contractions, showing a tendency to stabilize around the same absolute frequency value. Signal amplitude increased in the trapezius, the deltoid and the infraspinatus, but was constant in the biceps brachii. For some individuals rather high EMG activity was recorded in the muscles during the time the arm was supposed to be passively extended to the starting position, and this was found to be associated with lower strength and endurance levels. Longitudinal analyses showed that the mean power frequencies correlated better than the signal amplitudes with the three mechanical variables. The results suggest that the initial steep decrease in mechanical performance and mean power frequency is caused by fatiguing of type 2 motor units.     

The effect of short-term changes in body mass distribution on feed-forward postural control

It was recently shown that short-term changes in the whole body mass and associated changes in the vertical position of the center of mass (COM) modify anticipatory postural adjustments (APAs) [Li X, Aruin AS. The effect of short-term changes in the body mass on anticipatory postural adjustments. Exp Brain Res 2007;181:333–46]. In this study, we investigated whether changes in the body mass distribution and related changes in the anterior–posterior COM position affect APA generation. Fourteen subjects were instructed to catch a 2.2 kg load with their arms extended while standing with no additional weight or while carrying a 9.08 kg weight. Adding weight to a backpack, front pack or belly pocket was associated with an increase of the whole body mass, but it also involved changes in the anterior–posterior (A/P) and vertical positions of the COM. Electromyographic activity of leg and trunk muscles, body kinematics, and ground reaction forces were recorded and quantified within the typical time intervals of APAs. APAs were modified in conditions with changed body mass distribution: increased magnitude of anticipatory EMG activity in leg and trunk muscles, as well as co-activation of leg muscles and decreased anticipatory displacement of the COM in the vertical direction, were seen in conditions with increased body mass. Changes in the COM position induced in both A/P and vertical directions were associated with increased anticipatory EMG activity. In addition, they were linked to a co-activation of muscles at the ankle joints and significant changes in the center of pressure (COP) position. Modifications of the COM position induced in the A/P direction were related to increased anticipatory EMG activity in the leg and trunk muscles. At the same time, no significant differences in anticipatory EMG activity or displacement of COP were observed when changes of COM position were induced in the vertical direction. The study outcome suggests that the CNS uses different strategies while generating APAs in conditions with changes in the COM position induced in the anterior–posterior and vertical directions.     

The effect of ammonium chloride and sodium bicarbonate ingestion on the physical working capacity at the fatigue threshold

The purpose of this investigation was to examine the effect of ammonium chloride (NH4Cl) and sodium bicarbonate (NaHCO3) ingestion on the physical working capacity at the fatigue threshold (PWCFT). Eighteen adult males (mean age, SD = 23, 2 years) volunteered for two experiments (experiment 1, n = 9; experiment 2, n = 9). In both experiments, the subjects orally ingested 0.3 g.kg-1 body weight of NH4Cl and NaHCO3 over a 3-h period in random order on days separated by 72 h or more. In experiment 1, following ingestion of the substance, the subjects performed a discontinuous incremental cycle ergometer test to the onset of PWCFT which was estimated from integrated electromyography voltages at the vastus lateralis muscle. In experiment 2, the subjects performed a continuous PWCFT test. The results of these experiments indicated that NH4Cl and NaHCO3 ingestion had no significant (P greater than 0.05) effect on PWCFT (experiment 1: NH4Cl = 257, SD 26 W; NaHCO3 = 256, SD 22 W; t = 0.06; r = 0.866; experiment 2: NH4Cl = 231, 14 W; NaHCO3 = 216, 16 W; t = 1.78; r = 0.857).     

Biomechanical and structural response of healing Achilles tendon to fatigue loading following acute injury

Achilles tendon injuries affect both athletes and the general population, and their incidence is rising. In particular, the Achilles tendon is subject to dynamic loading at or near failure loads during activity, and fatigue induced damage is likely a contributing factor to ultimate tendon failure. Unfortunately, little is known about how injured Achilles tendons respond mechanically and structurally to fatigue loading during healing. Knowledge of these properties remains critical to best evaluate tendon damage induction and the ability of the tendon to maintain mechanical properties with repeated loading. Thus, this study investigated the mechanical and structural changes in healing mouse Achilles tendons during fatigue loading. Twenty four mice received bilateral full thickness, partial width excisional injuries to their Achilles tendons (IACUC approved) and twelve tendons from six uninjured mice were used as controls. Tendons were fatigue loaded to assess mechanical and structural properties simultaneously after 0, 1, 3, and 6 weeks of healing using an integrated polarized light system. Results showed that the number of cycles to failure decreased dramatically (37-fold, p<0.005) due to injury, but increased throughout healing, ultimately recovering after 6 weeks. The tangent stiffness, hysteresis, and dynamic modulus did not improve with healing (p<0.005). Linear regression analysis was used to determine relationships between mechanical and structural properties. Of tendon structural properties, the apparent birefringence was able to best predict dynamic modulus (R²=0.88–0.92) throughout healing and fatigue life. This study reinforces the concept that fatigue loading is a sensitive metric to assess tendon healing and demonstrates potential structural metrics to predict mechanical properties.     

The reliability of determining the onset of medial gastrocnemius muscle activity during a stretch-shorten-cycle action

The instant at which a muscle increases its level of activity from baseline represents the onset of muscle activity. Accurate identification of muscle onset allows determination of temporal and amplitude characteristics of the surface electromyography (sEMG) signal. This investigation determined the intra- and inter-tester reliability for determining the onset of medial gastrocnemius (MG) activity using visual and automated methods. One hundred hop cycles, performed at 2.2 Hz, were selected from sEMG recordings (bandpass filtered 50–500 Hz and full wave rectified) of ten participants who performed three trials of single-leg hopping. The onset of MG muscle activity was identified by 3 separate investigators on two separate occasions and an automated method (10% of the peak activation amplitude). The duration of the anticipatory period, from muscle onset to initial ground contact, was then determined. Intra-tester (ICC from 0.72 to 0.95) and inter-tester reliability (ICC from 0.70 to 0.88) were high as was comparison to the automated method (ICC = 0.90). These findings indicate that visual onset detection was highly reproducible between testing sessions, independent investigators and comparable to an automated method. These methods may be used reliably to determine the onset of MG muscle activity during a stretch-shorten-cycle muscle action.     

Agonist and antagonist muscle activation during maximal and submaximal isokinetic fatigue tests of the knee extensors

The purpose of this study was to examine the differences in electromyographic activity of agonist and antagonist knee musculature between a maximal and a submaximal isokinetic fatigue protocol. Fourteen healthy males (age: 24.3 ± 2.5 years) performed 25 maximal (MIFP) and 60 submaximal (SIFP) isokinetic concentric efforts of the knee extensors at 60° s⁻¹, across a 90° range of motion. The two protocols were performed a week apart. The EMG activity of vastus medialis (VM), vastus lateralis (VL) and biceps femoris (BF) were recorded using surface electrodes. The peak torque (PT) and average EMG (aEMG) were expressed as percentages of pre-fatigue maximal value. One-way analysis of variance indicated a significant (p < 0.05) decline of PT during the maximal (45.7%) and submaximal (46.8%) protocols. During the maximal test, the VM and VL aEMG initially increased and then decreased. In contrast, VM and VL aEMG continuously increased during submaximal testing (p < 0.05). The antagonist (BF) aEMG remained constant during maximal test but it increased significantly and then declined during the submaximal testing. The above results indicate that agonist and antagonist activity depends on the intensity of the selected isokinetic fatigue test.     

Anticipation mechanism in body sway control and effect of muscle fatigue

The aim of this work is to quantify the occurrence of an anticipatory mechanism in the control of quiet standing by measuring the lag between the myoelectric activity of the lateral gastrocnemius muscle and the stabilometric signal, as well as to determine the influence of the muscle fatigue on this process. Stabilometric and electromyographic (EMG) signals were synchronously collected from 22 subjects. Gastrocnemius fatigue was induced by a sustained plantar flexed posture until muscle failure. The data acquisition lasted for 120 s before and after the induced fatigue. After mean removal, the root mean square values of the EMG (RMS-EMG) were calculated for each 20 ms period. The normalized cross-correlation function was estimated to find the time delay between RMS-EMG and stabilometric signals. Anticipation values up to 1.62 s were found both before and after fatigue conditions (p < 0.05), indicating that this mechanism plays an important role in body sway control. The fatigue caused a significant increase in the latency between the myoelectric activity of the gastrocnemius muscle and the movements of the center of pressure (p < 0.05).     

Time course of changes in torque and neuromuscular parameters during a sustained isometric forearm flexion task to fatigue anchored to a constant rating of perceived exertion

Objective:This study examined the time course of changes in torque and electromyographic (EMG) and mechanomyographic (MMG) responses during a sustained isometric task anchored to a constant perception of exertion (RPE).Methods:Twelve college-aged men performed an isometric forearm flexion task to failure anchored to RPE=7 (OMNI-RES scale). The amplitude (AMP) and frequency (MPF) of the EMG and MMG signals from the biceps brachii were recorded. Repeated measures ANOVAs were used to examine differences for the normalized (%MVIC) torque and neuromuscular parameters.Results:The time to task failure (TTF) was 678.0±468.1s. Torque decreased significantly (p<0.001, η_p²=0.774) across time and all subjects reduced torque to zero. Post-hoc comparisons indicated that the torque values from 20–100% TTF were less than the value at 10% TTF. There were no significant (p>0.05) changes from 10–100% TTF for the EMG and MMG parameters.Conclusion:We hypothesize that RPE was maintained by various mechanisms throughout the task: group III/IV afferent neurons, adequate blood flow, and a combination of reduced contractile efficiency, collective afferent feedback (group III/IV afferents) from muscles involved with forearm flexion, and motivation that resulted in an initial decrease, plateau, and final decline in torque to zero, respectively.     

Quantitative assessment of upper limb muscle fatigue depending on the conditions of repetitive task load

The aim of this study was to discriminate fatigue of upper limb muscles depending on the external load, through the development and analysis of a muscle fatigue index. Muscle fatigue is expressed by a fatigue index based on an amplitude parameter (calculated in the time domain) and a fatigue index based on a frequency parameter (a parameter calculated in the frequency domain). The fatigue index involves a regression function that describes changes in the EMG signal parameter, time elapsing before muscle fatigue and the probability of specific trends in changes in EMG parameters for the population under study.

The experimental study covered a group of 10 young men. During the study, they exerted force at a specific level and for a specific time in 12 load variants. During the study, EMG signals from four muscles of the upper limb were recorded (trapezius pars descendents, biceps brachii caput breve, extensor carpi radialis brevis, flexor carpi ulnaris). For each variant and for each examined muscles, the value of the fatigue index was calculated. Values of that index quantitatively expressed fatigue of a specific muscle in a specific load variant.

A statistical analysis indicated variation in the fatigue of the biceps brachii caput breve, extensor carpi radialis brevis, and flexor carpi ulnaris muscles depending on the external load (load variant) according to the task performed with the upper limb.

The study demonstrated usefulness of the fatigue index in expressing quantitatively muscle fatigue and in discriminating muscle fatigue depending on the external load.     

Kinetic measures of restabilisation during volitional stepping reveal age-related alterations in the control of mediolateral dynamic stability

Research examining age-related changes in dynamic stability during stepping has recognised the importance of the restabilisation phase, subsequent to foot-contact. While regulation of the net ground reaction force (GRF_net) line of action is believed to influence dynamic stability during steady-state locomotion, such control during restabilisation remains unknown. This work explored the origins of age-related decline in mediolateral dynamic stability by examining the line of action of GRF_net relative to the centre of mass (COM) during restabilisation following voluntary stepping. Healthy younger and older adults (n=20 per group) performed three single-step tasks (varying speed and step placement), altering the challenge to stability control. Age-related differences in magnitude and intertrial variability of the angle of divergence of GRF_net line of action relative to the COM were quantified, along with the peak mediolateral and vertical GRF_net components. The angle of divergence was further examined at discrete points during restabilisation, to uncover events of potential importance to stability control. Older adults exhibited a reduced angle of divergence throughout restabilisation. Temporal and spatial constraints on stepping increased the magnitude and intertrial variability of the angle of divergence, although not differentially among the older adults. Analysis of the time-varying angle of divergence revealed age-related reductions in magnitude, with increases in timing and intertrial timing variability during the later phase of restabilisation. This work further supports the idea that age-related challenges in lateral stability control emerge during restabilisation. Age-related alterations during the later phase of restabilisation may signify challenges with reactive control.     

Time–frequency and principal-component methods for the analysis of EMGs recorded during a mildly fatiguing exercise on a cycle ergometer

Electromyographic signals contain the information on muscle activity and have to be frequently averaged, compared, classified or details need to be extracted. A time–frequency analysis, based on wavelets, was previously presented. The analysis transformed an EMG signal into an EMG-intensity-pattern showing the intensities at any point in time for the frequencies filtered out by the wavelets. The purpose of the present study was:

1. to define and apply a new EMG-pattern-space for the analysis of EMG-intensity-patterns; and

2. to determine the variation of EMG-intensity-patterns while getting mildly fatigued by cycling on a cycle-ergometer.

The coordinates spanning the pattern space were principal components of the measured EMG-intensity-patterns. A point in pattern-space thus represented an EMG-intensity-pattern. Fatigue resulted in points moving along a line in pattern space. The line was characterized by an intercept at time 0 and a slope. Thus mild fatigue caused a shift from an initial intensity-pattern representing the intercept to a final intensity-pattern adding gradually larger amounts of the pattern representing the slope. The intensity-pattern of the slope revealed the physiologically important individual strategies for coping with mild fatigue. Changes were observed at different times and at different frequencies during the cycling movement.