Changes in movement variability and task performance during a fatiguing repetitive pointing task

Changes in neuromuscular strategies employed with fatigue during multi-joint movements are still poorly understood. Studies have shown that motor variability of individual joints increases when performing upper limb tasks to fatigue, while movement parameters related to the task goal remain constant. However, how the inter-limb coordination and its variability change during specific movement phases with fatigue is still unclear. The aim of this study was to assess the effects of neck-shoulder fatigue on shoulder and elbow kinematic variabilities, shoulder-elbow coordination and its variability, and endpoint characteristics during different phases of a forward pointing movement. Nineteen healthy young adults continuously performed a repetitive pointing task until fatigue (Borg rating of 8/10). Changes in elbow-shoulder coordination through the movement were assessed using the continuous relative phase and statistical nonparametric mapping methods. At the end of the task, muscle fatigue was evidenced by significant increases in anterior deltoid (+13%) and biceps brachii (+30%) activity. Shoulder horizontal abduction, elbow flexion variability and shoulder-elbow coordination variability were increased with fatigue at different moments of the movement cycle (shoulder: during the first 17% and most of the second half movement, elbow: from 73% to 91%, coordination: almost the whole movement). However, movement timing errors and endpoint spatial variability were mostly preserved, even with fatigue. We showed that increased variability with fatigue is not only observed in the fatigued joint (shoulder), but also in the elbow and shoulder-elbow coordination, and may have a goal of preserving global task performance.     

Adaptive Postural Control for Joint Immobilization during Multitask Performance

Motor abundance is an essential feature of adaptive control. The range of joint combinations enabled by motor abundance provides the body with the necessary freedom to adopt different positions, configurations, and movements that allow for exploratory postural behavior. This study investigated the adaptation of postural control to joint immobilization during multi-task performance. Twelve healthy volunteers (6 males and 6 females; 21–29 yr) without any known neurological deficits, musculoskeletal conditions, or balance disorders participated in this study. The participants executed a targeting task, alone or combined with a ball-balancing task, while standing with free or restricted joint motions. The effects of joint configuration variability on center of mass (COM) stability were examined using uncontrolled manifold (UCM) analysis. The UCM method separates joint variability into two components: the first is consistent with the use of motor abundance, which does not affect COM position (V_UCM); the second leads to COM position variability (V_ORT). The analysis showed that joints were coordinated such that their variability had a minimal effect on COM position. However, the component of joint variability that reflects the use of motor abundance to stabilize COM (V_UCM) was significant decreased when the participants performed the combined task with immobilized joints. The component of joint variability that leads to COM variability (V_ORT) tended to increase with a reduction in joint degrees of freedom. The results suggested that joint immobilization increases the difficulty of stabilizing COM when multiple tasks are performed simultaneously. These findings are important for developing rehabilitation approaches for patients with limited joint movements.     

Cognitive cost of motor reorganizations associated with muscular fatigue during a repetitive pointing task

Muscular fatigue is known to impair motor performance and to catalyse the development of upper limb musculoskeletal disorders. In order to delay the deleterious effects of muscular fatigue, the central nervous system (CNS) employs compensatory strategies. The cognitive cost of such compensatory strategies was assessed in 10 male subjects who alternatively performed two dual-task protocols before and immediately after an exhaustion procedure specific to upper arm abductor musculature. The main motor tasks were an isometric force-matching and a rapid multi-joint pointing. A secondary probe reaction time (RT) task was performed during both protocols and served as an indicator of attentional demands. Overall motor task performance was maintained despite fatigue. Kinematic and electromyographic data revealed that subjects used motor reorganization during the pointing task when fatigued. The RT increased with fatigue in both dual-task protocols, but this increase was significantly higher during the pointing task than during the force-matching task.The results highlight that the motor reorganization used by the CNS under muscular fatigue states require higher attentional demands than the initial motor organization. Finally, the capacity to delay the deleterious effects of muscular fatigue seems to depend on the proportion of cognitive resources available to plan the compensatory motor strategy.     

Adaptations to isolated shoulder fatigue during simulated repetitive work. Part II: Recovery

The shoulder allows kinematic and muscular changes to facilitate continued task performance during prolonged repetitive work. The purpose of this work was to examine changes during simulated repetitive work in response to a fatigue protocol. Participants performed 20 one-minute work cycles comprised of 4 shoulder centric tasks, a fatigue protocol, followed by 60 additional cycles. The fatigue protocol targeted the anterior deltoid and cycled between static and dynamic actions. EMG was collected from 14 upper extremity and back muscles and three-dimensional motion was captured during each work cycle. Participants completed post-fatigue work despite EMG manifestations of muscle fatigue, reduced flexion strength (by 28%), and increased perceived exertion (∼3 times). Throughout the post-fatigue work cycles, participants maintained performance via kinematic and muscular adaptations, such as reduced glenohumeral flexion and scapular rotation which were task specific and varied throughout the hour of simulated work. By the end of 60 post-fatigue work cycles, signs of fatigue persisted in the anterior deltoid and developed in the middle deltoid, yet perceived exertion and strength returned to pre-fatigue levels. Recovery from fatigue elicits changes in muscle activity and movement patterns that may not be perceived by the worker which has important implications for injury risk.     

Experience Does Not Equal Expertise in Recognizing Infrequent Incoming Gunfire: Neural Markers for Experience and Task Expertise at Peak Behavioral Performance

For a soldier, decisions to use force can happen rapidly and sometimes lead to undesired consequences. In many of these situations, there is a rapid assessment by the shooter that recognizes a threat and responds to it with return fire. But the neural processes underlying these rapid decisions are largely unknown, especially amongst those with extensive weapons experience and expertise. In this paper, we investigate differences in weapons experts and non-experts during an incoming gunfire detection task. Specifically, we analyzed the electroencephalography (EEG) of eleven expert marksmen/soldiers and eleven non-experts while they listened to an audio scene consisting of a sequence of incoming and non-incoming gunfire events. Subjects were tasked with identifying each event as quickly as possible and committing their choice via a motor response. Contrary to our hypothesis, experts did not have significantly better behavioral performance or faster response time than novices. Rather, novices indicated trends of better behavioral performance than experts. These group differences were more dramatic in the EEG correlates of incoming gunfire detection. Using machine learning, we found condition-discriminating EEG activity among novices showing greater magnitude and covering longer periods than those found in experts. We also compared group-level source reconstruction on the maximum discriminating neural correlates and found that each group uses different neural structures to perform the task. From condition-discriminating EEG and source localization, we found that experts perceive more categorical overlap between incoming and non-incoming gunfire. Consequently, the experts did not perform as well behaviorally as the novices. We explain these unexpected group differences as a consequence of experience with gunfire not being equivalent to expertise in recognizing incoming gunfire.     

Biomechanical mechanism of lateral trunk lean gait for knee osteoarthritis patients

The biomechanical mechanism of lateral trunk lean gait employed to reduce external knee adduction moment (KAM) for knee osteoarthritis (OA) patients is not well known. This mechanism may relate to the center of mass (COM) motion. Moreover, lateral trunk lean gait may affect motor control of the COM displacement. Uncontrolled manifold (UCM) analysis is an evaluation index used to understand motor control and variability of the motor task. Here we aimed to clarify the biomechanical mechanism to reduce KAM during lateral trunk lean gait and how motor variability controls the COM displacement. Twenty knee OA patients walked under two conditions: normal and lateral trunk lean gait conditions. UCM analysis was performed with respect to the COM displacement in the frontal plane. We also determined how the variability is structured with regards to the COM displacement as a performance variable. The peak KAM under lateral trunk lean gait was lower than that under normal gait. The reduced peak KAM observed was accompanied by medially shifted knee joint center, shortened distance of the center of pressure to knee joint center, and shortened distance of the knee–ground reaction force lever arm during the stance phase. Knee OA patients with lateral trunk lean gait could maintain kinematic synergy by utilizing greater segmental configuration variance to the performance variable. However, the COM displacement variability of lateral trunk lean gait was larger than that of normal gait. Our findings may provide clinical insights to effectively evaluate and prescribe gait modification training for knee OA patients.     

Adaptations to isolated shoulder fatigue during simulated repetitive work. Part I: Fatigue

Upper extremity muscle fatigue is challenging to identify during industrial tasks and places changing demands on the shoulder complex that are not fully understood. The purpose of this investigation was to examine adaptation strategies in response to isolated anterior deltoid muscle fatigue while performing simulated repetitive work. Participants completed two blocks of simulated repetitive work separated by an anterior deltoid fatigue protocol; the first block had 20 work cycles and the post-fatigue block had 60 cycles. Each work cycle was 60 s in duration and included 4 tasks: handle pull, cap rotation, drill press and handle push. Surface EMG of 14 muscles and upper body kinematics were recorded. Immediately following fatigue, glenohumeral flexion strength was reduced, rating of perceived exertion scores increased and signs of muscle fatigue (increased EMG amplitude, decreased EMG frequency) were present in anterior and posterior deltoids, latissimus dorsi and serratus anterior. Along with other kinematic and muscle activity changes, scapular reorientation occurred in all of the simulated tasks and generally served to increase the width of the subacromial space. These findings suggest that immediately following fatigue people adapt by repositioning joints to maintain task performance and may also prioritize maintaining subacromial space width.     

An optimisation-based model for full-body upright reaching movements

An optimal simulation 3D model for full-body upright reaching movements was developed using graphic-based modelling tools (SimMechanics) to generate an inverse dynamics model of the skeleton and using parameterisation methods for a sensory motor controller. The adaptive weight coefficient of the cost function based on the final motor task error (i.e. distance between end-effector and target at the end of movement) was used to correct motor task error and physiological measurements (e.g. joint power, centre of mass displacement, etc.). The output of the simulation models using various cost functions were compared to experimental data from 15 healthy participants performing full-body upright reaching movements. The proposed method can reasonably predict full-body voluntary movements in terms of final posture, joint power, and movement of the centre of mass (COM) using simple algebraic calculations of inverse dynamics and forward kinematics instead of the complicated integrals of the forward dynamics. We found that the combination of several control strategies, i.e. minimising end-effector error, total joint power and body COM produced the best fit of the full-body reaching task.     

Coordination strategies used in stone knapping

Stone tool‐use and manufacture is seen as an important skill during the evolution of our species and recently there has been increased interest in the understanding of perceptual‐motor abilities underlying this skill. This study provides further information with respect to the motor strategies used during stone knapping. Kinematics of the striking arm were recorded in expert and novice knappers while producing flakes of two different sizes. Using Uncontrolled Manifold Analysis, the results showed that knappers structure joint angle movements such that the hammer trajectory variability is minimized across trials, with experts displaying significantly smaller variability compared with novices. Principal component analysis further revealed that a single component captures the complexity of the strike and that the strike is governed by movements of the elbow and the wrist. Analysis of movement velocities indicated that both groups adjusted movement velocities according to flake size although experts used smaller hammer, wrist, and elbow velocities in both flake conditions compared with novices. The results suggest that while the gross striking movement is easy to replicate for a novice knapper, it requires prolonged training before a knapper becomes attuned to the finer details necessary for controlled flaking. © 2013 Wiley Periodicals, Inc.     

Local state space temporal fluctuations: a methodology to reveal changes during a fatiguing repetitive task

The effect of muscular fatigue on temporal and spectral features of muscle activities and motor performance, i.e., kinematics and kinetics, has been studied. It is of value to quantify fatigue related kinematic changes in biomechanics and sport sciences using simple measurements of joint angles. In this work, a new approach was introduced to extract kinematic changes from 2D phase portraits to study the fatigue adaptation patterns of subjects performing elbow repetitive movement. This new methodology was used to test the effect of load and repetition rate on the temporal changes of an elbow phase portrait during a dynamic iso-inertial fatiguing task. The local flow variation concept, which quantifies the trajectory shifts in the state space, was used to track the kinematic changes of an elbow repetitive fatiguing task in four conditions (two loads and two repetition rates). Temporal kinematic changes due to muscular fatigue were measured as regional curves for various regions of the phase portrait and were also expressed as a single curve to describe the total drift behavior of trajectories due to fatigue. Finally, the effect of load and repetition rate on the complexity of kinematic changes, measured by permutation entropy, was tested using analysis of variance with repeated measure design. Statistical analysis showed that kinematic changes fluctuated more (showed more complexity) under higher loads (p=0.014), but did not differ under high and low repetition rates (p=0.583). Using the proposed method, new features for complexity of kinematic changes could be obtained from phase portraits. The local changes of trajectories in epochs of time reflected the temporal kinematic changes in various regions of the phase portrait, which can be used for qualitative and quantitative assessment of fatigue adaptation of subjects and evaluation of the influence of task conditions (e.g., load and repetition rate) on kinematic changes.     

Cortical Mechanisms of Central Fatigue and Sense of Effort

The purpose of this study was to investigate cortical mechanisms upstream to the corticospinal motor neuron that may be associated with central fatigue and sense of effort during and after a fatigue task. We used two different isometric finger abduction protocols to examine the effects of muscle activation and fatigue the right first dorsal interosseous (FDI) of 12 participants. One protocol was intended to assess the effects of muscle activation with minimal fatigue (control) and the other was intended to elicit central fatigue (fatigue). We hypothesized that high frequency repetitive transcranial magnetic stimulation (rTMS) of the supplementary motor area (SMA) would hasten recovery from central fatigue and offset a fatigue-induced increase in sense of effort by facilitating the primary motor cortex (M1). Constant force-sensation contractions were used to assess sense of effort associated with muscle contraction. Paired-pulse TMS was used to assess intracortical inhibition (ICI) and facilitation (ICF) in the active M1 and interhemispheric inhibitory (IHI) was assessed to determine if compensation occurs via the resting M1. These measures were made during and after the muscle contraction protocols. Corticospinal excitability progressively declined with fatigue in the active hemisphere. ICF increased at task failure and ICI was also reduced at task failure with no changes in IHI found. Although fatigue is associated with progressive reductions in corticospinal excitability, compensatory changes in inhibition and facilitation may act within, but not between hemispheres of the M1. rTMS of the SMA following fatigue enhanced recovery of maximal voluntary force and higher levels of ICF were associated with lower sense of effort following stimulation. rTMS of the SMA may have reduced the amount of upstream drive required to maintain motor output, thus contributing to a lower sense of effort and increased rate of recovery of maximal force.     

Two-arm trajectory planning in a manipulation task

This paper addresses the trajectory planning problem for a task which requires positioning and orienting an object firmly grasped by two hands at a visually specified goal configuration in the horizontal plane. The motor task involves three degrees of freedom (two translational and one rotational), and the motions of the arms are constrained by the physical coupling through the held object. Experimentally measured trajectories of two arms in the coordinated positioning/orienting task are presented. The hypothesis that the rotational and translational components of motions are decoupled and independently planned is tested. Two explicit mathematical models to account for the kinematic features of the two-arm motions are formulated, and the predictions of the models are compared with the experimental data. Both models extend the minimum-jerk model to the two-arm coordinated motions case. The trajectories predicted by the models were found to be in qualitative agreement with the experimental data. However, neither model could account for the observed configuration dependence of the motions, nor for some of the properties of the measured velocity components of the motions. Our findings support the idea that the rotational and translational components of two-arm motions in the positioning/orienting task are independently planned in extra-personal space, and are further combined in a hierarchical fashion to produce the observed motions. The tested models may serve as a basis for further investigations of issues pertinent to the generation of two-arm trajectories. Received: 27 March 1995 / Accepted in revised form: 17 September 1996     

Fatigue and muscle activation during submaximal elbow flexion in children with cerebral palsy

The purpose of this study was to investigate whether children with cerebral palsy (CP), like typically developing peers, would compensate for muscle fatigue by recruiting additional motor units during a sustained low force contraction until task failure.Twelve children with CP and 17 typically developing peers performed one submaximal isometric elbow flexion contraction until the task could no longer be sustained at on average 25% (range 10–35%) of their maximal voluntary torque. Meanwhile surface electromyography (EMG) was measured from the biceps brachii and triceps brachii, and acceleration variations of the forearm were detected by an accelerometer. Slopes of the change in EMG amplitude and median frequency and accelerometer variation during time normalised to their initial values were calculated.Strength and time to task failure were similar in both groups. Children with CP exhibited a lower increase in EMG amplitude of the biceps brachii and triceps brachii during the course of the sustained elbow flexion task, while there were no significant group differences in median frequency decrease or acceleration variation increase. This indicates that children with CP do not compensate muscle fatigue with recruitment of additional motor units during sustained low force contractions.     

Electromyographic response is altered during robotic surgical training with augmented feedback

There is a growing prevalence of robotic systems for surgical laparoscopy. We previously developed quantitative measures to assess robotic surgical proficiency, and used augmented feedback to enhance training to reduce applied grip force and increase speed. However, there is also a need to understand the physiological demands of the surgeon during robotic surgery, and if training can reduce these demands. Therefore, the goal of this study was to use clinical biomechanical techniques via electromyography (EMG) to investigate the effects of real-time augmented visual feedback during short-term training on muscular activation and fatigue. Twenty novices were trained in three inanimate surgical tasks with the da Vinci Surgical System. Subjects were divided into five feedback groups (speed, relative phase, grip force, video, and control). Time- and frequency-domain EMG measures were obtained before and after training. Surgical training decreased muscle work as found from mean EMG and EMG envelopes. Grip force feedback further reduced average and total muscle work, while speed feedback increased average muscle work and decreased total muscle work. Training also increased the median frequency response as a result of increased speed and/or reduced fatigue during each task. More diverse motor units were recruited as revealed by increases in the frequency bandwidth post-training. We demonstrated that clinical biomechanics using EMG analysis can help to better understand the effects of training for robotic surgery. Real-time augmented feedback during training can further reduce physiological demands. Future studies will investigate other means of feedback such as biofeedback of EMG during robotic surgery training.     

Modelling of direct motor program learning in fast human arm motions

We propose and simulate a new paradigm for organization of motor control in fast and accurate human arm motions. We call the paradigm direct motor program learning since the control programs are learned directly without knowing or learning the dynamics of a controlled system.The idea is to approximate the dependence of the motor control programs on the vector of the task parameters rather than to use a model of the system dynamics. We apply iterative learning control and scattered data multivariate approximation techniques to achieve the goal. The advantage of the paradigm is that the control complexity depends neither on the order nor on the nonlinearity of the system dynamics.We simulate the direct motor program learning paradigm in the task of point-to-point control of fast planar human arm motions. Simulation takes into account nonlinear arm dynamics, muscle force dynamics, delay in low-level reflex feedback, time dependence of the feedback gains and coactivation of antagonist muscles. Despite highly nonlinear time-variant dynamics of the controlled system, reasonably good motion precision is obtained over a wide range of the task parameters (initial and final positions of the arm). The simulation results demonstrate that the paradigm is indeed viable and could be considered as a possible explanation for the organization of motor control of fast motions.     

Lateral stabilization improves walking in people with myelomeningocele

Muscle weakness and sensory deficits in people with myelomeningocele (MMC) make their walking control a greater challenge. We know little about how people with MMC optimize their walking balance. Recently, researchers have argued that medial-lateral control of gait requires more active neural input than the anterior-posterior direction, which is more passive. Our goal was to investigate the effect of providing external lateral stabilization (ELS) on walking patterns in people with MMC. We examined 12 people with MMC who could perform at least 4-6 independent steps. We found that the normalized step width (SW) was decreased 20% from without stabilizer to with stabilizer, where as the normalized step length (SL) was increased 4.17% from without stabilizer to with stabilizer. The ELS resulted in 25.10% reduction in centre of mass (COM) ranges of motions in the medial-lateral direction and 13.43% reduction in pelvic range of motions in the frontal plane. Our results suggested that by decreasing the medial-lateral control demands in people with MMC, we could improve gait with smaller SW, longer SL as well as reduced COM and pelvic ranges of motion in the frontal plane. In addition, ELS decreased energy cost and muscle co-activation of soleus and vastus lateralis that may help in diminishing the chances of pain and fatigue in people with MMC. Exploring the effect of the ELS provided us information that might be used to increase mobility safety and to develop a superior rehabilitation intervention for people with MMC.     

Population Differences in Postural Response Strategy Associated with Exposure to a Novel Continuous Perturbation Stimuli: Would Dancers Have Better Balance on a Boat?

Central or postural set theory suggests that the central nervous system uses short term, trial to trial adaptation associated with repeated exposure to a perturbation in order to improve postural responses and stability. It is not known if longer-term prior experiences requiring challenging balance control carryover as long-term adaptations that influence ability to react in response to novel stimuli. The purpose of this study was to determine if individuals who had long-term exposure to balance instability, such as those who train on specific skills that demand balance control, will have improved ability to adapt to complex continuous multidirectional perturbations. Healthy adults from three groups: 1) experienced maritime workers (n = 14), 2) novice individuals with no experience working in maritime environments (n = 12) and 3) individuals with training in dance (n = 13) participated in the study. All participants performed a stationary standing task while being exposed to five 6 degree of freedom motions designed to mimic the motions of a ship at sea. The balance reactions (change-in-support (CS) event occurrences and characteristics) were compared between groups. Results indicate dancers demonstrated significantly fewer CS events than novices during the first trial, but did not perform as well as those with offshore experience. Linear trend analyses revealed that short-term adaptation across all five trials was dependent on the nature of participant experience, with dancers achieving postural stability earlier than novices, but later than those with offshore experience. These results suggest that long term previous experiences also have a significant influence on the neural control of posture and balance in the development of compensatory responses.     

American Society of Biomechanics Journal of Biomechanics Award 2018: Adaptive motor planning of center-of-mass trajectory during goal-directed walking in novel environments

To aid in the successful execution of goal-directed walking (discrete movement from a start location to an end target) the central nervous system forms a predictive motor plan. For the motor plan to be effective, it must be adapted in response to environmental changes. Despite motor planning being inherent to goal-directed walking, it is not understood how the nervous system adapts these plans to interact with changing environments. Our objective was to understand how people adapt motor plans of center of mass (COM) trajectory during goal-directed walking in response to a consistent change in environmental dynamics. Participants preformed a series of goal-directed walking trials in a novel environment created by a cable robot that applied a lateral force field to their COM. We hypothesized that participants would adapt to the environment by forming an internal model of their COM trajectory within the force field. Our findings support this hypothesis. Initially, we found COM trajectory significantly deviated in the same direction as the applied field, relative to baseline (no field) (p = 0.002). However, with practice in the field, COM trajectory adapted back to the baseline (p = 0.6). When we unexpectedly removed the field, participants demonstrated after-effects, COM trajectory deviated in the direction opposite of the field relative to baseline (p < 0.001). Our findings suggest that when performing a goal-directed walking task, people adapt a motor plan that predicts the COM trajectory that will emerge from the interaction between a specific set of motor commands and the external environment.     

Shoulder muscle co-ordination during chronic and acute experimental neck-shoulder pain. An occupational pain study

Little is known about the mechanisms leading to chronic neck-shoulder musculoskeletal disorders (MSD). The aim of the present study was to investigate and compare motor function during controlled, low load, repetitive work together with chronic or acute experimental neck-shoulder pain. The clinical study was performed on workers with (n = 12) and without (n = 6) chronic neck-shoulder pain. In the experimental study, experimental muscle pain was induced in healthy subjects by intra-muscular injection of hypertonic saline into the trapezius muscle (n = 10). The assessed parameters related to motor performance were: work task event duration, cutting forces, surface electromyogram (EMG) activity in four shoulder muscles, displacement of the centre of pressure, and arm and trunk 3D movements. For controlled cutting force levels, chronic and acute experimental pain provoked a series of changes: a decreased working rhythm and a protective reorganisation of muscle synergy (experimental study), higher EMG frequency contents which may indicate altered motor unit recruitment, and greater postural activity and a tendency towards increased arm and trunk movements. These pain-related changes can play a role in the development of MSD. The present clinical and experimental study demonstrated similar interactions between motor co-ordination and neck-shoulder pain in occupational settings. We therefore suggest that this experimental model can be used to study mechanisms related to MSD. Information on such modulatory processes may help in the design of new strategies aimed at reducing the development of MSD.