Sensory systems in the control of movement

Biomaterials-Based Technologies in Skeletal Muscle Tissue Engineering

For many clinically prevalent severe injuries, the inherent regenerative capacity of skeletal muscle remains inadequate. Skeletal muscle tissue engineering (SMTE) seeks to meet this clinical demand. With continuous progress in biomedicine and related technologies including micro/nanotechnology and 3D printing, numerous studies have uncovered various intrinsic mechanisms regulating skeletal muscle regeneration and developed tailored biomaterial systems based on these understandings. Here, the skeletal muscle structure and regeneration process are discussed and the diverse biomaterial systems derived from various technologies are explored in detail. Biomaterials serve not merely as local niches for cell growth, but also as scaffolds endowed with structural or physicochemical properties that provide tissue regenerative cues such as topographical, electrical, and mechanical signals. They can also act as delivery systems for stem cells and bioactive molecules that have been shown as key participants in endogenous repair cascades. To achieve bench-to-bedside translation, the typical effect enabled by biomaterial systems and the potential underlying molecular mechanisms are also summarized. Insights into the roles of biomaterials in SMTE from cellular and molecular perspectives are provided. Finally, perspectives on the advancement of SMTE are provided, for which gene therapy, exosomes, and hybrid biomaterials may hold promise to make important contributions.

Corticospinal excitability and reflex modulation in a contralateral non-stretched muscle following unilateral stretching

PURPOSE

Muscle stretching effect on the range of motion (ROM) and force deficit in non-stretched muscle, and the underlying mechanisms, is an ongoing issue. This study aimed to investigate crossover stretching effects and mechanisms on the plantar flexor muscles.

METHODS

Fourteen recreationally active females (n = 5) and males (n = 9) performed six sets of 45-s static stretching (SS) (15-s recovery) to the point of discomfort of the dominant leg (DL) plantar flexors or control (345-s rest). Participants were tested for a single 5-s pre- and post-test maximal voluntary isometric contraction (MVIC) with each plantar flexor muscle and were tested for DL and non-DL ROM. They were tested pre- and post-test (immediate, 10-s, 30-s) for the Hoffman (H)-reflex and motor-evoked potentials (MEP) from transcranial magnetic stimulation in the contralateral, non-stretched muscle.

RESULTS

Both the DL and non-DL-MVIC force had large magnitude, significant (↓10.87%, p = 0.027, pƞ2 = 0.4) and non-significant (↓9.53%, p = 0.15, pƞ2 = 0.19) decreases respectively with SS. The SS also significantly improved the DL (6.5%, p < 0.001) and non-DL (5.35%, p = 0.002) ROM. The non-DL MEP/MMax and HMax/MMax ratio did not change significantly.

CONCLUSION

Prolonged static stretching improved the stretched muscle's ROM. However, the stretched limb's force was negatively affected following the stretching protocol. The ROM improvement and large magnitude force impairment (statistically non-significant) were transferred to the contralateral muscles. The lack of significant changes in spinal and corticospinal excitability confirms that the afferent excitability of the spinal motoneurons and corticospinal excitability may not play a substantial role in non-local muscle's ROM or force output responses.

Muscle force-length dynamics during walking over obstacles indicates delayed recovery and a shift towards more 'strut-like' function in birds with proprioceptive deficit

Recent studies of in vivo muscle function in guinea fowl revealed that distal leg muscles rapidly modulate force and work to stabilize running in uneven terrain. Previous studies focused on running only, and it remains unclear how muscular mechanisms for stability differ between walking and running. Here, we investigated in vivo function of the lateral gastrocnemius (LG) during walking over obstacles. We compared muscle function in birds with intact (iLG) versus self-reinnervated LG (rLG). Self-reinnervation results in proprioceptive feedback deficit due to loss of monosynaptic stretch reflex. We tested the hypothesis that proprioceptive deficit results in decreased modulation of EMG activity in response to obstacle contact, and a delayed obstacle recovery compared with that for iLG. We found that total myoelectric intensity (Etot) of iLG increased by 68% in obstacle strides (S 0) compared with level terrain, suggesting a substantial reflex-mediated response. In contrast, Etot of rLG increased by 31% in S 0 strides compared with level walking, but also increased by 43% in the first post-obstacle (S +1) stride. In iLG, muscle force and work differed significantly from level walking only in the S 0 stride, indicating a single-stride recovery. In rLG, force increased in S 0, S +1 and S +2 compared with level walking, indicating three-stride obstacle recovery. Interestingly, rLG showed little variation in work output and shortening velocity in obstacle terrain, indicating a shift towards near-isometric strut-like function. Reinnervated birds also adopted a more crouched posture across level and obstacle terrains compared with intact birds. These findings suggest gait-specific control mechanisms in walking and running.

Effects of integrated action and sensory observation therapy based on mirror neuron and embodied cognition theory on upper limb sensorimotor function in chronic stroke: a study protocol for a randomised controlled trial

INTRODUCTION

This study protocol aims to explore the effectiveness and neural mechanism of the integration of action observation therapy (AOT) and sensory observation therapy (SOT) for post-stroke patients on upper limb sensorimotor function.

METHODS AND ANALYSIS

This is a single-centre, single-blind, randomised controlled trial. A total of 69 patients with upper extremity hemiparesis after stroke will be recruited and randomly divided into an AOT group, a combined action observation and somatosensory stimulation therapy (AOT+SST) group, and a combined AOT and SOT (AOT+SOT) group in a 1:1:1 ratio. Each group will receive 30 min of daily treatment, five times weekly for 4 weeks. The primary clinical outcome will be the Fugl-Meyer Assessment for Upper Extremity. Secondary clinical outcomes will include the Box and Blocks Test, modified Barthel Index and sensory assessment. All clinical assessments and resting-state functional MRI and diffusion tensor imaging data will be obtained at pre-intervention (T1), post-intervention (T2) and 8 weeks of follow-up (T3).

ETHICS AND DISSEMINATION

The trial was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Chinese Traditional Medicine (Grant No. 2020-178). The results will be submitted to a peer-review journal or at a conference.

TRIAL REGISTRATION NUMBER

ChiCTR2000040568.

Human movement in simulated hypogravity-Bridging the gap between space research and terrestrial rehabilitation

Human movement is optimized to Earth's gravity and based on highly complex interactions between sensory and neuro-muscular systems. Yet, humans are able to adapt-at least partially-to extreme environments upon and beyond Earth's surface. With upcoming Lunar Gateway and Artemis missions, it is crucial to increase our understanding of the impact of hypogravity-i.e., reduced vertical loading-on physiological and sensory-motor performances to improve countermeasure programs, and define crewmember's readiness to perform mission critical tasks. Several methodologies designed to reduce vertical loading are used to simulate hypogravity on Earth, including body weight support (BWS) devices. Countering gravity and offloading the human body is also used in various rehabilitation scenarios to improve motor recovery in neurological and orthopedic impairments. Thus, BWS-devices have the potential of advancing theory and practice of both space exploration and terrestrial rehabilitation by improving our understanding of physiological and sensory-motor adaptations to reduced vertical loading and sensory input. However, lack of standardization of BWS-related research protocols and reporting hinders the exchange of key findings and new advancements in both areas. The aim of this introduction paper is to review the role of BWS in understanding human movement in simulated hypogravity and the use of BWS in terrestrial rehabilitation, and to identify relevant research areas contributing to the optimization of human spaceflight and terrestrial rehabilitation. One of the main aims of this research topic is to facilitate standardization of hypogravity-related research protocols and outcome reporting, aimed at optimizing knowledge transfer between space research and BWS-related rehabilitation sciences.

Spinal inhibitory interneurons: regulators of coordination during locomotor activity

Since the early 1900's it has been known that a neural network, situated entirely within the spinal cord, is capable of generating the movements required for coordinated locomotion in limbed vertebrates. Due the number of interneurons in the spinal cord, and the extent to which neurons with the same function are intermingled with others that have divergent functions, the components of this neural circuit (now referred to as the locomotor central pattern generator-CPG) have long proven to be difficult to identify. Over the past 20 years a molecular approach has been incorporated to study the locomotor CPG. This approach has resulted in new information regarding the identity of its component interneurons, and their specific role during locomotor activity. In this mini review the role of the inhibitory interneuronal populations that have been shown to be involved in locomotor activity are described, and their specific role in securing left-right, and flexor extensor alternation is outlined. Understanding how these interneuronal populations are activated, modulated, and interact with one another will help us understand how locomotor behavior is produced. In addition, a deeper understanding of the structure and mechanism of function of the locomotor CPG has the potential to assist those developing strategies aimed at enhancing recovery of motor function in spinal cord injured patients.

Short-latency stretch reflexes depend on the balance of activity in agonist and antagonist muscles during ballistic elbow movements

The spinal stretch reflex is a fundamental building block of motor function, with a sensitivity that varies continuously during movement and when changing between movement and posture. Many have investigated task-dependent reflex sensitivity, but few have provided simple, quantitative analyses of the relationship between the volitional control and stretch reflex sensitivity throughout tasks that require coordinated activity of several muscles. Here, we develop such an analysis and use it to test the hypothesis that modulation of reflex sensitivity during movement can be explained by the balance of activity within agonist and antagonist muscles better than by activity only in the muscle homonymous with the reflex. Subjects completed hundreds of flexion and extension movements as small, pseudorandom perturbations of elbow angle were applied to obtain estimates of stretch reflex amplitude throughout the movement. A subset of subjects performed a postural control task with muscle activities matched to those during movement. We found that reflex modulation during movement can be described by background activity in antagonist muscles about the elbow much better than by activity only in the muscle homonymous to the reflex (P < 0.001). Agonist muscle activity enhanced reflex sensitivity, whereas antagonist activity suppressed it. Surprisingly, the magnitude of these effects was similar, suggesting a balance of control between agonists and antagonists very different from the dominance of sensitivity to homonymous activity during posture. This balance is due to a large decrease in sensitivity to homonymous muscle activity during movement rather than substantial changes in the influence of antagonistic muscle activity.NEW & NOTEWORTHY This study examined the sensitivity of the stretch reflexes elicited in elbow muscles to the background activity in these same muscles during movement and postural tasks. We found a heightened reciprocal control of reflex sensitivity during movement that was not present during maintenance of posture. These results help explain previous discrepancies in reflex sensitivity measured during movement and posture and provide a simple model for assessing their contributions to muscle activity in both tasks.

Secondary auditory cortex mediates a sensorimotor mechanism for action timing

The ability to accurately determine when to perform an action is a fundamental brain function and vital to adaptive behavior. The behavioral mechanism and neural circuit for action timing, however, remain largely unknown. Using a new, self-paced action timing task in mice, we found that deprivation of auditory, but not somatosensory or visual input, disrupts learned action timing. The hearing effect was dependent on the auditory feedback derived from the animal's own actions, rather than passive environmental cues. Neuronal activity in the secondary auditory cortex was found to be both correlated with and necessary for the proper execution of learned action timing. Closed-loop, action-dependent optogenetic stimulation of the specific task-related neuronal population within the secondary auditory cortex rescued the key features of learned action timing under auditory deprivation. These results unveil a previously underappreciated sensorimotor mechanism in which the secondary auditory cortex transduces self-generated audiomotor feedback to control action timing.

Control of Mammalian Locomotion by Somatosensory Feedback

When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.

Epidural spinal cord stimulation as an intervention for motor recovery after motor complete spinal cord injury

Spinal cord injury (SCI) commonly results in permanent loss of motor, sensory, and autonomic function. Recent clinical studies have shown that epidural spinal cord stimulation may provide a beneficial adjunct for restoring lower extremity and other neurological functions. Herein, we review the recent clinical advances of lumbosacral epidural stimulation for restoration of sensorimotor function in individuals with motor complete SCI and we discuss the putative neural pathways involved in this promising neurorehabilitative approach. We focus on three main sections: review recent clinical results for locomotor restoration in complete SCI; discuss the contemporary understanding of electrical neuromodulation and signal transduction pathways involved in spinal locomotor networks; and review current challenges of motor system modulation and future directions toward integrative neurorestoration. The current understanding is that initial depolarization occurs at the level of large diameter dorsal root proprioceptive afferents that when integrated with interneuronal and latent residual supraspinal translesional connections can recruit locomotor centers and augment downstream motor units. Spinal epidural stimulation can initiate excitability changes in spinal networks and supraspinal networks. Different stimulation parameters can facilitate standing or stepping, and it may also have potential for augmenting myriad other sensorimotor and autonomic functions. More comprehensive investigation of the mechanisms that mediate the transformation of dysfunctional spinal networks to higher functional states with a greater focus on integrated systems-based control system may reveal the key mechanisms underlying neurological augmentation and motor restoration after severe paralysis.

The neural mechanisms of manual dexterity

The hand endows us with unparalleled precision and versatility in our interactions with objects, from mundane activities such as grasping to extraordinary ones such as virtuoso pianism. The complex anatomy of the human hand combined with expansive and specialized neuronal control circuits allows a wide range of precise manual behaviours. To support these behaviours, an exquisite sensory apparatus, spanning the modalities of touch and proprioception, conveys detailed and timely information about our interactions with objects and about the objects themselves. The study of manual dexterity provides a unique lens into the sensorimotor mechanisms that endow the nervous system with the ability to flexibly generate complex behaviour.

Developmental Differences in the Relationships Between Sensorimotor and Executive Functions

Background

There is evidence that sensorimotor and executive functions are inherently intertwined, but that the relationship between these functions differ depending on an individual’s stage in development (e.g., childhood, adolescence, adulthood).

Objective

In this study, sensorimotor and executive function performance was examined in a group of children (n = 40; 8–12 years), adolescents (n = 39; 13–17 years), and young adults (n = 83; 18–24 years) to investigate maturation of these functions, and how the relationships between these functions differ between groups.

Results

Adults and adolescents outperformed children on all sensorimotor and executive functions. Adults and adolescents exhibited similar levels of executive functioning, but adults outperformed adolescents on two sensorimotor functioning measures (eye-hand coordination spatial precision and proprioceptive variability). Regression analysis demonstrated that executive functions contribute to children’s sensorimotor performance, but do not contribute to adolescent’s sensorimotor performance.

Conclusion

These findings highlight the key role that developmental stage plays in the relationship between sensorimotor and executive functions. Specifically, executive functions appear to contribute to more successful sensorimotor function performance in childhood, but not during adolescence. It is likely that sensorimotor functions begin to develop independently from executive functions during adolescence, and therefore do not contribute to successful sensorimotor performance. The change in the relationship between sensorimotor and executive functions is important to take into consideration when developing sensorimotor and executive function interventions.

Unprompted Alteration of Freely Chosen Movement Rate During Stereotyped Rhythmic Movement: Examples and Review

Investigations of behavior and control of voluntary stereotyped rhythmic movement contribute to the enhancement of motor function and performance of disabled, sick, injured, healthy, and exercising humans. The present article presents examples of unprompted alteration of freely chosen movement rate during voluntary stereotyped rhythmic movements. The examples, in the form of both increases and decreases of movement rate, are taken from activities of cycling, finger tapping, and locomotion. It is described that, for example, strength training, changed power output, repeated bouts, and changed locomotion speed can elicit an unprompted alteration of freely chosen movement rate. The discussion of the examples is based on a tripartite interplay between descending drive, rhythm-generating spinal neural networks, and sensory feedback, as well as terminology from dynamic systems theory.

Proprioception in Action: A Matter of Ecological and Social Interaction

The aim of this paper is to provide a theoretical and formal framework to understand how the proprioceptive and kinesthetic system learns about body position and possibilities for movement in ongoing action and interaction. Whereas most weak embodiment accounts of proprioception focus on positionalist descriptions or on its role as a source of parameters for internal motor control, we argue that these aspects are insufficient to understand how proprioception is integrated into an active organized system in continuous and dynamic interaction with the environment. Our strong embodiment thesis is that one of the main theoretical principles to understand proprioception, as a perceptual experience within concrete situations, is the coupling with kinesthesia and its relational constitution—self, ecological, and social. In our view, these aspects are underdeveloped in current accounts, and an enactive sensorimotor theory enriched with phenomenological descriptions may provide an alternative path toward explaining this skilled experience. Following O'Regan and Noë (2001) sensorimotor contingencies conceptualization, we introduce three distinct notions of proprioceptive kinesthetic-sensorimotor contingencies (PK-SMCs), which we describe conceptually and formally considering three varieties of perceptual experience in action: PK-SMCs-self, PK-SMCs-self-environment, and PK-SMC-self-other. As a proof of concept of our proposal, we developed a minimal PK model to discuss these elements in detail and show their explanatory value as important guides to understand the proprioceptive/kinesthetic system. Finally, we also highlight that there is an opportunity to develop enactive sensorimotor theory in new directions, creating a bridge between the varieties of experiences of oneself and learning skills.

Non-local Acute Passive Stretching Effects on Range of Motion in Healthy Adults: A Systematic Review with Meta-analysis

BACKGROUND

Stretching a muscle not only increases the extensibility or range of motion (ROM) of the stretched muscle or joint but there is growing evidence of increased ROM of contralateral and other non-local muscles and joints.

OBJECTIVE

The objective of this meta-analysis was to quantify crossover or non-local changes in passive ROM following an acute bout of unilateral stretching and to examine potential dose-response relations.

METHODS

Eleven studies involving 14 independent measures met the inclusion criteria. The meta-analysis included moderating variables such as sex, trained state, stretching intensity and duration.

RESULTS

The analysis revealed that unilateral passive static stretching induced moderate magnitude (standard mean difference within studies: SMD: 0.86) increases in passive ROM with non-local, non-stretched joints. Moderating variables such as sex, trained state, stretching intensity, and duration did not moderate the results. Although stretching duration did not present statistically significant differences, greater than 240-s of stretching (SMD: 1.24) exhibited large magnitude increases in non-local ROM compared to moderate magnitude improvements with shorter (< 120-s: SMD: 0.72) durations of stretching.

CONCLUSION

Passive static stretching of one muscle group can induce moderate magnitude, global increases in ROM. Stretching durations greater than 240 s may have larger effects compared with shorter stretching durations.

Tuning of feedforward control enables stable muscle force-length dynamics after loss of autogenic proprioceptive feedback

Animals must integrate feedforward, feedback and intrinsic mechanical control mechanisms to maintain stable locomotion. Recent studies of guinea fowl (Numida meleagris) revealed that the distal leg muscles rapidly modulate force and work output to minimize perturbations in uneven terrain. Here we probe the role of reflexes in the rapid perturbation responses of muscle by studying the effects of proprioceptive loss. We induced bilateral loss of autogenic proprioception in the lateral gastrocnemius muscle (LG) using self-reinnervation. We compared in vivo muscle dynamics and ankle kinematics in birds with reinnervated and intact LG. Reinnervated and intact LG exhibit similar steady state mechanical function and similar work modulation in response to obstacle encounters. Reinnervated LG exhibits 23ms earlier steady-state activation, consistent with feedforward tuning of activation phase to compensate for lost proprioception. Modulation of activity duration is impaired in rLG, confirming the role of reflex feedback in regulating force duration in intact muscle.

We Are Upright-Walking Cats: Human Limbs as Sensory Antennae During Locomotion

Humans and cats share many characteristics pertaining to the neural control of locomotion, which has enabled the comprehensive study of cutaneous feedback during locomotion. Feedback from discrete skin regions on both surfaces of the human foot has revealed that neuromechanical responses are highly topographically organized and contribute to "sensory guidance" of our limbs during locomotion.

Elastic tissue forces mask muscle fiber forces underlying muscle spindle Ia afferent firing rates in stretch of relaxed rat muscle

Stretches of relaxed cat and rat muscle elicit similar history-dependent muscle spindle Ia firing rates that resemble history-dependent forces seen in single activated muscle fibers ( Nichols and Cope, 2004). Owing to thixotropy, whole musculotendon forces and muscle spindle firing rates are history dependent during stretch of relaxed cat muscle, where both muscle force and muscle spindle firing rates are elevated in the first stretch in a series of stretch-shorten cycles ( Blum et al., 2017). By contrast, rat musculotendon exhibits only mild thixotropy, such that the measured forces when stretched cannot explain history-dependent muscle spindle firing rates in the same way ( Haftel et al., 2004). We hypothesized that history-dependent muscle spindle firing rates elicited in stretch of relaxed rat muscle mirror history-dependent muscle fiber forces, which are masked at the level of whole musculotendon force by extracellular tissue force. We removed estimated extracellular tissue force contributions from recorded musculotendon force using an exponentially elastic tissue model. We then showed that the remaining estimated muscle fiber force resembles history-dependent muscle spindle firing rates recorded simultaneously. These forces also resemble history-dependent forces recorded in stretch of single activated fibers that are attributed to muscle cross-bridge mechanisms ( Campbell and Moss, 2000). Our results suggest that history-dependent muscle spindle firing in both rats and cats arise from history-dependent forces owing to thixotropy in muscle fibers.

Synergistic influences of sensory and central stimuli on non-voluntary rhythmic arm movements

In recent years, neuromodulation of the cervical spinal circuitry has become an area of interest for investigating rhythmogenesis of the human spinal cord and interaction between cervical and lumbosacral circuitries, given the involvement of rhythmic arm muscle activity in many locomotor tasks. We have previously shown that arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations in unloading body conditions. Here we investigated the excitability of the cervical spinal circuitry by applying different peripheral and central stimuli in healthy humans. The rationale for applying combined stimuli is that the efficiency of only one stimulus is generally limited. We found that low-intensity electrical stimulation of the superficial arm median nerve can evoke rhythmic arm movements. Furthermore, the movements were enhanced by additional peripheral stimuli (e.g., arm muscle vibration, head turns or passive rhythmic leg movements). Finally, low-frequency transcranial magnetic stimulation of the motor cortex significantly facilitated rhythmogenesis. The findings are discussed in the general framework of a brain-spinal interface for developing adaptive central pattern generator-modulating therapies.

Effect of Kinesio taping on Y-balance test performance and the associated leg muscle activation patterns in children with developmental coordination disorder: A randomized controlled trial

BACKGROUND

Children with developmental coordination disorder (DCD) have leg muscular deficits which negatively affects their dynamic postural stability. Kinesio tape (KT) could enhance muscle activation, postural control and functional activities in healthy individuals. Therefore, we hypothesized that the usage of KT may address the postural instability problem of children with DCD.

RESEARCH QUESTION

To investigate the immediate effect of KT on dynamic postural stability and the associated lower limb muscle activity in children with DCD.

METHODS

Forty-nine children with DCD were recruited where twenty-five children were randomly assigned to the KT group (mean age = 8.18 ± 1.16 years) and twenty-four to the control group (mean age = 8.06 ± 0.93 years). KT group received KT application to the rectus femoris and gastrocnemius muscles whereas the control group received no intervention. Measurements were taken before and after the application of KT. Dynamic balance performance was measured using a lower quartile Y-balance test (YBT-LQ). Leg muscle peak activation and time-to-peak muscle activation of the dominant lower limb during YBT-LQ were measured by surface electromyography.

RESULTS

YBT-LQ composite score increased by 6.3% in the KT group at posttest (95% CI: -7.308, -2.480). In addition, a higher rectus femoris peak activation was illustrated for YBT-LQ anterior (32.5%; 95% CI: -48.619, -16.395) and posteromedial (24.6%; 95% CI: -42.631, -6.591) reach directions from pretest values in the KT group. Moreover, KT group exhibited a 38% (95% CI: 0.015, 2.983) longer gastrocnemius medialis time-to-peak duration for YBT-LQ posteromedial reach direction when compared to the control group.

SIGNIFICANCE

KT revealed an immediate beneficial effect on YBT-LQ performance. Application of KT also increased rectus femoris peak activation and lengthened the muscle time-to-peak duration for specific reach directions. Incorporating KT as an adjunct with dynamic balance training programme could be beneficial for children with DCD.

Effect of Kinesio taping on electromyographic activity of leg muscles during gait in children with developmental coordination disorder: A randomized controlled trial

OBJECTIVE

This study aimed to evaluate the effectiveness of Kinesio tape (KT) on lower limb muscle activation pattern in children with developmental coordination disorder (DCD) during walking.

DESIGN

A parallel-group randomized controlled trial.

SETTING

University laboratory setting.

PARTICIPANTS

Twenty-five children with DCD were randomly allocated to the KT group (mean age = 7.97 years) and 24 to the control group (mean age = 8.04 years).

INTERVENTION

KT group received KT application to the quadriceps and gastrocnemius muscles whereas the control group received no intervention.

MEASUREMENTS

Peak muscle activation (in percentage of maximal voluntary isometric contraction [%MVIC]) in the lower limbs during gait was measured by means of surface electromyography, electrogoniometry, and foot contact switches.

RESULTS

Gastrocnemius medialis activation during mid stance (23.46%MVIC, 95% CI = -32.53, -14.39) and late stance phases (3.25%MVIC, 95% CI = -5.67, -0.81) of gait increased after the application of KT in the KT group compared to baseline values. The KT group demonstrated 26.87%MVIC (95% CI = 26.87, 7.11) higher gastrocnemius medialis muscle peak activation during mid stance phase at post-test when compared with the control group. Moreover, gastrocnemius medialis and biceps femoris muscle peak activation during loading response decreased by 8.36%MVIC (95% CI = 2.71, 14.02) and 3.54%MVIC (95% CI = 1.08, 6.01), respectively, in the control group overtime.

CONCLUSIONS

The application of KT on children with DCD had an increased gastrocnemius medialis muscle activation during stance phase. KT could be incorporated into gait re-education programmes to facilitate muscle contraction in these children.

Brain Activation During Passive and Volitional Pedaling After Stroke

Background:

Prior work indicates that pedaling-related brain activation is lower in people with stroke than in controls. We asked whether this observation could be explained by between-group differences in volitional motor commands and pedaling performance.

Methods:

Individuals with and without stroke performed passive and volitional pedaling while brain activation was recorded with functional magnetic resonance imaging. The passive condition eliminated motor commands to pedal and minimized between-group differences in pedaling performance. Volume, intensity, and laterality of brain activation were compared across conditions and groups.

Results:

There were no significant effects of condition and no Group × Condition interactions for any measure of brain activation. Only 53% of subjects could minimize muscle activity for passive pedaling.

Conclusions:

Altered motor commands and pedaling performance are unlikely to account for reduced pedaling-related brain activation poststroke. Instead, this phenomenon may be due to functional or structural brain changes. Passive pedaling can be difficult to achieve and may require inhibition of excitatory descending drive.

Analytical CPG model driven by limb velocity input generates accurate temporal locomotor dynamics

The ability of vertebrates to generate rhythm within their spinal neural networks is essential for walking, running, and other rhythmic behaviors. The central pattern generator (CPG) network responsible for these behaviors is well-characterized with experimental and theoretical studies, and it can be formulated as a nonlinear dynamical system. The underlying mechanism responsible for locomotor behavior can be expressed as the process of leaky integration with resetting states generating appropriate phases for changing body velocity. The low-dimensional input to the CPG model generates the bilateral pattern of swing and stance modulation for each limb and is consistent with the desired limb speed as the input command. To test the minimal configuration of required parameters for this model, we reduced the system of equations representing CPG for a single limb and provided the analytical solution with two complementary methods. The analytical and empirical cycle durations were similar (R 2 = 0.99) for the full range of walking speeds. The structure of solution is consistent with the use of limb speed as the input domain for the CPG network. Moreover, the reciprocal interaction between two leaky integration processes representing a CPG for two limbs was sufficient to capture fundamental experimental dynamics associated with the control of heading direction. This analysis provides further support for the embedded velocity or limb speed representation within spinal neural pathways involved in rhythm generation.

Acoustic and visual pacesetter influence on the energy expenditure in a cycling exercise

BACKGROUND

The aim of this study was to evaluate the effects of acoustic and visual pacesetters on the energy expenditure in a steady state 30-minute long cycling.

METHODS

Eighteen healthy male subjects (age 27.6±4.59 years; height 1.78±0.07 m; body mass 80.1±7.85 kg) performed a 30-minute submaximal exercise at a constant workload on a cycle ergometer. The imposed workload required a metabolic expenditure corresponding to 70% of ventilatory threshold for each subject. Energy expenditure - expressed as a caloric equivalent relative to the total net oxygen consumption during exercise - was evaluated using three conditions: control (CT), no external pacesetter; acoustic (AT), listening to rhythmic acoustic stimuli at 120 beat per minute; and visual (VT), seeing footage consisting of eight different images in a looped sequence at 120 frames per minute.

RESULTS

All measured parameters qualified the exercise as requiring mainly an aerobic metabolism, showing no pain and no fatigue. AT and VT energy expenditure (5.0±0.44 and 4.9±0.39 MET respectively) were significantly lower compared to CT (5.5±0.49 MET), while no difference between AT and VT were recognized.

CONCLUSIONS

This study confirmed the ergogenic effect of the acoustic pacesetter on a 30-minute steady state rhythmic exercise. Novelty is that the visual pacesetter too was able to increase the mechanical efficiency as the same manner than the acoustic one. The present setting adopting visual pacesetter could be used in special categories, such as the deaf or in innovative technological tools as head-mounted display devices.

Neural Mechanisms of High-Level Vision

The last three decades have seen major strides in our understanding of neural mechanisms of high-level vision, or visual cognition of the world around us. Vision has also served as a model system for the study of brain function. Several broad insights, as yet incomplete, have recently emerged. First, visual perception is best understood not as an end unto itself, but as a sensory process that subserves the animal's behavioral goal at hand. Visual perception is likely to be simply a side effect that reflects the readout of visual information processing that leads to behavior. Second, the brain is essentially a probabilistic computational system that produces behaviors by collectively evaluating, not necessarily consciously or always optimally, the available information about the outside world received from the senses, the behavioral goals, prior knowledge about the world, and possible risks and benefits of a given behavior. Vision plays a prominent role in the overall functioning of the brain providing the lion's share of information about the outside world. Third, the visual system does not function in isolation, but rather interacts actively and reciprocally with other brain systems, including other sensory faculties. Finally, various regions of the visual system process information not in a strict hierarchical manner, but as parts of various dynamic brain-wide networks, collectively referred to as the "connectome." Thus, a full understanding of vision will ultimately entail understanding, in granular, quantitative detail, various aspects of dynamic brain networks that use visual sensory information to produce behavior under real-world conditions. © 2017 American Physiological Society. Compr Physiol 8:903-953, 2018.

Neurophysiological Mechanisms Underpinning Stretch-Induced Force Loss

It is well known that prolonged passive muscle stretch reduces maximal muscle force production. There is a growing body of evidence suggesting that adaptations occurring within the nervous system play a major role in this stretch-induced force reduction. This article reviews the existing literature, and some new evidence, regarding acute neurophysiological changes in response to passive muscle stretching. We discuss the possible contribution of supra-spinal and spinal structures to the force reduction after passive muscle stretch. In summary, based on the recent evidence reviewed we propose a new hypothesis that a disfacilitation occurring at the motoneuronal level after passive muscle stretch is a major factor affecting the neural efferent drive to the muscle and, subsequently, its ability to produce maximal force.

Kinesthetic Senses

The kinesthetic senses are the senses of position and movement of the body, senses we are aware of only on introspection. A method used to study kinesthesia is muscle vibration, which engages afferents of muscle spindles to trigger illusions of movement and changed position. When vibrating elbow flexors, it generates sensations of forearm extension, when vibrating extensors, sensations of forearm flexion. Vibrating the elbow joint produces no illusion. Vibrating flexors and extensors together at the same frequency also produces no illusion, because what is perceived is the signal difference between antagonist muscles of each arm and between arms. The size of the illusion depends on how the muscle has been conditioned beforehand, due to a property of muscle called thixotropy. When measuring the illusion, blindfolded subjects may carry out a matching or pointing task. In pointing, signals from muscle spindles are less important than in matching. Afferent signals from kinesthetic receptors project to areas of somatosensory cortex to generate sensations of detection and location. This is referred to the body model, which provides information about size and shape of body parts. Kinesthesia, together with vision and touch, is associated with the sense of body ownership. All three can combine or each, on its own, can generate ownership. Related is the sense of agency, the sense of being responsible for one's own actions. In recent times, much progress has been made using neuroimaging techniques to identify the various areas of the brain likely to be responsible for generating these sensations. © 2017 American Physiological Society. Compr Physiol 8:1157-1183, 2018.

Linear feature projection-based real-time decoding of limb state from dorsal root ganglion recordings

Proprioceptive afferent activities recorded by a multichannel microelectrode have been used to decode limb movements to provide sensory feedback signals for closed-loop control in a functional electrical stimulation (FES) system. However, analyzing the high dimensionality of neural activity is one of the major challenges in real-time applications. This paper proposes a linear feature projection method for the real-time decoding of ankle and knee joint angles. Single-unit activity was extracted as a feature vector from proprioceptive afferent signals that were recorded from the L7 dorsal root ganglion during passive movements of ankle and knee joints. The dimensionality of this feature vector was then reduced using a linear feature projection composed of projection pursuit and negentropy maximization (PP/NEM). Finally, a time-delayed Kalman filter was used to estimate the ankle and knee joint angles. The PP/NEM approach had a better decoding performance than did other feature projection methods, and all processes were completed within the real-time constraints. These results suggested that the proposed method could be a useful decoding method to provide real-time feedback signals in closed-loop FES systems.

A Systematic Review on Muscle Synergies: From Building Blocks of Motor Behavior to a Neurorehabilitation Tool

The central nervous system (CNS) is believed to utilize specific predefined modules, called muscle synergies (MS), to accomplish a motor task. Yet questions persist about how the CNS combines these primitives in different ways to suit the task conditions. The MS hypothesis has been a subject of debate as to whether they originate from neural origins or nonneural constraints. In this review article, we present three aspects related to the MS hypothesis: (1) the experimental and computational evidence in support of the existence of MS, (2) algorithmic approaches for extracting them from surface electromyography (EMG) signals, and (3) the possible role of MS as a neurorehabilitation tool. We note that recent advances in computational neuroscience have utilized the MS hypothesis in motor control and learning. Prospective advances in clinical, medical, and engineering sciences and in fields such as robotics and rehabilitation stand to benefit from a more thorough understanding of MS.

Linear Feature Projection-Based Sensory Event Detection from the Multiunit Activity of Dorsal Root Ganglion Recordings

Afferent signals recorded from the dorsal root ganglion can be used to extract sensory information to provide feedback signals in a functional electrical stimulation (FES) system. The goal of this study was to propose an efficient feature projection method for detecting sensory events from multiunit activity-based feature vectors of tactile afferent activity. Tactile afferent signals were recorded from the L4 dorsal root ganglion using a multichannel microelectrode for three types of sensory events generated by mechanical stimulation on the rat hind paw. The multiunit spikes (MUSs) were extracted as multiunit activity-based feature vectors and projected using a linear feature projection method which consisted of projection pursuit and negentropy maximization (PP/NEM). Finally, a multilayer perceptron classifier was used to detect sensory events. The proposed method showed a detection accuracy superior to those of other linear and nonlinear feature projection methods and all processes were completed within real-time constraints. Results suggest that the proposed method could be useful to detect sensory events in real time. We have demonstrated the methodology for an efficient feature projection method to detect real-time sensory events from the multiunit activity of dorsal root ganglion recordings. The proposed method could be applied to provide real-time sensory feedback signals in closed-loop FES systems.

Model of a bilateral Brown-type central pattern generator for symmetric and asymmetric locomotion

The coordinated activity of muscles is produced in part by spinal rhythmogenic neural circuits, termed central pattern generators (CPGs). A classical CPG model is a system of coupled oscillators that transform locomotor drive into coordinated and gait-specific patterns of muscle recruitment. The network properties of this conceptual model can be simulated by a system of ordinary differential equations with a physiologically inspired coupling locus of interactions capturing the timing relationship for bilateral coordination of limbs in locomotion. Whereas most similar models are solved numerically, it is intriguing to have a full analytical description of this plausible CPG architecture to illuminate the functionality within this structure and to expand it to include steering control. Here, we provided a closed-form analytical solution contrasted against the previous numerical method. The evaluation time of the analytical solution was decreased by an order of magnitude when compared with the numerical approach (relative errors, <0.01%). The analytical solution tested and supported the previous finding that the input to the model can be expressed in units of the desired limb locomotor speed. Furthermore, we performed parametric sensitivity analysis in the context of controlling steering and documented two possible mechanisms associated with either an external drive or intrinsic CPG parameters. The results identify specific propriospinal pathways that may be associated with adaptations within the CPG structure. The model offered several network configurations that may generate the same behavioral outcomes. NEW & NOTEWORTHY Using a simple process of leaky integration, we developed an analytical solution to a robust model of spinal pattern generation. We analyzed the ability of this neural element to exert locomotor control of the signal associated with limb speeds and tested the ability of this simple structure to embed steering control using the velocity signal in the model's inputs or within the internal connectivity of its elements.

Escape from homeostasis: spinal microcircuits and progression of amyotrophic lateral sclerosis

In amyotrophic lateral sclerosis (ALS), loss of motoneuron function leads to weakness and, ultimately, respiratory failure and death. Regardless of the initial pathogenic factors, motoneuron loss follows a specific pattern: the largest α-motoneurons die before smaller α-motoneurons, and γ-motoneurons are spared. In this article, we examine how homeostatic responses to this orderly progression could lead to local microcircuit dysfunction that in turn propagates motoneuron dysfunction and death. We first review motoneuron diversity and the principle of α-γ coactivation and then discuss two specific spinal motoneuron microcircuits: those involving proprioceptive afferents and those involving Renshaw cells. Next, we propose that the overall homeostatic response of the nervous system is aimed at maintaining force output. Thus motoneuron degeneration would lead to an increase in inputs to motoneurons, and, because of the pattern of neuronal degeneration, would result in an imbalance in local microcircuit activity that would overwhelm initial homeostatic responses. We suggest that this activity would ultimately lead to excitotoxicity of motoneurons, which would hasten the progression of disease. Finally, we propose that should this be the case, new therapies targeted toward microcircuit dysfunction could slow the course of ALS.

Sensor-Motor Maps for Describing Linear Reflex Composition in Hopping

In human and animal motor control several sensory organs contribute to a network of sensory pathways modulating the motion depending on the task and the phase of execution to generate daily motor tasks such as locomotion. To better understand the individual and joint contribution of reflex pathways in locomotor tasks, we developed a neuromuscular model that describes hopping movements. In this model, we consider the influence of proprioceptive length (LFB), velocity (VFB) and force feedback (FFB) pathways of a leg extensor muscle on hopping stability, performance and efficiency (metabolic effort). Therefore, we explore the space describing the blending of the monosynaptic reflex pathway gains. We call this reflex parameter space a sensor-motor map. The sensor-motor maps are used to visualize the functional contribution of sensory pathways in multisensory integration. We further evaluate the robustness of these sensor-motor maps to changes in tendon elasticity, body mass, segment length and ground compliance. The model predicted that different reflex pathway compositions selectively optimize specific hopping characteristics (e.g., performance and efficiency). Both FFB and LFB were pathways that enable hopping. FFB resulted in the largest hopping heights, LFB enhanced hopping efficiency and VFB had the ability to disable hopping. For the tested case, the topology of the sensor-motor maps as well as the location of functionally optimal compositions were invariant to changes in system designs (tendon elasticity, body mass, segment length) or environmental parameters (ground compliance). Our results indicate that different feedback pathway compositions may serve different functional roles. The topology of the sensor-motor map was predicted to be robust against changes in the mechanical system design indicating that the reflex system can use different morphological designs, which does not apply for most robotic systems (for which the control often follows a specific design). Consequently, variations in body mechanics are permitted with consistent compositions of sensory feedback pathways. Given the variability in human body morphology, such variations are highly relevant for human motor control.

Muscle proprioceptors in adult rat: mechanosensory signaling and synapse distribution in spinal cord

The characteristic signaling and intraspinal projections of muscle proprioceptors best described in the cat are often generalized across mammalian species. However, species-dependent adaptations within this system seem necessary to accommodate asymmetric scaling of length, velocity, and force information required by the physics of movement. In the present study we report mechanosensory responses and intraspinal destinations of three classes of muscle proprioceptors. Proprioceptors from triceps surae muscles in adult female Wistar rats anesthetized with isoflurane were physiologically classified as muscle spindle group Ia or II or as tendon organ group Ib afferents, studied for their firing responses to passive-muscle stretch, and in some cases labeled and imaged for axon projections and varicosities in spinal segments. Afferent projections and the laminar distributions of provisional synapses in rats closely resembled those found in the cat. Afferent signaling of muscle kinematics was also similar to reports in the cat, but rat Ib afferents fired robustly during passive-muscle stretch and Ia afferents displayed an exaggerated dynamic response, even after locomotor scaling was accounted for. These differences in mechanosensory signaling by muscle proprioceptors may represent adaptations for movement control in different animal species.NEW & NOTEWORTHY Muscle sensory neurons signal information necessary for controlling limb movements. The information encoded and transmitted by muscle proprioceptors to networks in the spinal cord is known in detail only for the cat, but differences in size and behavior of other species challenge the presumed generalizability. This report presents the first findings detailing specializations in mechanosensory signaling and intraspinal targets for functionally identified subtypes of muscle proprioceptors in the rat.

Neurophysiology and neural engineering: a review

Neurophysiology is the branch of physiology concerned with understanding the function of neural systems. Neural engineering (also known as neuroengineering) is a discipline within biomedical engineering that uses engineering techniques to understand, repair, replace, enhance, or otherwise exploit the properties and functions of neural systems. In most cases neural engineering involves the development of an interface between electronic devices and living neural tissue. This review describes the origins of neural engineering, the explosive development of methods and devices commencing in the late 1950s, and the present-day devices that have resulted. The barriers to interfacing electronic devices with living neural tissues are many and varied, and consequently there have been numerous stops and starts along the way. Representative examples are discussed. None of this could have happened without a basic understanding of the relevant neurophysiology. I also consider examples of how neural engineering is repaying the debt to basic neurophysiology with new knowledge and insight.

The power features of Masseter muscle activity in tension-type and migraine without aura headache during open-close clench cycles

Introduction

Different types of headaches and TMJ click influence the masseter muscle activity. The aim of this study was to assess the trend of energy level of the electromyography (EMG) activity of the masseter muscle during open-close clench cycles in migraine without aura (MOA) and tension-type headache (TTH) with or without TMJ click.

Methods

Twenty-five women with MOA and twenty four women with TTH participated in the study. They matched with 25 healthy subjects, in terms of class of occlusion and prevalence of temporomandibular joint (TMJ) with click. The EMG of both masseter muscles were recorded during open-close clench cycles at a rate of 80 cycles per minute for 15 seconds. The mouth opening was restricted to two centimeters by mandibular motion frame. Signal processing steps have been done on the EMG as: noise removing, smoothing, feature extraction, and statistical analyzing. The six statistical parameters of energy computed were mean, Variance, Skewness, Kurtosis, and first and second half energy over all signal energy.

Results

A three-way ANOVA indicated that during all the cycles, the mean of energy was more and there was a delay in showing the peak of energy in the masseter of the left side with clicked TMJ in MOA group compared to the two other groups, while this pattern occurred inversely in the side with no-clicked TMJ (P < 0.009). The variation of energy was significantly less in MOA group compared to the two other groups in the no-clicked TMJ (P < 0.003). However, the proportion of the first or second part of signal energy to all energy showed that TTH group had less energy in the first part and more energy in the second part in comparison to the two other groups (P < 0.05).

Conclusion

The study showed different changes in the energy distribution of masseter muscle activity during cycles in MOA and TTH. MOA, in contrast to TTH, had lateralization effect on EMG and interacted with TMJ click.

Multiunit Activity-Based Real-Time Limb-State Estimation from Dorsal Root Ganglion Recordings

Proprioceptive afferent activities could be useful for providing sensory feedback signals for closed-loop control during functional electrical stimulation (FES). However, most previous studies have used the single-unit activity of individual neurons to extract sensory information from proprioceptive afferents. This study proposes a new decoding method to estimate ankle and knee joint angles using multiunit activity data. Proprioceptive afferent signals were recorded from a dorsal root ganglion with a single-shank microelectrode during passive movements of the ankle and knee joints, and joint angles were measured as kinematic data. The mean absolute value (MAV) was extracted from the multiunit activity data, and a dynamically driven recurrent neural network (DDRNN) was used to estimate ankle and knee joint angles. The multiunit activity-based MAV feature was sufficiently informative to estimate limb states, and the DDRNN showed a better decoding performance than conventional linear estimators. In addition, processing time delay satisfied real-time constraints. These results demonstrated that the proposed method could be applicable for providing real-time sensory feedback signals in closed-loop FES systems.

Emergence of gamma motor activity in an artificial neural network model of the corticospinal system

Muscle spindle discharge during active movement is a function of mechanical and neural parameters. Muscle length changes (and their derivatives) represent its primary mechanical, fusimotor drive its neural component. However, neither the action nor the function of fusimotor and in particular of γ-drive, have been clearly established, since γ-motor activity during voluntary, non-locomotor movements remains largely unknown. Here, using a computational approach, we explored whether γ-drive emerges in an artificial neural network model of the corticospinal system linked to a biomechanical antagonist wrist simulator. The wrist simulator included length-sensitive and γ-drive-dependent type Ia and type II muscle spindle activity. Network activity and connectivity were derived by a gradient descent algorithm to generate reciprocal, known target α-motor unit activity during wrist flexion-extension (F/E) movements. Two tasks were simulated: an alternating F/E task and a slow F/E tracking task. Emergence of γ-motor activity in the alternating F/E network was a function of α-motor unit drive: if muscle afferent (together with supraspinal) input was required for driving α-motor units, then γ-drive emerged in the form of α-γ coactivation, as predicted by empirical studies. In the slow F/E tracking network, γ-drive emerged in the form of α-γ dissociation and provided critical, bidirectional muscle afferent activity to the cortical network, containing known bidirectional target units. The model thus demonstrates the complementary aspects of spindle output and hence γ-drive: i) muscle spindle activity as a driving force of α-motor unit activity, and ii) afferent activity providing continuous sensory information, both of which crucially depend on γ-drive.

A novel path to chronic proprioceptive disability with oxaliplatin: Distortion of sensory encoding

Persistent neurotoxic side effects of oxaliplatin (OX) chemotherapy, including sensory ataxia, limit the efficacy of treatment and significantly diminish patient quality of life. The common explanation for neurotoxicity is neuropathy, however the degree of neuropathy varies greatly among patients and appears insufficient in some cases to fully account for disability. We recently identified an additional mechanism that might contribute to sensory ataxia following OX treatment. In the present study, we tested whether that mechanism, selective modification of sensory signaling by muscle proprioceptors might result in behavioral deficits in rats. OX was administered once per week for seven weeks (cumulative dose i.p. 70mg/kg) to adult female Wistar rats. Throughout and for three weeks following treatment, behavioral analysis was performed daily on OX and sham control rats. Compared to controls, OX rats demonstrated errors in placing their hind feet securely and/or correctly during a horizontal ladder rung task. These behavioral deficits occurred together with modification of proprioceptor signaling that eliminated sensory encoding of static muscle position while having little effect on encoding of dynamic changes in muscle length. Selective inability to sustain repetitive firing in response to static muscle stretch led us to hypothesize that OX treatment impairs specific ionic currents, possibly the persistent inward Na currents (NaPIC) that are known to support repetitive firing during static stimulation in several neuron types, including the class of large diameter dorsal root ganglion cells that includes muscle proprioceptors. We tested this hypothesis by determining whether the chronic effects of OX on the firing behavior of muscle proprioceptors in vivo were mimicked by acute injection of NaPIC antagonists. Both riluzole and phenytoin, each having multiple drug actions but having only antagonist action on NaPIC in common, reproduced selective modification of proprioceptor signaling observed in OX rats. Taken together, these findings lead us to propose that OX chemotherapy contributes to movement disability by modifying sensory encoding, possibly via a chronic neurotoxic effect on NaPIC in the sensory terminals of muscle proprioceptors.

Human Spinal Motor Control

Human studies in the past three decades have provided us with an emerging understanding of how cortical and spinal networks collaborate to ensure the vast repertoire of human behaviors. Humans have direct cortical connections to spinal motoneurons, which bypass spinal interneurons and exert a direct (willful) muscle control with the aid of a context-dependent integration of somatosensory and visual information at cortical level. However, spinal networks also play an important role. Sensory feedback through spinal circuitries is integrated with central motor commands and contributes importantly to the muscle activity underlying voluntary movements. Regulation of spinal interneurons is used to switch between motor states such as locomotion (reciprocal innervation) and stance (coactivation pattern). Cortical regulation of presynaptic inhibition of sensory afferents may focus the central motor command by opening or closing sensory feedback pathways. In the future, human studies of spinal motor control, in close collaboration with animal studies on the molecular biology of the spinal cord, will continue to document the neural basis for human behavior.