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Schwarz A, Averta G, Veerbeek JM, Luft AR, Held JPO, Valenza G, Biechi A, Bianchi M. A functional analysis-based approach to quantify upper limb impairment level in chronic stroke patients: a pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4198-4204. [PMID: 31946795 DOI: 10.1109/embc.2019.8857732] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The accurate assessment of upper limb motion impairment induced by stroke - which represents one of the primary causes of disability world-wide - is the first step to successfully monitor and guide patients' recovery. As of today, the majority of the procedures relies on clinical scales, which are mostly based on ordinal scaling, operator-dependent, and subject to floor and ceiling effects. In this work, we intend to overcome these limitations by proposing a novel approach to analytically evaluate the level of pathological movement coupling, based on the quantification of movement complexity. To this goal, we consider the variations of functional Principal Components applied to the reconstruction of joint angle trajectories of the upper limb during daily living task execution, and compared these variations between two conditions, i.e. the affected and non-affected arm. A Dissimilarity Index, which codifies the severity of the upper limb motor impairment with respect to the movement complexity of the non-affected arm, is then proposed. This methodology was validated as a proof of concept upon a set of four chronic stroke subjects with mild to moderate arm and hand impairments. As a first step, we evaluated whether the derived outcomes differentiate between the two conditions upon the whole data-set. Secondly, we exploited this concept to discern between different subjects and impairment levels. Results show that: i) differences in terms of movement variability between the affected and nonaffected upper limb are detectable and ii) different impairment profiles can be characterized for single subjects using the proposed approach. Although provisional, these results are very promising and suggest this approach as a basis ingredient for the definition of a novel, operator-independent, sensitive, intuitive and widely applicable scale for the evaluation of upper limb motion impairment.
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Higurashi Y, Maier MA, Nakajima K, Morita K, Fujiki S, Aoi S, Mori F, Murata A, Inase M. Locomotor kinematics and EMG activity during quadrupedal versus bipedal gait in the Japanese macaque. J Neurophysiol 2019; 122:398-412. [DOI: 10.1152/jn.00803.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Several qualitative features distinguish bipedal from quadrupedal locomotion in mammals. In this study we show quantitative differences between quadrupedal and bipedal gait in the Japanese monkey in terms of gait patterns, trunk/hindlimb kinematics, and electromyographic (EMG) activity, obtained from 3 macaques during treadmill walking. We predicted that as a consequence of an almost upright body axis, bipedal gait would show properties consistent with temporal and spatial optimization countering higher trunk/hindlimb loads and a less stable center of mass (CoM). A comparatively larger step width, an ~9% longer duty cycle, and ~20% increased relative duration of the double-support phase were all in line with such a strategy. Bipedal joint kinematics showed the strongest differences in proximal, and least in distal, hindlimb joint excursions compared with quadrupedal gait. Hindlimb joint coordination (cyclograms) revealed more periods of single-joint rotations during bipedal gait and predominance of proximal joints during single support. The CoM described a symmetrical, quasi-sinusoidal left/right path during bipedal gait, with an alternating shift toward the weight-supporting limb during stance. Trunk/hindlimb EMG activity was nonuniformally increased during bipedal gait, most prominently in proximal antigravity muscles during stance (up to 10-fold). Non-antigravity hindlimb EMG showed altered temporal profiles during liftoff or touchdown. Muscle coactivation was more, but muscle synergies less, frequent during bipedal gait. Together, these results show that behavioral and EMG properties of bipedal vs. quadrupedal gait are quantitatively distinct and suggest that the neural control of bipedal primate locomotion underwent specific adaptations to generate these particular behavioral features to counteract increased load and instability. NEW & NOTEWORTHY Bipedal locomotion imposes particular biomechanical constraints on motor control. In a within-species comparative study, we investigated joint kinematics and electromyographic characteristics of bipedal vs. quadrupedal treadmill locomotion in Japanese macaques. Because these features represent (to a large extent) emergent properties of the underlying neural control, they provide a comparative, behavioral, and neurophysiological framework for understanding the neural system dedicated to bipedal locomotion in this nonhuman primate, which constitutes a critical animal model for human bipedalism.
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Affiliation(s)
- Yasuo Higurashi
- Department of Physiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Marc A. Maier
- Integrative Neuroscience and Cognition Center, UMR 8002, Centre National de la Recherche Scientifique-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Life Sciences, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Katsumi Nakajima
- Department of Physiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Kazunori Morita
- Department of Physiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Soichiro Fujiki
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Shinya Aoi
- Department of Aeronautics and Astronautics, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Futoshi Mori
- Department of Occupational Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Hiroshima, Japan
| | - Akira Murata
- Department of Physiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Masahiko Inase
- Department of Physiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
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Gesslbauer B, Hruby LA, Roche AD, Farina D, Blumer R, Aszmann OC. Axonal components of nerves innervating the human arm. Ann Neurol 2017; 82:396-408. [PMID: 28833372 DOI: 10.1002/ana.25018] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/19/2017] [Accepted: 08/13/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Axons traveling within the brachial plexus are responsible for the dexterous control of human arm and hand movements. Despite comprehensive knowledge on the topographical anatomy of nerves innervating the human upper limbs, the definite quantity of sensory and motor axons within this neural network remains elusive. Our aim was to perform a quantitative analysis of the axonal components of human upper limb nerves based on highly specific molecular features from spinal cord level to the terminal nerves at wrist level. METHODS Nerve specimen harvest at predefined harvesting sites (plexus roots and cords as well as major nerves originating from the brachial plexus innervating the arm and hand) was performed in 9 human heart-beating organ donors. Double immunofluorescence staining using antibodies against choline-acetyltransferase and neurofilament was performed to differentiate motor and sensory axons on nerve cross sections. RESULTS Three hundred fifty thousand axons emerge from the spinal cord to innervate the human upper limb, of which 10% are motor neurons. In all nerves studied, sensory axons outnumber motor axons by a ratio of at least 9:1. The sensory axon contribution increases when moving distally, whereas only 1,700 motor axons reach the hand to innervate the intrinsic musculature. INTERPRETATION Our results suggest that upper limb motor execution, and particularly dexterous coordination of hand movement, require an unexpectedly low number of motor neurons, with a large convergence of afferent input for feedback control. Ann Neurol 2017;82:396-408.
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Affiliation(s)
- Bernhard Gesslbauer
- Christian Doppler Laboratory for Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria.,Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Laura A Hruby
- Christian Doppler Laboratory for Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria
| | - Aidan D Roche
- Christian Doppler Laboratory for Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria.,Department of Plastic Surgery, North Bristol NHS Trust, Bristol, United Kingdom
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Roland Blumer
- Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Vienna, Austria
| | - Oskar C Aszmann
- Christian Doppler Laboratory for Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria.,Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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Averta G, Della Santina C, Battaglia E, Felici F, Bianchi M, Bicchi A. Unvealing the Principal Modes of Human Upper Limb Movements through Functional Analysis. Front Robot AI 2017. [DOI: 10.3389/frobt.2017.00037] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Reyes A, Laine CM, Kutch JJ, Valero-Cuevas FJ. Beta Band Corticomuscular Drive Reflects Muscle Coordination Strategies. Front Comput Neurosci 2017; 11:17. [PMID: 28420975 PMCID: PMC5378725 DOI: 10.3389/fncom.2017.00017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/10/2017] [Indexed: 12/11/2022] Open
Abstract
During force production, hand muscle activity is known to be coherent with activity in primary motor cortex, specifically in the beta-band (15–30 Hz) frequency range. It is not clear, however, if this coherence reflects the control strategy selected by the nervous system for a given task, or if it instead reflects an intrinsic property of cortico-spinal communication. Here, we measured corticomuscular and intermuscular coherence between muscles of index finger and thumb while a two-finger pinch grip of identical net force was applied to objects which were either stable (allowing synergistic activation of finger muscles) or unstable (requiring individuated finger control). We found that beta-band corticomuscular coherence with the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles, as well as their beta-band coherence with each other, was significantly reduced when individuated control of the thumb and index finger was required. We interpret these findings to show that beta-band coherence is reflective of a synergistic control strategy in which the cortex binds task-related motor neurons into functional units.
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Affiliation(s)
- Alexander Reyes
- Brain-Body Dynamics Lab, Department of Biomedical Engineering, University of Southern CaliforniaLos Angeles, CA, USA
| | - Christopher M Laine
- Brain-Body Dynamics Lab, Department of Biomedical Engineering, University of Southern CaliforniaLos Angeles, CA, USA
| | - Jason J Kutch
- Applied Mathematical Physiology Lab, Division of Biokinesiology and Physical Therapy, University of Southern CaliforniaLos Angeles, CA, USA
| | - Francisco J Valero-Cuevas
- Brain-Body Dynamics Lab, Department of Biomedical Engineering, University of Southern CaliforniaLos Angeles, CA, USA
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