The bliss (not the problem) of motor abundance (not redundancy)

Analysis of Connectivity in Electromyography Signals to Examine Neural Correlations in the Activation of Lower Leg Muscles for Postural Stability: A Pilot Study

In quiet standing, the central nervous system implements a pre-programmed ankle strategy of postural control to maintain upright balance and stability. This strategy comprises a synchronized common neural drive delivered to synergistically grouped muscles. This study evaluated connectivity between EMG signals of the unilateral and bilateral homologous muscle pairs of the lower legs during various standing balance conditions using magnitude-squared coherence (MSC). The leg muscles examined included the right and left tibialis anterior (TA), medial gastrocnemius (MG), and soleus (S). MSC is a frequency domain measure that quantifies the linear phase relation between two signals and was analyzed in the alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-100 Hz) neural frequency bands for feet together and feet tandem, with eyes open and eyes closed conditions. Results showed that connectivity in the beta and lower and upper gamma bands (30-100 Hz) was influenced by standing balance conditions and was indicative of a neural drive originating from the motor cortex. Instability was evaluated by comparing less stable standing conditions with a baseline-eyes open feet together stance. Changes in connectivity in the beta and gamma bands were found to be most significant in the muscle pairs of the back leg during a tandem stance regardless of dominant foot placement. MSC identified the MG:S muscle pair as significant for the right and left leg. The results of this study provided insight into the neural mechanism of postural control.

A multi-level analysis of motor and behavioural dynamics in 9-month-old preterm and term-born infants during changing emotional and interactive contexts

Computational analysis of infant movement has significant potential to reveal markers of developmental health. We report two studies employing dynamic analyses of motor kinematics and motor behaviours, which characterise movement at two levels, in 9-month-old infants. We investigate the effect of preterm birth (< 33 weeks of gestation) and the effect of changing emotional and social-interactive contexts in the still-face paradigm. First, multiscale permutation entropy was employed to analyse acceleration kinematic timeseries data collected from Inertial Measurement Unit (IMU) sensors on infants' torso, wrists, and ankles (N = 32: 10 term; 22 preterm). Second, Recurrence Quantification Analysis was used to characterise patterns of second-to-second behavioural changes, from observationally coded behavioural timeseries on infants' emotional self-regulation (N = 111: 61 term; 50 preterm). We found frequency-specific effects of context on permutation entropy. Relative to infants born at term (> 37 weeks of gestation), infants born preterm showed greater permutation entropy in their left ankle and torso movements, but not in right ankle or wrist movements. We did not find effects of preterm birth or emotional context on micro-level behavioural dynamics. Our methodology and findings inform future work using multiscale entropy to study infant development. Dynamic analysis of behaviour is a relatively young field, and applications to emotional self-regulation requires further methodological development.

Useful and Useless Misnomers in Motor Control

This article addresses the issue of using terms and concepts in motor control that are ill-defined, undefined, and/or imported from nonbiological fields. In many of such cases, the discourse turns nonscientific and unproductive. Some of such terms are potentially useful but need to be properly and exactly defined. Other terms seem to be misleading and nonfixable. There is also an intermediate group with terms that may or may not be useful if defined properly. The paper presents three examples per group: "reflex," "synergy," and "posture" versus "motor program," "efference copy," and "internal model" versus "muscle tone," "stiffness and impedance," and "redundancy." These terms are analyzed assuming that motor control is a branch of natural science, which must be analyzed using laws of nature, not a subfield of the control theory. In the discussion, we also accept the framework of the theory of movement control with spatial referent coordinates as the only example built on laws of nature with clearly formulated physical and physiological nature of the control parameters.

Neuromechanical Circuits of the Spinal Motor Apparatus

The evolution of mechanisms for terrestrial locomotion has resulted in multi-segmented limbs that allow navigation on irregular terrains, changing of direction, manipulation of external objects, and control over the mechanical properties of limbs important for interaction with the environment, with corresponding changes in neural pathways in the spinal cord. This article is focused on the organization of these pathways, their interactions with the musculoskeletal system, and the integration of these neuromechanical circuits with supraspinal mechanisms to control limb impedance. It is argued that neural pathways from muscle spindles and Golgi tendon organs form a distributive impedance controller in the spinal cord that controls limb impedance and coordination during responses to external disturbances. These pathways include both monosynaptic and polysynaptic components. Autogenic, monosynaptic pathways serve to control the spring-like properties of muscles preserving the nonlinear relationship between stiffness and force. Intermuscular monosynaptic pathways compensate for inertial disparities between the inertial properties of limb segments and help to control inertial coupling between joints and axes of rotation. Reciprocal inhibition controls joint stiffness in conjunction with feedforward cocontraction commands. Excitatory force feedback becomes operational during locomotion and increases muscular stiffness to accommodate the higher inertial loads. Inhibitory force feedback is widely distributed among muscles. It is integrated with excitatory pathways from muscle spindles and Golgi tendon organs to determine limb stiffness and interjoint coordination during interactions with the environment. The intermuscular distribution of force feedback is variable and serves to modulate limb stiffness to meet the physical demands of different motor tasks. © 2024 American Physiological Society. Compr Physiol 14:5789-5838, 2024.

Central mechanisms of muscle tone regulation: implications for pain and performance

Muscle tone represents a foundational property of the motor system with the potential to impact musculoskeletal pain and motor performance. Muscle tone is involuntary, dynamically adaptive, interconnected across the body, sensitive to postural demands, and distinct from voluntary control. Research has historically focused on pathological tone, peripheral regulation, and contributions from passive tissues, without consideration of the neural regulation of active tone and its consequences, particularly for neurologically healthy individuals. Indeed, simplistic models based on the stretch reflex, which neglect the central regulation of tone, are still perpetuated today. Recent advances regarding tone are dispersed across different literatures, including animal physiology, pain science, motor control, neurology, and child development. This paper brings together diverse areas of research to construct a conceptual model of the neuroscience underlying active muscle tone. It highlights how multiple tonic drive networks tune the excitability of complex spinal feedback circuits in concert with various sources of sensory feedback and in relation to postural demands, gravity, and arousal levels. The paper also reveals how tonic muscle activity and excitability are disrupted in people with musculoskeletal pain and how tone disorders can lead to marked pain and motor impairment. The paper presents evidence that integrative somatic methods address the central regulation of tone and discusses potential mechanisms and implications for tone rehabilitation to improve pain and performance.

Age-related differences in behavioral outcomes of bimanual functional motor tasks in children and adolescents with cerebral palsy: a scoping review

AIM

The objective of this review is to determine age-related differences in behavioral outcomes of bimanual motor tasks in children and adolescents with cerebral palsy (CP).

METHOD

This review followed the 6-stage Joanna Briggs Institute methodology. The Embase, EBSCO CINAHL, and PubMed databases were searched on May 2024. We included studies that employed instrumented measures to assess bimanual tasks in individuals with CP aged between 3 and 19 years.

RESULTS

Twenty-eight studies were included after full-text screening. This review reported on 544 individuals with CP. Bimanual tasks were grouped in seven categories and their varying complexities were listed and analyzed. There are numerous methods for assessing bimanual performance. The listed methods have shown that the gap between children with CP and healthy peers widens as task complexity increases. The data suggest that age-related outcomes result from a complex interaction between atypical development, the severity of deficits, and the context-dependent nature of the protocols.

CONCLUSION

The lack of standardized reporting on age-related results limits our understanding of bimanual developmental functions in CP. Standardizing these measures will enhance our understanding of bimanual function and better define the principles guiding therapeutic interventions, ultimately improving outcomes for individuals with CP.

Motor actions across psychiatric disorders: A research domain criteria (RDoC) perspective

The motor system is critical for understanding the pathophysiology and treatment of mental illness. Abnormalities in the processes that allow us to plan and execute movement in a goal-directed, context-appropriate manner (i.e., motor actions) are especially central to clinical motor research. Within this context, the NIMH Research Domain Criteria (RDoC) framework now includes a Motor Actions construct within the recently incorporated Sensorimotor Systems Domain, providing a useful framework for conducting research on motor action processes. However, there is limited available resources for understanding or implementing this framework. We address this gap by providing a comprehensive critical review and conceptual integration of the current clinical literature on the subconstructs comprising the Motor Actions construct. This includes a detailed discussion of each Motor Action subconstruct (e.g., action planning/execution) and its measurement across different units of analysis (e.g., molecules to behavior), the temporal and conceptual relationships among the Motor Action subconstructs (and other relevant RDoC domain constructs), and how abnormalities in these Motor Action subconstructs manifest in mental illness. Together, the review illustrates how motor system dysfunction is implicated in the pathophysiology of many psychiatric conditions and demonstrates shared and distinct mechanisms that may account for similar manifestations of motor abnormalities across disorders.

Terra incognita of the uncontrolled manifold

The review addresses the central concept of the uncontrolled manifold (UCM) hypothesis, which has become a major framework for analysis of performance-stabilizing motor synergies. The major goals are to summarize the status quo in the field and to ask new questions stimulating new studies. We focus on a few main questions: What is the UCM? What are the likely neural origins of the UCM? How is the UCM reflected in movement patterns? Are properties of the UCM similar in all directions? We contrast experience-based features of movements seen very soon after the movement initiation versus those based on on-line sensory feedback signals. Furthermore, we address a number of poorly explored issues such as the differences in characteristic times of processes within the UCM and orthogonal to the UCM space, the interplay between movement stability and optimality, the origin of preferred sharing patterns of performance variables across abundant sets of elements and of their intertrial variability, problems with the UCM-based analysis in different spaces, and likely neurophysiological mechanisms contributing to the UCM formation. In particular, we focus on the UCM in spaces of hypothetical neural control variables, which we associate with the reciprocal and coactivation commands to the effectors. Analysis of performance-stabilizing synergies within the UCM framework in abundant spaces of kinetic, kinematic and electromyographic variables at the selected level of analysis may be practically useful. However, mapping findings in such studies onto neural control mechanisms has been challenging.

Kinematic coding: Measuring information in naturalistic behaviour

Recent years have seen an explosion of interest in naturalistic behaviour and in machine learning tools for automatically tracking it. However, questions about what to measure, how to measure it, and how to relate naturalistic behaviour to neural activity and cognitive processes remain unresolved. In this Perspective, we propose a general experimental and computational framework - kinematic coding - for measuring how information about cognitive states is encoded in structured patterns of behaviour and how this information is read out by others during social interactions. This framework enables the design of new experiments and the generation of testable hypotheses that link behaviour, cognition, and neural activity at the single-trial level. Researchers can employ this framework to identify single-subject, single-trial encoding and readout computations and address meaningful questions about how information encoded in bodily motion is transmitted and communicated.

Implicit motor adaptation patterns in a redundant motor task manipulating a stick with both hands

The remarkable ability of the motor system to adapt to novel environments has traditionally been investigated using kinematically non-redundant tasks, such as planar reaching movements. This limitation prevents the study of how the motor system achieves adaptation by altering the movement patterns of our redundant body. To address this issue, we developed a redundant motor task in which participants reached for targets with the tip of a virtual stick held with both hands. Despite the redundancy of the task, participants consistently employed a stereotypical strategy of flexibly changing the tilt angle of the stick depending on the direction of tip movement. Thus, this baseline relationship between tip-movement direction and stick-tilt angle constrained both the physical and visual movement patterns of the redundant system. Our task allowed us to systematically investigate how the motor system implicitly changed both the tip-movement direction and the stick-tilt angle in response to imposed visual perturbations. Both types of perturbations, whether directly affecting the task (tip-movement direction) or not (stick-tilt angle around the tip), drove adaptation, and the patterns of implicit adaptation were guided by the baseline relationship. Consequently, tip-movement adaptation was associated with changes in stick-tilt angle, and intriguingly, even seemingly ignorable stick-tilt perturbations significantly influenced tip-movement adaptation, leading to tip-movement direction errors. These findings provide a new understanding that the baseline relationship plays a crucial role not only in how the motor system controls movement of the redundant system, but also in how it implicitly adapts to modify movement patterns.

Proprioceptive Reweighting and Postural Control are Impaired Among Elite Athletes Following Anterior Cruciate Ligament Reconstruction

Background

After anterior cruciate ligament reconstruction (ACLR), the risk of recurrence can reach 20%, partially due to poor postural control and impaired sensory processing. Lack of flexibility in proprioceptive postural strategy has recently been shown to be a potential risk factor for ACL injury.

Hypothesis/Purpose

This study aimed to compare proprioceptive reweighting and postural control between ACLR and controls elite athletes. It has been hypothesized that athletes with ACLR exhibit impaired proprioceptive reweighting and poor postural control.

Study design

Cross-sectional study.

Methods

Fifty-two ACLR and 23 control elite athletes (50 males and 25 females, mean age 24.7 years) were included. Proprioceptive reweighting was determined using the evolution of proprioceptive weighting (eRPW), calculated from the center of pressure (CoP) displacements generated by tendon vibration during bilateral standing tasks on firm and foam surfaces. An eRPW <95% classified individuals as flexible (i.e., able to reweight proprioceptive signals from the ankle to the lumbar region), whereas an eRPW >105% classified individuals as rigid (i.e., maintaining an ankle dominant strategy). CoP velocity (vCoP) and CoP ellipse area (EA) were used to characterize postural control. Independent sample t-test and a Chi-squared test were used to compare eRPW, vCoP, EA, and the proportion of flexible and rigid athletes between groups.

Results

The eRPW was higher in the ACLR group (100.9±58.8 vs. 68.6±26.6%; p=0.031; Rank biserial correlation=0.314; medium), with a greater proportion of rigid athletes than in the control group (38.5 vs. 4.4%; p=0.010), reflecting lower proprioceptive reweighting. The ACLR group had greater EA on foam surface (8.0±4.6 vs. 6.3±4.4cm²; p=0.019), revealing poorer postural control.

Conclusion

Elite athletes with ACLR showed impaired proprioceptive reweighting and poor postural control on an unstable surface. This reflects an inability to adapt proprioceptive weighting when balance conditions are changing and suboptimal postural strategies.

Level of Evidence

3b.

The effects of sport-specific training on individuals action strategies while avoiding a virtual player approaching on a 45° angle while completing a secondary task

Sports provide varying scenarios where athletes must interact with and avoid opposing players in dynamic environments. As such, sport-specific training can improve one's ability to integrate visual information which may result in improved collision avoidance behaviours. However, improved visuomotor capabilities are highly task dependent (i.e., athletes must be tested in sport-specific settings). The current study examined whether sport-specific training influenced individuals' collision avoidance behaviours during a sport-specific task in virtual reality. Untrained young adults (N = 21, 22.9±1.9 yrs, 11 males) and specifically trained athletes (N = 18, 20±1.5 yrs, 7 males) were immersed in a virtual environment and were instructed to walk along a 7.5m path towards a goal located along the midline. Two virtual players positioned 2.83m to the left and right of the midline approached participants on a 45° angle at one of three speeds: 0.8x, 1.0x, or 1.2x each participant's average walking speed. Participants were instructed to walk to a goal without colliding with the virtual players while performing a secondary task; reporting whether a shape changed above either of the virtual players' heads. Results revealed that athletes had a higher percentage of correct responses on the secondary task compared to untrained young adults. However, there was no group differences in the average time to first avoidance or average minimum clearance, but athletes were more variable in their avoidance behaviours. Findings from this study demonstrate that athletes may be more adaptive in their behaviours and may perform better on attentionally demanding tasks in dynamic environments.

Comparative analysis of motor skill acquisition in a novel bimanual task: the role of mental representation and sensorimotor feedback

Introduction

This study investigates the multifaceted nature of motor learning in a complex bimanual task by examining the interplay between mental representation structures, biomechanics, tactile pressure, and performance. We developed a novel maze game requiring participants to maneuver a rolling sphere through a maze, exemplifying complex sequential coordination of vision and haptic control using both hands. A key component of this study is the introduction of cognitive primitives, fundamental units of cognitive and motor actions that represent specific movement patterns and strategies.

Methods

Participants were divided into two groups based on initial performance: poor performers (PPG) and good performers (GPG). The experimental setup employed motion capture and innovative tactile sensors to capture a detailed multimodal picture of the interaction process. Our primary aims were to (1) assess the effects of daily practice on task performance, biomechanics, and tactile pressure, (2) examine the relationship between changes in mental representation structures and skill performance, and (3) explore the interplay between biomechanics, tactile pressure, and cognitive representation in motor learning.

Results

Performance analysis showed that motor skills improved with practice, with the GPG outperforming the PPG in maze navigation efficiency. Biomechanical analysis revealed that the GPG demonstrated superior movement strategies, as indicated by higher peak velocities and fewer velocity peaks during task execution. Tactile feedback analysis showed that GPG participants applied more precise and focused pressure with their right-hand thumb, suggesting enhanced motor control. Cognitively, both groups refined their mental representation structures over time, but the GPG exhibited a more structured and sophisticated cognitive mapping of the task post-practice.

Discussion

The findings highlight the intertwined nature of biomechanical control, tactile feedback, and cognitive processing in motor skill acquisition. The results support established theories, such as the cognitive action architecture approach, emphasizing the role of mental representation in planning and executing motor actions. The integration of cognitive primitives in our analysis provides a theoretical framework that connects observable behaviors to underlying cognitive strategies, enhancing the understanding of motor learning across various contexts. Our study underscores the necessity of a holistic approach to motor learning research, recognizing the complex interaction between cognitive and motor processes in skill acquisition.

An arm swing enhances the proximal-to-distal delay in joint extension during a countermovement jump

An abundance of degrees of freedom (DOF) exist when executing a countermovement jump (CMJ). This research aims to simplify the understanding of this complex system by comparing jump performance and independent functional DOF (fDOF) present in CMJs without (CMJNoArms) and with (CMJArms) an arm swing. Principal component analysis was used on 39 muscle forces and 15 3-dimensional joint contact forces obtained from kinematic and kinetic data, analyzed in FreeBody (a segment-based musculoskeletal model). Jump performance was greater in CMJArms with the increased ground contact time resulting in higher external (p = 0.012), hip (p < 0.001) and ankle (p = 0.009) vertical impulses, and slower hip extension enhancing the proximal-to-distal joint extension strategy. This allowed the hip muscles to generate higher forces and greater time-normalized hip vertical impulse (p = 0.006). Three fDOF were found for the muscle forces and 3-dimensional joint contact forces during CMJNoArms, while four fDOF were present for CMJArms. This suggests that the underlying anatomy provides mechanical constraints during a CMJ, reducing the demand on the control system. The additional fDOF present in CMJArms suggests that the arms are not mechanically coupled with the lower extremity, resulting in additional variation within individual motor strategies.

Two aspects of feed-forward control of action stability: effects of action speed and unexpected events

We explored two types of anticipatory synergy adjustments (ASA) during accurate four-finger total force production task. The first type is a change in the index of force-stabilizing synergy during a steady state when a person is expecting a signal to produce a quick force change, which is seen even when the signal does not come (steady-state ASA). The other type is the drop in in the synergy index prior to a planned force change starting at a known time (transient ASA). The subjects performed a task of steady force production at 10% of maximal voluntary contraction (MVC) followed by a ramp to 20% MVC over 1 s, 3 s, and as a step function (0 s). In another task, in 50% of the trials during the steady-state phase, an unexpected signal could come requiring a quick force pulse to 20% MVC (0-surprise). Inter-trial variance in the finger force space was used to quantify the index of force-stabilizing synergy within the uncontrolled manifold hypothesis. We observed significantly lower synergy index values during the steady state in the 0-ramp trials compared to the 1-ramp and 3-ramp trials. There was also larger transient ASA during the 0-ramp trials. In the 0-surprise condition, the synergy index was significantly higher compared to the 0-ramp condition whereas the transient ASA was significantly larger. The finding of transient ASA scaling is of importance for clinical studies, which commonly involve populations with slower actions, which can by itself be associated with smaller ASAs. The participants varied the sharing pattern of total force across the fingers more in the task with "surprises". This was coupled to more attention to precision of performance, i.e., inter-trial deviations from the target as reflected in smaller variance affecting total force, possibly reflecting higher concentration on the task, which the participants perceived as more challenging compared to a similar task without surprise targets.

Exploring motor skill acquisition in bimanual coordination: insights from navigating a novel maze task

In this study, we introduce a novel maze task designed to investigate naturalistic motor learning in bimanual coordination. We developed and validated an extended set of movement primitives tailored to capture the full spectrum of scenarios encountered in a maze game. Over a 3-day training period, we evaluated participants' performance using these primitives and a custom-developed software, enabling precise quantification of performance. Our methodology integrated the primitives with in-depth kinematic analyses and thorough thumb pressure assessments, charting the trajectory of participants' progression from novice to proficient stages. Results demonstrated consistent improvement in maze performance and significant adaptive changes in joint behaviors and strategic recalibrations in thumb pressure distribution. These findings highlight the central nervous system's adaptability in orchestrating sophisticated motor strategies and the crucial role of tactile feedback in precision tasks. The maze platform and setup emerge as a valuable foundation for future experiments, providing a tool for the exploration of motor learning and coordination dynamics. This research underscores the complexity of bimanual motor learning in naturalistic environments, enhancing our understanding of skill acquisition and task efficiency while emphasizing the necessity for further exploration and deeper investigation into these adaptive mechanisms.

Force reflections of auditory and tactile action-effect weighting in motor planning

Most voluntary actions have only few goals, which provides considerable freedom in the selection of action parameters. Recent studies showed that task-irrelevant aspects of the task context influence the motor parameters of the actions in a way which seems to reflect the relative importance of these aspects within the underlying action representation. The present study investigated how the intensity of auditory action-effects affected force exertion patterns in a self-paced action production task. Participants applied force impulses with their index finger on a force-sensitive resistor every three seconds. In four separate conditions, force impulses elicited no sound, or elicited tones with 69, 59 or 49 dB intensity. The results showed that participants applied more force when tone intensity was lower, and when tones were absent. These force differences were also present in the first 60 ms following tone onset, implying that these reflected differences in motor planning. The results are compatible with the notion that actions are represented in terms of their sensory effects, which are weighted differently-presumably to maintain an optimal level of overall auditory and tactile stimulation in the present case. These results hint at the potential usefulness of motor parameters as readouts of action intentions.

Hierarchical Organization and Adjustment of Force Coordination in Response to Self-Triggered and External-Triggered Cues in Simulated Archery Performance

The purpose of this study was to investigate the hierarchical organization of digit force production and its effect on stability and performance during the simulated archery task. The simulated archery shooting task required the production of a prescribed level of force in virtual space with the left hand and an equivalent force with all 4 fingers of right hand. A single trial had 2 phases, including static force production as aiming in archery and quick force release to shoot the virtual arrow. The timing of the force release was determined by the participant's choice or response to the external cue. The coordination indices, that is, the synergy index, of force stabilization were quantified in 2 hierarchies by decomposing the variance components. The accuracy and precision of the hit position of the virtual arrow were calculated as performance-related indices. The results confirmed that the precision, that is, reproducibility, of the performance was greater when the force release time was determined by the self-selected time, suggesting the beneficial effect of the anticipatory mechanism. There was a distinct synergistic organization of digit forces for the stabilization of net forces in both bimanual and multifinger levels, which was especially correlated with the precision of performance.

Deactivation and collective phasic muscular tuning for pointing direction: Insights from machine learning

Arm movements in our daily lives have to be adjusted for several factors in response to the demands of the environment, for example, speed, direction or distance. Previous research has shown that arm movement kinematics is optimally tuned to take advantage of gravity effects and minimize muscle effort in various pointing directions and gravity contexts. Here we build upon these results and focus on muscular adjustments. We used Machine Learning to analyze the ensemble activities of multiple muscles recorded during pointing in various directions. The advantage of such a technique would be the observation of patterns in collective muscular activity that may not be noticed using univariate statistics. By providing an index of multimuscle activity, the Machine Learning (ML) analysis brought to light several features of tuning for pointing direction. In attempting to trace tuning curves, all comparisons were done with respects to pointing in the horizontal, gravity free plane. We demonstrated that tuning for direction does not take place in a uniform fashion but in a modular manner in which some muscle groups play a primary role. The antigravity muscles were more finely tuned to pointing direction than the gravity muscles. Of note, was their tuning during the first half of downward pointing. As the antigravity muscles were deactivated during this phase, it supported the idea that deactivation is not an on-off function but is tuned to pointing direction. Further support for the tuning of the negative portions of the phasic EMG was provided by the observation of progressively improving classification accuracies with increasing angular distance from the horizontal. We also demonstrated that the durations of these negative phases, without information on their amplitudes, is tuned to pointing directions. Overall, these results show that the motor system tunes muscle commands to exploit gravity effects and reduce muscular effort. It quantitatively demonstrates that phasic EMG negativity is an essential feature of muscle control. The ML analysis was done using Linear Discriminant analysis (LDA) and Support Vector Machines (SVM). The two led to the same conclusions concerning the movements being investigated, hence showing that the former, computationally inexpensive technique is a viable tool for regular investigation of motor control.

Transferring Sensor-Based Assessments to Clinical Practice: The Case of Muscle Synergies

Sensor-based assessments in medical practice and rehabilitation include the measurement of physiological signals such as EEG, EMG, ECG, heart rate, and NIRS, and the recording of movement kinematics and interaction forces. Such measurements are commonly employed in clinics with the aim of assessing patients' pathologies, but so far some of them have found full exploitation mainly for research purposes. In fact, even though the data they allow to gather may shed light on physiopathology and mechanisms underlying motor recovery in rehabilitation, their practical use in the clinical environment is mainly devoted to research studies, with a very reduced impact on clinical practice. This is especially the case for muscle synergies, a well-known method for the evaluation of motor control in neuroscience based on multichannel EMG recordings. In this paper, considering neuromotor rehabilitation as one of the most important scenarios for exploiting novel methods to assess motor control, the main challenges and future perspectives for the standard clinical adoption of muscle synergy analysis are reported and critically discussed.

Synergic control of the minimum toe clearance in young and older adults during foot swing on treadmill walking in different speeds

BACKGROUND

The vertical toe position at minimum toe clearance (MTC) in the swing phase is critical for walking safety. Consequently, the joints involved should be strictly controlled and coordinated to stabilize the foot at MTC. The uncontrolled manifold (UCM) hypothesis framework has been used to determine the existence of synergies that stabilize relevant performance variables during walking. However, no study investigated the presence of a multi-joint synergy stabilizing the foot position at MTC and the effects of age and walking speed on this synergy.

RESEARCH QUESTIONS

Is there a multi-joint synergy stabilizing MTC during treadmill walking? Does it depend on the persons' age and walking speed?

METHODS

Kinematic data from 23 young and 15 older adults were analyzed using the UCM approach. The participants walked on a treadmill at three speeds: slow, self-selected, and fast. The sagittal and frontal joint angles from the swing and stance legs and pelvis obliquity were used as motor elements and the vertical toe position at MTC was the performance variable. The variances in the joint space that affected (VORT, 'bad' variance) and did not affect (VUCM, 'good' variance) the toe position at MTC and the synergy index (ΔV) were computed.

RESULTS

The ΔV>0 was revealed for all subjects. Walking speed did not affect ΔV in older adults, whereas ΔV reduced with speed in young adults. ΔV was higher for older than for young adults at self-selected and fast speeds, owing to a lower VORT in the older group.

SIGNIFICANCE

The vertical toe position at MTC was stabilized by a strong multi-joint synergy. In older adults, this synergy was stronger, as they were better at limiting VORT than young adults. Reduced VORT in older adults could be caused by more constrained walking, which may be associated with anxiety due to walking on a treadmill.

Multifractal perturbations to multiplicative cascades promote multifractal nonlinearity with asymmetric spectra

Biological and psychological processes have been conceptualized as emerging from intricate multiplicative interactions among component processes across various spatial and temporal scales. Among the statistical models employed to approximate these intricate nonlinear interactions across scales, one prominent framework is that of cascades. Despite decades of empirical work using multifractal formalisms, several fundamental questions persist concerning the proper interpretations of multifractal evidence of nonlinear cross-scale interactivity. Does multifractal spectrum width depend on multiplicative interactions, constituent noise processes participating in those interactions, or both? We conducted numerical simulations of cascade time series featuring component noise processes characterizing a range of nonlinear temporal correlations: nonlinearly multifractal, linearly multifractal (obtained via the iterative amplitude adjusted wavelet transform of nonlinearly multifractal), phase-randomized linearity (obtained via the iterative amplitude adjustment Fourier transform of nonlinearly multifractal), and phase and amplitude randomized (obtained via shuffling of nonlinearly multifractal). Our findings show that the multiplicative interactions coordinate with the nonlinear temporal correlations of noise components to dictate emergent multifractal properties. Multiplicative cascades with stronger nonlinear temporal correlations make multifractal spectra more asymmetric with wider left sides. However, when considering multifractal spectral differences between the original and surrogate time series, even multiplicative cascades produce multifractality greater than in surrogate time series, even with linearized multifractal noise components. In contrast, additivity among component processes leads to a linear outcome. These findings provide a robust framework for generating multifractal expectations for biological and psychological models in which cascade dynamics flow from one part of an organism to another.

Postural control in gymnasts: anisotropic fractal scaling reveals proprioceptive reintegration in vestibular perturbation

Dexterous postural control subtly complements movement variability with sensory correlations at many scales. The expressive poise of gymnasts exemplifies this lyrical punctuation of release with constraint, from coarse grain to fine scales. Dexterous postural control upon a 2D support surface might collapse the variation of center of pressure (CoP) to a relatively 1D orientation-a direction often oriented towards the focal point of a visual task. Sensory corrections in dexterous postural control might manifest in temporal correlations, specifically as fractional Brownian motions whose differences are more and less correlated with fractional Gaussian noises (fGns) with progressively larger and smaller Hurst exponent H. Traditional empirical work examines this arrangement of lower-dimensional compression of CoP along two orthogonal axes, anteroposterior (AP) and mediolateral (ML). Eyes-open and face-forward orientations cultivate greater variability along AP than ML axes, and the orthogonal distribution of spatial variability has so far gone hand in hand with an orthogonal distribution of H, for example, larger in AP and lower in ML. However, perturbing the orientation of task focus might destabilize the postural synergy away from its 1D distribution and homogenize the temporal correlations across the 2D support surface, resulting in narrower angles between the directions of the largest and smallest H. We used oriented fractal scaling component analysis (OFSCA) to investigate whether sensory corrections in postural control might thus become suborthogonal. OFSCA models raw 2D CoP trajectory by decomposing it in all directions along the 2D support surface and fits the directions with the largest and smallest H. We studied a sample of gymnasts in eyes-open and face-forward quiet posture, and results from OFSCA confirm that such posture exhibits the classic orthogonal distribution of temporal correlations. Head-turning resulted in a simultaneous decrease in this angle Δθ, which promptly reversed once gymnasts reoriented their heads forward. However, when vision was absent, there was only a discernible negative trend in Δθ, indicating a shift in the angle's direction but not a statistically significant one. Thus, the narrowing of Δθ may signify an adaptive strategy in postural control. The swift recovery of Δθ upon returning to a forward-facing posture suggests that the temporary reduction is specific to head-turning and does not impose a lasting burden on postural control. Turning the head reduced the angle between these two orientations, facilitating the release of postural degrees of freedom towards a more uniform spread of the CoP across both dimensions of the support surface. The innovative aspect of this work is that it shows how fractality might serve as a control parameter of adaptive mechanisms of dexterous postural control.

Affordances for throwing: An uncontrolled manifold analysis

Movement systems are massively redundant, and there are always multiple movement solutions to any task demand; motor abundance. Movement consequently exhibits 'repetition without repetition', where movement outcomes are preserved but the kinematic details of the movement vary across repetitions. The uncontrolled manifold (UCM) concept is one of several methods that analyses movement variability with respect to task goals, to quantify repetition without repetition and test hypotheses about the control architecture producing a given abundant response to a task demand. However, like all these methods, UCM is under-constrained in how it decomposes a task and performance. In this paper, we propose and test a theoretical framework for constraining UCM analysis, specifically the perception of task-dynamical affordances. Participants threw tennis balls to hit a target set at 5m, 10m or 15m, and we performed UCM analysis on the shoulder-elbow-wrist joint angles with respect to variables derived from an affordance analysis of this task as well as more typical biomechanical variables. The affordance-based UCM analysis performed well, although data also showed thrower dynamics (effectivities) need to be accounted for as well. We discuss how the theoretical framework of affordances and affordance-based control can be connected to motor abundance methods in the future.

Motor flexibility to stabilize the toe position during obstacle crossing in older adults: an investigation using an uncontrolled manifold analysis

Introduction

An age-related decrease in the ability to exploit the abundant degrees of freedom of the body, referred to as motor flexibility, leads to a heightened fall risk. The present study investigated motor flexibility to stabilize the toe position during obstacle crossing in older adults and its correlation with the magnitude of foot elevation.

Methods

Twenty-six older adults (70.9 ± 7.4 years old) and 21 younger adults (25.4 ± 5.0 years old) walked and crossed an obstacle, during which the dominant limb was always the leading limb. An uncontrolled manifold (UCM) analysis was used to quantify the flexibility during obstacle crossing as the synergy index, with the vertical toe position being regarded as the performance variable and the segment angles of the lower limbs as the elemental variables.

Results and discussion

The results showed that older participants had a significantly lower synergy index for the trailing limb before the moment of obstacle crossing than younger participants, suggesting reduced flexibility in part. The results also showed that, regardless of age, foot elevation was negatively correlated with the synergy index, suggesting that a so-called "conservative strategy" (i.e., a tendency to show extraordinarily high foot elevation to ensure collision avoidance) may be related to their reduced motor flexibility.

Concurrent Supra-Postural Auditory-Hand Coordination Task Affects Postural Control: Using Sonification to Explore Environmental Unpredictability in Factors Affecting Fall Risk

Clinical screening tests for balance and mobility often fall short of predicting fall risk. Cognitive distractors and unpredictable external stimuli, common in busy natural environments, contribute to this risk, especially in older adults. Less is known about the effects of upper sensory-motor coordination, such as coordinating one's hand with an external stimulus. We combined movement sonification and affordable inertial motion sensors to develop a task for the precise measurement and manipulation of full-body interaction with stimuli in the environment. In a double-task design, we studied how a supra-postural activity affected quiet stance. The supra-postural task consisted of rhythmic synchronization with a repetitive auditory stimulus. The stimulus was attentionally demanding because it was being modulated continuously. The participant's hand movement was sonified in real time, and their goal was to synchronize their hand movement with the stimulus. In the unpredictable condition, the tempo changed at random points in the trial. A separate sensor recorded postural fluctuations. Young healthy adults were compared to older adult (OA) participants without known risk of falling. The results supported the hypothesis that supra-postural coordination would entrain postural control. The effect was stronger in OAs, supporting the idea that diminished reserve capacities reduce the ability to isolate postural control from sensory-motor and cognitive activity.

Visuomotor tracking strategies in children: associations with neurodevelopmental symptoms

Children with neurodevelopmental disorders (NDDs) often display motor problems that may impact their daily lives. Studying specific motor characteristics related to spatiotemporal control may inform us about the mechanisms underlying their challenges. Fifty-eight children with varying neurodevelopmental symptoms load (median age: 5.6 years, range: 2.7-12.5 years) performed an interactive tablet-based tracking task. By investigating digit touch errors relative to the target's movement direction, we found that a load of neurodevelopmental symptoms was associated with reduced performance in the tracking of abrupt alternating directions (zigzag) and overshooting the target. In contrast, reduced performance in children without neurodevelopmental symptoms was associated with lagging behind the target. Neurodevelopmental symptom load was also associated with reduced flexibility in correcting for lateral deviations in smooth tracking (spiral). Our findings suggest that neurodevelopmental symptoms are associated with difficulties in motor regulation related to inhibitory control and reduced flexibility, impacting motor control in NDDs.

Behavioral dynamics of conversation, (mis)communication and coordination in noisy environments

During conversations people coordinate simultaneous channels of verbal and nonverbal information to hear and be heard. But the presence of background noise levels such as those found in cafes and restaurants can be a barrier to conversational success. Here, we used speech and motion-tracking to reveal the reciprocal processes people use to communicate in noisy environments. Conversations between twenty-two pairs of typical-hearing adults were elicited under different conditions of background noise, while standing or sitting around a table. With the onset of background noise, pairs rapidly adjusted their interpersonal distance and speech level, with the degree of initial change dependent on noise level and talker configuration. Following this transient phase, pairs settled into a sustaining phase in which reciprocal speech and movement-based coordination processes synergistically maintained effective communication, again with the magnitude of stability of these coordination processes covarying with noise level and talker configuration. Finally, as communication breakdowns increased at high noise levels, pairs exhibited resetting behaviors to help restore communication-decreasing interpersonal distance and/or increasing speech levels in response to communication breakdowns. Approximately 78 dB SPL defined a threshold where behavioral processes were no longer sufficient for maintaining effective conversation and communication breakdowns rapidly increased.

Effects of fatigue on intramuscle force-stabilizing synergies

We applied the recently introduced concept of intramuscle synergies in spaces of motor units (MUs) to quantify indexes of such synergies in the tibialis anterior during ankle dorsiflexion force production tasks and their changes with fatigue. We hypothesized that MUs would be organized into robust groups (MU modes), which would covary across trials to stabilize force magnitude, and the indexes of such synergies would drop under fatigue. Healthy, young subjects (n = 15; 8 females) produced cyclical, isometric dorsiflexion forces while surface electromyography was used to identify action potentials of individual MUs. Principal component analysis was used to define MU modes. The framework of the uncontrolled manifold (UCM) was used to analyze intercycle variance and compute the synergy index, ΔVZ. Cyclical force production tasks were repeated after a nonfatiguing exercise (control) and a fatiguing exercise. Across subjects, fatigue led, on average, to a 43% drop in maximal force and fewer identified MUs per subject (29.6 ± 2.1 vs. 32.4 ± 2.1). The first two MU modes accounted for 81.2 ± 0.08% of variance across conditions. Force-stabilizing synergies were present across all conditions and were diminished after fatiguing exercise (1.49 ± 0.40) but not control exercise (1.76 ± 0.75). Decreased stability after fatigue was caused by an increase in the amount of variance orthogonal to the UCM. These findings contrast with earlier studies of multieffector synergies demonstrating increased synergy index under fatigue. We interpret the results as reflections of a drop in the gain of spinal reflex loops under fatigue. The findings corroborate an earlier hypothesis on the spinal nature of intramuscle synergies.NEW & NOTEWORTHY Across multielement force production tasks, fatigue of an element leads to increased indexes of force stability (synergy indexes). Here, however, we show that groups of motor units in the tibialis anterior show decreased indexes of force-stabilizing synergies after fatiguing exercise. These findings align intramuscle synergies with spinal mechanisms, in contrast to the supraspinal control of multimuscle synergies.

Agreement and consistency in the triaging of musculoskeletal primary care referrals by vetting clinicians using a knowledge-based triage tool

BACKGROUND

Primary care referrals received by secondary care services are vetted or triaged to pathways best suited for patients' needs. If knowledge-based triaging is used by vetting clinicians, accuracy is required to avoid incorrect decisions being made. With limited evidence to support best practice, we aimed to evaluate consistency across vetting clinicians' decisions and their agreement with a criterion decision.

METHODS

Twenty-nine trained vetting clinicians (18 female) representative of pay grades independently triaged five musculoskeletal physiotherapy referral cases into one of 10 decisions using an internally developed triage tool. Agreement across clinicians' decisions between and within cases was assessed using Fleiss's kappa overall and within pay grade. Proportions of triage decisions consistent with criterion decisions were assessed using Cochran's Q test.

RESULTS

Clinician agreement was fair for all cases (κ = 0.385) irrespective of pay grade but varied within clinical cases (κ = -0.014-0.786). Proportions of correct triage decisions were significantly different across cases [Q(4) = 33.80, P < 0.001] ranging from 17% to 83%.

CONCLUSIONS

Agreement and consistency in decisions were variable using the tool. Ensuring referrer information is accurate is vital, as is developing, automating and auditing standards for certain referrals with clear pathways. But we argue that variable vetting outcomes might represent healthy pathway abundance and should not simply be automated in response to perceived inefficiencies.

Integrating Motor Variability Evaluation Into Movement System Assessment

Common assessment tools for determining therapeutic success in rehabilitation typically focus on task-based outcomes. Task-based outcomes provide some understanding of the individual's functional ability and motor recovery; however, these clinical outcomes may have limited translation to a patient's functional ability in the real world. Limitations arise because (1) the focus on task-based outcome assessment often disregards the complexity of motor behavior, including motor variability, and (2) mobility in highly variable real-world environments requires movement adaptability that is made possible by motor variability. This Perspective argues that incorporating motor variability measures that reflect movement adaptability into routine clinical assessment would enable therapists to better evaluate progress toward optimal and safe real-world mobility. The challenges and opportunities associated with incorporating variability-based assessment of pathological movements are also discussed. This Perspective also indicates that the field of rehabilitation needs to leverage technology to advance the understanding of motor variability and its impact on an individual's ability to optimize movement.

IMPACT

This Perspective contends that traditional therapeutic assessments do not adequately evaluate the ability of individuals to adapt their movements to the challenges faced when negotiating the dynamic environments encountered during daily life. Assessment of motor variability derived during movement execution can address this issue and provide better insight into a patient's movement stability and maneuverability in the real world. Creating such a shift in motor system assessment would advance understanding of rehabilitative approaches to motor system recovery and intervention.

Modeling Human Suboptimal Control: A Review

This review paper provides an overview of the approaches to model neuromuscular control, focusing on methods to identify nonoptimal control strategies typical of populations with neuromuscular disorders or children. Where possible, the authors tightened the description of the methods to the mechanisms behind the underlying biomechanical and physiological rationale. They start by describing the first and most simplified approach, the reductionist approach, which splits the role of the nervous and musculoskeletal systems. Static optimization and dynamic optimization methods and electromyography-based approaches are summarized to highlight their limitations and understand (the need for) their developments over time. Then, the authors look at the more recent stochastic approach, introduced to explore the space of plausible neural solutions, thus implementing the uncontrolled manifold theory, according to which the central nervous system only controls specific motions and tasks to limit energy consumption while allowing for some degree of adaptability to perturbations. Finally, they explore the literature covering the explicit modeling of the coupling between the nervous system (acting as controller) and the musculoskeletal system (the actuator), which may be employed to overcome the split characterizing the reductionist approach.

Responsiveness of the Reaching Performance Scale for Stroke

OBJECTIVE

The objective of the study was to estimate the internal and external responsiveness of the Reaching Performance Scale for Stroke (RPSS) in individuals with stroke.

DESIGN

Retrospective analysis of data from 4 randomized controlled trials.

SETTING

Recruitment locations spanning rehabilitation centers and hospitals in Canada, Italy, Argentina, Peru, and Thailand.

PARTICIPANTS

Data from 567 participants (acute to chronic stroke; N=567) were available.

INTERVENTIONS

All 4 studies involved training using virtual reality for upper limb rehabilitation.

MAIN OUTCOME MEASURES

RPSS and upper extremity Fugl-Meyer Assessment (FMA-UE) scores. Responsiveness was quantified for all data and across different stages of stroke. Internal responsiveness of the RPSS was quantified as effect-sizes calculated using post and preintervention change data. External responsiveness was quantified using orthogonal regressions between FMA-UE and RPSS scores. The area under the Receiver Operating Characteristic curve (AUC) was quantified based on the ability of RPSS scores to detect change above FMA-UE minimal clinically important different values across different stages of stroke.

RESULTS

The RPSS had high internal responsiveness overall and across the acute or subacute and chronic stages of stroke. For external responsiveness, orthogonal regression analyses indicated that change in FMA-UE scores had positive moderate correlations with both RPSS Close and Far Target scores for all data and across the acute or subacute and chronic stages of stroke (0.6

CONCLUSIONS

In addition to being reliable and valid, the RPSS is also responsive. Along with the FMA-UE, using RPSS scores can help present a more comprehensive picture of motor compensations to characterize poststroke upper limb motor improvement.

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Key Words

• Movement quality
• cerebrovascular accident
• compensation
• outcomes
• reaching
• restitution or true recovery
• upper limb

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MESH Headings

• Humans
• Disability Evaluation
• Recovery of Function
• Retrospective Studies
• Stroke
• Stroke Rehabilitation
• Upper Extremity
• Randomized Controlled Trials as Topic

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Grants Collapse

Affiliation(s)

Sandeep K Subramanian Departments of Physical Therapy, Physician Assistant Studies and Rehabilitation Medicine, University of Texas Health San Antonio, San Antonio, TX
Gita Margolese School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
Andrea Turolla Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Laboratory of Rehabilitation Technologies, Hospital San Camillo IRCCS, Venice, Italy
Gustavo Saposnik Stroke Outcomes and Decision Neuroscience Unit, Unity Health Toronto, University of Toronto, Toronto, Canada
Mindy F Levin School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada.

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Experience influences kinematic motor synergies: an Uncontrolled manifold approach to simulated Nordic skiing

Motor synergies are defined as central nervous system mechanisms which adjust participating degrees of freedom to ensure dynamic stability (control) of certain performance variables and have been identified during many motor tasks. The potential for synergistic control of individual segments during full-body tasks is often overlooked. Thus, this study compared individual differences in the potential stabilization of multiple performance variables on the basis of experience during a full-body sport activity. Normalized time series of synergy indices from Uncontrolled Manifold analyses on experienced (n = 9) and inexperienced (n = 19) participants were analysed using statistical parametric mapping during simulated Nordic skiing. Regardless of experience, hand, upper arm, and whole-body centre of mass (COM) kinematics were found to be stabilized by kinematic motor synergies. Only experienced Nordic skiers stabilized trunk COM position at all, while trunk COM velocity was stabilized for a longer duration than inexperienced participants. However, inexperienced participants stabilized hand velocity for a greater duration overall and to a greater magnitude during early pull phase than the experienced skiers. That motor synergies for hand and trunk COM velocity differed between experience groups suggests potential utility for these performance variables as indicators of motor skill development for full-body tasks such as Nordic skiing.

Alterations in the preferred direction of individual arm muscle activation after stroke

Introduction

Stroke survivors have challenges appropriately coordinating the multiple muscles, resulting in a deficit in motor control. Therefore, comprehending the mechanism underlying abnormal intermuscular coordination becomes crucial in developing effective rehabilitation strategies. Quantitative analyses have been employed at pairwise or multi-dimensional levels to understand the underlying mechanism of abnormal intermuscular coordination and its relationship to motor impairment. However, how alterations in individual muscle activation contribute to abnormal intermuscular coordination, motor impairment, and motor performance remains unclear. Thus, we investigated the alterations in the preferred direction of individual muscles after stroke and their relationship with stroke-induced changes in intermuscular coordination, clinical motor impairment, and qualities of motor performance during isometric force generation in the upper extremity.

Methods

Twenty-four stroke survivors and six age-matched controls were recruited and performed isometric force target matches while recording electromyographic signals from eight upper limb muscles. We determined the preferred activation direction of each muscle, evaluated abnormal intermuscular coordination through a muscle synergy analysis, assessed motor impairment using upper extremity Fugl-Meyer Assessment scores, and examined motor performance characteristics defined by force trajectory features.

Results

The post-stroke alterations in the preferred direction of the brachioradialis, anterior, middle, and posterior deltoid were correlated with the motor impairment level and attributed to the changes in muscle synergy characteristics. Only alterations in the preferred direction of the brachioradialis and posterior deltoid activation in forward-backward and upward-downward axes were associated with the qualities of isometric force generation, respectively.

Discussion

These findings imply that alterations in the preferred direction of individual muscle activation contribute to various aspects of motor deficit following stroke. This insight may serve as a foundation for the development of innovative stroke neurorehabilitation approaches that take into account specific attributes of individual muscle activation, including their preferred activation direction.

Bilateral arm movements are coordinated via task-dependent negotiations between independent and codependent control, but not by a "coupling" control policy

Prior research has shown that coordination of bilateral arm movements might be attributed to either control policies that minimize performance and control costs regardless of bilateral symmetry or by control coupling, which activates bilaterally homologous muscles as a single unit to achieve symmetric performance. We hypothesize that independent bimanual control (movements of one arm are performed without influence on the other) and codependent bimanual control (two arms are constrained to move together with high spatiotemporal symmetry) are two extremes on a coordination spectrum that can be negotiated to meet infinite variations in task demands. To better understand and distinguish between these views, we designed a task where minimization of either control costs or asymmetry would yield different patterns of coordination. Participants made bilateral reaches with a shared visual cursor to a midline target. We then covertly varied the gain contribution of either hand to the shared cursor's horizontal position. Across two experiments, we show that bilateral coordination retains high task-dependent sensitivity to subtle visual feedback gain asymmetries applied to the shared cursor. Specifically, we found a change from strong spatial covariation between hands during equal gains to more independent control during asymmetric gains, which occurred rapidly and with high specificity to the dimension of gain manipulation. Furthermore, the extent of spatial covariation was graded to the magnitude of perpendicular gain asymmetry between hands. These findings suggest coordination of bilateral arm movements flexibly maneuvers along a continuous coordination spectrum in a task-dependent manner that cannot be explained by bilateral control coupling.NEW & NOTEWORTHY Minimization of performance and control costs and efferent coupling between bilaterally homologous muscle groups have been separately hypothesized to describe patterns of bimanual coordination. Here, we address whether the mechanisms mediating independent and codependent control between limbs can be weighted for successful task performance. Using bilaterally asymmetric visuomotor gain perturbations, we show bimanual coordination can be characterized as a negotiation along a spectrum between extremes of independent and codependent control, but not efferent control coupling.

Relation between the kinematic synergy controlling swing foot and visual exploration during obstacle crossing

To step over obstacles of varying heights, two distinct ongoing streams of activities-visual exploration of the environment and gait adjustment- were required to occur concurrently without interfering each other. Yet, it remains unclear whether and how the manner of embodied behavior of visual exploration is related to the synergistic control of foot trajectory to negotiate with the irregular terrain. Thus, we aimed to explore that how the synergistic control of the vertical trajectory of the swing foot (i.e., obstacle clearance) crossing an obstacle is related to the manner of visual exploration of the environment during approach. Twenty healthy young adults crossed an obstacle (depth: 1 cm, width: 60 cm, height: 8 cm) during their comfortable-speed walking. The visual exploration was evaluated as the amount of time spent in fixating the vicinity of the obstacle on the floor during the period from two to four steps prior to crossing the obstacle, and the strengths of kinematic synergy to control obstacle clearance were estimated using the uncontrolled manifold approach. We found that the participants with relatively weak synergy spent more time fixating at the vicinity of the obstacle from two to four steps prior to crossing the obstacle, and those participants exhibited greater amount of head flexion movement compared to those with stronger kinematic synergy. Taking advantage of this complex relationship between exploratory activities (e.g. looking movement) and performative activities (e.g. adjustment of ground clearance) would be crucial to adapt walking in a complex environment.

Neuromuscular control: from a biomechanist's perspective

Understanding neural control of movement necessitates a collaborative approach between many disciplines, including biomechanics, neuroscience, and motor control. Biomechanics grounds us to the laws of physics that our musculoskeletal system must obey. Neuroscience reveals the inner workings of our nervous system that functions to control our body. Motor control investigates the coordinated motor behaviours we display when interacting with our environment. The combined efforts across the many disciplines aimed at understanding human movement has resulted in a rich and rapidly growing body of literature overflowing with theories, models, and experimental paradigms. As a result, gathering knowledge and drawing connections between the overlapping but seemingly disparate fields can be an overwhelming endeavour. This review paper evolved as a need for us to learn of the diverse perspectives underlying current understanding of neuromuscular control. The purpose of our review paper is to integrate ideas from biomechanics, neuroscience, and motor control to better understand how we voluntarily control our muscles. As biomechanists, we approach this paper starting from a biomechanical modelling framework. We first define the theoretical solutions (i.e., muscle activity patterns) that an individual could feasibly use to complete a motor task. The theoretical solutions will be compared to experimental findings and reveal that individuals display structured muscle activity patterns that do not span the entire theoretical solution space. Prevalent neuromuscular control theories will be discussed in length, highlighting optimality, probabilistic principles, and neuromechanical constraints, that may guide individuals to families of muscle activity solutions within what is theoretically possible. Our intention is for this paper to serve as a primer for the neuromuscular control scientific community by introducing and integrating many of the ideas common across disciplines today, as well as inspire future work to improve the representation of neural control in biomechanical models.

Movement preferences of the wrist and forearm during activities of daily living

BACKGROUND

During activities of daily living, the main degrees of freedom of the forearm and wrist-forearm pronation-supination (PS), wrist flexion-extension (FE), and wrist radial-ulnar deviation (RUD)-combine seamlessly to allow the hand to engage with and manipulate objects in our environment. Yet the combined behavior of these three degrees of freedom is relatively unknown.

PURPOSE

To provide a characterization of natural forearm and wrist kinematics (joint configuration, movement direction, and speed) during activities of daily living.

STUDY DESIGN

This is a descriptive cross-sectional study.

METHODS

Ten healthy subjects performed 24 activities of daily living chosen to represent a wide variety of activities, while we measured their PS, FE, and RUD angles using electromagnetic motion capture. The orientation of the forearm and wrist was represented in the three-dimensional "configuration space" spanned by PS, FE, and RUD. From the time course of forearm and wrist orientation in configuration space, we extracted three-dimensional distributions of joint configuration, movement direction, and speed.

RESULTS

Most joint configurations were focused in a relatively small area: subjects spent roughly 50% of the time in the central 20% of their functional range of motion. Some movement directions were significantly more common than others (p < 0.001); in particular, the direction of the dart-thrower's motion (DTM) was about three times more common than motion perpendicular to it. Most movements were slow: the likelihood of moving at increasing speeds dropped off exponentially. Interestingly, the most common high-speed motion combined the DTM with a twist from pronation to supination. As this motion allows one to pick up an object in front of one's body and bring it to the head, it is essential for self-care. Thus, although many activities of daily living follow the DTM without significant forearm rotation, the greatest importance of the DTM may lie in its combination with forearm rotation.

CONCLUSIONS

Despite the wide variety of activities, we found evidence of preferred movement behavior, and this behavior showed significant coupling between the wrist and forearm.

The concepts of muscle activity generation driven by upper limb kinematics

BACKGROUND

The underlying motivation of this work is to demonstrate that artificial muscle activity of known and unknown motion can be generated based on motion parameters, such as angular position, acceleration, and velocity of each joint (or the end-effector instead), which are similarly represented in our brains. This model is motivated by the known motion planning process in the central nervous system. That process incorporates the current body state from sensory systems and previous experiences, which might be represented as pre-learned inverse dynamics that generate associated muscle activity.

METHODS

We develop a novel approach utilizing recurrent neural networks that are able to predict muscle activity of the upper limbs associated with complex 3D human arm motions. Therefore, motion parameters such as joint angle, velocity, acceleration, hand position, and orientation, serve as input for the models. In addition, these models are trained on multiple subjects (n=5 including , 3 male in the age of 26±2 years) and thus can generalize across individuals. In particular, we distinguish between a general model that has been trained on several subjects, a subject-specific model, and a specific fine-tuned model using a transfer learning approach to adapt the model to a new subject. Estimators such as mean square error MSE, correlation coefficient r, and coefficient of determination R² are used to evaluate the goodness of fit. We additionally assess performance by developing a new score called the zero-line score. The present approach was compared with multiple other architectures.

RESULTS

The presented approach predicts the muscle activity for previously through different subjects with remarkable high precision and generalizing nicely for new motions that have not been trained before. In an exhausting comparison, our recurrent network outperformed all other architectures. In addition, the high inter-subject variation of the recorded muscle activity was successfully handled using a transfer learning approach, resulting in a good fit for the muscle activity for a new subject.

CONCLUSIONS

The ability of this approach to efficiently predict muscle activity contributes to the fundamental understanding of motion control. Furthermore, this approach has great potential for use in rehabilitation contexts, both as a therapeutic approach and as an assistive device. The predicted muscle activity can be utilized to guide functional electrical stimulation, allowing specific muscles to be targeted and potentially improving overall rehabilitation outcomes.

Exploring the role of task on kinematic variability and assessing consistency in individual responses across repetitive manual tasks

To gain a greater understanding of motor variability (MV) as an individual trait, the effect of task type on MV and individual consistency in MV across three tasks was investigated. Twenty participants performed repetitive carrying, lifting, and simulated sawing tasks. MV was assessed using the linear measure of mean point-by-point standard deviation in three-dimensional upper body joint angles. Task type affected MV, where carrying showed higher MV compared to sawing (23-29%) and lifting (12-19%). Furthermore, MV was higher in lifting compared to sawing (12-25%). Poor to moderate individual consistency (ICC = 0.42-0.63) was found across tasks. Task type determined MV and only some support for MV as an individual trait across tasks was found. Based on this work, differences in degrees of freedom afforded by the task influence the opportunity to exploit MV, and possibly individual consistency in MV magnitude is specific to the degrees of freedom afforded by the task. Practitioner summary: In repetitive tasks, movement variability has been proposed as an individual characteristic independent of task characteristics, where repeaters show consistently low variability, while replacers show consistently high variability. In the current study, only moderate support was demonstrated for variability as a consistent individual characteristic across different manual tasks.AbbreviationMV: Motor variability; WRMSDs: Work-related musculoskeletal disorders; DOF: Degrees of freedom; meanSD: Mean standard deviation; SD: Standard deviation; H: Handle (of simulated sawing setup); T: Track (of simulated sawing setup); F: Frame (of simulated sawing setup); ICC: Intraclass correlation; UE: Upper extremity; MMH: Manual material handling; EMG: Electromyography.

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

BACKGROUND

Chronic low back pain (CLBP) is a highly prevalent disease with poorly understood underlying mechanisms. In particular, altered trunk muscle coordination in response to specific trunk tasks remains largely unknown.

METHODS

We investigated the muscle synergies during 11 trunk movement and stability tasks in 15 healthy individuals (8 females and 7 males, aged 21. 3 (20.1-22.8) ± 0.6 years) and in 15 CLBP participants (8 females and 7 males, aged 20. 9 (20.2-22.6) ± 0.7 years) by recording the surface electromyographic activities of 12 back and abdominal muscles (six muscles unilaterally). Non-negative matrix factorization was performed to extract the muscle synergies.

RESULTS

We found six trunk muscle synergies and temporal patterns in both groups. The high similarity of the trunk synergies and temporal patterns in the groups suggests that both groups share the common feature of the trunk coordination strategy. We also found that trunk synergies related to the lumbar erector spinae showed lower variability in the CLBP group. This may reflect the impaired back muscles that reshape the trunk synergies in the fixed structure of CLBP. Furthermore, the higher variability of trunk synergies in the other muscle regions such as in the latissimus dorsi and oblique externus, which were activated in trunk stability tasks in the CLBP group, represented more individual motor strategies when the trunk tasks were highly demanding.

CONCLUSION

Our work provides the first demonstration that individual modular organization is fine-tuned while preserving the overall structures of trunk synergies and temporal patterns in the presence of persistent CLBP.

Substituting some unassisted practice with robotic guidance: Assessing the feasibility of auditory-cued mixed practice for music-based interventions

BACKGROUND

There is equivocal evidence regarding the effectiveness of robotic guidance on the (re)learning of voluntary motor skills. Robotic guidance can improve the performance of continuous/ tracking skills, although being seldom more effective than unassisted practice alone. However, most of the previous studies employed robotic guidance on all intervention trials. Recently, we showed that mixing robotic guidance with unassisted practice (i.e., mixed practice) can significantly improve the learning of a golf putting task. Yet, these mixed practice studies involved self-paced movements in a standing posture, thus less applicable to rehabilitation contexts.

OBJECTIVE

The current study aimed to investigate the influence of mixed practice on the timing accuracy of an upper-limb, rhythmic, sequential task. The goal was to assess the feasibility of integrating mixed practice with music-based interventions.

METHODS

Two groups of participants performed circle-drawing sequences in synchrony with rhythmic auditory signals. They completed a pre-test and an acquisition phase, followed by immediate retention and transfer tests. One group received robotic guidance on 50% of the acquisition trials (i.e., mixed practice), whereas another group always practiced unassisted. The pre-test, retention, and transfer tests were performed unassisted.

RESULTS

Both groups significantly improved their timing accuracy and precision between the pre-test and the retention test.

CONCLUSION

This study provides further evidence that mixed practice can facilitate the (re)learning of voluntary actions, especially with the type of externally paced upper-limb movements employed in music-based interventions.

The integration of action-oriented multisensory information from target and limb within the movement planning and execution

The planning and execution of a grasping or reaching movement toward targets we sense with the other hand requires integrating multiple sources of sensory information about the limb performing the movement and the target of the action. In the last two decades, several sensory and motor control theories have thoroughly described how this multisensory-motor integration process occurs. However, even though these theories were very influential in their respective field, they lack a clear, unified vision of how target-related and movement-related multisensory information integrates within the action planning and execution phases. This brief review aims to summarize the most influential theories in multisensory integration and sensory-motor control by underscoring their critical points and hidden connections, providing new ideas on the multisensory-motor integration process. Throughout the review, I wll propose an alternative view of how the multisensory integration process unfolds along the action planning and execution and I will make several connections with the existent multisensory-motor control theories.

Attentional focus effects on joint covariation in a reaching task

Adopting an external focus of attention (EF) has been found beneficial over internal focus (IF) for performing motor skills. Previous studies primarily examined focus of attention (FOA) effects on performance outcomes (such as error and accuracy), with relatively less emphasis on movement coordination. Given that human movements are kinematically and kinetically abundant (Gefland & Latash, 1998), FOA instructions may change how motor abundance is utilized by the CNS. This study applied the uncontrolled manifold analysis (UCM) to address this question in a reaching task. Healthy young adults (N = 38; 22 ± 1 yr; 7 men, 31 women) performed planar reaching movements to a target using either the dominant or nondominant arm under two different FOA instructions: EF and IF. Reaching was performed without online visual feedback and at a preferred pace. Joint angles of the clavicle-scapula, shoulder, elbow, and wrist were recorded, and their covariation for controlling dowel endpoint position was analyzed via UCM. As expected, IF led to a higher mean radial error than EF, driven by increases in aiming bias and variability. Consistent with this result, the UCM analysis showed that IF led to higher goal-relevant variance among the joints (V_ORT) compared to EF starting from the first 20% of the reach to the end. However, the goal-irrelevant variance (V_UCM)-index of joint variance that does not affect the end-effector position-did not show FOA effects. The index of stability of joint coordination with respect to endpoint position (ΔV) was also not different between the EF and IF. Consistent with the constrained action hypothesis, these results provide evidence that IF disrupted goal-relevant joint covariation starting in the early phases of the reach without affecting goal-irrelevant coordination.

Precision aiming performance with the paretic upper limb is associated with center of pressure patterns in individuals with chronic stroke

BACKGROUND

Individuals with stroke commonly demonstrate upper-limb sensorimotor impairments. Upper-limb tasks occur against a background level of postural control and thus require a flexible postural control system to facilitate performance. Anterior precision aiming tasks, for example, benefit from lower medial-lateral (ML) center of pressure (COP) fluctuations (where increased fluctuations erode performance) relative to anterior-posterior (AP) fluctuations (where increased fluctuations do not strongly influence performance). After stroke, individuals may compensate for upper-limb impairments by increasing trunk movement which increases overall COP fluctuations and thus may make it more difficult to modulate COP in a task-sensitive manner.

RESEARCH QUESTION

Do upper-limb task demands modulate COP movement patterns after stroke?

METHODS

In this cross-sectional study, adults with chronic stroke (n = 23) and unilateral upper-limb impairments were immersed in a virtual environment displaying an anterior target. Participants aimed to maintain the position of a virtual laser pointer (via handheld controller) in the target with each hand. COP was concurrently recorded. Mixed effects models and correlations were used to detect differences in COP patterns between limbs and movement planes and evaluate associations between task performance and COP patterns, respectively.

RESULTS

Participants showed greater COP standard deviation and regularity in the AP compared to the ML direction. The magnitude of difference between AP and ML COP metrics was greater using the nonparetic limb. Task performance was moderately and positively associated with task-sensitive COP patterns (i.e., higher AP:ML ratios of COP metrics) using the paretic upper limb. Participants consistently demonstrated high levels of task performance and task-sensitive COP movement patterns using the nonparetic limb.

SIGNIFICANCE

Impairments in postural control after stroke may be related to the upper limb used. It is important to recognize the role of directional COP variability and regularity in the context of a task goal after stroke.