Phase plane analysis of biarticular muscles in stepping

Variability in inter-joint coordination during walking of elderly adults and its association with clinical balance measures

BACKGROUND

Walking requires coordination among multiple joints. Little is known about the association between the coordination ability and fall risks in elderly adults. This study investigated variability of inter-joint coordination in elderly adults and determined its correlation to clinical balance measures.

METHODS

Gait analyses of 15 non-fallers and 15 fallers were performed during walking. Continuous relative phase, derived from phase angles of two adjacent joints, was used to assess the inter-joint coordination. Variability of inter-joint coordination was calculated as the average standard deviation of all points on the ensemble continuous relative phase curve over a gait cycle, namely the deviation phase. Outcomes from three clinical balance tests, including Berg Balance Test, Dynamic Gait Index and Timed Up-and-Go, were examined.

FINDINGS

No significant group differences were detected in hip-knee deviation phase values after accounting for differences in walking speeds. For the knee-ankle deviation phase, fallers demonstrated significantly greater values in the stance phase but smaller values in the swing phase. The hip-knee deviation phase values demonstrated a negative correlation with Dynamic Gait Index, and the knee-ankle deviation phase values had a negative correlation with Dynamic Gait Index and a positive correlation with Timed Up-and-Go time.

INTERPRETATION

Excessive variability of the supporting limb and reduced variability of the swing limb in knee-ankle inter-joint coordination of fallers may contribute to their risk of imbalance or tripping during walking. Compared to Berg Balance Test and Timed Up-and-Go, Dynamic Gait Index scores might be more sensitive to reflect declines in inter-joint coordination during walking.

The contribution of vision, proprioception, and efference copy in storing a neural representation for guiding trail leg trajectory over an obstacle

Stepping over obstacles requires vision to guide the leading leg, but direct visual information is not available to guide the trailing leg. The neural mechanisms for establishing a stored obstacle representation and thus facilitating the trail leg trajectory in humans are unknown. Twenty-four subjects participated in one of three experiments, which were designed to investigate the contribution of visual, proprioceptive, and efference copy signals. Subjects stepped over an obstacle with their lead leg, stopped, and straddled the obstacle for a delay period before stepping over it with their trail leg while toe elevation was recorded. Subsequently, we calculated maximum toe elevation and toe clearance. First, we found that subjects could accurately scale trail leg toe elevation and clearance, despite straddling an obstacle for up to 2 min, similar to quadrupeds. Second, we found that when the lead leg was passively moved over an obstacle (eliminating an efference copy signal and altering proprioception) without vision, trail leg toe elevation and clearance were reduced, and variability increased compared with when subjects actively moved their lead leg. Trail leg toe measures returned to normal when vision was provided during the passive manipulation. Finally, we found that altering lead leg proprioceptive feedback by adding mass to the ankle had no effect on trail leg toe measures. Taken together, our results suggest that humans can store a neural representation of obstacle properties for extended periods of time and that vision appears to be sufficient in this process to guide trail leg trajectory.

Physiology and interpretation of the electromyogram

The purpose of this review is to consider some issues in the interpretation of the electromyogram (EMG) and to discuss current areas of controversy regarding use of the EMG. We consider the underlying physiology and origin of the EMG signal and offer an abbreviated discussion of measurement issues and selected factors that affect the characteristics of the EMG signal. We discuss many of the problems affecting interpretation, including normalization, crosstalk, and issues specific to contraction. In the final section, we consider topics of current interest in electromyography, such as muscle fatigue, task specificity, multichannel representations, and muscle fiber conduction velocity. We present, in addition, alternative analysis techniques. This review should interest researchers and clinicians who seek to obtain the valuable information inherent in the EMG while respecting the potential sources of variance and misinterpretation.