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Fiori L, Castiglia SF, Chini G, Draicchio F, Sacco F, Serrao M, Tatarelli A, Varrecchia T, Ranavolo A. The Lower Limb Muscle Co-Activation Map during Human Locomotion: From Slow Walking to Running. Bioengineering (Basel) 2024; 11:288. [PMID: 38534562 DOI: 10.3390/bioengineering11030288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
The central nervous system (CNS) controls movements and regulates joint stiffness with muscle co-activation, but until now, few studies have examined muscle pairs during running. This study aims to investigate differences in lower limb muscle coactivation during gait at different speeds, from walking to running. Nineteen healthy runners walked and ran at speeds ranging from 0.8 km/h to 9.3 km/h. Twelve lower limb muscles' co-activation was calculated using the time-varying multi-muscle co-activation function (TMCf) with global, flexor-extension, and rostro-caudal approaches. Spatiotemporal and kinematic parameters were also measured. We found that TMCf, spatiotemporal, and kinematic parameters were significantly affected by gait speed for all approaches. Significant differences were observed in the main parameters of each co-activation approach and in the spatiotemporal and kinematic parameters at the transition between walking and running. In particular, significant differences were observed in the global co-activation (CIglob, main effect F(1,17) = 641.04, p < 0.001; at the transition p < 0.001), the stride length (main effect F(1,17) = 253.03, p < 0.001; at the transition p < 0.001), the stride frequency (main effect F(1,17) = 714.22, p < 0.001; at the transition p < 0.001) and the Center of Mass displacement in the vertical (CoMy, main effect F(1,17) = 426.2, p < 0.001; at the transition p < 0.001) and medial-lateral (CoMz, main effect F(1,17) = 120.29 p < 0.001; at the transition p < 0.001) directions. Regarding the correlation analysis, the CoMy was positively correlated with a higher CIglob (r = 0.88, p < 0.001) and negatively correlated with Full Width at Half Maximum (FWHMglob, r = -0.83, p < 0.001), whereas the CoMz was positively correlated with the global Center of Activity (CoAglob, r = 0.97, p < 0.001). Positive and negative strong correlations were found between global co-activation parameters and center of mass displacements, as well as some spatiotemporal parameters, regardless of gait speed. Our findings suggest that walking and running have different co-activation patterns and kinematic characteristics, with the whole-limb stiffness exerted more synchronously and stably during running. The co-activation indexes and kinematic parameters could be the result of global co-activation, which is a sensory-control integration process used by the CNS to deal with more demanding and potentially unstable tasks like running.
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Affiliation(s)
- Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
- Behavioral Neuroscience PhD Program, Department of Physiology and Pharmacology, Sapienza University, Viale dell'Università 30, 00185 Rome, Italy
| | - Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100 Latina, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy
| | - Giorgia Chini
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Floriana Sacco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100 Latina, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
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2
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Faccioli S, Cavalagli A, Falocci N, Mangano G, Sanfilippo I, Sassi S. Gait analysis patterns and rehabilitative interventions to improve gait in persons with hereditary spastic paraplegia: a systematic review and meta-analysis. Front Neurol 2023; 14:1256392. [PMID: 37799279 PMCID: PMC10548139 DOI: 10.3389/fneur.2023.1256392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023] Open
Abstract
Background Hereditary spastic paraplegias (HSPs) are a group of inheritance diseases resulting in gait abnormalities, which may be detected using instrumented gait analysis. The aim of this systematic review was 2-fold: to identify specific gait analysis patterns and interventions improving gait in HSP subjects. Methods A systematic review was conducted in PubMed, Cochrane Library, REHABDATA, and PEDro databases, in accordance with reporting guidelines of PRISMA statement and Cochrane's recommendation. The review protocol was recorded on the PROSPERO register. Patients with pure and complicated HSP of any age were included. All types of studies were included. Risk of bias, quality assessment, and meta-analysis were performed. Results Forty-two studies were included: 19 were related to gait analysis patterns, and 24 were intervention studies. The latter ones were limited to adults. HSP gait patterns were similar to cerebral palsy in younger subjects and stroke in adults. Knee hyperextension, reduced range of motion at knee, ankle, and hip, reduced foot lift, and increased rapid trunk and arm movements were reported. Botulinum injections reduced spasticity but uncovered weakness and improved gait velocity at follow-up. Weak evidence supported intrathecal baclofen, active intensive physical therapy (i.e., robot-assisted gait training, functional exercises, and hydrotherapy), and functional electrical stimulation. Some improvements but adverse events were reported after transcranial magnetic stimulation, transcutaneous spinal direct current stimulation, and spinal cord stimulation implant. Conclusion Knee hyperextension, non-sagittal pelvic movements, and reduced ROM at the knee, ankle, and hip represent the most peculiar patterns in HSP, compared to diplegic cerebral palsy and stroke. Botulinum improved comfortable gait velocity after 2 months. Nonetheless, interventions reducing spasticity might result in ineffective functional outcomes unveiling weakness. Intensive active physical therapy and FES might improve gait velocity in the very short term.
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Affiliation(s)
- Silvia Faccioli
- Children Rehabilitation Unit, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Angela Cavalagli
- Children Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy
| | - Nicola Falocci
- Office of Policy Evaluation and Statistical Studies, Umbria Legislative Assembly, Perugia, Italy
| | - Giulia Mangano
- Department of Physical Medicine and Rehabilitation, Azienda Sanitaria Provinciale 3 (ASP 3), Acireale Hospital, Catania, Italy
| | | | - Silvia Sassi
- Children Rehabilitation Unit, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia, Italy
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3
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Manto M, Serrao M, Filippo Castiglia S, Timmann D, Tzvi-Minker E, Pan MK, Kuo SH, Ugawa Y. Neurophysiology of cerebellar ataxias and gait disorders. Clin Neurophysiol Pract 2023; 8:143-160. [PMID: 37593693 PMCID: PMC10429746 DOI: 10.1016/j.cnp.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
There are numerous forms of cerebellar disorders from sporadic to genetic diseases. The aim of this chapter is to provide an overview of the advances and emerging techniques during these last 2 decades in the neurophysiological tests useful in cerebellar patients for clinical and research purposes. Clinically, patients exhibit various combinations of a vestibulocerebellar syndrome, a cerebellar cognitive affective syndrome and a cerebellar motor syndrome which will be discussed throughout this chapter. Cerebellar patients show abnormal Bereitschaftpotentials (BPs) and mismatch negativity. Cerebellar EEG is now being applied in cerebellar disorders to unravel impaired electrophysiological patterns associated within disorders of the cerebellar cortex. Eyeblink conditioning is significantly impaired in cerebellar disorders: the ability to acquire conditioned eyeblink responses is reduced in hereditary ataxias, in cerebellar stroke and after tumor surgery of the cerebellum. Furthermore, impaired eyeblink conditioning is an early marker of cerebellar degenerative disease. General rules of motor control suggest that optimal strategies are needed to execute voluntary movements in the complex environment of daily life. A high degree of adaptability is required for learning procedures underlying motor control as sensorimotor adaptation is essential to perform accurate goal-directed movements. Cerebellar patients show impairments during online visuomotor adaptation tasks. Cerebellum-motor cortex inhibition (CBI) is a neurophysiological biomarker showing an inverse association between cerebellothalamocortical tract integrity and ataxia severity. Ataxic gait is characterized by increased step width, reduced ankle joint range of motion, increased gait variability, lack of intra-limb inter-joint and inter-segmental coordination, impaired foot ground placement and loss of trunk control. Taken together, these techniques provide a neurophysiological framework for a better appraisal of cerebellar disorders.
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Affiliation(s)
- Mario Manto
- Service des Neurosciences, Université de Mons, Mons, Belgium
- Service de Neurologie, CHU-Charleroi, Charleroi, Belgium
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, University of Rome Sapienza, Polo Pontino, Corso della Repubblica 79 04100, Latina, Italy
- Gait Analysis LAB Policlinico Italia, Via Del Campidano 6 00162, Rome, Italy
| | - Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, University of Rome Sapienza, Polo Pontino, Corso della Repubblica 79 04100, Latina, Italy
- Gait Analysis LAB Policlinico Italia, Via Del Campidano 6 00162, Rome, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, via Bassi, 21, 27100 Pavia, Italy
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Elinor Tzvi-Minker
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
- Syte Institute, Hamburg, Germany
| | - Ming-Kai Pan
- Cerebellar Research Center, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin 64041, Taiwan
- Department and Graduate Institute of Pharmacology, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- Department of Medical Research, National Taiwan University Hospital, Taipei 10002, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei City 11529, Taiwan
- Initiative for Columbia Ataxia and Tremor, Columbia University Irving Medical Center, New York, NY, USA
| | - Sheng-Han Kuo
- Institute of Biomedical Sciences, Academia Sinica, Taipei City 11529, Taiwan
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
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Lassmann C, Ilg W, Rattay TW, Schöls L, Giese M, Haeufle DFB. Dysfunctional neuro-muscular mechanisms explain gradual gait changes in prodromal spastic paraplegia. J Neuroeng Rehabil 2023; 20:90. [PMID: 37454121 PMCID: PMC10349428 DOI: 10.1186/s12984-023-01206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND In Hereditary Spastic Paraplegia (HSP) type 4 (SPG4) a length-dependent axonal degeneration in the cortico-spinal tract leads to progressing symptoms of hyperreflexia, muscle weakness, and spasticity of lower extremities. Even before the manifestation of spastic gait, in the prodromal phase, axonal degeneration leads to subtle gait changes. These gait changes - depicted by digital gait recording - are related to disease severity in prodromal and early-to-moderate manifest SPG4 participants. METHODS We hypothesize that dysfunctional neuro-muscular mechanisms such as hyperreflexia and muscle weakness explain these disease severity-related gait changes of prodromal and early-to-moderate manifest SPG4 participants. We test our hypothesis in computer simulation with a neuro-muscular model of human walking. We introduce neuro-muscular dysfunction by gradually increasing sensory-motor reflex sensitivity based on increased velocity feedback and gradually increasing muscle weakness by reducing maximum isometric force. RESULTS By increasing hyperreflexia of plantarflexor and dorsiflexor muscles, we found gradual muscular and kinematic changes in neuro-musculoskeletal simulations that are comparable to subtle gait changes found in prodromal SPG4 participants. CONCLUSIONS Predicting kinematic changes of prodromal and early-to-moderate manifest SPG4 participants by gradual alterations of sensory-motor reflex sensitivity allows us to link gait as a directly accessible performance marker to emerging neuro-muscular changes for early therapeutic interventions.
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Affiliation(s)
- Christian Lassmann
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Department of Computer Engineering, Wilhelm-Schickard-Institute for Computer Science, University of Tuebingen, Tuebingen, Germany
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Centre for Integrative Neuroscience (CIN), Tuebingen, Germany
| | - Tim W. Rattay
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Center for Rare Diseases (ZSE), University of Tuebingen, Tuebingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, and Center for Neurology, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Center for Rare Diseases (ZSE), University of Tuebingen, Tuebingen, Germany
| | - Martin Giese
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Centre for Integrative Neuroscience (CIN), Tuebingen, Germany
| | - Daniel F. B. Haeufle
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Centre for Integrative Neuroscience (CIN), Tuebingen, Germany
- Institute for Modeling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
- Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany
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5
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Laßmann C, Ilg W, Schneider M, Völker M, Haeufle DFB, Schüle R, Giese M, Synofzik M, Schöls L, Rattay TW. Specific Gait Changes in Prodromal Hereditary Spastic Paraplegia Type 4: preSPG4 Study. Mov Disord 2022; 37:2417-2426. [PMID: 36054444 DOI: 10.1002/mds.29199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/01/2022] [Accepted: 08/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In hereditary spastic paraplegia type 4 (SPG4), subclinical gait changes might occur years before patients realize gait disturbances. The prodromal phase of neurodegenerative disease is of particular interest to halt disease progression by future interventions before impairment has manifested. OBJECTIVE The objective of this study was to identify specific movement abnormalities before the manifestation of gait impairment and quantify disease progression in the prodromal phase. METHODS Seventy subjects participated in gait assessment, including 30 prodromal SPAST pathogenic variant carriers, 17 patients with mild-to-moderate manifest SPG4, and 23 healthy control subjects. An infrared-camera-based motion capture system assessed gait to analyze features such as range of motion and continuous angle trajectories. Those features were correlated with disease severity as assessed by the Spastic Paraplegia Rating Scale, neurofilament light chain as a fluid biomarker indicating neurodegeneration, and motor-evoked potentials. RESULTS Compared with healthy control subjects, we found an altered gait pattern in prodromal pathogenic variant carriers during the swing phase in the segmental angle of the foot (Dunn's post hoc test, q = 3.1) and heel ground clearance (q = 2.8). Furthermore, range of motion of segmental angle was reduced for the foot (q = 3.3). These changes occurred in prodromal pathogenic variant carriers without quantified leg spasticity in clinical examination. Gait features correlated with neurofilament light chain levels, central motor conduction times of motor-evoked potentials, and Spastic Paraplegia Rating Scale score. CONCLUSIONS Gait analysis can quantify changes in prodromal and mild-to-moderate manifest SPG4 patients. Thus, gait features constitute promising motor biomarkers characterizing the subclinical progression of spastic gait and might help to evaluate interventions in early disease stages. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Christian Laßmann
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Computer Engineering, Wilhelm-Schickard-Institute for Computer Science, University of Tübingen, Tübingen, Germany.,Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Centre for Integrative Neuroscience (CIN), Tübingen, Germany
| | - Marc Schneider
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Centre for Integrative Neuroscience (CIN), Tübingen, Germany
| | - Maximilian Völker
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and Center of Neurology, University of Tübingen, Tübingen, Germany
| | - Daniel F B Haeufle
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Centre for Integrative Neuroscience (CIN), Tübingen, Germany.,Computational Biophysics and Biorobotics, Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
| | - Rebecca Schüle
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Center for Rare Diseases (ZSE) University of Tübingen, Tübingen, Germany
| | - Martin Giese
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Centre for Integrative Neuroscience (CIN), Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Center for Rare Diseases (ZSE) University of Tübingen, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Center for Rare Diseases (ZSE) University of Tübingen, Tübingen, Germany
| | - Tim W Rattay
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Center for Rare Diseases (ZSE) University of Tübingen, Tübingen, Germany
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6
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Zhvansky DS, Sylos-Labini F, Dewolf A, Cappellini G, d’Avella A, Lacquaniti F, Ivanenko Y. Evaluation of Spatiotemporal Patterns of the Spinal Muscle Coordination Output during Walking in the Exoskeleton. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22155708. [PMID: 35957264 PMCID: PMC9370895 DOI: 10.3390/s22155708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 06/01/2023]
Abstract
Recent advances in the performance and evaluation of walking in exoskeletons use various assessments based on kinematic/kinetic measurements. While such variables provide general characteristics of gait performance, only limited conclusions can be made about the neural control strategies. Moreover, some kinematic or kinetic parameters are a consequence of the control implemented on the exoskeleton. Therefore, standard indicators based on kinematic variables have limitations and need to be complemented by performance measures of muscle coordination and control strategy. Knowledge about what happens at the spinal cord output level might also be critical for rehabilitation since an abnormal spatiotemporal integration of activity in specific spinal segments may result in a risk for abnormalities in gait recovery. Here we present the PEPATO software, which is a benchmarking solution to assess changes in the spinal locomotor output during walking in the exoskeleton with respect to reference data on normal walking. In particular, functional and structural changes at the spinal cord level can be mapped into muscle synergies and spinal maps of motoneuron activity. A user-friendly software interface guides the user through several data processing steps leading to a set of performance indicators as output. We present an example of the usage of this software for evaluating walking in an unloading exoskeleton that allows a person to step in simulated reduced (the Moon's) gravity. By analyzing the EMG activity from lower limb muscles, the algorithms detected several performance indicators demonstrating differential adaptation (shifts in the center of activity, prolonged activation) of specific muscle activation modules and spinal motor pools and increased coactivation of lumbar and sacral segments. The software is integrated at EUROBENCH facilities to benchmark the performance of walking in the exoskeleton from the point of view of changes in the spinal locomotor output.
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Affiliation(s)
- Dmitry S. Zhvansky
- Institute for Information Transmission Problems, Russian Academy of Sciences, 127994 Moscow, Russia;
| | - Francesca Sylos-Labini
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Arthur Dewolf
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Germana Cappellini
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea d’Avella
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98100 Messina, Italy
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (F.S.-L.); (A.D.); (G.C.); (A.d.); (F.L.)
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7
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Dewolf AH, Sylos-Labini F, Cappellini G, Zhvansky D, Willems PA, Ivanenko Y, Lacquaniti F. Neuromuscular Age-Related Adjustment of Gait When Moving Upwards and Downwards. Front Hum Neurosci 2021; 15:749366. [PMID: 34744664 PMCID: PMC8566537 DOI: 10.3389/fnhum.2021.749366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Locomotor movements are accommodated to various surface conditions by means of specific locomotor adjustments. This study examined underlying age-related differences in neuromuscular control during level walking and on a positive or negative slope, and during stepping upstairs and downstairs. Ten elderly and eight young adults walked on a treadmill at two different speeds and at three different inclinations (0°, +6°, and −6°). They were also asked to ascend and descend stairs at self-selected speeds. Full body kinematics and surface electromyography of 12 lower-limb muscles were recorded. We compared the intersegmental coordination, muscle activity, and corresponding modifications of spinal motoneuronal output in young and older adults. Despite great similarity between the neuromuscular control of young and older adults, our findings highlight subtle age-related differences in all conditions, potentially reflecting systematic age-related adjustments of the neuromuscular control of locomotion across various support surfaces. The main distinctive feature of walking in older adults is a significantly wider and earlier activation of muscles innervated by the sacral segments. These changes in neuromuscular control are reflected in a reduction or lack of propulsion observed at the end of stance in older adults at different slopes, with the result of a delay in the timing of redirection of the centre-of-mass velocity and of an unanticipated step-to-step transition strategy.
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Affiliation(s)
- Arthur H Dewolf
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Germana Cappellini
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Dmitry Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - Patrick A Willems
- Laboratoire de Physiologie et Biomecanique de la Locomotion, Université catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco Lacquaniti
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
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8
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Gaßner H, List J, Martindale CF, Regensburger M, Klucken J, Winkler J, Kohl Z. Functional gait measures correlate to fear of falling, and quality of life in patients with Hereditary Spastic Paraplegia: A cross-sectional study. Clin Neurol Neurosurg 2021; 209:106888. [PMID: 34455170 DOI: 10.1016/j.clineuro.2021.106888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/12/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Gait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients' self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard. METHODS HSP patients ("pure" phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test). RESULTS Functional gait measures correlated to fear of falling (gait speed: r = -0.726; step length: r = -0.689; TUG: r = 0.721; 2-min: r = -0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = -0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = -0.787; step length: r = -0.821; TUG: r = 0.756; 2-min: r = -0.791). CONCLUSION Functional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician's evaluation and support the clinical workup by more objective parameters.
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Affiliation(s)
- Heiko Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Julia List
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | | | - Martin Regensburger
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Jochen Klucken
- Medical Valley - Digital Health Application Center GmbH, Bamberg, Germany; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Zacharias Kohl
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany; Department of Neurology, University of Regensburg, Regensburg, Germany.
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9
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Dewolf AH, Sylos-Labini F, Cappellini G, Ivanenko Y, Lacquaniti F. Age-related changes in the neuromuscular control of forward and backward locomotion. PLoS One 2021; 16:e0246372. [PMID: 33596223 PMCID: PMC7888655 DOI: 10.1371/journal.pone.0246372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/18/2021] [Indexed: 01/14/2023] Open
Abstract
Previous studies found significant modification in spatiotemporal parameters of backward walking in healthy older adults, but the age-related changes in the neuromuscular control have been considered to a lesser extent. The present study compared the intersegmental coordination, muscle activity and corresponding modifications of spinal montoneuronal output during both forward and backward walking in young and older adults. Ten older and ten young adults walked forward and backward on a treadmill at different speeds. Gait kinematics and EMG activity of 14 unilateral lower-limb muscles were recorded. As compared to young adults, the older ones used shorter steps, a more in-phase shank and foot motion, and the activity profiles of muscles innervated from the sacral segments were significantly wider in each walking condition. These findings highlight age-related changes in the neuromuscular control of both forward and backward walking. A striking feature of backward walking was the differential organization of the spinal output as compared to forward gait. In addition, the resulting spatiotemporal map patterns also characterized age-related changes of gait. Finally, modifications of the intersegmental coordination with aging were greater during backward walking. On the whole, the assessment of backward walk in addition to routine forward walk may help identifying or unmasking neuromuscular adjustments of gait to aging.
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Affiliation(s)
- Arthur H. Dewolf
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy
- * E-mail:
| | | | - Germana Cappellini
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco Lacquaniti
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
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10
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Ranavolo A, Serrao M, Draicchio F. Critical Issues and Imminent Challenges in the Use of sEMG in Return-To-Work Rehabilitation of Patients Affected by Neurological Disorders in the Epoch of Human-Robot Collaborative Technologies. Front Neurol 2020; 11:572069. [PMID: 33414754 PMCID: PMC7783040 DOI: 10.3389/fneur.2020.572069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/30/2020] [Indexed: 01/07/2023] Open
Abstract
Patients affected by neurological pathologies with motor disorders when they are of working age have to cope with problems related to employability, difficulties in working, and premature work interruption. It has been demonstrated that suitable job accommodation plans play a beneficial role in the overall quality of life of pathological subjects. A well-designed return-to-work program should consider several recent innovations in the clinical and ergonomic fields. One of the instrument-based methods used to monitor the effectiveness of ergonomic interventions is surface electromyography (sEMG), a multi-channel, non-invasive, wireless, wearable tool, which allows in-depth analysis of motor coordination mechanisms. Although the scientific literature in this field is extensive, its use remains significantly underexploited and the state-of-the-art technology lags expectations. This is mainly attributable to technical and methodological (electrode-skin impedance, noise, electrode location, size, configuration and distance, presence of crosstalk signals, comfort issues, selection of appropriate sensor setup, sEMG amplitude normalization, definition of correct sEMG-related outcomes and normative data) and cultural limitations. The technical and methodological problems are being resolved or minimized also thanks to the possibility of using reference books and tutorials. Cultural limitations are identified in the traditional use of qualitative approaches at the expense of quantitative measurement-based monitoring methods to design and assess ergonomic interventions and train operators. To bridge the gap between the return-to-work rehabilitation and other disciplines, several teaching courses, accompanied by further electrodes and instrumentations development, should be designed at all Bachelor, Master and PhD of Science levels to enhance the best skills available among physiotherapists, occupational health and safety technicians and ergonomists.
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Affiliation(s)
- Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
- Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
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11
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Neuromechanical adjustments when walking with an aiding or hindering horizontal force. Eur J Appl Physiol 2019; 120:91-106. [DOI: 10.1007/s00421-019-04251-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/28/2019] [Indexed: 02/02/2023]
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12
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Hereditary spastic paraplegia: from diagnosis to emerging therapeutic approaches. Lancet Neurol 2019; 18:1136-1146. [PMID: 31377012 DOI: 10.1016/s1474-4422(19)30235-2] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/20/2019] [Accepted: 05/29/2019] [Indexed: 12/16/2022]
Abstract
Hereditary spastic paraplegia (HSP) describes a heterogeneous group of genetic neurodegenerative diseases characterised by progressive spasticity of the lower limbs. The pathogenic mechanism, associated clinical features, and imaging abnormalities vary substantially according to the affected gene and differentiating HSP from other genetic diseases associated with spasticity can be challenging. Next generation sequencing-based gene panels are now widely available but have limitations and a molecular diagnosis is not made in most suspected cases. Symptomatic management continues to evolve but with a greater understanding of the pathophysiological basis of individual HSP subtypes there are emerging opportunities to provide targeted molecular therapies and personalised medicine.
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13
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Dewolf AH, Ivanenko YP, Zelik KE, Lacquaniti F, Willems PA. Differential activation of lumbar and sacral motor pools during walking at different speeds and slopes. J Neurophysiol 2019; 122:872-887. [PMID: 31291150 DOI: 10.1152/jn.00167.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Organization of spinal motor output has become of interest for investigating differential activation of lumbar and sacral motor pools during locomotor tasks. Motor pools are associated with functional grouping of motoneurons of the lower limb muscles. Here we examined how the spatiotemporal organization of lumbar and sacral motor pool activity during walking is orchestrated with slope of terrain and speed of progression. Ten subjects walked on an instrumented treadmill at different slopes and imposed speeds. Kinetics, kinematics, and electromyography of 16 lower limb muscles were recorded. The spinal locomotor output was assessed by decomposing the coordinated muscle activation profiles into a small set of common factors and by mapping them onto the rostrocaudal location of the motoneuron pools. Our results show that lumbar and sacral motor pool activity depend on slope and speed. Compared with level walking, sacral motor pools decrease their activity at negative slopes and increase at positive slopes, whereas lumbar motor pools increase their engagement when both positive and negative slope increase. These findings are consistent with a differential involvement of the lumbar and the sacral motor pools in relation to changes in positive and negative center of body mass mechanical power production due to slope and speed.NEW & NOTEWORTHY In this study, the spatiotemporal maps of motoneuron activity in the spinal cord were assessed during walking at different slopes and speeds. We found differential involvement of lumbar and sacral motor pools in relation to changes in positive and negative center of body mass power production due to slope and speed. The results are consistent with recent findings about the specialization of neuronal networks located at different segments of the spinal cord for performing specific locomotor tasks.
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Affiliation(s)
- A H Dewolf
- Laboratory of Biomechanics and Physiology of Locomotion, Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Y P Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - K E Zelik
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee
| | - F Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, Rome, Italy
| | - P A Willems
- Laboratory of Biomechanics and Physiology of Locomotion, Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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14
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The Effect of Repetitive Transcranial Magnetic Stimulation on Motor Symptoms in Hereditary Spastic Paraplegia. Neural Plast 2019; 2019:7638675. [PMID: 31214256 PMCID: PMC6535885 DOI: 10.1155/2019/7638675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/11/2019] [Accepted: 04/24/2019] [Indexed: 12/11/2022] Open
Abstract
Background Hereditary spastic paraplegia (HSP) is a heterogeneous group of inherited disorders affecting predominantly the motor cortex and pyramidal tract, which results in slowly progressing gait disorders, as well as spasticity and weakness of lower extremities. Repetitive transcranial magnetic stimulation (rTMS) has been previously investigated as a therapeutic tool for similar motor deficits in a number of neurologic conditions. The aim of this randomized, controlled trial was to investigate the therapeutic potential of rTMS in various forms of HSP, including pure and complicated forms, as well as adrenomyeloneuropathy. Methods We recruited 15 patients (five women and 10 men; mean age 43.7 ± 10.6 years) with the mentioned forms of HSP. The intervention included five sessions of bilateral 10 Hz rTMS over primary motor areas of the muscles of lower extremities and five sessions of similar sham stimulation. Results One patient dropped out due to seizure, and 14 patients completed the study protocol. After real stimulation, the strength of the proximal and distal muscles of lower extremities increased, and the spasticity of the proximal muscles decreased. Change in spasticity was still present during follow-up assessment. No effect was observed regarding gait velocity. No changes were seen after sham stimulation. A post hoc analysis revealed an inverse relation between motor threshold and the change of the strength after active rTMS. Conclusions rTMS may have potential in improving weakness and spasticity of lower extremities in HSP, especially of proximal muscles whose motor areas are located more superficially. This trial is registered with Clinicaltrials.gov NCT03627416.
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15
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Yokoyama H, Kaneko N, Ogawa T, Kawashima N, Watanabe K, Nakazawa K. Cortical Correlates of Locomotor Muscle Synergy Activation in Humans: An Electroencephalographic Decoding Study. iScience 2019; 15:623-639. [PMID: 31054838 PMCID: PMC6547791 DOI: 10.1016/j.isci.2019.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/09/2019] [Accepted: 04/04/2019] [Indexed: 01/17/2023] Open
Abstract
Muscular control during walking is believed to be simplified by the coactivation of muscles called muscle synergies. Although significant corticomuscular connectivity during walking has been reported, the level at which the cortical activity is involved in muscle activity (muscle synergy or individual muscle level) remains unclear. Here we examined cortical correlates of muscle activation during walking by brain decoding of activation of muscle synergies and individual muscles from electroencephalographic signals. We demonstrated that the activation of locomotor muscle synergies was decoded from slow cortical waves. In addition, the decoding accuracy for muscle synergies was greater than that for individual muscles and the decoding of individual muscle activation was based on muscle-synergy-related cortical information. These results indicate the cortical correlates of locomotor muscle synergy activation. These findings expand our understanding of the relationships between brain and locomotor muscle synergies and could accelerate the development of effective brain-machine interfaces for walking rehabilitation.
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Affiliation(s)
- Hikaru Yokoyama
- Department of Electrical and Electronic Engineering, Tokyo University of Agriculture and Technology, Koganei-shi, Tokyo 184-8588, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Naotsugu Kaneko
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Tetsuya Ogawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Noritaka Kawashima
- Department of Rehabilitation for the Movement Functions, Research Institute of National Rehabilitation Center for the Disabled, Tokorozawa-shi, Saitama 359-0042, Japan
| | - Katsumi Watanabe
- Faculty of Science and Engineering, Waseda University, Shinjuku-ku Tokyo 169-8555, Japan; Art & Design, University of New South Wales, Sydney, NSW 2021, Australia; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan.
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16
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Martino G, Ivanenko Y, Serrao M, Ranavolo A, Draicchio F, Casali C, Lacquaniti F. Locomotor coordination in patients with Hereditary Spastic Paraplegia. J Electromyogr Kinesiol 2019; 45:61-69. [PMID: 30836301 DOI: 10.1016/j.jelekin.2019.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022] Open
Abstract
Locomotion is a complex behaviour that requires the coordination of multiple body segments and muscle groups. Here we investigated how the weakness and spasticity in individuals with Hereditary Spastic Paraplegia (HSP) affect the coordination patterns of the lower limbs. We analysed kinematics and electromyographic (EMG) activity from 12 leg muscles in 21 persons with HSP and 20 control subjects at matched walking speeds. To assess the locomotor coordination, we examined the covariation between thigh, shank and foot elevation angles by means of principal component analysis and the modular organization of EMG patterns using the non-negative matrix factorization algorithm. The characteristic features of the HSP gait consisted in changes of the elevation angles covariation, the shape of the gait loop, reduced range of motion of the distal segments and significantly lower foot lift. The EMG factorization analysis revealed a comparable structure of the motor output between HSP and control groups, but significantly wider basic temporal patterns associated with muscles innervated from the sacral spinal segments in HSP. Overall, the applied methodology highlighted the impact of the corticospinal degeneration and spasticity on the coordination of distal limb segments and basic muscle modules associated with distal spinal segments.
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Affiliation(s)
- G Martino
- Centre of Space Bio-medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy.
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - M Serrao
- Rehabilitation Centre Policlinico Italia, 00162 Rome, Italy; Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
| | - A Ranavolo
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, 00078 Rome, Italy
| | - F Draicchio
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, 00078 Rome, Italy
| | - C Casali
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
| | - F Lacquaniti
- Centre of Space Bio-medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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