Age-associated impairement in endpoint accuracy of goal-directed contractions performed with two fingers is due to altered activation of the synergistic muscles

Older adults use a motor plan that is detrimental to endpoint control

Here, we aimed to understand if older adults (OA) use a unique motor plan that is detrimental to endpoint control. We performed two experiments that used ankle ballistic contractions that reversed at the target. In Experiment 1, eight young adults (YA; 27.1 ± 4.2) and eight OA (73.3 ± 4.5) aimed to perform an ankle dorsiflexion-plantarflexion movement that reversed at 9° in 180 ms (target). We found that the coordination pattern (motor plan) differed for the two groups. OA used significantly greater soleus (SOL) activity to reverse the ankle movement than YA and exhibited greater tibialis anterior (TA) muscle activity variability (p < 0.05). OA exhibited worse endpoint control than YA, which associated with the exacerbated TA variability (R² > 0.2; p < 0.01). Experiment 2 aimed to confirm that the OA motor plan was detrimental to endpoint control. Fifteen YA (20.5 ± 1.4) performed an ankle dorsiflexion-plantarflexion contraction that reversed at 30% MVC in 160 ms by using either a pattern that mimicked OA (High SOL) or YA (Low SOL). With the High SOL coordination pattern, YA exhibited impaired endpoint control and greater TA activation variability. These findings provide strong evidence that OA select a unique motor plan that is detrimental to endpoint control.

Neuromuscular variability and spatial accuracy in children and older adults

Our ability to control movements is influenced by the developmental status of the neuromuscular system. Consequently, movement control improves from childhood to early adulthood but gradually declines thereafter. However, no study has compared movement accuracy between children and older adults. The purpose of this study was to compare endpoint accuracy during a fast goal-directed movement task in children and older adults. Ten pre-adolescent children (9.7 ± 0.67 yrs) and 19 older adults (71.95 ± 6.99 yrs) attempted to accurately match a peak displacement of the foot to a target (9° in 180 ms) with a dorsiflexion movement. We recorded electromyographic activity from the tibialis anterior (agonist) and soleus (antagonist) muscles. We quantified position error (i.e. spatial accuracy) as well as the coordination, magnitude, and variability of the antagonistic muscles. Children exhibited greater position error than older adults (36.4 ± 13.4% vs. 27.0 ± 9.8%). This age-related difference in spatial accuracy, was related to a more variable activation of the agonist muscle (R²: 0.358; P < 0.01). These results suggest that an immature neuromuscular system, compared to an aged one, affects the generation and refinement of the motor plan which increases the variability in the neural drive to the muscle and reduces spatial accuracy in children.

Voluntary reduction of force variability via modulation of low-frequency oscillations

Visual feedback can influence the force output by changing the power in frequencies below 1 Hz. However, it remains unknown whether visual guidance can help an individual reduce force variability voluntarily. The purpose of this study, therefore, was to determine whether an individual can voluntarily reduce force variability during constant contractions with visual guidance, and whether this reduction is associated with a decrease in the power of low-frequency oscillations (0-1 Hz) in force and muscle activity. Twenty young adults (27.6 ± 3.4 years) matched a force target of 15% MVC (maximal voluntary contraction) with ankle dorsiflexion. Participants performed six visually unrestricted contractions, from which we selected the trial with the least variability. Following, participants performed six visually guided contractions and were encouraged to reduce their force variability within two guidelines (±1 SD of the least variable unrestricted trial). Participants decreased the SD of force by 45% (P < 0.001) during the guided condition, without changing mean force (P > 0.2). The decrease in force variability was associated with decreased low-frequency oscillations (0-1 Hz) in force (R ² = 0.59), which was associated with decreased low-frequency oscillations in EMG bursts (R ² = 0.35). The reduction in low-frequency oscillations in EMG burst was positively associated with power in the interference EMG from 35 to 60 Hz (R ² = 0.47). In conclusion, voluntary reduction of force variability is associated with decreased low-frequency oscillations in EMG bursts and consequently force output. We provide novel evidence that visual guidance allows healthy young adults to reduce force variability voluntarily likely by adjusting the low-frequency oscillations in the neural drive.

Augmented effects of EMG biofeedback interfaced with virtual reality on neuromuscular control and movement coordination during reaching in children with cerebral palsy

BACKGROUND

The purpose of the present study was to compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps (T:B) muscle activity imbalance and elbow joint movement coordination during a reaching motor taskOBJECTIVE: To compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps muscle activity imbalance and elbow joint movement coordination during a reaching motor task in normal children and children with spastic cerebral palsy (CP).

METHODS

18 children with spastic CP (2 females; mean±standard deviation = 9.5 ± 1.96 years) and 8 normal children (3 females; mean ± standard deviation = 9.75 ± 2.55 years) were recruited from a local community center. All children with CP first underwent one intensive session of EMG feedback (30 minutes), followed by one session of the EMG-VR feedback (30 minutes) after a 1-week washout period. Clinical tests included elbow extension range of motion (ROM), biceps muscle strength, and box and block test. EMG triceps and biceps (T:B) muscle activity imbalance and reaching movement acceleration coordination were concurrently determined by EMG and 3-axis accelerometer measurements respectively. Independent t-test and one-way repeated analysis of variance (ANOVA) were performed at p < 0.05.

RESULTS

The one-way repeated ANOVA was revealed to be significantly effective in elbow extension ROM (p = 0.01), biceps muscle strength (p = 0.01), and box and block test (p = 0.03). The one-way repeated ANOVA also revealed to be significantly effective in the peak triceps muscle activity (p = 0.01). However, one-way repeated ANOVA produced no statistical significance in the composite 3-dimensional movement acceleration coordination data (p = 0.12).

CONCLUSIONS

The present study is a first clinical trial that demonstrated the superior benefits of the EMG biofeedback when augmented by virtual reality exercise games in children with spastic CP. The augmented EMG and VR feedback produced better neuromuscular balance control in the elbow joint than the EMG biofeedback alone.

Force steadiness as a predictor of time to complete a pegboard test of dexterity in young men and women

The purpose of the study was to evaluate the capacity of an expanded set of force steadiness tasks to explain the variance in the time it takes young men and women to complete the grooved pegboard test. In a single experimental session, 30 participants (mean ± SD) (24.2 ± 4.0 yr; 15 women) performed the grooved pegboard test, two tests of hand speed, measurements of muscle strength, and a set of submaximal, steady contractions. The steadiness tasks involved single and double actions requiring isometric contractions in the directions of wrist extension, a pinch between the index finger and thumb, and index finger abduction. Time to complete the grooved pegboard test ranged from 41.5 to 67.5 s. The pegboard times (53.9 ± 6.2 s) were not correlated with any of the strength measurements or the reaction time test of hand speed. A stepwise, multiple-regression analysis indicated that much of the variance (R(2) = 0.70) in pegboard times could be explained by a model that comprised two predictor variables derived from the steadiness tasks: time to match the target during a rapid force-matching task and force steadiness (coefficient of variation for force) during a single-action task. Moreover, the pegboard times were significantly faster for women (51.7 ± 6.8 s) than men (56.1 ± 4.9 s). Participants with slower pegboard times seemed to place a greater emphasis on accuracy than speed as they had longer times to match the target during the rapid force-matching task and exhibited superior force steadiness during the single-action task.

Motor control differs for increasing and releasing force

Control of the motor output depends on our ability to precisely increase and release force. However, the influence of aging on force increase and release remains unknown. The purpose of this study, therefore, was to determine whether force control differs while increasing and releasing force in young and older adults. Sixteen young adults (22.5 ± 4 yr, 8 females) and 16 older adults (75.7 ± 6.4 yr, 8 females) increased and released force at a constant rate (10% maximum voluntary contraction force/s) during an ankle dorsiflexion isometric task. We recorded the force output and multiple motor unit activity from the tibialis anterior (TA) muscle and quantified the following outcomes: 1) variability of force using the SD of force; 2) mean discharge rate and variability of discharge rate of multiple motor units; and 3) power spectrum of the multiple motor units from 0-4, 4-10, 10-35, and 35-60 Hz. Participants exhibited greater force variability while releasing force, independent of age (P < 0.001). Increased force variability during force release was associated with decreased modulation of multiple motor units from 35 to 60 Hz (R(2) = 0.38). Modulation of multiple motor units from 35 to 60 Hz was further correlated to the change in mean discharge rate of multiple motor units (r = 0.66) and modulation from 0 to 4 Hz (r = -0.64). In conclusion, these findings suggest that force control is altered while releasing due to an altered modulation of the motor units.

Motor Output Variability Impairs Driving Ability in Older Adults

BACKGROUND

The functional declines with aging relate to deficits in motor control and strength. In this study, we determine whether older adults exhibit impaired driving as a consequence of declines in motor control or strength.

METHODS

Young and older adults performed the following tasks: (i) maximum voluntary contractions of ankle dorsiflexion and plantarflexion; (ii) sinusoidal tracking with isolated ankle dorsiflexion; and (iii) a reactive driving task that required responding to unexpected brake lights of the car ahead. We quantified motor control with ankle force variability, gas position variability, and brake force variability. We quantified reactive driving performance with a combination of gas pedal error, premotor and motor response times, and brake pedal error.

RESULTS

Reactive driving performance was ~30% more impaired (t = 3.38; p < .01) in older adults compared with young adults. Older adults exhibited greater motor output variability during both isolated ankle dorsiflexion contractions (t = 2.76; p < .05) and reactive driving (gas pedal variability: t = 1.87; p < .03; brake pedal variability: t = 4.55; p < .01). Deficits in reactive driving were strongly correlated to greater motor output variability (R ² = .48; p < .01) but not strength (p > .05).

CONCLUSIONS

This study provides novel evidence that age-related declines in motor control but not strength impair reactive driving. These findings have implications on rehabilitation and suggest that interventions should focus on improving motor control to enhance driving-related function in older adults.

Processing of visual information compromises the ability of older adults to control novel fine motor tasks

We performed two experiments to determine whether amplified motor output variability and compromised processing of visual information in older adults impair short-term adaptations when learning novel fine motor tasks. In Experiment 1, 12 young and 12 older adults underwent training to learn how to accurately trace a sinusoidal position target with abduction-adduction of their index finger. They performed 48 trials, which included 8 blocks of 6 trials (the last trial of each block was performed without visual feedback). Afterward, subjects received an interference task (watched a movie) for 60 min. We tested retention by asking subjects to perform the sinusoidal task (5 trials) with and without visual feedback. In Experiment 2, 12 young and 10 older adults traced the same sinusoidal position target with their index finger and ankle at three distinct visual angles (0.25°, 1° and 5.4°). In Experiment 1, the movement error and variability were greater for older adults during the visual feedback trials when compared with young adults. In contrast, during the no-vision trials, age-associated differences in movement error and variability were ameliorated. Short-term adaptations in learning the sinusoidal task were similar for young and older adults. In Experiment 2, lower amount of visual feedback minimized the age-associated differences in movement variability for both the index finger and ankle movements. We demonstrate that although short-term adaptations are similar for young and older adults, older adults do not process visual information as well as young adults and that compromises their ability to control novel fine motor tasks during acquisition, which could influence long-term retention and transfer.

The Effect of Antagonist Muscle Sensory Input on Force Regulation

The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels. At lower torque levels (5%, 10%, and 15%), subjects produced greater knee torque error following tendon tapping compared with the same torque levels without tendon tapping. In contrast, we did not find any difference in torque output at higher target levels (20%, 30%, and 40%) between trials with and without tendon tapping. We also observed a load-dependent increase in the magnitude of agonist muscle activity after tendon taps, with no associated load-dependent increase in agonist and antagonist co-activation, or reflex inhibition from the antagonist tapping. The findings suggest that at relatively low muscle activity there is a deficiency in the ability to correct motor output after sensory disturbances, and cortical centers (versus sub-cortical) are likely involved.

Force control is related to low-frequency oscillations in force and surface EMG

Force variability during constant force tasks is directly related to oscillations below 0.5 Hz in force. However, it is unknown whether such oscillations exist in muscle activity. The purpose of this paper, therefore, was to determine whether oscillations below 0.5 Hz in force are evident in the activation of muscle. Fourteen young adults (21.07±2.76 years, 7 women) performed constant isometric force tasks at 5% and 30% MVC by abducting the left index finger. We recorded the force output from the index finger and surface EMG from the first dorsal interosseous (FDI) muscle and quantified the following outcomes: 1) variability of force using the SD of force; 2) power spectrum of force below 2 Hz; 3) EMG bursts; 4) power spectrum of EMG bursts below 2 Hz; and 5) power spectrum of the interference EMG from 10–300 Hz. The SD of force increased significantly from 5 to 30% MVC and this increase was significantly related to the increase in force oscillations below 0.5 Hz (R² = 0.82). For both force levels, the power spectrum for force and EMG burst was similar and contained most of the power from 0–0.5 Hz. Force and EMG burst oscillations below 0.5 Hz were highly coherent (coherence = 0.68). The increase in force oscillations below 0.5 Hz from 5 to 30% MVC was related to an increase in EMG burst oscillations below 0.5 Hz (R² = 0.51). Finally, there was a strong association between the increase in EMG burst oscillations below 0.5 Hz and the interference EMG from 35–60 Hz (R² = 0.95). In conclusion, this finding demonstrates that bursting of the EMG signal contains low-frequency oscillations below 0.5 Hz, which are associated with oscillations in force below 0.5 Hz.

Altered activation of the antagonist muscle during practice compromises motor learning in older adults

Aging impairs the activation of muscle; however, it remains unclear whether it contributes to deficits in motor learning in older adults. The purpose of this study was to determine whether altered activation of antagonistic muscles in older adults during practice inhibits their ability to transfer a motor task ipsilaterally. Twenty young (25.1 ± 3.9 yr; 10 men, 10 women) and twenty older adults (71.5 ± 4.8 yr; 10 men, 10 women) participated. Half of the subjects practiced 100 trials of a rapid goal-directed task with ankle dorsiflexion and were tested 1 day later with elbow flexion (transfer). The rest did not perform any ankle practice and only performed the task with elbow flexion. The goal-directed task consisted of rapid movement (180 ms) to match a spatiotemporal target. For each limb, we recorded the EMG burst activity of the primary agonist and antagonist muscles. The rate of improvement during task acquisition (practice) was similar for young and older adults (P > 0.3). In contrast, only young adults were able to transfer the task to the upper limb. Specifically, young adults who practiced ankle dorsiflexion exhibited ∼30% (P < 0.05) lower movement error and ∼60% (P < 0.05) lower antagonist EMG burst activity compared with older adults who received equal practice and young adults who did not receive any ankle dorsiflexion practice. These results provide novel evidence that the deficient motor learning in older adults may be related to a differential activation of the antagonist muscle, which compromises their ability to acquire the task during practice.

Aging and limb alter the neuromuscular control of goal-directed movements

The purpose of this study was to determine whether the neuromuscular control of goal-directed movements is different for young and older adults with the upper and lower limbs. Twenty young (25.1 ± 3.9 years) and twenty older adults (71.5 ± 4.8 years) attempted to accurately match the displacement of their limb to a spatiotemporal target during ankle dorsiflexion or elbow flexion movements. We quantified neuromuscular control by examining the movement endpoint accuracy and variability, and the antagonistic muscle activity using surface electromyography (EMG). Our results indicate that older adults exhibit impaired endpoint accuracy with both limbs due to greater time variability. In addition, older adults exhibit greater EMG burst and lower EMG burst variability as well as lower coactivation of the antagonistic muscles. The impaired accuracy of older adults during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas their impaired accuracy during lower limb movements was related to the amplified EMG bursts. The upper limb exhibited greater movement control than the lower limb, and different neuromuscular parameters were related to the accuracy and consistency for each limb. Greater endpoint error during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas greater endpoint error during lower limb movements was related to the amplified EMG bursts. These findings indicate that the age-associated impairments in movement control are associated with altered activation of the involved antagonistic muscles. In addition, independent of age, the neuromuscular control of goal-directed movements is different for the upper and lower limbs.