Positional difference of malleoli-midpoint from three-dimensional geometric centre of rotation of ankle and its effect on ankle joint kinetics

Age-related impairments and influence of visual feedback when learning to stand with unexpected sensorimotor delays

Background

While standing upright, the brain must accurately accommodate for delays between sensory feedback and self-generated motor commands. Natural aging may limit adaptation to sensorimotor delays due to age-related decline in sensory acuity, neuromuscular capacity and cognitive function. This study examined balance learning in young and older adults as they stood with robot-induced sensorimotor delays.

Methods

A cohort of community dwelling young (mean = 23.6 years, N = 20) and older adults (mean = 70.1 years, N = 20) participated in this balance learning study. Participants stood on a robotic balance simulator which was used to artificially impose a 250 ms delay into their control of standing. Young and older adults practiced to balance with the imposed delay either with or without visual feedback (i.e., eyes open or closed), resulting in four training groups. We assessed their balance behavior and performance (i.e., variability in postural sway and ability to maintain upright posture) before, during and after training. We further evaluated whether training benefits gained in one visual condition transferred to the untrained condition.

Results

All participants, regardless of age or visual training condition, improved their balance performance through training to stand with the imposed delay. Compared to young adults, however, older adults had larger postural oscillations at all stages of the experiments, exhibited less relative learning to balance with the delay and had slower rates of balance improvement. Visual feedback was not required to learn to stand with the imposed delay, but it had a modest effect on the amount of time participants could remain upright. For all groups, balance improvements gained from training in one visual condition transferred to the untrained visual condition.

Conclusion

Our study reveals that while advanced age partially impairs balance learning, the older nervous system maintains the ability to recalibrate motor control to stand with initially destabilizing sensorimotor delays under differing visual feedback conditions.

Three-dimensional architecture of human medial gastrocnemius fascicles in vivo: Regional variation and its dependence on muscle size

Fascicle architecture (length and pennation angle) can vary regionally within a muscle. The architectural variability in human muscles has been evaluated in vivo, but the interindividual variation and its determinants remain unclear. Considering that within‐muscle non‐uniform changes in pennation angle are associated with change in muscle size by chronic mechanical loading, we hypothesized that the regional variation in fascicle architecture is dependent on interindividual variation in muscle size. To test this hypothesis, we reconstructed fascicles three‐dimensionally along and across the whole medial gastrocnemius in the right lower leg of 15 healthy adults (10 males and 5 females, 23.7 ± 3.3 years, 165.8 ± 8.3 cm, 61.9 ± 11.4 kg, mean ± standard deviation) in neutral ankle joint position with the knee fully extended, using magnetic resonance diffusion tensor imaging and tractography. The 3D‐reconstructed fascicles arose from the deep aponeurosis with variable lengths and angles both in sagittal and coronal planes. The fascicle length was significantly longer in the middle (middle‐medial: 52.4 ± 6.1 mm, middle‐lateral: 52.0 ± 5.1 mm) compared to distal regions (distal‐medial: 41.0 ± 5.0 mm, distal‐lateral: 38.9 ± 3.6 mm, p < 0.001). The 2D pennation angle (angle relative to muscle surface) was significantly greater in distal than middle regions, and medial than lateral regions (middle‐medial: 26.6 ± 3.1°, middle‐lateral: 24.1 ± 2.3°, distal‐medial: 31.2 ± 3.6°, distal‐lateral: 29.2 ± 3.0°, p ≤ 0.017), while only a proximo‐distal difference was significant (p < 0.001) for 3D pennation angle (angle relative to line of action of muscle). These results clearly indicate fascicle's architectural variation in 3D. The magnitude of regional variation evaluated as standard deviation across regions differed considerably among individuals (4.0–10.7 mm for fascicle length, 0.9–5.0° for 2D pennation angle, and 3.0–8.8° for 3D pennation angle), which was positively correlated with the muscle volume normalized to body mass (r = 0.659–0.828, p ≤ 0.008). These findings indicate muscle‐size dependence of the variability of fascicle architecture.

Test-retest reliability of entire time-series data from hip, knee and ankle kinematics and kinetics during one-leg hops for distance: Analyses using integrated pointwise indices

Motion capture systems enable in-depth interpretations of human movements based on data from three-dimensional joint angles and moments. Such analyses carry important bearings for evaluation of movement control during for instance hop landings among sports-active individuals from a performance perspective but also in rehabilitation. Recent statistical development allows analysis of entire time-series of angle and moment during hops using functional data analysis, but the reliability of such multifaceted data is not established. We used integrated pointwise indices (intra-class correlation, ICC; standard error of measurement, SEM) to establish the test-retest reliability of three-dimensional hip, knee and ankle angle and moment curves during landings of one-leg hop for distance (OLHD) in 23 asymptomatic individuals aged 18-28. We contrasted these findings to reliability of discrete variables extracted at specific events (initial contact, peak value). We extended the calculations of ICC and SEM to handle unbalanced situations (varying number of repetitions) to include all available data. Hip and knee angle curves proved reliable with stable ICC curves throughout the landing, with integrated ICCs ≥ 0.71 for all planes except for knee internal/external rotation (ICC = 0.57). Hip and knee moment curves and ankle angle and moments were less reliable and less stable, particularly in the first ~ 10-25% of the landing (integrated ICCs 0.44-0.57). Curve data were generally not in agreement with the results for discrete event data, thus advocating analysis of curve data which contains more information. To conclude, hip and knee angle curve data during OLHD landings can reliably be evaluated, while moment curves necessitate careful consideration.