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Pingue V, Mirando M, Cazzulani B, Bellaviti G, Saporiti F, Zanga C, Nardone A. Neck muscle spasticity in patients with disorder of consciousness: a pilot study. Eur J Phys Rehabil Med 2024; 60:412-419. [PMID: 38502553 DOI: 10.23736/s1973-9087.24.08176-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Disorder of consciousness (DOC) is a state of prolonged altered consciousness due to severe acquired brain injury (ABI). DOC can be differentiated into coma, unresponsive wakefulness syndrome (UWS), or minimally conscious state (MCS) depending on the behavioral features observed and their relationship to the level of consciousness. Spasticity is one of the most frequently reported medical comorbidities in DOC patients. Since there is a critical lack of spasticity-focused studies and, in turn, of target treatment, we designed this pilot prospective study to evaluate cervical spine muscle spasticity and its effect on rehabilitation outcome in a large cohort of patients followed from the post-acute phase to 6 months after severe ABI. AIM To evaluate neck muscle spasticity and investigate its impact on neurological and functional outcome in a large cohort of adult patients with DOC followed from post-acute to 6 months after severe ABI. DESIGN Single-center prospective pilot study. SETTING Highly specialized inpatient neurorehabilitation clinic. POPULATION Patients with severe ABI admitted within 3 months after the acute event to our Neurorehabilitation Unit between May 21st, 2019 and April 23rd, 2020 for treatment of DOC as a part of their rehabilitation program. METHODS In this single-center prospective pilot study demographic data, etiology of ABI (traumatic versus non-traumatic), DOC evaluated with the revised Coma Recovery Scale (CRS-R), and neurological and functional outcome assessed respectively with the Glasgow Coma Scale (GCS) and Functional Independence Measure (FIM) were considered. During cervical examination, we assessed spasticity with the Modified Ashworth Scale (MAS), deviation of head alignment with a goniometer, and pain with the Nociception Coma Scale-Revised (NCS-R). RESULTS Of the 48 patients, 41.7% were diagnosed with UWS and 58.3% were in a minimally conscious state (MCS). We found spasticity of neck muscles in 91.7% of patients, with no difference in severity (assessed with MAS) between UWV and MCS. The NCS-R score at cervical spine examination was lower in UWS than MCS. Spasticity was severer in patients with traumatic brain injury (TBI) compared to non-traumatic. At multiple linear regression analysis, younger age, hemisyndrome, and tetraparesis were independent predictors of severity of neck muscle spasticity in MCS. More severe spasticity was a predictor of worse neurological and functional outcome at discharge in UWS patients, independently of the other confounding variables at admission (e.g., age, severity of brain injury, functional assessment, and pain). CONCLUSIONS Spasticity of neck muscles frequently develops in patients with DOC and is more severe in those after TBI. UWV and MCS have different spasticity profiles as regards risk factors and neurological and functional outcome. Severity of neck muscle spasticity in UWV patients may represent an early indicator of worse neurological and functional outcome after inpatient rehabilitation. CLINICAL REHABILITATION IMPACT Our findings could prompt clinicians to redefine the rehabilitation aims regarding spasticity and to estimate the functional outcome in patients undergoing intensive rehabilitation after severe ABI.
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Affiliation(s)
- Valeria Pingue
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy -
| | - Marta Mirando
- Centro Studi Attività Motorie (CSAM), ICS Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Benedetta Cazzulani
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Gianluca Bellaviti
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Filippo Saporiti
- Department of Neuroscience, Division of Specialistic Rehabilitation, ASST Ovest Milanese, Legnano, Milan, Italy
| | - Cristina Zanga
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonio Nardone
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Morimoto T, Hirata H, Watanabe K, Kato K, Otani K, Mawatari M, Nikaido T. The Usefulness of Deep Tendon Reflexes in the Diagnosis of Lumbar Spine Diseases: A Narrative Review. Cureus 2024; 16:e55772. [PMID: 38586775 PMCID: PMC10999014 DOI: 10.7759/cureus.55772] [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] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
The deep tendon reflex (DTR) is a more objective indicator than sensory and muscle assessments for lumbar spine disorders. Further, unlike sensory and muscle assessments that require patient cooperation, the DTR can be assessed even in patients with impaired consciousness or cognition. Therefore, DTR assessment with a hammer is an essential neurological test for lumbar spinal diseases. However, despite the usefulness of DTR assessment, few reports have described the significance of increased, diminished, or absent deep lower extremity reflexes in lumbar spine diseases. This review outlines the history of DTR of the lower limbs and describes the techniques, evaluation, and interpretation of DTR for the diagnosis of lumbar spine diseases. The patellar tendon reflex (PTR) was the first parameter of lower extremity DTR identified to have clinical usefulness, followed by the Achilles tendon reflex (ATR), pathological reflexes (Babinski reflex), and reflex enhancement (Jendrassik maneuver). They have now become an integral part of clinical examination. To determine whether an increase or decrease in DTR is pathological, it is necessary to determine left-right differences, differences between the upper and lower extremities, and the overall balance of the limb. There are several critical limitations and pitfalls in interpreting DTRs for lumbar spine diseases. Attention should be paid to examiner and patient factors that make the DTR assessment less objective. When there is a discrepancy between clinical and imaging findings and the level of the lumbosacral nerve root disorder is difficult to diagnose, the presence of a lumbosacral transitional vertebra, nerve root malformation, or furcal nerve should be considered. In addition, assessing the DTR after the gait loading test and standing extension loading test, which induce lumbosacral neuropathy, will help provide a rationale for the diagnosis.
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Affiliation(s)
- Tadatsugu Morimoto
- Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, JPN
| | - Hirohito Hirata
- Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, JPN
| | - Kazuyuki Watanabe
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, JPN
| | - Kinshi Kato
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, JPN
| | - Koji Otani
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, JPN
| | - Masaaki Mawatari
- Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, JPN
| | - Takuya Nikaido
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, JPN
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Wages NP, Mousa MH, Clark LA, Tavoian D, Arnold WD, Elbasiouny SM, Clark BC. Reductions in Motor Unit Firing are Associated with Clinically Meaningful Leg Extensor Weakness in Older Adults. Calcif Tissue Int 2024; 114:9-23. [PMID: 37603077 PMCID: PMC10791983 DOI: 10.1007/s00223-023-01123-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
Weakness, one of the key characteristics of sarcopenia, is a significant risk factor for functional limitations and disability in older adults. It has long been suspected that reductions in motor unit firing rates (MUFRs) are one of the mechanistic causes of age-related weakness. However, prior work has not investigated the extent to which MUFR is associated with clinically meaningful weakness in older adults. Forty-three community-dwelling older adults (mean: 75.4 ± 7.4 years; 46.5% female) and 24 young adults (mean: 22.0 ± 1.8 years; 58.3% female) performed torque matching tasks at varying submaximal intensities with their non-dominant leg extensors. Decomposed surface electromyographic recordings were used to quantify MUFRs from the vastus lateralis muscle. Computational modeling was subsequently used to independently predict how slowed MUFRs would negatively impact strength in older adults. Bivariate correlations between MUFRs and indices of lean mass, voluntary activation, and physical function/mobility were also assessed in older adults. Weak older adults (n = 14) exhibited an approximate 1.5 and 3 Hz reduction in MUFR relative to non-weak older adults (n = 29) at 50% and 80% MVC, respectively. Older adults also exhibited an approximate 3 Hz reduction in MUFR relative to young adults at 80% MVC only. Our model predicted that a 3 Hz reduction in MUFR results in a strength decrement of 11-26%. Additionally, significant correlations were found between slower MUFRs and poorer neuromuscular quality, voluntary activation, chair rise time performance, and stair climb power (r's = 0.31 to 0.43). These findings provide evidence that slowed MUFRs are mechanistically linked with clinically meaningful leg extensor weakness in older adults.
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Affiliation(s)
- Nathan P Wages
- Ohio Musculoskeletal and Neurological Institute, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA.
- Department of Biomedical Sciences, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA.
- Department of Neuroscience, Cell Biology & Physiology, Wright State University, 350 NEC Building, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
| | - Mohamed H Mousa
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA
| | - Leatha A Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA
- Department of Family Medicine, Ohio University, Athens, OH, USA
| | - Dallin Tavoian
- Ohio Musculoskeletal and Neurological Institute, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA
- Department of Physiology, University of Arizona, Tucson, AZ, USA
| | - W David Arnold
- NextGen Precision Health, The University of Missouri, Columbia, MO, USA
| | - Sherif M Elbasiouny
- Department of Neuroscience, Cell Biology & Physiology, Wright State University, 350 NEC Building, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA.
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA.
- Department of Biomedical Sciences, Ohio University, 250 Irvine Hall, 1 Ohio University, Athens, OH, 45701, USA.
- Division of Geriatric Medicine, Ohio University, Athens, OH, USA.
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Orssatto LBR, Borg DN, Pendrith L, Blazevich AJ, Shield AJ, Trajano GS. DO MOTONEURON DISCHARGE RATES SLOW WITH AGING? A SYSTEMATIC REVIEW AND META-ANALYSIS. Mech Ageing Dev 2022; 203:111647. [PMID: 35218849 DOI: 10.1016/j.mad.2022.111647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/03/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
Nervous system maladaptation is linked to the loss of maximal strength and motor control with aging. Motor unit discharge rates are a critical determinant of force production; thus, lower discharge rates could be a mechanism underpinning maximal strength and motor control losses during aging. This meta-analysis summarized the findings of studies comparing motor unit discharge rates between young and older adults, and examined the effects of the selected muscle and contraction intensity on the magnitude of discharge rates difference between these two groups. Estimates from 29 studies, across a range of muscles and contraction intensities, were combined in a multilevel meta-analysis, to investigate whether discharge rates differed between young and older adults. Motor unit discharge rates were higher in younger than older adults, with a pooled standardized mean difference (SMD) of 0.66 (95%CI= 0.29-1.04). Contraction intensity had a significant effect on the pooled SMD, with a 1% increase in intensity associated with a 0.009 (95%CI= 0.003-0.015) change in the pooled SMD. These findings suggest that reductions in motor unit discharge rates, especially at higher contraction intensities, may be an important mechanism underpinning age-related losses in maximal force production.
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Affiliation(s)
- Lucas B R Orssatto
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia.
| | - David N Borg
- Griffith University, Menzies Health Institute Queensland, The Hopkins Centre, Brisbane, Australia
| | - Linda Pendrith
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
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Kirk EA, Gilmore KJ, Rice CL. Anconeus motor unit firing rates during isometric and muscle-shortening contractions comparing young and very old adults. J Neurophysiol 2021; 126:1122-1136. [PMID: 34495770 DOI: 10.1152/jn.00219.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
With effects of aging, voluntary neural drive to the muscle, measured as motor unit (MU) firing rate, is lower in older adults during sustained isometric contractions compared with young adults, but differences remain unknown during limb movements. Therefore, our purpose was to compare MU firing rates during both isometric and shortening contractions between two adult age groups. We analyzed intramuscular electromyography of single-MU recordings in the anconeus muscle of young (n = 8, 19-33 yr) and very old (n = 13, 78-93 yr) male adults during maximal voluntary contractions (MVCs). In sustained isometric and muscle-shortening contractions during limb movement, MU trains were linked with elbow joint kinematic parameters throughout the contraction time course. The older group was 33% weaker and 10% slower during movements than the young group (P < 0.01). In isometric contractions, median firing rates were 42% lower (P < 0.01) in the older group (18 Hz) compared with the young group (31 Hz), but during shortening contractions firing rates were higher for both age groups and not statistically different between groups. As a function of contraction time, firing rates at MU recruitment threshold were 39% lower in the older group, but the firing rate decrease was attenuated threefold throughout shortening contraction compared with the young group. At the single-MU level, age-related differences during isometric contractions (i.e., pre-movement initiation) do not remain constant throughout movement that comprises greater effects of muscle shortening. Results indicate that neural drive is task dependent and during movement in older adults it is decreased minimally.NEW & NOTEWORTHY Changes of neural drive to the muscle with adult aging, measured as motor unit firing rates during limb movements, are unknown. Throughout maximal voluntary efforts we found that, in comparison with young adults, firing rates were lower during isometric contraction in older adults but not different during elbow extension movements. Despite the older group being ∼33% weaker across contractions, their muscles can receive neural drive during movements that are similar to that of younger adults.
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Affiliation(s)
- Eric A Kirk
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Kevin J Gilmore
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Charles L Rice
- School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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6
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Combinational spectral band activation complexity: Uncovering hidden neuromuscular firing dynamics in EMG. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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7
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Škarabot J, Ansdell P, Brownstein CG, Hicks KM, Howatson G, Goodall S, Durbaba R. Reduced corticospinal responses in older compared with younger adults during submaximal isometric, shortening, and lengthening contractions. J Appl Physiol (1985) 2019; 126:1015-1031. [PMID: 30730812 DOI: 10.1152/japplphysiol.00987.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to assess differences in motor performance, as well as corticospinal and spinal responses to transcranial magnetic and percutaneous nerve stimulation, respectively, during submaximal isometric, shortening, and lengthening contractions between younger and older adults. Fifteen younger [26 yr (SD 4); 7 women, 8 men] and 14 older [64 yr (SD 3); 5 women, 9 men] adults performed isometric and shortening and lengthening dorsiflexion on an isokinetic dynamometer (5°/s) at 25% and 50% of contraction type-specific maximums. Motor evoked potentials (MEPs) and H reflexes were recorded at anatomical zero. Maximal dorsiflexor torque was greater during lengthening compared with shortening and isometric contractions ( P < 0.001) but was not age dependent ( P = 0.158). However, torque variability was greater in older compared with young adults ( P < 0.001). Background electromyographic (EMG) activity was greater in older compared with younger adults ( P < 0.005) and was contraction type dependent ( P < 0.001). As evoked responses are influenced by both the maximal level of excitation and background EMG activity, the responses were additionally normalized {[MEP/maximum M wave (Mmax)]/root-mean-square EMG activity (RMS) and [H reflex (H)/Mmax]/RMS}. (MEP/Mmax)/RMS and (H/Mmax)/RMS were similar across contraction types but were greater in young compared with older adults ( P < 0.001). Peripheral motor conduction times were prolonged in older adults ( P = 0.003), whereas peripheral sensory conduction times and central motor conduction times were not age dependent ( P ≥ 0.356). These data suggest that age-related changes throughout the central nervous system serve to accommodate contraction type-specific motor control. Moreover, a reduction in corticospinal responses and increased torque variability seem to occur without a significant reduction in maximal torque-producing capacity during older age. NEW & NOTEWORTHY This is the first study to have explored corticospinal and spinal responses with aging during submaximal contractions of different types (isometric, shortening, and lengthening) in lower limb musculature. It is demonstrated that despite preserved maximal torque production capacity corticospinal responses are reduced in older compared with younger adults across contraction types along with increased torque variability during dynamic contractions. This suggests that the age-related corticospinal changes serve to accommodate contraction type-specific motor control.
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Affiliation(s)
- Jakob Škarabot
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom
| | - Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom
| | - Callum G Brownstein
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom.,Université Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France
| | - Kirsty M Hicks
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom.,Water Research Group, School of Environmental Sciences and Development, Northwest University , Potchefstroom , South Africa
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom
| | - Rade Durbaba
- Faculty of Health and Life Sciences, Northumbria University , Newcastle Upon Tyne , United Kingdom
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Škarabot J, Ansdell P, Brownstein C, Howatson G, Goodall S, Durbaba R. Differences in force normalising procedures during submaximal anisometric contractions. J Electromyogr Kinesiol 2018; 41:82-88. [PMID: 29857263 DOI: 10.1016/j.jelekin.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 11/27/2022] Open
Abstract
Eccentric contractions are thought to require a unique neural activation strategy. However, due to greater intrinsic force generating capacity of muscle fibres during eccentric contraction, the understanding of neural modulation of different contraction types during submaximal contractions may be impeded by the force normalisation procedure employed. In the present experiment, subjects performed maximal isometric dorsiflexion at shorter (80°), intermediate (90°) and longer (100°) muscle lengths, and maximal concentric and eccentric contractions. Thereafter, submaximal concentric and eccentric contractions were performed normalised to either isometric maximum at 90° (ISO), contraction type specific maximum (CTS) or muscle length specific maximum (MLS). When using ISO or MLS for normalisation, mean submaximal eccentric torque levels were significantly lower when compared to CTS normalisation (11 and 7% lower compared to CTS; p = 0.003 and p = 0.018 for ISO and MLS, respectively). These experimentally observed differences closely matched those expected from the predictive model. During submaximal concentric contraction, mean torque levels were similar between ISO and CTS normalisation with similar discrepancies noted in EMG activity. These findings suggest that normalising to ISO and MLS might not be accurate for assessment and prescription of submaximal eccentric contractions.
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Affiliation(s)
- Jakob Škarabot
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom.
| | - Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Callum Brownstein
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom; Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Rade Durbaba
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
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Yon HM, Naidu M. Activation of Akt and the signaling of phosphorylated Akt in the L5 dorsal root ganglia in aging rats. J ANAT SOC INDIA 2017. [DOI: 10.1016/j.jasi.2017.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Mota IA, Fernandes JB, Cardoso MN, Sala-Blanch X, Kofler M, Valls-Solé J. Temporal profile of the effects of regional anesthesia on the cutaneous reflexes of foot muscles. Exp Brain Res 2015; 233:2587-96. [PMID: 26025613 DOI: 10.1007/s00221-015-4329-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 05/14/2015] [Indexed: 12/23/2022]
Abstract
We analyzed the effects of an anesthetic sciatic nerve block on the cutaneomuscular reflex (cMR) and the cutaneous silent period (cSP) of foot muscles, in order to investigate further the type of fibers involved in their generation. In 14 neurologically normal patients with indication for surgical treatment of hallux valgus, we recorded from the extensor digitorum brevis muscle the reflex responses elicited by high-intensity electrical stimulation of the big toe at various time periods, ranging from 0 to 20 min, after ultrasound-guided sciatic nerve popliteal anesthetic block. The first effect was a delay in cSP onset latency, with no changes in end latency. The cMR remained unaltered up to when subjects were no longer able to maintain the contraction. The effects of local anesthetics on peripheral nerves allow for recognition of the different types of fibers contributing to the cMR and the cSP in muscles of the lower limb.
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Affiliation(s)
- Isabella A Mota
- Hospital Universitario Lauro Wanderley, João Pessoa, Paraiba, Brazil
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11
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Kallio J, Søgaard K, Avela J, Komi PV, Selänne H, Linnamo V. Motor unit discharge rate in dynamic movements of the aging soleus. Front Hum Neurosci 2014; 8:773. [PMID: 25324763 PMCID: PMC4179534 DOI: 10.3389/fnhum.2014.00773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/11/2014] [Indexed: 11/13/2022] Open
Abstract
Aging is related to a variety of changes at the muscular level. It seems that the age-related changes in motor unit activation are muscle- and intensity dependent. The purpose of this study was to examine the motor unit discharge rate (MUDR) in both isometric and dynamic contractions of the aging soleus muscle. Eight elderly males participated in the study. The subjects performed isometric and dynamic plantar flexions while seated in an ankle dynamometer. The force levels studied were 10, 20, 40, 60, 80 and 100% of the isometric (ISO) maximal voluntary contractions (MVC) in ISO and 10, 20 and 40% in concentric (CON) and eccentric (ECC) contractions. Soleus intramuscular EMG was recorded with bipolar fine-wire electrodes and decomposed to individual trains of motor unit discharges. In ISO the MUDR increased with each force level from 40 to 100% MVC. In dynamic contractions the descriptive analysis showed a higher MUDR in CON compared to ISO or ECC. The difficulties of recording single motor units in dynamic contractions, especially in the elderly is discussed.
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Affiliation(s)
- Jouni Kallio
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä Jyväskylä, Finland
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark Odense, Denmark
| | - Janne Avela
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä Jyväskylä, Finland
| | - Paavo V Komi
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä Jyväskylä, Finland
| | - Harri Selänne
- LIKES, Foundation for Sport and Health Sciences Jyväskylä, Finland
| | - Vesa Linnamo
- Vuokatti Snowpolis, Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä Jyväskylä, Finland
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McCool P, Fraser GD, Chan ADC, Petropoulakis L, Soraghan JJ. Identification of contaminant type in surface electromyography (EMG) signals. IEEE Trans Neural Syst Rehabil Eng 2014; 22:774-83. [PMID: 24760926 DOI: 10.1109/tnsre.2014.2299573] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The ability to recognize various forms of contaminants in surface electromyography (EMG) signals and to ascertain the overall quality of such signals is important in many EMG-enabled rehabilitation systems. In this paper, new methods for the automatic identification of commonly occurring contaminant types in surface EMG signals are presented. Such methods are advantageous because the contaminant type is typically not known in advance. The presented approach uses support vector machines as the main classification system. Both simulated and real EMG signals are used to assess the performance of the methods. The contaminants considered include: 1) electrocardiogram interference; 2) motion artifact; 3) power line interference; 4) amplifier saturation; and 5) additive white Gaussian noise. Results show that the contaminants can readily be distinguished at lower signal to noise ratios, with a growing degree of confusion at higher signal to noise ratios, where their effects on signal quality are less significant.
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Abstract
Background A clinical parameter commonly used to assess the neurological status of an individual is the tendon reflex response. However, the clinical method of evaluation often leads to subjective conclusions that may differ between examiners. Moreover, attempts to quantify the reflex response, especially in older age groups, have produced inconsistent results. This study aims to examine the influence of age on the magnitude of the patellar tendon reflex response. Methodology/Principal Findings This study was conducted using the motion analysis technique with the reflex responses measured in terms of knee angles. Forty healthy subjects were selected and categorized into three different age groups. Patellar reflexes were elicited from both the left and right patellar tendons of each subject at three different tapping angles and using the Jendrassik maneuver. The findings suggested that age has a significant effect on the magnitude of the reflex response. An angle of 45° may be the ideal tapping angle at which the reflex can be elicited to detect age-related differences in reflex response. The reflex responses were also not influenced by gender and were observed to be fairly symmetrical. Conclusions/Significance Neurologically normal individuals will experience an age-dependent decline in patellar reflex response.
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Kallio J, Søgaard K, Avela J, Komi PV, Selänne H, Linnamo V. Motor unit firing behaviour of soleus muscle in isometric and dynamic contractions. PLoS One 2013; 8:e53425. [PMID: 23405069 PMCID: PMC3566171 DOI: 10.1371/journal.pone.0053425] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 11/29/2012] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Understanding the detailed control of human locomotion and balance can be improved, when individual motor units can be isolated and their firing rates followed in natural movement of large, fuctionally important muscles. For this reason the present study investigated the motor unit discharge rate (MUDR) in isometric and dynamic contractions of the soleus muscle. METHODS Eleven males performed isometric (10-100% MVC) and dynamic (10-40% MVC) plantar flexions. Intramuscular EMG was measured from Soleus with bipolar wire-electrodes and decomposed with custom built "Daisy" software. RESULTS The Soleus MUDR was significantly higher in concentric compared to isometric or eccentric contractions at all submaximal force levels (P<0.05). In isometric contractions MUDR increased up to 100% MVC. CONCLUSION Motor unit discharge properties of a large plantarflexor can be measured in dynamic and maximal contractions. For a given torque output, MUDR is dependent upon contraction type, as set by the major mechanical differences between concentric and eccentric actions.
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Affiliation(s)
- Jouni Kallio
- Neuromuscular Research Center, Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland.
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Ahamed NU, Sundaraj K, Ahmad B, Rahman M, Islam A, Ali A. Surface Electromyography Assessment of the Biceps Brachii Muscle between the Endplate Region and Distal Tendon Insertion: Comparison in Terms of Gender, Dominant Arm and Contraction. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | - Badlisha Ahmad
- School of Computer & Communication Engineering, Universiti Malaysia Perlis
| | - Matiur Rahman
- College of Computer Science and Information System, Najran University, Kingdom of Saudi Arabia
| | - Anamul Islam
- School of Computer & Communication Engineering, Universiti Malaysia Perlis
| | - Asraf Ali
- School of Computer & Communication Engineering, Universiti Malaysia Perlis
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Neuromuscular function during drop jumps in young and elderly males. J Electromyogr Kinesiol 2012; 22:852-8. [DOI: 10.1016/j.jelekin.2012.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 05/15/2012] [Accepted: 05/16/2012] [Indexed: 11/19/2022] Open
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Age-related decreases in motor unit discharge rate and force control during isometric plantar flexion. J Electromyogr Kinesiol 2012; 22:983-9. [DOI: 10.1016/j.jelekin.2012.05.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 05/15/2012] [Accepted: 05/16/2012] [Indexed: 11/23/2022] Open
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Mixco A, Reynolds M, Tracy B, Reiser RF. Aging-Related Cocontraction Effects During Ankle Strategy Balance Recovery Following Tether Release in Women. J Mot Behav 2012; 44:1-11. [DOI: 10.1080/00222895.2011.633944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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