The impact of localized fatigue on contralateral tremor and muscle activity is exacerbated by standing posture

Analysis of physiological tremors during different intensities of armcurl exercises using wearable three-axis accelerometers in healthy young men: a pilot study

PURPOSE

The purpose of this pilot study was to determine whether physiological tremors (PTs) assessed using an accelerometer could be used to evaluate resistance exercise intensity.

METHODS

Twenty healthy young men with no prior experience of resistance exercise were recruited. Different intensities (resting, 30%, 50%, and 70% of their predetermined one-repetition maximum (1-RM)) of arm-curl exercise were used to elicit PT. The total work was held equally by varying the number of repetitions, with five sets for each intensity. Sessions of varying intensities were performed randomly with a washout period of at least a week. PT responses were recorded during exercise using accelerometers (3-axis) attached to the wrist and ear. Electromyography (EMG) data were obtained from the biceps brachii muscle during exercise. PT and EMG data were expressed as the average root mean square index.

RESULTS

The EMG amplitude increased significantly as exercise intensity increased. Furthermore, PT amplitude significantly increased as exercise intensity increased. Moreover, the Borg rating of perceived exertion (RPE) and lactic acid levels increased significantly. The wrist PT was related to ear PT, EMG, RPE, and lactic acid levels. Additionally, ear PT was associated with EMG, RPE, and lactic acid levels.

CONCLUSION

This pilot study identified changes in PT during resistance exercise at different intensities. We suggest that the use of PT analyses during these exercises provides a more intuitive delineation of resistance exercise intensity and fatigue.

The Effect of Lower-Body Blood Flow Restriction on Static and Perturbated Stable Stand in Young, Healthy Adults

Muscular fatigue can affect postural control processes by impacting on the neuromuscular and somatosensory system. It is assumed that this leads to an increased risk of injury, especially in sports such as alpine skiing that expose the body to strong and rapidly changing external forces. In this context, posture constraints and contraction-related muscular pressure may lead to muscular deoxygenation. This study investigates whether these constraints and pressure affect static and dynamic postural control. To simulate impaired blood flow in sports within a laboratory task, oxygen saturation was manipulated locally by using an inflatable cuff to induce blood flow restriction (BFR). Twenty-three subjects were asked to stand on a perturbatable platform used to assess postural-related movements. Using a 2 × 2 within-subject design, each participant performed postural control tasks both with and without BFR. BFR resulted in lower oxygenation of the m. quadriceps femoris (p = 0.024) and was associated with a significantly lower time to exhaustion (TTE) compared to the non-restricted condition [F_(1,19) = 16.22, p < 0.001, η_p² = 0.46]. Perturbation resulted in a significantly increased TTE [F_(1,19) = 7.28, p = 0.014, η_p² = 0.277]. There were no significant effects on static and dynamic postural control within the saturation conditions. The present data indicate that BFR conditions leads to deoxygenation and a reduced TTE. Postural control and the ability to regain stability after perturbation were not affected within this investigation.

Cross-limb dynamics of postural tremor due to limb loading to fatigue: neural overflow but not coupling

Many experiments have shown independence of the index finger dynamics under bilateral postural tremor protocols. Here we investigated in young adults the dynamics of bilateral multidirectional postural tremor and forearm muscle activity under the progressively fatiguing conditions supporting an external weight to the point of induced postural failure. When no loads were applied, tremor in the vertical (VT) and mediolateral (ML) directions was similar with prominent peaks within 2- to 4-Hz and 8- to 12-Hz bandwidths. Contrastingly tremor in the anterior-posterior (AP) direction was characterized by a single peak between 0 and 2 Hz. Although no tremor coupling occurred cross limbs, strong within-limb coupling was found between ML and VT directions when no loads were applied (coherence range: 0.77–0.85), implying that these oscillations are related and likely derived from mechanical sources. Applying an external load to the index finger(s) led to significant increases in the amplitude of VT tremor and EMG activity within that limb but also caused increases in tremor directions not aligned with the gravitational vector (AP and ML). Significant increases in VT and ML tremor and EMG activity in the contralateral (unloaded) limb were also found when a single index finger was loaded; however, this bilateral increase did not align with increases in interlimb coupling (coherence <0.21). The effects of fatigue caused by prolonged loading were widespread, affecting tremor and muscle activity in both limbs through a combination of neural and mechanical mechanisms. The single- and dual-limb loading to fatigue increased neural overflow but not tremor coupling between the index fingers.

NEW & NOTEWORTHY This study investigated bilateral multidirectional tremor under unloaded and loaded conditions. We found that tremor in the mediolateral and vertical directions within a limb were strongly coupled, a result not reported previously. Furthermore, when holding a weight to failure, tremor in all directions increased. Tremor also increased in the contralateral (unloaded) limb despite no interlimb coupling. This contralateral increase in tremor following loading a limb until fatigue is hypothesized to stem from motor-overflow effects.

The pattern of coupling dynamics between postural motion, isotonic hand movements and physiological tremor

This study was designed to examine differences in the coupling dynamics between upper limb motion, physiological tremor and whole body postural sway in young healthy adults. Acceleration of the hand and fingers, forearm EMG activity and postural sway data were recorded. Estimation of the degree of bilateral and limb motion-postural sway coupling was determined by cross correlation, coherence and Cross-ApEn analyses. The results revealed that, under postural tremor conditions, there was no significant coupling between limbs, muscles or sway across all metrics of coupling. In contrast, performing a rapid alternating flexion/extension movement about the wrist joint (with one or both limbs) resulted in stronger coupling between limb motion and postural sway. These results support the view that, for physiological tremor responses, the control of postural sway is maintained independent to tremor in the upper limb. However, increasing the level of movement about a distal segment of one arm (or both) leads to increased coupling throughout the body. The basis for this increased coupling would appear to be related to the enhanced neural drive to task-specific muscles within the upper limb.

Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy

We aim for this contribution to operate bi-directionally, both as a "bedside to bench" reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial conditions.

Bilateral tremor responses to unilateral loading and fatiguing muscle contractions

Although physiological tremor has been extensively studied within a single limb, tremor relationships between limbs are not well understood. Early investigations proposed that tremor in each limb is driven by CNS oscillators operating in parallel. However, recent evidence suggests that tremor in both limbs arises from shared neural inputs and is more likely to be observed under perturbed conditions. In the present study, postural tremor about the elbow joint and elbow flexor EMG activity were examined on both sides of the body in response to unilateral loading and fatiguing muscle contractions. Applying loads of 0.5, 1.0, 1.5, and 3.0 kg to a single limb increased tremor and muscle activity in the loaded limb but did not affect the unloaded limb, indicating that manipulating the inertial characteristics of a limb does not evoke bilateral tremor responses. In contrast, maximal-effort unilateral isometric contractions resulted in increased tremor and muscle activity in both the active limb and the nonactive limb without any changes in between-limb tremor or muscle coupling. When unilateral contractions were repeated intermittently, to the extent that maximum torque generation about the elbow joint declined by 50%, different tremor profiles were observed in each limb. Specifically, unilateral fatigue altered coupling between limbs and generated a bilateral response such that tremor and brachioradialis EMG decreased for the fatigued limb and increased in the contralateral nonfatigued limb. Our results demonstrate that activity in the nonactive limb may be due to a "spillover" effect rather than directly coupled neural output to both arms and that between-limb coupling for tremor and muscle activity is only altered under considerably perturbed conditions, such as fatigue-inducing contractions.

The dynamics of finger tremor in multiple sclerosis is affected by whole body position

Multiple sclerosis (MS) is a disease that results in widespread damage to the nervous system. One consequence of this disease is the emergence of enhanced tremor. This study was designed to (1) compare the tremor responses of persons with MS to that of healthy adults and to (2) examine the impact of whole body position (i.e., seated/standing) on tremor. Bilateral postural tremor was recorded using accelerometers attached to each index finger. Results revealed some similarity of tremor between groups in regard to the principal features (e.g., presence of peaks in similar frequency ranges). However, significant differences were observed with tremor for the MS persons being of greater amplitude, more regular (lower ApEn) and more strongly coupled across limbs compared to the elderly. The effects of body position were consistent across all subjects, with tremor increasing significantly from sitting-to-standing. However, the tremor increase for the MS group was greater than the elderly. Overall, the tremor for MS group was negatively affected by both this disease process and the nature of the task being performed. This latter result indicates that tremor does not simply reflect the feed-forward output of the neuromotor system but that it is influenced by the task constraints.

Organization of physiological tremors and coordination solutions to postural pointing on an uneven stance surface

The study investigated the destabilization effect on multi-segment physiological tremors and coordinative control for a postural-suprapostural task under different stance conditions. Twenty volunteers executed postural pointing from a level surface and a seesaw balance board; meanwhile, physiological tremors of the whole postural system and fluctuation movements of fingertip/stance surface were recorded. In reference to level stance, seesaw stance led to much fewer tremor increments of the upper limb and less fluctuation movement of the fingertip than tremor increment of the lower limb and rolling movement of the stance surface. Tremor coupling between the adjacent segments organized differentially with stance surface. In reference to level stance, seesaw stance reinforced tremor coupling of the upper limb but enfeebled the coupling in the arm-lumbar and calf-foot complexes. Stance-related differences in physiological tremors could be explained by characteristic changes in the primary and secondary principal components (PC1 and PC2), with relatively high communality with segment tremors of the lower and upper limbs, respectively. Seesaw stance introduced a prominent 4-8Hz spectral peak in PC1 and potentiated 1-4Hz and 8-12Hz spectral peaks of PC2. Structural reorganization of physiological tremors with stance configuration suggests that seesaw stance involves distinct suprapostural and postural synergies for regulating degree of freedom in joint space.

Muscle cramp in pediatric Charcot-Marie-Tooth disease type 1A: prevalence and predictors

OBJECTIVES

To identify correlates of calf cramp in children with Charcot-Marie-Tooth disease type 1A (CMT1A).

METHODS

Throughout Australia, 81 children aged 2-16 years with CMT1A were recruited. Measures of strength, ankle range, foot posture, balance, agility, endurance, gait, and neurophysiology were collected. Post hoc logistic regression analyses were performed to identify independent predictors of calf cramp.

RESULTS

Of the 81 children, 26 (32%) reported calf cramp, and 1 child each reported toe, quadriceps, or arm cramp. Calf cramp was associated (p < 0.05) with older age; the presence of hand tremor; stronger foot inversion, eversion, dorsiflexion, and plantarflexion; and better performance in long-jump and 9-hole peg tests. Logistic regression analysis revealed only increasing age (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.11-1.58; p = 0.002) and the presence of hand tremor (OR 3.81, 95% CI 1.18-12.56; p = 0.028) as independent predictors of calf cramp.

CONCLUSION

Calf cramps are common in children with CMT1A and worsen with age. This study revealed a previously unrecognized link between cramp and hand tremor in children with CMT1A. Further investigation of proposed mechanisms and risk factors common to both cramp and tremor will contribute to our understanding of these common complications of CMT1A.