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Tomita Y, Sekiguchi Y, Mayo NE. Efficacy of a Single-Bout of Auditory Feedback Training on Gait Performance and Kinematics in Healthy Young Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:3206. [PMID: 38794060 PMCID: PMC11125153 DOI: 10.3390/s24103206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/25/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the immediate effects of auditory feedback training on gait performance and kinematics in 19 healthy young adults, focusing on bilateral changes, despite unilateral training. Baseline and post-training kinematic measurements, as well as the feedback training were performed on a treadmill with a constant velocity. Significant improvements were seen in step length (trained: 590.7 mm to 611.1 mm, 95%CI [7.609, 24.373]; untrained: 591.1 mm to 628.7 mm, 95%CI [10.698, 30.835]), toe clearance (trained: 13.9 mm to 16.5 mm, 95%CI [1.284, 3.503]; untrained: 11.8 mm to 13.7 mm, 95%CI [1.763, 3.612]), ankle dorsiflexion angle at terminal stance (trained: 8.3 deg to 10.5 deg, 95%CI [1.092, 3.319]; untrained: 9.2 deg to 12.0 deg, 95%CI [1.676, 3.573]), hip flexion angular velocity, (trained: -126.5 deg/s to -131.0 deg/s, 95%CI [-9.054, -2.623]; untrained: -130.2 deg/s to -135.3 deg/s, 95%CI [-10.536, -1.675]), ankle angular velocity at terminal stance (trained: -344.7 deg/s to -359.1 deg/s, 95%CI [-47.540, -14.924]; untrained: -340.3 deg/s to -376.9 deg/s, 95%CI [-37.280, -13.166s]), and gastrocnemius EMG activity (trained: 0.60 to 0.66, 95%CI [0.014, 0.258]; untrained: 0.55 to 0.65, 95%CI [0.049, 0.214]). These findings demonstrate the efficacy of auditory feedback training in enhancing key gait parameters, highlighting the bilateral benefits from unilateral training.
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Affiliation(s)
- Yosuke Tomita
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki 370-0033, Japan; (Y.T.); (Y.S.)
| | - Yoshihiro Sekiguchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki 370-0033, Japan; (Y.T.); (Y.S.)
| | - Nancy E. Mayo
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC H3G 1Y5, Canada
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2
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da Silva Costa AA, Moraes R, den Otter R, Gennaro F, Bakker L, Rocha Dos Santos PC, Hortobágyi T. Corticomuscular and intermuscular coherence as a function of age and walking balance difficulty. Neurobiol Aging 2024; 141:85-101. [PMID: 38850592 DOI: 10.1016/j.neurobiolaging.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/12/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older individuals (n=19, 71y) walked 13 m overground, on a 6-cm-wide ribbon overground, and on a 6-cm-wide (5-cm-high) beam. Walking distance as a proxy for walking balance and speed were computed. CMC was estimated between electroencephalographic signal at Cz electrode and surface electromyographic signals of seven leg muscles, while IMC was calculated in four pairs of leg muscles, during stance and swing gait phases. With increasing difficulty, walking balance decreased in old individuals and speed decreased gradually independent of age. Beam walking increased IMC, while age increased IMC in proximal muscle pairs, and decreased IMC in distal muscle pairs. Age and difficulty increased CMC independent of gait phases. Concluding, CMC and IMC increased with walking balance difficulty and age, except for distal muscle pairs, which had lower IMC with age. These findings suggest an age-related increase in corticospinal involvement in the neural control of walking balance. DATA AVAILABILITY: The datasets used in this study are available from the corresponding author upon reasonable request.
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Affiliation(s)
- Andréia Abud da Silva Costa
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands.
| | - Renato Moraes
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Rob den Otter
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Federico Gennaro
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Lisanne Bakker
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Paulo Cezar Rocha Dos Santos
- Department of Computer Science & Applied Mathematics, Weizmann Institute of Science, Israel; The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; IDOR/Pioneer Science Initiative, Rio de Janeiro, RJ, Brazil
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Department of Kinesiology, Hungarian University of Sports Science, Budapest 1123, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
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3
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Lorenz DL, van den Bogert AJ. A comprehensive dataset on biomechanics and motor control during human walking with discrete mechanical perturbations. PeerJ 2024; 12:e17256. [PMID: 38699182 PMCID: PMC11064863 DOI: 10.7717/peerj.17256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/27/2024] [Indexed: 05/05/2024] Open
Abstract
Background Humans have a remarkable capability to maintain balance while walking. There is, however, a lack of publicly available research data on reactive responses to destabilizing perturbations during gait. Methods Here, we share a comprehensive dataset collected from 10 participants who experienced random perturbations while walking on an instrumented treadmill. Each participant performed six 5-min walking trials at a rate of 1.2 m/s, during which rapid belt speed perturbations could occur during the participant's stance phase. Each gait cycle had a 17% probability of being perturbed. The perturbations consisted of an increase of belt speed by 0.75 m/s, delivered with equal probability at 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80% of the stance phase. Data were recorded using motion capture with 25 markers, eight inertial measurement units (IMUs), and electromyography (EMG) from the tibialis anterior (TA), soleus (SOL), lateral gastrocnemius (LG), rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and gluteus maximus (GM). The full protocol is described in detail. Results We provide marker trajectories, force plate data, EMG data, and belt speed information for all trials and participants. IMU data is provided for most participants. This data can be useful for identifying neural feedback control in human gait, biologically inspired control systems for robots, and the development of clinical applications.
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Affiliation(s)
- Dana L. Lorenz
- Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, Ohio, United States
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4
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Shin S, Simpkins C, Ahn J, Yang F. Impact of standing perturbation intensities on fall and stability outcomes in healthy young adults. J Biomech 2024; 168:112123. [PMID: 38696984 DOI: 10.1016/j.jbiomech.2024.112123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/14/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
Motorized treadmills have been extensively used in investigating reactive balance control and developing perturbation-based interventions for fall prevention. However, the relationship between perturbation intensity and its outcome has not been quantified. The primary purpose of this study was to quantitatively analyze how the treadmill belt's peak velocity affects the perturbation outcome and other metrics related to the reactive balance in young adults while the total belt displacement is controlled at 0.36 m. Thirty-one healthy young adults were randomly assigned into three groups with different peak belt speeds: low (0.9 m/s), medium (1.2 m/s), and high (1.8 m/s). Protected by a safety harness, participants were exposed to a forward support surface translation while standing at an unexpected timing on an ActiveStep treadmill. The primary (perturbation outcome: fall vs. recovery) and secondary (dynamic stability, hip descent, belt distance at liftoff, and recovery step latency) outcome measures were compared among groups. Results revealed that a higher perturbation intensity is correlated with a greater faller rate (p < 0.001). Compared to the low- and medium-intensity groups, the high-intensity group was less stable (p < 0.001) with a larger hip descent (p < 0.001) and a longer belt distance (p < 0.001) at the recovery step liftoff. The results suggest that the increased perturbation intensity raises the risk of falling with larger instability and poorer reactive performance after a support surface translation-induced perturbation in healthy young adults. The findings could furnish preliminary guidance for us to design and select the optimal perturbation intensity that can maximize the effects of perturbation-based training protocols.
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Affiliation(s)
- Sangwon Shin
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Jiyun Ahn
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA.
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5
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Severini G, Koenig A, Cajigas I, Lesniewski-Laas N, Niemi J, Bonato P. Subsensory stochastic electrical stimulation targeting muscle afferents alters gait control during locomotor adaptations to haptic perturbations. iScience 2023; 26:107038. [PMID: 37360695 PMCID: PMC10285629 DOI: 10.1016/j.isci.2023.107038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/20/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Subsensory noise stimulation targeting sensory receptors has been shown to improve balance control in healthy and impaired individuals. However, the potential for application of this technique in other contexts is still unknown. Gait control and adaptation rely heavily on the input from proprioceptive organs in the muscles and joints. Here we investigated the use of subsensory noise stimulation as a means to influence motor control by altering proprioception during locomotor adaptations to forces delivered by a robot. The forces increase step length unilaterally and trigger an adaptive response that restores the original symmetry. Healthy participants performed two adaptation experiments, one with stimulation applied to the hamstring muscles and one without. We found that participants adapted faster but to a lesser extent when undergoing stimulation. We argue that this behavior is because of the dual effect that the stimulation has on the afferents encoding position and velocity in the muscle spindles.
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Affiliation(s)
- Giacomo Severini
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
- School of Electrical and Electronic Engineering, University College Dublin, Dublin, Dublin 4, Ireland
- Centre for Biomedical Engineering, University College Dublin, Dublin, Dublin 4, Ireland
| | - Alexander Koenig
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Iahn Cajigas
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
- Department of Neurological Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | | | - James Niemi
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Paolo Bonato
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
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6
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Eginyan G, Zhou X, Williams AMM, Lam T. Effects of motor stimulation of the tibial nerve on corticospinal excitability of abductor hallucis and pelvic floor muscles. FRONTIERS IN REHABILITATION SCIENCES 2023; 3:1089223. [PMID: 36726808 PMCID: PMC9884817 DOI: 10.3389/fresc.2022.1089223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023]
Abstract
Introduction Peripheral nerve stimulation can modulate the excitability of corticospinal pathways of muscles in the upper and lower limbs. Further, the pattern of peripheral nerve stimulation (continuous vs. intermittent) may be an important factor determining the modulation of this corticospinal excitability. The pelvic floor muscles (PFM) are crucial for maintaining urinary continence in humans, and share spinal segmental innervation with the tibial nerve. We explored the idea of whether the neuromodulatory effects of tibial nerve stimulation (TibNS) could induce effects on somatic pathways to the PFM. We evaluated the effects of two patterns of stimulation (intermittent vs. continuous) on corticospinal excitability of the PFM compared to its effect on the abductor hallucis (AH) muscle (which is directly innervated by the tibial nerve). We hypothesized that intermittent TibNS would increase, while continuous stimulation would decrease, the excitability of both AH and PFM. Methods Twenty able-bodied adults (20-33 years of age) enrolled in this study. TibNS was delivered either intermittently (1 ms pulses delivered at 30Hz with an on:off duty cycle of 600:400 ms, for 60 min), or continuously (1 ms pulses delivered at 30Hz for 36 min) just above the motor threshold of the AH. We randomized the order of the stimulation pattern and tested them on separate days. We used surface electromyography (EMG) to record motor-evoked responses (MEP) in the PFM and AH following transcranial magnetic stimulation (TMS). We generated stimulus-response (SR) curves to quantify the changes in peak-to-peak MEP amplitude relative to TMS intensity to assess changes in corticospinal excitability pre- and post-stimulation. Results and Conclusion We found that TibNS increased corticospinal excitability only to AH, with no effects in PFM. There was no difference in responses to continuous vs. intermittent stimulation. Our results indicate a lack of effect of TibNS on descending somatic pathways to the PFM, but further investigation is required to explore other stimulation parameters and whether neuromodulatory effects may be spinal in origin.
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Affiliation(s)
- Gevorg Eginyan
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada,School of Kinesiology, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Xueqing Zhou
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada,School of Kinesiology, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Alison M. M. Williams
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada,School of Kinesiology, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Tania Lam
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada,School of Kinesiology, University of British Columbia (UBC), Vancouver, BC, Canada,Correspondence: Tania Lam
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7
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Abstract
When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.
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Affiliation(s)
- Alain Frigon
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
| | - Turgay Akay
- Department of Medical Neuroscience, Atlantic Mobility Action Project, Brain Repair Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Boris I Prilutsky
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
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8
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Schmidt A, Feldotto B, Gumpert T, Seidel D, Albu-Schäffer A, Stratmann P. Adapting Highly-Dynamic Compliant Movements to Changing Environments: A Benchmark Comparison of Reflex- vs. CPG-Based Control Strategies. Front Neurorobot 2021; 15:762431. [PMID: 34955801 PMCID: PMC8709475 DOI: 10.3389/fnbot.2021.762431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/18/2021] [Indexed: 12/02/2022] Open
Abstract
To control highly-dynamic compliant motions such as running or hopping, vertebrates rely on reflexes and Central Pattern Generators (CPGs) as core strategies. However, decoding how much each strategy contributes to the control and how they are adjusted under different conditions is still a major challenge. To help solve this question, the present paper provides a comprehensive comparison of reflexes, CPGs and a commonly used combination of the two applied to a biomimetic robot. It leverages recent findings indicating that in mammals both control principles act within a low-dimensional control submanifold. This substantially reduces the search space of parameters and enables the quantifiable comparison of the different control strategies. The chosen metrics are motion stability and energy efficiency, both key aspects for the evolution of the central nervous system. We find that neither for stability nor energy efficiency it is favorable to apply the state-of-the-art approach of a continuously feedback-adapted CPG. In both aspects, a pure reflex is more effective, but the pure CPG allows easy signal alteration when needed. Additionally, the hardware experiments clearly show that the shape of a control signal has a strong influence on energy efficiency, while previous research usually only focused on frequency alignment. Both findings suggest that currently used methods to combine the advantages of reflexes and CPGs can be improved. In future research, possible combinations of the control strategies should be reconsidered, specifically including the modulation of the control signal's shape. For this endeavor, the presented setup provides a valuable benchmark framework to enable the quantitative comparison of different bioinspired control principles.
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Affiliation(s)
- Annika Schmidt
- Sensor Based Robotic Systems and Intelligent Assistance Systems, Department of Informatics, Technical University of Munich, Garching, Germany.,German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Weßling, Germany
| | - Benedikt Feldotto
- Robotics, Artificial Intelligence and Real-Time Systems, Department of Informatics, Technical University of Munich, Garching, Germany
| | - Thomas Gumpert
- German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Weßling, Germany
| | - Daniel Seidel
- German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Weßling, Germany
| | - Alin Albu-Schäffer
- Sensor Based Robotic Systems and Intelligent Assistance Systems, Department of Informatics, Technical University of Munich, Garching, Germany.,German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Weßling, Germany
| | - Philipp Stratmann
- Sensor Based Robotic Systems and Intelligent Assistance Systems, Department of Informatics, Technical University of Munich, Garching, Germany.,German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Weßling, Germany
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9
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Di Russo A, Stanev D, Armand S, Ijspeert A. Sensory modulation of gait characteristics in human locomotion: A neuromusculoskeletal modeling study. PLoS Comput Biol 2021; 17:e1008594. [PMID: 34010288 PMCID: PMC8168850 DOI: 10.1371/journal.pcbi.1008594] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/01/2021] [Accepted: 04/16/2021] [Indexed: 11/18/2022] Open
Abstract
The central nervous system of humans and other animals modulates spinal cord activity to achieve several locomotion behaviors. Previous neuromechanical models investigated the modulation of human gait changing selected parameters belonging to CPGs (Central Pattern Generators) feedforward oscillatory structures or to feedback reflex circuits. CPG-based models could replicate slow and fast walking by changing only the oscillation’s properties. On the other hand, reflex-based models could achieve different behaviors through optimizations of large dimensional parameter spaces. However, they could not effectively identify individual key reflex parameters responsible for gait characteristics’ modulation. This study investigates which reflex parameters modulate the gait characteristics through neuromechanical simulations. A recently developed reflex-based model is used to perform optimizations with different target behaviors on speed, step length, and step duration to analyze the correlation between reflex parameters and their influence on these gait characteristics. We identified nine key parameters that may affect the target speed ranging from slow to fast walking (0.48 and 1.71 m/s) as well as a large range of step lengths (0.43 and 0.88 m) and step duration (0.51, 0.98 s). The findings show that specific reflexes during stance significantly affect step length regulation, mainly given by positive force feedback of the ankle plantarflexors’ group. On the other hand, stretch reflexes active during swing of iliopsoas and gluteus maximus regulate all the gait characteristics under analysis. Additionally, the results show that the hamstrings’ group’s stretch reflex during the landing phase is responsible for modulating the step length and step duration. Additional validation studies in simulations demonstrated that the modulation of identified reflexes is sufficient to regulate the investigated gait characteristics. Thus, this study provides an overview of possible reflexes involved in modulating speed, step length, and step duration of human gaits. This study investigates the possible reflex parameters that the central nervous system could use to modulate human locomotion. Specifically, we target the modulation of three gait characteristics: speed, step length, and step duration. We utilize human locomotion simulations with a previously developed reflex-based model and perform multiple optimizations ranging targeting low to high values of the three gait characteristics investigated. From the data acquired in optimizations, we investigate which reflex parameter correlates most with the gait characteristics changes. We identified nine key reflex parameters affecting gait modulation, performed validation experiments, and verified that the optimization of key reflex parameters alone could generate modulation in the studied locomotion behaviors. Kinematics, ground reaction forces, and muscle activity obtained in simulations show similarities with past experimental studies on gait modulation. Therefore, the identified parameters could potentially be used by the nervous system to regulate locomotion behaviors in a task-dependent manner. Other circuits not modeled in this study could play a crucial role in gait modulation, and further investigations should be done in the co-optimization of feedforward and feedback circuits.
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Affiliation(s)
- Andrea Di Russo
- Biorobotics Laboratory, École polytechnique fédérale de Lausanne, School of Engineering, Institute of Bioengineering, Lausanne, Switzerland
- * E-mail:
| | - Dimitar Stanev
- Biorobotics Laboratory, École polytechnique fédérale de Lausanne, School of Engineering, Institute of Bioengineering, Lausanne, Switzerland
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Auke Ijspeert
- Biorobotics Laboratory, École polytechnique fédérale de Lausanne, School of Engineering, Institute of Bioengineering, Lausanne, Switzerland
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10
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Yegian AK, Tucker Y, Bramble DM, Lieberman DE. Neuromechanical linkage between the head and forearm during running. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 174:752-762. [PMID: 33491216 DOI: 10.1002/ajpa.24234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/04/2020] [Accepted: 12/20/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The main objective was to test the hypothesis of a neuromechanical link in humans between the head and forearm during running mediated by the biceps brachii and superior trapezius muscles. We hypothesized that this linkage helps stabilize the head and combats rapid forward pitching during running which may interfere with gaze stability. MATERIALS AND METHODS Thirteen human participants walked and ran on a treadmill while motion capture recorded body segment kinematics and electromyographic sensors recorded muscle activation. To test perturbations to the linkage system we compared participants running normally as well as with added mass to the face and the hand. RESULTS The results confirm the presence of a neuromechanical linkage between the head and forearm mediated by the biceps and superior trapezius during running but not during walking. In running, the biceps and superior trapezius activations were temporally linked during the stride cycle, and adding mass to either the head or hand increased activation in both muscles, consistent with our hypothesis. During walking the forces acting on the body segments and muscle activation levels were much smaller than during running, indicating no need for a linkage to keep the head and gaze stable. DISCUSSION The results suggest that the evolution of long distance running in early Homo may have favored selection for reduced rotational inertia of both the head and forearm through synergistic muscle activation, contributing to the transition from australopith head and forelimb morphology to the more human-like form of Homo erectus. Selective pressures from the evolution of bipedal walking were likely much smaller, but may explain in part the intermediate form of the australopith scapula between that of extant apes and humans.
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Affiliation(s)
- Andrew K Yegian
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Yanish Tucker
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Dennis M Bramble
- Department of Biology, University of Utah, Salt Lake City, Utah, USA
| | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
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11
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A model for the transfer of control from the brain to the spinal cord through synaptic learning. J Comput Neurosci 2020; 48:365-375. [PMID: 33009635 DOI: 10.1007/s10827-020-00767-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 08/06/2020] [Accepted: 09/11/2020] [Indexed: 12/20/2022]
Abstract
The spinal cord is essential to the control of locomotion in legged animals and humans. However, the actual circuitry of the spinal controller remains only vaguely understood. Here we approach this problem from the viewpoint of learning. More precisely, we assume the circuitry evolves through the transfer of control from the brain to the spinal cord, propose a specific learning mechanism for this transfer based on the error between the cord and brain contributions to muscle control, and study the resulting structure of the spinal controller in a simplified neuromuscular model of human locomotion. The model focuses on the leg rebound behavior in stance and represents the spinal circuitry with 150 muscle reflexes. We find that after learning a spinal controller has evolved that produces leg rebound motions in the absence of a central brain input with only three structural reflex groups. These groups contain individual reflexes well known from physiological experiments but thought to serve separate purposes in the control of human locomotion. Our results suggest a more holistic interpretation of the role of individual sensory projections in spinal networks than is common. In addition, we discuss potential neural correlates for the proposed learning mechanism that may be probed in experiments. Together with such experiments, neuromuscular models of spinal learning likely will become effective tools for uncovering the structure and development of the spinal control circuitry.
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12
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Spastic movement disorder: should we forget hyperexcitable stretch reflexes and start talking about inappropriate prediction of sensory consequences of movement? Exp Brain Res 2020; 238:1627-1636. [DOI: 10.1007/s00221-020-05792-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/18/2020] [Indexed: 12/29/2022]
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13
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Zaaya M, Pulverenti TS, Islam MA, Knikou M. Transspinal stimulation downregulates activity of flexor locomotor networks during walking in humans. J Electromyogr Kinesiol 2020; 52:102420. [PMID: 32334377 DOI: 10.1016/j.jelekin.2020.102420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/20/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022] Open
Abstract
The objective of this study was to establish the effects of transspinal stimulation on short-latency tibialis anterior (TA) flexion reflex during walking in healthy humans. Single pulse transspinal stimulation was delivered at a conditioning-test (C-T) interval either after (~20 ms) or simultaneously with the last pulse of the pulse train (0 ms) delivered to the medial arch of the right foot. Transspinal stimulation was delivered at sub- and supra-threshold intensities of the spinally-mediated TA transspinal evoked potential. Stimulation was delivered randomly at different phases of the step cycle, based on the foot switch threshold signal, which was divided into 16 equal bins. The TA flexion reflex facilitation under control conditions occurred at heel contact and then progressively from late stance phase reaching its peak at early and late swing phases. Transspinal stimulation at a negative and suprathreshold 0 ms C-T interval depressed flexion reflex excitability at all phases of the step cycle. The short-latency TA flexion reflex depression was possibly mediated through spinal inhibitory interneurons acting at both pre- and post- motoneuronal sites or by transspinal stimulation affecting directly the activity of the flexor half spinal center. These results reveal direct actions of transspinal stimulation on human spinal locomotor networks.
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Affiliation(s)
- Morad Zaaya
- Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, The City University of New York, Staten Island, NY, USA
| | - Timothy S Pulverenti
- Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, The City University of New York, Staten Island, NY, USA.
| | - Md Anamul Islam
- Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, The City University of New York, Staten Island, NY, USA
| | - Maria Knikou
- Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, The City University of New York, Staten Island, NY, USA; PhD Program in Biology and Collaborative Neuroscience Program, Graduate Center of The City University of New York and College of Staten Island, New York, NY, USA
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Nanivadekar AC, Ayers CA, Gaunt RA, Weber DJ, Fisher LE. Selectivity of afferent microstimulation at the DRG using epineural and penetrating electrode arrays. J Neural Eng 2019; 17:016011. [PMID: 31577993 PMCID: PMC9131467 DOI: 10.1088/1741-2552/ab4a24] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We have shown previously that microstimulation of the lumbar dorsal root ganglia (L5-L7 DRG) using penetrating microelectrodes, selectively recruits distal branches of the sciatic and femoral nerves in an acute preparation. However, a variety of challenges limit the clinical translatability of DRG microstimulation via penetrating electrodes. For clinical translation of a DRG somatosensory neural interface, electrodes placed on the epineural surface of the DRG may be a viable path forward. The goal of this study was to evaluate the recruitment properties of epineural electrodes and compare their performance with that of penetrating electrodes. Here, we compare the number of selectively recruited distal nerve branches and the threshold stimulus intensities between penetrating and epineural electrode arrays. APPROACH Antidromically propagating action potentials were recorded from multiple distal branches of the femoral and sciatic nerves in response to epineural stimulation on 11 ganglia in four cats to quantify the selectivity of DRG stimulation. Compound action potentials (CAPs) were recorded using nerve cuff electrodes implanted around up to nine distal branches of the femoral and sciatic nerve trunks. We also tested stimulation selectivity with penetrating microelectrode arrays implanted into ten ganglia in four cats. A binary search was carried out to identify the minimum stimulus intensity that evoked a response at any of the distal cuffs, as well as whether the threshold response selectively occurred in only a single distal nerve branch. MAIN RESULTS Stimulation evoked activity in just a single peripheral nerve through 67% of epineural electrodes (35/52) and through 79% of the penetrating microelectrodes (240/308). The recruitment threshold (median = 9.67 nC/phase) and dynamic range of epineural stimulation (median = 1.01 nC/phase) were significantly higher than penetrating stimulation (0.90 nC/phase and 0.36 nC/phase, respectively). However, the pattern of peripheral nerves recruited for each DRG were similar for stimulation through epineural and penetrating electrodes. SIGNIFICANCE Despite higher recruitment thresholds, epineural stimulation provides comparable selectivity and superior dynamic range to penetrating electrodes. These results suggest that it may be possible to achieve a highly selective neural interface with the DRG without penetrating the epineurium.
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Affiliation(s)
- Ameya C Nanivadekar
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, United States of America. Rehabilitation Neural Engineering Laboratories, 3520 Fifth Avenue, Suite 300, Pittsburgh, PA 15213, United States of America. Center for Neural Basis of Cognition, Pittsburgh, PA 15213, United States of America
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15
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Jensen P, Frisk R, Spedden ME, Geertsen SS, Bouyer LJ, Halliday DM, Nielsen JB. Using Corticomuscular and Intermuscular Coherence to Assess Cortical Contribution to Ankle Plantar Flexor Activity During Gait. J Mot Behav 2019; 51:668-680. [PMID: 30657030 DOI: 10.1080/00222895.2018.1563762] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present study used coherence and directionality analyses to explore whether the motor cortex contributes to plantar flexor muscle activity during the stance phase and push-off phase during gait. Subjects walked on a treadmill, while EEG over the leg motorcortex area and EMG from the medial gastrocnemius and soleus muscles was recorded. Corticomuscular and intermuscular coherence were calculated from pair-wise recordings. Significant EEG-EMG and EMG-EMG coherence in the beta and gamma frequency bands was found throughout the stance phase with the largest coherence towards push-off. Analysis of directionality revealed that EEG activity preceded EMG activity throughout the stance phase until the time of push-off. These findings suggest that the motor cortex contributes to ankle plantar flexor muscle activity and forward propulsion during gait.
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Affiliation(s)
- Peter Jensen
- Department of Nutrition Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Rasmus Frisk
- Elsass Institute , Charlottenlund, Denmark .,Department of Neuroscience, University of Copenhagen , Copenhagen , Denmark
| | | | - Svend Sparre Geertsen
- Department of Nutrition Exercise and Sports, University of Copenhagen , Copenhagen , Denmark .,Department of Neuroscience, University of Copenhagen , Copenhagen , Denmark
| | - Laurent J Bouyer
- CIRRIS-Department of Rehabilitation, Universite Laval , Quebec City , Canada
| | - David M Halliday
- Department of Electronic Engineering, University of York , York, UK
| | - Jens Bo Nielsen
- Elsass Institute , Charlottenlund, Denmark .,Department of Neuroscience, University of Copenhagen , Copenhagen , Denmark
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16
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Nataraj R, van den Bogert AJ. Simulation Analysis of Linear Quadratic Regulator Control of Sagittal-Plane Human Walking-Implications for Exoskeletons. J Biomech Eng 2019; 139:2648716. [PMID: 28787476 DOI: 10.1115/1.4037560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The linear quadratic regulator (LQR) is a classical optimal control approach that can regulate gait dynamics about target kinematic trajectories. Exoskeletons to restore gait function have conventionally utilized time-varying proportional-derivative (PD) control of leg joints. But, these PD parameters are not uniquely optimized for whole-body (full-state) performance. The objective of this study was to investigate the effectiveness of LQR full-state feedback compared to PD control to maintain bipedal walking of a sagittal-plane computational model against force disturbances. Several LQR controllers were uniquely solved with feedback gains optimized for different levels of tracking capability versus control effort. The main implications to future exoskeleton control systems include (1) which LQR controllers out-perform PD controllers in walking maintenance and effort, (2) verifying that LQR desirably produces joint torques that oppose rapidly growing joint state errors, and (3) potentially equipping accurate sensing systems for nonjoint states such as hip-position and torso orientation. The LQR controllers capable of longer walk times than respective PD controllers also required less control effort. During sudden leg collapse, LQR desirably behaved like PD by generating feedback torques that opposed the direction of leg-joint errors. Feedback from nonjoint states contributed to over 50% of the LQR joint torques and appear critical for whole-body LQR control. While LQR control poses implementation challenges, such as more sensors for full-state feedback and operation near the desired trajectories, it offers significant performance advantages over PD control.
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Jochumsen M, Cremoux S, Robinault L, Lauber J, Arceo JC, Navid MS, Nedergaard RW, Rashid U, Haavik H, Niazi IK. Investigation of Optimal Afferent Feedback Modality for Inducing Neural Plasticity with A Self-Paced Brain-Computer Interface. SENSORS 2018; 18:s18113761. [PMID: 30400325 PMCID: PMC6264113 DOI: 10.3390/s18113761] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
Abstract
Brain-computer interfaces (BCIs) can be used to induce neural plasticity in the human nervous system by pairing motor cortical activity with relevant afferent feedback, which can be used in neurorehabilitation. The aim of this study was to identify the optimal type or combination of afferent feedback modalities to increase cortical excitability in a BCI training intervention. In three experimental sessions, 12 healthy participants imagined a dorsiflexion that was decoded by a BCI which activated relevant afferent feedback: (1) electrical nerve stimulation (ES) (peroneal nerve-innervating tibialis anterior), (2) passive movement (PM) of the ankle joint, or (3) combined electrical stimulation and passive movement (Comb). The cortical excitability was assessed with transcranial magnetic stimulation determining motor evoked potentials (MEPs) in tibialis anterior before, immediately after and 30 min after the BCI training. Linear mixed regression models were used to assess the changes in MEPs. The three interventions led to a significant (p < 0.05) increase in MEP amplitudes immediately and 30 min after the training. The effect sizes of Comb paradigm were larger than ES and PM, although, these differences were not statistically significant (p > 0.05). These results indicate that the timing of movement imagery and afferent feedback is the main determinant of induced cortical plasticity whereas the specific type of feedback has a moderate impact. These findings can be important for the translation of such a BCI protocol to the clinical practice where by combining the BCI with the already available equipment cortical plasticity can be effectively induced. The findings in the current study need to be validated in stroke populations.
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Affiliation(s)
- Mads Jochumsen
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
| | - Sylvain Cremoux
- LAMIH, UMR CNRS 8201, Université Polytechnique des Hauts de France, Valenciennes 59313, France.
| | - Lucien Robinault
- LAMIH, UMR CNRS 8201, Université Polytechnique des Hauts de France, Valenciennes 59313, France.
| | - Jimmy Lauber
- LAMIH, UMR CNRS 8201, Université Polytechnique des Hauts de France, Valenciennes 59313, France.
| | - Juan Carlos Arceo
- LAMIH, UMR CNRS 8201, Université Polytechnique des Hauts de France, Valenciennes 59313, France.
| | - Muhammad Samran Navid
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg 9000, Denmark.
- New Zealand College of Chiropractic, Auckland 1060, New Zealand.
| | - Rasmus Wiberg Nedergaard
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg 9000, Denmark.
- New Zealand College of Chiropractic, Auckland 1060, New Zealand.
| | - Usman Rashid
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 0627, New Zealand.
| | - Heidi Haavik
- New Zealand College of Chiropractic, Auckland 1060, New Zealand.
| | - Imran Khan Niazi
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
- New Zealand College of Chiropractic, Auckland 1060, New Zealand.
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 0627, New Zealand.
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Carson RG. Get a grip: individual variations in grip strength are a marker of brain health. Neurobiol Aging 2018; 71:189-222. [PMID: 30172220 DOI: 10.1016/j.neurobiolaging.2018.07.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/06/2018] [Accepted: 07/29/2018] [Indexed: 02/06/2023]
Abstract
Demonstrations that grip strength has predictive power in relation to a range of health conditions-even when these are assessed decades later-has motivated claims that hand-grip dynamometry has the potential to serve as a "vital sign" for middle-aged and older adults. Central to this belief has been the assumption that grip strength is a simple measure of physical performance that provides a marker of muscle status in general, and sarcopenia in particular. It is now evident that while differences in grip strength between individuals are influenced by musculoskeletal factors, "lifespan" changes in grip strength within individuals are exquisitely sensitive to integrity of neural systems that mediate the control of coordinated movement. The close and pervasive relationships between age-related declines in maximum grip strength and expressions of cognitive dysfunction can therefore be understood in terms of the convergent functional and structural mediation of cognitive and motor processes by the human brain. In the context of aging, maximum grip strength is a discriminating measure of neurological function and brain health.
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Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
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Mrachacz-Kersting N, Aliakbaryhosseinabadi S. Comparison of the Efficacy of a Real-Time and Offline Associative Brain-Computer-Interface. Front Neurosci 2018; 12:455. [PMID: 30050400 PMCID: PMC6050354 DOI: 10.3389/fnins.2018.00455] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/14/2018] [Indexed: 01/20/2023] Open
Abstract
An associative brain-computer-interface (BCI) that correlates in time a peripherally generated afferent volley with the peak negativity (PN) of the movement related cortical potential (MRCP) induces plastic changes in the human motor cortex. However, in this associative BCI the movement timed to a cue is not detected in real time. Thus, possible changes in reaction time caused by factors such as attention shifts or fatigue will lead to a decreased accuracy, less pairings, and likely reduced plasticity. The aim of the current study was to compare the effectiveness of this associative BCI intervention on plasticity induction when the MRCP PN time is pre-determined from a training data set (BCIoffline), or detected online (BCIonline). Ten healthy participants completed both interventions in randomized order. The average detection accuracy for the BCIonline intervention was 71 ± 3% with 2.8 ± 0.7 min-1 false detections. For the BCIonline intervention the PN did not differ significantly between the training set and the actual intervention (t9 = 0.87, p = 0.41). The peak-to-peak motor evoked potentials (MEPs) were quantified prior to, immediately following, and 30 min after the cessation of each intervention. MEP results revealed a significant main effect of time, F(2,18) = 4.46, p = 0.027. The mean TA MEP amplitudes were significantly larger 30 min after (277 ± 72 μV) the BCI interventions compared to pre-intervention MEPs (233 ± 64 μV) regardless of intervention type and stimulation intensity (p = 0.029). These results provide further strong support for the associative nature of the associative BCI but also suggest that they likely differ to the associative long-term potentiation protocol they were modeled on in the exact sites of plasticity.
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Affiliation(s)
- Natalie Mrachacz-Kersting
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Susan Aliakbaryhosseinabadi
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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20
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Springer S, Friedman I, Ohry A. Thoracopelvic assisted movement training to improve gait and balance in elderly at risk of falling: a case series. Clin Interv Aging 2018; 13:1143-1149. [PMID: 29950824 PMCID: PMC6016007 DOI: 10.2147/cia.s166956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Age-related changes in coordinated movement pattern of the thorax and pelvis may be one of the factors contributing to fall risk. This report describes the feasibility of using a new thoracopelvic assisted movement device to improve gait and balance in an elderly population with increased risk for falls. Methods In this case series, 19 older adults were recruited from an assisted living facility. All had gait difficulties (gait speed <1.0 m/s) and history of falls. Participants received 12 training sessions with the thoracopelvic assisted movement device. Functional performance was measured before, during (after 6 sessions), and after the 12 sessions. Outcomes measures were Timed Up and Go, Functional Reach Test, and the 10-meter Walk Test. Changes in outcomes were calculated for each participant in the context of minimal detectable change (MDC) values. Results More than 25% of participants showed changes >MDC in their clinical measures after 6 treatment sessions, and more than half improved >MDC after 12 sessions. Six subjects (32%) improved their Timed Up and Go time by >4 seconds after 6 sessions, and 10 (53%) after 12 sessions. After the intervention, 4 subjects (21%) improved their 10-meter Walk Test velocity from limited community ambulation (0.4-0.8 m/s) to functional community ambulation (>0.8 m/s). Conclusion Thoracopelvic assisted movement training that mimics normal walking pattern may have clinical implications, by improving skills that enhance balance and gait function. Additional randomized, controlled studies are required to examine the effects of this intervention on larger cohorts with a variety of subjects.
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Affiliation(s)
- Shmuel Springer
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | | | - Avi Ohry
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Reuth Rehabilitation and Medical Center, Tel Aviv, Israel
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21
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Needle AR, Baumeister J, Farquhar WB, Greaney JL, Higginson JS, Kaminski TW, Swanik CB. The relationship between the sensory responses to ankle-joint loading and corticomotor excitability. Int J Neurosci 2017; 128:435-441. [DOI: 10.1080/00207454.2017.1396219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alan R. Needle
- Department of Health & Exercise Science, Appalachian State University, Boone, NC, USA
| | - Jochen Baumeister
- Exercise & Neuroscience Unit, Institute of Health, Nutrition, and Sports Sciences, Europa-Universität Flensburg, Flensburg, Germany
| | - William B. Farquhar
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
| | - Jody L. Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Jill S. Higginson
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Thomas W. Kaminski
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
| | - C. Buz Swanik
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
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Pagel A, Ranzani R, Riener R, Vallery H. Bio-Inspired Adaptive Control for Active Knee Exoprosthetics. IEEE Trans Neural Syst Rehabil Eng 2017; 25:2355-2364. [PMID: 28858807 DOI: 10.1109/tnsre.2017.2744987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
On the quest to bring function of prosthetic legs closer to their biological counterparts, the intuitive interplay of their control with the user's impedance modulation is key. We present two control features to enable more physiological and more user-adaptive control of prosthetic legs: a neuromusculoskeletal impedance model ( ) including a reflexive component, and a human model reference adaptive controller ( ), which can be combined with the former. In stance-phase simulations, the allowed to control a prosthetic leg with physiological knee joint angle and moment. When perturbations were applied, the reduced the resulting root mean square error (RMSE) between simulated and physiological reference angle by 96%. In a pilot experiment with two unimpaired and one amputee subject, gait with the deviated more from a physiological reference than with a conventional visco-elastic impedance controller. Subjects, however, preferred the . When adding the to either of the two impedance controllers, the RMSE between the actual and the physiological reference angle was reduced by up to 54%. Subjects confirmed this finding and reported an easier stance-to-swing transition. Simulation and pilot experiment suggest that a reflex-based impedance controller combined with an adaptive controller may improve user-cooperative behavior of active knee exoprostheses.
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Applying a pelvic corrective force induces forced use of the paretic leg and improves paretic leg EMG activities of individuals post-stroke during treadmill walking. Clin Neurophysiol 2017; 128:1915-1922. [PMID: 28826022 DOI: 10.1016/j.clinph.2017.07.409] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 07/06/2017] [Accepted: 07/16/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine whether applying a mediolateral corrective force to the pelvis during treadmill walking would enhance muscle activity of the paretic leg and improve gait symmetry in individuals with post-stroke hemiparesis. METHODS Fifteen subjects with post-stroke hemiparesis participated in this study. A customized cable-driven robotic system based over a treadmill generated a mediolateral corrective force to the pelvis toward the paretic side during early stance phase. Three different amounts of corrective force were applied. Electromyographic (EMG) activity of the paretic leg, spatiotemporal gait parameters and pelvis lateral displacement were collected. RESULTS Significant increases in integrated EMG of hip abductor, medial hamstrings, soleus, rectus femoris, vastus medialis and tibialis anterior were observed when pelvic corrective force was applied, with pelvic corrective force at 9% of body weight inducing greater muscle activity than 3% or 6% of body weight. Pelvis lateral displacement was more symmetric with pelvic corrective force at 9% of body weight. CONCLUSIONS Applying a mediolateral pelvic corrective force toward the paretic side may enhance muscle activity of the paretic leg and improve pelvis displacement symmetry in individuals post-stroke. SIGNIFICANCE Forceful weight shift to the paretic side could potentially force additional use of the paretic leg and improve the walking pattern.
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Geertsen SS, Willerslev-Olsen M, Lorentzen J, Nielsen JB. Development and aging of human spinal cord circuitries. J Neurophysiol 2017; 118:1133-1140. [PMID: 28566459 DOI: 10.1152/jn.00103.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/25/2017] [Accepted: 05/25/2017] [Indexed: 01/25/2023] Open
Abstract
The neural motor circuitries in the spinal cord receive information from our senses and the rest of the nervous system and translate it into purposeful movements, which allow us to interact with the rest of the world. In this review, we discuss how these circuitries are established during early development and the extent to which they are shaped according to the demands of the body that they control and the environment with which the body has to interact. We also discuss how aging processes and physiological changes in our body are reflected in adaptations of activity in the spinal cord motor circuitries. The complex, multifaceted connectivity of the spinal cord motor circuitries allows them to generate vastly different movements and to adapt their activity to meet new challenges imposed by bodily changes or a changing environment. There are thus plenty of possibilities for adaptive changes in the spinal motor circuitries both early and late in life.
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Affiliation(s)
- Svend Sparre Geertsen
- Neural Control of Movement Research Group, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen N, Denmark.,Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen N, Denmark; and
| | - Maria Willerslev-Olsen
- Neural Control of Movement Research Group, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen N, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Jakob Lorentzen
- Neural Control of Movement Research Group, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen N, Denmark.,Elsass Institute, Charlottenlund, Denmark
| | - Jens Bo Nielsen
- Neural Control of Movement Research Group, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen N, Denmark; .,Elsass Institute, Charlottenlund, Denmark
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Pichiorri F, Mrachacz-Kersting N, Molinari M, Kleih S, Kübler A, Mattia D. Brain-computer interface based motor and cognitive rehabilitation after stroke – state of the art, opportunity, and barriers: summary of the BCI Meeting 2016 in Asilomar. BRAIN-COMPUTER INTERFACES 2016. [DOI: 10.1080/2326263x.2016.1246328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Floriana Pichiorri
- Neuroelectrical Imaging and BCI lab, Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | - Natalie Mrachacz-Kersting
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D3, 9220, Aalborg Ø, Denmark
| | - Marco Molinari
- Neuroelectrical Imaging and BCI lab, Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | - Sonja Kleih
- Institute of Psychology, University of Würzburg, Marcusstraße 9-11, 97070, Würzburg, Germany
| | - Andrea Kübler
- Institute of Psychology, University of Würzburg, Marcusstraße 9-11, 97070, Würzburg, Germany
| | - Donatella Mattia
- Neuroelectrical Imaging and BCI lab, Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
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Toney ME, Chang YH. The motor and the brake of the trailing leg in human walking: leg force control through ankle modulation and knee covariance. Exp Brain Res 2016; 234:3011-23. [PMID: 27334888 DOI: 10.1007/s00221-016-4703-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
Abstract
Human walking is a complex task, and we lack a complete understanding of how the neuromuscular system organizes its numerous muscles and joints to achieve consistent and efficient walking mechanics. Focused control of select influential task-level variables may simplify the higher-level control of steady-state walking and reduce demand on the neuromuscular system. As trailing leg power generation and force application can affect the mechanical efficiency of step-to-step transitions, we investigated how joint torques are organized to control leg force and leg power during human walking. We tested whether timing of trailing leg force control corresponded with timing of peak leg power generation. We also applied a modified uncontrolled manifold analysis to test whether individual or coordinated joint torque strategies most contributed to leg force control. We found that leg force magnitude was adjusted from step to step to maintain consistent leg power generation. Leg force modulation was primarily determined by adjustments in the timing of peak ankle plantar-flexion torque, while knee torque was simultaneously covaried to dampen the effect of ankle torque on leg force. We propose a coordinated joint torque control strategy in which the trailing leg ankle acts as a motor to drive leg power production while trailing leg knee torque acts as a brake to refine leg power production.
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Affiliation(s)
- Megan E Toney
- School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Young-Hui Chang
- School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, USA. .,Comparative Neuromechanics Laboratory, School of Applied Physiology, Georgia Institute of Technology, 555 14th St NW, Atlanta, GA, 30332-0356, USA.
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Mrachacz-Kersting N, Jiang N, Stevenson AJT, Niazi IK, Kostic V, Pavlovic A, Radovanovic S, Djuric-Jovicic M, Agosta F, Dremstrup K, Farina D. Efficient neuroplasticity induction in chronic stroke patients by an associative brain-computer interface. J Neurophysiol 2015; 115:1410-21. [PMID: 26719088 DOI: 10.1152/jn.00918.2015] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/18/2015] [Indexed: 01/12/2023] Open
Abstract
Brain-computer interfaces (BCIs) have the potential to improve functionality in chronic stoke patients when applied over a large number of sessions. Here we evaluated the effect and the underlying mechanisms of three BCI training sessions in a double-blind sham-controlled design. The applied BCI is based on Hebbian principles of associativity that hypothesize that neural assemblies activated in a correlated manner will strengthen synaptic connections. Twenty-two chronic stroke patients were divided into two training groups. Movement-related cortical potentials (MRCPs) were detected by electroencephalography during repetitions of foot dorsiflexion. Detection triggered a single electrical stimulation of the common peroneal nerve timed so that the resulting afferent volley arrived at the peak negative phase of the MRCP (BCIassociative group) or randomly (BCInonassociative group). Fugl-Meyer motor assessment (FM), 10-m walking speed, foot and hand tapping frequency, diffusion tensor imaging (DTI) data, and the excitability of the corticospinal tract to the target muscle [tibialis anterior (TA)] were quantified. The TA motor evoked potential (MEP) increased significantly after the BCIassociative intervention, but not for the BCInonassociative group. FM scores (0.8 ± 0.46 point difference, P = 0.01), foot (but not finger) tapping frequency, and 10-m walking speed improved significantly for the BCIassociative group, indicating clinically relevant improvements. Corticospinal tract integrity on DTI did not correlate with clinical or physiological changes. For the BCI as applied here, the precise coupling between the brain command and the afferent signal was imperative for the behavioral, clinical, and neurophysiological changes reported. This association may become the driving principle for the design of BCI rehabilitation in the future. Indeed, no available BCIs can match this degree of functional improvement with such a short intervention.
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Affiliation(s)
- Natalie Mrachacz-Kersting
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark;
| | - Ning Jiang
- Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Andrew James Thomas Stevenson
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Imran Khan Niazi
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Vladimir Kostic
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Pavlovic
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasa Radovanovic
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Kim Dremstrup
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dario Farina
- Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
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Solopova IA, Selionov VA, Zhvansky DS, Gurfinkel VS, Ivanenko Y. Human cervical spinal cord circuitry activated by tonic input can generate rhythmic arm movements. J Neurophysiol 2015; 115:1018-30. [PMID: 26683072 DOI: 10.1152/jn.00897.2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/16/2015] [Indexed: 01/03/2023] Open
Abstract
The coordination between arms and legs during human locomotion shares many features with that in quadrupeds, yet there is limited evidence for the central pattern generator for the upper limbs in humans. Here we investigated whether different types of tonic stimulation, previously used for eliciting stepping-like leg movements, may evoke nonvoluntary rhythmic arm movements. Twenty healthy subjects participated in this study. The subject was lying on the side, the trunk was fixed, and all four limbs were suspended in a gravity neutral position, allowing unrestricted low-friction limb movements in the horizontal plane. The results showed that peripheral sensory stimulation (continuous muscle vibration) and central tonic activation (postcontraction state of neuronal networks following a long-lasting isometric voluntary effort, Kohnstamm phenomenon) could evoke nonvoluntary rhythmic arm movements in most subjects. In ∼40% of subjects, tonic stimulation elicited nonvoluntary rhythmic arm movements together with rhythmic movements of suspended legs. The fact that not all participants exhibited nonvoluntary limb oscillations may reflect interindividual differences in responsiveness of spinal pattern generation circuitry to its activation. The occurrence and the characteristics of induced movements highlight the rhythmogenesis capacity of cervical neuronal circuitries, complementing the growing body of work on the quadrupedal nature of human gait.
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Affiliation(s)
- I A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia;
| | - V A Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - D S Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - V S Gurfinkel
- Biomedical Engineering Department, Oregon Health and Science University, Portland, Oregon; and
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, Fondazione Santa Lucia, Rome, Italy
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Sloot LH, van den Noort JC, van der Krogt MM, Bruijn SM, Harlaar J. Can Treadmill Perturbations Evoke Stretch Reflexes in the Calf Muscles? PLoS One 2015; 10:e0144815. [PMID: 26669665 PMCID: PMC4682928 DOI: 10.1371/journal.pone.0144815] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/24/2015] [Indexed: 11/19/2022] Open
Abstract
Disinhibition of reflexes is a problem amongst spastic patients, for it limits a smooth and efficient execution of motor functions during gait. Treadmill belt accelerations may potentially be used to measure reflexes during walking, i.e. by dorsal flexing the ankle and stretching the calf muscles, while decelerations show the modulation of reflexes during a reduction of sensory feedback. The aim of the current study was to examine if belt accelerations and decelerations of different intensities applied during the stance phase of treadmill walking can evoke reflexes in the gastrocnemius, soleus and tibialis anterior in healthy subjects. Muscle electromyography and joint kinematics were measured in 10 subjects. To determine whether stretch reflexes occurred, we assessed modelled musculo-tendon length and stretch velocity, the amount of muscle activity, as well as the incidence of bursts or depressions in muscle activity with their time delays, and co-contraction between agonist and antagonist muscle. Although the effect on the ankle angle was small with 2.8±1.0°, the perturbations caused clear changes in muscle length and stretch velocity relative to unperturbed walking. Stretched muscles showed an increasing incidence of bursts in muscle activity, which occurred after a reasonable electrophysiological time delay (163-191 ms). Their amplitude was related to the muscle stretch velocity and not related to co-contraction of the antagonist muscle. These effects increased with perturbation intensity. Shortened muscles showed opposite effects, with a depression in muscle activity of the calf muscles. The perturbations only slightly affected the spatio-temporal parameters, indicating that normal walking was retained. Thus, our findings showed that treadmill perturbations can evoke reflexes in the calf muscles and tibialis anterior. This comprehensive study could form the basis for clinical implementation of treadmill perturbations to functionally measure reflexes during treadmill-based clinical gait analysis.
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Affiliation(s)
- Lizeth H. Sloot
- Dept. of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Josien C. van den Noort
- Dept. of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Marjolein M. van der Krogt
- Dept. of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Sjoerd M. Bruijn
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, the Netherlands
- Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Jaap Harlaar
- Dept. of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
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Kubota S, Hirano M, Koizume Y, Tanabe S, Funase K. Changes in the Spinal Neural Circuits are Dependent on the Movement Speed of the Visuomotor Task. Front Hum Neurosci 2015; 9:667. [PMID: 26696873 PMCID: PMC4678204 DOI: 10.3389/fnhum.2015.00667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/23/2015] [Indexed: 12/02/2022] Open
Abstract
Previous studies have shown that spinal neural circuits are modulated by motor skill training. However, the effects of task movement speed on changes in spinal neural circuits have not been clarified. The aim of this research was to investigate whether spinal neural circuits were affected by task movement speed. Thirty-eight healthy subjects participated in this study. In experiment 1, the effects of task movement speed on the spinal neural circuits were examined. Eighteen subjects performed a visuomotor task involving ankle muscle slow (nine subjects) or fast (nine subjects) movement speed. Another nine subjects performed a non-visuomotor task (controls) in fast movement speed. The motor task training lasted for 20 min. The amounts of D1 inhibition and reciprocal Ia inhibition were measured using H-relfex condition-test paradigm and recorded before, and at 5, 15, and 30 min after the training session. In experiment 2, using transcranial magnetic stimulation (TMS), the effects of corticospinal descending inputs on the presynaptic inhibitory pathway were examined before and after performing either a visuomotor (eight subjects) or a control task (eight subjects). All measurements were taken under resting conditions. The amount of D1 inhibition increased after the visuomotor task irrespective of movement speed (P < 0.01). The amount of reciprocal Ia inhibition increased with fast movement speed conditioning (P < 0.01), but was unchanged by slow movement speed conditioning. These changes lasted up to 15 min in D1 inhibition and 5 min in reciprocal Ia inhibition after the training session. The control task did not induce changes in D1 inhibition and reciprocal Ia inhibition. The TMS conditioned inhibitory effects of presynaptic inhibitory pathways decreased following visuomotor tasks (P < 0.01). The size of test H-reflex was almost the same size throughout experiments. The results suggest that supraspinal descending inputs for controlling joint movement are responsible for changes in the spinal neural circuits, and that task movement speed is one of the critical factors for inducing plastic changes in reciprocal Ia inhibition.
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Affiliation(s)
- Shinji Kubota
- Human Motor Control Laboratory, Department of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University Hiroshima, Japan ; Research Fellow of the Japan Society for the Promotion of Science Tokyo, Japan
| | - Masato Hirano
- Human Motor Control Laboratory, Department of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University Hiroshima, Japan ; Research Fellow of the Japan Society for the Promotion of Science Tokyo, Japan
| | - Yoshiki Koizume
- Human Motor Control Laboratory, Department of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University Hiroshima, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University Aichi, Japan
| | - Kozo Funase
- Human Motor Control Laboratory, Department of Human Sciences, Graduate School of Integrated Arts and Sciences, Hiroshima University Hiroshima, Japan
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Geertsen SS, Kirk H, Lorentzen J, Jorsal M, Johansson CB, Nielsen JB. Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness. Clin Neurophysiol 2015; 126:2320-9. [DOI: 10.1016/j.clinph.2015.02.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/05/2015] [Accepted: 02/15/2015] [Indexed: 10/24/2022]
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Seiterle S, Susko T, Artemiadis PK, Riener R, Igo Krebs H. Interlimb coordination in body-weight supported locomotion: A pilot study. J Biomech 2015; 48:2837-43. [PMID: 25990210 DOI: 10.1016/j.jbiomech.2015.04.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 04/28/2015] [Indexed: 11/25/2022]
Abstract
Locomotion involves complex neural networks responsible for automatic and volitional actions. During locomotion, motor strategies can rapidly compensate for any obstruction or perturbation that could interfere with forward progression. In this pilot study, we examined the contribution of interlimb pathways for evoking muscle activation patterns in the contralateral limb when a unilateral perturbation was applied and in the case where body weight was externally supported. In particular, the latency of neuromuscular responses was measured, while the stimulus to afferent feedback was limited. The pilot experiment was conducted with six healthy young subjects. It employed the MIT-Skywalker (beta-prototype), a novel device intended for gait therapy. Subjects were asked to walk on the split-belt treadmill, while a fast unilateral perturbation was applied mid-stance by unexpectedly lowering one side of the split-treadmill walking surfaces. Subject's weight was externally supported via the body-weight support system consisting of an underneath bicycle seat and the torso was stabilized via a loosely fitted chest harness. Both the weight support and the chest harness limited the afferent feedback. The unilateral perturbations evoked changes in the electromyographic activity of the non-perturbed contralateral leg. The latency of all muscle responses exceeded 100ms, which precludes the conjecture that spinal cord alone is responsible for the perturbation response. It suggests the role of supraspinal or midbrain level pathways at the inter-leg coordination during gait.
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Affiliation(s)
- Stefan Seiterle
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, 3-137 Cambridge, MA 02139, USA; Department of Mechanical and Process Engineering, ETH Zurich, Switzerland
| | - Tyler Susko
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, 3-137 Cambridge, MA 02139, USA
| | | | - Robert Riener
- Department of Health Sciences and Technology, ETH Zurich, Switzerland; Faculty of Medicine, University of Zurich, Switzerland
| | - Hermano Igo Krebs
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, 3-137 Cambridge, MA 02139, USA; Department Neurology and Division Rehabilitative Medicine, University of Maryland, School of Medicine, USA; Department of Physical Medicine and Rehabilitation, Fujita Health University, Japan; Institute of Neuroscience, University of Newcastle, UK.
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Sousa ASP, Tavares JMRS. Interlimb Coordination During Step-to-Step Transition and Gait Performance. J Mot Behav 2015; 47:563-74. [PMID: 25893693 DOI: 10.1080/00222895.2015.1023391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Most energy spent in walking is due to step-to-step transitions. During this phase, the interlimb coordination assumes a crucial role to meet the demands of postural and movement control. The authors review studies that have been carried out regarding the interlimb coordination during gait, as well as the basic biomechanical and neurophysiological principles of interlimb coordination. The knowledge gathered from these studies is useful for understanding step-to-step transition during gait from a motor control perspective and for interpreting walking impairments and inefficiency related to pathologies, such as stroke. This review shows that unimpaired walking is characterized by a consistent and reciprocal interlimb influence that is supported by biomechanical models, and spinal and supraspinal mechanisms. This interlimb coordination is perturbed in subjects with stroke.
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Affiliation(s)
- Andreia S P Sousa
- a Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana , Portugal
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Solopova IA, Selionov VA, Sylos-Labini F, Gurfinkel VS, Lacquaniti F, Ivanenko YP. Tapping into rhythm generation circuitry in humans during simulated weightlessness conditions. Front Syst Neurosci 2015; 9:14. [PMID: 25741250 PMCID: PMC4332337 DOI: 10.3389/fnsys.2015.00014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/27/2015] [Indexed: 12/25/2022] Open
Abstract
An ability to produce rhythmic activity is ubiquitous for locomotor pattern generation and modulation. The role that the rhythmogenesis capacity of the spinal cord plays in injured populations has become an area of interest and systematic investigation among researchers in recent years, despite its importance being long recognized by neurophysiologists and clinicians. Given that each individual interneuron, as a rule, receives a broad convergence of various supraspinal and sensory inputs and may contribute to a vast repertoire of motor actions, the importance of assessing the functional state of the spinal locomotor circuits becomes increasingly evident. Air-stepping can be used as a unique and important model for investigating human rhythmogenesis since its manifestation is largely facilitated by a reduction of external resistance. This article aims to provide a review on current issues related to the “locomotor” state and interactions between spinal and supraspinal influences on the central pattern generator (CPG) circuitry in humans, which may be important for developing gait rehabilitation strategies in individuals with spinal cord and brain injuries.
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Affiliation(s)
- Irina A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Science Moscow, Russia
| | - Victor A Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Science Moscow, Russia
| | - Francesca Sylos-Labini
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy
| | - Victor S Gurfinkel
- Biomedical Engineering Department, Oregon Health and Science University Portland, OR, USA
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy ; Department of Systems Medicine, University of Rome Tor Vergata Rome, Italy
| | - Yuri P Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia Rome, Italy
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Lee DK, Ulrich BD. Functioning of peripheral Ia pathways in leg muscles of newly walking toddlers. Hum Mov Sci 2015; 40:193-210. [PMID: 25613011 DOI: 10.1016/j.humov.2014.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 07/31/2014] [Accepted: 12/12/2014] [Indexed: 11/17/2022]
Abstract
Monosynaptic and polysynaptic spinal level reflexes in the leg muscles of infants show significant dispersion across muscles, high variability, and no change in response patterns over the first 10 months. Here we tested the hypothesized relation between early walking experience and the tuning of these responses in three primary gait muscles of participants in four subgroups: cruisers (n=7) and toddlers with one (n=5), two (n=5), or three (n=5) months of walking experience. Reflex responses in multiple Ia pathways - tendon reflex (T-reflex), vibration-induced inhibition of the T-reflex (VIM-T-reflex), and tonic vibration-induced reflex (VIR), were elicited by mechanical stimuli applied to the distal tendons of the quadriceps, gastrocnemius-soleus, and tibialis anterior of both legs. Walking skill was assessed via a GAITRite mat. Generally, walking experience seemed to be related to slowly emerging improvements and, depending on muscle tested and pathway, progress was quite varied. Amplitude and latency of reflex responses were more clearly impacted by age or leg length while the ratio or distribution pattern of reflex response among antagonist pairs of muscles was impacted by walking experience and skill. As walking experience increased, the ratio of reflex responses tended to increase for the stimulated and decrease for the antagonist reflex loops with distribution of the pattern shifting gradually toward a single type of reflex response in all tested muscles. The very slow tuning of these reflexes may underlie the many missteps and falls reported to occur during early walking and suggest that subsequent studies should continue to follow the developmental trajectory through the first year of walking experience.
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Affiliation(s)
- Do Kyeong Lee
- Developmental Neuromotor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Beverly D Ulrich
- Developmental Neuromotor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA
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Pfeifer S, Riener R, Vallery H. Knee stiffness estimation in physiological gait. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:1607-10. [PMID: 25570280 DOI: 10.1109/embc.2014.6943912] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
During physiological gait, humans continuously modulate their knee stiffness, depending on the demands of the activity and the terrain. A similar functionality could be provided by modern actuators in transfemoral prosthesis. However, quantitative data on how knee stiffness is modulated during physiological gait is still missing. This is likely due to the experimental difficulties associated with identifying knee stiffness by applying perturbations during gait. It is our goal to quantify such stiffness modulation during gait without the need to apply perturbations. Therefore, we have recently presented an approach to quantify knee stiffness from kinematic, kinetic and electromyographic (EMG) measurements, and have validated it in isometric conditions. The goal of this paper is to extend this approach to non-isometric conditions by combining inverse dynamics and EMG measurements, and to quantify physiological stiffness modulation in the example of level-ground walking. We show that stiffness varies substantially throughout a gait cycle, with a stiffness of around 100 Nm/rad during swing phase, and a peak of 450 Nm/rad in stance phase. These quantitative results may be beneficial for design and control of transfemoral prostheses and orthoses that aim to restore physiological function.
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Tucker MR, Olivier J, Pagel A, Bleuler H, Bouri M, Lambercy O, Millán JDR, Riener R, Vallery H, Gassert R. Control strategies for active lower extremity prosthetics and orthotics: a review. J Neuroeng Rehabil 2015; 12:1. [PMID: 25557982 PMCID: PMC4326520 DOI: 10.1186/1743-0003-12-1] [Citation(s) in RCA: 345] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/05/2014] [Indexed: 12/11/2022] Open
Abstract
: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user.This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user's sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies.As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os--not as independent devices, but as actors within an ecosystem--is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers.Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use.The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user's neuromusculoskeletal system and are practical for use in locomotive ADL.
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Affiliation(s)
- Michael R Tucker
- />Rehabilitation Engineering Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
| | - Jeremy Olivier
- />Robotic Systems Laboratory, Institute for Microengineering, EPFL, Lausanne, Switzerland
| | - Anna Pagel
- />Sensory Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
| | - Hannes Bleuler
- />Robotic Systems Laboratory, Institute for Microengineering, EPFL, Lausanne, Switzerland
| | - Mohamed Bouri
- />Robotic Systems Laboratory, Institute for Microengineering, EPFL, Lausanne, Switzerland
| | - Olivier Lambercy
- />Rehabilitation Engineering Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
| | - José del R Millán
- />Defitech Chair in Non-Invasive Brain-Machine Interface, Center for Neuroprosthetics, Institute of Bioengineering, EPFL, Lausanne, Switzerland
| | - Robert Riener
- />Sensory Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
- />Faculty of Medicine, Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Heike Vallery
- />Sensory Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
- />Faculty of Mechanical, Maritime and Materials Engineering, Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Roger Gassert
- />Rehabilitation Engineering Lab, Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
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Ren Xu, Ning Jiang, Mrachacz-Kersting N, Chuang Lin, Asin Prieto G, Moreno JC, Pons JL, Dremstrup K, Farina D. A Closed-Loop Brain–Computer Interface Triggering an Active Ankle–Foot Orthosis for Inducing Cortical Neural Plasticity. IEEE Trans Biomed Eng 2014; 61:2092-101. [DOI: 10.1109/tbme.2014.2313867] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
Locomotion in a complex environment is often not steady, but the mechanisms used by animals to power and control unsteady locomotion (stability and maneuverability) are not well understood. We use behavioral, morphological, and impulsive perturbations to determine the compensations used during unsteady locomotion. At the level both of the whole-body and of joints, quasi-stiffness models are useful for describing adjustments to the functioning of legs and joints during maneuvers. However, alterations to the mechanics of legs and joints often are distinct for different phases of the step cycle or for specific joints. For example, negotiating steps involves independent changes of leg stiffness during compression and thrust phases of stance. Unsteady locomotion also involves parameters that are not part of the simplest reduced-parameter models of locomotion (e.g., the spring-loaded inverted pendulum) such as moments of the hip joint. Extensive coupling among translational and rotational parameters must be taken into account to stabilize locomotion or maneuver. For example, maneuvers with morphological perturbations (increased rotational inertial turns) involve changes to several aspects of movement, including the initial conditions of rotation and ground-reaction forces. Coupled changes to several parameters may be employed to control maneuvers on a trial-by-trial basis. Compensating for increased rotational inertia of the body during turns is facilitated by the opposing effects of several mechanical and behavioral parameters. However, the specific rules used by animals to control translation and rotation of the body to maintain stability or maneuver have not been fully characterized. We initiated direct-perturbation experiments to investigate the strategies used by humans to maintain stability following center-of-mass (COM) perturbations. When walking, humans showed more resistance to medio-lateral perturbations (lower COM displacement). However, when running, humans could recover from the point of maximum COM displacement faster than when walking. Consequently, the total time necessary for recovery was not significantly different between walking and running. Future experiments will determine the mechanisms used for compensations during unsteady locomotion at the behavioral, joint, and muscle levels. Using reduced-parameter models will allow common experimental and analytical frameworks for the study of both stability and maneuverability and the determination of general control strategies for unsteady locomotion.
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Affiliation(s)
- Mu Qiao
- *Kinesiology Program, School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA; Department of Kinesiology, California State University, San Marcos, CA 92096, USA
| | - Devin L Jindrich
- *Kinesiology Program, School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA; Department of Kinesiology, California State University, San Marcos, CA 92096, USA
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Sylos-Labini F, La Scaleia V, d'Avella A, Pisotta I, Tamburella F, Scivoletto G, Molinari M, Wang S, Wang L, van Asseldonk E, van der Kooij H, Hoellinger T, Cheron G, Thorsteinsson F, Ilzkovitz M, Gancet J, Hauffe R, Zanov F, Lacquaniti F, Ivanenko YP. EMG patterns during assisted walking in the exoskeleton. Front Hum Neurosci 2014; 8:423. [PMID: 24982628 PMCID: PMC4058900 DOI: 10.3389/fnhum.2014.00423] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/27/2014] [Indexed: 12/30/2022] Open
Abstract
Neuroprosthetic technology and robotic exoskeletons are being developed to facilitate stepping, reduce muscle efforts, and promote motor recovery. Nevertheless, the guidance forces of an exoskeleton may influence the sensory inputs, sensorimotor interactions and resulting muscle activity patterns during stepping. The aim of this study was to report the muscle activation patterns in a sample of intact and injured subjects while walking with a robotic exoskeleton and, in particular, to quantify the level of muscle activity during assisted gait. We recorded electromyographic (EMG) activity of different leg and arm muscles during overground walking in an exoskeleton in six healthy individuals and four spinal cord injury (SCI) participants. In SCI patients, EMG activity of the upper limb muscles was augmented while activation of leg muscles was typically small. Contrary to our expectations, however, in neurologically intact subjects, EMG activity of leg muscles was similar or even larger during exoskeleton-assisted walking compared to normal overground walking. In addition, significant variations in the EMG waveforms were found across different walking conditions. The most variable pattern was observed in the hamstring muscles. Overall, the results are consistent with a non-linear reorganization of the locomotor output when using the robotic stepping devices. The findings may contribute to our understanding of human-machine interactions and adaptation of locomotor activity patterns.
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Affiliation(s)
- Francesca Sylos-Labini
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy
| | - Valentina La Scaleia
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy
| | - Andrea d'Avella
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
| | - Iolanda Pisotta
- Spinal Cord Rehab Unit and CaRMA Lab, Santa Lucia Foundation Rome, Italy
| | | | - Giorgio Scivoletto
- Spinal Cord Rehab Unit and CaRMA Lab, Santa Lucia Foundation Rome, Italy
| | - Marco Molinari
- Spinal Cord Rehab Unit and CaRMA Lab, Santa Lucia Foundation Rome, Italy
| | - Shiqian Wang
- Biomechanical Engineering, Delft University of Technology Delft, Netherlands
| | - Letian Wang
- Biomechanical Engineering, University of Twente Enschede, Netherlands
| | | | - Herman van der Kooij
- Biomechanical Engineering, Delft University of Technology Delft, Netherlands ; Biomechanical Engineering, University of Twente Enschede, Netherlands
| | - Thomas Hoellinger
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles Brussels, Belgium
| | - Guy Cheron
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles Brussels, Belgium
| | | | | | - Jeremi Gancet
- Space Applications Services N.V./S.A. Zaventem, Belgium
| | | | | | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy ; Department of Systems Medicine, University of Rome Tor Vergata Rome, Italy
| | - Yuri P Ivanenko
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
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Schliessmann D, Schuld C, Schneiders M, Derlien S, Glöckner M, Gladow T, Weidner N, Rupp R. Feasibility of visual instrumented movement feedback therapy in individuals with motor incomplete spinal cord injury walking on a treadmill. Front Hum Neurosci 2014; 8:416. [PMID: 24987344 PMCID: PMC4060051 DOI: 10.3389/fnhum.2014.00416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/23/2014] [Indexed: 11/15/2022] Open
Abstract
Background: Incomplete spinal cord injury (iSCI) leads to motor and sensory deficits. Even in ambulatory persons with good motor function an impaired proprioception may result in an insecure gait. Limited internal afferent feedback (FB) can be compensated by provision of external FB by therapists or technical systems. Progress in computational power of motion analysis systems allows for implementation of instrumented real-time FB. The aim of this study was to test if individuals with iSCI can normalize their gait kinematics during FB and more importantly maintain an improvement after therapy. Methods: Individuals with chronic iSCI had to complete 6 days (1 day per week) of treadmill-based FB training with a 2 weeks pause after 3 days of training. Each day consists of an initial gait analysis followed by 2 blocks with FB/no-FB. During FB the deviation of the mean knee angle during swing from a speed matched reference (norm distance, ND) is visualized as a number. The task consists of lowering the ND, which was updated after every stride. Prior to the tests in patients the in-house developed FB implementation was tested in healthy subjects with an artificial movement task. Results: Four of five study participants benefited from FB in the short and medium term. Decrease of mean ND was highest during the first 3 sessions (from 3.93 ± 1.54 to 2.18 ± 1.04). After the pause mean ND stayed in the same range than before. In the last 3 sessions the mean ND decreased slower (2.40 ± 1.18 to 2.20 ± 0.90). Direct influences of FB ranged from 60 to 15% of reduction in mean ND compared to initial gait analysis and from 20 to 1% compared to no-FB sessions. Conclusions: Instrumented kinematic real-time FB may serve as an effective adjunct to established gait therapies in normalizing the gait pattern after incomplete spinal cord injury. Further studies with larger patient groups need to prove long term learning and the successful transfer of newly acquired skills to activities of daily living.
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Affiliation(s)
- Daniel Schliessmann
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Christian Schuld
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Matthias Schneiders
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Steffen Derlien
- Institut für Physiotherapie, University Hospital Jena Jena, Germany
| | - Maria Glöckner
- Institut für Physiotherapie, University Hospital Jena Jena, Germany
| | | | - Norbert Weidner
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Rüdiger Rupp
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
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42
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Gandolfi M, Geroin C, Picelli A, Munari D, Waldner A, Tamburin S, Marchioretto F, Smania N. Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial. Front Hum Neurosci 2014; 8:318. [PMID: 24904361 PMCID: PMC4033226 DOI: 10.3389/fnhum.2014.00318] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 04/29/2014] [Indexed: 12/01/2022] Open
Abstract
Background: Extensive research on both healthy subjects and patients with central nervous damage has elucidated a crucial role of postural adjustment reactions and central sensory integration processes in generating and “shaping” locomotor function, respectively. Whether robotic-assisted gait devices might improve these functions in Multiple sclerosis (MS) patients is not fully investigated in literature. Purpose: The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and sensory integration balance training (SIBT) in improving walking and balance performance in patients with MS. Methods: Twenty-two patients with MS (EDSS: 1.5–6.5) were randomly assigned to two groups. The RAGT group (n = 12) underwent end-effector system training. The SIBT group (n = 10) underwent specific balance exercises. Each patient received twelve 50-min treatment sessions (2 days/week). A blinded rater evaluated patients before and after treatment as well as 1 month post treatment. Primary outcomes were walking speed and Berg Balance Scale. Secondary outcomes were the Activities-specific Balance Confidence Scale, Sensory Organization Balance Test, Stabilometric Assessment, Fatigue Severity Scale, cadence, step length, single and double support time, Multiple Sclerosis Quality of Life-54. Results: Between groups comparisons showed no significant differences on primary and secondary outcome measures over time. Within group comparisons showed significant improvements in both groups on the Berg Balance Scale (P = 0.001). Changes approaching significance were found on gait speed (P = 0.07) only in the RAGT group. Significant changes in balance task-related domains during standing and walking conditions were found in the SIBT group. Conclusion: Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT.
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Affiliation(s)
- Marialuisa Gandolfi
- Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy
| | - Christian Geroin
- Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy
| | - Alessandro Picelli
- Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy
| | - Daniele Munari
- Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy
| | - Andreas Waldner
- Department of Neurological Rehabilitation, Private Hospital Villa Melitta Bolzano, Italy
| | - Stefano Tamburin
- Neurology Section, Department of Neurological and Movement Sciences, University of Verona Verona, Italy
| | | | - Nicola Smania
- Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy ; Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy
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43
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La Scaleia V, Ivanenko YP, Zelik KE, Lacquaniti F. Spinal motor outputs during step-to-step transitions of diverse human gaits. Front Hum Neurosci 2014; 8:305. [PMID: 24860484 PMCID: PMC4030139 DOI: 10.3389/fnhum.2014.00305] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 04/25/2014] [Indexed: 12/22/2022] Open
Abstract
Aspects of human motor control can be inferred from the coordination of muscles during movement. For instance, by combining multimuscle electromyographic (EMG) recordings with human neuroanatomy, it is possible to estimate alpha-motoneuron (MN) pool activations along the spinal cord. It has previously been shown that the spinal motor output fluctuates with the body's center-of-mass motion, with bursts of activity around foot-strike and foot lift-off during walking. However, it is not known whether these MN bursts are generalizable to other ambulation tasks, nor is it clear if the spatial locus of the activity (along the rostrocaudal axis of the spinal cord) is fixed or variable. Here we sought to address these questions by investigating the spatiotemporal characteristics of the spinal motor output during various tasks: walking forward, backward, tiptoe and uphill. We reconstructed spinal maps from 26 leg muscle EMGs, including some intrinsic foot muscles. We discovered that the various walking tasks shared qualitative similarities in their temporal spinal activation profiles, exhibiting peaks around foot-strike and foot-lift. However, we also observed differences in the segmental level and intensity of spinal activations, particularly following foot-strike. For example, forward level-ground walking exhibited a mean motor output roughly 2 times lower than the other gaits. Finally, we found that the reconstruction of the spinal motor output from multimuscle EMG recordings was relatively insensitive to the subset of muscles analyzed. In summary, our results suggested temporal similarities, but spatial differences in the segmental spinal motor outputs during the step-to-step transitions of disparate walking behaviors.
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Affiliation(s)
- Valentina La Scaleia
- Department of Systems Medicine, University of Rome Tor Vergata Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy ; Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
| | - Yuri P Ivanenko
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
| | - Karl E Zelik
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
| | - Francesco Lacquaniti
- Department of Systems Medicine, University of Rome Tor Vergata Rome, Italy ; Centre of Space Bio-medicine, University of Rome Tor Vergata Rome, Italy ; Laboratory of Neuromotor Physiology, Santa Lucia Foundation Rome, Italy
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Wellinghoff MA, Bunchman AM, Dean JC. Gradual mechanics-dependent adaptation of medial gastrocnemius activity during human walking. J Neurophysiol 2014; 111:1120-31. [PMID: 24335207 PMCID: PMC3949234 DOI: 10.1152/jn.00251.2013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 12/08/2013] [Indexed: 01/13/2023] Open
Abstract
While performing a simple bouncing task, humans modify their preferred movement period and pattern of plantarflexor activity in response to changes in system mechanics. Over time, the preferred movement pattern gradually adapts toward the resonant frequency. The purpose of the present experiments was to determine whether humans undergo a similar process of gradually adapting their stride period and plantarflexor activity after a change in mechanical demand while walking. Participants walked on a treadmill while we measured stride period and plantarflexor activity (medial gastrocnemius and soleus). Plantarflexor activity during stance was divided into a storage phase (30-65% stance) and a return phase (65-100% stance) based on when the Achilles tendon has previously been shown to store and return mechanical energy. Participants walked either on constant inclines (0%, 1%, 5%, 9%) or on a variable incline (0-1%) for which they were unaware of the incline changes. For variable-incline trials, participants walked under both single-task and dual-task conditions in order to vary the cognitive load. Both stride period and plantarflexor activity increased at steeper inclines. During single-task walking, small changes in incline were followed by gradual adaptation of storage-phase medial gastrocnemius activity. However, this adaptation was not present during dual-task walking, indicating some level of cognitive involvement. The observed adaptation may be the result of using afferent feedback in order to optimize the contractile conditions of the plantarflexors during the stance phase. Such adaptation could serve to improve metabolic economy but may be limited in clinical populations with disrupted proprioception.
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Affiliation(s)
- Molly A Wellinghoff
- Division of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina; and
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Kumar D, Swanik CB, Reisman DS, Rudolph KS. Individuals with medial knee osteoarthritis show neuromuscular adaptation when perturbed during walking despite functional and structural impairments. J Appl Physiol (1985) 2013; 116:13-23. [PMID: 24072409 DOI: 10.1152/japplphysiol.00244.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neuromuscular control relies on sensory feedback that influences responses to changing external demands, and the normal response is for movement and muscle activation patterns to adapt to repeated perturbations. People with knee osteoarthritis (OA) are known to have pain, quadriceps weakness, and neuromotor deficits that could affect adaption to external perturbations. The aim of this study was to analyze neuromotor adaptation during walking in people with knee OA (n = 38) and controls (n = 23). Disability, quadriceps strength, joint space width, malalignment, and proprioception were assessed. Kinematic and EMG data were collected during undisturbed walking and during perturbations that caused lateral translation of the foot at initial contact. Knee excursions and EMG magnitudes were analyzed. Subjects with OA walked with less knee motion and higher muscle activation and had greater pain, limitations in function, quadriceps weakness, and malalignment, but no difference was observed in proprioception. Both groups showed increased EMG and decreased knee motion in response to the first perturbation, followed by progressively decreased EMG activity and increased knee motion during midstance over the first five perturbations, but no group differences were observed. Over 30 trials, EMG levels returned to those of normal walking. The results illustrate that people with knee OA respond similarly to healthy individuals when exposed to challenging perturbations during functional weight-bearing activities despite structural, functional, and neuromotor impairments. Mechanisms underlying the adaptive response in people with knee OA need further study.
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Affiliation(s)
- Deepak Kumar
- Interdisciplinary Program in Biomechanics and Movement Sciences, University of Delaware, Newark, Delaware
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Wutzke CJ, Mercer VS, Lewek MD. Influence of lower extremity sensory function on locomotor adaptation following stroke: a review. Top Stroke Rehabil 2013; 20:233-40. [PMID: 23841971 DOI: 10.1310/tsr2003-233] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Following stroke, people commonly demonstrate locomotor impairments including reduced walking speed and spatiotemporal asymmetry. Rehabilitation programs have been effective in increasing gait speed, but spatiotemporal asymmetry has been more resistant to change. The inability to modify gait patterns for improved symmetry may be related, in part, to impairments in lower extremity sensation. Assessment of lower extremity sensory impairments in people post stroke, including cutaneous and proprioceptive sensation, has been insufficiently studied. Conventional rehabilitation programs, including body weight-supported walking or robotic assistance, that modify sensory feedback intended to alter lower extremity movement patterns have shown limited success in improving gait symmetry. Rehabilitation programs that amplify specific gait asymmetries have demonstrated the potential to ultimately produce more symmetric gait, presumably by allowing individuals post stroke to more readily perceive their gait asymmetry. The effectiveness of such error augmentation paradigms, however, may be influenced by lower extremity sensation and the ability of the central nervous system to be aware of altered lower extremity movement. The purpose of this review is to critically examine the literature on lower extremity sensory function and its influence on gait adaptation in people post stroke.
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Affiliation(s)
- Clinton J Wutzke
- Interdisciplinary Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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48
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Deschamps K, Matricali GA, Roosen P, Nobels F, Tits J, Desloovere K, Bruyninckx H, Flour M, Deleu PA, Verhoeven W, Staes F. Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes. Clin Biomech (Bristol, Avon) 2013; 28:813-9. [PMID: 23829980 DOI: 10.1016/j.clinbiomech.2013.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 06/15/2013] [Accepted: 06/17/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Reduction in foot mobility has been identified as a key factor of altered foot biomechanics in individuals with diabetes mellitus. This study aimed at comparing in vivo segmental foot kinematics and coupling in patients with diabetes with and without neuropathy to control adults. METHODS Foot mobility of 13 diabetic patients with neuropathy, 13 diabetic patients without neuropathy and 13 non-diabetic persons was measured using an integrated measurement set-up including a plantar pressure platform and 3D motion analysis system. In this age-, sex- and walking speed matched comparative study; differences in range of motion quantified with the Rizzoli multisegment foot model throughout different phases of the gait cycle were analysed using one-way repeated measures analysis of variance (ANOVA). Coupling was assessed with cross-correlation techniques. FINDINGS Both cohorts with diabetes showed significantly lower motion values as compared to the control group. Transverse and sagittal plane motion was predominantly affected with often lower range of motion values found in the group with neuropathy compared to the diabetes group without neuropathy. Most significant changes were observed during propulsion (both diabetic groups) and swing phase (predominantly diabetic neuropathic group). A trend of lower cross-correlations between segments was observed in the cohorts with diabetes. INTERPRETATION Our findings suggest an alteration in segmental kinematics and coupling during walking in diabetic patients with and without neuropathy. Future studies should integrate other biomechanical measurements as it is believed to provide additional insight into neural and mechanical deficits associated to the foot in diabetes.
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Affiliation(s)
- K Deschamps
- KU Leuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Multidisciplinary Diabetic Foot Clinic, University Hospitals Leuven, Weligerveld 1, 3212 Pellenberg, Belgium; Institut D'Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Weligerveld 1, 3212 Pellenberg, Belgium.
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Long-term neuroplasticity in spinal cord injury patients: A study on movement-related brain potentials. Int J Psychophysiol 2013; 87:205-14. [DOI: 10.1016/j.ijpsycho.2013.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 12/27/2012] [Accepted: 01/15/2013] [Indexed: 11/17/2022]
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Klarner T, Blouin JS, Carpenter MG, Lam T. Contributions to enhanced activity in rectus femoris in response to Lokomat-applied resistance. Exp Brain Res 2012. [PMID: 23183638 DOI: 10.1007/s00221-012-3345-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The application of resistance during the swing phase of locomotion is a viable approach to enhance activity in the rectus femoris (RF) in patients with neurological damage. Increased muscle activity is also accompanied by changes in joint angle and stride frequency, consequently influencing joint angular velocity, making it difficult to attribute neuromuscular changes in RF to resistance. Thus, the purpose of this study was to evaluate the effects of resistance on RF activity while constraining joint trajectories. Participants walked in three resistance conditions; 0 % (no resistance), 5 and 10 % of their maximum voluntary contraction (MVC). Visual and auditory biofeedback was provided to help participants maintain the same knee joint angle and stride frequency as during baseline walking. Lower limb joint trajectories and RF activity were recorded. Increasing the resistance, while keeping joint trajectories constant with biofeedback, independently enhanced swing phase RF activity. Therefore, the observed effects in RF are related to resistance, independent of any changes in joint angle. Considering resistance also affects stride frequency, a second experiment was conducted to evaluate the independent effects of resistance and stride frequency on RF activity. Participants walked in four combinations of resistance at 0 and 10 %MVC and natural and slow stride frequency conditions. We observed significant increases in RF activity with increased resistance and decreased stride frequency, confirming the independent contribution of resistance on RF activity as well as the independent effect of stride frequency. Resistance and stride frequency may be key parameters in gait rehabilitation strategies where either of these may be manipulated to enhance swing phase flexor muscle activity in order to maximize rehabilitation outcomes.
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Affiliation(s)
- Taryn Klarner
- School of Kinesiology, University of British Columbia, Vancouver, Canada
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