Within-step modulation of leg muscle activity by afferent feedback in human walking

Attenuation of muscle spindle firing with artificially increased series compliance during stretch of relaxed muscle

Muscle spindles relay vital mechanosensory information for movement and posture, but muscle spindle feedback is coupled to skeletal motion by a compliant tendon. Little is known about the effects of tendon compliance on muscle spindle feedback during movement, and the complex firing of muscle spindles makes these effects difficult to predict. Our goal was to investigate changes in muscle spindle firing using added series elastic elements (SEEs) to mimic a more compliant tendon, and to characterize the accompanying changes in firing with respect to muscle-tendon unit (MTU) and muscle fascicle displacements (recorded via sonomicrometry). Sinusoidal, ramp-and-hold and triangular stretches were analysed to examine potential changes in muscle spindle instantaneous firing rates (IFRs) in locomotor- and perturbation-like stretches as well as serial history dependence. Added SEEs effectively reduced overall MTU stiffness and generally reduced muscle spindle firing rates, but the effect differed across stretch types. During sinusoidal stretches, peak and mean firing rates were not reduced and IFR was best-correlated with fascicle velocity. During ramp stretches, SEEs reduced the initial burst, dynamic and static responses of the spindle. Notably, IFR was negatively related to fascicle displacement during the hold phase. During triangular stretches, SEEs reduced the mean IFR during the first and second stretches, affecting the serial history dependence of mean IFR. Overall, these results demonstrate that tendon compliance may attenuate muscle spindle feedback during movement, but these changes cannot be fully explained by reduced muscle fascicle length or velocity, or MTU force.

Attenuation of muscle spindle firing with artificially increased series compliance during stretch of relaxed muscle

Muscle spindles relay vital mechanosensory information for movement and posture, but muscle spindle feedback is coupled to skeletal motion by a compliant tendon. Little is known about the effects of tendon compliance on muscle spindle feedback during movement, and the complex firing of muscle spindles make these effects difficult to predict. Our goal was to investigate changes in muscle spindle firing using added series elastic elements (SEEs) to mimic a more compliant tendon, and to characterize the accompanying changes in firing with respect to muscle-tendon unit (MTU) and muscle fascicle displacements (recorded via sonomicrometry). Sinusoidal, ramp-hold-release, and triangular stretches were analyzed to examine potential changes in muscle spindle instantaneous firing rates (IFRs) in locomotor- and perturbation-like stretches as well as history dependence. Added SEEs effectively reduced overall MTU stiffness and generally reduced muscle spindle firing rates, but the effect differed across stretch types. During sinusoidal stretches, peak firing rates were reduced and IFR was strongly correlated with fascicle velocity. During ramp stretches, SEEs reduced the dynamic and static responses of the spindle during lengthening but had no effect on initial bursts at the onset of stretch. Notably, IFR was negatively related to fascicle displacement during the hold phase. During triangular stretches, SEEs reduced the mean IFR during the first and second stretches, affecting the history dependence of mean IFR. Overall, these results demonstrate that tendon compliance may attenuate muscle spindle feedback during movement, but these changes cannot be fully explained by reduced muscle fascicle length and velocity.

Identifying Individuals Who Currently Report Feelings of Anxiety Using Walking Gait and Quiet Balance: An Exploratory Study Using Machine Learning

Literature suggests that anxiety affects gait and balance among young adults. However, previous studies using machine learning (ML) have only used gait to identify individuals who report feeling anxious. Therefore, the purpose of this study was to identify individuals who report feeling anxious at that time using a combination of gait and quiet balance ML. Using a cross-sectional design, participants (n = 88) completed the Profile of Mood Survey-Short Form (POMS-SF) to measure current feelings of anxiety and were then asked to complete a modified Clinical Test for Sensory Interaction in Balance (mCTSIB) and a two-minute walk around a 6 m track while wearing nine APDM mobility sensors. Results from our study finds that Random Forest classifiers had the highest median accuracy rate (75%) and the five top features for identifying anxious individuals were all gait parameters (turn angles, variance in neck, lumbar rotation, lumbar movement in the sagittal plane, and arm movement). Post-hoc analyses suggest that individuals who reported feeling anxious also walked using gait patterns most similar to older individuals who are fearful of falling. Additionally, we find that individuals who are anxious also had less postural stability when they had visual input; however, these individuals had less movement during postural sway when visual input was removed.

Soleus H-reflex modulation during a double-legged drop landing task

Muscle spindle afferent feedback is modulated during different phases of locomotor tasks in a way that facilitates task goals. However, only a few studies have studied H-reflex modulation during landing. This study aimed to characterize soleus (SOL) H-reflex modulation during the flight and early landing period of drop landings. Since landing presumably involves a massive increase in spindle afferent firing due to rapid SOL muscle stretching, we hypothesized H-reflex size would decrease near landing reflecting neural modulation to prevent excessive motoneuron excitation. The soleus H-reflex was recorded during drop landings from a 30 cm height in nine healthy adults. Electromyography (SOL, tibialis anterior (TA), medial gastrocnemius, and vastus lateralis), ankle and knee joint motion and ground reaction force were recorded during landings. Tibial nerve stimulation was timed to elicit H-reflexes during the flight and early ground contact period (five 30 ms Bins from 90 ms before to 60 ms after landing). The H-reflexes recorded after landing (0-30 and 30-60 ms) were significantly smaller (21-36% less) than that recorded during the flight periods (90-0 ms before ground contact; P ≤ 0.004). The decrease in H-reflex size not occurring until after ground contact indicates a time-critical modulation of reflex gain during the last 30 ms of flight (i.e., time of tibial nerve stimulation). H-reflex size reduction after ground contact supports a probable neural strategy to prevent excessive reflex-mediated muscle activation and thereby facilitates appropriate musculotendon and joint stiffness.

Stretch reflexes

Many of us know about stretch reflexes from the doctor's office, when a physician taps the tendon near our kneecap to elicit a quick knee extension. This procedure is used as a diagnostic tool to determine the integrity of the spinal cord and the extension response it elicits may seem otherwise useless. In fact, the tendon tap taps into one aspect of a critical building block of mammalian motor control, the stretch reflexes. Stretch reflexes are often thought to quickly resist unexpected changes in muscle length via a very simple circuit in the spinal cord, and this is one circuit that the tendon tap engages. It turns out, however, that stretch reflexes support a myriad of functions and are highly flexible. Under naturalistic conditions, stretch reflexes are shaped by peripheral physiology and engage neural circuits spanning the spinal cord, brainstem and cerebral cortex. In this Primer, we outline what is currently known about stretch reflex function and its underlying mechanisms, with a specific focus on how the cascade of nested responses collectively known as stretch reflexes interact with and build off of one another to support real-world motor behavior.

Sensory modulation of gait characteristics in human locomotion: A neuromusculoskeletal modeling study

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.

Locomotor patterns change over time during walking on an uneven surface

During walking, uneven surfaces impose new demands for controlling balance and forward progression at each step. It is unknown to what extent walking may be refined given an amount of stride-to-stride unpredictability at the distal level. Here, we explored the effects of an uneven terrain surface on whole-body locomotor dynamics immediately following exposure and after a familiarization period. Eleven young, unimpaired adults walked for 12 min on flat and uneven terrain treadmills. The whole-body center of mass excursion range (COM_exc) and peak velocity (COM_vel), step length and width were estimated. On first exposure to uneven terrain, we saw significant increases in medial-lateral COM_exc and lateral COM_vel, and in the variability of COM_exc, COM_vel and foot placement in both anterior-posterior and medial-lateral directions. Increases in step width and decreases in step length supported the immediate adoption of a cautious, restrictive solution on uneven terrain. After familiarization, step length increased and the variability of anterior-posterior COM_vel and step length reduced, while step width and lateral COM_vel reduced, alluding to a refinement of movement and a reduction of conservative strategies over time. However, the variability of medial-lateral COM_exc and lateral COM_vel increased, consistent with the release of previously constrained degrees of freedom. Despite this increase in variability, a strong relationship between step width and medial-lateral center of mass movement was maintained. Our results indicate that movement strategies of unimpaired adults when walking on uneven terrain can evolve over time with longer exposure to the surface.

Large Propulsion Demands Increase Locomotor Adaptation at the Expense of Step Length Symmetry

There is an interest to identify factors facilitating locomotor adaptation induced by split-belt walking (i.e., legs moving at different speeds) because of its clinical potential. We hypothesized that augmenting braking forces, rather than propulsion forces, experienced at the feet would increase locomotor adaptation during and after split-belt walking. To test this, forces were modulated during split-belt walking with distinct slopes: incline (larger propulsion than braking), decline (larger braking than propulsion), and flat (similar propulsion and braking). Step length asymmetry was compared between groups because it is a clinically relevant measure robustly adapted on split-belt treadmills. Unexpectedly, the group with larger propulsion demands (i.e., the incline group) changed their gait the most during adaptation, reached their final adapted state more quickly, and had larger after-effects when the split-belt perturbation was removed. We also found that subjects who experienced larger disruptions of propulsion forces in early adaptation exhibited greater after-effects, which further highlights the catalytic role of propulsion forces on locomotor adaptation. The relevance of mechanical demands on shaping our movements was also indicated by the steady state split-belt behavior, during which each group recovered their baseline leg orientation to meet leg-specific force demands at the expense of step length symmetry. Notably, the flat group was nearly symmetric, whereas the incline and decline group overshot and undershot step length symmetry, respectively. Taken together, our results indicate that forces propelling the body facilitate gait changes during and after split-belt walking. Therefore, the particular propulsion demands to walk on a split-belt treadmill might explain the gait symmetry improvements in hemiparetic gait following split-belt training.

Uneven terrain exacerbates the deficits of a passive prosthesis in the regulation of whole body angular momentum in individuals with a unilateral transtibial amputation

BACKGROUND

Uneven ground is a frequently encountered, yet little-studied challenge for individuals with amputation. The absence of control at the prosthetic ankle to facilitate correction for surface inconsistencies, and diminished sensory input from the extremity, add unpredictability to an already complex control problem, and leave limited means to produce appropriate corrective responses in a timely manner. Whole body angular momentum, L, and its variability across several strides may provide insight into the extent to which an individual can regulate their movement in such a context. The aim of this study was to explore L in individuals with a transtibial amputation, when challenged by an uneven surface. We hypothesized that, similar to previous studies, sagittal plane L would be asymmetrical on uneven terrain, and further, that uneven terrain would evoke a greater variability in L from stride to stride in individuals with amputation in comparison to unimpaired individuals, due to a limited ability to discern and correct for changing contours beneath the prosthetic foot.

METHODS

We examined sagittal plane L in ten individuals with a unilateral transtibial amputation and age- and gender- matched control participants walking on flat (FT) and uneven (UT) treadmills. The average range of L in the first 50% of the gait cycle (L_R), the average L at foot contact (L_C) and their standard deviations (vL_R, vL_C) were computed over 60 strides on each treadmill.

RESULTS

On both surfaces we observed a higher L_R on the prosthetic side and a reduced L_C on the sound side (p < 0.001) in the amputee cohort, consistent with previous findings. UT invoked an increase in L_C (p = 0.006), but not L_R (p = 0.491). vL_R, and vL_C were higher in individuals with amputation (p < 0.001, p = 0.002), and increased in both groups on UT (p < 0.001).

CONCLUSIONS

These findings support previous assertions that individuals with amputation regulate L less effectively, and suggest that the deficits of the prosthesis are exacerbated on uneven terrain, potentially to the detriment of balance. Further, the results indicate that a greater demand may be placed on the unaffected side to control movement.

Barefoot running does not affect simple reaction time: an exploratory study

Background

Converging evidence comparing barefoot (BF) and shod (SH) running highlights differences in foot-strike patterns and somatosensory feedback, among others. Anecdotal evidence from SH runners attempting BF running suggests a greater attentional demand may be experienced during BF running. However, little work to date has examined whether there is an attentional cost of BF versus SH running.

Objective

This exploratory study aimed to examine whether an acute bout of BF running would impact simple reaction time (SRT) compared to SH running, in a sample of runners naïve to BF running.

Methods

Eight male distance runners completed SRT testing during 10 min of BF or SH treadmill running at 70% maximal aerobic speed (17.9 ± 1.4 km h⁻¹). To test SRT, participants were required to press a hand-held button in response to the flash of a light bulb placed in the center of their visual field. SRT was tested at 1-minute intervals during running. BF and SH conditions were completed in a pseudo-randomized and counterbalanced crossover fashion. SRT was defined as the time elapsed between the light bulb flash and the button press. SRT errors were also recorded and were defined as the number of trials in which a button press was not recorded in response to the light bulb flash.

Results

Overall, SRT later in the exercise bouts showed a statistically significant increase compared to earlier (p < 0.05). Statistically significant increases in SRT were present at 7 min versus 5 min (0.29 ± 0.02 s vs. 0.27 ± 0.02 s, p < 0.05) and at 9 min versus 2 min (0.29 ± 0.03 s vs. 0.27 ± 0.03 s, p < 0.05). However, BF running did not influence this increase in SRT (p > 0.05) or the number of SRT errors (17.6 ± 6.6 trials vs. 17.0 ± 13.0 trials, p > 0.05).

Discussion

In a sample of distance runners naïve to BF running, there was no statistically significant difference in SRT or SRT errors during acute bouts of BF and SH running. We interpret these results to mean that BF running does not have a greater attentional cost compared to SH running during a SRT task throughout treadmill running. Literature suggests that stride-to-stride gait modulation during running may occur predominately via mechanisms that preclude conscious perception, thus potentially attenuating effects of increased somatosensory feedback experienced during BF running. Future research should explore the present experimental paradigm in a larger sample using over-ground running trials, as well as employing different tests of attention.

Patterns of intermuscular inhibitory force feedback across cat hindlimbs suggest a flexible system for regulating whole limb mechanics

Prior work has suggested that Golgi tendon organ feedback, via its distributed network linking muscles spanning all joints, could be used by the nervous system to help regulate whole limb mechanics if appropriately organized. We tested this hypothesis by characterizing the patterns of intermuscular force-dependent feedback between the primary extensor muscles spanning the knee, ankle, and toes in decerebrate cat hindlimbs. Intermuscular force feedback was evaluated by stretching tendons of selected muscles in isolation and in pairwise combinations and then measuring the resulting force-dependent intermuscular interactions. The relative inhibitory feedback between extensor muscles was examined, as well as symmetry of the interactions across limbs. Differences in the directional biases of inhibitory feedback were observed across cats, with three patterns identified as points on a spectrum: pattern 1, directional bias of inhibitory feedback onto the ankle extensors and toe flexors; pattern 2, convergence of inhibitory feedback onto ankle extensors and mostly balanced inhibitory feedback between vastus muscle group and flexor hallucis longus, and pattern 3, directional bias of inhibitory feedback onto ankle and knee extensors. The patterns of inhibitory feedback, while different across cats, were symmetric across limbs of individual cats. The variable but structured distribution of force feedback across cat hindlimbs provides preliminary evidence that inhibitory force feedback could be a regulated neural control variable. We propose the directional biases of inhibitory feedback observed experimentally could provide important task-dependent benefits, such as directionally appropriate joint compliance, joint coupling, and compensation for nonuniform inertia. NEW & NOTEWORTHY Feedback from Golgi tendon organs project widely among extensor motor nuclei in the spinal cord. The distributed nature of force feedback suggests these pathways contribute to the global regulation of limb mechanics. Analysis of this network in individual animals indicates that the strengths of these pathways can be reorganized appropriately for a variety of motor tasks, including level walking, slope walking, and landing.

Muscle spindles in human tibialis anterior encode muscle fascicle length changes

Muscle spindles provide exquisitely sensitive proprioceptive information regarding joint position and movement. Through passively driven length changes in the muscle-tendon unit (MTU), muscle spindles detect joint rotations because of their in-parallel mechanical linkage to muscle fascicles. In human microneurography studies, muscle fascicles are assumed to follow the MTU and, as such, fascicle length is not measured in such studies. However, under certain mechanical conditions, compliant structures can act to decouple the fascicles, and, therefore, the spindles, from the MTU. Such decoupling may reduce the fidelity by which muscle spindles encode joint position and movement. The aim of the present study was to measure, for the first time, both the changes in firing of single muscle spindle afferents and changes in muscle fascicle length in vivo from the tibialis anterior muscle (TA) during passive rotations about the ankle. Unitary recordings were made from 15 muscle spindle afferents supplying TA via a microelectrode inserted into the common peroneal nerve. Ultrasonography was used to measure the length of an individual fascicle of TA. We saw a strong correlation between fascicle length and firing rate during passive ankle rotations of varying rates (0.1-0.5 Hz) and amplitudes (1-9°). In particular, we saw responses observed at relatively small changes in muscle length that highlight the sensitivity of the TA muscle to small length changes. This study is the first to measure spindle firing and fascicle dynamics in vivo and provides an experimental basis for further understanding the link between fascicle length, MTU length, and spindle firing patterns.NEW & NOTEWORTHY Muscle spindles are exquisitely sensitive to changes in muscle length, but recordings from human muscle spindle afferents are usually correlated with joint angle rather than muscle fascicle length. In this study, we monitored both muscle fascicle length and spindle firing from the human tibialis anterior muscle in vivo. Our findings are the first to measure these signals in vivo and provide an experimental basis for exploring this link further.

Self-reinnervated muscles lose autogenic length feedback, but intermuscular feedback can recover functional connectivity

In this study, we sought to identify sensory circuitry responsible for motor deficits or compensatory adaptations after peripheral nerve cut and repair. Self-reinnervation of the ankle extensor muscles abolishes the stretch reflex and increases ankle yielding during downslope walking, but it remains unknown whether this finding generalizes to other muscle groups and whether muscles become completely deafferented. In decerebrate cats at least 19 wk after nerve cut and repair, we examined the influence of quadriceps (Q) muscles' self-reinnervation on autogenic length feedback, as well as intermuscular length and force feedback, among the primary extensor muscles in the cat hindlimb. Effects of gastrocnemius and soleus self-reinnervation on intermuscular circuitry were also evaluated. We found that autogenic length feedback was lost after Q self-reinnervation, indicating that loss of the stretch reflex appears to be a generalizable consequence of muscle self-reinnervation. However, intermuscular force and length feedback, evoked from self-reinnervated muscles, was preserved in most of the interactions evaluated with similar relative inhibitory or excitatory magnitudes. These data indicate that intermuscular spinal reflex circuitry has the ability to regain functional connectivity, but the restoration is not absolute. Explanations for the recovery of intermuscular feedback are discussed, based on identified mechanisms responsible for lost autogenic length feedback. Functional implications, due to permanent loss of autogenic length feedback and potential for compensatory adaptations from preserved intermuscular feedback, are discussed.

Vibrotactile stimulation of fast-adapting cutaneous afferents from the foot modulates proprioception at the ankle joint

It has previously been shown that cutaneous sensory input from across a broad region of skin can influence proprioception at joints of the hand. The present experiment tested whether cutaneous input from different skin regions across the foot can influence proprioception at the ankle joint. The ability to passively match ankle joint position (17° and 7° plantar flexion and 7° dorsiflexion) was measured while cutaneous vibration was applied to the sole (heel, distal metatarsals) or dorsum of the target foot. Vibration was applied at two different frequencies to preferentially activate Meissner's corpuscles (45 Hz, 80 μm) or Pacinian corpuscles (255 Hz, 10 μm) at amplitudes ∼3 dB above mean perceptual thresholds. Results indicated that cutaneous input from all skin regions across the foot could influence joint-matching error and variability, although the strongest effects were observed with heel vibration. Furthermore, the influence of cutaneous input from each region was modulated by joint angle; in general, vibration had a limited effect on matching in dorsiflexion compared with matching in plantar flexion. Unlike previous results in the upper limb, we found no evidence that Pacinian input exerted a stronger influence on proprioception compared with Meissner input. Findings from this study suggest that fast-adapting cutaneous input from the foot modulates proprioception at the ankle joint in a passive joint-matching task. These results indicate that there is interplay between tactile and proprioceptive signals originating from the foot and ankle.

Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies

Automaticity is a hallmark feature of walking in adults who are healthy and well-functioning. In the context of walking, “automaticity” refers to the ability of the nervous system to successfully control typical steady state walking with minimal use of attention-demanding executive control resources. Converging lines of evidence indicate that walking deficits and disorders are characterized in part by a shift in the locomotor control strategy from healthy automaticity to compensatory executive control. This is potentially detrimental to walking performance, as an executive control strategy is not optimized for locomotor control. Furthermore, it places excessive demands on a limited pool of executive reserves. The result is compromised ability to perform basic and complex walking tasks and heightened risk for adverse mobility outcomes including falls. Strategies for rehabilitation of automaticity are not well defined, which is due to both a lack of systematic research into the causes of impaired automaticity and to a lack of robust neurophysiological assessments by which to gauge automaticity. These gaps in knowledge are concerning given the serious functional implications of compromised automaticity. Therefore, the objective of this article is to advance the science of automaticity of walking by consolidating evidence and identifying gaps in knowledge regarding: (a) functional significance of automaticity; (b) neurophysiology of automaticity; (c) measurement of automaticity; (d) mechanistic factors that compromise automaticity; and (e) strategies for rehabilitation of automaticity.

Functioning of peripheral Ia pathways in leg muscles of newly walking toddlers

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.

A model of muscle-tendon function in human walking at self-selected speed

Although joint biomechanics and whole-body energetics are well documented for human walking, the underlying mechanisms that govern individual muscle-tendon behaviors are not fully understood. Here, we present a computational model of human walking that unifies muscle and joint biomechanics with whole-body metabolism for level-ground walking at self-selected speed. In the model, muscle-tendon units that dorsiflex the ankle, and flex and extend the knee, are assumed to act as linear springs upon neural activation; each muscle-tendon is modeled as a tendon spring in series with an isometric force source. To provide the mechanical power lost in step-to-step gait transitions, a Hill-type soleus muscle is modeled to actively plantar flex the ankle using muscle state and force as reflex feedback signals. Finally, to stabilize the trunk during stance, and to protract and retract each leg throughout the swing phase, two mono-articular Hill-type muscles actuate the model's hip joint. Following a forward dynamics optimization procedure, the walking model is shown to predict muscle and joint biomechanics, as well as whole-body metabolism, supporting the idea that the preponderance of leg muscles operate isometrically, affording the relatively high metabolic walking economy of humans.

Gradual mechanics-dependent adaptation of medial gastrocnemius activity during human walking

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.

Evaluation of lower limb cross planar kinetic connectivity signatures post-stroke

Following stroke, aberrant three dimensional multijoint gait impairments emerge that present in kinematic asymmetries such as circumduction. A precise pattern of cross-planar coordination may underlie abnormal hemiparetic gait as several studies have underscored distinctive neural couplings between medio-lateral control and sagittal plane progression during walking. Here we investigate potential neuromechanical constraints governing abnormal multijoint coordination post-stroke. 15 chronic monohemispheric stroke patients and 10 healthy subjects were recruited. Coupled torque production patterns were assessed using a volitional isometric torque generation task where subjects matched torque targets for a primary joint in 4 directions while receiving visual feedback of the magnitude and direction of the torque. Secondary torques at other lower limb joints were recorded without subject feedback. We find that common features of cross-planar connectivity in stroke subjects include statistically significant frontal to sagittal plane kinetic coupling that overlay a common sagittal plane coupling in healthy subjects. Such coupling is independent of proximal or distal joint control and limb biomechanics. Principal component analysis of the stroke aggregate kinetic signature reveals unique abnormal frontal plane coupling features that explain a larger percentage of the total torque coupling variance. This study supports the idea that coupled cross-planar kinetic outflow between the lower limb joints uniquely emerges during pathological control of frontal plane degrees of freedom resulting in a generalized extension of the limb. It remains to be seen if a pattern of lower limb motor outflow that is centrally mediated contributes to abnormal hemiparetic gait.

Contributions to enhanced activity in rectus femoris in response to Lokomat-applied resistance

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.

Neuromuscular strategies for the transitions between level and hill surfaces during walking

Despite continual fluctuations in walking surface properties, humans and animals smoothly transition between terrains in their natural surroundings. Walking transitions have the potential to influence dynamic balance in both the anterior-posterior and medial-lateral directions, thereby increasing fall risk and decreasing mobility. The goal of the current manuscript is to provide a review of the literature that pertains to the topic of surface slope transitions between level and hill surfaces, as well as report the recent findings of two experiments that focus on the neuromuscular strategies of surface slope transitions. Our results indicate that in anticipation of a change in surface slope, neuromuscular patterns during level walking prior to a hill are significantly different from the patterns during level walking without the future change in surface. Typically, the changes in muscle activity were due to co-contraction of opposing muscle groups and these changes correspond to modifications in head pitch. In addition, further experiments revealed that the neck proprioceptors may be an initial source of feedback for upcoming surface slope transitions. Together, these results illustrate that in order to safely traverse varying surfaces, transitions strides are functionally distinct from either level walking or hill walking independently.

Speed adaptation in a powered transtibial prosthesis controlled with a neuromuscular model

Control schemes for powered ankle-foot prostheses would benefit greatly from a means to make them inherently adaptive to different walking speeds. Towards this goal, one may attempt to emulate the intact human ankle, as it is capable of seamless adaptation. Human locomotion is governed by the interplay among legged dynamics, morphology and neural control including spinal reflexes. It has been suggested that reflexes contribute to the changes in ankle joint dynamics that correspond to walking at different speeds. Here, we use a data-driven muscle-tendon model that produces estimates of the activation, force, length and velocity of the major muscles spanning the ankle to derive local feedback loops that may be critical in the control of those muscles during walking. This purely reflexive approach ignores sources of non-reflexive neural drive and does not necessarily reflect the biological control scheme, yet can still closely reproduce the muscle dynamics estimated from biological data. The resulting neuromuscular model was applied to control a powered ankle-foot prosthesis and tested by an amputee walking at three speeds. The controller produced speed-adaptive behaviour; net ankle work increased with walking speed, highlighting the benefits of applying neuromuscular principles in the control of adaptive prosthetic limbs.

Positive afferent feedback to the human soleus muscle during quiet standing

INTRODUCTION

In this study we investigated the mechanisms responsible for soleus muscle contraction during quiet standing.

METHODS

Subjects stood on a platform that was randomly moved forward or downward or rotated around the ankle.

RESULTS

Downward perturbation caused a short-latency drop in averaged rectified soleus electromyography (SOL EMG). SOL drop increased monotonically with downward acceleration amplitude. Ischemia above the knee abolished or diminished this drop. Ischemia above the ankle had no diminishing effect. Vibration of the Achilles tendon had a diminishing effect on the amplitude of SOL responses.

CONCLUSIONS

The short-latency drop in SOL observed for downward perturbation might be due to a decrease in positive afferent feedback due to the sudden decrease in body weight. This implies the existence of an ongoing afferent feedback loop toward the SOL motoneuron pool from force-sensitive receptors. Both Ia and Ib afferents probably play a role in the responses observed.

Stair walking transitions are an anticipation of the next stride

According to the CDC, the majority of fall-related accidents occur during stair walking. It is likely that the required increases in range of motion and muscle activity during stair walking contribute to increased fall risk. In addition, compared to level walking, the transition strides before and after stair walking demonstrate increased fall risk. We hypothesized that the transition strides would have joint angle trajectories and muscle activity patterns that are most similar to a theoretical transition stride, calculated as the mean between the before stride and the after stride. Twelve healthy men completed the protocol of level and stair walking. We analyzed three sagittal plane joint angles and six leg muscle activity patterns of the left leg for transitions from level to stairs and from stairs to level, both up and down. We compared each time point of the transition strides to the corresponding time points of the before stride, the after stride, and a theoretical mean stride with a series of 2-sample t-tests. Contrary to our hypothesis, all transition strides exhibited the least number of significantly different time points with the after stride (34%), not the mean stride (51%). This result suggests that the mechanics of a transition stride are not simply an intermediate between a before stride and an after stride, neither are they a continuation of the before stride, but rather they are a unique anticipation of the upcoming surface.

Involvement of the corticospinal tract in the control of human gait

Given the inherent mechanical complexity of human bipedal locomotion, and that complete spinal cord lesions in human leads to paralysis with no recovery of gait, it is often suggested that the corticospinal tract (CST) has a more predominant role in the control of walking in humans than in other animals. However, what do we actually know about the contribution of the CST to the control of gait? This chapter will provide an overview of this topic based on the premise that a better understanding of the role of the CST in gait will be essential for the design of evidence-based approaches to rehabilitation therapy, which will enhance gait ability and recovery in patients with lesions to the central nervous system (CNS). We review evidence for the involvement of the primary motor cortex and the CST during normal and perturbed walking and during gait adaptation. We will also discuss knowledge on the CST that has been gained from studies involving CNS lesions, with a particular focus on recent data acquired in people with spinal cord injury.

Functioning of peripheral Ia pathways in infants with typical development: responses in antagonist muscle pairs

In muscle responses of proprioceptive origin, including the stretch/tendon reflex (T-reflex), the corresponding reciprocal excitation and irradiation to distant muscles have been described from newborn infants to older adults. However, the functioning of other responses mediated primarily by Ia-afferents has not been investigated in infants. Understanding the typical development of these multiple pathways is critical to determining potential problems in their development in populations affected by neurological disease, such as spina bifida or cerebral palsy. Hence, the goal of the present study was to quantify the excitability of Ia-mediated responses in lower limb muscles of infants with typical development. These responses were elicited by mechanical stimulation applied to the distal tendons of the gastrocnemius-soleus (GS), tibialis anterior (TA) and quadriceps (QAD) muscles of both legs in twelve 2- to 10-month-old infants and recorded simultaneously in antagonist muscle pairs by surface EMG. Tendon taps alone elicited responses in either, both or neither muscle. The homonymous response (T-reflex) was less frequent in the TA than the GS or QAD muscle. An 80 Hz vibration superimposed on tendon taps induced primarily an inhibition of monosynaptic responses; however, facilitation also occurred in either muscle of the recorded pair. These responses were not influenced significantly by age or gender. Vibration alone produced a tonic reflex response in the vibrated muscle (TVR) and/or the antagonist muscle (AVR). However, for the TA muscle the TVR was more frequently elicited in older than younger infants. High variability was common to all responses. Overall, the random distribution and inconsistency of muscle responses suggests that the gain of Ia-mediated feedback is unstable. We propose that during infancy the central nervous system needs to learn to set stable feedback gain, or destination of proprioceptive assistance, based on their use during functional movements. This will tailor the neuromuscular connectivity to support adaptive motor behaviors.

Ultrasonography as a tool to study afferent feedback from the muscle-tendon complex during human walking

In humans, one of the most common tasks in everyday life is walking, and sensory afferent feedback from peripheral receptors, particularly the muscle spindles and Golgi tendon organs (GTO), makes an important contribution to the motor control of this task. One factor that can complicate the ability of these receptors to act as length, velocity and force transducers is the complex pattern of interaction between muscle and tendinous tissues, as tendon length is often considerably greater than muscle fibre length in the human lower limb. In essence, changes in muscle-tendon mechanics can influence the firing behaviour of afferent receptors, which may in turn affect the motor control. In this review we first summarise research that has incorporated the use of ultrasound-based techniques to study muscle-tendon interaction, predominantly during walking. We then review recent research that has combined this method with an examination of muscle activation to give a broader insight to neuromuscular interaction during walking. Despite the advances in understanding that these techniques have brought, there is clearly still a need for more direct methods to study both neural and mechanical parameters during human walking in order to unravel the vast complexity of this seemingly simple task.

Short-term locomotor adaptation to a robotic ankle exoskeleton does not alter soleus Hoffmann reflex amplitude

BACKGROUND

To improve design of robotic lower limb exoskeletons for gait rehabilitation, it is critical to identify neural mechanisms that govern locomotor adaptation to robotic assistance. Previously, we demonstrated soleus muscle recruitment decreased by approximately 35% when walking with a pneumatically-powered ankle exoskeleton providing plantar flexor torque under soleus proportional myoelectric control. Since a substantial portion of soleus activation during walking results from the stretch reflex, increased reflex inhibition is one potential mechanism for reducing soleus recruitment when walking with exoskeleton assistance. This is clinically relevant because many neurologically impaired populations have hyperactive stretch reflexes and training to reduce the reflexes could lead to substantial improvements in their motor ability. The purpose of this study was to quantify soleus Hoffmann (H-) reflex responses during powered versus unpowered walking.

METHODS

We tested soleus H-reflex responses in neurologically intact subjects (n=8) that had trained walking with the soleus controlled robotic ankle exoskeleton. Soleus H-reflex was tested at the mid and late stance while subjects walked with the exoskeleton on the treadmill at 1.25 m/s, first without power (first unpowered), then with power (powered), and finally without power again (second unpowered). We also collected joint kinematics and electromyography.

RESULTS

When the robotic plantar flexor torque was provided, subjects walked with lower soleus electromyographic (EMG) activation (27-48%) and had concomitant reductions in H-reflex amplitude (12-24%) compared to the first unpowered condition. The H-reflex amplitude in proportion to the background soleus EMG during powered walking was not significantly different from the two unpowered conditions.

CONCLUSION

These findings suggest that the nervous system does not inhibit the soleus H-reflex in response to short-term adaption to exoskeleton assistance. Future studies should determine if the findings also apply to long-term adaption to the exoskeleton.

Achilles tendon length changes during walking in long-term diabetes patients

BACKGROUND

Diabetes leads to numerous side effects, including an increased density of collagen fibrils and thickening of the Achilles tendon. This may increase tissue stiffness and could affect stretch distribution between muscle and tendinous tissues during walking. The primary aim of this study was to examine stretch distribution between muscle and tendinous tissues in the medial gastrocnemius muscle-tendon unit in long-term diabetes patients and control subjects during walking.

METHODS

Achilles tendon length changes were investigated in 13 non-neuropathic diabetes patients and 12 controls, whilst walking at a self selected speed across a 10 m force platform. Electromyographic activity was recorded in the medial gastrocnemius, soleus and tibialis anterior muscles, goniometers were used to detect joint angle changes, and ultrasound was used to estimate tendon length changes.

FINDINGS

Achilles tendon length changes were attenuated in diabetes patients compared to controls, and were inversely correlated with diabetes duration (r=-0.628; P<0.05), as was ankle range of motion (r=-0.693; P<0.01). Tendon length changes were also independent of walking speed (r=-0.299; P=0.224) and age (r=0.115; P=0.721) in the diabetic group.

INTERPRETATION

Stretch distribution between muscle and tendon during walking is altered in diabetic patients, which could decrease walking efficiency, a factor that may be exacerbated with increasing diabetes duration. Diabetes-induced changes in mechanical tendon properties may be at least partly responsible for attenuated tendon length changes during walking in this patient group.

Load rather than length sensitive feedback contributes to soleus muscle activity during human treadmill walking

Walking requires a constant adaptation of locomotor output from sensory afferent feedback mechanisms to ensure efficient and stable gait. We investigated the nature of the sensory afferent feedback contribution to the soleus motoneuronal drive and to the corrective stretch reflex by manipulating body load and ankle joint angle. The volunteers walked on a treadmill ( approximately 3.6 km/h) connected to a body weight support (BWS) system. To manipulate the load sensitive afferents the level of BWS was switched between 5 and 30% of body weight. The effect of transient changes in BWS on the soleus stretch reflex was measured by presenting dorsiflexion perturbations ( approximately 5 degrees, 360-400 degrees/s) in mid and late stances. Short (SLRs) and medium latency reflexes (MLRs) were quantified in a 15 ms analysis window. The MLR decreased with decreased loading (P = 0.045), but no significant difference was observed for the SLR (P = 0.13). Similarly, the effect of the BWS was measured on the unload response, i.e., the depression in soleus activity following a plantar-flexion perturbation ( approximately 5.6 degrees, 203-247 degrees/s), quantified over a 50 ms analysis window. The unload response decreased with decreased load (P > 0.001), but was not significantly affected (P = 0.45) by tizanidine induced depression of the MLR (P = 0.039, n = 6). Since tizanidine is believed to depress the group II afferent pathway, these results are consistent with the idea that force-related afferent feedback contributes both to the background locomotor activity and to the medium latency stretch reflex. In contrast, length-related afferent feedback may contribute to only the medium latency stretch reflex.

Afferent Contribution to Locomotor Muscle Activity During Unconstrained Overground Human Walking: An Analysis of Triceps Surae Muscle Fascicles

Plantar flexor series elasticity can be used to dissociate muscle–fascicle and muscle–tendon behavior and thus afferent feedback during human walking. We used electromyography (EMG) and high-speed ultrasonography concomitantly to monitor muscle activity and muscle fascicle behavior in 19 healthy volunteers as they walked across a platform. On random trials, the platform was dropped (8 cm, 0.9 g acceleration) or held at a small inclination (up to ±3° in the parasagittal plane) with respect to level ground. Dropping the platform in the mid and late phases of stance produced a depression in the soleus muscle activity with an onset latency of about 50 ms. The reduction in ground reaction force also unloaded the plantar flexor muscles. The soleus muscle fascicles shortened with a minimum delay of 14 ms. Small variations in platform inclination produced significant changes in triceps surae muscle activity; EMG increased when stepping on an inclined surface and decreased when stepping on a declined surface. This sensory modulation of the locomotor output was concomitant with changes in triceps surae muscle fascicle and gastrocnemius tendon length. Assuming that afferent activity correlates to these mechanical changes, our results indicate that within-step sensory feedback from the plantar flexor muscles automatically adjusts muscle activity to compensate for small ground irregularities. The delayed onset of muscle fascicle movement after dropping the platform indicates that at least the initial part of the soleus depression is more likely mediated by a decrease in force feedback than length-sensitive feedback, indicating that force feedback contributes to the locomotor activity in human walking.

Joint kinetic response during unexpectedly reduced plantar flexor torque provided by a robotic ankle exoskeleton during walking

During human walking, plantar flexor activation in late stance helps to generate a stable and economical gait pattern. Because plantar flexor activation is highly mediated by proprioceptive feedback, the nervous system must modulate reflex pathways to meet the mechanical requirements of gait. The purpose of this study was to quantify ankle joint mechanical output of the plantar flexor stretch reflex response during a novel unexpected gait perturbation. We used a robotic ankle exoskeleton to mechanically amplify the ankle torque output resulting from soleus muscle activation. We recorded lower-body kinematics, ground reaction forces, and electromyography during steady-state walking and during randomly perturbed steps when the exoskeleton assistance was unexpectedly turned off. We also measured soleus Hoffmann- (H-) reflexes at late stance during the two conditions. Subjects reacted to the unexpectedly decreased exoskeleton assistance by greatly increasing soleus muscle activity about 60ms after ankle angle deviated from the control condition (p<0.001). There were large differences in ankle kinematic and electromyography patterns for the perturbed and control steps, but the total ankle moment was almost identical for the two conditions (p=0.13). The ratio of soleus H-reflex amplitude to background electromyography was not significantly different between the two conditions (p=0.4). This is the first study to show that the nervous system chooses reflex responses during human walking such that invariant ankle joint moment patterns are maintained during perturbations. Our findings are particularly useful for the development of neuromusculoskeletal computer simulations of human walking that need to adjust reflex gains appropriately for biomechanical analyses.

Effects of prolonged walking on neural and mechanical components of stretch responses in the human soleus muscle

After repeated passive stretching, tendinous tissue compliance increases in the human soleus (SOL) muscle-tendon unit. During movement, such changes would have important consequences for neural and mechanical stretch responses. This study examined the existence of such effects in response to a 75 min walking intervention. Eleven healthy subjects walked on a treadmill at 4 km h(1) with a robotic stretch device attached to the left leg. Ultrasonography was used to measure SOL fascicle lengths, and surface EMG activity was recorded in the SOL and tibialis anterior (TA) muscles. Perturbations of 6 deg were imposed at three different measurement intervals: Pre (immediately before the walking intervention), Mid (after approximately 30 min of walking) and Post (immediately after the intervention). Between the Pre-Mid and Mid-Post intervals, subjects walked for 30 min at a gradient of 3%. After the intervention, the amplitude and velocity of fascicle stretch both decreased (by 46 and 59%, respectively; P < 0.001) in response to a constant external perturbation, as did short (33%; P < 0.01) and medium (25%; P < 0.01) latency stretch reflex amplitudes. A faster perturbation elicited at the end of the protocol resulted in a recovery of fascicle stretch velocities and short latency reflex amplitudes to the pre-exercise values. These findings suggest that repeated stretching and shortening of a muscle-tendon unit can induce short-term structural changes in the tendinous tissues during human walking. The data also highlight the effect of these changes on neural feedback from muscle sensory afferents.

Timing-specific transfer of adapted muscle activity after walking in an elastic force field

Human locomotion results from interactions between feedforward (central commands from voluntary and automatic drive) and feedback (peripheral commands from sensory inputs) mechanisms. Recent studies have shown that locomotion can be adapted when an external force is applied to the lower limb. To better understand the neural control of this adaptation, the present study investigated gait modifications resulting from exposure to a position-dependent force field. Ten subjects walked on a treadmill before, during, and after exposure to a force field generated by elastic tubing that pulled the foot forward and up during swing. Lower limb kinematics and electromyographic (EMG) activity were recorded during each walking period. During force field exposure, peak foot velocity was initially increased by 38%. As subjects adapted, peak foot velocity gradually returned to baseline in <or=125 strides. In the adapted state, hamstring EMG activity started earlier (16% before toe off) and remained elevated throughout swing. After force field exposure, foot velocity was initially reduced by 22% and returned to baseline in 9-51 strides. Aftereffects in hamstring EMGs consisted of increased activity around toe off. Contrary to the adapted state, this increase was not maintained during the rest of swing. Together, these results suggest that while the neural control of human locomotion can adapt to force field exposure, the mechanisms underlying this adaptation may vary according to the timing in the gait cycle. Adapted hamstring EMG activity may rely more on feedforward mechanisms around toe off and more on feedback mechanisms during the rest of swing.

Sudden Drop in Ground Support Produces Force-Related Unload Response in Human Overground Walking

Humans maneuver easily over uneven terrain. To maintain smooth and efficient gait the motor system needs to adapt the locomotor output to the walking environment. In the present study we investigate the role of sensory feedback in adjusting the soleus muscle activity during overground walking in 19 healthy volunteers. Subjects walked unrestrained over a hydraulically actuated platform. On random trials the platform was accelerated downward at 0.8 g, unloading the plantar flexor muscles in midstance or late stance. The drop of the platform resulted in a significant depression of the soleus muscle activity of −17.9% (SD 2) and −21.4% (SD 2), with an onset latency of 49 ms (SD 1) and 45 ms (SD 1) in midstance and late stance, respectively. Input to the vestibular apparatus (i.e., the head acceleration) occurred at a latency 10.0 ms (SD 2.4) following the drop and ankle dorsiflexion velocity was decreased starting 22 ms (SD 15) after the drop. To investigate the role of length- and velocity-sensitive afferents on the depression in soleus muscle activity, the ankle rotation was arrested by using an ankle foot orthotic as the platform was dropped. Preventing the ankle movement did not significantly change the soleus depression in late stance [−18.2% (SD 15)], whereas the depression in midstance was removed [+4.9% (SD 13)]. It is concluded that force feedback from ankle extensors increases the locomotor output through positive feedback in late stance. In midstance the effect of force feedback was not observed, suggesting that spindle afferents may have a more significant effect on the output during this phase of the step cycle.

Tibialis anterior stretch reflex in early stance is suppressed by repetitive transcranial magnetic stimulation

A rapid plantar flexion perturbation in the early stance phase of walking elicits a large stretch reflex in tibialis anterior (TA). In this study we use repetitive transcranial magnetic stimulation (rTMS) to test if this response is mediated through a transcortical pathway. TA stretch reflexes were elicited in the early stance phase of the step cycle during treadmill walking. Twenty minutes of 1 Hz rTMS at 115% resting motor threshold (MT(r)) significantly decreased (P < 0.05) the magnitude of the later component of the reflex at a latency of approximately 100 ms up to 25 min after the rTMS. Control experiments in which stretch reflexes were elicited during sitting showed no effect on the spinally mediated short and medium latency stretch reflexes (SLR and MLR) while the long latency stretch reflex (LLR) and the motor-evoked potential (MEP) showed a significant decrease 10 min after 115% MT(r) rTMS. This study demonstrates that 1 Hz rTMS applied to the leg area of the motor cortex can suppress the long latency TA stretch reflex during sitting and in the stance phase of walking. These results are in line with the hypothesis that the later component of the TA stretch reflex in the stance phase of walking is mediated by a transcortical pathway. An alternative explanation for the observed results is that the reflex is mediated by subcortical structures that are affected by the rTMS. This study also shows that rTMS may be used to study the neural control of walking.