Contribution of afferent feedback to the soleus muscle activity during human locomotion

Sensory signals of unloading in insects are tuned to distinguish leg slipping from load variations in gait: experimental and modeling studies

In control of walking, sensory signals of decreasing forces are used to regulate leg lifting in initiation of swing and to detect loss of substrate grip (leg slipping). We used extracellular recordings in two insect species to characterize and model responses to force decrements of tibial campaniform sensilla, receptors that detect forces as cuticular strains. Discharges to decreasing forces did not occur upon direct stimulation of the sites of mechanotransduction (cuticular caps) but were readily elicited by bending forces applied to the leg. Responses to bending force decreases were phasic but had rate sensitivities similar to discharges elicited by force increases in the opposite direction. Application of stimuli of equivalent amplitude at different offset levels showed that discharges were strongly dependent upon the tonic level of loading: firing was maximal to complete unloading of the leg but substantially decreased or eliminated by sustained loads. The contribution of cuticle properties to sensory responses was also evaluated: discharges to force increases showed decreased adaptation when mechanical stress relaxation was minimized; firing to force decreases could be related to viscoelastic “creep” in the cuticle. Discharges to force decrements apparently occur due to cuticle viscoelasticity that generates transient strains similar to bending in the opposite direction. Tuning of sensory responses through cuticular and membrane properties effectively distinguishes loss of substrate grip/complete unloading from force variations due to gait in walking. We have successfully reproduced these properties in a mathematical model of the receptors. Sensors with similar tuning could fulfil these functions in legs of walking machines.

NEW & NOTEWORTHY Decreases in loading of legs are important in the regulation of posture and walking in both vertebrates and invertebrates. Recordings of activities of tibial campaniform sensilla, which encode forces in insects, showed that their responses are specifically tuned to detect force decreases at the end of the stance phase of walking or when a leg slips. These results have been reproduced in a mathematical model of the receptors and also have potential applications in robotics.

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.

Automatic rule-based generation of spinal cord connectome model for a neuro-musculoskeletal limb in-silico

Studying spinal interactions with muscles has been of great importance for over a century. However, with surging spinal-related movement pathologies, the need for computational models to study spinal pathways is increasing. Although spinal cord connectome models have been developed, anatomically relevant spinal neuromotor models are rare. However, building and maintaining such models is time consuming. In this study, the concept of the rule-based generation of a spinal connectome was introduced and lumbosacral connectome generation was demonstrated as an example. Furthermore, the rule-based autogenerated connectome models were synchronized with lower-limb musculoskeletal models to create an in-silico test bed. Using this setup, the role of the autogenic Ia-excitatory pathway in controlling the ankle angle was tested.

Measuring Kinematic Response to Perturbed Locomotion in Young Adults

Daily life activities often require humans to perform locomotion in challenging scenarios. In this context, this study aimed at investigating the effects induced by anterior-posterior (AP) and medio-lateral (ML) perturbations on walking. Through this aim, the experimental protocol involved 12 participants who performed three tasks on a treadmill consisting of one unperturbed and two perturbed walking tests. Inertial measurement units were used to gather lower limb kinematics. Parameters related to joint angles, as the range of motion (ROM) and its variability (CoV), as well as the inter-joint coordination in terms of continuous relative phase (CRP) were computed. The AP perturbation seemed to be more challenging causing differences with respect to normal walking in both the variability of the ROM and the CRP amplitude and variability. As ML, only the ankle showed different behavior in terms of joint angle and CRP variability. In both tasks, a shortening of the stance was found. The findings should be considered when implementing perturbed rehabilitative protocols for falling reduction.

Evaluation of force feedback in walking using joint torques as "naturalistic" stimuli

Control of adaptive walking requires the integration of sensory signals of muscle force and load. We have studied how mechanoreceptors (tibial campaniform sensilla) encode “naturalistic” stimuli derived from joint torques of stick insects walking on a horizontal substrate. Previous studies showed that forces applied to the legs using the mean torque profiles of a proximal joint were highly effective in eliciting motor activities. However, substantial variations in torque direction and magnitude occurred at the more distal femorotibial joint, which can generate braking or propulsive forces and provide lateral stability. To determine how these forces are encoded, we used torque waveforms of individual steps that had maximum values in stance in the directions of flexion or extension. Analysis of kinematic data showed that the torques in different directions tended to occur in different ranges of joint angles. Variations within stance were not accompanied by comparable changes in joint angle but often reflected vertical ground reaction forces and leg support of body load. Application of torque waveforms elicited sensory discharges with variations in firing frequency similar to those seen in freely walking insects. All sensilla directionally encoded the dynamics of force increases and showed hysteresis to transient force decreases. Smaller receptors exhibited more tonic firing. Our findings suggest that dynamic sensitivity in force feedback can modulate ongoing muscle activities to stabilize distal joints when large forces are generated at proximal joints. Furthermore, use of “naturalistic” stimuli can reproduce characteristics seen in freely moving animals that are absent in conventional restrained preparations.

NEW & NOTEWORTHY Sensory encoding of forces during walking by campaniform sensilla was characterized in stick insects using waveforms of joint torques calculated by inverse dynamics as mechanical stimuli. Tests using the mean joint torque and torques of individual steps showed the system is highly sensitive to force dynamics (dF/dt). Use of “naturalistic” stimuli can reproduce characteristics of sensory discharges seen in freely walking insects, such as load transfer among legs.

Neuronal Actions of Transspinal Stimulation on Locomotor Networks and Reflex Excitability During Walking in Humans With and Without Spinal Cord Injury

This study investigated the neuromodulatory effects of transspinal stimulation on soleus H-reflex excitability and electromyographic (EMG) activity during stepping in humans with and without spinal cord injury (SCI). Thirteen able-bodied adults and 5 individuals with SCI participated in the study. EMG activity from both legs was determined for steps without, during, and after a single-pulse or pulse train transspinal stimulation delivered during stepping randomly at different phases of the step cycle. The soleus H-reflex was recorded in both subject groups under control conditions and following single-pulse transspinal stimulation at an individualized exactly similar positive and negative conditioning-test interval. The EMG activity was decreased in both subject groups at the steps during transspinal stimulation, while intralimb and interlimb coordination were altered only in SCI subjects. At the steps immediately after transspinal stimulation, the physiological phase-dependent EMG modulation pattern remained unaffected in able-bodied subjects. The conditioned soleus H-reflex was depressed throughout the step cycle in both subject groups. Transspinal stimulation modulated depolarization of motoneurons over multiple segments, limb coordination, and soleus H-reflex excitability during assisted stepping. The soleus H-reflex depression may be the result of complex spinal inhibitory interneuronal circuits activated by transspinal stimulation and collision between orthodromic and antidromic volleys in the peripheral mixed nerve. The soleus H-reflex depression by transspinal stimulation suggests a potential application for normalization of spinal reflex excitability after SCI.

Modulation of soleus stretch reflexes during walking in people with chronic incomplete spinal cord injury

In people with spasticity due to chronic incomplete spinal cord injury (SCI), it has been presumed that the abnormal stretch reflex activity impairs gait. However, locomotor stretch reflexes across all phases of walking have not been investigated in people with SCI. Thus, to understand modulation of stretch reflex excitability during spastic gait, we investigated soleus stretch reflexes across the entire gait cycle in nine neurologically normal participants and nine participants with spasticity due to chronic incomplete SCI (2.5–11 year post-injury). While the participant walked on the treadmill at his/her preferred speed, unexpected ankle dorsiflexion perturbations (6° at 250°/s) were imposed every 4–6 steps. The soleus H-reflex was also examined. In participants without SCI, spinal short-latency “M1”, spinal medium latency “M2”, and long-latency “M3” were clearly modulated throughout the step cycle; the responses were largest in the mid-stance and almost completely suppressed during the stance-swing transition and swing phases. In participants with SCI, M1 and M2 were abnormally large in the mid–late-swing phase, while M3 modulation was similar to that in participants without SCI. The H-reflex was also large in the mid–late-swing phase. Elicitation of H-reflex and stretch reflexes in the late swing often triggered clonus and affected the soleus activity in the following stance. In individuals without SCI, moderate positive correlation was found between H-reflex and stretch reflex sizes across the step cycle, whereas in participants with SCI, such correlation was weak to non-existing, suggesting that H-reflex investigation would not substitute for stretch reflex investigation in individuals after SCI.

Effect of Kinesio taping on electromyographic activity of leg muscles during gait in children with developmental coordination disorder: A randomized controlled trial

OBJECTIVE

This study aimed to evaluate the effectiveness of Kinesio tape (KT) on lower limb muscle activation pattern in children with developmental coordination disorder (DCD) during walking.

DESIGN

A parallel-group randomized controlled trial.

SETTING

University laboratory setting.

PARTICIPANTS

Twenty-five children with DCD were randomly allocated to the KT group (mean age = 7.97 years) and 24 to the control group (mean age = 8.04 years).

INTERVENTION

KT group received KT application to the quadriceps and gastrocnemius muscles whereas the control group received no intervention.

MEASUREMENTS

Peak muscle activation (in percentage of maximal voluntary isometric contraction [%MVIC]) in the lower limbs during gait was measured by means of surface electromyography, electrogoniometry, and foot contact switches.

RESULTS

Gastrocnemius medialis activation during mid stance (23.46%MVIC, 95% CI = -32.53, -14.39) and late stance phases (3.25%MVIC, 95% CI = -5.67, -0.81) of gait increased after the application of KT in the KT group compared to baseline values. The KT group demonstrated 26.87%MVIC (95% CI = 26.87, 7.11) higher gastrocnemius medialis muscle peak activation during mid stance phase at post-test when compared with the control group. Moreover, gastrocnemius medialis and biceps femoris muscle peak activation during loading response decreased by 8.36%MVIC (95% CI = 2.71, 14.02) and 3.54%MVIC (95% CI = 1.08, 6.01), respectively, in the control group overtime.

CONCLUSIONS

The application of KT on children with DCD had an increased gastrocnemius medialis muscle activation during stance phase. KT could be incorporated into gait re-education programmes to facilitate muscle contraction in these children.

The effect of unilateral blood flow restriction on temporal and spatial gait parameters

Blood flow restriction walking (BFR-W) is becoming more frequently used in aerobic and strength training and it has been proposed that BFR-W can be used in clinical populations. BFR-W may change gait stability yet few studies have assessed gait changes during or following BFR-W. The aim of this study was to assess if spatial-temporal gait parameters change during and following BFR-W. Twenty-four participants completed two walking sessions (>48-hours apart); 1) Unilateral BFR-W applied at the dominant thigh, 2) walking without BFR. In each session participants performed a 5-min warmup, 15-min walking intervention and 10-min active recovery. The warmup and active recovery were performed without BFR on both days. Measurements were attained at baseline, during the intervention and post-intervention using the GAITRite®. Linear mixed models were applied to each measured variable. Fixed factors were timepoint (warmup, intervention, and active recovery), condition (BFR-W and control walking) and condition × timepoint. Random factors were subject and subject × condition. Participants took shorter (3.2-cm (mean difference), CI_95%: 0.8–5.6-cm) and wider strides (1.4-cm, CI_95%: 0.9–1.9-cm) during BFR-W. For single leg measures, participants took shorter steps (2.8-cm, CI_95%: 1.7–4.0-cm) with a faster single support time (7.5-ms, CI_95%: 2.9–12.0-ms) on the non-dominant (unoccluded) leg during BFR-W compared to the non-dominant leg during control walking. There were no differences in step length and single support time between the dominant (occluded) leg during BFR-W compared to the dominant leg during control walking. There were no significant changes in velocity, cadence or double support time between BFR-W and control walking (P > 0.05). BFR-W caused small transient changes to several gait parameters. These changes should be considered when using BFR-W in clinical populations.

Walking with perturbations: a guide for biped humans and robots

This paper provides an update on the neural control of bipedal walking in relation to bioinspired models and robots. It is argued that most current models or robots are based on the construct of a symmetrical central pattern generator (CPG). However, new evidence suggests that CPG functioning is basically asymmetrical with its flexor half linked more tightly to the rhythm generator. The stability of bipedal gait, which is an important problem for robots and biological systems, is also addressed. While it is not possible to determine how biological biped systems guarantee stability, robot solutions can be useful to propose new hypotheses for biology. In the second part of this review, the focus is on gait perturbations, which is an important topic in robotics in view of the frequent falls of robots when faced with perturbations. From the human physiology it is known that the initial reaction often consists of a brief interruption followed by an adequate response. For instance, the successful recovery from a trip is achieved using some basic reactions (termed elevating and lowering strategies), that depend on the phase of the step cycle of the trip occurrence. Reactions to stepping unexpectedly in a hole depend on comparing expected and real feedback. Implementation of these ideas in models and robotics starts to emerge, with the most advanced robots being able to learn how to fall safely and how to deal with complicated disturbances such as provided by walking on a split-belt.

Role of muscle spindle feedback in regulating muscle activity strength during walking at different speed in mice

Terrestrial animals increase their walking speed by increasing the activity of the extensor muscles. However, the mechanism underlying how this speed-dependent amplitude modulation is achieved remains obscure. Previous studies have shown that group Ib afferent feedback from Golgi tendon organs that signal force is one of the major regulators of the strength of muscle activity during walking in cats and humans. In contrast, the contribution of group Ia/II afferent feedback from muscle spindle stretch receptors that signal angular displacement of leg joints is unclear. Some studies indicate that group II afferent feedback may be important for amplitude regulation in humans, but the role of muscle spindle feedback in regulation of muscle activity strength in quadrupedal animals is very poorly understood. To examine the role of feedback from muscle spindles, we combined in vivo electrophysiology and motion analysis with mouse genetics and gene delivery with adeno-associated virus. We provide evidence that proprioceptive sensory feedback from muscle spindles is important for the regulation of the muscle activity strength and speed-dependent amplitude modulation. Furthermore, our data suggest that feedback from the muscle spindles of the ankle extensor muscles, the triceps surae, is the main source for this mechanism. In contrast, muscle spindle feedback from the knee extensor muscles, the quadriceps femoris, has no influence on speed-dependent amplitude modulation. We provide evidence that proprioceptive feedback from ankle extensor muscles is critical for regulating muscle activity strength as gait speed increases. NEW & NOTEWORTHY Animals upregulate the activity of extensor muscles to increase their walking speed, but the mechanism behind this is not known. We show that this speed-dependent amplitude modulation requires proprioceptive sensory feedback from muscle spindles of ankle extensor muscle. In the absence of muscle spindle feedback, animals cannot walk at higher speeds as they can when muscle spindle feedback is present.

Repeated Bout Rate Enhancement Is Elicited by Various Forms of Finger Tapping

Voluntary rhythmic movements, such as, for example, locomotion and other cyclic tasks, are fundamental during everyday life. Patients with impaired neural or motor function often take part in rehabilitation programs, which include rhythmic movements. Therefore, it is imperative to have the best possible understanding of control and behaviour of human voluntary rhythmic movements. A behavioural phenomenon termed repeated bout rate enhancement has been established as an increase of the freely chosen index finger tapping frequency during the second of two consecutive tapping bouts. The present study investigated whether the phenomenon would be elicited when the first bout consisted of imposed passive finger tapping or air tapping. These two forms of tapping were applied since they can be performed without descending drive (passive tapping) and without afferent feedback related to impact (air tapping) – as compared to tapping on a surface. Healthy individuals (n = 33) performed 3-min tapping bouts separated by 10 min rest. Surface electromyographic, kinetic, and kinematic data were recorded. Supportive experiments were made to measure, for example, the cortical sensory evoked potential (SEP) response during the three different forms of tapping. Results showed that tapping frequencies in the second of two consecutive bouts increased by 12.9 ± 14.8% (p < 0.001), 9.9 ± 6.0% (p = 0.001), and 16.8 ± 13.6% (p = 0.005) when the first bout had consisted of tapping, passive tapping, and air tapping, respectively. Rate enhancement occurred without increase in muscle activation. Besides, the rate enhancements occurred despite that tapping, as compared with passive tapping and air tapping, resulted in different cortical SEP responses. Based on the present findings, it can be suggested that sensory feedback in an initial bout increases the excitability of the spinal central pattern generators involved in finger tapping. This can eventually explain the phenomenon of repeated bout rate enhancement seen after a consecutive bout of finger tapping.

Force dynamics and synergist muscle activation in stick insects: the effects of using joint torques as mechanical stimuli

Many sensory systems are tuned to specific parameters of behaviors and have effects that are task-specific. We have studied how force feedback contributes to activation of synergist muscles in serially homologous legs of stick insects. Forces were applied using conventional half-sine or ramp and hold functions. We also utilized waveforms of joint torques calculated from experiments in freely walking animals. In all legs, forces applied to either the tarsus (foot) or proximal leg segment (trochanter) activated synergist muscles that generate substrate grip and support, but coupling of the depressor muscle to tarsal forces was weak in the front legs. Activation of trochanteral receptors using ramp and hold functions generated positive feedback to the depressor muscle in all legs when animals were induced to seek substrate grip. However, discharges of the synergist flexor muscle showed adaptation at moderate force levels. In contrast, application of forces using torque waveforms, which do not have a static hold phase, produced sustained discharges in muscle synergies with little adaptation. Firing frequencies reflected the magnitude of ground reaction forces, were graded to changes in force amplitude, and could also be modulated by transient force perturbations added to the waveforms. Comparison of synergist activation by torques and ramp and hold functions revealed a strong influence of force dynamics (dF/d t). These studies support the idea that force receptors can act to tune muscle synergies synchronously to the range of force magnitudes and dynamics that occur in each leg according to their specific use in behavior. NEW & NOTEWORTHY The effects of force receptors (campaniform sensilla) on leg muscles and synergies were characterized in stick insects using both ramp and hold functions and waveforms of joint torques calculated by inverse dynamics. Motor responses were sustained and showed reduced adaptation to the more "natural" and nonlinear torque stimuli. Calculation of the first derivative (dF/d t) of the torque waveforms demonstrated that this difference was correlated with the dynamic sensitivities of the system.

Sensory Feedback in Interlimb Coordination: Contralateral Afferent Contribution to the Short-Latency Crossed Response during Human Walking

A constant coordination between the left and right leg is required to maintain stability during human locomotion, especially in a variable environment. The neural mechanisms underlying this interlimb coordination are not yet known. In animals, interneurons located within the spinal cord allow direct communication between the two sides without the need for the involvement of higher centers. These may also exist in humans since sensory feedback elicited by tibial nerve stimulation on one side (ipsilateral) can affect the muscles activation in the opposite side (contralateral), provoking short-latency crossed responses (SLCRs). The current study investigated whether contralateral afferent feedback contributes to the mechanism controlling the SLCR in human gastrocnemius muscle. Surface electromyogram, kinematic and kinetic data were recorded from subjects during normal walking and hybrid walking (with the legs moving in opposite directions). An inverse dynamics model was applied to estimate the gastrocnemius muscle proprioceptors’ firing rate. During normal walking, a significant correlation was observed between the magnitude of SLCRs and the estimated muscle spindle secondary afferent activity (P = 0.04). Moreover, estimated spindle secondary afferent and Golgi tendon organ activity were significantly different (P ≤ 0.01) when opposite responses have been observed, that is during normal (facilitation) and hybrid walking (inhibition) conditions. Contralateral sensory feedback, specifically spindle secondary afferents, likely plays a significant role in generating the SLCR. This observation has important implications for our understanding of what future research should be focusing on to optimize locomotor recovery in patient populations.

Changes in muscle spindle firing in response to length changes of neighboring muscles

Skeletal muscle force can be transmitted to the skeleton, not only via its tendons of origin and insertion but also through connective tissues linking the muscle belly to surrounding structures. Through such epimuscular myofascial connections, length changes of a muscle may cause length changes within an adjacent muscle and hence, affect muscle spindles. The aim of the present study was to investigate the effects of epimuscular myofascial forces on feedback from muscle spindles in triceps surae muscles of the rat. We hypothesized that within an intact muscle compartment, muscle spindles not only signal length changes of the muscle in which they are located but can also sense length changes that occur as a result of changing the length of synergistic muscles. Action potentials from single afferents were measured intra-axonally in response to ramp-hold release (RHR) stretches of an agonistic muscle at different lengths of its synergist, as well as in response to synergist RHRs. A decrease in force threshold was found for both soleus (SO) and lateral gastrocnemius afferents, along with an increase in length threshold for SO afferents. In addition, muscle spindle firing could be evoked by RHRs of the synergistic muscle. We conclude that muscle spindles not only signal length changes of the muscle in which they are located but also local length changes that occur as a result of changing the length and relative position of synergistic muscles.

Physical therapy combined with corticosteroid intervention for systemic lupus erythematosus with central nervous system involvement: a case report

[Purpose] Systemic lupus erythematosus (SLE) is a chronic, immune-mediated disease, affecting 0.1% of the general population. To date, few studies have investigated the efficacy of physical therapy for SLE patients with CNS involvement. The aim of this study was to report whether the combined use of corticosteroids and physical therapy, consisting of reflex inhibition and functional training, was beneficial to functional recovery. [Subjects and Methods] A 22-year-old male SLE patient with CNS involvement requested physical therapy due to strong spasticity of the trunk and limbs in a bedridden state. Corticosteroid intervention and physical therapy were undertaken for 16 days. [Result] After 16 days of the interventions, the patient demonstrated stabilized and alleviated neurological symptoms and an improved functional level. [Conclusion] The present case indicates that physical therapy combined with corticosteroids might be a possible treatment and rehabilitation method to effectively recover motor function for SLE patients who have strong spasticity due to CNS involvement.

Altering length and velocity feedback during a neuro-musculoskeletal simulation of normal gait contributes to hemiparetic gait characteristics

Background

Spasticity is an important complication after stroke, especially in the anti-gravity muscles, i.e. lower limb extensors. However the contribution of hyperexcitable muscle spindle reflex loops to gait impairments after stroke is often disputed. In this study a neuro-musculoskeletal model was developed to investigate the contribution of an increased length and velocity feedback and altered reflex modulation patterns to hemiparetic gait deficits.

Methods

A musculoskeletal model was extended with a muscle spindle model providing real-time length and velocity feedback of gastrocnemius, soleus, vasti and rectus femoris during a forward dynamic simulation (neural control model). By using a healthy subject’s base muscle excitations, in combination with increased feedback gains and altered reflex modulation patterns, the effect on kinematics was simulated. A foot-ground contact model was added to account for the interaction effect between the changed kinematics and the ground. The qualitative effect i.e. the directional effect and the specific gait phases where the effect is present, on the joint kinematics was then compared with hemiparetic gait deviations reported in the literature.

Results

Our results show that increased feedback in combination with altered reflex modulation patterns of soleus, vasti and rectus femoris muscle can contribute to excessive ankle plantarflexion/inadequate dorsiflexion, knee hyperextension/inadequate flexion and increased hip extension/inadequate flexion during dedicated gait cycle phases. Increased feedback of gastrocnemius can also contribute to excessive plantarflexion/inadequate dorsiflexion, however in combination with excessive knee and hip flexion. Increased length/velocity feedback can therefore contribute to two types of gait deviations, which are both in accordance with previously reported gait deviations in hemiparetic patients. Furthermore altered modulation patterns, in particular the reduced suppression of the muscle spindle feedback during swing, can contribute largely to an increased plantarflexion and knee extension during the swing phase and consequently to hampered toe clearance.

Conclusions

Our results support the idea that hyperexcitability of length and velocity feedback pathways, especially in combination with altered reflex modulation patterns, can contribute to deviations in hemiparetic gait. Surprisingly, our results showed only subtle temporal differences between length and velocity feedback. Therefore, we cannot attribute the effects seen in kinematics to one specific type of feedback.

Function dictates the phase dependence of vision during human locomotion

In human and animal locomotion, sensory input is thought to be processed in a phase-dependent manner. Here we use full-field transient visual scene motion toward or away from subjects walking on a treadmill. Perturbations were presented at three phases of walking to test 1) whether phase dependence is observed for visual input and 2) whether the nature of phase dependence differs across body segments. Results demonstrated that trunk responses to approaching perturbations were only weakly phase dependent and instead depended primarily on the delay from the perturbation. Recording of kinematic and muscle responses from both right and left lower limb allowed the analysis of six distinct phases of perturbation effects. In contrast to the trunk, leg responses were strongly phase dependent. Leg responses during the same gait cycle as the perturbation exhibited gating, occurring only when perturbations were applied in midstance. In contrast, during the postperturbation gait cycle, leg responses occurred at similar response phases of the gait cycle over a range of perturbation phases. These distinct responses reflect modulation of trunk orientation for upright equilibrium and modulation of leg segments for both hazard accommodation/avoidance and positional maintenance on the treadmill. Overall, these results support the idea that the phase dependence of responses to visual scene motion is determined by different functional tasks during walking.

Restoring walking after spinal cord injury: operant conditioning of spinal reflexes can help

People with incomplete spinal cord injury (SCI) frequently suffer motor disabilities due to spasticity and poor muscle control, even after conventional therapy. Abnormal spinal reflex activity often contributes to these problems. Operant conditioning of spinal reflexes, which can target plasticity to specific reflex pathways, can enhance recovery. In rats in which a right lateral column lesion had weakened right stance and produced an asymmetrical gait, up-conditioning of the right soleus H-reflex, which increased muscle spindle afferent excitation of soleus, strengthened right stance and eliminated the asymmetry. In people with hyperreflexia due to incomplete SCI, down-conditioning of the soleus H-reflex improved walking speed and symmetry. Furthermore, modulation of electromyographic activity during walking improved bilaterally, indicating that a protocol that targets plasticity to a specific pathway can trigger widespread plasticity that improves recovery far beyond that attributable to the change in the targeted pathway. These improvements were apparent to people in their daily lives. They reported walking faster and farther, and noted less spasticity and better balance. Operant conditioning protocols could be developed to modify other spinal reflexes or corticospinal connections; and could be combined with other therapies to enhance recovery in people with SCI or other neuromuscular disorders.

The effects of uniquely-processed titanium on biological systems: implications for human health and performance

Titanium is biocompatible and widely utilized in a variety of applications. Recently, titanium in pico-nanometer scale and soluble form (Aqua Titan) has expanded its use to applied human health and performance. The purpose of this article is to review the current evidence associated with specific physiological responses to Aqua Titan-treated materials. In vitro studies have shown that application of Aqua Titan can modify membrane potential and long-term potentiation in isolated hippocampal neurons, suggesting reduced pain memory as a possible mechanism for reported analgesia. Proximal contact with Aqua Titan-treated titanium increased gene expression, protein synthesis, cell growth and adhesion in normal cultured muscle and bone cells, suggesting application for Aqua Titan in clinical implant procedures and wound healing. Evidence for beneficial effects on neuromuscular control of muscle-tendon function and improvements in running economy in human athletes was seen when Aqua Titan-treated tape was applied to the human triceps surae following fatigue induced by prior strenuous exercise. Finally, behavioral responses and effects on the autonomic nervous system to environmental exposure suggest Aqua Titan may promote a mild relaxant, or stress-suppressive response. Together, data suggest exposure to Aqua Titan-treated materials modulates aspects of growth and function in neuronal and other musculoskeletal cells with possible benefits to musculotendinous recovery from exercise and to the systemic response to stress.

Effect of microtitanium impregnated tape on the recovery of triceps surae musculotendinous function following strenuous running

We previously reported increased running economy and joint range of motion (ROM) during subsequent exercise performed 48-h following strenuous exercise while wearing garments containing micro-titanium particles generated from high-pressure aqueous processing of titanium (AQUA TITAN^TM). Here we utilised an isolated plantarflexion triceps surae model and AQUA TITAN-treated flexible tape to determine if dermal application of the micro-titanium could account for meaningful changes in functional properties of the musculotendinous unit. In a randomised double-blind crossover, 20 trained men day 1, baseline measures, AQUA TITAN or placebo tape covering the triceps surae, intermittent high-intensity treadmill running; day 2, rest; day 3, post-stress post-treatment outcome measures. Outcomes comprised: plantarflexion ROM via isokinetic dynamometry; short latency reflex from electromyography; Achilles tendon stiffness from isometric dynamometry, ultrasonography (Achilles-medial-gastrocnemius junction), motion analysis, and force-length modelling. High-intensity exercise with placebo tape reduced tendon stiffness (-16.5%; 95% confidence limits ±8.1%; small effect size), relative to non-taped baseline, but this effect was negligible (-5.9%; ±9.2%) with AQUA TITAN (AQUA TITAN-placebo difference -11.3%; ±11.6%). Change in latency relative to baseline was trivial with placebo (1.6%; ±3.8%) but large with AQUA TITAN (-11.3%; ±3.3%). The effects on ROM with AQUA TITAN (1.6%; ±2.0%) and placebo were trivial (-1.6% ±1.9%), but the small difference (3.1%; ±2.7%) possibly greater with AQUA TITAN. AQUA TITAN tape accelerated the reflex response and attenuated reduced Achilles tendon stiffness following fatiguing exercise. Altered neuromuscular control of tendon stiffness via dermal application of micro-titanium treated materials may facilitate restoration of musculotendinous contractile performance following prior strenuous exercise.

Effect of afferent feedback and central motor commands on soleus H-reflex suppression during arm cycling

Suppression of soleus H-reflex amplitude in stationary legs is seen during rhythmic arm cycling. We examined the influence of various arm-cycling parameters on this interlimb reflex modulation to determine the origin of the effect. We previously showed the suppression to be graded with the frequency of arm cycling but not largely influenced by changes in peripheral input associated with crank length. Here, we more explicitly explored the contribution of afferent feedback related to arm movement on the soleus H-reflex suppression. We explored the influence of load and rate of muscle stretch by manipulating crank-load and arm-muscle vibration during arm cycling. Furthermore, internally driven ("Active") and externally driven ("Passive") arm cycling was compared. Soleus H-reflexes were evoked with tibial nerve stimulation during stationary control and rhythmic arm-cycling conditions, including: 1) six different loads; 2) with and without vibration to arm muscles; and 3) Active and Passive conditions. No significant differences were seen in the level of suppression between the different crank loads or between conditions with and without arm-muscle vibration. Furthermore, in contrast to the clear effect seen during active cycling, passive arm cycling did not significantly suppress the soleus H-reflex amplitude. Current results, in conjunction with previous findings, suggest that the afferent feedback examined in these studies is not the primary source responsible for soleus H-reflex suppression. Instead, it appears that central motor commands (supraspinal or spinal in origin) associated with frequency of arm cycling are relatively more dominant sources.

The relationship between foot motion and lumbopelvic-hip function: a review of the literature

Excessive pronation has been implicated in the development of numerous overuse injuries of the lower limb and is suggested to cause more proximal biomechanical dysfunction. Functional foot orthoses (FFO) are frequently prescribed for lower limb injury associated with excessive foot pronation and have been demonstrated to have efficacy with specific conditions. However, the mechanism of action of FFO is largely unknown. Research investigating the kinematic and kinetic changes associated with FFO use is inconclusive. Furthermore there is a growing body of evidence suggesting that changes to muscle activity patterns in response to FFO may be responsible for their therapeutic effect. Additionally, current research suggests dysfunction of musculature of the lumbopelvic-hip complex is involved in lower extremity functional changes and is related to the development some pathologies traditionally attributed to excessive foot pronation. Evidence of temporal coupling between the hip and the foot and changes in hip muscle activity associated with FFO use further suggest a relationship between proximal and distal lower limb function. The aim of this review is to discuss the association between foot and lumbopelvic-hip complex dysfunction and injury, assess the evidence for functional changes to lower limb and lumbopelvic-hip function with FFO use and finally to discuss the potential for changes to hip musculature activation with FFO use to influence distal mechanics and produce a therapeutic benefit.

Preferred movement patterns during a simple bouncing task

Elastic tissues in the human body can store and return mechanical energy passively, reducing the metabolic cost of cyclical movements. However, it is not clear whether humans prefer movement patterns that optimize this storage and return. We investigated the preferred movement pattern during a bouncing task for which non-invasive techniques can identify the resonant frequency, which is the least metabolically costly. We quantified the preferred and resonant bounce frequencies for three mechanical conditions. During 'normal' trials, subjects bounced while reclined on a sled that moves along a track. During 'added mass' trials, mass was added to the sled. During 'added stiffness' trials, a spring was attached between the sled and the supporting frame, parallel to the track. Subsequently, we quantified the preferred bounce frequencies during ischemia, a technique that disrupts the available sensory feedback. Mechanical condition had a significant effect on both the preferred and resonant frequencies. Changes in preferred frequency scaled with resonant frequency, but the preferred frequency was significantly lower than the resonant frequency. These results indicate that humans adapt their preferred bouncing pattern in response to changes in mechanical condition. Humans may prefer a lower than resonant frequency because of an inability to sense metabolic cost during our relatively short trials. In contrast, during ischemia the preferred bounce frequency remained constant even when mechanical condition was varied, indicating that feedback is necessary to adapt the preferred frequency to changes in mechanics. These findings suggest that disrupted sensory feedback may prevent humans from choosing the optimal movement pattern.

H-reflex modulation in the human medial and lateral gastrocnemii during standing and walking

INTRODUCTION

The soleus H-reflex is dynamically modulated during walking. However, modulation of the gastrocnemii H-reflexes has not been studied systematically.

METHODS

The medial and lateral gastrocnemii (MG and LG) and soleus H-reflexes were measured during standing and walking in humans.

RESULTS

Maximum H-reflex amplitude was significantly smaller in MG (mean 1.1 mV) or LG (1.1 mV) than in soleus (3.3 mV). Despite these size differences, the reflex amplitudes of the three muscles were positively correlated. The MG and LG H-reflexes were phase- and task-dependently modulated in ways similar to the soleus H-reflex.

CONCLUSIONS

Although there are anatomical and physiological differences between the soleus and gastrocnemii muscles, the reflexes of the three muscles are similarly modulated during walking and between standing and walking. Our findings support the hypothesis that these reflexes are synergistically modulated during walking to facilitate ongoing movement.

Chondroitinase ABC reduces time to muscle reinnervation and improves functional recovery after sciatic nerve transection in rats

Application of chondroitinase ABC (ChABC) to injured peripheral nerves improves axon regeneration, but it is not known whether functional recovery is also improved. Recordings of EMG activity [soleus (Sol) M response and H reflexes] evoked by nerve stimulation and of Sol and tibialis anterior (TA) EMG activity and hindlimb and foot kinematics during slope walking were made to determine whether ChABC treatment of the sciatic nerve at the time of transection improves functional recovery. Recovery of evoked EMG responses began as multiple small responses with a wide range of latencies that eventually coalesced into one or two more distinctive and consistent responses (the putative M response and the putative H reflex) in both groups. Both the initial evoked responses and the time course of their maturation returned sooner in the ChABC group than in the untreated (UT) group. The reinnervated Sol and TA were coactivated during treadmill locomotion during downslope, level, and upslope walking throughout the study period in both UT and ChABC-treated rats. By 10 wk after nerve transection and repair, locomotor activity in Sol, but not TA, had returned to its pretransection pattern. There was an increased reliance on central control of Sol activation across slopes for both groups as interpreted from elevated prestance Sol EMG activity that was no longer modulated with slope. Limb length and orientation during locomotion were similar to those observed prior to nerve injury during upslope walking only in the ChABC-treated rats. Thus treatment of cut nerves with ChABC leads to improvements in functional recovery.

Triceps surae short latency stretch reflexes contribute to ankle stiffness regulation during human running

During human running, short latency stretch reflexes (SLRs) are elicited in the triceps surae muscles, but the function of these responses is still a matter of controversy. As the SLR is primarily mediated by Ia afferent nerve fibres, various methods have been used to examine SLR function by selectively blocking the Ia pathway in seated, standing and walking paradigms, but stretch reflex function has not been examined in detail during running. The purpose of this study was to examine triceps surae SLR function at different running speeds using Achilles tendon vibration to modify SLR size. Ten healthy participants ran on an instrumented treadmill at speeds between 7 and 15 km/h under 2 Achilles tendon vibration conditions: no vibration and 90 Hz vibration. Surface EMG from the triceps surae and tibialis anterior muscles, and 3D lower limb kinematics and ground reaction forces were simultaneously collected. In response to vibration, the SLR was depressed in the triceps surae muscles at all speeds. This coincided with short-lasting yielding at the ankle joint at speeds between 7 and 12 km/h, suggesting that the SLR contributes to muscle stiffness regulation by minimising ankle yielding during the early contact phase of running. Furthermore, at the fastest speed of 15 km/h, the SLR was still depressed by vibration in all muscles but yielding was no longer evident. This finding suggests that the SLR has greater functional importance at slow to intermediate running speeds than at faster speeds.

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.

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.

Feedback and feedforward locomotor adaptations to ankle-foot load in people with incomplete spinal cord injury

Humans with spinal cord injury (SCI) modulate locomotor output in response to limb load. Understanding the neural control mechanisms responsible for locomotor adaptation could provide a framework for selecting effective interventions. We quantified feedback and feedforward locomotor adaptations to limb load modulations in people with incomplete SCI. While subjects airstepped (stepping performed with kinematic assistance and 100% bodyweight support), a powered-orthosis created a dorisflexor torque during the "stance phase" of select steps producing highly controlled ankle-load perturbations. When given repetitive, stance phase ankle-load, the increase in hip extension work, 0.27 J/kg above baseline (no ankle-load airstepping), was greater than the response to ankle-load applied during a single step, 0.14 J/kg (P = 0.029). This finding suggests that, at the hip, subjects produced both feedforward and feedback locomotor modulations. We estimate that, at the hip, the locomotor response to repetitive ankle-load was modulated almost equally by ongoing feedback and feedforward adaptations. The majority of subjects also showed after-effects in hip kinetic patterns that lasted 3 min in response to repetitive loading, providing additional evidence of feedforward locomotor adaptations. The magnitude of the after-effect was proportional to the response to repetitive ankle-foot load (R(2) = 0.92). In contrast, increases in soleus EMG amplitude were not different during repetitive and single-step ankle-load exposure, suggesting that ankle locomotor modulations were predominately feedback-based. Although subjects made both feedback and feedforward locomotor adaptations to changes in ankle-load, between-subject variations suggest that walking function may be related to the ability to make feedforward adaptations.

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.

Soleus H-reflex gain, threshold, and amplitude as function of body posture and load in spinal cord intact and injured subjects

In this study, we established parameters of the soleus H-reflex excitability in response to changes of posture and load in 8 chronic spinal cord injured (SCI) and 10 spinal-intact subjects. The soleus H-reflex recruitment curve was established in all subjects while they were supine, seated, and standing on a stable treadmill. During standing, body weight support (BWS) was provided via an upper body harness and ranged in SCI subjects from 20%-50% and in spinal-intact subjects was set at 0% and 50%. Stimuli corresponding to the H-threshold (H(th)), maximal H-reflex amplitude (H(max)), and 50% of H(max) as well as the reflex gain were estimated based on a sigmoid function of the ascending limb of the soleus H-reflex recruitment curve. The soleus H-reflex gain, H(max) amplitude, and stimuli corresponding to H(th), 50% of H(max), and H(max) were increased in SCI subjects regardless of the body position and loading. Further, the reflex gain was not modulated appropriately during conditions of weight bearing in SCI subjects. Impaired spinal reflex excitability in SCI subjects is accompanied by changes of the H-reflex recruitment curve parameters regardless of presence or absence of body loading.

Presynaptic modulation of Ia afferents in young and old adults when performing force and position control

The present work investigated presynaptic modulation of Ia afferents in the extensor carpi radialis (ECR) when young and old adults exerted a wrist extension force either to support an inertial load (position control) or to achieve an equivalent constant torque against a rigid restraint (force control) at 5, 10, and 15% of the maximal force. H reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. A conditioning stimulus was applied to the median nerve above the elbow to assess presynaptic inhibition of homonymous Ia afferents (D1 inhibition) or at the wrist (palmar branch) to assess the ongoing presynaptic inhibition of heteronymous Ia afferents that converge onto the ECR motor neuron pool (heteronymous Ia facilitation). The young adults had less D1 inhibition and greater heteronymous Ia facilitation during the position task (79 and 132.1%, respectively) compared with the force task (69.1 and 115.1%, respectively, P < 0.05). In contrast, the old adults exhibited no difference between the two tasks for either D1 inhibition ( approximately 72%) or heteronymous Ia facilitation ( approximately 114%). Contraction intensity did not influence the amount of D1 inhibition or heteronymous Ia facilitation for either group of subjects. The amount of antagonist coactivation was similar between tasks for young adults, whereas it was greater in the position task for old adults (P = 0.02). These data indicate that in contrast to young adults, old adults did not modulate presynaptic inhibition of Ia afferents when controlling the position of a compliant load but rather increased coactivation of the antagonist muscle.

Fast responses to stepping on an unexpected surface height depend on intact large-diameter nerve fibers: a study on Charcot-Marie-Tooth type 1A disease

The contribution of reflexes from the large myelinated afferents in the control of normal and perturbed gait in humans is a highly debated issue. One way to investigate this topic is by studying normal and perturbed gait in patients lacking large myelinated fibers in the distal limb (Charcot-Marie-Tooth [CMT] type 1A disease). Such patients should have delayed and decreased reflexes if the latter depend on these large myelinated fibers. To elicit the reflexes, both patients and controls had to step on a platform that was either at the same level or lowered by 5 cm. In control subjects, landing on a level surface induced short-latency responses in the biceps femoris and tibialis anterior muscles, whereas such responses were largely absent in the patients. Similarly, stepping down unexpectedly induced a very fast muscle synergy, leading to a brake of the forward propulsion in the controls, which was significantly reduced and delayed (on average 32 ms) in the patients. The observed changes correlated with both sensory and motor deficits. Nevertheless, it is concluded that the results are primarily related to the sensory deficits, since the delayed or absent responses appeared in both upper and lower leg muscles, whereas only the latter showed motor deficits. The data are taken as evidence that large-diameter afferents from the distal leg are essential for fast reflex activations induced by stepping on a level or lowered surface unexpectedly.

Ankle load modulates hip kinetics and EMG during human locomotion

The purpose of this research was to examine the role of isolated ankle-foot load in regulating locomotor patterns in humans with and without spinal cord injury (SCI). We used a powered ankle-foot orthosis to unilaterally load the ankle and foot during robotically assisted airstepping. The load perturbation consisted of an applied dorsiflexion torque designed to stimulate physiological load sensors originating from the ankle plantar flexor muscles and pressure receptors on the sole of the foot. We hypothesized that 1) the response to load would be phase specific with enhanced ipsilateral extensor muscle activity and joint torque occurring when unilateral ankle-foot load was provided during the stance phase of walking and 2) that the phasing of subject produced hip moments would be modulated by varying the timing of the applied ankle-foot load within the gait cycle. As expected, both SCI and nondisabled subjects demonstrated a significant increase (P < 0.05) in peak hip extension moments (142 and 43% increase, respectively) when given ankle-foot load during the stance phase compared with no ankle-foot load. In SCI subjects, this enhanced hip extension response was accompanied by significant increases (P < 0.05) in stance phase gluteus maximus activity (27% increase). In addition, when ankle-foot load was applied either 200 ms earlier or later within the gait cycle, SCI subjects demonstrated significant phase shifts ( approximately 100 ms) in hip moment profile (P < 0.05; i.e., the onset of hip extension moments occurred earlier when ankle-foot load was applied earlier). This study provides new insights into how individuals with spinal cord injury use sensory feedback from ankle-foot load afferents to regulate hip joint moments and muscle activity during gait.

Force Regulation of Ankle Extensor Muscle Activity in Freely Walking Cats

To gain insight into the relative importance of force feedback to ongoing ankle extensor activity during walking in the conscious cat, we isolated the medial gastrocnemius muscle (MG) by denervating the other ankle extensors and measured the magnitude of its activity at different muscle lengths, velocities, and forces accomplished by having the animals walk up and down a sloped pegway. Mathematical models of proprioceptor dynamics predicted afferent activity and revealed that the changes in muscle activity under our experimental conditions were strongly correlated with Ib activity and not consistently associated with changes in Ia or group II activity. This allowed us to determine the gains within the force feedback pathway using a simple model of the neuromuscular system and the measured relationship between MG activity and force. Loop gain increased with muscle length due to the intrinsic force–length property of muscle. The gain of the pathway that converts muscle force to motoneuron depolarization was independent of length. To better test for a causal relationship between modulation of force feedback and changes in muscle activity, a second set of experiments was performed in which the MG muscle was perturbed during ground contact of the hind foot by dropping or lifting the peg underfoot. Collectively, these investigations support a causal role for force feedback and indicate that about 30% of the total muscle activity is due to force feedback during level walking. Force feedback's role increases during upslope walking and decreases during downslope walking, providing a simple mechanism for compensating for changes in terrain.

Heterogenic feedback between hindlimb extensors in the spontaneously locomoting premammillary cat

Electrophysiological studies in anesthetized animals have revealed that pathways carrying force information from Golgi tendon organs in antigravity muscles mediate widespread inhibition among other antigravity muscles in the feline hindlimb. More recent evidence in paralyzed or nonparalyzed decerebrate cats has shown that some inhibitory pathways are suppressed and separate excitatory pathways from Golgi tendon organ afferents are opened on the transition from steady force production to locomotor activity. To obtain additional insight into the functions of these pathways during locomotion, we investigated the distribution of force-dependent inhibition and excitation during spontaneous locomotion and during constant force exertion in the premammillary decerebrate cat. We used four servo-controlled stretching devices to apply controlled stretches in various combinations to the gastrocnemius muscles (G), plantaris muscle (PLAN), flexor hallucis longus muscle (FHL), and quadriceps muscles (QUADS) during treadmill stepping and the crossed-extension reflex (XER). We recorded the force responses from the same muscles and were therefore able to evaluate autogenic (intramuscular) and heterogenic (intermuscular) reflexes among this set of muscles. In previous studies using the intercollicular decerebrate cat, heterogenic inhibition among QUADS, G, FHL, and PLAN was bidirectional. During treadmill stepping, heterogenic feedback from QUADS onto G and G onto PLAN and FHL remained inhibitory and was force-dependent. However, heterogenic inhibition from PLAN and FHL onto G, and from G onto QUADS, was weaker than during the XER. We propose that pathways mediating heterogenic inhibition may remain inhibitory under some forms of locomotion on a level surface but that the strengths of these pathways change to result in a proximal to distal gradient of inhibition. The potential contributions of heterogenic inhibition to interjoint coordination and limb stability are discussed.

Differential effects of plantar desensitization on locomotion dynamics

Reduced plantar sensation secondary to chronic diffuse polyneuropathy (PN) is believed to reduce locomotor stability, especially when walking at non-preferred speeds. However, the contribution of plantar sensation to the maintenance of locomotor stability is not entirely clear. The purpose of this study was to examine the effects of acute loss of plantar sensation on the stability-related kinematic properties of walking at different speeds. Lower-extremity joint kinematics were acquired as healthy young adults walked on a treadmill at their preferred walking speed (PWS) and three predetermined speeds (0.8, 1.0, and 1.2m/s) under both normal and desensitized conditions. Desensitization of the foot soles was induced by ice-exposure, and plantar pressure sensation was assessed by a 5.07 monofilament. The average magnitude of stride duration variability (SDvar) and lower-extremity joint angle variability (JTvar), as well as short- and long-term "finite-time" Lyapunov exponents (lambda(ST)(*), lambda(LT)(*)) associated with lower-extremity joint angles were computed. Ice-induced plantar desensitization led to increased lambda(ST)(*) ( approximately 40%) and lambda(LT)(*) (approximately 8%) values but did not affect SDvar or JTvar. Higher treadmill speed led to greater lambda(ST)(*) and lambda(LT)(*) values, but the speed effects were not influenced by plantar desensitization.While acute loss of plantar sensation does not appear to influence the magnitude of spatial or temporal variability, it did attenuate the state-space trajectory divergence caused by stride-to-stride variability (i.e., lambda(ST)( *) and lambda(LT)(*)). However, as opposed to walking at PWS, otherwise healthy locomotor systems do not appear to place increased reliance on plantar sensation when walking at non-preferred treadmill speeds.

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

To maintain smooth and efficient gait the motor system must adjust for changes in the ground on a step-to-step basis. In the present study we investigated the role of sensory feedback as 19 able-bodied human subjects walked over a platform that mimicked an uneven supporting surface. Triceps surae muscle activation was assessed during stance as the platform was set to different inclinations (+/-3 deg, +/-2 deg and 0 deg rotation in a parasagittal plane about the ankle). Normalized triceps surae muscle activity was significantly increased when the platform was inclined (2 deg: 0.153 +/- 0.051; 3 deg: 0.156 +/- 0.053) and significantly decreased when the platform was declined (-3 deg: 0.133 +/- 0.048; -2 deg: 0.132 +/- 0.049) compared with level walking (0.141 +/- 0.048) for the able-bodied subjects. A similar experiment was performed with a subject who lacked proprioception and touch sensation from the neck down. In contrast with healthy subjects, no muscle activation changes were observed in the deafferented subject. Our results demonstrate that the ability to compensate for small irregularities in the ground surface relies on automatic within-step sensory feedback regulation rather than conscious predictive control.

Decreased contribution from afferent feedback to the soleus muscle during walking in patients with spastic stroke

We investigated the contribution of afferent feedback to the soleus (SOL) muscle activity during the stance phase of walking in patients with spastic stroke. A total of 24 patients with hemiparetic spastic stroke and age-matched healthy volunteers participated in the study. A robotic actuator attached to the foot and leg was used to apply 3 types of ankle perturbations during treadmill walking. First, fast dorsiflexion perturbations were applied to elicit stretch reflexes in the SOL muscle. The SOL short-latency stretch reflex was facilitated in the patients (1.4 +/- 0.3) compared with the healthy volunteers (1.0 +/- 0.3, P = .05). Second, fast plantar flexion perturbations were applied during the stance phase to unload the plantar flexor muscles, thus, removing the afferent input from these muscles to the SOL motoneurons. These perturbations produced a distinct decrease in SOL activity that was significantly smaller in the patients (-30 +/- 3%) compared with the control subjects (-43 +/- 4%, P = .03). Third, slow-velocity, small-amplitude ankle trajectory modifications mimicking small deviations in the walking surface were applied to evaluate the afferent-mediated amplitude modulation of the locomotor SOL electromyogram (EMG). In the healthy volunteers these perturbations generated gradual increments and decrements on the SOL EMG; however, in the patients the SOL EMG modulation was significantly depressed (P = .04). Moreover, this depression was related to the spasticity level measured by the Ashworth score. These results indicate that although the stretch reflex response is facilitated during spastic gait, the contribution of afferent feedback to the ongoing locomotor SOL activity is depressed in patients with spastic stroke.

Muscle proprioceptive feedback and spinal networks

This review revolves primarily around segmental feedback systems established by muscle spindle and Golgi tendon organ afferents, as well as spinal recurrent inhibition via Renshaw cells. These networks are considered as to their potential contributions to the following functions: (i) generation of anti-gravity thrust during quiet upright stance and the stance phase of locomotion; (ii) timing of locomotor phases; (iii) linearization and correction for muscle nonlinearities; (iv) compensation for muscle lever-arm variations; (v) stabilization of inherently unstable systems; (vi) compensation for muscle fatigue; (vii) synergy formation; (viii) selection of appropriate responses to perturbations; (ix) correction for intersegmental interaction forces; (x) sensory-motor transformations; (xi) plasticity and motor learning. The scope will at times extend beyond the narrow confines of spinal circuits in order to integrate them into wider contexts and concepts.

Tuning posture to body load: decreases in load produce discrete sensory signals in the legs of freely standing cockroaches

Decreases in load are important cues in the control of posture and walking. We recorded activities of the tibial campaniform sensilla, receptors that monitor forces as strains in the exoskeleton, in the middle legs of freely moving cockroaches. Small magnets were attached to the thorax and body load was changed by applying currents to a coil below the substrate. Body position was monitored by video recording. The tibial sensilla are organized into proximal and distal subgroups that have different response properties and reflex effects: proximal sensilla excite extensor motoneurons while distal receptors inhibit extensor firing. Sudden load decreases elicited bursts from distal sensilla, while increased load excited proximal receptors. The onset of sensory discharges closely approximated the time of peak velocity of body movement in both load decreases and increases. Firing of distal sensilla rapidly adapted to sustained unloading, while proximal sensilla discharged tonically to load increases. Load decreases of small amplitude or at low rates produced only inhibition of proximal activity while decrements of larger size or rate elicited distal firing. These response properties may provide discrete signals that either modulate excitatory extensor drive during small load variations or inhibit support prior to compensatory stepping or initiation of swing.

Muscle reflexes in motion: how, what, and why?

Methods have been developed to study excitatory and inhibitory reflexes during human movements because dramatic task-dependent changes occur between different voluntary activities, and phase-dependent changes occur within cyclic movements. Interestingly, segmental reflexes are relatively unimportant for standing balance, although reflex responses are strong, yet they contribute substantially to force in several muscles during walking, when some reflex responses are weaker.

Stance- and Locomotion-Dependent Processing of Vibration-Induced Proprioceptive Inflow From Multiple Muscles in Humans

We performed a whole-body mapping study of the effect of unilateral muscle vibration, eliciting spindle Ia firing, on the control of standing and walking in humans. During quiet stance, vibration applied to various muscles of the trunk-neck system and of the lower limb elicited a significant tilt in whole body postural orientation. The direction of vibration-induced postural tilt was consistent with a response compensatory for the illusory lengthening of the stimulated muscles. During walking, trunk-neck muscle vibration induced ample deviations of the locomotor trajectory toward the side opposite to the stimulation site. In contrast, no significant modifications of the locomotor trajectory could be detected when vibrating various muscles of the lower as well as upper limb. The absence of correlation between the effects of muscle vibration during walking and standing dismisses the possibility that vibration-induced postural changes can account for the observed deviations of the locomotor trajectory during walking. We conclude that the dissimilar effects of trunk-neck and lower limb muscle vibration during walking and standing reflect a general sensory-motor plan, whereby muscle Ia input is processed according to both the performed task and the body segment from which the sensory inflow arises.

Afferent-mediated modulation of the soleus muscle activity during the stance phase of human walking

The aim of this study was to investigate the contribution of proprioceptive feedback to the amplitude modulation of the soleus muscle activity during human walking. We have previously shown that slow-velocity, small-amplitude ankle dorsiflexion enhancements and reductions applied during the stance phase of the step cycle generate, respectively, increments and decrements on the ongoing soleus activity. We have also shown that the increments in soleus activity are at least partially mediated by feedback from group Ia fibres. In the present study, we further investigated the afferent-mediated contribution from muscle group II afferents, cutaneous and proprioceptive afferents from the foot, and load-sensitive afferents to the soleus EMG. Slow-velocity, small-amplitude ankle trajectory modifications were combined with the pharmaceutical depression of group II polysynaptic pathways with tizanidine hydrochloride, anaesthetic blocking of sensory information from the foot with injections of lidocaine hydrochloride, and modulation of load feedback by increasing and decreasing the body load. The depression of the group II afferents significantly reduced the soleus response to the ankle trajectory modifications. Blocking sensory feedback from the foot did not have an effect on the soleus muscle activity. Changes in body load affected the ongoing soleus activity level; however, it did not affect the amplitude of the soleus EMG responses to the ankle trajectory modifications. These results suggest that the feedback from group II afferents, and possibly from load-sensitive afferents, contribute to the amplitude modulation of the soleus muscle activity during the stance phase of the step cycle. However, feedback from cutaneous afferents and instrinsic proprioceptive afferents from the foot does not seem to contribute to this muscle activation.

Can co-activation reduce kinematic variability? A simulation study

Impedance modulation has been suggested as a means to suppress the effects of internal 'noise' on movement kinematics. We investigated this hypothesis in a neuro-musculo-skeletal model. A prerequisite is that the muscle model produces realistic force variability. We found that standard Hill-type models do not predict realistic force variability in response to variability in stimulation. In contrast, a combined motor-unit pool model and a pool of parallel Hill-type motor units did produce realistic force variability as a function of target force, largely independent of how the force was transduced to the tendon. To test the main hypothesis, two versions of the latter model were simulated as an antagonistic muscle pair, controlling the position of a frictionless hinge joint, with a distal segment having realistic inertia relative to the muscle strength. Increasing the impedance through co-activation resulted in less kinematic variability, except for the lowest levels of co-activation. Model behavior in this region was affected by the noise amplitude and the inertial properties of the model. Our simulations support the idea that muscular co-activation is in principle an effective strategy to meet accuracy demands.