Contralateral movement and extensor force generation alter flexion phase muscle coordination in pedaling

The Utilization of Forced-Rate Cycling to Facilitate Motor Recovery Following Stroke: A Randomized Clinical Trial

BACKGROUND

The potential for aerobic exercise (AE) to enhance neuroplasticity post-stroke has been theorized but not systematically investigated. Our aim was to determine the effects of forced-rate AE (FE) paired with upper extremity (UE) repetitive task practice (FE + RTP) compared to time-matched UE RTP (RTP only) on motor recovery.

METHODS

A single center randomized clinical trial was conducted from April 2019 to December 2022. Sixty individuals ≥6 months post-stroke with UE hemiparesis were randomized to FE + RTP (N = 30) or RTP only (N = 30), completing 90-minute sessions, 3×/week for 8 weeks. The FE + RTP group underwent 45-minute of FE (5-minute warm-up, 35-minute main set, and 5-minute cool down) followed by 45-minute of UE RTP. The RTP only group completed 90-minute of RTP. Primary outcomes were the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT). The 6-minute Walk Test (6MWT, secondary outcome) assessed walking capacity.

RESULTS

Sixty individuals enrolled and 56 completed the study. The RTP only group completed more RTP in terms of repetitions (411.8 ± 44.4 vs 222.8 ± 28.4, P < .001) and time (72.7 ± 6.7 vs 37.8 ± 2.4 minutes, P < .001) versus FE + RTP. There was no significant difference between groups on the FMA (FE + RTP, 36.2 ± 10.1-44.0 ± 11.8 and RTP only, 34.4 ± 11.0-41.2 ± 13.4, P = .43) or ARAT (FE + RTP, 32.5 ± 16.6-37.7 ± 17.9 and RTP only, 32.8 ± 18.6-36.4 ± 18.5, P = .88). The FE + RTP group demonstrated greater improvements on the 6MWT (274.9 ± 122.0-327.1 ± 141.2 m) versus RTP only (285.5 ± 160.3-316.9 ± 170.0, P = .003).

CONCLUSIONS

There was no significant difference between groups in the primary outcomes. The FE + RTP improved more on the 6MWT, a secondary outcome.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03819764.

FES Cycling and Closed-Loop Feedback Control for Rehabilitative Human–Robot Interaction

For individuals with movement impairments due to neurological injuries, rehabilitative therapies such as functional electrical stimulation (FES) and rehabilitation robots hold vast potential to improve their mobility and activities of daily living. Combining FES with rehabilitation robots results in intimately coordinated human–robot interaction. An example of such interaction is FES cycling, where motorized assistance can provide high-intensity and repetitive practice of coordinated limb motion, resulting in physiological and functional benefits. In this paper, the development of multiple FES cycling testbeds and safeguards is described, along with the switched nonlinear dynamics of the cycle–rider system. Closed-loop FES cycling control designs are described for cadence and torque tracking. For each tracking objective, the authors’ past work on robust and adaptive controllers used to compute muscle stimulation and motor current inputs is presented and discussed. Experimental results involving both able-bodied individuals and participants with neurological injuries are provided for each combination of controller and tracking objective. Trade-offs for the control algorithms are discussed based on the requirements for implementation, desired rehabilitation outcomes and resulting rider performance. Lastly, future works and the applicability of the developed methods to additional technologies including teleoperated robotics are outlined.

Muscular activity patterns in 1-legged vs. 2-legged pedaling

BACKGROUND

One-legged pedaling is of interest to elite cyclists and clinicians. However, muscular usage in 1-legged vs. 2-legged pedaling is not fully understood. Thus, the study was aimed to examine changes in leg muscle activation patterns between 2-legged and 1-legged pedaling.

METHODS

Fifteen healthy young recreational cyclists performed both 1-legged and 2-legged pedaling trials at about 30 Watt per leg. Surface electromyography electrodes were placed on 10 major muscles of the left leg. Linear envelope electromyography data were integrated to quantify muscle activities for each crank cycle quadrant to evaluate muscle activation changes.

RESULTS

Overall, the prescribed constant power requirements led to reduced downstroke crank torque and extension-related muscle activities (vastus lateralis, vastus medialis, and soleus) in 1-legged pedaling. Flexion-related muscle activities (biceps femoris long head, semitendinosus, lateral gastrocnemius, medial gastrocnemius, tensor fasciae latae, and tibialis anterior) in the upstroke phase increased to compensate for the absence of contralateral leg crank torque. During the upstroke, simultaneous increases were seen in the hamstrings and uni-articular knee extensors, and in the ankle plantarflexors and dorsiflexors. At the top of the crank cycle, greater hip flexor activity stabilized the pelvis.

CONCLUSION

The observed changes in muscle activities are due to a variety of changes in mechanical aspects of the pedaling motion when pedaling with only 1 leg, including altered crank torque patterns without the contralateral leg, reduced pelvis stability, and increased knee and ankle stiffness during the upstroke.

Functional modeling of pedaling kinematics for the Stroke patients

Understanding deficits in motor control through the analysis of pedaling biomechanics plays a key role in the treatment of stroke patients. A thorough study of the impact of different exercise patterns and workloads on the change between pre- and post-treatment movement patterns in the patients is therefore of utmost importance to the clinicians. The objective of this study was to analyze the difference between pre- and post-treatment pedaling torques when the patients are subject to different exercise groups with varying workloads. The effects of affected vs unaffected side along with the covariates age and BMI have also been accounted for in this work. Two different three-way ANOVA-based approaches have been implemented here. In the first approach, a random projection-based ANOVA technique has been performed treating the pedaling torques as functional response, whereas the second approach utilizes distance measures to summarize the difference between pre- and post-treatment torques and perform nonparametric tests on it. Bayesian bootstrap has been used here to perform tests on the median distance. A group of stroke patients have been studied in the Cleveland Clinic categorizing them into different exercise groups and workload patterns. The data obtained have been analyzed with the aforementioned techniques, and the results have been reported here. These techniques turn out to be promising and will help clinicians recommend personalized treatment to stroke patients for optimal results.

Design and Validation of a Lower-Limb Haptic Rehabilitation Robot

Present robots for investigating lower-limb motor control and rehabilitation focus on gait training. An alternative approach is to focus on restoring precursor abilities such as motor adaptation and volitional movement, as is common in upper-limb robotic therapy. Here we describe NOTTABIKE, a one degree-of-freedom rehabilitation robot designed to probe and promote these underlying capabilities. A recumbent exercise cycle platform is powered with a servomotor and instrumented with angular encoders, force-torque sensing pedals, and a wireless EMG system. Virtual environments ranging from spring-mass-damper systems to novel foot-to-crank mechanical laws present variants of leg-reaching and pedaling tasks that challenge perception, cognition, motion planning, and motor control systems. This paper characterizes the dynamic performance and haptic rendering accuracy of NOTTABIKE and presents an example motor adaptation task to illustrate its use. Torque and velocity mode controllers showed near unity magnitude ratio and phase loss less than 60 degrees up to 10 Hz. Spring rendering demonstrated 1% mean error in stiffness, and damper rendering performed comparably at 2.5%. Virtual mass rendering was less accurate but successful in varying perceived mass. NOTTABIKE will be used to study lower-limb motor adaptation in intact and impaired persons and to develop rehabilitation protocols that promote volitional movement recovery.

Impaired interlimb coordination is related to asymmetries during pedaling after stroke

OBJECTIVE

To understand whether lower limb asymmetry in chronic stroke is related to paretic motor impairment or impaired interlimb coordination.

METHODS

Stroke and control participants performed conventional, unilateral, and bilateral uncoupled pedaling. During uncoupled pedaling, the pedals were mechanically disconnected. Paretic mechanical work was measured during conventional pedaling. Pedaling velocity and muscle activity were compared across conditions and groups. Relative limb phasing was examined during uncoupled pedaling.

RESULTS

During conventional pedaling, EMG and mechanical work were lower in the paretic than the non-paretic limb (asymmetry). During unilateral pedaling with the paretic limb, muscle activity was larger, but velocity was slower and more variable than during conventional pedaling (evidence of paretic motor impairment). During uncoupled pedaling, muscle activity increased further, but velocity was slower and more variable than in other conditions (evidence of impaired interlimb coordination). Relative limb phasing was impaired in stroke participants. Regression analysis suggested that interlimb coordination may be a stronger predictor of asymmetry than paretic motor impairment.

CONCLUSIONS

Paretic motor impairment and impaired interlimb coordination may contribute to asymmetry during pedaling after stroke.

SIGNIFICANCE

Rehabilitation that addresses paretic motor impairment and impaired interlimb coordination may improve symmetry and maximize improvement.

Improved lower extremity pedaling mechanics in individuals with stroke under maximal workloads

Background Individuals with stroke present with motor control deficits resulting in the abnormal activation and timing of agonist and antagonist muscles and inefficient movement patterns. The analysis of pedaling biomechanics provides a window into understanding motor control deficits, which vary as a function of workload. Understanding the relationship between workload and motor control is critical when considering exercise prescription during stroke rehabilitation. Objectives To characterize pedaling kinematics and motor control processes under conditions in which workload was systematically increased to an eventual patient-specific maximum. Methods A cohort study was conducted in which 18 individuals with chronic stroke underwent a maximal exertion cardiopulmonary exercise test on a stationary cycle ergometer, during which pedaling torque was continuously recorded. Measures of force production, pedaling symmetry, and pedaling smoothness were obtained. Results Mean Torque increased significantly (p < 0.05) for both legs from initial to terminal workloads. Mean torque Symmetry Index, calculated for down and upstroke portions of the pedaling action, improved from 0.37(0.29) to 0.29(0.35) during downstroke (p = 0.007), and worsened during the upstroke: -0.37(0.38) to -0.62(0.46) (p < 0.001) from initial to terminal workloads. Low Torque Duration improved from initial to terminal workloads, decreasing from 121.1(52.9) to 58.1(39.6) degrees (p < 0.001), respectively. Smoothness of pedaling improved significantly from initial to terminal workloads (p < 0.001). Conclusions Improved pedaling kinematics at terminal workloads indicate that individuals with stroke demonstrate improved motor control with respect to the timing, sequencing, and activation of hemiparetic lower extremity musculature compared to lower workloads. Therapeutic prescription involving higher resistance may be necessary to sufficiently engage and activate the paretic lower extremity.

Part 2: Adaptation of Gait Kinematics in Unilateral Cerebral Palsy Demonstrates Preserved Independent Neural Control of Each Limb

Motor adaptation, or alteration of neural control in response to a perturbation, is a potential mechanism to facilitate motor learning for rehabilitation. Central nervous system deficits are known to affect locomotor adaptation; yet we demonstrated that similar to adults following stroke, children with unilateral brain injuries can adapt step length in response to unilateral leg weighting. Here, we extend our analysis to explore kinematic strategies underlying step length adaptation and utilize dynamical systems approaches to elucidate how neural control may differ in those with hemiplegic CP across legs and compared to typically developing controls. Ten participants with hemiplegic CP and ten age-matched controls participated in this study. Knee and hip joint kinematics were analyzed during unilateral weighting of each leg in treadmill walking to assess adaptation and presence and persistence of after-effects. Peak joint angle displacement was used to represent changes in joint angles during walking. We examined baseline and task-specific variability and local dynamic stability to evaluate neuromuscular control across groups and legs. In contrast to controls, children with unilateral CP had asymmetries in joint angle variability and local dynamic stability at baseline, showing increased variability and reduced stability in the dominant limb. Kinematic variability increased and local stability decreased during weighting of ipsilateral and contralateral limbs in both groups compared to baseline. After weight removal both measures returned to baseline. Analogous to the temporal-spatial results, children with unilateral CP demonstrated similar capability as controls to adapt kinematics to unilateral leg weighting, however, the group with CP differed across sides after weight removal with dominant limb after-effects fading more quickly than in controls. The change in kinematics did not completely return to baseline in the non-dominant limb of the CP group, producing a transient improvement in joint angle symmetry. Recent studies demonstrate that neural control of gait is multi-layered with distinct circuits for different types of walking and for each leg. Remarkably, our results demonstrate that children with unilateral brain injury retain these separate circuits for each leg during walking and, importantly, that those networks can be adapted independently from one another to improve symmetry in the short term.

Motor adaptations to unilateral quadriceps fatigue during a bilateral pedaling task

This study was designed to investigate how motor coordination adapts to unilateral fatigue of the quadriceps during a constant-load bilateral pedaling task. We first hypothesized that this local fatigue would not be compensated within the fatigued muscles leading to a decreased knee extension power. Then, we aimed to determine whether this decrease would be compensated by between-joints compensations within the ipsilateral leg and/or an increased contribution of the contralateral leg. Fifteen healthy volunteers were tested during pedaling at 350 W before and after a fatigue protocol consisting of 15 minutes of electromyostimulation on the quadriceps muscle. Motor coordination was assessed from myoelectrical activity (22 muscles) and joint powers calculated through inverse dynamics. Maximal knee extension torque decreased by 28.3%±6.8% (P<.0005) immediately after electromyostimulation. A decreased knee extension power produced by the ipsilateral leg was observed during pedaling (-22.8±12.3 W, -17.0%±9.4%; P<.0005). To maintain the task goal, participants primarily increased the power produced by the non-fatigued contralateral leg during the flexion phase. This was achieved by an increase in hip flexion power confirmed by a higher activation of the tensor fascia latae. These results suggest no adjustment of neural drive to the fatigued muscles and demonstrate no concurrent ipsilateral compensation by the non-fatigued muscles involved in the extension pedaling phase. Although interindividual variability was observed, findings provide evidence that participants predominantly adapted by compensating with the contralateral leg during its flexion phase. Both neural (between legs) and mechanical (between pedals) couplings and the minimization of cost functions might explain these results.

Motor adaptations to local muscle pain during a bilateral cyclic task

The aim of this study was to determine how unilateral pain, induced in two knee extensor muscles, affects muscle coordination during a bilateral pedaling task. Fifteen participants performed a 4-min pedaling task at 130 W in two conditions (Baseline and Pain). Pain was induced by injection of hypertonic saline into the vastus medialis (VM) and vastus lateralis (VL) muscles of one leg. Force applied throughout the pedaling cycle was measured using an instrumented pedal and used to calculate pedal power. Surface electromyography (EMG) was recorded bilaterally from eight muscles to assess changes in muscle activation strategies. Compared to Baseline, during the Pain condition, EMG amplitude of muscles of the painful leg (VL and VM-the painful muscles, and RF-another quadriceps muscle with no pain) was lower during the extension phase [(mean ± SD): VL: -22.5 ± 18.9%; P < 0.001; VM: -28.8 ± 19.9%; P < 0.001, RF: -20.2 ± 13.9%; P < 0.001]. Consistent with this, pedal power applied by the painful leg was also lower during the extension phase (-16.8 ± 14.2 W, P = 0.001) during Pain compared to Baseline. This decrease was compensated for by an 11.3 ± 8.1 W increase in pedal power applied by the non-painful leg during its extension phase (P = 0.04). These results support pain adaptation theories, which suggest that when there is a clear opportunity to compensate, motor adaptations to pain occur to decrease load within the painful tissue. Although the pedaling task offered numerous possibilities for compensation, only between-leg compensations were systematically observed. This finding is discussed in relation to the mechanical and neural constraints of the pedaling task.

Coordination of Hemiparetic Locomotion after Stroke Rehabilitation

Objectives. Determine whether a rehabilitation program targeting functional motor recovery of persons with poststroke hemiparesis improved motor coordination. Methods. A subgroup of 20 persons with poststroke hemiparesis (n = 11 in intervention and n =9incontrol group) was investigated from within a larger randomized controlled single-blind clinical trial of 100 patients. Motor coordination was measured using a pedaling task, and subjects in the intervention group pedaled during an intensive broad-based home exercise program that targeted flexibility, strength, balance, and endurance. Coordination variables based on paretic leg pedal forces and EMG of 4 thigh muscles were measured while pedaling pre- and postintervention. Results. Despite extensive pedaling practice, up to 30 half-hour sessions that were progressively more intense, there was no effect (P > 0.05) of the intervention on percent of total work done by the paretic leg, quantitative measures of EMG, or pedaling speed. However, walking speed was improved and pedaling and walking faster were associated after the intervention. Conclusions. There is no evidence of improved locomotor coordination postintervention. The increased walking and pedaling speed was likely achieved by a more proficient use of the same impaired pattern without EMG timing changes, likely because of increased strength and endurance postintervention. A more task-specific intervention may be required to improve coordination, consistent with principles of use-dependent plasticity.

Controlling legs for locomotion-insights from robotics and neurobiology

Walking is the most common terrestrial form of locomotion in animals. Its great versatility and flexibility has led to many attempts at building walking machines with similar capabilities. The control of walking is an active research area both in neurobiology and robotics, with a large and growing body of work. This paper gives an overview of the current knowledge on the control of legged locomotion in animals and machines and attempts to give walking control researchers from biology and robotics an overview of the current knowledge in both fields. We try to summarize the knowledge on the neurobiological basis of walking control in animals, emphasizing common principles seen in different species. In a section on walking robots, we review common approaches to walking controller design with a slight emphasis on biped walking control. We show where parallels between robotic and neurobiological walking controllers exist and how robotics and biology may benefit from each other. Finally, we discuss where research in the two fields diverges and suggest ways to bridge these gaps.

Locomotor adaptation is influenced by the interaction between perturbation and baseline asymmetry after stroke

Stroke survivors without cerebellar involvement retain the ability to adapt to the split-belt treadmill; however it has been suggested that their rate of adaptation may be slowed compared to those who are neurologically intact. Depending on limb placement, the split-belt treadmill can be configured to either exaggerate baseline asymmetry, or reduce it, which may affect the behavior of adaptation or de-adaptation. The objectives of this study were to characterize the rate and magnitude of locomotor (de)adaptation in chronic stroke survivors compared to healthy matched subjects, and to evaluate whether exaggeration or reduction of baseline asymmetry impact the responses. Seventeen stroke survivors and healthy subjects completed 10min of split-belt treadmill walking, then 5min of tied-belt walking. Stroke survivors completed this once with each leg on the fast belt. Magnitude and rate of (de)adaptation were evaluated for step length and limb phase asymmetry. There were no differences between the groups with the exception of the reduced step length asymmetry configuration, in which case there was a significantly reduced magnitude (p≤0.000) and rate (p=0.011) of adaptation when compared to controls. There was a similar trend observed during post-adaptation for the exaggerated asymmetry group. The rate and magnitude of locomotor (de)adaptation is similar between chronic stroke survivors and neurologically intact controls, except when the adaptation or de-adaptation response would take the stroke survivors away from a symmetric step length pattern. This suggests that there may be some benefit to symmetry that is recognized by the system.

Asymmetrical pedaling patterns in Parkinson's disease patients

BACKGROUND

Approximately 1.5 million Americans are affected by Parkinson's disease (Deponti et al., 2013) which includes the symptoms of postural instability and gait dysfunction. Currently, clinical evaluations of postural instability and gait dysfunction consist of a subjective rater assessment of gait patterns using items from the Unified Parkinson's Disease Rating Scale, and assessments can be insensitive to the effectiveness of medical interventions. Current research suggests the importance of cycling for Parkinson's disease patients, and while Parkinson's gait has been evaluated in previous studies, little is known about lower extremity control during cycling. The purpose of this study is to examine the lower extremity coordination patterns of Parkinson's patients during cycling.

METHODS

Twenty five participants, ages 44-72, with a clinical diagnosis of idiopathic Parkinson's disease participated in an exercise test on a cycle ergometer that was equipped with pedal force measurements. Crank torque, crank angle and power produced by right and left leg were measured throughout the test to calculate Symmetry Index at three stages of exercise (20 W, 60 W, maximum performance).

FINDINGS

Decreases in Symmetry Index were observed for average power output in Parkinson's patients as workload increased. Maximum power Symmetry Index showed a significant difference in symmetry between performance at both the 20 W and 60 W stage and the maximal resistance stage. Minimum power Symmetry Index did not show significant differences across the stages of the test. While lower extremity asymmetries were present in Parkinson's patients during pedaling, these asymmetries did not correlate to postural instability and gait dysfunction Unified Parkinson's Disease Rating Scale scores.

INTERPRETATION

This pedaling analysis allows for a more sensitive measure of lower extremity function than the Unified Parkinson's Disease Rating Scale and may help to provide unique insight into current and future lower extremity function.

EFFECT OF CYCLE ERGOMETER USING AN MR ROTARY BRAKE ON LOWER LIMB EXERCISE

In this study, a new cycle ergometer system using a magneto-rheological (MR) rotary brake was developed to improve muscular strength and reduce asymmetric pedaling characteristics for the rehabilitation of hemiplegia patients. For evaluation of this cycle ergometer, the characteristics of lower limb muscles were analyzed according to three factor of cycle system with MR rotary brake: (1) the electrical current of MR rotary brake, (2) the intensity and duration of cycling, (3) the application of visual feedback. The results showed that muscle activity was significantly different for various levels of current applied to the MR rotary brake. A higher current was associated with a higher integrated electromyography (IEMG) of the lower limb muscle. In low-intensity and long-term condition, IEMG of RF, TA, VL and VAS increased in the late stage of exercise (compared to the early stage), however, decreased in high-intensity and short term condition. The asymmetry of pedaling between the dominant and non-dominant leg was 19.63% in the non-visual feedback mode and 1.97% in the visual feedback mode. Therefore, our new cycle system using an MR brake with real time control of mechanical resistance can be used to enhance muscle strength in patients with hemiplegia and elderly people. Increased muscular activity of the lower limbs in patients with hemiplegia and the elderly is expected with low-intensity training over a long-term period.

Relative changes in ankle and hip control during bilateral joint movements in persons with multiple sclerosis

OBJECTIVE

The purpose of this study was to quantify hip and ankle impairments contributing to movement dysfunction in multiple sclerosis (MS).

METHODS

Volitional phasing of bilateral hip and ankle torques was assessed using a load-cell-instrumented servomotor drive system in ten participants with MS and 10 age-matched healthy participants. The hips and ankles were separately bilaterally oscillated 180° out of phase (40° range of motion) at a frequency of 0.75 Hz while the other joints were held stationary. Participants were instructed to assist in the same direction as the robot-imposed movement. The hip and ankle torques were measured and work was calculated for each movement.

RESULTS

Total negative work at the ankle was significantly different between groups (p=0.040). The participants with MS produced larger negative work during hip flexion (p=0.042) and ankle flexion (p=0.037). Negative work at the hip was significantly correlated with the Berg Balance Scores and Timed 25 Feet Walk Test, and trends demonstrated increasing negative work with increasing clinical impairment in MS.

CONCLUSIONS

These results suggest an increased importance of the hip in functional balance and gait in MS.

SIGNIFICANCE

Rehabilitation strategies targeting ankle recovery or compensation using the hip might improve movement function in MS.

Common muscle synergies for balance and walking

Little is known about the integration of neural mechanisms for balance and locomotion. Muscle synergies have been studied independently in standing balance and walking, but not compared. Here, we hypothesized that reactive balance and walking are mediated by a common set of lower-limb muscle synergies. In humans, we examined muscle activity during multidirectional support-surface perturbations during standing and walking, as well as unperturbed walking at two speeds. We show that most muscle synergies used in perturbations responses during standing were also used in perturbation responses during walking, suggesting common neural mechanisms for reactive balance across different contexts. We also show that most muscle synergies using in reactive balance were also used during unperturbed walking, suggesting that neural circuits mediating locomotion and reactive balance recruit a common set of muscle synergies to achieve task-level goals. Differences in muscle synergies across conditions reflected differences in the biomechanical demands of the tasks. For example, muscle synergies specific to walking perturbations may reflect biomechanical challenges associated with single limb stance, and muscle synergies used during sagittal balance recovery in standing but not walking were consistent with maintaining the different desired center of mass motions in standing vs. walking. Thus, muscle synergies specifying spatial organization of muscle activation patterns may define a repertoire of biomechanical subtasks available to different neural circuits governing walking and reactive balance and may be recruited based on task-level goals. Muscle synergy analysis may aid in dissociating deficits in spatial vs. temporal organization of muscle activity in motor deficits. Muscle synergy analysis may also provide a more generalizable assessment of motor function by identifying whether common modular mechanisms are impaired across the performance of multiple motor tasks.

Impaired foot-force direction regulation during postural loaded locomotion in individuals poststroke

Following stroke, hemiparesis results in impaired motor control. Specifically, inappropriate direction of foot-forces during locomotion has been reported. In our previous study (Liang and Brown 2011) that examined poststroke foot-force direction during a seated, supported locomotor task, we observed that foot-force control capabilities were preserved poststroke. In this current study, we sought to better understand the mechanisms underlying the interaction of locomotor and postural control as an interactive mechanism that might interfere, poststroke, with appropriate foot-force generation. We designed an experiment in which participants performed biomechanically controlled locomotor tasks, under posturally challenged pedaling conditions while they generated mechanical output that was comparable to pedaling conditions without postural challenge, thus allowing us to monitor the strategies that the nervous system adopts when postural conditions were manipulated. We hypothesized that, with postural influence, individuals poststroke would generate inappropriate shear forces accompanied by inappropriate changes to muscle activity patterns when performing a mechanically controlled locomotor task, and would be exaggerated with increased postural loading. Sixteen individuals with chronic poststroke hemiparesis and 14 age-similar nonimpaired controls pedaled on a cycle ergometer under 1) seated supported and 2) nonseated postural loaded pedaling conditions, generating matched pedal force outputs of two effort levels. When we compared postural influence with seated pedaling, we observed increased magnitudes of forward-directed shear forces in the paretic legs associated with increased magnitude of leg extensor muscle activity, but not in controls. These findings provide evidence to support a model that describes independent controllers for posture and locomotion, but that the interaction between the two controllers is impaired poststroke.

Review and perspective: neuromechanical considerations for predicting muscle activation patterns for movement

Muscle coordination may be difficult or impossible to predict accurately based on biomechanical considerations alone because of redundancy in the musculoskeletal system. Because many solutions exist for any given movement, the role of the nervous system in further constraining muscle coordination patterns for movement must be considered in both healthy and impaired motor control. On the basis of computational neuromechanical analyses of experimental data combined with modeling techniques, we have demonstrated several such neural constraints on the temporal and spatial patterns of muscle activity during both locomotion and postural responses to balance perturbations. We hypothesize that subject-specific and trial-by-trial differences in muscle activation can be parameterized and understood by a hierarchical and low-dimensional framework that reflects the neural control of task-level goals. In postural control, we demonstrate that temporal patterns of muscle activity may be governed by feedback control of task-level variables that represent the overall goal-directed motion of the body. These temporal patterns then recruit spatially-fixed patterns of muscle activity called muscle synergies that produce the desired task-level biomechanical functions that require multijoint coordination. Moreover, these principles apply more generally to movement, and in particular to locomotor tasks in both healthy and impaired individuals. Overall, understanding the goals and organization of the neural control of movement may provide useful reduced dimension parameter sets to address the degrees-of-freedom problem in musculoskeletal movement control. More importantly, however, neuromechanical analyses may lend insight and provide a framework for understanding subject-specific and trial-by-trial differences in movement across both healthy and motor-impaired populations.

Stance-phase force on the opposite limb dictates swing-phase afferent presynaptic inhibition during locomotion

Presynaptic inhibition is a powerful mechanism for selectively and dynamically gating sensory inputs entering the spinal cord. We investigated how hindlimb mechanics influence presynaptic inhibition during locomotion using pioneering approaches in an in vitro spinal cord-hindlimb preparation. We recorded lumbar dorsal root potentials to measure primary afferent depolarization-mediated presynaptic inhibition and compared their dependence on hindlimb endpoint forces, motor output, and joint kinematics. We found that stance-phase force on the opposite limb, particularly at toe contact, strongly influenced the magnitude and timing of afferent presynaptic inhibition in the swinging limb. Presynaptic inhibition increased in proportion to opposite limb force, as well as locomotor frequency. This form of presynaptic inhibition binds the sensorimotor states of the two limbs, adjusting sensory inflow to the swing limb based on forces generated by the stance limb. Functionally, it may serve to adjust swing-phase sensory transmission based on locomotor task, speed, and step-to-step environmental perturbations.

COMPUTER SIMULATION STUDY ON CENTRAL PATTERN GENERATOR: FROM BIOLOGY TO ENGINEERING

Central pattern generator (CPG) is a neuronal circuit in the nervous system that can generate oscillatory patterns for the rhythmic movements. Its simplified format, neural oscillator, is wildly adopted in engineering application. This paper explores the CPG from an integral view that combines biology and engineering together. Biological CPG and simplified CPG are both studied. Computer simulation reveals the mechanism of CPG. Some properties, such as effect of tonic input and sensory feedback, stable oscillation, robustness, entrainment etc., are further studied. The promising results provide foundation for the potential engineering application in future.

Descending control to the nonparetic limb degrades the cyclic activity of paretic leg muscles

During anti-phased locomotor tasks such as cycling or walking, hemiparetic phasing of muscle activity is characterized by inappropriate early onset of activity for some paretic muscles and prolonged activity in others. Pedaling with the paretic limb alone reduces inappropriate prolonged activity, suggesting a combined influence of contralesional voluntary commands and movement-related sensory feedback. Five different non-target leg movement state conditions were performed by 15 subjects post-stroke and 15 nonimpaired controls while they pedaled with the target leg and EMG was recorded bilaterally. Voluntary engagement of the non-lesioned motor system increased prolonged paretic vastus medialis (VM) activity and increased phase-advanced rectus femoris (RF) activity. We suggest bilateral descending commands are primarily responsible for the inappropriate activity in the paretic VM during anti-phase pedaling, and contribute to the dysfunctional motor output in the paretic RF. Findings from controls suggest that even an undamaged motor system can contribute to this phenomenon.

Multi-frequency arm cycling reveals bilateral locomotor coupling to increase movement symmetry

Upright stance has allowed for substantial flexibility in how the upper limbs interact with each other: the arms can be coordinated in alternating, synchronous, or asymmetric patterns. While synchronization is thought to be the default mode of coordination during bimanual movement, there is little evidence for any bilateral coupling during locomotor-like arm cycling movements. Multi-frequency tasks have been used to reveal bilateral coupling during bimanual movements, thus here we used a multi-frequency task to determine whether the arms are coupled during arm cycling. It was hypothesized that bilateral coupling would be revealed as changes in background EMG and cutaneous reflexes when temporal coordination was altered. Twelve subjects performed arm cycling at 1 and 2 Hz with one arm while the contralateral arm was either at rest, cycling at the same frequency, or cycling at a different frequency (i.e., multi-frequency cycling with one arm at 1 Hz and the other at 2 Hz). To evoke reflexes, the superficial radial nerve was stimulated at the wrist. EMG was collected continuously from muscles of both arms. Results showed that background EMG in the lower frequency arm was amplified while reflex amplitudes were unaltered during multi-frequency cycling. We propose that neural coupling between the arms aids in equalizing muscle activity during asymmetric tasks to permit stable movement. Conversely, such interactions between the arms would likely be unnecessary in determining a reflexive response to a perturbation of one arm. Therefore, bilateral coupling was expressed when it was relevant to symmetry.

Impaired muscle phasing systematically adapts to varied relative angular relationships during locomotion in people poststroke

After stroke, hemiparesis will result in impairments to locomotor control. Specifically, muscle coordination deficits, in the form of inappropriately phased muscle-activity patterns, occur in both the paretic and nonparetic limbs. These dysfunctional paretic muscle-coordination patterns can adapt to somatosensory inputs, and also the sensorimotor state of nonparetic limb can influence paretic limb. However, the relative contribution of interlimb pathways for improving paretic muscle-activation patterns in terms of phasing remains unknown. In this study, we investigated whether the paretic muscle-activity phasing can be influenced by the relative angular-spatial relationship of the nonparetic limb by using a split-crank ergometer, where the cranks could be decoupled. Eighteen participants with chronic stroke were asked to pedal bilaterally during each task while surface electromyogram signals were recorded bilaterally from four lower extremity muscles (vastus medialis, rectus femoris, tibialis anterior, and soleus). During each experiment, the relative angular crank positions were manipulated by increasing or decreasing their difference by randomly ordered increments of 30° over the complete cycle [0° (in phase pedaling), 30°, 60°, 90°, 120°, 150°, 180° (standard pedaling), 210°, 240°, 270°, 300°, 330° (out of phase pedaling)]. We found that the paretic and nonparetic muscle phasing in the cycle systematically adapted to varied relative angular relationships, and this systematic relationship was well modeled by a sinusoidal relationship. Also, the paretic uniarticular muscle (vastus medialis) showed larger phase shifts compared with biarticular muscle (rectus femoris). More importantly, for each stroke subject, we demonstrated an exclusive crank-angular relation that resulted in the generation of more appropriately phased paretic muscle activity. These findings provide new evidence to better understand the capability of impaired nervous system to produce a more normalized muscle-phasing pattern poststroke.

A split-crank bicycle ergometer uses servomotors to provide programmable pedal forces for studies in human biomechanics

This paper presents a novel computer-controlled bicycle ergometer, the TiltCycle, for use in human biomechanics studies of locomotion. The TiltCycle has a tilting (reclining) seat and backboard, a split pedal crankshaft to isolate the left and right loads to the feet of the pedaler, and two belt-driven, computer-controlled motors to provide assistance or resistance loads independently to each crank. Sensors measure the kinematics and force production of the legs to calculate work performed, and the system allows for goniometric and electromyography signals to be recorded. The technical description presented includes the mechanical design, low-level software and control algorithms, system identification and validation test results.

Neurophysiologic and rehabilitation insights from the split-belt and other locomotor adaptation paradigms

Locomotion is incredibly flexible. Humans are able to stay upright and navigate long distances in the face of ever-changing environments and varied task demands, such as walking while carrying a heavy object or in thick mud. The focus of this review is a behavior that is critical for this flexibility: motor adaptation. Adaptation is defined here as the process of adjusting a movement to new demands through trial-and-error practice. A key feature of adaptation is that more practice without the new demand is required to return the movement to its original state. Thus, motor adaptation is a short-term motor learning process. Several studies have been undertaken to determine how humans adapt walking to novel circumstances. Many of these studies have examined locomotor adaptation using a split-belt treadmill. The results of these studies of people who were healthy and people with neurologic damage suggest that the cerebellum is required for normal adaptation of walking and that the role of cerebral structures may be less critical. They also suggest that intersegmental and interlimb coordination is critical but readily adaptable to accommodate changes in the environment. Locomotor adaptation also can be used to determine the walking potential of people with specific neurologic deficits. For instance, split-belt and limb-weighting locomotor adaptation studies show that adults with chronic stroke are capable of improving weight-bearing and spatiotemporal symmetry, at least temporarily. Our challenge as rehabilitation specialists is to intervene in ways that maximize this capacity.

Abnormal volitional hip torque phasing and hip impairments in gait post stroke

The purpose of this study was to quantify how volitional control of hip torque relates to walking function poststroke. Volitional phasing of hip flexion and extension torques was assessed using a load-cell-instrumented servomotor drive system in 11 chronic stroke subjects and 5 age-matched controls. Hips were oscillated from approximately 40 degrees of hip flexion to 10 degrees of hip extension at a frequency of 0.50 Hz during three movement conditions [hips in phase (IP), 180 degrees out of phase (OP), and unilateral hip movement (UN)] while the knees and ankles were held stationary. The magnitude and phasing of hip, knee, and ankle torques were measured during each movement condition. Surface electromyography was measured throughout the legs. Over ground gait analysis was done for all stroke subjects. During robotic-assisted movement conditions, the paretic limb produced peak hip torques when agonist hip musculature was stretched instead of midway through the movement as seen in the nonparetic and control limbs (P < 0.012). However, mean torque magnitudes of the paretic and nonparetic limbs were not significantly different. Abnormalities of paretic hip torque phasing were more pronounced during bilateral movement conditions and were associated with quadriceps overactivity. The magnitude of flexion torque produced during maximal hip extension was correlated with the Fugl Meyer Score, self-selected walking speed, and maximal hip extension during over ground walking. These results suggest that hyperexcitable stretch reflexes in the paretic limb impair coordinated hip torque phasing and likely interfere with walking function post stroke.

Bilateral limb phase relationship and its potential to alter muscle activity phasing during locomotion

It is well established that the sensorimotor state of one limb can influence another limb and therefore bilateral somatosensory inputs make an important contribution to interlimb coordination patterns. However, the relative contribution of interlimb pathways for modifying muscle activation patterns in terms of phasing is less clear. Here we studied adaptation of muscle activity phasing to the relative angular positions of limbs using a split-crank ergometer, where the cranks could be decoupled to allow different spatial angular position relationships. Twenty neurologically healthy individuals performed the specified pedaling tasks at different relative angular positions while surface electromyographic (EMG) signals were recorded bilaterally from eight lower extremity muscles. During each experiment, the relative angular crank positions were altered by increasing or decreasing their difference by randomly ordered increments of 30 degrees over the complete cycle [0 degrees (in phase pedaling); 30, 60, 90, 120, 150, and 180 degrees (standard pedaling); and 210, 240, 270, 300, and 330 degrees out of phase pedaling]. We found that manipulating the relative angular positions of limbs in a pedaling task caused muscle activity phasing changes that were either delayed or advanced, dependent on the relative spatial position of the two cranks and this relationship is well-explained by a sine curve. Further, we observed that the magnitude of phasing changes in biarticular muscles (like rectus femoris) was significantly greater than those of uniarticular muscles (like vastus medialis). These results are important because they provide new evidence that muscle phasing can be systematically influenced by interlimb pathways.

Neuromechanical considerations for incorporating rhythmic arm movement in the rehabilitation of walking

We have extensively used arm cycling to study the neural control of rhythmic movements such as arm swing during walking. Recently rhythmic movement of the arms has also been shown to enhance and shape muscle activity in the legs. However, restricted information is available concerning the conditions necessary to maximally alter lumbar spinal cord excitability. Knowledge on the neuromechanics of a task can assist in the determination of the type, level, and timing of neural signals, yet arm swing during walking and arm cycling have not received a detailed neuromechanical comparison. The purpose of this research was to provide a combined neural and mechanical measurement approach that could be used to assist in the determination of the necessary and sufficient conditions for arm movement to assist in lower limb rehabilitation after stroke and spinal cord injury. Subjects performed three rhythmic arm movement tasks: (1) cycling (cycle); (2) swinging while standing (swing); and (3) swinging while treadmill walking (walk). We hypothesized that any difference in neural control between tasks (i.e., pattern of muscle activity) would reflect changes in the mechanical constraints unique to each task. Three-dimensional kinematics were collected simultaneously with force measurement at the hand and electromyography from the arms and trunk. All data were appropriately segmented to allow a comparison between and across conditions and were normalized and averaged to 100% movement cycle based on shoulder excursion. Separate mathematical principal components analysis of kinematic and neural variables was performed to determine common task features and muscle synergies. The results highlight important neural and mechanical features that distinguish differences between tasks. For example, there are considerable differences in the anatomical positions of the arms during each task, which relate to the moments experienced about the elbow and shoulder. Also, there are differences between tasks in elbow flexion/extension kinematics alongside differential muscle activation profiles. As well, mechanical assistance and constraints during all tasks could affect muscle recruitment and the functional role of muscles. Overall, despite neural and mechanical differences, the results are consistent with conserved common central motor control mechanisms operational for cycle, walk, and swing but appropriately sculpted to demands unique to each task. However, changing the mechanical parameters could affect the role of afferent feedback altering neural control and the coupling to the lower limbs.

Sensory Signals of Unloading in One Leg Follow Stance Onset in Another Leg: Transfer of Load and Emergent Coordination in Cockroach Walking

The transfer of load from one leg to another is an essential component in walking, but sense organs that signal this process have rarely been identified. We used high-speed digital imaging and neurophysiological recordings to characterize activities of tibial campaniform sensilla, receptors that detect forces via cuticular strains, in the middle legs of cockroaches during walking. Previous studies demonstrated that the distal tibial sensilla discharge when body load is suddenly decreased in freely standing animals. Sensory recordings during walking showed that distal receptors in the middle leg fired an intense burst near the end of the stance phase. We tested the hypothesis that initiation of distal firing resulted from the action of other legs entering stance. Analysis of leg movements in slow walking showed that sensory bursts in the middle leg closely followed stance onset of the ipsilateral hind leg while the ipsilateral front leg entered stance earlier in phase. Similar phases of leg movement were found in slow walking in experiments in which animals had no implanted recording wires. Those studies also demonstrated that the opposite middle leg entered stance earlier in phase. Measurements of leg positions in walking showed that the hind leg tarsus was placed closest to the middle leg, in keeping with a “targeting” strategy. Triggering of distal bursts in the middle leg by mechanical action of the hind leg could facilitate the onset of swing in the middle leg through local reflex effects and contribute to emergent coordination of leg movements in metachronal gaits.

Vertical perturbations of human gait: organisation and adaptation of leg muscle responses

During the last several years, evidence has arisen that the neuronal control of human locomotion depends on feedback from load receptors. The aim of the present study was to determine the effects and the course of sudden and unexpected changes in body load (vertical perturbations) on leg muscle activity patterns during walking on a treadmill. Twenty-two healthy subjects walking with 25% body weight support (BWS) were repetitively and randomly loaded to 5% or unloaded to 45% BWS during left mid-stance. At the new level of BWS, the subjects performed 3-11 steps before returning to 25% BWS (base level). EMG activity of upper and lower leg muscles was recorded from both sides. The bilateral leg muscle activity pattern changed following perturbations in the lower leg muscles and the net effect of the vertical perturbations showed onset latencies with a range of 90-105 ms. Body loading enhanced while unloading diminished the magnitude of ipsilateral extensor EMG amplitude, compared to walking at base level. Contralateral leg flexor burst activity was shortened following loading and prolonged following unloading perturbation while flexor EMG amplitude was unchanged. A general decrease in EMG amplitudes occurred during the course of the experiment. This is assumed to be due to adaptation. Only the muscles directly activated by the perturbations did not significantly change EMG amplitude. This is assumed to be due to the required compensation of the perturbations by polysynaptic spinal reflexes released following the perturbations. The findings underline the importance of load receptor input for the control of locomotion.

Neural regulation of rhythmic arm and leg movement is conserved across human locomotor tasks

It has been proposed that different forms of rhythmic human limb movement have a common central neural control ('common core hypothesis'), just as in other animals. We compared the modulation patterns of background EMG and cutaneous reflexes during walking, arm and leg cycling, and arm-assisted recumbent stepping. We hypothesized that patterns of EMG and reflex modulation during cycling and stepping (deduced from mathematical principal components analysis) would be comparable to those during walking because they rely on similar neural substrates. Differences between the tasks were assessed by evoking cutaneous reflexes via stimulation of nerves in the foot and hand in separate trials. The EMG was recorded from flexor and extensor muscles of the arms and legs. Angular positions of the hip, knee and elbow joints were also recorded. Factor analysis revealed that across the three tasks, four principal components explained more than 93% of the variance in the background EMG and middle-latency reflex amplitude. Phase modulation of reflex amplitude was observed in most muscles across all tasks, suggesting activity in similar control networks. Significant correlations between EMG level and reflex amplitude were frequently observed only during static voluntary muscle activation and not during rhythmic movement. Results from a control experiment showed that strong correlation between EMG and reflex amplitudes was observed during discrete, voluntary leg extension but not during walking. There were task-dependent differences in reflex modulation between the three tasks which probably arise owing to specific constraints during each task. Overall, the results show strong correlation across tasks and support common neural patterning as the regulator of arm and leg movement during various rhythmic human movements.

Modeling biological motor control for human locomotion with functional electrical stimulation

This paper develops a novel control system for functional electrical stimulation (FES) locomotion, which aims to generate normal locomotion for paraplegics via FES. It explores the possibility of applying ideas from biology to engineering. The neural control mechanism of the biological motor system, the central pattern generator, has been adopted in the control system design. Some artificial control techniques such as neural network control, fuzzy logic, control and impedance control are incorporated to refine the control performance. Several types of sensory feedback are integrated to endow this control system with an adaptive ability. A musculoskeletal model with 7 segments and 18 muscles is constructed for the simulation study. Satisfactory simulation results are achieved under this FES control system, which indicates a promising technique for the potential application of FES locomotion in future.

Muscle synergy organization is robust across a variety of postural perturbations

We recently showed that four muscle synergies can reproduce multiple muscle activation patterns in cats during postural responses to support surface translations. We now test the robustness of functional muscle synergies, which specify muscle groupings and the active force vectors produced during postural responses under several biomechanically distinct conditions. We aimed to determine whether such synergies represent a generalized control strategy for postural control or if they are merely specific to each postural task. Postural responses to multidirectional translations at different fore-hind paw distances and to multidirectional rotations at the preferred stance distance were analyzed. Five synergies were required to adequately reconstruct responses to translation at the preferred stance distance-four were similar to our previous analysis of translation, whereas the fifth accounted for the newly added background activity during quiet stance. These five control synergies could account for > 80% total variability or r2 > 0.6 of the electromyographic and force tuning curves for all other experimental conditions. Forces were successfully reconstructed but only when they were referenced to a coordinate system that rotated with the limb axis as stance distance changed. Finally, most of the functional muscle synergies were similar across all of the six cats in terms of muscle synergy number, synergy activation patterns, and synergy force vectors. The robustness of synergy organization across perturbation types, postures, and animals suggests that muscle synergies controlling task-variables are a general construct used by the CNS for balance control.

Central and sensory contributions to the activation and organization of muscle synergies during natural motor behaviors

Previous studies have suggested that the motor system may simplify control by combining a small number of muscle synergies represented as activation profiles across a set of muscles. The role of sensory feedback in the activation and organization of synergies has remained an open question. Here, we assess to what extent the motor system relies on centrally organized synergies activated by spinal and/or supraspinal commands to generate motor outputs by analyzing electromyographic (EMG) signals collected from 13 hindlimb muscles of the bullfrog during swimming and jumping, before and after deafferentation. We first established that, for both behaviors, the intact and deafferented data sets possess low and similar dimensionalities. Subsequently, we used a novel reformulation of the non-negative matrix factorization algorithm to simultaneously search for synergies shared by, and synergies specific to, the intact and deafferented data sets. Most muscle synergies were identified as shared synergies, suggesting that EMGs of locomotor behaviors are generated primarily by centrally organized synergies. Both the amplitude and temporal patterns of the activation coefficients of most shared synergies, however, were altered by deafferentation, suggesting that sensory inflow modulates activation of those centrally organized synergies. For most synergies, effects of deafferentation on the activation coefficients were not consistent across frogs, indicating substantial interanimal variability of feedback actions. We speculate that sensory feedback might adapt recruitment of muscle synergies to behavioral constraints, and the few synergies specific to the intact or deafferented states might represent afferent-specific modules or feedback reorganization of spinal neuronal networks.

Cutaneous reflexes during rhythmic arm cycling are insensitive to asymmetrical changes in crank length

The neural control of a movement depends upon the motor task performed. To further understand the neural regulation of different variations of the same type of movement, we created three dissimilar bilateral rhythmic arm cycling tasks by unilaterally manipulating crank length (CL). Modulation in the amplitude and sign of cutaneous reflexes was used as an index of neural control. Neurologically intact subjects performed three bilateral cycling trials at approximately 1 Hz with the ipsilateral crank arm at one of three different lengths. Cutaneous reflexes were evoked during each trial with trains (5 x 1.0 ms pulses at 300 Hz) of electrical stimulation delivered to the superficial radial nerve at the ipsilateral wrist. EMG recordings were made bilaterally from muscles acting at the shoulder, elbow, and wrist. Analysis was conducted after phase-averaging contingent upon the timing of stimulation in the movement cycle. CL variation created an asymmetrical cycling pattern and produced significant changes in the range of motion at the ipsilateral shoulder and elbow. Background EMG amplitude in muscles of the contralateral arm generally increased significantly as CL decreased. Therefore at a given phase in the movement cycle, the background EMG was different between the three cycling trials. In contrast, cutaneous reflex amplitudes in muscles of both arms were similar at each phase of the movement cycle between the different CLs trials at both early and middle latencies. This was particularly evident in muscles ipsilateral to nerve stimulation. We suggest that variations of arm cycling that primarily yield significant changes in the amplitude of muscle activity do not require significant task-specific change in neural control.

Unraveling interlimb interactions underlying bimanual coordination

Three sources of interlimb interactions have been postulated to underlie the stability characteristics of bimanual coordination but have never been evaluated in conjunction: integrated timing of feedforward control signals, phase entrainment by contralateral afference, and timing corrections based on the perceived error of relative phase. In this study, the relative contributions of these interactions were discerned through systematic comparisons of five tasks involving rhythmic flexion-extension movements about the wrist, performed bimanually (in-phase and antiphase coordination) or unimanually with or without comparable passive movements of the contralateral hand. The main findings were the following. 1) Contralateral passive movements during unimanual active movements induced phase entrainment to interlimb phasing of either 0 degrees (in-phase) or 180 degrees (antiphase). 2) Entrainment strength increased with the passive movements' amplitude, but was similar for in-phase and antiphase movements. 3) Coordination of unimanual active movements with passive movements of the contralateral hand (kinesthetic tracking) was characterized by similar bilateral EMG activity as observed in active bimanual coordination. 4) During kinesthetic tracking the timing of the movements of the active hand was modulated by afference-based error corrections, which were more pronounced during in-phase coordination. 5) Indications of in-phase coordination being more stable than antiphase coordination were most prominent during active bimanual coordination and marginal during kinesthetic tracking. Together the results indicated that phase entrainment by contralateral afference contributed equally to the stability of in-phase and antiphase coordination, and that differential stability of these patterns depended predominantly on integrated timing of feedforward signals, with only a minor role for afference-based error corrections.

Interlimb coordination during locomotion: what can be adapted and stored?

Interlimb coordination is critically important during bipedal locomotion and often must be adapted to account for varying environmental circumstances. Here we studied adaptation of human interlimb coordination using a split-belt treadmill, where the legs can be made to move at different speeds. Human adults, infants, and spinal cats can alter walking patterns on a split-belt treadmill by prolonging stance and shortening swing on the slower limb and vice versa on the faster limb. It is not known whether other locomotor parameters change or if there is a capacity for storage of a new motor pattern after training. We asked whether adults adapt both intra- and interlimb gait parameters during split-belt walking and show aftereffects from training. Healthy subjects were tested walking with belts tied (baseline), then belts split (adaptation), and again tied (postadaptation). Walking parameters that directly relate to the interlimb relationship changed slowly during adaptation and showed robust aftereffects during postadaptation. These changes paralleled subjective impressions of limping versus no limping. In contrast, parameters calculated from an individual leg changed rapidly to accommodate split-belts and showed no aftereffects. These results suggest some independence of neural control of intra- versus interlimb parameters during walking. They also show that the adult nervous system can adapt and store new interlimb patterns after short bouts of training. The differences in intra- versus interlimb control may be related to the varying complexity of the parameters, task demands, and/or the level of neural control necessary for their adaptation.

Interlimb Influences on Paretic Leg Function in Poststroke Hemiparesis

After stroke, paretic leg motor impairment is typically viewed as a unilateral control deficit. However, much of the neural circuitry controlling normal leg function is organized bilaterally to produce coordinated, task-specific activity in the two legs. Thus, as a result of contralesional neural control processes, paretic leg motor pattern generation may be substantially influenced by the nonparetic leg sensorimotor state during bilateral lower limb tasks. Accordingly, we investigated whether different paretic leg motor patterns are observed during mechanically equivalent bilateral and unilateral tasks and, if so, whether nonparetic leg participation improved or exacerbated paretic leg coordination deficits. A pedaling apparatus that mechanically decoupled the legs was used to present subjects with increasingly complex bi- and unilateral motor tasks: isometric force generation, discrete movement, and pedaling. Bilateral electromyographic and pedal force data were collected from 21 persons with chronic poststroke hemiparesis and 11 similarly aged controls. During isometric force generation and discrete movements, nonparetic leg influences on paretic leg coordination were similar and not markedly different from interlimb influences in controls. In bilateral pedaling, however, interlimb influences differed from controls such that paretic leg coordination deficits were exacerbated. During pedaling movements, the suppression of interlimb influences similar to those observed in isometric and discrete movement may occur in controls but may be disrupted in hemiparesis. We suggest that the coupling of pattern generation between the two legs may result in greater, albeit more impaired, paretic leg motor output during bilateral pedaling than during unilateral pedaling.

Alternate Leg Movement Amplifies Locomotor-Like Muscle Activity in Spinal Cord Injured Persons

It is now well recognized that muscle activity can be induced even in the paralyzed lower limb muscles of persons with spinal cord injury (SCI) by imposing locomotion-like movements on both of their legs. Although the significant role of the afferent input related to hip joint movement and body load has been emphasized considerably in previous studies, the contribution of the “alternate” leg movement pattern has not been fully investigated. This study was designed to investigate to what extent the alternate leg movement influenced this “locomotor-like” muscle activity. The knee-locked leg swing movement was imposed on 10 complete SCI subjects using a gait training apparatus. The following three different experimental conditions were adopted: 1) bilateral alternate leg movement, 2) unilateral leg movement, and 3) bilateral synchronous (in-phase) leg movement. In all experimental conditions, the passive leg movement induced EMG activity in the soleus and medial head of the gastrocnemius muscles in all SCI subjects and in the biceps femoris muscle in 8 of 10 SCI subjects. On the other hand, the EMG activity was not observed in the tibialis anterior and rectus femoris muscles. The EMG level of these activated muscles, as quantified by integrating the rectified EMG activity recorded from the right leg, was significantly larger for bilateral alternate leg movement than for unilateral and bilateral synchronous movements, although the right hip and ankle joint movements were identical in all experimental conditions. In addition, the difference in the pattern of the load applied to the leg among conditions was unable to explain the enhancement of EMG activity in the bilateral alternate leg movement condition. These results suggest that the sensory information generated by alternate leg movements plays a substantial role in amplifying the induced locomotor-like muscle activity in the lower limbs.

Three-dimensional model of the feline hindlimb

This article describes a three-dimensional musculoskeletal model of the feline hindlimb based on digitized musculoskeletal anatomy. The model consists of seven degrees of freedom: three at the hip and two each at the knee and ankle. Lines of action and via points for 32 major muscles of the limb are described. Interspecimen variability of muscle paths was surprisingly low; most via points displayed a scatter of only a few millimeters. Joint axes identified by mechanical techniques as noncoincident and nonorthogonal were further honed to yield moment arms consistent with previous reports. Interspecimen variability in joint axes was greater than that of muscle paths and highlights the importance of joint axes in kinematic models. The contribution of specific muscles to the direction of endpoint force generation is discussed.

Kinematic and EMG determinants in quadrupedal locomotion of a non-human primate (Rhesus)

We hypothesized that the activation patterns of flexor and extensor muscles and the resulting kinematics of the forelimbs and hindlimbs during locomotion in the Rhesus would have unique characteristics relative to other quadrupedal mammals. Adaptations of limb movements and in motor pool recruitment patterns in accommodating a range of treadmill speeds similar to other terrestrial animals in both the hindlimb and forelimb were observed. Flexor and extensor motor neurons from motor pools in the lumbar segments, however, were more highly coordinated than in the cervical segments. Unlike the lateral sequence characterizing subprimate quadrupedal locomotion, non-human primates use diagonal coordination between the hindlimbs and forelimbs, similar to that observed in humans between the legs and arms. Although there was a high level of coordination between hind- and forelimb locomotion kinematics, limb-specific neural control strategies were evident in the intersegmental coordination patterns and limb endpoint trajectories. Based on limb kinematics and muscle recruitment patterns, it appears that the hindlimbs, and notably the distal extremities, contribute more to body propulsion than the forelimbs. Furthermore, we found adaptive changes in the recruitment patterns of distal muscles in the hind- and forelimb with increased treadmill speed that likely correlate with the anatomical and functional evolution of hand and foot digits in monkeys. Changes in the properties of both the spinal and supraspinal circuitry related to stepping, probably account for the peculiarities in the kinematic and EMG properties during non-human primate locomotion. We suggest that such adaptive changes may have facilitated evolution toward bipedal locomotion.

Regulation of arm and leg movement during human locomotion

Walking can be a very automated process, and it is likely that central pattern generators (CPGs) play a role in the coordination of the limbs. Recent evidence suggests that both the arms and legs are regulated by CPGs and that sensory feedback also regulates the CPG activity and assists in mediating interlimb coordination. Although the strength of coupling between the legs is stronger than that between the arms, arm and leg movements are similarly regulated by CPG activity and sensory feedback (e.g., reflex control) during locomotion.

Neural coupling between upper and lower limbs during recumbent stepping

During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes ( P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity.

A limited set of muscle synergies for force control during a postural task

Recently developed computational techniques have been used to reduce muscle activation patterns of high complexity to a simple synergy organization and to bring new insights to the long-standing degrees of freedom problem in motor control. We used a nonnegative factorization approach to identify muscle synergies during postural responses in the cat and to examine the functional significance of such synergies for natural behaviors. We hypothesized that the simplification of neural control afforded by muscle synergies must be matched by a similar reduction in degrees of freedom at the biomechanical level. Electromyographic data were recorded from 8-15 hindlimb muscles of cats exposed to 16 directions of support surface translation. Results showed that as few as four synergies could account for >95% of the automatic postural response across all muscles and all directions. Each synergy was activated for a specific set of perturbation directions, and moreover, each was correlated with a unique vector of endpoint force under the limb. We suggest that, within the context of active balance control, postural synergies reflect a neural command signal that specifies endpoint force of a limb.