Differences in adaptation rates after virtual surgeries provide direct evidence for modularity

Muscle Synergy Analysis as a Tool for Assessing the Effectiveness of Gait Rehabilitation Therapies: A Methodological Review and Perspective

According to the modular hypothesis for the control of movement, muscles are recruited in synergies, which capture muscle coordination in space, time, or both. In the last two decades, muscle synergy analysis has become a well-established framework in the motor control field and for the characterization of motor impairments in neurological patients. Altered modular control during a locomotion task has been often proposed as a potential quantitative metric for characterizing pathological conditions. Therefore, the purpose of this systematic review is to analyze the recent literature that used a muscle synergy analysis of neurological patients' locomotion as an indicator of motor rehabilitation therapy effectiveness, encompassing the key methodological elements to date. Searches for the relevant literature were made in Web of Science, PubMed, and Scopus. Most of the 15 full-text articles which were retrieved and included in this review identified an effect of the rehabilitation intervention on muscle synergies. However, the used experimental and methodological approaches varied across studies. Despite the scarcity of studies that investigated the effect of rehabilitation on muscle synergies, this review supports the utility of muscle synergies as a marker of the effectiveness of rehabilitative therapy and highlights the challenges and open issues that future works need to address to introduce the muscle synergies in the clinical practice and decisional process.

Muscle synergies for multidirectional isometric force generation during maintenance of upright standing posture

Muscle synergies are defined as coordinated recruitment of groups of muscles with specific activation balances and time profiles aimed at generating task-specific motor commands. While muscle synergies in postural control have been investigated primarily in reactive balance conditions, the neuromechanical contribution of muscle synergies during voluntary control of upright standing is still unclear. In this study, muscle synergies were investigated during the generation of isometric force at the trunk during the maintenance of standing posture. Participants were asked to maintain the steady-state upright standing posture while pulling forces of different magnitudes were applied at the level at the waist in eight horizontal directions. Muscle synergies were extracted by nonnegative matrix factorization from sixteen lower limb and trunk muscles. An average of 5-6 muscle synergies were sufficient to account for a wide variety of EMG waveforms associated with changes in the magnitude and direction of pulling forces. A cluster analysis partitioned the muscle synergies of the participants into a large group of clusters according to their similarity, indicating the use of a subjective combination of muscles to generate a multidirectional force vector in standing. Furthermore, we found a participant-specific distribution in the values of cosine directional tuning parameters of synergy amplitude coefficients, suggesting the existence of individual neuromechanical strategies to stabilize the whole-body posture. Our findings provide a starting point for the development of novel diagnostic tools to assess muscle coordination in postural control and lay the foundation for potential applications of muscle synergies in rehabilitation.

Increased trial-to-trial similarity and reduced temporal overlap of muscle synergy activation coefficients manifest during learning and with increasing movement proficiency

Muscle synergy analyses are used to enhance our understanding of motor control. Spatially fixed synergy weights coordinate multiple co-active muscles through activation commands, known as activation coefficients. To gain a more comprehensive understanding of motor learning, it is essential to understand how activation coefficients vary during a learning task and at different levels of movement proficiency. Participants walked on a line, a beam, and learned to walk on a tightrope-tasks that represent different levels of proficiency. Muscle synergies were extracted from electromyography signals across all conditions and the number of synergies was determined by the knee-point of the total variance accounted for (tVAF) curve. The results indicated that the tVAF of one synergy decreased with task proficiency, with the tightrope task resulting in the highest tVAF compared to the line and beam tasks. Furthermore, with increasing proficiency and after a learning process, trial-to-trial similarity increased and temporal overlap of synergy activation coefficients decreased. Consequently, we propose that precise adjustment and refinement of synergy activation coefficients play a pivotal role in motor learning.

Self-organizing recruitment of compensatory areas maximizes residual motor performance post-stroke

Whereas the orderly recruitment of compensatory motor cortical areas after stroke depends on the size of the motor cortex lesion affecting arm and hand movements, the mechanisms underlying this reorganization are unknown. Here, we hypothesized that the recruitment of compensatory areas results from the motor system's goal to optimize performance given the anatomical constraints before and after the lesion. This optimization is achieved through two complementary plastic processes: a homeostatic regulation process, which maximizes information transfer in sensory-motor networks, and a reinforcement learning process, which minimizes movement error and effort. To test this hypothesis, we developed a neuro-musculoskeletal model that controls a 7-muscle planar arm via a cortical network that includes a primary motor cortex and a premotor cortex that directly project to spinal motor neurons, and a contra-lesional primary motor cortex that projects to spinal motor neurons via the reticular formation. Synapses in the cortical areas are updated via reinforcement learning and the activity of spinal motor neurons is adjusted through homeostatic regulation. The model replicated neural, muscular, and behavioral outcomes in both non-lesioned and lesioned brains. With increasing lesion sizes, the model demonstrated systematic recruitment of the remaining primary motor cortex, premotor cortex, and contra-lesional cortex. The premotor cortex acted as a reserve area for fine motor control recovery, while the contra-lesional cortex helped avoid paralysis at the cost of poor joint control. Plasticity in spinal motor neurons enabled force generation after large cortical lesions despite weak corticospinal inputs. Compensatory activity in the premotor and contra-lesional motor cortex was more prominent in the early recovery period, gradually decreasing as the network minimized effort. Thus, the orderly recruitment of compensatory areas following strokes of varying sizes results from biologically plausible local plastic processes that maximize performance, whether the brain is intact or lesioned.

A tensor decomposition reveals ageing-induced differences in muscle and grip-load force couplings during object lifting

Do motor patterns of object lifting movements change as a result of ageing? Here we propose a methodology for the characterization of these motor patterns across individuals of different age groups. Specifically, we employ a bimanual grasp-lift-replace protocol with younger and older adults and combine measurements of muscle activity with grip and load forces to provide a window into the motor strategies supporting effective object lifts. We introduce a tensor decomposition to identify patterns of muscle activity and grip-load force ratios while also characterizing their temporal profiles and relative activation across object weights and participants of different age groups. We then probe age-induced changes in these components. A classification analysis reveals three motor components that are differentially recruited between the two age groups. Linear regression analyses further show that advanced age and poorer manual dexterity can be predicted by the coupled activation of forearm and hand muscles which is associated with high levels of grip force. Our findings suggest that ageing may induce stronger muscle couplings in distal aspects of the upper limbs, and a less economic grasping strategy to overcome age-related decline in manual dexterity.

Motor learning in multijoint virtual arm movements with novel kinematics

Humans move their hands toward precise positions, a skill supported by the coordination of multiple joint movements, even in the presence of inherent redundancy. However, it remains unclear how the central nervous system learns the relationship between redundant joint movements and hand positions when starting from scratch. To address this question, a virtual-arm reaching task was performed in which participants were required to move a cursor corresponding to the hand of a virtual arm to a target. The joint angles of the virtual arm were determined by the heights of the participants' fingers. The results demonstrated that the participants moved the cursor to the target straighter and faster in the late phase than they did in the initial phase of learning. This improvement was accompanied by a reduction in the amount of angular changes in the virtual limb joint, predominantly characterized by an increased reliance on the virtual shoulder joint as opposed to the virtual wrist joint. These findings suggest that the central nervous system selects a combination of multijoint movements that minimize motor effort while learning novel upper-limb kinematics.

Myoelectric control and virtual reality to enhance motor rehabilitation after stroke

Effective upper-limb rehabilitation for severely impaired stroke survivors is still missing. Recent studies endorse novel motor rehabilitation approaches such as robotic exoskeletons and virtual reality systems to restore the function of the paretic limb of stroke survivors. However, the optimal way to promote the functional reorganization of the central nervous system after a stroke has yet to be uncovered. Electromyographic (EMG) signals have been employed for prosthetic control, but their application to rehabilitation has been limited. Here we propose a novel approach to promote the reorganization of pathological muscle activation patterns and enhance upper-limb motor recovery in stroke survivors by using an EMG-controlled interface to provide personalized assistance while performing movements in virtual reality (VR). We suggest that altering the visual feedback to improve motor performance in VR, thereby reducing the effect of deviations of the actual, dysfunctional muscle patterns from the functional ones, will actively engage patients in motor learning and facilitate the restoration of functional muscle patterns. An EMG-controlled VR interface may facilitate effective rehabilitation by targeting specific changes in the structure of muscle synergies and in their activations that emerged after a stroke-offering the possibility to provide rehabilitation therapies addressing specific individual impairments.

Learning leaves a memory trace in motor cortex

How are we able to learn new behaviors without disrupting previously learned ones? To understand how the brain achieves this, we used a brain-computer interface (BCI) learning paradigm, which enables us to detect the presence of a memory of one behavior while performing another. We found that learning to use a new BCI map altered the neural activity that monkeys produced when they returned to using a familiar BCI map in a way that was specific to the learning experience. That is, learning left a "memory trace" in the primary motor cortex. This memory trace coexisted with proficient performance under the familiar map, primarily by altering neural activity in dimensions that did not impact behavior. Forming memory traces might be how the brain is able to provide for the joint learning of multiple behaviors without interference.

Spatiotemporal modulation of a common set of muscle synergies during unpredictable and predictable gait perturbations in older adults

Muscle synergies as functional low-dimensional building blocks of the neuromotor system regulate the activation patterns of muscle groups in a modular structure during locomotion. The purpose of the current study was to explore how older adults organize locomotor muscle synergies to counteract unpredictable and predictable gait perturbations during the perturbed steps and the recovery steps. Sixty-three healthy older adults (71.2±5.2 years) participated in the study. Mediolateral and anteroposterior unpredictable and predictable perturbations during walking were introduced using a treadmill. Muscle synergies were extracted from the electromyographic activity of 13 lower limb muscles using Gaussian non-negative matrix factorization. The four basic synergies responsible for unperturbed walking (weight acceptance, propulsion, early swing and late swing) were preserved in all applied gait perturbations, yet their temporal recruitment and muscle contribution in each synergy were modified (P<0.05). These modifications were observed for up to four recovery steps and were more pronounced (P<0.05) following unpredictable perturbations. The recruitment of the four basic walking synergies in the perturbed and recovery gait cycles indicates a robust neuromotor control of locomotion by using activation patterns of a few and well-known muscle synergies with specific adjustments within the synergies. The selection of pre-existing muscle synergies while adjusting the time of their recruitment during challenging locomotor conditions may improve the effectiveness to deal with perturbations and promote the transfer of adaptation between different kinds of perturbations.

Generalization in de novo learning of virtual upper limb movements is influenced by motor exploration

The acquisition of new motor skills from scratch, also known as de novo learning, is an essential aspect of motor development. In de novo learning, the ability to generalize skills acquired under one condition to others is crucial because of the inherently limited range of motor experiences available for learning. However, the presence of generalization in de novo learning and its influencing factors remain unclear. This study aimed to elucidate the generalization of de novo motor learning by examining the motor exploration process, which is the accumulation of motor experiences. To this end, we manipulated the exploration process during practice by changing the target shape using either a small circular target or a bar-shaped target. Our findings demonstrated that the amount of learning during practice was generalized across different conditions. Furthermore, the extent of generalization is influenced by movement variability in the control space, which is irrelevant to the task, rather than the target shapes themselves. These results confirmed the occurrence of generalization in de novo learning and suggest that the exploration process within the control space plays a significant role in facilitating this generalization.

Theoretical limits on the speed of learning inverse models explain the rate of adaptation in arm reaching tasks

An essential aspect of human motor learning is the formation of inverse models, which map desired actions to motor commands. Inverse models can be learned by adjusting parameters in neural circuits to minimize errors in the performance of motor tasks through gradient descent. However, the theory of gradient descent establishes limits on the learning speed. Specifically, the eigenvalues of the Hessian of the error surface around a minimum determine the maximum speed of learning in a task. Here, we use this theoretical framework to analyze the speed of learning in different inverse model learning architectures in a set of isometric arm-reaching tasks. We show theoretically that, in these tasks, the error surface and, thus the speed of learning, are determined by the shapes of the force manipulability ellipsoid of the arm and the distribution of targets in the task. In particular, rounder manipulability ellipsoids generate a rounder error surface, allowing for faster learning of the inverse model. Rounder target distributions have a similar effect. We tested these predictions experimentally in a quasi-isometric reaching task with a visuomotor transformation. The experimental results were consistent with our theoretical predictions. Furthermore, our analysis accounts for the speed of learning in previous experiments with incompatible and compatible virtual surgery tasks, and with visuomotor rotation tasks with different numbers of targets. By identifying aspects of a task that influence the speed of learning, our results provide theoretical principles for the design of motor tasks that allow for faster learning.

Optimization of modularity during development to simplify walking control across multiple steps

Introduction

Walking in adults relies on a small number of modules, reducing the number of degrees of freedom that needs to be regulated by the central nervous system (CNS). While walking in toddlers seems to also involve a small number of modules when considering averaged or single-step data, toddlers produce a high amount of variability across strides, and the extent to which this variability interacts with modularity remains unclear.

Methods

Electromyographic activity from 10 bilateral lower limb muscles was recorded in both adults (n = 12) and toddlers (n = 12) over 8 gait cycles. Toddlers were recorded while walking independently and while being supported by an adult. This condition was implemented to assess if motor variability persisted with reduced balance constraints, suggesting a potential central origin rather than reliance on peripheral regulations. We used non-negative matrix factorization to model the underlying modular command with the Space-by-Time Decomposition method, with or without averaging data, and compared the modular organization of toddlers and adults during multiple walking strides.

Results

Toddlers were more variable in both conditions (i.e. independent walking and supported by an adult) and required significantly more modules to account for their greater stride-by-stride variability. Activations of these modules varied more across strides and were less parsimonious compared to adults, even with diminished balance constraints.

Discussion

The findings suggest that modular control of locomotion evolves between toddlerhood and adulthood as the organism develops and practices. Adults seem to be able to generate several strides of walking with less modules than toddlers. The persistence of variability in toddlers when balance constraints were lowered suggests a link with the ability to explore rather than with corrective mechanisms. In conclusion, the capacity of new walkers to flexibly activate their motor command suggests a broader range of possible actions, though distinguishing between modular and non-modular inputs remains challenging.

Muscle synergies are associated with intermuscular coherence and cortico-synergy coherence in an isometric upper limb task

To elucidate the underlying physiological mechanisms of muscle synergies, we investigated long-range functional connectivity by cortico-muscular (CMC), intermuscular (IMC) and cortico-synergy (CSC) coherence. Fourteen healthy participants executed an isometric upper limb task in synergy-tuned directions. Cortical activity was recorded using 32-channel electroencephalography (EEG) and muscle activity using 16-channel electromyography (EMG). Using non-negative matrix factorisation (NMF), we calculated muscle synergies from two different tasks. A preliminary multidirectional task was used to identify synergy-preferred directions (PDs). A subsequent coherence task, consisting of generating forces isometrically in the synergy PDs, was used to assess the functional connectivity properties of synergies. Overall, we were able to identify four different synergies from the multidirectional task. A significant alpha band IMC was consistently present in all extracted synergies. Moreover, IMC alpha band was higher between muscles with higher weights within a synergy. Interestingly, CSC alpha band was also significantly higher across muscles with higher weights within a synergy. In contrast, no significant CMC was found between the motor cortex area and synergy muscles. The presence of a shared input onto synergistic muscles within a synergy supports the idea of neurally derived muscle synergies that build human movement. Our findings suggest cortical modulation of some of the synergies and the consequential existence of shared input between muscles within cortically modulated synergies.

Persistent changes in motor adaptation strategies after perturbations that require exploration of novel muscle activation patterns

Motor skill learning requires the acquisition of novel muscle patterns and a new control policy-a process that requires time. In contrast, motor adaptation often requires only the adjustment of existing muscle patterns-a fast process. By altering the mapping of muscle activations onto cursor movements in a myoelectrically controlled virtual environment, we are able to create perturbations that require either the recombination of existing muscle synergies (compatible virtual surgery) or the learning of novel muscle patterns (incompatible virtual surgery). We investigated whether adaptation to a compatible surgery is affected by prior exposure to an incompatible surgery, i.e., a motor skill learning task. We found that adaptation to a compatible surgery was characterized by a decrease in the quality of muscle pattern reconstructions using the original synergies and an increase in reaction times only after exposure to an incompatible surgery. In contrast, prior exposure to a compatible surgery did not affect the learning process required to overcome an incompatible surgery. The fact that exposure to an incompatible surgery had a profound effect on the muscle patterns during the adaptation to a subsequent compatible surgery and not vice versa suggests that null space exploration, possibly combined with an explicit exploration strategy, is engaged during exposure to an incompatible surgery and remains enhanced during a new adaptation episode. We conclude that motor skill learning, requiring novel muscle activation patterns, leads to changes in the exploration strategy employed during a subsequent perturbation.NEW & NOTEWORTHY Motor skill learning requires the acquisition of novel muscle patterns, whereas motor adaptation requires adjusting existing ones. We wondered whether training a new motor skill affects motor adaptation strategies. We show that learning an incompatible perturbation, a complex skill requiring new muscle synergies, affects the muscle patterns observed during adaption to a compatible perturbation, which requires adjusting the existing synergies. Our results suggest that motor skill learning results in persistent changes in the exploration strategy.

From monkeys to humans: observation-basedEMGbrain-computer interface decoders for humans with paralysis

Objective. Intracortical brain-computer interfaces (iBCIs) aim to enable individuals with paralysis to control the movement of virtual limbs and robotic arms. Because patients' paralysis prevents training a direct neural activity to limb movement decoder, most iBCIs rely on 'observation-based' decoding in which the patient watches a moving cursor while mentally envisioning making the movement. However, this reliance on observed target motion for decoder development precludes its application to the prediction of unobservable motor output like muscle activity. Here, we ask whether recordings of muscle activity from a surrogate individual performing the same movement as the iBCI patient can be used as target for an iBCI decoder.Approach. We test two possible approaches, each using data from a human iBCI user and a monkey, both performing similar motor actions. In one approach, we trained a decoder to predict the electromyographic (EMG) activity of a monkey from neural signals recorded from a human. We then contrast this to a second approach, based on the hypothesis that the low-dimensional 'latent' neural representations of motor behavior, known to be preserved across time for a given behavior, might also be preserved across individuals. We 'transferred' an EMG decoder trained solely on monkey data to the human iBCI user after using Canonical Correlation Analysis to align the human latent signals to those of the monkey.Main results. We found that both direct and transfer decoding approaches allowed accurate EMG predictions between two monkeys and from a monkey to a human.Significance. Our findings suggest that these latent representations of behavior are consistent across animals and even primate species. These methods are an important initial step in the development of iBCI decoders that generate EMG predictions that could serve as signals for a biomimetic decoder controlling motion and impedance of a prosthetic arm, or even muscle force directly through functional electrical stimulation.

Generating variability from motor primitives during infant locomotor development

Motor variability is a fundamental feature of developing systems allowing motor exploration and learning. In human infants, leg movements involve a small number of basic coordination patterns called locomotor primitives, but whether and when motor variability could emerge from these primitives remains unknown. Here we longitudinally followed 18 infants on 2-3 time points between birth (~4 days old) and walking onset (~14 months old) and recorded the activity of their leg muscles during locomotor or rhythmic movements. Using unsupervised machine learning, we show that the structure of trial-to-trial variability changes during early development. In the neonatal period, infants own a minimal number of motor primitives but generate a maximal motor variability across trials thanks to variable activations of these primitives. A few months later, toddlers generate significantly less variability despite the existence of more primitives due to more regularity within their activation. These results suggest that human neonates initiate motor exploration as soon as birth by variably activating a few basic locomotor primitives that later fraction and become more consistently activated by the motor system.

Exposure to an incompatible virtual surgery impacts the null space components of the muscle patterns after re-adaptation but not the task performance

Under the synergy hypothesis, novel muscle synergies may be required for motor skill learning. We have developed a "virtual surgery" experimental paradigm that alters the mapping of muscle activations onto virtual cursor motion during an isometric reaching task using myoelectric control. By creating virtual surgeries that are "incompatible" with the original synergies, we can investigate learning new muscle synergies in controlled experimental conditions. We have previously shown that participants are able to improve their task performance after an incompatible virtual surgery, using novel muscle patterns to overcome the perturbation. In this work, we investigated whether the activation of novel muscle patterns, that are required after an incompatible virtual surgery, affects task performance or the muscle patterns after re-adaptation to the unperturbed baseline mapping. We found that experiencing an incompatible virtual surgery did not affect the task performance during the baseline mapping. However, the adaptation to the incompatible virtual surgery resulted in changes in the null space components of the muscle patterns used in the unperturbed task.

A novel force-constrained non-negative matrix factorization algorithm reveals the effectiveness of muscle synergies in the task space

According to the synergy hypothesis, the motor system recruits a small number of synergies in a task-dependent manner. Existing synergy extraction algorithms typically only consider the muscle pattern and it remains unclear to which extent muscle synergies encode task-relevant variations of muscle activity. We propose a novel force-constrained non-negative matrix algorithm (FCNMF) based on a gradient descent update rule that considers also the task space by adding a term penalizing force reconstruction error in the cost function. We validated the FCNMF algorithm using simulated muscle data and corrupted them by noise. We compared task performances with reconstructed trajectories using synergies (RS) extracted from the FCNMF algorithm and from the standard multiplicative non-negative matrix factorization NMF algorithm. We found that FCNMF outperforms NMF for different types of noise. Finally, we demonstrated the effectiveness of FCNMF on EMG data collected during an isometric reaching task. The new algorithm accurately reconstructs the trajectories in all participants, even in those for which the NMF algorithm fails. These findings show the effectiveness of muscle synergies extracted considering the task space, possibly thanks to the robustness of FCNMF against non-isotropic noise present in muscle data, suggesting that they provide an effective strategy for motor coordination.

A Serious Game for the Assessment of Visuomotor Adaptation Capabilities during Locomotion Tasks Employing an Embodied Avatar in Virtual Reality

The study of visuomotor adaptation (VMA) capabilities has been encompassed in various experimental protocols aimed at investigating human motor control strategies and/or cognitive functions. VMA-oriented frameworks can have clinical applications, primarily in the investigation and assessment of neuromotor impairments caused by conditions such as Parkinson's disease or post-stroke, which affect the lives of tens of thousands of people worldwide. Therefore, they can enhance the understanding of the specific mechanisms of such neuromotor disorders, thus being a potential biomarker for recovery, with the aim of being integrated with conventional rehabilitative programs. Virtual Reality (VR) can be entailed in a framework targeting VMA since it allows the development of visual perturbations in a more customizable and realistic way. Moreover, as has been demonstrated in previous works, a serious game (SG) can further increase engagement thanks to the use of full-body embodied avatars. Most studies implementing VMA frameworks have focused on upper limb tasks and have utilized a cursor as visual feedback for the user. Hence, there is a paucity in the literature about VMA-oriented frameworks targeting locomotion tasks. In this article, the authors present the design, development, and testing of an SG-based framework that addresses VMA in a locomotion activity by controlling a full-body moving avatar in a custom VR environment. This workflow includes a set of metrics to quantitatively assess the participants' performance. Thirteen healthy children were recruited to evaluate the framework. Several quantitative comparisons and analyses were run to validate the different types of introduced visuomotor perturbations and to evaluate the ability of the proposed metrics to describe the difficulty caused by such perturbations. During the experimental sessions, it emerged that the system is safe, easy to use, and practical in a clinical setting. Despite the limited sample size, which represents the main limitation of the study and can be compensated for with future recruitment, the authors claim the potential of this framework as a useful instrument for quantitatively assessing either motor or cognitive impairments. The proposed feature-based approach gives several objective parameters as additional biomarkers that can integrate the conventional clinical scores. Future studies might investigate the relation between the proposed biomarkers and the clinical scores for specific disorders such as Parkinson's disease and cerebral palsy.

Muscle synergies for evaluating upper limb in clinical applications: A systematic review

INTRODUCTION

Muscle synergies have been proposed as a strategy employed by the central nervous system to control movements. Muscle synergy analysis is a well-established framework to examine the pathophysiological basis of neurological diseases and has been applied for analysis and assessment in clinical applications in the last decades, even if it has not yet been widely used in clinical diagnosis, rehabilitative treatment and interventions. Even if inconsistencies in the outputs among studies and lack of a normative pipeline including signal processing and synergy analysis limit the progress, common findings and results are identifiable as a basis for future research. Therefore, a literature review that summarizes methods and main findings of previous works on upper limb muscle synergies in clinical environment is needed to i) summarize the main findings so far, ii) highlight the barriers limiting their use in clinical applications, and iii) suggest future research directions needed for facilitating translation of experimental research to clinical scenarios.

METHODS

Articles in which muscle synergies were used to analyze and assess upper limb function in neurological impairments were reviewed. The literature research was conducted in Scopus, PubMed, and Web of Science. Experimental protocols (e.g., the aim of the study, number and type of participants, number and type of muscles, and tasks), methods (e.g., muscle synergy models and synergy extraction methods, signal processing methods), and the main findings of eligible studies were reported and discussed.

RESULTS

383 articles were screened and 51 were selected, which involved a total of 13 diseases and 748 patients and 1155 participants. Each study investigated on average 15 ± 10 patients. Four to forty-one muscles were included in the muscle synergy analysis. Point-to-point reaching was the most used task. The preprocessing of EMG signals and algorithms for synergy extraction varied among studies, and non-negative matrix factorization was the most used method. Five EMG normalization methods and five methods for identifying the optimal number of synergies were used in the selected papers. Most of the studies report that analyses on synergy number, structure, and activations provide novel insights on the physiopathology of motor control that cannot be gained with standard clinical assessments, and suggest that muscle synergies may be useful to personalize therapies and to develop new therapeutic strategies. However, in the selected studies synergies were used only for assessment; different testing procedures were used and, in general, study-specific modifications of muscle synergies were observed; single session or longitudinal studies mainly aimed at assessing stroke (71% of the studies), even though other pathologies were also investigated. Synergy modifications were either study-specific or were not observed, with few analyses available for temporal coefficients. Thus, several barriers prevent wider adoption of muscle synergy analysis including a lack of standardized experimental protocols, signal processing procedures, and synergy extraction methods. A compromise in the design of the studies must be found to combine the systematicity of motor control studies and the feasibility of clinical studies. There are however several potential developments that might promote the use of muscle synergy analysis in clinical practice, including refined assessments based on synergistic approaches not allowed by other methods and the availability of novel models. Finally, neural substrates of muscle synergies are discussed, and possible future research directions are proposed.

CONCLUSIONS

This review provides new perspectives about the challenges and open issues that need to be addressed in future work to achieve a better understanding of motor impairments and rehabilitative therapy using muscle synergies. These include the application of the methods on wider scales, standardization of procedures, inclusion of synergies in the clinical decisional process, assessment of temporal coefficients and temporal-based models, extensive work on the algorithms and understanding of the physio-pathological mechanisms of pathology, as well as the application and adaptation of synergy-based approaches to various rehabilitative scenarios for increasing the available evidence.

Use of Surface Electromyography to Estimate End-Point Force in Redundant Systems: Comparison between Linear Approaches

Estimation of the force exerted by muscles from their electromyographic (EMG) activity may be useful to control robotic devices. Approximating end-point forces as a linear combination of the activities of multiple muscles acting on a limb may lead to an inaccurate estimation because of the dependency between the EMG signals, i.e., multi-collinearity. This study compared the EMG-to-force mapping estimation performed with standard multiple linear regression and with three other algorithms designed to reduce different sources of the detrimental effects of multi-collinearity: Ridge Regression, which performs an L2 regularization through a penalty term; linear regression with constraints from foreknown anatomical boundaries, derived from a musculoskeletal model; linear regression of a reduced number of muscular degrees of freedom through the identification of muscle synergies. Two datasets, both collected during the exertion of submaximal isometric forces along multiple directions with the upper limb, were exploited. One included data collected across five sessions and the other during the simultaneous exertion of force and generation of different levels of co-contraction. The accuracy and consistency of the EMG-to-force mappings were assessed to determine the strengths and drawbacks of each algorithm. When applied to multiple sessions, Ridge Regression achieved higher accuracy (R² = 0.70) but estimations based on muscle synergies were more consistent (differences between the pulling vectors of mappings extracted from different sessions: 67%). In contrast, the implementation of anatomical constraints was the best solution, both in terms of consistency (R² = 0.64) and accuracy (74%), in the case of different co-contraction conditions. These results may be used for the selection of the mapping between EMG and force to be implemented in myoelectrically controlled robotic devices.

EMG space similarity feedback promotes learning of expert-like muscle activation patterns in a complex motor skill

Augmented feedback provided by a coach or augmented reality system can facilitate the acquisition of a motor skill. Verbal instructions and visual aids can be effective in providing feedback about the kinematics of the desired movements. However, many skills require mastering not only kinematic, but also complex kinetic patterns, for which feedback is harder to convey. Here, we propose the electromyography (EMG) space similarity feedback, which may indirectly convey kinematic and kinetic feedback by comparing the muscle activations of the learner and an expert in the task. The EMG space similarity feedback is a score that reflects how well a set of muscle synergies extracted from the expert can reconstruct the learner's EMG when performing the task. We tested the EMG space similarity feedback in a virtual bimanual polishing task that uses a robotic system to simulate the dynamics of a real polishing operation. We measured the expert's and learner's EMG from eight muscles in each arm during the real and virtual polishing tasks, respectively. The goal of the virtual task was to smoothen the surface of a virtual object. Therefore, we defined performance in the task as the smoothness of the object at the end of a trial. We separated learners into real feedback and null feedback groups to assess the effects of the EMG space similarity feedback. The real and null feedback groups received veridic and no EMG space similarity feedback, respectively. Subjects participated in five training sessions on different days, and we evaluated their performance on each day. Subjects in both groups were able to increase smoothness throughout the training sessions, with no significant differences between groups. However, subjects in the real feedback group were able to improve in the EMG space similarity score to a significantly greater extent than the null feedback group. Additionally, subjects in the real feedback group produced muscle activations that became increasingly consistent with an important muscle synergy found in the expert. Our results indicate that the EMG space similarity feedback promotes acquiring expert-like muscle activation patterns, suggesting that it may assist in the acquisition of complex motor skills.

Similarity of hand muscle synergies elicited by transcranial magnetic stimulation and those found during voluntary movement

Converging evidence in human and animal models suggests that exogenous stimulation of the motor cortex (M1) elicits responses in the hand with similar modular structure to that found during voluntary grasping movements. The aim of this study was to establish the extent to which modularity in muscle responses to transcranial magnetic stimulation (TMS) to M1 resembles modularity in muscle activation during voluntary hand movements involving finger fractionation. Electromyography (EMG) was recorded from eight hand-forearm muscles in eight healthy individuals. Modularity was defined using non-negative matrix factorization to identify low-rank approximations (spatial muscle synergies) of the complex activation patterns of EMG data recorded during high-density TMS mapping of M1 and voluntary formation of gestures in the American Sign Language alphabet. Analysis of synergies revealed greater than chance similarity between those derived from TMS and those derived from voluntary movement. Both data sets included synergies dominated by single intrinsic hand muscles presumably to meet the demand for highly fractionated finger movement. These results suggest that corticospinal connectivity to individual intrinsic hand muscles may be combined with modular multimuscle activation via synergies in the formation of hand postures.NEW & NOTEWORTHY This is the first work to examine the similarity of modularity in hand muscle responses to transcranial magnetic stimulation (TMS) of the motor cortex and that derived from voluntary hand movement. We show that TMS-elicited muscle synergies of the hand, measured at rest, reflect those found in voluntary behavior involving finger fractionation. This work provides a basis for future work using TMS to investigate muscle activation modularity in the human motor system.

Heksor: The CNS substrate of an adaptive behavior

Over the past half‐century, the largely hardwired central nervous system (CNS) of 1970 has become the ubiquitously plastic CNS of today, in which change is the rule not the exception. This transformation complicates a central question in neuroscience: how are adaptive behaviours – behaviours that serve the needs of the individual – acquired and maintained through life? It poses a more basic question: how do many adaptive behaviours share the ubiquitously plastic CNS? This question compels neuroscience to adopt a new paradigm. The core of this paradigm is a CNS entity with unique properties, here given the name heksor from the Greek hexis. A heksor is a distributed network of neurons and synapses that changes itself as needed to maintain the key features of an adaptive behaviour, the features that make the behaviour satisfactory. Through their concurrent changes, the numerous heksors that share the CNS negotiate the properties of the neurons and synapses that they all use. Heksors keep the CNS in a state of negotiated equilibrium that enables each heksor to maintain the key features of its behaviour. The new paradigm based on heksors and the negotiated equilibrium they create is supported by animal and human studies of interactions among new and old adaptive behaviours, explains otherwise inexplicable results, and underlies promising new approaches to restoring behaviours impaired by injury or disease. Furthermore, the paradigm offers new and potentially important answers to extant questions, such as the generation and function of spontaneous neuronal activity, the aetiology of muscle synergies, and the control of homeostatic plasticity.

Design of an Isometric End-Point Force Control Task for Electromyography Normalization and Muscle Synergy Extraction From the Upper Limb Without Maximum Voluntary Contraction

Muscle synergy analysis via surface electromyography (EMG) is useful to study muscle coordination in motor learning, clinical diagnosis, and neurorehabilitation. However, current methods to extract muscle synergies in the upper limb suffer from two major issues. First, the necessary normalization of EMG signals is performed via maximum voluntary contraction (MVC), which requires maximal isometric force production in each muscle. However, some individuals with motor impairments have difficulties producing maximal effort in the MVC task. In addition, the MVC is known to be highly unreliable, with widely different forces produced in repeated measures. Second, synergy extraction in the upper limb is typically performed with a multidirection reaching task. However, some participants with motor impairments cannot perform this task because it requires precise motor control. In this study, we proposed a new isometric rotating task that does not require precise motor control or large forces. In this task, participants maintain a cursor controlled by the arm end-point force on a target that rotates at a constant angular velocity at a designated force level. To relax constraints on motor control precision, the target is widened and blurred. To obtain a reference EMG value for normalization without requiring maximal effort, we estimated a linear relationship between joint torques and muscle activations. We assessed the reliability of joint torque normalization and synergy extraction in the rotating task in young neurotypical individuals. Compared with normalization with MVC, joint torque normalization allowed reliable EMG normalization at low force levels. In addition, the extraction of synergies was as reliable and more stable than with the multidirection reaching task. The proposed rotating task can, therefore, be used in future motor learning, clinical diagnosis, and neurorehabilitation studies.

Central Commands to the Elbow and Shoulder Muscles During Circular Planar Movements of Hand With Simultaneous Generation of Tangential Forces

This study examines some of the non-linear effects of signal transduction in the human motor system, with particular emphasis on muscle hysteresis. The movement tests were analyzed in a group of eight subjects, which were asked to develop tangential force using visual biofeedback while performing slow, externally imposed, circular movements of right hand holding a moving handle operated by a computerized mechatronic system. The positional changes in the averaged EMGs of the elbow and shoulder muscles were compared for all combinations of direction of movement and generated force. Additionally, for one of the subjects, there was carried out MRI identification and 3D printing of the bones of the forelimb, shoulder, scapula and collarbone, which made it possible to reconstruct for him the length and force traces of all the muscles under study. The averaged EMG traces in muscles of both joints show their close correspondence to the related force traces, however, the co-activation patterns of activity in agonists and antagonists were also often encountered. The EMG waves related to the respective force waves were strongly dependent on the predominant direction of the muscle length changes within the correspondent force wave locations: the EMG intensities were higher for the shortening muscle movements (concentric contractions) and lower during muscle lengthening (eccentric contractions). The data obtained allows to suggest that for two-joint movements of the forelimbs, it is sufficient to consider the force and activation synergies (patterns of simultaneous activity in different muscles), ignoring at the first stage the effects associated with kinematic synergy. On the other hand, the data obtained indicate that the movement kinematics has a strong modulating effect on the activation synergy, dividing it into concentric and eccentric subtypes, in accordance with the known non-linear features of the muscle dynamics. It has been shown that the concentric and eccentric differences in the responses of the shoulder muscles are more clearly distinguishable than those in the elbow muscles. The shoulder muscles also have a more pronounced symmetry of the averaged EMG responses with respect to the ascending and descending phases of force waves, while demonstrating a lower degree of antagonist cocontraction. The data obtained suggest that the central commands in two-joint movements are determined mainly by the interdependence of force and activation synergies including both intra- and inter-joint components, while kinematic synergy can be interpreted as a potent modulator of activation synergy.

Motor synergy generalization framework for new targets in multi-planar and multi-directional reaching task

Humans can rapidly adapt to new situations, even though they have redundant degrees of freedom (d.f.). Previous studies in neuroscience revealed that human movements could be accounted for by low-dimensional control signals, known as motor synergies. Many studies have suggested that humans use the same repertories of motor synergies among similar tasks. However, it has not yet been confirmed whether the combinations of motor synergy repertories can be re-used for new targets in a systematic way. Here we show that the combination of motor synergies can be generalized to new targets that each repertory cannot handle. We use the multi-directional reaching task as an example. We first trained multiple policies with limited ranges of targets by reinforcement learning and extracted sets of motor synergies. Finally, we optimized the activation patterns of sets of motor synergies and demonstrated that combined motor synergy repertories were able to reach new targets that were not achieved with either original policies or single repertories of motor synergies. We believe this is the first study that has succeeded in motor synergy generalization for new targets in new planes, using a full 7-d.f. arm model, which is a realistic mechanical environment for general reaching tasks.

Task space exploration improves adaptation after incompatible virtual surgeries

Humans have a remarkable capacity to learn new motor skills, a process that requires novel muscle activity patterns. Muscle synergies may simplify the generation of muscle patterns through the selection of a small number of synergy combinations. Learning new motor skills may then be achieved by acquiring novel muscle synergies. In a previous study, we used myoelectric control to construct virtual surgeries that altered the mapping from muscle activity to cursor movements. After compatible virtual surgeries, which could be compensated by recombining subject-specific muscle synergies, participants adapted quickly. In contrast, after incompatible virtual surgeries, which could not be compensated by recombining existing synergies, participants explored new muscle patterns, but failed to adapt. Here, we tested whether task space exploration can promote learning of novel muscle synergies, required to overcome an incompatible surgery. Participants performed the same reaching task as in our previous study, but with more time to complete each trial, thus allowing for exploration. We found an improvement in trial success after incompatible virtual surgeries. Remarkably, improvements in movement direction accuracy after incompatible surgeries occurred faster for corrective movements than for the initial movement, suggesting that learning of new synergies is more effective when used for feedback control. Moreover, reaction time was significantly higher after incompatible than after compatible virtual surgeries, suggesting an increased use of an explicit adaptive strategy to overcome incompatible surgeries. Taken together, these results indicate that exploration is important for skill learning and suggest that human participants, with sufficient time, can learn new muscle synergies.

Neural Network Models for Spinal Implementation of Muscle Synergies

Muscle synergies have been proposed as functional modules to simplify the complexity of body motor control; however, their neural implementation is still unclear. Converging evidence suggests that output projections of the spinal premotor interneurons (PreM-INs) underlie the formation of muscle synergies, but they exhibit a substantial variation across neurons and exclude standard models assuming a small number of unitary “modules” in the spinal cord. Here we compared neural network models for muscle synergies to seek a biologically plausible model that reconciles previous clinical and electrophysiological findings. We examined three neural network models: one with random connections (non-synergy model), one with a small number of spinal synergies (simple synergy model), and one with a large number of spinal neurons representing muscle synergies with a certain variation (population synergy model). We found that the simple and population synergy models emulate the robustness of muscle synergies against cortical stroke observed in human stroke patients. Furthermore, the size of the spinal variation of the population synergy matched well with the variation in spinal PreM-INs recorded in monkeys. These results suggest that a spinal population with moderate variation is a biologically plausible model for the neural implementation of muscle synergies.

A Bayesian approach to model individual differences and to partition individuals: case studies in growth and learning curves

The first objective of the paper is to implement a two stage Bayesian hierarchical nonlinear model for growth and learning curves, particular cases of longitudinal data with an underlying nonlinear time dependence. The aim is to model simultaneously individual trajectories over time, each with specific and potentially different characteristics, and a time-dependent behavior shared among individuals, including eventual effect of covariates. At the first stage inter-individual differences are taken into account, while, at the second stage, we search for an average model. The second objective is to partition individuals into homogeneous groups, when inter individual parameters present high level of heterogeneity. A new multivariate partitioning approach is proposed to cluster individuals according to the posterior distributions of the parameters describing the individual time-dependent behaviour. To assess the proposed methods, we present simulated data and two applications to real data, one related to growth curve modeling in agriculture and one related to learning curves for motor skills. Furthermore a comparison with finite mixture analysis is shown.

Evidence for a cost of time in the invigoration of isometric reaching movements

How the brain determines the vigor of goal-directed movements is a fundamental question in neuroscience. Recent evidence has suggested that vigor results from a trade-off between a cost related to movement production (cost of movement) and a cost related to our brain's tendency to temporally discount the value of future reward (cost of time). However, whether it is critical to hypothesize a cost of time to explain the vigor of basic reaching movements with intangible reward is unclear because the cost of movement may be theoretically sufficient for this purpose. Here we directly address this issue by designing an isometric reaching task whose completion can be accurate and effortless in prefixed durations. The cost of time hypothesis predicts that participants should be prone to spend energy to save time even if the task can be accomplished at virtually no motor cost. Accordingly, we found that all participants generated substantial amounts of force to invigorate task accomplishment, especially when the prefixed duration was long enough. Remarkably, the time saved by each participant was linked to their original vigor in the task and predicted by an optimal control model balancing out movement and time costs. Taken together, these results supports the existence of an idiosyncratic, cognitive cost of time that underlies the invigoration of basic isometric reaching movements.

Simultaneous control of natural and extra degrees of freedom by isometric force and electromyographic activity in the muscle-to-force null space

OBJECTIVE

Muscle activation patterns in the muscle-to-force null space, i.e., patterns that do not generate task-relevant forces, may provide an opportunity for motor augmentation by allowing to control additional end-effectors simultaneously to natural limbs. Here we tested the feasibility of muscular null space control for augmentation by assessing simultaneous control of natural and extra degrees of freedom.

APPROACH

We instructed eight participants to control translation and rotation of a virtual 3D end-effector by simultaneous generation of isometric force at the hand and null space activity extracted in real-time from the electromyographic signals recorded from 15 shoulder and arm muscles. First, we identified the null space components that each participant could control more naturally by voluntary co-contraction. Then, participants performed several blocks of a reaching and holding task. They displaced an ellipsoidal cursor to reach one of nine targets by generating force, and simultaneously rotated the cursor to match the target orientation by activating null space components. We developed an information-theoretic metric, an index of difficulty defined as the sum of a spatial and a temporal term, to assess individual null space control ability for both reaching and holding.

MAIN RESULTS

On average, participants could reach the targets in most trials already in the first block (72%) and they improved with practice (maximum 93%) but holding performance remained lower (maximum 43%). As there was a high inter-individual variability in performance, we performed a simulation with different spatial and temporal task conditions to estimate those for which each individual participants would have performed best.

SIGNIFICANCE

Muscular null space control is feasible and may be used to control additional virtual or robotics end-effectors. However, decoding of motor commands must be optimized according to individual null space control ability.

Basic locomotor muscle synergies used in land walking are finely tuned during underwater walking

Underwater walking is one of the most common hydrotherapeutic exercises. Therefore, understanding muscular control during underwater walking is important for optimizing training regimens. The effects of the water environment on walking are mainly related to the hydrostatic and hydrodynamic theories of buoyancy and drag force. To date, muscular control during underwater walking has been investigated at the individual muscle level. However, it is recognized that the human nervous system modularly controls multiple muscles through muscle synergies, which are sets of muscles that work together. We found that the same set of muscle synergies was shared between the two walking tasks. However, some task-dependent modulation was found in the activation combination across muscles and temporal activation patterns of the muscle synergies. The results suggest that the human nervous system modulates activation of lower-limb muscles during water walking by finely tuning basic locomotor muscle synergies that are used during land walking to meet the biomechanical requirements for walking in the water environment.

Forward and backward walking share the same motor modules and locomotor adaptation strategies

Forward and backward walking are remarkably similar motor behaviors to the extent that backward walking has been described as a time-reversed version of forward walking. However, because they display different muscle activity patterns, it has been questioned if forward and backward walking share common control strategies. To investigate this point, we used a split-belt treadmill experimental paradigm designed to elicit healthy individuals' motor adaptation by changing the speed of one of the treadmill belts, while keeping the speed of the other belt constant. We applied this experimental paradigm to both forward and backward walking. We analyzed several adaptation parameters including step symmetry, stability, and energy expenditure as well as the characteristics of the synergies of lower-limb muscles. We found that forward and backward walking share the same muscle synergy modules. We showed that these modules are marked by similar patterns of adaptation driven by stability and energy consumption minimization criteria, both relying on modulating the temporal activation of the muscle synergies. Our results provide evidence that forward and backward walking are governed by the same control and adaptation mechanisms.

Brain-Machine Interfaces: Lessons for Prosthetic Hand Control

Brain-machine interfaces (BMI) are being developed to restore upper limb function for persons with spinal cord injury or other motor degenerative conditions. BMI and implantable sensors for myoelectric prostheses directly extract information from the central or peripheral nervous system to provide users with high fidelity control of their prosthetic device. Control algorithms have been highly transferable between the 2 technologies but also face common issues. In this review of the current state of the art in each field, the authors point out similarities and differences between the 2 technologies that may guide the implementation of common solutions to these challenges.

Task-relevant and task-irrelevant variability causally shape error-based motor learning

Recent studies of motor learning show dissociable roles of reward- and sensory-prediction errors in updating motor commands by using typical adaptation paradigms where force or visual perturbations are imposed on hand movements. Such classic adaptation paradigms ignore a problem of redundancy inherently embedded in the motor pathways where the central nervous system has to find a unique solution in the high-dimensional motor command space. Computationally, a possible way of solving such a redundancy problem is exploring and updating motor commands based on the learned knowledge of the structures of both the motor pathways and the tasks. However, the effects of task-irrelevant motor command exploration in structure learning and its effects on reward-based and error-based learning have yet to be examined. Here, we used a redundant motor task where participants manipulated a cursor on a monitor screen with their hand gesture movements and then analyzed single-trial motor learning by fitting models consisting of reward-based and error-based learning contributions. We found that the error-based learning rate positively correlated with both task-relevant and task-irrelevant variability, likely reflecting the effect of motor exploration in structure learning. Further modeling results show that the effects of both task-relevant and task-irrelevant variability are simultaneous, and not mediated by one another. In contrast, the reward-based learning rate correlated with neither task-relevant nor task-irrelevant variability. Thus, although not having a direct influence on the task outcome, exploration in the task-irrelevant space late in training has a significant effect on the learning of a task structure used for error-based learning. This suggests that motor exploration, in both task-relevant and task-irrelevant spaces, has an essential role in error-based motor learning in a redundant motor mechanism.

Effects of body weight support and guidance force settings on muscle synergy during Lokomat walking

BACKGROUND

The Lokomat is a robotic device that has been suggested to make gait therapy easier, more comfortable, and more efficient. In this study, we asked whether the Lokomat promotes physiological muscle activation patterns, a fundamental question when considering motor learning and adaptation.

METHODS

We investigated lower limb muscles coordination in terms of muscle activity level, muscle activity pattern similarity, and muscle synergy in 15 healthy participants walking at 3 km/h on either a treadmill or in a Lokomat at various guidance forces (GF: 30, 50 or 70%) and body weight supports (BWS: 30, 50 or 70% of participant's body weight).

RESULTS

Walking in the Lokomat was associated with a greater activation level of the rectus femoris and vastus medialis (×2-3) compared to treadmill walking. The level of activity tended to be diminished in gastrocnemius and semi-tendinosus, which particularly affected the similarity with treadmill walking (normalized scalar product NSP = 0.7-0.8). GF and BWS independently altered the muscle activation pattern in terms of amplitude and shape. Increasing BWS decreased the level of activity in all but one muscle (the soleus). Increasing GF slightly improved the similarity with treadmill walking for the tibialis anterior and vastus medialis muscles. The muscle synergies (N = 4) were similar (NSP = 0.93-0.97), but a cross-validation procedure revealed an alteration by the Lokomat. The activation of these synergies differed (NSP = 0.74-0.82).

CONCLUSION

The effects of GF and BWS are modest compared to the effect of the Lokomat itself, suggesting that Lokomat design should be improved to promote more typical muscle activity patterns.

Dissociating Sensorimotor Recovery and Compensation During Exoskeleton Training Following Stroke

The quality of arm movements typically improves in the sub-acute phase of stroke affecting the upper extremity. Here, we used whole arm kinematic analysis during reaching movements to distinguish whether these improvements are due to true recovery or to compensation. Fifty-three participants with post-acute stroke performed ∼80 reaching movement tests during 4 weeks of training with the ArmeoSpring exoskeleton. All participants showed improvements in end-effector performance, as measured by movement smoothness. Four ArmeoSpring angles, shoulder horizontal (SH) rotation, shoulder elevation (SE), elbow rotation, and forearm rotation, were recorded and analyzed. We first characterized healthy joint coordination patterns by performing a sparse principal component analysis on these four joint velocities recorded during reaching tests performed by young control participants. We found that two dominant joint correlations [SH with elbow rotation and SE with forearm rotation] explained over 95% of variance of joint velocity data. We identified two clusters of stroke participants by comparing the evolution of these two correlations in all tests. In the "Recoverer" cluster (N = 19), both joint correlations converged toward the respective correlations for control participants. Thus, Recoverers relearned how to generate smooth end-effector movements while developing joint movement patterns similar to those of control participants. In the "Compensator" cluster (N = 34), at least one of the two joint correlations diverged from the corresponding correlation of control participants. Compensators relearned how to generate smooth end-effector movements by discovering various new compensatory movement patterns dissimilar to those of control participants. New compensatory patterns included atypical decoupling of the SE and forearm joints, and atypical coupling of the SH rotation and elbow joints. There was no difference in clinical impairment level between the two groups either at the onset or at the end of training as assessed with the Upper Extremity Fugl-Meyer scale. However, at the start of training, the Recoverers showed significantly faster improvements in end-effector movement smoothness than the Compensators. Our analysis can be used to inform neurorehabilitation clinicians on how to provide movement feedback during practice and suggest avenues for refining exoskeleton robot therapy to reduce compensatory patterns.

Can spatial filtering separate voluntary and involuntary components in children with dyskinetic cerebral palsy?

The design of myocontrolled devices faces particular challenges in children with dyskinetic cerebral palsy because the electromyographic signal for control contains both voluntary and involuntary components. We hypothesized that voluntary and involuntary components of movements would be uncorrelated and thus detectable as different synergistic patterns of muscle activity, and that removal of the involuntary components would improve online EMG-based control. Therefore, we performed a synergy-based decomposition of EMG-guided movements, and evaluated which components were most controllable using a Fitts' Law task. Similarly, we also tested which muscles were most controllable. We then tested whether removing the uncontrollable components or muscles improved overall function in terms of movement time, success rate, and throughput. We found that removal of less controllable components or muscles did not improve EMG control performance, and in many cases worsened performance. These results suggest that abnormal movement in dyskinetic CP is consistent with a pervasive distortion of voluntary movement rather than a superposition of separable voluntary and involuntary components of movement.

Approaches to revealing the neural basis of muscle synergies: a review and a critique

The central nervous system (CNS) may produce coordinated motor outputs via the combination of motor modules representable as muscle synergies. Identification of muscle synergies has hitherto relied on applying factorization algorithms to multimuscle electromyographic data (EMGs) recorded during motor behaviors. Recent studies have attempted to validate the neural basis of the muscle synergies identified by independently retrieving the muscle synergies through CNS manipulations and analytic techniques such as spike-triggered averaging of EMGs. Experimental data have demonstrated the pivotal role of the spinal premotor interneurons in the synergies' organization and the presence of motor cortical loci whose stimulations offer access to the synergies, but whether the motor cortex is also involved in organizing the synergies has remained unsettled. We argue that one difficulty inherent in current approaches to probing the synergies' neural basis is that the EMG generative model based on linear combination of synergies and the decomposition algorithms used for synergy identification are not grounded on enough prior knowledge from neurophysiology. Progress may be facilitated by constraining or updating the model and algorithms with knowledge derived directly from CNS manipulations or recordings. An investigative framework based on evaluating the relevance of neurophysiologically constrained models of muscle synergies to natural motor behaviors will allow a more sophisticated understanding of motor modularity, which will help the community move forward from the current debate on the neural versus nonneural origin of muscle synergies.

Plasticity of muscle synergies through fractionation and merging during development and training of human runners

Complex motor commands for human locomotion are generated through the combination of motor modules representable as muscle synergies. Recent data have argued that muscle synergies are inborn or determined early in life, but development of the neuro-musculoskeletal system and acquisition of new skills may demand fine-tuning or reshaping of the early synergies. We seek to understand how locomotor synergies change during development and training by studying the synergies for running in preschoolers and diverse adults from sedentary subjects to elite marathoners, totaling 63 subjects assessed over 100 sessions. During development, synergies are fractionated into units with fewer muscles. As adults train to run, specific synergies coalesce to become merged synergies. Presences of specific synergy-merging patterns correlate with enhanced or reduced running efficiency. Fractionation and merging of muscle synergies may be a mechanism for modifying early motor modules (Nature) to accommodate the changing limb biomechanics and influences from sensorimotor training (Nurture).

Reorganization of Muscle Coordination Underlying Motor Learning in Cycling Tasks

The hypothesis of modular control, which stands on the existence of muscle synergies as building blocks of muscle coordination, has been investigated in a great variety of motor tasks and species. Yet, its role during learning processes is still largely unexplored. To what extent is such modular control flexible, in terms of spatial structure and temporal activation, to externally or internally induced adaptations, is a debated issue. To address this question, we designed a biofeedback experiment to induce changes in the timing of muscle activations during leg cycling movements. The protocol consisted in delaying the peak of activation of one target muscle and using its electromyography (EMG) envelope as visual biofeedback. For each of the 10 healthy participants, the protocol was repeated for three different target muscles: Tibialis Anterioris (TA), Gastrocnemius Medialis (GM), and Vastus Lateralis (VL). To explore the effects of the conditioning protocol, we analyzed changes in the activity of eight lower limb muscles by applying different models of modular motor control [i.e., fixed spatial components (FSC) and fixed temporal components (FTC)]. Our results confirm the hypothesis that visual EMG biofeedback is able to induce changes in muscle coordination. Subjects were able to shift the peak of activation of the target muscle, with a delay of (49 ± 27°) across subjects and conditions. This time shift generated a reorganization of all the other muscles in terms of timing and amplitude. By using different models of modular motor control, we demonstrated that neither spatially invariant nor temporally invariant muscle synergies alone were able to account for these changes in muscle coordination after learning, while temporally invariant muscle synergies with adjustments in timing could capture most of muscle activity adaptations observed after the conditioning protocol. These results suggest that short-term learning in rhythmic tasks is built upon synergistic temporal commands that are robust to changes in the task demands.

Characterization of the Adaptation to Visuomotor Rotations in the Muscle Synergies Space

The adaptation to visuomotor rotations is one of the most studied paradigms of motor learning. Previous literature has presented evidence of a dependency between the process of adaptation to visuomotor rotations and the constrains dictated by the workspace of the biological actuators, the muscles, and their co-activation strategies, modeled using muscle synergies analysis. To better understand this relationship, we asked a sample of healthy individuals (N = 7) to perform two experiments aiming at characterizing the adaptation to visuomotor rotations in terms of rotations of the activation space of the muscle synergies during isometric reaching tasks. In both experiments, subjects were asked to adapt to visual rotations altering the position mapping between the force exerted on a fixed manipulandum and the movement of a cursor on a screen. In the first experiment subjects adapted to three different visuomotor rotation angles (30°, 40°, and 50° clockwise) applied to the whole experimental workspace. In the second experiment subjects adapted to a single visuomotor rotation angle (45° clockwise) applied to eight different sub-spaces of the whole workspace, while also performing movements in the rest of the unperturbed workspace. The results from the first experiment confirmed the hypothesis that visuomotor rotations induce rotations in the synergies activation workspace that are proportional to the visuomotor rotation angle. The results from the second experiment showed that rotations affecting limited sub-spaces of the whole workspace are adapted for by rotating only the synergies involved in the movement, with an angle proportional to the distance between the preferred angle of the synergy and the sub-space covered by the rotation. Moreover, we show that the activation of a synergy is only rotated when the sub-space covered by the visual perturbation is applied at the boundaries of the workspace of the synergy. We found these results to be consistent across subjects, synergies and sub-spaces. Moreover, we found a correlation between synergies and muscle rotations further confirming that the adaptation process can be well described, at the neuromuscular level, using the muscle synergies model. These results provide information on how visuomotor rotations can be used to induce a desired neuromuscular response.

When 90% of the variance is not enough: residual EMG from muscle synergy extraction influences task performance

Muscle synergies are usually identified via dimensionality reduction techniques, such that the identified synergies reconstruct the muscle activity to an accuracy level defined heuristically, often set to 90% of the variance. Here, we question the assumption that the residual muscle activity not explained by the synergies is due to noise. We hypothesize instead that the residual activity is not entirely random and can influence the execution of motor tasks. Young healthy subjects performed an isometric reaching task in which the surface electromyography of 10 arm muscles was mapped onto a two-dimensional force used to control a cursor. Three to five synergies explained 90% of the variance in muscle activity. We altered the muscle-force mapping via "hard" and "easy" virtual surgeries. Whereas in both surgeries the forces associated with synergies spanned the same dimension of the virtual environment, the muscle-force mapping was as close as possible to the initial mapping in the easy surgery; in contrast, it was as far as possible in the hard surgery. This design maximized potential differences in reaching errors attributable to residual activity. Results show that the easy surgery produced smaller directional errors than the hard surgery. Additionally, simulations of surgeries constructed with 1 to 10 synergies show that the errors in the easy and hard surgeries differ significantly for up to 8 synergies, which explains 98% of the variance on average. Our study thus indicates the need for cautious interpretations of results derived from synergy extraction techniques based on heuristics with lenient accuracy levels.NEW & NOTEWORTHY The muscle synergy hypothesis posits that the central nervous system simplifies motor control by grouping muscles into modules. Current techniques use dimensionality reduction, such that the identified synergies reconstruct 90% of the muscle activity. We show that residual muscle activity following such identification can have a large systematic effect on movements, even when the number of synergies approaches the number of muscles. Current synergy extraction techniques must therefore be updated to identify true physiological synergies.

The effects of motor modularity on performance, learning and generalizability in upper-extremity reaching: a computational analysis

It has been hypothesized that the central nervous system simplifies the production of movement by limiting motor commands to a small set of modules known as muscle synergies. Recently, investigators have questioned whether a low-dimensional controller can produce the rich and flexible behaviours seen in everyday movements. To study this issue, we implemented muscle synergies in a biomechanically realistic model of the human upper extremity and performed computational experiments to determine whether synergies introduced task performance deficits, facilitated the learning of movements, and generalized to different movements. We derived sets of synergies from the muscle excitations our dynamic optimizations computed for a nominal task (reaching in a plane). Then we compared the performance and learning rates of a controller that activated all muscles independently to controllers that activated the synergies derived from the nominal reaching task. We found that a controller based on synergies had errors within 1 cm of a full-dimensional controller and achieved faster learning rates (as estimated from computational time to converge). The synergy-based controllers could also accomplish new tasks-such as reaching to targets on a higher or lower plane, and starting from alternative initial poses-with average errors similar to a full-dimensional controller.