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Ivanenko Y, Shapkova EY, Petrova DA, Kleeva DF, Lebedev MA. Exoskeleton gait training with spinal cord neuromodulation. Front Hum Neurosci 2023; 17:1194702. [PMID: 37250689 PMCID: PMC10213721 DOI: 10.3389/fnhum.2023.1194702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Neuromodulating the locomotor network through spinal cord electrical stimulation (SCES) is effective for restoring function in individuals with gait deficits. However, SCES alone has limited effectiveness without concurrent locomotor function training that enhances activity-dependent plasticity of spinal neuronal networks by sensory feedback. This mini review discusses recent developments in using combined interventions, such as SCES added to exoskeleton gait training (EGT). To develop personalized therapies, it is crucial to assess the state of spinal circuitry through a physiologically relevant approach that identifies individual characteristics of spinal cord function to develop person-specific SCES and EGT. The existing literature suggests that combining SCES and EGT to activate the locomotor network can have a synergistic rehabilitative effect on restoring walking abilities, somatic sensation, and cardiovascular and bladder function in paralyzed individuals.
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Affiliation(s)
| | - Elena Y. Shapkova
- Saint-Petersburg State Research Institute of Phthisiopulmonology, Saint Petersburg, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, Saint Petersburg, Russia
| | - Daria A. Petrova
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Daria F. Kleeva
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Mikhail A. Lebedev
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences, Saint Petersburg, Russia
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2
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Esposito D, Centracchio J, Andreozzi E, Gargiulo GD, Naik GR, Bifulco P. Biosignal-Based Human-Machine Interfaces for Assistance and Rehabilitation: A Survey. SENSORS 2021; 21:s21206863. [PMID: 34696076 PMCID: PMC8540117 DOI: 10.3390/s21206863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022]
Abstract
As a definition, Human–Machine Interface (HMI) enables a person to interact with a device. Starting from elementary equipment, the recent development of novel techniques and unobtrusive devices for biosignals monitoring paved the way for a new class of HMIs, which take such biosignals as inputs to control various applications. The current survey aims to review the large literature of the last two decades regarding biosignal-based HMIs for assistance and rehabilitation to outline state-of-the-art and identify emerging technologies and potential future research trends. PubMed and other databases were surveyed by using specific keywords. The found studies were further screened in three levels (title, abstract, full-text), and eventually, 144 journal papers and 37 conference papers were included. Four macrocategories were considered to classify the different biosignals used for HMI control: biopotential, muscle mechanical motion, body motion, and their combinations (hybrid systems). The HMIs were also classified according to their target application by considering six categories: prosthetic control, robotic control, virtual reality control, gesture recognition, communication, and smart environment control. An ever-growing number of publications has been observed over the last years. Most of the studies (about 67%) pertain to the assistive field, while 20% relate to rehabilitation and 13% to assistance and rehabilitation. A moderate increase can be observed in studies focusing on robotic control, prosthetic control, and gesture recognition in the last decade. In contrast, studies on the other targets experienced only a small increase. Biopotentials are no longer the leading control signals, and the use of muscle mechanical motion signals has experienced a considerable rise, especially in prosthetic control. Hybrid technologies are promising, as they could lead to higher performances. However, they also increase HMIs’ complexity, so their usefulness should be carefully evaluated for the specific application.
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Affiliation(s)
- Daniele Esposito
- Department of Electrical Engineering and Information Technologies, Polytechnic and Basic Sciences School, University of Naples “Federico II”, 80125 Naples, Italy; (D.E.); (J.C.); (E.A.); (P.B.)
| | - Jessica Centracchio
- Department of Electrical Engineering and Information Technologies, Polytechnic and Basic Sciences School, University of Naples “Federico II”, 80125 Naples, Italy; (D.E.); (J.C.); (E.A.); (P.B.)
| | - Emilio Andreozzi
- Department of Electrical Engineering and Information Technologies, Polytechnic and Basic Sciences School, University of Naples “Federico II”, 80125 Naples, Italy; (D.E.); (J.C.); (E.A.); (P.B.)
| | - Gaetano D. Gargiulo
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2747, Australia;
- The MARCS Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Ganesh R. Naik
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2747, Australia;
- The Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA 5042, Australia
- Correspondence:
| | - Paolo Bifulco
- Department of Electrical Engineering and Information Technologies, Polytechnic and Basic Sciences School, University of Naples “Federico II”, 80125 Naples, Italy; (D.E.); (J.C.); (E.A.); (P.B.)
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3
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Effects of body weight support and guidance force settings on muscle synergy during Lokomat walking. Eur J Appl Physiol 2021; 121:2967-2980. [PMID: 34218291 DOI: 10.1007/s00421-021-04762-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/29/2021] [Indexed: 01/05/2023]
Abstract
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.
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Karunakaran KK, Abbruzzese K, Androwis G, Foulds RA. A Novel User Control for Lower Extremity Rehabilitation Exoskeletons. Front Robot AI 2020; 7:108. [PMID: 33501275 PMCID: PMC7805763 DOI: 10.3389/frobt.2020.00108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/13/2020] [Indexed: 01/28/2023] Open
Abstract
Lower extremity exoskeletons offer the potential to restore ambulation to individuals with paraplegia due to spinal cord injury. However, they often rely on preprogrammed gait, initiated by switches, sensors, and/or EEG triggers. Users can exercise only limited independent control over the trajectory of the feet, the speed of walking, and the placement of feet to avoid obstacles. In this paper, we introduce and evaluate a novel approach that naturally decodes a neuromuscular surrogate for a user's neutrally planned foot control, uses the exoskeleton's motors to move the user's legs in real-time, and provides sensory feedback to the user allowing real-time sensation and path correction resulting in gait similar to biological ambulation. Users express their desired gait by applying Cartesian forces via their hands to rigid trekking poles that are connected to the exoskeleton feet through multi-axis force sensors. Using admittance control, the forces applied by the hands are converted into desired foot positions, every 10 milliseconds (ms), to which the exoskeleton is moved by its motors. As the trekking poles reflect the resulting foot movement, users receive sensory feedback of foot kinematics and ground contact that allows on-the-fly force corrections to maintain the desired foot behavior. We present preliminary results showing that our novel control can allow users to produce biologically similar exoskeleton gait.
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Affiliation(s)
- Kiran K Karunakaran
- Kessler Foundation, West Orange, NJ, United States.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Kevin Abbruzzese
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States.,Stryker Corporation, Mahwah, NJ, United States
| | - Ghaith Androwis
- Kessler Foundation, West Orange, NJ, United States.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Richard A Foulds
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States.,Really Useful Robots, LLC, Langhorne, PA, United States
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Haddas R, Cox J, Belanger T, Ju KL, Derman PB. Characterizing gait abnormalities in patients with cervical spondylotic myelopathy: a neuromuscular analysis. Spine J 2019; 19:1803-1808. [PMID: 31207317 DOI: 10.1016/j.spinee.2019.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Gait impairment is a hallmark of cervical spondylotic myelopathy (CSM). It has been shown to affect quality of life but has not been well defined. Further electromyographic (EMG) characterization of the gait cycle may help elucidate the true neuromuscular pathology with implications on prognosis and rehabilitation techniques. PURPOSE This study compares neuromuscular activity in patients with CSM to that of healthy age-matched controls. STUDY DESIGN Nonrandomized, prospective, concurrent control cohort study. METHODS Neuromuscular activity was measured in 40 patients with symptomatic CSM during a series of over-ground gait trials at a self-selected speed before surgical intervention. External oblique, multifidus, erector spinae, rectus femoris, semitendinosus, tibialis anterior, medial gastrocnemius, and medial deltoid were assessed. Identical measurements were taken in 25 healthy control patients. Differences in time of muscle onset, peak EMG, time to peak EMG, and integrated electromyography (iEMG) were assessed using one-way ANOVA. RESULTS There were no significant differences between patients with CSM and healthy controls with respect to time of muscle contraction onset. Peak EMG muscle activity was significantly higher in the medial deltoid of patients with CSM (39.3% vs. 23.3% sMVC, p=.042), but no other differences were seen in the remaining muscles tested. They also demonstrated significantly longer time to peak EMG muscle activity compared with controls in 5 of the 8 muscles tested, including the multifidus (20.2 vs. 16.8 ms, p=.050), erector spinae (18.2 vs. 8.9 ms, p<.001), semitendinosis (26.3 vs. 22.4 ms, p=.037), tibialis anterior (14.7 vs. 11.0 ms, p=.050), and medial deltoid (24.2 vs. 9.2 ms, p<.001). Compared with controls, patients with CSM demonstrated significantly higher iEMG activity in the semitendinosis (586.5% vs. 272.5 sMVC, p=.047) and medial deltoid (87.62% vs. 22.5% sMVC, p=.008). CONCLUSIONS The onset of muscle activity is not delayed in CSM patients, but many key muscles take longer to fully contract. This produces a situation in which patients with CSM are unable to fully fire their muscles with sufficient speed to maintain a normal gait. The core and lower extremity muscles do not contract with increased peak amplitude in response, but the deltoid and hamstring muscles are more active, suggesting compensatory activity as patients attempt to maintain balance. The end result is less efficient ambulation. These findings provide a more nuanced understanding of gait in individuals suffering from CSM and may have implications on rehabilitation protocols.
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Shimizu Y, Kadone H, Kubota S, Suzuki K, Saotome K, Ueno T, Abe T, Marushima A, Watanabe H, Endo A, Tsurumi K, Ishimoto R, Matsushita A, Koda M, Matsumura A, Sankai Y, Hada Y, Yamazaki M. Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report. J Spinal Cord Med 2019; 42:460-468. [PMID: 29351051 PMCID: PMC6718935 DOI: 10.1080/10790268.2017.1423267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Context: We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. Findings: A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Conclusion/clinical relevance: Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.
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Affiliation(s)
- Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan,Correspondence to: Yukiyo Shimizu, MD, PhD, Department of Rehabilitation Medicine, University of Tsukuba Hospital, 2-1-1, Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Ph: +81-29-853-3219, Fax: +81-29-853-3162.
| | - Hideki Kadone
- Center for Innovative Medicine and Engineering, University of Tsukuba Hospital, Ibaraki, Japan
| | - Shigeki Kubota
- Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kenji Suzuki
- Center for Cybernics Research, University of Tsukuba, Ibaraki, Japan
| | - Kousaku Saotome
- Center for Cybernics Research, University of Tsukuba, Ibaraki, Japan
| | - Tomoyuki Ueno
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Aiki Marushima
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroki Watanabe
- Center for Cybernics Research, University of Tsukuba, Ibaraki, Japan,Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ayumu Endo
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Kazue Tsurumi
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Ryu Ishimoto
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Akira Matsushita
- Department of Neurosurgery, Ibaraki Prefectural University Hospital of Health Sciences, Ibaraki, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akira Matsumura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yoshiyuki Sankai
- Faculty of Systems and Information Engineering, University of Tsukuba, Ibaraki, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Synergistic influences of sensory and central stimuli on non-voluntary rhythmic arm movements. Hum Mov Sci 2019; 64:230-239. [PMID: 30798047 DOI: 10.1016/j.humov.2019.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 01/26/2019] [Accepted: 02/14/2019] [Indexed: 11/22/2022]
Abstract
In recent years, neuromodulation of the cervical spinal circuitry has become an area of interest for investigating rhythmogenesis of the human spinal cord and interaction between cervical and lumbosacral circuitries, given the involvement of rhythmic arm muscle activity in many locomotor tasks. We have previously shown that arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations in unloading body conditions. Here we investigated the excitability of the cervical spinal circuitry by applying different peripheral and central stimuli in healthy humans. The rationale for applying combined stimuli is that the efficiency of only one stimulus is generally limited. We found that low-intensity electrical stimulation of the superficial arm median nerve can evoke rhythmic arm movements. Furthermore, the movements were enhanced by additional peripheral stimuli (e.g., arm muscle vibration, head turns or passive rhythmic leg movements). Finally, low-frequency transcranial magnetic stimulation of the motor cortex significantly facilitated rhythmogenesis. The findings are discussed in the general framework of a brain-spinal interface for developing adaptive central pattern generator-modulating therapies.
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8
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Shimizu Y, Kadone H, Kubota S, Suzuki K, Abe T, Ueno T, Soma Y, Sankai Y, Hada Y, Yamazaki M. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury. Front Neurosci 2017; 11:649. [PMID: 29209163 PMCID: PMC5702458 DOI: 10.3389/fnins.2017.00649] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/08/2017] [Indexed: 12/24/2022] Open
Abstract
Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20–67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60–90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings suggest that upper-limb-triggered HAL ambulation is a safe and feasible option for rehabilitation in patients with complete quadri/paraplegia caused by chronic SCI.
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Affiliation(s)
- Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hideki Kadone
- Center for Innovative Medicine and Engineering, University of Tsukuba Hospital, Tsukuba, Japan
| | - Shigeki Kubota
- Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kenji Suzuki
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoyuki Ueno
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yuichiro Soma
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Active and passive contributions to arm swing: Implications of the restriction of pelvis motion during human locomotion. Hum Mov Sci 2017; 57:314-323. [PMID: 28958710 DOI: 10.1016/j.humov.2017.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 11/22/2022]
Abstract
Current research has yet to determine how passive dynamics and active neural control contribute to upper limb swing during human locomotion. The present study aimed to investigate these contributions by restricting pelvis motion during walking, thereby altering the upward energy transfer from the swinging lower limbs. Ten healthy individuals walked freely on a treadmill (CON) and with an apparatus that reduced pelvis motion (PR) at three walking speeds (0.9, 1.3, and 1.8m/s). Spatiotemporal characteristics of limb movement and muscle activation were recorded and analyzed. When wearing the apparatus, the ranges of the sagittal and transverse rotations of the trunk and shoulders, as well as vertical trunk center of mass movement all decreased. At higher treadmill speeds, the movement amplitudes of the upper and lower limbs increased. This increase was less pronounced in the upper limbs when the apparatus reduced pelvis motion. However, this decrease in arm swing was accompanied with a preservation of upper and lower limb muscle activity amplitudes. The temporal coordination between upper and lower limbs was also conserved irrespective of the PR or CON conditions. Relating shoulder muscle activities to upper limb kinematics suggested these muscles mainly acted eccentrically, providing evidence that passive elements are a significant factor in arm swing control. However, the conserved muscle activity patterns and temporal coupling of limb movements when pelvis motion was reduced are suggestive of an underlying active maintenance of the locomotor pattern via linked upper and lower limb neural networks.
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10
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Zehr EP, Barss TS, Dragert K, Frigon A, Vasudevan EV, Haridas C, Hundza S, Kaupp C, Klarner T, Klimstra M, Komiyama T, Loadman PM, Mezzarane RA, Nakajima T, Pearcey GEP, Sun Y. Neuromechanical interactions between the limbs during human locomotion: an evolutionary perspective with translation to rehabilitation. Exp Brain Res 2016; 234:3059-3081. [PMID: 27421291 PMCID: PMC5071371 DOI: 10.1007/s00221-016-4715-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 06/27/2016] [Indexed: 11/10/2022]
Abstract
During bipedal locomotor activities, humans use elements of quadrupedal neuronal limb control. Evolutionary constraints can help inform the historical ancestry for preservation of these core control elements support transfer of the huge body of quadrupedal non-human animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after neurotrauma where interlimb coordination is lost or compromised. The present state of the field supports including arm activity in addition to leg activity as a component of gait retraining after neurotrauma.
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Affiliation(s)
- E P Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1.
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada.
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.
| | - Trevor S Barss
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Katie Dragert
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
| | - Alain Frigon
- Department of Pharmacology-physiology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Erin V Vasudevan
- Department of Physical Therapy, SUNY Stony Brook University, Stony Brook, NY, USA
| | - Carlos Haridas
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
| | - Sandra Hundza
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
- Motion and Mobility Rehabilitation Laboratory, University of Victoria, Victoria, BC, Canada
| | - Chelsea Kaupp
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Taryn Klarner
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Marc Klimstra
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
- Motion and Mobility Rehabilitation Laboratory, University of Victoria, Victoria, BC, Canada
| | - Tomoyoshi Komiyama
- Division of Sports and Health Science, Chiba University, Chiba, Japan
- The United Graduate School of Education, Tokyo Gakugei University, Tokyo, Japan
| | - Pamela M Loadman
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Rinaldo A Mezzarane
- Laboratory of Signal Processing and Motor Control, College of Physical Education, Universidade de Brasília-UnB, Brasília, Brazil
| | - Tsuyoshi Nakajima
- Department of Integrative Physiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Gregory E P Pearcey
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Yao Sun
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
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11
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Solopova IA, Selionov VA, Zhvansky DS, Gurfinkel VS, Ivanenko Y. Human cervical spinal cord circuitry activated by tonic input can generate rhythmic arm movements. J Neurophysiol 2015; 115:1018-30. [PMID: 26683072 DOI: 10.1152/jn.00897.2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/16/2015] [Indexed: 01/03/2023] Open
Abstract
The coordination between arms and legs during human locomotion shares many features with that in quadrupeds, yet there is limited evidence for the central pattern generator for the upper limbs in humans. Here we investigated whether different types of tonic stimulation, previously used for eliciting stepping-like leg movements, may evoke nonvoluntary rhythmic arm movements. Twenty healthy subjects participated in this study. The subject was lying on the side, the trunk was fixed, and all four limbs were suspended in a gravity neutral position, allowing unrestricted low-friction limb movements in the horizontal plane. The results showed that peripheral sensory stimulation (continuous muscle vibration) and central tonic activation (postcontraction state of neuronal networks following a long-lasting isometric voluntary effort, Kohnstamm phenomenon) could evoke nonvoluntary rhythmic arm movements in most subjects. In ∼40% of subjects, tonic stimulation elicited nonvoluntary rhythmic arm movements together with rhythmic movements of suspended legs. The fact that not all participants exhibited nonvoluntary limb oscillations may reflect interindividual differences in responsiveness of spinal pattern generation circuitry to its activation. The occurrence and the characteristics of induced movements highlight the rhythmogenesis capacity of cervical neuronal circuitries, complementing the growing body of work on the quadrupedal nature of human gait.
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Affiliation(s)
- I A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia;
| | - V A Selionov
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - D S Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - V S Gurfinkel
- Biomedical Engineering Department, Oregon Health and Science University, Portland, Oregon; and
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, Fondazione Santa Lucia, Rome, Italy
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