In Standing, Corticospinal Excitability Is Proportional to COP Velocity Whereas M1 Excitability Is Participant-Specific

Cerebellum-Cerebrum paired target magnetic stimulation on balance function and brain network of patients with stroke: A functional near-infrared spectroscopy pilot study

Transcranial magnetic stimulation (TMS) modulation over the cerebellum, primary motor cortex, and supplementary motor cortex individually can improve the balance function of patients with stroke. However, whether their combination could have a better balance modulation effect is uncertain. Therefore, we hypothesized that performing TMS over a combination of these targets can regulate the balance function of patients with stroke. We compared the effects of one-session TMS on eye-open and eye-closed balance conditions in patients with stroke, using different target pairs of unilateral cerebellar (CB-single), cerebellar-primary motor cortex (CB-M1), and cerebellar-supplementary motor area (CB-SMA) targets. A total of 31 patients with stroke were enrolled and randomly divided into three groups to receive single sessions of intermittent theta burst stimulation each. Functional near-infrared spectrum data on resting and standing task states (eye-open and eye-closed) and center of pressure parameters (eye-open and eye-closed) were collected before and after the intervention. Compared with the results in the CB-single group, five intergroup differences in the changes in the center of pressure parameters in the CB-M1 group and two significant differences in the CB-SMA group were observed after one session of intermittent theta burst stimulation. In the CB-SMA group, 12 out of the 14 parameters improved significantly in the EC condition after the intervention. Meanwhile, the functional near-infrared spectrum results showed that the CB-SMA group exhibited a significant inhibitory pattern in the resting-state functional connectivity, which was not observed in the other two groups. In conclusion, we believe that paired targeting of the CB-SMA can reshape the brain network and improve the balance function of patients with stroke.

Acute effects of ankle plantar flexor force-matching exercises on postural strategy during single leg standing in healthy adults

BACKGROUND

Ankle plantar flexor force steadiness, assessed by measuring the fluctuation of the force around the submaximal target torque, has been associated with postural stability.

RESEARCH QUESTION

To investigate whether a force-matching exercise, where submaximal steady torque is maintained at the target torque, can modulate postural strategy immediately.

METHODS

Twenty-eight healthy young adults performed ankle plantar flexor force-matching exercises at target torques of 5%, 20%, and 50% of maximum voluntary contraction (MVC), in a randomized crossover trial. Participants with their ankle in a neutral position were instructed to maintain isometric contraction at each target torque, as measured by a dynamometer, for 20 s with 3 sets of 5 contractions. Before and after the force-matching exercises, the anterior-posterior velocities and standard deviation of the center of pressure (COP) on the stable platform and the tilt angle of the unstable platform during 20-seconds single-leg standing were measured. The velocities and standard deviations of the COP and tilt angle before and after the exercises were compared using paired t-tests.

RESULTS

The tilt angle velocity of an unstable platform significantly decreased after the force-matching exercise at a target torque of 5% MVC (p = 0.029), whereas it was unchanged after the exercises at target torques of 20% and 50% MVC. The standard deviations of the tilt angle of unstable platform test did not change significantly after any exercise. Furthermore, no significant differences were observed in the COP velocities or standard deviations on the stable platform test after any exercise.

SIGNIFICANCE

Our findings suggest that repeated exertion training at low-intensity contractions can affect postural stability in an unstable condition. Particularly, force-matching exercise at very low-intensity torque, such as 5% of MVC, may be an effective method to improve postural control in the unstable condition, but not in a stable condition.

The effects of stroboscopic balance training on cortical activities in athletes with chronic ankle instability

OBJECTIVES

To investigate the effect of a 6-week stroboscopic balance training program on cortical activities in athletes with chronic ankle instability.

DESIGN

Randomized controlled trial.

SETTING

Single-center.

PARTICIPANTS

Thirty-nine participants were assigned to the strobe group (SG, n = 13), non-strobe group (NSG, n = 13), and control group (CG, n = 13).

MAIN OUTCOME MEASURES

Cortical activity and balance velocity were evaluated while the athletes were on the HUBER balance device. Electroencephalographic measurements of cortical activity were made at the transition from bipedal stance to single-leg stance.

RESULTS

The SG showed significant increases in Cz theta and alpha values and COP-v (center of pressure velocity) between pretest and posttest (p < 0.001, p = 0.003, p < 0.001). Posttest Cz theta was significantly higher in the SG compared to the CG (p = 0.009) and posttest Cz alpha was significantly higher in the SG compared to the NSG (p = 0.039) and CG (p = 0.001). Posttest COP-v was significantly higher in the SG than in the CG (p = 0.031) and NSG (p = 0.03).

CONCLUSIONS

Stroboscopic training may be clinically beneficial to improve balance parameters in athletes with CAI, and may have utility in sport-specific activity phases of rehabilitation to reduce visual input and increase motor control.

Standing task difficulty related increase in agonist-agonist and agonist-antagonist common inputs are driven by corticospinal and subcortical inputs respectively

In standing, coordinated activation of lower extremity muscles can be simplified by common neural inputs to muscles comprising a functional synergy. We examined the effect of task difficulty on common inputs to agonist-agonist (AG-AG) pairs supporting direction specific reciprocal muscle control and agonist-antagonist (AG-ANT) pairs supporting stiffness control. Since excessive stiffness is energetically costly and limits the flexibility of responses to perturbations, compared to AG-ANT, we expected greater AG-AG common inputs and a larger increase with increasing task difficulty. We used coherence analysis to examine common inputs in three frequency ranges which reflect subcortical/spinal (0–5 and 6–15 Hz) and corticospinal inputs (6–15 and 16–40 Hz). Coherence was indeed higher in AG-AG compared to AG-ANT muscles in all three frequency bands, indicating a predilection for functional synergies supporting reciprocal rather than stiffness control. Coherence increased with increasing task difficulty, only in AG-ANT muscles in the low frequency band (0–5 Hz), reflecting subcortical inputs and only in AG-AG group in the high frequency band (16–40 Hz), reflecting corticospinal inputs. Therefore, common neural inputs to both AG-AG and AG-ANT muscles increase with difficulty but are likely driven by different sources of input to spinal alpha motor neurons.