The integration of vestibular and somatosensory information for the control of lower limb musculature remains elusive. To determine whether a subthreshold vestibular input influences the cutaneous evoked response, the isometric EMG activity in the posturally inactive soleus muscles of 13 healthy, seated subjects was collected. Vestibular afferents were activated using galvanic vestibular stimulation (GVS; 1.8–2.5mA, 500ms), while percutaneous electrical stimulation was delivered to the distal tibial nerve (11ms train of 3 × 1.0 ms pulses, 200Hz) to activate foot sole skin afferents. GVS elicited responses in soleus both independently and when combined with cutaneous stimulation. The responses to the combined sensory input showed an interaction between the two sensory modalities to influence muscle activation. Of note is the presence of significant muscle modulation in the combined condition, where subthreshold vestibular inputs altered the outcome of the cutaneous reflex response. This finding has implications for individuals with sensory deficiency. In the case of an absent or deficient sensory modality, balance protective reflexes to maintain postural equilibrium may be enhanced with targeted sensory augmentation.
Kristen E. Thomas and Leah R. Bent
Thomas J. Burkholder and T. Richard Nichols
Postural regulation is an important part of a variety of motor tasks, including quiet standing and locomotion. Muscle length feedback, both the autogenic length feedback arising from a muscle's own spindles, and heterogenic length feedback, arising from its agonists and antagonists, is a strong modulator of muscle force and well suited to postural maintenance. The effects of this reflex feedback on 3-D force generation and limb mechanics are not known. In this paper, we present a mechanical model for relating 3-D changes in cat hindlimb posture to changes in muscle lengths. These changes in muscle length are used to estimate changes in both intrinsic muscle force generation and muscle activation by length feedback pathways. Few muscles are found to have directly agonist mechanical actions, and most differ by more than 20°. Endpoint force fields are largely uniform across the space investigated. Both autogenic and heterogenic feedback contribute to whole limb resistance to perturbation, autogenic pathways being most dramatic. Length feedback strongly reinforced a restoring force in response to end-point displacement.
Akinori Nagano and Karin G.M. Gerritsen
The purpose of this study was twofold: (a) to systematically investigate the effect of altering specific neuromuscular parameters on maximum vertical jump height, and (b) to systematically investigate the effect of strengthening specific muscle groups on maximum vertical jump height. A two-dimensional musculoskeletal model which consisted of four rigid segments, three joints, and six Hill-type muscle models, representing the six major muscles and muscle groups in the lower extremity that contribute to jumping performance, was trained systematically. Maximum isometric muscle force, maximum muscle shortening velocity, and maximum muscle activation, which were manipulated to simulate the effects of strength training, all had substantial effects on jumping performance. Part of the increase in jumping performance could be explained solely by the interaction between the three neuromuscular parameters. It appeared that the most effective way to improve jumping performance was to train the knee extensors among all lower extremity muscles. For the model to fully benefit from any training effects of the neuromuscular system, it was necessary to continue to reoptimize the muscle coordination, in particular after the strength training sessions that focused on increasing maximum isometric muscle force.
Alycia Fong Yan, Richard Smith, Benedicte Vanwanseele and Claire Hiller
There has been little scientific investigation of the impact of dance shoes on foot motion or dance injuries. The pointed (plantar-flexed) foot is a fundamental component of both the technical requirements and the traditional aesthetic of ballet and jazz dancing. The aims of this study were to quantify the externally observed angle of plantar flexion in various jazz shoes compared with barefoot and to compare the sagittal plane bending stiffness of the various jazz shoes. Sixteen female recreational child dancers were recruited for 3D motion analysis of active plantar flexion. The jazz shoes tested were a split-sole jazz shoe, full-sole jazz shoe, and jazz sneaker. A shoe dynamometer measured the stiffness of the jazz shoes. The shoes had a significant effect on ankle plantar flexion. All jazz shoes significantly restricted the midfoot plantar flexion angle compared with the barefoot condition. The split-sole jazz shoe demonstrated the least restriction, whereas the full-sole jazz shoe the most midfoot restriction. A small restriction in metartarsophalangeal plantar flexion and a greater restriction at the midfoot joint were demonstrated when wearing stiff jazz shoes. These restrictions will decrease the aesthetic of the pointed foot, may encourage incorrect muscle activation, and have an impact on dance performance.
Elena J. Caruthers, Julie A. Thompson, Ajit M.W. Chaudhari, Laura C. Schmitt, Thomas M. Best, Katherine R. Saul and Robert A. Siston
Sit-to-stand transfer is a common task that is challenging for older adults and others with musculoskeletal impairments. Associated joint torques and muscle activations have been analyzed two-dimensionally, neglecting possible three-dimensional (3D) compensatory movements in those who struggle with sit-to-stand transfer. Furthermore, how muscles accelerate an individual up and off the chair remains unclear; such knowledge could inform rehabilitation strategies. We examined muscle forces, muscleinduced accelerations, and interlimb muscle force differences during sit-to-stand transfer in young, healthy adults. Dynamic simulations were created using a custom 3D musculoskeletal model; static optimization and induced acceleration analysis were used to determine muscle forces and their induced accelerations, respectively. The gluteus maximus generated the largest force (2009.07 ± 277.31 N) and was a main contributor to forward acceleration of the center of mass (COM) (0.62 ± 0.18 m/s2), while the quadriceps opposed it. The soleus was a main contributor to upward (2.56 ± 0.74 m/s2) and forward acceleration of the COM (0.62 ± 0.33 m/s2). Interlimb muscle force differences were observed, demonstrating lower limb symmetry cannot be assumed during this task, even in healthy adults. These findings establish a baseline from which deficits and compensatory strategies in relevant populations (eg, elderly, osteoarthritis) can be identified.
Maria Grazia Benedetti, Lisa Berti, Antonio Frizziero, Donata Ferrarese and Sandro Giannini
Surface replacement of the hip is aimed especially at active patients, and it seems to achieve optimal functional results in a short time if associated with a tailored rehabilitation protocol.
To assess the functional outcome in a group of active patients after hip resurfacing.
Clinical measurement and controlled laboratory study in a case series.
8 patients and a control group of 10 subjects.
Patients treated with Birmingham hip-resurfacing system and a tailored rehabilitation protocol
Main Outcome Measures:
Clinical assessment (Harris Hip Score [HHS]) and instrumented gait analysis including muscular electromyographic assessment. Patients were assessed preoperatively and at 3 and 9 mo follow-up after surgery.
HHS showed a significant increase from the baseline to 3- (P = .008) and 9-month (P = .014) follow-up; 5 patients returned to sport. Gait pattern in the presented case series of patients improved substantially 3 mo postoperatively, and minimal further changes were present 9 months postoperatively. Residual abnormalities of time-distance and hip-kinematics parameters were consistent with a slow gait. A complete restoration of the muscle-activation pattern during gait was achieved.
Hip resurfacing associated with a rehabilitation protocol based on the characteristics of the implant provides excellent clinical and functional outcome, especially for very active patients.
Annina B. Schmid, Linda Dyer, Thomas Böni, Ulrike Held and Florian Brunner
Various studies report decreased muscle activation in the concavity of the curve in patients with scoliosis. Such decreased muscle-performance capacity could lead to sustained postural deficits.
To investigate whether specific asymmetrical sports therapy exercises rather than symmetrical back strengthening can increase EMG amplitudes of paraspinal muscles in the concavity of the curve.
16 patients with idiopathic scoliosis.
Patients performed 4 back-strengthening exercises (front press, lat pull-down, roman chair, bent-over barbell row) during 1 test session. Each exercise was performed in a symmetrical and asymmetrical variant and repeated 3 times.
Main Outcome Measure:
EMG amplitudes of the paraspinal muscles were recorded in the thoracic and lumbar apexes of the scoliotic curve during each exercise. Ratios of convex- to concave-side EMG activity were calculated.
Statistical analysis revealed that the asymmetrical variants of front press at the lumbar level (P = .002) and roman chair and bent-over barbell row at the thoracic level (P < .0001, .001 respectively) were superior in increasing EMG amplitudes in the concavity of the scoliotic curve.
Specific asymmetrical exercises increase EMG amplitudes of paraspinal muscles in the concavity. If confirmed in longitudinal studies measuring improvements of postural deficits, these exercises may advance care of patients with scoliosis.
Saira Chaudhry, Dylan Morrissey, Roger C. Woledge, Dan L. Bader and Hazel R.C. Screen
Triceps surae eccentric exercise is more effective than concentric exercise for treating Achilles tendinopathy, however the mechanisms underpinning these effects are unclear. This study compared the biomechanical characteristics of eccentric and concentric exercises to identify differences in the tendon load response. Eleven healthy volunteers performed eccentric and concentric exercises on a force plate, with ultrasonography, motion tracking, and EMG applied to measure Achilles tendon force, lower limb movement, and leg muscle activation. Tendon length was ultrasonographically tracked and quantified using a novel algorithm. The Fourier transform of the ground reaction force was also calculated to investigate for tremor, or perturbations. Tendon stiffness and extension did not vary between exercise types (P = .43). However, tendon perturbations were significantly higher during eccentric than concentric exercises (25%–40% higher, P = .02). Furthermore, perturbations during eccentric exercises were found to be negatively correlated with the tendon stiffness (R 2 = .59). The particular efficacy of eccentric exercise does not appear to result from variation in tendon stiffness or extension within a given session. However, varied perturbation magnitude may have a role in mediating the observed clinical effects. This property is subject-specific, with the source and clinical timecourse of such perturbations requiring further research.
Kristof Kipp, Ron Pfeiffer, Michelle Sabick, Chad Harris, Jeanie Sutter, Seth Kuhlman and Kevin Shea
The purpose of this study was to investigate muscle activation patterns during a landing task in boys and girls through the use of muscle synergies. Electromyographical data from six lower extremity muscles were collected from 11 boys and 16 girls while they performed single-leg drop-landings. Electromyographical data from six leg muscles were rectified, smoothed, and normalized to maximum dynamic muscle activity during landing. Data from 100 ms before to 100 ms after touchdown were submitted to factor analyses to extract muscle synergies along with the associated activation and weighing coefficients. Boys and girls both used three muscle synergies. The activation coefficients of these synergies captured muscle activity during the prelanding, touchdown, and postlanding phases of the single-leg drop-landing. Analysis of the weighing coefficients indicated that within the extracted muscle synergies the girls emphasized activation of the medial hamstring muscle during the prelanding and touchdown synergy whereas boys emphasized activation of the vastus medialis during the postlanding synergy. Although boys and girls use similar muscle synergies during single-leg drop-landings, they differed in which muscles were emphasized within these synergies. The observed differences in aspects related to the muscle synergies during landing may have implications with respect to knee injury risk.
Priyanka Banerjee, Stephen H.M Brown, Samuel J. Howarth and Stuart M. McGill
The ProFitter 3-D Cross Trainer is a labile surface device used in the clinic and claimed to train spine stability. The purpose of this study was to quantify the spine mechanics (compression and shear forces and stability), together with muscle activation mechanics (surface electromyography) of the torso and hip, during three ProFitter exercises. Trunk muscle activity was relatively low while exercising on the device (<25%MVC). Gluteus medius activity was phasic with the horizontal sliding position, especially for an experienced participant. Sufficient spinal stability was achieved in all three exercise conditions. Peak spinal compression values were below 3400 N (maximum 3188 N) and peak shear values were correspondingly low (under 500 N). The exercises challenge whole-body dynamic balance while producing very conservative spine loads. The motion simultaneously integrates hip and torso muscles in a way that appears to ensure stabilizing motor patterns in the spine. This information will assist with clinical decision making about the utility of the device and exercise technique in rehabilitation and training programs.