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Alex V. Nowicky, Alison H. McGregor and Nick J. Davey

We used transcranial magnetic stimulation (TMS) to study corticospinal excitability to erector Spinae (ES) muscles during graded voluntary contractions in bilateral trunk extension (BTE) and forced expiratory breath holding (FEBH) in normal individuals. Motor evoked potentials (MEPs) could be produced in all subjects in the absence of voluntary activation. At maximum voluntary contraction, levels of surface electromyographic (EMG) activity were 4 times greater during BTE than FEBH. When EMG was normalized to maximum. MEP amplitudes increased in proportion to contraction in both tasks. MEPs in FEBH were compared with extrapolated values at similar EMG levels in BTE and were found to be larger. EMG and MEPs in left and right ES were symmetrical throughout the range of contractions in both tasks. ES muscles have a facilitation pattern similar to that previously shown in leg muscles, but subtle differences at low levels of EMG suggest that the facilitation is dependent on the task.

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Adam S. Lepley, Allison M. Strouse, Hayley M. Ericksen, Kate R. Pfile, Phillip A. Gribble and Brian G. Pietrosimone

Context:

Components of gluteal neuromuscular function, such as strength and corticospinal excitability, could potentially influence alterations in lower extremity biomechanics during jump landing.

Objective:

To determine the relationship between gluteal muscle strength, gluteal corticospinal excitability, and jump-landing biomechanics in healthy women.

Setting:

University laboratory.

Design:

Descriptive laboratory study.

Participants:

37 healthy women (21.08 ± 2.15 y, 164.8 ± 5.9 cm, 65.4 ± 12.0 kg).

Interventions:

Bilateral gluteal strength was assessed through maximal voluntary isometric contractions (MVIC) using an isokinetic dynamometer. Strength was tested in the open chain in prone and side-lying positions for the gluteus maximus and gluteus medius muscles, respectively. Transcranial magnetic stimulation was used to elicit measures of corticospinal excitability. Participants then performed 3 trials of jump landing from a 30-cm box to a distance of 50% of their height, with an immediate rebound to a maximal vertical jump. Each jump-landing trial was video recorded (2-D) and later scored for errors.

Main Outcome Measures:

MVICs normalized to body mass were used to assess strength in the gluteal muscles of the dominant and nondominant limbs. Corticospinal excitability was assessed by means of active motor threshold (AMT) and motor-evoked potentials (MEP) elicited at 120% of AMT. The Landing Error Scoring System (LESS) was used to evaluate jump-landing biomechanics.

Results:

A moderate, positive correlation was found between dominant gluteus maximus MEP and LESS scores (r = .562, P = .029). No other significant correlations were observed for MVIC, AMT, or MEP for the gluteus maximus and gluteus medius, regardless of limb.

Conclusions:

The findings suggest a moderate relationship between dominant gluteus maximus corticospinal excitability and a clinical measure of jump-landing biomechanics. Further research is required to substantiate the findings and expand our understanding of the central nervous system’s role in athletic movement.

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Brian G. Pietrosimone, Adam S. Lepley, Hayley M. Ericksen, Phillip A. Gribble and Jason Levine

Background:

Disability is common in a proportion of patients after anterior cruciate ligament reconstruction (ACL-R). Neuromuscular quadriceps deficits are a hallmark impairment after ACL-R, yet the link between muscle function and disability is not understood.

Purposes:

To evaluate the ability of quadriceps strength and cortical excitability to predict self-reported disability in patients with ACL-R.

Methods:

Fifteen participants with a history of ACL-R (11 female, 4 male; 172 ± 9.8 cm, 70.4 ± 17.5 kg, 54.4 ± 40.9 mo postsurgery) were included in this study. Corticospinal excitability was assessed using active motor thresholds (AMT), while strength was assessed with maximal voluntary isometric contractions (MVIC). Both voluntary strength and corticospinal excitability were used to predict disability measured with the International Knee Documentation Committee Index (IKDC).

Results:

The overall multiple-regression model significantly predicted 66% of the variance in self-reported disability as measured by the IKDC index (R 2 = .66, P = .01). Initial imputation of MVIC into the model accounted for 61% (R 2 = .61, P = .01) of the variance in IKDC. The subsequent addition of AMT into the model accounted for an insignificant increase of 5% (Δ R 2 = .05, P = .19) in the prediction capability of the model.

Conclusions:

Quadriceps voluntary strength and cortical excitability predicted two-thirds of the variance in disability of patients with ACL-R, with strength accounting for virtually all of the predictive capability of the model.

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Sheng Li

This study investigated the possible role of the corticospinal system during force generation and force relaxation. Nine young and healthy subjects were instructed to produce a total force with four fingers within a hand following a preset force generation and relaxation ramp template closely. Excitability of corticospinal (CS) projections was assessed by single- and paired-pulse TMS. Errors introduced by a finger force were partially compensated by other finger forces during force generation, but were amplified during force relaxation. The CS excitability was greater during force generation than maintenance or relaxation. No difference in intracortical inhibition or facilitation was found. Nonnormalized finger extensor EMG responses remained unchanged. The findings suggest that force relaxation is not just a withdrawal from activation, and multifinger interactions are likely controlled beyond the primary motor cortex.

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David B. Copithorne, Davis A. Forman and Kevin E. Power

The purpose of this study was to determine if supraspinal and/or spinal motoneuron excitability of the biceps brachii were differentially modulated before: 1) arm cycling and 2) an intensity-matched tonic contraction. Surface EMG recordings of motor evoked potentials (MEPs) and cervicomedullary motor evoked potentials (CMEPs) were used to assess supraspinal and spinal motoneuron excitability, respectively. MEP amplitudes were larger and onset latencies shorter, before arm cycling and tonic contraction when compared with rest with no intent to move, but with no difference between motor outputs. CMEP amplitudes and onset latencies remained unchanged before cycling and tonic contraction compared with rest. Premovement enhancement of corticospinal excitability was due to an increase in supraspinal excitability that was not task-dependent. This suggests that a common neural drive is used to initiate both motor outputs with task-dependent changes in neural excitability only being evident once the motor outputs have begun.

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Francesca Wightman, Suzanne Delves, Caroline M. Alexander and Paul H. Strutton

Descending bilateral control of external oblique (EO) and latissimus dorsi (LD) was investigated using transcranial magnetic stimulation. Contralateral (CL) motor evoked potential (MEP) thresholds were lower and latencies were shorter than for ipsilateral (IL) MEPs. Hotspots for EO were symmetrical; this was not the case for LD. The volumes of drive to the left and right muscles were not different. The laterality index was not different between the left and right muscles. The average index for the EO muscles was closer to zero than that for LD, suggesting a stronger IL drive to EO. The symmetry of drive to each muscle did not differ; however, the symmetry of drive varies within a subject for different muscles and between subjects for the same muscle. The findings may be useful in understanding a number of clinical conditions relating to the trunk and also for predicting the outcome of rehabilitative strategies.

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Stephen P. Bailey, Julie Hibbard, Darrin La Forge, Madison Mitchell, Bart Roelands, G. Keith Harris and Stephen Folger

purpose of this study is to determine the effects of different forms of CHO MR on quadriceps muscle performance and corticospinal excitability. It is hypothesized that a CHO MR will elicit an increase in corticomotor excitability and an improvement in quadriceps muscle function; however, the type of CHO

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Julie P. Burland, Adam S. Lepley, Marc Cormier, Lindsay J. DiStefano and Lindsey K. Lepley

activity (spinal-reflexive and corticospinal excitability), and quadriceps function (strength and activation) in both early and late ACLR populations. Methods Patients Twenty-nine patients who had sustained a primary, unilateral ACL rupture and subsequently underwent ACLR were recruited from a single

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Matthew Harkey, Michelle McLeod, Ashley Van Scoit, Masafumi Terada, Michael Tevald, Phillip Gribble and Brian Pietrosimone

Context:

Altered neuromuscular function and decreased dorsiflexion range of motion (DFROM) have been observed in patients with chronic ankle instability (CAI). Joint mobilizations are indicated for restoring DFROM and dynamic postural control, yet it remains unknown if a mobilization can alter neuromuscular excitability in muscles surrounding the ankle.

Objective:

To determine the immediate effects of a Maitland grade III anterior-to-posterior joint mobilization on spinal-reflex and corticospinal excitability in the fibularis longus (FL) and soleus (SOL), DFROM, and dynamic postural control.

Design:

Single-blinded randomized control trial.

Setting:

Research laboratory.

Patients:

30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group.

Intervention:

Maitland grade III anterior-to-posterior joint mobilization.

Main Outcome Measures:

Spinal-reflex excitability was measured with the Hoffmann reflex, while corticospinal excitability was evaluated with transcranial magnetic stimulation. DFROM was measured seated with the knee extended, and dynamic postural control was quantified with the Star Excursion Balance Test. Separate 2 × 2 repeated-measures ANOVAs were performed for each outcome measure. Dependent t tests were used to evaluate individual differences within groups in the presence of significance.

Results:

Spinal-reflex and corticospinal excitability of the SOL and FL were not altered in the mobilization or control group (P > .05). DFROM increased immediately after the mobilization (P = .05) but not in the control group, while dynamic postural control was unchanged in both groups (P > .05).

Conclusion:

A single joint-mobilization treatment was efficacious at restoring DFROM in participants with CAI; however, excitability of spinal reflex and corticospinal pathways at the ankle and dynamic postural control were unaffected.

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Sheng Li, Jennifer A. Stevens, Derek G. Kamper and William Z. Rymer

The purpose of this study was to investigate the effect of motor imagery on the premotor time (PMT). Twelve healthy adults performed reaction time movements in response to external visual signals at rest, when holding an object (muscle activation), or performing different background imagined movements (motor imagery). When compared to rest, muscle activation reduced the PMT; imagined finger extension of the right hand and imagined finger flexion of the left hand elongated the PMT; imagined finger flexion of the right hand had no effect on the PMT. This movement-specific effect is interpreted as the sum of the excitatory effect caused by enhanced corticospinal excitability specifically for the primary mover of the imagined movement and an overall inhibition associated with increased task complexity during motor imagery. Our results clearly demonstrate that motor imagery has movement-specific effects on the PMT.