Gait termination : a review of experimental methods and the effects of aging and gait pathologies

The study of human gait has expanded and diversified to the extent that it is now possible to identify a substantive literature concerning a variety of gait tasks, such as gait initiation [Halliday SE, Winter DA, Frank JS, Patla AE, Prince F. The initiation of gait in young, elderly, and Parkinson's disease subjects. Gait Posture 1998;8:8–14; Mickelborough J, van der Linden ML, Tallis RC, Ennos AR. Muscle activity during gait initiation in normal elderly people. Gait Posture 2004;19:50–57], stepping over and across obstacles [Patla AE, Prentice SD, Robinson C, Newfold J. Visual control of locomotion: strategies for changing direction and for going over obstacles. J Exp Psych 1991;17:603–34; Chen, HC, Ashton-Miller JA, Alexander NB, Schultz AB. Effect of age and available response time on ability to step over an obstacle. J Gerontol 1994;49:227–33; Sparrow WA, Shinkfield AJ, Chow S, Begg RK. Gait characteristics in stepping over obstacles. Hum Mov Sci 1996;15:605–22; Begg RK, Sparrow WA, Lythgo ND. Time-domain analysis of foot–ground reaction forces in negotiating obstacles. Gait Posture 1998;7:99–109; Patla AE, Rietdyk S. Visual control of limb trajectory over obstacles during locomotion: effect of obstacle height and width. Gait Posture 1993;1:45–60] negotiating raised surfaces such as curbs and stairs [Begg RK, Sparrow WA. Gait characteristics of young and older individuals negotiating a raised surface: implications for the prevention of falls. J Gerontol Med Sci 2000;55A:147–54; Mcfayden BJ, Winter DA. An integrated biomechanical analysis of normal stair ascent and descent. J Biomech 1988;21:733–44]. In addition, increasing research interest in age-related declines in gait that might predispose individuals to falls has engendered a very extensive literature concerning ageing effects on gait. While rapid locomotor adjustments are common in the course of daily activities there has been no previous review of the findings concerning gait adaptations when walking is terminated both rapidly and unexpectedly. The aims of this review were first, to summarise the key research findings and methodological considerations from studies of termination. The second aim was to demonstrate the effects of ageing and gait pathologies on termination with respect to the regulation of step characteristics, lower-limb muscle activation patterns and foot–ground reaction forces.

Age and walking speed effects on muscle recruitment in gait termination

During gait termination at normal walking speed, older adults more frequently employ two-step responses, increasing their stopping distance and stopping time more than younger controls. This study investigated ageing effects on lower limb muscle recruitment patterns during stopping at three walking speeds. Twelve young male (26±3.7 years, range 19–30) and 12 gender-matched older participants (72±4.3 years, range 65–82) terminated walking at normal, medium and maximum speed. A visual stopping stimulus was presented 10 ms following either left or right heel-contact with no stimulus (catch) on 30% of trials. Electromyographic (EMG) activity was recorded from the tibialis anterior (TA), soleus (SOL), biceps femoris (BF), vastus lateralis (VL) and gluteus medius (GM). Older males more frequently (46% of trials) took two-steps to stop than young males (20%). The stance leg muscles responded significantly faster than the swing leg, and with increased speed, fewer swing limb muscles contributed to stopping. Older males were slower to respond with the stance leg, at 215 ms following the stimulus compared with 176 ms for the younger group. They also recruited fewer swing leg muscles with less frequent activation of the soleus and gluteus medius. Failure to activate muscles would provide less extensor torque to maintain the centre of gravity anterior to the forward base of support. This would decrease the total force opposing horizontal velocity in order to bring the body to rest and, as a consequence, encourage an additional step prior to stopping.

An electromyographic comparison of neck conditioning exercises in healthy controls

The purpose of this study was to compare surface electromyography (EMG) activation levels of selected neck muscles for two common neck-training modalities (Thera-Band and Cybex). Seventeen asymptomatic subjects (eight men and nine women) with a mean age 23.4 years were recruited. EMG activation normalized to maximal voluntary isometric contraction (MVIC) was measured with subjects performing exercises with green, blue, and black Thera-Bands and 50%, 70%, and 90% of 3RM for the Cybex modality. Four variables were used to depict exercise intensity: average and peak EMG activation in the concentric and eccentric phases. Significant differences (P <= 0.05) in EMG activation were evident when comparing intensities of the Cybex modality with each other and when comparing the Cybex intensities with Thera-Band intensities in most cases. Minimal differences were found among differing intensities of Thera-Band. Thera-Band exercise resulted in low-level EMG activation (range, flexion 3.8-15.7% MVIC; range, extension 20.2-34.8% MVIC); therefore, such exercise may be useful in rehabilitation programs. Cybex exercise (range, flexion 20.9-83.5% MVIC; range, extension 40.6-95.8% MVIC) may be useful for occupation-related injury prevention. However, exercise prescription should be undertaken with care as the mechanical loading on passive spinal structures is unknown.

Reliability of surface EMG measurements of the quadriceps during maximal isometric contractions following water immersion

Background: The influence of water immersion on neuromuscular function is of importance to a number of disciplines; however, the reliability of surface electromyography (SEMG) following water immersion is not known. This study examined the reliability of SEMG amplitude during maximal voluntary isometric contractions (MVICs) of the vastus lateralis following water immersion.

Methods: Using a Biodex isokinetic dynamometer and in a randomized order, 12 healthy male subjects performed four MVICs at 60° knee flexion on both the dominant and nondominant kicking legs, and the SEMG was recorded. Each subject's dominant and nondominant kicking leg was then randomly assigned to have SEMG electrodes removed or covered during 15 min of water immersion (20°C–25°C). Following water immersion, subjects performed a further four MVICs.

Results: Intraclass correlation coefficient (ICC) and the relative standard error of measurement (%SEM) of SEMG amplitude showed moderate to high trial-to-trial reliability when electrodes were covered (0.93% and 2.79%) and removed (0.95% and 2.10%, respectively).

Conclusions: The results of the this study indicate that SEMG amplitude of the vastus lateralis may be accurately determined during maximal voluntary contractions following water immersion if electrodes are either removed or covered with water-resistive tape during the immersion.

Examination of EMG normalisation methods for the study of the posterior and posterolateral neck muscles in healthy controls

The purpose of this study was to examine the reliability of normalisation methods used in the study of the posterior and posterolateral neck muscles in a group of healthy controls. Six asymptomatic male subjects performed a total of 12 maximum voluntary isometric contractions (MVIC) and 60%-submaximal isometric contractions (60%-MVIC) against the torque arm of an isokinetic dynamometer whilst surface and intramuscular electromyography (EMG) was recorded unilaterally from representative posterior and posterolateral locations. Reliability was calculated using intra-class correlation coefficient (ICC), relative standard error of measurement (%SEM) and relative coefficient of variation (%CV). Maximal torque output was found to be highly reliable in the directions of extension and right lateral bending when the first of three MVIC contractions was excluded. When averaged across contraction direction, high reliability was found for both surface (MVIC: ICC = 0.986, %SEM = 7.5, %CV = 9.2; 60%-MVIC: ICC = 0.975, %SEM = 10, %CV = 13.7) and intramuscular (MVIC: ICC = 0.910, %SEM = 20, %CV = 19.1; 60%-MVIC: ICC = 0.952, %SEM = 16.5, %CV = 13.5) electrodes. Intramuscular electrodes displayed the least reliability in right lateral bending. The use of visual feedback markedly increased the reliability of 60%-MVIC contractions.

Neck muscle activation and head postures in common high performance aerial combat maneuvers

Introduction: Neck injuries are common in high performance combat pilots and have been attributed to high gravitational forces and the non-neutral head postures adopted during aerial combat maneuvers. There is still little known about the pathomechanics of these injuries.

Methods: Six Royal Australian Air Force Hawk pilots flew a sortie that included combinations of three +Gz levels (1, 3, and 5) and four head postures (Neutral, Turn, Extension, and Check-6). Surface electromyography from neck and shoulder muscles was recorded in flight. Three-dimensional measures of head postures adopted in flight were estimated postflight with respect to end-range of the cervical spine using an electromagnetic tracking device.

Results: Mean muscle activation increased significantly with both increasing +Gz and non-neutral head postures. Check-6 at +5 Gz (mean activation of all muscles = 51% MVIC) elicited significantly greater muscle activation in most muscles when compared with Neutral, Extension, and Turn head postures. High levels of muscle co-contraction were evident in high acceleration and non-neutral head postures. Head kinematics showed Check-6 was closest to end-range in any movement plane (86% ROM in rotation) and produced the greatest magnitude of rotation in other planes. Turn and Extension showed a large magnitude of rotation with reference to end-range in the primary plane of motion but displayed smaller rotations in other planes.

Discussion: High levels of neck muscle activation and co-contraction due to high +Gz and head postures close to end range were evident in this study, suggesting the major influence of these factors on the pathomechanics of neck injuries in high performance combat pilots.

Reliability of normalisation methods for EMG analysis of neck muscles

Acceptable reliability of normalisation contractions in electromyography (EMG) is paramount for testing conducted over a number of days or if normal laboratory strength testing equipment is unavailable. This study examined the reliability of maximal voluntary isometric contractions (MVIC) and sub-maximal (60%) isometric contractions for use in neck muscle EMG studies. Surface EMG was recorded bilaterally from eight sites around the neck at C4/5 level from five healthy male subjects. Subjects performed MVIC and sub-maximal normalisation contractions using an isokinetic dynamometer (ID) and a portable cable dynamometer with attached strain gauge (PCD) in addition to a MVIC against a manual resistance (MR). Subjects were tested in flexion, extension, left and right lateral bending and were retested by the same tester within a two-week period. Intra class correlation co-efficients (ICC) were calculated for each testing method and contraction direction and a mean ICC was calculated across all contraction directions. All normalisation methods produced excellent within-day reliability (mean ICC >0.80) but only the MVICs using the ID and PCD had acceptable reliability when assessed between-days. This study confirmed the validity of using MVICs elicited using the ID and PCD as reliable reference contractions for the normalisation of neck EMG.

Neck exercises compared to muscle activation during aerial combat maneuvers

Introduction: Performing specific neck strengthening exercises has been proposed to decrease the incidence of neck injury and pain in high performance combat pilots. However, there is little known about these exercises in comparison to the demands on the neck musculature in flight.

Methods: Eight male non-pilots performed specific neck exercises using two different modalities (elastic band and resistance machine) at six different intensities in flexion, extension, and lateral bending. Six Royal Australian Air Force Hawk pilots flew a sortie that included combinations of three +Gz levels and four head positions. Surface electromyography (EMG) from selected neck and shoulder muscles was recorded in both activities.

Results: Muscle activation levels recorded during the three elastic band exercises were similar to in-flight EMG collected at +1 Gz (15% MVIC). EMG levels elicited during the 50% resistance machine exercises were between the +3 Gz (9-40% MVIC) and +5 Gz (16-53% MVIC) ranges of muscle activations in most muscles. EMG recorded during 70% and 90% resistance machine exercises were generally higher than in-flight EMG at +5 Gz.

Discussion: Elastic band exercises could possibly be useful to pilots who fly low +Gz missions while 50% resistance machine mimicked neck loads experienced by combat pilots flying high +Gz ACM. The 70% and 90% resistance machine intensities are known to optimize maximal strength but should be administered with care because of the unknown spinal loads and diminished muscle force generating capacity after exercise.

Neurophysiological responses after short-term strength training of the biceps brachii muscle

The neural adaptations that mediate the increase in strength in the early phase of a strength training program are not well understood; however, changes in neural drive and corticospinal excitability have been hypothesized. To determine the neural adaptations to strength training, we used transcranial magnetic stimulation (TMS) to compare the effect of strength training of the right elbow flexor muscles on the functional properties of the corticospinal pathway. Motorevoked potentials (MEPs) were recorded from the right biceps brachii (BB) muscle from 23 individuals (training group; n = 13 and control group; n = 10) before and after 4 weeks of progressive overload strength training at 80% of 1-repetition maximum (1 RM). The TMS was delivered at 10% of the root mean square electromyographic signal (rmsEMG) obtained from a maximal voluntary contraction (MVC) at intensities of 5% of stimulator output below active motor threshold (AMT) until saturation of the MEP (MEP maxl. Strength training resulted in a 28% (p = 0.0001) increase in 1 RM strength, and this was accompanied by a 53% increase (p = 0.05) in the amplitude of the MEP at AMT; 33% (p = 0.05) increase in MEP at 20% above AMT, and a 38% increase at MEPmax (p = 0.04). There were no significant differences in the estimated slope (p = 0.4 7) or peak slope of the stimulus-response curve for the left primary motor cortex (M1) after strength training (p = 0.61). These results demonstrate that heavy-load isotonic strength training alters neural transmission via the corticospinal pathway projecting to the motoneurons controlling BB and in part underpin the strength changes observed in this study.

Change in running kinematics after cycling are related to alterations in running economy in triathletes

Emerging evidence suggests that cycling may influence neuromuscular control during subsequent running but the relationship between altered neuromuscular control and run performance in triathletes is not well understood. The aim of this study was to determine if a 45 min high-intensity cycle influences lower limb movement and muscle recruitment during running and whether changes in limb movement or muscle recruitment are associated with changes in running economy (RE) after cycling. RE, muscle activity (surface electromyography) and limb movement (sagittal plane kinematics) were compared between a control run (no preceding cycle) and a run performed after a 45 min high-intensity cycle in 15 moderately trained triathletes. Muscle recruitment and kinematics during running after cycling were altered in 7 of 15 (46%) triathletes. Changes in kinematics at the knee and ankle were significantly associated with the change in VO₂ after cycling (p < 0.05). The change in ankle angle at foot contact alone explained 67.1% of the variance in VO₂. These findings suggest that cycling does influence limb movement and muscle recruitment in some triathletes and that changes in kinematics, especially at the ankle, are closely related to alterations in running economy after cycling.

Altered movement patterns but not muscle recruitment in moderately trained triathletes during running after cycling

Previous studies have shown that cycling can directly influence neuromuscular control during subsequent running in some highly trained triathletes, despite these triathletes' years of practice of the cycle-run transition. The aim of this study was to determine whether cycling has the same direct influence on neuromuscular control during running in moderately trained triathletes. Fifteen moderately trained triathletes participated. Kinematics of the pelvis and lower limbs and recruitment of 11 leg and thigh muscles were compared between a control run (no prior exercise) and a 30 min run that was preceded by a 15 min cycle (transition run). Muscle recruitment was different between control and transition runs in only one of 15 triathletes (<7%). Changes in joint position (mean difference of 3°) were evident in five triathletes, which persisted beyond 5 min of running in one triathlete. Our findings suggest that some moderately trained triathletes have difficulty reproducing their pre-cycling movement patterns for running initially after cycling, but cycling appears to have little influence on running muscle recruitment in moderately trained triathletes.

Innervation zone shift at different levels of isometric contraction in the biceps brachii muscle

Experiments were carried out to examine whether innervation zone (IZ) location remains stable at different levels of isometric contraction in the biceps brachii muscle (BB), and to determine how the proximity of the IZ affects common surface electromyography (sEMG) parameters. Twelve subjects performed maximal (MVC) and submaximal voluntary isometric contractions at 10%, 20%, 30%, 40%, 50% and 75% of MVC. sEMG signals were recorded with a 13 rows  5 columns grid of electrodes from the short head of BB. The IZ shifted in the proximal direction by up to 2.4 cm, depending upon the subject and electrode column. The mean shift of all the columns was 0.6 ± 0.4 cm (10% vs. 100% MVC, P < 0.001). This shift biased the average values of mean frequency (+21.8 ± 9.9 Hz, P < 0.001), root mean square (0.16 ± 0.15 mV, P < 0.05) and conduction velocity (1.15 ± 0.93 m/s, P < 0.01) in the channels immediately proximal to the IZ. The shift in IZ could be explained by shortening of the muscle fibers, and thus lengthening of the (distal) tendon due to increasing force. These results underline the importance of individual investigation of IZ locations before the placement of sEMG electrodes, even in isometric contractions.

What has transcranial magnetic stimulation taught us about neural adaptations to strength training? A brief review

The evidence for neural mechanisms underpinning rapid strength increases has been investigated and discussed for over 30 years using indirect methods, such as surface electromyography, with inferences made toward the nervous system. Alternatively, electrical stimulation techniques such as the Hoffman reflex, volitional wave, and maximal wave have provided evidence of central nervous system changes at the spinal level. For 25 years, the technique of transcranial magnetic stimulation (TMS) has allowed for noninvasive supraspinal measurement of the human nervous system in a number of areas such as fatigue, skill acquisition, clinical neurophysiology, and neurology. However, it has only been within the last decade that this technique has been used to assess neural changes after strength training. The aim of this brief review is to provide an overview of TMS, discuss specific strength training studies that have investigated changes, after short-term strength training in healthy populations in upper and lower limbs, and conclude with further research suggestions and the application of this knowledge for the strength and conditioning coach.

No difference in 1RM strength and muscle activation during the barbell chest press on a stable and unstable surface

Exercise or Swiss balls are increasingly being used with conventional resistance exercises. There is little evidence supporting the efficacy of this approach compared to traditional resistance training on a stable surface. Previous studies have shown that force output may be reduced with no change in muscle electromyography (EMG) activity while others have shown increased muscle EMG activity when performing resistance exercises on an unstable surface. This study compared 1RM strength, and upper body and trunk muscle EMG activity during the barbell chest press exercise on a stable (flat bench) and unstable surface (exercise ball). After familiarization, 13 subjects underwent testing for 1RM strength for the barbell chest press on both a stable bench and an exercise ball, each separated by at least 7 days. Surface EMG was recorded for 5 upper body muscles and one trunk muscle from which average root mean square of the muscle activity was calculated for the whole 1RM lift and the concentric and eccentric phases. Elbow angle during each lift was recorded to examine any range-of-motion differences between the two surfaces. The results show that there was no difference in 1RM strength or muscle EMG activity for the stable and unstable surfaces. In addition, there was no difference in elbow range-of-motion between the two surfaces. Taken together, these results indicate that there is no reduction in 1RM strength or any differences in muscle EMG activity for the barbell chest press exercise on an unstable exercise ball when compared to a stable flat surface. Moreover, these results do not support the notion that resistance exercises performed on an exercise ball are more efficacious than traditional stable exercises.