Motor unit synchronization is reduced in anterior knee pain

Anterior knee pain (AKP) is common and has been argued to be related to poor patellofemoral joint control due to impaired coordination of the vasti muscles. However, there are conflicting data. Changes in motor unit firing may provide more definitive evidence. Synchronization of motor unit action potentials (MUAPs) in vastus medialis obliquus (VMO) and vastus lateralis (VL) may contribute to coordination in patellofemoral joint control. We hypothesized that synchronization may be reduced in AKP. Recordings of single MUAPs were made from VMO and multiunit electromyograph (EMG) recordings were made from VL. Averages of VL EMG recordings were triggered from the single MUAPs in VMO. Motor units in VL firing in association with the VMO motor units would appear as a peak in the VL EMG average. Data were compared to previous normative data. The proportion of trials in which a peak was identified in the triggered averages of VL EMG was reduced in people with AKP (38%) compared to controls (90%). Notably, although 80% of subjects had values less than controls, 20% were within normal limits. These results provide new evidence that motor unit synchronization is modified in the presence of pain and provide evidence for motor control dysfunction in AKP. Perspective: This study shows that coordination of motor units between the medial and lateral vasti muscles in people with anterior knee pain is reduced compared to people without knee pain. It confirms that motor control dysfunction is a factor in this condition and has implications for selection of rehabilitation strategies. (c) 2005 by the American Pain Society.

Motor unit synchronization between medial and lateral vasti muscles

Objective: Accurate neuromuscular control of the patellofemoral joint is important in knee joint mechanics. Strategies to coordinate the vasti muscles, such as motor unit synchronization, may simplify control of patellar tracking. This study investigated motor unit synchronization between vastus medialis (VM) and lateralis (VL). Methods: Electromyographic (EMG) recordings of single motor unit action potentials (MUAPs) were made from VM and single- and multi-unit recordings were made from VL. Synchronization was quantified from peaks in the cross-correlogram generated from single MUAP pairs in VL and VM. The proportion of motor units in VM with synchronized firing in VL was also quantified from peaks in averages of multiunit VL EMG triggered from the VM MUAP. Results: A high degree of synchronization of motor unit firing between VM and VL was identified. Results were similar for cross-correlation (similar to 45% of cases) and triggered averages (similar to 41% of cases). Conclusions: The data suggest that synchronization between VM and VL is higher than expected. Agreement between traditional cross-correlation and triggered averaging methods suggest that this new technique may provide a more clinically viable method to quantify synchronization. Significance: High synchronization between VM and VL may provide a solution to simplify control of the mechanically unstable patellofemoral joint. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Degrees of freedom and motor planning in purposive movement

This paper presents empirical evidence suggesting that healthy humans can perform a two degree of freedom visuo-motor pursuit tracking task with the same response time delay as a one degree of freedom task. In contrast, the time delay of the response is influenced markedly by the nature of the motor synergy required to produce it. We suggest a conceptual account of this evidence based on adaptive model theory, which combines theories of intermittency from psychology and adaptive optimal control from engineering. The intermittent response planning stage has a fixed period. It possesses multiple optimal trajectory generators such that multiple degrees of freedom can be planned concurrently, without requiring an increase in the planning period. In tasks which require unfamiliar motor synergies, or are deemed to be incompatible, internal adaptive models representing movement dynamics are inaccurate. This means that the actual response which is produced will deviate from the one which is planned. For a given target-response discrepancy, corrective response trajectories of longer duration are planned, consistent with the principle of speed-accuracy trade-off. Compared to familiar or compatible tasks, this results in a longer response time delay and reduced accuracy. From the standpoint of the intermittency approach, the findings of this study help make possible a more integral and predictive account of purposive action. (c) 2005 Elsevier B.V. All rights reserved.

Deceleration affects anticipatory and reactive components of triggered postural responses

Understanding the physiological and psychological factors that contribute to healthy and pathological balance control in man has been made difficult by the confounding effects of the perturbations used to test balance reactions. The present study examined how postural responses were influenced by the acceleration-deceleration interval of an unexpected horizontal translation. Twelve adult males maintained balance during unexpected forward and backward surface translations with two different acceleration-deceleration intervals and presentation orders (serial or random). SHORT perturbations consisted of an initial acceleration (peak acceleration 1.3 m s(-2); duration 300 ms) followed 100 ms later by a deceleration. LONG perturbations had the same acceleration as SHORT perturbations, followed by a 2-s interval of constant velocity before deceleration. Surface and intra-muscular electromyography (EMG) from the leg, trunk, and shoulder muscles were recorded along with motion and force plate data. LONG perturbations induced larger trunk displacements compared to SHORT perturbations when presented randomly and larger EMG responses in proximal and distal muscles during later (500-800 ms) response intervals. During SHORT perturbations, activity in some antagonist muscles was found to be associated with deceleration and not the initial acceleration of the support surface. When predictable, SHORT perturbations facilitated the use of anticipatory mechanisms to attenuate early (100-400 ms) EMG response amplitudes, ankle torque change and trunk displacement. In contrast, LONG perturbations, without an early deceleration effect, did not facilitate anticipatory changes when presented in a predictable order. Therefore, perturbations with a short acceleration-deceleration interval can influence triggered postural responses through reactive effects and, when predictable with repeated exposure, through anticipatory mechanisms.

Postural activity of the abdominal muscles varies between regions of these muscles and between body positions

The abdominal muscles have an important role in control and movement of the lumbar spine and pelvis. Given there is new evidence of morphological and functional differences between distinct anatomical regions of the abdominal muscles, this study investigated whether there are regional differences in postural activity of these muscles and whether recruitment varies between different body positions. Eleven subjects with no history of low back pain that affected function or for which they sought treatment participated in the study. Electromyographic (EMG) activity of the upper, middle and lower regions of transversus abdominis (TrA), the middle and lower regions of obliquus internus abdominis (OI) and the middle region of obliquus externus abdominis (OE) was recorded using intramuscular electrodes. All subjects performed rapid, unilateral shoulder flexion in standing and six subjects also moved their upper limb in sitting. There were regional differences in the postural responses of TrA with limb movement. Notably, the onset of EMG of the upper region was later than that of the lower and middle regions. There were no differences in the EMG onsets of lower and middle TrA or OI. The postural responses of the abdominal muscles were also found to differ between body positions, with recruitment delayed in sitting compared to standing. This study showed that there is regional differentiation in TrA activity with challenges to postural control and that body position influences the postural responses of the abdominal muscles. These results may reflect variation in the contribution of abdominal muscle regions to stability of the trunk. (c) 2004 Elsevier B.V. All rights reserved.

Effect of knee joint angle on motor unit synchronization

Activity of the vasti has been argued to vary through knee range of movement due to changes in passive support of the patellofemoral joint and the relative contribution of these muscles to knee extension. Efficient function of the knee is dependent on optimal control of the patellofemoral joint, largely through coordinated activity of the medial and lateral quadriceps. Motor unit synchronization may provide a mechanism to coordinate the activity of vastus medialis (VMO) and vastus lateralis (VL), and may be more critical in positions of reduced passive support for the patellofemoral joint (i.e., full extension). Therefore, the aim of this study was to determine whether the degree of motor unit synchronization between the vasti muscles is dependent on joint angle. Electromyographic (EMG) recordings of single motor unit action potentials (MUAPs) were made from VMO and multiunit recordings from VL during isometric contractions of the quadriceps at 0 degrees, 30 degrees, and 60 degrees of knee flexion. The degree of synchronization between motor unit firing was evaluated by identification of peaks in the rectified EMG averages of VL, triggered from MUA-Ps in VMO. The proportion of cases in which there was a significant peak in the triggered averages was calculated. There was no significant difference in the degree of synchronization between the vasti at different knee angles (p = 0.57). These data suggest that this basic coordinative mechanism between the vasti muscles is controlled consistently throughout knee range of motion, and is not augmented at specific angles where the requirement for dynamic control of stability is increased. (D 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Illusory changes in head position induced by neck muscle vibration can alter the perception of elbow position

Acuity for elbow joint position sense (JPS) is reduced when head position is modified. Movement of the head is associated with biomechanical changes in the neck and shoulder musculoskeletal system, which may explain changes in elbow JPS. The present study aimed to determine whether elbow JPS is also influenced by illusory changes in head position. Simultaneous vibration of sternocleidomastoid (SCM) and the contralateral splenius was applied to 14 healthy adult human subjects. Muscle vibration or passive head rotation was introduced between presentation and reproduction of a target elbow position. Ten out of 14 subjects reported illusions consistent with lengthening of the vibrated muscles. In these 10 subjects, absolute error for elbow JPS increased with left SCM/right splenius vibration but not with right SCM/left splenius vibration. Absolute error also increased with right rotation, with a trend for increased error with left rotation. These results demonstrated that both actual and illusory changes in head position are associated with diminished acuity for elbow JPS, suggesting that the influence of head position on upper limb JPS depends, at least partially, on perceived head position.

Postural activity of the pelvic floor muscles is delayed during rapid arm movements in women with stress urinary incontinence

The aim of this study was to determine whether postural activity of the pelvic floor (PF) and abdominal muscles differs between continent and incontinent women during rapid arm movements that present a postural challenge to the trunk. A further aim was to study the effect of bladder filling. Electromyographic activity (EMG) of the PF, abdominal, erector spinae (ES), and deltoid muscles was recorded with surface electrodes. During rapid shoulder flexion and extension, PF EMG increased before that of the deltoid in continent women, but after the deltoid in incontinent women (p= 0.002). In many incontinent women, PF EMG decreased before the postural activation. Although delayed, postural PF EMG amplitude was greater in women with incontinence ( p= 0.010). In both groups, PF EMG decreased and abdominal and ES EMG increased when the bladder was moderately full. These findings would be expected to have negative consequences for continence and lumbopelvic stability in women with incontinence.

Reduced variability of postural strategy prevents normalization of motor changes induced by back pain: A risk factor for chronic trouble?

Variability is fundamental to biological systems and is important in posturomotor learning and control. Pain induces a protective postural strategy, although variability is normally preserved. If variability is lost, does the normal postural strategy return when pain stops? Sixteen subjects performed arm movements during control trials, when the movement evoked back pain and then when it did not. Variability in the postural strategy of the abdominal muscles and pain-related cognitions were evaluated. Only those subjects for whom pain induced a reduction in variability of the postural strategy failed to return to a normal strategy when pain stopped. They were also characterized by their pain-related cognitions. Ongoing perception of threat to the back may exert tighter evaluative control over variability of the postural strategy.

Postural control is not systematically related to reading skills:implications for the assessment of balance as a risk factor for developmental dyslexia

Impaired postural control has been associated with poor reading skills, as well as with lower performance on measures of attention and motor control variables that frequently co-occur with reading difficulties. Measures of balance and motor control have been incorporated into several screening batteries for developmental dyslexia, but it is unclear whether the relationship between such skills and reading manifests as a behavioural continuum across the range of abilities or is restricted to groups of individuals with specific disorder phenotypes. Here were obtained measures of postural control alongside measures of reading, attention and general cognitive skills in a large sample of young adults (n = 100). Postural control was assessed using centre of pressure (CoP) measurements, obtained over 5 different task conditions. Our results indicate an absence of strong statistical relationships between balance measures with either reading, cognitive or attention measures across the sample as a whole. © 2014 Loras et al.