Muscle activation and cutaneous reflex modulation during rhythmic and discrete arm tasks in orthopaedic shoulder instability

2006 ◽  
Vol 179 (3) ◽  
pp. 339-351 ◽  
Author(s):  
Sandra R. Hundza ◽  
E. Paul Zehr
Keyword(s):  
Shoulder Instability ◽  
Muscle Activation ◽  
Reflex Modulation ◽  
Cutaneous Reflex

scholarly journals Rhythmic arm cycling training improves walking and neurophysiological integrity in chronic stroke: the arms can give legs a helping hand in rehabilitation

2018 ◽  
Vol 119 (3) ◽  
pp. 1095-1112 ◽  
Author(s):  
Chelsea Kaupp ◽  
Gregory E. P. Pearcey ◽  
Taryn Klarner ◽  
Yao Sun ◽  
Hilary Cullen ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Chronic Stroke ◽  
Reflex Modulation ◽  
Walking Ability ◽  
Functional Rehabilitation ◽  
Cutaneous Reflex ◽  
Arm Cycling ◽  
Interlimb Coupling ◽  
Before And After ◽  
Cycling Training

Training locomotor central pattern-generating networks (CPGs) through arm and leg cycling improves walking in chronic stroke. These outcomes are presumed to result from enhanced interlimb connectivity and CPG function. The extent to which rhythmic arm training activates interlimb CPG networks for locomotion remains unclear and was assessed by studying chronic stroke participants before and after 5 wk of arm cycling training. Strength was assessed bilaterally via maximal voluntary isometric contractions in the legs and hands. Muscle activation during arm cycling and transfer to treadmill walking were assessed in the more affected (MA) and less affected (LA) sides via surface electromyography. Changes to interlimb coupling during rhythmic movement were evaluated using modulation of cutaneous reflexes elicited by electrical stimulation of the superficial radial nerve at the wrist. Bilateral soleus stretch reflexes were elicited at rest and during 1-Hz arm cycling. Clinical function tests assessed walking, balance, and motor function. Results show significant changes in function and neurophysiological integrity. Training increased bilateral grip strength, force during MA plantarflexion, and muscle activation. “Normalization” of cutaneous reflex modulation was found during arm cycling. There was enhanced activity in the dorsiflexor muscles on the MA side during the swing phase of walking. Enhanced interlimb coupling was shown by increased modulation of MA soleus stretch reflex amplitudes during arm cycling after training. Clinical evaluations showed enhanced walking ability and balance. These results are consistent with training-induced changes in CPG function and interlimb connectivity and underscore the need for arm training in the functional rehabilitation of walking after neurotrauma.NEW & NOTEWORTHY It has been suggested but not tested that training the arms may influence rehabilitation of walking due to activation of interneuronal patterning networks after stroke. We show that arm cycling training improves strength, clinical function, coordination of muscle activity during walking, and neurological connectivity between the arms and the legs. The arms can, in fact, give the legs a helping hand in rehabilitation of walking after stroke.

scholarly journals Exploiting Interlimb Arm and Leg Connections for Walking Rehabilitation: A Training Intervention in Stroke

2016 ◽  
Vol 2016 ◽  
pp. 1-19 ◽  
Author(s):  
Taryn Klarner ◽  
Trevor S. Barss ◽  
Yao Sun ◽  
Chelsea Kaupp ◽  
Pamela M. Loadman ◽  
...  
Keyword(s):  
Neural Control ◽  
Cost Effective ◽  
Treadmill Walking ◽  
Reflex Modulation ◽  
Walking Ability ◽  
Cutaneous Reflex ◽  
Walking Rehabilitation ◽  
Increased Strength ◽  
Stride Duration ◽  
Cycling Training

Rhythmic arm and leg (A&L) movements share common elements of neural control. The extent to which A&L cycling training can lead to training adaptations which transfer to improved walking function remains untested. The purpose of this study was to test the efficacy of A&L cycling training as a modality to improve locomotor function after stroke. Nineteen chronic stroke (>six months) participants were recruited and performed 30 minutes of A&L cycling training three times a week for five weeks. Changes in walking function were assessed with (1) clinical tests; (2) strength during isometric contractions; and (3) treadmill walking performance and cutaneous reflex modulation. A multiple baseline (3 pretests) within-subject control design was used. Data show that A&L cycling training improved clinical walking status increased strength by ~25%, improved modulation of muscle activity by ~25%, increased range of motion by ~20%, decreased stride duration, increased frequency, and improved modulation of cutaneous reflexes during treadmill walking. On most variables, the majority of participants showed a significant improvement in walking ability. These results suggest that exploiting arm and leg connections with A&L cycling training, an accessible and cost-effective training modality, could be used to improve walking ability after stroke.

scholarly journals Shoulder-Pacemaker Treatment Concept for Posterior Positional Functional Shoulder Instability: A Prospective Clinical Trial

2020 ◽  
Vol 48 (9) ◽  
pp. 2097-2104
Author(s):  
Philipp Moroder ◽  
Fabian Plachel ◽  
Heiko Van-Vliet ◽  
Christiane Adamczewski ◽  
Victor Danzinger
Keyword(s):  
Treatment Effect ◽  
Shoulder Instability ◽  
Conventional Therapy ◽  
Muscle Activation ◽  
Case Series ◽  
Activity Level ◽  
Study Cohort ◽  
Treatment Concept ◽  
Muscle Activation Patterns

Background: Pathological muscle activation patterns of the external rotators and periscapular muscles can result in posterior positional functional shoulder instability (PP-FSI). In several patients, physical therapy and surgical treatment are not successful. Purpose: The shoulder-pacemaker treatment concept was evaluated prospectively in patients with PP-FSI and previously failed conventional therapy attempt. Study Design: Case series; Level of evidence, 4. Methods: A negative selection of 24 consecutive cases of noncontrollable PP-FSI in 16 patients with previously failed conventional therapy were included in this prospective study. The shoulder-pacemaker treatment consisted of an electrical muscle stimulation–based therapy protocol with 9 to 18 one-hour treatment sessions. Two patients were excluded because of nonadherence to the training schedule, leaving a final study cohort of 21 cases in 14 patients. Follow-up included assessment of clinical function, impairment during daily activities and sports, satisfaction, Western Ontario Shoulder Instability Index (WOSI), Rowe score, and Subjective Shoulder Value at 0 weeks, 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and 24 months after intervention. Results: WOSI, Subjective Shoulder Value, and Rowe score showed a highly significant improvement at all time points of follow-up ( P < .001). Young age ( P = .005), low weight ( P = .019), shoulder activity level ( P = .003), unilateral affliction ( P = .046), and higher baseline WOSI score ( P = .04) were associated with a better treatment effect. Cases with increased glenoid retroversion, posterior scapulohumeral decentering, and dysplastic bony glenoid shape showed a trend toward shorter treatment effect duration. No complications during the intervention or follow-up period were observed. Conclusion: The shoulder-pacemaker therapy concept is an effective treatment with rapid improvement and sustained outcome over the course of 2 years in patients with noncontrollable PP-FSI with previously failed conventional treatment. Young and more athletic patients with lower weight and unilateral pathology respond best to the treatment.

Effects of chronic ankle instability on cutaneous reflex modulation during walking

2019 ◽  
Vol 237 (8) ◽  
pp. 1959-1971 ◽  
Author(s):  
Leif P. Madsen ◽  
Koichi Kitano ◽  
David M. Koceja ◽  
E. Paul Zehr ◽  
Carrie L. Docherty
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Reflex Modulation ◽  
Cutaneous Reflex

scholarly journals Bipedal reflex coordination to tactile stimulation of the sural nerve during human running

1995 ◽  
Vol 73 (5) ◽  
pp. 1947-1964 ◽  
Author(s):  
A. A. Tax ◽  
B. M. Van Wezel ◽  
V. Dietz
Keyword(s):  
Sural Nerve ◽  
Elementary Property ◽  
Emg Activity ◽  
Reflex Modulation ◽  
Step Cycle ◽  
Perception Threshold ◽  
Reflex Responses ◽  
Cutaneous Reflex ◽  
Human Running ◽  
Stimulation Of

1. Cutaneous reflex responses were elicited during human running (8 km/h) on a treadmill by electrical stimulation of the sural nerve at the ankle. Stimulus trains (5 pulses of 1 ms at 200 Hz) at three nonnociceptive intensities, which were 1.5, 2.0, and 2.5 times perception threshold (PT), were delivered at 16 phases of the step cycle. For 11 subjects the surface electromyographic (EMG) activity of both the ipsilateral and contralateral long head of the biceps femoris (iBF and cBF, respectively), the semitendinosus (iST and cST), the rectus femoris (iRF and cRF), and the tibialis anterior (iTA and cTA) were recorded. 2. During human running nonnociceptive sural nerve stimulation appears to be sufficient to elicit large, widespread and statistically significant reflex responses, with a latency of approximately 80 ms and a duration of approximately 30 ms. These reflex responses seem to be an elementary property of human locomotion. This is indicated by the occurrence of the responses in all subjects, the consistency of most of the reflex patterns across the subjects and, apart from a small amount of habituation, the reproducibility of the responses during the course of the experiment. 3. The responses are modulated continuously throughout the step cycle such that their magnitude does not in general covary with the background locomotor activities. This is observed most clearly in iST, iTA, and cTA for which statistically significant reflex reversals are demonstrated, and in cRF and cTA for which the responses are gated during most of the step cycle. 4. The response magnitude generally increases as a function of increasing intensity, whereas the phase-dependent reflex modulation is intensity independent. 5. A functional dissociation within the ipsilateral hamstring muscles is demonstrated: the iBF and iST show an antagonistic reflex pattern (facilitatory and suppressive, respectively) during the periods of synergistic background locomotor activity in the step cycle. Contralaterally, however, the cBF and cST are reflexively activated as close synergists during these periods. 6. The reflex responses and their phase-dependent modulation are different for the homologous muscles in the two legs. Yet, some similarities are observed. These are present rather with respect to the phase of the corresponding leg than with respect to the phase of the stimulated leg. Both observations suggest that the phase-dependent reflex modulation is controlled separately in the ipsilateral and contralateral legs. 7. The response simultaneity in all investigated muscles supports the notion of a coordinated cutaneous interlimb reflex during human running.(ABSTRACT TRUNCATED AT 400 WORDS)

scholarly journals Muscle activation patterns in patients with recurrent shoulder instability

2012 ◽  
Vol 6 (4) ◽  
pp. 101 ◽  
Author(s):  
Ali Noorani ◽  
Alex Malone ◽  
Simon Lambert ◽  
Ian Bayley ◽  
Joseph Cowan ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Muscle Activation ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Recurrent Shoulder Instability

Prior experience does not alter modulation of cutaneous reflexes during manual wheeling and symmetrical arm cycling

2013 ◽  
Vol 109 (9) ◽  
pp. 2345-2353 ◽  
Author(s):  
Megan K. MacGillivray ◽  
Marc Klimstra ◽  
Bonita Sawatzky ◽  
E. Paul Zehr ◽  
Tania Lam
Keyword(s):  
Amplitude Modulation ◽  
Reflex Response ◽  
Reflex Modulation ◽  
Cutaneous Reflexes ◽  
Triceps Brachii ◽  
Reflex Amplitude ◽  
Cutaneous Reflex ◽  
Arm Cycling ◽  
Cyclic Movements ◽  
Middle Latency

Previous research has reported that training and experience influence H-reflex amplitude during rhythmic activity; however, little research has yet examined the influence of training on cutaneous reflexes. Manual wheelchair users (MWUs) depend on their arms for locomotion. We postulated that the daily dependence and high amount of use of the arms for mobility in MWUs would show differences in cutaneous reflex modulation during upper limb cyclic movements compared with able-bodied control subjects. We hypothesized that MWUs would demonstrate increased reflex response amplitudes for both manual wheeling and symmetrical arm cycling tasks. The superficial radial nerve was stimulated randomly at different points of the movement cycle of manual wheeling and symmetrical arm cycling in MWUs and able-bodied subjects naive to wheeling. Our results showed that there were no differences in amplitude modulation of early- or middle-latency cutaneous reflexes between the able-bodied group and the MWU group. However, there were several differences in amplitude modulation of cutaneous reflexes between tasks (manual wheeling and symmetrical arm cycling). Specifically, differences were observed in early-latency responses in the anterior and posterior deltoid muscles and biceps and triceps brachii as well as in middle-latency responses in the anterior and posterior deltoid. These data suggest that manual wheeling experience does not modify the pattern of cutaneous reflex amplitude modulation during manual wheeling. The differences in amplitude modulation of cutaneous reflexes between tasks may be a result of mechanical differences (i.e., hand contact) between tasks.

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