Determining the Delay Time of the Muscles Around the Knee Joint in Response to Rotational Perturbation From Support Surface

Introduction: Knee joint injuries usually occur in a short time, so analyzing the mechanism and process of this short time can be helpful to prevent similar injuries. This study aimed to determine and compare the reaction time of knee muscles and investigate the effect of knee position and perturbation direction on the reaction time of knee muscles in response to horizontal rotational perturbation applied to lower leg from support surface area. Materials and Methods: A total of 30 healthy women volunteers were received ±35 degrees of horizontal rotational perturbation and speed of 120 degrees per second from the sole while standing on the right leg in four conditions (external versus internal rotation of surface while the knee was in both extension and flexion position). Electromyography of knee muscles (vastus medialis and lateralis, medial and lateral hamstring and medial and lateral gastrocnemius) was measured to study the reaction time. Results: The reaction time of knee muscles during the perturbation was relatively long in this study (124 to 151 ms). It seems that muscles are recruited simultaneously in most conditions except in external rotation perturbation, with extension knee that the internal gastrocnemius muscle had significantly less delay time than the internal hamstring (P<0.05) and external quadriceps (P<0.05). The results show that most of these muscles do not react selectively and dependently on perturbation direction and knee position in response to horizontal rotational perturbation. Conclusion: In this study, little difference was seen in the reaction time of most knee muscles in all conditions. Thus in response to this type of perturbation, the knee muscles showed co-contraction.

The Stepping Threshold Test for Reactive Balance: Validation of Two Observer-Based Evaluation Strategies to Assess Stepping Behavior in Fall-Prone Older Adults

Introduction: Measurement of reactive balance is critical for fall prevention but is severely underrepresented in the clinical setting due to the lack of valid assessments. The Stepping Threshold Test (STT) is a newly developed instrumented test for reactive balance on a movable platform, however, it has not yet been validated for fall-prone older adults. Furthermore, different schemes of observer-based evaluation seem possible. The aim of this study was to investigate validity with respect to fall risk, interpretability, and feasibility of the STT using two different evaluation strategies.Methods: This study involved 71 fall-prone older adults (aged ≥ 65) who underwent progressively increasing perturbations in four directions for the STT. Single and multiple-step thresholds for each perturbation direction were determined via two observer-based evaluation schemes, which are the 1) consideration of all steps (all-step-count evaluation, ACE) and 2) consideration of those steps that extend the base of support in the direction of perturbation (direction-sensitive evaluation, DSE). Established balance measures including global (Brief Balance Evaluations Systems Test, BriefBEST), proactive (Timed Up and Go, TUG), and static balance (8-level balance scale, 8LBS), as well as fear of falling (Short Falls Efficacy Scale—International, FES-I) and fall occurrence in the past year, served as reference measurements.Results: The sum scores of STT correlated moderately with the BriefBEST (ACE: r = 0.413; DSE: r = 0.388) and TUG (ACE: r = −0.379; DSE: r = −0.435) and low with the 8LBS (ACE: r = 0.173; DSE: r = 0.246) and Short FES-I (ACE: r = −0.108; DSE: r = −0.104). The sum scores did not distinguish between fallers and non-fallers. No floor/ceiling effects occurred for the STT sum score, but these effects occurred for specific STT thresholds for both ACE (mean floor effect = 13.04%, SD = 19.35%; mean ceiling effect = 4.29%, SD = 7.75%) and DSE (mean floor effect = 7.86%, SD = 15.23%; mean ceiling effect = 21.07%, SD = 26.08). No severe adverse events occurred.Discussion: Correlations between the STT and other balance tests were in the expected magnitude, indicating convergent validity. However, the STT could not distinguish between fallers and non-fallers, referring to a need for further studies and prospective surveys of falls to validate the STT. Current results did not allow a definitive judgment on the advantage of using ACE or DSE. Study results represented a step toward a reactive balance assessment application in a clinical setting.

The role of feedback in the production of skilled finger sequences

Actions involving fine control of the hand, for example grasping an object, rely heavily on sensory information from the fingertips. While the integration of feedback during execution of individual movements is well understood, less is known about the use of sensory feedback in the control of skilled movement sequences. To address this gap, we trained participants to produce sequences of finger movements on a keyboard-like device over a four-day training period. Participants received haptic, visual, and auditory feedback indicating the occurrence of each finger press. We then either transiently delayed or advanced the feedback for a single press by a small amount of time (30 or 60 ms). We observed that participants rapidly adjusted their ongoing finger press by either accelerating or prolonging the ongoing press, in accordance with the direction of the perturbation. Furthermore, we could show that this rapid behavioural modulation was driven by haptic feedback. While these feedback-driven adjustments reduced in size with practice, they were still clearly present at the end of training. In contrast to the directionally-specific effect we observed on the perturbed press, a feedback perturbation resulted in a delayed onset of the subsequent presses irrespective of perturbation direction or feedback modality. This observation is consistent with a hierarchical organization of skilled movement sequences, with different levels reacting distinctly to sensory perturbations.

The Effect of Pitch Auditory Feedback Perturbations on the Production of Anticipatory Phrasal Prominence and Boundary

Purpose In this study, we investigated how the direction and timing of a perturbation in voice pitch auditory feedback during phrasal production modulated the magnitude and latency of the pitch-shift reflex as well as the scaling of acoustic production of anticipatory intonation targets for phrasal prominence and boundary. Method Brief pitch auditory feedback perturbations (±200 cents for 200-ms duration) were applied during the production of a target phrase on the first or the second word of the phrase. To replicate previous work, we first measured the magnitude and latency of the pitch-shift reflex as a function of the direction and timing of the perturbation within the phrase. As a novel approach, we also measured the adjustment in the production of the phrase-final prominent word as a function of perturbation direction and timing by extracting the acoustic correlates of pitch, loudness, and duration. Results The pitch-shift reflex was greater in magnitude after perturbations on the first word of the phrase, replicating the results from Mandarin speakers in an American English–speaking population. Additionally, the production of the phrase-final prominent word was acoustically enhanced (lengthened vowel duration and increased intensity and fundamental frequency) after perturbations earlier in the phrase, but more so after perturbations on the first word in the phrase. Conclusion The timing of the pitch perturbation within the phrase modulated both the magnitude of the pitch-shift reflex and the production of the prominent word, supporting our hypothesis that speakers use auditory feedback to correct for immediate production errors and to scale anticipatory intonation targets during phrasal production.

Muscle Contributions to L4-5 Joint Rotational Stiffness following Sudden Trunk Flexion and Extension Perturbations

The purpose of this study was to investigate the contribution of individual muscles (MJRSm) to total joint rotational stiffness (MJRST) about the lumbar spine's L4-5 joint prior to, and following, sudden dynamic flexion or extension perturbations to the trunk. We collected kinematic and surface electromyography (sEMG) data while subjects maintained a kneeling posture on a parallel robotic platform, with their pelvis constrained by a harness. The parallel robotic platform caused sudden inertial trunk flexion or extension perturbations, with and without the subjects being aware of the timing and direction. Prevoluntary muscle forces incorporating both short and medium latency neuromuscular responses contributed significantly to joint rotational stiffness, following both sudden trunk flexion and extension motions. MJRST did not change with perturbation direction awareness. The lumbar erector spinae were always the greatest contributor to MJRST. This indicates that the neuromuscular feedback system significantly contributed to MJRST, and this behaviour likely enhances joint stability following sudden trunk flexion and extension perturbations.

Stability limits modulate whole-body motor learning

Our daily movements exert forces upon the environment and also upon our own bodies. To control for these forces, movements performed while standing are usually preceded by anticipatory postural adjustments (APAs). This strategy is effective at compensating for an expected perturbation, as it reduces the need to compensate for the perturbation in a reactive manner. However, it can also be risky if one anticipates the incorrect perturbation, which could result in movements outside stability limits and a loss of balance. Here, we examine whether the margin for error defined by these stability limits affects the amount of anticipation. Specifically, will one rely more on anticipation when the margin for error is lower? Will the degree of anticipation scale with the margin for error? We took advantage of the asymmetric stability limits (and margins for error) present in the sagittal plane during upright stance and investigated the effect of perturbation direction on the magnitude of APAs. We also compared anticipatory postural control with the anticipatory control observed at the arm. Standing subjects made reaching movements to multiple targets while grasping the handle of a robot arm. They experienced forward or backward perturbing forces depending on the target direction. Subjects learned to anticipate the forces and generated APAs. Although subjects had the biomechanical capacity to adapt similarly in the forward and backward directions, APAs were reduced significantly in the backward direction, which had smaller stability limits and a smaller margin for error. Interestingly, anticipatory control produced at the arm, where stability limits are not as relevant, was not affected by perturbation direction. These results suggest that stability limits modulate anticipatory control, and reduced stability limits lead to a reduction in anticipatory postural control.

Context-Dependent Partitioning of Motor Learning in Bimanual Movements

Human subjects easily adapt to single dynamic or visuomotor perturbations. In contrast, when two opposing dynamic or visuomotor perturbations are presented sequentially, interference is often observed. We examined the effect of bimanual movement context on interference between opposing perturbations using pairs of contexts, in which the relative direction of movement between the two arms was different across the pair. When each perturbation direction was associated with a different bimanual context, such as movement of the arms in the same direction versus movement in the opposite direction, interference was dramatically reduced. This occurred over a short period of training and was seen for both dynamic and visuomotor perturbations, suggesting a partitioning of motor learning for the different bimanual contexts. Further support for this was found in a series of transfer experiments. Having learned a single dynamic or visuomotor perturbation in one bimanual context, subjects showed incomplete transfer of this learning when the context changed, even though the perturbation remained the same. In addition, we examined a bimanual context in which one arm was moved passively and show that the reduction in interference requires active movement. The sensory consequences of movement are thus insufficient to allow opposing perturbations to be co-represented. Our results suggest different bimanual movement contexts engage at least partially separate representations of dynamics and kinematics in the motor system.