The effects of discharge variability on the contractile responses generated by the human leg muscles

Both recruitment and rate coding are well-known mechanisms by which the human nervous system grades muscle force. This thesis has utilised the mechanism of rate coding to generate optimised stimulation patterns that enhance contractile responses in both a fatigued and non-fatigued state. Human motoneurones are known to fire with significant discharge variability (irregularity) during voluntary contractions. Yet many of the mechanisms as to why they fire in this manner, are still unclear. This thesis has tested the hypotheses that integrating physiological variability into trains of stimuli could offer some advantages to the human neuromuscular system that have not yet been explored. We have stimulated single motor axons and multiple motor units with long, short and continuous trains of stimuli that integrate discharge variability. The results reported in this thesis highlight the benefits that discharge irregularity offers to improving contractile responses and reducing fatigue in human leg muscles. While the entirety of this research has been conducted in healthy human subjects, there is a potential for this to translate clinically. Functional electrical stimulation (FES) or neuromuscular stimulation is a well-known therapy utilised after stroke or spinal cord injury to assist in restoring motor function. It can help to reduce muscle atrophy, improve contractility and increase muscle strength by electrically exciting the muscles via surface electrodes directly over the muscle belly. Current FES stimulation patterns often incorporate high frequency, constant-interval stimuli that do not resemble the physiological patterns that are exhibited during normal voluntary contractions. This thesis has used novel stimulation patterns that emulate the firing of volitionally active motoneurones in an attempt to increase contractile responses and reduce the magnitude of muscular fatigue

A DIC based technique to measure the contraction of a skeletal muscle engineered tissue

Tissue engineering is a multidisciplinary science based on the application of engineering approaches to biologic tissue formation. Engineered tissue internal organization represents a key aspect to increase biofunctionality before transplant and, as regarding skeletal muscles, the potential of generating contractile forces is dependent on the internal fiber organization and is reflected by some macroscopic parameters, such as the spontaneous contraction. Here we propose the application of digital image correlation (DIC) as an independent tool for an accurate and noninvasive measurement of engineered muscle tissue spontaneous contraction. To validate the proposed technique we referred to the X-MET, a promising 3-dimensional model of skeletal muscle. The images acquired through a high speed camera were correlated with a custom-made algorithm and the longitudinal strain predictions were employed for measuring the spontaneous contraction. The spontaneous contraction reference values were obtained by studying the force response.The relative error between the spontaneous contraction frequencies computed in both ways was always lower than 0.15%. In conclusion, the use of a DIC based systemallows for an accurate and noninvasive measurement of biological tissues’ spontaneous contraction, in addition to the measurement of tissue strain field on any desired region of interest during electrical stimulation

Muscle fiber typology substantially influences time to recover from high-intensity exercise

Human fast-twitch muscle fi- bers generate high power in a short amount of time but are easily fatigued, whereas slow-twitch fibers are more fatigue resistant. The transfer of this knowledge to coaching is hampered by the invasive nature of the current evaluation of muscle typology by biopsies. Therefore, a noninvasive method was developed to estimate muscle typology through proton magnetic resonance spectroscopy in the gastrocnemius. The aim of this study was to investigate whether male subjects with an a priori-determined fast typology (FT) are character- ized by a more pronounced Wingate exercise-induced fatigue and delayed recovery compared with subjects with a slow typology (ST). Ten subjects with an estimated higher percentage of fast-twitch fibers and 10 subjects with an estimated higher percentage of slow-twitch fibers underwent the test protocol, consisting of three 30-s all-out Wingate tests. Recovery of knee extension torque was evaluated by maximal voluntary contraction combined with electrical stimulation up to 5 h after the Wingate tests. Although both groups delivered the same mean power across all Wingates, the power drop was higher in the FT group (—61%) compared with the ST group (—41%). The torque at maximal voluntary contraction had fully recovered in the ST group after 20 min, whereas the FT group had not yet recovered 5 h into recovery. This noninvasive estimation of muscle typology can predict the extent of fatigue and time to recover following repeated all-out exercise and may have applications as a tool to individualize training and recovery cycles. NEW & NOTEWORTHY A one-fits-all training regime is present in most sports, though the same training implies different stimuli in athletes with a distinct muscle typology. Individualization of training based on this muscle typology might be important to optimize per- formance and to lower the risk for accumulated fatigue and potentially injury. When conducting research, one should keep in mind that the muscle typology of participants influences the severity of fatigue and might therefore impact the results

Comparison of acute physiological effects between alternating current and pulsed current electrical muscle stimulation

Electrical muscle stimulation (EMS) is widely used in rehabilitation and sport training, and alternating current and pulsed current EMS are commonly used. However, no systematic comparison between alternating and pulsed current EMS has been made in the previous studies. The main aim of this research was to compare acute physiological responses between the alternating and pulsed current EMS. The secondary purpose of the research was to investigate further muscle damage induced by EMS-evoked isometric contractions. Three experimental studies were conducted in the thesis project together with literature review about EMS

Development of an apparatus to quantify the volitional muscle performance of rat plantar flexors in vivo

An in vivo animal model was developed to study the effects of voluntary eccentric, concentric, and isometric muscle actions and varying work-rest cycles on muscle performance, behavior, and histological and biochemical response. Using a custom-designed apparatus that was attached to a standard operant chamber, rats were operantly conditioned with food rewards to perform a voluntary lifting task to generate controlled movement of the plantar flexors. An opening in the front panel of the operant chamber allowed the rat to enter a Plexiglas tube that was mounted vertically to restrict the movement of the rat. A load cell was embedded in a platform at the bottom of the tube to measure the dynamic force exerted by the plantar flexors. Inside the tube, a neck ring was supported by a yoke that moved along two vertical shafts via linear bearings. A displacement transducer (LVDT) was attached to the weight pan to measure the range of motion of the lift, and allowed determination of velocity and acceleration of the lifting motion. The apparatus allowed the rat to enter the tube through the opening, insert its neck into the ring, and lift the ring assembly. The entire process was computer automated, and vertical displacement, time during each lift, and dynamic forces exerted during each lift were sampled at 100 Hz via a computer-controlled data acquisition system. This apparatus allows skeletal muscle performance to be studied longitudinally and in a controlled biomechanical environment. The apparatus is well suited to study the effect of chronic voluntary muscle actions and work-rest cycles on behavior and physiological outcomes

Doctor of Philosophy

dissertationParalysis due to spinal cord injury or stroke can leave a person with intact peripheral nerves and muscles, but deficient volitional motor control, thereby reducing their health and quality of life. Functional neuromuscular stimulation (FNS) has been widely studied and employed in clinical devices to aid and restore lost or deficient motor function. Strong, selective, and fatigue-resistant muscle forces can be evoked by asynchronously stimulating small independent groups of motor neurons via multiple intrafascicular electrodes on an implanted Utah slanted electrode array (USEA). Determining the parameters of asynchronous intrafascicular multi-electrode stimulation (aIFMS), i.e., the per-electrode stimulus intensities and the interelectrode stimulus phasing, to evoke precise muscle force or joint motion presents unique challenges because this system has multiple-inputs, the n independently stimulated electrodes, but only one measurable output, the evoked endpoint isometric force or joint position. This dissertation presents three studies towards developing robust real-time control of aIFMS. The first study developed an adaptive feedforward algorithm for selecting aIFMS per-electrode stimulus intensities and interelectrode stimulus phasing to evoke a variety of isometric ankle plantar-flexion force trajectories. In simulation and experiments, desired step, sinusoidal, and more-complex time-varying isometric forces were successfully evoked. The second study developed a closed-loop feedback control method for determining aIFMS per-electrode stimulus intensities to evoke precise single-muscle isometric ankle plantar-flexion force trajectories, in real-time. Using a proportional closed-loop force-feedback controller, desired step, sinusoid, and more complex time-varying forces were evoked with good response characteristics, even in the presence of nonlinear system dynamics, such as muscle fatigue. The third study adapted and extended the closed-loop feedback controller to the more demanding task of controlling joint position in the presence of opposing joint torques. A proportional-plus-velocity-plus-integral (PIV) joint-angle feedback controller evoked and held desired steps in position with responses th a t were stable, consistent, and robust to disturbances. The controller evoked smooth ramp-up (concentric) and ramp-down (eccentric) motion, as well as precise slow moving sinusoidal motion. The control methods developed in this dissertation provide a foundation for new lower-limb FNS-based neuroprostheses that can generate sustained and coordinated muscle forces and joint motions that will be desired by paralyzed individuals on a daily basis. proportional-plus-velocity-plus-integral (PIV) joint-angle feedback controller evoked and held desired steps in position with responses th a t were stable, consistent, and robust to disturbances. The controller evoked smooth ramp-up (concentric) and ramp-down (eccentric) motion, as well as precise slow moving sinusoidal motion. The control methods developed in this dissertation provide a foundation for new lower-limb FNS-based neuroprostheses that can generate sustained and coordinated muscle forces and joint motions that will be desired by paralyzed individuals on a daily basis

New control strategies for neuroprosthetic systems

The availability of techniques to artificially excite paralyzed muscles opens enormous potential for restoring both upper and lower extremity movements with\ud neuroprostheses. Neuroprostheses must stimulate muscle, and control and regulate the artificial movements produced. Control methods to accomplish these tasks include feedforward (open-loop), feedback, and adaptive control. Feedforward control requires a great deal of information about the biomechanical behavior of the limb. For the upper extremity, an artificial motor program was developed to provide such movement program input to a neuroprosthesis. In lower extremity control, one group achieved their best results by attempting to meet naturally perceived gait objectives rather than to follow an exact joint angle trajectory. Adaptive feedforward control, as implemented in the cycleto-cycle controller, gave good compensation for the gradual decrease in performance observed with open-loop control. A neural network controller was able to control its system to customize stimulation parameters in order to generate a desired output trajectory in a given individual and to maintain tracking performance in the presence of muscle fatigue. The authors believe that practical FNS control systems must\ud exhibit many of these features of neurophysiological systems