Estimates of persistent inward current in human motor neurons during postural sway

Persistent inward current (PIC) is a membrane property critical for increasing gain of motor neuron output. In humans, most estimates of PIC are made from plantarflexor or dorsiflexor motor units with the participant in a seated position with the knee flexed. This seated and static posture neglects the task-dependent nature of the monoaminergic drive that modulates PIC activation. Seated estimates may drastically underestimate the amount of PIC that occurs in human motor neurons during functional movement. The current study estimated PIC using the conventional paired motor unit technique which uses the difference between reference unit firing frequency at test unit recruitment and reference unit firing frequency at test unit de-recruitment (∆F) during triangular-shaped, isometric ramps in plantarflexion force as an estimate of PIC. Estimates of PIC were also made during standing anterior postural sway, a postural task that elicits a ramped increase and decrease in soleus motor unit activation similar to the conventional seated ramp contractions. For each motor unit pair, ∆F estimates of PIC made during conventional isometric ramps in the seated posture were compared to those made during standing postural sway. Baseline reciprocal inhibition (RI) was also measured in each posture using the post-stimulus time histogram (PSTH) technique. Hyperpolarizing input has been shown to have a reciprocal relationship with PIC in seated posture and RI was measured to examine if the same reciprocal relationship holds true during functional PIC estimation. It was hypothesized that an increase in ∆F would be seen during standing compared to sitting due to greater neuromodulatory input. We found that ∆F estimates during standing postural sway were equal (2.44 ± 1.17, p=0.44) to those in seated PIC estimates (2.73± 1.20) using the same motor unit pair. Reciprocal inhibition was significantly lower when measured in a standing posture (0.0031 ± 0.0251,

Effect of cadence on locomotor–respiratory coupling during upper-body exercise

Introduction: Asynchronous arm-cranking performed at high cadences elicits greater cardiorespiratory responses compared to low cadences. This has been attributed to increased postural demand and locomotor–respiratory coupling (LRC), and yet, this has not been empirically tested. This study aimed to assess the effects of cadence on cardiorespiratory responses and LRC during upper-body exercise. Methods: Eight recreationally-active men performed arm-cranking exercise at moderate and severe intensities that were separated by 10 min of rest. At each intensity, participants exercised for 4 min at each of three cadences (50, 70, and 90 rev min−1) in a random order, with 4 min rest-periods applied in-between cadences. Exercise measures included LRC via whole- and half-integer ratios, cardiorespiratory function, perceptions of effort (RPE and dyspnoea), and diaphragm EMG using an oesophageal catheter. Results: The prevalence of LRC during moderate exercise was highest at 70 vs. 50 rev min−1 (27 ± 10 vs. 13 ± 9%, p = 0.000) and during severe exercise at 90 vs. 50 rev min−1 (24 ± 7 vs. 18 ± 5%, p = 0.034), with a shorter inspiratory time and higher mean inspiratory flow (p < 0.05) at higher cadences. During moderate exercise, (Formula presented.) and fC were higher at 90 rev min−1 (p < 0.05) relative to 70 and 50 rev min−1 ((Formula presented.) 1.19 ± 0.25 vs. 1.05 ± 0.21 vs. 0.97 ± 0.24 L min−1; fC 116 ± 11 vs. 101 ± 13 vs. 101 ± 12 b min−1), with concomitantly elevated dyspnoea. There were no discernible cadence-mediated effects on diaphragm EMG. Conclusion: Participants engage in LRC to a greater extent at moderate-high cadences which, in turn, increase respiratory airflow. Cadence rate should be carefully considered when designing aerobic training programmes involving the upper-limbs

Respiratory mechanics during upper body exercise in healthy humans

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThe physiological responses to upper-body exercise (UBE) are well established. Few published studies, however, have attempted to elucidate the mechanical ventilatory responses to UBE. There is empirical evidence that respiratory function may be compromised by UBE during which the ventilatory and postural functions of the ‘respiratory’ muscles may be exacerbated. Therefore, the aims of this thesis were: 1) to characterise the mechanical-ventilatory responses to UBE in healthy subjects; 2) to explore the putative mechanisms that underpin the respiratory responses to UBE; and 3) to assess whether the mechanical-ventilatory stress imposed by UBE induces contractile fatigue of the respiratory muscles. Compared to lower-body exercise (LBE; leg cycling) at ventilation-matched work rates, UBE (arm-cranking) resulted in constraint of tidal volume, higher respiratory frequency, and greater neural drive to the respiratory muscles. Furthermore, end-expiratory lung volume was significantly elevated during peak UBE compared to LBE (39 ± 8 vs. 29 ± 8% vital capacity, p 0.05). In conclusion, mechanical-ventilatory function may be compromised during UBE due to complex interactions between thoracic muscle recruitment, central neural drive and thoracic volume displacement. This thesis presents novel findings which may have important functional implications for clinical populations who report breathlessness during activities of daily living that involve the upper-body, as well a

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction

There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report.This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Before opening up for comments on the webpages of ICS and IUGA, five experts from physiotherapy, neurology, urology, urogynecology, and nursing were invited to comment on the paper.A Terminology Report on the conservative management of female pelvic floor dysfunction, encompassing over 200 separate definitions, has been developed. It is clinically based, with the most common symptoms, signs, assessments, diagnoses, and treatments defined. Clarity and ease of use have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Ongoing review is not only anticipated, but will be required to keep the document updated and as widely acceptable as possible.A consensus-based terminology report for the conservative management of female pelvic floor dysfunction has been produced, aimed at being a significant aid to clinical practice and a stimulus for research

THE RELATIONSHIP BETWEEN MUSCULOSKELETAL STRENGTH, PHYSIOLOGICAL CHARACTERISTICS, AND KNEE KINESTHESIA FOLLOWING FATIGUING EXERCISE

Fatiguing exercise may result in impaired functional joint stability and increased risk of unintentional injury. While there are several musculoskeletal and physiological characteristics related to fatigue onset, their relationship with proprioceptive changes following fatigue has not been examined. The purpose of this study was to establish the relationship between musculoskeletal and physiological characteristics and changes in proprioception, measured by threshold to detect passive motion (TTDPM), following fatiguing exercise. Twenty, physically active females participated (age: 28.65 ± 5.6 years, height: 165.6 ± 4.3 cm, weight: 61.8 ± 8.0 kg, BMI: 22.5± 2.3 kg/m2, BF: 23.3 ± 5.4%). During Visit 1, subjects completed an exercise history and 24-hour dietary questionnaire, and body composition, TTDPM familiarization, isokinetic knee strength, and maximal oxygen uptake/lactate threshold assessments. During Visit 2, subjects completed TTDPM and isometric knee strength testing prior to and following a fatiguing exercise protocol. Wilcoxon signed rank tests determined TTDPM and isometric knee strength changes from pre- to post- fatigue. Spearman’s rho correlation coefficients determined the relationship between strength and physiological variables with pre- to post-fatigue changes in TTDPM and with pre-fatigue and post-fatigue TTDPM in extension and flexion (α=0.05). No significant differences were demonstrated from pre-fatigue to post-fatigue TTDPM despite a significant decrease in isometric knee flexion strength (P<0.01) and flexion/extension ratio (P<0.05) following fatigue. No significant correlations were observed between strength or physiological variables and changes in TTDPM from pre- to post-fatigue in extension or flexion. Flexion/extension ratio was significantly correlated with pre-fatigue TTDPM in extension (r=-0.231, P<0.05). Peak oxygen uptake was significantly correlated with pre-fatigue (r=-0.500, P<0.01) and post-fatigue (r=-0.520, P<0.05) TTDPM in extension. No significant relationships were demonstrated between musculoskeletal and physiological characteristics and changes in TTDPM following fatigue. The results suggest that highly trained individuals may have better proprioception, and that the high fitness level of subjects in this investigation may have contributed to absence of TTDPM deficits following fatigue despite reaching a high level of perceptual and physiological fatigue. Future studies should consider various subject populations, other musculoskeletal strength characteristics, and different modalities of proprioception to determine the most important contributions to proprioceptive changes following fatigue

A neurophysiological examination of voluntary isometric contractions: modulations in sensorimotor oscillatory dynamics with contraction force and physical fatigue, and peripheral contributions to maximal force production

Human motor control is a complex process involving both central and peripheral components of the nervous system. Type Ia afferent input contributes to both motor unit recruitment and firing frequency, however, whether maximal force production is dependent on this input is unclear. Therefore, chapter 2 examined maximal and explosive force production of the knee extensors following prolonged infrapatellar tendon vibration; designed to attenuate the efficacy of the homonymous Ia afferent-α-motoneuron pathway. Despite a marked decrease in H-reflex amplitude, indicating an attenuated efficacy of the Ia afferent-α-motoneuron pathway, both maximal and explosive force production were unaffected after vibration. This suggested that maximal and explosive isometric quadriceps force production was not dependent upon Ia afferent input to the homonymous motor unit pool. Voluntary movements are linked with various modulations in ongoing neural oscillations within the supraspinal sensorimotor system. Despite considerable interest in the oscillatory responses to movements per se, the influence of the motor parameters that define these movements is poorly understood. Subsequently, chapters 3 and 4 investigated how the motor parameters of voluntary contractions modulated the oscillatory amplitude. Chapter 3 recorded electroencephalography from the leg area of the primary sensorimotor cortex in order to investigate the oscillatory responses to isometric unilateral contractions of the knee-extensors at four torque levels (15, 30, 45 and 60% max.). An increase in movement-related gamma (30-50 Hz) activity was observed with increments in knee-extension torque, whereas oscillatory power within the delta (0.5-3 Hz), theta (3-7 Hz), alpha (7-13 Hz) and beta (13-30 Hz) bands were unaffected. Chapter 4 examined the link between the motor parameters of voluntary contraction and modulations in beta (15-30 Hz) oscillations; specifically, movement-related beta decrease (MRBD) and post-movement beta rebound (PMBR). Magnetoencephalography (MEG) was recorded during isometric ramp and constant-force wrist-flexor contractions at distinct rates of force development (10.4, 28.9 and 86.7% max./s) and force output (5, 15, 35 and 60%max.), respectively. MRBD was unaffected by RFD or force output, whereas systematic modulation of PMBR by both contraction force and RFD was identified for the first time. Specifically, increments in isometric contraction force increased PMBR amplitude, and increments in RFD increased PMBR amplitude but decreased PMBR duration. Physical fatigue arises not only from peripheral processes within the active skeletal muscles but also from supraspinal mechanisms within the brain. However, exactly how cortical activity is modulated during fatigue has received a paucity of attention. Chapter 5 investigated whether oscillatory activity within the primary sensorimotor cortex was modulated when contractions were performed in a state of physical fatigue. MEG was recorded during submaximal isometric contractions of the wrist-flexors performed both before and after a fatiguing series of isometric wrist-flexions or a time matched control intervention. Physical fatigue offset the attenuation in MRBD observed during the control trial, whereas PMBR was increased when submaximal contractions were performed in a fatigued state

Mechanomyographic Parameter Extraction Methods: An Appraisal for Clinical Applications

The research conducted in the last three decades has collectively demonstrated that the skeletal muscle performance can be alternatively assessed by mechanomyographic signal (MMG) parameters. Indices of muscle performance, not limited to force, power, work, endurance and the related physiological processes underlying muscle activities during contraction have been evaluated in the light of the signal features. As a non-stationary signal that reflects several distinctive patterns of muscle actions, the illustrations obtained from the literature support the reliability of MMG in the analysis of muscles under voluntary and stimulus evoked contractions. An appraisal of the standard practice including the measurement theories of the methods used to extract parameters of the signal is vital to the application of the signal during experimental and clinical practices, especially in areas where electromyograms are contraindicated or have limited application. As we highlight the underpinning technical guidelines and domains where each method is well-suited, the limitations of the methods are also presented to position the state of the art in MMG parameters extraction, thus providing the theoretical framework for improvement on the current practices to widen the opportunity for new insights and discoveries. Since the signal modality has not been widely deployed due partly to the limited information extractable from the signals when compared with other classical techniques used to assess muscle performance, this survey is particularly relevant to the projected future of MMG applications in the realm of musculoskeletal assessments and in the real time detection of muscle activity

Muscular Properties and Balance Control in Older Adults

The goal of this dissertation was to understand the role of age-related changes in muscle mechanical properties in the control of upright posture in humans. First, a methodology for estimating subject-specific muscle properties in healthy young and older individuals was developed. Magnetic resonance and ultrasound imaging were used in conjunction with dynamometer experiments, musculoskeletal modeling, and numerical optimization to estimate the properties of the dorsiflexor and individual plantarflexor (gastrocnemius and soleus) muscles for 12 young and 12 older adults (balanced for gender). With aging there were declines in maximal isometric strength and increases in series-elastic stiffness in the male subjects, but no differences in the female subjects. Regardless of gender, there were age-related changes in the shape of the force-velocity relation, such that the older subjects produced less relative force during both concentric and eccentric muscle contractions. The second study tested the balance abilities of the same subjects under a variety of static (quiet stance, leaning forward/backward) and dynamic (swaying at preferred/imposed frequencies, maximal reaching, external perturbation) conditions. The older adults performed more poorly on most of the balance tasks. While maximal isometric force made a smaller than expected contribution to predicting balancing ability, the force-length, force-velocity and force-extension properties of the muscles were all predictive of the age-related declines in balance control, explaining ~40% of the variance as independent predictors and ~50% when these factors were combined. Finally, a feedback-driven inverted pendulum model of postural control was developed, which incorporated realistic representations of young and old dorsiflexor and individual plantarflexor muscles using the previously estimated mechanical properties. A sensitivity analysis was performed by manipulating the properties of the plantarflexor muscles. The balancing ability of the model was most influenced by the optimal length of the contractile component and the slack length of the series elastic component of the plantarflexor muscle models. The quiet stance model highlighted the importance of the force-length relation of muscle to the stabilization of upright posture. This dissertation demonstrated that there are age-related changes in the dorsi- and plantarflexor mechanical properties, and these changes are associated with the declines in postural control that accompany aging

다중손가락 과제 수행 시 인간의 감각 및 인지 처리 과정의 정량화

학위논문 (박사) -- 서울대학교 대학원 : 사범대학 체육교육과, 2021. 2. 박재범.The continuously varied states of human body and surrounding environment require instantaneous motor adaptations and the understanding of motor goal to achieve desired actions. These sensory and cognitive processes have been investigated as elements in motor control during last five decades. Specially, the task dependency on sensory and cognitive processes suggest the effects of movement properties in terms of environment situation and motor goal. However, these effects were mostly empirically summarized with the measurements of either neural activity or simple motor accomplishment unilaterally. The current thesis addresses the quantification of sensory and cognitive processes based on simultaneous measurements of brain activity and synergic motor performance during multi-digit actions with different movement properties. Multi-digit action as a representation of synergic movements has developed into a widespread agency to quantify the efficacy of motor control, as the reason applied in this thesis. In this thesis, multi-digit rotation and pressing tasks were performed with different movement directions, frequencies, feedback modalities, or task complexities. (Chapter 3) The changes of movement direction induced a decrease in motor synergy but regardless of which direction. (Chapter 4 and 5) Increased frequency of rhythmic movement reduced synergic motor performance associate with decreased sensory process and less efficient cognitive process. (Chapter 6) More comprehensive feedback modality improved synergic performance with increased sensory process. (Chapter 7) Increased movement complexity had a consistent but stronger effect as increased frequency on synergic performance and efficiency of cognitive process. These observations suggest that several movement properties affect the contributions of sensory and cognitive processes to motor control which can be quantified through either neural activity or synergic motor performance. Accordingly, those movement properties may be applied in the rehabilitation of motor dysfunction by developing new training programs or assistant devices. Additionally, it may be possible to develop a simplified while efficient method to estimate the contribution of sensory or cognitive process to motor control.시시각각으로 변화하는 신체 상태와 주변 환경의 상호작용 속에서 알맞은 움직임을 수행하기 위해서는 그에 따른 즉각적인 운동 적응(motor adaptation) 과정와 과제 목표에 대한 이해가 필요하다. 이를 위해 인간의 감각 및 인지 처리과정은 운동 제어 분야의 중요한 요소로 여겨졌다. 선행연구에 따르면, 운동 과제에 따라 변화하는 감각 및 인지 처리과정은 주변 환경과 과제의 목표에 따라 움직임의 특성에 영향을 미친다고 보고되어왔다. 그러나 이러한 영향은 대부분 단순한 운동과제 수행 결과 또는 측정된 신경 활동에 의해 경험적으로 요약된 결과에 국한되어 있다. 따라서 본 논문은 다양한 움직임 특성을 가진 다중 손가락 과제 수행 시, 뇌 활동 (Brain activity)과 더불어 손가락들 간의 협응적인 움직임의 수행 결과를 동시 측정하여 과제의 특성에 따른 감각 및 인지 처리과정의 변화를 분석했다. 다중 손가락 과제는 운동 제어의 성능 효율성을 정량화하기 위해 사용되는 대표적인 과제다. 본 논문에서는 다양한 조건의 움직임 방향, 움직임의 주기빈도, 감각 피드백 양식 또는 과제 난이도에 따른 다중 손가락 회전 동작 및 힘 생성 과제를 사용했다. 연구 결과로는, (문단 3) 움직임 방향이 변화하기 전에 변화할 방향에 상관없이 협응적인 움직임이 악화되었다. (문단 4와 5) 움직임의 주기빈도가 증가할수록 협응적인 움직임이 악화됐으며, 이와 관련된 감각 및 인지 처리과정의 효율성도 감소되었다. (문단 6) 단일 감각 피드백 제공조건에 비해 종합적인 감각 피드백은 증가된 감각 처리과정과 함께 협응적인 움직임을 향상시켰다. (문단 7) 과제의 난이도가 증가할수록 협응적인 움직임과 인지 처리과정의 효율성은 감소되었으며, 움직임의 주기빈도 조건에 비해 과제의 난이도에 따라 협응적인 움직임과 인지 처리과정에 미치는 영향은 상대적으로 더 크게 나타났다. 이러한 결과는 움직임 특성에 따른 뇌 활동과 협응적인 과제 수해 결과를 통해 운동 제어 과정에서 감각 및 인지 처리과정의 기여정도를 정량화할 수 있다는 점을 시사한다. 따라서 움직임 특성에 따른 감각 및 인지 처리 과정의 기여정도의 변화는 운동 기능 장애를 가진 사람들의 새로운 재활 훈련 프로그램 및 움직임 보조 장치를 개발하기 위한 실험적인 근거로 적용될 수 있다. 또한 감각 또는 인지 과정이 운동 제어에 미치는 영향을 추정하기 위한 효율적인 방법을 개발하는데 도움이 될 것이다.Chapter 1. Introduction 1 1.1 Problem statement 1 1.2 Study objective 2 1.3 Organization of dissertation 3 Chapter 2. Background 6 2.1 Motor system 6 2.1.1 Ascending pathway 6 2.1.2 Descending pathway 8 2.1.3 Brain networks 9 2.2 Motor synergy 11 2.2.1 Synergy in performance 12 2.2.2 Synergy in muscles 13 2.2.3 Synergy in neurons 14 2.3 Motor control 15 2.1.1 Sensory process 16 2.1.2 Cognitive process 19 Chapter 3. Effect of movement direction: Multi-Finger Interaction and Synergies in Finger Flexion and Extension Force Production 23 3.1 Abstract 23 3.2 Introduction 24 3.3 Method 28 3.4 Results 35 3.4.1 Maximal voluntary contraction (MVC) force and finger independency 36 3.4.2 Timing indices 37 3.4.3 Multi-finger synergy indices in mode space 39 3.4.4 Multi-finger synergy indices in force space 43 3.5 Discussion 44 3.5.1 Finger independency during finger flexion and extension 44 3.5.2 Multi-finger synergies in force and mode spaces 46 3.5.3 Anticipatory synergy adjustment 48 Chapter 4. Effect of Frequency: Brain Oxygenation Magnitude and Mechanical Outcomes during Multi-Digit Rhythmic Rotation Task 51 4.1 Abstract 51 4.2 Introduction 51 4.3 Methods 55 4.4 Results 61 4.4.1 PET imaging 61 4.4.2 Finger forces 62 4.4.3 UCM analysis 64 4.4.4 Correlation between neural activation and mechanics 65 4.5 Discussion 66 4.5.1 Regions involved in feedback 67 4.5.2 Regions involved in feedforward 69 4.5.3 Corporation of feedforward and feedback 71 4.6 Conclusions 72 Chapter 5. Effect of frequency: Prefrontal Cortex Oxygenation during Multi-Digit Rhythmic Pressing Actions using fNIRS 74 5.1 Abstract 74 5.2 Introduction 74 5.3 Method 77 5.4 Results 84 5.4.1 Performance 84 5.4.2 Multi-digit coordination indices 84 5.4.3 Functional connectivity (FC) 87 5.5 Discussion 88 5.6 Conclusion 91 Chapter 6. Effect of Sensory Modality: Multi-Sensory Integration during Multi-Digit Rotation Task with Different Frequency 92 6.1 Abstract 92 6.2 Introduction 92 6.3 Method 94 6.4 Results 100 6.4.1 Performance 100 6.4.2 Multi-digit coordination indices 101 6.5 Discussion 101 6.6 Conclusion 103 Chapter 7. Effect of Task Complexity: Prefrontal Cortex Oxygenation during Multi-Digit Pressing Actions with Different Frequency Components 104 7.1 Abstract 104 7.2 Introduction 104 7.3 Method 106 7.4 Results 112 7.4.1 Performance 112 7.4.2 Multi-finger coordination indices 113 7.4.3 Functional connectivity (FC) 114 7.5 Discussion 115 7.5.1 Relation between Frequency and task complexity 115 7.5.2 Cognitive process in motor control 116 7.5.3 Relation between motor coordination and cognitive process 118 7.6 Conclusion 119 Chapter 8. Conclusions and Future Work 120 8.1 Summary of conclusions 120 8.2 Future work 121 Bibliography 122 Abstract in Korean 160Docto