Modulation of Stretch Reflexes of the Finger Flexors by Sensory Feedback from the Proximal Upper Limb Poststroke

Neural coupling of proximal and distal upper limb segments may have functional implications in the recovery of hemiparesis after stroke. The goal of the present study was to investigate whether the stretch reflex response magnitude of spastic finger flexor muscles poststroke is influenced by sensory input from the shoulder and the elbow and whether reflex coupling of muscles throughout the upper limb is altered in spastic stroke survivors. Through imposed extension of the metacarpophalangeal (MCP) joints, stretch of the relaxed finger flexors of the four fingers was imposed in 10 relaxed stroke subjects under different conditions of proximal sensory input, namely static arm posture (3 different shoulder/elbow postures) and electrical stimulation (surface stimulation of biceps brachii or triceps brachii, or none). Fast (300°/s) imposed stretch elicited stretch reflex flexion torque at the MCP joints and reflex electromyographic (EMG) activity in flexor digitorum superficialis. Both measures were greatest in an arm posture of 90° of elbow flexion and neutral shoulder position. Biceps stimulation resulted in greater MCP stretch reflex flexion torque. Fast imposed stretch also elicited reflex EMG activity in nonstretched heteronymous upper limb muscles, both proximal and distal. These results suggest that in the spastic hemiparetic upper limb poststroke, sensorimotor coupling of proximal and distal upper limb segments is involved in both the increased stretch reflex response of the finger flexors and an increased reflex coupling of heteronymous muscles. Both phenomena may be mediated through changes poststroke in the spinal reflex circuits and/or in the descending influence of supraspinal pathways

Identifying intrinsic and reflexive contributions to low-back stabilization

Motor control deficits have been suggested as potential cause and/or effect of a-specific chronic low-back pain and its recurrent behavior. Therefore, the goal of this study is to identify motor control in low-back stabilization by simultaneously quantifying the intrinsic and reflexive contributions. Upper body sway was evoked using continuous force perturbations at the trunk, while subjects performed a resist or relax task. Frequency response functions (FRFs) and coherences of the admittance (kinematics) and reflexes (sEMG) were obtained. In comparison with the relax task, the resist task resulted in a 61% decrease in admittance and a 73% increase in reflex gain below 1.1 Hz. Intrinsic and reflexive contributions were captured by a physiologically-based, neuromuscular model, including proprioceptive feedback from muscle spindles (position and velocity) and Golgi tendon organs (force). This model described on average 90% of the variance in kinematics and 39% of the variance in sEMG, while resulting parameter values were consistent over subjects

Incremental embodied chaotic exploration of self-organized motor behaviors with proprioceptor adaptation

This paper presents a general and fully dynamic embodied artificial neural system, which incrementally explores and learns motor behaviors through an integrated combination of chaotic search and reflex learning. The former uses adaptive bifurcation to exploit the intrinsic chaotic dynamics arising from neuro-body-environment interactions, while the latter is based around proprioceptor adaptation. The overall iterative search process formed from this combination is shown to have a close relationship to evolutionary methods. The architecture developed here allows realtime goal-directed exploration and learning of the possible motor patterns (e.g., for locomotion) of embodied systems of arbitrary morphology. Examples of its successful application to a simple biomechanical model, a simulated swimming robot, and a simulated quadruped robot are given. The tractability of the biomechanical systems allows detailed analysis of the overall dynamics of the search process. This analysis sheds light on the strong parallels with evolutionary search

Neuro-musculoskeletal Models: A Tool to Study the Contribution of Muscle Dynamics to Biological Motor Control

Das Verständnis der Prinzipien, die menschlichen Bewegungen zugrunde liegen, ist die Basis für die Untersuchung der Entstehung gesunder Bewegungen und, was noch wichtiger ist, der Entstehung motorischer Störungen aufgrund neurodegenerativer Erkrankungen oder anderer pathologischer Zustände. Dieses Verständnis zu erlangen ist jedoch herausfordernd, da menschliche Bewegung das Ergebnis eines komplexen, dynamischen Zusammenspiels von biochemischen und biophysikalischen Prozessen im Bewegungsapparat und den hierarchisch organisierten neuronalen Kontrollstrukturen ist. Um die Wechselwirkungen dieser Strukturen zu untersuchen, bieten Computersimulationen, die mathematische Modelle des muskuloskelettalen Systems mit Modellen seiner neuronalen Kontrolle kombinieren, ein nützliches Werkzeug. In diesen Simulationen können einzelne Prozesse oder ganze Funktionseinheiten deaktiviert oder gestört werden, um die Auswirkungen dieser Veränderungen auf die vorhergesagten Bewegungen zu untersuchen. Die Plausibilität der zugrundeliegenden Modelle kann durch den Vergleich der Simulationen mit Daten aus Humanexperimenten und biologisch inspirierten Robotermodellen beurteilt werden. Das Ziel dieser Arbeit war es, neuro-muskuloskelettale Modelle als Hilfsmittel zur Untersuchung von Konzepten der biologischen Bewegungskontrolle zu verwenden. Von besonderem Interesse war der Beitrag der Muskeldynamik zur Kontrolle, d.h. wie die intrinsischen muskuloskelettalen Eigenschaften die motorische Kontrolle vereinfachen, ohne die motorische Genauigkeit zu beeinträchtigen. Zusätzlich wurde der Einfluss propriozeptiver Reflexmechanismen in verschiedenen Szenarien getestet. Die verwendeten neuro-muskuloskelettalen Modelle sind eine Kombination von Mehrkörpermodellen der Muskel-Skelett-Struktur des Armes oder des ganzen Körpers mit einem biologisch inspirierten hybriden Gleichgewichtspunkt-Kontrollmodell. In einer Simulationsstudie stellten wir fest, dass unser Armmodell realistische Reaktionen auf externe mechanische Störungen für zielgerichtete Bewegungen mit einem Freiheitsgrad vorhersagt. Auf dieser Grundlage simulierten wir die Anwendung von tragbaren Assistenzgeräten zur Kompensation unerwünschter Hypermetrie, d.h. einer überschießenden Reaktion bei zielgerichteten Bewegungen im Zusammenhang mit zerebellärer Ataxie und anderen neurodegenerativen Erkrankungen. Wir fanden heraus, dass einfache mechanische Hilfsmittel ausreichend sein können, um die Hypermetrien auf ein normales Niveau zu reduzieren. Wir stellten jedoch auch fest, dass die Größe des Drehmoments und der Kraft, die zur Kompensation der Störung erforderlich sind, möglicherweise deutlich unterschätzt wird, wenn die Muskel-Sehnen-Eigenschaften im Modell nicht berücksichtigt werden. Die Ergebnisse dieser beiden Studien bestätigten die Hypothese aus der Literatur, dass die Morphologie des Muskel-Skelett-Systems signifikant zur Bewegung beiträgt und somit deren Kontrolle vereinfacht. Deshalb haben wir einen informationstheoretischen Ansatz verwendet, um diesen Beitrag für zielgerichtete und oszillatorische Armbewegungen mit zwei Freiheitsgraden zu charakterisieren. Die Ergebnisse bestätigten, dass die unteren Kontrollebenen, einschließlich der Muskeln und ihrer Aktivierungsdynamik, wichtige Beiträge zur gesamten Kontrollhierarchie leisten. Beispielsweise führt ein einfaches, stückweise konstantes Muskelstimulationssignal, das nur wenig Information enthält, zu einer geschmeidigen Bewegung. Der physiologische Detailgrad, der in unseren Muskel-Skelett-Modellen enthalten ist, ermöglicht nicht nur die Untersuchung von Theorien zur motorischen Kontrolle, sondern auch die Untersuchung von Größen wie inneren Kräften in Muskeln und Gelenken, die experimentell normalerweise nicht zugänglich sind. Diese Größen sind zum Beispiel in der Ergonomie und für die Entwicklung von Assistenzgeräten von Bedeutung. In einer Ganzkörpersimulationsstudie untersuchten wir den Beitrag des Dehnungsreflexes zu den resultierenden Muskelkräften bei einer aktiven externen Repositionierung des Hüftgelenkes für einen großen Bereich von Bewegungsgeschwindigkeiten. Wir fanden heraus, dass der relative Kraftbeitrag des Feedback-Mechanismus vom modellierten kognitiven Zustand abhängig ist und einen nicht vernachlässigbaren Beitrag leistet, insbesondere bei hohen Repositionsgeschwindigkeiten. Die Gesamtheit unserer Ergebnisse zeigt, dass die Eigenschaften des Bewegungsapparates signifikant zur Erzeugung und Kontrolle von Bewegung beitragen und es daher wichtig ist, sie bei der Modellierung der menschlichen Bewegung zu berücksichtigen. Daher sprechen die Ergebnisse für die Kombination eines physiologisch fundierten biomechanischen und biochemischen Modells des Bewegungsapparates mit biologisch inspirierten Konzepten der motorischen Kontrolle. Diese Computersimulationen haben sich als ein nützliches Werkzeug zum Verständnis der Prozesse erwiesen, die der Erzeugung gesunder und pathologisch beeinträchtigter menschlicher Bewegungen zugrunde liegen.Understanding the principles underlying human movement is the basis for investigating the generation of healthy movements and, more importantly, the origins of motor disorders due to neurodegenerative diseases or other pathological conditions. However, gaining this understanding is challenging since human motion is the result of a complex, dynamic interplay of biochemical and biophysical processes in the musculoskeletal system and the hierarchically organized neuronal control structures. To study the interactions of these structures, computer simulations that combine mathematical models of the musculoskeletal system with models of its neuronal control provide a useful tool. In these simulations, single processes or whole functional units can be disabled or perturbed to study the effects of these changes on the predicted movements. The plausibility of the underlying models can be assessed by comparing the simulations with data from human experiments and biologically inspired robotic models. The purpose of this work was to use neuro-musculoskeletal models as tools to study concepts of biological motor control. Of particular interest was the contribution of muscle dynamics to the control, i.e. how the intrinsic musculoskeletal properties simplify motor control without compromising motor accuracy. Additionally, the influence of proprioceptive reflex mechanisms was tested in different scenarios. The neuro-musculoskeletal models that were used are a combination of multibody musculoskeletal models of the arm or the whole body with a biologically inspired hybrid equilibrium-point controller. In a simulation study, we found that our arm model predicts realistic reactions to external mechanical perturbations while performing one-degree-of-freedom goal-directed movements. Based on this, we simulated the application of wearable assistive devices to compensate for unwanted hypermetria, i.e. an overshooting response in goal-directed movements associated with cerebellar ataxia and other neurodegenerative disorders. We found that simple mechanical devices may be sufficient to reduce the hypermetria to a normal level. However, we also observed that the magnitude of torque and power that is required to compensate for the disorder may be significantly underestimated if muscle-tendon characteristics are not considered in the computational model. The results of these two studies confirmed the hypothesis from literature that the morphology of musculoskeletal systems significantly contributes to the movement and thus simplifies its control. Therefore, we made use of the information-theoretic approach of quantifying morphological computation to characterize this contribution for goal-directed and oscillatory arm movements with two degrees of freedom. The results asserted that the lower levels of control, including the muscles and their activation dynamics, make important contributions to the overall control hierarchy. For example, a simple piecewise constant muscle stimulation signal that contains only little information results in a smooth movement. The level of physiological detail that is included in our musculoskeletal models does not only allow for the examination of motor control theories but also makes it possible to study quantities like internal forces in muscles and joints, usually not experimentally accessible. These quantities are relevant, for example, in ergonomics and for the development of assistive devices. In a whole-body simulation study, we investigated the contribution of the stretch reflex to the resulting muscle forces during active external repositioning of the hip joint for a large range of movement velocities. We found that, depending on the modeled cognitive state, the relative force contribution of the feedback mechanism is not negligible, especially for high repositioning velocities. The entirety of our results shows that the properties of the musculoskeletal system significantly contribute to the generation and control of movement and, thus, it is important to take them into account when modeling human movement. Therefore, the results advocate the combination of a physiologically well-founded biomechanical and biochemical model of the musculoskeletal system with biologically inspired concepts of motor control. These computer simulations have proven to be a useful tool towards the comprehension of the processes underlying the generation of healthy and pathologically impaired human movements

Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

OBJECTIVE: This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. BACKGROUND: Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. METHOD: We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or all of the postural reflexes either in Earth's gravity or in microgravitational environments. Studies testing the function of each postural component, as well as those discussing postural reflex interactions, were also included in this review. DISCUSSION: It is quite apparent from the indexed literature we searched that posture is largely maintained by reflexive, involuntary control. While reflexive components for postural control are found in skin and joint receptors, somatic graviceptors, and baroreceptors throughout the body, much of the reflexive postural control mechanisms are housed, or occur, within the head and neck region primarily. We suggest that the postural reflexes may function in a hierarchical fashion. This hierarchy may well be based on the gravity-dependent or gravity-independent nature of each postural reflex. Some or all of these postural reflexes may contribute to the development of a postural body scheme, a conceptual internal representation of the external environment under normal gravity. This model may be the framework through which the postural reflexes anticipate and adapt to new gravitational environments. CONCLUSION: Visual and vestibular input, as well as joint and soft tissue mechanoreceptors, are major players in the regulation of static upright posture. Each of these input sources detects and responds to specific types of postural stimulus and perturbations, and each region has specific pathways by which it communicates with other postural reflexes, as well as higher central nervous system structures. This review of the postural reflex structures and mechanisms adds to the growing body of posture rehabilitation literature relating specifically to chiropractic treatment. Chiropractic interest in these reflexes may enhance the ability of chiropractic physicians to treat and correct global spine and posture disorders. With the knowledge and understanding of these postural reflexes, chiropractors can evaluate spinal configurations not only from a segmental perspective, but can also determine how spinal dysfunction may be the ultimate consequence of maintaining an upright posture in the presence of other postural deficits. These perspectives need to be explored in more detail

Identifying Low-Back Stabilization in Low-Back Pain and the Influence of Tactile Information

Dieen, J.H. van [Promotor]Veeger, H.E.J. [Promotor