Correction: The center of pressure and ankle muscle co-contraction in response to anterior-posterior perturbations.
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ABSTRACT:
SUBMITTER: PLOS ONE Staff
PROVIDER: S-EPMC6880986 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Though both contraction of agonist muscles and co-contraction of antagonistic muscle pairs across the ankle joint are essential to postural stability, they are perceived to operate independently of each other, In an antagonistic setup, agonist muscles contract generating moment about the joint, while antagonist muscles contract generating stiffness across the joint. While both work together in maintaining robustness in the face of external perturbations, contractions of agonist muscles and co-contractions of antagonistic muscle pairs across the ankle joint play different roles in responding to and adapting to external perturbations. To determine their respective roles, we exposed participants to repeated perturbations in both large and small magnitudes. The center of pressure (COP) and a co-contraction index (CCI) were used to quantify the activation of agonist muscles and antagonistic muscle pairs across the ankle joint. Our results found that participants generated moment of a large magnitude across the ankle joint-a large deviation in the COP curve-in response to perturbations of a large magnitude (p <0.05), whereas the same participants generated higher stiffness about the ankle-a larger value in CCI-in response to perturbations of a small magnitude (p <0.05). These results indicate that participants use different postural strategies pertaining to circumstances. Further, the moment across the ankle decreased with repetitions of the same perturbation (p <0.05), and CCI tended to remain unchanged even in response to a different perturbation following repetition of the same perturbation (p <0.05). These findings suggest that ankle muscle contraction and co-contraction play different roles in regaining and maintaining postural stability. This study demonstrates that ankle moment and stiffness are not correlated in response to external perturbations.
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Project description:Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.
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Project description:Increased tibial slope can be a cause of recurrent instability after anterior cruciate ligament reconstruction. This article presents a technique for an anterior closing-wedge osteotomy for slope correction. The indications for this procedure are patients with recurrent instability after anterior cruciate ligament reconstruction with a neutral leg axis or slightly varus deformity and a posterior slope of more than 12°. The exposure of the anterior aspect of the tibia is best made through an anterior approach approximately 1 to 2 cm medial to the tibial tuberosity. Hohmann retractors are placed from the medial and lateral sides behind the proximal tibia. The osteotomy lines are marked with 2 converging Kirschner wires with the use of an image intensifier. The entry point of the first Kirschner wire is just below the most inferior fibers of the patellar tendon. The hinge of the osteotomy should be just below the tibial insertion of the posterior cruciate ligament. The osteotomy is performed with an oscillating saw. The posterior cortex of the tibia should be left intact. After removal of the anterior base wedge, the osteotomy is closed by manual pressure. Osteosynthesis is performed with a lag screw from the tibial tuberosity to the distal tibia and an angular stable plate fixator.
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Project description:This study aimed to assess modulation of lower leg muscle reflex excitability and co-contraction during unipedal balancing on compliant surfaces in young and older adults. Twenty healthy adults (ten aged 18-30 years and ten aged 65-80 years) were recruited. Soleus muscle H-reflexes were elicited by electrical stimulation of the tibial nerve, while participants stood unipedally on a robot-controlled balance platform, simulating different levels of surface compliance. In addition, electromyographic data (EMG) of soleus (SOL), tibialis anterior (TA), and peroneus longus (PL) and full-body 3D kinematic data were collected. The mean absolute center of mass velocity was determined as a measure of balance performance. Soleus H-reflex data were analyzed in terms of the amplitude related to the M wave and the background EMG activity 100 ms prior to the stimulation. The relative duration of co-contraction was calculated for soleus and tibialis anterior, as well as for peroneus longus and tibialis anterior. Center of mass velocity was significantly higher in older adults compared to young adults ([Formula: see text] and increased with increasing surface compliance in both groups ([Formula: see text]. The soleus H-reflex gain decreased with surface compliance in young adults [Formula: see text], while co-contraction increased [Formula: see text]. Older adults did not show such modulations, but showed overall lower H-reflex gains [Formula: see text] and higher co-contraction than young adults [Formula: see text]. These results suggest an overall shift in balance control from the spinal level to supraspinal levels in older adults, which also occurred in young adults when balancing at more compliant surfaces.
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Project description:Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), soleus and medial gastrocnemius were collected bilaterally. The iSCI-group exhibited more co-contractions than the AB-group (EO: 0.208% vs. 75.163%, p = 0.004; EC: 1.767% vs. 92.373%, p = 0.016). Furthermore, postural sway was larger during co-contractions than during no co-contraction in the iSCI-group (EO: 1.405 cm/s2 vs. 0.867 cm/s2, p = 0.023; EC: 1.831 cm/s2 vs. 1.179 cm/s2, p = 0.030), but no differences were found for the AB-group (EO: 0.393 cm/s2 vs. 0.499 cm/s2, p = 1.00; EC: 0.686 cm/s2 vs. 0.654 cm/s2, p = 1.00). To investigate the mechanism, we performed a computational simulation study using an inverted pendulum model and linear controllers. An increase of mechanical stiffness in the simulated iSCI-group resulted in increased postural sway (EO: 2.520 cm/s2 vs. 1.174 cm/s2, p < 0.001; EC: 4.226 cm/s2 vs. 1.836 cm/s2, p < 0.001), but not for the simulated AB-group (EO: 0.658 cm/s2 vs. 0.658 cm/s2, p = 1.00; EC: 0.943 cm/s2 vs. 0.926 cm/s2, p = 0.190). Thus, we demonstrated that co-contractions may be a compensatory strategy for individuals with iSCI to accommodate for decreased motor function, but co-contractions may result in increased ankle mechanical joint stiffness and consequently postural sway.
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Project description:The mechanism of knee osteoarthritis development after anterior cruciate ligament injuries is poorly understood. The objective of this study was to evaluate knee gait variables, muscle co-contraction indices and knee joint loading in young subjects with anterior cruciate ligament deficiency (ACLD, n?=?36), versus control subjects (n?=?12). A validated, electromyography-informed model was used to estimate joint loading. For the involved limb of ACLD subjects versus control, muscle co-contraction indices were higher for the medial (p?=?0.018, effect size?=?0.93) and lateral (p?=?0.028, effect size?=?0.83) agonist-antagonist muscle pairs. Despite higher muscle co-contraction, medial compartment contact force was lower for the involved limb, compared to both the uninvolved limb (mean difference?=?0.39 body weight, p?=?0.009, effect size?=?0.70) as well as the control limb (mean difference?=?0.57 body weight, p?=?0.007, effect size?=?1.14). Similar observations were made for total contact force. For involved versus uninvolved limb, the ACLD group demonstrated lower vertical ground reaction force (mean difference?=?0.08 body weight, p?=?0.010, effect size?=?0.70) and knee flexion moment (mean difference?=?1.32% body weight * height, p?=?0.003, effect size?=?0.76), during weight acceptance. These results indicate that high muscle co-contraction does not always result in high knee joint loading, which is thought to be associated with knee osteoarthritis. Long-term follow-up is required to evaluate how gait alterations progress in non-osteoarthritic versus osteoarthritic subjects. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Project description:Manipulative actions involving unstable interactions with the environment require controlling mechanical impedance through muscle co-contraction. While much research has focused on how the central nervous system (CNS) selects the muscle patterns underlying a desired movement or end-point force, the coordination strategies used to achieve a desired end-point impedance have received considerably less attention. We recorded isometric forces at the hand and electromyographic (EMG) signals in subjects performing a reaching task with an external disturbance. In a virtual environment, subjects displaced a cursor by applying isometric forces and were instructed to reach targets in 20 spatial locations. The motion of the cursor was then perturbed by disturbances whose effects could be attenuated by increasing co-contraction. All subjects could voluntarily modulate co-contraction when disturbances of different magnitudes were applied. For most muscles, activation was modulated by target direction according to a cosine tuning function with an offset and an amplitude increasing with disturbance magnitude. Co-contraction was characterized by projecting the muscle activation vector onto the null space of the EMG-to-force mapping. Even in the baseline the magnitude of the null space projection was larger than the minimum magnitude required for non-negative muscle activations. Moreover, the increase in co-contraction was not obtained by scaling the baseline null space projection, scaling the difference between the null space projections in any block and the projection of the non-negative minimum-norm muscle vector, or scaling the difference between the null space projections in the perturbed blocks and the baseline null space projection. However, the null space projections in the perturbed blocks were obtained by linear combination of the baseline null space projection and the muscle activation used to increase co-contraction without generating any force. The failure of scaling rules in explaining voluntary modulation of arm co-contraction suggests that muscle pattern generation may be constrained by muscle synergies.
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Project description:An excessive posterior tibial slope has been identified as a potential risk factor for anterior cruciate ligament tears. Anterior closing-wedge osteotomy decreases the posterior slope and can eliminate this risk factor in patients with recurrent instability and greater than 12° posterior slope. We will describe an anterior closing-wedge osteotomy technique performed at the tibial tubercle (TT), in which the TT is not detached to preserve the extensor mechanism attachment. A vertical cut is performed in the sagittal plane just posterior to the TT, leaving a distal cortical hinge. Two proximal parallel K-wires and 2 distal parallel K-wires convergent to the proximal ones are inserted from the anterior cortex on both sides of the tubercle toward the tibial posterior cortex at the posterior cruciate ligament's tibial insertion. Proximal and distal cuts are performed to remove the bone wedge. Reduction is achieved by gentle knee extension. Fixation is completed with 2 staples placed medially and laterally to the TT.
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Project description:This study concerned the effects of brisk perturbations applied to the shoulders of standing subjects to displace them either forwards or backwards, our aim being to characterise the responses to these disturbances. Subjects stood on a force platform, and acceleration was measured at the level of C7, the sacrum and both tibial tuberosities. Surface EMG was measured from soleus (SOL), tibialis anterior (TA), the hamstrings (HS), quadriceps (QUAD), rectus abdominis (RA) and lumbar paraspinal (PS) muscles. Trials were recorded for each of four conditions: subjects' eyes open (reference) or closed and on a firm (reference) or compliant surface. Observations were also made of voluntary postural reactions to a tap over the deltoid. Anterior perturbations (mean C7 acceleration 251.7 mg) evoked activity within the dorsal muscles (SOL, HS, PS) with a similar latency to voluntary responses to shoulder tapping. Responses to posterior perturbations (mean C7 acceleration -240.4 mg) were more complex beginning, on average, at shorter latency than voluntary activity (median TA 78.0 ms). There was activation of TA, QUAD and SOL associated with initial forward acceleration of the lower legs. The EMG responses consisted of an initial phasic discharge followed by a more prolonged one. These responses differ from the pattern of automatic postural responses that follow displacements at the level of the ankles, and it is unlikely that proprioceptive afferents excited by ankle movement had a role in the initial responses. Vision and surface properties had only minor effects. Perturbations of the upper trunk evoke stereotyped compensatory postural responses for each direction of perturbation. For posterior perturbations, EMG onset occurs earlier than for voluntary responses.
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Project description:The influence of loading on muscular hypertrophy has previously been studied in rodents by removal of synergistic muscles or various weight-lifting regimes. We present a novel model, evoking hypertrophy in the rat's tibialis anterior (TA) muscle by means of an implanted single channel electrical nerve stimulator. The amount of load experienced by the TA was measured in acute experiments in anaesthetized rats with contractions over a range of stimulation frequency and amplitude. A novel electrode configuration allowed us to elicit concentric, isometric and eccentric contractions within the same setup. This was achieved by 'SpillOver' stimulation in which we adjusted the amount of co-activation of the stronger antagonistic plantarflexors by increasing the stimulus above the level that caused full recruitment of the dorsiflexor muscles. The effect of loading on hypertrophy of the TA was tested in 3-4 week stimulation experiments in two groups of freely-moving rats, with a protocol that resembles typical resistance-training in humans. One group performed concentric contractions with no antagonistic co-contraction (unloaded, UNL, n = 5). In the other group the TA was loaded by simultaneous co-contraction of the antagonistically acting plantarflexors (SpillOver, n = 5). The wet mass of the stimulated TA increased in both groups; by 5.4 ± 5.5% for the UNL-group and 13.9 ± 2.9% for the SpillOver-group, with significantly greater increase in the SpillOver-group (p<0.05). Our results correlate well with values reported in literature, demonstrating that SpillOver-stimulation is a suitable model in which to study muscular hypertrophy. Even higher gains in muscle-mass may be possible by optimizing and adjusting the stimulation parameters according to the principles of progressive resistance training.
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