Motor imagery drives the effects of combined action observation and motor imagery on corticospinal excitability for coordinative lower-limb actions.

Combined action observation and motor imagery (AOMI) facilitates corticospinal excitability (CSE) and may potentially induce plastic-like changes in the brain in a similar manner to physical practice. This study used transcranial magnetic stimulation (TMS) to explore changes in CSE for AOMI of coordinative lower-limb actions. Twenty-four healthy adults completed two baseline (BLH, BLNH) and three AOMI conditions, where they observed a knee extension while simultaneously imagining the same action (AOMICONG), plantarflexion (AOMICOOR-FUNC), or dorsiflexion (AOMICOOR-MOVE). Motor evoked potential (MEP) amplitudes were recorded as a marker of CSE for all conditions from two knee extensor, one dorsi flexor, and two plantar flexor muscles following TMS to the right leg representation of the left primary motor cortex. A main effect for experimental condition was reported for all three muscle groups. MEP amplitudes were significantly greater in the AOMICONG condition compared to the BLNH condition (p = .04) for the knee extensors, AOMICOOR-FUNC condition compared to the BLH condition (p = .03) for the plantar flexors, and AOMICOOR-MOVE condition compared to the two baseline conditions for the dorsi flexors (ps ≤ .01). The study findings support the notion that changes in CSE are driven by the imagined actions during coordinative AOMI.

The effects of combined action observation and motor imagery on corticospinal excitability and movement outcomes: Two meta-analyses.

Motor simulation interventions involving motor imagery (MI) and action observation (AO) have received considerable interest in the behavioral sciences. A growing body of research has focused on using AO and MI simultaneously, termed 'combined action observation and motor imagery' (AOMI). The current paper includes two meta-analyses that quantify changes in corticospinal excitability and motor skill performance for AOMI compared to AO, MI and control conditions. Specifically, the first meta-analysis collated and synthesized existing motor evoked potential (MEP) amplitude data from transcranial magnetic stimulation studies and the second meta-analysis collated and synthesized existing movement outcome data from behavioral studies. AOMI had a positive effect compared to control and AO but not MI conditions for both MEP amplitudes and movement outcomes. No methodological factors moderated the effects of AOMI, indicating a robust effect of AOMI across the two outcome variables. The results of the meta-analyses are discussed in relation to existing literature on motor simulation and skill acquisition, before providing viable directions for future research on this topic.

Effect of head pitch and roll orientations on magnetically induced vertigo.

KEY POINTS: Lying supine in a strong magnetic field, such as in magnetic resonance imaging scanners, can induce a perception of whole-body rotation. The leading hypothesis to explain this invokes a Lorentz force mechanism acting on vestibular endolymph that acts to stimulate semicircular canals. The hypothesis predicts that the perception of whole-body rotation will depend on head orientation in the field. Results showed that the direction and magnitude of apparent whole-body rotation while stationary in a 7 T magnetic field is influenced by head orientation. The data are compatible with the Lorentz force hypothesis of magnetic vestibular stimulation and furthermore demonstrate the operation of a spatial transformation process from head-referenced vestibular signals to Earth-referenced body motion. ABSTRACT: High strength static magnetic fields are known to induce vertigo, believed to be via stimulation of the vestibular system. The leading hypothesis (Lorentz forces) predicts that the induced vertigo should depend on the orientation of the magnetic field relative to the head. In this study we examined the effect of static head pitch (-80 to +40 deg; 12 participants) and roll (-40 to +40 deg; 11 participants) on qualitative and quantitative aspects of vertigo experienced in the dark by healthy humans when exposed to the static uniform magnetic field inside a 7 T MRI scanner. Three participants were additionally examined at 180 deg pitch and roll orientations. The effect of roll orientation on horizontal and vertical nystagmus was also measured and was found to affect only the vertical component. Vertigo was most discomforting when head pitch was around 60 deg extension and was mildest when it was around 20 deg flexion. Quantitative analysis of vertigo focused on the induced perception of horizontal-plane rotation reported online with the aid of hand-held switches. Head orientation had effects on both the magnitude and the direction of this perceived rotation. The data suggest sinusoidal relationships between head orientation and perception with spatial periods of 180 deg for pitch and 360 deg for roll, which we explain is consistent with the Lorentz force hypothesis. The effects of head pitch on vertigo and previously reported nystagmus are consistent with both effects being driven by a common vestibular signal. To explain all the observed effects, this common signal requires contributions from multiple semicircular canals.

Neuromechanical interference of posture on movement: evidence from Alexander technique teachers rising from a chair.

While Alexander technique (AT) teachers have been reported to stand up by shifting weight gradually as they incline the trunk forward, healthy untrained (HU) adults appear unable to rise in this way. This study examines the hypothesis that HU have difficulty rising smoothly, and that this difficulty relates to reported differences in postural stiffness between groups. A wide range of movement durations (1-8 s) and anteroposterior foot placements were studied under the instruction to rise at a uniform rate. Before seat-off (SO) there were clear and profound performance differences between groups, particularly for slower movements, that could not be explained by strength differences. For each movement duration, HU used approximately twice the forward center-of-mass (CoM) velocity and vertical feet-loading rate as AT. For slow movements, HU violated task instruction by abruptly speeding up and rapidly shifting weight just before SO. In contrast, AT shifted weight gradually while smoothly advancing the CoM, achieving a more anterior CoM at SO. A neuromechanical model revealed a mechanism whereby stiffness affects standing up by exacerbating a conflict between postural and balance constraints. Thus activating leg extensors to take body weight hinders forward CoM progression toward the feet. HU's abrupt weight shift can be explained by reliance on momentum to stretch stiff leg extensors. AT's smooth rises can be explained by heightened dynamic tone control that reduces leg extensor resistance and improves force transmission across the trunk. Our results suggest postural control shapes movement coordination through a dynamic "postural frame" that affects the resistive behavior of the body.

Violation of the craniocentricity principle for vestibularly evoked balance responses under conditions of anisotropic stability.

The balance response direction to electrically evoked vestibular perturbation is closely tied to head orientation. Such craniocentric response organization is expected of a simple error correction process. Here we ask whether this is maintained when the body is made more stable, but with the stability being greater in one direction than another. Since it is known that vestibularly evoked balance responses become smaller as body stability increases, the following two outcomes are possible: (1) response magnitude is attenuated, but with craniocentricity maintained; and (2) anisotropy of stability is considered such that components of the response are differentially attenuated, which would violate a craniocentric organizing principle. We tested these alternatives by measuring the direction of balance responses to electrical vestibular stimulation across a range of head orientations and stance widths in healthy humans. With feet together, the response was highly craniocentric. However, when stance width was increased so that the body was more stable in the frontal plane, response direction became biased toward the sagittal direction. This resulted in a nonlinear relationship between head orientation and response direction. While stance width changes the mechanical state of the body, the effect was also present when lateral light touch was used to produce anisotropy in stability, demonstrating that a significantly altered mechanical state was not crucial. We conclude that the balance system does not simply act according to the direction of vestibular input. Instead, it appears to assign greater relevance to components of vestibular input acting in the plane of lesser body stability than the plane of greater body stability, and acts accordingly.

A dynamic model of the eye nystagmus response to high magnetic fields.

It was recently shown that high magnetic fields evoke nystagmus in human subjects with functioning vestibular systems. The proposed mechanism involves interaction between ionic currents in the endolymph of the vestibular labyrinth and the static magnetic field. This results in a Lorentz force that causes endolymph flow to deflect the cupulae of the semi-circular canals to evoke a vestibular-ocular reflex (VOR). This should be analogous to stimulation by angular acceleration or caloric irrigation. We made measurements of nystagmus slow-phase velocities in healthy adults experiencing variable magnetic field profiles of up to 7 T while supine on a bed that could be moved smoothly into the bore of an MRI machine. The horizontal slow-phase velocity data were reliably modelled by a linear transfer function incorporating a low-pass term and a high-pass adaptation term. The adaptation time constant was estimated at 39.3 s from long exposure trials. When constrained to this value, the low-pass time constant was estimated at 13.6 ± 3.6 s (to 95% confidence) from both short and long exposure trials. This confidence interval overlaps with values obtained previously using angular acceleration and caloric stimulation. Hence it is compatible with endolymph flow causing a cupular deflection and therefore supports the hypothesis that the Lorentz force is a likely transduction mechanism of the magnetic field-evoked VOR.

On the vertigo due to static magnetic fields.

Vertigo is sometimes experienced in and around MRI scanners. Mechanisms involving stimulation of the vestibular system by movement in magnetic fields or magnetic field spatial gradients have been proposed. However, it was recently shown that vestibular-dependent ocular nystagmus is evoked when stationary in homogenous static magnetic fields. The proposed mechanism involves Lorentz forces acting on endolymph to deflect semicircular canal (SCC) cupulae. To investigate whether vertigo arises from a similar mechanism we recorded qualitative and quantitative aspects of vertigo and 2D eye movements from supine healthy adults (n = 25) deprived of vision while pushed into the 7T static field of an MRI scanner. Exposures were variable and included up to 135s stationary at 7T. Nystagmus was mainly horizontal, persisted during long-exposures with partial decline, and reversed upon withdrawal. The dominant vertiginous perception with the head facing up was rotation in the horizontal plane (85% incidence) with a consistent direction across participants. With the head turned 90 degrees in yaw the perception did not transform into equivalent vertical plane rotation, indicating a context-dependency of the perception. During long exposures, illusory rotation lasted on average 50 s, including 42 s whilst stationary at 7T. Upon withdrawal, perception re-emerged and reversed, lasting on average 30 s. Onset fields for nystagmus and perception were significantly correlated (p<.05). Although perception did not persist as long as nystagmus, this is a known feature of continuous SSC stimulation. These observations, and others in the paper, are compatible with magnetic-field evoked-vertigo and nystagmus sharing a common mechanism. With this interpretation, response decay and reversal upon withdrawal from the field, are due to adaptation to continuous vestibular input. Although the study does not entirely exclude the possibility of mechanisms involving transient vestibular stimulation during movement in and out of the bore, we argue these are less likely.

The mathematical description of the body centre of mass 3D path in human and animal locomotion.

Although the 3D trajectory of the body centre of mass during ambulation constitutes the 'locomotor signature' at different gaits and speeds for humans and other legged species, no quantitative method for its description has been proposed in the literature so far. By combining the mathematical discoveries of Jean Baptiste Joseph Fourier (1768-1830, analysis of periodic events) and of Jules Antoine Lissajous (1822-1880, parametric equation for closed loops) we designed a method simultaneously capturing the spatial and dynamical features of that 3D trajectory. The motion analysis of walking and running humans, and the re-processing of previously published data on trotting and galloping horses, as moving on a treadmill, allowed to obtain closed loops for the body centre of mass showing general and individual locomotor characteristics. The mechanical dynamics due to the different energy exchange, the asymmetry along each 3D axis, and the sagittal and lateral energy recovery, among other parameters, were evaluated for each gait according to the present methodology. The proposed mathematical description of the 3D trajectory of the body centre of mass could be used to better understand the physiology and biomechanics of normal locomotion, from monopods to octopods, and to evaluate individual deviations with respect to average values as resulting from gait pathologies and the restoration of a normal pattern after pharmacological, physiotherapeutic and surgical treatments.

Gait in SWEDDs patients: comparison with Parkinson's disease patients and healthy controls.

Patients diagnosed with Parkinson's disease on clinical grounds who subsequently turn out to have normal dopamine transporter imaging have been referred to as SWEDDs (scans without evidence of dopaminergic deficits). Despite having clinical features similar to those of Parkinson's disease, these patients seem to have different pathophysiology, prognosis, and treatment requirements. In this study we determined the similarities and differences in the gaits of SWEDDs and Parkinson's disease patients to investigate whether walking patterns can distinguish these entities. We used 3-D motion capture to analyze the gaits of 11 SWEDDs patients (who had unilateral or asymmetric upper limb tremor with a rest component), 12 tremor-dominant Parkinson's disease patients, and 13 healthy control participants. In common with Parkinson's disease patients, SWEDDs patients had a slow gait mainly because of a small stride length, as well as a reduced arm swing. However, several abnormal features of posture and gait in Parkinson's disease were normal in SWEDDs. Thus, SWEDDs patients had normal trunk and elbow posture, normal stride length variability, and normal bilateral step-phase coordination, all of which were abnormal in Parkinson's disease patients. We also searched for signs of ataxic movements during normal and tandem walking, but found no evidence that ataxic gait was a general feature in SWEDDs. These findings could aid the clinician in identification of potential tremulous SWEDDs cases. © 2011 Movement Disorder Society.

Lack of otolith involvement in balance responses evoked by mastoid electrical stimulation.

Passing current through mastoid electrodes (conventionally termed galvanic vestibular stimulation; GVS) evokes a balance response containing a short- and a medium-latency response. The origins of these two responses are debated. Here we test the hypotheses that they originate from net signals evoked by stimulation of otolith and semi-circular canal afferents, respectively. Based on anatomy and function, we predicted the directions of the stimulus-evoked net head rotation vector from the canals and the linear acceleration net vector from the otoliths. We tested these predictions in healthy adults by obtaining responses with the head in strategic postures to alter the relevance of the signals to the balance system. Cross-covariance between a stochastic waveform of stimulating current and motor output was used to assess the balance responses. Consistent with the canal hypothesis, with the head pitched down the medium-latency EMG response was abolished while the short-latency EMG response was maintained. The results, however, did not support the otolith hypothesis. The direction of the linear acceleration signal from the otoliths was predicted to change substantially when using monaural stimuli compared to binaural stimuli. In contrast, short-latency response direction measured from ground-reaction forces was not altered. It was always directed along the inter-aural axis irrespective of whether the stimulus was applied binaurally or monaurally, whether the head was turned in yaw through 90 deg, whether the head was pitched down through 90 deg, or combinations of these manipulations. We conclude that a net canal signal evoked by GVS contributes to the medium-latency response whilst a net otolith signal does not make a significant contribution to either the short- or medium-latency responses.

Non-linear vector summation of left and right vestibular signals for human balance.

The left and right vestibular organs always transduce the same signal of head movement, and with natural stimuli can only be activated simultaneously. To investigate how signals from the left and right vestibular organs are integrated to control human balance we electrically modulated the firing of vestibular afferents from each labyrinth independently and measured the resulting balance responses. Stimulation of one side at a time (monaural) showed that individual leg muscles receive equal inputs from the two labyrinths even though a single labyrinth appeared capable of signalling 3-D head motion. To deduce principles of left-right integration, balance responses to simultaneous stimulation of both sides (binaural) were compared with responses to monaural stimuli. The binaural whole-body response direction was compatible with vector summation of the left and right monaural responses. The binaural response magnitude, however, was only 64-74% that predicted by the monaural sum. This probably reflects a central non-linearity between vestibular input and motor output because stimulation of just one labyrinth revealed a power law relationship between stimulus current and response size with exponents 0.56 (force) and 0.51 (displacement). Thus, doubling total signal magnitude either by doubling monaural current or by binaural stimulation produced equivalent responses. We conclude that both labyrinths provide independent estimates of head motion that are summed vectorially and transformed non-linearly into motor output. The former process improves signal-to-noise and reduces artifactual common-mode changes, while the latter enhances responses to small signals, all critical for detecting the small head movements needed to control human balance.

Determining the direction of vestibular-evoked balance responses using stochastic vestibular stimulation.

As a tool for investigating vestibulo-motor function, stochastic vestibular stimulation (SVS) has some advantages over galvanic vestibular stimulation. However, there is no technique currently available for extracting direction information from SVS-evoked motor responses. It is essential to be able to measure the direction of response if one wishes to investigate the operation of key spatial transformation processes in the brain. Here we describe and validate a technique for determining the direction of SVS-evoked balance responses based on the correlation between a random waveform of stimulating current and ground-reaction shear force.

Neuromuscular and balance responses to flywheel inertial versus weight training in older persons.

AIM: Loss of muscle strength and balance are main characteristics of physical frailty in old age. Postural sway is associated with muscle contractile capacity and to the ability of rapidly correcting ankle joint changes. Thus, resistance training would be expected to improve not only strength but also postural balance. METHODS: In this study, age-matched older individuals (69.9+/-1.3 years) were randomly assigned to flywheel (n=12), or weight-lifting (n=12) groups, training the knee extensors thrice weekly for 12 weeks. The hypotheses were that owing to a larger eccentric loading of the knee extensors, flywheel training would result in (a) greater gains in quadriceps strength; (b) greater improvements in balance performance compared with weight-lifting training. Isokinetic dynamometry, B-mode ultrasonography, electromyography, percutaneous muscle stimulation and magnetic resonance imaging were employed to acquire the parameters of interest. RESULTS: Following training, knee extensors peak isokinetic power increased by 28% (P<0.01) in the flywheel group with no change in the weight-lifting group. Adaptations of the gastrocnemius muscle also occurred in both groups. The gastrocnemius characteristic with the highest response to training was tendon stiffness, with increases of 54% and 136% in the weight-lifting and flywheel groups, respectively (P<0.01). The larger increase in tendon stiffness in the flywheel group was associated with an improvement in postural balance (P<0.01). CONCLUSION: Quadriceps flywheel loading not only produces a greater increase in power than weight training but its physiological benefits also transfer/overspill to the plantarflexor muscle-tendon unit resulting in a significantly improved balance. These findings support our initial hypotheses.

The impact of physical training on locomotor function in older people.

Locomotor function declines in old age. Based on 55 studies, this review appraises current evidence on the impact of physical training interventions on locomotor function in older people. Overall, the literature indicates that physical training can have a beneficial impact on locomotor function in older people. This also holds true in various sub-populations including those who are very old, those who have functional limitations and those with chronic health problems. Improvements in locomotor function can be seen within 4-6 weeks of physical training, although the potential that improvements may appear earlier has not been investigated. Recent studies provide evidence of a dose-response relationship between intensity of strength training and improvement in locomotor function in older people. However, whether such a relationship exists for other training modes has not yet been investigated. Based on current evidence, the optimal training modes or combination of training modes (strength, aerobic, balance, coordination, etc.) and the optimal frequency of training for improvement in locomotor function are unclear.

Gastrocnemius specific force is increased in elderly males following a 12-month physical training programme.

The aim of the present investigation was to determine whether muscle force per physiological cross sectional area (PCSA) of the lateral gastrocnemius (GL) of elderly males increased following a 12-month physical training programme. Eleven elderly males were assigned to a 12-month training programme (TRN mean age 72.7 +/- 3.3 years, mean +/- SD) and eight elderly males were allocated to a control group (CTRL, 73.9 +/- 4.0 years) who maintained their habitual physical activity levels. In vivo measurements of muscle architecture, muscle volume (VOL), achilles tendon moment arm length and plantarflexor torque were used to estimate GL PCSA (VOL/fascicle length) and specific force (GL fascicle force/GL PCSA). Maximal GL fascicle force was calculated accounting for agonist muscle activation and antagonist co-activation. Following training GL fascicle force increased by 31% (P < 0.01), which was not entirely accounted for by a 17% increase in PCSA (from 27.2 +/- 5.9 to 31.8 +/- 6.2 cm(2), P < 0.05). Specific force increased significantly from 8.9 +/- 1.9 to 11.2 +/- 3.0 N cm(-2) (P < 0.05). Pennation angle, but not fascicle length, increased by 12% with training (P < 0.05). The CTRL group showed no change in muscle size, strength or architecture over the 12-month period. In conclusion, with the level of agonist and antagonist muscle activity accounted for a 12-month strength training programme resulted in an increase in both PCSA and specific force in elderly males.

Effect of a 12-month physical conditioning programme on the metabolic cost of walking in healthy older adults.

The metabolic cost of walking (C(W)) is increased in healthy older adults. Previously, this has been suggested to be associated with age-related decline in physiological/functional factors such as stability and muscle size and strength. Physical training can improve such factors as well as aspects of gait performance in older adults. The aim of this investigation was to determine if it also has a beneficial impact on (lowers) C(W). Thirty-eight community dwelling older adults (aged 70-82 years) assigned to a training group (TRA, n=25) or a control group (CON, n=13) participated in a 12-month intervention. TRA followed a multi-component physical conditioning programme involving supervised resistance, aerobic, and balance exercises twice per week. They also undertook home based exercises once per week. CON carried on with their normal daily activities. C(W) and indicators of functional capacity (knee extensor isometric strength, single leg balance time, sit and reach, stand and reach, and 6 min walk distance) were assessed prior to and following the intervention. Significant improvements in knee extensor isometric strength (+21%), single leg balance time (+30%), and 6 min walk distance (+6%) were observed in TRA (P<0.05) but not in CON. However, no change in C(W) was observed. In conclusion, this investigation has shown that a multi-component physical conditioning programme had a beneficial impact on functional capacity but did not lower C(W) in healthy community dwelling older adults.

Centre of mass motion during stair negotiation in young and older men.

The aim of this study was to compare centre of mass (COM) motion and its separation from centre of pressure (COP) as 13 young men (aged 23-36 years) and 15 healthy, community dwelling older men (aged 73-84 years) ascended and descended a three step staircase at a controlled cadence of approximately 90 steps/min. Centre of mass was obtained from whole body motion analysis, and simultaneously, COP was obtained using force plates built into the steps. The following variables were investigated: medio-lateral COM range of motion; peak antero-posterior and medio-lateral COM-COP separation; and peak antero-posterior, medio-lateral, and vertical COM velocities. No significant differences in these variables between young men and older men were present during ascent or descent. It was concluded that frontal plane dynamic stability during stair negotiation is well maintained in healthy older men, and that healthy older men do not exhibit an altered strategy in traversing the COM in the plane of progression during stair negotiation.

Kinematics of stair descent in young and older adults and the impact of exercise training.

Stair descent is a challenging task in old age. This study firstly investigated lower extremity kinematics during stair descent in young (YOU) and healthy, community dwelling older adults (OLD). Secondly, the impact of an exercise training intervention on age-related differences in stair descent was assessed. At baseline, a motion analysis system was used to determine spatio-temporal gait variables and lower extremity kinematics as YOU (n=23, age=27+/-3 years) and OLD (n=34, age=73+/-4 years) descended a three step staircase. The older adults were then divided into training (TRA) and control (CON) groups. For 12 months, TRA performed resistance, aerobic, balance, and flexibility exercises under supervision in a class environment (twice per week) and unsupervised at home (once per week). CON carried on with normal daily activities. Following the intervention, baseline measurements were repeated in TRA and CON. At baseline, total descent, stride cycle, and single support times were longer in OLD than in YOU. In addition, sagittal plane knee motion was lower in OLD whilst frontal and transverse plane pelvis and hip motion were higher in OLD. Exercise training did not reduce the age-related differences observed. In conclusion healthy older adults perform stair descent at a slower speed and with greater motion outside the plane of progression than young adults. We found no evidence that these differences are reduced by generic exercise training, at least in non-frail older adults.

Muscle strength, volume and activation following 12-month resistance training in 70-year-old males.

In elderly males muscle plantar flexor maximal voluntary contraction (MVC) torque normalised to muscle volume (MVC/VOL) is reduced compared to young males as a result of incomplete muscle activation in the elderly. The aim of the present study was to determine the influence of a 12-month resistance training programme on muscle volume, strength, MVC/VOL, agonist activation and antagonist coactivation of the plantarfexors in elderly males. Thirteen elderly males aged 70 years and over (range 70-82 years), completed a 12-month whole body resistance-training programme (TRN), training three times a week. Another eight males (range 18-30 years), who maintained their habitual physical activity for the same 12-month period as the TRN group acted as controls (CTRL). Isometric plantarflexor maximal voluntary contraction (MVC) torque increased in the TRN group by 20% (P < 0.01), from 113.1 +/- 22.0 Nm to 141.5 +/- 19.2 Nm. Triceps surae volume (TS VOL) assessed using MRI, increased by 12%, from 796.3 +/- 78.9 cm(3) to 916.8 +/- 144.4 cm(3) . PF activation, measured using supramaximal double twitch interpolation, increased from 83.6+/-11.0% pre training, to 92.1 +/- 7.6% post training (P < 0.05). Dorsiflexion MVC and antagonist coactivation (assessed using surface electromyography) did not change with training. Plantarflexor MVC torque normalized for triceps surae muscle volume (MVC/VOL) was 142.6 +/- 32.4 kN m(-2) before training and 157.0 +/- 27.9 kN m(-2) after training (a non-significant increase of 8%). No significant change in any measurement was observed in the CTRL group. This study has shown that the gain in muscle strength in response to long-term (12-month) training in older men is mostly accounted for by an increased muscle volume and activation.