Influence of oral motor tasks on postural muscle activity during dynamic reactive balance.

BACKGROUND: Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions. OBJECTIVE: It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co-contraction ratio (CCR). METHODS: Forty-eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one-legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture-relevant muscles and muscle pairs were analysed during platform forward acceleration. RESULTS: Tongue pressing caused an adjustment of co-contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance. CONCLUSION: The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery.

Persisting effects of jaw clenching on dynamic steady-state balance.

The effects of jaw clenching on balance has been shown under static steady-state conditions but the effects on dynamic steady-state balance have not yet been investigated. On this basis, the research questions were: 1) if jaw clenching improves dynamic steady-state balance; 2) if the effects persist when the jaw clenching task loses its novelty and the increased attention associated with it; 3) if the improved dynamic steady-state balance performance is associated with decreased muscle activity. A total of 48 physically active healthy adults were assigned to three groups differing in intervention (Jaw clenching and balance training (JBT), only balance training (OBT) or the no-training control group (CON)) and attending two measurement points separated by two weeks. A stabilometer was used to assess the dynamic steady-state balance performance in a jaw clenching and non-clenching condition. Dynamic steady-state balance performance was measured by the time at equilibrium (TAE). The activities of tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF), biceps femoris (BF) and masseter (MA) muscles were recorded by a wireless EMG system. Integrated EMG (iEMG) was calculated to quantify the muscle activities. All groups had better dynamic steady-state balance performance in the jaw clenching condition than non-clenching at T1, and the positive effects persisted at T2 even though the jaw clenching task lost its novelty and attention associated with it after balance training with simultaneous jaw clenching. Independent of the intervention, all groups had better dynamic steady-state balance performances at T2. Moreover, reductions in muscle activities were observed at T2 parallel to the dynamic steady-state balance performance improvement. Previous studies showed that jaw clenching alters balance during upright standing, predictable perturbations when standing on the ground and unpredictable perturbations when standing on an oscillating platform. This study complemented the previous findings by showing positive effects of jaw clenching on dynamic steady-state balance performance.

Effects of jaw clenching on dynamic reactive balance task performance after 1-week of jaw clenching training.

Introduction: Good balance is essential for human daily life as it may help to improve the quality of life and reduce the risk of falls and associated injuries. The influence of jaw clenching on balance control has been shown under static and dynamic conditions. Nevertheless, it has not yet been investigated whether the effects are mainly associated with the dual-task situation or are caused by jaw clenching itself. Therefore, this study investigated the effects of jaw clenching on dynamic reactive balance task performance prior to and after 1 week of jaw clenching training. It was hypothesized that jaw clenching has stabilizing effects resulting in a better dynamic reactive balance performance, and these effects are not related to dual-task benefits. Methods: A total of 48 physically active and healthy adults (20 women and 28 men) were distributed into three groups, one habitual control group (HAB) and two jaw clenching groups (JAW and INT) that had to clench their jaws during the balance tasks at T1 and T2. One of those two groups, the INT group, additionally practiced the jaw clenching task for 1 week, making it familiar and implicit at T2. The HAB group did not receive any instruction regarding jaw clenching condition. Dynamic reactive balance was assessed using an oscillating platform perturbed in one of four directions in a randomized order. Kinematic and electromyographic (EMG) data were collected using a 3D motion capture system and a wireless EMG system, respectively. Dynamic reactive balance was operationalized by the damping ratio. Furthermore, the range of motion of the center of mass (CoM) in perturbation direction (RoMCoM_AP or RoMCoM_ML), as well as the velocity of CoM (VCoM) in 3D, were analyzed. The mean activity of the muscles relevant to the perturbation direction was calculated to investigate reflex activities. Results: The results revealed that jaw clenching had no significant effects on dynamic reactive balance performance or CoM kinematics in any of these three groups, and the automation of jaw clenching in the INT group did not result in a significant change either. However, high learning effects, as revealed by the higher damping ratio values and lower VCoM at T2, were detected for the dynamic reactive balance task even without any deliberate balance training in the intervention phase. In the case of backward perturbation of the platform, the soleus activity in a short latency response phase increased for the JAW group, whereas it decreased for HAB and INT after the intervention. In the case of forward acceleration of the platform, JAW and INT showed a higher tibialis anterior muscle activity level in the medium latency response phase compared to HAB at T1. Discussion: Based on these findings, it can be suggested that jaw clenching may lead to some changes in reflex activities. However, the effects are limited to anterior-posterior perturbations of the platform. Nevertheless, high learning effects may have overall overweighed the effects related to jaw clenching. Further studies with balance tasks leading to less learning effects are needed to understand the altered adaptations to a dynamic reactive balance task related to simultaneous jaw clenching. Analysis of muscle coordination (e.g., muscle synergies), instead of individual muscles, as well as other experimental designs in which the information from other sources are reduced (e.g., closed eyes), may also help to reveal jaw clenching effects.

Changes in Key Biomechanical Parameters According to the Expertise Level in Runners at Different Running Speeds.

Running has become increasingly popular worldwide. Among runners, there exists a wide range of expertise levels. Investigating the differences between runners at two extreme levels, that is novices and experts, is crucial to understand the changes that occur as a result of multiple years of training. Vertical oscillation of center of mass (CoM), stride frequency normalized to the leg length, and duty factor, which describes the step time relative to the flight time, are key biomechanical parameters that have been shown to be closely related to the running economy and are used to characterize the running style. The variability characteristics of these parameters may reveal valuable information concerning the control of human locomotion. However, how the expertise level and running speed affect the variability of these key biomechanical parameters has not yet been investigated. The aim of this study was to analyze the effects of expertise level (novice vs. expert) and running speed (10 km/h vs. 15 km/h) on these parameters and their variability. It was hypothesized that expert runners would have lower vertical oscillation of CoM, normalized stride frequency, and duty factor and show less variability in these parameters. The parameters' variability was operationalized by the coefficient of variation. The mean values and variability of these key biomechanical parameters according to expertise level and running speed were compared with rmANOVAs. The results showed that the experts had a lower duty factor and less variable vertical oscillation of CoM and normalized stride frequency, independently of the running speed. At a higher running speed, the variability of vertical oscillation of CoM was higher, whereas that of normalized stride frequency and duty factor did not change significantly. To the best of our knowledge, this is the first study analyzing the effects of expertise level and running speed on the variability of key biomechanical parameters.

Running-Induced Fatigue Changes the Structure of Motor Variability in Novice Runners.

Understanding the effects of fatigue is a central issue in the context of endurance sports. Given the popularity of running, there are numerous novices among runners. Therefore, understanding the effects of fatigue in novice runners is an important issue. Various studies have drawn conclusions about the control of certain variables by analyzing motor variability. One variable that plays a crucial role during running is the center of mass (CoM), as it reflects the movement of the whole body in a simplified way. Therefore, the aim of this study was to analyze the effects of fatigue on the motor variability structure that stabilizes the CoM trajectory in novice runners. To do so, the uncontrolled manifold approach was applied to a 3D whole-body model using the CoM as the result variable. It was found that motor variability increased with fatigue (UCMꓕ). However, the UCMRatio did not change. This indicates that the control of the CoM decreased, whereas the stability was not affected. The decreases in control were correlated with the degree of exhaustion, as indicated by the Borg scale (during breaking and flight phase). It can be summarized that running-induced fatigue increases the step-to-step variability in novice runners and affects the control of their CoM.

Influence of Controlled Stomatognathic Motor Activity on Sway, Control and Stability of the Center of Mass During Dynamic Steady-State Balance-An Uncontrolled Manifold Analysis.

Multiple sensory signals from visual, somatosensory and vestibular systems are used for human postural control. To maintain postural stability, the central nervous system keeps the center of mass (CoM) within the base of support. The influence of the stomatognathic motor system on postural control has been established under static conditions, but it has not yet been investigated during dynamic steady-state balance. The purpose of the study was to investigate the effects of controlled stomatognathic motor activity on the control and stability of the CoM during dynamic steady-state balance. A total of 48 physically active and healthy adults were assigned to three groups with different stomatognathic motor conditions: jaw clenching, tongue pressing and habitual stomatognathic behavior. Dynamic steady-state balance was assessed using an oscillating platform and the kinematic data were collected with a 3D motion capturing system. The path length (PL) of the 3D CoM trajectory was used for quantifying CoM sway. Temporal dynamics of the CoM movement was assessed with a detrended fluctuation analysis (DFA). An uncontrolled manifold (UCM) analysis was applied to assess the stability and control of the CoM with a subject-specific anthropometric 3D model. The statistical analysis revealed that the groups did not differ significantly in PL, DFA scaling exponents or UCM parameters. The results indicated that deliberate jaw clenching or tongue pressing did not seem to affect the sway, control or stability of the CoM on an oscillating platform significantly. Because of the task-specificity of balance, further research investigating the effects of stomatognathic motor activities on dynamic steady-state balance with different movement tasks are needed. Additionally, further analysis by use of muscle synergies or co-contractions may reveal effects on the level of muscles, which were not visible on the level of kinematics. This study can contribute to the understanding of postural control mechanisms, particularly in relation to stomatognathic motor activities and under dynamic conditions.

Corrigendum: Fatigue-Related Changes in Spatiotemporal Parameters, Joint Kinematics and Leg Stiffness in Expert Runners During a Middle-Distance Run.

[This corrects the article DOI: 10.3389/fspor.2021.634258.].

Changes in spatiotemporal parameters, joint and CoM kinematics and leg stiffness in novice runners during a high-intensity fatigue protocol.

Even though running enjoys growing popularity, the effects of fatigue on the running kinematics of novices have rarely been studied. This is surprising, given the risk of running-related injuries when detrimental movement patterns are adopted. Therefore, the goal of the present study was to characterize the effects of fatigue induced by a high-intensity running protocol on spatiotemporal and stiffness parameters as well as on joint kinematics and center of mass (CoM) motion in novice runners. 14 participants performed a standardized treadmill familiarization and ran at 13 km/h until voluntary exhaustion. Kinematics were captured using a 3D motion capture system. Spatiotemporal and stiffness parameters as well as the range of motion (RoM) of the joints and CoM were compared by use of paired t-tests. Time series of the joint angles and CoM motion were analyzed by the statistical parametric mapping method. The results revealed that novice runners did not change spatiotemporal or stiffness parameters, but showed adaptations in joint kinematics, e.g. decreased dorsiflexion and increased pronation in the ankle joint during the swing phase. The findings of this study underline the importance of strengthening the ankle joint to prevent excessive pronation and increase its stability in novice runners.

Influence of controlled masticatory muscle activity on dynamic reactive balance.

BACKGROUND: The influence of the stomatognatic system on human posture control has been investigated under static conditions, but the effects on dynamic balance have not yet been considered. OBJECTIVE: Investigating the influence of different functional stomatognatic activities (jaw clenching (JAW), tongue pressing (TON) and habitual jaw position (HAB)) on postural performance during a dynamic reactive balance task. METHODS: Forty-eight physically active and healthy adults were assigned to three groups differing in oral-motor tasks (JAW, TON or HAB). Dynamic reactive balance was assessed by an oscillating platform which was externally perturbed in four directions. Performance was quantified by means of Lehr's damping ratio. Mean speeds of the selected anatomical regions (head, trunk, pelvis, knee and foot) were analysed to determine significant performance differences. RESULTS: The groups differed significantly in balance performance in direction F (i.e., forwards acceleration of the platform). Post hoc tests revealed that the JAW group had significantly better performance compared with both the HAB and TON groups. Better performance was associated with a decreased mean speed of the analysed anatomical regions. CONCLUSION: JAW can improve dynamic reactive balance but the occurrence of positive effects seems to be task-specific and not general. TON seems not to have any observable effects on dynamic reactive balance performance, at least when evaluating it with an oscillating platform. JAW might be a valuable strategy which could possibly reduce the risk of falls in elderly people; however, further investigations are still needed.

Stride-to-Stride Variability of the Center of Mass in Male Trained Runners After an Exhaustive Run: A Three Dimensional Movement Variability Analysis With a Subject-Specific Anthropometric Model.

The motion of the human body can be described by the motion of its center of mass (CoM). Since the trajectory of the CoM is a crucial variable during running, one can assume that trained runners would try to keep their CoM trajectory constant from stride to stride. However, when exposed to fatigue, runners might have to adapt certain biomechanical parameters. The Uncontrolled Manifold approach (UCM) and the Tolerance, Noise, and Covariation (TNC) approach are used to analyze changes in movement variability while considering the overall task of keeping a certain task relevant variable constant. The purpose of this study was to investigate if and how runners adjust their CoM trajectory during a run to fatigue at a constant speed on a treadmill and how fatigue affects the variability of the CoM trajectory. Additionally, the results obtained with the TNC approach were compared to the results obtained with the UCM analysis in an earlier study on the same dataset. Therefore, two TNC analyses were conducted to assess effects of fatigue on the CoM trajectory from two viewpoints: one analyzing the CoM with respect to a lab coordinate system (PVlab) and another one analyzing the CoM with respect to the right foot (PVfoot). Full body kinematics of 13 healthy young athletes were captured in a rested and in a fatigued state and an anthropometric model was used to calculate the CoM based on the joint angles. Variability was quantified by the coefficient of variation of the length of the position vector of the CoM and by the components Tolerance, Noise, and Covariation which were analyzed both in 3D and the projections in the vertical, anterior-posterior and medio-lateral coordinate axes. Concerning PVlab we found that runners increased their stride-to-stride variability in medio-lateral direction (1%). Concerning PVfoot we found that runners lowered their CoM (4 mm) and increased their stride-to-stride variability in the absorption phase in both 3D and in the vertical direction. Although we identified statistically relevant differences between the two running states, we have to point out that the effects were small (CV ≤ 1%) and must be interpreted cautiously.

Fatigue-Related Changes in Spatiotemporal Parameters, Joint Kinematics and Leg Stiffness in Expert Runners During a Middle-Distance Run.

Fatigue with its underlying mechanisms and effects is a broadly discussed topic and an important phenomenon, particularly in endurance sports. Although several studies have already shown a variety of changes in running kinematics with fatigue, few of them have analyzed competitive runners and even fewer have focused on middle-distance running. Furthermore, the studies investigating fatigue-related changes have mostly reported the results in terms of discrete parameters [e.g., range of motion (RoM)] in the frontal or sagittal plane, and therefore potentially overlooked effects occurring in subphases of the gait cycle or in the transverse plane. On this basis, the goal of the present study was to analyze the effects of exhaustive middle-distance running on expert runners by means of both discrete parameters and time series analysis in 3D. In this study, 13 runners ran on a treadmill to voluntary exhaustion at their individually determined fatigue speeds which was held constant during the measurements. Kinematic data were collected by means of a 3D motion capture system. Spatiotemporal and stiffness parameters as well as the RoM of joints and of center of mass (CoM) within the stance and flight phases were calculated. Independent t-tests were performed to investigate any changes in means and coefficients of variation (CV) of these parameters between the rested (PRE) and fatigued (POST) state. Statistical parametric mapping method was applied on the time series data of the joints and the CoM. Results from this exploratory study revealed that during a middle-distance run, expert runners change their stance time, rather than their step frequency or step length in order to maintain the constant running speed as long as possible. Increased upper body movements occurred to counteract the increased angular moment of the lower body possibly due to longer stance times. These findings provide insights into adaptation strategies of expert runners during a fatiguing middle-distance run and may serve a valuable information particularly for comparisons with other group of runners (e.g., females or non-athletes) as well with other conditions (e.g., non-constant speed or interval training), and might be useful for the definition of training goals (e.g., functional core training).

Modularity in Motor Control: Similarities in Kinematic Synergies Across Varying Locomotion Tasks.

Kinematic synergies (kSYN) provide an approach to quantify the covariation of joint motions and to explain the mechanisms underlying human motor behavior. A low-dimensional control strategy by means of the activation of a moderate number of kSYN would simplify the performance of complex motor tasks. The purpose of this study was to examine similarities between the kSYN of varying locomotion tasks: straight-line walking, walking a 90° spin turn and walking upstairs. Task-specific kSYN were extracted from full body kinematic recordings of 13 participants by principal component analysis. The first five kSYN accounting for most of the variance within each task were selected for further analysis following previous studies. The similarities between the kSYN of the three different locomotion tasks were quantified by calculating cosine similarities (SIM), as a vector-based similarity measure ranging from 0 (no similarity) to 1 (high similarity), between absolute principal component loading vectors. A SIM between two kSYN > 0.8 was interpreted as highly similar. Two to three highly similar kSYN were identified when comparing two individual tasks with each other. One kSYN, primarily characterized by anteversion and retroversion of the arms and legs, were found to be similar in all three tasks. Additional kSYN that occurred between individual tasks reflected mainly an upwards/downwards movement of the body or a countercyclical knee flexion/extension. The results demonstrate that the three investigated locomotion tasks are characterized by kSYN and that certain kSYN repeatedly occur across the three locomotion tasks. PCA yields kSYN which are in descent order according to their amount of total variance accounted for. Referring to the placing of a kSYN within the order as priorization, we found a change in priorization of repeatedly occurring kSYN across the individual tasks. The findings support the idea that movements can be efficiently performed through a flexible combination of a lower number of control-relevant variables.

Effect of Different Knee Braces in ACL-Deficient Patients.

Knee braces are often used during rehabilitation after ACL injury. There are two main concepts, rigid and soft braces, but studies comparing the two show conflicting results. Most studies used movement tasks with low translational or rotational loads and did not provide joint kinematics. Therefore, the purpose of this study was to investigate the influence of two different knee braces (rigid vs. soft) on knee joint kinematics in ACL-deficient patients compared to an unbraced control condition using two tasks (walking and 180° cutting) provoking knee movements in the frontal and transverse planes. 17 subjects with ACL-deficient knees participated in this study. 3D knee joint kinematics were recorded. To provoke frontal plane knee joint motion a laterally tilting plate was applied during a walking task. Both braces reduced the maximum valgus angle compared to the unbraced condition, stabilizing the knee joint against excessive valgus motion. Yet, no differences in peak abduction angle between the two braces were found. However, a significant extension deficit was observed with the rigid brace. Moreover, both braces increased transverse plane RoM and peak internal rotation angle, with the effects being significantly larger with the rigid brace. These effects have been associated with decreased knee stability and unphysiological cartilage loading. Therefore, the soft brace seems to be able to limit peak abduction with a lesser impact on physiological gait compared to the rigid brace. The cutting task was selected to provoke transverse plane knee movement and large external knee rotation was expected. However, none of the braces was able to reduce peak external knee rotation. Again, an increase in transverse plane RoM was observed with both braces. Based on these results, no brace outmatched the other in the second task. This study was the first attempt to clarify the effect of brace design for the stabilization of the knee joint during movements with frontal and transverse plane loading. However, to provide physicians and patients with a comprehensive guideline for brace usage, future studies will have to extent these findings to other daily or sportive movement tasks.

Variability of running coordination in experts and novices: A 3D uncontrolled manifold analysis.

The uncontrolled manifold (UCM) approach has been widely used in recent studies to examine variability in daily tasks; however, it has not yet been used to study running or the effects of expertise. Therefore, the aim of this study was to analyse the synergy structure stabilizing the centre of mass (CoM) trajectory in experts compared to novices during running at two different speeds using a subject-specific 3D model. A total of 25 healthy young adults (13 experts, 12 novices) participated in the study. All subjects ran at 10 and 15 km h-1 on a treadmill. In each case, kinematics of 20 consecutive gait cycles were recorded and the effects of expertise and gait cycle phase on the synergy structure were investigated at both speeds. Specifically, the variance affecting the CoM ( U C M ⊥ ) , the variance not affecting the CoM ( U C M ∥ ) , and their ratio ( U C M R a t i o ) were analysed. Descriptively, in both groups there was a synergy stabilizing the CoM trajectory in running. However, the ANOVA showed no differences in U C M R a t i o between the two groups. In novices, U C M ⊥ and U C M ∥ were significantly higher compared to experts at the 15 km h-1 condition. In both groups, there was more variability in the stance phase compared to the flight phase in the majority of cases. The results indicate that experts adopted a more consistent running style. The stride-to-stride variability was diminished but not abolished. This difference was only visible at the 15 km h-1 condition. Furthermore, variability was less constrained in the stance phase compared to the flight phase.

Influence of fatigue on running coordination: A UCM analysis with a geometric 2D model and a subject-specific anthropometric 3D model.

Although fatigue is a central issue in endurance sports little is known about the effects of fatigue on coordination. The uncontrolled manifold (UCM) approach has been widely used in recent studies to examine coordination in human movement; however, it has not been used to study the effects of fatigue on running. Therefore, the aim of this study was to analyze the effects of fatigue on the synergy structure stabilizing the center of mass (CoM) trajectory in experienced runners during high-intensity running using the UCM approach. A total of 13 healthy young experienced runners participated in the study. Based on a lactate threshold testing undertaken one week prior to the measurements, participants were asked to run on a treadmill at their individual "fatigue-speed" until exhaustion. The kinematics of 20 consecutive gait cycles were recorded at the beginning (rested) and at the end (fatigue) of the protocol. The effects of fatigue on the synergy structure were investigated using a geometric 2D model and a subject-specific anthropometric 3D model. Specifically, the variance affecting the CoM trajectory (UCM⊥), the variance not affecting the CoM trajectory (UCM‖), and their ratio (UCMRatio) were analyzed for different gait cycle phases (absorption, propulsion and flight phase). Three-way repeated-measures ANOVA tests revealed differences between the two models. Fatigue-induced changes in the UCM structure could only be detected using the 3D model. UCMRatio did not change, but UCM⊥ increased during flight phase. In the 2D model, UCMRatio and both components were higher during the propulsion phase than during the absorption phase in both the rested and the fatigued state. Using a current concept for analyzing motor coordination, the UCM approach, only minor changes with fatigue were detected using the 3D subject-specific model. This indicates that the runners were able to control the trajectory of their CoM when fatigued. As the 2D model was not able to detect these changes, our study emphasizes that future studies on the effects of fatigue should focus on 3D analyses.

Biofidelity Corridors for Sternum Kinematics in Low-Speed Side Impacts.

OBJECTIVE: Field data show that side impact car crashes have become responsible for a greater proportion of the fatal crashes compared to frontal crashes, which suggests that the protection gained in frontal impact has not been matched in side impact. One of the reasons is the lack of understanding of the torso injury mechanisms in side impact. In particular, the deformation of the rib cage and how it affects the mechanical loading of the individual ribs have yet to be established. Therefore, the objective of this study was to characterize the ribcage deformation in side impacts by describing the kinematics of the sternum relative to the spine. METHODS: The 3D kinematics of the 1st and of the 5th or 6th thoracic vertebrae and of the sternum were obtained for three Post Mortem Human Subjects (PMHS) impacted laterally by a rigid wall traveling at 15 km/h. The experimental data were processed to express the kinematics of the sternum relative to the spine throughout the impact event. Methods were developed to interpolate the kinematics of the vertebrae for which experimental data were not available. RESULTS: The kinematics of the sternocostal junction for ribs 1 to 6 as well as the orientation of the sternum were expressed in the vertebra coordinate systems defined for each upper thoracic vertebra (T1 to T6). Corridors were designed for the motion of the sternum relative to each vertebra. In the experiments, the sternum moved upward for all rib levels (1 to 6), and away from the spine with an amplitude that increased with the decreasing rib level (from rib 1 to rib 6). None of the differences observed in the kinematics could be correlated to the occurrence of rib fractures. CONCLUSIONS: This study provides both qualitative and quantitative information for the ribcage skeletal kinematics in side impact. This data set provides the information required to better evaluate computational models of the thorax for side impact simulations. The corridors developed in this study provide new biofidelity targets for the impact response of the ribcage. This study contributes to augmenting the state of knowledge of the human chest deformation in side impact to better characterize the rib fracture mechanisms.