Muscle co-activation in the elderly contributes to control of hip and knee joint torque and endpoint force.

We investigated the coordinated activity patterns of muscles based on cosine tuning in the elderly during an isometric force exertion task. We also clarified whether these coordinated activity patterns contribute to the control of hip and knee joint torque and endpoint force as co-activation. Preferred direction (PD) of activity for each muscle in 10 young and 8 older males was calculated from the lower limb muscle activity during isometric force exertion task in various directions. The covariance of endpoint force (η) was calculated from the exerted force data using a force sensor. Relationship between PD and η was used to examine the effect of muscle co-activation on the control of endpoint force. Co-activation between rectus femoris and semitendinosus/biceps femoris increased with changes in muscle PD. Additionally, the η values were significantly low, suggesting that co-activation of multiple muscles may contribute to endpoint force exertion. The mechanism for cooperative muscle activity is determined by the cosine tuning of the PD of each muscle, which affects the generation of hip and knee joint torque and endpoint force exertion. Co-activation of each muscle's PD changes with age, causing increased muscle co-activation to control torque and force. We demonstrated that co-activation in the elderly is a stabilizer of unsteady joints and a muscle control strategy for cooperative muscle activity.

Clinical utility of markerless motion capture for kinematic evaluation of sit-to-stand during 30 s-CST at one year post total knee arthroplasty: a retrospective study.

BACKGROUND: Although the importance of kinematic evaluation of the sit-to-stand (STS) test of total knee arthroplasty (TKA) patients is clear, there have been no reports analyzing STS during the 30-s chair sit-up test (30 s-CST) with a focus on kinematic characteristics. This study aimed to demonstrate the clinical utility of kinematic analysis of STS during the 30 s-CST by classifying STS into subgroups based on kinematic parameters, and to determine whether differences in movement strategies are expressed as differences in clinical outcomes. METHODS: The subjects were all patients who underwent unilateral TKA due to osteoarthritis of the knee and were followed up for one year postoperatively. Forty-eight kinematic parameters were calculated using markerless motion capture by cutting STS in the 30 s-CST. The principal components of the kinematic parameters were extracted and grouped by kinematic characteristics based on the principal component scores. Clinical significance was examined by testing whether differences in patient-reported outcome measures (PROMs) were observed. RESULTS: Five principal components were extracted from the 48 kinematic parameters of STS and classified into three subgroups (SGs) according to their kinematic characteristics. It was suggested that SG2, using a kinematic strategy similar to the momentum transfer strategy shown in previous studies, performed better in PROMs and, in particular, may be associated with achieving a "forgotten joint", which is considered the ultimate goal after TKA. CONCLUSIONS: Clinical outcomes differed according to kinematic strategies used STS, suggesting that kinematic analysis of STS in 30 s-CST may be useful in clinical practice. TRIAL REGISTRATION: This study was approved by the Medical Ethical Committee of the Tokyo Women's Medical University (approval number: 5628 on May 21, 2021).

Movement-synchronized cerebellum rhythm coordinates multi-joint movements in young and elderly adults.

Rhythmic limb multi-joint movement like locomotion is controlled by intralimb coordination. Intralimb coordination changes entail immediate alterations in movement patterns and be related with cerebellum function. Synchronized cerebellum activity has known to modulate the frequency of walking, but not known the effect of only intralimb coordination. The purpose of this study was to reveal the effect of synchronized and unsynchronized cerebellum activity on the coordination of multi-joint movements of the unilateral leg in young and elderly people. To achieve our purpose, we applied synchronized and unsynchronized cerebellum transcranial alternating current stimulation during cyclic unilateral multi-joint movement by visual tracking task. The results showed that the reduction in comprehensive synchrony between targets and movements through trials had no significant differences under all stimulus conditions in young and elderly people. However, the reduction in variation of synchronization through trials was significantly smaller under the synchronized transcranial alternating current stimulation condition in both young and elderly groups. Variation of synchronization was remarkably reduced under the synchronized transcranial alternating current stimulation condition for the elderly group. This study showed that movement-synchronized cerebellum activity contributes to reducing fluctuations in movement synchrony by coordinating unilateral multi-joint movements. Moreover, this reduction was remarkable in the elderly group.

Compensatory relationship of mechanical energy in paretic limb during sit-to-stand motion of stroke survivors.

The sit-to-stand motion is a prerequisite for walking and is therefore frequently performed in daily life. Diseases such as stroke often make performing it challenging. Even the stroke survivors who can stand up, the number of sit-to-stand motions they perform each day is lower than that of healthy adults. The inability of stroke survivors to stand up many times might be due to uneven distribution of mechanical energy expenditure across body parts. However, it was unclear in which body part this mechanical energy expenditure was concentrated, i.e., whether it was due to co-contraction of the paretic limb or compensation by the sound limb. Thus, this study aims to identify which body parts are responsible for mechanical energy expenditure in stroke survivors. Ten stroke survivors and ten healthy adults performed sit-to-stand motion recorded using motion capture cameras. We created a 3-D human model and calculated the mechanical energy expenditure for each joint and segment. The stroke survivors expended more mechanical energy in the affected hip and waist in contrast to the affected knee. Notably, a compensatory relationship for mechanical energy expenditure was observed between adjacent joints on the affected side and not between the affected and sound limbs. This is because stroke survivors may have achieved the sit-to-stand motion by compensating for the distal part with the less impaired proximal part. In addition, the more severe the movement disorders, the more mechanical energy must be expended in the paretic hip to achieve the sit-to-stand motion. These results could contribute to fundamental knowledge about more comfortable daily living in stroke survivors.

Determination of relationship between foot arch, hindfoot, and hallux motion using Oxford foot model: Comparison between walking and running.

BACKGROUND: The foot arch plays an important role in propulsion and shock absorption during walking and running; however, the relationship among the foot arch, metatarsal locking theory, and nature of the windlass mechanism (WM) remain unclear. RESEARCH QUESTION: What are the differences in the kinematic relationship between the foot arch, hindfoot, and hallux during walking and running? METHODS: Relative angles within the foot were measured in 18 healthy men using the Oxford foot model (OFM). Data for barefoot walking at a comfortable speed and rearfoot running at 2.0 m/s were collected. Angles of the forefoot relative to the hindfoot (OFM-arch), hallux relative to the forefoot (Hallux) on the sagittal plane, and hindfoot relative to the shank (Hindfoot) on three anatomical planes were obtained. The medial longitudinal arch (MLA) angle was calculated to verify that OFM-arch can substitute the MLA angle. Each parameter was subjected to cross-correlation analysis and Wilcoxon signed-rank tests to examine the relationship with OFM-arch and compare them during walking and running. RESULT: OFM-arch was similar to the conventional MLA projection angle in both trials (gait: 0.79, running: 0.96 p < 0.01). Synchronization of the OFM-arch and Hallux angles was higher in running than in walking (gait: -0.09, running: -0.75 p < 0.01). Hindfoot supination was unrelated to OFM-arch. Hindfoot angle on the transverse plane exhibited a moderate relationship with OFM-arch, indicating different correlations in walking and running (gait: 0.63, running: -0.68 p < 0.01). SIGNIFICANCE: The elevation of the foot arch due to hallux dorsiflexion differed during walking and running; hence, other factors besides WM (such as intrinsic muscles) may affect the foot arch elevation during running. The hindfoot in the frontal plane does not contribute to arch raising and foot stability during running; it features different relationships with OFM-arch during walking and running.

Adaptive changes in foot placement for split-belt treadmill walking in individuals with stroke.

BACKGROUND: Adaptation to split-belt treadmill walking differs between individual stroke survivors. Many discussions only address spatiotemporal parameters that are related to movement, and the changes in interlimb spatiotemporal parameters as a consequence of adaptation are poorly understood. OBJECTIVES: To investigate symmetry of the center of pressure (CoP) position relative to the center of mass (CoM), and ascertain whether this can be used to identify differences in adaptation of interlimb spatiotemporal parameters among stroke survivors during split-belt walking. METHODS: Twenty-two chronic post-stroke patients and nine elderly controls walked in tied- then split-belt (2:1 ratio of fast:slow) conditions. Spatiotemporal parameters were compared within groups to assess symmetry of the CoM-CoP angle at foot contact. RESULTS: Asymmetry of the CoM-CoP angle was associated with asymmetry of spatiotemporal parameters. Re-establishment of symmetry of CoM-CoP angle was reflected in re-established symmetry of spatiotemporal parameters in post-stroke and control participants. CONCLUSIONS: Post-stroke patients who re-establish symmetry of the COM-COP angle are able to adapt their walking for split-belt perturbation. This suggests that predictively symmetric foot placements on the fast and slow sides are necessary for adaptation in walking. Symmetrical foot placement is achieved by interlimb coordination and may contribute to dynamic stability.