Children with developmental coordination disorder are less able to fine-tune muscle activity in anticipation of postural perturbations than typically developing counterparts.

The majority of children with developmental coordination disorder (DCD) struggle with static and dynamic balance, yet there is limited understanding of the underlying neuromechanical mechanisms that underpin poor balance control in these children. Eighteen children with DCD and seven typically developing (TD) children aged 7-10 years stood with eyes open on a moveable platform progressively translated antero-posteriorly through three frequencies (0.1, 0.25 and 0.5 Hz). Myoelectric activity of eight leg muscles, whole-body 3D kinematics and centre of pressure were recorded. At each frequency, postural data were divided into transition-state and steady-state cycles. Data were analyzed using a linear mixed model with follow-up Tukey's pairwise comparisons. At the slowest frequency, children with DCD behaved like age-matched TD controls. At the fastest frequency, children with DCD took a greater number of steps, had a greater centre of mass variability, had a greater centre of pressure area, and tended to activate their muscles earlier and for longer than TD children. Children with DCD did not alter their postural response following prolonged exposure to platform movement, however they made more, non-structured postural adjustments in the medio-lateral direction as task difficulty increased. At the faster oscillation frequencies, children with DCD adopted a different muscle recruitment strategy to TD children. Activating their muscles earlier and for longer may suggest that children with DCD attempt to predict and react to postural disturbances, however the resulting anticipatory muscle excitation patterns do not seem as finely tuned to the perturbation as those demonstrated by TD children. Future work should examine the impact of balance training interventions on the muscle recruitment strategies of children with DCD, to ensure optimal interventions can be prescribed.

Physical and electrophysiological motor unit characteristics are revealed with simultaneous high-density electromyography and ultrafast ultrasound imaging.

Electromyography and ultrasonography provide complementary information about electrophysiological and physical (i.e. anatomical and mechanical) muscle properties. In this study, we propose a method to assess the electrical and physical properties of single motor units (MUs) by combining High-Density surface Electromyography (HDsEMG) and ultrafast ultrasonography (US). Individual MU firings extracted from HDsEMG were used to identify the corresponding region of muscle tissue displacement in US videos. The time evolution of the tissue velocity in the identified region was regarded as the MU tissue displacement velocity. The method was tested in simulated conditions and applied to experimental signals to study the local association between the amplitude distribution of single MU action potentials and the identified displacement area. We were able to identify the location of simulated MUs in the muscle cross-section within a 2 mm error and to reconstruct the simulated MU displacement velocity (cc > 0.85). Multiple regression analysis of 180 experimental MUs detected during isometric contractions of the biceps brachii revealed a significant association between the identified location of MU displacement areas and the centroid of the EMG amplitude distribution. The proposed approach has the potential to enable non-invasive assessment of the electrical, anatomical, and mechanical properties of single MUs in voluntary contractions.

EMG Signals Can Reveal Information Sharing between Consecutive Pedal Cycles.

PURPOSE: Producing a steady cadence and power while cycling results in fairly consistent average pedal forces for every revolution, although small fluctuations about an average force do occur. This force can be generated by several combinations of muscles, each with slight fluctuations in excitation for every pedal cycle. Fluctuations such as these are commonly thought of as random variation about average values. However, research into fluctuations of stride length and stride time during walking shows information can be contained in the order of fluctuations. This order, or structure, is thought to reveal underlying motor control strategies. Previously, we found persistent structure in the fluctuations of EMG signals during cycling using entropic half-life analysis. These EMG signals contained fluctuations across multiple timescales, such as those within a burst of excitation, between the burst and quiescent period of a cycle, and across multiple cycles. It was not clear which sources of variation contributed to the persistent structure in the EMG. METHODS: In this study, we manipulated variation at different timescales in EMG intensity signals to identify the sources of structure observed during cycling. Nine participants cycled at a constant power and cadence for 30 min while EMG was collected from six muscles of the leg. RESULTS: We found persistent structure across multiple pedal cycles of average EMG intensities, as well as average pedal forces and durations. In addition, we found the entropic half-life did not quantify fluctuations within a burst of EMG intensity; instead, it detected unstructured variation between the burst and quiescent period within a cycle. CONCLUSIONS: The persistent structure in average EMG intensities suggests that fluctuations in muscle excitation are regulated from cycle to cycle.

Monitoring of Dynamic Plantar Foot Temperatures in Diabetes with Personalised 3D-Printed Wearables.

Diabetic foot ulcers (DFUs) are a life-changing complication of diabetes that can lead to amputation. There is increasing evidence that long-term management with wearables can reduce incidence and recurrence of this condition. Temperature asymmetry measurements can alert to DFU development, but measurements of dynamic information, such as rate of temperature change, are under investigated. We present a new wearable device for temperature monitoring at the foot that is personalised to account for anatomical variations at the foot. We validate this device on 13 participants with diabetes (no neuropathy) (group name D) and 12 control participants (group name C), during sitting and standing. We extract dynamic temperature parameters from four sites on each foot to compare the rate of temperature change. During sitting the time constant of temperature rise after shoe donning was significantly (p < 0.05) faster at the hallux (p = 0.032, 370.4 s (C), 279.1 s (D)) and 5th metatarsal head (p = 0.011, 481.9 s (C), 356.6 s (D)) in participants with diabetes compared to controls. No significant differences at the other sites or during standing were identified. These results suggest that temperature rise time is faster at parts of the foot in those who have developed diabetes. Elevated temperatures are known to be a risk factor of DFUs and measurement of time constants may provide information on their development. This work suggests that temperature rise time measured at the plantar surface may be an indicative biomarker for differences in soft tissue biomechanics and vascularisation during diabetes onset and progression.

Ultrasound imaging to assess skeletal muscle architecture during movements: a systematic review of methods, reliability, and challenges.

B-mode ultrasound is often used to quantify muscle architecture during movements. Our objectives were to 1) systematically review the reliability of fascicle length (FL) and pennation angles (PA) measured using ultrasound during movements involving voluntary contractions; 2) systematically review the methods used in studies reporting reliability, discuss associated challenges, and provide recommendations to improve the reliability and validity of dynamic ultrasound measurements; and 3) provide an overview of computational approaches for quantifying fascicle architecture, their validity, agreement with manual quantification of fascicle architecture, and advantages and drawbacks. Three databases were searched until June 2019. Studies among healthy human individuals aged 17-85 yr that investigated the reliability of FL or PA in lower-extremity muscles during isoinertial movements and that were written in English were included. Thirty studies (n = 340 participants) were included for reliability analyses. Between-session reliability as measured by coefficient of multiple correlations (CMC), and coefficient of variation (CV) was FL CMC: 0.89-0.96; CV: 8.3% and PA CMC: 0.87-0.90; CV: 4.5-9.6%. Within-session reliability was FL CMC: 0.82-0.99; CV: 0.0-6.7% and PA CMC: 0.91; CV: 0.0-15.0%. Manual analysis reliability was FL CMC: 0.89-0.96; CV: 0.0-15.9%; PA CMC: 0.84-0.90; and CV: 2.0-9.8%. Computational analysis FL CMC was 0.82-0.99, and PA CV was 14.0-15.0%. Eighteen computational approaches were identified, and these generally showed high agreement with manual analysis and high validity compared with phantoms or synthetic images. B-mode ultrasound is a reliable method to quantify fascicle architecture during movement. Additionally, computational approaches can provide a reliable and valid estimation of fascicle architecture.

During Cycling What Limits Maximum Mechanical Power Output at Cadences above 120 rpm?

PURPOSE: A key determinant of muscle coordination and maximum power output during cycling is pedaling cadence. During cycling, the neuromuscular system may select from numerous solutions that solve the task demands while producing the same result. For more challenging tasks, fewer solutions will be available. Changes in the variability of individual muscle excitations (EMG) and multimuscle coordination, quantified by entropic half-life (EnHL), can reflect the number of solutions available at each system level. We, therefore, ask whether reduced variability in muscle coordination patterns occur at critical cadences and if they coincide with reduced variability in excitations of individual muscles. METHODS: Eleven trained cyclists completed an array of cadence-power output conditions. The EnHL of EMG intensity recorded from 10 leg muscles and EnHL of principal components describing muscle coordination were calculated. Multivariate adaptive regressive splines were used to determine the relationships between each EnHL and cycling condition or excitation characteristics (duration, duty cycle). RESULTS: Muscle coordination became more persistent at cadences up to 120 rpm, indicated by increasing EnHL values. Changes in EnHL at the level of the individual muscles differed from the changes in muscle coordination EnHL, with longer EnHL occurring at the slowest (<80 rpm) and fastest (>120 rpm) cadences. The EnHL of the main power producing muscles, however, reached a minimum by 80 rpm and did not change across the faster cadences studied. CONCLUSIONS: Muscle coordination patterns, rather than the contribution of individual muscles, are key to power production at faster cadences in trained cyclists. Reductions in maximum power output at cadences above 120 rpm could be a function of the time available to coordinate orientation and transfer of forces to the pedals.

Elongation differences between the sub-tendons of gastrocnemius medialis and lateralis during plantarflexion in different frontal plane position of the foot.

BACKGROUND: Gastrocnemius medialis (GM) and lateralis (GL) act at the ankle complex in the sagittal and frontal planes and there is evidence that their actions can be somewhat uncoupled from each other. Some independence of GM and GL from each other could be advantageous, e.g. to stabilise the ankle complex in unstable walking conditions. Given the compartmentalised structure of the Achilles tendon, the sub-tendons of GM and GL may exhibit different elongation during plantarflexion contractions, particularly with the foot in different frontal plane positions. RESEARCH QUESTIONS: METHODS: Sub-tendon elongation was determined from 18 participants during ramped isometric plantarflexion contractions to 70% of their maximum voluntary contraction (MVC) level with the foot in neutral, inversion and eversion. One-dimensional statistical parametric mapping was applied to determine elongation differences. RESULTS: Elongation within a sub-tendon did not differ in the three foot positions. Elongation was similar between both sub-tendons at very low contraction levels, but GM sub-tendon elongation exceeded GL sub-tendon displacement significantly from 30% MVC. The elongation differences between the sub-tendons were not affected by foot position. SIGNIFICANCE: Greater GM sub-tendon elongation is likely caused by the greater force production capability of GM but may also indicate that the sub-tendons of GM and GL have different mechanical properties, which is currently unknown. Elongation differences were contraction level dependent suggesting that contributions of GM and GL to plantarflexion torque may also be contraction level dependent.

Description and validation of the LocoWhisk system: Quantifying rodent exploratory, sensory and motor behaviours.

BACKGROUND: Previous studies have demonstrated that analysing whisker movements and locomotion allows us to quantify the behavioural consequences of sensory, motor and cognitive deficits in rodents. Independent whisker and feet trackers exist but there is no fully-automated, open-source software and hardware solution, that measures both whisker movements and gait. NEW METHOD: We present the LocoWhisk arena and new accompanying software (ARTv2) that allows the automatic detection and measurement of both whisker and gait information from high-speed video footage. RESULTS: We demonstrate the new whisker and foot detector algorithms on high-speed video footage of freely moving small mammals, and show that whisker movement and gait measurements collected in the LocoWhisk arena are similar to previously reported values in the literature. COMPARISON WITH EXISTING METHOD(S): We demonstrate that the whisker and foot detector algorithms, are comparable in accuracy, and in some cases significantly better, than readily available software and manual trackers. CONCLUSION: The LocoWhisk system enables the collection of quantitative data from whisker movements and locomotion in freely behaving rodents. The software automatically records both whisker and gait information and provides added statistical tools to analyse the data. We hope the LocoWhisk system and software will serve as a solid foundation from which to support future research in whisker and gait analysis.

Foreground Detection Analysis of Ultrasound Image Sequences Identifies Markers of Motor Neurone Disease across Diagnostically Relevant Skeletal Muscles.

Diagnosis of motor neurone disease (MND) includes detection of small, involuntary muscle excitations, termed fasciculations. There is need to improve diagnosis and monitoring of MND through provision of objective markers of change. Fasciculations are visible in ultrasound image sequences. However, few approaches that objectively measure their occurrence have been proposed; their performance has been evaluated in only a few muscles; and their agreement with the clinical gold standard for fasciculation detection, intramuscular electromyography, has not been tested. We present a new application of adaptive foreground detection using a Gaussian mixture model (GMM), evaluating its accuracy across five skeletal muscles in healthy and MND-affected participants. The GMM provided good to excellent accuracy with the electromyography ground truth (80.17%-92.01%) and was robust to different ultrasound probe orientations. The GMM provides objective measurement of fasciculations in each of the body segments necessary for MND diagnosis and hence could provide a new, clinically relevant disease marker.

How Do the Mechanical Demands of Cycling Affect the Information Content of the EMG?

PURPOSE: The persistence of phase-related information in EMG signals can be quantified by its entropic half-life (EnHL). It has been proposed that the EnHL would increase with the demands of a movement task, and thus increase as the pedaling power increased during cycling. However, simulation work on the properties of EMG signals suggests that the EnHL depends on burst duration and duty cycle in the EMG that may not be related to task demands. This study aimed to distinguish between these alternate hypotheses. METHODS: The EnHL was characterized for 10 muscles from nine cyclists cycling at a range of powers (35 to 260 W) and cadences (60-140 rpm) for the raw EMG, phase-randomized surrogate EMG, EMG intensity, and the principal components describing the muscle coordination patterns. RESULTS: There was phase-related information in the raw EMG signals and EMG intensities that was related to the EMG burst duration, duty cycle pedaling cadence, and power. The EnHL for the EMG intensities of the individual muscles (excluding quadriceps) and for the coordination patterns decreased as cycling power and cadence increased. CONCLUSIONS: The EnHL provide information on the structure of the motor control signals and their constituent motor unit action potentials, both within and between muscles, rather than on the mechanical demands of the cycling task per se.

A novel automated rodent tracker (ART), demonstrated in a mouse model of amyotrophic lateral sclerosis.

BACKGROUND: Generating quantitative metrics of rodent locomotion and general behaviours from video footage is important in behavioural neuroscience studies. However, there is not yet a free software system that can process large amounts of video data with minimal user interventions. NEW METHOD: Here we propose a new, automated rodent tracker (ART) that uses a simple rule-based system to quickly and robustly track rodent nose and body points, with minimal user input. Tracked points can then be used to identify behaviours, approximate body size and provide locomotion metrics, such as speed and distance. RESULTS: ART was demonstrated here on video recordings of a SOD1 mouse model, of amyotrophic lateral sclerosis, aged 30, 60, 90 and 120days. Results showed a robust decline in locomotion speeds, as well as a reduction in object exploration and forward movement, with an increase in the time spent still. Body size approximations (centroid width), showed a significant decrease from P30. COMPARISON WITH EXISTING METHOD(S): ART performed to a very similar accuracy as manual tracking and Ethovision (a commercially available alternative), with average differences in coordinate points of 0.6 and 0.8mm, respectively. However, it required much less user intervention than Ethovision (6 as opposed to 30 mouse clicks) and worked robustly over more videos. CONCLUSIONS: ART provides an open-source option for behavioural analysis of rodents, performing to the same standards as commercially available software. It can be considered a validated, and accessible, alternative for researchers for whom non-invasive quantification of natural rodent behaviour is desirable.

Movement Complexity and Neuromechanical Factors Affect the Entropic Half-Life of Myoelectric Signals.

Appropriate neuromuscular functioning is essential for survival and features underpinning motor control are present in myoelectric signals recorded from skeletal muscles. One approach to quantify control processes related to function is to assess signal variability using measures such as Sample Entropy. Here we developed a theoretical framework to simulate the effect of variability in burst duration, activation duty cycle, and intensity on the Entropic Half-Life (EnHL) in myoelectric signals. EnHLs were predicted to be <40 ms, and to vary with fluctuations in myoelectric signal amplitude and activation duty cycle. Comparison with myoelectic data from rats walking and running at a range of speeds and inclines confirmed the range of EnHLs, however, the direction of EnHL change in response to altered locomotor demand was not correctly predicted. The discrepancy reflected different associations between the ratio of the standard deviation and mean signal intensity ([Formula: see text]) and duty factor in simulated and physiological data, likely reflecting additional information in the signals from the physiological data (e.g., quiescent phase content; variation in action potential shapes). EnHL could have significant value as a novel marker of neuromuscular responses to alterations in perceived locomotor task complexity and intensity.

Passive Muscle-Tendon Unit Gearing Is Joint Dependent in Human Medial Gastrocnemius.

Skeletal muscles change length and develop force both passively and actively. Gearing allows muscle fiber length changes to be uncoupled from those of the whole muscle-tendon unit. During active contractions this process allows muscles to operate at mechanically favorable conditions for power or economical force production. Here we ask whether gearing is constant in passive muscle; determining the relationship between fascicle and muscle-tendon unit length change in the bi-articular medial gastrocnemius and investigating the influence of whether motion occurs at the knee or ankle joint. Specifically, the same muscle-tendon unit length changes were elicited by rotating either the ankle or knee joint whilst simultaneously measuring fascicle lengths in proximal and distal muscle regions using B-mode ultrasound. In both the proximal and distal muscle region, passive gearing values differed depending on whether ankle or knee motion occurred. Fascicle length changes were greater with ankle motion, likely reflecting anatomical differences in proximal and distal passive tendinous tissues, as well as shape changes of the adjacent mono-articular soleus. This suggests that there is joint-dependent dissociation between the mechanical behavior of muscle fibers and the muscle-tendon unit during passive joint motions that may be important to consider when developing accurate models of bi-articular muscles.

Increased intensity and reduced frequency of EMG signals from feline self-reinnervated ankle extensors during walking do not normalize excessive lengthening.

Kinematics of cat level walking recover after elimination of length-dependent sensory feedback from the major ankle extensor muscles induced by self-reinnervation. Little is known, however, about changes in locomotor myoelectric activity of self-reinnervated muscles. We examined the myoelectric activity of self-reinnervated muscles and intact synergists to determine the extent to which patterns of muscle activity change as almost normal walking is restored following muscle self-reinnervation. Nerves to soleus (SO) and lateral gastrocnemius (LG) of six adult cats were surgically transected and repaired. Intramuscular myoelectric signals of SO, LG, medial gastrocnemius (MG), and plantaris (PL), muscle fascicle length of SO and MG, and hindlimb mechanics were recorded during level and slope (±27°) walking before and after (10-12 wk postsurgery) self-reinnervation of LG and SO. Mean myoelectric signal intensity and frequency were determined using wavelet analysis. Following SO and LG self-reinnervation, mean myoelectric signal intensity increased and frequency decreased in most conditions for SO and LG as well as for intact synergist MG (P < 0.05). Greater elongation of SO muscle-tendon unit during downslope and unchanged magnitudes of ankle extensor moment during the stance phase in all walking conditions suggested a functional deficiency of ankle extensors after self-reinnervation. Possible effects of morphological reorganization of motor units of ankle extensors and altered sensory and central inputs on the changes in myoelectric activity of self-reinnervated SO and LG are discussed.

Ultrasound-Based Detection of Fasciculations in Healthy and Diseased Muscles.

Involuntary muscle activations are diagnostic indicators of neurodegenerative pathologies. Currently detected by invasive intramuscular electromyography, these muscle twitches are found to be visible in ultrasound images. We present an automated computational approach for the detection of muscle twitches, and apply this to two muscles in healthy and motor neuron disease-affected populations. The technique relies on motion tracking within ultrasound sequences, extracting local movement information from muscle. A statistical analysis is applied to classify the movement, either as noise or as more coherent movement indicative of a muscle twitch. The technique is compared to operator identified twitches, which are also assessed to ensure operator agreement. We find that, when two independent operators manually identified twitches, higher interoperator agreement (Cohen's κ) occurs when more twitches are present (κ = 0.94), compared to a lower number (κ = 0.49). Finally, we demonstrate, via analysis of receiver operating characteristics, that our computational technique detects muscle twitches across the entire dataset with a high degree of accuracy (0.83 < accuracy < 0.96).

Spatial variation of compound muscle action potentials across human gastrocnemius medialis.

The massed action potential (M wave) elicited through nerve stimulation underpins a wide range of physiological and mechanical understanding of skeletal muscle structure and function. Although systematic approaches have evaluated the effect of different factors on M waves, the effect of the location and distribution of activated fibers within the muscle remains unknown. By detecting M waves from the medial gastrocnemius (MG) of 12 participants with a grid of 128 electrodes, we investigated whether different populations of muscle units have different spatial organization within MG. If populations of muscle units occupy discrete MG regions, current pulses of progressively greater intensities applied to the MG nerve branch would be expected to lead to local changes in M-wave amplitudes. Electrical pulses were therefore delivered at 2 pps, with the current pulse amplitude increased every 10 stimuli to elicit different degrees of muscle activation. The localization of MG response to increases in current intensity was determined from the spatial distribution of M-wave amplitude. Key results revealed that increases in M-wave amplitude were detected somewhat locally, by 10-50% of the 128 electrodes. Most importantly, the electrodes detecting greatest increases in M-wave amplitude were localized at different regions in the grid, with a tendency for greater stimulation intensities to elicit M waves in the more distal MG region. The presented results indicate that M waves recorded locally may not provide a representative MG response, with major implications for the estimation of, e.g., the maximal stimulation levels, the number of motor units, and the onset and normalization in H-reflex studies.

How much does the human medial gastrocnemius muscle contribute to ankle torques outside the sagittal plane?

Ankle movements in the frontal plane are less prominent though not less relevant than movements in the plantar or dorsal flexion direction. Walking on uneven terrains and standing on narrow stances are examples of circumstances likely imposing marked demands on the ankle medio-lateral stabilization. Following our previous evidence associating lateral bodily sways in quiet standing to activation of the medial gastrocnemius (MG) muscle, in this study we ask: how large is the MG contribution to ankle torque in the frontal plane? By arranging stimulation electrodes in a selective configuration, current pulses were applied primarily to the MG nerve branch of ten subjects. The contribution of populations of MG motor units of progressively smaller recruitment threshold to ankle torque was evaluated by increasing the stimulation amplitude by fixed amounts. From smallest intensities (12-32 mA) leading to the firstly observable MG twitches in force-plate recordings, current pulses reached intensities (56-90 mA) below which twitches in other muscles could not be observed from the skin. Key results showed a substantial MG torque contribution tending to rotate upward the foot medial aspect (ankle inversion). Nerve stimulation further revealed a linear relationship between the peak torque of ankle plantar flexion and inversion, across participants (Pearson R>.81, p<.01). Specifically, regardless of the current intensity applied, the peak torque of ankle inversion amounted to about 13% of plantar flexion peak torque. Physiologically, these results provide experimental evidence that MG activation may contribute to stabilize the body in the frontal plane, especially under situations of challenged stability.

Myoelectric activity along human gastrocnemius medialis: different spatial distributions of postural and electrically elicited surface potentials.

It has recently been shown that motor units in human medial gastrocnemius (MG), activated during standing, occupy relatively small territories along the muscle's longitudinal axis. Such organisation provides potential for different motor tasks to produce differing regional patterns of activity. Here, we investigate whether postural control and nerve electrical stimulation produce equal longitudinal activation patterns in MG. Myoelectric activity, at different proximal-distal locations of MG, was recorded using a linear electrode array. To ensure differences in signal amplitude between channels did not result from local, morphological factors two experimental protocols were completed: (i) quiet standing; (ii) electrical stimulation of the tibial nerve. Averaged, rectified values (ARVs) were calculated for each channel in each condition. The distribution of signals along electrode channels was described using linear regression and differences between protocols at each channel determined as the ratio between mean ARV from standing: stimulation protocols. Ratio values changed systematically across electrode channels in seven (of eight) participants, with larger values in distal channels. The distribution of ARV along MG therefore differed between experimental conditions. Compared to fibres of units activated during MG nerve stimulation, units activated during standing may have a tendency to be more highly represented in the distal muscle portion.