[Effects of elastic stockings on venous flow during simple movements and muscular contractions of lower limb in healthy volunteers. Pilot study]. / Effets de la contention elastique sur le flux veineux au cours de mouvements simples et de contractions musculaires du membre inférieur chez le volontaire sain. Etude pilote.

AIM: To study common femoral vein flow during simple movements and voluntary contractions of muscles of lower limbs in healthy volunteers and to evaluate the effects of elastic stocking on venous flow. METHODOLOGY: Experimental study. Ten subjects, aged 21 to 25 years, underwent duplex ultrasound to examine venous flow, the lower limb being fitted with sensors to characterize kinematics and of muscle activity. MOVEMENTS STUDIED: In supine position: thigh muscles contraction. forefoot dorsal flexion. Standing on both feet: thigh muscles contraction, tip-toe, front load transfer, extension of the leg on the knee, loading on one limb, forefoot back flexion. Data were recorded with a computerised system for secondary analysis. A mean venous velocity was calculated after elimination of parasite signals. Venous velocity was correlated with muscle signals. The procedure was repeated with the patient wearing a thigh-length class II elastic stockings (Varisma Innothera Ltd). RESULTS, CONCLUSION: All movements increased venous flow. Wearing elastic stockings increased the venous flush due to movements or muscle contractions. The level of muscle activity during the same movement or the same muscle contraction varied from one subject to the other.

Chronology of upper limb anticipatory postural adjustments associated with voluntary wrist flexions and extensions in humans.

Six sitting healthy subjects were instructed to keep a constant upper limb posture while performing wrist flexions and extensions. Acceleration of the wrist, elbow and shoulder joints, and surface electromyograms (EMGs) of the upper limb's main flexors and extensors were studied. Results indicated the existence of anticipatory (APA) and corrective postural adjustments. The APAs were based on a reproducible directional chronology of postural muscle activations. As shown by a simple mechanical model, this chronology was in accordance with the muscular torque which should be applied to the joints to keep the upper limb posture constant. All these data indicate that APA are involved in segmental posture, where their general organization is similar to those of APA associated with whole-body movements. The use of constant directional postural synergies well agrees with a simplification of the motor control according to Bernstein's theory.

Effects of postural muscle fatigue on the relation between segmental posture and movement.

The purpose of this study was to examine whether fatigue of postural muscles might influence the coordination between segmental posture and movement. Seven healthy adults performed series of fifteen fast wrist flexions and extensions while being instructed to keep a dominant upper limb posture as constant as possible. These series of voluntary movements were performed before and after a fatiguing submaximal isometric elbow flexion, and also with or without the help of an elbow support. Surface EMG from muscles Deltoïdeus anterior, Biceps brachii, Triceps brachii, Flexor carpi ulnaris, Extensor carpi radialis were recorded simultaneously with wrist, elbow and shoulder accelerations and wrist and elbow displacements. Fatigue was evidenced by a shift of the elbow and shoulder muscles EMG spectra towards low frequencies. Kinematics of wrist movements and corresponding activations of wrist prime-movers, as well as the background of postural muscle activation before wrist movement were not modified. There were only slight changes in timing of postural muscle activations. These data indicate that postural fatigue induced by a low-level isometric contraction has no effect on voluntary movement and requires no dramatic adaptation in postural control.

Electromyographic and biomechanical characteristics of segmental postural adjustments associated with voluntary wrist movements. Influence of an elbow support.

This study re-investigates the characteristics of segmental postural adjustments associated with rapid mono-articular movements and analyses their dependence on initial postural conditions. Subjects performed rapid voluntary wrist flexions and extensions while maintaining their upper limb posture as stable as possible, with or without an elbow support. Surface electromyographic activity (EMG) was recorded from Flexor carpi ulnaris, Extensor carpi radialis, Biceps brachii, Triceps brachii and Deltoideus anterior. The kinematics of the three joints and kinetics in the support condition were also recorded. A planar mechanical model was used to determine the muscle torque required to keep the upper limb posture constant while performing wrist movements. All subjects showed anticipatory postural adjustments (APA) which, unlike those described for whole-body postural control, could not counteract in advance the perturbing inter-segmental forces created by the movement. Postural muscles were activated before the wrist movement with a chronology specific to the direction of the wrist movement. Some postural muscular activities anticipated that of the prime-movers in accordance with muscle torque, which had to be applied to the joints to keep the upper limb posture constant. These results reveal that the central nervous system (CNS) uses the same organization of the motor command for the control of both segmental and whole-body posture: APA and corrective postural adjustments (CPA), which are based on well-organized anticipatory postural muscle activities (APMA), except that APA can be non-efficient in segmental postural control. The presence or absence of an elbow support influenced the level of activation of postural muscle but not their chronology. This result suggests that the CNS uses a sequence of APMA: a postural muscle synergy which is predetermined as a function of the intended direction of the movements and modulates the gain towards certain muscles, in accordance with the gravitational effects, and supports reaction changes.