Antagonism of 5-HT2 receptors attenuates self-sustained firing of human motor units.

5-HT2 receptors on motoneurones play a critical role in facilitating persistent inward currents (PICs). Although facilitation of PICs can enhance self-sustained firing after periods of excitation, the relationship between 5-HT2 receptor activity and self-sustained firing in human motor units (MUs) has not been resolved. MU activity was assessed from the tibialis anterior of 10 healthy adults (24.9 ± 2.8 years) during two contraction protocols. Both protocols featured steady-state isometric contractions with constant descending drive to the motoneurone pool. However, one protocol also included an additional phase of superimposed descending drive. Adding and then removing descending drive in the middle of steady-state contractions altered MU firing behaviour across the motor pool, where newly recruited units in the superimposed phase were unable to switch off (P = 0.0002), and units recruited prior to additional descending drive reduced their discharge rates (P < 0.0001, difference in estimated marginal means (∆) = 2.24 pulses/s). The 5-HT2 receptor antagonist, cyproheptadine, was then administered to determine whether changes in MU firing were mediated by serotonergic mechanisms. 5-HT2 receptor antagonism caused reductions in MU discharge rate (P < 0.001, ∆ = 1.65 pulses/s), recruitment threshold (P = 0.00112, ∆ = 1.09% maximal voluntary contraction) and self-sustained firing duration (P < 0.0001, ∆ = 1.77s) after the additional descending drive was removed in the middle of the steady-state contraction. These findings indicate that serotonergic neuromodulation plays a key role in facilitating discharge and self-sustained firing of human motoneurones, where adaptive changes in MU recruitment must occur to meet the demands of the contraction. KEY POINTS: Animal and cellular preparations indicate that somato-dendritic 5-HT2 receptors regulate the intrinsic excitability of motoneurones. 5-HT2 receptor antagonism reduces estimates of persistent inward currents in motoneurones, which contribute to self-sustained firing when synaptic inputs are reduced or removed. This human study employed a contraction task that slowly increased (and then removed) the additional descending drive in the middle of a steady-state contraction where marked self-sustained firing occurred when the descending drive was removed. 5-HT2 receptor antagonism caused widespread reductions in motor unit (MU) discharge rates during contractions, which was accompanied by reduced recruitment threshold and attenuation of self-sustained firing duration after the removal of the additional descending drive to motoneurones. These findings support the role that serotonergic neuromodulation is a key facilitator of MU discharge and self-sustained firing of human motoneurones, where adaptative changes in MU recruitment must occur to meet the demands of the contraction.

Synaptic inputs to motor neurons underlying muscle coactivation for functionally different tasks have different spectral characteristics.

The central nervous system (CNS) may produce the same endpoint trajectory or torque profile with different muscle activation patterns. What differentiates these patterns is the presence of cocontraction, which does not contribute to effective torque generation but allows to modulate joints' mechanical stiffness. Although it has been suggested that the generation of force and the modulation of stiffness rely on separate pathways, a characterization of the differences between the synaptic inputs to motor neurons (MNs) underlying these tasks is still missing. In this study, participants coactivated the same pair of upper-limb muscles, i.e., the biceps brachii and the triceps brachii, to perform two functionally different tasks: limb stiffness modulation or endpoint force generation. Spike trains of MNs were identified through decomposition of high-density electromyograms (EMGs) collected from the two muscles. Cross-correlogram showed a higher synchronization between MNs recruited to modulate stiffness, whereas cross-muscle coherence analysis revealed peaks in the ß-band, which is commonly ascribed to a cortical origin. These peaks did not appear during the coactivation for force generation, thus suggesting separate cortical inputs for stiffness modulation. Moreover, a within-muscle coherence analysis identified two subsets of MNs that were selectively recruited to generate force or regulate stiffness. This study is the first to highlight different characteristics, and probable different neural origins, of the synaptic inputs driving a pair of muscles under different functional conditions. We suggest that stiffness modulation is driven by cortical inputs that project to a separate set of MNs, supporting the existence of a separate pathway underlying the control of stiffness.NEW & NOTEWORTHY The characterization of the pathways underlying force generation or stiffness modulation are still unknown. In this study, we demonstrated that the common input to motor neurons of antagonist muscles shows a high-frequency component when muscles are coactivated to modulate stiffness but not to generate force. Our results provide novel insights on the neural strategies for the recruitment of multiple muscles by identifying specific spectral characteristics of the synaptic inputs underlying functionally different tasks.

Can local vibration alter the contribution of persistent inward currents to human motoneuron firing?

The response of spinal motoneurons to synaptic input greatly depends on the activation of persistent inward currents (PICs), which in turn are enhanced by the neuromodulators serotonin and noradrenaline. Local vibration (LV) induces excitatory Ia input onto motoneurons and may alter neuromodulatory inputs. Therefore, we investigated whether LV influences the contribution of PICs to motoneuron firing. This was assessed in voluntary contractions with concurrent, ongoing LV, as well as after a bout of prolonged LV. High-density surface electromyograms (HD-EMG) of the tibialis anterior were recorded with a 64-electrode matrix. Twenty males performed isometric, triangular, dorsiflexion contractions to 20% and 50% of maximal torque at baseline, during LV of the tibialis anterior muscle, and after 30-min of LV. HD-EMG signals were decomposed, and motor units tracked across time points to estimate PICs through a paired motor unit analysis, which quantifies motor unit recruitment-derecruitment hysteresis (ΔF). During ongoing LV, ΔF was lower for both 20% and 50% ramps. Although significant changes in ΔF were not observed after prolonged LV, a differential effect across the motoneuron pool was observed. This study demonstrates that PICs can be non-pharmacologically modulated by LV. Given that LV leads to reflexive motor unit activation, it is postulated that lower PIC contribution to motoneuron firing during ongoing LV results from decreased neuromodulatory inputs associated with lower descending corticospinal drive. A differential effect in motoneurons of different recruitment thresholds after prolonged LV is provocative, challenging the interpretation of previous observations and motivating future investigations. KEY POINTS: Neuromodulatory inputs from the brainstem influence motoneuron intrinsic excitability through activation of persistent inward currents (PICs). PICs make motoneurons more responsive to excitatory input. We demonstrate that vibration applied on the muscle modulates the contribution of PICs to motoneuron firing, as observed through analysis of the firing of single motor units. The effects of PICs on motoneuron firing were lower when vibration was concurrently applied during voluntary ramp contractions, likely due to lower levels of neuromodulation. Additionally, prolonged exposure to vibration led to differential effects of lower- vs. higher-threshold motor units on PICs, with lower-threshold motor units tending to present an increased and higher-threshold motor units a decreased contribution of PICs to motoneuron firing. These results demonstrate that muscle vibration has the potential to influence the effects of neuromodulation on motoneuron firing. The potential of using vibration as a non-pharmacological neuromodulatory intervention should be further investigated.

Blockade of 5-HT2 receptors suppresses motor unit firing and estimates of persistent inward currents during voluntary muscle contraction in humans.

Serotonergic neuromodulation contributes to enhanced voluntary muscle activation. However, it is not known how the likely motoneurone receptor candidate (5-HT2 ) influences the firing rate and activation threshold of motor units (MUs) in humans. The purpose of this study was to determine whether 5-HT2 receptor activity contributes to human MU behaviour during voluntary ramped contractions of differing intensity. High-density surface EMG (HDsEMG) of the tibialis anterior was assessed during ramped isometric dorsiflexions at 10, 30, 50 and 70% of maximal voluntary contraction (MVC). MU characteristics were successfully extracted from HDsEMG of 11 young adults (four female) pre- and post-ingestion of 8 mg cyproheptadine or a placebo. Antagonism of 5-HT2 receptors caused a reduction in MU discharge rate during steady-state muscle activation that was independent of the level of contraction intensity [P < 0.001; estimated mean difference (∆) = 1.06 pulses/s], in addition to an increase in MU derecruitment threshold (P < 0.013, ∆ = 1.23% MVC), without a change in force during MVC (P = 0.652). A reduction in estimates of persistent inward current amplitude was observed at 10% MVC (P < 0.001, ∆ = 0.99 Hz) and 30% MVC (P = 0.003, ∆ = 0.75 Hz) that aligned with 5-HT changes in MU firing behaviour attributable to 5-HT2 antagonism. Overall, these findings indicate that 5-HT2 receptor activity has a role in regulating the discharge rate in populations of spinal motoneurones when performing voluntary contractions. This study provides evidence of a direct link between MU discharge properties, persistent inward current activity and 5-HT2 receptor activity in humans. KEY POINTS: Activation of 5-HT receptors on the soma and dendrites of motoneurones regulates their excitability. Previous work using chlorpromazine and cyproheptadine has demonstrated that the 5-HT2 receptor regulates motoneurone activity in humans with chronic spinal cord injury and non-injured control subjects. It is not known how the 5-HT2 receptor directly influences motor unit (MU) discharge and MU recruitment in larger populations of human motoneurones during voluntary contractions of differing intensity. Despite the absence of change in force during maximal voluntary dorsiflexions, 5-HT2 receptor antagonism caused a reduction in MU discharge rate during submaximal steady-state muscle contraction, in addition to an increase in MU derecruitment threshold, irrespective of the submaximal contraction intensity. Reductions in estimates of persistent inward currents after 5-HT2 receptor antagonism support the viewpoint that the 5-HT2 receptor plays a crucial role in regulating motor activity, whereby a persistent inward current-based mechanism is involved in regulating the excitability of human motoneurones.

Acute adaptation of central and peripheral motor unit features to exercise-induced fatigue differs with concentric and eccentric loading.

NEW FINDINGS: What is the central question of this study? Conflicting evidence exists on motor unit (MU) firing rate in response to exercise-induced fatigue, possibly due to the contraction modality used: Do MU properties adapt similarly following concentric and eccentric loading? What is the main finding and its importance? MU firing rate increased following eccentric loading only despite a decline in absolute force. Force steadiness deteriorated following both loading methods. Central and peripheral MU features are altered in a contraction type-dependant manner, which is an important consideration for training interventions. ABSTRACT: Force output of muscle is partly mediated by the adjustment of motor unit (MU) firing rate (FR). Disparities in MU features in response to fatigue may be influenced by contraction type, as concentric (CON) and eccentric (ECC) contractions demand variable amounts of neural input, which alters the response to fatigue. This study aimed to determine the effects of fatigue following CON and ECC loading on MU features of the vastus lateralis (VL). High-density surface (HD-sEMG) and intramuscular (iEMG) electromyography were used to record MU potentials (MUPs) from bilateral VLs of 12 young volunteers (six females) during sustained isometric contractions at 25% and 40% of the maximum voluntary contraction (MVC), before and after completing CON and ECC weighted stepping exercise. Multi-level mixed effects linear regression models were performed with significance assumed as P < 0.05. MVC decreased in both CON and ECC legs post-exercise (P < 0.0001), as did force steadiness at both 25% and 40% MVC (P < 0.004). MU FR increased in ECC at both contraction levels (P < 0.001) but did not change in CON. FR variability increased in both legs at 25% and 40% MVC following fatigue (P < 0.01). From iEMG measures at 25% MVC, MUP shape did not change (P > 0.1) but neuromuscular junction transmission instability increased in both legs (P < 0.04), and markers of fibre membrane excitability increased following CON only (P = 0.018). These data demonstrate that central and peripheral MU features are altered following exercise-induced fatigue and differ according to exercise modality. This is important when considering interventional strategies targeting MU function.

Lower motor unit discharge rates in gastrocnemius lateralis, but not in gastrocnemius medialis or soleus, in runners with Achilles tendinopathy: a pilot study.

OBJECTIVES: Deficits in muscle performance could be a consequence of a reduced ability of a motor neuron to increase the rate in which it discharges. This study aimed to investigate motor unit (MU) discharge properties of each triceps surae muscle (TS) and TS torque steadiness during submaximal intensities in runners with Achilles tendinopathy (AT). METHODS: We recruited runners with (n = 12) and without (n = 13) mid-portion AT. MU discharge rate was analysed for each of the TS muscles, using high-density surface electromyography during 10 and 20% isometric plantar flexor contractions. RESULTS: MU mean discharge rate was lower in the gastrocnemius lateralis (GL) in AT compared to controls. In AT, GL MU mean discharge rate did not increase as torque increased from 10% peak torque, 8.24 pps (95% CI 7.08 to 9.41) to 20%, 8.52 pps (7.41 to 9.63, p = 0.540); however, in controls, MU discharge rate increased as torque increased from 10%, 8.39 pps (7.25-9.53) to 20%, 10.07 pps (8.89-11.25, p < 0.001). There were no between-group difference in gastrocnemius medialis (GM) or soleus (SOL) MU discharge rates. We found no between-group differences in coefficient of variation of MU discharge rate in any of the TS muscles nor in TS torque steadiness. CONCLUSION: Our data demonstrate that runners with AT may have a lower neural drive to GL, failing to increase MU discharge rate to adjust for the increase in torque demand. Further research is needed to understand how interventions focussing on increasing neural drive to GL would affect muscle function in runners with AT.

Force Steadiness: From Motor Units to Voluntary Actions.

Voluntary actions are controlled by the synaptic inputs that are shared by pools of spinal motor neurons. The slow common oscillations in the discharge times of motor units due to these synaptic inputs are strongly correlated with the fluctuations in force during submaximal isometric contractions (force steadiness) and moderately associated with performance scores on some tests of motor function. However, there are key gaps in knowledge that limit the interpretation of differences in force steadiness.

Deficit in knee extension strength following anterior cruciate ligament reconstruction is explained by a reduced neural drive to the vasti muscles.

The persistence of quadriceps weakness represents a major concern following anterior cruciate ligament reconstruction (ACLR). The underlying adaptations occurring in the activity of spinal motoneurons are still unexplored. This study examined the discharge patterns of large populations of motor units (MUs) in the vastus lateralis (VL) and vastus medialis muscles following ACLR. Nine ACLR individuals and 10 controls performed unilateral trapezoidal contractions of the knee extensor muscles at 35%, 50% and 70% of the maximal voluntary isometric force (MVIF). High-density surface electromyography (HDsEMG) was used to record the myoelectrical activity of the vasti muscles in both limbs. HDsEMG signals were decomposed with a convolutive blind source separation method and MU properties were extracted and compared between sides and groups. The ACLR group showed a lower MVIF on the reconstructed side compared to the contralateral side (28.1%; P < 0.001). This force deficit was accompanied by reduced MU discharge rates (∼21%; P < 0.05), lower absolute MU recruitment and derecruitment thresholds (∼22% and ∼22.5%, respectively; P < 0.05) and lower input-output gain of motoneurons (27.3%; P = 0.009). Deficits in MU discharge rates of the VL and in absolute recruitment and derecruitment thresholds of both vasti MUs were associated with deficits in MVIF (P < 0.05). A strong between-side correlation was found for MU discharge rates of the VL of ACLR individuals (P < 0.01). There were no significant between-group differences (P > 0.05). These results indicate that mid- to long-term strength deficits following ACLR may be attributable to a reduced neural drive to vasti muscles, with potential changes in excitatory and inhibitory synaptic inputs. KEY POINTS: Impaired expression and control of knee extension forces is common after anterior cruciate ligament reconstruction and is related to high risk of a second injury. To provide novel insights into the neural basis of this impairment, the discharge patterns of motor units in the vastus lateralis and vastus medialis were investigated during voluntary force contractions. There was lower knee extensor strength on the reconstructed side with respect to the contralateral side, which was explained by deficits in motor unit discharge rate and an altered motoneuronal input-output gain. Insufficient excitatory inputs to motoneurons and increased inhibitory afferent signals potentially contributed to these alterations. These results further our understanding of the neural underpinnings of quadriceps weakness following anterior cruciate ligament reconstruction and can help to develop effective rehabilitation protocols to regain muscle strength and reduce the risk of a second injury.

Fatigue induces altered spatial myoelectric activation patterns in the medial gastrocnemius during locomotion.

This research investigates the effects of muscle fatigue on spatial myoelectric patterns in the lower limb during locomotion. Both spatial and frequency aspects of neuromuscular recruitment in the medial gastrocnemius change in response to fatigue, resulting in altered myoelectric patterns during walking and running. These data may help us better understand the adaptations that occur in lower limb muscles to avoid overuse injuries caused by fatigue.

Regional changes in muscle activity do not underlie the repeated bout effect in the human gastrocnemius muscle.

The repeated bout effect (RBE) confers protection following exercise-induced muscle damage. Typical signs of this protective effect are significantly less muscle soreness and faster recovery of strength after the second bout. The aim of this study was to compare regional changes in medial gastrocnemius (MG) muscle activity and mechanical hyperalgesia after repeated bouts of eccentric exercise. Twelve healthy male participants performed two bouts of eccentric heel drop exercise (separated by 7 days) while wearing a vest equivalent to 20% of their body weight. High-density MG electromyographic amplitude maps and topographical pressure pain sensitivity maps were created before, two hours (2H), and two days (2D) after both exercise bouts. Statistical parametric mapping was used to identify RBE effects on muscle activity and mechanical hyperalgesia, using pixel-level statistics when comparing maps. The results revealed a RBE, as a lower strength loss (17% less; P < .01) and less soreness (50% less; P < .01) were found after the second bout. However, different muscle regions were activated 2H and 2D after the initial bout but not following the repeated bout. Further, no overall changes in EMG distribution or mechanical hyperalgesia were found between bouts. These results indicate that muscle activation is unevenly distributed during the initial bout, possibly to maintain muscle function during localized mechanical fatigue. However, this does not reflect a strategy to confer protection during the repeated bout by activating undamaged/non-fatigued muscle areas.

Alteration in HDEMG Spatial Parameters of Trunk Muscle Due to Handle Design during Pushing.

Previous research identifies that pushing and pulling is responsible for approximately 9-18% of all low back injuries. Additionally, the handle design of a cart being pushed can dramatically alter a worker's capacity to push (≅9.5%). Surprisingly little research has examined muscle activation of the low back and its role in muscle function. Therefore, the purpose of this study was to examine the effects of handle design combination of pushing a platform truck cart on trunk muscle activity. Twenty participants (10 males and 10 females, mean age = 24.3 ± 4.3 years) pushed 475 lbs using six different handle combinations involving handle orientation (vertical/horizontal/semi-pronated) and handle height (hip/shoulder). Multichannel high-density EMG (HDsEMG) was recorded for left and right rectus abdominis, erector spinae, and external obliques. Pushing at hip height with a horizontal handle orientation design (HH) resulted in significantly less (p < 0.05) muscle activity compared to the majority of other handle designs, as well as a significantly higher entropy than the shoulder handle height involving either the semi-pronated (p = 0.023) or vertical handle orientation (p = 0.028). The current research suggests that the combination of a hip height and horizontal orientation handle design may require increased muscle demand of the trunk and alter the overall muscle heterogeneity and pattern of the muscle activity.

Automated Channel Selection in High-Density sEMG for Improved Force Estimation.

Accurate and real-time estimation of force from surface electromyogram (EMG) signals enables a variety of applications. We developed and validated new approaches for selecting subsets of high-density (HD) EMG channels for improved and lower-dimensionality force estimation. First, a large dataset was recorded from a number of participants performing isometric contractions in different postures, while simultaneously recording HD-EMG channels and ground-truth force. The EMG signals were acquired from three linear surface electrode arrays, each with eight monopolar channels, and were placed on the long head and short head of the biceps brachii and brachioradialis. After data collection and pre-processing, fast orthogonal search (FOS) was employed for force estimation. To select a subset of channels, principal component analysis (PCA) in the frequency domain and a novel index called the power-correlation ratio (PCR), which maximizes the spectral power while minimizing similarity to other channels, were used. These approaches were compared to channel selection using time-domain PCA. We selected one, two, and three channels per muscle from the original seven differential channels to reduce the redundancy and correlation in the dataset. In the best case, we achieved an approximate improvement of 30% for force estimation while reducing the dimensionality by 57% for a subset of three channels.

Canonical maximization of coherence: A novel tool for investigation of neuronal interactions between two datasets.

Synchronization between oscillatory signals is considered to be one of the main mechanisms through which neuronal populations interact with each other. It is conventionally studied with mass-bivariate measures utilizing either sensor-to-sensor or voxel-to-voxel signals. However, none of these approaches aims at maximizing synchronization, especially when two multichannel datasets are present. Examples include cortico-muscular coherence (CMC), cortico-subcortical interactions or hyperscanning (where electroencephalographic EEG/magnetoencephalographic MEG activity is recorded simultaneously from two or more subjects). For all of these cases, a method which could find two spatial projections maximizing the strength of synchronization would be desirable. Here we present such method for the maximization of coherence between two sets of EEG/MEG/EMG (electromyographic)/LFP (local field potential) recordings. We refer to it as canonical Coherence (caCOH). caCOH maximizes the absolute value of the coherence between the two multivariate spaces in the frequency domain. This allows very fast optimization for many frequency bins. Apart from presenting details of the caCOH algorithm, we test its efficacy with simulations using realistic head modelling and focus on the application of caCOH to the detection of cortico-muscular coherence. For this, we used diverse multichannel EEG and EMG recordings and demonstrate the ability of caCOH to extract complex patterns of CMC distributed across spatial and frequency domains. Finally, we indicate other scenarios where caCOH can be used for the extraction of neuronal interactions.

Self-massage prior to stretching improves flexibility in young and middle-aged adults.

We examined the influence of stretching alone (SS) or combined with self-massage (SM) on maximal ankle dorsiflexion angle, maximal voluntary contraction (MVC) torque and calf muscle activity, and subcutaneous tissue thickness in 15 young (25 ± 3 years) and 15 middle-aged (45 ± 5 years) adults. Participants performed two sessions of calf muscle stretches (3x 30-s stretches, 30-s rest): stretch after a 60-s control condition (SS) and stretch after 60 s of self-massage with therapy balls (SM). Evaluations were performed before and 5 min after the intervention. Linear mixed effects model revealed no main effect for age on ROM or MVC and significant main effects for treatment and time. Change in ankle angle was greater after SM: SS = 3.1 ± 2°, SM = 6.2 ± 3.3° (Hedges' g = 0.98, p < 0.001). Similar results were observed for MVC torque: SS = -4 ± 16%, SM = 12 ± 16% (Hedges' g = 0.97, p = 0.0001). Changes in MVC torque and absolute EMG amplitude were correlated, but subcutaneous tissue thickness was not altered by treatment. The gains in ROM were more pronounced in less flexible middle-aged adults, underscoring the need to include flexibility exercises in their training.

A Novel Spatial Feature for the Identification of Motor Tasks Using High-Density Electromyography.

Estimation of neuromuscular intention using electromyography (EMG) and pattern recognition is still an open problem. One of the reasons is that the pattern-recognition approach is greatly influenced by temporal changes in electromyograms caused by the variations in the conductivity of the skin and/or electrodes, or physiological changes such as muscle fatigue. This paper proposes novel features for task identification extracted from the high-density electromyographic signal (HD-EMG) by applying the mean shift channel selection algorithm evaluated using a simple and fast classifier-linear discriminant analysis. HD-EMG was recorded from eight subjects during four upper-limb isometric motor tasks (flexion/extension, supination/pronation of the forearm) at three different levels of effort. Task and effort level identification showed very high classification rates in all cases. This new feature performed remarkably well particularly in the identification at very low effort levels. This could be a step towards the natural control in everyday applications where a subject could use low levels of effort to achieve motor tasks. Furthermore, it ensures reliable identification even in the presence of myoelectric fatigue and showed robustness to temporal changes in EMG, which could make it suitable in long-term applications.

Spatial distribution of HD-EMG improves identification of task and force in patients with incomplete spinal cord injury.

BACKGROUND: Recent studies show that spatial distribution of High Density surface EMG maps (HD-EMG) improves the identification of tasks and their corresponding contraction levels. However, in patients with incomplete spinal cord injury (iSCI), some nerves that control muscles are damaged, leaving some muscle parts without an innervation. Therefore, HD-EMG maps in patients with iSCI are affected by the injury and they can be different for every patient. The objective of this study is to investigate the spatial distribution of intensity in HD-EMG recordings to distinguish co-activation patterns for different tasks and effort levels in patients with iSCI. These patterns are evaluated to be used for extraction of motion intention. METHOD: HD-EMG was recorded in patients during four isometric tasks of the forearm at three different effort levels. A linear discriminant classifier based on intensity and spatial features of HD-EMG maps of five upper-limb muscles was used to identify the attempted tasks. Task and force identification were evaluated for each patient individually, and the reliability of the identification was tested with respect to muscle fatigue and time interval between training and identification. RESULTS: Three feature sets were analyzed in the identification: 1) intensity of the HD-EMG map, 2) intensity and center of gravity of HD-EMG maps and 3) intensity of a single differential EMG channel (gold standard). Results show that the combination of intensity and spatial features in classification identifies tasks and effort levels properly (Acc = 98.8 %; S = 92.5 %; P = 93.2 %; SP = 99.4 %) and outperforms significantly the other two feature sets (p < 0.05). CONCLUSION: In spite of the limited motor functionality, a specific co-activation pattern for each patient exists for both intensity, and spatial distribution of myoelectric activity. The spatial distribution is less sensitive than intensity to myoelectric changes that occur due to fatigue, and other time-dependent influences.

Soft Robotics to Enhance Upper Limb Endurance in Individuals with Multiple Sclerosis.

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system and can result in various symptoms, including muscle weakness, spasticity, and fatigue, ultimately leading to the deterioration of the musculoskeletal system. However, in recent years, exosuits have emerged as a game-changing solution to assist individuals with MS during their daily activities. These lightweight and affordable wearable robotic devices have gained immense popularity. In our study, we assessed the performance of an elbow exosuit on eight individuals with MS using high-density electromyography to measure biceps muscle activity. The results demonstrated that our prototype significantly reduced muscle effort during both dynamic and isometric tasks while increasing the elbow range of motion. In addition, the exosuit effectively delayed the onset of muscle fatigue, enhancing endurance for people with MS and enabling them to perform heavy duty tasks for a longer period.

Plantar intrinsic foot muscle activity and its relationship with postural sway during tiptoe standing in ballet dancers and non-dancers.

BACKGROUND: Minimizing postural sway during tiptoe standing is essential for ballet dancers. Investigation of the activity of the plantar intrinsic foot muscles (PIFMs) may provide insight into postural sway in dancers. Herein, we compared PIFM activity during tiptoe standing between dancers and non-dancers and examined its relationship with postural sway. METHODS: We enrolled 14 female ballet dancers and 13 female non-dancers. Electromyography (EMG) amplitudes of 64 channels of PIFMs and center of pressure (COP) data were recorded during bipedal tiptoe standing tasks performed with ankle plantarflexion angles of 20°, 40°, and 60° (dancers only). The EMG amplitudes were normalized to those during the maximum voluntary contraction, and the muscle activity level and its coefficient of variation over time (EMG-CVtime) during the task were assessed. Standard deviations in the anteroposterior and mediolateral directions, velocity, and area were calculated from the COP data. RESULTS: Most COP and EMG variables were significantly lower in dancers than in non-dancers in both the 20° and 40° tasks (p < 0.05). Significant correlations were found between most combinations of the COP and EMG variables in both the 20° and 40° tasks in the whole cohort (r = 0.468-0.807, p ≤ 0.014). In the 60° task in dancers, COP velocity was strongly correlated with EMG-CVtime (r = 0.700, p = 0.005). CONCLUSION: These results provide novel evidence that the PIFMs do not require high activity, but rather that its low, steady activity is the key, to achieve less postural sway during bipedal tiptoe standing in dancers.