Early manifestation of arm–leg coordination during stepping on a surface in human neonates

Exploring the cortical involvement in sensorimotor integration during early stages of independent walking

The control of human locomotion is governed by a combination of congenital and emerging locomotor muscle synergies. The first arguably build on spinal and brainstem circuitries, whereas the latter have a cortical resemblance. By hypothesis this cortical activity reflects sensorimotor integration which matures during the development of walking. We therefore investigated the role of sensory information by manipulating the gravitational loading in 23 toddlers walking on an instrumented treadmill while recording 3D kinematics, EEG, and EMG of 24 trunk and lower extremity muscles. Sensory loading was manipulated via low and high levels of external body weight support. Cortico-synergy connectivity was compared between the two different support levels and at two stages of gait development: onset of independent walking (just after the first steps) and at six months of walking experience. These two age groups consisted of different subjects. For twelve toddlers data quantity and quality met requirements to enter analysis. Four muscle synergies sufficed to characterise gait, regardless of support level and developmental stage. Cortico-synergy coherence confirmed involvement of the sensorimotor cortex only in the two emerging synergies associated with walking onset. Reduced sensory loading was accompanied by a decreased coherence but only in toddlers with little walking experience. That gravitational loading alters the cortical resemblance of the synergies, especially at an early age, suggests that it reflects the integration of sensory information, at least to some extent. Our findings hint at the importance of sensorimotor integration in the emergence of the synergies linked to the onset of independent walking.

Exploring harmonic walking development in children with unilateral cerebral palsy and typically developing toddlers: Insights from walking experience

This longitudinal study investigated the impact of the first independent steps on harmonic gait development in unilateral cerebral palsy (CP) and typically developing (TD) children. We analysed the gait ratio values (GR) by comparing the duration of stride/stance, stance/swing and swing/double support phases. Our investigation focused on identifying a potential trend towards the golden ratio value of 1.618, which has been observed in the locomotion of healthy adults as a characteristic of harmonic walking. Locomotor ability was assessed in both groups at different developmental stages: before and after the emergence of independent walking. Results revealed that an exponential fit was observed only after the first unsupported steps were taken. TD children achieved harmonic walking within a relatively short period (approximately one month) compared to children with CP, who took about seven months to develop harmonic walking. Converging values for stride/stance and stance/swing gait ratios, averaged on the two legs, closely approached the golden ratio in TD children (R2 = 0.9) with no difference in the analysis of the left vs right leg separately. In contrast, children with CP exhibited a trend for stride/stance and stance/swing (R2 = 0.7), with distinct trends observed for the most affected leg which did not reach the golden ratio value for the stride/stance ratio (GR = 1.5), while the least affected leg exceeded it (GR = 1.7). On the contrary, the opposite trend was observed for the stance/swing ratio. These findings indicate an overall harmonic walking in children with CP despite the presence of asymmetry between the two legs. These results underscore the crucial role of the first independent steps in the progressive development of harmonic gait over time.

Whole Body Coordination for Self-Assistance in Locomotion

The dynamics of the human body can be described by the accelerations and masses of the different body parts (e.g., legs, arm, trunk). These body parts can exhibit specific coordination patterns with each other. In human walking, we found that the swing leg cooperates with the upper body and the stance leg in different ways (e.g., in-phase and out-of-phase in vertical and horizontal directions, respectively). Such patterns of self-assistance found in human locomotion could be of advantage in robotics design, in the design of any assistive device for patients with movement impairments. It can also shed light on several unexplained infrastructural features of the CNS motor control. Self-assistance means that distributed parts of the body contribute to an overlay of functions that are required to solve the underlying motor task. To draw advantage of self-assisting effects, precise and balanced spatiotemporal patterns of muscle activation are necessary. We show that the necessary neural connectivity infrastructure to achieve such muscle control exists in abundance in the spinocerebellar circuitry. We discuss how these connectivity patterns of the spinal interneurons appear to be present already perinatally but also likely are learned. We also discuss the importance of these insights into whole body locomotion for the successful design of future assistive devices and the sense of control that they could ideally confer to the user.

Measurement and Analysis of Human Infant Crawling for Rehabilitation: A Narrative Review

When a child shows signs of potential motor developmental disorders, early diagnosis of central nervous system (CNS) impairment is beneficial. Known as the first CNS-controlled mobility for most of infants, mobility during crawling usually has been used in clinical assessments to identify motor development disorders. The current clinical scales of motor development during crawling stage are relatively subjective. Objective and quantitative measures of infant crawling afford the possibilities to identify those infants who might benefit from early intervention, as well as the evaluation of intervention progress. Thus, increasing researchers have explored objective measurements of infant crawling in typical and atypical developing infants. However, there is a lack of comprehensive review on infant-crawling measurement and analysis toward bridging the gap between research crawling analysis and potential clinical applications. In this narrative review, we provide a practical overview of the most relevant measurements in human infant crawling, including acquisition techniques, data processing methods, features extraction, and the potential value in objective assessment of motor function in infancy; meanwhile, the possibilities to develop crawling training as early intervention to promote the locomotor function for infants with locomotor delays are also discussed.

Increasing muscle activity correlations during spontaneous movements in the first six months of life

Spontaneous muscle activity in the first months of life is an important prerequisite to developing voluntary motor skills and to adapting sensorimotor circuits and muscle tone to body and environmental changes. Even though high variability is a characteristic of early development, several studies have reported significant correlations of limb movements. These assessments were typically made based on kinematics, while the analysis of lower and upper limb muscle activity may provide additional information about maturation of the neuromuscular control. To this end, we examined the electromyographic activity of 12 muscles of the upper and lower limbs in full-term healthy infants (n = 40) aged from 1 week to six months. An increase of ipsilateral and contralateral limb muscle activity correlations with age was found in both flexors and extensors and may reflect a progressive emergence of elements of coordinative neuromuscular behaviour. Correlations between arm and leg muscle responses also increased during passive leg movements. Overall, the findings are consistent with maturation of physiologically relevant neuromuscular network connections during the course of transition from spontaneous-like to voluntary goal-directed movements during early development.

Newborn crawling and rooting in response to maternal breast odor

A growing literature shows that perception and action are already tightly coupled in the newborn. The current study aimed to examine the nature of the coupling between olfactory stimuli from the mother and the newborn's crawling and rooting (exploratory movements of the head). To examine the coupling, the crawling and rooting behavior of 28 2-day-old newborns were studied while they were supported prone on a mobility device shaped like a mini skateboard, the Crawliskate®, their head positioned directly on top of a pad infused with either their mother's breast odor (Maternal) or the odor of water (Control). Video and 3D kinematic analyses of the number and types of limb movements and quantification of displacement across the surface revealed that newborns are significantly more efficient crawlers when they smell the maternal odor, moving greater distances although performing fewer locomotor movements. In addition, the newborns made significantly more head rooting movements in the presence of the maternal odor. These findings suggest that the circuitry underlying quadrupedal locomotion and exploratory movements of the head is already adaptable to olfactory information via higher brain processing. Moreover, the coupling between olfaction and the two action systems, locomotion and rooting, is already differentiated. As crawling enables the newborn to move toward the mother's breast immediately after birth and facilitates mother-infant interaction, the results of this study highlight the potential value of using maternal odors to stimulate mobility in infants at risk of motor delay and/or deprived of this odor when born prematurely.

Maturation of the Locomotor Circuitry in Children With Cerebral Palsy

The first years of life represent an important phase of maturation of the central nervous system, processing of sensory information, posture control and acquisition of the locomotor function. Cerebral palsy (CP) is the most common group of motor disorders in childhood attributed to disturbances in the fetal or infant brain, frequently resulting in impaired gait. Here we will consider various findings about functional maturation of the locomotor output in early infancy, and how much the dysfunction of gait in children with CP can be related to spinal neuronal networks vs. supraspinal dysfunction. A better knowledge about pattern generation circuitries in infancy may improve our understanding of developmental motor disorders, highlighting the necessity for regulating the functional properties of abnormally developed neuronal locomotor networks as a target for early sensorimotor rehabilitation. Various clinical approaches and advances in biotechnology are also considered that might promote acquisition of the locomotor function in infants at risk for locomotor delays.

Muscle Synergies and Coherence Networks Reflect Different Modes of Coordination During Walking

When walking speed is increased, the frequency ratio between the arm and leg swing switches spontaneously from 2:1 to 1:1. We examined whether these switches are accompanied by changes in functional connectivity between multiple muscles. Subjects walked on a treadmill with their arms swinging along their body while kinematics and surface electromyography (EMG) of 26 bilateral muscles across the body were recorded. Walking speed was varied from very slow to normal. We decomposed EMG envelopes and intermuscular coherence spectra using non-negative matrix factorization (NMF), and the resulting modes were combined into multiplex networks and analyzed for their community structure. We found five relevant muscle synergies that significantly differed in activation patterns between 1:1 and 2:1 arm-leg coordination and the transition period between them. The corresponding multiplex network contained a single module indicating pronounced muscle co-activation patterns across the whole body during a gait cycle. NMF of the coherence spectra distinguished three EMG frequency bands: 4-8, 8-22, and 22-60 Hz. The community structure of the multiplex network revealed four modules, which clustered functional and anatomical linked muscles across modes of coordination. Intermuscular coherence at 4-22 Hz between upper and lower body and within the legs was particularly pronounced for 1:1 arm-leg coordination and was diminished when switching between modes of coordination. These findings suggest that the stability of arm-leg coordination is associated with modulations in long-distant neuromuscular connectivity.

Motion tracking in developmental research: Methods, considerations, and applications

In this chapter, we explore the use of motion tracking methodology in developmental research. With motion tracking, also called motion capture, human movements can be precisely recorded and analyzed. Motion tracking provides developmental researchers with objective measurements of motor and (socio-)cognitive development. It can further be used to create carefully-controlled stimuli videos and can offer means of measuring development outside of the lab. We discuss three types of motion tracking that lend themselves to developmental applications. First, marker-based systems track optical or electromagnetic markers or sensors placed on the body and offer high accuracy measurements. Second, markerless methods entail image processing of videos to track the movement of bodies without participants being hindered by physical markers. Third, inertial motion tracking measures three-dimensional movements and can be used in a variety of settings. The chapter concludes by examining three example topics from developmental literature in which motion tracking applications have contributed to our understanding of human development.

Emergence of Different Gaits in Infancy: Relationship Between Developing Neural Circuitries and Changing Biomechanics

How does gait-specific pattern generation evolve in early infancy? The idea that neural and biomechanical mechanisms underlying mature walking and running differ to some extent and involve distinct spinal and supraspinal neural circuits is supported by various studies. Here we consider the issue of human gaits from the developmental point of view, from neonate stepping to adult mature gaits. While differentiating features of the walk and run are clearly distinct in adults, the gradual and progressive developmental bifurcation between the different gaits suggests considerable sharing of circuitry. Gaits development and their biomechanical determinants also depend on maturation of the musculoskeletal system. This review outlines the possible overlap in the neural and biomechanical control of walking and running in infancy, supporting the idea that gaits may be built starting from common, likely phylogenetically conserved elements. Bridging connections between movement mechanics and neural control of locomotion could have profound clinical implications for technological solutions to understand better locomotor development and to diagnose early motor deficits. We also consider the neuromuscular maturation time frame of gaits resulting from active practice of locomotion, underlying plasticity of development.

Muscle Responses to Passive Joint Movements in Infants During the First Year of Life

Muscle tone represents one of the important concepts for characterizing changes in the state of the developing nervous system. It can be manifested in the level of activity of flexors and extensors and in muscle reactions to its passive stretching (StR) or shortening (ShR). Here we investigated such reactions in a cohort of healthy infants aged from 2 weeks to 12 months. We examined the presence and the characteristics of StR and ShR during slow passive cyclic flexion/extension movements (T~3 s) in the hip, knee, ankle, and elbow joints while awake infants were in the supine position. The results showed that most infants demonstrated prominent ShRs in response to passive joint rotations, although the StR was observed more frequently, suggesting that the ShR is an important component of adaptive motor behavior already at an early developmental stage. Interestingly, the occurrence of both StR and ShR in most muscles significantly decreased throughout the first year of life. Passive cyclic flexion/extension movements could also evoke rhythmic muscle responses in other joints or in the contralateral limb, however, such responses were predominantly observed in younger infants (<6 months). A noticeable manifestation of muscle reactions at an early developmental stage, along with spontaneous motor activity in this period of life, may reflect the processes underlying a formation of appropriate muscle tone and the self-organization of neural circuits. A substantial reduction of ipsilateral and contralateral muscle responses to passive movements with age is consistent with the idea of a functional reorganization of the motor circuitry during early development.

What Does Prone Skateboarding in the Newborn Tell Us About the Ontogeny of Human Locomotion?

The crawling behavior of sixty 2-day-old newborns was studied while they were supported prone on a mini skateboard and on a pediatric mattress without additional support. Analyses of the number and types of limb movements and their characteristics, the coactivation of limb pairs, and the displacement across the surface, revealed that newborns can crawl with locomotor patterns similar to those documented during quadrupedal locomotion in animals and human adults. This was particularly apparent on the skateboard. This discovery suggests that locomotor circuitry underlying quadrupedal locomotion develops during fetal life. Drawing upon other evidence for a quadrupedal organization underlying bipedal gait, we argue that early quadrupedal training may enhance interventions designed to hasten the onset of independent walking.

Synergistic influences of sensory and central stimuli on non-voluntary rhythmic arm movements

In recent years, neuromodulation of the cervical spinal circuitry has become an area of interest for investigating rhythmogenesis of the human spinal cord and interaction between cervical and lumbosacral circuitries, given the involvement of rhythmic arm muscle activity in many locomotor tasks. We have previously shown that arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations in unloading body conditions. Here we investigated the excitability of the cervical spinal circuitry by applying different peripheral and central stimuli in healthy humans. The rationale for applying combined stimuli is that the efficiency of only one stimulus is generally limited. We found that low-intensity electrical stimulation of the superficial arm median nerve can evoke rhythmic arm movements. Furthermore, the movements were enhanced by additional peripheral stimuli (e.g., arm muscle vibration, head turns or passive rhythmic leg movements). Finally, low-frequency transcranial magnetic stimulation of the motor cortex significantly facilitated rhythmogenesis. The findings are discussed in the general framework of a brain-spinal interface for developing adaptive central pattern generator-modulating therapies.