Effect of age and gender in the control of elbow flexion movements

The legacy of Gerald L. Gottlieb in human movement neuroscience

In this paper, we review the legacy of Gerald (Gerry) Gottlieb in various fields related to the neural control of human movement. His studies on the myotatic (stretch) reflex and postmyotatic responses to ankle joint perturbations paved the way for current explorations of long-loop reflexes and their role in the control of movement. The dual-strategy hypothesis introduced order into a large body of literature on the triphasic muscle activation patterns seen over a variety of voluntary movements in healthy persons. The dual-strategy hypothesis continues to be important for understanding the performance of subjects with disordered motor control. The principle of linear synergy (covariance of joint torques) was an attempt to solve one of the notorious problems of motor redundancy, which remains an important topic in the field. Gerry's attitude toward the equilibrium-point hypothesis varied between rejection and using it to explore patterns of hypothetical control variables and movement variability. The discovery of reciprocal excitation in healthy neonates fostered other studies of changes in spinal cord physiology as motor skills develop. In addition, studies of people with spasticity and the effects of treatment with intrathecal baclofen were crucial in demonstrating the possibility of unmasking voluntary movements after suppression of the hyperreflexia of spasticity. Gerry Gottlieb contributed a significant body of knowledge that formed a solid foundation from which to study a variety of neurological diseases and their treatments, and a more comprehensive and parsimonious foundation to describe the neural control of human movement.

A strategy of faster movements used by elderly humans to lift objects of increasing weight in ecological context

It is not known whether, during the course of aging, changes occur in the motor strategies used by the CNS for lifting objects of different weights. Here, we analyzed the kinematics of object-lifting in two different healthy groups (young and elderly people) plus one well-known deafferented patient (GL). The task was to reach and lift onto a shelf an opaque cylindrical object with changing weight. The movements of the hand and object were recorded with electromagnetic sensors. In an ecological context (i.e. no instruction was given about movement speed), we found that younger participants, elderly people and GL did not all move at the same speed and that, surprisingly, elder people are faster. We also observed that the lifting trajectories were constant for both the elderly and the deafferented patient while younger participants raised their hand higher when the object weighed more. It appears that, depending on age and on available proprioceptive information, the CNS uses different strategies of lifting. We suggest that elder people tend to optimize their feedforward control in order to compensate for less functional afferent feedback, perhaps to optimize movement time and energy expenditure at the expense of high precision. In the case of complete loss of proprioceptive input, however, compensation follows a different strategy as suggested by GL's behavior who moved more slowly compared to both our younger and older participants.

Forward-backward postural protective stepping responses in young and elderly adults

OBJECTIVES

Protective steps are essential for fall avoidance. Most studies only examined forwards stepping despite considerable bio-mechanical and visual differences between the forwards and backwards directions. We assess forward-backward differences in protective steps in a young and elderly group.

METHODS

Protective stepping responses were elicited by a platform moving unpredictably either forwards or backwards. For control purposes, voluntary steps, in response to vibration cues on the forehead or occiput were also recorded. Reaction time (RT), length and angular velocity of the steps were measured in 13 young (age 19-35years) and 13 elderly (age 58-86years) healthy volunteers.

RESULTS

(i) Protective vs voluntary steps: protective steps were earlier, faster and longer than voluntary steps. (ii) Forwards-backwards differences: RT was quicker for backwards than forwards protective steps, in contrast to voluntary steps where RTs were similar in the two directions. (iii) Age difference: the elderly had universally slower steps and they generated shorter backwards than forwards protective steps.

CONCLUSIONS

Protective steps appear more robust than voluntary steps - they are earlier (shorter RT), longer and faster than voluntary steps, indicating an automatic rather than a volitional reaction. Backwards protective steps occur earlier than forwards; such promptness may have evolved out of bio-mechanical features which make falling backwards easier. Since our elderly subjects had an average age <70years, their slower and shorter protective backwards steps may represent the first abnormality in this rescue postural response. The findings in the elderly may partly depend on dysfunction in fronto-basal ganglia postural loops.

Arm-curl field test for older women: is it a measure of arm strength?

The facilitative effect of physical activity on age-related decline is well documented. Specifically, it has been found to reduce the risk of dependency. However, physical activity programs for older adults should be carefully designed so that improvements in all aspects of movement and physical capacities are achieved. This means that efficient fitness measurements should be made available for coaches and trainers. The arm-curl test is a common field test known for measuring the strength of upper extremities in older age. The objective of the current study was to determine to what extent this test indeed assesses arm strength as well as other fitness aspects such as arm muscle endurance or general endurance. Scores of the arm-curl test were compared with strength and endurance of elbow flexors measured by an isokinetic dynamometer and general endurance measured by a stress test in 48 independently functioning women (age 72.04 ± 6.28 yr). Significant correlations were indicated between the arm-curl scores and both isokinetic endurance (r = 0.452) and general endurance (r = 0.437); however, a very low nonsignificant correlation was found between the arm-curl and isokinetic maximal strength scores. Coaches must be aware of the fact that the repetitive arm-curl exercise contains a significant aerobic component and thus may contribute to aerobic fitness and arm muscle endurance but not necessarily to arm strength.

Variability of EMG patterns: a potential neurophysiological marker of Parkinson's disease?

OBJECTIVE

This study evaluated whether changes in the electromygraphic (EMG) pattern during rapid point-to-point movements in individuals diagnosed with PD can: (1) distinguish PD subjects from healthy subjects and (2) determine if differences in the EMG pattern reflect disease severity in PD.

METHODS

Three groups of 10 PD subjects and 10 age/sex-matched healthy subjects performed rapid 72 degree point-to-point elbow flexion movements. PD subjects were divided, a priori, into three groups based upon off medication motor UPDRS score.

RESULTS

Measures related to the EMG pattern distinguished all PD subjects and 9 out of 10 healthy subjects, resulting in 100% sensitivity. Further, significant correlations were shown between EMG measures and the motor UPDRS score. After 30 months, the one healthy subject whose EMG pattern was abnormal was reexamined. The EMG measures remained abnormal and the motor UPDRS score went from 0 to 10. Parkinson's disease was diagnosed.

CONCLUSION

Measures related to the variability of the EMG pattern during rapid point-to-point movements provide neurophysiological measures that objectively distinguish PD subjects from healthy subjects. These measures also correlate with disease severity.

SIGNIFICANCE

EMG measures may provide a non-invasive measure that is sensitive and specific for identifying individuals with PD.

Developmental changes in unimanual and bimanual aiming movements

The aim of this study was twofold: (a) analyze the development of reaction time (RT) and movement time (MT) for bimanual and unimanual movements and (b) investigate the interaction of age and sex on the changes in RT and MT. Participants (5-, 8-, and 11-year-olds) were asked to aim at target buttons under three conditions of movement: unimanual, bimanual symmetrical, and bimanual nonsymmetrical. As expected, RTs for bimanual symmetrical movements were shorter than RTs for unimanual and bimanual nonsymmetrical movements in the 5-year-olds. By the age of 8, bimanual nonsymmetrical movements still yielded longer RTs than unimanual and bimanual symmetrical movements, which no longer differed from each other. Regarding MT, in the 2 younger groups there was an advantage of unimanual over bimanual symmetrical movements. The latter were executed faster than nonsymmetrical movements at all ages. These results suggest that the evolution of RT and MT with age reflects development of interhemispheric transfer of information. It appears that the functional improvement of such transfer, which depends on the corpus callosum, progressively enables contralateral motor inhibition and the coordination of complex bilateral movements. The exchange of movement feedback information could mature more slowly than that of feed-forward information, explaining the extended time course of MT evolution.

A female advantage in the serial production of non-representational learned gestures

Clinical research has demonstrated a sex difference in the neuroanatomical organization of the limb praxis system. To test for a corresponding sex difference in the functioning of this system, we compared healthy men and women on a gesture production task modeled after those used in apraxia research. In two separate studies, participants were taught to perform nine non-representational gestures in response to computer-generated color cues. After extensive practice with the gestures, the color cues were placed on a timer and presented in randomized sequences at progressively faster speeds. A detailed videotape analysis revealed that women in both studies committed significantly fewer 'praxic' errors than men (i.e., errors that resembled those seen in limb apraxia). This was true during both the untimed practice trials and the speeded trials of the task, despite equivalent numbers of errors between the sexes in the 'non-praxic' (i.e., executory) error categories. Women in both studies also performed the task at significantly faster speeds than men. This finding was not accounted for by a female advantage in extraneous elements of the task, i.e., speed of color processing, associative retrieval, or motor execution. Together, the two studies provide convergent support for a female advantage in the efficiency of forelimb gesture production. They are consistent with emerging evidence of a sex difference in the anatomical organization of the praxis system.

The EXCITE trial: attributes of the Wolf Motor Function Test in patients with subacute stroke

The Wolf Motor Function Test (WMFT) has been used in rehabilitation studies of chronic stroke patients, but until now its psychometric properties have not been evaluated in patients with subacute stroke. Two hundred twenty-nine participants with subacute stroke (3-9 months postinjury) at 7 research sites met inclusion criteria for the EXCITE Trial and were randomized into immediate or delayed (by 1 year) constraint-induced movement therapy treatment. All evaluations were undertaken by assessors standardized in the administration of the WMFT and masked to treatment designation. Participants were also assessed using the Fugl Meyer Motor Assessment (FMA). Delayed group members had measurements repeated 2 weeks following baseline assessment to determine learning or exposure effects. The results demonstrate that the WMFT differentiated higher from lower functioning participants across sites; scores were uninfluenced by hand dominance or affected side. Women exhibited slower performance times than men. The Functional Ability scale (FAS) portion of the WMFT also revealed lower scores among lower functioning participants and women. Minimal changes were observed after repeating the WMFT among delayed group participants 2 weeks later. The FMA revealed similar results when the total group was divided into higher and lower functional levels at its midpoint score of 33. The WMFT discriminates higher from lower functioning participants tested across research sites. Comparable findings using the FMA support the criterion validity of the WMFT.

Timing of ball release in overarm throws affects ball speed in unskilled but not skilled individuals

We tested the hypothesis that variability in the timing of ball release in overarm throws affects ball speed. Nine unskilled and six skilled throwers made 30 throws fast and accurately from a sitting and standing position. Angular positions of finger and arm segments were recorded with search-coils at 1000 Hz; ball speed was measured with a radar gun. The time of ball release from the fingertips was measured with respect to seven arm kinematic reference points. Mean timing windows for ball release were 28 ms for unskilled throwers and 7 ms for skilled throwers. Mixed-model analyses of variance showed that a there was a statistically significant relationship between ball speed and the timing of ball release in unskilled throwers, but not in skilled throwers. This was presumably due to the difference in variability of the timing of ball release between the two groups. In contrast, skilled throwers showed a relationship between ball speed and peak forearm angular velocity (one measure of arm speed). We conclude that although variability in the timing of ball release can affect ball speed, this is only a major factor in unskilled throwers. When skilled throwers throw fast, variability in ball speed is due to variability in arm speed.

Muscle activation patterns in point-to-point and reversal movements in healthy, older subjects and in subjects with Parkinson's disease

When young, healthy subjects perform rapid point-to-point and reversal movements over a range of distances, the patterns of muscle activation associated with accelerating the limb toward the target are modulated in the same way for both movement tasks. Differences in patterns of muscle activation for these two movement types are not observed until the deceleration phase of the movements. In this study, we first test the hypothesis that healthy, older subjects and subjects with Parkinson's disease will modulate the pattern of muscle activation in the same way during the acceleration phase of point-to-point and reversal elbow movements. Second, we test the hypothesis that healthy, older subjects and subjects with Parkinson's disease exhibit the same relationship in muscle activation patterns between the two movement types that have been observed for the young in the deceleration phase of the movements. Subjects performed point-to-point and reversal movements initiated in the direction of flexion over three distances (36, 54 and 72 degrees) "as fast as possible". Angle, velocity, acceleration and surface EMGs from biceps and triceps were recorded. With respect to the first hypothesis, the EMG, kinetic, and kinematic measures related to the acceleration phase of the movements were modulated in the same way for both movement types in the healthy older subjects. In the Parkinson's disease group, the kinematic and kinetic measures during the acceleration phase of the movements were the same in both movement types; however, the flexor and extensor EMG activation was smaller during reversal movements than during point-to-point movements. With respect to the second hypothesis, in contrast to that found in young subjects, in healthy older subjects, there was no significant difference between the movement types in the flexor EMG activity immediately after the time of peak velocity. This difference between younger and older subjects may be attributed to the fact that older subjects perform both movement types more slowly than do younger subjects. Although subjects with Parkinson's disease also move slowly, the flexor EMG shuts off more abruptly and more completely just after the time of peak velocity during reversal movements than during point-to-point movements. These results show that (1) for healthy subjects, when the task requirements are the same for the two movement types (acceleration phase), muscle activation patterns are modulated in the same way, and (2) both age and disease alter the relationship of muscle activation, kinetics and kinematics between point-to-point and reversal movements.

EMG remains fractionated in Parkinson's disease, despite practice-related improvements in performance

OBJECTIVE

We studied the ability of patients with Parkinson's disease to improve their performance in a motor task requiring both speed and accuracy in the execution of elbow flexion movements. Our goal was to investigate the changes in electromyographic activity associated with the changes in movement performance.

METHODS

Eleven patients on anti-Parkinsonian medication were tested. The patients were selected for being bradykinetic, having little or no resting tremor or dyskinesias, and being in stages II or III of the Hoehn and Yahr rating scale.

RESULTS

The untrained patients displayed multiple bursts of agonist activity, characteristic of Parkinsonian EMG recordings. All patients improved their performance by increasing peak velocity while maintaining movement accuracy within strict boundaries. With practice, the patients' performance changed in a manner similar to that which has been previously observed for performance curves in neurologically normal subjects. As movement duration decreased (i.e. peak velocity increased), we observed a slight decrease in the number of agonist bursts and an increase in the average burst duration. However, the patients continued to generate a fractionated, multi-burst agonist pattern.

CONCLUSIONS

We conclude that Parkinsonian patients benefit from practice by improving their performance but remain fundamentally impaired in the generation of muscle activation patterns. This study has shown that the generation of fractionated, multiple short bursts of EMG activity that is characteristic of movements made by Parkinsonian patients is not normalized by practice.

Gender dependent EMGs of runners resolved by time/frequency and principal pattern analysis

A promising approach for the analysis of surface electromyograms is to use wavelets to determine the spectral distribution of the signal intensity at any time. The authors have recently proposed using non-linearly scaled wavelets to obtain intensity patterns, which reflect the spectral distribution at any given time point. Further analysis of intensity-patterns is greatly facilitated by representing them as linear combinations of a base set of principal-patterns. The weight with which each principal-pattern contributes to the intensity-pattern can be represented on a set of orthogonal axes that span a previously introduced pattern space. The purpose of the present study was to show how to use pattern space to discriminate and classify male and female runners based on the electromyograms of five muscles of the limb. The results showed that there were significant gender specific differences, which allowed more than a 95% correct classification of the subjects as males or females. Classification was possible irrespective of the shod condition while running. Gender specific differences occurred at well-defined time periods during the movement. Common to both genders was that spectral changes did not parallel the changes in total signal intensity.

Effect of medication on EMG patterns in individuals with Parkinson's disease

Individuals with Parkinson's disease show dramatic improvements in their ability to move when medicated. However, the neural cause of this improvement is unclear. One hypothesis is that neural activation patterns, as measured by surface electromyography (EMG), are normalized by medication. We tested this hypothesis by investigating the effect of medication on the electromyographic (EMG) patterns recorded when individuals with idiopathic Parkinson's disease performed elbow flexion movements over three movement distances while off and on antiparkinsonian medication. When the subjects were off medication, they lacked the ability to modulate the agonist EMG burst duration with changes in movement distance. The ability to modulate agonist EMG burst duration is characteristic of the EMG patterns observed in healthy subjects. Also, multiple agonist bursts were exhibited during the acceleration phase. As expected, medication diminished the clinical signs of Parkinson's disease, increased movement speed, and increased the magnitude of the first agonist burst. Medication did not restore agonist burst duration modulation with movement distance, did not change the frequency of agonist bursting, and did not alter the timing of the antagonist activation. These results show that medication does not alter the temporal profile of EMG activation.