Activation of plantar flexor muscles is constrained by multiple muscle synergies rather than joint torques

The effect of knee angle and subject position on plantar flexors isokinetic performance and muscular activity

BACKGROUND: Assessment of the plantar flexion (PF) isokinetic performance has been greatly diverse and based on personal preferences rather than standardized guidelines. OBJECTIVE: To examine the performance of the plantar flexors under different settings including knee joint angle and subject position. METHODS: Thirteen women and 20 men took part in this study. The isokinetic protocol (60∘/s) was set to ankle movement between 10∘ dorsiflexion to 30∘ PF. Participants performed three repetitions of concentric PF in randomly-ordered knee angles; 15∘, 45∘ and 90∘, and in seated and supine positions. Surface electromyography (EMG) data were collected from the Soleus (SOL) and Gastrocnemius. RESULTS: Knee angle impacted the PF moment (P⩽ 0.001–0.026) and work (P⩽ 0.05) measures in both genders. The moment and work measures were significantly less in the 90∘ than those in the 45∘ and 15∘ positions. The 45∘ position had the highest values, particularly in sitting in the male participants. Only the GL EMG data was significantly impacted (P= 0.017) by the subject position. However, the difference was trivial (1.6%). The SOL muscle showed a consistent pattern of increased activity when the knee was in flexion. CONCLUSION: The 45∘ position seems to be optimal for obtaining the highest isokinetic PF scores.

Dynamic Modulation of a Learned Motor Skill for Its Recruitment

Humans learn motor skills (MSs) through practice and experience and may then retain them for recruitment, which is effective as a rapid response for novel contexts. For an MS to be recruited for novel contexts, its recruitment range must be extended. In addressing this issue, we hypothesized that an MS is dynamically modulated according to the feedback context to expand its recruitment range into novel contexts, which do not involve the learning of an MS. The following two sub-issues are considered. We previously demonstrated that the learned MS could be recruited in novel contexts through its modulation, which is driven by dynamically regulating the synergistic redundancy between muscles according to the feedback context. However, this modulation is trained in the dynamics under the MS learning context. Learning an MS in a specific condition naturally causes movement deviation from the desired state when the MS is executed in a novel context. We hypothesized that this deviation can be reduced with the additional modulation of an MS, which tunes the MS-produced muscle activities by using the feedback gain signals driven by the deviation from the desired state. Based on this hypothesis, we propose a feedback gain signal-driven tuning model of a learned MS for its robust recruitment. This model is based on the neurophysiological architecture in the cortico-basal ganglia circuit, in which an MS is plausibly retained as it was learned and is then recruited by tuning its muscle control signals according to the feedback context. In this study, through computational simulation, we show that the proposed model may be used to neurophysiologically describe the recruitment of a learned MS in novel contexts.

Interlimb Asymmetries and Ipsilateral Associations of Plantar Flexors and Knee Extensors Rate-of-Force Development Scaling Factor

Rate of force/torque development scaling factor (RFD-SF/RTD-SF) was recently introduced as a tool to quantify the neuromuscular quickness, and it could have potential for interlimb asymmetry identification. Moreover, positive relationships in RFD-SF ability among different muscle groups were shown, but not in the lower extremity. The first aim of our study was to use RTD-SF for interlimb asymmetry identification. The second aim was to determine associations between plantar flexors (PF) and knee extensors (KE). Forty young healthy athletes (14.8 ± 1.2 years) performed explosive isometric contractions to a span of torque levels for PF and KE. From rapid isometric contractions, the RTD-SF and linearity (r2) of the regression line were calculated. Using RTD-SF we identified 10% (PF) and 15% (KE) of subjects with contralateral asymmetries (>15% criterion). The results revealed significant positive moderate correlation in RTD-SF between PF and KE (r = 0.401, p < 0.05). We supported that RTD-SF can be a useful tool for interlimb asymmetry identification. Future research about observed asymmetry in rapid submaximal contractions deserves more attention, as most of the functional sport specific activities put high demands on rapid force production. Our study as first confirmed positive associations in RTD-SF ability between muscle groups in lower limbs.

Clinical Course of Motor Deficits from Lumbosacral Radiculopathy Due to Disk Herniation

BACKGROUND

The clinical course of motor deficits from lumbosacral radiculopathy appears to improve with or without surgery. Strength measurements have been confined to manual muscle testing (MMT) and have not been extensively followed and quantified in prior studies.

OBJECTIVE

To determine if motor weakness and patient-reported outcomes related to lumbosacral radiculopathy improve without surgical intervention over the course of 12 months.

DESIGN

Prospective observational cohort.

SETTING

Outpatient academic spine practice.

PARTICIPANTS

Adults with acute radicular weakness due to disk herniation.

METHODS

Forty patients with radiculopathy and strength deficit were followed over a 12-month period. Objective strength and performance tests as well as survey-based measurements were collected at baseline and then every 3 months. Patients underwent comprehensive pain management and rehabilitation and/or surgical approaches as determined in coordination with the treating specialist. This study was approved by the institutional review board of Colorado.

MAIN OUTCOME MEASUREMENTS

Testing of strength was through MMT, handheld dynamometer, and performance-based testing. Furthermore, visual analog scale, modified Oswestry Disability Index, and 36-Item Short Form Health Survey (SF-36) were used to measure pain and disability outcomes.

RESULTS

Of the 40 patients, 33 (82.5%) did not have surgery; 7 (17.5%) had surgery. Twenty-four of the 33 patients (60%) did not undergo surgery and were followed for 12 months (Comprehensive Pain Management and Rehabilitation, Complete [CPM&R-C]), and 9 (22%) did not have surgery and lacked at least one follow-up evaluation (Comprehensive Pain Management and Rehabilitation, Incomplete [CPM&R-I]). No statistically significant differences were found on baseline measures of strength deficits and SF-36 domains between the CPM&R-C, Surgery, and CPM&R-I groups. Pain and disability scores in the Surgery group were significantly higher than in the CPM&R-C at baseline. There were statistically significant improvements in all areas of strength, pain, and function when comparing measurements at the 12-month follow-up to baseline in the CPM&R-C group.

CONCLUSIONS

Individuals with motor deficits due to lumbosacral radiculopathy improve over time regardless of treatment choice. Most did not choose surgery, and almost all of these patients regained full strength at 1 year. Strength recovery typically occurred in the first 3 months, but there was ongoing recovery over the course of a year.

LEVEL OF EVIDENCE

II.