How much does the human medial gastrocnemius muscle contribute to ankle torques outside the sagittal plane?

Ankle movements in the frontal plane are less prominent though not less relevant than movements in the plantar or dorsal flexion direction. Walking on uneven terrains and standing on narrow stances are examples of circumstances likely imposing marked demands on the ankle medio-lateral stabilization. Following our previous evidence associating lateral bodily sways in quiet standing to activation of the medial gastrocnemius (MG) muscle, in this study we ask: how large is the MG contribution to ankle torque in the frontal plane? By arranging stimulation electrodes in a selective configuration, current pulses were applied primarily to the MG nerve branch of ten subjects. The contribution of populations of MG motor units of progressively smaller recruitment threshold to ankle torque was evaluated by increasing the stimulation amplitude by fixed amounts. From smallest intensities (12–32 mA) leading to the firstly observable MG twitches in force-plate recordings, current pulses reached intensities (56–90 mA) below which twitches in other muscles could not be observed from the skin. Key results showed a substantial MG torque contribution tending to rotate upward the foot medial aspect (ankle inversion). Nerve stimulation further revealed a linear relationship between the peak torque of ankle plantar flexion and inversion, across participants (Pearson R > .81, p < .01). Specifically, regardless of the current intensity applied, the peak torque of ankle inversion amounted to about 13% of plantar flexion peak torque. Physiologically, these results provide experimental evidence that MG activation may contribute to stabilize the body in the frontal plane, especially under situations of challenged stability.     

Positive relationship between passive muscle stiffness and rapid force production

We aimed to examine the relationship among the muscle shear modulus at rest, maximal joint torque, and rate of torque development (RTD). Twenty-seven participants (28 ± 5 years, 13 women) were recruited in the study. The cross-sectional area (CSA) of the medial gastrocnemius (MG) muscle belly and shear modulus at an ankle joint angle of 0° were calculated using magnetic resonance imaging and ultrasound shear wave elastography, respectively. Subsequently, participants performed maximal isometric plantar flexion at 0° ankle joint angle [maximal voluntary contraction (MVC) test] as fast and hard as possible (RTD test). RTD was calculated from the time–torque curve over time intervals of 0–30, 0–50, 0–100, 0–150, and 0–200 ms from the onset of plantar flexion during the RTD test and was normalized by MVC torque to exclude muscle strength. MG CSA correlated significantly with MVC torque (r = 0.572), whereas MG shear modulus did not. In contrast, MG shear modulus correlated significantly with normalized RTD at all time intervals (r = 0.460–0.496). These results suggest that passive muscle stiffness is not associated with muscle force; however, higher passive muscle stiffness at a given joint angle may contribute to rapid force production.     

Inter- and intra-lower limb joint coordination of non-expert classical ballet dancers during tiptoe standing

The main objective of this study was to compare ballet dancers’ and non-dancers’ joint coordination during tiptoe standing. Nine female non-expert ballet dancers and nine female non-dancers were asked to perform heel-toe and tiptoe standing for approximately 30 s, during which the center of pressure (COP) and kinematic data from the metatarsophalangeal, ankle, knee, and hip joints were measured. Principal component analysis was performed on the angular displacements to determine joint coordination. The weighting vectors suggested that dancers’ ankle and knee joints fluctuated in-phase in the anteroposterior direction, whereas all combinations of adjacent joints had anti-phase coordination for non-dancers. In addition, there was a significant difference in the intra-joint coordination pattern between groups. In particular, dancers’ metatarsophalangeal (MP) and ankle joints tended to sway to the left-front or right-rear. However, there were no differences between the groups in the path length or rectangular COP. These results suggest that dancers maintained quiet postures via a decrease in the mechanical degree of freedom and that postural expertise may not be determined from a traditional COP analysis, even during unstable tiptoe standing. This in-phase coordination, which has an arch-like configuration, could be characteristic of dancers’ lithe legs.     

Using Corticomuscular and Intermuscular Coherence to Assess Cortical Contribution to Ankle Plantar Flexor Activity During Gait

The present study used coherence and directionality analyses to explore whether the motor cortex contributes to plantar flexor muscle activity during the stance phase and push-off phase during gait. Subjects walked on a treadmill, while EEG over the leg motorcortex area and EMG from the medial gastrocnemius and soleus muscles was recorded. Corticomuscular and intermuscular coherence were calculated from pair-wise recordings. Significant EEG–EMG and EMG–EMG coherence in the beta and gamma frequency bands was found throughout the stance phase with the largest coherence towards push-off. Analysis of directionality revealed that EEG activity preceded EMG activity throughout the stance phase until the time of push-off. These findings suggest that the motor cortex contributes to ankle plantar flexor muscle activity and forward propulsion during gait.     

Ankle Intrinsic Stiffness in Subcortical Poststroke Subjects

The authors' purpose was to evaluate bilateral ankle intrinsic stiffness in subcortical poststroke subjects. Ten subcortical poststroke subjects and 10 healthy controls participated in this study. The ankle passive stiffness at 3 different speeds and the electromyographic activity of the soleus, the gastrocnemius, and the tibialis anterior muscles of poststroke contralesional (CONTRA) and ipsilesional (IPSI) limbs and of one limb of healthy subjects were assessed. Ankle electromyographic activity was collected to ensure that reflexive or voluntary muscle activity was not being elicited during the passive movements. A significant interaction was observed between the effects of the limb (IPSI vs. CONTRA vs. control) and ankle position, F(4, 28) = 3.285, p = .025, and between the effects of the limb and the velocity of stretch, F(2, 14) = 4.209, p = .037. While increased intrinsic stiffness was observed in the CONTRA limb of poststroke subjects at ankle neutral position when the passive stretch was applied with a velocity of 1°/s (p = .021), the IPSI limb of poststroke subjects presented increased stiffness at 20º of plantar flexion when the stretch was applied with a velocity of 5°/s (p = .009) when compared to healthy group. Subcortical poststroke subjects present increased intrinsic stiffness in both the CONTRA and IPSI limbs in specific ankle amplitudes.     

Effects of plantar cutaneo-muscular and tendon vibration on posture and balance during quiet and perturbed stance

Modulation of lower limb somatosensory information by tendon or plantar vibration produces directionally specific, vibration-induced falling reactions that depend on the tendon or the region of the sole that is vibrated. This study characterized the effects of different patterns of plantar cutaneo-muscular vibration and bilateral Achilles tendon vibration (ATV) on the postural strategies observed during quiet and perturbed stance. Twelve healthy young participants stood barefooted, with their vision blocked, on two sets of plantar vibrators placed on two AMTI force plates embedded in a moveable support surface. Two other vibrators were positioned over the Achilles tendons. Participants were randomly exposed to different patterns of plantar cutaneo-muscular and ATV. Tilts of the support surface in the toes-up (TU) and toes-down (TD) directions were given 5-8 s after the beginning of vibration. Body kinematics in 3D and ground reaction forces were recorded. Bilateral ATV applied with or without rearfoot vibration (RFV) during quiet stance resulted in a whole-body backward leaning accompanied by an increase in trunk extension and hip and knee flexion. RFV alone produced a forward whole-body tilt with increased flexion in trunk, hip, and ankle. When stance was perturbed by TU tilts, the center of mass (CoM) and center of pressure (CoP) displacements were larger in the presence of RFV or ATV and associated with increased peak trunk flexion. TD tilts with or without ATV resulted in no significant difference in CoM and CoP displacements, while larger trunk extension and smaller distal angular displacements were observed during ATV. RFV altered the magnitude of the balance reactions, as observed by an increase in CoP displacements and variable response in trunk displacement. Significant interactions between ATV and RFV were obtained for the peak angular excursions for both directions of perturbations, where ATV either enhanced (for TU tilts) or attenuated (for TD tilts) the influence of RFV. Manipulating somatosensory information from the plantar cutaneo-muscular and muscle spindle Ia afferents thus results in altered and widespread postural responses, as shown by profound changes in body kinematics and CoM and CoP displacements. This suggests that the CNS uses plantar cutaneo-muscular and ankle spindle afferent inputs to build an appropriate reference of verticality that influences the control of equilibrium during quiet and perturbed stance.     

A modified surface EMG biomarker for gait assessment in spastic cerebral palsy

ObjectiveMuscle clinical metrics are crucial for spastic cocontraction management in children with Cerebral Palsy (CP). We investigated whether the ankle plantar flexors cocontraction index (CCI) normalized with respect to the bipedal heel rise (BHR) approach provides more robust spastic cocontraction estimates during gait than those obtained through the widely accepted standard maximal isometric plantar flexion (IPF).MethodsTen control and 10 CP children with equinus gait pattern performed the BHR and IPF testing and walked barefoot 10-m distance. We compared agonist medial gastrocnemius EMG during both testing and CCIs obtained as the ratios of antagonist EMG during swing phase of gait and either BHR or IPF agonist EMG.ResultsAgonist EMG values from the BHR were: (i) internally reliable (Cronbach's α = 0.993), (ii) ~50 ± 0.4% larger than IPF, (iii) and positively correlated. Derived CCIs were significantly smaller (p < 0.05) in both populations.ConclusionThe bipedal heel rise approach may be accurate enough to reveal greater agonist activity of plantar flexors than the maximal isometric plantar flexion and seems to be more appropriate to obtain cocontraction estimates during swing of gait.SignificanceThis modified biomarker may represent a step forward towards improved accuracy of spastic gait management in pediatric.     

Does a visual reference help ballet dancers turn more successfully?

In dance, performing multiple rotations around the longitudinal axis is a complex task that can only be accomplished proficiently by highly skilled dancers. However, this extraordinary skill has been investigated sparsely. The few studies to date have focused on the biomechanical analysis of ballet rotations. However, none have investigated the influence of visual information on continuous rotations, such as Fouettés or à la Seconde turns. Therefore, the present study aims to examine the role of a visual reference on balance control and the dance-specific head coordination – spotting – during turning performance of highly skilled ballet dancers. To this end, 12 participants performed 12 Fouettés (females) or à la Seconde turns (males) with and without a visual reference. As dependent measures, we analysed balance control (i.e., supporting foot path length), spotting duration, head isolation, and orientation (i.e., deviation of pelvis from the front). A linear mixed model was performed to analyse the influence of the visual conditions overall and over the continued performance of 12 consecutive rotations. The results revealed that overall, path length was significantly smaller in the condition without a visual reference. Spotting duration and head isolation did not differ significantly between conditions. Moreover, dancers oriented themselves better towards the front in the condition with a visual reference. When looking closer into the progression of performance over each consecutive rotation, highly skilled ballet dancers significantly decreased the supporting foot path length, and improved orientation when turning with a visual reference. On the other hand, without a visual reference, the dancers increased the spotting duration over time. Additionally, dancers increased head isolation towards the end of the turns in both conditions. These findings suggest that a visual reference helps ballet dancers sustain performance of consecutive rotations, mainly in optimising balance control and orientation. Thus, the more rotations a ballet dancer must turn, the more relevant a visual reference becomes for sustaining successful performance.     

Neuromuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inversion perturbations during a single leg drop-landing

While neuromuscular control deficits during inversion perturbations in chronic ankle instability (CAI) cohorts are well documented in the literature, anticipatory motor control strategies to inversion perturbations in CAI are largely unknown. The purpose of this study was to examine neuromuscular control and ankle kinematics in individuals with CAI (n = 15) and matched controls (n = 15) during unexpected and expected single leg drop-landings onto a tilted surface rotated 20° in the frontal plane. Muscle activity from 200 ms pre- to post-landing was recorded from the tibialis anterior (TA), medial gastrocnemius (MG), peroneus longus (PL) and peroneus brevis (PB). Mean muscle activity, co-contraction index (CCI), and peroneal latency was analyzed. Ankle inversion angle at initial contact, time to maximum inversion angle, maximum inversion angle and velocity were also assessed. Significantly longer PL latency, less time to maximum inversion and greater maximum inversion angle was found in CAI compared to controls. Regarding landing condition, significantly greater maximum inversion angle, less inversion at initial contact, longer PB latency, less TA activity and frontal plane CCI during the post-landing phase was found during the unexpected perturbation. Prolonged PL latency and altered ankle kinematics suggests reduced frontal plane ankle stabilization in CAI. However, similar motor control strategies were utilized in both groups during the ankle inversion perturbations.     

The relationship between hip,knee and ankle muscle mechanical characteristics and gait transition speed

The purpose of the present study was to explore the relationship between mechanical characteristics of hip, knee and ankle extensor and flexor muscle groups and gait transition speed. The sample included 29 physically active male adults homogenized regarding their anthropometric dimensions. Isokinetic and isometric leg muscle mechanical characteristics were assessed by an isokinetic dynamometer, while individual walk-to-run (WRT) and run-to-walk transition speeds (RWT) were determined using the standard increment protocol. The relationship between transition speeds and mechanical variables scaled to body size was determined using Pearson correlation and stepwise linear regression. The highest correlations were found for isokinetic power of ankle dorsal flexors and WRT (r = .468, p < .01) and the power of hip extensors and RWT (r = .442, p < .05). These variables were also the best predictors of WRT and RWT revealing approximately 20% of explained variance. Under the isometric conditions, the maximal force and rate of force development of hip flexors and ankle plantar flexors were moderately related with WRT and RWT (ranged from r = .340 to .427). The only knee muscle mechanical variable that correlated with WRT was low velocity knee flexor torque (r = .366, p < .05). The results generally suggest that the muscle mechanical properties, such as the power of ankle dorsal flexors and hip extensors, influence values of WRT and RWT.     

Unipodal performance and leg muscle mass in jumping skills among ballet dancers

We examined the vertical jump performance of each leg among 10 right-footed female ballet dancers with 1 yr. of international professional experience (quadrilles: Opera ballerinas). Their mean age was 17.5 yr. (SD=0.3). The maximal height of the unilateral jump was recorded, and muscle mass was evaluated by biphotonic absorptiometry method. Muscle mass and maximal jump height were similar for the two legs. A strong inverse relation was found between the muscle mass of the right leg (67%) and maximal jump height (r=-.81, p<.01) but not for the left leg. These results highlight a functional asymmetry and the effect of motor laterality in dance.     

Media influence and body dissatisfaction in preadolescent ballet dancers and non-physically active girls

ObjectivesThe present study analysed media influences and body dissatisfaction in preadolescent non-professional female ballet dancers and non-physically active girls.DesignCross-sectional design.MethodParticipants were 135 Italian preadolescent girls: 67 non-professional ballet dancers (M = 12.28 years) and 68 non-physically active girls (M = 12.56 years). Participants completed a questionnaire assessing body mass index (BMI), perceived media pressure to reach the societal body ideal, thin-ideal internalization, athletic internalization and body dissatisfaction.ResultsNo significant differences between ballet dancers and non-dancers emerged on age; however, dancers had a significantly lower BMI. Therefore, BMI was used as a covariate. No significant difference between the two groups emerged on perceived media pressure or thin-ideal internalization. Ballet dancers reported a higher level of athletic internalization and were more dissatisfied with their bodies than non-physically active girls. BMI emerged as the most important predictor of preadolescents' body dissatisfaction for both groups. Among non-dancers, perceived media pressure predicted body dissatisfaction both directly and indirectly via thin-ideal internalization. Among dancers, perceived media pressure predicted body dissatisfaction both directly and indirectly via athletic internalization but not via thin-ideal internalization.ConclusionsMedia influence emerged as an important predictor of body dissatisfaction for both groups, although the internalization of an athletic body ideal was more salient for the ballet dancers. These findings are noteworthy because they offer some clues for possible intervention programs aimed at promoting healthier body images in preadolescent ballet dancers and non-dancers and extend the existing literature on ballet dancers' body dissatisfaction.     

Ankle kinetics and plantarflexor morphology in older runners with different lifetime running exposures

Running promotes better cardiovascular health and has positive effects on the musculoskeletal system in older adults. However, older adults have lower ankle plantarflexor torques and positive powers during running, and exhibit changes in plantarflexor morphology than young adults. Since older runners who run as much as younger runners exhibit youthful ankle mechanical outputs, running exposure may preserve the locomotor factors that mediate running speed. The purpose of this study was to compare ankle mechanical output during running and plantarflexor morphological characteristics between older runners who have low or high lifetime running exposure. Ten older runners with low lifetime running exposure and nine older runners with high lifetime running exposure performed over-ground running trials at 3.0 m/s (±5%) while kinematic and ground reaction force (GRF) data were collected and used to compute joint angular kinetics. Right medial gastrocnemius morphological characteristics were assessed using ultrasonography at rest and during isometric contractions. Ankle torques, powers, and plantarflexor morphology were compared between groups. Older runners with different lifetime running exposures ran with similar ankle mechanical output (i.e. no effect of running exposure) (p > .05) and exhibited similar medial gastrocnemius morphology during isometric testing. The findings from this study demonstrate that lifetime running exposure does not appear to influence ankle mechanical output or plantarflexor morphology in middle-aged runners.     

Gastrocnemius and soleus are selectively activated when adding knee extensor activity to plantar flexion

The gastrocnemius is a biarticular muscle that acts not only as a plantar flexor, but also as a knee flexor, meaning that it is an antagonist during knee extension. In contrast, the soleus is a monoarticular plantar flexor. Based on this anatomical difference, these muscles’ activities should be selectively activated during simultaneous plantar flexion and knee extension, which occur during many activities of daily living. This study examined the selective activation of gastrocnemius and soleus activities when voluntary isometric activation of knee extensors was added to voluntary isometric plantar flexion. Ten male volunteers performed isometric plantar flexion at 10%, 20%, and 30% of maximum effort. During each plantar flexion task, isometric knee extension was added at 0%, 50%, and 100% of maximum effort. When knee extension was added, the average rectified value of the electromyographic activity of the medial gastrocnemius was significantly depressed (P = .002), whereas that of the soleus was significantly increased (P < .001) regardless of the plantar flexion level. These results suggest that plantar flexion with concurrent knee extensor activity leads to selective activation of the soleus and depression of the synergistic activity of the gastrocnemius.     

跟腱龙装置微创治疗急性跟腱断裂的临床疗效

报道应用跟腱龙（Achillon）装置微创技术治疗急性跟腱断裂的短期疗效。2009年10月～2013年4月共收治29例急性跟腱断裂患者,其中全部为运动损伤,年龄23岁～49岁,平均35．5岁。受伤至手术时间2天～5天。术前经临床查体及M RI检查确诊。术中采用跟腱断裂处3cm横行切口,使用跟腱龙装置进行跟腱缝合。术后早期功能锻炼并随访记录并发症和AOFAS评分。结果29例患者随访6个月～22个月,平均15个月,没有患者出现切口感染、跟腱再断裂、腓肠神经损伤等严重的并发症。平均AOFAS 评分94．1分。跟腱龙微创技术治疗急性跟腱断裂具有令人满意的疗效。     

A Dance with Many Secrets: The Experience of Emotional Harm from the Perspective of Past Professional Female Ballet Dancers in Canada

Originating in the Italian and French courts, ballet is an age-old art that fuses aesthetics and athleticism (Wulff, 2008). Despite changing times, ballet masters and mistresses tenaciously hold on to a sense of deep traditionalism. However, some scholars suggest that unwavering devotion to the art may conceal troubled embodied relations and oppressive practices (Gvion, 2008). In this study, we drew on the phenomenological research tradition in an effort to further examine the power relations that play out on the body in the world of Canadian professional ballet (Papaefstathiou, Rhind, & Brakenridge, 2013). Twenty past professional female ballet dancers from across Canada participated in this study. Our dedicated dancers were relentless. They sacrificed body and mind in the pursuit of excellence in a broader cultural context that expected nothing less. The dancers normalized harmful emotional experiences, inappropriate sexual transgressions, and chronic injury (Gvion, 2008). They also described experiences of neglect—and feeling replaceable—after the onset of injury. We have attempted to theorize our findings within the context of embodiment literature and the work of gender theorists. Emboldened by our dancers’ voices, we have shed light—and broken secrets—regarding some of the harmful practices that still characterize professional ballet in Canada. We hope that our work might further continue efforts to democratize power imbalances in professional ballet and ultimately enhance holistic dancer development and health.     

Aging-related cocontraction effects during ankle strategy balance recovery following tether release in women

Increased antagonistic muscle activation during balance recovery has been documented during proprioceptive reliant responses in older adults. The authors examined ankle muscle cocontraction levels in young and older adults during balance recovery from a tether-release-induced, vestibular-input-reliant perturbation. Nine healthy young adult and 9 older women without history of falls performed maximum isometric plantar flexion and dorsiflexion trials followed by balance recovery trials using the ankle strategy. Surface electromyography data normalized to isometric conditions were analyzed during the 100 ms prior to release, the 50 ms immediately after release, and the 100-ms epochs from 100-400 ms following release. No differences existed in gastrocnemius and soleus activity levels (p > .05), though antagonistic tibialis anterior activity was greater in the older adults during the 300-400 ms epoch (young: 23.5 ± 5.8%, older: 38.7 ± 9.4%; p = .001). Vestibular-dominated perturbations may increase antagonistic activity during the recovery phase in older adults, inhibiting efficient balance recovery during proprioceptive and vestibular reliant perturbations.     

Age and gender moderate the effects of localized muscle fatigue on lower extremity joint torques used during quiet stance

This study examined the effects of localized muscle fatigue, age, and gender on lower extremity joint torques used during quiet stance. Thirty-two participants performed exercises designed to fatigue the ankle plantarflexors, knee extensors, torso extensors, or shoulder flexors. Body kinematics and ground reaction forces were obtained both before and after the exercises, and joint torques were derived via inverse dynamics. Single joint fatigue affected torque variability at all lower extremity joints, with similar changes for both age groups. Males and females exhibited increased ankle torque variability after different tasks, with males showing more variability after ankle fatigue and females after shoulder and lumbar fatigue. Correlations between peak torques and torque variability differed between males and females and between age groups in certain cases. The results of this study suggested that both age and gender moderate the effects of fatigue on postural control and should be considered when developing strategies to prevent occupational falls.     

Ankle muscles activation and postural stability with Star Excursion Balance Test in healthy individuals

IntroductionThe ankle joint, a part of the kinetic chain of the lower limb, plays a significant role in the maintenance of postural stability during bipedal and unipedal balancing activities. This study aimed to evaluate the neuromuscular control of the ankle joint and the postural stability while executing the Star Excursion Balance Test (SEBT), by recording the EMG activity of the extrinsic ankle musculature and the displacement of the center of pressure (CoP).MethodsThe EMG activity of the tibialis anterior (TA), the peroneus brevis (PB) and the medial and lateral gastrocnemius (GM, GL), along with the anteroposterior and mediolateral displacements (APd and MLd) of CoP as well as the plantar pressure distribution of the supportive lower limb were recorded during reaching to the eight directions of SEBT in 29 healthy, physically active college students (15 males and 14 females; mean ± SD of age 25.6 ± 4.5 yrs.; height: 172.5 ± 8.2 cm; body weight: 67.7 ± 13.6 kg; and BMI: 22.6 ± 2.9 kg/m²).ResultsThe tibialis anterior muscle demonstrated the greatest EMG activity during SEBT, followed by the PB, GL and GM muscles. The increased EMG activity of TA and PB during the execution of all posterior-oriented and lateral directions coincided with a decreased APd of CoP and increased reaching distances. The opposite occurred during the execution of all the anterior-oriented and medial directions. The differences among the directions of SEBT regarding the EMG activity of GL, GM and the mediolateral displacement of CoP were, in general, not significant.ConclusionsThe neuromuscular control of the ankle joint and the associated postural stability during SEBT was highly depended upon the activation level of TA and PB, which should be considered by clinicians and sports specialists when using this test for screening and/or rehabilitation purposes.     

Sport Skill–Specific Expertise Biases Sensory Integration for Spatial Referencing and Postural Control

The authors asked how sport expertise modulates visual field dependence and sensory reweighting for controlling posture. Experienced soccer athletes, ballet dancers, and nonathletes performed (a) a Rod and Frame test and (b) a 100-s bipedal stance task during which vision and proprioception were successively or concurrently disrupted in 20-s blocks. Postural adaptation was assessed in the mean center of pressure displacement, root mean square of center of pressure velocity and ankle muscles integrated electromyography activity. Soccer athletes were more field dependent than were nonathletes. During standing, dancers were more destabilized by vibration and required more time to reweigh sensory information compared with the other 2 groups. These findings reveal a sport skill–specific bias in the reweighing of sensory inputs for spatial orientation and postural control.