Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements

To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions.     

Multi-body dynamic coupling mechanism for generating throwing arm velocity during baseball pitching

The purpose of this study was to identify the detailed mechanism how the maximum throwing arm endpoint velocity is determined by the muscular torques and non-muscular interactive torques from the perspective of the dynamic coupling among the trunk, thorax and throwing and non-throwing arm segments. The pitching movements of ten male collegiate baseball pitchers were measured by a three-dimensional motion capture system. Using the induced-segmental velocity analysis (IVA) developed in this study, the maximum fingertip velocity of the throwing arm (MFV) was decomposed into each contribution of the muscular torques, passive motion-dependent torques due to gyroscopic moment, Coriolis force and centrifugal force, and other interactive torque components. The results showed that MFV (31.6 ± 1.7 m/s) was mainly attributed to two different mechanisms. The first is the passive motion-dependent effect on increasing the angular velocities of three joints (thorax rotation, elbow extension and wrist flexion). The second is the muscular torque effect of the shoulder internal rotation (IR) torque on generating IR angular velocity. In particular, the centrifugal force-induced elbow extension motion, which was the greatest contributor among individual joint contributions, was caused primarily by the angular velocity-dependent forces associated with the humerus, thorax, and trunk rotations. Our study also found that a compensatory mechanism was achieved by the negative and positive contributions of the muscular torque components. The current IVA is helpful to understand how the rapid throwing arm movement is determined by the dynamic coupling mechanism.     

Physicians' H]ead and Body Positions as Determinants of Perceived Rapport

The relationship between physicians' b]ody movement and judgments of rapport was examined in this study. One-hundred eighteen observers rated physicians' b]ehavior on 14 bipolar scales assessing dimensions of empathy. Physicians' n]onverbal behavior was manipulated so that there were three levels of trunk angle (forward, straight, backward), two levels of arm position (open, folded), two levels of leg position (open, crossed), and two levels of head attitude (nodding, not-nodding). Significant effects were found for trunk angle, head attitude, and arm posture; physicians who leaned forward with open arm positions and nodded their head were judged more positively. Discussion focuses on the reinforcing valuc of nodding, judges' p]erceptions of physicians' a]ccessibility conveyed by trunk and arm postures, and expressions of dominance in physician-patient encounters.     

Analysis of toddlers' gait after six months of independent walking to identify autism: a preliminary study

This research analyzed gait in toddlers and tested the hypothesis that movement can be used as an early indicator of Autistic Disorder. It was proposed that an early identification method could indicate differences in the gait of toddlers with autism as opposed to those with typical development or with mental retardation. Observational methods were applied to retrospective home videos of 42 children after 6 mo. of independent walking. In particular, the Walking Observation Scale was used, which includes 11 items that analyze gait through three axes of foot movements, arm movements, and global movements. Analysis showed different distributions for the three groups, i.e., the autistic group differed from the other two on scores for the Walking Observation Scale and each axis. After 6 mo. of independent walking, different patterns in gait among groups were evident. These results agree with recently published evidence which acknowledges the importance of movement as an early indicator for differential diagnosis of autism.     

Repeated Exposure to Forward Support-Surface Perturbation During Overground Walking Alters Upper-Body Kinematics and Step Parameters

Locomotion requires both proactive and reactive control strategies to maintain balance. The current study aimed to: (i) ascertain upper body postural responses following first exposure to a forward (slip) support-surface perturbation; (ii) investigate effects of repeated perturbation exposure; (iii) establish relationships between arms and other response components (trunk; center of mass control). Young adults (N = 11) completed 14 walking trials on a robotic platform; six elicited a slip response. Kinematic analyses were focused on extrapolated center of mass position (xCoM), bilateral upper- and forearm elevation velocity, trunk angular velocity, and step parameters. Results demonstrated that postural responses evoked in the first slip exposure were the largest in magnitude (e.g., reduced backward stability, altered reactive stepping, etc.) and preceded by anticipatory anterior adjustments of xCoM. In relation to the perturbed leg, the large contra- and ipsilateral arm responses observed (in first exposure) were characteristically asymmetric and scaled to the degree of peak trunk extension. With repeated exposure, xCoM anticipatory adjustments were altered and in turn, reduced posterior xCoM motion occurred following a slip (changes plateaued at second exposure). The few components of the slip response that persisted across multiple exposures did so at a lesser magnitude (e.g., step length and arms).     

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.     

Changes in lower limb co-contraction and stiffness by toddlers with Down syndrome and toddlers with typical development during the acquisition of independent gait

During gait acquisition, children learn to use their changing resources to meet the requirements of the task. Compared to typically developing toddlers (TD), toddlers with Down syndrome (DS) have functionally different musculoskeletal characteristics, such as hypotonia, and joint and ligament laxity, that could produce a reduced passive stiffness. The interplay between this inherently lower passive stiffness and the demands of walking may result in different strategies during gait acquisition. This study compared normalized global stiffness and lower limb's co-contraction indices (CCI) used by toddlers with TD (n=12) and with DS (n=12), during the early stages of gait acquisition. Stiffness and CCI were normalized by gravitational torque (mLg) in both phases of gait (stance, swing). Five longitudinal evaluations were conducted from the onset of locomotion until three months post-acquisition. All children were video taped and had electromyographic (EMG) recordings from muscle pairs of one leg, which were used to calculate CCI of hip, knee, ankle, and total leg CCI. Body and lower limb stiffness were calculated according to a hybrid pendulum resonance equation. Results from ANOVAs revealed no group differences on stiffness or on CCI's during stance but children with DS showed greater CCI during swing. Despite the structural musculoskeletal differences between toddlers with TD and with DS, the similarities observed in their processes of gait development suggest functional equivalences.     

Trunk posture affects upper extremity function of adults

This study examined the effects of various seated trunk postures on upper extremity function. 59 adults were tested using the Jebsen Taylor Hand Function Test while in three different trunk postures. Significant mean differences between the neutral versus the flexed and laterally flexed trunk postures were noted during selected tasks. Specifically, dominant hand performance during the tasks of feeding and lifting heavy cans was significantly slower while the trunk was flexed and laterally flexed than when performed in the neutral trunk position. Performance of the nondomi nant hand during the tasks of picking up small objects, page turning, as well as the total score was slower while the trunk was flexed compared to performance in the neutral trunk position. These findings support the assumption that neutral trunk posture improves upper extremity performance during daily activities although the effect is not consistent across tasks. Findings are discussed along with limitations and recommendations for research.     

Comparing the effect of haptic modalities on walking balance control: Is using one or two arms better?

BackgroundAdding haptic input by lightly touching a railing or using haptic anchors may improve walking balance control. Typical use of the railing(s) and haptic anchors requires the use of one and two arms in an extended position, respectively. It is unclear whether it is arm configuration and/or the number of arms used or the addition of sensory input that affects walking balance control.Research questionThis study examined whether using one arm or two arms to add haptic input through light touch on a railing or using the haptic anchors affects walking balance control.MethodsIn this study, young adults (n = 24) walked while using (actual use) or pretending to use (pretend use) the railing(s) and haptic anchors with one or two arms. Inertial-based sensors (Mobility Lab, APDM) were used to measure stride velocity, relative time spent in double support (%DS), and peak normalized medio-lateral trunk velocity (pnMLTV).ResultsUsing two arms lead to a decrease in pnMLTV compared to using one arm and pnMLTV was lower in the actual use trials compared to the pretend use trials for the anchors only. Stride velocity and %DS did not change between trials when one or two arms were used or when participants actually or pretended to use the haptic tools. Participants walked slower when using the railing compared to the anchors.SignificanceThe importance of considering the number of arms is highlighted in the improved balance control when using two arms with either tool. The augmented sensory input adds to the stabilizing effect of arm configuration for the anchors but not the railings. These results have implications for future research and rehabilitation efforts emphasizing sensorimotor integration to improve walking balance control.     

Adaptive Dynamics of the Leg Movement Patterns of Human Infants: I. The Effects of Posture on Spontaneous Kicking

This is the first of two articles in which we describe how infants adapt their spontaneous leg movements to changes in posture or to elicitation of behaviors by a mechanical treadmill. In this article, we compare the kinematics of kicks produced by 3-month-old infants in three postures, supine, angled (45°), and vertical, and examine the changes in muscular and nonmuscular force contributions to limb trajectory. By manipulating posture we were able to assess the sensitivity of the nascent motor system to changes in the gravitational context. The postural manipulation elicited a distinct behavioral and dynamic effect. In the more upright postures, gravitational resistance to motion at the hip was 4 to 10 times greater than resistance met in the supine posture, necessitating larger muscle torques to drive hip flexion. Kicks produced in the vertical posture showed a reduction in hip joint range of motion and an increase in synchronous joint flexion and extension at the hip and knee. At the same time, hip and knee muscle torques were also more highly correlated in kicks performed in the vertical than in the supine or angled posture. This increased correlation between muscle torques at the hip and knee implicates anatomical and energetic constraints—the intrinsic limb dynamics—in creating coordinated limb behavior out of nonspecific muscle activations.     

Changes in step variability of new walkers with typical development and with Down syndrome

Models of human gait are based on adult locomotion. C. E. Bauby and A. D. Kuo (2000) proposed that adults rely on passive mechanisms at the spinal level to control motion in the anteroposterior direction and rely on direct monitoring of postural control in the lateral direction. The authors' purpose in this study was to determine if that model applies to control at the onset of walking in typically developing toddlers (n = 9) and in toddlers with Down syndrome (n = 6). Their longitudinal data suggested that toddlers control gait in a distinctly different manner than adults do. An adult pattern of control emerges with experience. In addition, the effect of experience on the emergence of that pattern is magnified by task-specific early intervention. The present data support the emergence and discovery of efficient patterns of control in this fundamental human behavior.     

Early stage of walking: development of control in mediolateral and anteroposterior directions

The authors examined the changes in bipedal gait of toddlers in the anteroposterior (AP) and mediolateral (ML) directions, as a set, at the onset of independent gait and 1 month after onset. Two groups with distinctly different dynamic resources were studied: 8 toddlers with typical development (TD) and 8 toddlers with Down syndrome (DS). Three-dimensional kinematic data were collected, and gait parameters, such as walking speed, stride length, and stride frequency, as well as the ratio of exchange between potential energy and kinetic energy of the center of mass (COM), were calculated. Displacement of the COM in the AP and ML directions were also analyzed. For some gait variables, toddlers with DS seemed to show more mature values at walking onset than their peers with TD. Those group differences reversed and increased by Visit 2. When the authors considered the motion of the COM of the system, it became clear that the qualitative differences between those groups were characterized primarily by constraints in the ML direction. The authors propose that establishment of coupling between AP and ML oscillations is a key component for the emergence of independent bipedal walking for both populations.     

Motor maps and synergies

Consider the process of raising and lowering the arm in the sagittal plane. Different parts of different muscles operate over different sectors of the angular range. How and why does the nervous system implement this differential muscle activation according to joint angle? We contend that such control depends on the adaptive formation of motor maps. These solve the problem of redundancy in the musculoskeletal system by connecting a relatively small number of cortical columns in the motor cortex to a large number of alpha motor neuron pools. We argue that motor maps are formed such that each functional muscle is activated in proportion to its moment arm about the movement. Because of this the required agonist and antagonist turning forces are generated with a minimum demand for metabolic energy. We know from biomechanical principles that, at any given posture, those muscle fibres that change length most in response to a small joint-angle change are those with the greatest moment arm. Likewise those that change least have the smallest. By establishing a model of the polynomial relationships between the lengths of functional muscles l and the corresponding changes in joint angles theta, the nervous system can generate signals partial differentiallj/ partial differentialthetai (where lj is the length of the jth functional muscle and thetai is the magnitude of the ith elemental movement). These signals create motor maps by modulating the gains of descending motor pathways. As a result, functional muscles are activated in proportion to their moment arms. This reduces the demand for metabolic energy to a minimum. Since moment arms change with joint angle, it also accounts for the experimental observations above. Such motor mapping effectively provides a minimum energy "wired-in" synergy. Established in utero, motor maps are the first stage of synergy formation and provide the basis for the development of subsequent task-dependent synergies.     

Enhanced arm swing alters interlimb coordination during overground walking in individuals with traumatic brain injury

The current study investigated interlimb coordination in individuals with traumatic brain injury (TBI) during overground walking. The study involved 10 participants with coordination, balance, and gait abnormalities post-TBI, as well as 10 sex- and age-matched healthy control individuals. Participants walked 12 m under two experimental conditions: 1) at self-selected comfortable walking speeds; and 2) with instructions to increase the amplitude and out-of-phase coordination of arm swinging. The gait was assessed with a set of spatiotemporal and kinematic parameters including the gait velocity, step length and width, double support time, lateral displacement of the center of mass, the amplitude of horizontal trunk rotation, and angular motions at shoulder and hip joints in sagittal plane. Interlimb coordination (coupling) was analyzed as the relative phase angles between the left and right shoulders, hips, and contralateral shoulders and hips, with an ideal out-of-phase coupling of 180° and ideal in-phase coupling of 0°. The TBI group showed much less interlimb coupling of the above pairs of joint motions than the control group. When participants were required to increase and synchronize arm swinging, coupling between shoulder and hip motions was significantly improved in both groups. Enhanced arm swinging was associated with greater hip and shoulder motion amplitudes, and greater step length. No other significant changes in spatiotemporal or kinematic gait characteristics were found in either group. The results suggest that arm swinging may be a gait parameter that, if controlled properly, can improve interlimb coordination during overground walking in patients with TBI.     

Starting position of movement and perception of angle of trunk flexion while standing with eyes closed.

The present study attempted to investigate the effect of position on the perception of angle of trunk flexion while standing. For this purpose, the range effect was factored out by setting the constant target angle at 10 degrees, with varied starting positions of trunk flexion. We found that subjects underestimated angle of trunk flexion when the starting position was close to a quiet standing posture, overestimated when close to maximum trunk flexion, and correctly perceived it when at the middle position. Less perceptual distortion was observed at the positions close to maximum trunk flexion in the present study than in our previous one, in which various target angles of trunk flexion were reproduced from a quiet standing posture. The reduced distortion in the present study was believed to have resulted from factoring out the range effect. The flexion angle of the hip joint changed in tandem with that of the trunk, while very little movement was observed in the ankle, knee, and neck joints. Judging from the changing pattern of hip-joint angle, the muscle activity of the erector spinae and biceps femoris increased gradually to 90 degrees trunk flexion. In contrast, the actual increment of muscle activity reached zero or a minimum value at the middle angles as the angle of trunk flexion increased. It was assumed that the abrupt change in kinesthetic information associated with muscle activity exerted a great influence on the perception of trunk flexion.     

Adaptive Dynamics of the Leg Movement Patterns of Human Infants: I. The Effects of Posture on Spontaneous Kicking

This is the first of two articles in which we describe how infants adapt their spontaneous leg movements to changes in posture or to elicitation of behaviors by a mechanical treadmill. In this article, we compare the kinematics of kicks produced by 3-month-old infants in three postures, supine, angled (45 degrees ), and vertical, and examine the changes in muscular and nonmuscular force contributions to limb trajectory. By manipulating posture we were able to assess the sensitivity of the nascent motor system to changes in the gravitational context. The postural manipulation elicited a distinct behavioral and dynamic effect. In the more upright postures, gravitational resistance to motion at the hip was 4 to 10 times greater than resistance met in the supine posture, necessitating larger muscle torques to drive hip flexion. Kicks produced in the vertical posture showed a reduction in hip joint range of motion and an increase in synchronous joint flexion and extension at the hip and knee. At the same time, hip and knee muscle torques were also more highly correlated in kicks performed in the vertical than in the supine or angled posture. This increased correlation between muscle torques at the hip and knee implicates anatomical and energetic constraints-the intrinsic limb dynamics-in creating coordinated limb behavior out of nonspecific muscle activations.     

Rhythmic priming across effector systems: A randomized controlled trial with Parkinson’s disease patients

This study investigated the immediate effects of auditory-motor entrainment across effector systems by examining whether Rhythmic Auditory Stimulation training of arm or finger movements would modulate gait speed. Forty-one participants with idiopathic Parkinson’s Disease were randomly assigned to 3 groups. Participants in the finger-tapping group tapped in synchrony with a metronome set to 20% faster pace than the pre-training walking cadence, whereas participants in the other group were asked to swing both arms in an alternating motion in synchrony with the metronome. Participants in the control condition did not receive training. To assess gait parameters pre- and post-training, participants walked on a 14-meter flat walkway at his/her preferred walking cadence with no auditory cueing. Results indicated that there was a significant increase in gait velocity after the finger tapping training (p < .005), whereas no differences were observed in the arm swing (p = .802) and in the control conditions (p = .525). Similarly, there were significant changes in gait cadence post-training in the finger tapping group (p < .005), but not after arm swing training (p = .879) or control (p = .759). There were no significant changes in stride length post-training in none of the groups. These findings suggest that auditory-motor entrainment in one effector system may prime a second effector system. Interestingly, however, the priming effect on gait was only observed in the finger tapping condition and not with synchronized arm swing movements. These findings have significant implications for motor rehabilitation and open new avenues for further investigation of the mechanisms underlying cross-effector coupling.     

Influences of elbow,shoulder, trunk motion and temporospatial parameters on arm swing asymmetry of Parkinson's disease during walking

Arm swing asymmetry is commonly observed in early Parkinson's disease (PD) and has been found to be useful for early diagnosis. However, there are uncertainties about the nature of its relationships with gait parameters, especially shoulder and elbow motions. Therefore, this study explored how these relationships are different between PD and controls. Forty one early PD and 23 controls were included. Participants walked at self-selected speed for 3D motion analysis. Arm swing at the wrist (AS), temporospatial parameters and kinematics in elbow, shoulder and trunk were obtained. Amplitudes and asymmetries of these variables were compared between PD and control groups. PD group showed increased AS asymmetry, compared to controls. Multiple hierarchical regression analysis on AS asymmetry was conducted in order to investigate how PD influences on the relationship between AS asymmetry and other variables. In pooled data (PD and control group), asymmetries in elbow and shoulder range of motion (RoM) were significant predictors for AS asymmetry but walking speed and asymmetries in temporospatial parameters were not significant. Group effect (PD effect) was significantly mediated by only elbow RoM asymmetry. Interaction between group and elbow RoM asymmetry was statistically significant, indicating that group was an effect modifier for elbow RoM asymmetry effect on AS asymmetry. Conclusively, arm swing asymmetry measured at the wrist represents the involvement of PD effect on the unilateral and distal upper limb in early stage. These findings are helpful for future researches related to clinical applications and mechanisms of arm swing asymmetry in PD.     

Ipsilesional arm reaching movements are not affected by the postural configuration adopted by individuals with stroke

Individuals with stroke present several impairments in the ipsilesional arm reaching movements that can limit the execution of daily living activities. These impairments depend on the side of the brain lesion. The present study aimed to compare the arm reaching movements performed in sitting and standing positions and to examine whether the effects of the adopted posture configuration depend on the side of the brain lesion. Twenty right-handed individuals with stroke (half with right hemiparesis and a half with left hemiparesis) and twenty healthy adults (half used the left arm) reached toward a target displayed on a monitor screen placed in one of three heights (i.e., upper, central, or lower targets). Participants performed the reaches in sitting and standing positions under conditions where the target location was either well-known in advance (certainty condition) or unknown until the movement onset (uncertainty condition). The values of movement onset time, movement time, and constant error were compared across conditions (posture configuration and uncertainty) and groups for each target height. Individuals with stroke were slower and spent more time to start to move than healthy participants, mainly when they reached the superior target in the upright position and under the uncertainty condition. Individuals who have suffered a right stroke were more affected by the task conditions and those who suffered a left stroke showed less accurate reaches. Overall, these results were observed regardless of the adopted posture. The current findings suggested that ipsilesional arm reaching movements are not affected by the postural configuration adopted by individuals with stroke. The central nervous system modulates the reaching movements according to the target position, adopted posture, and the uncertainty in the final target position to be reached.     

Upper limb movement analysis during gait in multiple sclerosis patients

PurposeGait disorders in multiple sclerosis (MS) are well studied; however, no previous study has described upper limb movements during gait. However, upper limb movements have an important role during locomotion and can be altered in MS patients due to direct MS lesions or mechanisms of compensation. The aim of this study was to describe the arm movements during gait in a population of MS patients with low disability compared with a healthy control group.MethodsIn this observational study we analyzed the arm movements during gait in 52 outpatients (mean age: 39.7 ± 9.6 years, female: 40%) with relapsing-remitting MS with low disability (mean EDSS: 2 ± 1) and 25 healthy age-matched controls using a 3-dimension gait analysis.ResultsMS patients walked slower, with increased mean elbow flexion and decreased amplitude of elbow flexion (ROM) compared to the control group, whereas shoulder and hand movements were similar to controls. These differences were not explained by age or disability.ConclusionUpper limb alterations in movement during gait in MS patients with low disability can be characterized by an increase in mean elbow flexion and a decrease in amplitude (ROM) for elbow flexion/extension. This upper limb movement pattern should be considered as a new component of gait disorders in MS and may reflect subtle motor deficits or the use of compensatory mechanisms.