Vestibulospinal reflexes elicited with a tone burst method are dependent on spatial orientation.

Balance involves several sensory modalities including vision, proprioception and the vestibular system. This study aims to investigate vestibulospinal activation elicited by tone burst stimulation in various muscles and how head position influences these responses. We recorded electromyogram (EMG) responses in different muscles (sternocleidomastoid-SCM, cervical erector spinae-ES-C, lumbar erector spinae-ES-L, gastrocnemius-G, and tibialis anterior-TA) of healthy participants using tone burst stimulation applied to the vestibular system. We also evaluated how head position affected the responses. Tone burst stimulation elicited reproducible vestibulospinal reflexes in the SCM and ES-C muscles, while responses in the distal muscles (ES-L, G, and TA) were less consistent among participants. The magnitude and polarity of the responses were influenced by the head position relative to the cervical spine. When the head was rotated or tilted, the polarity of the vestibulospinal responses changed, indicating the integration of vestibular and proprioceptive inputs in generating these reflexes. Overall, our study provides valuable insights into the complexity of vestibulospinal reflexes and their modulation by head position. However, the high variability in responses in some muscles limits their clinical application. These findings may have implications for future research in understanding vestibular function and its role in posture and movement control.

Sensorimotor adaptation of locomotor synergies to gravitational constraint.

This study investigates the impact of gravity on lower limb muscle coordination during pedaling. It explores how pedaling behaviors, kinematics, and muscle activation patterns dynamically adapts to changes in gravity and resistance levels. The experiment was conducted in parabolic flights, simulating microgravity, hypergravity (1.8 g), and normogravity conditions. Participants pedaled on an ergometer with varying resistances. The goal was to identify potential changes in muscle synergies and activation strategies under different gravitational contexts. Results indicate that pedaling cadence adjusted naturally in response to both gravity and resistance changes. Cadence increased with higher gravity and decreased with higher resistance levels. Muscular activities were characterized by two synergies representing pull and push phases of pedaling. The timing of synergy activation was influenced by gravity, with a delay in activation observed in microgravity compared to other conditions. Despite these changes, the velocity profile of pedaling remained stable across gravity conditions. The findings strongly suggest that the CNS dynamically manages the shift in body weight by finely tuning muscular coordination, thereby ensuring the maintenance of a stable motor output. Furthermore, electromyography analysis suggest that neuromuscular discharge frequencies were not affected by gravity changes. This implies that the types of muscle fibers recruited during exercise in modified gravity are similar to those used in normogravity. This research has contributed to a better understanding of how the human locomotor system responds to varying gravitational conditions, shedding light on the potential mechanisms underlying astronauts' gait changes upon returning from space missions.

Intuitive movement-based prosthesis control enables arm amputees to reach naturally in virtual reality.

Impressive progress is being made in bionic limbs design and control. Yet, controlling the numerous joints of a prosthetic arm necessary to place the hand at a correct position and orientation to grasp objects remains challenging. Here, we designed an intuitive, movement-based prosthesis control that leverages natural arm coordination to predict distal joints missing in people with transhumeral limb loss based on proximal residual limb motion and knowledge of the movement goal. This control was validated on 29 participants, including seven with above-elbow limb loss, who picked and placed bottles in a wide range of locations in virtual reality, with median success rates over 99% and movement times identical to those of natural movements. This control also enabled 15 participants, including three with limb differences, to reach and grasp real objects with a robotic arm operated according to the same principle. Remarkably, this was achieved without any prior training, indicating that this control is intuitive and instantaneously usable. It could be used for phantom limb pain management in virtual reality, or to augment the reaching capabilities of invasive neural interfaces usually more focused on hand and grasp control.

Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam.

The effects of nefopam and ketamine on pain control and rehabilitation after total knee replacement were compared in a prospective, double blinded study. Seventy-five patients were randomly assigned to receive a 0.2mg kg(-1) bolus of nefopam or ketamine, followed by a 120microg kg(-1) h(-1) continuous infusion until the end of surgery, and 60microg kg(-1) h(-1) until the second postoperative day, or an equal volume of saline considered as placebo. Pain scores measured on a visual analog scale at rest and on mobilization, and patient-controlled intravenous morphine consumption, were assessed during 48h. We measured the maximal knee flexion on the third postoperative day, and the delay to obtain a 90 degrees flexion. Ketamine and nefopam reduced morphine consumption (p<0.0001). Pain scores, were lower at rest and on mobilization in the ketamine group compared to the two other groups at all times of measurement. Pain score were lower in patients receiving nefopam compared to placebo, on arrival in the recovery room and at 2h. Ketamine improved knee flexion on post operative day 3 (59 degrees [33-63] vs. 50 degrees [47-55] and 50 degrees [44-55] in ketamine, placebo and nefopam groups, respectively, p<0.0002) and decreased the delay to flex the knee at 90 degrees (9.1+/-4.2 vs. 12.3+/-4.0 days, in ketamine and placebo groups, respectively, p=0.01). Ketamine produces opioid-sparing, decreases pain intensity, and improves mobilization after total knee replacement. Nefopam achieves less significant results in that circumstances.