Acquiring musculoskeletal skills with curriculum-based reinforcement learning.

Efficient musculoskeletal simulators and powerful learning algorithms provide computational tools to tackle the grand challenge of understanding biological motor control. Our winning solution for the inaugural NeurIPS MyoChallenge leverages an approach mirroring human skill learning. Using a novel curriculum learning approach, we trained a recurrent neural network to control a realistic model of the human hand with 39 muscles to rotate two Baoding balls in the palm of the hand. In agreement with data from human subjects, the policy uncovers a small number of kinematic synergies, even though it is not explicitly biased toward low-dimensional solutions. However, selectively inactivating parts of the control signal, we found that more dimensions contribute to the task performance than suggested by traditional synergy analysis. Overall, our work illustrates the emerging possibilities at the interface of musculoskeletal physics engines, reinforcement learning, and neuroscience to advance our understanding of biological motor control.

Analysis of muscle synergies and muscle network in sling exercise rehabilitation technique.

The study assessed motor control strategies across the four sling exercises of supine sling exercise (SSE), prone sling exercise (PSE), left side-lying sling exercise (LLSE), and right side-lying sling exercise (RLSE) positions base on the muscle synergies and muscle network analyses. Muscle activities of bilateral transversus abdominis (TA), rectus abdominis, multifidus (MF), and erector spinae (ES) were captured via surface electromyography. Muscle synergies were extracted through principal components analysis (PCA) and non-negative matrix factorization (NNMF). Muscle synergies number, muscle synergies complexity, muscle synergies sparseness, muscle synergies clusters and muscle networks were calculated. PCA results indicated that SSE and PSE decomposed into 2.88 ± 0.20 and 2.82 ± 0.15 synergies respectively, while the LLSE and RLSE positions decomposed into 3.76 ± 0.14 and 3.71 ± 0.11 muscle synergies, respectively, which were more complex (P = 0.00) but less sparse (P = 0.01). Muscle synergies clusters analysis indicated common muscle synergies among different sling exercises. SSE position demonstrated specific muscle synergies with a strong contribution of the bilateral TA. LLSE-specific synergy has a strong contribution of the left erector spinae (ES). The RLSE-specific synergy has significant contributions from the right ES and multifidus. Muscle networks were functionally organized, with clustering coefficient (F(1.5, 24) = 6.041, P = 0.01) and global efficiency of the undirected network (F(1.5, 24) = 6.041, P = 0.01), and betweenness-centrality of the directed network (F(2.7, 44) = 6.453, P = 0.00). Our research highlights the importance of evaluating muscle synergies and network adaptation strategies in individuals with neuromuscular disorders and developing targeted therapeutic interventions accordingly.

EFFECTS OF SPINAL TRANSECTION AND LOCOMOTOR SPEED ON MUSCLE SYNERGIES OF THE CAT HINDLIMB.

It was suggested that during locomotion, the nervous system controls movement by activating groups of muscles, or muscle synergies. Analysis of muscle synergies can reveal the organization of spinal locomotor networks and how it depends on the state of the nervous system, such as before and after spinal cord injury, and on different locomotor conditions, including a change in speed. The goal of this study was to investigate the effects of spinal transection and locomotor speed on hindlimb muscle synergies and their time-dependent activity patterns in adult cats. EMG activities of 15 hindlimb muscles were recorded in 9 adult cats of either sex during tied-belt treadmill locomotion at speeds of 0.4, 0.7, and 1.0 m/s before and after recovery from a low thoracic spinal transection. We determined EMG burst groups using cluster analysis of EMG burst onset and offset times and muscle synergies using non-negative matrix factorization. We found five major EMG burst groups and five muscle synergies in each of six experimental conditions (2 states × 3 speeds). In each case, the synergies accounted for at least 90% of muscle EMG variance. Both spinal transection and locomotion speed modified subgroups of EMG burst groups and the composition and activation patterns of selected synergies. However, these changes did not modify the general organization of muscle synergies. Based on the obtained results, we propose an organization for a pattern formation network of a two-level central pattern generator that can be tested in neuromechanical simulations of spinal circuits controlling cat locomotion.

The impact of ankle-foot orthotics on selective motor control during gait in children and adolescents with cerebral palsy.

BACKGROUND: Children with cerebral palsy (CP) often exhibit altered selective motor control during gait (SMCg). Ankle-foot-orthoses (AFOs) are used in this population to improve gait, by reducing the degrees of freedom at the ankle joint. However, the specific impact of AFOs on SMCg and whether this effect is more related to gait deviations or motor development remains unclear. RESEARCH QUESTION: Do AFOs impact SMCg, and is the change related to joint kinematics or age? METHODS: Gait analysis data from 53 children and adolescents with spastic CP, walking both barefoot and with AFOs, were included. Electromyography data from six lower-limb muscles, and lower limb joint kinematics were analyzed for both walking conditions. SMCg was quantified by the total variance in electromyography activity accounted for by one synergy (tVAF1), where an increase in tVAF1 indicates a decrease in SMCg. Kinematic gait deviation was assessed using the Gait-Profile-Score (GPS) and sagittal plane ankle Gait-Variable-Score (ankle-GVS). All analyses were performed for the more clinically involved leg only. RESULTS: Walking with AFOs resulted in a mean increase in tVAF1 of 0.02±0.07 (p=0.015) and a median increase in ankle-GVS of 3.4º (p>0.001). No significant changes were observed in GPS, and no correlation was found between the changes in tVAF1 and ankle-GVS. A significant positive moderate correlation was found between the change in tVAF1 and age, even with ankle-GVS as a covariate (r=0.45; p>0.001). SIGNIFICANCE: Walking with an AFO resulted in a small decrease in SMCg, with large inter-participant variability. Younger participants showed a greater decrease in SMCg, which may indicate greater neuromuscular plasticity in early developmental stages.

Kinematic and neuromuscular characterization of cognitive involvement in gait control in healthy young adults.

The signature of cognitive involvement in gait control has rarely been studied using both kinematic and neuromuscular features. The present study aimed to address this gap. Twenty-four healthy young adults walked on an instrumented treadmill in a virtual environment under two optic flow conditions: normal (NOF) and perturbed (POF, continuous mediolateral pseudorandom oscillations). Each condition was performed under single-task and dual-task conditions of increasing difficulty (1-, 2-, 3-back). Subjective mental workload (raw NASA-TLX), cognitive performance (mean reaction time and d-prime), kinematic (steadiness, variability and complexity in the mediolateral and anteroposterior directions) and neuromuscular (duration and variability of motor primitives) control of gait were assessed. The cognitive performance and the number and composition of motor modules were unaffected by simultaneous walking, regardless of the optic flow condition. Kinematic and neuromuscular variability was greater under POF compared to NOF conditions. Young adults sought to counteract POF by rapidly correcting task-relevant gait fluctuations. The depletion of cognitive resources through dual-tasking led to reduced kinematic and neuromuscular variability and this occurred to the same extent regardless of simultaneous working memory (WM) load. Increasing WM load led to a prioritization of gait control in the mediolateral direction over the anteroposterior direction. The impact of POF on kinematic variability (step velocity) was reduced when a cognitive task was performed simultaneously, but this phenomenon was no modulated by WM load. Collectively, these results shed important light on how young adults adjust the processes involved in goal-directed locomotion when exposed to varying levels of task and environmental constraints.

Investigation of adaptive muscle synergy modulated motor responses to grasping perturbations.

This study investigated how muscle synergies adapt in response to unexpected changes in object weight during lifting tasks. The aim was to discover which motor control strategies individuals use to maintain their grasping performance. Muscle synergies were extracted from the muscle activity of fifteen healthy participants who lifted objects of identical appearance but varying weights in a randomized order, which introduced artificial perturbations. Reaching and manipulation phases of object lifting were analyzed using constrained non-negative matrix factorization and k-means clustering. Participants exhibited a perturbation-independent and thus consistent recruitment of spatial synergy components, while significant adaptations in muscle synergy activation occurred in response to unexpected perturbations. Perturbations caused by unexpectedly heavy objects led to delayed and gradual increases in muscle synergy activation until the force required to lift the object was reached. In contrast, perturbations caused by lighter objects led to reductions in excess muscle synergy activation occurring later. Sensorimotor control maintains the modularity of muscle synergies. Even when external mechanical perturbations occur, the grasping performance is preserved, and control is adapted solely through muscle synergy activation. These results suggest that using pure spatial synergy components as control signals for myoelectric arm prostheses may prevent them from malfunctioning due to external perturbations.

Neuroplastic alterations in common synaptic inputs and synergistic motor unit clusters controlling the vastii muscles of individuals with ACL reconstruction.

This cross-sectional study aims to elucidate the neural mechanisms underlying the control of knee extension forces in individuals with anterior cruciate ligament reconstruction (ACLR). Eleven soccer players with ACLR and nine control players performed unilateral isometric knee extensions at 10% and 30% of their maximum voluntary force (MVF). Simultaneous recordings of high-density surface electromyography (HDEMG) and force output were conducted for each lower limb, and HDEMG data from the vastus lateralis (VL) and vastus medialis (VM) muscles were decomposed into individual motor unit spike trains. Force steadiness was estimated using the coefficient of variation of force. An intramuscular coherence analysis was adopted to estimate the common synaptic input (CSI) converging to each muscle. A factor analysis was applied to investigate the neural strategies underlying the control of synergistic motor neuron clusters, referred to as motor unit modes. Force steadiness was similar between lower limbs. However, motor neurons innervating the VL on the reconstructed side received a lower proportion of CSI at low-frequency bandwidths (<5 Hz) compared with the unaffected lower limbs (P < 0.01). Furthermore, the reconstructed side demonstrated a higher proportion of motor units associated with the neural input common to the synergistic muscle, as compared with the unaffected lower limbs (P < 0.01). These findings indicate that the VL muscle of reconstructed lower limbs contribute marginally to force steadiness and that a plastic rearrangement in synergistic clusters of motor units involved in the control of knee extension forces is evident following ACLR.NEW & NOTEWORTHY Chronic quadriceps dysfunction is common after anterior cruciate ligament reconstruction (ACLR). We investigated voluntary force control strategies by estimating common inputs to motor neurons innervating the vastii muscles. Our results showed attenuated common inputs to the vastus lateralis and plastic rearrangements in functional clusters of motor neurons modulating knee extension forces in the reconstructed limb. These findings suggest neuroplastic adjustments following ACLR that may occur to fine-tune the control of quadriceps forces.

Identifying alterations in hand movement coordination from chronic stroke survivors using a wearable high-density EMG sleeve.

Objective.Non-invasive, high-density electromyography (HD-EMG) has emerged as a useful tool to collect a range of neurophysiological motor information. Recent studies have demonstrated changes in EMG features that occur after stroke, which correlate with functional ability, highlighting their potential use as biomarkers. However, previous studies have largely explored these EMG features in isolation with individual electrodes to assess gross movements, limiting their potential clinical utility. This study aims to predict hand function of stroke survivors by combining interpretable features extracted from a wearable HD-EMG forearm sleeve.Approach.Here, able-bodied (N= 7) and chronic stroke subjects (N= 7) performed 12 functional hand and wrist movements while HD-EMG was recorded using a wearable sleeve. A variety of HD-EMG features, or views, were decomposed to assess alterations in motor coordination.Main Results.Stroke subjects, on average, had higher co-contraction and reduced muscle coupling when attempting to open their hand and actuate their thumb. Additionally, muscle synergies decomposed in the stroke population were relatively preserved, with a large spatial overlap in composition of matched synergies. Alterations in synergy composition demonstrated reduced coupling between digit extensors and muscles that actuate the thumb, as well as an increase in flexor activity in the stroke group. Average synergy activations during movements revealed differences in coordination, highlighting overactivation of antagonist muscles and compensatory strategies. When combining co-contraction and muscle synergy features, the first principal component was strongly correlated with upper-extremity Fugl Meyer hand sub-score of stroke participants (R2= 0.86). Principal component embeddings of individual features revealed interpretable measures of motor coordination and muscle coupling alterations.Significance.These results demonstrate the feasibility of predicting motor function through features decomposed from a wearable HD-EMG sleeve, which could be leveraged to improve stroke research and clinical care.

Alternative muscle synergy patterns of upper limb amputees.

Myoelectric hand prostheses are effective tools for upper limb amputees to regain hand functions. Much progress has been made with pattern recognition algorithms to recognize surface electromyography (sEMG) patterns, but few attentions was placed on the amputees' motor learning process. Many potential myoelectric prostheses users could not fully master the control or had declined performance over time. It is possible that learning to produce distinct and consistent muscle activation patterns with the residual limb could help amputees better control the myoelectric prosthesis. In this study, we observed longitudinal effect of motor skill learning with 2 amputees who have developed alternative muscle activation patterns in response to the same set of target prosthetic actions. During a 10-week program, amputee participants were trained to produce distinct and constant muscle activations with visual feedback of live sEMG and without interaction with prosthesis. At the end, their sEMG patterns were different from each other and from non-amputee control groups. For certain intended hand motion, gradually reducing root mean square (RMS) variance was observed. The learning effect was also assessed with a CNN-LSTM mixture classifier designed for mobile sEMG pattern recognition. The classification accuracy had a rising trend over time, implicating potential performance improvement of myoelectric prosthesis control. A follow-up session took place 6 months after the program and showed lasting effect of the motor skill learning in terms of sEMG pattern classification accuracy. The results indicated that with proper feedback training, amputees could learn unique muscle activation patterns that allow them to trigger intended prosthesis functions, and the original motor control scheme is updated. The effect of such motor skill learning could help to improve myoelectric prosthetic control performance.

Changes in walking function and neural control following pelvic cancer surgery with reconstruction.

Introduction: Surgical planning and custom prosthesis design for pelvic cancer patients are challenging due to the unique clinical characteristics of each patient and the significant amount of pelvic bone and hip musculature often removed. Limb-sparing internal hemipelvectomy surgery with custom prosthesis reconstruction has become a viable option for this patient population. However, little is known about how post-surgery walking function and neural control change from pre-surgery conditions. Methods: This case study combined comprehensive walking data (video motion capture, ground reaction, and electromyography) with personalized neuromusculoskeletal computer models to provide a thorough assessment of pre- to post-surgery changes in walking function (ground reactions, joint motions, and joint moments) and neural control (muscle synergies) for a single pelvic sarcoma patient who received internal hemipelvectomy surgery with custom prosthesis reconstruction. Pre- and post-surgery walking function and neural control were quantified using pre- and post-surgery neuromusculoskeletal models, respectively, whose pelvic anatomy, joint functional axes, muscle-tendon properties, and muscle synergy controls were personalized using the participant's pre-and post-surgery walking and imaging data. For the post-surgery model, virtual surgery was performed to emulate the implemented surgical decisions, including removal of hip muscles and implantation of a custom prosthesis with total hip replacement. Results: The participant's post-surgery walking function was marked by a slower self-selected walking speed coupled with several compensatory mechanisms necessitated by lost or impaired hip muscle function, while the participant's post-surgery neural control demonstrated a dramatic change in coordination strategy (as evidenced by modified time-invariant synergy vectors) with little change in recruitment timing (as evidenced by conserved time-varying synergy activations). Furthermore, the participant's post-surgery muscle activations were fitted accurately using his pre-surgery synergy activations but fitted poorly using his pre-surgery synergy vectors. Discussion: These results provide valuable information about which aspects of post-surgery walking function could potentially be improved through modifications to surgical decisions, custom prosthesis design, or rehabilitation protocol, as well as how computational simulations could be formulated to predict post-surgery walking function reliably given a patient's pre-surgery walking data and the planned surgical decisions and custom prosthesis design.

Realistic 3D human saccades generated by a 6-DOF biomimetic robotic eye under optimal control.

We recently developed a biomimetic robotic eye with six independent tendons, each controlled by their own rotatory motor, and with insertions on the eye ball that faithfully mimic the biomechanics of the human eye. We constructed an accurate physical computational model of this system, and learned to control its nonlinear dynamics by optimising a cost that penalised saccade inaccuracy, movement duration, and total energy expenditure of the motors. To speed up the calculations, the physical simulator was approximated by a recurrent neural network (NARX). We showed that the system can produce realistic eye movements that closely resemble human saccades in all directions: their nonlinear main-sequence dynamics (amplitude-peak eye velocity and duration relationships), cross-coupling of the horizontal and vertical movement components leading to approximately straight saccade trajectories, and the 3D kinematics that restrict 3D eye orientations to a plane (Listing's law). Interestingly, the control algorithm had organised the motors into appropriate agonist-antagonist muscle pairs, and the motor signals for the eye resembled the well-known pulse-step characteristics that have been reported for monkey motoneuronal activity. We here fully analyse the eye-movement properties produced by the computational model across the entire oculomotor range and the underlying control signals. We argue that our system may shed new light on the neural control signals and their couplings within the final neural pathways of the primate oculomotor system, and that an optimal control principle may account for a wide variety of oculomotor behaviours. The generated data are publicly available at https://data.ru.nl/collections/di/dcn/DSC_626870_0003_600.

Muscle synergies for multidirectional isometric force generation during maintenance of upright standing posture.

Muscle synergies are defined as coordinated recruitment of groups of muscles with specific activation balances and time profiles aimed at generating task-specific motor commands. While muscle synergies in postural control have been investigated primarily in reactive balance conditions, the neuromechanical contribution of muscle synergies during voluntary control of upright standing is still unclear. In this study, muscle synergies were investigated during the generation of isometric force at the trunk during the maintenance of standing posture. Participants were asked to maintain the steady-state upright standing posture while pulling forces of different magnitudes were applied at the level at the waist in eight horizontal directions. Muscle synergies were extracted by nonnegative matrix factorization from sixteen lower limb and trunk muscles. An average of 5-6 muscle synergies were sufficient to account for a wide variety of EMG waveforms associated with changes in the magnitude and direction of pulling forces. A cluster analysis partitioned the muscle synergies of the participants into a large group of clusters according to their similarity, indicating the use of a subjective combination of muscles to generate a multidirectional force vector in standing. Furthermore, we found a participant-specific distribution in the values of cosine directional tuning parameters of synergy amplitude coefficients, suggesting the existence of individual neuromechanical strategies to stabilize the whole-body posture. Our findings provide a starting point for the development of novel diagnostic tools to assess muscle coordination in postural control and lay the foundation for potential applications of muscle synergies in rehabilitation.

Transferring Sensor-Based Assessments to Clinical Practice: The Case of Muscle Synergies.

Sensor-based assessments in medical practice and rehabilitation include the measurement of physiological signals such as EEG, EMG, ECG, heart rate, and NIRS, and the recording of movement kinematics and interaction forces. Such measurements are commonly employed in clinics with the aim of assessing patients' pathologies, but so far some of them have found full exploitation mainly for research purposes. In fact, even though the data they allow to gather may shed light on physiopathology and mechanisms underlying motor recovery in rehabilitation, their practical use in the clinical environment is mainly devoted to research studies, with a very reduced impact on clinical practice. This is especially the case for muscle synergies, a well-known method for the evaluation of motor control in neuroscience based on multichannel EMG recordings. In this paper, considering neuromotor rehabilitation as one of the most important scenarios for exploiting novel methods to assess motor control, the main challenges and future perspectives for the standard clinical adoption of muscle synergy analysis are reported and critically discussed.

Decoding temporal muscle synergy patterns based on brain activity for upper extremity in ADL movements.

Muscle synergies have been hypothesized as specific predefined motor primitives that the central nervous system can reduce the complexity of motor control by using them, but how these are expressed in brain activity is ambiguous yet. The main purpose of this paper is to develop synergy-based neural decoding of motor primitives, so for the first time, brain activity and muscle synergy map of the upper extremity was investigated in the activity of daily living movements. To find the relationship between brain activities and muscle synergies, electroencephalogram (EEG) and electromyogram (EMG) signals were acquired simultaneously during activities of daily living. To extract the maximum correlation of neural commands with muscle synergies, application of a combined partial least squares and canonical correlation analysis (PLS-CCA) method was proposed. The Elman neural network was used to decode the relationship between extracted motor commands and muscle synergies. The performance of proposed method was evaluated with tenfold cross-validation and muscle synergy estimation of brain activity with R, VAF, and MSE of 84 ± 2.6%, 70 ± 4.7%, and 0.00011 ± 0.00002 were quantified respectively. Furthermore, the similarity between actual and reconstructed muscle activations was achieved more than 92% for correlation coefficient. To compare with the existing methods, our results showed significantly more accuracy of the model performance. Our results confirm that use of the expression of muscle synergies in brain activity can estimate the neural decoding performance for motor control that can be used to develop neurorehabilitation tools such as neuroprosthesis.

SynergyAnalyzer: A Matlab toolbox implementing mixed-matrix factorization to identify kinematic-muscular synergies.

BACKGROUND AND OBJECTIVE: A new direction in the study of motor control was opened about two decades ago with the introduction of a model for the generation of motor commands as combination of muscle synergies. Muscle synergies provide a simple yet quantitative framework for analyzing the hierarchical and modular architecture of the human motor system. However, to gain insights on the functional role of muscle synergies, they should be related to the task space. The recently introduced mixed-matrix factorization (MMF) algorithm extends the standard approach for synergy extraction based on non-negative matrix factorization (NMF) allowing to factorize data constituted by a mixture of non-negative variables (e.g. EMGs) and unconstrained variables (e.g. kinematics, naturally including both positive and negative values). The kinematic-muscular synergies identified by MMF provide a direct link between muscle synergies and the task space. In this contribution, we support the adoption of MMF through a Matlab toolbox for the extraction of kinematic-muscular synergies and a set of practical guidelines to allow biomedical researchers and clinicians to exploit the potential of this novel approach. METHODS: MMF is implemented in the SynergyAnalyzer toolbox using an object-oriented approach. In addition to the MMF algorithm, the toolbox includes standard methods for synergy extraction (NMF and PCA), as well as methods for pre-processing EMG and kinematic data, and for plotting data and synergies. RESULTS: As an example of MMF application, kinematic-muscular synergies were extracted from EMG and kinematic data collected during reaching movements towards 8 targets on the sagittal plane. Instructions and command lines to achieve such results are illustrated in detail. The toolbox has been released as an open-source software on GitHub under the GNU General Public License. CONCLUSIONS: Thanks to its ease of use and adaptability to a variety of datasets, SynergyAnalyzer will facilitate the adoption of MMF to extract kinematic-muscular synergies from mixed EMG and kinematic data, a useful approach in biomedical research to better understand and characterize the functional role of muscle synergies.

Age-related changes in muscle coordination patterns of stepping responses to recover from loss of balance.

INTRODUCTION: Reactive stepping capacity to recover from a loss of balance declines with aging, which increases the risk of falling. To gain insight into the underlying mechanisms, we investigated whether muscle coordination patterns of reactive stepping differed between healthy young and older individuals. METHODS: We performed a cross-sectional study between 15 healthy young and 14 healthy older adults. They recovered from 200 multidirectional platform translations that evoked reactive stepping responses. We determined spatiotemporal step variables and used muscle synergy analysis to characterize stance- and swing-leg muscle coordination patterns from the start of perturbation until foot landing. RESULTS: We observed delayed step onsets in older individuals, without further spatiotemporal differences. Muscle synergy structure was not different between young and older individuals, but age-related differences were observed in the time-varying synergy activation patterns. In anterior-posterior directions, the older individuals demonstrated significantly enhanced early swing-leg synergy activation consistent with non-stepping behavior. In addition, around step onset they demonstrated increased levels of synergy coactivation (mainly around the ankle) in lateral and anterior directions, which did not appear to hamper foot clearance. CONCLUSION: Although synergy structure was not affected by age, the delayed step onsets and the enhanced early synergy recruitment point at a relative bias towards non-stepping behavior in older adults. They may need more time for accumulating information on the direction of perturbation and making the corresponding sensorimotor transformations before initiating the step. Future work may investigate whether perturbation-based training improves these age-related deficits.

Utilising dynamic motor control index to identify age-related differences in neuromuscular control.

PURPOSE: Considering the relationship between aging and neuromuscular control decline, early detection of age-related changes can ensure that timely interventions are implemented to attenuate or restore neuromuscular deficits. The dynamic motor control index (DMCI), a measure based on variance accounted for (VAF) by one muscle synergy (MS), is a metric used to assess age-related changes in neuromuscular control. The aim of the study was to investigate the use of one-synergy VAF, and consecutively DMCI, in assessing age-related changes in neuromuscular control over a range of exercises with varying difficulty. METHODS: Thirty-one subjects walked on a flat and inclined treadmill, as well as performed forward and lateral stepping up tasks. Motion and muscular activity were recorded, and muscle synergy analysis was conducted using one-synergy VAF, DMCI, and number of synergies. RESULTS: Difference between older and younger group was observed for one-synergy VAF, DMCI for forward stepping up task (one-synergy VAF difference of 2.45 (0.22, 4.68) and DMCI of 9.21 (0.81, 17.61), p = 0.033), but not for lateral stepping up or walking. CONCLUSION: The use of VAF based metrics and specifically DMCI, rather than number of MS, in combination with stepping forward exercise can provide a low-cost and easy to implement approach for assessing neuromuscular control in clinical settings.

Direction-Specific Changes in Trunk Muscle Synergies in Individuals With Extension-Related Low Back Pain.

Background Identifying altered trunk control is critical for treating extension-related low back pain (ERLBP), a common subgroup classified by clinical manifestations. The changed coordination of trunk muscles within this group during particular trunk tasks is still not clearly understood. Objectives The objective of this study is to investigate trunk muscle coordination during 11 trunk movement and stability tasks in individuals with ERLBP compared to non-low back pain (LBP) participants. Methods Thirteen individuals with ERLBP and non-LBP performed 11 trunk movement and stability tasks. We recorded the electromyographic activities of six back and abdominal muscles bilaterally. Trunk muscle coordination was assessed using the non-negative matrix factorization (NMF) method to identify trunk muscle synergies. Results The number of synergies in the ERLBP group during the cross-extension and backward bend tasks was significantly higher than in the non-LBP group (p<0.05). The cluster analysis identified the two trunk synergies for each task with strikingly similar muscle activation patterns between groups. In contrast, the ERLBP group exhibited additional trunk muscle synergies that were not identified in the non-LBP group. The number of synergies in the other tasks did not differ between groups (p>0.05). Conclusion Individuals with ERLBP presented directionally specific alterations in trunk muscle synergies that were considered as increased coactivations of multiple trunk muscles. These altered patterns may contribute to the excessive stabilization of and the high frequency of hyperextension in the spine associated with the development and persistence of ERLBP.

Influence of Backpack Carriage and Walking Speed on Muscle Synergies in Healthy Children.

Four to five muscle synergies account for children's locomotion and appear to be consistent across alterations in speed and slopes. Backpack carriage induces alterations in gait kinematics in healthy children, raising questions regarding the clinical consequences related to orthopedic and neurological diseases and ergonomics. However, to support clinical decisions and characterize backpack carriage, muscle synergies can help with understanding the alterations induced in this condition at the motor control level. In this study, we investigated how children adjust the recruitment of motor patterns during locomotion, when greater muscular demands are required (backpack carriage). Twenty healthy male children underwent an instrumental gait analysis and muscle synergies extraction during three walking conditions: self-selected, fast and load conditions. In the fast condition, a reduction in the number of synergies (three to four) was needed for reconstructing the EMG signal with the same accuracy as in the other conditions (three to five). Synergies were grouped in only four clusters in the fast condition, while five clusters were needed for the self-selected condition. The right number of clusters was not clearly identified in the load condition. Speed and backpack carriage altered nearly every spatial-temporal parameter of gait, whereas kinematic alterations reflected mainly hip and pelvis adaptations. Although the synergistic patterns were consistent across conditions, indicating a similar motor pattern in different conditions, the fast condition required fewer synergies for reconstructing the EMG signal with the same level of accuracy.

Investigating the impact of external load on muscle synergies during bipedal squats.

PURPOSE: A broad functional movement repertoire is crucial for engaging in physical activity and reducing the risk of injury, both of which are central aspects of lifelong health. As a fundamental exercise in both recreational and rehabilitative training regimes, the bipedal squat (SQBp) incorporates many everyday movement patterns. Crucially, SQBp can only be considered functional if the practitioner can meet the coordinative demands. Many factors affect coordinative aspects of an exercise, most notably external load. Since compound movements are assumed to be organized in a synergistic manner, we employed muscle synergy analysis to examine differences in muscle synergy properties between various external load levels during SQBp. METHODS: Ten healthy male recreational athletes were enrolled in the present study. Each participant performed three sets of ten SQBp on a smith machine at three submaximal load levels (50%, 62.5%, and 75% of 3 repetition maximum) across three non-consecutive days. Muscle activity was recorded from 12 prime movers of SQBp by way of electromyography (EMG). Muscle synergies were analyzed in terms of temporal activation patterns, i.e., waveform, as well as the relative input of each muscle into individual synergies, i.e., weight contribution. RESULTS: Waveforms of muscle synergies did not differ between loads. Weight contributions showed significant differences between load levels, albeit only for the gastrocnemius muscle in a single synergy. CONCLUSION: Taken together, our results imply mostly stable spatiotemporal composition of muscle activity during SQBp, underlining the importance of technical competence during compound movement performance in athletic and rehabilitative settings.