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Objectives:The purpose of this study was to investigate the electromechanical properties of atrophied muscle in patients with anterior cruciate ligament (ACL) reconstruction and to examine the relationship of changes in these properties for a voluntarily elicited maximal isometric contraction and peripherally stimulated twitch contraction. Background: It is not known if, following ACL reconstruction, a prolonged reaction time to a sudden stimulus is due to impaired proprioception in the knee joint, a prolonged processing interval in the central nervous system, or a greater elasticity in the series elastic component of the quadriceps femoris. Methods: Seventeen patients were recruited 2 to 3 months following a unilateral ACL reconstruction. Both the involved leg (ACL-invo group) and the uninvolved leg (ACL-uninvo group) were studied. Twenty-two athletes (training group) and 18 control subjects (control group) were also tested. These subjects performed voluntary maximal isometric contraction (MVC) of the quadriceps femoris. Maximal twitch response was also elicited by a supramaximal electrical stimulation to the femoral nerve, and surface electromyograms were recorded from the vastus lateralis in all four groups. Results: Total reaction time for MVC in the ACL-invo group (250.47 ms) was prolonged compared to that of the control and training groups. Twitch response in the ACL-invo group (25.26 ms) was prolonged compared to that of the other three groups. Premotor time during both MVC and twitch response did not differ among the four groups. Electromechanical delay during MVC (53.62 ms) and the evoked electromechanical delay in twitch response (20.04 ms) were prolonged in the ACL-invo group as compared to the other three groups. Conclusions: Prolonged electromechanical delay in twitch response may be due to peripheral physiological disruptions (eg, stiffness of the series elastic component, changes of peripheral Science and Biomedical Engineering, Tsukuba, muscle fiber-type composition, or a decrease in function of the excitation-contraction coupling process). A prolonged electromechanical delay in twitch response can also explain the prolonged electromechanical delay observed for MVC. These findings suggest that prolonged total reaction time in MVC, when secondary to a visual stimulus in atrophied human quadriceps femoris muscle after ACL reconstruction, may be principally due to prolongation of electromechanical delay produced by peripheral physiological alterations. However, the contribution of premotor time to prolonged total reaction time was not revealed. Our results do not completely eliminate the possibility that central nervous system processing time and other neural factors are involved in the prolongation of reaction time. J Orthop Sports Phys Ther 2002;32:158-165.

It is well known that kinesthetic illusions can be induced by stimulation of several sensory systems (proprioception, touch, vision…). In this study we investigated the cerebral network underlying a kinesthetic illusion induced by visual stimulation by using functional magnetic resonance imaging (fMRI) in humans. Participants were instructed to keep their hand still while watching the video of their own moving hand (Self Hand) or that of someone else's moving hand (Other Hand). In the Self Hand condition they experienced an illusory sensation that their hand was moving whereas the Other Hand condition did not induce any kinesthetic illusion. The contrast between the Self Hand and Other Hand conditions showed significant activation in the left dorsal and ventral premotor cortices, in the left Superior and Inferior Parietal lobules, at the right Occipito-Temporal junction as well as in bilateral Insula and Putamen. Most strikingly, there was no activation in the primary motor and somatosensory cortices, whilst previous studies have reported significant activation in these regions for vibration-induced kinesthetic illusions. To our knowledge, this is the first study that indicates that humans can experience kinesthetic perception without activation in the primary motor and somatosensory areas. We conclude that under some conditions watching a video of one's own moving hand could lead to activation of a network that is usually involved in processing copies of efference, thus leading to the illusory perception that the real hand is indeed moving.

Barring a few studies, there are not enough established treatments to improve upper limb motor function in patients with severe impairments due to chronic stroke. This study aimed to clarify the effect of the kinesthetic perceptional illusion induced by visual stimulation (KINVIS) on upper limb motor function and the relationship between motor function and resting-state brain networks. Eleven patients with severe paralysis of upper limb motor function in the chronic phase (seven men and four women; age: 54.7 ± 10.8 years; 44.0 ± 29.0 months post-stroke) participated in the study. Patients underwent an intervention consisting of therapy using KINVIS and conventional therapeutic exercise (TherEX) for 10 days. Our originally developed KiNvis TM system was applied to induce KINVIS while watching the movement of the artificial hand. Clinical outcomes were examined to evaluate motor functions and resting-state brain functional connectivity (rsFC) by analyzing blood-oxygen-level-dependent (BOLD) signals measured using functional magnetic resonance imaging (fMRI). The outcomes of motor function (Fugle-Meyer Assessment, FMA) and spasticity (Modified Ashworth Scale, MAS) significantly improved after the intervention. The improvement in MAS scores for the fingers and the wrist flexors reached a minimum of clinically important differences. Before the intervention, strong and significant negative correlations between the motor functions

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