Tibialis Anterior muscle coherence during controlled voluntary activation in patients with spinal cord injury: diagnostic potential for muscle strength, gait and spasticity

Bravo-Esteban, Elisabeth; Taylor, Julian; Aleixandre, M.; Simón-Martínez, Cristina; Torricelli, Diego; Pons, José L; Gómez-Soriano, Julio

doi:10.1186/1743-0003-11-23

Cited by 19 publications

(39 citation statements)

References 68 publications

(118 reference statements)

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“…It would be interesting to test whether changes in IMC become substantiated and robust in longer term motor adaptation protocols and follow the “savings” measured in follow-up adaptation sessions on future days/weeks (Haith et al, 2015; Huberdeau et al, 2015). Evidence of high frequency activity may give crucial physiological insight into mechanisms of functional recovery and, following the examples found in the literature (Nishimura et al, 2009; Kisiel-Sajewicz et al, 2011; Fisher et al, 2012; Bravo-Esteban et al, 2014), we suggest high frequency IMC (40–100 Hz) should be further investigated in long term neurological conditions such as stroke.…”

Section: Discussionsupporting

confidence: 76%

High-Frequency Intermuscular Coherence between Arm Muscles during Robot-Mediated Motor Adaptation

et al. 2017

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Adaptation of arm reaching in a novel force field involves co-contraction of upper limb muscles, but it is not known how the co-ordination of multiple muscle activation is orchestrated. We have used intermuscular coherence (IMC) to test whether a coherent intermuscular coupling between muscle pairs is responsible for novel patterns of activation during adaptation of reaching in a force field. Subjects (N = 16) performed reaching trials during a null force field, then during a velocity-dependent force field and then again during a null force field. Reaching trajectory error increased during early adaptation to the force-field and subsequently decreased during later adaptation. Co-contraction in the majority of all possible muscle pairs also increased during early adaptation and decreased during later adaptation. In contrast, IMC increased during later adaptation and only in a subset of muscle pairs. IMC consistently occurred in frequencies between ~40–100 Hz and during the period of arm movement, suggesting that a coherent intermuscular coupling between those muscles contributing to adaptation enable a reduction in wasteful co-contraction and energetic cost during reaching.

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Section: Discussionsupporting

confidence: 76%

High-Frequency Intermuscular Coherence between Arm Muscles during Robot-Mediated Motor Adaptation

et al. 2017

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“…56 Imaging and electrophysiological measures associated with walking capacity In recent years, there has been growing interest in identifying electrophysiological and radiographical biomarkers that can predict locomotor outcomes. 60,144,145 Recent evidence from studies of TMS 146 and EMG coherence 60,144 have provided additional support for the importance of corticospinal pathways in human walking. More generally, there is some evidence that magnetic resonance imaging (MRI)-based measures are correlated with impairment.…”

Section: Variables Associated With Walking Functionmentioning

confidence: 99%

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

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et al. 2017

Journal of Neurotrauma

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Restoration of walking ability is an area of great interest in the rehabilitation of persons with spinal cord injury. Because many cortical, subcortical, and spinal neural centers contribute to locomotor function, it is important that intervention strategies be designed to target neural elements at all levels of the neuraxis that are important for walking ability. While to date most strategies have focused on activation of spinal circuits, more recent studies are investigating the value of engaging supraspinal circuits. Despite the apparent potential of pharmacological, biological, and genetic approaches, as yet none has proved more effective than physical therapeutic rehabilitation strategies. By making optimal use of the potential of the nervous system to respond to training, strategies can be developed that meet the unique needs of each person. To complement the development of optimal training interventions, it is valuable to have the ability to predict future walking function based on early clinical presentation, and to forecast responsiveness to training. A number of clinical prediction rules and association models based on common clinical measures have been developed with the intent, respectively, to predict future walking function based on early clinical presentation, and to delineate characteristics associated with responsiveness to training. Further, a number of variables that are correlated with walking function have been identified. Not surprisingly, most of these prediction rules, association models, and correlated variables incorporate measures of volitional lower extremity strength, illustrating the important influence of supraspinal centers in the production of walking behavior in humans.

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“…Moreover, we have recently demonstrated low intramuscular TA muscle coherence in subjects with the SCI spasticity syndrome, suggesting that this motor disorder is related to a dysfunction of descending motor drive. 36 We have also shown that exaggerated lower limb flexor reflex activity evoked in patients with incomplete SCI correlates with poor residual gait function. 16 However, it is also possible that abnormal CR activity after SCI may be associated with recovery of motor or locomotor function after injury.…”

Section: Discussionmentioning

confidence: 95%

“…29,31 Adoption of clinically relevant outcome measures, such as the Spinal Cord Assessment Tool for Spastic reflexes (SCATS), which provides a better evaluation of evoked flexor reflex activity, should also be evaluated. 16,36,67 Several experimental aspects of the reflex testing technique remain to be addressed, such as identifying correctly CR thresholds and normalising EMG data across experimental groups. We defined TA CR reflex threshold in part on the subjective assessment of the stimulus being innocuous.…”

Section: Discussionmentioning

confidence: 99%

“…As considered in previous studies, slight muscle hypertonia (1 in the modified Ashworth scale) without the presence of spasms (0 in the Penn scale) was operationally defined as not characteristic of the spasticity syndrome. 16,36,37 Ten subjects with SCI were recruited without the spasticity syndrome. All clinical evaluations were assessed by a physiotherapist working at the hospital who was blinded to the experimental design of the study.…”

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Abnormal cutaneous flexor reflex activity during controlled isometric plantarflexion in human spinal cord injury spasticity syndrome

et al. 2016

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Study design: Although abnormal cutaneous reflex (CR) activity has been identified during gait after incomplete spinal cord injury (SCI), this activity has not been directly compared in subjects with and without the spasticity syndrome. Objectives: Characterisation of CR activity during controlled rest and 'ramp and hold' phases of controlled plantarflexion in subjects with and without the SCI spasticity syndrome. Design: Transverse descriptive study with non-parametric group analysis. Setting: SCI rehabilitation hospital. Methods: Tibialis Anterior (TA) reflexes were evoked by innocuous cutaneous plantar sole stimulation during rest and ramp and hold phases of plantarflexion torque in non-injured subjects (n = 10) and after SCI with (n = 9) and without (n = 10) hypertonia and/or involuntary spasm activity. Integrated TA reflex responses were analysed as total (50-300 ms) or short (50-200 ms) and long-latency (200-300 ms) activity. Results: Total and long-latency TA activity was inhibited in non-injured subjects and the SCI group without the spasticity syndrome during plantarflexion torque but not in the SCI spasticity group. Furthermore, loss of TA reflex inhibition during plantarflexion correlated with time after SCI (ρ = 0.79, P = 0.009). Moreover, TA reflex activity inversely correlated with maximum plantarflexion torque in the spasticity group (ρ = − 0.75, P = 0.02), despite similar non-reflex TA electromyographic activity during plantarflexion after SCI in subjects with (0.11, 0.08-0.13 mV) or without the spasticity syndrome (0.09, 0.07-0.12 mV). Conclusions: This reflex testing procedure supports previously published evidence for abnormal CR activity after SCI and may characterise the progressive disinhibition of TA reflex activity during controlled plantarflexion in subjects diagnosed with the spasticity syndrome. Spinal Cord (2016) 54, 687-694; doi:10.1038/sc.2016.9; published online 23 February 2016 INTRODUCTION Spasticity was originally defined as an increase in velocity-dependent, tonic stretch reflexes to passive movement 1 and has been used to describe a number of signs and symptoms that together contribute to the syndrome. 2 Cutaneous reflex (CR) dysfunction has also been regarded as an additional sign of the spasticity syndrome following spinal cord injury (SCI), 3-9 especially when detected in subjects with hypertonia and increased tonic stretch reflexes. [10][11][12] In addition, abnormal flexor reflex excitability is present during subacute 4,13 and chronic SCI, 14,15 impacts on residual gait function after SCI 16 and interferes with daily activities. 17 Lower limb CR activity in humans is modulated by several segmental and descending control mechanisms, 18-21 and the loss of descending modulatory mechanisms may contribute to the SCI spasticity syndrome. Tibialis Anterior (TA) muscle reflex activity evoked following cutaneous stimulation of the plantar surface (Pl-TA CR) [22][23][24] has been used as a test to assess the integrity of segmental and descending motor control mechanisms in healthy...

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Tibialis Anterior muscle coherence during controlled voluntary activation in patients with spinal cord injury: diagnostic potential for muscle strength, gait and spasticity

Cited by 19 publications

References 68 publications

High-Frequency Intermuscular Coherence between Arm Muscles during Robot-Mediated Motor Adaptation

High-Frequency Intermuscular Coherence between Arm Muscles during Robot-Mediated Motor Adaptation

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

Abnormal cutaneous flexor reflex activity during controlled isometric plantarflexion in human spinal cord injury spasticity syndrome

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