A Transparent Lower Limb Perturbator to Investigate Joint Impedance During Gait

Joint impedance plays an important role in postural control and movement. However, current experimental knowledge on lower limb impedance during gait is limited to the ankle joint. We designed the LOwer limb PERturbator (LOPER) aimed to assess knee and hip joint impedance during gait. The LOPER applies force perturbations with a 39 Hz...

Validation of online intrinsic and reflexive joint impedance estimates using correlation with EMG measurements

Biofeedback of online system identification estimates of intrinsic and reflexive joint impedance can be used by able-bodied subjects to voluntarily modulate their reflexive impedance independent of the intrinsic contribution. Similar to EMG-based paradigms, this could potentially be used to reduce muscle hyperreflexia in people with...

Reducing the Soleus Stretch Reflex With Conditioning: Exploring Game- and Impedance-Based Biofeedback

People with spasticity, i.e., stretch hyperreflexia, have a limited functional independence and mobility. While a broad range of spasticity treatments is available, many treatments are invasive, non-specific, or temporary and might have negative side effects. Operant conditioning of the stretch reflex is a promising non-invasive paradigm with...

Neurophysiological validation of simultaneous intrinsic and reflexive joint impedance estimates

Background: People with brain or neural injuries, such as cerebral palsy or spinal cord injury, commonly have joint hyper-resistance. Diagnosis and treatment of joint hyper-resistance is challenging due to a mix of tonic and phasic contributions. The parallel-cascade (PC) system identification technique offers a potential solution to...

Disentangling acceleration-, velocity-, and duration-dependency of the shortand medium-latency stretch reflexes in the ankle plantarflexors

Motorized assessment of the stretch reflex is instrumental to gain understanding of the stretch reflex, its physiological origin and to differentiate effects of neurological disorders, like spasticity. Both short-latency (M1) and medium-latency (M2) stretch reflexes have been reported to depend on the velocity and acceleration of an applied...

Rapid limb-specific modulation of vestibular contributions to ankle muscle activity during locomotion

During walking, the vestibular influence on locomotor activity is phase-dependent and modulated in both limbs with changes in velocity. It is unclear, however, whether this bilateral modulation is due to a coordinated mechanism between both limbs or instead through limb-specific processes that remain masked by the symmetric nature of locomotion....

Identification of Hip and Knee Joint Impedance During the Swing Phase of Walking

Knowledge on joint impedance during walking in various conditions is relevant for clinical decision-making and the development of robotic gait trainers, leg prostheses, leg orthotics and wearable exoskeletons. Whereas ankle impedance during walking has been experimentally assessed, knee and hip joint impedance during walking have not been...

Assessment of the underlying systems involved in standing balance: The additional value of electromyography in system identification and parameter estimation

Background: Closed loop system identification (CLSIT) is a method to disentangle the contribution of underlying systems in standing balance. We investigated whether taking into account lower leg muscle activation in CLSIT could improve the reliability and accuracy of estimated parameters identifying the underlying systems. Methods: Standing...

The reliance on vestibular information during standing balance control decreases with severity of vestibular dysfunction

The vestibular system is involved in gaze stabilization and standing balance control. However, it is unclear whether vestibular dysfunction affects both processes to a similar extent. Therefore, the objective of this study was to determine how the reliance on vestibular information during standing balance control is related to gaze...

Estimating ankle torque and dynamics of the stabilizing mechanism: No need for horizontal ground reaction forces

Changes in human balance control can objectively be assessed using system identification techniques in combination with support surface translations. However, large, expensive and complex motion platforms are required, which are not suitable for the clinic. A treadmill could be a simple alternative to apply support surface translations. In...

Effect of amplitude and number of repetitions of the perturbation on system identification of human balance control during stance

To unravel the underlying mechanisms of human balance control, system identification techniques are applied in combination with dedicated perturbations, like support surface translations. However, it remains unclear what the optimal amplitude and number of repetitions of the perturbation signal are. In this study we investigated the effect of...

Examining the role of intrinsic and reflexive contributions to ankle joint hyper-resistance treated with botulinum toxin-A

Background: Spasticity, i.e. stretch hyperreflexia, increases joint resistance similar to symptoms like hypertonia and contractures. Botulinum neurotoxin-A (BoNT-A) injections are a widely used intervention to reduce spasticity. BoNT-A effects on spasticity are poorly understood, because clinical measures, e.g. modified Ashworth scale (MAS),...

Validation of online intrinsic and reflexive joint impedance estimates using correlation with EMG measurements