NeuroControl of movement: System identification approach for clinical benefit

Progress in diagnosis and treatment of movement disorders after neurological diseases like stroke, cerebral palsy (CP), dystonia and at old age requires understanding of the altered capacity to adequately respond to physical obstacles in the environment. With posture and movement disorders, the control of muscles is hampered, resulting in...

Comprehensive neuromechanical assessment in stroke patients: Reliability and responsiveness of a protocol to measure neural and non-neural wrist properties

Background: Understanding movement disorder after stroke and providing targeted treatment for post stroke patients requires valid and reliable identification of biomechanical (passive) and neural (active and reflexive) contributors. Aim of this study was to assess test-retest reliability of passive, active and reflexive parameters and to...

Early motor learning changes in upper-limb dynamics and shoulder complex loading during handrim wheelchair propulsion

Background To propel in an energy-efficient manner, handrim wheelchair users must learn to control the bimanually applied forces onto the rims, preserving both speed and direction of locomotion. Previous studies have found an increase in mechanical efficiency due to motor learning associated with changes in propulsion technique, but it is...

Wheelchair-specific fitness of inactive people with long-term spinal cord injury

Objectives: To describe wheelchair-specific anaerobic work capacity, isometric strength and peak aerobic work capacity of physically inactive people with long-term spinal cord injury using outcomes of tests that are feasible for use in rehabilitation centres, and to determine associations among these fitness components. Design: Cross-sectional...

Differentiation between non-neural and neural contributors to ankle joint stiffness in cerebral palsy

Background Spastic paresis in cerebral palsy (CP) is characterized by increased joint stiffness that may be of neural origin, i.e. improper muscle activation caused by e.g. hyperreflexia or non-neural origin, i.e. altered tissue viscoelastic properties (clinically: “spasticity” vs. “contracture”). Differentiation between these components is hard...

Variability in bimanual wheelchair propulsion: Consistency of two instrumented wheels during handrim wheelchair propulsion on a motor driven treadmill

Background Handrim wheelchair propulsion is a complex bimanual motor task. The bimanually applied forces on the rims determine the speed and direction of locomotion. Measurements of forces and torques on the handrim are important to study status and change of propulsion technique (and consequently mechanical strain) due to processes of learning,...

The gap between clinical gaze and systematic assessment of movement disorders after stroke

Background: Movement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different...

The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study

Background In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Orthoses are frequently prescribed. However, it is...

Short range stiffness elastic limit depends on joint velocity

Muscles behave as elastic springs during the initial strain phase, indicated as short range stiffness (SRS). Beyond a certain amount of strain the muscle demonstrates a more viscous behavior. The strain at which the muscle transits from elastic- to viscous-like behavior is called the elastic limit and is believed to be the result of breakage of...

The relation between neuromechanical parameters and Ashworth score in stroke patients

Quantifying increased joint resistance into its contributing factors i.e. stiffness and viscosity ("hypertonia") and stretch reflexes ("hyperreflexia") is important in stroke rehabilitation. Existing clinical tests, such as the Ashworth Score, do not permit discrimination between underlying tissue and reflexive (neural) properties. We propose an...

Tizanidine does not affect the linear relation of stretch duration to the long latency M2 response of m. flexor carpi radialis

The long latency M2 electromyographic response of a suddenly stretched active muscle is stretch duration dependent of which the nature is unclear. We investigated the inXuence of the group II aVerent blocker tizanidine on M2 response characteristics of the m. Xexor carpi radialis (FCR). M2 response magnitude and eliciting probability in a group...

Muscle weakness and lack of reflex gain adaptation predominate during post-stroke posture control of the wrist

Background Instead of hyper-reflexia as sole paradigm, post-stroke movement disorders are currently considered the result of a complex interplay between neuronal and muscular properties, modified by level of activity. We used a closed loop system identification technique to quantify individual contributors to wrist joint stiffness during an...

The monosynaptic Ia afferent pathway can largely explain the stretch duration effect of the long latency M2 response

Sudden stretch of active muscle typically results in two characteristic electromyographic responses: the short latency M1 and the long latency M2. The M1 response originates from the monosynaptic Ia afferent reflex pathway. The M2 response is less well understood and is likely a compound response to different afferent inputs mediated by spinal...