Paired changes in electromechanical delay and musculo-tendinous stiffness after endurance or plyometric training

When measured in vivo electromechanical delay (EMD) depends mainly on the elastic properties of the muscle–tendon unit. Recent studies have shown changes in stiffness of the triceps surae (TS) following a period of training. To confirm the influence of musculo-tendinous stiffness on EMD, this study investigates paired changes in these two parameters after a training period. Two types of training known to induce opposite changes in stiffness were analysed. EMD and musculo-tendinous stiffness were measured on adult subjects before and after 10 weeks of endurance (n = 21) or plyometric (n = 9) trainings. EMD was defined as the time lag between the TS M-wave latency and the onset of muscle twitch evoked at rest by supramaximal electrical stimulations of the posterior tibial nerve. Quick release tests were used to evaluate the musculo-tendinous stiffness of the ankle plantar flexors. The stiffness index was defined as the slope of the relationship between angular stiffness and external torque values. Endurance training, known to preferentially activate the slow, stiffer muscle fibers, leads to a decrease in EMD and to an increase in stiffness index. Following plyometric training, which specifically recruits fast, more compliant fibers, EMD and the stiffness index exhibited adaptations directionally opposite to those seen with endurance training. When pooling the data for the two subject groups, a correlation was found between changes in EMD and changes in musculo-tendinous stiffness indexes. Thus, changes in EMD values are proposed to indirectly link to changes in musculo-tendinous stiffness for subjects involved in muscle training.     

机械性踝关节不稳定患者中腓骨肌功能的表面肌电研究

评价机械性踝关节不稳定中腓骨肌的功能变化.20名单侧机械性踝关节不稳定患者的双侧踝关节在行走过程中模拟内翻动作时接受表面肌电测试,以患侧踝关节作为不稳定组,以同一患者的对侧无症状踝关节作为正常对照组.计算并比较两组踝关节腓骨长肌和腓骨短肌的标化平均波幅和激发时间的差异.在模拟内翻动作中,不稳定组的腓骨长肌和腓骨短肌的标...     

Hip kinematics during a stop-jump task in patients with chronic ankle instability

Context:

Chronic ankle instability (CAI) commonly develops after lateral ankle sprain. Movement pattern differences at proximal joints may play a role in instability.

Objective:

To determine whether people with mechanical ankle instability (MAI) or functional ankle instability (FAI) exhibited different hip kinematics and kinetics during a stop-jump task compared with “copers.”

Design:

Cross-sectional study.

Setting:

Sports medicine research laboratory.

Patients or Other Participants:

Sixty-three recreational athletes, 21 (11 men, 10 women) per group, matched for sex, age, height, mass, and limb dominance. All participants reported a history of a moderate to severe ankle sprain. The participants with MAI and FAI reported 2 or more episodes of giving way at the ankle in the last year and decreased functional ability; copers did not. The MAI group demonstrated clinically positive anterior drawer and talar tilt tests, whereas the FAI group and copers did not.

Intervention(s):

Participants performed a maximum-speed approach run and a 2-legged stop jump followed by a maximum vertical jump.

Main Outcome Measure(s):

An electromagnetic tracking device synchronized with a force plate collected data during the stance phase of a 2-legged stop jump. Hip motion was measured from initial contact to takeoff into the vertical jump. Group differences in hip kinematics and kinetics were assessed.

Results:

The MAI group demonstrated greater hip flexion at initial contact and at maximum (P = .029 and P = .017, respectively) and greater hip external rotation at maximum (P = .035) than the coper group. The MAI group also demonstrated greater hip flexion displacement than both the FAI (P = .050) and coper groups (P = .006). No differences were noted between the FAI and coper groups in hip kinematic variables or among any of the groups in ground reaction force variables.

Conclusions:

The MAI group demonstrated different hip kinematics than the FAI and coper groups. Proximal joint motion may be affected by ankle joint function and laxity, and clinicians may need to assess proximal joints after repeated ankle sprains.     

护踝对功能性踝关节不稳患者下肢运动生物力学特征的影响

目的 探究护踝对功能性踝关节不稳(functional ankle instability,FAI)患者的保护作用,为其护踝的选择提供依据。 方法 15 名 FAI 患者随机佩戴半刚性、弹性护踝及无护踝以自选速度步行和跑步,运用红外光点运动捕捉系统和三维测力台采集其下肢运动生物力学参数。 通过 3×2 重复设计的双因素方差分析检验护踝和运动模式对下肢运动学、动力学和能量吸收的影响。 结果 护踝与运动模式对本研究中所有指标均无交互作用(P>0. 05)。不论运动模式,与无护踝相比,弹性护踝显著减少了 FAI 患者踝关节内翻角峰值、内翻角速度和踝关节能量吸收(P<0. 05),同时增加了踝关节外翻力矩( P < 0. 001);而半刚性护踝增加了踝关节内翻角峰值和内翻角速度(P<0. 05)。 此外,弹性护踝可降低着地时刻的膝关节内旋力矩和外旋力矩峰值(P<0. 05)。 结论 与无护踝相比,弹性护踝通过减小踝关节内翻角、内翻角速度和能量吸收,增大踝关节外翻力矩,继而起到预防踝关节扭伤的作用。 FAI 患者佩戴半刚性护踝后需定时关注踝关节慢性损伤风险。 整体来看,弹性护踝的防护效果可能更有效,且未引起膝关节功能补偿,可作为预防 FAI 患者踝关节扭伤的有效措施。     

Influence of musculo-tendinous stiffness of the plantar ankle flexor muscles upon maximal power output on a cycle ergometre

The importance of maximal voluntary torque (T (MVC)), maximal rate of torque development (MRTD) and musculo-tendinous stiffness of the triceps surae for maximal power output on a cycle ergometre (P (max)) was studied in 21 healthy subjects by studying the relationships between maximal cycling power related to body mass (P (max)?BM(-1)) with T (MVC), MRTD and different indices of musculo-tendinous stiffness of the ankle flexor. P (max)?BM(-1) was calculated from the data of an all-out force-velocity test on a Monark cycle ergometre. T (MVC) and MRTD were measured on a specific ankle ergometre. Musculo-tendinous stiffness was estimated by means of quick releases at 20, 40, 60 and 80% T (MVC) on the same ankle ergometre. P (max)?BM(-1) was significantly and positively correlated with MRTD related to body mass but the positive correlation between P (max)?BM(-1) and T (MVC) did not reach the significance level (0.05). P (max)?BM(-1) was significantly and positively correlated with the estimation of stiffness at 40% T (MVC) (S(0.4)), but not with stiffness at 20, 60 and 80% T (MVC). The results of the present study suggest that maximal power output during cycling is significantly correlated with the level of musculo-tendinous stiffness which corresponds to torque range around peak torque at optimal pedal rate. However, the low coefficient of determination (r (2)?=?0.203) between P (max)?BM(-1) and S (0.4)?BM(-1) suggested that P (max)?BM(-1) largely depended on other factors than the musculo-tendinous stiffness of the only plantar flexors.     

Explosive neuromuscular performance of males versus females

The purpose of the study was to investigate sex-related differences in explosive muscular force production, as measured by electromechanical delay (EMD) and rate of force development (RFD), and to examine the physiological mechanisms responsible for any differences. The neuromuscular performance of untrained males (n = 20) and females (n = 20) was assessed during a series of isometric knee extension contractions; explosive and maximal voluntary efforts, as well as supramaximal evoked twitches and octets (eight pulses at 300 Hz). Evoked and voluntary EMD were determined from twitch and explosive contractions. The RFD was recorded over consecutive 50 ms time windows from force onset during evoked and explosive contractions, and normalized to maximal strength. Neuromuscular activity during explosive voluntary contractions was measured with EMG of the superficial knee extensors normalized to maximal M-wave. Muscle size (thickness) and muscle-tendon unit (MTU) stiffness were assessed using ultrasonic images of the vastus lateralis at rest and during ramped contractions. Males and females had similar evoked and voluntary EMD. Males were 33% stronger (P < 0.001) and their absolute RFD was 26-56% greater (all time points P < 0.05) compared with females. Muscle size (P < 0.001) and absolute MTU stiffness were also greater for males (P < 0.05). However, normalized RFD was similar for both sexes during the first 150 ms of the explosive voluntary contractions (P > 0.05). This was consistent with the similar normalized twitch and octet RFD, MTU stiffness and agonist EMG (all P > 0.05). When differences in maximal strength were accounted for, the evoked capacity of the knee extensors for explosive force production and the ability to utilize that capacity during explosive voluntary contractions was similar for males and females.     

Assessment tools for identifying functional limitations associated with functional ankle instability

CONTEXT: Assessment tools should identify functional limitations associated with functional ankle instability (FAI) by discriminating unstable from stable ankles. OBJECTIVE: To identify assessment tools that discriminated FAI from stable ankles and determine the most accurate assessment tool for discriminating between FAI and stable ankles. DESIGN: Case-control study. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Fifteen individuals with FAI and 15 healthy individuals; participants with unilateral FAI reported "giving-way" sensations and ankle sprains, whereas healthy participants did not. INTERVENTION(S): Participants answered 12 questions on the Ankle Joint Functional Assessment Tool (AJFAT). They also performed a single-leg jump landing, which required them to jump to half their maximum jump height, land on a single leg, and stabilize quickly on a force plate. MAIN OUTCOME MEASURE(S): Receiver operating characteristic curves determined cutoff scores for discriminating between ankle groups for AJFAT total score and resultant vector (RV) time to stabilization. Accuracy values for discriminating between groups were determined by calculating the area under the receiver operating characteristic curves. RESULTS: The cutoff score for discriminating between FAI and stable ankles was > or =26 (sensitivity = 1, specificity = 1) and > or =1.58 seconds (sensitivity = 0.67, specificity = 0.73) for the AJFAT total score and RV time to stabilization, respectively. The area under the curve for the AJFAT was 1.0 (asymptotic significance <.05), whereas the RV time to stabilization had an area under the curve of 0.72 (asymptotic significance <.05). CONCLUSIONS: The AJFAT was an excellent assessment tool for discriminating between ankle groups, whereas RV time to stabilization was a fair assessment tool. Although both assessments discriminated between ankle groups, the AJFAT more accurately discriminated between groups than the RV time to stabilization did. Future researchers should confirm these findings using a prospective research design.     

Electromechanical delay in skeletal muscle under normal movement conditions

Electromechanical delays (EMD), the time from onset of EMG activity to change in acceleration or deceleration of the forearm, were studied in concentric and eccentric contractions of biceps and triceps brachii muscles. Horizontal flexion and extension movements were performed at varying speeds by 10 subjects. EMD time in concentric contractions for biceps was 41 +/- 13 ms and for triceps was 26 +/- 11 ms and was not influenced by the velocity of the movement. In eccentric contractions at the slow velocity the biceps EMD time was 38 +/- 13 ms and shortened to 28 +/- 10 ms at the faster velocity. The eccentric triceps EMD, however, was not significantly altered by movement velocity and averaged 30 +/- 7 ms. The data provided support for the hypothesis that stretching of the series elastic component, to a point where muscle force can be detected, is the primary determinant of the EMD phenomenon. However, there are complex interactions of the effects on EMD of muscle fiber type composition, whether the contraction is concentric or eccentric, and the velocity of the movement as well as possible gamma system influence. These complications require that consideration of electromechanical delay be made when phasic relationships between muscle force or joint torque generation from different muscles are inferred from EMGs.     

Dynamic postural stability in subjects with braced, functionally unstable ankles

Context: Research concerning prophylactic ankle stabilizers (PASs) has focused on healthy subjects, and the results cannot be generalized to the functional ankle instability (FAI) population, a population that has an increased risk of reinjury and is likely to wear PASs. Objective: To determine whether PASs improve dynamic postural stability in FAI subjects as compared with a control (no-brace) condition. Design: A crossover design was used to determine the effects of PASs on dynamic postural stability and vertical ground reaction forces. Setting: Biomechanics laboratory. Patients or Other Participants: Twenty-eight subjects with unilateral FAI, 13 men (age = 21.5 +/- 1.2 years, height = 181.5 +/- 10.5 cm, mass = 77.6 +/- 17.2 kg) and 15 women (age = 20.5 +/- 1.1 years, height = 169.4 +/- 8.2 cm, mass = 67.9 +/- 8.8 kg). Intervention(s): A jump protocol required subjects to perform a 2-legged jump to a height equivalent to 50% of their maximum vertical leap and land on a single leg. Main Outcome Measure(s): The dynamic postural stability index, the directional components (medial-lateral, anterior-posterior, and vertical), and vertical ground reaction force after a jump landing. Results: Compared with the control condition, only the vertical component score was reduced (improved) with the application of a soft or semirigid PAS (P < .01). Conclusions: Soft and semirigid PASs did not improve dynamic postural stability as measured by the Dynamic Postural Stability Index. However, PASs may help with the attenuation of vertical forces.     

Muscle activation following sudden ankle inversion during standing and walking

Dynamic response characteristics of ankle musculature following sudden ankle inversion have traditionally been tested in a static, standing position. However, this model does not take into consideration muscle activity and loading characteristics associated with active gait. This study compared muscle reaction times and amplitudes from sudden ankle inversion during standing (standing group) and walking (walking group) using one of two similar devices for each of these conditions. Surface EMG was collected from the peroneus longus (PL), brevis (PB), and tibialis anterior (TA) of the dominant leg from 25 subjects (age 20 ± 1 years, height 174.0 ± 10.2 cm, mass 74.3 ± 12.9 kg) for each condition (walking and standing). Time to total inversion ROM (28°) was greater in the walking group (114.9 ± 15.0 ms) than the standing group (65.6 ± 17.8 ms, P < 0.05), whereas reaction time was less in the peroneals in the walking group (PL 56.9 ± 8.4 ms, PB 60.1 ± 10.6 ms, TA 65.0 ± 14.9 ms) compared to the standing group (PL 74.3 ± 8.5 ms, PB 73.5 ± 8.2 ms, TA 73.3 ± 8.3, P < 0.05). Additionally, Peak normalized EMG (% MVIC) for the walking condition (PL 367 ± 254, PB 405 ± 359, TA 84 ± 39) exceeded that of the standing condition (PL 310 ± 239, PB 328 ± 215, TA 76 ± 39, P < 0.05), and average normalized EMG (% MVIC) was greater in the peroneals for the walking condition (PL 233 ± 171, PB 280 ± 255) than the standing condition (PL 164 ± 131, PB 193 ± 137, P < 0.05). The differences noted between the conditions provide evidence that a dynamic response to ankle injury mechanisms is much different in a walking model compared to a traditional standing model. A walking model may be a more functional approach for evaluating dynamic response characteristics of ankle musculature due to sudden ankle inversion.     

Cutaneous mechanisms of isometric ankle force control

The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force output. We used repetitive electrical stimulation of the superficial peroneal (foot dorsum) and medial plantar nerves (foot sole) to disrupt cutaneous afferent input in 8 healthy subjects. We measured the effects of repetitive nerve stimulation on (1) tactile thresholds, (2) performance in an ankle force-matching and (3) an ankle position-matching task. Additional force-matching experiments were done to compare the effects of transient versus continuous stimulation in 6 subjects and to determine the effects of foot anesthesia using lidocaine in another 6 subjects. The results showed that stimulation decreased cutaneous sensory function as evidenced by increased touch threshold. Absolute dorsiflexion force error increased without visual feedback during peroneal nerve stimulation. This was not a general effect of stimulation because force error did not increase during plantar nerve stimulation. The effects of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases.     

The electro-mechanical delay of the erector spinae muscle: influence of rate of force development,fatigue and electrode location

Summary Electro-mechanical delay (EMD) values of the erector spinae muscle were obtained using a technique based on the cross-correlation between the force and the electromyogram (EMG). Seven subjects performed a series of 20 submaximal dynamic isometric contractions in a seated position at two frequencies (0.5 Hz and 1 Hz) to study the influence of the rate of force development on EMD. Mean EMD values of 125.7 (SD 28.1) ms (1 Hz) and 136.8 (SD 28.6) ms (0.5 Hz) were shown to differ significantly (P=0.02). This finding supports the hypothesis that EMD is inversely related to the rate of force development and implies that the time to stretch the series elastic component is an important factor determining EMD. After performing a series of fatiguing contractions EMD did not differ significantly from the control value. Multiple regression analysis showed that maximal voluntary contraction force (MVC) and endurance time of the fatiguing exercise correlated significantly with EMD. The site from which the EMG signal was recorded had no significant influence on EMD. However, the coefficient of correlation between force and the EMG-signal differed significantly between electrode positions. The magnitude of the EMD values found emphasized the need to account for this delay when interpreting temporal patterns of activation of the muscles in, for example, lifting tasks.     

Functional performance testing in participants with functional ankle instability and in a healthy control group

CONTEXT: Functional ankle instability (FAI) affects a large part of the population. Inconsistent findings have been reported regarding the existence of functional performance deficits in individuals with FAI. OBJECTIVE: To examine functional performance in participants with FAI compared with participants in a control group during 2 hopping tests. DESIGN: Case-control study. SETTINGS: Athletic training research laboratory. PATIENTS OR OTHER PARTICIPANTS: There were 40 college-aged individuals who participated in our study: 20 with FAI and 20 without FAI. We defined FAI as history of an ankle sprain and residual episodes of "giving way." INTERVENTION(S): Participants completed 2 functional performance tests (FPTs): the single-limb hopping and the single-limb hurdle tests. MAIN OUTCOME MEASURE(S): Time to complete each test was recorded. Following each FPT, participants were asked if their ankles felt unstable during the test. RESULTS: We found no difference between participants in the FAI and control groups for the hopping or hurdle tests (P > .05). When asked if their ankles felt unstable during the FPTs, approximately half of the participants in the FAI group and none of the participants in the control group reported a feeling of instability. Subsequently, a secondary analysis of variance was calculated with participants grouped into 3 categories: control participants, FAI participants reporting instability symptoms during FPT (FAI-S), and FAI participants not reporting instability symptoms during FPT (FAI-NS). Results revealed a difference among the 3 groups for the single-limb hopping test (P < .01). Post hoc analysis revealed a difference between the FAI-S participants and both the control and the FAI-NS participants. No difference was identified for the single-limb hurdle test (P = .41). CONCLUSIONS: The FAI-S participants had performance deficits during the single-limb hopping test. Therefore, clinicians could use this simple hopping test as an additional method to determine the presence of FAI.     

Low-load eversion force sense, self-reported ankle instability, and frequency of giving way

Context: Functional ankle instability has been attributed to proprioceptive loss. However, in previous studies of proprioception,authors have not investigated the ability to sense force at the ankle. Additionally, previous investigators have viewed functional ankle instability as either a present or absent condition,rather than a continuum.Objective: To determine the relationship of ankle giving-way frequency and perceived ankle instability to ankle eversion force sense.Design: Cohort design.Setting: Sports medicine research laboratory. Patients or Other Participants: Twenty individuals (5 men,15 women) with a history of unilateral ankle instability.Intervention(s): We tested subjects with 2 loads: 10% and 30% of maximal voluntary isometric contraction. Main Outcome Measure(s): We measured eversion force sense by calculating absolute, constant, and variable errors from a 3-trial force-matching procedure. Furthermore, subjects reported their frequency of giving way in units of times per day,week, or month, and these data were extrapolated to estimate annual giving-way frequency. Finally, subjects answers to 6 questions about ankle stability during typical daily or sports activities were summed to create a perceived ankle instability index.Results: Significant relationships were found for only the 10% maximal voluntary isometric contraction. For absolute error,a positive relationship existed between the number of self reported episodes of giving way and eversion force sense for both ipsilateral (r .58) and contralateral (r .49) testing of the injured ankle. Constant error was correlated with giving way(r = -.56) for ipsilateral testing of the injured ankle. The ankle instability index was also positively correlated with eversion force sense absolute error (r .51) for ipsilateral testing only.Conclusions: Our results suggest that subjects with ankle instability had difficulty replicating eversion forces. Specifically,larger errors were related to both self-reported giving-way episodes and perceived ankle instability.     

Eccentric plantar-flexor torque deficits in participants with functional ankle instability

CONTEXT: Inversion ankle sprains can lead to a chronic condition called functional ankle instability (FAI). Limited research has been reported regarding isokinetic measures for the plantar flexors and dorsiflexors of the ankle. OBJECTIVE: To examine the isokinetic eccentric torque measures of the ankle musculature in participants with stable ankles and participants with functionally unstable ankles during inversion, eversion, plantar flexion, and dorsiflexion. DESIGN: Case-control study. SETTING: Athletic training research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty participants with a history of "giving way" were included in the FAI group. Inclusion criteria for the FAI group included a history of at least 1 ankle sprain and repeated episodes of giving way. Twenty participants with no prior history of ankle injury were included in the control group. INTERVENTION(S): Isokinetic eccentric torque was assessed in each participant. MAIN OUTCOME MEASURE(S): Isokinetic eccentric testing was conducted for inversion-eversion and plantar-flexion-dorsiflexion movements. Peak torque values were standardized to each participant's body weight. The average of the 3 trials for each direction was used for statistical analysis. RESULTS: A significant side-by-group interaction was noted for eccentric plantar flexion torque (P < .01). Follow-up t tests revealed a significant difference between the FAI limb in the FAI group and the matched limb in the control group. Additionally, a significant difference was seen between the sides of the control group (P = .03). No significant interactions were identified for eccentric inversion, eversion, or dorsiflexion torques (P > .05). CONCLUSIONS: A deficit in plantar flexion torque was identified in the functionally unstable ankles. No deficits were identified for inversion, eversion, or dorsiflexion torque. Therefore, eccentric plantar flexion strength may be an important contributing factor to functional ankle instability.     

Effects of a task failure exercise on the peroneus longus and brevis during perturbed gait

Ankle inversion injuries represent the most common trauma sustained by athletes. Muscle fatigue from activity may contribute to a delay in the response of the ankle proprioceptors and dynamic restraints during unexpected inversion. The purpose of this investigation was to determine changes in peroneal average EMG, peak EMG, and time to peak EMG following a task failure exercise. Thirty-two subjects (age 20+/-1.43 yrs; 21 male, 11 female) with no lower extremity injuries reported for data collection. Data were collected from each subject's dominant leg using surface electromyography (EMG). EMG electrodes were applied over the peroneus longus (PL) and brevis (PB) using a standard protocol Subjects walked at a fixed pace on a 6.1 m runway with one section that could be unexpectedly dropped into 30 degrees of inversion upon foot contact. Trials with perturbed and unperturbed gait were randomized to reduce prediction of the unexpected inversion. Once 3 trials of perturbed gait were recorded, subjects completed an isotonic activity that isolated the peroneals. The task was completed to failure. Immediately following the task failure exercise, subjects walked on the perturbation runway once again until 3 trials of perturbed gait were recorded. Analysis revealed no significant differences with regard to average muscle activity between pre- and post-task failure exercise for the PL (F1,31 = 0.133; p = 0.718) or for the PB (F1,31 = 0.795; p = 0.380). There was also no significant difference in peak muscle activity pre- to post-task failure for the PL (F1,31 = 0.032; p = 0.859) or the PB (F1,31 = 0.156; p = 0.695). Finally, there was no significant difference in time-to-peak muscle activity pre- to post-task failure for the PL (F1,31 = 0.830; p = 0.369) or the PB (F1,31 = 1.037; p = 0.316). We concluded that the task failure exercise did not contribute to changes in peroneal activity during perturbed gait. These results indicate that peroneal fatigue does not play a significant role in the incidence of inversion ankle sprains.     

Influence of plantar cutaneous afferents on early compensatory reactions to forward fall

The influence of cutaneous afferents in the compensatory reactions to a forward fall was investigated. Modification of cutaneous afferent activity was obtained in two different ways: first, by varying the initial pedal support conditions, secondly by anesthetizing the plantar foot sole. The initial pedal support conditions were: 1) bipedal posture, 2) unipedal posture, with contact and 3) unipedal posture, without contact. Nine healthy subjects participated in the control (without anesthesia) experimental session, of which three subjects participated in a session where the plantar sole was anesthetized. The compensatory reactions to a perturbation of balance of a subject initially with a bipedal stance, showed synchronized EMG activity in both Soleus muscles, starting on average at 59 ms, and a burst of EMG activity in the Tibialis Anterior of the starting foot after 200 ms. When the subject was in unipedal posture, the EMG responses on the side which was without support, showed several modifications: the EMG burst in Soleus was strikingly depressed, the response in Tibialis Anterior appeared earlier (mean latency 90 ms) and its magnitude was enhanced. When this foot was in contact with a rigid support, the Soleus showed a short burst of activity and the activity in Tibialis Anterior started at a mean latency of 150 ms.(ABSTRACT TRUNCATED AT 250 WORDS)     

Efficacy of the Star Excursion Balance Tests in Detecting Reach Deficits in Subjects With Chronic Ankle Instability

OBJECTIVE: Chronic instability after lateral ankle sprain has been shown to cause balance deficits during quiet standing. Although static balance assessment in those with ankle instability has been thoroughly examined in the literature, few researchers have studied performance on more dynamic tasks. Our purpose was to determine if the Star Excursion Balance Tests (SEBTs), lower extremity reach tests, can detect deficits in subjects with chronic ankle instability. DESIGN AND SETTING: We performed all testing in a university athletic training facility. We tested lower extremity reach using the SEBTs, which incorporates single-leg stance with maximal reach of the contralateral leg. SUBJECTS: Twenty subjects with unilateral, chronic ankle instability (age = 19.8 +/- 1.4 years, height = 176.8 +/- 4.5 cm, mass = 82.9 +/- 21.2 kg) and 20 uninjured subjects matched by sex, sport, and position (age = 20.2 +/- 1.4 years, height = 178.7 +/- 4.1 cm, mass = 82.7 +/- 19.9 kg). MEASUREMENTS: We measured the reach distances in centimeters (cm) and averaged 3 reaches in each of the 8 directions while the subjects stood on each leg for data analysis. RESULTS: The group with chronic ankle instability demonstrated significantly decreased reach while standing on the injured limb compared with the matched limb of the uninjured group (78.6 cm versus 82.8 cm). Additionally, subjects with chronic ankle instability reached significantly less when standing on their injured limbs as compared with their uninjured limbs (78.6 cm versus 81.2 cm). CONCLUSIONS: The SEBTs appear to be an effective means for determining reach deficits both between and within subjects with unilateral chronic ankle instability.     

Muscle stiffness in human ankle dorsiflexors: intrinsic and reflex components

1. The purpose of this study was to evaluate the mechanical response to stretch in normal human ankle dorsiflexors at different levels of voluntary contraction. In an active muscle, the total mechanical response is the sum of the intrinsic response from the contractile apparatus, the response from passive tissues, and the reflex mediated response. Each of these components was investigated. 2. The total incremental stiffness was defined as the ratio between the torque increment and the amplitude of the stretch. In 14 subjects the total stiffness increased from approximately 0.6 N.m/deg to approximately 2.5 N.m/deg at 50% of MVC and remained constant (+/- 10%) from 30 to 80% of MVC. 3. The contribution to incremental stiffness from intrinsic muscle properties was measured during electrical stimulation of the deep peroneal nerve at 7-50 Hz. Intrinsic stiffness increased linearly with torque from approximately 0.5 N.m/deg to approximately 2.5 N.m/deg at 80% of MVC. 4. The reflex component (total minus intrinsic stiffness) had a maximum of 0.5-1.5 N.m/deg at 30-50% of MVC and was approximately zero at no and maximal contraction. For intermediate levels of contraction the reflex increased the stiffness with 40-100% of the intrinsic stiffness in this flexor muscle. 5. The reflex contribution to total stiffness began approximately 50 ms after onset of stretch and peaked 150-300 ms after onset of stretch. 6. Total, intrinsic, and reflex mediated stiffness were all nearly independent of the amplitude of stretch in the range from 2 to 7 degrees. The higher stiffness observed for 1 degree stretches could be due to "short range stiffness" of the cross bridges. 7. Stretching of a contracting muscle generates large force increments even for moderate amplitudes of stretch. Approximately half of this force increment is due to the stretch reflex, which makes the muscle stiffer than predicted from the intrinsic stiffness. These findings in human flexor muscles are surprisingly similar to previous findings in extensor muscles of the decerebrate cat.     

Balance control under different passive contributions of the ankle extensors: quiet standing on inclined surfaces

Human bipedal stance is often modeled as a single inverted pendulum that pivots at the ankle joints in the sagittal plane. Because the center of body mass is usually maintained in front of the ankle joints, ankle extensor torque is continuously required to prevent the body from falling. During quiet standing, both passive and active mechanisms contribute to generate the ankle extensor torque counteracting gravity. This study aimed to investigate the active stabilization mechanism in more detail. Eight healthy subjects were requested to stand quietly on three different surfaces of 1) toes-up, 2) level, and 3) toes-down. Surface electromyogram (EMG) was recorded from the medial head of the gastrocnemius (MG), soleus (SOL), and tibialis anterior muscles. Inclination angle of the body was simultaneously measured. As a result, we found that EMG activities of MG and SOL were lowest during the toes-up standing and highest during the toes-down, indicating that increased (decreased) passive contribution required less (more) extensor torque generated by active muscle contraction. Frequency domain analysis also revealed that sway-related modulation of the ankle extensor activity (0.12–4.03 Hz) was unchanged among the three foot inclinations. On the other hand, isometric contraction strength of these muscles increased as the slope declined (toes-up < level < toes-down). These results support the idea that by regulating the isometric contraction strength, the CNS maintains a constant level of muscle tone and resultant ankle stiffness irrespective of the passive contribution. Such control scheme would be crucial when we consider the low bandwidth of the intermittent controller.