Gait characteristics in people with type 2 diabetes mellitus

Sixteen control subjects and 15 subjects with type 2 diabetes were examined to compare gait characteristics during walking in a linear path and in turns of 0.33 and 0.66 m diameter. Subjects were excluded if there was diminished sensation in the feet or impairment of strength in the legs. This was done to isolate the effect of diabetes gait independent of loss of sensation. Gait was assessed through contact sensors on the foot, video, and two axis accelerometers mounted bilaterally on the head, shoulders, hips, knees and ankles. The results of these experiments showed that subjects with diabetes walked significantly slower (P<0.05) than control subjects and with a wider stance (P<0.01), both for walking in a linear path (velocity of subjects with diabetes was 62.2% that of controls and stance was 134.9% wider than controls) and when making turns (velocity 50.6% of controls and stance 120.1% wider than that of controls). Accelerometry showed increased flexion/extension and lateral movement of the major joints in subjects with diabetes during both walking in a linear path and turns compared to control subjects. Part of the increased movement at the joints in the subjects with diabetes was due to tremor in both the 8 Hz and 16 Hz bands. These findings suggest that at least some of the increased joint movement during walking in people with diabetes is likely neurological in origin and not related to muscle weakness or loss of sensation in the feet.     

慢跑的速度对青年女性下肢关节及肌肉的影响

目的 探讨合理的慢跑速度对体形和步姿的影响,使人在慢跑健身的同时兼得柔美的体态。方法 根据相关测量选择5种慢跑速度。利用运动捕捉系统采集研究对象(15位青年女性志愿者)在慢跑速度下的运动学数据,同时对下肢8块主要肌肉的肌电信号进行采集。计算获得在不同慢跑速度下髋、膝及踝关节矢状面的关节角度变化的均值。选择数据最接近均值的对象作为研究对象并进行运动学分析。结果 计算获得了该研究对象在不同慢跑速度下髋、膝及踝关节矢状面的关节角度以及下肢8块主要肌肉的激活度曲线。运用打分的方法,本文给出了研究对象慢跑速度、慢跑阶段、肌肉激活度与关节角度之间的关系。结论 各关节角的变化范围和各肌肉最大激活度并不随慢跑速度的变化而单调变化。本文为青年女性健身时选择适合自己的慢跑速度提供了参考。     

Selection and coordination of human locomotor forms following cerebellar damage

We have previously shown that control subjects use two distinct temporal strategies when stepping on an inclined surface during walking: one for level and 10 degrees surfaces and another for 20 and 30 degrees surfaces. These two temporal strategies were characterized by systematic shifts in the timing of muscle activity and peak joint angles. We examined whether cerebellar subjects with mild to moderate gait ataxia were impaired in their ability to select these two temporal strategies, adjust peak joint angle amplitudes, and/or adjust one joint appropriately with respect to movements and constraints at another joint. Subjects walked on a level surface and on different wedges (10, 20, and 30 degrees ) presented in the context of level walking. In a single trial, a subject walked on a level surface in approach to a wedge, took a single step on the wedge, and continued walking on an elevated level surface beyond the wedge. Cerebellar subjects used two temporal strategies, one for the level and 10 degrees surfaces and another for 20 and 30 degrees surfaces. Cerebellar strategies were similar to those used by controls except for the timing of ankle-joint movement on the steeper wedges. Cerebellar subjects adjusted the peak amplitudes of individual joint angles normally, with the exception of peak ankle plantarflexion. However, they exhibited greater trial-to-trial variability of peak hip and knee joint angles that increased as a function of wedge inclination. The most substantial deficit noted in the cerebellar group was in the relative movement of multiple joints. Cerebellar subjects demonstrated multijoint coordination deficits in all conditions, although these deficits were most pronounced during stance on the steeper wedges. On the 30 degrees wedge, cerebellar subjects showed abnormal relative movement of hip, knee, and ankle joints and the most substantial decomposition of movement. We speculate that to simplify multijoint control, cerebellar subjects decomposed their movement by fixing the ankle joint in a dorsiflexed position on the steepest wedges. Our results suggest that the cerebellum may not be critical in selecting the basic motor patterns for the two temporal strategies because cerebellar subjects produced appropriate timing shifts at most joints. Instead, our data suggest that the cerebellum is most critical for adjusting the relative movement of multiple joints, especially to accommodate external constraints.     

Compensation for interaction torques during single- and multijoint limb movement

During multijoint limb movements such as reaching, rotational forces arise at one joint due to the motions of limb segments about other joints. We report the results of three experiments in which we assessed the extent to which control signals to muscles are adjusted to counteract these "interaction torques." Human subjects performed single- and multijoint pointing movements involving shoulder and elbow motion, and movement parameters related to the magnitude and direction of interaction torques were manipulated systematically. We examined electromyographic (EMG) activity of shoulder and elbow muscles and, specifically, the relationship between EMG activity and joint interaction torque. A first set of experiments examined single-joint movements. During both single-joint elbow (experiment 1) and shoulder (experiment 2) movements, phasic EMG activity was observed in muscles spanning the stationary joint (shoulder muscles in experiment 1 and elbow muscles in experiment 2). This muscle activity preceded movement and varied in amplitude with the magnitude of upcoming interaction torque (the load resulting from motion of the nonstationary limb segment). In a third experiment, subjects performed multijoint movements involving simultaneous motion at the shoulder and elbow. Movement amplitude and velocity at one joint were held constant, while the direction of movement about the other joint was varied. When the direction of elbow motion was varied (flexion vs. extension) and shoulder kinematics were held constant, EMG activity in shoulder muscles varied depending on the direction of elbow motion (and hence the sign of the interaction torque arising at the shoulder). Similarly, EMG activity in elbow muscles varied depending on the direction of shoulder motion for movements in which elbow kinematics were held constant. The results from all three experiments support the idea that central control signals to muscles are adjusted, in a predictive manner, to compensate for interaction torques-loads arising at one joint that depend on motion about other joints.     

下肢不等长对步态影响的实验分析

目的采用正常人体单侧增高模拟下肢不等长,分析下肢不等长步态特征,研究下肢不等长对步态的影响,为下肢假肢穿戴者因下肢不等长引起的慢性疾病提供理论依据。方法通过单侧穿鞋增高人为制造下肢不等长,利用三维动态捕捉系统和地面反力采集设备采集受试者在正常步态和下肢不等长步态下的时空参数、地面反力和关节角度,并进行对比分析。结果下肢不等长步态与正常步态在步长、步长时间和单侧支撑期存在显著差异。下肢不等长步态左右腿足跟着地期垂直方向地面反力均大于正常步态,髋、膝、踝角度存在明显变化。结论下肢不等长是造成行走步态异常的重要原因,可能是下肢假肢穿戴者产生腿部关节疾病的原因。     

Comportement du pied et de la cheville au cours de la marche de sujets asymptomatiques

Lower limb amputee gait evaluation is allowed by kinematic and ground reaction force analysis. Motion capture is a non invasive means of gait evaluation. A protocol taking account of the foot and lower limb joints has been proposed. Thirty-five subjects participated in this study. Stride parameters and spatiotemporal parameters were recorded in a database. Correlations were established between the metatarsophalangeal joint, the walking speed and the propulsive forces. These correlations underline the functional significance of feet in the propulsion phase. This study aims at comparative analysis between lower limb amputees and sound people and at prosthetic feet evaluation.     

Impact of gait problems and falls on functioning in independent living persons of 55 years and over: a community survey

In a cross-sectional, population-based study among community-dwelling persons of 55 years and over the incidence of falls, risk indicators for falls, specifically age, and the impact of gait problems, falls and other risk factors on functioning was determined. A randomly age-stratified sample (n = 655) was taken from all independent living persons of 55 years and over (n = 2269) and registered in a primary health care centre. They received a mail questionnaire concerning demographic data, history of falls and injuries due to falls, physical and mental health status, gait problems, functional status, including social activities. The response rate was 62% (n = 405). Of the subjects aged 55 years and of those aged 65 years and over, 25% and 31% respectively fell at least once in the previous year. Half of the people reporting falls fell more than once. Serious injury occurred in 9% of the fallers, with 4% fractures. There is a significant association between falling and age and, even more clearly, between gait problems and age. The main risk factors of single and recurrent falls were female gender, physical health status and gait problems. Logistic regression analysis reveals that the main determinants of falling in general are gait problems and female gender and, of recurrent falling female gender, physical complaints and gait problems. Falls have some negative effect on functioning, i.e. mobility range and social activities, but this is overshadowed by mental status indicators and gait problems.     

Soft tissue surgery for equinus deformity in spastic hemiplegic cerebral palsy: effects on kinematic and kinetic parameters

The purpose of this study was to evaluate how soft tissue surgery for correcting equinus deformity affects the kinematic and kinetic parameters of the ankle and proximal joints. Sixteen children with spastic hemiplegic cerebral palsy and equinus deformities (age range 3-16 years) were included. Soft tissue surgeries were performed exclusively on the ankle joint area in all subjects. Using computerized gait analysis (Vicon 370 Motion Analysis System), the kinematic and kinetic parameters during barefoot ambulation were collected preoperatively and postoperatively. In all 16 children, the abnormally increased ankle plantar flexion and pelvis anterior tilting on the sagittal plane were significantly improved without a weakening of push-off (p < 0.05). In a group of 8 subjects with a recurvatum knee gait pattern before operation, the postoperative kinematic and kinetic parameters of the knee joint were significantly improved (p < 0.05). In a group of 8 subjects with ipsilateral pelvic external rotation before operation, the postoperative pelvic deviations on the transverse plane were significantly decreased (p < 0.05). These findings suggest that the soft tissue surgery for correcting equinus deformity improves not only the abnormal gait pattern of the ankle, but also that of the knee and pelvis.     

基于影像学及计算机图像处理方法研究活体腰椎小关节结构三维分布

目的基于小关节三维重建图像分析软骨下皮质骨厚度、小关节面面积及关节间隙宽度的三维分布情况,研究其结构特点及变化规律,并比较腰痛患者及健康人中这些参数的差别。方法对90名研究对象分别行仰卧位CT扫描,获取L1～S1 5个节段小关节的二维图像,重建后分别获得软骨下皮质骨、小关节面及关节间隙的三维面点云图。研究上述参数在整个关节面上、以及关节面的不同区域的分布特点,比较它们在不同腰椎节段、性别、年龄及症状组中的差异。结果 (1)软骨下皮质骨厚度方面,在上关节突,头端区最厚;在下关节突,尾端区最厚。中央区的厚度明显小于其他各区。各区之间的差别在低位节段腰椎中(L4/5,L5/S1)较明显。(2)小关节平均面积为(173.2±3.6)mm2,且随腰椎节段及年龄的增加而增大,L4/5节段以下及40岁以上更加明显。腰痛患者上关节突关节面的面积明显较下关节突关节面的面积大(L5/S1节段除外)。腰痛患者的小关节面积明显大于健康人。(3)小关节间隙平均宽度为(1.46±0.08)mm,随年龄增加而变窄,40岁以上者更明显,女性均较男性宽,腰痛患者则显著变窄。分区比较时,关节面头侧关节间隙较尾侧间隙宽,中央区的间隙普遍较周围区宽,这些差别在腰痛患者及下3个节段中更明显。结论计算机图像处理及重建分析技术可以较准确的测量三维空间内形状复杂的小关节的相关参数。小关节各结构在三维空间的分布具有一定特点,这些特点与关节面形态、关节间应力及关节退变等因素有关,反映了长期的负荷状态下人体结构的适应性改变。     

Multijoint arm movements in cerebellar ataxia: Abnormal control of movement dynamics

In cerebellar ataxia, kinematic aberrations of multijoint movements are thought to originate from deficiencies in generating muscular torques that are adequate to control the mechanical consequences of dynamic interaction forces. At this point the exact mechanisms that lead to an abnormal control of interaction torques are not known. In principle, the generation of inadequate muscular torques may result from an impairment in generating sufficient levels of torques or from an inaccurate assessment and prediction of the mechanical consequences of movements of one limb segment on adjacent joints. We sought to differentiate the relative contribution of these two mechanisms and, therefore, analyzed intersegmental dynamics of multijoint pointing movements in healthy subjects and in patients with cerebellar degeneration. Unrestrained vertical arm movements were performed at three different target movement velocities and recorded using an optoelectronic tracking system. An inverse dynamics approach was employed to compute net joint torques, muscular torques, dynamic interaction torques and gravitational torques acting at the elbow and shoulder joint. In both groups, peak dynamic interaction forces and peak muscular forces were largest during fast movements. In contrast to normal subjects, patients produced hypermetric movements when executing fast movements. Hypermetric movements were associated with smaller peak muscular torques and smaller rates of torque change at elbow and shoulder joints. The patients’ deficit in generating appropriate levels of muscular force were prominent during two different phases of the pointing movement. Peak muscular forces at the elbow were reduced during the initial phase of the movement when simultaneous shoulder joint flexion generated an extensor influence upon the elbow joint. When attempting to terminate the movement, gravitational and dynamic interaction forces caused overshooting extension at the elbow joint. In normal subjects, muscular torque patterns at shoulder and elbow joint were synchronized in that peak flexor and extensor muscular torques occurred simultaneously at both joints. This temporal pattern of muscular torque generation at shoulder and elbow joint was preserved in patients. Our data suggest that an impairment in generating sufficient levels of phasic muscular torques significantly contributes to the patients’ difficulties in controlling the mechanical consequences of dynamic interaction forces during multijoint movements. Received: 28 October 1996 / Accepted: 30 September 1997     

Detection of simultaneous movement at two human arm joints

To detect joint movement, the brain relies on sensory signals from muscle spindles that sense the lengthening and shortening of the muscles. For single-joint muscles, the unique relationship between joint angle and muscle length makes this relatively straightforward. However, many muscles cross more than one joint, making their spindle signals potentially ambiguous, particularly when these joints move in opposite directions. We show here that simultaneous movement at adjacent joints sharing biarticular muscles affects the threshold for detecting movements at either joint whereas it has no effect for non-adjacent joints. The angular displacements required for 70% correct detection were determined in 12 subjects for movements imposed on the shoulder, elbow and wrist at angular velocities of 0.25–2 deg s⁻¹. When moved in isolation, detection thresholds at each joint were similar to those reported previously. When movements were imposed on the shoulder and wrist simultaneously, there were no changes in the thresholds for detecting movement at either joint. In contrast, when movements in opposite directions at velocities greater than 0.5 deg s⁻¹ were imposed on the elbow and wrist simultaneously, thresholds increased. At 2 deg s⁻¹, the displacement threshold was approximately doubled. Thresholds decreased when these adjacent joints moved in the same direction. When these joints moved in opposite directions, subjects more frequently perceived incorrect movements in the opposite direction to the actual. We conclude that the brain uses potentially ambiguous signals from biarticular muscles for kinaesthesia and that this limits acuity for detecting joint movement when adjacent joints are moved simultaneously.     

Kinematic and dynamic synergies of human precision-grip movements

We analyzed the adaptability of human thumb and index finger movement kinematics and dynamics to variations of precision grip aperture and movement velocity. Six subjects performed precision grip opening and closing movements under different conditions of movement velocity and movement aperture (thumb and index finger tip-to-tip distance). Angular motion of the thumb and index finger joints was recorded with a CyberGlove and a three-dimensional biomechanical model was used for solving the inverse dynamics problem during precision grip movements, i.e., for calculating joint torques from experimentally obtained angular variations. The time-varying joint angles and joint torques were analyzed by principal-component analysis to quantify the contributions of individual joints in kinematic and dynamic synergies. At the level of movement kinematics, we found subject-specific angular contributions. However, the adaptation to large aperture, achieved by an increase of the relative contribution of the proximal joints, was subject-invariant. At the level of movement dynamics, the adaptation of thumb-index finger movements to task constraints was similar among all subjects and required the linear scaling of joint torques, the synchronization of joint torques under high velocity conditions, and a flexible redistribution of joint torques between the proximal joint of the thumb and that of the index finger. This work represents one of the first attempts at calculating the joint torques during human precision-grip movements and indicates that the dynamic synergies seem to be remarkably simple compared with the synergies found for movement kinematics.     

Accuracy of voluntary movements at the thumb and elbow joints

Summary Subjects made simultaneously movements from a common rest position and attempted to align corresponding joints (elbow joints, or distal joints of thumb), on opposite sides of the body. When misalignments were expressed in angular terms, variability of performance within and between subjects was greater for thumb than for elbow joints. When the misalignments were expressed in terms of linear misalignment at the end of the moved lever arms, variability of performance within and between subjects was less for thumb than elbow joints. However, when the misalignments were expressed in terms of mean proportional changes in the lengths of fascicles in muscles operating at the joints, variabilities of performances at both joints were similar. In another test, subjects made small unloaded movements at either the elbow joint or the distal thumb joint to guide a cursor along a narrow path. When the movement task was made similar for the elbow and thumb joints in terms of either the angular excursion required, or the required linear excursion of the moved lever tip, accuracy of performances at the two joints varied greatly. Only when the tasks were similar in terms of the mean proportional changes of length in fascicles of muscles operating at the joints, were performances at the two joints of similar accuracy. The results suggest that proportional change in muscle fascicle length is a significant variable for the CNS in proprioception and the control of voluntary movement.     

基于自适应CPG的人体节律运动协同特征刻画

人体柔顺自然的节律运动是全身各关节协同有序转动的展现,关节间的耦合时序与动态转动特性内蕴着人体节律运动中各肢体间的协同关系。招募20名年轻健康被试(男女各半)进行行走与跳绳实验,采集运动时主要关节的角度数据;引入自适应Hopf振荡器参数辨识模型并结合关节协同相位分布,针对人体节律运动协同特征的刻画问题进行研究。通过设立关节相位基准点,解算人体关节间耦合转动时序,基于自适应Hopf振荡器,建立关节单元参数辨识模型,获取复杂关节动态转动规律的刻画参数,进而利用中枢模式发生器(CPG)网络的相位耦合特性,重构完整的人体节律协同运动,并对重构结果的准确性进行量化分析。结果表明,基于刻画参数还原的人体节律运动姿态规范,关节重构轨迹与实际数据变化规律高度一致,两者间的相关系数高于0.99,最大平均误差低于0.01 rad,最大误差小于0.03 rad,阈值绝对偏差在4%以下。所提出的关节转动时序计算准则和自适应关节单元参数辨识方法,可准确刻画人体节律运动中的关节耦合特性与协同规律。     

Localization of knee joint cartilage pathology by multichannel vibroarthrography

This paper proposes non-invasive techniques to localize sound or vibroarthrographic (VAG) signal sources in human knee joints. VAG signals from normal subjects, patients who subsequently underwent arthroscopy, and cadavers with arthroscopically-created lesions, obtained by stimulation with a finger tap over the mid-patella and swinging movement of the leg, were analyzed for time delays using cross-correlation functions for source localization. Correct results were obtained for 13 of the 14 subjects tested by finger stimulation, and for 11 of the 12 subjects whose VAG signals during swinging movement were analyzed. The techniques could be valuable in the diagnosis and treatment of knee pathology before and after joint surgery or drug therapy.     

Changes in gastrocnemii activation at mid-to-late stance markedly affects the intact and anterior cruciate ligament deficient knee biomechanics and stability in gait

IntroductionWe aimed to quantify the sensitivity in biomechanical response and stability of the intact and anterior cruciate ligament deficient (ACL-D) joints at mid-to-late stance periods of gait to the alterations in activation of gastrocnemii (Gas) muscles.MethodsA validated kinematics-driven musculoskeletal finite-element model of the lower extremity is used to compute knee joint response and stability under reported kinetics–kinematics of healthy subjects. Activation in Gas is altered under prescribed gait data at the mid-to-late stance of gait and associated changes in remaining muscle forces/contact forces/areas/ACL force and joint stability are computed in both intact and ACL-D joints.ResultsIn the intact joint, the anterior-tibial-translation (ATT) as well as ACL and joint contact forces follow variations in Gas forces. Both the stability and ATT of an ACL-D joint are restored to the near-intact levels when the activity in Gas is reduced. Knee joint instability, excessive ATT as well as larger peak articular contact stresses with a posterior shift in contact areas are estimated under greater Gas forces.ConclusionsACL-D joint is unstable with ATT > 10 mm under larger activities in Gas. Gas is an ACL-antagonist while hamstrings and soleus are ACL-agonists. The near-intact joint stability and ATT of an ACL-D joint can be restored at a lower activation in Gas; or in other words, when activation in ACL-antagonist muscles drops compared with that in ACL-agonist muscles. Results could help analyze the gait of ACL-D copers and non-copers and provide better understanding towards improved preventive, diagnostic, and treatment approaches.     

Coordination of multi-joint arm movements in cerebellar ataxia: Analysis of hand and angular kinematics

Kinematic abnormalities of fast multijoint movements in cerebellar ataxia include abnormally increased curvature of hand trajectories and an increased hand path and are thought to originate from an impairment in generating appropriate levels of muscle torques to support normal coordination between shoulder and elbow joints. Such a mechanism predicts that kinematic abnormalities are pronounced when fast movements are performed and large muscular torques are required. Experimental evidence that systematically explores the effects of increasing movement velocities on movement kinematics in cerebellar multijoint movements is limited and to some extent contradictory. We, therefore, investigated angular and hand kinematics of natural multijoint pointing movements in patients with cerebellar degenerative disorders and healthy controls. Subjects performed self-paced vertical pointing movements with their right arms at three different target velocities. Limb movements were recorded in three-dimensional space using a two-camera infrared tracking system. Differences between patients and healthy subjects were most prominent when the subjects performed fast movements. Peak hand acceleration and deceleration were similar to normals during slow and moderate velocity movements but were smaller for fast movements. While altering movement velocities had little or no effect on the length of the hand path and angular motion of elbow and shoulder joints in normal subjects, the patients exhibited overshooting motions (hypermetria) of the hand and at both joints as movement velocity increased. Hypermetria at one joint always accompanied hypermetria at the neighboring joint. Peak elbow angular deceleration was markedly delayed in patients compared with normals. Other temporal movement variables such as the relative timing of shoulder and elbow joint motion onsets were normal in patients. Kinematic abnormalities of multijoint arm movements in cerebellar ataxia include hypermetria at both the elbow and the shoulder joint and, as a consequence, irregular and enlarged paths of the hand, and they are marked with fast but not with slow movements. Our findings suggest that kinematic movement abnormalities that characterize cerebellar limb ataxia are related to an impairment in scaling movement variables such as joint acceleration and deceleration normally with movement speed. Most likely, increased hand paths and decomposition of movement during slow movements, as described earlier, result from compensatory mechanisms the patients may employ if maximum movement accuracy is required.     

Biomechanical effects of body weight support with a novel robotic walker for over-ground gait rehabilitation

Body weight support (BWS) promotes better functional outcomes for neurologically challenged patients. Despite the established effectiveness of BWS in gait rehabilitation, the findings on biomechanical effects of BWS training still remain contradictory. Therefore, the aim of this study is to comprehensively investigate the effects of BWS. Using a newly developed robotic walker which can facilitate pelvic motions with an active BWS unit, we compared gait parameters of ten healthy subjects during a 10-m walk with incremental levels of body weight unloading, ranging from 0 to 40 % at 10 % intervals. Significant changes in joint angles and gait temporospatial parameters were observed. In addition, the results of an EMG signal study showed that the intensity of muscle activation was significantly reduced with increasing BWS levels. The reduction was found at the ankle, knee, and hip joints in the sagittal plane as well as at the hip joint in the frontal plane. The results of this study provide an important indication of increased lateral body balance and greater stabilization in sagittal and frontal plane during gait. Our findings provide a better understanding of the biomechanical effects of BWS during gait, which will help guide the gait rehabilitation strategies.     

High prevalence of tarsal coalitions and tarsal joint variants in a recent cadaver sample and its possible significance

Tarsal coalitions (TC) are defined as fibrous (beyond normal ligaments), cartilaginous, or osseous unions of at least two tarsal bones. Most of the clinical studies report the prevalence of TC as <1%, but they disregard the asymptomatic coalitions. Because TC have been associated with pathologic conditions, including degenerative arthritic changes, knowledge of their prevalence has clinical importance. The aim of our study was to establish the prevalence of TC and tarsal joint variants. A total of 114 feet from 62 cadavers (average age = 78 years) without obvious foot pathologies were dissected at the Department of Anatomical Sciences, The University of Adelaide. Ten non-osseous TC in eight subjects were identified: two talocalcaneal and eight calcaneonavicular (occurred twice bilaterally). Variant calcaneonavicular and cuboideonavicular joints were found in 8% and 31% of feet, respectively. Other joint variants included a variable number of talocalcaneal joint surfaces and sesamoid bones. No secondary TC (due to trauma, infections, or neoplasm) were found. Our study demonstrated that the overall prevalence of TC is higher (13%) than previously thought; tarsal joint variations (39%) and sesamoid bones (42%) were common as well. The supposed secular increase in the prevalence of TC as well as the high number of anatomical variants could reflect a short-term response to altered life-style or a microevolutionary trend due to relaxed selection.     

Influence of movement speed on accuracy and coordination of reaching movements to memorized targets in three-dimensional space in a deafferented subject

Multiarticular reaching movements at different speeds produce differential demands for the on-line control of ongoing movements and for the predictive control of intersegmental dynamics. The aim of this study was to assess the ability of a proprioceptively deafferented patient and aged-matched control subjects to make precise and coordinated three-dimensional reaching movements at different speeds without vision during the movement. A patient with a complete loss of proprioception below the neck (C.F.) and five control subjects made reaching movements to four remembered visual targets at slow, natural, and fast speeds. All movements were performed without vision of the arm during the movements. The spatial accuracy, the movement kinematics and the interjoint coordination of these movements were analyzed. Results showed that control subjects made larger spatial errors at both slow and fast speeds than at natural speed. However, they synchronized motions at the shoulder and elbow joints and kept most movement kinematic features invariant across speed conditions. In contrast, C.F. failed to produce smooth and simultaneous motions at the shoulder and elbow joints at all speeds. Surprisingly, however, he made much larger errors than control subjects at slow and natural speeds, but not at fast speed. Analysis of patterns of interjoint coordination revealed that, when instructed to move fast, C.F. initiated arm movements by fixing the elbow while moving the shoulder joint to damp interaction torques exerted on the elbow joint from motion of the upper arm. The results demonstrated that, although proprioceptive loss disrupted normal control of multijoint movements at all speeds, when performing relatively fast three-dimensional movements, C.F. could control intersegmental dynamics by reducing the number of active joints. More importantly, the results highlight the dual role of proprioception in controlling multijoint movements; that is, to provide important cues both for the predictive control of interaction torques and for the synchronization of adjacent joints even when interactive torques are very small. These findings support the idea that proprioceptive input is used by the CNS to update an internal model of limb dynamics that adapts the motor plan according to biomechanical contexts. Electronic Publication