Hidehito Tomita

Changes in muscle thickness of gastrocnemius and soleus associated with age and sex

Background and aims: Gastrocnemius and soleus in the triceps surae have functional and histological differences. We therefore investigated age-related changes in muscle thickness of these two muscles, as well as the difference in these changes between men and women. Methods: Participants comprised 847 healthy adults aged 20 to 79 years. A B-mode ultrasound scanner, with participants sitting on a chair, was used to measure muscle thickness from the midpoint of the gastrocnemius medialis muscle at the level of maximum girth (target point). The ratio of muscle thickness to height was calculated. The inter-rater and intra-rater reliability of measuring muscle thickness with the ultrasound scanner and the validity of the target point were demonstrated before the examination. Results: Gastrocnemius was significantly thinner in women aged 60 or older and in men aged 50 or older, compared with their counterparts in their 20s. For soleus, no significant differences in thickness were found among the age groups in either sex. Decline in muscle thickness from age 40–79 was greater for gastrocnemius than for soleus. Conclusions: These results confirm that gastrocnemius starts to deteriorate earlier and atrophies at a faster pace than soleus. A significant sex difference was found only in the onset age of gastrocnemius deterioration, which was earlier in men than in women.

Deficits in task-specific modulation of anticipatory postural adjustments in individuals with spastic diplegic cerebral palsy

We examined whether individuals with spastic diplegic cerebral palsy (SDCP) have the ability to utilize lower leg muscles in anticipatory postural adjustments (APAs) associated with voluntary arm movement while standing, as well as the ability to modulate APAs with changes in the degree of postural perturbation caused by arm movement. Seven individuals with spastic diplegia (SDCP group, 12-22 yr of age) and seven age- and sex-matched individuals without disability (control group) participated in this study. Participants flexed both shoulders and lifted a load under two different load conditions, during which electromyographic activities of focal and postural muscles were recorded. Although the timing of anticipatory activation of the erector spinae and medial hamstring (MH) muscles was similar in the two participant groups, that of the gastrocnemius (GcM) muscle was significantly later in the SDCP group than in the control group. An increase in anticipatory postural muscle activity with an increase in load was observed in MH and GcM in the control group but not in GcM in the SDCP group. The degree of modulation in MH was significantly smaller in the SDCP group than in the control group. An additional experiment confirmed that these differences in APAs between the two participant groups were unlikely to be attributable to their differences in initial standing posture before load lift. The present findings suggest that lower leg muscles play a minor role in APAs in individuals with spastic diplegia. In addition, it is likely that these individuals have difficulty modulating anticipatory postural muscle activity with changes in the degree of postural perturbation.

Increase in corticospinal excitability of limb and trunk muscles according to maintenance of neck flexion

The effect of maintenance of neck flexion on corticospinal excitability of limb and trunk muscles was investigated using transcranial magnetic stimulation (TMS). Nine healthy young subjects participated in this experiment. Every measurement was performed with subjects sitting on a chair. Target muscles were the first dorsal interosseous (FDI), biceps brachii (BB), triceps brachii (TB), rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GcM) on the right side. TMS was applied to the left primary motor cortex, and motor evoked potential (MEP) was measured from the muscles listed above. Optimal stimulus location and resting motor threshold (RMT) were identified for each target muscle, and stimulus intensity used was 120% of RMT. MEPs of the target muscle were recorded with the chin resting on a chin support (chin-on condition) with neck in 20 degrees of flexion, and with voluntary maintenance of the neck flexion posture (chin-off condition). Amplitude and latency of MEP and background activity of target muscles were analyzed. For FDI, BB, TB, ES, and RF, amplitude of MEP increased and latency shortened in the chin-off compared with the chin-on condition. No significant difference in background activity of each target muscle was found between the two conditions. Corticospinal excitability of limb and trunk muscles was selectively enhanced while neck flexion was maintained.

Effects of stance width on postural movement pattern and anticipatory postural control associated with unilateral arm abduction.

We investigated the effects of stance width on postural movement pattern and activation timing of postural muscles during unilateral arm abduction. Thirty-two healthy subjects abducted the right arm at their own timing. Stance width was 0, 9, 18 or 27 cm. Movement angles of leg lateral inclination and trunk lateral flexion to the leg in the frontal plane were analyzed. Based on movement angles at 0 cm width, subjects were classified into three groups: contralateral whole body leaning (CWBLg); ipsilateral trunk flexion (ITFg); and contralateral trunk flexion (CTFg). A high correlation between the movement angles was obtained at 0 cm width (r=0.82). With increasing stance width, postural movement pattern in the ITFg shifted to patterns characterized by lateral flexion of the trunk toward the side opposite to arm movement, and movement angle of leg-inclination in ITFg and CWBLg decreased. At 0 cm width, left gluteus medius and tensor fascia latae were activated significantly about 40 ms ahead of the right middle deltoid in CWBLg and CTFg, but not in ITFg. However, preceding activation became prominent (about 20 ms) in ITFg for wide stances. Moreover, bilateral activation of the tensor fascia latae was observed in CTFg for all widths.

Postural Movement Pattern and Muscle Action Sequence Associated with Self-Paced Bilateral Arm Flexion during Standing

Investigated were postural movement pattern and action sequence of postural muscles while subjects rapidly flexed both arms during standing. The arm movement was started at the subjects own pace. Subjects were healthy individuals; 48 men and 53 women. Postural movement pattern was classified based on the movement angles of foot-leg (ankle joint) and leg-trunk (hip joint). Electromyograms were recorded from the anterior deltoid, biceps femoris, and erector spinae. The time difference between action onsets of the latter two muscles and the anterior deltoid was analyzed. Movement angles of the ankle and hip for both sexes were distributed on a similar linear regression line (y = −2.092 × −2.552 (r = −.71). The postural movement pattern was categorized based on the distribution into three types: hip flexion (in the 2nd quadrant), backward leaning (the 3rd), and hip extension (the 4th). The proportion of subjects was 26% in the hip flexion type, 55% in backward leaning type, and 19% in hip extension type. The action of biceps femoris and erector spinae significantly preceded that of anterior deltoid in the backward leaning and hip extension types but did not in the hip flexion type.

Use of the sit-to-stand task to evaluate motor function of older adults using telemetry

BackgroundPhysical exercises are widely used in community programs, but not all older adults are willing to participate. Information and communication technology may solve this problem by allowing older people to participate in fitness programs at home. Use of remote instruction will facilitate physical exercise classes without requiring that participants gather at one place. The aim of this study was to examine use of a sit-to-stand task in evaluating motor function using conventional video communication in a telemetry system to enable real-time monitoring, and evaluation in physical performance of older adults at home.MethodsThe participants were 59 older individuals and 81 university students. Three physical exercise batteries were used: arm curl, figure-of-eight walk test, and functional reach. The knee extension maximum angular velocity (KEMAV) and the iliac elevation maximum velocity (IEMV) during standing up from a chair and the heel rise frequency were used in the motion-capture measurements. The results were assessed using multi-group structural equation modeling (SEM) for the young and older groups.ResultsYoung participants consistently performed better than their older counterparts on all items. Analyses with multi-group SEM based on correlations between items yielded a good model-fit for the data. Among all path diagrams for IEMV and KEMAV in the older and young groups, paths from muscular strength to skillfulness showed significant effects. The path from the IEMV to muscular strength was also significant in the older group.ConclusionsMulti-group SEM suggested that video-based measurements of IEMV during sit-to-stand motion can estimate muscular strength, which suggests that remote monitoring of physical performance can support wellness of community-dwelling older adults.

Effects of allocation of visuo-spatial attention to visual stimuli triggering unilateral arm abduction on anticipatory postural control.

OBJECTIVE We investigated the effects of allocation of visuo-spatial attention to visual stimuli triggering arm movement on anticipatory postural control. METHODS Fourteen healthy right-handed subjects participated in the study. Visual stimuli were randomly presented to the left or right visual field on a screen. An attention-directing cue or a non-directional cue was presented at 1000ms before visual stimulus onset. Subjects focused or divided visuo-spatial attention (focused- and divided-attention conditions, respectively) based on types of cues, and abducted the left or right arm rapidly in response to target stimuli (with 30% probability of visual stimuli) according to the side of presentation. Peak-to-peak amplitude of P1 and N1 components of event-related potentials (P1-N1 amplitude) elicited by visual stimuli and activation timing of postural muscles with respect to the middle deltoid were measured. RESULTS Compared with divided-attention condition, in focused-attention condition P1-N1 amplitude at occipital electrodes was enhanced and activation of the left hip abductors during right arm abduction was hastened. A significant correlation was observed between the attention-related changes in these two measurements. CONCLUSIONS Anticipatory postural control during right arm abduction was influenced by attention-related modulation of sensory-perceptual processing. SIGNIFICANCE These findings are important for understanding of the effects of visuo-spatial attention on anticipatory postural control.

Effects of severity of gross motor disability on anticipatory postural adjustments while standing in individuals with bilateral spastic cerebral palsy

BACKGROUND Although individuals with bilateral spastic cerebral palsy (BSCP) exhibit several deficits in anticipatory postural adjustments (APAs) while standing, effects of severity of motor disability on their APAs are unclear. AIMS To determine whether individuals with BSCP exhibit severity-dependent deficits in APAs. METHODS AND PROCEDURES Seven individuals with level II BSCP (BSCP-II group) and seven with level III BSCP (BSCP-III group) according to the Gross Motor Function Classification System and seven healthy controls lifted a load under two different load conditions. OUTCOMES AND RESULTS Anticipatory activities of the erector spinae (ES), medial hamstring (MH), and gastrocnemius (GCM) were smaller in the two BSCP groups than in the control group. Although the anticipatory GCM activity was similar between the BSCP groups, the ES and MH activities were larger in the BSCP-II group than in the BSCP-III group. In the BSCP-II group, an increase in anticipatory activity with an increase in load was observed in the MH, but not in the GCM. In the BSCP-III group, load-related modulation was not found in the MH or GCM. CONCLUSIONS AND IMPLICATIONS The present findings suggest that in individuals with BSCP with severe motor disability, APA deficits extend to more proximal parts of the body.