Maria Stella Valle

Analysis of Ankle Kinetics during Walking in Individuals with Down Syndrome.

The biomechanical characteristics of the ankle during gait of 17 participants with Down syndrome, ages 8 to 36 years, were investigated. Ten volunteers without disabilities of comparable anthropometric parameters were the control group. A 3-dimensional gait analysis was performed using an optoelectronic system equipped with a force platform. Participants with Down syndrome showed significant decreases of plantar-flexor moments and of A1 and A2 joint powers. Furthermore, correlation between kinetic and temporal spatial parameters was markedly reduced or weak in comparison to the control group. These results point out a hypofunctioning of ankle, probably due to hypotonia and ligament laxity.

The pendulum test as a tool to evaluate passive knee stiffness and viscosity of patients with rheumatoid arthritis

BackgroundThe pendulum test of Wartenberg is a technique commonly used to measure passive knee motion with the aim to assess spasticity. We used this test to evaluate changes of the knee angular displacement, passive stiffness and viscosity in rheumatoid arthritis patients. Stiffness and viscosity represent passive resistances to joint motion associated with the structural properties of the joint tissue and of the muscular-tendon complex. Stiffness can be considered an intrinsic property of the tissues to resist deformation, while viscosity is related to cohesive forces between adjacent layers of tissues. Both parameters may influence the joint range of motion affecting angular displacement.MethodsNine women with rheumatoid arthritis were compared with a group of healthy women. With the subject half-lying, the relaxed knee was dropped from near-full extension and the characteristics of the ensuring damped unsustained knee oscillation evaluated. The kinematics of leg oscillations was recorded using ultrasonic markers (Zebris CMS HS 10) and the kinetic data were calculated from kinematic and anthropometric measures.ResultsKnee stiffness significantly increased (p < 0.001) in patients with respect to the control group, while differences in viscosity were not significant. Moreover, the amplitudes of first knee flexion (the maximal flexion excursion after knee release) and first knee extension (the maximal extension excursion after the first knee flexion) were significantly decreased (p < 0.001). A regression analysis showed that disease severity correlated moderately with stiffness (R2 = 0.68) and first flexion (R2 = 0.78). Using a multivariate regression, we found that increasing stiffness was the main factor for the reduction of flexion and extension motions.ConclusionWe showed that the Wartenberg test can be considered a practical tool to measure mechanical changes of knee caused by rheumatoid arthritis. This novel application of Wartenberg test could be useful to follow up the effects of pharmacological and rehabilitative interventions in this disease.

Cerebellar encoding of limb position

In this paper, we review single and multijoint studies that, over the years, have provided insight on the cerebellar encoding of limb spatial position. In particular, we present support to the idea that the cerebellum integrates signals from multiple sources to encode global limb parameters. Then, we highlight the result of recent studies that analyzed quantitatively the relationships between limb endpoint position and cerebellar activity. These findings suggest that the cerebellum may share with other central sensorymotor structures an anisotropic representation of limb position characterized by a strong bias along the anteroposterior axis. Finally, we speculate that this anisotropy may also subtend an internal representation of limb mechanics.

Information processing in the spinocerebellar system.

The purpose of this study was to determine whether sensory information about limb kinematics relayed to the cerebellum over spinocerebellar pathways may be modified at the cerebellar level. We tested this by recording from dorsal spinocerebellar tract (DSCT) and Purkinje cells under the same experimental conditions in which the hindlimbs of anesthetized cats were passively moved through a series of step-like movement cycles. A population analysis of the response behavior showed that DSCT neurons encode a combination of limb axis position and movement velocity, whereas the Purkinje cells located in the DSCT cerebellar target areas encode limb axis velocity and position independently. We conclude from this that the cerebellum may somehow extract a velocity component from the afferent input signal.

Processing of Limb Kinematics in the Interpositus Nucleus

Neural representations of limb movement kinematic parameters are common among central nervous system structures involved in motor control, such as the interpositus nucleus of the cerebellum. Much experimental evidence indicates that neurons in the interpositus may encode limb kinematic parameters both during active, voluntary actions and during limb motion imposed passively, which entrains only sensory afferents. With respect to the sensory processing of information related to movement kinematics, we show that interpositus neuronal activity can parse out the directional from the scalar component (i.e., the movement speed) of the velocity vector. Moreover, a differential role for the anterior and posterior portion of interpositus in encoding these parameters emerged from these data, since the activity of the posterior interpositus was specifically associated to changes of movement speed. Limb movement representations in the interpositus nucleus may be instrumental for the control of goal-directed movements such as shaping hand during grasping or precise foot placement during gait. Finally, we discuss the idea that sensory information about the movement kinematics contribute to both feedback and anticipatory processes for limb movement control.

Anisotropic representation of forelimb position in the cerebellar cortex and nucleus interpositus of the rat

The relationship between the spatial location of limb and the activity of cerebellar neurons has received little attention and its nature still remains ambiguous. To address this question we studied the activity of Purkinje and nucleus interpositus cells in relation to the spatial location of rat forelimb. A computer-controlled robot arm displaced the limb passively across 15 positions distributed on a parasagittal plane. The limb was upheld for 8 s in each position, which was identified by the Cartesian coordinates of the forepaw. We selected the neurons whose activities were significantly modulated by forepaw position and found that the majority represented preferentially one spatial dimension of the Cartesian plane both in the cerebellar cortex and nucleus interpositus. In particular, the antero-posterior axis was best represented in cerebellar neuronal discharges. This result suggests that the intermediate part of the cerebellum might encode limb position by way of an anisotropic representation of the spatial coordinates of the limb end-point.

On the relation of rat's external cuneate activity to global parameters of forelimb posture.

Using anesthetized adult rats, we studied the relationships between the activity of cells belonging to the external cuneate nucleus (ECN) and passive forelimb positions. In essence, we sought to distinguish between a representation of limb position based on local limb parameters (individual joint angles, for example) or a representation based on more global parameters such as the length and the orientation of the limb axis. Using multivariate regression analyses we found that most neurons showed strong linear relationships with the length and the orientation of the limb axis. Relationships to individual joint angles were, instead, rather weak and in most cases not significant. This result implies an extensive integration of sensory information at the level of second order sensory neurons.

Functional assessments of the knee joint biomechanics by using pendulum test in adults with Down syndrome

In this study, we assessed kinematics and viscoelastic features of knee joint in adults with Down syndrome (DS) by means of the Wartenberg pendulum test. This test allows the measuring of the kinematics of the knee joint during passive pendular motion of leg under the influence of gravity. In addition, by a combination of kinematic and anthropometric data, pendulum test provides estimates of joint viscoelastic properties by computing damping and stiffness coefficients. To monitor the occurrences of muscle activation, the surface electromyogram (EMG) of muscle rectus femoris was recorded. The experimental protocol was performed in a group of 10 adults with DS compared with 10 control adults without DS. Joint motion amplitude, velocity, and acceleration of the leg during the first knee flexion significantly decreased in persons with DS with respect to those without DS. This behavior was associated with the activation of rectus femoris in subjects with DS that resulted in increasing of joint resistance shortly after the onset of the first leg flexion. The EMG bursts mostly occurred between 50 and 150 ms from the leg flexion onset. During the remaining cycles of pendular motion, persons with DS exhibited passive leg oscillations with low tonic EMG activity and reduced damping coefficient compared with control subjects. These results suggest that adults with DS might perform preprogrammed contractions to increase joint resistance and compensate for inherent joint instability occurring for quick and unpredictable perturbations. The reduction of damping coefficients observed during passive oscillations could be a predictor of muscle hypotonia.

Distribution of spinocerebellar Purkinje cell responses to passive forelimb movements in the rat.

We recorded Purkinje cell activity throughout the spinocerebellum of anaesthetized rats while imposing circular passive movements to the unrestrained forelimb. The aim was to understand the type of processing of sensory information occurring at the level of the cerebellar cortex, on the basis that precerebellar sensory neurons have been shown to represent whole limb movement parameters better than single joint movements. We observed that neurons representing sensory aspects of arm movements were scattered throughout the spinocerebellar cortex without a distinct segregation from those that did not respond, albeit the relative density of responsive and unresponsive neurons was quite variable and depended on the area of the cortex. Furthermore, Purkinje cells that responded significantly to the arm movement cycles all showed the same response pattern consisting of a firing rate increase during the downward extension of the arm. These results are discussed as suggesting a coordinate framework for the representation of proprioceptive information in the cerebellum congruent to that observed for encoding motor parameters.

Cerebellar cortical activity in the cat anterior lobe during hindlimb stepping

We recorded from over 250 single cortical neurons throughout the medial anterior lobe of the cat cerebellum during passive movements of the ipsilateral hindlimb resembling stepping on a moving treadmill. We applied three different quantitative analysis techniques to determine the extent of neuronal modulation that could be accounted for by the stepping movements. The analyses all indicated that up to half the recorded neurons in all five lobules responded to these passive hindlimb movements. We reconstructed the locations of the recorded neurons on a 2-D map of the cerebellar cortex in order to determine the spatial distribution of responsive cells. Cells that were located in the classical hindlimb projection areas of the anterior lobe (in lobules 2 and 3) were generally most responsive to the limb movement with activity patterns that generally had a linear relationship to hindlimb kinematics. Cells in lobules 4 and 5, considered as classical forelimb areas of the cerebellum, were also responsive. Although these cells tended to have noisier firing patterns, many were found to be modulated nevertheless by the hindlimb movements. We also found a clear demarcation between zones b and c, with a higher fraction of responsive cells in all lobules located in zone b.