Sandra R. Hundza

Neural regulation of rhythmic arm and leg movement is conserved across human locomotor tasks

It has been proposed that different forms of rhythmic human limb movement have a common central neural control (‘common core hypothesis’), just as in other animals. We compared the modulation patterns of background EMG and cutaneous reflexes during walking, arm and leg cycling, and arm‐assisted recumbent stepping. We hypothesized that patterns of EMG and reflex modulation during cycling and stepping (deduced from mathematical principal components analysis) would be comparable to those during walking because they rely on similar neural substrates. Differences between the tasks were assessed by evoking cutaneous reflexes via stimulation of nerves in the foot and hand in separate trials. The EMG was recorded from flexor and extensor muscles of the arms and legs. Angular positions of the hip, knee and elbow joints were also recorded. Factor analysis revealed that across the three tasks, four principal components explained more than 93% of the variance in the background EMG and middle‐latency reflex amplitude. Phase modulation of reflex amplitude was observed in most muscles across all tasks, suggesting activity in similar control networks. Significant correlations between EMG level and reflex amplitude were frequently observed only during static voluntary muscle activation and not during rhythmic movement. Results from a control experiment showed that strong correlation between EMG and reflex amplitudes was observed during discrete, voluntary leg extension but not during walking. There were task‐dependent differences in reflex modulation between the three tasks which probably arise owing to specific constraints during each task. Overall, the results show strong correlation across tasks and support common neural patterning as the regulator of arm and leg movement during various rhythmic human movements.

The Quadrupedal Nature of Human Bipedal Locomotion

During rhythmic movement, arm activity contributes to the neural excitation of leg muscles. These observations are consistent with the emergence of human bipedalism and nonhuman primate arboreal quadrupedal walking. These neural and biomechanical linkages could be exploited in rehabilitation after neurotrauma to allow the arms to give the legs a helping hand during gait rehabilitation. Summary: Neuronal interactions between arm and leg activity during rhythmic human movement assist in coordinating locomotion and may be usefully exploited in rehabilitation of walking.

Accurate and Reliable Gait Cycle Detection in Parkinson's Disease

There is a growing interest in the use of Inertial Measurement Unit (IMU)-based systems that employ gyroscopes for gait analysis. We describe an improved IMU-based gait analysis processing method that uses gyroscope angular rate reversal to identify the start of each gait cycle during walking. In validation tests with six subjects with Parkinson disease (PD), including those with severe shuffling gait patterns, and seven controls, the probability of True-Positive event detection and False-Positive event detection was 100% and 0%, respectively. Stride time validation tests using high-speed cameras yielded a standard deviation of 6.6 ms for controls and 11.8 ms for those with PD. These data demonstrate that the use of our angular rate reversal algorithm leads to improvements over previous gyroscope-based gait analysis systems. Highly accurate and reliable stride time measurements enabled us to detect subtle changes in stride time variability following a Parkinsons exercise class. We found unacceptable measurement accuracy for stride length when using the Aminian gyro-based biomechanical algorithm, with errors as high as 30% in PD subjects. An alternative method, using synchronized infrared timing gates to measure velocity, combined with accurate mean stride time from our angular rate reversal algorithm, more accurately calculates mean stride length.

Neural Mechanisms Influencing Interlimb Coordination during Locomotion in Humans: Presynaptic Modulation of Forearm H-Reflexes during Leg Cycling

Presynaptic inhibition of transmission between Ia afferent terminals and alpha motoneurons (Ia PSI) is a major control mechanism associated with soleus H-reflex modulation during human locomotion. Rhythmic arm cycling suppresses soleus H-reflex amplitude by increasing segmental Ia PSI. There is a reciprocal organization in the human nervous system such that arm cycling modulates H-reflexes in leg muscles and leg cycling modulates H-reflexes in forearm muscles. However, comparatively little is known about mechanisms subserving the effects from leg to arm. Using a conditioning-test (C-T) stimulation paradigm, the purpose of this study was to test the hypothesis that changes in Ia PSI underlie the modulation of H-reflexes in forearm flexor muscles during leg cycling. Subjects performed leg cycling and static activation while H-reflexes were evoked in forearm flexor muscles. H-reflexes were conditioned with either electrical stimuli to the radial nerve (to increase Ia PSI; C-T interval  = 20 ms) or to the superficial radial (SR) nerve (to reduce Ia PSI; C-T interval  = 37–47 ms). While stationary, H-reflex amplitudes were significantly suppressed by radial nerve conditioning and facilitated by SR nerve conditioning. Leg cycling suppressed H-reflex amplitudes and the amount of this suppression was increased with radial nerve conditioning. SR conditioning stimulation removed the suppression of H-reflex amplitude resulting from leg cycling. Interestingly, these effects and interactions on H-reflex amplitudes were observed with subthreshold conditioning stimulus intensities (radial n., ∼0.6×MT; SR n., ∼ perceptual threshold) that did not have clear post synaptic effects. That is, did not evoke reflexes in the surface EMG of forearm flexor muscles. We conclude that the interaction between leg cycling and somatosensory conditioning of forearm H-reflex amplitudes is mediated by modulation of Ia PSI pathways. Overall our results support a conservation of neural control mechanisms between the arms and legs during locomotor behaviors in humans.

Phase-dependent modulation of soleus H-reflex amplitude induced by rhythmic arm cycling

Rhythmic arm cycling is known to suppress the Hoffmann (H-) reflex amplitudes in the soleus (Sol) muscles of stationary legs. However, it has remained unclear if this suppression is modulated according to the phase of movement in the cycle path or is rather a general setting of excitability level related to rhythmic movement. In the present study we investigated the phase-dependent modulation of the Sol H-reflex induced by rhythmic arm cycling by examining reflex amplitudes at 12 phases of the arm cycle movement. Arm cycling tasks consisted of bilateral, ipsilateral and contralateral movement. Additionally, data were also sampled at 12 static arm positions mimicking those occurring during movement. H-reflexes were evoked and recorded at constant motor wave amplitudes across all conditions. Suppression of Sol H-reflex amplitude was dependent upon the phase of movement (main effect p<0.0001) during arm cycling, but not during static positioning. Results suggest that locomotor central pattern generators may contribute to the phasic reflex modulation observed in this study. The phasic modulation was more pronounced during bilateral movement, however aspects of the neural control driving this modulation were also present during ipsilateral and contralateral movement.

Robotic-assisted stepping modulates monosynaptic reflexes in forearm muscles in the human

Although the amplitude of the Hoffmann (H)-reflex in the forelimb muscles is known to be suppressed during rhythmic leg movement, it is unknown which factor plays a more important role in generating this suppression-movement-related afferent feedback or feedback related to body loading. To specifically explore the movement- and load-related afferent feedback, we investigated the modulation of the H-reflex in the flexor carpi radialis (FCR) muscle during robotic-assisted passive leg stepping. Passive stepping and standing were performed using a robotic gait-trainer system (Lokomat). The H-reflex in the FCR, elicited by electrical stimulation to the median nerve, was recorded at 10 different phases of the stepping cycle, as well as during quiet standing. We confirmed that the magnitude of the FCR H-reflex was suppressed significantly during passive stepping compared with during standing. The suppressive effect on the FCR H-reflex amplitude was seen at all phases of stepping, irrespective of whether the stepping was conducted with body weight loaded or unloaded. These results suggest that movement-related afferent feedback, rather than load-related afferent feedback, plays an important role in suppressing the FCR H-reflex amplitude.

Neuromechanical interactions between the limbs during human locomotion: an evolutionary perspective with translation to rehabilitation.

During bipedal locomotor activities, humans use elements of quadrupedal neuronal limb control. Evolutionary constraints can help inform the historical ancestry for preservation of these core control elements support transfer of the huge body of quadrupedal non-human animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after neurotrauma where interlimb coordination is lost or compromised. The present state of the field supports including arm activity in addition to leg activity as a component of gait retraining after neurotrauma.

Convergence in Reflex Pathways from Multiple Cutaneous Nerves Innervating the Foot Depends upon the Number of Rhythmically Active Limbs during Locomotion

Neural output from the locomotor system for each arm and leg influences the spinal motoneuronal pools directly and indirectly through interneuronal (IN) reflex networks. While well documented in other species, less is known about the functions and features of convergence in common IN reflex system from cutaneous afferents innervating different foot regions during remote arm and leg movement in humans. The purpose of the present study was to use spatial facilitation to examine possible convergence in common reflex pathways during rhythmic locomotor limb movements. Cutaneous reflexes were evoked in ipsilateral tibialis anterior muscle by stimulating (in random order) the sural nerve (SUR), the distal tibial nerve (TIB), and combined simultaneous stimulation of both nerves (TIB&SUR). Reflexes were evoked while participants performed rhythmic stepping and arm swinging movement with both arms and the leg contralateral to stimulation (ARM&LEG), with just arm movement (ARM) and with just contralateral leg movement (LEG). Stimulation intensities were just below threshold for evoking early latency (<80 ms to peak) reflexes. For each stimulus condition, rectified EMG signals were averaged while participants held static contractions in the stationary (stimulated) leg. During ARM&LEG movement, amplitudes of cutaneous reflexes evoked by combined TIB&SUR stimulation were significantly larger than simple mathematical summation of the amplitudes evoked by SUR or TIB alone. Interestingly, this extra facilitation seen during combined nerve stimulation was significantly reduced when performing ARM or LEG compared to ARM&LEG. We conclude that locomotor rhythmic limb movement induces excitation of common IN reflex pathways from cutaneous afferents innervating different foot regions. Importantly, activity in this pathway is most facilitated during ARM&LEG movement. These results suggest that transmission in IN reflex pathways is weighted according to the number of limbs directly engaged in human locomotor activity and underscores the importance of arm swing to support neuronal excitability in leg muscles.

Concurrent Indicators of Gait Velocity and Variability Are Associated with 25-Year Cognitive Change: A Retrospective Longitudinal Investigation

Background/Objectives: Physical function indicators, including gait velocity, stride time and step length, are linked to neural and cognitive function, morbidity and mortality. Whereas cross-sectional associations are well documented, far less is known about long-term patterns of cognitive change as related to objective indicators of mobility-related physical function. Methods: Using data from the Victoria Longitudinal Study, a long-term investigation of biological and health aspects of aging and cognition, we examined three aspects of cognition-physical function linkages in 121 older adults. First, we examined a simple marker of physical function (3 m timed-walk) as a predictor of cross-sectional differences and up to 25-year change for four indicators of cognitive function. Second, we tested associations between two markers of gait function derived from the GAITRite system (velocity and stride-time variability) and differences and change in cognition. Finally, we evaluated how increasing cognitive load during GAITRite assessment influenced the associations between gait and cognition. Results: The simple timed-walk measure, commonly used in clinical and research settings, was a minor predictor of change in cognitive function. In contrast, the objectively measured indicator of walking speed significantly moderated long-term cognitive change. Under increasing cognitive load, the moderating influence of velocity on cognitive change increased, with increasing variability in stride time also emerging as a predictor of age-related cognitive decline. Conclusion: These findings: (a) underscore the utility of gait as a proxy for biological vitality and for indexing long-term cognitive change; and (b) inform potential mechanisms underlying age-related linkages in physical and cognitive function.

Walking Phase Modulates H-Reflex Amplitude in Flexor Carpi Radialis

ABSTRACT It is well established that remote whole-limb rhythmic movement (e.g., cycling or stepping) induces suppression of the Hoffman (H-) reflex evoked in stationary limbs. However, the dependence of reflex amplitude on the phase of the movement cycle (i.e., phase-dependence) has not been consistent across this previous research. The authors investigated the phase-dependence of flexor carpi radialis (FCR) H-reflex amplitudes during active walking and in kinematically matched static postures across the gait cycle. FCR H-reflexes were elicited in the stationary forearm with electrical stimulation to the median nerve. Significant phase-dependent modulation occurred during walking when the gait cycle was examined with adequate phase resolution. The suppression was greatest during midstance and midswing, suggesting increased ascending communication during these phases. There was no phase-dependent modulation in static standing postures and no correlation between lower limb background electromyography levels and H-reflex amplitude during active walking. This evidence, along with previous research demonstrating no phase modulation during passive walking, suggests that afferent feedback associated with joint position and leg muscle activation levels are not the sole source of the phase modulation seen during active walking. Possible sources of phase modulation include combinations of afferent feedback related to active movement or central motor commands or both.