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Biomedical subjects

D M Corcos

Publications and source records attributed to D M Corcos.

At least 37 records · Page 2Linked to original sources
PubMed1997

Cerebellar hypermetria: reduction in the early component of the antagonist electromyogram.

Several articles have described the electromyographic (EMG) patterns underlying cerebellar hypermetria. However, the description of the EMG associated with hypermetria is not consistent between studies. It is hypothesized that the reason for this concerns the criteria used to define and describe the antagonist latency. Several studies on neurologically normal individuals have shown that there are two components to the antagonist EMG: an early component and a late component. However, many studies have identified only one component and have not defined whether it was the early or late component. A reanalysis of one published data set that had previously identified only one antagonist component was performed. The reanalysis suggests that hypermetria can be caused by an absence of an early antagonist EMG component, a delayed late component, or both. In addition, a new measure is suggested that allows this hypothesis to be further evaluated.

Cerebellar Diseases↗
PubMed1997

Coping with systematic bias during bilateral movement.

The present studies examined the nature of kinematic interlimb interference during bilateral elbow movements of 1:1, 2:1 and 3:1 frequency ratios and the manner in which subjects cope with coordination bias. Analysis of movement trajectories in the first experiment indicated progressively greater angular velocity assimilation across 2:1 and 3:1 conditions. The desired temporal relationship was maintained by slowing or pausing the low-frequency movement at peak extension while the high-frequency arm produced intervening cycles. An increase in amplitude was also evident for concurrent, homologous cycles. Movement smoothness was emphasized and additional practice was provided in a second experiment. This resulted in dissociated peak angular velocity between limbs and eliminated hesitations and amplitude effects. Bias was still evident, however, as an intermittent approach toward a 1:1 ratio within each cycle. This systematic tendency was somewhat greater at the lower of two absolute frequency combinations but was not influenced by the role of each arm in producing the higher or lower frequency movement. The findings from the first experiment suggest that subjects initially accommodate interlimb kinematic assimilation, while producing the intended timing ratio, by intermittently slowing or pausing the lower-frequency movement. This attenuates the need for bilaterally-disparate movement parameters and provides additional time for organizing residual kinematic differences, perhaps reducing "transient coupling." Evidence from the second experiment indicates that subtle relative motion preferences are still evident following sufficient practice to perform the movements smoothly. The within-cycle locations of the points of greatest interlimb bias for the 2:1 rhythms were positively displaced from those previously observed for 1:1 oscillations. The persistent coordination tendencies noted in both experiments perhaps reflect an assimilation/compensation cycle and constitute one potential source of the systematic error that often emerges during the acquisition of complex skills.

Adult↗
PubMed1997

Does parkinsonian action tremor contribute to muscle weakness in Parkinson's disease?

The aim of this study was to see whether action tremor contributes to the weakness which can be measured in some muscles in patients with Parkinson's disease, by preventing fully fused contraction of motor units. Strength and action tremor were recorded during maximal wrist extension in patients when they were on and off antiparkinsonian medication, and in age- and sex-matched healthy subjects. Peak torque and mean rectified EMG levels were reduced by 25% and 30% (n = 7), respectively, when patients were off medication (compared with when they were on medication). In parkinsonian patients off treatment, action tremor was visible in torque and EMG records, and had a frequency of approximately 10 Hz. The absolute amplitude of this tremor was considerably smaller in patients on medication and in control subjects. In patients, medication reduced action tremor in torque and EMG by 37% and 57%, respectively, so that tremor amplitude approached that in normals. Similar changes were seen when action tremor was expressed as % peak torque of % mean rectified EMG. In parkinsonian patients off medication, a 10-Hz synchronizing influence dominates muscle activity at the wrist. The results is an incompletely fused muscle contraction, which is an important factor contributing to the weakness present in the off-medication state. Antiparkinsonian medication releases motor units from the 10-Hz synchronizing influence, enabling higher discharge rates, fused contraction and improved force generation.

Aged↗
PubMed1997

Multidimensional assessment of motor function in a child with cerebral palsy following intrathecal administration of baclofen.

This case report describes an 11-year-old boy with spastic diplegia whose reflex status, range of motion (ROM), strength, and motor performance were measured before and after implantation of an indwelling system for delivery of intrathecally administered baclofen. Before baclofen use, the subject experienced clonus that interfered with walking, needed assistance with transfers, and was unable to independently put on underwear and socks. Measures of spasticity, kinematics and electromyographic activity during voluntary movements, ROM, Gross Motor Function Measure (GMFM) scores, and self-reports of change were obtained at baseline, before and after bolus baclofen injection, during a double-blind placebo-controlled clinical trial of baclofen administration via an indwelling pump, and after 1 and 2 years of baclofen therapy. Spasticity, Babinski reflexes, clonus, strength, and coactivation of antagonist muscles during voluntary movement were decreased shortly after baclofen administration began. Hip and ankle ROM increased, upper-extremity movement speed increased, independence in dressing and transfers improved, and orthoses were discarded. After 1 and 2 years, GMFM scores were 7.8% and 6.4% above baseline, respectively; the subject won a fitness award. After 2 years, ROM was worse than at baseline and concerns regarding hip subluxation arose. Single-joint movement control and independence improved and spasticity decreased during baclofen administration.

Activities of Daily Living↗
PubMed1996

Strength in Parkinson's disease: relationship to rate of force generation and clinical status.

Maximum elbow flexor and extensor muscle strength was measured in 9 patients with Parkinson's disease on and off antiparkinsonian medication. In addition, the rate of force generation, the rate of actively returning force to resting levels, and passive release of force "relaxation" were measured in submaximal contractions. The measures of strength and contraction time were correlated with changes in clinical status as measured by the Unified Parkinson's Disease Rating Scale. When patients were off medication, their reduction in strength was significantly greater in extension than flexion. The reduction in flexion strength did not reach statistical significance. The extensor weakness was primarily due to decreased tonic activation of the extensor muscles and not to muscle coactivation. Muscle relaxation time was much more prolonged than was force generation time or active force return time. The increase in relaxation time and the decrease in extensor strength both correlated with changes in clinical status. Finally, changes in extensor torque correlated with the time to actively return force, suggesting that reduced strength is related to a reduced ability to generate rapid contractions in some patients with Parkinson's disease. These results suggest that there is an asymmetric distribution of muscle weakness in Parkinson's disease and that selected measures of muscle strength and muscle relaxation correlate with changes in clinical status.

Aged↗
PubMed1996

Effect of stimulation in the ventral intermediate nucleus of the thalamus on limb control in Parkinson's disease: a case study.

This study focuses on upper extremity strength and movement control in a patient with Parkinson's disease who had stimulating electrodes surgically implanted in the ventral intermediate nucleus (VIM) of the left thalamus. We examined torque generation and control of movement distance in single degree-of-freedom elbow movements under three different stimulation conditions: (a) no stimulation, (b) high stimulation, in which tremor was minimized but there was also tingling and perceived weakness, and (c) moderate stimulation, in which tremor was partially reduced, but there was also a subjective sense of increased strength compared with the high-stimulation condition. The patient's ability to generate both steady torque and rapid movements was poorest with no stimulation. The patient generated the largest torques with moderate stimulation and performed the fastest movements with high stimulation. However, even with tremor minimized, the patient's electromyogram (EMG) burst patterns were not typical of those of neurologically healthy subjects, although the movements were clearly improved.

Elbow↗
PubMed1996

Nonlinear control of movement distance at the human elbow.

The kinematic, kinetic, and electromyographic (EMG) patterns observed during fast, single-joint flexion movement have been widely studied as a paradigm for understanding voluntary movement. Several patterns have been described that depend upon the movement task (e.g., distance, speed, and load). A previous model that interpreted differences in EMG patterns in terms of pulse-height or pulse-width modulation of rectangular pulses of motoneuron pool excitation cannot explain all the EMG patterns reported in the literature. We proposed a more general version of that model, consisting of a set of four equations, which specify the parameters of the excitation pulses for a wide variety of movement tasks. Here we report experiments in which subjects performed fast elbow flexions over a range of distances from 2.8 degrees to 45 degrees. The EMG patterns that we observe are consistent with this more general model. We conclude that this model is sufficient to specify muscle excitation patterns that will launch a movement toward and stop it in the neighborhood of a target. This model operates on the basis of prior knowledge about the task rather than feedback received during the task.

Adult↗
PubMed1996

Coordinating two degrees of freedom during human arm movement: load and speed invariance of relative joint torques.

1. Eight subjects performed three series of pointing tasks with the unconstrained arm. Series one and two required subjects to move between two fixed targets as quickly as possible with different weights attached to the wrist. By specifying initial and final positions of the finger tip, the first series was performed by flexion of both shoulder and elbow and the second by shoulder flexion and elbow extension. The third series required flexion at both joints, and subjects were instructed to vary movement speed. We examined how variations in load or intended speed were associated with changes in the amount and timing of the electromyographic (EMG) activity and the net muscle torque production. 2. EMG and torque patterns at the individual joints varied with load and speed according to most of the same rules we have described for single-joint movements. 1) Movements were produced by biphasic torque pulses and biphasic or triphasic EMG bursts at both joints. 2) The accelerating impulse was proportional to the load when the subject moved "as fast and accurately as possible" or to speed if that was intentionally varied. 3) The area of the EMG bursts of agonist muscles varied with the impulse. 4) The rates of rise of the net muscle torques and of the EMG bursts were proportional to intended speed and insensitive to inertial load. 5) The areas of the antagonist muscle EMG bursts were proportional to intended movement speed but showed less dependence on load, which is unlike what is observed during single-joint movements. 3. Comparisons across joints showed that the impulse produced at the shoulder was proportional to that produced at the elbow as both varied together with load and speed. The torques at the two joints varied in close synchrony, achieving maxima and going through zero almost simultaneously. 4. We hypothesize that "coordination" of the elbow and shoulder is by the planning and generation of synchronized, biphasic muscle torque pulses that remain in near linear proportionality to each other throughout most of the movement. This linear synergy produces movements with the commonly observed kinematic properties and that are preserved over changes in speed and load.

Arm↗
PubMed1995

Relations between joint torque, motion, and electromyographic patterns at the human elbow.

Voluntary movements may be considered kinematic actions resulting from the neural control patterns that activate the motoneuron pools. One school of thought proposes that specific features of the intended kinematic trajectory such as the duration of acceleration are used by the central nervous system to plan muscle activation patterns. Our own experience suggests that it is the intended force trajectory that is directed by muscle activation patterns. Although under many circumstances these two approaches lead to indistinguishable behavior patterns, examples of movements that are incompatible with the former but not the latter approach are presented in this manuscript.

Biomechanical Phenomena↗
PubMed1995

The effects of intrathecally administered baclofen on function in patients with spasticity.

The purpose of this article is to review the literature on the effects of intrathecally administered baclofen on impairment in spasticity and muscle activation patterns, on functional limitations in mobility and self-care, and on disability in daily life roles. We found plentiful evidence of improvement in spasticity, spasms, and bladder function and some reports of improved patterns of muscle activation and kinematics of single-joint movement. Improved ability to accomplish transfers, self-care, and locomotion is less consistently studied but has also been reported in about 60% to 70% of patients. Evidence of improved quality of life is primarily anecdotal but may be found in 10% to 30% of patients. We conclude that research protocols should be developed to clarify effects on control of voluntary movement, functional limitations, and quality of life.

Activities of Daily Living↗
PubMed1994

The effects of practice on movement distance and final position reproduction: implications for the equilibrium-point control of movements.

Predictions of two views on single-joint motor control, namely programming of muscle force patterns and equilibrium-point control, were compared with the results of experiments with reproduction of movement distance and final location during fast unidirectional elbow flexions. Two groups of subjects were tested. The first group practiced movements over a fixed distance (36 degrees), starting from seven different initial positions (distance group, DG). The second group practiced movements from the same seven initial positions to a fixed final location (location group, LG). Later, all the subjects were tested at the practiced task with their eyes closed, and then, unexpectedly for the subjects, they were tested at the other, unpracticed task. In both groups, the task to reproduce final position had lower indices of final position variability than the task to reproduce movement distance. Analysis of the linear regression lines between initial position and final position (or movement distance) also demonstrated a better (more accurate) performance during final position reproduction than during distance reproduction. The data are in a good correspondence with the predictions of the equilibrium-point hypothesis, but not with the predictions of the force-pattern control approach.

Adult↗
PubMed1994

Practice and transfer effects during fast single-joint elbow movements in individuals with Down syndrome.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the effects of prolonged practice of a simple motor task (a fast, unidirectional single-joint movement) on different indexes of motor performance in individuals with Down syndrome. SUBJECTS: Eight individuals with Down syndrome were tested before and after practice involving 1,100 movements. METHODS: The test consisted of three series of elbow flexion movements. In the first series, the subjects were asked to move "as fast as possible" over four distances. In the second series, the subjects moved over one distance at a "comfortable speed." The initial position of the elbow joint for these two series of movements was 55 degrees into flexion (full elbow extension equals 0 degrees). In the third series, the subjects were also asked to move "as fast as possible" over two distances, but from another initial elbow position (73 degrees into flexion). RESULTS: After training over a 2-week period, all subjects improved their performance on all tasks as reflected by both kinematic and electromyographic data. In particular, they increased the quantity of the agonist activity, decreased the antagonist onset latency, and doubled their peak velocity. They were able to transfer the improvement in their performance to the nontrained distances and to the different starting position. Subjects decreased their movement time by proportionally decreasing both the acceleration and deceleration times. CONCLUSION AND DISCUSSION: This study supports the idea that subjects with Down syndrome can use patterns of muscle activation that are qualitatively indistinguishable from those used by individuals who are neurologically normal. With appropriate training, individuals with Down syndrome achieved similar levels of motor performance to that described in the literature for individuals who are neurologically normal.

Acceleration↗
PubMed1994

Task dependent patterns of muscle activation at the shoulder and elbow for unconstrained arm movements.

1. Six subjects performed three series of pointing tasks with the unconstrained arm. Series one and two required subjects to move as fast as possible with different weights attached to the wrist. The first required flexion at both shoulder and elbow joints. The second required shoulder flexion and elbow extension. The third series required flexion at both joints and subjects were intentionally instructed to vary movement speed. These three pointing tasks were selected as the simplest progression from single to multiple degree of freedom movements in which different patterns of motoneuron excitation are required depending on whether movements are made against different loads or at different intended speeds. 2. Changes in load and changes in intended speed both produced systematic but different changes in the patterns of muscle activity and joint torque in both the elbow and shoulder muscles. These patterns are the same found during constrained, single-joint elbow flexion movements. The changes are expressed in the rates of rise, durations, and latencies of the electromyographic (EMG) bursts and in the rates of rise of torque that have specific dependencies based on the force requirements of the task. 3. A consistent, almost linear relationship is observed between muscle torque at the shoulder and at the elbow for all three tasks. Similar systematic changes were not seen in the kinematic description of joint angles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Principles for learning single-joint movements. I. Enhanced performance by practice.

This study investigated changes in myoelectric and mechanical variables for movements made "as fast as possible" as a function of practice in the context of the dual-strategy hypothesis of motor control (Gottlieb et al. 1989b). Five male subjects made 1400 rapid elbow flexion movements in ten blocks of 20 trials over seven experimental sessions. Improved performance was defined as increased peak movement velocity, decreased peak velocity variability, increased acceleration and deceleration, a proportionately greater increase in peak deceleration than peak acceleration, and greater consistency in terminal location. The changes observed over experimental sessions were very similar to (but larger and more consistent than) those seen for the first experimental session, with the partial exception of the timing of the antagonist electromyogram (EMG). In general, the increases in the values of the measured mechanical variables covary with myoelectric measures in the same way as when subjects are asked to intentionally change speed in accordance with the rules of the speed-sensitive strategy (Corcos et al. 1989). However, there are differences between subjects in the extent to which speed changes can be attributable to the agonist muscle, the antagonist muscle, or in the timing between the muscles. In one of the five subjects, the latency of the antagonist EMG decreased over blocks on the 1st day but increased over experimental sessions and was consequently activated proportionately later in the movement. This suggests that extended practice can give at least some subjects flexibility in modifying the motor programs that underlie movement.

Adult↗
PubMed1993

Principles for learning single-joint movements. II. Generalizing a learned behavior.

The previous paper in this series showed that changes both within and between experimental sessions can be understood in the framework of the dual-strategy hypothesis of motor control, with a modification sometimes required for the timing of the antagonist muscle. The present paper extends these findings by determining how practicing movements at one distance generalizes to changes in performance at other distances. Five subjects made elbow flexion movements over five different distances (pretest). They then performed 1400 movements (seven sessions of ten blocks of 20 trials) at only one of those distances. The subjects then repeated the flexion movements over the five different distances (posttest). On the posttest, subjects decreased their average movement time by 20 ms. In addition, their movements became less variable. The electromyographic pattern of the faster movements was characterized by a more rapidly rising electromyogram, for three of the subjects, and an antagonist latency that decreased.

Adult↗
PubMed1993

Preprogrammed reactions in individuals with Down syndrome: the effects of instruction and predictability of the perturbation.

Preprogrammed reactions to unexpected loadings and unloadings of an elbow joint resisting an extending bias load were studied in subjects with Down syndrome. The subjects were instructed to either "let go" or "return back as fast as possible." Both predictable and unpredictable perturbation directions were used. Integrated electromyograms of the two elbow flexors and two elbow extensors were used to characterize the preprogrammed reactions. All the subjects were able to modulate their preprogrammed reactions in response to a change in the instruction. They were also able to grade the preprogrammed responses corresponding to the magnitude of the perturbation. Two basic patterns of modulation were observed, "reciprocal" and "coactivation." There were no effects of the predictability of the perturbation direction. Reconstructed joint compliant characteristics suggested an unchanged gain in the arc of the tonic stretch reflex. We propose that there are no abnormalities in the preprogrammed reactions of some individuals with Down syndrome. The apparent "clumsiness" of individuals with Down syndrome in a changing environment is assumed to reflect an adaptation to their impaired decision-making ability. The high variability of motor performance in subjects with Down syndrome may result from mixing different strategies for solving motor tasks.

Adolescent↗
PubMed1992

Effects of practice on final position reproduction.

Three subjects practiced fast, accurate 36 degrees elbow flexion movements to a 2.5 degrees target for 14 sessions of 100 trials (total, 1400 trials). Subjects then returned for a 15th experimental session in which they were asked to perform 15 movements under identical conditions to the practice condition. They were then tested under three experimental conditions without visual feedback: (1) identical to the practice conditions, (2) with small shifts in starting position (+/- 3 degrees of the practiced starting position), that were insufficient for subjective discrimination and, therefore, subjects were instructed to repeat the practiced movements; and (3) with a large shift in starting position (range, +/- 15 degrees of the practiced starting position), under the instruction to move to the same target. Experimental conditions 2 and 3 demonstrated that shifts in starting position were partially correlated with shifts in final position. These results are interpreted from the point of view of the equilibrium-point hypothesis of motor control.

Adult↗