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Biomedical subjects

H Barbeau

Publications and source records attributed to H Barbeau.

At least 55 records · Page 3Linked to original sources
PubMed1995

A treadmill apparatus and harness support for evaluation and rehabilitation of gait.

This report describes a treadmill apparatus for the evaluation and rehabilitation of gait in disabled persons. The apparatus incorporates a body weight support system as well as mechanisms to change certain conditions: treadmill belt speed, upward-downward and lateral slopes, and provision of obstacles. The apparatus enables elements of a treadmill walking pattern to be visible in persons for whom gait evaluation or rehabilitation may not otherwise be possible. It also allows for exploration of factors that limit the adaptability of gait in person after disease or injury by changing the mechanical demand of the locomotor task.

Adult↗
PubMed1994

The effects of parallel bars, body weight support and speed on the modulation of the locomotor pattern of spastic paretic gait. A preliminary communication.

The effects of walking with and without parallel bars, providing 40% body weight support (BWS) and increasing speed on the gait pattern of spastic paretic subjects during treadmill locomotion were investigated. In asymmetrically involved subjects, walking without parallel bars led to a more symmetrical gait pattern with decreased compensation of the less involved side. This was accompanied by changes in electromyographic (EMG) and sagittal angular displacement profiles which favoured a more normal swing phase of the more involved limb. When symmetrically involved subjects walked without parallel bars, increases in EMG activity, with prolonged activation during the stance phase were noted, especially in the distal muscles. Providing 40% BWS facilitated gait when walking without parallel bars especially in the asymmetrically or severely involved subjects who showed marked difficulty at 0% BWS. Forty percent BWS led to a decrease in clonus associated with walking without parallel bars. Higher treadmill speeds increased clonus in some subjects while in others it only caused a small increase in EMG amplitude. Implications for gait training are discussed.

Adult↗
PubMed1994

Enhancement of locomotor recovery following spinal cord injury.

Recent advances have been made in new experimental approaches to enhance locomotor recovery in spinal cord-injured subjects. Research in adult animals whose spinal cords have been transected (spinal animals) has focused particularly on locomotor recovery and the use of pharmacological tools to trigger and modulate the locomotor pattern. This provides a rational basis for the rehabilitation and pharmacotherapy of locomotion in spinal cord-injured patients. Findings in the field of locomotor training, locomotor pharmacotherapy, and functional electrical stimulation are reviewed. It is argued that a combination of the various approaches will provide an optimal base for functional locomotor recovery.

Animals↗
PubMed1994

Effects of conditioning cutaneomuscular stimulation on the soleus H-reflex in normal and spastic paretic subjects during walking and standing.

1. The modulation of the soleus H-reflex by a conditioning cutaneomuscular stimulation was investigated in 10 normal and 10 spastic paretic subjects who suffered from incomplete spinal cord lesions. The different motor tasks examined were standing, locomotion, and the maintenance of static limb postures to mimic critical gait events. The test soleus H-reflex was obtained by stimulating the tibial nerve in the popliteal fossa with a single 1-ms pulse at an intensity that produced a barely detectable M wave. The conditioning stimulus, consisting of an 11-ms train of three 1-ms pulses at 200 Hz, was delivered to the ipsilateral medial plantar arch, stimulating predominantly the medial plantar nerve, at an innocuous intensity of 2.5-3.0 X sensory threshold and at a conditioning-test delay of 45 ms. 2. During quiet standing, the H-reflex amplitude was inhibited only marginally by the conditioning cutaneomuscular stimulation, not reaching statistical significance in either the normal or spastic group of subjects. Although there was a trend of reflex inhibition in the normal subjects as the conditioning intensity was increased, a reversed trend of reflex facilitation was observed in the spastic patients. 3. During treadmill walking, the conditioned H-reflex was inhibited significantly during all phases in all the normal subjects and in one mildly impaired patient. In the moderately and severely impaired patients, cutaneomuscular stimulation selectively inhibited the soleus H-reflex in the early stance and swing phases, thereby producing a near normal phasic modulation pattern. Such modulatory effects were not present under static gait-mimicking conditions. 4. The task-specific and phase-dependent effects of cutaneomuscular stimulation on the soleus H-reflex in the spinal cord-injured patients revealed strong inhibitory influence on Ia afferents from cutaneomuscular inputs. It is plausible that inhibition occurs at both pre- and postsynaptic levels. 5. It is concluded that normal Ia modulatory mechanisms during locomotion are deficient in spastic spinal cord-injured patients and can partially and artificially be restored by cutaneomuscular stimulation applied to the sole of the foot. This can be used as a functional electrical stimulation (FES) regime in gait rehabilitation.

Adult↗
PubMed1993

Noradrenergic agonists and locomotor training affect locomotor recovery after cord transection in adult cats.

In one series of experiments, the effects of noradrenergic, serotonergic, and dopaminergic precursors and agonists on the initiation of locomotion were investigated within the first week after complete spinalization at +13 in five adult cats. In addition, the effects of clonidine and daily locomotor training were investigated during the first week after transection in another cat. The electromyographic (EMG) activity of vastus lateralis (VL) and semitendinosus (St) was recorded bilaterally through percutaneously implanted copper wires in all cats. The movement of the hindlimbs on the treadmill was also simultaneously videorecorded before and after the injection of drugs. Without drug injection, strong and sustained perineal or abdominal stimulation did not induce any prolonged episodes of coordinated stepping on the treadmill during the first week after spinalization. St often had sustained activity, in contrast to VL, in which minimal or no activity was present. Injection of apomorphine (0.3 to 0.5 mg/kg, n = 3), a dopaminergic agonist, or DL-5-HTP (50 mg/kg, n = 2), a serotonergic precursor, failed to induce locomotion at such an early stage after spinalization. In contrast, injection of either L-dopa (50-60 mg/kg, n = 2), a noradrenergic precursor, or clonidine (150 micrograms/kg, n = 2), a noradrenergic agonist, induced locomotion on the treadmill. The animal demonstrated bilateral foot placement on the soles and complete weight support of the hindquarters. The spinal cat could follow the treadmill speed up to 0.80 ms-1. However, these effects disappeared when the NA drugs were tapered off.(ABSTRACT TRUNCATED AT 250 WORDS)

5-Hydroxytryptophan↗
PubMed1991

Initiation and modulation of the locomotor pattern in the adult chronic spinal cat by noradrenergic, serotonergic and dopaminergic drugs.

The effects of noradrenergic, serotonergic and dopaminergic drugs, and their interaction were studied in 8 adult spinal cats during the first week following spinalisation and up to 3 months, when the animals had reached a steady state in their locomotor pattern. During the first week, when no episodes of coordinated stepping were observed, injection of the serotonergic precursor (DL-5-HTP) or a dopaminergic agonist (apomorphine) failed to induce locomotion. In contrast, injection of either a noradrenaline precursor (L-DOPA) or an agonist (clonidine) induced locomotion when the hindlimbs were placed on a moving belt. The spinal animal demonstrated a bilateral foot placement on the plantar surface, as well as transient weight support of the hindquarters at a treadmill speed up to 0.80 m/s. The movement pattern and the electromyographic activity resemble those of the intact cat in many aspects. This locomotion-triggering effect of L-DOPA or clonidine was also observed when given after DL-5-HTP or apomorphine. At around 3 months following spinalisation, when the animal showed a stable and regular locomotor pattern, injection of clonidine increased the step cycle duration, resulting in a prolonged flexor and extensor burst duration as the EMG amplitude was unchanged or slightly increased. Injected in the same animal, quipazine, a serotonergic agonist, increased both the duration and the amplitude of flexor and extensor EMGs. In contrast to the serotonergic and the noradrenergic agonists, apomorphine and L-DOPA augmented mainly the flexor activity which could even lead to a sustained flexion when the dose was increased. When combining clonidine to a serotonergic drug, the characteristics of the modulation of the locomotor pattern resulting from each drug were retained. The present results demonstrate that (1) the noradrenergic system is probably the most important system for the initiation of locomotion; (2) the three monoaminergic descending systems (mimicked by the precursor and agonists) can modify rather specifically different aspects of the well established locomotor pattern in the same chronic spinal cat and (3) the effect of monoaminergic drugs are reproducible when given in similar time periods in different chronic spinal cats. The present study provides insight into the role of the noradrenergic, serotonergic and dopaminergic system in the initiation and in the modulation of the locomotion pattern following spinalisation. The above studies also provide a basis to investigate the effects of these drugs in spinal cord-injured patients.

Animals↗
PubMed1991

Modulation of locomotor patterns and spasticity with clonidine in spinal cord injured patients.

This double blind cross-over study, involving 9 chronic spinal cord injured (SCI) patients (6 paraplegic and 3 paretic), was a first attempt to investigate the effects of the noradrenergic agonist, clonidine, on the modulation of the locomotor pattern and spasticity in patients with spinal cord lesions. Electromyographic (EMG), footswitch and video recordings were made as the patients walked on a treadmill with the support of an overhead harness if needed. Overground locomotion was also assessed in the paretic patients. All 3 spastic paretic patients had kinematic deviations and abnormal EMG recruitment profiles during the premedication or placebo sessions. With clonidine therapy one patient demonstrated a marked improvement in locomotor function. This patient progressed from non-ambulation to limited independent ambulation as the extent of coactivation in antagonist muscles decreased. The other 2 paretics who presented limited spasticity showed minimal changes while on clonidine. In the paraplegic patients, clonidine did not elicit locomotor activity, although there were marked reductions in stretch reactions and clonus during assisted locomotion. They remained incapable of locomotion, either during the control period or during the clonidine therapy. These results indicate that clonidine may be a potentially useful medication for both locomotion and certain manifestations of spasticity in SCI patients but further investigation is warranted.

Adult↗
PubMed1991

H-reflex modulation during walking in spastic paretic subjects.

Hoffman (H) reflexes were elicited from the soleus muscle during treadmill walking in 21 spastic paretic patients. The soleus and tibialis anterior muscles were reciprocally activated during walking in most patients, much like that observed in healthy individuals. The pattern of H-reflex modulation varied considerably between patients, from being relatively normal in some patients to a complete absence of modulation in others. The most common pattern observed was a lack of H-reflex modulation through the stance phase and slight depression of the reflex in the swing phase, considerably less modulation than that of normal subjects under comparable walking conditions. The high reflex amplitudes during periods of the step cycle such as early stance seems to be related to the stretch-induced large electromyogram bursts in the soleus in some subjects. The abnormally active reflexes appear to contribute to the clonus encountered during walking in these patients. In three patients who were able to walk for extended periods, the effect of stimulus intensity was examined. Two of these patients showed a greater degree of reflex modulation at lower stimulus intensities, suggesting that the lack of modulation observed at higher stimulus intensities is a result of saturation of the reflex loop. In six other patients, however, no reflex modulation could be demonstrated even at very low stimulus intensities.

Adult↗
PubMed1991

Influence of body weight support on normal human gait: development of a gait retraining strategy.

The recovery of locomotion, following interactive training with graded weight support, in the adult spinal cat has led to the proposal that removal of body weight may be a therapeutic tool in human gait retraining. There would be benefits, however, in knowing normal responses of humans to partial weight bearing before applying this strategy to patients. In this study, 10 nondisabled male subjects walked on a treadmill while 0%, 30%, 50%, and 70% of their body weight was supported by a modified climbing harness. To dissociate the changes attributable to walking speed from those attributable to body weight, each subject walked at the specified body-weight-support (BWS) levels and at full weight bearing (FWB) at the same speed. Simultaneously, electromyographic data from the right leg muscles, footswitch signals, and video recording of joint motion were collected. The FWB and BWS gaits appeared similar, except at the highest level of BWS studied (ie, 70% of BWS). Significant differences among other BWS and FWB trials at comparable speeds included decreases in percentage of stance, percentage of total double-limb support time, and maximum hip and knee flexor swing angle. Other adaptations to BWS were a reduction in the mean burst amplitude of the muscles that are active during stance and an increase in the mean burst amplitude of the tibialis anterior muscle. The possible implications of this new gait retraining strategy for patients with neurological impairment are discussed. [Finch L, Barbeau H, Arsenault B. Influence of body weight support on normal human gait: development of a gait retraining strategy.

Adult↗
PubMed1990

The effects of serotonergic drugs on the locomotor pattern and on cutaneous reflexes of the adult chronic spinal cat.

The effects of serotonergic substances on the locomotor pattern and cutaneous reflexes were studied in 3 adult chronic spinal cats trained for 1-3 months to walk with their hindlimbs on a treadmill. The 5-hydroxytryptamine (5-HT) precursor, 5-hydroxytryptophan (5-HTP), and two 5-HT agonists, 5-methoxy-N,N-dimethyltryptamine and quipazine, were found to generally increase the step length and augment the amplitude of hindlimb extensors and flexors as well as axial muscles. Correspondingly, the excursion of the hip, the knee and the ankle joints was increased, mainly in the flexion direction. Cyproheptadine, a 5-HT antagonist, partially or completely antagonised these effects. The threshold current needed to elicit a flexion reflex by stimulating the dorsum of the paw through implanted wires, was lower after the injection of 5-HT agonists than in the immediately preceding control period. Fast paw shaking initiated by dipping the paw in water was unchanged after quipazine and was not abolished by cyproheptadine. In accordance with others, our results suggest that serotonergic drugs may increase the excitability of several types of spinal neurones, including motoneurones, and consequently influence the locomotor pattern as well as the reflex responsiveness. The changes observed with serotonergic agonists were different in many respects from those obtained with noradrenergic agonists and these differences are discussed. This may indicate specific roles for these classes of substances on locomotor function and reflex activity and also provide a basis for further clinical investigations.

5-Hydroxytryptophan↗
PubMed1990

The combined effects of clonidine and cyproheptadine with interactive training on the modulation of locomotion in spinal cord injured subjects.

The combined effects of a noradrenergic agonist, clonidine, and a serotonergic antagonist, cyproheptadine, together with an interactive locomotor training program incorporating progressive body weight support and treadmill walking exercise, were investigated in two chronic spinal cord injured subjects. Both subjects had no independent locomotor ability due to severe spasticity. Kinematic, temporal distance and electromyographic (EMG) data were collected during treadmill walking. The EMG activity of the lower limb muscles, initially characterized by tonic discharge and abnormal timing, became more phasic with less clonus following medication, which was related to a change in the kinematic pattern. Further kinematic and functional improvement were gained by training. Previously wheelchair-bound, both patients became functionally ambulatory overground with the aid of Canadian crutches. Thus, a potentially effective strategy for facilitating the expression of the locomotor pattern following spinal cord injury is proposed. This preliminary study showed that such a treatment strategy could possibly lead to a recovery of locomotor function in some chronic, wheelchair-bound spinal cord injured patients who had previously been stabilized on conventional therapies.

Adult↗
PubMed1990

The effects of cyproheptadine on locomotion and on spasticity in patients with spinal cord injuries.

The effects of cyproheptadine, a serotonergic antagonist, were studied in seven patients with spastic paresis of spinal origin. Six patients were included in a double blind crossover trial (maximal dose 24 mg/day). The patients were evaluated on both their spasticity and locomotor function. Four of the patients also participated in an open trial in which cyproheptadine was administered for a minimum of six months at optimal dose. Patients walked on a treadmill at full weight bearing when possible, or with 40% of their body weight externally supported, as required, by an overhead harness system. Cyproheptadine considerably decreased the sustained ankle clonus and episodes of spontaneous spasms observed in all the patients who previously presented these manifestations of spasticity. Two patients who required body weight support (BWS) during locomotion could walk at full weight bearing during cyproheptadine therapy. A more normal timing of EMG patterns in these patients during cyproheptadine therapy was associated with temporal distance changes and marked improvement of joint angular displacement. In contrast, the other patients showed marginal changes in the EMG and the kinematic pattern but eventually managed to walk at a higher speed. These preliminary results suggest that cyproheptadine can reduce spasticity and enhance locomotor function in spinal cord injured patients.

Adult↗
PubMed1989

A dynamic EMG profile index to quantify muscular activation disorder in spastic paretic gait.

Spasticity is a complex phenomenon that interferes with motor control. Existing clinical and physiological measures of spasticity have mainly focused on the evaluation of clonus and reflexes. Subjected to the limitation of testing in a resting position, the results may not necessarily reflect the extent of functional impairment caused by spasticity. To evaluate spasticity in a dynamic, voluntary movement such as locomotion, a task-specific approach is essential. A dynamic index, I, derived from the EMG activity obtained during treadmill walking in human subjects, is therefore proposed as a functionally relevant measurement of spasticity in locomotion. I, defined as the ratio of integrated EMG in the pre-determined 'off' window of the normalized gait cycle to that in the 'on' window, would indicate the degree of abnormal activation of locomotor muscles from their normally relaxed state as compared to the total recruitment in the active state during walking. The present study done on 5 normal and 8 spastic paraparetic subjects showed that I was homogeneously low in the normal group but abnormally high and variable in the spastic group. A case study has further demonstrated that I is sensitive to the alteration in locomotor spasticity with pharmacological intervention, and the change in I parallels the improvement in the kinematics observed. This preliminary study indicates that the proposed index appears to be a functionally relevant and dynamic measurement of spastic locomotor disorder.

Adult↗
PubMed1989

The effects of body weight support on the locomotor pattern of spastic paretic patients.

The effects of mechanically supporting a percentage of body weight on the gait pattern of spastic paretic subjects during treadmill locomotion was investigated. Electromyographic (EMG), joint angular displacement and temporal distance data were simultaneously recorded while 7 spastic paretic subjects walked at 0% and 40% body weight support (BWS) at their maximal comfortable treadmill speed. Forty percent BWS produced a general decrease in EMG mean burst amplitude for the lower limb muscles investigated with instances of more appropriate EMG timing in relation to the gait cycle. The joint angular displacement data at 40% BWS revealed straighter trunk and knee alignment during the weight bearing phase especially at initial foot-floor contact and midstance. An increase in single limb support time and a decrease in percentage total double support time were evident at 40% BWS. An increase in stride length and maximum comfortable walking speed was also seen with BWS. The use of BWS during treadmill locomotion as a therapeutic approach to retrain gait in neurologically impaired patients is discussed.

Adult↗
PubMed1987

The effects of clonidine and yohimbine on locomotion and cutaneous reflexes in the adult chronic spinal cat.

The effects on the locomotor pattern of a noradrenergic agonist (clonidine) and an antagonist (yohimbine) were studied in 3 adult chronic spinal cats walking on a treadmill. In the early post-transection period, when the cat walked mainly on the tip of its feet, without supporting its own weight, it was observed that clonidine (150 micrograms/kg) could induce a good bilateral foot placement and intermittent complete weight support. When clonidine was given 1-3 months following the transection, at a time when the spinal cats had a stable and regular locomotor performance, the step length increased markedly, especially at low speeds. This was associated with an increase in the duration of the flexor and extensor bursts, as well as an increase of the angular excursion of all joints. These effects, seen during forward locomotion, were also observed during backward locomotion. In addition, the latter was more easily elicited after clonidine. Yohimbine (1.5-3 mg/kg) partially antagonized these effects. The threshold current needed to elicit a small flexion reflex through wires implanted in the dorsum of the paw was 2-3 times higher after clonidine. Trains of shocks in the animal, standing quietly, did not induce the prolonged late discharges normally found in acute spinal cats. Fast paw shaking, elicited by dipping one paw in water, was abolished by clonidine and reappeared after yohimbine. These results indicate that noradrenergic drugs may influence both spinal locomotion and the excitability of cutaneous reflexes. This class of substances could thus play a useful role in the recovery and/or maintenance of locomotor functions after spinal trauma.

Animals↗
PubMed1987

Recovery of locomotion after chronic spinalization in the adult cat.

Cats were spinalized (T13) as adults and were trained to walk with the hindlimbs on a treadmill. After 3 weeks to 3 months and up to 1 year depending on the animal, all were capable of walking on the plantar surface of the feet and support the weight of the hindquarters. Interactive training appeared to accelerate the recovery of locomotion and maintain smooth locomotor movements. Despite the obvious loss of voluntary control and equilibrium which the experimenter partially compensated for by maintaining the thorax and/or the tail, the cats could walk with a regular rhythm and a well-coordinated hindlimb alternation at speeds of 0.1-1.2 m/s. Cycle duration as well as stance and swing duration resembled those of normal cats at comparable speeds. The range of angular motion was also similar to that observed in intact cats as was the coupling between different joints. The EMG activity of the hindlimb and lumbar axial muscles also retained the characteristics observed in the intact animal. Some deficits such as a dragging of the foot in early swing and diminution of the angular excursion in the knee were seen at later stages. Thus, the adult spinal cat preparation is considered as a useful model to study the influence of different types of training and of different drugs or other treatments in the process of locomotor recovery after injury to the spinal cord.

Adaptation, Physiological↗