Biomedical subjects

W Z Rymer

Publications and source records attributed to W Z Rymer.

At least 37 records · Page 2Linked to original sources

PubMed2000

Hyperactive tendon reflexes in spastic multiple sclerosis: measures and mechanisms of action.

OBJECTIVE: To develop new measures of tendon reflexes and evaluate hyperactive reflexes in patients with spastic multiple sclerosis (MS). DESIGN: With the subject relaxed, a hand-held instrumented hammer was used to tap the patellar tendon and record the tapping force, while knee extension torque and quadriceps EMG were recorded isometrically as measures of the reflex response. SETTING: Research laboratory in a rehabilitation hospital. SUBJECTS: Ten spastic MS and 14 healthy subjects. MAIN OUTCOME MEASURES: Tendon tapping force (designated as system input), reflex torque (as output), their dynamic relationship (characterized as system parameters tendon reflex gain, contraction rate, and reflex loop delay), Ashworth scale, and tendon reflex scale. RESULTS: The system parameters provide more repeatable measures than do input or output parameters alone because they quantify the input and output simultaneously and dynamically. Compared with control subjects, MS patients had a significantly lower threshold in tapping force (p = .026), yet their evoked reflex torque was significantly higher (p = .033). Despite significant quadriceps weakness (p < .0001), MS patients had a significantly higher reflex gain (p = .0002) and contraction rate (p = .0002), and shorter reflex loop delay (p = .0046), indicating hyperexcitability of motoneurons and peripheral receptors, and indicating that relatively more of the muscle was activated reflexively, with greater recruitment of larger fast-twitch fibers. Both the reflex gain and rate measures correlated more closely with the Ashworth scale and tendon reflex scale than did the output measures, indicating their potential clinical value. CONCLUSIONS: With appropriate simplification, the method may be used in clinical practice to quantify more precisely the tendon jerk than is currently feasible with standard clinical tests.

Adult↗

PubMed2000

Limit cycle behavior in spasticity: analysis and evaluation.

We examined ankle clonus in four spastic subjects to determine whether this oscillatory behavior has the properties of a limit cycle, and whether it is driven by peripheral sensory input or by a spinal generator. Using Floquet Theory and Poincare sections to assess reflex stability, we found that cycle-to-cycle variability was small, such that the Floquet multipliers were always less than unity. Furthermore, the steady-state periodic orbit was not dependent on the initial position of the ankle. Both of these findings, coupled with strong correlations between the size of the applied load and the frequency of ankle movements and electromyogram burst frequency suggests that clonus behaves as a locally stable limit cycle driven from peripheral receptors. To better understand how nonlinear elements might produce stable oscillatory motion, we simulated the ankle stretch reflex response. We found that delays in the pathway caused the reflex to come on during the shortening phase of movement, so the additional reflex torque required to sustain oscillatory ankle movements was quite small. Furthermore, because the resistance to stretch is largely due to passive mechanics whose properties are quite stationary, the system is robust to small perturbations within the reflex pathway.

Adult↗

PubMed2000

Control strategies for the transition from multijoint to single-joint arm movements studied using a simple mechanical constraint.

Changes were studied in neuromotor control that were evoked by constraining the motion of the elbow joint during planar, supported movements of the dominant arm in eight normal human subjects. Electromyograph (EMG) recordings from shoulder and arm muscles were used to determine whether the normal multijoint muscle activity patterns associated with reaching to a visual target were modified when the movement was reduced to a single-joint task, by pinning the elbow to a particular location in the planar work space. Three blocks of 150 movements each were used in the experiments. Subjects were presented with the unconstrained task in the first and third blocks with an intervening block of constrained trials. Kinematic, dynamic, and EMG measures of performance were compared across blocks. The imposition of the pin constraint caused predictable changes in kinematic performance, in that near-linear motions of the hand became curved. This was followed by changes in limb dynamic performance at the elbow. However, changes in EMG activity at the shoulder lagged the kinematic changes substantially (by about 15 trials). The gradual character of the changes in EMG timing does not support a primary role for segmental reflex action in mediating the transition between multijoint and single-joint control strategies. Furthermore, the scope and magnitude of these changes argues against the notion that human motor performance is driven by the optimization of muscle- or joint-related criteria alone. The findings are best described as reflecting the actions of a feedforward adaptive controller that has properties that are modified progressively according to the environmental state.

Adult↗

PubMed2000

Damping actions of the neuromuscular system with inertial loads: soleus muscle of the decerebrate cat.

A transient perturbation applied to a limb held in a given posture can induce oscillations. To restore the initial posture, the neuromuscular system must provide damping, which is the dissipation of the mechanical energy imparted by such a perturbation. Despite their importance, damping properties of the neuromuscular system have been poorly characterized. Accordingly, this paper describes the damping characteristics of the neuromuscular system interacting with inertial loads. To quantitatively examine damping, we coupled simulated inertial loads to surgically isolated, reflexively active soleus muscles in decerebrate cats. A simulated force impulse was applied to the load, causing a muscle stretch, which elicited a reflex response. The resulting deviation from the initial position gave rise to oscillations, which decayed progressively. Damping provided by the neuromuscular system was then calculated from the load kinetics. To help interpret our experimental results, we compared our kinetic measurements with those of an analogous linear viscoelastic system and found that the experimental damping properties differed in two respects. First, the amount of damping was greater for large oscillation amplitudes than for small (damping is independent of amplitude in a linear system). Second, plots of force against length during the induced movements showed that damping was greater for shortening than lengthening movements, reflecting greater effective viscosity during shortening. This again is different from the behavior of a linear system, in which damping effects would be symmetrical. This asymmetric and nonlinear damping behavior appears to be related to both the intrinsic nonlinear mechanical properties of the soleus muscle and to stretch reflex properties. The muscle nonlinearities include a change in muscle force-generating capacity induced by forced lengthening, akin to muscle yield, and the nonlinear force-velocity property of muscle, which is different for lengthening versus shortening. Stretch reflex responses are also known to be asymmetric and amplitude dependent. The finding that damping is greater for larger amplitude motion represents a form of automatic gain adjustment to a larger perturbation. In contrast, because of reduced damping at small amplitudes, smaller oscillations would tend to persist, perhaps contributing to normal or "physiological" tremor. This lack of damping for small amplitudes may represent an acceptable compromise for postural regulation in that there is substantial damping for larger movements, where energy dissipation is more critical. Finally, the directional asymmetry in energy dissipation provided by muscle and reflex properties must be reflected in the neural mechanisms for a stable posture.

Animals↗

PubMed2000

Persistence of motor adaptation during constrained, multi-joint, arm movements.

We studied the stability of changes in motor performance associated with adaptation to a novel dynamic environment during goal-directed movements of the dominant arm. Eleven normal, human subjects made targeted reaching movements in the horizontal plane while holding the handle of a two-joint robotic manipulator. This robot was programmed to generate a novel viscous force field that perturbed the limb perpendicular to the desired direction of movement. Following adaptation to this force field, we sought to determine the relative role of kinematic errors and dynamic criteria in promoting recovery from the adapted state. In particular, we compared kinematic and dynamic measures of performance when kinematic errors were allowed to occur after removal of the viscous fields, or prevented by imposing a simulated, mechanical "channel" on movements. Hand forces recorded at the handle revealed that when kinematic errors were prevented from occurring by the application of the channel, recovery from adaptation to the novel field was much slower compared with when kinematic aftereffects were allowed to take place. In particular, when kinematic errors were prevented, subjects persisted in generating large forces that were unnecessary to generate an accurate reach. The magnitude of these forces decreased slowly over time, at a much slower rate than when subjects were allowed to make kinematic errors. This finding provides strong experimental evidence that both kinematic and dynamic criteria influence motor adaptation, and that kinematic-dependent factors play a dominant role in the rapid loss of adaptation after restoring the original dynamics.

Adaptation, Physiological↗

PubMed2000

End points of planar reaching movements are disrupted by small force pulses: an evaluation of the hypothesis of equifinality.

A single force pulse was applied unexpectedly to the arms of five normal human subjects during nonvisually guided planar reaching movements of 10-cm amplitude. The pulse was applied by a powered manipulandum in a direction perpendicular to the motion of the hand, which gripped the manipulandum via a handle at the beginning, at the middle, or toward the end the movement. It was small and brief (10 N, 10 ms), so that it was barely perceptible. We found that the end points of the perturbed motions were systematically different from those of the unperturbed movements. This difference, dubbed "terminal error," averaged 14.4 +/- 9.8% (mean +/- SD) of the movement distance. The terminal error was not necessarily in the direction of the perturbation, although it was affected by it, and it did not decrease significantly with practice. For example, while perturbations involving elbow extension resulted in a statistically significant shift in mean end-point and target-acquisition frequency, the flexion perturbations were not clearly affected. We argue that this error distribution is inconsistent with the "equilibrium point hypothesis" (EPH), which predicts minimal terminal error is determined primarily by the variance in the command signal itself, a property referred to as "equifinality." This property reputedly derives from the "spring-like" properties of muscle and is enhanced by reflexes. To ensure that terminal errors were not due to mid-course voluntary corrections, we only accepted trials in which the final position was already established before such a voluntary response to the perturbation could have begun, that is, in a time interval shorter than the minimum reaction time (RT) for that subject. This RT was estimated for each subject in supplementary experiments in which the subject was instructed to move to a new target if perturbed and to the old target if no perturbation was detected. These RT movements were found to either stop or slow greatly at the original target, then re-accelerate to the new one. The average latency of this second motion was used to estimate the voluntary RT for each subject (316 ms mean). Additionally, we found that the hand neither exerted target-oriented force against the handle nor drifted toward the desired end point just before coming to rest, making it unlikely that the mechanical properties of the manipulandum prevented the hand from reaching its intended target.

Adaptation, Physiological↗

PubMed1999

Reorganization of flexion reflexes in the upper extremity of hemiparetic subjects.

We examined spatiotemporal abnormalities in the flexor reflex response in the impaired upper extremity of hemiparetic subjects. Electrical stimulation was used to elicit flexion reflexes in both upper extremities of 8 hemiparetic brain-injured and 6 control subjects. Electromyograms (EMGs) were recorded from 12 arm muscles, and reflex forces and moments were recorded at the wrist with a load cell, and converted to shoulder and elbow torques. We found that the onset of reflex torque and EMG was delayed in the impaired arm and delays were greater at the shoulder than at the elbow. The normal reflex torque response consisted of elbow flexion, shoulder extension, and shoulder adduction. In contrast, in the impaired limb shoulder, flexion torque was observed in 7 subjects and shoulder abduction in 3. The delays in reflex onset and altered torque patterns in the impaired arm may be related to the abnormal movement synergies observed following stroke. &copy 1999 John Wiley & Sons, Inc.

Adult↗

PubMed1999

Guidance-based quantification of arm impairment following brain injury: a pilot study.

This paper reports the design and preliminary testing of a device for evaluating arm impairment after brain injury. The assisted rehabilitation and measurement (ARM) Guide is capable of mechanically guiding reaching and retrieval movements across the workspace and of measuring constraint forces and range of motion during guidance. We tested the device on four hemiplegic brain-injured individuals and four unimpaired control subjects. During guided movement, the brain-injured subjects generated distinct spatial patterns of constraint force with their impaired arms that were consistent with the standard flexion and extension "synergies" described in the clinical literature. In addition, the impaired arms exhibited well-defined workspace deficits as measured by the ARM Guide. These results suggest that constraint force and range of motion measurements during mechanically guided movement may prove useful for precise monitoring of arm impairment and of the effects of treatment techniques targeted at abnormal synergies and workspace deficits.

Adult↗

PubMed1999

System identification of tendon reflex dynamics.

Patellar tendon reflexes were evaluated in 12 healthy adult subjects using several measures of the reflex responses and of the system input-output relationship. A hand-held instrumented hammer was used to tap the patellar tendon and to elicit the reflex response. Tendon reflex dynamics were estimated using the recorded tapping force (as input) and the quadriceps muscle electromyogram and knee joint extension torque signals (as output). A dome-shaped rubber pad was mounted onto the most sensitive spot on the patellar tendon, where it served as a tapping target, and helped to reduce the reflex variability significantly (p < 0.01). The input-output properties of the system relating the reflex torque to the tapping force were characterized using several measures: the tendon reflex gain (Gtr), contraction rate (Rc), and half-relaxation rate (Rhr). Reflex loop delay (t(d)) was estimated using the delay from the onset of tapping force to the onset of reflex torque. We determined that these system parameters provided significantly more repeatable and consistent characterization of tendon reflexes than did reflexive torque or EMG signals alone (p < 0.025). The input-output relationship relating the EMG signals of the stretched muscle to the tapping force was also identified to help characterize neuromuscular dynamics of tendon reflexes. The observed sensitivity and consistency of the reflex system measures suggest that with appropriate simplification of the instrumentation, these methods may prove useful in routine clinical practice, and may allow more precise quantification of the tendon jerk than is currently feasible with standard clinical tests.

Adult↗

PubMed1999

A simulation study of reflex instability in spasticity: origins of clonus.

Clonus is defined as an involuntary rhythmic muscle contraction that generally occurs in people who have sustained lesions involving descending motor pathways in the neuraxis, and is usually accompanied by other signs of reflex hyperexcitability such as spasticity. This paper hypothesizes that clonus arises when two conditions occur simultaneously: 1) the reflex pathway contains long delay times (implying innervation of distal limb muscles, exacerbated when these muscles display slow twitch properties) and 2) the excitability of the motoneurons is enhanced. This paper tested this dual hypothesis by developing a computer model representing the ankle reflex pathway. This model included the ankle muscles, afferent and efferent pathways, and a monosynaptic spinal link between spindle afferents and motoneurons. Simulations show that as the motoneuron current threshold was reduced (reflecting increased excitability of spinal motoneurons), normal reflex responses became unstable and oscillations developed similar to those observed in spastic patients. In parallel, when we choose reflex delay times typical for distal leg muscles in man, system stability is poor, and oscillations occur readily with increasing motoneuron excitability. As simulated pathway delays are reduced, oscillatory behavior is also reduced, and usually damps out. Conversely, as simulated reflex delays are increased, oscillations increase in amplitude and do not decay. Finally, these two phenomena interact, so that increasing motoneuron excitability will induce reflex oscillations for intermediate loop delays. These findings support the hypothesis that unstable oscillatory behavior, such as the oscillations observed in clonus, will occur when the motoneuron excitability increases in a reflex pathway containing long delays. This change in excitability is mediated by a reduction in motoneuron firing threshold, rather than by an increase in feedback gain. Furthermore, we demonstrate that sustained oscillations occur readily through self reexcitation, which reduces the need to propose that a "central oscillator" must be involved in generating clonus.

Algorithms↗

PubMed1999

Mechatronic assessment of arm impairment after chronic brain injury.

Significant potential exists for mechatronic devices to improve assessment and treatment of individuals with a movement disability following stroke, traumatic brain injury, or cerebral palsy. We report the use of a mechatronic device for evaluation of the arm after chronic brain injury. We performed a series of experiments with the device in order to identify the relative contribution of three different motor impairments to decreased active range of motion of reaching in five brain-injured subjects. Our findings were that passive tissue restraint and agonist weakness, rather than antagonist restraint, were the most common contributors to decreased active range of motion. These results demonstrate the feasibility of objective assessment of functional movement using a mechatronic device, and could provide the basis for improved, individualized treatment planning and monitoring following brain injury.

Arm↗

PubMed1998

In vivo human knee joint dynamic properties as functions of muscle contraction and joint position.

Information on the dynamic properties (joint stiffness, viscosity and limb inertia) of the human knee joint is scarce in the literature, especially for actively contracting knee musculature. A joint driving device was developed to apply small-amplitude random perturbations to the human knee at several flexion angles with the subject maintaining various levels of muscle contraction. It was found that joint stiffness and viscosity increased with muscle contraction substantially, while limb inertia was constant. Stiffness produced by the quadriceps was highest at 30 degrees flexion and decreased with increasing or decreasing flexion angle, while knee flexors produced highest stiffness at 90 degree flexion. When knee flexion was < 60 degrees, stiffness produced by the quadriceps was higher than that of the hamstrings and gastrocnemius at the same level of background muscle torque, while knee flexor muscles produced higher stiffnesses than the quadriceps at 90 degree flexion. Similar but less obvious trends were observed for joint viscosity. Passive joint stiffness at full knee extension was significantly higher than in more flexed positions. Surprisingly, as the knee joint musculature changed from relaxed to contracting at 50% MVC, system damping ratio remained at about 0.2. This outcome potentially simplifies neuromuscular control of the knee joint. In contrast, the natural undamped frequency increased more than twofold, potentially making the knee joint respond more quickly to the central nervous system commands. The approach described here provides us with a potentially valuable tool to quantify in vivo dynamic properties of normal and pathological human knee joints.

Computer Simulation↗

PubMed1998

In vivo determination of the direction of rotation and moment-angle relationship of individual elbow muscles.

The direction of rotation (DOR) of individual elbow muscles, defined as the direction in which a muscle rotates the forearm relative to the upper arm in three-dimensional space, was studied in vivo as a function of elbow flexion and forearm rotation. Electrical stimulation was used to activate an individual muscle selectively, and the resultant flexion-extension, supination-pronation, and varus-valgus moments were used to determine the DOR. Furthermore, multi-axis moment-angle relationships of individual muscles were determined by stimulating the muscle at a constant submaximal level across different joint positions, which was assumed to result in a constant level of muscle activation. The muscles generate significant moments about axes other than flexion-extension, which is potentially important for actively controlling joint movement and maintaining stability about all axes. Both the muscle DOR and the multi axis moments vary with the joint position systematically. Variations of the DOR and moment-angle relationship across muscle twitches of different amplitudes in a subject were small, while there were considerable variations between subjects.

Biomechanical Phenomena↗

PubMed1998

Decorrelating actions of Renshaw interneurons on the firing of spinal motoneurons within a motor nucleus: a simulation study.

A simulation of spinal motoneurons and Renshaw cells was constructed to examine possible functions of recurrent inhibition. Recurrent inhibitory feedback via Renshaw cells is known to be weak. In our model, consistent with this, motoneuron firing was only reduced by a few pulses per second. Our initial hypothesis was that Renshaw cells would suppress synchronous firings of motoneurons caused by shared, dynamic inputs. Each motoneuron received an identical pattern of noise in its input. Synchrony coefficients were defined as the average motoneuron population firing relative to the activity of selected reference motoneurons; positive coefficients resulted if the motoneuron population was particularly active at the same time the reference motoneuron was active. With or without recurrent inhibition, the motoneuron pools tended to show little if any synchronization. Recurrent inhibition was expected to reduce the synchrony even further. Instead, it reduced the variance of the synchrony coefficients, without a comparable effect on the average. This suggests-surprisingly-that both positive and negative correlations between motoneurons are suppressed by recurrent inhibition. In short, recurrent inhibition may operate as a negative feedback mechanism to decorrelate motoneurons linked by common inputs. A consequence of this decorrelation is the suppression of spectral activity that apparently arises from correlated motoneuron firings due to common excitatory drive. Without recurrent inhibition, the power spectrum of the total motoneuron pool firings showed a peak at a frequency corresponding to the largest measured firing rates of motoneurons in the pool. Recurrent inhibition either reduced or abolished this peak, presumably by minimizing the likelihood of correlated firing among pool elements. Renshaw cells may act to diminish physiological tremor, by removing oscillatory components from aggregate motoneuron activity. Recurrent inhibition also improved coherence between the aggregate motoneuron output and the common drive, at frequencies above the frequency of the "synchronous" peak. Sensitivity analyses demonstrated that the spectral effect became stronger as the duration of inhibitory synaptic conductance was shortened with either the magnitude or the spatial extent of the inhibitory conductances increased to maintain constant net inhibition. Overall, Renshaw inhibition appears to be a powerful way to adjust the dynamic behavior of a neuron population with minimal impact on its static gain.

Animals↗

PubMed1998

Damping in reflexively active and areflexive lengthening muscle evaluated with inertial loads.

Damping in reflexively active and areflexive lengthening muscle evaluated with inertial loads. J. Neurophysiol. 80: 3369-3372, 1998. Studies of active areflexive muscle have shown that during a constant velocity stretch the increment in force elicited by an incremental length change falls dramatically after a few hundred micrometers of stretch, a finding labeled as "muscle yield." The mechanical behavior after the yield was like a viscous damper, in that force varied only with velocity. In light of these observations, our aims were to determine whether viscous properties are also evident under more physiological conditions, specifically under inertial loading, and to evaluate the damping action of reflexively intact compared with that of deafferented muscle. The active soleus muscle in a decerebrate cat was forcibly stretched by a simulated inertia with a specified initial velocity. We compared muscle length changes when afferent pathways were intact with those recorded after cutting the dorsal roots. Our findings were that areflexive muscle showed highly damped responses, with large changes in mean muscle length, indicative of high viscosity relative to stiffness. In contrast, reflexively active muscle produced lightly damped oscillations, with minimal changes in mean length, reflecting low viscosity and high stiffness. It appears that the stretch reflect modifies the relative contributions of elastic and viscous-like forces, maintaining elasticity, which in turn sustains oscillations. These differences highlight tradeoffs between positional and velocity regulation, in that elastic properties of reflexively active muscle promote oscillations with modest change in mean muscle length, whereas viscous-like properties of areflexive muscle produce damped responses, with poor positional regulation.

Algorithms↗

PubMed1997

Is knee joint proprioception worse in the arthritic knee versus the unaffected knee in unilateral knee osteoarthritis?

OBJECTIVE: Neuromuscular joint protection requires proprioceptive input and motor output. Impairment of proprioception in knee osteoarthritis (OA) may contribute to, and/or result from, the disease. If this impairment was exclusively a local result of OA, a between-knee difference would be expected in patients with unilateral OA (UOA). To explore causal directions, 2 hypotheses were tested: 1) proprioception is worse in UOA patients versus elderly controls; 2) proprioception is worse in the arthritic knee versus the unaffected knee in UOA patients. METHODS: Twenty-eight UOA patients (Kellgren-Lawrence grade > or =2 in 1 knee and <2 in the other knee) and 29 elderly controls were enrolled. The unaffected knee of each UOA patient and both knees of the elderly controls were required to meet symptom, examination, and radiographic criteria. Proprioception (detection threshold of joint displacement after slow, passive, automated knee motion), body mass index, pain, functional status, range of motion, and laxity were measured. RESULTS: UOA patients had worse proprioception than did elderly controls, in either knee. A between-knee difference was not found in UOA patients. CONCLUSION: Impaired proprioception is not exclusively a local result of disease in knee OA. The relative importance of impaired proprioception in the development and progression of knee OA will require longitudinal study.

Aged↗

PubMed1997

Effect of age and osteoarthritis on knee proprioception.

OBJECTIVE: To test the hypotheses that 1) knee position sense declines with age; 2) patients with osteoarthritis (OA) have worse knee position sense than elderly controls; and 3) knee position sense is correlated with functional status. METHODS: The threshold for detection of knee joint displacement was measured in 30 patients with bilateral knee OA (Kellgren/Lawrence grade > or =2 in both knees), 29 elderly controls (who met clinical and radiographic criteria for exclusion of OA), and 25 young controls. Range of motion, laxity, radiographic severity, and functional status were also assessed. RESULTS: A moderate correlation was found between joint displacement detection threshold and age (r = 0.598 and r = 0.501 for the right knee and the left knee, respectively). The threshold was substantially and significantly different between the OA patients and the elderly controls. Proprioceptive impairment was associated with worse disease-specific functional status. CONCLUSION: Proprioception declines with age, and is further impaired in elderly patients with knee OA. Poor proprioception may contribute to functional impairment in knee OA.

Adult↗

PubMed1997

Role of intrinsic muscle properties in producing smooth movements.

Human upper limb movement trajectories have been shown to be quite smooth, in that time derivatives of end point position (r), including d3r/dt3 (i.e., jerk), appear to be minimized during rapid voluntary reaching tasks. Studies have suggested that these movements are implemented by an optimal neural controller which seeks to minimize a cost function, such as average jerk cost, over the course of these motions. While this hypothetical control strategy is widely supported, there are substantial difficulties associated with implementing such a controller, including ambiguities inherent in transformations from Cartesian to joint coordinates, and the lack of appropriate transducers to provide information about higher derivatives of limb motion to the nervous system. Given these limitations, we evaluate the possibility that smoothing of movement might be induced primarily by the intrinsic mechanical properties of muscle by recording the trajectories of inertially loaded muscle with the excitatory input held constant. These trajectories are compared with those predicted by a minimum-jerk optimization model, and by a Hill-based muscle model. Our results indicate that trajectories produced by inertially loaded muscle alone are smooth (in the minimum-jerk sense), and that muscle properties may suffice to account for much of the observed smoothing of voluntary motion, obviating the need for an optimizing neural strategy.

Animals↗