An entire field of research was born when a paper entitled ‘On the education of muscular control and power’ first discussed a “psychical rather than a physical” bilateral adaptation to a unilateral training program. Although the true relevance of this paper would not be recognized for over a century, its novel findings, describing adaptations resulting from physical and skilled training, continue to influence scientific literature to this day. Most notably, Scripture coined the term ‘cross-education’ to describe the improvement in strength or functional performance of not only the trained limb but also in the untrained contralateral limb. Recently, unilateral training or ‘cross-education’ has been highlighted as a possible rehabilitation strategy during recovery from unilateral injuries. However, a number of limitations must be addressed within the scientific literature in order to properly apply unilateral resistance training as an effective rehabilitation strategy. Therefore, the primary goal of this dissertation was to address a number of fundamental issues related to optimizing unilateral resistance training. One such issue is knowledge on the time course of strength increase during unilateral resistance training. The primary purpose of Chapter 2 was to characterize the time-course of strength changes in both the trained and untrained limbs during unilateral handgrip training. Experiment 1 assessed the time-course with a ‘traditional’ training protocol (3x/week for 6 weeks: 18 total sessions) while Experiment 2 assessed a “compressed” protocol in which the number of sessions and contractions were matched but participants trained for eighteen consecutive days. An anticipated outcome was the determination of the minimum number of sessions required to induce contralateral strength gains in the upper limb. A secondary purpose of this study was to examine whether spinally-mediated adaptations in muscle afferent reflex pathways occur after unilateral handgrip training. Experiment 1 indicated six weeks of handgrip training significantly increased force output in both trained and untrained limbs. This strength increase was accompanied by changes in the maximal muscle activation in the trained limb only. Time course data indicated the trained limb was significantly stronger than baseline after the 3rd week of training (session 9) while the untrained limb was stronger after 5 weeks (15 sessions) of unilateral handgrip training. Interestingly, the rate at which strength increased in the untrained limb was similar to the trained side. These strength increases were also accompanied by significant changes in the current needed to produce H@50 in the trained, and Hmax in both the trained and untrained limb indicating alterations in spinal cord excitability. Experiment 2 showed a similar number of sessions was needed to induce significant strength gains in the untrained limb. This indicates training without rest days may be the most efficient protocol within a clinical population when the trained limb is not the focus of recovery. It remains necessary to determine if specific strategies can be employed to optimize unilateral resistance training interventions to increase strength gains. To date, no study has directly assessed the relative contribution of afferent pathways to cross-education. Cutaneous feedback from the skin provides perceptual information about joint position and movement. Unilateral training involves forceful contractions that activate cutaneous receptors in the skin, producing widespread and powerful effects between limbs. Providing “enhanced” cutaneous stimulation during unilateral contractions may alter excitability of interlimb reflex pathways, modifying the contralateral increase in strength. Therefore, the purpose of Chapter 3 was to determine the relative contribution of cutaneous afferent pathways as a mechanism of cross-education by directly assessing if unilateral cutaneous stimulation alters ipsilateral and contralateral strength gains. Participants were randomly assigned to either a voluntary contraction (TRAIN), cutaneous stimulation (STIM), or cutaneous stimulation during voluntary contraction (TRAIN+STIM) group. Each participant completed 6 sets of 8 reps 3x/week for 5 weeks. TRAIN included unilateral maximal voluntary isometric contractions (MVCs) of the wrist extensors. STIM training included cutaneous stimulation (2xRT for 3sec @ 50Hz) of the superficial radial (SR) nerve at the wrist only. TRAIN+STIM included MVCs of the wrist extensors with SR stimulation provided for the duration of the contraction. Two pre-training and 1 post-training session assessed the relative increase in force output during MVCs for wrist flexion, wrist extension and handgrip strength. Results indicated unilateral wrist extension training alone (TRAIN) increased force output in both trained and untrained wrist extensors. Providing ‘enhanced’ sensory feedback via electrical stimulation during training (TRAIN+STIM) led to similar increases in strength in the trained limb compared to TRAIN. However, the major finding revealed that ‘enhanced’ feedback in the TRAIN+STIM group completely blocked interlimb strength transfer to the untrained wrist extensors. It appears the large mismatched sensory volley which was provided may have interfered with the integration of the appropriate sensory cues to the untrained cortex and impaired the ability to induce “cross-education”. It may be possible to enhance effects of training by altering excitability via apparel such as compression garments. Currently, it is unknown whether tactile input to the skin induced via compression apparel may alter transmission of muscle afferent feedback within a limb. Thus, the purpose of Chapter 4 was to examine if sustained input to the skin via compression garment modulates sensory feedback transmission in the upper limb using the Hoffmann (H-) reflex as a probe. The purpose of these experiments was to: 1) explore the effects of compression gear on sensory feedback transmission in the upper limb during a static task, and 2) if the task (locomotor vs. reaching) or phase of a movement differentially modulated this transmission of sensory information. Furthermore, differences in performance of the discrete reaching task were assessed to provide data on whether a compression garment leads to alteration in motor task performance. Combined results from both parts of the study suggest that tactile input provided to the skin via compression garments modulates the excitability of afferent connections independent of descending input. The alteration in excitability occurs across multiple sensory pathways and across multiple movement tasks. Interestingly, there was a significant reduction in the number of errors made during the reaching task, which provides preliminary evidence of an improved performance while wearing a compression garment. Therefore, the compression sleeve appears to increase precision and sensitivity at the joint where it is applied. Overall, these results address many fundamental questions which have previously limited effective translation for rehabilitative interventions. These results provide preliminary guidelines for subsequent strength training interventions to prescribe the optimal ‘dose’ of unilateral strength training to maximize benefits while minimizing intervention burden. These studies also help refine a unifying model of unilateral strength training to include contributions from central motor output as well as afferent feedback. These studies highlight the importance of appropriate sensory feedback during maximal force production and the impact that sensory information from the skin can have on motor output in the nervous system. / Graduate / 0317 / 0719 / 0382

No description available.

<p>Neurodynamics refers to the mechanical and physiological components of</p> <p>the nervous system and the interconnections between them (Shacklock, 1995).</p> <p>This is a phase 1 pilot trial investigating the immediate effect of a neurodynamic</p> <p>treatment as compared to a sham treatment in eight participants with low back</p> <p>pain. Primary outcome measures included: H-reflex latency and nerve</p> <p>conduction velocity. Secondary outcome measures included: the sitting slump</p> <p>test and visual analog scale for pain following a neurodynamic treatment</p> <p>compared to a sham treatment on eight participants with low back pain. T-tests</p> <p>were used to analyze any differences between the groups at baseline and post-</p> <p>intervention. No statistically significant differences were observed between the</p> <p>groups at baseline. Statistically significant differences were noted post-</p> <p>intervention between the treatment groups for H-reflex latency (t(5)=4.323,</p> <p>p=0.008) and the unaffected leg sitting slump test (t(5)=3.402, p=0.019). The H-</p> <p>reflex latency increased for the group following the neurodynamic treatment and</p> <p>decreased following the sham treatment. This was not expected and is of</p> <p>interest due to the possible mechanisms that may be underlying these</p> <p>phenomena. Despite the small sample size used in this study, differences were</p> <p>observed and displayed trends that were unanticipated. These between-group</p> <p>differences are of interest but require further investigation using a larger sample</p> <p>population. Sample size calculations for future studies based on the primary</p> <p>outcome measures yielded a sample of 2008 participants. This accounted for</p> <p>both a 20% difference between the two groups and a 20% dropout rate. Future</p> <p>studies need to investigate the most beneficial length of time, type and dosage of</p> <p>neurodynamic treatments, as well as, the most appropriate times to assess the</p> <p>outcome measures. Comparison to controls would be beneficial in subsequent</p> <p>studies.</p> / Master of Science Rehabilitation Science (MSc)

No description available.

Antecedendo movimentos voluntariamente gerados, existe atividade neuronal encefálica que se inicia alguns segundos antes da execução deste movimento. Esta atividade preparatória é responsável pela elaboração de um plano de execução que alcança a via final comum para realização de um ato motor voluntário, os motoneurônios. Entretanto, na última década, evidências apontam para a participação de circuitos neuronais na medula espinhal apresentando padrão de atividade similar aos padrões observados em áreas encefálicas e que, possivelmente, estaria relacionado a uma atividade preparatória para o movimento voluntariamente gerado. Por este motivo, o presente trabalho teve por objetivo verificar a atividade de circuitos neuronais na medula espinhal durante diferentes instantes de proximidade da ação voluntariamente gerada em paradigma de tarefa motora com período de instrução. Para isso, inicialmente, 15 sujeitos saudáveis, sem histórico de doença neuromuscular foram submetidos ao protocolo experimental. O protocolo experimental constituiu-se do processo de recrutamento dos sujeitos, sua preparação para o ensaio dentro do ambiente experimental, bem como as orientações necessárias para execução dos procedimentos e paradigmas. Os procedimentos referem-se às etapas realizadas para captação do reflexo H, bem como desta captação sob a influência de técnica de condicionamento por inibição pré-sináptica. Essa captação ocorreu em janelas de aquisição em que o sujeito encontrava-se em repouso e em três instantes de expectativa para a execução de ação voluntária, estando o músculo sóleo atuando como agonista (flexão plantar) ou antagonista (dorsiflexão), em paradigma de tarefa motora voluntária com período de instrução. Após os registros, por meio de processamento dos sinais coletados, foi possível se calcular a amplitude pico-a-pico do reflexo H nas diferentes condições experimentais de proximidade da execução (1000, 600 e 200 milissegundos) e de atuação do músculo sóleo (agonista e antagonista) que foi usado para: (1) análise da variação da excitabilidade reflexa, em porcentagem da onda M máxima, (2) análise da ocorrência de inibição pré-sináptica e (3) análise da variação da inibição pré-sináptica, em porcentagem de inibição. Os resultados mostram que a porcentagem da onda M máxima aumentou significativamente nos três instantes de proximidade com os sujeitos estando em expectativa da execução da tarefa motora quando o músculo sóleo atuaria como agonista da contração, quando comparados com os registros obtidos nas mesmas condições em repouso. Contudo, somente a 200 ms da execução é que foi observado aumento da porcentagem da onda M máxima quando o músculo sóleo atuaria como antagonista. Inibição pré-sináptica ocorreu em todas as condições experimentais, contudo aumento significativo da porcentagem de inibição pré-sináptica foi somente observado a 200 ms da execução da tarefa motora em que o músculo sóleo atuaria como antagonista. Diferenças entre agonista e antagonista com relação ao padrão de excitabilidade reflexa foi somente observado a 600 ms de proximidade da execução da tarefa e essas diferenças com relação à porcentagem de inibição pré-sináptica foi somente detectada a 200 ms. Nossos resultados nos permitem concluir que circuitos neuronais na medula espinhal apresentam atividade no período preparatório para a execução de tarefa motora voluntária que podem estar relacionadas ao comportamento de expectativa da realização de uma ação motora eminente, bem como relacionada ao planejamento motor para a ação a longa proximidade da execução de movimentos. / There is brain activity preceding voluntary movements a few seconds before the execution of the movement. This preparatory activity is responsible for the execution plan that reaches the final common pathway, i.e., the motoneurons. In the last decade, there have been reports indicating the involvement of spinal cord circuits in the preparatory activity for movement. The present work has the objective of verifying the activity of spinal cord neuronal circuits at different times preceding a voluntary action, under an instructed delay period paradigm. Fifteen healthy subjects participated in the study. The protocol included an explanation of the experimental tasks. Electrophysiological recordings of the H reflex with and without presynaptic inhibition conditioning were employed. The epochs of H reflex recording were associated either with a resting period or with one of three pre-action periods. The subject received a cue at an appropriate time about the type of contraction: plantarflexion or dorsiflexion. Peak to peak H reflex values were computed in the control resting period and at 1000 ms, 600 ms and 200 ms before the action. Percent values of H amplitude with respect to maximum M values were computed as well as the level of presynaptic inhibition. The results have shown that the relative H reflex value increased significantly at the three premovement times for the soleus under an agonist contraction (i.e., plantarflexion) when compared to control. However, when the soleus was an antagonist to the contraction (i.e., dorsiflexion) there was a statistical difference in the H amplitude only at 200 ms before movement. Presynaptic inhibition occurred in all experimental conditions, however only at 200 ms before contraction there was a significant increase. Differences in reflex excitability between agonist and antagonist activity were only observed at 600 ms before action. On the other hand, differences in presynaptic inhibition were only found at 200 ms before contraction. The results indicated that spinal cord neuronal circuits are activated during the preparatory period preceding a voluntary action. These may be correlated with an expectancy behavior for the execution of an imminent motor action and also with the planning of a motor action at larger times preceding movement execution.

Muscle performance is partially a consequence of its recent contractile history. Postactivation potentiation (PAP) can occur after muscle contractions and leads to enhanced neuromuscular performance. The purpose of this dissertation was to explain the relationship between muscle factors (twitch potentiation, TP) and neural factors (reflex potentiation, RP) contributing to overall PAP following a non-fatiguing volitional muscle contraction. The tibial nerves of fifteen resistance trained volunteers (eleven men, four women) were stimulated intermittently at supramaximal (Mmax) and submaximal (Hmax) intensities for 20 minutes on separate days under three conditions: rest (Control); after a after a 10 second maximum voluntary isometric contraction (MVIC) of the plantarflexors; and after a low frequency fatigue protocol prior to the MVIC. Plantarflexion isometric torque and rate of force development (RFD), and soleus and gastrocnemius EMG Hmax/Mmax ratios, were analyzed. Both experimental conditions resulted in TP at 10 seconds post-MVIC compared to the control condition. The two experimental conditions were not different for any measure. Torque and RFD at Hmax (overall PAP) were highest at 3 and 4.5 minutes post MVIC, respectively, but were not significantly different from the control condition. EMG values generally were insignificantly increased in the experimental conditions versus the control condition. Mmax torque and RFD significantly contributed to Hmax torque and RFD at 20 seconds, Hmax peak, and 20 minute post-MVIC time points. The soleus significantly contributed to Hmax torque at 20 seconds and 20 minutes post-MVIC, and Hmax RFD at 20 seconds, 4.5 minutes, and 20 minutes post-MVIC. The results of this study suggest that both muscle and neural factors play a significant role in overall PAP, and that neural factors may play a more meaningful role in RFD potentiation than torque potentiation.

Made available in DSpace on 2014-12-17T15:16:07Z (GMT). No. of bitstreams: 1 FabioLM.pdf: 1201794 bytes, checksum: a0d59fd87797a00a671d5be8a4198404 (MD5) Previous issue date: 2009-10-29 / Funda??o de Amparo a Pesquisa do Estado de S?o Paulo / Cerebrovascular accident (CVA) is a term used to characterize an ischemic or hemorrhagic vascular injury, which has got as main clinic manifestations, the motor and reflex function disturbance. In the first stage there is flaccidity and loss of voluntary movements that afterwards is substituted by mass patterns and spasticity. The spasticity brings with itself functional deficits and can generate negative impacts in various motor patterns. The aim of this research was to investigate the hyperreflexia and identify the immediate effects of transcutaneous nervous stimulation (TENS) and cryotherapy in the spasticity and electromyographic activity of hemiparetic subjects. The study is characterized as an almost experimental type, in which were selected, to compose the sample, 16 patients of both sex with CVA sequel. These individuals were evaluated by collecting the amplitude peak to peak and H reflex latency, Motor response (M response) in solear muscle and the electromyography (EMG) of the injured and healthy legs anterior tibial muscles. In the injured limb the evaluations occurred in different days for cryotherapy, TENS and control, in two moments, before and after the interventions. The healthy limb was evaluated one single time to serve as baseline, for comparison with the injured limb. It was used an statistic analysis, the t paired student test to identify the H reflex differences, latency and EMG of the injured and healthy limbs and to compare the results before and after the recourses application. The ANOVA for related samples was used to identify the differences among the recourses used. It was attributed for the statistic tests a significance level of 5%. The amplitude peak to peak of normalized maximum H reflex through the maximum motor response (Hmax/Mmax), showed itself significantly increased in the injured limb (p=0.0245). The H reflex latency was presented reduced in the injured limb (p=0, 0375). The electromyographic activity was showed decreased in the injured limb (p< 0.0001). After the TENS there was a Hm?x/Mm?x ratio decrease (0.60?0.16 versus 0.49.?0.18; P = 0.0006). Nonetheless, Just after the cryotherapy application there was an increase of Hm?x/Mm?x ratio (0.58 ? 0,15 to 0.77 ? 0.13, P=0,0007) and increase of signal latency (30.41 ? 1.87 versus 33.24 ? 2.19; P=0.0001). The electromyographic activity wasn t altered significantly by any resource. It was met statistic significant differences when the Hm?x/Mm?x P<0.0001) ratio and H reflex latency (P<0.0001) were compared between the post TENS, cryotherapy and control. One can conclude that the TENS can be used to spasticity immediate reduction, and that the cryotherapy can increase the hyperreflexia state in spastic patients. Nonetheless, the spasticity decrease or increase didn t provoke lectromyographic activity change in the muscle that is opponent to the spastic one / Acidente Vascular Encef?lico (AVE) ? o termo empregado para caracterizar uma les?o vascular isqu?mica ou hemorr?gica, que tem como principais manifesta??es cl?nicas, o dist?rbio da fun??o motora e reflexa. No est?gio inicial h? presen?a de flacidez e falta de movimentos volunt?rios, que posteriormente ? substitu?do por padr?es em massa e espasticidade. A espasticidade traz consigo d?ficits funcionais e pode gerar impactos negativos em diversos padr?es motores. O objetivo da pesquisa foi investigar os efeitos imediatos da eletroestimula??o nervosa transcut?nea (TENS) e crioterapia na espasticidade e na atividade eletromiogr?fica de sujeitos hemipar?ticos. O estudo caracteriza-se por ser do tipo quase experimental, no qual foram selecionados para compor a amostra, 16 pacientes de ambos os sexos com sequela de AVE. Estes indiv?duos foram avaliados captando-se a amplitude pico a pico e lat?ncia do reflexo H, resposta Motora (resposta M) no m?sculo solear e o eletromiograma (EMG) do m?sculo tibial anterior do membro comprometido e n?o comprometido. No membro comprometido as avalia??es ocorreram em dias diferentes para crioterapia TENS e controle, em dois momentos, antes e depois das interven??es. O membro n?o comprometido foi avaliado uma ?nica vez para servir como linha de base, para compara??o com o membro comprometido. Utilizou-se na an?lise estat?stica, o test t de student pareado para identificar as diferen?as do reflexo H, lat?ncia e EMG do membro comprometido e n?o comprometido e para comparar os resultados antes e depois da aplica??o dos recursos. A ANOVA para amostras relacionadas foi utilizada para identificar as diferen?as entre os recursos utilizados. Atribuiu-se para os testes estat?sticos o n?vel de signific?ncia de 5%. A amplitude pico a pico do reflexo H m?ximo normalizado pela resposta motora m?xima (Hm?x/Mm?x), mostrou-se significativamente aumentada no membro comprometido (p=0.0245). A lat?ncia do reflexo H reduziu no membro comprometido, com essa redu??o sendo estatisticamente significativa (p=0,0375). A atividade eletromiogr?fica se mostrou diminu?da no membro comprometido (p< 0.0001). Depois da TENS houve uma diminui??o da rela??o Hm?x/Mm?x (0.60?0.16 versus 0.49.?0.18; P = 0.0006). No entanto, logo ap?s a aplica??o do gelo houve um aumento da rela??o Hm?x/Mm?x (0.58 ? 0,15 para 0.77 ? 0.13, P=0,0007) e aumento da lat?ncia do sinal (30.41 ? 1.87 versus 33.24 ? 2.19; P=0.0001). A atividade eletromiogr?fica n?o foi alterada significativamente por nenhum recurso. Foram encontradas diferen?as estatisticamente significativas quando a raz?o Hm?x/Mm?x (P<0.0001) e lat?ncia do reflexo H (P<0.0001) foram comparadas entre o p?s-TENS, P?s- crioterapia e controle. Pode-se concluir que a TENS pode ser utilizada para fins de redu??o imediata da espasticidade, e que a crioterapia pode aumentar o estado de hiperreflexia nos pacientes esp?ticos. Entretanto, a diminui??o ou o aumento da espasticidade n?o ocasionou altera??o na atividade eletromiogr?fica do m?sculo antagonista ao esp?stico

Antecedendo movimentos voluntariamente gerados, existe atividade neuronal encefálica que se inicia alguns segundos antes da execução deste movimento. Esta atividade preparatória é responsável pela elaboração de um plano de execução que alcança a via final comum para realização de um ato motor voluntário, os motoneurônios. Entretanto, na última década, evidências apontam para a participação de circuitos neuronais na medula espinhal apresentando padrão de atividade similar aos padrões observados em áreas encefálicas e que, possivelmente, estaria relacionado a uma atividade preparatória para o movimento voluntariamente gerado. Por este motivo, o presente trabalho teve por objetivo verificar a atividade de circuitos neuronais na medula espinhal durante diferentes instantes de proximidade da ação voluntariamente gerada em paradigma de tarefa motora com período de instrução. Para isso, inicialmente, 15 sujeitos saudáveis, sem histórico de doença neuromuscular foram submetidos ao protocolo experimental. O protocolo experimental constituiu-se do processo de recrutamento dos sujeitos, sua preparação para o ensaio dentro do ambiente experimental, bem como as orientações necessárias para execução dos procedimentos e paradigmas. Os procedimentos referem-se às etapas realizadas para captação do reflexo H, bem como desta captação sob a influência de técnica de condicionamento por inibição pré-sináptica. Essa captação ocorreu em janelas de aquisição em que o sujeito encontrava-se em repouso e em três instantes de expectativa para a execução de ação voluntária, estando o músculo sóleo atuando como agonista (flexão plantar) ou antagonista (dorsiflexão), em paradigma de tarefa motora voluntária com período de instrução. Após os registros, por meio de processamento dos sinais coletados, foi possível se calcular a amplitude pico-a-pico do reflexo H nas diferentes condições experimentais de proximidade da execução (1000, 600 e 200 milissegundos) e de atuação do músculo sóleo (agonista e antagonista) que foi usado para: (1) análise da variação da excitabilidade reflexa, em porcentagem da onda M máxima, (2) análise da ocorrência de inibição pré-sináptica e (3) análise da variação da inibição pré-sináptica, em porcentagem de inibição. Os resultados mostram que a porcentagem da onda M máxima aumentou significativamente nos três instantes de proximidade com os sujeitos estando em expectativa da execução da tarefa motora quando o músculo sóleo atuaria como agonista da contração, quando comparados com os registros obtidos nas mesmas condições em repouso. Contudo, somente a 200 ms da execução é que foi observado aumento da porcentagem da onda M máxima quando o músculo sóleo atuaria como antagonista. Inibição pré-sináptica ocorreu em todas as condições experimentais, contudo aumento significativo da porcentagem de inibição pré-sináptica foi somente observado a 200 ms da execução da tarefa motora em que o músculo sóleo atuaria como antagonista. Diferenças entre agonista e antagonista com relação ao padrão de excitabilidade reflexa foi somente observado a 600 ms de proximidade da execução da tarefa e essas diferenças com relação à porcentagem de inibição pré-sináptica foi somente detectada a 200 ms. Nossos resultados nos permitem concluir que circuitos neuronais na medula espinhal apresentam atividade no período preparatório para a execução de tarefa motora voluntária que podem estar relacionadas ao comportamento de expectativa da realização de uma ação motora eminente, bem como relacionada ao planejamento motor para a ação a longa proximidade da execução de movimentos. / There is brain activity preceding voluntary movements a few seconds before the execution of the movement. This preparatory activity is responsible for the execution plan that reaches the final common pathway, i.e., the motoneurons. In the last decade, there have been reports indicating the involvement of spinal cord circuits in the preparatory activity for movement. The present work has the objective of verifying the activity of spinal cord neuronal circuits at different times preceding a voluntary action, under an instructed delay period paradigm. Fifteen healthy subjects participated in the study. The protocol included an explanation of the experimental tasks. Electrophysiological recordings of the H reflex with and without presynaptic inhibition conditioning were employed. The epochs of H reflex recording were associated either with a resting period or with one of three pre-action periods. The subject received a cue at an appropriate time about the type of contraction: plantarflexion or dorsiflexion. Peak to peak H reflex values were computed in the control resting period and at 1000 ms, 600 ms and 200 ms before the action. Percent values of H amplitude with respect to maximum M values were computed as well as the level of presynaptic inhibition. The results have shown that the relative H reflex value increased significantly at the three premovement times for the soleus under an agonist contraction (i.e., plantarflexion) when compared to control. However, when the soleus was an antagonist to the contraction (i.e., dorsiflexion) there was a statistical difference in the H amplitude only at 200 ms before movement. Presynaptic inhibition occurred in all experimental conditions, however only at 200 ms before contraction there was a significant increase. Differences in reflex excitability between agonist and antagonist activity were only observed at 600 ms before action. On the other hand, differences in presynaptic inhibition were only found at 200 ms before contraction. The results indicated that spinal cord neuronal circuits are activated during the preparatory period preceding a voluntary action. These may be correlated with an expectancy behavior for the execution of an imminent motor action and also with the planning of a motor action at larger times preceding movement execution.

Le risque de chute est une problématique bien présente chez les personnes âgées ou ayant une atteinte neurologique et reflète un déficit des mécanismes neuronaux assurant l’équilibre. De précédentes études démontrent que l’intégration des informations sensorielles est essentielle au contrôle de l’équilibre et que l’inhibition présynaptique (IP) serait un mécanisme important dans le contrôle de la transmission sensorielle. Ainsi, le but de cette étude était d’identifier la contribution du mécanisme d’IP à l’induction de réponses posturales efficaces suite à une perturbation d’équilibre. Notre hypothèse est qu’une diminution d’IP contribuerait à l’induction des ces réponses, en augmentant l’influence de la rétroaction sensorielle sur les réseaux de neurones spinaux. Afin de démontrer cette hypothèse, nous avons d’abord évalué l’excitabilité spinale pendant les perturbations vers l’avant ou vers l’arrière, à l’aide du réflexe H. L’excitabilité spinale était modulée selon la direction de la perturbation et cette modulation survenait dès 75 ou 100 ms (p<0.05), soit avant l’induction des réactions posturales. Puis, à l’aide de techniques plus précises de convergence spinale, nous avons démontré que l’IP était diminuée dès 75 et 100 ms dans les deux directions, suggérant que la transmission des informations sensorielles vers la moelle épinière est accrue juste avant le déclenchement de la réponse posturale. Cette étude met en évidence un mécanisme-clé permettant d’augmenter la rétroaction des informations sensorielles nécessaires à l’induction de réponses posturales appropriées. L’évaluation de ce mécanisme pourrait mener à une meilleure identification des individus à risque de chute. / Falls are a significant problem among the elderly or persons with a neurological impairment, and reflect a deficit in the nervous mechanisms underlying postural control. Previous research shows that the integration of sensory feedback is a crucial component of postural control and that presynaptic inhibition (PSI) plays an important role in controlling the sensory processing of information. The aim of this study was to identify the contribution of PSI to the induction of effective postural responses following an unexpected balance perturbation. We hypothesized that a decrease in PSI would contribute to the induction of these responses by increasing the influence of sensory feedback onto spinal networks during the perturbation. First we assessed the level of spinal excitability during perturbations, using the soleus H-reflex. Results show that spinal excitability is modulated according to the direction of the perturbation (forward and backward tilts) and that this modulation occurs 75 and 100 ms after tilt-onset in all subjects (p<0.05). To further estimate changes in PSI, spatial facilitation techniques were used. PSI was shown to decrease in both perturbation directions shortly after tilt onset at 75 and 100 ms (p<0.05), suggesting an increase in sensory transmission in the spinal cord. These observations suggest that sensory feedback is critical for the induction of effective postural responses and that impaired sensory transmission or integration, due to CNS lesions or ageing, may lead to certain balance deficits. Identifying patients with such impairments may improve fall risk-assessment and prevention.

Title: Consequences of forced hypokinesia on human movement aparatus. Objectives: The aim of this study was to find out the influence of forced hypokinesia after total hip replacement on the excitability of α motoneurons. I deal with the changes of H-reflex and M-wave latencies and the changes of the recruitment curves. The results of the operated and non-operated (kontrol) lower limb were compared. Methods: Five volunteers 3 - 4 weeks after total hip replacement participated in this study. The age was 62,4 (± 3,01). The H-reflex was elicited by stimulation of tibial nerve in a poplitel fossa. The H-reflex and M-wave latencies and its recruitment curves were obtained. After that the values of the operated lower limb were compared with the non-operated one (control). The results were evaluated as case studies. The EMG device Grass Telefactor was used to detect the electrical potential of soleus muscle. The rectangular pulses of 0,5 ms duration were used for stimulation tibial nerve by Grass 88 Stimulator. Then the data were transduced by CED Power 1401 device. Results: We found out that the H-reflexes of both lower limbs were not elicited in the case study no. 2 and the H-reflex of a control lower limb was not elicited in case study no. 1. The stimulus intensities for eliciting H-reflex and M-wave...