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Schwartz, M. H.

Publications and source records attributed to Schwartz, M. H..

4 recordsLinked to original sources

Muscle synergies are flexibly recruited during gait pattern exploration using motor control-based biofeedback

Understanding how the central nervous system coordinates diverse motor outputs has been a topic of extensive investigation. While it is generally accepted that a small set of synergies underlies many common activities, such as walking, whether synergies are equally robust across a broader array of gait patterns or can be flexibly modified remains unclear. Here, we evaluated the extent to which synergies changed as nondisabled adults (n = 14) explored gait patterns using custom biofeedback. Secondarily, we used Bayesian Additive Regression Trees to identify factors which were predictive of synergy modulation. Participants performed 41.1 {+/-} 8.0 gait patterns using biofeedback, during which synergy recruitment changed depending on the type and magnitude of gait pattern modification. Specifically, a consistent set of synergies was recruited to accommodate small deviations from baseline, but additional synergies emerged for larger gait changes. Synergy complexity was similarly modulated; complexity decreased for 82.6% of the attempted gait patterns, however, distal gait mechanics were highly predictive of these changes. In particular, greater ankle dorsiflexion moments and knee flexion through stance, as well as greater knee extension moments at initial contact corresponded to a reduction in synergy complexity. Taken together, these results suggest that the central nervous system preferentially adopts a low-dimensional, largely invariant control strategy, but can modify that strategy to produce diverse gait patterns. Beyond improving understanding of how synergies are recruited during gait, study outcomes may also help identify parameters that can be targeted with interventions to alter synergies and improve motor control following neurological injury.

neuroscience↗

Number of Synergies Impacts Sensitivity of Gait to Weakness and Contracture

Muscle activity during gait can be described by a small set of synergies, weighted groups of muscles, that are often theorized to reflect underlying neural control. For people with neurologic injuries, like in cerebral palsy or stroke, even fewer (e.g., < 5) synergies are required to explain muscle activity during gait. This reduction in synergies is thought to reflect simplified control strategies and is associated with impairment severity and treatment outcomes. Individuals with neurologic injuries also develop secondary musculoskeletal impairments, like weakness or contracture, that can also impact gait. The combined impacts of simplified control and musculoskeletal impairments on gait remains unclear. In this study, we use a musculoskeletal model constrained to synergies to simulate unimpaired gait. We vary the number of synergies (3-5), while simulating muscle weakness and contracture to examine how altered control impacts sensitivity to muscle weakness and contracture. Our results highlight that reducing the number of synergies increases sensitivity to weakness and contracture. For example, simulations using five-synergy control tolerated 40% and 51% more knee extensor weakness than those using four- and three-synergy control, respectively. Furthermore, the model became increasingly sensitive to contracture and proximal muscle weakness, such as hamstring and hip flexor weakness, when constrained to four- and three-synergy control. However, the models sensitivity to weakness of the plantarflexors and smaller bi-articular muscles was not affected by the number of synergies. These findings provide insight into the interactions between altered control and musculoskeletal impairments, emphasizing the importance of incorporating both in future simulation studies.

bioengineering↗

Synergies analysis produces consistent results between motion analysis laboratories

AimThe dynamic motor control index during walking (walk-DMC) has been shown to be related to patient outcomes and there has been an increasing interest from motion analysis centers regarding using this metric in their own practice. However, the methods for computing the index reported in the literature are not consistent. Here we propose a standardized method and investigate if this leads to results that are consistent between laboratories. MethodComparisons of typically developing controls are made between three independent motion analysis centers. Comparisons are also made between the proposed and previously published methods. A program script to compute the walk-DMC was used for this study and is made freely available with this manuscript. ResultsUsing this script, results are highly consistent between three participating centers. The currently proposed method results in a wider distribution of walk-DMC values than those previously reported. InterpretationUsing consistent processing methods, synergy measures are equivalent between centers. The major differences between current and published data are attributed to the use of concatenation of several walking trials.

bioengineering↗

Spasticity reduction in children with cerebral palsy is not associated with reduced energy consumption during walking

BackgroundThe average energy consumption during walking of children with cerebral palsy (CP) is over two times of that of typically developing (TD) children and fatigue is one of the top complaints of children with CP and their families. Spasticity has been theorized to contribute to increased energy consumption during walking in CP, but its role remains unclear.\n\nMethodsWe retrospectively compared the energy consumption of walking in children with diplegic CP before and after selective dorsal rhizotomy (SDR), a surgery that reduces spasticity. A control group of participants with CP who also underwent gait analysis but did not undergo SDR was matched to the SDR group by pre-surgery age, spasticity, and energy consumption. Energy consumption and spasticity were compared at baseline and follow-up for both groups.\n\nFindingsAs expected, the SDR group has a significantly greater decrease (-44%) in spasticity compared to matched peers with CP who did not undergo SDR (-16%, P<0.001). While both groups had a reduction in energy consumption between visits (12 % SDR and 14% no-SDR), there was no difference in the change in energy consumption between groups (P=0.4).\n\nInterpretation: Reducing spasticity did not contribute to greater reductions in energy consumption, suggesting that spasticity has minimal impact on elevated energy consumption during walking for children with CP. Energy consumption and spasticity decrease with age among children with CP. Identifying matched control groups of peers with CP is critical for research involving children with CP to account for changes due to development.\n\nHighlightsO_LIEnergy consumption is not reduced after rhizotomy compared to matched peers\nC_LIO_LISpasticity has minimal contribution to elevated energy during walking\nC_LIO_LIMatched control groups are critical in cerebral palsy research\nC_LI

bioengineering↗