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ABSTRACT Purpose Numerous exercise interventions to enhance motor function in cerebral palsy (CP) have been proposed, with varying degrees of effectiveness. Since motor function requires a combination of muscle strength, joint flexibility... more
ABSTRACT Purpose Numerous exercise interventions to enhance motor function in cerebral palsy (CP) have been proposed, with varying degrees of effectiveness. Since motor function requires a combination of muscle strength, joint flexibility and motor coordination, we designed a supervised multicomponent exercise intervention (EXECP) for individuals with CP. Our aim was to evaluate the effects of the EXECP intervention and its retention after it ceased. Methods The EXECP intervention combined strength training for the lower limbs and trunk muscles, passive stretching for the lower limb muscles and inclined treadmill gait training. Eighteen participants with CP (mean age: 14, 13 males) were tested twice before the three-month intervention and twice after the intervention, each test separated by three months. Seventeen typically developing age and sex-matched controls were tested twice. Motor function was assessed with the six minutes walking test (6MWT) and the gross motor function measure (GMFM) dimensions D and E. Passive joint flexibility was measured with goniometry. Isometric and concentric muscle strength were assessed at the knee, ankle and trunk joints. Results The EXECP intervention successfully increased 6MWT (p < 0.001), GMFM (p = 0.004) and muscle strength for knee and trunk muscles (p < 0.05), although no changes were observed for ankle joint muscles. Hip and knee joint flexibility also increased (p < 0.05). After the retention period, all tested variables except the 6MWT and knee joint flexibility regressed and were not different from the pre-tests. Conclusions The improvements in strength, flexibility, and possibly motor coordination brought by the EXECP intervention were transferred to significant functional gains. The regression towards baseline after the intervention highlights that training must be a life-long decision for individuals with CP.
Individuals at risk of Developmental Coordination Disorder (DCD) have low levels of physical activity in childhood due to impaired motor competence; however, physical activity levels in adulthood have not been established. This study... more
Individuals at risk of Developmental Coordination Disorder (DCD) have low levels of physical activity in childhood due to impaired motor competence; however, physical activity levels in adulthood have not been established. This study sought to determine the impact of DCD risk on physical activity levels in adults using accelerometry measurement. Participants (n = 656) from the Arvo Ylppö Longitudinal Study cohort had their motor competence assessed at the age of five years, and their physical activity quantified via device assessment at the age of 25 years. Between group differences were assessed to differentiate physical activity measures for individuals based on DCD risk status, with general linear modeling performed to control for the effects of sex, body mass index (BMI), and maternal education. Participants at risk of DCD were found to have a lower total number of steps (d = 0.3, p = 0.022) than those not at risk. Statistical modeling indicated that DCD risk status increased time spent in sedentary light activity (β = 0.1, 95% CI 0.02 to 0.3, p = 0.026) and decreased time spent in vigorous physical activity via interaction with BMI (β = 0.04, 95% CI 0.001 to 0.1, p = 0.025). Sensitivity analysis found that visuomotor impairment did not significantly impact physical activity but did increase the role of DCD risk status in some models. This 20‐year‐longitudinal study indicated that DCD risk status continues to negatively impact on levels of physical activity into early adulthood.
Hyper-resistance is an increased resistance to passive muscle stretch, a common feature in neurological disorders. Stretch hyperreflexia, an exaggerated stretch reflex response, is the neural velocity-dependent component of... more
Hyper-resistance is an increased resistance to passive muscle stretch, a common feature in neurological disorders. Stretch hyperreflexia, an exaggerated stretch reflex response, is the neural velocity-dependent component of hyper-resistance, and has been quantitatively measured using the stretch reflex threshold (i.e., joint angle at the stretch reflex electromyographic onset). In this study, we introduce a correction in how the stretch reflex threshold is calculated, by accounting for the stretch reflex latency (i.e., time between the stretch reflex onset at the muscle spindles and its appearance in the electromyographic signal). Furthermore, we evaluated how this correction affects the stretch reflex threshold in children and young adults with spastic cerebral palsy. A motor-driven ankle dynamometer induced passive ankle dorsiflexions at four incremental velocities in 13 children with cerebral palsy (mean age: 13.5 years, eight males). The stretch reflex threshold for soleus and m...
Controlled assessment of functional cortical networks is an unmet need in the clinical research of noncooperative subjects, such as infants. We developed an automated, pneumatic stimulation method to actuate naturalistic movements of an... more
Controlled assessment of functional cortical networks is an unmet need in the clinical research of noncooperative subjects, such as infants. We developed an automated, pneumatic stimulation method to actuate naturalistic movements of an infant’s hand, as well as an analysis pipeline for assessing the elicited electroencephalography (EEG) responses and related cortical networks. Twenty newborn infants with perinatal asphyxia were recruited, including 7 with mild-to-moderate hypoxic–ischemic encephalopathy (HIE). Statistically significant corticokinematic coherence (CKC) was observed between repetitive hand movements and EEG in all infants, peaking near the contralateral sensorimotor cortex. CKC was robust to common sources of recording artifacts and to changes in vigilance state. A wide recruitment of cortical networks was observed with directed phase transfer entropy, also including areas ipsilateral to the stimulation. The extent of such recruited cortical networks was quantified u...
Measuring muscle forces in vivo is invasive and consequently indirect methods e.g., electromyography (EMG) are used in estimating muscular force production. The aim of the present paper was to examine what kind of effect the disruption of... more
Measuring muscle forces in vivo is invasive and consequently indirect methods e.g., electromyography (EMG) are used in estimating muscular force production. The aim of the present paper was to examine what kind of effect the disruption of the physiological signal caused by the innervation zone has in predicting the force/torque output from surface EMG. Twelve men (age 26 (SD ±3)years; height 179 (±6)cm; body mass 73 (±6)kg) volunteered as subjects. They were asked to perform maximal voluntary isometric contraction (MVC) in elbow flexion, and submaximal contractions at 10%, 20%, 30%, 40%, 50% and 75% of the recorded MVC. EMG was measured from biceps brachii muscle with an electrode grid of 5 columns×13 rows. Force-EMG relationships were determined from individual channels and as the global mean value. The relationship was deemed inconsistent if EMG value did not increase in successive force levels. Root mean squared errors were calculated for 3rd order polynomial fits. All subjects had at least one (4-52) inconsistent channel. Two subjects had inconsistent relationship calculated from the global mean. The mean root mean squared error calculated using leave one out method for the fits of the individual channels (0.33±0.17) was higher (P<0.001) than the error for the global mean fit (0.16±0.08). It seems that the disruption of the physiological signal caused by the innervation zone affects the consistency of the force-EMG relationship on single bipolar channel level. Multichannel EMG recordings used for predicting force overcame this disruption.
Cerebral palsy (CP) is the most common motor disorder in childhood. Recent studies in children with CP have associated weakened sensorimotor performance with impairments in the major brain white-matter (WM) structure, corpus callosum... more
Cerebral palsy (CP) is the most common motor disorder in childhood. Recent studies in children with CP have associated weakened sensorimotor performance with impairments in the major brain white-matter (WM) structure, corpus callosum (CC). However, the relationship between CC structure and lower extremity performance, specifically gait and balance, remains unknown. This study investigated the transcallosal WM structure and lower limb motor stability performance in adolescents aged 10–18 years with spastic hemiplegic (n = 18) or diplegic (n = 13) CP and in their age-matched controls (n = 34). The modern diffusion-weighted MRI analysis included the diffusivity properties of seven CC subparts and the transcallosal lower limb sensorimotor tract of the dominant hemisphere. Children with CP had comprehensive impairments in the cross-sectional area, fractional anisotropy, and mean diffusivity of the CC and sensorimotor tract. Additionally, the extent of WM alterations varied between hemipl...
Piitulainen, Harri Tapio Functional adaptation of sarcolemma to physical stress Jyväskylä: University of Jyväskylä, 2010, 103 p. (Studies in Sport, Physical Education and Health, ISSN 0356-1070; 150) ISBN 978-951-39-3951-9 It is known for... more
Piitulainen, Harri Tapio Functional adaptation of sarcolemma to physical stress Jyväskylä: University of Jyväskylä, 2010, 103 p. (Studies in Sport, Physical Education and Health, ISSN 0356-1070; 150) ISBN 978-951-39-3951-9 It is known for a century that repetitive muscle activity where active lengthening of a muscle takes place with adequate intensity causes muscle soreness and prolonged loss of its force production capability. However, the exact mechanisms for this phenomenon have remained unclear. There is morphological evidence suggesting disruption in membrane structures of the muscle fibres after such an exercise. However, it is unclear how this is reflected in the function of the membrane structures, such as action potential propagation over sarcolemma, which is a crucial event for muscle fibre contractility. The aim of the present research was to find further knowledge for this issue by investigating the adaptation of sarcolemmal function after intensive exercise models with ...
Background Individuals with cerebral palsy (CP) have problems in everyday tasks such as walking and climbing stairs due to a combination of neuromuscular impairments such as spasticity, muscle weakness, reduced joint flexibility and poor... more
Background Individuals with cerebral palsy (CP) have problems in everyday tasks such as walking and climbing stairs due to a combination of neuromuscular impairments such as spasticity, muscle weakness, reduced joint flexibility and poor coordination. Development of evidence-based interventions are in pivotal role in the development of better targeted rehabilitation of CP, and thus in maintaining their motor function and wellbeing. Our aim is to investigate the efficacy of an individually tailored, multifaceted exercise intervention (EXECP) in children and young adults with CP. EXECP is composed of strength, flexibility and gait training. Furthermore, this study aims to verify the short-term retention of the adaptations three months after the end of the EXECP intervention. Methods Twenty-four children and young adults with spastic CP will be recruited to participate in a 9-month research project with a 3-month training intervention, consisting of two to three 90-min sessions per wee...
Tämän tutkielman tarkoitus oli selvittää kirjallisuuteen perustuen mitä menetelmiä on käytetty lihasvaurion tutkimuksessa ja mikä on lihasvaurion syntymekanismi. Lisäksi tarkoituksena oli selvittää lisätutkimuksien tarvetta aiheesta,... more
Tämän tutkielman tarkoitus oli selvittää kirjallisuuteen perustuen mitä menetelmiä on käytetty lihasvaurion tutkimuksessa ja mikä on lihasvaurion syntymekanismi. Lisäksi tarkoituksena oli selvittää lisätutkimuksien tarvetta aiheesta, miten ja millä menetelmillä lihasvauriota tulisi tulevaisuudessa tutkia. Lihasvaurio syntyy raskaan fyysisen kuormituksen seurauksena. Lihasvaurio näkyy muutoksina solutasolla ja lihaksen toiminnan tasolla. Lihasvauriotutkimuksessa on käytetty laaja-alaisesti eri menetelmiä. Lihasvauriota on arvioitu lihaksen toimintakykyä kuvaavien-, vauriota suoraan kuvaavien- ja vauriosta epäsuorasti kertovien muuttujien avulla. Lihasvaurion syntymekanismi on vaiheittain etenevä lihaskudoksen rakenteiden de- ja regeneratiivisia prosesseja sisältävä tapahtuma. Monia mekanismeja on ehdotettu selittämään lihasvaurion synty- ja palautumisprosessia kuten lihasmekaaniset tekijät, lihaksen rakenteellisten proteiinien vaurioituminen, muutokset lihassolun kalsium homeostaasis...
Cortical proprioceptive processing can be investigated using corticokinematic coherence (CKC). The findings show that CKC method is sensitive to temporal stability in the stimulation sequence. Although both regular and irregular sequences... more
Cortical proprioceptive processing can be investigated using corticokinematic coherence (CKC). The findings show that CKC method is sensitive to temporal stability in the stimulation sequence. Although both regular and irregular sequences resulted in robust coherence, the regular stimulation sequence with pneumatic movement actuator is recommended to maximize coherence strength and reproducibility to allow better comparability between groups or populations.
Tämän tutkimuksen tarkoitus oli selvittää uupumukseen asti suoritetun venymis- lyhenemissykli tyyppisen kuormituksen vaikutuksia dystrofiinin, α-syntrofiinin ja Na+- kanavien vasta-ainevärjäytymiseen ja geenien ilmentymiseen heti ja kaksi... more
Tämän tutkimuksen tarkoitus oli selvittää uupumukseen asti suoritetun venymis- lyhenemissykli tyyppisen kuormituksen vaikutuksia dystrofiinin, α-syntrofiinin ja Na+- kanavien vasta-ainevärjäytymiseen ja geenien ilmentymiseen heti ja kaksi päivää kuormituksen jälkeen. Lisäksi tarkoituksena oli selvittää aiheuttaako kyseinen kuormitus muutoksia hermolihasjärjestelmän suorituskyvyssä tai elektromyografiassa. Lihasväsymyksen aiheuttamaa voimantuottokyvyn heikkenemistä on selitetty ärsytys- supistus koplauksen (ECC) häiriintymisellä, jossa sarkoplasmisen retikkelin (SR) Ca2+ kinetiika häiriintyy. Mahdollinen syy tälle häiriölle voi olla Na+-kanavien toiminnan häiriintyminen, jolloin sarkolemman aktiopotentiaalin (AP) johtumisominaisuudet heikkenevät. Solutukirangan proteiinilla, α- syntrofiinilla on todennäköisesti yhdessä dystrofiinin ja dystrobreviinin kanssa Na+-kanavia stabiloiva rooli, joten näiden solutukirangan proteiinien vaurio/häiriö saattaisi aiheuttaa Na+-kanavien toiminnalli...
Individual temporal spectral evolution (TSE) curves for all subjects (T0, n = 21; T1-month, n = 8;T1-year, n= 19) for tactile and proprioceptive stimuli at three different measurements (T0, T1-month, T1-year).
As humans, we seamlessly hold objects in our hands, and may even lose consciousness of these objects. This phenomenon raises the unsettled question of the involvement of the cerebral cortex, the core area for voluntary motor control, in... more
As humans, we seamlessly hold objects in our hands, and may even lose consciousness of these objects. This phenomenon raises the unsettled question of the involvement of the cerebral cortex, the core area for voluntary motor control, in dynamically maintaining steady muscle force. To address this issue, we measured magnetoencephalographic brain activity from healthy adults who maintained a steady pinch grip. Using a novel analysis approach, we uncovered fine-grained temporal modulations in the ∼20-Hz sensorimotor brain rhythm and its coupling with muscle activity, with respect to several aspects of muscle force (rate of increase/decrease or plateauing high/low). These modulations preceded changes in force features by ∼40 ms and possessed behavioral relevance, as less salient or absent modulation predicted a more stable force output. These findings have consequences for the existing theories regarding the functional role of cortico-muscular coupling, and suggest that steady muscle co...
DI-fusion, le Dépôt institutionnel numérique de l'ULB, est l'outil de référencementde la production scientifique de l'ULB.L'interface de recherche DI-fusion permet de consulter les... more
DI-fusion, le Dépôt institutionnel numérique de l'ULB, est l'outil de référencementde la production scientifique de l'ULB.L'interface de recherche DI-fusion permet de consulter les publications des chercheurs de l'ULB et les thèses qui y ont été défendues.
Studying white matter connections with tractography is a promising approach to understand the development of different brain processes, such as proprioception. An emerging method is to use functional brain imaging to select the cortical... more
Studying white matter connections with tractography is a promising approach to understand the development of different brain processes, such as proprioception. An emerging method is to use functional brain imaging to select the cortical seed points for tractography, which is considered to improve the functional relevance and validity of the studied connections. However, it is unknown whether different functional seeding methods affect the spatial and microstructural properties of the given white matter connection. Here, we compared functional magnetic resonance imaging, magnetoencephalography, and manual seeding of thalamocortical proprioceptive tracts for finger and ankle joints separately. We showed that all three seeding approaches resulted in robust thalamocortical tracts, even though there were significant differences in localization of the respective proprioceptive seed areas in the sensorimotor cortex, and in the microstructural properties of the obtained tracts. Our study sh...
To maintain steady motor output, distracting sensory stimuli need to be blocked. To study the effects of brief auditory and visual distractors on the human primary motor (M1) cortex, we monitored magnetoencephalographic (MEG) cortical... more
To maintain steady motor output, distracting sensory stimuli need to be blocked. To study the effects of brief auditory and visual distractors on the human primary motor (M1) cortex, we monitored magnetoencephalographic (MEG) cortical rhythms, electromyogram (EMG) of finger flexors, and corticomuscular coherence (CMC) during right-hand pinch (force 5-7% of maximum) while 1-kHz tones and checkerboard patterns were presented for 100 ms once every 3.5-5 s. Twenty-one subjects (out of twenty-two) showed statistically significant ∼20-Hz CMC. Both distractors elicited a covert startle-like response evident in changes of force and EMG (∼50% of the background variation) but without any visible movement, followed by ∼1-s enhancement of CMC (auditory on average by 75%, P < 0.001; visual by 33%, P < 0.05) and rolandic ∼20-Hz rhythm (auditory by 14%, P < 0.05; visual by 11%, P < 0.01). Directional coupling of coherence from muscle to the M1 cortex (EMG→MEG) increased for ∼0.5 s at the onset of the CMC enhancement, but only after auditory distractor (by 105%; P < 0.05), likely reflecting startle-related proprioceptive afference. The 20-Hz enhancements occurred in the left M1 cortex and were for the auditory stimuli preceded by an early suppression (by 7%, P < 0.05). Task-unrelated distractors modulated corticospinal coupling at ∼20 Hz. We propose that the distractors triggered covert startle-like responses, resulting in proprioceptive afference to the cortex, and that they also transiently disengaged the…
Corticokinematic coherence (CKC) quantifies the phase coupling between limb kinematics and cortical neurophysiological signals reflecting proprioceptive feedback to the primary sensorimotor (SM1) cortex. We studied CKC to proprioceptive... more
Corticokinematic coherence (CKC) quantifies the phase coupling between limb kinematics and cortical neurophysiological signals reflecting proprioceptive feedback to the primary sensorimotor (SM1) cortex. We studied CKC to proprioceptive stimulation (i.e. movement-actuator-evoked movements) of right-hand digits (index, middle, ring and little) performed simultaneously or separately. CKC was computed between magnetoencephalography (MEG) and finger acceleration signals. The strongest CKC was obtained by stimulating the fingers simultaneously at fixed 3-Hz frequency, and can, therefore, be recommended as design for fast functional localization of the hand area in the primary sensorimotor (SM1) cortex using MEG. The peaks of CKC sources were concentrated in the hand region of the SM1 cortex, but did not follow consistent somatotopic order. This result suggests that spatial specificity of MEG is not sufficient to separate proprioceptive finger representations of the same hand adequately o...
The most important message in this report is that the corticokinematic coherence (CKC) method is a feasible and reproducible tool to quantify, map, and follow cortical proprioceptive (“the movement sense”) processing using EEG that is... more
The most important message in this report is that the corticokinematic coherence (CKC) method is a feasible and reproducible tool to quantify, map, and follow cortical proprioceptive (“the movement sense”) processing using EEG that is more widely available for CKC recordings than previously used magnetoencephalographic designs, in basic research, but especially in clinical environments. We provide useful recommendations for optimal EEG derivations for cost-effective experimental designs, allowing large sample size studies.
Piitulainen, Harri 2006. Sarcolemmal excitability after eccentric exercise in man. Master thesis (Pro Gradu). Department of Biology of Physical Activity, University of Jyvaskyla, Finland. 49 pages. Experiments were carried out to test the... more
Piitulainen, Harri 2006. Sarcolemmal excitability after eccentric exercise in man. Master thesis (Pro Gradu). Department of Biology of Physical Activity, University of Jyvaskyla, Finland. 49 pages. Experiments were carried out to test the sarcolemmal excitability after intensive eccentric elbow flexor exercise (two sets of 20 repetitions) in humans. Electrically elicited surface compound muscle action potential (M-wave) properties from 30 s stimulation trains (20 Hz) were recorded from the biceps brachii muscle immediately after the exercise and during 48 h follow-up period. The results indicated that M-wave properties (area, amplitude, root mean square and duration) were reduced when measured immediately post-exercise. However, this was not the case two days after the exercise, although subjects had clear symptoms of delayed-onset muscle soreness and the maximal voluntary isometric and eccentric torques were still depressed by 12.2 ± 9 % (P < 0.001) and 17.7 ± 9 % (P < 0.001)...
DI-fusion, le Dépôt institutionnel numérique de l'ULB, est l'outil de référencementde la production scientifique de l'ULB.L'interface de recherche DI-fusion permet de consulter les... more
DI-fusion, le Dépôt institutionnel numérique de l'ULB, est l'outil de référencementde la production scientifique de l'ULB.L'interface de recherche DI-fusion permet de consulter les publications des chercheurs de l'ULB et les thèses qui y ont été défendues.
There is limited evidence about gait stability and its alteration by concurrent motor and cognitive tasks in children with cerebral palsy (CP). We examined gait stability and how it is altered by constrained cognitive or motor task in CP... more
There is limited evidence about gait stability and its alteration by concurrent motor and cognitive tasks in children with cerebral palsy (CP). We examined gait stability and how it is altered by constrained cognitive or motor task in CP and their typically developed (TD) controls. Gait kinematics were recorded using inertial-measurement units (IMU) from 18 patients with hemiplegia (13.5 ± 2.4 years), 12 with diplegia (13.0 ± 2.1 years), and 31 TD controls (13.5 ± 2.2 years) during unconstrained gait, and motor (carrying a tray) and cognitive (word naming) task constrained gait at preferred speed (~400 steps/task). Step duration, its standard deviation and refined-compound-multiscale entropy (RCME) were computed independently for vertical and resultant horizontal accelerations. Gait complexity was higher for patients with CP than TD in all tasks and directions (p < 0.001-0.01), being pronounced in vertical direction, cognitive task and for diplegic patients (p < 0.05-0.001). T...
Beta rhythm modulation has been used as a biomarker to reflect the functional state of the sensorimotor cortex in both healthy subjects and patients. Here, the effect of reduced alertness and active attention to the stimulus on beta... more
Beta rhythm modulation has been used as a biomarker to reflect the functional state of the sensorimotor cortex in both healthy subjects and patients. Here, the effect of reduced alertness and active attention to the stimulus on beta rhythm modulation was investigated. Beta rhythm modulation to tactile stimulation of the index finger was recorded simultaneously with MEG and EEG in 23 healthy subjects (mean 23, range 19–35 years). The temporal spectral evolution method was used to obtain the peak amplitudes of beta suppression and rebound in three different conditions (neutral, snooze, and attention). Neither snooze nor attention to the stimulus affected significantly the strength of beta suppression nor rebound, although a decrease in suppression and rebound strength was observed in some subjects with a more pronounced decrease of alertness. The reduction of alertness correlated with the decrease of suppression strength both in MEG (left hemisphere r = 0.49; right hemisphere r = 0.49...
In this article, we present the clinical indications and advances in the use of magnetoencephalography to map the primary sensorimotor (SM1) cortex in neurosurgical patients noninvasively. We emphasize the advantages of... more
In this article, we present the clinical indications and advances in the use of magnetoencephalography to map the primary sensorimotor (SM1) cortex in neurosurgical patients noninvasively. We emphasize the advantages of magnetoencephalography over sensorimotor mapping using functional magnetic resonance imaging. Recommendations to the referring physicians and the clinical magnetoencephalographers to achieve appropriate sensorimotor cortex mapping using magnetoencephalography are proposed. We finally provide some practical advice for the use of corticomuscular coherence, cortico-kinematic coherence, and mu rhythm suppression in this indication. Magnetoencephalography should now be considered as a method of reference for presurgical functional mapping of the sensorimotor cortex.

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