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Recent studies have investigated muscle synergies as biomarkers for stroke, but it remains controversial if muscle synergies and clinical observation convey the same information on motor impairment. We aim to identify whether muscle synergies and clinical scales convey the same information or not. Post-stroke patients were administered an upper limb treatment. Before (T0) and after (T1) treatment, we assessed motor performance with clinical scales and motor output with EMG-derived muscle synergies. We implemented an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) to identify the underlying relationships among all variables, at T0 and T1, and a general linear regression model to infer any relationships between the similarity between the affected and unaffected synergies (Median-sp) and clinical outcomes at T0. Clinical variables improved with rehabilitation whereas muscle-synergy parameters did not show any significant change. EFA and CFA showed that clinical variables and muscle-synergy parameters (except Median-sp) were grouped into different factors. Regression model showed that Median-sp could be well predicted by clinical scales. The information underlying clinical scales and muscle synergies are therefore different. However, clinical scales well predicted the similarity between the affected and unaffected synergies. Our results may have implications on personalizing rehabilitation protocols.

In the study of muscle synergies during the maintenance of single-leg stance (SLS) there are methodological issues that must be taken into account before performing the synergy extraction. In particular, it is important to distinguish between epochs of surface electromyographic (sEMG) signals corresponding to a 'good' balance control during the SLS test, from those characterized by an 'excessive' body sway. The aim of this work is to assess the robustness in the segmentation and selection of sEMG signal epochs to be chosen as input for the synergy extraction algorithm. The robustness is evaluated in terms of: 1) consistency of the number of muscle synergies, and 2) weight vector correlation. Our results show that the same number of muscle synergies and similar weight vectors are obtained, independently from the threshold chosen to build the segmentation mask. The methodology proposed may help the interpretation of muscle synergies in SLS test.

Background The above-knee amputation of a lower limb is a severe impairment that affects significantly the ability to walk; considering this, a complex adaptation strategy at the neuromuscular level is needed in order to be able to move safely with a prosthetic knee. In literature, it has been demonstrated that muscle activity during walking can be described via the activation of a small set of muscle synergies. The analysis of the composition and the time activation profiles of such synergies have been found to be a valid tool for the description of the motor control schemes in pathological subjects. Methods In this study, we used muscle synergy analysis techniques to characterize the differences in the modular motor control schemes between a population of 14 people with trans-femoral amputation and 12 healthy subjects walking at two different (slow and normal self-selected) speeds. Muscle synergies were extracted from a 12 lower-limb muscles sEMG recording via non-negative matrix factorization. Equivalence of the synergy vectors was quantified by a cross-validation procedure, while differences in terms of time activation coefficients were evaluated through the analysis of the activity in the different gait sub-phases. Results Four synergies were able to reconstruct the muscle activity in all subjects. The spatial component of the synergy vectors did not change in all the analysed populations, while differences were present in the activity during the sound limb’s stance phase. Main features of people with trans-femoral amputation’s muscle synergy recruitment are a prolonged activation of the module composed of calf muscles and an additional activity of the hamstrings’ module before and after the prosthetic heel strike. Conclusions Synergy-based results highlight how, although the complexity and the spatial organization of motor control schemes are the same found in healthy subjects, substantial differences are present in the synergies’ recruitment of people with trans femoral amputation. In particular, the most critical task during the gait cycle is the weight transfer from the sound limb to the prosthetic one. Future studies will integrate these results with the dynamics of movement, aiming to a complete neuro-mechanical characterization of people with trans-femoral amputation’s walking strategies that can be used to improve the rehabilitation therapies.

The aim of this study was to investigate the muscle coordination underlying pedaling in untrained subjects by using the muscle synergies paradigm, and to connect it with the inter-individual variability of EMG patterns and applied forces. Nine subjects performed a pedaling exercise on a cycle-simulator. Applied forces were recorded by means of instrumented pedals able to measure two force components. EMG signals were recorded from eight muscles of the dominant leg, and Nonnegative Matrix Factorization was applied to extract muscle synergy vectors W and time-varying activation coefficients H. Inter-individual variability was assessed for EMG patterns, force profiles, and H. Four modules were sufficient to reconstruct the muscle activation repertoire for all the subjects (variance accounted for >90% for each muscle). These modules were found to be highly similar between subjects in terms of W (mean r = .89), while most of the variability in force profiles and EMG patterns was reflected, in the muscle synergy structure, in the variability of H. These four modules have a functional interpretation when related to force distribution along the pedaling cycle, and the structure of W is shared with that present in human walking, suggesting the existence of a modular motor control in humans.

Recent studies have reported evidence that the motor system may rely on a modular organization, even if this behavior has yet to be confirmed during motor adaptation. The aim of the present study is to investigate the modular motor control mechanisms underlying the execution of pedaling by untrained subjects in different biomechanical conditions. We use the muscle synergies framework to characterize the muscle coordination of 11 subjects pedaling under two different conditions. The first one consists of a pedaling exercise with a strategy freely chosen by the subjects (Preferred Pedaling Technique, PPT), while the second condition constrains the gesture by means of a real time visual feedback of mechanical effectiveness (Effective Pedaling Technique, EPT). Pedal forces, recorded using a pair of instrumented pedals, were used to calculate the Index of Effectiveness (IE). EMG signals were recorded from eight muscles of the dominant leg and Non-negative Matrix Factorization (NMF) was applied for the extraction of muscle synergies. All the synergy vectors, extracted cycle by cycle for each subject, were pooled across subjects and conditions and underwent a 2-dimensional Sammon's non-linear mapping. Seven representative clusters were identified on the Sammon's projection, and the corresponding eight-dimensional synergy vectors were used to reconstruct the repertoire of muscle activation for all subjects and all pedaling conditions (VAF > 0.8 for each individual muscle pattern). Only 5 out of the 7 identified modules were used by the subjects during the PPT pedaling condition, while 2 additional modules were found specific for the pedaling condition EPT. The temporal recruitment of three identified modules was highly correlated with IE. The structure of the identified modules was found similar to that extracted in other studies of human walking, partly confirming the existence of shared and task specific muscle synergies, and providing further evidence on the modularity of the motor system.

According to the model of muscle synergies, the central nervous system (CNS) is organised in a modular structure, such that any muscle activation can be produced as a linear superposition of predefined time-varying profiles (i.e. synergies). This organisation might contribute to simplify the control of the musculoskeletal apparatus. Taking inspiration from these findings, we propose a method to identify the synergies that can be used to control a given dynamical system for the task of tracking a set of trajectories. Further, we show how the same approach can be applied to assess the impact of the number of synergies on the performance of the control method. From the theoretical point of view, we provide a novel interpretation of synergies inspired by the Karhunen- Loève decomposition; furthermore, our method suggests that the quality of a set of synergies should be measured in task space rather then in input space.

Cycling training is strongly applied in post-stroke rehabilitation, but how its modular control is altered soon after stroke has been not analyzed yet. EMG signals from 9 leg muscles and pedal forces were measured bilaterally during recumbent pedaling in 16 post-acute stroke patients and 12 age-matched healthy controls. Patients were asked to walk over a GaitRite mat and standard gait parameters were computed. Four muscle synergies were extracted through nonnegative matrix factorization in healthy subjects and patients unaffected legs. Two to four synergies were identified in the affected sides and the number of synergies significantly correlated with the Motricity Index (Spearman’s coefficient = 0.521). The reduced coordination complexity resulted in a reduced biomechanical performance, with the two-module sub-group showing the lowest work production and mechanical effectiveness in the affected side. These patients also exhibited locomotor impairments (reduced gait speed, asymmetrical stance time, prolonged double support time). Significant correlations were found between cycling-based metrics and gait parameters, suggesting that neuro-mechanical quantities of pedaling can inform on walking dysfunctions. Our findings support the use of pedaling as a rehabilitation method and an assessment tool after stroke, mainly in the early phase, when patients can be unable to perform a safe and active gait training. Electronic supplementary material The online version of this article (doi:10.1007/s10439-016-1660-0) contains supplementary material, which is available to authorized users.