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[PMID]:28457998
[Au] Autor:Karacan I; Cidem M; Cidem M; Türker KS
[Ad] Endereço:Physical Medicine and Rehabilitation Department, Bagcilar Training and Research Hospital, Istanbul, Turkey. Electronic address: ilhankaracan@hotmail.com.
[Ti] Título:Whole-body vibration induces distinct reflex patterns in human soleus muscle.
[So] Source:J Electromyogr Kinesiol;34:93-101, 2017 Jun.
[Is] ISSN:1873-5711
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The neuronal mechanisms underlying whole body vibration (WBV)-induced muscular reflex (WBV-IMR) are not well understood. To define a possible pathway for WBV-IMR, this study investigated the effects of WBV amplitude on WBV-IMR latency by surface electromyography analysis of the soleus muscle in human adult volunteers. The tendon (T) reflex was also induced to evaluate the level of presynaptic Ia inhibition during WBV. WBV-IMR latency was shorter when induced by low- as compared to medium- or high-amplitude WBV (33.9±5.3msvs. 43.8±3.6 and 44.1±4.2ms, respectively). There was no difference in latencies between T-reflex elicited before WBV (33.8±2.4ms) and WBV-IMR induced by low-amplitude WBV. Presynaptic Ia inhibition was absent during low-amplitude WBV but was present during medium- and high-amplitude WBV. Consequently, WBV induces short- or long-latency reflexes depending on the vibration amplitude. During low-amplitude WBV, muscle spindle activation may induce the short- but not the long-latency WBV-IMR. Furthermore, unlike the higher amplitude WBV, low-amplitude WBV does not induce presynaptic inhibition at the Ia synaptic terminals.
[Mh] Termos MeSH primário: Músculo Esquelético/fisiologia
Reflexo de Estiramento
Vibração/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Contração Muscular
Modalidades de Fisioterapia
Tempo de Reação
Vibração/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171207
[Lr] Data última revisão:
171207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28945740
[Au] Autor:Blum KP; Lamotte D'Incamps B; Zytnicki D; Ting LH
[Ad] Endereço:Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia, United States of America.
[Ti] Título:Force encoding in muscle spindles during stretch of passive muscle.
[So] Source:PLoS Comput Biol;13(9):e1005767, 2017 Sep.
[Is] ISSN:1553-7358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Muscle spindle proprioceptive receptors play a primary role in encoding the effects of external mechanical perturbations to the body. During externally-imposed stretches of passive, i.e. electrically-quiescent, muscles, the instantaneous firing rates (IFRs) of muscle spindles are associated with characteristics of stretch such as length and velocity. However, even in passive muscle, there are history-dependent transients of muscle spindle firing that are not uniquely related to muscle length and velocity, nor reproduced by current muscle spindle models. These include acceleration-dependent initial bursts, increased dynamic response to stretch velocity if a muscle has been isometric, and rate relaxation, i.e., a decrease in tonic IFR when a muscle is held at a constant length after being stretched. We collected muscle spindle spike trains across a variety of muscle stretch kinematic conditions, including systematic changes in peak length, velocity, and acceleration. We demonstrate that muscle spindle primary afferents in passive muscle fire in direct relationship to muscle force-related variables, rather than length-related variables. Linear combinations of whole muscle-tendon force and the first time derivative of force (dF/dt) predict the entire time course of transient IFRs in muscle spindle Ia afferents during stretch (i.e., lengthening) of passive muscle, including the initial burst, the dynamic response to lengthening, and rate relaxation following lengthening. Similar to acceleration scaling found previously in postural responses to perturbations, initial burst amplitude scaled equally well to initial stretch acceleration or dF/dt, though later transients were only described by dF/dt. The transient increase in dF/dt at the onset of lengthening reflects muscle short-range stiffness due to cross-bridge dynamics. Our work demonstrates a critical role of muscle cross-bridge dynamics in history-dependent muscle spindle IFRs in passive muscle lengthening conditions relevant to the detection and sensorimotor response to mechanical perturbations to the body, and to previously-described history-dependence in perception of limb position.
[Mh] Termos MeSH primário: Potenciais de Ação/fisiologia
Mecanotransdução Celular/fisiologia
Modelos Biológicos
Fusos Musculares/fisiologia
Músculo Esquelético/fisiologia
Reflexo de Estiramento/fisiologia
[Mh] Termos MeSH secundário: Simulação por Computador
Módulo de Elasticidade/fisiologia
Seres Humanos
Estimulação Física
Estresse Mecânico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170926
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pcbi.1005767


  3 / 3250 MEDLINE  
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[PMID]:28855493
[Au] Autor:Yamakawa T; Mizuta K; Kurokawa K; Nagasawa H; Yamada T; Suzuki E; Wada M
[Ad] Endereço:Department of Neurology, Yamagata Prefectural Central Hospital.
[Ti] Título:Clinical characteristics of 17 adult patients with epidemic myalgia associated with human parechovirus type 3 infection.
[So] Source:Rinsho Shinkeigaku;57(9):485-491, 2017 09 30.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We investigated 17 adult cases (14 males and 3 females) of myalgia induced by human parechovirus type 3 (HPeV3) infection, treated during the summers of 2008, 2011, 2014, and 2016. The patients were aged between 21 and 50 years. The limbs and trunk of all patients were affected, and severe myalgia, muscle weakness, and decreased grip strength were observed. In addition to myalgia and muscle weakness, symptoms included fever in 14 (82%), upper respiratory inflammation in 8 (47%), gastroenteritis in 4 (24%), and scrotal pain in 4 (29% of males) patients. Tendon reflexes were preserved, and serum creatine kinase level increased in all but 1 patient. Spinal MRI was performed for 3 patients, with normal results. Musculoskeletal MRI scans showed abnormal signals in the femoral muscles in 2 of 5 patients. In a nerve conduction test, the frequency of F wave appearance in the median nerve was 40% or less in 5 of 9 patients, and repeater F waves were seen in 2 patients. Of these, 7 patients had infants in their families, and developed fever around the same time; they may have been infected by these infants. All patients recovered within 1-2 weeks. HPeV3 infection is characterized by severe myalgia, and is frequently observed in summer every 2-3 years.
[Mh] Termos MeSH primário: Parechovirus
Infecções por Picornaviridae/complicações
Infecções por Picornaviridae/virologia
Pleurodinia Epidêmica/etiologia
Pleurodinia Epidêmica/virologia
[Mh] Termos MeSH secundário: Adulto
Surtos de Doenças
Feminino
Febre
Seres Humanos
Lactente
Japão/epidemiologia
Angiografia por Ressonância Magnética
Masculino
Meia-Idade
Debilidade Muscular
Músculo Esquelético/diagnóstico por imagem
Condução Nervosa
Infecções por Picornaviridae/epidemiologia
Infecções por Picornaviridae/fisiopatologia
Pleurodinia Epidêmica/epidemiologia
Pleurodinia Epidêmica/fisiopatologia
Reflexo de Estiramento
Estações do Ano
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001035


  4 / 3250 MEDLINE  
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[PMID]:28826019
[Au] Autor:Turpin NA; Feldman AG; Levin MF
[Ad] Endereço:Department of Neuroscience, Montreal, QC, Canada; Institute of Biomedical Engineering, University of Montreal, Montreal, QC, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
[Ti] Título:Stretch-reflex threshold modulation during active elbow movements in post-stroke survivors with spasticity.
[So] Source:Clin Neurophysiol;128(10):1891-1897, 2017 Oct.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Voluntary movements post-stroke are affected by abnormal muscle activation due to exaggerated stretch reflexes (SRs). We examined the ability of post-stroke subjects to regulate SRs in spastic muscles. METHODS: Elbow flexor and extensor EMGs and joint angle were recorded in 13 subjects with chronic post-stroke spasticity. Muscles were either stretched passively (relaxed arm) or actively (antagonist contraction) at different velocities. Velocity-dependent SR thresholds were defined as angles where stretched muscle EMG exceeded 3SDs of baseline. Sensitivity of SRs to stretch velocity was defined as µ. The regression through thresholds was interpolated to zero velocity to obtain the tonic SR threshold (TSRT) angle. RESULTS: Compared to passive stretches, TSRTs during active motion occurred at longer muscle lengths (i.e., increased in flexors and decreased in extensors by 10-40°). Values of µ increased by 1.5-4.0. Changes in flexor TSRTs during active compared to passive stretches were correlated with clinical spasticity (r=-0.68) and arm motor impairment (r=0.81). CONCLUSIONS: Spasticity thresholds measured at rest were modulated during active movement. Arm motor impairments were related to the ability to modulate SR thresholds between the two states rather than to passive-state values. SIGNIFICANCE: Relationship between spasticity and movement disorders may be explained by deficits in SR threshold range of regulation and modifiability, representing a measure of stroke-related sensorimotor deficits.
[Mh] Termos MeSH primário: Articulação do Cotovelo/fisiologia
Movimento/fisiologia
Espasticidade Muscular/fisiopatologia
Reflexo de Estiramento/fisiologia
Limiar Sensorial/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Espasticidade Muscular/diagnóstico
Espasticidade Muscular/etiologia
Acidente Vascular Cerebral/complicações
Acidente Vascular Cerebral/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170822
[St] Status:MEDLINE


  5 / 3250 MEDLINE  
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[PMID]:28818139
[Au] Autor:Paloski WH; Reschke MF; Feiveson AH
[Ti] Título:Bed Rest and Intermittent Centrifugation Effects on Human Balance and Neuromotor Reflexes.
[So] Source:Aerosp Med Hum Perform;88(9):812-818, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The effects of repeated centrifugation in association with head-down tilt (HDT) bed rest (BR) on the mediation of basic reflexes associated with the major postural muscles was investigated as a potential countermeasure for maintaining balance control and neuromotor reflex function. METHODS: There were 15 male volunteers who were exposed to 21 d of 6° HDT-BR. Eight were treated with daily 1-h artificial gravity (AG) exposures aboard a short radius centrifuge that provided 1-g footward loading at heart level. The other seven served as HDT-BR control subjects. Balance control was assessed using a standard computerized dynamic posturography (CDP) protocol that was modified by adding low-frequency pitch-plane head movements. Neuromotor reflex function was assessed using tendon stretch reflexes (MSR) and functional stretch reflex (FSR) data collected from the triceps surae muscle group. RESULTS: CDP performance was degraded by HDT-BR in both groups (ranging from 24 to 26%), but was unaffected by AG. BR also degraded MSR and FSR functions in both groups, with increased peak reflex latencies between 1.5 and 1.95 ms, but AG maintained pre-BR latencies for the MSR subjects. DISCUSSION: AG exposure did not modify balance control from pre-BR responses, but did help prevent decrements in FSR latencies post-BR.Paloski WH, Reschke MF, Feiveson AH. Bed rest and intermittent centrifugation effects on human balance and neuromotor reflexes. Aerosp Med Hum Perform. 2017; 88(9):812-818.
[Mh] Termos MeSH primário: Repouso em Cama
Gravidade Alterada
Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia
Intolerância Ortostática/fisiopatologia
Equilíbrio Postural/fisiologia
Reflexo de Estiramento/fisiologia
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Adulto
Voluntários Saudáveis
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4819.2017


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[PMID]:28816944
[Au] Autor:Annino G; Iellamo F; Palazzo F; Fusco A; Lombardo M; Campoli F; Padua E
[Ad] Endereço:aMovement Science Institute bDepartment of Systems Medicine, Faculty of Medicine and Surgery, Tor Vergata University of Rome cDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University dClinical Laboratory of Experimental Medicine, Fondazione Santa Lucia IRCCS eI.R.C.C.S. San Raffaele Pisana, Rome, Italy.
[Ti] Título:Acute changes in neuromuscular activity in vertical jump and flexibility after exposure to whole body vibration.
[So] Source:Medicine (Baltimore);96(33):e7629, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study was aimed to investigate the neuromuscular activity after 10 minutes of exposure to a whole body vibration (WBV) session.Twenty male young adults (24.8 ±â€Š2.5 year olds) were randomized and divided into 2 groups: the vibration group (VG) was exposed to 10 minutes of WBV at 35 Hz; performed 10 minutes of WBV at 35 Hz (displacement = 5 mm; magnitude = 5 g); the nonvibrated group (NVG) was the placebo group that maintained the same position on the plate but without exposure to any type of vibration. Subjects were evaluated with counter movement jump (CMJ) and muscular flexibility by means of electromyographic (EMG) analysis recorded on the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and gastrocnemius lateralis (LG).The 10 minutes of WBV showed an increase in muscular flexibility, associated with a decrease of EMG activity in BF (P < .01) and jump height. The latter was associated with a reduction of EMGs activity in BF (P < .01). The control group did not show any significant difference in all considered parameters.These results support the hypothesis that 10 minutes of WBV had effects on flexibility and explosive strength performance influencing neuromuscular behavior through inhibitor effects on antagonist muscles more than the stretch reflex activity on agonist muscles.
[Mh] Termos MeSH primário: Extremidade Inferior/fisiologia
Músculo Esquelético/fisiologia
Modalidades de Fisioterapia
Reflexo de Estiramento/fisiologia
Vibração/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Eletromiografia
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007629


  7 / 3250 MEDLINE  
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[PMID]:28662201
[Au] Autor:Masugi Y; Obata H; Inoue D; Kawashima N; Nakazawa K
[Ad] Endereço:Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Komaba, Meguro-ku, Tokyo, Japan.
[Ti] Título:Neural effects of muscle stretching on the spinal reflexes in multiple lower-limb muscles.
[So] Source:PLoS One;12(6):e0180275, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:While previous studies have shown that muscle stretching suppresses monosynaptic spinal reflex excitability in stretched muscles, its effects on non-stretched muscles is still largely unknown. The purpose of this study was to examine the effects of muscle stretching on monosynaptic spinal reflex in non-stretched muscles. Ten healthy male subjects participated in this study. Muscle stretching of the right triceps surae muscle was performed using a motor torque device for 1 minute. Three different dorsiflexion torques (at approximately 5, 10, and 15 Nm) were applied during muscle stretching. Spinal reflexes evoked by transcutaneous spinal cord stimulation were recorded in both the lower-limb muscles before, during, and at 0 and 5 min following muscle stretching. The amplitudes of the spinal reflexes in both the stretched and non-stretched muscles in the right (ipsilateral) leg were smaller during stretching compared to before, and at 0 and 5 min after stretching. Furthermore, the degree of reduction in the amplitude of the spinal reflexes in the right (ipsilateral) leg muscles increased significantly as the dorsiflexion torque (i.e., stretching of the right triceps surae muscles) increased. In contrast, reduction in the amplitude of the spinal reflexes with increasing dorsiflexion torque was not seen in the left (contralateral) leg muscles. Our results clearly indicate that muscle stretching has inhibitory effects on monosynaptic spinal reflexes, not only in stretched muscles, but also in non-stretched muscles of the ipsilateral leg.
[Mh] Termos MeSH primário: Perna (Membro)/fisiologia
Músculo Esquelético/fisiologia
Reflexo de Estiramento
Medula Espinal/fisiologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180275


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[PMID]:28214063
[Au] Autor:Muñiz AE
[Ad] Endereço:827 Via Del Sur, Mesquite, TX 77401. Electronic address: antonio.muniz2050@gmail.com.
[Ti] Título:Multiple cranial nerve neuropathies, ataxia and, areflexia: Miller Fisher syndrome in a child and review.
[So] Source:Am J Emerg Med;35(4):661.e1-661.e4, 2017 04.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ataxia/etiologia
Doenças dos Nervos Cranianos/etiologia
Síndrome de Miller Fisher/diagnóstico
[Mh] Termos MeSH secundário: Ataxia/diagnóstico
Pré-Escolar
Doenças dos Nervos Cranianos/diagnóstico
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Síndrome de Miller Fisher/complicações
Reflexo de Estiramento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE


  9 / 3250 MEDLINE  
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[PMID]:28113221
[Au] Autor:Jalaleddini K; Tehrani ES; Kearney RE
[Ti] Título:A Subspace Approach to the Structural Decomposition and Identification of Ankle Joint Dynamic Stiffness.
[So] Source:IEEE Trans Biomed Eng;64(6):1357-1368, 2017 Jun.
[Is] ISSN:1558-2531
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The purpose of this paper is to present a structural decomposition subspace (SDSS) method for decomposition of the joint torque to intrinsic, reflexive, and voluntary torques and identification of joint dynamic stiffness. METHODS: First, it formulates a novel state-space representation for the joint dynamic stiffness modeled by a parallel-cascade structure with a concise parameter set that provides a direct link between the state-space representation matrices and the parallel-cascade parameters. Second, it presents a subspace method for the identification of the new state-space model that involves two steps: 1) the decomposition of the intrinsic and reflex pathways and 2) the identification of an impulse response model of the intrinsic pathway and a Hammerstein model of the reflex pathway. RESULTS: Extensive simulation studies demonstrate that SDSS has significant performance advantages over some other methods. Thus, SDSS was more robust under high noise conditions, converging where others failed; it was more accurate, giving estimates with lower bias and random errors. The method also worked well in practice and yielded high-quality estimates of intrinsic and reflex stiffnesses when applied to experimental data at three muscle activation levels. CONCLUSION: The simulation and experimental results demonstrate that SDSS accurately decomposes the intrinsic and reflex torques and provides accurate estimates of physiologically meaningful parameters. SIGNIFICANCE: SDSS will be a valuable tool for studying joint stiffness under functionally important conditions. It has important clinical implications for the diagnosis, assessment, objective quantification, and monitoring of neuromuscular diseases that change the muscle tone.
[Mh] Termos MeSH primário: Articulação do Tornozelo/fisiologia
Módulo de Elasticidade/fisiologia
Modelos Biológicos
Contração Muscular/fisiologia
Músculo Esquelético/fisiologia
Reflexo de Estiramento/fisiologia
[Mh] Termos MeSH secundário: Simulação por Computador
Seres Humanos
Amplitude de Movimento Articular/fisiologia
Estresse Mecânico
Torque
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1109/TBME.2016.2604293


  10 / 3250 MEDLINE  
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[PMID]:28061380
[Au] Autor:Forghani A; Preuss R; Milner T
[Ad] Endereço:Center for Applied Biomechanics, University of Virginia, Charlottesville, USA. Electronic address: af5yr@virginia.edu.
[Ti] Título:Postural response characterization of standing humans to multi-directional, predictable and unpredictable perturbations to the arm.
[So] Source:J Electromyogr Kinesiol;32:83-92, 2017 Feb.
[Is] ISSN:1873-5711
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:When the arm of a standing human is perturbed in an unpredictable direction, postural muscles are activated at latencies as short as 50-110ms. While the motion of the body clearly progresses in hand-to-leg sequence, there is no systematic muscle activation sequence from the arm to the leg muscles, suggesting that the activation of the muscles is not likely the result of local stretch reflexes. In fact, the lower limb muscles are activated before the upright posture is significantly disturbed. The short-latency activation amplitude and the activation probability are clearly tuned to the direction of the arm perturbation for both rostral and caudal muscles. The effect of central set on the short-latency response has been investigated by manipulating the predictability of the perturbations. Possible underlying neural mechanisms have been discussed.
[Mh] Termos MeSH primário: Braço/fisiologia
Postura
[Mh] Termos MeSH secundário: Adulto
Eletromiografia/métodos
Feminino
Seres Humanos
Perna (Membro)/fisiologia
Masculino
Músculo Esquelético/fisiologia
Tempo de Reação
Reflexo de Estiramento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE



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