Limit cycle behavior in spasticity: analysis and evaluation

The authors examined ankle clonus in four spastic subjects to determine whether this oscillatory behavior has the properties of a limit cycle, and whether it is driven by peripheral sensory input or by a spinal generator. Using Floquet Theory and Poincare sections to assess reflex stability, the authors found that cycle-to-cycle variability was small, such that the Floquet multipliers were always less than unity. Furthermore, the steady-state periodic orbit was not dependent on the initial position of the ankle. Both of these findings, coupled with strong correlations between the size of the applied load and the frequency of ankle movements and electromyogram burst frequency suggests that clonus behaves as a locally stable limit cycle driven from peripheral receptors. To better understand how nonlinear elements might produce stable oscillatory motion, the authors simulated the ankle stretch reflex response. They found that delays in the pathway caused the reflex to come on during the shortening phase of movement, so the additional reflex torque required to sustain oscillatory ankle movements was quite small. Furthermore, because the resistance to stretch is largely due to passive mechanics whose properties are quite stationary, the system is robust to small perturbations within the reflex pathway.

[1]  E. Walsh,et al.  Clonus: beats provoked by the application of a rhythmic force. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[2]  M R Dimitrijevic,et al.  Clonus: the role of central mechanisms. , 1980, Journal of neurology, neurosurgery, and psychiatry.

[3]  J. van den Berg,et al.  EMG to force processing I: An electrical analogue of the Hill muscle model. , 1981, Journal of biomechanics.

[4]  A. Nayfeh,et al.  Applied nonlinear dynamics : analytical, computational, and experimental methods , 1995 .

[5]  P. Rack,et al.  The ankle stretch reflexes in normal and spastic subjects. The response to sinusoidal movement. , 1984, Brain : a journal of neurology.

[6]  J. Houk,et al.  Dependence of dynamic response of spindle receptors on muscle length and velocity. , 1981, Journal of neurophysiology.

[7]  Y. Hurmuzlu,et al.  On the measurement of dynamic stability of human locomotion. , 1994, Journal of biomechanical engineering.

[8]  P D Neilson,et al.  Comparison of stretch reflexes and shortening reactions in activated normal subjects with those in Parkinson's disease , 1973, Journal of neurology, neurosurgery, and psychiatry.

[9]  H Rodgers,et al.  A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity , 1999, Clinical rehabilitation.

[10]  R. Stein,et al.  Frequency response of human soleus muscle. , 1976, Journal of neurophysiology.

[11]  D. Winter,et al.  Models of recruitment and rate coding organization in motor-unit pools. , 1993, Journal of neurophysiology.

[12]  B. Dobkin,et al.  Human lumbosacral spinal cord interprets loading during stepping. , 1997, Journal of neurophysiology.

[13]  Gerald L. Gottlieb,et al.  Physiological clonus in man , 1977, Experimental Neurology.

[14]  M D Binder,et al.  Computer simulation of the steady-state input-output function of the cat medial gastrocnemius motoneuron pool. , 1991, Journal of neurophysiology.

[15]  W Z Rymer,et al.  Quantitative relations between hypertonia and stretch reflex threshold in spastic hemiparesis , 1988, Annals of neurology.

[16]  R. Granit,et al.  Observations of clonus in the cat's soleus muscle. , 1959, Anales de la Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay.

[17]  A. Hof In vivo measurement of the series elasticity release curve of human triceps surae muscle , 1998 .

[18]  A. Rossi,et al.  Clonus in man: a rhythmic oscillation maintained by a reflex mechanism. , 1990, Electroencephalography and clinical neurophysiology.

[19]  W. Rymer,et al.  Spastic hypertonia: mechanisms and measurement. , 1989, Archives of physical medicine and rehabilitation.

[20]  W A Cook,et al.  Antagonistic muscles in the production of clonus in man , 1967, Neurology.

[21]  J. van den Berg,et al.  EMG to force processing II: Estimation of parameters of the Hill muscle model for the human triceps surae by means of a calfergometer. , 1981, Journal of biomechanics.

[22]  W Z Rymer,et al.  A simulation study of reflex instability in spasticity: origins of clonus. , 1999, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[23]  R. Stephenson A and V , 1962, The British journal of ophthalmology.