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J Appl Physiol (June 4, 2004). doi:10.1152/japplphysiol.01350.2003
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Submitted on December 16, 2003
Accepted on May 28, 2004

Neural Coupling Between Upper and Lower Limbs During Recumbent Stepping

Helen J Huang1* and Daniel P Ferris2

1 Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
2 Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA; Department of Movement Science, University of Michigan, Ann Arbor, Michigan, USA

* To whom correspondence should be addressed. E-mail: hjhuang{at}umich.edu.

During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e. self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally-driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with: 1) active upper and lower limbs at an easy resistance level (Active Arms & Legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (Self-Driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (Externally-Driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-Driven EMG amplitudes were always higher than Externally-Driven EMG amplitudes (ANOVA p < 0.05). As resistance and upper limb exertion increased, Self-Driven EMG amplitudes also increased. EMG bursts during Self-Driven and Active Arms & Legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity.




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