Spatial zones for muscle coactivation and the control of postural stability.

It is hypothesized that, depending on the motor task, the angular range of a joint may be subdivided into zones in which agonist and antagonist muscles are coactive, only one group of muscles is active or neither group is active. It is further hypothesized that central commands may change the size and location of these spatial zones. We investigated whether spatial zones are used by the nervous system and how they may be changed to provide postural stability of the elbow. We compared responses to sudden unloading of the elbow flexors in neurologically normal subjects with those in patients with postural control deficits due to unilateral hemispheric and/or subcortical lesions. By studying responses in patients, we sought to determine whether the specification of zones of agonist/antagonist muscle coactivation ("coactivation zones") may be essential for postural stability. At an initial elbow angle (130 degrees; full extension is 180 degrees), flexors were pre-activated by compensating an initial load which was equal to approximately 30% of the subject's maximal isometric voluntary contraction effort. Subjects were instructed not to correct the arm displacement elicited by a sudden decrease in the load. Data from 10 trials were collected at each of 4-6 final load levels (separated by 1.5-2 Nm) in order to map out the relationship between torque and angle in each subject. The procedure was repeated from a more flexed initial position of the elbow (100 degrees). EMG activity from two elbow flexors and two elbow extensors, as well as torque, velocity and joint position were recorded. Healthy control subjects and patients with mild clinical symptoms had coactivation zones or small silent zones around the final positions established after unloading. In these subjects, final positions of the limb were stable. Voluntary movement, i.e., transition of the limb from one initial position to another, was associated with a change in the location of the zone in articular space. The presence of large silent zones in patients with moderate or severe symptoms was correlated with postural instability and oscillations about the final position of the arm after unloading. The comparison of results from healthy and hemiparetic subjects implies that the central specification of the size and the location of a coactivation zone may be fundamental for the control of posture and movement.