The present prognosis for the recovery of voluntary control of movement in patients diagnosed as motor complete is generally poor. Herein we introduce a novel and noninvasive stimulation strategy of painless transcutaneous electrical enabling motor control and a pharmacological enabling motor control strategy to neuromodulate the physiological state of the spinal cord. This neuromodulation enabled the spinal locomotor networks of individuals with motor complete paralysis for 2-6 years American Spinal Cord Injury Association Impairment Scale (AIS) to be re-engaged and trained. We showed that locomotor-like stepping could be induced without voluntary effort within a single test session using electrical stimulation and training. We also observed significant facilitation of voluntary influence on the stepping movements in the presence of stimulation over a 4-week period in each subject. Using these strategies we transformed brain-spinal neuronal networks from a dormant to a functional state sufficiently to enable recovery of voluntary movement in five out of five subjects. Pharmacological intervention combined with stimulation and training resulted in further improvement in voluntary motor control of stepping-like movements in all subjects. We also observed on-command selective activation of the gastrocnemius and soleus muscles when attempting to plantarflex. At the end of 18 weeks of weekly interventions the mean changes in the amplitude of voluntarily controlled movement without stimulation was as high as occurred when combined with electrical stimulation. Additionally, spinally evoked motor potentials were readily modulated in the presence of voluntary effort, providing electrophysiological evidence of the re-establishment of functional connectivity among neural networks between the brain and the spinal cord.

Recent findings suggest that not only the lack of physical activity, but also prolonged times of sedentary behaviour where major locomotor muscles are inactive, significantly increase the risk of chronic diseases. The purpose of this study was to provide details of quadriceps and hamstring muscle inactivity and activity during normal daily life of ordinary people. Eighty-four volunteers (44 females, 40 males, 44.1±17.3 years, 172.3±6.1 cm, 70.1±10.2 kg) were measured during normal daily life using shorts measuring muscle electromyographic (EMG) activity (recording time 11.3±2.0 hours). EMG was normalized to isometric MVC (EMGMVC) during knee flexion and extension, and inactivity threshold of each muscle group was defined as 90% of EMG activity during standing (2.5±1.7% of EMGMVC). During normal daily life the average EMG amplitude was 4.0±2.6% and average activity burst amplitude was 5.8±3.4% of EMGMVC (mean duration of 1.4±1.4 s) which is below the EMG level required for walking (5 km/h corresponding to EMG level of about 10% of EMGMVC). Using the proposed individual inactivity threshold, thigh muscles were inactive 67.5±11.9% of the total recording time and the longest inactivity periods lasted for 13.9±7.3 min (2.5–38.3 min). Women had more activity bursts and spent more time at intensities above 40% EMGMVC than men (p<0.05). In conclusion, during normal daily life the locomotor muscles are inactive about 7.5 hours, and only a small fraction of muscle's maximal voluntary activation capacity is used averaging only 4% of the maximal recruitment of the thigh muscles. Some daily non-exercise activities such as stair climbing produce much higher muscle activity levels than brisk walking, and replacing sitting by standing can considerably increase cumulative daily muscle activity.

A simple tailored counseling was able to reduce muscle inactivity time by 33 min, which was reallocated to 21 min of light muscle activity. During work time, average EMG amplitude increased by 13%, reaching an average of 1.8% of EMG MVC. If maintained, this observed short-term effect may have health-benefiting consequences.

It is shown for the first time that EMG shorts can be used for EE estimations across a wide range of physical activity intensities in a heterogeneous group. Across all loads, HR is a superior method of predicting EE, whereas ACC is most accurate for level loads at the population level. At low levels of physical activity in changing terrains, thigh muscle EMG provides more accurate EE estimations than those in ACC and HR if individual calibrations are performed.

Exercise for fitness does not decrease the muscular inactivity time during normal daily life Finni Juutinen, Taija; Haakana, Piia; Pesola, Arto; Pullinen, Teemu Finni Juutinen, T., Haakana, P., Pesola, A., & Pullinen, T. (2014). Exercise for fitness does not decrease the muscular inactivity time during normal daily life. Scandinavian Journal of Medicine and Science in Sports, 24 (1), 211-219. doi:10.1111/j.1600-0838.2012.01456.x The time spent in sedentary behaviors has been shown to be independent of exercise in epidemiological studies. We examined within an individual whether exercise alters the time of muscular inactivity within his/her normal daily life. Quadriceps and hamstring muscle EMG activities and heart rate were measured during 1-6 days of normal daily living of ordinary people. Of 84 volunteers measured, 27 (15 men, 12 women, 40.7±16.5 years) fulfilled the criteria of having at least one day with and one day without exercise for fitness (total of 87 days analyzed, 13.0 ± 2.5 h/day).Reported exercises varied from Nordic walking to strength training and ball games lasting 30-150 min (mean 83±30min). Exercise increased the time spent at moderateto-vigorous muscle activity (6±4% to 9±6 %, p<0.01) and energy expenditure (13±22 %, p<0.05). Muscular inactivity, defined individually below that measured during standing, comprised 72±12% of day without and 68±13% of day with exercise (n.s). Duration of exercise correlated positively to the increase in moderate-tovigorous muscle activity time (r=0.312, p<0.05) but not with inactivity time. In conclusion, exercise for fitness, regardless of its duration, does not decrease the inactivity time during normal daily life. This is possible by slight modifications in daily non-exercise activities.