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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurosci.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurosci.</abbrev-journal-title>
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<issn pub-type="epub">1662-453X</issn>
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<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fnins.2025.1657677</article-id>
<article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Research</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Muscle responses to limb block during spontaneous movements in infants</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Rubeca</surname>
<given-names>Damiana</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Dolinskaya</surname>
<given-names>Irina Y.</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Selionov</surname>
<given-names>Victor A.</given-names>
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<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Keshishian</surname>
<given-names>Elena S.</given-names>
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<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Solopova</surname>
<given-names>Irina A.</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<name>
<surname>Sylos-Labini</surname>
<given-names>Francesca</given-names>
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<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<surname>Lacquaniti</surname>
<given-names>Francesco</given-names>
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<surname>Ivanenko</surname>
<given-names>Yury</given-names>
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<aff id="aff1"><label>1</label><institution>Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia</institution>, <city>Rome</city>, <country country="it">Italy</country></aff>
<aff id="aff2"><label>2</label><institution>Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata</institution>, <city>Rome</city>, <country country="it">Italy</country></aff>
<aff id="aff3"><label>3</label><institution>Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems</institution>, <city>Moscow</city>, <country country="ru">Russia</country></aff>
<aff id="aff4"><label>4</label><institution>Department of Neonatology, Moscow Research Institute of Clinical Pediatrics of Russian Federation</institution>, <city>Moscow</city>, <country country="ru">Russia</country></aff>
<author-notes>
<corresp id="c001"><label>&#x002A;</label>Correspondence: Francesca Sylos-Labini, <email xlink:href="mailto:f.syloslabini@hsantalucia.it">f.syloslabini@hsantalucia.it</email>; Yury Ivanenko, <email xlink:href="mailto:y.ivanenko@hsantalucia.it">y.ivanenko@hsantalucia.it</email></corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2025-11-25">
<day>25</day>
<month>11</month>
<year>2025</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2025</year>
</pub-date>
<volume>19</volume>
<elocation-id>1657677</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>07</month>
<year>2025</year>
</date>
<date date-type="rev-recd">
<day>31</day>
<month>10</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>07</day>
<month>11</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 Rubeca, Dolinskaya, Selionov, Keshishian, Solopova, Sylos-Labini, Lacquaniti and Ivanenko.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Rubeca, Dolinskaya, Selionov, Keshishian, Solopova, Sylos-Labini, Lacquaniti and Ivanenko</copyright-holder>
<license>
<ali:license_ref start_date="2025-11-25">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Young infants manifest prominent neuromuscular responses to changes in muscle length, along with a variety of spontaneous movements. The first months of life are an important period during which sensorimotor integration and muscle tone gradually mature. In adults, muscle responses may also be observed when coordinated limb movements are transiently blocked. Given that infants normally exhibit spontaneous limb activity, here we examined whether a transient upper or lower limb block evoked consistent muscle responses while the infants were allowed to perform spontaneous movements with the other limbs. We examined polymyographic recordings in 12 bilateral arm and leg muscles in full-term and preterm infants (1&#x2013;7&#x202F;months old). Overall, muscle activity, its spectral characteristics, and agonist&#x2013;antagonist coactivation were comparable before and after the block in both full-term and preterm infants, suggesting that the transient limb immobilization effect is not evident or consistent, as opposed to previously reported prominent muscle responses to muscle lengthening or shortening. The lack of consistent muscular responses to limb block supports the idea that individual limb motion during spontaneous movements is relatively independent of the control of other limbs, and that sensory input during changes in muscle length is more effective in revealing sensorimotor connections than its non-appearance.</p>
</abstract>
<kwd-group>
<kwd>spontaneous movements</kwd>
<kwd>limb block</kwd>
<kwd>muscle responses</kwd>
<kwd>preterm infants</kwd>
<kwd>early development</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the State Task of the Ministry of Science and Higher Education of the Russian Federation (project FFNU-2025-0047), Italian Ministry of Health (Ricerca Corrente, IRCCS Fondazione Santa Lucia; Ricerca Finalizzata RF-2019-12370232), INAIL (BRIC 2022 LABORIUS), Italian University Ministry (MUR PRIN 20229KE3T5 - NEO-MUSCLE-MAP, PRIN 2020EM9A8X, 2020RB4N9, 2022T9YJXT, 2022YXLNR7 and #NEXTGENERATIONEU NGEU National Recovery and Resilience Plan NRRP, project MNESYS PE0000006 &#x2013; A Multiscale integrated approach to the study of the nervous system in health and disease DN. 1553 11.10.2022), and the Complementary National Plan PNC-I.1 DARE &#x2013; DigitAl lifelong pRevEntion initiative (code PNC0000002).</funding-statement>
</funding-group>
<counts>
<fig-count count="6"/>
<table-count count="1"/>
<equation-count count="3"/>
<ref-count count="53"/>
<page-count count="14"/>
<word-count count="9273"/>
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<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Neurodevelopment</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<title>Introduction</title>
<p>Researchers interested in developmental biology and clinical perspectives may be particularly interested in examining how infants&#x2019; muscles react to active and passive movements or sensory stimulation during early development (<xref ref-type="bibr" rid="ref1">Andrews and Fitzgerald, 1999</xref>; <xref ref-type="bibr" rid="ref6">Cornelissen et al., 2013</xref>; <xref ref-type="bibr" rid="ref42">Solopova et al., 2019</xref>; <xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>). Kinematic characteristics and inter-limb coordination are being frequently used to assess general movements (<xref ref-type="bibr" rid="ref49">Thelen et al., 1987</xref>; <xref ref-type="bibr" rid="ref34">Piek and Carman, 1994</xref>; <xref ref-type="bibr" rid="ref50">Vaal et al., 2000</xref>; <xref ref-type="bibr" rid="ref14">Gima et al., 2011</xref>; <xref ref-type="bibr" rid="ref22">Karch et al., 2012</xref>; <xref ref-type="bibr" rid="ref32">Ohmura et al., 2016</xref>; <xref ref-type="bibr" rid="ref53">Zuzarte et al., 2019</xref>), and alterations of kinematic patterns or the lack of variations in the way spontaneous movements (SMs) occur may be signs of early impairments (<xref ref-type="bibr" rid="ref36">Prechtl et al., 1997</xref>; <xref ref-type="bibr" rid="ref23">Kwong et al., 2018</xref>). Nonetheless, the examination of muscle activity offers further information on the maturation of the neuromuscular spinal and supraspinal control despite high inter-trial variability in infants (<xref ref-type="bibr" rid="ref38">Ritterband-Rosenbaum et al., 2017</xref>; <xref ref-type="bibr" rid="ref44">Sylos-Labini et al., 2022</xref>; <xref ref-type="bibr" rid="ref19">Kanazawa et al., 2023</xref>). This includes the irradiation of sensory responses to distant or antagonist muscles, as well as the manifestation of prominent muscle responses to muscle lengthening and shortening in young infants (<xref ref-type="bibr" rid="ref31">Myklebust and Gottlieb, 1993</xref>; <xref ref-type="bibr" rid="ref47">Teulier et al., 2011</xref>; <xref ref-type="bibr" rid="ref42">Solopova et al., 2019</xref>).</p>
<p>The way muscles react to changes in muscle length can be interpreted as signs of dynamic muscular tone associated with postural resistive or compliant behaviour (<xref ref-type="bibr" rid="ref4">Cacciatore et al., 2024</xref>). Muscle responses can be seen not only in lengthening and shortening, but also in limb immobilization, especially if it is imposed during ongoing movements of the upper and lower limbs. For instance, in adults, they may be observed when coordinated limb movements are transiently blocked, causing consistent aftereffects, such as the continuation of rhythmic muscle activity imposed by preceding limb movement or the appearance of tonic postural activity (<xref ref-type="bibr" rid="ref15">Gurfinkel and Ivanenko, 1987</xref>; <xref ref-type="bibr" rid="ref43">Sylos-Labini et al., 2014</xref>). In neonates, a transient lower limb block during stepping movements may significantly affect ipsilateral proximal muscle activities, while the sudden release of the blocked limb may elicit the immediate initiation of the swing phase, with hip flexion and a burst of an ankle flexor muscle (<xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>). Therefore, if limb block is viewed as a disruption to continuing coordinated inter- or intra-limb activity, it could be used as a probe to determine the presence or the level of inter-limb coordination or interactions between tonic and phasic muscle activity.</p>
<p>Here, we examined muscle responses to the transient limb block during active wakefulness in infants (1&#x2013;7&#x202F;months old) while testing supine and making spontaneous limb movements, which is typical for this age group. Previous research has also shown that preterm infants may have higher rates of muscular responses and a different time course of muscle power development (<xref ref-type="bibr" rid="ref5">Cioni and Prechtl, 1990</xref>; <xref ref-type="bibr" rid="ref7">de Groot et al., 1992</xref>; <xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>), therefore we included both full-term and preterm infants in this investigation. Manual manipulations of flexion and extension joint movements are commonly used to assess muscle tone in infants in clinical settings (<xref ref-type="bibr" rid="ref29">McIntyre et al., 2011</xref>; <xref ref-type="bibr" rid="ref27">Marinelli et al., 2013</xref>), and we also used a manual limb block done by the same experimenter. We aimed at investigating the presence of consistent muscle responses to either blocking a single upper or lower limb or blocking both upper and lower limbs at once, while the infants were free to continue spontaneous movements with other limbs. To this end, we analysed electromyographic (EMG) recordings from 12 bilateral arm and leg muscles, as well as changes in the level of muscle activity, spectral characteristics, and against-antagonist coactivation before and after the block. The rationale of using these analyses is that they have been demonstrated to be successful in detecting changes in muscle activity characteristics during stepping and kicking movements in infants during their first year of life (<xref ref-type="bibr" rid="ref46">Teulier et al., 2012</xref>; <xref ref-type="bibr" rid="ref45">Sylos-Labini et al., 2020</xref>, <xref ref-type="bibr" rid="ref44">2022</xref>).</p>
</sec>
<sec sec-type="methods" id="sec2">
<title>Methods</title>
<sec id="sec3">
<title>Participants</title>
<p>Participants were 20 full-term infants (7 females and 13 males, from 0.5 to 7.5&#x202F;months postnatal age) and 18 preterm infants (10 females and 8 males, from 1 to 7&#x202F;months corrected age at the time of investigation) (<xref ref-type="table" rid="tab1">Table 1</xref>). For full-term infants, inclusion criteria were: an Apgar score &#x003E;7 at 1 and 5&#x202F;min, no delivery events or perinatal history, no known neurological or musculoskeletal issues, and a gestational age (GA)&#x202F;&#x003E;&#x202F;38&#x202F;weeks. For preterm infants, criteria included an Apgar score &#x003E;7 at 1 and 5&#x202F;min, clinical stability at measurement, and a birth GA&#x202F;&#x003E;&#x202F;25&#x202F;weeks. The exclusion criteria were congenital malformations or infections, genetic and metabolic diseases, malignant disorders, and ongoing mechanical ventilation therapy. Overall, the characteristics of the preterm infants were: birth at 25&#x2013;36&#x202F;weeks of GA and birth weight 0.6&#x2013;3.2&#x202F;kg. Two of them were extremely preterm (25&#x2013;28&#x202F;weeks of GA), one was very preterm (29&#x2013;31&#x202F;weeks of GA), seven were moderately preterm (32&#x2013;33&#x202F;weeks of GA), and eight were late preterm (34&#x2013;36&#x202F;weeks of GA) (<xref ref-type="table" rid="tab1">Table 1</xref>). Experiments were performed at the Moscow Research Institute of Clinical Pediatrics. The study was carried out in accordance with the Declaration of Helsinki for experiments on humans, and the protocol had been approved by the Ethics Committee of the Moscow Research Institute of Clinical Pediatrics (protocol n.14/18). The infant&#x2019;s parent gave informed written consent to participate in the study.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Characteristics of full-term and preterm infants, recorded blocked limb conditions (&#x201C;arm,&#x201D; &#x201C;leg,&#x201D; &#x201C;ipsi arm-leg,&#x201D; &#x201C;contra arm-leg&#x201D;) and the respective block duration (the total is also indicated as mean&#x202F;&#x00B1;&#x202F;SD, and range in parentheses).</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="2">Group</th>
<th align="center" valign="top" rowspan="2">ID</th>
<th align="center" valign="top" rowspan="2">GA (weeks)</th>
<th align="center" valign="top" rowspan="2">Gender</th>
<th align="center" valign="top" rowspan="2">Age (mo)</th>
<th align="center" valign="top" rowspan="2">Weight (kg)</th>
<th align="center" valign="top" colspan="4">Block duration (s)</th>
</tr>
<tr>
<th align="center" valign="top">arm</th>
<th align="center" valign="top">leg</th>
<th align="center" valign="top">ipsi arm-leg</th>
<th align="center" valign="top">contra arm-leg</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle" rowspan="21">Full-term</td>
<td align="center" valign="middle">F01</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">1.5</td>
<td align="center" valign="middle">4.20</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">36</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">10</td>
</tr>
<tr>
<td align="center" valign="middle">F02</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">5</td>
<td align="center" valign="middle">7.00</td>
<td align="center" valign="middle">15</td>
<td align="center" valign="middle">22</td>
<td align="center" valign="middle">21</td>
<td align="center" valign="middle">10</td>
</tr>
<tr>
<td align="center" valign="middle">F03</td>
<td align="center" valign="middle">41</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">7.5</td>
<td align="center" valign="middle">7.10</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">13</td>
<td align="center" valign="middle">14</td>
<td align="center" valign="middle">9</td>
</tr>
<tr>
<td align="center" valign="middle">F04</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">3</td>
<td align="center" valign="middle">5.60</td>
<td align="center" valign="middle">9</td>
<td align="center" valign="middle">18</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">12</td>
</tr>
<tr>
<td align="center" valign="middle">F05</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">5.5</td>
<td align="center" valign="middle">7.20</td>
<td align="center" valign="middle">23</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">27</td>
<td align="center" valign="middle">15</td>
</tr>
<tr>
<td align="center" valign="middle">F06</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">3</td>
<td align="center" valign="middle">5.50</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">9</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">17</td>
</tr>
<tr>
<td align="center" valign="middle">F07</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">1.5</td>
<td align="center" valign="middle">4.35</td>
<td align="center" valign="middle">7</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">7</td>
<td align="center" valign="middle">7</td>
</tr>
<tr>
<td align="center" valign="middle">F08</td>
<td align="center" valign="middle">41</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">5</td>
<td align="center" valign="middle">6.90</td>
<td align="center" valign="middle">9</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">7</td>
<td align="center" valign="middle">-</td>
</tr>
<tr>
<td align="center" valign="middle">F09</td>
<td align="center" valign="middle">41</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">6.5</td>
<td align="center" valign="middle">8.30</td>
<td align="center" valign="middle">15</td>
<td align="center" valign="middle">21</td>
<td align="center" valign="middle">17</td>
<td align="center" valign="middle">21</td>
</tr>
<tr>
<td align="center" valign="middle">F10</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">3</td>
<td align="center" valign="middle">5.10</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">19</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">9</td>
</tr>
<tr>
<td align="center" valign="middle">F11</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">6</td>
<td align="center" valign="middle">6.90</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">6</td>
<td align="center" valign="middle">13</td>
</tr>
<tr>
<td align="center" valign="middle">F12</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">5.38</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">18</td>
<td align="center" valign="middle">21</td>
<td align="center" valign="middle">14</td>
</tr>
<tr>
<td align="center" valign="middle">F13</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">0.5</td>
<td align="center" valign="middle">3.25</td>
<td align="center" valign="middle">6</td>
<td align="center" valign="middle">9</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">13</td>
</tr>
<tr>
<td align="center" valign="middle">F14</td>
<td align="center" valign="middle">39</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">3</td>
<td align="center" valign="middle">5.80</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">11</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">9</td>
</tr>
<tr>
<td align="center" valign="middle">F15</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">5</td>
<td align="center" valign="middle">7.00</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">11</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">8</td>
</tr>
<tr>
<td align="center" valign="middle">F16</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">8.10</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">14</td>
<td align="center" valign="middle">14</td>
<td align="center" valign="middle">9</td>
</tr>
<tr>
<td align="center" valign="middle">F17</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">4.77</td>
<td align="center" valign="middle">10</td>
<td align="center" valign="middle">14</td>
<td align="center" valign="middle">8</td>
<td align="center" valign="middle">14</td>
</tr>
<tr>
<td align="center" valign="middle">F18</td>
<td align="center" valign="middle">40</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">3</td>
<td align="center" valign="middle">6.10</td>
<td align="center" valign="middle">15</td>
<td align="center" valign="middle">23</td>
<td align="center" valign="middle">13</td>
<td align="center" valign="middle">17</td>
</tr>
<tr>
<td align="center" valign="middle">F19</td>
<td align="center" valign="middle">41</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">1.5</td>
<td align="center" valign="middle">4.50</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">7</td>
</tr>
<tr>
<td align="center" valign="middle">F20</td>
<td align="center" valign="middle">41</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">3.5</td>
<td align="center" valign="middle">4.50</td>
<td align="center" valign="middle">26</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">15</td>
<td align="center" valign="middle">10</td>
</tr>
<tr>
<td align="center" valign="middle">Total</td>
<td colspan="2"/>
<td align="center" valign="middle">3.8&#x202F;&#x00B1;&#x202F;1.4<break/>(0.5&#x2013;7.5)</td>
<td align="center" valign="middle">5.8&#x202F;&#x00B1;&#x202F;1.2<break/>(3.2&#x2013;8.3)</td>
<td align="center" valign="middle">13.1&#x202F;&#x00B1;&#x202F;4<break/>(6&#x2013;26)</td>
<td align="center" valign="middle">16.3&#x202F;&#x00B1;&#x202F;4.3<break/>(9&#x2013;36)</td>
<td align="center" valign="middle">13&#x202F;&#x00B1;&#x202F;4.2<break/>(6&#x2013;27)</td>
<td align="center" valign="middle">11.8&#x202F;&#x00B1;&#x202F;3.1<break/>(7&#x2013;21)</td>
</tr>
<tr>
<td align="left" valign="middle" rowspan="19">Preterm</td>
<td align="center" valign="middle">P01</td>
<td align="center" valign="top">33</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">5.8</td>
<td align="center" valign="middle">7.10</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">20</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">-</td>
</tr>
<tr>
<td align="center" valign="middle">P02</td>
<td align="center" valign="top">32</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">7.00</td>
<td align="center" valign="middle">10/31</td>
<td align="center" valign="middle">30/30</td>
<td align="center" valign="middle">20/20</td>
<td align="center" valign="middle">-</td>
</tr>
<tr>
<td align="center" valign="middle">P03</td>
<td align="center" valign="top">30</td>
<td align="center" valign="middle">m</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">6.80</td>
<td align="center" valign="middle">13</td>
<td align="center" valign="middle">28</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">24</td>
</tr>
<tr>
<td align="center" valign="middle">P04</td>
<td align="center" valign="top">35</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">2</td>
<td align="center" valign="middle">3.50</td>
<td align="center" valign="middle">4</td>
<td align="center" valign="middle">7</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">-</td>
</tr>
<tr>
<td align="center" valign="middle">P05</td>
<td align="center" valign="top">35</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">2</td>
<td align="center" valign="middle">3.65</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">12</td>
<td align="center" valign="middle">-</td>
<td align="center" valign="middle">-</td>
</tr>
<tr>
<td align="center" valign="middle">P06</td>
<td align="center" valign="top">34</td>
<td align="center" valign="middle">f</td>
<td align="center" valign="middle">1.5</td>
<td align="center" valign="middle">5.50</td>
<td align="center" valign="middle">14</td>
<td align="center" valign="middle">16</td>
<td align="center" valign="middle">6</td>
<td align="center" valign="middle">14</td>
</tr>
<tr>
<td align="center" valign="middle">P07</td>
<td align="center" valign="top">32</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">7.20</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">20</td>
<td align="center" valign="top">31</td>
<td align="center" valign="top">20</td>
</tr>
<tr>
<td align="center" valign="top">P08</td>
<td align="center" valign="top">35</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">7</td>
<td align="center" valign="top">6.30</td>
<td align="center" valign="top">15</td>
<td align="center" valign="top">20</td>
<td align="center" valign="top">13</td>
<td align="center" valign="top">20</td>
</tr>
<tr>
<td align="center" valign="top">P09</td>
<td align="center" valign="top">36</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">7.20</td>
<td align="center" valign="top">17</td>
<td align="center" valign="top">16</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">18</td>
</tr>
<tr>
<td align="center" valign="top">P10</td>
<td align="center" valign="top">34</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">3.30</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">-</td>
<td align="center" valign="top">3</td>
</tr>
<tr>
<td align="center" valign="top">P11</td>
<td align="center" valign="top">35</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">4.5</td>
<td align="center" valign="top">7.10</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">20</td>
<td align="center" valign="top">11</td>
<td align="center" valign="top">18</td>
</tr>
<tr>
<td align="center" valign="top">P12</td>
<td align="center" valign="top">26</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">6.00</td>
<td align="center" valign="top">11</td>
<td align="center" valign="top">17</td>
<td align="center" valign="top">16</td>
<td align="center" valign="top">17</td>
</tr>
<tr>
<td align="center" valign="top">P13</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">6.20</td>
<td align="center" valign="top">-</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">16</td>
<td align="center" valign="top">4</td>
</tr>
<tr>
<td align="center" valign="top">P14</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">6.70</td>
<td align="center" valign="top">6</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">7</td>
<td align="center" valign="top">8</td>
</tr>
<tr>
<td align="center" valign="top">P15</td>
<td align="center" valign="top">34</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">5.5</td>
<td align="center" valign="top">7.00</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">11</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">6</td>
</tr>
<tr>
<td align="center" valign="top">P16</td>
<td align="center" valign="top">28</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">6</td>
<td align="center" valign="top">6.20</td>
<td align="center" valign="top">9</td>
<td align="center" valign="top">18</td>
<td align="center" valign="top">11</td>
<td align="center" valign="top">6</td>
</tr>
<tr>
<td align="center" valign="top">P17</td>
<td align="center" valign="top">34</td>
<td align="center" valign="top">f</td>
<td align="center" valign="top">2.5</td>
<td align="center" valign="top">4.70</td>
<td align="center" valign="top">-</td>
<td align="center" valign="top">15/12</td>
<td align="center" valign="top">20</td>
<td align="center" valign="top">16</td>
</tr>
<tr>
<td align="center" valign="top">P18</td>
<td align="center" valign="top">32</td>
<td align="center" valign="top">m</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">5.30</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">16/12</td>
<td align="center" valign="top">5/11</td>
<td align="center" valign="top">14</td>
</tr>
<tr>
<td align="center" valign="top">Total</td>
<td colspan="2"/>
<td align="center" valign="top">3.7&#x202F;&#x00B1;&#x202F;1.3<break/>(1&#x2013;7)</td>
<td align="center" valign="top">5.9&#x202F;&#x00B1;&#x202F;1<break/>(3.3&#x2013;7.2)</td>
<td align="center" valign="top">12.3&#x202F;&#x00B1;&#x202F;4.1<break/>(4&#x2013;31)</td>
<td align="center" valign="top">16.6&#x202F;&#x00B1;&#x202F;5.1<break/>(5&#x2013;30)</td>
<td align="center" valign="top">13.9&#x202F;&#x00B1;&#x202F;4.9<break/>(6&#x2013;31)</td>
<td align="center" valign="top">13.4&#x202F;&#x00B1;&#x202F;5.7<break/>(3&#x2013;24)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>GA, gestational age. For child P02, P17, and P18, arm, leg, and ipsilateral arm-leg block conditions were recorded twice, but not consecutively (the duration of both blocks is indicated).</p>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="sec4">
<title>Experimental setup and data recording</title>
<p>The experimental session lasted ~30&#x202F;min (including placement of EMG electrodes). Before recording the different block limb conditions, infants were allowed to move freely during active wakefulness while lying supine on a standard medical couch for at least ~3&#x2013;5&#x202F;min. Thereafter, we proceeded to the execution of the four block conditions: arm, leg, ipsilateral arm-leg (block of arm and ipsilateral leg), and contralateral arm-leg (block of arm and contralateral leg) block (<xref ref-type="fig" rid="fig1">Figure 1A</xref>). During the experiments, all infants remained in the active and alert awake state; no sessions were recorded in which infants transitioned to quiet wakefulness or showed signs of drowsiness. Infants did not exhibit signs of distress (e.g., crying) during either spontaneous movements or limb block procedures. In most subjects, we also recorded spontaneous and passive movements in addition to limb blocks, and we have previously reported EMG activity characteristics during spontaneous and passive joint movements (<xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>). Here we report the analysis of muscle activity during four different block limb conditions. Most infants had all block conditions recorded, and overall, we performed 17, 20, 18, and 19 recordings of arm, leg, ipsilateral arm-leg, and contralateral arm-leg blocks, respectively, for full-term infants, and 15, 21, 16, and 14 recordings for preterm infants (<xref ref-type="table" rid="tab1">Table 1</xref>). The order of block limbs was randomized across infants. During the block, the limb was gently but firmly kept in a horizontal position (the leg extended below the hip and the arm positioned near the trunk, as shown in <xref ref-type="fig" rid="fig1">Figure 1A</xref>). Manual manipulations of flexion and extension joint movements are commonly used to assess muscle responses in infants in clinical settings (<xref ref-type="bibr" rid="ref29">McIntyre et al., 2011</xref>; <xref ref-type="bibr" rid="ref27">Marinelli et al., 2013</xref>). In our study, feasibility and infant comfort were prioritized by performing the limb block manually by the experimenter. Horizontal alignment and visual inspection of limb position during recording were used to maintain intra-rater consistency across infants and conditions. The limb block for the leg was executed slightly faster than that for the arm to achieve the horizontal position (since the leg was typically closer to the horizontal when the experimenter initiated the block). Nevertheless, the block of both upper and lower limbs was executed relatively quickly by the same experimenter (within ~0.3&#x202F;s interval, and the end of this interval deemed the block&#x2019;s onset). The duration of the block varied across the probes (3&#x2013;36&#x202F;s, <xref ref-type="table" rid="tab1">Table 1</xref>), with a period of at least 4&#x2013;5&#x202F;s allowed between blocks.</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Experimental procedure and analyses. <bold>(A)</bold> Experimental setup for different limb block conditions in full-term and preterm infants: arm, leg, ipsilateral arm-leg, and contralateral arm-leg block. We analyzed the time intervals spanning 2&#x202F;s before and after limb block (<italic>t</italic> =&#x202F;B) or release (<italic>t</italic> =&#x202F;R). <bold>(B)</bold> The schematic diagram illustrates the assessment of neural pathway functioning and sensorimotor responses to limb block during spontaneous limb movements. Three analytical approaches (lower panels) were used to evaluate EMG patterns following limb block (and release): changes in mean EMG activity, intrinsic rhythmicity of the neural drive (neural power spectra), and agonist&#x2013;antagonist coactivation. These analyses were conducted within a 2-s pre- and post-block time window.</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g001.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Diagram illustrating the examination of motor control and neurophysiological pathways in infants. Panel A shows a sequence of drawings and photos depicting an infant's limbs highlighted in different colors, with a timing chart indicating periods of block and release. Panel B depicts a schematic of neural pathways involving the brain, spinal cord, and limbs, illustrating descending and ascending pathways between the brain and muscles. At the bottom, there are three graphs showcasing mean EMG, spectral analysis, and against-antagonist coactivation, representing motor responses, EMG activity rhythm, and intra-limb coordination.</alt-text>
</graphic>
</fig>
<p>EMG activity was recorded bilaterally using the Trigno Wireless System (Delsys Inc., bandwidth 20&#x2013;450&#x202F;Hz, overall gain 1,000, sampling rate 963&#x202F;Hz) from the following muscles: biceps brachii (BB), triceps brachii (TB), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius lateralis (LG). The size of the Trigno bar EMG electrodes was relatively small (5&#x202F;mm) in order to minimize crosstalk. The skin was cleaned and gently rubbed with alcohol before the electrodes were placed. All movements were recorded by a digital video camera (PanasonicHC-V760EE-<italic>&#x03BA;</italic>, 1920&#x202F;&#x00D7;&#x202F;1080pixels, 50 frames/s). The EMG and video recordings were synchronized.</p>
</sec>
<sec id="sec5">
<title>Data analysis</title>
<p>The recordings were first examined to determine the onset and release of limb blocks in each condition. Two independent experimenters examined the original video recordings and assessed the block intervals for each limb. In the majority of cases, there was significant consistency between observers: on average, the difference was ~1&#x2013;2 frames of video recordings (~20&#x2013;40&#x202F;ms) pooling all limb blocks and infants together (and we used the mean between the two values as the onset). We compared EMGs recorded 2-s pre-block interval [&#x2212;2&#x202F;s, B] and 2-s post-block interval [B, 2&#x202F;s] (where B is block onset). The rationale for analysing a specific time interval (2&#x202F;s before and 2&#x202F;s after block onset) was that if limb block is considered a disruption to continuing coordinated activity, it can be used as a probe to determine the presence of inter-limb coordination, similar to how limb block or loading during stepping (with cycle duration of ~2&#x202F;s in infants) is used to examine automatic/reflexive responses (<xref ref-type="bibr" rid="ref25">Lam et al., 2003</xref>; <xref ref-type="bibr" rid="ref33">Pang et al., 2003</xref>; <xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>). We also assessed whether there were changes during block release (comparing time intervals [&#x2212;2&#x202F;s, R] and [R, 2&#x202F;s], where R is block release).</p>
<p>All data analyses were performed using custom-written programs in Matlab (MathWorks, Natick, MA). Initially, the raw EMG data were visually examined to identify artefacts and eliminate corrupted data segments (which were quite small: about 4%) from subsequent analysis. The EMG data were high-pass filtered at 60&#x202F;Hz, notch filtered at 50&#x202F;Hz, full-wave rectified and low-pass filtered at 3&#x202F;Hz to obtain the envelope time series. All the filters were zero-lag fourth-order Butterworth filters. The EMG envelopes were time interpolated over a normalized 100-point time base. To evaluate the effect of limb block, we analysed changes in (1) mean muscle activity, (2) its spectral characteristics, and (3) antagonist coactivation (<xref ref-type="fig" rid="fig1">Figure 1B</xref>).</p>
<p><italic>Mean EMG activity.</italic> To characterise the general features of muscle activity, we calculated and compared the mean amplitude of rectified EMG profiles before (&#x2212;2&#x202F;s, B) and after (B, 2&#x202F;s) block onset. Nevertheless, it is important to note that measuring EMG amplitude in &#x03BC;V is a qualitative measurement due to variances in skin impedance across infants. In addition, while the 2-s analysis window was originally chosen to probe disruptions in ongoing coordinated activity (see above), we also examined whether varying the time window, using shorter (0.5&#x202F;s) or longer (3&#x202F;s) intervals, would influence the results.</p>
<p><italic>Spectral analysis.</italic> In order to reveal changes in the frequency content of the EMGs of individual muscles, as it may occur in some limb movements (<xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>), we applied the FOOOF algorithm (<xref ref-type="bibr" rid="ref12">Donoghue et al., 2020</xref>; <xref ref-type="bibr" rid="ref44">Sylos-Labini et al., 2022</xref>) that models the power spectral density (PSD) of EMG data as a combination of periodic and aperiodic components. The periodic activity <italic>G<sub>n</sub></italic> is rhythmic, like neural oscillations, is identified by peaks in the power spectrum and is modelled as sum of N total Gaussians, described as:</p>
<disp-formula id="E1"><label>(1)</label><mml:math id="M1"><mml:mrow><mml:msub><mml:mi>G</mml:mi><mml:mi>n</mml:mi></mml:msub><mml:mrow><mml:mo>(</mml:mo><mml:mi>f</mml:mi><mml:mo>)</mml:mo></mml:mrow><mml:mo>=</mml:mo><mml:mi>A</mml:mi><mml:mo>&#x2217;</mml:mo><mml:mi>exp</mml:mi><mml:mrow><mml:mo>(</mml:mo><mml:mrow><mml:mfrac><mml:mrow><mml:mo>&#x2212;</mml:mo><mml:msup><mml:mrow><mml:mrow><mml:mo>(</mml:mo><mml:mrow><mml:mi>f</mml:mi><mml:mo>&#x2212;</mml:mo><mml:msub><mml:mi>f</mml:mi><mml:mi>c</mml:mi></mml:msub></mml:mrow><mml:mo>)</mml:mo></mml:mrow></mml:mrow><mml:mn>2</mml:mn></mml:msup></mml:mrow><mml:mrow><mml:mn>2</mml:mn><mml:msup><mml:mi>&#x03C3;</mml:mi><mml:mn>2</mml:mn></mml:msup></mml:mrow></mml:mfrac></mml:mrow><mml:mo>)</mml:mo></mml:mrow><mml:mi mathvariant="normal"></mml:mi><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/></mml:mrow></mml:math></disp-formula>
<p>where <italic>A</italic> is the power of the peak, <italic>f<sub>c</sub></italic> is the central frequency, <italic>&#x03C3;</italic> is the standard deviation (bandwidth) of the Gaussian, and <italic>f</italic> is the frequency vector.</p>
<p>Aperiodic activity <italic>L</italic> is non-rhythmic (e.g., white noise) and is modelled using a Lorentzian function, written as:</p>
<disp-formula id="E2"><label>(2)</label><mml:math id="M2"><mml:mrow><mml:mi>L</mml:mi><mml:mrow><mml:mo>(</mml:mo><mml:mi>f</mml:mi><mml:mo>)</mml:mo></mml:mrow><mml:mo>=</mml:mo><mml:mi>b</mml:mi><mml:mo>&#x2212;</mml:mo><mml:mi>log</mml:mi><mml:mrow><mml:mo>(</mml:mo><mml:mrow><mml:mi>k</mml:mi><mml:mo>+</mml:mo><mml:msup><mml:mi>f</mml:mi><mml:mi>&#x03C7;</mml:mi></mml:msup></mml:mrow><mml:mo>)</mml:mo></mml:mrow><mml:mi mathvariant="normal"></mml:mi><mml:mi mathvariant="normal"></mml:mi><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/></mml:mrow></mml:math></disp-formula>
<p>where <italic>b</italic> is the broadband offset, <italic>&#x03C7;</italic> is the exponent, and <italic>k</italic> is the &#x201C;knee&#x201D; parameter, accounting for the bend in the aperiodic component. Broadband power refers to fluctuations occurring over a broad range of frequencies. The final outputs of the FOOOF algorithm are the parameters defining the best fit for the N Gaussians in <xref ref-type="disp-formula" rid="E1">Equation 1</xref> and the aperiodic component in <xref ref-type="disp-formula" rid="E2">Equation 2</xref>.</p>
<p><italic>Correlation and coactivation of antagonist muscles.</italic> Finally, we analysed potential changes in activation of antagonist muscles following the block. For analysing antagonist muscles, we calculated the Pearson correlation coefficient (<italic>r</italic>) and the coactivation index (<italic>CI</italic>) between pairs of antagonists (BB-TB, RF-BF, and TA-LG) in 2-s pre- and post-block intervals. The <italic>CI</italic> was assessed using the following formula (<xref ref-type="bibr" rid="ref40">Rudolph et al., 2000</xref>; <xref ref-type="bibr" rid="ref26">Mari et al., 2014</xref>; <xref ref-type="bibr" rid="ref28">Martino et al., 2014</xref>; <xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>):</p>
<disp-formula id="E3"><label>(3)</label><mml:math id="M3"><mml:mrow><mml:mi>C</mml:mi><mml:mi>I</mml:mi><mml:mo>=</mml:mo><mml:mfrac><mml:mrow><mml:munder><mml:mstyle displaystyle="true"><mml:mo>&#x2211;</mml:mo></mml:mstyle><mml:mi>N</mml:mi></mml:munder><mml:mrow><mml:mo>{</mml:mo><mml:mrow><mml:mfrac><mml:mrow><mml:mrow><mml:mo>[</mml:mo><mml:mrow><mml:mi>E</mml:mi><mml:mi>M</mml:mi><mml:msub><mml:mi>G</mml:mi><mml:mi>H</mml:mi></mml:msub><mml:mrow><mml:mo>(</mml:mo><mml:mi>j</mml:mi><mml:mo>)</mml:mo></mml:mrow><mml:mo>+</mml:mo><mml:mi>E</mml:mi><mml:mi>M</mml:mi><mml:msub><mml:mi>G</mml:mi><mml:mi>L</mml:mi></mml:msub><mml:mrow><mml:mo>(</mml:mo><mml:mi>j</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:mrow><mml:mo>]</mml:mo></mml:mrow></mml:mrow><mml:mn>2</mml:mn></mml:mfrac></mml:mrow><mml:mo>}</mml:mo></mml:mrow><mml:mo>&#x2217;</mml:mo><mml:mrow><mml:mo>[</mml:mo><mml:mrow><mml:mfrac><mml:mrow><mml:mi>E</mml:mi><mml:mi>M</mml:mi><mml:msub><mml:mi>G</mml:mi><mml:mi>L</mml:mi></mml:msub><mml:mrow><mml:mo>(</mml:mo><mml:mi>j</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:mrow><mml:mrow><mml:mi>E</mml:mi><mml:mi>M</mml:mi><mml:msub><mml:mi>G</mml:mi><mml:mi>H</mml:mi></mml:msub><mml:mrow><mml:mo>(</mml:mo><mml:mi>j</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:mrow></mml:mfrac></mml:mrow><mml:mo>]</mml:mo></mml:mrow></mml:mrow><mml:mi>N</mml:mi></mml:mfrac><mml:mi mathvariant="normal"></mml:mi><mml:mi mathvariant="normal"></mml:mi><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/><mml:mspace width="0.25em"/></mml:mrow></mml:math></disp-formula>
<p>where <italic>EMG<sub>H</sub></italic> and <italic>EMG<sub>L</sub></italic> represent the antagonist muscle pairs&#x2019; highest and lowest activity, respectively, and <italic>N</italic> is the number of temporal points digitized in the selected interval ([&#x2212;2&#x202F;s, B] or [B, 2&#x202F;s]). The <italic>CI</italic> was averaged over the entire interval duration (from 1 to <italic>N</italic>) in order to provide a global measure of the coactivity level. When this parameter is used <xref ref-type="disp-formula" rid="E3">Equation 3</xref>, high <italic>CI</italic> values indicate a high level of activation of both muscles, whereas low <italic>CI</italic> values indicate either a low-level activation in both muscles or a high-level activation in one muscle with a low-level activation in the other muscle in the pair.</p>
</sec>
<sec id="sec6">
<title>Statistics</title>
<p>Since the null hypothesis of normality of these data was rejected by performing the Shapiro&#x2013;Wilk W-test (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05), we used non-parametric statistical methods. To compare independent samples, we used the Kruskal-Wallis test and the Mann&#x2013;Whitney U test with a Holm-Bonferroni correction for the effects of full-term vs. preterm group, time interval before vs. after block onset, and block conditions on the EMG activity of six muscle pairs. In addition, for comparisons of mean EMG activity per subject and muscle, we calculated the rank-biserial correlation (rB) as a measure of effect size. The non-parametric Wilcoxon rank sum test was used to evaluate the differences between full-term and preterm infants in the average periodic and aperiodic parameters of PSD. The level of statistical significance was 0.05. All statistical analyses were performed using MATLAB software.</p>
</sec>
</sec>
<sec sec-type="results" id="sec7">
<title>Results</title>
<sec id="sec8">
<title>EMG activity</title>
<p>Different limb block (arm, leg, ipsilateral arm-leg, contralateral arm-leg) conditions were tested in 20 healthy full-term and 18 preterm infants. <xref ref-type="fig" rid="fig2">Figure 2</xref> shows examples of EMG traces during contralateral arm-leg block (panel A) and release (panel B) for full-term and preterm infants in the time interval including 2&#x202F;s before and 2&#x202F;s after limb block/release. The EMGs for each infant were separated into blocked and unblocked limbs. Before the block, the infant was allowed to move spontaneously in a supine position, so that some EMG activity could be detected before the block began, as well as after block release.</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>Examples of muscle responses to limb block. <bold>(A)</bold> Examples of EMGs for blocked and unblocked limbs in two full-term and two preterm infants during contralateral arm-leg block displayed for the time interval including 2&#x202F;s before [&#x2212;2&#x202F;s, B] and after [B, 2&#x202F;s] limb block. Vertical dotted lines indicate block onset (B, block). <bold>(B)</bold> Examples of EMGs for block release in four infants (R, release). Note variable EMG patterns during both limb blocks and releases. BB, biceps; TB, triceps; RF, rectus femoris; BF, biceps femoris; LG, gastrocnemius lateralis; TA, tibialis anterior.</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g002.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Graphical comparison of muscle activity in infants. Panel A shows "block" condition for both full-term and preterm infants, with data for blocked and unblocked limbs labeled as BB, TB, RF, BF, LG, and TA. Panel B illustrates the "release" condition. Each panel includes waveforms over a period of time, with a scale indicating 100 microvolts. An illustration of an infant highlights the limb position.</alt-text>
</graphic>
</fig>
<p>Despite the standardized block condition performed, we did not find a stereotyped response but rather significant variability in time-varying EMG profiles among muscles, infants and groups, illustrated also in <xref ref-type="fig" rid="fig3">Figure 3</xref> for all infants (left panels). We compared the mean levels of EMG activity before and after the block (<xref ref-type="fig" rid="fig3">Figure 3</xref>, right panels). Statistical tests showed no significant differences between time intervals (before and after block) for full-term and preterm infants and for blocked/unblocked muscles (<italic>p</italic> &#x003E;&#x202F;0.1, Kruskal-Wallis test and Mann&#x2013;Whitney U post-hoc test). As a measure of effect size for these comparisons, we calculated the rank-biserial correlation (rB). Across muscles and conditions, rB values were generally small, ranging from approximately &#x2212;0.48 to 0.28, consistent with negligible or weak effects. These results suggest that the EMG activity remained largely unchanged before and after the limb block across infants and muscles.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>Muscle activity during limb blocks in full-term <bold>(A)</bold> and preterm <bold>(B)</bold> infants. Left panels: EMG data of blocked and unblocked limbs of individual subjects (in grey) and ensemble-averaged EMG profiles across subjects (in colour, mean&#x202F;+&#x202F;SD) during time interval [&#x2212;2&#x202F;s, 2&#x202F;s] relative to block onset (<italic>t</italic>&#x202F;=&#x202F;B). Vertical dotted lines indicate block onset. Right panels: corresponding mean EMG activity (+SD) across subjects for each muscle and block condition. For single arm and leg blocks (two left columns), the EMGs of unblocked left and right limbs were pooled together. Note similar levels of EMGs before [&#x2212;2&#x202F;s, B] and after [B, 2&#x202F;s] limb block.</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g003.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Electromyography (EMG) data comparison for full-term and preterm infants showing muscle activity before and after limb blocking. Panel A displays full-term, while Panel B shows preterm infants. Each panel includes line graphs of EMG signals for blocked and unblocked limbs across muscles (BB, TB, RF, BF, LG, TA) using different colors for arm, leg, ipsilateral, and contralateral blocks. Bar graphs indicate mean EMG values before and after the block, with error bars reflecting variability. Illustrations of infants indicate limb blocking steps.</alt-text>
</graphic>
</fig>
<p>In addition to the variable (inconsistent) responses observed across infants (<xref ref-type="fig" rid="fig2">Figures 2</xref>, <xref ref-type="fig" rid="fig3">3</xref>), we also did not find consistent muscle activation patterns within individual subjects across the four limb-block conditions (<xref ref-type="fig" rid="fig1">Figure 1A</xref>). This variability may reflect differences in responses between upper and lower limbs or could be related to the limited number of probes, as only one trial per block condition was available for most infants (<xref ref-type="table" rid="tab1">Table 1</xref>). Nevertheless, these findings suggest that the transient effect of limb immobilization is neither evident nor consistent across limbs or participants (<xref ref-type="fig" rid="fig3">Figure 3</xref>).</p>
<p>Regarding group differences, we also assessed whether the general level of activity prior to the block differed between full-term and preterm infants. It is, however, worth noting that EMG amplitudes were evaluated in microvolts, which should be considered only a rough estimate of muscle activity. In most signal analysis protocols, comparisons are typically made relative to a baseline period representing resting activity. However, in the present study, defining a true baseline was not simple, as infants continuously performed spontaneous movements during active wakefulness and were rarely completely still. Therefore, we used the 2-s pre-block interval as the reference for ongoing motor activity before perturbation. Following this approach, we compared mean EMG values between full-term and preterm infants across all muscles and conditions in interval [&#x2212;2&#x202F;s, B] (<xref ref-type="fig" rid="fig4">Figure 4</xref>). No significant differences were found between groups (<italic>p</italic> &#x003E;&#x202F;0.03, Kruskal-Wallis test and Mann&#x2013;Whitney U post-hoc test), consistent with the other comparisons reported.</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>Mean muscle activity in full-term vs. preterm infants in the 2-s pre-block interval. Mean EMG activity (+SD) is shown (in &#x03BC;V) for both blocked and unblocked limbs. For single arm and leg blocks (two left columns), the EMGs of unblocked left and right limbs were pooled together.</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g004.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Bar chart comparing mean EMG in two-second pre-block interval for full-term and preterm infants. It includes six muscle groups: BB, TB, RF, BF, LG, and TA, divided into blocked and unblocked limbs. Bars represent blocks of arm, leg, ipsilateral arm-leg, and contralateral arm-leg, illustrated in blue, green, light blue, and pink, respectively. The chart highlights differences between full-term and preterm infants, with a scale indicating 5 microvolts.</alt-text>
</graphic>
</fig>
<p>Finally, the choice of the 2-s analysis window (2&#x202F;s before and 2&#x202F;s after block onset) was based on the rationale that the limb block transiently interrupts the ongoing coordinated motor activity, in a manner similar to how limb perturbations or loading during stepping (cycle duration &#x2248;2&#x2013;3&#x202F;s in infants) are used to evaluate reflexive and adaptive motor responses (<xref ref-type="bibr" rid="ref25">Lam et al., 2003</xref>; <xref ref-type="bibr" rid="ref33">Pang et al., 2003</xref>; <xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>). Nevertheless, we verified whether using somewhat different time windows, either shorter (0.5&#x202F;s) or longer (3&#x202F;s), would affect the results. For both shorter (0.5&#x202F;s) or longer (3&#x202F;s) window analyses, statistical tests showed no significant differences between time intervals (before and after block) for full-term and preterm infants and for blocked/unblocked muscles (<italic>p</italic> &#x003E;&#x202F;0.05, Kruskal-Wallis test and Mann&#x2013;Whitney U post-hoc test).</p>
</sec>
<sec id="sec9">
<title>Spectral EMG analysis</title>
<p>To reveal the frequency content of the EMGs of individual muscles, we applied an algorithm (<xref ref-type="bibr" rid="ref12">Donoghue et al., 2020</xref>; <xref ref-type="bibr" rid="ref44">Sylos-Labini et al., 2022</xref>) that modelled the power spectral density (PSD) of EMGs as a combination of periodic and aperiodic components (<xref ref-type="fig" rid="fig5">Figure 5</xref>). Model fitting was accurate, with average <italic>r</italic><sup>2</sup>&#x202F;=&#x202F;0.795 (95% confidence interval; 0.80 for full-term and 0.79 for preterm).</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>Parametrized frequency analysis of EMG data. <bold>(A)</bold> Power spectral density (PSD) for all full-term (upper) and all preterm (lower) infants in time interval [B, 2&#x202F;s], calculated from rectified EMGs for all muscles together using Fast Fourier Transform (FFT) and fitted with an algorithm for parameterizing PSDs into periodic and aperiodic components. Grey lines represent fitted PSDs from individual subjects, black lines represent average fitted PSD across subjects, light coloured lines represent the aperiodic component from the individual PSDs, and dark coloured lines represent the average aperiodic component across subjects. <bold>(B)</bold> Characteristics of periodic and aperiodic components in the time intervals [&#x2212;2&#x202F;s, B] and [B, 2&#x202F;s]. Upper panels: average (+SD) number of peaks, central frequency, power and bandwidth of the peaks across subjects and muscles are shown on the left; percent number of peaks for corresponding central frequencies are shown on the right. Lower panels: average (+SD) exponent (upper) and offset (lower) of the aperiodic component across subjects (the data for all muscles were pooled together). Circles denote the distribution of individual values (per subject and muscle) within the specified condition and time window.</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g005.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Spectral analysis of EMG power spectral density (PSD) for full-term and preterm infants. Panel A shows PSD for arms and legs, with individual and average fitted PSD in different colors. Panel B compares periodic and aperiodic components. Bar graphs display number of peaks, frequency, power, and bandwidth for full-term and preterm infants, with histograms showing frequency peaks. Different colors represent different body regions.</alt-text>
</graphic>
</fig>
<p>The periodic component of PSD for each muscle had no significant number of peaks: the average number of peaks for each condition and each time interval ([&#x2212;2&#x202F;s, B] and [B, 2&#x202F;s]) resulted in &#x003C;1 (all muscles pooled together) with no significant differences between groups (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Wilcoxon rank sum test; <xref ref-type="fig" rid="fig5">Figure 5B</xref>). Percent number of peaks for corresponding central frequencies are shown on the right of <xref ref-type="fig" rid="fig5">Figure 5B</xref>. The central frequencies of the peaks ranged from ~1&#x2013;2.5 (~30% of peaks were in the range 1.9&#x2013;2.3&#x202F;Hz for both full-term and preterm infants), with a mean of ~1.2&#x202F;Hz, and the percentage of central frequencies decreased toward 0 and 3&#x202F;Hz (<xref ref-type="fig" rid="fig5">Figure 5B</xref>, right panels). The other parameters of the peaks in the spectra (peak central frequency ~1.2&#x202F;Hz, bandwidth ~1&#x202F;Hz, and peak power ~2&#x202F;&#x03BC;V<sup>2</sup>/Hz) also showed no significant differences between block conditions, time intervals and groups (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Wilcoxon rank sum test; <xref ref-type="fig" rid="fig5">Figure 5B</xref>).</p>
<p>For the aperiodic component, the best model involved the knee parameter equal to 1 (k&#x202F;=&#x202F;1) for all conditions (not shown), which was not different between the infant groups. The other aperiodic parameters, namely, the broadband offset and the exponent (<italic>see Methods</italic>), were also not significantly different between full-term and preterm infants (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Wilcoxon rank sum test; <xref ref-type="fig" rid="fig5">Figure 5B</xref>, lower panels).</p>
</sec>
<sec id="sec10">
<title>Correlation and coactivation of antagonist muscles</title>
<p>Coupling between pairs of antagonist muscles is often used to assess the relationship between their activity or changes in limb rigidity following perturbation (<xref ref-type="bibr" rid="ref40">Rudolph et al., 2000</xref>; <xref ref-type="bibr" rid="ref26">Mari et al., 2014</xref>; <xref ref-type="bibr" rid="ref42">Solopova et al., 2019</xref>; <xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>). <xref ref-type="fig" rid="fig6">Figure 6</xref> illustrates the results of such analyses for antagonist muscles using parameters like Pearson&#x2019;s correlation coefficient (<italic>r</italic>) and coactivation index (<italic>CI</italic>) before and after limb blocks. Overall, both <italic>r</italic> (~0.2&#x2013;0.7) and <italic>CI</italic> (~0.1&#x2013;0.3) were relatively small (<xref ref-type="fig" rid="fig6">Figure 6</xref>) and showed no significant difference between time intervals [&#x2212;2&#x202F;s, B] and [B, 2&#x202F;s] for all block conditions and pairs of antagonist muscles (BB-TB, RF-BF, and TA-LG) for both full-term and preterm infants (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.1, Kruskal-Wallis test and Mann&#x2013;Whitney U post-hoc test).</p>
<fig position="float" id="fig6">
<label>Figure 6</label>
<caption>
<p>Correlation and coactivation of antagonist muscles during limb block in full-term and preterm infants. Correlation (<italic>r</italic>) and coactivation (<italic>CI</italic>) of antagonist muscles (BB-TB, RF-BF, and TA-LG) were calculated in the time intervals [&#x2212;2&#x202F;s, B] and [B, 2&#x202F;s].</p>
</caption>
<graphic xlink:href="fnins-19-1657677-g006.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Bar graphs showing muscle activation in full-term and preterm babies with blocked and unblocked limbs. Categories include arm, leg, ipsilateral arm-leg, and contralateral arm-leg. Graphs cover correlation and coactivation, labeled BB-TB, RF-BF, and TA-LG. Blocks: blue (arm), green (leg), cyan (ipsilateral arm-leg), pink (contralateral arm-leg). Time scale: minus two seconds to two seconds.</alt-text>
</graphic>
</fig>
</sec>
<sec id="sec11">
<title>Changes in muscle activity during limb block release</title>
<p>We also examined potential changes in EMG activity during limb block release, comparing the 2-s pre- and post-release intervals. Similar to the onset of limb block (<xref ref-type="fig" rid="fig3">Figures 3</xref>, <xref ref-type="fig" rid="fig5">5</xref>, <xref ref-type="fig" rid="fig6">6</xref>), we did not find differences in the levels of EMGs before [&#x2212;2&#x202F;s, R] and after [R, 2&#x202F;s] limb release (not shown) (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Kruskal-Wallis test and Mann&#x2013;Whitney U post-hoc test), and we observed significant variability in time-varying EMG profiles (<xref ref-type="fig" rid="fig2">Figure 2B</xref>), as during limb block. Also, the periodic and aperiodic spectral EMG components (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Wilcoxon rank sum test) and agonist&#x2013;antagonist muscle coactivation (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.1, Mann&#x2013;Whitney U post-hoc test) were not different in 2-s pre- and post-release intervals.</p>
</sec>
<sec id="sec12">
<title>Effect of age on muscle activity following block</title>
<p>While we were interested in the overall effect of limb block during spontaneous movements during the first 7&#x202F;months after birth (<xref ref-type="fig" rid="fig3">Figures 3</xref>&#x2013;<xref ref-type="fig" rid="fig6">6</xref>) [SMs are typically observed within 5&#x2013;7&#x202F;months after birth (<xref ref-type="bibr" rid="ref18">Jensen et al., 1995</xref>; <xref ref-type="bibr" rid="ref10">Dolinskaya et al., 2021</xref>)], the kinematics of SMs show some age-related changes (<xref ref-type="bibr" rid="ref37">Prechtl and Hopkins, 1986</xref>; <xref ref-type="bibr" rid="ref34">Piek and Carman, 1994</xref>; <xref ref-type="bibr" rid="ref14">Gima et al., 2011</xref>; <xref ref-type="bibr" rid="ref21">Kanemaru et al., 2012</xref>; <xref ref-type="bibr" rid="ref32">Ohmura et al., 2016</xref>). Therefore, we also verified whether there were systematic age-related differences in the EMG activity of a given upper or lower limb muscle following its block (pooling all conditions when the corresponding limb was blocked or not). To this end, infants (<xref ref-type="table" rid="tab1">Table 1</xref>) were separated into three age groups (&#x003C;2.5 mo, 2.5&#x2013;4.5 mo, and 4.5&#x2013;7.5 mo). We found no significant age-related differences in mean EMG activity before and after block for any muscle or age group (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05, Kruskal-Wallis test).</p>
</sec>
</sec>
<sec sec-type="discussion" id="sec13">
<title>Discussion</title>
<p>We examined whether infants (both full-term and preterm) during the first half-year after birth reveal changes in how muscles respond to the temporary mechanical block of one or two limbs during SMs, while the other limbs were allowed to move. To this aim, we analysed polymyographic recordings in the lower and upper limb muscles using multiple analytical approaches, including time-domain EMG averaging, power spectral density analysis, and coactivation/correlation indices (<xref ref-type="fig" rid="fig1">Figure 1B</xref>, <xref ref-type="fig" rid="fig3">3</xref>&#x2013;<xref ref-type="fig" rid="fig6">6</xref>). Infants did not appear to discontinue their ongoing muscular activity immediately after the block, whether in the blocked or unblocked limbs, which was still noticeable (<xref ref-type="fig" rid="fig3">Figure 3</xref>), albeit varying between limbs and infants (<xref ref-type="fig" rid="fig2">Figure 2</xref>). While the analyses (<xref ref-type="fig" rid="fig3">Figures 3</xref>&#x2013;<xref ref-type="fig" rid="fig6">6</xref>) only represent an &#x2018;integrative&#x2019; measure of coordination, across all of them no consistent or stereotyped EMG responses were found in either the blocked or the unblocked limbs during the 2-s pre- and post-block intervals.</p>
<sec id="sec14">
<title>Interpretation of the lack of consistent responses</title>
<p>Mechanical stimulations are often employed to assess responsiveness or inter-limb sensorimotor connections throughout early development, but the results reported in the literature are diverse, depending on the experimental paradigm and developmental stage investigated.</p>
<p>For instance, kicking supine with a load at the ankle may make either the duration of flexion or extension of the loaded leg longer (<xref ref-type="bibr" rid="ref30">Musselman and Yang, 2007</xref>) although the authors did not find significant changes in the muscle activation. Some previous studies reported changes in the interlimb coordination in human infants in response to unilateral weighting of the limb, that changes the proprioceptive input and/or limits limb movements. Infants may respond to the unilateral weight during SM with an increase in kicks of the non-weighted leg compared to the number of kicks in the weighted leg (<xref ref-type="bibr" rid="ref49">Thelen et al., 1987</xref>; <xref ref-type="bibr" rid="ref50">Vaal et al., 2000</xref>), consistent with studies on newborn animals (<xref ref-type="bibr" rid="ref3">Brumley and Robinson, 2013</xref>), suggesting a role of proprioception and movement-related feedback to modulate spontaneous motor activity during early motor development. Limb weighting experiments used paradigms in which kicking behaviour (from one to several minutes) was evaluated during a baseline period and again when the weight was added to one of the limbs. However, for such proprioceptive manipulations, infants typically began to change their pattern of leg kicking after some period of exposure to unilateral weighting or an interlimb yoke (<xref ref-type="bibr" rid="ref48">Thelen, 1994</xref>) in line with a delayed onset of such adjustments in perinatal rats (<xref ref-type="bibr" rid="ref39">Robinson et al., 2008</xref>), implying a general non-specific effect rather than an automatic/reflexive response, whereas muscular responses to limb block may differ in functional role and underlying mechanisms.</p>
<p>To our knowledge, there has been no comprehensive investigation of alterations in the coordination of activity across different muscle groups in response to limb block during SMs. Given that inter-limb coupling during early spontaneous activity is known to be weak but significant, both in kinematic correlations between upper and lower limbs during stepping (<xref ref-type="bibr" rid="ref24">La Scaleia et al., 2018</xref>; <xref ref-type="bibr" rid="ref13">Forma et al., 2019</xref>) and during spontaneous movements (<xref ref-type="bibr" rid="ref35">Piek et al., 2002</xref>; <xref ref-type="bibr" rid="ref21">Kanemaru et al., 2012</xref>), we also employed a two-limb block (ipsilateral and contralateral, <xref ref-type="fig" rid="fig1">Figure 1A</xref>), to test whether proprioceptive feedback from multiple limbs might enhance such coupling. Averaged muscle activity (<xref ref-type="fig" rid="fig3">Figures 3</xref>, <xref ref-type="fig" rid="fig4">4</xref>), its spectral characteristics (<xref ref-type="fig" rid="fig5">Figure 5</xref>), and against-antagonist coactivation (<xref ref-type="fig" rid="fig6">Figure 6</xref>) were similar before and after the block of different limbs in both full-term and preterm infants. The results (<xref ref-type="fig" rid="fig3">Figures 3</xref>&#x2013;<xref ref-type="fig" rid="fig6">6</xref>) corroborate generally poor velocity and position correlations of the limb endpoints during SMs in healthy infants. For example, the pattern of spontaneous movements changes from a general activity involving all limbs to an activity involving more selective interlimb coordination from 2 to 4&#x202F;months of age; however, such correlations are significant but weak, requiring a large number of movements to reveal them (<xref ref-type="bibr" rid="ref21">Kanemaru et al., 2012</xref>). Therefore, if one considers the applied manipulation (limb block) as a disruption to continuing coordinated muscle activity, the lack of consistent responses (<xref ref-type="fig" rid="fig3">Figures 3</xref>, <xref ref-type="fig" rid="fig5">5</xref>, <xref ref-type="fig" rid="fig6">6</xref>) may be interpreted as a manifestation of immature and weakly integrated sensorimotor connections between the limbs during SMs.</p>
<p>The lack of consistent responses during limb block is opposed to the rapid and coordinated responses observed during stepping movements or manipulations related to muscle tone examination in similar age ranges. For example, applying load of one leg or trip-inducing stimuli during stepping movements can elicit immediate responses, such as an increase in hip and knee flexor muscle torque (<xref ref-type="bibr" rid="ref25">Lam et al., 2003</xref>; <xref ref-type="bibr" rid="ref33">Pang et al., 2003</xref>), and transient leg block and release may evoke immediate tonic or phasic muscle reactions (<xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>). Other manual manipulations, such as passive joint flexions and extensions, are able to reveal consistent muscle reactions to lengthening and shortening, which is a powerful manifestation of developing muscle tone in infants, and it is quite impressive that such reactions in some muscles occur in a high proportion (&#x003E;90%) of passive movements (<xref ref-type="bibr" rid="ref42">Solopova et al., 2019</xref>). Thus, the presence of sensory input during changes in muscle length is likely to be more effective in revealing sensorimotor connections throughout early development than its non-appearance (during limb block).</p>
</sec>
<sec id="sec15">
<title>Neurodevelopmental and clinical implications</title>
<p>The absence of systematic EMG changes likely reflects a genuine physiological characteristic of early motor organization. During the first months after birth, neural circuits supporting inter-limb coordination are functionally present but still immature. Spinal networks can generate segmental reflexes and basic motor patterns, while supraspinal inputs are emerging and only weakly integrated with spinal circuits (<xref ref-type="bibr" rid="ref52">Yang et al., 2015</xref>; <xref ref-type="bibr" rid="ref2">Blumberg and Adolph, 2023</xref>). Coupling between limbs depends on the gradual maturation of sensorimotor feedback loops. In this context, a transient limb block during SMs may not yet trigger organized responses, as the developing system is not fully tuned to integrate proprioceptive signals across limbs. This interpretation is consistent with developmental neurophysiology: although muscle tone and segmental reflexes can be elicited early, the integration of sensory feedback into coordinated inter-limb responses emerges gradually through experience-dependent plasticity (<xref ref-type="bibr" rid="ref41">Schouenborg, 2010</xref>; <xref ref-type="bibr" rid="ref16">Hadders-Algra, 2014</xref>).</p>
<p>The sample of preterm infants (<xref ref-type="table" rid="tab1">Table 1</xref>) was heavily biased toward moderate and late preterm infants (overall, 15 out of 18 preterm infants had 32 or more weeks of gestational age). Therefore, we do not know whether a sample more representative of extreme and very preterm infants would display behaviour comparable to that reported here. This point is relevant also with regard to potential clinical implications, since it is well known that infants at risk of developing cerebral palsy or other neurodevelopmental motor disorders mainly fall in the categories of extreme and very preterm infants, i.e., they are born before 32&#x202F;weeks of gestational age and/or weigh less than 2.5&#x202F;kg at birth. Clinically, the absence of systematic adjustments, as observed in our healthy sample, may be used as a baseline reference for identifying early deviations in motor coordination, potentially informing early assessment and intervention strategies. Variability is an inherent property of sensorimotor behaviour at any age of life (<xref ref-type="bibr" rid="ref51">Vidal and Lacquaniti, 2021</xref>). As far as it concerns early development, the presence of consistent or exaggerated responses to brief limb manipulations could serve as an early indicator of atypical sensorimotor development, such as hyperconnected pathways or altered inter-limb coupling. For instance, a well-established feature of motor behaviour in infants with cerebral palsy is the stereotyped nature of their SMs, which contrasts with the variability and flexibility observed in typically developing infants (<xref ref-type="bibr" rid="ref17">Hadders-Algra, 2018</xref>; <xref ref-type="bibr" rid="ref23">Kwong et al., 2018</xref>).</p>
</sec>
<sec id="sec16">
<title>Limitations</title>
<p>The study has some limitations. First, standardizing the exact moment of limb block was challenging due to the inherent variability of spontaneous movements. A larger number of trials might be necessary to detect relationships between transient limb block and the phase or type of SMs episodes (e.g., &#x2018;writhing&#x2019; or &#x2018;fidgety&#x2019;, <xref ref-type="bibr" rid="ref37">Prechtl and Hopkins, 1986</xref>). Second, the sex distribution of our sample was unequal (full-term: 7 females and 13 males; preterm: 10 females and 8 males). Although not inherently problematic, sex-related differences in motor development have been reported (<xref ref-type="bibr" rid="ref37">Prechtl and Hopkins, 1986</xref>; <xref ref-type="bibr" rid="ref9">Dinkel and Snyder, 2020</xref>). However, these differences also appear to be influenced by a combination of biological and socio-cultural factors, which are difficult to fully control in this type of protocol. Third, our analysis treats each group (full-term and preterm) as homogeneous, although some infants may have shown a response while others did not, depending on factors such as age or neurological maturity. More consistent responses might therefore be observed in certain individuals, but a larger number of probes would be required to examine interindividual variability, particularly in the context of identifying early indicators of atypical sensorimotor development. Nevertheless, when considering the full populations of full-term and preterm infants, the findings indicate that the transient effect of limb immobilization is neither evident nor consistent across limbs or participants (<xref ref-type="fig" rid="fig3">Figures 3</xref>, <xref ref-type="fig" rid="fig5">5</xref>, <xref ref-type="fig" rid="fig6">6</xref>). Despite these limitations, the use of three complementary analytical approaches (amplitude, spectral, and coactivation analyses; <xref ref-type="fig" rid="fig1">Figure 1B</xref>) strengthens confidence that this null finding does not reflect methodological artefacts but rather reflects immaturity of interlimb coupling.</p>
</sec>
</sec>
<sec sec-type="conclusions" id="sec17">
<title>Conclusion</title>
<p>In sum, the results suggest that the lack of consistent muscle responses to limb block (<xref ref-type="fig" rid="fig3">Figures 3</xref>&#x2013;<xref ref-type="fig" rid="fig5">5</xref>) may be indicative of weak inter-limb coordination during SMs, as compared to similar manipulations during stepping movements (<xref ref-type="bibr" rid="ref25">Lam et al., 2003</xref>; <xref ref-type="bibr" rid="ref8">Dewolf et al., 2022</xref>). Infant motor activity during the first half-year after birth is essential for the development of voluntary motor skills, muscle tone, and calibration of the proprioceptive system. High variability of neuromuscular signals and responses during SMs may attest neonatal immaturity, but they also involve potential benefits for learning locomotor tasks (<xref ref-type="bibr" rid="ref37">Prechtl and Hopkins, 1986</xref>; <xref ref-type="bibr" rid="ref41">Schouenborg, 2010</xref>; <xref ref-type="bibr" rid="ref44">Sylos-Labini et al., 2022</xref>; <xref ref-type="bibr" rid="ref11">Dolinskaya et al., 2023</xref>). Further research may provide new empirical evidence on the emergence of muscle coordinative behaviour, which has clinical implications for abnormal development (<xref ref-type="bibr" rid="ref16">Hadders-Algra, 2014</xref>; <xref ref-type="bibr" rid="ref20">Kanemaru et al., 2014</xref>) as well as the mechanisms driving early maturation of sensory circuitries.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec18">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, upon reasonable request.</p>
</sec>
<sec sec-type="ethics-statement" id="sec19">
<title>Ethics statement</title>
<p>The studies involving humans were approved by Ethics Committee of the Moscow Research Institute of Clinical Pediatrics (protocol n.14/18). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants&#x2019; legal guardians/next of kin.</p>
</sec>
<sec sec-type="author-contributions" id="sec20">
<title>Author contributions</title>
<p>DR: Software, Visualization, Formal analysis, Writing &#x2013; original draft, Methodology, Data curation, Writing &#x2013; review &#x0026; editing. ID: Methodology, Investigation, Writing &#x2013; review &#x0026; editing, Formal analysis. VS: Writing &#x2013; review &#x0026; editing, Investigation. EK: Writing &#x2013; review &#x0026; editing, Investigation. IS: Formal analysis, Writing &#x2013; review &#x0026; editing, Conceptualization, Investigation, Funding acquisition. FS-L: Methodology, Conceptualization, Writing &#x2013; review &#x0026; editing, Visualization, Software, Funding acquisition, Formal analysis. FL: Funding acquisition, Conceptualization, Supervision, Writing &#x2013; review &#x0026; editing. YI: Methodology, Project administration, Writing &#x2013; review &#x0026; editing, Supervision, Visualization, Formal analysis, Writing &#x2013; original draft, Funding acquisition, Conceptualization.</p>
</sec>
<sec sec-type="COI-statement" id="sec21">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
<p>The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.</p>
</sec>
<sec sec-type="ai-statement" id="sec22">
<title>Generative AI statement</title>
<p>The authors declare that no Gen AI was used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec sec-type="disclaimer" id="sec23">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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<fn-group>
<fn fn-type="custom" custom-type="edited-by" id="fn0001"><p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/129037/overview">Vincenzo Leuzzi</ext-link>, Sapienza University of Rome, Italy</p></fn>
<fn fn-type="custom" custom-type="reviewed-by" id="fn0002"><p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1318305/overview">Veronica Lopez-Virgen</ext-link>, University of Colima, Mexico</p>
<p><ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/2188194/overview">Hirotaka Gima</ext-link>, Tokyo Metropolitan University, Japan</p></fn>
</fn-group>
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