Motor Synergies in Physical Therapy: The Uncontrolled Manifold Approach; A Narrative Review

Document Type : Review Articles


1 PhD Candidate, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Associate Professor, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz AND Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

4 Associate Professor, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

5 Professor, Department of Physical Therapy, School of Paramedical Sciences AND Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

6 Assistant Professor, Department of Neurology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranMotor Synergies in Physical Therapy: The Uncontrolled Manifold Approach; A Narrative Review



Introduction: Movement is the main identity and the base of knowledge and practice in physical therapy; thus, the advances in motor control science, and motor learning and development are linked to physical therapy clinical activity. The purpose of this narrative review article was to describe a prominent approach in motor control with potential to better understanding and diagnosis of movement dysfunctions, the uncontrolled manifold (UCM).Materials and Methods: In this narrative review, databases such as PubMed, Web of Science, and Google Scholar were searched from 1999 till 2017, using the key words “Synergy”, “Uncontrolled Manifold”, “Motor Control”, and “Anticipatory Synergy Adjustment”.Results: Finally, 37 studies were included. Most studies discussed the degree of freedom problem in human movements, history of synergy, characteristics of synergy, introducing the uncontrolled manifold approach as a tool for quantifying the synergy, and clinical applications of this method in the assessments of movement dysfunctions.Conclusion: Using this method provides the ability to identify the connections between functional activities with motor synergies, synergy strength index, and the anticipatory synergy adjustments. The uncontrolled manifold offers a science-based approach to guide clinical decision making on whether synergies have to be broken, reinforced, or created new synergies in patients with movement dysfunctions.


  1. Bellamy J. Vision statement for the physical therapy profession and guiding principles to achieve the vision [Online]. [cited 2013]; Available from: URL:
  2. Turvey MT. Coordination. Am Psychol 1990; 45(8): 938-53.
  3. Latash ML. The bliss (not the problem) of motor abundance (not redundancy). Exp Brain Res 2012; 217(1): 1-5.
  4. Latash ML, Levin MF, Scholz JP, Schoner G. Motor control theories and their applications. Medicina (Kaunas) 2010; 46(6): 382-92.
  5. Latash ML, Scholz JP, Schoner G. Toward a new theory of motor synergies. Motor Control 2007; 11(3): 276-308.
  6. Latash ML. Synergy. Oxford, UK: Oxford University Press; 2008.
  7. Bobath B. Adult hemiplegia: Evaluation and treatment. Oxford, UK: Heinemann Medical; 1990.
  8. Latash ML, Gorniak S, Zatsiorsky VM. Hierarchies of synergies in human movements. Kinesiology (Zagreb) 2008; 40(1): 29-38.
  9. Latash ML, Anson JG. Synergies in health and disease: relations to adaptive changes in motor coordination. Phys Ther 2006; 86(8): 1151-60.
  10. Scholz JP, Schoner G. The uncontrolled manifold concept: Identifying control variables for a functional task. Exp Brain Res 1999; 126(3): 289-306.
  11. Latash ML, Huang X. Neural control of movement stability: Lessons from studies of neurological patients. Neuroscience 2015; 301: 39-48.
  12. Davids K, Bennett S, Newell KM. Movement System Variability. Champaign, IL: Human Kinetics; 2006.
  13. Smith LI. A tutorial on Principal Components Analysis (Computer Science Technical Report No. OUCS-2002-12). Otago, New Zealand: Department of Computer Science, University of Otago; 2002.
  14. Daffertshofer A, Lamoth CJ, Meijer OG, Beek PJ. PCA in studying coordination and variability: A tutorial. Clin Biomech (Bristol, Avon) 2004; 19(4): 415-28.
  15. Davids K, Glazier P, Araujo D, Bartlett R. Movement systems as dynamical systems: the functional role of variability and its implications for sports medicine. Sports Med 2003; 33(4): 245-60.
  16. Latash ML, Krishnamoorthy V, Scholz JP, Zatsiorsky VM. Postural synergies and their development. Neural Plast 2005; 12(2-3): 119-30.
  17. Latash ML, Scholz JP, Schoner G. Motor control strategies revealed in the structure of motor variability. Exerc Sport Sci Rev 2002; 30(1): 26-31.
  18. Olafsdottir H, Yoshida N, Zatsiorsky VM, Latash ML. Elderly show decreased adjustments of motor synergies in preparation to action. Clin Biomech (Bristol, Avon) 2007; 22(1): 44-51.
  19. Olafsdottir HB, Zatsiorsky VM, Latash ML. The effects of strength training on finger strength and hand dexterity in healthy elderly individuals. J Appl Physiol (1985) 2008; 105(4): 1166-78.
  20. Latash ML, Kang N, Patterson D. Finger coordination in persons with Down syndrome: atypical patterns of coordination and the effects of practice. Exp Brain Res 2002; 146(3): 345-55.
  21. Park J, Wu YH, Lewis MM, Huang X, Latash ML. Changes in multifinger interaction and coordination in Parkinson's disease. J Neurophysiol 2012; 108(3): 915-24.
  22. Jo HJ, Mattos D, Lucassen EB, Huang X, Latash ML. Changes in multidigit synergies and their feed-forward adjustments in multiple sclerosis. J Mot Behav 2017; 49(2): 218-28.
  23. Shim JK, Olafsdottir H, Zatsiorsky VM, Latash ML. The emergence and disappearance of multi-digit synergies during force-production tasks. Exp Brain Res 2005; 164(2): 260-70.
  24. Kim SW, Shim JK, Zatsiorsky VM, Latash ML. Anticipatory adjustments of multi-finger synergies in preparation for self-triggered perturbations. Exp Brain Res 2006; 174(4): 604-12.
  25. Reisman DS, Scholz JP. Workspace location influences joint coordination during reaching in post-stroke hemiparesis. Exp Brain Res 2006; 170(2): 265-76.
  26. Reisman DS, Scholz JP. Aspects of joint coordination are preserved during pointing in persons with post-stroke hemiparesis. Brain 2003; 126(Pt 11): 2510-27.
  27. Domkin D, Laczko J, Djupsjobacka M, Jaric S, Latash ML. Joint angle variability in 3D bimanual pointing: uncontrolled manifold analysis. Exp Brain Res 2005; 163(1): 44-57.
  28. Domkin D, Laczko J, Jaric S, Johansson H, Latash ML. Structure of joint variability in bimanual pointing tasks. Exp Brain Res 2002; 143(1): 11-23.
  29. Mehravar M, Yadollah-Pour N, Tajali S, Shaterzadeh-Yazdi Mj, Majdinasab N. The role of anticipatory postural adjustments and compensatory control of posture in balance control of patients with multiple sclerosis. J Mech Med Biol 2015; 15(5): 1550087.
  30. Tajali S, Negahban H, Shaterzadeh MJ, Mehravar M, Salehi R, Narimani R, et al. Multijoint coordination during sit-to-stand task in people with non-specific chronic low back pain. Biomed Eng Appl Basis Commun 2013; 25(01): 1350010.
  31. Tajali S, Negahban H, Yazdi MJS, Salehi R, Mehravar M, Parnianpour M. The effects of postural difficulty conditions on variability of joint kinematic patterns during sit to stand task in normals and patients with non-specific chronic low back pain. Proceedings of the 1st Middle East Conference on Biomedical Engineering; 2011 Feb 22-25; Sharjah, United Arab Emirates. p. 300-03.
  32. Reisman DS, Scholz JP, Schoner G. Coordination underlying the control of whole body momentum during sit-to-stand. Gait Posture 2002; 15(1): 45-55.
  33. Reisman DS, Scholz JP, Schoner G. Differential joint coordination in the tasks of standing up and sitting down.
  34. J Electromyogr Kinesiol 2002; 12(6): 493-505.
  35. Papi E, Rowe PJ, Pomeroy VM. Analysis of gait within the uncontrolled manifold hypothesis: stabilisation of the centre of mass during gait. J Biomech 2015; 48(2): 324-31.
  36. Krishnan V, Rosenblatt NJ, Latash ML, Grabiner MD. The effects of age on stabilization of the mediolateral trajectory of the swing foot. Gait Posture 2013; 38(4): 923-8.
  37. Black DP, Smith BA, Wu J, Ulrich BD. Uncontrolled manifold analysis of segmental angle variability during walking: preadolescents with and without Down syndrome. Exp Brain Res 2007; 183(4): 511-21.
  38. Wang Y, Asaka T, Watanabe K. Multi-muscle synergies in elderly individuals: preparation to a step made under the self-paced and reaction time instructions. Exp Brain Res 2013; 226(4): 463-72.
  39. Wang Y, Zatsiorsky VM, Latash ML. Muscle synergies involved in preparation to a step made under the self-paced and reaction time instructions. Clin Neurophysiol 2006; 117(1): 41-56.
  40. Wang Y, Watanabe K, Asaka T. Muscle synergies in preparation to a step made with obstacle in elderly individuals.
  41. J Neuroeng Rehabil 2015; 12: 10.
  42. Jo HJ, Maenza C, Good DC, Huang X, Park J, Sainburg RL, et al. Effects of unilateral stroke on multi-finger synergies and their feed-forward adjustments. Neuroscience 2016; 319: 194-205.
Volume 13, Issue 5 - Serial Number 5
January 2018
Pages 296-302
  • Receive Date: 11 March 2018
  • Revise Date: 19 April 2024
  • Accept Date: 22 May 2022