The extraction of neural strategies from the surface EMG

Mental fatigue impairs physical performance but not the neural drive to the muscle: a preliminary analysis

Mental fatigue (MF) does not only affect cognitive but also physical performance. This study aimed to explore the effects of MF on muscle endurance, rate of perceived exertion (RPE), and motor units' activity. Ten healthy males participated in a randomised crossover study. The subjects attended two identical experimental sessions separated by 3 days with the only difference of a cognitive task (incongruent Stroop task [ST]) and a control condition (watching a documentary). Perceived MF and motivation were measured for each session at baseline and after each cognitive task. Four contractions at 20% of maximal voluntary contraction (MVIC) were performed at baseline, after each cognitive and after muscle endurance task while measuring motor units by high-density surface electromyography. Muscle endurance until failure at 50% of MVIC was measured after each cognitive task and the RPE was measured right after failure. ST significantly increased MF (p = 0.001) reduced the motivation (p = 0.008) for the subsequent physical task and also impaired physical performance (p = 0.044). However, estimates of common synaptic inputs and motor unit discharge rates as well as RPE were not affected by MF (p > 0.11). In conclusion, MF impairs muscle endurance and motivation for the physical task but not the neural drive to the muscle at any frequency bands. Although it is physiologically possible for mentally fatigued subjects to generate an optimal neuromuscular function, the altered motivation seems to limit physical performance. Preliminarily, our results suggest that the corticospinal pathways are not affected by MF.

Neuromuscular control: from a biomechanist's perspective

Understanding neural control of movement necessitates a collaborative approach between many disciplines, including biomechanics, neuroscience, and motor control. Biomechanics grounds us to the laws of physics that our musculoskeletal system must obey. Neuroscience reveals the inner workings of our nervous system that functions to control our body. Motor control investigates the coordinated motor behaviours we display when interacting with our environment. The combined efforts across the many disciplines aimed at understanding human movement has resulted in a rich and rapidly growing body of literature overflowing with theories, models, and experimental paradigms. As a result, gathering knowledge and drawing connections between the overlapping but seemingly disparate fields can be an overwhelming endeavour. This review paper evolved as a need for us to learn of the diverse perspectives underlying current understanding of neuromuscular control. The purpose of our review paper is to integrate ideas from biomechanics, neuroscience, and motor control to better understand how we voluntarily control our muscles. As biomechanists, we approach this paper starting from a biomechanical modelling framework. We first define the theoretical solutions (i.e., muscle activity patterns) that an individual could feasibly use to complete a motor task. The theoretical solutions will be compared to experimental findings and reveal that individuals display structured muscle activity patterns that do not span the entire theoretical solution space. Prevalent neuromuscular control theories will be discussed in length, highlighting optimality, probabilistic principles, and neuromechanical constraints, that may guide individuals to families of muscle activity solutions within what is theoretically possible. Our intention is for this paper to serve as a primer for the neuromuscular control scientific community by introducing and integrating many of the ideas common across disciplines today, as well as inspire future work to improve the representation of neural control in biomechanical models.

A Novel Wall Touch-Single Limb Stance Exercise for Dynamic Activation o f Gluteus Maximus - A Cross Sectional Study

Objective

Gluteus maximus (GM) dysfunction is associated with spinal/lower extremity musculoskeletal conditions. Studies on weightbearing GM exercises that can be used earlier in rehabilitation is limited. Utilizing GM isometric contraction and load transmission to thoracolumbar fascia during trunk straightening under unilateral stance, we for the first time describe Wall Touch Single Limb Stance (WT-SLS) exercise. Specific exercise prescription may be rationalised using knowledge of how upper and lower fibres of GM (UGM, LGM) respond during novel WT-SLS.

Methodology

Surface EMG signals from UGM and LGM were compared among WT-SLS, Step up (SU) and Unilateral wall squat (UWS) in healthy subjects (N = 24). Raw data was normalized and expressed as percentage of maximum voluntary isometric contraction (%MVIC). Relative easiness in performing the exercises was scored using Borg's CR10 scale. Statistical significance was defined as p < 0.05.

Results

WT-SLS had the highest %MVIC for both UGM and LGM (p < 0.0001), suggesting maximum activation of GM in healthy adults by our novel exercise. WT-SLS generated more motor unit action potentials, and had significantly greater activity for UGM than LGM (p = 0.0429). Remaining exercises had no differential activation of UGM and LGM. WT-SLS was perceived as only 'slight' exertion.

Conclusions

WT-SLS depicted the greatest muscle activation, suggesting possible better clinical and functional outcomes considering GM activation and strengthening. UGM was preferentially activated during WT-SLS, but not during SU and UWS. Therefore, targeting GM with our novel exercise may improve gluteal weakness and dysfunction in lumbar radiculopathy, knee ligament injuries; as preventive measure for injury; or for postural correction.

Evolution of surface electromyography: From muscle electrophysiology towards neural recording and interfacing

Surface electromyography (EMG) comprises a recording of electrical activity from the body surface generated by muscle fibres during muscle contractions. Its characteristics depend on the fibre membrane potentials and the neural activation signal sent from the motor neurons to the muscles. EMG has been classically used as the primary investigation tool in kinesiology studies in a variety of applications. More recently, surface EMG techniques have evolved from single-channel methods to high-density systems with hundreds of electrodes. High-density EMG recordings can be deconvolved to estimate the discharge times of spinal motor neurons innervating the recorded muscles, with algorithms that have been developed and validated in the last two decades. Within limits and with some variability across muscles, these techniques provide a non-invasive method to study relatively large populations of motor neurons in humans. Surface EMG is thus evolving from a peripheral measure of muscle electrical activity towards a neural recording and neural interfacing signal. These advances in technology have had a major impact on our fundamental understanding of the neural control of movement and have exposed new perspectives in neurotechnologies. Here we provide an overview and perspective of modern EMG technology, as derived from past achievements, and its impact in neurophysiology and neural engineering.

Task-related differences in peroneus longus muscle fiber conduction velocity

It has been identified that the peroneus longus presents a regional activity. Specifically, a greater activation of the anterior and posterior compartments has been observed during eversion, whereas a lower activation of the posterior compartment has been reported during plantarflexion. In addition to myoelectrical amplitude, motor unit recruitment can be inferred indirectly from muscle fiber conduction velocity (MFCV). However, there are few reports of MFCV of the regions that make up a muscle, and even less, MFCV of the peroneus longus compartments. This study aimed to analyze the MFCV of peroneus longus compartments during eversion and plantarflexion. Twenty-one healthy individuals were assessed. High-density surface electromyography was recorded from the peroneus longus during eversion and plantarflexion at 10%, 30%, 50%, and 70% of maximal voluntary isometric contraction. The posterior compartment presented a lower MFCV than the anterior compartment during plantarflexion, and both compartments did not show differences in MFCV during eversion; however, the posterior compartment showed an increase in MFCV during eversion compared to plantarflexion. Differences observed in the MFCV of the peroneus longus compartments could support a regional activation strategy and, to some extent, explain different motor unit recruitment strategies of the peroneus longus during ankle movements.

Muscle synergies for evaluating upper limb in clinical applications: A systematic review

INTRODUCTION

Muscle synergies have been proposed as a strategy employed by the central nervous system to control movements. Muscle synergy analysis is a well-established framework to examine the pathophysiological basis of neurological diseases and has been applied for analysis and assessment in clinical applications in the last decades, even if it has not yet been widely used in clinical diagnosis, rehabilitative treatment and interventions. Even if inconsistencies in the outputs among studies and lack of a normative pipeline including signal processing and synergy analysis limit the progress, common findings and results are identifiable as a basis for future research. Therefore, a literature review that summarizes methods and main findings of previous works on upper limb muscle synergies in clinical environment is needed to i) summarize the main findings so far, ii) highlight the barriers limiting their use in clinical applications, and iii) suggest future research directions needed for facilitating translation of experimental research to clinical scenarios.

METHODS

Articles in which muscle synergies were used to analyze and assess upper limb function in neurological impairments were reviewed. The literature research was conducted in Scopus, PubMed, and Web of Science. Experimental protocols (e.g., the aim of the study, number and type of participants, number and type of muscles, and tasks), methods (e.g., muscle synergy models and synergy extraction methods, signal processing methods), and the main findings of eligible studies were reported and discussed.

RESULTS

383 articles were screened and 51 were selected, which involved a total of 13 diseases and 748 patients and 1155 participants. Each study investigated on average 15 ± 10 patients. Four to forty-one muscles were included in the muscle synergy analysis. Point-to-point reaching was the most used task. The preprocessing of EMG signals and algorithms for synergy extraction varied among studies, and non-negative matrix factorization was the most used method. Five EMG normalization methods and five methods for identifying the optimal number of synergies were used in the selected papers. Most of the studies report that analyses on synergy number, structure, and activations provide novel insights on the physiopathology of motor control that cannot be gained with standard clinical assessments, and suggest that muscle synergies may be useful to personalize therapies and to develop new therapeutic strategies. However, in the selected studies synergies were used only for assessment; different testing procedures were used and, in general, study-specific modifications of muscle synergies were observed; single session or longitudinal studies mainly aimed at assessing stroke (71% of the studies), even though other pathologies were also investigated. Synergy modifications were either study-specific or were not observed, with few analyses available for temporal coefficients. Thus, several barriers prevent wider adoption of muscle synergy analysis including a lack of standardized experimental protocols, signal processing procedures, and synergy extraction methods. A compromise in the design of the studies must be found to combine the systematicity of motor control studies and the feasibility of clinical studies. There are however several potential developments that might promote the use of muscle synergy analysis in clinical practice, including refined assessments based on synergistic approaches not allowed by other methods and the availability of novel models. Finally, neural substrates of muscle synergies are discussed, and possible future research directions are proposed.

CONCLUSIONS

This review provides new perspectives about the challenges and open issues that need to be addressed in future work to achieve a better understanding of motor impairments and rehabilitative therapy using muscle synergies. These include the application of the methods on wider scales, standardization of procedures, inclusion of synergies in the clinical decisional process, assessment of temporal coefficients and temporal-based models, extensive work on the algorithms and understanding of the physio-pathological mechanisms of pathology, as well as the application and adaptation of synergy-based approaches to various rehabilitative scenarios for increasing the available evidence.

The Effects of Anchor Schemes on Performance Fatigability, Neuromuscular Responses and the Perceived Sensations That Contributed to Task Termination

The present study examined the effect of anchor schemes on the time to task failure (TTF), performance fatigability, neuromuscular responses, and the perceived sensations that contributed to task termination following the sustained, isometric forearm flexion tasks. Eight women completed sustained, isometric forearm flexion tasks anchored to RPE = 8 (RPEFT) and the torque (TRQFT) that corresponded to RPE = 8. The subjects performed pre-test and post-test maximal isometric contractions to quantify performance fatigability and changes in electromyographic amplitude (EMG AMP) and neuromuscular efficiency (NME). In addition, the subjects completed a post-test questionnaire (PTQ) to quantify the contributions of perceived sensations to task termination. Repeated measure ANOVAs were used to assess the mean differences for TTF, performance fatigability, and neuromuscular responses. Wilcoxon Signed Rank Tests were used to assess the differences between anchor schemes for the average values from the PTQ item scores. For TTF, the RPEFT was longer than the TRQFT (174.9 ± 85.6 vs. 65.6 ± 68.0 s; p = 0.006). Collapsed across the anchor scheme, there were decreases in torque (23.7 ± 5.5 Nm vs. 19.6 ± 4.9 Nm; p < 0.001) and NME (1.00 ± 0.00 vs. 0.76 ± 0.15; p = 0.003). There were no significant (p > 0.577) changes for EMG AMP. For the PTQ, there were no differences (p > 0.05) between anchor schemes. There were, however, inter-individual differences in the response scores. The current findings indicated that performance fatigability was likely due to peripheral fatigue (based on NME), not central fatigue (based on EMG AMP). Furthermore, the use of a PTQ may serve as a simple tool to assess the contributions of perceived sensations to task termination.

Exacerbated central fatigue and reduced exercise capacity in early-stage breast cancer patients treated with chemotherapy

PURPOSE

The present study aimed to characterize the etiology of exercise-induced neuromuscular fatigue and its consequences on the force-duration relationship to provide mechanistic insights into the reduced exercise capacity characterizing early-stage breast cancer patients.

METHODS

Fifteen early-stage breast cancer patients and fifteen healthy women performed 60 maximal voluntary isometric quadriceps contractions (MVCs, 3 s of contraction, 2 s of relaxation). The critical force was determined as the mean force of the last six contractions, while W' was calculated as the force impulse generated above the critical force. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQTw) evoked by supramaximal electrical stimulation, respectively.

RESULTS

Early-stage breast cancer patients demonstrated lower MVC than controls preexercise (- 15%, P = 0.022), and this reduction persisted throughout the 60-MVC exercise (- 21%, P = 0.002). The absolute critical force was lower in patients than in controls (144 ± 29N vs. 201 ± 47N, respectively, P < 0.001), while W' was similar (P = 0.546), resulting in lower total work done (- 23%, P = 0.001). This was associated with lower muscle activation in the vastus lateralis (P < 0.001), vastus medialis (P = 0.003) and rectus femoris (P = 0.003) in patients. Immediately following exercise, ΔVA showed a greater reduction in patients compared to controls (- 21.6 ± 13.3% vs. - 12.6 ± 7.7%, P = 0.040), while ΔQTw was similar (- 60.2 ± 13.2% vs. - 52.8 ± 19.4%, P = 0.196).

CONCLUSION

These findings support central fatigue as a primary cause of the reduction in exercise capacity characterizing early-stage breast cancer patients treated with chemotherapy.

CLINICAL TRIALS REGISTRATION

No. NCT04639609-November 20, 2020.

A real-time and convex model for the estimation of muscle force from surface electromyographic signals in the upper and lower limbs

Surface electromyography (sEMG) is a signal consisting of different motor unit action potential trains and records from the surface of the muscles. One of the applications of sEMG is the estimation of muscle force. We proposed a new real-time convex and interpretable model for solving the sEMG-force estimation. We validated it on the upper limb during isometric voluntary flexions-extensions at 30%, 50%, and 70% Maximum Voluntary Contraction in five subjects, and lower limbs during standing tasks in thirty-three volunteers, without a history of neuromuscular disorders. Moreover, the performance of the proposed method was statistically compared with that of the state-of-the-art (13 methods, including linear-in-the-parameter models, Artificial Neural Networks and Supported Vector Machines, and non-linear models). The envelope of the sEMG signals was estimated, and the representative envelope of each muscle was used in our analysis. The convex form of an exponential EMG-force model was derived, and each muscle's coefficient was estimated using the Least Square method. The goodness-of-fit indices, the residual signal analysis (bias and Bland-Altman plot), and the running time analysis were provided. For the entire model, 30% of the data was used for estimation, while the remaining 20% and 50% were used for validation and testing, respectively. The average R-square (%) of the proposed method was 96.77 ± 1.67 [94.38, 98.06] for the test sets of the upper limb and 91.08 ± 6.84 [62.22, 96.62] for the lower-limb dataset (MEAN ± SD [min, max]). The proposed method was not significantly different from the recorded force signal (p-value = 0.610); that was not the case for the other tested models. The proposed method significantly outperformed the other methods (adj. p-value < 0.05). The average running time of each 250 ms signal of the training and testing of the proposed method was 25.7 ± 4.0 [22.3, 40.8] and 11.0 ± 2.9 [4.7, 17.8] in microseconds for the entire dataset. The proposed convex model is thus a promising method for estimating the force from the joints of the upper and lower limbs, with applications in load sharing, robotics, rehabilitation, and prosthesis control for the upper and lower limbs.

Effect of electrical stimulation training and detraining on abdominal muscle function

BACKGROUND

Electrical muscle stimulation (EMS) has been applied in many rehabilitation settings for muscle strengthening, facilitation of muscle contraction, re-education of muscle action, and maintenance of muscle strength and size during prolonged immobilization.

OBJECTIVE

The purpose of this study was to investigate effect of 8 weeks of EMS training on abdominal muscle function and to determine whether the training effect could be maintained after 4 weeks of EMS detraining.

METHODS

Twenty-five subjects performed EMS training for 8 weeks. Before and after 8 weeks of EMS training, and after 4 weeks of EMS detraining, muscle size (cross-sectional area [CSA] of the rectus abdominals [RA] and lateral abdominal wall [LAW]), strength, endurance, and lumbopelvic control (LC) were measured.

RESULTS

There were significant increases in CSA [RA (p< 0.001); LAW (p< 0.001)], strength [trunk flexor (p= 0.005); side-bridge (p< 0.05)], endurance [trunk flexor (p= 0.010); side-bridge (p< 0.05)], and LC (p< 0.05) after 8 weeks of EMS training. The CSA of the RA (p< 0.05) and the LAW (p< 0.001) were measured after 4 weeks of detraining and they were greater than that of the baseline. There were no significant differences in abdominal strength, endurance, and LC between baseline measurements and post-detraining.

CONCLUSION

The study indicates that there is less of a detraining effect on muscle size than on muscle strength, endurance, and LC.

Consensus for experimental design in electromyography (CEDE) project: Single motor unit matrix

The analysis of single motor unit (SMU) activity provides the foundation from which information about the neural strategies underlying the control of muscle force can be identified, due to the one-to-one association between the action potentials generated by an alpha motor neuron and those received by the innervated muscle fibers. Such a powerful assessment has been conventionally performed with invasive electrodes (i.e., intramuscular electromyography (EMG)), however, recent advances in signal processing techniques have enabled the identification of single motor unit (SMU) activity in high-density surface electromyography (HDsEMG) recordings. This matrix, developed by the Consensus for Experimental Design in Electromyography (CEDE) project, provides recommendations for the recording and analysis of SMU activity with both invasive (needle and fine-wire EMG) and non-invasive (HDsEMG) SMU identification methods, summarizing their advantages and disadvantages when used during different testing conditions. Recommendations for the analysis and reporting of discharge rate and peripheral (i.e., muscle fiber conduction velocity) SMU properties are also provided. The results of the Delphi process to reach consensus are contained in an appendix. This matrix is intended to help researchers to collect, report, and interpret SMU data in the context of both research and clinical applications.

High-density Surface Electromyography as Biomarker of Muscle Aging

Sarcopenia is a muscle disease with adverse changes that increase throughout the lifetime but with different chronological scales between individuals. Addressing "early muscle aging" is becoming a critical issue for prevention. Through the CHRONOS study, we demonstrated the ability of the high-density surface electromyography (HD-sEMG), a noninvasive, wireless, portable technology, to detect both healthy muscle aging and accelerated muscle aging related to a sedentary lifestyle, one of the risk factors of sarcopenia. The HD-sEMG signals were analyzed in 91 healthy young, middle-aged, and old subjects (25-75 years) distributed according to their physical activity status (82 active and 9 sedentary; International Physical Activity Questionnaire) and compared with current methods for muscle evaluation, including muscle mass (dual-energy X-ray absorptiometry [DXA], ultrasonography), handgrip strength, and physical performance. The HD-sEMG signals were recorded from the rectus femoris during sit-to-stand trials, and 2 indexes were analyzed: muscular contraction intensity and muscle contraction dynamics. The clinical parameters did not differ significantly across the aging and physical activity levels. Inversely, the HD-sEMG indexes were correlated to age and were different significantly through the age categories of the 82 active subjects. They were significantly different between sedentary subjects aged 45-54 years and active ones at the same age. The HD-sEMG indexes of sedentary subjects were not significantly different from those of older active subjects (≥55 years). The muscle thicknesses evaluated using ultrasonography were significantly different between the 5 age decades but did not show a significant difference with physical activity. The HD-sEMG technique can assess muscle aging and physical inactivity-related "early aging," outperforming clinical and DXA parameters.

Chronic training status affects muscle excitation of the vastus lateralis during repeated contractions

This study examined electromyographic amplitude (EMG_RMS)-force relationships during repeated submaximal knee extensor muscle actions among chronic aerobically-(AT), resistance-trained (RT), and sedentary (SED) individuals. Fifteen adults (5/group) attempted 20 isometric trapezoidal muscle actions at 50% of maximal strength. Surface electromyography (EMG) was recorded from vastus lateralis (VL) during the muscle actions. For the first and last successfully completed contractions, linear regression models were fit to the log-transformed EMG_RMS-force relationships during the linearly increasing and decreasing segments, and the b terms (slope) and a terms (antilog of y-intercept) were calculated. EMG_RMS was averaged during steady force. Only the AT completed all 20 muscle actions. During the first contraction, the b terms for RT (1.301 ​± ​0.197) were greater than AT (0.910 ​± ​0.123; p ​= ​0.008) and SED (0.912 ​± ​0.162; p ​= ​0.008) during the linearly increasing segment, and in comparison to the linearly decreasing segment (1.018 ​± ​0.139; p ​= ​0.014), respectively. For the last contraction, the b terms for RT were greater than AT during the linearly increasing (RT ​= ​1.373 ​± ​0.353; AT ​= ​0.883 ​± ​0.129; p ​= ​0.018) and decreasing (RT ​= ​1.526 ​± ​0.328; AT ​= ​0.970 ​± ​0.223; p ​= ​0.010) segments. In addition, the b terms for SED increased from the linearly increasing (0.968 ​± ​0.144) to decreasing segment (1.268 ​± ​0.126; p ​= ​0.015). There were no training, segment, or contraction differences for the a terms. EMG_RMS during steady force increased from the first- ([64.08 ​± ​51.68] ​μV) to last-contraction ([86.73 ​± ​49.55] ​μV; p ​= ​0.001) collapsed across training statuses. The b terms differentiated the rate of change for EMG_RMS with increments in force among training groups, indicating greater muscle excitation to the motoneuron pool was necessary for the RT than AT during the linearly increasing and decreasing segments of a repetitive task.

Relative contribution of neuromuscular activation, muscle size, and muscle quality to maximum strength output of the thigh muscles in young individuals

This study aimed to investigate the relationship between maximal muscle strength and neuromuscular activation, muscle size, and quality of quadriceps (QF) and hamstring muscles (HM). The study included 24 young men and women. The neuromuscular activation parameter was recorded using a single-channel surface electromyography (EMG) with the root mean square (RMS) during maximal isometric knee extension and flexion from four muscles: rectus femoris and vastus lateralis for QF; biceps femoris and semitendinosus for HM. In addition, the peak torque was measured during the same session. B-mode ultrasonographic transverse images were obtained from the anterior, lateral, and posterior thighs. Furthermore, we calculated the muscle thickness (MT) and echo intensity (EI) of the four muscles as indicators of muscle size and quality. The averaged MT, EI, and absolute RMS of QF were calculated by averaging the values of the rectus femoris and vastus lateralis, and that of HM was calculated by averaging the values of the biceps femoris and semitendinosus. The knee extension peak torque was correlated with EI (r = -0.61, P < 0.01) and RMS (r = 0.53, P < 0.01) in the QF. In contrast, the knee flexion peak torque was correlated with RMS (r = 0.53, P < 0.05) but not with MT and EI in HM. In addition, EI and RMS in QF, and RMS in HM were selected as the major determinants of muscle strength in the stepwise regression analysis. These results suggest that muscle strength is moderately associated with different factors related to the thigh muscles in young individuals.

Surface electromyography analysis of mirror movements under unilateral movement in stroke patients: A retrospective study

Objective

Mirror movements (MMs) are common abnormal motor performance in patients with poststroke hemiparesis. The study aimed to utilize the Electromyography (EMG) characterization of MMs in stroke patients and explore the relationship between MMs and the motor function of affected limbs.

Methods

Sixty patients with stroke who had used to undergo clinical assessment and surface Electromyography (sEMG) were selected in this study. We investigated the standardized net excitation (SNE) and overflow percentage (OF) as a measure of mirror activities on bilateral muscles of stroke patients.

Results

In stroke patients, mirror activities occurred in both affected and unaffected muscles during maximal contractions. We found that OF at unilateral contraction on the affected side (UCA) was significantly greater than that at unilateral contraction on the unaffected side (UCU). Additionally, a negative correlation between OF at UCA and Brunnstrom stages on admission and discharge. However, there were no significant correlations between OF and disease duration, Barthel Index, or the degree of improvement in all clinical evaluations. We still found a positive correlation between SNE at UCA and the improvement of the Brunnstrom stage of the hand. But we could not find any significant correlation between SNE and other clinical evaluation scores.

Conclusion

In conclusion, the study found mirror activities in both affected and unaffected muscles, confirming an asymmetry between them. Although the mechanisms are still unclear, we confirmed a significant correlation between MMs at UCA and the motor function of the affected upper extremity, which might provide further evidences for understanding MMs in stroke patients and a new research direction on evaluation for motor function and outcomes of stroke patients.

Responsiveness of electromyographically assessed skeletal muscle inactivity: methodological exploration and implications for health benefits

Prolonged sedentary behaviour is detrimental to health due to low contractile activity in large lower extremity muscle groups. This muscle inactivity can be measured with electromyography (EMG), but it is unknown how methodological factors affect responsiveness longitudinally. This study ranks 16 different EMG inactivity thresholds based on their responsiveness (absolute and standardized effect size, responsiveness) using data from a randomized controlled trial targeted at reducing and breaking up sedentary time (InPact, ISRCTN28668090). EMG inactivity duration and usual EMG inactivity bout duration (weighted median of bout lengths) were measured from large lower extremity muscle groups (quadriceps, hamstring) with EMG-sensing shorts. The results showed that the EMG inactivity threshold above signal baseline (3 μV) provided overall the best responsiveness indices. At baseline, EMG inactivity duration of 66.8 ± 9.6% was accumulated through 73.9 ± 36.0 s usual EMG inactivity bout duration, both of which were reduced following the intervention (-4.8 percentage points, -34.3 s). The proposed methodology can reduce variability in longitudinal designs and the detailed results can be used for sample size calculations. Reducing EMG inactivity duration and accumulating EMG inactivity in shorter bouts has a potential influence on muscle physiology and health.

Sex-specific myoelectric manifestations of localized fatigue during a multi-joint repetitive task

We have previously demonstrated that fatigue at different locations impacts joint angles, angular variability, and coordination variability differently. However, the neuromuscular control aspects underlying these kinematic changes have never been demonstrated. Seventeen young adults (8 males) were recruited. Electromyographic electrodes were placed on: upper trapezius, pectoralis major, anterior and middle deltoid, biceps and triceps brachii, and left and right erector spinae. Subjects performed the repetitive pointing task (RPT) at 1 Hz for 30 s before and after localized fatigue tasks, which consisted of one shoulder, one elbow and one lower back isometric fatiguing protocols until exhaustion in randomized order. Electromyographic amplitude (RMS), variability (SD) and mean power frequency (MnPF) were calculated for each of the pre-fatigue and post-fatigue RPT trials. There were sex × fatigue location interaction effects on upper trapezius RMS (p = 0.038) with males' values increasing the most after shoulder fatigue. Females' triceps brachii RMS was greater compared to males after shoulder, elbow, and trunk fatigue (p = 0.003, p = 0.001 and p = 0.007 respectively). There were sex × fatigue location effects on left erector spinae MnPF (p = 0.011) with males and females' values decreasing the most after trunk fatigue, but more so in males. Results demonstrate that males and females compensate differently during a repetitive pointing task when their elbows, shoulders and trunks are locally fatigued, which could have implications on sex-specific workplace injury risks. See Table 1 for acronyms.

No effect of coactivation on fatigue-induced decreases in isokinetic and isometric torque in healthy young male adults

BACKGROUND

Antagonist activation may contribute to fatigue-induced decreases in torque while assisting in the maintenance of joint stability. This study utilized a reciprocal, slow velocity (60°·s^-1) forearm flexion and extension fatiguing task to examine the contributions of coactivation to torque production at slow and moderate (180°·s^-1) velocities, as well as during a maximal voluntary isometric contraction (MVIC).

METHODS

Twelve recreationally active men (mean ± SD: age = 21.7 ± 1.6 years; body mass = 83.5 ± 8.8 kg; height = 179.4 ± 5.2 cm) completed isokinetic (60 and 180°·s^-1) and isometric pre-testing of forearm flexion and extension, followed by 50 maximal, reciprocal, isokinetic muscle actions at 60°·s^-1, followed by post-testing. The amplitude (AMP) of the electromyographic (EMG) signals from the biceps and triceps brachii were simultaneously recorded. Torque and EMG AMP were normalized to the corresponding values from the pre-testing peak torque movements. Repeated measures ANOVAs and pairwise comparisons were used to identify mean changes in torque, EMG AMP, and coactivation ratios.

RESULTS

The torque analyses indicated greater (p < 0.03) decreases for 180°·s^-1 (24%) and MVIC (23%) than 60°·s^-1 (14%) for forearm flexion. For forearm extension, there were no differences (p > 0.05) in fatigability between velocities. For EMG AMP there were no changes (p > 0.05) from pre- to post-testing for any velocity or movement. There were no changes (p > 0.05) in the coactivation ratio for forearm flexion, but significant increases (13.6 ± 6.6 to 16.9 ± 6.0; p = 0.003) for forearm extension, collapsed across Velocity.

CONCLUSIONS

There was velocity- and movement-specific fatigability for forearm flexion and extension. The parallel, fatigue-induced EMG AMP responses indicated that coactivation did not contribute to the decreases in torque and would not affect elbow joint stability.

Inter-muscular networks of synchronous muscle fiber activation

Skeletal muscles continuously coordinate to facilitate a wide range of movements. Muscle fiber composition and timing of activation account for distinct muscle functions and dynamics necessary to fine tune muscle coordination and generate movements. Here we address the fundamental question of how distinct muscle fiber types dynamically synchronize and integrate as a network across muscles with different functions. We uncover that physiological states are characterized by unique inter-muscular network of muscle fiber cross-frequency interactions with hierarchical organization of distinct sub-networks and modules, and a stratification profile of links strength specific for each state. We establish how this network reorganizes with transition from rest to exercise and fatigue-a complex process where network modules follow distinct phase-space trajectories reflecting their functional role in movements and adaptation to fatigue. This opens a new area of research, Network Physiology of Exercise, leading to novel network-based biomarkers of health, fitness and clinical conditions.

People with chronic low back pain display spatial alterations in high-density surface EMG-torque oscillations

We quantified the relationship between spatial oscillations in surface electromyographic (sEMG) activity and trunk-extension torque in individuals with and without chronic low back pain (CLBP), during two submaximal isometric lumbar extension tasks at 20% and 50% of their maximal voluntary torque. High-density sEMG (HDsEMG) signals were recorded from the lumbar erector spinae (ES) with a 64-electrode grid, and torque signals were recorded with an isokinetic dynamometer. Coherence and cross-correlation analyses were applied between the filtered interference HDsEMG and torque signals for each submaximal contraction. Principal component analysis was used to reduce dimensionality of HDsEMG data and improve the HDsEMG-based torque estimation. sEMG-torque coherence was quantified in the δ(0–5 Hz) frequency bandwidth. Regional differences in sEMG-torque coherence were also evaluated by creating topographical coherence maps. sEMG-torque coherence in the δ band and sEMG-torque cross-correlation increased with the increase in torque in the controls but not in the CLBP group (p = 0.018, p = 0.030 respectively). As torque increased, the CLBP group increased sEMG-torque coherence in more cranial ES regions, while the opposite was observed for the controls (p = 0.043). Individuals with CLBP show reductions in sEMG-torque relationships possibly due to the use of compensatory strategies and regional adjustments of ES-sEMG oscillatory activity.

The impact of local therapies for breast cancer on shoulder muscle health and function

Advances in breast cancer treatment have improved patient survival but have also created complications, such as shoulder morbidity, impacting the patient's quality of life. Local therapies for breast cancer influence shoulder muscle health through changes to the muscular microenvironment, macroscopic muscle morphology, and neuromuscular function. Our findings suggest both surgery and radiation therapy compromise the healthy functioning of shoulder musculature. Mastectomy and post-mastectomy breast reconstruction directly affect shoulder function through muscle morphology and neuromuscular function alterations. Radiation therapy damages satellite cells and myocytes, causing cell death both during treatment and years after recovery. This damage creates an environment limited in its ability to prevent atrophy. However, research to date is limited to a small number of analyses with small experimental populations and a lack of control for covariates. Future research to uncover the pathophysiological mechanisms underlying shoulder morbidity after breast cancer treatment must integrate measures of shoulder muscle health and shoulder function.

Caffeine Increases Endurance Performance via Changes in Neural and Muscular Determinants of Performance Fatigability

PURPOSE

In the present study, we tested the hypothesis that caffeine would increase endurance performance via attenuation of neural and muscular determinants of performance fatigability during high-intensity, whole-body exercise.

METHODS

Ten healthy males cycled until exhaustion (89% ± 2% of V̇O2max) after the ingestion of caffeine or placebo. During another four visits, the same exercise was performed after either caffeine or placebo ingestion but with exercise discontinued after completing either 50% or 75% of the duration of placebo trial. An additional trial with caffeine ingestion was also performed with interruption at the placebo time to exhaustion (isotime). Performance fatigability was measured via changes in maximal voluntary contraction, whereas neural and muscular determinants of performance fatigability were quantified via preexercise to postexercise decrease in quadriceps voluntary activation (VA) and potentiated twitch force, respectively.

RESULTS

Compared with the placebo, caffeine increased time to exhaustion (+14.4 ± 1.6%, P = 0.017, 314.4 ± 47.9 vs 354.9 ± 40.8 s). Caffeine did not change the rate of decline in maximal voluntary contraction (P = 0.209), but caffeine reduced the twitch force decline at isotime when stimulating at single twitch (-58.6 ± 22.4 vs -45.7 ± 21.9%, P = 0.014) and paired 10 Hz electrical stimuli (-37.3 ± 13.2 vs -28.2 ± 12.9%, P = 0.025), and reduced the amplitude of electromyography signal during cycling at isotime (P = 0.034). The decline in VA throughout the trial was lower (P = 0.004) with caffeine (-0.5 ± 4.2%) than with placebo (-5.8 ± 8.5%). Caffeine also maintained peripheral oxygen saturation at higher levels (95.0 ± 1.9%) than placebo (92.0 ± 6.2%, P = 0.016).

CONCLUSIONS

Caffeine ingestion improves performance during high-intensity, whole-body exercise via attenuation of exercise-induced reduction in VA and contractile function.

Teaching Essential EMG Theory to Kinesiologists and Physical Therapists Using Analogies Visual Descriptions, and Qualitative Analysis of Biophysical Concepts

Electromyography (EMG) is a multidisciplinary field that brings together allied health (kinesiology and physical therapy) and the engineering sciences (biomedical and electrical). Since the physical sciences are used in the measurement of a biological process, the presentation of the theoretical foundations of EMG is most conveniently conducted using math and physics. However, given the multidisciplinary nature of EMG, a course will most likely include students from diverse backgrounds, with varying levels of math and physics. This is a pedagogical paper that outlines an approach for teaching foundational concepts in EMG to kinesiologists and physical therapists that uses a combination of analogies, visual descriptions, and qualitative analysis of biophysical concepts to develop an intuitive understanding for those who are new to surface EMG. The approach focuses on muscle fiber action potentials (MFAPs), motor unit action potentials (MUAPs), and compound muscle action potentials (CMAPs) because changes in these waveforms are much easier to identify and describe in comparison to the surface EMG interference pattern (IP).

Corticospinal control of a challenging ankle task in incomplete spinal cord injury

After incomplete spinal cord injury (iSCI), the control of lower extremity movements may be affected by impairments in descending corticospinal tract function. Previous iSCI studies demonstrated relatively well-preserved movement control during simple alternating dorsi- and plantarflexions albeit with severely reduced motor strength and range of motion. However, this task required comparably limited fine motor control, impeding the sensitivity to assess the modulatory capacity of corticospinal control. Therefore, we introduced a more challenging ankle motor task requiring complex and dynamic feedback-based movement adjustments to modulate corticospinal drive. Nineteen individuals with iSCI and 22 control subjects performed two different ankle movement tasks: i) a regular, auditory-guided ankle movement task at a constant frequency as baseline assessment, and ii) an irregular, visually-guided ankle movement task following a predefined trajectory as a more challenging motor task. Both tasks were performed separately and in a randomised order. Electromyography (EMG) and kinematic data were recorded. EMG frequency characteristics were investigated using wavelet transformations. Control participants exhibited a shift of relative EMG intensity from higher (>100Hz) to lower frequencies (20-60Hz) comparing the regular with the irregular movement task. There is evidence that EMG activity within these lower frequencies comprise information on corticospinal drive. The EMG frequency shift was less pronounced for the less impaired leg and absent for the more impaired leg of individuals with iSCI. The precision error during the irregular task was significantly higher for individuals with iSCI (more impaired leg: 12.34±11.14%; less impaired leg: 6.93±2.74%) compared to control participants (4.10±0.84%). These results, along with the walking performance, correlated well with the delta frequency shift between the regular and irregular movement task in the 38Hz band (corticospinal drive frequency) in the iSCI group, suggesting that task performance is related to the capacity to modulate corticospinal control. The irregular movement task holds promise as a tool for revealing further insights into corticospinal control of single-joint movements. It may serve as a surrogate marker for the assessment of modulatory capacity and the integrity of corticospinal control in individuals with iSCI early after injury and throughout rehabilitation.

Can phase angle from bioelectrical impedance analysis associate with neuromuscular properties of the knee extensors?

Maintenance and improvement of neuromuscular functions is crucial for everyone regardless of age. An easy way to assess neuromuscular properties without muscle contraction is useful especially for those who cannot perform strenuous muscular force production, such as older adults and patients with orthopedic or cognitive disorders. Bioelectrical impedance analysis (BIA) can assess body electrical properties e.g., phase angle (PhA) which is regarded as muscle quantity/quality index. The purpose of this study was to investigate associations of PhA with neuromuscular properties of the knee extensors in 55 young (n = 23) and older (n = 32) adults. The values of PhA of the right thigh and whole-body were determined with BIA at 50 kHz. The participants performed 4-s maximal voluntary isometric contraction (MVIC) to measure peak torque (PT_MVIC), and 1-s brief MVIC to assess rate of torque development (RTD) over the time interval of 0–200 ms. As markers of physiological mechanisms of muscle force production, twitch contractile properties (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque) of the knee extensors obtained by femoral nerve electrical stimulation, and muscle activity assessed as root mean square values of electromyographic activity (EMG-RMS) during PT_MVIC and RTD measurements were measured. Thigh and whole-body PhA significantly correlated with PT_MVIC (r ≥ 0.555, p < 0.001) and electrically evoked twitch parameters (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque; |r| ≥ 0.420, p ≤ 0.001), but not RTD (r ≤ 0.237, p ≥ 0.081) or EMG-RMSs (|r| ≤ 0.214, p ≥ 0.117). Stepwise multiple linear regression analysis revealed that thigh PhA was selected as a significant variable to predict PT_MVIC but not RTD. Whole-body PhA was not selected as a significant variable to predict PT_MVIC or RTD. In conclusion, both thigh and whole-body PhA can associate with maximal voluntary muscle strength of the knee extensors, and this association may be due to intrinsic contractile properties but not neural aspects. Regarding prediction of the knee extensor strength, thigh PhA is preferable as the predictor rather than whole-body PhA which is used as a widely acknowledged indicator of sarcopenia.

Membrane capacitance and characteristic frequency are associated with contractile properties of skeletal muscle

The cell membrane capacitance (Cm) and characteristic frequencies (fc) of tissues can be obtained using segmental bioelectrical impedance spectroscopy (S-BIS). Higher Cm and lower fc are associated with a larger surface area of skeletal muscle fibers with T-tubules in the tissues. Muscle fiber membrane is one of the major physiological factors that influence surface electromyograms (EMGs) as well as the number of recruited motor units so that the amplitude of surface EMG may be correlated with Cm and fc. The aim of the current study was to examine the association of fc or Cm in the lower leg with contractile and neuromuscular properties in the plantar flexors. We analyzed data from 59 participants (29 women) aged 21-83 years. The Cm, fc, and intracellular water (ICW) in the lower leg were obtained using S-BIS. We measured electrical-evoked torque, maximal voluntary contraction (MVC) torque, and amplitude of EMG normalized by the M wave during MVC contraction. The high Cm group had a significantly lower fc and significantly higher MVC torque, estimated maximum torque, twitch torque, and root mean square (RMS) of EMG normalized by the M wave (EMG:M) in the musculus triceps surae compared to the low Cm group (P < 0.05). Cm was positively and fc was negatively correlated with the nRMS of EMG:M in the triceps surae (P < 0.05). S-BIS recordings can be used to detect changes in skeletal muscle membrane capacitance, which may provide insights into the number of T-tubules. The muscle capacitance measured with S-BIS can be predictive of muscle force generation.

Neuromuscular and structural tendon adaptations after 6 weeks of either concentric or eccentric exercise in individuals with non-insertional Achilles tendinopathy: protocol for a randomised controlled trial

INTRODUCTION

There is limited evidence on the neural strategies employed by the central nervous system to control muscle force in the presence of non-insertional Achilles tendinopathy (NIAT). Additionally, the neuromuscular mechanisms by which exercise may help to resolve tendon pain remain unclear.

OBJECTIVE

This study aims to first establish changes in the gastrocnemius-soleus motor unit firing properties after applying a training protocol of 6 weeks based on either controlled eccentric or concentric contractions in individuals with NIAT. Second, we want to determine changes in the level of pain and function and mechanical and structural properties of the Achilles tendon after applying the same training protocol. Additionally, we want to compare these variables at baseline between individuals with NIAT and asymptomatic controls.

METHODS AND ANALYSIS

A total of 26 individuals with chronic (>3 months) NIAT and 13 healthy controls will participate in the study. Individuals with NIAT will be randomised to perform eccentric or concentric training for 6 weeks. Motor unit firing properties of the medial gastrocnemius, lateral gastrocnemius and soleus muscles will be assessed using high-density surface electromyography, as well as Achilles tendon length, cross-sectional area, thickness and stiffness using B-mode ultrasonography and shear wave elastography. Moreover, participants will complete a battery of questionnaires to document their level of pain and function.

ETHICS AND DISSEMINATION

Ethical approval (ERN-20-0604A) for the study was obtained from the Science, Technology, Engineering and Mathematics Ethical Review Committee of the University of Birmingham. The results of the study will be published in peer-review journals.

TRIAL REGISTRATION NUMBER

ISRCTN46462385.

Uterine slow wave: directionality and changes with imminent delivery

OBJECTIVE

The slow wave (SW) of the electrohysterogram (EHG) may contain relevant information on the electrophysiological condition of the uterus throughout pregnancy and labor. Our aim was to assess differences in the SW as regards the imminence of labor and the directionality of uterine myoelectrical activity.

APPROACH

The SW of the EHG was extracted from the signals of the Icelandic 16-electrode EHG database in the bandwidth [5, 30] mHz and its power, spectral content, complexity and synchronization between the horizontal (X) and vertical (Y) directions were characterized by the root mean square (RMS), dominant frequency (domF), sample entropy (SampEn) and maximum cross-correlation (CCmax) of the signals, respectively. Significant differences between parameters at time-to-delivery (TTD) ≤7 vs. >7 days and between the horizontal vs. vertical directions were assessed.

MAIN RESULTS

The SW power significantly increased in both directions as labor approached (TTD≤7d vs. >7d (mean±SD): x= 0.12±0.10 vs. 0.08±0.06mV; y= 0.12±0.09 vs. 0.08±0.05mV), as well as the dominant frequency in the horizontal direction (= 9.1±1.3 vs. 8.5±1.2mHz) and the synchronization between both directions (= 0.44±0.16 vs. 0.36±0.14). Furthermore, its complexity decreased in the vertical direction (= 6.13·10-2±8.7·10-3 vs. 6.50·10-2±8.3·10-3), suggesting a higher cell-to-cell electrical coupling. Whereas there were no differences between the SW features in both directions in the general population, statistically significant differences were obtained between them in individuals in many cases.

SIGNIFICANCE

Our results suggest that the SW of the EHG is related to bioelectrical events in the uterus and could provide objective information to clinicians in challenging obstetric scenarios.

Acute Neuromuscular and Hormonal Responses to Power, Strength, and Hypertrophic Protocols and Training Background

This study investigated how two slightly different athlete groups would differ in acute neuromuscular and endocrine responses to specific resistance exercise loadings and recovery compared to untrained participants. Power athletes (PA, n = 8), strength athletes (SA, n = 8) and non-athletes (NA, n = 7) performed power (PL, 7 × 6 × 50% of 1RM), maximal strength (MSL, 7 × 3 × 3RM), and hypertrophic (HL, 5 × 10 × 10RM) loadings in Smith-machine back-squat. Neuromuscular performance, serum testosterone, growth hormone, and cortisol concentrations, and blood lactate (BL) were measured before (Pre), at Mid and after (Post) loading, and after recovery for 24 and 48 h. All loadings led to acute decreases in neuromuscular performance and elevations in hormone concentrations and BL. During PL, a significant group × time interactions occurred in maximal isometric force [F_{(4, 40)} = 4.189, p = 0.006, ηp2 = 0.295] indicating a greater decrease in PA compared to SA from Pre to Mid (p < 0.05), and in countermovement jump height [F_{(4, 40)} = 2.895, p = 0.034, ηp2 = 0.224] indicating a greater decrease in NA compared to SA from Pre to Mid (p < 0.05). During HL, growth hormone was higher in Mid and Post in SA compared to NA (p < 0.05). No significant interactions were found during recovery. The differences during PL and HL suggest that the training background may enhance acute responses during the present loadings, whereas it seemed to have a limited effect on the recovery.

Kinematic synergies in over-ground slip recovery outcomes: Distinct strategies or a single strategy?

BACKGROUND

After experiencing an unexpected slip perturbation, individuals' behavioral performance can be classified into three categories: recovery, feet-forward fall, and split fall. Researchers are uncertain whether these differences in slip outcomes are due to distinct strategies or part of a single strategy.

RESEARCH QUESTION

Whether older adults with different behavioral outcomes during their novel slip have different kinematic synergies?

METHODS

The kinematic synergies were extracted from segment angles in 87 participants using principal component analysis (PCA). The first two principal components (PC1 and PC2) in pre-slip, early-reactive, and late-reactive phases were compared across different slip outcomes.

RESULTS

Results showed that the kinematic synergies in pre-slip and early-reactive phases are highly consistent among the three outcomes (recovery, split fall, and feet-forward fall). For the late-reactive phase, both split falls and feet-forward falls showed different kinematics synergies from recoveries.

SIGNIFICANCE

Our findings indicated that a single strategy might be used for different slip outcomes in the pre-slip and early-reactive phases, while distinct strategies were used by fallers compared to recovered individuals. Specifically, larger trunk flexion in pre-slip phase, larger knee flexion and plantar flexion of the slipping limb in both early-reactive and late-reactive phase, and larger knee extension of the recovery limb in late-reactive phase would lower the fall risk. This study would help to assess the vulnerabilities in control strategy, according to which individualized treatment could be provided to reduce predisposition to specific types of falls.

Hamstring muscle activation strategies during eccentric contractions are related to the distribution of muscle damage

Large inter‐individual variability of activation strategies is observed during hamstring strengthening exercises but their consequences remain unexplored. The objective of this study was to determine whether individual activation strategies are related to the distribution of damage across the hamstring muscle heads semimembranosus (SM), semitendinosus (ST), and biceps femoris (BF) after eccentric contractions. 24 participants performed 5 sets of 15 maximal eccentric contractions of knee flexors on a dynamometer, while activation of each muscle head was assessed using surface electromyography. Knee flexion maximal isometric strength was assessed before exercise and 48 h afterward. Shear modulus was measured using shear wave elastography before exercise and 30 min afterward to quantify the distribution of damage across the hamstring muscle heads. At 48 h, maximal knee flexion torque had decreased by 15.9% ± 16.9% (p < 0.001). Although no differences between activation ratios of each muscle were found during the eccentric exercise (all p > 0.364), we reported a heterogeneous distribution of damage, with a larger change in shear modulus of ST/Hams than SM/Hams (+70.8%, p < 0.001) or BF/Hams (+50.3%, p < 0.001). A large correlation was found between the distribution of activation and the distribution of damage for ST/Hams (r = 0.69; p < 001). This study provides evidence that the distribution of activation during maximal eccentric contractions has mechanical consequences for synergist muscles. Further studies are needed to understand whether individual activation strategies influence the distribution of structural adaptations after a training program.

Estimating muscle activation from EMG using deep learning-based dynamical systems models

Objective. To study the neural control of movement, it is often necessary to estimate how muscles are activated across a variety of behavioral conditions. One approach is to try extracting the underlying neural command signal to muscles by applying latent variable modeling methods to electromyographic (EMG) recordings. However, estimating the latent command signal that underlies muscle activation is challenging due to its complex relation with recorded EMG signals. Common approaches estimate each muscle's activation independently or require manual tuning of model hyperparameters to preserve behaviorally-relevant features.Approach. Here, we adapted AutoLFADS, a large-scale, unsupervised deep learning approach originally designed to de-noise cortical spiking data, to estimate muscle activation from multi-muscle EMG signals. AutoLFADS uses recurrent neural networks to model the spatial and temporal regularities that underlie multi-muscle activation.Main results. We first tested AutoLFADS on muscle activity from the rat hindlimb during locomotion and found that it dynamically adjusts its frequency response characteristics across different phases of behavior. The model produced single-trial estimates of muscle activation that improved prediction of joint kinematics as compared to low-pass or Bayesian filtering. We also applied AutoLFADS to monkey forearm muscle activity recorded during an isometric wrist force task. AutoLFADS uncovered previously uncharacterized high-frequency oscillations in the EMG that enhanced the correlation with measured force. The AutoLFADS-inferred estimates of muscle activation were also more closely correlated with simultaneously-recorded motor cortical activity than were other tested approaches.Significance.This method leverages dynamical systems modeling and artificial neural networks to provide estimates of muscle activation for multiple muscles. Ultimately, the approach can be used for further studies of multi-muscle coordination and its control by upstream brain areas, and for improving brain-machine interfaces that rely on myoelectric control signals.

Visuo-Motor Affective Interplay: Bonding Scenes Promote Implicit Motor Pre-dispositions Associated With Social Grooming-A Pilot Study

Proximity and interpersonal contact are prominent components of social connection. Giving affective touch to others is fundamental for human bonding. This brief report presents preliminary results from a pilot study. It explores if exposure to bonding scenes impacts the activity of specific muscles related to physical interaction. Fingers flexion is a very important component when performing most actions of affectionate contact. We explored the visuo-motor affective interplay by priming participants with bonding scenes and assessing the electromyographic activity of the fingers flexor muscle, in the absence of any overt movements. Photographs of dyads in social interaction and of the same dyads not interacting were employed. We examined the effects upon the electromyographical activity: (i) during the passive exposure to pictures, and (ii) during picture offset and when expecting the signal to perform a fingers flexion task. Interacting dyads compared to matched non-interacting dyads increased electromyographic activity of the fingers flexor muscle in both contexts. Specific capture of visual bonding cues at the level of visual cortex had been described in the literature. Here we showed that the neural processing of visual bonding cues reaches the fingers flexor muscle. Besides, previous visualization of bonding cues enhanced background electromyographic activity during motor preparation to perform the fingers flexion task, which might reflect a sustained leakage of central motor activity downstream leading to increase in firing of the respective motor neurons. These data suggest, at the effector level, an implicit visuo-motor connection in which social interaction cues evoke intrinsic dispositions toward affectionate social behavior.

Evaluating Electromyography and Sonomyography Sensor Fusion to Estimate Lower-Limb Kinematics Using Gaussian Process Regression

Research on robotic lower-limb assistive devices over the past decade has generated autonomous, multiple degree-of-freedom devices to augment human performance during a variety of scenarios. However, the increase in capabilities of these devices is met with an increase in the complexity of the overall control problem and requirement for an accurate and robust sensing modality for intent recognition. Due to its ability to precede changes in motion, surface electromyography (EMG) is widely studied as a peripheral sensing modality for capturing features of muscle activity as an input for control of powered assistive devices. In order to capture features that contribute to muscle contraction and joint motion beyond muscle activity of superficial muscles, researchers have introduced sonomyography, or real-time dynamic ultrasound imaging of skeletal muscle. However, the ability of these sonomyography features to continuously predict multiple lower-limb joint kinematics during widely varying ambulation tasks, and their potential as an input for powered multiple degree-of-freedom lower-limb assistive devices is unknown. The objective of this research is to evaluate surface EMG and sonomyography, as well as the fusion of features from both sensing modalities, as inputs to Gaussian process regression models for the continuous estimation of hip, knee and ankle angle and velocity during level walking, stair ascent/descent and ramp ascent/descent ambulation. Gaussian process regression is a Bayesian nonlinear regression model that has been introduced as an alternative to musculoskeletal model-based techniques. In this study, time-intensity features of sonomyography on both the anterior and posterior thigh along with time-domain features of surface EMG from eight muscles on the lower-limb were used to train and test subject-dependent and task-invariant Gaussian process regression models for the continuous estimation of hip, knee and ankle motion. Overall, anterior sonomyography sensor fusion with surface EMG significantly improved estimation of hip, knee and ankle motion for all ambulation tasks (level ground, stair and ramp ambulation) in comparison to surface EMG alone. Additionally, anterior sonomyography alone significantly improved errors at the hip and knee for most tasks compared to surface EMG. These findings help inform the implementation and integration of volitional control strategies for robotic assistive technologies.

Clarify Sit-to-Stand Muscle Synergy and Tension Changes in Subacute Stroke Rehabilitation by Musculoskeletal Modeling

Post-stroke patients exhibit distinct muscle activation electromyography (EMG) features in sit-to-stand (STS) due to motor deficiency. Muscle activation amplitude, related to muscle tension and muscle synergy activation levels, is one of the defining EMG features that reflects post-stroke motor functioning and motor impairment. Although some qualitative findings are available, it is not clear if and how muscle activation amplitude-related biomechanical attributes may quantitatively reflect during subacute stroke rehabilitation. To better enable a longitudinal investigation into a patient's muscle activation changes during rehabilitation or an inter-subject comparison, EMG normalization is usually applied. However, current normalization methods using maximum voluntary contraction (MVC) or within-task peak/mean EMG may not be feasible when MVC cannot be obtained from stroke survivors due to motor paralysis and the subject of comparison is EMG amplitude. Here, focusing on the paretic side, we first propose a novel, joint torque-based normalization method that incorporates musculoskeletal modeling, forward dynamics simulation, and mathematical optimization. Next, upon method validation, we apply it to quantify changes in muscle tension and muscle synergy activation levels in STS motor control units for patients in subacute stroke rehabilitation. The novel method was validated against MVC-normalized EMG data from eight healthy participants, and it retained muscle activation amplitude differences for inter- and intra-subject comparisons. The proposed joint torque-based method was also compared with the common static optimization based on squared muscle activation and showed higher simulation accuracy overall. Serial STS measurements were conducted with four post-stroke patients during their subacute rehabilitation stay (137 ± 22 days) in the hospital. Quantitative results of patients suggest that maximum muscle tension and activation level of muscle synergy temporal patterns may reflect the effectiveness of subacute stroke rehabilitation. A quality comparison between muscle synergies computed with the conventional within-task peak/mean EMG normalization and our proposed method showed that the conventional was prone to activation amplitude overestimation and underestimation. The contributed method and findings help recapitulate and understand the post-stroke motor recovery process, which may facilitate developing more effective rehabilitation strategies for future stroke survivors.

The Effects of the Biceps Brachii and Brachioradialis on Elbow Flexor Muscle Strength and Spasticity in Stroke Patients

Objective

Muscle weakness and spasticity are common consequences of stroke, leading to a decrease in physical activity. The effective implementation of precision rehabilitation requires detailed rehabilitation evaluation. We aimed to analyze the surface electromyography (sEMG) signal features of elbow flexor muscle (biceps brachii and brachioradialis) spasticity in maximum voluntary isometric contraction (MVIC) and fast passive extension (FPE) in stroke patients and to explore the main muscle groups that affect the active movement and spasticity of the elbow flexor muscles to provide an objective reference for optimizing stroke rehabilitation.

Methods

Fifteen patients with elbow flexor spasticity after stroke were enrolled in this study. sEMG signals of the paretic and nonparetic elbow flexor muscles (biceps and brachioradialis) were detected during MVIC and FPE, and root mean square (RMS) values were calculated. The RMS values (mean and peak) of the biceps and brachioradialis were compared between the paretic and nonparetic sides. Additionally, the correlation between the manual muscle test (MMT) score and the RMS values (mean and peak) of the paretic elbow flexors during MVIC was analyzed, and the correlation between the modified Ashworth scale (MAS) score and the RMS values (mean and peak) of the paretic elbow flexors during FPE was analyzed.

Results

During MVIC exercise, the RMS values (mean and peak) of the biceps and brachioradialis on the paretic side were significantly lower than those on the nonparetic side (p < 0.01), and the RMS values (mean and peak) of the bilateral biceps were significantly higher than those of the brachioradialis (p < 0.01). The MMT score was positively correlated with the mean and peak RMS values of the paretic biceps and brachioradialis (r = 0.89, r = 0.91, r = 0.82, r = 0.85; p < 0.001). During FPE exercise, the RMS values (mean and peak) of the biceps and brachioradialis on the paretic side were significantly higher than those on the nonparetic side (p < 0.01), and the RMS values (mean and peak) of the brachioradialis on the paretic side were significantly higher than those of the biceps (p < 0.01). TheMAS score was positively correlated with the mean RMS of the paretic biceps and brachioradialis (r = 0.62, p = 0.021; r = 0.74, p = 0.004), and the MAS score was positively correlated with the peak RMS of the paretic brachioradialis (r = 0.59, p = 0.029) but had no significant correlation with the peak RMS of the paretic biceps (r = 0.49, p > 0.05).

Conclusions

The results confirm that the biceps is a vital muscle in active elbow flexion and that the brachioradialis plays an important role in elbow flexor spasticity, suggesting that the biceps should be the focus of muscle strength training of the elbow flexors and that the role of the brachioradialis should not be ignored in the treatment of elbow flexor spasticity. This study also confirmed the application value of sEMG in the objective assessment of individual muscle strength and spasticity in stroke patients.

Measuring Muscle Activity in Sprinters Using T2-Weighted Magnetic Resonance Imaging

PURPOSE

This study aimed to investigate the level of muscle activity during sprint running using T2-weighted magnetic resonance imaging.

METHODS

Fourteen male sprinters (age 21.2 [4.0] y; height 171.8 [4.2] cm, weight 65.5 [5.3] kg, 100-m personal record 11.01 [0.41] s; mean [SD]) performed 3 sets of three 60-m round-trip sprints. Before and after the round-trip sprints, 3 T magnetic resonance imaging scans were performed to obtain the T2 values of the 14 athletes' lower-extremity muscles.

RESULTS

After the 60-m round-trip sprints, the T2 value of the gluteus maximus, long head of biceps femoris, semitendinosus, semimembranosus, adductor brevis, adductor longus, adductor magnus, and gracilis increased significantly. The rate of change in the T2 values before and after the 60-m round-trip sprints was notably higher in the semitendinosus and gluteus maximus than in the other muscles.

CONCLUSIONS

These findings demonstrate the specific physiological metabolism of the lower-extremity muscles during fast sprinting. There are particularly high levels of muscle activity in the gluteus maximus and semitendinosus during sprint performance.

Lower limb muscle activation in response to balance-perturbed tasks during walking in older adults: A systematic review

BACKGROUND

Declines in muscular function may hinder our ability to properly respond balance perturbations during walking. Examining age-related differences in muscle activation during balance-perturbed walking could be an important summary of literature to guide future clinical or scientific research.

RESEARCH QUESTION

Are there differences in lower limb muscle activation between young and older adults when responding to balance perturbations during walking?

METHODS

A literature search was conducted in October 2020 to identify relevant articles using Pubmed, Scopus, Web of Science, Ovid EMBASE, and CINAHL. Inclusion criteria were defined to identify studies investigating lower limb muscle activation in healthy older adults during balance-perturbed walking. Data extraction was independently performed by both authors. Outcome measures included key findings of lower limb muscle activations during walking and balance-related tasks (e.g. multidirectional perturbations, different speeds, cognitive tasks, slippery/slopes, and obstacles).

RESULTS

This article reviewed fourteen studies including 230 older adults (age: 70 ± 4.5, females: 124 [53.9%]) and 230 young adults (age: 23 ± 2.0, females: 113 [49.1%]). The overall quality of included studies was fair, with a mean score of 76%. Twelve lower limb muscles were assessed during balance-perturbed walking. All studies reported electromyographic measurements, including magnitude, timing, co-contraction indices, and variability of activation.

SIGNIFICANCE

Compared to young adults, older adults demonstrated different adaptations in lower limb muscle activation during balance-perturbed walking. Co-contraction of ankle and knee joint muscles had more conclusive results, with the majority reporting an increased co-contraction in older adults, especially when balance is perturbed by a physical task. These data suggest that coordination between agonist and antagonist muscles is important to provide necessary stabilization during balance-perturbed walking.

Impaired phase synchronization of motor-evoked potentials reflects the degree of motor dysfunction in the lesioned human brain

The functional corticospinal integrity (CSI) can be indexed by motor-evoked potentials (MEP) following transcranial magnetic stimulation of the motor cortex. Glial brain tumors in motor-eloquent areas are frequently disturbing CSI resulting in different degrees of motor dysfunction. However, this is unreliably mirrored by MEP characteristics. In 59 consecutive patients with diffuse glial tumors and 21 healthy controls (CTRL), we investigated the conventional MEP features, that is, resting motor threshold (RMT), amplitudes and latencies. In addition, frequency-domain MEP features were analyzed to estimate the event-related spectral perturbation (ERSP), and the induced phase synchronization by intertrial coherence (ITC). The clinical motor status was captured including the Medical Research Council Scale (MRCS), the Grooved Pegboard Test (GPT), and the intake of antiepileptic drugs (AED). Motor function was classified according to MRCS and GPT as no motor deficit (NMD), fine motor deficits (FMD) and gross motor deficits (GMD). CSI was assessed by diffusion-tensor imaging (DTI). Motor competent subjects (CTRL and NMD) had similar ERSP and ITC values. The presence of a motor deficit (FMD and GMD) was associated with an impairment of high-frequency ITC (150-300 Hz). GMD and damage to the CSI demonstrated an additional reduction of high-frequency ERSP (150-300 Hz). GABAergic AED increased ERSP but not ITC. Notably, groups were indistinguishable based on conventional MEP features. Estimating MEP phase synchronization provides information about the corticospinal transmission after transcranial magnetic stimulation and reflects the degree of motor impairment that is not captured by conventional measures.

Adaptation in Gait to Lunar and Martian Gravity Unloading During Long-Term Isolation in the Ground-Based Space Station Model

The aim of the experiment was to evaluate the adaptive responses of biomechanical and electromyographic parameters to vertical unloading (Lunar—0.15 G and Martian—0.35 G) when walking during the 4-month isolation experiment SIRIUS-19 in the ground-based space station model (GBI). The study involved 6 healthy international crew members of the SIRIUS-19 project aged 34 ± 6.2 years (3 women and 3 men). Body Weight Unloading (BWU) conditions was created by the h/p/cosmos airwalk system. The locomotor test included walking (3.5 ± 0.3 km/h) with a sequential change of BWU modes: 5-min walking with 0% BWU (1 G), 5-min walking with 65% BWU (0.35 G) and 5-min walking with 85% BWU (0.15 G). Ground Reaction Force was recorded by the h/p/cosmos treadmill device. Muscle Lab Model 4000e device was used to record the electromyographic signals of the hip and shin muscles. The locomotor test was performed twice before GBI, monthly during GBI and 1 week after leaving isolation. The results obtained before GBI demonstrate that the changes of support and proprioceptive afferentation signals play significant role in reorganizing of the biomechanical structure of motor acts and the development of new movement patterns. The results of the study are consistent with the previously obtained results of other studies in this direction. Despite the fact that during the GBI the participants of the experiment performed regular physical training, a decrease in the performance indicators values was detected, especially pronounced after 100 days of GBI. This is probably due to limited space of a space station model, as well as the development of a special motor stereotype in it. Noteworthy are the results obtained after the 4th session of the experiment, indicating the effect of sensorimotor learning. We think that the data obtained in this study will be useful in research both in gravitational physiology and in clinical medicine.

Design of an Effective Prosthetic Hand System for Adaptive Grasping with the Control of Myoelectric Pattern Recognition Approach

In this paper, we develop a prosthetic bionic hand system to realize adaptive gripping with two closed-loop control loops by using a linear discriminant analysis algorithm (LDA). The prosthetic hand contains five fingers and each finger is driven by a linear servo motor. When grasping objects, four fingers except the thumb would adjust automatically and bend with an appropriate gesture, while the thumb is stretched and bent by the linear servo motor. Since the change of the surface electromechanical signal (sEMG) occurs before human movement, the recognition of sEMG signal with LDA algorithm can help to obtain people’s action intention in advance, and then timely send control instructions to assist people to grasp. For activity intention recognition, we extract three features, Variance (VAR), Root Mean Square (RMS) and Minimum (MIN) for recognition. As the results show, it can achieve an average accuracy of 96.59%. This helps our system perform well for disabilities to grasp objects of different sizes and shapes adaptively. Finally, a test of the people with disabilities grasping 15 objects of different sizes and shapes was carried out and achieved good experimental results.

fNIRS-Based Upper Limb Motion Intention Recognition Using an Artificial Neural Network for Transhumeral Amputees

Prosthetic arms are designed to assist amputated individuals in the performance of the activities of daily life. Brain machine interfaces are currently employed to enhance the accuracy as well as number of control commands for upper limb prostheses. However, the motion prediction for prosthetic arms and the rehabilitation of amputees suffering from transhumeral amputations is limited. In this paper, functional near-infrared spectroscopy (fNIRS)-based approach for the recognition of human intention for six upper limb motions is proposed. The data were extracted from the study of fifteen healthy subjects and three transhumeral amputees for elbow extension, elbow flexion, wrist pronation, wrist supination, hand open, and hand close. The fNIRS signals were acquired from the motor cortex region of the brain by the commercial NIRSport device. The acquired data samples were filtered using finite impulse response (FIR) filter. Furthermore, signal mean, signal peak and minimum values were computed as feature set. An artificial neural network (ANN) was applied to these data samples. The results show the likelihood of classifying the six arm actions with an accuracy of 78%. The attained results have not yet been reported in any identical study. These achieved fNIRS results for intention detection are promising and suggest that they can be applied for the real-time control of the transhumeral prosthesis.

Alterations of tibialis anterior muscle activation pattern in subjects with type 2 diabetes and diabetic peripheral neuropathy

Diabetic peripheral neuropathy (DPN) is associated with loss of motor units (MUs), which can cause changes in the activation pattern of muscle fibres. This study investigated the pattern of muscle activation using high-density surface electromyography (HD-sEMG) signals from subjects with type 2 diabetes mellitus (T2DM) and DPN. Thirty-five adults participated in the study: 12 healthy subjects (HV), 12 patients with T2DM without DPN (No-DPN) and 11 patients with T2DM with DPN (DPN). HD-sEMG signals were recorded in the tibialis anterior muscle during an isometric contraction of ankle dorsiflexion at 50% of the maximum voluntary isometric contraction (MVIC) during 30-s. The calculated HD-sEMG signals parameters were the normalised root mean square (RMS), normalised median frequency (MDF), coefficient of variation (CoV) and modified entropy (ME). The RMS increased significantly (p = 0.001) with time only for the DPN group, while the MDF decreased significantly (p < 0.01) with time for the three groups. Moreover, the ME was significantly lower (p = 0.005), and CoV was significantly higher (p = 0.003) for the DPN group than the HV group. Using HD-sEMG, we have demonstrated a reduction in the number of MU recruited by individuals with DPN. This study provides proof of concept for the clinical utility of this technique for identifying neuromuscular impairment caused by DPN.

Intramuscle Synergies: Their Place in the Neural Control Hierarchy

We accept a definition of synergy introduced by Nikolai Bernstein and develop it for various actions, from those involving the whole body to those involving a single muscle. Furthermore, we use two major theoretical developments in the field of motor control—the idea of hierarchical control with spatial referent coordinates and the uncontrolled manifold hypothesis—to discuss recent studies of synergies within spaces of individual motor units (MUs) recorded within a single muscle. During the accurate finger force production tasks, MUs within hand extrinsic muscles form robust groups, with parallel scaling of the firing frequencies. The loading factors at individual MUs within each of the two main groups link them to the reciprocal and coactivation commands. Furthermore, groups are recruited in a task-specific way with gains that covary to stabilize muscle force. Such force-stabilizing synergies are seen in MUs recorded in the agonist and antagonist muscles but not in the spaces of MUs combined over the two muscles. These observations reflect inherent trade-offs between synergies at different levels of a control hierarchy. MU-based synergies do not show effects of hand dominance, whereas such effects are seen in multifinger synergies. Involuntary, reflex-based, force changes are stabilized by intramuscle synergies but not by multifinger synergies. These observations suggest that multifinger (multimuscle synergies) are based primarily on supraspinal circuitry, whereas intramuscle synergies reflect spinal circuitry. Studies of intra- and multimuscle synergies promise a powerful tool for exploring changes in spinal and supraspinal circuitry across patient populations.