EMG and muscle force: An introduction

Integrated Wearable System for Monitoring Skeletal Muscle Force of Lower Extremities

Continuous monitoring of lower extremity muscles is necessary, as the muscles support many human daily activities, such as maintaining balance, standing, walking, running, and jumping. However, conventional electromyography and physiological cross-sectional area methods inherently encounter obstacles when acquiring precise and real-time data pertaining to human bodies, with a notable lack of consideration for user comfort. Benefitting from the fast development of various fabric-based sensors, this paper addresses these current issues by designing an integrated smart compression stocking system, which includes compression garments, fabric-embedded capacitive pressure sensors, an edge control unit, a user mobile application, and cloud backend. The pipeline architecture design and component selection are discussed in detail to illustrate a comprehensive user-centered STIMES design. Twelve healthy young individuals were recruited for clinical experiments to perform maximum voluntary isometric ankle plantarflexion contractions. All data were simultaneously collected through the integrated smart compression stocking system and a muscle force measurement system (Humac NORM, software version HUMAC2015). The obtained correlation coefficients above 0.92 indicated high linear relationships between the muscle torque and the proposed system readout. Two-way ANOVA analysis further stressed that different ankle angles (p = 0.055) had more important effects on the results than different subjects (p = 0.290). Hence, the integrated smart compression stocking system can be used to monitor the muscle force of the lower extremities in isometric mode.

Effect of Hand Grip and Center of Mass Location on Muscle Activity While Manipulating a Surgical Table Segment

OCCUPATIONAL APPLICATIONSHand grip location relative to the center of mass of an object can impact the activity of trunk and upper limb muscles. Aligning the hand grip location with the center of mass in the anterior/posterior direction minimizes muscle activity. Whether a proximal or distal grip requires more effort appears to be muscle dependent. Our work illustrates how design features influencing hand grip and center of mass location, such as handles and hand-operated mechanisms, can impact the user. Reducing physical effort via design is important to improve usability and help mitigate the high incidence of musculoskeletal injury resulting from manual materials handling tasks.

Screw Stimulation Thresholds for Neuromonitoring in Minimally Invasive Oblique Lateral Lumbar Interbody Fusion (OLLIF): A Correlational Study

INTRODUCTION

This study presents findings from an investigation into the correlation of neuromonitoring techniques in minimally invasive lumbar fusions and their open counterparts regarding acceptable thresholds for screw stimulation. The threshold for acceptable stimulation value for open surgery has been established. The study compared acceptable thresholds for open pedicle screws where there is more connection between the screw and the soft tissue.

METHODS

The neuromonitoring data of 17 patients who underwent oblique lateral lumbar interbody fusion (OLLIF) procedures between September 2023 to May 2024 were reviewed. Neuromonitoring was conducted throughout surgeries, recording stimulation thresholds for pedicle screws insulated and uninsulated, to simulate the environment of a screw during open and minimally invasive surgery respectively. Patients' BMI was also collected for potential correlation analysis.

RESULTS

Results indicate a discernible correlation between stimulation thresholds in open and minimally invasive surgeries, but no definitive correlation with BMI due to sample size limitations. Though a significant correlation between the two stimulating styles is apparent, there is a good correlation to suggest what threshold should determine a standard stimulation threshold for minimally invasive surgeries.

CONCLUSION

The study emphasizes the need for refined neuromonitoring strategies in minimally invasive spinal fusion (MISF) surgeries to ensure patient safety and surgical effectiveness. Further research with larger cohorts is recommended to establish optimized protocols that have a clearly defined amplitude for MISF thresholds.

Effects of static exercises on hip muscle fatigue and knee wobble assessed by surface electromyography and inertial measurement unit data

Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training. Inertial measurement units (IMUs) are wearable devices used to measure human motion, yet it remains unclear if they can be used as a low-cost alternative method to measure hip muscle fatigue. The goals of this work were to (1) identify which of five pre-selected exercises most consistently and effectively elicited muscle fatigue in the gluteus maximus, gluteus medius, and rectus femoris muscles and (2) determine the relationship between muscle fatigue using sEMG sensors and knee wobble using an IMU device. This work suggests that a wall sit and single leg knee raise activity fatigue the gluteus medius, gluteus maximus, and rectus femoris muscles most reliably (p < 0.05) and that the gluteus medius and gluteus maximus muscles were fatigued to a greater extent than the rectus femoris (p = 0.031 and p = 0.0023, respectively). Additionally, while acceleration data from a single IMU placed on the knee suggested that more knee wobble may be an indicator of muscle fatigue, this single IMU is not capable of reliably assessing fatigue level. These results suggest the wall sit activity could be used as simple, static exercise to elicit hip muscle fatigue in the clinic, and that assessment of knee wobble in addition to other IMU measures could potentially be used to infer muscle fatigue under controlled conditions. Future work examining the relationship between IMU data, muscle fatigue, and multi-limb dynamics should be explored to develop an accessible, low-cost, fast and standardized method to measure fatiguability of the hip muscles in the clinic.

Tutorial. Surface electromyogram (sEMG) amplitude estimation: Best practices

This tutorial intends to provide insight, instructions and "best practices" for those who are novices-including clinicians, engineers and non-engineers-in extracting electromyogram (EMG) amplitude from the bipolar surface EMG (sEMG) signal of voluntary contractions. A brief discussion of sEMG amplitude extraction from high density sEMG (HDsEMG) arrays and feature extraction from electrically elicited contractions is also provided. This tutorial attempts to present its main concepts in a straightforward manner that is accessible to novices in the field not possessing a wide range of technical background (if any) in this area. Surface EMG amplitude, also referred to as the sEMG envelope [often implemented as root mean square (RMS) sEMG or average rectified value (ARV) sEMG], quantifies the voltage variation of the sEMG signal and is grossly related to the overall neural excitation of the muscle and to peripheral parameters. The tutorial briefly reviews the physiological origin of the voluntary sEMG signal and sEMG recording, including electrode configurations, sEMG signal transduction, electronic conditioning and conversion by an analog-to-digital converter. These topics have been covered in greater detail in prior tutorials in this series. In depth descriptions of state-of-the-art methods for computing sEMG amplitude are then provided, including guidance on signal pre-conditioning, absolute value vs. square-law detection, selection of appropriate sEMG amplitude smoothing filters and attenuation of measurement noise. The tutorial provides a detailed list of best practices for sEMG amplitude estimation.

An EMG-to-Force Processing Approach to Estimating Knee Muscle Forces during Adult, Self-Selected Speed Gait

BACKGROUND

The purpose of this study was to determine the force production during self-selected speed normal gait by muscle-tendon units that cross the knee. The force of a single knee muscle is not directly measurable without invasive methods, yet invasive techniques are not appropriate for clinical use. Thus, an EMG-to-force processing (EFP) model was developed which scaled muscle-tendon unit (MTU) force output to gait EMG.

METHODS

An EMG-to-force processing (EFP) model was developed which scaled muscle-tendon unit (MTU) force output to gait EMG. Active muscle force power was defined as the product of MTU forces (derived from EFP) and that muscle's contraction velocity. Net knee EFP moment was determined by summing individual active knee muscle moments. Net knee moments were also calculated for these study participants via inverse dynamics (kinetics plus kinematics, KIN). The inverse dynamics technique used are well accepted and the KIN net moment was used to validate or reject this model. Closeness of fit of the moment power curves for the two methods (during active muscle forces) was used to validate the model.

RESULTS

The correlation between the EFP and KIN methods was sufficiently close, suggesting validation of the model's ability to provide reasonable estimates of knee muscle forces.

CONCLUSIONS

The EMG-to-force processing approach provides reasonable estimates of active individual knee muscle forces in self-selected speed walking in neurologically intact adults.

A deep dive into the static force transmission of the human masticatory system and its biomechanical effects on the temporomandibular joint

OBJECTIVE

This study aims to investigate the biomechanical behavior and reveal the force transmission patterns of the human masticatory system through advanced three-dimensional finite element (FE) models.

METHODS

The FE model was constructed according to the medical images of a healthy male adult. It contains full skull structures, detailed temporomandibular joints (TMJs) with discs, complete dentitions, masticatory muscles, and related ligaments. Several static bite scenarios were simulated to demonstrate the effects of bite positions and muscle force recruitments on the force transmission patterns.

RESULTS

Molar occlusal surfaces are the primary force transmission region for clenching. Sensitivity analysis demonstrated that the stiffness of the bite substance would not alter the force transmission patterns but could affect the maximum contact stresses on the discs and the occlusal surfaces. During the unilateral clenching tasks, the high-stress region on the discal surfaces shifted ipsilaterally. The presence or absence of the molar cushions would significantly affect the biomechanical response of the masticatory system.

SIGNIFICANCE

FE analysis is an effective way of investigating biomechanical responses involving complicated interactions. Enriching the static analysis of the masticatory system with a detailed model can help understand better how the forces were transmitted and the significance of TMJs during the clenching process.

Using Bayesian inference to estimate plausible muscle forces in musculoskeletal models

Background

Musculoskeletal modeling is currently a preferred method for estimating the muscle forces that underlie observed movements. However, these estimates are sensitive to a variety of assumptions and uncertainties, which creates difficulty when trying to interpret the muscle forces from musculoskeletal simulations. Here, we describe an approach that uses Bayesian inference to identify plausible ranges of muscle forces for a simple motion while representing uncertainty in the measurement of the motion and the objective function used to solve the muscle redundancy problem.

Methods

We generated a reference elbow flexion–extension motion and computed a set of reference forces that would produce the motion while minimizing muscle excitations cubed via OpenSim Moco. We then used a Markov Chain Monte Carlo (MCMC) algorithm to sample from a posterior probability distribution of muscle excitations that would result in the reference elbow motion. We constructed a prior over the excitation parameters which down-weighted regions of the parameter space with greater muscle excitations. We used muscle excitations to find the corresponding kinematics using OpenSim, where the error in position and velocity trajectories (likelihood function) was combined with the sum of the cubed muscle excitations integrated over time (prior function) to compute the posterior probability density.

Results

We evaluated the muscle forces that resulted from the set of excitations that were visited in the MCMC chain (seven parallel chains, 500,000 iterations per chain). The estimated muscle forces compared favorably with the reference forces generated with OpenSim Moco, while the elbow angle and velocity from MCMC matched closely with the reference (average RMSE for elbow angle = 2°; and angular velocity = 32°/s). However, our rank plot analyses and potential scale reduction statistics, which we used to evaluate convergence of the algorithm, indicated that the chains did not fully mix.

Conclusions

While the results from this process are a promising step towards characterizing uncertainty in muscle force estimation, the computational time required to search the solution space with, and the lack of MCMC convergence indicates that further developments in MCMC algorithms are necessary for this process to become feasible for larger-scale models.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-022-01008-4.

Impact of digital boards on hand and neck muscle activity during online teaching process

Academicians across the globe due to Covid 19 shifted to online teaching as a mainstream method by replacing the chalk and talk method. The main objective of this study is to find the impact of different sizes of digital boards used for online teaching on muscle activity and muscle fatigue, and then results are compared with conventional writing. Initially, a questionnaire survey is conducted among 100 college professors about the issue they faced while using online teaching methods. Experimental analysis are then conducted using electromyography sensor (sEMG) among ten college professors and their muscle activity on the dominant hand and neck while writing on two commercially available digital boards namely Type 1 (small writing area) and Type 2 (large writing area). Four muscles namely Flexor carpi radialis, Extensor carpi radialis, Biceps brachii, and Sternocleidomastoid (SCM) are chosen for the study. The results are then compared with muscle activity while writing on conventional A4 sheets. Normalized root mean square (RMS) is used to assess the muscle activity and the trend line of MPF value is utilized to assess the muscle fatigue. The results show that SCM muscle has more muscle activation compared to other selected muscles followed by flexor carpi radialis. Subjective analysis is carried out using the Borg scale, which has reported that Type 2 digital board having larger working area was preferred by the participants as it reduces muscle fatigue.

Soft Bioelectronics Based on Nanomaterials

Recent advances in nanostructured materials and unconventional device designs have transformed the bioelectronics from a rigid and bulky form into a soft and ultrathin form and brought enormous advantages to the bioelectronics. For example, mechanical deformability of the soft bioelectronics and thus its conformal contact onto soft curved organs such as brain, heart, and skin have allowed researchers to measure high-quality biosignals, deliver real-time feedback treatments, and lower long-term side-effects in vivo. Here, we review various materials, fabrication methods, and device strategies for flexible and stretchable electronics, especially focusing on soft biointegrated electronics using nanomaterials and their composites. First, we summarize top-down material processing and bottom-up synthesis methods of various nanomaterials. Next, we discuss state-of-the-art technologies for intrinsically stretchable nanocomposites composed of nanostructured materials incorporated in elastomers or hydrogels. We also briefly discuss unconventional device design strategies for soft bioelectronics. Then individual device components for soft bioelectronics, such as biosensing, data storage, display, therapeutic stimulation, and power supply devices, are introduced. Afterward, representative application examples of the soft bioelectronics are described. A brief summary with a discussion on remaining challenges concludes the review.

Influence of upper limb training and analyzed muscles on estimate of physical activity during cereal grinding using saddle quern and rotary quern

Experimental grinding has been used to study the relationship between human humeral robusticity and cereal grinding in the early Holocene. However, such replication studies raise two questions regarding the robusticity of the results: whether female nonathletes used in previous research are sufficiently comparable to early agricultural females, and whether previous analysis of muscle activation of only four upper limb muscles is sufficient to capture the stress of cereal grinding on upper limb bones. We test the influence of both of these factors. Electromyographic activity of eight upper limb muscles was recorded during cereal grinding in an athletic sample of 10 female rowers and in 25 female nonathletes and analyzed using both an eight- and four-muscle model. Athletes had lower activation than nonathletes in the majority of measured muscles, but except for posterior deltoid these differences were non-significant. Furthermore, both athletes and nonathletes had lower muscle activation during saddle quern grinding than rotary quern grinding suggesting that the nonathletes can be used to model early agricultural females during saddle and rotary quern grinding. Similarly, in both eight- and four-muscle models, upper limb loading was lower during saddle quern grinding than during rotary quern grinding, suggesting that the upper limb muscles may be reduced to the previously used four-muscle model for evaluation of the upper limb loading during cereal grinding. Another implication of our measurements is to question the assumption that skeletal indicators of high involvement of the biceps brachii muscle can be interpreted as specifically indicative of saddle quern grinding.

The high energetic cost of rapid force development in muscle

Muscles consume metabolic energy for active movement, particularly when performing mechanical work or producing force. Less appreciated is the cost for activating muscle quickly, which adds considerably to the overall cost of cyclic force production. However, the cost magnitude relative to the cost of mechanical work, which features in many movements, is unknown. We therefore tested whether fast activation is costly compared with performing work or producing isometric force. We hypothesized that metabolic cost would increase with a proposed measure termed force rate (rate of increase in muscle force) in cyclic tasks, separate from mechanical work or average force level. We tested humans (N=9) producing cyclic knee extension torque against an isometric dynamometer (torque 22 N m, cyclic waveform frequencies 0.5-2.5 Hz), while also quantifying quadriceps muscle force and work against series elasticity (with ultrasonography), along with metabolic rate through respirometry. Net metabolic rate increased by more than four-fold (10.5 to 46.8 W) with waveform frequency. At high frequencies, the hypothesized force-rate cost accounted for nearly half (40%) of energy expenditure. This exceeded the cost for average force (17%) and was comparable to the cost for shortening work (43%). The force-rate cost is explained by additional active calcium transport necessary for producing forces at increasing waveform frequencies, owing to rate-limiting dynamics of force production. The force-rate cost could contribute substantially to the overall cost of movements that require cyclic muscle activation, such as locomotion.

SWEAT2 study: effectiveness of trunk training on muscle activity after stroke. A randomized controlled trial

BACKGROUND

Trunk training after stroke is an effective method for improving trunk control, standing balance and mobility. The SWEAT² study attempts to discover the underlying mechanisms leading to the observed mobility carry-over effects after trunk training.

AIM

A secondary analysis investigating the effect of trunk training on muscle activation patterns, muscle synergies and motor unit recruitment of trunk and lower limbs muscles, aimed to provide new insights in gait recovery after stroke.

DESIGN

Randomized controlled trial.

SETTING

Monocentric study performed in the RevArte Rehabilitation Hospital (Antwerp, Belgium).

POPULATION

Forty-five adults diagnosed with first stroke within five months, of which 39 completed treatment and were included in the analysis.

METHODS

Participants received 16 hours of additional trunk training (N.=19) or cognitive training (N.=20) over the course of four weeks (1 hour, 4 times a week). They were assessed by an instrumented gait analysis with electromyography of trunk and lower limb muscles. Outcome measures were linear integrated normalized envelopes of the electromyography signal, the amount and composition of muscle synergies calculated by nonnegative matrix factorization and motor unit recruitment calculated, by mean center wavelet frequencies. Multivariate analysis with post-hoc analysis and statistical parametric mapping of the continuous curves were performed.

RESULTS

No significant differences were found in muscle activation patterns and the amount of muscle synergies. In 42% of the subjects, trunk training resulted in an additional muscle synergy activating trunk muscles in isolation, as compared to 5% in the control group. Motor unit recruitment of the of trunk musculature showed decreased fast-twitch motor recruitment in the erector spinae muscle after trunk training: for the hemiplegic (t[37]=2.44, P=0.021) and non-hemiplegic erector spinae muscle (t[37]=2.36, P=0.024).

CONCLUSIONS

Trunk training improves selective control and endurance of trunk musculature after sub-acute stroke.

CLINICAL REHABILITATION IMPACT

What is new to the actual clinical rehabilitation knowledge is that: trunk training does not alter muscle activation patterns or the amount of muscle synergies over time; a decrease in fast-twitch motor recruitment in the erector spinae muscle was found during walking after trunk training; trunk training seems to increase the fatigue-resistance of the back muscles and enables more isolated activation.

Testing the propulsive role of m. peroneus longus during quadrupedal walking in Varanus exanthematicus

Some varanid lizards show a prominent and highly distinctive lateral calcaneal process. It has been posited that this structure serves as a lateral "heel" to increase the moment arm for m. peroneus longus, allowing it to function as a powerful propulsive muscle. However, to confirm that m. peroneus longus serves this function requires electromyographic data showing activity during tarsal plantarflexion in the late part of the stance phase. Muscle activity patterns of m. peroneus longus, m. tibialis anterior, and mm. gastrocnemii were collected from two savannah monitors (Varanus exanthematicus) during quadrupedal walking. Across strides, m. peroneus longus shows an early onset just before hindlimb touchdown and an offset that is highly correlated with that of mm. gastrocnemii. These patterns are consistent across individuals. However, the fact that the first onset of m. peroneus longus appears to be around the end of swing phase, with activity continuing throughout the remainder of stance, suggests that this muscle likely serves other functional purposes during locomotion beside propulsion. This, paired with the fact that qualitative comparisons of m. peroneus longus activity across other lizard species reveal remarkably similar patterns, suggests the propulsive role of m. peroneus longus in V. exanthematicus was probably built upon existing muscle activity patterns present in ancestral squamates and then exaggerated through modifications to lateral calcaneal heel and the associated proximal expansion of the fifth metatarsal.

In vivo force-length and activation dynamics of two distal rat hindlimb muscles in relation to gait and grade

Muscle function changes to meet the varying mechanical demands of locomotion across different gait and grade conditions. A muscle's work output is determined by time-varying patterns of neuromuscular activation, muscle force and muscle length change, but how these patterns change under different conditions in small animals is not well defined. Here, we report the first integrated in vivo force-length and activation patterns in rats, a commonly used small animal model, to evaluate the dynamics of two distal hindlimb muscles (medial gastrocnemius and plantaris) across a range of gait (walk, trot and gallop) and grade (level and incline) conditions. We use these data to explore how the pattern of force production, muscle activation and muscle length changes across conditions in a small quadrupedal mammal. As hypothesized, we found that the rat muscles show limited fascicle strains during active force generation in stance across gaits and grades, indicating that these distal rat muscles generate force economically but perform little work, similar to patterns observed in larger animals during level locomotion. Additionally, given differences in fiber type composition and variation in motor unit recruitment across the gait and grade conditions examined here for these muscles, the in vivo force-length behavior and neuromuscular activation data reported here can be used to validate improved two-element Hill-type muscle models.

Loss of selective wrist muscle activation in post-stroke patients

Purpose: Loss of selective muscle activation after stroke contributes to impaired arm function, is difficult to quantify and is not systematically assessed yet. The aim of this study was to describe and validate a technique for quantification of selective muscle activation of wrist flexor and extensor muscles in a cohort of post-stroke patients. Patterns of selective muscle activation were compared to healthy volunteers and test-retest reliability was assessed.Materials and methods: Activation Ratios describe selective activation of a muscle during its expected optimal activation as agonist and antagonist. Activation Ratios were calculated from electromyography signals during an isometric maximal torque task in 31 post-stroke patients and 14 healthy volunteers. Participants with insufficient voluntary muscle activation (maximal electromyography signal <3SD higher than baseline) were excluded.Results: Activation Ratios at the wrist were reliably quantified (Intraclass correlation coefficients 0.77-0.78). Activation Ratios were significantly lower in post-stroke patients compared to healthy participants (p < 0.05).Conclusion: Activation Ratios allow for muscle-specific quantification of selective muscle activation at the wrist in post-stroke patients. Loss of selective muscle activation may be a relevant determinant in assigning and evaluating therapy to improve functional outcome.Implications for RehabilitationLoss of selective muscle activation after stroke contributes to impaired arm function, is difficult to quantify and is not systematically assessed yet.The ability for selective muscle activation is a relevant determinant in assigning and evaluating therapy to improve functional outcome, e.g., botulinum toxin.Activation Ratios allow for reliable and muscle-specific quantification of selective muscle activation in post-stroke patients.

Biomechanical Methods to Quantify Muscle Effort During Resistance Exercise

Chiu, LZF. Biomechanical methods to quantify muscle effort during resistance exercise. J Strength Cond Res 32(2): 502-513, 2018-Muscle hypertrophy and strength adaptations elicited by resistance training are dependent on the force exerted by active muscles. As an exercise may use many muscles, determining force for individual muscles or muscle groupings is important to understand the relation between an exercise and these adaptations. Muscle effort-the amount of force or a surrogate measure related to the amount of force exerted during a task-can be quantified using biomechanical methods. The purpose of this review was to summarize the biomechanical methods used to estimate muscle effort in movements, particularly resistance training exercises. These approaches include the following: (a) inverse dynamics with rigid body models, (b) forward dynamics and EMG-driven models, (c) normalized EMG, and (d) inverse dynamics with point-mass models. Rigid body models quantify muscle effort as net joint moments. Forward dynamics and EMG-driven models estimate muscle force as well as determine the effect of a muscle's action throughout the body. Nonlinear relations between EMG and muscle force and normalization reference action selection affect the usefulness of EMG as a measure of muscle effort. Point-mass models include kinetics calculated from barbell (or other implement) kinematics recorded using electromechanical transducers or measured using force platforms. Point-mass models only allow the net force exerted on the barbell or lifter-barbell system to be determined, so they cannot be used to estimate muscle effort. Data from studies using rigid body models, normalized EMG, and musculoskeletal modeling should be combined to develop hypotheses regarding muscle effort; these hypotheses should be verified by training interventions.

Separation of electrocardiographic from electromyographic signals using dynamic filtration

Trunk muscle electromyographic (EMG) signals are often contaminated by the electrical activity of the heart. During low or moderate muscle force, these electrocardiographic (ECG) signals disturb the estimation of muscle activity. Butterworth high-pass filters with cut-off frequency of up to 60 Hz are often used to suppress the ECG signal. Such filters disturb the EMG signal in both frequency and time domain. A new method based on the dynamic application of Savitzky-Golay filter is proposed. EMG signals of three left trunk muscles and pure ECG signal were recorded during different motor tasks. The efficiency of the method was tested and verified both with the experimental EMG signals and with modeled signals obtained by summing the pure ECG signal with EMG signals at different levels of signal-to-noise ratio. The results were compared with those obtained by application of high-pass, 4th order Butterworth filter with cut-off frequency of 30 Hz. The suggested method is separating the EMG signal from the ECG signal without EMG signal distortion across its entire frequency range regardless of amplitudes. Butterworth filter suppresses the signals in the 0-30 Hz range thus preventing the low-frequency analysis of the EMG signal. An additional disadvantage is that it passes high-frequency ECG signal components which is apparent at equal and higher amplitudes of the ECG signal as compared to the EMG signal. The new method was also successfully verified with abnormal ECG signals.

A subject-specific biomechanical control model for the prediction of cervical spine muscle forces

BACKGROUND

The aim of the present study is to propose a subject-specific biomechanical control model for the estimation of active cervical spine muscle forces.

METHODS

The proprioception-based regulation model developed by Pomero et al. (2004) for the lumbar spine was adapted to the cervical spine. The model assumption is that the control strategy drives muscular activation to maintain the spinal joint load below the physiological threshold, thus avoiding excessive intervertebral displacements. Model evaluation was based on the comparison with the results of two reference studies. The effect of the uncertainty on the main model input parameters on the predicted force pattern was assessed. The feasibility of building this subject-specific model was illustrated with a case study of one subject.

FINDINGS

The model muscle force predictions, although independent from EMG recordings, were consistent with the available literature, with mean differences of 20%. Spinal loads generally remained below the physiological thresholds. Moreover, the model behavior was found robust against the uncertainty on the muscle orientation, with a maximum coefficient of variation (CV) of 10%.

INTERPRETATION

After full validation, this model should offer a relevant and efficient tool for the biomechanical and clinical study of the cervical spine, which might improve the understanding of cervical spine disorders.

Cocontraction measured with short-range stiffness was higher in obstetric brachial plexus lesions patients compared to healthy subjects

We suggest short range stiffness (SRS) at the elbow joint as an alternative diagnostic for EMG to assess cocontraction. Elbow SRS is compared between obstetric brachial plexus lesion (OBPL) patients and healthy subjects (cross-sectional study design). Seven controls (median 28years) and five patients (median 31years) isometrically flexed and extended the elbow at rest and three additional torques [2.1,4.3,6.4Nm] while a fast stretch stimulus was applied. SRS was estimated in silico using a neuromechanical elbow model simulating the torque response from the imposed elbow angle. SRS was higher in patients (250±36Nm/rad) than in controls (150±21Nm/rad, p=0.014), except for the rest condition. Higher elbow SRS suggested greater cocontraction in patients compared to controls. SRS is a promising mechanical alternative to assess cocontraction, which is a frequently encountered clinical problem in OBPL due to axonal misrouting.

Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans

Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann-Whitney U test. Kruskal-Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.

Quantifying thigh muscle co-activation during isometric knee extension contractions: within- and between-session reliability

Muscle co-activation around the knee is important during ambulation and balance. The wide range of methodological approaches for the quantification of co-activation index (CI) makes comparisons across studies and populations difficult. The present study determined within- and between-session reliability of different methodological approaches for the quantification of the CI of the knee extensor and flexor muscles during maximum voluntary isometric contractions (MVICs). Eight healthy volunteers participated in two repeated testing sessions. A series of knee extension MVICs of the dominant leg with concomitant torque and electromyographic (EMG) recordings were captured. CI was calculated utilizing different analytical approaches. Intraclass correlation coefficient (ICC) showed that within-session measures displayed higher reliability (ICC>0.861) and lower variability (Coefficient of variation; CV<21.8%) than between-session measures (ICC<0.645; CV>24.2%). A selection of a 500ms or larger window of RMS EMG activity around the PT delivered more reliable and less variable results than other approaches. Our findings suggest that the CI can provide a reliable measure for comparisons among conditions and is best utilized for within-session experimental designs.

Relationship of EMG/SMG features and muscle strength level: an exploratory study on tibialis anterior muscles during plantar-flexion among hemiplegia patients

BACKGROUND

Improvement in muscle strength is an important aim for the rehabilitation of hemiplegia patients. Presently, the rehabilitation prescription depends on the evaluation results of muscle strength, which are routinely estimated by experienced physicians and therefore not finely quantitative. Widely-used quantification methods for disability, such as Barthel Index (BI) and motor component of Functional Independent Measure (M-FIM), yet have limitations in their application, since both of them differentiated disability better in lower than higher disability, and they are subjective and recorded in wide scales. In this paper, to explore finely quantitative measures for evaluation of muscle strength level (MSL), we start with the study on quantified electromyography (EMG) and sonomyography (SMG) features of tibialis anterior (TA) muscles among hemiplegia patients.

METHODS

12 hemiplegia subjects volunteered to perform several sets of plantar-flexion movements in the study, and their EMG signals and SMG signals were recorded on TA independently to avoid interference. EMG data were filtered and then the root-mean-square (RMS) was computed. SMG signals, specifically speaking, the muscle thickness of TA, were manually measured by two experienced operators using ultrasonography. Reproducibility of the SMG assessment on TA between operators was evaluated by non-parametric test (independent sample T test). Possible relationship between muscle thickness changes (TC) of TA and muscle strength level of hemiplegia patients was estimated.

RESULTS

Mean of EMG RMS between subjects is found linearly correlated with MSL (R2 = 0.903). And mean of TA muscle TC amplitudes is also linearly correlated with MSL among dysfunctional legs (R2 = 0.949). Moreover, rectified TC amplitudes (dysfunctional leg/ healthy leg, DLHL) and rectified EMG signals (DLHL) are found in linear correlation with MSL, with R2 = 0.756 and R2 = 0.676 respectively. Meanwhile, the preliminary results demonstrate that patients' peak values of TC are generally proportional to their personal EMG peak values in 12 dysfunctional legs and 12 healthy legs (R2 = 0.521).

CONCLUSIONS

It's concluded that SMG could be a promising option to quantitatively estimate MSL for hemiplegia patients during rehabilitation besides EMG. However, after this exploratory study, they should be further investigated on a larger number of subjects.

Cranial humerus translation, deltoid activation, adductor co-activation and rotator cuff disease - different patterns in rotator cuff tears, subacromial impingement and controls

BACKGROUND

Arm adductor co-activation during abduction has been reported as a potential compensation mechanism for a narrow subacromial space in patients with rotator cuff dysfunction. We assessed differences in acromiohumeral distance at rest and the amount of humerus translation during active abduction and adduction in patients with rotator cuff tears (n=20) and impingement (n=30) and controls (n=10), controlled for deltoid, pectoralis major, latissimus dorsi and teres major activation (electromyography).

METHODS

During the acquirement of shoulder radiographs, subjects performed standardized isometric arm abduction and adduction tasks. EMG's were normalized between -1 and 1 using the "Activation Ratio", where low values express (pathologic) co-activation, e.g. adductor activation during abduction.

FINDINGS

In patients with cuff tears mean rest acromiohumeral distance was 7.6mm (SD=1.6): 3.5mm narrower compared to patients with impingement (95%-CI: 2.4-4.5) and 1.3mm narrower compared to controls (95%-CI: -0.1-2.7). Both during abduction and adduction tasks, cranial translation was observed with equal magnitudes for patients and controls, with average values of 2.3 and 1.7mm, respectively. Where patients with cuff tears had lower adductor Activation Ratios (i.e. more adductor co-activation during abduction), no association between abductor/adductor muscle activation and acromiohumeral distance was found.

INTERPRETATION

The subacromial space is narrower in patients with rotator cuff tears compared to patients with impingement and controls. We found additional subacromial narrowing during isometric abduction and, to a lesser amount, during adduction in all subjects and more adductor co-activation in patients with cuff tears. We found no association between subacromial space and activation of the deltoid and main adductors.

Emergence of the advancing neuromechanical phase in a resistive force dominated medium

Undulatory locomotion, a gait in which thrust is produced in the opposite direction of a traveling wave of body bending, is a common mode of propulsion used by animals in fluids, on land, and even within sand. As such, it has been an excellent system for discovery of neuromechanical principles of movement. In nearly all animals studied, the wave of muscle activation progresses faster than the wave of body bending, leading to an advancing phase of activation relative to the curvature toward the tail. This is referred to as "neuromechanical phase lags" (NPL). Several multiparameter neuromechanical models have reproduced this phenomenon, but due to model complexity, the origin of the NPL has proved difficult to identify. Here, we use perhaps the simplest model of undulatory swimming to predict the NPL accurately during sand-swimming by the sandfish lizard, with no fitting parameters. The sinusoidal wave used in sandfish locomotion, the friction-dominated and noninertial granular resistive force environment, and the simplicity of the model allow detailed analysis, and reveal the fundamental mechanism responsible for the phenomenon: the combination of synchronized torques from distant points on the body and local traveling torques. This general mechanism should help explain the NPL in organisms in other environments; we therefore propose that sand-swimming could be an excellent system with which to generate and test other neuromechanical models of movement quantitatively. Such a system can also provide guidance for the design and control of robotic undulatory locomotors in complex environments.

Predicting muscle forces in gait from EMG signals and musculotendon kinematics

An EMG-driven muscle model for determining muscle force-time histories during gait is presented. The model, based on Hill's equation (1938), incorporates morphological data and accounts for changes in musculotendon length, velocity, and the level of muscle excitation for both concentric and eccentric contractions. Musculotendon kinematics were calculated using three-dimensional cinematography with a model of the musculoskeletal system. Muscle force-length-EMG relations were established from slow isokinetic calibrations. Walking muscle force-time histories were determined for two subjects. Joint moments calculated from the predicted muscle forces were compared with moments calculated using a linked segment, inverse dynamics approach. Moment curve correlations ranged from r = 0.72 to r = 0.97 and the root mean square (RMS) differences were from 10 to 20 Nm. Expressed as a relative RMS, the moment differences ranged from a low of 23% at the ankle to a high of 72% at the hip. No single reason for the differences between the two moment curves could be identified. Possible explanations discussed include the linear EMG-to-force assumption and how well the EMG-to-force calibration represented excitation for the whole muscle during gait, assumptions incorporated in the muscle modeling procedure, and errors inherent in validating joint moments predicted from the model to moments calculated using linked segment, inverse dynamics. The closeness with which the joint moment curves matched in the present study supports using the modeling approach proposed to determine muscle forces in gait.

EMG patterns during running: Intra- and inter-individual variability

Rectified surface electromyographic (EMG) patterns of five healthy, young, physically-fit subjects running at 4.2 m s(-1) on a treadmill were recorded with the objective of defining a normal profile of EMG activity for running gait. This knowledge is important in understanding how the central nervous system (CNS) controls simple running tasks under normal conditions. The EMG signals from seven muscles (erector spinae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius) were recorded, together with footswitch signals. The intra- and inter-individual variability of each muscle's EMG profile and peak times were analysed. Interindividual EMG peak time values were analysed to define the timing of the activity of the muscles studied relative to the stride cycle and its subphases. For each muscle, little variation was found within individuals in EMG profile and peak time across trials, but differences between subjects were significant (P < 0.01). EMG peak time analysis showed two distinct activation sequences of different muscles: the first at stance phase and the second at terminal swing. In conclusion, in spite of a significant variability among subjects in EMG profile and peak time values for each muscle, the EMG peak timing analysis showed a sequence of activation at stance phase, no EMG peak activity during the first double swing and another sequence of activation during terminal swing. These findings are evidence of a neuromuscular control strategy common to all subjects.

Optimal feedback control and the long-latency stretch response

There has traditionally been a separation between voluntary control processes and the fast feedback responses which follow mechanical perturbations (i.e., stretch "reflexes"). However, a recent theory of motor control, based on optimal control, suggests that voluntary motor behavior involves the sophisticated manipulation of sensory feedback. We have recently proposed that one implication of this theory is that the long-latency stretch "reflex", like voluntary control, should support a rich assortment of behaviors because these two processes are intimately linked through shared neural circuitry including primary motor cortex. In this review, we first describe the basic principles of optimal feedback control related to voluntary motor behavior. We then explore the functional properties of upper-limb stretch responses, with a focus on how the sophistication of the long-latency stretch response rivals voluntary control. And last, we describe the neural circuitry that underlies the long-latency stretch response and detail the evidence that primary motor cortex participates in sophisticated feedback responses to mechanical perturbations.

Evaluation of the minimum energy hypothesis and other potential optimality criteria for human running

A popular hypothesis for human running is that gait mechanics and muscular activity are optimized in order to minimize the cost of transport (CoT). Humans running at any particular speed appear to naturally select a stride length that maintains a low CoT when compared with other possible stride lengths. However, it is unknown if the nervous system prioritizes the CoT itself for minimization, or if some other quantity is minimized and a low CoT is a consequential effect. To address this question, we generated predictive computer simulations of running using an anatomically inspired musculoskeletal model and compared the results with data collected from human runners. Three simulations were generated by minimizing the CoT, the total muscle activation or the total muscle stress, respectively. While all the simulations qualitatively resembled real human running, minimizing activation predicted the most realistic joint angles and timing of muscular activity. While minimizing the CoT naturally predicted the lowest CoT, minimizing activation predicted a more realistic CoT in comparison with the experimental mean. The results suggest a potential control strategy centred on muscle activation for economical running.

Effect of knee flexion angle on ground reaction forces, knee moments and muscle co-contraction during an impact-like deceleration landing: implications for the non-contact mechanism of ACL injury

Investigating landing kinetics and neuromuscular control strategies during rapid deceleration movements is a prerequisite to understanding the non-contact mechanism of ACL injury. The purpose of this study was to quantify the effect of knee flexion angle on ground reaction forces, net knee joint moments, muscle co-contraction and lower extremity muscles during an impact-like, deceleration task. Ground reaction forces and knee joint moments were determined from video and force plate records of 10 healthy male subjects performing rapid deceleration single leg landings from a 10.5 cm height with different degrees of knee flexion at landing. Muscle co-contraction was based on muscle moments calculated from an EMG-to-moment processing model. Ground reaction forces and co-contraction indices decreased while knee extensor moments increased significantly with increased degrees of knee flexion at landing (all p<0.005). Higher ground reaction forces when landing in an extended knee position suggests they are a contributing factor in non-contact ACL injuries. Increased knee extensor moments and less co-contraction with flexed knee landings suggest that quadriceps overload may not be the primary cause of non-contact ACL injuries. The results bring into question the counterbalancing role of the hamstrings during dynamic movements. The soleus may be a valuable synergist stabilizing the tibia against anterior translation at landing. Movement strategies that lessen the propagation of reaction forces up the kinetic chain may help prevent non-contact ACL injuries. The relative interaction of all involved thigh and lower leg muscles, not just the quadriceps and hamstrings should be considered when interpreting non-contact ACL injury mechanisms.

Temporal evolution of "automatic gain-scaling"

The earliest neural response to a mechanical perturbation, the short-latency stretch response (R1: 20-45 ms), is known to exhibit "automatic gain-scaling" whereby its magnitude is proportional to preperturbation muscle activity. Because gain-scaling likely reflects an intrinsic property of the motoneuron pool (via the size-recruitment principle), counteracting this property poses a fundamental challenge for the nervous system, which must ultimately counter the absolute change in load regardless of the initial muscle activity (i.e., show no gain-scaling). Here we explore the temporal evolution of gain-scaling in a simple behavioral task where subjects stabilize their arm against different background loads and randomly occurring torque perturbations. We quantified gain-scaling in four elbow muscles (brachioradialis, biceps long, triceps lateral, triceps long) over the entire sequence of muscle activity following perturbation onset-the short-latency response, long-latency response (R2: 50-75 ms; R3: 75-105 ms), early voluntary corrections (120-180 ms), and steady-state activity (750-1250 ms). In agreement with previous observations, we found that the short-latency response demonstrated substantial gain-scaling with a threefold increase in background load resulting in an approximately twofold increase in muscle activity for the same perturbation. Following the short-latency response, we found a rapid decrease in gain-scaling starting in the long-latency epoch ( approximately 75-ms postperturbation) such that no significant gain-scaling was observed for the early voluntary corrections or steady-state activity. The rapid decrease in gain-scaling supports our recent suggestion that long-latency responses and voluntary control are inherently linked as part of an evolving sensorimotor control process through similar neural circuitry.

Interpreting muscle function from EMG: lessons learned from direct measurements of muscle force

Electromyography is often used to infer the pattern of production of force by skeletal muscles. The interpretation of muscle function from the electromyogram (EMG) is challenged by the fact that factors such as type of muscle fiber, muscle length, and muscle velocity can all influence the relationship between electrical and mechanical activity of a muscle. Simultaneous measurements of EMG, muscle force, and fascicle length in hindlimb muscles of wild turkeys allow us to probe the quantitative link between force and EMG. We examined two features of the force-EMG relationship. First, we measured the relaxation electromechanical delay (r-EMD) as the time from the end of the EMG signal to time of the end of force. This delay varied with locomotor speed in the lateral gastrocnemius (LG); it was longer at slow walking speeds than for running. This variation in r-EMD was not explained by differences in muscle length trajectory, as the magnitude of r-EMD was not correlated with the velocity of shortening of the muscle during relaxation. We speculate that the longer relaxation times at slow walking speeds compared with running may reflect the longer time course of relaxation in slower muscles fibers. We also examined the relationship between magnitude of force and EMG across a range of walking and running speeds. We analyzed the force-EMG relationship during the swing phase separately from the force-EMG relationship during stance phase. During stance, force amplitude (average force) was linearly related to mean EMG amplitude (average EMG). Forces during swing phase were lower than predicted from the stance phase force-EMG relationship. The different force-EMG relationships during the stance and swing phases may reflect the contribution of passive structures to the development of force, or a nonlinear force-EMG relationship at low levels of muscle activity. Together the results suggest that any inference of force from EMG must be done cautiously when a broad range of activities is considered.

Continuous monitoring of sonomyography, electromyography and torque generated by normal upper arm muscles during isometric contraction: sonomyography assessment for arm muscles

The aim of this study is to demonstrate the feasibility of using the continuous signals about the thickness and pennation angle changes of muscles detected in real-time from ultrasound images, named as sonomyography (SMG), to characterize muscles under isometric contraction, along with synchronized surface electromyography (EMG) and generated torque signals. The right biceps brachii muscles of seven normal young adult subjects were tested. We observed that exponential functions could well represent the relationships between the normalized EMG root-mean-square (RMS) and the torque, the RMS and the muscle deformation SMG, and the RMS and the pennation angle SMG for the data of the contraction phase, with exponent coefficients of 0.0341 +/- 0.0148 (Mean SD), 0.0619 +/- 0.0273, and 0.0266 +/- 0.0076, respectively. In addition, the preliminary results also demonstrated linear relationships between the normalized torque and the muscle deformation as well as the pennation angle with the ratios of 9 .79 +/- 3.01 and 2.02 +/- 0.53, respectively. The overall mean R2 for the regressions was approximately 0.9 and the overall mean relative root mean square error (RRMSE) smaller than 15%. The potential values of SMG together with EMG to provide a more comprehensive assessment for the muscle functions should be further investigated with more subjects and more muscle groups.

Static optimization of muscle forces during gait in comparison to EMG-to-force processing approach

Individual muscle forces evaluated from experimental motion analysis may be useful in mathematical simulation, but require additional musculoskeletal and mathematical modelling. A numerical method of static optimization was used in this study to evaluate muscular forces during gait. The numerical algorithm used was built on the basis of traditional optimization techniques, i.e., constrained minimization technique using the Lagrange multiplier method to solve for constraints. Measuring exact muscle forces during gait analysis is not currently possible. The developed optimization method calculates optimal forces during gait, given a specific performance criterion, using kinematics and kinetics from gait analysis together with muscle architectural data. Experimental methods to validate mathematical methods to calculate forces are limited. Electromyography (EMG) is frequently used as a tool to determine muscle activation in experimental studies on human motion. A method of estimating force from the EMG signal, the EMG-to-force approach, was recently developed by Bogey et al. [Bogey RA, Perry J, Gitter AJ. An EMG-to-force processing approach for determining ankle muscle forcs during normal human gait. IEEE Trans Neural Syst Rehabil Eng 2005;13:302-10] and is based on normalization of activation during a maximum voluntary contraction to documented maximal muscle strength. This method was adapted in this study as a tool with which to compare static optimization during a gait cycle. Muscle forces from static optimization and from EMG-to-force muscle forces show reasonably good correlation in the plantarflexor and dorsiflexor muscles, but less correlation in the knee flexor and extensor muscles. Additional comparison of the mathematical muscle forces from static optimization to documented averaged EMG data reveals good overall correlation to patterns of evaluated muscular activation. This indicates that on an individual level, muscular force patterns from mathematical models can arguably be more accurate than from those obtained from surface EMG during gait, though magnitude must still be validated.

Analyzing gastrocnemius EMG-activity and sway data from quiet and perturbed standing

In an experiment, we combined force plate measurements and surface EMG in studying quiet and perturbed standing, involving MS (Multiple sclerosis) and controls. The aim of this paper is to report the results thus obtained on the relation between filtered gastrocnemius (GA) EMG and the anterior-posterior center-of-pressure (A/P COP) coordinate. The main finding is the good correspondence between A/P COP and the filtered GA EMG in the low frequency range. The EMG envelope was calculated using a zero-lag filter. Combining this with time shifts around 250-350 ms produced a high correlation (85.5+/-8.4%) between the GA-EMG envelope and the A/P COP. This EMG-COP relation was closest when using a low cut-off frequency value around 1 Hz in calculating the EMG envelope. Based on this filtering procedure we estimated the average EMG-COP time shift to be 283+/-43 ms between the GA-EMG envelope and A/P COP (which "lags" behind EMG envelope). This shift is consistent with the 1 Hz cut-off and phase shift produced by a corresponding critically damped second-order filter, and is about twice the corresponding twitch time. These results suggest that GA is to a large extent responsible for the phasic control of the anterior-posterior balance during quiet standing. A small difference (p<0.03) was found between mean time shift thus obtained for controls (n=4) and MS (n=6) while sway area showed a major difference (p<0.01). The paper also compares three alternative filters for numerical calculation of the EMG-envelope.

In vivo assessment of elbow flexor work and activation during stretch-shortening cycle tasks

The purpose of this study was to use an electromyography (EMG) based muscle model to investigate the performance enhancement of stretch-shortening cycle (SSC) tasks at different elbow flexion-extension velocities. A torque motor was used to oscillate the forearms of seven healthy male subjects (23-40 years) during SSC and non-SSC contractions at four frequencies of movement (.58, 1.5, 2.4 and 3.3Hz) over a range of 105 degrees -162 degrees of elbow extension. The torque was integrated as a function of joint angle to yield the work produced by the elbow flexors. The elbow flexors were transcutaneously stimulated with a voltage equivalent to 60% maximum voluntary isometric contraction torque for 4s at 50Hz. EMG of the elbow flexors and extensors was recorded from the biceps and triceps respectively. The processed EMG was used to drive a Hill based model to predict the torque of the elbow flexors. Results indicate that muscle work increases from non-SSC to SSC trials. Work decreases for SSC and non-SSC trials with increasing velocity. The simulated constant activation muscle model predicted work well for all trials and conditions, indicating muscle model accuracy. The EMG driven model predicted well for all non-SSC trials, but significantly underestimated the work for SSC tasks, suggesting that the contractile component is directly involved in optimising muscle work during SSC tasks.

How Changing the Inversion/Eversion Foot Angle Affects the Nondriving Intersegmental Knee Moments and the Relative Activation of the Vastii Muscles in Cycling

Nondriving intersegmental knee moment components (i.e., varus/valgus and internal/external axial moments) are thought to be primarily responsible for the etiology of overuse knee injuries such as patellofermoral pain syndrome in cycling because of their relationship to muscular imbalances. However the relationship between these moments and muscle activity has not been studied. Thus the four primary objectives of this study were to test whether manipulating the inversion/eversion foot angle alters the varus/valgus knee moment (Objective 1) and axial knee moment (Objective 2) and to determine whether activation patterns of the vastus medialis oblique (VMO), vastus lateralis (VL), and tensor fascia latae (TFL) were affected by changes in the varus/valgus (Objective 3) and axial knee moments (Objective 4). To fulfill these objectives, pedal loads and lower limb kinematic data were collected from 15 subjects who pedaled with five randomly assigned inversion/eversion angles: 10 deg and 5 deg everted and inverted and 0deg (neutral). A previously described mathematical model was used to compute the nondriving intersegmental knee moments throughout the crank cycle. The excitations of the VMO, VL, and TFL muscles were measured with surface electromyography and the muscle activations were computed. On average, the 10-deg everted position decreased the peak varus moment by 55% and decreased the peak internal axial moment by 53% during the power stroke (crank cycle region where the knee moment is extensor). A correlation analysis revealed that the VMO/VL activation ratio increased significantly and the TFL activation decreased significantly as the varus moment decreased. For both the VMO/VL activation ratio and the TFL activation, a path analysis indicated that the varus/valgus moment was highly correlated to the axial moment but that the correlation between muscle activation and the varus moment was due primarily to the varus/valgus knee moment rather than the axial knee moment. The conclusion from these results is that everting the foot may be beneficial towards either preventing or ameliorating patellofemoral pain syndrome in cycling.

Reliability of a practicable EMG-moment model for antagonist moment prediction

Although the use of practicable EMG-moment models for knee joint moment prediction appears promising, the repeatability of the estimated forces remains unclear. The purpose of this study was to apply an EMG-moment model to predict the antagonist moment of the knee flexors (Mflx) during maximal isometric knee extension efforts. Nine healthy males performed maximal isometric knee extension and flexion contractions at 0 degrees , 45 degrees and 90 degrees angles with recordings of the net moment and EMG of thigh muscles. Calibration knee flexion efforts were performed at different levels of intensity and the resulting EMG-moment curves were fitted using second-order polynomials. The polynomials were then used to predict Mflx. This procedure was repeated a week after. The results indicated non-significant differences in test-retest Mflx. Intraclass correlation coefficients ranged from 0.852 to 0.912 indicating high test-retest reliability of the estimated Mflx. For isometric contractions, the present model is suitable as a method to estimate antagonist muscle moments.

Review of motor control mechanisms underlying impact absorption from falls

The absorption of impacts resulting from contact with a landing surface during gait, running and drop landings has received considerable attention in the literature. This research has important clinical relevance as failure to appropriately plan and control impact absorption may lead to injuries to the musculo-skeletal system. This review attempts to summarize evidence gathered by studies on the motor control aspects of impact absorption during landing movements. Although this review focuses primarily on the control of landings from self-initiated falls or 'drop landings', an understanding of the motor control mechanisms underlying impact absorption is essential to understand common anticipatory and reflex mechanisms involved in a broader variety of movements such as running and jumping. The review is structured in three parts: the first two parts examine the preparatory muscle activity occurring during the fall (Part I) and after touch down (Part II). Part III explores the proposed sensorimotor mechanisms underlying the control of landing. The review concludes with as yet unresolved questions and directions for future research.

Accuracy of a practicable EMG to force model for knee muscles

A practicable EMG-force model is evaluated for muscles about the knee. The model included envelope signal processing and a gain-dependency of knee angle and angular velocity. Six healthy subjects participated in the experiments. For calibration, maximal isokinetic contractions about the knee were performed on a dynamometer with recordings of knee joint movement, net moment and EMG of thigh muscles. The model parameters were fitted on these calibration experiments. For validation, estimated moments from the EMG levels were compared to the actual exerted moments of two independent isokinetic contractions. Averaged RMS values of the difference ranged from 11 to 20% of the actual exerted moment. For isokinetic concentric contractions, the present model is suitable as a method to estimate muscle moments.