Inter-electrode spacing of surface EMG sensors: Reduction of crosstalk contamination during voluntary contractions

Antagonist Activation Measurement in Triceps Surae Using High-Density and Bipolar Surface EMG in Chronic Hemiparesis

After a stroke, antagonist muscle activation during agonist command impedes movement. This study compared measurements of antagonist muscle activation using surface bipolar EMG in the gastrocnemius medialis (GM) and high-density (HD) EMG in the GM and soleus (SO) during isometric submaximal and maximal dorsiflexion efforts, with knee flexed and extended, in 12 subjects with chronic hemiparesis. The coefficients of antagonist activation (CAN) of GM and SO were calculated according to the ratio of the RMS amplitude during dorsiflexion effort to the maximal agonist effort for the same muscle. Bipolar CAN (BipCAN) was compared to CAN from channel-specific (CsCAN) and overall (OvCAN) normalizations of HD-EMG. The location of the CAN centroid was explored in GM, and CAN was compared between the medial and lateral portions of SO. Between-EMG system differences in GM were observed in maximal efforts only, between BipCAN and CsCAN with lower values in BipCAN (p < 0.001), and between BipCAN and OvCAN with lower values in OvCAN (p < 0.05). The CAN centroid is located mid-height and medially in GM, while the CAN was similar in medial and lateral SO. In chronic hemiparesis, the estimates of GM hyperactivity differ between bipolar and HD-EMGs, with channel-specific and overall normalizations yielding, respectively, higher and lower CAN values than bipolar EMG. HD-EMG would be the way to develop personalized rehabilitation programs based on individual antagonist activations.

Older adults use fewer muscles to overcome perturbations during a seated locomotor task

Locomotor perturbations provide insights into humans' response to motor errors. We investigated the differences in motor adaptation and muscle cocontraction between young and older adults during perturbed-arm and -leg recumbent stepping. We hypothesized that besides prolonged adaptation due to use-dependent learning, older adults would exhibit greater muscle cocontraction than young adults in response to the perturbations. Perturbations were brief increases in resistance applied during each stride at the extension onset or midextension of the left or right leg. Seventeen young adults and eleven older adults completed four 10-min perturbed stepping tasks. Subjects were instructed to follow a visual pacing cue, step smoothly, and use all their limbs to drive the stepper. Results showed that young and older adults did not decrease their errors with more perturbation experience, and errors did not wash out after perturbations were removed. Interestingly, older adults consistently had smaller motor errors than young adults in response to the perturbations. Older adults used fewer muscles to drive the stepper and had greater cocontraction than young adults. The results suggest that, despite similar motor error responses, young and older adults use distinctive muscle recruitment patterns to perform the motor task. Age-related motor strategies help track motor changes across the human life span and are a baseline for rehabilitation and performance assessment.NEW & NOTEWORTHY Older adults often demonstrate greater cocontraction and motor errors than young adults in response to motor perturbations. We demonstrated that older adults reduced their motor errors more than young adults with brief perturbations during recumbent stepping while maintaining greater muscle cocontraction. In doing so, older adults largely used one muscle pair to drive the stepper, tibialis anterior and soleus, whereas young adults used all muscles. These two muscles are crucial for maintaining upright balance.

Benchtop Performance of Novel Mixed Ionic-Electronic Conductive Electrode Form Factors for Biopotential Recordings

Background: Traditional gel-based (wet) electrodes for biopotential recordings have several shortcomings that limit their practicality for real-world measurements. Dry electrodes may improve usability, but they often suffer from reduced signal quality. We sought to evaluate the biopotential recording properties of a novel mixed ionic-electronic conductive (MIEC) material for improved performance. Methods: We fabricated four MIEC electrode form factors and compared their signal recording properties to two control electrodes, which are electrodes commonly used for biopotential recordings (Ag-AgCl and stainless steel). We used an agar synthetic skin to characterize the impedance of each electrode form factor. An electrical phantom setup allowed us to compare the recording quality of simulated biopotentials with ground-truth sources. Results: All MIEC electrode form factors yielded impedances in a similar range to the control electrodes (all <80 kΩ at 100 Hz). Three of the four MIEC samples produced similar signal-to-noise ratios and interfacial charge transfers as the control electrodes. Conclusions: The MIEC electrodes demonstrated similar and, in some cases, better signal recording characteristics than current state-of-the-art electrodes. MIEC electrodes can also be fabricated into a myriad of form factors, underscoring the great potential this novel material has across a wide range of biopotential recording applications.

Spatiotemporal modulation of a common set of muscle synergies during unpredictable and predictable gait perturbations in older adults

Muscle synergies as functional low-dimensional building blocks of the neuromotor system regulate the activation patterns of muscle groups in a modular structure during locomotion. The purpose of the current study was to explore how older adults organize locomotor muscle synergies to counteract unpredictable and predictable gait perturbations during the perturbed steps and the recovery steps. Sixty-three healthy older adults (71.2±5.2 years) participated in the study. Mediolateral and anteroposterior unpredictable and predictable perturbations during walking were introduced using a treadmill. Muscle synergies were extracted from the electromyographic activity of 13 lower limb muscles using Gaussian non-negative matrix factorization. The four basic synergies responsible for unperturbed walking (weight acceptance, propulsion, early swing and late swing) were preserved in all applied gait perturbations, yet their temporal recruitment and muscle contribution in each synergy were modified (P<0.05). These modifications were observed for up to four recovery steps and were more pronounced (P<0.05) following unpredictable perturbations. The recruitment of the four basic walking synergies in the perturbed and recovery gait cycles indicates a robust neuromotor control of locomotion by using activation patterns of a few and well-known muscle synergies with specific adjustments within the synergies. The selection of pre-existing muscle synergies while adjusting the time of their recruitment during challenging locomotor conditions may improve the effectiveness to deal with perturbations and promote the transfer of adaptation between different kinds of perturbations.

Evaluation of trunk muscle coactivation predictions in multi-body models

Musculoskeletal simulations with muscle optimization aim to minimize muscle effort, hence are considered unable to predict the activation of antagonistic muscles. However, activation of antagonistic muscles might be necessary to satisfy the dynamic equilibrium. This study aims to elucidate under which conditions coactivation can be predicted, to evaluate factors modulating it, and to compare the antagonistic activations predicted by the lumbar spine model with literature data. Simple 2D and 3D models, comprising of 2 or 3 rigid bodies, with simple or multi-joint muscles, were created to study conditions under which muscle coactivity is predicted. An existing musculoskeletal model of the lumbar spine developed in AnyBody was used to investigate the effects of modeling intra-abdominal pressure (IAP), linear/cubic and load/activity-based muscle recruitment criterion on predicted coactivation during forward flexion and lateral bending. The predicted antagonist activations were compared to reported EMG data. Muscle coactivity was predicted with simplified models when multi-joint muscles were present or the model was three-dimensional. During forward flexion and lateral bending, the coactivation ratio predicted by the model showed good agreement with experimental values. Predicted coactivation was negligibly influenced by IAP but substantially reduced with a force-based recruitment criterion. The conditions needed in multi-body models to predict coactivity are: three-dimensionality or multi-joint muscles, unless perfect antagonists. The antagonist activations are required to balance 3D moments but do not reflect other physiological phenomena, which might explain the discrepancies between model predictions and experimental data. Nevertheless, the findings confirm the ability of the multi-body trunk models to predict muscle coactivity and suggest their overall validity.

Assessment of Self-report, Palpation, and Surface Electromyography Dataset During Isometric Muscle Contraction

Measuring muscle fatigue involves assessing various components within the motor system. While subjective and sensor-based measures have been proposed, a comprehensive comparison of these assessment measures is currently lacking. This study aims to bridge this gap by utilizing three commonly used measures: participant self-reported perceived muscle fatigue scores, a sports physiotherapist's manual palpation-based muscle tightness scores, and surface electromyography sensors. Compensatory muscle fatigue occurs when one muscle group becomes fatigued, leading to the involvement and subsequent fatigue of other muscles as they compensate for the workload. The evaluation of compensatory muscle fatigue focuses on nine different upper body muscles selected by the sports physiotherapist. With a cohort of 30 male subjects, this study provides a valuable dataset for researchers and healthcare practitioners in sports science, rehabilitation, and human performance. It enables the exploration and comparison of diverse methods for evaluating different muscles in isometric contraction.

Nonlinear spatio-temporal filter to reduce crosstalk in bipolar electromyogram

Objective.The wide detection volume of surface electromyogram (EMG) makes it prone to crosstalk, i.e. the signal from other muscles than the target one. Removing this perturbation from bipolar recordings is an important open problem for many applications.Approach.An innovative nonlinear spatio-temporal filter is developed to estimate the EMG generated by the target muscle by processing noisy signals from two bipolar channels, placed over the target and the crosstalk muscle, respectively. The filter is trained on some calibration data and then can be applied on new signals. Tests are provided in simulations (considering different thicknesses of the subcutaneous tissue, inter-electrode distances, locations of the EMG channels, force levels) and experiments (from pronator teres and flexor carpi radialis of 8 healthy subjects).Main results.The proposed filter allows to reduce the effect of crosstalk in all investigated conditions, with a statistically significant reduction of its root mean squared of about 20%, both in simulated and experimental data. Its performances are also superior to those of a blind source separation method applied to the same data.Significance.The proposed filter is simple to be applied and feasible in applications in which single bipolar channels are placed over the muscles of interest. It can be useful in many fields, such as in gait analysis, tests of myoelectric fatigue, rehabilitation with EMG biofeedback, clinical studies, prosthesis control.

Modified motor unit properties in residual muscle following transtibial amputation

Objective.Neural signals in residual muscles of amputated limbs are frequently decoded to control powered prostheses. Yet myoelectric controllers assume muscle activities of residual muscles are similar to that of intact muscles. This study sought to understand potential changes to motor unit (MU) properties after limb amputation.Approach.Six people with unilateral transtibial amputation were recruited. Surface electromyogram (EMG) of residual and intacttibialis anterior(TA) andgastrocnemius(GA) muscles were recorded while subjects traced profiles targeting up to 20% and 35% of maximum activation for each muscle (isometric for intact limbs). EMG was decomposed into groups of MU spike trains. MU recruitment thresholds, action potential amplitudes (MU size), and firing rates were correlated to model Henneman's size principle, the onion-skin phenomenon, and rate-size associations. Organization (correlation) and modulation (rates of change) of relations were compared between intact and residual muscles.Main results.The residual TA exhibited significantly lower correlation and flatter slopes in the size principle and onion-skin, and each outcome covaried between the MU relations. The residual GA was unaffected for most subjects. Subjects trained prior with myoelectric prostheses had minimally affected slopes in the TA. Rate-size association correlations were preserved, but both residual muscles exhibited flatter decay rates.Significance.We showed peripheral neuromuscular damage also leads to spinal-level functional reorganizations. Our findings suggest models of MU recruitment and discharge patterns for residual muscle EMG generation need reparameterization to account for disturbances observed. In the future, tracking MU pool adaptations may also provide a biomarker of neuromuscular control to aid training with myoelectric prostheses.

Masseter and digastric muscle activity evaluation using a novel electromyogram that utilizes elastic sheet electrodes

PURPOSE

To evaluate the reproducibility and reliability of a novel electromyogram (EMG) device with a flexible sheet sensor for measuring muscle activity related to mastication and swallowing.

METHODS

We developed a new EMG device made of elastic sheet electrodes to measure the masseter and digastric muscle activities for evaluating mastication and swallowing. To examine the measurement reproducibility of the new EMG device, masseter muscle activity was analyzed using the intraclass correlation coefficient (ICC). Further, we measured the maximum amplitude, duration, integrated value, and signal-to-noise ratio (SNR) using the new EMG device and conventional EMG devices and evaluated the reliability using ICC and Bland-Altman analysis.

RESULTS

We confirmed high ICC (1,1) and ICC (2,1) scores (0.92 and 0.88, respectively) while measuring the reproducibility of the new EMG device. When compared to the active electrode EMG device, we found a high correlation for the maximum amplitude (0.90), duration (0.99), integrated values (0.90), and SNR (0.75), with no observation of significant fixed errors. Moreover, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed. Compared with the passive electrode EMG device, the maximum amplitude and duration were highly correlated (0.73 and 0.89). In addition, the SNR exhibited a significant fixed error. In contrast, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed.

CONCLUSIONS

Our results suggest that the new EMG device can be used to reliably and reproducibly evaluate muscle activity during mastication and swallowing.

The Sensitivity of Bipolar Electromyograms to Muscle Excitation Scales With the Inter-Electrode Distance

The value of surface electromyograms (EMGs) lies in their potential to non-invasively probe the neuromuscular system. Whether muscle excitation may be accurately inferred from bipolar EMGs depends on how much the detected signal is both sensitive and specific to the excitation of the target muscle. While both are known to be a function of the inter-electrode distance (IED), specificity has been of long concern in the physiological literature. In contrast, sensitivity, at best, has been implicitly assumed. Here we provide evidence that the IED imposes a biophysical constraint on the sensitivity of surface EMG. From 20 healthy subjects, we tested the hypothesis that excessively reducing the IED limits EMGs' physiological content. We detected bipolar EMGs with IEDs varying from 5 mm to 50 mm from two skeletal muscles with distinct architectures, gastrocnemius and biceps brachii. Non-parametric statistics and Bayesian hierarchical modelling were used to evaluate the dependence of the onset of muscle excitation and signal-to-noise ratio (SNR) on the IED. Experimental results revealed that IED critically affects the sensitivity of bipolar EMGs for both muscles-indeliberately reducing the IED yields EMGs that are not representative of the whole muscle, hampering validity. Simulation results substantiate the generalization of experimental results to small and large electrodes. Based on current and previous findings, we discuss a potentially valid procedure for defining the most appropriate IED for a single bipolar, surface recording-i.e., the distance from the electrode to the target muscle boundary may heuristically serve as a lower bound when choosing an IED.

Automated spatial localization of ankle muscle sites and model-based estimation of joint torque post-stroke via a wearable sensorised leg garment

Assessing a patient's musculoskeletal function during over-ground walking is a primary objective in post-stroke rehabilitation, due to the importance of walking recovery for everyday life. However, the quantitative assessment of musculoskeletal function currently requires lab-constrained equipment, and labor-intensive analyses, which hampers assessment in standard clinical settings. The development of fully wearable systems for the online estimation of muscle-tendon forces and resulting joint torque would aid clinical assessment of motor recovery, it would enhance the detection of neuro-muscular anomalies and it would consequently enable highly personalized treatments. Here, we present a wearable technology that combines (1) a soft garment for the human leg sensorized with 64 flexible and dry electromyography (EMG) electrodes, (2) a generalized and automated algorithm for the localization of leg muscle sites, and (3) an EMG-driven musculoskeletal modeling framework for the estimation of ankle dorsi-plantar flexion torques. Our results showed that the automated clustering algorithm could detect muscle locations in both healthy and post-stroke individuals. The estimated muscle-specific EMG envelopes could be used to drive forward person-specific musculoskeletal models and estimate resulting joint torques accurately across all healthy and post-stroke individuals and across different walking speeds (R2  > 0.82 and RMSD  < 0.16). The technology we proposed opens new avenues for automated muscle localization and quantitative musculoskeletal function assessment during gait in both healthy and neurologically impaired individuals.

Measurement of the lumbrical muscle activity of the hand using electromyography supported by the ultrasound imaging technique with string navigation

Although placing surface electrodes on small muscles by palpation is difficult, ultrasound guidance may enable electrode placement on the small muscles. This study aimed to examine whether ultrasound guidance is helpful for placement of electrodes on a small muscle, such as the hand lumbrical muscle. Twelve dominant hands of 12 healthy right-handed adults were included in this study. The first lumbrical muscle belly of the hands was identified using ultrasound guidance with a string navigation technique for placing surface electrodes. This technique was designed to identify the location of the center of the muscle belly under ultrasound imaging using a string. After the electrodes were placed on the muscle belly using this technique, the surface electromyographic signals of the first lumbrical, first dorsal interosseous, and adductor pollicis muscles were recorded. The activity of the lumbrical muscle could be separately measured of the first dorsal interosseous and adductor pollicis muscles. This technique has the potential to enable surface electromyography of small muscles for which placement of surface electrodes by palpation is challenging.

Spinal Muscle Thickness and Activation during Abdominal Hollowing and Bracing in CrossFit® Athletes

Exercises that improve muscle activation are essential for maintaining spinal stability and preventing low back pain. The purpose of this study was to compare the effects of abdominal hollowing and bracing on the activation of the core muscles in CrossFit® participants using ultrasound and electromyography (EMG). Twenty-four healthy adults aged 21 to 42 years old with at least two years of CrossFit® experience performed three core stability exercises (plank, side plank, bridge) with abdominal hollowing and bracing. We measured the ultrasound relative thickness of the local core muscles (transversus abdominis, internal oblique, and lumbar multifidus), and the EMG percentage of maximal voluntary contraction (MVC) of the global core muscles (rectus abdominis, external oblique, and iliocostalis lumborum). Analysis of variance tests showed that the relative thickness of the local core muscles was greater (p = 0.016) during hollowing (range from 26.8 ± 5.33 to 88.4 ± 11.9% of rest) than bracing (range from 15.9 ± 3.54 to 61.2 ± 15.9% of rest), while the EMG of the global muscles was greater (p = 0.001) in bracing (range from 24.4 ± 7.30 to 72.5 ± 9.17% of MVC) than hollowing (range from 16.4 ± 3.70 to 56.6 ± 7.65% of MVC). These results indicate that the recruitment of spinal muscles during popular exercises is achieved with both hollowing and bracing. Nevertheless, it appears that hollowing tends to recruit more of the local muscles, whilst bracing recruits more of the global muscles. The grading of the exercises varied between muscles and varied between maneuvers, especially for the surface abdominals and lumbar muscles. CrossFit® practitioners can choose to use either hollowing or bracing to activate their core muscles more selectively or more appropriately, depending on the goal and purpose of the exercise.

Wavelet Analysis of Respiratory Muscle sEMG Signals during the Physiological Breakpoint of Static Dry End-Expiratory Breath-Holding in Naive Apneists: A Pilot Study

The wavelet spectral characteristics of three respiratory muscle signals (scalenus (SC), parasternal intercostal (IC), and rectus abdominis (RA)) and one locomotor muscle (brachioradialis (BR)) were analyzed in the time-frequency (T-F) domain during voluntary breath-holding (BH), with a focus on the physiological breakpoint that is commonly considered the first involuntary breathing movement (IBM) that signals the end of the easy-going phase of BH. The study was performed for an end-expiratory BH physiological breaking point maneuver on twelve healthy, physically active, naive breath-holders/apneists (six professional athletes; six recreational athletes, and two individuals in the post-COVID-19 period) using surface electromyography (sEMG). We observed individual effects that were dependent on muscle oxygenation and each person's fitness, which were consistent with the mechanism of motor unit (MU) recruitment and the transition of slow-twitch oxidative (type 1) to fast-twitch glycolytic (type 2) muscle fibers. Professional athletes had longer BH durations (BHDs) and strong hypercapnic responses regarding the expiratory RA muscle, which is activated abruptly at higher BHDs in a person-specific range below 250 Hz and is dependent on the BHD. This is in contrast with recreational athletes, who had strong hypoxic responses regarding inspiratory IC muscle, which is activated faster and gradually in the frequency range of 250-450 Hz (independent of the person and BHD). This pilot study preliminarily indicates that it is possible to noninvasively assess the physiological characteristics of skeletal muscles, especially oxygenation, and improve physical fitness tests by determining the T-F features of elevated myoelectric IC and RA activity during BH.

Evaluation of Novel Embroidered Textile-Electrodes Made from Hybrid Polyamide Conductive Threads for Surface EMG Sensing

Recently, there has been an increase in the number of reports on textile-based dry electrodes that can detect biopotentials without the need for electrolytic gels. However, these textile electrodes have a higher electrode skin interface impedance due to the improper contact between the skin and the electrode, diminishing the reliability and repeatability of the sensor. To facilitate improved skin-electrode contact, the effects of load and holding contact pressure were monitored for an embroidered textile electrode composed of multifilament hybrid thread for its application as a surface electromyography (sEMG) sensor. The effect of the textile's inter-electrode distance and double layering of embroidery that increases the density of the conductive threads were studied. Electrodes embroidered onto an elastic strap were wrapped around the forearm with a hook and loop fastener and tested for their performance. Time domain features such as the Root Mean Square (RMS), Average Rectified Value (ARV), and Signal to Noise Ratio (SNR) were quantitatively monitored in relation to the contact pressure and load. Experiments were performed in triplicates, and the sEMG signal characteristics were observed for various loads (0, 2, 4, and 6 kg) and holding contact pressures (5, 10, and 20 mmHg). sEMG signals recorded with textile electrodes were comparable in amplitude to those recorded using typical Ag/AgCl electrodes (28.45 dB recorded), while the signal-to-noise ratios were, 11.77, 19.60, 19.91, and 20.93 dB for the different loads, and 21.33, 23.34, and 17.45 dB for different holding pressures. The signal quality increased as the elastic strap was tightened further, but a pressure higher than 20 mmHg is not recommended because of the discomfort experienced by the subjects during data collection.

High-Fidelity sEMG Signals Recorded by an on-Skin Electrode Based on AgNWs for Hand Gesture Classification Using Machine Learning

The human forearm is one of the most densely distributed parts of the human body, with the most irregular spatial distribution of muscles. A number of specific forearm muscles control hand motions. Acquiring high-fidelity sEMG signals from human forearm muscles is vital for human-machine interface (HMI) applications based on gesture recognition. Currently, the most commonly used commercial electrodes for detecting sEMG or other electrophysiological signals have a rigid nature without stretchability and cannot maintain conformal contact with the human skin during deformation, and the adhesive hydrogel used in them to reduce skin-electrode impedance may shrink and cause skin inflammation after long-term use. Therefore, developing elastic electrodes with stretchability and biocompatibility for sEMG signal recording is essential for developing HMI. Here, we fabricated a nanocomposite hybrid on-skin electrode by infiltrating silver nanowires (AgNWs), a one-dimensional (1D) nano metal material with conductivity, into polydimethylsiloxane (PDMS), a silicone elastomer with a similar Young's modulus to that of the human skin. The AgNW on-skin electrode has a thickness of 300 μm and low sheet resistance of 0.481 ± 0.014 Ω/sq and can withstand the mechanical strain of up to 54% and maintain a sheet resistance lower than 1 Ω/sq after 1000 dynamic strain cycles. The AgNW on-skin electrode can record high signal-to-noise ratio (SNR) sEMG signals from forearm muscles and can reflect various force levels of muscles by sEMG signals. Besides, four typical hand gestures were recognized by the multichannel AgNW on-skin electrodes with a recognition accuracy of 92.3% using machine learning method. The AgNW on-skin electrode proposed in this study has great potential and promise in various HMI applications that employ sEMG signals as control signals.

Ultrathin crystalline-silicon-based strain gauges with deep learning algorithms for silent speech interfaces

A wearable silent speech interface (SSI) is a promising platform that enables verbal communication without vocalization. The most widely studied methodology for SSI focuses on surface electromyography (sEMG). However, sEMG suffers from low scalability because of signal quality-related issues, including signal-to-noise ratio and interelectrode interference. Hence, here, we present a novel SSI by utilizing crystalline-silicon-based strain sensors combined with a 3D convolutional deep learning algorithm. Two perpendicularly placed strain gauges with minimized cell dimension (<0.1 mm²) could effectively capture the biaxial strain information with high reliability. We attached four strain sensors near the subject’s mouths and collected strain data of unprecedently large wordsets (100 words), which our SSI can classify at a high accuracy rate (87.53%). Several analysis methods were demonstrated to verify the system’s reliability, as well as the performance comparison with another SSI using sEMG electrodes with the same dimension, which exhibited a relatively low accuracy rate (42.60%).

Designing an efficient platform that enables verbal communication without vocalization remains a challenge. Here, the authors propose a silent speech interface by utilizing a deep learning algorithm combined with strain sensors attached near the subject’s mouth, able to collect 100 words and classify at a high accuracy rate.

Muscle Engagement Monitoring Using Self-Adhesive Elastic Nanocomposite Fabrics

Insight into, and measurements of, muscle contraction during movement may help improve the assessment of muscle function, quantification of athletic performance, and understanding of muscle behavior, prior to and during rehabilitation following neuromusculoskeletal injury. A self-adhesive, elastic fabric, nanocomposite, skin-strain sensor was developed and validated for human movement monitoring. We hypothesized that skin-strain measurements from these wearables would reveal different degrees of muscle engagement during functional movements. To test this hypothesis, the strain sensing properties of the elastic fabric sensors, especially their linearity, stability, repeatability, and sensitivity, were first verified using load frame tests. Human subject tests conducted in parallel with optical motion capture confirmed that they can reliably measure tensile and compressive skin-strains across the calf and tibialis anterior. Then, a pilot study was conducted to assess the correlation of skin-strain measurements with surface electromyography (sEMG) signals. Subjects did biceps curls with different weights, and the responses of the elastic fabric sensors worn over the biceps brachii and flexor carpi radialis (i.e., forearm) were well-correlated with sEMG muscle engagement measures. These nanocomposite fabric sensors were validated for monitoring muscle engagement during functional activities and did not suffer from the motion artifacts typically observed when using sEMGs in free-living community settings.

Higher Leg and Trunk Muscle Activation during Balance Control in Copers versus People with Chronic Ankle Instability and Healthy Female Athletes

Highlights

Abstract

More than 70% of people with ankle sprain experience chronic ankle instability. However, some people are well adapted to this damage (copers) and do not suffer from chronic ankle instability (CAI). This cross-sectional study involved 34 female athletes, who were classified into three groups (athletes with CAI, copers, and healthy athletes) and tested on a Biodex Balance System. Surface electromyography (EMG) and balance scores were monitored. The coper and healthy group exhibited higher medial gastrocnemius (MG) EMG activity during unstable balance conditions. The rectus abdominus (RA) in the coper group and rectus femoris (RF) in the healthy group showed greater EMG activity compared to CAI during unstable conditions. During stable conditions, the coper group showed greater RA EMG activity compared to CAI, as well as higher tibialis anterior (TA) EMG activity compared to the healthy group. Additionally, balance error scores were higher in the CAI group than those in the healthy group under unstable conditions. In conclusion, decreased EMG activity of the MG, RF, and RA in CAI athletes may contribute to impaired balance in these individuals. The increased EMG activity of the MG, TA, and RA in copers might result in more trunk and ankle stability.

Providing physical relief for nurses by collaborative robotics

Manual patient handling is one of the most significant challenges leading to musculoskeletal burden among healthcare workers. Traditional working techniques could be enhanced by innovations that can be individually adapted to the physical capacity of nurses. We evaluated the use of a robotic system providing physical relief by collaboratively assisting nurses in manual patient handling tasks. By quantifying kinetic and muscle activity data, it was possible to distinguish two kinds of movement patterns. Highly asymmetric postures and movements corresponded to distinct extremes in lower limb and spine muscle activity data. The use of collaborative robotics significantly reduced maximum force exertion in the caregiving process by up to 51%. Lateral flexion and torsion of the trunk were reduced by up to 54% and 87%, respectively, leading to a significant reduction in mean spine muscle activity of up to 55%. These findings indicate the feasibility of collaborative robot-assisted patient handling and emphasize the need for future individual intervention programs to prevent physical burden in care.

BodyWorks: interactive interdisciplinary online teaching tools for biomechanics and physiology teaching

Remote teaching can be both challenging and motivating. Professors and lecturers have developed innovative strategies to improve students' education and engage students in synchronous and asynchronous classes. In this Illuminations paper, we describe BodyWorks, online tools to support courses in physiology, motor control, and biomechanics. The tools are interactive and easy to use, have low computer and internet demands, and can be used in many conditions and topics of study. All resources are freely available online in three different languages. We hope our initiative can help professors and students worldwide promote more interactive and engaging motor control and related topics classes for both synchronous and asynchronous formats.

Retentive capacity of power output and linear versus non-linear mapping of power loss in the isotonic muscular endurance test

The limit of dynamic endurance during repetitive contractions has been referred to as the point of muscle fatigue, which can be measured by mechanical and electrophysiological parameters combined with subjective estimates of load tolerance for revealing the human real-world capacity required to work continuously. In this study, an isotonic muscular endurance (IME) testing protocol under a psychophysiological fatigue criterion was developed for measuring the retentive capacity of the power output of lower limb muscles. Additionally, to guide the development of electrophysiological evaluation methods, linear and non-linear techniques for creating surface electromyography (sEMG) models were compared in terms of their ability to estimate muscle fatigue. Forty healthy college-aged males performed three trials of an isometric peak torque test and one trial of an IME test for the plantar flexors and knee and hip extensors. Meanwhile, sEMG activity was recorded from the medial gastrocnemius, lateral gastrocnemius, vastus medialis, rectus femoris, vastus lateralis, gluteus maximus, and biceps femoris of the right leg muscles. Linear techniques (amplitude-based parameters, spectral parameters, and instantaneous frequency parameters) and non-linear techniques (a multi-layer perception neural network) were used to predict the time-dependent power output during dynamic contractions. Two mechanical manifestations of muscle fatigue were observed in the IME tests, including power output reduction between the beginning and end of the test and time-dependent progressive power loss. Compared with linear mapping (linear regression) alone or a combination of sEMG variables, non-linear mapping of power loss during dynamic contractions showed significantly higher signal-to-noise ratios and correlation coefficients between the actual and estimated power output. Muscular endurance required in real-world activities can be measured by considering the amount of work produced or the activity duration via the recommended IME testing protocol under a psychophysiological termination criterion. Non-linear mapping techniques provide more powerful mapping of power loss compared with linear mapping in the IME testing protocol.

A comparison of teres minor and infraspinatus muscle activation in the prone position

Background

Methods

Results

Conclusion

The Symmetry of Fatigue of Lower Limb Muscles in 400 m Run Based on Electromyography Signals

Background: This study assesses curved track effects on fatigue symmetry and lower limb muscle activity while taking maximum velocity running kinematics into account. Methods: Polish master class athletes were examined (age 24.6 ± 3.67 years, bm 78.9 ± 6.02 kg, and bh 186.1 ± 6.63 cm). The measurements were made on a 400 m synthetic surface athletics track. The DelSys 16 channel system was employed to measure the activity of the right and left leg muscles. The kinematic variables of the run were obtained using a 3-axis accelerometer built into the recorder. Results: The study revealed curved track effects on asymmetric muscle activity and running kinematics in the first two sections of the run. On the first curve, the symmetry index (SI) was 8.1%, while in on straight, it was 11.5%. Moreover, significantly lower values of the fatigue index b were found for the right limb (F(3.36) = 6.504; p = 0.0152). Conclusions: A reduction of asymmetric muscle activity is linked with compensatory muscle stimulation triggered by the nervous system and with adjusting running kinematics to changing external conditions. Therefore, the main focus further research should be on the optimal interaction between stride length and frequency in relation to the muscle activity corresponding to the track geometry.

Electromyography Recordings Detect Muscle Activity Before Observable Contractions in Acute Stroke Care

OBJECTIVE

To evaluate muscle activity in the arms of adult stroke survivors with limited or no arm movement during acute care.

DESIGN

Prospective observational study.

SETTING

Acute care regional stroke center.

PARTICIPANTS

We recruited adults (N=21) who had a stroke within the previous 5 days who were admitted to a level 1 trauma hospital and had a National Institutes of Health Stroke Scale score >1 for arm function at the time of recruitment. A total of 21 adults (13 men, 8 women) with an average age of 60±15 years were recruited an average of 3±1 days after their stroke. Eleven (7 men, 4 women; age, 56±11y) had no observable or palpable arm muscle activity (Manual Muscle Test [MMT]=0) and 10 (6 men, 4 women; age, 64±1y) had detectable activity (MMT>0).

INTERVENTIONS

Dual mode sensors (electromyography and accelerometry) were placed on the anterior deltoid, biceps, triceps, wrist extensors, and wrist flexors of the impaired arm.

MAIN OUTCOME MEASURES

The number of muscle contractions, as well as average duration, amplitude, and co-contraction patterns were evaluated for each participant.

RESULTS

Muscle contractions were observed in all 5 muscles for all participants using electromyography (EMG) recordings. Contractions were easily identified from 30 minutes of monitoring for participants with an MMT >0, but up to 3 hours of monitoring was required for participants with an MMT=0 to detect contractions in all 5 muscles during standard care. Only the wrist extensors demonstrated significantly larger amplitude contractions for participants with an MMT>0 than those with an MMT=0. Co-contraction was rare, involving less than 10% of contractions. Co-contraction of 2 muscles most commonly aligned with the flexor synergy pattern commonly observed after stroke. For participants with an MMT=0, the number of contractions and maximum amplitude were moderately correlated with MMT scores at follow-up.

CONCLUSIONS

Muscle activity was detected with surface EMG recordings during standard acute care, even for individuals with no observable activity by clinical examination. Wearable sensors may be useful for monitoring early muscle activity and movement after stroke.

Flexible Dry Electrodes for EMG Acquisition within Lower Extremity Prosthetic Sockets

Acquisition of surface electromyography (sEMG) from a person with an amputated lower extremity (LE) during prosthesis-assisted walking remains a significant challenge due to the dynamic nature of the gait cycle. Current solutions to sEMG-based neural control of active LE prostheses involve a combination of customized electrodes, prosthetic sockets, and liners. These technologies are generally: (i) incompatible with a subject's existing prosthetic socket and liners; (ii) uncomfortable to use; and (iii) expensive. This paper presents a flexible dry electrode design for sEMG acquisition within LE prosthetic sockets which seeks to address these issues. Design criteria and corresponding design decisions are explained and a proposed flexible electrode prototype is presented. Performances of the proposed electrode and commercial Ag/AgCl electrodes are compared in seated subjects without amputations. Quantitative analyses suggest comparable signal qualities for the proposed novel electrode and commercial electrodes. The proposed electrode is demonstrated in a subject with a unilateral transtibial amputation wearing her own liner, socket, and the portable sEMG processing platform in a preliminary standing and level ground walking study. Qualitative analyses suggest the feasibility of real-time sEMG data collection from load-bearing, ambulatory subjects.

Acquisition of Surface EMG Using Flexible and Low-Profile Electrodes for Lower Extremity Neuroprosthetic Control

For persons with lower extremity (LE) amputation, acquisition of surface electromyography (sEMG) from within the prosthetic socket remains a significant challenge due to the dynamic loads experienced during the gait cycle. However, these signals are critical for both understanding the clinical effects of LE amputation and determining the desired control trajectories of active LE prostheses. Current solutions for collecting within-socket sEMG are generally (i) incompatible with a subject's prescribed prosthetic socket and liners, (ii) uncomfortable, and (iii) expensive. This study presents an alternative within-socket sEMG acquisition paradigm using a novel flexible and low-profile electrode. First, the practical performance of this Sub-Liner Interface for Prosthetics (SLIP) electrode is compared to that of commercial Ag/AgCl electrodes within a cohort of subjects without amputation. Then, the corresponding SLIP electrode sEMG acquisition paradigm is implemented in a single subject with unilateral transtibial amputation performing unconstrained movements and walking on level ground. Finally, a quantitative questionnaire characterizes subjective comfort for SLIP electrode and commercial Ag/AgCl electrode instrumentation setups. Quantitative analyses suggest comparable signal qualities between SLIP and Ag/AgCl electrodes while qualitative analyses suggest the feasibility of using the SLIP electrode for real-time sEMG data collection from load-bearing, ambulatory subjects with LE amputation.

Understanding the effect of window length and overlap for assessing sEMG in dynamic fatiguing contractions: A non-linear dimensionality reduction and clustering

The Short-Time Fourier transform (STFT) is a helpful tool to identify muscle fatigue with clinical and sports applications. However, the choice of STFT parameters may affect the estimation of myoelectrical manifestations of fatigue. Here, we determine the effect of window length and overlap selections on the frequency slope and the coefficient of variation from EMG spectrum features in fatiguing contractions. We also determine whether STFT parameters affect the relationship between frequency slopes and task failure. Eighty-eight healthy adult men performed one-leg heel-rise until exhaustion. A factorial design with a window length of 50, 100, 250, 500, and 1000 ms with 0, 25, 50, 75, and 90% of overlap was used. The frequency slope was non-linearly fitted as a task failure function, followed by a dimensionality reduction and clustering analysis. The STFT parameters elicited five patterns. A small window length produced a higher slope frequency for the peak frequency (p < 0.001). The contrary was found for the mean and median frequency (p < 0.001). A larger window length elicited a higher slope frequency for the mean and peak frequencies. The largest frequency slope and dispersion was found for a window length of 50 ms without overlap using peak frequency. A combination of 250 ms with 50% of overlap reduced the dispersion both for peak, median, and mean frequency, but decreased the slope frequency. Therefore, the selection of STFT parameters during dynamic contractions should be accompanied by a mechanical measure of the task failure, and its parameters should be adjusted according to the experiment's requirements.

Neural adaptations to long-term resistance training: evidence for the confounding effect of muscle size on the interpretation of surface electromyography

This study compared elbow flexor (EF; experiment 1) and knee extensor (KE; experiment 2) maximal compound action potential (M_max) amplitude between long-term resistance trained (LTRT; n = 15 and n = 14, 6 ± 3 and 4 ± 1 yr of training) and untrained (UT; n = 14 and n = 49) men, and examined the effect of normalizing electromyography (EMG) during maximal voluntary torque (MVT) production to M_max amplitude on differences between LTRT and UT. EMG was recorded from multiple sites and muscles of EF and KE, M_max was evoked with percutaneous nerve stimulation, and muscle size was assessed with ultrasonography (thickness, EF) and magnetic resonance imaging (cross-sectional area, KE). Muscle-electrode distance (MED) was measured to account for the effect of adipose tissue on EMG and M_max. LTRT displayed greater MVT (+66%-71%, P < 0.001), muscle size (+54%-56%, P < 0.001), and M_max amplitudes (+29%-60%, P ≤ 0.010) even when corrected for MED (P ≤ 0.045). M_max was associated with the size of both muscle groups (r ≥ 0.466, P ≤ 0.011). Compared with UT, LTRT had higher absolute voluntary EMG amplitude for the KE (P < 0.001), but not the EF (P = 0.195), and these differences/similarities were maintained after correction for MED; however, M_max normalization resulted in no differences between LTRT and UT for any muscle and/or muscle group (P ≥ 0.652). The positive association between M_max and muscle size, and no differences when accounting for peripheral electrophysiological properties (EMG/M_max), indicates the greater absolute voluntary EMG amplitude of LTRT might be confounded by muscle morphology, rather than providing a discrete measure of central neural activity. This study therefore suggests limited agonist neural adaptation after LTRT.NEW & NOTEWORTHY In a large sample of long-term resistance-trained individuals, we showed greater maximal M-wave amplitude of the elbow flexors and knee extensors compared with untrained individuals, which appears to be at least partially mediated by differences in muscle size. The lack of group differences in voluntary EMG amplitude when normalized to maximal M-wave suggests that differences in muscle morphology might impair interpretation of voluntary EMG as an index of central neural activity.

Surface Electromyography-Based Recognition, Synthesis, and Perception of Prosodic Subvocal Speech

Purpose This study aimed to evaluate a novel communication system designed to translate surface electromyographic (sEMG) signals from articulatory muscles into speech using a personalized, digital voice. The system was evaluated for word recognition, prosodic classification, and listener perception of synthesized speech. Method sEMG signals were recorded from the face and neck as speakers with (n = 4) and without (n = 4) laryngectomy subvocally recited (silently mouthed) a speech corpus comprising 750 phrases (150 phrases with variable phrase-level stress). Corpus tokens were then translated into speech via personalized voice synthesis (n = 8 synthetic voices) and compared against phrases produced by each speaker when using their typical mode of communication (n = 4 natural voices, n = 4 electrolaryngeal [EL] voices). Naïve listeners (n = 12) evaluated synthetic, natural, and EL speech for acceptability and intelligibility in a visual sort-and-rate task, as well as phrasal stress discriminability via a classification mechanism. Results Recorded sEMG signals were processed to translate sEMG muscle activity into lexical content and categorize variations in phrase-level stress, achieving a mean accuracy of 96.3% (SD = 3.10%) and 91.2% (SD = 4.46%), respectively. Synthetic speech was significantly higher in acceptability and intelligibility than EL speech, also leading to greater phrasal stress classification accuracy, whereas natural speech was rated as the most acceptable and intelligible, with the greatest phrasal stress classification accuracy. Conclusion This proof-of-concept study establishes the feasibility of using subvocal sEMG-based alternative communication not only for lexical recognition but also for prosodic communication in healthy individuals, as well as those living with vocal impairments and residual articulatory function. Supplemental Material https://doi.org/10.23641/asha.14558481.

Machine-Learning-Based Prediction of Gait Events From EMG in Cerebral Palsy Children

Machine-learning techniques are suitably employed for gait-event prediction from only surface electromyographic (sEMG) signals in control subjects during walking. Nevertheless, a reference approach is not available in cerebral-palsy hemiplegic children, likely due to the large variability of foot-floor contacts. This study is designed to investigate a machine-learning-based approach, specifically developed to binary classify gait events and to predict heel-strike (HS) and toe-off (TO) timing from sEMG signals in hemiplegic-child walking. To this objective, sEMG signals are acquired from five hemiplegic-leg muscles in nearly 2500 strides from 20 hemiplegic children, acknowledged as Winters' group 1 and 2. sEMG signals, segmented in overlapping windows of 600 samples (pace = 5 samples), are used to train a multi-layer perceptron model. Intra-subject and inter-subject experimental settings are tested. The best-performing intra-subject approach is able to provide in the hemiplegic population a mean classification accuracy (±SD) of 0.97±0.01 and a suitable prediction of HS and TO events, in terms of average mean absolute error (MAE, 14.8±3.2 ms for HS and 17.6±4.2 ms for TO) and F1-score (0.95±0.03 for HS and 0.92±0.07 for TO). These results outperform previous sEMG-based attempts in cerebral-palsy populations and are comparable with outcomes achieved by reference approaches in control populations. In conclusion, the findings of the study prove the feasibility of neural networks in predicting the two main gait events using surface EMG signals, also in condition of high variability of the signal to predict as in hemiplegic cerebral palsy.

Contribution of the peroneus longus neuromuscular compartments to eversion and plantarflexion of the ankle

Compartmentalization of animal and human skeletal muscle by multiple motor nerve branches known as the neuromuscular compartment (NMC) has been observed primarily in muscles that participate in a plane of motion. In this context, the peroneus longus muscle contributes to eversion and plantarflexion of the ankle and the presence of NMCs has been reported. However, no research has reported the selective activation of the compartments of the peroneus longus during the performance of different ankle movements. The purpose of this research was to determine the contribution of peroneus longus NMCs, through multi-channel surface electromyography (sEMG), to eversion and plantarflexion movements. Multi-channel sEMG was recorded from the peroneus longus muscle by using an electrode grid during eversion and plantarflexion of the ankle at 10%, 30%, 50%, and 70% of maximal voluntary isometric contraction (MVIC). The root mean square and displacement of the center of mass position in the X (COMx) and Y (COMy) components were calculated. The primary finding was that eversion showed significantly higher sEMG amplitude than plantarflexion in the posterior compartment in low, moderate, and high percentages of MVIC. However, no significant difference in sEMG amplitude was observed in the anterior compartment between eversion and plantarflexion. In addition, a posterior displacement of the COMx in eversion compared to plantarflexion in all MVIC percentages, with greater topographic distancing of the COMx at higher levels of activation. In conclusion, the peroneus longus muscle presented NMCs; the anterior compartment contributed to both eversion and plantarflexion movements, whereas the posterior compartment mainly contributed to the eversion movement of the ankle in low, moderate, and high percentages of MVIC.

Electromyography activity of the teres minor muscle with varying positions of horizontal abduction in the quadruped position

Background

The teres minor (TMi) muscle exposed relatively high activity during the acceleration and deceleration phases of the throwing motion, compared with the infraspinatus muscle. However, few studies have identified TMi muscle activity in intervention exercises. The purpose of this study was to investigate TMi muscle activities in different horizontal adduction positions in the quadruped horizontal abduction exercise. This study hypothesized that TMi muscle activity would differ in response to resistance application across different horizontal adduction positions.

Materials and methods

Nineteen collegiate baseball players volunteered their participation. Raw electromyography activity of the TMi muscle along with 7 different muscles attached to the scapula on the dominant-side were collected, and normalized by each of the corresponding maximum voluntary isometric contractions. All subjects performed manual isometric resistance horizontal abduction exercises at 90° and 135° of abduction with 3 horizontal adduction angles in the quadruped position: 1) coronal, 2) scapular, and 3) sagittal plane. Electromyography data were also collected from rhythmical concentric contraction of horizontal abduction at 90° of abduction in the quadruped position.

Results

TMi muscle activity was significantly greater with the arm positioned in the coronal plane than that of the scapular and sagittal planes (41, 26, and 17% maximum voluntary isometric contraction, respectively) (P < .05).

Conclusion

The present study demonstrated that TMi muscle activity varied depending on horizontal adduction positions.

Introduction of a sEMG Sensor System for Autonomous Use by Inexperienced Users

Wearable devices play an increasing role in the rehabilitation of patients with movement disorders. Although information about muscular activation is highly interesting, no approach exists that allows reliable collection of this information when the sensor is applied autonomously by the patient. This paper aims to demonstrate the proof-of-principle of an innovative sEMG sensor system, which can be used intuitively by patients while detecting their muscular activation with sufficient accuracy. The sEMG sensor system utilizes a multichannel approach based on 16 sEMG leads arranged circularly around the limb. Its design enables a stable contact between the skin surface and the system's dry electrodes, fulfills the SENIAM recommendations regarding the electrode size and inter-electrode distance and facilitates a high temporal resolution. The proof-of-principle was demonstrated by elbow flexion/extension movements of 10 subjects, proving that it has root mean square values and a signal-to-noise ratio comparable to commercial systems based on pre-gelled electrodes. Furthermore, it can be easily placed and removed by patients with reduced arm function and without detailed knowledge about the exact positioning of the sEMG electrodes. With its features, the demonstration of the sEMG sensor system's proof-of-principle positions it as a wearable device that has the potential to monitor muscular activation in home and community settings.

Intramuscular EMG For Abstract Myoelectric Control: A Proof Of Concept Study

Myoelectric prostheses are commonly controlled by surface EMG. Many control algorithms, including the user learning-based control paradigm abstract control, benefit from independent control signals. Measuring at the surface of the skin reduces the signal independence through cross talk. To increase the number of independent signals, intramuscular EMG recordings might be a viable alternative for myoelectric control. This proof of concept study investigated if real time abstract myoelectric control is possible with intramuscular measurements. Six participants performed a 4-target and 12-target abstract control task with both surface and intramuscular EMG recordings. The results suggest that intramuscular EMG is suitable for abstract control, and that performance could be increased in the future by stabilizing the amplitude of the processed intramuscular EMG signal.

Muscle Synergies Reliability in the Power Clean Exercise

Muscle synergy extraction has been utilized to investigate muscle coordination in human movement, namely in sports. The reliability of the method has been proposed, although it has not been assessed previously during a complex sportive task. Therefore, the aim of the study was to evaluate intra- and inter-day reliability of a strength training complex task, the power clean, assessing participants' variability in the task across sets and days. Twelve unexperienced participants performed four sets of power cleans in two test days after strength tests, and muscle synergies were extracted from electromyography (EMG) data of 16 muscles. Three muscle synergies accounted for almost 90% of variance accounted for (VAF) across sets and days. Intra-day VAF, muscle synergy vectors, synergy activation coefficients and individual EMG profiles showed high similarity values. Inter-day muscle synergy vectors had moderate similarity, while the variables regarding temporal activation were still strongly related. The present findings revealed that the muscle synergies extracted during the power clean remained stable across sets and days in unexperienced participants. Thus, the mathematical procedure for the extraction of muscle synergies through nonnegative matrix factorization (NMF) may be considered a reliable method to study muscle coordination adaptations from muscle strength programs.

Inverse modelling to reduce crosstalk in high density surface electromyogram

Surface electromyogram (EMG) has a relatively large detection volume, so that it could include contributions both from the target muscle of interest and from nearby regions (i.e., crosstalk). This interference can prevent a correct interpretation of the activity of the target muscle, limiting the use of surface EMG in many fields. To counteract the problem, selective spatial filters have been proposed, but they reduce the representativeness of the data from the target muscle. A better solution would be to discard only crosstalk from the signal recorded in monopolar configuration (thus, keeping most information on the target muscle). An inverse modelling approach is here proposed to estimate the contributions of different muscles, in order to focus on the one of interest. The method is tested with simulated monopolar EMGs from superficial nearby muscles contracted at different force levels (either including or not model perturbations and noise), showing statistically significant improvements in information extraction from the data. The median over the entire dataset of the mean squared error in representing the EMG of the muscle under the detection electrode was reduced from 11.2% to 4.4% of the signal energy (5.3% if noisy data were processed); the median bias in conduction velocity estimation (from 3 monopolar channels aligned to the muscle fibres) was decreased from 2.12 to 0.72 m/s (1.1 m/s if noisy data were processed); the median absolute error in the estimation of median frequency was reduced from 1.02 to 0.67 Hz in noise free conditions and from 1.52 to 1.45 Hz considering noisy data.

Muscle Activity After Stroke: Perspectives on Deploying Surface Electromyography in Acute Care

After a stroke, clinicians and patients struggle to determine if and when muscle activity and movement will return. Surface electromyography (EMG) provides a non-invasive window into the nervous system that can be used to monitor muscle activity, but is rarely used in acute care. In this perspective paper, we share our experiences deploying EMG in the clinic to monitor stroke survivors. Our experiences have demonstrated that deploying EMG in acute care is both feasible and useful. We found that current technology can be used to comfortably and non-obtrusively monitor muscle activity, even for patients with no detectable muscle activity by traditional clinical assessments. Monitoring with EMG may help clinicians quantify muscle activity, track recovery, and inform rehabilitation. With further research, we perceive opportunities in using EMG to inform prognosis, enable biofeedback training, and provide metrics necessary for supporting and justifying care. To leverage these opportunities, we have identified important technical challenges and clinical barriers that need to be addressed. Affordable wireless EMG system that can provide high-quality data with comfortable, secure interfaces that can be worn for extended periods are needed. Data from these systems need to be quickly and automatically processed to create round-ready results that can be easily interpreted and used by the clinical team. We believe these challenges can be addressed by integrating and improving current methods and technology. Deploying EMG in the clinic can open new pathways to understanding and improving muscle activity and recovery for individuals with neurologic injury in acute care and beyond.

Identifying tasks to elicit maximum voluntary contraction in the muscles of the forearm

Maximum voluntary contractions (MVCs) are often used for the normalisation of electromyography data to enable comparison of signal patterns within and between study participants. Recommendations regarding the types of tasks that are needed to collect MVCs for the muscles of the forearm have been made, specifically advocating the use of resisted moment tasks to get better estimates of forearm MVCs. However, a protocol detailing which specific tasks to employ has yet to be published. Furthermore, the effects of limb dominance on the collection of MVCs have not been considered previously. Muscle activity was monitored while 23 participants performed nine isometric, resisted tasks. The tasks that are likely to elicit MVC in the flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis, extensor carpi ulnaris, extensor carpi radialis, extensor digitorum communis, and pronator teres were identified. Thus, targeted protocols can be designed to mitigate against fatigue. Hand dominance had limited effect, with differences being found only in the finger flexors and extensors (p< 0.03). Thus, use of the contralateral flexor digitorum superficialis and extensor digitorum communis muscles to obtain baselines for activation levels and patterns may not be appropriate.

Dry Epidermal Electrodes Can Provide Long-Term High Fidelity Electromyography for Limited Dynamic Lower Limb Movements

Due to the limitations of standard wet Silver/Silver Chloride (Ag/AgCl) hydrogel electrodes and the growing demand for long-term high fidelity surface electromyography (EMG) recording, dry epidermal electrodes are of great interest. Evaluating the usability and signal fidelity of dry epidermal electrodes could help determine the extent of potential applications using EMG electrodes. We collected EMG signals over eight days from the right rectus femoris of seven subjects using single-use dry epidermal electrodes and traditional Ag/AgCl electrodes while covered and uncovered during dynamic movements (leg extension, sit-to-stand, and treadmill walking at 0.75 m/s and 1.30 m/s). We quantified signal fidelity using signal-to-noise ratio (SNR); signal-to-motion ratio (SMR); and a metric we previously developed, the Signal Quality Index, which considers that better EMG signal quality requires both good signal-to-noise ratio and good signal-to-motion ratio. Wear patterns over the eight days degraded EMG signal quality. Uncovered epidermal electrodes that remained intact and maintained good adhesion to the skin had signal-to-noise ratios, signal-to-motion ratios, and Signal Quality Index values that were above the acceptable thresholds for limited dynamic lower limb movements (leg extension and sit-to-stand). This indicated that dry epidermal electrodes could provide good signal quality across all subjects for five days for these movements. For walking, the signal-to-noise ratios of the uncovered epidermal electrodes were still above the acceptable threshold, but signal-to-motion ratios and the Signal Quality Index values were far below the acceptable thresholds. The signal quality of the epidermal electrodes that showed no visible wear was stable over five days. As expected, covering the epidermal electrodes improved signal quality, but only for limited dynamic lower limb movements. Overall, single-use dry epidermal electrodes were able to maintain high signal quality for long-term EMG recording during limited dynamic lower limb movements, but further improvement is needed to reduce motion artifacts for whole body dynamic movements such as walking.

Effects of Tonic Muscle Activation on Amplitude-Modulated Cervical Vestibular Evoked Myogenic Potentials (AMcVEMPs) in Young Females: Preliminary Findings

Cervical vestibular evoked myogenic potentials (cVEMPs) are usually elicited by transient tonebursts, but when elicited by amplitude-modulated (AM) tones, they can provide new information about cVEMPs. Previous reports of cVEMPs elicited by AM tones, or AMcVEMPs, have not systematically examined the effects of tonic EMG activation on their response properties. Fourteen young, healthy female adults (ages 20-24) with clinically normal audiograms participated in this study. AMcVEMPs were elicited with bone-conducted 500 Hz tones amplitude modulated at a rate of 37 Hz and recorded for five different EMG targets ranging from 0 to 90 μV. Amplitude increased linearly as tonic EMG activation increased. Signal-to-noise ratio (SNR) was minimal at 0 μV, but robust and with equivalent values from 30 to 90 μV; phase coherence and EMG-corrected amplitude had findings similar to SNR across EMG target levels. Interaural asymmetry ratios for SNR and phase coherence were substantially lower than those for raw or corrected amplitude. AMcVEMP amplitude scaled with tonic EMG activation similar to transient cVEMPs. Signal-to-noise ratio, phase coherence, and EMG-corrected amplitude plateaued across a range of EMG values, suggesting that these properties of the response reach their maximum values at relatively low levels of EMG activation and that higher levels of EMG activation are not necessary to record robust AMcVEMPs.

The Application of Double Elastic Band Exercise in the 90/90 Arm Position for Overhead Athletes

BACKGROUND

Traditional exercises performed with the shoulder in the position of 90° abduction and external rotation with elbow flexion (90/90) while using a single elastic band showed moderate activity of both the lower trapezius (LT) and infraspinatus (IS) muscle. The purpose of this study was to investigate activity of the teres minor (TMi) and the LT muscles during standing external rotation exercise with the shoulder in the 90/90 position with 2 elastic bands in both the frontal and the scapular plane.

HYPOTHESIS

TMi, IS, and LT muscle activities will vary depending on whether the shoulder is positioned in the frontal or scapular plane with the application of 2 elastic bands. Also, the serratus anterior (SA) and teres major (TMa) muscles will produce different muscular activity patterns during exercises performed with 2 elastic bands in the frontal plane compared with the TMi and LT muscles.

STUDY DESIGN

Controlled laboratory study.

LEVEL OF EVIDENCE

Level 4.

METHODS

A total of 21 collegiate baseball players volunteered to participate. The electromyography (EMG) activities of the TMi, IS, LT, SA, TMa, middle deltoid (MD), posterior deltoid, and upper trapezius (UT) muscles were measured with the 90/90 arm position during both isometric and oscillation resistance exercises with 2 elastic bands oriented in the frontal and scapular planes.

RESULTS

A significant difference was observed in EMG activity of both the TMi and the LT muscles between single and double elastic band applications in the frontal plane (P < 0.05). In contrast, EMG activity of the IS, SA, and TMa muscles was significantly increased in the scapular plane compared with the frontal plane (P < 0.05).

CONCLUSION

The standing 90/90 position effectively increased both TMi and LT muscle EMG activity with the double elastic band in the frontal plane while minimizing UT and MD muscle activity. EMG activity of the IS, SA, and TMa muscles increased with exercise in the scapular plane as compared with the frontal plane.

CLINICAL RELEVANCE

Oscillation movement under double elastic band application differentiated external rotator muscle and scapular muscle activities between the frontal and scapular plane during the 90/90 exercise in the frontal plane compared with the scapular plane. Clinicians can utilize each of the scapular and frontal positions based on their desired focus for muscular activation.

Complexity Analysis of Surface Electromyography for Assessing the Myoelectric Manifestation of Muscle Fatigue: A Review

The surface electromyography (sEMG) records the electrical activity of muscle fibers during contraction: one of its uses is to assess changes taking place within muscles in the course of a fatiguing contraction to provide insights into our understanding of muscle fatigue in training protocols and rehabilitation medicine. Until recently, these myoelectric manifestations of muscle fatigue (MMF) have been assessed essentially by linear sEMG analyses. However, sEMG shows a complex behavior, due to many concurrent factors. Therefore, in the last years, complexity-based methods have been tentatively applied to the sEMG signal to better individuate the MMF onset during sustained contractions. In this review, after describing concisely the traditional linear methods employed to assess MMF we present the complexity methods used for sEMG analysis based on an extensive literature search. We show that some of these indices, like those derived from recurrence plots, from entropy or fractal analysis, can detect MMF efficiently. However, we also show that more work remains to be done to compare the complexity indices in terms of reliability and sensibility; to optimize the choice of embedding dimension, time delay and threshold distance in reconstructing the phase space; and to elucidate the relationship between complexity estimators and the physiologic phenomena underlying the onset of MMF in exercising muscles.

Knee joint kinematics and neuromuscular responses in female athletes during and after multi-directional perturbations

The purpose of this study was to investigate weight-bearing knee joint kinematic and neuromuscular responses during lateral, posterior, rotational, and combination (simultaneous lateral, posterior, and rotational motions) perturbations and post-perturbations phases in 30° flexed-knee and straight-knee conditions. Thirteen healthy female athletes participated. Knee joint angles and muscle activity of vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MD) muscles were computed. Knee abducted during lateral perturbations, whereas it adducted during the other perturbations. It was internally rotated during flexed-knee and externally rotated during straight-knee perturbations and post-perturbations. VL and VM's mean and maximum activities during flexed-knee perturbations were greater than those of straight-knee condition. BF's mean activities were greater during flexed-knee perturbations compared with straight-knee condition, while its maximum activities observed during combination perturbations. ST's maximum activities during combination perturbations were greatest compared with the other perturbations. LG and MG's activities were greater during straight-knee conditions. Compared with the perturbation phase, the mean and maximum muscles' activities were significantly greater during post-perturbations. The time of onset of maximum muscle activity showed a distinctive pattern among the perturbations and phases. The perturbation direction is an important variable which induces individualized knee kinematic and neuromuscular response.

Robotic body weight support enables safe stair negotiation in compliance with basic locomotor principles

BACKGROUND

After a neurological injury, mobility focused rehabilitation programs intensively train walking on treadmills or overground. However, after discharge, quite a few patients are not able to independently negotiate stairs, a real-world task with high physical and psychological demands and a high injury risk. To decrease fall risk and improve patients' capacity to navigate typical environments, early stair negotiation training can help restore competence and confidence in safe stair negotiation. One way to enable early training in a safe and permissive environment is to unload the patient with a body weight support system. We here investigated if unloaded stair negotiation complies with basic locomotor principles, in terms of enabling performance of a physiological movement pattern with minimal compensation.

METHODS

Seventeen able-bodied participants were unloaded with 0-50% bodyweight during self-paced ascent and descent of a 4-tread staircase. Spatio-temporal parameters, joint ranges of motion, ground reaction forces and myoelectric activity in the main lower limb muscles of participants were compared between unloading levels. Likelihood ratio tests of separated linear mixed models of the investigated outcomes assessed if unloading affects the parameters in general. Subsequent post-hoc testing revealed which levels of unloading differed from unsupported stair negotiation.

RESULTS

Unloading affected walking velocity, joint ranges of motion, vertical ground reaction force parameters and myoelectric activity in all investigated muscles for stair ascent and descent while step width and single support duration were only affected during ascent. A reduction with increasing levels of body weight support was seen in walking velocity (0.07-0.12 m/s), ranges of motion of the knee and hip (2-10°), vertical ground reaction force peaks (10-70%) and myoelectric activity (17-70%). An increase with unloading was only seen during ascent for ankle range of motion and tibialis anterior activity at substantial unloading.

CONCLUSIONS

Body weight support facilitates stair negotiation by providing safety and support against gravity. Although unloading effects are present in most parameters, up to 30% body weight support these changes are small, and no dysfunctional patterns are introduced. Body weight support therefore fulfills all the necessary requirements for early stair negotiation training.

Non-invasive detection of low-level muscle fatigue using surface EMG with wavelet decomposition

Median frequency (MDF) is widely used for detection and tracking of muscle fatigue using surface electromyography (sEMG). However, MDF does not behave consistently or accurately distinguish fatigued from non-fatigued states. In this paper, we study the concept of low-level fatigue and propose increasing average ratio (IAR) and trigger pattern index (TPI) based on discrete wavelet transform (DWT) for distinguishing low-level muscle fatigue. We recorded sEMG using an 8-electode linear monopolar array during isometric contractions from brachioradialis (BRD), biceps brachii long head (BBL), and biceps brachii short head (BBS) muscles of different subjects when performing force exertion. We then calculated the proposed parameters for characterizing low-level fatigue. The analysis indicated that the proposed approach is more consistent and stable when distinguishing low-level muscle fatigue and sheds light on the behavior of sEMG in frequency domain with respect to low-fatigue force exertion.

Tutorial. Surface EMG detection in space and time: Best practices

This tutorial is aimed to non-engineers using, or planning to use, surface electromyography (sEMG) as an assessment tool in the prevention, monitoring and rehabilitation fields. Its first purpose is to address the issues related to the origin and nature of the signal and to its detection (electrode size, distance, location) by one-dimensional (bipolar and linear arrays) and two-dimensional (grids) electrode systems while avoiding advanced mathematical, physical or physiological issues. Its second purpose is to outline best practices and provide general guidelines for proper signal detection. Issues related to the electrode-skin interface, signal conditioning and interpretation will be discussed in subsequent tutorials.