EMG and MMG activities of agonist and antagonist muscles in Parkinson’s disease patients during absolute submaximal load holding

Mechanomyography and acceleration show interlimb asymmetries in Parkinson patients without tremor compared to controls during a unilateral motor task

The mechanical muscular oscillations are rarely the objective of investigations regarding the identification of a biomarker for Parkinson's disease (PD). Therefore, the aim of this study was to investigate whether or not this specific motor output differs between PD patients and controls. The novelty is that patients without tremor are investigated performing a unilateral isometric motor task. The force of armflexors and the forearm acceleration (ACC) were recorded as well as the mechanomyography of the biceps brachii (MMGbi), brachioradialis (MMGbra) and pectoralis major (MMGpect) muscles using a piezoelectric-sensor-based system during a unilateral motor task at 70% of the MVIC. The frequency, a power-frequency-ratio, the amplitude variation, the slope of amplitudes and their interlimb asymmetries were analysed. The results indicate that the oscillatory behavior of muscular output in PD without tremor deviates from controls in some parameters: Significant differences appeared for the power-frequency-ratio (p = 0.001, r = 0.43) and for the amplitude variation (p = 0.003, r = 0.34) of MMGpect. The interlimb asymmetries differed significantly concerning the power-frequency-ratio of MMGbi (p = 0.013, r = 0.42) and MMGbra (p = 0.048, r = 0.39) as well as regarding the mean frequency (p = 0.004, r = 0.48) and amplitude variation of MMGpect (p = 0.033, r = 0.37). The mean (M) and variation coefficient (CV) of slope of ACC differed significantly (M: p = 0.022, r = 0.33; CV: p = 0.004, r = 0.43). All other parameters showed no significant differences between PD and controls. It remains open, if this altered mechanical muscular output is reproducible and specific for PD.

Parkinson patients without tremor show changed patterns of mechanical muscle oscillations during a specific bilateral motor task compared to controls

The pathophysiology of Parkinson's disease (PD) is still not understood. There are investigations which show a changed oscillatory behaviour of brain circuits or changes in variability of, e.g., gait parameters in PD. The aim of this study was to investigate whether or not the motor output differs between PD patients and healthy controls. Thereby, patients without tremor are investigated in the medication off state performing a special bilateral isometric motor task. The force and accelerations (ACC) were recorded as well as the Mechanomyography (MMG) of the biceps brachii, the brachioradialis and of the pectoralis major muscles using piezoelectric-sensors during the bilateral motor task at 60% of the maximal isometric contraction. The frequency, a specific power ratio, the amplitude variation and the slope of amplitudes were analysed. The results indicate that the oscillatory behaviour of motor output in PD patients without tremor deviates from controls: thereby, the 95%-confidence-intervals of power ratio and of amplitude variation of all signals are disjoint between PD and controls and show significant differences in group comparisons (power ratio: p = 0.000-0.004, r = 0.441-0.579; amplitude variation: p = 0.000-0.001, r = 0.37-0.67). The mean frequency shows a significant difference for ACC (p = 0.009, r = 0.43), but not for MMG. It remains open, whether this muscular output reflects changes of brain circuits and whether the results are reproducible and specific for PD.

Inter- and Intra-Individual Differences in EMG and MMG during Maximal, Bilateral, Dynamic Leg Extensions

The purpose of this study was to compare the composite, inter-individual, and intra-individual differences in the patterns of responses for electromyographic (EMG) and mechanomyographic (MMG) amplitude (AMP) and mean power frequency (MPF) during fatiguing, maximal, bilateral, and isokinetic leg extension muscle actions. Thirteen recreationally active men (age = 21.7 ± 2.6 years; body mass = 79.8 ± 11.5 kg; height = 174.2 ± 12.7 cm) performed maximal, bilateral leg extensions at 180°·s⁻¹ until the torque values dropped to 50% of peak torque for two consecutive repetitions. The EMG and MMG signals from the vastus lateralis (VL) muscles of both limbs were recorded. Four 2(Leg) × 19(time) repeated measures ANOVAs were conducted to examine mean differences for EMG AMP, EMG MPF, MMG AMP, and MMG MPF between limbs, and polynomial regression analyses were performed to identify the patterns of neuromuscular responses. The results indicated no significant differences between limbs for EMG AMP (p = 0.44), EMG MPF (p = 0.33), MMG AMP (p = 0.89), or MMG MPF (p = 0.52). Polynomial regression analyses demonstrated substantial inter-individual variability. Inferences made regarding the patterns of neuromuscular responses to fatiguing and bilateral muscle actions should be considered on a subject-by-subject basis.

Levodopa-Induced Changes in Electromyographic Patterns in Patients with Advanced Parkinson's Disease

Levodopa medication is the most efficient treatment for motor symptoms of Parkinson's disease (PD). Levodopa significantly alleviates rigidity, rest tremor, and bradykinesia in PD. The severity of motor symptoms can be graded with UPDRS-III scale. Levodopa challenge test is routinely used to assess patients' eligibility to deep-brain stimulation (DBS) in PD. Feasible and objective measurements to assess motor symptoms of PD during levodopa challenge test would be helpful in unifying the treatment. Twelve patients with advanced PD who were candidates for DBS treatment were recruited to the study. Measurements were done in four phases before and after levodopa challenge test. Rest tremor and rigidity were evaluated using UPDRS-III score. Electromyographic (EMG) signals from biceps brachii and kinematic signals from forearm were recorded with wireless measurement setup. The patients performed two different tasks: arm isometric tension and arm passive flexion-extension. The electromyographic and the kinematic signals were analyzed with parametric, principal component, and spectrum-based approaches. The principal component approach for isometric tension EMG signals showed significant decline in characteristics related to PD during levodopa challenge test. The spectral approach on passive flexion-extension EMG signals showed a significant decrease on involuntary muscle activity during the levodopa challenge test. Both effects were stronger during the levodopa challenge test compared to that of patients' personal medication. There were no significant changes in the parametric approach for EMG and kinematic signals during the measurement. The results show that a wireless and wearable measurement and analysis can be used to study the effect of levodopa medication in advanced Parkinson's disease.

Comparing electro- and mechano-myographic muscle activation patterns in self-paced pediatric gait

Electromyography (EMG) is the standard modality for measuring muscle activity. However, the convenience and availability of low-cost accelerometer-based wearables makes mechanomyography (MMG) an increasingly attractive alternative modality for clinical applications. Literature to date has demonstrated a strong association between EMG and MMG temporal alignment in isometric and isokinetic contractions. However, the EMG-MMG relationship has not been studied in gait. In this study, the concurrence of EMG- and MMG-detected contractions in the tibialis anterior, lateral gastrocnemius, vastus lateralis, and biceps femoris muscles were investigated in children during self-paced gait. Furthermore, the distribution of signal power over the gait cycle was statistically compared between EMG-MMG modalities. With EMG as the reference, muscular contractions were detected based on MMG with balanced accuracies between 88 and 94% for all muscles except the gastrocnemius. MMG signal power differed from that of EMG during certain phases of the gait cycle in all muscles except the biceps femoris. These timing and power distribution differences between the two modalities may in part be related to muscle fascicle length changes that are unique to muscle motion during gait. Our findings suggest that the relationship between EMG and MMG appears to be more complex during gait than in isometric and isokinetic contractions.

Features for muscle fatigue computed from electromyogram and mechanomyogram: A new one

Muscle fatigue produces negative effects in the performance and it may lead to a muscle failure. This problem makes the quantitative grading of muscle fatigue a necessity in ergonomic and physiological research. Moreover, the quantitative grading of muscle fatigue is needed to increase work and sport productivity and prevent several accidents that result from muscle fatigue. Even though there are many studies for this aim, there is no quantitative criterion for the evaluation of muscle fatigue. The main reason is that muscle fatigue is a complex physiological situation that is dependent on several parameters. Our aim in this study is to present a new feature to evaluate muscle fatigue and prove the reliability of the new feature by making correlation analyses between this with other features. For this aim, electromyography and mechanomyography signals were simultaneously recorded from the biceps brachii and triceps brachii muscles during the isometric and isotonic contractions of 60 healthy volunteers (30 females, 30 males). The mean power frequency and median frequency, which are used in the literature, were compared to the frequency ratio change, the new measure; correlations between the frequency ratio change and the mean power frequency and median frequency were analysed. There was a high correlation between the features, and frequency ratio change can be used to quantitatively evaluate muscle fatigue.

Spike shape analysis of electromyography for parkinsonian tremor evaluation

INTRODUCTION

Standard electromyography (EMG) parameters have limited utility for evaluation of Parkinson disease (PD) tremor. Spike shape analysis (SSA) EMG parameters are more sensitive than standard EMG parameters for studying motor control mechanisms in healthy subjects. SSA of EMG has not been used to assess parkinsonian tremor. This study assessed the utility of SSA and standard time and frequency analysis for electromyographic evaluation of PD-related resting tremor.

METHODS

We analyzed 1-s periods of EMG recordings to detect nontremor and tremor signals in relaxed biceps brachii muscle of seven mild to moderate PD patients.

RESULTS

SSA revealed higher mean spike amplitude, duration, and slope and lower mean spike frequency in tremor signals than in nontremor signals. Standard EMG parameters (root mean square, median, and mean frequency) did not show differences between the tremor and nontremor signals.

CONCLUSIONS

SSA of EMG data is a sensitive method for parkinsonian tremor evaluation.

Mechanomyographic parameter extraction methods: an appraisal for clinical applications

The research conducted in the last three decades has collectively demonstrated that the skeletal muscle performance can be alternatively assessed by mechanomyographic signal (MMG) parameters. Indices of muscle performance, not limited to force, power, work, endurance and the related physiological processes underlying muscle activities during contraction have been evaluated in the light of the signal features. As a non-stationary signal that reflects several distinctive patterns of muscle actions, the illustrations obtained from the literature support the reliability of MMG in the analysis of muscles under voluntary and stimulus evoked contractions. An appraisal of the standard practice including the measurement theories of the methods used to extract parameters of the signal is vital to the application of the signal during experimental and clinical practices, especially in areas where electromyograms are contraindicated or have limited application. As we highlight the underpinning technical guidelines and domains where each method is well-suited, the limitations of the methods are also presented to position the state of the art in MMG parameters extraction, thus providing the theoretical framework for improvement on the current practices to widen the opportunity for new insights and discoveries. Since the signal modality has not been widely deployed due partly to the limited information extractable from the signals when compared with other classical techniques used to assess muscle performance, this survey is particularly relevant to the projected future of MMG applications in the realm of musculoskeletal assessments and in the real time detection of muscle activity.

Mechanomyography and muscle function assessment: a review of current state and prospects

Previous studies have explored to saturation the efficacy of the conventional signal (such as electromyogram) for muscle function assessment and found its clinical impact limited. Increasing demand for reliable muscle function assessment modalities continues to prompt further investigation into other complementary alternatives. Application of mechanomyographic signal to quantify muscle performance has been proposed due to its inherent mechanical nature and ability to assess muscle function non-invasively while preserving muscular neurophysiologic information. Mechanomyogram is gaining accelerated applications in evaluating the properties of muscle under voluntary and evoked muscle contraction with prospects in clinical practices. As a complementary modality and the mechanical counterpart to electromyogram; mechanomyogram has gained significant acceptance in analysis of isometric and dynamic muscle actions. Substantial studies have also documented the effectiveness of mechanomyographic signal to assess muscle performance but none involved comprehensive appraisal of the state of the art applications with highlights on the future prospect and potential integration into the clinical practices. Motivated by the dearth of such critical review, we assessed the literature to investigate its principle of acquisition, current applications, challenges and future directions. Based on our findings, the importance of rigorous scientific and clinical validation of the signal is highlighted. It is also evident that as a robust complement to electromyogram, mechanomyographic signal may possess unprecedented potentials and further investigation will be enlightening.

The utility of electromyography and mechanomyography for assessing neuromuscular function: a noninvasive approach

This article introduces the utility of electromyography (EMG) and mechanomyography (MMG) for the assessment of neuromuscular function, and discusses the interpretation of the EMG and MMG signals for various exercise perturbations. The results of these studies suggest that the use of EMG and MMG to determine muscle fatigue is robust. Future studies with clinical populations are needed, however, to determine the optimal use of EMG and/or MMG for assessing muscle function in rehabilitative settings.

A model of the surface electromyogram in pathological tremor

The study developed a novel multi-scale model for simulating the surface electromyogram (EMG) of an antagonistic pair of muscles during pathological tremor. By combining and expanding mathematical descriptions from motor units to limb kinematics, the model constitutes the first attempt to simulate the surface EMG and the individual motor unit activity under the influence of descending voluntary command, oscillatory noise in the descending signal, and afferent feedback when controlling a freely moving limb to achieve a predefined angular trajectory. The oscillatory noise was adjusted to simulate various types of pathological tremor. The simulations replicated previously reported experimental results for the power spectral density of the surface EMG, the angular velocity of the limb, and single motor unit activity. The model provides a powerful tool for extracting information about how the surface EMG can be used to describe tremor in various conditions, including different tremor frequencies and intensities, that cannot be achieved solely with experimental approaches.

On functional motor adaptations: from the quantification of motor strategies to the prevention of musculoskeletal disorders in the neck-shoulder region

BACKGROUND

Occupations characterized by a static low load and by repetitive actions show a high prevalence of work-related musculoskeletal disorders (WMSD) in the neck-shoulder region. Moreover, muscle fatigue and discomfort are reported to play a relevant initiating role in WMSD.

AIMS

To investigate relationships between altered sensory information, i.e. localized muscle fatigue, discomfort and pain and their associations to changes in motor control patterns.

MATERIALS & METHODS

In total 101 subjects participated. Questionnaires, subjective assessments of perceived exertion and pain intensity as well as surface electromyography (SEMG), mechanomyography (MMG), force and kinematics recordings were performed.

RESULTS

Multi-channel SEMG and MMG revealed that the degree of heterogeneity of the trapezius muscle activation increased with fatigue. Further, the spatial organization of trapezius muscle activity changed in a dynamic manner during sustained contraction with acute experimental pain. A graduation of the motor changes in relation to the pain stage (acute, subchronic and chronic) and work experience were also found. The duration of the work task was shorter in presence of acute and chronic pain. Acute pain resulted in decreased activity of the painful muscle while in subchronic and chronic pain, a more static muscle activation was found. Posture and movement changed in the presence of neck-shoulder pain. Larger and smaller sizes of arm and trunk movement variability were respectively found in acute pain and subchronic/chronic pain. The size and structure of kinematics variability decreased also in the region of discomfort. Motor variability was higher in workers with high experience. Moreover, the pattern of activation of the upper trapezius muscle changed when receiving SEMG/MMG biofeedback during computer work.

DISCUSSION

SEMG and MMG changes underlie functional mechanisms for the maintenance of force during fatiguing contraction and acute pain that may lead to the widespread pain seen in WMSD. A lack of harmonious muscle recruitment/derecruitment may play a role in pain transition. Motor behavior changed in shoulder pain conditions underlining that motor variability may play a role in the WMSD development as corroborated by the changes in kinematics variability seen with discomfort. This prognostic hypothesis was further, supported by the increased motor variability among workers with high experience.

CONCLUSION

Quantitative assessments of the functional motor adaptations can be a way to benchmark the pain status and help to indentify signs indicating WMSD development. Motor variability is an important characteristic in ergonomic situations. Future studies will investigate the potential benefit of inducing motor variability in occupational settings.

An examination of cross-talk among surface mechanomyographic signals from the superficial quadriceps femoris muscles during isometric muscle actions

The purpose of this study was to examine cross-talk among the mechanomyographic (MMG) signals from the superficial quadriceps femoris muscles during submaximal to maximal isometric muscle actions of the leg extensors. Eleven healthy men (age=20.1+/-1.1yr, mean+/-SD) volunteered to randomly perform isometric muscle actions in 10% increments from 10% to 90% of the maximum voluntary contraction (MVC). During each muscle action, MMG signals were detected from the vastus lateralis, rectus femoris, and vastus medialis with three separate accelerometers. Cross-correlation was used to quantify cross-talk among the vastus lateralis, rectus femoris, and vastus medialis during each muscle action. The results showed cross-correlation coefficients that ranged from R(x,y)=.124-.714, but generally speaking, the coefficients were between .1 and .3. In addition, there were no consistent differences among the cross-talk levels for the three muscles, and the cross-correlation coefficients generally did not increase with isometric torque. Thus, MMG can be used to examine muscle function from each of the superficial quadriceps femoris muscles during isometric muscle actions.