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Ogrezeanu DC, Calatayud J, Rodríguez S, Carrasco JJ, Martinez-Valdes E, Casaña J, Cruz-Montecinos C, Andersen LL, Aagaard P, López-Bueno R, Pérez-Alenda S. Acute neuromuscular and perceptual responses to blood flow restriction exercise in adults with severe haemophilia: A pilot study. Haemophilia 2024. [PMID: 39099074 DOI: 10.1111/hae.15084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION No previous studies have implemented a standard blood flow restriction (BFR) training session in people with severe haemophilia (PwH), where this type of training has been contraindicated. AIMS The purpose of this study was to evaluate the tolerability, adverse events, and neuromuscular and perceptual responses to an acute session of low load (LL) knee extensions with BFR in PwH under prophylaxis. METHODS Eight PwH performed one LL-BFR session with 40% arterial occlusion pressure (AOP). Perceptual responses and adverse effects were assessed, together with high-density surface electromyography of vastus medialis (VM) and lateralis (VL). RESULTS Significant normalized root mean square differences were found within each set, but not between sets. Spatial distribution (centroid displacement (p > .05), modified entropy (VM, set two, cycles three and five, p = .032) and coefficient of variation (VM, set two, cycles four and five lower than cycle three (p = .049; p = .036)) showed changes within each set. Median frequency showed a slight increase during cycle four of set four (p = .030). Rate of perceived exertion slightly increased with each set while tolerability slightly decreased in the last set and fear of training with BFR generally decreased after the session. CONCLUSIONS In PwH, a LL-BFR session at 40% AOP is safe and feasible. Our results suggest that potential muscle impairments may blunt neuromuscular adaptations induced by BFR.
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Affiliation(s)
- Daniel C Ogrezeanu
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sergi Rodríguez
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
- Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - José Casaña
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Aragón, Spain
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
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Nishikawa Y, Watanabe K, Holobar A, Kitamura R, Maeda N, Hyngstrom AS. Sex differences in laterality of motor unit firing behavior of the first dorsal interosseous muscle in strength-matched healthy young males and females. Eur J Appl Physiol 2024; 124:1979-1990. [PMID: 38366213 PMCID: PMC11199256 DOI: 10.1007/s00421-024-05420-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE The purpose of this study was to compare laterality in motor unit firing behavior between females and males. METHODS Twenty-seven subjects (14 females) were recruited for this study. The participants performed ramp up and hold isometric index finger abduction at 10, 30, and 60% of their maximum voluntary contraction (MVC). High-density surface electromyography (HD-sEMG) signals were recorded in the first dorsal interosseous (FDI) muscle and decomposed into individual motor unit (MU) firing behavior using a convolution blind source separation method. RESULTS In total, 769 MUs were detected (females, n = 318 and males, n = 451). Females had a significantly higher discharge rate than males at each relative torque level (10%: male dominant hand, 13.4 ± 2.7 pps vs. female dominant hand, 16.3 ± 3.4 pps; 30%: male dominant hand, 16.1 ± 3.9 pps vs. female dominant hand, 20.0 ± 5.0 pps; and 60%: male dominant hand, 19.3 ± 3.8 vs. female dominant hand, 25.3 ± 4.8 pps; p < 0.0001). The recruitment threshold was also significantly higher in females than in males at 30 and 60% MVC. Furthermore, males exhibited asymmetrical discharge rates at 30 and 60% MVC and recruitment thresholds at 30 and 60% MVC, whereas no asymmetry was observed in females. CONCLUSION In the FDI muscle, compared to males, females exhibited different neuromuscular strategies with higher discharge rates and recruitment thresholds and no asymmetrical MU firing behavior. Notably, the findings that sex differences in neuromuscular activity also occur in healthy individuals provide important information for understanding the pathogenesis of various diseases.
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Affiliation(s)
- Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan.
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Nagoya, Japan
| | - Aleš Holobar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Ryoka Kitamura
- Graduate School of Frontier Engineering, Kanazawa University, Kanazawa, Japan
| | - Noriaki Maeda
- Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Yoshikawa K, Nakamori M, Ushio K, Toko M, Yamada H, Nishikawa Y, Fukuoka T, Maruyama H, Mikami Y. Analysis of the suprahyoid muscles during tongue elevation: High-density surface electromyography as a novel tool for swallowing-related muscle assessment. J Oral Rehabil 2024. [PMID: 38736136 DOI: 10.1111/joor.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND High-density surface electromyography (HD-sEMG) has enabled non-invasive analysis of motor unit (MU) activity and recruitment, but its application to swallowing-related muscles is limited. OBJECTIVE We aimed to investigate the utility of HD-sEMG for quantitatively evaluating the MU recruitment characteristics of the suprahyoid muscles during tongue elevation. METHODS We measured the sEMG activity of the suprahyoid muscles of healthy participants during tongue elevation using HD-sEMG. Maximum voluntary contraction (MVC) was measured, followed by data collection during sustained and ramp-up tasks to capture suprahyoid muscle activity. Changes in the temporal/spatial MU recruitment patterns within individual suprahyoid muscles were analysed. RESULTS This study enrolled 16 healthy young adults (mean age: 27.8 ± 5.3 years; eight males and eight females). Increasing muscle force corresponded to a decrease in modified entropy and correlation coefficient and an increase in the coefficient of variation. No significant differences were observed between male and female participants. CONCLUSION The results of this study, consistent with those observed in other muscles, such as the vastus lateralis muscle, suggest that HD-sEMG is a valuable and reliable tool for quantitatively evaluating MU recruitment in the suprahyoid muscles. This measurement technique holds promise for novel assessments of swallowing function.
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Affiliation(s)
- Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuichi Nishikawa
- Institute of Science and Engineering, Faculty of Frontier Engineering, Kanazawa University, Kanazawa, Japan
| | - Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashihiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
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Magris R, Nardello F, Bombieri F, Monte A, Zamparo P. Characterization of the vastus lateralis torque-length, and knee extensors torque-velocity and power-velocity relationships in people with Parkinson's disease. Front Sports Act Living 2024; 6:1380864. [PMID: 38725475 PMCID: PMC11079174 DOI: 10.3389/fspor.2024.1380864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Parkinson's disease (PD) is a prevalent neurodegenerative condition observed primarily in the elderly population that gives rise to motor and non-motor symptoms, one of which is muscle weakness. The aim of this study was to characterize the vastus lateralis torque-fascicle length (T-L) and the knee extensors torque-angular velocity (T-V) and power-angular velocity (P-V) relationships in PD patients and to investigate the influence of muscle geometry on muscle mechanics. Methods Participants (11 PD: patients, 9 CR: age matched healthy controls; 10 CY: young healthy controls) performed: (i) isometric contractions (e.g., MVC) to obtain the torque-angle and T-L relationships; (ii) isokinetic (e.g., iso-velocity) contractions to obtain the T-V and P-V relationships. During the experiments, the architecture of vastus lateralis (pennation angle, fascicle length, muscle thickness) was also determined by using an ultrasound apparatus. Results Significant differences were observed between PD patients and physically matched control groups (CR and CY) in terms of maximum isometric force (calculated as the apex of the T-L curve) and maximum mechanical power (apex of the P-V curve), but not in maximum shortening velocity. Among the mechanical variables investigated, mechanical power was able to identify differences between the less and the more affected side in PD patients, suggesting that this parameter could be useful for clinical evaluation in this population. Conclusions The observed results cannot be explained by differences in muscle geometry at rest (similar in the three cohorts), but rather by the muscle capacity to change in shape during contraction, that is impaired in PD patients.
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Affiliation(s)
- Riccardo Magris
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Ogrezeanu DC, López-Bueno L, Sanchís-Sánchez E, Carrasco JJ, Cuenca-Martínez F, Suso-Martí L, López-Bueno R, Cruz-Montecinos C, Martinez-Valdes E, Casaña J, Calatayud J. Neuromuscular Responses and Perceptions of Health Status and Pain-Related Constructs in End-Stage Knee Osteoarthritis During Resistance Training With Blood Flow Restriction. J Strength Cond Res 2024; 38:762-772. [PMID: 38090743 DOI: 10.1519/jsc.0000000000004680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
ABSTRACT Ogrezeanu, DC, López-Bueno, L, Sanchís-Sánchez, E, Carrasco, JJ, Cuenca-Martínez, F, Suso-Martí, L, López-Bueno, R, Cruz-Montecinos, C, Martinez-Valdes, E, Casaña, J, and Calatayud, J. Neuromuscular responses and perceptions of health status and pain-related constructs in end-stage knee osteoarthritis during resistance training with blood flow restriction. J Strength Cond Res 38(4): 762-772, 2024-We aimed to evaluate the neuromuscular responses and their relationship with health status, kinesiophobia, pain catastrophizing, and chronic pain self-efficacy in patients with end-stage knee osteoarthritis during acute resistance training with different levels of blood flow restriction (BFR). Seventeen patients with end-stage knee osteoarthritis participated in 3 experimental sessions separated by 3 days, performing 4 sets of knee extensions with low load and 3 levels of concurrent BFR performed in a random order: control (no BFR), BFR at 40% arterial occlusion pressure (AOP), and BFR at 80% AOP. Normalized root-mean-square (nRMS), nRMS spatial distribution (centroid displacement, modified entropy, and coefficient of variation), and normalized median frequency (nFmed) were calculated from the vastus medialis (VM) and lateralis (VL) using high-density surface electromyography. Subjects were asked to report adverse effects after the sessions. In the VM, nRMS was higher with 80% AOP than with 40% AOP ( p = 0.008) and control ( p < 0.001), whereas there were no differences between conditions in the VL. Normalized root-mean-square also showed an association with pain catastrophizing, chronic pain self-efficacy, and health status (VM: -0.50, 0.49, -0.42; VL: -0.39, 0.27, -0.33). Spatial distribution varied between conditions but mostly in the VL. Overall, nFmed did not vary, with only a slight increase in the VL with 40% AOP, between set 3 and 4. BFR during knee extensions at 80% AOP increases VM activity and VL amplitude distribution more than 40% AOP and control. Importantly, muscle activity increases are modulated by pain catastrophizing, chronic pain self-efficacy, and health status in these patients, and kinesiophobia seems to especially modulate entropy.
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Affiliation(s)
- Daniel C Ogrezeanu
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Laura López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Enrique Sanchís-Sánchez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; and
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Avila ER, Williams SE, Disselhorst-Klug C. Advances in EMG measurement techniques, analysis procedures, and the impact of muscle mechanics on future requirements for the methodology. J Biomech 2023; 156:111687. [PMID: 37339541 DOI: 10.1016/j.jbiomech.2023.111687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023]
Abstract
Muscular coordination enables locomotion and interaction with the environment. For more than 50 years electromyography (EMG) has provided insights into the central nervous system control of individual muscles or muscle groups, enabling both fine and gross motor functions. This information is available either at individual motor units (Mus) level or on a more global level from the coordination of different muscles or muscle groups. In particular, non-invasive EMG methods such as surface EMG (sEMG) or, more recently, spatial mapping methods (High-Density EMG - HDsEMG) have found their place in research into biomechanics, sport and exercise, ergonomics, rehabilitation, diagnostics, and increasingly for the control of technical devices. With further technical advances and a growing understanding of the relationship between EMG and movement task execution, it is expected that with time, especially non-invasive EMG methods will become increasingly important in movement sciences. However, while the total number of publications per year on non-invasive EMG methods is growing exponentially, the number of publications on this topic in journals with a scope in movement sciences has stagnated in the last decade. This review paper contextualizes non-invasive EMG development over the last 50 years, highlighting methodological progress. Changes in research topics related to non-invasive EMG were identified. Today non-invasive EMG procedures are increasingly used to control technical devices, where muscle mechanics have a minor influence. In movement science, however, the effect of muscle mechanics on the EMG signal cannot be neglected. This explains why non-invasive EMG's relevance in movement sciences has not developed as expected.
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Affiliation(s)
- Elisa Romero Avila
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Germany
| | - Sybele E Williams
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Germany
| | - Catherine Disselhorst-Klug
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Germany.
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Robinault L, Niazi IK, Kumari N, Amjad I, Menard V, Haavik H. Non-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering. Brain Sci 2023; 13:946. [PMID: 37371424 DOI: 10.3390/brainsci13060946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Non-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject's body and clusters of markers on the subject's spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.
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Affiliation(s)
- Lucien Robinault
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Amjad
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Rehabilitation and Allied Health Sciences and Department of Biomedical Engineering, Riphah International University, Islamabad 46000, Pakistan
| | - Vincent Menard
- M2S Laboratory, ENS Rennes, University of Rennes 2, 35065 Rennes, France
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
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Muscle Strength and Power in People With Parkinson Disease: A Systematic Review and Meta-analysis. J Neurol Phys Ther 2023; 47:3-15. [PMID: 36318503 DOI: 10.1097/npt.0000000000000421] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE No studies have synthesized the literature regarding mechanical muscle function (ie, strength, power, rate of force development [RFD]) in people with Parkinson disease (PD). Here, we aimed to expand our understanding of mechanical muscle function in people with PD (PwPD) by systematically reviewing (1) the psychometric properties of isokinetic/isometric dynamometry in PD, (2) the literature comparing mechanical muscle function in PwPD with healthy controls (HC), and (3) reported associations between muscle mechanical muscle function and functional capacity and/or disease severity. METHODS Systematic literature search in 6 databases. Included studies had to (1) enroll and report data on PwPD, (2) include assessment(s) of psychometric properties (ie, validity, reliability, responsiveness) of isokinetic/isometric dynamometry in PD, and/or (3) assess mechanical muscle function in both PwPD and HC using isokinetic/isometric dynamometry. RESULTS A total of 40 studies were included. Aim 1 studies (n = 2) showed high reliability for isometric dynamometry (hip-abductor/dorsiflexor/trunk flexor-extensor/handgrip: intraclass correlations coefficients range = 0.92-0.98). Aim 2 studies (n = 40) showed impaired mechanical muscle function (ie, strength, power, RFD) in PwPD compared with HC (effect sizes range = 0.52-1.89). Aim 3 studies (n = 11) showed weak-to-strong associations between overall and lower extremities muscle strength and functional capacity and/or disease severity outcomes (ie, Unified Parkinson Disease Rating Scale). DISCUSSION AND CONCLUSIONS Sparse methodological evidence suggests high reliability when using dynamometry in PwPD. Muscle strength, power, and RFD are impaired in PwPD compared with HC. Muscle strength is associated with functional capacity and disease severity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A403 ).
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Influence of forward head posture on muscle activation pattern of the trapezius pars descendens muscle in young adults. Sci Rep 2022; 12:19484. [PMID: 36376467 PMCID: PMC9662113 DOI: 10.1038/s41598-022-24095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Forward head posture (FHP) is a serious problem causing head and neck disability, but the characteristics of muscle activity during long-term postural maintenance are unclear. This study aimed to investigate a comparison of electromyography (EMG) activation properties and subjective fatigue between young adults with and without habitual FHP. In this study, we examined the changes in the spatial and temporal distribution patterns of muscle activity using high-density surface EMG (HD-SEMG) in addition to mean frequency, a conventional measure of muscle fatigue. Nineteen male participants were included in the study (FHP group (n = 9; age = 22.3 ± 1.5 years) and normal group (n = 10; age = 22.5 ± 1.4 years)). Participants held three head positions (e.g., forward, backward, and neutral positions) for a total of 30 min each, and the EMG activity of the trapezius pars descendens muscle during posture maintenance was measured by HD-SEMG. The root mean square (RMS), the modified entropy, and the correlation coefficient were calculated. Additionally, the visual analogue scale (VAS) was evaluated to assess subjective fatigue. The RMS, VAS, modified entropy, and correlation coefficients were significantly higher in the FHP group than in the normal group (p < 0.001). With increasing postural maintenance time, the modified entropy and correlation coefficient values significantly decreased, and the mean frequency and VAS values significantly increased (p < 0.001). Furthermore, the forward position had significantly higher RMS, correlation coefficient, modified entropy, and VAS values than in the neutral position (p < 0.001). The HD-SEMG potential distribution patterns in the FHP group showed less heterogeneity and greater muscle activity in the entire muscle and subjective fatigue than those in the normal group. Excess muscle activity even in the neutral/comfortable position in the FHP group could potentially be a mechanism of neuromuscular conditions in this population.
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Detecting motor unit abnormalities in amyotrophic lateral sclerosis using high-density surface EMG. Clin Neurophysiol 2022; 142:262-272. [PMID: 35902304 DOI: 10.1016/j.clinph.2022.06.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to detect specific motor unit (MU) abnormalities in people with amyotrophic lateral sclerosis (ALS) compared to controls using high-density surface electromyography (HD-SEMG). METHODS Sixteen people with ALS and 16 control subjects. The participants performed ramp up and sustained contractions at 30% of their maximal voluntary contraction. HD-SEMG signals were recorded in the vastus lateralis muscle and decomposed into individual MU firing behavior using a convolution blind source separation method. RESULTS In total, 339 MUs were detected (people with ALS; n = 93, control subjects; n = 246). People with ALS showed significantly higher mean firing rate, recruitment threshold, coefficient of variation of the MU firing rate, MU firing rate at recruitment, and motoneurons excitability than those of control subjects (p < 0.001). The number of MU, MU firing rate, recruitment threshold, and MU firing rate at recruitment were significantly correlated with disease severity (p < 0.001). Multivariable analysis revealed that an increased MU firing rate at recruitment was independently associated with ALS. CONCLUSIONS These results suggest increased excitability at recruitment, which is consistent with neurodegeneration results in a compensatory increase in MU activity. SIGNIFICANCE Abnormal MU firing behavior provides an important physiological index for understanding the pathophysiology of ALS.
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KOMIYA MAKOTO, MAEDA NORIAKI, NISHIKAWA YUICHI, SASADAI JUNPEI, MORIKAWA MASANORI, TASHIRO TSUBASA, FUJISHITA HIRONORI, URABE YUKIO. SPATIAL DISTRIBUTION PATTERN OF THE ELECTROMYOGRAPHIC POTENTIAL IN THE VASTUS MEDIALIS AND LATERALIS MUSCLES FOR THREE KNEE FLEXION ANGLES DURING ISOMETRIC KNEE EXTENSION. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Understanding the function of the vastus lateralis (VL) and vastus medialis (VM) muscles is important since these muscles are essential for daily and sport activities. The association between the knee flexion angle and spatial muscle activation is controversial. This study compares the distribution patterns of multi-channel electromyographic activities of the VL and VM muscles at three knee flexion angles for three intensities of isometric contraction. Sixteen men performed isometric knee extensions at 30%, 50% and 70% maximal voluntary contraction (MVC), at [Formula: see text], [Formula: see text] and [Formula: see text] knee flexion. Alterations in the spatial electromyographic potential distribution were determined by the root mean square (RMS), modified entropy, and coefficient of variation in the spatial electromyographic potential. Modified entropy and the coefficient of variation showed differences in the VM muscle between [Formula: see text] and [Formula: see text] knee flexion. The RMS at the three angles was similar between the VL and VM muscles, with no differences in contraction intensities at 30%, 50%, or 70% MVC. The VL and VM muscle function differed among knee flexion angles, as did activity in the distal and proximal VM muscles. These findings suggest the need for functional evaluation of the VL and VM muscles at each knee flexion angle.
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Affiliation(s)
- MAKOTO KOMIYA
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - NORIAKI MAEDA
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - YUICHI NISHIKAWA
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - JUNPEI SASADAI
- Sports Medical Center, Japan Institute of Sports, Sciences, Tokyo, Japan
| | - MASANORI MORIKAWA
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - TSUBASA TASHIRO
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - YUKIO URABE
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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12
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Favretto MA, Cossul S, Andreis FR, Nakamura LR, Ronsoni MF, Tesfaye S, Selvarajah D, Marques JLB. Alterations of tibialis anterior muscle activation pattern in subjects with type 2 diabetes and diabetic peripheral neuropathy. Biomed Phys Eng Express 2022; 8. [PMID: 34933285 DOI: 10.1088/2057-1976/ac455b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/21/2021] [Indexed: 11/11/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is associated with loss of motor units (MUs), which can cause changes in the activation pattern of muscle fibres. This study investigated the pattern of muscle activation using high-density surface electromyography (HD-sEMG) signals from subjects with type 2 diabetes mellitus (T2DM) and DPN. Thirty-five adults participated in the study: 12 healthy subjects (HV), 12 patients with T2DM without DPN (No-DPN) and 11 patients with T2DM with DPN (DPN). HD-sEMG signals were recorded in the tibialis anterior muscle during an isometric contraction of ankle dorsiflexion at 50% of the maximum voluntary isometric contraction (MVIC) during 30-s. The calculated HD-sEMG signals parameters were the normalised root mean square (RMS), normalised median frequency (MDF), coefficient of variation (CoV) and modified entropy (ME). The RMS increased significantly (p = 0.001) with time only for the DPN group, while the MDF decreased significantly (p < 0.01) with time for the three groups. Moreover, the ME was significantly lower (p = 0.005), and CoV was significantly higher (p = 0.003) for the DPN group than the HV group. Using HD-sEMG, we have demonstrated a reduction in the number of MU recruited by individuals with DPN. This study provides proof of concept for the clinical utility of this technique for identifying neuromuscular impairment caused by DPN.
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Affiliation(s)
- M A Favretto
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - S Cossul
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - F R Andreis
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - L R Nakamura
- Department of Informatics and Statistics, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - M F Ronsoni
- Department of Endocrinology and Metabolism, University Hospital, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - S Tesfaye
- Diabetes Research Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - D Selvarajah
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - J L B Marques
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Association between the Degree of Pre-Synaptic Dopaminergic Pathway Degeneration and Motor Unit Firing Behavior in Parkinson's Disease Patients. SENSORS 2021; 21:s21196615. [PMID: 34640935 PMCID: PMC8512333 DOI: 10.3390/s21196615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 12/14/2022]
Abstract
The relationship between motor unit (MU) firing behavior and the severity of neurodegeneration in Parkinson’s disease (PD) is not clear. This study aimed to elucidate the association between degeneration with dopaminergic pathways and MU firing behavior in people with PD. Fourteen females with PD (age, 72.6 ± 7.2 years, disease duration, 3.5 ± 2.1 years) were enrolled in this study. All participants performed a submaximal, isometric knee extension ramp-up contraction from 0% to 80% of their maximal voluntary contraction strength. We used high-density surface electromyography with 64 electrodes to record the muscle activity of the vastus lateralis muscle and decomposed the signals with the convolution kernel compensation technique to extract the signals of individual MUs. We calculated the degree of degeneration of the central lesion-specific binding ratio by dopamine transporter single-photon emission computed tomography. The primary, novel results were as follows: (1) moderate-to-strong correlations were observed between the degree of degeneration of the central lesion and MU firing behavior; (2) a moderate correlation was observed between clinical measures of disease severity and MU firing behavior; and (3) the methods of predicting central nervous system degeneration from MU firing behavior abnormalities had a high detection accuracy with an area under the curve >0.83. These findings suggest that abnormalities in MU activity can be used to predict central nervous system degeneration following PD.
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14
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Maeda N, Komiya M, Nishikawa Y, Morikawa M, Tsutsumi S, Tashiro T, Fukui K, Kimura H, Urabe Y. Effect of Acute Static Stretching on the Activation Patterns Using High-Density Surface Electromyography of the Gastrocnemius Muscle during Ramp-Up Task. SENSORS 2021; 21:s21144841. [PMID: 34300581 PMCID: PMC8309794 DOI: 10.3390/s21144841] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/01/2021] [Accepted: 07/13/2021] [Indexed: 12/01/2022]
Abstract
This study aimed to evaluate motor unit recruitment during submaximal voluntary ramp contraction in the medial head of the gastrocnemius muscle (MG) by high-density spatial electromyography (SEMG) before and after static stretching (SS) in healthy young adults. SS for gastrocnemius was performed in 15 healthy participants for 2 min. Normalized peak torque by bodyweight of the plantar flexor, muscle activity at peak torque, and muscle activation patterns during ramp-up task were evaluated before and after SS. Motor unit recruitment during the submaximal voluntary contraction of the MG was measured using SEMG when performing submaximal ramp contractions during isometric ankle plantar flexion from 30 to 80% of the maximum voluntary contraction (MVC). To evaluate the changes in the potential distribution of SEMG, the root mean square (RMS), modified entropy, and coefficient of variation (CV) were calculated from the dense surface EMG data when 10% of the MVC force was applied. Muscle activation patterns during the 30 to 80% of MVC submaximal voluntary contraction tasks were significantly changed from 50 to 70% of MVC after SS when compared to before. The variations in motor unit recruitment after SS indicate diverse motor unit recruitments and inhomogeneous muscle activities, which may adversely affect the performance of sports activities.
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Affiliation(s)
- Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
- Correspondence: ; Tel.: +81-82-257-5410; Fax: +81-82-257-5344
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa 920-1192, Japan;
| | - Masanori Morikawa
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Aichi, Obu City 474-8511, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
| | - Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
| | - Kazuki Fukui
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
| | - Hiroaki Kimura
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima University, Hiroshima 734-8551, Japan;
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.K.); (M.M.); (S.T.); (T.T.); (K.F.); (Y.U.)
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15
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Nishikawa Y, Watanabe K, Orita N, Maeda N, Kimura H, Tanaka S, Hyngstrom A. Influence of hybrid assistive limb gait training on spatial muscle activation patterns in spinal muscular atrophy type III. F1000Res 2021; 10:214. [PMID: 34249338 PMCID: PMC8258705 DOI: 10.12688/f1000research.50951.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Despite the potential benefits, the effects of Hybrid Assistive Limb (HAL) gait training on changes in neuromuscular activation that accompany functional gains in individuals with spinal muscular atrophy (SMA) type III is not well known. In this article, we quantify the effects of HAL gait training on spatial muscle activity patterns in a patient with SMA type III using multi-channel surface electromyography (SEMG). Methods: A 21-years old male (168 cm, 47.8 kg) with spinal muscular atrophy type III, when diagnosed at 18-years old by genetic screening, participated in this case study. Although he presented with forearm distal muscle weakness, atrophy of the intrinsic muscles of the hand, and neuromuscular fatigue, his activities of daily living is independent. The patient underwent a separate, single 33-minute session of both HAL and treadmill gait training. To evaluate the coefficient of variation (CoV) of force and alterations in the SEMG spatial distribution patterns, modified entropy and CoV of root mean square (RMS) were calculated from the vastus lateralis (VL) muscle before and after the intervention of HAL and treadmill gait training. Each training session was separated by a period of one month to avoid cross-over effects. Results: There was a greater decrease in the ΔCoV of force and an increase in the magnitude of whole VL muscle activation from pre-intervention to post-intervention with the HAL gait training as compared to the treadmill gait training. In response to only HAL gait training, the CoV of RMS was higher, and the modified entropy was lower post-intervention than pre-intervention. Conclusions: Our results support the notion that HAL gait training has a positive benefit on motor output not only in the magnitude of SEMG generated but also the patterns of neural activation.
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Affiliation(s)
- Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Ishikawa, 920-1192, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sports Sciences, Chukyo University, Nagoya, Aichi, 470-0393, Japan
| | - Naoya Orita
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Hiroshima, 734-8551, Japan
| | - Noriaki Maeda
- Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, 734-8551, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Hiroshima, 734-8551, Japan
| | - Shinobu Tanaka
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Ishikawa, 920-1192, Japan
| | - Allison Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, 53233, USA
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16
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Nishikawa Y, Watanabe K, Holobar A, Maeda N, Maruyama H, Tanaka S. Identification of the laterality of motor unit behavior in female patients with parkinson's disease using high-density surface electromyography. Eur J Neurosci 2020; 53:1938-1949. [PMID: 33377245 DOI: 10.1111/ejn.15099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/24/2020] [Accepted: 12/24/2020] [Indexed: 12/27/2022]
Abstract
Patients with Parkinson's disease (PD) have greater laterality of muscle contraction properties than other people with parkinsonism diseases. However, few studies have reported the laterality of MU activation properties of the lower extremity muscles in patients with PD. The aim of the present study was to identify the laterality of MU behavior in PD patients using high-density surface electromyography (HD-SEMG). Eleven female patients with PD (age, 69.2 ± 6.2 years, disease duration, 2.7 ± 0.9 years, Unified Parkinson's disease Rating Scale score, 13 (9-16)), and 9 control female subjects (age, 66.8 ± 3.5 years) were enrolled in the present study. All subjects performed a sustained isometric knee extension in a 30% maximal voluntary contraction (MVC) task for 20 s. HD-SEMG signals were used to record and extract single MU firing behavior in the vastus lateralis muscle during submaximal isometric knee extensor contractions with 64 electrodes and decomposed with the convolution kernel compensation technique to extract individuals MUs. Compared to the control subjects, the patients with PD exhibited laterality of the MU firing rate and an absence of a relationship between the mean MU firing rate and MU threshold. Patients with PD exhibit laterality of MU behavior and experience MU behavioral abnormalities even with mild symptoms such as Hoehn & Yahr stage ≤ 3 and disease duration = 2.7 ± 0.9. These findings suggest the importance of considering the detection of abnormal muscle properties in PD patients beginning in the early phase of the disease.
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Affiliation(s)
- Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Aleš Holobar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Noriaki Maeda
- Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinobu Tanaka
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan
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17
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Wang KL, Burns M, Xu D, Hu W, Fan SY, Han CL, Wang Q, Michitomo S, Xia XT, Zhang JG, Wang F, Meng FG. Electromyography Biomarkers for Quantifying the Intraoperative Efficacy of Deep Brain Stimulation in Parkinson's Patients With Resting Tremor. Front Neurol 2020; 11:142. [PMID: 32161571 PMCID: PMC7054231 DOI: 10.3389/fneur.2020.00142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/07/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: Deep brain stimulation (DBS) is an effective therapy for resting tremor in Parkinson's disease (PD). However, quick and objective biomarkers for quantifying the efficacy of DBS intraoperatively are lacking. Therefore, we aimed to study how DBS modulates the intraoperative neuromuscular pattern of resting tremor in PD patients and to find predictive surface electromyography (sEMG) biomarkers for quantifying the intraoperative efficacy of DBS. Methods: Intraoperative sEMG of 39 PD patients with resting tremor was measured with the DBS on and off, respectively, during the intraoperative DBS testing stage. Twelve signal features (time and frequency domains) were extracted from the intraoperative sEMG data. These sEMG features were associated with the clinical outcome to evaluate the efficacy of intraoperative DBS. Also, an sEMG-based prediction model was established to predict the clinical improvement rate (IR) of resting tremor with DBS therapy. Results: A typical resting tremor with a peak frequency of 4.93 ± 0.98 Hz (mean ± SD) was measured. Compared to the baseline, DBS modulated significant neuromuscular pattern changes in most features except for the peak frequency, by decreasing the motor unit firing rate, amplitude, or power and by changing the regularity pattern. Three sEMG features were detected with significant associations with the clinical improvement rate (IR) of the tremor scale: peak frequency power (R = 0.37, p = 0.03), weighted root mean square (R = 0.42, p = 0.01), and modified mean amplitude power (R = 0.48, p = 0.003). These were adopted to train a Gaussian process regression model with a leave-one-out cross-validation procedure. The prediction values from the trained sEMG prediction model (1,000 permutations, p = 0.003) showed a good correlation (r = 0.47, p = 0.0043) with the true IR of the tremor scale. Conclusion: DBS acutely modulated the intraoperative resting tremor, mainly by suppressing the amplitude and motor unit firing rate and by changing the regularity pattern, but not by modifying the frequency pattern. Three features showed strong robustness and could be used as quick intraoperative biomarkers to quantify and predict the efficacy of DBS in PD patients with resting tremor.
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Affiliation(s)
- Kai-Liang Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Mathew Burns
- Department of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Dan Xu
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Wei Hu
- Department of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Shi-Ying Fan
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Chun-Lei Han
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Qiao Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Shimabukuro Michitomo
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Xiao-Tong Xia
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Fan-Gang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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18
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Martinez-Valdes E, Wilson F, Fleming N, McDonnell SJ, Horgan A, Falla D. Rowers with a recent history of low back pain engage different regions of the lumbar erector spinae during rowing. J Sci Med Sport 2019; 22:1206-1212. [DOI: 10.1016/j.jsams.2019.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 06/13/2019] [Accepted: 07/16/2019] [Indexed: 11/16/2022]
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19
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Cantú H, Nantel J, Millán M, Paquette C, Côté JN. Abnormal Muscle Activity and Variability Before, During, and After the Occurrence of Freezing in Parkinson's Disease. Front Neurol 2019; 10:951. [PMID: 31551912 PMCID: PMC6733893 DOI: 10.3389/fneur.2019.00951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022] Open
Abstract
Freezing of gait (FOG) is often experienced in advanced stages of Parkinson's disease (PD) and can lead to an increased risk of falls. Although spatiotemporal characteristics of FOG are well-described, their underlying neuromuscular mechanisms remain poorly understood. Several studies have demonstrated an abnormal activation of distal muscles of the lower limb and coordination impairments during gait in people with PD (pwPD). However, few have investigated how various characteristics of electromyograms (EMGs) change before, during and after a freezing episode (FE). Our objective was to quantify changes in proximal and distal leg muscle activity associated with FEs. In this study, 12 pwPD, confirmed as freezers, performed a repetitive stepping-in-place task used to elicit FE. Surface EMGs were collected from proximal [rectus femoris and biceps femoris (BF)] and distal [tibialis anterior (TA) and gastrocnemius medialis (GM)] muscles. Data epochs of 500 ms were extracted from EMG time series at four different periods: baseline, 2 s before a FE, during a FE, and 2 s after a FE. For each epoch, EMG amplitude [root-mean-square (RMS)], variability [coefficient of variation (CoV)], and inter-muscle functional connectivity (mutual information) were quantified. Results from the analysis of 21 FEs show a significant main effect of Period for EMG amplitude in bilateral TA and in the least affected GM (p < 0.01), with decreased activation before freezing that remained low during and after the FE. On the other hand, a main effect of Period was also found in bilateral BF muscles (p < 0.01) but with increased activation before freezing that was generally sustained during and after FE. Main effects of Period were also found for all measures of variability, except for the least affected GM, showing reduced variability during the FE that returned to baseline in all muscles except both TA. Moreover, an increase in functional connectivity between the least affected distal muscles was seen before the FE. Our findings confirm that many characteristics of EMG patterns of both distal and proximal leg muscles change throughout periods of a FE, suggesting both impairment and adaptive strategies from proximal muscles.
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Affiliation(s)
- Hiram Cantú
- Departamento de Ingeniería Biomédica, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza García, Mexico.,Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, QC, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Michelle Millán
- Departamento de Ingeniería Biomédica, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza García, Mexico
| | - Caroline Paquette
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | - Julie N Côté
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, QC, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
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20
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The effect of medication on vastus lateralis muscle activation patterns in Parkinson's disease patients. J Electromyogr Kinesiol 2018; 42:66-73. [PMID: 29960263 DOI: 10.1016/j.jelekin.2018.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 11/22/2022] Open
Abstract
The effect of levodopa on muscle activity patterns in Parkinson's disease (PD) patients is currently unclear. The aim of the present study was to compare the spatial distribution pattern of electromyographic activity during sustained isometric contraction in PD patients during on- and off-medication periods using multi-channel surface electromyography (SEMG). Ten female PD patients were recruited for the present study. All patients performed a sustained isometric knee extension at 10% maximum voluntary contraction task for 60 s. To evaluate alterations in the spatial SEMG potential distribution, the coefficient of variation (CV) of force, normalized root mean square (RMS), modified entropy, CV of the RMS, and correlation coefficients were calculated at during contraction task. The off-medication period exhibited more fluctuation during the contraction task than those in the on-medication period. The off-medication period exhibited less change in modified entropy, the CV of RMS, the correlation coefficient and patterns of spatial SEMG distribution. These data demonstrated that the heterogeneity and changes in the activation pattern are smaller in the off-medication period than in those in the on-medication period. These findings might indicate that levodopa enhanced the activation of muscle action potentials during force production.
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