EMG-interference pattern analysis

Effect of work boot shaft stiffness and sole flexibility on boot clearance and shank muscle activity when walking on simulated coal mining surfaces: implications for reducing trip risk

Mining work boot shaft stiffness and sole flexibility variations are likely to affect how a miner moves their foot to clear the ground thus influencing their risk of tripping. Despite the potential negative consequences associated with tripping, limited research has investigated how these boot design features might contribute to a miner's trip risk. Therefore, this study aimed to investigate the effects of systematic variations to boot shaft stiffness and sole flexibility on lower limb alignment and shank muscle activity at toe off and boot clearance during initial swing when 20 males walked across two simulated coal mining surfaces. Although knee and hip alignment remained constant, changes to boot shaft stiffness and sole flexibility significantly interacted to influence the shank muscle activity and ankle alignment displayed at toe off. To reduce the risk of tripping, underground coal miners should avoid a boot with a stiff shaft, regardless of the sole flexibility.

Periscapular activity in subjects with scapular dyskinesis during push-ups on stable and unstable support surfaces

BACKGROUND: The scapular dyskinesis has been described as a sign of scapular instability due to weakness or imbalance of scapular muscles. OBJECTIVE: The aim of this study was to compare the EMG activity of the periscapular and abdominal muscles of asymptomatic subjects without and with scapular dyskinesis type II during a push-up exercise performed on different surface stability conditions. METHODS: Twenty-seven physically active men were allocated into two groups: the Control group (n= 14); and the Dyskinesis group (n= 13). All participants performed three variations of the push-up exercise: Stable, Push-up with hand instability, and Push-up with hand and feet instability. The EMG activity of serratus anterior, upper (UT), middle (MT) and lower (LT) trapezius, external oblique (EO) and rectus abdominis (RA) was recorded during each task. RESULTS: The control group showed an increase in MT activity (mean difference -3.46 to 8.66) under both instability conditions compared to stable push-ups (p< 0.001). The comparison between groups showed that the control group had higher MT activity (mean difference -10.07 to 13.82) compared to the dyskinesis group under unstable conditions (p< 0.012). CONCLUSION: The insertion of unstable surfaces increased MT activity in the control group only. The insertion of the unstable surface, either the hands or the footrest, did not provide significant effects for the other muscles.

Use of unstable exercises in periscapular muscle activity: A systematic review and meta-analysis of electromyographic studies

BACKGROUND

The use of unstable surfaces has been proposed to increase the neuromuscular demand. This strategy has been adopted to generate an increase in the activity of periscapular muscles due to its role in the stabilization of the scapula. However, the influence of this instability on the EMG activity remains uncertain. The aim of this study was to analyze the effects of using unstable surfaces on the EMG activity of the periscapular muscles.

METHODS

A comprehensive search in the PubMed, EMBASE, SCIELO, Web of Science, SCOPUS, Cochrane and LILACS databases was undertaken from their year of inception up to December 2019. Studies which directly investigated the EMG activity of periscapular muscles in healthy individuals while performing exercises for the upper limbs in stable and unstable conditions.

RESULTS

A total of 33 studies which evaluated a total of 678 healthy individuals were found according to the eligibility criteria. A meta-analysis identified that the EMG activity of the upper trapezius showed a trivial increase with the insertion of the unstable surface (P = 0.04; SMD = 0.14 [95%CI 0.00, 0.27]). No significant effects were observed on the middle trapezius (P = 0.10) and lower trapezius (P = 0.25). A decrease of the anterior serratus EMG activity with a small effect size was observed by implementing an unstable surface (P = 0.01; SMD = -0.21 [95%CI -0.36, -0.05]).

CONCLUSION

The use of unstable surfaces generated a trivial increase in the upper trapezius activity, and a slight decrease in the anterior serratus activity. No effect was observed on the middle and lower trapezius.

Sensitivity and specificity of single and combined clouds analyses compared with quantitative motor unit potential analysis

INTRODUCTION

Turns-amplitude, number of small segments (NSS)-activity, and envelope-activity clouds are three methods of electromyography (EMG) interference pattern analysis. Our objective was to evaluate the sensitivity and specificity of each individual cloud analysis and combined clouds analysis to compare with that of quantitative motor unit potential (QMUP) analysis.

METHODS

A total of 379 muscles from 100 patients were analyzed by both QMUP and clouds analyses. Calculation of sensitivity and specificity was based on the clinical diagnosis as the "gold standard."

RESULTS

For discrimination of abnormal vs normal and neuropathic vs non-neuropathic, combined clouds analysis had greater sensitivity than QMUP analysis and any single cloud analysis, but there were no differences in specificity. For discrimination of myopathic vs non-myopathic, combined clouds analysis and single cloud analysis had greater sensitivity than QMUP analysis, but there were no differences in specificity.

DISCUSSION

Combined clouds analysis was superior to QMUP and each single cloud analysis for distinguishing normal, myopathic, and neuropathic muscles.

Electromyography as a Means of Assessing Masticatory Muscle Activity in Patients with Pain-Related Temporomandibular Disorders

Aim

The aim of this study was to evaluate masticatory muscle electrical activity in patients with pain-related and pain-free temporomandibular disorders (TMDs) as well as in subjects with no TMD.

Methods

Ninety children with mixed dentition were recruited to the study. Of this total, 30 subjects were diagnosed with pain-related TMD (TMD-P), 30 with pain-free TMD (TMD-PF), and 30 without TMD. We used Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) to assess the presence of TMD in the examined children. The electromyographical (EMG) potentials of the temporalis and masseter muscles were measured with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC).

Results

An analysis of the EMG recordings showed statistically significant intergroup differences in masticatory muscle electrical activity at rest and during MVC. Significantly higher rest temporalis muscle activity was noted in pain-related TMD subjects compared with that children from the pain-free TMD and non-TMD groups, as well as in TMD-PF children in relation to those without TMD. The EMG potentials of the temporalis muscle during MVC were much lower in patients with TMD-P than in pain-free TMD and non-TMD subjects. Masseter muscle activity at rest in the TMD-pain group was significantly greater, and masseter muscle EMG potentials during clenching were markedly lower than in patients with no TMD diagnosis.

Conclusion

The use of electromyography to assess masticatory muscle function revealed alterations in the pattern of temporalis and masseter muscle activity in patients with pain-related TMD compared with the pain-free subjects.

Estimation of Motor Unit Global Firing Rate by Maximum Power Amplitude

Motor unit (MU) global firing rate is widely applied in physiological and clinical investigation. Currently it still remains difficult to measure the MU global firing rate from sEMG. In this study, we propose a new feature of maximum power amplitude (MPA) from sEMG power spectrum. Based on an analysis of mathematical model and simulated signals, MPA was demonstrated to be highly correlated with the MU global firing rate. The performance of MPA was comparable with features based on sEMG amplitude in the time domain. Moreover, the simulation results showed that the square of MPA changed accordingly with the output force, indicating potential application estimating force using MPA².

Assessment of bee venom therapy in animal model of statin-induced myopathy

Background

Statin-induced myopathy is the most common adverse effect of statins. Bee venom provides a potential mean of controlling immune responses and inflammatory reactions; the proposed mechanisms for statin-induced myopathy.

Objective

The present study aimed at clarification of the role of the bee venom in prevention of statin-induced myopathy.

Materials and methods

It was carried out on 30 Sprague-Dawley female rats. Rats were randomly classified into 3 groups: control group, statin group which received statins for 2 weeks, and venom group that was exposed to alternate day actual bee sting concurrent to statins administration for 2 weeks. Quantitative electromyography (QEMG) was performed as well as serum creatine kinase (CK) and cholesterol levels, in addition to in vitro muscle contractility tests.

Results

QEMG and contractility tests showed significant changes in the statin group compared to both control and venom groups. Serum cholesterol level decreased with increase in CK levels in the statin and venom groups compared to controls; however, the CK level was significantly lower in the venom group as compared to the statin group.

Conclusion

Bee venom therapy offers a simple and available means of prophylaxis against the myopathic effects induced by statins in animal model. However, it partly restricts the therapeutic effect of statins.

Effect of work boot shaft stiffness and sole flexibility on lower limb muscle activity and ankle alignment at initial foot-ground contact when walking on simulated coal mining surfaces: Implications for reducing slip risk

Design features of safety work boots have the potential to influence how underground coal miners' feet interact with the challenging surfaces they walk on and, in turn, their risk of slipping. Despite the importance of work boot design in reducing the risk of miners slipping, limited research has investigated how boot design features, such as shaft stiffness and sole flexibility, affect the way miners walk. Therefore, this study aimed to investigate the effects of systematic variations to boot shaft stiffness and sole flexibility on lower limb muscle activity and ankle motion in preparation for initial foot-ground contact when 20 males walked across two simulated coal mining surfaces under four mining boot conditions. It was concluded that a boot which has different flexibility and stiffness between the shaft and sole is a better design option to reduce underground coal miners' slip risk than a boot that has a stiff shaft and stiff sole or flexible shaft and flexible sole.

Improved MUP Template Estimation Using Local Time Warping and Kernel Weighted Averaging

A motor unit potential (MUP) template, which represents the shapes of the MUPs within a MUP train, provides information related to the morphology and physiology of the sampled motor unit. This work presents an improved MUP template estimation technique that uses local time warping and kernel weighted ensemble averaging. An analysis of the algorithm, and a description of the improvements compared with spike triggered averaging is given. MUP template estimates were evaluated using simulated EMG signals with a known gold standard template for each motor unit potential train. Statistically significant reduction in template estimation error is shown, both within the baseline and duration portions of a MUP.

A Novel Interpretation of Sample Entropy in Surface Electromyographic Examination of Complex Neuromuscular Alternations in Subacute and Chronic Stroke

The objective of this paper was to develop sample entropy (SampEn) as a novel surface electromyogram (EMG) biomarker to quantitatively examine post-stroke neuromuscular alternations. The SampEn method was performed on surface EMG interference patterns recorded from biceps brachii muscles of nine healthy control subjects, fourteen subjects with subacute stroke, and eleven subjects with chronic stroke, respectively. Measurements were collected during isometric contractions of elbow flexion at different constant force levels. By producing diagnostic decisions for individual muscles, two categories of abnormalities in some paretic muscles were discriminated in terms of abnormally increased and decreased SampEn. The efficiency of the SampEn was demonstrated by its comparable performance with a previously reported clustering index (CI) method. Mixed SampEn (or CI) patterns were observed in paretic muscles of subjects with stroke indicating complex neuromuscular changes at work as a result of a hemispheric brain lesion. Although both categories of SampEn (or CI) abnormalities were observed in both subacute and chronic stages of stroke, the underlying processes contributing to the SampEn abnormalities might vary a lot in stroke stage. The SampEn abnormalities were also found in contralateral muscles of subjects with chronic stroke indicating the necessity of applying interventions to contralateral muscles during stroke rehabilitation. Our work not only presents a novel method for quantitative examination of neuromuscular changes, but also explains the neuropathological mechanisms of motor impairments and offers guidelines for a better design of effective rehabilitation protocols toward improved motor recovery.

Effectiveness of robo-assisted lower limb rehabilitation for spastic patients: A systematic review

BACKGROUND

Though many rehabilitative treatments are available for treatment of spasticity, thus the effectiveness of different robo-rehabilitative devices needs to be evaluated through a systematic review.

OBJECTIVE

The objective of this study is to focuses on the efficacy of Robot assistive rehabilitation device for the removal of spasticity from the lower limb of Spastic patients.

DATA SOURCESSOURCES

PubMed, Web of Sciences, EMBASE (Excerpta Medical database), CDSR (Cochrane database of systematic reviews), Scopus, IEEE Xplore, Wiley online library, MEDLINE (OvidSP), Science Direct, Springer Link were from January 1980 to September 2017 DATA EXTRACTIONEXTRACTION: Seventy-one publications from eleven databases published were selected using keywords Ankle foot, spasticity, robotic rehabilitation, efficacy of robotics and Ankle foot rehabilitation. The review is narrowed down to twenty-six articles which were selected for they focused on effects of Robot assistive rehabilitation device quantitatively.

RESULT

A quantitative study from analyzing 26 studies comprising of 786 subjects is carried out. The major outcome of the effectiveness of the robot assistive therapy for the movement of ankle and functioning of gait is deduced. As the used protocols and treatment procedures vary, made comparative study complex or impracticable.

CONCLUSION

Robo-rehabilitation possesses an ability to provide unified therapy protocols with greater ease in comparison to conventional therapies. They continuously prove to be irreplaceable assistant devices when it comes to providing excellent treatment in terms of improvement from this study. Though many mechatronic devices are available but the devices for treatment of early stage rehabilitation of stroke patients is very limited.

Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders

Aim

The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P).

Methods

The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC).

Results

The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group.

Conclusion

Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function.

The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: A reliability and correlation study

AIMS

The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments.

METHODS

One hundred and fifty women with pelvic floor disorders participated on one occasion, and 20 women returned for the same investigations by two different raters on 3 different days. At each session, PFM strength was assessed using palpation (both the modified Oxford Grading Scale and the Levator ani testing), manometry, and dynamometry; and PFM activation was assessed using sEMG.

RESULTS

The interrater reliability of manometry, dynamometry, and sEMG (both root-mean-square [RMS] and integral average) was high (Lin's Concordance Correlation Coefficient [CCC] = 0.95, 0.93, 0.91, 0.86, respectively), whereas the interrater reliability of both palpation grading scales was low (Cohen's Kappa [k] = 0.27-0.38). The intrarater reliability of manometry (CCC = 0.96), and dynamometry (CCC = 0.96) were high, whereas intrarater reliability of both palpation scales (k = 0.78 for both), and of sEMG (CCC = 0.79 vs 0.80 for RMS vs integral average) was moderate. The Bland-Altman plot showed good inter and intrarater agreement, with little random variability for all instruments. The correlations among palpation, manometry, and dynamometry were moderate (coefficient of determination [r² ] ranged from 0.52 to 0.75), however, transperineal sEMG amplitude was only weakly correlated with all measures of strength (r²  = 0.23-0.30).

CONCLUSIONS

Manometry and dynamometry are more reliable tools than vaginal palpation for the assessment of PFM strength in women with pelvic floor disorders, especially when different raters are involved. The different PFM strength measures used clinically are moderately correlated; whereas, PFM activation recorded using transperineal sEMG is only weakly correlated with PFM strength. Results from perineal sEMG should not be interpreted in the context of reporting PFM strength.

The use of electromyography interference pattern analysis to determine muscle force of the deep digital flexor muscle in healthy and laminitic horses

BACKGROUND

In equine laminitis, the deep digital flexor muscle (DDFM) appears to have increased muscle force, but evidence-based confirmation is lacking.

OBJECTIVES

The purpose of this study was to test if the DDFM of laminitic equines has an increased muscle force detectable by needle electromyography interference pattern analysis (IPA).

ANIMALS AND METHODS

The control group included six Royal Dutch Sport horses, three Shetland ponies and one Welsh pony [10 healthy, sound adults weighing 411 ± 217 kg (mean ± SD) and aged 10 ± 5 years]. The laminitic group included three Royal Dutch Sport horses, one Friesian, one Haflinger, one Icelandic horse, one Welsh pony, one miniature Appaloosa and six Shetland ponies (14 adults, weight 310 ± 178 kg, aged 13 ± 6 years) with acute/chronic laminitis. The electromyography IPA measurements included firing rate, turns/second (T), amplitude/turn (M) and M/T ratio. Statistical analysis used a general linear model with outcomes transformed to geometric means.

RESULTS

The firing rate of the total laminitic group was higher than the total control group. This difference was smaller for the ponies compared to the horses; in the horses, the geometric mean difference of the laminitic group was 1.73 [geometric 95% confidence interval (CI) 1.29-2.32], and in the ponies this value was 1.09 (geometric 95% CI 0.82-1.45).

CONCLUSION AND CLINICAL RELEVANCE

In human medicine, an increased firing rate is characteristic of increased muscle force. Thus, the increased firing rate of the DDFM in the context of laminitis suggests an elevated muscle force. However, this seems to be only a partial effect as in this study, the unchanged turns/second and amplitude/turn failed to prove the recruitment of larger motor units with larger amplitude motor unit potentials in laminitic equids.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015

REASONS FOR PERFORMING STUDY

In cases of laminitis, an increased muscle force or contracture of the deep digital flexor muscle (DDFM) is suggested, but evidence-based research is lacking.

OBJECTIVES

To test if the DDFM of laminitic equines shows an increased muscle force detectable by needle-EMG including Interference Pattern Analysis (IPA).

STUDY DESIGN

Cross-sectional study.

METHODS

Three groups consisted of Group 0 (control): 6 Royal Dutch Sport horses, 3 Shetland ponies and one Welsh pony (healthy, sound adults, mean ± s.d. weight 411 ± 217 kg). Group 1: 3 Royal Dutch Sport horses, one Friesian, one Haflinger, one Icelandic horse, 2 Welsh ponies, one miniature Appaloosa and 6 Shetland ponies (adults, mean ± s.d. weight 310 ± 172 kg) suffering from acute or chronic laminitis. EMG measurements including firing frequency (F) and IPA parameters Turns/Second (T), Amplitude/Turn (M) and Ratio M/T (R) were performed. ANOVA was used to analyse data. P values of P<0.05 were considered significant.

RESULTS

Mean ± s.d. F of Group 0 and Group 1 was 53 ± 11 and 72 ± 21 Hz, mean ± s.d. T was 112 ± 57 and 106 ± 42, mean ± s.d. M was 284 ± 51 and 254 ± 38 μV and mean ± s.d. R was 0.39 ± 0.17 and 0.42 ± 0.16%, respectively. The firing frequency of Group 1 was significantly higher compared to Group 0 (P = 0.02), whereas other differences were not significant.

CONCLUSIONS

In human medicine, an increased firing frequency is a characteristic of increased muscle force [1,2]. Thus, the increased firing frequency of the DDFM in case of laminitis suggests an elevated muscle force. As all parameters show a high variance, a repeated study including a larger test group is advised. Ethical animal research: Data collection from controls was approved by the Animal Welfare Committee of Utrecht University, approval number 2008.III.07.061 and 2013.III.01.012. Clinical cases were privately owned and written owner consent was obtained.

SOURCE OF FUNDING

None. Competing interests: None declared.

Estimating the tendency of motor unit recruitment during steady-hold and rapid contractions using surface EMG and Turns-amplitude analysis

PURPOSE

The purpose of this study was to investigate changes in the interference pattern in surface electromyography (EMG), and its relationship with the tendency of motor unit (MU) recruitment during steady-hold and rapid muscle contractions.

METHODS

Fifteen healthy adults (eight females and seven males, 22.6 ± 1.5 years old) performed steady-hold and rapid isometric contractions of the bicep brachii, adductor pollicis, and tibialis anterior muscles at various force levels. Surface EMG recordings were analyzed using Turns-Amplitude Analysis (TAA).

RESULTS

During steady-hold contractions, the number of turns per second (T/s) increased exponentially with force during submaximal contractions, and plateaued after force levels of 66, 70 and 57 % MVC for the tibialis anterior, bicep brachii and adductor pollicis muscles, respectively. These force levels were proximate to the maximal recruitment threshold (MaxRT) reported previously. The slopes of the T/s-force relationships before the MaxRT were significantly greater than the slopes after the MaxRT for all three muscles tested. During rapid contraction, the slopes of the T/s-force relationships were significantly lower than the slopes of the steady-hold contraction at 20-40 % MVC in all three muscles, and for 40-60 % MVC in TA muscles.

CONCLUSIONS

Our results suggested that the changes in the number of turns in surface EMG with respect to muscle force can be used to estimate the force levels at which the majority of the MUs to be recruited, and completion of MU recruitment was observed at lower force levels during rapid muscle contraction.

Effects of wearing gumboots and leather lace-up boots on lower limb muscle activity when walking on simulated underground coal mine surfaces

This study aimed to investigate the effects of wearing two standard underground coal mining work boots (a gumboot and a leather lace-up boot) on lower limb muscle activity when participants walked across simulated underground coal mining surfaces. Quadriceps (rectus femoris, vastus medialis, vastus lateralis) and hamstring (biceps femoris, semitendinosus) muscle activity were recorded as twenty male participants walked at a self-selected pace around a circuit while wearing each boot type. The circuit consisted of level, inclined and declined surfaces composed of rocky gravel and hard dirt. Walking in a leather lace-up boot, compared to a gumboot, resulted in increased vastus lateralis and increased biceps femoris muscle activity when walking on sloped surfaces. Increased muscle activity appears to be acting as a slip and/or trip prevention strategy in response to challenging surfaces and changing boot features.

Increased turn/amplitude parameters following subvastus approach in total knee arthroplasty

PURPOSE

To compare the improvement of the vastus medialis component of the quadriceps muscle electrophysiologically after the subvastus and medial parapatellar approaches in total knee arthroplasty (TKA).

METHODS

A total 26 patients that underwent primary unilateral in TKA were included into the study. TKAs were carried out via subvastus approach in 15 patients, while 11 patients were operated via medial parapatellar approach. The electrophysiological evaluations were carried out blindly with regard to the type of the surgical approach before the operation and at 6th week post-operatively. Non-surgical side was also evaluated as a control. Assessments were patellar tendon reflex analysis, motor unit potential analysis and interference pattern analysis (IPA) including turn-amplitude analysis and IPA during maximum contraction.

RESULTS

When they were compared to the pre-operative values, "the total mean amplitude" and "the mean turn/sec" parameters were significantly increased in group of subvastus approach (p = 0.017 and p = 0.009, respectively) at the post-operative 6th week. We would not be able to find any difference regarding the other electrophysiological parameters. There was also no significant difference between groups.

CONCLUSION

If there was no significant difference in all the electrophysiological parameters, the increase in turn-amplitude analysis in the group of subvastus approach would be considered as an indicator of a faster functional improvement of knee extensor mechanism in these cases.

Pattern of electromyographic activity in mastication muscles of adolescents with temporomandibular disorder

[Purpose] The aim of the present study was to assess the behavior of the mean and median frequencies of the electromyography signal of the mastication muscles of adolescents with different degrees of TMD severity. [Subjects] Forty-two adolescents aged 14 to 18 years. [Methods] The adolescents were classified according to severity using the Helkimo Index. The control group consisted of 14 subjects with no signs or symptoms of TMD. Three readings were taken in during maximum intercuspation and mandibular rest, with each reading lasting 10 seconds. [Results] Significant differences (p=0.0001) were found in the mean frequency (Hz) between the control group (CG), mild TMD group (MG) and moderate/severe TMD group (MSG), especially during mandibular rest, for all muscles evaluated: right temporal: CG (137.5), MG (194.2), MSG (291.7); left temporal: CG (106.9), MG (200.6), MSG (294.2); right masseter: CG (155.7), MG (242.8), MSG (278.3); left masseter: CG (125.0), MG (214.6), MSG (316.7). Greater differences among groups were found under the condition of mandibular rest.

CONCLUSIONS

Adolescents with TMD especially those with more severe symptoms exhibit hyperactivity of the mastication muscles.

Design and assessment of a low-cost, electromyographically controlled, prosthetic hand

The study reported here explored the design and realization of a low-cost, electromyographically controlled hand prosthesis for amputees living in developing countries. The developed prosthesis is composed of a light aluminum structure with opposing fingers connected to a DC motor that imparts only the movement of grasp. Problems associated with surface electromyographic signal acquisition and processing, motor control, and evaluation of grasp force were addressed, with the goal of minimizing cost and ensuring easy assembly. Simple analog front ends amplify and condition the electromyographic signals registered from two antagonist muscles by surface electrodes. Analog signals are sampled at 1 kHz and processed by a microcontroller that drives the motor with a supply voltage proportional to the muscular contraction, performing the opening and closing of the opposing fingers. Reliable measurements of the level of muscle contractions were obtained by specific digital processing: real-time operators implementing the root mean square value, mean absolute value, standard deviation, and mean absolute differential value were compared in terms of efficiency to estimate the EMG envelope, computational load, and time delay. The mean absolute value operator was adopted at a time window of 64 milliseconds. A suitable calibration procedure was proposed to overcome problems associated with the wide variation of electromyograph amplitude and background noise depending on the specific patient’s muscles selected. A pulse-width modulated signal drives the DC motor, allowing closing and opening of the prosthesis. The relationship between the motor-driver signal and the actual hand-grasp force developed by the prosthesis was measured using a hand-held grip dynamometer. The resulting force was proportional to current for moderate values of current and then saturated. The motor torque, and, in turn, the force elicited, can be measured by sensing the current absorbed by the motor. Therefore, the grasp force can be opportunely limited or controlled. The cost of the only electronic and mechanical components of the electromyographically controlled hand was about US$50; other costs, such as the cost of labor to assemble the prosthesis and the production of adapters for patients, were not estimated.

Beyond muscular effects: depression of spinal recurrent inhibition after botulinum neurotoxin A

The natural target of the botulinum neurototoxin type A (BoNT-A) is the neuromuscular junction. When injected into a muscle, BoNT-A is internalized by motoneurone terminals where it functions as an endopeptidase, cleaving protein components of the synaptic machinery responsible for vesicle docking and exocytosis. As a result, BoNT-A induces a characteristic flaccid paralysis of the affected muscle. In animal models, BoNT-A applied in the periphery can also influence central activity via retrograde transport and transcytosis. An analogous direct central effect in humans is still debated. The present study was designed to address whether BoNT-A modifies the activity of the spinal recurrent inhibitory pathways, when injected at muscular level, in humans. To avoid methodological bias, the recurrent inhibition from an injected muscle (soleus) was investigated on an untreated muscle (quadriceps), and stimulation parameters (producing recurrent inhibition) were monitored on a third non-injected muscle but innervated by the same nerve as the soleus (flexor digitorum brevis). The experiments were performed on 14 post-stroke patients exhibiting spasticity in ankle plantarflexors, candidates for BoNT-A. One month after BoNT-A, the level of recurrent inhibition was depressed. It is suggested that the depression of recurrent inhibition was induced by BoNT-A, injected peripherally, through axonal transport and blockade of the cholinergic synapse between motoneurone recurrent collaterals and Renshaw cells.

Quantifying muscle asymmetries in cervical dystonia with electrical impedance: a preliminary assessment

OBJECTIVE

Cervical dystonia (CD) lacks an objective quantitative measure. Electrical impedance myography (EIM) is a non-invasive assessment method sensitive to changes in muscle structure and physiology. We evaluate the potential role of EIM in quantifying CD, hypothesizing that patients would demonstrate differences in the symmetry of muscle electrical resistance compared to controls, and that this asymmetry would decrease after botulinum neurotoxin (BoNT) treatment.

METHODS

EIM was performed on the sternocleidomastoid (SCM) and cervical paraspinal (PS) muscles of CD patients and age-matched controls. 50 kHz resistance was analyzed, comparing side-to-side asymmetry in patients and controls, and, in patients, before and after BoNT treatment.

RESULTS

Sixteen patients and 10 controls were included. Resistance asymmetry was on average 3-5 times higher in patients than controls. Receiver operating characteristic analysis demonstrated 91% accuracy of discriminating CD from normal. From pre-treatment to maximum BoNT effect, asymmetry decreased from 20.8(13.9-26.1)% to 6.2(3.1-9.9)% (SCM), and from 16.0(14.3-16.0)% to 8.4(7.0-9.2)% (PS), p<0.05 (median, interquartile range).

CONCLUSIONS

EIM effectively differentiates normal subjects from CD patients by revealing asymmetries in resistance values and detects improvement in muscle symmetry after treatment.

SIGNIFICANCE

These results suggest that EIM, a painless, non-invasive measure, can provide a useful quantitative metric in CD evaluation and deserves further study.

Multiplicative multi-fractal modeling of electromyography signals for discerning neuropathic conditions

In this paper, we present a new method for multi-scale analysis of electromyography signals based on an interesting fractal process known as multiplicative cascade multi-fractal. Using simulated needle electromyography signals, we show this method provides a means for discrimination of normal and neuropathic electromyography signals. We also present experimental results that show the new parameters, computed using multiplicative cascade multi-fractal modeling, are more robust than the conventional signal parameter, number of turns, in the presence of additive noise. Results of multiplicative cascade multi-fractal modeling are consistent with other multi-scale approaches; advantages and differences are high lighted.

Classification of localized muscle fatigue with genetic programming on sEMG during isometric contraction

Genetic Programming is used to generate a solution that can classify localized muscle fatigue from filtered and rectified surface electromyography (sEMG). The GP has two classification phases, the GP training phase and a GP testing phase. In the training phase, the program evolved with multiple components. One component analyzes statistical features extracted from sEMG to chop the signal into blocks and label them using a fuzzy classifier into three classes: Non-Fatigue, Transition-to-Fatigue and Fatigue. The blocks are then projected onto a two-dimensional Euclidean space via two further (evolved) program components. K-means clustering is then applied to group similar data blocks. Each cluster is then labeled according to its dominant members. The programs that achieve good classification are evolved. In the testing phase, it tests the signal using the evolved components, however without the use of a fuzzy classifier. As the results show the evolved program achieves good classification and it can be used on any unseen isometric sEMG signals to classify fatigue without requiring any further evolution. The GP was able to classify the signal into a meaningful sequence of Non-Fatigue-->Transition-to-Fatigue-->Fatigue. By identifying a Transition-to Fatigue state the GP can give a prediction of an oncoming fatigue. The genetic classifier gave promising results 83.17% correct classification on average of all signals in the test set, especially considering that the GP is classifying muscle fatigue for ten different individuals.

The estimation of short intra-cortical inhibition depends on the proportion of spinal motoneurones activated by corticospinal inputs

OBJECTIVE

The high variability of SICI limits its utility and by extension that of TMS in clinical neurophysiology. Non-linear summation of descending volleys due to heterogeneous motoneurone properties, on which MEP size depends, has not previously been implicated as an issue in SICI evaluation.

METHODS

MEP size and SICI were normalised to the test MEP (mV), and as a percentage of M(max) to take account of the proportion of motoneurone pool activated by TMS. Two EMG systems, producing large and small MEPs, were used to determine how the normalisation affected MEPs of different amplitude.

RESULTS

M(max) normalisation (i) counteracted the influence of recording conditions on the MEP size, (ii) revealed a significant influence of the test size on SICI (between medium and large MEPs), and of test size on the conditioning intensity (the larger the MEP, the stronger the SICI), and (iii) decreased the variability.

CONCLUSIONS

Data normalised to M(max) better reflect the motoneurone recruitment after SICI. To enhance reproducibility, MEP should be normalised to M(max). This adjusts for some of the non-linear properties at the spinal, and possibly, at cortical levels.

SIGNIFICANCE

To reduce variability is important because TMS is becoming widely adopted and is being used in patients.

Towards smart prosthetic hand: Adaptive probability based skeletan muscle fatigue model

Skeletal muscle force can be estimated using surface electromyographic (sEMG) signals. Usually, the surface location for the sensors is near the respective muscle motor unit points. Skeletal muscles generate a spatial EMG signal, which causes cross talk between different sEMG signal sensors. In this study, an array of three sEMG sensors is used to capture the information of muscle dynamics in terms of sEMG signals. The recorded sEMG signals are filtered utilizing optimized nonlinear Half-Gaussian Bayesian filters parameters, and the muscle force signal using a Chebyshev type-II filter. The filter optimization is accomplished using Genetic Algorithms. Three discrete time state-space muscle fatigue models are obtained using system identification and modal transformation for three sets of sensors for single motor unit. The outputs of these three muscle fatigue models are fused with a probabilistic Kullback Information Criterion (KIC) for model selection. The final fused output is estimated with an adaptive probability of KIC, which provides improved force estimates.

Electromyographic activity of masseter and temporal muscles with different facial types

OBJECTIVES

To compare the electromyographic (EMG) activity of the masseter and anterior portion of temporal muscles in different vertical facial types.

MATERIALS AND METHODS

Clinical examination, cephalometric analysis, and electromyographic examination were performed in 44 volunteers ranging from 18 to 35 years old. The volunteers were classified on the basis of their vertical facial characteristics into three groups-brachyfacial, mesofacial, and dolicofacial-by the grouping analysis. The EMG records were obtained with three repetitions during mandibular rest, maximum voluntary contraction in intercuspidation, and simultaneous bilateral isotonic contraction. The Kolmogorov-Smirnov and Levene tests were applied to verify the normality and homogeneity of variance. Analysis of variance and the Kruskal-Wallis test identified statistical differences among groups that did not present normality and homogeneity of distribution, respectively. Significance for all statistical tests was set at P < .05.

RESULTS

At rest, only the right temporal and masseter muscles presented statistically significant differences among the groups. The differences were observed between groups 1 and 2 (P = .02) and 1 and 3 (P = .038) for the right temporal muscle, and between groups 1 and 2 (P = .029) for the right masseter muscle. Generally, group 1 presented the lowest EMG values for the four muscles evaluated during rest. For isotonic evaluation, none of the groups of muscles presented statistically significant differences.

CONCLUSION

Different vertical facial types do not determine distinct patterns of EMG activity for the masseter and anterior portion of temporal muscles during rest and bilateral mastication.

Levator ani denervation and reinnervation 6 months after childbirth

OBJECTIVE

The objective of the study was to assess the prevalence of levator ani denervation and reinnervation 6 months after the first delivery.

STUDY DESIGN

Ninety-six primigravida women underwent quantitative electromyography of the levator ani during the third trimester and twice postpartum. A 95% confidence interval for normal function was created using interference pattern analysis. Fifty-seven who completed the study are presented in this secondary data analysis. Postpartum muscle sites outside the normal range were considered abnormal. Obstetric and demographic characteristics were assessed.

RESULTS

Of 57 subjects, 70% had no denervation. Of the 30% with denervation at 6 weeks, 35% recovered by 6 months. Obstetric or maternal characteristics were not predictive of denervation or reinnervation, except subjects with persistent denervation tended toward lower body mass index (BMI) independent of mode of delivery.

CONCLUSION

Nearly one-third of women have levator ani denervation after first delivery, but many recover by 6 months. Denervation is not clearly associated with mode of delivery, but higher maternal BMI may be protective.

Neuromuscular recovery of the biceps brachii muscle after resistance exercise

The aim of this study was to determine the time to restore the biceps brachii (BB) electromyographic (EMG) activity after the biceps curl (BC) exercise, at different intensities. Ten males performed initially maximal voluntary isometric contractions (MVC) of the elbow flexors, followed by one isometric submaximal contraction at 50% MVC (reference contraction). After this, four bouts of the BC at 25%, 30%, 35%, and 40% 1 RM during 1 minute (randomly assigned, with 10 minutes rest between them) were performed. During the rest intervals at preestablished moments (15 seconds, 1, 3, 5, and 10 min), isometric 50% MVC were performed. The EMG variables (root mean square [RMS], zero crossings [ZC], median frequency, [MF] and peak power [PP]) at rest were compared with reference values. Immediately after the exercise, RMS and PP increased, while ZC and MF decreased, indicating fatigue. After 1 minute most of the variables were similar to the reference. Different load levels did not affect the EMG recovery. In conclusion, the EMG variables recovered after 1 minute rest, indicating the optimal muscular condition for subsequent bouts.

Mouth Breathing Syndrome: cervical muscles recruitment during nasal inspiration before and after respiratory and postural exercises on Swiss Ball

OBJECTIVE

This study aimed to evaluate the recruitment of cervical muscles during nasal inspiration before and after breathing and postural exercises on the Swiss Ball in children with Mouth Breathing Syndrome (MBS).

METHOD

Surface electromyography from the sternocleidomastoid (SCM), sub-occipitals and upper Trapezius muscles was recorded during nasal inspiration, before and at the end of three months of the treatment. A physical therapy program consisting in muscular stretching and strengthening exercises along with naso-diaphragmatic breathing on the Swiss Ball were carried out for body posture realignment and respiratory training. Nineteen mouth breathing children, mean age of 10.6 years, both genres, were the subjects of this study. In order to establish a comparison between the eletromyographic results (normalized values) obtained from pre and post-physical therapy program it was used the Wilcoxon non-parametric test for dependent data.

RESULTS

It was found a significant decrease (p<0.01) in the electromyographic activity during nasal inspiration in all tested muscles after treatment (11.3-3.6% in the SCM, 22.4-11.7% in the sub-occipitals and 8.9-3.1% in the upper Trapezius). At the end of the treatment, the assessed muscles reached lower activity electromyographic levels during nasal inspiration and they became closer of those in the quiet position.

CONCLUSION

The lower activity after the physical therapy program in these muscles indicates a less effort of the accessory inspiratory muscles, probably due to a better performance of diaphragm muscle with the improvement of the body posture.

Changes in intracellular action potential profile affect parameters used in turns/amplitude analysis

The influence of changes in the intracellular action potential (IAP) spatial profile on motor unit potentials (MUPs), number of turns per second (NTs), and mean turn amplitude were simulated and analyzed. We show why measurement of NTs was "the best indicator of neurogenic affection" and why the lower diagnostic yield of turns/amplitude analysis in myopathy could be due to changes in IAP shape caused by elevated free calcium concentration. The results explain the complications observed when interference electromyographic signals obtained during high levels of isometric contractions were analyzed. We show that, in contrast to earlier assumptions, the effect of increased IAP spike duration on NTs was stronger than that of a decrease in muscle fiber propagation velocity (MFPV). The decrease in the NTs could occur without a drop-out of MUs and/or a decrease in their firing rates, and without a change in MFPV and synchronous firing.

Efficacy of physical therapy on cervical muscle activity and on body posture in school-age mouth breathing children

INTRODUCTION

The mouth breathing resulting from nasal obstruction has been highly incident, mostly as a consequence of allergic rhinitis. In children, such condition is more concerned because it causes alteration during their development, which may generate deformities.

OBJECTIVE

To evaluate the efficacy of a program of combined postural exercise and breathing, on the cervical muscles and body posture in school-age mouth breathing children.

MATERIALS AND METHODS

Nineteen mouth breathing children, mean age of 10.6 years, both genders, were recruited either from a public school or from a speech-therapy service. The evaluation procedures were electromyographic recordings from the sternocleidomastoid (SCM), sub-occipitals (SOC) and upper trapezius (UT) muscles and computerized photographic analysis pre and post-treatment. The subjects were submitted to a 12-week of a Physical Therapy Program (PTP) consisted by (a) muscular stretching and strengthening exercises using a Swiss ball combined to (b) naso-diaphragmatic re-education.

RESULTS

There was a significant reduction (p<0.05) in the electrical activity on the assessed muscles during quiet position (5, 19 and 7.1% to 3, 2 and 10.3% for SCM, SOC and UT, respectively) and aligned posture (7, 19 and 8% to 4, 9 and 2.6% for SCM, SOC and UT, respectively) after treatment. Improvement in the postural deviation, especially reduction in forward head posture and abducted scapula were demonstrated in the computerized photographic analysis.

CONCLUSION

A combination of postural and breathing exercises was effective in restoring muscle imbalances and posture in a group of school-age mouth breathing children, as measured by changes in electrical activity and positional data.

Analysis of surface EMG spike shape across different levels of isometric force

This research evaluated changes in surface electromyographic (SEMG) spike shape across different levels of isometric force. Ninety-six subjects generated three 5-s isometric step contractions of the elbow flexors at 40, 60, 80, and 100% of maximal voluntary contraction (MVC). Force and bipolar SEMG activity were monitored concurrently. The mean spike amplitude (MSA) exhibited a linear increase across the four levels of force. The mean spike frequency (MSF) remained stable from 40 to 80% of MVC; it then decreased from 80 to 100% of MVC. There was a concomitant increase in mean spike slope (MSS) that indicates that the biceps brachii (BB) relied on the recruitment of higher threshold motor units (MUs) from 40 to 80% of MVC. However, there progressive decrease in the mean number of peaks per spike (MNPPS) that suggests that MU synchronization was additionally required to increase force from 80 to 100% of MVC. The spike shape measures, taken together, indicate that the decrease in frequency content of the signal was due to synchronization, not an increased probability of temporal overlap due an increase in rate-coding.

Firing properties of motor units during fatigue in subjects after stroke

The purpose of this work was to investigate the electromyographic (EMG) fatigue representations in muscles of subjects after stroke at the level of motor unit, based on the analysis of mean power frequency (MPF) in the power density spectrum (PDS) for intramuscular EMG and our previous modeling and experiment studies on the neuromuscular transmission failure (NTF). NTF due to the local muscular fatigue had been captured in motor unit signals from healthy subjects during a submaximal fatigue contraction previously. In this study, the EMG signals for the biceps brachii muscles were collected by needle electrodes from the affected and unaffected arms of six hemiplegic subjects after stroke, and from the dominated arm of six healthy subjects during a full maximum voluntary contraction (MVC) and a subsequent 20% MVC. The MPF of EMG trials detected intramuscularly during the full and 20% MVCs, and the parameters of motor unit action potential trains (MUAPTs) during 20% MVC were analyzed in three groups: the normal (from healthy subjects), unaffected (from subjects after stroke), and affected (from subjects after stroke). It was found that during the full MVC the MPFs of the normal and unaffected groups decreased more than the affected when monitored by a moving time window of 2 s. The comparison on the overall MPF during the full MVC for these three groups over the whole time course of the EMG signal (18 s) were: the affected overall MPF was higher than the unaffected (P < 0.05); and the unaffected overall MPF was larger than the normal (P < 0.05). However, no significant decrease in MPF was found for these three groups during 20% MVC. The NTF was captured in most MUAPTs in the groups of the normal and unaffected rather than in the affected group, symbolized by the lowered rates of change (RCs) of firing rate (FR) (P < 0.05), more MUAPTs with positive RCs of maximum oscillation (MO) in MUAPT power density spectra (P < 0.05), and the significant higher RCs of minimum inter-pulse interval (MINI) (P < 0.05) in the normal and unaffected compared to the affected group. Enhanced neural drives to the motor units of the unaffected and affected groups were observed during 20% MVC, which possibly came from the bilateral neural inputs due to the disinhibition of the ipsilateral projections in subjects after stroke. For identifying the fatigue associated with NTF, the motor unit firing parameters, FR, MINI, and MO, were more sensitive than the MPF. The results obtained in this work provided a further understanding on the EMG of the fatigue processes in paretic and non-paretic muscles during voluntary contractions.

Prediction of Intrauterine Pressure From Electrohysterography Using Optimal Linear Filtering

We propose a method of predicting intrauterine pressure (IUP) from external electrohysterograms (EHG) using a causal FIR Wiener filter. IUP and 8-channel EHG data were collected simultaneously from 14 laboring patients at term, and prediction models were trained and tested using 10-min windows for each patient and channel. RMS prediction error varied between 5-14 mmHg across all patients. We performed a 4-way analysis of variance on the RMS error, which varied across patients, channels, time (test window) and model (train window). The patient-channel interaction was the most significant factor while channel alone was not significant, indicating that different channels produced significantly different RMS errors depending on the patient. The channel-time factor was significant due to single-channel bursty noise, while time was a significant factor due to multichannel bursty noise. The time-model interaction was not significant, supporting the assumption that the random process generating the IUP and EHG signals was stationary. The results demonstrate the capabilities of optimal linear filter in predicting IUP from external EHG and offer insight into the factors that affect prediction error of IUP from multichannel EHG recordings.

Singularity Characteristics of Needle EMG IP Signals

Clinical electromyography (EMG) interference pattern (IP) signals can reveal more diagnostic information than their constituents, the motor unit action potentials (MUAPs). Singularities and irregular structures typically characterize the mathematically defined content of information in signals. In this paper, a wavelet transform method is used to detect and quantify the singularity characteristics of EMG IP signals using the Lipschitz exponent (LE) and measures derived from it. The performance of the method is assessed in terms of its ability to discriminate healthy, myopathic and neuropathic subjects and how it compares with traditionally used Turns Analysis (TA) methods and a method recently developed by the authors, interscale wavelet maximum (ISWM). Highly significant intergroup differences were found using the LE method. Most of the singularity measures have a performance similar to that of ISWM and considerably better than that of TA. Some measures such as the ratio of the mean LE value to the number of singular points in the signal have considerably superior performance to both methods. These findings add weight to the view that wavelet analysis methods offer an effective way forward in the quantitative analysis of EMG IP signal to assist the clinician in the diagnosis of neuromuscular disorders.

Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients

Temporomandibular disorders (TMD) are characterized by several signs and symptoms, such as pain and changes in the electrical activity of masticatory muscles. Considering that transcutaneous electrical nerve stimulation (TENS) is a resource indicated to promote analgesia, the objective of this study was to evaluate the effect of TENS on pain and electromyographic (EMG) activity of the jaw elevator muscles in TMD patients. This study evaluated 35 female volunteers: 19 TMD patients (mean age = 23.04 +/- 3.5) and 16 normal subjects (mean age = 23.3 +/- 3.0). Transcutaneous electrical nerve stimulation (conventional mode, 150 Hz) was applied once to each group for 45 minutes. Surface electromyography (gain of 100 times and 1 kHz sampling frequency) and the visual analogue scale (VAS) were applied before and immediately after TENS application. Both VAS data and root mean square (RMS) values were analyzed using Student's t-test. The TMD group, compared to the control group, showed higher EMG activity of the jaw elevator muscles at rest. No difference was observed between the groups regarding maximum voluntary clenching (MVC). In TMD patients, TENS reduced both pain and EMG activity of the anterior portion of the temporal muscle, increasing the activity of the masseter muscles during MVC. It is possible to conclude that a single TENS application is effective in pain reduction. However, it does not act homogeneously on the features of the electric activity of the muscles evaluated.

Biomechanical and electromyographic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy

This study evaluated the biomechanical and electromyographic effects of conventional ankle foot orthoses (AFOs) and dynamic ankle foot orthoses (DAFOs) on gait in patients with spastic cerebral palsy (CP). Thirteen patients with dynamic equinus underwent motion analysis with electromyography. Both AFOs and DAFOs provided longer stride length, permitted pre-positioning for initial contact, and successfully controlled the excessive plantarflexion during the swing phase. Median frequency (MF) of EMG signal indicated that extremely high firing was found in the patient's lower limbs compared to controls that resulted in tiredness. The DAFOs allowed a significantly larger total ankle range of motion than the AFOs. However, AFOs significantly reduced the MF while DAFOs did not. The reduced MF seen when wearing AFOs suggested an improvement of walking endurance. The DAFO had the advantage of less restriction on ankle movement, which avoids muscular atrophy and improves orthotic compliance.

Physiologically based simulation of clinical EMG signals

An algorithm that generates electromyographic (EMG) signals consistent with those acquired in a clinical setting is described. Signals are generated using a model constructed to closely resemble the physiology and morphology of skeletal muscle, combined with line source models of commonly used needle electrodes positioned in a way consistent with clinical studies. The validity of the simulation routines is demonstrated by comparing values of statistics calculated from simulated signals with those from clinical EMG studies of normal subjects. The simulated EMG signals may be used to explore the relationships between muscle structure and activation and clinically acquired EMG signals. The effects of motor unit (MU) morphology, activation, and neuromuscular junction activity on acquired signals can be analyzed at the fiber, MU and muscle level. Relationships between quantitative features of EMG signals and muscle structure and activation are discussed.

Effects of evoked pain on the electromyogram and compound muscle action potential of the brachial biceps muscle

Muscle pain is often accompanied by a feeling of muscle fatigue and weakness. We examined the effect of experimental muscle pain on the electromyogram (EMG) during maximal voluntary contraction (MVC), and on the compound muscle action potential (CMAP) of the brachial biceps muscle. Twenty-one healthy subjects were injected intramuscularly with 0.1 ml/30 microg of the vanilloid receptor agonist (capsaicin) or 0.2 ml of 5% hypertonic saline. A Teflon-coated cannulated EMG needle was used to record the EMG interference pattern (IP) at MVC. The CMAP of the brachial biceps muscle was obtained by stimulation of the musculocutaneous nerve at the axilla using surface electrodes. Amplitude, mean frequency of the power spectrum, and turns/s of the interference pattern were reduced after pain induced by capsaicin or hypertonic saline. Latency, amplitude, and area-under-curve of the CMAP did not change after injection of either substance. Acute stimulation of muscle nociceptors thus produced a fatiguelike change in the interference pattern during MVC, possibly due to a decrease in motoneuron firing rate and increased muscle fatigability.