Crosstalk in surface electromyography of the proximal forearm during gripping tasks

Effects of forearm rotation on wrist flexor and extensor muscle activities

The forearm muscles coordinately control wrist motion, and their activity is affected by forearm rotation. Although forearm rotation has been implicated in the development of lateral and medial epicondylitis, its biomechanical background remains unknown. Therefore, the present study investigated the activity of wrist muscles in various forearm positions. Surface electromyography of the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris was performed on 40 healthy upper limbs. We initially measured muscle strength and electromyographic activity (integrated electromyographic value per second) at maximum voluntary output towards wrist extension and flexion in a neutral position. We then assessed electromyographic activity under constant wrist torque (75% of maximum strength in the neutral position) in pronation, the neutral position, and supination. The percentage of maximum electromyographic activity was evaluated for each position. In wrist extension, the extensor carpi radialis brevis was activated during forearm pronation, while extensor carpi ulnaris activity did not change in any forearm position. In wrist flexion, the flexor carpi radialis was activated during forearm supination, while flexor carpi ulnaris activity was significantly lower with forearm pronation than in the neutral position. Since muscle activation increases traction force at the tendon origin, forearm positions that increase muscle activity may be a biomechanical risk factor for the development of tendinopathy. The present results are consistent with epidemiological and pathological findings on lateral and medial epicondylitis. These results provide insights into wrist biomechanics and the pathophysiology of lateral and medial epicondylitis.

Improving localization and measurements of M-waves using high-density surface electromyography

Surface electromyography (sEMG) is useful for studying muscle function and controlling prosthetics, but cross talk from nearby muscles often limits its effectiveness. High-density surface EMG (HD-sEMG) improves spatial resolution, allowing for the isolation of M-waves in the densely packed forearm muscles. This study assessed HD-sEMG for localizing M-waves and evaluated the impact of spatial filters on cross talk reduction. We administered peripheral nerve stimulation to activate forearm muscles in five participants. We analyzed cross talk by correlating the shape of M-waves between electrodes and used ultrasound to confirm muscle identity and location. At low-stimulation intensities, we successfully isolated M-waves with minimal cross talk without spatial filtering. Higher recruitment levels produced significant cross talk, which was reduced by applying bipolar or tripolar spatial filters. M-waves from the monopolar HD-sEMG montage showed high correlations between electrodes (r = 0.97 transversely; r = 0.95 longitudinally), while bipolar and tripolar montages showed lower correlations (bipolar: r = 0.41 transversely; r = 0.19 longitudinally; tripolar: r = 0.17 transversely; r = 0.01 longitudinally). The tripolar filter significantly reduced cross talk (51.10% amplitude decay one electrode away) compared with no filter (10.32% amplitude decay one electrode away), effectively reducing cross talk to negligible levels at distances ≥2.55 cm. Ultrasound was crucial for distinguishing true activation from artifacts caused by converging signals along muscle boundaries. Spatially filtered HD-sEMG accurately detects and isolates M-waves in the forearm, and ultrasound imaging is useful for verifying the location and identity of the muscles underlying the HD-sEMG grids.NEW & NOTEWORTHY This study introduces an innovative approach to enhancing evoked potential measurements using high-density surface electromyography (HD-sEMG). The precision and localization of evoked potentials are significantly improved by spatial filters and ultrasound imaging, offering a novel method for better assessing motor pathway integrity. These advancements could lead to more accurate tools for detecting and treating neurological deficits, making it a significant contribution to neurophysiological research.

Effects of wrist and finger posture on finger independence

Intended actions of one finger produce involuntary movement or force in other fingers. Mechanical and neural factors limit finger independence. The interplay between anatomical factors, wrist and finger postures, and finger independence remain unclear. The purpose of this study was to determine the effects of wrist and metacarpophalangeal (MCP) posture on involuntary finger forces and extensor digitorum (ED) activity. Twenty participants performed submaximal isometric finger extensions in three wrist positions (30° extension, neutral, and 30° flexion) and two MCP postures (straight and 90° flexion). Involuntary index finger force increased with MCP flexion, suggesting the importance of intertendinous connections in finger independence. Consistent with previous research, ED activity was generally higher in wrist extension than neutral and flexed postures. Understanding the role of passive properties within the hand may help us improve finger rehabilitation strategies.

Effects of the IronHand® Soft Exoskeleton on Forearm Muscle Activity During in Field Automotive Assembly Tasks

OCCUPATIONAL APPLICATIONSWhen compared to not using a soft-hand exoskeleton, the IronHand® caused both increases and decreases in forearm muscle activity while completing automotive assembly tasks. Surprisingly, although there were reductions in muscle activity when wearing the IronHand®, only a few of these decreases resulted in muscle activity changing such that they fell to below recommended ergonomic thresholds. Despite this, some individuals in our study clearly benefited from the device, and this suggests that there is potential for widespread use of such a device if fine tuned to the individual and task demands. Much work is still required for a design that will allow for optimal physical benefit.

Prediction of Dexterous Finger Forces With Forearm Rotation Using Motoneuron Discharges

Motor unit (MU) discharge information obtained via electromyogram (EMG) decomposition can be used to decode dexterous multi-finger movement intention for neural-machine interfaces (NMI). However, the variation of the motor unit action potential (MUAP) shape resulted from forearm rotation leads to the decreased performance of EMG decomposition, especially under the real-time condition and then the degradation of motion decoding accuracy. The object of this study was to develop a method to realize the accurate extraction of MU discharge information across forearm pronated/supinated positions in the real-time condition for dexterous multi-finger force prediction. The FastICA-based EMG decomposition technique was used and the proposed method obtained multiple separation vectors for each MU at different forearm positions in the initialization phase. Under the real-time condition, the MU discharge information was extracted adaptively using the separation vector extracted at the nearest forearm position. As comparison, the previous method that utilized a single constant separation vector to extract MU discharges across forearm positions and the conventional method that utilized the EMG amplitude information were also performed. The results showed that the proposed method obtained a significantly better performance compared with the other two methods, manifested in a larger coefficient of determination ( [Formula: see text] and a smaller root mean squared error (RMSE) between the predicted and recorded force. Our results demonstrated the feasibility and the effectiveness of the proposed method to extract MU discharge information during forearm rotation for dexterous force prediction under the real-time conditions. Further development of the proposed method could potentially promote the application of the EMG decomposition technique for continuous dexterous motion decoding in a realistic NMI application scenario.

Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque

Eccentric contractions of the wrist extensors worsen lateral epicondylitis (LE), whose pathophysiology may involve sex differences in wrist torque. This study aimed to investigate sex differences in wrist torque in patients with LE. The wrist extension and flexion torques of 22 patients with LE (11 males and 11 females) were measured. Maximum muscle output over time was measured for 20 s, initial torque was defined as muscle strength, and the degree of eccentric contraction was quantified and defined as the eccentric contraction index (ECI). The affected/unaffected side ratio of the wrist extensor, extensor/flexor ratio of muscle strength, and affected/unaffected side difference of ECI between sexes were statistically analyzed. Furthermore, correlations between wrist extensor torque, ECI, and Visual Analog Scale of pain during the examination were evaluated. Females were found to display lower affected/unaffected side ratios of the wrist extensor and wrist extension/flexion ratios for the affected side, compared with males; however, no differences were found in the wrist extension/flexion ratios for the unaffected side in both sexes. Additionally, females presented with larger differences between the affected and unaffected sides in the ECI. Based on correlations between wrist torques, ECI, and pain, females tended to suppress muscle output to prevent pain from eccentric contraction of wrist extensors more than males, which would induce an imbalance in muscle strength of the wrist extensors and flexors. This imbalance may result in chronic eccentric contraction of the wrist extensors with gripping, exacerbating LE.

Reducing Motor Variability Enhances Myoelectric Control Robustness Across Untrained Limb Positions

The limb position effect is a multi-faceted problem, associated with decreased upper-limb prosthesis control acuity following a change in arm position. Factors contributing to this problem can arise from distinct environmental or physiological sources. Despite their differences in origin, the effect of each factor manifests similarly as increased input data variability. This variability can cause incorrect decoding of user intent. Previous research has attempted to address this by better capturing input data variability with data abundance. In this paper, we take an alternative approach and investigate the effect of reducing trial-to-trial variability by improving the consistency of muscle activity through user training. Ten participants underwent 4 days of myoelectric training with either concurrent or delayed feedback in a single arm position. At the end of training participants experienced a zero-feedback retention test in multiple limb positions. In doing so, we tested how well the skill learned in a single limb position generalized to untrained positions. We found that delayed feedback training led to more consistent muscle activity across both the trained and untrained limb positions. Analysis of patterns of activations in the delayed feedback group suggest a structured change in muscle activity occurs across arm positions. Our results demonstrate that myoelectric user-training can lead to the retention of motor skills that bring about more robust decoding across untrained limb positions. This work highlights the importance of reducing motor variability with practice, prior to examining the underlying structure of muscle changes associated with limb position.

Understanding the biomechanics of the forearm during the dart thrower's motion

This study investigated the contribution of different forearm muscles, namely the flexor carpi ulnaris, extensor carpi radialis longus and brevis, extensor carpi ulnaris and flexor carpi radialis, during the dart thrower's motion. Thirteen healthy participants were recruited. The forearm muscle activation patterns during the dart thrower's motion were measured using surface electromyography. The average root mean square for the extensor carpi ulnaris was found to be the highest during the dart thrower's motion. Muscle activations during the dart thrower's motion were heterogeneous among the participants. The results suggest the rehabilitation protocol for patients with wrist injuries should be reconsidered.

Exploring forearm muscle coordination and training applications of various grip positions during maximal isometric finger dead-hangs in rock climbers

Background

Maximal isometric finger dead-hangs are used in rock climbing to strengthen finger flexors. Although various grip positions are often used when performing finger dead-hangs, little is known regarding how these grip positions can affect forearm muscle activity. Understanding how forearm muscles are recruited during dead-hangs could help foreseeing the potential for training of different grip positions. The aim of the present study was to explore the training applications of the various grip positions by comparing the activity of forearm muscles during maximal dead-hangs in rock climbers.

Materials & Methods

Twenty-five climbers performed maximal dead-hangs in three climbing-specific grip positions: CRIMP, SLOPE, and SLOPER. We recorded the maximal loads used and the sEMG of the flexor digitorum profundus (FDP), the flexor digitorum superficialis (FDS), the flexor carpi radialis (FCR), and the extensor digitorum communis (EDC). Individual and global (sum of all muscles) root mean square (RMS) and neuromuscular efficiency (NME) values were computed. Repeated measures analysis were performed to assess grip differences (p < 0.05).

Results

SLOPER showed the largest maximal load values among the three grip positions (p < 0.001, d ≥ 2.772). Greater global (p ≤ 0.044, d ≥ 0.268), FDS (p ≤ 0.005, d ≥ 0.277), and FCR (p < 0.001, d ≥ 1.049) activity was observed for the SLOPER compared to CRIMP and SLOPE, while EDC (p ≤ 0.005, d ≥ 0.505) showed lower activity in the SLOPER compared to the other two grip positions. SLOPER presented the highest global (p < 0.001, d ≥ 0.629), FDP (p < 0.001, d ≥ 0.777), FDS (only CRIMP vs SLOPER: p < 0.001, d = 0.140), and EDC NME (p < 0.001, d ≥ 1.194). The CRIMP showed greater FDS activity (p = 0.001, d = 0.386) and lower NME (p = 0.003, d = 0.125) compared to SLOPE.

Conclusions

These results revealed that, under maximum intensity conditions, SLOPER could stimulate the FDS and FCR better than the other grip positions at the expense of using greater loads. Similarly, maximum CRIMP dead-hang could better stimulate the FDS than the SLOPE, even when using similar loads.

Preservation of functional descending input to paralyzed upper extremity muscles in motor complete cervical spinal cord injury

OBJECTIVE

Spinal cord injury (SCI) is classified as complete or incomplete depending on the extent of sensorimotor preservation below the injury level. However, individuals with complete SCIs can voluntarily activate paralyzed lower limb muscles alone or by engaging non-paralyzed muscles during neurophysiological assessments, indicating presence of residual pathways across the injury. However, similar phenomena have not been explored for the upper extremity (UE) muscles following cervical SCIs.

METHODS

Eighteen individuals with motor complete cervical SCI (AIS A or B) and five age-matched non-injured (NI) individuals performed various UE events against manual resistance during functional neurophysiological assessment (FNPA), and electromyographic (EMG) activity was recorded from UE muscles.

RESULTS

Our findings demonstrated i) voluntary activation of clinically paralyzed muscles as evident from EMG readouts, ii) increased activity in these muscles during events engaging muscles above the injury level, iii) reduced spectral properties of paralyzed muscles in SCI compared to NI participants.

CONCLUSIONS

Functional EMG activity in clinically paralyzed muscles indicate presence of residual pathways across the injury establishing supralesional control over the sublesional neural circuitry.

SIGNIFICANCE

The findings may help explain the neurophysiological basis for UE recovery and can be exploited in designing rehabilitation techniques to facilitate UE recovery following cervical SCIs.

Effects of multidirectional elastic tape on forearm muscle activity and wrist extension during submaximal gripping in individuals with lateral elbow tendinopathy: A randomised crossover trial

BACKGROUND

Lateral elbow tendinopathy is associated with changes to forearm muscle activity and wrist posture during gripping. Multidirectional elastic tape is thought to exert a deloading effect on underlying musculotendinous structures, which could potentially alter muscle activity or wrist posture.

METHODS

This single-blinded randomised crossover trial compared the immediate effects of tensioned multidirectional elastic tape, untensioned control tape, and no tape, in individuals with lateral elbow tendinopathy. Muscle activity of extensor carpi radialis longus and brevis, extensor carpi ulnaris, and extensor digitorum and wrist extension angle were recorded during a submaximal gripping task. Muscle activity was normalised to the maximum amplitude recorded during maximal grip. Change scores were calculated (post-condition minus baseline). Repeated-measure analyses of variance were used to examine between-condition differences.

FINDINGS

27 participants (16 males, mean age (SD): 48.6 (11.9) years) underwent all conditions. Extensor digitorum muscle activity was reduced during the multidirectional elastic tape, compared to control tape and no tape (MD -5.6% [95%CI: -9.9 to -1.3], MD -5.8% [95%CI: -10.2 to -1.4], respectively). Extensor carpi ulnaris muscle activity was reduced during the multidirectional elastic tape, compared to the control tape (mean difference [MD] -3.2% [95%CI: -5.3 to -1.1]), but increased during the control tape, compared to the no tape (MD 2.9% [95%CI: 0.8 to 5.0]). No differences were observed in extensor carpi radialis brevis or longus muscle activity, or extension wrist angle between conditions.

INTERPRETATION

A decreased in extensor carpi ulnaris and extensor digitorum muscle activity during multidirectional elastic tape may be evidence of a deloading effect during submaximal gripping.

Changes of agonist and synergist muscles activity during a sustained submaximal brake-pulling gesture

We analyzed the time course of changes in muscle activity of the prime mover and synergist muscles during a sustained brake-pulling action and investigated the relationship between muscle activity and braking force fluctuation (FF). Thirty-two participants performed a continuous fatiguing protocol (CFP) at 30% of maximal voluntary contraction (MVC) until failure. Surface electromyography was used to analyze root mean square (RMS) values in the flexor digitorum superficialis (FD), flexor carpi radialis (FC), extensor digitorum communis (ED), extensor carpi radialis (EC), brachioradialis (BR), biceps brachii (BB), and triceps brachii (TB). The FF and RMS in all muscles increased progressively (P<0.01) during the CFP, with sharp increments at time limit particularly in FD and FC (P<0.001). The RMS of the FD and FC were comparable to the baseline MVC values at time limit, in comparison to the other muscles that did not reach such levels of activity (P<0.003). The three flexor/extensor ratios used to measure coactivation levels decreased significantly (P<0.001). In contrast to RMS, MVC was still depressed at the minute 10 of recovery. The results suggest that the time limit was mainly constrained by fatigue-related mechanisms of the FD and FC but not by those of other synergist and antagonist muscles.

Alterations in forearm muscle activation patterns after scapholunate interosseous ligament injury: A dynamic electromyography study

STUDY DESIGN

Case control.

PURPOSE OF THE STUDY

This study aimed to investigate the alterations seen in the activation patterns of the forearm muscles and to demonstrate the associated functional outcomes, in patients with scapholunate interosseous ligament (SLIL) injury.

METHODS

The study involved 15 patients with SLIL injury (instability group) and 11 healthy participants (control group). Both groups were evaluated with regard to their pain, grip strength, and upper extremity functional level (disabilities of the arm, shoulder and hand and patient-rated wrist evaluation questionnaires), and they also underwent a dynamic electromyography analysis of their forearm muscle activity. The activation patterns of the extensor carpi ulnaris (ECU), extensor carpi radialis (ECR), flexor carpi ulnaris, and flexor carpi radialis muscles during wrist extension and flexion were recorded by means of surface electromyography.

RESULTS

In the instability group, the pain severity was higher and the functional level was worse than in the control group (P < .05). Furthermore, during wrist extension, the ECR activity was lower and the ECU activity was higher in the instability group than in the control group (P < .05).

CONCLUSION

Dynamic stabilization of the wrist, flexor carpi ulnaris, and flexor carpi radialis muscles have been shown to play an active role with ECU and ECR. Increased ECU and decreased ECR activation may pose a potential risk in terms of enhancing the scapholunate gap. We, therefore, propose that appropriate preventive neuromuscular exercise strategies implemented as part of a physiotherapy program for patients with SLIL lesions might increase the contribution of the dynamic stability effect of the relevant muscles.

Electrode Size and Placement for Surface EMG Bipolar Detection from the Brachioradialis Muscle: A Scoping Review

The brachioradialis muscle (BRD) is one of the main elbow flexors and is often assessed by surface electromyography (sEMG) in physiology, clinical, sports, ergonomics, and bioengineering applications. The reliability of the sEMG measurement strongly relies on the characteristics of the detection system used, because of possible crosstalk from the surrounding forearm muscles. We conducted a scoping review of the main databases to explore available guidelines of electrode placement on BRD and to map the electrode configurations used and authors' awareness on the issues of crosstalk. One hundred and thirty-four studies were included in the review. The crosstalk was mentioned in 29 studies, although two studies only were specifically designed to assess it. One hundred and six studies (79%) did not even address the issue by generically placing the sensors above BRD, usually choosing large disposable ECG electrodes. The analysis of the literature highlights a general lack of awareness on the issues of crosstalk and the need for adequate training in the sEMG field. Three guidelines were found, whose recommendations have been compared and summarized to promote reliability in further studies. In particular, it is crucial to use miniaturized electrodes placed on a specific area over the muscle, especially when BRD activity is recorded for clinical applications.

A Systematic Review of EMG Applications for the Characterization of Forearm and Hand Muscle Activity during Activities of Daily Living: Results, Challenges, and Open Issues

The role of the hand is crucial for the performance of activities of daily living, thereby ensuring a full and autonomous life. Its motion is controlled by a complex musculoskeletal system of approximately 38 muscles. Therefore, measuring and interpreting the muscle activation signals that drive hand motion is of great importance in many scientific domains, such as neuroscience, rehabilitation, physiotherapy, robotics, prosthetics, and biomechanics. Electromyography (EMG) can be used to carry out the neuromuscular characterization, but it is cumbersome because of the complexity of the musculoskeletal system of the forearm and hand. This paper reviews the main studies in which EMG has been applied to characterize the muscle activity of the forearm and hand during activities of daily living, with special attention to muscle synergies, which are thought to be used by the nervous system to simplify the control of the numerous muscles by actuating them in task-relevant subgroups. The state of the art of the current results are presented, which may help to guide and foster progress in many scientific domains. Furthermore, the most important challenges and open issues are identified in order to achieve a better understanding of human hand behavior, improve rehabilitation protocols, more intuitive control of prostheses, and more realistic biomechanical models.

Upper limb position affects pain-free grip strength in individuals with lateral elbow tendinopathy

BACKGROUND AND PURPOSE

Pain-free grip (PFG) force is commonly used to monitor treatment outcomes in lateral elbow tendinopathy (LET); however, it is unclear whether changes in forearm and elbow position affect PFG force values. This study aims to examine the effect of elbow/shoulder and forearm position on non-normalised and normalised PFG force in individuals with unilateral LET.

METHODS

A cohort study including 21 subjects with clinically diagnosed unilateral LET (13 females, mean [SD] age 50 [8] years) performed PFG force (symptomatic arm) and maximal grip (asymptomatic arm) tasks using four upper limb positions: (1) shoulder neutral, elbow flexed (90°), forearm pronated; (2) shoulder neutral, elbow flexed (90°), forearm neutral; (3) shoulder flexed (90°), elbow extended, forearm pronated; and (4) shoulder flexed (90°), elbow extended, forearm neutral. PFG force was normalised to the maximal grip of the asymptomatic side. Repeated-measures analyses of variance were used to compare non-normalised and PFG force normalised to maximal grip between positions.

RESULTS

Both non-normalised and normalised PFG forces were greater in position 2 than position 1, position 3 and position 4 (elbow-by-forearm interaction non-normalised p = 0.002, normalised p = 0.004). There were no differences between positions 1, 3 and 4 for either non-normalised or normalised PFG strength.

DISCUSSION

This study shows that PFG force was higher when performed with forearm neutral supination/pronation, elbow flexion and shoulder neutral than other tested positions, and irrespective of whether PFG force was normalised to the maximal grip force of the contralateral limb. This indicates that arm position should be standardised for comparison.

Crosstalk in Mechanomyographic Signals From Elbow Flexor Muscles During Submaximal to Maximal Isometric Flexion, Pronation, and Supination Torque Tasks

This study analyzed the crosstalk in mechanomyographic (MMG) signals from elbow flexors during isometric muscle actions from 20% to 100% maximum voluntary isometric contraction (MVIC). Twenty-five young, healthy, male participants performed the isometric elbow flexion, forearm pronation, and supination tasks at an elbow joint angle of 90 deg. The MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were recorded using accelerometers. The cross-correlation coefficient was used to quantify the crosstalk in MMG signals, recorded in a direction transverse to muscle fiber axis, among the muscle pairs (P1: BB and BRA, P2: BRA and BRD, and P3: BB and BRD). In addition, the MMG RMS and MPF were quantified. The mean normalized RMS and mean MPF exhibited increasing (r > 0.900) and decreasing (r < -0.900) trends, respectively, with increases in the effort levels in all three tasks. The magnitude of crosstalk ranged from 0.915% to 21.565% in all three muscle pairs. The crosstalk was found to exhibit high positive correlations with submaximal to maximal flexion [P1 (r = 0.970), P2 (r = 0.951), and P3 (r = 0.824)], pronation [P1 (r = 0.811), P2 (r = 0.763), and P3 (r = 0.901)] and supination [P1 (r = 0.898), P2 (r = 0.838), and P3 (r = 0.852)] torque levels (eight out of nine p-values were < 0.05). Regardless of the high positive correlation between crosstalk and level of effort, the crosstalk remained at a low range (0.915-21.565%) with increases in the torque levels.

The Accurate Assessment of Muscle Excitation Requires the Detection of Multiple Surface Electromyograms

When sampling electromyograms (EMGs) with one pair of electrodes, it seems implicitly assumed the detected signal reflects the net muscle excitation. However, this assumption is discredited by observations of local muscle excitation. Therefore, we hypothesize that the accurate assessment of muscle excitation requires multiple EMG detection and consideration of electrode-fiber alignment. We advise prudence when drawing inferences from individually collected EMGs.

Inverse modelling to reduce crosstalk in high density surface electromyogram

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

Dynamic Wrist Flexion and Extension Fatigue Induced via Submaximal Contractions Similarly Impairs Hand Tracking Accuracy in Young Adult Males and Females

We evaluated the effects of muscle fatigue on hand-tracking performance in young adults. Differences were quantified between wrist flexion and extension fatigability, and between males and females. Participants were evaluated on their ability to trace a pattern using a 3-degrees-of-freedom robotic manipulandum before (baseline) and after (0, 1, 2, 4, 6, 8, and 10 mins) a submaximal-intensity fatigue protocol performed to exhaustion that isolated the wrist flexors or extensors on separate days. Tracking tasks were performed at all time points, while maximal voluntary contractions (MVCs) were performed at baseline, and 2, 6-, and 10-mins post-task termination. We evaluated movement smoothness (jerk ratio, JR), shape reproduction (figural error, FE), and target tracking accuracy (tracking error, TE). MVC force was significantly lower in females (p < 0.05), lower than baseline for all timepoints after task termination (p < 0.05), with no muscle group-dependent differences. JR did not return to baseline until 10-mins post-task termination (most affected), while FE returned at 4-mins post-task termination, and TE at 1-min post-task termination. Males tracked the target with significantly lower JR (p < 0.05), less TE (p < 0.05), and less FE (p < 0.05) than females. No muscle group-dependent changes in hand-tracking performance were observed. Based on this work, hand tracking accuracy is similarly impaired following repetitive submaximal dynamic wrist flexion or extension. The differences between male and female fatigability was independent of the changes in our tracking metrics.

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

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

Evaluation of Swallowing Related Muscle Activity by Means of Concentric Ring Electrodes

Surface electromyography (sEMG) can be helpful for evaluating swallowing related muscle activity. Conventional recordings with disc electrodes suffer from significant crosstalk from adjacent muscles and electrode-to-muscle fiber orientation problems, while concentric ring electrodes (CREs) offer enhanced spatial selectivity and axial isotropy. The aim of this work was to evaluate CRE performance in sEMG recordings of the swallowing muscles. Bipolar recordings were taken from 21 healthy young volunteers when swallowing saliva, water and yogurt, first with a conventional disc and then with a CRE. The signals were characterized by the root-mean-square amplitude, signal-to-noise ratio, myopulse, zero-crossings, median frequency, bandwidth and bilateral muscle cross-correlations. The results showed that CREs have advantages in the sEMG analysis of swallowing muscles, including enhanced spatial selectivity and the associated reduction in crosstalk, the ability to pick up a wider range of EMG frequency components and easier electrode placement thanks to its radial symmetry. However, technical changes are recommended in the future to ensure that the lower CRE signal amplitude does not significantly affect its quality. CREs show great potential for improving the clinical monitoring and evaluation of swallowing muscle activity. Future work on pathological subjects will assess the possible advantages of CREs in dysphagia monitoring and diagnosis.

Muscle activity and architecture as a predictor of hand-grip strength

BACKGROUND

Grip strength is a powerful predictor of disability as well as a good indicator of physical activity.

OBJECTIVES

This study aimed to relate ultrasound (US) and electromyography (EMG) simultaneously to maximum hand-grip strength during an isometric contraction.

APPROACH

This is a cross-sectional study. Data acquisition was done with a dynamometer, US and EMG. Outcome variables included maximum strength during the hand-grip gesture, maximum muscle activity and change in muscle thickness. A non-linear regression analysis was performed to analyse the relationship between all outcome variables.

MAIN RESULTS

A total of 38 subjects (18 men and 20 women) participated in the study. The mean results for hand-grip strength were 25.50 (SD 6.55) kg of maximum strength, a change in muscle thickness of 1.83 (SD 0.75) mm and an EMG activity of 499.29 (SD 224.20) µV. Hand-grip strength had a high correlation with muscle thickness (R ² = 0.61) and EMG activity (R ² = 0.95). The correlation between maximum muscle activity and change in muscle thickness was R ² = 0.83.

SIGNIFICANCE

The results of the present study demonstrate that this new method based on electromyographic activity and muscule architecture could be important in the development of the hand-grip test.

Non-invasive assessment of motor unit activation in relation to motor neuron level and lesion location in stroke and spinal muscular atrophy

BACKGROUND

Neuromuscular disorders e.g. spinal muscular atrophy and stroke have a negative impact on functional movement capability. These disorders affect lower and upper motor neurons respectively.

METHODS

In this study high spatial resolution electromyography was used to record the motor unit activity in 3 groups: healthy subjects, a spinal muscular atrophy group and a stroke group. 7 clinically sensitive parameters were used to analyze the activation patterns of a few motor units.

FINDINGS

In the case of spinal muscular atrophy there was no effect on motor unit activation but on their number. Stroke was characterized by fewer active motor units and a significantly reduced firing rate with low variability.

INTERPRETATION

The results suggest, that for stroke, information from the brain is modified thereby resulting in motor units firing at their natural frequency. Thus, high spatial resolution electromyography and the chosen parameters facilitate non-invasive, objective differentiation and analysis of the activation patterns of motor units in neuromuscular disorders.

Automatic Detection of Contracting Muscle Regions via the Deformation Field of Transverse Ultrasound Images: A Feasibility Study

Accurate identification of contracting muscles can help us to understand the muscle function in both physiological and pathological conditions. Conventional electromyography (EMG) have limited access to deep muscles, crosstalk, or instability in the recordings. Accordingly, a novel framework was developed to detect contracting muscle regions based on the deformation field of transverse ultrasound images. We first estimated the muscle movements in a stepwise calculation, to derive the deformation field. We then calculated the divergence of the deformation field to locate the expanding or shrinking regions during muscle contractions. Two preliminary experiments were performed to evaluate the feasibility of the developed algorithm. Using concurrent intramuscular EMG recordings, Experiment I verified that the divergence map can capture the activity of superficial and deep muscles, when muscles were activated voluntarily or through electrical stimulation. Experiment II verified that the divergence map can only capture contracting muscles but not muscle shortening during passive movements. The results demonstrated that the divergence can individually capture the activity of muscles at different depths, and was not sensitive to muscle shortening during passive movements. The proposed framework can automatically detect the regions of contracting muscle, and could potentially serve as a tool to assess the functions of a group of muscles concurrently.

Effects of Mental Effort on Premotor Muscle Activity and Maximal Grip Force

The present study sought to evaluate how mental effort modulates premotor activity within forearm muscles in the context of an isometric grasping task. Muscle activity of the flexor digitorum superficialis (FDS) and extensor digitorum communis (EDC) was recorded during the application of maximum grip forces in nineteen healthy adult subjects. Each subject was examined under two experimental conditions: 1) spontaneous initiation of grasp (SI) and 2) focused concentration preceding the initiation of grasp (CA). Two novel parameters, the mean premotor duration (MPD) and the mean premotor power (MPP) were used to distinguish patterns of muscle activity. Here we tested the hypothesis was maximal grip strength is primed by muscle activity during the premotor phase. Our results demonstrate that MPD for each muscle group was significantly longer in the CA condition than for the SI condition (BF₁₀ = 491497) and that MPP was significantly greater in EDC than in FDS (BF₁₀ = 4305). Furthermore, both the MPD and MPP of the EDC were significantly correlated with maximum grip force. These results suggest that the increase of premotor activity consequent to the mental effort (focused concentration) may support internal biomechanical and physiological mechanisms which serve to enhance patterns of neuromuscular synergies.

Stable, three degree-of-freedom myoelectric prosthetic control via chronic bipolar intramuscular electrodes: a case study

Background

Modern prosthetic hands are typically controlled using skin surface electromyographic signals (EMG) from remaining muscles in the residual limb. However, surface electrode performance is limited by changes in skin impedance over time, day-to-day variations in electrode placement, and relative motion between the electrodes and underlying muscles during movement: these limitations require frequent retraining of controllers. In the presented study, we used chronically implanted intramuscular electrodes to minimize these effects and thus create a more robust prosthetic controller.

Methods

A study participant with a transradial amputation was chronically implanted with 8 intramuscular EMG electrodes. A K Nearest Neighbor (KNN) regression velocity controller was trained to predict intended joint movement direction using EMG data collected during a single training session. The resulting KNN was evaluated over 12 weeks and in multiple arm posture configurations, with the participant controlling a 3 Degree-of-Freedom (DOF) virtual reality (VR) hand to match target VR hand postures. The performance of this EMG-based controller was compared to a position-based controller that used movement measured from the participant’s opposite (intact) hand. Surface EMG was also collected for signal quality comparisons.

Results

Signals from the implanted intramuscular electrodes exhibited less crosstalk between the various channels and had a higher Signal-to-Noise Ratio than surface electrode signals. The performance of the intramuscular EMG-based KNN controller in the VR control task showed no degradation over time, and was stable over the 6 different arm postures. Both the EMG-based KNN controller and the intact hand-based controller had 100% hand posture matching success rates, but the intact hand-based controller was slightly superior in regards to speed (trial time used) and directness of the VR hand control (path efficiency).

Conclusions

Chronically implanted intramuscular electrodes provide negligible crosstalk, high SNR, and substantial VR control performance, including the ability to use a fixed controller over 12 weeks and under different arm positions. This approach can thus be a highly effective platform for advanced, multi-DOF prosthetic control.

Myoelectric signals and pattern recognition from implanted electrodes in two TMR subjects with an osseointegrated communication interface

Permanent implantation of electrodes for prosthetic control is now possible using an osseointegrated implant as a long-term stable communication interface (e-OPRA). The number of myoelectric sites to host such electrodes can be increased by Targeted Muscle Reinnervation (TMR). Traditionally, patients need to wait several months before the TMR signals are strong enough to be recorded by electrodes placed over the skin. In this study, we report the evolution of the TMR myoelectric signals recorded from two subjects via implanted electrodes using e-OPRA, and monitored for up to 48 weeks after surgery. The signals were analyzed with regard to amplitude (signal-to-noise ratio), independence (cross-correlation) and myoelectric pattern recognition (classification accuracy). TMR signals appeared at the first follow-up, one month post-surgery, and developed around 20 dB by the last. Cross-correlation between signals decreased over time and converged to a few percentage points. Classification accuracies were over 97% by the last follow up. These preliminary results suggest that implanted electrodes via the e-OPRA interface allow for an earlier and more effective use of motor signals from TMR sites compared to conventional skin surface electrodes.

Changes in the Muscle Activity of Gymnasts During a Handstand on Various Apparatus

Kochanowicz, A, Niespodziński, B, Mieszkowski, J, Marina, M, Kochanowicz, K, and Zasada, M. Changes in the muscle activity of gymnasts during a handstand on various apparatus. J Strength Cond Res 33(6): 1609-1618, 2019-Gymnasts perform handstands on various apparatus, both in stable and unstable conditions. Such performances require specific muscle activation, which should differ depending on the condition and expertise of the gymnast. Therefore, the aim of the study was to evaluate (a) the difference in electromyography (EMG) between handstands performed on 3 apparatus (floor, rings, and parallel bars); and (b) the difference between young and well-trained adult gymnasts. Ten adult (25 ± 3.94 years) and 15 young (13.9 ± 0.7 years) gymnasts participated in the study. We investigated EMG amplitude in 13 muscles normalized by arbitrary angle maximal isometric voluntary contraction (normalized root mean square [NRMS]). In comparison with the handstand on the floor (61 ± 28%), the wrist flexor muscles of gymnasts exhibited a decreased NRMS on the parallel bars (44 ± 25%; p = 0.017), and rings (46 ± 32%; p = 0.029), whereas no changes were observed in the triceps brachii. The rest of the investigated muscles showed a higher NRMS in rings. Differences between young and adult gymnasts were seen in the triceps brachii and anterior deltoid muscles, where more experienced gymnasts showed 19.1% (p = 0.014) and 17.6% (p = 0.048) lower NRMS, respectively. The different gymnastic apparatus led to specific muscle activation. This activation predominantly depended on hand support conditions, which alternated the primary wrist strategy of the handstand balance control, and in consequence, the activation of other muscles controlling balance. Training focused on the development of motor control and strength of the anterior deltoid, pectoralis major, latissimus dorsi, biceps brachii, and trapezius descendens muscles to improve handstand performance.

Model-Based Estimation of Individual Muscle Force Based on Measurements of Muscle Activity in Forearm Muscles During Isometric Tasks

OBJECTIVE

Several forward dynamics estimation approaches have been proposed to estimate individual muscle force. However, characterization of the estimation error that arises when measurements are available only from a subset of the muscles involved in the movement under analysis, as is the case of the forearm muscles, has been limited. Our objectives were: first, to quantify the accuracy of forward-dynamics muscle force estimators for forearm muscles; and second, to develop a muscle force estimator that is accurate even when measurements are available only from a subset of muscles acting on a given joint or segment.

METHODS

We developed a neuromusculoskeletal (NMSK) estimator that integrates forward dynamics estimation with a neural model of muscle cocontraction to estimate individual muscle force during isometric contractions, suitable to operate when measurements are not available for all muscles. We developed a computational framework to assess the effect of physiological variability in muscle cocontraction, cross-talk, and measurement error on the estimator accuracy using a sensitivity analysis. We thus compared the performance of our estimator with that of a standard estimator that neglects the contribution of unmeasured muscles.

RESULTS

The NMSK estimator reduces the estimation error by 25% in average noise conditions. Moreover, the NMSK estimator is robust against physiological variability in muscle cocontraction and outperforms the standard estimator even when the validity of the neural model is compromised.

CONCLUSION AND SIGNIFICANCE

In isometric tasks, the NMSK estimator reduces muscle force estimation error compared to a standard estimator, and may enable future applications involving estimation of forearm muscle force during coordinated movements.

The effect of two types of maximal voluntary contraction and two electrode positions in field recordings of forearm extensor muscle activity during hotel room cleaning

Purpose. This study aimed to investigate the effects of using hand grip or resisted wrist extension as the reference contraction, and two electrode positions, on field recordings of forearm extensor muscle activity. Materials and methods. Right forearm extensor muscle activity was recorded using two electrode pairs (over the most prominent part (position 2) and proximal to that (position 1)) during one working day in 13 female hotel housekeepers. Each subject performed the two maximal voluntary contractions (MVCs), and the electrical activity obtained during these (maximal voluntary electrical activity (MVE)) was used for normalization. Each set of recordings was analysed twice, once using hand grip as the MVC and once using resisted wrist extension. Results. Resisted wrist extension showed a higher group mean MVE than hand grip. Position 2 had higher correlation between MVE and force during the MVCs. The workload during cleaning was lower when using resisted wrist extension as reference than when using hand grip (24%MVE vs 46%MVE; p = 0.002 at position 2) for the 90th percentile. The workload (99th percentile) was overestimated in two subjects when using hand grip as reference. Conclusions. Problems associated with poorly activated forearm extensors can be overcome by using resisted wrist extension as reference.

Influence of Sacroiliac Bracing on Muscle Activation Strategies During 2 Functional Tasks in Standing-Tolerant and Standing-Intolerant Individuals

People who develop low back pain during standing (standing-intolerant) are a subclinical group at risk for clinical low back pain. Standing-intolerant individuals respond favorably to stabilization exercise and may be similar to people with sacroiliac joint dysfunction that respond to stabilization approaches including sacroiliac joint (SIJ) bracing. The purpose was to characterize muscle activation and response to SIJ bracing in standing-tolerant and standing-intolerant individuals during forward flexion and unilateral stance. Trunk and hip electromyography data were collected from 31 participants (17 standing-tolerant and 14 standing-intolerant) while performing these tasks with and without SIJ bracing. Kinematics were captured concurrently and used for movement phase identification. Cross-correlation quantified trunk coactivation and extensor timing during return-to-stand from forward flexion; root mean square amplitude quantified gluteal activity during unilateral stance. The standing-intolerant group had elevated erector spinae-external oblique coactivation without bracing, and erector spinae-internal oblique coactivation with bracing during return-to-stand compared with standing-tolerant individuals. Both groups reversed extensor sequencing during return-to-stand with bracing. Standing-tolerant individuals had higher hip abductor activity in nondominant unilateral stance and increased hip extensor activity with bracing. SIJ bracing could be a useful adjunct to other interventions targeted toward facilitating appropriate muscle activation in standing-intolerant individuals.

Finite element analysis of knee and ankle joint during gait based on motion analysis

Contact pressures in the articular cartilage during gait affect injuries and the degenerative arthritis of knee and ankle joints. However, only contact forces at the knee and ankle joints during gait can be estimated by using a rigid body dynamic model. The contact pressure distribution can be obtained quantitatively for a static posture by using finite element (FE) analysis in most cases. The purpose of this study is to develop a new method to obtain the contact pressure distribution at the knee and ankle joints during gait by integrating FE analysis with rigid body dynamic analysis. In this method, a reference FE model of the lower extremity is constructed first and is then transformed to each stance phase of the gait obtained from dynamic analysis by using homogeneous transformation. The muscle forces and ground reaction force (GRF) during gait obtained from the dynamic analysis were used as loading conditions for FE analysis. Finally, the contact pressure distribution at the tibia plateau cartilage and talus cartilage were estimated at the 1st peak, mid-stance, and the 2nd peak at the same time. The present method can provide the contact pressure distribution at the knee and ankle joints over the entire gait.

A review on crosstalk in myographic signals

PURPOSE

Crosstalk in myographic signals is a major hindrance to the understanding of local information related to individual muscle function. This review aims to analyse the problem of crosstalk in electromyography and mechanomyography.

METHODS

An initial search of the SCOPUS database using an appropriate set of keywords yielded 290 studies, and 59 potential studies were selected after all the records were screened using the eligibility criteria. This review on crosstalk revealed that signal contamination due to crosstalk remains a major challenge in the application of surface myography techniques. Various methods have been employed in previous studies to identify, quantify and reduce crosstalk in surface myographic signals.

RESULTS

Although correlation-based methods for crosstalk quantification are easy to use, there is a possibility that co-contraction could be interpreted as crosstalk. High-definition EMG has emerged as a new technique that has been successfully applied to reduce crosstalk.

CONCLUSIONS

The phenomenon of crosstalk needs to be investigated carefully because it depends on many factors related to muscle task and physiology. This review article not only provides a good summary of the literature on crosstalk in myographic signals but also discusses new directions related to techniques for crosstalk identification, quantification and reduction. The review also provides insights into muscle-related issues that impact crosstalk in myographic signals.

A comparison of fine wire insertion techniques for deep finger flexor muscle electromyography

INTRODUCTION

Intramuscular electromyography electrodes targeting flexor digitorum profundus (FDP) are inserted via the anterior or medial aspect of the forearm. These two methods pose different risks to neurovascular structures which overly FDP. This study aimed to compare the insertion depth and consider advantages and limitations of two different techniques to insert intramuscular electrodes into FDP.

METHODS

Using ultrasound imaging, neurovascular structures were identified along the path of FDP electrode insertion at the junction of the proximal and middle third of the ulna, bilaterally, in ten healthy individuals. Insertion depth was compared between the anterior and medial approaches for the mid muscle belly and targeted insertion to the index finger fascicle of FDP.

RESULTS

In our sample the ulnar artery was superficial to the FDP muscle when viewed anteriorly and was beyond the furthest border of FDP when viewed medially. Compared to the anterior approach, the medial insertion depth was 1.5 cm (95%CI 1.4-1.7, p < 0.001) less to the mid-belly of FDP and 0.6 cm (95%CI 0.4-0.7, p < 0.001) less to the index finger fascicle of FDP.

DISCUSSION

The medial approach involves less depth and lower risk for perforation of neurovascular structures when inserting intramuscular electrodes into the FDP muscle.

Virtual Sensor of Surface Electromyography in a New Extensive Fault-Tolerant Classification System

A few prosthetic control systems in the scientific literature obtain pattern recognition algorithms adapted to changes that occur in the myoelectric signal over time and, frequently, such systems are not natural and intuitive. These are some of the several challenges for myoelectric prostheses for everyday use. The concept of the virtual sensor, which has as its fundamental objective to estimate unavailable measures based on other available measures, is being used in other fields of research. The virtual sensor technique applied to surface electromyography can help to minimize these problems, typically related to the degradation of the myoelectric signal that usually leads to a decrease in the classification accuracy of the movements characterized by computational intelligent systems. This paper presents a virtual sensor in a new extensive fault-tolerant classification system to maintain the classification accuracy after the occurrence of the following contaminants: ECG interference, electrode displacement, movement artifacts, power line interference, and saturation. The Time-Varying Autoregressive Moving Average (TVARMA) and Time-Varying Kalman filter (TVK) models are compared to define the most robust model for the virtual sensor. Results of movement classification were presented comparing the usual classification techniques with the method of the degraded signal replacement and classifier retraining. The experimental results were evaluated for these five noise types in 16 surface electromyography (sEMG) channel degradation case studies. The proposed system without using classifier retraining techniques recovered of mean classification accuracy was of 4% to 38% for electrode displacement, movement artifacts, and saturation noise. The best mean classification considering all signal contaminants and channel combinations evaluated was the classification using the retraining method, replacing the degraded channel by the virtual sensor TVARMA model. This method recovered the classification accuracy after the degradations, reaching an average of 5.7% below the classification of the clean signal, that is the signal without the contaminants or the original signal. Moreover, the proposed intelligent technique minimizes the impact of the motion classification caused by signal contamination related to degrading events over time. There are improvements in the virtual sensor model and in the algorithm optimization that need further development to provide an increase the clinical application of myoelectric prostheses but already presents robust results to enable research with virtual sensors on biological signs with stochastic behavior.

Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders

BACKGROUND:

Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable.

OBJECTIVE:

To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning.

METHODS:

Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions.

RESULTS:

The group mean EMG amplitudes for resisted wrist extension were 1.2–1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip.

CONCLUSIONS:

The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

A new therapeutic application of brain-machine interface (BMI) training followed by hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for patients with severe hemiparetic stroke: A proof of concept study

BACKGROUND

Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy improved paretic upper extremity motor function in patients with severe to moderate hemiparesis. We hypothesized that brain machine interface (BMI) training would be able to increase paretic finger muscle activity enough to apply HANDS therapy in patients with severe hemiparesis, whose finger extensor was absent.

OBJECTIVE

The aim of this study was to assess the efficacy of BMI training followed by HANDS therapy in patients with severe hemiparesis.

METHODS

Twenty-nine patients with chronic stroke who could not extend their paretic fingers were participated this study. We applied BMI training for 10 days at 40 min per day. The BMI detected the patients' motor imagery of paretic finger extension with event-related desynchronization (ERD) over the affected primary sensorimotor cortex, recorded with electroencephalography. Patients wore a motor-driven orthosis, which extended their paretic fingers and was triggered with ERD. When muscle activity in their paretic fingers was detected with surface electrodes after 10 days of BMI training, we applied HANDS therapy for the following 3 weeks. In HANDS therapy, participants received closed-loop, electromyogram-controlled, neuromuscular electrical stimulation (NMES) combined with a wrist-hand splint for 3 weeks at 8 hours a day. Before BMI training, after BMI training, after HANDS therapy and 3month after HANDS therapy, we assessed Fugl-Meyer Assessment upper extremity motor score (FMA) and the Motor Activity Log14-Amount of Use (MAL-AOU) score.

RESULTS

After 10 days of BMI training, finger extensor activity had appeared in 21 patients. Eighteen of 21 patients then participated in 3 weeks of HANDS therapy. We found a statistically significant improvement in the FMA and the MAL-AOU scores after the BMI training, and further improvement was seen after the HANDS therapy.

CONCLUSION

Combining BMI training with HANDS therapy could be an effective therapeutic strategy for severe UE paralysis after stroke.

Specificity of surface EMG recordings for gastrocnemius during upright standing

The relatively large pick-up volume of surface electrodes has for long motivated the concern that muscles other than that of interest may contribute to surface electromyograms (EMGs). Recent findings suggest however the pick-up volume of surface electrodes may be smaller than previously appreciated, possibly leading to the detection of surface EMGs insensitive to muscle activity. Here we combined surface and intramuscular recordings to investigate how comparably action potentials from gastrocnemius and soleus are represented in surface EMGs detected with different inter-electrode distances. We computed the firing instants of motor units identified from intramuscular EMGs detected from gastrocnemius and soleus while five participants stood upright. We used these instants to trigger and average surface EMGs detected from multiple skin regions along gastrocnemius. Results from 66 motor units (whereof 31 from gastrocnemius) revealed the surface-recorded amplitude of soleus action potentials was 6% of that of gastrocnemius and did not decrease for inter-electrode distances smaller than 4 cm. Gastrocnemius action potentials were more likely detected for greater inter-electrode distances and their amplitude increased steeply up to 5 cm inter-electrode distance. These results suggest that reducing inter-electrode distance excessively may result in the detection of surface EMGs insensitive to gastrocnemius activity without substantial attenuation of soleus crosstalk.

Musculoskeletal model-based control interface mimics physiologic hand dynamics during path tracing task

OBJECTIVE

We investigated the feasibility of a novel, customizable, simplified EMG-driven musculoskeletal model for estimating coordinated hand and wrist motions during a real-time path tracing task.

APPROACH

A two-degree-of-freedom computational musculoskeletal model was implemented for real-time EMG-driven control of a stick figure hand displayed on a computer screen. After 5-10 minutes of undirected practice, subjects were given three attempts to trace 10 straight paths, one at a time, with the fingertip of the virtual hand. Able-bodied subjects completed the task on two separate test days.

MAIN RESULTS

Across subjects and test days, there was a significant linear relationship between log-transformed measures of accuracy and speed (Pearson's r  =  0.25, p  <  0.0001). The amputee subject could coordinate movement between the wrist and MCP joints, but favored metacarpophalangeal joint motion more highly than able-bodied subjects in 8 of 10 trials. For able-bodied subjects, tracing accuracy was lower at the extremes of the model's range of motion, though there was no apparent relationship between tracing accuracy and fingertip location for the amputee. Our result suggests that, unlike able-bodied subjects, the amputee's motor control patterns were not accustomed to the multi-joint dynamics of the wrist and hand, possibly as a result of post-amputation cortical plasticity, disuse, or sensory deficits.

SIGNIFICANCE

To our knowledge, our study is one of very few that have demonstrated the real-time simultaneous control of multi-joint movements, especially wrist and finger movements, using an EMG-driven musculoskeletal model, which differs from the many data-driven algorithms that dominate the literature on EMG-driven prosthesis control. Real-time control was achieved with very little training and simple, quick (~15 s) calibration. Thus, our model is potentially a practical and effective control platform for multifunctional myoelectric prostheses that could restore more life-like hand function for individuals with upper limb amputation.

The influence of different non-articular proximal forearm orthoses (brace) widths in the wrist extensors muscle activity, range of motion and grip strength in healthy volunteers

PURPOSE

The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects.

METHODS

Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects.

RESULTS

According to our findings the non-articular proximal forearm orthoses (2.5 cm - narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01).

CONCLUSIONS

A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to confirm these findings.