Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects

Can intermittent changes in trunk extensor muscle length delay muscle fatigue development?

Muscle length changes may evoke alternating activity and consequently reduce local fatigue and pain during prolonged static bending. The aim of this study was to assess whether a postural intervention involving intermittent trunk extensor muscle length changes (INTERMITTENT) can delay muscle fatigue during prolonged static bending when compared to a near-isometric condition (ISOMETRIC) or when participants were allowed to voluntarily vary muscle length (VOLUNTARY). These three conditions were completed by 11 healthy fit male participants, in three separate sessions of standing with 30 ± 3 degrees trunk inclination until exhaustion. Conventional and high-density electromyography (convEMG and HDsEMG, respectively) were measured on the left and right side of the spine, respectively. The endurance time for INTERMITTENT was 33.6% greater than ISOMETRIC (95% CI: [3.8, 63.5]; p = 0.027) and 29.4% greater than VOLUNTARY (95% CI: [7.0, 51.7]; p = 0.010), but not different between ISOMETRIC and VOLUNTARY. The convEMG and HDsEMG amplitude coefficient of variation was significantly greater for INTERMITTENT versus ISOMETRIC. The rate of change in convEMG and HDsEMG spectral content did not reveal significant differences between conditions as found in endurance time. Additional regression analyses between endurance time and rate of change in convEMG (p > 0.05) and HDsEMG (R2 = 0.39-0.65, p = 0.005-0.039) spectral content indicated that HDsEMG better reflects fatigue development in low-level contractions. In conclusion, imposed intermittent trunk extensor muscle length changes delayed muscle fatigue development when compared to a near-isometric condition or when participants were allowed to voluntarily vary muscle length, possibly due to evoking alternating activity between/within trunk extensor muscles.

A novel motorized office chair causes low-amplitude spinal movements and activates trunk muscles: A cross-over trial

INTRODUCTION

Inactivity and long periods of sitting are common in our society, even though they pose a health risk. Dynamic sitting is recommended to reduce this risk. The purpose of this study was to investigate the effect of continuous passive motion (CPM) conducted by a novel motorized office chair on lumbar lordosis and trunk muscle activation, oxygen uptake and attentional control.

STUDY DESIGN

Randomized, single-session, crossover with two periods/conditions.

METHODS

Twenty office workers (50% women) sat for one hour on the motorized chair, one half with CPM, the other not. The starting condition (CPM/no CPM) was switched in half of the sample. The participants were equipped with a spirometric cart, surface EMG, the Epionics SPINE system and performed a computer-based test for attentional control (AX-CPT). Outcomes were lumbar sagittal movements and posture, number of trunk muscle activations, attentional control and energy expenditure.

RESULTS

The CPM of the chair causes frequent low-amplitude changes in lumbar lordosis angle (moved: 498 ± 133 vs. static: 45 ± 38) and a higher number of muscle activations. A periodic movement pattern of the lumbar spine according to the movement of the chair was observed in every participant, although, sitting behavior varied highly between individuals. Attentional control was not altered in the moved condition (p = .495; d = .16). Further, oxygen uptake did not increase higher than 1.5 MET.

CONCLUSION

The effects of the motorized chair can be particularly useful for people with static sitting behavior. Further studies should investigate, whether CPM provides the assumed beneficial effects of dynamic sitting on the spine.

Trunk extensor muscle endurance and its relationship to action potential conduction velocity and spectral parameters estimated using high-density electromyography

Trunk extensor muscle fatigue typically manifests as a decline in spectral content of surface electromyography. However, previous research on the relationship of this decline with trunk extensor muscle endurance have shown inconsistent results. The decline of spectral content mainly reflects the decrease in average motor unit action potential conduction velocity (CV). We evaluated whether the rate of change in CV, as well as two approaches employing the change in spectral content, are related to trunk extensor muscle endurance. Fourteen healthy male participants without a low-back pain history performed a non-strictly controlled static forward trunk bending trial until exhaustion while standing. For 13 participants, physiologically plausible CV estimates were obtained from high-density surface electromyography bilaterally from T6 to L5. Laterally between L1 and L2, the linear rate of CV change was strongly correlated to endurance time (R2 = 0.79), whereas analyses involving the linear rate of change in spectral measures showed a lower (R2 = 0.38) or no correlation. For medial electrode locations, estimating CV and its relationship with endurance time was less successful, while the linear rate of change in spectral measures correlated moderately to endurance time (R2 = 0.44; R2 = 0.56). This study provides guidance on monitoring trunk extensor muscle fatigue development using electromyography.

A method to quantify the reduction of back and hip muscle fatigue of lift-support exoskeletons

Cumulative back muscle fatigue plays a role in the occurrence of low-back injuries in occupations that require repetitive lifting of heavy loads and working in forward leaning postures. Lift-support exoskeletons have the potential to reduce back and hip muscle activity, thereby delaying the onset of fatigue in these muscles. Therefore, exoskeletons are being considered a potentially important tool to further reduce workload-related injuries. However, today no standards have been established on how to benchmark the support level of lift-support exoskeletons. This work proposes an experimental protocol to quantify the support level of a lift-support exoskeletons on instant changes in muscle activity and fatigue development while maintaining a static forward leaning posture. It then applies the protocol to experimentally assess the effect of the support provided by a commercially available lift-support exoskeleton, the LiftSuit 2.0 (Auxivo AG, Schwerzenbach, Switzerland), on the user. In a sample of 14 participants, the amplitude of the muscle activity of the back muscles and hip muscles () was significantly reduced. Wearing the exoskeleton significantly reduced the amount of fatigue developed during the task (). Changes in muscle fatigue can be objectively recorded and correlated with relevant changes for exoskeleton users: the time a task can be performed and perceived low-back fatigue. Thus, including such measures of fatigue in standardized benchmarking procedures will help quantify the benefits of exoskeletons for occupational use.

An Occupational Shoulder Exoskeleton Reduces Muscle Activity and Fatigue During Overhead Work

Objective. This paper assesses the effect of a passive shoulder exoskeleton prototype, Exo4Work, on muscle activity, muscle fatigue and subjective experience during simulated occupational overhead and non-overhead work. Methods. Twenty-two healthy males performed six simulated industrial tasks with and without Exo4Work exoskeleton in a randomized counterbalanced cross-over design. During these tasks electromyography, heart rate, metabolic cost, subjective parameters and performance parameters were acquired. The effect of the exoskeleton and the body side on these parameters was investigated. Results. Anterior deltoid activity and fatigue reduced up to 16% and 41%, respectively, during isometric overhead work, and minimized hindrance of the device during non-overhead tasks. Wearing the exoskeleton increased feelings of frustration and increased discomfort in the areas where the exoskeleton and the body interfaced. The assistive effect of the exoskeleton was less prominent during dynamic tasks. Conclusion. This exoskeleton may reduce muscle activity and delay development of muscle fatigue in an overhead working scenario. For dynamic applications, the exoskeleton's assistive profile, which mimics the gravitational torque of the arm, is potentially sub-optimal. Significance. This evaluation paper is the first to report reduced muscle fatigue and activity when working with an occupational shoulder exoskeleton providing one third of the gravitational torque of the arm during overhead work. These results stress the potential of occupational shoulder exoskeletons in overhead working situations and may direct towards longitudinal field experiments. Additionally, this experiment may stimulate future work to further investigate the effect of different assistive profiles.

The neuromuscular responses in patients with Parkinson's disease under different conditions during whole-body vibration training

BACKGROUND

Whole-body vibration (WBV) training can provoke reactive muscle response and thus exert beneficial effects in various neurological patients. This study aimed to investigate the muscles activation and acceleration transmissibility of the lower extremity to try to understand the neuromuscular control in the Parkinson's disease (PD) patients under different conditions of the WBV training, including position and frequency.

METHODS

Sixteen PD patients and sixteen controls were enrolled. Each of them would receive two WBV training sessions with 3 and 20 Hz mechanical vibration in separated days. In each session, they were asked to stand on the WBV machine with straight and then bended knee joint positions, while the vibration stimulation was delivered or not. The electromyographic (EMG) signals and the segmental acceleration from the lower extremity were recorded and processed. The amplitude, co-contraction indexes (CCI), and normalized median frequency slope (NMFS) from the EMG signals, and the acceleration transmissibility were calculated.

RESULTS

The results showed larger rectus femoris (RF) amplitudes under 3 Hz vibration than those in 20 Hz and no vibration conditions; larger tibialis anterior (TA) in 20 Hz than in no vibration; larger gastrocnemius (GAS) in 20 Hz than in 3 Hz and no vibration. These results indicated that different vibration frequencies mainly induced reactive responses in different muscles, by showing higher activation of the knee extensors in 3 Hz and of the lower leg muscles in 20 Hz condition, respectively. Comparing between groups, the PD patients reacted to the WBV stimulation by showing larger muscle activations in hamstring (HAM), TA and GAS, and smaller CCI in thigh than those in the controls. In bended knee, it demonstrated a higher RF amplitude and a steeper NMFS but smaller HAM activations than in straight knee position. The higher acceleration transmissibility was found in the control group, in the straight knee position and in the 3 Hz vibration conditions.

CONCLUSION

The PD patients demonstrated altered neuromuscular control compared with the controls in responding to the WBV stimulations, with generally higher EMG amplitude of lower extremity muscles. For designing WBV strengthening protocol in the PD population, the 3 Hz with straight or flexed knee protocol was recommended to recruit more thigh muscles; the bended knee position with 20 Hz vibration was for the shank muscles.

Paraspinal strength and electromyographic fatigue in patients with sub-acute back pain and controls: Reliability, clinical applicability and between-group differences

BACKGROUND

Paraspinal muscle strength and fatigue are considered important in low back pain (LBP) prevention and rehabilitation. High reliability of paraspinal strength and electromyographic (EMG)-fatigue parameters has not been universally reported. Moreover, the discriminative validity of these parameters requires further exploration, under the threat of potentially poor reliability of the methods examined.

AIM

To investigate the reliability and discriminative validity of paraspinal strength and EMG-related fatigue in subjects with recurrent LBP and healthy participants.

METHODS

Test-retest measurements were performed in 26 healthy and 66 LBP volunteers, for reliability. Paraspinal isometric maximal and mean strength were determined with a maximum voluntary isometric contraction (MVIC) protocol, performed in a custom-made device. For the fatigue test, participants performed a 60% MIVC level continuous isometric contraction of the paraspinals, in conjunction with EMG analysis from 4 muscle sites of the lumbar spine. Initial median frequency (IMF), the median frequency slope (MFslope), as well as the root mean square (RMS) slope EMG parameters were used as fatigue measures. Data were analysed with repeated measures ANOVA for test-retest differences. For reliability, the intraclass correlation coefficient (ICC_3,1), standard error of the measurement (SEM) and the smallest detectable difference (SDD) were reported. Group-related differences for fatigue measures were analysed with a Multivariate Analysis of Covariance, with age, weight and strength as covariates.

RESULTS

Isometric strength presented statistically significant between-day differences (P < 0.01), however these did not exceed 10% (healthy: 7.2%/LBP-patients: 9.7%) and ICC reliability values were excellent, yet test-retest error was increased for the patient group (healthy: ICC_3,1: 0.92-0.96, SEM: 5.72-5.94 Hz, SDD: 18.51%-18.57%/LBP-patients: ICC_3,1: 0.91-0.96, SEM: 6.49-6.96, SDD: 30.75%-31.61%). For the frequency data, IMF reliability was excellent (healthy: ICC_3,1: 0.91-0.94, SEM: 3.45-7.27 Hz, SDD: 9.56%-20.14%/patients: ICC_3,1: 0.90-0.94, SEM: 6.41-7.59 Hz, SDD: 17.75%-21.02%) and of MF raw and normalised slopes was good (healthy: ICC_3,1: 0.78-0.82, SEM: 4.93-6.02 Hz, SDD: 13.66-16.67%/LBP-patients: ICC_3,1: 0.83-0.85, SEM: 6.75-7.47 Hz, SDD: 18.69%-20.69%). However, the reliability for RMS data presented unacceptably high SDD values and were not considered further. For discriminative validity, less MVIC and less steep MFslopes were registered for the patient group (P < 0.01).

CONCLUSION

Reliability and discriminative ability of paraspinal strength and EMG-related frequency parameters were demonstrated in healthy participants and patients with LBP.

Trunk muscle endurance, strength and flexibility in rural subsistence farmers and urban industrialized adults in western Kenya

OBJECTIVES

High trunk muscle endurance, strength, and moderate flexibility reportedly help maintain musculoskeletal health, but there is evidence for tradeoffs among these variables as well as sex differences in trunk muscle endurance and strength. To test if these observations extend similarly to both men and women in nonindustrial and industrial environments, we investigated intra-individual associations and group and sex differences in trunk muscle endurance, strength, and flexibility among 74 (35 F, 39 M; age range: 18-61 years) adults from the same Kalenjin-speaking population in western Kenya. We specifically compared men and women from an urban community with professions that do not involve manual labor with rural subsistence farmers, including women who frequently carry heavy loads.

METHODS

Trunk muscle endurance, strength, and flexibility were measured with exercise tests and electromyography (EMG).

RESULTS

We found a positive correlation between trunk extensor strength and endurance (R = .271, p ≤ .05) and no associations between strength or endurance and flexibility. Rural women had higher trunk extensor and flexor endurance, EMG-determined longissimus lumborum endurance, and trunk extensor strength than urban women (all p ≤ .05). Rural women had higher trunk extensor and flexor endurance than rural men (both p ≤ .05). Urban women had lower trunk flexor and extensor endurance than urban men (both p ≤ .01).

CONCLUSIONS

High levels of physical activity among nonindustrial subsistence farmers, particularly head carrying among women, appear to be associated with high trunk muscle endurance and strength, which may have important benefits for helping maintain musculoskeletal health.

The effect of the standing angle on reducing fatigue among prolonged standing workers

BACKGROUND

Many occupations require workers to stand for prolonged periods, which can cause discomfort, pain and even injures. Some supermarkets in life provide a foot pad for checkout staff to let them stand on it at work, thereby reducing standing fatigue caused by standing for a long time. The inclined platform is the same as the foot pad mentioned above. That is, the staff stepped on it and relieved standing fatigue to a certain extent.

OBJECTIVE

The study aims to analyze how the standing angle affects fatigue among prolonged standing workers and tries to find an inclined platform with a specific angle to reduce standing fatigue.

METHODS

This experiment studied fatigue of the inclined platforms with different angles on prolonged standing workers, eight participants were selected to participate in the test. The plantar pressures and sEMG (Surface Electromyography) were used to collect the physiological information change of prolonged standing participants in the lower limb and waist. The visual analogue scale was used as a subjective method to measure the psychological fatigue.

RESULTS AND CONCLUSION

The study highlights the relationship between standing angle and lower limb fatigue. The inclination of the standing platform has different effects on the participants under different time conditions. When participants stand on inclined platforms at 0°, 5° and 10°, the iEMG (Integrated Electromyography) values of the gastrointestinal muscle were not significantly different until the third sampling point (40 minutes). After that self-regulation of lower limb muscles is better when standing on an inclined platform between 5° and 10°, it has a certain effect on alleviating lower limb fatigue. This knowledge is crucial for the design of the inclined working platforms fitting the needs of prolonged standing workers.

Electromyography activities in patients with lower lumbar disc herniation

BACKGROUND

Lumbar disc herniation (LDH) can affect lower limb muscle function resulting in an abnormal gait. This study aims to use surface electromyography (SEMG) to evaluate patients with L4/L5 and L5/S1 LDH throughout muscle movement.

METHODS

Twenty L4/L5 LDH patients (L5 Group), twenty L5/S1 LDH patients (S1 Group), and twenty healthy controls (Healthy) were recruited for the study. SEMG of bilateral tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of patients were recorded using the DELSYS Wireless EMG System (TrignoTM Wireless Systems, Delsys Inc., USA). Root-mean-square (RMS), mean power frequency (MPF), and median frequency (MF) were compared between bilateral limbs in each participant.

RESULTS

Reduced MPF and MF was found in TA measurements of the L5 Group and LG measurements of the S1 Group. The MPF and MF of the TA of symptomatic limbs of the L5 Group were reduced when compared to asymptomatic limbs (p= 0.006, p= 0.012, p< 0.05), and there were no significant differences in LG measurements (p> 0.05). The LG MPF and MF of the S1 Group in symptomatic limbs were reduced when compared to asymptomatic limbs (p= 0.006, p= 0.017, p< 0.05), and there were no significant differences in TA measurements (p> 0.05). Although there were no significant differences in RMS between bilateral limbs of the L5 and S1 Groups, we found some changes in RMS curves. First, compared to asymptomatic limbs of L4/L5LDH patients, β-peaks in the TA of symptomatic limbs appeared earlier. Second, two peaks in the LG of symptomatic limbs were found in L5/S1 LDH patients.

CONCLUSION

TA is affected in patients with LDH of L4/L5, and LG is affected in patients with LDH of L5/S1. As demonstrated, SEMG can identify LDH-related muscle dysfunction.

Low-profile elastic exosuit reduces back muscle fatigue

We investigated the extent to which an un-motorized, low-profile, elastic exosuit reduced the rate of fatigue for six lumbar extensor muscles during leaning. Six healthy subjects participated in an A-B-A (withdrawal design) study protocol, which involved leaning at 45º for up to 90 s without exosuit assistance (A1), then with assistance (B), then again without assistance (A2). The exosuit provided approximately 12–16 Nm of lumbar extension torque. We measured lumbar muscle activity (via surface electromyography) and assessed fatigue rate via median frequency slope. We found that five of the six subjects showed consistent reductions in fatigue rate (ranging from 26% to 87%) for a subset of lumbar muscles (ranging from one to all six lumbar muscles measured). These findings objectively demonstrate the ability of a low-profile elastic exosuit to reduce back muscle fatigue during leaning, which may improve endurance for various occupations.

A study on the paraspinal muscle surface electromyography in acute nonspecific lower back pain

Aim of this study was to determine if surface electromyography (sEMG) could provide objective data in monitoring the alteration of signal amplitude of myoelectric activity of the paraspinal muscles in the patients with acute nonspecific lower back pain (ANLBP), and to explore the correlation between sEMG data and symptom relief in the ANLBP patients before and after massage therapy.Forty-five ANLBP patients and 20 healthy subjects were enrolled into this study. Patients were given massage therapy for 1 week. The average electromyography (AEMG), visual analogue scale (VAS), and distance of finger to floor (DFTF) were measured before and after treatment.AEMG at flexion and maintained flexion positions were significantly higher in the ANLBP group compared to that in the control group. At extension position, in contrast, AEMG was significantly lower in the ANLBP patients than that of control group, and there was no significant difference between the 2 groups at upright position. After massage therapy for the ANLBP patients, AEMG was significantly reduced at flexion and maintained flexion positions, but significantly increased at extension position than that before treatment. VAS and DFTF were also significantly reduced after treatment. In addition, AEMG alteration at maintained flexion position was significantly correlated with improvement of VAS or DFTF.Myoelectric activity of the paraspinal muscles in the ANLBP patients was different from that of healthy subjects. Massage therapy not only relived patients' symptoms, but also normalized myoelectric activity of the paraspinal muscles in the ANLBP patients.

Insertion and Presence of Fine-Wire Intramuscular Electrodes to the Lumbar Paraspinal Muscles Do Not Affect Muscle Performance and Activation During High-Exertion Spinal Extension Activities

BACKGROUND

Low back pain (LBP) is commonly associated with paraspinal muscle dysfunctions. A method to study deep lumbar paraspinal (ie, multifidus) muscle function and neuromuscular activation pattern is intramuscular electromyography (EMG). Previous studies have shown that the procedure does not significantly impact muscle function during activities involving low-level muscle contractions. However, it is currently unknown how muscular function and activation are affected during high-exertion contractions.

OBJECTIVE

To examine the effects of insertion and presence of fine-wire EMG electrodes in the lumbar multifidus on muscle strength, endurance, and activation profiles during high-exertion spinal extension muscle contractions.

DESIGN

Single-blinded, repeated measures intervention trial.

SETTING

University clinical research laboratory PARTICIPANTS: Twenty individuals between the ages of 18-40 free of recent and current back pain.

METHODS

Muscle performance was assessed during 3 conditions (with [WI] and without [WO] presence of intramuscular electrodes, and insertion followed by removal [IO]). Isometric spinal extension strength was assessed with a motorized dynamometer. Muscle endurance was assessed using the Sorensen test with neuromuscular activation profiles analyzed during the endurance test.

MAIN OUTCOME MEASUREMENTS

Spinal extensor muscle strength, endurance, and activation.

RESULTS

Our data showed no significant difference in isometric strength (P = .20) between the 3 conditions. A significant difference in muscle endurance was found (P = .03). Post hoc analysis showed that the muscle endurance in the IO condition was significantly higher than the WO condition (161.3 ± 58.3 versus 142.1 ± 48.2 seconds, P = .04), likely due to a learning effect. All 3 conditions elicited minimal pain (range 0-4/10) and comparable muscle activation profiles.

CONCLUSION

Our findings suggested the sonographically guided insertion and presence of fine-wire intramuscular EMG electrodes in the lumbar multifidus muscles had no significant impact on spinal extension muscle function. This study provides evidence that implementing intramuscular EMG does not affect muscle performance during high-exertion contractions in individuals with no current back pain.

LEVEL OF EVIDENCE

II.

The effect of epoch length on time and frequency domain parameters of electromyographic and mechanomyographic signals

The selection of epoch lengths affects the time and frequency resolution of electromyographic (EMG) and mechanomyographic (MMG) signals, as well as decisions regarding the signal processing techniques to use for determining the power density spectrum. No previous studies, however, have examined the effects of epoch length on parameters of the MMG signal. The purpose of this study was to examine the differences between epoch lengths for EMG amplitude, EMG mean power frequency (MPF), MMG amplitude, and MMG MPF from the VL and VM muscles during MVIC muscle actions as well as at each 10% of the time to exhaustion (TTE) during a continuous isometric muscle action of the leg extensors at 50% of MVIC. During the MVIC trial, there were no significant (p > 0.05) differences between epoch lengths (0.25, 0.50, 1.00, and 2.00-s) for mean absolute values for any of the EMG or MMG parameters. During the submaximal, sustained muscle action, however, absolute MMG amplitude and MMG MPF were affected by the length of epoch. All epoch related differences were eliminated by normalizing the absolute values to MVIC. These findings supported normalizing EMG and MMG parameter values to MVIC and utilizing epoch lengths that ranged from 0.25 to 2.00-s.

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.

Effects of Shoulder Taping on Discomfort and Electromyographic Responses of the Neck While Texting on a Touchscreen Smartphone

Background

Prolonged neck flexion during smartphone use is known as a factor of neck pain and alteration of neck muscle activity. Studies on the effects of shoulder taping on neck discomfort and neck muscle responses while texting on a smartphone are still lacking. The aim of this study was to examine the effects of shoulder taping on neck discomfort using a numerical rating scale, and neck muscle activity and fatigue using a surface electromyography during a texting task on a touchscreen smartphone.

Methods

Twenty-five healthy adolescents used the dominant hand to perform a 30-minute texting task using a touchscreen smartphone at two separate times under one of the following two conditions: taping across the upper trapezius muscle and no taping. Neck discomfort, normalized root mean square, and normalized median frequency slopes for upper trapezius, cervical erector spinae, and sternocleidomastoid muscles were recorded.

Results

The results revealed that shoulder taping provided significantly lower neck discomfort than no taping (p < 0.001). However, shoulder taping did not significantly alter normalized root mean square and normalized median frequency slope values of all muscles when compared with no taping controls.

Conclusion

Shoulder taping reduces neck discomfort but does not affect neck muscle activity and fatigue while texting on a touchscreen smartphone.

EMG signal-based gait phase recognition using a GPES library and ISMF

This paper presents a gait phase recognition method using an electromyogram (EMG) with a gait phase EMG signal (GPES) library and an integrated spectral matching filter (ISMF). Existing pattern recognition using an EMG signal has several innate problems in trying to control a gait assistant robot. The GPES library is robust against amplitude bias owing to the use of derivative analysis and integral reconstruction, while an ISMF reflects better timing characteristics of EMG signals than the time domain feature extraction algorithm. Therefore, it can provide fast detection of gait phase recognition using EMG signals. The experimental results show that the average accuracy of the proposed method is 17% better than that of the existing method. The result also shows that the average latency time of the gait phase recognition of the proposed method is 26.2msec whereas that of the existing method is 195.2msec.

Interaction of body mass index and age in muscular activities among backpack carrying male schoolchildren

BACKGROUND

The complex and limited understanding of the interactions among multiple factors associated with back pain occurrence among schoolchildren might explain the current inconclusive and contradictory findings on the issue. The global increase in the prevalence of childhood overweight and obesity, which reportedly affects children's physical abilities, calls for concern among school/children ergonomists and other stakeholders.

OBJECTIVE

The study investigated the interaction of body mass index (BMI) and age on the muscular activities, backpack height and perceived level of pain arising from carrying different weight of backpacks.

METHODS

Surface electromyography analysis of erector spinae and trapezius muscular activities was conducted on 47 primary schoolchildren aged between 8 and 11 years. Repeated measure ANOVA were carried out on the data.

RESULTS

There was significant difference in all the measures of muscular activities, backpack height and pain rating at different levels of backpack weight. However, the children were only significantly fatigable in the erector spinae muscles of the lower back and not in the trapezius of the upper back. The interactive effect of BMI was more pronounced than the children's age.

CONCLUSIONS

The study shows that it is not appropriate for all schoolchildren to have the same backpack weight limit and obese schoolchildren should carry a lower bag-to-body ratio of backpack weight. The younger children also need an appropriate bag surface-to-trunk ratio size of backpack as they were more affected by the position of the backpack.

MEASUREMENT OF UPPER LIMB MUSCLE FATIGUE USING DEEP BELIEF NETWORKS

In recent years, a robust increasing interest has been observed in wearable devices featuring smart health, smart fitness, and human–machine interaction applications. While we gained some advances on use of surface electromyography (sEMG) signals recorded from upper extremities for controlling external devices, only limited attempt has been made to track the status of targeted muscles and forecast muscle fatigue onset. In this study, we address use of sEMG signals acquired from upper extremities to predict onset of muscle fatigue using deep belief networks (DBNs) as a learning mechanism. We demonstrate that a deep architecture can learn from raw data and provide comparable performance to feature-based approaches. Experimental results show that the DBNs model investigated in this study achieves an average classification accuracy of 85.3% without any subject-oriented calibration and achieves a best case accuracy of 97.60%. A transient-to-fatigue state is introduced before the fatigue onsets as an early warning state. The aim of this paper is to evaluate the performance of the popular deep models in real fatigue detection applications. The model provides a promising result compared with state-of-art works without any feature selection process, which could potentially generate better features while reducing the requirement for expertise in data.

An Epidermal Stimulation and Sensing Platform for Sensorimotor Prosthetic Control, Management of Lower Back Exertion, and Electrical Muscle Activation

The design of an ultrathin, conformal electronic device that integrates electrotactile stimulation with electromyography, temperature, and strain sensing in a single, simple platform is reported. Experiments demonstrate simultaneous use of multiple modes of operation of this type of device in the sensorimotor control of robotic systems, in the monitoring of lower back exertion and in muscle stimulation.

Flexible Inkjet-Printed Multielectrode Arrays for Neuromuscular Cartography

Flexible Poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (

PEDOT

PSS) conductive-polymer multielectrode arrays (MEAs) are fabricated without etching or aggressive lift-off processes, only by additive solution processes. Inkjet printing technology has several advantages, such as a customized design and a rapid realization time, adaptability to different patients and to different applications. In particular, inkjet printing technology, as additive and "contactless" technology, can be easily inserted into various technological fabrication steps on different substrates at low cost. In vivo electrochemical impedance spectroscopy measurements show the time stability of such MEAs. An equivalent circuit model is established for such flexible cutaneous MEAs. It is shown that the charge transfer resistance remains the same, even two months after fabrication. Surface electromyography and electrocardiography measurements show that the

PEDOT

PSS MEAs record electrophysiological activity signals that are comparable to those obtained with unitary Ag/AgCl commercial electrodes. Additionally, such MEAs offer parallel and simultaneous recordings on multiple locations at high surface density. It also proves its suitability to reconstruct an innervation zone map and opens new perspectives for a better control of amputee's myoelectric prostheses. The employment of additive technologies such as inkjet printing suggests that the integration of multifunctional sensors can improve the performances of ultraflexible brain-computer interfaces.

The Activity of Surface Electromyographic Signal of Selected Muscles during Classic Rehabilitation Exercise

Objectives. Prone bridge, unilateral bridge, supine bridge, and bird-dog are classic rehabilitation exercises, which have been advocated as effective ways to improve core stability among healthy individuals and patients with low back pain. The aim of this study was to investigate the activity of seven selected muscles during rehabilitation exercises through the signal of surface electromyographic. Approaches. We measured the surface electromyographic signals of four lower limb muscles, two abdominal muscles, and one back muscle during rehabilitation exercises of 30 healthy students and then analyzed its activity level using the median frequency method. Results. Different levels of muscle activity during the four rehabilitation exercises were observed. The prone bridge and unilateral bridge caused the greatest muscle fatigue; however, the supine bridge generated the lowest muscle activity. There was no significant difference (P > 0.05) between left and right body side muscles in the median frequency slope during the four rehabilitation exercises of seven muscles. Conclusions. The prone bridge can affect the low back and lower limb muscles of most people. The unilateral bridge was found to stimulate muscles much more active than the supine bridge. The bird-dog does not cause much fatigue to muscles but can make most selected muscles active.

Do sweep rowers symmetrically activate their low back muscles during indoor rowing?

This study investigates whether sweep rowers activate their low back muscles asymmetrically when exercising on a rowing ergometer. Given that indoor rowing imposes equal loading demands to left and right back muscles, any side differences in activation are expected to reflect asymmetric adaptations resulting from sweep rowing. In addition to trunk kinematics, surface electromyograms (EMGs) were sampled from multiple skin locations along the lumbar spine of six elite, sweep rowers. The distribution of EMG amplitude along the spine was averaged across strokes and compared between sides. Key results indicate a significant effect of trunk side on EMG amplitude and on the low back region where EMG amplitude was greatest. Such side differences were unlikely because of trunk lateral inclination and rotation, which were smaller than 5° for all rowers tested. Moreover, asymmetries manifested differently between participants; there was not a clear predominance of greater EMG amplitude toward the right/left side in portside/starboard rowers. These results suggest that (a) even during indoor rowing, sweep rowers activate asymmetrically their low back muscles; (b) factors other than rowing side might be associated with low back asymmetries; (c) spatial distribution of surface EMG amplitude is sensitive to bilateral changes in back muscles' activation.

Peculiarities of extracellular potentials produced by deep muscles. Part 2: motor unit potentials

The potential fields generated by single fibres far from the sources are non-propagating. This suggests that there should be differences in the features of surface motor unit (MU) potentials (MUPs) detected from deep and superficial muscles. We explored the features using a simulation approach. We have shown that the non-propagating character and similar shapes among surface MUPs recorded over a wide area above deep muscles with monopolar or longitudinal single differential (LSD) electrodes are natural. Contrary to close distances, at large radial distances single differentiation did not emphasize MUP main phase relative weight. The position of the end plate area could be estimated with LSD detections only for MUs with long (123 mm) almost symmetric fibres. With short fibres, the LSD main phase was masked by the outlined terminal phases. This could be misleading in MUP analysis since the terminal phases reflect standing sources. The highly asymmetric fibres could yield peculiar MUP shapes resembling MUPs of two distinct MUs. We have shown that the relative weight of terminal phases at large fibre-electrode distance decreases under abnormal peripheral conditions. However, the changes in membrane depolarization due to fatigue or pathology could be assessed non-invasively also from deep muscles.

Peculiarities of extracellular potentials produced by deep muscles. Part 1: single fibre potential fields

The similarity among surface electromyography (EMG) signals recorded by the poles of electrode arrays above deep muscles like erector spinae is a substantial obstacle in determining major muscle characteristics. What makes EMG signals so different when detected at various distances from the fibres? To answer this question, we simulated and analyzed extracellular potential fields produced by a single muscle fibre. We considered the fields at a few specific time instants. They corresponded to the origination of two depolarized zones at the end-plate, their propagation along both semi-fibres, and extinction at the fibre-ends. We used intracellular action potentials and muscle fibre propagation velocities typical for non-fatigued or fatigued muscle fibres. We have shown that at relatively small distances from the fibre, the strong potential fields are concentrated mainly near the sources. The interaction between potential fields is weak and the propagation of the fields and EMG signals in relatively long fibres is clearly apparent. At large distances, the potential fields are wide and the interaction between the fields produced by the two depolarized zones is strong. The total potential field could remain non-propagating during the entire main phase. As a result, the propagation will be obscured also in EMG signals.

Spectral analysis of EMG using intramuscular electrodes reveals non-linear fatigability characteristics in persons with chronic low back pain

Greater fatigability across lumbar extensors has been reported in persons with chronic low back pain (LBP), however, extensor atrophy tends to be local to the site of pain. Therefore, specific ultrasound guided local and remote intramuscular electromyographic recordings were undertaken during an isometric horizontal trunk hold in two carefully matched cohorts; persons with and without LBP. The test was performed to self-determined maximal hold time, and the control group held the horizontal position longer (P < 0.001). A power spectral analysis was performed to calculate the normalized median frequency (NMF) slope for both the first and last 30s of the fatigue test due to the group difference in hold times. There were no significant group differences in NMF slope at the first 30s of testing (P = 0.650). The NMF slope for the first and last 30s was not different in healthy subjects (P = 0.688), but was different in persons with LBP, illustrated by shallowing of the slope at the last 30s of the test (P = 0.008). A between muscle comparison in the LBP group showed greater non-linear behavior in the deep multifidus (painful region) in contrast to T10 longissimus thoracis (nonpainful region) (P = 0.013). Possible explanations for these findings are discussed.

Assessment of muscle fatigue associated with prolonged standing in the workplace

Objectives

The objectives of this study were to determine the psychological fatigue and analyze muscle activity of production workers who are performing processes jobs while standing for prolonged time periods.

Methods

The psychological fatigue experienced by the workers was obtained through questionnaire surveys. Meanwhile, muscle activity has been analyzed using surface electromyography (sEMG) measurement. Lower extremities muscles include: erector spinae, tibialis anterior, and gastrocnemius were concurrently measured for more than five hours of standing. Twenty male production workers in a metal stamping company participated as subjects in this study. The subjects were required to undergo questionnaire surveys and sEMG measurement.

Results

Results of the questionnaire surveys found that all subjects experienced psychological fatigue due to prolonged standing jobs. Similarly, muscle fatigue has been identified through sEMG measurement. Based on the non-parametric statistical test using the Spearman's rank order correlation, the left erector spinae obtained a moderate positive correlation and statistically significant (r_s = 0.552, p < 0.05) between the results of questionnaire surveys and sEMG measurement.

Conclusion

Based on this study, the authors concluded that prolonged standing was contributed to psychological fatigue and to muscle fatigue among the production workers.

Mechanisms of cramp contractions: peripheral or central generation?

We analysed the cramp threshold (i.e. the minimum frequency of electrical stimulation capable of inducing a cramp) and the behaviour of individual motor units during cramps electrically elicited in the absence (intact condition) and presence (blocked condition) of a peripheral nerve block in eight healthy subjects. The cramp threshold was significantly greater in the blocked than in the intact condition (18 ± 3 Hz vs. 13 ± 3 Hz; P = 0.01). Cramp duration and peak EMG amplitude in the intact condition (55.6 ± 19.2 s and 47.5 ± 24.8 μV, respectively) were significantly greater compared to the blocked condition (2.6 ± 1.3 s and 13.9 ± 8.8 μV; P < 0.01). All motor units identified in the blocked condition (n = 38) had a shorter interval of activity and a greater discharge rate compared to the intact condition (n = 37) (respectively, 1.1 ± 1.0 s vs. 29.5 ± 21.8 s, P < 0.0001; 25.7 ± 11.6 pulses s(-1) vs. 20.0 ± 5.9 pulses s(-1); P < 0.05). The motor unit activity detected during the blocked condition corresponded to spontaneous discharges of the motor nerves, while in the intact condition the motor unit discharge patterns presented the typical characteristics of motor neuron discharges. These results indicate a spinal involvement at the origin of cramps and during their development.

A review of non-invasive techniques to detect and predict localised muscle fatigue

Muscle fatigue is an established area of research and various types of muscle fatigue have been investigated in order to fully understand the condition. This paper gives an overview of the various non-invasive techniques available for use in automated fatigue detection, such as mechanomyography, electromyography, near-infrared spectroscopy and ultrasound for both isometric and non-isometric contractions. Various signal analysis methods are compared by illustrating their applicability in real-time settings. This paper will be of interest to researchers who wish to select the most appropriate methodology for research on muscle fatigue detection or prediction, or for the development of devices that can be used in, e.g., sports scenarios to improve performance or prevent injury. To date, research on localised muscle fatigue focuses mainly on the clinical side. There is very little research carried out on the implementation of detecting/predicting fatigue using an autonomous system, although recent research on automating the process of localised muscle fatigue detection/prediction shows promising results.

Acute effect of labile surfaces during core stability exercises in people with and without low back pain

OBJECTIVE

The purpose of this study was to measure trunk muscle activity, whole body balance, and lumbar range of motion during core stability exercises in individuals with and without low back pain (LBP) on and off a labile surface.

DESIGN

Descriptive cross-sectional study.

SETTING

University laboratory.

PARTICIPANTS

Ten individuals with chronic non-specific LBP and 10 matched control subjects.

MAIN OUTCOME MEASURES

Bilateral trunk muscle activity was measured using surface electromyography (EMG); whole body balance was measured by quantifying the dispersion of the centre of pressure (CoP); lumbar range of motion (LROM) was measured with single-axis inclinometers.

RESULTS

Individuals with LBP had adaptive recruitment patterns during the side-bridge and modified push-up exercises. CoP dispersion and LROM were not different between groups for any exercise. The labile surface did not change the difference between groups, and only increased muscle activity during the side-bridge (p<0.05). The labile surface increased LROM (p=0.35) and CoP dispersion (p<0.001) during the quadruped, decreased LROM during squats (p=0.05), and increased CoP dispersion during push-ups (p=0.04).

CONCLUSION

Individuals with LBP exhibited adaptive trunk muscle activity levels while maintaining similar levels of balance and lumbar movement to healthy controls. Since research suggests no one mode of exercise is more beneficial in LBP rehabilitation, the practicality and safety of labile surfaces for LBP exercise rehabilitation must be questioned from this study.

Comparison between the degree of motor unit short-term synchronization and recurrence quantification analysis of the surface EMG in two human muscles

OBJECTIVE

To verify if non-linear recurrence analysis of the surface EMG is a suitable tool for assessing motor unit short-term synchronization.

METHODS

Surface and intramuscular EMG signals were recorded from the abductor digiti minimi and vastus medialis muscles of 12 and 10 healthy men, respectively, during isometric contractions. In the abductor digiti minimi, EMG signals were additionally recorded after a contraction sustained for 1min at 50% of the maximal force. In both muscles, percent of determinism (%DET) was estimated from the surface EMG and common input strength (CIS) index was computed from motor unit recordings.

RESULTS

For both muscles, CIS did not correlate with %DET (abductor digiti minimi: R(2)=0.11, P=0.12; vastus medialis: R(2)=0.04, P=0.56). Although the values of CIS for the vastus medialis were lower than those of the abductor digiti minimi (P<0.001), the %DET values did not differ between the two muscles (71.6+/-5.5% vs 66.9+/-8.7%; P=0.12).

CONCLUSION

The variable %DET extracted from the surface EMG is a poor indicator of the degree of motor unit short-term synchronization.

SIGNIFICANCE

The study provides a systematic evaluation of a technique previously proposed for the estimation of a clinically relevant characteristic of motor unit behavior.

Trunk muscle activation patterns and spine kinematics when using an oscillating blade: influence of different postures and blade orientations

OBJECTIVE

To compare trunk muscle activation patterns and trunk kinematics when using an oscillating blade in standing and unsupported sitting postures, and with different orientations of the blade.

DESIGN

A cross-sectional survey of trunk muscle activities and lumbar motion.

SETTING

Biomechanics research laboratory.

PARTICIPANTS

Healthy men (N=13).

INTERVENTIONS

An oscillating blade was held with 2 hands and oscillated with vertical and horizontal orientations of blade. These exercises were performed both in an erect standing position and in an erect sitting position.

MAIN OUTCOME MEASURES

Surface electromyography from 14 trunk and 2 shoulder muscles, together with lumbar angular displacement in the 3 planes of motion, were measured while subjects used an oscillating blade at different performance variations. Electromyographic signals were normalized to isometric maximal voluntary contraction (MVC) amplitudes.

RESULTS

With the exception of internal oblique and anterior deltoid for the horizontal condition, and erector spinae at L5 level for the vertical condition, the subject's posture had no effect on trunk muscular recruitment when using the oscillating blade. The vertical blade orientation resulted in higher amplitudes of spine rotation on the horizontal plane and produced the greatest activation levels of the internal oblique (47% MVC), pectoralis major (33% MVC), and external oblique (23% MVC). On the other hand, the horizontal orientation resulted in the greatest activation levels of erector spinae at T9 level (28% MVC), latissimus dorsi (26% MVC), and rectus abdominis (17% MVC).

CONCLUSIONS

Muscle activation and spine motion from using an oscillating blade were not affected by the standing or sitting posture of the subject. The choice of blade orientation was more important, because it defined the main group of muscles recruited during the exercise.

Motor unit properties of biceps brachii in chronic stroke patients assessed with high-density surface EMG

The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii in poststroke patients using high-density surface electromyography (sEMG). Eighteen chronic hemiparetic stroke patients took part. The Fugl-Meyer score for the upper extremity was assessed. Subjects performed an isometric step contraction consisting of force levels from 5%-50% maximal voluntary contraction while sEMG of the biceps brachii was recorded with a two-dimensional 16-channel electrode array. This was repeated for both sides. Motor unit action potentials (MUAPs) were extracted from the EMG signals, and their root-mean-square value (RMS(MUAP), reflecting MU size) and mean frequency of the power spectrum (FMEAN(MUAP), reflecting recruitment threshold) were calculated. FMEAN(MUAP) was smaller on the affected than on the unaffected side, indicating an increased contribution of low-threshold MUs, possibly related to degeneration of high-threshold MUs. The ratio of RMS(MUAP) on the affected side divided by that on the unaffected side correlated significantly with the Fugl-Meyer score. This ratio may reflect the extent to which reinnervation has occurred on the affected side.

Back and hip extensor muscles fatigue in healthy subjects: task-dependency effect of two variants of the Sorensen test

Paraspinal muscle fatigability during various trunk extension tests has been widely investigated by electromyography (EMG), and its task-dependency is established recently. Hip extensor muscle fatigability during the Sorensen test has been reported. The aim of the present experiments was to evaluate the task-dependency of back and hip extensor muscle fatigue during two variants of the Sorensen test. We hypothesized that the rate of muscular fatigue of the hip and back extensor muscles varies according to the test position. Twenty healthy young males with no history of low back pain volunteered to participate in this cross-sectional study. They were asked to perform two body weight-dependent isometric back extension tests (S1 = Sorensen test; S2 = modified Sorensen on a 45 degrees Roman chair). Surface EMG activity of the paraspinal muscles (T10 and L5 levels) and hip extensor muscles (gluteus maximus; biceps femoris) was recorded, and muscular fatigue was assessed through power spectral analysis of the EMG data by calculating the rate of median power frequency change. We observed hip extensor muscle fatigue simultaneously with paraspinal muscle fatigue during both Sorensen variants. However, only L5 level EMG fatigue indices showed a task-dependency effect between S1 and S2. Hip extensor muscles appear to contribute to load sharing of the upper body mass during both Sorensen variants, but to a different extent because L5 level fatigue differs between the Sorensen variants. Our findings suggest that task-dependency has to be considered when EMG variables are compared between two types of lumbar muscle-fatiguing tasks.

Electromyography for assessment of pain in low back muscles

BACKGROUND AND PURPOSE

Pain is currently evaluated with "subjective" methods (eg, patient self-report). This study aimed to test whether fatigue indexes are able to accurately discriminate between subjects with and subjects without low back pain.

SUBJECTS

Sixty subjects separated into 2 groups--a group with low back pain (n=30) and a group without low back pain (n=30)--participated in this study.

METHODS

Electromyographic (EMG) and force data were obtained during a muscle fatigue test. The same test was repeated to monitor recovery. Linear regression analysis was used to obtain fatigue indexes.

RESULTS

Subjects with pain produced significantly lower force values than those without pain. The use of fatigue indexes and force values permitted accurate classification in 89.5% of cases.

DISCUSSION AND CONCLUSION

The results confirm that subjects with pain show early myoelectrical manifestations of muscle fatigue and that EMG can be a useful tool in the evaluation of low back pain.