Influence of fatigue on hand muscle coordination and EMG-EMG coherence during three-digit grasping

Aquatic Feasibility of Limbs Application of Tourniquets (AFLAT) during a Lifeguard Water Rescue: A Simulation Pilot Study

INTRODUCTION

Control of massive hemorrhage (MH) is a life-saving intervention. The use of tourniquets has been studied in prehospital and battlefield settings but not in aquatic environments.

OBJECTIVE

The aim of this research is to assess the control of MH in an aquatic environment by analyzing the usability of two tourniquet models with different adjustment mechanisms: windlass rod versus ratchet.

METHODOLOGY

A pilot simulation study was conducted using a randomized crossover design to assess the control of MH resulting from an upper extremity arterial perforation in an aquatic setting. A sample of 24 trained lifeguards performed two randomized tests: one using a windlass-based Combat Application Tourniquet 7 Gen (T-CAT) and the other using a ratchet-based OMNA Marine Tourniquet (T-OMNA) specifically designed for aquatic use on a training arm for hemorrhage control. The tests were conducted after swimming an approximate distance of 100 meters and the tourniquets were applied while in the water. The following parameters were recorded: time of rescue (rescue phases and tourniquet application), perceived fatigue, and technical actions related to tourniquet skills.

RESULTS

With the T-OMNA, 46% of the lifeguards successfully stopped the MH compared to 21% with the T-CAT (P = .015). The approach swim time was 135 seconds with the T-OMNA and 131 seconds with the T-CAT (P = .42). The total time (swim time plus tourniquet placement) was 174 seconds with the T-OMNA and 177 seconds with the T-CAT (P = .55). The adjustment time (from securing the Velcro to completing the manipulation of the windlass or ratchet) for the T-OMNA was faster than with the T-CAT (six seconds versus 19 seconds; P < .001; effect size [ES] = 0.83). The perceived fatigue was high, with a score of seven out of ten in both tests (P = .46).

CONCLUSIONS

Lifeguards in this study demonstrated the ability to use both tourniquets during aquatic rescues under conditions of fatigue. The tourniquet with the ratcheting-fixation system controlled hemorrhage in less time than the windlass rod-based tourniquet, although achieving complete bleeding control had a low success rate.

Muscle synergies are associated with intermuscular coherence and cortico-synergy coherence in an isometric upper limb task

To elucidate the underlying physiological mechanisms of muscle synergies, we investigated long-range functional connectivity by cortico-muscular (CMC), intermuscular (IMC) and cortico-synergy (CSC) coherence. Fourteen healthy participants executed an isometric upper limb task in synergy-tuned directions. Cortical activity was recorded using 32-channel electroencephalography (EEG) and muscle activity using 16-channel electromyography (EMG). Using non-negative matrix factorisation (NMF), we calculated muscle synergies from two different tasks. A preliminary multidirectional task was used to identify synergy-preferred directions (PDs). A subsequent coherence task, consisting of generating forces isometrically in the synergy PDs, was used to assess the functional connectivity properties of synergies. Overall, we were able to identify four different synergies from the multidirectional task. A significant alpha band IMC was consistently present in all extracted synergies. Moreover, IMC alpha band was higher between muscles with higher weights within a synergy. Interestingly, CSC alpha band was also significantly higher across muscles with higher weights within a synergy. In contrast, no significant CMC was found between the motor cortex area and synergy muscles. The presence of a shared input onto synergistic muscles within a synergy supports the idea of neurally derived muscle synergies that build human movement. Our findings suggest cortical modulation of some of the synergies and the consequential existence of shared input between muscles within cortically modulated synergies.

Effects of wrist posture and stabilization on precision grip force production and muscle activation patterns

Most of the power for generating forces in the fingers arises from muscles located in the forearm. This configuration maximizes finger joint range of motion while minimizing finger mass and inertia. The resulting multiarticular arrangement of the tendons, however, complicates independent control of the wrist and the digits. Actuating the wrist impacts sensorimotor control of the fingers and vice versa. The goal of this study was to systematically investigate interactions between isometric wrist and digit control. Specifically, we examined how the need to maintain a specified wrist posture influences precision grip. Fifteen healthy adults produced maximum precision grip force at 11 different wrist flexion/extension angles, with the arm supported, under two conditions: 1) the participant maintained the desired wrist angle while performing the precision grip and 2) a robot maintained the specified wrist angle. Wrist flexion/extension posture significantly impacted maximum precision grip force (P < 0.001), with the greatest grip force achieved when the wrist was extended 30° from neutral. External wrist stabilization by the robot led to a 20% increase in precision grip force across wrist postures. Increased force was accompanied by increased muscle activation but with an activation pattern similar to the one used when the participant had to stabilize their wrist. Thus, simultaneous wrist and finger requirements impacted performance of an isometric finger task. External wrist stabilization can promote increased precision grip force resulting from increased muscle activation. These findings have potential clinical significance for individuals with neurologically driven finger weakness, such as stroke survivors.NEW & NOTEWORTHY We explored the interdependence between wrist and fingers by assessing the influence of wrist posture and external stabilization on precision grip force generation. We found that maximum precision grip force occurred at an extended wrist posture and was 20% greater when the wrist was Externally Stabilized. The latter resulted from amplification of muscle activation patterns from the Self-Stabilized condition rather than adoption of new patterns exploiting external wrist stabilization.

The Influence of Transcranial Alternating Current Stimulation on Fatigue Resistance

Previous research has shown that some forms of non-invasive brain stimulation can increase fatigue resistance. The purpose of this study is to determine the influence of transcranial alternating current stimulation (tACS) on the time to task failure (TTF) of a precision grip task. The study utilized a randomized, double-blind, SHAM-controlled, within-subjects design. Twenty-six young adults completed two experimental sessions (tACS and SHAM) with a 7-day washout period between sessions. Each session involved a fatiguing isometric contraction of the right hand with a precision grip with either a tACS or SHAM stimulation applied to the primary motor cortex (M1) simultaneously. For the fatiguing contraction, the participants matched an isometric target force of 20% of the maximum voluntary contraction (MVC) force until task failure. Pre- and post-MVCs were performed to quantify the force decline due to fatigue. Accordingly, the dependent variables were the TTF and MVC force decline as well as the average EMG activity, force error, and standard deviation (SD) of force during the fatiguing contractions. The results indicate that there were no significant differences in any of the dependent variables between the tACS and SHAM conditions (p value range: 0.256-0.820). These findings suggest that tACS does not increase the TTF during fatiguing contractions in young adults.

Recovery of pinch force sense after short-term fatigue

The aim of this study was to identify the exact origin of force sense and identify whether it arises centrally or peripherally. The present study was designed to analyze the effects of short-term fatigue on pinch force sense and the duration of these effects. During the fatigue protocol, twenty (10 men and 10 women; Mage = 22.0 years old) young Chinese participants were asked to squeeze maximally until the pinch grip force decreased to 50% of its maximal due to fatigue. Participants were instructed to produce the target force (10% of maximal voluntary isometric contraction) using the same hand before and after fatigue (immediately, 10, 30, 60, 180, 300 s). The results showed significantly higher absolute error immediately after fatigue (1.22 ± 1.06 N) than before fatigue (0.68 ± 0.34 N), and 60 s (0.76 ± 0.69 N), 180 s (0.67 ± 0.42 N), and 300 s (0.75 ± 0.37 N) after fatigue (all P < 0.05) but with no effect on the variable error (P > 0.05). It was also revealed that there was a significant overestimate of the constant error values before (0.32 ± 0.61 N) and immediately after fatigue (0.80 ± 1.38 N, all P < 0.05), while no significant overestimation or underestimation exceeded 300 s after fatigue (P > 0.05). Our study results revealed that short-term fatigue resulted in a significant decrease in force sense accuracy, but it did not affect force sense consistently; however, force sense accuracy recovered to a certain extent within 10 s and 30 s, whereas it recovered fully within 60 s, and force sense directivity improvement exceeded 300 s after fatigue. The present study shows that the sense of tension (peripherally) is also an important factor affecting force sense. Our study supports the view that the periphery is part of the origin of force sense.

Cerebellar Excitability Regulates Physical Fatigue Perception

Fatigue is the subjective sensation of weariness, increased sense of effort, or exhaustion and is pervasive in neurologic illnesses. Despite its prevalence, we have a limited understanding of the neurophysiological mechanisms underlying fatigue. The cerebellum, known for its role in motor control and learning, is also involved in perceptual processes. However, the role of the cerebellum in fatigue remains largely unexplored. We performed two experiments to examine whether cerebellar excitability is affected after a fatiguing task and its association with fatigue. Using a crossover design, we assessed cerebellar inhibition (CBI) and perception of fatigue in humans before and after "fatigue" and "control" tasks. Thirty-three participants (16 males, 17 females) performed five isometric pinch trials with their thumb and index finger at 80% maximum voluntary capacity (MVC) until failure (force <40% MVC; fatigue) or at 5% MVC for 30 s (control). We found that reduced CBI after the fatigue task correlated with a milder perception of fatigue. In a follow-up experiment, we investigated the behavioral consequences of reduced CBI after fatigue. We measured CBI, perception of fatigue, and performance during a ballistic goal-directed task before and after the same fatigue and control tasks. We replicated the observation that reduced CBI after the fatigue task correlated with a milder perception of fatigue and found that greater endpoint variability after the fatigue task correlated with reduced CBI. The proportional relation between cerebellar excitability and fatigue indicates a role of the cerebellum in the perception of fatigue, which might come at the expense of motor control.SIGNIFICANCE STATEMENT Fatigue is one of the most common and debilitating symptoms in neurologic, neuropsychiatric, and chronic illnesses. Despite its epidemiological importance, there is a limited understanding of the neurophysiological mechanisms underlying fatigue. In a series of experiments, we demonstrate that decreased cerebellar excitability relates to lesser physical fatigue perception and worse motor control. These results showcase the role of the cerebellum in fatigue regulation and suggest that fatigue- and performance-related processes might compete for cerebellar resources.

Abnormal proximal-distal interactions in upper-limb of stroke survivors during object manipulation: A pilot study

Despite its importance, abnormal interactions between the proximal and distal upper extremity muscles of stroke survivors and their impact on functional task performance has not been well described, due in part to the complexity of upper extremity tasks. In this pilot study, we elucidated proximal-distal interactions and their functional impact on stroke survivors by quantitatively delineating how hand and arm movements affect each other across different phases of functional task performance, and how these interactions are influenced by stroke. Fourteen subjects, including nine chronic stroke survivors and five neurologically-intact subjects participated in an experiment involving transport and release of cylindrical objects between locations requiring distinct proximal kinematics. Distal kinematics of stroke survivors, particularly hand opening, were significantly affected by the proximal kinematics, as the hand aperture decreased and the duration of hand opening increased at the locations that requires shoulder abduction and elbow extension. Cocontraction of the extrinsic hand muscles of stroke survivors significantly increased at these locations, where an increase in the intermuscular coherence between distal and proximal muscles was observed. Proximal kinematics of stroke survivors was also affected by the finger extension, but the cocontraction of their proximal muscles did not significantly increase, suggesting the changes in the proximal kinematics were made voluntarily. Our results showed significant proximal-to-distal interactions between finger extension and elbow extension/shoulder abduction of stroke survivors exist during their functional movements. Increased cocontraction of the hand muscles due to increased neural couplings between the distal and proximal muscles appears to be the underlying mechanism.

[Update on prosthesis for partial hand and finger amputations]

Partial hand and finger amputations are relatively rare but devastating due to the consequences they provoque. In addition, they are more likely than lower limb amputations in car accidents, work accidents and by certain weapons of war. Men are going to have a much higher risk of traumatic amputation than women, with a rate 6.6 times higher. Fitting can be a complex process and a challenge for professionals. For this reason, it is important to know all the options available on the market that can meet the needs of patients, from cosmetic to myoelectric prostheses. Fitting requires the coordinated activity of a multiassistant clinical work team, the center of the team being the person who has suffered the amputation, who must have all the information possible to be able to actively participate in decision-making.

Force and electromyography reflections of sensory action-effect weighting during pinching

Ideomotor theories suggest that different action-effects are not equally important in goal-directed actions, and that task-relevant information are weighted stronger during the representation of actions. This stronger weighting of task-relevant action-effects might also enable to utilize them as retrieval cues of the corresponding motor patterns. The aim of the present study was to investigate how the consistent presence or absence of a sound action-effect influenced the retrieval of the motor components of a simple, everyday action (pinching) as reflected by the pattern of force application and surface electromyogram (sEMG) recorded from the abductor pollicis brevis (APB) and first dorsal interosseous (FDI). Participants applied pairs of pinch impulses to a force sensitive resistor (FSR). The presence or absence of a sound action-effect and the between-action interval (BAI, 2 or 4 s) were manipulated blockwise, whereas the target force level (low or high) was randomly cued from trial to trial. When actions resulted in a sound, force and sEMG activity were reduced. This effect was more pronounced for low target force level trials, which is compatible with a stronger weighting of the sound action-effect when the intensity of the tactile and proprioceptive action-effects is low. Surprisingly, the FDI activity was more variable within actions pairs in the 2 s BAI conditions, which suggests that action pairs separated by the longer time interval might have been represented differently from those separated by the shorter interval.

Execution of natural manipulation in the air enhances the beta-rhythm intermuscular coherences of the human arm depending on muscle pairs

Natural manipulation tasks in air consist of two kinematic components: a grasping component, with activation of the hand muscles, and a lifting component, with activation of the proximal muscles. However, it remains unclear whether the synchronized motor commands to the hand/proximal arm muscles are divergently controlled during the task. Therefore, we examined how intermuscular coherence was modulated depending on the muscle combinations during grip and lift (G&L) tasks. Electromyograms (EMGs) were recorded from the biceps brachii (BB), triceps brachii (TB), flexor digitorum superficialis (FDS), and extensor digitorum communis (EDC) muscles. The participants were required to maintain G&L tasks involving a small cubical box with the thumb and index and middle fingers. Consequently, we found that the beta-rhythm coherence (15-35 Hz) in BB-TB, BB-FDS, and TB-EDC pairs during G&L was significantly larger than that during the isolated task with cocontraction of the two target muscles but not BB-EDC, TB-FDS, and FDS-EDC (task and muscle pair specificities). These increases in beta-rhythm coherence were also observed in intramuscular EMG recordings. Furthermore, the results from the execution of several mimic G&L tasks revealed that the separated task-related motor signals and combinations between the motor signals/sensations of the fingertips or object load had minor contributions to the increase in the coherence. These results suggest that during G&L the central nervous system regulates synchronous drive onto motoneurons depending on the muscle pairs and that the multiple combination effect of the sensations of touch/object load and motor signals in the task promotes the synchrony of these pairs.NEW & NOTEWORTHY Natural manipulation in air consists of two kinematic components: grasping, with activation of hand muscles, and lifting, with activation of proximal muscles. We show that during the maintenance of object manipulation in air the central nervous system regulates the synchronous drive onto human motoneuron pools depending on the hand/proximal muscle pairs and that the multiple combination effect of the sensations of touch/object load and motor signals in the task promotes the synchrony of these pairs.

Less common synaptic input between muscles from the same group allows for more flexible coordination strategies during a fatiguing task

This study aimed to determine whether neural drive is redistributed between muscles during a fatiguing isometric contraction, and if so, whether the initial level of common synaptic input between these muscles constrains this redistribution. We studied two muscle groups: triceps surae (14 participants) and quadriceps (15 participants). Participants performed a series of submaximal isometric contractions and a torque-matched contraction maintained until task failure. We used high-density surface electromyography to identify the behavior of 1874 motor units from the soleus, gastrocnemius medialis (GM), gastrocnemius lateralis(GL), rectus femoris, vastus lateralis (VL), and vastus medialis(VM). We assessed the level of common drive between muscles in absence of fatigue using a coherence analysis. We also assessed the redistribution of neural drive between muscles during the fatiguing contraction through the correlation between their cumulative spike trains (index of neural drive). The level of common drive between VL and VM was significantly higher than that observed for the other muscle pairs, including GL-GM. The level of common drive increased during the fatiguing contraction, but the differences between muscle pairs persisted. We also observed a strong positive correlation of neural drive between VL and VM during the fatiguing contraction (r=0.82). This was not observed for the other muscle pairs, including GL-GM, which exhibited differential changes in neural drive. These results suggest that less common synaptic input between muscles allows for more flexible coordination strategies during a fatiguing task, i.e., differential changes in neural drive across muscles. The role of this flexibility on performance remains to be elucidated.

Multiplex Recurrence Network Analysis of Inter-Muscular Coordination During Sustained Grip and Pinch Contractions at Different Force Levels

Production of functional forces by human motor systems require coordination across multiple muscles. Grip and pinch are two prototypes for grasping force production. Each grasp plays a role in a range of hand functions and can provide an excellent paradigm for studying fine motor control. Despite previous investigations that have characterized muscle synergies during general force production, it is still unclear how intermuscular coordination differs between grip and pinch and across different force outputs. Traditional muscle synergy analyses, such as non-negative matrix factorization or principal component analysis, utilize dimensional reduction without consideration of nonlinear characteristics of muscle co-activations. In this study, we investigated the novel method of multiplex recurrence networks (MRN) to assess the inter-muscular coordination for both grip and pinch at different force levels. Unlike traditional methods, the MRN can leverage intrinsic similarities in muscle contraction dynamics and project its layers to the corresponding weighted network (WN) to better model muscle interactions. Twenty-four healthy volunteers were instructed to grip and pinch an apparatus with force production at 30%, 50%, and 70% of their respective maximal voluntary contraction (MVC). The surface electromyography (sEMG) signals were recorded from eight muscles, including intrinsic and extrinsic muscles spanning the hand and forearm. The sEMG signals were then analyzed using MRNs and WNs. Interlayer mutual information ( I ) and average edge overlap ( ω ) of MRNs and average shortest path length ( L ) of WNs were computed and compared across groups for grasp types (grip vs. pinch) and force levels (30%, 50% and 70% MVC). Results showed that the extrinsic, rather than the intrinsic muscles, had significant differences in network parameters between both grasp types ( ), and force levels ( ), and especially at higher force levels. Furthermore, I and ω were strengthened over time ( ) except with pinch at 30% MVC. Results suggest that the central nervous system (CNS) actively increases cortical oscillations over time in response to increasing force levels and changes in force production with different sustained grasping types. Muscle coupling in extrinsic muscles was higher than in intrinsic muscles for both grip and pinch. The MRNs may be a valuable tool to provide greater insights into inter-muscular coordination patterns of clinical populations, assess neuromuscular function, or stabilize force control in prosthetic hands.

Directed Information Flow Analysis Reveals Muscle Fatigue-Related Changes in Muscle Networks and Corticomuscular Coupling

As a common neurophysiological phenomenon, voluntary muscle fatigue is accompanied by changes in both the central nervous system and peripheral muscles. Considering the effectiveness of the muscle network and the functional corticomuscular coupling (FCMC) in analyzing motor function, muscle fatigue can be analyzed by quantitating the intermuscular coupling and corticomuscular coupling. However, existing coherence-based research on muscle fatigue are limited by the inability of the coherence algorithm to identify the coupling direction, which cannot further reveal the underlying neural mechanism of muscle fatigue. To address this problem, we applied the time-delayed maximal information coefficient (TDMIC) method to quantitate the directional informational interaction in the muscle network and FCMC during a right-hand stabilized grip task. Eight healthy subjects were recruited to the present study. For the muscle networks, the beta-band information flow increased significantly due to muscle fatigue, and the information flow between the synergist muscles were stronger than that between the synergist and antagonist muscles. The information flow in the muscle network mainly flows to flexor digitorum superficialis (FDS), flexor carpi ulnar (FCU), and brachioradialis (BR). For the FCMC, muscle fatigue caused a significant decrease in the beta- and gamma-band bidirectional information flow. Further analysis revealed that the beta-band information flow was significantly stronger in the descending direction [electroencephalogram (EEG) to surface electromyography (sEMG)] than that in the ascending direction (sEMG to EEG) during pre-fatigue tasks. After muscle fatigue, the beta-band information flow in the ascending direction was significantly stronger than that in the descending direction. The present study demonstrates the influence of muscle fatigue on information flow in muscle networks and FCMC. We proposes that beta-band intermuscular and corticomuscular informational interaction plays an adjusting role in autonomous movement completion under muscle fatigue. Directed information flow analysis can be used as an effective method to explore the neural mechanism of muscle fatigue on the macroscopic scale.

Effect of tibial plateau levelling osteotomy and rehabilitation on muscle function in cruciate-deficient dogs evaluated with acoustic myography

The objective of the study was to determine the function of the biceps femoris, quadriceps, gastrocnemius and semitendinosus muscles at the walk in dogs with unilateral clinical cruciate disease and palpable joint instability. To compare function before and after a tibial plateau levelling osteotomy (TPLO) procedure, and after six weeks of subsequent rehabilitation therapy. Fourteen adult client-owned dogs with cranial cruciate ligament deficiency (CCLD). Orthopaedic examination, temporospatial gait analysis and acoustic myography (AMG) recordings were made at three time points: before TPLO, and post-operatively at two and eight weeks. A rehabilitation program started 2 weeks after surgery and was either in-clinic along with in-home rehabilitation or in-home only. Statistics included: repeated measures ANOVA and paired t-tests. Significance was set at P<0.05. When comparing the affected versus the unaffected limb in the CCLD dogs, there were no significant differences found in AMG values between baseline and other time points for the quadriceps and semitendinosus muscles. The gastrocnemius and biceps femoris muscles had a significant change in spatial summation (S) score over time. The gastrocnemius (S) score was not significantly different to the unaffected limb by 8 weeks post TPLO. There was no significant effect of rehabilitation method on S score. Dogs with in-clinic rehabilitation regained more symmetry in thigh circumference versus in-home only. Lameness parameters improved but did not completely resolve in all dogs by week 8 post TPLO. The function of the gastrocnemius muscles in affected limbs was significantly different to normal limbs at baseline and 2 weeks post TPLO but not at 8 weeks. Thigh symmetry, but no other parameters, was improved with the addition of in-clinic rehabilitation.

Long-Term Application of Cerebellar Transcranial Direct Current Stimulation Does Not Improve Motor Learning in Parkinson's Disease

Cerebellar transcranial direct current stimulation (c-tDCS) enhances motor skill acquisition and motor learning in young and old adults. Since the cerebellum is involved in the pathophysiology of Parkinson’s disease (PD), c-tDCS may represent an intervention with potential to improve motor learning in PD. The primary purpose was to determine the influence of long-term application of c-tDCS on motor learning in PD. The secondary purpose was to examine the influence of long-term application of c-tDCS on transfer of motor learning in PD. The study was a randomized, double-blind, SHAM-controlled, between-subjects design. Twenty-one participants with PD were allocated to either a tDCS group or a SHAM stimulation group. Participants completed 9 practice sessions over a 2-week period that involved extensive practice of an isometric pinch grip task (PGT) and a rapid arm movement task (AMT). These practice tasks were performed over a 25-min period concurrent with either anodal c-tDCS or SHAM stimulation. A set of transfer tasks that included clinical rating scales, manual dexterity tests, and lower extremity assessments were quantified in Test sessions at Baseline, 1, 14, and 28 days after the end of practice (EOP). There were no significant differences between the c-tDCS and SHAM groups as indicated by performance changes in the practice and transfer tasks from Baseline to the 3 EOP Tests. The findings indicate that long-term application of c-tDCS does not improve motor learning or transfer of motor learning to a greater extent than practice alone in PD.

Restoring Form and Function to the Partial Hand Amputee: Prosthetic Options from the Fingertip to the Palm

Partial hand amputations are the most common upper extremity amputations and affect individuals across a spectrum of socioeconomic and geographic backgrounds. Prosthetic devices can provide straightforward solutions to the devastating aesthetic, functional, psychological, and social deficits caused by these injuries. However, because of the recent development of multiple partial hand prosthetic devices, many hand providers remain unaware of their applicability in practice. This article highlights the various classes of partial hand prostheses currently available, including passive functional, body-powered, and externally powered options. Familiarity with these partial hand prostheses will better enable providers to care for partial hand amputees.

Altered supraspinal motor networks in survivors of poliomyelitis: A cortico-muscular coherence study

OBJECTIVE

Poliomyelitis results in changes to the anterior horn cell. The full extent of cortical network changes in the motor physiology of polio survivors has not been established. Our aim was to investigate how focal degeneration of the lower motor neurons (LMN) in infancy/childhood affects motor network connectivity in adult survivors of polio.

METHODS

Surface electroencephalography (EEG) and electromyography (EMG) were recorded during an isometric pincer grip task in 25 patients and 11 healthy controls. Spectral signal analysis of cortico-muscular (EEG-EMG) coherence (CMC) was used to identify the cortical regions that are functionally synchronous and connected to the periphery during the pincer grip task.

RESULTS

A pattern of CMC was noted in polio survivors that was not present in healthy individuals. Significant CMC in low gamma frequency bands (30-47 Hz) was observed in frontal and parietal regions.

CONCLUSION

These findings imply a differential engagement of cortical networks in polio survivors that extends beyond the motor cortex and suggest a disease-related functional reorganisation of the cortical motor network.

SIGNIFICANCE

This research has implications for other similar LMN conditions, including spinal muscular atrophy (SMA). CMC has potential in future clinical trials as a biomarker of altered function in motor networks in post-polio syndrome, SMA, and other related conditions.

An Acute Application of Cerebellar Transcranial Direct Current Stimulation Does Not Improve Motor Performance in Parkinson's Disease

Transcranial direct current stimulation of the cerebellum (c-tDCS) improves motor performance in young and old adults. Based on the cerebellar involvement in Parkinson’s disease (PD), c-tDCS could have potential to improve motor function in PD. The purpose was to determine the effects of c-tDCS on motor performance in PD while participants were on medications. The study was a randomized, double-blind, SHAM-controlled, between-subjects design. Twenty-two participants with PD were allocated to either a c-tDCS group or a SHAM group. All participants completed one experimental session and performed two motor tasks with their most affected hand in a Baseline condition (no stimulation) and an Experimental condition. The motor tasks were a visuomotor isometric precision grip task (PGT) and a rapid arm movement task (AMT). The primary dependent variables were force error and endpoint error in the PGT and AMT, respectively. There were no significant differences in force error or endpoint error in the Experimental condition between the c-tDCS and SHAM groups. These results indicate that an acute application of c-tDCS does not enhance motor performance in hand and arm tasks in PD. Longer-term c-tDCS application over multiple days may be needed to enhance motor function in PD.

Dynamic Analysis of Muscle Coordination at Different Force Levels during Grip and Pinch with Multiplex Recurrence Network

Muscle synergistic contraction to produce force has been recognized as an important neurophysiological mechanism in neuromuscular system. Despite a range of approaches, such as nonnegative matrix factorization or principal component analysis that have been widely used, limitations still exist in analysis of dynamic coordination of multiple muscles. In addition, it is still less studied about the potential difference of muscle dynamic coordination at different force levels during grip and pinch within the same framework. With this aim, this study analyzed the dynamic coordination of multiple upper-limb muscles at low, medium and high force levels during pinch and grip with multiplex recurrence network (MRN). Twenty-four healthy subjects participated in the experiment. Subjects were instructed to grip an apparatus to match the target force as stably as they could for 10 s. Surface electromyographic (sEMG) signals were recorded from 8 upper-limb muscles and analyzed by the MRN. The interlayer mutual information (I) and the average edge overlap (ω) of MRNs were calculated to quantify muscle correlation and muscle synchronization, respectively. Results showed that I and ω values of extrinsic muscles' MRNs during grip were significantly higher than that during grip at medium and high force. Furthermore, the I and ω values of extrinsic muscle networks during grip increased with augmented force levels. No significant changes were found for the intrinsic muscles with force output levels. These findings indicate that the muscles coordination patterns between grip and pinch were different and higher co-contraction of extrinsic muscles is favorable to synergistic force production. With the force output increased, muscles' coordination was augmented in extrinsic muscles, but no change in intrinsic muscles because of independent and complicated control of fingers. This study provides an analytical tool for dynamic muscles coordination and provides insights into the mechanisms of synergistic control of muscle contractions for force production.Clinical Relevance-This study provides a novel analytical tool for muscle coordination during force production, which may facilitate the evaluation of neuromuscular function or serve as indicators for neuromuscular disorders.

Intermuscular coherence between homologous muscles during dynamic and static movement periods of bipedal squatting

Coordination of functionally coupled muscles is a key aspect of movement execution. Demands on coordinative control increase with the number of involved muscles and joints, as well as with differing movement periods within a given motor sequence. While previous research has provided evidence concerning inter- and intramuscular synchrony in isolated movements, compound movements remain largely unexplored. With this study, we aimed to uncover neural mechanisms of bilateral coordination through intermuscular coherence (IMC) analyses between principal homologous muscles during bipedal squatting (BpS) at multiple frequency bands (alpha, beta, and gamma). For this purpose, participants performed bipedal squats without additional load, which were divided into three distinct movement periods (eccentric, isometric, and concentric). Surface electromyography (EMG) was recorded from four homologous muscle pairs representing prime movers during bipedal squatting. We provide novel evidence that IMC magnitudes differ between movement periods in beta and gamma bands, as well as between homologous muscle pairs across all frequency bands. IMC was greater in the muscle pairs involved in postural and bipedal stability compared with those involved in muscular force during BpS. Furthermore, beta and gamma IMC magnitudes were highest during eccentric movement periods, whereas we did not find movement-related modulations for alpha IMC magnitudes. This finding thus indicates increased integration of afferent information during eccentric movement periods. Collectively, our results shed light on intermuscular synchronization during bipedal squatting, as we provide evidence that central nervous processing of bilateral intermuscular functioning is achieved through task-dependent modulations of common neural input to homologous muscles.

NEW & NOTEWORTHY It is largely unexplored how the central nervous system achieves coordination of homologous muscles of the upper and lower body within a compound whole body movement, and to what extent this neural drive is modulated between different movement periods and muscles. Using intermuscular coherence analysis, we show that homologous muscle functions are mediated through common oscillatory input that extends over alpha, beta, and gamma frequencies with different synchronization patterns at different movement periods.

Age-specific modulation of intermuscular beta coherence during gait before and after experimentally induced fatigue

We examined the effects of age on intermuscular beta-band (15–35 Hz) coherence during treadmill walking before and after experimentally induced fatigue. Older (n = 12) and younger (n = 12) adults walked on a treadmill at 1.2 m/s for 3 min before and after repetitive sit-to-stand, rSTS, to induce muscle fatigability. We measured stride outcomes and coherence from 100 steps in the dominant leg for the synergistic (biceps femoris (BF)-semitendinosus, rectus femoris (RF)-vastus lateralis (VL), gastrocnemius lateralis (GL)-Soleus (SL), tibialis anterior (TA)-peroneus longus (PL)) and for the antagonistic (RF-BF and TA-GL) muscle pairs at late swing and early stance. Older vs. younger adults had 43–62% lower GL-SL, RF-VL coherence in swing and TA-PL and RF-VL coherence in stance. After rSTS, RF-BF coherence in late swing decreased by ~ 20% and TA-PL increased by 16% independent of age (p = 0.02). Also, GL-SL coherence decreased by ~ 23% and increased by ~ 23% in younger and older, respectively. Age affects the oscillatory coupling between synergistic muscle pairs, delivered presumably via corticospinal tracts, during treadmill walking. Muscle fatigability elicits age-specific changes in the common fluctuations in muscle activity, which could be interpreted as a compensation for muscle fatigability to maintain gait performance.

The effects of aging on the distribution and strength of correlated neural inputs to postural muscles during unperturbed bipedal stance

The present study investigated the effects of aging on the distribution of common descending neural drives to main postural muscles acting on the ankle, knee, hip, and lower trunk. The presence, distribution, and strength of these drives were assessed using intermuscular coherence estimations at a low-frequency band (0-55 Hz). Ten healthy older adults (68.7 ± 3.5 years) with no recent history of falls and ten healthy younger adults (26.8 ± 2.7 years) performed bipedal stances with eyes either opened or closed. Electromyographic (EMG) signals of six postural muscles were recorded. Estimations of intermuscular coherence were obtained from fifteen muscle pairs and four muscle groups. In general, single-pair and pooled coherence analyzes revealed significant levels of signal synchronization within 1-10 Hz. Significant common drives to anterior, posterior, and antagonist muscle groups were observed for both cohorts of participants. However, older participants showed significantly stronger EMG-EMG synchronization in the frequency domain compared to younger participants. It seems that age-related sarcopenia, visual-vestibular-proprioceptive decline, cortical activation increase, presynaptic inhibition modulation decrease, and co-contraction increase had a major impact on strengthening the common drives to the aforementioned muscle groups. Differently from young adults, the absence of visual inputs did not reduce the magnitude of signal synchronization in older adults. These results suggest that the aging central nervous system seems to organize similar arrangements of common drives to postural antagonist muscles at different joints, and to postural muscles pushing the body either forward or backward when visual information is not available.

Is there sufficient evidence to explain the cause of sexually dimorphic behaviour in force steadiness?

Neuromuscular noise is a determining factor in the control of isometric force steadiness (FS), quantified as coefficient of variation (CV) of force around a preestablished target output. In this paper we examine sex-related differences of neural, muscular, and tendon influences on neuromuscular noise to understand FS in females and males. We use evidence from the literature to identify that CV of force is higher in females compared with males in the upper and lower body, with sex-related differences becoming less apparent with increasing age. Evaluation of sex-related physiology in tandem with results from FS studies indicate that differences in fibre type, contractile properties, and number of motor units (MUs) are unlikely contributors to differences in FS between females and males. MU type, behaviour of the population (inclusive of number of active MUs from the population), agonist–antagonist activity, maximal strength, and tendon mechanics are probable contributors to sexually dimorphic behaviour in FS. To clearly determine underlying causes of sex-related differences in FS, further study and reporting between females and males is required. Females and males are included in many studies; however, rich data on sexually dimorphic behaviour is lost when data are collapsed across sex or identified as nonsignificant without supporting values. This poses a challenge to identifying the underlying cause of females having higher CV of force than males. This review provides evidence of sexually dimorphic behaviour in FS and suggests that physiological differences between females and males effect neuromuscular noise, and in-turn contribute to sex-related differences in FS.

Effect of Task Failure on Intermuscular Coherence Measures in Synergistic Muscles

The term “task failure” describes the point when a person is not able to maintain the level of force required by a task. As task failure approaches, the corticospinal command to the muscles increases to maintain the required level of force in the face of a decreased mechanical efficacy. Nevertheless, most motor tasks require the synergistic recruitment of several muscles. How this recruitment is affected by approaching task failure is still not clear. The increase in the corticospinal drive could be due to an increase in synergistic recruitment or to overlapping commands sent to the muscles individually. Herein, we investigated these possibilities by combining intermuscular coherence and synergy analysis on signals recorded from three muscles of the quadriceps during dynamic leg extension tasks. We employed muscle synergy analysis to investigate changes in the coactivation of the muscles. Three different measures of coherence were used. Pooled coherence was used to estimate the command synchronous to all three muscles, pairwise coherence the command shared across muscle pairs and residual coherence the command peculiar to each couple of muscles. Our analysis highlights an overall decrease in synergistic command at task failure and an intensification of the contribution of the nonsynergistic shared command.

Interface Prostheses With Classifier-Feedback-Based User Training

It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.

Effects of hand configuration on muscle force coordination, co-contraction and concomitant intermuscular coupling during maximal isometric flexion of the fingers

PURPOSE

The mechanisms governing the control of musculoskeletal redundancy remain to be fully understood. The hand is highly redundant, and shows different functional role of extensors according to its configuration for a same functional task of finger flexion. Through intermuscular coherence analysis combined with hand musculoskeletal modelling during maximal isometric hand contractions, our aim was to better understand the neural mechanisms underlying the control of muscle force coordination and agonist-antagonist co-contraction.

METHODS

Thirteen participants performed maximal isometric flexions of the fingers in two configurations: power grip (Power) and finger-pressing on a surface (Press). Hand kinematics and force/moment measurements were used as inputs in a musculoskeletal model of the hand to determine muscular tensions and co-contraction. EMG-EMG coherence analysis was performed between wrist and finger flexors and extensor muscle pairs in alpha, beta and gamma frequency bands.

RESULTS

Concomitantly with tailored muscle force coordination and increased co-contraction between Press and Power (mean difference: 48.08%; p < 0.05), our results showed muscle-pair-specific modulation of intermuscular coupling, characterized by pair-specific modulation of EMG-EMG coherence between Power and Press (p < 0.05), and a negative linear association between co-contraction and intermuscular coupling for the ECR/FCR agonist-antagonist muscle pair (r = - 0.65; p < 0.05).

CONCLUSIONS

This study brings new evidence that pair-specific modulation of EMG-EMG coherence is related to modulation of muscle force coordination during hand contractions. Our results highlight the functional importance of intermuscular coupling as a mechanism contributing to the control of muscle force synergies and agonist-antagonist co-contraction.

Beta Band Corticomuscular Drive Reflects Muscle Coordination Strategies

During force production, hand muscle activity is known to be coherent with activity in primary motor cortex, specifically in the beta-band (15–30 Hz) frequency range. It is not clear, however, if this coherence reflects the control strategy selected by the nervous system for a given task, or if it instead reflects an intrinsic property of cortico-spinal communication. Here, we measured corticomuscular and intermuscular coherence between muscles of index finger and thumb while a two-finger pinch grip of identical net force was applied to objects which were either stable (allowing synergistic activation of finger muscles) or unstable (requiring individuated finger control). We found that beta-band corticomuscular coherence with the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles, as well as their beta-band coherence with each other, was significantly reduced when individuated control of the thumb and index finger was required. We interpret these findings to show that beta-band coherence is reflective of a synergistic control strategy in which the cortex binds task-related motor neurons into functional units.

Fadiga dos músculos extensores do punho diminui a força de preensão palmar

RESUMO O objetivo deste estudo foi avaliar os efeitos de um protocolo de fadiga dos músculos extensores de punho na força de preensão e da pinça lateral através da dinamometria e eletromiografia de superfície (EMG). Foram selecionados 40 indivíduos do sexo masculino, divididos em dois grupos: preensão ou pinça lateral. O protocolo de fadiga foi baseado no teste de 1 Repetição Máxima (1-RM), seguido da realização do movimento de extensão de punho repetidas vezes com carga de 75% da 1-RM. Os voluntários realizaram as tarefas de preensão ou pinça lateral associadas à dinamometria. A EMG foi realizada para ambos os grupos, analisando o comportamento, segundo o protocolo, pela frequência mediana (FM) do extensor radial do carpo (ERC), do extensor ulnar do carpo (EUC) e do flexor superficial dos dedos (FD). A dinamometria de preensão ou pinça lateral e a EMG foram realizadas antes e após o protocolo de fadiga para ambos os grupos. O protocolo de fadiga foi eficaz na diminuição da força de preensão palmar (43,5±3,85 kgf inicial e 36,50±5,1 kgf final) e da pinça lateral (10,26±1,01 kgf inicial e 8,54±0,86 kgf final), bem como na diminuição da FM, sugerindo uma condição de fadiga do EUC no grupo preensão. Os achados do presente estudo possibilitam relacionar a fadiga dos extensores de punho à diminuição de força em atividades funcionais, como a preensão, o que pode implicar em disfunções musculoesqueléticas do membro superior.

High-Frequency Intermuscular Coherence between Arm Muscles during Robot-Mediated Motor Adaptation

Adaptation of arm reaching in a novel force field involves co-contraction of upper limb muscles, but it is not known how the co-ordination of multiple muscle activation is orchestrated. We have used intermuscular coherence (IMC) to test whether a coherent intermuscular coupling between muscle pairs is responsible for novel patterns of activation during adaptation of reaching in a force field. Subjects (N = 16) performed reaching trials during a null force field, then during a velocity-dependent force field and then again during a null force field. Reaching trajectory error increased during early adaptation to the force-field and subsequently decreased during later adaptation. Co-contraction in the majority of all possible muscle pairs also increased during early adaptation and decreased during later adaptation. In contrast, IMC increased during later adaptation and only in a subset of muscle pairs. IMC consistently occurred in frequencies between ~40–100 Hz and during the period of arm movement, suggesting that a coherent intermuscular coupling between those muscles contributing to adaptation enable a reduction in wasteful co-contraction and energetic cost during reaching.

Factors affecting the musculoskeletal disorders of workers in the frozen food manufacturing factories in Thailand

The purpose of this research was to study factors affecting musculoskeletal disorders. The sample population of the study was 528 factory workers from the frozen food industry, as well as a controlled group of 255 office workers. The samples were collected during interviews using the Nordic questionnaire to assess musculoskeletal disorders, and to assess the risk by the rapid upper limb assessment and rapid entire body assessment techniques. The findings of the study were that most symptoms were found in the dissecting department, higher than in the controlled group. The details of the symptoms were, accordingly: elbow pain (adjusted odds ratio, 35.1; 95% CI [17.4, 70.9]). Regarding the risk of alcohol drinking, workers were exposed to more risks when alcohol was consumed. It is suggested that workers' health should be monitored regularly. People who work in a cold environment should be encouraged to wear body protection and to avoid drinking.

Muscle fatigue increases beta-band coherence between the firing times of simultaneously active motor units in the first dorsal interosseous muscle

Synchronization between the firing times of simultaneously active motor units (MUs) is generally assumed to increase during fatiguing contractions. To date, however, estimates of MU synchronization have relied on indirect measures, derived from surface electromyographic (EMG) interference signals. This study used intramuscular coherence to investigate the correlation between MU discharges in the first dorsal interosseous muscle during and immediately following a submaximal fatiguing contraction, and after rest. Coherence between composite MU spike trains, derived from decomposed surface EMG, were examined in the delta (1-4 Hz), alpha (8-12 Hz), beta (15-30 Hz), and gamma (30-60 Hz) frequency band ranges. A significant increase in MU coherence was observed in the delta, alpha, and beta frequency bands postfatigue. In addition, wavelet coherence revealed a tendency for delta-, alpha-, and beta-band coherence to increase during the fatiguing contraction, with subjects exhibiting low initial coherence values displaying the greatest relative increase. This was accompanied by an increase in MU short-term synchronization and a decline in mean firing rate of the majority of MUs detected during the sustained contraction. A model of the motoneuron pool and surface EMG was used to investigate factors influencing the coherence estimate. Simulation results indicated that changes in motoneuron inhibition and firing rates alone could not directly account for increased beta-band coherence postfatigue. The observed increase is, therefore, more likely to arise from an increase in the strength of correlated inputs to MUs as the muscle fatigues.

The proportion of common synaptic input to motor neurons increases with an increase in net excitatory input

α-Motor neurons receive synaptic inputs from spinal and supraspinal centers that comprise components either common to the motor neuron pool or independent. The input shared by motor neurons--common input--determines force control. The aim of the study was to investigate the changes in the strength of common synaptic input delivered to motor neurons with changes in force and with fatigue, two conditions that underlie an increase in the net excitatory drive to the motor neurons. High-density surface electromyogram (EMG) signals were recorded from the tibialis anterior muscle during contractions at 20, 50, and 75% of the maximal voluntary contraction force (in 3 sessions separated by at least 2 days), all sustained until task failure. EMG signal decomposition identified the activity of a total of 1,245 motor units. The coherence values between cumulative motor unit spike trains increased with increasing force, especially for low frequencies. This increase in coherence was not observed when comparing two subsets of motor units having different recruitment thresholds, but detected at the same force level. Moreover, the coherence values for frequencies <5 Hz increased at task failure with respect to the beginning of the contractions for all force levels. In conclusion, the results indicated that the relative strength of common synaptic input to motor neurons increases with respect to independent input when the net excitatory drive to motor neurons increases as a consequence of a change in force and fatigue.

Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?

BACKGROUND

The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp.

QUESTIONS/PURPOSES

We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase?

METHODS

We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (Fr) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system.

RESULTS

The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2-7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1-5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2-3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2-2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035-0.050 for thumb and 0.016-0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3-1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9-2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039-0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6-0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3-0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6-0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3-0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20-0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16-0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05-0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04-0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04-0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02-0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20-0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02-0.02 N], p = 0.01).

CONCLUSIONS

Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release.

CLINICAL RELEVANCE

The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.

Power spectrum of the rectified EMG: when and why is rectification beneficial for identifying neural connectivity?

OBJECTIVE

The identification of common oscillatory inputs to motor neurons in the electromyographic (EMG) signal power spectrum is often preceded by EMG rectification for enhancing the low-frequency oscillatory components. However, rectification is a nonlinear operator and its influence on the EMG signal spectrum is not fully understood. In this study, we aim at determining when EMG rectification is beneficial in the study of oscillatory inputs to motor neurons.

APPROACH

We provide a full mathematical description of the power spectrum of the rectified EMG signal and the influence of the average shape of the motor unit action potentials on it. We also provide a validation of these theoretical results with both simulated and experimental EMG signals.

MAIN RESULTS

Simulations using an advanced computational model and experimental results demonstrated the accuracy of the theoretical derivations on the effect of rectification on the EMG spectrum. These derivations proved that rectification is beneficial when assessing the strength of low-frequency (delta and alpha bands) common synaptic inputs to the motor neurons, when the duration of the action potentials is short, and when the level of cancellation is relatively low. On the other hand, rectification may distort the estimation of common synaptic inputs when studying higher frequencies (beta and gamma), in a way dependent on the duration of the action potentials, and may introduce peaks in the coherence function that do not correspond to physiological shared inputs.

SIGNIFICANCE

This study clarifies the conditions when rectifying the surface EMG is appropriate for studying neural connectivity.

Common musculoskeletal problem experienced by fishing industry workers

Introduction:

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world and a major cause of disability in the workplace. Awkward working posture is a main risk factor for developing WMSDs. Assessment of exposure level to WMSDs risks can be an appropriate base for planning and implementing interventional ergonomics program in the workplace. Fihing in India is a major industry in the coastal states employing over 14 million people. The job demand of fishermen make them vulnerable for various musculoskeletal problems This study was conducted among workers of fishing industry in Mumbai, India with the objective to determine WMSDs prevalence in fishing industry.

Materials and Methods:

In this cross-sectional study, 110 randomly selected workers from fishing industry, India, Mumbai, Anonymous questionnaire was used to study prevalence of WMSDs.visual analogue scale used to assess intensity of pain.

Results:

The results of NMQ revealed that WMSDs occurrence was high. The highest rates of WMSDs prevalence were reported in Low back(92.4%), Shoulder (64.8%) and Knee(31%) and Hand (25%).

Conclusion:

This study showed that maximum of the fishermen have musculoskeletal problem with the most common joint involved is low back and then followed by shoulder, knee, and hand. Ergonomic risk factor involved were found to be repeated pulling and throwing of the net as well as repeated bending forward action to lift heavy load and transfer that heavy load.

Fatigue-related electromyographic coherence and phase synchronization analysis between antagonistic elbow muscles

The aim of this study was to examine coherence and phase synchronization between antagonistic elbow muscles and thus to explore the coupling and common neural inputs of antagonistic elbow muscles during sustained submaximal isometric fatiguing contraction. Fifteen healthy male subjects sustained an isometric elbow flexion at 20 % maximal level until exhaustion, while surface electromyographic signals (sEMG) were collected from biceps brachii (BB) and triceps brachii (TB). sEMG signals were divided into the first half (stage 1 with minimal fatigue) and second half (stage 2 with severe fatigue) of the contraction. Coherence and phase synchronization analysis was conducted between sEMG of BB and TB, and coherence value and phase synchronization index in alpha (8-12 Hz), beta (15-35 Hz) and gamma (35-60 Hz) frequency bands were obtained. Significant increase in EMG-EMG coherence and phase synchronization index in alpha and beta frequency bands between antagonistic elbow flexion muscles was observed all increased in stage 2 compared to stage 1. Coupling of EMG activities between antagonistic muscles increased as a result of fatigue caused by 20 % maximal level sustained isometric elbow flexion, indicating the increased interconnection between synchronized cortical neurons and the motoneuron pool of BB and TB, which may be cortical in origin. This increased coupling may help to maintain coactivation level so as to ensure joint stability on the basis of maintaining the joint force output.

Quantification of functional hand grip using electromyography and inertial sensor-derived accelerations: clinical implications

BACKGROUND

Assessing hand injury is of great interest given the level of involvement of the hand with the environment. Knowing different assessment systems and their limitations generates new perspectives. The integration of digital systems (accelerometry and electromyography) as a tool to supplement functional assessment allows the clinician to know more about the motor component and its relation to movement. Therefore, the purpose of this study was the kinematic and electromyography analysis during functional hand movements.

METHOD

Ten subjects carried out six functional movements (terminal pinch, termino-lateral pinch, tripod pinch, power grip, extension grip and ball grip). Muscle activity (hand and forearm) was measured in real time using electromyograms, acquired with the Mega ME 6000, whilst acceleration was measured using the AcceleGlove.

RESULTS

Electrical activity and acceleration variables were recorded simultaneously during the carrying out of the functional movements. The acceleration outcome variables were the modular vectors of each finger of the hand and the palm. In the electromyography, the main variables were normalized by the mean and by the maximum muscle activity of the thenar region, hypothenar, first interosseous dorsal, wrist flexors, carpal flexors and wrist extensors.

CONCLUSIONS

Knowing muscle behavior allows the clinician to take a more direct approach in the treatment. Based on the results, the tripod grip shows greater kinetic activity and the middle finger is the most relevant in this regard. Ball grip involves most muscle activity, with the thenar region playing a fundamental role in hand activity.

CLINICAL RELEVANCE

Relating muscle activation, movements, individual load and displacement offers the possibility to proceed with rehabilitation by individual component.

The extraction of neural strategies from the surface EMG: an update

A surface EMG signal represents the linear transformation of motor neuron discharge times by the compound action potentials of the innervated muscle fibers and is often used as a source of information about neural activation of muscle. However, retrieving the embedded neural code from a surface EMG signal is extremely challenging. Most studies use indirect approaches in which selected features of the signal are interpreted as indicating certain characteristics of the neural code. These indirect associations are constrained by limitations that have been detailed previously (Farina D, Merletti R, Enoka RM. J Appl Physiol 96: 1486-1495, 2004) and are generally difficult to overcome. In an update on these issues, the current review extends the discussion to EMG-based coherence methods for assessing neural connectivity. We focus first on EMG amplitude cancellation, which intrinsically limits the association between EMG amplitude and the intensity of the neural activation and then discuss the limitations of coherence methods (EEG-EMG, EMG-EMG) as a way to assess the strength of the transmission of synaptic inputs into trains of motor unit action potentials. The debated influence of rectification on EMG spectral analysis and coherence measures is also discussed. Alternatively, there have been a number of attempts to identify the neural information directly by decomposing surface EMG signals into the discharge times of motor unit action potentials. The application of this approach is extremely powerful, but validation remains a central issue.

Subspace based adaptive denoising of surface EMG from neurological injury patients

OBJECTIVE

After neurological injuries such as spinal cord injury, voluntary surface electromyogram (EMG) signals recorded from affected muscles are often corrupted by interferences, such as spurious involuntary spikes and background noises produced by physiological and extrinsic/accidental origins, imposing difficulties for signal processing. Conventional methods did not well address the problem caused by interferences. It is difficult to mitigate such interferences using conventional methods. The aim of this study was to develop a subspace-based denoising method to suppress involuntary background spikes contaminating voluntary surface EMG recordings.

APPROACH

The Karhunen-Loeve transform was utilized to decompose a noisy signal into a signal subspace and a noise subspace. An optimal estimate of EMG signal is derived from the signal subspace and the noise power. Specifically, this estimator is capable of making a tradeoff between interference reduction and signal distortion. Since the estimator partially relies on the estimate of noise power, an adaptive method was presented to sequentially track the variation of interference power. The proposed method was evaluated using both semi-synthetic and real surface EMG signals.

MAIN RESULTS

The experiments confirmed that the proposed method can effectively suppress interferences while keep the distortion of voluntary EMG signal in a low level. The proposed method can greatly facilitate further signal processing, such as onset detection of voluntary muscle activity.

SIGNIFICANCE

The proposed method can provide a powerful tool for suppressing background spikes and noise contaminating voluntary surface EMG signals of paretic muscles after neurological injuries, which is of great importance for their multi-purpose applications.

The effect of tendon vibration on motor unit activity, intermuscular coherence and force steadiness in the elbow flexors of males and females

BACKGROUND

Compartmentalized responses in motor unit (MU) activity of the short head (SH) and long head (LH) of the biceps brachii are observed following forearm position change. Differential muscle spindle afferent distribution has been proposed as a potential mechanism underlying this behaviour. Tendon vibration is an effective, non-invasive method of increasing muscle spindle afferent activity of a target muscle group offering a paradigm in which this hypothesis may be investigated further.

AIM

To determine the effect of tendon vibration on MU recruitment and discharge rates of the SH and LH, muscle activity of the elbow flexors and triceps brachii, intermuscular coherence among the SH, LH, brachioradialis and triceps brachii and force steadiness in young males and females during isometric elbow flexion.

METHODS

Intramuscular electromyography (EMG) of the SH and LH, and surface EMG of the elbow flexors were recorded pre- and post-vibration during low-force isometric contractions. Motor unit recruitment thresholds, MU discharge rates and MU discharge variability; surface EMG amplitude, intermuscular coherence and force steadiness were determined pre- and post-vibration.

RESULTS

Differential changes in all MU properties, EMG amplitude and intermuscular coherence were observed among elbow flexors. Although MU properties exhibited differential changes, they accounted for little variance in isometric force steadiness. However, intermuscular EMG coherence among all muscles investigated was reduced post-vibration.

CONCLUSION

Uncoupling of common oscillatory input as a result of differential muscle spindle afferent inputs to elbow flexors may be responsible for the reduction in force steadiness following tendon vibration and a forearm position change.

Selective effects of arm proximal and distal muscles fatigue on force coordination in manipulation tasks

Effects of muscle fatigue on force coordination and task performance of various manipulation tasks are explored. Grip force (GF; normal force component acting at the digits-object contact area) and load force (LF; tangential component that lifts and holds objects) were recorded prior to and after fatiguing the distal (DAM; i.e., GF producing) and proximal arm muscles (PAM; LF producing). Results reveal a deterioration of GF scaling (i.e., averaged GF-LF ratio), GF-LF coupling (their correlation), and task performance (ability to exert a prescribed LF pattern) associated with DAM, but not PAM fatigue. Deteriorated force coordination clearly increases the likelihood of dropping an object; however, the observed selective effects of DAM and PAM fatigue represent a novel finding deserving of further research.

Motor unit activity after eccentric exercise and muscle damage in humans

It is well known that unaccustomed eccentric exercise leads to muscle damage and soreness, which can produce long-lasting effects on muscle function. How this muscle damage influences muscle activation is poorly understood. The purpose of this brief review is to highlight the effect of eccentric exercise on the activation of muscle by the nervous system, by examining the change in motor unit activity obtained from surface electromyography (EMG) and intramuscular recordings. Previous research shows that eccentric exercise produces unusual changes in the EMG–force relation that influences motor performance during isometric, shortening and lengthening muscle contractions and during fatiguing tasks. When examining the effect of eccentric exercise at the single motor unit level, there are substantial changes in recruitment thresholds, discharge rates, motor unit conduction velocities and synchronization, which can last for up to 1 week after eccentric exercise. Examining the time course of these changes suggests that the increased submaximal EMG after eccentric exercise most likely occurs through a decrease in motor unit conduction velocity and an increase in motor unit activity related to antagonist muscle coactivation and low-frequency fatigue. Furthermore, there is a commonly held view that eccentric exercise produces preferential damage to high-threshold motor units, but the evidence for this in humans is limited. Further research is needed to establish whether there is preferential damage to high-threshold motor units after eccentric exercise in humans, preferably by linking changes in motor unit activity with estimates of motor unit size using selective intramuscular recording techniques.