Mechanomyography versus electromyography, in monitoring the muscular fatigue

An Exploration of Wearable Device Features Used in UK Hospital Parkinson Disease Care: Scoping Review

BACKGROUND

The prevalence of Parkinson disease (PD) is becoming an increasing concern owing to the aging population in the United Kingdom. Wearable devices have the potential to improve the clinical care of patients with PD while reducing health care costs. Consequently, exploring the features of these wearable devices is important to identify the limitations and further areas of investigation of how wearable devices are currently used in clinical care in the United Kingdom.

OBJECTIVE

In this scoping review, we aimed to explore the features of wearable devices used for PD in hospitals in the United Kingdom.

METHODS

A scoping review of the current research was undertaken and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The literature search was undertaken on June 6, 2022, and publications were obtained from MEDLINE or PubMed, Embase, and the Cochrane Library. Eligible publications were initially screened by their titles and abstracts. Publications that passed the initial screening underwent a full review. The study characteristics were extracted from the final publications, and the evidence was synthesized using a narrative approach. Any queries were reviewed by the first and second authors.

RESULTS

Of the 4543 publications identified, 39 (0.86%) publications underwent a full review, and 20 (0.44%) publications were included in the scoping review. Most studies (11/20, 55%) were conducted at the Newcastle upon Tyne Hospitals NHS Foundation Trust, with sample sizes ranging from 10 to 418. Most study participants were male individuals with a mean age ranging from 57.7 to 78.0 years. The AX3 was the most popular device brand used, and it was commercially manufactured by Axivity. Common wearable device types included body-worn sensors, inertial measurement units, and smartwatches that used accelerometers and gyroscopes to measure the clinical features of PD. Most wearable device primary measures involved the measured gait, bradykinesia, and dyskinesia. The most common wearable device placements were the lumbar region, head, and wrist. Furthermore, 65% (13/20) of the studies used artificial intelligence or machine learning to support PD data analysis.

CONCLUSIONS

This study demonstrated that wearable devices could help provide a more detailed analysis of PD symptoms during the assessment phase and personalize treatment. Using machine learning, wearable devices could differentiate PD from other neurodegenerative diseases. The identified evidence gaps include the lack of analysis of wearable device cybersecurity and data management. The lack of cost-effectiveness analysis and large-scale participation in studies resulted in uncertainty regarding the feasibility of the widespread use of wearable devices. The uncertainty around the identified research gaps was further exacerbated by the lack of medical regulation of wearable devices for PD, particularly in the United Kingdom where regulations were changing due to the political landscape.

Masticatory Function in Individuals with Temporomandibular Disorders: A Systematic Review and Meta-Analysis

The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol in the PubMed, Cochrane Library, LILACS, EBSCO, Scielo, between 2012 and 2022. The methodological quality was assessed by using the Newcastle-Ottawa Study Quality Assessment Scale. Mean differences and 95% confidence intervals were calculated and combined in meta-analyses. A total of 1202 participants were included in this systematic review (690 with TMD; 512 without TMD), with 22 articles being included in the qualitative analysis. Only three studies enabled the comparative analysis of the results. Ten articles showed a high methodological quality and a low risk of bias, and twelve had a low methodological quality and an increased risk of bias. The meta-analysis showed that the differences between the intervention and control groups were not statistically significant for the percentage overlapping coefficient of the anterior temporal muscle, for the masseter, and for the torque coefficient. The parameters analyzed with the compound technique for chewing showed altered mandibular functions in individuals with TMD. With the EMG method, it was possible to suggest that TMD in adult individuals causes compensatory muscle behaviors, and several changes in the masticatory function were found.

Effects of Upper Blepharoplasty Techniques on Headaches, Eyebrow Position, and Electromyographic Outcomes: A Randomized Controlled Trial

The aim of this study was to assess changes in headaches, eyebrow height, and electromyographic (EMG) outcomes of the frontalis and orbicularis oculi muscles, after an upper blepharoplasty with or without resecting a strip of orbicularis oculi muscle. In a randomized controlled trial, 54 patients received an upper blepharoplasty involving either only removing skin (group A) or removing skin with an additional strip of orbicularis muscle (group B). Preoperative, and 6 and 12 months postoperative headache complaints were assessed using the HIT-6 scores and eyebrow heights were measured on standardised photographs. Surface EMG measurements, i.e., electrical activity and muscle fatigue, were assessed for the frontalis and orbicularis oculi muscles preoperatively and 2, 6, and 12 months postoperatively. Significantly fewer headaches were reported following a blepharoplasty. The eyebrow height had decreased, but did not differ between groups. Regarding the surface EMG measurements, only group A's frontalis muscle electrical activity had decreased significantly during maximal contraction 12 months after surgery (80 vs. 39 mV, p = 0.026). Fatigue of both the frontalis and the orbicularis oculi muscles did not change significantly postoperatively compared to baseline. EMG differences between groups were minor and clinically insignificant. The eyebrow height decreased and patients reported less headaches after upper blepharoplasty irrespective of the used technique.

Effects of Differing Foam Rolling Periods on Training Volume and Myoelectric Responses of Lower-Body Muscles

ABSTRACT

Santana, HG, Paz, GA, Willardson, JM, de Araújo Farias, D, and Miranda, H. Effects of differing foam rolling periods on training volume and myoelectric responses of lower-body muscles. J Strength Cond Res 36(12): 3311-3318, 2022-Foam rolling (FR) is a practice that has increased in popularity before and after resistance training. The purpose of this study was to compare the acute effects of different foam rolling periods for the lower body muscles on subsequent performance, myoelectric activity and rating of perceived exertion in trained men. Fourteen men (26.2 ± 3.2 years, 178 ± 0.04 cm, 82.2 ± 10 kg and body mass index 25.9 ± 3.3kg/m -2 ) volunteered for this study. Four repetition maximum (4-RM) loads were determined for hexagonal bar deadlift and 45°-angled leg press during test and retest sessions over two nonconsecutive days. The experimental conditions included a traditional protocol (TP) with no prior foam rolling, and four other conditions that involved FR applied to the quadriceps, hamstrings and triceps surae for one set of 30 sec (P1), two sets of 30 sec (P2), three sets of 30 sec (P3), or four sets of 30 sec (P4).The resistance training consisted of five sets with 4-RM loads. The number of repetitions completed, the myoelectric activity of lower limbs were recorded, as well as the rating of perceived exertion for each protocol. There were no differences between the protocols in the total repetitions for the hexagonal bar deadlift and 45° angled leg press exercises. Similar results between protocols were also noted for muscle activity and rated perceived exertion (RPE). Therefore, the results of the present study indicated that the FR didn't provide effects on performance, myoelectric activity and rating of perceived exertion responses during high intensity resistance performance for lower limb exercises.

Physiological factors affecting the mechanical performance of peripheral muscles: A perspective for long COVID patients through a systematic literature review

Background: Peripheral muscle weakness can be measured quantitatively in long COVID patients. Mechanomyography (MMG) is an alternative tool to measure muscle strength non-invasively.

Objective: This literature review aims to provide evidence on the efficacy of MMG in measuring muscle strength for long COVID patients and to determine the physiological factors that may affect the use of MMG in assessing muscle performance.

Methods: A systematic literature review was conducted using EBSCO’s MEDLINE Complete. A total of five out of 2,249 potential publications fulfilled the inclusion criteria.

Results: The selected studies addressed muscle performance based on the physiological effects of age, gender, and physical activity level. MMG is sensitive in measuring muscle strength for long COVID patients due to its higher signal-to-noise ratio and lightweight accelerometers. Its neglectable skin impedance and low risk of influences during the recording of surface motions make MMG a reliable tool.

Conclusion: Muscle performance is affected by age, gender, and physical activity level. Sensors, such as MMG, as well as the length of the muscle and the characteristics of the muscle activity, are important considerations when choosing a sensor for diagnostic evaluation. The efficacy of MMG in measuring muscle strength for long COVID patients and the physiological factors that may affect the use of MMG in assessing muscle performance are discussed.

Analysis of anthropometrics and mechanomyography signals as forearm flexion, pronation and supination torque predictors

This study aimed to analyze anthropometrics and mechanomyography (MMG) signals as forearm flexion, pronation, and supination torque predictors. 25 young, healthy, male participants performed isometric forearm flexion, pronation, and supination tasks from 20 to 100% maximal voluntary isometric contraction (MVIC) while maintaining 90° at the elbow joint. Nine anthropometric measures were recorded, and MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were digitally acquired using triaxial accelerometers. These were then correlated with torque values. Significant positive correlations were found for arm circumference (CA) and MMG root mean square (RMS) values with flexion torque. Flexion torque might be predicted using CA (r = 0.426–0.575), a pseudo for muscle size while MMG_RMS (r = 0.441), an indication of muscle activation.

An Exploration of Wearable Device Features Used in UK Hospital Parkinson Disease Care: Scoping Review (Preprint).. [DOI: 10.2196/preprints.42950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

The prevalence of Parkinson disease (PD) is becoming an increasing concern owing to the aging population in the United Kingdom. Wearable devices have the potential to improve the clinical care of patients with PD while reducing health care costs. Consequently, exploring the features of these wearable devices is important to identify the limitations and further areas of investigation of how wearable devices are currently used in clinical care in the United Kingdom.

OBJECTIVE

In this scoping review, we aimed to explore the features of wearable devices used for PD in hospitals in the United Kingdom.

METHODS

A scoping review of the current research was undertaken and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The literature search was undertaken on June 6, 2022, and publications were obtained from MEDLINE or PubMed, Embase, and the Cochrane Library. Eligible publications were initially screened by their titles and abstracts. Publications that passed the initial screening underwent a full review. The study characteristics were extracted from the final publications, and the evidence was synthesized using a narrative approach. Any queries were reviewed by the first and second authors.

RESULTS

Of the 4543 publications identified, 39 (0.86%) publications underwent a full review, and 20 (0.44%) publications were included in the scoping review. Most studies (11/20, 55%) were conducted at the Newcastle upon Tyne Hospitals NHS Foundation Trust, with sample sizes ranging from 10 to 418. Most study participants were male individuals with a mean age ranging from 57.7 to 78.0 years. The AX3 was the most popular device brand used, and it was commercially manufactured by Axivity. Common wearable device types included body-worn sensors, inertial measurement units, and smartwatches that used accelerometers and gyroscopes to measure the clinical features of PD. Most wearable device primary measures involved the measured gait, bradykinesia, and dyskinesia. The most common wearable device placements were the lumbar region, head, and wrist. Furthermore, 65% (13/20) of the studies used artificial intelligence or machine learning to support PD data analysis.

CONCLUSIONS

This study demonstrated that wearable devices could help provide a more detailed analysis of PD symptoms during the assessment phase and personalize treatment. Using machine learning, wearable devices could differentiate PD from other neurodegenerative diseases. The identified evidence gaps include the lack of analysis of wearable device cybersecurity and data management. The lack of cost-effectiveness analysis and large-scale participation in studies resulted in uncertainty regarding the feasibility of the widespread use of wearable devices. The uncertainty around the identified research gaps was further exacerbated by the lack of medical regulation of wearable devices for PD, particularly in the United Kingdom where regulations were changing due to the political landscape.

CLINICALTRIAL

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Case Study: Intra- and Interpersonal Coherence of Muscle and Brain Activity of Two Coupled Persons during Pushing and Holding Isometric Muscle Action

Inter-brain synchronization is primarily investigated during social interactions but had not been examined during coupled muscle action between two persons until now. It was previously shown that mechanical muscle oscillations can develop coherent behavior between two isometrically interacting persons. This case study investigated if inter-brain synchronization appears thereby, and if differences of inter- and intrapersonal muscle and brain coherence exist regarding two different types of isometric muscle action. Electroencephalography (EEG) and mechanomyography/mechanotendography (MMG/MTG) of right elbow extensors were recorded during six fatiguing trials of two coupled isometrically interacting participants (70% MVIC). One partner performed holding and one pushing isometric muscle action (HIMA/PIMA; tasks changed). The wavelet coherence of all signals (EEG, MMG/MTG, force, ACC) were analyzed intra- and interpersonally. The five longest coherence patches in 8−15 Hz and their weighted frequency were compared between real vs. random pairs and between HIMA vs. PIMA. Real vs. random pairs showed significantly higher coherence for intra-muscle, intra-brain, and inter-muscle-brain activity (p < 0.001 to 0.019). Inter-brain coherence was significantly higher for real vs. random pairs for EEG of right and central areas and for sub-regions of EEG left (p = 0.002 to 0.025). Interpersonal muscle-brain synchronization was significantly higher than intrapersonal one, whereby it was significantly higher for HIMA vs. PIMA. These preliminary findings indicate that inter-brain synchronization can arise during muscular interaction. It is hypothesized both partners merge into one oscillating neuromuscular system. The results reinforce the hypothesis that HIMA is characterized by more complex control strategies than PIMA. The pilot study suggests investigating the topic further to verify these results on a larger sample size. Findings could contribute to the basic understanding of motor control and is relevant for functional diagnostics such as the manual muscle test which is applied in several disciplines, e.g., neurology, physiotherapy.

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

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

FEATURES ANALYSIS AND SYSTEM IDENTIFICATION OF MECHANOMYOGRAPHY AND ELECTROMYOGRAPHY UNDER TRANSCRANIAL MAGNETIC STIMULATION

Transcranial magnetic stimulation (TMS) is an electrophysiological technique that uses alternating magnetic fields to deliver electric current and stimulate the cerebral cortex. When TMS is used for the evaluation of brain diseases, it is necessary to detect the contraction of the corresponding muscles in the cerebral cortex stimulated by TMS, and the muscle activity referred to as motor evoked potential (MEP). This study simultaneously recorded the mechanomyography (MMG) and electromyography (EMG) from the right abductor pollicis brevis muscle during TMS with different intensities in order to observe whether the MEP parameters from MMG signals showed similar trait of EMG recordings. Moreover, the subspace method (N4SID) and transfer function were used to identify the TMS–MMG system. In this system, the input was a pulse signal of TMS, and the output was the MMG signal detected from the target muscle. The TMS–MMG system was identified as a fourth-order model. This study also analyzed the internal features of the system and demonstrated that the poles of healthy subjects were distributed in a range, and the gain increased with the increase of the TMS intensity. It was found that MMG signals can be used as diagnostic indicators of TMS, and the TMS–MMG model can be used to further explore the details of how TMS generates responses measured with MMG.

One Session Effects of Knee Motion Visualization Using Immersive Virtual Reality in Patients with Hemophilic Arthropathy

(1) Background: Hemophilic knee arthropathy is characterized by a loss of muscle mass and decreased strength of the quadriceps muscle. The visualization of movement aims to favor the recruitment of the motor system in the same premotor and parietal areas, as would happen with the active execution of the observed action. The aim was to evaluate changes in quadriceps activation in patients with hemophilic knee arthropathy following immersive VR visualization of knee extension movements. (2) Methods: We recruited 13 patients with severe hemophilia A and knee arthropathy. Patients underwent a 15 min session of immersive VR visualization of knee extension movements. The quadriceps muscle activation was evaluated by surface electromyography. (3) Results: After the intervention, there were no changes in the muscle activation of vastus medialis, vastus lateralis, or rectus femoris muscles. There was a large effect size of changes in rectus femoris muscle activation. Age and knee joint damage did not correlate with changes in quadriceps activation. Dominance, inhibitor development, and type of treatment were not related with post-intervention muscle activation. (4) Conclusions: A session of immersive VR visualization of knee extension movement does not modify quadriceps muscle activation. A specific protocol for patients with hemophilic knee arthropathy may be effective in improving the activation of the rectus femoris muscle.

Effects of compression garments on surface EMG and physiological responses during and after distance running

BACKGROUND

The few previous studies that focused on the effects of compression garments (CG) on distance running performance have simultaneously measured electromyogram, physiological, and perceptual parameters. Therefore, this study investigated the effects of CG on muscle activation and median frequency during and after distance running, as well as blood-lactate concentration and rating of perceived exertion (RPE) during distance running.

METHODS

Eight healthy male recreational runners were recruited to randomly perform two 40 min treadmill running trials, one with CG, and the other with control garment made of normal cloth. The RPE and the surface electromyography (EMG) of 5 lower extremity muscles including gluteus maximus (GM), rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA), and gastrocnemius (GAS) were measured during the running trial. The blood-lactate levels before and after the running trial were measured.

RESULTS

Wearing CG led to significant lower muscle activation (p  <  0.05) in the GM (decreased 7.40%-14.31%), RF (decreased 4.39%-4.76%), and ST (decreased 3.42%-7.20%) muscles; moreover, significant higher median frequency (p< 0.05) in the GM (increased 5.57%) and ST (increased 10.58%) muscles. Wearing CG did not alter the RPE values or the blood-lactate levels (p > 0.05).

CONCLUSION

Wearing CG was associated with significantly lower muscle activation and higher median frequency in the running-related key muscles during distance running. This finding suggested that wearing CG may improve muscle function, which might enhance running performance and prevent muscle fatigue.

Effect of push-up variations performed with Swiss ball on muscle electromyographic amplitude in trained men: A cross-sectional study

PURPOSE

To compare the use of three variations of push-ups: traditional (stable surface), performed with hands on the Swiss ball (Swiss ball-hands), and performed with feet on the Swiss ball (Swiss ball-feet) on surface electromyography activity (sEMG) in the agonist and stabilizer muscles.

METHODS

Ten trained men (26 ± 5 years, 76.8 ± 8.7 kg, 1.70 ± 0.06 m) performed one experimental protocol within-subjects in a randomized design. Each subject performed one set of 10 of each of the push-up variations (5-min rest between sets). The sEMG activity was assessed for pectoralis major, triceps brachii, anterior deltoids, and rectus abdominis. One-way repeated-measures ANOVA (Bonferroni) compared push-up variations within-muscles (p < 0.05).

RESULTS

Pectoralis major sEMG was similar between exercises. Anterior deltoid sEMG activity was greater for stable surface than for Swiss ball-hands (p = 0.001). Triceps brachii sEMG activity was greater during Swiss ball-hands than during stable surface (p = 0.001) and Swiss ball-feet (p = 0.043), and Swiss ball-feet was greater than stable surface (p = 0.001). Rectus abdominis sEMG activity was greater during Swiss ball-hands than during stable surface (p = 0.0001) and Swiss ball-feet (p = 0.036), while Swiss ball-feet was greater than stable surface (p = 0.046).

CONCLUSIONS

Push-ups performed with hands on the Swiss ball may be considered an advanced variation that should be used when the goal is to achieve greater challenge of the rectus abdominis and triceps brachii. Novice subjects or those with weakness/injury should perform push-ups with hands on a stable surface, and with progression, push-ups with feet on Swiss ball could be adopted before hands on Swiss ball.

Quadriceps mechanomyography reflects muscle fatigue during electrical stimulus-sustained standing in adults with spinal cord injury - a proof of concept

This study investigates whether mechanomyography (MMG) produced from contracting muscles as a measure of their performance could be a proxy of muscle fatigue during a sustained functional electrical stimulation (FES)-supported standing-to-failure task. Bilateral FES-evoked contractions of quadriceps and glutei muscles, of four adults with motor-complete spinal cord injury (SCI), were used to maintain upright stance using two different FES frequencies: high frequency (HF - 35 Hz) and low frequency (LF - 20 Hz). The time at 30° knee angle reduction was taken as the point of critical "fatigue failure", while the generated MMG characteristics were used to track the pattern of force development during stance. Quadriceps fatigue, which was primarily responsible for the knee buckle, was characterized using MMG-root mean square (RMS) amplitude. A double exponential decay model fitted the MMG fatigue data with good accuracy [R2 = 0.85-0.99; root mean square error (RMSE) = 2.12-8.10] implying changes in the mechanical activity performance of the muscle's motor units. Although the standing duration was generally longer for the LF strategy (31-246 s), except in one participant, when compared to the HF strategy, such differences were not significant (p > 0.05) but suggested a faster muscle fatigue onset during HF stimulation. As MMG could discriminate between different stimulation frequencies, we speculate that this signal can quantify muscle fatigue characteristics during prolonged FES applications.

Myoelectric Responses of Lower-Body Muscles Performing Squat and Lunge Exercise Variations Adopting Visual Feedback With a Laser Sensor

STUDY DESIGN

Cross-over study.

CONTEXT

The squat, single-leg squat, forward lunge, and reverse lunge are fundamental movements often performed in activities of daily living, sports competitions, and sport-specific training.

OBJECTIVE

The purpose of this study was to investigate the effect of visual feedback with a laser sensor (VFLS) versus a control condition on the myoelectric activity (surface electromyography [sEMG]) of the vastus medialis oblique (VMO), vastus lateralis, gluteus medius (Gmed), and erector spinae muscles during the performance of several squat variations with bodyweight.

METHODS

Nineteen female college students (20 [2.5] y, 165.3 [10.2] cm, 66.4 [4.1] kg, 2 [1.2] y of resistance training experience) with a background in strength or sports training volunteered to participate in this study. Over 4 separate visits, subjects performed 2 sets of 10 repetitions of a squat variation exercise in random order (ie, squat, single-leg squat, forward lunge, and reverse lunge). The first set of a given squat variation condition was considered a control set, and then after 3-minute rest, a second set was performed with VFLS.

RESULTS

Significant decreases in VMO and Gmed myoelectric activity were observed during the VFLS set versus the control set for the forward lunge exercise (P = .03). No differences were observed between the control set and VFLS set in the sEMG normalized signal for all muscles analyzed for the squat and single-leg squat, respectively. However, the sample entropy of the sEMG signal for the erector spinae became more irregular during the VFLS set versus the control set for the squat exercise (P = .01), whereas the Gmed presented a more irregular sEMG signal during the VFLS set versus the control set for the single-leg squat (P = .08).

CONCLUSION

Laser sensor biofeedback may induce significant decreases in VMO and Gmed activation performing forward lunge exercise. Therefore, laser sensor biofeedback may induce a reduction in muscle activity of neutralizers muscles during a few squat bodyweight variations (bilateral, single-leg, forward, and reverse lunge).

Segmenting Mechanomyography Measures of Muscle Activity Phases Using Inertial Data

Electromyography (EMG) is the standard technology for monitoring muscle activity in laboratory environments, either using surface electrodes or fine wire electrodes inserted into the muscle. Due to limitations such as cost, complexity, and technical factors, including skin impedance with surface EMG and the invasive nature of fine wire electrodes, EMG is impractical for use outside of a laboratory environment. Mechanomyography (MMG) is an alternative to EMG, which shows promise in pervasive applications. The present study used an exerting squat-based task to induce muscle fatigue. MMG and EMG amplitude and frequency were compared before, during, and after the squatting task. Combining MMG with inertial measurement unit (IMU) data enabled segmentation of muscle activity at specific points: entering, holding, and exiting the squat. Results show MMG measures of muscle activity were similar to EMG in timing, duration, and magnitude during the fatigue task. The size, cost, unobtrusive nature, and usability of the MMG/IMU technology used, paired with the similar results compared to EMG, suggest that such a system could be suitable in uncontrolled natural environments such as within the home.

Description and Intrarater Test-Retest Reliability of a Reverse-Action Method to Assess Ankle Evertor Muscle Performance: The I-to-V Test

Purpose: Reverse action (RA) of the ankle evertor muscle is when the proximal attachment moves toward the distal attachment, moving the lower leg in the frontal plane when the foot and ankle are fixed on the ground and inducing ankle eversion. The purpose of this study was to describe an RA method for measuring ankle evertor muscle performance. Method: Eighteen healthy individuals were recruited for this study. To assess the RA of their ankle evertors, the participants sat with their knees together and their feet firmly planted on the floor, then spread their knees as far apart as possible. A tester used a measuring tape to measured the distance (in cm) between the medial tibial tuberosity of the tested side and that of the non-tested side. In the end range position of the RA, ankle evertor electromyographic activity was recorded simultaneously. The intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were calculated to establish the intrarater test-retest reliability. The correlation between each performance value and muscle activity was assessed using a linear correlation model. Results: The proposed method of assessing RA performance was highly reliable (ICC=0.95) and had a low SEM (1.63 cm); in addition, the performance value showed a strong positive correlation with ankle evertor muscle activity (ρ=0.90; 95% CI: 0.79, 0.95; p=0.01). Conclusions: The proposed RA method of assessing the ankle evertor muscles can be used as a simple, reliable, economical performance test. It can also be used as an alternate method of testing the peroneal muscles rather than selectively measuring ankle evertor performance because hip external rotation occurs when performing RA.

Mechanomyography-based muscle fatigue detection during electrically elicited cycling in patients with spinal cord injury

Patients with spinal cord injury (SCI) benefit from muscle training with functional electrical stimulation (FES). For safety reasons and to optimize training outcome, the fatigue state of the target muscle must be monitored. Detection of muscle fatigue from mel frequency cepstral coefficient (MFCC) feature of mechanomyographic (MMG) signal using support vector machine (SVM) classifier is a promising new approach. Five individuals with SCI performed FES cycling exercises for 30 min. MMG signals were recorded on the quadriceps muscle group (rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM)) and categorized into non-fatigued and fatigued muscle contractions for the first and last 10 min of the cycling session. For each subject, a total of 1800 contraction-related MMG signals were used to train the SVM classifier and another 300 signals were used for testing. The average classification accuracy (4-fold) of non-fatigued and fatigued state was 90.7% using MFCC feature, 74.5% using root mean square (RMS), and 88.8% with combined MFCC and RMS features. Inter-subject prediction accuracy suggested training and testing data to be based on a particular subject or large collection of subjects to improve fatigue prediction capacity. Graphical abstract ᅟ.

Analysis of fatigue in the three heads of the triceps brachii during isometric contractions at various effort levels

OBJECTIVE

The objective of this study was to investigate fatigue in the three heads of the triceps brachii (TB) muscle using surface electromyography (sEMG) obtained at 30%, 45% and 60% of maximal voluntary contraction (MVC).

METHODS

Twenty-five subjects performed isometric elbow extension until failure, and the rate of fatigue (ROF), time to fatigue (TTF) and normalized TTF (NTTF) were statistically analysed. Subsequently, the behaviour of root-mean-square (RMS), mean-power frequency (MPF) and median-power frequency (MDF) under pre-, onset- and post-fatigue conditions were compared.

RESULTS

The findings indicated that, among the heads, ROF was statistically significant at 30% and 45% MVC (P<0.05) but TTF and NTTF at all intensities was statistically insignificant (P>0.05). For every head, only TTF was statistically significant (P<0.05) at different intensities. MPF and MDF under pre-, onset- and post-fatigue conditions were statistically significant (P<0.05) among the heads at all intensities, whereas RMS showed no such behaviour.

CONCLUSION

The investigated parameters reveal that the three heads of TB act independently before fatigue onset and appear to work in union after fatigue. Synergist head pairs exhibit similar spectral and temporal behaviour in contrast to the non-synergist TB head pair. We find spectral parameters to be more specific predictors of fatigue.

A systematic review of muscle activity assessment of the biceps brachii muscle using mechanomyography

This systematic review aims to categorically analyses the literature on the assessment of biceps brachii (BB) muscle activity through mechanomyography (MMG). The application of our search criteria to five different databases identified 319 studies. A critical review of the 48 finally selected records, revealed the diversity of protocols and parameters that are employed in MMG-based assessments of BB muscle activity. The observations were categorized into the following: muscle torque, fatigue, strength and physiology. The available information on the muscle contraction protocol, sensor(s), MMG signal parameters and obtained results were then tabulated based on these categories for further analysis. The review affirms that - 1) MMG is suitable for skeletal muscle activity assessment and can be employed potentially for further investigation of the BB muscle activity and condition (e.g., force, torque, fatigue, and contractile properties), 2) a majority of the records focused on static contractions of the BB, and the analysis of dynamic muscle contractions using MMG is thus a research gap, and 3) very few studies have focused on the analysis of BB muscle activity under externally stimulated contractions. Taken together, the findings of this review on BB activity assessment using MMG affirm the potential of MMG as an alternative tool.

Effect of exercise order with barbell and machine modalities on upper body volume load and myoelectric activity

The purpose of this study was to investigate the influence of exercise order on volume load (VL) and myoelectric activation (EMG) during the bench press (BP), military press (MP) and close-grip bench press (CGBP) exercises executed with a barbell and Smith machine. Twelve men experienced in resistance training performed four different exercise sessions in randomised order. Each session consisted of four sets of a given exercise order: O1 = CGBP + MP + BP with barbell; O2 = inverse O1 with barbell, O3 = same O1 with Smith Machine; O4 = same O2 with Smith machine. EMG was assessed for the Clavicular head pectoralis major (PMC), anterior deltoid (AD), triceps brachii long head (TBLH) and biceps brachii (BB). Results showed that VL in BP was affected by exercise order, independent of the mode (p < 0.05). However, the CGBP showed higher VL in O1. Moreover, when the BP was positioned last in the sequence (O1 and O3), myoelectric activity was higher for PMC, AD and TBLH (p < 0.05). Findings were similar in the CGBP (PMC and TBLH), but for the AD (Smith machine > barbell, p < 0.05). Therefore, it appears that the order and modes of exercises influence both volume load and myoelectric activation patterns during multiple set of resistance training.

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.

Reliability of mechanomyographic amplitude measurements for trunk muscles during maximal voluntary isometric contraction

BACKGROUND

Mechanomyography (MMG) has been used to investigate mechanical characteristics of muscle contraction in clinical and experimental settings.

OBJECTIVE

The aim of this study was to determine the test-retest reliability of mechanomyographic amplitude (MMGRMS) measurements as a tool for measuring the maximal voluntary isometric contractions (MVICs) of trunk muscles in healthy participants.

METHODS

There were ten young adults participating in this study. Accelerometers were used to detect surface MMG signals from three trials of 5-s MVICs of the rectus abdominis, external obliques, erector spinae, and multifidus in the vertical, transverse, and longitudinal directions. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change were calculated.

RESULTS

Good to excellent test-retest reliability of mechanomyographic amplitude (MMGRMS) measurements was achieved for all MVICs of trunk muscles in healthy participants, as indicated by ICCs ranging from 0.99 to 0.64 for MMGRMS of the trunk muscles during MVIC.

CONCLUSIONS

This study demonstrates that MMG is a reliable measurement to detect the activation amplitudes of trunk muscles during MVIC.

Mechanomyography and Torque during FES-Evoked Muscle Contractions to Fatigue in Individuals with Spinal Cord Injury

A mechanomyography muscle contraction (MC) sensor, affixed to the skin surface, was used to quantify muscle tension during repetitive functional electrical stimulation (FES)-evoked isometric rectus femoris contractions to fatigue in individuals with spinal cord injury (SCI). Nine persons with motor complete SCI were seated on a commercial muscle dynamometer that quantified peak torque and average torque outputs, while measurements from the MC sensor were simultaneously recorded. MC-sensor-predicted measures of dynamometer torques, including the signal peak (SP) and signal average (SA), were highly associated with isometric knee extension peak torque (SP: r = 0.91, p < 0.0001), and average torque (SA: r = 0.89, p < 0.0001), respectively. Bland-Altman (BA) analyses with Lin's concordance (ρC) revealed good association between MC-sensor-predicted peak muscle torques (SP; ρC = 0.91) and average muscle torques (SA; ρC = 0.89) with the equivalent dynamometer measures, over a range of FES current amplitudes. The relationship of dynamometer torques and predicted MC torques during repetitive FES-evoked muscle contraction to fatigue were moderately associated (SP: r = 0.80, p < 0.0001; SA: r = 0.77; p < 0.0001), with BA associations between the two devices fair-moderate (SP; ρC = 0.70: SA; ρC = 0.30). These findings demonstrated that a skin-surface muscle mechanomyography sensor was an accurate proxy for electrically-evoked muscle contraction torques when directly measured during isometric dynamometry in individuals with SCI. The novel application of the MC sensor during FES-evoked muscle contractions suggested its possible application for real-world tasks (e.g., prolonged sit-to-stand, stepping,) where muscle forces during fatiguing activities cannot be directly measured.

Features for muscle fatigue computed from electromyogram and mechanomyogram: A new one

Muscle fatigue produces negative effects in the performance and it may lead to a muscle failure. This problem makes the quantitative grading of muscle fatigue a necessity in ergonomic and physiological research. Moreover, the quantitative grading of muscle fatigue is needed to increase work and sport productivity and prevent several accidents that result from muscle fatigue. Even though there are many studies for this aim, there is no quantitative criterion for the evaluation of muscle fatigue. The main reason is that muscle fatigue is a complex physiological situation that is dependent on several parameters. Our aim in this study is to present a new feature to evaluate muscle fatigue and prove the reliability of the new feature by making correlation analyses between this with other features. For this aim, electromyography and mechanomyography signals were simultaneously recorded from the biceps brachii and triceps brachii muscles during the isometric and isotonic contractions of 60 healthy volunteers (30 females, 30 males). The mean power frequency and median frequency, which are used in the literature, were compared to the frequency ratio change, the new measure; correlations between the frequency ratio change and the mean power frequency and median frequency were analysed. There was a high correlation between the features, and frequency ratio change can be used to quantitatively evaluate muscle fatigue.

Efeito do tempo de contração e repouso na atividade dos músculos masseter e temporal anterior em indivíduos com DTM

RESUMO Objetivo O principal objetivo deste estudo foi investigar o efeito do tempo de contração e repouso na atividade dos músculos masseter e temporal. Métodos 49 sujeitos do sexo feminino com idade entre 18 e 30 anos foram divididos em grupos DTM (n: 26) e controle (n: 23). A eletromiografia de superfície foi utilizada para avaliar os músculos temporal anterior e masseter durante protocolos de contração e repouso muscular. Foram analisados os parâmetros eletromiográfico raiz quadrada da média, frequência mediana e o coeficiente da inclinação da reta de regressão linear. Resultados Foi encontrado efeito significativo do tempo no protocolo de contração e de repouso muscular. No protocolo de contração, sujeitos com DTM apresentaram significativa diminuição da frequência mediana no masseter direito e do coeficiente de inclinação do músculo temporal direito comparados ao grupo controle. Conclusão Apesar de os sujeitos com DTM apresentarem maior suscetibilidade à fadiga, comparados aos controles, ambos os grupos devem respeitar o tempo máximo de 5 s de contração voluntária máxima e no mínimo 30 s de repouso entre sucessivas contrações da musculatura mastigatória durante protocolos de avaliação clínica ou de pesquisa.

Effects of different rest intervals between antagonist paired sets on repetition performance and muscle activation

Recent evidence suggests that exercising the antagonist musculature acutely enhances subsequent performance for the agonist musculature. The purpose of this study was to examine the effects of different rest intervals between sets for exercises that involve antagonistic muscle groups, a technique referred to as antagonist paired sets (APS). Fifteen recreationally trained men were tested for knee extension (KE) exercise performance, with or without previous knee flexion (KF) exercise for the antagonist musculature. The following protocols were performed in random order with 10 repetition maximum loads for the KF and KE exercises: (a) traditional protocol (TP)-1 set of KE only to repetition failure; (b) paired sets with minimal allowable rest (PMR)-1 set of KF followed immediately by a set of KE; (c) P30-30-second rest between paired sets of KF and KE; (d) P1-1-minute rest between paired sets; (e) P3-3-minute rest between paired sets; and (f) P5-5-minute rest between paired sets. The number of repetitions performed and electromyographic (EMG) activity of vastus lateralis, vastus medialis (VM), and rectus femoris (RF) muscles were recorded during the KE set in each protocol. It was demonstrated that significantly greater KE repetitions were completed during the PMR, P30, and P1 protocols vs. the TP protocol. Significantly greater EMG activity was demonstrated for the RF muscle during the KE exercise in the PMR and P30 vs. the TP, P3, and P5, respectively. In addition, significantly greater EMG activity was demonstrated for the VM muscle during the PMR vs. all other protocols. The results of this study indicate that no rest or relatively shorter rest intervals (30 seconds and 1 minute) between APS might be more effective to elicit greater agonist repetition enhancement and muscle activation.

Bioelectrical activity of the pelvic floor muscles during synchronous whole-body vibration--a randomized controlled study

Background

More and more frequently stress urinary incontinence affects young healthy women. Hence, early implementation of effective preventive strategies in nulliparous continent women is essential, including pelvic floor muscle training. An initial evaluation based on the bioelectrical activity of the pelvic floor muscles (PFM) during whole-body vibration (WBV) would help to devise the best individualized training for prevention of stress urinary incontinence in woman. We hypothesized that synchronous WBV enhances bioelectrical activity of the PFM which depends on vibration frequency and peak-to-peak vibration displacement.

Methods

The sample consisted of 36 nulliparous continent women randomly allocated to three comparative groups. Group I and II subjects participated in synchronous whole-body vibrations on a vibration platform; the frequency and peak-to-peak displacement of vibration were set individually for each group. Control participants performed exercises similar to those used in the study groups but without the concurrent application of vibrations. Pelvic floor surface electromyography (sEMG) activity was recorded using a vaginal probe during three experimental trials limited to 30s, 60s and 90s. The mean amplitude and variability of the signal were normalized to the Maximal Voluntary Contraction – MVC.

Results

Friedman’s two-way ANOVA revealed a statistically significant difference in the mean normalized amplitudes (%MVC) of the sEMG signal from the PFM during 60s- and 90s-trials between the group exposed to high-intensity WBV and control participants (p < 0.05). Longer trial duration was associated with a statistically significant decrease in the variability of sEMG signal amplitude in the study and control groups (p < 0.05).

Conclusions

Synchronous high-intensity WBV (40 Hz, 4 mm) of long duration (60s, 90s) significantly enhances the activation of the PFM in young continent women. Prolonged maintenance of a static position significantly decreases the variability of sEMG signal amplitude independent of whole-body vibrations. Single whole-body vibrations in nulliparous continent women does not cause pelvic floor muscle fatigue.

Trial registration

The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12615000966594); registration date: 15/09/2015.

Mechanomyography and muscle function assessment: a review of current state and prospects

Previous studies have explored to saturation the efficacy of the conventional signal (such as electromyogram) for muscle function assessment and found its clinical impact limited. Increasing demand for reliable muscle function assessment modalities continues to prompt further investigation into other complementary alternatives. Application of mechanomyographic signal to quantify muscle performance has been proposed due to its inherent mechanical nature and ability to assess muscle function non-invasively while preserving muscular neurophysiologic information. Mechanomyogram is gaining accelerated applications in evaluating the properties of muscle under voluntary and evoked muscle contraction with prospects in clinical practices. As a complementary modality and the mechanical counterpart to electromyogram; mechanomyogram has gained significant acceptance in analysis of isometric and dynamic muscle actions. Substantial studies have also documented the effectiveness of mechanomyographic signal to assess muscle performance but none involved comprehensive appraisal of the state of the art applications with highlights on the future prospect and potential integration into the clinical practices. Motivated by the dearth of such critical review, we assessed the literature to investigate its principle of acquisition, current applications, challenges and future directions. Based on our findings, the importance of rigorous scientific and clinical validation of the signal is highlighted. It is also evident that as a robust complement to electromyogram, mechanomyographic signal may possess unprecedented potentials and further investigation will be enlightening.

Cross-talk in mechanomyographic signals from the forearm muscles during sub-maximal to maximal isometric grip force

PURPOSE

This study aimed: i) to examine the relationship between the magnitude of cross-talk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles with the sub-maximal to maximal isometric grip force, and with the anthropometric parameters of the forearm, and ii) to quantify the distribution of the cross-talk in the MMG signal to determine if it appears due to the signal component of intramuscular pressure waves produced by the muscle fibers geometrical changes or due to the limb tremor.

METHODS

Twenty, right-handed healthy men (mean ± SD: age  = 26.7±3.83 y; height  = 174.47±6.3 cm; mass  = 72.79±14.36 kg) performed isometric muscle actions in 20% increment from 20% to 100% of the maximum voluntary isometric contraction (MVIC). During each muscle action, MMG signals generated by each muscle were detected using three separate accelerometers. The peak cross-correlations were used to quantify the cross-talk between two muscles.

RESULTS

The magnitude of cross-talk in the MMG signals among the muscle groups ranged from, R2(x, y) = 2.45-62.28%. Linear regression analysis showed that the magnitude of cross-talk increased linearly (r2 = 0.857-0.90) with the levels of grip force for all the muscle groups. The amount of cross-talk showed weak positive and negative correlations (r2 = 0.016-0.216) with the circumference and length of the forearm respectively, between the muscles at 100% MVIC. The cross-talk values significantly differed among the MMG signals due to: limb tremor (MMGTF), slow firing motor unit fibers (MMGSF) and fast firing motor unit fibers (MMGFF) between the muscles at 100% MVIC (p<0.05, η2 = 0.47-0.80).

SIGNIFICANCE

The results of this study may be used to improve our understanding of the mechanics of the forearm muscles during different levels of the grip force.

Whole-body isometric force/torque measurements for functional assessment in neuro-rehabilitation: user interface and data pre-processing techniques

A diagnostic platform for the early functional assessment of post-stroke patients was designed in order to perform isometric measurements during activities of daily living (ADL) tasks. The outcome of these measurements can contribute to verify the integrity of a post-stroke existing or altered "internal model" for a particular functional task. A complete and reliable software application for the diagnostic platform was designed, developed and tested in three European hospitals. The software application was divided into two main modules: a graphical user interface (GUI) and the data pre-processing techniques for the interpretation of recorded biomedical and clinical data. This paper presents the software application associated to the platform, aimed at analysing and interpreting the huge amount of data recorded and collected during the experimental trials. Its main objective is related to validating the onset detection and data reduction. The software application presented in this paper has been working and validated with success in three different clinical centres in Europe and it can be effectively used both as assessment tool in rehabilitation and as research tool in neuroscience.

MEASUREMENT AND ESTIMATION OF MUSCLE CONTRACTION STRENGTH USING MECHANOMYOGRAPHY BASED ON ARTIFICIAL NEURAL NETWORK ALGORITHM

Muscle contraction strength estimation using mechanomyographic (MMG) signal is typically calculated by the root mean square (RMS) amplitude. Raw MMG signal is processed by rectification, low-pass filtering, and mapping. In this work, beside RMS amplitude, another significant parameter of MMG signal, i.e. frequency variance (VAR), is introduced and used for constructing an algorithm for estimating the muscle contraction strength. Seven participants produced isometric contractions about the elbow while MMG signal and generated torque (resultant of muscle contraction strength) of biceps brachii were recorded. We found that MMG RMS increased monotonously and VAR decreased under incremental voluntary contractions. Based on these results, a two-layer neural network was utilized for the model of estimating the muscle contraction strength from MMG RMS and VAR. Experimental evaluation was performed under constant posture and sinusoidal contractions at 0.5 Hz, 0.25 Hz, 0.125 Hz, and random frequency. The results of the proposed algorithm and MMG RMS linear mapping were also compared. The proposed algorithm has better accuracy than linear mapping for all contraction frequencies. The mean absolute error decreased 6% for the 0.5Hz contraction, 43% for 0.25 Hz contraction, 52% for 0.125 Hz contraction, and 30% for random frequency contraction.

Correlation between mechanomyography features and passive movements in healthy and paraplegic subjects

Mechanomyography (MMG) measures both muscular contraction and stretching activities and can be used as feedback in the control of neuroprostheses with Functional Electrical Stimulation (FES). In this study we evaluated the correlation between MMG features and passive knee angular movement of rectus femoris and vastus lateralis muscles acquired from healthy volunteers (HV) and spinal cord injured volunteers (SCIV). Twelve HV and thirteen SCIV were submitted to passive and FES elicited knee extensions and in each extension, eleven windows of analysis with 0.5s length were inspected. Temporal (RMS and INT) and frequency (MF and μ3) features were extracted. Spearman correlation coefficients (p) were computed in order to check correlations between the features obtained from both MMG sensors. The correlation between MMG(MF) and MMG temporal analysis (RMS and INT) to HV was classified as positive, moderate (p from 0.635 to 0.681) and high (p from 0.859 to 0.870), and weak (positive e negative) to SCIV. These results differ from those obtained in voluntary contraction or artificially evoked by functional electrical stimulation and may be relevant in applications with closed loop control systems.

Effects of local elastic compression on muscle strength, electromyographic, and mechanomyographic responses in the lower extremity

The purpose of this study was to investigate the effect of elastic compression on muscle strength, electromyographic (EMG), and mechanomyographic (MMG) responses of quadriceps femoris during isometric and isokinetic contractions. Twelve participants performed 5s isometric maximal voluntary contractions (MVC) and 25 consecutive and maximal isokinetic knee extensions at 60 and 300°/s with no (control, CC), medium (MC), and high (HC) compression applied to the muscle. The EMG and MMG signals were collected simultaneously with muscle isometric and isokinetic strength data. The results showed that the elevated compression did not improve peak torque, peak power, average power, total work, and regression of torque in the isometric and isokinetic contractions. However, the root mean squared value of EMG in both HC and MC significantly decreased compared with CC at 60 and 300°/s (p<0.01). Furthermore, the EMG mean power frequency in HC was significantly higher than that in CC at 60°/s (p<0.05) whereas no significant compression effect was found in the MMG mean power frequency. These findings provide preliminary evidence suggesting that the increase in local compression pressure may effectively increase muscle efficiency and this might be beneficial in reducing muscle fatigue during concentric isokinetic muscle contractions.

Mechanomyographic response during FES in healthy and paraplegic subjects

Mechanomyography (MMG) registers lateral oscillations of contracting muscles. Functional electrical stimulation (FES) improves the rehabilitation of paraplegic subjects and can be used in neuroprosthesis control. During FES application, muscular contraction responses may vary, possibly due to fatigue or adaptation of nerve cells face to electrical stimuli. This study measured the differences in MMG RMS and median frequency (MF) features between healthy (HV) and spinal cord injury (SCI) volunteers. Ten HV and three SCI participated in the research. FES waveform consisted of a monophasic square wave, 1kHz pulse frequency, 100us active pulse period and 3ms active burst period with burst frequency of 70Hz. For each stimulation series, three analysis windows were inspected. RMS and MF variations were inversely related. The obtained results may help to create new strategies of muscular closed-loop control.

Optimal FES parameters based on mechanomyographic efficiency index

Functional electrical stimulation (FES) can artificially elicit movements in spinal cord injured (SCI) subjects. FES control strategies involve monitoring muscle features and setting FES profiles so as to postpone the installation of muscle fatigue or nerve cell adaptation. Mechanomyography (MMG) sensors register the lateral oscillations of contracting muscles. This paper presents an MMG efficiency index (EI) that may indicate most efficient FES electrical parameters to control functional movements. Ten healthy and three SCI volunteers participated in the study. Four FES profiles with two FES sessions were applied with in-between 15min rest interval. MMG RMS and median frequency were inserted into the EI equation. EI increased along the test. FES profile set to 1kHz pulse frequency, 200εs active pulse duration and burst frequency of 50Hz was the most efficient.

The effect of a complex agonist and antagonist resistance training protocol on volume load, power output, electromyographic responses, and efficiency

The objective of this study was to investigate the acute effects of performing traditional set (TS) vs. complex set (CS) agonist-antagonist training over 3 consecutive sets, on bench press throw (BPT) throw height (TH), peak velocity (PV), peak power (PP), bench pull volume load (VL), and electromyographic (EMG) activity. Eighteen trained men performed 2 testing protocols: TS comprising 3 sets of Bpull followed by 3 sets of BPT performed in approximately 20 minutes or CS comprising 3 sets of both Bpull and BPT performed in an alternating manner in approximately 10 minutes. Throw height, PV, PP, and EMG activity were not different within, or between, the 2 conditions. Bench pull VL decreased significantly from set 1 to sets 2 and 3, under both conditions. Decreases from set 1 to set 2 were 14.55 +/- 26.11 and 9.07 +/- 13.89% and from set 1 to set 3 were 16.87 +/- 29.90 and 14.17 +/- 18.37% under CS and TS, respectively. There was no difference in VL per set, or session, between the conditions. Although there was no augmentation of the power measures, CS was determined to have approximately twice the efficiency (ouput/time) as compared to TS. Efficiency calculations for VL, TH, PV, and PP are 103.47 kg.min, 26.25 cm.min, 1.98 m.s.min, 890.39 W.min under CS and 54.71 kg.min, 13.02 cm.min, 0.99 m.s.min, 459.28 W.min under TS. Comparison of EMG activity between the protocols suggests the level of neuromuscular fatigue did not differ under the 2 conditions. Complex set training would appear to be an effective method of exercise with respect to efficiency and the maintenance of TH, PV, PP, and VL.