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Liao F, Zhao H, Lin CF, Chen P, Chen P, Onyemere K, Jan YK. Application of Multiscale Sample Entropy in Assessing Effects of Exercise Training on Skin Blood Flow Oscillations in People with Spinal Cord Injury. ENTROPY (BASEL, SWITZERLAND) 2023; 25:e25040690. [PMID: 37190478 PMCID: PMC10138099 DOI: 10.3390/e25040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
Spinal cord injury (SCI) causes a disruption of autonomic nervous regulation to the cardiovascular system, leading to various cardiovascular and microvascular diseases. Exercise training is an effective intervention for reducing risk for microvascular diseases in healthy people. However, the effectiveness of exercise training on improving microvascular function in people with SCI is largely unknown. The purpose of this study was to compare blood flow oscillations in people with spinal cord injury and different physical activity levels to determine if such a lifestyle might influence skin blood flow. A total of 37 participants were recruited for this study, including 12 athletes with SCI (ASCI), 9 participants with SCI and a sedentary lifestyle (SSCI), and 16 healthy able-bodied controls (AB). Sacral skin blood flow (SBF) in response to local heating at 42 °C for 50 min was measured using laser Doppler flowmetry. The degree of the regularity of blood flow oscillations (BFOs) was quantified using a multiscale entropy approach. The results showed that BFO was significantly more irregular in ASCI and AB compared to SSCI during the maximal vasodilation period. Our results also demonstrate that the difference in the regularity of BFOs between original SBF signal and phase-randomized surrogate time series was larger in ASCI and AB compared to SSCI. Our findings indicate that SCI causes a loss of complexity of BFOs and exercise training may improve complexity in people with SCI. This study demonstrates that multiscale entropy is a sensitive method for detecting differences between different categories of people with SCI and might be able to detect effects of exercise training related to skin blood flow.
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Affiliation(s)
- Fuyuan Liao
- Department of Biomedical Engineering, Xi'an Technological University, Xi'an 710021, China
| | - Hengyang Zhao
- School of Electronic Information Engineering, Xi'an Technological University, Xi'an 710021, China
| | - Cheng-Feng Lin
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Panpan Chen
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | | | | | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Effects of Muscle Fatigue and Recovery on Complexity of Surface Electromyography of Biceps Brachii. ENTROPY 2021; 23:e23081036. [PMID: 34441176 PMCID: PMC8391607 DOI: 10.3390/e23081036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022]
Abstract
This study aimed to investigate the degree of regularity of surface electromyography (sEMG) signals during muscle fatigue during dynamic contractions and muscle recovery after cupping therapy. To the best of our knowledge, this is the first study assessing both muscle fatigue and muscle recovery using a nonlinear method. Twelve healthy participants were recruited to perform biceps curls at 75% of the 10 repetitions maximum under four conditions: immediately and 24 h after cupping therapy (-300 mmHg pressure), as well as after sham control (no negative pressure). Cupping therapy or sham control was assigned to each participant according to a pre-determined counter-balanced order and applied to the participant's biceps brachii for 5 min. The degree of regularity of the sEMG signal during the first, second, and last 10 repetitions (Reps) of biceps curls was quantified using a modified sample entropy (Ems) algorithm. When exercise was performed immediately or 24 h after sham control, Ems of the sEMG signal showed a significant decrease from the first to second 10 Reps; when exercise was performed immediately after cupping therapy, Ems also showed a significant decrease from the first to second 10 Reps but its relative change was significantly smaller compared to the condition of exercise immediately after sham control. When exercise was performed 24 h after cupping therapy, Ems did not show a significant decrease, while its relative change was significantly smaller compared to the condition of exercise 24 h after sham control. These results indicated that the degree of regularity of sEMG signals quantified by Ems is capable of assessing muscle fatigue and the effect of cupping therapy. Moreover, this measure seems to be more sensitive to muscle fatigue and could yield more consistent results compared to the traditional linear measures.
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Liao F, Zhang K, Zhou L, Chen Y, Elliott J, Jan YK. Effect of Different Local Vibration Frequencies on the Multiscale Regularity of Plantar Skin Blood Flow. ENTROPY 2020; 22:e22111288. [PMID: 33287056 PMCID: PMC7712514 DOI: 10.3390/e22111288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 12/14/2022]
Abstract
Local vibration has shown promise in improving skin blood flow (SBF). However, there is no consensus on the selection of the best vibration frequency. An important reason may be that previous studies utilized time- and frequency-domain parameters to characterize vibration-induced SBF responses. These parameters are unable to characterize the structural features of the SBF response to local vibrations, thus contributing to the inconsistent findings seen in vibration research. The objective of this study was to provide evidence that nonlinear dynamics of SBF responses would be an important aspect for assessing the effect of local vibration on SBF. Local vibrations at 100 Hz, 35 Hz, and 0 Hz (sham vibration) with an amplitude of 1 mm were randomly applied to the right first metatarsal head of 12 healthy participants for 10 min. SBF at the same site was measured for 10 min before and after local vibration. The degree of regularity of SBF was quantified using a multiscale sample entropy algorithm. The results showed that 100 Hz vibration significantly increased multiscale regularity of SBF but 35 Hz and 0 Hz (sham vibration) did not. The significant increase of regularity of SBF after 100 Hz vibration was mainly attributed to increased regularity of SBF oscillations within the frequency interval at 0.0095–0.15 Hz. These findings support the use of multiscale regularity to assess effectiveness of local vibration on improving skin blood flow.
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Affiliation(s)
- Fuyuan Liao
- Department of Biomedical Engineering, Xi’an Technological University, Xi’an 710021, China;
| | - Keying Zhang
- Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA; (K.Z.); (L.Z.)
| | - Lingling Zhou
- Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA; (K.Z.); (L.Z.)
| | - Yanni Chen
- Department of Pediatrics, Xi’an Jiaotong University Health Science Center, Xi’an 710021, China;
| | - Jeannette Elliott
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
| | - Yih-Kuen Jan
- Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA; (K.Z.); (L.Z.)
- Correspondence: ; Tel.: +1-217-300-7253
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Jan YK, Liao F, Cheing GL, Pu F, Ren W, Choi HM. Differences in skin blood flow oscillations between the plantar and dorsal foot in people with diabetes mellitus and peripheral neuropathy. Microvasc Res 2019; 122:45-51. [DOI: 10.1016/j.mvr.2018.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022]
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Using Multiscale Entropy to Assess the Efficacy of Local Cooling on Reactive Hyperemia in People with a Spinal Cord Injury. ENTROPY 2019; 21:e21010090. [PMID: 33266806 PMCID: PMC7514201 DOI: 10.3390/e21010090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 11/18/2022]
Abstract
Pressure ulcers are one of the most common complications of a spinal cord injury (SCI). Prolonged unrelieved pressure is thought to be the primary causative factor resulting in tissue ischemia and eventually pressure ulcers. Previous studies suggested that local cooling reduces skin ischemia of the compressed soft tissues based on smaller hyperemic responses. However, the effect of local cooling on nonlinear properties of skin blood flow (SBF) during hyperemia is unknown. In this study, 10 wheelchair users with SCI and 10 able-bodied (AB) controls underwent three experimental protocols, each of which included a 10-min period as baseline, a 20-min intervention period, and a 20-min period for recovering SBF. SBF was measured using a laser Doppler flowmetry. During the intervention period, a pressure of 60 mmHg was applied to the sacral skin, while three skin temperature settings were tested, including no temperature change, a decrease by 10 °C, and an increase by 10 °C, respectively. A multiscale entropy (MSE) method was employed to quantify the degree of regularity of blood flow oscillations (BFO) associated with the SBF control mechanisms during baseline and reactive hyperemia. The results showed that under pressure with cooling, skin BFO both in people with SCI and AB controls were more regular at multiple time scales during hyperemia compared to baseline, whereas under pressure with no temperature change and particularly pressure with heating, BFO were more irregular during hyperemia compared to baseline. Moreover, the results of surrogate tests indicated that changes in the degree of regularity of BFO from baseline to hyperemia were only partially attributed to changes in relative amplitudes of endothelial, neurogenic, and myogenic components of BFO. These findings support the use of MSE to assess the efficacy of local cooling on reactive hyperemia and assess the degree of skin ischemia in people with SCI.
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Liao F, Cheing GLY, Ren W, Jain S, Jan YK. Application of Multiscale Entropy in Assessing Plantar Skin Blood Flow Dynamics in Diabetics with Peripheral Neuropathy. ENTROPY 2018; 20:e20020127. [PMID: 33265218 PMCID: PMC7512620 DOI: 10.3390/e20020127] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 11/16/2022]
Abstract
Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus, while tissue ischemia caused by impaired vasodilatory response to plantar pressure is thought to be a major factor of the development of DFUs, which has been assessed using various measures of skin blood flow (SBF) in the time or frequency domain. These measures, however, are incapable of characterizing nonlinear dynamics of SBF, which is an indicator of pathologic alterations of microcirculation in the diabetic foot. This study recruited 18 type 2 diabetics with peripheral neuropathy and eight healthy controls. SBF at the first metatarsal head in response to locally applied pressure and heating was measured using laser Doppler flowmetry. A multiscale entropy algorithm was utilized to quantify the regularity degree of the SBF responses. The results showed that during reactive hyperemia and thermally induced biphasic response, the regularity degree of SBF in diabetics underwent only small changes compared to baseline and significantly differed from that in controls at multiple scales (p < 0.05). On the other hand, the transition of regularity degree of SBF in diabetics distinctively differed from that in controls (p < 0.05). These findings indicated that multiscale entropy could provide a more comprehensive assessment of impaired microvascular reactivity in the diabetic foot compared to other entropy measures based on only a single scale, which strengthens the use of plantar SBF dynamics to assess the risk for DFU.
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Affiliation(s)
- Fuyuan Liao
- Department of Biomedical Engineering, Xi’an Technological University, Xi’an 710021, China
| | - Gladys L. Y. Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Weiyan Ren
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 South Fourth Street, MC-588, Champaign, IL 61820, USA
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Sanjiv Jain
- Department of Physical Medicine and Rehabilitation, Carle Hospital, Urbana, IL 61801, USA
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 South Fourth Street, MC-588, Champaign, IL 61820, USA
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
- Correspondence: ; Tel.: +1-217-300-7253
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Liao F, Jan YK. Nonlinear dynamics of skin blood flow response to mechanical and thermal stresses in the plantar foot of diabetics with peripheral neuropathy. Clin Hemorheol Microcirc 2018; 66:197-210. [PMID: 28482622 DOI: 10.3233/ch-160239] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. OBJECTIVE The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy. METHODS 18 type 2 diabetics with peripheral neuropathy and 8 healthy controls were recruited. SBF at the first metatarsal head in response to a loading pressure of 300 mmHg and a local heating was measured using laser Doppler flowmetry. A sample entropy approach was used to quantify the degree of regularity of SBF. RESULTS Our results showed that the regularity degree of SBF in the diabetic foot underwent only small changes during post-occlusive reactive hyperemia and thermally induced biphasic response compared to non-diabetics. SBF of the diabetic foot has higher degree of irregularity during reactive hyperemia because of attenuated myogenic activity, and demonstrated higher regularity during the biphasic response largely due to significantly enhanced cardiac activities. CONCLUSIONS This study suggests that the regularity degree of SBF at the first metatarsal head could be used to assess impaired microvascular reactivity and thus may be used to assess the risk for DFU in diabetics with peripheralneuropathy.
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Affiliation(s)
- Fuyuan Liao
- Department of Biomedical Engineering, Xi'an Technological University, Xi'an, China
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Computational Science and Engineering Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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