Analysis and applications of respiratory surface EMG: report of a round table meeting

Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.

Kinematic Evidence of Root-to-Shoot Signaling for the Coding of Support Thickness in Pea Plants

Plants such as climbers characterized by stems or tendrils need to find a potential support (e.g., pole, stick, other plants or trees) to reach greater light exposure. Since the time when Darwin carried out research on climbing plants, several studies on plants’ searching and attachment behaviors have demonstrated their unique ability to process some features of a support to modulate their movements accordingly. Nevertheless, the strategies underlying this ability have yet to be uncovered. The present research tries to fill this gap by investigating how the interaction between above- (i.e., stems, tendrils, …) and below-ground (i.e., the root system) plant organs influences the kinematics of their approach-to-grasp movements. Using three-dimensional (3D) kinematic analysis, we characterized the movements of pea plants (Pisum sativum L.) as they leaned towards supports whose below- and above-ground parts were characterized by different thicknesses (i.e., thin below- thick above-ground, or the opposite). As a control condition, the plants were placed next to supports with the same thickness below and above ground (i.e., either entirely thin or thick). The results suggest that the information regarding below- and above-ground parts of a support appears to be integrated and modulates the reach-to-grasp behavior of the plant. Information about the support conveyed by the root system seems to be particularly important to achieve the end-goal of movement.

The coding of object thickness in plants: When roots matter

Tendrils are clasping structures used by climbing plants to anchor and support their vines that coil around suitable hosts to achieve the greatest exposure to sunlight. Although recent evidence suggests that climbing plants are able to sense the presence of a potential stimulus in the environment and to plan the tendrils' movements depending on properties such as its thickness, the mechanisms underlying thickness sensing in climbing plants have yet to be uncovered. The current research set out to use three-dimensional kinematical analysis to investigate if and in what way the root system contributed to thickness sensing. Experiment 1 was designed to confirm that the movement of the tendrils of pea plants (Pisum sativum L.) is planned and controlled on the basis of stimulus thickness when the stimulus is inserted into the substrate. Experiment 2 was designed to investigate what happens when the stimulus is lifted to the ground so as to impede the root system from sensing it. The results confirmed that tendrils' kinematics depend on thickness when the stimulus is available to the root system but not when it is unavailable to it. These findings suggest that the root system plays a pivotal role in sensing the presence and the thickness of a stimulus and that the information perceived affects the planning and the execution of the climbing plants' reach-to-grasp movements. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

On-line control of movement in plants

At first glance, plants seem relatively immobile and, unlike animals, unable to interact with the surroundings or escape stressful environments. But, although markedly different from those of animals, movement pervades all aspects of plant behaviour. Here, we focused our investigation on the approaching movement of climbing plants, that is the movement they perform to reach-to-climb a support. In particular, we examined whether climbing plants evolved a motor accuracy mechanism as to improve the precision of their movement and how this eventually differs from animal species. For this purpose, by means of three-dimensional kinematical analysis, we investigated whether climbing plants have the ability to correct online their movement by means of secondary submovements, and if their frequency production is influenced by the difficulty of the task. Results showed, not only that plants correct their movement in flight, but also that they strategically increase the production of secondary submovements when the task requires more precision, exactly as humans do. These findings support the hypothesis that the movement of plants is far cry from being a simple cause-effect mechanism, but rather is appropriately planned, controlled and eventually corrected.

A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors

BACKGROUND

Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing.

OBJECTIVE

To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated with electromyograph-triggered functional electrical stimulation, is superior to advanced conventional therapy (ACT) of equal intensity in the recovery of arm functions, dexterity, strength, activities of daily living, and quality of life after stroke.

METHODS

A single-blind RCT recruiting 72 patients was conducted. Patients, randomly allocated to 2 groups, were trained for 9 weeks, 3 times per week: the experimental group performed task-oriented exercises assisted by RETRAINER for 30 minutes plus ACT (60 minutes), whereas the control group performed only ACT (90 minutes). Patients were assessed before, soon after, and 1 month after the end of the intervention. Outcome measures were as follows: Action Research Arm Test (ARAT), Motricity Index, Motor Activity Log, Box and Blocks Test (BBT), Stroke Specific Quality of Life Scale (SSQoL), and Muscle Research Council.

RESULTS

All outcomes but SSQoL significantly improved over time in both groups (P < .001); a significant interaction effect in favor of the experimental group was found for ARAT and BBT. ARAT showed a between-group change of 11.5 points (P = .010) at the end of the intervention, which increased to 13.6 points 1 month after. Patients considered RETRAINER moderately usable (System Usability Score of 61.5 ± 22.8).

CONCLUSIONS

Hybrid robotic systems, allowing to perform personalized, intensive, and task-oriented training, with an enriched sensory feedback, was superior to ACT in improving arm functions and dexterity after stroke.

Speed-accuracy trade-off in plants

Speed-accuracy trade-off (SAT) is the tendency for decision speed to covary with decision accuracy. SAT is an inescapable property of aimed movements being present in a wide range of species, from insects to primates. An aspect that remains unsolved is whether SAT extends to plants' movement. Here, we tested this possibility by examining the swaying in circles of the tips of shoots exhibited by climbing plants (Pisum sativum L.) as they approach to grasp a potential support. In particular, by means of three-dimensional kinematical analysis, we investigated whether climbing plants scale movement velocity as a function of the difficulty to coil a support. Results showed that plants are able to process the properties of the support before contact and, similarly to animal species, strategically modulate movement velocity according to task difficulty.

Using UHF RFID Properties to Develop and Optimize an Upper-Limb Rehabilitation System

Rehabilitation of the upper limb is an important aspect of the therapy for people affected by neuromotor diseases for the recovery of the capability to perform activities of daily living (ADLs). Nonetheless, the costs associated with the administration of rehabilitation therapy and the increasing number of patients highlight the need for new solutions. Technology-based solutions and, in particular, telerehabilitation could strongly impact in this field. In this paper, a new system based on radiofrequency (RF) technology is presented which is able to effectively provide home-based telerehabilitation and extract meaningful information on the therapy execution performance. The technology has been tuned to the needs of the rehabilitation system, optimizing the hardware, the communication protocol and the software control. A methodology for extracting the execution time of the rehabilitation tasks, the distance covered by the patient's hand in each subtask and the velocity profile is presented. The results show that a highly usable system for the rehabilitation of the upper limb has been developed using the RF technology and that performance metrics can be reliably extracted by the acquired signals.

Movidea: A Software Package for Automatic Video Analysis of Movements in Infants at Risk for Neurodevelopmental Disorders

Early detecting the presence of neurodevelopmental disorders plays an important role in the effectiveness of the treatment. In this paper, we present a novel tool to extract motion features using single camera video recordings of infants. The Movidea software was developed to allow the operator to track the movement of end-effectors of infants in free moving conditions and extract movement features automatically. Movidea was used by different operators to analyze a set of video recordings and its performance was evaluated. The results showed that Movidea performance did not vary with the operator, and the tracking was also stable in home-video recordings. Even if the setup allowed for a two-dimensional analysis, most of the informative content of the movement was maintained. The reliability of the measures and features extracted, as well as the easiness of use, may boost the uptake of the proposed solution in clinical settings. Movidea overcomes the current limitation in the clinical practice in early detection of neurodevelopmental disorders by providing objective measures based on reliable data, and adds a new tool for the motor analysis of infants through unobtrusive technology.

Flexible control of movement in plants

Although plants are essentially sessile in nature, these organisms are very much in tune with their environment and are capable of a variety of movements. This may come as a surprise to many non-botanists, but not to Charles Darwin, who reported that plants do produce movements. Following Darwin's specific interest on climbing plants, this paper will focus on the attachment mechanisms by the tendrils. We draw attention to an unsolved problem in available literature: whether during the approach phase the tendrils of climbing plants consider the structure of the support they intend to grasp and plan the movement accordingly ahead of time. Here we report the first empirical evidence that this might be the case. The three-dimensional (3D) kinematic analysis of a climbing plant (Pisum sativum L.) demonstrates that the plant not only perceives the support, but it scales the kinematics of tendrils' aperture according to its thickness. When the same support is represented in two-dimensions (2D), and thus unclimbable, there is no evidence for such scaling. In these circumstances the tendrils' kinematics resemble those observed for the condition in which no support was offered. We discuss these data in light of the evidence suggesting that plants are equipped with sensory mechanisms able to provide the necessary information to plan and control a movement.

The combined action of a passive exoskeleton and an EMG-controlled neuroprosthesis for upper limb stroke rehabilitation: First results of the RETRAINER project

The combined use of Functional Electrical Stimulation (FES) and robotic technologies is advocated to improve rehabilitation outcomes after stroke. This work describes an arm rehabilitation system developed within the European project RETRAINER. The system consists of a passive 4-degrees-of-freedom exoskeleton equipped with springs to provide gravity compensation and electromagnetic brakes to hold target positions. FES is integrated in the system to provide additional support to the most impaired muscles. FES is triggered based on the volitional EMG signal of the same stimulated muscle; in order to encourage the active involvement of the patient the volitional EMG is also monitored throughout the task execution and based on it a happy or sad emoji is visualized at the end of each task. The control interface control of the system provides a GUI and multiple software tools to organize rehabilitation exercises and monitor rehabilitation progress. The functionality and the usability of the system was evaluated on four stroke patients. All patients were able to use the system and judged positively its wearability and the provided support. They were able to trigger the stimulation based on their residual muscle activity and provided different levels of active involvement in the exercise, in agreement with their level of impairment. A randomized controlled trial aimed at evaluating the effectiveness of the RETRAINER system to improve arm function after stroke is currently ongoing.

Tuning of Muscle Synergies During Walking Along Rectilinear and Curvilinear Trajectories in Humans

The aim of this study was to develop a methodology based on muscle synergies to investigate whether rectilinear and curvilinear walking shared the same neuro-motor organization, and how this organization was fine-tuned by the walking condition. Thirteen healthy subjects walked on rectilinear and curvilinear paths. Electromyographic data from thirteen back and lower-limb muscles were acquired, together with kinematic data using inertial sensors. Four macroscopically invariant muscle synergies, extracted through non-negative matrix factorization, proved a shared modular organization across conditions. The fine-tuning of muscle synergies was studied through non-negative matrix reconstruction, applied by fixing muscle weights or activation profiles to those of the rectilinear condition. The activation profiles tended to be recruited for a longer period and with a larger amplitude during curvilinear walking. The muscles of the posterior side of the lower limb were those mainly influenced by the fine-tuning, with the muscles inside the rotation path being more active than the outer muscles. This study shows that rectilinear and curvilinear walking share a unique motor command. However, a fine-tuning in muscle synergies is introduced during curvilinear conditions, adapting the kinematic strategy to the new biomechanical needs.

A multi-channel biomimetic neuroprosthesis to support treadmill gait training in stroke patients

This study presents an innovative multi-channel neuroprosthesis that induces a biomimetic activation of the main lower-limb muscles during treadmill gait training to be used in the rehabilitation of stroke patients. The electrostimulation strategy replicates the physiological muscle synergies used by healthy subjects to walk on a treadmill at their self-selected speed. This strategy is mapped to the current gait sub-phases, which are identified in real time by a custom algorithm. This algorithm divides the gait cycle into six sub-phases, based on two inertial sensors placed laterally on the shanks. Therefore, the pre-defined stimulation profiles are expanded or stretched based on the actual gait pattern of each single subject. A preliminary experimental protocol, involving 10 healthy volunteers, was carried out to extract the muscle synergies and validate the gait-detection algorithm, which were afterwards used in the development of the neuroprosthesis. The feasibility of the neuroprosthesis was tested on one healthy subject who simulated different gait patterns, and a chronic stroke patient. The results showed the correct functioning of the system. A pilot study of the neurorehabilitation treatment for stroke patients is currently being carried out.