Normalization of the hip abductors rate of activation during a voluntary step task in older adults: Reliability and differences among approaches.

BACKGROUND: Voluntary stepping tasks are used to measure the ability of an individual to step and has been associated with fall risk in older adults. Although electromyography (EMG) amplitude is measured during stepping tasks, there is no consensus about the reference EMG value that should be used to normalize the signal. The purpose of the present study was to 1) investigate the impact of using different EMG parameters as a reference to normalize the rate of activation (RoA) of the hip abductor muscles across lateral voluntary step trials and the differences between trials, and 2) to investigate the reliability among trials of the reference EMG values. METHODS: Nineteen older adults (>65 years of age) performed ten lateral choice reaction stepping test (CRST), while the gluteus medius and tensor fascia latae EMG were recorded. Three reference EMG values were calculated and used to normalize RoA during the stepping task. A repeated-measures ANOVA was used (normalized RoA[3] x trial[3]) to compare normalized EMG across trials, and an intraclass correlation coefficient and coefficient of variation were used for the inter-trial reliability of the reference EMG values. RESULTS: The present study showed that gluteus medius and tensor fascia latae RoA normalized values from the stance and stepping leg (right or left side) measured during CRST are different according to the reference EMG value(P<0.001), with no differences across trials. Overall, the EMG procedures showed high inter-trial reliability, with a few exceptions. SIGNIFICANCE: Therefore, after careful examination of our results, the peak and mean EMG amplitudes showed consistently higher intraclass correlation coefficients; however, the former may provide a more intuitive reference value.

A Comparison of Bioelectric and Biomechanical EMG Normalization Techniques in Healthy Older and Young Adults during Walking Gait.

This study compares biomechanical and bioelectric electromyography (EMG) normalization techniques across disparate age cohorts during walking to assess the impact of normalization methods on the functional interpretation of EMG data. The biomechanical method involved scaling EMG to a target absolute torque (EMGTS) from a joint-specific task and the chosen bioelectric methods were peak and mean normalization taken from the EMG signal during gait, referred to as dynamic mean and dynamic peak normalization (EMGMean and EMGPeak). The effects of normalization on EMG amplitude, activation pattern, and inter-subject variability were compared between disparate cohorts, including OLD (76.6 yrs N = 12) and YOUNG (26.6 yrs N = 12), in five lower-limb muscles. EMGPeak normalization resulted in differences between YOUNG and OLD cohorts in Biceps Femoris (BF) and Medial Gastrocnemius (MG) that were not observed with EMGMean or EMGTS normalization. EMGPeak and EMGMean normalization also demonstrated interactions between age and the phase of gait in BF that were not seen with EMGTS. Correlations showed that activation patterns across the gait cycle were similar between all methods for both age groups and the coefficient of variation comparisons found that EMGTS produced the greatest inter-subject variability. We have shown that the normalization technique can influence the interpretation of findings when comparing disparate populations, highlighting the need to carefully interpret functional differences in EMG between disparate cohorts.

Standard isometric contraction has higher reliability than maximum voluntary isometric contraction for normalizing electromyography during level walking among older adults with knee osteoarthritis.

Introduction: Electromyography (EMG) normalization often relies on maximum voluntary isometric contraction (MVIC), which may not be suitable for knee osteoarthritis (KOA) patients due to difficulties in generating maximum joint torques caused by pain. This study aims to assess the reliability of standard isometric contraction (SIC) for EMG normalization in older adults with KOA, comparing it with MVIC. Methods: We recruited thirty-five older adults with KOA and collected root mean square EMG amplitudes from seven muscles in the affected limb during level walking, SIC, and MVIC tests. EMG data during level walking were normalized using both SIC and MVIC methods. This process was repeated after at least 1 week. We calculated intra-class correlation coefficients (ICCs) with 95% confidence intervals to evaluate between- and within-day reliabilities. Results: SIC tests showed higher between- (ICC: 0.75-0.86) and within-day (ICC: 0.84-0.95) ICCs across all seven muscles compared to MVIC tests. When normalized with SIC, all seven muscles exhibited higher between- (ICC: 0.67-0.85) and within-day (ICC: 0.88-0.99) ICCs compared to MVIC normalization. Conclusion: This study suggests that SIC may offer superior movement consistency and reliability compared to MVIC for EMG normalization during level walking in older adults with KOA.

Normalization of the electromyography amplitude during a multiple-set resistance training protocol: Reliability and differences between approaches.

The first aim was to investigate the impact of different electromyography (EMG) parameters as a reference to normalize the EMG amplitude of the superficial quadriceps femoris muscles across different sets of a knee extension exercise. The second aim is to examine the reliability between days of the EMG parameters used as a reference. Eleven young males attended the laboratory on 4 different days and performed one repetition maximum test, maximumvoluntary isometric contractions, and a resistance training protocol until failure. Surface EMG was placed over the rectus femoris, vastus lateralis, and vastus medialis muscles. Seven EMG parameters were calculated from the tasks and used to normalize EMG amplitude measured during the resistance training protocol. A repeated-measures two-way ANOVA was used (normalized EMG amplitude × set) to compare normalized EMG across sets, while an intraclass correlation coefficient, coefficient of variation, and Bland-Altman plots were used to calculate the intra-day reliability of the EMG parameters. The present investigation showed that normalized EMG amplitude of the superficial muscles of the quadriceps measured during a knee extension exercise is influenced by the EMG parameter and depends on the muscle. While rectus femoris and vastus lateralis normalized EMG amplitude presented one parameter among seven showing similar value to the other parameters, VM showed two. Lastly, all EMG parameters for all muscles presented an overall excellent reliability and agreement between days.

Design of an Isometric End-Point Force Control Task for Electromyography Normalization and Muscle Synergy Extraction From the Upper Limb Without Maximum Voluntary Contraction.

Muscle synergy analysis via surface electromyography (EMG) is useful to study muscle coordination in motor learning, clinical diagnosis, and neurorehabilitation. However, current methods to extract muscle synergies in the upper limb suffer from two major issues. First, the necessary normalization of EMG signals is performed via maximum voluntary contraction (MVC), which requires maximal isometric force production in each muscle. However, some individuals with motor impairments have difficulties producing maximal effort in the MVC task. In addition, the MVC is known to be highly unreliable, with widely different forces produced in repeated measures. Second, synergy extraction in the upper limb is typically performed with a multidirection reaching task. However, some participants with motor impairments cannot perform this task because it requires precise motor control. In this study, we proposed a new isometric rotating task that does not require precise motor control or large forces. In this task, participants maintain a cursor controlled by the arm end-point force on a target that rotates at a constant angular velocity at a designated force level. To relax constraints on motor control precision, the target is widened and blurred. To obtain a reference EMG value for normalization without requiring maximal effort, we estimated a linear relationship between joint torques and muscle activations. We assessed the reliability of joint torque normalization and synergy extraction in the rotating task in young neurotypical individuals. Compared with normalization with MVC, joint torque normalization allowed reliable EMG normalization at low force levels. In addition, the extraction of synergies was as reliable and more stable than with the multidirection reaching task. The proposed rotating task can, therefore, be used in future motor learning, clinical diagnosis, and neurorehabilitation studies.

Clarify Sit-to-Stand Muscle Synergy and Tension Changes in Subacute Stroke Rehabilitation by Musculoskeletal Modeling.

Post-stroke patients exhibit distinct muscle activation electromyography (EMG) features in sit-to-stand (STS) due to motor deficiency. Muscle activation amplitude, related to muscle tension and muscle synergy activation levels, is one of the defining EMG features that reflects post-stroke motor functioning and motor impairment. Although some qualitative findings are available, it is not clear if and how muscle activation amplitude-related biomechanical attributes may quantitatively reflect during subacute stroke rehabilitation. To better enable a longitudinal investigation into a patient's muscle activation changes during rehabilitation or an inter-subject comparison, EMG normalization is usually applied. However, current normalization methods using maximum voluntary contraction (MVC) or within-task peak/mean EMG may not be feasible when MVC cannot be obtained from stroke survivors due to motor paralysis and the subject of comparison is EMG amplitude. Here, focusing on the paretic side, we first propose a novel, joint torque-based normalization method that incorporates musculoskeletal modeling, forward dynamics simulation, and mathematical optimization. Next, upon method validation, we apply it to quantify changes in muscle tension and muscle synergy activation levels in STS motor control units for patients in subacute stroke rehabilitation. The novel method was validated against MVC-normalized EMG data from eight healthy participants, and it retained muscle activation amplitude differences for inter- and intra-subject comparisons. The proposed joint torque-based method was also compared with the common static optimization based on squared muscle activation and showed higher simulation accuracy overall. Serial STS measurements were conducted with four post-stroke patients during their subacute rehabilitation stay (137 ± 22 days) in the hospital. Quantitative results of patients suggest that maximum muscle tension and activation level of muscle synergy temporal patterns may reflect the effectiveness of subacute stroke rehabilitation. A quality comparison between muscle synergies computed with the conventional within-task peak/mean EMG normalization and our proposed method showed that the conventional was prone to activation amplitude overestimation and underestimation. The contributed method and findings help recapitulate and understand the post-stroke motor recovery process, which may facilitate developing more effective rehabilitation strategies for future stroke survivors.

Evaluation of Synergy Extrapolation for Predicting Unmeasured Muscle Excitations from Measured Muscle Synergies.

Electromyography (EMG)-driven musculoskeletal modeling relies on high-quality measurements of muscle electrical activity to estimate muscle forces. However, a critical challenge for practical deployment of this approach is missing EMG data from muscles that contribute substantially to joint moments. This situation may arise due to either the inability to measure deep muscles with surface electrodes or the lack of a sufficient number of EMG channels. Muscle synergy analysis (MSA) is a dimensionality reduction approach that decomposes a large number of muscle excitations into a small number of time-varying synergy excitations along with time-invariant synergy weights that define the contribution of each synergy excitation to all muscle excitations. This study evaluates how well missing muscle excitations can be predicted using synergy excitations extracted from muscles with available EMG data (henceforth called "synergy extrapolation" or SynX). The method was evaluated using a gait data set collected from a stroke survivor walking on an instrumented treadmill at self-selected and fastest-comfortable speeds. The evaluation process started with full calibration of a lower-body EMG-driven model using 16 measured EMG channels (collected using surface and fine wire electrodes) per leg. One fine wire EMG channel (either iliopsoas or adductor longus) was then treated as unmeasured. The synergy weights associated with the unmeasured muscle excitation were predicted by solving a nonlinear optimization problem where the errors between inverse dynamics and EMG-driven joint moments were minimized. The prediction process was performed for different synergy analysis algorithms (principal component analysis and non-negative matrix factorization), EMG normalization methods, and numbers of synergies. SynX performance was most influenced by the choice of synergy analysis algorithm and number of synergies. Principal component analysis with five or six synergies consistently predicted unmeasured muscle excitations the most accurately and with the greatest robustness to EMG normalization method. Furthermore, the associated joint moment matching accuracy was comparable to that produced by initial EMG-driven model calibration using all 16 EMG channels per leg. SynX may facilitate the assessment of human neuromuscular control and biomechanics when important EMG signals are missing.

Global electromyographic signal characteristics depend on maximal isometric contraction method in the knee extensors.

OBJECTIVE: To determine if maximal isometric contraction (MVIC) method (i.e., ramp (MVICRAMP) versus traditional MVIC) influences (1) maximal voluntary isometric torque (MVIT) production of the knee extensors, (2) electromyographic signal amplitude (EMGAMP), and (3) EMG mean power frequency (EMGMPF) of the rectus femoris and vastus lateralis in moderately-to highly-activated subjects. We hypothesized that EMGAMP would be greater during the MVICRAMP than MVIC muscle contractions, but that there would be no difference in MVIT. APPROACH: Twenty-five males (23.4 ±â€¯3.4 y; % voluntary activation = 93.9 ±â€¯5.1%) visited the laboratory and completed MVICRAMPs and MVICs. During all contractions, leg extensor torque and sEMG signals from the vastus lateralis (VL) and rectus femoris (RF) were recorded. MAIN RESULTS: There was no significant difference in the MVIT produced (p = 0.65) or in EMGMPF (p = 0.052) during MVICRAMP versus MVIC. However, EMGAMP was 18.1% higher during the MVICRAMP than MVIC (p = 0.004). SIGNIFICANCE: Maximal isometric muscle contraction method significantly influenced EMGAMP, and had a moderate effect on EMGMPF (d = 0.49). Investigators who utilize MVICs to determine maximal EMG signal amplitude and frequency to normalize their EMG signals should be aware of these differences.

Maximal voluntary isometric contraction tests for normalizing electromyographic data from different regions of supraspinatus and infraspinatus muscles: Identifying reliable combinations.

This study aimed to identify optimal sets of maximal voluntary isometric contractions (MVICs) for normalizing EMG data from anterior and posterior regions of the supraspinatus, and superior, middle and inferior regions of the infraspinatus. 31 right-handed young healthy individuals (15 males, 16 females) participated. EMG activity was obtained from two regions of supraspinatus and three regions of infraspinatus muscles via fine wire electrodes. Participants performed 15 MVIC tests against manual resistance. The EMG data were normalized to the maximum values. Optimal sets of MVIC combinations, defined as those which elicited >90% MVIC activation in the muscles of interest in >80% and >90% of the population, were obtained. EMG data from the inferior region of infraspinatus were removed from analysis due to technical problem. No single test achieved maximal activation of both regions of either the supraspinatus or infraspinatus. Instead, a combination of 6-8 MVICs were required to reach >90% MVIC activation in both parts of those muscles. In all regions of the rotator cuff muscles, the optimal combination was obtained with 8-10 MVICs. The proposed combinations can reduce inter-participant variability in generating maximal activation from different regions of the supraspinatus and infraspinatus muscles.

EMG normalization method based on grade 3 of manual muscle testing: Within- and between-day reliability of normalization tasks and application to gait analysis.

Electromyography (EMG) is an important parameter in Clinical Gait Analysis (CGA), and is generally interpreted with timing of activation. EMG amplitude comparisons between individuals, muscles or days need normalization. There is no consensus on existing methods. The gold standard, maximum voluntary isometric contraction (MVIC), is not adapted to pathological populations because patients are often unable to perform an MVIC. The normalization method inspired by the isometric grade 3 of manual muscle testing (isoMMT3), which is the ability of a muscle to maintain a position against gravity, could be an interesting alternative. The aim of this study was to evaluate the within- and between-day reliability of the isoMMT3 EMG normalizing method during gait compared with the conventional MVIC method. Lower limb muscles EMG (gluteus medius, rectus femoris, tibialis anterior, semitendinosus) were recorded bilaterally in nine healthy participants (five males, aged 29.7±6.2years, BMI 22.7±3.3kgm-2) giving a total of 18 independent legs. Three repeated measurements of the isoMMT3 and MVIC exercises were performed with an EMG recording. EMG amplitude of the muscles during gait was normalized by these two methods. This protocol was repeated one week later. Within- and between-day reliability of normalization tasks were similar for isoMMT3 and MVIC methods. Within- and between-day reliability of gait EMG normalized by isoMMT3 was higher than with MVIC normalization. These results indicate that EMG normalization using isoMMT3 is a reliable method with no special equipment needed and will support CGA interpretation. The next step will be to evaluate this method in pathological populations.

Spatial variability of muscle activity during human walking: the effects of different EMG normalization approaches.

Human leg muscles are often activated inhomogeneously, e.g. in standing. This may also occur in complex tasks like walking. Thus, bipolar surface electromyography (sEMG) may not accurately represent whole muscle activity. This study used 64-electrode high-density sEMG (HD-sEMG) to examine spatial variability of lateral gastrocnemius (LG) muscle activity during the stance phase of walking, maximal voluntary contractions (MVCs) and maximal M-waves, and determined the effects of different normalization approaches on spatial and inter-participant variability. Plantar flexion MVC, maximal electrically elicited M-waves and walking at self-selected speed were recorded in eight healthy males aged 24-34. sEMG signals were assessed in four ways: unnormalized, and normalized to MVC, M-wave or peak sEMG during the stance phase of walking. During walking, LG activity varied spatially, and was largest in the distal and lateral regions. Spatial variability fluctuated throughout the stance phase. Normalizing walking EMG signals to the peak value during stance reduced spatial variability within LG on average by 70%, and inter-participant variability by 67%. Normalizing to MVC reduced spatial variability by 17% but increased inter-participant variability by 230%. Normalizing to M-wave produced the greatest spatial variability (45% greater than unnormalized EMG) and increased inter-participant variability by 70%. Unnormalized bipolar LG sEMG may provide misleading results about representative muscle activity in walking due to spatial variability. For the peak value and MVC approaches, different electrode locations likely have minor effects on normalized results, whereas electrode location should be carefully considered when normalizing walking sEMG data to maximal M-waves.

Inter-subject variability of muscle synergies during bench press in power lifters and untrained individuals.

The purpose of the study was to elucidate the role of expertise on muscle synergies involved in bench press. Ten expert power lifters (EXP) and nine untrained participants (UNT) completed three sets of eight repetitions at 60% of three repetition maximum in bench press. Muscle synergies were extracted from surface electromyography data of 21 bench press cycles using non-negative matrix factorization algorithm. The synergy activation coefficient represents the relative contribution of the muscle synergy to the overall muscle activity pattern, while the muscle synergy vector represents the relative weighting of each muscle within each synergy. Describing more than 90% of the variability, two muscle synergies reflected the eccentric and concentric phase. The cross-correlations (ρ(max)) for synergy activation coefficient 2 (concentric phase) were 0.83 [0.71;0.88] and 0.59 [0.49;0.77] [Median ρ(max) (25th;75th percentile)] (P = 0.001) in UNT and EXP, respectively. Median correlation coefficient (ρ) for muscle synergy vector 2 was 0.15 [-0.08;0.46] and 0.48 [0.02;0.70] (P = 0.03) in UNT and EXP, respectively. Thus, EXP showed larger inter-subject variability than UNT in the synergy activation coefficient during the concentric phase, while the muscle synergy vectors were less variable in EXP. This points at the importance of a specialized neural strategy in elite bench press performance.