The Effects of the StartReact on Reaction Time, Rate of Force Development, and Muscle Activity in Biceps Brachii.

The StartReact test, increasingly popular for assessing cortico-reticular functioning, is a valid method to influence the firing of reticulospinal tract neurons noninvasively. However, there remains limited evidence on how different stimuli employed in the StartReact test impact motor output in humans. The present study tested elbow flexor responses of 33 adults (aged 26-48 years) to visual stimuli only (LED light), audio-visual (80 dB) stimuli, and startle-inducing audio-visual (120 dB) stimuli sitting with the arm supinated in an electromechanical dynamometer. Surface electromyogram (EMG) recorded muscle activity from the right biceps brachii muscle. Participants were presented with 20 stimuli for each of the three conditions in pseudorandom order with interstimulus intervals of ~8 s. Reaction times were calculated from the stimulus trigger to the initial rise in the EMG signal above 7 × SD from baseline. Rate of torque development (RTD) and EMG signals were recorded throughout and analyzed over their initial 50 ms and 100 ms time-windows. Reaction times were reduced from visual (169 ± 23) to audio-visual (140 ± 23) and further reduced to startle-inducing audio-visual stimuli (108 ± 19, p < 0.001). While RTD and EMG were consistently greatest following startle-inducing stimuli (p < 0.001), they were also enhanced following all audio-visual stimuli over 100 ms (p < 0.05). It appears that startle-inducing audio-visual stimuli result in shorter reaction times, increased RTD, and enhanced muscle activity within the initial 50 ms, likely from subcortical upregulation. However, the 100 ms time-window suggests cortical upregulation following all audio-visual stimuli considering the longer transmission times.

A Comparison of Throwing Arm Kinetics and Ball Velocity in High School Pitchers With Overall Fast and Overall Slow Cumulative Joint and Segment Velocities.

BACKGROUND: Individual maximum joint and segment angular velocities have shown positive associations with throwing arm kinetics and ball velocity in baseball pitchers. PURPOSE: To observe how cumulative maximum joint and segment angular velocities, irrespective of sequence, affect ball velocity and throwing arm kinetics in high school pitchers. STUDY DESIGN: Descriptive laboratory study. METHODS: High school (n = 55) pitchers threw 8 to 12 fastball pitches while being evaluated with 3-dimensional motion capture (480 Hz). Maximum joint and segment angular velocities (lead knee extension, pelvis rotation, trunk rotation, shoulder internal rotation, and forearm pronation) were calculated for each pitcher. Pitchers were classified as overall fast, overall slow, or high velocity for each joint or segment velocity subcategory, or as population, with any pitcher eligible to be included in multiple subcategories. Kinematic and kinetic parameters were compared among the various subgroups using t tests with post hoc regressions and multivariable regression models created to predict throwing arm kinetics and ball velocity, respectively. RESULTS: The lead knee extension and pelvis rotation velocity subgroups achieved significantly higher normalized elbow varus torque (P = .016) and elbow flexion torque (P = .018) compared with population, with equivalent ball velocity (P = .118). For every 1-SD increase in maximum pelvis rotation velocity (87 deg/s), the normalized elbow distractive force increased by 4.7% body weight (BW) (B = 0.054; ß = 0.290; P = .013). The overall fast group was older (mean ± standard deviation, 16.9 ± 1.4 vs 15.4 ± 0.9 years; P = .007), had 8.9-mph faster ball velocity (32.7 ± 3.1 vs 28.7 ± 2.3 m/s; P = .002), and had significantly higher shoulder internal rotation torque (63.1 ± 17.4 vs 43.6 ± 12.0 Nm; P = .005), elbow varus torque (61.8 ± 16.4 vs 41.6 ± 11.4 Nm; P = .002), and elbow flexion torque (46.4 ± 12.0 vs 29.5 ± 6.8 Nm; P < .001) compared with the overall slow group. A multiregression model for ball velocity based on maximum joint and segment angular velocities and anthropometrics predicted 53.0% of variance. CONCLUSION: High school pitchers with higher maximum joint and segment velocities, irrespective of sequence, demonstrated older age and faster ball velocity at the cost of increased throwing shoulder and elbow kinetics. CLINICAL RELEVANCE: Pitchers and coaching staff should consider this trade-off between faster ball velocity and increasing throwing arm kinetics, an established risk factor for elbow injury.

Sex-related differences in corticospinal excitability outcome measures of the biceps brachii during a submaximal elbow flexor contraction.

The purpose of this study was to investigate the effects of sex, muscle thickness, and subcutaneous fat thickness (SFT) on corticospinal excitability outcome measures of the biceps brachii. Eighteen participants (10 males and 8 females) completed this study. Ultrasound was used to assess biceps brachii muscle thickness and the overlying SFT. Transcranial magnetic stimulation (TMS) was used to determine corticospinal excitability by inducing motor-evoked potentials (MEPs) at eight different TMS intensities from 90% to 160% of active motor threshold (AMT) from the biceps brachii during an isometric contraction of the elbow flexors at 10% of maximum voluntary contraction (MVC). Biceps brachii maximal compound muscle action potential (Mmax) was also recorded prior to and after TMS. Males had higher (p < 0.001) biceps brachii muscle thickness and lower SFT, produced higher levels of MVC force and had, on average, higher (p < 0.001) MEP amplitudes at lower (p < 0.05) percentages of maximal stimulator output than females during the 10% elbow flexion MVC. Multiple linear regression modeling revealed that sex was not associated with any of the neurophysiological parameters examined, while SFT showed a positive association with the stimulation intensity required at AMT (p = 0.035) and a negative association with biceps brachii pre-stimulus electromyography (EMG) activity (p = 0.021). Additionally, there was a small positive association between muscle thickness and biceps brachii pre-stimulus EMG activity (p = 0.049). Overall, this study suggests that some measures of corticospinal excitability may be different between the sexes and influenced by SFT and muscle thickness.

Describing the Flick Movement Kinematic Biomechanically and Investigating the Effect of Thrower's Ten Exercises in Underwater Hockey Players.

CONTEXT: Analyzing flick movement kinematics biomechanically is important to prevent sport-related injuries in underwater hockey players since the aquatic-based flick movement is completely different from land-based flick movements. The study aimed to describe the flick movement kinematic biomechanically in underwater hockey players. Moreover, this study further aimed to investigate the effect of the Thrower's Ten exercises on flick movement kinematics in underwater hockey players. DESIGN: Descriptive laboratory study. METHODS: Seventeen underwater hockey players (age: 26.2 [4.3] y; sports age: 6.2 [4.5] y) were included. First, 2 underwater cameras using motion capture video analysis MATLAB were used to biomechanically analyze the angular changes on the shoulder, elbow, wrist, and body while players were performing the flick movements. Players were then recruited to the Thrower's Ten exercise program for 6 weeks. Flick movement kinematics and flick-throwing distance were recorded at baseline and 6 weeks. RESULTS: The flick movement kinematic patterns demonstrated increased shoulder flexion (from 102.5° to 144.9°), wrist extension (from 9.5° to 10.8°), and upper-extremity rotation (from 5.7° to 56.8°) while decreased elbow extension (from 107.7° to 159.2°) from the stick met the puck until the competition of the movement. The Thrower's Ten exercises improved the elbow extension (P = .04), wrist extension (P = .01), body rotation (P < .001), and flick-throwing distance (P < .001) from baseline to 6 weeks. CONCLUSION: This study describes the underwater flick kinematic technique biomechanically and interprets preliminary findings for the first time. Thus, 6 weeks of Thrower's Ten exercise program provides more body muscle movements than the smaller ones during the flick movements and higher flick-throwing distance in underwater hockey players.

Acute Dosing Strategy with Vistula Tart Cherries for Recovery of Strenuous Exercise-A Feasibility Study.

Tart cherry (TC) consumption has become a popular nutritional strategy for recovery, particularly for the attenuation of markers associated with muscle damage. However, there are relatively few studies that have examined an acute dosing strategy. The aim of this pilot study was to explore the feasibility of using powdered Vistula TC for recovery following a bout of muscle-damaging exercise. Twenty-two recreationally active participants (mean ± SD age, stature, and mass were 23 ± 3 years old, 173 ± 10 cm, and 74 ± 17 kg, respectively) performed 40 (5 sets of 8 repetitions) maximal lengthening contractions of the elbow flexors. The participants were randomised to receive either a spray-dried TC extract or a calorie-matched placebo (12 TC, 10 placebo) for 4 days in total, starting on the day of exercise. Dependent measures of maximal voluntary contraction (MVC), muscle soreness (assessed via visual analogue scales; VAS), pain pressure threshold (PPT), range of motion (ROM), and upper arm limb girth were taken at baseline (pre), 24, 48, and 72 h post damaging exercise. There were significant changes over time among all the variables (MVC, VAS, PPT, ROM, and girth, p ≤ 0.014). There were no significant differences between the conditions for any of the variables (MVC, VAS, PPT, ROM, and girth, p > 0.3). The TC group did not recover at an accelerated rate compared to the placebo. This study provides initial insights into the use of powdered Vistula TC and its effect following strenuous (damaging) exercise bouts. Vistula TC did not improve recovery when taken acutely following a bout of damaging exercise to the elbow flexors.

Elbow Gesture Recognition with an Array of Inductive Sensors and Machine Learning.

This work presents a novel approach for elbow gesture recognition using an array of inductive sensors and a machine learning algorithm (MLA). This paper describes the design of the inductive sensor array integrated into a flexible and wearable sleeve. The sensor array consists of coils sewn onto the sleeve, which form an LC tank circuit along with the externally connected inductors and capacitors. Changes in the elbow position modulate the inductance of these coils, allowing the sensor array to capture a range of elbow movements. The signal processing and random forest MLA to recognize 10 different elbow gestures are described. Rigorous evaluation on 8 subjects and data augmentation, which leveraged the dataset to 1270 trials per gesture, enabled the system to achieve remarkable accuracy of 98.3% and 98.5% using 5-fold cross-validation and leave-one-subject-out cross-validation, respectively. The test performance was then assessed using data collected from five new subjects. The high classification accuracy of 94% demonstrates the generalizability of the designed system. The proposed solution addresses the limitations of existing elbow gesture recognition designs and offers a practical and effective approach for intuitive human-machine interaction.

Minimum Intensity of Daily Six Eccentric Contractions to Increase Muscle Strength and Size.

Our previous study showed that daily six maximal eccentric contractions that were performed 5 days a week for 4 weeks increased maximal voluntary isometric (MVC-ISO), concentric (MVC-CON), and eccentric contraction (MVC-ECC) strength of the elbow flexors and muscle thickness of biceps brachii and brachialis (MT) by 8.3 ± 4.9%, 11.1 ± 7.4%, 13.5 ± 11.5%, and 10.6 ± 5.1%, respectively. In the present study, we tested the hypothesis that the muscle strength and MT would still increase when the training intensity was reduced to 2/3 or 1/3 of the peak MVC-ECC torque. Thirty-six healthy young (19-24 years) adults who had not performed resistance training were placed to three groups (n = 12/group): 2/3MVC or 1/3MVC that performed six eccentric contractions with 2/3 or 1/3 MVC-ECC load using a dumbbell 5 days a week for 4 weeks or control group that did not perform any training. Changes in the MVC-ISO, MVC-CON, MVC-ECC torque, and MT before and after the 4-week period were compared among the groups and with the group of the previous study in which six maximal eccentric contractions were performed 5 days a week for 4 weeks (MVC group; n = 12). The control and 1/3MVC groups showed no significant changes in any measures. Significant (p < 0.05) increases in MVC-ISO (10.3 ± 11.4%), MVC-CON (10.9 ± 9.5%), and MVC-ECC (9.3 ± 8.8%) torque and MT (10.1 ± 9.2%) were observed for the 2/3MVC group. These changes were not significantly different from those of the MVC group. These results suggest that the 2/3-intensity eccentric contractions with a dumbbell are as effective as maximal-intensity isokinetic eccentric contractions to induce muscle adaptations.

Evidence of the existence of multiple modules for the stroke-caused flexion synergy from Fugl-Meyer assessment scores.

Stroke-caused synergies may result from the preferential use of the reticulospinal tract (RST) due to damage to the corticospinal tract. The RST branches multiple motoneuron pools across the arm together resulting in gross motor control or abnormal synergies, and accordingly, the controllability of individual muscles decreases. However, it is not clear whether muscles involuntarily activated by abnormal synergy vary depending on the muscles voluntarily activated when motor commands descend through the RST. Studies showed that abnormal synergies may originate from the merging and reweighting of synergies in individuals without neurological deficits. This leads to a hypothesis that those abnormal synergies are still selectively excited depending on the context. In this study, we test this hypothesis, leveraging the Fugl-Meyer assessment that could characterize the neuroanatomical architecture in individuals with a wide range of impairments. We examine the ability to perform an out-of-synergy movement with the flexion synergy caused by either shoulder or elbow loading. The results reveal that about 14% [8/57, 95% confidence interval (5.0%, 23.1%)] of the participants with severe impairment (total Fugl-Meyer score <29) in the chronic phase (6 months after stroke) are able to keep the elbow extended during shoulder loading and keep the shoulder at neutral during elbow loading. Those participants underwent a different course of neural reorganization, which enhanced abnormal synergies in comparison with individuals with mild impairment (P < 0.05). These results provide evidence that separate routes and synergy modules to motoneuron pools across the arm might exist even if the motor command is mediated possibly via the RST.NEW & NOTEWORTHY We demonstrate that abnormal synergies are still selectively excited depending on the context.

Differential Modulation of Motor Unit Behavior When a Fatiguing Contraction Is Matched for Torque versus EMG.

INTRODUCTION: When an isometric contraction is sustained at a submaximal torque, activation of the motoneuron pool increases, making it difficult to interpret neural excitability alterations. Thus, more recently, isometric contractions with maintained electromyographic (EMG) activity (matched-EMG) are being used to induce fatigue; however, little is known about the neurophysiological adjustments that occur to satisfy the requirements of the task. METHODS: For our study, 16 participants performed a 10-min sustained isometric elbow flexion contraction at 20% maximal voluntary contraction (MVC) torque or the level of integrated biceps brachii EMG recorded at 20% MVC torque. Surface EMG was used to assess global median frequency, and four fine-wire electrode pairs were used to obtain motor unit (MU) discharge rate from biceps brachii. Torque or EMG steadiness was also assessed throughout the fatiguing contractions. RESULTS: MU discharge rate increased and torque steadiness decreased during the matched-torque contraction; however, MU discharge rate decreased during the matched-EMG contraction, and no changes occurred for EMG steadiness. Data pooled for the two contractions revealed a decrease in global median frequency. Lastly, a greater loss of MVC torque was observed immediately after the matched-torque compared with matched-EMG contraction. CONCLUSIONS: These findings indicate that, during a matched-torque fatiguing contraction, the nervous system increases MU discharge rates at the cost of poorer steadiness to maintain the requisite torque. In contrast, during a matched-EMG fatiguing contraction, a reduction of MU discharge rates allows for maintenance of EMG steadiness.

Two synergistic types of muscles were detected during forearm rotation exercise by T2 cumulative frequency curves using 0.2 T magnetic resonance imaging.

The purpose of this study was the detection and characterization of synergistic muscle activity. Using T2-map MRI, T2 values for 10 forearm muscles in 11 healthy adult volunteers were obtained in the resting state and after isotonic forearm supination and pronation exercises with the elbow extended. T2 was normalized by Z = (T2e-T2r)/SDr, where T2e was T2 after exercise, while T2r and SDr were the reference values of 34 ms and 3 ms, respectively. Using the cumulative frequency curves of Z values (CFZ), we detected 2 and 3 synergistic muscles for supination and pronation, respectively, and divided these into 2 types, one activated by exercise strength dependently, and the other, independent of exercise strength, activated by only a smaller fraction of the participants. We also detected co-contraction for the supination. Thus, CFZ is a useful visualization tool to detect and characterize not only synergistic muscle, but also co-contraction muscle.

Evaluation of generic EMG-Torque models across two Upper-Limb joints.

Advanced single-use dynamic EMG-torque models require burdensome subject-specific calibration contractions and have historically been assumed to produce lower error than generic models (i.e., models that are identical across subjects and muscles). To investigate this assumption, we studied generic one degree of freedom (DoF) models derived from the ensemble median of subject-specific models, evaluated across subject, DoF and joint. We used elbow (N = 64) and hand-wrist (N = 9) datasets. Subject-specific elbow models performed statistically better [5.79 ± 1.89 %MVT (maximum voluntary torque) error] than generic elbow models (6.21 ± 1.85 %MVT error). However, there were no statistical differences between subject-specific vs. generic models within each hand-wrist DoF. Next, we evaluated generic models across joints. The best hand-wrist generic model had errors of 6.29 ± 1.85 %MVT when applied to the elbow. The elbow generic model had errors of 7.04 ± 2.29 %MVT when applied to the hand-wrist. The generic elbow model was statistically better in both joints, compared to the generic hand-wrist model. Finally, we tested Butterworth filter models (a simpler generic model), finding no statistical differences between optimum Butterworth and subject-specific models. Overall, generic models simplified EMG-torque training without substantive performance degradation and provided the possibility of transfer learning between joints.

Effects of isometric training and R.I.C.E. treatment on the arm muscle performance of swimmers with elbow pain.

The effects of IT and R.I.C.E. treatment on arm muscle performance in overhead athletes with elbow pain (EP) have been partially validated. However, there is a lack of research evidence regarding the efficacy of these two methods on arm muscle performance among swimmers with EP. The aim of this study was to investigate the trends and differences in the effects of IT and R.I.C.E. treatment on arm muscle performance among swimmers with EP. The main outcomes were the time effects and group effects of interventions on muscle voluntary contraction (MVC). Sixty elite freestyle swimmers from Tianjin, China, voluntarily participated in the study and completed a 10-week intervention program. Swimmers with EP in the IT group showed a positive trend in MVC, with an approximately 2% increase, whereas the MVC of subjects in the R.I.C.E. treatment group and control group decreased by approximately 4% and 5%, respectively. In comparison, the effects of the IT intervention on the MVC of the triceps and brachioradialis muscles in swimmers with EP were significant (p = 0.042 < 0.05, p = 0.027 < 0.05). The mean MVC value of the IT group (0.60) was greater than that of the other two groups (0.51, 0.50). IT has a beneficial impact on the MVC performance of the triceps and brachioradialis muscles in swimmers with EP. It is recommended that professionals consider incorporating IT into regular training routines to mitigate the risk of EP issues. Future research should examine the effectiveness of both interventions on hand-grip strength and completion time in 50-m freestyle swim drills in order for swimmers with EP to return to this sport.

Blood flow restriction increases necessary muscle excitation of the elbow flexors during a single high-load contraction.

PURPOSE: To investigate the effects of blood flow restriction (BFR) on electromyographic amplitude (EMGRMS)-force relationships of the biceps brachii (BB) during a single high-load muscle action. METHODS: Twelve recreationally active males and eleven recreationally active females performed maximal voluntary contractions (MVCs), followed by an isometric trapezoidal muscle action of the elbow flexors at 70% MVC. Surface EMG was recorded from the BB during BFR and control (CON) visits. For BFR, cuff pressure was 60% of the pressure required to completely occlude blood at rest. Individual b (slope) and a terms (gain) were calculated from the log-transformed EMGRMS-force relationships during the linearly increasing and decreasing segments of the trapezoid. EMGRMS during the steady force segment was normalized to MVC EMGRMS. RESULTS: For BFR, the b terms were greater during the linearly increasing segment than the linearly decreasing segment (p < 0.001), and compared to the linearly increasing segment for CON (p < 0.001). The a terms for BFR were greater during the linearly decreasing than linearly increasing segment (p = 0.028). Steady force N-EMGRMS was greater for BFR than CON collapsed across sex (p = 0.041). CONCLUSION: BFR likely elicited additional recruitment of higher threshold motor units during the linearly increasing- and steady force-segment. The differences between activation and deactivation strategies were only observed with BFR, such as the b terms decreased and the a terms increased for the linearly decreasing segment in comparison to the increasing segment. However, EMGRMS-force relationships during the linearly increasing- and decreasing-segments were not different between sexes during BFR and CON.

Weekly minimum frequency of one maximal eccentric contraction to increase muscle strength of the elbow flexors.

PURPOSE: Our previous study showed that one 3-s maximal eccentric contraction a day performed 5 days a week for 4 weeks (5DW) increased maximal voluntary contraction (MVC) strength of the elbow flexors more than 10%. The present study examined whether muscle strength would still increase when the frequency was reduced to 2 days or 3 days per week. METHODS: Twenty-six healthy young adults were recruited in the present study and placed to two groups (n = 13/group) based on the weekly frequency of the one 3-s maximal eccentric contraction for two (2DW) or three days per week (3DW) for 4 weeks. Changes in MVC-isometric, MVC-concentric, MVC-eccentric torque of the elbow flexors, and muscle thickness of biceps brachii and brachialis (MT) before and after the 4-week training were compared between 2DW and 3DW groups, and also compared to the 5DW group in the previous study. RESULTS: The 2DW group showed no significant changes in MVC torque. Significant (P < 0.05) increases in MVC-concentric (2.5 ± 10.4%) and MVC-eccentric (3.9 ± 4.9%) torque were observed for the 3DW group, but the magnitude of the increase was smaller (P < 0.05) than that presented by the 5DW group (12.8 ± 9.6%, 12.2 ± 7.8%). No significant changes in MT were evident for any of the groups. CONCLUSION: These results suggest that at least three days a week are necessary for the one 3-s maximal eccentric contraction to be effective for increasing muscle strength, and more frequent sessions in a week (e.g., 5 days) appear to induce greater increases in muscle strength.

Prevalence of bilateral ulnar nerve subluxation among professional baseball pitchers.

BACKGROUND: Radiographic and physical examination findings of ulnar nerve instability have been recognized in overhead throwing athletes, despite the fact that some of these abnormalities may be asymptomatic and represent adaptive changes. While recommendations for screening and early detection have been made that can adversely impact an athletes' career, the presence of bilateral ulnar nerve subluxation and its relationship with medial elbow symptoms has not been characterized in professional overhead throwing athletes. PURPOSE: To characterize the prevalence of bilateral ulnar nerve subluxation among professional baseball pitchers. METHODS: A cross-sectional observational analysis was conducted utilizing standardized ultrasonographic examinations of bilateral elbows in 91 consecutive professional baseball pitchers (median age, 22 years; range, 17-30 years). The relationship between ulnar nerve subluxation and ulnar nerve signs, symptoms, and provocative physical examination maneuvers was also investigated. RESULTS: The prevalence of bilateral ulnar nerve subluxation was 26.4% (95% CI, 17.7%-36.7%; 24 of the 91 athletes). Thirty-five athletes (38.5%; 95% CI, 28.4%-49.2%) had subluxation in at least 1 elbow. No athletes with subluxation had positive ulnar nerve signs, symptoms, or provocative tests. CONCLUSION: Ulnar nerve subluxation is common among professional pitchers, and is more often than not bilateral. In this population of athletes, ulnar nerve subluxation does not appear to be associated with pathological findings.

Muscle fatigue tracking during dynamic elbow flexion-extension movements with a varying hand load.

Muscle fatigue monitoring, an important element in a fatigue risk management process, can help optimize work intensity and reduce risks for musculoskeletal injuries. An experiment was conducted to determine whether myoelectric manifestations of muscle fatigue can reflect the pace of fatigue development associated with varying load intensity. Twenty male participants performed elbow flexion-extension movements with alternating hand loads (2 kg vs. 1 kg) for 16 min. The pace of fatigue in the biceps brachii in response to load variation was quantified by electromyographic (EMG) fatigue measures collected during the dynamic elbow flexion-extension movements and periodic submaximal isometric elbow flexion trials. The isometric and dynamic EMG measures, except for the amplitude of dynamic EMG, indicated fatigue development during the 2-kg isotonic movements and partial recovery with the 1 kg load. Study results suggest the potential of EMG measures for fatigue monitoring during dynamic work tasks with varying load intensity.

Relationships between Changes in Muscle Shear Modulus, Urinary Titin N- Terminal Fragment, and Maximum Voluntary Contraction Torque after Eccentric Exercise of the Elbow Flexors.

The study aimed to investigate the relationships between the shear modulus of the biceps brachii (BB) and brachialis muscle (BA) and the total of the two (BB+BA), and urinary titin N-terminal fragment (UTF), maximum voluntary isometric contraction (MVC), and other indirect markers. Fifteen healthy men performed five sets of 10 eccentric contractions using a dumbbell corresponding to 50% of MVC at 90° measured at baseline. The elbow joint of the left arm was extended from 90° to 180° (180° = full extension) in 5 s in the exercise, and was returned with support from the examiner to prevent concentric contraction. Shear modulus of BB and BA were measured by ultrasound shear wave elastography, and UTF, MVC, and range of motion of the elbow joint (ROM) were recorded before; immediately after; and 1, 24, 48, 72, 96, and 168 h after the exercise. After calculating the shear modulus of BB and BA, two values were added (BB+BA). The shear modulus peaked at 48 h, UTF peaked at 96 h, MVC and ROM changed largest at immediately, and muscle soreness peaked at 48 h post-exercise. Significant (p < 0.05) relationships were found between changes in BB shear modulus and BA shear modulus (r = 0.874), BB+BA shear modulus (r = 0.977), UTF (r = 0.681), and MVC (r = -0.538). Significant (p < 0.05) relationships were also observed between changes in BA shear modulus and BB+BA shear modulus (r = 0.957), UTF (r = 0.682), MVC (r = -0.522), and ROM (r = -0.600). Moreover, significant (p < 0.05) relationships were observed between changes in BB+BA shear modulus and UTF (r = 0.703), MVC (r = -0.549), and ROM (r = -0.547). These results indicate that shear modulus of each muscle (i.e., BB and BA) provide more precise information about muscle damage than UTF, MVC and ROM.

Detecting age-related changes in skeletal muscle mechanics using ultrasound shear wave elastography.

Aging leads to a decline in muscle mass and force-generating capacity. Ultrasound shear wave elastography (SWE) is a non-invasive method to capture age-related muscular adaptation. This study assessed biceps brachii muscle (BB) mechanics, hypothesizing that shear elastic modulus reflects (i) passive muscle force increase imposed by length change, (ii) activation-dependent mechanical changes, and (iii) differences between older and younger individuals. Fourteen healthy volunteers aged 60-80 participated. Shear elastic modulus, surface electromyography, and elbow torque were measured at five elbow positions in passive and active states. Data collected from young adults aged 20-40 were compared. The BB passive shear elastic modulus increased from flexion to extension, with the older group exhibiting up to 52.58% higher values. Maximum elbow flexion torque decreased in extended positions, with the older group 23.67% weaker. Significant effects of elbow angle, activity level, and age on total and active shear elastic modulus were found during submaximal contractions. The older group had 20.25% lower active shear elastic modulus at 25% maximum voluntary contraction. SWE effectively quantified passive and activation-dependent BB mechanics, detecting age-related alterations at rest and during low-level activities. These findings suggest shear elastic modulus as a promising biomarker for identifying altered muscle mechanics in aging.

Air Efficient Soft Wearable Robot for High-Torque Elbow Flexion Assistance.

Recent developments in soft wearable robots have shown promise for assistive and rehabilitative use-cases. For inflatable approaches, a major challenge in developing portable systems is finding a balance between portability, performance, and usability. In this paper, we present a textile-based robotic sleeve that can provide functional elbow flexion assistance and is compatible with a portable actuation unit (PAU). Flexion is driven by a curved textile actuator with internal pneumatic supports (IPS). We show that the addition of IPS improves torque generation and increases battery-powered actuations by 60%. We demonstrate that the device can provide enough torque throughout the ROM of the elbow joint for daily life assistance. Specifically, the device generates 13.5 Nm of torque at 90°. Experimental testing in five healthy individuals and two individuals with Amyotrophic Lateral Sclerosis (ALS) demonstrates its impact on wearer muscle activity and kinematics. The results with healthy subjects show that the device was able to reduce the bicep muscle activity by an average of 49.1±13.3% during static and dynamic exercises, 43.6±11.1% during simulated ADLs, and provided an assisted ROM of 134°±13°. Both ALS participants reported a reduced rate of perceived exertion during both static and dynamic tasks while wearing the device and had an average ROM of 115°±8°. Future work will explore other applications of the IPS and extend the approach to assisting multiple joints.

Decoding Upper-Limb Movement Intention Through Adaptive Dynamic Movement Primitives: A Proof-of-Concept Study with a Shoulder-Elbow Exoskeleton.

This work presents an intention decoding algorithm that can be used to control a 4 degrees-of-freedom shoulder-elbow exoskeleton in reaching tasks. The algorithm was designed to assist the movement of users with upper-limb impairments who can initiate the movement by themselves. It relies on the observation of the initial part of the user's movement through joint angle measures and aims to estimate in real-time the phase of the movement and predict the goal position of the hand in the reaching task. The algorithm is based on adaptive Dynamic Movement Primitives and Gaussian Mixture Models. The performance of the algorithm was verified in robot-assisted planar reaching movements performed by one healthy subject wearing the exoskeleton. Tests included movements of different amplitudes and orientations. Results showed that the algorithm could predict the hand's final position with an error lower than 5 cm after 0.25 s from the movement onset, and that the final position reached during the tests was on average less than 4 cm far from the target position. Finally, the effects of the assistance were observed in a reduction of the activation of the Biceps Brachii and of the time to execute the reaching tasks.