Muscle activity and hypoalgesia in blood flow restricted versus unrestricted effort-matched resistance exercise in healthy adults.

This study assessed muscle activity (root mean square, RMS, and median frequency, MDF) to evaluate the acute response to blood flow restriction (BFR) resistance exercise (RE) and conventional moderate intensity (MI) RE. We also performed exploratory analyses of differences based on sex and exercise-induced hypoalgesia (EIH). Fourteen asymptomatic individuals performed four sets of unilateral leg press with their dominant leg to volitional fatigue under two exercise conditions: BFR RE and MI RE. Dominant side rectus femoris (RF) and vastus lateralis (VL) muscle activity were measured using surface electromyography (sEMG) through exercise. RMS and MDF were calculated and compared between conditions and timepoints using a linear mixed model. Pressure pain thresholds (PPT) were tested before and immediately after exercise and used to quantify EIH. Participants were then divided into EIH responders and nonresponders, and the differences on RMS and MDF were compared between the two groups using Hedges' g. RMS significantly increased over time (RF: p = 0.0039; VL: p = 0.001) but not between conditions (RF: p = 0.4; VL: p = 0.67). MDF decreased over time (RF: p = 0.042; VL: p < 0.001) but not between conditions (RF: p = 0.74; VL: p = 0.77). Consistently lower muscle activation was found in females compared with males (BRF, RF: g = 0.63; VL, g = 0.5. MI, RF: g = 0.72; VL: g = 1.56), with more heterogeneous findings in MDF changes. For BFR, EIH responders showed greater RMS changes (Δ RMS) (RF: g = 0.90; VL: g = 1.21) but similar MDF changes (Δ MDF) (RF: g = 0.45; VL: g = 0.28) compared to nonresponders. For MI, EIH responders demonstrated greater increase on Δ RMS (g = 0.61) and decrease on Δ MDF (g = 0.68) in RF but similar changes in VL (Δ RMS: g = 0.40; Δ MDF: g = 0.39). These results indicate that when exercising to fatigue, no statistically significant difference was observed between BFR RE and conventional MI RE in Δ RMS and Δ MDF. Lower muscle activity was noticed in females. While exercising to volitional fatigue, muscle activity may contribute to EIH.

Lower-limb Nonparametric Functional Muscle Network: Test-retest Reliability Analysis.

Objective: Functional muscle network analysis has attracted a great deal of interest in recent years, promising high sensitivity to changes of intermuscular synchronicity, studied mostly for healthy subjects and recently for patients living with neurological conditions (e.g., those caused by stroke). Despite the promising results, the between- and within-session reliability of the functional muscle network measures are yet to be established. Here, for the first time, we question and evaluate the test-retest reliability of non-parametric lower-limb functional muscle networks for controlled and lightly-controlled tasks, i.e., sit-to-stand, and over-the-ground walking, respectively, in healthy subjects. Method: Fifteen subjects (eight females) were included over two sessions on two different days. The muscle activity was recorded using 14 surface electromyography (sEMG) sensors. The intraclass correlation coefficient (ICC) of the within-session and between-session trials was quantified for the various network metrics, including degree and weighted clustering coefficient. In order to compare with common classical sEMG measures, the reliabilities of the root mean square (RMS) of sEMG and the median frequency (MDF) of sEMG were also calculated. Results: The ICC analysis revealed superior between-session reliability for muscle networks, with statistically significant differences when compared to classic measures. Conclusion and Significance: This paper proposed that the topographical metrics generated from functional muscle network can be reliably used for multi-session observations securing high reliability for quantifying the distribution of synergistic intermuscular synchronicities of both controlled and lightly controlled lower limb tasks. In addition, the low number of sessions required by the topographical network metrics to reach reliable measurements indicates the potential as biomarkers during rehabilitation.

Deep learning for deterioration prediction of COVID-19 patients based on time-series of three vital signs.

Unrecognized deterioration of COVID-19 patients can lead to high morbidity and mortality. Most existing deterioration prediction models require a large number of clinical information, typically collected in hospital settings, such as medical images or comprehensive laboratory tests. This is infeasible for telehealth solutions and highlights a gap in deterioration prediction models based on minimal data, which can be recorded at a large scale in any clinic, nursing home, or even at the patient's home. In this study, we develop and compare two prognostic models that predict if a patient will experience deterioration in the forthcoming 3 to 24 h. The models sequentially process routine triadic vital signs: (a) oxygen saturation, (b) heart rate, and (c) temperature. These models are also provided with basic patient information, including sex, age, vaccination status, vaccination date, and status of obesity, hypertension, or diabetes. The difference between the two models is the way that the temporal dynamics of the vital signs are processed. Model #1 utilizes a temporally-dilated version of the Long-Short Term Memory model (LSTM) for temporal processes, and Model #2 utilizes a residual temporal convolutional network (TCN) for this purpose. We train and evaluate the models using data collected from 37,006 COVID-19 patients at NYU Langone Health in New York, USA. The convolution-based model outperforms the LSTM based model, achieving a high AUROC of 0.8844-0.9336 for 3 to 24 h deterioration prediction on a held-out test set. We also conduct occlusion experiments to evaluate the importance of each input feature, which reveals the significance of continuously monitoring the variation of the vital signs. Our results show the prospect for accurate deterioration forecast using a minimum feature set that can be relatively easily obtained using wearable devices and self-reported patient information.

Lower-Limb Non-Parametric Functional Muscle Network: Test-Retest Reliability Analysis.

Functional muscle network analysis has attracted a great deal of interest in recent years, promising high sensitivity to changes of intermuscular synchronicity, studied mostly for healthy subjects and recently for patients living with neurological conditions (e.g., those caused by stroke). Despite the promising results, the between- and within-session reliability of the functional muscle network measures are yet to be established. Here, for the first time, we question and evaluate the test-retest reliability of non-parametric lower-limb functional muscle networks for controlled and lightly-controlled tasks, i.e., sit-to-stand, and over-the-ground walking, respectively, in healthy subjects. Fifteen subjects (eight females) were included over two sessions on two different days. The muscle activity was recorded using 14 surface electromyography (sEMG) sensors. The intraclass correlation coefficient (ICC) of the within-session and between-session trials was quantified for the various network metrics, including degree and weighted clustering coefficient. In order to compare with common classical sEMG measures, the reliabilities of the root mean square (RMS) of sEMG and the median frequency (MDF) of sEMG were also calculated. The ICC analysis revealed superior between-session reliability for muscle networks, with statistically significant differences when compared to classic measures. This paper proposed that the topographical metrics generated from functional muscle network can be reliably used for multi-session observations securing high reliability for quantifying the distribution of synergistic intermuscular synchronicities of both controlled and lightly controlled lower limb tasks. In addition, the low number of sessions required by the topographical network metrics to reach reliable measurements indicates the potential as biomarkers during rehabilitation.

Non-parametric Functional Muscle Network as a Robust Biomarker of Fatigue.

Characterization of fatigue using surface electromyography (sEMG) data has been motivated for rehabilitation and injury-preventative technologies. Current sEMG-based models of fatigue are limited due to (a) linear and parametric assumptions, (b) lack of a holistic neurophysiological view, and (c) complex and heterogeneous responses. This paper proposes and validates a data-driven non-parametric functional muscle network analysis to reliably characterize fatigue-related changes in synergistic muscle coordination and distribution of neural drive at the peripheral level. The proposed approach was tested on data collected in this study from the lower extremities of 26 asymptomatic volunteers (13 subjects were assigned to the fatigue intervention group, and 13 age/gender-matched subjects were assigned to the control group). Volitional fatigue was induced in the intervention group by moderate-intensity unilateral leg press exercises. The proposed non-parametric functional muscle network demonstrated a consistent decrease in connectivity after the fatigue intervention, as indicated by network degree, weighted clustering coefficient (WCC), and global efficiency. The graph metrics displayed consistent and significant decreases at the group level, individual subject level, and individual muscle level. For the first time, this paper proposed a non-parametric functional muscle network and highlighted the corresponding potential as a sensitive biomarker of fatigue with superior performance to conventional spectrotemporal measures.

Linear versus Nonlinear Muscle Networks: A Case Study to Decode Hidden Synergistic Patterns During Dynamic Lower-limb Tasks.

This paper, for the first time, compares the behaviors of nonlinear versus linear muscle networks in decoding hidden peripheral synergistic neural patterns during dynamic functional tasks. In this paper, we report a case study during which one healthy subject conducts a series of four lower limb repetitive tasks. Specifically, the paper focuses on tasks that involve the right knee joint, including walking, sit-tostand, stepping, and drop-jump. Twelve muscles were recorded using the Delsys Trigno system. The linear muscle network was generated using coherence analysis, and the nonlinear network was generated using Spearman's correlation. The results show that the degree, clustering coefficient, and global efficiency of the muscle network have the highest value among tasks in the linear domain for the walking task, while a low linear synergistic network behavior for the sit-to-stand is observed. On the other hand, the results show that the nonlinear functional muscle network decodes high connectivity (degree) and clustering coefficient and efficiency for the sit-tostand when compared with other tasks. We have also developed a two-dimensional functional connectivity plane composed of linear and nonlinear features and shown that it can span the lower-limb dynamic task space. The results of this paper for the first time highlight the importance of observing both linear and nonlinear connectivity patterns, especially for complex dynamic tasks. It should also be noted that through a simultaneous EEG recording (using BrainVision System), we have shown that, indeed, cortical activity may indirectly explain highly-connected nonlinear muscle network for the sit-to-stand task, highlighting the importance of nonlinear muscle network as a neurophysiological window of observation beyond the periphery.

Perilaryngeal-Cranial Functional Muscle Network Differentiates Vocal Tasks: A Multi-Channel sEMG Approach.

OBJECTIVE: Objective evaluation of physiological responses using non-invasive methods for the assessment of vocal performance and voice disorders has attracted great interest. This paper, for the first time, aims to implement and evaluate perilaryngeal-cranial functional muscle networks. The study investigates the variations in topographical characteristics of the network and the corresponding ability to differentiate vocal tasks. METHOD: Twelve surface electromyography (sEMG) signals were collected bilaterally from six perilaryngeal and cranial muscles. Data were collected from eight subjects (four females) without a known history of voice disorders. The proposed muscle network is composed of pairwise coherence between sEMG recordings. The network metrics include (a) network degree and (b) weighted clustering coefficient (WCC). RESULTS: The varied phonation tasks showed the median degree, and WCC of the muscle network ascend monotonically, with a high effect size ( |rrb| âˆ¼ 0.5). Pitch glide, singing, and speech tasks were significantly distinguishable using degree and WCC ( |rrb| âˆ¼ 0.8). Also, pitch glide had the highest degree and WCC among all tasks (degree , WCC ). In comparison, classic spectrotemporal measures showed far less effectiveness (max |rrb|=0.12) in differentiating the vocal tasks. CONCLUSION: Perilaryngeal-cranial functional muscle network was proposed in this paper. The study showed that the functional muscle network could robustly differentiate the vocal tasks while the classic assessment of muscle activation fails to differentiate. SIGNIFICANCE: For the first time, we demonstrate the power of a perilaryngeal-cranial muscle network as a neurophysiological window to vocal performance. In addition, the study also discovers tasks with the highest network involvement, which may be utilized in the future to monitor voice disorders and rehabilitation.

Perspective: Wearable Internet of Medical Things for Remote Tracking of Symptoms, Prediction of Health Anomalies, Implementation of Preventative Measures, and Control of Virus Spread During the Era of COVID-19.

The COVID-19 pandemic has highly impacted the communities globally by reprioritizing the means through which various societal sectors operate. Among these sectors, healthcare providers and medical workers have been impacted prominently due to the massive increase in demand for medical services under unprecedented circumstances. Hence, any tool that can help the compliance with social guidelines for COVID-19 spread prevention will have a positive impact on managing and controlling the virus outbreak and reducing the excessive burden on the healthcare system. This perspective article disseminates the perspectives of the authors regarding the use of novel biosensors and intelligent algorithms embodied in wearable IoMT frameworks for tackling this issue. We discuss how with the use of smart IoMT wearables certain biomarkers can be tracked for detection of COVID-19 in exposed individuals. We enumerate several machine learning algorithms which can be used to process a wide range of collected biomarkers for detecting (a) multiple symptoms of SARS-CoV-2 infection and (b) the dynamical likelihood of contracting the virus through interpersonal interaction. Eventually, we enunciate how a systematic use of smart wearable IoMT devices in various social sectors can intelligently help controlling the spread of COVID-19 in communities as they enter the reopening phase. We explain how this framework can benefit individuals and their medical correspondents by introducing Systems for Symptom Decoding (SSD), and how the use of this technology can be generalized on a societal level for the control of spread by introducing Systems for Spread Tracing (SST).