Current developments in surface electromyography.

Background/aim: Surface electromyography (surface EMG) is a primary technique to detect the electrical activities of muscles through surface electrodes. In recent years, surface EMG applications have grown from conventional fields into new fields. However, there is a gap between the progress in the research of surface EMG and its clinical acceptance, characterized by the translational knowledge and skills in the widespread use of surface EMG among the clinician community. To reduce this gap, it is necessary to translate the updated surface EMG applications and technological advances into clinical research. Therefore, we aimed to present a perspective on recent developments in the application of surface EMG and signal processing methods. Materials and methods: We conducted this scoping review following the Joanna Briggs Institute (JBI) method. We conducted a general search of PubMed and Web of Science to identify key search terms. Following the search, we uploaded selected articles into Rayyan and removed duplicates. After prescreening 133 titles and abstracts, we assessed 91 full texts according to the inclusion criteria. Results: We concluded that surface EMG has made innovative technological progress and has research potential for routine clinical applications and a wide range of applications, such as neurophysiology, sports and art performances, biofeedback, physical therapy and rehabilitation, assessment of physical exercises, muscle strength, fatigue, posture and postural control, movement analysis, muscle coordination, motor synergies, modelling, and more. Novel methods have been applied for surface EMG signals in terms of time domain, frequency domain, time-frequency domain, statistical methods, and nonlinear methods. Conclusion: Translating innovations in surface EMG and signal analysis methods into routine clinical applications can be a helpful tool with a growing and valuable role in muscle activation measurement in clinical practices. Thus, researchers must build many more interfaces that give opportunities for continuing education and research with more contemporary techniques and devices.

Effects of Sensory Input Interactions on Components of Nonlinear Dynamics of Postural Sway in Aging.

Postural control involves complex nonlinear dynamics influenced by the interaction and adaptation of different sensory inputs. However, it is not how these inputs interact with one another due to the complex complications associated with aging, particularly concerning the nonlinear dynamics of postural sway. This study aimed to examine how different sensory inputs, surface conditions, and aging factors to influence postural control mechanisms between young and older by investigating the nonlinear dynamics of postural control using the stabilogram diffusion analysis (SDA) and entropy methods. SDA parameters were much greater on foam surfaces than on firm surfaces for both groups in eyes-open and eyes-closed conditions (p ≤ 0.05). For older subjects, there were significant differences in entropy values between firm and foam surfaces (p ≤ 0.05) but no significant difference between eyes conditions (p > 0.05). For both SDA and entropy parameters, surface and age interaction potentially revealed significant differences between young and older subjects (p ≤ 0.05) than eyes and age interaction. The present study provided insight into uncovering the complex relationships between sensory inputs, surface conditions, age, and their potential interaction effects on postural control mechanisms that could mitigate falls and alleviate the fear of falling, particularly in older populations.

Awareness and attitudes towards infectious diseases among teachers and administrators: Evaluation of health-related school program and practices.

BACKGROUND: Schools play a crucial role in promoting health education and awareness about infectious diseases. This study aims to examine teachers' and administrators' awareness and attitudes towards infectious diseases and their specific health-related applications. METHODS: This study used a new scale to collect survey data from 435 teachers and administrators. The validity and reliability of the scale were assessed by factor analysis. Pearson correlation and regression analysis were conducted to explore the relationships between variables. T-tests and one-way ANOVA were employed for group comparisons. RESULTS: The findings revealed a concerning skepticism among a significant portion of participants towards the effectiveness of vaccines in ending epidemics and a lack of health education activities in schools. Significant differences were observed in the scores for physical measures, educational activities, awareness, observation, and attitudes based on school type and ownership of certificates (p ≤ 0.05). CONCLUSIONS: This study highlights the need for continuous education and awareness-raising efforts to develop sustainable school health practices. Integrating diverse health professionals into school health management teams can enhance health services in educational settings. The present study also emphasizes the importance of comprehensive health education in understanding infectious diseases, preventive measures, and proper hygiene practices.

Electromyographic analysis of the traditional and spin throwing techniques for goalball games related to ball velocity for selected upper extremity muscles.

BACKGROUND: Goalball is a popular sport among visually impaired individuals, offering many physical and social benefits. Evaluating performance in Goalball, particularly understanding factors influencing ball velocity during throwing techniques, is essential for optimizing training programs and enhancing player performance. However, there is limited research on muscle activation patterns during Goalball throwing movements, needing further investigation to address this gap. Therefore, this study aims to examine muscle activity in sub-elite visually impaired Goalball players during different throwing techniques and visual conditions, focusing on its relationship with ball velocity. METHODS: 15 sub-elite Goalball players (2 female, 13 males; mean age of 20.46 ± 2.23 years) participated in the study. Muscle activity was evaluated with the Myo armband, while ball velocity was measured using two cameras and analyzed with MATLAB software. Different visual conditions were simulated using an eye band, and the effects of these conditions on muscle activation and ball velocity were examined. RESULTS: The flexor muscles were found to be more active during the spin throw techniques with the eyes open (p = 0.011). The extensor muscles were found to be more active in the eyes-closed spin throw techniques compared to the eyes-open position (p = 0.031). Ball velocity was found related to the flexor muscles. Interestingly, no significant differences in ball velocity were observed between different throwing techniques or visual conditions (p > 0.05). CONCLUSIONS: Ball velocity, one of the performance indicators of the athlete, is primarily related to upper extremity flexor muscle strength rather than visual acuity. It has less visual acuity, but an athlete with more upper-extremity flexor muscle strength will have an advantage in Goalball game. The spin throw technique, which is reported to provide a biomechanical advantage for professional players in the literature, did not provide an advantage in terms of ball velocity for the sub elite players evaluated in our study. This knowledge can inform the development of targeted training programs aimed at improving technique and enhancing ball velocity in Goalball players.

The effect of foot somatosensory loss in postural control during Functional reach test in patients with diabetic polyneuropathy: A controlled study.

BACKGROUND: In patients with diabetic polyneuropathy (DPN), differences in postural control due to losing the lower limb somatosensory information were reported. However, it is still unclear by which mechanisms the dynamic postural instability is caused. OBJECTIVES: This study aimed to investigate postural control differences and neuromuscular adaptations resulting from foot somatosensory loss due to DPN. METHODS: In this controlled cross-sectional study, fourteen DPN patients and fourteen healthy controls performed the Functional Reach Test (FRT) as a dynamic task. The postural control metrics were simultaneously measured using force plate, motion capture system, and surface electromyography (sEMG). The main metrics including reach length (FR), FR to height ratio (FR/H), displacement of CoM and CoP, moment arm (MA), and arch height ratio. Also, kinematic (range of motion of ankle, knee, and hip joints), and sEMG metrics (latencies and root mean square amplitudes of ankle and hallux muscles) were measured. To compare variables between groups, the independent sample T-test for (normally distributed) and the Mann-Whitney U test (non-normally distributed) were used. RESULTS: The subjects' reach length (FR), FR to height ratio, absolute MA, and displacement of CoM were significantly shorter than controls, while displacement of CoP was not significant. Arch height ratio was found significantly lower in DPN patients. We observed that CoM was lagging CoP in patients (MA = + 0.89) while leading in controls (MA = -1.60). Although, the muscles of patients showed significantly earlier activation, root mean square sEMG amplitudes were found similar. Also, DPN patients showed significantly less hip flexion, knee extension, and ankle plantar flexion. CONCLUSIONS: This study presented that decreasing range of motion at lower limbs' joints and deterioration in foot function caused poor performance at motor execution during FRT in DPN patients.

A novel approach to the diagnostic assessment of carpal tunnel syndrome based on the frequency domain of the compound muscle action potential.

Conventional electrophysiological (EP) tests may yield ambiguous or false-negative results in some patients with signs and symptoms of carpal tunnel syndrome (CTS). Therefore, researchers tend to investigate new parameters to improve the sensitivity and specificity of EP tests. We aimed to investigate the mean and maximum power of the compound muscle action potential (CMAP) as a novel diagnostic parameter, by evaluating diagnosis and classification performance using the supervised Kohonen self-organizing map (SOM) network models. The CMAPs were analyzed using the fast Fourier transform (FFT). The mean and maximum power parameters were calculated from the power spectrum. A counter-propagation artificial neural network (CPANN), supervised Kohonen network (SKN) and XY-fused network (XYF) were compared to evaluate the classification and diagnostic performance of the parameters using the confusion matrix. The mean and maximum power of the CMAP were significantly lower in patients with CTS than in the normal group (p < 0.05), and the XYF network had the best total performance of classification with 91.4%. This study suggests that the mean and maximum power of the CMAP can be considered as less time-consuming parameters for the diagnosis of CTS without using additional EP tests which can be uncomfortable for the patient due to poor tolerance to electrical stimulation.

Comparison of Interpolation Methods in the Diagnosis of Carpal Tunnel Syndrome

Background: Diagnosis of carpal tunnel syndrome is based on clinical symptoms, examination findings, and electrodiagnostic studies. For carpal tunnel syndrome, the most useful of these are nerve conduction studies. However, nerve conduction studie can result in ambiguous or false-negative results, particularly for mild carpal tunnel syndrome. Increasing the number of nerve conduction studie tests improves accuracy but also increases time, cost, and discomfort. To improve accuracy without additional testing, the terminal latency index and residual latency are additional calculations that can be performed using the minimum number of tests. Recently, the median sensory-ulnar motor latency difference was devised as another way to improve diagnostic accuracy for mild carpal tunnel syndrome. Aims: The median sensory-ulnar motor latency difference, terminal latency index, and residual latency were compared for diagnostic accuracy according to severity of carpal tunnel syndrome. Study Design: Diagnostic accuracy study. Methods: A total of 657 subjects were retrospectively enrolled. The carpal tunnel syndrome group consisted of 546 subjects with carpal tunnel syndrome according to nerve conduction studie (all severities). The control group consisted of 121 subjects with no hand symptoms and normal nerve conduction studie. All statistical analyses were performed using SAS v9.4. Means were compared using one-way ANOVA with the Bonferroni adjustment. Sensitivity, specificity, positive predictive value, and negative predictive value were compared, including receiver operating characteristic curve analysis. Results: For mild carpal tunnel syndrome, the median sensory-ulnar motor latency difference showed higher specificity and positive predictive value rates (0.967 and 0.957, respectively) than terminal latency index (0.603 and 0.769, respectively) and residual latency (0.818 and 0.858, respectively). The area under the receiver operating characteristic was highest for the median sensory-ulnar motor latency difference (0.889), followed by the residual latency (0.829), and lastly the terminal latency index (0.762). Differences were statistically significant (median sensory-ulnar motor latency difference being the most accurate). For moderate carpal tunnel syndrome, sensitivity and specificity rates of residual latency (0.989 and 1.000) and terminal latency index (0.983 and 0.975) were higher than those for median sensory-ulnar motor latency difference (0.866 and 0.958). Differences in area under the receiver operating characteristic curve were not significantly significant, but median sensory-ulnar motor latency difference sensitivity was lower. For severe carpal tunnel syndrome, residual latency yielded 1.000 sensitivity, specificity, positive predictive value, negative predictive value and area beneath the receiver operating characteristic curve. Differences in area under the receiver operating characteristic curve were not significantly different. Conclusion: The median sensory-ulnar motor latency difference is the best calculated parameter for diagnosing mild carpal tunnel syndrome. It requires only a simple calculation and no additional testing. Residual latency and the terminal latency index are also useful in diagnosing mild to moderate carpal tunnel syndrome.

Using fuzzy logic for diagnosis and classification of spasticity.

BACKGROUND/AIM: Spasticity is generally defined as a sensory-motor control disorder. However, there is no pathophysiological mechanism or appropriate measurement and evaluation standards that can explain all aspects of a possible spasticity occurrence. The objective of this study is to develop a fuzzy logic classifier (FLC) diagnosis system, in which a quantitative evaluation is performed by surface electromyography (EMG), and investigate underlying pathophysiological mechanisms of spasticity. MATERIALS AND METHODS: Surface EMG signals recorded from the tibialis anterior and medial gastrocnemius muscles of hemiplegic patients with spasticity and a healthy control group were analyzed in standing, resting, dorsal flexion, and plantar flexion positions. The signals were processed with different methods: by using their amplitudes in the time domain, by applying short-time Fourier transform, and by applying wavelet transform. A Mamdani-type multiple-input, single-output FLC with 64 rules was developed to analyze EMG signals. RESULTS: The wavelet transform provided better positive findings among all three methods used in this study. The FLC test results showed that the test was 100% sensitive to identify spasticity with 95.8% accuracy and 93.8% specificity. CONCLUSION: A FLC was successfully designed to detect and identify spasticity in spite of existing measurement difficulties in its nature.