Temporal Variability in Stride Kinematics during the Application of TENS: A Machine Learning Analysis.

INTRODUCTION: The purpose of our report was to use a Random Forest classification approach to predict the association between transcutaneous electrical nerve stimulation (TENS) and walking kinematics at the stride level when middle-aged and older adults performed the 6-min test of walking endurance. METHODS: Data from 41 participants (aged 64.6 ± 9.7 years) acquired in two previously published studies were analyzed with a Random Forest algorithm that focused on upper and lower limb, lumbar, and trunk kinematics. The four most predictive kinematic features were identified and utilized in separate models to distinguish between three walking conditions: burst TENS, continuous TENS, and control. SHAP analysis and linear mixed models were used to characterize the differences among these conditions. RESULTS: Modulation of four key kinematic features - toe-out angle, toe-off angle, and lumbar range of motion (ROM) in coronal and sagittal planes - accurately predicted walking conditions for the burst (82% accuracy) and continuous (77% accuracy) TENS conditions compared with control. Linear mixed models detected a significant difference in lumbar sagittal ROM between the TENS conditions. SHAP analysis revealed that burst TENS was positively associated with greater lumbar coronal ROM, smaller toe-off angle, and less lumbar sagittal ROM. Conversely, continuous TENS was associated with less lumbar coronal ROM and greater lumbar sagittal ROM. CONCLUSIONS: Our approach identified four kinematic features at the stride level that could distinguish between the three walking conditions. These distinctions were not evident in average values across strides.

Consensus for experimental design in electromyography (CEDE) project: Checklist for reporting and critically appraising studies using EMG (CEDE-Check).

The diversity in electromyography (EMG) techniques and their reporting present significant challenges across multiple disciplines in research and clinical practice, where EMG is commonly used. To address these challenges and augment the reproducibility and interpretation of studies using EMG, the Consensus for Experimental Design in Electromyography (CEDE) project has developed a checklist (CEDE-Check) to assist researchers to thoroughly report their EMG methodologies. Development involved a multi-stage Delphi process with seventeen EMG experts from various disciplines. After two rounds, consensus was achieved. The final CEDE-Check consists of forty items that address four critical areas that demand precise reporting when EMG is employed: the task investigated, electrode placement, recording electrode characteristics, and acquisition and pre-processing of EMG signals. This checklist aims to guide researchers to accurately report and critically appraise EMG studies, thereby promoting a standardised critical evaluation, and greater scientific rigor in research that uses EMG signals. This approach not only aims to facilitate interpretation of study results and comparisons between studies, but it is also expected to contribute to advancing research quality and facilitate clinical and other practical applications of knowledge generated through the use of EMG.

Motor unit modes in the calf muscles during a submaximal isometric contraction are changed by brief stretches.

The purpose of our study was to investigate the influence of a stretch intervention on the common modulation of discharge rate among motor units in the calf muscles during a submaximal isometric contraction. The current report comprises a computational analysis of a motor unit dataset that we published previously (Mazzo et al., 2021). Motor unit activity was recorded from the three main plantar flexor muscles while participants performed an isometric contraction at 10% of the maximal voluntary contraction force before and after each of two interventions. The interventions were a control task (standing balance) and static stretching of the plantar flexor muscles. A factorization analysis on the smoothed discharge rates of the motor units from all three muscles yielded three modes that were independent of the individual muscles. The composition of the modes was not changed by the standing-balance task, whereas the stretching exercise reduced the average correlation in the second mode and increased it in the third mode. A centroid analysis on the correlation values showed that most motor units were associated with two or three modes, which were presumed to indicate shared synaptic inputs. The percentage of motor units adjacent to the seven centroids changed after both interventions: Control intervention, mode 1 decreased and the shared mode 1 + 2 increased; stretch intervention, shared modes either decreased (1 + 2) or increased (1 + 3). These findings indicate that the neuromuscular adjustments during both interventions were sufficient to change the motor unit modes when the same task was performed after each intervention. KEY POINTS: Based on covariation of the discharge rates of motor units in the calf muscles during a submaximal isometric contraction, factor analysis was used to assign the correlated discharge trains to three motor unit modes. The motor unit modes were determined from the combined set of all identified motor units across the three muscles before and after each participant performed a control and a stretch intervention. The composition of the motor unit modes changed after the stretching exercise, but not after the control task (standing balance). A centroid analysis on the distribution of correlation values found that most motor units were associated with a shared centroid and this distribution, presumably reflecting shared synaptic input, changed after both interventions. Our results demonstrate how the distribution of multiple common synaptic inputs to the motor neurons innervating the plantar flexor muscles changes after a brief series of stretches.

More Variability in Tibialis Anterior Function during the Adduction of the Foot than Dorsiflexion of the Ankle.

INTRODUCTION: The aim of the study was to compare maximal force, force steadiness, and the discharge characteristics of motor units in the tibialis anterior (TA) muscle during submaximal isometric contractions for ankle dorsiflexion and adduction of the foot. METHODS: Nineteen active young adults performed maximal and submaximal isometric dorsiflexion and adduction contractions at five target forces (5%, 10%, 20%, 40%, and 60% maximal voluntary contraction [MVC]). The activity of motor units in TA was recorded by high-density EMG. RESULTS: The maximal force was similar between dorsiflexion and adduction, despite EMG amplitude for TA being greater ( P < 0.05) during dorsiflexion than adduction. Τhe coefficient of variation (CV) for force (force steadiness) during dorsiflexion was always less ( P < 0.05) than during adduction, except of 5% MVC force. No differences were observed for mean discharge rate; however, the regression between the changes in discharge rate relative to the change of force was significant for dorsiflexion ( R2 = 0.25, P < 0.05) but not for adduction. Discharge variability, however, was usually less during dorsiflexion. The CV for interspike interval was less ( P < 0.05) at 10%, 20%, and 40% MVC but greater at 60% MVC during dorsiflexion than adduction. Similarly, the SD values of the filtered cumulative spike train of the motor units in TA were less ( P < 0.05) at 5%, 10%, 20%, and 40% MVC during dorsiflexion than adduction. CONCLUSIONS: Although the mean discharge rate of motor units in TA was similar during foot adduction and ankle dorsiflexion, discharge variability was less during dorsiflexion resulting in less accurate performance of the steady adduction contractions. The neural drive to bifunctional muscles differs during their accessory function, which must be considered for training and rehabilitation interventions.

Control of motor output during steady submaximal contractions is modulated by contraction history.

The purpose of the study was to investigate the influence of contraction history on force steadiness and the associated EMG activity during submaximal isometric contractions performed with the dorsiflexor muscles. The key feature of the protocol was a triangular ramp contraction performed in the middle of a steady contraction at a lower target force. The target force during the ramp contraction was 20% MVC greater than that during the steady contraction. Thirty-seven healthy individuals (21 men and 16 women) performed the submaximal tasks with the ankle dorsiflexors. Electromyography (EMG) signals were recorded from tibialis anterior with a pair of surface electrodes. The coefficient of variation for force was significantly greater during the second steady contraction compared with the first one at each of the seven target forces (p < 0.015; d = 0.38-0.92). Although the average applied force during the steady contractions before and after the triangular contraction was the same (p = 0.563), the mean EMG amplitude for the steady contractions performed after the triangular contraction was significantly greater at each of the seven target forces (p < 0.0001; d = 0.44-0.68). Also, there were significant differences in mean EMG frequency between the steady contractions performed before and after the triangular contraction (p < 0.01; d = 0.13-0.82), except at 10 and 20% MVC force. The greater force fluctuations during a steady submaximal contraction after an intervening triangular contraction indicate a change in the discharge characteristics of the involved motor units.

Footedness but not dominance influences force steadiness during isometric dorsiflexion in young men.

The aim of the study was to assess the potential influence of footedness and dominance on maximal force, force fluctuations and neural drive during dorsiflexion. Fifteen left-footed (LF) and fifteen right-footed (RF) young adults performed 2 maximal voluntary contractions (MVC) and 3 steady submaximal isometric contractions at five target forces (5, 10, 20, 40 and 60% MVC) with the dorsiflexors of both legs. High-density electromyography (EMG) was used to record the discharge characteristics of motor units (MUs) of Tibialis Anterior. MVC force and EMG amplitude (root mean square) were similar between the two legs and groups (p > 0.05). Force fluctuations (Coefficient of Variation, CoV for force), mean discharge rate of MUs, discharge variability (CoV of interspike interval), and variability in neural drive (standard deviation of filtered cumulative spike train) were greater (p < 0.05) and the input-output gain of the MUs (ΔDR/ΔF) was lower (p < 0.05) for the LF relative to the RF group. The differences in force fluctuations during steady contractions with the dorsiflexors were associated with footedness but not with dominance. They reflect greater variability in motor neuron output, as suggested by coefficient of variation for interspike interval (independent input) and the standard deviation of the smoothed discharge times (common input).

Influence of transcutaneous electrical nerve stimulation on the distance walked by older adults during the 6-min test of walking endurance.

The purpose of our study was to compare the influence of two types of transcutaneous electrical nerve stimulation (TENS) on the performance of older adults on the 6-min test of walking endurance and on the ability to maintain balance during upright standing. Twenty-six healthy older adults (72 ± 5.4 yrs) performed tests of motor function while TENS was applied to the tibialis anterior and rectus femoris muscles of each leg. Linear mixed models were used to compare the influence of TENS on walking distance in a 6-min test of walking endurance and on sway-area rate in tests of standing balance. There was a significant decrease in the distances walked in each minute of the 6-min walk test for both the Continuous and Burst TENS modes compared with Baseline (p < 0.01 and p < 0.001, respectively). The influence of TENS on walking distance was associated with several significant effects on the mean and coefficient of variation for stride length and stride frequency between the first and last minute of the test and between the two TENS modes and the Baseline values. In contrast, there was no significant effect of TENS on sway-area rate in any balance test, which indicates that the supplementary sensory feedback compromised walking performance of older adults but not the ability to maintain balance during upright standing.

Alternating or Bilateral Exercise Training does not Influence Force Control during Single-Leg Submaximal Contractions with the Dorsiflexors.

The aim of the study was to assess the influence of habitual training history on force steadiness and the discharge characteristics of motor units in tibialis anterior during submaximal isometric contractions. Fifteen athletes whose training emphasized alternating actions (11 runners and 4 cyclists) and fifteen athletes who relied on bilateral actions with leg muscles (7 volleyball players, 8 weight-lifters) performed 2 maximal voluntary contractions (MVC) with the dorsiflexors, and 3 steady contractions at 8 target forces (2.5%, 5%, 10%, 20%, 30%, 40%, 50% and 60% MVC). The discharge characteristics of motor units in tibialis anterior were recorded using high-density electromyography grids. The MVC force and the absolute (standard deviation) and normalized (coefficient of variation) amplitudes of the force fluctuations at all target forces were similar between groups. The coefficient of variation for force decreased progressively from 2.5% to 20% MVC force, then it plateaued until 60% MVC force. Mean discharge rate of the motor units in tibialis anterior was similar at all target forces between groups. The variability in discharge times (coefficient of variation for interspike interval) and the variability in neural drive (coefficient of variation of filtered cumulative spike train) was also similar for the two groups. These results indicate that athletes who have trained with either alternating or bilateral actions with leg muscles has similar effects on maximal force, force control, and variability in the independent and common synaptic input during a single-limb isometric task with the dorsiflexors.

Influence of transcutaneous electrical nerve stimulation on walking kinematics and standing balance of older adults who differ in walking speed.

The purpose was to determine the impact of transcutaneous electrical nerve stimulation (TENS) on measures of walking kinematics and standing balance of healthy older adults who were stratified into two groups based on differences in the distance walked during the 6-min test of walking endurance. Regression models were developed to explain the variance in the 6-min distance and to assess the predictive power of balance metrics to categorize the 26 older adults (72 ± 5.4 yrs) as either slow or fast walkers. Walking kinematics were measured during 6- and 2-min walk tests that were performed with and without the concurrent application of TENS to the hip flexor and ankle dorsiflexor muscles. Participants walked briskly during the 6-min test and at a preferred pace during the 2-min test. The supplementary sensory stimulation provided by TENS did not alter the power of the models to explain the variance in the Baseline 6-min distance: Baseline, R2 = 0.85; TENS, R2 = 0.83. In contrast, TENS improved the explanatory power of the data obtained during the 2-min walk to account for the variance in the Baseline 6-min distance: no TENS, R2 = 0.40; TENS, R2 = 0.64. Logistic regression models based on force-plate and kinematic data obtained during the balance tasks were able to discriminate between the two groups with excellent certainty. The impact of TENS was greatest when older adults walked at a preferred speed but not when they walked at a brisk pace or performed tests of standing balance.

Practice-Induced Changes in Manual Dexterity of Older Adults Depend on Initial Pegboard Time.

INTRODUCTION: The purpose of our study was to determine the influence of practice on the pegboard times and peg-manipulation phases of older adults who were classified as having either slow or fast initial pegboard times. METHODS: Participants ( n = 26, 70 ± 6.6 yr) completed two evaluation sessions and six practice sessions in which they performed 25 trials (5 blocks of 5 trials) of the grooved pegboard test. All practice sessions were supervised, and the time to complete each trial was recorded. In each evaluation session, the pegboard was mounted on a force transducer so that the downward force applied to the board could be measured. RESULTS: Participants were stratified into two groups based on the initial time to complete the grooved pegboard test: a fast group (68.1 ± 6.0 s) and a slow group (89.6 ± 9.2 s). Both groups exhibited the classic two-phase profile (acquisition + consolidation) for learning a de novo motor skill. Despite the similar learning profile for the two groups, there were differences between groups in the phases of the peg-manipulation cycle that became faster with practice. The fast group seemed to reduce trajectory variability when transporting the peg, whereas the slow group seemed to exhibit both a decrease in trajectory variability and greater precision when inserting pegs into the holes. CONCLUSIONS: The changes underlying practice-induced decreases in grooved pegboard time differed for older adults who initially had either a fast or a slow pegboard time.

Evolution of surface electromyography: From muscle electrophysiology towards neural recording and interfacing.

Surface electromyography (EMG) comprises a recording of electrical activity from the body surface generated by muscle fibres during muscle contractions. Its characteristics depend on the fibre membrane potentials and the neural activation signal sent from the motor neurons to the muscles. EMG has been classically used as the primary investigation tool in kinesiology studies in a variety of applications. More recently, surface EMG techniques have evolved from single-channel methods to high-density systems with hundreds of electrodes. High-density EMG recordings can be deconvolved to estimate the discharge times of spinal motor neurons innervating the recorded muscles, with algorithms that have been developed and validated in the last two decades. Within limits and with some variability across muscles, these techniques provide a non-invasive method to study relatively large populations of motor neurons in humans. Surface EMG is thus evolving from a peripheral measure of muscle electrical activity towards a neural recording and neural interfacing signal. These advances in technology have had a major impact on our fundamental understanding of the neural control of movement and have exposed new perspectives in neurotechnologies. Here we provide an overview and perspective of modern EMG technology, as derived from past achievements, and its impact in neurophysiology and neural engineering.

Neuromuscular electrical stimulation improves reaction time and execution time of roundhouse kick in highly skilled martial arts athletes.

The purpose of the study was to evaluate the influence of neuromuscular electrical stimulation (NMES) on a roundhouse kick (RHK) and the rate of force development (RFD) and peak force during maximal isometric contractions with the knee extensors. Sixteen martial arts athletes were randomly assigned to either a training group (NMES + martial arts) or a control group (martial arts). The RHK was performed to a fixed target located approximately 1.5 m away from the athlete. The reaction time and execution time were quantified with a light-sensor system. Participants were tested before and after completing 15 sessions of training (5 weeks, 3 sessions/week, 90 min/session). In addition, the training group performed another 15 sessions (3 sessions/week, 30 min/session) in which electrical stimulation was superimposed on maximal isometric contractions of the quadriceps (100 Hz, 450 µs). There were no statistically significant changes in either RFD or maximal isometric force for either group (p > 0.05). However, the training group experienced significant reductions (p < 0.05) in both reaction time (-9.2%) and the execution time (-5.9%). The findings indicate that supplemental NMES training can improve sport-specific movements, such as the RHK, without any changes in maximal force capabilities in skilled martial arts athletes.

Metabolic costs of walking and arm reaching in persons with mild multiple sclerosis.

Movement slowness is a common and disruptive symptom of multiple sclerosis (MS). A potential cause is that individuals with MS slow down to conserve energy as a behavioral adjustment to heightened metabolic costs of movement. To investigate this prospect, we measured the metabolic costs of both walking and seated arm reaching at five speeds in persons with mild MS (pwMS; n = 13; 46.0 ± 7.7 yr) and sex- and age-matched controls (HCs; n = 13; 45.8 ± 7.8 yr). Notably, the cohort of pwMS was highly mobile and no individuals required a cane or aid when walking. We found that the net metabolic power of walking was approximately 20% higher for pwMS across all speeds (P = 0.0185). In contrast, we found no differences in the gross power of reaching between pwMS and HCs (P = 0.492). Collectively, our results suggest that abnormal slowness of movement in MS-particularly reaching-is not the consequence of heightened effort costs and that other sensorimotor mechanisms are playing a considerable role in slowing.NEW & NOTEWORTHY Individuals with multiple sclerosis (MS) often move more slowly than those without the disease. A possible cause is that movements in MS are more energetically expensive and slowing is an adaptation to conserve metabolic resources. Here, we find that while walking is more costly for persons with MS, arm-reaching movements are not. These results bring into question the driving force of movement slowness in MS and implicate other motor-related networks contributing to slowing.

The Forces Generated by Agonist Muscles during Isometric Contractions Arise from Motor Unit Synergies.

The purpose of our study was to identify the low-dimensional latent components, defined hereafter as motor unit modes, underlying the discharge rates of the motor units in two knee extensors (vastus medialis and lateralis, eight men) and two hand muscles (first dorsal interossei and thenars, seven men and one woman) during submaximal isometric contractions. Factor analysis identified two independent motor unit modes that captured most of the covariance of the motor unit discharge rates. We found divergent distributions of the motor unit modes for the hand and vastii muscles. On average, 75% of the motor units for the thenar muscles and first dorsal interosseus were strongly correlated with the module for the muscle in which they resided. In contrast, we found a continuous distribution of motor unit modes spanning the two vastii muscle modules. The proportion of the muscle-specific motor unit modes was 60% for vastus medialis and 45% for vastus lateralis. The other motor units were either correlated with both muscle modules (shared inputs) or belonged to the module for the other muscle (15% for vastus lateralis). Moreover, coherence of the discharge rates between motor unit pools was explained by the presence of shared synaptic inputs. In simulations with 480 integrate-and-fire neurons, we demonstrate that factor analysis identifies the motor unit modes with high levels of accuracy. Our results indicate that correlated discharge rates of motor units that comprise motor unit modes arise from at least two independent sources of common input among the motor neurons innervating synergistic muscles.SIGNIFICANCE STATEMENT It has been suggested that the nervous system controls synergistic muscles by projecting common synaptic inputs to the engaged motor neurons. In our study, we reduced the dimensionality of the output produced by pools of synergistic motor neurons innervating the hand and thigh muscles during isometric contractions. We found two neural modules, each representing a different common input, that were each specific for one of the muscles. In the vastii muscles, we found a continuous distribution of motor unit modes spanning the two synergistic muscles. Some of the motor units from the homonymous vastii muscle were controlled by the dominant neural module of the other synergistic muscle. In contrast, we found two distinct neural modules for the hand muscles.

Consensus for experimental design in electromyography (CEDE) project: Single motor unit matrix.

The analysis of single motor unit (SMU) activity provides the foundation from which information about the neural strategies underlying the control of muscle force can be identified, due to the one-to-one association between the action potentials generated by an alpha motor neuron and those received by the innervated muscle fibers. Such a powerful assessment has been conventionally performed with invasive electrodes (i.e., intramuscular electromyography (EMG)), however, recent advances in signal processing techniques have enabled the identification of single motor unit (SMU) activity in high-density surface electromyography (HDsEMG) recordings. This matrix, developed by the Consensus for Experimental Design in Electromyography (CEDE) project, provides recommendations for the recording and analysis of SMU activity with both invasive (needle and fine-wire EMG) and non-invasive (HDsEMG) SMU identification methods, summarizing their advantages and disadvantages when used during different testing conditions. Recommendations for the analysis and reporting of discharge rate and peripheral (i.e., muscle fiber conduction velocity) SMU properties are also provided. The results of the Delphi process to reach consensus are contained in an appendix. This matrix is intended to help researchers to collect, report, and interpret SMU data in the context of both research and clinical applications.

Tempo-controlled resistance training of the hip abductors and ankle dorsiflexors with light loads does not improve postural sway in older adults.

The force steadiness capabilities of the hip abductors and ankle dorsiflexors can explain a significant amount of the variance in postural sway during four types of standing balance tests. Control over balance, as well as force steadiness, generally worsens with aging, although the latter can be improved with unique training interventions. The purpose of our study was to assess how tempo-controlled, light-load resistance training of the hip abductors and ankle dorsiflexors influences performance in clinical movement tests, postural sway, muscle strength, and force steadiness in older adults. Participants (n = 28, 70 ± 7 years, 8 men) completed nine training sessions for either the hip abductors or ankle dorsiflexors in the nondominant leg. Training involved lifting a load equal to 15% of the maximal force achieved during an isometric contraction. Linear mixed-effects models revealed no changes (p > 0.05) in Sit-To-Stand test, Timed Up-and-Go test, maximal voluntary contraction (MVC) torque, or postural sway from before to after either training intervention. Only the dorsiflexor group significantly improved nondominant leg dorsiflexion force steadiness, but this did not translate to any other tasks. However, absolute and relative measures of MVC torque and force steadiness of the hip abductors and ankle dorsiflexors in the dominant and nondominant legs could predict sway-area rate in each of the four standing balance conditions. The responsiveness of leg muscles to light-load steadiness training in older adults appears to depend on the type of exercises performed during the intervention.

Finger dexterity measured by the Grooved Pegboard test indexes Parkinson's motor severity in a tremor-independent manner.

Fine motor impairments are frequent complaints in people with Parkinson's disease (PD). While they may develop at an early stage of the disease, they become more problematic as the disease progresses. Tremors and fine motor symptoms may seem related, but evidence suggests two distinct phenomena. The purpose of our study was to investigate the relationships between fine motor skills and clinical characteristics of PD patients. We hypothesized worse fine motor skills to be associated with greater motor severity that is independent of tremor. We measured fine motor abilities using the Grooved Pegboard test (GPT) in each hand separately and collected clinical and demographics data in a cohort of 82 persons with PD. We performed regression analyses between GPT scores and a range of outcomes: motor severity, time from diagnosis, age and tremors. We also explored similar associations using finger and hand dexterity scores from a standardized PD rating scale. Our results indicate that scores on the GPT for each hand, as measures of manual dexterity, are associated with motor severity and time from diagnosis. The presence of tremors was not a confounding factor, as hypothesized, but age was associated with GPT scores for the dominant hand. Motor severity was also associated with hand and finger dexterity as measured by single items from the clinical Parkinson's rating scale. These findings suggest that the GPT to be useful tool for motor severity assessments of people with PD.

Leg Dominance Does Not Influence Maximal Force, Force Steadiness, or Motor Unit Discharge Characteristics.

PURPOSE: The aim of our study was to compare maximal force, force steadiness, and discharge characteristics of motor units in tibialis anterior during contractions with the dorsiflexors of the dominant and nondominant legs at low-to-moderate target forces and three ankle angles. METHODS: Twenty young adults performed maximal and submaximal isometric contractions (5%, 10%, 20%, 40%, and 60% of maximal voluntary contraction (MVC)) with the dorsiflexors of the dominant and nondominant legs at three ankle angles (75°, short length; 90°, intermediate length; 105°, long length). High-density EMG signals from the tibialis anterior muscle of each leg were recorded. RESULTS: Maximal force (average dominant, 182.9 ± 64.5 N; nondominant, 179.0 ± 58.8 N) and the fluctuations in force, quantified as absolute (SD) and normalized amplitudes (coefficient of variation (CoV)), were similar between the two legs across the three ankle angles (average CoV for dominant, 1.5% ± 1.0%; nondominant, 1.7% ± 1.3%). The CoV for force for both legs decreased from 5% to 20% MVC force, and then it plateaued at 40% and 60% MVC force. EMG amplitude, mean discharge rate of motor units, discharge variability (interspike interval), and the variability in neural drive (filtered cumulative spike train) were similar between the two legs across the submaximal contractions. CONCLUSIONS: MVC force and force steadiness were similar across ankle angles and target forces between the dominant and nondominant legs. The attributes that underlie the self-reported identification of a dominant leg were not associated with the force capacity or the control of force for the dorsiflexor muscles, at least during isometric contractions.

Consensus for experimental design in electromyography (CEDE) project: High-density surface electromyography matrix.

High-density surface electromyography (HDsEMG) can be used to measure the spatial distribution of electrical muscle activity over the skin. As this distribution is associated with the generation and propagation of muscle fiber action potentials, HDsEMG is processed to extract information on regional muscle activation, muscle fiber characteristics and behaviour of individual motor units. This matrix, developed by the Consensus for Experimental Design in Electromyography (CEDE) project, summarizes recommendations on the use of HDsEMG in experimental studies. For each application, recommendations are included regarding electrode montage, electrode type and configuration, electrode location and orientation, data analysis, and interpretation. Cautions and reporting standards are also included. The steps of the Delphi process to reach consensus are contained in an appendix. This matrix is intended to help researchers when collecting, reporting, and interpreting HDsEMG data. It is hoped that this document will be used to generate new empirical evidence to improve how HDsEMG is used in research and in clinical applications.