Synaptic inputs to motor neurons underlying muscle coactivation for functionally different tasks have different spectral characteristics.

The central nervous system (CNS) may produce the same endpoint trajectory or torque profile with different muscle activation patterns. What differentiates these patterns is the presence of cocontraction, which does not contribute to effective torque generation but allows to modulate joints' mechanical stiffness. Although it has been suggested that the generation of force and the modulation of stiffness rely on separate pathways, a characterization of the differences between the synaptic inputs to motor neurons (MNs) underlying these tasks is still missing. In this study, participants coactivated the same pair of upper-limb muscles, i.e., the biceps brachii and the triceps brachii, to perform two functionally different tasks: limb stiffness modulation or endpoint force generation. Spike trains of MNs were identified through decomposition of high-density electromyograms (EMGs) collected from the two muscles. Cross-correlogram showed a higher synchronization between MNs recruited to modulate stiffness, whereas cross-muscle coherence analysis revealed peaks in the ß-band, which is commonly ascribed to a cortical origin. These peaks did not appear during the coactivation for force generation, thus suggesting separate cortical inputs for stiffness modulation. Moreover, a within-muscle coherence analysis identified two subsets of MNs that were selectively recruited to generate force or regulate stiffness. This study is the first to highlight different characteristics, and probable different neural origins, of the synaptic inputs driving a pair of muscles under different functional conditions. We suggest that stiffness modulation is driven by cortical inputs that project to a separate set of MNs, supporting the existence of a separate pathway underlying the control of stiffness.NEW & NOTEWORTHY The characterization of the pathways underlying force generation or stiffness modulation are still unknown. In this study, we demonstrated that the common input to motor neurons of antagonist muscles shows a high-frequency component when muscles are coactivated to modulate stiffness but not to generate force. Our results provide novel insights on the neural strategies for the recruitment of multiple muscles by identifying specific spectral characteristics of the synaptic inputs underlying functionally different tasks.

Serious Game with Electromyography Feedback and Physical Therapy in Young Children with Unilateral Spastic Cerebral Palsy and Equinus Gait: A Prospective Open-Label Study.

The clinical effects of a serious game with electromyography feedback (EMGs_SG) and physical therapy (PT) was investigated prospectively in children with unilateral spastic cerebral palsy (USCP). An additional aim was to better understand the influence of muscle shortening on function. Thirty children with USCP (age 7.6 ± 2.1 years) received four weeks of EMGs_SG sessions 2×/week including repetitive, active alternating training of dorsi- and plantar flexors in a seated position. In addition, each child received usual PT treatment ≤ 2×/week, involving plantar flexor stretching and command strengthening on dorsi- and plantar flexors. Five-Step Assessment parameters, including preferred gait velocity (normalized by height); plantar flexor extensibility (XV1); angle of catch (XV3); maximal active ankle dorsiflexion (XA); and derived coefficients of shortening, spasticity, and weakness for both soleus and gastrosoleus complex (GSC) were compared pre and post treatment (t-tests). Correlations were explored between the various coefficients and gait velocities at baseline. After four weeks of EMGs_SG + PT, there was an increase in normalized gait velocity from 0.72 ± 0.13 to 0.77 ± 0.13 m/s (p = 0.025, d = 0.43), a decrease in coefficients of shortening (soleus, 0.10 ± 0.07 pre vs. 0.07 ± 0.08 post, p = 0.004, d = 0.57; GSC 0.16 ± 0.08 vs. 0.13 ± 0.08, p = 0.003, d = 0.58), spasticity (soleus 0.14 ± 0.06 vs. 0.12 ± 0.07, p = 0.02, d = 0.46), and weakness (soleus 0.14 ± 0.07 vs. 0.11 ± 0.07, p = 0.005, d = 0.55). At baseline, normalized gait velocity correlated with the coefficient of GSC shortening (R = -0.43, p = 0.02). Four weeks of EMGs_SG and PT were associated with improved gait velocity and decreased plantar flexor shortening. A randomized controlled trial comparing EMGs_SG and conventional PT is needed.

Perceptive SARS-CoV-2 End-To-End Ultrasound Video Classification through X3D and Key-Frames Selection.

The SARS-CoV-2 pandemic challenged health systems worldwide, thus advocating for practical, quick and highly trustworthy diagnostic instruments to help medical personnel. It features a long incubation period and a high contagion rate, causing bilateral multi-focal interstitial pneumonia, generally growing into acute respiratory distress syndrome (ARDS), causing hundreds of thousands of casualties worldwide. Guidelines for first-line diagnosis of pneumonia suggest Chest X-rays (CXR) for patients exhibiting symptoms. Potential alternatives include Computed Tomography (CT) scans and Lung UltraSound (LUS). Deep learning (DL) has been helpful in diagnosis using CT scans, LUS, and CXR, whereby the former commonly yields more precise results. CXR and CT scans present several drawbacks, including high costs. Radiation-free LUS imaging requires high expertise, and physicians thus underutilise it. LUS demonstrated a strong correlation with CT scans and reliability in pneumonia detection, even in the early stages. Here, we present an LUS video-classification approach based on contemporary DL strategies in close collaboration with Fondazione IRCCS Policlinico San Matteo's Emergency Department (ED) of Pavia. This research addressed SARS-CoV-2 patterns detection, ranked according to three severity scales by operating a trustworthy dataset comprising ultrasounds from linear and convex probes in 5400 clips from 450 hospitalised subjects. The main contributions of this study are related to the adoption of a standardised severity ranking scale to evaluate pneumonia. This evaluation relies on video summarisation through key-frame selection algorithms. Then, we designed and developed a video-classification architecture which emerged as the most promising. In contrast, the literature primarily concentrates on frame-pattern recognition. By using advanced techniques such as transfer learning and data augmentation, we were able to achieve an F1-Score of over 89% across all classes.

Is the attenuation effect on the ankle muscles activity from the EMG biofeedback generalized to - or compensated by - other lower limb muscles during standing?

Biofeedback based on electromyograms (EMGs) has been recently proposed to reduce exaggerated postural activity. Whether the effect of EMG biofeedback on the targeted muscles generalizes to - or is compensated by - other muscles is still an open question we address here. Fourteen young individuals were tested in three 60 s standing trials, without and with EMG-audio feedback: (i) collectively from soleus and medial gastrocnemius and (ii) from medial gastrocnemii. The Root Mean Square (RMS) of bipolar EMGs sampled from postural muscles bilaterally was computed to assess the degree of activity and postural sway was assessed from the center of pressure (CoP). In relation to standing at naturally, EMG-audio feedback from soleus and medial gastrocnemii decreased plantar flexors' activity (∼10 %) but at the cost of increased amplitude of tibialis anterior (∼5%) and vasti muscles (∼20 %) accompanied by a posterior shift of the mean CoP position. However, EMG-audio feedback from medial gastrocnemii reduced only plantar flexors' activity (∼5%) when compared to standing at naturally. Current results suggest the EMG biofeedback has the potential to reduce calf muscles' activity without loading other postural muscles especially when using medial gastrocnemii as feedback source, with implications on postural training aimed at assisting individuals in activating more efficiently postural muscles during standing.

Electomyographic activities of shoulder muscles during Handwheelchair.Q vs pushrim wheelchair propulsion.

Different mechanisms of force transmission have been developed for the movement of wheelchairs, from the standard pushrim propulsion to the handbike. Contributing to this repertoire, we recently developed a system of propulsion based on a pulley-cable mechanism, the Handwheelchair.Q. In contrast to other propulsion systems, the Handwheelchair.Q requires users to extend the shoulders and flex the elbows to move the wheelchair forward, mimicking the rowing gesture. Whether however our proposed, propulsion system imposes a similar degree of shoulder muscles excitation with respect to the conventional, pushrim system is yet to be addressed. In this study we therefore assess whether the Handwheelchair.Q demands a similar degree and timing of muscle excitation with respect to the pushrim wheelchair, for a given travelled distance. We address this issue by sampling the angular speed of the two wheels and the surface EMGs from ten, shoulder muscles, while seven subjects use the two propulsion systems at constantly low and high speeds, one at a time. As expected, results revealed opposite muscle groups were excited when comparing the two mechanisms for wheelchair propulsion. ANOVA statistics indicated the amplitude of EMGs was greater for shoulder flexors and elbow extensors during the drive phase of pushrim propulsion, with the opposite being observed for the Handwheelchair.Q. Interestingly, from the angular speed we observed a significantly greater average displacement was achieved with the Handwheelchair.Q. Our results support therefore the notion that, with respect to pushrim propulsion, subjects were able to move faster without overloading the shoulder muscle with the Handwheelchair.Q.

Are the forearm muscles excited equally in different, professional piano players?

BACKGROUND AND OBJECTIVES: Professional pianists tend to develop playing-related musculoskeletal disorders mostly in the forearm. These injuries are often due to overuse, suggesting the existence of a common forearm region where muscles are often excited during piano playing across subjects. Here we use a grid of electrodes to test this hypothesis, assessing where EMGs with greatest amplitude are more likely to be detected when expert pianists perform different excerpts. METHODS: Tasks were separated into two groups: classical excerpts and octaves, performed by eight, healthy, professional pianists. Monopolar electromyograms (EMGs) were sampled with a grid of 96 electrodes, covering the forearm region where hand and wrist muscles reside. Regions providing consistently high EMG amplitude across subjects were assessed with a non-parametric permutation test, designed for the statistical analysis of neuroimaging experiments. Spatial consistency across trials was assessed with the Binomial test. RESULTS: Spatial consistency of muscle excitation was found across subjects but not across tasks, confining at most 20% of the electrodes in the grid. These local groups of electrodes providing high EMG amplitude were found at the ventral forearm region during classical excerpts and at the dorsal region during octaves, when performed both at preferred and at high, playing speeds. DISCUSSION: Our results revealed that professional pianists consistently load a specific forearm region, depending on whether performing octaves or classical excerpts. This spatial consistency may help furthering our understanding on the incidence of playing-related muscular disorders and provide an anatomical reference for the study of active muscle loading in piano players using surface EMG.

Design and Characterization of a Textile Electrode System for the Detection of High-Density sEMG.

Muscle activity monitoring in dynamic conditions is a crucial need in different scenarios, ranging from sport to rehabilitation science and applied physiology. The acquisition of surface electromyographic (sEMG) signals by means of grids of electrodes (High-Density sEMG, HD-sEMG) allows obtaining relevant information on muscle function and recruitment strategies. During dynamic conditions, this possibility demands both a wearable and miniaturized acquisition system and a system of electrodes easy to wear, assuring a stable electrode-skin interface. While recent advancements have been made on the former issue, detection systems specifically designed for dynamic conditions are at best incipient. The aim of this work is to design, characterize, and test a wearable, HD-sEMG detection system based on textile technology. A 32-electrodes, 15 mm inter-electrode distance textile grid was designed and prototyped. The electrical properties of the material constituting the detection system and of the electrode-skin interface were characterized. The quality of sEMG signals was assessed in both static and dynamic contractions. The performance of the textile detection system was comparable to that of conventional systems in terms of stability of the traces, properties of the electrode-skin interface and quality of the collected sEMG signals during quasi-isometric and highly dynamic tasks.

Is fatigue a muscular phenomenon in Parkinson's disease? Implications for rehabilitation.

BACKGROUND: Fatigue in Parkinson's disease (PD) compromises patients' physical activity and poses questions on how to plan correct rehabilitation training. In addition, the relationship between subjective perceived fatigue and fatigue in motor performance is not yet entirely understood. Therefore, a conclusive interpretation of muscular mechanisms of fatigue in PD has not yet been achieved. Among the various instrumental evaluations for fatigue, multichannel surface electromyography (sEMG) is a recognized tool that permits the study of myoelectric manifestations of fatigue. AIM: The aim of this study was to assess if muscles in PD show a different myoelectric fatigue pattern compared to the muscles of healthy age-matched subjects. DESIGN: The design was observational controlled study. POPULATION: Idiopathic Parkinson's Disease, Hohen &Yahr II and III stage, Parkinsonian Fatigue Scale average score ≥2.95, no therapy modification in the 4 weeks preceding the study; exclusion criteria: mini mental state examination ≤24, upper limb disease/symptoms that might interfere with sEMG analysis, presence of other fatigue-related conditions. Twenty patients were selected according to these criteria. Twenty untrained healthy subjects were matched. METHODS: All subjects underwent a muscle fatigue protocol and a sEMG analysis of the right biceps brachii muscle during electrically stimulated and voluntary contractions in order to obtain a myoelectric fatigue muscular pattern. The myoelectric pattern is characterized by the modifications of the following sEMG variables: reduction of mean frequency and muscle fiber conduction velocity, increase of average rectified value. RESULTS: No statistical differences were observed between groups for sEMG variables and muscular electric behavior in all contraction conditions (all P>0.05). CONCLUSIONS: Our results show that parkinsonian muscles do not differ from the muscles of healthy age-matched subjects in developing peripheral myoelectric fatigue. Nevertheless, the role of fatigue perception at rest and particularly during physical activity must be clearly understood in order to further target the rehabilitative approach for fatigued parkinsonian patients and to reduce hypomobility. CLINICAL REHABILITATION IMPACT: In rehabilitative terms, these findings allow us to highlight the possibility of performing sustained training with isometric contractions in PD subjects; therefore, fatigue "per se" does not constitute a barrier for the execution of muscular exercises, likewise intensive.

Investigating the effect of a passive trunk exoskeleton on local discomfort, perceived effort and spatial distribution of back muscles activity.

This study aimed at determining the effect of a passive exoskeleton on local perceived discomfort, perceived effort and low back muscles' activity. Thirteen volunteers performed two simulated working tasks with and without the exoskeleton. In the static task, the exoskeleton decreased the lumbar perceived discomfort, the perceived effort and the level of low back muscles' activity (∼10%) while increasing discomfort in the chest and feet. The percent decrease in EMG amplitude was correlated with the percent increase in perceived effort with exoskeleton. For the dynamic task, the exoskeleton increased the discomfort in the chest and decreased the level of back muscle activity (∼5%). Current findings suggest exoskeleton is effective in reducing the back load while increasing the perceived discomfort at non-targeted body regions in both working tasks. The concurrent increase of discomfort in non-targeted areas probably led to a higher perceived effort despite the reduction of low back muscle activity. Practitioner summary: This study provided insights into exoskeleton effects on local discomfort, perceived effort and muscle activity. Overall, the potential benefits of passive exoskeleton should be considered alongside its adverse effects on the non-targeted body regions that can lead to an increase of perceived effort despite the reduction of back muscle activity.

Timing and Modulation of Activity in the Lower Limb Muscles During Indoor Rowing: What Are the Key Muscles to Target in FES-Rowing Protocols?

The transcutaneous stimulation of lower limb muscles during indoor rowing (FES Rowing) has led to a new sport and recreation and significantly increased health benefits in paraplegia. Stimulation is often delivered to quadriceps and hamstrings; this muscle selection seems based on intuition and not biomechanics and is likely suboptimal. Here, we sample surface EMGs from 20 elite rowers to assess which, when, and how muscles are activated during indoor rowing. From EMG amplitude we specifically quantified the onset of activation and silencing, the duration of activity and how similarly soleus, gastrocnemius medialis, tibialis anterior, rectus femoris, vastus lateralis and medialis, semitendinosus, and biceps femoris muscles were activated between limbs. Current results revealed that the eight muscles tested were recruited during rowing, at different instants and for different durations. Rectus and biceps femoris were respectively active for the longest and briefest periods. Tibialis anterior was the only muscle recruited within the recovery phase. No side differences in the timing of muscle activity were observed. Regression analysis further revealed similar, bilateral modulation of activity. The relevance of these results in determining which muscles to target during FES Rowing is discussed. Here, we suggest a new strategy based on the stimulation of vasti and soleus during drive and of tibialis anterior during recovery.

Contraction level, but not force direction or wrist position, affects the spatial distribution of motor unit recruitment in the biceps brachii muscle.

PURPOSE: Different motor units (MUs) in the biceps brachii (BB) muscle have been shown to be preferentially recruited during either elbow flexion or supination. Whether these different units reside within different regions is an open issue. In this study, we tested wheter MUs recruited during submaximal isometric tasks of elbow flexion and supination for two contraction levels and with the wrist fixed at two different angles are spatially localized in different BB portions. METHODS: The MUs' firing instants were extracted by decomposing high-density surface electromyograms (EMG), detected from the BB muscle of 12 subjects with a grid of electrodes (4 rows along the BB longitudinal axis, 16 columns medio-laterally). The firing instants were then used to trigger and average single-differential EMGs. The average rectified value was computed separately for each signal and the maximal value along each column in the grid was retained. The center of mass, defined as the weighted mean of the maximal, average rectified value across columns, was then consdiered to assess the medio-lateral changes in the MU surface representation between conditions. RESULTS: Contraction level, but neither wrist position nor force direction (flexion vs. supination), affected the spatial distribution of BB MUs. In particular, higher forces were associated with the recruitment of BB MUs whose action potentials were represented more medially. CONCLUSION: Although the action potentials of BB MUs were represented locally across the muscle medio-lateral region, dicrimination between elbow flexion or supination seems unlikely from the surface representation of MUs action potentials.

A Modular, Smart, and Wearable System for High Density sEMG Detection.

OBJECTIVE: The use of linear or bi-dimensional electrode arrays for surface EMG detection (HD-sEMG) is gaining attention as it increases the amount and reliability of information extracted from the surface EMG. However, the complexity of the setup and the encumbrance of HD-sEMG hardware currently limits its use in dynamic conditions. The aim of this paper was to develop a miniaturized, wireless, and modular HD-sEMG acquisition system for applications requiring high portability and robustness to movement artifacts. METHODS: A system with modular architecture was designed. Its core is a miniaturized 32-channel amplifier (Sensor Unit - SU) sampling at 2048 sps/ch with 16 bit resolution and wirelessly transmitting data to a PC or a mobile device. Each SU is a node of a Body Sensor Network for the synchronous signal acquisition from different muscles. RESULTS: A prototype with two SUs was developed and tested. Each SU is small (3.4 cm × 3 cm × 1.5 cm), light (16.7 g), and can be connected directly to the electrodes; thus, avoiding the need for customary, wired setup. It allows to detect HD-sEMG signals with an average noise of 1.8 µVRMS and high performance in terms of rejection of power-line interference and motion artefacts. Tests performed on two SUs showed no data loss in a 22 m range and a ±500 µs maximum synchronization delay. CONCLUSIONS: Data collected in a wide spectrum of experimental conditions confirmed the functionality of the designed architecture and the quality of the acquired signals. SIGNIFICANCE: By simplifying the experimental setup, reducing the hardware encumbrance, and improving signal quality during dynamic contractions, the developed system opens new perspectives in the use of HD-sEMG in applied and clinical settings.

Design of a Wireless, Modular and Programmable Neuromuscular Electrical Stimulator.

The use of electrical stimulation to elicit single twitches and tetanic contractions of skeletal muscles has increased markedly in the last years, with applications ranging from basic physiology to clinical settings. Addressing all possible needs required by different applications with an electrical stimulator is challenging as it requires the device to be highly flexible in terms of stimulation configurations (number of channels and electrode location), and possibility to control the stimulation patterns (timing and stimulation profiles). This paper describes a new wireless, modular, and programmable electrical stimulator integrating the possibility to acquire and use biomechanical signals to trigger the stimulation output. A closed-loop FES Cycling setup has been presented to show a possible application of the system.

Towards the Design of an Impedance-Controlled HD-sEMG Amplifier: A Feasibility Study.

The use of multiple surface EMG electrodes (High-Density surface EMG - HD-sEMG) allows the extraction of anatomical and physiological information either at the muscle or at the motor unit level with applications in several fields ranging from clinical neurophysiology to the control of prosthetic devices. These applications need to acquire monopolar sEMG signals free from power line interference arising from the capacitive coupling between the subject, the acquisition system and the power line. The aim of this work is to provide a common mode analysis of the detection system used to collect monopolar sEMG signals, characterizing different configuration of the reference electrodes leading to different behaviors in terms of immunity to the power line interference. Based on the experimental results, a new impedance-controlled HD-sEMG signal amplifier is proposed and discussed.

Design and Test of a Biomechanical Model for the Estimation of Knee Joint Angle During Indoor Rowing: Implications for FES-Rowing Protocols in Paraplegia.

Functional electrical stimulation of lower limb muscles during rowing provides a means for the cardiovascular conditioning in paraplegia. The possibility of shaping stimulation profiles according to changes in knee angle, so far conceived as changes in seat position, may help circumventing open issues associated with muscle fatigue and movement coordination. Here, we present a subject-specific biomechanical model for the estimation of knee joint angle during indoor rowing. Anthropometric measurements and foot and seat positions are inputs to the model. We tested our model on two samples of elite rowers; 15 able-bodied, and 11 participants in the Rio 2016 Paralympic games. Paralympic rowers presented minor physical disabilities (LTA-PD classification), enabling them to perform the full rowing cycle (with legs, trunks, and arms). Knee angle was estimated from the rowing machine seat position, measured with a linear encoder, and transmitted wirelessly to a computer. Key results indicate the root mean square error (RMSE) between estimated and measured angles did not depend on group and stroke rate ( ). Significantly greater RMSE values were observed, however, within the rowing cycle ( ), reaching on average 8 deg in the mid-recovery phase. Differences between estimated and measured knee angle values resulted in slightly earlier (5%) detection of knee flexion, regardless of the group and stroke rate considered. Offset of knee extension, knee angle at catch and range of knee motion were identified equally well with our model and with inertial sensors. These results suggest our model describes accurately the movement of knee joint during indoor rowing.

Does the activity of ankle plantar flexors differ between limbs while healthy, young subjects stand at ease?

Inferences on the active contribution of plantar flexors to the stabilisation of human standing posture have been drawn from surface electromyograms (EMGs). Surface EMGs were however often detected unilaterally, presuming the myoelectric activity from muscles in a single leg reflects the pattern of muscle activation in both legs. In this study we question whether surface EMGs detected from plantar flexor muscles in both legs provide equal estimates of the duration of activity. Arrays of surface electrodes were used to collect EMGs from gastrocnemius and soleus muscles while twelve, young male participants stood at ease for 60 s. Muscles in each leg were deemed active whenever the Root Mean Square amplitude of EMGs (40 ms epochs) detected by any channel in the arrays exceeded the noise level, defined from EMGs detected during rest. The Chi-Square statistics revealed significant differences in the relative number of active periods for both muscles in 10 out of 12 participants tested, ranging from 2% to 65% (χ2 > 17.90; P < 0.01). Pearson correlation analysis indicated side differences in the duration of gastrocnemius though not soleus activity were associated with the centre of pressure mean, lateral position (R = 0.60; P = 0.035). These results suggest therefore that surface EMGs may provide different estimates of the timing of plantar flexors' activity if collected unilaterally during standing and that asymmetric activation may be not necessarily associated with weight distribution between limbs. Depending on the body side from which EMGs are collected, the active contribution of plantar flexors to standing stabilization may be either under- or over-valued.

Comparison of chairs based on HDsEMG of back muscles, biomechanical and comfort indices, for violin and viola players: A short-term study.

This work investigates the effect of different seats on violin and viola players sitting postures using High-Density-surface-Electromyography techniques (HDsEMG), biomechanical and comfort indices. Five types of chairs were assessed on 18 violin and three viola players by comparing: (a) pelvic tilt and kyphosis and lordosis angles, (b) subjective comfort indices, and (c) EMG amplitude of erector spinae and trapezius. Sitting "as you like" on a standard orchestra chair is the condition with the highest subjective comfort (but not significantly different from other chairs). A saddle chair with low back support is associated to the lowest EMG of the erector spinae (p < 0.05) and a saddle stool is associated to the spinal angles closest to those of the standing posture. In 12 out of 21 (57%) musicians, the erector spinae was activated in an intermittent manner, regardless of the chair used. These findings justify further research on the selected chairs, on muscle fatigue and on the intermittent postural control strategy.

Localised sampling of myoelectric activity may provide biased estimates of cocontraction for gastrocnemius though not for soleus and tibialis anterior muscles.

Proper muscle activity quantification is highly relevant to monitor and treat spastic cocontraction. As activity may distribute unevenly within muscle volumes, particularly for pennate calf muscles, surface electromyograms (EMGs) detected by traditional bipolar montage may provide biased estimations of muscle activity. We compared cocontraction estimates obtained using bipolar vs grids of electrodes (high-density EMG, HD-EMG). EMGs were collected from medial gastrocnemius, soleus and tibialis anterior during isometric plantar and dorsi-flexion efforts at three levels (30%, 70% and 100% MVC), knee flexed and extended. Cocontraction index (CCI) was estimated separately for each electrode pair in the grid. While soleus and tibialis anterior CCI estimates did not depend on the detection system considered, for gastrocnemius bipolar electrodes provided larger cocontraction estimates than HD-EMG at highest effort levels, at both knee angles (ANOVA; P < .001). Interestingly, HD-EMG detected greater gastrocnemius EMGs distally during plantar flexions, and greater CCI values proximally during dorsiflexions. These results suggest that bipolar electrodes: (i) provide reliable estimates of soleus and tibialis anterior cocontraction; (ii) may under-or overestimate gastrocnemius cocontraction, depending on their distal or proximal position.

The Spatial Distribution of Ankle Muscles Activity Discriminates Aged from Young Subjects during Standing.

During standing, age-related differences in the activation of ankle muscles have been reported from surface electromyograms (EMGs) sampled locally. Given though activity seems to distribute unevenly within ankle muscles, the local sampling of surface EMGs may provide a biased view on how often and how much elderly and young individuals activate these muscles during standing. This study aimed therefore at sampling EMGs from multiple regions of individual ankle muscles to evaluate whether the distribution of muscle activity differs between aged and young subjects during standing. Thirteen young and eleven aged, healthy subjects were tested. Surface EMGs were sampled at multiple skin locations from tibialis anterior, soleus and medial and lateral gastrocnemius muscles while subjects stood at ease. The root mean square amplitude of EMGs was considered to estimate the duration, the degree of activity and the size of the region where muscle activity was detected. Our main findings revealed the medial gastrocnemius was active for longer periods in aged (interquartile interval; 74.1-98.2%) than young (44.9-81.9%) individuals (P = 0.02). Similarly, while tibialis anterior was rarely active in young (0.7-4.4%), in elderly subjects (2.6-82.5%) it was often recruited (P = 0.01). Moreover, EMGs with relatively higher amplitude were detected over a significantly wider proximo-distal region of medial gastrocnemius in aged (29.4-45.6%) than young (20.1-31.3%) subjects (P = 0.04). These results indicate the duration and the size of active muscle volume, as quantified from the spatial distribution of surface EMGs, may discriminate aged from young individuals during standing; elderlies seem to rely more heavily on the active loading of ankle muscles to control their standing posture than young individuals. Most importantly, current results suggest different conclusions on the active control of standing posture may be drawn depending on the skin location from where EMGs are collected, in particular for the medial gastrocnemius.

Examination of Poststroke Alteration in Motor Unit Firing Behavior Using High-Density Surface EMG Decomposition.

Recent advances in high-density surface electromyogram (EMG) decomposition have made it a feasible task to discriminate single motor unit activity from surface EMG interference patterns, thus providing a noninvasive approach for examination of motor unit control properties. In the current study, we applied high-density surface EMG recording and decomposition techniques to assess motor unit firing behavior alterations poststroke. Surface EMG signals were collected using a 64-channel 2-D electrode array from the paretic and contralateral first dorsal interosseous (FDI) muscles of nine hemiparetic stroke subjects at different isometric discrete contraction levels between 2 to 10 N with a 2 N increment step. Motor unit firing rates were extracted through decomposition of the high-density surface EMG signals and compared between paretic and contralateral muscles. Across the nine tested subjects, paretic FDI muscles showed decreased motor unit firing rates compared with contralateral muscles at different contraction levels. Regression analysis indicated a linear relation between the mean motor unit firing rate and the muscle contraction level for both paretic and contralateral muscles (p < 0.001), with the former demonstrating a lower increment rate (0.32 pulses per second (pps)/N) compared with the latter (0.67 pps/N). The coefficient of variation (averaged over the contraction levels) of the motor unit firing rates for the paretic muscles (0.21 ± 0.012) was significantly higher than for the contralateral muscles (0.17 ± 0.014) (p < 0.05). This study provides direct evidence of motor unit firing behavior alterations poststroke using surface EMG, which can be an important factor contributing to hemiparetic muscle weakness.