Analysis of anthropometrics and mechanomyography signals as forearm flexion, pronation and supination torque predictors.

This study aimed to analyze anthropometrics and mechanomyography (MMG) signals as forearm flexion, pronation, and supination torque predictors. 25 young, healthy, male participants performed isometric forearm flexion, pronation, and supination tasks from 20 to 100% maximal voluntary isometric contraction (MVIC) while maintaining 90° at the elbow joint. Nine anthropometric measures were recorded, and MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were digitally acquired using triaxial accelerometers. These were then correlated with torque values. Significant positive correlations were found for arm circumference (CA) and MMG root mean square (RMS) values with flexion torque. Flexion torque might be predicted using CA (r = 0.426-0.575), a pseudo for muscle size while MMGRMS (r = 0.441), an indication of muscle activation.

Fatigue effect on cross-talk in mechanomyography signals of extensor and flexor forearm muscles during maximal voluntary isometric contractions.

OBJECTIVE: This paper presents the analyses of the fatigue effect on the cross-talk in mechanomyography (MMG) signals of extensor and flexor forearm muscles during pre- and post-fatigue maximum voluntary isometric contraction (MVIC). METHODS: Twenty male participants performed repetitive submaximal (60% MVIC) grip muscle contractions to induce muscle fatigue and the results were analyzed during the pre- and post-fatigue MVIC. MMG signals were recorded on the extensor digitorum (ED), extensor carpi radialis longus (ECRL), flexor digitorum superficialis (FDS) and flexor carpi radialis (FCR) muscles. The cross-correlation coefficient was used to quantify the cross-talk values in forearm muscle pairs (MP1, MP2, MP3, MP4, MP5 and MP6). In addition, the MMG RMS and MMG MPF were calculated to determine force production and muscle fatigue level, respectively. RESULTS: The fatigue effect significantly increased the cross-talk values in forearm muscle pairs except for MP2 and MP6. While the MMG RMS and MMG MPF significantly decreased (p<0.05) based on the examination of the mean differences from pre- and post-fatigue MVIC. CONCLUSION: The presented results can be used as a reference for further investigation of cross-talk on the fatigue assessment of extensor and flexor muscles' mechanic.

Asthma severity identification from pulmonary acoustic signal for computerized decision support system.

OBJECTIVE: Breath sound has information about underlying pathology and condition of subjects. The purpose of this study was to examine asthmatic acuteness levels (Mild, Moderate, Severe) using frequency features extracted from wheeze sounds. Further, analysis was extended to observe behaviour of wheeze sounds in different datasets. METHODS: Segmented and validated wheeze sounds was collected from 55 asthmatic patients from the trachea and lower lung base (LLB) during tidal breathing maneuvers. Segmented wheeze sounds have been grouped in to nine datasets based on auscultation location, breath phases and a combination of phase and location. Frequency based features F25, F50, F75, F90, F99 and mean frequency (MF) were calculated from normalized power spectrum. Subsequently, multivariate analysis was performed. RESULTS: Generally frequency features observe statistical significance (p < 0.05) for the majority of datasets to differentiate severity level Ʌ = 0.432-0.939, F(12, 196-1534) = 2.731-11.196, p < 0.05, ɳ2 = 0.061-0.568. It was observed that selected features performed better (higher effect size) for trachea related samples Ʌ = 0.432-0.620, F(12, 196-498) = 6.575-11.196, p < 0.05, ɳ2 = 0.386-0.568. CONCLUSIONS: The results demonstrated dthat severity levels of asthmatic patients with tidal breathing can be identified through computerized wheeze sound analysis. In general, auscultation location and breath phases produce wheeze sounds with different characteristics.

Crosstalk in Mechanomyographic Signals From Elbow Flexor Muscles During Submaximal to Maximal Isometric Flexion, Pronation, and Supination Torque Tasks.

This study analyzed the crosstalk in mechanomyographic (MMG) signals from elbow flexors during isometric muscle actions from 20% to 100% maximum voluntary isometric contraction (MVIC). Twenty-five young, healthy, male participants performed the isometric elbow flexion, forearm pronation, and supination tasks at an elbow joint angle of 90 deg. The MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were recorded using accelerometers. The cross-correlation coefficient was used to quantify the crosstalk in MMG signals, recorded in a direction transverse to muscle fiber axis, among the muscle pairs (P1: BB and BRA, P2: BRA and BRD, and P3: BB and BRD). In addition, the MMG RMS and MPF were quantified. The mean normalized RMS and mean MPF exhibited increasing (r > 0.900) and decreasing (r < -0.900) trends, respectively, with increases in the effort levels in all three tasks. The magnitude of crosstalk ranged from 0.915% to 21.565% in all three muscle pairs. The crosstalk was found to exhibit high positive correlations with submaximal to maximal flexion [P1 (r = 0.970), P2 (r = 0.951), and P3 (r = 0.824)], pronation [P1 (r = 0.811), P2 (r = 0.763), and P3 (r = 0.901)] and supination [P1 (r = 0.898), P2 (r = 0.838), and P3 (r = 0.852)] torque levels (eight out of nine p-values were < 0.05). Regardless of the high positive correlation between crosstalk and level of effort, the crosstalk remained at a low range (0.915-21.565%) with increases in the torque levels.

Analysis of the crosstalk in mechanomyographic signals along the longitudinal, lateral and transverse axes of elbow flexor muscles during sustained isometric forearm flexion, supination and pronation exercises.

OBJECTIVE: To analyse the influence of muscle fibre axis on the degree of crosstalk in mechanomyographic (MMG) signals during sustained isometric forearm flexion, pronation and supination exercises performed at 80% maximum voluntary contraction (MVC) at an elbow joint angle of 90°. METHODS: MMG signals in longitudinal, lateral and transverse directions of muscle fibres were recorded from the elbow flexors of twenty-five male subjects using triaxial accelerometers. Cross-correlation coefficients were used to quantify the degree of crosstalk in all nine possible pairs of fibre axes, all muscle pairs and all exercises. RESULTS: MMG root mean square (RMS) was statistically significant among the fibre axes (p<0.05, η2=0.17- 0.34) except for biceps brachii and brachioradialis in supination and brachialis in flexion. Overall mean crosstalk values in the three muscle pairs (biceps brachii & brachialis, brachialis & brachioradialis and brachioradialis & biceps brachii) were found to be 6.09-52.17%, 4.01-61.42% and 2.16-51.85%, respectively. Crosstalk values showed statistical significance among all nine axes pairs (p<0.05, η2=0.16-0.51) except for biceps brachii & brachialis during pronation. The transverse axes pair generated the lowest mean crosstalk values (2.16-9.14%). CONCLUSION: MMG signals recorded using accelerometers from the transverse axes of muscle fibres in the elbow flexors are unique and yield the least amount of crosstalk.

Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity and Speed Variations of Triceps Push-Down Exercise.

The objective of this study was to investigate the effects of changes in exercise intensity and speed on the three heads of the triceps brachii (TB) during triceps push-down exercise until task failure. Twenty-five subjects performed triceps push-down exercise at three different intensities (30, 45, and 60% 1RM) and speeds (slow, medium, and fast) until failure, and surface electromyography (sEMG) signals were recorded from the lateral, long and medial heads of the TB. The endurance time (ET), number of repetitions (NR) and rate of fatigue (ROF) were analyzed. Subsequently, the root-mean-square (RMS), mean power frequency (MPF) and median frequency (MDF) under no-fatigue (NF) and fatigue (Fa) conditions were statistically compared. The findings reveal that ROF increases with increase in the intensity and speed, and the opposite were obtained for the ET. The ROF in the three heads were comparable for all intensities and speeds. The ROF showed a significant difference (P < 0.05) among the three intensities and speeds for all heads. The three heads showed significantly different (P < 0.05) MPF and MDF values for all the performed exercises under both conditions, whereas the RMS values were significantly different only under Fa conditions. The current observations suggest that exercise intensity and speed affect the ROF while changes in intensity do not affect the MPF and MDF under Fa conditions. The behavior of the spectral parameters indicate that the three heads do not work in unison under any of the conditions. Changes in the speed of triceps push-down exercise affects the lateral and long heads, but changes in the exercise intensity affected the attributes of all heads to a greater extent.

Analysis of wheeze sounds during tidal breathing according to severity levels in asthma patients.

Objective: This study aimed to statistically analyze the behavior of time-frequency features in digital recordings of wheeze sounds obtained from patients with various levels of asthma severity (mild, moderate, and severe), and this analysis was based on the auscultation location and/or breath phase. Method: Segmented and validated wheeze sounds were collected from the trachea and lower lung base (LLB) of 55 asthmatic patients during tidal breathing maneuvers and grouped into nine different datasets. The quartile frequencies F25, F50, F75, F90 and F99, mean frequency (MF) and average power (AP) were computed as features, and a univariate statistical analysis was then performed to analyze the behavior of the time-frequency features. Results: All features generally showed statistical significance in most of the datasets for all severity levels [χ2 = 6.021-71.65, p < 0.05, η2 = 0.01-0.52]. Of the seven investigated features, only AP showed statistical significance in all the datasets. F25, F75, F90 and F99 exhibited statistical significance in at least six datasets [χ2 = 4.852-65.63, p < 0.05, η2 = 0.01-0.52], and F25, F50 and MF showed statistical significance with a large η2 in all trachea-related datasets [χ2 = 13.54-55.32, p < 0.05, η2 = 0.13-0.33]. Conclusion: The results obtained for the time-frequency features revealed that (1) the asthma severity levels of patients can be identified through a set of selected features with tidal breathing, (2) tracheal wheeze sounds are more sensitive and specific predictors of severity levels and (3) inspiratory and expiratory wheeze sounds are almost equally informative.

Association of anthropometric parameters with amplitude and crosstalk of mechanomyographic signals during forearm flexion, pronation and supination torque tasks.

This study aimed to quantify the association of four anthropometric parameters of the human arm, namely, the arm circumference (CA), arm length (LA), skinfold thickness (ST) and inter-sensor distance (ISD), with amplitude (RMS) and crosstalk (CT) of mechanomyography (MMG) signals. Twenty-five young, healthy, male participants were recruited to perform forearm flexion, pronation and supination torque tasks. Three accelerometers were employed to record the MMG signals from the biceps brachii (BB), brachialis (BRA) and brachioradialis (BRD) at 80% maximal voluntary contraction (MVC). Signal RMS was used to quantify the amplitude of the MMG signals from a muscle, and cross-correlation coefficients were used to quantify the magnitude of the CT among muscle pairs (BB & BRA, BRA & BRD, and BB & BRD). For all investigated muscles and pairs, RMS and CT showed negligible to low negative correlations with CA, LA and ISD (r = -0.0001--0.4611), and negligible to moderate positive correlations with ST (r = 0.004-0.511). However, almost all of these correlations were statistically insignificant (p > 0.05). These findings suggest that RMS and CT values for the elbow flexor muscles recorded and quantified using accelerometers appear invariant to anthropometric parameters.

Analysis of fatigue in the three heads of the triceps brachii during isometric contractions at various effort levels.

OBJECTIVE: The objective of this study was to investigate fatigue in the three heads of the triceps brachii (TB) muscle using surface electromyography (sEMG) obtained at 30%, 45% and 60% of maximal voluntary contraction (MVC). METHODS: Twenty-five subjects performed isometric elbow extension until failure, and the rate of fatigue (ROF), time to fatigue (TTF) and normalized TTF (NTTF) were statistically analysed. Subsequently, the behaviour of root-mean-square (RMS), mean-power frequency (MPF) and median-power frequency (MDF) under pre-, onset- and post-fatigue conditions were compared. RESULTS: The findings indicated that, among the heads, ROF was statistically significant at 30% and 45% MVC (P<0.05) but TTF and NTTF at all intensities was statistically insignificant (P>0.05). For every head, only TTF was statistically significant (P<0.05) at different intensities. MPF and MDF under pre-, onset- and post-fatigue conditions were statistically significant (P<0.05) among the heads at all intensities, whereas RMS showed no such behaviour. CONCLUSION: The investigated parameters reveal that the three heads of TB act independently before fatigue onset and appear to work in union after fatigue. Synergist head pairs exhibit similar spectral and temporal behaviour in contrast to the non-synergist TB head pair. We find spectral parameters to be more specific predictors of fatigue.

A review on crosstalk in myographic signals.

PURPOSE: Crosstalk in myographic signals is a major hindrance to the understanding of local information related to individual muscle function. This review aims to analyse the problem of crosstalk in electromyography and mechanomyography. METHODS: An initial search of the SCOPUS database using an appropriate set of keywords yielded 290 studies, and 59 potential studies were selected after all the records were screened using the eligibility criteria. This review on crosstalk revealed that signal contamination due to crosstalk remains a major challenge in the application of surface myography techniques. Various methods have been employed in previous studies to identify, quantify and reduce crosstalk in surface myographic signals. RESULTS: Although correlation-based methods for crosstalk quantification are easy to use, there is a possibility that co-contraction could be interpreted as crosstalk. High-definition EMG has emerged as a new technique that has been successfully applied to reduce crosstalk. CONCLUSIONS: The phenomenon of crosstalk needs to be investigated carefully because it depends on many factors related to muscle task and physiology. This review article not only provides a good summary of the literature on crosstalk in myographic signals but also discusses new directions related to techniques for crosstalk identification, quantification and reduction. The review also provides insights into muscle-related issues that impact crosstalk in myographic signals.

Characterization and classification of asthmatic wheeze sounds according to severity level using spectral integrated features.

OBJECTIVE: This study aimed to investigate and classify wheeze sounds of asthmatic patients according to their severity level (mild, moderate and severe) using spectral integrated (SI) features. METHOD: Segmented and validated wheeze sounds were obtained from auscultation recordings of the trachea and lower lung base of 55 asthmatic patients during tidal breathing manoeuvres. The segments were multi-labelled into 9 groups based on the auscultation location and/or breath phases. Bandwidths were selected based on the physiology, and a corresponding SI feature was computed for each segment. Univariate and multivariate statistical analyses were then performed to investigate the discriminatory behaviour of the features with respect to the severity levels in the various groups. The asthmatic severity levels in the groups were then classified using the ensemble (ENS), support vector machine (SVM) and k-nearest neighbour (KNN) methods. RESULTS AND CONCLUSION: All statistical comparisons exhibited a significant difference (p < 0.05) among the severity levels with few exceptions. In the classification experiments, the ensemble classifier exhibited better performance in terms of sensitivity, specificity and positive predictive value (PPV). The trachea inspiratory group showed the highest classification performance compared with all the other groups. Overall, the best PPV for the mild, moderate and severe samples were 95% (ENS), 88% (ENS) and 90% (SVM), respectively. With respect to location, the tracheal related wheeze sounds were most sensitive and specific predictors of asthma severity levels. In addition, the classification performances of the inspiratory and expiratory related groups were comparable, suggesting that the samples from these locations are equally informative.

A systematic review of muscle activity assessment of the biceps brachii muscle using mechanomyography.

This systematic review aims to categorically analyses the literature on the assessment of biceps brachii (BB) muscle activity through mechanomyography (MMG). The application of our search criteria to five different databases identified 319 studies. A critical review of the 48 finally selected records, revealed the diversity of protocols and parameters that are employed in MMG-based assessments of BB muscle activity. The observations were categorized into the following: muscle torque, fatigue, strength and physiology. The available information on the muscle contraction protocol, sensor(s), MMG signal parameters and obtained results were then tabulated based on these categories for further analysis. The review affirms that - 1) MMG is suitable for skeletal muscle activity assessment and can be employed potentially for further investigation of the BB muscle activity and condition (e.g., force, torque, fatigue, and contractile properties), 2) a majority of the records focused on static contractions of the BB, and the analysis of dynamic muscle contractions using MMG is thus a research gap, and 3) very few studies have focused on the analysis of BB muscle activity under externally stimulated contractions. Taken together, the findings of this review on BB activity assessment using MMG affirm the potential of MMG as an alternative tool.

Virtual phacoemulsification surgical simulation using visual guidance and performance parameters as a feasible proficiency assessment tool.

BACKGROUND: Computer based surgical training is believed to be capable of providing a controlled virtual environment for medical professionals to conduct standardized training or new experimental procedures on virtual human body parts, which are generated and visualised three-dimensionally on a digital display unit. The main objective of this study was to conduct virtual phacoemulsification cataract surgery to compare performance by users with different proficiency on a virtual reality platform equipped with a visual guidance system and a set of performance parameters. METHODS: Ten experienced ophthalmologists and six medical residents were invited to perform the virtual surgery of the four main phacoemulsification cataract surgery procedures - 1) corneal incision (CI), 2) capsulorhexis (C), 3) phacoemulsification (P), and 4) intraocular lens implantation (IOL). Each participant was required to perform the complete phacoemulsification cataract surgery using the simulator for three consecutive trials (a standardized 30-min session). The performance of the participants during the three trials was supported using a visual guidance system and evaluated by referring to a set of parameters that was implemented in the performance evaluation system of the simulator. RESULTS: Subjects with greater experience obtained significantly higher scores in all four main procedures - CI1 (ρ = 0.038), CI2 (ρ = 0.041), C1 (ρ = 0.032), P2 (ρ = 0.035) and IOL1 (ρ = 0.011). It was also found that experience improved the completion times in all modules - CI4 (ρ = 0.026), C4 (ρ = 0.018), P6 (ρ = 0.028) and IOL4 (ρ = 0.029). Positive correlation was observed between experience and anti-tremor - C2 (ρ = 0.026), P3 (ρ = 0.015), P4 (ρ = 0.042) and IOL2 (ρ = 0.048) and similarly with anti-rupture - CI3 (ρ = 0.013), C3 (ρ = 0.027), P5 (ρ = 0.021) and IOL3 (ρ = 0.041). No significant difference was observed between the groups with regards to P1 (ρ = 0.077). CONCLUSIONS: Statistical analysis of the results obtained from repetitive trials between two groups of users reveal that augmented virtual reality (VR) simulators have the potential and capability to be used as a feasible proficiency assessment tool for the complete four main procedures of phacoemulsification cataract surgery (ρ < 0.05), indicating the construct validity of the modules simulated with augmented visual guidance and assessed through performance parameters.

A systematic review of phacoemulsification cataract surgery in virtual reality simulators.

The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training.