Evidence of changes in load sharing during isometric elbow flexion with ramped torque

This study aimed to: (1) test the repeatability of Supersonic Shear Imaging measures of muscle shear elastic modulus of four elbow flexor muscles during isometric elbow flexion with ramped torque; (2) determine the relationship between muscle shear elastic modulus and elbow torque for the four elbow flexor muscles, and (3) investigate changes in load sharing between synergist elbow flexor muscles with increases in elbow flexor torque. Ten subjects performed ten isometric elbow flexions consisting of linear torque ramps of 30-s from 0 to 40% of maximal voluntary contraction. The shear elastic modulus of each elbow flexor muscle (biceps brachii long head [BB(LH)], biceps brachii short head [BB(SH)], brachialis [BA], and brachoradialis [BR]) and of triceps brachii long head [TB] was measured twice with individual muscles recorded in separate trials in random order. A good repeatability of the shape of the changes in shear elastic modulus as a function of torque was found for each elbow flexor muscle (r-values: 0.85 to 0.94). Relationships between the shear elastic modulus and torque were best explained by a second order polynomial, except BA where a higher polynomial was required. Statistical analysis showed that BB(SH) and BB(LH) had an initial slow change at low torques followed by an increasing rate of increase in modulus with higher torques. In contrast, the BA shear elastic modulus increased rapidly at low forces, but plateaued at higher forces. These results suggest that changes in load sharing between synergist elbow flexors could partly explain the non-linear EMG-torque relationship classically reported for BB during isometric efforts.     

Shear modulus of multifidus and longissimus muscles measured using shear wave elastography correlates with muscle activity,but depends on image quality

Shear wave elastography (SWE) estimates shear modulus in muscle. This is interpreted as an index of muscle stiffness, but depends on muscle characteristics. This study evaluated relationship between shear modulus and myoelectric activity of lumbar multifidus and longissimus muscles to assess its validity. Intramuscular electromyography (EMG) of multifidus (deep [DM], superficial [SM] fibres) at L4/5, longissimus [LG] at L2, were recorded in nine healthy participants. Participants performed isometric trunk extension in side-lying from 0 to 30% maximal voluntary contraction (MVC) with EMG amplitude feedback. Using SWE, two regions of interest (ROI) were investigated in each muscle. Generally, shear modulus was moderately correlated with root mean squared (RMS) EMG (r = 0.50–0.78). Univariate and multiple regression analyses showed ultrasound/SWE features of ‘B-mode quality’ (24.5%), ‘%Void pixels’ (17.9%) and ‘Connective tissue’ (16.2%) explained most variation in the shear modulus/EMG relationship. Regression prediction scores generated using imaging features were correlated with r-coefficients of shear modulus/EMG relationship. When analysis was restricted to high quality data (i.e., regression prediction score above an a priori defined threshold), the shear modulus/EMG relationship increased to r = 0.70–0.96. Although a linear relationship between shear modulus/EMG was confirmed, supporting validity of SWE measures in anatomically distinct back muscles, this depends on image quality.     

Mechanomyographic and electromyographic responses of the vastus medialis muscle during isometric and concentric muscle actions

The purpose of this study was to examine the patterns for the mechanomyographic (MMG) and electromyographic (EMG) amplitude and mean power frequency (MPF) vs. torque relationships during submaximal to maximal isometric and isokinetic muscle actions. Seven men (mean +/- SD age, 22.4 +/- 1.3 years) volunteered to perform isometric and concentric isokinetic leg extension muscle actions at 20, 40, 60, 80, and 100% of maximal voluntary contraction (MVC) and peak torque (PT) on a Cybex II dynamometer. A piezoelectric MMG recording sensor was placed between bipolar surface EMG electrodes on the vastus medialis. Polynomial regression and separate 1-way repeated-measures analysis of variance were used to analyze the EMG amplitude, MMG amplitude, EMG MPF, and MMG MPF data for the isometric and isokinetic muscle actions. For the isometric muscle actions, EMG amplitude (R(2) = 0.999) and MMG MPF (R(2) = 0.946) increased to MVC, mean MMG amplitude increased to 60% MVC and then plateaued, and mean EMG MPF did not change (p > 0.05) across torque levels. For the isokinetic muscle actions, EMG amplitude (R(2) = 0.988) and MMG amplitude (R(2) = 0.933) increased to PT, but there were no significant mean changes with torque for EMG MPF or MMG MPF. The different torque-related responses for EMG and MMG amplitude and MPF may reflect differences in the motor control strategies that modulate torque production for isometric vs. dynamic muscle actions. These results support the findings of others and suggest that isometric torque production was modulated by a combination of recruitment and firing rate, whereas dynamic torque production was modulated primarily through recruitment.     

Muscle activation and the isokinetic torque-velocity relationship of the human triceps surae

The influence of muscle activation and the time allowed for torque generation on the angle-specific torque-velocity relationship of the triceps surae was studied during plantar flexion using supramaximal electrical stimulation and a release technique on six male subjects [mean (SD) age 25 (4) years]. Torque-velocity data were obtained under different levels of constant muscle activation by varying the stimulus frequency and the time allowed for isometric torque generation prior to release and isokinetic shortening. To eliminate the effects of the frequency response on absolute torque the isokinetic data were normalized to the maximum isometric torque values at 0.44 rad. There were no significant differences in the normalized torques generated at any angular velocity using stimulus frequencies of 20, 50 or 80 Hz. When the muscle was stimulated at 50 Hz the torques obtained after a 400 ms and 1 s pre-release isometric contraction did not differ significantly. However, with no pre-release contraction significantly less torque was generated at all angular velocities beyond 1.05 rad · s^–1 when compared with either the 200, 400 ms or 1 s condition. With a 200 ms pre-release contraction significantly less torque was generated at angular velocities beyond 1.05 rad · s^–1 when compared with the 400 ms or 1 s conditions. It would seem that the major factor governing the shape of the torque-velocity curve at a constant level of muscle activation is the time allowed for torque generation.     

Estimation of individual muscle force using elastography

Background

Estimation of an individual muscle force still remains one of the main challenges in biomechanics. In this way, the present study aimed: (1) to determine whether an elastography technique called Supersonic Shear Imaging (SSI) could be used to estimate muscle force, (2) to compare this estimation to that one provided by surface electromyography (EMG), and (3) to determine the effect of the pennation of muscle fibers on the accuracy of the estimation.

Methods and Results

Eleven subjects participated in two experimental sessions; one was devoted to the shear elastic modulus measurements and the other was devoted to the EMG recordings. Each session consisted in: (1) two smooth linear torque ramps from 0 to 60% and from 0 to 30% of maximal voluntary contraction, for the first dorsal interosseous and the abductor digiti minimi, respectively (referred to as “ramp contraction”); (2) two contractions done with the instruction to freely change the torque (referred to as “random changes contraction”). Multi-channel surface EMG recordings were obtained from a linear array of eight electrodes and the shear elastic modulus was measured using SSI. For ramp contractions, significant linear relationships were reported between EMG activity level and torque (R² = 0.949±0.036), and between shear elastic modulus and torque (R² = 0.982±0.013). SSI provided significant lower RMS_deviation between measured torque and estimated torque than EMG activity level for both types of contraction (1.4±0.7 vs. 2.8±1.4% of maximal voluntary contraction for “ramp contractions”, p<0.01; 4.5±2.3 vs. 7.9±5.9% of MVC for “random changes contractions”, p<0.05). No significant difference was reported between muscles.

Conclusion

The shear elastic modulus measured using SSI can provide a more accurate estimation of individual muscle force than surface EMG. In addition, pennation of muscle fibers does not influence the accuracy of the estimation.     

Accessory muscle activation during the superimposed burst technique

Quadriceps muscle activation is assessed using the superimposed burst technique. This technique involves percutaneous muscle stimulation superimposed during maximal isometric volitional knee extension. It is unknown whether accessory muscle activation during maximal knee extension influences estimates of quadriceps muscle activation. Our aim was to compare accessory muscle activation while performing the superimposed burst technique using investigator delivered verbal instruction to constrain the system (CS) and a participant preferred (PP) technique. Twenty five healthy, active individuals (13M/12F, age=23.8 ± 3.35, height=72.73 ± 14.51 cm, and weight=175.29 ± 9.59 kg) were recruited for this study. All participants performed superimposed burst testing with (CS) and without (PP) verbal instruction to encourage isolated quadriceps activation during maximal isometric knee extension. The main outcome variables measured were knee extension torque, quadriceps central activation ratio and mean EMG of vastus lateralis, biceps femoris, and lumbar paraspinal muscles. There were significant differences in knee extension torque (CS=2.87 ± 0.93 Nm/kg, PP=3.40 ± 1.12 Nm/kg, p<0.001), superimposed burst torque (CS=3.40 ±0.98 Nm/kg, PP=3.75 ± 1.11 Nm/kg, p=0.002) and quadriceps CAR (CS=84.1 ± 12.0%, PP=90.2 ± 9.9%, p<0.001) between the techniques. There was also a significant difference in lumbar paraspinal EMG (CS=6.40 ± 8.52%, PP=11.86 ± 14.89%, p=0.043) between the techniques however vastus lateralis EMG was not significantly different. Patient instruction via verbal instruction to constrain proximal structures may help patient minimize confounders to knee extension torque generation while maximizing quadriceps activation.     

Spatio-temporal evaluation of neck muscle activation during postural perturbations in healthy subjects.

The purpose of this study was to examine the spatio-temporal activation of the sternocleidomastoid (SCM) and cervical extensor (CE) muscles with respect to the deltoid muscle onset during rapid voluntary upper limb movement in healthy volunteers. The repeatability and reliability of the spatio-temporal aspects of the myoelectric signals were also examined. Ten subjects performed bilateral and unilateral rapid upper limb flexion, abduction and extension in response to a visual stimulus. EMG onsets and normalised root mean square (nRMS) values were calculated for the SCM and CE muscles. Subjects attended three testing sessions over non-consecutive days allowing the repeatability and reliability of these measures to be assessed. The SCM and CE muscles demonstrated feed-forward activation (activation within 50 ms of deltoid onset) during rapid arm movements in all directions. The sequence and magnitude of neck muscle activation displayed directional specificity, however, the neck flexor and extensor muscles displayed co-activation during all perturbations. EMG onsets demonstrated high repeatability in terms of repeated measure precision (nSEM in the range 1.9-5.7%). This was less evident for the repeatability of nRMS values. The results of this study provide a greater understanding of cervical neuromotor control strategies. During bilateral and unilateral upper limb perturbations, the SCM and CE muscles demonstrate feed-forward co-activation. It seems apparent that feed-forward activation of neck muscles is a mechanism necessary to achieve stability for the visual and vestibular systems, whilst ensuring stabilisation and protection of the cervical spine.     

Heterogeneity of muscle activation in relation to force direction: A multi-channel surface electromyography study on the triceps surae muscle

Several skeletal muscles can be divided into sub-modules, called neuromuscular compartments (NMCs), which are thought to be controlled independently and to have distinct biomechanical functions. We looked for distinct muscle activation patterns in the triceps surae muscle (TS) using surface electromyography (EMG) during voluntary contraction. Nine subjects performed isometric and isotonic plantar flexions combined with forces along pre-defined directions. Besides the forces under the ball of the foot, multi-channel surface EMG was measured with electrodes homogeneously distributed over the entire TS. Using principal component analysis, common (global) components were omitted from the EMG signals, thereby estimating muscle activity sufficiently accurate to track fine fluctuations of force during an isotonic contraction (r = 0.80 ± 0.09). A subsequent cluster analysis showed a topographical organization of co-activated parts of the muscle that was different between subjects. Low and negative correlations between the EMG activity within clusters were found, indicating a substantial heterogeneity of TS activation. The correlations between cluster time series and forces at the foot in specific directions differed substantially between clusters, showing that the differentially activated parts of the TS had specific biomechanical functions.     

Electromyography of superficial and deep neck muscles during isometric, voluntary, and reflex contractions

Increasingly complex models of the neck neuromusculature need detailed muscle and kinematic data for proper validation. The goal of this study was to measure the electromyographic activity of superficial and deep neck muscles during tasks involving isometric, voluntary, and reflexively evoked contractions of the neck muscles. Three male subjects (28-41 years) had electromyographic (EMG) fine wires inserted into the left sternocleidomastoid, levator scapulae, trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles. Surface electrodes were placed over the left sternohyoid muscle. Subjects then performed: (i) maximal voluntary contractions (MVCs) in the eight directions (45 deg intervals) from the neutral posture; (ii) 50 N isometric contractions with a slow sweep of the force direction through 720 deg; (iii) voluntary oscillatory head movements in flexion and extension; and (iv) initially relaxed reflex muscle activations to a forward acceleration while seated on a sled. Isometric contractions were performed against an overhead load cell and movement dynamics were measured using six-axis accelerometry on the head and torso. In all three subjects, the two anterior neck muscles had similar preferred activation directions and acted synergistically in both dynamic tasks. With the exception of splenius capitis, the posterior and posterolateral neck muscles also showed consistent activation directions and acted synergistically during the voluntary motions, but not during the sled perturbations. These findings suggest that the common numerical-modeling assumption that all anterior muscles act synergistically as flexors is reasonable, but that the related assumption that all posterior muscles act synergistically as extensors is not. Despite the small number of subjects, the data presented here can be used to inform and validate a neck model at three levels of increasing neuromuscular-kinematic complexity: muscles generating forces with no movement, muscles generating forces and causing movement, and muscles generating forces in response to induced movement. These increasingly complex data sets will allow researchers to incrementally tune their neck models' muscle geometry, physiology, and feedforward/feedback neuromechanics.     

Mechanomyogram amplitude vs. isometric ankle plantarflexion torque of human medial gastrocnemius muscle at different ankle joint angles

The purpose of this study was to investigate the influence of changes in ankle joint angle on the mechanomyogram (MMG) amplitude of the human medial gastrocnemius (MG) muscle during voluntary isometric plantarflexion contractions. Ten healthy individuals were asked to perform voluntary isometric contractions at six different contraction intensities (from 10% to 100%) and at three different ankle joint angles (plantarflexion of 26°; plantarflexion of 10°; dorsiflexion of 3°). MMG signals were recorded from the surface over the MG muscle, using a 3-axis accelerometer. The relations between root mean square (RMS) MMG and isometric plantarflexion torque at different ankle joint angles were characterized to evaluate the effects of altered muscle mechanical properties on RMS MMG.We found that the relation between RMS MMG and plantarflexion torque is changed at different ankle joint angles: RMS MMG increases monotonically with increasing the plantarflexion torque but decreases as the ankle joint became dorsiflexed. Moreover, RMS MMG shows a negative correlation with muscle length, with passive torque, and with maximum voluntary torque, which were all changed significantly at different ankle joint angles.Our findings demonstrate the potential effects of changing muscle mechanical properties on muscle vibration amplitude. Future studies are required to explore the major sources of this muscle vibration from the perspective of muscle mechanics and muscle activation level, attributable to changes in the neural command.     

Impact of the EMG normalization method on muscle activation and the antagonist-agonist co-contraction index during active elbow extension: Practical implications for post-stroke subjects

Electromyographic (EMG) raw signals are sensitive to intrinsic and extrinsic factors. Consequently, EMG normalization is required to draw proper interpretations of standardized data. Specific recommendations are needed regarding a relevant EMG normalization method for participants who show atypical EMG patterns, such as post-stroke subjects. This study compared three EMG normalization methods (“isometric MVC”, “isokinetic MVC”, “isokinetic MVC kinematic-related”) on muscle activations and the antagonist-agonist co-contraction index. Fifteen post-stroke subjects and fifteen healthy controls performed active elbow extensions, followed by isometric and isokinetic maximum voluntary contractions (MVC). Muscle activations were obtained by normalizing EMG envelopes during active movement using a reference value determined for each EMG normalization method. The results showed no significant difference between the three EMG normalization methods in post-stroke subjects on muscle activation and the antagonist-agonist co-contraction index. We highlighted that the antagonist-agonist co-contraction index could underestimate the antagonist co-contraction in the presence of atypical EMG patterns. Based on its practicality and feasibility, we recommend the use of isometric MVC as a relevant procedure for EMG normalization in post-stroke subjects. We suggest combined analysis of the antagonist-agonist co-contraction index and agonist and antagonist activations to properly investigate antagonist co-contraction in the presence of atypical EMG patterns during movement.     

Muscle enhancement using closed-loop electrical stimulation: volitional versus induced torque.

In cases of partial deficiency of muscle activation capacity, force augmentation can be achieved by hybrid activation, i.e., by combining electrical stimulation (ES) with volitional activation. In this activation modality the shares of the volitional and induced torques within the overall hybrid torque are unknown. The purpose of this study was to suggest a computational approach to parcel out the volitional and stimulation induced components of joint torque generated during combined voluntary and electrical activation of the Tibialis Anterior muscle (TA). For this purpose, isometric contraction of the TA was studied on 5 healthy subjects, using an activation protocol involving ES alone, volitional activation alone and hybrid activation. Ankle torque and TA EMG were measured. A computational algorithm was developed to dissociate the volitional from the overall torque, based on EMG filtering and on pre-measured calibration curves of volitional torque versus EMG. The results indicated that for a certain hybrid torque there is a linear decaying relationship between the induced torque and the volitional torque shares. Moreover, based on a defined enhancement ratio, the results indicate that within the range of stimulation intensities, there exist regions of increased facilitation, in which the stimulation efficiency is higher under combined compared to isolated conditions.     

The shear wave elastic modulus and the increased nuclear factor kappa B (NF-kB/p65) and cyclooxygenase-2 (COX-2) expression in the area of myofascial trigger points activated in a rat model by blunt trauma to the vastus medialis

We aimed to elucidate the increased inflammatory cytokines expression such as nuclear factor kappa B (NF-kB/p65), cyclooxygenase-2 (COX-2), and voltage-gated calcium channels (VGCC) in the area of activated myofascial trigger points (MTrPs) in a rat model by blunt trauma to the vastus medialis and to evaluate the feasibility of a quantitative analysis of muscle elastic modulus using shear wave elastography (SWE). Twelve 7-week-old male SD rats were divided into normal (NM, n = 6) and model groups (MO, n = 6). In the MO group, MTrPs were activated with a blunt strike to the left vastus medialis and subsequent eccentric exercise for 8 weeks. After 4 weeks of rest, the elastic modulus in the focal site was evaluated using SWE. Electromyography (EMG) data were collected at MTrPs and muscle tissues were evaluated for expression of nuclear factor kappa B (NF-kB/p65), cyclooxygenase-2 (COX-2) protein, and voltage-gated calcium channels (VGCC). The number of the palpable taut bands; EMG frequency and amplitude; elastic modulus values; and NFkB/p65, COX-2, and VGCC expression levels were significantly higher for the left focal area in the MO group compared to those for the NM group (p’s < 0.05). These findings suggest that elastic modulus measurement using ultrasound SWE may be effective in evaluating MPS. In addition, increased COX-2, NFkB/p65, and VGCC expression may expand the integrated hypothesis of trigger points.     

Spatial EMG potential distribution pattern of vastus lateralis muscle during isometric knee extension in young and elderly men

The aim of the present study was to compare spatial electromyographic (EMG) potential distribution during force production between elderly and young individuals using multi-channel surface EMG (SEMG). Thirteen elderly (72-79 years) and 13 young (21-27 years) healthy male volunteers performed ramp submaximal contraction during isometric knee extension from 0% to 65% of maximal voluntary contraction. During contraction, multi-channel EMG was recorded from the vastus lateralis muscle. To evaluate alteration in heterogeneity and pattern in spatial EMG potential distribution, coefficient of variation (CoV), modified entropy and correlation coefficients with initial torque level were calculated from multi-channel SEMG at 5% force increment. Increase in CoV and decrease in modified entropy of RMS with increase of exerted torque were significantly smaller in elderly group (p < 0.05) and correlation coefficients with initial torque level were significantly higher in elderly group than in young group at moderate torque levels (p < 0.05). These data suggest that the increase of heterogeneity and the change in the activation pattern are smaller in elderly individuals than in young individuals. We speculated that multi-channel SEMG pattern in elderly individual reflects neuromuscular activation strategy regulated predominantly by clustering of similar type of muscle fibers in aged muscle.     

Linear relationship between electromyography and shear wave elastography measurements persists in deep muscles of the upper extremity

Recent works have demonstrated a linear relationship between muscle activation and shear modulus in various superficial muscles. As such, it may be possible to overcome limitations of traditional electromyography (EMG) methods by assessing activation using shear wave elastography. However, the relationship has not been wholly validated in deep muscles. This study measured the association between squared shear wave velocity, which is related to shear modulus, and activation within superficial and deep muscles. This relationship was also compared between surface and intramuscular EMG electrodes. We simultaneously recorded EMG and shear wave velocity in one deep (brachialis) and one superficial (brachioradialis) muscle in ten healthy individuals during isometric elbow flexion across a wide range of contraction intensities. Muscle activation and squared shear wave velocity demonstrated good reliability (ICC > 0.75) and showed a linear relationship (P < 0.05) for all muscle/EMG electrode type combinations (study conditions) after down-sampling. Study condition was not a significant within-subject factor to the slope or intercept of the relationship (P > 0.05). This work demonstrates that activation of both superficial and deep muscles can be assessed noninvasively using ultrasound shear wave elastography and is a critical step toward demonstrating elastography’s utility as an alternative to EMG.     

Effects of local elastic compression on muscle strength, electromyographic, and mechanomyographic responses in the lower extremity

The purpose of this study was to investigate the effect of elastic compression on muscle strength, electromyographic (EMG), and mechanomyographic (MMG) responses of quadriceps femoris during isometric and isokinetic contractions. Twelve participants performed 5 s isometric maximal voluntary contractions (MVC) and 25 consecutive and maximal isokinetic knee extensions at 60 and 300 °/s with no (control, CC), medium (MC), and high (HC) compression applied to the muscle. The EMG and MMG signals were collected simultaneously with muscle isometric and isokinetic strength data. The results showed that the elevated compression did not improve peak torque, peak power, average power, total work, and regression of torque in the isometric and isokinetic contractions. However, the root mean squared value of EMG in both HC and MC significantly decreased compared with CC at 60 and 300 °/s (p < 0.01). Furthermore, the EMG mean power frequency in HC was significantly higher than that in CC at 60 °/s (p < 0.05) whereas no significant compression effect was found in the MMG mean power frequency. These findings provide preliminary evidence suggesting that the increase in local compression pressure may effectively increase muscle efficiency and this might be beneficial in reducing muscle fatigue during concentric isokinetic muscle contractions.     

Redundancy or heterogeneity in the electric activity of the biceps brachii muscle? Added value of PCA-processed multi-channel EMG muscle activation estimates in a parallel-fibered muscle

Conventional bipolar EMG provides imprecise muscle activation estimates due to possibly heterogeneous activity within muscles and due to improper alignment of the electrodes with the muscle fibers. Principal component analysis (PCA), applied on multi-channel monopolar EMG yielded substantial improvements in muscle activation estimates in pennate muscles. We investigated the degree of heterogeneity in muscle activity and the contribution of PCA to muscle activation estimates in biceps brachii (BB), which has a relatively simply parallel-fibered architecture. EMG-based muscle activation estimates were assessed by comparison to elbow flexion forces in isometric, two-state isotonic contractions in eleven healthy male subjects. Monopolar EMG was collected over the entire surface of the BB with about 63 electrodes. Estimation quality of different combinations of EMG channels showed that heterogeneous activation was found mainly in medio-lateral direction, whereas adding channels in the longitudinal direction added largely redundant information. Multi-channel bipolar EMG amplitude improved muscle activation estimates by 5–14% as compared to a single bipolar. PCA-processed monopolar EMG amplitude yielded a further improvement of (12–22%). Thus multi-channel EMG, processed with PCA, substantially improves the quality of muscle activation estimates compared conventional bipolar EMG in BB.     

Muscle specificity in tests of cervical flexor muscle performance.

The deep cervical flexor (DCF) muscles are considered to be of substantial clinical importance in the management of neck pain. While conventional cervical flexion (CF) dynamometry methods have been used frequently to assess the capacity of the cervical flexor muscles, it has been suggested that cranio-cervical flexion (CCF) methods may provide a more specific test of DCF muscle performance. This study compared the activation of the deep and superficial cervical flexor muscles between tests of isometric cranio-cervical flexion (CCF) and conventional cervical flexion (CF) dynamometry. Normalised root-mean-square values were recorded for the deep cervical flexor (DCF), sternocleidomastoid (SCM), anterior scalene (AS), and sternohyoid (SH) muscles during isometric CCF and CF tests at maximal voluntary contraction (MVC), 50% MVC, and 20% MVC in ten healthy volunteers. The results demonstrated significantly greater electromyography (EMG) amplitude for the SCM (P<.001-.002) and AS (P<.001-.001) muscles in the CF test conditions (MVC, 20%MVC, and 50%MVC) compared to CCF test conditions. Moreover, the SH muscle demonstrated significantly greater EMG amplitude during CF compared to CCF but only in the 50% MVC and 20% MVC conditions (P=.007 and .02 respectively). These results demonstrate that dynamometry tests of CF result in greater activity of the superficial cervical flexor muscles compared to tests of CCF. As a result, CCF dynamometry may provide a more specific method to assess and retrain DCF muscle performance, compared to conventional CF in which superficial muscle activity may mask impaired performance of the DCF muscles.     

Automated estimation of ankle muscle EMG envelopes and resulting plantar-dorsi flexion torque from 64 garment-embedded electrodes uniformly distributed around the human leg

The design of personalized movement training and rehabilitation pipelines relies on the ability of assessing the activation of individual muscles concurrently with the resulting joint torques exerted during functional movements. Despite advances in motion capturing, force sensing and bio-electrical recording technologies, the estimation of muscle activation and resulting force still relies on lengthy experimental and computational procedures that are not clinically viable. This work proposes a wearable technology for the rapid, yet quantitative, assessment of musculoskeletal function. It comprises of (1) a soft leg garment sensorized with 64 uniformly distributed electromyography (EMG) electrodes, (2) an algorithm that automatically groups electrodes into seven muscle-specific clusters, and (3) a EMG-driven musculoskeletal model that estimates the resulting force and torque produced about the ankle joint sagittal plane. Our results show the ability of the proposed technology to automatically select a sub-set of muscle-specific electrodes that enabled accurate estimation of muscle excitations and resulting joint torques across a large range of biomechanically diverse movements, underlying different excitation patterns, in a group of eight healthy individuals. This may substantially decrease time needed for localization of muscle sites and electrode placement procedures, thereby facilitating applicability of EMG-driven modelling pipelines in standard clinical protocols.