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.     

Analysis of motor unit spike trains estimated from high-density surface electromyography is highly reliable across operators

There is a growing interest in decomposing high-density surface electromyography (HDsEMG) into motor unit spike trains to improve knowledge on the neural control of muscle contraction. However, the reliability of decomposition approaches is sometimes questioned, especially because they require manual editing of the outputs. We aimed to assess the inter-operator reliability of the identification of motor unit spike trains. Eight operators with varying experience in HDsEMG decomposition were provided with the same data extracted using the convolutive kernel compensation method. They were asked to manually edit them following established procedures. Data included signals from three lower leg muscles and different submaximal intensities. After manual analysis, 126 ± 5 motor units were retained (range across operators: 119–134). A total of 3380 rate of agreement values were calculated (28 pairwise comparisons × 11 contractions/muscles × 4–28 motor units). The median rate of agreement value was 99.6%. Inter-operator reliability was excellent for both mean discharge rate and time at recruitment (intraclass correlation coefficient > 0.99). These results show that when provided with the same decomposed data and the same basic instructions, operators converge toward almost identical results. Our data have been made available so that they can be used for training new operators.     

Evaluation of Novel EMG Biofeedback for Postural Correction During Computer Use

Postural correction is an effective rehabilitation technique used to treat chronic neck and shoulder pain, and is aimed toward reducing the load on the surrounding muscles by adopting a neutral posture. The objective of this investigation was to evaluate the effectiveness of real-time high-density surface EMG (HDsEMG) biofeedback for postural correction during typing. Twenty healthy participants performed a typing task with two forms of postural feedback: (1) verbal postural coaching and (2) verbal postural coaching plus HDsEMG biofeedback. The interface used activity from two HDsEMG arrays placed over the trapezius designed to shift trapezius muscle activity inferiorly. The center of gravity across both arrays was used to quantify the spatial distribution of trapezius activity. Planar angles taken from upper extremity reflective markers quantified cervicoscapular posture. During the biofeedback condition, trapezius muscle activity was located 12.74 ± 3.73 mm more inferior, the scapula was 2.58 ± 1.18° more adducted and 0.23 ± 0.24° more depressed in comparison to verbal postural coaching alone. The results demonstrate the short-term effectiveness of a real-time HDsEMG biofeedback intervention to achieve postural correction, and may be more effective at creating an inferior shift in trapezius muscle activity in comparison to verbal postural coaching alone.     

Consensus for experimental design in electromyography (CEDE) project: Amplitude normalization matrix

The general purpose of normalization of EMG amplitude is to enable comparisons between participants, muscles, measurement sessions or electrode positions. Normalization is necessary to reduce the impact of differences in physiological and anatomical characteristics of muscles and surrounding tissues. Normalization of the EMG amplitude provides information about the magnitude of muscle activation relative to a reference value. It is essential to select an appropriate method for normalization with specific reference to how the EMG signal will be interpreted, and to consider how the normalized EMG amplitude may change when interpreting it under specific conditions. This matrix, developed by the Consensus for Experimental Design in Electromyography (CEDE) project, presents six approaches to EMG normalization: (1) Maximal voluntary contraction (MVC) in same task/context as the task of interest, (2) Standardized isometric MVC (which is not necessarily matched to the contraction type in the task of interest), (3) Standardized submaximal task (isometric/dynamic) that can be task-specific, (4) Peak/mean EMG amplitude in task, (5) Non-normalized, and (6) Maximal M-wave. General considerations for normalization, features that should be reported, definitions, and “pros and cons” of each normalization approach are presented first. This information is followed by recommendations for specific experimental contexts, along with an explanation of the factors that determine the suitability of a method, and frequently asked questions. This matrix is intended to help researchers when selecting, reporting and interpreting EMG amplitude data.     

Surface electromyography in animal biomechanics: A systematic review

The study of muscle activity using surface electromyography (sEMG) is commonly used for investigations of the neuromuscular system in man. Although sEMG has faced methodological challenges, considerable technical advances have been made in the last few decades. Similarly, the field of animal biomechanics, including sEMG, has grown despite being confronted with often complex experimental conditions. In human sEMG research, standardised protocols have been developed, however these are lacking in animal sEMG. Before standards can be proposed in this population group, the existing research in animal sEMG should be collated and evaluated. Therefore the aim of this review is to systematically identify and summarise the literature in animal sEMG focussing on (1) species, breeds, activities and muscles investigated, and (2) electrode placement and normalisation methods used. The databases PubMed, Web of Science, Scopus, and Vetmed Resource were searched systematically for sEMG studies in animals and 38 articles were included in the final review. Data on methodological quality was collected and summarised. The findings from this systematic review indicate the divergence in animal sEMG methodology and as a result, future steps required to develop standardisation in animal sEMG are proposed.     

Diaphragmatic electromyography using a multiple electrode array

We have developed a new technique for diaphragmatic electromyography using an array of seven sequential electrode pairs at 1.0-cm spacing on an esophageal catheter. This array provides information about the spatial distribution of the electrical field generated by the diaphragm and reveals a sharply peaked variation of electrical potential with distance along the esophagus. The rectified and integrated information from each of the seven pairs is summed to give an approximation to the total electrical activity over the span of the array, providing a signal that is relatively insensitive to the position of the array over approximately 4 cm of catheter movement and removes the requirement for balloon stabilization of the catheter. With our array, we have confirmed the artifact in the evoked compound muscle action potential that seems to be related to diaphragmatic shape as reported by others who used supramaximal phrenic nerve stimulation, but the magnitude of this artifact (compared with the functional residual capacity level) was modest near functional residual capacity, averaging 12 +/- 14% (SD) for lung volumes 1.0 l above and -4 +/- 15% for lung volumes 1.0 l below functional residual capacity along the rib cage-abdomen relaxation line.     

Analysis of motor units with high-density surface electromyography

Although the behaviour of individual motor units is classically studied with intramuscular EMG, recently developed techniques allow its analysis also from EMG recorded in multiple locations over the skin surface (high-density surface EMG). The analysis of motor units from the surface EMG is useful when the insertion of needles is not desirable or not possible. Moreover, surface EMG allows the measure of motor unit properties which are difficult to assess with invasive technology (e.g., muscle fiber conduction velocity or location of innervation zones) and may increase the number of detectable motor units with respect to selective intramuscular recordings. Although some limitations remain, both the discharge pattern and muscle fiber properties of individual motor units can currently be analyzed non-invasively. This review presents the conditions and methodologies which allow the investigation of motor units with surface EMG.     

Consensus for experimental design in electromyography (CEDE) project: Terminology matrix

Consensus on the definition of common terms in electromyography (EMG) research promotes consistency in the EMG literature and facilitates the integration of research across the field. This paper presents a matrix developed within the Consensus for Experimental Design in Electromyography (CEDE) project, providing definitions for terms used in the EMG literature. The definitions for physiological and technical terms that are common in EMG research are included in two tables, with key information on each definition provided in a comment section. A brief outline of some basic principles for recording and analyzing EMG is included in an appendix, to provide researchers new to EMG with background and context for understanding the definitions of physiological and technical terms. This terminology matrix can be used as a reference to aid researchers new to EMG in reviewing the EMG literature.     

Surface electromyography assessment of back muscle intrinsic properties.

The purpose of this study was to assess (1) the reliability and (2) the sensitivity to low back pain status and gender of different EMG indices developed for the assessment of back muscle weakness, muscle fiber composition and fatigability. Healthy subjects (men and women) and chronic low back pain patients (men only) performed, in a static dynamometer, maximal and submaximal static trunk extension tasks (short and long duration) to assess weakness, fiber composition and fatigue. Surface EMG signals were recorded from four (bilateral) pairs of back muscles and three pairs of abdominal muscles. To assess reliability of the different EMG parameters, 40 male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three occasions. Reliable EMG indices were achieved for both healthy and chronic low back pain subjects when specific measurement strategies were applied. The EMG parameters used to quantify weakness and fiber composition were insensitive to low back status and gender. The EMG fatigue parameters did not detect differences between genders but unexpectedly, healthy men showed higher fatigability than back pain patients. This result was attributed to the smaller absolute load that was attributed to the patients, a load that was defined relative to their maximal strength, a problematic measure with this population. An attempt was made to predict maximal back strength from anthropometric measurements but this prediction was prone to errors. The main difficulties and some potential solutions related to the assessment of back muscle intrinsic properties were discussed.     

Cross-correlation as a method for comparing dynamic electromyography signals during gait

Current clinical interpretation of dynamic electromyography (EMG) data is usually based on qualitative assessments of muscle timing. Cross-correlation may provide a method for objectively comparing the timing and shape of EMG signals. This study used cross-correlation to compare EMG signals from different walking trials, different test sessions, and different individuals in able-bodied adults. Cross-correlation results (R-values) for different walking trials within a single test session were high, averaging > or = 0.90 for all muscles tested (R = 1.0 indicates exact agreement). Cross-correlation values were also high among trials from different test sessions conducted by the same and different examiners (average R > or = 0.78 for all muscles). R-values were much more variable when comparing different subjects (average 0.40-0.81, range 0.00-0.91). R-values were lower for the medial hamstrings and rectus femoris compared with the other muscles tested. These results suggest that cross-correlation may be useful for evaluating changes in an individual patient's muscle activation patterns, such as before and after surgery, but not for comparing EMG patterns among different individuals, such as between patients and normative data. This is especially true for biarticular muscles such as the hamstrings and rectus femoris, which may have variable activation patterns and/or increased sensitivity to electrode placement. Cross-correlation may also be useful for identifying appropriate muscles for transfer, identifying "outlier" trials within a test session, and selecting representative EMG curves for a given patient. The advantages of cross-correlation are that it considers shape of the EMG signal in addition to timing and that the assessments it provides are objective, rather than subjective.     

New insights into pain-related changes in muscle activation revealed by high-density surface electromyography

High-density surface electromyography (HDEMG) is an electrophysiological technique that can be used to quantify the spatial distribution of activity within muscles. When pain-free individuals perform sustained or repetitive tasks, different regions within a muscle become progressively more active; this is thought to reflect a strategy to redistribute the load to different regions, thus limiting localised muscle fatigue. The use of HDEMG has revealed that when people with musculoskeletal pain perform the same tasks, the distribution of activity within the same muscle is usually different, and the same muscle region tends to be active throughout the whole task without progressive activation of different muscle regions. This potentially results in a focal overload of a muscle region, and may contribute to fatigue, localised muscle pain and potentially pain persistence and/or recurrence over time. Interestingly, not all patients with musculoskeletal pain present with this regional alteration in muscle activation, reflecting the heterogeneity of patient presentations. This article will briefly review the technique of HDEMG followed by a review of studies demonstrating spatial redistribution of muscle activity in asymptomatic people during both isometric and dynamic conditions, including functional tasks. Lastly, the article will provide a review of HDEMG studies with a focus on changes in the behaviour of the lumbar erector spine and upper trapezius in people with spinal pain. These studies have revealed subtle changes in the distribution of muscle activity in people with spinal pain, which may have relevance for onset, persistence or recurrence of symptoms and could become a target of novel therapeutic approaches.     

Technique for interpretation of electromyography for concentric and eccentric contractions in gait

We present a technique to combine muscle shortening and lengthening velocity information with electromyographic (EMG) profiles during gait. A biomechanical model was developed so that each muscle's length could be readily calculated over time as a function of angles of the joints it crossed. The velocity of shortening and lengthening of the muscle fiber was then calculated, and with computer graphics this information was overlaid on the EMG profiles. Thus, researchers and clinicians were not only able to interpret the processed EMG signal as level of activity (tension) but also to gain insight as to the muscles' role as generators (muscle shortening) or absorbers (muscle lengthening) of energy. Six common muscles are documented, using database profiles; soleus (SOL), medial gastrocnemius (MG), tibialis anterior (TA), vastus lateralis (VL), rectus femoris (RF), and semitendinosus (ST). The protocol thus demonstrates a relatively simple technique for calculating muscle fiber velocity and for combining that velocity information with EMG activity profiles.     

Crosstalk in surface electromyography of the proximal forearm during gripping tasks.

Electromyographic (EMG) crosstalk was systematically analyzed to evaluate the magnitude of common signal present between electrode pairs around the forearm. Surface EMG was recorded and analyzed from seven electrode pairs placed circumferentially around the proximal forearm in six healthy individuals. The cross-correlation function was used to determine the amount of common signal, which was found to decrease as the distance between electrode pairs increased, but was not significantly altered by forearm posture (pronation, neutral, supination). Overall, approximately 40% common signal was detected between adjacent electrode pairs (3 cm apart), dropping to about 10% at 6 cm spacing and 2.5% at 9 cm. The magnitude of common signal approached 50% between adjacent electrode pairs over the extensor muscles, while over 60% was observed between neighbouring sites on the flexor aspect of the forearm. Although flexor and extensor EMG amplitude was similar, less than 2% common signal was present between flexor and extensor electrode pairs during both pinch and grasp tasks. Maximum grip force production was not affected by forearm rotation for pinch, but reduced 18% from neutral (mid-prone) to pronation during grasp (p=0.01). In spite of differences in grip force, mean muscle activity did not vary between the three forearm postures during maximum pinch or grasp trials. While this study improved our knowledge of crosstalk and electrode spacing issues, further examination of forearm EMG is required to improve understanding of muscle loading, EMG properties and motor control during gripping tasks.     

A new surface electromyography analysis method to determine spread of muscle fiber conduction velocities.

Muscle fiber conduction velocity (MFCV) estimation from surface signals is widely used to study muscle function, e.g., in neuromuscular disease and in fatigue studies. However, most analysis methods do not yield information about the velocity distribution of the various motor unit action potentials. We have developed a new method-the interpeak latency method (IPL)-to calculate both the mean MFCV and the spread of conduction velocities in vivo, from bipolar surface electromyogram (sEMG) during isometric contractions. sEMG was analyzed in the biceps brachii muscle in 15 young male volunteers. The motor unit action potential peaks are automatically detected with a computer program. Associated peaks are used to calculate a mean MFCV and the SD. The SD is taken as a measure of the MFCV spread. The main finding is that the IPL method can derive a measure of MFCV spread at different contraction levels. In conclusion, the IPL method provides accurate values for the MFCV and additionally gives information about the scatter of conduction velocities.     

Numerical simulation of fibrous biomaterials with randomly distributed fiber network structure

This paper presents a computational framework to simulate the mechanical behavior of fibrous biomaterials with randomly distributed fiber networks. A random walk algorithm is implemented to generate the synthetic fiber network in 2D used in simulations. The embedded fiber approach is then adopted to model the fibers as embedded truss elements in the ground matrix, which is essentially equivalent to the affine fiber kinematics. The fiber–matrix interaction is partially considered in the sense that the two material components deform together, but no relative movement is considered. A variational approach is carried out to derive the element residual and stiffness matrices for finite element method (FEM), in which material and geometric nonlinearities are both included. Using a data structure proposed to record the network geometric information, the fiber network is directly incorporated into the FEM simulation without significantly increasing the computational cost. A mesh sensitivity analysis is conducted to show the influence of mesh size on various simulation results. The proposed method can be easily combined with Monte Carlo (MC) simulations to include the influence of the stochastic nature of the network and capture the material behavior in an average sense. The computational framework proposed in this work goes midway between homogenizing the fiber network into the surrounding matrix and accounting for the fully coupled fiber–matrix interaction at the segment length scale, and can be used to study the connection between the microscopic structure and the macro-mechanical behavior of fibrous biomaterials with a reasonable computational cost.     

iEMG: Imaging electromyography

Advanced data analysis and visualization methodologies have played an important role in making surface electromyography both a valuable diagnostic methodology of neuromuscular disorders and a robust brain–machine interface, usable as a simple interface for prosthesis control, arm movement analysis, stiffness control, gait analysis, etc. But for diagnostic purposes, as well as for interfaces where the activation of single muscles is of interest, surface EMG suffers from severe crosstalk between deep and superficial muscle activation, making the reliable detection of the source of the signal, as well as reliable quantification of deeper muscle activation, prohibitively difficult. To address these issues we present a novel approach for processing surface electromyographic data. Our approach enables the reconstruction of 3D muscular activity location, making the depth of muscular activity directly visible. This is even possible when deep muscles are overlaid with superficial muscles, such as seen in the human forearm. The method, which we call imaging EMG (iEMG), is based on using the crosstalk between a sufficiently large number of surface electromyographic electrodes to reconstruct the 3D generating electrical potential distribution within a given area. Our results are validated by in vivo measurements of iEMG and ultrasound on the human forearm.     

High density electromyography data of normally limbed and transradial amputee subjects for multifunction prosthetic control

Pattern recognition based control of powered upper limb myoelectric prostheses offers a means of extracting more information from the available muscles than conventional methods. By identifying repeatable patterns of muscle activity across multiple muscle sites rather than relying on independent EMG signals it is possible to provide more natural, reliable control of myoelectric prostheses. The purposes of this study were to (1) determine if participants can perform distinctive muscle activation patterns associated with multiple wrist and hand movements reliably and (2) to show that high density EMG can be applied individually to determine the electrode location of a clinically acceptable number of electrodes (maximally eight) to classify multiple wrist and hand movements reliably in transradial amputees. Eight normally limbed subjects (five female, three male) and four transradial amputee subjects (two traumatic and congenital) subjects participated in this study, which examined the classification accuracies of a pattern recognition control system. It was found that tasks could be classified with high accuracy (85-98%) with normally limbed subjects (10-13 tasks) and with amputees (4-6) tasks. In healthy subjects, reducing the number of electrodes to eight did not affect accuracy significantly when those electrodes were optimally placed, but did reduce accuracy significantly when those electrodes were distributed evenly. In the amputee subjects, reducing the number of electrodes up to 4 did not affect classification accuracy or the number of tasks with high accuracy, independent of whether those remaining electrodes were evenly distributed or optimally placed. The findings in healthy subjects suggest that high density EMG testing is a useful tool to identify optimal electrode sites for pattern recognition control, but its use in amputees still has to be proven. Instead of just identifying the electrode sites where EMG activity is strong, clinicians will be able to choose the electrode sites that provide the most important information for classification.     

Use of surface electromyography to estimate neck muscle activity

This paper reviews the literature concerning the use of surface electromyography (sEMG) for the study of the neck musculature in response to work and workplace design during light work and semi-static tasks. The paper also draws upon basic research and biomechanical modeling in order to provide methodological recommendations for the use of surface electromyography in this region of the body and to identify areas which require further investigation. The paper includes review and discussion of electrode site location, methods of normalization, data reliability, and factors that can affect sEMG signals from this region, including noise, physiologic artifact, stress, visual deficiencies, and pain. General guidance for maximum exertions with the neck musculature, for sEMG normalization or other purposes, is also included.     

The role of transmembrane proteins on force transmission in skeletal muscle

Lateral transmission of force from myofibers laterally to the surrounding extracellular matrix (ECM) via the transmembrane proteins between them is impaired in old muscles. Changes in geometrical and mechanical properties of ECM of skeletal muscle do not fully explain the impaired lateral transmission with aging. The objective of this study was to determine the role of transmembrane proteins on force transmission in skeletal muscle. In this study, a 2D finite element model of single muscle fiber composed of myofiber, ECM, and the transmembrane proteins between them was developed to determine how changes in spatial density and mechanical properties of transmembrane proteins affect the force transmission in skeletal muscle. We found that force transmission and stress distribution are not affected by mechanical stiffness of the transmembrane proteins due to its non-linear stress–strain relationship. Results also showed that the muscle fiber with insufficient transmembrane proteins near the end of muscle fiber transmitted less force than that with more proteins does. Higher stress was observed in myofiber, ECM, and proteins in the muscle fiber with fewer proteins.