In vivo forces generated by finger flexor muscles do not depend on the rate of fingertip loading during an isometric task

Risk factors for activity-related tendon disorders of the hand include applied force, duration, and rate of loading. Understanding the relationship between external loading conditions and internal tendon forces can elucidate their role in injury and rehabilitation. The goal of this investigation is to determine whether the rate of force applied at the fingertip affects in vivo forces in the flexor digitorum profundus (FDP) tendon and the flexor digitorum superficialis (FDS) tendon during an isometric task. Tendon forces, recorded with buckle force transducers, and fingertip forces were simultaneously measured during open carpal tunnel surgery as subjects (N=15) increased their fingertip force from 0 to 15N in 1, 3, and 10s. The rates of 1.5, 5, and 15N/s did not significantly affect FDP or FDS tendon to fingertip force ratios. For the same applied fingertip force, the FDP tendon generated more force than the FDS. The mean FDP to fingertip ratio was 2.4+/-0.7 while the FDS to tip ratio averaged 1.5+/-1.0 (p<0.01). The fine motor control needed to generate isometric force ramps at these specific loading rates probably required similar high activation levels of multiple finger muscles in order to stabilize the finger and control joint torques at the force rates studied. Therefore, for this task, no additional increase in muscle force was observed at higher rates. These findings suggest that for high precision, isometric pinch maneuvers under static finger conditions, tendon forces are independent of loading rate.     

Measuring lifting forces in rock climbing: effect of hold size and fingertip structure

This study investigates the hypothesis that shallow edge lifting force in high-level rock climbers is more strongly related to fingertip soft tissue anatomy than to absolute strength or strength to body mass ratio. Fifteen experienced climbers performed repeated maximal single hand lifting exercises on rectangular sandstone edges of depth 2.8, 4.3, 5.8, 7.3, and 12.5 mm while standing on a force measurement platform. Fingertip soft tissue dimensions were assessed by ultrasound imaging. Shallow edge (2.8 and 4.3 mm) lifting force, in newtons or body mass normalized, was uncorrelated with deep edge (12.5 mm) lifting force (r < .1). There was a positive correlation (r = .65, p < .05) between lifting force in newtons at 2.8 mm edge depth and tip of bone to tip of finger pulp measurement (r < .37 at other edge depths). The results confirm the common perception that maximum lifting force on a deep edge ("strength") does not predict maximum force production on very shallow edges. It is suggested that increased fingertip pulp dimension or plasticity may enable increased deformation of the fingertip, increasing the skin to rock contact area on very shallow edges, and thus increase the limit of force production. The study also confirmed previous assumptions of left/right force symmetry in climbers.     

The proprioceptive map of the arm is systematic and stable, but idiosyncratic

Visual and somatosensory signals participate together in providing an estimate of the hand's spatial location. While the ability of subjects to identify the spatial location of their hand based on visual and proprioceptive signals has previously been characterized, relatively few studies have examined in detail the spatial structure of the proprioceptive map of the arm. Here, we reconstructed and analyzed the spatial structure of the estimation errors that resulted when subjects reported the location of their unseen hand across a 2D horizontal workspace. Hand position estimation was mapped under four conditions: with and without tactile feedback, and with the right and left hands. In the task, we moved each subject's hand to one of 100 targets in the workspace while their eyes were closed. Then, we either a) applied tactile stimulation to the fingertip by allowing the index finger to touch the target or b) as a control, hovered the fingertip 2 cm above the target. After returning the hand to a neutral position, subjects opened their eyes to verbally report where their fingertip had been. We measured and analyzed both the direction and magnitude of the resulting estimation errors. Tactile feedback reduced the magnitude of these estimation errors, but did not change their overall structure. In addition, the spatial structure of these errors was idiosyncratic: each subject had a unique pattern of errors that was stable between hands and over time. Finally, we found that at the population level the magnitude of the estimation errors had a characteristic distribution over the workspace: errors were smallest closer to the body. The stability of estimation errors across conditions and time suggests the brain constructs a proprioceptive map that is reliable, even if it is not necessarily accurate. The idiosyncrasy across subjects emphasizes that each individual constructs a map that is unique to their own experiences.     

Detection of surface electromyography recording time interval without muscle fatigue effect for biceps brachii muscle during maximum voluntary contraction

The effects of fatigue on maximum voluntary contraction (MVC) parameters were examined by using force and surface electromyography (sEMG) signals of the biceps brachii muscles (BBM) of 12 subjects. The purpose of the study was to find the sEMG time interval of the MVC recordings which is not affected by the muscle fatigue. At least 10 s of force and sEMG signals of BBM were recorded simultaneously during MVC. The subjects reached the maximum force level within 2 s by slightly increasing the force, and then contracted the BBM maximally. The time index of each sEMG and force signal were labeled with respect to the time index of the maximum force (i.e. after the time normalization, each sEMG or force signal’s 0 s time index corresponds to maximum force point). Then, the first 8 s of sEMG and force signals were divided into 0.5 s intervals. Mean force, median frequency (MF) and integrated EMG (iEMG) values were calculated for each interval. Amplitude normalization was performed by dividing the force signals to their mean values of 0 s time intervals (i.e. ?0.25 to 0.25 s). A similar amplitude normalization procedure was repeated for the iEMG and MF signals. Statistical analysis (Friedman test with Dunn’s post hoc test) was performed on the time and amplitude normalized signals (MF, iEMG). Although the ANOVA results did not give statistically significant information about the onset of the muscle fatigue, linear regression (mean force vs. time) showed a decreasing slope (Pearson-r = 0.9462, p < 0.0001) starting from the 0 s time interval. Thus, it might be assumed that the muscle fatigue starts after the 0 s time interval as the muscles cannot attain their peak force levels. This implies that the most reliable interval for MVC calculation which is not affected by the muscle fatigue is from the onset of the EMG activity to the peak force time. Mean, SD, and range of this interval (excluding 2 s gradual increase time) for 12 subjects were 2353, 1258 ms and 536–4186 ms, respectively. Exceeding this interval introduces estimation errors in the maximum amplitude calculations of MVC–sEMG studies for BBM. It was shown that, simultaneous recording of force and sEMG signals was required to calculate the maximum amplitude of the MVC–sEMG more accurately.     

Control of Fingertip Forces in Young and Older Adults Pressing against Fixed Low- and High-Friction Surfaces

Mobile computing devices (e.g., smartphones and tablets) that have low-friction surfaces require well-directed fingertip forces of sufficient and precise magnitudes for proper use. Although general impairments in manual dexterity are well-documented in older adults, it is unclear how these sensorimotor impairments influence the ability of older adults to dexterously manipulate fixed, low-friction surfaces in particular. 21 young and 18 older (65+ yrs) adults produced maximal voluntary contractions (MVCs) and steady submaximal forces (2.5 and 10% MVC) with the fingertip of the index finger. A Teflon covered custom-molded splint was placed on the fingertip. A three-axis force sensor was covered with either Teflon or sandpaper to create low- and high-friction surfaces, respectively. Maximal downward forces (F_z) were similar (p = .135) for young and older adults, and decreased by 15% (p<.001) while pressing on Teflon compared to sandpaper. Fluctuations in F_z during the submaximal force-matching tasks were 2.45× greater (p<.001) for older adults than in young adults, and reached a maximum when older adults pressed against the Teflon surface while receiving visual feedback. These age-associated changes in motor performance are explained, in part, by altered muscle activity from three hand muscles and out-of-plane forces. Quantifying the ability to produce steady fingertip forces against low-friction surfaces may be a better indicator of impairment and disability than the current practice of evaluating maximal forces with pinch meters. These age-associated impairments in dexterity while interacting with low-friction surfaces may limit the use of the current generation of computing interfaces by older adults.     

Relation between the ankle joint angle and the maximum isometric force of the toe flexor muscles

The purpose of this study was to investigate the relationships between the ankle joint angle and maximum isometric force of the toe flexor muscles. Toe flexor strength and electromyography activity of the foot muscles were measured in 12 healthy men at 6 different ankle joint angles with the knee joint at 90 deg in the sitting position. To measure the maximum isometric force of the toe flexor muscles, subjects exerted maximum force on a toe grip dynamometer while the activity levels of the intrinsic and extrinsic plantar muscles were measured. The relation between ankle joint angle and maximum isometric force of the toe flexor muscles was determined, and the isometric force exhibited a peak when the ankle joint was at 70–90 deg on average. From this optimal neutral position, the isometric force gradually decreased and reached its nadir in the plantar flexion position (i.e., 120 deg). The EMG activity of the abductor hallucis (intrinsic plantar muscle) and peroneus longus (extrinsic plantar muscle) did not differ at any ankle joint angles. The results of this study suggest that the force generation of toe flexor muscles is regulated at the ankle joint and that changes in the length-tension relations of the extrinsic plantar muscle could be a reason for the force-generating capacity at the metatarsophalangeal joint when the ankle joint angle is changed.     

The contribution of the wrist, elbow and shoulder joints to single-finger tapping

We aimed to determine the role of the wrist, elbow and shoulder joints to single-finger tapping. Six human subjects tapped with their index finger at a rate of 3 taps/s on a keyswitch across five conditions, one freestyle (FS) and four instructed tapping strategies. The four instructed conditions were to tap on a keyswitch using the finger joint only (FO), the wrist joint only (WO), the elbow joint only (EO), and the shoulder joint only (SO). A single-axis force plate measured the fingertip force. An infra-red active-marker three-dimensional motion analysis system measured the movement of the fingertip, hand, forearm, upper arm and trunk. Inverse dynamics estimated joint torques for the metacarpal-phalangeal (MCP), wrist, elbow, and shoulder joints. For FS tapping 27%, 56%, and 18% of the vertical fingertip movement were a result of flexion of the MCP joint and wrist joint and extension of the elbow joint, respectively. During the FS movements the net joint powers between the MCP, wrist and elbow were positively correlated (correlation coefficients between 0.46 and 0.76) suggesting synergistic efforts. For the instructed tapping strategies (FO, WO, EO, and SO), correlations decreased to values below 0.35 suggesting relatively independent control of the different joints. For FS tapping, the kinematic and kinetic data indicate that the wrist and elbow contribute significantly, working in synergy with the finger joints to create the fingertip tapping task.     

The effect of torque direction and cylindrical handle diameter on the coupling between the hand and a cylindrical handle

Pheasant and O'Neill's torque model (1975) was modified to account for grip force distributions. The modified model suggests that skin friction produced by twisting an object in the direction of fingertips causes flexion of the distal phalanges and increases grip force and, thus, torque. Twelve subjects grasped a cylindrical object with diameters of 45.1, 57.8, and 83.2 mm in a power grip, and performed maximum torque exertions about the long axis of the handle in two directions: the direction the thumb points and the direction the fingertips point. Normal force on the fingertips increased with torque toward the fingertips, as predicted by the model. Consequently, torque toward the fingertips was 22% greater than torque toward the thumb. Measured torque and fingertip forces were compared with model predictions. Torque could be predicted well by the model. Measured fingertip force and thumb force were, on average, 27% less than the predicted values. Consistent with previous studies, grip force decreased as the handle diameter increased from 45.1 to 83.2 mm. This may be due not only to the muscle length-strength relationship, but also to major active force locations on the hand: grip force distributions suggest that a small handle allows fingertip force and thumb force to work together against the palm, resulting in a high reaction force on the palm, and, therefore, a high grip force. For a large handle, fingertip force and thumb force act against each other, resulting in little reaction force on the palm and, thus, a low grip force.     

Non-linear viscoelastic models predict fingertip pulp force-displacement characteristics during voluntary tapping

We evaluated whether lumped-parameter non-linear viscoelastic models of human fingertip tissue can describe fingertip force-displacement characteristics during a range of rapid, dynamic tapping tasks. Eight human subjects tapped with their index finger on the surface of a rigid load cell while an optical system tracked fingertip position using an infra-red LED attached to the fingernail. Four different tapping conditions were tested: normal and high-speed taps with a relaxed hand, and normal and high-speed taps with the other fingers co-contracted. A non-linear viscoelastic model comprised of an instantaneous stiffness function and viscous relaxation function was capable of predicting fingertip tissue force response due to measured pulp compression under these four different loading conditions. The model could successfully reconstruct very rapid (less than 5 ms) force transients, and forces occurring over time periods greater than 100 ms, with errors of 10%. Model parameters varied by less than 20% over the four conditions, despite almost 3-fold differences in average forces and 38% differences in fingertip velocities. Energy dissipation by the fingertip averaged 81%, and varied little (<3%) across conditions, despite a 1. 5-fold range of energy input. The ability of a lumped-parameter model to describe fingertip force-displacement characteristics during a range of conditions contributes both to understanding the transmission of force through the fingertip to the musculoskeletal system and to predicting the stimulation of mechano-receptors located within the fingertip.     

Inheritance of finger pattern types in MZ and DZ twins

Digital patterns of a sample on twins were analyzed to estimate the resemblance between monozygotic (MZ) and dizygotic (DZ) twins and to evaluate the mode of inheritance by the use of maximum likelihood based variance decomposition analysis. MZ twin resemblance of finger pattern types appears to be more pronounced than in DZ twins, which suggests the presence of genetic factors in the forming of fingertip patterns. The most parsimonious model shows twin resemblance in count of all three basic finger patterns on 10 fingers. It has significant dominant genetic variance component across all fingers. In the general model, the dominant genetic variance component proportion is similar for all fingertips (about 60%) and the sibling environmental variance is significantly nonzero, but the proportion between additive and dominant variance components was different. Application of genetic model fitting technique of segregation analyses clearly shows mode of inheritance. A dominant genetic variance component or a specific genetic system modifies the phenotypic expression of the fingertip patterns. The present study provided evidence of strong genetic component in finger pattern types and seems more informative compared to the earlier traditional method of correlation analysis.     

Effects of Visual Cues of Object Density on Perception and Anticipatory Control of Dexterous Manipulation

Anticipatory force planning during grasping is based on visual cues about the object’s physical properties and sensorimotor memories of previous actions with grasped objects. Vision can be used to estimate object mass based on the object size to identify and recall sensorimotor memories of previously manipulated objects. It is not known whether subjects can use density cues to identify the object’s center of mass (CM) and create compensatory moments in an anticipatory fashion during initial object lifts to prevent tilt. We asked subjects (n = 8) to estimate CM location of visually symmetric objects of uniform densities (plastic or brass, symmetric CM) and non-uniform densities (mixture of plastic and brass, asymmetric CM). We then asked whether subjects can use density cues to scale fingertip forces when lifting the visually symmetric objects of uniform and non-uniform densities. Subjects were able to accurately estimate an object’s center of mass based on visual density cues. When the mass distribution was uniform, subjects could scale their fingertip forces in an anticipatory fashion based on the estimation. However, despite their ability to explicitly estimate CM location when object density was non-uniform, subjects were unable to scale their fingertip forces to create a compensatory moment and prevent tilt on initial lifts. Hefting object parts in the hand before the experiment did not affect this ability. This suggests a dichotomy between the ability to accurately identify the object’s CM location for objects with non-uniform density cues and the ability to utilize this information to correctly scale their fingertip forces. These results are discussed in the context of possible neural mechanisms underlying sensorimotor integration linking visual cues and anticipatory control of grasping.     

Lumped parameter thermal model for the study of vascular reactivity in the fingertip

Vascular reactivity (VR) denotes changes in volumetric blood flow in response to arterial occlusion. Current techniques to study VR rely on monitoring blood flow parameters and serve to predict the risk of future cardiovascular complications. Because tissue temperature is directly impacted by blood flow, a simplified thermal model was developed to study the alterations in fingertip temperature during arterial occlusion and subsequent reperfusion (hyperemia). This work shows that fingertip temperature variation during VR test can be used as a cost-effective alternative to blood perfusion monitoring. The model developed introduces a function to approximate the temporal alterations in blood volume during VR tests. Parametric studies are performed to analyze the effects of blood perfusion alterations, as well as any environmental contribution to fingertip temperature. Experiments were performed on eight healthy volunteers to study the thermal effect of 3 min of arterial occlusion and subsequent reperfusion (hyperemia). Fingertip temperature and heat flux were measured at the occluded and control fingers, and the finger blood perfusion was determined using venous occlusion plethysmography (VOP). The model was able to phenomenologically reproduce the experimental measurements. Significant variability was observed in the starting fingertip temperature and heat flux measurements among subjects. Difficulty in achieving thermal equilibration was observed, which indicates the important effect of initial temperature and thermal trend (i.e., vasoconstriction, vasodilatation, and oscillations).     

Directional Coordination of Thumb and Finger Forces during Precision Pinch

The human opposable thumb enables the hand to perform dexterous manipulation of objects, which requires well-coordinated digit force vectors. This study investigated the directional coordination of force vectors generated by the thumb and index finger during precision pinch. Fourteen right-handed, healthy subjects were instructed to exert pinch force on an externally stabilized apparatus with the pulps of the thumb and index finger. Subjects applied forces to follow a force-ramp profile that linearly increased from 0 to 12 N and then decreased to 0 N, at a rate of ±3 N/s. Directional relationships between the thumb and index finger force vectors were quantified using the coordination angle (CA) between the force vectors. Individual force vectors were further analyzed according to their projection angles (PAs) with respect to the pinch surface planes and the shear angles (SAs) within those planes. Results demonstrated that fingertip force directions were dependent on pinch force magnitude, especially at forces below 2 N. Hysteresis was observed in the force-CA relationship for increasing and decreasing forces and fitted with exponential models. The fitted asymptotic values were 156.0±6.6° and 150.8±9.3° for increasing and decreasing force ramps, respectively. The PA of the thumb force vector deviated further from the direction perpendicular to the pinching surface planes than that of the index finger. The SA showed that the index finger force vector deviated in the ulnar-proximal direction, whereas the thumb switched its force between the ulnar-proximal and radial-proximal directions. The findings shed light on the effects of anatomical composition, biomechanical function, and neuromuscular control in coordinating digit forces during precision pinch, and provided insight into the magnitude-dependent force directional control which potentially affects a range of dexterous manipulations.     

Differences in Context and Feedback Result in Different Trajectories and Adaptation Strategies in Reaching

Computational models of motor control have often explained the straightness of horizontal planar reaching movements as a consequence of optimal control. Departure from rectilinearity is thus regarded as sub-optimal. Here we examine if subjects may instead select to make curved trajectories following adaptation to force fields and visuomotor rotations. Separate subjects adapted to force fields with or without visual feedback of their hand trajectory and were retested after 24 hours. Following adaptation, comparable accuracies were achieved in two ways: with visual feedback, adapted trajectories in force fields were straight whereas without it, they remained curved. The results suggest that trajectory shape is not always straight, but is also influenced by the calibration of available feedback signals for the state estimation required by the task. In a follow-up experiment, where additional subjects learned a visuomotor rotation immediately after force field, the trajectories learned in force fields (straight or curved) were transferred when directions of the perturbations were similar but not when directions were opposing. This demonstrates a strong bias by prior experience to keep using a recently acquired control policy that continues to produce successful performance inspite of differences in tasks and feedback conditions. On relearning of force fields on the second day, facilitation by intervening visuomotor rotations occurred only when required motor adjustments and calibration of feedback signals were similar in both tasks. These results suggest that both the available feedback signals and prior history of learning influence the choice and maintenance of control policy during adaptations.     

Assessment of spatial acuity at the fingertip with grating (JVP) domes: validity for use in an elderly population

JVP domes are of a set of small grating surfaces recently introduced for cutaneous spatial resolution measurement. The gratings are placed on the skin and subjects are required to identify the orientation of grooves and bars. The finest grating whose orientations are discriminated reliably (75% correct) provides an estimate of the spatial resolution limit in the tested area. In the present study, we sought to determine the capacity of elderly subjects to resolve such grating stimuli in order to obtain normative data for this population. Thirty-two elderly individuals in good health (range: 60-88 years) were assessed for their ability to perceive grating orientation at the tip of the dominant index finger. Testing proceeded from the widest grating dome (3 mm) to the next (e.g., 2 mm), until the performance level dropped below 75% correct discrimination. The grating orientation task proved to be very difficult for most subjects and only a minority (14/32) was able to provide reliable reports of grating orientation even with presentation of the widest dome available (3 mm). Accordingly, individual grating resolution thresholds were often considerably higher (> 2.5 mm, n = 26) than values previously reported in young adults for the fingertip region (approximately 1 mm). These results suggest that the current set of grating domes may not be adequate for spatial acuity measurement at the fingertip of older adults. New larger grating dimensions should be added to the set presently available to improve their sensitivity for an older population.     

Assessment of spatial acuity at the fingertip with grating (JVP) domes: validity for use in an elderly population

JVP domes are of a set of small grating surfaces recently introduced for cutaneous spatial resolution measurement. The gratings are placed on the skin and subjects are required to identify the orientation of grooves and bars. The finest grating whose orientations are discriminated reliably (75% correct) provides an estimate of the spatial resolution limit in the tested area. In the present study, we sought to determine the capacity of elderly subjects to resolve such grating stimuli in order to obtain normative data for this population. Thirty-two elderly individuals in good health (range: 60-88 years) were assessed for their ability to perceive grating orientation at the tip of the dominant index finger. Testing proceeded from the widest grating dome (3 mm) to the next (e.g., 2 mm), until the performance level dropped below 75% correct discrimination. The grating orientation task proved to be very difficult for most subjects and only a minority (14/32) was able to provide reliable reports of grating orientation even with presentation of the widest dome available (3 mm). Accordingly, individual grating resolution thresholds were often considerably higher (>2.5 mm, n = 26) than values previously reported in young adults for the fingertip region (approximately 1 mm). These results suggest that the current set of grating domes may not be adequate for spatial acuity measurement at the fingertip of older adults. New larger grating dimensions should be added to the set presently available to improve their sensitivity for an older population.     

Modular neuromuscular control of human locomotion by central pattern generator

The central pattern generators (CPG) in the spinal cord are thought to be responsible for producing the rhythmic motor patterns during rhythmic activities. For locomotor tasks, this involves much complexity, due to a redundant system of muscle actuators with a large number of highly nonlinear muscles. This study proposes a reduced neural control strategy for the CPG, based on modular organization of the co-active muscles, i.e., muscle synergies. Four synergies were extracted from the EMG data of the major leg muscles of two subjects, during two gait trials each, using non-negative matrix factorization algorithm. A Matsuoka׳s four-neuron CPG model with mutual inhibition, was utilized to generate the rhythmic activation patterns of the muscle synergies, using the hip flexion angle and foot contact force information from the sensory afferents as inputs. The model parameters were tuned using the experimental data of one gait trial, which resulted in a good fitting accuracy (RMSEs between 0.0491 and 0.1399) between the simulation and experimental synergy activations. The model׳s performance was then assessed by comparing its predictions for the activation patterns of the individual leg muscles during locomotion with the relevant EMG data. Results indicated that the characteristic features of the complex activation patterns of the muscles were well reproduced by the model for different gait trials and subjects. In general, the CPG- and muscle synergy-based model was promising in view of its simple architecture, yet extensive potentials for neuromuscular control, e.g., resolving redundancies, distributed and fast control, and modulation of locomotion by simple control signals.     

Surface EMG analysis on normal subjects based on isometric voluntary contraction

The objective of this study was to compute reference SEMG values for normal subjects of 13 parameters extracted in the time, frequency and bispectrum domain, from the Biceps Brachii (BB) muscle generated under isometric voluntary contraction (IVC). SEMG signals were recorded from 94 subjects for 5 s at 10, 30, 50, 70 and 100% of maximum voluntary contraction (MVC). The Wilcoxon signed rank test was applied to detect significant differences or not at p < 0.05 between force levels for each of the 13 parameters. The main findings of this study can be summarized as follows: (i) The time domain parameters turns per second and number of zero crossings per second increase significantly with force level. (ii) The power spectrum median frequency parameter decreases significantly with force level, whereas maximum power and total power increase significantly with force level. (iii) The bispectrum parameter, maximum amplitude, increases significantly with force level with the exception the transition from 30% to 50% MVC. Although, the tests for Gaussianity and linearity show no significant difference with force level, the SEMG signal exhibits a more Gaussian distribution with increase of force up to 70% MVC. The SEMG linearity test, which is a measure of how constant the bicoherence index is in the bi-frequency domain, shows that the signal’s bicoherence index is less constant (hence, the signal is less linear) at 70% of MVC compared to 10, 30, 50 and 100% MVC. (iv) The time domain parameters have good correlation between them as well as, between each one of them and maximum and total power. The median frequency has a good (negative) correlation with the bispectrum peak amplitude. (v) No significant differences exist between values based on gender or age. The findings of this study can further be used for the assessment of subjects suffering with neuromuscular disorders, or in the rehabilitation laboratory for monitoring the elderly or the disabled, or in the occupational medicine laboratory.     

The effects of gastrocnemius–soleus muscle forces on ankle biomechanics during triple arthrodesis

This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major ankle muscles were simulated and corresponded well with the trend of their EMG signals. These forces were applied to the finite element model to obtain stress distributions for patients with triple arthrodesis and normal subjects in three stages of the gait cycle, i.e. heel strike, midstance, and heel rise. The results demonstrated that the stress distribution patterns of the tibio-talar joint in patients with triple arthrodesis differ from those of normal subjects in investigated gait cycle stages. The mean and standard deviations for maximum stresses in the tibo-talar joint in the stance phase for patients and normal subjects were 9.398e7 ± 1.75e7 and 7.372e7 ± 4.43e6 Pa, respectively. The maximum von Mises stresses of the tibio-talar joint for all subjects in the stance phase found to be on the lateral side of the inferior surface of the joint. The results also indicate that, in patients with triple arthrodesis, increasing gastrocnemius–soleus muscle force reduces the stress on the medial malleolus compared with normal subjects. Most of stresses in this area are between 45 and 109 kPa, and will decrease to almost 32 kPa in patients after increasing of 40% in gastrocnemius–soleus muscle force.     

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.