EMG monitoring in functional electrostimulation]

When using functional electrical stimulation (FES), correct adjustment of stimulation parameters, and monitoring of the stimulated muscle is mandatory if tissue damage is to be avoided. Although several FES systems are already in regular use, a method for direct muscle monitoring is still lacking. This paper investigates the suitability of the electromyogram (EMG) for such a purpose. In six sheep, the right latissimus dorsi muscle (LDM) and the associated thoracodorsal nerve were exposed. Stimulation was effected via electrodes placed on the nerve. Three electrodes were placed in the LDM for EMG recording, and the tendon was connected to a force transducer for isometric force measurement. Stimulation was applied for one second (burst), followed by a three-second pause. The stimulation current was increased in 0.2 mA steps, starting at 0 mA and ending at 4 mA. Throughout the investigation, the EMG signal was monitored with an oscilloscope. In addition, the EMG signal and the force transducer signal were recorded for subsequent analysis. An analysis of the data of all six sheep revealed an almost linear relationship between muscle force and m-wave amplitude (magnitude of r = 0.95, p < 0.001). M-wave monitoring during EMG recording with three intramuscular electrodes is a reliable method of monitoring FES-induced muscle activity, but the absolute force cannot be measured.     

Electromyographic measures of muscle activation and changes in muscle architecture of human elbow flexors during fatiguing contractions.

The study compared changes in intramuscular and surface recordings of EMG amplitude with ultrasound measures of muscle architecture of the elbow flexors during a submaximal isometric contraction. Ten subjects performed a fatiguing contraction to task failure at 20% of maximal voluntary contraction force. EMG activity was recorded in biceps brachii, brachialis, and brachioradialis muscles using intramuscular and surface electrodes. The rates of increase in the amplitude of the surface EMG for the long and short heads of biceps brachii and brachioradialis were greater than those for the intramuscular recordings measured at different depths. The amplitude of the intramuscular recordings from three muscles increased at a similar rate (P = 0.13), as did the amplitude of the three surface recordings from two muscles (P = 0.83). The increases in brachialis thickness (27.7 +/- 5.7 to 30.9 +/- 3.5 mm; P < 0.05) and pennation angle (10.9 +/- 3.5 to 16.5 +/- 4.8 degrees ; P = 0.003) were not associated with the increase in intramuscular EMG amplitude (P > 0.58). The increase in brachioradialis thickness (22.8 +/- 4.8 to 25.5 +/- 3.4 mm; P = 0.0075) was associated with the increase in the amplitude for one of two intramuscular EMG signals (P = 0.007, r = 0.79). The time to failure was more strongly associated with the rate of increase in the amplitude of the surface EMG than that for the intramuscular EMG, which suggests that the surface measurement provides a more appropriate measure of the change in muscle activation during a fatiguing contraction.     

Evolution of surface electromyography: From muscle electrophysiology towards neural recording and interfacing

Surface electromyography (EMG) comprises a recording of electrical activity from the body surface generated by muscle fibres during muscle contractions. Its characteristics depend on the fibre membrane potentials and the neural activation signal sent from the motor neurons to the muscles. EMG has been classically used as the primary investigation tool in kinesiology studies in a variety of applications. More recently, surface EMG techniques have evolved from single-channel methods to high-density systems with hundreds of electrodes. High-density EMG recordings can be deconvolved to estimate the discharge times of spinal motor neurons innervating the recorded muscles, with algorithms that have been developed and validated in the last two decades. Within limits and with some variability across muscles, these techniques provide a non-invasive method to study relatively large populations of motor neurons in humans. Surface EMG is thus evolving from a peripheral measure of muscle electrical activity towards a neural recording and neural interfacing signal. These advances in technology have had a major impact on our fundamental understanding of the neural control of movement and have exposed new perspectives in neurotechnologies. Here we provide an overview and perspective of modern EMG technology, as derived from past achievements, and its impact in neurophysiology and neural engineering.     

EMG muscle scanning: comparison to attached surface electrodes.

Electromyographic (EMG) muscle scanning measures brief samples of integrated muscle action potentials from individual muscles using a hand-held scanner with post-style electrodes. This "scanning" technique is widely used by biofeedback practitioners to quickly assess muscle activity in the diagnosis of musculoskeletal disorders. In an effort to compare muscle scanning with the established technique using attached surface electrodes, ten healthy subjects (25-35 years old) were scanned using 2-second sampling at five bilateral muscle sites while simultaneously monitoring the same sites with surface electrodes. This was repeated using 10-second scanning samplings. Pearson's product-moment correlations between scanning for 2 seconds and prolonged surface recording at all sites were 0.54-0.89. Scanning for 10 seconds improved the correlations to 0.68-0.91. EMG scanning for 2 seconds compares favorably with attached surface electrode recording. Comparisons are further improved by 10-second scans.     

Insight into the function of the obturator internus muscle in humans: Observations with development and validation of an electromyography recording technique

There are no direct recordings of obturator internus muscle activity in humans because of difficult access for electromyography (EMG) electrodes. Functions attributed to this muscle are based on speculation and include hip external rotation/abduction, and a role in stabilization as an “adjustable ligament” of the hip. Here we present (1) a technique to insert intramuscular EMG electrodes into obturator internus plus (2) the results of an investigation of obturator internus activity relative to that of nearby hip muscles during voluntary hip efforts in two hip positions and a weight-bearing task. Fine-wire electrodes were inserted with ultrasound guidance into obturator internus, gluteus maximus, piriformis and quadratus femoris in ten participants. Participants performed ramped and maximal isometric hip efforts (open kinetic chain) into flexion/extension, abduction/adduction, and internal/external rotation, and hip rotation to end range in standing. Analysis of the relationship between activity of the obturator internus and the other hip muscles provided evidence of limited contamination of the recordings with crosstalk. Obturator internus EMG amplitude was greatest during hip extension, then external rotation then abduction, with minimal to no activation in other directions. Obturator internus EMG was more commonly the first muscle active during abduction and external rotation than other muscles. This study describes a viable and valid technique to record obturator internus EMG and provides the first evidence of its activation during simple functions. The observation of specificity of activation to certain force directions questions the hypothesis of a general role in hip stabilisation regardless of force direction.     

Static optimization underestimates antagonist muscle activity at the glenohumeral joint: A musculoskeletal modeling study

Static optimization is commonly employed in musculoskeletal modeling to estimate muscle and joint loading; however, the ability of this approach to predict antagonist muscle activity at the shoulder is poorly understood. Antagonist muscles, which contribute negatively to a net joint moment, are known to be important for maintaining glenohumeral joint stability. This study aimed to compare muscle and joint force predictions from a subject-specific neuromusculoskeletal model of the shoulder driven entirely by measured muscle electromyography (EMG) data with those from a musculoskeletal model employing static optimization. Four healthy adults performed six sub-maximal upper-limb contractions including shoulder abduction, adduction, flexion, extension, internal rotation and external rotation. EMG data were simultaneously measured from 16 shoulder muscles using surface and intramuscular electrodes, and joint motion evaluated using video motion analysis. Muscle and joint forces were calculated using both a calibrated EMG-driven neuromusculoskeletal modeling framework, and musculoskeletal model simulations that employed static optimization. The EMG-driven model predicted antagonistic muscle function for pectoralis major, latissimus dorsi and teres major during abduction and flexion; supraspinatus during adduction; middle deltoid during extension; and subscapularis, pectoralis major and latissimus dorsi during external rotation. In contrast, static optimization neural solutions showed little or no recruitment of these muscles, and preferentially activated agonistic prime movers with large moment arms. As a consequence, glenohumeral joint force calculations varied substantially between models. The findings suggest that static optimization may under-estimate the activity of muscle antagonists, and therefore, their contribution to glenohumeral joint stability.     

Ultrasound-guided insertion of intramuscular electrodes into suboccipital muscles in the non-human primate

The head-neck system is highly complex from a biomechanical and musculoskeletal perspective. Currently, the options for recording the recruitment of deep neck muscles in experimental animals are limited to chronic approaches requiring permanent implantation of electromyographic electrodes. Here, we describe a method for targeting deep muscles of the dorsal neck in non-human primates with intramuscular electrodes that are inserted acutely. Electrode insertion is guided by ultrasonography, which is necessary to ensure placement of the electrode in the target muscle. To confirm electrode placement, we delivered threshold electrical stimulation through the intramuscular electrode and visualized the muscle twitch. In one animal, we also compared recordings obtained from acutely- and chronically-implanted electrodes. This method increases the options for accessing deep neck muscles, and hence could be used in experiments for which the invasive surgery inherent to a chronic implant is not appropriate. This method could also be extended to the injection of pharmacological agents or anatomical tracers into specific neck muscles.     

Chronic polyelectromyography in awake, unrestrained animals.

A procedure is described for making an implantable electrode array for recording EMG activity in muscles of awake, unrestrained animals (rats and cats) at rest, during rhythmic activity and in response to various reflexogenic stimuli. The electrode array consists of a percutaneous connector (covered with Dow-Corning Silastic Medical Adhesive), steel wire spiral leads contained in silicone tubing and silicone plate probes with platinum electrodes. These plate probes can be fixed either to the bone underneath the muscle, slipped under the fascia, or fixed between muscles. EMG records are presented of postural activity and ambulation in rats, mastication in cats and unilateral and bilateral spinal and supraspinal reflex responses in rat hind limb muscles up to 6 months after implantation. The advantages (and drawbacks) of this technique and its possible uses in neurophysiology are enumerated in the discussion.     

Comparison of force and EMG measures in normal and reinnervated tibialis anterior muscles of the rat.

The relationship between motor unit force and the recorded voltage produced by activated muscle unit fibres (electromyogram, EMG) was examined in normal and reinnervated rat tibialis anterior muscles. The number, cross-sectional area, and radial distance from the recording electrode of muscle fibres in a given unit, obtained directly from a sample of glycogen-depleted motor units, were analysed in relation to the magnitude of the EMG signal produced by that unit. EMG peak to peak amplitude and area varied as approximately the square root of twitch force in both normal and reinnervated units. Furthermore, the EMG amplitude increased approximately as the total cross-sectional area of the motor unit (number of muscle fibres x the average cross-sectional area of the fibres) and inversely with approximately the square root of the distance of fibres from the recording electrodes on the surface of the muscle.     

Specificity of esophageal electrode recordings of posterior cricoarytenoid muscle activity

Esophageal electrodes have been used for recording the electromyographic (EMG) activity of the posterior cricoarytenoid muscle (PCA). To determine the specificity of this EMG technique, esophageal electrode recordings were compared with intramuscular recordings in eight anesthetized mongrel dogs. Intramuscular wire electrodes were placed in the right and left PCA, and the esophageal electrode was introduced through the nose or mouth and advanced into the upper esophagus. On direct visualization of the upper airway, the unshielded catheter electrode entered the esophagus on the right or left side. Cold block of the recurrent laryngeal nerve (RLN) ipsilateral to the esophageal electrode was associated with a marked decrease in recorded activity, whereas cold block of the contralateral RLN resulted only in a small reduction in activity. After supplemental doses of anesthesia were administered, bilateral RLN cold block essentially abolished the activity recorded with the intramuscular electrodes as well as that recorded with the esophageal electrode. Before supplemental doses of anesthesia were given, especially after vagotomy, the esophageal electrode, and in some cases the intramuscular electrodes, recorded phasic inspiratory activity not originating from the PCA. Therefore, one should be cautious in interpreting the activity recorded from esophageal electrodes as originating from the PCA, especially in conditions associated with increased respiratory efforts.     

Electromyographic recordings of paraspinal muscles: Variations related to subcutaneous tissue thickness

The aim of this study was to assess the effect on EMG amplitude measures of variations in the thickness of underlying tissue between surface electrodes and the active muscle. 20 normal subjects with different amounts of subcutaneous tissue performed comparable constant force contractions for a 45-second period, during which paraspinal EMG recordings were taken. Three measures of subcutaneous tissue thickness were obtained from each subject: Body Mass Index, total body fat as calculated by Durnin's formula, and skinfold thickness at the recording sites. The results show that (i) the greater the thickness of subcutaneous tissue between the surface recording site and the contracting muscles, the lower the recorded electromyographic activity, and that (ii) up to 81.2% of the variance in the EMG measures can be explained by variation in the amount of subcutaneous tissue. These findings support the view that the absolute level of surface-recorded EMG cannot simply be taken at face value. The amplitude of the signal will be affected by, for example, the amount of body fat.Supported by the Physician's Services Inc. Foundation.     

Subject-specific thumb muscle activity during functional tasks of daily life

BackgroundThe trapeziometacarpal joint is subjected to high compressive forces during powerful pinch and grasp tasks due to muscle loading. In addition, muscle contraction is important for stability of the joint. The aim of the present study is to explore if different muscle activation patterns can be found between three functional tasks.MethodsIsometric forces and fine-wire electromyographic (fEMG) activity produced by three intrinsic and four extrinsic thumb muscles were measured in 10 healthy female volunteers. The participants performed isometric contractions in a lateral key pinch, a power grasp and a jar twist task. The tasks were executed with and without EMG recording to verify if electrode placement influenced force production.ResultsA subject-specific muscle recruitment was found which remained largely unchanged across tasks. Extrinsic thumb muscles were significantly more active than intrinsic muscles in all tasks. Insertion of the fEMG electrodes decreased force production significantly in all tasks.ConclusionThe thumb muscles display a high variability in muscle activity during functional tasks of daily life. The results of this study suggest that to produce a substantial amount of force, a well-integrated, but subject-specific, co-contraction between the intrinsic and extrinsic thumb muscles is necessary.     

A new technique for the selective recording of extensor carpi radialis longus and brevis EMG.

Tennis Elbow or Lateral Epicondylalgia is manifested by pain over the region of the lateral epicondyle of the humerus, related to use of the wrist extensor muscles. Extensor carpi radialis longus (ECRL) and brevis (ECRB) have been implicated in the dysfunction associated with Lateral Epicondylalgia. For muscles in the human forearm, particularly those in close proximity, selective recordings are nearly impossible without the use of fine wire, indwelling electrodes. These can be inserted in precise locations and have small recording areas. Standard electromyography texts indicate, however, that the activity of ECRL and ECRB cannot be distinguished, even with intramuscular electrodes. We present a new technique for determining the most appropriate sites at which to insert intramuscular electrodes for selective recordings of ECRB and ECRL. The location of ECRB and ECRL was measured on 10 cadaver specimens, 5 right arms and 5 left arms. The distance from the muscle origin to (1) insertion, (2) largest portion of the muscle belly, (3) most proximal fibres and (4) most distal fibres were measured and expressed relative to forearm length. The mean distance and 95% confidence interval was calculated for each of the four measures. These data indicated a significant separation of the belly of each muscle along the length of the forearm. These relative distances were used to mark electrode insertion points on three volunteers. Fine wire electrodes were used to record the electromyogram in three participants. Each participant was required to perform isometric contractions to produce (1) wrist extension torque, (2) radial deviation torque, (3) elbow flexion torque and (4) finger extension. The electromyographic recordings show clear differentiation of ECRB and ECRL with the relative activation patterns reflecting the underlying anatomical organisation of the two muscles. This technique provides an important objective method that can be used in conjunction with manual muscle testing to provide a means of ensuring accurate intramuscular electromyographic recording from these two muscles.     

Rectus femoris surface myoelectric signal cross-talk during static contractions

The clinical application of EMG requires that the recorded signal is representative of the muscle of interest and is not contaminated with signals from adjacent muscles. Some authors report that surface EMG is not suitable for obtaining information on a single muscle but rather reflects muscle group function [J. Perry, C.S. Easterday, D.J. Antonelli, Surface versus intramuscular electrodes for electromyography of superficial and deep muscles. Physical Therapy 61 (1981) 7–15]. Other authors report however, that surface EMG is adequate to determine individual muscle function, once guidelines pertaining to data acquisition are followed [D.A. Winter, A.J. Fuglevand, S.E. Archer. Cross-talk in surface electromyography: theoretical and practical estimates. Journal of Electromyography and Kinesiology 4 (1994) 15–26]. The aim of this study was to determine whether surface EMG was suitable for monitoring rectus femoris (RF) activity during static contractions. Five healthy subjects, having given written informed consent, participated in this trial. Surface and fine wire EMG from the rectus femoris and the vastus lateralis (VL) muscles were recorded simultaneously during a protocol of static contractions consisting of knee extensions and hip flexions. Ratios were used to quantify the relationship between the surface EMG amplitude value and the fine wire EMG amplitude value for the same contraction. The results showed that hip flexion contractions elicited RF activation only and that knee extension contractions elicited fine wire activity in VL only. When the relationship between RF surface and RF fine wire electrodes was compared for hip flexion and knee extension contractions, it was observed that for all subjects, there was a tendency for increased RF surface activity in the absence of RF fine wire activity during knee extensions. It was concluded that the activity recorded by the RF surface electrode arrangement during knee extension consisted of EMG from the vastii, i.e., cross-talk and that vastus intermedius was the most likely origin of the erroneous signal. Therefore it is concluded that for accurate EMG information from RF, fine wire electrodes are necessary during a range of static contractions.     

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.     

The effect of handedness on electromyographic activity of human shoulder muscles during movement.

The aim of the study was to investigate whether there was a difference in the electromyographic (EMG) activity of human shoulder muscles between the dominant and nondominant side during movement and to explore whether a possible side-difference depends on the specific task. We compared the EMG activity with surface and intramuscular electrodes in eight muscles of both shoulders in 20 healthy subjects whose hand preference was evaluated using a standard questionnaire. EMG signals were recorded during abduction and external rotation. During abduction, the normalized EMG activity was significantly smaller on the dominant side compared to the nondominant side for all the muscles except for infraspinatus and lower trapezius (P 相似文献   

On the suitability of using surface electrode placements to estimate muscle activity of the rotator cuff as recorded by intramuscular electrodes

BackgroundElectromyography (EMG) is commonly used to assess muscle activity. Although previous studies have had moderate success in predicting individual intramuscular muscle activity from surface electrodes, extensive data does not exist for the rotator cuff. This study aimed to determine how reliably surface electrodes represent rotator cuff activity during 20 maximal exertions.MethodsFive channels of EMG were recorded on the following rotator cuff muscles: supraspinatus and infraspinatus intramuscular and surface recordings, and teres minor intramuscular recordings. An additional 3 surface electrodes were placed over the upper and middle trapezius and posterior deltoid. Subjects performed ramped maximal voluntary contractions (MVCs) for each muscle, followed by 20 isometric maximal exertions. Linear least squares best fit regressions (unconstrained and constrained with zero-intercept) were used to compare: intramuscular and surface supraspinatus and infraspinatus signals, respectively, and intramuscular teres minor and surface infraspinatus signals.FindingsRelationships existed between wire and surface electrode measurements for all rotator cuff muscles: supraspinatus (r² = 0.73); teres minor (r² = 0.61); infraspinatus (r² = 0.40), however prediction equations indicated large overestimations and offsets.InterpretationWhen appropriate multiplicative coefficients are considered, surface supraspinatus and infraspinatus electrodes may be used to estimate intramuscular supraspinatus and teres minor activations, respectively, in maximal exertions similar to those tested. However, until these relationships are better defined in other postures, intensities and exertion types, the use of surface electrodes to estimate indwelling rotator cuff activity is cautioned against.     

Methodological aspects of SEMG recordings for force estimation – A tutorial and review

Insight into the magnitude of muscle forces is important in biomechanics research, for example because muscle forces are the main determinants of joint loading. Unfortunately muscle forces cannot be calculated directly and can only be measured using invasive procedures. Therefore, estimates of muscle force based on surface EMG measurements are frequently used. This review discusses the problems associated with surface EMG in muscle force estimation and the solutions that novel methodological developments provide to this problem. First, some basic aspects of muscle activity and EMG are reviewed and related to EMG amplitude estimation. The main methodological issues in EMG amplitude estimation are precision and representativeness. Lack of precision arises directly from the stochastic nature of the EMG signal as the summation of a series of randomly occurring polyphasic motor unit potentials and the resulting random constructive and destructive (phase cancellation) superimpositions. Representativeness is an issue due the structural and functional heterogeneity of muscles. Novel methods, i.e. multi-channel monopolar EMG and high-pass filtering or whitening of conventional bipolar EMG allow substantially less variable estimates of the EMG amplitude and yield better estimates of muscle force by (1) reducing effects of phase cancellation, and (2) adequate representation of the heterogeneous activity of motor units within a muscle. With such methods, highly accurate predictions of force, even of the minute force fluctuations that occur during an isometric and isotonic contraction have been achieved. For dynamic contractions, EMG-based force estimates are confounded by the effects of muscle length and contraction velocity on force producing capacity. These contractions require EMG amplitude estimates to be combined with modeling of muscle contraction dynamics to achieve valid force predictions.     

EMG muscle scanning: Comparison to attached surface electrodes

Electromyographic (EMG) muscle scanning measures brief samples of integrated muscle action potentials from individual muscles using a hand-held scanner with post-style electrodes. This scanning technique is widely used by biofeedback practitioners to quickly assess muscle activity in the diagnosis of musculoskeletal disorders. In an effort to compare muscle scanning with the established technique using attached surface electrodes, ten healthy subjects (25–35 years old) were scanned using 2-second sampling at five bilateral muscle sites while simultaneously monitoring the same sites with surface electrodes. This was repeated using 10-second scanning samplings. Pearson's product-moment correlations between scanning for 2 seconds and prolonged surface recording at all sites were 0.54–0.89. Scanning for 10 seconds improved the correlations to 0.68–0.91. EMG scanning for 2 seconds compares favorably with attached surface electrode recording. Comparisons are further improved by 10-second scans.     

A biomechanical model to estimate corrective changes in muscle activation patterns for stroke patients

We have created a model to estimate the corrective changes in muscle activation patterns needed for a person who has had a stroke to walk with an improved gait-nearing that of an unimpaired person. Using this model, we examined how different functional electrical stimulation (FES) protocols would alter gait patterns. The approach is based on an electromyographically (EMG)-driven model to estimate joint moments. Different stimulation protocols were examined, which generated different corrective muscle activation patterns. These approaches grouped the muscles together into flexor and extensor groups (to simulate FES using surface electrodes) or left each muscle to vary independently (to simulate FES using intramuscular electrodes). In addition, we limited the maximal change in muscle activation (to reduce fatigue). We observed that with the two protocols (grouped and ungrouped muscles), the calculated corrective changes in muscle activation yielded improved joint moments nearly matching those of unimpaired subjects. The protocols yielded different muscle activation patterns, which could be selected based on practical condition. These calculated corrective muscle activation changes can be used in studying FES protocols, to determine the feasibility of gait retraining with FES for a given subject and to determine which protocols are most reasonable.