Amplitude-related characteristics of motor unit and M-wave potentials during fatigue. A simulation study using literature data on intracellular potential changes found in vitro.

To realize possible reasons for changes in EMG amplitude characteristics with fatigue, we analyzed motor unit potentials (MUPs) and M-waves under simultaneous variations of the intracellular action potential (IAP) amplitude, duration, and shape as well as of the muscle fiber propagation velocity and desynchronization in activation of individual muscle fibers. Analysis was performed through computer simulation of MUPs and M-waves detected at different distances from active fibers in infinite anisotropic volume conductor. Changes in the IAP spike and negative after-potential were taken from in vitro experiments reported in the literature. It was shown that the amplitudes of MUP and M-wave detected simultaneously at different distances could decrease close to the active fibers, be almost unchanged at middle distances, and increase far from the fibers even under IAP amplitude decreasing. This reflected the distance-dependent effects of changes in the IAP profile along the fiber. Electrode position affected sensitivity of MUP and M-wave durations to changes in the IAP duration and propagation velocity. Thus, the signal area and RMS depended on electrode position and could change with fatigue in a way different from that of signal amplitude. The results can help to avoid misleading interpretation of EMG changes.     

Simulation analysis of interference EMG during fatiguing voluntary contractions. Part II--changes in amplitude and spectral characteristics.

Capabilities of amplitude and spectral methods for information extraction from interference EMG signals were assessed through simulation and preliminary experiment. Muscle was composed of 4 types of motor units (MUs). Different hypotheses on changes in firing frequency of individual MUs, intracellular action potential (IAP) and muscle fibre propagation velocity (MFPV) during fatigue were analyzed. It was found that changes in amplitude characteristics of interference signals (root mean square, RMS, or integrated rectified value, IEMG) detected by intramuscular and surface electrodes differed. RMS and IEMG of surface detected interference signals could increase even under MU firing rate reduction and without MU synchronisation. IAP profile lengthening can affect amplitude characteristics more significantly than MU firing frequency. Thus, an increase of interference EMG amplitude is unreliable to reflect changes in the neural drive. The ratio between EMG amplitude and contraction response can hardly characterise the so-called 'neuromuscular efficiency'. The recently proposed spectral fatigue indices can be used for quantification of interference EMG signals. The indices are practically insensitive to MU firing frequency. IAP profile lengthening and decrease in MFPV enhanced the index value, while recruitment of fast fatigable MUs reduced it. Sensitivity of the indices was higher than that of indices traditionally used.     

Intracellular action potential generation and extinction strongly affect the sensitivity of M-wave characteristic frequencies to changes in the peripheral parameters with muscle fatigue.

Changes in muscle fibre propagation velocity (MFPV) and shape of intracellular action potentials (IAPs) accompany peripheral muscle fatigue. We have shown through mathematical simulations that the effects of IAP generation and extinction reduced the sensitivity of the mean (fmean) and median (fmed) frequency of M-wave power spectra to individual changes in MFPV. Due to the differences in weighting of the spectral components used for calculation of the characteristic frequencies, the highest spectral components of the M-wave affected the fmean more than the fmed. These components are related to the M-wave leading edge that reflects the IAP depolarization phase. They reduced the sensitivity of the spectral moment of order 1 to individual changes in MFPV and increased its sensitivity to IAP changes. Since the changes of the IAP depolarization phase during the final stages of peripheral muscle fatigue affected the fmean more, the range of the relative reductions of the fmean and fmed were approximately the same under combined changes in IAP and MFPV. The sensitivities of M-wave characteristic frequencies depended also on the electrode arrangement and position as well as on the length of active muscle fibres.     

Simulation analysis of interference EMG during fatiguing voluntary contractions. Part I: What do the intramuscular spike amplitude–frequency histograms reflect?

Decline in amplitude of EMG signals and in the rate of counts of intramuscularly recorded spikes during fatigue is often attributed to a progressive reduction of the neural drive only. As a rule, alterations in intracellular action potential (IAP) are not taken into account. To test correctness of the hypothesis, the effect of various discharge frequency patterns as well as changes in IAP shape and muscle fibre propagation velocity (MFPV) on the spike amplitude-frequency histogram of intramuscular interference EMG signals were simulated and analyzed. It was assumed that muscle was composed of four types of motor units (MUs): slow-twitch fatigue resistant, fast-twitch fatigue resistant, fast intermediate, and fast fatigable. MFPV and IAP duration at initial stage before fatigue as well as their changes differed for individual MU types. Fatigability of individual MU types in normal conditions as well as in the case of ischaemic or low oxygen conditions due to restricted blood flow was also taken into account. It was found that spike amplitude-frequency histogram is poorly sensitive to MU firing frequency, while it is highly sensitive to IAP profile lengthening. It is concluded that spike amplitude-frequency analysis can hardly provide a correct measure of MU rate-coding pattern during fatigue.     

Simulation analysis of the performance of a novel high sensitive spectral index for quantifying M-wave changes during fatigue.

A high sensitive fatigue index is desired to improve stimulation strategy and to prevent muscle damage in functional electrical simulations. The great number of indexes used shows that there is no index that satisfies all investigators. A way to develop a high sensitive index for quantifying M-wave changes during fatigue and to estimate its performance was analyzed. The changes in M-wave and its frequency distribution due to variations of intracellular action potential (IAP) and muscle fibre propagation velocity (MFPV) with fatigue were simulated. It was found that the ratio between the spectral moments of order -1 and 2 was considerably more sensitive to peripheral muscle fatigue than the mean (the ratio between the spectral moments of order 1 and 0) and median frequency traditionally used. The sensitivity of the new index depended on the electrode arrangement and position in respect to the active fibres. The belly-tendon detection promised the highest index sensitivity. The length of the active fibres also affected the index sensitivity. The shorter the fibres the lower was the index sensitivity. The sensitivity of the new index could be relatively high even in the case of traditionally used high-pass cut-off frequencies that could distort the M-wave shape.     

Interpretation of EMG integral or RMS and estimates of “neuromuscular efficiency” can be misleading in fatiguing contraction

In occupational and sports physiology, reduction of neuromuscular efficiency (NME) and elevation of amplitude characteristics, such as root mean square (RMS) or integral of surface electromyographic (EMG) signals detected during fatiguing submaximal contraction are often related to changes in neural drive. However, there is data showing changes in the EMG integral (I_EMG) and RMS due to peripheral factors. Causes for these changes are not fully understood. On the basis of computer simulation, we demonstrate that lengthening of intracellular action potential (IAP) profile typical for fatiguing contraction could affect EMG amplitude characteristics stronger than alteration in neural drive (central factors) defined by number of active motor units (MUs) and their firing rates. Thus, relation of these EMG amplitude characteristics only to central mechanisms can be misleading. It was also found that to discriminate between changes in RMS or I_EMG due to alterations in neural drive from changes due to alterations in peripheral factors it is better to normalize RMS of EMG signals to the RMS of M-wave. In massive muscles, such normalization is more appropriate than normalization to either peak-to-peak amplitude or area of M-wave proposed in literature.     

Factors affecting the turns analysis of the interference EMG signal

This study was performed to evaluate the relative significance of changes typical for muscle fatigue on quantitative parameters obtained from turns analysis of simulated intramuscular and surface interference electromyographic (EMG) signals. Effects of reduction of firing rate of motor units (MUs) and changes of intracellular action potential (IAP) profile along active fibers were analyzed. A new analytic function was proposed to simulate changes in IAP shape at different stages of muscle fatigue. In intramuscular EMG, both the decrease in firing rate of MUs and the changes in IAP profile led to reduction in the number of turns per second (NTs) and mean turn amplitude (MTA). The development of fatigue and especially the changes in IAP profile could explain why NTs increased up to only about 50% of maximal voluntary contraction, and remained unchanged above that level of efforts or even decreased. These effects should be especially pronounced in patients with myopathy whose IAP and muscle fatigability are expected to be abnormal. In surface EMG, the MTA increased considerably with fatigue; the sensitivity of NTs to reduction in firing rate (or number of discharges) was low. Thus, the benefits of the turns analysis of surface EMG signals should be lower not only in diagnosis of myopathy but also neuropathy.     

Physiological characteristics of motor units in the brachioradialis muscle across fatiguing low-level isometric contractions.

The purpose of this study was to determine (i) if decomposition-based quantitative electromyography (DQEMG) could detect changes in motor unit potential (MUP) morphology and motor unit (MU) firing pattern statistics associated with muscle fatigue, (ii) if any detected changes are correlated with surface electromyographic (SEMG) signs of fatigue, and (iii) if significant fatigue-dependent changes are repeatable within individuals. Mean MU firing rates and the morphology of MUPs detected using needle and surface electrodes during constant-torque isometric contractions held until exhaustion were investigated in the brachioradialis (BR) muscle in 10 healthy volunteers (mean age=28.6 yr, SD+/-3.9). Time dependant changes were investigated using an analysis of variance with normalized time as a main effect. Partial correlation coefficients were computed using a repeated measures analysis of covariance to determine if changes in MU firing rates, needle-detected MUPs and surface-detected MUPs (SMUPs) were related to changes in SEMG signal amplitude and frequency parameters. Intraclass correlation coefficients (ICCs) were used to determine the within-subject repeatability of changes in MU firing rates, and MUP and SMUP parameters. Significant decreases in mean MU firing rates were found along with significant increases in various duration and area related parameters in both MUPs and SMUPs across the fatiguing contraction. The SEMG signal demonstrated the expected changes with fatigue: an increase in amplitude and a decrease in frequency content. SEMG amplitude was significantly positively correlated with SMUP peak-to-peak voltage (r=0.85, p<0.05), and SMUP area (r=0.86, p<0.05). Mean power frequency was significantly negatively correlated with SMUP negative peak duration (r=-0.74, p<0.05). The significant time-dependent changes were reliably observed (ICCs were 0.94 for MUP peak to peak amplitude, 0.97 for MUP area and 0.95 for MUP area to amplitude ratio, 0.95 for SMUP peak-to-peak voltage, 0.83 for SMUP area, 0.99 for SMUP negative peak amplitude and 0.88 for SMUP negative peak area). The decreases in mean MU firing rates measured along with the increases in amplitude, duration and area parameters of MUPs and SMUPs and their partial correlation with SEMG amplitude during submaximal fatiguing contractions of the BR, suggest that recruitment is a main cause of increased SEMG amplitude parameters with fatigue. We conclude that DQEMG can be effectively and reliably used to detect changes in physiological characteristics of MUs that accompany fatigue.     

Limiting mechanisms of force production after repetitive dynamic contractions in human triceps surae.

The influence of repetitive dynamic fatiguing contractions on the neuromuscular characteristics of the human triceps surae was investigated in 10 subjects. The load was 50% of the torque produced during a maximal voluntary contraction, and the exercise ended when the ankle range of motion declined to 50% of control. The maximal torque of the triceps surae and the electromyographic (EMG) activities of the soleus and medial gastrocnemius were studied in response to voluntary and electrically induced contractions before and after the fatiguing task and after 5 min of recovery. Reflex activities were also tested by recording the Hoffmann reflex (H reflex) and tendon reflex (T reflex) in the soleus muscle. The results indicated that whereas the maximal voluntary contraction torque, tested in isometric conditions, was reduced to a greater extent (P < 0.05) at 20 degrees of plantar flexion (-33%) compared with the neutral position (-23%) of the ankle joint, the EMG activity of both muscles was not significantly reduced after fatigue. Muscle activation, tested by the interpolated-twitch method or the ratio of the voluntary EMG to the amplitude of the muscle action potential (M-wave), as well as the neuromuscular transmission and sarcolemmal excitation, tested by the M-wave amplitude, did not change significantly after the fatiguing exercise. Although the H and T reflexes declined slightly (10-13%; P < 0.05) after fatigue, these adjustments did not appear to have a direct deleterious effect on muscle activation. In contrast, alterations in the mechanical twitch time course and postactivation potentiation indicated that intracellular Ca(2+)-controlled excitation-contraction coupling processes most likely played a major role in the force decrease after dynamic fatiguing contractions performed for short duration.     

Electromyogram median frequency, spectral compression and muscle fibre conduction velocity during sustained sub-maximal contraction of the brachioradialis muscle.

Changes in the median frequency of the power spectrum of the surface electromyogram (EMG) are commonly used to detect muscle fatigue. Previous research has indicated that changes in the median frequency are related to decreases in muscle fibre conduction velocity (MFCV) during sustained fatiguing contractions. However, in experimental studies the median frequency has been consistently observed to decrease by a relatively greater amount than MFCV. In this paper, a new estimate of EMG frequency compression, the Spectral Compression Estimate (SCE), is compared with the median frequency of the EMG power spectrum, the median frequency of the EMG amplitude spectrum and MFCV measured during sustained, isometric, fatiguing contractions of the brachioradialis muscle at 30, 50 and 80% maximum voluntary contraction (MVC). The SCE is found to provide a better estimate of the observed changes in MFCV than the median frequency of either the EMG power spectrum or EMG amplitude spectrum.     

Triceps surae stretch and voluntary contraction alters maximal M-wave magnitude.

Reliability of the motor response (M-wave) is fundamental in many reflex studies; however it has recently been shown to change during some investigations. The aim of this investigation was to determine if triceps surae stretch and voluntary contraction, or recording and analysis techniques, affect the maximal M-wave magnitude. The maximal M-wave was investigated in human gastrocnemius and soleus during different foot positions and during triceps surae contraction. Both bipolar and monopolar-recoding methods, and area and peak-to-peak (PTP) amplitude analysis methods were used. RESULTS: Maximal M-wave magnitude changed significantly between test muscle conditions, and is largest during dorsiflexion, probably due to changes in muscle bulk and recording electrode relationship. The maximal M-wave was up to 88% smaller when recorded by bipolar electrodes compared to monopolar electrodes, which is discussed in relation to signal cancellation. Area analysis provided more significant differences in M-wave magnitude between test muscle conditions than did PTP amplitude analysis, and the maximal M-wave shape changed significantly between test muscle conditions. This study suggests that maximal M-wave magnitude can vary depending on muscle condition, it highlights the importance of using correct recording and analysis techniques, and questions the reliability of using M-wave magnitude to monitor the relationship between the nerves and stimulating electrodes.     

Estimation of the muscle fibre semi-length under varying joint positions on the basis of non-invasively extracted motor unit action potentials.

Changes in muscle fibre length and surface electrode position with respect to the muscle fibres affect the amplitude and frequency characteristics of surface electromyography (SEMG) in different ways. Knowledge of changes in muscle fibre length would help towards a better interpretation of the signals. The possibility of estimating the length through SEMG during voluntary contractions was checked in this study. The fibres' semi-length was estimated from the product of the conduction velocity and conduction time during which the wave of excitation propagated from the end-plate region to the ends of the fibres. Short (10 s), moderate (30% of maximum voluntary contraction) isometric contractions were performed by 10 subjects at different elbow joint angles (80-140 degrees in steps of 20 degrees ). Monopolar signals were detected non-invasively, using a two-dimensional electrode array. High spatial resolution EMG and a decomposition technique were utilised to extract single motor unit activities for triggered averaging and to estimate conduction velocity. A significant increase with joint angle was found in conduction time and estimated fibre semi-length. Changes in conduction velocity with joint angle were found to be not significant. The methodology described allows the relative changes in fibres' semi-length to be estimated from SEMG data.     

Force output during fatigue with progressively increasing stimulation frequency

There is currently a controversy over whether stimulation frequencies should increase or decrease to optimize force output over time. This study compared changes in thenar muscle force and M-wave amplitude during progressively increasing (20–40 Hz), decreasing (40–20 Hz) and constant (20 Hz) frequency stimulation of the median nerve continuously for 3 min. Twenty-three individuals participated in three sets of experiments. There was no significant difference in the force–time integrals between the three fatigue tasks. The rate of fatigue was not correlated to the number of stimulation pulses delivered (20 Hz: 3600, 20–40 and 40–20 Hz: 5400). All fatigue tasks caused a significant reduction in M-wave amplitude and the reduction was largest for the 20–40 Hz protocol. However, multiple linear regression analysis revealed that the M-wave amplitude could not predict the changes in force over time for the 20 Hz or 20–40 Hz protocols. Thus during sustained evoked contractions with stimulation frequencies within the physiological range, frequencies can vary significantly without changing the overall force–time integral.     

Variations in the Spatial Distribution of the Amplitude of Surface Electromyograms Are Unlikely Explained by Changes in the Length of Medial Gastrocnemius Fibres with Knee Joint Angle

This study investigates whether knee position affects the amplitude distribution of surface electromyogram (EMG) in the medial gastrocnemius (MG) muscle. Of further concern is understanding whether knee-induced changes in EMG amplitude distribution are associated with regional changes in MG fibre length. Fifteen surface EMGs were acquired proximo-distally from the MG muscle while 22 (13 male) healthy participants (age range: 23–47 years) exerted isometric plantar flexion at 60% of their maximal effort, with knee fully extended and at 90 degrees flexion. The number of channels providing EMGs with greatest amplitude, their relative proximo-distal position and the EMG amplitude averaged over channels were considered to characterise changes in myoelectric activity with knee position. From ultrasound images, collected at rest, fibre length, pennation angle and fat thickness were computed for MG proximo-distal regions. Surface EMGs detected with knee flexed were on average five times smaller than those collected during knee extended. However, during knee flexed, relatively larger EMGs were detected by a dramatically greater number of channels, centred at the MG more proximal regions. Variation in knee position at rest did not affect the proximo-distal values obtained for MG fibre length, pennation angle and fat thickness. Our main findings revealed that, with knee flexion: i) there is a redistribution of activity within the whole MG muscle; ii) EMGs detected locally unlikely suffice to characterise the changes in the neural drive to MG during isometric contractions at knee fully extended and 90 degrees flexed positions; iii) sources other than fibre length may substantially contribute to determining the net, MG activation.     

Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects.

This paper focuses on methodological issues related to surface electromyographic (EMG) signal detection from the low back muscles. In particular, we analysed (1) the characteristics (in terms of propagating components) of the signals detected from these muscles; (2) the effect of electrode location on the variables extracted from surface EMG; (3) the effect of the inter-electrode distance (IED) on the same variables; (4) the possibility of assessing fatigue during high and very low force level contractions. To address these issues, we detected single differential surface EMG signals by arrays of eight electrodes from six locations on the two sides of the spine, at the levels of the first (L1), the second (L2), and the fifth (L5) lumbar vertebra. In total, 42 surface EMG channels were acquired at the same time during both high and low force, short and long duration contractions. The main results were: (1) signal quality is poor with predominance of non-travelling components; (2) as a consequence of point (1), in the majority of the cases it is not possible to reliably estimate muscle fiber conduction velocity; (3) despite the poor signal quality, it was possible to distinguish the fatigue properties of the investigated muscles and the fatigability at different contraction levels; (4) IED affects the sensitivity of surface EMG variables to electrode location and large IEDs are suggested when spectral and amplitude analysis is performed; (5) the sensitivity of surface EMG variables to changes in electrode location is on average larger than for other muscles with less complex architecture; (6) IED influences amplitude initial values and slopes, and spectral variable initial values; (7) normalized slopes for both amplitude and spectral variables are not affected by IED and, thus, are suggested for fatigue analysis at different postures or during movement, when IED may change in different conditions (in case of separated electrodes); (8) the surface EMG technique at the global level of amplitude and spectral analysis cannot be used to characterize fatigue properties of low back muscles during very low level, long duration contractions since in these cases the non-stable MU pool has a major influence on the EMG variables. These considerations clarify issues only partially investigated in past studies. The limitations indicated above are important and should be carefully discussed when presenting surface EMG results as a means for low back muscle assessment in clinical practice.     

Variability of the fatigue response of paralyzed skeletal muscle in relation to the time after spinal cord injury: mechanical and electrophysiological characteristics

The aim of this study was to determine the effect of the time after spinal cord injury (less than and greater than 10 months) on the mechanical and electrophysiological characteristics of muscle fatigue of the paralyzed electrically stimulated quadriceps muscle. Morphologically and histochemically, a relationship was observed between muscle fatigue and the delay from injury, revealing a critical period of enzymatic turning and a maximum peak of atrophy around the 10th month after the injury, followed by a long-term stabilization. Knee-torque output and M-wave variables (amplitude, latency, duration, and root mean square, RMS) of two muscular heads of the quadriceps were recorded in 19 paraplegic patients during a 120-s isometric contraction. The fatiguing muscle contraction was elicited by supramaximal continuous 20-Hz electrical stimulation. Compared to the chronic group, the acutely paralyzed group showed a greater resistance to fatigue (amount and rate of force decline, P < or = 0.01), smaller alterations of the M-wave amplitude and RMS, and a limited decrease of the muscle fiber conduction velocity (P < 0.05). Mechanical and electrophysiological changes during fatigue provided a clear functional support of the transformation of skeletal muscle under the lesion and of the existence of a critical period of muscular turn. In conclusion, when considering the artificial restoration of motor function, the evolution of the endurance and force-generating capabilities of the muscle actuator must be taken into account, particularly when tasks require important safety conditions (e.g., standing and walking).     

Low-level activity of the trunk extensor muscles causes electromyographic manifestations of fatigue in absence of decreased oxygenation

This study was designed to determine whether trunk extensor fatigue occurs during low-level activity and whether this is associated with a drop in muscle tissue oxygenation. Electromyography (EMG) feedback was used to impose constant activity in a part of the trunk extensor muscles. We hypothesized that electromyographic manifestations of fatigue and decreased oxygenation would be observed at the feedback site and that EMG activity at other sites would be more variable without fatigue manifestations. Twelve volunteers performed 30-min contractions at 2% and 5% of the maximum EMG amplitude (EMGmax) at the feedback site. EMG was recorded from six sites over the lumbar extensor muscles and near-infrared spectroscopy was used to measure changes in oxygenation at the feedback site (left L3 level, 3 cm paravertebral). In both conditions, mean EMG activity was not significantly different between electrode sites, whereas the coefficient of variation was lower at the feedback site compared to other recording sites. The EMG mean power frequency (MPF) decreased consistently at the feedback site only. At 5% EMGmax, the decrease in MPF was significant at the group level at all sites ipsilateral to the feedback site. These results suggest that the limited variability of muscle activity at the EMG feedback site and at ipsilateral locations enhances fatigue development. No decreases in tissue oxygenation were detected. In conclusion, even at mean activity levels as low as 2% EMGmax, fatigue manifestations were found in the trunk extensors. These occured in absence of changes in oxygenation of the muscle tissue.     

Single motor unit and fiber action potentials during fatigue

Muscle fatigue is defined as a loss of tension development during constant stimulation. Although the relationship is not well documented, muscle fatigue has been inferred from electromyogram (EMG) signals. The purpose of this study was to determine the relationship between the amplitude and duration of single motor unit action potentials (MUAPs) and the loss of tension development (fatigue) in the medial gastrocnemius muscles of cats. Single motor units were fatigued by continuous stimulation at 10 or 80 Hz or with trains of 40-Hz stimuli. When motor units were stimulated at 10 Hz and with trains at 40 Hz (low frequency), tension declined and remained depressed during recovery. The changes in the MUAP correlated poorly with changes in tension. During and after stimulation at 80 Hz (high frequency), changes in the amplitude and duration of MUAPs correlated highly with changes in tension development. Since the EMG signal is dependent on a summation and cancellation of individual MUAPs, the EMG provides a reasonable estimate of high-frequency fatigue but an unreliable measure of low-frequency fatigue.     

Effect of elbow joint angle on force–EMG relationships in human elbow flexor and extensor muscles

The purpose of this study was to examine the effect of joint angle on the relationship between force and electromyogram (EMG) amplitude and median frequency, in the biceps, brachioradialis and triceps muscles. Surface EMG were measured at eight elbow angles, during isometric flexion and extension at force levels from 10% to 100% of maximum voluntary contraction (MVC). Joint angle had a significant effect on MVC force, but not on MVC EMG amplitude in all of the muscles examined. The median frequency of the biceps and triceps EMG decreased with increasing muscle length, possibly due to relative changes in electrode position or a decrease in muscle fibre diameter. The relationship between EMG amplitude and force, normalised with respect to its maximum force at each angle, did not vary with joint angle in the biceps or brachioradialis muscles over all angles, or in the triceps between 45° and 120° of flexion. These results suggest that the neural excitation level to each muscle is determined by the required percentage of available force rather than the absolute force required. It is, therefore, recommended that when using surface EMG to estimate muscle excitation, force should be normalised with respect to its maximum value at each angle.     

Single fiber EMG Fiber density and its relationship to Macro EMG amplitude in reinnervation

The objective was to elucidate the relation between the Macro EMG parameters fiber density (FD) and Macro amplitude in reinnervation in the purpose to use the FD parameter as a surrogate marker for reinnervation instead of the Macro amplitude.Macro EMG with FD was performed in 278 prior polio patients. The Biceps Brachii and the Tibialis anterior muscles were investigated.FD was more sensitive for detection of signs of reinnervation but showed lesser degree of abnormality than the Macro amplitude. FD and Macro MUP amplitude showed a non-linear relation with a great variation in FD for given Macro amplitude level.The relatively smaller increase in FD compared to Macro amplitude in addition to the non-linear relationship between the FD and the Macro amplitude regarding reinnervation in prior polio can be due to technical reasons and muscle fiber hypertrophy. The FD parameter has a relation to Macro MUP amplitude but cannot alone be used as a quantitative marker of the degree of reinnervation.