Alberto Rainoldi

Repeatability of surface EMG variables during voluntary isometric contractions of the biceps brachii muscle.

The repeatability of initial value and rate of change of mean spectral frequency (MNF), average rectified values (ARV) and muscle fiber conduction velocity (CV) was investigated in the dominant biceps brachii of ten normal subjects during sustained isometric voluntary contractions. Four levels of contraction were studied: 10%, 30%, 50% and 70% of the maximal voluntary contraction level (MVC). Each contraction was repeated three times in each of three different days for a total of nine contractions/level/subject and 90 contractions per level across the ten subjects. Repeatability was investigated using the Intraclass Correlation Coefficient (ICC) and the standard error of the mean (SEM) of the estimates for each subject. Contrary to observations in other muscles, CV estimates appeared to be very repeatable both within and between subjects. CV showed a small but significant increase when contraction force increased from 10% to 50% MVC but no change for further increase of force. As force increased, MNF showed a slight decrease possibly related to a wider spreading of the CV values. The rate of time decrement of MNF and CV increased with the level of contraction. The normalized decrement (% of initial value per second) was in general higher for MNF than for CV and was more repeatable between subjects at 10% MVC than at 70% MVC. A final observation is that a resting time of 5 minutes may not be sufficient after a contraction at 50% or 70% MVC.

Geometrical factors in surface EMG of the vastus medialis and lateralis muscles

Surface EMG signals detected in dynamic conditions are affected by a number of artefacts. Among them geometrical factors play an important role. During movement the muscle slides with respect to the skin because of the variation of its length. Such a shift can considerably modify sEMG amplitude. The purpose of this work is to assess geometrical artefacts on sEMG during isometric contractions at different muscle lengths. The average rectified value (ARV) of 15 single differential signals was obtained by means of a linear array of 16 bar electrodes from the vastus medialis and lateralis muscles. The knee angle was changed from 75 degrees to 165 degrees in steps of 30 degrees and voluntary isometric contractions at a low, medium and high force level were performed for each angle. The ARV pattern was normalized with respect to the mean activity to compare signals from different joint angles. From the data collected it was possible to separate the geometrical changes from the changes due to different intensities of activation. In three out of five subjects, we found (within the resolution of our measures) a 1 cm shift for the vastus medialis muscle while no shift was observed for the other two subjects. For the vastus lateralis muscle a 1 cm shift was found in two out of four subjects. Such a shift produces the main contribution to geometrical artefacts. To avoid such artefacts the innervation zones should be located and the EMG electrodes should not be placed near them.

Myoelectric manifestations of sternocleidomastoid and anterior scalene muscle fatigue in chronic neck pain patients

OBJECTIVE This study compares myoelectric manifestations of fatigue of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles between 10 chronic neck pain subjects and 10 normal matched controls. METHODS Surface electromyography (sEMG) signals were recorded from the sternal head of SCM and AS muscles bilaterally during sub-maximal isometric cervical flexion contractions at 25 and 50% of the maximum voluntary contraction (MVC). The mean frequency, average rectified value and conduction velocity of the sEMG signal were calculated to quantify myoelectric manifestations of muscle fatigue. RESULTS For both the SCM and AS muscles, the Mann-Whitney U test indicated that the initial value and slope of the mean frequency in neck pain patients were greater than in healthy subjects (P < 0.05). This was significant both at 25 and 50% of MVC. CONCLUSIONS These results suggest: (a) a predominance of type-II fibres in the neck pain patients and/or (b) greater fatigability of the superficial cervical flexors in neck pain patients. These results are in agreement with previous muscle biopsy studies in subjects with neck pain, which identified transformation of slow-twitch type-1 fibres to fast-twitch type-IIB fibres, as well as the clinical observation of reduced endurance in the cervical flexors in neck pain patients.

Surface EMG: The issue of electrode location

This paper contributes to clarifying the conditions under which electrode position for surface EMG detection is critical and leads to estimates of EMG variables that are different from those obtained in other nearby locations. Whereas a number of previous works outline the need to avoid the innervation zone (or the muscle belly), many authors place electrodes in the central part or bulge of the muscle of interest where the innervation zone is likely to be. Computer simulations are presented to explain the effect of the innervation zone on amplitude, frequency and conduction velocity estimates from the signal and the need to avoid placing electrodes near it. Experimental signals recorded from some superficial muscles of the limbs and trunk (abductor pollicis brevis, flexor pollicis brevis, biceps, upper trapezius, vastus medialis, vastus lateralis) were processed providing support for the findings obtained from simulations. The use of multichannel techniques is recommended to estimate the location of the innervation zone and to properly choose the optimal position of the detection point(s) allowing meaningful estimates of EMG variables during movement analysis.

Compensation of the effect of sub-cutaneous tissue layers on surface EMG: a simulation study

A mathematical model of a four-layer medium (muscle+fat+skin+air) is investigated. The system is studied in cartesian coordinates with the hypotheses of muscle anisotropy and isotropy of the fat and skin layers, assuming the fat to be less conductive than the skin. Determination of the potential distribution over the skin, due to sources in the muscle, is based on the solution of the Poisson equation in the spatial frequency domain in the different media. The arbitrary constants are determined imposing the boundary conditions. In this way the transfer function of the fat and skin layers is found and can be used to compute the potential distribution of the muscle-fat interface. The physiological parameters were obtained from literature. The results of simulation studies are proposed; it is clear that the subcutaneous tissue layers produce an attenuation and widening of the potential distribution present at the muscle surface. These effects can be partially compensated using high-pass spatial filters as proposed in the literature. A new class of bidimensional spatial filters is proposed; the filters are defined on the basis of the information about the isotropic layers rather than being general filters. An approximation of the ideal inverse transfer function of the sub-cutaneous layers is proposed as a discrete spatial filter that can be implemented with matrices with a small number of electrodes (maximum of 25 electrodes) and practicable interelectrode distance. A simulated evaluation of the new filter and the limitations of the approach are presented.

Repeatability of maximal voluntary force and of surface EMG variables during voluntary isometric contraction of quadriceps muscles in healthy subjects

The repeatability of initial values and rate of change of EMG signal mean spectral frequency (MNF), average rectified values (ARV), muscle fiber conduction velocity (CV) and maximal voluntary contraction (MVC) was investigated in the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles of both legs of nine healthy male subjects during voluntary, isometric contractions sustained for 50 s at 50% MVC. The values of MVC were recorded for both legs three times on each day and for three subsequent days, while the EMG signals have been recorded twice a day for three subsequent days. The degree of repeatability was investigated using the Fisher test based upon the ANalysis Of VAriance (ANOVA), the Standard Error of the Mean (SEM) and the Intraclass Correlation Coefficient (ICC). Data collected showed a high level of repeatability of MVC measurement (normalized SEM from 1.1% to 6.4% of the mean). MNF and ARV initial values also showed a high level of repeatability (ICC>70% for all muscles and legs except right VMO). At 50% MVC level no relevant pattern of fatigue was observed for the VMO and VL muscles, suggesting that other portions of the quadriceps might have contributed to the generated effort. These observations seem to suggest that in the investigation of muscles belonging to a multi-muscular group at submaximal level, the more selective electrically elicited contractions should be preferred to voluntary contractions.

Repeatability of surface EMG variables in the sternocleidomastoid and anterior scalene muscles

Abstract. In this study we examined the repeatability and reliability of the surface electromyographic (sEMG) signal mean frequency (MNF), average rectified value (ARV) and conduction velocity (CV) measured for the sternocleidomastoid (SCM) and the anterior scalene (AS) muscles in nine healthy volunteers during 15-s isometric cervical flexion contractions at 50% of the maximal voluntary contraction level over 3 non-consecutive days. Repeatability and reliability estimates were obtained for the initial values and rates of change of each sEMG variable by using both the Intraclass Correlation Coefficient (ICC) and the normalised standard error of the mean (nSEM). Results from SCM indicated good levels of repeatability for the initial value and slope of ARV (ICC>65%). For the AS, high levels of repeatability were identified for the initial value of MNF (ICC>70%) and the slope of ARV (ICC>75%). Values of nSEM in the range 2.8–7.2% were obtained for the initial values of MNF and CV for both SCM and AS, indicating clinically acceptable measurement precision. The low value obtained for the nSEM of the initial value of MNF for the AS, in combination with the high ICC, indicates that of all of the variables examined, this variable could offer the best normative index to distinguish between subjects with and without neck pain, and represents the sEMG variable of choice for future evaluation purposes.

Neck flexor muscle fatigue is side specific in patients with unilateral neck pain.

Despite the evidence of greater fatigability of the cervical flexor muscles in neck pain patients, the effect of unilaterality of neck pain on muscle fatigue has not been investigated. This study compared myoelectric manifestations of sternocleidomastoid (SCM) and anterior scalene (AS) muscle fatigue between the painful and non‐painful sides in patients with chronic unilateral neck pain. Myoelectric signals were recorded from the sternal head of SCM and the AS muscles bilaterally during sub‐maximal isometric cervical flexion contractions at 25% and 50% of the maximum voluntary contraction (MVC). The time course of the mean power frequency, average rectified value and conduction velocity of the electromyographic signals were calculated to quantify myoelectric manifestations of muscle fatigue. Results revealed greater estimates of the initial value and slope of the mean frequency for both the SCM and AS muscles on the side of the patients neck pain at 25% and 50% of MVC. These results indicate greater myoelectric manifestations of muscle fatigue of the superficial cervical flexor muscles ipsilateral to the side of pain. This suggests a specificity of the effect of pain on muscle function and hence the need for specificity of therapeutic exercise in the management of neck pain patients.

Neuromuscular efficiency of the sternocleidomastoid and anterior scalene muscles in patients with chronic neck pain

Purpose: This study compared the neuromuscular efficiency (NME) of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles between 20 chronic neck pain patients and 20 asymptomatic controls. Method: Myoelectric signals were recorded from the sternal head of SCM and the AS muscles as subjects performed sub-maximal isometric cervical flexion contractions at 25 and 50% of the maximum voluntary contraction (MVC). The NME was calculated as the ratio between MVC and the corresponding average rectified value of the EMG signal. Ultrasonography was used to measure subcutaneous tissue thickness over the SCM and AS to ensure that differences did not exist between groups. Results: For both the SCM and AS muscles, NME was shown to be significantly reduced in patients with neck pain at 25% MVC (p < 0.05). Subcutaneous tissue thickness over the SCM and AS muscles was not different between groups. Conclusions: Reduced NME in the superficial cervical flexor muscles in patients with neck pain may be a measurable altered muscle strategy for dysfunction in other muscles. This aberrant pattern of muscle activation appears to be most evident under conditions of low load. NME, when measured at 25% MVC, may be a useful objective measure for future investigation of muscle dysfunction in patients with neck pain.

Multichannel Surface EMG for the Non-Invasive Assessment of the Anal Sphincter Muscle

Background/Aims: This work focuses on recording, processing and interpretation of multichannel surface EMG detected from the external anal sphincter muscle. The aim is to describe the information that can be extracted from signals recorded with such a technique. Methods: The recording of many signals from different locations on a muscle allows the extraction of additional information on muscle physiology and anatomy with respect to that obtained by classic bipolar recordings. Multichannel EMG methods have been recently developed for the assessment of the external anal sphincter. An anal probe was used in this study to record signals at different depths within the anal canal during contractions at different effort levels. The plug is 150 mm in length and 14 mm in diameter, holding a circumferential array of 16 equally spaced silver bar electrodes, located at a distance of 20 mm from the probe tip and aligned with the probe axis. Results: Information about localization of the innervation zone, fiber length, EMG amplitude, muscle fiber conduction velocity and single motor unit analysis can be obtained from the signals recorded with the circumferential array by means of innovative signal processing techniques. Conclusions: The type of information extracted from multichannel surface EMG signals cannot be obtained with other currently available techniques. The technological innovation described in this work is promising for a further insight into the investigation of pelvic floor pathologies and rehabilitation treatments.