Sauro Emerick Salomoni

Semi-automatic detection of the left ventricular border

Two semi-automatic methods for the detection of the left ventricular border in two-dimensional short axis echocardiographic images are presented and compared. In these methods, the left ventricular area variation curve is calculated during a complete cardiac cycle after the segmentation of several frames. This allows the evaluation of the cardiovascular dynamics and the identification of important clinical parameters. The algorithms are proposed as several independent modules. The results are validated through the comparison between the semi-automatic continuous boundaries and manuals boundaries sketched by a medical specialist.

Muscle fatigue increases the amplitude of fluctuations of tangential forces during isometric contractions.

The orientation of the resultant force during a given contraction depends on the architecture of the muscles involved, and cooperation among muscles may induce force fluctuations in multiple directions. A novel setup for recording three-dimensional forces was developed to assess the effects of muscle fatigue on submaximal contractions. Fifteen subjects performed isometric dorsiflexions, elbow flexions, knee extensions, plantarflexions, and trunk extensions (12 s, 2.5-80% of maximal voluntary force) before and after a fatigue protocol. Electromyography (EMG) was recorded from relevant muscles. The standard deviation of force in the three directions and the agonist EMG amplitude increased with target force (p<.045), while the coefficient of variation of force and total excursions of the center of pressure showed maximal values at low target forces, reaching a plateau at moderate forces. Fatigue induced higher force fluctuations in task-related and tangential directions and increased agonist EMG amplitude for all muscle groups (p<.04). Fluctuations of tangential forces were greater during knee extensions compared with other muscle groups (p<.007). The present data demonstrate that fatigue increases the amplitude of force fluctuations in task-related and tangential forces. Moreover, alternation of activity between multiple synergist muscles is associated with increased fluctuations of tangential forces, especially during fatigue.

Reorganised motor control strategies of trunk muscles due to acute low back pain

This study assessed how the low back motor control strategies were affected by experimental pain. In twelve volunteers the right m. longissimus was injected by hypertonic and isotonic (control) saline. The pain intensity was assessed on a visual analog scale (VAS). Subjects were seated on a custom-designed chair including a 3-dimensional force sensor adjusted to the segmental height of T1. Electromyography (EMG) was recorded bilaterally from longissimus, multifidus, rectus abdominis, and external oblique muscles. Isometric trunk extensions were performed before, during, and after the saline injections at 5%, 10%, and 20% of maximum voluntary contraction force. Visual feedback of the extension force was provided whereas the tangential force components were recorded. Compared with isotonic saline, VAS scores were higher following hypertonic saline injections (P<.01). Experimental low back pain reduced the EMG activity bilaterally of the rectus abdominis muscles during contractions at 10% and 20% MVC (P<.01) although force accuracy and tangential force variability was not affected. Increased variability in the tangential force composition was found during pain compared with the non-painful condition (P<.05). The immediate adaptation to pain was sufficient to maintain the quality of the task performance; however the long-term consequence of such adaptation is unknown and may overload other structures.

Spatial reorganisation of muscle activity correlates with change in tangential force variability during isometric contractions

The aim of this study was to quantify the effects of spatial reorganisation of muscle activity on task-related and tangential components of force variability during sustained contractions. Three-dimensional forces were measured from isometric elbow flexion during submaximal contractions (50s, 5-50% of maximal voluntary contraction (MVC)) and total excursion of the centre of pressure was extracted. Spatial electromyographic (EMG) activity was recorded from the biceps brachii muscle. The centroids of the root mean square (RMS) EMG and normalised mutual information (NMI) maps were computed to assess spatial muscle activity and spatial relationship between EMG and task-related force variability, respectively. Result showed that difference between the position of the centroids at the beginning and at the end of the contraction of the RMS EMG and the NMI maps were different in the medial-lateral direction (P<0.05), reflecting that muscle regions modulate their activity without necessarily modulating the contribution to the task-related force variability over time. Moreover, this difference between shifts of the centroids was positively correlated with the total excursion of the centre of pressure at the higher levels of contractions (>30% MVC, R(2)>0.30, P<0.05), suggesting that changes in spatial muscle activity could impact on the modulation of tangential forces. Therefore, within-muscle adaptations do not necessarily increase force variability, and this interaction can be quantified by analysing the RMS EMG and the NMI map centroids.

On the behavior of surface electromyographic variables during the menstrual cycle

The goal of this work is to study the behavior of electromyographic variables during the menstrual cycle. Ten female volunteers (24.0 ± 2.8 years of age) performed fatiguing isometric contractions, and electromyographic signals were measured on the biceps brachii in four phases of the menstrual cycle. Adaptations of classical algorithms were used for the estimation of the root mean square (RMS) value, absolute rectified value (ARV), mean frequency (MNF), median frequency (MDF), and conduction velocity (CV). The CV estimator had a higher (p = 0.002) rate of decrease at the end of the follicular phase and at the end of the luteal phase. The MDF (p = 0.002) and MNF (p = 0.004) estimators had a higher rate of decrease at the beginning of the follicular phase and at the end of the luteal phase. No significant differences between phases of the menstrual cycle were detected with the ARV and RMS estimators (p > 0.05). These results suggest that the behavior of the muscles in women presents different characteristics during different phases of the menstrual cycle. In particular, women were more susceptible to fatigue at the end of the luteal phase.

Development of a microcontrolled bioinstrumentation system for active control of leg prostheses

This article describes the design of a microcontrolled bioinstrumentation system for active control of leg prostheses, using 4-channel electromyographic signal (EMG) detection and a single-channel electrogoniometer. The system is part of a control and instrumentation architecture in which a master processor controls the tasks of slave microcontrollers, through a RS-485 interface. Several signal processing methods are integrated in the system, for feature extraction (Recursive Least Squares), feature projection (Self Organizing Maps), and pattern classification (Levenberg-Marquardt Neural Network). The acquisition of EMG signals and additional mechanical information could help improving the precision in the control of leg prostheses.

Gender differences in muscle fatigue of the biceps brachii and influences of female menstrual cycle in electromyography variables

Several studies report gender differences in response to fatigue. Most results suggest that females have higher muscle endurance than males. Possible explanations lie on differences in muscle mass, substrate utilization, muscle morphology and neuromuscular activation. One relevant aspect not always considered is the hormonal fluctuations during the female menstrual cycle. The present work observed eighteen healthy and untrained adults (eight males, 26.9 ± 4.0 yr and ten females, 24.0 ± 2.8 yr) performing fatiguing isometric contractions to evaluate both the influence of menstrual cycle and gender differences in fatigability. Surface electromyographic signals were recorded from the biceps brachii using a linear electrode array of eight electrodes during 90 seconds at 40% of maximal voluntary contraction. Root mean square (RMS), mean frequency (MNF) the conduction velocity (CV) values were estimated using windows of 0.5 seconds. Female subjects showed overall lower fatigability, demonstrated by the lower mean CV decrease (1.494) compared to males (1.787). However, in periods of high decreases in hormones concentrations in females (the end of both the follicular and luteal phases), higher CV decreases were observed (1.921 and 2.183). These results indicate the need of considering the effects of hormonal fluctuations in females when observing gender effects on muscle fatigue.

Trunk muscle activation during movement with a new exercise device for lumbo‐pelvic reconditioning

Gravitational unloading leads to adaptations of the human body, including the spine and its adjacent structures, making it more vulnerable to injury and pain. The Functional Re‐adaptive Exercise Device (FRED) has been developed to activate the deep spinal muscles, lumbar multifidus (LM) and transversus abdominis (TrA), that provide inter‐segmental control and spinal protection. The FRED provides an unstable base of support and combines weight bearing in up‐right posture with side alternating, elliptical leg movements, without any resistance to movement. The present study investigated the activation of LM, TrA, obliquus externus (OE), obliquus internus (OI), abdominis, and erector spinae (ES) during FRED exercise using intramuscular fine‐wire and surface EMG. Nine healthy male volunteers (27 ± 5 years) have been recruited for the study. FRED exercise was compared with treadmill walking. It was confirmed that LM and TrA were continually active during FRED exercise. Compared with walking, FRED exercise resulted in similar mean activation of LM and TrA, less activation of OE, OI, ES, and greater variability of lumbo‐pelvic muscle activation patterns between individual FRED/gait cycles. These data suggest that FRED continuously engages LM and TrA, and therefore, has the potential as a stationary exercise device to train these muscles.

Reduced maximal force during acute anterior knee pain is associated with deficits in voluntary muscle activation

Although maximal voluntary contraction (MVC) force is reduced during pain, studies using interpolated twitch show no consistent reduction of voluntary muscle drive. The present study aimed to test if the reduction in MVC force during acute experimental pain could be explained by increased activation of antagonist muscles, weak voluntary activation at baseline, or changes in force direction. Twenty-two healthy volunteers performed maximal voluntary isometric knee extensions before, during, and after the effects of hypertonic (pain) and isotonic (control) saline injections into the infrapatellar fat pad. The MVC force, voluntary activation, electromyographic (EMG) activity of agonist, antagonist, and auxiliary (hip) muscles, and pain cognition and anxiety scores were recorded. MVC force was 9.3% lower during pain than baseline (p < 0.001), but there was no systematic change in voluntary activation. Reduced MVC force during pain was variable between participants (SD: 14%), and was correlated with reduced voluntary activation (r = 0.90), baseline voluntary activation (r = − 0.62), and reduced EMG amplitude of agonist and antagonist muscles (all r > 0.52), but not with changes in force direction, pain or anxiety scores. Hence, reduced MVC force during acute pain was mainly explained by deficits in maximal voluntary drive.

Breathing and Singing: Objective Characterization of Breathing Patterns in Classical Singers

Singing involves distinct respiratory kinematics (i.e. movements of rib cage and abdomen) to quiet breathing because of different demands on the respiratory system. Professional classical singers often advocate for the advantages of an active control of the abdomen on singing performance. This is presumed to prevent shortening of the diaphragm, elevate the rib cage, and thus promote efficient generation of subglottal pressure during phonation. However, few studies have investigated these patterns quantitatively and inter-subject variability has hindered the identification of stereotypical patterns of respiratory kinematics. Here, seven professional classical singers and four untrained individuals were assessed during quiet breathing, and when singing both a standard song and a piece of choice. Several parameters were extracted from respiratory kinematics and airflow, and principal component analysis was used to identify typical patterns of respiratory kinematics. No group differences were observed during quiet breathing. During singing, both groups adapted to rhythmical constraints with decreased time of inspiration and increased peak airflow. In contrast to untrained individuals, classical singers used greater percentage of abdominal contribution to lung volume during singing and greater asynchrony between movements of rib cage and abdomen. Classical singers substantially altered the coordination of rib cage and abdomen during singing from that used for quiet breathing. Despite variations between participants, principal component analysis revealed consistent pre-phonatory inward movements of the abdominal wall during singing. This contrasted with untrained individuals, who demonstrated synchronous respiratory movements during all tasks. The inward abdominal movements observed in classical singers elevates intra-abdominal pressure and may increase the length and the pressure-generating capacity of rib cage expiratory muscles for potential improvements in voice quality.