High-Density Electromyography Provides Improved Understanding of Muscle Function for Those With Amputation

Transtibial amputation can significantly impact an individual's quality of life including the completion of activities of daily living. Those with lower limb amputations can harness the electrical activity from their amputated limb muscles for myoelectric control of a powered prosthesis. While these devices use residual muscles from transtibial-amputated limb as an input to the controller, there is little research characterizing the changes in surface electromyography (sEMG) signal generated by the upper leg muscles. Traditional surface EMG is limited in the number of electrode sites while high-density surface EMG (HDsEMG) uses multiple electrode sites to gather more information from the muscle. This technique is promising for not only the development of myoelectric-controlled prostheses but also advancing our knowledge of muscle behavior with clinical populations, including post-amputation. The HDsEMG signal can be used to develop spatial activation maps and features of these maps can be used to gain valuable insight into muscle behavior. Spatial features of HDsEMG can provide information regarding muscle activation, muscle fiber heterogeneity, and changes in muscle distribution and can be used to estimate properties of both the amputated limb and intact limb. While there are a few studies that have examined HDsEMG in amputated lower limbs they have been limited to movements such as gait. The purpose of this study was to examine the quadriceps muscle during a slow, moderate and fast isokinetic knee extensions from a control group as well as a clinical patient with a transtibial amputation. HDsEMG was collected from the quadriceps of the dominant leg of 14 young, healthy males (mean age = 25.5 ± 7 years old). Signals were collected from both the intact and amputated limb muscle of a 23 year old clinical participant to examine differences between the affected and unaffected leg. It was found that there were differences between the intact and amputated limb limb of the clinical participant with respect to muscle activation and muscle heterogeneity. While this study was limited to one clinical participant, it is important to note the differences in muscle behavior between the intact and amputated limb limb. Understanding these differences will help to improve training protocols for those with amputation.

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Muscle Activation during Gait in Unilateral Transtibial Amputee Patients with Prosthesis: The Influence of the Insole Material Density

Journal of Clinical Medicine ◽

10.3390/jcm10143119 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3119

Author(s):

Nuria Sarroca ◽

María José Luesma ◽

José Valero ◽

Javier Deus ◽

Josefa Casanova ◽

...

Keyword(s):

Muscle Activity ◽

Muscle Activation ◽

Quadriceps Muscle ◽

Lower Limbs ◽

Control Group ◽

Gait Patterns ◽

Material Density ◽

Transtibial Amputee ◽

Complex Process ◽

Muscle Groups

Background: Walking is a complex process that is highly automated and efficient. This knowledge is essential for the study of pathological gait. The amputation of lower limbs involves new biomechanical load and gait patterns, and injuries due to overload or disuse may occur. The objective of this study is to assess muscle activation as part of the gait in unilateral transtibial amputee patients with prosthesis, at different speeds and with different plantar supports. Method: Included in the sample were 25 people with amputation and 25 control participants. Muscle activation was evaluated in both groups by means of surface electromyography (EMG) under normal and altered conditions. Results: Control participants did not show statistically significant differences (p ˃ 0.05) between their muscle groups, irrespective of support and speed. However, people with amputation did show differences in muscle activity in the quadriceps, all of which occurred at the highest speeds, irrespective of support. In the analysis between groups, significant differences (p < 0.05) were obtained between the leg of the amputee patient and the leg of the control participant, all of them in the quadriceps, and at speeds 3 and 4, regardless of the insole used. Conclusions: Participants with unilateral transtibial amputation carry out more quadriceps muscle activity during gait compared to the control group.

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Changes in the Ground Reaction Force, Lower-Limb Muscle Activity, and Joint Angles in Athletes with Unilateral Ankle Dorsiflexion Restriction During A Rebound-Jump Task

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk3040052 ◽

2018 ◽

Vol 3 (4) ◽

pp. 52

Author(s):

Hitoshi Kondo

Keyword(s):

Ground Reaction Force ◽

Muscle Activation ◽

Reaction Force ◽

Maximum Voluntary Contraction ◽

Quadriceps Muscle ◽

Ankle Dorsiflexion ◽

Lower Limbs ◽

Control Group ◽

Joint Angles ◽

Hip Flexion

Background: This study compared differences between a control group and a group with unilateral ankle dorsiflexion restriction in the ground reaction force (GRF), angles of the lower limbs joints, and muscular activity during a rebound-jump task in athletes who continue to perform sports activities with unilateral ankle dorsiflexion restriction. Methods: The athletes were divided into the following two groups: The dorsiflexion group included those with a difference of ≥7° between bilateral ankle dorsiflexion angles (DF), and the control group included those with a difference of <7° between the two ankles (C). An ankle foot orthosis was attached to subjects in group C to apply a restriction on the right-angle dorsiflexion angle. The percentage of maximum voluntary contraction (%MVC) of the legs musculature, components of the GRF, and the hip and knee joint angles during the rebound-jump task were compared between groups DF and C. Results: Group DF showed increased %MVC of the quadriceps muscle, decreased upward component of the GRF, decreased hip flexion, and increased knee eversion angles. Conclusions: This study highlighted that athletes with ankle dorsiflexion restriction had significantly larger knee eversion angles in the rebound-jump task. The reduced hip flexion was likely caused by the restricted ankle dorsiflexion and compensated by the observed increase in quadriceps muscle activation when performing the jump.

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Arthroscopic Imaging Treatment and Clinical Rehabilitation of Knee Sports Injuries

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3742 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1780-1788

Author(s):

Habaxi Kaken ◽

Shanshan Wang ◽

Wei Zhao ◽

Baoerjiang Asihaer ◽

Li Wang

Keyword(s):

Muscle Strength ◽

Knee Joint ◽

Sports Injuries ◽

Cruciate Ligament ◽

Quadriceps Muscle ◽

Lower Limbs ◽

Continuous Passive Motion ◽

Control Group ◽

Pressure Therapy ◽

Quick Recovery

This article studies the effects of arthroscopic imaging treatment and clinical rehabilitation of knee sports injuries. Arthroscopy was used to perform meniscus trimming and resection for 40 patients with knee sports injuries. The ages of the patients ranged from 20 to 60 years old. All patients received routine rehabilitation training such as continuous passive motion of the knee joint, biofeedback of the lower limbs, and air pressure therapy of the lower limbs. In addition, the control group was given muscle strength training, and the training began after the patients received the quadriceps muscle strength test. The removal of the joint cavity and the joint debridement has achieved satisfactory treatment results. In the experiment, the test cases were divided into two groups, and the sensor test platform was used for signal collection. Normal activities can be resumed 2 weeks after the operation. After a follow-up of 6 to 24 months, the knee joint pain disappeared, the joint was free of swelling, and the knee function was normal up to 93%. Arthroscopic reconstruction of the anterior and posterior cruciate ligament joint repair/reconstruction of the medial and posterolateral ligament knots is safe and feasible for the treatment of multiple ligament injuries of the knee joint. It has the advantages of less trauma and quick recovery. Early postoperative systemic and standardized rehabilitation exercises can obtain good knee joint function.

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Assessment of an Assistive Control Approach Applied in an Active Knee Orthosis Plus Walker for Post-Stroke Gait Rehabilitation

Sensors ◽

10.3390/s20092452 ◽

2020 ◽

Vol 20 (9) ◽

pp. 2452

Author(s):

Ana Cecilia Villa-Parra ◽

Jessica Lima ◽

Denis Delisle-Rodriguez ◽

Laura Vargas-Valencia ◽

Anselmo Frizera-Neto ◽

...

Keyword(s):

Healthy Subjects ◽

Muscle Activation ◽

Inertial Sensors ◽

Lower Limbs ◽

Trunk Muscles ◽

Control Group ◽

Gait Rehabilitation ◽

Control Approach ◽

Post Stroke ◽

Knee Orthosis

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.

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Robotic Exoskeleton Gait Training in Stroke: An Electromyography-Based Evaluation

Frontiers in Neurorobotics ◽

10.3389/fnbot.2021.733738 ◽

2021 ◽

Vol 15 ◽

Author(s):

Valeria Longatelli ◽

Alessandra Pedrocchi ◽

Eleonora Guanziroli ◽

Franco Molteni ◽

Marta Gandolla

Keyword(s):

Muscle Activation ◽

Gait Training ◽

Gait Pattern ◽

Rehabilitation Program ◽

Lower Limbs ◽

Control Group ◽

Robotic Exoskeleton ◽

Lower Limb Muscles ◽

Subacute Stroke ◽

Efficient Gait

The recovery of symmetric and efficient walking is one of the key goals of a rehabilitation program in patients with stroke. The use of overground exoskeletons alongside conventional gait training might help foster rhythmic muscle activation in the gait cycle toward a more efficient gait. About twenty-nine patients with subacute stroke have been recruited and underwent either conventional gait training or experimental training, including overground gait training using a wearable powered exoskeleton alongside conventional therapy. Before and after the rehabilitation treatment, we assessed: (i) gait functionality by means of clinical scales combined to obtain a Capacity Score, and (ii) gait neuromuscular lower limbs pattern using superficial EMG signals. Both groups improved their ability to walk in terms of functional gait, as detected by the Capacity Score. However, only the group treated with the robotic exoskeleton regained a controlled rhythmic neuromuscular pattern in the proximal lower limb muscles, as observed by the muscular activation analysis. Coherence analysis suggested that the control group (CG) improvement was mediated mainly by spinal cord control, while experimental group improvements were mediated by cortical-driven control. In subacute stroke patients, we hypothesize that exoskeleton multijoint powered fine control overground gait training, alongside conventional care, may lead to a more fine-tuned and efficient gait pattern.

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Analysis of Lower Extremity Muscle Activation Using EMG

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.573.797 ◽

2014 ◽

Vol 573 ◽

pp. 797-802

Author(s):

L. Vidhya ◽

S. Saranya ◽

S. Poonguzhali

Keyword(s):

Lower Limb ◽

Muscle Activation ◽

Surface Emg ◽

Control Group ◽

Therapy Planning ◽

Activation Patterns ◽

Gait Patterns ◽

Lower Limb Muscles ◽

Lower Extremity Muscle ◽

Pathological Gait

Electromyography (EMG) has been widely used as a tool to understand and distinguish between normal and pathological gait. This study aims at understanding the activation patterns of lower limb muscles viz. Gastrocnemius and Tibialis Anterior in the dominant leg of subjects with normal (n=5) as well as pathological (n=2) gait patterns. The paper presents a normative pattern of these muscles during normal walking condition from which the deviation of affected group from the control group is observed. For this analysis, Surface EMG signals along with Force Sensitive Resistor values are acquired. These surface EMG signals picked up during the muscle activity are interfaced with a PC via EMG acquisition system. The acquired signals were processed and analyzed which can be used for rehabilitative therapy planning.

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The impact of comprehensive Physiotherapy with Biofeedback on the functional state of patients with Lumbar Spine pain

Medycyna Manualna ◽

10.5604/01.3001.0013.5283 ◽

2019 ◽

Vol XXIII (1) ◽

pp. 35-42

Author(s):

Grzegorz Mańko ◽

Sabina Tim ◽

Angelika Sosulska ◽

Łukasz Dobranowski ◽

Beata Stach ◽

...

Keyword(s):

Research Group ◽

Muscle Activation ◽

Rating Scale ◽

Pain Scale ◽

Abdominal Muscle ◽

Lower Limbs ◽

Control Group ◽

Lumbosacral Spine ◽

Comprehensive Therapy ◽

The Impact

Introduction: Chronic pain in the lumbosacral spine are becoming a problem for younger and younger people and affect the deterioration of the condition functional patients. Material and methods: Two groups were studied twice, 20 patients (in each group) with lower back pain, attending physiotherapy. In the research group applied comprehensive physiotherapy, and only physical treatments were applied in the control group. To measure effects of therapy were used: the VAS scale, the BPFS Stratford Functional Pain Scale Rating Scale, two weight test, Pressure Bio-Feedback Stabilizer device for muscle activation testing transverse abdomen muscle. Results: In the research group compared to the control group, (p<0.05) a significantly lower level of pain was obtained, assessed on the VAS scale (p=0.003) and in terms of improving functioning significantly (p=0.017) higher level of functional possibilities (by 17.4%). In the research group significantly (p=0.011) more people achieved the correct value of the symmetry of lower limbs, which is in the range of 1- 1.15. All (100%) treated with comprehensive physiotherapy improved transverse abdominal muscle activation TrA. Conclusions: Using the comprehensive physiotherapy reduces pain and improve functional possibilities. Contributes to an even load on the lower limbs in anteroposterior surface and improve the symmetry index of lower limbs. Comprehensive therapy is more effective form treating patients rather than using physical therapy alone. Training transverse abdomen muscle reduces the severity of pain and increases daily activities.

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Global Muscle Coactivation of the Sound Limb in Gait of People with Transfemoral and Transtibial Amputation

Sensors ◽

10.3390/s20092543 ◽

2020 ◽

Vol 20 (9) ◽

pp. 2543 ◽

Cited By ~ 3

Author(s):

Antonella Tatarelli ◽

Mariano Serrao ◽

Tiwana Varrecchia ◽

Lorenzo Fiori ◽

Francesco Draicchio ◽

...

Keyword(s):

Healthy Subjects ◽

Muscle Activation ◽

Gait Cycle ◽

Control Strategies ◽

Control Group ◽

Transfemoral Amputation ◽

Prosthetic Device ◽

Transtibial Amputation ◽

Prosthetic Devices ◽

Simultaneous Activation

The aim of this study was to analyze the effect of the level of amputation and various prosthetic devices on the muscle activation of the sound limb in people with unilateral transfemoral and transtibial amputation. We calculated the global coactivation of 12 muscles using the time-varying multimuscle coactivation function method in 37 subjects with unilateral transfemoral amputation (10, 16, and 11 with mechanical, electronic, and bionic prostheses, respectively), 11 subjects with transtibial amputation, and 22 healthy subjects representing the control group. The results highlighted that people with amputation had a global coactivation temporal profile similar to that of healthy subjects. However, amputation increased the level of the simultaneous activation of many muscles during the loading response and push-off phases of the gait cycle and decreased it in the midstance and swing subphases. This increased coactivation probably plays a role in prosthetic gait asymmetry and energy consumption. Furthermore, people with amputation and wearing electronic prosthesis showed lower global coactivation when compared with people wearing mechanical and bionic prostheses. These findings suggest that the global lower limb coactivation behavior can be a useful tool to analyze the motor control strategies adopted and the ability to adapt to the prosthetic device.

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Effect of stretching through the pilates method – controlled, randomized clinical study.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2019.17.719 ◽

2020 ◽

pp. 1-7

Author(s):

Vanessa Stasiu ◽

Luiz Alfredo Braun Ferreira ◽

Martyna Athaus ◽

Jean Pereira ◽

Fernando Sluchensci dos Santos ◽

...

Keyword(s):

Muscle Activation ◽

Intervention Group ◽

Surface Emg ◽

Electrical Signal ◽

Muscle Performance ◽

Control Group ◽

Electromyographic Activity ◽

Randomized Clinical Study ◽

Before And After ◽

Pilates Method

Introduction: Stretching is a therapeutic technique used to increase joint range of motion and flexibility and can be used as a warm-up to prevent injury or improve muscle performance. Pilates is one of the techniques used for such benefits, improving posture, body conditioning, aiding physical and mental control, which main characteristic is resistance work and dynamic stretching. Electromyography (EMG) is the study of muscle function by checking the electrical signal coming from the muscle, as well as the study of the motor unit activity. Objective: To evaluate the electromyographic activity of the hamstring muscles using the surface EMG before and after the application of a stretching protocol through Pilates. Methods: The sample consisted of 30 healthy individuals, 15 participants from the Control Group (CG) and 15 from the Pilates Group (PG), randomly selected from which 18 were selected for analysis. Electromyography was used to evaluate hamstring muscle activity before and after the exercises. For statistical analysis was used the SPSS software version 21, for the normality of the data was used the Kolmogorov-Smirnov test, and for the comparison between the groups was used the T-Student test. The treatment program was performed in the Guairacá Integrated Clinics in Guarapuava-PR, and consisted of ten Pilates exercises during two weekly sessions of forty minute each for five weeks. Results: There was a statistically significant increase (p = 0.00) in the muscle activation amplitude (RMS) of the femoral and semitendinosus biceps muscles after the Pilates stretching protocol in the intervention group when compared with the control group. Conclusion: It was concluded that the Pilates Method exercise protocol directed to hamstring stretching twice a week for five weeks significantly increased muscle activation and that physical inactivity led to a reduction in this activity observed in the control group. It is recommended that further studies be developed analyzing variables not yet studied, aiming to increase scientific knowledge about the influence of stretching through Pilates on muscle performance.

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Quadriceps muscle strength after training with a cycloergometer in patients on hemodialysis

Fisioterapia em Movimento ◽

10.1590/1980-5918.032.ao37 ◽

2019 ◽

Vol 32 ◽

Author(s):

Adriana Linda Abdo ◽

Yvoty Alves dos Santos Sens ◽

Luiz Antonio Miorin ◽

Vivian Bertoni Xavier ◽

Antonio de Olival Fernandes ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Muscle Strength ◽

Functional Disability ◽

Intervention Group ◽

Quadriceps Muscle ◽

Lower Limbs ◽

Control Group ◽

Quadriceps Muscle Strength ◽

Informed Consent Form

Abstract Introduction: Functional disability is common in patients with chronic kidney disease, especially in those on hemodialysis. Muscle strength can be evaluated by a dynamometer; however, no study using this technique on the quadriceps of patients undergoing hemodialysis was found in literature. Objective: To assess the effects of cycloergometer training on the quadriceps muscle strength of patients with chronic kidney disease undergoing hemodialysis. Method: This was a clinical trial including 46 patients, both men and women, over 18 years old who had been undergoing hemodialysis for more than six months and signed an informed consent form. Patients were allocated into two groups: intervention group (n = 22) and control group (n = 20). The intervention group underwent intradialytic training in a physical therapy protocol with the cycloergometer for two months, whereas the control group, in turn, was only reevaluated two months after the initial evaluation. All patients were assessed for demographic data at baseline and, two months later for quadriceps muscle strength by standardized dynamometry and with the use of a rigid belt and suction cups. Results: A significant increase was detected in quadriceps muscle strength in the right and left lower limbs in the intervention group when compared with the control group. Conclusion: Quadriceps muscle strength improved after patients with chronic kidney disease on hemodialysis underwent training with the cycloergometer.

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