Microneedle Array Electrodes Fabricated With 3D Printing Technology for High-Quality Electrophysiological Acquisition.

Electrophysiological recordings are vital in assessing biological functions, diagnosing diseases, and facilitating biofeedback and rehabilitation. The applications of conventional wet (gel) electrodes often come with some limitations. Microneedle array electrodes (MAEs) present a possible solution for high-quality electrophysiological acquisition, while the prior technologies for MAE fabrication have been either complex, expensive, or incapable of producing microneedles with uniform dimensions. This work employed a projection stereolithography (P µ SL) 3D printing technology to fabricate MAEs with micrometer-level precision. The MAEs were compared with gel and flat electrodes on electrode-skin interface impedance (EII) and performances of EMG and ECG acquisition. The experimental results indicate that the P µ SL 3D printing technology contributed to an easy-to-perform and low-cost fabrication approach for MAEs. The developed MAEs exhibited promising EII and enabled a stable EMG and ECG acquisition in different conditions without inducing skin allergies, inflammation, or injuries. This research lies in the development of a type of customizable MAE with considerable biomedical application potentials for ultra-minimally invasive or non-invasive electrophysiological acquisition.

Loading Recognition for Lumbar Exoskeleton Based on Multi-Channel Surface Electromyography From Low Back Muscles.

Lumbar exoskeleton is an assistive robot, which can reduce the risk of injury and pain in low back muscles when lifting heavy objects. An important challenge it faces involves enhancing assistance with minimal muscle energy consumption. One of the viable solutions is to adjust the force or torque of assistance in response to changes in the load on the low back muscles. It requires accurate loading recognition, which has yet to yield satisfactory outcomes due to the limitations of available measurement tools and load classification methods. This study aimed to precisely identify muscle loading using a multi-channel surface electromyographic (sEMG) electrode array on the low back muscles, combined with a participant-specific load classification method. Ten healthy participants performed a stoop lifting task with objects of varying weights, while sEMG data was collected from the low back muscles using a 3x7 electrode array. Nineteen time segments of the lifting phase were identified, and time-domain sEMG features were extracted from each segment. Participant-specific classifiers were built using four classification algorithms to determine the object weight in each time segment, and the classification performance was evaluated using a 5-fold cross-validation method. The artificial neural network classifier achieved an impressive accuracy of up to 96%, consistently improving as the lifting phase progressed, peaking towards the end of the lifting movement. This study successfully achieves accurate recognition of load on low back muscles during the object lifting task. The obtained results hold significant potential in effectively reducing muscle energy consumption when wearing a lumbar exoskeleton.

A randomized controlled trial investigating the impact of a single flash cupping session on patients with chronic lower back pain using multichannel surface electromyographic assessment.

BACKGROUND: Chronic lower back pain (CLBP) is one of the most common disorders worldwide. Flash cupping has the ability to relieve CLBP; nevertheless, its impact on CLBP and the likely mechanism of action have not been studied. OBJECTIVE: The goal of this study was to assess the impact of a single, brief cupping session on CLBP and low back muscle activity using multichannel surface electromyography (sEMG). METHODS: In this randomized controlled trial, 24 patients with CLBP were enrolled and randomly assigned to the control group (treated by acupuncture) and cupping group (treated by acupuncture and flash cupping). Acupuncture was applied on the shen shu (BL23), dachang shu (BL25), and wei zhong (BL40) acupoints in both the groups. A brief cupping treatment was applied to the shen shu (BL23), qihai shu (BL24), dachang shu (BL25), guanyuan shu (BL26), and xiaochang shu (BL27) acupoints on both sides of the lower back in the cupping group. The numeric rating scale (NRS) was used to assess therapy efficacy for lower back pain (LBP) before and after treatment. Surface EMG data collected during symmetrical trunk flexion-extension movements were utilized to measure lower back muscle activity and the effectiveness of LBP therapy. RESULTS: There was no statistically significant difference (P= 0.63) in pain intensity between the two groups before and after treatment. There was a statistically significant difference (P= 0.04) between the control group and the cupping group in the sEMG topographic map parameter CoGx-To-Midline. CONCLUSION: This study established a connection between the action mechanism of flash cupping and enhanced horizontal synchronization of lower back muscular activity.

Effect Analysis of Wearing an Lumbar Exoskeleton on Coordinated Activities of the Low Back Muscles Using sEMG Topographic Maps.

Lumbar exoskeleton has potential to assist in lumbar movements and thereby prevent impairment of back muscles. However, due to limitations of evaluation tools, the effect of lumbar exoskeletons on coordinated activities of back muscles is seldom investigated. This study used the surface electromyography (sEMG) topographic map based on multi-channel electrodes from low back muscles to analyze the effects. Thirteen subjects conducted two tasks, namely lifting and holding a 20kg-weight box. For each task, three different trials, not wearing exoskeleton (NoExo), wearing exoskeleton but power-off (OffExo), and wearing exoskeleton and power-on (OnExo), were randomly conducted. Root-mean-square (RMS) and median-frequency (MDF) topographic maps of the recorded sEMG were constructed. Three parameters, average pixel values, distribution of center of gravity (CoG), and entropy, were extracted from the maps to assess the muscle coordinated activities. In the lifting task, results showed the average pixel values of RMS maps for the NoExo trial were lower than those for the OffExo trial ( [Formula: see text]) but the same as those for the OnExo trial ( [Formula: see text]0.05). The distribution of CoG showed a significant difference between NoExo and OnExo trials ( [Formula: see text]). In the holding task, RMS and MDF maps' average pixel values showed significant differences between NoExo and OnExo trials ( [Formula: see text]). These findings suggest that active lumbar exoskeletons can reduce the load on low back muscles in the static holding task rather than in the dynamic lifting task. This proves sEMG topographic maps offer a new way to evaluate such effects, thereby helping improve the design of lumbar exoskeleton systems.

An Approach for EEG Denoising Based on Wasserstein Generative Adversarial Network.

Electroencephalogram (EEG) recordings often contain artifacts that would lower signal quality. Many efforts have been made to eliminate or at least minimize the artifacts, and most of them rely on visual inspection and manual operations, which is time/labor-consuming, subjective, and incompatible to filter massive EEG data in real-time. In this paper, we proposed a deep learning framework named Artifact Removal Wasserstein Generative Adversarial Network (AR-WGAN), where the well-trained model can decompose input EEG, detect and delete artifacts, and then reconstruct denoised signals within a short time. The proposed approach was systematically compared with commonly used denoising methods including Denoised AutoEncoder, Wiener Filter, and Empirical Mode Decomposition, with both public and self-collected datasets. The experimental results proved the promising performance of AR-WGAN on automatic artifact removal for massive data across subjects, with correlation coefficient up to 0.726±0.033, and temporal and spatial relative root-mean-square error as low as 0.176±0.046 and 0.761±0.046, respectively. This work may demonstrate the proposed AR-WGAN as a high-performance end-to-end method for EEG denoising, with many on-line applications in clinical EEG monitoring and brain-computer interfaces.

Hairy-Skin-Adaptive Viscoelastic Dry Electrodes for Long-Term Electrophysiological Monitoring.

Long-term epidermal electrophysiological (EP) monitoring is crucial for disease diagnosis and human-machine synergy. The human skin is covered with hair that grows at an average rate of 0.3 mm per day. This impedes a stable contact between the skin and dry epidermal electrodes, resulting in motion artifacts during ultralong-term EP monitoring. Therefore, accurate and high-quality EP signal detection remains challenging. To address this issue, a new solution-the hairy-skin-adaptive viscoelastic dry electrode (VDE) is reported. This innovative technology is capable of bypassing hair and filling into the skin wrinkles, leading to long-lasting and stable interface impedance. The VDE maintains a stable interface impedance for a remarkable period of 48 days and 100 cycles. The VDE is highly effective in shielding against hair disturbances in electrocardiography (ECG) monitoring, even during intense chest expansion, and in electromyography (EMG) monitoring during large strain. Furthermore, the VDE is easily attachable to the skull without requiring any electroencephalogram (EEG) cap or bandage, making it an ideal solution for EEG monitoring. This work represents a substantial breakthrough in the field of EP monitoring, providing a solution for the previously challenging issue of monitoring human EP signals on hairy skin.

The analgesic effect of different interactive modes of virtual reality: A prospective functional near-infrared spectroscopy (fNIRS) study.

Virtual reality has demonstrated its analgesic effectiveness. However, its optimal interactive mode for pain relief is yet unclear, with rare objective measurements that were performed to explore its neural mechanism. Objective: This study primarily aimed at investigating the analgesic effect of different VR interactive modes via functional near-infrared spectroscopy (fNIRS) and exploring its correlations with the subjectively reported VR experience through a self-rating questionnaire. Methods: Fifteen healthy volunteers (Age: 21.93 ± 0.59 years, 11 female, 4 male) were enrolled in this prospective study. Three rounds of interactive mode, including active mode, motor imagery (MI) mode, and passive mode, were successively facilitated under consistent noxious electrical stimuli (electrical intensity: 23.67 ± 5.69 mA). Repeated-measures of analysis of variance (ANOVA) was performed to examine its pain relief status and cortical activation, with post hoc analysis after Bonferroni correction performed. Spearman's correlation test was conducted to explore the relationship between VR questionnaire (VRQ) items and cortical activation. Results: A larger analgesic effect on the active (-1.4(95%CI, -2.23 to -0.57), p = 0.001) and MI modes (-0.667(95%CI, -1.165 to -0.168), p = 0.012) was observed compared to the passive mode in the self-rating pain score, with no significant difference reported between the two modes (-0.733(95%CI, -1.631 to.165), p = 0.131), associated with diverse activated cortical region of interest (ROI) in charge of motor and cognitive functions, including the left primary motor cortex (LM1), left dorsal-lateral prefrontal cortex (LDLPFC), left primary somatosensory cortex (LS1), left visual cortex at occipital lobe (LOL), and left premotor cortex (LPMC). On the other hand, significant correlations were found between VRQ items and different cortical ROIs (r = -0.629 to 0.722, p < 0.05) as well as its corresponding channels (r = -0.599 to 0.788, p < 0.05). Conclusion: Our findings suggest that VR can be considered as an effective non-invasive approach for pain relief by modulating cortical pain processing. A better analgesic effect can be obtained by exciting and integrating cortical ROIs in charge of motor and cognitive functions. The interactive mode can be easily tailored to be in line with the client's characteristics, in spite of the diverse cortical activation status when an equivalent analgesic effect can be obtained.

Analysis of Muscular Electrical Activity and Blood Perfusion of Upper Extremity in Patients with Hemiplegic Shoulder Pain: A Pilot Study.

Background: Hemiplegic shoulder pain (HSP) is a common symptom for post-stroke patients, which has a severely adverse impact on their rehabilitation outcomes. However, the cause of HSP has not been clearly identified due to its complicated multifactorial etiologies. As possible causes of HSP, the abnormality of both muscular electrical activity and blood perfusion remains lack of investigations. Objective: This study aimed to analyze the alteration of muscular electrical activity and blood perfusion of upper extremity in patients with HSP by using surface electromyography (sEMG) and laser speckle contrast imaging (LSCI) measurement techniques, which may provide some insight into the etiology of HSP. Methods: In this observational and cross-sectional study, three groups of participants were recruited. They were hemiplegic patients with shoulder pain (HSP group), hemiplegic patients without shoulder pain (HNSP group), and healthy participants (Healthy group). The sEMG data and blood perfusion data were collected from all the subjects and used to compute three different physiological measures, the root-mean-square (RMS) and median-frequency (MDF) parameters of sEMG recordings, and the perfusion unit (PU) parameter of blood perfusion imaging. Results: The RMS parameter of sEMG showed significant difference (p < 0.05) in the affected side between HSP, HNSP, and Healthy groups. The MDF parameter of sEMG and PU parameter of blood perfusion showed no significant difference in both sides among the three groups (p > 0.05). The RMS parameter of sEMG showed a statistically significant correlation with the pain intensity (r = -0.691, p =0.012). Conclusion: This study indicated that the muscular electrical activity of upper extremity had a correlation with the presence of HSP, and the blood perfusion seemed to be no such correlation. The findings of the study suggested an alternative way to explore the mechanism and treatment of HSP.

Effective Evaluation of Finger Sensation Evoking by Non-Invasive Stimulation for Sensory Function Recovery in Transradial Amputees.

Synergetic recovery of both somatosensory and motor functions is highly desired by limb amputees to fully regain their lost limb abilities. The commercially available prostheses can restore the lost motor function in amputees but lack intuitive sensory feedback. The previous studies showed that electrical stimulation on the arm stump would be a promising approach to induce sensory information into the nervous system, enabling the possibility of realizing sensory feedback in limb prostheses. However, there are currently limited studies on the effective evaluation of the sensations evoked by transcutaneous electrical nerve stimulation (TENS). In this paper, a multichannel TENS platform was developed and the different stimulus patterns were designed to evoke stable finger sensations for a transradial amputee. Electroencephalogram (EEG) was recorded simultaneously during TENS on the arm stump, which was utilized to evaluate the evoked sensations. The experimental results revealed that different types of sensations on three phantom fingers could be stably evoked for the amputee by properly selecting TENS patterns. The analysis of the event-related potential (ERP) of EEG recordings further confirmed the evoked sensations, and ERP latencies and curve characteristics for different phantom fingers showed significant differences. This work may provide insight for an in-depth understanding of how somatosensation could be restored in limb amputees and offer technical support for the applications of non-invasive sensory feedback systems.

Synergy Analysis of Back Muscle Activities in Patients With Adolescent Idiopathic Scoliosis Based on High-Density Electromyogram.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) is a common structural spinal deformity and is typically associated with altered muscle properties. However, it is still unclear how muscle activities and the underlying neuromuscular control are changed in the entire scoliotic zone, restricting the corresponding pathology investigation and treatment enhancements. METHODS: High-density electromyogram (HD-EMG) was utilized to explore the neuromuscular synergy of back muscle activities. For each of ten AIS patients and ten healthy subjects for comparison, an HD-EMG array was placed on their back from T8 to L4 to record EMG signals when performing five spinal motions (flexion/extension, lateral bending, axial rotation, siting, and standing). From the HD-EMG recordings, muscle synergies were extracted using the non-negative matrix factorization method and the topographical maps of EMG root-mean-square were constructed. RESULTS: For both the AIS and healthy subjects, the experimental results indicated that two muscle synergy groups could explain over 90% of recorded muscle activities for all five motions. During flexion/extension, the patients presented statistically significant higher activations on the convex side in the entire root-mean-square maps and synergy vector maps (p < 0.05). During lateral bending and axial rotation, the patients exhibited less activated muscles on the dominant actuating side relative to the contralateral side and their synergy vector maps showed a less homogenous and more diffuse distribution of muscle contraction with statistically different centers of gravity. CONCLUSION: The findings suggest a scoliotic spine might adopt an altered modular muscular coordination strategy to actuate different dominant muscles as adapted compensations for the deformation.

Effect of Electroacupuncture on Shoulder Subluxation in Poststroke Patients with Hemiplegic Shoulder Pain: A Sham-Controlled Study Using Multidimensional Musculoskeletal Ultrasound Assessment.

OBJECTIVE: This study aimed to use multidimensional musculoskeletal ultrasound imaging technique to investigate the effect of electroacupuncture (EA) on shoulder subluxation in poststroke patients with hemiplegic shoulder pain. METHODS: In this prospective single-blind, randomized, sham-controlled study, thirty-four patients with shoulder subluxation and hemiplegic shoulder pain were recruited and randomly assigned into the EA group or the sham EA (SEA) group. In the EA group, EA was applied to the Jian yu (LI15), Bi nao (LI14), Jian zhen (SI9), and Jian liao (TE14) acupoints. In the SEA group, the EA was applied 15 mm away from the Lou gu (SP7), Di ji (SP8), Jiao xin (KI8), and Zhu bin (KI9) acupoints. Both groups underwent treatment 30 minutes/day, five days a week, for two weeks using dense waves with a frequency of 2/100 Hz. A Visual Analogue Scale (VAS) was used to evaluate the effectiveness of treatment in reducing shoulder pain. Musculoskeletal ultrasound was used to evaluate the changes of measures of shoulder subluxation in multidimensions (i.e., the acromiohumeral distance, AHD; acromion-greater tuberosity, AGT; and acromion-lesser tuberosity, ALT). Both the within- and between-groups treatment effects were assessed. RESULTS: The pain intensity measured by VAS and shoulder subluxation measured by musculoskeletal ultrasound (i.e., AHD, AGT, and ALT) showed significant (p < 0.05) within-group difference in both groups. The between-group difference appeared in the pain intensity (p < 0.05), while it disappeared in the three measures of shoulder subluxation (p > 0.05). CONCLUSIONS: Using VAS for measuring pain intensity and multidimensional musculoskeletal ultrasound imaging technique for measuring shoulder subluxation, this study finds that the hemiplegic shoulder pain can be improved significantly by the EA while the shoulder subluxation cannot be. Our findings further reveal the analgesic mechanism of EA on hemiplegic shoulder pain following stroke.

Mapping Responses of Lumbar Paravertebral Muscles to Single-Pulse Cortical TMS Using High-Density Surface Electromyography.

Motor evoked potential (MEP), which was elicited by transcranial magnetic stimulation (TMS), has been widely used to detect corticospinal projection from TMS cortical site to trunk muscles. It can help to find the stimulation hotspot in the scalp. However, it fails to precisely describe coordinated activities of trunk muscle groups with only single-channel myoelectric signal. In this study, we aimed to use high-density surface electromyography (sEMG) to explore the effect of cortical TMS on lumbar paravertebral muscles in healthy subjects. The cortical site at 1 cm anterior and 4 cm lateral to vertex was chosen to simulate using a single-pulse TMS with different intensities and forward-bending angles. A high-density electrode array (45 channels) was placed on the surface of lumbar paravertebral muscles to record sEMG signals during a TMS experiment. MEP signals elicited by TMS were extracted from 45-channel recordings and one topographic map of the MEP amplitudes with six spatial features was constructed at each sampling point. The results showed TMS could successfully evoke an oval area with high intensity in the MEP topographic map, while this area mainly located in ipsilateral side of the TMS site. Intensity features related to the high intensity area rose significantly with TMS intensity and forward-bending angle increasing, but location features showed no change. The optimal stimulation parameters were 80% of maximum stimulator output (MSO) for TMS intensity and 30/60 degree for forward-bending angle. This study provided a potentially effective mapping tool to explore the hotspot for transcranial stimulation on trunk muscles.

Facial Electromyography Mapping in Healthy and Bell's Palsy Subjects: A High-Density Surface EMG Study.

Bell's palsy impairs the symmetry of facial appearance and movement. Detailed examination of facial muscle activities should be important for the diagnosis and treatment of the Bell's palsy. In this study, facial muscle activities in normal and Bell's palsy conditions were measured using a high-density (HD) electromyography (EMG) technique. The EMG signals during active tasks (four different facial expressions) and resting task were collected with a HD array of EMG electrodes from forehead and cheek muscles. To visualize facial EMG activities, the EMG maps were reconstructed from the HD-EMG recordings. The two-dimension (2D) correlation coefficients between right and left sides of facial EMG maps were calculated to evaluate the symmetry of facial muscle activities during these tasks. Our experimental results showed that the 2D correlation coefficients during active tasks were different significantly (P<0.01) between the healthy group(n=4) and Bell's palsy group(n=3). These results demonstrated that the synchronism of facial muscle activities during active tasks in healthy subjects is greater than that in the Bell's palsy subjects. This pilot study suggested that HD-EMG would be a potential technique to assess abnormal asymmetric activities of facial muscles for Bell's palsy.

Effect of dry-electrode-based transcranial direct current stimulation on chronic low back pain and low back muscle activities: A double-blind sham-controlled study.

BACKGROUND: Dry-electrode-based transcranial direct current stimulation is a new type of non-invasive brain stimulation system which relieves chronic low back pain and improves related muscle movement, in a way that overcomes the drawback of conventional systems. OBJECTIVE: To investigate the effectiveness of dry-electrode-based transcranial direct current stimulation in relieving chronic low back pain and altering pain-related low back muscles movement, by using pain assessment tool and surface electromyographic topography. METHODS: We conducted a prospective, double-blind, randomized, sham-controlled study. 60 patients with non-specific chronic low back pain were randomly and evenly allocated into tDCS and sham groups. Each group accepted a single 20-minute stimulation at 2 mA on the primary motor cortex. Numeric rating scale for pain intensity assessment and root-mean-square difference parameter from surface electromyographic topography were measured before and after stimulation. The current direction in brain using finite element method was simulated to verify the current distribution under dry stimulation electrode. RESULTS: After stimulation, the pain intensity in the tDCS group significantly decreased, while it did not show evident change in the sham group. However, change of root-mean-square difference parameters between tDCS and sham groups showed no significant difference. Simulation results based on finite element method showed most of current focused on primary motor cortex while peak value of current density was 0.225 A/m2. CONCLUSIONS: Dry-electrode-based transcranial direct current stimulation can lower pain perception in patients with chronic low back pain. The analgesic mechanism can affect the top-down modulation pathway of pain.

Assessment of Lumbar Muscles Coordinated Activity Based on High-Density Surface Electromyography: A Pilot Study.

Trunk-movement involves coordinated activity of different lumbar muscles. By assessing the lumbar muscles activity, the pathogeny of some neuromuscular disease might be revealed. Surface electromyography (sEMG) could be used to measure the muscle activity, but for assessing lumbar muscles coordinated activity, there lacks of an accurate and comprehensive application of sEMG. High-density (HD) sEMG provides a potential to assess lumbar muscles coordinated activity more accurately. Thus, in this pilot study, the objective was to assess the lumbar muscles coordinated activity based on HD sEMG. By placing a 5×15 array (75 channels) of HD sEMG electrodes to the surface of the low back area, the sEMG signal from four healthy subjects could be collected. In order to analyze the lumbar muscles coordinated activity, the sEMG signal during different trunk-movements was recorded. Through calculating the root-mean-square (RMS) of each channel and interpolating the RMS value between channels, the sEMG topography could be obtained. The high activity area in the topography showed a regular distribution during different trunk-movements. It might be useful for further assessment of lumbar disease such as low back pain.

Transcranial direct current stimulation of the primary motor cortex on postoperative pain and spontaneous oscillatory electroencephalographic activity following lumbar spine surgery: A pilot study.

BACKGROUND: Transcranial direct current stimulation (tDCS) on primary motor cortex (M1) provides a new way to relieve postoperative pain. Previous studies only found postoperative analgesia dosage significantly reduced in tDCS group while the patient-controlled analgesia (PCA) was applied. However, there lacks the study about the effect of M1-tDCS on pain intensity and brain activity while the analgesia dosage is the same for both groups. OBJECTIVE: To investigate whether M1-tDCS can (1) reduce pain intensity and (2) change spontaneous electroencephalography (EEG) oscillations in prefrontal cortex, in patients with postoperative pain, after taking the constant dosage of analgesics. METHODS: A prospective, single-blind, randomized, sham-controlled study was conducted. 32 patients with postoperative pain after lumbar spine surgery were recruited. All patients received same dosage of dezocine before intervention. In the morning of the first day after surgery and before dezocine injection, a single 20-minute session of anodal M1-tDCS was applied to 'tDCS' group while sham stimulation to 'sham' group. Numeric rating scale (NRS) and resting-state EEG with eyes-closed were measured and analyzed. EEG spectral powers were analyzed using repeated measures analysis of variance (ANOVA). Correlation analysis was conducted between the change of NRS and the change of spectral power. RESULTS: The NRS in "tDCS" group significantly decreased (p < 0.01) while not in "sham" group after intervention. Only spectral power within alpha2 band (10-13 Hz) in Fp1 and beta1 band (13-20 Hz) in Fp1 showed significant Time×Intervention interaction effect. These changes of the spectral power also showed significant correlation with the change of NRS. CONCLUSIONS: The postoperative pain intensity in patients receiving surgery could reduce after a single session of anodal M1-tDCS compared to sham M1-tDCS. The effect to the top-down dimension of postoperative pain might account for the analgesic effect of M1-tDCS, which reflecting slow oscillations in left prefrontal EEG.

A Machine Learning-based Surface Electromyography Topography Evaluation for Prognostic Prediction of Functional Restoration Rehabilitation in Chronic Low Back Pain.

STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to investigate the feasibility and applicability of support vector machine (SVM) algorithm in classifying patients with LBP who would obtain satisfactory or unsatisfactory progress after the functional restoration rehabilitation program. SUMMARY OF BACKGROUND DATA: Dynamic surface electromyography (SEMG) topography has demonstrated the potential use in predicting the prognosis of functional restoration rehabilitation for patients with low back pain (LBP). However, processing from raw SEMG topography to make prediction is not easy to clinicians. METHODS: A total of 30 patients with nonspecific LBP were recruited and divided into "responding" and "non-responding" group according to the change of Visual analog pain rating scale and Oswestry Disability Index. Each patient received a 12-week functional restoration rehabilitation program. A normal database was calculated from a control group from 48 healthy participants. Root-mean-square difference (RMSD) was extracted from the recorded dynamic SEMG topography during symmetrical and asymmetrical trunk-movement. SVM and cross-validation were applied to the prediction based on the optimized features selected by the sequential floating forward selection (SFFS) algorithm. RESULTS: RMSD feature parameters following rehabilitation in the "responding" group showed a significant difference (P < 0.05) with the one in the "nonresponding" group. The SVM classifier with Quadratic kernel based on SFFS-selected features showed the best prediction performance (accuracy: 96.67%, sensitivity: 100%, specificity: 93.75%, average area under curve [AUC]: 0.8925) comparing with linear kernel (accuracy: 80.00%, sensitivity: 85.71%, specificity: 75.00%, average AUC: 0.7825), polynomial kernel (accuracy: 93.33%, sensitivity: 92.86%, specificity: 93.75%, average AUC: 0.9675), and radial basis function (RBF) kernel (accuracy: 86.67%, sensitivity: 85.71%, specificity: 87.50%, average AUC: 0.7900). CONCLUSION: The use of SVM-based classifier of SEMG topography can be applied to identify the patient responding to functional restoration rehabilitation, which will help the healthcare worker to improve the efficiency of LBP rehabilitation. LEVEL OF EVIDENCE: 3.

Motion recognition for simultaneous control of multifunctional transradial prostheses.

Electromyography (EMG) pattern-recognition based control strategies for multifunctional myoelectric prosthesis systems have been studied commonly in a controlled laboratory setting. Most previous efforts concentrated on evaluating the performance of EMG pattern-recognition algorithms in identifying one signal movement at a time. Therefore, the current motion classification methods would be limited with the difficulties in identifying the combined upper-limb motion classes that are commonly required in performing activities daily. In this paper, four improved classifier training schemes were proposed and investigated to address the difficulties mentioned above. Our preliminary results showed that three of the four proposed training schemes could improve the classification performance. The average classification accuracies of the three methods were 75.10% ± 9.71%, 76.95% ± 8.02%, and 77.56% ± 6.55% for the able-bodied subjects, and 63.38% ± 7.51%, 62.55% ± 9.06%, and 62.50% ± 9.36% for the transradial amputees, respectively. These results suggested that the proposed methods could provide better classification performance in identifying the combined motions than the current methods.