Synaptic inputs to motor neurons underlying muscle coactivation for functionally different tasks have different spectral characteristics.

The central nervous system (CNS) may produce the same endpoint trajectory or torque profile with different muscle activation patterns. What differentiates these patterns is the presence of cocontraction, which does not contribute to effective torque generation but allows to modulate joints' mechanical stiffness. Although it has been suggested that the generation of force and the modulation of stiffness rely on separate pathways, a characterization of the differences between the synaptic inputs to motor neurons (MNs) underlying these tasks is still missing. In this study, participants coactivated the same pair of upper-limb muscles, i.e., the biceps brachii and the triceps brachii, to perform two functionally different tasks: limb stiffness modulation or endpoint force generation. Spike trains of MNs were identified through decomposition of high-density electromyograms (EMGs) collected from the two muscles. Cross-correlogram showed a higher synchronization between MNs recruited to modulate stiffness, whereas cross-muscle coherence analysis revealed peaks in the ß-band, which is commonly ascribed to a cortical origin. These peaks did not appear during the coactivation for force generation, thus suggesting separate cortical inputs for stiffness modulation. Moreover, a within-muscle coherence analysis identified two subsets of MNs that were selectively recruited to generate force or regulate stiffness. This study is the first to highlight different characteristics, and probable different neural origins, of the synaptic inputs driving a pair of muscles under different functional conditions. We suggest that stiffness modulation is driven by cortical inputs that project to a separate set of MNs, supporting the existence of a separate pathway underlying the control of stiffness.NEW & NOTEWORTHY The characterization of the pathways underlying force generation or stiffness modulation are still unknown. In this study, we demonstrated that the common input to motor neurons of antagonist muscles shows a high-frequency component when muscles are coactivated to modulate stiffness but not to generate force. Our results provide novel insights on the neural strategies for the recruitment of multiple muscles by identifying specific spectral characteristics of the synaptic inputs underlying functionally different tasks.

Design of a Wireless, Modular and Programmable Neuromuscular Electrical Stimulator.

The use of electrical stimulation to elicit single twitches and tetanic contractions of skeletal muscles has increased markedly in the last years, with applications ranging from basic physiology to clinical settings. Addressing all possible needs required by different applications with an electrical stimulator is challenging as it requires the device to be highly flexible in terms of stimulation configurations (number of channels and electrode location), and possibility to control the stimulation patterns (timing and stimulation profiles). This paper describes a new wireless, modular, and programmable electrical stimulator integrating the possibility to acquire and use biomechanical signals to trigger the stimulation output. A closed-loop FES Cycling setup has been presented to show a possible application of the system.

Effect of contraction force and knee joint angle on the spatial representation of soleus activity using high-density surface EMG.

The meaningful use of surface electromyographic signals (sEMG) is to find an electrode position and orientation in which the sEMG signals can be detected reliably. This becomes more challenging when muscles with pinnate fiber architecture are investigated. In this study, the effects of contraction force and knee inclination on the spatial representation of the soleus muscle activity on the skin surface have been investigated by using two-dimensional electrode grids. Four differently oriented bipolar leads have been calculated to identify not only a proper electrode location but also an adequate orientation of the bipolar lead. Relative measures have been introduced to compare changes in the spatial RMS distribution. It has been shown that in the case of the soleus muscle, bipolar electrodes should be placed on the lateral side. Additionally, the location of the electrodes should be rather proximal than distal, and the orientation of the bipolar lead should be 45° to the lateral side with respect to a line connecting the insertion of the Achilles tendon and the junction between both gastrocnemius heads. Our results have been used to identify adequate electrode locations and orientations in a muscle with such a complex architecture like the soleus muscle. Additionally, new parameters have been introduced, helping to analyze the resulting information about the spatial activation pattern in the soleus muscle.

How much does the human medial gastrocnemius muscle contribute to ankle torques outside the sagittal plane?

Ankle movements in the frontal plane are less prominent though not less relevant than movements in the plantar or dorsal flexion direction. Walking on uneven terrains and standing on narrow stances are examples of circumstances likely imposing marked demands on the ankle medio-lateral stabilization. Following our previous evidence associating lateral bodily sways in quiet standing to activation of the medial gastrocnemius (MG) muscle, in this study we ask: how large is the MG contribution to ankle torque in the frontal plane? By arranging stimulation electrodes in a selective configuration, current pulses were applied primarily to the MG nerve branch of ten subjects. The contribution of populations of MG motor units of progressively smaller recruitment threshold to ankle torque was evaluated by increasing the stimulation amplitude by fixed amounts. From smallest intensities (12-32 mA) leading to the firstly observable MG twitches in force-plate recordings, current pulses reached intensities (56-90 mA) below which twitches in other muscles could not be observed from the skin. Key results showed a substantial MG torque contribution tending to rotate upward the foot medial aspect (ankle inversion). Nerve stimulation further revealed a linear relationship between the peak torque of ankle plantar flexion and inversion, across participants (Pearson R>.81, p<.01). Specifically, regardless of the current intensity applied, the peak torque of ankle inversion amounted to about 13% of plantar flexion peak torque. Physiologically, these results provide experimental evidence that MG activation may contribute to stabilize the body in the frontal plane, especially under situations of challenged stability.

Myoelectric activity along human gastrocnemius medialis: different spatial distributions of postural and electrically elicited surface potentials.

It has recently been shown that motor units in human medial gastrocnemius (MG), activated during standing, occupy relatively small territories along the muscle's longitudinal axis. Such organisation provides potential for different motor tasks to produce differing regional patterns of activity. Here, we investigate whether postural control and nerve electrical stimulation produce equal longitudinal activation patterns in MG. Myoelectric activity, at different proximal-distal locations of MG, was recorded using a linear electrode array. To ensure differences in signal amplitude between channels did not result from local, morphological factors two experimental protocols were completed: (i) quiet standing; (ii) electrical stimulation of the tibial nerve. Averaged, rectified values (ARVs) were calculated for each channel in each condition. The distribution of signals along electrode channels was described using linear regression and differences between protocols at each channel determined as the ratio between mean ARV from standing: stimulation protocols. Ratio values changed systematically across electrode channels in seven (of eight) participants, with larger values in distal channels. The distribution of ARV along MG therefore differed between experimental conditions. Compared to fibres of units activated during MG nerve stimulation, units activated during standing may have a tendency to be more highly represented in the distal muscle portion.

Do surface electromyograms provide physiological estimates of conduction velocity from the medial gastrocnemius muscle?

Muscle fiber conduction velocity (CV) is commonly estimated from surface electromyograms (EMGs) collected with electrodes parallel to muscle fibers. If electrodes and muscle fibers are not located in parallel planes, CV estimates are biased towards values far over the physiological range. In virtue of their pinnate architecture, the fibers of muscles such as the gastrocnemius are hardly aligned in planes parallel to surface electrodes. Therefore, in this study we investigate whether physiological CV estimates can be obtained from the gastrocnemius muscle. Specifically, with a large grid of 16×8 electrodes we map CV estimates over the whole gastrocnemius muscle while eleven subjects exerted isometric plantar flexions at three different force levels. CV was estimated for couples of single differential EMGs and estimate locations (i.e., channels) were classified as physiological and non-physiological, depending on whether CV estimates were within the physiological range (3-6ms(-1)) or not. Physiological CV values could be estimated from a markedly small muscle region for eight participants; channels providing physiological CV estimates corresponded to about 5% of the total number of channels. As expected, physiological and non-physiological channels were clustered in distinct regions. CV estimates within the physiological range were obtained for the most distal gastrocnemius portion (ANOVA, P<0.001), where occurrences of propagating potentials were often verified through visual analysis. For the first time, this study shows that CV might be reliably assessed from surface EMGs collected from the most distal gastrocnemius region.

Recruitment of motor units in the medial gastrocnemius muscle during human quiet standing: is recruitment intermittent? What triggers recruitment?

The recruitment and the rate of discharge of motor units are determinants of muscle force. Within a motoneuron pool, recruitment and rate coding of individual motor units might be controlled independently, depending on the circumstances. In this study, we tested whether, during human quiet standing, the force of the medial gastrocnemius (MG) muscle is predominantly controlled by recruitment or rate coding. If MG control during standing was mainly due to recruitment, then we further asked what the trigger mechanism is. Is it determined internally, or is it related to body kinematics? While seven healthy subjects stood quietly, intramuscular electromyograms were recorded from the MG muscle with three pairs of wire electrodes. The number of active motor units and their mean discharge rate were compared for different sway velocities and positions. Motor unit discharges occurred more frequently when the body swayed faster and forward (Pearson R = 0.63; P < 0.0001). This higher likelihood of observing motor unit potentials was explained chiefly by the recruitment of additional units. During forward body shifts, the median number of units detected increased from 3 to 11 (P < 0.0001), whereas the discharge rate changed from 8 ± 1.1 (mean ± SD) to 10 ± 0.9 pulses/s (P = 0.001). Strikingly, motor units did not discharge continuously throughout standing. They were recruited within individual, forward sways and intermittently, with a modal rate of two recruitments per second. This modal rate is consistent with previous circumstantial evidence relating the control of standing to an intrinsic, higher level planning process.

Are the myoelectric manifestations of fatigue distributed regionally in the human medial gastrocnemius muscle?

Myoelectric fatigue typically manifests as variations in the amplitude and spectrum of surface electromyograms (EMGs). Interestingly, these variations seem to be represented locally in different muscles. In this study, we ask whether such a regional distribution of myoelectric fatigue extends to the medial gastrocnemius (MG) muscle. If the MG muscle is activated locally during fatiguing contractions, or if the most fatigable MG fibers are located at distinct muscle regions, then, the myoelectric manifestations of MG fatigue are expected to appear locally in a grid of surface electrodes. With a matrix of surface electrodes (7×15 single-differential EMGs) we show that myoelectric fatigue, indeed, manifests regionally in the MG muscle of 12 subjects, who exerted intermittent, fatiguing plantar flections at 50% of their maximal effort. Contrary to the root mean square amplitude, the median frequency of surface EMGs varied consistently across subjects throughout the plantar flections (P=0.002). On average, changes in EMG spectrum were represented at 78-93 (interquartile interval) out of the 105 channels in the matrix, though with different degrees across channels. For all participants, about 29% of the channels detected significantly greater reductions in median frequency when compared to all channels in the matrix (P<0.003). Strikingly, these channels were not sparsely distributed; they rather occupied localized skin regions across subjects. Physiologically, our results suggest that, during sub-maximal fatiguing tasks, myoelectric manifestations of MG fatigue are represented in spatially localized muscle regions. Technically, the possibility of studying myoelectric fatigue in the MG muscle appears to depend on the electrode location.

Insights gained into the interpretation of surface electromyograms from the gastrocnemius muscles: A simulation study.

Interpretation of surface electromyograms (EMG) is usually based on the assumption that the surface representation of action potentials does not change during their propagation. This assumption does not hold for muscles whose fibers are oblique to the skin. Consequently, the interpretation of surface EMGs recorded from pinnate muscles unlikely prompts from current knowledge. Here we present a complete analytical model that supports the interpretation of experimental EMGs detected from muscles with oblique architecture. EMGs were recorded from the medial gastrocnemius muscle during voluntary and electrically elicited contractions. Preliminary indications obtained from simulated and experimental signals concern the spatial localization of surface potentials and the myoelectric fatigue. Specifically, the spatial distribution of surface EMGs was localized about the fibers superficial extremity. Strikingly, this localization increased with the pinnation angle, both for the simulated EMGs and the recorded M-waves. Moreover, the average rectified value (ARV) and the mean frequency (MNF) of interference EMGs increased and decreased with simulated fatigue, respectively. The degree of variation in ARV and MNF did not depend on the pinnation angle simulated. Similar variations were observed for the experimental EMGs, although being less evident for a higher fiber inclination. These results are discussed on a physiological context, highlighting the relevance of the model proposed here for the interpretation of gastrocnemius EMGs and for conceiving future experiments on muscles with pinnate geometry.

Postural activation of the human medial gastrocnemius muscle: are the muscle units spatially localised?

In cat medial gastrocnemius (MG), fibres supplied by individual motoneurones (muscle units) distribute extensively along the muscle longitudinal axis. In the human MG, the size of motor unit territory is unknown. It is uncertain if the absolute size of muscle unit territory or the size relative to the whole muscle is most comparable with the cat. By comparing intramuscular and surface electromyograms we tested whether muscle units extend narrowly or widely along the human MG muscle. Due to the pennation of the MG, if individual motoneurones supply fibres scattered along the muscle, then action potentials of single motor units are expected to appear sparsely on the surface of the skin. In nine healthy subjects, pairs of wire electrodes were inserted in three locations along the MG muscle (MG60%, MG75% and MG90%). A longitudinal array of 16 surface electrodes was positioned alongside the intramuscular electrodes. While subjects stood quietly, 55 motor units were identified, of which, significantly more units were detected in the most distal sites. The surface action potentials had maximum amplitude at 4.40 ±1.67 (mean±S.D.), 8.02±2.16 and 11.63±2.09 cm (P <0.001) from the most proximal surface electrode, for motor units in the MG60%, MG75% and MG90% locations, respectively. Single motor unit potentials were recorded by five consecutive surface electrodes, at most, indicating that muscle units extend shortly along the MG longitudinal axis. It is concluded that relative to the whole muscle, and compared with the cat, muscle units in human MG are localised. The localisation of muscle units might have implications for the regional control of muscle activity.

Advances in surface EMG: recent progress in clinical research applications.

This article is the second part of a larger review work that has been structured in three parts. The three parts concern a) advances in surface EMG detection and processing techniques, b) recent progress in surface EMG clinical research applications, and c) myoelectric control in neurorehabilitation. This second part concerns state of the art applications of surface EMG techniques to a) the external anal sphincter in relation to episiotomy and incontinence; b) the assessment of postural control mechanisms; c) exercise physiology, electrical stimulation and muscle cramps; and d) ergonomics and work-related neuromuscular disorders. The material is presented with an effort to fill gaps left by previous reviews and identify areas open for future research.

Advances in surface EMG: recent progress in detection and processing techniques.

This article is the first section of a review work structured in three parts and concerning a) advances in surface EMG detection and processing techniques, b) recent progress in surface EMG clinical research applications and, c) myoelectric control in neurorehabilitation. This article deals with the state of the art regarding a) the electrode-skin interface (equivalent circuits, skin treatment, conductive gels), b) signal detection modalities, spatial filters and front-end amplifiers, c) power line interference removal, separation of propagating and non-propagating potentials and removal of outliers from surface EMG signal maps, d) segmentation of surface EMG signal maps, e) decomposition of surface EMG into the constituent action potential trains, and f) relationship between surface EMG and force. The material is presented with an effort to fill gaps left by previous reviews and identify areas open for future research.

Automatic segmentation of surface EMG images: Improving the estimation of neuromuscular activity.

Surface electromyograms (EMGs) recorded with a couple of electrodes are meant to comprise representative information of the whole muscle activation. Nonetheless, regional variations in neuromuscular activity seem to occur in numerous conditions, from standing to passive muscle stretching. In this study, we show how local activation of skeletal muscles can be automatically tracked from EMGs acquired with a bi-dimensional grid of surface electrodes (a grid of 8 rows and 15 columns was used). Grayscale images were created from simulated and experimental EMGs, filtered and segmented into clusters of activity with the watershed algorithm. The number of electrodes on each cluster and the mean level of neuromuscular activity were used to assess the accuracy of the segmentation of simulated signals. Regardless of the noise level, thickness of fat tissue and acquisition configuration (monopolar or single differential), the segmentation accuracy was above 60%. Accuracy values peaked close to 95% when pixels with intensity below approximately 70% of maximal EMG amplitude in each segmented cluster were excluded. When simulating opposite variations in the activity of two adjacent muscles, watershed segmentation produced clusters of activity consistently centered on each simulated portion of active muscle and with mean amplitude close to the simulated value. Finally, the segmentation algorithm was used to track spatial variations in the activity, within and between medial and lateral gastrocnemius muscles, during isometric plantar flexion contraction and in quiet standing position. In both cases, the regionalization of neuromuscular activity occurred and was consistently identified with the segmentation method.

Is the stabilization of quiet upright stance in humans driven by synchronized modulations of the activity of medial and lateral gastrocnemius muscles?

A matrix of 120 electromyogram (EMG) electrodes (8 rows and 15 columns) was used to investigate individual activation patterns of the medial (MG) and lateral gastrocnemius (LG) muscles during forward sways of the body in human quiet stance. This matrix was positioned on the right calf of eight subjects after identification of the MG and LG contours with ultrasound scanning. Gray-scale images were generated with the maxima and minima of the cross-correlation function between the envelope of each EMG signal and the body center of pressure (CoP) for individual forward sways. These images were automatically segmented to reduce the data set into representative and local values of EMG-CoP cross-correlation for each muscle. On average, modulations in EMG amplitude preceded the onset of forward sways with a variable timing, with both gastrocnemius muscles being similarly and synchronously modulated in 193 out of 236 sways. Variations in the timing of activation between muscles were less frequent, although consistent across subjects and significantly correlated with changes in the direction and velocity of body sways. Interestingly, the time shift between EMG and CoP traces sometimes varied consistently along different channels of the same column of electrodes, either in proximal-to-distal or distal-to-proximal direction. The variable EMG-CoP cross-correlation delay was not congruent with the delay expected for the propagation of surface potentials along muscle fibers. Comparison of surface EMGs with intramuscular EMGs recorded from six subjects demonstrated that surface potentials provide high spatial selectivity, thus supporting the notion of selective activation of motor units during quiet standing. Hence, the stabilization of the quiet standing posture likely relies on flexible rather than stereotyped mechanisms of control.

Postural sway changes during pregnancy: a descriptive study using stabilometry.

OBJECTIVE: This study aims to analyse changes in body sway over the course of pregnancy. STUDY DESIGN: This is a descriptive study in which stabilometric tests were applied at three stages of pregnancy and with a combination of different visual conditions (eyes open/closed) and support base configuration (feet together/apart). Twenty healthy pregnant women participated in the study. Changes in postural control with pregnancy were analysed via the elliptical area of the stabilograms and spectral analysis of the displacements of the centre of pressure (COP) along the lateral and anterior/posterior directions. RESULTS: The elliptical area encompassing the COP significantly increased over the course of the pregnancy for the feet apart and eyes closed test protocols. The spectral analysis revealed a significant increase of COP oscillations along the anterior-posterior direction when subjects stood with the eyes open/feet together and feet apart. A reduction (significant) of the lateral oscillations of COP was observed for the eyes open/feet together protocol. CONCLUSION: Pregnancy induced significant changes in the postural control when pregnant women stood with a reduced support base or with eyes closed.

Effect of the shoulder position on the biceps brachii emg in different dumbbell curls.

Incline Dumbbell Curl (IDC) and Dumbbell Preacher Curl (DPC) are two variations of the standard Dumbbell Biceps Curl (DBC), generally applied to optimize biceps brachii contribution for elbow flexion by fixing shoulder at a specific angle. The aim of this study is to identify changes in the neuromuscular activity of biceps brachii long head for IDC, DPC and DBC exercises, by taking into account the changes in load moment arm and muscle length elicited by each dumbbell curl protocol. A single cycle (concentric-eccentric) of DBC, IDC and DPC, was applied to 22 subjects using a submaximal load of 40% estimated from an isometric MVC test. The neuromuscular activity of biceps brachii long head was compared by further partitioning each contraction into three phases, according to individual elbow joint range of motion. Although all protocols elicited a considerable level of activation of the biceps brachii muscle (at least 50% of maximum RMS), the contribution of this muscle for elbow flexion/extension varied among exercises. The submaximal elbow flexion (concentric) elicited neuro muscular activity up to 95% of the maximum RMS value during the final phase of IDC and DBC and 80% for DPC at the beginning of the movement. All exercises showed significant less muscle activity for the elbow extension (eccentric). The Incline Dumbbell Curl and the classical Dumbbell Biceps Curl resulted in similar patterns of biceps brachii activation for the whole range of motion, whereas Dumbbell Preacher Curl elicited high muscle activation only for a short range of elbow joint angle. Key pointsThe Incline Dumbbell Curl and the Dumbbell Biceps Curl resulted in a considerable neuromuscular effort throughout the whole elbow range of motion.The Incline Dumbbell Curl and the Dumbbell Biceps Curl may be preferable for the improvement of biceps brachii force in training programs.