Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review

Background: Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives: (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited-channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. Method: A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. Results: Seventy-eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). Conclusion: Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA

Firmware design of a portable medical device to measure the quadriceps muscle group after a total knee arthroplasty by EMG, LBIA and clinical score methods

El objetivo de este proyecto es el diseño del firmware de un dispositivo médico portátil para mediciones de EMG y LBIA, que se utilizará para la evaluación de pacientes de artroplastia total de rodilla, para estudiar la progresión de diferentes prótesis de rodilla (Medial-Pivot y Ultra-Congruente). En la tesis, se expone el conocimiento actual de los estudios y aplicaciones de EMG y LBIA, junto con los dispositivos comerciales utilizados actualmente. Además, se han estudiado e implementado las diferentes técnicas de filtrado y procesamiento digital para señales de EMG y LBIAs. Adicionalmente, se ha realizado un estudio estadístico preliminar con datos LBIA de 12 pacientes de artroplastia total de rodilla. El diseño del firmware de esta tesis incluye: los procesos de adquisición de datos con el uso de diferentes ADCs (Conversor Analógico a Digital) (de la propia placa y externos, utilizando la interfaz SPI) y un DAC (Conversor Digital a Analógico), el correspondiente procesamiento de la señal y la extracción de sus características, la comunicación con un dispositivo externo utilizando un módulo BLE externo con interfaz UART, el proceso de encriptación de los datos médicos, la funcionalidad de manejo de errores y la aproximación del nivel de batería. En esta tesis, todos los flujos de trabajo de los procesos se exponen y explican mediante diagramas de flujo, mientras que se justifica cada cálculo y configuración. Además, todo el código correspondiente se ha programado en lenguaje C y se expone en los anexos. También se ha revisado la normativa aplicable y se ha analizado tanto el impacto ambiental como el coste económico del producto. Por último, se proponen mejoras para futuros trabajos.The aim of this project is the firmware design for a portable medical device for EMG and LBIA measurements which will be used for the assessment of total knee arthroplasty patients to study the progression of different knee prostheses (Medial-Pivot and Ultra-Congruent). For its realization, the state of the art of the EMG and LBIA studies and applications are exposed, along with the currently used medical devices. In addition, the different digital filtering and processing techniques for these studies have been studied and implemented. Furthermore, a preliminary statistical study has been performed with LBIA data from 12 patients with total knee arthroplasty. The firmware design of this thesis includes: the acquiring data processes with the use of different ADCs (from the actual board and external, using the SPI interface) and a DAC, the corresponding signal processing and feature abstraction, the communication with an external device using an external BLE module with UART interface, the medical data encrypting process, the error handling functionality, and the battery level approximation. In this work, all the process workflows are exposed and explained using flowcharts, while every calculation and configuration is justified. In addition, all the corresponding code has been programmed using C language and exposed in the Annexes. Moreover, the applicable regulation has been reviewed, and both the environmental impact and economic cost of the product have been analyzed. Finally, improvements are proposed for future work.L'objectiu d'aquest projecte és el disseny del microprogramari d'un dispositiu mèdic portàtil per a mesures d'EMG i LBIA. L’aparell mèdic s'utilitzarà per a l'avaluació de pacients d'artroplàstia total de genoll per estudiar la progressió de dues pròtesis de genoll (Medial-Pivot i Ultra- Congruent). En el treball, s'exposa el coneixement actual dels estudis i aplicacions d'EMG i LBIA, juntament amb els dispositius comercials utilitzats actualment. A més, s'han estudiat i implementat les diferents tècniques de filtrat i processament digital dels senyals de EMG i LBIA. Addicionalment, s'ha fet un estudi estadístic preliminar amb dades de LBIA de 12 pacients amb artroplàstia total de genoll. El disseny del microprogramari d'aquesta tesi inclou: els processos d'adquisició de dades fent ús de diferents ADCs (de la pròpia placa i externs, utilitzant la interfície SPI) i un DAC, el processament dels senyals i l'abstracció de les seves característiques, la comunicació amb un dispositiu extern utilitzant un mòdul BLE extern amb interfície UART, el procés d'encriptació de les dades mèdiques, la funcionalitat de l’avaluació d'errors i l'aproximació del nivell de bateria. En aquest treball, totes les funcionalitats del dispositiu s'exposen i s'expliquen mitjançant diagrames de flux i es justifiquen els càlculs i configuracions corresponents. Tot el codi desenvolupat s'ha programat en llenguatge C i s'exposa als annexos. A més, s'ha revisat la normativa aplicable i s'ha analitzat tant l'impacte ambiental com el cost econòmic de l’aparell. Finalment, es proposen millores per a futurs desenvolupaments

Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism : A scoping review

Background Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited-channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. Method A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. Results Seventy-eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). Conclusion Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.Peer reviewe

High Fidelity Tape Transfer Printing Based On Chemically Induced Adhesive Strength Modulation

Transfer printing, a two-step process (i.e. picking up and printing) for heterogeneous integration, has been widely exploited for the fabrication of functional electronics system. To ensure a reliable process, strong adhesion for picking up and weak or no adhesion for printing are required. However, it is challenging to meet the requirements of switchable stamp adhesion. Here we introduce a simple, high fidelity process, namely tape transfer printing(TTP), enabled by chemically induced dramatic modulation in tape adhesive strength. We describe the working mechanism of the adhesion modulation that governs this process and demonstrate the method by high fidelity tape transfer printing several types of materials and devices, including Si pellets arrays, photodetector arrays, and electromyography (EMG) sensors, from their preparation substrates to various alien substrates. High fidelity tape transfer printing of components onto curvilinear surfaces is also illustrated

Optimization of the position of single-lead wireless sensor with low electrodes separation distance for ECG-derived respiration

A classical method for estimation of respiratory information from electrocardiogram (ECG), called ECG - derived respiration (EDR), is using flexible electrodes located at standard electrocardiography positions. This work introduces an alternative approach suitable for miniaturized sensors with low inter-electrode separation and electrodes fixed to the sensor encapsulation. Application of amplitude EDR algorithm on single-lead wireless sensor system with optimized electrode positions shows results comparable with standard robust systems. The modified method can be applied in daily physiological monitoring, in sleep studies or implemented in smart clothes when standard respiration techniques are not suitable

A versatile wearable based on reconfigurable hardware for biomedical measurements

In this work a versatile hardware platform based on reconfigurable devices is presented. This platform it intended for the acquisition of multiple biosignals, only requiring a reconfiguration to switch applications. This prototype has been combined with graphene-based, flexible electrodes to cover the application to different biosignals presented in this paper, which are electrocardiogram, electrooculogram and electromyogram. The features of this system provide to the user and to medical personnel a complete set of diagnosis tools, available both at home and hospitals, to be used as a triage tool and for remote patient monitoring. Additionally, an Android application has been developed for signal processing and data presentation to the user. The results obtained demonstrate the wide range of possibilities in portable/wearable applications of the combination of reconfigurable devices and flexible electronics, especially for the remote monitoring of patients using multiple biosignals of interest. The versatility of this device makes it a complete set of monitoring tools integrated in a reduced size device

An analogue approach for the processing of biomedical signals

Constant device scaling has signifcantly boosted electronic systems design in the digital domain enabling incorporation of more functionality within small silicon area and at the same time allows high-speed computation. This trend has been exploited for developing high-performance miniaturised systems in a number of application areas like communication, sensor network, main frame computers, biomedical information processing etc. Although successful, the associated cost comes in the form of high leakage power dissipation and systems reliability. With the increase of customer demands for smarter and faster technologies and with the advent of pervasive information processing, these issues may prove to be limiting factors for application of traditional digital design techniques. Furthermore, as the limit of device scaling is nearing, performance enhancement for the conventional digital system design methodology cannot be achieved any further unless innovations in new materials and new transistor design are made. To this end, an alternative design methodology that may enable performance enhancement without depending on device scaling is much sought today.Analogue design technique is one of these alternative techniques that have recently gained considerable interests. Although it is well understood that there are several roadblocks still to be overcome for making analogue-based system design for information processing as the main-stream design technique (e.g., lack of automated design tool, noise performance, efficient passive components implementation on silicon etc.), it may offer a faster way of realising a system with very few components and therefore may have a positive implication on systems performance enhancement. The main aim of this thesis is to explore possible ways of information processing using analogue design techniques in particular in the field of biomedical systems

Hardware design of a portable medical device to measure the quadriceps muscle group after a total knee arthroplasty by EMG, LBIA and clinical score methods

El propòsit d'aquest projecte és el disseny del hardware d'un dispositiu mèdic portàtil per a mesurar senyals d'electromiografia (EMG) i bioimpedància localitzada (LBIA), que s'utilitzarà per avaluar la progressió de dues pròtesis de genoll (Medial-Pivot i Ultra- Congruent) en pacients operats d'una artroplàstia total de genoll per a l'hospital Germans Trias i Pujol de Badalona. Per això, s'ha realitzat un estudi complet sobre els senyals d'EMG i LBIA, per tal de definir les característiques necessàries de l'equip mèdic i poder optimitzar el disseny electrònic. Per l'adquisició de senyals EMG, s'ha dissenyat i simulat un sistema compost per diferents fases, que treballen independentment per adquirir, amplificar, filtrar i adaptar el senyal EMG pel seu futur processament digital. D'altra banda, per obtenir valors de la bioimpedància localitzada dels diferents músculs que conformen el quàdriceps, s'ha dissenyat un sistema compost per dos grans blocs; el primer bloc és l'etapa d'injecció, on es genera i s'injecta un senyal feble de corrent altern a la zona a mesurar, mentre que el segon bloc, és l'etapa d'adquisició de senyals. Aquest últim s'encarrega d'adquirir la diferència de voltatge produïda per la injecció de corrent al múscul (anteriorment mencionat) per després calcular la bioimpedància a partir de la llei d'ohm. Tots els senyals són digitalitzats mitjançant el microcontrolador STM32F407VG, que s'encarregarà de processar i aconseguir les dades claus per determinar quina de les deus pròtesis desenvolupa una millor funció mecànica i una millor adaptació biològica. És important remarcar que tot el disseny, sigui per a EMG o LBIA s'ha dut a terme de manera discreta sense fer servir Front-Ends comercials o integrats complexos més que l'amplificador d'instrumentació o ADC. En addició, el present treball inclou una primera estimació dels costos de producció i fabricació per a una sola unitat, càlculs de consums i funcionament (sorolls, CMRR del sistema i amplada de banda) i una simulació completa d'EMG i LBIA per observar com funciona i es du a terme cada etapa del circuit. Finalment, en tractar-se d'un equip mèdic, també s'ha revisat la normativa aplicable i se n'ha analitzat l'impacte ambiental, s'ha proposat i definit diferents punts per a futurs treballs, com podria ser la validació i testatge de l'equip, càlculs més aproximats de consums i perfilar la bill of materials (BOM) per a grans demandes de components.The purpose of this project is the hardware design of a portable medical device to measure electromyography (EMG) and localized bioimpedance (LBIA) signals, which will be used to evaluate the adaptability and progression of two knee prostheses (medial-pivot and ultra-congruent) in patients undergoing total knee arthroplasty at the Germans Trias i Pujol Hospital in Badalona. For this, the present work undercovers the relevant properties of the EMG and LBIA signals in order to define the characteristics of the medical equipment and thus optimize its electronic design. For the EMG measurements, a system made up of different stages has been designed and simulated. These phases work independently to acquire, amplify, filter, and adapt the EMG signal for its further digital processing. On the other hand, to obtain the bioimpedance values of different quadriceps muscles, a system composed of two large blocks has been designed; the first is the injection block, where a weak alternating current signal is generated and injected into the area to be measured, while the second block is the signal acquisition stage. The purpose of the latter is to acquire the voltage difference produced by the injection of current (mentioned above) and then obtain the bioimpedance from Ohm's law. All the signals are digitized from the STM32F407VG microcontroller, which will be in charge of processing and obtaining the key data to determine which of the two prostheses performs a better mechanical function and biological adaptation. It is important to note that the entire design, whether for EMG or LBIA, has been developed discreetly without using commercial Front-Ends or complex ICs other than the instrumentation amplifier or ADC. In addition, the thesis includes a first estimation of the production and manufacturing costs for a single unit, calculations of consumption and work operation (noise, CMRR of the system and bandwidth) and a complete simulation of EMG and LBIA to observe how it works on each stage for both circuits. Finally, as it is a medical device, the applicable regulations have also been reviewed and its environmental impact has been analysed. Additionally, different points have been proposed and defined for future work, such as the construction of the PCB and its respective validation, improving both the consumption calculations and the list of materials (BOM) for large component demands.El propósito de este proyecto es el diseño del Hardware de un dispositivo médico portátil para mediciones de electromiografía (EMG) y bioimpedancia localizada (LBIA), que se utilizará para estudiar la evolución de la adaptabilidad y funcionamiento de dos prótesis de rodilla (medial-pívot y ultracongruente) en pacientes operados de artroplastia total de rodilla en el Hospital Germans Trias i Pujol de Badalona. Para ello, se ha realizado un estudio exhaustivo sobre las propiedades de las señales de EMG y LBIA con la finalidad de definir las características del equipo médico y de esta forma, optimizar el diseño electrónico del mismo. Para la lectura de mediciones EMG, se ha diseñado y simulado un sistema constituido por distintas etapas, que trabajan independientemente para adquirir, amplificar, filtrar, y adaptarla señal EMG para su posterior procesado digital. Por otro lado, para obtener los valores de bioimpedancia de distintos músculos del cuádriceps, se ha diseñado un sistema compuesto por dos grandes bloques; el primero es el bloque de inyección, donde se genera y se inyecta una señal débil de corriente alterna en la zona a medir, mientras que el segundo bloque es la etapa de adquisición de señales. Esta última tiene como finalidad adquirir la diferencia de voltaje producido por la inyección de corriente (anteriormente mencionada) para después obtener la bioimpedancia a partir de la ley de ohm. Todas las señales son digitalizadas a partir del microcontrolador STM32F407VG, que se encargará de procesar y obtener los datos claves para determinar cuál de las dos prótesis desempeña una mejor función mecánica y adaptación biológica. Es importante remarcar que todo el diseño, ya sea para EMG o LBIA, se ha desarrollado de manera discreta sin usar Front-Ends comerciales o integrados complejos más que el amplificador de instrumentación o ADC. En adición, la tesis incluye una primera estimación de los costes de producción y fabricación para una sola unidad, cálculos de consumos y funcionamiento (ruidos, CMRR del sistema y ancho de banda) y una simulación completa de EMG y LBIA para observar cómo funciona y se desarrolla cada etapa de los distintos circuitos. Finalmente, al tratarse de un equipo médico, también se ha revisado la normativa aplicable y se ha analizado el impacto ambiental del mismo. Por último, se han propuesto y definido distintos puntos para futuros trabajos, como es la construcción de la PCB y su respectiva validación, realizar cálculos más aproximados de consumos y perfilar la lista de materiales (BOM) para grandes demandas de componentes