The effect of transcranial direct current stimulation on perception of effort in an isolated isometric elbow flexion task

This is the author's manuscript as accepted for publication in Motor Control. The final published article is available from the link below, copyright @ 2013 Human Kinetics.The purported ergogenic actions of transcranial direct current stimulation (tDCS) applied to motor cortex (M1) on force production and perception of effort were investigated using a 10-item numerical rating scale (0–10 NRS) in nonfatiguing bouts of a force-matching task utilizing isometric elbow flexion. Using a crossover design, 12 healthy volunteers received sham, anodal, and cathodal tDCS randomly for 10 min (1.5 mA, 62 ìA/cm2) to the left M1 in a double-blind manner. Cor- ticospinal excitability changes were also monitored using transcranial magnetic stimulation (TMS) with surface electromyography (sEMG) to monitor both motor evoked potentials (MEPs) and force-EMG from right m. biceps brachii and m. brachioradialis brachii. No significant differences between the verum and sham stimulation were obtained for elbow flexion maximum voluntary force, perception of effort, or sEMG. There were also no significant differences in MEP changes for the types of tDCS, which is consistent with reports that tDCS excitability effects are diminished during ongoing cognitive and motor activities.Brunel Universit

Evaluation of the numeric rating scale for perception of effort during isometric elbow flexion exercise

This is the author's accepted manuscript. The final publication is available at Springer via http://dx.doi.org/10.1007/s00421-011-2074-1.The aim of the study was to examine the reliability and validity of the numerical rating scale (0-10 NRS) for rating perception of effort during isometric elbow flexion in healthy people. 33 individuals (32 ± 8 years) participated in the study. Three re-test measurements within one session and three weekly sessions were undertaken to determine the reliability of the scale. The sensitivity of the scale following 10 min isometric fatiguing exercise of the elbow flexors as well as the correlation of the effort with the electromyographic (EMG) activity of the flexor muscles were tested. Perception of effort was tested during isometric elbow flexion at 10, 30, 50, 70, 90, and 100% MVC. The 0-10 NRS demonstrated an excellent test–retest reliability [intra class correlation (ICC) = 0.99 between measurements taken within a session and 0.96 between 3 consecutive weekly sessions]. Exploratory curve fitting for the relationship between effort ratings and voluntary force, and underlying EMG showed that both are best described by power functions (y = ax b ). There were also strong correlations (range 0.89–0.95) between effort ratings and EMG recordings of all flexor muscles supporting the concurrent criterion validity of the measure. The 0-10 NRS was sensitive enough to detect changes in the perceived effort following fatigue and significantly increased at the level of voluntary contraction used in its assessment (p < 0.001). These findings suggest the 0-10 NRS is a valid and reliable scale for rating perception of effort in healthy individuals. Future research should seek to establish the validity of the 0-10 NRS in clinical settings.School of Health Science and Social Care, Brunel Universit

Computational Intelligence in Electromyography Analysis

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG may be used clinically for the diagnosis of neuromuscular problems and for assessing biomechanical and motor control deficits and other functional disorders. Furthermore, it can be used as a control signal for interfacing with orthotic and/or prosthetic devices or other rehabilitation assists. This book presents an updated overview of signal processing applications and recent developments in EMG from a number of diverse aspects and various applications in clinical and experimental research. It will provide readers with a detailed introduction to EMG signal processing techniques and applications, while presenting several new results and explanation of existing algorithms. This book is organized into 18 chapters, covering the current theoretical and practical approaches of EMG research

Motion Analysis for Experimental Evaluation of an Event-Driven FES System

In this work, a system for controlling Functional Electrical Stimulation (FES) has been experimentally evaluated. The peculiarity of the system is to use an event-driven approach to modulate stimulation intensity, instead of the typical feature extraction of surface ElectroMyoGraphic (sEMG) signal. To validate our methodology, the system capability to control FES was tested on a population of 17 subjects, reproducing 6 different movements. Limbs trajectories were acquired using a gold standard motion tracking tool. The implemented segmentation algorithm has been detailed, together with the designed experimental protocol. A motion analysis was performed through a multiparametric evaluation, including the extraction of features such as the trajectory area and the movement velocity. The obtained results show a median cross-correlation coefficient of 0.910 and a median delay of 800 ms, between each couple of voluntary and stimulated exercise, making our system comparable w.r.t. state-of-the-art works. Furthermore, a 97.39% successful rate on movement replication demonstrates the feasibility of the system for rehabilitation purposes

Tutorial: A Versatile Bio-Inspired System for Processing and Transmission of Muscular Information

Device wearability and operating time are trending topics in recent state-of-art works on surface ElectroMyoGraphic (sEMG) muscle monitoring. No optimal trade-off, able to concurrently address several problems of the acquisition system like robustness, miniaturization, versatility, and power efficiency, has yet been found. In this tutorial we present a solution to most of these issues, embedding in a single device both an sEMG acquisition channel, with our custom event-driven hardware feature extraction technique (named Average Threshold Crossing), and a digital part, which includes a microcontroller unit, for (optionally) sEMG sampling and processing, and a Bluetooth communication, for wireless data transmission. The knowledge acquired by the research group brought to an accurate selection of each single component, resulting in a very efficient prototype, with a comfortable final size (57.8mm x 25.2mm x 22.1mm) and a consistent signal-to-noise ratio of the acquired sEMG (higher than 15 dB). Furthermore, a precise design of the firmware has been performed, handling both signal acquisition and Bluetooth transmission concurrently, thanks to a FreeRTOS custom implementation. In particular, the system adapts to both sEMG and ATC transmission, with an application throughput up to 2 kB s-1 and an average operating time of 80 h (for high resolution sEMG sampling), relaxable to 8Bs-1 throughput and about 230 h operating time (considering a 110mAh battery), in case of ATC acquisition only. Here we share our experience over the years in designing wearable systems for the sEMG detection, specifying in detail how our event-driven approach could benefit the device development phases. Some previous basic knowledge about biosignal acquisition, electronic circuits and programming would certainly ease the repeatability of this tutorial

The reliability of methods to estimate the number and size of human motor units and their use with large limb muscles

Purpose: Current methods for estimating muscle motor unit (MU) number provide values which are remarkably similar for muscles of widely differing size, probably because surface electrodes sample from similar and relatively small volumes in each muscle. We have evaluated an alternative means of estimating MU number that takes into account differences in muscle size. Methods: Intramuscular motor unit potentials (MUPs) were recorded and muscle cross-sectional area (CSA) was measured using MRI to provide a motor unit number estimate (iMUNE). This was compared to the traditional MUNE method, using compound muscle action potentials (CMAP) and surface motor unit potentials (sMUPs) recorded using surface electrodes. Data were collected from proximal and distal regions of the vastus lateralis (VL) in young and old men while test–retest reliability was evaluated with VL, tibialis anterior and biceps brachii. Results: MUPs, sMUPs and CMAPs were highly reliable (r = 0.84–0.91). The traditional MUNE, based on surface recordings, did not differ between proximal and distal sites of the VL despite the proximal CSA being twice the distal CSA. iMUNE, however, gave values that differed between young and old and were proportional to the muscle size. Conclusion: When evaluating the contribution that MU loss makes to muscle atrophy, such as in disease or ageing, it is important to have a method such as iMUNE, which takes into account any differences in total muscle size

Applications of EMG in Clinical and Sports Medicine

This second of two volumes on EMG (Electromyography) covers a wide range of clinical applications, as a complement to the methods discussed in volume 1. Topics range from gait and vibration analysis, through posture and falls prevention, to biofeedback in the treatment of neurologic swallowing impairment. The volume includes sections on back care, sports and performance medicine, gynecology/urology and orofacial function. Authors describe the procedures for their experimental studies with detailed and clear illustrations and references to the literature. The limitations of SEMG measures and methods for careful analysis are discussed. This broad compilation of articles discussing the use of EMG in both clinical and research applications demonstrates the utility of the method as a tool in a wide variety of disciplines and clinical fields

The relationship between perception of effort and physiological responses to an acute fatiguing task of the elbow flexors. Evaluation of a new rating scale of perception of effort

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.While fatigue is a common daily phenomenon, the exact relationship between perception of effort and fatigue is still unknown. Existing tools for assessing perception of effort are effectively limited to whole body exercise, while current methods for assessing voluntary activation are painful and not feasible for clinical application. The main aims of this thesis were to evaluate existing methodologies for their appropriateness in assessing perception of effort and voluntary activation following isolated muscle function testing, and to examine the relationship between subjective perception of effort and objective changes in the healthy motor control system. The implementation of reliable and valid assessment tools in clinical practice may enable clarification of the pathogenesis of many neurological conditions that have chronic fatigue as a key feature. Four studies of within-subjects repeated measures design have been conducted. Sixtynine healthy volunteers were recruited among staff and students of Brunel University. Magnetic stimulation was tested as a valid alternative to electrical stimulation in the conventional single-pulse Twitch Interpolation Technique. The 0–10 Numeric Rating Scale (NRS) was also tested for its reliability and validity in assessing the perception of effort during isometric exercise of elbow flexors. The changes of perception of effort following a submaximal elbow flexion fatiguing task, as well as following transcranial direct current stimulation (tDCS) over the motor cortex were also tested. The main findings showed significant differences between peripheral and magnetic stimulation in conventional single-pulse Twitch Interpolation Technique. The 0–10 NRS demonstrated linear properties and reported excellent test-retest reliability and good concurrent criterion validity in recording perception of effort under repeated isometric contractions of elbow flexors. Ten minutes of a submaximal intermittent isometric fatiguing exercise produced a significant elevation in rating of perceived effort, which was associated with central and peripheral neurophysiological changes of the motor control system. In contrast, perception of effort did not change significantly following 10 minutes of tDCS. The major findings of this thesis suggest the 0–10 NRS is a valid and reliable scale for rating perception of effort in healthy individuals. Further testing of the scale on patients is needed to establish its validity in clinical settings. Additionally, the findings indicate a substantial role of perception of effort in the voluntary motor control system. However, further research towards revealing the underlying mechanisms of perceived effort regulation in both health and disease is required

Neuromechanics of maximum and explosive strength across knee-joint angles

The primary purpose of this thesis was to assess the effect of knee-joint angle on the neuromechanics of maximal and explosive contractions, specifically torque and neuromuscular activation, as well as the influence of isometric resistance training (RT) on these variables and thus joint angle specificity of training adaptations. It was found that electrode location had a pronounced effect on surface electromyography (sEMG) amplitude during maximum isometric voluntary contractions (MVCs) and moderate relationship between subcutaneous tissue thickness and sEMG amplitude (R2=0.31 up to 0.38) was reduced but not consistently removed by maximal M-Wave (MMAX) normalization [up to R2= 0.16 (peak-to-peak) and R2= 0.23 (Area)]. Thus, MMAX peak-to-peak was the better normalization parameter that removed the influence of electrode location and substantially reduced the influence of subcutaneous tissue thickness. Maximal torque-angle relationship presented an inverted U shape with both, agonist (measure by two different techniques) and antagonist neuromuscular activation both differing with knee-joint angle and thus, both likely contributing to the torque-angle relationship. Absolute explosive torque-angle relationship exhibited higher torques at mid-range knee joint angles in a similar manner to maximal strength, whilst the ability to explosively express the available torque (i.e. relative to maximal strength) revealed only subtle differences between joint angles. Agonist neuromuscular activation showed increases from extended to flexed positions during both maximum and explosive contractions (at all time points; ~6% to ~34%) and evoked contractile properties presented opposite patterns with twitch torque increasing (~5% to ~30%) and octet torque decreasing (~2% to ~14%) with knee flexion. Finally, after 4 weeks of RT at a 65° knee-joint angle evidence of joint angle specificity was provided from both within-group (greater gains at 3 angles than others) and between-group evidence (greater gains at 2 angles than others) for maximal strength but not for explosive strength and neuromuscular activation. In summary, this thesis demonstrated: (1) higher strength values at middle knee-joint positions than more flexed and/or extended positions during maximal and explosive contractions; (2) how agonist neuromuscular activation contributes to the beforementioned changes in strength; (3) how muscle contractile properties contribute to the explosive strength across knee-joint angles; and finally (4) that joint angle specificity has a neural basis