Estimation of Absolute States of Human Skeletal Muscle via Standard B-Mode Ultrasound Imaging and Deep Convolutional Neural Networks

Objective: To test automated in vivo estimation of active and passive skeletal muscle states using ultrasonic imaging. Background: Current technology (electromyography, dynamometry, shear wave imaging) provides no general, non-invasive method for online estimation of skeletal muscle states. Ultrasound (US) allows non-invasive imaging of muscle, yet current computational approaches have never achieved simultaneous extraction nor generalisation of independently varying, active and passive states. We use deep learning to investigate the generalizable content of 2D US muscle images. Method: US data synchronized with electromyography of the calf muscles, with measures of joint moment/angle were recorded from 32 healthy participants (7 female, ages: 27.5, 19-65). We extracted a region of interest of medial gastrocnemius and soleus using our prior developed accurate segmentation algorithm. From the segmented images, a deep convolutional neural network was trained to predict three absolute, driftfree, components of the neurobiomechanical state (activity, joint angle, joint moment) during experimentally designed, simultaneous, independent variation of passive (joint angle) and active (electromyography) inputs. Results: For all 32 held-out participants (16-fold cross-validation) the ankle joint angle, electromyography, and joint moment were estimated to accuracy 55±8%, 57±11%, and 46±9% respectively. Significance: With 2D US imaging, deep neural networks can encode in generalizable form, the activitylength-tension state relationship of these muscles. Observation only, low power, 2D US imaging can provide a new category of technology for non-invasive estimation of neural output, length and tension in skeletal muscle. This proof of principle has value for personalised muscle assessment in pain, injury, neurological conditions, neuropathies, myopathies and ageing

The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample

Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample.Methods/Principal Findings: standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as “repetitive strain injury” (RSI).Conclusions/Significance: the large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectivel