Search

Objective: Electromyography (EMG) and acceleration (ACC) measurements are potential methods for quantifying efficacy of deep brain stimulation (DBS) treatment in Parkinson's disease (PD). The treatment efficacy depends on the settings of DBS parameters (pulse amplitude, frequency and width). This study quantified, if EMG and ACC signal features differ between different DBS settings and if DBS effect is unequal between different muscles., Methods: EMGs were measured from biceps brachii (BB) and tibialis anterior (TA) muscles of 13 PD patients. ACCs were measured from wrists. Measurements were performed during seven different settings of DBS and analyzed using methods based on spectral analysis, signal morphology and nonlinear dynamics., Results: The results showed significant within-subject differences in the EMG signal kurtosis, correlation dimension, recurrence rate and EMG-ACC coherence between different DBS settings for BB but not for TA muscles. Correlations between EMG feature values and clinical rest tremor and rigidity scores were weak but significant., Conclusions: Surface EMG features differed between different DBS settings and DBS effect was unequal between upper and lower limb muscles., Significance: EMG changes pointed to previously defined optimal settings in most of patients, which should be quantified even more deeply in the upcoming studies., (Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Background: It is generally accepted that muscles may activate via the common nociceptive flexion reflex (NFR) in response to painful stimuli associated with tensile or compressive forces on peripheral nerves. Following the basic assumption that the radial nerve may be stressed around the elbow during the execution of the Mills manipulation, two positions considered to have different mechanical effects on the radial nerve and the brachial plexus were tested in order to i) explore whether muscles are activated in certain patterns with concomitant changes in nerve tension, ii) establish whether muscle responses can be modified with mechanical unloading of the brachial plexus., Methods: Muscle responses were quantified bilaterally in eight subjects (N = 16) during Mills Manipulation (MM) pre-manipulative positioning and a Varied position that putatively produces less mechanical tension in the brachial plexus. End range pre-manipulative stretch was used in order to simulate the effects of Mills manipulation. Electromyographic signals were recorded with a 16 channel portable EMG unit and correlated with kinematic data from three charge-coupled device adjustable cameras which allowed for precise movement tracking., Results: Compared with the Standard Mills manipulation position, the Varied position produced significantly reduced myoelectric activity (P ≤ .001) in all test muscles. Additional subjective data support the notion that certain muscle activity patterns were protective., Conclusion: It seems that protective muscles are selectively activated in a specific pattern in order to protect the radial nerve from mechanical tension by shortening its pathway, suggesting integration of muscle and neural mechanisms. Furthermore, the significantly decreased myoelectric activity with reduced mechanical tension in the brachial plexus may help controlling collateral effects of the Mills manipulation itself, making it potentially safer and more specific.

Background: To evaluate the clinical significance of lateral lumbar spinal canal stenosis (LLSCS), found by magnetic resonance imaging (MRI), through correlating the imaging findings with patient symptoms, walking capacity and electromyography (EMG) measurements., Method: 102 patients with symptoms of LSS referred for operative treatment were studied in this uncontrolled study. Of these patients, subjects with distinct only lateral LSS were included. Accordingly, 140 roots in 14 patients (mean age 58, range 48-76 years, male 43%) were evaluated. In MR images the entrance and mid zones of the lateral lumbar nerve root canal were graded as normal, narrowed but not compressed, or compressed. In quantitative analysis, the minimal widths of the lateral recess and mid zone area were measured. Clinical symptoms were recorded with the Oswestry Disability Index (ODI), overall Visual Analogue Scale (VAS), specific low back pain (LBP; NRS-11), specific leg pain (LP NRS-11), Beck Depression Inventory (BDI) and walking distance in the treadmill test. Lumbar paraspinal (L2- L5) and lower limb (L3 - S1) needle EMG studies were performed. The findings were classified root by root as 1 = normal, 2 = abnormal. The associations between radiological, EMG and clinical findings were tested with each other., Results: EMG findings were normal in 92 roots and abnormal in 48 roots. All of the patients had at least one abnormal nerve root finding. Severity of the mid zone stenosis in MRI correlated with abnormal EMG findings (p = 0.015). Patients with abnormal EMG had also higher scores in the VAS (41.9 ± 25.7 vs 31.5 ± 18.1; p = 0.018), NRS leg pain (7.5 ± 1.5 vs 6.3 ± 2.1; p = 0.000) and BDI (9.8 ± 3.8 vs 8.0 ± 3.9; p = 0.014). However, no statistically significant correlations between MRI findings and clinical symptoms or walking capacity were found., Conclusions: Among persons previously selected for surgery, lateral stenosis seen on MRI correlates with EMG, and thus may be a clinically significant finding. Our EMG findings were also associated with patient symptoms. However, no relationships between the MRI findings and symptoms or walking capacity were found, suggesting their multifactorial etiology.

The aim of this work was to differentiate patients with essential tremor from patients with Parkinson's disease. Electromyographic data from biceps brachii muscles and kinematic data from arms during isometric tension of the arms were measured from 17 patients with essential tremor, 35 patients with Parkinson's disease and 40 healthy controls. The EMG signals were divided to smaller segments from which histograms were calculated. The histogram shape was analysed with a feature dimension reduction method, the principal component analysis, and the shape parameters were used to differentiate between different subject groups. Three parameters, RMS-amplitude, sample entropy and peak frequency were determined from the kinematic measurements of the arms. The height and the side differences of the histogram were the most effective for differentiating between essential tremor and Parkinson's disease groups. The histogram parameters of patients with essential tremor were more similar to patients with Parkinson's disease than healthy controls. With this method it was possible to discriminate 13/17 patients with essential tremor from 26/35 patients with Parkinson's disease and 14/17 patients with essential tremor from 29/40 healthy controls. The kinematic parameters of patients with essential tremor were closer to parameters of patients with Parkinson's disease compared to healthy controls. Combining EMG and kinematic analysis did not increase discrimination efficiency but provided more reliability to the discrimination of subject groups., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Deep brain stimulation (DBS) is an effective treatment method for motor symptoms of advanced Parkinson's disease. DBS-electrode is implanted to subthalamic nucleus to give precisely allocated electrical stimuli to brain. The optimal stimulus type has to be adjusted individually. Disease severity, main symptoms and biological factors play a role in correctly setting up the device. Currently there are no objective methods to assess the efficacy of DBS, hence the adjustment is based solely on clinical assessment. In optimal case an objectively measurable feature would point the right settings of DBS. Surface electromyographic and kinematic measurements have been used in Parkinson's disease research. As Parkinson's disease symptoms are known to change the EMG signal properties, these methods could be helpful aid in the clinical adjustment of DBS. In this study, 13 patients with advanced Parkinson's disease who received DBS treatment were measured. The patients were measured with seven different settings of the DBS in clinical range including changes in stimulation amplitude, frequency and pulse width. The EMG analysis was based on parameters that characterize EMG signal morphology. Correlation dimension and recurrence rate made the most significant difference in relation to optimal settings. In conclusion, EMG analysis is able to detect differences between the DBS setups, and can help in finding the correct parameters.

The aim of this work was to differentiate patients with essential tremor from patients with Parkinson's disease. The electromyographic signal from the biceps brachii muscle was measured during isometric tension from 17 patients with essential tremor, 35 patients with Parkinson's disease, and 40 healthy controls. The EMG signals were high pass filtered and divided to smaller segments from which histograms were calculated using 200 histogram bins. EMG signal histogram shape was analysed with a feature dimension reduction method, the principal component analysis, and the shape parameters were used to differentiate between different patient groups. The height of the histogram and the side difference between left and right hand were the best discriminators between essential tremor and Parkinson's disease groups. With this method, it was possible to discriminate 13/17 patients with essential tremor from 26/35 patients with Parkinson's disease and 14/17 patients with essential tremor from 29/40 healthy controls.

Deep brain stimulation (DBS) is effective in reducing motor symptoms in Parkinson's disease (PD). However, objective methods for quantifying its efficacy are lacking. We present a principal component (PC)-based tracking method for quantifying the effects of DBS in PD by using electromyography (EMG) and acceleration measurements. Ten parameters capturing PD characteristic signal features were initially extracted from isometric EMG and acceleration recordings. Using a PC approach, the original parameters were transformed into a smaller number of PCs. Finally, the effects of DBS were quantified by examining the PCs in a low-dimensional feature space. The EMG and acceleration data from 13 PD patients with DBS ON and OFF, and 13 healthy age-matched controls were used for analysis. Clinical evaluation of patients showed that their motor symptoms were effectively reduced with DBS. The analysis results showed that the signal characteristics of 12 patients were more similar to those of the healthy controls with DBS ON than with DBS OFF. These observations indicate that the PC-based tracking method can be used to objectively quantify the effects of DBS on the neuromuscular function of PD patients. Further studies are suggested to estimate the clinical sensitivity of the method to different types of PD.

Parkinson's disease (PD) is characterized by motor disabilities that can be alleviated reasonably with appropriate medication. However, there is a lack of objective methods for quantifying the efficacy of treatment in PD. We applied here an objective method for quantifying the effects of medication in PD using EMG and acceleration measurements and analysis. In the method, four signal features were calculated from the EMG and acceleration recordings of both sides of the body: the kurtosis and recurrence rate of EMG, and the amplitude and sample entropy of acceleration. Principal component approach was used for reducing the number of variables. EMG and acceleration data measured from nine PD patients were used for analysis. The patients were measured in four different medication conditions: with medication off, and two and three and four hours after taking the medication. The results showed that in eight patients the EMG recordings changed into less spiky and the acceleration recordings into more complex after taking the medication. A reverse phenomenon in the signal characteristics was observed in seven patients 3-4 hours after taking the medication. The results indicate that the presented method is potentially useful for quantifying objectively the effects of medication on the neuromuscular function in PD.

In this paper, we examine the potential of electromyographic (EMG) and acceleration measurements in discriminating patients with Parkinson's disease (PD) from healthy persons. Two types of muscle contractions are examined: static contractions of biceps brachii muscles and elbow extension movements. Twelve features are extracted from static and ten features from extension measurements. These features describe signal morphology and nonlinear characteristics, power spreading in EMG wavelet scalograms and spectral coherence. Principal component approach is applied separately for static and extension trial to reduce the number of features before discrimination. The discrimination between subjects is done in a two-dimensional space by applying cluster analysis to the best discriminating principal components. The discrimination power of the used method was estimated with EMG and acceleration data measured from 56 patients with PD and 59 healthy controls. In the cluster analysis, three clusters were formed: one cluster with most (85%) of the healthy persons and two clusters with 80% of patients. Patients were divided into two clusters based on their type of motor disability (problems during movement and/or static contraction). Discrimination results show that EMG and acceleration measurements are potential for discriminating patients with PD from healthy persons. Furthermore, they have potential in the objective clinical assessment of PD.

A novel method for discrimination of dynamic muscle contractions between patients with Parkinson's disease (PD) and healthy controls on the basis of surface electromyography (EMG) and acceleration measurements is presented. In this method, dynamic EMG and acceleration measurements are analyzed using nonlinear methods and wavelets. Ten parameters capturing Parkinson's disease (PD) characteristic features in the measured signals are extracted. Each parameter is computed as time-varying, and for elbow flexion and extension movements separately. For discrimination between subjects, the dimensionality of the feature vectors formed from these parameters is reduced using a principal component approach. The cluster analysis of the low-dimensional feature vectors is then performed for flexion and extension movements separately. The EMG and acceleration data measured from 49 patients with PD and 59 healthy controls are used for analysis. According to clustering results, the method could discriminate 80 % of patient extension movements from 87 % of control extension movements, and 73 % of patient flexion movements from 82 % of control flexion movements. The results show that dynamic EMG and acceleration measurements can be informative for assessing neuromuscular dysfunction in PD, and furthermore, they may help in the objective clinical assessment of the disease.

The aim of this study was to evaluate a variety of traditional and novel surface electromyography (SEMG) characteristics of biceps brachii muscle in patients with Parkinson's disease (PD) and compare the results with the healthy old and young control subjects. Furthermore, the aim was to define the optimal biceps brachii loading level that would most likely differentiate patients from controls. The results indicated that such nonlinear SEMG parameters as %Recurrence, %Determinism and SEMG distribution kurtosis, correlation dimension and sample entropy were significantly different between the PD patients and healthy controls. These novel nonlinear parameters, unlike traditional spectral or amplitude parameters, correlated with the Unified Parkinson's Disease Rating Scale (UPDRS) and finger tapping scores. The most significant between group differences were found in the loading condition where no additional weights were applied in isometric elbow flexion. No major difference of SEMG characteristics was detected between old and young control subjects. In conclusion, the novel SEMG parameters can differentiate the patients with PD from healthy control subjects and these parameters may have potential in the assessment of the severity of PD.

In this paper, we bring out modern methods that are potential in analysing differences in the dynamic surface electromyographic (EMG) and acceleration measurements between patients with Parkinson's disease (PD) and healthy persons. These methods are the correlation dimension of EMG, the recurrence rate of EMG, the power of acceleration and the sample entropy of acceleration. In this study, these methods were used to extract features from surface EMG and acceleration recordings measured during elbow flexion and extension movements. The extracted features were used to form high-dimensional feature vectors and the dimensionality of these vectors was then reduced by using the principal component approach. Finally, the feature vectors were discriminated between subjects by using the principal components. The discrimination power of the presented approach was tested with EMG and acceleration data measured from 46 patients with PD (on-medication) and 59 healthy controls. Discrimination results showed that the present method was able to discriminate dynamic EMG and acceleration recordings between patients with PD and healthy controls. Therefore, dynamic surface EMG and acceleration measurements may have potential in the objective and quantitative assessment and diagnosis of PD.

A novel approach is presented for the analysis of surface electromyogram (EMG) morphology in Parkinson's disease (PD). The method is based on histogram and crossing rate (CR) analysis of the EMG signal. In the method, histograms and CR values are used as high-dimensional feature vectors. The dimensionality of them is then reduced using the Karhunen-Loève transform (KLT). Finally, the discriminant analysis of feature vectors is performed in low-dimensional eigenspace. Histograms and CR values were chosen for analysis, because Parkinsonian EMG signals typically involve patterns of EMG bursts. Traditional methods of EMG amplitude and spectral analysis are not effective in analyzing impulse-like signals. The method, which was tested with EMG signals measured from 25 patients with PD and 22 healthy controls, was promising for discriminating between these two groups of subjects. The ratio of correct discrimination by augmented KLT was 86% for the control group and 72% for the patient group. On the basis of these results, further studies are suggested in order to evaluate the usability of this method in early stage diagnostics of PD.

Objectives: Pelvic floor muscle training (PFMT) is commonly used in combination with biofeedback devices for stress urinary incontinence. A new electromyography (EMG)-based home-use device for PFMT is tested for healthy and stress incontinent patients., Subjects and Methods: Altogether 31 women with genuine stress incontinence (GSI) and 35 controls without urinary symptoms were measured with a vaginal surface EMG probe. EMG activity during three rapid contractions (5 s) in supine and standing positions were observed., Results: Mean values of three rapid contractions were 17.0 microV (range 6.5-59.0, S.D. 10.5) in the supine position and 12.9 microV (range 5.0-33.0, S.D. 5.9) in the standing position among incontinent patients and 19.5 microV (range 9.0-43.5, S.D. 8.4) and 18.2 microV (range 8.0-43.5, S.D. 8.7) among the controls, respectively. A significant difference (P=0.006) was found in the mean values of three rapid contractions in the standing position between GSI patients and asymptomatic women. In regression analysis, EMG values were dependent on age (P=0.004 in the supine, P=0.009 in the standing) in both groups, but not on parity, body mass index (BMI) or episiotomies., Conclusions: In the study groups, the EMG activity of pelvic floor muscles (PFMs) decreased during aging. Although the tested surface EMG device showed a tendency that incontinent patients have lower PFM activities especially in the standing position, the value of surface EMG method as a diagnostic tool is not well established. However, the tested EMG-based device for PFMT will be helpful as guidance for incontinent patients.

Objective: To assess the activities of the paraspinal and abdominal muscles during manually assisted therapeutic exercises (MATEs) and nonassisted therapeutic exercises (NATEs) that are used in the initial phases of the progressive exercise programs designed for the treatment of low back pain., Design: Thirteen healthy subjects volunteered in the study. Surface electromyography (EMG) was recorded. The recorded EMG signal was averaged and normalized to the maximal EMG amplitude obtained during the maximal voluntary contraction (%EMGmax)., Results: In general, the %EMGmax values were higher during NATEs than during MATEs. Sitting seemed to activate lumbar L5 level paraspinal muscles to the same extent as MATEs., Conclusion: MATEs require only minimal trunk muscle activities, and thus, they may not be sufficiently intense to improve the trunk muscle performance. NATEs require high trunk muscle activities that are adequate for improving the trunk muscle performance, but they may cause high compressive loading of the lumbar spine, and if unchecked, this can aggravate low back pain.

Background: Therapeutic exercises are widely used in the treatment of low back problems. Clinical knowledge about targeting the load in these exercises, however, is insufficient. This study assessed the L2 and L5 level paraspinal and gluteus maximus muscle activities in different therapeutic exercises. Intramuscular and surface electromyography (EMG) measurements were obtained to study whether surface EMG measurements can be used in the assessment of multifidus muscle function., Methods: Eleven healthy subjects (5 men, 6 women) 21 to 38 years of age volunteered for the study. The subjects performed 18 different therapeutic exercises. During the exercises paraspinal EMG was recorded using fine wire and surface electrodes. The normalized peak and average muscle EMG activities (percentage of amplitude in maximal voluntary contraction [MVC]) during each task were determined., Results: The correlations between the average intramuscular and surface activities of the normalized EMG (% of MVC) at the L2 and L5 levels were .928 and .950, respectively. The peak and average EMG amplitudes of the exercises were below 50% and 25% of MVC, respectively. At the L5 level, the multifidus peak and average EMG amplitudes (% MVC) were higher in women than in men, whereas no significant difference was found at the L2 level. In women, the normalized multifidus EMG amplitude was higher at the L5 level than at the L2 level, whereas no significant difference was found in men. In both sexes, the normalized EMG amplitude was higher in the multifidus than in the longissimus muscle., Conclusion: Surface EMG measurements may be used in the assessment of multifidus muscle function. Simple therapeutic exercises are effective in activating the lumbar paraspinal muscles.

The principles of electromyographic (EMG) analysis can be divided into the following groups: signal or motor unit shape analysis, amplitude analysis, multi-channel or successive time difference analysis, signal frequency composition analysis, change of frequency time based analysis based on simultaneous amplitude or frequency based analysis or concentric and excentric work based shape and amplitude ratio analysis. The aim of this paper is to present an ambulatory portable device for surface EMG analysing both for integrated EMG and for spectral analysis. The reliability of surface EMG recordings have established. The recent new technology gets a possibility to measure by reliable way surface EMG on-line during exercise, rehabilitation or occupational conditions. Portable EMG measurement unit and analysing program seems to be suitable for documentation of the response of rehabilitation programs, effects of physiotherapy, analysing the muscle balance and activity of sportsman and for documentation of occupational health problems. Automatic interpretation and wide data base for patient data makes the system useful in daily practice.

The purpose of this study was to develop a submaximal repetitive isoinertial back muscle endurance test by defining the relationships between the power spectral indices of paraspinal muscle electromyographic (EMG) activities, endurance time and a subjective estimate of fatigue (Borg scale). Bilateral surface EMG recordings were obtained over the lumbar paraspinal muscles in ten individuals who were currently free from back pain. All subjects performed repetitive upper trunk extensions (25 degrees flexion and 5 degrees extension, 30 repetitions per min), while movement below the third lumbar vertebral body was mechanically restricted. The load level depended upon upper body mass, sex, and age. The tests continued for as long as the subjects were able to maintain the required repetition rate (endurance time). Median (MF) and mean power frequency (MPF) slopes were calculated by performing a fast Fourier transformation after confirmation of EMG stationarity by recurrence quantification analysis. MF and MPF correlations with endurance time/Borg scale were measured for the first 60 s (0.60-0.88/0.42-0.86), the first 90 s (0.62-0.89/0.52-0.90), the first 120 s (0.50-0.76/0.41-0.73), and the entire repetitive run (0.63-0.88/0.54-0.90). To test for the reproducibility of the spectral indices EMGs were recorded for 2 min during repetitive loading from the same subjects on two consecutive days. Corresponding spectral slopes of MF and MPF were correlated at 60 s (0.36-0.93), 90 s (0.58-0.92), and 120 s (0.70-0.94) at the L3-L4 and L5-S1 levels, indicating good reproducibility of results from alternate recording sessions at the L5-S1 level. It is concluded that paraspinal muscle spectral indices (MF and MPF) measured before the onset of total muscle fatigue are good predictors of endurance time and are closely related to the subjective perception of fatigue.

Surface rms-EMG measurement as a real time monitoring method for detecting the anaerobic threshold during a bicycle ergometer test was evaluated and compared with blood lactate and ventilatory parameters. The study group consisted of 12 healthy ice hockey players. The anaerobic threshold indicated as dislinearity of increase in blood lactate level, ventilatory parameters and myoelectrical activity was observed at the work level of 300 (range 270-330) W in each case. The linearity disappeared at same time in the rms-EMG-load ratio both in working (quadriceps and gastrocnemius) and nonworking (frontalis) muscles. The rms-EMG follow-up was easier to perform than measurements of blood lactate and ventilatory parameters.

1. On-line monitoring of surface rms-EMG for detecting the anaerobic threshold during a cycle ergometer test was evaluated and compared with blood lactate and ventilatory parameters in 12 healthy icehockey players. 2. Dislinearity of increase in blood lactate level, ventilatory parameters and myoelectrical activity was observed at the mean work level of 300 (range 270-330) watts in each case. 3. The linearity disappeared at the same time in the rms-EMG-load ratio in working quadriceps and gastrocnemius muscles while also in nonworking frontalis muscle a change in EMG level was noticed. 4. The break point in rms-EMG did not correlate with the changes in skin humidity and temperature. No change was observed in spectral properties of the myoelectrical signals. 5. The rms-EMG follow-up is easier to perform than measurements of blood lactate and ventilatory parameters in the determination of anaerobic threshold.

Objective: To examine the effects of strength training on maximal force, cross‐sectional area (CSA), and electromyographic (EMG) activity of muscles and serum hormone concentrations in elderly females with fibromyalgia (FM). Methods: Twenty‐six patients with FM were randomly assigned to a training (FMT; n = 13; mean age 60 years) or a control (FMC; n = 13; 59 years) group. FMT performed progressive strength training twice a week for 21 weeks. The measurements included maximal isometric and concentric leg extension forces, EMG activity of the vastus lateralis and medialis, CSA of the quadriceps femoris, and serum concentrations of testosterone (T), free testosterone (FT), growth hormone (GH), insulin‐like growth factor‐1 (IGF‐1), dehydroepiandrosterone sulfate (DHEAS), and cortisol. Subjectively perceived symptoms of FM were also assessed. Results: All patients were able to complete the training. In FMT strength training led to increases of 36% (p<0.001) and 33% (p<0.001) in maximal isometric and concentric forces, respectively. The CSA increased by 5% (p<0.001) and the EMG activity in isometric action by 47% (p<0.001) and in concentric action by 57% (p<0.001). Basal serum hormone concentrations remained unaltered during strength training. The subjective perceived symptoms showed a minor decreasing tendency (ns). No statistically significant changes occurred in any of these parameters in FMC. Conclusion: Progressive strength training increases strength, CSA, and voluntary activation of the trained muscles in elderly women with FM, while the measured basal serum hormone concentrations remain unaltered. Strength training benefits the overall physical fitness of the patients without adverse effects or any exacerbation of symptoms and should be included in the rehabilitation programmes of elderly patients with FM. [ABSTRACT FROM AUTHOR]