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Biomedical subjects

A B Arsenault

Publications and source records attributed to A B Arsenault.

At least 19 recordsLinked to original sources

Median frequency of the electromyographic signal: effect of time-window location on brief step contractions.

The purpose of this study was to determine, for different back muscles, if the median frequency (MF) of the electromyographic (EMG) power spectrum changes according to the position of the time window during a 5 s step contraction. Twenty males with no known back problems were standing upright in a dynamometer allowing lower limb and pelvis stabilization. Trunk extension efforts were performed by pushing on a force platform positioned at the T4 level while the extension moment at L5/S1 was displayed as visual feedback. The EMG signals from four homologous back muscles (multifidus at L5, ilicostalis lumborum at L3, and longissimus at L1 and T10) were collected using active surface electrodes during two 5 s static step contractions performed at five force levels (10, 20, 40, 60 and 80% of the maximal voluntary contraction). The root mean square (RMS) and MF values of the EMG signals corresponding to three 250 ms time windows (beginning, middle and end of each step contraction) were computed. The RMS values of several back muscles increased from the first to the third time window for contractions performed at high force levels only. However, a concomitant decrease in the MF values was observed only for the left multifidus muscle. It was concluded that muscle fatigue does not generally manifest itself during 5 s step contractions through the EMG signal. However, it is recommended to use step contractions lasting less than 5 s and to choose a time window located in the first 1-3 s to completely eliminate the possible effects of fatigue.

Adult↗

Effects of upper and lower limb static exertions on global synkineses in hemiparetic subjects.

OBJECTIVES: Global synkineses are nonpurposive pathological involuntary muscle activities or movements elicited at several or all of the joints of the affected limb or limbs during voluntary forceful resisted contractions. The purpose of this study was to assess the effect of upper and lower limb exertions on manifestations of upper limb global synkineses in hemiparetic subjects. DESIGN: Involuntary muscle activities on the affected upper limb of 11 hemiparetic subjects and on the left or right upper limb of 10 control subjects were recorded using surface electromyography during successive bilateral maximal ankle exertions and during contralateral grips. RESULTS: Significant differences in the level of involuntary electromyography (EMG) activities were observed between experimental conditions (ANOVAs, p < 0.05). EMG levels in hemiparetic subjects were significantly higher during contralateral grip tasks than during the ankle exertions. CONCLUSION: These results suggest that upper limb global synkinases are more prevalent in specific tasks and that this task specificity may reflect the neurophysiological mechanisms involved in the generation of global synkinases.

Adult↗

Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors.

OBJECTIVE: To determine, using the Muscular Utilization Ratio (MUR) method, whether plantarflexor weakness is among the factors preventing stroke subjects from walking at faster speeds. Potential compensations by the hip flexors were also examined. DESIGN: A convenience sample of 17 chronic stroke subjects in a context of a descriptive study. BACKGROUND: Gait speed is correlated with the residual strength of the muscles involved in gait in stroke subjects. However, it has not been established if this residual strength limits gait speed. METHODS: Kinetic and kinematic data for comfortable and maximal gait speeds were collected on the paretic side, and were used to determine the moments in plantarflexion (mechanical demand: MUR numerator) during the push-off phase. The maximal potential moment (MUR denominator) of the plantarflexors during gait was predicted using an equation derived from dynamometric data collected with a Biodex system. The MURs of the plantarflexors were then calculated at every 1% interval of the push-off phase. The pull-off phase of gait and the hip flexor strength were also examined. RESULTS: Ten subjects of the sample had a MUR value between 80 and 150% at maximal gait speed. These subjects produced the lowest peak torques in plantarflexion. Each of the four fastest subjects of this group had a large hip flexion moment during the pull-off phase of gait and produced high hip flexion torque values on the dynamometer. Each of the seven remaining subjects had a MUR value under 70% when they walked at maximal speed. CONCLUSIONS: Weakness of the plantarflexors should be considered as one factor limiting gait speed in 10 hemiparetic subjects. Some subjects with weak plantarflexors could walk rapidly because they compensated with the hip flexors. For the remaining stroke subjects, factors other than weakness of the plantarflexors have to be considered in order to explain the reduction in their gait speed.

Adolescent↗

A static dynamometer measuring simultaneous torques exerted at the upper limb.

The majority of available dynamometers are designed to measure force or torque in one specific direction, one joint at a time. For the quantification of motor incoordination in neurological patient populations, these dynamometers provide limited information about the global behavior of the limb under investigation. This report describes the potential use and function of a static dynamometer measuring torques exerted simultaneously at the shoulder (flexion-extension, abduction-adduction, internal-external rotation), elbow (flexion-extension), and forearm (pronation-supination). Orthogonal forces were measured at the arm and wrist using strain gauge transducers interfaced with a laboratory computer. The lever arms were specified to a software program and the joint torques were calculated in real time according to static equilibrium equations. The use of the dynamometer is illustrated by characterizing for one hemiparetic subject, the joints torques recorded at the shoulder, elbow, and forearm during isolated submaximal grip exertions at different force levels on both sides. The torques generated at the shoulder, elbow and forearm during the hand grip tasks on the affected side were significantly higher than those obtained on the nonaffected side and increased with the grip force level. These differences probably reflect the loss of movement selectivity observed following a lesion in the central nervous system. Further studies are currently being undertaken in neurological patient populations to characterize and quantify motor deficits using this dynamometer. As a long term goal, we hope that the method and technologies described here will contribute to the evaluation and rehabilitation of these populations.

Biofeedback, Psychology↗

Relationships between torque, velocity and power output during plantarflexion in healthy subjects.

This study investigated the relationships existing between torque, velocity and power output during plantarflexion. Using a Biodex dynamometric system, 15 healthy subjects performed three maximal dynamic tests, ranging from -12 degrees (-0.209 rad) of dorsiflexion to +47 degrees (+0.818 rad) of plantarflexion and one static test (test 4) at an angle of +10 degrees (+0.174 rad). The dynamic assessment included a 30 degrees s-1 (0.52 rad s-1) concentric isokinetic test (test 1) preceded by a 2-sec maximal pre-loading contraction. The other two dynamic tests were performed using the isotonic mode of testing with a selected torque of 27 N m; one of these tests was executed with pre-loading (test 2) while the other was performed without pre-loading (test 3). The results indicated that the dynamic peak torque, the peak power and the peak velocity were obtained in test 1, test 2 and test 3, respectively. These peak values, as well as the values of torque (test 1 and test 4), power (test 2) and velocity (test 3) obtained at a constant angle +10 degrees (+0.174 rad), were selected for the correlation analyses. The results showed that the torque, velocity and power output during plantarflexion were linearly related to one another with significant correlations (0.71 < r < 0.92; p < 0.01). This finding suggests that a common factor of muscular performance is assessed. Furthermore, these results indicated that the maximal torque produced by a subject can be predictive of his or her maximal velocity and power. Consequently, a stronger subject can generate higher velocity and power than a weaker subject when tested with the same load during maximal effort.

Adult↗

Dynamometric assessment of the plantarflexors in hemiparetic subjects: relations between muscular, gait and clinical parameters.

The aims of this study were to investigate, in 16 subjects with hemiparesis, the plantarflexor muscle performance of the paretic side and to determine the level of the relationships between muscular parameters, clinical measures and gait performance. A Biodex dynamometric system was used to evaluate static and dynamic torques, power and maximal rate of tension development of the plantarflexor muscles. The clinical measures included the Fugl-Meyer assessment (FMA), the "Up & Go" test and an evaluation of ankle muscle tone. Velocity, cadence, stride length and gait cycle duration were determined for each subject at both comfortable and maximal safe speeds using foot contacts and videographic data. Results indicated that dynamometric values produced by the hemiparetic subjects were reduced in comparison to those reported for healthy subjects. Their torque-angle curves had a curvilinear shape which indicated pronounced decrease of torque for plantarflexion efforts at the beginning of the movement. Torques produced at different velocities of testing did not demonstrate significant differences (MANOVAs: p > 0.05) but power values were significantly different. Results also showed that all the selected muscular parameters (torque, power and maximal rate of tension development) were moderately to highly interrelated (0.65 < r < 0.94; p < 0.01) suggesting that a common factor of muscular performance was assessed. Furthermore, the dynamometric data were significantly associated with some of the clinical measures (sensation and lower limb motor control scores of the FMA) but were not related to the gait variables (Pearson's r < 0.45; p > 0.05). This last finding suggests that the relationship between plantarflexor strength and the level of gait performance in adults with stroke is complex. The relationship may be influenced by other factors such as muscular compensations within and between limbs and motor control impairments.

Adolescent↗

Effects of transcutaneous electrical nerve stimulation on the H-reflex of muscles of different fibre type composition.

Differential effects of repetitive stimulation of low threshold afferents on both the recruitment threshold and motoneuronal excitability of type I and type II motor units have been demonstrated. The present study was aimed at further investigating the differential effects of 30 minutes of transcutaneous electrical nerve stimulation (TENS) on the H-reflex amplitude (Hmax/2) of the Soleus (SO), gastrocnemius lateralis (GL) and medialis (GM) muscles. Eleven healthy subjects were tested in order to evaluate the effects of TENS on either the common peroneal (CPN), saphenous or sural nerve. The experimental session consisted of three consecutive 45 min periods. Within each of these periods, H-reflexes were recorded before, during and after the TENS was applied. It was hypothesized that repetitive low threshold afferent stimulation would either have inhibitory or facilitatory effects on the H-reflex amplitude of the SO or gastrocnemii muscles respectively. Non-parametric Friedman ANOVAs revealed a significant tendency (p < 0.05) toward inhibition of the H-reflex amplitude of the SO and GL muscle during TENS applied over either the CPN or sural nerve, as well as that of the GM during repetitive stimulation of the saphenous nerve. Although the present study failed to reveal any differential effects of TENS on the H-reflex amplitude of muscle on different fibre type content, the significant decrease in H-reflex observed on the triceps surae muscles during TENS applied over the CPN might have promising clinical outcomes for hyperreflexive subjects.

Adult↗

Preloading and range of motion effect on plantarflexor muscle performance.

OBJECTIVE: To determine the effects of maximal preloading and range of motion (ROM) on the mechanical parameters of the plantarflexor muscles obtained while using the isotonic mode of testing of a Biodex dynamometer. DESIGN: A convenience sample of healthy subjects in the context of a descriptive comparative study. SETTING: Research laboratory in Canada. SUBJECTS: Fifteen volunteered subjects without history of injury or disorder to the right lower extremity. MEASUREMENTS: Four maximal isotonic tests were performed against a selected load of 27Nm. For the first two tests, the movement at the ankle ranged from -12 degrees (dorsiflexion) to +32 degrees (plantarflexion); one of these tests was preceded by a 2-second maximal preloading contraction, while the other was performed without preloading. For the other two tests, the ROM at the ankle was increased by 15 degrees of plantarflexion and thus ranged from -12 degrees to +47 degrees; again one of these tests was executed with preloading and the other without preloading. RESULTS: The four tests showed differences in the mechanical parameters (MANOVA p < .05). At angles of -10 degrees and +5 degrees, subjects produced higher torque and power but lower velocity values for the two tests preceded by a maximal preloading. The effect of ROM was demonstrated at +20 degrees where tests performed in a small amplitude reached a lower velocity than the corresponding tests performed in a larger amplitude. Based on the velocity profiles, the results also revealed that maximal preloading changed the selected isotonic movement of the Biodex dynamometer to an isoaccelerative movement characterized by high torque and power production. CONCLUSIONS: Isotonic assessment using the Biodex dynamometer provides different values of torque, velocity, and power depending on the testing conditions used. In clinical settings, it would be important to control these testing conditions.

Analysis of Variance↗

A mechanical model to study the relationship between gait speed and muscular strength.

This study proposes a mechanical model to investigate the relationship between gait speed and strength of the ankle plantarflexor muscles. The model calculates the muscular utilization ratio (MUR) of the plantarflexor muscles during gait by comparing the plantarflexion moment used while walking to the maximal moment of the plantarflexors estimated from dynamometric measurements. To verify the model, MURs of the plantarflexor muscles were calculated for five healthy subjects and one hemiparetic subject walking at different speeds (slow, self-selected, and fast). Generally, the results of the healthy subjects revealed that MURs increase with an increasing gait speed: average (+/-SD) peak values of MUR reached 58.8% (+/-18.5), 65.6% (+/-17.2) and 71.0% (+/-17.8) for the slow, self-selected, and fast speeds, respectively. The average peak value of MURs at the self-selected speed corresponds to values reported in electromyographic studies of the plantarflexor muscles. At self-selected gait speed, the hemiparetic subject presented a higher peak MUR (80.5%) of the plantarflexors and a lower gait velocity when compared to healthy subjects. For the hemiparetic subject, peak values of MUR of the plantarflexor muscles at maximal walking speed reached 100% suggesting that full activation of the plantarflexors had been reached preventing him from walking faster. From these preliminary results, it appears that MURs calculated by the proposed model are sensitive to the mechanical demands imposed on a group of muscles during a task (eg., increase in gait speed) and to change in the maximal plantarflexor's strength (eg., weakness). The proposed model seems to have the potential to demonstrate whether muscle weakness limits maximal gait speed in hemiparetic subjects. However, considering the complexity of gait speed regulation in hemiparetic patients, the model should be tested on a large number of hemiparetic subjects.

Adolescent↗

Effects of transcutaneous electrical nerve stimulation on H-reflex and spinal spasticity.

The purpose of this study was to investigate the short-term effects of transcutaneous electrical nerve stimulation (TENS; 99 Hz; 250 ms pulses) on H-reflex and spinal spasticity. Considering the reflex hyperexcitability commonly displayed in spinal cord-injured subjects, it was hypothesized that repetitive low threshold afferent stimulation would have an inhibitory effect on the triceps surae H-reflexes which could also be reflected by a decrease in plantarflexor spasticity. Clonus, Achilles tendon reflex and modified Ashworth evaluations were performed on 14 spinal cord-injured subjects prior to and after 30 minutes' application of TENS. Non-parametric statistical analyses (n = 14; alpha = 0.05) failed to reveal significant effects of TENS on H-reflex amplitude. However, there was a significant decrease in scores for the Achilles tendon reflex and the modified Ashworth test. The clonus score decreased in most subjects post-TENS, although not in a statistically significant manner. The present pilot results thus suggest that TENS appears to be effective in reducing spinal spasticity, as measured clinically.

Adult↗

Changes in the electromyographic spectrum power distribution caused by a progressive increase in the force level.

The purpose of the present study was to determine the specific changes occurring in the power spectrum with an increasing force level during isometric contractions. Surface electromyographic signals of the triceps brachii (TB) and the anconeus (AN) of 29 normal subjects were recorded during isometric ramp contractions performed from 0 to 100% of the maximum voluntary contraction (MVC) in a 5-s period. Power spectra were obtained at 10, 20, 30, 40, 50, 60, 70, 80 and 90% MVC. Changes in the shape of these spectra were evaluated visually and with the calculation of several statistical parameters related to the distribution of power along the frequency axis, such as median frequency and mean power frequency, standard deviation, skewness, first and third quartiles and half-power range. For the AN, the behaviour of the spectrum was relatively similar across subjects, presenting a shift toward higher frequencies without any major change in the shape of the spectrum. For the TB, subjects with a thin skinfold thickness presented similar behaviours. In subjects with a thicker skinfold, however, a loss of power in the high frequency region paralleled the increase in the force level. Significant correlations were obtained between the extent of the change in the value of higher order statistical parameters across force and the thickness of the skin. This points out the importance of the skinfold layer when recording with surface electrodes. Furthermore, the use of a combination of several parameters appears to provide a better appreciation of the changes occurring in the spectrum than any single parameter taken alone.

Adult↗

Comparison of the EMG power spectrum of the human soleus and gastrocnemius muscles.

The purpose of this study was to compare the behaviour of electromyographic (EMG) power spectrum statistics, mean power frequency (MPF) and median frequency (MF), across increasing force levels of the soleus (SO), gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) muscles. Surface EMG signals of these three muscles were recorded in 12 men and 10 women during both (1) ramp (single ongoing contractions with the force increasing linearly from 0 to 100% of the maximum voluntary contraction (MVC); and (2) step (steady force levels: 10, 20, 30, 40, 60 and 80% MVC) static (isometric) plantar flexions. Power spectral analysis of these signals was performed on single 256-ms windows at all of the above-mentioned force levels, for both types of contraction. The MF and MPF were calculated from each of the obtained spectra. A less pronounced increase in the MF or MPF was expected for the SO because of its higher type I fibre content. The main results are as follows: (1) similar behaviours were found in the value of MPF and MF across increasing force for the SO and GL muscles, while the GM gave rise to a different behaviour; (2) no difference was found between ramp and step contractions in the behaviour of either MF or MPF across force levels; and (3) different behaviours were observed between the MF and MPF across increasing force levels, for both ramp and step contractions. Our initial expectations were thus not confirmed. It is concluded that the present results support the hypothesis that the EMG power spectrum may be more sensitive to the diameter of the fibres than to the fibre type proportion of the triceps surae muscles. Furthermore, the sensitivity of the power spectrum statistics of a given muscle to the low-pass filter effect of its skin layer was also emphasized.

Adult↗

Absence of consistent effects of repetitive transcutaneous electrical stimulation on soleus H-reflex in normal subjects.

Our purpose was to determine the effects of transcutaneous electrical nerve stimulation (TENS) on the soleus H-reflex amplitude in normal subjects. Eleven subjects were tested in five experimental sessions, the purpose of which was to compare the effects of 30 minutes of TENS delivered at either 50 or 99Hz (250 microseconds pulses) on a mixed (common peroneal nerve or CPN) versus a sensory (sural) nerve. The soleus H-reflex was elicited according to the classic protocol of Hugon (1973). Control values (Hctrl) were measured for 5 minutes prior to and for 10 minutes after the TENS was administered at twice the sensory threshold. No statistically significant session (treatment) effects (two-way ANOVAs for repeated measures; alpha = 0.05) resulted from the stimulation of the CPN or the sural nerve at 50 or 99Hz. However, although no specific trends were shown across all subjects, there was a definite tendency towards inhibition (> or = 10% Hctrl) of the H-reflex in 63% of the subjects after 30 minutes of TENS at 99Hz over the CPN, and in 50% of the subjects when TENS was applied over the sural nerve at 99Hz. The inherent variability of the H-reflex amplitude in normal subjects as well as the use of different stimulation paradigms and TENS parameters could explain the controversial findings present in the literature.

Adult↗

Effects of TENS and topical skin anesthesia on soleus H-reflex and the concomitant influence of skin/muscle temperature.

The purpose of this study was to determine, in ten healthy subjects, the extent of soleus motoneuronal excitability during conditions of increased (transcutaneous electrical nerve stimulation [TENS]), decreased (Xylocaine [lidocaine]a anaesthesia) and normal (placebo anaesthesia) cutaneous inputs. Increased cutaneous activity was evoked using a TENS unit, with the two pairs of electrodes placed respectively over the Achilles (S2 dermatome) and tibialis anterior (L5 dermatome) tendons. Experimental and placebo topical anaesthesia were obtained after rubbing Xylocaine (5%) and Vaselineb ointment, respectively, on the skin surface overlying the Achilles tendon. Sets of ten H-responses (Hmax/2) were evoked at a frequency of 1 shock/30s and averaged at regular time intervals before, during and after the testing conditions. The results showed a gradual increase (up to 40% after 20 minutes) of H-reflex amplitude during TENS regardless of whether it was applied on the L5 or S2 dermatome. Furthermore, placebo anesthesia (Vaseline) caused the same gradual facilitatory response (up to 100% after 50 minutes) as that obtained during Xylocaine anaesthesia. Power spectral analysis of the H-responses obtained over time showed that the increase in the peak-to-peak H-response value was accompanied by a shift of the spectral content toward low frequencies. This shift occurred concomitantly with a cooling of the skin overlying the soleus muscle.

Administration, Topical↗

Characterization of contralateral torques during static hip efforts in healthy subjects and subjects with hemiparesis.

Contralateral torques exerted at the hip were measured in healthy subjects and subjects with hemiparesis performing unilateral static hip efforts in abduction, adduction, flexion and extension, in a sitting position, at two torque levels. In general, the ipsilateral hip efforts were accompanied by mirrored contralateral torques in both groups of subjects. The directionality of these contralateral torques indicates that their action at the pelvis is mechanically opposite to the ipsilateral efforts, suggesting that they ensure the stabilization of the pelvis. In healthy subjects, analyses of variance showed no difference in the magnitude of the contralateral torques with regard to which limb was used to perform the task. However, a significant increase in magnitude was demonstrated in the contralateral torques concurrent with the increasing level of effort requested ipsilaterally. In hemiparetic subjects, when performing the tasks with their paretic limb, the magnitude of the contralateral torques was significantly increased in the non-paretic limb when compared with those measured in the paretic limb during non-paretic limb efforts. Based on the present results, a model of postural control is presented to explain the relationship between the ipsilateral and contralateral torques. Using this model, it is hypothesized that the increased contralateral torques observed in hemiparetic subjects when performing the tasks with their paretic limb is related to the weakness of the paretic muscles. The clinical importance of exercises used for the re-education of the paretic lower limb in this population, which consist of resisting the non-paretic hip movements in order to strengthen the paretic hip muscles, is discussed in light of these results.

Adult↗

EMG power spectra of elbow extensors during ramp and step isometric contractions.

The goal of the present study was to compare electromyogram (EMG) power spectra obtained from step (constant force level) and ramp (progressive increase in the force level) isometric contractions. Data windows of different durations were also analysed for the step contractions, in order to evaluate the stability of EMG power spectrum statistics. Fourteen normal subjects performed (1) five ramp elbow extensions ranging from 0 to 100% of the maximum voluntary contraction (MVC) and (2) three stepwise elbow extensions maintained at five different levels of MVC. Spectral analysis of surface EMG signals obtained from triceps brachii and anconeus was performed. The mean power frequency (MPF) and the median frequency (MF) of each power spectrum were obtained from 256-ms windows taken at 10, 20, 40, 60 and 80% MVC for each type of contraction and in addition on 512-, 1024- and 2048-ms windows for the step contractions. No significant differences (P greater than 0.05) were found in the values of both spectral statistics between the different window lengths. Even though no significant differences (P greater than 0.05) were found between the ramp and the step contractions, significant interactions (P less than 0.05) between these two types of contraction and the force level were found for both the MPF and the MF data. These interactions point out the existence of different behaviours for both the MPF and the MF across force levels between the two types of contraction.

Adult↗

Clinical significance of the V-shaped space in the subluxed shoulder of hemiplegics.

Recently, it has been proposed that shoulder subluxation in hemiplegia is accompanied by 1) the appearance of a V-shaped articular configuration occurring between the humeral head and glenoid fossa and 2) the presence of chronic pain. The main purpose of this study was to investigate the validity of these statements. We evaluated 40 hemiplegic subjects over 3 months. Radiographs of the affected and nonaffected shoulders were taken at both a frontal plane (0 degree) and a 45 degree incidence. From these patients, subluxed (n = 19) and nonsubluxed (n = 21) groups were formed. Pain was evaluated using the Present Pain Intensity index of the McGill Pain Questionnaire. On these x-ray films, measurements were taken of the V-shaped space, abduction of the arm, and rotation of the scapula. The statistical analysis (analysis of variance for repeated measures) contrasted the results obtained from the nonaffected side with those from the affected side over the 3 months studied. At the 45 degree angle, which better exposes the articular configuration of the shoulder, the difference in the V angle between the affected and nonaffected shoulders was significant for the subluxed group (p less than 0.01), indicating that such a V-shaped space can be identified. The measures taken also indicate that a downward subluxation of the humeral head occurs relative to the scapula without any systematic abduction of the humerus or downward rotation of the scapula. None of the results obtained from the frontal plane x-ray films was significant. Finally, no significant relation was found between subluxation and shoulder pain.

Adult↗