Biomedical subjects

C L Hubley-Kozey

Publications and source records attributed to C L Hubley-Kozey.

5 recordsLinked to original sources

PubMed2005

Neuromuscular alterations during walking in persons with moderate knee osteoarthritis.

This paper compared the neuromuscular responses during walking between those with early-stage knee osteoarthritis (OA) to asymptomatic controls. The rationale for studying those with mild to moderate knee OA was to determine the alterations in response to dynamic loading that might be expected before severe pain, joint space narrowing and joint surface changes occur. We used pattern recognition techniques to explore both amplitude and shape changes of the surface electromyograms recorded from seven muscles crossing the knee joint of 40 subjects with knee OA and 38 asymptomatic controls during a walking task. The principal patterns for each muscle grouping explained over 83% of the variance in the waveforms. This result supported the notion that the main neuromuscular patterns were similar between asymptomatic controls and those with OA, reflecting the specific roles of the major muscles during walking. ANOVA revealed significant (p<0.05) differences in the principal pattern scores reflecting both amplitude and shape alterations in the OA group and among muscles. These differences captured subtle changes in the neuromuscular responses of the subjects with OA throughout different phases of the gait cycle and most likely reflected changes in the mechanical environment (joint loading, instability) and pain. The subjects with OA attempted to increase activity of the lateral sites and reduce activity in the medial sites, having minimal but prolonged activity during late stance. Therefore, alterations in neuromuscular responses were found even in this high functioning group with moderate knee OA.

Adult↗

PubMed2000

Muscle activation in therapeutic exercises to improve trunk stability.

OBJECTIVE: To evaluate the relative activation amplitudes from 3 abdominal and 2 trunk extensor muscle sites in healthy subjects performing the pelvic tilt, abdominal hollowing, and level 1 of the trunk stability test (TST level 1) exercises and to compare the activation amplitudes among muscle sites and exercises. DESIGN: Prospective comparative study. SETTING: Motion Analysis Research Center, Dalhousie University, Canada. PARTICIPANTS: Twenty-four healthy men (mean age, 30 +/- 8.1 yr [SD]) without low back pain. INTERVENTIONS: Subjects performed 3 exercises in a balanced order, repeating each exercise 5 times while surface electromyography (EMG) was recorded from the 5 muscle sites. Exercises were divided into 2 phases: movement and stabilization. The root-mean-square amplitude of the EMG for each phase was calculated and normalized to the maximal voluntary isometric contraction (MVIC) amplitude for each muscle. A 2-factor repeated-measures analysis of variance (ANOVA) tested the muscle by exercise interaction and the main effects for each phase separately. MAIN OUTCOME MEASURES: Normalized activation amplitude was the main dependent variable. Ensemble-average curves were calculated to examine the phasing of activation. RESULTS: ANOVA showed a statistically significant interaction (p < .05) for both phases, indicating the 3 exercises recruited the 5 muscle sites using different patterns of relative activation. The external oblique (EO) muscle site was activated to higher amplitudes than the other 4 sites in all 3 exercises for both phases. The highest activity was recorded from the EO during the pelvic tilt, just more than 25% of MVIC. The only exercise to recruit the erector spinae to significantly higher amplitudes than the multifidus site was the TST level 1. CONCLUSIONS: Study exercises were not interchangeable for the patterns of trunk muscle activation amplitudes. The exercises did not recruit the abdominal muscles to adequate levels for strengthening for this healthy sample; however, all 5 muscle sites were activated, forming the basis of a stabilizing exercise approach.

Abdominal Muscles↗

PubMed1995

Spatial features in body-surface potential maps can identify patients with a history of sustained ventricular tachycardia.

BACKGROUND: Regional disparities of ventricular primary-repolarization properties contribute to an electrophysiological substrate for arrhythmias. Such disparities can be assessed from body-surface distributions of ECG QRST areas. Our objective was to isolate and test those features of QRST-area distributions that would be suitable for identifying patients at risk for life-threatening ventricular arrhythmias. METHODS AND RESULTS: We recorded ECGs simultaneously from 120 leads during sinus rhythm for 204 patients taking no antiarrhythmic drugs: half had had sustained ventricular tachycardia (VT); the other half, a myocardial infarction but no history of VT. For each patient, we calculated the QRST area in each lead and, using Karhunen-Loeve (K-L) expansion, reduced these data to 16 coefficients (each relating to one spatial feature, an eigenvector, derived from the total set of 204 QRST-area maps). Using stepwise discriminant analysis, we selected feature subsets that best discriminated between the two groups, and we estimated by a bootstrap procedure using 1000 trials how these subsets would perform on a prospective patient population. The mean diagnostic performance of the classifier for 1000 randomly selected training sets (n = 102 in each, with both groups equally represented) increased monotonically with the number of features used for classification. The initial trend for the corresponding test sets (n = 102 in each) was the same but reversed when the number of features exceeded eight. For an optimal set of eight spatial features, the sensitivity and specificity of the classifier for detecting patients with VT in 1000 test sets were (mean +/- SD) 90.3 +/- 4.3% and 78.0 +/- 6.1%, and its positive and negative predictive accuracies were 80.7 +/- 4.2% and 89.2 +/- 4.2%, respectively. Use of QRS duration as a supplementary feature to eight K-L coefficients can, in the test sets, increase specificity to 80.9 +/- 5.4% and positive predictive accuracy to 82.8 +/- 3.9% compared with the results for the optimal number of eight K-L features alone. CONCLUSIONS: Multiple body-surface ECGs contain valuable spatial features that can identify the presence of an arrhythmogenic substrate in the myocardium of patients at risk for ventricular arrhythmias. Our results compare very favorably with those achieved by any other known test, invasive or noninvasive, for arrhythmogenicity.

Body Surface Potential Mapping↗

PubMed1992

Electrocardiographic body surface mapping in patients with ventricular tachycardia. Assessment of utility in the identification of effective pharmacological therapy.

BACKGROUND: Body surface maps of net QRST deflection areas (isointegrals) reflect regional ventricular repolarization properties. Vulnerability to ventricular tachyarrhythmias is associated with maps that feature multiple islands (extrema) of positive and negative values; such maps reflect regional disparity of ventricular recovery properties. The value of body surface mapping in prediction of the efficacy of antiarrhythmic therapy for ventricular tachyarrhythmias has not been determined. METHODS AND RESULTS: Isointegral ECG body surface mapping was performed in 51 patients with inducible ventricular tachycardia having programmed stimulation studies at baseline and after oral quinidine therapy. The degree of nondipolarity of QRST isointegral distribution was expressed by the number of extrema and by the percentage contribution of nondipolar eigenvectors after Karhunen-Loeve transformation. QRST isointegral nondipolarity was greater in ventricular tachycardia patients than in 51 age- and sex-matched normal subjects expressed as mean number of extrema (4.1 +/- 2.8 versus 2.0 +/- 0.2, respectively), mean eigenvector-determined nondipolar content percentages (12.4 +/- 10.1% versus 4.5 +/- 4.9%), prevalence of abnormal numbers of extrema (63% versus 4%), or prevalence of abnormal nondipolar content percentages (33% versus 4%) (each p less than 0.01). Quinidine prevented ventricular tachycardia induction in 14 patients. Patients for whom quinidine was or was not effective had similar nondipolarity indexes at baseline. However, maps on quinidine differed as a function of antiarrhythmic efficacy. Although effective therapy produced no significant mean changes in nondipolarity, ineffective therapy increased the number of extrema compared with baseline (5.4 +/- 3.4 versus 3.8 +/- 2.5, respectively) (p = 0.002). Individually, 43% of patients on effective therapy had drug-induced decreases in numbers of extrema compared with 14% of those on ineffective therapy (p = 0.02). Furthermore, 29% of patients on effective therapy showed drug-induced increases in numbers of extrema compared with 62% of those on ineffective therapy (p = 0.03). CONCLUSIONS: QRST isointegral body surface mapping shows promise as a noninvasive measure of drug efficacy in patients with ventricular tachycardia.

Anti-Arrhythmia Agents↗

PubMedDate not supplied

Differentiating temporal electromyographic waveforms between those with chronic low back pain and healthy controls.

OBJECTIVES: Temporal activation patterns from abdominal and lumbar muscles were compared between healthy control subjects and those with chronic low back pain. STUDY DESIGN: A cross-sectional comparative study. BACKGROUND: Synergist and antagonist coactivity has been considered an important neuromuscular control strategy to maintain spinal stability. Differences in onset times and amplitudes have been reported from trunk muscle EMG recordings between healthy subjects and those with low back pain;however, evaluating temporal EMG waveforms should demonstrate whether differences exist in the ability of those with and those without low back pain to respond to changing perturbations. METHODS: The Karhunen-Loève expansion was applied to the ensemble-average EMG profiles recorded from four abdominal and three trunk extensor muscle sites while subjects performed a leg-lifting task aimed at challenging lumbar spine stability. The principal patterns were derived and the weighting coefficients for each pattern were the main dependent variables in a series of two-factor (group and muscle) mixed ANOVA models. RESULTS: Three principal patterns explained 96% of the variance in the temporal EMG profiles. The ANOVAs revealed statistically significant group and muscle main effects (P<0.05) for the principal pattern and significant group by muscle interactions (P<0.05) for patterns two and three. Post hoc analysis showed that patterns were not different among all muscle sites for the healthy controls, but differences were significant for the low back pain group. CONCLUSIONS: The healthy group coactivated all seven sites with the same temporal pattern of activation. The low back pain group used different activation patterns indicative of a lack of synergistic coactivitation among the muscle sites examined. RELEVANCE: These results provide a foundation for developing a diagnostic classifier of neuromuscular impairment associated with low back pain, that could be used to evaluate the effectiveness of therapeutic interventions to improve muscle coactivation.

Abdominal Muscles↗