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Biomedical subjects

P Bonato

Publications and source records attributed to P Bonato.

12 recordsLinked to original sources

Muscle fatigue and fatigue-related biomechanical changes during a cyclic lifting task.

STUDY DESIGN: Electromyographic and biomechanical methods were utilized to investigate correlations between indexes of localized muscle fatigue and changes in the kinematics and kinetics of motion during a cyclic lifting task. SUMMARY OF BACKGROUND DATA: Recent advances in time-frequency analysis procedures for electromyographicic signal processing provide a new way of studying localized muscle fatigue during dynamic contractions. These methods provide a means to investigate fatigue-related functional impairments in patients with low back pain. OBJECTIVES: To study the relationship between localized muscle fatigue and the biomechanics of lifting and lowering a weighted box. Fatigue-related changes in the electromyographicic signal of trunk and limb muscles were evaluated and compared to kinematic and kinetic measures in order to determine whether lifting strategy is modified with fatigue. METHODS: A total of 14 healthy male subjects (26 +/- 5 years) cyclically lifted and lowered a 13 kg box (12 lifts/min) for 4.5 minutes. A 5-second static maximum lifting task was included immediately before and after the cyclic lifting task to measure changes in lifting strength and static electromyographicic fatigue indexes. Electromyographic signals from 14 muscle sites (including paravertebral and limb muscles) were measured. Changes in the electromyographicic Instantaneous Median Frequency, a fatigue index, were computed using time-frequency analysis methods. This index was compared with more standardized measures of fatigue, such as those based on electromyographicic median frequency acquired during a static trunk extension test, subjective fatigue measures, and maximal static lifting strength. Biomechanical measures were gathered using a motion analysis system to study kinematic and kinetic changes during the lifting task. RESULTS: During the cyclic lifting task, the electromyographic Instantaneous Median Frequency significantly decreased over time in the paravertebral muscles, but not in the limb muscles. Paravertebral electromyographicic Instantaneous Median Frequency changes were consistent with self-reports of fatigue as well as decreases in trunk extension strength. The magnitude of muscle-specific changes in electromyographicic Instantaneous Median Frequency was not significantly correlated with electromyographicic median frequency changes from the static trunk extension task. The load of the box relative to the maximal static lifting strength significantly affected the electromyographicic Instantaneous Median Frequency changes of paravertebral back muscles. Significant changes with fatigue during the task were found in the angular displacements at the knee, hip, trunk, and elbow. These biomechanical changes were associated with increased peak torque and forces at the L4-L5 vertebral segment. CONCLUSIONS: Our results demonstrate correlation between localized muscle fatigue and biomechanical adaptations that occur during a cyclic lifting task. This new technique may provide researchers and clinicians with a means to investigate fatigue-related effects of repetitive work tasks or assessment procedures that might be useful in improving education, lifting ergonomy, and back school programs. Although both the dynamic and static tasks resulted in spectral shifts in the electromyographicic data, the fact that these methods led to different muscle-specific findings indicates that they should not be considered as equivalent assessment procedures.

Adult↗

Low-frequency oscillations (<0.3 Hz) in the electromyographic (EMG) activity of the human trapezius muscle during sleep.

The surface electromyographic (EMG) signal from right and left trapezius muscles and the heart rate were recorded over 24 h in 27 healthy female subjects. The root-mean-square (RMS) value of the surface EMG signals and the heartbeat interval time series were calculated with a time resolution of 0.2 s. The EMG activity during sleep showed long periods with stable mean amplitude, modulated by rhythmic components in the frequency range 0.05-0.2 Hz. The ratio between the amplitude of the oscillatory components and the mean amplitude of the EMG signal was approximately constant over the range within which the phenomenon was observed, corresponding to a peak-to-peak oscillatory amplitude of approximately 10% of the mean amplitude. The duration of the periods with stable mean amplitude ranged from a few minutes to approximately 1 h, usually interrupted by a sudden change in the activity level or by cessation of the muscle activity. Right and left trapezius muscles presented the same pattern of FM. In supplementary experiments, rhythmic muscle activity pattern was also demonstrated in the upper extremity muscles of deltoid, biceps, and forearm flexor muscles. There was no apparent association between the rhythmic components in the muscle activity pattern and the heart rate variability. To our knowledge, this is the first time that the above-described pattern of EMG activity during sleep is documented. On reanalysis of earlier recorded trapezius motor unit firing pattern in experiments on awake subjects in a situation with mental stress, low-FM of firing with similar frequency content was detected. Possible sources of rhythmic excitation of trapezius motoneurons include slow-wave cortical oscillations represented in descending cortico-spinal pathways, and/or activation by monoaminergic pathways originating in the brain stem reticular formation. The analysis of muscle activity patterns may provide an important new tool to study neural mechanisms in human sleep.

Adult↗

Time-frequency parameters of the surface myoelectric signal for assessing muscle fatigue during cyclic dynamic contractions.

The time-dependent shift in the spectral content of the surface myoelectric signal to lower frequencies has proven to be a useful tool for assessing localized muscle fatigue. Unfortunately, the technique has been restricted to constant-force, isometric contractions because of limitations in the processing methods used to obtain spectral estimates. A novel approach is proposed for calculating spectral parameters from the surface myoelectric signal during cyclic dynamic contractions. The procedure was developed using Cohen class time-frequency transforms to define the instantaneous median and mean frequency during cyclic dynamic contractions. Changes in muscle length, force, and electrode position contribute to the nonstationarity of the surface myoelectric signal. These factors, unrelated to localized fatigue, can be constrained and isolated for cyclic dynamic contractions, where they are assumed to be constant for identical phases of each cycle. Estimation errors for the instantaneous median and mean frequency are calculated from synthesized signals. It is shown that the instantaneous median frequency is affected by an error slightly lower than that related to the instantaneous mean frequency. In addition, we present a sample application to surface myoelectric signals recorded from the first dorsal interosseous muscle during repetitive abduction/adduction of the index finger against resistance. Results indicate that the variability of the instantaneous median frequency is related to the repeatability of the biomechanics of the exercise.

Electromyography↗

Time-frequency methods applied to muscle fatigue assessment during dynamic contractions.

This paper discusses the assessment of the electrical manifestations of muscle fatigue during dynamic contractions. In the past, the study of muscle fatigue was restricted to isometric constant force contractions because, in this contraction paradigm, the myoelectric signal may be considered as wide sense stationary over epochs lasting up to two or three seconds, and hence classic spectral estimation techniques may be applied. Recently, the availability of spectral estimation techniques specifically designed for nonstationary signal analysis made it possible to extend the employment of muscle fatigue assessment to cyclic dynamic contractions, thus increasing noticeably its possible clinical applications. After presenting the basics of time-frequency distributions, we introduce instantaneous spectral parameters well suited to tracking spectral changes due to muscle fatigue, discuss the issues of quasi-stationarity and quasi-cyclostationarity, and present different strategies of signal analysis to be utilized with cyclic dynamic contractions. We present preliminary results obtained by analyzing data collected from paraspinal muscles during repetitive lift movements, from the first dorsal interosseus during abduction-adduction movements of the index finger, and from knee flexors and extensors during isokinetic exercise. In conclusion, data herein reported demonstrate that the described techniques allow for evidencing the electrical manifestations of muscle fatigue in different paradigms of cyclic dynamic contractions. We believe that the extension of the objective assessment of the electrical manifestations of muscle fatigue from static to dynamic contractions may increase considerably the interest of researchers and clinicians and open new application fields, as ergonomics and sports medicine.

Electromyography↗

Myoelectric activation pattern during gait in total knee replacement: relationship with kinematics, kinetics, and clinical outcome.

Gait usually presents an excellent improvement after total knee replacement. Nevertheless, some abnormalities persist even after a long period of time. The abnormal knee patterns have been attributed to several possible causes, such as implant geometry and surgical technique, posterior cruciate ligament sparing/sacrificing, preoperative "stiff-knee" pattern due to pain and altered biomechanics, weakness of the extensor muscles, preoperative arthritic pattern, proprioceptive deficiency, and multijoint degenerative involvement. Cocontraction of the knee flexors and extensors is a common strategy adopted to reduce strain and shear forces at the joint, but it increases compressive forces and joint loading. Even in patients with an excellent functional score, the duration of the implant may be compromised by an altered neuromuscular control of the knee. In this paper, we report a single case study carried out over two years on a patient that underwent total knee replacement. The aim of this work is to show that quantitative gait analysis is essential to augment the understanding of the mechanisms underlying gait, thus enabling clinicians to adapt the rehabilitation program to the specific patient. Although the limits of single case reports are obvious, we believe that this evaluation methodology could be beneficial for assessing the effectiveness of rehabilitation programs aimed at achieving an active control of the knee during gait through a correct muscular activation pattern.

Biomechanical Phenomena↗

Gait abnormalities in minimally impaired multiple sclerosis patients.

Subclinical evidence of gait abnormalities were identified in a group of seven patients with multiple sclerosis, EDSS scored 0 - 2, without functional limitations. A movement analysis technique was used to identify gait parameters indicative of impaired motor function during walking. Abnormalities related primarily to time-distance parameters (reduced speed of progression, shorter strides, prolonged double support phase) and muscular function (premature recruitment of gastrocnemius and late relaxation of tibialis anterior during stance phase) were identified regardless the severity of the clinical score. The gait analysis procedure was able to provide the clinician with evidence of motor abnormalities prior to functional disturbance observable by a trained physician. These minimal dysfunctions may have resulted from reflex mechanisms impaired by delayed transmission through long loop pathways or else as a result of a nonspecific protective gait strategy to improve balance control. The technique described in this study may be useful to identify earlier starting points for follow-up and physiotherapy.

Adult↗

A proposal for standardizing urine collections for bone resorption markers measurement.

Diurnal variations in the excretion of bone resorption markers were assessed in order to identify the type of urine collection which provides the most information on bone resorption rate and its relation to measuring bone dynamics in a postmenopausal population. Sixty women, ages 43-67 and without disease or treatment known to affect bone mineral density, were divided into two groups on the basis of femoral mineral density T-score: <1.5 (Group I), >1.5 (Group II). Bone formation was assessed by measuring bone alkaline phosphatase activity and osteocalcin concentration, bone resorption by urinary hydroxyproline, pyridinoline and deoxypiridinoline, N-telopeptide, galactosyl hydroxylysine, and CrossLaps. To identify the more appropriate collection times, urine samples were collected from 7 am to 3 pm; from 3 pm to 11 pm; from 11 pm to 7 am. Twenty-four hour urine collection and first morning void urine samples were also measured. The findings suggest that nocturnal collection and first morning void samples provide the most reliable data on the rate of bone degradation, possibly showing bone loss not only in osteopenic patients but also in women with a low T-score. Nocturnal and first morning samples should therefore be recommended in order to standardize sample collection, as they enable an accurate assessment of bone resorption markers and improved comparability to results from different studies, as well as a less cumbersome collection modality.

Adult↗

EMG assessment of back muscle function during cyclical lifting.

A new approach to estimating the frequency compression of the surface EMG signal during cyclical dynamic exercise is described. The basic properties of the method are first developed using simulated EMG signals. Spectral compression is measured by defining the instantaneous median frequency from time-frequency representations of the signal derived from a transformation of the Cohen class. The technique is then used to process real EMG signals from paraspinal muscles during repetitive lifting. Our purpose was to use this new procedure to identify (a) whether changes in the instantaneous median frequency among concurrently active paraspinal muscles during repetitive trunk extension produces a 'fatigue pattern' that is indicative of normal functioning, and (b) whether this pattern is different when the subject produces a sustained isometric trunk extension. Four healthy subjects (26 +/- 4 years; 3 males, 1 female) were tested in both a Back Analysis System, for the production of a sustained static isometric contraction, and a LIDO-Lift Controller (Loredan), for repetitive lifting and lowering of a weighted box. EMG signals were recorded concurrently from six bilateral lumbar paraspinal regions during these tasks. The results demonstrate that static and dynamic tasks result in very different patterns of EMG spectral changes, suggestive of differences in load-sharing and underlying metabolic fatigue processes. Unlike the linear decrease in median frequency observed for static contractions, during dynamic contractions instantaneous median frequency behavior is non-linear and more complex. Examples are provided in which distinct periods of instantaneous median frequency decay are followed by periods of recovery during a single trial of repetitive lifting. It is hypothesized that this difference reflects a complex strategy of utilizing muscle load-sharing during strenuous dynamic exercise to provide periods of metabolic recovery that limit localized fatigue. New analysis procedures to characterize this complex behavior are needed to enhance the technique for assessment of impairment in patients with lower back pain.

Adult↗

A statistical method for the measurement of muscle activation intervals from surface myoelectric signal during gait.

The aim of this work is to present an original double-threshold detector of muscle activation, specifically developed for gait analysis. This detector operates on the raw myoelectric signal and, hence, it does not require any envelope detection. Its performances are fixed by the values of three parameters, namely, false-alarm probability (Pfa), detection probability, and time resolution. Double-threshold detectors are preferable to single-threshold ones because, for a fixed value of the Pfa, they yield higher detection probability; furthermore, they allow the user to select the couple false alarm-detection probability with a higher degree of freedom, thus, adapting the performances of the detector to the characteristics of the myoelectric signal of interest and of the experimental situation. In this paper, first we derive the detection algorithm and describe different strategies for selecting its parameters, then we present the performances of the proposed procedure evaluated by means of computer simulations, and finally we report an example of application to myoelectric signals recorded during gait. The characterization of the proposed double-threshold detector demonstrates that, in most practical situations, the bias of the estimates of the on-off transitions is smaller than 10 ms, the standard deviation may be kept lower than 15 ms, and the percentage of erroneous patterns is below 5%. These results show that this detection approach is satisfactory in research applications as well as in the clinical practice.

Algorithms↗

Improved late potential analysis in frequency domain.

This work presents a technique to improve the identification of late potentials (LP) in patients affected by greater arrhythmogenic right ventricular disease (GARVD). Several authors have documented the correlation between GARVD and LP by means of time domain analysis. Moreover, the high incidence of bundle branch block in patients affected by GARVD suggests LP analysis in the frequency domain be performed. The method of spectral mapping of the ECG with Fourier transform was adopted. This consists in dividing the ST segment into 25 subsegments and estimating their frequency components by means of the fast Fourier transform. Recently, it was documented that this technique suffers from poor reproducibility of results. Low reproducibility is the consequence of an improper localization of the analysed QRS segments. An algorithm to increase the QRS end point identification reproducibility is proposed. An optimal QRS filter was adopted as well as a technique based on the Hilbert transform. This technique allowed the reliability of the normality factor estimates to be improved. The computed normality factors on the XYZ leads and on the vector magnitude were used to classify patients and healthy subjects; 28 patients affected by greater arrhythmogenic right ventricular disease and 35 healthy subjects were analysed in the study. High sensitivity was obtained with respect to GARVD and clinical sustained ventricular tachycardia by means of a cluster analysis technique. By applying the technique proposed in this paper the identification of LP in GARVD was increased from 47% to 88%, when clinical sustained ventricular tachycardia was documented, whereas in patients affected by GARVD but not prone to sustained ventricular tachycardia LP identification increases from 18% to 64%.

Algorithms↗