PubMed Health⌕ Search

Biomedical subjects

S H Roy

Publications and source records attributed to S H Roy.

At least 19 recordsLinked to original sources

Coordination training in individuals with incomplete spinal cord injury: consideration of motor hierarchical structures.

STUDY DESIGN: Clinical commentary. OBJECTIVE: To discuss the method of coordination training to enhance motor skills in persons after spinal cord injury (SCI). METHOD: From the literature and clinical experience, we learn that basic motor skills like walking are refined and maintained through the millions of repetitions that take place as part of normal development. These coordinated patterns function effectively as a form of training to the system because of the presence of neural pathways that mediate commands between higher and lower levels of the central nervous system (CNS). When these pathways are disrupted as a result of a lesion, the question that arises is whether retraining can be effective. RESULTS/DISCUSSION: The question is directed at the common practice among rehabilitation professionals to prescribe and carry out tireless repetitions of coordinated motor activities in people with SCI lesions. We discuss this fundamental question from the perspective of understanding differences in maturation and function of higher motor centres and lower motor centres.

Central Nervous System↗

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↗

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↗

Modeling of surface myoelectric signals--Part II: Model-based signal interpretation.

Experimental electromyogram (EMG) data from the human biceps brachii were simulated using the model described in [10] of this work. A multichannel linear electrode array, spanning the length of the biceps, was used to detect monopolar and bipolar signals, from which double differential signals were computed, during either voluntary or electrically elicited isometric contractions. For relatively low-level voluntary contractions (10%-30% of maximum force) individual firings of three to four-different motor units were identified and their waveforms were closely approximated by the model. Motor unit parameters such as depth, size, fiber orientation and length, location of innervation and tendonous zones, propagation velocity, and source width were estimated using the model. Two applications of the model are described. The first analyzes the effects of electrode rotation with respect to the muscle fiber direction and shows the possibility of conduction velocity (CV) over- and under-estimation. The second focuses on the myoelectric manifestations of fatigue during a sustained electrically elicited contraction and the interrelationship between muscle fiber CV, spectral and amplitude variables, and the length of the depolarization zone. It is concluded that a) surface EMG detection using an electrode array, when combined with a model of signal propagation, provides a useful method for understanding the physiological and anatomical determinants of EMG waveform characteristics and b) the model provides a way for the interpretation of fatigue plots.

Action Potentials↗

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↗

Classification of paraspinal muscle impairments by surface electromyography.

The purpose of this article is to provide an overview of research to develop surface electromyographic (EMG) measurements for classification of paraspinal muscle impairments in persons with low back pain (LBP). The process of developing laboratory and clinically based protocols is described. Results of studies to evaluate the reliability of these measurements and their relationships with impairments and function are discussed. Research efforts to incorporate EMG spectral measurements, such as the median frequency, into a classification system to identify different types of muscle impairments are documented. Discriminant functions have been calculated based on case-control studies to identify 2 kinds of LBP impairments from constant-force isometric tasks: (1) excessive fatigue due to muscle deconditioning and (2) inhibition of muscle activation secondary to pain or pain-related behaviors. New areas of investigation designed to improve the classification accuracy of such functions using procedures other than discriminant analysis are described. Work in progress to extend the application of the technique to tasks other than those involving just isometric contraction, including those involving repetitive trunk movement, is also described.

Adult↗

Classification of back muscle impairment based on the surface electromyographic signal.

A surface electromyographic (EMG) procedure for classifying muscle impairments in persons with low back pain (LBP) is described. The procedure was studied using a device, the Back Analysis System (BAS), to acquire and process EMG signals from six bilateral muscle sites during sustained isometric contractions designed to progressively fatigue the lower back. Back muscle impairment was determined on the basis of the different ways in which the EMG median frequency parameters change as a function of contraction duration and muscle site. The article describes a series of studies that have been useful in developing an automated procedure for identifying back muscle impairment by comparing individual test results to a normative database. To date, the research results have produced multivariate discriminant functions that have identified two muscle impairment categories associated with deconditioning and imbalances secondary to LBP. We have found that the functions can distinguish individuals with and without LBP with an accuracy of approximately 90%. Other studies are described in which the technique is applied to monitoring changes in muscle performance capability that occur following rehabilitation for LBP. Many of our findings here are also compared to the results of independent studies by others using similar procedures. The need for further research and development of the technique to improve its clinical applicability is also described.

Diagnosis, Computer-Assisted↗

Development of new protocols and analysis procedures for the assessment of LBP by surface EMG techniques.

Spectral parameters of the surface electromyographic (EMG) signal from lumbar back muscles assessed during a fatiguing isometric contraction can be used to classify different categories of low back pain (LBP) subjects and control subjects without LBP. In the test protocol currently used at the NeuroMuscular Research Center at Boston University, subjects contract their back muscles at 80% of their maximal voluntary contraction (MVC) force. This fatigue-based protocol has been successfully applied to persons with subacute or chronic LBP; those in acute pain, however, have not been included because of their inability to perform a maximal exertion. In this paper we will examine the force sensitivity of the currently used EMG parameters and also give an overview of some of our efforts to develop new test procedures. Our goal is to develop force-insensitive surface EMG parameters that can be used for classification purposes in populations of subjects who develop low trunk extension forces. In addition, the development of a model to predict MVC from anthropometrical measurements will be presented.

Adult↗

Spectral electromyographic assessment of back muscles in patients with low back pain undergoing rehabilitation.

STUDY DESIGN: A surface electromyographic procedure for evaluating back muscle impairment was studied in patients undergoing rehabilitation for low back pain. OBJECTIVES: The results were analyzed to determine whether the electromyographic procedure was able to: 1) distinguish muscle impairment between patients with low back pain and normal subjects, and 2) monitor changes in muscle function after low back pain rehabilitation. METHODS: Patients with chronic low back pain (n = 85) were tested to measure the median frequency of the electromyographic signals from six lumbar electrode sites during sustained trunk extensions. A subset (n = 28) of these patients was re-tested after low back pain rehabilitation. A discriminant function for classifying subjects into "low back pain" and "normal" groups was formulated using the electromyographic data from a subset of the patients with low back pain (n = 28) and a normative sample (n = 42). Results for this "learning" sample were compared with results using the same function on the remaining "holdout" sample of patients (n = 57) and an additional normative sample (n = 6). Differences in electromyographic parameters before and after rehabilitation also were analyzed. RESULTS: The discriminant function classified subjects into low back pain and normal groups, with 86% and 89% correct classification for the "learning" and "holdout" samples, respectively. These classification results were independent of trunk extensor strength. Changes in median frequency after the rehabilitation program were consistent with improvements in back muscle fatigability. CONCLUSION: These findings demonstrate how electromyographic spectral measurements may be used to identify and monitor back muscle impairment in patients undergoing rehabilitation for low back pain.

Adult↗

The effects of spaceflight on open-loop and closed-loop postural control mechanisms: human neurovestibular studies on SLS-2.

Stabilogram-diffusion analysis was used to examine how prolonged periods in microgravity affect the open-loop and closed-loop postural control mechanisms. It was hypothesized that following spaceflight: (1) the effective stochastic activity of the open-loop postural control schemes in astronauts is increased; (2) the effective stochastic activity and uncorrelated behavior, respectively, of the closed-loop postural control mechanisms in astronauts are increased; and (3) astronauts utilized open-loop postural controls schemes for shorter time intervals and smaller displacements. Four crew members and two alternates from the 14-day Spacelab Life Sciences 2 Mission were included in the study. Each subject was tested under eyes-open, quiet-standing conditions on multiple preflight and postflight days. The subjects' center-of-pressure trajectories were measured with a force platform and analyzed according to stabilogram-diffusion analysis. It was found that the effective stochastic activity of the open-loop postural control schemes in three of the four crew members was increased following spaceflight. This result is interpreted as an indication that there may be in-flight adaptations to higher-level descending postural control pathways, e.g., a postflight increase in the tonic activation of postural muscles. This change may also be the consequence of a compensatory (e.g., "stiffening") postural control strategy that is adopted by astronauts to account for general feeling of postflight unsteadiness. The crew members, as a group, did not exhibit any consistent preflight/postflight differences in the steady-state behavior of their closed-loop postural control mechanisms or in the functional interaction of their open-loop and closed-loop postural control mechanisms. These results are interpreted as indications that although there may be in-flight adaptations to the vestibular system and/or proprioceptive system, input from the visual system can compensate for such changes during undisturbed stance.

Humans↗

Effects of muscle fiber type and size on EMG median frequency and conduction velocity.

This paper describes an in vitro method for comparing surface-detected electromyographic median frequency (MF) and conduction velocity (CV) parameters with histochemical measurements of muscle fiber type composition and cross-sectional area (CSA). Electromyographic signals were recorded during electrically elicited tetanic contractions from rat soleus, extensor digitorum longus, and diaphragm muscles placed in an oxygenated Krebs bath. Fibers were typed as slow oxidative, fast oxidative glycolytic, and fast glycolytic based on histochemical enzyme stains. Muscles with a greater percentage of fast glycolytic and fast oxidative glycolytic fibers exhibited greater initial values of MF and CV as well as a greater reduction in these variables over the course of the contraction. Regression indicated that fiber type composition could be predicted based on two MF parameters. A weighted measure of muscle fiber CSA was found to be linearly related to both initial MF and CV. The results of this study suggest that MF and CV parameters recorded during a muscular contraction are related to muscle fiber type composition and muscle fiber CSA.

Animals↗

Lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism.

OBJECTIVE: To compare parameters of muscle energy metabolism in patients with fibromyalgia syndrome (FMS) and sedentary controls. METHODS: Thirteen female FMS patients and 13 female sedentary controls underwent a standardized clinical assessment (including dolorimeter measurements of the upper trapezius and tibialis anterior muscles) and a standardized aerobic fitness test including measurement of maximum oxygen uptake (VO2max). Phosphorus (31P) magnetic resonance spectroscopy studies of the upper trapezius and tibialis anterior muscles were then performed in FMS patients and controls, at rest and during and following a muscle-fatiguing exercise protocol. RESULTS: FMS patients and controls had similar levels of VO2max and of maximum voluntary contraction (MVC) of the upper trapezius and tibialis anterior muscles. After controlling for VO2max and MVC, measurements of phosphocreatine (PCr), inorganic phosphate (P(i)), and intracellular pH in these muscles were not significantly different in FMS patients versus sedentary controls either at rest, during exercise, or during recovery. In the patients with FMS, no correlation was found between overall or local pain severity and the principal muscle metabolic parameter, PCr/P(i). Inverse correlations between dolorimeter scores at 2 muscle sites and tibialis anterior PCr/P(i) were found both in patients and in controls. CONCLUSION: This study demonstrates that under the conditions studied, muscle energy metabolism in FMS is no different than that in sedentary controls. These findings do not support the hypothesis that detectable defects in muscle energy metabolism occur in FMS.

Adult↗

Combined use of surface electromyography and 31P-NMR spectroscopy for the study of muscle disorders.

This article describes the use of combining spectral electromyographic signal techniques with phosphorus magnetic resonance (31P-NMR) spectroscopy for the purpose of studying muscle disorders. The quantification of muscle fatigue by electromyographic spectral variables such as the median frequency is summarized. Its development as a laboratory and clinical tool is presented, with an emphasis toward its potential as an assessment procedure. Similarly, the use of 31P-NMR spectroscopy for noninvasive measurement of phosphate metabolites and intracellular pH during fatigue are described. The limitations of this procedure are presented and compared with surface electromyographic techniques. Suggestions are made for combining these techniques for the purpose of monitoring muscle metabolic and electrophysiologic changes in situ during fatiguing exercises. A recent study in which these techniques were combined to evaluate the underlying mechanisms of fatigue in patients with fibromyalgia is described.

Adult↗

Comparison of spinal mobility and isometric trunk extensor forces with electromyographic spectral analysis in identifying low back pain.

This study compared conventional clinical measurements with electromyographic (EMG) spectral measurements for identification of individuals with low back pain (LBP). Twenty freshman sweep rowers were subjects for this study. Range-of-motion (ROM) measurements were taken for forward bending (FB), backward bending (BB) (double inclinometers), lateral bending (LB) (tape measure), and rotation (double-arm goniometer). Intratester reliability for ROM was also assessed. The Back Analysis System was used to determine static trunk extensor strength (ie, maximal voluntary contraction [MVC]) and to compute EMG spectral parameters from a paraspinal multi-electrode array. A two-group stepwise discriminant-analysis procedure for the ROM and MVC variables correctly identified 57% of the rowers with LBP and 63% of the rowers without LBP. A similar discriminant-analysis procedure for EMG spectral parameters correctly identified either 88% of the rowers with LBP and 100% of the rowers without LBP or 100% of the rowers with LBP and 88% of the rowers with LBP, depending on whether EMG measurements of recovery were calculated at 1 minute or at 2 minutes into the recovery period. Sensitivity (66%) and specificity (71%) results from the more traditional tests suggest that these techniques may be of limited usefulness for LBP screening or diagnosis.

Adult↗

pH-induced effects on median frequency and conduction velocity of the myoelectric signal.

H+ accumulation at the sarcolemma is believed to play a key role in determining the electrophysiological correlates of fatigue. This paper describes an in vitro method to externally manipulate muscle pH while measuring the resultant effect on surface-detected median frequency (MDF) and conduction velocity (CV) parameters. Hamster muscle diaphragm strips (n = 8) were isolated with the phrenic nerve intact and placed in an oxygenated Krebs bath (26 degrees C). The muscle was clamped to a noncompliant load cell to measure isometric contractile tension. Tetanic contraction was developed via 40-Hz supermaximal stimulation of the phrenic nerve. Differential signals were recorded from three electromyogram (EMG) detection surfaces for computation of CV (via the phase shift in the EMG signals) and MDF. Repeated trials were conducted at bath pHs of 7.4, 7.0, and 6.6. Bath pH was altered by aerating predetermined concentrations of O2 and CO2 into the bath. Decreases in bath pH resulted in decreases in both initial MDF and initial CV. The differences in initial MDF and initial CV were significant (P less than 0.001) for each of the bath pH conditions. In general, the change in bath pH resulted in an equal percent change in initial MDF and initial CV. This suggests that the change in bath pH caused a decrease in CV without significantly altering the fundamental shape of the M wave. In contrast, the EMG was altered differently during stimulated contractions. During stimulation, the rate of decay of CV was 65% of the rate of decay of MDF.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Fatigue, recovery, and low back pain in varsity rowers.

The purpose of this study was to determine whether surface electromyography (EMG) from the erector spinae muscles could correctly identify individuals with low back pain without a population of elite athletes. A similar technique had previously been successful in identifying low back pain patients within a non-athletic population. A Back Analysis System was used to compute the median frequency of the EMG power density spectrum to monitor metabolic changes in back muscles associated with muscle fatigue. Twenty-three members of a men's collegiate varsity crew team consisting of port (N = 13) and starboard (N = 10) rowers were tested in a laboratory during a fatigue-inducing isometric contraction sustained at a relatively high, constant force. Six of the rowers tested were further classified as having low back pain. A brief test contraction was repeated at a fixed interval following the fatiguing contraction to monitor recovery. A two-group discriminant analysis procedure correctly classified 100% of the rowers with low back pain and 93% of the rowers without back pain on the basis of the median frequency data. The median frequency parameters related to recovery were the best discriminators of back pain. A similar analysis correctly classified 100% of the port rowers and 100% of the starboard rowers on the basis of their spectral parameters. The best discriminating variables in this instance were the median frequency parameters relating to both fatigability and recovery. Results from this study demonstrate that low back pain and asymmetrical muscle function in rowers can be assessed on the basis of EMG spectral analysis.

Adult↗

Lumbar muscle fatigue and chronic lower back pain.

There currently is a clinical need for an objective technique to assess muscle dysfunction associated with chronic lower back pain. A Back Analysis System for objectively measuring local fatigue in the back extensor muscles is presented. The reliability and validity of this technique was evaluated by testing chronic low-back pain patients and control subjects without back pain. Concurrent surface electromyograms (EMG) were detected from multiple back muscles during sustained isometric contractions at different force levels of trunk extension. Median frequency parameters of the EMG power density spectrum were monitored to quantify localized muscle fatigue. Results indicated: 1) high reliability estimates for repeated trials; 2) significant differences (P less than 0.05) in median frequency parameters between lower back pain patients and control subjects for specific combinations of contractile force level and muscle site tested; 3) Median Frequency parameters correctly classified lower back pain and control subjects using a two-group discriminant analysis procedure. The applicability of this technique as a treatment outcome measure and diagnostic screening method for lower back pain patients is discussed.

Adult↗

New motor control assessment techniques for evaluating individuals with severe handicaps: a case study.

Prescription of assistive devices for motor-handicapped individuals requires assessment of their motor capabilities. When patients' motor deficits are particularly severe, wide individual differences in the location and type of abnormalities complicate the assessment process. The precision of assessment has been greatly increased in recent years by the use of quantitative, computer-aided motion analysis, which facilitates statistical examination and comparison with normal individuals. This paper discusses a case study wherein a 24-year-old male nonvocal cerebral palsy patient was assessed for his ability to operate assistive communication devices. Three computer-aided measurement protocols were employed to evaluate the patient and two controls: performance using the patient's existing communication aid was evaluated in terms of rate and accuracy of communication using standardized spelling and response time tasks; volitional myoelectric activity was surveyed to identify possible myoelectric control sites for communication aid operation; a study of head position and its time derivatives was conducted to explore the feasibility of proportional control of a communication aid. Comparison of handicapped and control subject data indicated that, despite several characteristic motor control deficits, the handicapped subject was capable of proportional control of lateral head rotation and binary control of frontalis myoelectric signals. These movements could be used to operate a proportionally-controlled, direct-selection communication aid that could substantially increase the subject's communication rate. Work in progress includes the expansion of the handicapped and unimpaired subject databases and further development of the techniques discussed here to include three-dimensional motion analysis and objective measurement of muscle fatigue.

Adult↗