Mechanomyography and Torque during FES-Evoked Muscle Contractions to Fatigue in Individuals with Spinal Cord Injury

A mechanomyography muscle contraction (MC) sensor, affixed to the skin surface, was used to quantify muscle tension during repetitive functional electrical stimulation (FES)-evoked isometric rectus femoris contractions to fatigue in individuals with spinal cord injury (SCI). Nine persons with motor complete SCI were seated on a commercial muscle dynamometer that quantified peak torque and average torque outputs, while measurements from the MC sensor were simultaneously recorded. MC-sensor-predicted measures of dynamometer torques, including the signal peak (SP) and signal average (SA), were highly associated with isometric knee extension peak torque (SP: r = 0.91, p < 0.0001), and average torque (SA: r = 0.89, p < 0.0001), respectively. Bland-Altman (BA) analyses with Lin’s concordance (ρC) revealed good association between MC-sensor-predicted peak muscle torques (SP; ρC = 0.91) and average muscle torques (SA; ρC = 0.89) with the equivalent dynamometer measures, over a range of FES current amplitudes. The relationship of dynamometer torques and predicted MC torques during repetitive FES-evoked muscle contraction to fatigue were moderately associated (SP: r = 0.80, p < 0.0001; SA: r = 0.77; p < 0.0001), with BA associations between the two devices fair-moderate (SP; ρC = 0.70: SA; ρC = 0.30). These findings demonstrated that a skin-surface muscle mechanomyography sensor was an accurate proxy for electrically-evoked muscle contraction torques when directly measured during isometric dynamometry in individuals with SCI. The novel application of the MC sensor during FES-evoked muscle contractions suggested its possible application for real-world tasks (e.g., prolonged sit-to-stand, stepping,) where muscle forces during fatiguing activities cannot be directly measured.

[1]  Francisco Sepulveda,et al.  A Review of Non-Invasive Techniques to Detect and Predict Localised Muscle Fatigue , 2011, Sensors.

[2]  Nur Azah Hamzaid,et al.  Mechanomyography and muscle function assessment: a review of current state and prospects. , 2014, Clinical biomechanics.

[3]  D. Guiraud,et al.  FES-Induced Torque Prediction With Evoked EMG Sensing for Muscle Fatigue Tracking , 2011, IEEE/ASME Transactions on Mechatronics.

[4]  Glen M. Davis,et al.  Estimation of Electrically-Evoked Knee Torque from Mechanomyography Using Support Vector Regression , 2016, Sensors.

[5]  Saso Tomazic,et al.  In-Vivo Measurement of Muscle Tension: Dynamic Properties of the MC Sensor during Isometric Muscle Contraction , 2014, Sensors.

[6]  M. Tarata Mechanomyography versus Electromyography, in monitoring the muscular fatigue , 2003, Biomedical engineering online.

[7]  Nur Azah Hamzaid,et al.  Mechanomyographic Parameter Extraction Methods: An Appraisal for Clinical Applications , 2014, Sensors.

[8]  P. Komi,et al.  Signal characteristics of EMG during fatigue , 1977, European Journal of Applied Physiology and Occupational Physiology.

[9]  Andrei Krassioukov,et al.  International standards for neurological classification of spinal cord injury, revised 2011. , 2012, Topics in spinal cord injury rehabilitation.

[10]  Veljko M. Milutinovic,et al.  MC Sensor—A Novel Method for Measurement of Muscle Tension , 2011, Sensors.

[11]  S. Lalwani,et al.  Spinal cord injury. , 2011, Journal of neurosurgery. Spine.

[12]  W. Frontera,et al.  Muscle fatigue and muscle injury. , 2000, Physical medicine and rehabilitation clinics of North America.

[13]  D. Altman,et al.  Applying the right statistics: analyses of measurement studies , 2003, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[14]  C. Lynch,et al.  Functional Electrical Stimulation , 2017, IEEE Control Systems.

[15]  N. A. Hamzaid,et al.  Torque and mechanomyogram relationships during electrically-evoked isometric quadriceps contractions in persons with spinal cord injury. , 2016, Medical engineering & physics.

[16]  Eli Isakov,et al.  EMG as an indicator of fatigue in isometrically FES-activated paralyzed muscles , 1994 .

[17]  M. Stokes,et al.  Muscle fatigue as a limiting factor in functional electrical stimulation: A review , 1989 .

[18]  Huosheng Hu,et al.  The Usefulness of Mean and Median Frequencies in Electromyography Analysis , 2012 .

[19]  T. Moritani,et al.  Assessment of lower-back muscle fatigue using electromyography, mechanomyography, and near-infrared spectroscopy , 2001, European Journal of Applied Physiology.

[20]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[21]  M. Hayashibe,et al.  Evoked EMG-based torque prediction under muscle fatigue in implanted neural stimulation , 2011, Journal of neural engineering.

[22]  R. Puers,et al.  THE ACCELEROMETER MMG MEASUREMENT APPROACH, IN MONITORING THE MUSCULAR FATIGUE , 2001 .

[23]  Glen M. Davis,et al.  Evoked EMG versus Muscle Torque during Fatiguing Functional Electrical Stimulation-Evoked Muscle Contractions and Short-Term Recovery in Individuals with Spinal Cord Injury , 2014, Sensors.

[24]  Vera Lúcia da Silveira Nantes Button,et al.  Avaliação da fadiga muscular pela mecanomiografia durante a aplicação de um protocolo de EENM , 2009 .

[25]  W. Durfee,et al.  Surface EMG as a fatigue indicator during FES-induced isometric muscle contractions. , 1997, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[26]  R. Enoka,et al.  Muscle fatigue: what, why and how it influences muscle function , 2008, The Journal of physiology.

[27]  W. Durfee,et al.  Reducing muscle fatigue in FES applications by stimulating with N-let pulse trains , 1995, IEEE Transactions on Biomedical Engineering.

[28]  W. Miller,et al.  Managing fatigue following spinal cord injury: A qualitative exploration , 2009, Disability and rehabilitation.