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Spasticity is a motor condition present in 75 to 88% of children with Cerebral Palsy (CP). One form of treatment is called punctual mechanical oscillation (PO). The current study aimed to study different protocols for the application of PO and the magnitude of their effects. In total, 7children with medical diagnosis of CP and ICD (International Classification of Diseases) were included. The first intervention protocol (Int1) consisted of the application of PO to the spastic muscle tendon and the second intervention protocol (Int2) to the muscle belly ofthe spastic antagonist muscle. For evaluation, the Modified Ashworth Scale (MAS) was used, while simultaneously capturing the mechanomyography (MMG) signals. Data were collected pre-intervention and 1 (Post1), 15 (Post15), 30 (Post30), 45 (Post45), and60 (Post60) minutes after the interventions. The MAS values (median ± interquartile range) post intervention were statistically lower when compared to the pre values in the 2 protocols studied; in Int1between Pre (2 ± 0) andPost15 (0 ± 1.75), Post30 (0 ± 1), Post45 (1 ± 1),and Post60 (1 ± 1), and in Int2only between Pre (2 ± 1) and Post1 (0 ± 1).The values found in the MMG in both its temporal and spectral domains did not follow a pattern (p>0.05). The comparison between the protocols did not demonstrate statistical differences in any characteristics (MAS, MMGMF, and MMGRMS). However, PO was shown to be a therapeutic resource that modulated spasticity for up to 60 minutes after its application, and PO could contribute as a tool to aid the treatment of spasticity. Introdução: A espasticidade é uma condição motora presente em 75 a 88 % das crianças com Paralisia Cerebral (PC). Uma forma de tratamento é a chamada oscilação mecânica pontual (OP). Este trabalho teve por objetivo estudar diferentes protocolos de aplicação da OP e a magnitude de seus efeitos. Métodos: Foram incluídas 7 crianças com diagnóstico médico de PC e CID (Classificação Internacional de Doenças). O primeiro protocolo de intervenção (Int1) consistiu na aplicação de OP no tendão do músculo espástico e o segundo protocolo de intervenção (Int2) no ventre muscular do músculo antagonista espástico. Para avaliação, foi utilizada a Escala Modificada de Ashworth (EMA), capturando simultaneamente os sinais da mecanomiografia (MMG). Os dados foram coletados antes da intervenção e 1 (Pós1), 15 (Pós15), 30 (Pós30), 45 (Pós45) e 60 (Pós60) minutos após as intervenções. Resultados: Os valores do MAS (mediana ± intervalo interquartil) pós-intervenção foram estatisticamente menores quando comparados aos pré-valores nos 2 protocolos estudados; no Int1 entre Pré (2 ± 0) e Pós15 (0 ± 1,75), Pós30 (0 ± 1), Pós45 (1 ± 1) e Pós60 (1 ± 1) e no Int2 apenas entre Pré (2 ± 1) e Pós1 (0 ± 1). Os valores encontrados no MMG nos domínios temporal e espectral não seguiram um padrão (p> 0,05). Conclusão: A comparação entre os protocolos não demonstrou diferenças estatísticas em nenhuma característica (EMA, MMGMF, and MMGRMS). No entanto, a OP mostrou-se um recurso terapêutico que modulou a espasticidade por até 60 minutos após a sua aplicação, e a OP poderia contribuir como uma ferramenta para auxiliar o tratamento da espasticidade.

Introduction Military police activity individuals performing operational activity remain 12 hours using mandatory safety equipment. This work aimed to verify the electromyographic response in operational military police officers before and after a cycle of two working days. Methods Forty-four male individuals were evaluated, with an average age of 34.59 ± 8.05. The used protocol consisted in the evaluation of paravertebral muscles and rectus abdominis muscles in a maximum isometric voluntary contraction test (MVC) during trunk extension movements, starting from the sitting position. Moreover, the Roland-Morris functional evaluation questionnaire and the Corlett and Manenica diagram for painful areas were used. An electromyograph with 16 pre-set channels was used. Signals were processed in time (EMGME) and spectral (EMGMF) domains, using the MatLab® program. The Shapiro-Wilk test and Wilcoxon Signed Ranks Test were applied. Statistical analyses were performed through the SPSS v21.0 software and Microsoft Office Excel 2010, considering p < 0.05 as significance level. Results Results showed statistical differences in the post-working day for time analysis, an EMGME decrease in the right rectus abdominis muscle (p = 0.016) and in the age-stratified sample, with individuals over 31 years old (p = 0.016); in the spectral analysis, EMGMF reduction in the right iliocostalis (p = 0.027) and right and left side in the stratified sample, in individuals over 31 years old and with more than 10 years of service. Conclusion The used protocol highlighted a decrease in the amplitude of the electromyographic signal, as well as possible muscle fatigue on the right side where officers usually carry their weapons.

A motor neural prosthesis based on surface functional electrical stimulation (sFES) can restore functional movement (e.g., standing, walking) in patients with a spinal cord injury (SCI). sFES generates muscle contractions in antigravity muscles and allows balance-assisted standing. This induced standing has several benefits, such as improved cardiovascular function, decreased incidence of urinary infections, reduced joint contractures, and muscle atrophy. The duration of sFES assisted standing is limited due to the quick onset of muscle fatigue. Currently, there is no method available to reliably estimate real-time muscle fatigue during sFES. Simply monitoring the M-wave changes is not suitable due to the high signal disturbances that arise during multi-channel electrical stimulation. Mechanomyography (MMG) is immune to electrical stimulation artifacts and can be used to detect subtle vibrations on the surface of the skin related to activation of the underlying muscle's motor units (MU). The aim of this study was to develop a method for detecting muscle fatigue brought on by sFES. The method was tested in three different heads of the quadriceps muscle in SCI patients during electrically elicited quasi-isometric contraction. Six spinal cord-injured male volunteers, with no voluntary control of the quadriceps muscle participated in the study. Electrical bursts of voltage-controlled monophasic square pulses at frequencies of 1 kHz (50% duty cycle) at 50 Hz (15% duty cycle) were used to generate thigh muscle contractions that controlled the knee joint in the sagittal plane. The pulse amplitudes were set to position the knee joint at a 5° angle from the horizontal plane and when the knee angle dropped to 20° (e.g., the quadriceps were unable to hold the lower leg in the desired position), the test was terminated. Two data segments lasting 10 s each, at the beginning and end of each test, were analyzed. The muscle contraction was assessed by MMG sensors positioned on the rectus femoris, vastus lateralis, and vastus medialis muscles. Data segments were decomposed into 11 frequency bands using a Cauchy wavelet transform. In the initial time interval (non-fatigued muscle), the power peak was concentrated in the 11.31 Hz frequency band. In the final interval (muscle fatigued) this peak shifted to lower frequencies (2 and 6 Hz frequency bands). The decreased frequency was most prominent during the last 4 s of the recordings. It was shown that MMG could be used as a real-time indicator of muscle fatigue during FES-induced isometric contraction of quadriceps; hence, MMG could be used in closed-loop control as a fatigue detector. Subsequent studies for non-isometric contractions could possibly lead to prediction of muscle fatigue before contractile failure during functional use of the muscle.

The core muscles can be evaluated through functional tests, such as the prone bridge test (PBT) and supine unilateral bridge test (SUBT). However, there are differences in reliability and muscle fatigue related to these tests.The study evaluated 30 sedentary individuals and 30 individuals who practiced resistance exercises. Participants performed the PBT and SUBT in association with muscle recruitment, through surface electromyography of the upper and lower limbs and trunk muscles. The order of the tests was random and the participants performed one repetition of each test until fatigue. After a 30-min rest interval the participants repeated the tests. After one week, the participants returned and repeated the tests.The resistance group (RG) presented longer PBT holding time (RG 111.8 ± 9.4 and sedentary group (SG) 81 ± 7.7; p = 0.01), while the holding time in the SUBT was similar for both groups (RG = 100.7 ± 8.1 and SG = 79 ± 9.2; p = 0.09). Good to excellent reliability (ICC0.836; SEM 3.85) was established for the PBT and SUBT. Comparing the two groups there were no significant differences or interactions regarding muscle fatigue. The intragroup analysis on the PBT indicated greater gluteus maximus muscle fatigue, and for the SUBT the rectus abdominis presented greater fatigue, in both groups.The PBT and SUBT are reliable. Resistance exercise practitioners maintain the PBT for a longer time. The PBT led to greater gluteus maximus muscle fatigue, while the SUBT generated greater fatigue in the rectus abdominis and gluteus medius, in both groups.

Functional electrical stimulation (FES) is a method of activating paralyzed muscles. During FES application, fast muscle fatigue can occur (the inability of stimulated muscles to generate force). Therefore, it is beneficial to estimate the muscle fatigue for FES closed-loop control for walking to prevent unexpected muscle collapse and adapt the FES strategy in real time. Mechanomyography (MMG) is a noninvasive technique for registering myofiber vibrations, representing an ideal candidate for the provision of feedback. The hypothesis was that MMG signals could effectively detect muscle fatigue and, thus, provide feedback. We tested this hypothesis by analyzing the wavelet transform of signals from an MMG sensor positioned over the rectus femoris muscle during electrically evoked contractions in subjects with spinal cord injury (SCI). The signals were collected from a total of 24 lower limb muscles. We investigated both legs of 15 participants with spinal cord injury (male, YOA = 27.13 ± 5.05, M = 75.8 ± 10.35 kg, and H = 1.78 ± 0.07 m, American Spinal Injury Impairment Scale (AIS) A and B). All MMG signals were analyzed in 12 frequency bands from 5 to 53 Hz. We found different trends in the magnitudes in different frequency bands. The magnitude decreased in 13, 16, 20, 25, and 35 Hz bands in correlation with fatigue. The greatest statistical difference was found at 20 Hz and 25 Hz. This result suggests that processed MMG signals indicate muscle fatigue and can, thus, be used as the feedback in FES systems.

The Paralympic boccia is a sport played by athletes with spasticity and severe impairment in the four limbs. Three (BC1, BC2, and BC3) of the four classes in boccia allow People with Cerebral Palsy (CP) to participate. The ranking is performed manually through the American Spasticity Scale. Like all qualitative scales, however, this evokes controversy among the evaluation board members who apply it, altering the classification of the athletes. A helpful option would be the use of mechanomyography (MMG), a method of acquiring muscle vibrations quantitatively based on accelerometers. Thus, the objective of this article was to conduct a pilot study analyzing the differences in the MMG signals of flexors and extensors muscles between two groups: 6 boccia athletes with spasticity and 6 non-impaired. Volunteers remained seated on the wheelchair, with their elbow bent close to 90°. They were verbally stimulated to perform the manual grip by pressing the evaluator’s hand while the MMG signals were recorded and stored. The mean MMGRMS descriptor was calculated for each signal. The experimental tests indicated differences between the two groups. For the spasticity group: 0.4058 and 0.4258 mV for the left flexor and extensor wrist muscles, respectively; 0.4215 and 0.4529 mV for the right flexor and extensor wrist muscles, respectively. For the non-impaired group, the MMGRMS was 0.3694 and 0.3945 mV for the left flexor and extensor wrist muscles, respectively; 0.35033 and 0.3728 mV for the right flexor and extensor wrist muscles, respectively. Thus, these results indicate greater spasticity for the spastic group and so, volunteers classification in lower levels.

This work proposes the classification of motor imagery signals for brain-machine interfaces with functional electrical stimulation in the quadriceps muscle. Five volunteers participated in the test, 3 healthy participants, aged 28 ± 3 years, and 2 paraplegic volunteers, aged 43 (ASIA-B, C7 level - 16 years) and 47 (ASIA-A, T7 level - 20 years) years respectively. In total, each participant performed 90 repetitions of motor imaging of the lower limb under electrical stimulation, with frequencies of 20Hz, 35Hz, and 50Hz and current amplitude of 20mA. The patterns were analyzed off-line and submitted to the classification architectures after application of spatial filtering to extract the characteristics. The classification of the patterns was performed using the architectures: (i) Linear Discriminant Analysis (LDA), (ii) Multilayer Perceptron (MLP), and (iii) Support Vector Machine (SVM). To validate the proposal, the performance was compared between the classifiers through the accuracy of cross validation, variance, precision, and sensitivity. With the SVM classifier, the best accuracy percentage was 86.5%. These results are promising and the trained architectures are feasible for implementation in neuroprostheses with lower computational resources.

The use of neuromuscular electrical stimulation (NMES) to artificially restore movement in people with complete spinal cord injury (SCI) induces an accelerated process of muscle fatigue. Fatigue increases the time between the beginning of NMES and the onset of muscle force (DelayTOT ). Understanding how much muscle fatigue affects the DelayTOT in people with SCI could help in the design of closed-loop neuroprostheses that compensate for this delay, thus making the control system more stable. The aim of this study was to evaluate the impact of the extent of fatigue on DelayTOT and peak force of the lower limbs in people with complete SCI. Fifteen men-young adults with complete SCI (paraplegia and tetraplegia) and stable health-participated in the experiment. DelayTOT was defined as the time interval between the beginning of NMES application until the onset of muscle force. The electrical intensity of NMES applied was adjusted individually and consisted of the amplitude required to obtain a full extension of the knee (0°), considering the maximum electrically stimulated extension (MESE). Subsequently, 70% of the MESE was applied during the fatigue induction protocol. Significant differences were identified between the moments before and after the fatigue protocol, both for peak force (P ≤ .026) and DelayTOT (P ≤ .001). The medians and interquartile range of the DelayTOT were higher in postfatigue (199.0 ms) when compared to the moment before fatigue (146.5 ms). The medians and interquartile range of the peak force were higher in unfatigued lower limbs (0.43 kgf) when compared to the moment postfatigue (0.27 kgf). The results support the hypothesis that muscle fatigue influences the increase in DelayTOT and decrease in force production in people with SCI. For future applications, the combined evaluation of the delay and force in SCI patients provides valuable feedback for NMES paradigms. The study will provide potentially critical muscle mechanical evidence for the investigation of the evolution of atrophy.

Introduction This study aims to assess the influence of different skinfold thicknesses (ST) and their relation to the attenuation of the mechanomyographic (MMG) signal at different force levels (maximal voluntary contraction – MVC, 40% of MVC and 70% of MVC) of the rectus femoris muscle. Methods Fifteen volunteers were divided in two groups: ST lower than 10mm (G35) (7 participants). Student t tests were employed to investigate differences between G35 regarding MMG analysis parameters (acceleration root mean square – aRMS, zero crossing – ZC, and median frequency – MDF), for the X, Y and Z axes, as well as for the modulus of these three axes. Results We found that thicker layers of body fat act as attenuator filters for the MMG signal [MDFMVC: X (p = 0.005), Z (p = 0.003); MDF70%MVC: X (p = 0.034); ZCMVC: Z (p = 0.037), modulus (p = 0.005); ZC70%MVC: Z (p = 0.047)]. We found significant correlation between ST values and aRMS in three levels, in the Yaxis (p = 0.591), for the group G35 in 40%MVC (R2 = 0.610), and 70%MVC (R2 = 0.592). The MDF parameter showed correlation with ST values only in the Yaxis in 70%MVC (R2 = 0.700) for G>35. Conclusions We observed MMG signal attenuation in at least one of the parameters analyzed for each level of the rectus femoris muscle force, indicating that MMG signals are significantly attenuated with increasing thickness of the subcutaneous fat layer.

Background The mechanisms underlying impaired balance in chronic obstructive pulmonary disease (COPD) are poorly understood, which makes it difficult to choose the best therapeutic approaches. Therefore, this study aimed to investigate patterns of muscular activation to maintain balance and its determinants in this population. Methods Thirty-three subjects with COPD and 33 controls were assessed by a force platform in four tasks: standing with eyes opened (FHEO) and closed (FHEC); standing on unstable surface (SUS) and one-legged stance (OLS). Electromyographic activity of lower limb, trunk and neck muscles was concomitantly recorded. To asses functional balance, Brief-balance evaluation systems and timed up & go (TUG) tests were applied. Lung function, exercise capacity and muscle force were also assessed. Results Subjects with COPD presented worse balance and higher scalene activation than controls in OLS (mean difference 23.0 [95%CI 1.7–44.3] %Δ μVRMS; P = 0.034), besides presenting also higher activation of gluteus medius during FHEC task (mean difference 1.5 [95%CI 0.2–2.8] %Δ μVRMS; P = 0.023) and taking longer to complete the TUG (mean difference 0.6 [95%CI 0.1–1.2] seconds; P = 0.042). Exercise capacity and peripheral muscle force were determinants of functional balance (r2 = 0.505), whereas age (OR = 1.24; 95%CI 1.02–1.52) and total lung capacity (OR = 2.42; 95%CI 1.05–5.56) were determinants of static balance. Conclusion Individuals with COPD have worse static and functional balance in comparison with controls, besides presenting higher activation of scalene and gluteus medius during static balance tasks. Exercise capacity and peripheral muscle force emerged as determinants of functional balance, whereas age and lung hyperinflation contributed to poor static balance.

The application of low-intensity electrical stimulation (LIES) to neural tissue increases neurochemical factors responsible for regeneration as nerve growth factor. Stem cell (SC) therapy for patients with Spinal cord injury (SCI) promote some increase functional improvement.ObjectiveInvestigate the electromyographic response in paraplegic dogs undergoing LIES and SC transplantation.Methods27 dogs paraplegics with SCI were divided into three groups with different types of therapy. GADSC: two SC transplants (n = 9); GLIES: LIES (n = 8); GCOMB: two SC transplants and LIES (n = 10). Adipose derived mesenchymal stem cells (ADSCs) were transplanted by lumbar puncture in the amount of 1.2 × 106 cells/50 μL. Acupuncture needles positioned in the interspinous space were used for stimulation. The electrical stimulation was applied with a mean voltage ∼30 mV and four consecutive modulated frequencies (5 Hz, 10 Hz, 15 Hz and 20 Hz) within 5 min each. The patients motor performance was evaluated before (Pre) the procedure and after 30 (Post30) and 60 (Post60) days, from electromyography root mean square (EMGRMS) registered with subcutaneous electrodes in the vastus lateralis muscle, while the animals were in quadrupedal position.ResultsAll three groups showed a significant intra-group increase of EMGRMS (Pre vs. Post30 or Pre vs. Post60). However, there were no statistically significant differences between Post30 and Post60. The inter-group test (GADSC X GLIES X GCOMB) did not present significance when compared the instants Pre (p = 0.34), Post30 (p = 0.78) and Post60 (p = 0.64).ConclusionSome dogs recovered motor activity, expressed by the EMGRMS, in all groups, in pre vs. post (30 or 60 days) comparisons. This is the peer-reviewed version of the article: Krueger, E., Magri, L.M.S., Botelho, A.S., Bach, F.S., Rebellato, C.L.K., Fracaro, L., Fragoso, F.Y.I., Villanova, J.A., Brofman, P.R.S., Popović-Maneski, L., 2019. Effects of low-intensity electrical stimulation and adipose derived stem cells transplantation on the time-domain analysis-based electromyographic signals in dogs with SCI. Neuroscience Letters 696, 38–45. [https://doi.org/10.1016/j.neulet.2018.12.004] Published version: [https://hdl.handle.net/21.15107/rcub_dais_4595]

The muscle-machine interface assists in the neuroplasticity of healthy with lesions during the combination of electromyography techniques and functional electrical stimulation (EMG-FES). This case report aimed to evaluate this interface for rehabilitation in a post-stroke participant. For the treatment, an EMG-FES interface was associated with functional exercises for wrist and finger extension. This case report aimed to evaluate this interface for rehabilitation in a post-stroke participant. The protocol was applied 3x/week during 12 sessions. Were applied eliminatory tests (Mini mental exam, active range of motion and Ashworth modified scale), functional tests (Fugl Meyer scale and 9 hole peg test) and electromyography evaluation in time (EMGRMS) and frequency (EMGMDF) domain. In the functional tests occurred increase in sensibility, mobility, oriented tasks and pain reduction (18/48 to 23/48) and the electromyography showed an increase 35.12 VRMS in EMGRMS and 123 Hz in EMGMDF. This interface is effective for improving voluntary movement of hand extension after stroke.

Pain in the lower limbs is common in athletes and a limiting factor in performance. Acupuncture has shown positive effects as an analgesic treatment and may potentially be used for pain reduction in runners. This study aimed to analyze the parameters associated with knee pain by correlating strength parameters of the musculature assessed in runners treated with acupuncture. A descriptive longitudinal study was conducted on 34 runners of both sexes aged 20 to 52 years, who presented with knee-related pain from January to June, 2015. Two pain questionnaires and a maximal strength test with electromyographic evaluation of the rectus femoris, vastus lateralis, and medialis muscles were used, and patients were monitored during five follow-up visits after an acupuncture protocol. All participants reported experiencing a decrease in knee pain after treatment. The affected limbs showed an increase in average strength by 34% and 25% compared to the contralateral limb. An increase in the number of motor units recruited for the three muscles was observed in both limbs. In conclusion, the proposed acupuncture protocol was effective in reducing pain symptoms in the knee region of athletes, thus influencing their gain in strength and muscle balance.A dor em membros inferiores é comum em atletas e representa um aspecto limitante ao rendimento. Buscando atenuação para a dor desta população, utiliza-se a acupuntura por apresentar bons efeitos na analgesia. Objetivo: analisar os parâmetros relacionados à dor de joelho correlacionando os parâmetros de força das musculaturas avaliadas em corredores submetidos a tratamento de acupuntura. Métodos: Foi realizado um estudo longitudinal, de janeiro a junho de 2015, com 34 corredores de 20 a 52 anos de ambos os sexos, que apresentassem dor de joelho. Foram aplicados dois questionários de dor e um teste de força máxima com avaliação eletromiográfica dos músculos reto femoral, vasto lateral e medial, com cinco atendimentos seguindo um protocolo de acupuntura. Resultados: Todos os voluntários relataram diminuição da dor de joelho após o tratamento. A média de força do membro afetado teve incremento de 34% e do membro contralateral de 25%. Verificou-se aumento no número de recrutamento de unidades motoras para os três músculos avaliados em ambos os membros. Conclusão: O protocolo proposto se mostrou eficaz na diminuição da sintomatologia dolorosa na região de joelhos de atletas corredores, interferindo no ganho de força e no equilíbrio muscular.

Aims: This study tested whether performing exergames with and without additional external load could induce to different internal load demand for young adults. Methods: Fifteen young women (24.4 ± 4.06 years) participated in the study. Electromyography (EMG) activity, heart rate (HR) and overall and local rating of perceived exertion (RPE) were determined in “Just Dance” and “Ski” exergames without additional external load and with additional external load of 5% of body mass attached bilaterally to the ankles in “Just Dance” and using a weight vest in “Ski”. Results: EMG, HR and overall RPE presented similar responses between loads in both exergames (p>.05). However, local RPE differentiate internal load only in “Just Dance”, with higher values with additional load (with additional load: 11.2 ± 2.1 RPE; without additional load: 10.3 ± 1.4 RPE; p = .037). Conclusion: Therefore, performing exergames with an additional external load of 5% of young women body mass did not induce different internal load demand in “Just Dance” and “Ski” exergames compared to performing such games without external load. However, the greater local RPE in “Just Dance” exergame after adding the external load suggests that a higher amount of load (i.e., > 5% of body mass) to this population may generate different internal load demand.

The modified Ashworth scale (MAS) is the most widely used measurement technique to assess levels of spasticity. In MAS, the evaluator graduates spasticity considering his/her subjective analysis of the muscular endurance during passive stretching. Therefore, it is a subjective scale. Mechanomyography (MMG) allows registering the vibrations generated by muscle contraction and stretching events that propagate through the tissue until the surface of the skin. With this in mind, this study aimed to investigate possible correlations between MMG signal and muscle spasticity levels determined by MAS. We evaluated 34 limbs considered spastic by MAS, including upper and lower limbs of 22 individuals of both sexes. Simultaneously, the MMG signals of the spastic muscle group (agonists) were acquired. The features investigated involved, in the time domain, the median energy (MMGME) of the MMG Z-axis (perpendicular to the muscle fibers) and, in the frequency domain, the median frequency (MMG mf ). The Kruskal-Wallis test (p me . There was a high linear correlation between the MMG me and MAS (R2=0.9557) and also a high correlation as indicated by Spearman test (ρ=0.9856; p mf did not present significant differences between MAS spasticity levels. There was moderate linear correlation between MAS and MMG mf (R2=0.4883 and Spearman test [ρ = 0.4590; p < 0.001]). Between the two investigated features, we conclude that the median energy is the most viable feature to evaluate spasticity due to strong correlations with the MAS.

INTRODUCTION: The evaluation of muscular tissue condition can be accomplished with mechanomyography (MMG), a technique that registers intramuscular mechanical waves produced during a fiber's contraction and stretching that are sensed or interfaced on the skin surface. OBJECTIVE: Considering the scope of MMG measurements and recent advances involving the technique, the goal of this paper is to discuss mechanomyography updates and discuss its applications and potential future applications. METHODS: Forty-three MMG studies were published between the years of 1987 and 2013. RESULTS: MMG sensors are developed with different technologies such as condenser microphones, accelerometers, laser-based instruments, etc. Experimental protocols that are described in scientific publications typically investigated the condition of the vastus lateralis muscle and used sensors built with accelerometers, third and fourth order Butterworth filters, 5-100Hz frequency bandpass, signal analysis using Root Mean Square (RMS) (temporal), Median Frequency (MDF) and Mean Power Frequency (MPF) (spectral) features, with epochs of 1 s. CONCLUSION: Mechanomyographic responses obtained in isometric contractions differ from those observed during dynamic contractions in both passive and functional electrical stimulation evoked movements. In the near future, MMG features applied to biofeedback closed-loop systems will help people with disabilities, such as spinal cord injury or limb amputation because they may improve both neural and myoelectric prosthetic control. Muscular tissue assessment is a new application area enabled by MMG; it can be useful in evaluating the muscular tonus in anesthetic blockade or in pathologies such as myotonic dystrophy, chronic obstructive pulmonary disease, and disorders including dysphagia, myalgia and spastic hypertonia. New research becomes necessary to improve the efficiency of MMG systems and increase their application in rehabilitation, clinical and other health areas.

Thermography is a non-invasive and non-painful technique that allows the generation of high resolution images without any physical contact. This paper presents the main applications involving biomedical thermography nowadays. For this purpose, it was performed a literature review through the known electronic based search options, such as, Wiley Online Library, ScienceDirect, Scielo, Google Scholar, IEEE Xplorer, Elsevier, Medline, Pubmed. Preferentially, it was used English language with the following keywords: medical termography, medical infrared images, thermographic assessment, thermography assessment e medical infrared imaging. It was followed the retrospective method, searching for research papers involving a window time of the last five years, from 2007 to 2012. It is noticed at a certai n level of detail, that thermography is being applied mainly at the following areas: orthopedic, odontology, surgery procedures, sports, oncology, cardiology, angiology, endocrinology, Forensic Medicine, hemodynamics, obstetric, physiotherapy and ergonomic. Therefore, it is concluded that the use of thermography and other clinical observations and additional exams together, may assist to define medical diagnostics or to evaluate the efficacy of the therapeutic methods employed.

Studies involving sensory substitution or feedback date back to the 1960s. These seek to apply stimuli to body regions with full sensitivity to replace the information lost due to damaged, deficient, or absent sensory pathway. The main techniques applied are electrotactile stimulation (ETS) and vibrotactile stimulation. The objective of this article is to present a synopsis of current knowledge regarding technologies that employ electrical, mechanical, and pneumatic resources in the sensory system as tools for physical rehabilitation. ETS can be applied as a therapeutic intervention in the treatment of equilibrium disorders, as systems of myoelectric prostheses in amputees whose mechanoreceptors were removed together with the limb, as artificial skins developed prior to the application of prostheses and as prophylactic treatments for pressure sores. Vibrotactile or mechanotactile sensory substitutions that employ electromechanical and piezoelectric devices or inert gas jets facilitate the training of equilibrium maintenance in patients with vestibular alterations, as well as the development of alternative and expanded communication technologies in signaling and augmented reality for people with auditory and/or visual disabilities. The cybernetic resources developed for physical rehabilitation described herein were shown to efficiently generate sensory stimuli and the artificial control of tactile perception. Notwithstanding the greater functional simplicity of mechanotactile systems, the majority of the reviewed studies focused on ETS systems. The results of this study demonstrate the progress and potential of these technologies, as well as the results of evaluations of their use and current limitations in the electrical and mechanical devices employed in functional sensory system rehabilitation.

Estudos científicos ainda questionam se a fisioterapia intensiva asso­ciada ao uso da roupa com elásticos (suit-órteses dinâmicas) produzem ou não desfechos benéficos para indivíduos com déficits neurológi­cos. Objetivo. Determinar os ganhos na função motora de tronco de crianças com diagnóstico de paralisia cerebral submetidas à cinco semanas de Terapia Neuromotora Intensiva (TNMI) com uso do traje do PediaSuit. Trata-se de um estudo observacional longitudinal de caráter quantitativo. Resultados. Foram avaliadas 22 crianças de 03 a 08 anos de idade, com déficitsneuromotores relacionados a parali­sia cerebral. Foram utilizados dois instrumentos de medida: A esca­la GMFM 88 e um sistema de eletrogoniometriawi-fi (com sensores sem fio) denominado Biofeed® (Biosmart®). Os resultados do GMFM mostraram diferença estatística (p

Spinal cord injury (SCI) is classified as neurological disorder that affects motor and sensory function below the injury level. Studies show that application of low-intensity electrical stimulation (LIES) to neural tissue increases neurochemical factors responsible for regeneration as nerve growth factor. Stem cell (SC) therapy for patients with SCI can result in the replacement of injured neurons after trauma. The electromechanical delay (EMD) is defined as time elapsed between the onset of muscle electrical activation and onset of force production. A dog diagnosed with incomplete thoracolumbar SCI followed by disc hernia between the vertebral segments LI and L2, was evaluated by electromyography and mechanomyography after surgical decompression procedure, one SC transplantation and LIES. We observed motor response and decrease in the EMD from 8.25ms to 5.75ms after the procedures. The wavelet decomposition of EMG signals showed reestablishment of vastus lateralis muscle activity 30 days after the procedure. In addition, the EMG RMS increased from 3.3 µV RMS to 157 µV RMS . The preliminary results of this case report indicate positive effects of the hybrid therapy involving stem cells and low-intensity electrical stimulation after surgical decompression.

INTRODUCTION: Functional electrical stimulation (FES) may evoke movements in people with movement impairments due to neurological lesion. The mean value of electrical current or voltage during FES depends on the stimulatory profile parameters. To investigate the relationship between peak and mean amplitudes of the stimulator output voltage while causing a knee extension angle change from 90º to 40º to choose the best and safest profile to be applied in people who have suffered a spinal cord injury. METHODS: Healthy (N = 10) volunteers and those with spinal cord injuries (N = 10) participated in this study. Each FES profile (P1, P2, P3 and P4) had 1-kHz pulses (100 µs or 200 µs on and 900 µs or 800 µs off) with burst frequencies of 50 Hz (3 ms on and 17 ms off) or 70 Hz (3 ms on and 11 ms off) and peak amplitudes set between 53-125V for healthy volunteers and 68-198 V for volunteers with spinal cord injury. RESULTS: The highest mean amplitude were obtained using a FES profile with active/total pulse period of 200 us/1000 us and burst frequency of 3ms/14ms. The best results of mean amplitude were observed using a FES profile duty cycle of 10% for pulses (100 µs/1000 µs) and 15% for bursts (3 ms/20 ms). CONCLUSION: The FES profile (100 µs - 50 Hz) seems to be the most suitable for both groups, inasmuch as it presents smaller mean amplitudes and peak amplitudes similar to other FES profiles.

Introduction: Signal analysis involves time and/or frequency domains, and correlations are described in the literature for voluntary contractions. However, there are few studies about those correlations using mechanomyography (MMG) response during functional electrical stimulation (FES) elicited contractions in spinal cord injured subjects. This study aimed to determine the correlation between spectral and temporal MMG features during FES application to healthy (HV) and spinal cord injured volunteers (SCIV). Methods: Twenty volunteers participated in the research divided in two groups: HV (N=10) and SCIV (N=10). The protocol consisted of four FES profiles transcutaneously applied to quadriceps femoris muscle via femoral nerve. Each application produced a sustained knee extension greater than 65º up to 2 min without adjusting FES intensity. The investigation involved the correlation between MMG signal root mean square (RMS) and mean frequency (MF). Results: HV and SCIV indicated that MMGRMS and MMGMF variations were inversely related with -0.12 ≥ r ≥ -0.82. The dispersion between MMGMF and MMGRMS reached 0.50 ≤ r2 ≤ 0.64. Conclusion The increase in MMGRMS and the decrease in MMGMF may be explained by the motor units coherence during fatigue state or by motor neuron adaptation (habituation) along FES application (without modification on parameters).

Introduction: The aim of this study was to compare and correlate the results of fat percentage by skinfold thickness using portable ultrasound (US) and scientific adipometer in adults. Methods: During2012 we evaluated 120 military men, divided according to the value of the body mass index (BMI). Wecollected: weight, height, SF and US in nine points (triceps, subscapular, biceps, chest, medium axillary,abdominal, supra iliac, anterior thigh and calf ). Statistical analysis was performed using nonparametrictests as Spearman correlation coefficient and paired with Wilcoxon Signed Ranks Test. Results:For the correlation of the percentage of fat obtained through seven skinfolds and values obtained bymeasuring it with US, the following results were obtained: p=0.421 (BMI

Introduction Iontophoresis is a noninvasive technique used to increase transdermal penetration of substances through the skin layer (epidermis, dermis and hypodermis) in a controlled manner. Technological advance in recent decades have provided reduced cost of equipment needed for implementation, which allowed for the expansion of this technique. Objective The aim of this paper is to present the state of the art on iontophoresis, ranging from the atomic characteristics of the ion formation to the current applications of the technique. Methods Were researched papers from databases: IOP publishing, ScienceDirect, Pubmed, Springer, IEEE Xplore, Google Scholar and books with keywords iontophoresis, ions, topical applications between 1967 and 2010. Results Were selected (number of papers and database) 1 IOP Publishing, 1 from ScienceDirect, Central, 1 from Springer, 2 from PubMed, 11 from IEEE Xplore, 35 from Google Scholar, and 15 books, totaling 66 references and websites with nationally marketed electrotherapy products. Conclusion Iontophoresis is suitable for applications such as acetic acid (calcific tendinitis and myositis ossificans), calcium chloride and magnesium sulfate (control of musculoskeletal spasms), dexamethasone (inflammation), lidocaine (inflammation of soft tissues), zinc oxide (rheumatoid arthritis). It is also used in cosmetic applications with devices attached to the skin and for eye treatment aimed at specific tissues of the eye, providing a treatment option for various eye diseases, reducing the complications secondary to traditional methods of treatment. The advantages are the significant increase in the release and control of therapeutic agents, including drugs with high molecular weight. The disadvantages of iontophoresis are the complexity of the drug release system and prolonged exposure of the skin to an electrical current. Introdução A iontoforese é uma técnica não invasiva utilizada para aumentar, de forma controlada, a penetração transdermal de substâncias através das camadas da pele (epiderme, derme e hipoderme). O avanço tecnológico nas últimas décadas proporcionou uma redução no custo dos equipamentos necessários à sua aplicação, o que possibilitou a expansão dessa técnica. Objetivo Apresentar o estado da arte sobre iontoforese, abrangendo desde as características atômicas da formação do íon até as atuais aplicações da técnica. Métodos Foram pesquisados artigos das bases de pesquisa: IOP publishing, ScienceDirect, Pubmed, Springer, IEEE Xplore, Google Scholar e livros com os unitermos: iontophoresis, ions, topical applications entre os anos de 1967 e 2010. Resultados Foram selecionados (número de artigos e base de pesquisa) 1 da IOP Publishing, 1 da ScienceDirect, 1 da Springer, 2 da PubMed, 11 da IEEE Xplore, 35 do Google Scholar e 15 livros, totalizando 66 referências, além de websites com produtos comerciais nacionais de eletroterapia. Conclusão A iontoforese é indicada para aplicações como de ácido acético (tendinite calcificante e miosite ossificante), cloreto de cálcio e sulfato de magnésio (controle de espasmos musculoesqueléticos), dexametasona (inflamação), lidocaína (inflamação de tecidos moles), óxido de zinco (artrite reumatóide). Também é utilizada em aplicações cosméticas com dispositivos aderidos à pele e em tratamento ocular visando tecidos específicos do olho, oferecendo uma forma de tratamento para diversas doenças oculares, diminuindo as complicações apresentadas em métodos clássicos de tratamento. As vantagens são o significativo aumento na liberação e controle de agentes terapêuticos, incluindo fármacos com alto peso molecular. As desvantagens encontradas na iontoforese são a complexidade do sistema de liberação do fármaco e exposição prolongada da pele a uma corrente elétrica.

The goal of this paper is to investigate the temporal-spectral decomposition content during a maximal electrically evoked contraction (MEEC) in two spinal cord injured participants using triaxial mechanomyography (MMG). Two male spinal cord injured volunteers performed the tests both injured at T7 neurologic level. The triaxial MMG signal of rectus femoris muscle was processed with Cauchy wavelet transform adjusted to third-order 5–50 Hz bandpass Butterworth filter. A custom electrical stimulator voltage-controlled was configured: pulse frequency set to 1 kHz (20% duty cycle) and burst (modulating) frequency set to 70 Hz (20% active period). The MEEC force was performed by increasing the electrical stimulating magnitude (∼3 V/s to avoid motoneuron adaptation/habituation) until the force started to level off. We conclude that the peak energy of MMG signal frequency did not occur simultaneously with the maximal electrically evoked contraction to rectus femoris muscle. Moreover, the vibration vector of muscle, expressed in three axes (X, Y and Z), presented different fired frequencies, mainly between X (transverse) and Z (perpendicular) axis, where the frequencies fired by Z axis were greater.

Regiões distintas do sistema nervoso central ativam o sistema neuromuscular. Atualmente, utilizam-se sistemas artificiais para mimetizarem as ações fisiológicas perdidas devido a uma lesão neurológica. A estimulação elétrica de tecidos humanos in vivo, como forma de tratamento, desenvolveu-se por meio de pesquisas e do aprimoramento da tecnologia. Pessoas que sofreram lesão medular podem perder parcial ou totalmente a função motora de uma determinada região corporal. A aplicação de estimulação elétrica no tecido neuromuscular gera movimentação artificial que pode desenvolver uma melhora de longo prazo através da plasticidade neuronal. A estimulação elétrica funcional pode utilizar variados parâmetros, eletrodos e locais de aplicação. Quando o ajuste e correção dos parâmetros estimulatórios ocorre manualmente, tem-se um sistema em malha aberta, quando ocorre automaticamente, o sistema denomina-se controle em malha fechada. Ambas as formas contribuem para a reabilitação física de pacientes acometidos por lesão neuronal. Os sistemas em malha fechada apresentam vantagens em relação aos de malha aberta, como a correção automática dos parâmetros de estimulação. Assim, com o desenvolvimento de estratégias de controle e a criação de interfaces amigáveis, a ativação do conjunto de equipamentos e softwares que viabilizarão o movimento artificial poderá ser efetuada pelo próprio usuário, assemelhando-se ao sistema fisiológico humano.

Nutritional changes are commonly related to children with cerebral palsy (CP), since these are problems as: dysphagia, vomiting and gastrointestinal reflux. For nutritional monitoring, body composition has become an important tool and has been present in this population assessments routine. In this sense, the aim of this study was to develop an equation for body composition estimate for children with cerebral palsy, aged between 5 and 6 years, using skinfolds, from the results of body composition obtained by Dual Energy X-rays Absormetry (DEXA). The study included 10 male children with cerebral palsy, aged between five and six-years-old, who participated in the physical therapy intensive program in Vitoria research center, Curitiba, Brazil. Participants were assessed by: the Gross Motor Function Classification System; DEXA; and skinfold thickness. The skinfolds that showed better correlation with the total fat percentage and segmental fat percentage were: biceps and abdominal. The results of the regression analysis obtained equations to estimate the fat percentage by skinfold thickness with R2: 1.000 and 0.971, to seven and two skinfold thickness, respectively. In this sense, it is recommended to use the equation that utilizes the biceps and abdominal skinfolds thickness to estimate fat percentage of children with cerebral palsy, as this presents good estimation indicators.

The goal of this paper is to evaluate the mechanomyography (MMG) response of rectus femoris muscle based on Cauchy wavelet (CaW) during contraction evoked by functional eletrical stimulation (FES) in a spinal cord injured person. The participant was ranked in American Spinal Injury Association (ASIA) impairment scale as A, i.e. without contraction or sensibility below the lesion level (T3). A triaxial (Z, X and Y axes) MMG sensor was placed over the rectus femoris muscle belly. The CaW was processed in initial and final moments of FES application. The results showed that frequency in (a) initial moment tends to be near the adjusted FES burst frequency (50 Hz), however, in (b) final moment presents compression to frequencies below 18.63 Hz in Z and X axes and in Y axis below 51.12 Hz, therefore, indicating the fibers do not follow the physiological muscular activation mode, as suggested by De Luca and Erim during FES. CaW appears to be suitable to carry out the MMG response during FES application to a spinal cord injured subject making it an important analysis tool because it can show the specific frequency band during neuromuscular physiological changes.

The assessment and physiological register of muscular tissue can be done through mechanomyography (MMG). The oscillation of muscular displacement is acquired on the skin surface, insomuch that the skinfold thickness can influence in MMG response. The aim of this study is verify the influence of different skinfold thickness on MMG features responses. Triaxial MMG was used over the rectus femoris muscle belly of ten volunteers during maximal voluntary contraction. MMG spectral and temporal analyses were made and specific features (root mean square (RMS), Integral (Int), mean frequency (MF), zero-crossing (ZC), and μ3) were correlated with skinfold thickness. Moderate and high negative correlation occurred to MMG mean frequency in axes X (ρ = - 0.57) and Y (ρ = -0.75), respectively. As the fat tissue behaves like a low-pass filter, i.e. the thicker his skinfold the shorter its bandwidth; therefore, the skinfold thicknesses result in lower frequency responses. So, hereafter these results may be applied to calibrate MMG responses as biofeedback systems in, for instance, neuroprostheses.

Mechanomyography (MMG) measures both muscular contraction and stretching activities and can be used as feedback in the control of neuroprostheses with Functional Electrical Stimulation (FES). In this study we evaluated the correlation between MMG features and passive knee angular movement of rectus femoris and vastus lateralis muscles acquired from healthy volunteers (HV) and spinal cord injured volunteers (SCIV). Twelve HV and thirteen SCIV were submitted to passive and FES elicited knee extensions and in each extension, eleven windows of analysis with 0.5s length were inspected. Temporal (RMS and INT) and frequency (MF and μ3) features were extracted. Spearman correlation coefficients (p) were computed in order to check correlations between the features obtained from both MMG sensors. The correlation between MMG(MF) and MMG temporal analysis (RMS and INT) to HV was classified as positive, moderate (p from 0.635 to 0.681) and high (p from 0.859 to 0.870), and weak (positive e negative) to SCIV. These results differ from those obtained in voluntary contraction or artificially evoked by functional electrical stimulation and may be relevant in applications with closed loop control systems.

Functional electrical stimulation (FES) improves paraplegic subjects rehabilitation and may be used in neuroprosthesis systems. Superficial mechanomyography (MMG) monitors the contracting muscles oscillations. The goal of this paper is to compare the relationships between MMG features and knee angles during open chain movements artificially evoked by different FES off times (5s; 10s and 15s) in a spinal cord injured volunteer. FES waveform consisted of a monophasic square wave, 1kHz pulse frequency, 300μs active pulse period and 3ms active burst period with burst frequency of 70Hz. Sixteen artificial contractions were generated by FES applied to the quadriceps femoral muscle pre- and pos-interval of 15min, totalizing thirty two contractions. Temporal (RMS value) and spectral (median frequency) MMG features were analyzed for rectus femoris and vastus lateralis muscles. MMGRMS and MMGMF variations were inversely related, with correlation coefficients values from -0.30 until -0.79. These results may help create new FES closed-loop control strategies by MMG features.

Mechanomyography (MMG) registers lateral oscillations of contracting muscles. Functional electrical stimulation (FES) improves the rehabilitation of paraplegic subjects and can be used in neuroprosthesis control. During FES application, muscular contraction responses may vary, possibly due to fatigue or adaptation of nerve cells face to electrical stimuli. This study measured the differences in MMG RMS and median frequency (MF) features between healthy (HV) and spinal cord injury (SCI) volunteers. Ten HV and three SCI participated in the research. FES waveform consisted of a monophasic square wave, 1kHz pulse frequency, 100us active pulse period and 3ms active burst period with burst frequency of 70Hz. For each stimulation series, three analysis windows were inspected. RMS and MF variations were inversely related. The obtained results may help to create new strategies of muscular closed-loop control.

Functional electrical stimulation (FES) can artificially elicit movements in spinal cord injured (SCI) subjects. FES control strategies involve monitoring muscle features and setting FES profiles so as to postpone the installation of muscle fatigue or nerve cell adaptation. Mechanomyography (MMG) sensors register the lateral oscillations of contracting muscles. This paper presents an MMG efficiency index (EI) that may indicate most efficient FES electrical parameters to control functional movements. Ten healthy and three SCI volunteers participated in the study. Four FES profiles with two FES sessions were applied with in-between 15min rest interval. MMG RMS and median frequency were inserted into the EI equation. EI increased along the test. FES profile set to 1kHz pulse frequency, 200εs active pulse duration and burst frequency of 50Hz was the most efficient.

A uthors have emphasized the need for previous care in order to perform reliable bioimpedance acquisition. Despite of this need some authors have reported that intense physical training has little effect on Bioimpedance Analysis (BIA), while other ones have observed significant effects on bioimpedance parameters in the same condition, leading to body composition estimates considered incompatible with human physiology. The aim of this work was to quantify the changes in bioimpedance parameters, as well as in body fluids estimates by BIA, after four hours of intense physical activity with free water replacement in young males. Xitron Hydra 4200 equipment was used to acquire bioimpedance data before and immediately after the physical training. After data acquisition body fluids were estimates from bioimpedance parameters. Height and weight of all subjects were also acquired to the nearest 0.1 cm and 0.1 kg, respectively. Results point that among the bioimpedance parameter, extracellular resistance presented the most coherent behavior, leading to reliable estimates of the extracellular fluid and part of the total body water. Results also show decreases in height and weight of the participants, which were associated to the decrease in body hydration and in intervertebral discs.

What mechanism has greater influence on skin temperature during, and after, the muscular work: peripheral vasoconstriction or muscle heat dissipation? And yet, at what time each one preponderates? In this sense, the present study aimed to analyze, in time domain, the skin temperature variations during muscular exercise. This study can be characterized as a short-term longitudinal study. The study was conducted with two male able-bodied volunteers, with 22 and 23 yrs, both physically active. The exercise proposed was the unilateral biceps curl, with dominant arm. The data from the contralateral arm was used as control. A Visual Analogue Scale (VAS) for pain was used to monitor the muscular pain perception during 48 hours after the exercise. The results show the temperature decreases during the first minute (between the start and the end of the first set of exercise). The end of 3rd set can be observed an average increase in the temperature of study arm of approximately 8.4% compared to the initial temperature and an average difference of approximately 6.6% compared to the control arm. In conclusion, the temperature of the skin over the main muscle of high-intensity exercise (performing until fatigue) decreases at the initial stage and then increases continuously until muscle fatigue. The exercise induced muscle damage (EIMD) can be predicted by assessment of muscle skin temperature 24 hours after exercise.

Several pathologies can cause muscle spasticity. Modified Ashworth scale (MAS) can rank spasticity, however its results depend on the physician subjective evaluation. This study aims to show a new approach to spasticity assessment by means of MMG analysis of hamstrings antagonist muscle group (quadriceps muscle). Four subjects participated in the study, divided into two groups regarding MAS (MAS0 and MAS1). MMG sensors were positioned over the muscle belly of rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) muscles. The range of movement was acquired with an electrogoniometer placed laterally to the knee. The system was based on a LabVIEW acquisition program and the MMG sensors were built with triaxial accelerometers. The subjects were submitted to stretching reflexes and the integral of the MMG (MMG(INT)) signal was calculated to analysis. The results showed that the MMG(INT) was greater to MAS1 than to MAS0 [muscle RF (p = 0.004), VL (p = 0.001) and VM (p = 0.007)]. The results showed that MMG was viable to detect a muscular tonus increase in antagonist muscular group (quadriceps femoris) of spinal cord injured volunteers.