Gait analysis using wearable sensors is an inexpensive, convenient, and efficient manner of providing useful information for multiple health-related applications. As a clinical tool applied in the rehabilitation and diagnosis of medical conditions and sport activities, gait analysis using wearable sensors shows great prospects. The current paper reviews available wearable sensors and ambulatory gait analysis methods based on the various wearable sensors. After an introduction of the gait phases, the principles and features of wearable sensors used in gait analysis are provided. The gait analysis methods based on wearable sensors is divided into gait kinematics, gait kinetics, and electromyography. Studies on the current methods are reviewed, and applications in sports, rehabilitation, and clinical diagnosis are summarized separately. With the development of sensor technology and the analysis method, gait analysis using wearable sensors is expected to play an increasingly important role in clinical applications.

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Gait analysis using wearable sensors.

Study Design. Cross-sectional study. Objective. This study compared neck muscle activation patterns during and after a repetitive upper limb task between patients with idiopathic neck pain, whiplash-associated disorders, and controls. Summary of Background Data. Previous studies have identified altered motor control of the upper trapezius during functional tasks in patients with neck pain. Whether the cervical flexor muscles demonstrate altered motor control during functional activities is unknown. Methods. Electromyographic activity was recorded from the sternocleidomastoid, anterior scalenes, and upper trapezius muscles. Root mean square electromyographic amplitude was calculated during and on completion of a functional task. Results. A general trend was evident to suggest greatest electromyograph amplitude in the sternocleidomastoid, anterior scalenes, and left upper trapezius muscles for the whiplash-associated disorders group, followed by the idiopathic group, with lowest electromyographic amplitude recorded for the control group. A reverse effect was apparent for the right upper trapezius muscle. The level of perceived disability ( Neck Disability Index score) had a significant effect on the electromyographic amplitude recorded between neck pain patients. Conclusions. Patients with neck pain demonstrated greater activation of accessory neck muscles during a repetitive upper limb task compared to asymptomatic controls. Greater activation of the cervical muscles in patients with neck pain may represent an altered pattern of motor control to compensate for reduced activation of painful muscles. Greater perceived disability among patients with neck pain accounted for the greater electromyographic amplitude of the superficial cervical muscles during performance of the functional task.

Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task.

Study Design Experimental laboratory study. Objectives To quantify and compare electromyographic signal amplitude of the gluteus maximus and gluteus medius muscles during exercises of varying difficulty to determine which exercise most effectively recruits these muscles. Background Gluteal muscle weakness has been proposed to be associated with lower extremity injury. Exercises to strengthen the gluteal muscles are frequently used in rehabilitation and injury prevention programs without scientific evidence regarding their ability to activate the targeted muscles. Methods Surface electromyography was used to quantify the activity level of the gluteal muscles in 21 healthy, physically active subjects while performing 12 exercises. Repeated-measures analyses of variance were used to compare normalized mean signal amplitude levels, expressed as a percent of a maximum voluntary isometric contraction (MVIC), across exercises. Results Significant differences in signal amplitude among exercises were noted for the...

Gluteal Muscle Activation During Common Therapeutic Exercises

The objective of this study was to compare onset of deep and superficial cervical flexor muscle activity during rapid, unilateral arm movements between ten patients with chronic neck pain and 12 control subjects. Deep cervical flexor (DCF) electromyographic activity (EMG) was recorded with custom electrodes inserted via the nose and fixed by suction to the posterior mucosa of the oropharynx. Surface electrodes were placed over the sternocleidomastoid (SCM) and anterior scalene (AS) muscles. While standing, subjects flexed and extended the right arm in response to a visual stimulus. For the control group, activation of DCF, SCM and AS muscles occurred less than 50 ms after the onset of deltoid activity, which is consistent with feedforward control of the neck during arm flexion and extension. When subjects with a history of neck pain flexed the arm, the onsets of DCF and contralateral SCM and AS muscles were significantly delayed (p<0.05). It is concluded that the delay in neck muscle activity associated with movement of the arm in patients with neck pain indicates a significant deficit in the automatic feedforward control of the cervical spine. As the deep cervical muscles are fundamentally important for support of the cervical lordosis and the cervical joints, change in the feedforward response may leave the cervical spine vulnerable to reactive forces from arm movement.

Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain.

Analysis of motor units with high-density surface electromyography.

A method for positioning electrodes during surface EMG recordings in lower limb muscles.

Muscle fatigue induced by two different resistances: Elastic tubing versus weight machines

Elastic tubes are devices relatively inexpensive, easy to use, portable and safe, which are claimed to provide advantages with respect to training with free weights or weight machine. The aim of this work was to assess neuromuscular modification induced by the use of two different muscle contraction modalities (elastic versus weight resistances) until exhaustion. Fourteen healthy physically active male students (age: 28±6 years; body mass 72.1±11.0kg; height: 173.5±6.9cm) were recruited. They were requested to reach exhaustion with dynamic contraction at 70% of their own One Repetition Maximal (1RM) using, in two different days and in random order, Thera Band® tubes or traditional weight plates on an arm machine designed and built for those tasks. Before and after such contractions a standardized fatiguing isometric test (3 Maximal Voluntary Contractions, MVC plus 60s at 60% MVC) was requested to assess differences induced by the exhaustion sessions. During fatiguing tests surface EMG signals were recorded from biceps brachii muscle with linear arrays of eight electrodes (silver bars 10mm apart, 5mm long, and 1mm diameter) in single differential configuration. Initial values and rates of change of Average Rectified Value (ARV), MeaN power Frequency (MNF) and muscle fiber Conduction Velocity (CV) were calculated to compare the effects of the two contraction modalities. No differences were found between "elastic session" and "weight session" PRE MVCs (31.9±8.8 and 29.9±8.3nm, respectively) and endurance times (28±6 and 26±7s, respectively). The same was observed for POST values. During the post-contraction isometric fatigue test, the only parameters influenced by the contraction modality were the initial CV and the rate of change in CV which were 12% and 37% greater (p<0.05) respectively after contractions performed with elastic resistance compared to free weights. These findings confirm others for which contractions done with the use of elastic band seem to require greater muscle activation; moreover, they highlight a sort of "muscle conditioning" after that specific contraction modality which requires the use of faster motor units. It is thus possible to consider the practical use of such elastic devices to increase the neuromuscular activation, for instance in specific rehabilitation settings where slow movements with minimal risk of injury are requested (post surgery rehabilitation, physical activity with elderly people or children).

Muscle fatigue induced by two different resistances: elastic tubing versus weight machines

The aim of this study was to determine whether the rate of change of surface EMG variables during a constant force isometric fatiguing contraction (80% MVC, 30 s of duration) of vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles is able to distinguish between nine sprinters and nine long distance runners. Signals were recorded with linear arrays of eight electrodes. Muscle fiber conduction velocity (CV), mean frequency (MNF) of EMG signal power spectrum and average rectified value (ARV) of the EMG signal were calculated both from the whole signal (global approach) and from motor unit action potentials (MUAP distribution approach) extracted from the signal. Results showed significant differences only in the MUAP distribution approach. For this approach, the rates of change of conduction velocity (CV) (both absolute and normalized with respect to the initial value) were found to be always greater in the sprinter (VMO: −0.012 ± 0.011 m s −2 and −0.25 ± 0.21%/s; VL: −0.014 ± 0.009 m s −2 and −0.27 ± 0.17%/s) than in the long distance runner group (VMO: −0.004 ± 0.006 m s −2 and −0.08 ± 0.14%/s; VL: 0.003 ± 0.012 m s −2 and 0.08 ± 0.26%/s) (VL: p = 0.016, VMO: p = 0.034). No differences were observed in the CV initial values and in rates of change of MNF, while MNF initial values recorded from the VMO were found to be greater (119.6 ± 25.1 Hz) in the sprinter group than in the long distance runner group (99.2 ± 12.1 Hz, p = 0.016). A correlation was found between initial values and rates of change of CV in the VMO (r = 0.61, p < 0.01, N = 18, Spearman correlation coefficient). The consistency of these findings with the expected fiber type composition between sprinters and long distance runners and the identification of a set of candidated variables for the assessment

https://iopscience.iop.org/article/10.1088/0967-3334/29/3/004/pdf

Differences in myoelectric manifestations of fatigue in sprinters and long distance runners.

Simple Summary The bioelectrical phase angle is a raw parameter that can be utilized as an indicator of performance, muscle quantity and hydration status of cells. However, sex- and sport-specific phase angle reference percentiles are lacking for the athletic population. For the first time, this study provides 5th, 15th, 50th, 85th, and 95th reference percentiles for phase angle in male and female athletes practicing different sports. These reference values can be used to track body composition and performance related-outcomes in sports practice, while leveraging the portability of bioelectric impedance analysis. Abstract The present study aimed to develop reference values for bioelectrical phase angle in male and female athletes from different sports. Overall, 2224 subjects participated in this study [1658 males (age 26.2 ± 8.9 y) and 566 females (age 26.9 ± 6.6 y)]. Participants were categorized by their sport discipline and sorted into three different sport modalities: endurance, velocity/power, and team sports. Phase angle was directly measured using a foot-to-hand bioimpedance technology at a 50 kHz frequency during the in-season period. Reference percentiles (5th, 15th, 50th, 85th, and 95th) were calculated and stratified by sex, sport discipline and modality using an empirical Bayesian analysis. This method allows for the sharing of information between different groups, creating reference percentiles, even for sports disciplines with few observations. Phase angle differed (men: p < 0.001; women: p = 0.003) among the three sport modalities, where endurance athletes showed a lower value than the other groups (men: vs. velocity/power: p = 0.010, 95% CI = −0.43 to −0.04; vs. team sports: p < 0.001, 95% CI = −0.48 to −0.02; women: vs. velocity/power: p = 0.002, 95% CI = −0.59 to −0.10; vs. team sports: p = 0.015, 95% CI = −0.52 to −0.04). Male athletes showed a higher phase angle than female athletes within each sport modality (endurance: p < 0.01, 95% CI = 0.63 to 1.14; velocity/power: p < 0.01, 95% CI = 0.68 to 1.07; team sports: p < 0.01, 95% CI = 0.98 to 1.23). We derived phase angle reference percentiles for endurance, velocity/power, and team sports athletes. Additionally, we calculated sex-specific references for a total of 22 and 19 sport disciplines for male and female athletes, respectively. This study provides sex- and sport-specific percentiles for phase angle that can track body composition and performance-related parameters in athletes.

/pdf/reference-percentiles-for-bioelectrical-phase-angle-in-1tla3qri.pdf

G. Melchiorri

Papers

A method for positioning electrodes during surface EMG recordings in lower limb muscles.

Muscle fatigue induced by two different resistances: Elastic tubing versus weight machines

Muscle fatigue induced by two different resistances: elastic tubing versus weight machines

Differences in myoelectric manifestations of fatigue in sprinters and long distance runners.

Reference Percentiles for Bioelectrical Phase Angle in Athletes