Effect of Forearm Postures and Elbow Joint Angles on Elbow Flexion Torque and Mechanomyography in Neuromuscular Electrical Stimulation of the Biceps Brachii

Neuromuscular electrical stimulation plays a pivotal role in rehabilitating muscle function among individuals with neurological impairment. However, there remains uncertainty regarding whether the muscle’s response to electrical excitation is affected by forearm posture, joint angle, or a combinatio...

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Bibliographic Details
Main Authors: Raphael Uwamahoro, Kenneth Sundaraj, Farah Shahnaz Feroz
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Sensors
Subjects:
Online Access:https://www.mdpi.com/1424-8220/23/19/8165
Description
Summary:Neuromuscular electrical stimulation plays a pivotal role in rehabilitating muscle function among individuals with neurological impairment. However, there remains uncertainty regarding whether the muscle’s response to electrical excitation is affected by forearm posture, joint angle, or a combination of both factors. This study aimed to investigate the effects of forearm postures and elbow joint angles on the muscle torque and MMG signals. Measurements of the torque around the elbow and MMG of the biceps brachii (BB) muscle were conducted in 36 healthy subjects (age, 22.24 ± 2.94 years; height, 172 ± 0.5 cm; and weight, 67.01 ± 7.22 kg) using an in-house elbow flexion testbed and neuromuscular electrical stimulation (NMES) of the BB muscle. The BB muscle was stimulated while the forearm was positioned in the neutral, pronation, or supination positions. The elbow was flexed at angles of 10°, 30°, 60°, and 90°. The study analyzed the impact of the forearm posture(s) and elbow joint angle(s) on the root-mean-square value of the torque (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">T</mi><mi mathvariant="normal">Q</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula>). Subsequently, various MMG parameters, such as the root-mean-square value (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula>), the mean power frequency (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">P</mi><mi mathvariant="normal">F</mi></mrow></msub><mo>)</mo></mrow></semantics></math></inline-formula>, and the median frequency (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">D</mi><mi mathvariant="normal">F</mi></mrow></msub></mrow></semantics></math></inline-formula>), were analyzed along the longitudinal, lateral, and transverse axes of the BB muscle fibers. The test–retest interclass correlation coefficient (ICC<sub>21</sub>) for the torque and MMG ranged from 0.522 to 0.828. Repeated-measure ANOVAs showed that the forearm posture and elbow flexion angle significantly influenced the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">T</mi><mi mathvariant="normal">Q</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula> (<i>p</i> < 0.05). Similarly, the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula>, <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">P</mi><mi mathvariant="normal">F</mi></mrow></msub></mrow></semantics></math></inline-formula>, and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">D</mi><mi mathvariant="normal">F</mi></mrow></msub></mrow></semantics></math></inline-formula> showed significant differences among all the postures and angles (<i>p</i> < 0.05). However, the combined main effect of the forearm posture and elbow joint angle was insignificant along the longitudinal axis (<i>p</i> > 0.05). The study also found that the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula> and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">T</mi><mi mathvariant="normal">Q</mi></mrow><mrow><mi mathvariant="normal">R</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">S</mi></mrow></msub></mrow></semantics></math></inline-formula> increased with increases in the joint angle from 10° to 60° and decreased at greater angles. However, during this investigation, the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">P</mi><mi mathvariant="normal">F</mi></mrow></msub></mrow></semantics></math></inline-formula> and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">M</mi><mi mathvariant="normal">G</mi></mrow><mrow><mi mathvariant="normal">M</mi><mi mathvariant="normal">D</mi><mi mathvariant="normal">F</mi></mrow></msub></mrow></semantics></math></inline-formula> exhibited a consistent decrease in response to increases in the joint angle for the lateral and transverse axes of the BB muscle. These findings suggest that the muscle contraction evoked by NMES may be influenced by the interplay between actin and myosin filaments, which are responsible for muscle contraction and are, in turn, influenced by the muscle length. Because restoring the function of limbs is a common goal in rehabilitation services, the use of MMG in the development of methods that may enable the real-time tracking of exact muscle dimensional changes and activation levels is imperative.
ISSN:1424-8220