Displaying publications 1 - 20 of 42 in total

Abstract:
Sort:
  1. Palaniappan R, Sundaraj K, Sundaraj S
    BMC Bioinformatics, 2014;15:223.
    PMID: 24970564 DOI: 10.1186/1471-2105-15-223
    Pulmonary acoustic parameters extracted from recorded respiratory sounds provide valuable information for the detection of respiratory pathologies. The automated analysis of pulmonary acoustic signals can serve as a differential diagnosis tool for medical professionals, a learning tool for medical students, and a self-management tool for patients. In this context, we intend to evaluate and compare the performance of the support vector machine (SVM) and K-nearest neighbour (K-nn) classifiers in diagnosis respiratory pathologies using respiratory sounds from R.A.L.E database.
  2. Palaniappan R, Sundaraj K, Sundaraj S, Huliraj N, Revadi SS
    Clin Respir J, 2016 Jul;10(4):486-94.
    PMID: 25515741 DOI: 10.1111/crj.12250
    BACKGROUND: Monitoring respiration is important in several medical applications. One such application is respiratory rate monitoring in patients with sleep apnoea. The respiratory rate in patients with sleep apnoea disorder is irregular compared with the controls. Respiratory phase detection is required for a proper monitoring of respiration in patients with sleep apnoea.

    AIMS: To develop a model to detect the respiratory phases present in the pulmonary acoustic signals and to evaluate the performance of the model in detecting the respiratory phases.

    METHODS: Normalised averaged power spectral density for each frame and change in normalised averaged power spectral density between the adjacent frames were fuzzified and fuzzy rules were formulated. The fuzzy inference system (FIS) was developed with both Mamdani and Sugeno methods. To evaluate the performance of both Mamdani and Sugeno methods, correlation coefficient and root mean square error (RMSE) were calculated.

    RESULTS: In the correlation coefficient analysis in evaluating the fuzzy model using Mamdani and Sugeno method, the strength of the correlation was found to be r = 0.9892 and r = 0.9964, respectively. The RMSE for Mamdani and Sugeno methods are RMSE = 0.0853 and RMSE = 0.0817, respectively.

    CONCLUSION: The correlation coefficient and the RMSE of the proposed fuzzy models in detecting the respiratory phases reveals that Sugeno method performs better compared with the Mamdani method.

  3. Talib I, Sundaraj K, Lam CK, Hussain J, Ali MA
    Eur J Appl Physiol, 2019 Jan;119(1):9-28.
    PMID: 30242464 DOI: 10.1007/s00421-018-3994-9
    PURPOSE: Crosstalk in myographic signals is a major hindrance to the understanding of local information related to individual muscle function. This review aims to analyse the problem of crosstalk in electromyography and mechanomyography.

    METHODS: An initial search of the SCOPUS database using an appropriate set of keywords yielded 290 studies, and 59 potential studies were selected after all the records were screened using the eligibility criteria. This review on crosstalk revealed that signal contamination due to crosstalk remains a major challenge in the application of surface myography techniques. Various methods have been employed in previous studies to identify, quantify and reduce crosstalk in surface myographic signals.

    RESULTS: Although correlation-based methods for crosstalk quantification are easy to use, there is a possibility that co-contraction could be interpreted as crosstalk. High-definition EMG has emerged as a new technique that has been successfully applied to reduce crosstalk.

    CONCLUSIONS: The phenomenon of crosstalk needs to be investigated carefully because it depends on many factors related to muscle task and physiology. This review article not only provides a good summary of the literature on crosstalk in myographic signals but also discusses new directions related to techniques for crosstalk identification, quantification and reduction. The review also provides insights into muscle-related issues that impact crosstalk in myographic signals.

  4. Shaharum SM, Sundaraj K, Palaniappan R
    Bosn J Basic Med Sci, 2012 Nov;12(4):249-55.
    PMID: 23198941
    The purpose of this paper is to present an evidence of automated wheeze detection system by a survey that can be very beneficial for asthmatic patients. Generally, for detecting asthma in a patient, stethoscope is used for ascertaining wheezes present. This causes a major problem nowadays because a number of patients tend to delay the interpretation time, which can lead to misinterpretations and in some worst cases to death. Therefore, the development of automated system would ease the burden of medical personnel. A further discussion on automated wheezes detection system will be presented later in the paper. As for the methodology, a systematic search of articles published as early as 1985 to 2012 was conducted. Important details including the hardware used, placement of hardware, and signal processing methods have been presented clearly thus hope to help and encourage future researchers to develop commercial system that will improve the diagnosing and monitoring of asthmatic patients.
  5. Talib I, Sundaraj K, Lam CK, Sundaraj S
    J Musculoskelet Neuronal Interact, 2018 12 01;18(4):446-462.
    PMID: 30511949
    This systematic review aims to categorically analyses the literature on the assessment of biceps brachii (BB) muscle activity through mechanomyography (MMG). The application of our search criteria to five different databases identified 319 studies. A critical review of the 48 finally selected records, revealed the diversity of protocols and parameters that are employed in MMG-based assessments of BB muscle activity. The observations were categorized into the following: muscle torque, fatigue, strength and physiology. The available information on the muscle contraction protocol, sensor(s), MMG signal parameters and obtained results were then tabulated based on these categories for further analysis. The review affirms that - 1) MMG is suitable for skeletal muscle activity assessment and can be employed potentially for further investigation of the BB muscle activity and condition (e.g., force, torque, fatigue, and contractile properties), 2) a majority of the records focused on static contractions of the BB, and the analysis of dynamic muscle contractions using MMG is thus a research gap, and 3) very few studies have focused on the analysis of BB muscle activity under externally stimulated contractions. Taken together, the findings of this review on BB activity assessment using MMG affirm the potential of MMG as an alternative tool.
  6. Lam CK, Sundaraj K, Sulaiman MN
    Medicina (Kaunas), 2013;49(1):1-8.
    PMID: 23652710
    The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training.
  7. Palaniappan R, Sundaraj K, Sundaraj S
    Comput Methods Programs Biomed, 2017 Jul;145:67-72.
    PMID: 28552127 DOI: 10.1016/j.cmpb.2017.04.013
    BACKGROUND: The monitoring of the respiratory rate is vital in several medical conditions, including sleep apnea because patients with sleep apnea exhibit an irregular respiratory rate compared with controls. Therefore, monitoring the respiratory rate by detecting the different breath phases is crucial.

    OBJECTIVES: This study aimed to segment the breath cycles from pulmonary acoustic signals using the newly developed adaptive neuro-fuzzy inference system (ANFIS) based on breath phase detection and to subsequently evaluate the performance of the system.

    METHODS: The normalised averaged power spectral density for each segment was fuzzified, and a set of fuzzy rules was formulated. The ANFIS was developed to detect the breath phases and subsequently perform breath cycle segmentation. To evaluate the performance of the proposed method, the root mean square error (RMSE) and correlation coefficient values were calculated and analysed, and the proposed method was then validated using data collected at KIMS Hospital and the RALE standard dataset.

    RESULTS: The analysis of the correlation coefficient of the neuro-fuzzy model, which was performed to evaluate its performance, revealed a correlation strength of r = 0.9925, and the RMSE for the neuro-fuzzy model was found to equal 0.0069.

    CONCLUSION: The proposed neuro-fuzzy model performs better than the fuzzy inference system (FIS) in detecting the breath phases and segmenting the breath cycles and requires less rules than FIS.

  8. Talib I, Sundaraj K, Hussain J, Lam CK, Ahmad Z
    Sci Rep, 2022 Sep 27;12(1):16086.
    PMID: 36168025 DOI: 10.1038/s41598-022-20223-6
    This study aimed to analyze anthropometrics and mechanomyography (MMG) signals as forearm flexion, pronation, and supination torque predictors. 25 young, healthy, male participants performed isometric forearm flexion, pronation, and supination tasks from 20 to 100% maximal voluntary isometric contraction (MVIC) while maintaining 90° at the elbow joint. Nine anthropometric measures were recorded, and MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were digitally acquired using triaxial accelerometers. These were then correlated with torque values. Significant positive correlations were found for arm circumference (CA) and MMG root mean square (RMS) values with flexion torque. Flexion torque might be predicted using CA (r = 0.426-0.575), a pseudo for muscle size while MMGRMS (r = 0.441), an indication of muscle activation.
  9. Islam A, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA
    Muscle Nerve, 2015 Jun;51(6):899-906.
    PMID: 25204740 DOI: 10.1002/mus.24454
    In this study, we analyzed the crosstalk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles of the forearm during wrist flexion (WF) and extension (WE) and radial (RD) and ulnar (UD) deviations.
  10. Hussain J, Sundaraj K, Subramaniam ID, Lam CK
    J Musculoskelet Neuronal Interact, 2019 09 01;19(3):276-285.
    PMID: 31475934
    OBJECTIVE: The objective of this study was to investigate fatigue in the three heads of the triceps brachii (TB) muscle using surface electromyography (sEMG) obtained at 30%, 45% and 60% of maximal voluntary contraction (MVC).

    METHODS: Twenty-five subjects performed isometric elbow extension until failure, and the rate of fatigue (ROF), time to fatigue (TTF) and normalized TTF (NTTF) were statistically analysed. Subsequently, the behaviour of root-mean-square (RMS), mean-power frequency (MPF) and median-power frequency (MDF) under pre-, onset- and post-fatigue conditions were compared.

    RESULTS: The findings indicated that, among the heads, ROF was statistically significant at 30% and 45% MVC (P<0.05) but TTF and NTTF at all intensities was statistically insignificant (P>0.05). For every head, only TTF was statistically significant (P<0.05) at different intensities. MPF and MDF under pre-, onset- and post-fatigue conditions were statistically significant (P<0.05) among the heads at all intensities, whereas RMS showed no such behaviour.

    CONCLUSION: The investigated parameters reveal that the three heads of TB act independently before fatigue onset and appear to work in union after fatigue. Synergist head pairs exhibit similar spectral and temporal behaviour in contrast to the non-synergist TB head pair. We find spectral parameters to be more specific predictors of fatigue.

  11. Talib I, Sundaraj K, Lam CK
    J Musculoskelet Neuronal Interact, 2020 06 01;20(2):194-205.
    PMID: 32481235
    OBJECTIVE: To analyse the influence of muscle fibre axis on the degree of crosstalk in mechanomyographic (MMG) signals during sustained isometric forearm flexion, pronation and supination exercises performed at 80% maximum voluntary contraction (MVC) at an elbow joint angle of 90°.

    METHODS: MMG signals in longitudinal, lateral and transverse directions of muscle fibres were recorded from the elbow flexors of twenty-five male subjects using triaxial accelerometers. Cross-correlation coefficients were used to quantify the degree of crosstalk in all nine possible pairs of fibre axes, all muscle pairs and all exercises.

    RESULTS: MMG root mean square (RMS) was statistically significant among the fibre axes (p<0.05, η2=0.17- 0.34) except for biceps brachii and brachioradialis in supination and brachialis in flexion. Overall mean crosstalk values in the three muscle pairs (biceps brachii & brachialis, brachialis & brachioradialis and brachioradialis & biceps brachii) were found to be 6.09-52.17%, 4.01-61.42% and 2.16-51.85%, respectively. Crosstalk values showed statistical significance among all nine axes pairs (p<0.05, η2=0.16-0.51) except for biceps brachii & brachialis during pronation. The transverse axes pair generated the lowest mean crosstalk values (2.16-9.14%).

    CONCLUSION: MMG signals recorded using accelerometers from the transverse axes of muscle fibres in the elbow flexors are unique and yield the least amount of crosstalk.

  12. Nabi FG, Sundaraj K, Lam CK, Palaniappan R
    J Asthma, 2020 04;57(4):353-365.
    PMID: 30810448 DOI: 10.1080/02770903.2019.1576193
    Objective: This study aimed to statistically analyze the behavior of time-frequency features in digital recordings of wheeze sounds obtained from patients with various levels of asthma severity (mild, moderate, and severe), and this analysis was based on the auscultation location and/or breath phase. Method: Segmented and validated wheeze sounds were collected from the trachea and lower lung base (LLB) of 55 asthmatic patients during tidal breathing maneuvers and grouped into nine different datasets. The quartile frequencies F25, F50, F75, F90 and F99, mean frequency (MF) and average power (AP) were computed as features, and a univariate statistical analysis was then performed to analyze the behavior of the time-frequency features. Results: All features generally showed statistical significance in most of the datasets for all severity levels [χ2 = 6.021-71.65, p 
  13. Uwamahoro R, Sundaraj K, Subramaniam ID
    Biomed Eng Online, 2021 Jan 03;20(1):1.
    PMID: 33390158 DOI: 10.1186/s12938-020-00840-w
    This research has proved that mechanomyographic (MMG) signals can be used for evaluating muscle performance. Stimulation of the lost physiological functions of a muscle using an electrical signal has been determined crucial in clinical and experimental settings in which voluntary contraction fails in stimulating specific muscles. Previous studies have already indicated that characterizing contractile properties of muscles using MMG through neuromuscular electrical stimulation (NMES) showed excellent reliability. Thus, this review highlights the use of MMG signals on evaluating skeletal muscles under electrical stimulation. In total, 336 original articles were identified from the Scopus and SpringerLink electronic databases using search keywords for studies published between 2000 and 2020, and their eligibility for inclusion in this review has been screened using various inclusion criteria. After screening, 62 studies remained for analysis, with two additional articles from the bibliography, were categorized into the following: (1) fatigue, (2) torque, (3) force, (4) stiffness, (5) electrode development, (6) reliability of MMG and NMES approaches, and (7) validation of these techniques in clinical monitoring. This review has found that MMG through NMES provides feature factors for muscle activity assessment, highlighting standardized electromyostimulation and MMG parameters from different experimental protocols. Despite the evidence of mathematical computations in quantifying MMG along with NMES, the requirement of the processing speed, and fluctuation of MMG signals influence the technique to be prone to errors. Interestingly, although this review does not focus on machine learning, there are only few studies that have adopted it as an alternative to statistical analysis in the assessment of muscle fatigue, torque, and force. The results confirm the need for further investigation on the use of sophisticated computations of features of MMG signals from electrically stimulated muscles in muscle function assessment and assistive technology such as prosthetics control.
  14. Talib I, Sundaraj K, Lam CK
    Sci Rep, 2019 11 07;9(1):16166.
    PMID: 31700129 DOI: 10.1038/s41598-019-52536-4
    This study aimed to quantify the association of four anthropometric parameters of the human arm, namely, the arm circumference (CA), arm length (LA), skinfold thickness (ST) and inter-sensor distance (ISD), with amplitude (RMS) and crosstalk (CT) of mechanomyography (MMG) signals. Twenty-five young, healthy, male participants were recruited to perform forearm flexion, pronation and supination torque tasks. Three accelerometers were employed to record the MMG signals from the biceps brachii (BB), brachialis (BRA) and brachioradialis (BRD) at 80% maximal voluntary contraction (MVC). Signal RMS was used to quantify the amplitude of the MMG signals from a muscle, and cross-correlation coefficients were used to quantify the magnitude of the CT among muscle pairs (BB & BRA, BRA & BRD, and BB & BRD). For all investigated muscles and pairs, RMS and CT showed negligible to low negative correlations with CA, LA and ISD (r = -0.0001--0.4611), and negligible to moderate positive correlations with ST (r = 0.004-0.511). However, almost all of these correlations were statistically insignificant (p > 0.05). These findings suggest that RMS and CT values for the elbow flexor muscles recorded and quantified using accelerometers appear invariant to anthropometric parameters.
  15. Nabi FG, Sundaraj K, Lam CK
    J Pak Med Assoc, 2021 Jan;71(1(A)):41-46.
    PMID: 33484516 DOI: 10.47391/JPMA.156
    OBJECTIVE: Breath sound has information about underlying pathology and condition of subjects. The purpose of this study was to examine asthmatic acuteness levels (Mild, Moderate, Severe) using frequency features extracted from wheeze sounds. Further, analysis was extended to observe behaviour of wheeze sounds in different datasets.

    METHODS: Segmented and validated wheeze sounds was collected from 55 asthmatic patients from the trachea and lower lung base (LLB) during tidal breathing maneuvers. Segmented wheeze sounds have been grouped in to nine datasets based on auscultation location, breath phases and a combination of phase and location. Frequency based features F25, F50, F75, F90, F99 and mean frequency (MF) were calculated from normalized power spectrum. Subsequently, multivariate analysis was performed.

    RESULTS: Generally frequency features observe statistical significance (p < 0.05) for the majority of datasets to differentiate severity level Ʌ = 0.432-0.939, F(12, 196-1534) = 2.731-11.196, p < 0.05, ɳ2 = 0.061-0.568. It was observed that selected features performed better (higher effect size) for trachea related samples Ʌ = 0.432-0.620, F(12, 196-498) = 6.575-11.196, p < 0.05, ɳ2 = 0.386-0.568.

    CONCLUSIONS: The results demonstrated dthat severity levels of asthmatic patients with tidal breathing can be identified through computerized wheeze sound analysis. In general, auscultation location and breath phases produce wheeze sounds with different characteristics.

  16. Nabi FG, Sundaraj K, Lam CK, Palaniappan R
    Comput Biol Med, 2019 01;104:52-61.
    PMID: 30439599 DOI: 10.1016/j.compbiomed.2018.10.035
    OBJECTIVE: This study aimed to investigate and classify wheeze sounds of asthmatic patients according to their severity level (mild, moderate and severe) using spectral integrated (SI) features.

    METHOD: Segmented and validated wheeze sounds were obtained from auscultation recordings of the trachea and lower lung base of 55 asthmatic patients during tidal breathing manoeuvres. The segments were multi-labelled into 9 groups based on the auscultation location and/or breath phases. Bandwidths were selected based on the physiology, and a corresponding SI feature was computed for each segment. Univariate and multivariate statistical analyses were then performed to investigate the discriminatory behaviour of the features with respect to the severity levels in the various groups. The asthmatic severity levels in the groups were then classified using the ensemble (ENS), support vector machine (SVM) and k-nearest neighbour (KNN) methods.

    RESULTS AND CONCLUSION: All statistical comparisons exhibited a significant difference (p 

  17. Hussain J, Sundaraj K, Subramaniam ID
    PLoS One, 2020;15(1):e0228089.
    PMID: 31999750 DOI: 10.1371/journal.pone.0228089
    INTRODUCTION: Cognitive stress (CS) changes the peripheral attributes of a muscle, but its effect on multi-head muscles has not been investigated. The objective of the current research was to investigate the impact of CS on the three heads of the triceps brachii (TB) muscle.

    METHODS: Twenty-five young and healthy university students performed a triceps push-down exercise at 45% one repetition maximum (1RM) with and without CS until task failure, and the rate of fatigue (ROF), endurance time (ET) and number of repetitions (NR) for both exercises were analyzed. In addition, the first and last six repetitions of each exercise were considered non-fatiguing (NF) and fatiguing (Fa), respectively, and the root mean square (RMS), mean power frequency (MPF) and median frequency (MDF) for each exercise repetition were evaluated.

    RESULTS: The lateral and long head showed significant differences (P<0.05) in the ROF between the two exercises, and all the heads showed significant (P<0.05) differences in the RMS between the two exercises under NF conditions. Only the long head showed a significant difference (P<0.05) in the MPF and MDF between the two exercises. CS increases the ET (24.74%) and NR (27%) of the exercise. The three heads showed significant differences (P<0.05) in the RMS, MPF and MDF under all exercise conditions.

    CONCLUSION: A lower ROF was obtained with CS. In addition, the RMS was found to be better approximator of CS, whereas MPF and MDF were more resistant to the effect of CS. The results showed that the three heads worked independently under all conditions, and the non-synergist and synergist head pairs showed similar behavior under Fa conditions. The findings from this study provide additional insights regarding the functioning of each TB head.

  18. Islam MA, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA
    PLoS One, 2014;9(5):e96628.
    PMID: 24802858 DOI: 10.1371/journal.pone.0096628
    This study aimed: i) to examine the relationship between the magnitude of cross-talk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles with the sub-maximal to maximal isometric grip force, and with the anthropometric parameters of the forearm, and ii) to quantify the distribution of the cross-talk in the MMG signal to determine if it appears due to the signal component of intramuscular pressure waves produced by the muscle fibers geometrical changes or due to the limb tremor.
  19. Talib I, Sundaraj K, Lam CK
    J Biomech Eng, 2021 01 01;143(1).
    PMID: 32691054 DOI: 10.1115/1.4047850
    This study analyzed the crosstalk in mechanomyographic (MMG) signals from elbow flexors during isometric muscle actions from 20% to 100% maximum voluntary isometric contraction (MVIC). Twenty-five young, healthy, male participants performed the isometric elbow flexion, forearm pronation, and supination tasks at an elbow joint angle of 90 deg. The MMG signals from the biceps brachii (BB), brachialis (BRA), and brachioradialis (BRD) muscles were recorded using accelerometers. The cross-correlation coefficient was used to quantify the crosstalk in MMG signals, recorded in a direction transverse to muscle fiber axis, among the muscle pairs (P1: BB and BRA, P2: BRA and BRD, and P3: BB and BRD). In addition, the MMG RMS and MPF were quantified. The mean normalized RMS and mean MPF exhibited increasing (r > 0.900) and decreasing (r 
  20. Ahamed NU, Sundaraj K, Poo TS
    Proc Inst Mech Eng H, 2013 Mar;227(3):262-74.
    PMID: 23662342
    This article describes the design of a robust, inexpensive, easy-to-use, small, and portable online electromyography acquisition system for monitoring electromyography signals during rehabilitation. This single-channel (one-muscle) system was connected via the universal serial bus port to a programmable Windows operating system handheld tablet personal computer for storage and analysis of the data by the end user. The raw electromyography signals were amplified in order to convert them to an observable scale. The inherent noise of 50 Hz (Malaysia) from power lines electromagnetic interference was then eliminated using a single-hybrid IC notch filter. These signals were sampled by a signal processing module and converted into 24-bit digital data. An algorithm was developed and programmed to transmit the digital data to the computer, where it was reassembled and displayed in the computer using software. Finally, the following device was furnished with the graphical user interface to display the online muscle strength streaming signal in a handheld tablet personal computer. This battery-operated system was tested on the biceps brachii muscles of 20 healthy subjects, and the results were compared to those obtained with a commercial single-channel (one-muscle) electromyography acquisition system. The results obtained using the developed device when compared to those obtained from a commercially available physiological signal monitoring system for activities involving muscle contractions were found to be comparable (the comparison of various statistical parameters) between male and female subjects. In addition, the key advantage of this developed system over the conventional desktop personal computer-based acquisition systems is its portability due to the use of a tablet personal computer in which the results are accessible graphically as well as stored in text (comma-separated value) form.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links