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  1. Abd Aziz M, Hamzaid NA, Hasnan N
    J Vis Exp, 2022 Nov 11.
    PMID: 36440840 DOI: 10.3791/63149
    Execution of Sit-to-Stand (SitTS) in incomplete spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support, in particular, is a significant assistive factor while executing SitTS movement in SCI population. In addition, the application of functional electrical stimulation (FES) onto quadriceps and gluteus maximus muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower extremities during SitTS has not been thoroughly investigated. Two motor incomplete SCI paraplegics performed repetitive SitTS to fatigue exercise challenge. Their performance was investigated as a mixed-method case-control study comparing SitTS with and without the assistance of FES. Three sets of SitTS tests were completed with 5-min resting period allocated in between sets, with mechanomyography (MMG) sensors attached over the rectus femoris muscles bilaterally. The exercise was separated into 2 sessions; Day 1 for voluntary SitTS and Day 2 for FES-assisted SitTS. Questionnaires were conducted after every session to gather the participants' input about their repetitive SitTS experience. The analysis confirmed that a SitTS cycle could be divided into three phases; Phase 1 (Preparation to stand), Phase 2 (Seat-off), and Phase 3 (Initiation of hip extension), which contributed to 23% ± 7%, 16% ± 4% and 61% ± 6% of the SitTS cycle, respectively. The contribution of arms and legs during SitTS movement varied in different participants based on their legs' Medical Research Council (MRC) muscle grade. In particular, the applied arm forces start to increase clearly when the leg forces start to decline during standing. This finding is supported by the significantly reduced MMG signal indicating leg muscle fatigue and their reported feeling of tiredness.
    Matched MeSH terms: Muscle Fatigue/physiology
  2. Islam MA, Sundaraj K, Ahmad RB, Ahamed NU
    PLoS One, 2013;8(3):e58902.
    PMID: 23536834 DOI: 10.1371/journal.pone.0058902
    BACKGROUND: Mechanomyography (MMG) has been extensively applied in clinical and experimental practice to examine muscle characteristics including muscle function (MF), prosthesis and/or switch control, signal processing, physiological exercise, and medical rehabilitation. Despite several existing MMG studies of MF, there has not yet been a review of these. This study aimed to determine the current status on the use of MMG in measuring the conditions of MFs.

    METHODOLOGY/PRINCIPAL FINDINGS: Five electronic databases were extensively searched for potentially eligible studies published between 2003 and 2012. Two authors independently assessed selected articles using an MS-Word based form created for this review. Several domains (name of muscle, study type, sensor type, subject's types, muscle contraction, measured parameters, frequency range, hardware and software, signal processing and statistical analysis, results, applications, authors' conclusions and recommendations for future work) were extracted for further analysis. From a total of 2184 citations 119 were selected for full-text evaluation and 36 studies of MFs were identified. The systematic results find sufficient evidence that MMG may be used for assessing muscle fatigue, strength, and balance. This review also provides reason to believe that MMG may be used to examine muscle actions during movements and for monitoring muscle activities under various types of exercise paradigms.

    CONCLUSIONS/SIGNIFICANCE: Overall judging from the increasing number of articles in recent years, this review reports sufficient evidence that MMG is increasingly being used in different aspects of MF. Thus, MMG may be applied as a useful tool to examine diverse conditions of muscle activity. However, the existing studies which examined MMG for MFs were confined to a small sample size of healthy population. Therefore, future work is needed to investigate MMG, in examining MFs between a sufficient number of healthy subjects and neuromuscular patients.

    Matched MeSH terms: Muscle Fatigue/physiology
  3. Ibitoye MO, Hamzaid NA, Hasnan N, Abdul Wahab AK, Davis GM
    PLoS One, 2016;11(2):e0149024.
    PMID: 26859296 DOI: 10.1371/journal.pone.0149024
    BACKGROUND: Rapid muscle fatigue during functional electrical stimulation (FES)-evoked muscle contractions in individuals with spinal cord injury (SCI) is a significant limitation to attaining health benefits of FES-exercise. Delaying the onset of muscle fatigue is often cited as an important goal linked to FES clinical efficacy. Although the basic concept of fatigue-resistance has a long history, recent advances in biomedical engineering, physiotherapy and clinical exercise science have achieved improved clinical benefits, especially for reducing muscle fatigue during FES-exercise. This review evaluated the methodological quality of strategies underlying muscle fatigue-resistance that have been used to optimize FES therapeutic approaches. The review also sought to synthesize the effectiveness of these strategies for persons with SCI in order to establish their functional impacts and clinical relevance.

    METHODS: Published scientific literature pertaining to the reduction of FES-induced muscle fatigue was identified through searches of the following databases: Science Direct, Medline, IEEE Xplore, SpringerLink, PubMed and Nature, from the earliest returned record until June 2015. Titles and abstracts were screened to obtain 35 studies that met the inclusion criteria for this systematic review.

    RESULTS: Following the evaluation of methodological quality (mean (SD), 50 (6) %) of the reviewed studies using the Downs and Black scale, the largest treatment effects reported to reduce muscle fatigue mainly investigated isometric contractions of limited functional and clinical relevance (n = 28). Some investigations (n = 13) lacked randomisation, while others were characterised by small sample sizes with low statistical power. Nevertheless, the clinical significance of emerging trends to improve fatigue-resistance during FES included (i) optimizing electrode positioning, (ii) fine-tuning of stimulation patterns and other FES parameters, (iii) adjustments to the mode and frequency of exercise training, and (iv) biofeedback-assisted FES-exercise to promote selective recruitment of fatigue-resistant motor units.

    CONCLUSION: Although the need for further in-depth clinical trials (especially RCTs) was clearly warranted to establish external validity of outcomes, current evidence was sufficient to support the validity of certain techniques for rapid fatigue-reduction in order to promote FES therapy as an integral part of SCI rehabilitation. It is anticipated that this information will be valuable to clinicians and other allied health professionals administering FES as a treatment option in rehabilitation and aid the development of effective rehabilitation interventions.

    Matched MeSH terms: Muscle Fatigue/physiology*
  4. 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.

    Matched MeSH terms: Muscle Fatigue/physiology*
  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.
    Matched MeSH terms: Muscle Fatigue/physiology*
  6. 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.
    Matched MeSH terms: Muscle Fatigue/physiology
  7. Ajit Singh DK, Bailey M, Lee R
    Muscle Nerve, 2011 Jul;44(1):74-9.
    PMID: 21488056 DOI: 10.1002/mus.21998
    Loss of lumbar extensor muscle strength and fatigue resistance may contribute to functional disability.
    Matched MeSH terms: Muscle Fatigue/physiology*
  8. Zadry HR, Dawal SZ, Taha Z
    Int J Occup Saf Ergon, 2011;17(4):373-84.
    PMID: 22152503
    A study was conducted to investigate the effects of repetitive light tasks of low and high precision on upper limb muscles and brain activities. Surface electromyography (EMG) and electroencephalography (EEG) were used to measure the muscle and brain activity of 10 subjects. The results show that the root-mean-square (RMS) and mean power frquency (MPF) of the muscle activity and the mean power of the EEG alpha bands were higher on the high-precision task than on the low-precision one. There was also a high and significant correlation between upper limb muscle and brain activity during the tasks. The longer the time and the more precise the task, the more the subjects become fatigued both physically and mentally. Thus, these results could be potentially useful in managing fatigue, especially fatique related to muscle and mental workload.
    Matched MeSH terms: Muscle Fatigue/physiology
  9. Zadry HR, Dawal SZ, Taha Z
    Int J Occup Saf Ergon, 2016 Sep;22(3):374-83.
    PMID: 27053140 DOI: 10.1080/10803548.2016.1150094
    This study was conducted to develop muscle and mental activities on repetitive precision tasks. A laboratory experiment was used to address the objectives. Surface electromyography was used to measure muscle activities from eight upper limb muscles, while electroencephalography recorded mental activities from six channels. Fourteen university students participated in the study. The results show that muscle and mental activities increase for all tasks, indicating the occurrence of muscle and mental fatigue. A linear relationship between muscle activity, mental activity and time was found while subjects were performing the task. Thus, models were developed using those variables. The models were found valid after validation using other students' and workers' data. Findings from this study can contribute as a reference for future studies investigating muscle and mental activity and can be applied in industry as guidelines to manage muscle and mental fatigue, especially to manage job schedules and rotation.
    Matched MeSH terms: Muscle Fatigue/physiology
  10. Naeem J, Hamzaid NA, Islam MA, Azman AW, Bijak M
    Med Biol Eng Comput, 2019 Jun;57(6):1199-1211.
    PMID: 30687901 DOI: 10.1007/s11517-019-01949-4
    Patients with spinal cord injury (SCI) benefit from muscle training with functional electrical stimulation (FES). For safety reasons and to optimize training outcome, the fatigue state of the target muscle must be monitored. Detection of muscle fatigue from mel frequency cepstral coefficient (MFCC) feature of mechanomyographic (MMG) signal using support vector machine (SVM) classifier is a promising new approach. Five individuals with SCI performed FES cycling exercises for 30 min. MMG signals were recorded on the quadriceps muscle group (rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM)) and categorized into non-fatigued and fatigued muscle contractions for the first and last 10 min of the cycling session. For each subject, a total of 1800 contraction-related MMG signals were used to train the SVM classifier and another 300 signals were used for testing. The average classification accuracy (4-fold) of non-fatigued and fatigued state was 90.7% using MFCC feature, 74.5% using root mean square (RMS), and 88.8% with combined MFCC and RMS features. Inter-subject prediction accuracy suggested training and testing data to be based on a particular subject or large collection of subjects to improve fatigue prediction capacity. Graphical abstract ᅟ.
    Matched MeSH terms: Muscle Fatigue/physiology*
  11. Rahman IA, Mohamad N, Rohani JM, Zein RM
    Ind Health, 2018 Nov 21;56(6):492-499.
    PMID: 30210096 DOI: 10.2486/indhealth.2018-0043
    Prolonged standing can cause discomfort on the body of the workers and can lead to injury and occupational disease. One of the ergonomic intervention is through improving the work-rest scheduling. The purpose of this study are to identify the fatigue level from the perception of the worker and to investigate the impact of the work-rest scheduling to the standing workers for 12 h working time with a different gender. This study involved two methods which are self-assessment of the worker and direct measurement by using electromyography (EMG). For self-assessment, 80 workers have been interviewed using questionnaire in order to identify the fatigue level. For direct measurement, EMG was attached to the 15 selected workers at their respective leg and lower back to analyse the muscle efforts. In terms of perception, the results show the discomfort and fatigue level at the lower body region in the following order as foot ankle, lower back and leg. There is a significant difference between gender on discomfort pain for foot ankle and leg. The results show short frequent break by 10 min can reduce the fatigue at the leg and infrequent long break is preferable in order to reduce the fatigue at the lower back. In conclusion, it was found that prolonged standing affect the muscle fatigue and discomfort especially lower extremities such as foot ankle, lower back and leg. Besides that, different type of work rest scheduling and gender have significant result towards the muscle fatigue development.
    Matched MeSH terms: Muscle Fatigue/physiology*
  12. Glazier PS
    Hum Mov Sci, 2017 Dec;56(Pt A):139-156.
    PMID: 26725372 DOI: 10.1016/j.humov.2015.08.001
    Sports performance is generally considered to be governed by a range of interacting physiological, biomechanical, and psychological variables, amongst others. Despite sports performance being multi-factorial, however, the majority of performance-oriented sports science research has predominantly been monodisciplinary in nature, presumably due, at least in part, to the lack of a unifying theoretical framework required to integrate the various subdisciplines of sports science. In this target article, I propose a Grand Unified Theory (GUT) of sports performance-and, by elaboration, sports science-based around the constraints framework introduced originally by Newell (1986). A central tenet of this GUT is that, at both the intra- and inter-individual levels of analysis, patterns of coordination and control, which directly determine the performance outcome, emerge from the confluence of interacting organismic, environmental, and task constraints via the formation and self-organisation of coordinative structures. It is suggested that this GUT could be used to: foster interdisciplinary research collaborations; break down the silos that have developed in sports science and restore greater disciplinary balance to the field; promote a more holistic understanding of sports performance across all levels of analysis; increase explanatory power of applied research work; provide stronger rationale for data collection and variable selection; and direct the development of integrated performance monitoring technologies. This GUT could also provide a scientifically rigorous basis for integrating the subdisciplines of sports science in applied sports science support programmes adopted by high-performance agencies and national governing bodies for various individual and team sports.
    Matched MeSH terms: Muscle Fatigue/physiology
  13. 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.

    Matched MeSH terms: Muscle Fatigue/physiology*
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