Displaying publications 21 - 32 of 32 in total

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  1. Ibitoye MO, Hamzaid NA, Zuniga JM, Abdul Wahab AK
    Clin Biomech (Bristol, Avon), 2014 Jun;29(6):691-704.
    PMID: 24856875 DOI: 10.1016/j.clinbiomech.2014.04.003
    Previous studies have explored to saturation the efficacy of the conventional signal (such as electromyogram) for muscle function assessment and found its clinical impact limited. Increasing demand for reliable muscle function assessment modalities continues to prompt further investigation into other complementary alternatives. Application of mechanomyographic signal to quantify muscle performance has been proposed due to its inherent mechanical nature and ability to assess muscle function non-invasively while preserving muscular neurophysiologic information. Mechanomyogram is gaining accelerated applications in evaluating the properties of muscle under voluntary and evoked muscle contraction with prospects in clinical practices. As a complementary modality and the mechanical counterpart to electromyogram; mechanomyogram has gained significant acceptance in analysis of isometric and dynamic muscle actions. Substantial studies have also documented the effectiveness of mechanomyographic signal to assess muscle performance but none involved comprehensive appraisal of the state of the art applications with highlights on the future prospect and potential integration into the clinical practices. Motivated by the dearth of such critical review, we assessed the literature to investigate its principle of acquisition, current applications, challenges and future directions. Based on our findings, the importance of rigorous scientific and clinical validation of the signal is highlighted. It is also evident that as a robust complement to electromyogram, mechanomyographic signal may possess unprecedented potentials and further investigation will be enlightening.
  2. Naeem J, Hamzaid NA, Azman AW, Bijak M
    Biomed Tech (Berl), 2020 Aug 27;65(4):461-468.
    PMID: 32304295 DOI: 10.1515/bmt-2019-0191
    Functional electrical stimulation (FES) has been used to produce force-related activities on the paralyzed muscle among spinal cord injury (SCI) individuals. Early muscle fatigue is an issue in all FES applications. If not properly monitored, overstimulation can occur, which can lead to muscle damage. A real-time mechanomyography (MMG)-based FES system was implemented on the quadriceps muscles of three individuals with SCI to generate an isometric force on both legs. Three threshold drop levels of MMG-root mean square (MMG-RMS) feature (thr50, thr60, and thr70; representing 50%, 60%, and 70% drop from initial MMG-RMS values, respectively) were used to terminate the stimulation session. The mean stimulation time increased when the MMG-RMS drop threshold increased (thr50: 22.7 s, thr60: 25.7 s, and thr70: 27.3 s), indicating longer sessions when lower performance drop was allowed. Moreover, at thr70, the torque dropped below 50% from the initial value in 14 trials, more than at thr50 and thr60. This is a clear indication of muscle fatigue detection using the MMG-RMS value. The stimulation time at thr70 was significantly longer (p = 0.013) than that at thr50. The results demonstrated that a real-time MMG-based FES monitoring system has the potential to prevent the onset of critical muscle fatigue in individuals with SCI in prolonged FES sessions.
  3. Dzulkifli MA, Hamzaid NA, Davis GM, Hasnan N
    Front Neurorobot, 2018;12:50.
    PMID: 30147650 DOI: 10.3389/fnbot.2018.00050
    This study sought to design and deploy a torque monitoring system using an artificial neural network (ANN) with mechanomyography (MMG) for situations where muscle torque cannot be independently quantified. The MMG signals from the quadriceps were used to derive knee torque during prolonged functional electrical stimulation (FES)-assisted isometric knee extensions and during standing in spinal cord injured (SCI) individuals. Three individuals with motor-complete SCI performed FES-evoked isometric quadriceps contractions on a Biodex dynamometer at 30° knee angle and at a fixed stimulation current, until the torque had declined to a minimum required for ANN model development. Two ANN models were developed based on different inputs; Root mean square (RMS) MMG and RMS-Zero crossing (ZC) which were derived from MMG. The performance of the ANN was evaluated by comparing model predicted torque against the actual torque derived from the dynamometer. MMG data from 5 other individuals with SCI who performed FES-evoked standing to fatigue-failure were used to validate the RMS and RMS-ZC ANN models. RMS and RMS-ZC of the MMG obtained from the FES standing experiments were then provided as inputs to the developed ANN models to calculate the predicted torque during the FES-evoked standing. The average correlation between the knee extension-predicted torque and the actual torque outputs were 0.87 ± 0.11 for RMS and 0.84 ± 0.13 for RMS-ZC. The average accuracy was 79 ± 14% for RMS and 86 ± 11% for RMS-ZC. The two models revealed significant trends in torque decrease, both suggesting a critical point around 50% torque drop where there were significant changes observed in RMS and RMS-ZC patterns. Based on these findings, both RMS and RMS-ZC ANN models performed similarly well in predicting FES-evoked knee extension torques in this population. However, interference was observed in the RMS-ZC values at a time around knee buckling. The developed ANN models could be used to estimate muscle torque in real-time, thereby providing safer automated FES control of standing in persons with motor-complete SCI.
  4. Abu Bakar AR, Lai KW, Hamzaid NA
    Neurosci Lett, 2021 11 20;765:136250.
    PMID: 34536511 DOI: 10.1016/j.neulet.2021.136250
    Hearing loss is a common neurodegenerative disease that can start at any stage of life. Misalignment of the auditory neural impairment may impose challenges in processing incoming auditory stimulus that can be measured using electroencephalography (EEG). The electrophysiological behaviour response emanated from EEG auditory evoked potential (AEP) requires highly trained professionals for analysis and interpretation. Reliable automated methods using techniques of machine learning would assist the auditory assessment process for informed treatment and practice. It is thus highly required to develop models that are more efficient and precise by considering the characteristics of brain signals. This study aims to provide a comprehensive review of several state-of-the-art techniques of machine learning that adopt EEG evoked response for the auditory assessment within the last 13 years. Out of 161 initially screened articles, 11 were retained for synthesis. The outcome of the review presented that the Support Vector Machine (SVM) classifier outperformed with over 80% accuracy metric and was recognized as the best suited model within the field of auditory research. This paper discussed the comprehensive iterative properties of the proposed computed algorithms and the feasible future direction in hearing impaired rehabilitation.
  5. Hamdan PNF, Hamzaid NA, Abd Razak NA, Hasnan N
    J Sport Health Sci, 2022 Nov;11(6):671-680.
    PMID: 33068748 DOI: 10.1016/j.jshs.2020.10.002
    BACKGROUND: Due to its clinically proven safety and health benefits, functional electrical stimulation (FES) cycling has become a popular exercise modality for individuals with spinal cord injury (SCI). Since its inception in 2013, the Cybathlon championship has been a platform for publicizing the potential of FES cycling in rehabilitation and exercise for individuals with SCI. This study aimed to evaluate the contribution of the Cybathlon championship to the literature on FES cycling for individuals with SCI 3 years pre and post the staging of the Cybathlon championship in 2016.

    METHODS: Web of Science, Scopus, ScienceDirect, IEEE Xplore, and Google Scholar databases were searched for relevant studies published between January 2013 and July 2019. The quality of the included studies was objectively evaluated using the Downs and Black checklist.

    RESULTS: A total of 129 articles on FES cycling were retained for analysis. A total of 51 articles related to Cybathlon were reviewed, and 14 articles were ultimately evaluated for the quality. In 2017, the year following the Cybathlon championship, Web of Science cited 23 published studies on the championship, which was almost 5-fold more than that in 2016 (n = 5). Training was most often reported as a topic of interest in these studies, which mostly (76.7%) highlighted the training parameters of interest to participating teams in their effort to maximize their FES cycling performance during the Cybathlon championship.

    CONCLUSION: The present study indicates that the Cybathlon championship in 2016 contributed to the number of literature published in 2017 on FES cycling for individuals with SCI. This finding may contribute to the lessons that can be learned from participation in the Cybathlon and potentially provide additional insights into research in the field of race-based FES cycling.

  6. Rosley N, Hasnan N, Hamzaid NA, Davis GM, Manaf H
    Turk J Phys Med Rehabil, 2023 Mar;69(1):23-30.
    PMID: 37201013 DOI: 10.5606/tftrd.2023.9418
    OBJECTIVES: This study was conducted to investigate the effects of combined progressive resistance training (PRT) and functional electrical stimulation-evoked leg cycling exercise (FES-LCE) on isometric peak torque and muscle volume in individuals with incomplete spinal cord injury.

    PATIENTS AND METHODS: In the single-blind, randomized controlled trial performed between April 2015 and August 2016, 28 participants were randomized between two exercise interventions (FES-LCE+PRT and FES-LCE alone), and training was conducted over 12 weeks. The isometric muscle peak torque and muscle volume for both lower limbs were measured at the baseline and after 6 and 12 weeks. Linear mixed-model analysis of variance was performed to test the effects of FES-LCE+PRT versus FES-LCE on each outcome measure over time via an intention-to-treat analysis.

    RESULTS: Twenty-three participants (18 males, 5 females; mean age: 33.4±9.7 years; range 21 to 50 years) completed study (10 in the FES-LCE+PRT group, and 13 in the FES-LCE group). The 12-week pre-and posttraining change for left hamstrings' muscle peak torque in the FES-LCE+PRT group (mean difference=4.5±7.9 Nm, 45% change, p<0.05) was consistently higher than that in the FES-LCE group (mean difference=2.4±10.3 Nm, 4% change; p<0.018). The improvement in the right quadriceps muscle's peak torque of the FES-LCE+PRT group (mean difference=19±7.6 Nm, 31% change, p<0.05) was more significant compared to the FES-LCE group. The left muscle volume showed a remarkable increase after 12 weeks in the FES-LCE+PRT group (mean difference=0.3±9.3 L, 7% change, p<0.05).

    CONCLUSION: The combination of PRT and FES-LCE was better in improving lower limb muscle strength and volume in chronic incomplete individuals with spinal cord injury.

  7. Ramli MI, Hamzaid NA, Engkasan JP, Usman J
    Biomed Eng Online, 2023 May 22;22(1):50.
    PMID: 37217941 DOI: 10.1186/s12938-023-01103-0
    BACKGROUND: Over the decades, many publications have established respiratory muscle training (RMT) as an effective way in improving respiratory dysfunction in multiple populations. The aim of the paper is to determine the trend of research and multidisciplinary collaboration in publications related to RMT over the last 6 decades. The authors also sought to chart the advancement of RMT among people with spinal cord injury (SCI) over the last 60 years.

    METHODS: Bibliometric analysis was made, including the publications' profiles, citation analysis and research trends of the relevant literature over the last 60 years. Publications from all time frames were retrieved from Scopus database. A subgroup analysis of publications pertinent to people with SCI was also made.

    RESULTS: Research on RMT has been steadily increasing over the last 6 decades and across geographical locations. While medicine continues to dominate the research on RMT, this topic also continues to attract researchers and publications from other areas such as engineering, computer science and social science over the last 10 years. Research collaboration between authors in different backgrounds was observed since 2006. Source titles from non-medical backgrounds have also published articles pertinent to RMT. Among people with SCI, researchers utilised a wide range of technology from simple spirometers to electromyography in both intervention and outcome measures. With various types of interventions implemented, RMT generally improves pulmonary function and respiratory muscle strength among people with SCI.

    CONCLUSIONS: While research on RMT has been steadily increasing over the last 6 decades, more collaborations are encouraged in the future to produce more impactful and beneficial research on people who suffer from respiratory disorders.

  8. Hasnan N, Hamzaid NA, Magenthran V, Davis GM
    Games Health J, 2024 May 06.
    PMID: 38709784 DOI: 10.1089/g4h.2023.0047
    Background: Virtual reality (VR)-enhanced indoor hybrid cycling in people with spinal cord injury (SCI) can be comparable to outdoor hybrid cycling. Method: Eight individuals with chronic thoracic-lesion SCI performed voluntary arm and electrically assisted leg cycling on a hybrid recumbent tricycle. Exercises were conducted outdoors and indoors incorporating VR technology in which the outdoor environment was simulated on a large flat screen monitor. Electrical stimulation was applied bilaterally to the leg muscle groups. Oxygen uptake (VO2), heart rate, energy expenditures, and Ratings of Perceived Exertion were measured over a 30-minute outdoor test course that was also VR-simulated indoors. Immediately after each exercise, participants completed questionnaires to document their perceptual-psychological responses. Results: Mean 30-minute VO2 was higher for indoor VR exercise (average VO2-indoor VR-exercise: 1316 ± mL/min vs. outdoor cycling: 1255 ± 53 mL/min; highest VO2-indoor VR-exercise: 1615 ± 67 mL/min vs. outdoor cycling: 1725 ± 67 mL/min). Arm and leg activity counts were significantly higher during indoor VR-assisted hybrid functional electrical stimulation (FES) cycling than outdoors; 42% greater for the arms and 23% higher for the legs (P 
  9. Ramli MI, Hamzaid NA, Engkasan JP
    J Voice, 2019 Jul 09.
    PMID: 31300185 DOI: 10.1016/j.jvoice.2019.06.006
    OBJECTIVES: The aim of this study was to investigate the performance of mechanomyography (MMG) and electromyography (EMG) in monitoring the sternocleidomastoid (SCM) as accessory respiratory muscles when breathing during singing.

    METHODS: MMG and EMG were used to record the activity of the SCM in 32 untrained singers reciting a monotonous text and a standard folk song. Their voices were recorded and their pitch, or fundamental frequency (FF), and intensity were derived using Praat software. Instants of inhale and exhales were identified during singing from their voice recordings and the corresponding SCM MMG and EMG activities were analysed.

    RESULTS: The SCM MMG, and EMG signals during breathing while singing were significantly different than breathing at rest (p < 0.001). On the other hand, MMG was relatively better correlated to voice intensity in both reading and singing than EMG. EMG was better, but not significantly, correlated with FF in both reading and singing as compared to MMG.

    CONCLUSIONS: This study established MMG and EMG as the quantitative measurement tool to monitor breathing activities during singing. This is useful for applications related to singing therapy performance measure including potentially pathologically effected population. While the MMG and EMG could not distinguish FF and intensity significantly, it is useful to serve as a proxy of inhalation and exhalation levels throughout a particular singing session. Further studies are required to determine its efficacy in a therapeutic setting.

  10. Md Nadzri N, Hamzaid NA, Chung TY
    J Med Eng Technol, 2021 Oct;45(7):574-581.
    PMID: 34184592 DOI: 10.1080/03091902.2021.1936238
    Individuals with paraplegia spend their time on the wheelchair for life. Adapting to prolonged wheelchair seating for almost all activities of daily living is challenging. The loss of abilities to sense any pain or excessive seating pressure cause them to remain seated on the wheelchair without any pressure relief activities. This situation leads to secondary complications including pressure ulcer which further degrades the individual's health. To overcome this, a wheelchair seating pressure relief training system (WSETs) was developed. Optimal placement of the force sensitive resistors (FSR) as seating pressure sensors on the cushion were determined, and their responses were investigated with 5 paraplegics. Two different FSR orientations, A and B, were compared. Each paraplegic sat in resting position and then performed pressure relief activities (PRA) which included whole body push-up, left and right lean and forward lean, before returning to resting position. Orientation B, with more forward positioned FSRs, showed higher sensitivity, implying better capture of high-risk area of pressure ulcer development. The FSR sensor readings were significantly different among pressure relief activities in all subjects (p 
  11. 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.
  12. Ibitoye MO, Hamzaid NA, Ahmed YK
    Biomed Tech (Berl), 2023 Aug 28;68(4):329-350.
    PMID: 36852605 DOI: 10.1515/bmt-2021-0195
    Leg exercises through standing, cycling and walking with/without FES may be used to preserve lower limb muscle and bone health in persons with physical disability due to SCI. This study sought to examine the effectiveness of leg exercises on bone mineral density and muscle cross-sectional area based on their clinical efficacy in persons with SCI. Several literature databases were searched for potential eligible studies from the earliest return date to January 2022. The primary outcome targeted was the change in muscle mass/volume and bone mineral density as measured by CT, MRI and similar devices. Relevant studies indicated that persons with SCI that undertook FES- and frame-supported leg exercise exhibited better improvement in muscle and bone health preservation in comparison to those who were confined to frame-assisted leg exercise only. However, this observation is only valid for exercise initiated early (i.e., within 3 months after injury) and for ≥30 min/day for ≥ thrice a week and for up to 24 months or as long as desired and/or tolerable. Consequently, apart from the positive psychological effects on the users, leg exercise may reduce fracture rate and its effectiveness may be improved if augmented with FES.
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