Abstract

Transtibial amputation can significantly impact an individual's quality of life including the completion of activities of daily living. Those with lower limb amputations can harness the electrical activity from their amputated limb muscles for myoelectric control of a powered prosthesis. While these devices use residual muscles from transtibial-amputated limb as an input to the controller, there is little research characterizing the changes in surface electromyography (sEMG) signal generated by the upper leg muscles. Traditional surface EMG is limited in the number of electrode sites while high-density surface EMG (HDsEMG) uses multiple electrode sites to gather more information from the muscle. This technique is promising for not only the development of myoelectric-controlled prostheses but also advancing our knowledge of muscle behavior with clinical populations, including post-amputation. The HDsEMG signal can be used to develop spatial activation maps and features of these maps can be used to gain valuable insight into muscle behavior. Spatial features of HDsEMG can provide information regarding muscle activation, muscle fiber heterogeneity, and changes in muscle distribution and can be used to estimate properties of both the amputated limb and intact limb. While there are a few studies that have examined HDsEMG in amputated lower limbs they have been limited to movements such as gait. The purpose of this study was to examine the quadriceps muscle during a slow, moderate and fast isokinetic knee extensions from a control group as well as a clinical patient with a transtibial amputation. HDsEMG was collected from the quadriceps of the dominant leg of 14 young, healthy males (mean age = 25.5 ± 7 years old). Signals were collected from both the intact and amputated limb muscle of a 23 year old clinical participant to examine differences between the affected and unaffected leg. It was found that there were differences between the intact and amputated limb limb of the clinical participant with respect to muscle activation and muscle heterogeneity. While this study was limited to one clinical participant, it is important to note the differences in muscle behavior between the intact and amputated limb limb. Understanding these differences will help to improve training protocols for those with amputation.

Highlights

  • Transtibial amputation can negatively impact an individual including effects to their body image, vocation and ability to socialize [1]

  • Mean Root Mean Square (RMS) was generally greater for the clinical participant compared to the age-matched control as were intensity and differential intensity

  • This study showed that high-density surface EMG (HDsEMG) can be used to non-invasively examine the spatial distribution and neuromuscular physiology of those with amputation

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Summary

Introduction

Transtibial amputation can negatively impact an individual including effects to their body image, vocation and ability to socialize [1]. The risk of developing secondary complications such as osteoarthritis after a transtibial amputation suggests there should be more focus on performance assessments of the lower limb musculature during rehabilitation. These assessments can be measured safely with the use of an isokinetic dynamometer and can produce accurate muscle strength results for both dynamic and static conditions [2]. The isokinetic dynamometer is considered to be the gold standard as it is safe and can be used in a controlled environment and has been used successfully with prosthesis-wearing individuals with transtibial amputation to examine the knee extensors and flexors [4, 5]

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