EMG Levels Research Articles

Gravity support from a robotic exoskeleton increases spontaneous use of the nondominant upper extremity during a choice reaching task.

The objective was to determine whether gravity support for the left arm of right-handed participants would increase left arm use during a three-dimensional (3-D) reaching task in virtual reality. Twelve healthy control participants each completed 630 reaching movements broken into six blocks. The majority of targets were placed close to the midsagittal plane at three heights, and participants were free to use either limb when reaching for targets. The hand had to stay in the target for a prescribed dwell time before the target disappeared. For all reaching tasks within a block, the left arm gravity support was set to either 0% or 75% of full arm support. The blocks also varied in the dwell time (2, 4, or 6 s). The order of blocks was balanced across participants in terms of gravity support level and dwell time. Electromyogram (EMG) level in the left medial deltoid decreased with increasing gravity support (P < 0.001) and was higher for higher targets compared to lower targets (P < 0.001). The odds of using the left arm were 1.95 times higher with gravity support compared to no support (P < 0.001). With gravity support, we expected greater shifts toward the left arm in tasks that were more energetically demanding. This was not the case, as the increased use was evenly distributed across all target heights, and use decreased or remained unchanged with increasing dwell time. Results are discussed relative to current models of limb choice and the potential use of robotic gravity support to overcome learned nonuse in stroke patients.NEW & NOTEWORTHY We have shown that gravity support from a robotic exoskeleton increases use of the left arm of right-handed healthy participants. Prior work has shown similar results when movements of one arm are amplified in a virtual environment. The advantage of this approach is the potential to apply the intervention during functional task practice outside of the VR environment or during performance of actual activities of daily living (ADL).

Modality-Specific Feature Selection, Data Augmentation and Temporal Context for Improved Performance in Sleep Staging.

This work attempts to design an effective sleep staging system, making the best use of the available signals, strategies, and features in the literature. It must not only perform well on different datasets comprising healthy and clinical populations but also achieve good accuracy in cross-dataset experiments. Toward this end, we propose a model comprising multiple binary classifiers in a hierarchical fashion, where, at each level, one or more of EEG, EOG, and EMG are selected to best differentiate between two sleep stages. The best set of 100 features is chosen out of all the features derived from selected signals. The class imbalance in data is addressed by random undersampling and boosting techniques with decision trees as weak learners. Temporal context and data augmentation are used to improve the performance. We also evaluate the performance of our model by training and testing on different datasets. We compare the results of five approaches: using only EEG, EEG+EOG, EEG+EMG+EOG, EEG+EMG, and selective modality with a specific combination of EEG, EMG, and/or EOG at each level. The best results are obtained by considering features from EEG+EMG+EOG at each hierarchical level. The proposed model achieves average accuracies of 83.1%, 90.0%, 84.4%, 82.1%, 81.5%, 79.9%, and 73.7% on Sleep-EDF, Exp Sleep-EDF, ISRUC-S1, S2 and S3, DRMS-SUB, and DRMS-PAT datasets, respectively. For all the datasets except DRMS-SUB, the proposed method outperforms all the state-of-the-art approaches. Cross-dataset performance exceeds 80% for all datasets except DRMS-PAT; independent of whether the test data is from normal subjects or patients.

ELECTROMYOGRAPHIC ANALYSIS OF ANTERIOR, SUPERIOR AND POSTERIOR SHOULDER FUNCTION WHILE EXECUTING THE SPIKE IN VOLLEYBALL

This research aims to study the Electromyographic analysis of anterior, superior and posterior shoulder function while executing the spike in volleyball. Twelve male national and inter university level volleyball players, ranging from age 16 to 28 years, were purposively selected as subjects. The subjects were oriented for experiment and process was clarified to them. Observations were made on selected variables such as anterior muscles group includes Pectoralis Major (PMJ), Pectoralis Minor (PMN) and Bicepsbrachii (BB). Further superior muscle group includes Anterior Deltoid (AD), Middle Deltoid (MD) and Posterior Deltoid (PD). Posterior muscle group includes Triceps Brachii (TB), Latissimus Dorsi (LD) and Trapezius (TP). The muscles activities during spiking were tested by Neuro TracMyoPlus 4, as criterion measure. Micro volt (µv) was used to document scores/data, and further analysis of data was completed by help of SPSS version 17. The descriptive statistics was used for electromyographic analysis of shoulder function while executing the spike. Pearson Correlation technique was applied, having 0.05 level of significance to see the relationship of selected muscles with spiking action. The findings depicted that while spike the trapezius muscle has highest activation level of EMG, followed by anterior deltoid &amp; posterior deltoid; triceps muscles; pectoralis muscles in order of sequence. In contrast the biceps muscles function showed lowest activation level of EMG while carrying out of spike. The Pectoralis is the only muscle that was found correlated with the performance of spike. However, The insignificant correlation was found between the trapezius, biceps, triceps, anterior deltoid &amp; posterior deltoid with the performance of spike test. However, significant relationship was also found between biceps and triceps muscles groups among independent variables.

초음파용 프로브 설계의 인간공학적 분석

Objective: The present study is intended to analyze the design characteristics of ultrasonic probes in different sizes and shapes and identify the preferred design characteristics by ergonomic evaluation.<BR><BR>Background: The use of an ultrasound probe among sonographers in improper postures with high repetitions for long periods of time has resulted in a high incidence of musculoskeletal symptoms and/or disorders.<BR><BR>Method: While sonographers (n = 12) simulated ultrasound scanning tasks with two linear array probes (small-flat, SF; large-curved, LC) in different sizes and shapes by applying forces of 20±4N, EMG activities, body motions, and grip postures were measured. After completing the ultrasound simulation tasks, a comparative evaluation of subjective satisfaction with the two probe designs was conducted.<BR><BR>Results: The SF probe required a larger range of motion at the elbow (up to 9.9° on average), higher RMS EMG levels (-1.8~48.4%) during the probe rotation task at the shoulder (pectoralis and infraspinatus), neck (right/left sterno-cleido-mastoid and trapezius), and upper-arm (biceps), and larger finger joint angles (-6.3~15.8°) than the LC probe.<BR><BR>Conclusion: The SF probe was preferred to the LC probe in terms of grip fit, the opposite was found in terms of the efficiency of force transfer.<BR><BR>Application: The analysis and evaluation methods of ultrasound probe design and the identification of the preferred design characteristics of linear array probe will be of use to develop ergonomic probe designs that can reduce musculoskeletal symptoms and disorders among sonographers.

Evolution of Prodromal REM Sleep Behavior Disorder to Neurodegeneration: A Retrospective Longitudinal Case-Control Study.

Individuals with a history of recurrent dream-enactment behaviors, but with subthreshold REM sleep without atonia levels for REM sleep behavior disorder (RBD) diagnosis, are currently classified to have prodromal RBD (pRBD). However, the REM sleep-elevated EMG diagnostic cutoff, progression trajectory, and long-term neurodegenerative outcome of pRBD are not well understood. This study aimed to delineate the evolution of REM sleep EMG levels, determine the EMG cutoff score for diagnosing pRBD, and examine the risk for neurodegenerative diseases of pRBD. This retrospective longitudinal case-control study recruited patients with pRBD and age-matched, sex-matched, and follow-up duration-matched controls who were free of neurodegenerative disease at baseline in the Sleep Assessment Unit, the Chinese University of Hong Kong from 1997 to 2018. Patients and controls underwent clinical and video-polysomnography (PSG) assessments at baseline and follow-up(s). REM sleep EMG activity level on mentalis and anterior tibialis (AT) muscles on video-PSG at each visit was scored. The diagnosis of neurodegenerative diseases was confirmed by a neurologist. A total of 44 patients (age 67.4 ± 8.2 years, 6 females) and 44 controls were recruited. The combined REM sleep EMG level on mentalis and AT muscles of patients with pRBD significantly increased during 8.2 ± 3.3 years of follow-up (from 19.3% ± 9.7% to 47.3% ± 27.4% with estimated annual increase of 3.9%), yielding 29 patients with pRBD (66%) meeting the full-blown RBD diagnostic criteria. Baseline REM sleep mentalis and AT muscles EMG activity of patients who developed full-blown RBD could favorably differentiate pRBD from controls (6.3% for mentalis "any" and 9.1% for combination of mentalis any and bilateral AT muscles phasic EMG with an area under the curve of 0.88 [0.78-0.98] and 0.97 [0.92-1.00], respectively). Patients with pRBD had a higher risk for neurodegenerative diseases (9 developed Parkinson disease and 3 developed dementia with Lewy bodies) when compared with controls (5 developed Alzheimer disease, adjusted hazard ratio = 2.95, 95% CI = 1.02-8.54). pRBD has a predictive progression in both pathophysiology and neurodegenerative outcome. This finding has significant implications to the nosological status of pRBD, the current REM sleep-related EMG diagnostic criteria, spectrum concept of RBD, and future neuroprotective intervention. This study provides Class III evidence that EMG activity during REM sleep predicts the development of pRBD.

Adjunctive treatment of chronic migraine using an oral dental device: overview and results of a randomized placebo-controlled crossover study

ObjectiveTo assess the nocioceptive input of habitual nocturnal jaw clenching that acts as a contributing factor in migraine pathogenesis.BackgroundHabitual nocturnal jaw clenching has been implicated as a trigger, particularly in those whose headaches are present upon waking or shortly thereafter. Nocturnal EMG studies of patients diagnosed with migraine show nearly twice the temporalis clenching EMG levels and double the bite force as matched asymptomatic controls, leading to the speculation that parafunctional clenching activity may have some role in headache pathogenesis. The NTI (Nociceptive Trigeminal Inhibition) oral device is a dental splint designed to reduce nocturnal jaw clenching intensity and is FDA approved for the prevention of medically diagnosed migraine pain based on open label studies. There are no prior placebo-controlled trials to assess the migraine prevention efficacy of the NTI splint. This is the first placebo-controlled cross-over study to assess the efficacy of the NTI splint in patients with Chronic Migraine.MethodA placebo controlled, single-blinded cross-over study was done with IRB oversight assessing the efficacy of the NTI splint compared to placebo using the change in the HIT-6 score as the outcome measure.Results68% of refractory chronic migraine sufferers using the NTI as measured by sequential HIT 6 scores had at least a one-category improvement (severe to substantial, or substantial to some, or some to none) compared to 12% when using a placebo device. 36% of subjects using the NTI device reported a two-category improvement in their HIT-6 score, compared to 0% when using placebo.ConclusionThe improvement in HIT-6 scores produced by the NTI device, suggests that patients with Chronic Migraine may have intense nocturnal jaw clenching as a contributing factor to their headache related disability. An NTI device is one method of assessing whether jaw-clenching is a contributing factor to ongoing migraine.Trial registrationCurrent Controlled Trials NCT04871581. 04/05/2021. Retrospectively registered.

The aging-related decrease in cVEMP amplitude cannot be accounted for by normalization.

Cervical Vestibular Evoked Myogenic Potentials (cVEMP) is an electromyogenic measure commonly used in clinic to assess saccule function. The main parameters are peak-peak amplitude and interaural asymmetry ratio (IAR). Several non-vestibular factors may influence these parameters. Notably, a greater EMG contraction level prior to stimulation leads to an increased amplitude. As aging impacts both vestibular structures and muscle propreties, it is still a matter of debate whether the decrease in cVEMP amplitude observed in normal aging is due to EMG differences prior to stimulation or to the effect of aging on the sacculo-collic reflex pathway. At the clinical level, understanding the effect of aging on the relationship between EMG activity and cVEMP response (amplitude, asymmetry ratio) and the effect of normalization is crucial to improving the categorization of healthy versus pathological responses. To investigate whether normalization modifies cVEMP amplitude and asymmetry ratios differently in younger and older heatlhy adults. cVEMP recordings were conducted in 42 normal healthy participants divided in two age groups: younger (n = 29): mean = 22.79 years old SD = 1.66; and older (n = 13): mean = 69.00 years old SD = 3.61. Air-conducted cVEMP were recorded using Eclipse (Interacoustics, Denmark). The stimulus was a 95 dBnHL tone burst (500 Hz) with rise, plateau and fall time of 1 ms. cVEMP were recorded only when EMG levels were between 50μV and 150μV, using the Eclipse (Interacoustic, Denmark) monitoring system. No significant differences were observed for prestimulus EMG levels between younger and older participants (F(1,83) = 1.13, p = 0.291). However, significant differences between groups were observed for raw cVEMP amplitude (F(1,83) = 14.78; p < 0.001) and corrected cVEMP amplitude (F(1,83) = 21.85; p < 0.0001). A significant positive linear relationship between prestimulus EMG contraction level (RMS) and raw cVEMP amplitude was observed in younger participants (r2 = 0.234; p < 0.001), but not in older adults (r2 = -0.0144; p = 0.056). Finally, no significant differences between younger and older participants were observed for raw amplitude asymmetry ratios (F(1,41) = 0.124, p = 0.726) or normalized asymmetry ratios (F(1,41) = 0.726, p = 0.508). Our results suggest that when EMG is monitored and activation of the SCM is sufficient, the observed decline in cVEMP amplitude with normal aging does not seem to be caused by EMG differences and is therefore likely due to the known histopathological modifications of the vestibular system that occurs with normal aging.

The impact of vibration training on the development of some physical abilities of basketball juniors

Learning about the Effect of vibration training on some physical Own (muscular power - measure speed - measure dribble speed - Agility - balance) for Junior Basketball, The study based on an experimental approach for groups (experimental - control) using measurement before and after the program. The study targeted a sample from the Yarmouk Sports Club, and the total number (20) Player they were deliberately chosen, 2020/2021 season. The size of the experimental group was (10) players, and the size of the control group was (10) players. The results are reached There are statistically significant differences between the results of the experimental group and the control group in the after measurement in the level of physical abilities (muscular power - measure dribble speed - agility - balance) and the benefit of the experimental group.There are statistically significant differences between the results of the experimental group and the control group in the after measurement in the level of EMG and the benefit of the experimental group.

Differences in Electromyography during Self-Compassionate and Self-Critical Imageries According to the Level of Self-Criticism

The aim of this study was to analyze changes in muscle activity between high and low self-critical participants during the imagery of self-compassion, self-protection, and self-criticism. Muscle activity was measured by the Biopac MP36 while participants were listening to the imagery audio recording. Levels of self-criticism were measured by The Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS; Gilbert et al., 2004). From overall number of 110 participants, 30 participants were selected for further analysis based on their extreme level of self-criticism. The research sample consisted of 15 participants with high level of self-criticism and 15 with low level of self-criticism. The results showed that participants with higher levels of self-criticism had similar levels of muscle activity during the self-critical and self-protective phases of imagery. However, during the last self-compassionate imagery, participants with lower self-criticism returned to the baseline EMG levels, while those with higher self-criticism remained at high EMG levels. The results showed lower muscle activity in low self-critics while imagining inner compassionate part meaning. Therefore, low self-critics are probably better able to calm themselves down compared to high self-critics.

Surface electromyography of forearm and shoulder muscles during violin playing

The aims of this study were to explore muscle activity levels during different violin repertoires, quantify the general levels bilaterally in upper extremity muscles, and evaluate associations between muscle activity and anthropometrics characteristics. In 18 skilled violin players surface EMG was recorded bilaterally from trapezius (UT), flexor digitorum superficialis (FDS), extensor carpi ulnaris (ECU), extensor digitorum cummunis (EDC), and extensor carpi radialis (ECR) during A and E major scales played in three octaves and Mozart’s Violin Concerto no. 5. To compare side differences the static, median and peak levels of muscle activity were calculated from an amplitude probability distribution function (APDF). This study demonstrated that scales played as standardized tasks can be used to estimate the average muscle activity during violin playing. Comparing results from scales and the music piece revealed a similar muscle activity across all muscles in the music piece and E major scales. The static, median and peak EMG levels were higher in left than in right forearm muscles with left ECU presenting the highest peak load of 30 %MVE. Females demonstrated a higher muscle activity than males, but this was in accordance with differences in anthropometric measures.

Shoulder muscle activation strategies differ when lifting or lowering a load.

Lowering a load could be associated with abnormal shoulder and scapular motion. We tested the hypothesis that lowering a load involves different shoulder muscle coordination strategies compared to lifting a load. EMG activity of 13 muscles was recorded in 30 healthy volunteers who lifted and lowered a 6, 12 or 18kg box between three shelves. Kinematics, EMG levels and muscle synergies, extracted using non-negative matrix factorization, were analyzed. We found greater muscle activity level during lowering in four muscles (+ 1-2% MVC in anterior deltoid, biceps brachii, serratus anterior and pectoralis major). The movements were performed faster during lifting (18.2 vs. 15.9cm/s) but with similar hand paths and segment kinematics. The number of synergies was the same in both tasks. Two synergies were identified in ~ 75% of subjects, and one synergy in the others. Synergy #1 mainly activated prime movers' muscles, while synergy #2 co-activated several antagonist muscles. Synergies' structure was similar between lifting and lowering (Pearson's r ≈ 0.9 for synergy #1 and 0.7-08 for synergy #2). Synergy #2 was more activated during lowering and explained the greater activity observed in anterior deltoid, serratus anterior and pectoralis. Lifting and lowering a load were associated with similar synergy structure. In 3/4 of subjects, lowering movements involved greater activation of a "multiple antagonists" synergy. The other subjects co-contracted all shoulder muscles as a unit in both conditions. These inter-individual differences should be investigated in the occurrence of shoulder musculoskeletal disorders.

Hip Load Moments and Muscular Activity During Lifting

The load on the hip joint during lifting was studied. Healthy subjects lifted a 12.8 kg box from floor to table level with straight and flexed knees in four different ways. The loading moment of force about the bilateral hip axis was calculated by means of a computerized static sagittal plane model. The highest load moment, 124 Nm, occurred initially in the straight knee lift and the compressive joint reaction force was 2.7 times body-weight. The lowest load moment, 82 Nm, occurred in the flexed knee lift with the burden moved close to the trunk, the compressive force was 3.2 X bw. The load moment was also discussed in relation to the strength capability. The EMG levels of seven different hip muscles were normalized and expressed as a percentage of the recorded level of each muscle group during an isometric maximum voluntary contraction. The initial activity in the hamstrings was higher in the straight knee lift compared to flexed knees. The gluteus maximus was activated to a moderate level.

Disparate kinetics of change in responses to electrical stimulation at the thoracic and lumbar level during fatiguing isometric knee extension.

The present study compared the fatigue-induced change of matched-amplitude thoracic evoked potential (TMEP) and lumbar evoked potential (LEP) following electrical stimulation. Ten participants performed a 3 × 3 min isometric knee extension contraction separated by 4 min of recovery at the level of EMG required to produce 50% maximal voluntary contraction (MVC) force at baseline. The TMEP and LEP were evoked during the ongoing contraction at baseline and every minute into the fatiguing protocol and during recovery. Both responses were also assessed during a transcranial magnetic stimulation (TMS) evoked silent period to elicit a TMS-TMEP and TMS-LEP to assess responses without the confounding influence of descending drive. The results displayed disparate kinetics of the TMS-TMEP and TMS-LEP throughout the fatiguing protocol. The TMS-TMEP was reduced at all time points during exercise (P < 0.001), whereas the TMS-LEP was reduced at 2 min into set 1 and 1 min into sets 2 and 3 (P ≤ 0.04). TMS-LEPs were higher than the TMS-TMEPs at most time points (P ≤ 0.04). No change was observed in the TMEP or LEP. When evoked during the silent period, the reduction in TMEP is greater than the LEP during fatiguing isometric exercise. The disparate kinetics of change suggest that differential mechanisms are responsible for evoked responses to thoracic and lumbar stimulation. More research is required to identify the mechanisms responsible for the TMEP and LEP before precise inferences can be made on what fatigue-induced changes in these variables reflect.NEW & NOTEWORTHY Assessing spinal excitability using lumbar stimulation when measuring responses in lower limbs has been suggested as an alternative method that could circumvent the issues associated with thoracic stimulation. The present study compared responses to the two types of stimuli throughout a fatiguing protocol and demonstrated that lumbar evoked responses differ substantially from thoracic responses when measured in the absence of voluntary drive. These findings suggest that different mechanisms are responsible for evoked responses to thoracic and lumbar stimuli.

Effects of arm weight support on neuromuscular activation during reaching in chronic stroke patients.

To better understand how arm weight support (WS) can be used to alleviate upper limb impairment after stroke, we investigated the effects of WS on muscle activity, muscle synergy expression, and corticomotor excitability (CME) in 13 chronic stroke patients and 6 age-similar healthy controls. For patients, lesion location and corticospinal tract integrity were assessed using magnetic resonance imaging. Upper limb impairment was assessed using the Fugl-Meyer upper extremity assessment with patients categorised as either mild or moderate-severe. Three levels of WS were examined: low = 0, medium = 50 and high = 100% of full support. Surface EMG was recorded from 8 upper limb muscles, and muscle synergies were decomposed using non-negative matrix factorisation from data obtained during reaching movements to an array of 14 targets using the paretic or dominant arm. Interactions between impairment level and WS were found for the number of targets hit, and EMG measures. Overall, greater WS resulted in lower EMG levels, although the degree of modulation between WS levels was less for patients with moderate-severe compared to mild impairment. Healthy controls expressed more synergies than patients with moderate-severe impairment. Healthy controls and patients with mild impairment showed more synergies with high compared to low weight support. Transcranial magnetic stimulation was used to elicit motor-evoked potentials (MEPs) to which stimulus-response curves were fitted as a measure of corticomotor excitability (CME). The effect of WS on CME varied between muscles and across impairment level. These preliminary findings demonstrate that WS has direct and indirect effects on muscle activity, synergies, and CME and warrants further study in order to reduce upper limb impairment after stroke.

Perioperative vestibular assessment and testing

Vestibular disorders can be difficult to accurately diagnose and manage. A careful history and focused physical examination are typically adequate to establish a diagnosis and initiate medical treatment. Vestibular testing is an important component of the work-up, but it is particularly essential for patients being considered for surgical intervention for a vestibular disorder, where the testing can be used to more definitively confirm a suspected diagnosis and to determine baseline vestibular organ function. In this article, we will first briefly review key components of the history and physical examination of patients with vestibular complaints. We will then discuss the most commonly used vestibular tests and their role in the preoperative assessment of patients undergoing vestibular surgery, including nystagmography, caloric testing, rotary chair testing, video head impulse testing, and vestibular evoked myogenic potential testing.

Clinical efficacy of platelet rich plasma combined with Bio-oss artificial bone powder in repairing bone defects around implant

Objective To research the clinical effect of platelet rich plasma combined with Bio-oss artificial bone meal in repairing bone defects around implants. Methods From January 2015 to January 2017, 70 cases who completed the implant repair in Lishui People's Hospital, and later confirmed the defects around the implant were selected in the research.They were equally divided into observation group and control group according to admission, with 35 cases in each group.The control group was treated with Bio-oss artificial bone powder.The observation group was treated with platelet rich plasma combined with Bio-oss artificial bone powder.The clinical effects of the two groups were compared and analyzed. Results Before treatment, the probe depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival sulcus hemorrhage index (SBI) of the observation group and the control group were (7.18±1.31)mm, (5.68±0.87)mm, (1.23±0.31), (2.48±0.34) and (7.22±1.28)mm, (5.74±0.83)mm, (1.27±0.33), (2.53±0.36), respectively, which were significantly higher than those after treatment (all P<0.05). Before treatment, the bone mineral density (BMD) levels of the two groups were (35.48±4.58)g/cm3 and (35.74±4.61)g/cm3, respectively, which were significantly lower than those after treatment (all P<0.05). The levels of PD, CAL, PI and SBI in the observation group at 3 months and 6 months after treatment were (4.48±1.01)mm, (4.27±0.53)mm, (0.68±0.21), (1.12±0.13) and (3.43±0.76)mm, (3.58±0.54)mm, (0.38±0.07), (0.41±0.08), respectively, which were significantly lower than those in the control group [(5.19±0.83)mm, (4.83±0.71)mm, (0.89±0.27), (1.46±0.21) and (4.14±0.98)mm, (4.21±0.62)mm, (0.49±0.11), (0.63±0.13)], the differences were statistically significant (t=3.213, 3.739, 3.632, 8.144 and 3.387, 4.533, 4.991, 8.526, P=0.002, 0.000, 0.000, 0.000, 0.001, 0.000, 0.000, 0.000, 0.000, 0.000). The levels of TA anterior temporalis muscle EMG and MA masseter muscle EMG in the two groups at 6 months after treatment were (76.81±15.17)mV, (67.56±14.43)mV, (74.24±13.28)mV, (68.27±13.03)mV, (66.44±13.28)mV, (58.76±13.07)mV, (65.58±11.55)mV, (59.04±10.76)mV, respectively, which were significantly higher than those before treatment [(46.48±11.15) mV, (38.19±13.04) mV, (54.83±12.57) mV, (56.48±13.13) mV and (45.71±10.98) mV, (38.23±13.11)mV, (55.14±12.69) mV, (56.61±13.08) mV] (all P<0.05). After treatment, the ICP-HB, ICMAP-MC, TA, EMG levels in the observation group were significantly higher than those in the control group, the differences were statistically significant (t=3.042, 2.674, 2.911, 2.994, P=0.003, 0.009, 0.004 and 0.003). Conclusion The effect of rich plate plasma combined with Bio-oss artificial bone powder on the repair of bone defect around the implant is significant.The platelet rich plasma can speed up and improve the repair speed and repair quality of bone defect around the implant, so that the therapeutic effect of implant repair can be maintained for a long time. Key words: Alveolar bone loss; Dental implants; Platelet rich plasma; Bio-oss artificial bone meal; Bone defect around implant; Bone defect repair

The Study of Lower Limb EMG Signals Between Male and Female Muslim during Pertaining to Sujud Postures in Solat

Electromyography signal level in term of %MVC at lower limb muscles on static posture of feet during sujud (prostration) in solat had been studied based on the sayings of Prophet Muhammad (hadiths). Gastrocnemius and Tibialis Anterior were the chosen muscles as both are the major lower leg muscles on the lower limb part. A total of 10 male and 10 female subjects had participated in this study. The EMG data signal results were analyzed statistically using the Paired-Samples T Test as all the data are normally distributed. The statistical result showed that there is no significant difference of the muscles' signal on the respective posture between male and female. The result of EMG level in term of %MVC between male and female showed that during pertaining to sujud posture, Gastrocnemius muscles are more active in male while Tibialis Anterior muscles are more active in female.

Maturation of feedforward toe walking motor program is impaired in children with cerebral palsy.

Voluntary toe walking in adults is characterized by feedforward control of ankle muscles in order to ensure optimal stability of the ankle joint at ground impact. Toe walking is frequently observed in children with cerebral palsy, but the mechanisms involved have not been clarified. Here, we investigated maturation of voluntary toe walking in typically-developing children and typically-developed adults and compared it to involuntary toe walking in children with cerebral palsy. Twenty-eight children with cerebral palsy (age 3-14 years), 24 typically-developing children (age 2-14 years) and 15 adults (mean age 30.7 years) participated in the study. EMG activity was measured from the tibialis anterior and soleus muscles together with knee and ankle joint position during treadmill walking. In typically-developed adults, low step-to-step variability of the drop of the heel after ground impact was correlated with low tibialis anterior and high soleus EMG with no significant coupling between the antagonist muscle EMGs. Typically-developing children showed a significant age-related decline in EMG amplitude reaching an adult level at 10-12 years of age. The youngest typically-developing children showed a broad peak EMG-EMG synchronization (>100 ms) associated with large 5-15 Hz coherence between antagonist muscle activities. EMG coherence declined with age and at the age of 10-12 years no correlation was observed similar to adults. This reduction in coherence was closely related to improved step-to-step stability of the ankle joint position. Children with cerebral palsy generally showed lower EMG levels than typically-developing children and larger step-to-step variability in ankle joint position. In contrast to typically-developing children, children with cerebral palsy showed no age-related decline in tibialis anterior EMG amplitude. Motor unit synchronization and 5-15 Hz coherence between antagonist EMGs was observed more frequently in children with cerebral palsy when compared to typically-developing children and in contrast to typically-developing participants there was no age-related decline. We conclude that typically-developing children develop mature feedforward control of ankle muscle activity as they age, such that at age 10-12 years there is little agonist-antagonist muscle co-contraction around the time of foot-ground contact during toe walking. Children with cerebral palsy, in contrast, continue to co-contract agonist and antagonist ankle muscles when toe walking. We speculate that children with cerebral palsy maintain a co-contraction activation pattern when toe walking due to weak muscles and insufficient motor and sensory signalling necessary for optimization of feedforward motor programs. These findings are important for understanding of the pathophysiology and treatment of toe walking.

Operant Up-Conditioning of the Tibialis Anterior Motor-Evoked Potential in Multiple Sclerosis: Feasibility Case Studies.

Damage to the corticospinal pathway often results in weak dorsiflexion of the ankle, thereby limiting the mobility of people with multiple sclerosis (MS). Thus, strengthening corticospinal connectivity may improve locomotion. Here, we investigated the feasibility of tibialis anterior (TA) motor-evoked potential (MEP) operant conditioning and whether it can enhance corticospinal excitability and alleviate locomotor problems in people with chronic stable MS. The protocol consisted of 6 baseline and 24 up-conditioning sessions over 10 weeks. In all sessions, TA MEPs were elicited at 10% above active threshold while the sitting subject provided 30–35% maximum voluntary contraction (MVC) level of TA background EMG. During baseline sessions, MEPs were simply measured. During conditioning trials of the conditioning sessions, the subject was encouraged to increase MEP and was given immediate feedback indicating whether MEP size was above a criterion. In 3/4 subjects, TA MEP increased 32–75%, MVC increased 28–52%, locomotor EMG modulation improved in multiple leg muscles, and foot drop became less severe. In one of them, MEP and MVC increases were maintained throughout 3 years of extensive follow-up sessions. These initial results support a therapeutic possibility of MEP operant conditioning for improving locomotion in people with MS or other CNS disorders, such as spinal cord injury and stroke.

Education Research: The current state of neurophysiology education in selected neurology residency programs.

Prior research has illustrated there is a knowledge gap in neurology residents' neurophysiology education (EEG and EMG), and we sought to understand whether this is still an issue and to recognize the barriers in order to create solutions and improve education. Surveys were developed for adult neurology residents and one for program directors asking about confidence in neurophysiology knowledge, percent of graduates reaching level 4 ACGME (American Council of Graduate Medical Education) milestones in EEG and EMG, methods of learning used, interest in the subjects, and suggestions for improvements. Twenty-six program directors (19% responder rate) and 55 residents (from at least 16 different programs) completed the survey. Program directors thought that 85% of graduating residents met level 4 milestones in EEG and only 75% in EMG. Structured rotations and more time allocated to education of these topics were frequent barriers mentioned. Postgraduate year 4 residents were 60% and 67% confident in EEG and 64%, 59%, and 62.3% in EMG level 4 milestones. Learning to read EEGs was considered important throughout residents' training; however, this interest and value decreased over time with EMG. In our study, program directors suspect up to a quarter of residents may graduate not meeting level 4 ACGME milestones, and residents expressed lack of confidence in these areas. The educational methods used to instruct residents in EEG and EMG were similar as were the barriers they face across programs. This information hopefully will help fuel curriculum design and interest in these important neurology techniques.