Muscles Of Upper Limb Research Articles

Assessing the Effect of Cervical Transcutaneous Spinal Stimulation With an Upper Limb Robotic Exoskeleton and Surface Electromyography.

Transcutaneous spinal stimulation (TSS) is a promising rehabilitative intervention to restore motor function and coordination for individuals with spinal cord injury (SCI). The effects of TSS are most commonly assessed by evaluating muscle response to stimulation using surface electromyography (sEMG). Given the increasing use of robotic devices to deliver therapy and the emerging potential of hybrid rehabilitation interventions that combine neuromodulation with robotic devices, there is an opportunity to leverage the on-board sensors of the robots to measure kinematic and torque changes of joints in the presence of stimulation. This paper explores the potential for robotic assessment of the effects of TSS delivered to the cervical spinal cord. We used a four degree-of-freedom exoskeleton to measure the torque response of upper limb (UL) joints during stimulation, while simultaneously recording sEMG. We analyzed joint torque and electromyography data generated during TSS delivered over individual sites of the cervical spinal cord in neurologically intact participants. We show that site-specific effects of TSS are manifested not only by modulation of the amplitude of spinally evoked motor potentials in UL muscles, but also by changes in torque generated by individual UL joints. We observed preferential resultant action of proximal muscles and joints with stimulation at the rostral site, and of proximal joints with rostral-lateral stimulation. Robotic assessment can be used to measure the effects of TSS, and could be integrated into complex control algorithms that govern the behavior of hybrid neuromodulation-robotic systems.

Does Action Observation of the Whole Task Influence Mirror Neuron System and Upper Limb Muscle Activity Better Than Part Task in People With Stroke?

Background: Task-based action observation and imitation (AOI) is a promising intervention to enhance upper limb (UL) motor function poststroke. However, whether whole/part task must be trained in the AOI therapy needs further substantiation. Objective: The objective of this study is to assess and compare the mirror neuron activity and UL muscle activity during AOI of reaching task in terms of whole task (complete movement) and part task (proximal arm movements and distal arm movements). Methods: In this cross-sectional study, 26 participants with first-time unilateral stroke were asked to observe the prerecorded videos of a reaching task in terms of a whole task and proximal and distal components, followed by imitation of the task, respectively. Electroencephalographic (EEG) mu rhythm suppression and electromyographic amplitude of six UL muscles were measured during the task. Results: The analysis of EEG revealed a statistically significant mu suppression score, indicating mirror neuron system activity, during AOI of the whole task in C3 (p = <0.001) and C4 (p = <0.001) electrodes compared to the part task. Percentage maximum voluntary contraction amplitudes of the deltoid (p = 0.002), supraspinatus (p = <0.001), triceps brachii (p = 0.002), brachioradialis (p = 0.006), and extensor carpi radialis (p = <0.001) muscles showed a significant increase in muscle activity during AOI of the whole task. Also, there seems to be a task observation-specific activation of muscles following AOI of proximal or distal tasks. Conclusion: The practice of the whole task should be given emphasis while framing the AOI treatment module to enhance reaching in people with stroke. Trial registration: Clinical Trials Registry-India (CTRI) identifier: CTRI/2018/04/013466.

Inhibitory Components in Muscle Synergies Factorized by The Rectified Latent Variable Model from Electromyographic Data.

Non-negative matrix factorization (NMF), widely used in motor neuroscience for identifying muscle synergies from electromyographical signals (EMGs), extracts non-negative synergies and is yet unable to identify potential negative components (NegCps) in synergies underpinned by inhibitory spinal interneurons. To overcome this constraint, we propose to utilize rectified latent variable model (RLVM) to extract muscle synergies. RLVM uses an autoencoder neural network, and the weight matrix of its neural network could be negative, while latent variables must remain non-negative. If inputs to the model are EMGs, the weight matrix and latent variables represent muscle synergies and their temporal activation coefficients, respectively. We compared performances of NMF and RLVM in identifying muscle synergies in simulated and experimental datasets. Our simulated results showed that RLVM performed better in identifying muscle-synergy subspace and NMF had a good correlation with ground truth. Finally, we applied RLVM to a previously published experimental dataset comprising EMGs from upper-limb muscles and spike recordings of spinal premotor interneurons (PreM-INs) collected from two macaque monkeys during grasping tasks. RLVM and NMF synergies were highly similar, but a few small negative muscle components were observed in RLVM synergies. The muscles with NegCps identified by RLVM exhibited near-zero values in their corresponding synergies identified by NMF. Importantly, NegCps of RLVM synergies showed correspondence with the muscle connectivity of PreM-INs with inhibitory muscle fields, as identified by spike-triggered averaging of EMGs. Our results demonstrate the feasibility of RLVM in extracting potential inhibitory muscle-synergy components from EMGs.

Physiological determinants of mechanical efficiency during advanced ageing and disuse.

This study aimed to determine which physiological factors impact net efficiency (ηnet) in oldest-old individuals at different stages of skeletal muscle disuse. To this aim, we examined ηnet, central haemodynamics, peripheral circulation, and peripheral factors (skeletal muscle fibre type, capillarization and concentration of mitochondrial DNA [mtDNA]). Twelve young (YG; 25 ± 2 years), 12 oldest-old mobile (OM; 87 ± 3 years), and 12 oldest-old immobile (OI; 88 ± 4 years) subjects performed dynamic knee extensor (KE) and elbow flexors (EF) exercise. Pulmonary oxygen uptake, photoplethysmography, Doppler ultrasound and muscle biopsies of the vastus lateralis and biceps brachii were used to assess central and peripheral adaptations to advanced ageing and disuse. Compared to the YG (12.1 ± 2.4%), the ηnet of lower-limb muscle was higher in the OM (17.6 ± 3.5%, P < 0.001), and lower in the OI (8.9 ± 1.9%, P < 0.001). These changes in ηnet during KE were coupled with significant peripheral adaptations, revealing strong correlations between ηnet and the proportion of type I muscle fibres (r=0.82), as well as [mtDNA] (r=0.77). No differences in ηnet were evident in the upper-limb muscles between YG, OM and OI. In view of the differences in limb-specific activity across the lifespan, these findings suggest that ηnet is reduced by skeletal muscle inactivity and not by chronological age, per se. Likewise, this study revealed that the age-related changes in ηnet are not a consequence of central or peripheral haemodynamic adaptations, but are likely a product of peripheral changes related to skeletal muscle fibre type and mitochondrial density. KEY POINTS: Although the effects of ageing and muscle disuse deeply impact the cardiovascular and skeletal muscle function, the combination of these factors on the mechanical efficiency are still a matter of debate. By measuring both upper- and lower-limb muscle function, which experience differing levels of disuse, we examined the influence of central and peripheral haemodynamics, and skeletal muscle factors linked to mechanical efficiency. Across the ages and degree of disuse, upper-limb muscles exhibited a preserved work economy. In the legs the oldest-old without mobility limitations exhibited an augmented mechanical efficiency, which was reduced in those with an impairment in ambulation. These changes in mechanical efficiency were associated with the proportion of type I muscle fibres. Recognition that the mechanical efficiency is not simply age-dependent, but the consequence of inactivity and subsequent skeletal muscle changes, highlights the importance of maintaining physical activity across the lifespan.

Peculiarities of neuromuscular apparatus and component composition of limbs of qualified divers

To achieve a high sports result in diving it is necessary to have a good development of neuromuscular apparatus. It is important to study the factors influencing its functional state. The article presents a correlation analysis of the relationship between the parameters reflecting the state of the neuromuscular apparatus and indicators of the component composition of the upper and lower limbs of qualified divers. It is shown that it is necessary to develop muscle mass and reduce the amount of adipose tissue to accelerate the conductivity of nerve impulse along the nerves, to increase the synchronization of activation of motor units in the muscles of upper and lower limbs. This will improve the speed and strength qualities of muscles necessary in the performance of technically complex diving.

Development of a Postoperative Rehabilitation Training Device for Patients with Upper and Lower Limb Muscular Atrophy

Objective: To develop a rehabilitation training device applicable to upper limb and lower limb muscle atrophy in postoperative patients, early postoperative rehabilitation intervention, reasonable rehabilitation training, and exercise to reduce muscle atrophy, and to help improve the ability of postoperative patients to move independently. Methods: The upper limb rehabilitation training device is comprised of a bed body and a sliding mechanism, with the sliding mechanism having a fixed component, a telescopic component, a snap-on component, and a power component. The sliding mechanism on the bed body moves back and forth, and the corresponding exercise can be performed in any position on the bed body. The lower limb rehabilitation training device comprises a base plate, a fixing box, and a seat, with the fixing box's structure comprising a fixation frame, a moving box, a pedal, a pressing block, an activity block, and other devices. The upper limb training device can ensure the safety of patients and accompanying personnel, while exercising multiple parts of the patient's muscle groups, and increasing the device's applicability; the lower limb training device can be positioned in time; and the height of the pedal can be adjusted to solve the problem of the training device's rebound force accidentally shocking the lower limbs and the inconvenience of the pedal height, which afflict patients. Conclusion: The use of rehabilitation training device training, leads to early recovery of postoperative patients' independent activities, improvement of patients' postoperative self-care ability, promotion of patients' postoperative rehabilitation, enhancement of patients' quality of life, and a decrease in postoperative complications.

Characteristics of Skeletal Muscle Strength in Subjects With Interstitial Lung Disease

ObjectivesTo investigate muscle strength and the prevalence of muscle weakness in adults with interstitial lung diseases (ILDs) compared to healthy subjects. DesignCross-sectional (description of clinical features). SettingPublic referral center (University Hospital). ParticipantsOne hundred and twelve adults with ILD (n=48, 60±10yr, 68% female) and healthy counterparts (control group, n=64, 57±10yr, 58% female) (N=112). InterventionNot applicable. Main Outcome Measure(s)Muscle strength and prevalence of muscle weakness in adults with ILD. Muscle strength was assessed via maximal isometric voluntary contraction of dominant upper and lower limb muscle groups. Data from the control group were used to generate reference equations. Muscle weakness was defined as a muscle strength value below the lower limit of normal calculated using data from the control group. Data were expressed as mean ± SD or median [interquartile range] according to the data distribution. ResultsCompared to the control group, adults with ILD had lower muscle strength for all muscle groups assessed (values presented as %predicted: pectoralis major 75[57-86]%; quadriceps 72[58-87]%; latissimus dorsi 76[57-103]%; deltoid 74[64-98]%; biceps brachii 78[64-91]%; triceps brachii 84[62-101]%; P≤.001 for all). Prevalence of muscle weakness in people with ILD was 40% for pectoralis major, 25% for latissimus dorsi, 16% for triceps brachii, 20% for biceps brachii, 27% for deltoid and 46% for quadriceps. ConclusionsAdults with ILD present a generalised reduction in peripheral Muscle strength, ranging between 20% to 46% of people depending on the muscle group assessed. and it was more prevalent in lower limb muscles.

Osteoporotic phenotype of body composition: Relationship with nutritional status and physical condition in women with rheumatoid arthritis

Aim of the study – to assess the relationship of the osteoporotic phenotype of body composition with nutritional and physical status in women with rheumatoid arthritis (RA).Material and methods. 104 women (average age 59.5±8.7 years) with RA were enrolled. The examination included clinical, laboratory and instrumental (dual-energy X-ray absorptiometry) methods. Nutritional status was assessed using the Mini Nutrition Assessment-Short Form (MNA-SF), physical status – using the International Physical Activity Questionnaire (IPAQ), “Chair stand test”, handgrip strength, “Timed Up and Go test” and gait speed.Results. Osteoporotic phenotype was diagnosed in 38.5% of patients. Malnutrition and risk of malnutrition according to MNA-SF had 51.0% of women. Low and moderate level of physical activity according to IPAQ – 51.9% of patients. In multivariate logistic regression analysis, independent factors associated with osteoporotic phenotype were determined: walking &lt;30 minutes a day (odds ratio (OR) – 1.34; 95% confidence interval (95% CI): 0.11–17.32), low muscle strength of the upper extremities (handgrip strength less than 16 kg) (OR=7.12; 95% CI: 1.02–49.57) and lower extremities (“Chair stand test” more than 15 seconds) (OR=4.45; 95% CI: 1.08–18.42), body mass index (BMI) less than 25 kg/m2 (OR=1.39; 95% CI: 1.04–1.85).Conclusion. A high frequency of the osteoporotic phenotype of body composition was revealed in patients with RA, among whom almost half of the examined individuals had insufficient nutrition and/or reduced physical activity. Walking &lt;30 minutes a day, low upper and lower limb muscle strength, and BMI&lt;25 kg/m2 were associated with the osteoporotic phenotype.

Anaesthetic Management of a Patient with Guillain-Barré Syndrome undergoing Proximal Humerus Fracture Surgery: A Case Report

Guillain-Barré Syndrome (GBS) is an autoimmune disorder which can present in acute and chronic forms. It is an inflammatory demyelinating polyneuropathy. These patients pose potential perioperative risks of autonomic dysfunction and respiratory muscle weakness. The current case report shows a 66-year-old female with a history of a fall at home eight days prior to surgery, diagnosed with a right-sided proximal humerus fracture. The patient was a diagnosed case of GBS and hypertension since five years. For GBS, she had a history of Intensive Care Unit (ICU) admission for both upper and lower limb muscle weakness and breathlessness. She recovered with treatment of Intravenous Immunoglobulin (IVIg) and oxygen therapy. The weakness improved gradually over time but did not fully recover. The patient continued to have weakness in both lower and upper limbs prior to surgery. The patient underwent Joshi’s External Stabilising System (JESS) fixation surgery for the right proximal humerus fracture. Ultrasound-guided (USG) interscalene and superficial cervical plexus block were performed in view of pre-existing muscle weakness and to reduce the requirement of postoperative ventilator support. The intraoperative course was uneventful. The patient’s sensory and motor power returned to the same prior to surgery after the block’s effects subsided.

Effect of impedance characteristics on human cortical and upper limb muscle activity and work characteristics in human–robot physical interaction

Effect of impedance characteristics on human cortical and upper limb muscle activity and work characteristics in human–robot physical interaction

Assessment of the impact of occlusion training on upper limb muscle strength and endurance – preliminary study

Assessment of the impact of occlusion training on upper limb muscle strength and endurance – preliminary study

The effects of blood flow restriction training on post activation potentiation and upper limb muscle activation: a meta-analysis.

This meta-analysis aims to systematically evaluate the impact of blood flow restriction training (BFRT) on muscle activation and post-activation potentiation (PAP) in the upper limbs, to provide guidance for upper limb protocols aiming to enhance explosive strength and activation. PubMed, CNKI, Web of Science, and EBSCO databases were queried to identify randomized controlled trials (RCTs) investigating the effects of upper limb BFRT on muscle activation and PAP. Inclusion and exclusion criteria were applied using the Cochrane bias risk tool. Literature quality assessment and statistical analysis were conducted using Revman 5.4 and Stata 17.0 software. Sensitivity analysis and funnel plots were utilized to assess result stability and publication bias. A total of 31 articles involving 484 participants were included in the analysis. Meta-analysis results showed that upper limb BFRT significantly increased muscle iEMG values [SMD = 0.89, 95%CI (0.21, 1.58), p = 0.01]. BFRT had a significant effect on upper limb explosive force [SMD = 0.73, 95%CI (0.41, 1.04), p < 0.00001]. Subgroup analysis based on literature heterogeneity (I 2 = 92%, 80%) showed that exhaustive BFRT significantly decreased upper limb iEMG [SMD = -0.67, 95%CI (-1.25, -0.09), p = 0.01], with exercise modes including maximum output power of bench press [SMD = 1.87, 95%CI (0.22, 3.53), p < 0.0001], exercise intensity of 40%-70% 1RM [SMD = 1.31, 95%CI (0.61, 2.01), p < 0.0001], and pressure intensity of ≥60% AOP [SMD = 0.83, 95%CI (0.43, 1.23), p < 0.0001] reaching maximum effects and statistical significance. Upper limb BFRT can induce muscle activation and PAP. BFRT with 40%-70% 1RM and ≥60% AOP in the upper limbs is more likely to promote PAP. http://inplasy.com, identifier INPLASY202430008.

Association between upper limb muscle quality and knee osteoarthritis in dynapenia: an observational cross-sectional study.

Neurological and skeletal muscle properties are suggested causes of dynapenia. This study aimed to evaluate the relationship between upper limb muscle quality (grip strength/upper extremity muscle mass) and knee osteoarthritis in dynapenia, and to identify dynapenia-associated factors. Elderly individuals who responded to a public call for screening in Wakasa Town, Fukui Prefecture between June 2019 and November 2021 were included. The analysis included 433 participants (304 women aged 76.0 ± 7.1 years). Examination comprised (consecutively) a basic interview, physical function measurement, body composition measurement, and explanation of results. Dynapenia was observed in 67 patients. Binomial logistic regression analysis revealed that age, upper limb muscle quality score, and knee osteoarthritis were independent factors for dynapenia. Receiver operating characteristic analysis of the relationship between dynapenia and upper limb muscle quality showed an area under the curve of 0.806 (95% confidence interval: 0.658-0.953) for men (cut-off value, 14.3 kg/kg) and 0.849 for women (95% confidence interval: 0.858-0.968; cut-off value, 14.0 kg/kg). In conclusion, age, upper limb muscle quality, and knee osteoarthritis were independent factors of dynapenia. We demonstrated that upper limb muscle quality has good accuracy in detecting dynapenia in both men and women.

농촌지역 여성노인의 신체적 여가활동 참여가 신체적 기능과 삶의 질에 미치는 효과

Objective: This study aimed to assess the effects of a physical leisure activity program on the physical function and health-related quality of life of elderly women in rural areas. Methods: One hundred and thirteen elderly women living in rural communities participated using a one-group pre-post design. The physical leisure activity program was conducted for 16 group activities over 8 weeks. To determine changes in the physical function of the elderly after participation, muscle strength, flexibility, and balance ability were measured, and the 8 domain Short-Form Health Survey (SF-8) was used to examine changes in quality of life. Results: The physical function of the participants in the program was significantly increased in upper and lower limb muscle strength, balance, and flexibility (p &lt; 0.05). The total score of QOL of elderly women who participated in the program also improved from 335.73 ± 52.93 points to 395.42 ± 28.79 points, and significantly changed in all sub-items (p &lt; 0.05). Conclusion: Participation in leisure activities was confirmed effective not only in improving the physical health of the elderly women, but also in improving their quality of life. In the future, we look forward to the development and support of various participatory activity programs suitable for rural areas.

Health and Working Conditions of Delivery Workers in Ulsan, South Korea Article type

Objective: This study aimed to determine the current work environment and health conditions for delivery workers in Ulsan Metropolitan City.Methods: Data from 64 delivery workers were collected, including their sociodemographic and employment information, and their opinions on labor environment, health status, health check-ups, and national health services. Quantitative data were analyzed through frequency analysis to explore the results. Qualitative data, such as descriptive responses, were examined through a process of categorization and multi-frequency responses.Results: The primary risk exposure of delivery workers in workplace was vibration from machines, high temperatures enough to sweat even when not working, smoke, gas, dust, etc. (each at 50.0%). Physical threats during work included postures that caused fatigue or pain (76.6%) and direct interaction with people (76.6%). Challenges in welfare and support within the work environment included the lack of rest time or difficulty in utilizing it (60.9%), no regular mealtime (65.6%), and no provision of protective equipment by the company (57.8%). A total of 48.8% of delivery workers responded that there were health and safety risks in their work environment, and overall job satisfaction was low (59.4% expressed dissatisfaction). While the general health condition was good, there were numerous complaints of pain (79.7%). Specific health issues included upper limb muscle pain (70.3%), lower limb muscle pain (62.5%), and the most diagnosed disease was hyperlipidemia (23.4%). Over the past two years, 10.9% of the participants had not had health check-ups. 71.9% expressed their willingness to participate in health promotion services, followed by improvement in working conditions and the management of harmful substances, musculoskeletal disorders, and cardiovascular diseases.Conclusion: This study, by examining the health status of delivery workers in Ulsan Metropolitan City, provides valuable foundational data for improving their work environment and preventing occupational diseases among them.

The effect of a physical therapy programme on the condition of upper limb muscles in patients with rheumatoid arthritis

Introduction and aim. Rheumatoid arthritis is a chronic progressive systemic disease of the connective tissue affecting the joints, mainly small, of the erosive-destructive polyarthritis type, and frequent systemic inflammatory damage to internal organs. The purpose of the research is to evaluate the effectiveness of physical therapy on the muscles of upper limbs in patients with rheumatoid arthritis by the dynamics of muscle strength and strength index. Material and methods. To determine the strength of the muscles of the affected upper limbs were used dynamometry, calculated strength index as a percentage to assess the functional ability of the affected limb. All patients were divided into control (n=92) and main (n=96) groups, taking into account the functional insufficiency of the joints. Results. After 6 months of physical therapy, muscle strength indicators in the main group of patients with 1st degree of functional joints insufficiency (FJI) in the affected right limb increased by 3.1 kg, in the left by 3 kg; with 2nd degree FJI – in the right limb by 4.2 kg, in the left – by 3.7 kg, significantly exceeded the same indicators in patients of the control group (р&lt;0.05). Similarly, there was an increase in the strength index in the patients of the main group. Conclusion. Physical therapy technology has been developed and implemented effectively influenced the increase in muscle strength and strength index of affected upper limbs of the main group of patients with rheumatoid arthritis.

Hand and distal joint tremor are most coherent with the activity of elbow flexors and wrist extensors in persons with essential tremor.

Essential tremor (ET) affects millions of people. Although frontline treatment options (medication, deep brain stimulation, and focused ultrasound ablation) have provided significant relief, many patients are unsatisfied with the outcomes. Peripheral suppression techniques, such as injections of botulinum toxin or sensory electrical stimulation of muscles, are gaining popularity, but could be optimized if the muscles most responsible for a patient's tremor were identified. The purpose of this study was to quantify the relationship between the activity in various upper limb muscles and the resulting tremor in patients with ET. Surface electromyogram (sEMG) from the 15 major superficial muscles of the upper limb and displacement of the hand and upper limb joints were recorded from 22 persons with ET while they performed kinetic and postural tasks representative of activities of daily living. We calculated the peak coherence (frequency-dependent correlation) in the tremor band (4-8 Hz) between the sEMG of each muscle and the displacement in each major degree of freedom (DOF). Averaged across subjects with ET, the highest coherence was found between elbow flexors (particularly biceps brachii and brachioradialis) and the distal DOF (forearm, wrist, and hand motion), and between wrist extensors (extensor carpi radialis and ulnaris) and the same distal DOF. These coherence values represent the upper bound on the proportion of the tremor caused by each muscle. We conclude that, without further information, elbow flexors and wrist extensors should be among the first muscles considered for peripheral suppression techniques in persons with ET.NEW & NOTEWORTHY We characterized the relationships between activity in upper limb muscles and tremor in persons with essential tremor using coherence, which provides an upper bound on the proportion of the tremor due to each muscle. Averaged across subjects and various tasks, tremor in the hand and distal joints was most coherent with elbow flexors and wrist extensors. We conclude that, without further information, these muscle groups should be among the first considered for peripheral suppression techniques.

Analysis of Superior Extremity Strength on the Groundstroke Attack Skills of Tennis Athletes

A tennis player must be able to produce groundstroke attacks effectively because these strokes have an important strategic role in controlling and dominating the course of the match. To produce a groundstroke attack, a tennis player must have muscle strength in the superior extremities, because the superior extremities are the primary source of kinetic energy required to transfer momentum to the racket. Apart from that, good coordination between the muscles of the arms, shoulders, and back is also important to achieve optimality in groundstroke attacks. In a coordinated movement, energy from the tennis player's body is transferred through the arms to the tip of the racket when the racket makes contact with the ball. The aim of this study was to determine how much influence superior extremity strength has on forehand groundstroke skills. The type of research used is a correlational description, involving the independent variable being superior extremity muscle strength while the dependent variable is forehand groundstroke attack skill. The research sample was 20 POMNAS South Sulawesi tennis athletes taken by purposive sampling. The instruments used were the Bouncing Medicine Ball Test and the Hewitt Tennis Performance Test. Analysis through a correlation regression test. The results concluded that the ability to groundstroke attack was influenced by upper limb muscle strength by 59.3%.

Anesthetic Fade in Intraoperative Transcranial Motor Evoked Potential Monitoring Is Mainly due to Decreased Synaptic Transmission at the Neuromuscular Junction by Propofol Accumulation.

We previously reported that normalization of motor evoked potential (MEP) monitoring amplitude by compound muscle action potential (CMAP) after peripheral nerve stimulation prevented the expression of anesthetic fade (AF), suggesting that AF might be due to reduced synaptic transfer in the neuromuscular junction. We calculated the time at which AF began for each of craniotomy and spinal cord surgery, and examined whether AF was avoided by CMAP after peripheral nerve stimulation normalization in each. Similar studies were also made with respect to the upper and lower limb muscles. AF was observed in surgery lasting 160 minutes for craniotomy and 260 minutes or more for spinal surgery, and 195 minutes in the upper limb muscles and 135 minutes in the lower limb muscles. In all the series, AF could be avoided by CMAP after peripheral nerve stimulation normalization. AF of MEP occurred in both craniotomy and spinal cord surgery, and it was also corrected by CMAP after peripheral nerve stimulation. AF is considered to be mainly due to a decrease in synaptic transfer of the neuromuscular junction due to the accumulation of propofol because of the avoidance by CMAP normalization. However, it may be partially due to a decrease in the excitability of pyramidal tracts and α-motor neurons, because AF occurred earlier in the lower limb muscles than in the upper limb muscles.

Development and Validation of an Artificial Intelligence-Based Motion Analysis System for Upper Extremity Rehabilitation Exercises in Patients with Spinal Cord Injury: A Randomized Controlled Trial.

In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems.