Objective.To promote the development of objective and comprehensive motion function assessment for patients, based on high-density surface electromyography (HD-sEMG), this study investigates the temporal and spatial variations of neuromuscular activities related to upper limb motor dysfunction.Approach.Patients with unilateral upper limb motor dysfunction and healthy controls were enrolled in the study. HD-sEMG was collected from both arms while they were performing eight hand and wrist movements. Muscle synergies were extracted from the HD-sEMG. Symmetry of bilateral upper limb synergies and synergy differences between motions were proposed as spatial indicators to measure alterations in synergy spatial distribution. Additionally, as a temporal characteristic, the correlation of bilateral upper limb activation coefficient was proposed to describe the coordination control of the central nervous system. All temporal and spatial indicators were compared between patients and healthy subjects.Main results.The patients showed a significant decrease (p< 0.05) in the symmetry of bilateral upper limb synergy spatial distribution and correlation of bilateral upper limb activation coefficient. Patients with motor dysfunction also showed an increase in synergy similarity between motions, indicating altered spatial distribution of muscle synergies.Significance.These findings provide valuable insights into specific patterns associated with motor dysfunction, informing motor function assessment, and guiding targeted interventions and rehabilitation strategies for neurologically disordered patients.

UNASSIGNED: Beneficial effects have been observed for mechanical vibration stimulation (MVS), which are mainly attributed to tonic vibration reflex (TVR). TVR is reported to elicit synchronized motor unit activation during locally applied vibration. Similar effects are also observed in a novel vibration system referred to as functional force stimulation (FFS). However, the manifestation of TVR in FFS is doubted due to the use of global electromyography (EMG) features in previous analysis. Our study aims to investigate the effects of FFS on motor unit discharge patterns of the human biceps brachii by analyzing the motor unit spike trains decoded from the high-density surface EMG.
UNASSIGNED: Eighteen healthy subjects volunteered in FFS training with different amplitudes and frequencies. One hundred and twenty-eight channel surface EMG was recorded from the biceps brachii and then decoded after motion-artifact removal. The discharge timings were extracted and the coherence between different motor unit spike trains was calculated to quantify synchronized activation.
UNASSIGNED: Significant synchronization within the vibration cycle and/or its integer multiples is observed for all FFS trials, which increases with increased FFS amplitude. Our results reveal the basic physiological mechanism involved in FFS, providing a theoretical foundation for analyzing and introducing FFS into clinical rehabilitation programs.

Our study aimed to investigate the feasibility of using high-density surface electromyography (HD-sEMG) for swallowing assessment by comparing the quantitative parameters and topographic patterns of HD-sEMG between post-irradiated patients and healthy individuals.
Ten healthy volunteers and ten post-irradiated nasopharyngeal carcinoma patients were recruited. 96-channel HD-sEMG was recorded although each participant consumed different consistencies of food (thin and thick liquid, puree, congee, and soft rice). Dynamic topography was generated from the root mean square (RMS) of the HD-sEMG signals to illustrate the anterior neck muscle function in the swallowing process. The averaged power of muscles and the symmetry of swallowing patterns were assessed by objective parameters including average RMS, Left/Right Energy Ratio, and Left/Right Energy Difference.
The study showed different swallowing patterns between patients with dysphagia and healthy individuals. The mean RMS values were higher in the patient group compared to the healthy group, but the difference was not statistically significant. Asymmetrical patterns were shown in patients with dysphagia.
HD-sEMG is a promising technique that could be used to quantitatively evaluate the average power of neck muscles and the symmetry of swallowing activities in patients with swallowing difficulties.
Level 3 Laryngoscope, 133:2920-2928, 2023.

Objective.This study aims to characterize the motor units (MUs) distribution and recruitment pattern in the spastic and non-spastic bilateral biceps brachii muscles (BBMs) of chronic stroke survivors.Approach.High-density surface electromyography (HD-sEMG) signals were collected from both spastic and non-spastic BBMs of fourteen chronic stroke subjects during isometric elbow flexion at 10%, 30%, 50% and 100% maximal voluntary contractions (MVCs). By combining HD-sEMG decomposition and bioelectrical source imaging, MU innervation zones (MUIZs) of the decomposed MUs were first localized in the 3D space of spastic and non-spastic BBMs. The MU depth defined as the distance between the localized MUIZ and its normal projection on the skin surface was then normalized to the arm radius of each subject and averaged at given contraction level. The averaged MU depth at different contraction levels on a specific arm side (intra-side) and the bilateral depths under a specific contraction level (inter-side) were compared.Main results.The average depth of decomposed MUs increased with the contraction force and significant differences observed between 10% vs 50% (p< 0.0001), 10% vs 100% (p< 0.0001) and 30% vs 100% MVC (p= 0.0017) on the non-spastic side, indicating that larger MUs with higher recruitment threshold locate in deeper muscle regions. In contrast, no force-related difference in MU depth was observed on the spastic side, suggesting a disruption of orderly recruitment of MUs with increase of force level, or the MU denervation and the subsequent collateral reinnervation secondary to upper motor neuron lesions. Inter-side comparison demonstrated significant MU depth difference at 10% (p= 0.0048) and 100% force effort (p= 0.0026).Significance.This study represents the first effort to non-invasively characterize the MU distribution inside spastic and non-spastic bilateral BBM of chronic stroke patients by combining HD-sEMG recording, EMG signal decomposition and bioelectrical source imaging. The findings of this study advances our understanding regarding the neurophysiology of human muscles and the neuromuscular alterations following stroke. It may also offer important MU depth information for botulinum toxin injection in clinical post-stroke spasticity management.

Spasticity is a common post-stroke syndrome that imposes significant adverse impacts on patients and caregivers. This study aims to improve the efficiency of botulinum toxin (BoNT) in managing spasticity, by utilizing a three-dimensional innervation zone imaging (3DIZI) technique based on high-density surface electromyography (HD-sEMG) recordings. Stroke subjects were randomly assigned to two groups: the control group ([Formula: see text]) which received standard ultrasound-guided injections, and the experimental group ([Formula: see text]) which received 3DIZI-guided injections. The amount of BoNT given was consistent for all subjects. The Modified Ashworth Scale (MAS), compound muscle action potential (CMAP) and muscle activation volume (MAV) from bilateral biceps brachii muscles were obtained at the baseline, 3 weeks, and 3 months after injection. Intra-group and inter-group comparisons of MAS, CMAP amplitude and MAV were performed. An overall improvement in MAS of spastic elbow flexors was observed during the 3-week visit ([Formula: see text]), yet no statistically significant difference found with intra-group or inter-group analysis. Compared to the baseline, a significant reduction of CMAP amplitude and MAV were observed in the spastic biceps muscles of both groups at 3-week post-injection, and returned to approximate baseline value at 12-week post injection. A significantly higher reduction was found in CMAP amplitude ([Formula: see text]% versus [Formula: see text]%, [Formula: see text]) and MAV ([Formula: see text]% versus [Formula: see text]%, [Formula: see text]) in the experimental group compared to the control group. The study has demonstrated preliminary evidence that precisely directing BoNT to the innervation zones (IZs) localized by 3DIZI leads to a significantly higher treatment efficiency improvement in spasticity management. Results have also shown the feasibility of developing a personalized BoNT injection technique for the optimization of clinical treatment for post-stroke spasticity using proposed 3DIZI technique.

OBJECTIVE: Silent speech recognition (SSR) based on surface electromyography (sEMG) is an attractive non-acoustic modality of human-machine interfaces that convert the neuromuscular electrophysiological signals into computer-readable textual messages. The speaking process involves complex neuromuscular activities spanning a large area over the facial and neck muscles, thus the locations of the sEMG electrodes considerably affected the performance of the SSR system. However, most of the previous studies used only a quite limited number of electrodes that were placed empirically without prior quantitative analysis, resulting in uncertainty and unreliability of the SSR outcomes.
METHODS: In this study, the technique of high-density sEMG was proposed to provide a full representation of the articulatory muscle activities so that the optimal electrode configuration for silent speech recognition could be systemically explored. A total of 120 closely-spaced electrodes were placed on the facial and neck muscles to collect the high-density sEMG signals for classifying ten digits (0-9) silently spoken in both English and Chinese. The sequential forward selection algorithm was adopted to explore the optimal electrodes configurations.
RESULTS: The results showed that the classification accuracy increased rapidly and became saturated quickly when the number of selected electrodes increased from 1 to 120. Using only ten optimal electrodes could achieve a classification accuracy of 86% for English and 94% for Chinese, whereas as many as 40 non-optimized electrodes were required to obtain comparable accuracies. Also, the optimally selected electrodes seemed to be mostly distributed on the neck instead of the facial region, and more electrodes were required for English recognition to achieve the same accuracy.
CONCLUSIONS: The findings of this study can provide useful guidelines about electrode placement for developing a clinically feasible SSR system and implementing a promising approach of human-machine interface, especially for patients with speaking difficulties.

In this study, research was carried out on the end-effector force estimation of two representative multi-muscle contraction tasks: elbow flexion and palm-pressing. The aim was to ascertain whether an individual muscle or a combination of muscles is more suitable for the end-effector force estimation. High-density surface electromyography (HD-sEMG) signals were collected from four primary muscle areas of the upper arm and forearm: the biceps brachii (BB), brachialis (BR), triceps brachii (TB), brachioradialis (BRD), and extensor digitorum communis (EDC). The wrist pulling and palm-pressing forces were measured in elbow flexion and palm-pressing tasks, respectively. The deep belief network (DBN) was adopted to establish the relation between HD-sEMG and the measured force. The representative signals of the four primary areas, which were considered as the input signal of the force estimation model, were extracted by HD-sEMG using the principle component analysis (PCA) algorithm, and fed separately or together into the DBN. An index termed mean impact value (MIV) was proposed to describe the priority of different muscle groups for estimating the end-effector force. The experimental results demonstrated that, in multi-muscle isometric contraction tasks, the dominant muscles with the highest activation degree could track variations in the end-effector force more effectively, and are more suitable than a combination of muscles. The main contributions of this research are as follows: (1) To fuse the activation information from different muscles effectively, DBN was adopted to establish the relationship between HD-sEMG and the generated force, and achieved highly accurate force estimation. (2) Based on the well-trained DBN force estimation model, an index termed MIV was presented to evaluate the priority of muscles for estimating the generated force.

BACKGROUND: Swallowing is a continuous process with substantive interdependencies among different muscles, and it plays a significant role in our daily life. The aim of this study was to propose a novel technique based on high-density surface electromyography (HD sEMG) for the evaluation of normal swallowing functions.
METHODS: A total of 96 electrodes were placed on the front neck to acquire myoelectric signals from 12 healthy subjects while they were performing different swallowing tasks. HD sEMG energy maps were constructed based on the root mean square values to visualize muscular activities during swallowing. The effects of different volumes, viscosities, and head postures on the normal swallowing process were systemically investigated by using the energy maps.
RESULTS: The results showed that the HD sEMG energy maps could provide detailed spatial and temporal properties of the muscle electrical activity, and visualize the muscle contractions that closely related to the swallowing function. The energy maps also showed that the swallowing time and effort was also explicitly affected by the volume and viscosity of the bolus. The concentration of the muscular activities shifted to the opposite side when the subjects turned their head to either side.
CONCLUSIONS: The proposed method could provide an alternative method to physiologically evaluate the dynamic characteristics of normal swallowing and had the advantage of providing a full picture of how different muscle activities cooperate in time and location. The findings from this study suggested that the HD sEMG technique might be a useful tool for fast screening and objective assessment of swallowing disorders or dysphagia.