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EMG, Muscle Physiology and Behaviour 2

Author: Jennifer Wyndham

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Images: Pearson Education
Lippincott, Williams and Wilkins Lawrence Erlbaum Assoc
Jennifer.Wyndham@uts.edu.au
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Objectives
After this session you should be able to:
Discuss the merits of needling vs surface recording techniques Discuss current research in EMG studies on selected areas of pathophysiology:
Muscle disorders/disease Behaviour and emotion Speech and stuttering
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EMG in Clinical studies, 2009-2010

Eli P et al, 2009, Chemodenervation and Nerve Blocks in the Diagnosis and Management of Spasticity and Muscle Overactivity, PM&R, Sept, 1, 9, 842-851 Furtner M, et al., 2009, Cerebral Vasoreactivity Decreases Overnight in Study of Severe Obstructive Sleep Apnoea Syndrome, Sleep Medicine, Sept,10, 8, 875-881 Kumar S, and Prasad N, 2010, Torso Muscle EMG Prole Differences Between Patients of Back Pain and Control, Clinical Biomechanics , 25, 103-109 Meyr A et al., 2009, Epidemiological Aspects of the Surgical Correction of Structural Forefoot Pathology, J Ankle and Foot Surgery, Sept, 48, 5, 543-551 Pomerance J, 2009, The Cost-effectiveness of Non-surgical Vs Surgical Treatment of Carpal Tunnel Syndrome, J Hand Surgery, Sept, 34, 7, 1193-1200 Staugaard S, 2010, Threatening Faces and Social Anxiety: A literature review, Clinical Psychology Review 30, 669-690 Turker KS. 2010, Reexes As Tools to Study Human Neuromuscular System. Clin Neurophysiol :10.1016/ j.clinph., 201, .04.019. Waite DL, Brookman RL, Dickerson CR, 2010, On the Suitability of Using Surface Electrode Placements to Estimate Muscle Activity of the Rotator Cuff As Recorded by Intramuscular Electrodes, J Electromyography &Kinesiology, Sept, 20, 903-911
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EMG in Clinical studies, 2008- 2009

Chan JKK, et al., 2009, Posterior interosseous nerve palsy in rheumatoid arthritis: case report and literature review, J of Plastic, Reconstruct & Aesthetic Surgery, 62, e556 -e560 Niels OB, et al., 2009, Clinical Outcomes of Surgical Release Among Diabetic Patients With Carpal Tunnel Syndrome: Prospective Follow-up With Matched Controls, J Hand Surgery,Sept, 34, 7, 1177-1187 Jankovic J, 2009, Treatment of Hyperkinetic Movement Disorders, The Lancet Neurology, Sept, 8, 9, 844-856 Qu, X and Nussbaum MA, 2009, Evaluation of Passive and Active Control of Balance, J Biomechanics, August, 42, 12 1850-1855 Finsterer J, 2009, Mitochondrial Disorders, Cognitive Impairment and Dementia, J Neurological Sciences, August, 283, 1 &2, 143-148 Bartolo DC and Paterson HM, 2009, Anal incontinence, Best Practice &Research Clin Gastroentorolgy, August, 23, 4, 505-515 Baranowski AP, 2009, Chronic Pelvic Pain, Best Practice &Research Clin Gastroentorolgy, August, 23, 4, 593-610 Alizadehkhaiyat O, et al., 2009, Assessment of Functional Recovery in Tennis Elbow, J Electromyography and Kinesiology, August, 19, 4, 631-638 Ratnovsky A et al., 2008, Mechanics of Respiratory Muscles, Respiratory Physiology & Neurobiology, April, 163, 82-89
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EMG and Behaviour

How is the EMG signal used in research?
Biofeedback studies Frontalis EMG feedback for tension headache. Facial and neck EMG used in stuttering. Placebo and group situations need to be taken into account. NB Studies can be affected by social and environmental / situational factors Subjects may second guess the purpose of the experiment. Thus use dummy electrodes; recording in both social and onsocial contexts etc to minimise the problem

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Motor Performance and Reaction Time (RT)

Davis (1940) recorded EMG from forearm extensor muscles while subjects waited for a signal requiring a response. Muscle tension began 200-400 msec after the signal. RT was faster the higher the initial muscle tension was. RT was quicker and muscle tension higher for regular fore periods vs irregular periods. Kennedy and Travis (1948) looking at tracking from the frontalis muscle showed that RT became slower with low levels of tension and faster when tension level was high. Non involved muscles show low EMG activity. This has been linked with decreases in HR (Cardiac-somatic concept).
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EMG and Tracking

Tracking - movement of a control to indicate a moving target. i.e. Video games and pilots. Efficient tracking is related to moderate to high EMG level. Low muscular tension (indication of drowsiness) or very high (over exertion or fatigue) are associated with less efficient performance. Practice improves tracking. Simple repetition without fatigue improves performance. Motivation facilitates performance. Fatigue hinders it (Eason and White). Fatigue causes integrated EMG levels to increase but muscle efficiency to decrease.
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EMG and Speech

Oral EMGs occur during thinking (not confined to the larynx). Speech muscles are separate. (Goldstein (1972) review of the literature). muscle activity accompanies all cognitive phenomena, even though EMG may be of small magnitude McGuigan (1973) .

Sub vocalisation during reading limits reading rate to 150 words/m. Hardyck et al., (1966) found 17/50 subjects were sub vocalisers.

Audio EMG feedback of the laryngeal muscles * - within 30 min. all were able to read with EMG at resting levels. Reductions in reading fatigue occurred.

McGuigan (1973) in a contrasting view suggested that higher levels of oral EMG in children and less proficient adults enhances comprehension levels, and reduces distractions in a noisy environment.
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Marieb, Pearson education

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Involved in speech

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EMG and Emotion

Facial EMG Schwartz and colleagues (1970s) found different muscles are responsible for different facial expressions Muscles corrugators: knit the brows triangularis: depress the mouth zygomatic: responsible for smiles Using pleasant or unpleasant imagining. Fridlund and Cacioppo (1986) presented guidelines for electrode placements in facial EMG research. RHS of brain is active in spontaneous emotional response ie LHS muscles showed increased activity. This is contralateral control - RHS motor Copyright UTS cortex is more active Andreassi,

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EMG and Emotion (cont)

Individuals exposed to happy and angry pictures of facial expressions showed different responses. Happy picture increased zygomatic activity and angry faces elicited elevated corrugator activity (Dimber (1982). Further, measures of mood and EMG showed that feelings of elation and depression were elicited in 70% of subjects. Elation increased zygomatic activity and depression increased corrugator (Sirota and Schwartz,1982). It has been hypothesised that the facial muscles play a role as a feedback system for the experience of emotion. Original proposal by Darwin that facial expressions are biologically pre-wired and consistent between individuals. Gender difference. Women show more pronounced EMG response in the zygomatic and corrugator muscles. Females are more facially expressive than males (Dimberg 1997).
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Anger In and Out

Is there a difference in those who outwardly express anger vs. those who internalise? Jancke (1996) measured frontalis, corrugator, orbicularis oculi (below the eye) and zygomatic EMG. All subjects were asked to complete an IQ test. Control group was given neutral feedback thanking them for entering the study. Experimental group were told their score was too low and no payment would be given. Subjects who expressed anger outwardly had higher frontalis and corrugator activity. EMG displays serve a social communication purpose rather than reflecting felt emotions.
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EMG and Performance

Max effort can be maintained only for 1 min. 25% max for approx. 10min. Efficiency decreases when a high level of exertion is required. Maintaining performance under fatigue requires more energy (higher levels of EMG). 20min pencil-paper test doing an addition problem. Normal sleep vs. 32-56hr sleep deprivation. After sleep loss, EMG from the inactive forearm show that those with the greatest increases in EMG over normal levels, performed best (Wilkinson 1962). Desk slant position (Eastman and Kamon, 1976) ). EMG was recorded from deltoid, trapezius and spinae erector (lower back) while subjects performed reading and writing tasks at 12 and 24 degree desk tilts. Fatigue ratings were less and EMG activity was significantly less with a 24 degree tilt. Work stations can therefore be redesigned.
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* Muscles moving the forearm

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Flexor muscles (anterior compartment): biceps brachii, brachialis, coracobrachialis

Extensor muscles (posterior compartment): triceps brachii Anconeus assists triceps brachii

Marieb Pearson Ed
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EMG during Mental Activity

Operant Conditioning of EMG Hayes (1975) used EMG auditory feedback of muscle tension Grp 1. Vs Controls: Active or passive relaxation, Grp 2. No assistance group (told to be relaxed as possible) Grp 3. Non contingent feedback in the form of a random tone Grp 4. The EMG biofeedback group achieved greater degrees of muscle relaxation than either of the relaxation groups and much greater than either of the controls. However, lowering EMG level in one muscle (eg frontalis) does not generalise to other muscles. But, can show classical conditioning (recording EMG from the masseter and forearm muscles) in exp. Grp, with conditioned stimulus (CS) an audio tone, and an unconditioned stimulus (UCS) a different tone vs control Grp which only gets CS. Exp grp shows larger EMG to the CS than the control grp indicating conditioning of the muscle being recorded
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EMG and Sleep

A review of the EMG literature during sleep and dreaming, Goldstein (1972), indicated that the

onset of dreaming is marked by a reduction in neck and head EMG activity. EMGs decrease towards their lowest level 5 min before the onset of REM sleep. The lowest level of EMG was during REM sleep. Chin EMG is superior to lip EMG for identifying REM sleep. EMGs of apnoea victims show that they have a decrease or complete disappearance of activity in the muscles of the throat and upper airways compared to normal controls. This leads to obstructed airways Different rhythms in daily muscle tone in short sleepers (SSP) vs Long sleepers (LSP) ie different waking levels in muscle tone on EMG during a computer task SSP showed greater EMG activity in the morning , but not evening compared with LSP - appears that long sleepers peak later in the day than short sleepers!
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EMG Gradients
EMG has been shown to increase progressively from the beginning to the end of a task for both mental and physical activities (tracking). The increase is termed EMG gradients The slope of the gradient is related to level of motivation, the steeper the slope, the higher the motivation. Bartoshuk (1955) reported that for mirror tracing the gradient slope was related to speed and accuracy. Incentive level raised EMG gradient. Svebak and Murgatroyd (1985) found that serious-minded subjects had steeper gradients than playful persons (video car-racing simulation).
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EMG and Respiratory Muscles

EMG can detect abnormal muscle electrical activity in diseases / conditions, e.g. muscular dystrophy, muscle inammation, peripheral nerve damage, myasthenia gravis etc Incidence of respiratory muscle disorders (due to obesity or lung disease) e.g. COPD, asthma, chronic bronchitis is . Dysfunction of respiratory muscles may lead to respiratory failure where muscles cannot sustain work of normal quiet breathing. High airway resistance, lung hyperination, in COPD, force respiratory. muscles to increase their work in breathing. Breathing at abnormally high lung volume causes the inspiratory muscles to operate at non-optimal lengths, reducing their maximal contractile forces. Thus, the muscles are required to generate higher forces with each breath small changes in breathing pattern or demand in exercise would induce fatigue of the respiratory muscles Ref: Ratnovsky A, et al., 2008
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EMG and Respiratory Muscles (cont)

EMG can give information on level of muscle performance / activity with different respiratory tasks and at different lung volumes thus enables differentiation between different respiratory muscles. Measurements of EMG signals from the diaphragm during inspiration revealed peak values approx 50 V during quiet breathing, and maximal values approx 150 V as inspiration effort increases EMG also useful for assessing respiratory muscle endurance and fatigue after muscle training or exercise. Respiratory muscle fatigue is related to change in the power spectrum i.e. EMG measured Another indicator for muscle fatigue is a reduction in ratio between the EMG powers in high frequency band to that in the low frequency band (H/L ratio) Inspiratory loads higher than 50% of maximal diaphragmatic pressure lead to diaphragmatic fatigue" Ref: Ratnovsky A, et al., 2008"
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EMG and Muscle Disorders

Repetitive Strain Injury Repetitive movement has been known to be associated with the development of repetitive motion disorders (RMDs), a chronic overuse condition affecting muscles, nerves, joint leading to inflammation and /or pain (Fuller et al., 2008) Repetitive arm movements constitute a major facet of several workplace tasks (e.g. manufacturing, assembly line work, services) as well as many sporting and leisure activities During sustained maximal contraction, fatigue (reduced functional capacity) is observed as a decline in force output The effects of fatigue on a muscles output show as compression of the power spectrum towards lower frequencies in an EMG due to reduced motoneuronal excitation

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EMG and Muscle Disorders

Repetitive Strain Injury (cont) Other studies have shown increases in measures of the EMG amplitude (e.g. root-mean-square (RMS) value) concomitant to decreases in the frequency characteristics with fatigue development during submaximal contractions. Studies of the mechanisms of low-force muscle fatigue, indicate selective fatigue of low-threshold motor units during sustained wrist extensions and changes in physiological parameters (interleukin-6, muscle lactate, K+, local tissue oxygenation, total haemoglobin) at the neuromuscular junction of the trapezius muscle during low-load repetitive arm tasks. In addition, gender differences in various aspects of the fatigue response mechanisms (e.g. endurance time, strategies of muscle adaptation) have been documented recently
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EMG and NeuroMuscular Disorders

Myasthenia Gravis Autoimmune disease caused by an antibody- mediated loss of acetylcholine receptors at the neuromuscular junction and thus loss of communication between motor neuron and muscle. Peak incidence between age 20-30 yrs, 3X more common in women. In later life more men affected then women Weakness and fatigue with sustained muscle effort. Eye and periorbital muscle most commonly affected - ptosis (drooping upper eyelid) and diplopia (double vision). Also weakness in muscles for chewing, swallowing, and limb movements - more pronounced in proximal than distal parts Thus difficult climbing stairs and lifting objects.

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Ptosis in R eyelid

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EMG and NeuroMuscular Disorders

Myasthenia Gravis (cont) Lower facial muscles and thus speech impaired later in the disease. Myasthenia crisis (due to stress, illness pregnancy, post surgery) when weakness severe enough to compromise ventilation- need artificial ventilation Muscle weakness can be detected by single fibreelectromyography (EMG) This detects delayed or failed neuromuscular transmission in muscle fibres supplied by a single nerve fibre. This can be confirmed by an immunoassay test to detect the presence of acetylcholine receptor antibodies in the blood
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EMG and NeuroMuscular Disorders

Parkinsons Diseases
Parkinsons Disease is a degenerative disorder of basal ganglia function Specifically degeneration of the dopamine producing fibres in the substantia nigra Results in variable combinations of tremor, rigidity and bradykinesia (hypokinesis) Bradykinesia characterised by slowness in initiating and performing movement, difficulty in sudden unexpected stopping of voluntary movements Patients lean forward to maintain their centre of gravity Use surface EMG signals to discriminate Parkinson tremor from essential tremor ET is a relatively benign disease with the tremor being the main symptom Also used for diagnosis when hypokinesis first appears Copyright UTS
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EMG and NeuroMuscular Disorders

Parkinson's
Recent research indicates a genetic component in early onset form of Parkinson's Theory that auto-oxidation of catecholamines, such as dopamine, during melanin synthesis injures neurons in the substantia nigra. Increasing evidence that disease development may be due to accumulation of these toxic metabolites that the neurons cannot render harmless Latter due to disruption of the mitochondrial electron transport system which usually inactivate these metabolites Those with family history have mutations in the Park1 and sometimes Park2 gene. Latter is rare
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EMG and NeuroMuscular Disorders

Low Back Pain and Pelvic Floor Muscle tone Low back pain (LBP) is one of the most common conditions affecting all population, worldwide Ranked rst as a cause of disability and inability to work in the USA - high prevalence rate results in high associated economic and social costs The overall mechanical stability of the spinal column, especially in dynamic conditions and under heavy loads, is provided by the spinal column and the precisely coordinated surrounding muscles Australian longitudinal study on women found those with pre-existing incontinence, gastrointestinal problems and breathing disorders were more likely to develop LBP than women without such problems. This was a result of changes in control of the trunk muscles following involvement with incontinence, respiratory and gastrointestinal problems. Changes in morphology and altered postural activity of the trunk muscles including muscles of respiration and continence (provide mechanical support to the spine and pelvis) shown to be related to the development and occurrence of LBP Copyright UTS 26

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EMG and NeuroMuscular Disorders

Low Back Pain and Pelvic Floor Muscle tone
EMG of co-activation pattern of the pelvic oor and abdominal muscles (needle EMG for the abdominals & surface EMG for pelvic oor muscles (PFM)), found
- that the abdominals contract in response to a pelvic oor contraction command - that the pelvic oor contracts in response to both a hollowing and bracing abdominal command.

Thus pelvic floor can be facilitated by co-activating the abdominals and vice versa. Also, increasing abdominal muscle EMG activity resulted in increasing EMG activity in PFM PFM exercises were benecial in improving PFM strength and endurance. PFM exercise plus physiotherapy have a similar effect, BUT is not superior to routine physiotherapy for patients with chronic LBP (Mohseni-Bandpei MA, 2010). However, other studies indicate that improvement in abdominal strength and tone and resulting good posture does aid in reducing back pain. Further, 78% of women with LBP reported urinary incontinence i.e. LBP is a risk factor for urinary incontinence Various studies indicate that exercise of the abdominal muscles as well as the PFM to be benecial in maintaining PFM coordination, support, endurance, and strength and as well as aiding in control of incontinence.
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EMG and NeuroMuscular Disorders

Rheumatoid Arthritis
Chronic inammatory disorder that primarily affects the synovial joints. Symptoms include the loss of extension of the digits, or dropped nger, this may be caused by loss normal muscle function associated with subluxation of the ulna, and of extensor tendons over hand joints, and dislocation of the metacarpophalangeal joints (MCPJs), Posterior interosseous nerve (PIN) palsy, with a loss of digital extension, is a rare neurological complication of rheumatoid arthritis (RA). It may be caused by nerve entrapment, vasculitis or drug toxicity. The diagnosis of PIN palsy may be conrmed by electrophysiological studies which include EMG. The EMG results help determine treatment options- medical/drug therapy or surgery"
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EMG and Behaviour and Emotion

The threatening facial expression is considered an ancient sign of threat in human evolutionary history A mental disorder that seems especially relevant in relation to threatening faces is social phobia. Socially anxious individuals are particularly concerned with humiliating or embarrassing themselves when under the scrutiny of others A threatening facial expression can be a sign of disapproval and rejection, and might therefore function as an anxiety-provoking cue in people for whom approval is especially important People with social phobia form negative assumptions about how other people see them, and these assumptions cause a particular attentiveness to threatening environmental cues Facial EMG measures the valence Copyright UTS dimension or strength of emotions"
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EMG and Behaviour and Emotion

Hypothesis that a biological predisposition to react to emotional faces will manifest itself in a type of facial mimicry that can be measured with EMG. More specically, the large facial muscles, Zygomaticus major (controls smiling), and Corrugator supercilii (controls frowning), should show increased activation in response to happy and angry faces respectively. Some studies have found increased Corrugator activity (frowning) to angry faces in high, compared to low, socially anxious participants whereas others found no group differences in response to angry faces Importantly, the studies which found an effect specic to the angry faces, used long (100 ms) exposure durations, while others presented their stimuli until participant response. This difference in exposure duration appears to be crucial. Higher levels of social anxiety within their clinical population correlated with more pronounced avoidance of angry faces, compared to patients with lower levels of social anxiety.
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EMG and Stuttering

The neurophysiological processing of speech uency depends on the stability of temporal coordination between motor execution and the performed cognitive processing. " Developmental stuttering is a communication disorder that begins in early childhood, (between 3 - 6 years) characterized by involuntary disruptions in the uency of verbal expression." Hypothesized that stuttering may be due to a number of factors: - a temporal disruption of the simultaneous and successive programming of muscular movements; - an error in sequencing the normal motor commands that leads to a delay in production of the sound; - an anticipatory, apprehensive, hypertonic avoidance reaction an extraneous muscle activity]; " - the result of a deciency in speech motor skill such as a disorder in the coordination of different muscle systems (respiratory, articulatory or laryngeal) or slower retrieval of speech motor plans . "
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EMG and Stuttering

The most typical core behaviors are repetitions of sounds or syllables and articulatory xation, resulting in blocks or prolongations of sounds. Stutterers showed signicantly higher EMG levels in the lower orbicularis oris muscle at the time of speech onset and during speech production than nonstutterers. However, studies focusing on EMG of the lip muscles are controversial, and other studies have provided evidence that stuttering is not associated with unusually high levels of muscle activity in lip muscles. " The study by de Felicio et al.,(2007) was performed on the upper and lower lip muscles in order to compare individuals who stutter and uent speakers with respect to electromyographic activity in speech and non- speech tasks. " Note: Stuttering is recognized to have a genetic component (supported by twin and adoption studies) - approximately half of all stutterers have a family history of the disorder, However, the exact mode of transmission are not known"
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EMG and Stuttering

EMG study on stuttering noted: 1. the activity of the upper lip muscle was signicantly lower in the stutterers group than in the control group in some clinical conditions analyzed; 2. 3. there was no difference in the lower lip activity between stutterers and controls and the results do not conrm that subjects who stutter present higher levels of muscle activity in lip muscles than uent speakers. Findings, including the rest activity, do not conrm the view of stuttering as a hypertonic avoidance reaction or as an extraneous muscle activity Also no evidence that stutterers, during uent speech, present an increase in the activity of the lower lip muscle compared to non-stutterers [14]." In fact, the abnormal aspect of the EMG that has been observed in subjects who stutter is tremor in orofacial and laryngeal muscles during disuencies
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References:
Burke D, 2010, Whither Needle EMG, Clinical Neurophysiology, Editorial, 121 (2010) 1373-1375 de Felicio CM, Rodrigues RL, Freitas G, Vitti M, Hallak Regalo SC, 2007, International Journal of Pediatric Otorhinolaryngology (2007) 71, 1187 - 1192 Fuglsang-Frederiksen A, 2006, The role of different EMG methods in evaluating myopathy, Clin Neurophysiol, 117, 1173-89. Hossen A, Muthuraman M, Raethjen J, Deuschlc G, Heuteb U, 2010, Discrimination of Parkinsonian Tremor From Essential Tremor by Implementation of a Wavelet-based Softdecision Technique on EMG and Accelerometer Signals, Biomedical Signal

Processing and Control, 5, 181-188

DiscriminationofParkinsoniantremorfromessentialtremorbyimplementation ofawaveletbasedsoft-decisiontechniqueonEMGandaccelerometersignals " Mohseni-Bandpei MA, Rahmani, N, Behtash H, Karimloo M, 2010, The Effect of Pelvic oor Muscle Exercise on Women With Chronic Non-specic Low Back Pain, Journal of Bodywork & Movement Therapies, In Press Ratnovsky A, Elad D, Halpern P, 2008, Mechanics of Respiratory Muscles, Respiratory Physiology & Neurobiology 163, 82-89
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References:
Texts: Andreassi, JL, 2007, Psychophysiology 5th edition, (Ch 10 and 3), Lawrence Erlbaum Assoc, Mahwah, New Jersey Bear MF, Connors BW and Paradiso MA, 2007, Neuroscience 3rd edition, Lippincott, Williams & Wilkins, Wolter Kluwers, Philadelphia, (Ch 13) Marieb E, Human Anatomy and Physiology, current edition Porth CM, Pathophysiology: Concepts of Altered Halth States, Lippincott, Williams & Wilkins, Wolter Kluwers, Philadelphia, current edition

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