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Biomedical subjects

Kevin C McGill

Publications and source records attributed to Kevin C McGill.

7 recordsLinked to original sources

The effects of a 3-week use of lumbosacral orthoses on proprioception in the lumbar spine.

STUDY DESIGN: Longitudinal, repeated-measures, factorial design. The trunk axial rotation repositioning error was the dependent variable, while the orthoses, test mode (passive versus active), and the testing session were the independent variables. OBJECTIVES: To verify whether lumbosacral orthoses (LSOs) affect proprioception in the lumbar spine and whether these effects change over a 3-week period during which the LSO is consistently worn. BACKGROUND: To date, there is no compelling evidence that lumbar orthoses support the spine. One hypothesis advanced by several authors is that they may enhance position sense (proprioception) in the lumbar spine. METHODS AND MEASURES: Fourteen subjects without low back pain wore lumbosacral orthoses 3 hours a day for 3 weeks. Spine proprioception was tested in a seated posture in 3 sessions (days 0, 7, and 21). RESULTS: A significant 3-way interaction was found between the effects of the orthoses, session, and test mode (P = .03). The ratio of passive to active average error indicated that after 3 weeks of wearing LSO, proprioception in the passive test worsened in relation to the active test with the LSO. In contrast, proprioception in the passive test improved in relation to the active test when performed without the LSO. CONCLUSIONS: The LSO did affect proprioception in the lumbar spine. These effects most likely changed over time due to sensorimotor adaptation. However, no overall proprioceptive benefits could be ascertained from healthy subjects wearing the LSO.

Adolescent↗

EMGLAB: an interactive EMG decomposition program.

This paper describes an interactive computer program for decomposing EMG signals into their component motor-unit potential (MUP) trains and for averaging MUP waveforms. The program is able to handle single- or multi-channel signals recorded by needle or fine-wire electrodes during low and moderate levels of muscular contraction. It includes advanced algorithms for template matching, resolving superimpositions, and waveform averaging, as well as a convenient user interface for manually editing and verifying the results. The program also provides the ability to inspect the discharges of individual motor units more closely by subtracting out interfering activity from other MUP trains. Decomposition accuracy was assessed by cross-checking pairs of signals recorded by nearby electrodes during the same contraction. The results show that 100% accuracy can be achieved for MUPs with peak-to-peak amplitudes greater than 2.5 times the rms signal amplitude. Examples are presented to show how decomposition can be used to investigate motor-unit recruitment and discharge behavior, to study motor-unit architecture, and to detect action potential blocking in doubly innervated muscle fibers.

Action Potentials↗

Neuromuscular activation and motor-unit firing characteristics in cerebral palsy.

Muscle strength, neuromuscular activation, and motor-unit firing characteristics (firing rate, recruitment, and short-term synchronization) were assessed during voluntary contractions of the medial gastrocnemius (GAS) and tibialis anterior (TA) muscles of 10 participants with spastic diplegic or hemiplegic cerebral palsy (CP). The participants (six females, four males; age range 6 to 37y) walked with equinus gait at Gross Motor Function Classification System levels II to III. These were compared with 10 age-matched controls (five females; age range 7 to 35y). Neuromuscular activation was estimated by the ratio of surface electromyogram amplitude to M-wave amplitude elicited by supramaximal electrical nerve stimulation. Participants with CP produced significantly less torque (normalized by leg length) compared with controls (TA: mean 2.3, SD 1.6 vs mean 8.9, SD 3.4Nm/m; GAS mean 13.7, SD 7.1 vs mean 28.6, SD 5.1Nm/m, p < 0.001). Neuromuscular activation during maximum voluntary contraction was significantly reduced in the participants with CP compared with controls (mean 2.4, SD 1.5 vs mean 9.7, SD 2.7Nm/m for TA; mean 1.04, SD 0.41 vs mean 3.1, SD 1.2Nm/m for GAS, p < 0.001). When compared at the same submaximal level of neuromuscular activation, motor-unit recruitment and firing rates were not different between the groups, although short-term synchronization in TA was reduced in the participants with CP. These data indicate that weakness, known to be an important component of the motor deficit in CP, has a strong central component. Although the relation between recruitment and firing rate remained substantially intact at the low and moderate force contractions tested, results suggest that the participants with CP were unable to recruit higher threshold motor units or to drive lower threshold motor units to higher firing rates.

Adolescent↗

Increased jitter and blocking in normal muscles due to doubly innervated muscle fibers.

Increased jitter and intermittent impulse blocking in electromyographic (EMG) signals are considered evidence of transmission abnormality and are not usually associated with normal muscle. However, motor unit action potentials (MUAPs) that exhibit increased jitter and blocking have recently been shown to occur in the brachioradialis muscles of neurologically healthy subjects. The jitter and blocking result from collisions, refractoriness, and conduction-velocity variability in long muscle fibers that are innervated by two different motoneurons at widely separated endplates. We analyzed MUAPs obtained by decomposing EMG signals from the brachioradialis muscles of four normal subjects. The rate of blocking of some MUAP components was as high as 28%, the jitter between some components exceeded 300 micros (mean consecutive difference), and the mean incidence of irregular MUAPs was 14%. These values would be considered abnormal in many other muscles. Jitter from doubly innervated fibers can be distinguished from other types of pathological jitter because one component exhibits amplitude variability. Clinical neurophysiologists should be aware that increased jitter and blocking do not necessarily indicate pathology in brachioradialis and perhaps other long, parallel-fibered muscles.

Action Potentials↗

Electrophysiological evidence of adult human skeletal muscle fibres with multiple endplates and polyneuronal innervation.

Electromyographic (EMG) signals were recorded using intramuscular electrodes at six different sites in the brachioradialis muscles during voluntary isometric contractions in four subjects. The potential waveforms and discharge patterns of up to 12 simultaneously active motor units were identified from each signal using computer-aided decomposition. Out of a total of 301 motor unit potentials identified, 23 potentials exhibited behaviour consistent with having been generated by muscle fibres that were innervated by two different motoneurons at widely separated endplates. These potentials discharged in association with two different motor units, but were blocked or delayed whenever the two motor units discharged within a few milliseconds of one another. The blocking was consistent with a collision or refractoriness when one motoneuron tried to excite the fibre while it was already conducting an action potential initiated by the other motoneuron. The delays were consistent with decreased conduction velocity associated with incomplete recovery of the fibre after a preceding action potential. From the temporal separation between the discharges of the two motoneurons that resulted in blocking, the spatial separation between the endplates was estimated to be between 26 and 44 mm. These findings challenge the classical concept of the motor unit as an anatomically distinct and functionally independent entity. It is suggested that the human brachioradialis muscle may contain both long, polyneuronally innervated fibres and short, serially linked, singly innervated fibres.

Action Potentials↗

Optimal resolution of superimposed action potentials.

This paper presents a practical algorithm for resolving superimposed action potentials encountered during the decomposition of electromyographic signals. The problem is posed as an optimization problem: to align a set of templates with a given waveform to minimize the euclidean distance between them. The algorithm uses a recursive approach to search all possible discrete-time alignments, starting with the most likely ones and stopping once it can be verified that the optimal alignment has been found. Each candidate solution is aligned to finer-than-sampling-interval resolution using interpolation and continuous-time optimization. Both the cases in which the identities of the involved templates are known and not known are considered. Simulations are presented to show that the proposed algorithm is very accurate even for complex superpositions involving three or more similarly shaped templates, destructive interference, and added noise.

Action Potentials↗

Nerve conduction topography in geriatric hand assessment.

Motor nerve conduction is a noninvasive clinical test used to diagnose nerve problems such as carpal tunnel syndrome or peripheral neuropathy. Current techniques use a single-site recording over a superficial muscle. This traditional approach does not account for the electrical contributions from the other muscles innervated by the nerve being stimulated, which need to be considered with thumb carpometacarpal (CMC) degenerative joint disease (DJD) because these electrical contributions may change the anatomic relationship of the thenar muscles. This study recorded from 15 sites over the thenar eminence during motor nerve conduction studies of the median nerve of 12 young subjects with normal thenar anatomy and 25 elderly subjects with thumb CMC DJD. The maximum compound muscle action potential (CMAP) values did not occur in the same electrode position for the two groups, and traditional single-site recording would have resulted in smaller amplitudes and longer latencies for the elderly than the values noted with the multiple-site recordings. This pilot study of nerve conduction topography mapping with multiple-site recording illustrates that single-site studies may be misleading and supports further exploration of multichannel grid electrodes for topographic display and analysis of the CMAP.

Action Potentials↗