Download TELEMETERING ELECTROMYOGRAPHY OF MUSCLES USED

TELEMETERING
ELECTROMYOGRAPHY
WALKING
IN
J. JOSEPH
From
The
the
interactions
and
AND
RICHARD
of
Departmeizt
during
UP
Gui’s
of some
to
ascertain
ofCalifornia
walking
if there
determine
what
using
with
sequence
and
well
a telemetering
recorded
and
established
device
activity
and
have
pattern
of
method
by artefacts
School,
of the
a pattern
Relating
1966).
been
muscle
ofactivity
it is possible
ENGLAND
muscles
not
ofthe
is reduced
with
Loizdon
lower
limb
However,
the
back
among
muscle
involved.
the
of muscles
paper
attempts
individuals
and
to
and
by
Electromyography
action
trailing
have
established
of Artificial
actions
This
activity
long
and
of gait has been
to the Design
investigated.
of investigating
to dispense
USED
STAIRS
Medical
Joseph
stairs
extent
Hospital
and
Locomotion
Battye
down
is a consistent
is the
is a recognised
1947;
up and
MUSCLES
LONDON,
of the
been investigated
by means
of electromyography
( Report
on Fundamental
Studies
of Human
Limbs,
University
involved
during
DOWN
WATSON,
Analomi’,
walking
OF
of muscles,
wires
so that
interference
to a minimum.
METHODS
The
apparatus
amplifier
and
was
connected
one
for
Figure
used
for
transmitter
to
double
on moving
4 shows
up the
carried
two
recording
picking
a typical
on
the
beam
muscle
back
oscilloscopes,
photographic
recording
one
paper
of muscle
fully
potentials
subject’s
described
Initially,
activity.
They
investigated
were
hamstring
group,
body.
Surface
was
shaved,
scraped
remove
the
sites
Only
one
change
J
.
FIG.
-----
The
subject
amplifier
The
774
I
electrodes
thick
and
commercial
wearing
and
three
the
transmitter.
electrodes
are
hamstring
muscles.
over
tape.
adjacent
the
used
was
The
times
with
cleansed
made:
medius,
the
glass
with
over
skin
was
paper
alcohol.
hamstrings
silver
site
the
fine
00l
to
The
and
Joseph
were
investi-
lateral
and one
the knee joint.
cups
in
the
six further
side of the
electrode
(Battye
over the
above
of shallow
in
right
manner:
previously
one electrode
I 5 centimetres
186
The
quadriceps
gluteus
investigated
from
the
used.
and
hip,
to
Because
of difficulty
of the contraction
of
was
made
described
was
locomotor
soleus,
the
over
The
5 centimetre
15
centimetres
in diameter.
The cups were filled with
electrode
jelly and held in position
with
adhesive
If care was taken
to avoid
the spread
of jelly
between
electrodes
the records
were free from artefacts.
.
The
and
investigated.
significant
anterior,
of
in a standard
consisted
which
monitoring
apparatus
any
spinae.
activity
layer,
gated as a group
with
the medial
hamstrings,
.
tibialis
twenty
been
of
were
prepared
have
for
the muscles
electronic
flexors
gently
transistorised
receiver
heights
varied
from
175
from
60 to 84 kilograms.
muscle
were
keratinised
chosen
1966).
the
electrodes
muscle
used
from
history
and erector
pattern
of
anterior,
this
All recordings
a small
a radio
on walking
(Battye
and Joseph
1966).
from eighteen
to fifty-two
years were
Their
weights
femoris,
each
was
no
muscles
tibialis
subjects.
of which
All the
had
or injury.
and their
gluteus
maximus
determining
the
I) and
the potentials
in the paper
six men aged
investigated.
disturbance
centimetres
comprised
(Fig.
stairs
.
were
made
to the
THE
standard
JOURNAL
OF
dimensions
BONE
AND
used
JOINT
SURGERY
by
TELEMETERING
ELECTROMYOGRAPHY
builders
with
a rise
ordinary
shoes
and
walked
up and
down
of activity
each
of
was
of I65
seen
his
hips
and
taken
was
A
a tread
the
monitoring
limbs.
By
scale
a shirt.
he walked
AND
DOWN
two
sensitive
cell,
exact
subject
After
the
time
wore
were
made
photograph
the
from
was
photographic
when
his
subject
pattern
the
a regular
recordings
a flash
775
STAIRS
recording,
naturally.
the stairs.
the stairs,
the
The
Before
at least
a light
so that
of
recording
UP
of 28 centimetres.
oscilloscope,
means
of the
WALKING
and
subject
ascended
and descended
was about
halfway
up or down
time
taken
flash
was
photograph
was
known.
cinematograph
Previously
stairs.
and
IN
wore
the stairs
lower
on the
USED
a pair of shorts
several
times so that
and
on
MUSCLES
centimetres
socks
muscle
while the
When
the subject
recorded
OF
complete
films
step
1
had
the
during
been
ascent
2
‘
made
could
of one
subject
be divided
into
3
walking
up and
twenty-one
the
(Fig.
2)
5
4/v’
I
:
‘
down
stages
tij
(
8
!!
9
10
‘
12
11
‘
13,
L),1
n
FIG.
The
cinematograph
into
twenty-one
film
stages.
a random
point
during
appropriate
and
during
recognised
the
the
descent
into
the repetition
occupied
by one
or nineteen
stairs
of the
stage
for going down.
step (Fig. 2) and
divided
the recording
this photograph
the muscle
with the appropriate
activity
muscle
if potentials
which
of the divided
The flash
the notch
was taken.
stages ofthe
could
not
be
2
step,
in this
case stage
photograph
on the time
Thus
step.
attributed
to
artefact
or
VOL.
49 B,
NOVEMBER
1967
step
on the
(Fig.
stages
4).
recording
The
for
was
length
going
up
on
the
stage
stage of
it was possible
to relate
A muscle
was considered
that
4,
18.
was matched
with the appropriate
scale (Fig. 4) marked
at what
had an amplitude
exceeding
I 5 per cent of its peak value.
At the beginning
and end of each session
a calibration
signal
there was no variation
in the amplifier
throughout
the experiment.
NO.
i
walking
up stairs.
It shows
a step divided
below
is the flash
photograph
taken
at
This
photograph
is matched
with
the
nineteen
stages
(Fig. 3). A complete
of a similar
pattern
of muscle
activity
step was divided
into either
twenty-one
by
record
of a subject
The photograph
the recording.
i
to
the contraction
of
to show significant
activity
from
a nearby
was
recorded
to ensure
776
J.
JOSEPH
AND
R.
WATSON
RESULTS
The
the
periods
results
for
each
all
the
activity
for
going
up and
by
of activity
muscle
the
of the
in each
muscles
down
calculating
for each
investigated.
the stairs.
means
The
of
the
muscles
subject
in each
compared.
Figures
beginning
5 and
and
observations
end
made
ofthe
film
of a subject
step
divided
into
A
results
ofactivity
were
from
tracing
by
is a time
the
upper
As
has a
“
quadriceps
in walking
supporting
at the same
femoris
the pattern
scale
of
on
a flat
and
“
50
a
“
during
walking
of muscle
c/s.
The
activity
surface,
swinging
“
determined
stairs.
It shows
a complete
stages.
-
--
--
-
-
--..
up stairs.
A complete
beginning
B indicates
each
limb
.-
‘v
Wf
A,
at
when
while
There
the
step,
being
the
at
flash
subject
is a period
A1 to A2, can
repeated
photo
A2.
was
is going
when
both
The
be recognised
lower
tracing
taken.
up or down
limbs
stairs
are supporting
time.
WALKING
The
,.
A,
4
notch
phase.
for
subjects.
JvVW’’
in
of
obtained
,8
#{149}
FIG.
A recording
and
a pattern
V
down
nineteen
.#{149}
tabulated
3
walking
,,
[sso,.v
six
were
to detect
the
phases
the
M
FIG.
cinematograph
subjects
possible
6 summarise
on
r6_I_r
The
of the
It was
beginning
of the
step
of the
right
UP
limb
STAIRS
(stage
0) is taken
at the
stage
when
the
foot
is
flat on the stair and the left foot is beginning
to leave the ground.
The supporting
phase
of
the right limb lasts for fifteen
stages
(0 to 14) and the swinging
phase for six stages (15 to 20):
thus for about
two-thirds
ofthe
step the limb is supporting
and for about
one-third
it is swinging.
There
are
two
periods
lasting
about
six
stages
(10
to
15 and
supporting
simultaneously.
Tibia/is
anterior
is active
during
the swinging
phase
from stage
Soleus
is active
from
stage 0 to stage
1 1, from
the beginning
the opposite
limb is firmly placed
on the step above.
Quadricepsfernoris
begins
to decrease
is active
from
stage
at about
stage
7.
0 to stage
10 during
THE
0 to
5) when
both
14 to stage
19.
of the supporting
the supporting
JOURNAL
OF
phase.
BONE
AND
limbs
phase
are
until
Its activity
JOINT
SURGERY
TELEMETERING
ELECTROMYOGRAPHY
Hamstring
group
swinging
second
are
shows
phase;
and
of these
begin
during
the
phases
two
2)
phases
contracting
Hipflexors
OF
stage
beginning
strongly.
to contract
USED
of activity:
between
the
MUSCLES
IN
WALKING
1) between
18 and
stage
12 and
end
stage
7 during
of the contraction
at stage
UP
DOWN
12 and
the
is weak
their
AND
contraction
stage
14 during
supporting
but
after
777
STAIRS
phase.
stage
at stage
I the
2.
They
the
In
the
muscles
are active
phase.
swinging
Tibialis anterior
..--
-------.
Soleus
0..
-
Quadriceps femoris
.-
Hamstrings
Hamstrings
-0-
Hamstrings
.
----,_
#{149}Iip
flexors
Hip flexors
.:
-#{248}
Stuteus medius
-
Gtuteus medws
0
Gluteus maximus
-
Erector_spinae
Erector_spinae
---
L
i
.
I
0
!
3
I
6
!
9
FRAME
12
Gluteus
during
and
medius
Erector
begins
16 during
the
maximus
that
phase.
swinging
is active
of other
muscles
is active
spinae
I
I
15
I
‘
18
0
5
from the muscles
investigated
during
walking
up stairs.
and end of the phase
of activity.
The dotted
line indicates
in activity
found
in only half the subjects.
at stage
to contract
the supporting
Gluteus
than
of the results
obtained
indicate
the beginning
a marked
decrease
!
-______
NUMBER
FIG.
A summary
The arrows
Erector spinae
-------0.
-
In three
1 and ends
subjects
there
its contraction
was a weak
at stage
contraction
10. It is contracted
between
stages
from
stage
(between
in two
phases:
9.
1 to stage
stage
5 and
1) from
The
stage
stage
end
12).
of its contraction
11 to stage
13; and
is more
2) from
stage 8. The contraction
in the second
phase
is weaker
from
stage
3 to the end ofthe
and was seen in only half the subjects.
It may be added
that the left erector
investigated
in four subjects
and showed
a corresponding
pattern
of activity.
WALKING
The
VOL.
DOWN
49 B,
NO.
4,
limb is beginning
1 8 to stage
10-that
stage
I 1 to stage
NOVEMBER
1967
to be raised
is, for
1 7-that
variable
stage
16 to
contraction
spinae
was
STAIRS
As in walking
on the flat and up stairs each limb has a supporting
beginning
of the step (stage
0) is when
the right limb is placed
and the opposite
lasts from
stage
phase
lasts
from
13
phase.
from
twelve
is, for
and a swinging
flat on the stair
phase.
below
the stair above.
The supporting
phase
the nineteen
stages-and
the swinging
seven
of the nineteen
stages.
Both limbs
of
778
.i.
are supporting
lasts
about
support
from
by both
Tibia/is
stage
three-fifths
all twelve
the
end
is
for
active
from
step
WATSON
stage
and
the
18 to stage
swinging
2. The
phase
supporting
about
phase
two-fifths.
phase
thus
There
is
one-fifth
phase
during
)
and
swinging
R.
of the step, and this occurs
twice.
two
phases
: 1 from
stage 9 to stage
1 1 during
the swinging
2) from stage 17 to stage 2 (in eleven
out oftwelve
subjects)
in
subjects);
of the
about
AND
10 and
of the complete
limbs
anterior
(in
7 to stage
JOSEPH
and
the
beginning
Tibialis anterior
of the
supporting
phase.
Tibialis anterior
0.
Tibialis anterior
0
Soteus
Soleus
0’
Ouadriceps
femoris
Quadriceps lemons
Hamstrings
Hip flexors
Gluteus
0.
medius
Gluteus medius
0.
..-
Gluteus maximus
Gluteus maximus
Erector spinae
L
I
0
Erector spinae
I
I
I
I
I
3
I
6
Soleus
is active
from
Quadricepsfemoris
stage 0 and stage
phase
and
after
stage
the
Hipfiexors
impossible
to obtain
Gluteus
part
medius
of the
shows
swinging
beginning
of the
stages
maximus
1 8 and 0.
apparently
In spite
of repeated
found
in two of the subjects.
to stage
1 at the beginning
and
I
I
contracts
attempts
The
of the
I
0
18
NUMBER
muscles
6
investigated
7 throughout
during
most
of the
walking
down
stairs.
supporting
phase.
stage
16 to stage 8. This activity
is decreased
strongly
in two phases-at
the end of the
supporting
stage
most
I
15
of the
between
swinging
phase.
stage
1 1 to stage
1 5 during
the swinging
8 to stage
12. It should
be added
that
which
could
be satisfactorily
analysed.
from
activity
phase
Gluteus
six.
stage
active
from
from stage
a recording
between
of
18 to
from
shows
activity
from
3. It really
contracts
group are
are active
Hamstring
results
1
12
FIG.
of the
I
9
FRAME
A summary
Erector spinae
16 to stage
6.
supporting
in only
no evidence
This
activity
phase.
a proportion
others
showed
a small
supporting
phase.
of the
JOURNAL
during
is a decrease
subjects
of the
amount
THE
occurs
There
of contraction
phase.
in one subject
the
BONE
out
maximus
from
AND
late
in activity
studied-four
gluteus
of contraction
OF
it was
JOINT
was
stage
SURGERY
18
TELEMETERING
ELECTROMYOGRAPHY
Erector
is active
spinae
support
phase;
and
OF MUSCLES
from
pattern
WALKING
UP
AND
DOWN
779
STAIRS
1) from stage 7 to stage
10 during
the later part of the
stage
1 during
the later part of the swinging
phase.
considerable
difficulty
in determining
the phases
of activity
spinae
was investigated
in four
subjects
and showed
a
stage
17 to
It should
be added
that there was
of this muscle.
The left erector
corresponding
IN
phases:
in two
2)
USED
of activity.
DISCUSSION
Walking
the
stair
up stairs
above.
quadriceps
involves,
This
during
is achieved
femoris,
hamstrings
At the same time the
maximus.
a short
time
the
placed
firmly
on
supporting,
by
concerted,
the
an elevation
powerful
of the
contraction
limb
remains
on
the
stair
while
body
of
(acting
as extensors
of the thigh
at the
hip)
body is balanced
over the limb by the gluteus
elevating
with
the
begin to contract
of their activity
hamstring
the
the
on to
soleus,
and
gluteus
medius.
opposite
For
limb
is
above
continued
strong
contraction
during
that this
contraction
the
movement
of the
swinging
be for
erectores
may
Both
flexes
forwards
of the
The
phase
causes
flexion
is lifted
opposite
phase.
This
is considerable
upwards.
erector
The
spinae
is a somewhat
difficulty
The
hamstrings
apparently
of
the
leg
at the
and not due to
with the period
knee.
It should
muscle
contraction
of flexion.
limb is dorsiflexed
at the ankle,
flexed
at the knee and
it is carried
from the step below to the step above
and it is
on which the opposite
limb is placed.
The tibialis
anterior
this.
medius
seen in some of the subjects
during
the swinging
purpose
of abducting
the lower
spinae
contract
strikingly
in the
as the body
body.
supporting
There
the
soleus.
of the hip and it is suggested
that in this phase
of the leg at the knee (stages
1 8 to 20).
The
is to some extent
inertial
hamstrings
is short compared
During
the swinging
phase
the
flexed at the hip.
During
this stage
important
that the toe clears the step
is an important
muscle
in achieving
The contraction
of the gluteus
phase
of the
before
they act as extensors
they control
the final extension
activity
be noted
since the
stair
phase,
and then becomes
the supporting,
elevating
limb.
It is of
interest
that
the elevation
on to the stair above
is achieved
by the straightening
of the limb
placed
there and not by a lifting
upwards
by the calf muscles
of the limb on the stair below.
The contraction
of the quadriceps
femoris
is considerably
reduced
after
stage
7 as
compared
the
supporting
the
limb
early
flexion
ofthe
contracts
unexpected
in picking
up
slightly
as it clears
supporting
phase
trunk
markedly
assists
during
the stair.
when the
forward
the
trunk
movement
later
part
finding
and is difficult
to explain.
potentials
from
the flexors
of the
of the
hip
but
apparently
they contract
during
the swinging
phase
while the thigh is being flexed at the hip.
Walking
down
stairs involves
lowering
the body during
the supporting
phase
and this is
achieved
by the controlled
lengthening
of the soleus
and the quadriceps
femoris.
The gluteus
maximus
contracts
in only a proportion
of the subjects
and in these for only a short time and
not much
at the beginning
of this activity.
This prevents
the trunk
from flexing
at the hips
when
the
which
of the
lower
contraction
The
activity.
the
limb
becomes
supporting.
run into each other.
The
leg at the knee at the end
of the
soleus,
earlier
of the
is responsible
The
phase
quadriceps
femoris
is responsible
swinging
for the
phase.
lowering
has
The
of the
two
the final
later phase,
for
body.
gluteus
medius
also shows
two peaks
of activity
with an intervening
The first peak is at the end of the swinging
phase and may be a contraction
swinging
limb
from
adducting
across
the
midline
as the
of activity
phases
stage of extension
together
with the
pelvis
pivots
phase
of less
to prevent
horizontally
around
the supporting
limb.
The second
peak is the expected
activity
during
the supporting
phase
and prevents
the unsupported
side of the body from falling.
The hamstrings
are responsible
for flexing
the leg at the knee during
the swinging
phase.
The tibialis
anterior
shows two periods
ofactivity.
The first takes place during
the swinging
phase and prevents
the foot from dropping
as it passes
the stair.
The second
inverts
the foot
as
the
VOL.
it is placed
foot,
49 B,
while
NO.
on the step below.
Contrary
a subject
walks down stairs,
4,
NOVEMBER
1967
to what happens
when walking
on a flat surface,
is placed
toe to heel not heel to toe, while the weight
780
J. JOSEPH
is transferred
just
before
this
stage
along
the
the
overcomes
normal
of the
that
dorsiflexing
action
in walking
of inversion
one
session
to another.
a variable
from the
foot
by the
contracting
the
tibialis
and
Wright,
beginning
muscles
actively
that
anterior.
are
both
sides
that
back
in many
muscles,
that
individuals
of the
thus
(1962)
phase
of
to as flexors
during
contract
of
the early
the
at
same
of the subjects,
in
the results
varied
at different
trunk,
at
is more
early part of the
to contract
in
pelvis
on
degree
of flexion
back muscles.
soleus
It
referred
on the
It should
be added
of activity
of the
It is suggested
muscles
anterior
of the
Desai and Henderson
of the supporting
flex the thigh
the
tibialis
Contraction
of the latter
muscle
during
the
the tibialis
anterior
continues
time.
They prevent
flexing
of the trunk.
repeated
attempts
to determine
the phases
down
stairs with
of the potentials
place.
that
they
twice
of the
takes
of the
may be the explanation.
can be made
about
the hip.
So far as can be determined,
part of the swinging
phase.
The erector
spinae
contracts
from
Inversion
this
on a flat surface.
of the foot at the
phase
and this
assertions
R. WATSON
foot.
ensures
the continued
contraction
although
it is interesting
supporting
a movement
walking
Again
few
border
phase
the
difficult
to explain
supporting
phase,
the early
described
outer
supporting
AND
times
producing
walk
variable
up and
recordings
SUMMARY
I
Telemetering
certain
muscles
electromyography
of the lower limb
.
2.
During
walking
each complete
3. Walking
above
gluteus
is brought
maximus;
unsupported
phase
and
the
the
and
and
down
revealed
been
back
stairs
the
each
following
limb
phase.
of the
willingly
to
twice
below
control
thank
and
has
Firstly,
raising
the
quadriceps
prevents
body
femoris,
the body
on to the
hamstrings
falling
on
foot
during
the
limb is placed.
of
in
stair
and
to the
swinging
Thirdly,
flex the leg at the knee in the early part of the swinging
phase
and control
of extension
at the knee at the end of this phase.
Fourthly,
both erectores
in each
step
and
and dorsiflexes
the extension
control
the forward
Mr
R.
Medical
cooperated
George
for
Illustration
his
contract
technical
for their
bending
of the
body
at the vertebral
Firstly,
the body is lowered
on to the stair
and quadriceps
femoris
; the gluteus
medius
on to the unsupported
side.
Secondly,
the
of the supporting
phase
as the toe is placed
the foot in the middle
of the leg at the knee
Fourthly,
both erectores
spinae
trunk
at the vertebral
column.
We wish
Photography
pattern
of activity
up and down
stairs.
and swinging
phase
walked
a supporting
anterior
dorsiflexes
the
on which
the supporting
Walking
down
stairs
revealed
the following.
below
by the controlled
lengthening
of the soleus
at the same
time prevents
the body
from falling
tibialis
anterior
inverts
the foot at the beginning
hamstrings
the
investigate
subjects
facts.
4.
on the stair
to
the
about
by the contraction
of the soleus,
the gluteus
medius
at the same
time
part
contract
used
while
side.
Secondly,
the tibialis
helps the limb to clear the stair
hamstrings
terminal
spinae
column.
up
step.
up stairs
has
twice
help
in each
with
assistance
of the
during
in
swinging
phase.
Thirdly,
the
the middle
of the swinging
step
and
the apparatus,
preparing
the
prevent
the
figures,
forward
Departments
and
the
bending
of
Medical
who
so
subjects
in the investigation.
REFERENCES
BATTYE,
C. K., and
Walking.
CALIFORNIA
contractor’s
JOSEPH,
Medical
and
UNIVERSITY.
Report
J. (1966):
Biological
COLLEGE
on
Fundamental
An Investigation
Engineering,
OF
ENGINEERING.
Studies
by Telemetering
of the Activity
of Some
Muscles
in
4, 125.
PROSTHETIC
of
Human
DEVICES
Locomotion
RESEARCH
and
Other
PROJECT
information
(1 947)
: Sub-
Relating
Design
ofArtificialLimbs.
Covering
the Period
from September
1945 through
June 1947.
2 v. [Berkeley.]
WRIGHT,
D. G., DESAI, S. M., and HENDERSON,
W. H. (1962): Action ofthe Subtalar
and Ankle Joint Complex
during the Stance Phase of Walking.
Report No. 48. San Francisco:
University
ofCalifornia,
Biomechanics
Laboratory.
THE
JOURNAL
OF
BONE
AND
JOINT
SURGERY
to