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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