Browsing by Author "Ibitoye, Morufu"
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Item The Effectiveness of FES-Evoked EMG Potentials to Assess Muscle Force and Fatigue in Individuals with Spinal Cord Injury.(MDPI, 2014-07) Ibitoye, MorufuThe evoked electromyographic signal (eEMG) potential is the standard index used to monitor both electrical changes within the motor unit during muscular activity and the electrical patterns during evoked contraction. However, technical and physiological limitations often preclude the acquisition and analysis of the signal especially during functional electrical stimulation (FES)-evoked contractions. Hence, an accurate quantification of the relationship between the eEMG potential and FES-evoked muscle response remains elusive and continues to attract the attention of researchers due to its potential application in the fields of biomechanics, muscle physiology, and rehabilitation science. We conducted a systematic review to examine the effectiveness of eEMG potentials to assess muscle force and fatigue, particularly as a biofeedback descriptor of FES-evoked contractions in individuals with spinal cord injury. At the outset, 2867 citations were identified and, finally, fifty-nine trials met the inclusion criteria. Four hypotheses were proposed and evaluated to inform this review. The results showed that eEMG is effective at quantifying muscle force and fatigue during isometric contraction, but may not be effective during dynamic contractions including cycling and stepping. Positive correlation of up to r = 0.90 (p < 0.05) between the decline in the peak-to-peak amplitude of the eEMG and the decline in the force output during fatiguing isometric contractions has been reported. In the available prediction models, the performance index of the eEMG signal to estimate the generated muscle force ranged from 3.8% to 34% for 18 s to 70 s ahead of the actual muscle force generation. The strength and inherent limitations of the eEMG signal to assess muscle force and fatigue were evident from our findings with implications in clinical management of spinal cord injury (SCI) population.Item Effects of muscle fatigue on FES assisted walking of sci patients: A reviewSpringer(Springer, 2014) Ibitoye, MorufuItem Estimation of Electrically-Evoked Knee Torque from Mechanomyography Using Support Vector Regression(Sensors, 2016-07) Ibitoye, MorufuThe difficulty of real-time muscle force or joint torque estimation during neuromuscular electrical stimulation (NMES) in physical therapy and exercise science has motivated recent research interest in torque estimation from other muscle characteristics. This study investigated the accuracy of a computational intelligence technique for estimating NMES-evoked knee extension torque based on the Mechanomyographic signals (MMG) of contracting muscles that were recorded from eight healthy males. Simulation of the knee torque was modelled via Support Vector Regression (SVR) due to its good generalization ability in related fields. Inputs to the proposed model were MMG amplitude characteristics, the level of electrical stimulation or contraction intensity, and knee angle. Gaussian kernel function, as well as its optimal parameters were identified with the best performance measure and were applied as the SVR kernel function to build an effective knee torque estimation model. To train and test the model, the data were partitioned into training (70%) and testing (30%) subsets, respectively. The SVR estimation accuracy, based on the coefficient of determination (R2) between the actual and the estimated torque values was up to 94% and 89% during the training and testing cases, with root mean square errors (RMSE) of 9.48 and 12.95, respectively. The knee torque estimations obtained using SVR modelling agreed well with the experimental data from an isokinetic dynamometer. These findings support the realization of a closed-loop NMES system for functional tasks using MMG as the feedback signal source and an SVR algorithm for joint torque estimation.Item Inexpensive automated medication dispenser for persons with neurodegenerative illnesses in low resource settings, Journal of Medical Engineering & Technology(Tailor & Francis, 2019-11) Ibitoye, MorufuNeurodegenerative illnesses due to diseases or old age are typical examples of clinical conditions that may affect the proper observation of prescribed medication usage with negative consequence on dose potency. Commercially available medicine dispenser for these populations are expensive, complex to operate and/or beyond the reach of those living in low resource settings due to lack of social protection. This study presents the design and construction of an inexpensive ($49.6) medication dispenser suitable for point of care applications in low resource settings. The dispenser was constructed using a simple control mechanism based on Arduino® IDE that controlled three different micro servo motors to accommodate different shapes of medication. Sequel to the laboratory trials by abled individuals, we were able to demonstrate between 58% and 100% accuracy of the device when the three servo motors were simultaneously used to dispense medication of three different sizes. Following rigorous clinical trials in the target population, we intend to deploy this device for wider and independent usage by users in order to prevent unnecessary hospital admission meant to enforce compliance with appropriate medication usage for the users.Item Mechanomyographic Parameter Extraction Methods: An Appraisal for Clinical Applications(MDPI, 2014-12) Ibitoye, MorufuThe research conducted in the last three decades has collectively demonstrated that the skeletal muscle performance can be alternatively assessed by mechanomyographic signal (MMG) parameters. Indices of muscle performance, not limited to force, power, work, endurance and the related physiological processes underlying muscle activities during contraction have been evaluated in the light of the signal features. As a non-stationary signal that reflects several distinctive patterns of muscle actions, the illustrations obtained from the literature support the reliability of MMG in the analysis of muscles under voluntary and stimulus evoked contractions. An appraisal of the standard practice including the measurement theories of the methods used to extract parameters of the signal is vital to the application of the signal during experimental and clinical practices, especially in areas where electromyograms are contraindicated or have limited application. As we highlight the underpinning technical guidelines and domains where each method is well-suited, the limitations of the methods are also presented to position the state of the art in MMG parameters extraction, thus providing the theoretical framework for improvement on the current practices to widen the opportunity for new insights and discoveries. Since the signal modality has not been widely deployed due partly to the limited information extractable from the signals when compared with other classical techniques used to assess muscle performance, this survey is particularly relevant to the projected future of MMG applications in the realm of musculoskeletal assessments and in the real time detection of muscle activityItem Mechanomyography and muscle function assessment: A review of current state and prospects(Elsevier, 2014-06) Ibitoye, MorufuPrevious studies have explored to saturation the efficacy of the conventional signal (such as electromyogram) for muscle function assessment and found its clinical impact limited. Increasing demand for reliable muscle function assessment modalities continues to prompt further investigation into other complementary alternatives. Application of mechanomyographic signal to quantify muscle performance has been proposed due to its inherent mechanical nature and ability to assess muscle function non-invasively while preserving muscular neurophysiologic information. Mechanomyogram is gaining accelerated applications in evaluating the properties of muscle under voluntary and evoked muscle contraction with prospects in clinical practices. As a complementary modality and the mechanical counterpart to electromyogram; mechanomyogram has gained significant acceptance in analysis of isometric and dynamic muscle actions. Substantial studies have also documented the effectiveness of mechanomyographic signal to assess muscle performance but none involved comprehensive appraisal of the state of the art applications with highlights on the future prospect and potential integration into the clinical practices. Motivated by the dearth of such critical review, we assessed the literature to investigate its principle of acquisition, current applications, challenges and future directions. Based on our findings, the importance of rigorous scientific and clinical validation of the signal is highlighted. It is also evident that as a robust complement to electromyogram, mechanomyographic signal may possess unprecedented potentials and further investigation will be enlightening.Item Mechanomyography responses characterize altered muscle function during electrical stimulation-evoked cycling in individuals with spinal cord injury(Elsevier, 2018-07) Islam, M. A.; Ibitoye, MorufuBackground Investigation of muscle fatigue during functional electrical stimulation (FES)-evoked exercise in individuals with spinal cord injury using dynamometry has limited capability to characterize the fatigue state of individual muscles. Mechanomyography has the potential to represent the state of muscle function at the muscle level. This study sought to investigate surface mechanomyographic responses evoked from quadriceps muscles during FES-cycling, and to quantify its changes between pre- and post-fatiguing conditions in individuals with spinal cord injury. Methods Six individuals with chronic motor-complete spinal cord injury performed 30-min of sustained FES-leg cycling exercise on two days to induce muscle fatigue. Each participant performed maximum FES-evoked isometric knee extensions before and after the 30-min cycling to determine pre- and post- extension peak torque concomitant with mechanomyography changes. Findings Similar to extension peak torque, normalized root mean squared (RMS) and mean power frequency (MPF) of the mechanomyography signal significantly differed in muscle activities between pre- and post-FES-cycling for each quadriceps muscle (extension peak torque up to 69%; RMS up to 80%, and MPF up to 19%). Mechanomyographic-RMS showed significant reduction during cycling with acceptable between-days consistency (intra-class correlation coefficients, ICC = 0.51–0.91). The normalized MPF showed a weak association with FES-cycling duration (ICC = 0.08–0.23). During FES-cycling, the mechanomyographic-RMS revealed greater fatigue rate for rectus femoris and greater fatigue resistance for vastus medialis in spinal cord injured individuals. Interpretation Mechanomyographic-RMS may be a useful tool for examining real time muscle function of specific muscles during FES-evoked cycling in individuals with spinal cord injury.Item Prospects of Mechanomyography (MMG) in Muscle Function Assessment during FES Evoked Contraction: A Review(2014) Ibitoye, MorufuSignificant number of research attempts are noticed lately on validation of efficacy of alternative paradigm for muscle function assessment such as MMG after exhaustive trials on voluntary and evoked EMG with limited clinical and experimental impacts. Enhanced performance of conventional FES application for the SCI patients remains elusive partly due to lack of precise prediction of muscle force and fatigue. Quantification of muscle performance by processing MMG parameters is increasingly reported due to availability of inexpensive, non-invasive and sensitive sensors. Substantially, analysis of isometric and dynamic muscle actions using MMG signal during FES evoked contractions are being documented. However, the literature base to holistically address the signal’s applications to assess muscle performance with highlights on experimental and clinical practices could benefit from further validation. Sequel to a systematic literature survey, it is evident that MMG possesses certain salient potentials and further exploration and evaluation studies is suggested especially during evoked dynamic muscle action to further optimize the performance of FES system.Item Quadriceps mechanomyography reflects muscle fatigue during electrical stimulus-sustained standing in adults with spinal cord injury–a proof of concept(Elsevier, 2020) Ibitoye, MorufuThis study investigates whether mechanomyography (MMG) produced from contracting muscles as a measure of their performance could be a proxy of muscle fatigue during a sustained functional electrical stimulation (FES)-supported standing-to-failure task. Bilateral FES-evoked contractions of quadriceps and glutei muscles, of four adults with motor-complete spinal cord injury (SCI), were used to maintain upright stance using two different FES frequencies: high frequency (HF - 35 Hz) and low frequency (LF - 20 Hz). The time at 30° knee angle reduction was taken as the point of critical "fatigue failure", while the generated MMG characteristics were used to track the pattern of force development during stance. Quadriceps fatigue, which was primarily responsible for the knee buckle, was characterized using MMG-root mean square (RMS) amplitude. A double exponential decay model fitted the MMG fatigue data with good accuracy [R2 = 0.85-0.99; root mean square error (RMSE) = 2.12-8.10] implying changes in the mechanical activity performance of the muscle's motor units. Although the standing duration was generally longer for the LF strategy (31-246 s), except in one participant, when compared to the HF strategy, such differences were not significant (p > 0.05) but suggested a faster muscle fatigue onset during HF stimulation. As MMG could discriminate between different stimulation frequencies, we speculate that this signal can quantify muscle fatigue characteristics during prolonged FES applications.Item Restoring prolonged standing via functional electrical stimulation after spinal cord injury: A systematic review of control strategies(Elsevier, 2019-03) Ibitoye, MorufuBackground Functional Electrical Stimulation (FES) technologies can facilitate standing in persons with spinal cord injury (SCI), and prolonged standing elicited via FES may offer both functional and therapeutic benefits to users. However, the current attainable FES-evoked standing duration is typically short and below the threshold for clinical efficacy. To promote the objective selection of suitable control strategies to restore prolonged and higher-quality standing duration, this study summarised current and emerging approaches to FES standing. Method PubMed, IEEE Xplore,Web of Science and Google Scholar databases were searched for relevant studies on FES-evoked standing after SCI between the earliest return date and December 2017. Thereafter, the quality of all included studies was objectively evaluated using the Downs and Black methodological assessment checklist. Results Twenty-five full-length articles, with mean methodological quality score of 56%, met the inclusion criteria and were retained for analysis. Recent advancements to promote prolonged standing relied greatly on the use of voluntary upper extremities for balancing with arm engaged or disengaged. Some widely-reported constraints were issues of unpredictable postural sway, and unusual muscle responses and perturbations, such as spasm or spasticity, which diminished the reliability of the standing control sensors and algorithms. Conclusion Closed-loop control of FES-supported standing with arms-free modality and voluntary upper extremity balancing promoted the “longest” standing duration and “highest” efficacy among the reported methods, albeit with a limited successful transfer of the technology into the routine clinical practice or community deployment. However, open-loop control of FES standing appeared popular, particularly for its therapeutic gains, simplicity of use and other health and psychological benefits associated with weight bearing through the legs. The information from this study could stimulate useful knowledge that may promote clinically significant FES-supported standing duration.Item Strategies for Rapid Muscle Fatigue Reduction during FES Exercise in Individuals with Spinal Cord Injury: A Systematic Review.(PLOS, 2016-02) Ibitoye, MorufuRapid muscle fatigue during functional electrical stimulation (FES)-evoked muscle contractions in individuals with spinal cord injury (SCI) is a significant limitation to attaining health benefits of FES-exercise. Delaying the onset of muscle fatigue is often cited as an important goal linked to FES clinical efficacy. Although the basic concept of fatigue-resistance has a long history, recent advances in biomedical engineering, physiotherapy and clinical exercise science have achieved improved clinical benefits, especially for reducing muscle fatigue during FES-exercise. This review evaluated the methodological quality of strategies underlying muscle fatigue-resistance that have been used to optimize FES therapeutic approaches. The review also sought to synthesize the effectiveness of these strategies for persons with SCI in order to establish their functional impacts and clinical relevance. Methods Published scientific literature pertaining to the reduction of FES-induced muscle fatigue was identified through searches of the following databases: Science Direct, Medline, IEEE Xplore, SpringerLink, PubMed and Nature, from the earliest returned record until June 2015. Titles and abstracts were screened to obtain 35 studies that met the inclusion criteria for this systematic review. Results Following the evaluation of methodological quality (mean (SD), 50 (6) %) of the reviewed studies using the Downs and Black scale, the largest treatment effects reported to reduce muscle fatigue mainly investigated isometric contractions of limited functional and clinical relevance (n = 28). Some investigations (n = 13) lacked randomisation, while others were characterised by small sample sizes with low statistical power. Nevertheless, the clinical significance of emerging trends to improve fatigue-resistance during FES included (i) optimizing electrode positioning, (ii) fine-tuning of stimulation patterns and other FES parameters, (iii) adjustments to the mode and frequency of exercise training, and (iv) biofeedback-assisted FES-exercise to promote selective recruitment of fatigue-resistant motor units. Conclusion Although the need for further in-depth clinical trials (especially RCTs) was clearly warranted to establish external validity of outcomes, current evidence was sufficient to support the validity of certain techniques for rapid fatigue-reduction in order to promote FES therapy as an integral part of SCI rehabilitation. It is anticipated that this information will be valuable to clinicians and other allied health professionals administering FES as a treatment option in rehabilitation and aid the development of effective rehabilitation interventions.Item SVR Modelling of Mechanomyographic Signal Predicts Neuromuscular Stimulation-Evoked Knee Torque in Paralyzed Quadriceps Muscles undergoing Knee Extension Exercise(Elsevier, 2020-02) Ibitoye, MorufuBackground and objective Using traditional regression modelling, we have previously demonstrated a positive and strong relationship between paralyzed knee extensors' mechanomyographic (MMG) signals and neuromuscular electrical stimulation (NMES)-assisted knee torque in persons with spinal cord injuries. In the present study, a method of estimating NMES-evoked knee torque from the knee extensors’ MMG signals using support vector regression (SVR) modelling is introduced and performed in eight persons with chronic and motor complete spinal lesions. Methods The model was developed to estimate knee torque from experimentally derived MMG signals and other parameters related to torque production, including the knee angle and stimulation intensity, during NMES-assisted knee extension. Results When the relationship between the actual and predicted torques was quantified using the coefficient of determination (R2), with a Gaussian support vector kernel, the R2 value indicated an estimation accuracy of 95% for the training subset and 94% for the testing subset while the polynomial support vector kernel indicated an accuracy of 92% for the training subset and 91% for the testing subset. For the Gaussian kernel, the root mean square error of the model was 6.28 for the training set and 8.19 for testing set, while the polynomial kernels for the training and testing sets were 7.99 and 9.82, respectively. Conclusions These results showed good predictive accuracy for SVR modelling, which can be generalized, and suggested that the MMG signals from paralyzed knee extensors are a suitable proxy for the NMES-assisted torque produced during repeated bouts of isometric knee extension tasks. This finding has potential implications for using MMG signals as torque sensors in NMES closed-loop systems and provides valuable information for implementing this method in research and clinical settings.Item Torque and mechanomyogram relationships during electrically-evoked isometric quadriceps contractions in persons with spinal cord injury(Elsevier, 2016-06) Ibitoye, MorufuThe interaction between muscle contractions and joint loading produces torques necessary for movements during activities of daily living. However, during neuromuscular electrical stimulation (NMES)-evoked contractions in persons with spinal cord injury (SCI), a simple and reliable proxy of torque at the muscle level has been minimally investigated. Thus, the purpose of this study was to investigate the relationships between muscle mechanomyographic (MMG) characteristics and NMES-evoked isometric quadriceps torques in persons with motor complete SCI. Six SCI participants with lesion levels below C4 [(mean (SD) age, 39.2 (7.9) year; stature, 1.71 (0.05) m; and body mass, 69.3 (12.9) kg)] performed randomly ordered NMES-evoked isometric leg muscle contractions at 30°, 60° and 90° knee flexion angles on an isokinetic dynamometer. MMG signals were detected by an accelerometer-based vibromyographic sensor placed over the belly of rectus femoris muscle. The relationship between MMG root mean square (MMG-RMS) and NMES-evoked torque revealed a very high association (R2 = 0.91 at 30°; R2 = 0.98 at 60°; and R2 = 0.97 at 90° knee angles; P < 0.001). MMG peak-to-peak (MMG-PTP) and stimulation intensity were less well related (R2 = 0.63 at 30°; R2 = 0.67 at 60°; and R2 = 0.45 at 90° knee angles), although were still significantly associated (P ≤ 0.006). Test-retest interclass correlation coefficients (ICC) for the dependent variables ranged from 0.82 to 0.97 for NMES-evoked torque, between 0.65 and 0.79 for MMG-RMS, and from 0.67 to 0.73 for MMG-PTP. Their standard error of measurements (SEM) ranged between 10.1% and 31.6% (of mean values) for torque, MMG-RMS and MMG-PTP. The MMG peak frequency (MMG-PF) of 30 Hz approximated the stimulation frequency, indicating NMES-evoked motor unit firing rate. The results demonstrated knee angle differences in the MMG-RMS versus NMES-isometric torque relationship, but a similar torque related pattern for MMG-PF. These findings suggested that MMG was well associated with torque production, reliably tracking the motor unit recruitment pattern during NMES-evoked muscle contractions. The strong positive relationship between MMG signal and NMES-evoked torque production suggested that the MMG might be deployed as a direct proxy for muscle torque or fatigue measurement during leg exercise and functional movements in the SCI population.