View More View Less
  • 1 Tomishiro Central Hospital, Japan
  • 2 Graduate School of Medicine, University of the Ryukyus, Japan
  • 3 Osaka Electro-Communication University, Japan
  • 4 Graduate School of Medicine, University of the Ryukyus, Japan
  • 5 Advanced Medical Research Center, University of the Ryukyus, Japan
  • 6 Institute for the Promotion of Common Education, Kyoto Sangyo University, Japan
Restricted access

Purchase article

USD  $25.00

1 year subscription (Individual Only)

USD  $752.00

This study aimed to evaluate neuromuscular activation in the scalene and sternocleidomastoid muscles using surface electromyography (EMG) during progressively increased inspiratory flow, produced by increasing the respiratory rate under inspiratory-resistive loading using a mask ventilator. Moreover, we attempted to identify the EMG inflection point (EMGIP) on the graph, at which the root mean square (RMS) of the EMG signal values of the inspiratory muscles against the inspiratory flow velocity acceleration abruptly increases, similarly to the EMG anaerobic threshold (EMGAT) reported during incremental-resistive loading in other skeletal muscles. We measured neuromuscular activation of healthy male subjects and found that the inspiratory flow velocity increased by approximately 1.6-fold. We successfully observed an increase in RMS that corresponded to inspiratory flow acceleration with ρ ≥ 0.7 (Spearman’s rank correlation) in 17 of 27 subjects who completed the experimental protocol. To identify EMGIP, we analyzed the fitting to either a straight or non-straight line related to the increasing inspiratory flow and RMS using piecewise linear spline functions. As a result, EMGIP was identified in the scalene and sternocleidomastoid muscles of 17 subjects. We believe that the identification of EMGIP in this study infers the existence of EMGAT in inspiratory muscles. Application of surface EMG, followed by identification of EMGIP, for evaluating the neuromuscular activation of respiratory muscles may be allowed to estimate the signs of the respiratory failure, including labored respiration, objectively and non-invasively accompanied using accessory muscles in clinical respiratory care.

  • 1.

    Altenburg TM , Degens H , van Mechelen W , Sargeant AJ , de Haan A : Recruitment of single muscle fibers during submaximal cycling exercise. J. Appl. Physiol. 103, 17521756 (2007)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Bai TR , Rabinovitch BJ , Pardy RL : Near-maximal voluntary hyperpnea and ventilatory muscle function. J. Appl. Physiol. Respir. Environ. Exerc. Physiol. 57, 17421748 (1984)

    • Search Google Scholar
    • Export Citation
  • 3.

    Butler JE , McKenzie DK , Gandevia SC : Discharge properties and recruitment of human diaphragmatic motor units during voluntary inspiratory tasks. J. Physiol. 518, 907920 (1999)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Candotti CT , Loss JF , Melo Mde O , La Torre M , Pasini M , Dutra LA : Comparing the lactate and EMG thresholds of recreational cyclists during incremental pedaling exercise. Can. J. Physiol. Pharmacol. 86, 272278 (2008)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Chapman AR , Vicenzino B , Blanch P , Hodges PW : Patterns of leg muscle recruitment vary between novice and highly trained cyclists. J. Electromyogr. Kinesiol. 18, 359371 (2008)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Chiti L , Biondi G , Morelot-Panzini C , Raux M , Similowski T , Hug F : Scalene muscle activity during progressive inspiratory loading under pressure support ventilation in normal humans. Respir. Physiol. Neurobiol. 164, 441448 (2008)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Citterio G , Agostoni E , Piccoli S , Sironi S : Selective activation of parasternal muscle fibers according to breathing rate. Respir. Physiol. 48, 281295 (1982)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Citterio G , Sironi S , Piccoli S , Agostoni E : Slow to fast shift in inspiratory muscle fibers during heat tachypnea. Respir. Physiol. 51, 259274 (1983)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Edwards LJ , Stewart PW , MacDougall JE , Helms RW : A method for fitting regression splines with varying polynomial order in the linear mixed model. Stat. Med. 25, 513527 (2006)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Ertl P , Kruse A , Tilp M : Detecting fatigue thresholds from electromyographic signals: a systematic review on approaches and methodologies. J. Electromyogr. Kinesiol. 30, 216230 (2016)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Farina D , Macaluso A , Ferguson RA , De Vito G : Effect of power, pedal rate, and force on average muscle fiber conduction velocity during cycling. J. Appl. Physiol. 97, 20352041 (2004)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Farina D , Merletti R , Enoka RM : The extraction of neural strategies from the surface EMG. J. Appl. Physiol. 96, 14861495 (2004)

  • 13.

    Figueroa-Casas JB , Broukhim A , Vargas A , Milam L , Montoya R : Inter-observer agreement of spontaneous breathing trial outcome. Respir. Care 59, 13241328 (2014)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Fling BW , Knight CA , Kamen G : Relationships between motor unit size and recruitment threshold in older adults: implications for size principle. Exp. Brain Res. 197, 125133 (2009)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Gea J , Pascual S , Casadevall C , Orozco-Levi M , Barreiro E : Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J. Thorac. Dis. 7, 418438 (2015)

    • Search Google Scholar
    • Export Citation
  • 16.

    Haas CF , Loik PS : Ventilator discontinuation protocols. Respir. Care 57, 16491662 (2012)

  • 17.

    Hawkes EZ , Nowicky AV , McConnell AK : Diaphragm and intercostal surface EMG and muscle performance after acute inspiratory muscle loading. Respir. Physiol. Neurobiol. 155, 213219 (2007)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Helal JN , Guezennec CY , Goubel F : The aerobic-anaerobic transition: re-examination of the threshold concept including an electromyographic approach. Eur. J. Appl. Physiol. Occup. Physiol. 56, 643649 (1987)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Hug F , Laplaud D , Lucia A , Grelot L : A comparison of visual and mathematical detection of the electromyographic threshold during incremental pedaling exercise: a pilot study. J. Strength Cond. Res. 20, 704708 (2006)

    • Search Google Scholar
    • Export Citation
  • 20.

    Johnson BD , Babcock MA , Suman OE , Dempsey JA : Exercise-induced diaphragmatic fatigue in healthy humans. J. Physiol. 460, 385405 (1993)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Jurimae J , von Duvillard SP , Maestu J , Cicchella A , Purge P , Ruosi S , Jurimae T , Hamra J : Aerobic-anaerobic transition intensity measured via EMG signal in athletes with different physical activity patterns. Eur. J. Appl. Physiol. 101, 341346 (2007)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Lucia A , Sanchez O , Carvajal A , Chicharro JL : Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography. Br. J. Sports Med. 33, 178185 (1999)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Macintyre NR : Evidence-based assessments in the ventilator discontinuation process. Respir. Care 57, 16111618 (2012)

  • 24.

    Mador MJ , Acevedo FA : Effect of inspiratory muscle fatigue on breathing pattern during inspiratory resistive loading. J. Appl. Physiol. 70, 16271632 (1991)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Matsuura R , Arimitsu T , Yunoki T , Kimura T , Yamanaka K , Yano T : Effects of deception for intensity on surface electromyogram (SEMG) activity and blood lactate concentration during intermittent cycling followed by exhaustive cycling. Acta Physiol. Hung. 100, 5463 (2013)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Merletti R , Rainoldi A , Farina D : Surface electromyography for noninvasive characterization of muscle. Exerc. Sport Sci. Rev. 29, 2025 (2001)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Monks L , Seo MW , Kim HB , Jung HC , Song JK : High-intensity interval training and athletic performance in Taekwondo athletes. J. Sports Med. Phys. Fitness 57, 12521260 (2017)

    • Search Google Scholar
    • Export Citation
  • 28.

    Moritani T , Sherman WM , Shibata M , Matsumoto T , Shinohara M : Oxygen availability and motor unit activity in humans. Eur. J. Appl. Physiol. Occup. Physiol. 64, 552556 (1992)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Nadiv Y , Vachbroit R , Gefen A , Elad D , Zaretsky U , Moran D , Halpern P , Ratnovsky A : Evaluation of fatigue of respiratory and lower limb muscles during prolonged aerobic exercise. J. Appl. Biomech. 28, 139147 (2012)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Parkash A , Haider N , Khoso ZA , Shaikh AS : Frequency, causes and outcome of neonates with respiratory distress admitted to Neonatal Intensive Care Unit, National Institute of Child Health, Karachi. J. Pak. Med. Assoc. 65, 771775 (2015)

    • Search Google Scholar
    • Export Citation
  • 31.

    Perlovitch R , Gefen A , Elad D , Ratnovsky A , Karamer MR , Halpern P : Inspiratory muscles experience fatigue faster than the calf muscles during treadmill marching. Respir. Physiol. Neurobiol. 156, 6068 (2007)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Powers SK , Wiggs MP , Sollanek KJ , Smuder AJ : Ventilator-induced diaphragm dysfunction: cause and effect. Am. J. Physiol. Regul. Integr. Comp. Physiol. 305, R464R477 (2013)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Ramirez G , Hermans G , Troosters T : The assessment of inspiratory muscle fatigue in healthy individuals: a systematic review. Respir. Med. 107, 331346 (2013)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Scheinhorn DJ , Chao DC , Stearn-Hassenpflug M , Wallace WA : Outcome in post-ICU mechanical ventilation: a therapist-implemented weaning protocol. Chest 119, 236242 (2001)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Schmidt M , Chiti L , Hug F , Demoule A , Similowski T : Surface electromyogram of inspiratory muscles: a possible routine monitoring tool in the intensive care unit. Br. J. Anaesth. 106, 913914 (2011)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Segizbaeva MO , Donina ZhA , Timofeev NN , Korolyov YN , Golubev VN , Aleksandrova NP : EMG analysis of human inspiratory muscle resistance to fatigue during exercise. Adv. Exp. Med. Biol. 788, 197205 (2013)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Shaikh H , Morales D , Laghi F : Weaning from mechanical ventilation. Semin. Respir. Crit. Care Med. 35, 451468 (2014)

  • 38.

    Sheel AW : Respiratory muscle training in healthy individuals: physiological rationale and implications for exercise performance. Sports Med. 32, 567581 (2002)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Usui Y , Kobayashi T , Kakinuma H , Watanabe K , Kitajima T , Matsuno K : An anatomical basis for blocking of the deep cervical plexus and cervical sympathetic tract using an ultrasound-guided technique. Anesth. Analg. 110, 964968 (2010)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Wasserman K , Whipp BJ : Exercise physiology in health and disease. Am. Rev. Respir. Dis. 112, 219249 (1975)

  • 41.

    Wernbom M , Jarrebring R , Andreasson MA , Augustsson J : Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load. J. Strength Cond. Res. 23, 23892395 (2009)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Wilkins RL , Stoller JK , Kacmarek RM (2009): Egan’s Fundamentals of Respiratory Care (9th ed.). Mosby Elsevier, St. Louis, MO

  • 43.

    Xu C , Kwong JS , Zhang C : The use of piecewise linear spline function on dose-response meta-analysis. Ann. Transl. Med. 4, 389 (2016)