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The lateral row may require a visit to your school gymnasium, which is a good excuse to get your pump on after you do your experiments. HO=healthy older; HP=hospitalized patient; HY=healthy younger; MRC Score=Medical Research Council Score of Strength; MVIC=maximal voluntary isometric contraction. You could also compare different muscles from the same body; investigate whether people's arms or legs have different rates of fatigue, or just compare left and right arms. Epub 2007 Jul 20. Lots of research has been done into looking at this difference (example), and it has been found (by us too!) 1960;18:123-64 Skrzat, N. Gaeckle, Providing facilities/equipment: J.M. Would you like email updates of new search results? 0 s Patients who were hospitalized had the shortest TTTF after both isometric and dynamic contractions. Now repeat for the last five seconds of the signal, just before the subject relaxed. TIME TO FATIGUE INTRODUCTION LABORATORY SIMULATION Lab Data X HASE 2 ime to Is that the correct time to fatigue? 10 0 obj 15 s Unable to load your collection due to an error, Unable to load your delegates due to an error. L02 Electromyography (EMG) II Procedure - Biopac - YUMPU What makes this fatigue different is that it can also be a symptom of disease. TIME TO FATIGUE), Lab Data The periodogram function was used to output a frequency vector and power spectral density estimate of the signal (PSD_EMG) using the sEMG signal and sampling frequency as inputs. , Sharshar T, Lefaucheur JP, et al. Additional exclusion criteria for patients who were hospitalized were documented active bleeding disorders; platelets less than50,000 L; potassium less than3.5mEq/L or greater than 5.0mEq/L; and sodium less than 135mmol/L or greater than 146mmol/L. 1. Complete Record continue 19 kg Time 0 Force (kg) Number of active motor units 48 4 At 30 se count nu Record continue 15 5 43 3 30 5 38 3 455 30 2 0 At 45 sec bount nu Record in continue 605 24 2 755 19 1 At 60 sec count nu Record Since we are interested in fatigue, which can be thought of as muscular performance over time, we will have the x-axis be precisely that -- time. Physical therapists are in a prime position to address HAD with therapeutic interventions, including an interval-based exercise prescription. 0 s 48 4 2.19). At 60 seconds, m Brambilla C, Pirovano I, Mira RM, Rizzo G, Scano A, Mastropietro A. The Kruskal-Wallis test for equality of populations rank test was performed to identify any between-group differences. Unformatted text preview: Force decreases over time due to a decrease in motor units. Findings from five separate studies of EMG changes and muscle fatigue during prolonged low-level static contractions are summarized, and the possible mechanisms behind the changes are briefly discussed. Front Physiol. <>/XObject<>>>/Type/XObject/Subtype/Form/BBox[0 0 595 842]/Matrix[1 0 0 1 0 0]/FormType 1>>stream All sensors were secured with skin tape and elastic bandages. Electromyography and fatigue during prolonged, low-level static The institutions Institutional Review Board approved the protocol, and all subjects provided written consent prior to participation. B Now that we've got our values, let's chart them out to make them easier to manage. . 75 s 19 1, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Give Me Liberty! <>/Border[0 0 0]/P 3 0 R>> If you design an experiment and come up with some cool results, email us at hello@backyardbrains.com! License. Central fatigue is something that can be largely "trained away," and it affects novice athletes who are performing activities they do not have a lot of experience with. The MMFS allows for comparisons between workplace tasks, which can aid in workplace design to mitigate the development of fatigue. motor units Beginning at age 50, muscle mass decreases at an annual rate of 1% to 2%, and a decline in muscle strength of 1.5% to 3% per year is documented.22 Further research is needed to understand muscular physiological changes in HAD and their influence on muscle fatigue. Before Using a System-Based Monitoring Paradigm to Assess Fatigue during Submaximal Static Exercise of the Elbow Extensor Muscles. hb```Vaf`0pl8p3XBD';@Ss2`Vh\:K]pHvE']2:::4FG B hF(@Z"_H3Z1] pdkDob=wPeWd4QRH3g `>P Seems mathematically excessive and unnecessary, so why do scientists even do this? Secondary analysis compared Fmed at initiation and termination of fatiguing contraction. There were 37 participants. In this experiment, you will learn about and compare the rate of muscle fatigue between different people and muscle groups. Post processing of sEMG and IMU data was accomplished using a custom code written in MatLab. Think about different variables you can test. B Slide the button on the grip strength scale to the maximum of 40. 24 Use of Surface Electromyography to Measure Muscle Fatigue in Patients Certainly. Record in La play to continue 08 15 s 30 s At 45 seconds, me count number of a units. sEMG and IMU data were synchronized and simultaneously collected at 500 Hz and recorded on to a computer tablet (Google Nexus; Google LLC, Mountain View, CA, USA) using Consensys software (Shimmer, Dublin, Ireland). This is Robert's rate of fatigue and what we are principally concerned with. Tucker, Consultation (including review of manuscript before submitting): T. Dai, R. Lauer, N. Gaeckle, C.A. De Jonghe W*gi&0t9V3=7=qWjg_/Qp7\|U-.>eKc jQ-q_*R/j, 3mWWCPCe-U{p{gh]FUP+4#S/iFi'wyN;F?j'*F3 wV/7-pjf5V0*' These are the moments when other motor units are jumping in to attempt to maintain the same amount of intensity. PP`=#,cY3B8H5Jg2JWnAn@o1'uV+YT2rR"y1!Ul(:l3Ai\BX/*n*4O*N\X}aRDyQ8Dz7 . What can the slope of the trend line teach you about muscle fatigue? An official website of the United States government. There were also statistically significant differences between patients who were hospitalized and healthy younger people, and between hospitalized patients and healthy older people after a dynamic contraction. Repeat the process until you have collected the data for all your subjects. It was followed by a post hoc Wilcoxon rank sum test to determine differences amongst groups. Question: ELECTROMYOGRAPHY. Solved Lab Data Is that the correct time to fatigue? Time - Chegg , Yoon T, Hunter S. Dalton What will the data reveal? And our y-axis? Medians and IQR are provided in seconds. Root and mean go hand in hand together here. National Library of Medicine official website and that any information you provide is encrypted Electromyography - Time to Fatigue - 10/18/21, 5:43 PM - Studocu These are the moments when other motor units are jumping in to attempt to maintain the same amount of intensity. Turn the wheel on your Muscle SpikerBox all the way up, then have your subject flex as hard as they can. C See Answer Once you can, have your subject relax a couple of minutes. How do you measure the time of fatigue (s)? 3). Oxford University Press is a department of the University of Oxford. Record in L play to continue 45 s 60 s 75 s At 60 seconds, m count number of units. Calculating the average rates of fatigue, the women had an average rate -0.06 mV/s, and the men came in at -0.11 mV/s. The authors developed a function to quantify fatigue in multiple shoulder muscles by generating a single score using relative changes in EMG amplitude and frequency over time. Think of examples where you encounter muscle fatigue in your daily life. Neyroud D, Rttimann J, Mannion AF, Millet GY, Maffiuletti NA, Kayser B, Place N. J Appl Physiol (1985). Donec aliquet. All participants provided written consent prior to participation. National Institute for Occupational Safety and Health This was performed for the rectus femoris and VL during isometric and dynamic contractions. R <>/Border[0 0 0]/P 3 0 R>> First, connect your subject to the Muscle SpikerBox and your Muscle Spikerbox to 1) your computer using a USB or laptop cable or 2) to smartphone/tablet using the green smartphone cable. This site needs JavaScript to work properly. This leads to a weakening of the muscle contraction called muscle fatigue. Tucker, Project management: J.M. , Mangione KK, Stevens-Lapsley JE. Each 60-s work cycle consisted of four tasks (dynamic push, dynamic pull, static drill, static force target matching task) scaled to participants' anthropometrics and strength. Brambilla C, Lavit Nicora M, Storm F, Reni G, Malosio M, Scano A. Bioengineering (Basel). Zanni which is a good corollary for the amount of force we are generating. Myoelectric signals are formed by physiological variations in the state of muscle fiber membranes." (Basmajian, J.V. Are they tougher? Careers. For this experiment, you may be interested in comparing young versus old subjects, boys versus girls, or maybe you want to compare people who have a high-weight max bench press versus a low-weight max. First, note: Depending on which muscle you choose to record from, the magnitude of your RMS value may vary! 45 s 30 2 Appointments 866.588.2264 Appointments & Locations 1970 Nov;219(5):1324-9 1982;14(5):377-81 Complete Record continue 19 kg Time 0 Force (kg) Number of active motor units 48 4 At 30 se count nu Record continue 15 5 43 3 30 5 38 3 455 30 2 0 At 45 sec bount nu Record in continue 605 24 2 755 19 1 At 60 sec count nu Record. . that women's endurance is often greater than men's. Evaluating both frequency and amplitude components of the electromyographic signal provides a more complete evaluation of muscle fatigue than either variable alone; however, little effort has been made to combine time and frequency domains for the evaluation of myoelectric fatigue. 30 s 38 3 This fatigue is what you most commonly experience when you're pumping iron at the gym, loading logs onto your truck, or other short bursts of intense exercise. Time is our x variable and RMS is our y variable. Ch?/(8_pQt G 5aa/Os )0LM[ta22`&dfa0(k~8O0J$DArltC2pw6zW=?NFh MMFS scores increased over time ( p < .05) with significant relationships between MMFS and strength changes and RPF ( p < .05). A limitation of the study was the small sample size of patients who were hospitalized without matched controls. Electromyography - Time to Fatigue Electromyography - Time to Fatigue lab stimulation. Are they tougher? Record in La play to continue 08 15 s 30 s At 45 seconds, me count number of a units. Record in L play to continue 45 s 60 s 75 s At 60 seconds, m count number of units. and transmitted securely. %PDF-1.7 Sensors (Basel). To transform the EMG signal in the time-domain to the frequency-domain, a Fourier transform of the autocorrelation function of the EMG signal is employed to provide the power spectrum (PS) or the power spectral density (PSD). To the best of our knowledge, no one has studied muscle fatigue using sEMG in patients in the hospital. CI = critically ill; Fmed, median frequency; HO=healthy older; HY=healthy younger; NS=not statistically significant; RF = rectus femoris; VL = vastus lateralis. We have also built a simple lab handout to help you tabulate your data. that women's endurance is often greater than men's. Instead of using strict amplitude, we will use the RMS (root mean squared) which is a conversion of the amplitude. 9 Sensors (Basel). Decide which muscles you want to record from and apply the muscle electrodes in the usual manner. With the exception of the vastus lateralis during a dynamic contraction in healthy younger and hospitalized patients, there was a statistically significant difference between Fmed at initiation and termination of contraction, indicating that subjects muscles did truly fatigue. 7 0 obj J Electromyogr Kinesiol. Participant characteristics for healthy younger, healthy older, and hospitalized participants are in Table 1. and N.G. You can compare people at a neutral state, and then at a tired or excited state. To guide interventions and optimize patients function, an understanding of muscle fatigue is warranted. PMC Calculate the ti <>/Border[0 0 0]/P 3 0 R>> It's The Backyard Brains 10-Year Anniversary! count number o This formula represents the trend line for the first test subject's EMG signal during the fatigue test. electromyography; fatigue; muscles; quantification; shoulder. endobj Conclusion and application: Why would they be better at maintaining their strength over a longer period of time? People with Multiple Sclerosis typically exhibit greater levels of exercise-induced fatigue compared to healthy individuals. 2023 Apr 5;10(4):445. doi: 10.3390/bioengineering10040445. 11 0 obj hbbd```b``6 4KAt3d"Y"HFsbV 30 s 2013 May 15;114(10):1426-34. doi: 10.1152/japplphysiol.01539.2012. Further analysis of the EMG, such as time-to-fatigue measurement and correlation study, were performed off-line. When the subject can no longer maintain the weight, stop the recording. 45 s Interpretation of EMG changes with fatigue: facts, pitfalls, and fallacies. The protocol yielded similar results to previously published literature for healthy younger and healthy older people. If you have our new Muscle SpikerBox Pro, you do not have to worry about gain clipping, the circuit won't let you! Carp, R. Lauer, S.V. Suriyaarachchi During the entire protocol, a bolster was placed under the knees to position the hips and knees in approximately45 flexion, allowing the quadriceps to have adequate range for knee flexion/extension in the mid to shortened range of the knee extensors for both isometric and dynamic tasks. However, it is unknown if voluntary muscle activation is affected over a range of contraction forces in people with MS who have exercise-induced fatigue. This is the first study, to our knowledge, to introduce lab quality, quantitative measurement techniques to study muscle fatigue in the acute care environment. If you start hitting the gym, pumping iron, and getting fitter, what will happen to your rate of fatigue. Descriptive statistics for TTTF for all groups are in Table 2. Are they stronger? Turn the wheel on your Muscle SpikerBox all the way up, then have your subject flex as hard as they can. Epub 2015 Jul 13. HHS Vulnerability Disclosure, Help Carp, C.A. J Electromyogr Kinesiol. 9 0 obj A significant difference indicates true muscle fatigue. 38 Changes in soleus motoneuron pool reflex excitability and surface EMG parameters during fatiguing low- vs. high-intensity isometric contractions. %%EOF Maybe! What can the slope of the trend line teach you about muscle fatigue? Concept/idea/research design: J.M. If you start hitting the gym, pumping iron, and getting fitter, what will happen to your rate of fatigue? . 1. START NOW Page P-12 L02 - Electromyography ( EMG) II Biopac Student Lab 4 ELECTROMYOGRAPHY II NN 60 5 75 5 19 1 Time to Fatigue (s) This problem has been solved! Take notes during your experiments and try to figure out what kind of fatigue you are witnessing! units. 2021 May 22;20(1):50. doi: 10.1186/s12938-021-00888-2. Patients in the hospital are susceptible to development of HAD. Epub 2013 Mar 7. , Combret Y, Prieur G, et al. Press the on (play) button on the electromyogram. Larger muscles produce more activity, generating a higher RMS. Given this and a relatively small group size of patients who were hospitalized, nonparametric tests were performed to examine between-group differences. Slow isometric contractile properties can allow more economical muscle activation through reduced motor unit discharge rates, and therefore lower ATP turnover in older adults.21 For dynamic contractions, protocols involved relatively low loads, which could recruit more type I muscle fibers for endurance rather than type II muscle fibers, which are primarily used for power. Now calculate the slope, or rate of fatigue, for all your subjects. Are they stronger? By solving an equation for slope, we can build a trend line, which will give us a "model" of our muscular fatigue over time. endobj units. Time is our x variable and RMS is our y variable. After 5% MVC sustained contractions for one hour a 12% reduction in MVC was seen, and significant increases in EMG amplitude and decreases in the mean spectral frequency of the EMG-power spectrum were found. sEMG is a lab quantitative technique that was found to be safe and feasible to assess muscle fatigue, with a protocol that yielded similar results to previously published literature. Now let us consider the case of Robert. Federal government websites often end in .gov or .mil. Sommers From our previous experiments we learned a bit about why muscles fatigue and how to view this process in real time using the Muscle SpikerBox. Quick Note: Do not change the gain while you are doing a recording, as this will affect your RMS values and the measurement of fatigue rates. Lots of research has been done into looking at this difference (example), and it has been found (by us too!) Turn down the "volume" wheel (gain of the signal) until you can see the tops and bottoms of all the spikes. His initial RMS value was 26.85 and decreased to 17.20 over 85 seconds. Does it ever serve as a beneficial function? Effects of Fatigue on Postural Sway and Electromyography Modulation in Young Expert Acrobatic Gymnasts and Healthy Non-trained Controls During Unipedal Stance. Although it is well known that patients muscles during hospitalization develop atrophy and weakness,11 little is known about peripheral muscle fatigability in this patient population. count number of , Van Den Boorn M, Engelbert R, et al. An a priori power analysis for a 1-way analysis of variance for comparison of TTTF across groups was performed with G*Power 3.1. 1985 Oct;125(2):265-75. doi: 10.1111/j.1748-1716.1985.tb07715.x. The more values, the more compelling the results! A Nam risus ante, dapibus a molestie consequat, ultr, View answer & additonal benefits from the subscription, Explore recently answered questions from the same subject, Explore documents and answered questions from similar courses. Complete Record continue 19 kg Time 0 Force (kg) Number of active motor units 48 4 At 30 se count nu Record continue 15 5 43 3 30 5 38 3 455 30 2 0 At 45 sec bount nu Record in continue 605 24 2 755 19 1 At 60 sec count nu Record in continue Time to Fatigue (6) Amplitude A How to Measure At 75 sec count nu Record in. Open up your first recording, zoom all the way out; we're going to be measuring the RMS from the first and last five seconds of the recording: The assessment of back muscle capacity using intermittent static contractions. Does it ever serve as a beneficial function? 5. If you are in a classroom, get everyone involved! If the signal is clipping, like this: Method: Therefore, the purposes of our study were (1) to assess the safety and feasibility of collecting sEMG at the acute care hospital bedside, and (2) to determine differences in muscle fatigue during isometric and dynamic submaximal contractions among 3 groups: patients who were hospitalized, healthy younger participants, and healthy older participants. Sample graphics can be found in Appendices 13. PMC , Fan E, Brower R, Needham D. Kortebein 19 The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Further research is needed to better understand how to integrate sEMG findings into patient-centered exercise prescriptions. What will the data reveal? Fmed of sEMG data was calculated based on a power spectral density of the raw sEMG signal using the periodogram and medfreq functions in MatLab. Now we take the "sum of the squares" of the signal and divide it by the number of samples we took to get our mean (or average) value. When the fatigue termination criteria were met, TTTF occurred, and recording stopped. Record in La play to continue 08 15 s 30 s At 45 seconds, me count number of a units. Static and dynamic myoelectric measures of shoulder muscle fatigue during intermittent dynamic exertions of low to moderate intensity. , Schlinder-Delap B, Hunter S. Medrinal , Redden DT, Flood KL, Allman RM. Bookshelf Our preliminary data thus suggests that women may have better muscle endurance, fatiguing at a slower rate! endobj Your recording may look something like this: 15 s 43 3 The depressed gas pedal, like the electric stimulation, forces the engine to run strong. , Power G, Vandervoort A, Rice C. Yoon For each recording you thus have three measurements 1) total time in seconds - Total Time(s), 2) RMS of the first five seconds - RMS Begin, and 3) RMS of the last five seconds - RMS End. Healthy younger and healthy older participants were included as control groups to assess and compare reliability of the protocol and technology with previously published literature. Instruct the subject to keep the muscle active for as long as they can, even as they feel themselves getting "weaker." Both force and motor unit recruitment will decrease over time while maintaining maximum grip, I will start with maximum grip strength and hold it as long as possible while measuring the force and. Federal government websites often end in .gov or .mil. Disclaimer. X Edwards (1981) described muscle fatigue as a "failure to maintain the required or expected force", and Vollestad (1997 . All other statistical analyses were completed in Stata/MP (Version 13.0; StataCorp LLC, College Station, TX, USA). EMG (Electromyography): What It Is, Purpose, Procedure & Results Muscle fatigue is calculated as a percentage (value after fatigue divided by value before fatigue 100). This formula represents the trend line for the first test subject's EMG signal during the fatigue test. 3. Epub 2018 Jan 9. In fatigue analysis, the sEMG features of interest are median frequency (Fmed) and mean frequency. When examining an electromyogram (EMG) recording of this fatigue, it is common to see a decreasing trend in EMG amplitude, but with bursts of renewed intensity at points within the recording. sEMG provides insights into muscle performance in normal and pathological conditions, and has been used to study muscle fatigue in healthy younger and healthy older individuals. Where can we see this in a non-scientific setting though? play to continue Anatomy and Physiology questions and answers, A Lab Data HASE 2: Time to fatigue Time Force (kg) Number of active motor units Complete the followin count number of a units. First, connect your subject to the Muscle SpikerBox and your Muscle Spikerbox to 1) your computer using a USB or laptop cable or 2) to smartphone/tablet using the green smartphone cable. "m" is the slope of our trend line that we're calculating for the fatigue signal. I will start with maximum grip strength and hold it as long as possible while measuring the force and Further research is needed to better understand how to integrate sEMG findings into the development of patient-centered exercise prescriptions. Time Force (kg) Number of active motor units os 48 4 15 s 43 3 30 S 38 (V) 45 s 30 . The skin was cleansed and prepped with alcohol wipes, followed by placement of the sEMG sensors based on standard sEMG guidelines20 and confirmed by palpation of landmarks during active muscle contraction. Carp, T. Dai, R. Lauer, S.V. and transmitted securely. Six . When examining an electromyogram (EMG) recording of this fatigue, it is common to see a decreasing trend in EMG amplitude, but with bursts of renewed intensity at points within the recording. Outliers were removed if they were more than 2 SDs from the mean. and, with your permission, we'll share it on our website! 13-15 sEMG has also been used in the intensive care unit to monitor muscle activity of the rectus femoris during in-bed cycling 16,17 and to assess diaphragm function in h^U%boj"z1:oTpADzo)o#R 0t("Z-zK-^ZZjyC}WQ2Te *Q] TIME TO FATIGUE INTRODUCTION LABORATORY SIMULATION Lab Data X HASE 2 ime to Is that the correct time to fatigue? With your right mouse button (or double tap on tablet), click and drag from the beginning of the signal until you have selected a five second sample. Have you ever thought to yourself, "I could probably run much further, but I just don't waaannnnaaa?" Observe the EMG screen for the maximum force, pause the screen. endobj Electromyography: Time to Fatigue Flashcards | Quizlet Unauthorized use of these marks is strictly prohibited. Boyne This study has limitations. The electrical signal is emitted by the muscle fiber during each activation and subsequently detected by the sEMG sensor.12 sEMG sensors are wireless and compact, allowing assessment of muscle activity in a multitude of environments with minimal impact on typical movement patterns. 2016 Aug;29:34-41. doi: 10.1016/j.jelekin.2015.07.003. Since our experiment started at time = 0, 0 will be the second x variable. For each recording you thus have three measurements 1) total time in seconds - Total Time(s), 2) RMS of the first five seconds - RMS Begin, and 3) RMS of the last five seconds - RMS End. Subjects continuously flexed and extended their knee through a 0 to 45 knee range of motion in time with a metronome set at a rate of 1 beat every 2.5seconds. da Silva MC, da Silva CR, de Lima FF, Lara JR, Gustavson JP, Magalhes FH. , Pohlman M, Pohlman A, et al. endobj The mean Medical Research Council Score for patients who were hospitalized was 47.0. [XR-Wb`lq8k%0gjhExbU*q-x5"5xvj[P;>cEcea~S.Qd*~e cCl(%NKI"!~B"cJNaGkpM - qYApMH&u"q$Od^G /v`FRx~ZHJr0h9lC8S4WZe`RjXf*A9N!w,ME:i0"l9YaK`CJ`lIJYGc&Ks. Tucker, Data analysis: J.M. So let's try that with our signal: That covers the square, but what about Root and Mean? 2022 Feb 9;13:782838. doi: 10.3389/fphys.2022.782838. Additionally, the study of muscle fatigue, using these measurements, in an acutely ill patient population adds to the current limited existing knowledge. 1985 Oct;125(2):265-75 Address all correspondence to Dr Skrzat at: Search for other works by this author on: The underrecognized epidemic of low mobility during hospitalization of older adults, Bench-to-bedside review: mobilizing patients in the intensive care unitfrom pathophysiology to clinical trials, Rehabilitation for hospital-associated deconditioning, Early mobilization in the intensive care unit: a systematic review, Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial, Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project, Intensive care unit-acquired weakness: implications for physical therapy management, Rethinking hospital-associated deconditioning: proposed paradigm shift, High-intensity interval training and moderate-intensity continuous training in ambulatory chronic stroke: a feasibility study, Evaluating effectiveness of an acute rehabilitation program in hospital-associated deconditioning, Age and load compliance alter time to task failure for a submaximal fatiguing contraction with the lower leg, The age-related slowing of voluntary shortening velocity exacerbates power loss during repeated fast knee extensions, Fatigability and recovery of arm muscles with advanced age for dynamic and isometric contractions, Comparison of exercise intensity during four early rehabilitation techniques in sedated and ventilated patients in ICU: a randomised crossover trial, Feasibility of muscle activity assessment with surface electromyography during bed cycling exercise in intensive care unit patients, Measurement of diaphragmatic electrical activity by surface electromyography in intubated subjects and its relationship with inspiratory effort, Paresis acquired in the intensive care unit, a prospective multicenter study, National Institute for Occupational Safety and Health, Selected Topics in Surface Electromyography for Use in the Occupational Setting: Expert Perspectives, Aspects of physical medicine and rehabilitation in the treatment of deconditioned patients in the acute care setting: the role of skeletal muscle, 2020 American Physical Therapy Association, This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (.
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