Electromyography (EMG) Signal Processing to Evaluate Low-Frequency Tremors
Abstract
1. Introduction
2. Methodology
2.1. Study Design and Ethical Approval
2.2. Participants
2.3. Instrumentation
2.4. Task Protocol
- Handwriting: Adapted from MDS-UPDRS (Task 2.7). In the scale, this question is assessed through the participants’ experience over the past week of people having difficulties reading their handwriting. The choice to include this question as a quantitative task was based on the literature [30,31] regarding improving this evaluation as a motor task rather than a subjective question.
- Hobbies/activities: Adapted from MDS-UPDRS Part III (Task 3.3). To aim is to examine rigidity during movement. The participant was required to move an object from a position on their left-hand side, to a position on their right-hand side.
- Finger tapping: A combination of elements from MDS-UPDRS Part III (Task 3.3 and 3.4). Task 3.3’s objective was to examine rigidity, which is a slow passive movement of major joints, an activation manoeuvre that is recommended if no rigidity is detected, which is where Task 3.4 is integrated. Task 3.4 is where the participant taps their index finger on their thumb 10 times as quickly and as fully as possible.
- Hand movements: A replication of MDS-UPDRS Part III (Task 3.5). The participant is instructed to make a tight fist with the arm bent at the elbow so that the palm faces the examiner. The participant will open the hand 10 times as fully and as quickly as possible.
- Pronation–supination: Task 5 is a replication of Task 3.6 from Part III. The participant should extend their arm out in front of their body with the palms facing down, then turn the palm up and down alternately 10 times as fast and fully as possible.
- Kinetic tremor: Task 6 is adapted from Task 3.16 from Part III. This is tested by a finger-to-nose manoeuvre. With the arm starting in an outstretched position, the participant should perform at least 3 finger-to-nose manoeuvres. To minimise variability with the tasks during testing, a static object with three points horizontally placed was used in place of an examiner’s finger. The participant was to touch finger to nose from left to right.
- Postural tremor: Task 7 is a replication of Task 3.15 from Part III. The participant should stretch the arms out in front of the body with palms facing down, the wrist should be straight, and fingers comfortably spread.
- Baseline and post-baseline: Both baselines are adapted from Task 3.17 and 3.18 of the MDS-UPDRS. The participant should sit quietly in a chair with hands placed on the arm of the chair, and their feet comfortably supported on the floor for 10 s with no other directives.
2.5. Signal Pre-Processing
2.6. Statistical Analysis
3. Results
3.1. Rest Frequency (RFG) (3.5–6 Hz)
3.2. Action Frequency (AFG) (6–9 Hz)
3.3. Postural Frequencies (PFG) (9–12 Hz)
3.4. Normal Frequencies (NFG) (12+ Hz)
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| PD | Parkinson’s Disease |
| MDS-UPDRS | Movement Disorder Society—Unified Parkinson’s Disease Rating Scale |
| sEMG | Surface Electromyography |
| IMU | Inertial Measurement Units |
Appendix A
STFT Equations
References
- Bloem, B.R.; Okun, M.S.; Klein, C. Parkinson’s disease. Lancet 2021, 397, 2284–2303. [Google Scholar] [CrossRef]
- Saikia, A.; Majhi, V.; Hussain, M.; Paul, S.; Datta, A. Tremor Identification Using Machine Learning in Parkinson’s Disease. Early Detection of Neurological Disorders Using Machine Learning Systems. Available online: https://www.igi-global.com/chapter/tremor-identification-using-machine-learning-in-parkinsons-disease/www.igi-global.com/chapter/tremor-identification-using-machine-learning-in-parkinsons-disease/230114 (accessed on 25 February 2022).
- Kalia, L.V.; Lang, A.E. Parkinson’s disease. Lancet 2015, 386, 896–912. [Google Scholar] [CrossRef]
- Deb, R.; An, S.; Bhat, G.; Shill, H.; Ogras, U.Y. A Systematic Survey of Research Trends in Technology Usage for Parkinson’s Disease. Sensors 2022, 22, 5491. [Google Scholar] [CrossRef]
- Goetz, C.G.; Tilley, B.C.; Shaftman, S.R.; Stebbins, G.T.; Fahn, S.; Martinez-Martin, P.; Poewe, W.; Sampaio, C.; Stern, M.B.; Dodel, R.; et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Mov. Disord. 2008, 23, 2129–2170. [Google Scholar] [CrossRef]
- Pitton Rissardo, J.; Fornari Caprara, A.L. Parkinson’s disease rating scales: A literature review. Ann. Mov. Disord. 2020, 3, 3. [Google Scholar] [CrossRef]
- Rovini, E.; Maremmani, C.; Cavallo, F. How Wearable Sensors Can Support Parkinson’s Disease Diagnosis and Treatment: A Systematic Review. Front. Neurosci. 2017, 11, 555. [Google Scholar] [CrossRef] [PubMed]
- Kleinholdermann, U.; Wullstein, M.; Pedrosa, D. Prediction of motor Unified Parkinson’s Disease Rating Scale scores in patients with Parkinson’s disease using surface electromyography. Clin. Neurophysiol. 2021, 132, 1708–1713. [Google Scholar] [CrossRef]
- Daneault, J.-F.; Vergara-Diaz, G.; Parisi, F.; Admati, C.; Alfonso, C.; Bertoli, M.; Bonizzoni, E.; Carvalho, G.F.; Costante, G.; Fabara, E.E.; et al. Accelerometer data collected with a minimum set of wearable sensors from subjects with Parkinson’s disease. Sci. Data 2021, 8, 48. [Google Scholar] [CrossRef] [PubMed]
- Zhang, H.; Li, C.; Liu, W.; Wang, J.; Zhou, J.; Wang, S. A Multi-Sensor Wearable System for the Quantitative Assessment of Parkinson’s Disease. Sensors 2020, 20, 6146. [Google Scholar] [CrossRef]
- Marcante, A.; Di Marco, R.; Gentile, G.; Pellicano, C.; Assogna, F.; Pontieri, F.E.; Spalletta, G.; Macchiusi, L.; Gatsios, D.; Giannakis, A.; et al. Foot Pressure Wearable Sensors for Freezing of Gait Detection in Parkinson’s Disease. Sensors 2021, 21, 128. [Google Scholar] [CrossRef]
- Lu, R.; Xu, Y.; Li, X.; Fan, Y.; Zeng, W.; Tan, Y.; Ren, K.; Chen, W.; Cao, X. Evaluation of Wearable Sensor Devices in Parkinson’s Disease: A Review of Current Status and Future Prospects. Park. Dis. 2020, 2020, e4693019. [Google Scholar] [CrossRef] [PubMed]
- Forjaz, M.J.; Ayala, A.; Testa, C.M.; Bain, P.G.; Elble, R.; Haubenberger, D.; Rodriguez-Blazquez, C.; Deuschl, G.; Martinez-Martin, P.; International Parkinson and Movement Disorder Society Tremor Rating Scale Task Force. Proposing a Parkinson’s disease–specific tremor scale from the MDS-UPDRS. Mov. Disord. 2015, 30, 1139–1143. [Google Scholar] [CrossRef] [PubMed]
- Teshuva, I.; Hillel, I.; Gazit, E.; Giladi, N.; Mirelman, A.; Hausdorff, J.M. Using wearables to assess bradykinesia and rigidity in patients with Parkinson’s disease: A focused, narrative review of the literature. J. Neural Transm. 2019, 126, 699–710. [Google Scholar] [CrossRef] [PubMed]
- Capato, T.T.C.; Rodrigues, R.; Cury, R.G.; Teixeira, M.J.; Barbosa, E.R. Clinical assessment of upper limb impairments and functional capacity in Parkinson’s disease: A systematic review. Arq. Neuropsiquiatr. 2023, 81, 1008–1015. [Google Scholar] [CrossRef]
- Tolosa, E.; Garrido, A.; Scholz, S.W.; Poewe, W. Challenges in the diagnosis of Parkinson’s disease. Lancet Neurol. 2021, 20, 385–397. [Google Scholar] [CrossRef]
- Tenchov, R.; Sasso, J.M.; Zhou, Q.A. Evolving Landscape of Parkinson’s Disease Research: Challenges and Perspectives. ACS Omega 2025, 10, 1864–1892. [Google Scholar] [CrossRef]
- Lukšys, D.; Jonaitis, G.; Griškevičius, J. Quantitative Analysis of Parkinsonian Tremor in a Clinical Setting Using Inertial Measurement Units. Park. Dis. 2018, 2018, 1683831. [Google Scholar] [CrossRef]
- Hess, C.W.; Pullman, S.L. Tremor: Clinical Phenomenology and Assessment Techniques. Tremor Hyperkinetic Mov. 2012, 2. [Google Scholar] [CrossRef]
- Keba, M.; Bachmann, M.; Lass, J.; Rätsep, T.; Keba, M.; Bachmann, M.; Lass, J.; Rätsep, T. Assessing Parkinson’s Rest Tremor from the Wrist with Accelerometry and Gyroscope Signals in Patients with Deep Brain Stimulation: An Observational Study. J. Clin. Med. 2025, 14, 2073. [Google Scholar] [CrossRef]
- Women-and-Parkinsons-Research-and-Care-Agenda.pdf. Available online: https://www.parkinson.org/sites/default/files/documents/women-and-parkinsons-research-and-care-agenda.pdf (accessed on 21 March 2024).
- Ferri, R.; Fulda, S.; Cosentino, F.I.I.; Pizza, F.; Plazzi, G. A preliminary quantitative analysis of REM sleep chin EMG in Parkinson’s disease with or without REM sleep behavior disorder. Sleep Med. 2012, 13, 707–713. [Google Scholar] [CrossRef]
- Pfann, K.D.; Buchman, A.S.; Comella, C.L.; Corcos, D.M. Control of movement distance in Parkinson’s disease. Mov. Disord. 2001, 16, 1048–1065. [Google Scholar] [CrossRef]
- Yuvaraj, R.; Murugappan, M.; Mohamed Ibrahim, N.; Sundaraj, K.; Omar, M.I.; Mohamad, K.; Palaniappan, R. Detection of emotions in Parkinson’s disease using higher order spectral features from brain’s electrical activity. Biomed. Signal Process. Control 2014, 14, 108–116. [Google Scholar] [CrossRef]
- Medved, V.; Cifrek, M.; Medved, V.; Cifrek, M. Kinesiological Electromyography. In Biomechanics in Applications; IntechOpen: London, UK, 2011; ISBN 978-953-307-969-1. [Google Scholar][Green Version]
- Pasmanasari, E.D.; Pawitan, J.A. The Potential of Electromyography Signals as Markers to Detect and Monitor Parkinson’s Disease. Biomed. Pharmacol. J. 2021, 14, 373–378. [Google Scholar] [CrossRef]
- Shimmer3 EMG Unit. Shimmer Wearable Sensor Technology. Available online: https://shimmersensing.com/product/shimmer3-emg-unit/ (accessed on 3 April 2023).
- Documentation. Shimmer Wearable Sensor Technology. Available online: https://shimmersensing.com/support/wireless-sensor-networks-documentation/ (accessed on 6 March 2024).
- KendallTM H92SG Electrodes. Available online: https://www.cardinalhealth.co.uk/en_gb/medical-products/patient-care/electrocardiography/adult-monitoring-electrodes/general-monitoring-ecg-electrodes/long-term-electrodes/kendall-h92sg-electrodes.html (accessed on 13 January 2025).
- Talitckii, A.; Kovalenko, E.; Shcherbak, A.; Anikina, A.; Bril, E.; Zimniakova, O.; Semenov, M.; Dylov, D.V.; Somov, A. Comparative Study of Wearable Sensors, Video, and Handwriting to Detect Parkinson’s Disease. IEEE Trans. Instrum. Meas. 2022, 71, 2509910. [Google Scholar] [CrossRef]
- Orozco-Arroyave, J.R.; Vásquez-Correa, J.C.; Nöth, E. Current methods and new trends in signal processing and pattern recognition for the automatic assessment of motor impairments: The case of Parkinson’s disease. In Neurological Disorders and Imaging Physics, Volume 5: Applications in Dyslexia, Epilepsy and Parkinson’s; IOP Publishing: Bristol, UK, 2020. [Google Scholar]
- Hermens, H.J.; Freriks, B.; Disselhorst-Klug, C.; Rau, G. Development of recommendations for SEMG sensors and sensor placement procedures. J. Electromyogr. Kinesiol. Off. J. Int. Soc. Electrophysiol. Kinesiol. 2000, 10, 361–374. [Google Scholar] [CrossRef] [PubMed]
- Mello, R.G.T.; Oliveira, L.F.; Nadal, J. Digital Butterworth filter for subtracting noise from low magnitude surface electromyogram. Comput. Methods Programs Biomed. 2007, 87, 28–35. [Google Scholar] [CrossRef]
- Channa, A.; Ifrim, R.-C.; Popescu, D.; Popescu, N. A-WEAR Bracelet for Detection of Hand Tremor and Bradykinesia in Parkinson’s Patients. Sensors 2021, 21, 981. [Google Scholar] [CrossRef]
- Bermeo, A.; Bravo, M.; Huerta, M.; Soto, A. A system to monitor tremors in patients with Parkinson’s disease. In Proceedings of the 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, USA, 16–20 August 2016; pp. 5007–5010. [Google Scholar]
- Bazgir, O.; Habibi, S.A.H.; Palma, L.; Pierleoni, P.; Nafees, S. A Classification System for Assessment and Home Monitoring of Tremor in Patients with Parkinson’s Disease. J. Med. Signals Sens. 2018, 8, 65–72. [Google Scholar] [CrossRef]
- Bogey, R.A.; Elovic, E.P.; Bryant, P.R.; Geis, C.C.; Moroz, A.; O’Neill, B.J. Rehabilitation of movement disorders1. Arch. Phys. Med. Rehabil. 2004, 85, 41–45. [Google Scholar] [CrossRef]
- Brigham, E.O.; Morrow, R.E. The fast Fourier transform. IEEE Spectr. 1967, 4, 63–70. [Google Scholar] [CrossRef]
- Allen, J.B.; Rabiner, L.R. A unified approach to short-time Fourier analysis and synthesis. Proc. IEEE 1977, 65, 1558–1564. [Google Scholar] [CrossRef]
- Astuti, W.; Sediono, W.; Aibinu, A.M.; Akmeliawati, R.; Salami, M.J.E. Adaptive Short Time Fourier Transform (STFT) Analysis of seismic electric signal (SES): A comparison of Hamming and rectangular window. In Proceedings of the 2012 IEEE Symposium on Industrial Electronics and Applications, Bandung, Indonesia, 23–26 September 2012; pp. 372–377. [Google Scholar]
- IBM SPSS Statistics 28 Documentation. Available online: https://www.ibm.com/support/pages/ibm-spss-statistics-28-documentation (accessed on 3 August 2024).
- Berger, V.W.; Zhou, Y. Kolmogorov–Smirnov Test: Overview. In Wiley StatsRef: Statistics Reference Online; John Wiley & Sons, Ltd.: Hoboken, NJ, USA, 2014; ISBN 978-1-118-44511-2. [Google Scholar]
- McKight, P.E.; Najab, J. Kruskal-Wallis Test. In The Corsini Encyclopedia of Psychology; John Wiley & Sons, Ltd.: Hoboken, NJ, USA, 2010; p. 1. ISBN 978-0-470-47921-6. [Google Scholar]
- Deuschl, G.; Bain, P.; Brin, M.; Committee, A.H.S. Consensus Statement of the Movement Disorder Society on Tremor. Mov. Disord. 1998, 13, 2–23. [Google Scholar] [CrossRef] [PubMed]
- Gironell, A.; Pascual-Sedano, B.; Aracil, I.; Marín-Lahoz, J.; Pagonabarraga, J.; Kulisevsky, J. Tremor Types in Parkinson Disease: A Descriptive Study Using a New Classification. Park. Dis. 2018, 2018, 4327597. [Google Scholar] [CrossRef] [PubMed]
- Lee, H.J.; Lee, W.W.; Kim, S.K.; Park, H.; Jeon, H.S.; Kim, H.B.; Jeon, B.S.; Park, K.S. Tremor frequency characteristics in Parkinson’s disease under resting-state and stress-state conditions. J. Neurol. Sci. 2016, 362, 272–277. [Google Scholar] [CrossRef]
- Mailankody, P.; Thennarasu, K.; Nagaraju, B.C.; Yadav, R.; Pal, P.K. Re-emergent tremor in Parkinson’s disease: A clinical and electromyographic study. J. Neurol. Sci. 2016, 366, 33–36. [Google Scholar] [CrossRef]
- Su, D.; Zhang, F.; Liu, Z.; Yang, S.; Wang, Y.; Ma, H.; Manor, B.; Hausdorff, J.M.; Lipsitz, L.A.; Pan, H.; et al. Different effects of essential tremor and Parkinsonian tremor on multiscale dynamics of hand tremor. Clin. Neurophysiol. 2021, 132, 2282–2289. [Google Scholar] [CrossRef]
- Hossen, A.; Deuschl, G.; Groppa, S.; Heute, U.; Muthuraman, M. Discrimination of physiological tremor from pathological tremor using accelerometer and surface EMG signals. Technol. Health Care 2020, 28, 461–476. [Google Scholar] [CrossRef]
- Tremor|Parkinson’s Foundation. Available online: https://www.parkinson.org/understanding-parkinsons/movement-symptoms/tremor (accessed on 6 August 2024).
- Dirkx, M.F.; Zach, H.; Bloem, B.R.; Hallett, M.; Helmich, R.C. The nature of postural tremor in Parkinson disease. Neurology 2018, 90, e1095–e1103. [Google Scholar] [CrossRef]
- Mazzetta, I.; Zampogna, A.; Suppa, A.; Gumiero, A.; Pessione, M.; Irrera, F. Wearable Sensors System for an Improved Analysis of Freezing of Gait in Parkinson’s Disease Using Electromyography and Inertial Signals. Sensors 2019, 19, 948. [Google Scholar] [CrossRef]














| Group | Sample 1-Sample 2 | Test Statistic | Std. Error | Std. Test Statistic | Sig. | Adj. Sig. |
|---|---|---|---|---|---|---|
| Rest | 8-3 | 5.436 | 129 | 0.042 | 0.966 | 1.000 |
| Rest | 0-3 | −1520 | 427 | −3.553 | <0.001 | 0.014 |
| Rest | 8-6 | 714 | 320 | 2.227 | 0.026 | 0.935 |
| Action | 8-3 | 1540 | 467 | 3.297 | <0.001 | 0.035 |
| Action | 0-3 | −1526 | 468 | −3.258 | 0.001 | 0.040 |
| Action | 0-6 | −733 | 353 | −2.074 | 0.038 | 1.000 |
| Action | 8-6 | 746 | 351 | 2.123 | 0.034 | 1.000 |
| Postural | 1-6 | −632 | 379 | −1.666 | 0.096 | 1.000 |
| Postural | 6-2 | 9.506 | 476 | 0.020 | 0.984 | 1.000 |
| Postural | 0-6 | −773 | 353 | −2.188 | 0.029 | 1.000 |
| Postural | 6-7 | −233 | 505 | −0.461 | 0.645 | 1.000 |
| Postural | 6-5 | 143 | 504 | 0.284 | 0.776 | 1.000 |
| Postural | 6-4 | 197 | 512 | 0.386 | 0.699 | 1.000 |
| Group | Sample 1-Sample 2 | Test Statistic | Std. Error | Std. Test Statistic | Sig. | Adj. Sig. |
|---|---|---|---|---|---|---|
| Rest | 3-8 | −752 | 426 | −1.764 | 0.078 | 1.000 |
| Rest | 3-0 | 3737 | 427 | 8.735 | <0.001 | 0.000 |
| Rest | 6-8 | −3651 | 320 | −11.377 | <0.001 | 0.000 |
| Action | 3-8 | −962 | 467 | −2.059 | 0.039 | 1.000 |
| Action | 3-0 | 4400 | 468 | 9.390 | <0.001 | 0.000 |
| Action | 6-0 | 7301 | 353 | 20.666 | <0.001 | 0.000 |
| Action | 6-8 | −3863 | 351 | −10.992 | <0.001 | 0.000 |
| Postural | 6-1 | 4769 | 379 | 12.567 | <0.001 | 0.000 |
| Postural | 6-2 | 4865 | 476 | 10.220 | <0.001 | 0.000 |
| Postural | 6-0 | 6446 | 353 | 18.243 | <0.001 | 0.000 |
| Postural | 6-7 | −7442 | 505 | −14.714 | <0.001 | 0.000 |
| Postural | 6-5 | 14,343 | 504 | 28.410 | <0.001 | 0.000 |
| Postural | 6-4 | 17,271 | 512 | 33.726 | <0.001 | 0.000 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
Share and Cite
O’Sullivan, S.; Daly, M.; Murray, N.; Rodrigues, T.B. Electromyography (EMG) Signal Processing to Evaluate Low-Frequency Tremors. Sensors 2026, 26, 157. https://doi.org/10.3390/s26010157
O’Sullivan S, Daly M, Murray N, Rodrigues TB. Electromyography (EMG) Signal Processing to Evaluate Low-Frequency Tremors. Sensors. 2026; 26(1):157. https://doi.org/10.3390/s26010157
Chicago/Turabian StyleO’Sullivan, Samantha, Mark Daly, Niall Murray, and Thiago Braga Rodrigues. 2026. "Electromyography (EMG) Signal Processing to Evaluate Low-Frequency Tremors" Sensors 26, no. 1: 157. https://doi.org/10.3390/s26010157
APA StyleO’Sullivan, S., Daly, M., Murray, N., & Rodrigues, T. B. (2026). Electromyography (EMG) Signal Processing to Evaluate Low-Frequency Tremors. Sensors, 26(1), 157. https://doi.org/10.3390/s26010157

