2.1. sEMG Method
A selection of fifteen healthy volunteers to participate in the quasi-experimental setup was made. The age limit was between 18 and 65 years. All participants were physically healthy, with no history of neurological or orthopedic diseases, and no injuries or motor disorders of the upper limb. The research method and experimental protocol were explained in detail to each subject. On the day of the study, participants signed an informed consent form to participate, which had been previously approved by the Ethics Committee of the Institute of Biophysics and Biomedical Engineering. The experiments complied with the Declaration of Helsinki (ethical principles for medical research involving human subjects). All subjects completed the experimental protocol in full. There were no dropouts during the study.
Electromyographic signals were recorded from six whole muscles or muscle heads—two parts of the m. deltoideus, pars clavicularis, and pars spinata (Dcla, Dspi); m. biceps brachii (BB); and m. triceps brachii—caput longum (TB), m. brachialis (BR), and m. anconeus (AN). A telemetric system with eight channels, Telemyo 2400G2 of Noraxon, Inc. (Scottsdale, AZ, USA), was used. The circle “Skintact-premier” F-301 Ag/AgCl electrodes (Leonhard Lang GmbH, Innsbruck, Austria) with 2.5 cm interelectrode distance were used for non-invasive body contact and assessing surface EMG signals. The sampling frequency was 1500 Hz, which represents the number of times per second that the analog EMG signal is converted into digital values. To determine the contact points of the electrodes with which the prescriptions of the Seniam protocol were used (
http://www.seniam.org/), electrodes were placed only on the right hand, the dominant hand of all the participants.
The experimental protocol was performed from a sitting position and consisted of several identical upper limb exercises, which were, however, performed at different speeds and with or without an additional load of 0.5 kg on the wrist. Each motor task was performed within one minute.
Experimental protocol:
Position of relaxation. The subject sits on a chair with his gaze directed forward, arms relaxed loosely at his sides, and legs with 90-degree flexion at the hip, knee, and ankle joints, feet placed on the floor with a small distance between them.
Maximal isometric contractions were elicited for the six investigated muscles. The upper limb is passively brought into several starting positions, from which maximal isometric contractions are performed. For this purpose, the examiner stabilizes the upper extremity with the torse and one hand, while with the other and with the weight of the body, exerts pressure to provoke maximal contraction and counteracts the subject’s attempt to move his limb. In this way, muscle by muscle is selectively activated. These signals serve to normalize the EMG recordings.
The subject extends his right arm straight forward (90 degrees of flexion at the shoulder joint). The forearm is pronated, and the palm is facing the floor. From this position, several consecutive elbow flexions and extensions in the horizontal plane are performed with different movement characteristics. From the described starting position of the hand, four phases of activity begin. The first is flexion in the elbow joint until the fingers touch the opposite shoulder. This is followed by a phase of maintaining the position reached. From here comes the extension phase to the described starting position of the arm stretched forward. Finally, there is the phase of maintaining the position reached. Each of the active phases is performed with a duration of 10, 6, 2, and 1 s. Each maintenance phase is always 5 s. So, for the first cycle, we have a flexion phase of 10 s (fl10)—5 s (pose in flexed arm) followed by extension for 10 s (ex10)—5 s (pose in extended arm), which is repeated until the one-minute recording expires. For the second, third, and fourth cycles, abbreviations were related with speed duration, respectively, for flexion for 6 s (fl6), 2 s (fl2), and 1 s (fl1), and extension for 6 s (ex6), 2 s (ex2), and 1 s (ex1). Due to the different duration of the active part of the cycle, a different number of repetitions is obtained. In the subsequent processing, only one complete cycle is selected—the best performance. Next, a half-kilogram ergometric weight is placed on the wrist, and the same cycles are repeated with the same duration. Periods for flexion and extension were 10 s (fl10W/ex10W), 6 s (fl6W/ex6W), 2 s (fl2W/ex2W), and 1 s (fl1W/ex1W). Finally, we have 10 one-minute recordings—a recording of rest, of maximum isometric contraction for each of the 6 measured muscles of flexion and extension in the elbow joint in the horizontal plane (4 for flexion and 4 for extension with different durations of the active phases). The change in each interval was guided by an online Tabata interval timer. Thus, the subject received visual (on-screen countdown of seconds, as well as red color for posture and green color for active movement) and audio commands (a tap for each second that passed).
Figure 1 illustrates the experimental setup, including the raw EMG signals. These signals were recorded over 6 s active phases in the horizontal plane with a 0.5 kg load. The weight used meets three important criteria: it provokes a stronger muscle response, does not cause premature muscle fatigue, and does not engage additional muscle groups, if a grip is used. The channels correspond to specific muscles: Dcla (blue), Dspi (green), BB (red), TB (yellow), AN (purple), and BR (dark green). Channels seven and eight display 2D goniometer (Scottsdale, AZ, USA) data, aiding in movement start and end orientation. The vertical dotted line indicates the second in which the recording in the photo on the side was displayed. Electrode placement is shown on the right, with kinesiotape used to secure sensors and reduce movement artifacts.
Initially, all EMG recordings were visually observed, and only data from four men and six women were selected for analysis. The remaining five participants were excluded due to various issues such as unfilterable abnormal spikes, inability to maintain the experimental rhythm or arm position, significant cable fluctuations, EMG contamination, or unstable recordings. Despite the limitations imposed by the reduced sample size—such as decreased generalizability and potential underrepresentation of the target population—participants still had to be excluded to bring the sample as close as possible to the pre-determined protocol conditions. So, the question with excluding participants is whether to compromise the quality of the experimental design or the generalizability. In this case, priority is given to the reliability of the data over broader generalization.
The study conducted is real and experimental and therefore faces inevitable limitations. Restricting this research to healthy participants only is a purposeful methodological decision that aims to minimize sources of variation arising from pathological conditions (numerous and so different in their genesis and manifestation). Therefore, the focus of the study is on spontaneous muscle activity under normal physiological conditions and on establishing a clear baseline for future studies that would include clinical populations. This limitation reduces the direct generalizability of the results to patients with movement disorders, but it is a necessary step to achieve high internal validity of the experiment.
In order to be a non-invasive investigation, only superficial muscles were examined. This means that some muscles with a main action in a specific direction in the shoulder or elbow must be omitted because we do not have access to them. Despite this limitation, the use of sEMG was chosen because it is a suitable and accessible method for studying the synchronous activation of large muscle groups during functional movements. Something more, the participants do not feel any discomfort or pain during the testing. The duration of the protocol was chosen to maintain a high level of focus and execution precision on the part of the participants. A long protocol would have increased the risk of muscle fatigue and attentional impairment, which would directly compromise the quality of the EMG signals and the execution of the movement at the set pace.
The EMG data recorded during the position of relaxation underwent initial processing. This involved Butterworth high-pass filtration (4th order, 20 Hz cut-off frequency) and Butterworth low-pass filtration (4th order, 350 Hz cut-off frequency), consistent with established methods [
22]. The same filtration was then applied to EMGs from maximal isometric contractions to calculate six normalization coefficients for the movement EMGs.
For each movement task, the same filtration and normalization procedures were performed. Following a thorough visual inspection, only one trial from each flexion and extension movement cycle was chosen. The start and end points of these flexion and extension motions were precisely identified, and a specific time interval was selected. Within these intervals, the EMG data were rectified and smoothed (20 samples). Finally, the area under the rectified and smoothed curves was calculated for the corresponding time interval. These processed values were then used for the ICrA analysis, as detailed in the subsequent section.
2.2. ICrA Decision-Making Method
Attanassov et al., the founders of the ICrA approach [
13], elaborated the decision-making method for establishing correlation dependencies between a set of criteria. Thus, the slower or the harder to measure criteria can be replaced by those correlated with faster and easier to measure ones. Also, the mathematical tool can be useful for finding known or unknown correlation dependencies from the literature.
For a more accurate decision-making process, the ICrA relies on index matrices (IMs) for data arranging and intuitionistic fuzzy sets (IFSs) that account for uncertainty in the established dependency (positive or negative consonance) or dissonance for each criteria pair. In the beginning, the ICrA requires data sets of multiple objects measured against different criteria, presented in the form of IM.
| O1 | … | Oi | … | Om |
C1 | eC1,O1 | … | eC1,Oi | … | eC1,Om |
… | … | … | … | … | … |
Ck | eCk,O1 | … | eCk,Oi | … | eCk,Om |
… | … | … | … | … | … |
Cn | eCn,O1 | … | eCn,Oi | … | eCn,Om |
where
C1 …
Cn are criteria;
O1 …
Om are objects; and
eC1,
O1 …
eCn,
Om are elements.
Let
and
represent the number of cases in which
R(
eCk,Oi,
eCk,Oj) and
R(
eCl,Oi,
eCl,Oj) and, respectively,
R(
eCk,Oi,
eCk,Oj) and
(
eCl,Oi,
eCl,Oj) are simultaneously satisfied. It is evident that the total number of pairwise comparisons between the
n criteria is
n(
n − 1)/2. Hence,
Let for each
k,
l such that 1 ≤
k <
l ≤
n and for
n ≥ 2 we define two counters:
The pair
is an intuitionistic fuzzy pair (IFP). The IFP is an intuitionistic fuzzy evaluation of the relations between two criteria,
Ck and
Cl. Thus, the initial IM can be transformed into IM, containing only the relations between the criteria.
| C1 | … | Ck | … | Cn |
C1 | 〈1, 0〉 | … | | … | |
… | … | … | … | … | … |
Ck | | … | 〈1, 0〉 | … | |
… | … | … | … | … | … |
Cn | | … | | … | 〈1, 0〉 |
The final IM sets the degrees of correspondence, non-correspondence, and the degrees of uncertainty between the criteria C1, …, Cn. Thus, the ICrA-evaluated correlation dependencies have intuitionistic fuzzy pairs form with values between 0 and 1.
The last step of the algorithm is to determine positive (PosC) or negative (NegC) consonance and dissonance between the criteria, depending on the threshold values for μ and ν.
Let 0 ≤ α ≤ 1 and 0 ≤ β ≤ 1 be numbers such that α + β ≤ 1. The two criteria Ck and Cl are in the following:
PosC for > α and < β;
NegC for < β and > α;
Dissonance, otherwise.
PosC is found when the
µ-value is in the interval (0.75; 1.00], NegC appears when the
µ-value is between [0.00; 0.25], and dissonance is realized when the
µ-value hits the interval (0.25; 0.75]. More details about the
µ-value scale can be found in [
23].