EMG Breakpoints for Detecting Anaerobic Threshold and Respiratory Compensation Point in Recovered COVID-19 Patients

Overview

Journal J Electromyogr Kinesiol

Publisher Elsevier

Specialty Physiology

Date 2021 Jun 26

PMID 34174508

Authors

Murillo Frazao

Paulo Eugenio Silva

Lucas de Assis Pereira Cacau

Tullio Rocha Petrucci

Mariela Cometki Assis

Amilton da Cruz Santos

Maria do Socorro Brasileiro-Santos

Affiliations

Soon will be listed here.

Abstract

Introduction: A huge number of COVID-19 patients should be referred to rehabilitation programmes. Individualizing the exercise intensity by metabolic response provide good physiological results. The aim of this study was to investigate the validity of EMG as a non-invasive determinant of the anaerobic threshold and respiratory compensation point, for more precise exercise intensity prescription.

Methods: An observational cross-sectional study with 66 recovered COVID-19 patients was carried out. The patients underwent a cardiopulmonary exercise test with simultaneous assessment of muscle electromyography in vastus lateralis. EMG breakpoints were analyzed during the ramp-up protocol. The first and second EMG breakpoints were used for anaerobic threshold and respiratory compensation point determination.

Results: EMG and gas exchange analysis presented strong correlation in anaerobic threshold (r = 0.97, p < 0.0001) and respiratory compensation point detection (r = 0.99, p < 0.0001) detection. Bland-Altman analysis demonstrated a bias = -4.7 W (SD = 6.2 W, limits of agreement = -16.9 to 7.6) for anaerobic threshold detection in EMG compared to gas exchange analysis. In respiratory compensation point detection, Bland-Altman analysis demonstrated a bias = -2.1 W (SD = 4.5 W, limits of agreement = -10.9 to 6.6) in EMG compared to gas exchange analysis. EMG demonstrated a small effect size compared to gas exchange analysis in oxygen uptake and power output at anaerobic threshold and respiratory compensation point detection.

Conclusions: EMG analysis detects anaerobic threshold and respiratory compensation point without clinical significant difference than gas exchange analysis (gold standard method) in recovered COVID-19 patients.

References

Zamuner A, Catai A, Martins L, Sakabe D, Silva E . Identification and agreement of first turn point by mathematical analysis applied to heart rate, carbon dioxide output and electromyography. Braz J Phys Ther. 2013; 17(6):614-22. PMC: 4207143. DOI: 10.1590/S1413-35552012005000129. View

Hug F, Laplaud D, Lucia A, Grelot L . EMG threshold determination in eight lower limb muscles during cycling exercise: a pilot study. Int J Sports Med. 2006; 27(6):456-62. DOI: 10.1055/s-2005-865787. View

Jurimae J, von Duvillard S, Maestu J, Cicchella A, Purge P, Ruosi S . Aerobic-anaerobic transition intensity measured via EMG signals in athletes with different physical activity patterns. Eur J Appl Physiol. 2007; 101(3):341-6. DOI: 10.1007/s00421-007-0509-5. View

HENNEMAN E, Somjen G, Carpenter D . FUNCTIONAL SIGNIFICANCE OF CELL SIZE IN SPINAL MOTONEURONS. J Neurophysiol. 1965; 28:560-80. DOI: 10.1152/jn.1965.28.3.560. View

Vandoni M, Codrons E, Marin L, Correale L, Bigliassi M, Buzzachera C . Psychophysiological Responses to Group Exercise Training Sessions: Does Exercise Intensity Matter?. PLoS One. 2016; 11(8):e0149997. PMC: 4973874. DOI: 10.1371/journal.pone.0149997. View

HOUTZ S, FISCHER F . An analysis of muscle action and joint excursion during exercise on a stationary bicycle. J Bone Joint Surg Am. 1959; 41-A(1):123-31. View

. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003; 167(2):211-77. DOI: 10.1164/rccm.167.2.211. View

Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z . Characteristics of COVID-19 infection in Beijing. J Infect. 2020; 80(4):401-406. PMC: 7102527. DOI: 10.1016/j.jinf.2020.02.018. View

Tikkanen O, Hu M, Vilavuo T, Tolvanen P, Cheng S, Finni T . Ventilatory threshold during incremental running can be estimated using EMG shorts. Physiol Meas. 2012; 33(4):603-14. DOI: 10.1088/0967-3334/33/4/603. View

10.

Hug F, Bendahan D, Fur Y, Cozzone P, Grelot L . Heterogeneity of muscle recruitment pattern during pedaling in professional road cyclists: a magnetic resonance imaging and electromyography study. Eur J Appl Physiol. 2004; 92(3):334-42. DOI: 10.1007/s00421-004-1096-3. View

11.

Sarre G, Lepers R, Maffiuletti N, Millet G, Martin A . Influence of cycling cadence on neuromuscular activity of the knee extensors in humans. Eur J Appl Physiol. 2003; 88(4-5):476-9. DOI: 10.1007/s00421-002-0738-6. View

12.

Bearden S, Moffatt R . Leg electromyography and the VO2-power relationship during bicycle ergometry. Med Sci Sports Exerc. 2001; 33(7):1241-5. DOI: 10.1097/00005768-200107000-00025. View

13.

Hansen J, Sue D, Wasserman K . Predicted values for clinical exercise testing. Am Rev Respir Dis. 1984; 129(2 Pt 2):S49-55. DOI: 10.1164/arrd.1984.129.2P2.S49. View

14.

Hug F, Dorel S . Electromyographic analysis of pedaling: a review. J Electromyogr Kinesiol. 2007; 19(2):182-98. DOI: 10.1016/j.jelekin.2007.10.010. View

15.

Wasserman K, Whipp B . Excercise physiology in health and disease. Am Rev Respir Dis. 1975; 112(2):219-49. DOI: 10.1164/arrd.1975.112.2.219. View

16.

Hug F, Laplaud D, Savin B, Grelot L . Occurrence of electromyographic and ventilatory thresholds in professional road cyclists. Eur J Appl Physiol. 2003; 90(5-6):643-6. DOI: 10.1007/s00421-003-0949-5. View

17.

Whipp B . Dynamics of pulmonary gas exchange. Circulation. 1987; 76(6 Pt 2):VI18-28. View

18.

Glass S, Knowlton R, Sanjabi P, Sullivan J . Identifying the integrated electromyographic threshold using different muscles during incremental cycling exercise. J Sports Med Phys Fitness. 1998; 38(1):47-52. View

19.

Spruit M, Holland A, Singh S, Tonia T, Wilson K, Troosters T . COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force. Eur Respir J. 2020; 56(6. PMC: 7427118. DOI: 10.1183/13993003.02197-2020. View

20.

Lucia A, Sanchez O, Carvajal A, Chicharro J . Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography. Br J Sports Med. 1999; 33(3):178-85. PMC: 1756168. DOI: 10.1136/bjsm.33.3.178. View