Analysis and Applications of Respiratory Surface EMG: Report of a Round Table Meeting

Overview

Journal Crit Care

Specialty Critical Care

Date 2024 Jan 3

PMID 38166968

Authors

A H Jonkman

R S P Warnaar

W Baccinelli

N M Carbon

R F DCruz

J Doorduin

J L M van Doorn

J Elshof

L Estrada-Petrocelli

J Grasshoff

L M A Heunks

A A Koopman

D Langer

C M Moore

J M Nunez Silveira

E Petersen

D Poddighe

M Ramsay

A Rodrigues

L H Roesthuis

A Rossel

A Torres

M L Duiverman

E Oppersma

Affiliations

Soon will be listed here.

Abstract

Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.

Citing Articles

Machine Learning- and Deep Learning-Based Myoelectric Control System for Upper Limb Rehabilitation Utilizing EEG and EMG Signals: A Systematic Review.

Zaim T, Abdel-Hadi S, Mahmoud R, Khandakar A, Rakhtala S, Chowdhury M Bioengineering (Basel). 2025; 12(2).

PMID: 40001664 PMC: 11851773. DOI: 10.3390/bioengineering12020144.

A Simple, Low-Cost Implant for Reliable Diaphragm EMG Recordings in Awake, Behaving Rats.

Holmes T, Penaloza-Aponte J, Mickle A, Nosacka R, Dale E, Streeter K eNeuro. 2025; 12(2).

PMID: 39890457 PMC: 11839091. DOI: 10.1523/ENEURO.0444-24.2025.

Emerging Wearable Acoustic Sensing Technologies.

Liu T, Mao Y, Dou H, Zhang W, Yang J, Wu P Adv Sci (Weinh). 2025; 12(6):e2408653.

PMID: 39749384 PMC: 11809411. DOI: 10.1002/advs.202408653.

Methods to normalize surface electromyography in respiratory muscles: Is it similar between amyotrophic lateral sclerosis and healthy people?.

Wanderley E Lima T, Fonseca J, Silva A, Vieira R, Montemezzo D, Otto-Yanez M PLoS One. 2024; 19(12):e0315846.

PMID: 39705260 PMC: 11661598. DOI: 10.1371/journal.pone.0315846.

Respiratory muscle dysfunction in acute and chronic respiratory failure: how to diagnose and how to treat?.

Poddighe D, Van Hollebeke M, Rodrigues A, Hermans G, Testelmans D, Kalkanis A Eur Respir Rev. 2024; 33(174).

PMID: 39631928 PMC: 11615664. DOI: 10.1183/16000617.0150-2024.

References

Doorduin J, Sinderby C, Beck J, Stegeman D, van Hees H, van der Hoeven J . The calcium sensitizer levosimendan improves human diaphragm function. Am J Respir Crit Care Med. 2011; 185(1):90-5. DOI: 10.1164/rccm.201107-1268OC. View

Cavalcanti J, Fregonezi G, Sarmento A, Bezerra T, Gualdi L, Pennati F . Electrical activity and fatigue of respiratory and locomotor muscles in obstructive respiratory diseases during field walking test. PLoS One. 2022; 17(4):e0266365. PMC: 8975118. DOI: 10.1371/journal.pone.0266365. View

Rodrigues A, Janssens L, Langer D, Matsumura U, Rozenberg D, Brochard L . Semi-automated Detection of the Timing of Respiratory Muscle Activity: Validation and First Application. Front Physiol. 2022; 12:794598. PMC: 8762204. DOI: 10.3389/fphys.2021.794598. View

Duiverman M, de Boer E, van Eykern L, de Greef M, Jansen D, Wempe J . Respiratory muscle activity and dyspnea during exercise in chronic obstructive pulmonary disease. Respir Physiol Neurobiol. 2009; 167(2):195-200. DOI: 10.1016/j.resp.2009.04.018. View

Estrada L, Torres A, Sarlabous L, Jane R . Improvement in Neural Respiratory Drive Estimation From Diaphragm Electromyographic Signals Using Fixed Sample Entropy. IEEE J Biomed Health Inform. 2015; 20(2):476-85. DOI: 10.1109/JBHI.2015.2398934. View

Koopman A, van Dijk J, Oppersma E, Blokpoel R, Kneyber M . Surface electromyography to quantify neuro-respiratory drive and neuro-mechanical coupling in mechanically ventilated children. Respir Res. 2023; 24(1):77. PMC: 10010013. DOI: 10.1186/s12931-023-02374-w. View

Bourke S, Bullock R, Williams T, Shaw P, Gibson G . Noninvasive ventilation in ALS: indications and effect on quality of life. Neurology. 2003; 61(2):171-7. DOI: 10.1212/01.wnl.0000076182.13137.38. View

Dimitrov G, Arabadzhiev T, Mileva K, Bowtell J, Crichton N, Dimitrova N . Muscle fatigue during dynamic contractions assessed by new spectral indices. Med Sci Sports Exerc. 2006; 38(11):1971-9. DOI: 10.1249/01.mss.0000233794.31659.6d. View

Crescimanno G, Canino M, Marrone O . Asynchronies and sleep disruption in neuromuscular patients under home noninvasive ventilation. Respir Med. 2012; 106(10):1478-85. DOI: 10.1016/j.rmed.2012.05.013. View

10.

Adler D, Perrig S, Takahashi H, Espa F, Rodenstein D, Pepin J . Polysomnography in stable COPD under non-invasive ventilation to reduce patient-ventilator asynchrony and morning breathlessness. Sleep Breath. 2011; 16(4):1081-90. PMC: 3497941. DOI: 10.1007/s11325-011-0605-y. View

11.

Brochard L, Harf A, Lorino H, Lemaire F . Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis. 1989; 139(2):513-21. DOI: 10.1164/ajrccm/139.2.513. View

12.

Bellani G, Bronco A, Arrigoni Marocco S, Pozzi M, Sala V, Eronia N . Measurement of Diaphragmatic Electrical Activity by Surface Electromyography in Intubated Subjects and Its Relationship With Inspiratory Effort. Respir Care. 2018; 63(11):1341-1349. DOI: 10.4187/respcare.06176. View

13.

Dres M, Demoule A . Diaphragm dysfunction during weaning from mechanical ventilation: an underestimated phenomenon with clinical implications. Crit Care. 2018; 22(1):73. PMC: 5861656. DOI: 10.1186/s13054-018-1992-2. View

14.

McSharry P, Clifford G, Tarassenko L, Smith L . A dynamical model for generating synthetic electrocardiogram signals. IEEE Trans Biomed Eng. 2003; 50(3):289-94. DOI: 10.1109/TBME.2003.808805. View

15.

Lokin J, Dulger S, Glas G, Horn J . Transesophageal Versus Surface Electromyography of the Diaphragm in Ventilated Subjects. Respir Care. 2020; 65(9):1309-1314. DOI: 10.4187/respcare.07094. View

16.

Ando R, Ohya T, Kusanagi K, Koizumi J, Ohnuma H, Katayama K . Effect of inspiratory resistive training on diaphragm shear modulus and accessory inspiratory muscle activation. Appl Physiol Nutr Metab. 2020; 45(8):851-856. DOI: 10.1139/apnm-2019-0906. View

17.

Valko L, Baglyas S, Gyarmathy V, Gal J, Lorx A . Home mechanical ventilation: quality of life patterns after six months of treatment. BMC Pulm Med. 2020; 20(1):221. PMC: 7433042. DOI: 10.1186/s12890-020-01262-z. View

18.

Silva Junior E, Campos S, Leite W, de Sousa Melo P, Lins R, Rodrigues de Araujo M . Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review. PLoS One. 2023; 18(4):e0284911. PMC: 10138264. DOI: 10.1371/journal.pone.0284911. View

19.

Cecchini J, Schmidt M, Demoule A, Similowski T . Increased diaphragmatic contribution to inspiratory effort during neurally adjusted ventilatory assistance versus pressure support: an electromyographic study. Anesthesiology. 2014; 121(5):1028-36. DOI: 10.1097/ALN.0000000000000432. View

20.

Nguyen D, Amirjani N, McCaughey E, Gandevia S, Butler J, Hudson A . Differential activation of the human costal and crural diaphragm during voluntary and involuntary breaths. J Appl Physiol (1985). 2020; 128(5):1262-1270. DOI: 10.1152/japplphysiol.00790.2019. View