Role of Artificial Intelligence in Predicting Muscle Fatigue Using Virtual Reality Training
Study Details
Study Description
Brief Summary
The goal of this observational predicted study is to predict muscle fatigue using a specific AI algorithm in healthy vs post Covid-19 infected individuals. The main question it aims to answer is:
Can Artificial Intelligence be used as a reliable source of predicting localized muscle fatigue in healthy vs post Covid-19 infected individuals?
Participants will be divided into two groups: A healthy group and a post Covid-19 group.
-
Each group will undergo a familiarization process before the start of the exercises.
-
Then, each group will perform squatting exercises guided by the kynpasis virtual reality apparatus.
-
sEMG for the vastus lateralis and rectus femories, chest expansion, and goniometric measurements of the knee will be taken during different reported fatigue levels using the Biopac system.
-
Groups will continue squatting while recording their subjective fatigue levels using the Borg scale.
-
Data will then be run through machine learning processes to produce an AI algorithm capable of predicting isolated muscle fatigue.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Participants were divided into two groups, one consisting of healthy individuals and another consisting of Covid-19 subjects. Both groups received a familiarization training for the exercise to be performed with 15 minutes of rest afterwards, before the start of the data collection.
Squatting exercise was performed using a virtual reality (VR) machine (kynapsis) for guidance in both groups. Squats were performed while the hands were kept in front of the bodies and the knees flexed to 90 degrees following a rhythm of two seconds for descent, two second ascent mimicking the movement done on the VR machine.
Additional variables were considered, including chest expansion, and the range of motion using an electric goniometer, all being measured and recorded using the Biopac (BIOPAC Systems, Inc., Santa Barbara, CA) that, according to evidence, possess a high-pass frequency filter and bipolar electrode system.
The muscles tested are the 3 heads of the QF muscle RF, VM, and VL. Their areas were cleaned using alcohol and shaved to reduce resistance of electrodes. Three disposable sEMG surface electrodes were placed, two of them on the muscle belly with 2.5cm distance between them, and one control electrode placed on the agonist side, the participant was asked to extend their knee and flex it against resistance to locate the lateral and medial vasti. sEMG electrodes were placed on the subdivisions of the QF muscle during the exercise. The extracted data is then run through an AI algorithm that will analyze and predict muscle fatigue.
The Borg (C-10) scale was explained to the participants and was present in front of them while performing the exercise as an outcome measure to assess the subjective muscle fatigue that once reached will end the exercise.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Healthy Group Will perform squatting exercise while reporting subjective muscle fatigue levels periodically, until maximal subjective fatigue is reached Will have sEMG for vastus lateralis and rectus femoris, chest expansion, goniometry for the knee recording using the Biopac. |
Other: Squatting with the aid of Kynapsis Virtual Training apparatus.
Squatting exercise was performed using a virtual reality (VR) machine (kynapsis) for guidance in both groups. Squats were performed while the hands were kept in front of the bodies and the knees flexed to 90 degrees following a rhythm of two seconds for descent, two second ascent mimicking the movement done on the VR machine.
|
| Post Covid-19 Group Will perform squatting exercise while reporting subjective muscle fatigue levels periodically, until maximal subjective fatigue is reached Will have sEMG for vastus lateralis and rectus femoris, chest expansion, goniometry for the knee recording using the Biopac. |
Other: Squatting with the aid of Kynapsis Virtual Training apparatus.
Squatting exercise was performed using a virtual reality (VR) machine (kynapsis) for guidance in both groups. Squats were performed while the hands were kept in front of the bodies and the knees flexed to 90 degrees following a rhythm of two seconds for descent, two second ascent mimicking the movement done on the VR machine.
|
Outcome Measures
Primary Outcome Measures
- Surface electromyography [During the squatting exercise.]
non-invasive technique where electrodes were placed on the vastus lateralis and rectus femoris heads of the quadriceps femoris muscle, assessing it's myoelectric output. Their areas were cleaned using alcohol and shaved to reduce resistance of electrodes. Three disposable sEMG surface electrodes were placed, two of them on the muscle belly with 2.5cm distance between them, and one control electrode placed on the agonist side, the participant was asked to extend their knee and flex it against resistance to locate the lateral and medial vasti. sEMG electrodes were placed on the subdivisions of the QF muscle during the exercise. The extracted data is then run through an AI algorithm that will analyze and predict muscle fatigue.
- Borg (C-10) Scale [During the squatting exercise.]
Subjective scale for the participants to report muscle fatigue.
Secondary Outcome Measures
- Chest Expansion. [During the squatting exercise.]
Using a respiration transducer wrapped around the subject's chest using a velcro strap that transmits expansion data to the main receiver module of the Biopac, that will be recorded on the computer.
- Range of motion. [During the squatting exercise.]
Using an electric goniometer wired on the subject's knee that will transmit signals of range of motion to the receiver module of the Biopac that will be recorded on the computer.
Eligibility Criteria
Criteria
Inclusion Criteria:
- All subjects included in both groups of the study must be non-athletic healthy individuals, that avoided intense activities in the past 3 days. The subjects included in the Covid-19 group must have a confirmed positive PCR test done within an interval of 1 year.
Exclusion Criteria:
- The subjects who don't meet the inclusion criteria, being old age geriatrics (more than 50 years old), or having any respiratory, cardiac, renal, neuromuscular, orthopedic, and musculoskeletal disorders must be excluded from the study. Smokers and some medicinal drug users must be taken into consideration because it affects the performance and increases the fatigue levels.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Beirut Arab University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- A narrative review of immersive virtual reality's ergonomics and risks at the workplace: cybersickness, visual fatigue, muscular fatigue, acute stress, and mental overload Souchet, A.D., Lourdeaux, D., Pagani, A. et al. A narrative review of immersive virtual reality's ergonomics and risks at the workplace: cybersickness, visual fatigue, muscular fatigue, acute stress, and mental overload. Virtual Reality (2022). https://doi.org/10.1007/s10055-022-00672-0
- Ahmad I, Kim JY. Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting. Int J Environ Res Public Health. 2018 Apr 18;15(4):784. doi: 10.3390/ijerph15040784.
- Al-Mulla MR, Sepulveda F, Colley M. An autonomous wearable system for predicting and detecting localised muscle fatigue. Sensors (Basel). 2011;11(2):1542-57. doi: 10.3390/s110201542. Epub 2011 Jan 27.
- Alsobhi M, Khan F, Chevidikunnan MF, Basuodan R, Shawli L, Neamatallah Z. Physical Therapists' Knowledge and Attitudes Regarding Artificial Intelligence Applications in Health Care and Rehabilitation: Cross-sectional Study. J Med Internet Res. 2022 Oct 20;24(10):e39565. doi: 10.2196/39565.
- Caesaria, A. P., Endro Yulianto, Luthfiyah, S., Triwiyanto, T., & Rizal, A. (2023). Effect of Muscle Fatigue on EMG Signal and Maximum Heart Rate for Pre and Post Physical Activity. Journal of Electronics, Electromedical Engineering, and Medical Informatics, 5(1), 39-45. https://doi.org/10.35882/jeeemi.v5i1.278
- Calder KM, Stashuk DW, McLean L. Physiological characteristics of motor units in the brachioradialis muscle across fatiguing low-level isometric contractions. J Electromyogr Kinesiol. 2008 Feb;18(1):2-15. doi: 10.1016/j.jelekin.2006.08.012. Epub 2006 Nov 20.
- Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Healthc J. 2019 Jun;6(2):94-98. doi: 10.7861/futurehosp.6-2-94.
- Diem L, Fregolente-Gomes L, Warncke JD, Hammer H, Friedli C, Kamber N, Jung S, Bigi S, Funke-Chambour M, Chan A, Bassetti CL, Salmen A, Hoepner R. Fatigue in Post-COVID-19 Syndrome: Clinical Phenomenology, Comorbidities and Association With Initial Course of COVID-19. J Cent Nerv Syst Dis. 2022 May 24;14:11795735221102727. doi: 10.1177/11795735221102727. eCollection 2022.
- Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, Toresdahl BG, Rodeo SA, Casey EK, Mendias CL. Musculoskeletal Consequences of COVID-19. J Bone Joint Surg Am. 2020 Jul 15;102(14):1197-1204. doi: 10.2106/JBJS.20.00847.
- Donatelli, R.A. (2007) Sports-specific rehabilitation. St. Louis, MO: Churchill Livingstone.
- Dos Santos PK, Sigoli E, Braganca LJG, Cornachione AS. The Musculoskeletal Involvement After Mild to Moderate COVID-19 Infection. Front Physiol. 2022 Mar 18;13:813924. doi: 10.3389/fphys.2022.813924. eCollection 2022.
- Ducrocq GP, Blain GM. Relationship between neuromuscular fatigue, muscle activation and the work done above the critical power during severe-intensity exercise. Exp Physiol. 2022 Apr;107(4):312-325. doi: 10.1113/EP090043. Epub 2022 Mar 4.
- Faulkner JA, Larkin LM, Claflin DR, Brooks SV. Age-related changes in the structure and function of skeletal muscles. Clin Exp Pharmacol Physiol. 2007 Nov;34(11):1091-6. doi: 10.1111/j.1440-1681.2007.04752.x.
- Hall, J. E., & Hall, M. E. (2020). Guyton and Hall textbook of medical physiology e-Book. Elsevier Health Sciences.
- Joli J, Buck P, Zipfel S, Stengel A. Post-COVID-19 fatigue: A systematic review. Front Psychiatry. 2022 Aug 11;13:947973. doi: 10.3389/fpsyt.2022.947973. eCollection 2022.
- Kubo K, Ikebukuro T, Yata H. Effects of squat training with different depths on lower limb muscle volumes. Eur J Appl Physiol. 2019 Sep;119(9):1933-1942. doi: 10.1007/s00421-019-04181-y. Epub 2019 Jun 22.
- Luna A, Casertano L, Timmerberg J, O'Neil M, Machowsky J, Leu CS, Lin J, Fang Z, Douglas W, Agrawal S. Artificial intelligence application versus physical therapist for squat evaluation: a randomized controlled trial. Sci Rep. 2021 Sep 13;11(1):18109. doi: 10.1038/s41598-021-97343-y.
- Paneroni M, Simonelli C, Saleri M, Bertacchini L, Venturelli M, Troosters T, Ambrosino N, Vitacca M. Muscle Strength and Physical Performance in Patients Without Previous Disabilities Recovering From COVID-19 Pneumonia. Am J Phys Med Rehabil. 2021 Feb 1;100(2):105-109. doi: 10.1097/PHM.0000000000001641.
- Qian J, McDonough DJ, Gao Z. The Effectiveness of Virtual Reality Exercise on Individual's Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review. Int J Environ Res Public Health. 2020 Jun 10;17(11):4133. doi: 10.3390/ijerph17114133.
- Schoenfeld BJ. Squatting kinematics and kinetics and their application to exercise performance. J Strength Cond Res. 2010 Dec;24(12):3497-506. doi: 10.1519/JSC.0b013e3181bac2d7.
- Sun J, Liu G, Sun Y, Lin K, Zhou Z, Cai J. Application of Surface Electromyography in Exercise Fatigue: A Review. Front Syst Neurosci. 2022 Aug 11;16:893275. doi: 10.3389/fnsys.2022.893275. eCollection 2022.
- Tack C. Artificial intelligence and machine learning | applications in musculoskeletal physiotherapy. Musculoskelet Sci Pract. 2019 Feb;39:164-169. doi: 10.1016/j.msksp.2018.11.012. Epub 2018 Nov 23.
- Torvik, G. I., Triantaphyllou, E., Liao, T., & Waly, S. (1999, March). Predicting muscle fatigue via electromyography: A comparative study. In Proceedings of the 25th International Conference on Computers and Industrial Engineering (pp. 277-280)
- Wan JJ, Qin Z, Wang PY, Sun Y, Liu X. Muscle fatigue: general understanding and treatment. Exp Mol Med. 2017 Oct 6;49(10):e384. doi: 10.1038/emm.2017.194.
- AI in Prediciting Fatigue