Functional evaluation of triceps surae during heel rise test: from EMG frequency analysis to machine learning approach
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ORIGINAL ARTICLE
Functional evaluation of triceps surae during heel rise test: from EMG frequency analysis to machine learning approach Francesco Ferracuti1 · Sandro Fioretti1 · Emanuele Frontoni1 · Sabrina Iarlori1 Michele Riccio2 · Luca Romeo1 · Federica Verdini1
· Alessandro Mengarelli1 ·
Received: 15 April 2020 / Accepted: 31 October 2020 © International Federation for Medical and Biological Engineering 2020
Abstract Soleus muscle flap as coverage tissue is a possible surgical solution adopted to cover the wounds due to open fractures. Despite this procedure presents many clinical advantages, relatively poor information is available about the loss of functionality of triceps surae of the treated leg. In this study, a group of patients who underwent a soleus muscle flap surgical procedure has been analyzed through the heel rise test (HRT), in order to explore the triceps surae residual functionalities. A frequency band analysis was performed in order to assess whether the residual heads of triceps surae exhibit different characteristics with respect to both the non-treated lower limb and an age-matched control group. Then, an in-depth analysis based on a machine learning approach was proposed for discriminating between groups by generalizing across new unseen subjects. Experimental results showed the reliability of the proposed analyses for discriminating between-group at a specific time epoch and the high interpretability of the proposed machine learning algorithm allowed the temporal localization of the most discriminative frequency bands. Findings of this study highlighted that significant differences can be recognized in the myoelectric spectral characteristics between the treated and contralateral leg in patients who underwent soleus flap surgery. These experimental results may support the clinical decision-making for assessing triceps surae performance and for supporting the choice of treatment in plastic and reconstructive surgery. Keywords Heel rise test · Frequency band analysis · Soleus flap procedure · EMG · Machine learning · Support vector machine · Lasso
1 Introduction Muscle flap represents a widely used procedure in plastic and reconstructive surgery for treating several kinds of injuries affecting lower extremity, such as defects caused by trauma and tumors, open fractures, and joint or bone infections [7, 39, 45]. In particular, soft-tissue injuries following to open fractures, located on the shank, are commonly treated by using one head of gastrocnemius (GSM) or soleus (SL) as donor muscle for soft-tissue coverage [1, 7, 35, 43]. The use of local muscle flap is often preferred to fasciocutanous flaps to cover open wounds of the distal third of the leg because the former provides more tissue than the latter and furthermore the surgical procedure is
Sabrina Iarlori
[email protected]
Extended author information available on the last page of the article.
easier [1]. While a number of studies reported the suitability of such procedure for soft-tissue coverage, less evidence is availabl
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