The application of b-mode ultrasonography for analysis of human skeletal muscle

Cunningham, Ryan (2015) The application of b-mode ultrasonography for analysis of human skeletal muscle. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Skeletal muscles control the joints of the skeletal system and they allow human movement and interaction with the environment. They are vital for stability in balance, walking and running, and many other skilled motor tasks. To understand how muscles operate in general and specific situations there are a variety of tools at the disposal of research scientists and clinicians for analysing muscle function. Strain gauges for example allow the quantification of forces exerted during joint rotation. However, skeletal muscles are multilayer systems and often different muscles are responsible for the overall force generated during joint rotation. Therefore, strain gauges do not reveal the extent of the contribution of individual muscles during muscle function. The most widely-used and accepted muscle analysis tool is electromyography (EMG), which can measure the activation level of individual muscles by measuring the electrical potential propagating through muscle resulting from local activations of motor units. However, EMG does not linearly relate to any real physical forces, meaning that without prior knowledge of the force exertion on the level of the muscle, force cannot be estimated. EMG can measure superficial layers of muscle non-invasively by attaching surface electrodes (surface EMG) to the skin over the belly of the muscle. To measure the activity of individual muscle beneath the superficial muscle, a needle or thin-wire electrode must be inserted through the skin and into the muscle volume (intramuscular EMG), which is invasive and not practical in many situations. Furthermore, intramuscular EMG can only provide measurement of a very small volume (<1mm3) which can have varying amounts of active motor units. Ultrasonography is a powerful cost-effective non-invasive imaging technology which allows real-time observation of cross-sections of multiple layers of dynamic skeletal muscle. Recent advances in automated skeletal muscle ultrasound analysis techniques, and advances in image processing techniques make ultrasound a valuable line of investigation for analysis of dynamic skeletal muscle. This aim of this thesis is to study and develop advanced image analysis techniques applicable to the analysis of dynamic skeletal muscle. The broader aim is to understand the capacity/limits of ultrasound as a skeletal muscle analysis tool. The ideas presented within offer new approaches to modelling complex muscle architecture and function via ultrasound. Tools have also been developed here that will contribute to, and promote ultrasound skeletal muscle analysis as a new and emerging technology which may be used by clinicians and research scientists to develop our understanding of skeletal muscle function. The main findings of this thesis are that automated segmentation of architecturally simple and complex skeletal muscle groups is possible and accurate, and that information about joint angles and muscle activity/force can be automatically extracted directly from ultrasound images without the explicit knowledge of how to extract it. The techniques used offer new possibilities for non-invasive information extraction from complex muscle groups such as the muscles in the human posterior neck.