Sonomechanomyography (SMMG): Mapping of Skeletal Muscle Motion Onset during Contraction Using Ultrafast Ultrasound Imaging and Multiple Motion Sensors.

Background: Available methods for studying muscle dynamics, including electromyography (EMG), mechanomyography (MMG) and M-mode ultrasound, have limitations in terms of spatial resolution. Methods: This study developed a novel method/protocol of two-dimensional mapping of muscle motion onset using ultrafast ultrasound imaging, i.e., sono-mechano-myo-graphy (SMMG). The developed method was compared with the EMG, MMG and force outputs of tibialis anterior (TA) muscle during ankle dorsiflexion at different percentages of maximum voluntary contraction (MVC) force in healthy young adults. Results: Significant differences between all pairwise comparisons of onsets were identified, except between SMMG and MMG. The EMG onset significantly led SMMG, MMG and force onsets by 40.0 +/- 1.7 ms (p < 0.001), 43.1 +/- 5.2 ms (p < 0.005) and 73.0 +/- 4.5 ms (p < 0.001), respectively. Muscle motion also started earlier at the middle aponeurosis than skin surface and deeper regions when viewed longitudinally (p < 0.001). No significant effect of force level on onset delay was found. Conclusions: This study introduced and evaluated a new method/protocol, SMMG, for studying muscle dynamics and demonstrated its feasibility for muscle contraction onset research. This novel technology can potentially provide new insights for future studies of neuromuscular diseases, such as multiple sclerosis and muscular dystrophy.