Highly sensitive indicators of neck muscle fatigue derived from multimodal electrophysiological and metabolic coupling analysis

doi:10.12307/2026.499

Abstract

Abstract: BACKGROUND: Prolonged forward head posture induces neck muscle fatigue, a significant contributing factor to cervical spondylosis. Current unimodal monitoring approaches are inadequate to capture the dynamic coupling among muscle activation, metabolic activity, and motor control.
OBJECTIVE: To systematically evaluate the temporal characteristics of neck muscle fatigue using multimodal monitoring technology, thereby providing a theoretical foundation for early detection and intervention of cervical fatigue.
METHODS: Twenty healthy participants were recruited. Surface electromyography, near-infrared spectroscopy, and three-dimensional motion capture technology were synchronized to record electrophysiological signals, oxygenated hemoglobin concentration, and cervical kinematics during a sustained 45° static forward flexion task until subjective fatigue was reached (Borg CR-10 score ≥ 4). Temporal changes in root mean square amplitude, mean power frequency, muscle oxygen saturation, and normalized forward head angle were analyzed across fatigue stages segmented into 10% intervals of total endurance time.
RESULTS AND CONCLUSION: (1) The root mean square amplitude increased significantly (P < 0.001), while mean power frequency and muscle oxygen saturation decreased significantly (P < 0.001) throughout the task, with the reduction in muscle oxygen saturation commencing from the 40% fatigue stage. (2) Linear regression analyses revealed a stronger association between mean power frequency and muscle oxygen saturation (upper trapezius: R² = 0.58; middle trapezius: R² = 0.61), indicating that metabolic alterations preceded detectable electrophysiological changes. (3) The upper trapezius demonstrated earlier fatigue onset compared with the middle trapezius (P < 0.05). These findings suggest that multimodal integration of combined mean power frequency and muscle oxygen saturation monitoring serves as a highly sensitive strategy for early fatigue detection.

Key words: neck muscle fatigue, multimodal monitoring, surface electromyography, near-infrared spectroscopy, cervical spine biomechanics, mean power frequency

CLC Number:

Liu Yakun, Lu Guangqi, Liang Long, Li Jing, Sun Xinyue, Liu Guangwei, Zhou Shuaiqi, Mao Hanze, Ma Mingming, Hu Jiaming, Zhu Liguo, Zhuang Minghui, Yu Jie. Highly sensitive indicators of neck muscle fatigue derived from multimodal electrophysiological and metabolic coupling analysis[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(25): 6506-6511.

Figures/Tables 5

References

[1] 路广琦,庄明辉,常晓娟,等.在读医学硕博研究生颈椎失稳的相关表现及其生活习惯分析[J].颈腰痛杂志,2023,44(3):316-319.
[2] 李靖,路广琦,庄明辉,等.基于机器学习构建中青年人群颈椎失稳临床预测模型[J].中国组织工程研究,2025,29(33):7203-7210.
[3] 赵锦铎.揿针配合颈部肌群等长抗阻训练治疗青少年颈型颈椎病的临床研究[D].银川:宁夏医科大学,2024.
[4] ERNST MJ, SAX N, MEICHTRY A, et al. Cervical musculoskeletal impairments and pressure pain sensitivity in office workers with headache. Musculoskelet Sci Pract. 2023;66:102816.
[5] ZHANG W, CHEN Z. Functional Brain Changes in Younger Population of Cervical Spondylosis Patients with Chronic Neck Pain. J Pain Res. 2024;17: 4433-4445.
[6] SCANO A, GUANZIROLI E, BRAMBILLA C, et al. A narrative review on multi-domain instrumental approaches to evaluate neuromotor function in rehabilitation. Healthcare (Basel). 2023;11(16):2282.
[7] MING D, WANG X, XU R, et al. sEMG feature analysis on forearm muscle fatigue during isometric contractions. Trans Tianjin Univ. 2014;20(2): 139-143.
[8] SIMAR C, COLOT M, CEBOLLA AM, et al. Machine learning for hand pose classification from phasic and tonic EMG signals during bimanual activities in virtual reality. Front Neurosci. 2024;18:1329411.
[9] GERZ E, GERASKIN D, FRANKE J, et al.Tissue oxygenation during exercise measured with NIRS: reproducibility and influence of wavelengths[C]//Oxygen Transport to Tissue XXXV. Springer New York. 2013:171-177.
[10] 毕学翠,郑晓鸿,张英平.近红外光谱技术监控不同水平运动员递增负荷肌群肌氧变化特征[J].科学技术与工程,2024,24(35):14947-14957.
[11] FENG M, LIANG L, SUN W, et al. Measurements of cervical range of motion using an optical motion capture system: Repeatability and validity. Exp Ther Med. 2019;18(6):4193-4202.
[12] PAREDES-ACUNA N, UTPADEL-FISCHLER D, DING K, et al. Upper limb intention tremor assessment: opportunities and challenges in wearable technology. J Neuroeng Rehabil. 2024;21(1):8.
[13] GUNNAR B. The Borg CR Scales® Folder. Methods for measuring intensity of experience. Borg Perception. 2010:4.
[14] LI F, WU Y, SONG Z, et al. Characteristics of surface electromyogram signals after Pemberton pelvic osteotomy combined with femoral osteotomy in children with unilateral developmental dysplasia of the hip. Medicine (Baltimore). 2022;101(28):e29794.
[15] ZHONG S, JIA N, QU Y, et al. Analysis and study on biomarkers of local muscle fatigue caused by repetitive lifting task. BMC Musculoskelet Disord. 2024;25(1):660.
[16] CRUZ-MONTECINOS C, BUSTAMANTE A, CANDIA-GONZÁLEZ M, et al. Perceived physical exertion is a good indicator of neuromuscular fatigue for the core muscles. J Electromyogr Kinesiol. 2019;49:102360.
[17] PAUTZ N, OLIVIER B, STEYN F. The use of parametric effect sizes in single study musculoskeletal physiotherapy research: A practical primer. Phys Ther Sport. 2018;32:87-97.
[18] LI G, LIU D, YANG D, et al. The Impact of Different Muscle Relaxation Techniques on the Upper Trapezius and Its Relationship with the Middle Trapezius. J Physiol Invest. 2024;67(4):225-232.
[19] FU Y, MA S, MA B, et al. Innovative diagnostic framework for shoulder instability: a narrative review on machine learning-enhanced scapular dyskinesis assessment in sports injuries. Eur J Med Res. 2025;30(1):257.
[20] MIŠIĆ NŽ, OSTOJIĆ M, CVETKOVIĆ S, et al. Wavelet analysis of respiratory muscle sEMG signals during the physiological breakpoint of static dry end-expiratory breath-holding in Naive apneists: A pilot study. Sensors (Basel). 2023;23(16):7200.
[21] GARCIA-RETORTILLO S, IVANOV PC. Inter-muscular networks of synchronous muscle fiber activation. Front Netw Physiol. 2022;2:1059793.
[22] DE MEULEMEESTER K, CALDERS P, VAN DORPE J, et al. Morphological differences in the upper trapezius muscle between female office workers with and without trapezius myalgia: Facts or fiction?: A cross-sectional study. Am J Phys Med Rehabil. 2019;98(2):117-124.
[23] GILMORE CA, KAPURAL L, MCGEE MJ, et al. Percutaneous peripheral nerve stimulation for chronic low back pain: prospective case series with 1 year of sustained relief following short‐term implant. Pain Pract. 2020;20(3): 310-320.
[24] HUANG S, CAI S, LI G, et al. sEMG-based detection of compensation caused by fatigue during rehabilitation therapy: a pilot study. IEEE Access. 2019;7: 127055-127065.
[25] GOULDING RP, MARWOOD S. Interaction of factors determining critical power. Sports Med. 2023;53(3):595-613.
[26] MENEZES TCF, LEE MH, FONSECA BALLADARES DC, et al. Skeletal muscle pathology in pulmonary arterial hypertension and its contribution to exercise intolerance. J Am Heart Assoc. 2025;14(4):e036952.
[27] DE GASPERI R, MO C, AZULAI D, et al. Numb is required for optimal contraction of skeletal muscle. J Cachexia Sarcopenia Muscle. 2022;13(1): 454-466.
[28] 徐明伟,金龙哲,于露,等.长时间颈部前屈对颈部肌肉疲劳的影响[J].工程科学学报,2019,41(11):1493-1500.
[29] MORENO AJ, UTRILLA G, MARIN J, et al. Cervical spine assessment using passive and active mobilization recorded through an optical motion capture.J Chiropr Med. 2018;17(3):167-181.
[30] NIMBARTE AD, ZREIQAT MM, CHOWDHURY SK. Cervical flexion–relaxation response to neck muscle fatigue in males and females. J Electromyogr Kinesiol. 2014;24(6):965-971.
[31] GUO W, FANG Y, SHENG X, et al. Measuring motor unit discharge, myofiber vibration, and haemodynamics for enhanced myoelectric gesture recognition. IEEE Trans Instrum Meas. 2023;72:1-10.
[32] COMBALIA A, SÁNCHEZ-VIVES MV, DONEGAN T. Immersive virtual reality in orthopaedics—a narrative review. Int Orthop. 2024;48(1):21-30.
[33] LONG M, WU G, TAO F, et al. Nanofibrous textured silk aerogel with 3D channel arrays and adjustable mechanical properties for bone tissue regeneration. Int J Biol Macromol. 2024;278:134372.
[34] KOPYL S, SURMENEV R, SURMENEVA M, et al. Magnetoelectric effect: principles and applications in biology and medicine–a review. Mater Today Bio. 2021;12:100149.
[35] DIAO H, XIN H, JIN Z. Prediction of in vivo lower cervical spinal loading using musculoskeletal multi-body dynamics model during the head flexion/extension, lateral bending and axial rotation. Proc Inst Mech Eng H. 2018; 232(11):1071-1082.