The Efficiency of Manual Editing of High-Density Surface Electromyogram Decomposition Depends on the Recorded Muscle...

We investigated the agreement and accuracy of manual editing of the high-density electromyogram (hdEMG) decomposition results by seven human operators with various experience levels. All operators edited the same automatically decomposed experimental hdEMG from the first dorsal interosseous (FDI), tibialis anterior (TA), vastus lateralis (VL), and biceps brachii (BB) muscles, and synthetic hdEMG from soleus (SO) and BB muscles at 10%, 30%, 50% and 70% of maximum voluntary contraction. On average, operators kept $13.7~\pm ~7.4$ motor units (MUs) after editing and demonstrated relatively large disagreement in the calculated MU pulse trains (normalized root mean square difference) but relatively high agreement in the identified MU discharges. Inter-operator agreement positively correlated with the initial MU Pulse-to-Noise Ratio used as a quality measure of automatic MU identification, and negatively correlated with the muscle contraction level. Operators agreed more on the results of the simulated than experimental hdEMG. Among the experimental muscles tested, the greatest agreement was demonstrated for VL and the lowest for BB. We obtained similar results when comparing editing to the results of the most experienced operator and to ground truth in simulated cases: the greatest precision and sensitivity were demonstrated for VL, and the lowest for BB. The level of the operator's experience had a significant impact on the editing of synthetic hdEMG and the detection of the first MU discharge, but not on the rate of agreement or editing time of experimental hdEMG.