Real-time surface electromyography in Parkinson's disease patients during exercise-induced muscle fatigue

To explore the mechanisms underlying exercise-induced local muscle fatigue in patients with idiopathic Parkinson＇s disease （PD）,we used surface electromyography to record myoelectric signals from the tibialis anterior muscle during isometric contraction-induced fatigue until exhaustion.The results revealed no significant differences between patients with idiopathic PD and healthy controls in maximum voluntary contraction of the tibialis anterior muscle.The basic characteristics of surface electromyography were also similar between the two groups.The duration of isometric contraction at 50% maximum voluntary contraction was shortened in PD patients.In addition,PD patients exhibited a stronger increase in mean square amplitude,but a weaker decrease in median frequency and mean power frequency compared with healthy controls during isometric contraction.The skeletal muscles of PD patients revealed specificity of surface electromyography findings,indicating increased fatigability compared with healthy controls.

Role of a wireless surface electromyography in dystonic gait in functional movement disorders: A case report

BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.

Prosthetic Leg Locomotion-Mode Identification Based on High-Order Zero-Crossing Analysis Surface Electromyography

The research purpose was to improve the accuracy in identifying the prosthetic leg locomotion mode.Surface electromyography(sEMG)combined with high-order zero-crossing was used to identify the prosthetic leg locomotion modes.sEMG signals recorded from residual thigh muscles were chosen as inputs to pattern classifier for locomotion-mode identification.High-order zero-crossing were computed as the sEMG features regarding locomotion modes.Relevance vector machine(RVM)classifier was investigated.Bat algorithm(BA)was used to compute the RVM classifier kernel function parameters.The classification performance of the particle swarm optimization-relevance vector machine(PSO-RVM)and RVM classifiers was compared.The BA-RVM produced lower classification error in sEMG pattern recognition for the transtibial amputees over a variety of locomotion modes:upslope,downgrade,level-ground walking and stair ascent/descent.

Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography

Background It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis. Currently, there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea. This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition. Methods The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea. The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value, where the percent compensated electromyography value = （normal breath surface electromyography - apnea surface electromyography）/normal breath surface electromyography, and the percent compensated electromyography values among subjects were compared. The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined. Results The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index （R2=0.382, P 〈0.001）. Conclusions Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea. The neuromuscular contribution is different among subjects with obstructive sleep apnea.

A surface electromyography controlled steering assistance interface

Purpose–Two-handed automobile steering at low vehicle speeds may lead to reduced steering ability at large steering wheel angles and shoulder injury at high steering wheel rates(SWRs).As afirst step toward solving these problems,this study aims,firstly,to design a surface electromyography(sEMG)controlled steering assistance interface that enables hands-free steering wheel rotation and,secondly,to validate the effect of this rotation on path-following accuracy.Design/methodology/approach–A total of 24 drivers used biceps brachii sEMG signals to control the steering assistance interface at a maximized SWR in three driving simulator scenarios:U-turn,908 turn and 458 turn.For comparison,the scenarios were repeated with a slower SWR and a game steering wheel in place of the steering assistance interface.The path-following accuracy of the steering assistance interface would be validated if it was at least comparable to that of the game steering wheel.Findings–Overall,the steering assistance interface with a maximized SWR was comparable to a game steering wheel.For the U-turn,908 turn and 458 turn,the sEMG-based human–machine interface(HMI)had median lateral errors of 0.55,0.3 and 0.2 m,respectively,whereas the game steering wheel,respectively,had median lateral errors of 0.7,0.4 and 0.3 m.The higher accuracy of the sEMG-based HMI was statistically significant in the case of the U-turn.Originality/value–Although production automobiles do not use sEMG-based HMIs,and few studies have proposed sEMG controlled steering,the results of the current study warrant further development of a sEMG-based HMI for an actual automobile.

Automatic Detection of Outliers in Multi-Channel EMG Signals Using MFCC and SVM

The automatic detection of noisy channels in surface Electromyogram(sEMG)signals,at the time of recording,is very critical in making a noise-free EMG dataset.If an EMG signal contaminated by high-level noise is recorded,then it will be useless and can’t be used for any healthcare application.In this research work,a new machine learning-based paradigm is proposed to automate the detection of low-level and high-level noises occurring in different channels of high density and multi-channel sEMG signals.A modified version of mel fre-quency cepstral coefficients(mMFCC)is proposed for the extraction of features from sEMG channels along with other statistical parameters i-e complexity coef-ficient,hurst exponent,and root mean square.Several state-of-the-art classifiers such as Support Vector Machine(SVM),Ensemble Bagged Trees,Ensemble Sub-space Discriminant,and Logistic Regression are used to automatically identify an EMG channel either bad or good based on these extracted features.Comparison-based analyses of these classifiers have also been considered based on total classi-fication accuracy,prediction speed(observations/sec),and processing time.The proposed method is tested on 320 simulated EMG channels as well as 640 experi-mental EMG channels.SVM is used as our main classifier for the detection of noisy channels which gives a total classification accuracy of 99.4%for simulated EMG channels whereas accuracy of 98.9%is achieved for experimental EMG channels.

A novel functional electrical stimulation-control system for restoring motor function of post-stroke hemiplegic patients

Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, muki-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.

Paraspinal strength and electromyographic fatigue in patients with sub-acute back pain and controls:Reliability,clinical applicability and between-group differences

BACKGROUND Paraspinal muscle strength and fatigue are considered important in low back pain(LBP)prevention and rehabilitation.High reliability of paraspinal strength and electromyographic(EMG)-fatigue parameters has not been universally reported.Moreover,the discriminative validity of these parameters requires further exploration,under the threat of potentially poor reliability of the methods examined.AIM To investigate the reliability and discriminative validity of paraspinal strength and EMG-related fatigue in subjects with recurrent LBP and healthy participants.METHODS Test-retest measurements were performed in 26 healthy and 66 LBP volunteers,for reliability.Paraspinal isometric maximal and mean strength were determined with a maximum voluntary isometric contraction(MVIC)protocol,performed in a custom-made device.For the fatigue test,participants performed a 60% MIVC level continuous isometric contraction of the paraspinals,in conjunction with EMG analysis from 4 muscle sites of the lumbar spine.Initial median frequency(IMF),the median frequency slope(MFslope),as well as the root mean square(RMS)slope EMG parameters were used as fatigue measures.Data were analysed with repeated measures ANOVA for test-retest differences.For reliability,the intraclass correlation coefficient(ICC3,1),standard error of the measurement(SEM)and the smallest detectable difference(SDD)were reported.Group-related differences for fatigue measures were analysed with a Multivariate Analysis of Covariance,with age,weight and strength as covariates.RESULTS Isometric strength presented statistically significant between-day differences(P<0.01),however these did not exceed 10%(healthy:7.2%/LBP-patients:9.7%)and ICC reliability values were excellent,yet test-retest error was increased for the patient group(healthy:ICC3,1:0.92-0.96,SEM:5.72-5.94 Hz,SDD:18.51%-18.57%/LBP-patients:ICC3,1:0.91-0.96,SEM:6.49-6.96,SDD:30.75%-31.61%).For the frequency data,IMF reliability was excellent(healthy:ICC3,1:0.91-0.94,SEM:3.45-7.27 Hz,SDD:9.56%-20.14%/patients:ICC3,1:0.90-0.94,SEM:6.41-7.59 Hz,SDD:17.75%-21.02%)and of MF raw and normalised slopes was good(healthy:ICC3,1:0.78-0.82,SEM:4.93-6.02 Hz,SDD:13.66-16.67%/LBP-patients:ICC3,1:0.83-0.85,SEM:6.75-7.47 Hz,SDD:18.69%-20.69%).However,the reliability for RMS data presented unacceptably high SDD values and were not considered further.For discriminative validity,less MVIC and less steep MFslopes were registered for the patient group(P<0.01).CONCLUSION Reliability and discriminative ability of paraspinal strength and EMG-related frequency parameters were demonstrated in healthy participants and patients with LBP.

Analysis of sEMG signal for KOA classification

The sEMG signals are collected from the vastus lateralis,vastus medialis,biceps femoris,and semitendinosus of lower extremity during level walking among control subjects and knee osteoarthritis (OA) patients,the latter including mild,moderate and severe degree.The 5-fold cross-validation is used to measure the accuracy of the proposed analysis algorithm on collected sEMG recordings.For comparison,the more classical feature vectors of form factor,degree of skewness,kurtosis,and wavelet entropy are also tested.In experiment,the normalized energy ratio and marginal spectrum ratio achieve larger accuracy than the other features for all the four muscular groups.Moreover the accuracy of vastus medialis and biceps femoris are larger than that of vastus lateralis and semitendinosus.These results suggest that the normalized energy ratio and marginal spectrum ratio via the analysis of knee sEMG signals by HHT can server as characteristic parameters to easily classify osteoarthritis with noninvasive method.The more important muscular groups for maintaining the knee joint function are medialis and biceps femoris;as a result of that they should be exercise especially for rehabilitation.

Comparing the efficiency of artificial neural networks in sEMG-based simultaneous and continuous estimation of hand kinematics

Surface Electromyography(sEMG)plays a key role in many applications such as control of Human-Machine Interfaces(HMI)and neuromusculoskeletal modeling.It has strongly nonlinear relations to joint kinematics and reflects the subjects’intention in moving their limbs.Such relations have been traditionally examined by either integrated biomechanics and multi-body dynamics or gesture-based classification approaches.However,these methods have drawbacks that limit their usability.Different from them,joint kinematics can be continuously reconstructed from sEMG via estimation approaches,for instance,the Artificial Neural Networks(ANNs).The Comparison of different ANNs used in different studies is difficult,and in many cases,impossible.The current study focuses on fairly evaluating four types of ANN over the same dataset and conditions in proportional and simultaneous estimation of 15 hand joint angles from 10 sEMG signals.The presented ANNs are Feedforward,Cascade-Forward,Radial Basis Function(RBFNN),and Generalized Regression(GRNN).Each ANN is applied to its special parametric study.All the methods efficiently solved the regression problem of the complex multi-input multi-output bio-system.The RBFNN has the best performance over the others with a 79.80%mean correlation coefficient over all joints,and its accuracy reaches as high as 92.67%in some joints.Interestingly,the highest accuracy over individual joints is 93.46%,which is achieved via the GRNN.The good accuracy suggests that the proposed approaches can be used as alternatives to the previously adopted ones and can be employed effectively to synchronously control multi-degrees of freedom HMI and for general multi-joint kinematics estimation purposes.

Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic vs mini-open approach

BACKGROUND Rotator cuff(RC)tears are one of the most frequent pathologies within the shoulder girdle.Hand dominance and older age are associated with RC tears.Two different surgical procedures,the mini-open(MO)and all-arthroscopic(AA)approach,represented the standard of treatment.AIM To compare the clinical and biomechanical outcomes of two surgical techniques(AA vs MO procedure)performed to address the painful shoulder syndrome with partial or total supraspinatus tendon tear.METHODS Eighty-eight participants,50 following RC repair with AA and 38 with MO approach,were recruited in the present cross-sectional case-control study(ORTHO-SHOULDER,Prot.0054602).All patients underwent postoperative clinical evaluation for pain(Visual analogic scale),impairment,and disability(disability of the arm,shoulder,and hand)and limitation in daily activity(Constant-Murley score).Patients’shoulder mobility was also assessed in our Laboratory of Functional Movement through a wearable inertial sensor and surface electromyography to monitor kinematics and muscle activity during the movement on the frontal(abduction/adduction)and sagittal(flexion-extension)planes.RESULTS No statistically significant differences between the two procedures were observed in either main clinical score or range of motion.A significant increase in velocity during the movement execution and a higher contribution of upper trapezius muscles were found in the AA group compared with MO patients.CONCLUSION In terms of clinical scores,our findings were in line with previous results.However,the use of technology-based assessment of shoulder mobility has revealed significant differences between the two techniques in terms of mean velocity and pattern of muscle activation.

Randomized Controlled Pilot Trial of Truncal Exercises after Stroke to Improve Gait and Muscle Activity

The purpose of the present study was to evaluate the effects of a trunk exercise program on the gait and muscle activity in stroke patients. The participants of this pilot study included six hemiplegic stroke patients. The outcomes were surface electromyography (sEMG) and spatiotemporal gait parameters. In analysis of sEMG, no statistically difference was found between pre- and post-training of Maximal Voluntary Isometric Contraction (MVIC) in rectus abdominis and external abdominal oblique muscle, but it tended to increase. However, the gait parameter significantly increased in walking speed, walking cycle, and affected stride length in stroke patients. These results suggest that the trunk exercise program may in part improve the gait of chronic stroke patients.

Systematic reduction of leg muscle activity throughout a standard assessment of running footwear

Purpose This study aimed to investigate whether there is a systematic change of leg muscle activity,as quantified by surface electromyography(EMG),throughout a standard running footwear assessment protocol at a predetermined running speed.Methods Thirty-one physically active adults(15 females and 16 males)completed 5 testing rounds consisting of overground running trials at a speed of 3.5 m/s.The level of muscle activity from 6 major leg muscles was recorded using surface EMG.The variables assessed were the EMG total intensity as a function of time and the cumulative EMG overall intensity.Systematic effects of the chronological testing round(independent variable)on the normalized EMG overall intensity(dependent variable)were examined using Friedman analysis of variates and post hoc pairwise Wilcoxon signed-rank tests(α=0.05).Results There was a systematic reduction in overall EMG intensity for all 6 muscles over the time course of the running protocol(p<0.001)until the fourth testing round when EMG intensities reached a steady state.The one exception was the biceps femoris muscle,which showed a significant reduction of EMG intensity during the stance phase(p<0.001)but not the swing phase(p=0.16).Conclusion While running at a predetermined speed,the neuromuscular system undergoes an adaptation process characterized by a progressive reduction in the activity level of major leg muscles.This process may represent an optimization strategy of the neuromuscular system towards a more energetically efficient running style.Future running protocols should include a familiarization period of at least 7 min or 600 strides of running at the predetermined speed.

Gait Analysis of a Subject with Total Hip Arthroplasty

Introduction: gait analysis of a subject with total hip replacement is described. Objective: instrumental gait analysis of a subject 12 years after the total hip arthroplasty. Materials and Methods: in a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 64-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. All measurements were assessments by applying walking protocols on a straight surface of 8 m long. Results: abnormal slight activations of semitendinosus and tibialis anterior muscles, of the left limb, were observed throughout the gait cycle, no spatiotemporal parameters far from normal values were detected. Conclusions: it was possible to obtain an exhaustive analysis of the parameters associated with the gait of a subject after 12 years of total hip arthroplasty.

The effect of baduanjin exercise in rehabilitation for functional ankle instability:A study protocol for a randomized controlled pilot trial

Introduction:Patients with functional ankle instability(FAI)have problems with joint control,balance,gait,and postural symmetry.Baduanjin is a type of traditional Chinese exercise that has been shown to be effective in treating many diseases and symptoms.However,to date,the effect of Baduanjin in patients with FAI has not been proved.This pilot trial is an assessor-blinded randomized controlled trial,and its objective is to study the efficacy and safety of Baduanjin on the rehabilitation of patients with FAI.Methods:Seventy-two participants,who are eligible according to specified inclusion and exclusion criteria,will be randomized(in a 1:1 ratio),using a random number table,into two groups:a Baduanjin group and a conventional treatment group.The Baduanjin group will be subjected to the Baduanjin exercise in addition to the conventional treatment therapy.Participants’exercise programs will be implemented for 4 weeks(5 days a week).All participants will be assessed at baseline,and after two and 4 weeks of treatment.The surface electromyography results of the bilateral erector spinae,tibialis anterior,and peroneus longus will be the primary outcomes,while the balance function under different conditions and the level of FAI in daily life measured using the Cumberland Ankle Instability Tool will be the secondary outcomes.Ethics and Dissemination:The trial has been approved by the Research Ethical Committee of Dongzhimen Hospital,the First Affiliated Hospital of Beijing University of Chinese Medicine(no.DZMEC-KY-2019-18),and it will follow the principles of the Consolidated Standards of Reporting Trials statements as well as the Declaration of Helsinki.The findings of this study will be submitted for publication in peer-reviewed journals.The results will also be disseminated to the participants via phone calls or e-mail.

changes in muscle activity in patients with primary chronic headache

Objective:According to the Global Burden of Disease Study,updated in 2018,headache disorders are the second leading cause in the world and impaired quality of life and lead to reduce daily activity and can be the cause of headache-related disability.So,we desperately need to develop new painless and minimally invasive methods to facilitate diagnosis to improve the quality of headache care.Methods:Our study involved 92 participants over 18 years of age with a diagnosis of primary chronic headache.Among those,36 were with chronic tension type headache,26 were with a chronic migraine,and 30 were healthy participants.All patients were selected according to the criteria of the International Headache Society.Clinical questionnaires,instrumental data,and characteristics of headache episodes were collected from all participants.We evaluated the muscle activity of the pericranial and cervical muscles in patients with chronic headache to compare with healthy participants using Surface electromyography to determine if there is an alteration in muscle activity.Results:Surface electromyography data showed that there was a statistically significant difference in results between the target group and the control group,where patients with primary chronic headache had high amplitude and velocity in the studied muscles on the electromyogram.Among the participants,there was a difference in the intensity of headache attacks on the visual analog scale chronic tension type headache 5.2±1.4,chronic migraine 7.7±1.3,control group 1.6±0.7 and in the frequency of headache attacks per month chronic tension type headache 14.4±1.9,chronic migraine 17.3±2.9,the control group of participants had headache attacks of≤1 per month.Conclusion:We concluded that the patients with primary chronic headaches there are changes in the muscle activity of the pericranial and cervical muscles.In contrast to patients without chronic headaches,which,in turn,the method of surface electromyography may encourage further research in this area.

Conventional kinesiotherapy or Pilates mat exercises,what is more efficient for abdominal weakness?A feasibility study

The aim of this feasibility study was to contrast rectus abdominis (RA) muscle strength and electrical activity after two abdominal training protocols, conventional kinesiotherapy (CK) and Pilates mat exercises (PME). 13 participants were randomized to one of two groups: CK and PME, and were trained accordingly. The upper rectus abdominis (URA) and lower rectus abdominis (LRA) were independently examined and intra-group and inter-group comparison were done. Findings demonstrate a significant increase in RA strength after both protocols, relative to baseline. Significantly increased electrical activation was seen in the URA after CK. Training with PME, although as efficient as CK in strength improvement, produced decreased activation level of muscles. CK training induced an opposite result. The differences after training suggest that CK and PME training programmers may strength RA, but the neuromuscular activation strategies for that are not the same. PME can be incorporated into protocols to improve abdominals strength, and trunk stabilization.

An Interfacial Gel Electrode Patch with Tunable Hydrogen Bond Network for Electromyographic Sensing and Discrimination

The sensitivity and fidelity of surface electromyography(sEMG)signal monitoring is critical for muscle status and fatigue assessment,prosthetic control,and gesture recognition.However,the incompatible skin-electrode interface and complex electrophysiological environment restrict the sensitive acquisition and accurate analysis of sEMG signals.Focused on the impedance of the skin-electrode interface issue,we developed an interfacial gel electrode patch with a tunable hydrogen bond network to simultaneously achieve a conformal interface,suitable adhesion,and high conductivity for sEMG signal monitoring.By exploiting hydroxyethylidene diphosphonic acid(HEDP)and 2-hydroxyphosphono-acetic acid(HPAA)as hydrogen bonding regulators were introduced into the polyvinyl alcohol(PVA)-based hydrogel network to regulate the hydrogen bond cross-linking network.As a result,the balance of elastic modulus,adhesion,and electrical conductivity of PVA-HEDP-HPAA(PHH)hydrogel are achieved.The reliable electrodeskin interface is manipulated to achieve conformal contact by matching the elastic modulus,reducing the gap of electrode-skin interface by adhesion,and promoting ion and electron conduction by electrical conductivity.The PHH electrode patches exhibit a lower interfacial impedance(12.56 kΩ)and a signal-to-noise ratio of 38.09±1.28 dB for accurate analysis of muscle strength and evaluation of the fatigue state.With the assistance of the artificial neural network algorithm,seven gestures can be recognized with 100%prediction accuracy.The interfacial gel electrode patch contributes a bio-matching electrophysiological platform for prosthetic control,human–machine interaction,and clinical or athletic auxiliary monitoring.

Human-robot interface based on sEMG envelope signal for the collaborative wearable robot

Surface electromyography(sEMG)control interface is a common method for human-centered robotics.Researchers have frequently improved the recognition accuracy of sEMG through multichannel or high-precision signal acquisition devices.However,this increases the cost and complexity of the control system.Therefore,this study developed a control interface based on the sEMG enveloped signal for a collaborative wearable robot to improve the accuracy of sEMG recognition based on the time-domain(TD)features.Specifically,an acquisition device is developed to obtain the sEMG envelope signal,and 11 types of TD features are extracted from the sEMG envelope signal acquired from the upper limb.Furthermore,a dimension reduction method based on the correlation coefficient is proposed,transforming the 11-dimensional feature into a five-dimensional envelope feature set without decreasing the accuracy.Moreover,a recognition algorithm based on a neural network has also been proposed for gesture classification.Finally,the recognition accuracy of the proposed method,principal component analysis(PCA)feature set,and Hudgins TD feature set is compared,with their accuracy at 84.39%,72.44%,and 70.89%,respectively.Therefore,the results indicate that the envelope feature set performs better than the common gesture recognition method based on signal channel sEMG envelope signal.

浅析基于力学平衡原理针刺结合运动疗法治疗上交叉综合征疗效观察——随机临床试验

Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the outpatients of AcupunctureMoxibustion,Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine,the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria.Using the random number table method,they were divided into a combined treatment group(acupuncture plus kinesiotherapy,23 cases) and a simple kinesiotherapy group(22 patients).Treatment for 4 weeks was one course,and two consecutive courses were required.The visual analog scale(VAS) score,the score of the assessment scale for cervical spondylosis,the value of surface electromyography(root mean square,RMS),and the cervical curvature value were used in the evaluation.The allocation scheme was concealed from the outcome assessors.Results:The data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed.Before treatment,the differences were not statistically significant in the general conditions,VAS score,assessment score of cervical spondylosis,cervical curvature value,and RMS in UCS patients between the two groups(all P> 0.05).After treatment,the VAS score was reduced compared with that before treatment in both groups(all P <0.05).In two courses of treatment,the VAS score decreased as compared with that in one course of treatment in both groups(both P <0.05),and the VAS score in the combined treatment group decreased more obviously after each course of treatment(both P <0.05).The RMS decreased compared with that before treatment in each group(both P <0.05),and the decrease in the combined treatment group was more obvious(P <0.05).After treatment of each course,the assessment score was all increased as compared with that before treatment in two groups(all P <0.05).In two courses of treatment,the assessment score was increased as compared with that in one course of treatment in both groups(both P <0.05),and the score in the combined treatment group was increased more obviously in the two courses of treatment(P <0.05).Regarding either the intra-group comparison or the inter-group comparison before and after treatment,the differences were not statistically significant(all P> 0.05),suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS.However,cervical curvature tended to improve in the combined treatment group.The total effective rate was significantly different between the two groups(P <0.05),indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.Conclusion:Combined treatment with acupuncture,kinesiotherapy,and kinesiotherapy alleviated pain,relieved the symptoms and physical signs,and improved the daily movement of the patients.However,the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.