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The aim of this study was to quantify the laterality of motor unit (MU) activation properties in people with Parkinson's disease (PD) during force production (low- to high-intensity contraction) using high-density surface electromyography (HD-SEMG). Sixteen females with PD (age = 69.9 ± 7.6 years, disease duration = 4.9 ± 5.1 years) and 14 healthy female subjects (age = 68.6 ± 3.6 years) were enrolled in the study and performed submaximal ramp-up contractions during isometric knee extension. HD-SEMG signals were recorded from both vastus lateralis muscles. We calculated the level of heterogeneity in the spatial distribution patterns of the HD-SEMG signals and determined the modified entropy, coefficient of variation of the root mean square (RMS), and correlation coefficient to evaluate MU activation properties. Pearson's correlation coefficients were calculated to examine the relationships between disease severity and the RMS and EMG variables. The RMS value and heterogeneity were significantly higher and lower on the more-affected side in people with PD than on the other side in people with PD or either side in control subjects (p r > 0.6, p < 0.001). We compared the laterality of MU activation properties between the people with PD and the control subjects. These findings suggest that people with PD have asymmetrical MU activation properties, regardless of the magnitude of force production.
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