Load-dependent impairments in fibularis longus neural drive and motor unit rate coding.
Dr Michail Arvanitidis
Centre of Precision Rehabilitation for Spinal Pain
School of Sport, Exercise and Rehabilitation Sciences
University of Birmingham, United Kingdom
Dr Michail Arvanitidis (PT, PhD, MSc, MMACP) is a Postdoctoral Research Fellow at the Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom. His current research examines cervical adaptations in NASA astronauts following spaceflight, aiming to enhance astronaut health for future missions. His main interests involve studying motor adaptations in pain-affected or vulnerable populations.
Research
After their return to Earth, astronauts carry a markedly higher risk of cervical disc herniation, and the mechanisms behind it remain largely unexplored. Within the international Cervical in Space trial, funded by the UK Space Agency, this work examines how the cervical spine and its musculature adapt after spaceflight, and what that means for the design of countermeasures.
Understanding how persistent musculoskeletal pain influences force control, motor unit discharge behaviour and the spatial distribution of muscle activity. This work spans the trunk, neck, knee and ankle, and extends to populations at elevated risk through ageing or musculoskeletal injuries, with the aim of identifying measurable and modifiable rehabilitation targets.
Methods and tools
Positions
Project: Cervical in Space — cervical spine and muscle adaptation after spaceflight and relationship to herniation risk. Mentor: Prof. Deborah Falla.
Data collection, analysis and dissemination for the Cervical in Space programme alongside doctoral studies.
Astronaut neck strength and neuromuscular assessment protocols; HD-sEMG and dynamometry pipeline development.
Part-time clinical practice. Assessment and management of complex spinal and musculoskeletal presentations. Employer: Dr David W. Evans.
Outpatient musculoskeletal and post-surgical rehabilitation.
Education
Control of trunk muscle force in chronic low back pain, using high-density surface EMG and isokinetic dynamometry. Supervisors: Dr Eduardo Martinez-Valdes, Prof. Deborah Falla.
MMACP-accredited programme. Supervisors: Dr Eduardo Martinez-Valdes, Prof. Deborah Falla.
Supervisor: Prof. Georgios Gioftsos. Honorary fellowship, National Scholarships Foundation (2011–12).
Publications 29 published · 7 in progress
Under review & in preparation
Similar clinical improvements but distinct neuromechanical adaptations between training modes.
Greater dynamic trunk extensor fatigue resistance in older adults despite poorer torque steadiness.
Non-invasive HD-sEMG approach to estimate erector spinae muscle fibre size.
First synthesis showing neck-specific exercise may induce structural cervical muscle adaptation.
AR HD-sEMG biofeedback modified spatial muscle activation and improved knee extensor endurance by 27%.
2026
Simultaneous HD-sEMG and ultrasound via transparent electrodes revealed contraction-dependent neuromechanical coupling.
Age-related impairments in trunk force control with distinct HD-sEMG patterns.
Updated diagnostic accuracy evidence informing evidence-based clinical decision-making.
First demonstration of load- and muscle-dependent motor unit changes in Achilles tendinopathy.
Adaptive redistribution of neck muscle activity during experimentally induced soreness.
2025
Force steadiness is impaired in musculoskeletal pain — a candidate rehabilitation target.
Novel insight into neuromuscular impairments in patellofemoral pain during single-joint exercise.
The NOD is a valid, reliable, portable alternative to laboratory dynamometry.
Revealed regional differences in lumbar erector spinae activity in people with spinal pain.
Will inform countermeasures to reduce spinal pain and injury risk in astronauts.
First evidence of age-related differences in spatial lumbar activation under fatigue.
First meta-analysis showing reduced trunk muscle endurance in older adults.
First trial of torque-based visual feedback training for patellar tendinopathy.
2024
First study of how DOMS influences trunk HD-sEMG–torque relationships and lumbar kinematics.
First evidence of impaired torque steadiness and altered HD-sEMG–torque relationships in dynamic trunk contractions in CLBP.
Novel link between motor unit firing behaviour and Achilles tendon mechanical properties.
New HD-sEMG spatial metrics that characterise fatigue and predict muscle endurance.
2023
2022
Novel HD-sEMG approach overcoming decomposition challenges in the lumbar erector spinae.
International project on cervical spine adaptation after spaceflight and preventive strategies for astronauts.
2021
Altered, potentially less efficient lumbar erector spinae activation during dynamic fatigue in CLBP.
HD-sEMG discriminates biomechanical risk earlier and more accurately than traditional sEMG.
Pain affects motor unit behaviour differently across contraction speeds.
2019
First study to test whether humans can selectively modify trapezius activity using HD-sEMG visual feedback.
2016
Awards
Funding
Conference presentations 13 oral · 9 poster
Refereed conference proceedings. An asterisk marks the presenter.
Oral — 13 presentations
Poster — 9 presentations
Teaching and mentoring
Service
Journal peer review
Applied Psychophysiology and Biofeedback · BMC Musculoskeletal Disorders · Clinical Biomechanics · European Journal of Applied Physiology · European Spine Journal · Journal of Applied Biomechanics · Journal of Applied Physiology · Journal of Biomechanics · Journal of Electromyography and Kinesiology · Journal of Sports Sciences · Musculoskeletal Science and Practice · Occupational and Environmental Medicine · PLOS ONE · Scientific Reports
Registration and membership
Health and Care Professions Council (HCPC), 2018 · Chartered Society of Physiotherapy, 2018 · Musculoskeletal Association of Chartered Physiotherapists, 2019 · International Society of Electrophysiology and Kinesiology, 2020 · Association of Chartered Physiotherapists in Occupational Health and Ergonomics, 2026 · Panhellenic Association of Physiotherapists, 2016
Certification and training
Vehicle Ergonomics, ACPOHE, 2026 · Office Ergonomics (DSE), ACPOHE, 2026 · Supervised Machine Learning: Regression and Classification, DeepLearning.AI and Stanford Online, 2025 · R Programming, Johns Hopkins University, 2024 · The Data Scientist's Toolbox, Johns Hopkins University, 2023 · Certified Peer Reviewer Course, Elsevier, 2021 · Introduction to Programming with MATLAB, Vanderbilt University, 2019 · Otago Exercise Programme Leader Award, Later Life Training, 2015