The effects of indirect stimulation at 500-1,000 Hz on force production by the cat's slow-fibered soleus and mixed-fiber medial gastrocnemius (MG) muscles were compared for their relevance to the use of such "high-frequency" stimulation to modulate spasticity or the induced contraction of a centrally paralyzed muscle. Severe loss in force was seen in both muscles, and slow (S) motor units (MUs) within the MG showed about the same susceptibility as fast (FF) units. Both muscles and isolated fast and slow MUs within the MG exhibited an initial spike of tension and throughout stimulation a low level of residual tension. Despite the minimal output of work, a contribution to fatigue could be detected in the poststimulation period, as well as a delayed facilitative effect. Possible mechanisms are discussed.
The ligaments were considered, over several centuries, as the major restraints of the joints, keeping the associated bones in position and preventing instability, e.g. their separation from each other and/or mal-alignment. This project, conducted over 25 years, presents the following hypothesis: 1. Ligaments are also major sensory organs, capable of monitoring relevant kinesthetic and proprioceptive data. 2. Excitatory and inhibitory reflex arcs from sensory organs within the ligaments recruit/de-recruit the musculature to participate in maintaining joint stability as needed by the movement type performed. 3. The synergy of the ligament and associated musculature allocates prominent role for muscles in maintaining joint stability. 4. The viscoelastic properties of ligaments and their classical responses to static and cyclic loads or movements such as creep, tension-relaxation, hysteresis and strain rate dependence decreases their effectiveness as joint restraint and stabilizers and as sensory organs and exposes the joint to injury. 5. Long-term exposure of ligaments to static or cyclic loads/movements in a certain dose-duration paradigms consisting of high loads, long loading duration, high number of load repetitions, high frequency or rate of loading and short rest periods develops acute inflammatory responses which require long rest periods to resolve. These inflammatory responses are associated with a temporary (acute) neuromuscular disorder and during such period high exposure to injury is present. 6. Continued exposure of an inflamed ligament to static or cyclic load may result in a chronic inflammation and the associated chronic neuromuscular disorder known as cumulative trauma disorder (CTD). 7. The knowledge gained from basic and applied research on the sensory - motor function of ligaments can be used as infrastructure for translational research; mostly for the development of "smart orthotic" systems for ligament deficient patients. Three such "smart orthosis", for the knee and lumbar spine are described. 8. The knowledge gained from the basic and applied research manifests in new physiotherapy modalities for ligament deficient patients. Ligaments, therefore, are important structures with significant impact on motor control and a strong influence on the quality of movement, safety/stability of the joint and potential disorders that impact the safety and health of workers and athletes.
The evaluation of surface electromyography (sEMG) is commonly performed in children with cerebral palsy (CP) and reliable interpretation necessitates knowledge of the variability in age-matched, typically developing (TD) children. Variance ratio was calculated for inter-trial sEMG linear envelope (LE) and the Instantaneous Mean Frequency (IMNF) variability in the lower limb muscle in TD children, in three different age groups during slow, comfortable speed, and fast walking. Significantly greater variability was found in the 7-9 group compared to the 13-16years. Variability during both slow and fast walking was significantly greater compared to comfortable speed walking and was profound in the 7-9year age group. Variability of the IMNF was significantly greater than LE in the Tibialis-Anterior, Biceps-Femoris (BF), Vastus-Lateralis (VL), and Rectus-Femoris (RF). Clinical implications are that children under 10years are more variable than older children when walking either slower or faster than self-selected walking speed. This suggests that muscle activation patterns in gait mature at a later stage of childhood than do kinematic gait patterns. Greater precaution, therefore, is needed when comparing sEMG patterns of less than 10years of age patient and TD children.
Non-contact ACL injuries generally occur as the foot contacts the ground during cutting or landing maneuvers and the non-contact ACL injury rate is 2-8 times greater in females compared to males. To provide insight into the gender bias of this injury, this study set out to identify gender differences in the neuromuscular response of the quadriceps, hamstrings and gastrocnemii muscles in elite adolescent soccer players during the pre-contact and early stance phases of an unanticipated side-cut and cross-cut. For the early stance phase of the two maneuvers, females demonstrated greater rectus femoris activity compared to males. Throughout the pre-contact phase of the maneuvers, a rectus femoris activation difference was identified with females having an earlier and more rapid rise in muscle activity as initial ground contact approached. Females demonstrated greater lateral and medial gastrocnemii activity for the pre-contact and early stance phases of the side-cut and greater lateral gastrocnemii activity during early stance of the cross-cut. Timing of hamstring activity also differed between genders prior to foot contact. The differences suggest that the activation patterns observed in females might not be providing adequate joint protection and stability, thereby possibly having a contributing role towards increased non-contact ACL injuries in females.
The aim of the present study was to determine how the intra-muscular segments of three shoulder muscles were coordinated to produce isometric force impulses around the shoulder joint and how muscle segment coordination was influenced by changes in movement direction, mechanical line of action and moment arm (ma). Twenty male subjects (mean age 22 years; range 18-30 years) with no known history of shoulder pathologies, volunteered to participate in this experiment. Utilising an electromyographic technique, the timing and intensity of contraction within 19 muscle segments of three superficial shoulder muscles (Pectoralis Major, Deltoid and Latissimus Dorsi) were studied and compared during the production of rapid (e.g. approximately 400ms time to peak) isometric force impulses in four different movement directions of the shoulder joint (flexion, extension, abduction and adduction). The results of this investigation have suggested that the timing and intensity of each muscle segment's activation was coordinated across muscles and influenced by the muscle segment's moment arm and its mechanical line of action in relation to the intended direction of shoulder movement (e.g. flexion, extension, abduction or adduction). There was also evidence that motor unit task groups were formed for individual motor tasks which comprise motor units from both adjacent and distant muscles. It was also confirmed that for any particular motor task, individual muscle segments can be functionally classified as prime mover, synergist or antagonist - classifications which are flexible from one movement to the next.
The purpose of this study was to describe kinematic and kinetic differences between a group of ACL deficient subjects who were grouped according to functional ability. Sixteen patients with complete ACL rupture were studied; eight subjects had instability with activities of daily living (non-copers) and eight subjects had returned to all pre-injury activity without limitation (copers). Three-dimensional joint kinematics and kinetics were collected from the knee and ankle during walking, jogging and going up and over a step. Results showed that both groups mitigated the force with which they contacted the floor but non-copers consistently demonstrated less knee flexion in the involved limb. The copers used joint kinematics similar to those of their uninvolved knees and similar to knee motions reported in uninjured subjects. The reduced knee motion in the involved knee of the non-copers did not correlate directly with quadriceps femoris muscle weakness. The data suggest that the non-copers utilize a stabilization strategy which stiffens the knee joint which not only is unsuccessful but may lead to excessive joint contact forces which have the potential to damage articular structures. The copers use a strategy which permits normal knee kinematics and bodes well for joint integrity.
There are now at least nine methods for motor unit number estimation (MUNE) in living human muscles. All methods are based on the comparison of an average single motor unit potential (or twitch) with the response of the whole muscle. Such estimations have been performed for proximal and distal muscles of the arm and leg in healthy subjects and in patients with various neuromuscular disorders. In healthy subjects there is a loss of motor units which is most evident in distal muscles and after the age of 60 years. Substantial losses of motor units have been measured in patients with ALS, post-polio symptoms, and diabetic peripheral neuropathies. In contrast, normal MUNEs have been found in approximately half of patients with persisting obstetric brachial palsies. The sizes of motor units show considerable variations within the same muscle and also between muscles; very large units are usually present in severe partial denervation. Although many motor unit properties are largely governed by motoneurons, some exhibit less plasticity in humans than in other mammals.
It has been suggested that the coordination of the activity of multiple muscles results from the comparison of the actual configuration of the body with a referent configuration specified by the nervous system so that the recruitment and gradation of the activity of each skeletal muscle depend on the difference between these two configurations. Active movements may be produced by the modification of the referent configuration. The hypothesis predicts the existence of a global minimum in electromyographic (EMG) activity of multiple muscles during movements involving reversals in direction. This prediction was tested in five subjects by analysing movements resembling the act of reaching for an object placed beyond one's reach from a sitting position. In such movements, initially sitting subjects raise their body to a semi-standing position and then return to sitting. Consistent with the hypothesis is the observation of a global minimum in the surface EMG activity of 16 muscles of the arm, trunk and leg at a specific phase of the movement. When the minimum occurred, EMG activity of each muscle did not exceed 2-7% of its maximal activity during the movement. As predicted, global EMG minima occurred at the phase corresponding to the reversal in movement direction, that is, during the transition from raising to lowering of the body. The global EMG minimum may represent the point at which temporal matching occurs between the actual and the referent body configurations. This study implies a specific link between motor behavior and the geometric shape of the body modified by the brain according to the desired action.
Electromyogram (EMG) analyses (surface, intramuscular and evoked potentials) in studies of muscle function have attracted increasing attention during recent years and have been applied to assess muscle endurance capacity, anaerobic and lactate thresholds, muscle biomechanics, motor learning, neuromuscular relaxation, optimal walking and pedalling speeds, muscle soreness, neuromuscular diseases, motor unit (MU) activities (MU recruitment and rate coding), and skeletal muscle fatigue. This paper deals with the use of EMG analyses employed in the area of applied physiology and is divided into three sections: surface EMG analyses; intramuscular EMG analyses; and evoked potential analyses.
The influence of signal sampling frequency and the low-pass digital filter cutoff frequency on the minimum number of padding points when applied to kinematic data are factors often absent in data processing descriptions. This investigation determined a relationship between the number of padding points and the ratio of filter cutoff to signal sampling frequencies (f(c)/f(s)). Two kinematic recordings were used which represented signals with high and low deterministic variation magnitudes at the signals' beginning. Signal sampling rates (40-128 Hz) were generated at intervals of 1 Hz. Filter cutoff frequency was iterated from 2 to 10 Hz at 0.5 Hz intervals. Data extrapolation was performed using three different techniques (first order polynomial, third order polynomial, and data reflection). A maximum of 2s of padding points were added to the beginning of each test signal which was then dual-pass filtered using a second order Butterworth filter. For each successive increase in the number of padding points, the filtered test signal was compared to a criterion signal and the root mean square difference (RMSD) over the first second was calculated. The number of padding points required to attain a constant RMSD was recorded as the minimum number of padding points needed for that ratio of filter cutoff to sampling frequency. As f(c)/f(s) increased, the number of padding points decreased non-linearly. More padding points were required for the signal with higher deterministic variation at the beginning than the signal with lower deterministic variation. Additional padding points (beyond the determined minimum) did not further reduce the RMSD. The largest temporal extrapolation determined by the algorithm to produce a stable RMSD was 1s. It is suggested that a minimum of 1s of extraneous data be used when using a low-pass recursive digital filter to remove noise from kinematic data.
This review provides an overview of some of the growing body of research on the effects of spinal manipulation on sensory processing, motor output, functional performance and sensorimotor integration. It describes a body of work using somatosensory evoked potentials (SEPs), transcranial magnetic nerve stimulation, and electromyographic techniques to demonstrate neurophysiological changes following spinal manipulation. This work contributes to the understanding of how an initial episode(s) of back or neck pain may lead to ongoing changes in input from the spine which over time lead to altered sensorimotor integration of input from the spine and limbs.
Motorcycle riders must endure high levels of muscle tension for long periods of time, especially in their arms and forearms, when steering and using handlebar controls. Because the right hand operates the gas handle and front brakes, the present research focuses on fatigue in the right hand flexors. Ten adult riders, aged 32.5±5.5years, volunteered to participate in this study. During the 24h race each rider, on completion of a relay stage, visited the assessment box to do the following handgrip test sequence: (1) 10s of EMG recording at rest, (2) one 3-s maximal voluntary contraction (MVC), (3) 1min rest interval and (4) 50% MVC maintained during 10s. EMG amplitude (MP: μV) and median and mean frequency (MF and MPF: Hz) over the superficial finger flexors were recorded during the whole handgrip test sequence with adhesive surface electrodes. MVC values were maintained during the first two relays (50-60min duration in total) and dropped gradually thereafter (p<0.01). During the monitoring of the 50% MVC, mean amplitude increased (p=0.024) while median and mean frequency tended to decrease. These results suggest fatigue is produced in motorcycle riders in a 24h race. However, the expected reduction of EMG frequency was not confirmed given to a potentially large variability.
Computer display height and desk design to allow forearm support are two critical design features of workstations for information technology tasks. However there is currently no 3D description of head and neck posture with different computer display heights and no direct comparison to paper based information technology tasks. There is also inconsistent evidence on the effect of forearm support on posture and no evidence on whether these features interact. This study compared the 3D head, neck and upper limb postures of 18 male and 18 female young adults whilst working with different display and desk design conditions. There was no substantial interaction between display height and desk design. Lower display heights increased head and neck flexion with more spinal asymmetry when working with paper. The curved desk, designed to provide forearm support, increased scapula elevation/protraction and shoulder flexion/abduction.
The aftereffects of antidromic stimulation at 500 or 600 Hz on the discharge of isolated spindle Ia and II, and tendon organ Ib afferent fibers from the cat medial gastrocnemius muscle were examined to see what proprioceptive disturbances to expect when such "high-frequency," tension-attenuating stimulation is used to modulate contractions in orthotic applications. Three phases of poststimulation depression in spindle discharge were recognized: a complete pause in firing, a rapidly accelerating return of discharge, and a final more gradual approach to the control rate. When steady prestimulation discharge rates of Ia and II endings were equated through adjustment of muscle length, no obvious difference in effect on duration of the pause or position sensitivity was detected. Sensitivity to dynamic change in muscle length was also depressed, but responses returned earlier than when the muscle was held at a steady length. The dynamic responses of tendon organs were similarly depressed.
INTRODUCTION, OBJECTIVE: Gait analysis has provided important information about the variability of gait for patients prior to and after total hip arthroplasty (THA). The objective of this research was to clarify how the method of exposure in total hip arthroplasty affects the variability of gait. MATERIALS AND METHOD: Gait analysis was performed at 0.8m/s, 1.0m/s, and 1.2m/s on 25 patients with direct-lateral exposure (DL), 22 with antero-lateral exposure (AL) and 25 with posterior exposure (P) during total hip arthroplasty. The control group was represented by 45 healthy subjects of identical age. Gait analysis was performed pre-operatively and 3 and 6months after the surgery. Gait parameter variability was characterized by the coefficient of variance (CV) of spatial-temporal parameters and by the mean coefficient of variance (MeanCV) of angular parameters. RESULTS: The variability of gait tends to reach control values during the first 6months of the postoperative period in all three patient groups. Six months after THA, in patients operated with DL and AL exposure the variability of gait differs significantly from control values; however, in patients operated with P exposure, the variability of spatial-temporal and angular parameters - except the rotation of pelvis - was similar to that of controls. DISCUSSION, CONCLUSION: The type of surgical technique significantly influences the variability of gait. Difference in the variability of angular parameters predicts gait instability and increased risk of falling after THA without the joint capsule preserved. Joint capsule preservation ensures a recovery of gait variability. It should be taken into account when compiling rehabilitation protocols. Differences related to the method of exposure should be considered when abandoning therapeutic aids.
To test whether the influence of manual activity should be considered when interpreting the results of nerve conduction study (NCS) of the upper limbs performed during work shifts, we evaluated the short-term effect of 90-min repetitive manual work on NCS parameters. Twenty-eight healthy volunteers underwent NCS of the dominant limb at the end of an interview (T(0)), after a 30-min rest in sitting position (T(1)) and after performing a standardized 90-min manual task (T(2)). The task was designed to simulate typical assembly and packing activities. No significant differences were observed for skin temperature (Ts) and NCS parameters between T(0) and T(1). Significantly (p<0.001) higher Ts mean values were found at T(2) as compared to the previous tests for both females and males. The regression analysis showed an association between temperature variation and nerve conduction velocity values for the median and ulnar nerve at T(2) as compared to T(1). In females, a reduction of the mean sensory nerve action potential (SNAP) amplitude at T(2) was recorded, whereas an opposite trend was observed among males. Manual work is able to influence hand Ts and to modify NCS parameters. SNAP amplitudes changes suggest gender differences in peripheral nerve characteristics that deserve further investigation.
Retrospective features of 91 consecutive cases (68 men, 23 women; mean age 44.4 years) of radial mononeuropathy diagnosed over the last 8 years in two electromyography (EMG) services are reported to define the clinical and electrophysiological findings of radial neuropathies in relation to traumatic and non-traumatic causes and site of injury. The occurrence of radial neuropathy was 0.65 x 100 first electromyographic examinations. The most frequent site of damage was the main trunk at the spiral groove of the humerus (36%); the most frequent cause was nerve trauma (70%) due to fracture (36%). In neuropathies of the main trunk and posterior interosseous (PI) nerve, "complete nerve injury" was observed in 36% of cases, conduction motor block in 33% and motor conduction velocity slowing in 46%. At least one of these findings was present in 51%, whereas motor neurography was normal in 13% of cases. Sensory action potential (SAP) anomalies were observed in 51% of cases. In neuropathy of the superficial radial nerve, no SAP was detected in 30% of cases; in all others except one, SAP was reduced in amplitude. Non-traumatic neuropathies showed severer conduction block and less severe anomalies of SAP than traumatic neuropathies. No differences were found between men and women. EMG is essential for confirming the site of injury and neurographic study may be helpful for diagnosis, providing information about lesion type and severity.
It is generally assumed that raw surface EMG (sEMG) should be high pass filtered with cutoffs of 10-30 Hz to remove motion artifact before subsequent processing to estimate muscle force. The purpose of the current study was to explore the benefits of filtering out much of the raw sEMG signal when attempting to estimate accurate muscle forces. Twenty-five subjects were studied as they performed rapid static, anisotonic contractions of the biceps brachii. Biceps force was estimated (as a percentage of maximum) based on forces recorded at the wrist. An iterative approach was used to process the sEMG from the biceps brachii, using progressively greater high pass cutoff frequencies (20-440 Hz in steps of 30 Hz) with first and sixth order filters, as well as signal whitening, to determine the effects on the accuracy of EMG-based biceps force estimates. The results indicate that removing up to 99% of the raw sEMG signal power resulted in significant and substantial improvements in biceps force estimates. These findings challenge previous assumptions that the raw sEMG signal power between about 20 and 500 Hz should used when estimating muscle force. For the purposes of force prediction, it appears that a much smaller, high band of sEMG frequencies may be associated with force and the remainder of the spectrum has little relevance for force estimation.
The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior-posterior translations, medial-lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial-lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior-posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired.
The purpose of this study was to determine the effect of the ECG artifact on low-level trunk muscle activation amplitudes and assess the effectiveness of two methods used to remove the ECG. Simulations were performed and percent error in root mean square (RMS) amplitudes were calculated from uncontaminated and contaminated EMG signals at various ECG to EMG ratios. Two methods were used to remove the ECG: (1) filtering by adaptive sampling (FAS) and (2) Butterworth high pass filter at 30 Hz (BW-30 Hz HPF). The percent error was also calculated between the ECG removed and the uncontaminated EMG RMS amplitudes. Next, the BW-30 Hz HPF method was used to remove the ECG from 3-bilateral external oblique (EO) muscle sites collected from 30 healthy subjects performing a one handed lift and replace task. Two separate ANOVA models assessed the effects of ECG on the statistical interpretation of EO recruitment strategies. One model included EMG data that contained the ECG and the other model included EMG data after the ECG was removed. Large percent errors were observed when the ECG was not removed. These errors increased with larger ECG to EMG ratios. Both removal methods reduced the errors to below 10%, but the BW-30 Hz HPF method was more time efficient in removing the ECG artifact. Different statistical findings were observed among the muscle sites for the ECG contaminated model compared to the ECG removed model, which resulted in different conclusions concerning neuromuscular control.
It has been hypothesized that changes in trunk muscle activity in chronic low back pain (CLBP) reflect an underlying "guarding" mechanism, which will manifest itself as increased superficial abdominal - and lumbar muscle activity. During a functional task like walking, it may be further provoked at higher walking velocities. The purpose of this cross sectional study was to investigate whether subjects with CLBP show increased co-activation of superficial abdominal - and lumbar muscles during walking on a treadmill, when compared to asymptomatic controls. Sixty-three subjects with CLBP and 33 asymptomatic controls walked on a treadmill at different velocities. Surface electromyography data of the erector spinae, rectus abdominis and obliquus abdominis externus muscles were obtained and averaged per stride. Results show that, compared to asymptomatic controls, subjects with CLBP have increased muscle activity of the erector spinae and rectus abdominis, but not of the obliquus abdominis externus. These differences in trunk muscle activity between groups do not increase with higher walking velocities. In conclusion, the observed increased trunk muscle activity in subjects with CLBP during walking supports the guarding hypothesis.
The relative levels of pelvic floor muscle (PFM) activation and pressure generated by maximum voluntary PFM contractions were investigated in healthy continent women. The normal sequence of abdominal and PFM activation was determined. Fifteen women performed single and repeated maximum voluntary PFM contractions in supine, sitting and standing. PFM electromyographic (EMG) signals and associated intra-vaginal pressure data were recorded simultaneously. Surface EMG data were recorded from rectus abdominus (RA), external obliques (EO), internal obliques (IO) and transversus abdominus (TA). Abdominal and PFM EMG and intra-vaginal pressure amplitudes generated during voluntary PFM contractions were not different among the positions. Muscle activation sequence differed by position. In supine, EO activation preceded all other muscles by 27 ms (p = 0.043). In sitting, all of the muscles were activated simultaneously. In standing, RA and EO were activated 11 and 17 ms, respectively, prior to the PFMs and TA and IO were activated 10 and 12 ms, respectively, after the PFMs (p<0.001). The results suggest that women are able to perform equally strong PFM contractions in supine, sitting and standing, however the pattern of abdominal and PFM activation varies by position. These differences may be related to position-dependent urine leakage in women with stress incontinence.
Much discussion exists about which is the most effective technique to improve spine stability. The purpose of this study was to evaluate the effectiveness of abdominal bracing and abdominal hollowing maneuvers to control spine motion and stability against rapid perturbations. Eleven healthy males were posteriorly loaded in different experimental conditions: resting with no knowledge of the perturbation timing; performing each of the stabilization maneuvers at 10%, 15% and 20% of internal oblique maximum voluntary contraction with no knowledge of the perturbation timing; and naturally coactivating the trunk muscles when perturbation timing was known. An EMG biofeedback system was used to control the pattern and intensity of abdominal coactivation. The muscular preactivation of seven trunk muscles (bilaterally registered), the applied force, and the torso muscular and kinematic responses to loading were measured; and the spine stability and compression were modeled. The hollowing maneuver was not effective for reducing the kinematic response to sudden perturbation. On the contrary, the bracing maneuver fostered torso cocontraction, reduced lumbar displacement, and increased trunk stability, but at the cost of increasing spinal compression. When the timing of the perturbation was known, the participants were able to stabilize the trunk while imposing smaller spine compressive loads.
Sitting is a commonly adopted posture during work and prolonged exposures may have detrimental effects. Little attention has been paid to the thoracic spine and/or multiple axes of motion during prolonged sitting. Accordingly, this study examined three-dimensional motion and muscle activity of the trunk during two hours of uninterrupted sitting.
Ten asymptomatic males sat during a simulated office task. Kinematics were analyzed from six segments (Neck, Upper-, Mid-, and Lower-thoracic, Lumbar, and Pelvis) and electromyography was recorded from eight muscles bilaterally.
Four participants developed transient pain. These participants showed higher average muscle activations in the abdominal muscles. Additionally, the non-pain group showed less lateral bend positional change in the mid-thoracic region compared to the upper- and lower-thoracic regions. Weak-to-moderate positive correlations were also found between rated pain and low back muscle activation.
The results provided further evidence of reduced movement in non-pain developers and altered muscle activation patterns in pain developers. Low-level, prolonged static contractions could lead to an increased risk of injury; and though the increased abdominal activity in the pain developers was not directly associated with increased rated pain scores, this could indicate a pre-disposition to, or enhancer of, transient pain development.
Motor pattern re-education is often used by clinicians as part of treatment regimens for chronic low back pain. Such programmes are often validated by the analysis of the electromyographical (EMG) signal from specific muscles. Independent muscles are often compared using the raw amplitude of the EMG signal or comparing the ratio of the amplitudes of two muscles. Statistical inferences from these derived data may depend on minimizing the sources of error when manipulating the EMG signal profile data. This is particularly true for amplitude normalization procedures, their reliability and the subsequent derivation of amplitude ratios. The purpose of the study was first to examine the reliability of five amplitude normalized procedures and second to examine the sensitivity of raw versus ratio amplitude comparisons during two different abdominal muscle exercises. The study demonstrated that maximal effort amplitude normalization techniques reduce the sensitivity of raw data comparisons, but had little influence on the sensitivity of the ratio data in differentiating the two movement patterns. It was concluded that using the EMG signal profile to identify pathological movement strategies, in association with regional pain syndromes, needs special attention to the reliability and validity of the derived variables.
Recruitment patterns of the superficial and deep abdominal muscles have been well documented in the general population, but not in a group of individuals with a chronic cough, such as individuals with cystic fibrosis (CF), which may alter the recruitment patterns between the abdominal muscles. Therefore the two objectives of this study were (1) to identify whether recruitment of the superficial and deep abdominal muscles during abdominal hollowing (AH) and unilateral leg load (ULL) tasks differed between individuals with CF and a non-CF control group (C); and (2) to compare the muscle activity between the superficial and deep abdominal muscles across these tasks. Methods: Twenty-eight participants (14 with CF and 14 controls) performed (i) AH in supine at three target pressures of a pressure biofeedback unit (PBU) and (ii) a right-sided ULL. Surface electromyography (EMG) of the abdominal muscles was recorded and the amplitude of the signal was normalized to a maximum value (% max). Results: A 3-way repeated measures ANOVA showed a muscle × task interaction during the AH, but no between group differences. Bonferonni post hoc tests on pooled data showed the deep abdominal muscles to be significantly more active than the superficial muscles. A 2-way repeated measure ANOVA indicated no group differences during the ULL. Discussion: The results of this study demonstrate that adults with stable CF do not recruit their abdominal muscles differently from healthy control subjects during the AH and the ULL tasks. This suggests that coughing is not a risk factor for developing abdominal muscles imbalances in adults with cystic fibrosis.
Previous studies analyzing neuromuscular independence of the abdominal wall have involved a participant population with no specific training in separating individual muscle segments. We chose to study nine women trained in the art of middle-eastern dance, anticipating they may have unique skills in motor control. Specifically, we were searching for evidence of separation of upper rectus abdominis (URA) from lower rectus abdominis (LRA), as well as understanding what role the oblique muscles play in abdominal wall synergies. EMG analysis was done on eight trunk muscles bilaterally as the dancers participated in 30 dance, planar, and curl-up activities. The filtered data were then cross-correlated to determine the time lag between pairs of signals. Only three dance movements demonstrated consistent evidence of an ability to separate URA/LRA activation timing. The external and internal oblique muscles tend to align themselves temporally with the LRA. However, these findings were only evident in these three specific "belly-roll" conditions, all with low levels of muscle activation, and no external torque. Evidence of significantly different activation levels (% MVC) between URA/LRA was demonstrated in eight conditions, all of which required various pelvis movements with minimal thorax motion.
Lumbo-pelvic stability relies, amongst other factors, on co-contraction of the lumbo-pelvic muscles. However, during submaximal trunk flexion and extension efforts, co-contraction of antagonist muscles is limited. It was predicted that activity of the deeper lumbo-pelvic muscles that are often excluded from analysis (transversus abdominis (TrA) and the deep fascicles of multifidus (DM)), would increase with load in each direction. In eleven healthy subjects, electromyographic activity (EMG) was recorded from eight trunk muscles using surface and fine-wire electrodes. Subjects performed isometric flexion and extension efforts to submaximal loads of 50, 100, 150 and 200 N and a maximal voluntary contraction (MVC). Loading tasks were then repeated in trials in which subjects knew that the load would release at an unpredictable time. Compared to the starting position, EMG of all muscles, except DM, increased during MVC efforts in both directions. During the flexion and extension submaximal tasks, there was no increased co-contraction of antagonist muscles. However, TrA EMG increased in both directions. In the unpredictable trials, EMG of all lumbo-pelvic muscles except TrA was decreased. These findings provide further support for a contribution of TrA to lumbo-pelvic stability. In submaximal tasks, TrA activation may enhance stability as a strategy to improve trunk stiffness without requiring a concurrent increase in activity of the larger torque producing trunk muscles.
Delayed onset of muscle activity in abdominal muscles has been related to low back pain. To investigate this in larger clinical trials it would be beneficial if non-invasive and less cumbersome alternatives to intramuscular electromyography (EMG) were available. This study was designed to compare onset of muscle activity recorded by intramuscular EMG to onset of muscle deformations by ultrasound imaging. Muscle deformations were recorded by two ultrasound imaging modes at high time resolution (m-mode and tissue velocity) in separate sessions and compared to simultaneously recorded intramuscular EMG in three abdominal muscles. Tissue velocity imaging was converted to strain rate which measures deformation velocity gradients within small regions, giving information about the rate of local tissue shortening or lengthening along the beam axis. Onsets in transversus abdominis (TrA), obliquus internus abdominis (OI) and obliquus externus abdominis (OE) were recorded during rapid arm flexions in ten healthy subjects. During ultrasound m-mode recordings, the results showed that mean onsets by EMG were detected 7 ms (95% CI of mean difference; +/-4 ms) and 2 ms (95% CI of mean difference; +/-6 ms) before concurrent ultrasound m-mode detected onsets in TrA and OI, respectively. In contrast, OE onset was recorded 54 ms (95% CI of bias; +/-16 ms) later by EMG compared to ultrasound m-mode. The discrepancy of ultrasound m-mode to accurately record onset in OE was practically corrected in the ultrasound-based strain rate recordings. However, this could only be applied on half of the subjects due to the angle dependency between the ultrasound beam and the direction of the contraction in strain rate recordings. The angle dependency needs to be further explored.
The transversus abdominus muscle (TrA) has been demonstrated to be active prior to rapid movements of the upper and lower limbs. This activity is termed feed forward motivation. The lack of feed-forward activation for TrA has been demonstrated in subjects with low back pain. The measures used for investigation of TrA function have been fine-wire needle EMG. This limits the practical application of TrA study due to the cost and level of specialisation required for this technique. The objective of the current study was to investigate the validity and reliability of using a surface EMG site to replicate the findings for the feed-forward activation of TrA prior to rapid limb movement. A population of healthy, young males (n = 20) were studied and it was found that four of the subjects did not meet feed-forward criteria. These results were shown to be highly reliable after a 2-week period for the TrA/IO site only. The validity of the signal was further investigated using several functional tasks to specifically target muscles of the abdominal region. Using a cross-correlation analysis to evaluate crosstalk from adjacent muscles, it was concluded that the signal representing TrA/IO accurately demonstrates the functional activity of the muscle. This study has demonstrated a viable surface EMG method to evaluate the feed-forward activation of TrA/IO prior to rapid limb movement. This may lead to opportunities for the clinical application of this method. It was also a finding of this study that four asymptomatic subjects did not pre-activate, therefore providing a rationale for future prospective investigations on whether the lack of TrA/IO feed-forward activation is a cause or an effect of low back pain.
In a biomechanical model we described that for stability of the flat sacroiliac joints (SIJ) muscle forces are required which press the sacrum between the two hip bones (self-bracing). Shear loading of these joints is caused by gravity and longitudinally oriented muscles. Protection against shearing can come from transversely oriented muscles like the internal oblique (OI) abdominal muscles. For validation we used standing postures with significantly more or less OI activity compared to activity in a standardized erect standing reference posture. OI activity decreased significantly when (a) resting on one leg (the contralateral), as can be observed at bus stops, (b) tilting the pelvic backward and (c) applying a pelvic belt. We explain this decrease of OI activity by, respectively, decrease of gravity load, decrease of load from the psoas major muscles, and a substitute of self-bracing. The outcome of this study is in line with the biomechanical model on SIJ stability. Clinical relevance of this study regards aspecific low back pain and is found in the effect of the use of a pelvic belt, of a trunk position as adopted when wearing a small rucksack and of the benefit of exercising trunk muscles in extension and torsion.
The objective of this study was the measure the onset time of the transverse abdominis (TA) muscle during rapid unilateral shoulder movements in individuals with chronic low back pain (LBP), and to evaluate the relationship between latency times and self-report measures of pain and disability.
Descriptive cross-sectional study.
Eighty individuals with chronic LBP of a non-specific origin (males n=44, females n=36).
Responses of the right and left surface TA/internal obliques were measured using surface electromyography (EMG) during rapid unilateral shoulder flexion, abduction, and extension. Pain intensity was measured using a visual analog scale (VAS), and disability with the Oswestry disability index (ODI).
Seventy-five percent of individuals were identified as lacking feedforward activation. A significant sidexdirection main effect was identified, with the ipsilateral latency more delayed in flexion and abduction (F(2316)=58.2, p<0.001). Individuals without feedforward activation had lower ODI scores (23.2+/-6.9% vs 31.0+/-9.2%, mean difference 7.8%, 95% CI 3.9 to 11.6%, p<0.001). Regression analysis found that 17% of the variance in VAS scores for the entire sample (n=80) were explained by the latency times measured. This relationship was stronger when the sample was separated into individuals who did (n=20), and did not (n=60) have feedforward activation.
Deep abdominal muscle onsets during rapid limb movement were significantly associated with self-rated pain scores. Seventy-five percent of individuals with chronic non-specific LBP exhibited delayed activation. No evidence has been provided in this study to support, or refute the use of specific localized deep abdominal contractions for exercise rehabilitation programs.
The assessment of abdominal muscles has became popular in recent years because the study of "core muscles" is now considered a pivotal approach for a number of fields. The purpose of this study was to describe the innervation zone (IZ) locations and optimal electrode sites in two core muscles: the obliquus externus (OE) and the obliquus internus (OI) abdominis muscles. Twenty healthy male subjects were recruited and the IZ location was studied during a submaximal isometric contraction using multichannel surface EMG. The optimal electrode position for OI was found to be 2cm lower the most prominent point of the anterior superior iliac spine, just medial and superior to the inguinal ligament. The optimal electrode position for OE was found to be 14cm from the median line, lower the level of 1cm above umbilicus, parallel to the line extending from the most inferior point of the costal margin to the opposite pubic tubercle (almost 45° with respect to the median line). Findings showed that for OI and OE muscles it is possible to provide indications for a muscle belly area suited for proper positioning of at least an electrode pair.
Studies have shown an increased muscle activation at the opposite passive side during unilateral contractions. The purpose of the present study was to examine the influence of pain on muscle activation in the passive shoulder during unilateral shoulder abduction. Ten patients with unilateral rotator tendinosis of the shoulder and nine healthy controls performed unilateral maximal voluntary contractions (MVC) and sustained submaximal contractions with and without subacromial injections of local anaesthetics of the afflicted shoulder. Muscle activation was recorded by electromyography (EMG) from the trapezius, deltoid, infraspinatus and supraspinatus muscles in both shoulders. During MVCs, the EMG amplitude from muscles of the passive afflicted side was not different in patients and controls, and was not influenced by pain alterations. In contrast, the EMG amplitude from the muscles of the passive unafflicted side was lower in the patients and increased after pain reduction. During the sustained submaximal contraction the EMG amplitude increased gradually in the passive shoulder to 15-30% of the EMG amplitude observed during MVC. This response was not influenced by differences in pain. We conclude that muscle activation of the passive shoulder was closely related to the activation of the contracting muscles and thus related to central motor drive, and not directly influenced by changes in pain.
This prospective study evaluated differences in vastus medialis (VM) and gluteus medius (GM) EMG amplitude:composite hip abductor (gluteus maximus, gluteus medius, tensor fascia lata) EMG amplitude ratios among subjects with low or high relative femoral anteversion. Data were collected during the performance of a non-weight bearing, non-sagittal plane maximal volitional effort isometric combined hip abduction-external rotation maneuver. Eighteen nonimpaired athletically active females participated in this surface EMG study. Medial hip rotation (relative femoral anteversion estimate) was measured with a handheld goniometer. Subjects were grouped by medial hip rotation displacement (group 1 < or = 42 degrees =36.1+/-7 degrees and group 2 > 42 degrees =52.7+/-7 degrees ) for statistical analysis (Mann Whitney U-tests, p < 0.05). Group 2 had decreased VM (42+/-23% vs. 69+/-30%, U=19, p=0.034) and GM (62+/-25% vs. 96+/-39%, U=19, p=0.034) normalized mean peak EMG amplitude:composite mean peak hip abductor EMG amplitude ratios compared to group 1. Decreased normalized VM (-27%) and GM (-34%) EMG amplitudes among subjects with increased relative femoral anteversion suggest reduced dynamic frontal and transverse plane femoral control from these muscles, possibly contributing to the increased incidence of non-contact knee injury observed among athletic females.
We investigated the effects of stance width on postural movement pattern and activation timing of postural muscles during unilateral arm abduction. Thirty-two healthy subjects abducted the right arm at their own timing. Stance width was 0, 9, 18 or 27 cm. Movement angles of leg lateral inclination and trunk lateral flexion to the leg in the frontal plane were analyzed. Based on movement angles at 0 cm width, subjects were classified into three groups: contralateral whole body leaning (CWBLg); ipsilateral trunk flexion (ITFg); and contralateral trunk flexion (CTFg). A high correlation between the movement angles was obtained at 0 cm width (r=0.82). With increasing stance width, postural movement pattern in the ITFg shifted to patterns characterized by lateral flexion of the trunk toward the side opposite to arm movement, and movement angle of leg-inclination in ITFg and CWBLg decreased. At 0 cm width, left gluteus medius and tensor fascia latae were activated significantly about 40 ms ahead of the right middle deltoid in CWBLg and CTFg, but not in ITFg. However, preceding activation became prominent (about 20 ms) in ITFg for wide stances. Moreover, bilateral activation of the tensor fascia latae was observed in CTFg for all widths.
This study was conducted to test whether glenohumeral geometry, as measured through MRI scans, is correlated with upper arm strength. The isometric shoulder strength of 12 subjects during one-handed arm abduction in the coronal plane, in a range from 5 degrees to 30 degrees , was correlated with the geometries of their glenoid fossas. Seven parameters describing the glenohumeral joint geometry in the coronal plane were identified as having expected influence on shoulder strength. In addition to these, a new geometric parameter, named the area of glenoid asymmetry (AGA), was considered to reflect the concavity-compression mechanism as well as the inclination of the glenoid surface. As a result of the high correlation between the AGA and mean force and mean moment (0.80, p0.01 and 0.69, p <or= 0.05, respectively) at the glenohumeral joint in a coronal plane, the AGA was distinguished as a factor having influence on shoulder strength when an arm was abducted in a range from 5 degrees to 30 degrees .
PURPOSE: It is commonly stated that supraspinatus initiates abduction; however, there is no direct evidence to support this claim. Therefore, the aims of the present study were to determine whether supraspinatus initiates shoulder abduction by activating prior to movement and significantly earlier than other shoulder muscles and to determine if load or plane of movement influenced the recruitment timing of supraspinatus. METHODS: Electromyographic recordings were taken from seven shoulder muscles of fourteen volunteers during shoulder abduction in the coronal and scapular planes and a plane 30° anterior to the scapular plane, at 25%, 50% and 75% of maximum load. Initial activation timing of a muscle was determined as the time at which the average activation (over a 25ms moving window) was greater than three standard deviations above baseline measures. RESULTS: All muscles tested were activated prior to movement onset. Subscapularis was activated significantly later than supraspinatus, infraspinatus, deltoid and upper trapezius, while supraspinatus, infraspinatus, upper trapezius, lower trapezius, serratus anterior and deltoid all had similar initial activation times. The effects of load or plane of movement were not significant. CONCLUSIONS: Supraspinatus is recruited prior to movement of the humerus into abduction but not earlier than many other shoulder muscles, including infraspinatus, deltoid and axioscapular muscles. The common statement that supraspinatus initiates abduction is therefore, misleading.