Comparing trapezius muscle activity in the different planes of shoulder elevation.

PubMed

Ishigaki, Tomonobu; Ishida, Tomoya; Samukawa, Mina; Saito, Hiroshi; Hirokawa, Motoki; Ezawa, Yuya; Sugawara, Makoto; Tohyama, Harukazu; Yamanaka, Masanori

2015-05-01

[Purpose] The purpose of this study was to compare the upper, middle, and lower trapezius muscles' activity in the different planes of shoulder elevation. [Subjects] Twenty male subjects volunteered for this study. [Methods] Surface electromyographic (EMG) activity for each of the three regions of the trapezius muscles in the three different planes of elevation were collected while the participants maintained 30, 60, and 90 degrees of elevation in each plane. The EMG data were normalized with maximum voluntary isometric contraction (%MVIC), and compared among the planes at each angle of elevation. [Results] There were significantly different muscle activities among the elevation planes at each angle. [Conclusion] This study found that the three regions of the trapezius muscles changed their activity depending on the planes of shoulder elevation. These changes in the trapezius muscles could induce appropriate scapular motion to face the glenoid cavity in the correct directions in different planes of shoulder elevation.

Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius.

PubMed

Marker, Ryan J; Campeau, Serge; Maluf, Katrina S

2017-01-01

Psychosocial stress has been shown to influence several aspects of human motor control associated with the fight-or-flight response, including augmentation of upper trapezius muscle activity. Given the established role of the reticular formation in arousal, this study investigated the contribution of reticulospinal activation to trapezius muscle activity during exposure to an acute psychosocial stressor. Twenty-five healthy adults were exposed to startling acoustic stimuli (SAS) while performing a motor task during periods of low and high psychosocial stress. Acoustic startle reflexes (ASRs) were recorded in the upper trapezius during low intensity contractions using both surface and intramuscular electromyography. Exposure to the stressor increased subjective and physiological measures of arousal (P < 0.01). The majority of participants demonstrated inhibitory ASRs, whereas a small subgroup with significantly higher trait anxiety (n = 5) demonstrated excitatory ASRs in the low stress condition. Changes in synaptic input for inhibitory ASRs were confirmed by decreases in the discharge rate of single motor units in response to the SAS. ASRs decreased in magnitude for all participants during exposure to the acute psychosocial stressor. These findings suggest that the reticular formation has predominately inhibitory effects on the human upper trapezius during an ongoing motor task and that disinhibition caused by psychosocial stress may contribute to augmentation of trapezius muscle activity. Further research is required to investigate mechanisms underlying the complex ASRs characterized by this study, particularly the phase reversal to excitatory responses observed among more anxious individuals. This study is the first to quantify stress-evoked changes in the acoustic startle reflex in the upper trapezius muscle of humans, and our findings reveal a complex pattern of inhibitory and facilitatory responses consistent with observations in nonhuman primates. We further demonstrate that psychosocial stress consistently reduces the amplitude of these responses. These findings have implications for the control of motor behaviors in response to stress. Copyright © 2017 the American Physiological Society.

Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius

PubMed Central

Marker, Ryan J.; Campeau, Serge

2016-01-01

Psychosocial stress has been shown to influence several aspects of human motor control associated with the fight-or-flight response, including augmentation of upper trapezius muscle activity. Given the established role of the reticular formation in arousal, this study investigated the contribution of reticulospinal activation to trapezius muscle activity during exposure to an acute psychosocial stressor. Twenty-five healthy adults were exposed to startling acoustic stimuli (SAS) while performing a motor task during periods of low and high psychosocial stress. Acoustic startle reflexes (ASRs) were recorded in the upper trapezius during low intensity contractions using both surface and intramuscular electromyography. Exposure to the stressor increased subjective and physiological measures of arousal (P < 0.01). The majority of participants demonstrated inhibitory ASRs, whereas a small subgroup with significantly higher trait anxiety (n = 5) demonstrated excitatory ASRs in the low stress condition. Changes in synaptic input for inhibitory ASRs were confirmed by decreases in the discharge rate of single motor units in response to the SAS. ASRs decreased in magnitude for all participants during exposure to the acute psychosocial stressor. These findings suggest that the reticular formation has predominately inhibitory effects on the human upper trapezius during an ongoing motor task and that disinhibition caused by psychosocial stress may contribute to augmentation of trapezius muscle activity. Further research is required to investigate mechanisms underlying the complex ASRs characterized by this study, particularly the phase reversal to excitatory responses observed among more anxious individuals. NEW & NOTEWORTHY This study is the first to quantify stress-evoked changes in the acoustic startle reflex in the upper trapezius muscle of humans, and our findings reveal a complex pattern of inhibitory and facilitatory responses consistent with observations in nonhuman primates. We further demonstrate that psychosocial stress consistently reduces the amplitude of these responses. These findings have implications for the control of motor behaviors in response to stress. PMID:27832595

Effect of lidocaine patches on upper trapezius EMG activity and pain intensity in patients with myofascial trigger points: A randomized clinical study.

PubMed

Firmani, Mónica; Miralles, Rodolfo; Casassus, Rodrigo

2015-04-01

To compare the effects of 5% lidocaine patches and placebo patches on pain intensity and electromyographic (EMG) activity of an active myofascial trigger point (MTrP) of the upper trapezius muscle. Thirty-six patients with a MTrP in the upper trapezius muscle were randomly divided into two groups: 20 patients received lidocaine patches (lidocaine group) and 16 patients received placebo patches (placebo group). They used the patches for 12 h each day, for 2 weeks. The patch was applied to the skin over the upper trapezius MTrP. Spontaneous pain, pressure pain thresholds, pain provoked by a 4-kg pressure applied to the MTrP and trapezius EMG activity were measured before and after treatment. Baseline spontaneous pain values were similar in both groups and significantly lower in the lidocaine group than the placebo group after treatment. The baseline pressure pain threshold was significantly lower in the lidocaine group, but after treatment it was significantly higher in this group. Baseline and final values of the pain provoked by a 4-kg pressure showed no significant difference between the groups. Baseline EMG activity at rest and during swallowing of saliva was significantly higher in the lidocaine group, but no significant difference was observed after treatment. Baseline EMG activity during maximum voluntary clenching was similar in both groups, but significantly higher in the lidocaine group after treatment. These clinical and EMG results support the use of 5% lidocaine patches for treating patients with MTrP of the upper trapezius muscle.

Comparing trapezius muscle activity in the different planes of shoulder elevation

PubMed Central

Ishigaki, Tomonobu; Ishida, Tomoya; Samukawa, Mina; Saito, Hiroshi; Hirokawa, Motoki; Ezawa, Yuya; Sugawara, Makoto; Tohyama, Harukazu; Yamanaka, Masanori

2015-01-01

[Purpose] The purpose of this study was to compare the upper, middle, and lower trapezius muscles’ activity in the different planes of shoulder elevation. [Subjects] Twenty male subjects volunteered for this study. [Methods] Surface electromyographic (EMG) activity for each of the three regions of the trapezius muscles in the three different planes of elevation were collected while the participants maintained 30, 60, and 90 degrees of elevation in each plane. The EMG data were normalized with maximum voluntary isometric contraction (%MVIC), and compared among the planes at each angle of elevation. [Results] There were significantly different muscle activities among the elevation planes at each angle. [Conclusion] This study found that the three regions of the trapezius muscles changed their activity depending on the planes of shoulder elevation. These changes in the trapezius muscles could induce appropriate scapular motion to face the glenoid cavity in the correct directions in different planes of shoulder elevation. PMID:26157248

Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

PubMed Central

Chen, Kai-Hua; Hsiao, Kuang-Yu; Lin, Chu-Hsu; Chang, Wen-Ming; Hsu, Hung-Chih; Hsieh, Wei-Chi

2013-01-01

Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs) of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40) and Yanglingquan (GB34) points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side) versus sham needling on the contralateral lower limb (control side) in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM) upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P = 0.03) in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P = 0.036). Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle. PMID:23710218

An analysis of the activity and muscle fatigue of the muscles around the neck under the three most frequent postures while using a smartphone.

PubMed

Choi, Jung-Hyun; Jung, Min-Ho; Yoo, Kyung-Tae

2016-05-01

[Purpose] The purpose of this study was to identify changes in the activity and fatigue of the splenius capitis and upper trapezius muscles, which are agonists to the muscles supporting the head, under the three postures most frequently adopted while using a smartphone. [Subjects and Methods] The subjects were 15 college students in their 20s. They formed a single group and had to adopt three different postures (maximum bending, middle bending, and neutral). While the 15 subjects maintained the postures, muscle activity and fatigue were measured using surface electromyography. [Results] Comparison of the muscle fatigue caused by each posture showed statistically significant differences for the right splenius capitis, left splenius capitis, and left upper trapezius muscles. In addition, maintaining the maximum bending posture while using a smartphone resulted in higher levels of fatigue in the right splenius capitis, left splenius capitis, and left upper trapezius muscles compared with those for the middle bending posture. [Conclusion] Therefore, this study suggests that individuals should bend their neck slightly when using a smartphone, rather than bending it too much, or keep their neck straight to reduce fatigue of the cervical erector muscles.

A case of adult-onset reducing body myopathy presenting a novel clinical feature, asymmetrical involvement of the sternocleidomastoid and trapezius muscles.

PubMed

Fujii, Takayuki; Hayashi, Shintaro; Kawamura, Nobutoshi; Higuchi, Masa-Aki; Tsugawa, Jun; Ohyagi, Yasumasa; Hayashi, Yukiko K; Nishino, Ichizo; Kira, Jun-Ichi

2014-08-15

We herein report a 32-year-old woman with adult-onset reducing body myopathy (RBM) who had a mutation in the four-and-a-half LIM domain 1 gene (FHL1) and showed a marked asymmetrical involvement of sternocleidomastoid and trapezius muscles. At 30 years of age she noticed bilateral foot drop, and over the next two years developed difficulty raising her right arm. At 32 years of age she was admitted to our hospital for a diagnostic evaluation. Neurological examination showed moderate weakness and atrophy of her right sternocleidomastoid muscle, right trapezius muscle, and bilateral upper proximal muscles. There were severe weakness and atrophy of her bilateral tibialis anterior muscles. Her deep tendon reflexes were hypoactive in her upper extremities. Her serum creatine kinase level was mildly increased. Muscle biopsy specimens from the left tibialis anterior muscle revealed marked variation in fiber size, some necrotic or regenerating fibers, and reducing bodies. Gene analysis of FHL1 demonstrated a mutation: a heterozygous missense mutation of c.377G>A (p. C126T) in FHL1. Compared with previous adult-onset RBM cases harboring mutations in FHL1, our case was characterized by asymmetrical atrophy of the sternocleidomastoid and trapezius muscles. Copyright © 2014 Elsevier B.V. All rights reserved.

Intra and inter-rater reliability of infrared image analysis of masticatory and upper trapezius muscles in women with and without temporomandibular disorder.

PubMed

Costa, Ana C S; Dibai Filho, Almir V; Packer, Amanda C; Rodrigues-Bigaton, Delaine

2013-01-01

Infrared thermography is an aid tool that can be used to evaluate several pathologies given its efficiency in analyzing the distribution of skin surface temperature. To propose two forms of infrared image analysis of the masticatory and upper trapezius muscles, and to determine the intra and inter-rater reliability of both forms of analysis. Infrared images of masticatory and upper trapezius muscles of 64 female volunteers with and without temporomandibular disorder (TMD) were collected. Two raters performed the infrared image analysis, which occurred in two ways: temperature measurement of the muscle length and in central portion of the muscle. The Intraclass Correlation Coefficient (ICC) was used to determine the intra and inter-rater reliability. The ICC showed excellent intra and inter-rater values for both measurements: temperature measurement of the muscle length (TMD group, intra-rater, ICC ranged from 0.996 to 0.999, inter-rater, ICC ranged from 0.992 to 0.999; control group, intra-rater, ICC ranged from 0.993 to 0.998, inter-rater, ICC ranged from 0.990 to 0.998), and temperature measurement of the central portion of the muscle (TMD group, intra-rater, ICC ranged from 0.981 to 0.998, inter-rater, ICC ranged from 0.971 to 0.998; control group, intra-rater, ICC ranged from 0.887 to 0.996, inter-rater, ICC ranged from 0.852 to 0.996). The results indicated that temperature measurements of the masticatory and upper trapezius muscles carried out by the analysis of the muscle length and central portion yielded excellent intra and inter-rater reliability.

Motor innervation of the trapezius muscle: Intraoperative motor conduction study during neck dissection.

PubMed

Kim, Jin Hwan; Choi, Kyu Young; Lee, Kyu Ho; Lee, Dong Jin; Park, Bum Jung; Rho, Young-Soo

2014-01-01

To evaluate the motor input from the spinal accessory nerve (SAN) and the branches of the cervical plexus in an intraoperative motor nerve conduction study measuring motor action potentials by direct stimulation of the exposed nerve during neck dissection. The entire length of the SAN and the contributions from the upper cervical plexus were preserved. Compound muscle action potentials were measured for each part of the trapezius muscle on stimulation of the SAN, C2, C3, and C4 nerves. With stimulation of the spinal nerve, evoked responses were obtained from all 24 patients in the descending, transverse, and ascending trapezius muscle. C2 contributions were noted in 2 out of 24 patients; however, no patient revealed responses in all three parts of the muscle. C3 contributions were seen in 11 out of 24 patients, supplying all three parts of the muscle in 8 patients, and C4 contributions were noted in 20 out of 24 patients, supplying all three parts of the muscle in 16 of them. The SAN provided the most consistent motor input to the trapezius muscle. The C2, C3, and C4 nerves also provided motor input to the trapezius muscle; however, they were either inconsistently present or, when present, irregularly innervated the three parts of the trapezius muscle.

An analysis of the activity and muscle fatigue of the muscles around the neck under the three most frequent postures while using a smartphone

PubMed Central

Choi, Jung-Hyun; Jung, Min-Ho; Yoo, Kyung-Tae

2016-01-01

[Purpose] The purpose of this study was to identify changes in the activity and fatigue of the splenius capitis and upper trapezius muscles, which are agonists to the muscles supporting the head, under the three postures most frequently adopted while using a smartphone. [Subjects and Methods] The subjects were 15 college students in their 20s. They formed a single group and had to adopt three different postures (maximum bending, middle bending, and neutral). While the 15 subjects maintained the postures, muscle activity and fatigue were measured using surface electromyography. [Results] Comparison of the muscle fatigue caused by each posture showed statistically significant differences for the right splenius capitis, left splenius capitis, and left upper trapezius muscles. In addition, maintaining the maximum bending posture while using a smartphone resulted in higher levels of fatigue in the right splenius capitis, left splenius capitis, and left upper trapezius muscles compared with those for the middle bending posture. [Conclusion] Therefore, this study suggests that individuals should bend their neck slightly when using a smartphone, rather than bending it too much, or keep their neck straight to reduce fatigue of the cervical erector muscles. PMID:27313393

Evaluation of the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain: study protocol for a randomized controlled trial.

PubMed

Calamita, Simone Aparecida Penimpedo; Biasotto-Gonzalez, Daniela Aparecida; De Melo, Nivea Cristina; dos Santos, Douglas Meira; de Lassa, Roberta; de Mendonça, Fabiana Sarilho; Oliveira, Claudia Santos; Amorim, César Ferreira; Gonzalez, Tabajara Oliveira; Fumagalli, Marco Antônio; de Gomes, Cid André Fidelis Paula; Politti, Fabiano

2015-03-19

Nonspecific neck pain can cause considerable suffering, possible disability and reductions in quality of life and productivity. The aim of the proposed study is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. A total of 12 patients with nonspecific neck pain and 12 healthy subjects will be enrolled in a randomized, single-blind crossover study. Each subject will receive two forms of treatment in random order: a single session of traditional acupuncture (acupoints: triple energizer 5, 'Wai-guan' and large intestine 11, 'Qu-chi') and sham acupuncture. To eliminate carry-over treatment effects, a one-week wash-out period will be respected between sessions. Surface electromyography will be used to determine motor control in the upper trapezius muscle before and after treatment. The outcome measures in the group with neck pain will be a numerical pain rating scale (range: 0 (no pain) to 10 (maximum pain)), documentation of the pain area on a body chart and cervical range of motion. Comparisons before and after acupuncture treatment will demonstrate whether acupoints affect the activity of the upper trapezius muscle, pain and cervical range of motion. The purpose of this randomized clinical trial is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. Data will be published after the study is completed. The study will support the practice of evidence-based physical therapy for individuals with nonspecific neck pain. This trial was registered with Clinicaltrials.gov (identifier: NCT0984021 ) on 7 November 2013 ( https://clinicaltrials.gov/ct2/show/NCT01984021 ).

The influence of Positional Release Therapy on the myofascial trigger points of the upper trapezius muscle in computer users.

PubMed

Mohammadi Kojidi, M; Okhovatian, F; Rahimi, A; Baghban, A A; Azimi, H

2016-10-01

The purpose of the present study was to investigate the effect of Positional Release Therapy (PRT) in computer users via latent trigger points (LTrPs) of the upper trapezius muscle. Twenty-eight women with the upper trapezius MTrPs participated in this study. Subjects were randomly classified into two groups (14 in each group): the subjects in the Group 1 received PRT in shortened position while those in the group 2 received sham control in the neutral position of the upper trapezius muscle. They received three therapy sessions every other day for one week. The local pain intensity and Pressure pain threshold (PPT) were measured via Visual Analogue Scale (VAS) and algometry, respectively, before interventions and repeated 5 min after the first and third treatment sessions in each group. One-way ANOVA was used for data analysis. After treatment, between groups comparison revealed that for PPT and VAS, there were significant differences between the two groups (VAS and PPT; P < 0.05). Both groups (PRT and sham control) showed alleviation of pain and increase in PPT during three sessions of therapy although PRT showed to be more effective in these patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Shoulder External Rotation Fatigue and Scapular Muscle Activation and Kinematics in Overhead Athletes

PubMed Central

Joshi, Mithun; Thigpen, Charles A.; Bunn, Kevin; Karas, Spero G.; Padua, Darin A.

2011-01-01

Context: Glenohumeral external rotation (GH ER) muscle fatigue might contribute to shoulder injuries in overhead athletes. Few researchers have examined the effect of such fatigue on scapular kinematics and muscle activation during a functional movement pattern. Objective: To examine the effects of GH ER muscle fatigue on upper trapezius, lower trapezius, serratus anterior, and infraspinatus muscle activation and to examine scapular kinematics during a diagonal movement task in overhead athletes. Setting: Human performance research laboratory. Design: Descriptive laboratory study. Patients or Other Participants: Our study included 25 overhead athletes (15 men, 10 women; age = 20 ± 2 years, height = 180 ± 11 cm, mass = 80 ± 11 kg) without a history of shoulder pain on the dominant side. Interventions: We tested the healthy, dominant shoulder through a diagonal movement task before and after a fatiguing exercise involving low-resistance, high-repetition, prone GH ER from 0° to 75° with the shoulder in 90° of abduction. Main Outcome Measure(s): Surface electromyography was used to measure muscle activity for the upper trapezius, lower trapezius, serratus anterior, and infraspinatus. An electromyographic motion analysis system was used to assess 3-dimensional scapular kinematics. Repeated-measures analyses of variance (phase × condition) were used to test for differences. Results: We found a decrease in ascending-phase and descending-phase lower trapezius activity (F1,25 = 5.098, P = .03) and an increase in descending-phase infraspinatus activity (F1,25 = 5.534, P = .03) after the fatigue protocol. We also found an increase in scapular upward rotation (F1,24 = 3.7, P = .04) postfatigue. Conclusions: The GH ER muscle fatigue protocol used in this study caused decreased lower trapezius and increased infraspinatus activation concurrent with increased scapular upward rotation range of motion during the functional task. This highlights the interdependence of scapular and glenohumeral force couples. Fatigue-induced alterations in the lower trapezius might predispose the infraspinatus to injury through chronically increased activation. PMID:21944066

Lidocaine Injection in the Intramuscular Innervation Zone Can Effectively Treat Chronic Neck Pain Caused by MTrPs in the Trapezius Muscle.

PubMed

Xie, Peng; Qin, Bangyong; Yang, Fangjiu; Yu, Tian; Yu, Jin; Wang, Jiang; Zheng, Hong

2015-01-01

An increasing number of people suffer from neck pain due to life style and prolonged use of computers. Research has revealed that myofascial trigger points (MTrPs) and the intramuscular innervation zone (IZ) are involved in neck pain. MTrPs are induced mainly by IZ dysfunction of the affected skeletal muscle and the 2 do not overlap in location. The question is whether injection treatment in MTrPs or in the IZ is more effective to relieve MTrPs-associated pains. The precise location and body-surface map of the intramuscular IZ in the trapezius muscle and a clinical injection study in the IZ may provide a useful answer to the question. This study aimed to investigate the efficacy of lidocaine injection in the intramuscular IZ for the treatment of chronic neck pain caused by MTrPs in the trapezius muscle. Prospective observational study, approved by the local research ethics. University hospital, departments of Anesthesiology and Anatomy. First, for the determination of IZ distribution and body-surface mapping, a modified intramuscular Sihler's neural staining technique was applied to elucidate nerve distribution patterns of the trapezius muscle. Then, 120 patients with myofascial pain syndrome (MPS) of the trapezius muscle were randomly divided into 5 groups for analysis. Group 1 (n = 24) received injections of saline (0.9% NaCl) at the MTrPs. Group 2 (n = 24) received injections of 0.5% lidocaine at the MTrPs. Group 3 (n = 24) received injections of saline (0.9% NaCl) at the mid-upper trapezius (Point E). Group 4 (n = 24) received injections of 0.5% lidocaine at Point E. Group 5 (n = 24) received a combined injection of 0.5% lidocaine treatment at both Point E and the lower trapezius (Point F). The injection dose was 4 mL at each injection site. All patients received injections once a week for 4 weeks. The visual analogue scale (VAS) and the frequency of painful days per month (FPD) were obtained before treatment and at 2, 4, and 6 months after treatment. The intramuscular terminal nerve branches presented a "dendritic" distribution in the trapezius muscle and were connected with each other to form an S-shaped IZ belt in the middle of the muscle belly. Compared with the MTrP injection group, lidocaine-injection therapy in the IZ significantly reduced the degree and frequency of neck pain in patients at 6 months after treatment, especially the combined lidocaine-injection therapy in the IZ of both the mid-upper trapezius and the lower trapezius are more effective (all P < 0.05). This study confirms that lidocaine-injection therapy in the IZ significantly reduces the degree and frequency of neck pain in patients at 6 months after treatment. The combined lidocaine-injection therapy in the IZ of both the mid-upper trapezius and the lower trapezius is more effective. In addition, this study establishes a clear distribution map of intramuscular nerves that will be conducive to the future use of chemical blockers and electrical stimulation in the nervous system in treating MPS of the trapezius muscle. The small number of patients and the short duration of follow-up.

The immediate effects of manual stretching and cervicothoracic junction manipulation on cervical range of motion and upper trapezius pressure pain thresholds.

PubMed

Hanney, William J; Puentedura, Emilio J; Kolber, Morey J; Liu, Xinliang; Pabian, Patrick S; Cheatham, Scott W

2017-09-22

Myofascial pain is a common impairment treated with various manual interventions including spinal thrust manipulation and stretching; however, the comparative efficacy of each intervention is uncertain. Therefore, the purpose of this investigation was to evaluate thrust manipulation targeting the cervicothoracic junction compared to a manual stretch of the upper trapezius muscle on cervical range of motion and upper trapezius pressure pain thresholds (PPTs). Healthy participants with no significant history of neck pain were randomized into a thrust manipulation group, a stretching group, or a control group. Within group differences were evaluated via a dependent t-test, and group by time interactions were evaluated by a two-way repeated measures ANOVA. One hundred and two participants were recruited to participate. Baseline demographics revealed no significant differences between groups. Significant group by time interactions were found for changes in PPTs for both the right and left upper trapezius. Also, significant differences were found for changes in cervical extension, as well as right and left cervical side bending favoring the treatment groups. This study demonstrates the potential independent effectiveness of spinal thrust manipulation or stretching for reducing PPTs at the upper trapezius. Future research should further evaluate the limitation of PPTs as a measure of muscle sensitivity as well as factors that may contribute to variability in the measurements among individuals seeking care.

Electromyographic analysis of the serratus anterior and trapezius muscles during push-ups on stable and unstable bases in subjects with scapular dyskinesis.

PubMed

Pirauá, André Luiz Torres; Pitangui, Ana Carolina Rodarti; Silva, Juliana Pereira; Pereira dos Passos, Muana Hiandra; Alves de Oliveira, Valéria Mayaly; Batista, Laísla da Silva Paixão; Cappato de Araújo, Rodrigo

2014-10-01

The present study was performed to assess the electromyographic activity of the scapular muscles during push-ups on a stable and unstable surface, in subjects with scapular dyskinesis. Muscle activation (upper trapezius [UT]; lower trapezius [LT]; upper serratus anterior [SA_5th]; lower serratus anterior [SA_7th]) and ratios (UT/LT; UT/SA_5th; UT/ SA_7th) levels were determined by surface EMG in 30 asymptomatic men with scapular dyskinesis, during push-up performed on a stable and unstable surface. Multivariate analysis of variance with repeated measures was used for statistical analyses. The unstable surface caused a decrease in the EMG activity of the serratus anterior and an increase in EMG activity of the trapezius (p=0.001). UT/SA_5th and UT/ SA_7th ratios were higher during unstable push-ups (p=0.001). The results suggest that, in individuals with scapular dyskinesis, there is increased EMG activity of the trapezius and decreased EMG activity of the serratus anterior in response to an unstable surface. These results suggest that the performance of the push up exercise on an unstable surface may be more favorable to produce higher levels of trapezius activation and lower levels of serratus anterior activation. However, if the goal of the exercise program is the strengthening of the SA muscle, it is suggested to perform the push up on a stable surface. Copyright © 2014 Elsevier Ltd. All rights reserved.

A SYSTEMATIC REVIEW OF THE EXERCISES THAT PRODUCE OPTIMAL MUSCLE RATIOS OF THE SCAPULAR STABILIZERS IN NORMAL SHOULDERS

PubMed Central

Schory, Abbey; Bidinger, Erik; Wolf, Joshua

2016-01-01

ABSTRACT Purpose The purpose of this systematic review was to determine the exercises that optimize muscle ratios of the periscapular musculature for scapular stability and isolated strengthening. Methods A systematic search was performed in PubMed, CINAHL, SPORTDiscus, Scopus, and Discovery Layer. Studies were included if they examined the muscle activation of the upper trapezius compared to the middle trapezius, lower trapezius, or serratus anterior using EMG during open chain exercises. The participants were required to have healthy, nonpathological shoulders. Information obtained included maximal voluntary isometric contraction (MVIC) values, ratios, standard deviations, exercises, and exercise descriptions. The outcome of interest was determining exercises that create optimal muscle activation ratios between the scapular stabilizers. Results Fifteen observational studies met the inclusion criteria for the systematic review. Exercises with optimal ratios were eccentric exercises in the frontal and sagittal planes, especially flexion between 180 ° and 60 °. External rotation exercises with the elbow flexed to 90 ° also had optimal ratios for activating the middle trapezius in prone and side-lying positions. Exercises with optimal ratios for the lower trapezius were prone flexion, high scapular retraction, and prone external rotation with the shoulder abducted to 90 ° and elbow flexed. Exercises with optimal ratios for the serratus anterior were the diagonal exercises and scapular protraction. Conclusion This review has identified optimal positions and exercises for periscapular stability exercises. Standing exercises tend to activate the upper trapezius at a higher ratio, especially during the 60-120 ° range. The upper trapezius was the least active, while performing exercises in prone, side-lying, and supine positions. More studies need to be conducted to examine these exercises in greater detail and confirm their consistency in producing the optimal ratios determined in this review. Level of evidence 1a PMID:27274418

Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

PubMed Central

Dibai-Filho, Almir V.; Guirro, Elaine C. O.; Ferreira, Vânia T. K.; Brandino, Hugo E.; Vaz, Maíta M. O. L. L.; Guirro, Rinaldo R. J.

2015-01-01

BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC2,1) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices. PMID:25993626

The Location of Peak Upper Trapezius Muscle Activity During Submaximal Contractions is not Associated With the Location of Myofascial Trigger Points: New Insights Revealed by High-density Surface EMG.

PubMed

Barbero, Marco; Falla, Deborah; Mafodda, Luca; Cescon, Corrado; Gatti, Roberto

2016-12-01

To apply topographical mapping of the electromyography (EMG) amplitude recorded from the upper trapezius muscle to evaluate the distribution of activity and the location of peak activity during a shoulder elevation task in participants with and without myofascial pain and myofascial trigger points (MTrP) and compare this location with the site of the MTrP. Thirteen participants with myofascial pain and MTrP in the upper trapezius muscle and 12 asymptomatic individuals participated. High-density surface EMG was recorded from the upper trapezius muscle using a matrix of 64 surface electrodes aligned with an anatomic landmark system (ALS). Each participant performed a shoulder elevation task consisting of a series of 30 s ramped contractions to 15% or 60% of their maximal voluntary contraction (MVC) force. Topographical maps of the EMG average rectified value were computed and the peak EMG amplitude during the ramped contractions was identified and its location determined with respect to the ALS. The location of the MTrP was also determined relative to the ALS and Spearman correlation coefficients were used to examine the relationship between MTrP and peak EMG amplitude location. The location of the peak EMG amplitude was significantly (P<0.05) different between groups (participants with pain/MTrP: -0.32±1.2 cm at 15% MVC and -0.35±0.9 cm at 60% MVC relative to the ALS; asymptomatic participants: 1.0±1.3 cm at 15% MVC and 1.3±1.1 cm relative to the ALS). However, no correlation was observed between the position of the MTrP and peak EMG amplitude during the ramped contractions at either force level (15%: rs=0.039, P=0.9; 60%: rs=-0.087, P=0.778). People with myofascial pain and MTrP displayed a caudal shift of the distribution of upper trapezius muscle activity compared with asymptomatic individuals during a submaximal shoulder elevation task. For the first time, we show that the location of peak muscle activity is not associated with the location of the MTrP.

Cervical outlet syndrome due to an accessory part of the trapezius muscle in the posterior triangle of the neck.

PubMed

Hug, U; Burg, D; Meyer, V E

2000-06-01

A 48-year-old man presented with pain and sensory impairment radiating from the neck to the thumb and forefinger of the right hand when lifting weights and turning or tilting the head. The symptoms were due to an anomalous accessory part of the trapezius muscle crossing the upper part of the brachial plexus. Excision of the anomalous muscle and release of the clavicular part of the sternocleidomastoid muscle abolished the complaints.

Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue.

PubMed

Umehara, Jun; Kusano, Ken; Nakamura, Masatoshi; Morishita, Katsuyuki; Nishishita, Satoru; Tanaka, Hiroki; Shimizu, Itsuroh; Ichihashi, Noriaki

2018-02-23

Although the serratus anterior muscle has an important role in scapular movement, no study to date has investigated the effect of serratus anterior fatigue on scapular kinematics and shoulder muscle activity. The purpose of this study was to clarify the effect of serratus anterior fatigue on scapular movement and shoulder muscle activity. The study participants were 16 healthy men. Electrical muscle stimulation was used to fatigue the serratus anterior muscle. Shoulder muscle strength and endurance, scapular movement, and muscle activity were measured before and after the fatigue task. The muscle activity of the serratus anterior, upper and lower trapezius, anterior and middle deltoid, and infraspinatus muscles was recorded, and the median power frequency of these muscles was calculated to examine the degree of muscle fatigue. The muscle endurance and median power frequency of the serratus anterior muscle decreased after the fatigue tasks, whereas the muscle activities of the serratus anterior, upper trapezius, and infraspinatus muscles increased. External rotation of the scapula at the shoulder elevated position increased after the fatigue task. Selective serratus anterior fatigue due to electric muscle stimulation decreased the serratus anterior endurance at the flexed shoulder position. Furthermore, the muscle activities of the serratus anterior, upper trapezius, and infraspinatus increased and the scapular external rotation was greater after serratus anterior fatigue. These results suggest that the rotator cuff and scapular muscle compensated to avoid the increase in internal rotation of the scapula caused by the dysfunction of the serratus anterior muscle. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Electromyogram and perceived fatigue changes in the trapezius muscle during typewriting and recovery.

PubMed

Kimura, Mitsutoshi; Sato, Hirotaka; Ochi, Mamoru; Hosoya, Satoshi; Sadoyama, Tsugutake

2007-05-01

The purpose of the present study was to investigate the development and recovery of muscle fatigue in the upper trapezius muscle by analyzing electromyographic signals. Six male subjects performed a simulated typewriting task for four 25-min sessions. During fatigue and the following rest periods, subjective fatigue and surface electromyography (EMG) from the trapezius muscle during isometric contraction at 30% maximum voluntary contraction (MVC) were periodically measured in the interval. We detected a significant decrease in muscle fiber conduction velocity (MFCV) (P = 0.008) and median frequency (MDF) (P = 0.026) as well as an increase in root mean square (RMS) (P = 0.039) and subjective fatigue (P = 0.0004) during the fatigue period. During the recovery period, subjective fatigue decreased drastically and significantly (P = 0.0004), however, the EMG parameters did not recover completely. Thus, physiological muscle fatigue in the trapezius developed in accordance with subjective muscle fatigue during typewriting. On the other hand, differences between the physiological and subjective parameters were found during recovery. Further studies should be necessary to reveal the discrepancy could be a major factor of a transition from temporal phenomena to serious chronic muscle fatigue and to identify the necessity of some guidelines to prevent VDT work-related chronic muscle fatigue in the trapezius.

Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.

PubMed

Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue

2016-04-27

Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.

Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings.

PubMed

Marker, Ryan J; Maluf, Katrina S

2014-12-01

Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

PubMed

Ciuffolo, Fabio; Ferritto, Anna L; Muratore, Filippo; Tecco, Simona; Testa, Mauro; D'Attilio, Michele; Festa, Felice

2006-01-01

This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p < 0.05). Within-test group analysis showed a significant increase of the right upper trapezius activity (p < 0.05), whereas no changes were found by within-control group analysis. Lower risk of asymmetric muscle patterns and postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

PubMed

Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

2015-09-01

This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Changes in cervical range of motion, flexion-relaxation ratio and pain with visual display terminal work.

PubMed

Shin, Seung-Je; Yoo, Won-Gyu

2014-01-01

The static posture in visual display terminal (VDT) workers results in increased forward neck flexion and increased static muscle tension in the neck and shoulder regions. However, few studies have objectively quantified the change in head posture induced shoulder pain during VDT work. This study elucidated changes in pressure pain in the upper trapezius muscles, cervical ROM, and the cervical flexion--relaxation ratio after continuous long-term VDT work. Twelve young VDT workers were recruited. The pressure pain of the upper trapezius muscles, active CROM, and cervical flexion--relaxation ratio were measured in all subjects once before and once after VDT work. The pressure pain threshold of the right upper trapezius muscle was 6.9 ± 1.6 lb before VDT work and 6.1 ± 1.0 lb after VDT work, revealing a significant increase with VDT work. The cervical extension, left and right lateral flexion, and left rotation measurers decreased significantly with VDT work. We postulate that even short-term VDT work has the potential to cause problems. It is necessary to develop a CROM self-measuring device and to monitor patients' musculoskeletal changes frequently.

Effects of wearing rubber gloves on activities of the forearm and shoulder muscles during different dishwashing stages

PubMed Central

Yoo, Won-Gyu

2015-01-01

[Purpose] The present study examined the effects of wearing rubber gloves on the activities of the forearm and shoulder muscles during two dishwashing stages. [Subjects] This study included 10 young females. [Methods] The participants performed two dishwashing stages (washing and rinsing) with and without rubber gloves. The activities of the wrist flexor and upper trapezius muscles were measured using wireless electromyography. [Results] During the washing stage, the activities of the wrist flexor and upper trapezius muscles were significantly greater without gloves than with gloves when performing the same tasks. However, during the rinsing stage, the activities of these muscles did not differ significantly according to the use of gloves. [Conclusion] Dishwashers should wear gloves during the washing stage to prevent wrist and shoulder pain. PMID:26311980

Sensorimotor control and neuromuscular activity of the shoulder in adolescent competitive swimmers with generalized joint hypermobility.

PubMed

Frydendal, Thomas; Eshøj, Henrik; Liaghat, Behnam; Edouard, Pascal; Søgaard, Karen; Juul-Kristensen, Birgit

2018-05-05

Shoulder pain is highly prevalent in competitive swimmers, and generalized joint hypermobility (GJH) is considered a risk factor. Sensorimotor control deficiencies and altered neuromuscular activation of the shoulder may represent underlying factors. To investigate whether competitive swimmers with GJH including shoulder hypermobility (GJHS) differ in shoulder sensorimotor control and muscle activity from those without GJH and no shoulder hypermobility (NGJH). Competitive swimmers (aged 13-17) were recruited. GJHS or NGJH status was determined using the Beighton score (0-9) and Rotès-Quérol test (positive/negative). Inclusion criteria for GJHS were a Beighton score ≥5 and minimum one hypermobile shoulder, while NGJH was defined as a Beighton score ≤3 and no shoulder hypermobility. Three prone lying, upper-extremity weight-bearing shoulder stabilometric tests were performed on a force platform: Bilateral upper-extremity support eyes open (BL-EO) and eyes closed (BL-EC) and unilateral upper-extremity support eyes open (UL-EO). Surface electromyography (SEMG) was measured from the upper trapezius, lower trapezius, serratus anterior, infraspinatus and pectoralis major muscles. SEMG was normalized using maximal voluntary isometric contractions and presented relative to maximal voluntary SEMG (%MVE). Co-contraction index (CCI) was calculated for the following muscle pairs: upper trapezius-lower trapezius, upper trapezius-serratus anterior, and infraspinatus-pectoralis major. Between-group differences in stabilometric parameters, %MVE, and CCI were analyzed with a mixed effects model. Thirty-eight swimmers were enrolled as GJHS (n = 19) or NGJH (n = 19). There were no group differences in stabilometric parameters or CCI. GJHS displayed significantly decreased (29%) pectoralis major activity during BL-EO compared to NGJH (5.35 ± 1.77%MVE vs. 7.51 ± 1.96%MVE; p = 0.043). Adolescent competitive swimmers with GJHS displayed no shoulder sensorimotor control deficiencies and no generally altered shoulder muscle activity pattern, except for decreased pectoralis major activity in BL-EO. Longitudinal studies are needed to investigate whether decreased pectoralis major activation contributes to the development of shoulder pain in swimmers with GJHS. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of concurrent physical and cognitive demands on muscle activity and heart rate variability in a repetitive upper-extremity precision task.

PubMed

Srinivasan, Divya; Mathiassen, Svend Erik; Hallman, David M; Samani, Afshin; Madeleine, Pascal; Lyskov, Eugene

2016-01-01

Most previous studies of concurrent physical and cognitive demands have addressed tasks of limited relevance to occupational work, and with dissociated physical and cognitive task components. This study investigated effects on muscle activity and heart rate variability of executing a repetitive occupational task with an added cognitive demand integral to correct task performance. Thirty-five healthy females performed 7.5 min of standardized repetitive pipetting work in a baseline condition and a concurrent cognitive condition involving a complex instruction for correct performance. Average levels and variabilities of electromyographic activities in the upper trapezius and extensor carpi radialis (ECR) muscles were compared between these two conditions. Heart rate and heart rate variability were also assessed to measure autonomic nervous system activation. Subjects also rated perceived fatigue in the neck-shoulder region, as well as exertion. Concurrent cognitive demands increased trapezius muscle activity from 8.2% of maximum voluntary exertion (MVE) in baseline to 9.0% MVE (p = 0.0005), but did not significantly affect ECR muscle activity, heart rate, heart rate variability, perceived fatigue or exertion. Trapezius muscle activity increased by about 10%, without any accompanying cardiovascular response to indicate increased sympathetic activation. We suggest this slight increase in trapezius muscle activity to be due to changed muscle activation patterns within or among shoulder muscles. The results suggest that it may be possible to introduce modest cognitive demands necessary for correct performance in repetitive precision work without any major physiological effects, at least in the short term.

A study of surgeons' postural muscle activity during open, laparoscopic, and endovascular surgery.

PubMed

Szeto, G P Y; Ho, P; Ting, A C W; Poon, J T C; Tsang, R C C; Cheng, S W K

2010-07-01

Different surgical procedures impose different physical demands on surgeons and high prevalence rates of neck and shoulder pain have been reported among general surgeons. Past research has examined electromyography in surgeons mainly during simulated conditions of laparoscopic and open surgery but not during real-time operations and not for long durations. The present study compares the neck-shoulder muscle activities in three types of surgery and between different surgeons. The relationships of postural muscle activities to musculoskeletal symptoms and personal factors also are examined. Twenty-five surgeons participated in the study (23 men). Surface electromyography (EMG) was recorded in the bilateral cervical erector spinae, upper trapezius, and anterior deltoid muscles during three types of surgical procedures: open, laparoscopic, and endovascular. In each procedure, EMG data were captured for 30 min to more than 1 h. The surgeons were asked to rate any musculoskeletal symptoms before and after surgery. The present study showed significantly higher muscle activities in the cervical erector spinae and upper trapezius muscles in open surgery compared with endovascular and laparoscopic procedures. Muscle activities were fairly similar between endovascular and laparoscopic surgery. The upper trapezius usually has an important role in stabilizing both the neck and upper limb posture, and this muscle also recorded higher activities in open compared with laparoscopic and endovascular surgeries. Surgeons reported similar degrees of musculoskeletal symptoms in open and laparoscopic surgeries, which were higher than endovascular surgery. The present study showed that open surgery imposed significantly greater physical demands on the neck muscles compared with endovascular and laparoscopic surgeries. This may be due to the lighter manual task demands of these minimally invasive surgeries compared with open procedures, which generally required more dynamic movements and more forceful exertions.

The effects of Nordic Walking training on selected upper-body muscle groups in female-office workers: A randomized trial.

PubMed

Kocur, Piotr; Pospieszna, Barbara; Choszczewski, Daniel; Michalowski, Lukasz; Wiernicka, Marzena; Lewandowski, Jacek

2017-01-01

Regular Nordic Walking training could improve fitness and reduce tenderness in selected muscle groups in office workers. An assessment of the effects of a 12-week Nordic Walking training program on the perceived pain threshold (PPT) and the flexibility of selected upper-body muscle groups in postmenopausal female office workers. 39 office workers were selected at random for the treatment group (NWg, n = 20) and the control group (Cg, n = 19). The persons from the NW group completed a 12-week Nordic Walking training program (3 times a week/1 hour). PPTs measurements in selected muscles and functional tests evaluating upper-body flexibility (Back Scratch - BS) were carried out twice in every participant of the study: before and after the training program. A significant increase in PPT (kg/cm2) was observed in the following muscles in the NW group only: upper trapezius (from 1,32 kg/cm2 to 1,99 kg/cm2), mid trapezius (from 2,92 kg/cm2 to 3,30 kg/cm2), latissimus dorsi (from 1,66 kg/cm2 to 2,21 kg/cm2) and infraspinatus (from 1,63 kg/cm2 to 2,93 kg/cm2). Moreover, a significant improvement in the BS test was noted in the NW group compared with the control group (from -1,16±5,7 cm to 2,18±5,1 cm in the NW group vs from -2,52±6,1 to -2,92±6,2 in the control group). A 12-week Nordic Walking training routine improves shoulder mobility and reduces tenderness in the following muscles: trapezius pars descendens and middle trapezius, infraspinatus and latissimus dorsi, in female office workers.

Effect of backpack shoulder straps length on cervical posture and upper trapezius pressure pain threshold

PubMed Central

Abdelraouf, Osama Ragaa; Hamada, Hamada Ahmed; Selim, Ali; Shendy, Wael; Zakaria, Hoda

2016-01-01

[Purpose] This study was performed to investigate the effect of the length of backpack shoulder straps on upper trapezius muscle pain threshold and craniovertebral angle. [Subjects and Methods] There were 25 participants, with ages from 15 to 23 years old. Upper trapezius pain threshold and craniovertebral angle were measured for all subjects without the backpack then re-measured after walking on a treadmill for 15 min under 2 conditions: 1) wearing a backpack with short straps; and 2) wearing a backpack with long straps. [Results] there was a significant reduction in upper trapezius pain threshold and craniovertebral angle while carrying a backpack with long shoulder straps, compared to use of a backpack with short shoulder straps or no backpack. [Conclusion] A backpack with short straps is less harmful than a backpack with long straps. This result should be considered in ergonomic design of backpacks to reduce the incidence of various physiological and biomechanical disorders. PMID:27799665

Isometric muscle activation of the serratus anterior and trapezius muscles varies by arm position: a pilot study with healthy volunteers with implications for rehabilitation.

PubMed

Miyasaka, Junsuke; Arai, Ryuzo; Ito, Taisuke; Shingu, Nobuyuki; Hasegawa, Satoshi; Ibuki, Satoko; Ichihashi, Noriaki; Matsuda, Shuichi; Moritani, Toshio

2017-07-01

This study aimed to determine the most appropriate angle and moving direction of the arm for improving coordination of the periscapular muscles, including the serratus anterior (SA), upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT). Muscle activation amplitudes were evaluated in the SA, UT, MT, and LT in 11 healthy subjects by use of surface electromyography. The subjects were asked to maintain the arm position at 5 elevated positions with maximal effort against applied manual forces, which were directed from upper to lower (test 1), lower to upper (test 2), posterior to anterior in the frontal plane and lateral to medial in the sagittal plane (test 3), and anterior to posterior in the frontal plane and medial to lateral in the sagittal plane (test 4). The relative activity of the UT with respect to the SA, MT, and LT was calculated, resulting in the UT/SA, UT/MT, and UT/LT ratios. Test 4 in all positions but 150° of elevation in the frontal plane showed high activity of the SA with a low UT/SA ratio. High MT activity with a low UT/MT ratio was observed during test 3 at the 90° elevated position, whereas high LT activity without UT hyperactivation was not found. To strengthen the periscapular muscles in the balanced condition, horizontal adduction is recommended for the SA. Horizontal abduction at the 90° elevated position should be effective for the MT. Because no technique in this study was effective for the LT, further studies are needed. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects.

PubMed

Ruiz-Sáez, Mariana; Fernández-de-las-Peñas, César; Blanco, Cleofás Rodríguez; Martínez-Segura, Raquel; García-León, Rafael

2007-10-01

This study analyzed the immediate effects on pressure pain threshold (PPT) in latent myofascial trigger points (MTrPs) in the upper trapezius muscle of a single cervical spine manipulation directed at the C3 through C4 level. Seventy-two volunteers (27 men and 46 women; mean age, 31 years; SD, 10 years) participated in this study. Subjects underwent a screening process to establish both the presence of MTrPs in the upper trapezius muscle as described by Simons et al (Myofascial pain and dysfunction: the trigger point manual, vol 2. 3rd ed. Baltimore: Williams & Wilkins, 1999. p. 23-34) and the presence of intervertebral joint dysfunction at the C3 through C4 level by the lateral gliding test for the cervical spine. Subjects were divided randomly into 2 groups: manipulative group, which received a cervical spine manipulation directed at the C3 through C4 level, and a placebo group, which received a sham manual procedure. The outcome measure was the PPT on the MTrP in the upper trapezius muscle ipsilateral to the side of the joint dysfunction, which was assessed pretreatment and 1, 5, and 10 minutes posttreatment by an assessor blinded to the treatment allocation of the subject. The analysis of variance showed a significant effect for time (F = 5.157; P = .02) but not for side (F = 0.234; P = .63). Furthermore, an interaction between group and time was also found (F = 37.240; P < .001). The experimental group showed a trend toward an increase in PPT levels after the manipulative procedure, whereas the control group showed a trend toward a decrease in PPT. Positive within-group effect sizes ranging from medium to small were found in the manipulative group (0.1

Variability in spatio-temporal pattern of trapezius activity and coordination of hand-arm muscles during a sustained repetitive dynamic task.

PubMed

Samani, Afshin; Srinivasan, Divya; Mathiassen, Svend Erik; Madeleine, Pascal

2017-02-01

The spatio-temporal distribution of muscle activity has been suggested to be a determinant of fatigue development. Pursuing this hypothesis, we investigated the pattern of muscular activity in the shoulder and arm during a repetitive dynamic task performed until participants' rating of perceived exertion reached 8 on Borg's CR-10 scale. We collected high-density surface electromyogram (HD-EMG) over the upper trapezius, as well as bipolar EMG from biceps brachii, triceps brachii, deltoideus anterior, serratus anterior, upper and lower trapezius from 21 healthy women. Root-mean-square (RMS) and mean power frequency (MNF) were calculated for all EMG signals. The barycenter of RMS values over the HD-EMG grid was also determined, as well as normalized mutual information (NMI) for each pair of muscles. Cycle-to-cycle variability of these metrics was also assessed. With time, EMG RMS increased for most of the muscles, and MNF decreased. Trapezius activity became higher on the lateral side than on the medial side of the HD-EMG grid and the barycenter moved in a lateral direction. NMI between muscle pairs increased with time while its variability decreased. The variability of the metrics during the initial 10 % of task performance was not associated with the time to task termination. Our results suggest that the considerable variability in force and posture contained in the dynamic task per se masks any possible effects of differences between subjects in initial motor variability on the rate of fatigue development.

The effect of work-related sustained trapezius muscle activity on the development of neck and shoulder pain among young adults.

PubMed

Hanvold, Therese N; Wærsted, Morten; Mengshoel, Anne Marit; Bjertness, Espen; Stigum, Hein; Twisk, Jos; Veiersted, Kaj Bo

2013-07-01

This study aimed to evaluate if sustained trapezius muscle activity predicts neck and shoulder pain over a 2.5-year period. Forty young adults (15 hairdressers, 14 electricians, 5 students and 6 with various work) were followed during their first years of working life. Self-reported neck and shoulder pain during the last four weeks was assessed seven times over the observational period. Upper-trapezius muscle activity was measured during a full working day by bilateral surface electromyography (EMG) at baseline (winter 2006/7). Sustained trapezius muscle activity was defined as continuous muscle activity with amplitude >0.5% EMGmax lasting >4 minutes. The relative time of sustained muscle activity during the working day was calculated and further classified into low (0-29%), moderate (30-49%) and high (50-100%) level groups. Generalized estimating equations (GEE), adjusted for time, gender, mechanical workload, control-over-work intensity, physical activity, tobacco use, and prior neck and shoulder pain, showed that participants with a high level of sustained muscle activity had a rate of neck and shoulder pain three times higher than the low level group during a 2.5-year period. The association was strongest at the same time and shortly after the EMG measurement, indicating a time-lag of ≤6 months. The results support the hypothesis that sustained trapezius muscle activity is associated with neck and shoulder pain. This association was strongest analyzing cross-sectional and short-term effects.

Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls.

PubMed

Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela; Holtermann, Andreas; Taylor, Janet L; Søgaard, Karen

2017-10-01

Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique. Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction. Presented as mean±SD for cases and controls, respectively: VAS; 16.0±14.4mm and 2.1±4.1mm (P=0.004), MVC; 545±161N and 664±195N (P=0.016), upper trapezius muscle thickness; 10.9±1.9mm and 10.4±1.5mm (P=0.20), VA; 93.6±14.2% and 96.3±6.0% (P=0.29). In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of Crossed Brassiere Straps on Pain, Range of Motion, and Electromyographic Activity of Scapular Upward Rotators in Women With Scapular Downward Rotation Syndrome.

PubMed

Kang, Min-Hyeok; Choi, Ji-Young; Oh, Jae-seop

2015-12-01

Scapular downward rotation syndrome manifests as an abnormally downward-rotated scapula at rest or with arm motion and typically results in neck and shoulder pain. The brassiere strap has been suggested as a possible contributing factor to scapula downward rotation and pain in the upper trapezius because of increased downward rotational force on the lateral aspect of the scapula. No study, however, has examined the influences of a modified brassiere strap on pain in and the function of the scapular muscles. To examine the effects of crossed brassiere straps on the pressure pain threshold (PPT) of the upper trapezius, neck rotation range of motion (ROM), and electromyographic activity of the scapular upward rotators in females with scapular downward rotation syndrome. Cross-over design. Laboratory. In total, 15 female subjects with scapular downward rotation syndrome were recruited at hospitals and a local university. All participants performed neck rotation and humeral elevation under 2 different conditions: parallel and crossed brassiere straps. The PPT of the upper trapezius was measured using an analog algometer, whereas neck rotation ROM was quantified with a 3-dimensional ultrasonic motion analysis system. The electromyographic activities of the upper trapezius, serratus anterior, and lower trapezius during humeral elevation were assessed with a surface electromyography system. Outcome measures were assessed under parallel and crossed brassiere strap conditions, and differences in outcomes between the conditions were analyzed using a paired t-test. The PPT and neck rotation ROM were increased when the subject was wearing the brassiere with crossed versus parallel straps (P < .001). Greater electromyographic activities of the serratus anterior, lower trapezius, and lesser upper trapezius muscles during humeral elevation were found under the crossed strap condition than the parallel strap condition (P < .05). These findings provide useful information for clinicians when designing management programs to decrease pain and improve biomechanical function for females with scapular downward rotation syndrome. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography.

PubMed

Adigozali, Hakimeh; Shadmehr, Azadeh; Ebrahimi, Esmail; Rezasoltani, Asghar; Naderi, Farrokh

2017-01-01

In the present study, the intra-rater reliability of upper trapezius morphology, its mechanical properties and intramuscular blood circulation in females with myofascial pain syndrome were assessed using ultrasonography. A total of 37 patients (31.05 ± 10 years old) participated in this study. Ultrasonography producer was set up in three stages: a) Gray-scale: to measure muscle thickness, size and area of trigger points; b) Ultrasound elastography: to measure muscle stiffness; and c) Doppler imaging: to assess blood flow indices. According to data analysis, all variables, except End Diastolic Velocity (EDV), had excellent reliability (>0.806). Intra-class Correlation Coefficient (ICC) for EDV was 0.738, which was considered a poor to good reliability. The results of this study introduced a reliable method for developing details of upper trapezius features using muscular ultrasonography in female patients. These variables could be used for objective examination and provide guidelines for treatment plans in clinical settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preliminary evaluation of the sensitivity to change of DE-STA motor unit number estimation in the upper trapezius muscle in amyotrophic lateral sclerosis.

PubMed

Ives, Colleen T; Findlater, Karen; Shoesmith, Christen L; Doherty, Timothy J

2015-07-01

To compare the sensitivity to change of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) in the upper trapezius (UT) to that of various clinical outcome measures in subjects with amyotrophic lateral sclerosis (ALS). Ten patients with clinically probable or definite ALS were assessed at baseline, 2, 4 and 6months with the following outcome measures: manual muscle testing in five upper extremity muscle groups, scapular elevation and elbow flexion peak force measured with hand-held dynamometry, MUNE, forced vital capacity and the Revised ALS Functional Rating Scale (ALSFRS-R). ALSFRS-R was the only outcome measure for which there was a significant difference between baseline and 6months (p=0.034). ALSFRS-R had the largest standardized response mean (SRM), and was thus the most sensitive to change. MUNE demonstrated a decline over 6months and a moderate SRM (-0.63). This study has demonstrated a moderate degree of sensitivity to change for DE-STA MUNE as applied to the UT in subjects with ALS. In this preliminary study, DE-STA MUNE detected motor unit loss over 6months, with a moderate degree of sensitivity, in the upper trapezius of subjects with ALS. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

The effect of over-commitment and reward on trapezius muscle activity and shoulder, head, neck, and torso postures during computer use in the field

PubMed Central

Bruno Garza, Jennifer L.; Eijckelhof, Belinda H.W.; Huysmans, Maaike A.; Catalano, Paul J.; Katz, Jeffrey N.; Johnson, Peter W.; van Dieen, Jaap H.; van der Beek, Allard J.; Dennerlein, Jack T.

2015-01-01

Background Because of reported associations of psychosocial factors and computer related musculoskeletal symptoms, we investigated the effects of a workplace psychosocial factor, reward, in the presence of over-commitment, on trapezius muscle activity and shoulder, head, neck, and torso postures during computer use. Methods We measured 120 office workers across four groups (lowest/highest reward/over-commitment), performing their own computer work at their own workstations over a 2 hour period. Results Median trapezius muscle activity (p=0.04) and median neck flexion (p=0.03) were largest for participants reporting simultaneously low reward and high over-commitment. No differences were observed for other muscle activities or postures. Conclusions These data suggest that the interaction of reward and over-commitment can affect upper extremity muscle activity and postures during computer use in the real work environment. This finding aligns with the hypothesized biomechanical pathway connecting workplace psychosocial factors and musculoskeletal symptoms of the neck and shoulder. PMID:23818000

Efficacy and Safety of Single Botulinum Toxin Type A (Botox®) Injection for Relief of Upper Trapezius Myofascial Trigger Point: A Randomized, Double-Blind, Placebo-Controlled Study.

PubMed

Kwanchuay, Photsawee; Petchnumsin, Thavatchai; Yiemsiri, Pichet; Pasuk, Nakkamol; Srikanok, Wannarat; Hathaiareerug, Chanasak

2015-12-01

Botulinum toxin injection has been applied for pain relief in various chronic pain syndromes. Recently, systematic review studies reported inconclusive effects of Botulinum toxin in myofascial pain management. The present study aimed to demonstrate the efficacy and safety of Botulinum toxin type A (BTxA) (Botox®) injection for pain reduction in myofascial trigger point (MTrP) of the upper trapezius muscle. Thirty-three patients with 48 MTrP on the upper trapezius muscles over three months with moderate to severe pain intensity diagnosed at physical medicine and rehabilitation outpatient department were recruited between December 2011 and March 2012. Eligible patients were blinded and randomly injected with single 0.2 ml (20 IU) of BTxA for 24 MTrP and 0.2 ml of 0.9% NaCl solution for 24 MTrP at the most tender trigger point on the upper trapezius muscle. All patients were advised for stretching exercise and ergonomic adaptation throughout the study. At 3- and 6-week after injections, visual analogue scale (VAS), the pressure pain threshold (PPT), and reported adverse effects were measured. Both BTxA and control groups demonstrated statistically significant differences in VAS reduction and increased PPT after 3 weeks and 6 weeks compared with before treatment. There were no statistically significant differences in VAS reduction from baseline between the two groups at 3- and 6-week after treatment. A statistically significant difference in improvement of PPT from baseline and 6-week after BTxA injection compared with 0.9% NaCl group was shown (1.0 ± 0.9 and 0.5 ± 0.7, p = 0.036). There was mild degree side-effects that spontaneous resolved within one week in both groups without significant difference in percentage. No severe adverse effects were reported during the study. The efficacy in VAS reduction of a single 20 IU of Botulinum toxin type A (Botox®) injection was not different from 0.9% NaCl for myofascial trigger point at the upper trapezius muscle. However Botulinum toxin type A (Botox®) showed statistically significant more increased in pressure pain threshold at 6-week after injection without severe adverse effects.

Shoulder Muscle Activation Levels During the Push-Up-Plus Exercise on Stable and Unstable Surfaces.

PubMed

Torres, Rafaela J B; Pirauá, André L T; Nascimento, Vinícius Y S; Dos Santos, Priscila S; Beltrão, Natália B; de Oliveira, Valéria M A; Pitangui, Ana Carolina R; de Araújo, Rodrigo C

2017-07-01

The aim of this study was to evaluate the acute effect of the use of stable and unstable surfaces on electromyography (EMG) activity and coactivation of the scapular and upper-limb muscles during the push-up plus (with full protraction of the scapula). Muscle activation of anterior deltoid (AD), posterior deltoid (PD), pectoralis major, biceps brachii (BB), triceps brachii (TB), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) levels and coactivation index were determined by surface EMG in 20 young men during push-up plus performed on a stable and unstable condition (2 unstable devices applied to hands and feet). The paired t test and Cohen d were used for statistical analysis. The results showed that during the execution of the push-up plus on the unstable surface an increased EMG activity of the scapular stabilizing muscles (SA, MT, and LT) was observed, while AD and PD muscles showed a decrease. During exercise execution on the unstable surface there was a higher index of coactivation of the scapular muscles (SA-MT and UT-LT pairs). No significant differences were observed in TB-BB and AD-PD pairs. These results suggest that the push-up-plus exercise associated with unstable surfaces produced greater EMG activity levels and coactivation index of the scapular stabilizing muscle. On the other hand, the use of an unstable surface does not promote the same effect for the shoulder muscles.

Electromyographic Activity of Scapular Muscle Control in Free-Motion Exercise

PubMed Central

Nakamura, Yukiko; Tsuruike, Masaaki; Ellenbecker, Todd S.

2016-01-01

Context:  The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not completely known. Excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during humeral elevation. Objective:  To identify the effects of different exercise intensities on the scapular muscles during a free-motion “robbery” exercise performed in different degrees of shoulder abduction in seated and standing positions. Design:  Descriptive laboratory study. Setting:  Kinesiology Adapted Physical Education Laboratory. Patients or Other Participants:  A total of 15 healthy male college students (age = 20.5 ± 2.2 years, height = 174.5 ± 5.3 cm, mass = 63.8 ± 6.0 kg). Intervention(s):  Participants performed 5 repetitions of a randomized exercise sequence of the robbery exercise in 2 body positions (seated, standing), 2 shoulder-abducted positions (W [20°], 90/90 [90°]) at 3 intensities (0%, 3%, and 7% body weight). Main Outcome Measure(s):  Electromyographic (EMG) activity of the upper trapezius, lower trapezius, serratus anterior, anterior deltoid, and infraspinatus muscles of the upper extremity was collected. All EMG activities were normalized by the maximal voluntary isometric contraction of each corresponding muscle (%). Results:  The serratus anterior, anterior deltoid, and infraspinatus EMG activities were greater at 7% body weight in the seated position compared with the standing position (P < .05). The EMG activities in all 5 muscles were greater in the 90/90 position than in the W position (P < .05). Conclusions:  Scapular muscle activity modulated relative to changes in body posture and resistance intensity. These findings will enable clinicians to prescribe the appropriate level of exercise intensity and positioning during shoulder rehabilitation. PMID:26986055

Comparison of psychomotor function between music students and students participating in music training.

PubMed

Chansirinukor, Wunpen; Khemthong, Supalak

2014-07-01

To compare psychomotor function between a music student group who had music education and a non-music student group who participated in music training. Consecutive sampling was used for completing questionnaires, testing reaction times (visual, auditory, and tactile system), measuring electromyography of upper trapezius muscles both sides and taking photos of the Craniovertebral (CV) angle in the sitting position. Data collection was made twice for each student group: the music students at one-hour intervals for resting and conducting nonmusic activities, the non-music students at two-day intervals, 20 minutes/session, and performed music training (by a manual of keyboard notation). The non-music students (n = 65) improved reaction times, but responded slower than the music students except for the tactile system. The music students (n = 28) showed faster reaction times and higher activities of the trapezius muscle than the non-music students at post-test. In addition, the CV angle of the non-music students was significantly improved. The level of musical ability may influence the psychomotor function. Significant improvement was observed in visual, auditory and tactile reaction time, and CV angle in the non-music students. However upper trapezius muscle activities between both student groups were unchanged.

Protocol: Testing the Relevance of Acupuncture Theory in the Treatment of Myofascial Pain in the Upper Trapezius Muscle.

PubMed

Elsdon, Dale S; Spanswick, Selina; Zaslawski, Chris; Meier, Peter C

2017-01-01

A protocol for a prospective single-blind parallel four-arm randomized placebo-controlled trial with repeated measures was designed to test the effects of various acupuncture methods compared with sham. Eighty self-selected participants with myofascial pain in the upper trapezius muscle were randomized into four groups. Group 1 received acupuncture to a myofascial trigger point (MTrP) in the upper trapezius. Group 2 received acupuncture to the MTrP in addition to relevant distal points. Group 3 received acupuncture to the relevant distal points only. Group 4 received a sham treatment to both the MTrP and distal points using a deactivated acupuncture laser device. Treatment was applied four times within 2 weeks with outcomes measured throughout the trial and at 2 weeks and 4 weeks posttreatment. Outcome measurements were a 100-mm visual analog pain scale, SF-36, pressure pain threshold, Neck Disability Index, the Upper Extremity Functional Index, lateral flexion in the neck, McGill Pain Questionnaire, Massachusetts General Hospital Acupuncture Sensation Scale, Working Alliance Inventory (short form), and the Credibility Expectance Questionnaire. Two-way analysis of variance (ANOVA) with repeated measures were used to assess the differences between groups. Copyright © 2017 Medical Association of Pharmacopuncture Institute. Published by Elsevier B.V. All rights reserved.

Shoulder girdle muscle activity and fatigue in traditional and improved design carpet weaving workstations.

PubMed

Allahyari, Teimour; Mortazavi, Narges; Khalkhali, Hamid Reza; Sanjari, Mohammad Ali

2016-01-01

Work-related musculoskeletal disorders in the neck and shoulder regions are common among carpet weavers. Working for prolonged hours in a static and awkward posture could result in an increased muscle activity and may lead to musculoskeletal disorders. Ergonomic workstation improvements can reduce muscle fatigue and the risk of musculoskeletal disorders. The aim of this study is to assess and to compare upper trapezius and middle deltoid muscle activity in 2 traditional and improved design carpet weaving workstations. These 2 workstations were simulated in a laboratory and 12 women carpet weavers worked for 3 h. Electromyography (EMG) signals were recorded during work in bilateral upper trapezius and bilateral middle deltoid. The root mean square (RMS) and median frequency (MF) values were calculated and used to assess muscle load and fatigue. Repeated measure ANOVA was performed to assess the effect of independent variables on muscular activity and fatigue. The participants were asked to report shoulder region fatigue on the Borg's Category-Ratio scale (Borg CR-10). Root mean square values in workstation A are significantly higher than in workstation B. Furthermore, EMG amplitude was higher in bilateral trapezius than in bilateral deltoid. However, muscle fatigue was not observed in any of the workstations. The results of the study revealed that muscle load in a traditional workstation was high, but fatigue was not observed. Further studies investigating other muscles involved in carpet weaving tasks are recommended. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Load pattern and pressure pain threshold in the upper trapezius muscle and psychosocial factors in medical secretaries with and without shoulder/neck disorders.

PubMed

Hägg, G M; Aström, A

1997-01-01

A current hypothesis for the genesis of muscular complaints in the shoulder/neck region postulates that short periods with a completely relaxed muscle are essential to avoid complaints. Another hypothesis is that these disorders are related to psychosocial conditions at work. In order to test these hypotheses, 23 medical secretaries were investigated. The load pattern during work in the upper trapezius muscle bilaterally was assessed with electromyographic (EMG) technique and exposure variation analysis (EVA). In addition, pressure pain threshold (PPT) was measured on the trapezius muscle bilaterally and on the sternum. Psychosocial conditions at work were assessed with a questionnaire. The medical secretaries with complaints had significantly fewer episodes with totally or close to totally relaxed muscle compared with the healthy group. The group with complaints tended to have a more monotonous load pattern at low levels (approx. 1%-5% maximum voluntary contraction) while the healthy group had more frequent pauses but also somewhat more frequent short load peaks. The group with complaints showed lower PPT readings compared with the healthy group. However, the whole group had considerably lower PPTs than is usually reported in the literature. Of the 12 questions in the psychosocial questionnaire only one regarding work task satisfaction showed a significant difference between the two groups. Support is found for hypothesis that secretaries without complaints have more frequent episodes with totally relaxed muscle. A significant difference is found regarding work task satisfaction.

Surface Electromyographic Activity of the Upper Trapezius Before and After a Single Dry Needling Session in Female Office Workers With Trapezius Myalgia.

PubMed

De Meulemeester, Kayleigh; Calders, Patrick; Dewitte, Vincent; Barbe, Tom; Danneels, Lieven; Cagnie, Barbara

2017-12-01

Myofascial pain can be accompanied by a disturbed surface electromyographic (sEMG) activity. Nevertheless, the effect of myofascial treatment techniques, such as dry needling (DN), on the sEMG activity is poorly investigated. Several DN studies also emphasize the importance of eliciting local twitch responses (LTRs) during treatment. However, studies investigating the added value of LTRs are scarce. Therefore, the aims of this study were first to evaluate the effect of DN on the sEMG activity of myalgic muscle tissue, compared with no intervention (rest), and secondly to identify whether this effect is dependent of eliciting LTRs during DN. Twenty-four female office workers with work-related trapezius myalgia were included. After completion of a typing task, changes in sEMG activity were evaluated after a DN treatment of the upper trapezius, compared with rest. The sEMG activity increased after rest and after DN, but this increase was significantly smaller 10 minutes after DN, compared with rest. These differences were independent whether LTRs were elicited or not. Dry needling leads to a significantly lower increase in sEMG activity of the upper trapezius, compared with no intervention, after a typing task. This difference was independent of eliciting LTRs.

ITKids part II: variation of postures and muscle activity in children using different information and communication technologies.

PubMed

Ciccarelli, Marina; Straker, Leon; Mathiassen, Svend Erik; Pollock, Clare

2011-01-01

There are concerns that insufficient variation in postural and muscle activity associated with use of modern information and communication technology (ICT) presents a risk for musculoskeletal ill-health among school children. However, scientific knowledge on physical exposure variation in this group is limited. The purpose of this study was to quantify postures and muscle activity of school children using different types of ICT. Postures of the head, upper back and upper arm, and muscle activity of the right and left upper trapezius and right forearm extensors were measured over 10-12 hours in nine school children using different types of ICT at school and away-from-school. Variation in postures and muscle activity was quantified using two indices, EVA{sd} and APDF₉₀-₁₀. Paper-based (Old) ICT tasks produced postures that were less neutral but more variable than electronics-based (New ICT) and Non-ICT tasks. Non-ICT tasks involved mean postures similar to New ICT tasks, but with greater variation. Variation of muscle activity was similar between ICT types in the right and left upper trapezius muscles. Non-ICT tasks produced more muscle activity variation in the right forearm extensor group compared to New and Old ICT tasks. Different ICT tasks produce different degrees of variation in posture and muscle activity. Combining tasks that use different ICT may increase overall exposure variation. More research is needed to determine what degree of postural and muscle activity variation is associated with reduced risk of musculoskeletal ill-health.

Upper trapezius relaxation induced by TENS and interferential current in computer users with chronic nonspecific neck discomfort: An electromyographic analysis.

PubMed

Acedo, Adriano Alexandre; Luduvice Antunes, Ana Carolina; Barros dos Santos, André; Barbosa de Olveira, Cintia; Tavares dos Santos, Claudia; Colonezi, Gustavo Lacreta Toledo; Fontana, Felipe Antonio Medeiros; Fukuda, Thiago Yukio

2015-01-01

Recent studies have shown that a transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) application reduces pain in subjects with musculoskeletal disorders. However there are no clinical trials evaluating or comparing the muscle relaxation generated for these devices. To compare the muscle relaxation of the upper trapezius induced by the application of TENS and IFC in females with chronic nonspecific neck discomfort. Sixty-four females between 18 and 40 years of age and a history of nonspecific neck discomfort were randomly assigned to a TENS or an IFC group. The women in the TENS (N = 32; mean age 22 years) and IFC (N = 32, mean age 23 years) group were submitted to current application during 3 consecutive days and were assessed by electromyography (EMG) in different times aiming to quantify the muscular tension of the upper trapezius. A visual analogue scale (VAS) was used as pain measure at baseline (before TENS or IFC application) and at the end of the study. At baseline, demographic, pain, and EMG assessment data were similar between groups. Those in the IFC group had a significant trapezius relaxation after 3 IFC applications when compared to baseline and intermediate evaluations (P < 0.05). In contrast, the same analysis showed no significant difference between all assessments in the TENS group (P >0.05). In relation to pain relief, both groups showed an improvement at the end of the study when compared to baseline (both,P <0.05). The between-group analysis showed no difference for the subjects who received such IFC as TENS application (P <0.05). IFC induced the upper trapezius relaxation after 3 sessions in females with neck discomfort, but the TENS application did not change the muscular tension. However, these results should be carefully interpreted due to the lack of differences between groups. A significant pain decrease was found in the subjects of both groups, however, only the IFC application presented a clinically important improvement.

A comparison of muscle activity in using touchscreen smartphone among young people with and without chronic neck-shoulder pain.

PubMed

Xie, Yanfei; Szeto, Grace P Y; Dai, Jie; Madeleine, Pascal

2016-01-01

This study aimed to examine differences in muscle activity between young people with and without neck-shoulder pain (n = 20 in each group), when they performed texting on a smartphone. Texting was compared between using both hands ('bilateral texting') and with only one hand ('unilateral texting'). Texting tasks were also compared with computer typing. Surface electromyography from three proximal postural muscles and four distal hand/thumb muscles on the right side was recorded. Compared with healthy controls, young people with neck-shoulder pain showed altered motor control consisting of higher muscle activity in the cervical erector spinae and upper trapezius when performing texting and typing tasks. Generally, unilateral texting was associated with higher muscle loading compared with bilateral texting especially in the forearm muscles. Compared with computer typing, smartphone texting was associated with higher activity in neck extensor and thumb muscles but lower activity in upper and lower trapezius as well as wrist extensors. This study demonstrated that symptomatic individuals had increased muscle activity in the neck–shoulder region when texting on a smartphone. Contemporary ergonomic guidelines should include advice on how to interact with handheld electronic devices to achieve a relaxed posture and reduced muscle load in order to reduce the risk of musculoskeletal disorders.

Muscle activity and mood state during simulated plant factory work in individuals with cervical spinal cord injury

PubMed Central

Okahara, Satoshi; Kataoka, Masataka; Okuda, Kuniharu; Shima, Masato; Miyagaki, Keiko; Ohara, Hitoshi

2016-01-01

[Purpose] The present study investigated the physical and mental effects of plant factory work in individuals with cervical spinal cord injury and the use of a newly developed agricultural working environment. [Subjects] Six males with C5–C8 spinal cord injuries and 10 healthy volunteers participated. [Methods] Plant factory work involved three simulated repetitive tasks: sowing, transplantation, and harvesting. Surface electromyography was performed in the dominant upper arm, upper trapezius, anterior deltoid, and biceps brachii muscles. Subjects’ moods were monitored using the Profile of Mood States. [Results] Five males with C6–C8 injuries performed the same tasks as healthy persons; a male with a C5 injury performed fewer repetitions of tasks because it took longer. Regarding muscle activity during transplantation and harvesting, subjects with spinal cord injury had higher values for the upper trapezius and anterior deltoid muscles compared with healthy persons. The Profile of Mood States vigor scores were significantly higher after tasks in subjects with spinal cord injury. [Conclusion] Individuals with cervical spinal cord injury completed the plant factory work, though it required increased time and muscle activity. For individuals with C5–C8 injuries, it is necessary to develop an appropriate environment and assistive devices to facilitate their work. PMID:27134377

Effects of precision demands and mental pressure on muscle activation and hand forces in computer mouse tasks.

PubMed

Visser, Bart; De Looze, Michiel; De Graaff, Matthijs; Van Dieën, Jaap

2004-02-05

The objective of the present study was to gain insight into the effects of precision demands and mental pressure on the load of the upper extremity. Two computer mouse tasks were used: an aiming and a tracking task. Upper extremity loading was operationalized as the myo-electric activity of the wrist flexor and extensor and of the trapezius descendens muscles and the applied grip- and click-forces on the computer mouse. Performance measures, reflecting the accuracy in both tasks and the clicking rate in the aiming task, indicated that the levels of the independent variables resulted in distinguishable levels of accuracy and work pace. Precision demands had a small effect on upper extremity loading with a significant increase in the EMG-amplitudes (21%) of the wrist flexors during the aiming tasks. Precision had large effects on performance. Mental pressure had substantial effects on EMG-amplitudes with an increase of 22% in the trapezius when tracking and increases of 41% in the trapezius and 45% and 140% in the wrist extensors and flexors, respectively, when aiming. During aiming, grip- and click-forces increased by 51% and 40% respectively. Mental pressure had small effects on accuracy but large effects on tempo during aiming. Precision demands and mental pressure in aiming and tracking tasks with a computer mouse were found to coincide with increased muscle activity in some upper extremity muscles and increased force exertion on the computer mouse. Mental pressure caused significant effects on these parameters more often than precision demands. Precision and mental pressure were found to have effects on performance, with precision effects being significant for all performance measures studied and mental pressure effects for some of them. The results of this study suggest that precision demands and mental pressure increase upper extremity load, with mental pressure effects being larger than precision effects. The possible role of precision demands as an indirect mental stressor in working conditions is discussed.

Unilateral and Immediate Stimulation of Acupuncture Points Xiaohai (SI8) and Jianwaishu (SI14) of the Small Intestine Meridian Increases Electromyographic Activity and Strength in the Ipsilateral and Contralateral Upper Trapezius Muscle.

PubMed

de Souza, Leandro L; de Araujo, Fernanda L B; da Silva, Fernanda A M; Mucciaroni, Thaís S; de Araujo, João E

2016-10-01

We previously showed that a yin meridian of the upper limb decreased electromyographic activity (root mean square) and muscle strength ipsilateral and contralateral to the side of stimulation. Here, we tested the upper trapezius (UT) muscle response after stimulation of a yang meridian of the upper limb, the small intestine (SI). Thirty-eight healthy volunteers were randomized into the following groups: UT muscle (SI14), distant of the UT muscle (SI8), without stimulation (CG), and sham (R3). An acupuncturist certificated by the Brazilian Society of Physical Therapists and Acupuncturists performed the needle insertion. Each volunteer received only one stimulation to the right upper limb. The evaluation occurred before, 5 minutes after, and 20 minutes after needle withdrawal. The root mean square activity increased on the right side in the UT muscle for the SI8 and SI14 groups (F 3,37  = 4.67; p < 0.025) at the 20-minute evaluation. The most vigorous response occurred on the contralateral side because the effects were maintained for 5 minutes after withdrawal (F 3,37  = 4.52; p < 0.025). Both groups showed an increase in the UT muscle strength at the 20-minute evaluation (F 3,37  = 3.41; p < 0.025). The CG and R3 groups did not show any changes. Our data indicate that SI a yang meridian increases the UT muscle response. Copyright © 2016. Published by Elsevier B.V.

Comparison of isometric cervical flexor and isometric cervical extensor system exercises on patients with neuromuscular imbalance and cervical crossed syndrome associated forward head posture.

PubMed

Lee, Jaejin; Kim, Dohyeon; Yu, Kyunghoon; Cho, Youngki; You, Joshua H

2018-01-01

Isometric cervical flexor system exercise (ICF) and isometric cervical extensor system exercise (ICE) are cervical stabilization techniques that have been used to restore cervical crossed syndrome (CCS)-associated forward head posture. However, the therapeutic effects and underlying motor control mechanisms remain elusive. The purpose of present study was investigating the concurrent therapeutic effects of ICF and ICE on muscle size, muscle imbalance ratio, and muscle recruitment sequence using ultrasound imaging and electromyography. A total of 18 participants (7 females; age=24±4.0 years) with CCS associated with forward head posture underwent ICF and ICE. Paired t-test analysis was used for statistical analysis. Paired t-test analysis showed that sternocleidomastoid thickness was greater during ICF than ICE. Similarly, cross-sectional area and horizontal thickness of the longus colli were greater during ICE than ICF. The upper trapezius/lower trapezius muscle imbalance ratio and the pectoralis major/lower trapezius muscle imbalance ratio were significantly decreased during the application of ICE compared to ICF. These results provide compelling, mechanistic evidence as to how ICE is more beneficial for the restoration of neuromuscular imbalance than ICF in individuals with CCS.

Human Neck Response during Vertical Impact with Variable Weighted Helmets

DTIC Science & Technology

2006-09-01

activated, action potentials from the brain travel to motor neurons which branch out to the muscle fibers . EMG sensors record the action potentials of...the motor unit, comprised of several activated muscle fibers . An "EMG signal directly reflects the recruitment and firing characteristics of the...upper trapezius and SCM associated with isometric muscle contractions. They thoroughly investigated the mechanics of muscle fatigue during helmet loading

Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements.

PubMed

Siu, Aaron; Schinkel-Ivy, Alison; Drake, Janessa Dm

2016-10-01

To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Magnetic stimulation of the upper trapezius muscles in patients with migraine - A pilot study.

PubMed

Sollmann, Nico; Trepte-Freisleder, Florian; Albers, Lucia; Jung, Nikolai H; Mall, Volker; Meyer, Bernhard; Heinen, Florian; Krieg, Sandro M; Landgraf, Mirjam N

2016-11-01

Repetitive peripheral magnetic stimulation (rPMS) has been applied to musculoskeletal pain conditions. Since recent data show that migraine and tension-type headache (TTH) might be closely related to peripheral muscular pain in the neck and shoulder region (supporting the concept of the trigemino-cervical complex (TCC)), this pilot study explores the acceptance of rPMS to the upper trapezius muscles in migraine (partly in combination with TTH). We used rPMS to stimulate active myofascial trigger points (aTrPs) of the upper trapezius muscles in 20 young adults suffering from migraine. Acceptance was assessed by a standardized questionnaire, whereas self-rated effectiveness was evaluated by headache calendars and the Migraine Disability Assessment (MIDAS). Algometry was performed to explore the local effect of rPMS on the muscles. Acceptance of rPMS was shown in all subjects without any adverse events, and rPMS had a statistically significant impact on almost every parameter of the headache calendar and MIDAS. Among others, the number of migraine attacks (p < 0.001) and migraine intensity (p = 0.001) significantly decreased regarding pre- and post-stimulation assessments. Accordingly, 100.0% of subjects would repeat the stimulation, while 90.0% would recommend rPMS as a treatment option for migraine. rPMS might represent a promising tool to alleviate migraine symptoms within the context of myofascial pain. This might be due to stimulation-dependent modulation of the peripheral sensory effect within the TCC in migraine. However, sham-controlled studies with larger and more homogeneous cohorts are needed to prove a potential beneficial effect. Ethics Committee Registration Numbers: 356-14 and 447/14. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

PubMed Central

2011-01-01

Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. Results In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. Conclusions A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. Trial Registration ISRCTN60264809 PMID:21777478

Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.

PubMed

Andersen, Lars L; Hansen, Klaus; Mortensen, Ole S; Zebis, Mette K

2011-07-22

Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. ISRCTN60264809.

Relationship between sleep stages and nocturnal trapezius muscle activity.

PubMed

Müller, Christian; Nicoletti, Corinne; Omlin, Sarah; Brink, Mark; Läubli, Thomas

2015-06-01

Former studies reported a relationship between increased nocturnal low level trapezius muscle activity and neck or shoulder pain but it has not been explored whether trapezius muscle relaxation is related to sleep stages. The goal of the present study was to investigate whether trapezius muscle activity is related to different sleep stages, as measured by polysomnography. Twenty one healthy subjects were measured on four consecutive nights in their homes, whereas the first night served as adaptation night. The measurements included full polysomnography (electroencephalography (EEG), electrooculography (EOG), electromyography (EMG) and electrocardiography (ECG)), as well as surface EMG of the m. trapezius descendens of the dominant arm. Periods with detectable EMG activity of the trapezius muscle lasted on average 1.5% of the length of the nights and only in four nights it lasted longer than 5% of sleeping time. Neither rest time nor the length of periods with higher activity levels of the trapezius muscle did significantly differ between sleep stages. We found no evidence that nocturnal trapezius muscle activity is markedly moderated by the different sleep stages. Thus the results support that EMG measurements of trapezius muscle activity in healthy subjects can be carried out without concurrent polysomnographic recordings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Influence of smartphone use styles on typing performance and biomechanical exposure.

PubMed

Ko, Ping-Hsin; Hwang, Yaw-Huei; Liang, Huey-Wen

2016-06-01

Twenty-seven subjects completed 2-min typing tasks using four typing styles: right-hand holding/typing (S-thumb) and two-hand typing at three heights (B-low, B-mid and B-high). The styles had significant effects on typing performance, neck and elbow flexion and muscle activities of the right trapezius and several muscles of the right upper limb (p < 0.0001 by repeated-measure analysis of variance). The subjects typed the fewest words (error-adjusted characters per minute: 78) with the S-thumb style. S-thumb style resulted in similar flexion angles of the neck, elbow and wrist, but significantly increased muscle activities in all tested muscles compared with the B-mid style. Holding the phone high or low reduced the flexion angles of the neck and right elbow compared with the B-mid style, but the former styles increased the muscle activity of the right trapezius. Right-hand holding/typing was not a preferable posture due to high muscle activities and slow typing speed. Practitioner Summary: Right-hand holding/typing was not favoured, due to increased muscle activities and slower typing speed. Holding the phone high or low reduced the flexion angles of the neck and right elbow, but the former styles increased the muscle activity of the right trapezius compared with holding the phone at chest level.

Decreased thickness of the lower trapezius muscle in patients with unilateral neck pain.

PubMed

Uthaikhup, Sureeporn; Pensri, Chalomjai; Kawsoiy, Kanokon

2016-09-01

Thickness of the lower trapezius muscle in patients with neck pain has not been established. We examined the thickness of the lower trapezius muscle in patients with and without unilateral neck pain. Twenty women with unilateral (right) neck pain and 20 matched controls participated in the study. Thickness of the lower trapezius muscles was measured bilaterally at rest (0 ° and 120 ° of shoulder abduction) and during contraction (120 ° of shoulder abduction) using ultrasound imaging. The neck pain group had smaller thickness of the lower trapezius muscle on the painful side compared with controls both at rest and during contraction (P < 0.05). However, the percentage change in the lower trapezius thickness from rest to contraction (120 ° of shoulder abduction) was not different between groups (P > 0.05). Patients with neck pain had smaller thickness of the lower trapezius muscle on the painful side compared with healthy controls. Muscle Nerve 54: 439-443, 2016. © 2015 Wiley Periodicals, Inc.

Assessment of the maximum voluntary arm muscle contraction in sign language for the deaf.

PubMed

Regalo, S C H; Teixeira, V R; Vitti, M; Chaves, T C; Hallak, J E C; Bevilaqua-Grossi, D; Siriani de Oliveira, A

2006-01-01

The purpose of this study was to investigate the levels of upper member muscles' activation of deaf individuals, who use the Brazilian sign language - LIBRAS, comparing these findings to volunteers with no postural deviations and normal hearing Forty eight volunteers divided into two groups comprising healthy and deaf subjects (24 volunteers for each group). The signs of rest were obtained with the volunteer maintaining the upper member in an anatomical position, but with the forearm flexed and sustained by the lower member. Maximum voluntary isometric contractions (MVIC) of the biceps, triceps, deltoid, and trapezius muscles were performed in the position of muscular function testing. Statistical analysis was performed using the SPSS-10.0. Continuous data with normal distribution were analyzed by ANOVA with the significance level of p < 0.01. The normalized electromyographic muscle data obtained in muscular rest do not show statistically significant differences among the studies muscles, in both groups. In the comparison of normalized RMS values obtained in MVIC, the mean values for the trapezius muscle of deaf group were statistically lower than control group. This study's results indicate there are no differences between the levels of muscular activation for arm biceps, arm triceps, and the anterior portion of the deltoid muscle between the mean normalized RMS values of deaf and healthy individuals.

Lower trapezius flap for recalcitrant wounds of the posterior skull and spine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seyfer, A.E.

1988-05-01

The lower trapezius muscle and musculocutaneous flap has been useful in providing a reliable, expeditious closure for compromised defects of the upper spine and dorsal calvarium. It has been successfully employed in 6 patients as a one-stage procedure, all of whom had recalcitrant, postoperative wounds that failed to heal. It provides serviceable tissue that is able to withstand additional radiotherapy and also offers useful palliation without apparent disability. Pertinent anatomical and clinical considerations are discussed.

The association between upper trapezius activity and thorax movement in classical singing.

PubMed

Pettersen, V; Westgaard, R H

2004-12-01

This study aimed to examine in classical singing the phasing of the activity in upper trapezius (TR) to upper and lower thorax movement and to the phasing of activity in the intercostals (INT) and in the lateral abdominal (OBL) muscles. Electromyographic (EMG) activity was recorded from the TR, INT, and OBL muscles on the right side. Thorax movement (TX) was traced with two strain gauge sensors placed around the upper and lower thorax. Four professional opera singers (soprano, mezzo, tenor, and baritone) and four advanced student classical singers (three sopranos and one mezzo) participated. Three of the professional singers were 33 years, and one was 40 years. The students were between 23 and 30 years. Different arias, freely chosen by the singers from their professional repertoire, served as the singing task for the opera singers. All students sang "Summertime" from Porgy and Bess. All subjects performed their task three times with variation in vocal loudness (normal, forte, piano). Thereafter, for all subjects, a biofeedback (BF) procedure was performed on TR to lower TR activity and a repeat performance of the singing tasks was carried out. EMG activity from the three recording sites and upper and lower TX circumference were compared before and after BF. A phasing of upper TR activity to INT and OBL activity was discovered, all muscles supporting the expiration phase. During phonation, the upper TR contributes in the compression of upper TX, thus serving as an accessory muscle of expiration. Group results from both opera singers and student singers showed that EMG activity was significantly lowered after BF. The lowered TR activity resulted in an expanded upper TX circumference and less TX respiratory movement after BF.

Electromyographic analysis of knee push up plus variations: what is the influence of the kinetic chain on scapular muscle activity?

PubMed

Maenhout, A; Van Praet, K; Pizzi, L; Van Herzeele, M; Cools, A

2010-11-01

First, to look for appropriate closed kinetic chain exercises to restore intramuscular imbalance between upper trapezius (UT) and serratus anterior (SA) in overhead athletes. Second, to determine the influence of using diagonal pattern muscle recruitment during knee push up plus (KPP) exercises on scapular electromyographic activity. Single group repeated-measures design. Controlled laboratory study. Thirty-two physically active individuals in good general health who did not have a history of neck and/or shoulder injury or surgery nor participated in high-level overhead sports or performed upper limb strength training for more than 5 h/week. Interventions Subjects performed the standard KPP and six variations. Electromyographic activity of the three trapezius parts and the SA. Four exercises with a low UT/SA can be selected for rehabilitation of intramuscular balance: standard KPP, KPP with homolateral leg extension, KPP with a wobble board and homolateral leg extension and one-handed KPP. The use of a wobble board during KPP exercises and performance on one hand has no influence on SA electromyographic activity. Heterolateral leg extension during KPP stimulates lower trapezius activity, whereas homolateral leg extension stimulates SA activity. In case of intramuscular scapular imbalance, some exercises are preferable over others because of their low UT/SA ratio. The use of a kinetic chain approach during KPP exercises influences scapular muscle activity.

Quantification of Trapezius Muscle Innervation During Neck Dissections: Cervical Plexus Versus the Spinal Accessory Nerve.

PubMed

Svenberg Lind, Clara; Lundberg, Bertil; Hammarstedt Nordenvall, Lalle; Heiwe, Susanne; Persson, Jonas K E; Hydman, Jonas

2015-11-01

Despite increasing use of selective, nerve-sparing surgical techniques during neck dissections, the reported rate of postoperative paralysis of the trapezius muscle is still high. The aim of the study is to measure and compare motor inflow to the trapezius muscle, in order to better understand the peripheral neuroanatomy. Intraoperative nerve monitoring (electroneurography) in patients undergoing routine neck dissection (n=18). The innervation of the 3 functional parts of the trapezius muscle was mapped and quantified through compound muscle action potentials. In 18/18 (100%) of the patients, the spinal accessory nerve (SAN) innervated all parts of the trapezius muscle. In 7/18 (39%) of the patients, an active motor branch from the cervical plexus was detected, equally distributed to all functional parts of the trapezius muscle, at levels comparable to the SAN. Compared to the SAN, branches from cervical plexus provide a significant amount of neural input to all parts of the trapezius muscle. Intraoperative nerve monitoring can be used in routine neck dissections to detect these branches, which may be important following surgical injury to the SAN. © The Author(s) 2015.

Effects of gender and hand dominance on size of the lower trapezius muscle.

PubMed

Uthaikhup, Sureeporn; Wannaprom, Nipaporn; Kummaung, Panuwat

2015-10-01

The influence of gender and hand dominance on the size of the lower trapezius muscle has not been studied. We aimed to identify the effects of gender and hand dominance on thickness of this muscle. Thirty healthy subjects (15 men and 15 women) were recruited for the study. The thickness of the lower trapezius muscles was measured bilaterally at the level of T8 at rest and with contraction at 130° of shoulder abduction using ultrasound imaging. Men had significantly greater thickness of the lower trapezius muscle than women, both at rest and with contraction (P < 0.01). Greater lower trapezius muscle thickness was found on the dominant side compared with the non-dominant side (P < 0.05). Gender and side dominance differences should be controlled for when investigating lower trapezius muscle thickness. © 2015 Wiley Periodicals, Inc.

Friction massage versus kinesiotaping for short-term management of latent trigger points in the upper trapezius: a randomized controlled trial.

PubMed

Mohamadi, Marzieh; Piroozi, Soraya; Rashidi, Iman; Hosseinifard, Saeed

2017-01-01

Latent trigger points in the upper trapezius muscle may disrupt muscle movement patterns and cause problems such as cramping and decreased muscle strength. Because latent trigger points may spontaneously become active trigger points, they should be addressed and treated to prevent further problems. In this study we compared the short-term effect of kinesiotaping versus friction massage on latent trigger points in the upper trapezius muscle. Fifty-eight male students enrolled with a stratified sampling method participated in this single-blind randomized clinical trial (Registration ID: IRCT2016080126674N3) in 2016. Pressure pain threshold was recorded with a pressure algometer and grip strength was recorded with a Collin dynamometer. The participants were randomly assigned to two different treatment groups: kinesiotape or friction massage. Friction massage was performed daily for 3 sessions and kinesiotape was used for 72 h. One hour after the last session of friction massage or removal of the kinesiotape, pressure pain threshold and grip strength were evaluated again. Pressure pain threshold decreased significantly after both friction massage (2.66 ± 0.89 to 2.25 ± 0.76; P  = 0.02) and kinesiotaping (2.00 ± 0.74 to 1.71 ± 0.65; P  = 0.01). Grip strength increased significantly after friction massage (40.78 ± 9.55 to 42.17 ± 10.68; P  = 0.03); however there was no significant change in the kinesiotape group (39.72 ± 6.42 to 40.65 ± 7.3; P  = 0.197). There were no significant differences in pressure pain threshold (2.10 ± 0.11 & 1.87 ± 0.11; P  = 0.66) or grip strength (42.17 ± 10.68 & 40.65 ± 7.3; P  = 0.53) between the two study groups. Friction massage and kinesiotaping had identical short-term effects on latent trigger points in the upper trapezius. Three sessions of either of these two interventions did not improve latent trigger points. Registration ID in IRCT: IRCT2016080126674N3.

Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

PubMed

Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

2012-07-01

To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (P<0.001) were found; pectoralis major, infraspinatus, upper trapezius, and scalene muscles showed the largest referred pain areas (P<0.01), whereas the temporalis, masseter, and splenius capitis muscles showed the smallest (P<0.05). The combination of the referred pain from TrPs reproduced the overall clinical pain area in all participants. Blue-collar and white-collar workers exhibited a similar number of TrPs in the upper quadrant musculature. The referred pain elicited by active TrPs reproduced the overall pain pattern. The distribution of TrPs was not significantly different between groups. Clinicians should examine for the presence of muscle TrPs in blue-collar and white-collar workers.

The Trapezius Muscle Flap: A Viable Alternative for Posterior Scalp and Neck Reconstruction.

PubMed

Yang, Hee Jun; Lee, Dong Hun; Kim, Yang Woo; Lee, Sang Gu; Cheon, Young Woo

2016-11-01

The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigate the vascular anatomy of trapezius flaps in Asians in order to obtain information facilitating the safe design and elevation of flaps in which most of the muscle is preserved. A retrospective chart review was performed of 10 patients who underwent trapezius muscle flap for posterior neck and scalp defects. We also performed an anatomical study of 16 flaps harvested from 8 preserved Asian adult cadavers and evaluated the main landmarks relevant for trapezius muscle flap. In the anatomical study, the mean vertical height from the inferior angle of the scapula to the point at which the superficial cervical artery penetrated the trapezius was 4.31±2.14 cm. The mean vertical height of the trapezius muscle flap pivot point was 9.53±2.08 cm from the external occipital protuberance. Among the 10 flaps, partial necrosis on the overlaid skin graft occurred in 1 patient and postoperative seroma occurred in another patient. Vascular variations in the trapezius muscle flap are uncommon in Asians, but when present, such variations appear to have little impact on harvesting the flap or on its circulation. The trapezius muscle flap is a viable alternative for posterior neck and scalp reconstruction.

The Trapezius Muscle Flap: A Viable Alternative for Posterior Scalp and Neck Reconstruction

PubMed Central

Yang, Hee Jun; Kim, Yang Woo; Lee, Sang Gu

2016-01-01

Background The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigate the vascular anatomy of trapezius flaps in Asians in order to obtain information facilitating the safe design and elevation of flaps in which most of the muscle is preserved. Methods A retrospective chart review was performed of 10 patients who underwent trapezius muscle flap for posterior neck and scalp defects. We also performed an anatomical study of 16 flaps harvested from 8 preserved Asian adult cadavers and evaluated the main landmarks relevant for trapezius muscle flap. Results In the anatomical study, the mean vertical height from the inferior angle of the scapula to the point at which the superficial cervical artery penetrated the trapezius was 4.31±2.14 cm. The mean vertical height of the trapezius muscle flap pivot point was 9.53±2.08 cm from the external occipital protuberance. Among the 10 flaps, partial necrosis on the overlaid skin graft occurred in 1 patient and postoperative seroma occurred in another patient. Conclusions Vascular variations in the trapezius muscle flap are uncommon in Asians, but when present, such variations appear to have little impact on harvesting the flap or on its circulation. The trapezius muscle flap is a viable alternative for posterior neck and scalp reconstruction. PMID:27896183

Ciliary muscle contraction force and trapezius muscle activity during manual tracking of a moving visual target.

PubMed

Domkin, Dmitry; Forsman, Mikael; Richter, Hans O

2016-06-01

Previous studies have shown an association of visual demands during near work and increased activity of the trapezius muscle. Those studies were conducted under stationary postural conditions with fixed gaze and artificial visual load. The present study investigated the relationship between ciliary muscle contraction force and trapezius muscle activity across individuals during performance of a natural dynamic motor task under free gaze conditions. Participants (N=11) tracked a moving visual target with a digital pen on a computer screen. Tracking performance, eye refraction and trapezius muscle activity were continuously measured. Ciliary muscle contraction force was computed from eye accommodative response. There was a significant Pearson correlation between ciliary muscle contraction force and trapezius muscle activity on the tracking side (0.78, p<0.01) and passive side (0.64, p<0.05). The study supports the hypothesis that high visual demands, leading to an increased ciliary muscle contraction during continuous eye-hand coordination, may increase trapezius muscle tension and thus contribute to the development of musculoskeletal complaints in the neck-shoulder area. Further experimental studies are required to clarify whether the relationship is valid within each individual or may represent a general personal trait, when individuals with higher eye accommodative response tend to have higher trapezius muscle activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

The abnormalities of trapezius muscle might be a component of Poland's syndrome.

PubMed

Yiyit, Nurettin; Işıtmangil, Turgut; Oztürker, Coşkun

2014-11-01

Poland's syndrome is a rare unilateral congenital anomaly characterized by the absence of the pectoral muscle and hand anomalies. By the time, new components including the absence or hypoplasia of many muscles have been identified, however, the anomalies of trapezius muscle have not been reported in patients with Poland's syndrome. The accepted etiological theory is the temporary interruption of blood supply of the subclavian artery and its branches in the early gestational period. The artery of the trapezius muscle is also one of the branches of subclavian artery. Just because of that, it is likely to trapezius muscle be affected in patients with Poland's syndrome. We are presenting a case of Poland's syndrome associated with unilateral partial absence of trapezius muscle to support this hypothesis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of a worktable position on head and shoulder posture and shoulder muscles in manual material handling.

PubMed

Kim, Min-Hee; Yoo, Won-Gyu

2015-06-05

According to a recent research, manual working with high levels of static contraction, repetitive loads, or extreme working postures involving the neck and shoulder muscles causes an increased risk of neck and shoulder musculoskeletal disorders. We investigated the effects of the forwardly worktable position on head and shoulder angles and shoulder muscle activity in manual material handling tasks. The forward head and shoulder angles and the activity of upper trapezius, levator scapulae, and middle deltoid muscle activities of 15 workers were measured during performing of manual material handling in two tasks that required different forward head and shoulder angles. The second manual material task required a significantly increased forward head and shoulder angle. The upper trapezius and levator scapulae muscle activity in second manual material task was increased significantly compared with first manual material task. The middle deltoid muscle activity in second manual material task was not significantly different compared with first manual material task. Based on this result, the forward head and shoulder angles while performing manual work need to be considered in selection of the forward distance of a worktable form the body. The high level contractions of the neck and shoulder muscles correlated with neck and shoulder pain. Therefore, the forward distance of a worktable can be an important factor in preventing neck and shoulder pain in manual material handling workers.

An electromyographic analysis of shoulder muscle activation during push-up variations on stable and labile surfaces.

PubMed

Sandhu, Jaspal S; Mahajan, Shruti; Shenoy, Shweta

2008-04-01

Numerous exercises are used to strengthen muscles around the shoulder joint including the push-up and the push-up plus. An important consideration is the addition of surface instability in the form of swiss ball for rehabilitation and strength. The justification for the use of the swiss ball is based on its potential for increasing muscular demand required to maintain postural stability and for improving joint proprioception. Evidence for this is lacking in literature. To compare the myoelectric amplitude of shoulder muscles during push-ups on labile and stable surface. Same subject experimental study. Thirty healthy male subjects in the age group 20-30 years with a mean height of 173.65 cm (+/- SD 2.56) and a mean weight of 69.9 kg (+/-SD 0.2) were taken. Surface electromyogram was recorded from triceps, pectoralis major, serratus anterior and upper trapezius while performing push-up and push-up plus exercises, both on labile and stable surface. Significant increase in muscle activity was observed in pectoralis major and triceps muscle (only during eccentric phase of elbow pushups), while serratus anterior and upper trapezius showed no change in activation level on swiss ball. The addition of a swiss ball is capable of influencing shoulder muscle activity during push-up variations, although the effect is task and muscle dependent.

Activation of the serratus anterior and upper trapezius in a population with winged and tipped scapulae during push-up-plus and diagonal shoulder-elevation.

PubMed

Park, Se-Yeon; Yoo, Won-Gyu

2015-01-01

Scapular winging and tipping are types of abnormal scapular kinematics, which is caused by not only the entrapment of peripheral nerve, but also imbalance of the scapulothoracic musculatures. The purpose of this study was to investigate the presence of muscular imbalance in the middle and lower parts of the serratus anterior and upper trapezius in people with scapular winging and tipping. Twenty male participants (age, 23.0 ± 1.92 y) were placed into symptomatic group (n = 10) and control group (n = 10). Participants completed two individual trials of a push-up plus, and a diagonal shoulder elevation, while electromyography (EMG) recorded muscle activity of the low and middle serratus anterior and upper trapezius. The root mean squared EMG values for three muscles were normalized using maximum voluntary isometric contractions (%MVIC). The value was calculated using modified isolation equation for comparing activation of middle and lower serratus anterior (%isolation). During a diagonal shoulder elevation, the % maximal voluntary isometric contraction (%MVIC) data showed that the symptomatic participants had significantly greater activation of the middle serratus anterior compared to the control group (P = 0.01). During a diagonal shoulder elevation, the symptomatic participants had not only significantly increased %isolation of the middle serratus anterior, but also significantly decreased for the lower serratus anterior compare with the control group (p = 0.00). Present result indicated that different muscle activation between middle and lower serratus anterior could represent in group with scapular dyskinesis, and need for selective activation of the lower serratus anterior in patients with scapular winging and tipping.

Muscle Activation during Push-Ups with Different Suspension Training Systems.

PubMed

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C; Martín, Fernando F; Rogers, Michael E; Behm, David G; Andersen, Lars L

2014-09-01

The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key PointsCompared with standard push-ups on the floor, suspended push-ups increase core muscle activation.A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity.More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation.A suspended push-up is an effective method to achieve high muscle activity levels in the ABS.

Muscle Activation during Push-Ups with Different Suspension Training Systems

PubMed Central

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C.; Martín, Fernando F; Rogers, Michael E.; Behm, David G.; Andersen, Lars L.

2014-01-01

The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key Points Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation. A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity. More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation. A suspended push-up is an effective method to achieve high muscle activity levels in the ABS. PMID:25177174

Endurance and fatigue characteristics in the neck muscles during sub-maximal isometric test in patients with cervical radiculopathy.

PubMed

Halvorsen, Marie; Abbott, Allan; Peolsson, Anneli; Dedering, Åsa

2014-03-01

The aim of the study was to compare myoelectric manifestation in neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance test in patients with cervical radiculopathy and asymptomatic subjects. An additional aim was to explore associations between primary neck muscle endurance, myoelectric fatigability, and self-rated levels of fatigue, pain and subjective health measurements in patients with cervical radiculopathy. Muscle fatigue in the ventral and dorsal neck muscles was assessed in patients with cervical radiculopathy and in an asymptomatic group during an isometric neck muscle endurance test in prone and supine. 46 patients and 34 asymptomatic subjects participated. Surface electromyography signals were recorded from the sternocleidomastoid, cervical paraspinal muscles and upper and middle trapezius bilaterally during the endurance test. Subjective health measurements were assessed with questionnaires. The results showed altered neck muscle endurance in several of the muscles investigated with greater negative median frequency slope, greater variability, side imbalance, lower endurance time and higher experience of fatigue among the cervical radiculopathy patients compared with healthy subjects. Endurance times were significantly lower in both prone and in supine positions between the patients compared to asymptomatic subjects. During the neck muscle endurance test, fatigues in the upper trapezius muscles during the prone test and in the sternocleidomastoid muscles during the supine test were of more importance than self-perceived pain, fatigue, disability and kinesiophobia in predicting neck muscle endurance (NME). NME testing in the primary neck muscles seems to be an important factor to take into consideration in rehabilitation.

Wearing an Inflatable Vest Alters Muscle Activation and Trunk Angle While Paddling a Surfboard.

PubMed

Nessler, Jeff A; Hastings, Thomas; Greer, Kevin; Newcomer, Sean C

2017-08-01

Low back pain is a commonly reported problem among recreational surfers. Some individuals report that wearing a vest with an inflatable bladder that alters trunk angle may help to alleviate pain. The purpose of this study was to determine whether such a vest has an effect on muscle activation and extension of the lower back. Twelve recreational surfers completed 12 paddling trials at 1.1 m/s in a swim flume on both a shortboard and a longboard on 2 separate days. Three conditions of no vest, vest uninflated, and vest inflated were presented to participants in random order. Surface EMG and trunk angle were acquired via wireless sensors placed over the right erector spinae, mid-trapezius, upper trapezius, and latissimus dorsi. Wearing the inflated vest affected muscle activation: erector spinae and mid-trapezius demonstrated a significant decrease in activation relative to wearing no vest (12% and 18% respectively, p < .05). Trunk extension was also significantly reduced when the vest was inflated (18% reduction, p < .05). Results were similar for both the short and longboard, though this effect was greater while paddling the larger board. These results suggest that a properly inflated vest can alter trunk extension and muscle activity while paddling a surfboard in water.

Influence of fatigue and velocity on the latency and recruitment order of scapular muscles.

PubMed

Mendez-Rebolledo, Guillermo; Gatica-Rojas, Valeska; Guzman-Muñoz, Eduardo; Martinez-Valdes, Eduardo; Guzman-Venegas, Rodrigo; Berral de la Rosa, Francisco Jose

2018-07-01

To determine the influence of velocity and fatigue on scapular muscle activation latency and recruitment order during a voluntary arm raise task, in healthy individuals. Cross-sectional study. University laboratory. Twenty three male adults per group (high-velocity and low-velocity). Onset latency of scapular muscles [Anterior deltoid (AD), lower trapezius (LT), middle trapezius (MT), upper trapezius (UT), and serratus anterior (SA)] was assessed by surface electromyography. The participants were assigned to one of two groups: low-velocity or high-velocity. Both groups performed a voluntary arm raise task in the scapular plane under two conditions: no-fatigue and fatigue. The UT showed early activation (p < 0.01) in the fatigue condition when performing the arm raise task at a high velocity. At a low velocity and with no muscular fatigue, the recruitment order was MT, LT, SA, AD, and UT. However, the recruitment order changed in the high-velocity with muscular fatigue condition, since the recruitment order was UT, AD, SA, LT, and MT. The simultaneous presence of fatigue and high-velocity in an arm raise task is associated with a decrease in the UT activation latency and a modification of the recruitment order of scapular muscles. Copyright © 2018 Elsevier Ltd. All rights reserved.

Trapezius muscle activity increases during near work activity regardless of accommodation/vergence demand level.

PubMed

Richter, H O; Zetterberg, C; Forsman, M

2015-07-01

To investigate if trapezius muscle activity increases over time during visually demanding near work. The vision task consisted of sustained focusing on a contrast-varying black and white Gabor grating. Sixty-six participants with a median age of 38 (range 19-47) fixated the grating from a distance of 65 cm (1.5 D) during four counterbalanced 7-min periods: binocularly through -3.5 D lenses, and monocularly through -3.5 D, 0 D and +3.5 D. Accommodation, heart rate variability and trapezius muscle activity were recorded in parallel. General estimating equation analyses showed that trapezius muscle activity increased significantly over time in all four lens conditions. A concurrent effect of accommodation response on trapezius muscle activity was observed with the minus lenses irrespective of whether incongruence between accommodation and convergence was present or not. Trapezius muscle activity increased significantly over time during the near work task. The increase in muscle activity over time may be caused by an increased need of mental effort and visual attention to maintain performance during the visual tasks to counteract mental fatigue.

Trapezius Muscle Load, Heart Rate and Time Pressure during Day and Night Shift in Swiss and Japanese Nurses

PubMed Central

NICOLETTI, Corinne; MÜLLER, Christian; TOBITA, Itoko; NAKASEKO, Masaru; LÄUBLI, Thomas

2014-01-01

The aim of the present study was to analyze the activity of the trapezius muscle, the heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts. The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese nurses. The observed rest time of the trapezius muscle was longer for Swiss than for Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius muscle activity showed a different effect for Swiss than for Japanese nurses. It was higher during the day shift of Swiss nurses and higher during the night shift of Japanese nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of the shifts, time pressure increased for Japanese nurses and slightly decreased for those from Switzerland. Considering trapezius muscle activity and time pressure, the nursing profession was more burdening for the examined Japanese nurses than for Swiss nurses. In particular, the night shift for Japanese nurses was characterized by a high trapezius muscle activity and only few rest times for the trapezius muscle. PMID:24633074

Trapezius muscle activity and body movement at the beginning and the end of a workday and during the lunch period in female office employees

PubMed Central

NICOLETTI, Corinne; LÄUBLI, Thomas

2017-01-01

The aim of this study was to analyze the activity of the trapezius muscle and the arm acceleration during the course of a workday in office employees. It was examined if there are significant changes in trapezius muscle activity in the afternoon compared to the morning work period and relationships to the level of arm acceleration during lunchtime. Nineteen female office employees were recruited. A one hour period of the work in the morning, afternoon, and lunchtime were compared. The measures of the trapezius muscle activity and muscle rest time (TR) did not significantly differ between working in the morning (TR: median 10%; range 1%–49) or working in the afternoon (TR: median 18%; range 2%–34%). The 90th percentile of arm acceleration during lunch time significantly correlated with less trapezius muscle activity in the afternoon compared to the morning values (RT: Spearman R=0.80; p<0.01). Differences in the duration and level of trapezius muscle activity were bigger between the subjects than between different work periods or between lunchtime and work. Furthermore it seems that higher arm accelerations during lunch may be beneficial in reducing trapezius activity in the afternoon compared to the morning values. PMID:28090066

Trapezius muscle activity and body movement at the beginning and the end of a workday and during the lunch period in female office employees.

PubMed

Nicoletti, Corinne; Läubli, Thomas

2017-04-07

The aim of this study was to analyze the activity of the trapezius muscle and the arm acceleration during the course of a workday in office employees. It was examined if there are significant changes in trapezius muscle activity in the afternoon compared to the morning work period and relationships to the level of arm acceleration during lunchtime. Nineteen female office employees were recruited. A one hour period of the work in the morning, afternoon, and lunchtime were compared. The measures of the trapezius muscle activity and muscle rest time (TR) did not significantly differ between working in the morning (TR: median 10%; range 1%-49) or working in the afternoon (TR: median 18%; range 2%-34%). The 90 th percentile of arm acceleration during lunch time significantly correlated with less trapezius muscle activity in the afternoon compared to the morning values (RT: Spearman R=0.80; p<0.01). Differences in the duration and level of trapezius muscle activity were bigger between the subjects than between different work periods or between lunchtime and work. Furthermore it seems that higher arm accelerations during lunch may be beneficial in reducing trapezius activity in the afternoon compared to the morning values.

Trapezius muscle load, heart rate and time pressure during day and night shift in Swiss and Japanese nurses.

PubMed

Nicoletti, Corinne; Müller, Christian; Tobita, Itoko; Nakaseko, Masaru; Läubli, Thomas

2014-01-01

The aim of the present study was to analyze the activity of the trapezius muscle, the heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts. The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese nurses. The observed rest time of the trapezius muscle was longer for Swiss than for Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius muscle activity showed a different effect for Swiss than for Japanese nurses. It was higher during the day shift of Swiss nurses and higher during the night shift of Japanese nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of the shifts, time pressure increased for Japanese nurses and slightly decreased for those from Switzerland. Considering trapezius muscle activity and time pressure, the nursing profession was more burdening for the examined Japanese nurses than for Swiss nurses. In particular, the night shift for Japanese nurses was characterized by a high trapezius muscle activity and only few rest times for the trapezius muscle.

Muscle activity levels in upper-body push exercises with different loads and stability conditions.

PubMed

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan Carlos; Martin, Fernando; Rogers, Michael E

2014-11-01

Exercises that aim to stimulate muscular hypertrophy and increase neural drive to the muscle fibers should be used during rehabilitation. Thus, it is of interest to identify optimal exercises that efficiently achieve high muscle activation levels. The purpose of this study was to compare the muscle activation levels during push-up variations (ie, suspended push-ups with/without visual input on different suspension systems, and push-ups on the floor with/without additional elastic resistance) with the bench press exercise and the standing cable press exercise both performed at 50%, 70%, and 85% of the 1-repetition maximum. Young fit male university students (N = 29) performed 3 repetitions in all conditions under the same standardized procedures. Average amplitude of the electromyogram (EMG) root mean square for the rectus abdominis, external oblique, sternocostal head of the pectoralis major, anterior deltoid, long head of the triceps brachii, upper trapezius, anterior serratus, and posterior deltoid was recorded. The EMG signals were normalized to the maximum voluntary isometric contraction. The EMG data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Elastic-resisted push-ups induce similar EMG stimulus in the prime movers as the bench press at high loads while also providing a greater core challenge. Suspended push-ups are a highly effective way to stimulate abdominal muscles. Pectoralis major, anterior deltoid, and anterior serratus are highly elicited during more stable pushing conditions, whereas abdominal muscles, triceps brachii, posterior deltoid, and upper trapezius are affected in the opposite manner.

Scapular Bracing and Alteration of Posture and Muscle Activity in Overhead Athletes With Poor Posture

PubMed Central

Cole, Ashley K; McGrath, Melanie L; Harrington, Shana E; Padua, Darin A; Rucinski, Terri J; Prentice, William E

2013-01-01

Context Overhead athletes commonly have poor posture. Commercial braces are used to improve posture and function, but few researchers have examined the effects of shoulder or scapular bracing on posture and scapular muscle activity. Objective To examine whether a scapular stabilization brace acutely alters posture and scapular muscle activity in healthy overhead athletes with forward-head, rounded-shoulder posture (FHRSP). Design Randomized controlled clinical trial. Setting Applied biomechanics laboratory. Patients or Other Participants Thirty-eight healthy overhead athletes with FHRSP. Intervention(s) Participants were assigned randomly to 2 groups: compression shirt with no strap tension (S) and compression shirt with the straps fully tensioned (S + T). Posture was measured using lateral-view photography with retroreflective markers. Electromyography (EMG) of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) in the dominant upper extremity was measured during 4 exercises (scapular punches, W's, Y's, T's) and 2 glenohumeral motions (forward flexion, shoulder extension). Posture and exercise EMG measurements were taken with and without the brace applied. Main Outcome Measure(s) Head and shoulder angles were measured from lateral-view digital photographs. Normalized surface EMG was used to assess mean muscle activation of the UT, MT, LT, and SA. Results Application of the brace decreased forward shoulder angle in the S + T condition. Brace application also caused a small increase in LT EMG during forward flexion and Y's and a small decrease in UT and MT EMG during shoulder extension. Brace application in the S + T group decreased UT EMG during W's, whereas UT EMG increased during W's in the S group. Conclusions Application of the scapular brace improved shoulder posture and scapular muscle activity, but EMG changes were highly variable. Use of a scapular brace might improve shoulder posture and muscle activity in overhead athletes with poor posture. PMID:23672321

Rehabilitative ultrasound measurement of trapezius muscle contractile states in people with mild shoulder pain.

PubMed

O'Sullivan, Cliona; McCarthy Persson, Ulrik; Blake, Catherine; Stokes, Maria

2012-04-01

The utility of rehabilitative ultrasound imaging (RUSI) for assessing trapezius muscle contractile characteristics was investigated by examining whether muscle thickness changes during contraction (CT) differed between people with and without mild shoulder pain. In 18 subjects with mild shoulder pain (aged 28±8 years) and 18 matched controls, trapezius muscle thickness change was measured in prone at rest at 0° and during isometric CTs at 90° and 120° of shoulder abduction. Images were taken at four sites using a real-time ultrasound scanner (7-MHz linear transducer, 40 mm footprint). Percentage change in muscle thickness from rest was calculated. Differences between painful and non-painful shoulders and participant groups were examined by analysis of variance (ANOVA) and t-tests. There were no significant differences between groups or sides in trapezius muscle thickness change during CT. There was no significant difference in trapezius muscle resting thickness (RT) between painful and non-painful shoulders in the same subjects. Contractile ability of the trapezius muscle, assessed using RUSI was not impaired in subjects with mild shoulder pain during the test manoeuvres used. Further research is warranted involving patients with different severity of symptoms, using other test manoeuvres before RUSI can be advocated for assessing scapular muscle dysfunction. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quantitative Anatomy of the Trapezius Muscle in the Human Fetus.

PubMed

Badura, Mateusz; Grzonkowska, Magdalena; Baumgart, Mariusz; Szpinda, Michał

2016-01-01

The trapezius muscle consists of three parts that are capable of functioning independently. Its superior part together with the levator scapulae and rhomboids elevate the shoulder, the middle part retracts the scapula, while the inferior part lowers the shoulder. The present study aimed to supplement numerical data and to provide growth dynamics of the trapezius in the human fetus. Using methods of anatomical dissection, digital image analysis (NIS Elements AR 3.0), and statistics (Student's t-test, regression analysis), we measured the length, the width and the surface area of the trapezius in 30 fetuses of both sexes (13™ k,17™ … ) aged 13-19 weeks. Neither sex nor laterality differences were found. All the studied parameters of the trapezius increased proportionately with age. The linear functions were computed as follows: y = -103.288 + 10.514 × age (r = 0.957) for total length of the trapezius muscle, y = -67.439 + 6.689 × age (r = 0.856) for length of its descending part, y = -8.493 + 1.033 × age (r = 0.53) for length of its transverse part, y = -27.545 + 2.802 × age (r = 0.791) for length of its ascending part, y = -19.970 + 2.505 × age (r = 0.875) for width of the trapezius muscle, and y = -2670.458 + 212.029 × age (r = 0.915) for its surface area. Neither sex nor laterality differences exist in the numerical data of the trapezius muscle in the human fetus. The descending part of trapezius is the longest, while its transverse part is the shortest. The growth dynamics of the fetal trapezius muscle follows proportionately.

Loads Carried by Soldiers: Historical, Physiological, Biomechanical and Medical Aspects

DTIC Science & Technology

1989-06-01

EMG and cinematographic data in the study of load carriage. They showed that EMG activity of the trapezius, rectus femorls, gastrocnemus and erector... abdominal muscles. Backpack loads of 18 to 27 kg did not change the magnitude of this pressure while walking (45). MEDICAL ASPECTS RUCKSACK PARALYSIS...symptoms included minor pain , paresthesias, numbness and paralysis of the upper extremities. The shoulder girdle and elbow flexor muscle groups were usually

Inhibiting the Physiological Stress Effects of a Sustained Attention Task on Shoulder Muscle Activity.

PubMed

Wixted, Fiona; O'Riordan, Cliona; O'Sullivan, Leonard

2018-01-11

The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing operators often monitor automated process for long periods of their work shift. Prolonged monitoring work requires sustained attention, which is a cognitive process that humans are typically poor at and find stressful. As sustained attention becomes an increasing requirement of manufacturing operators' job content, the resulting stress experienced could contribute to the onset of many health problems, including work related musculoskeletal disorders (WRMSDs). The SART attention test was completed by a group of participants before and after a breathing intervention exercise. The effects of the abdominal breathing intervention on breathing rate, upper trapezius muscle activity and end-tidal CO₂ were evaluated. The breathing intervention reduced the moderation effect of end-tidal CO₂ on upper trapezius muscle activity. Abdominal breathing could be a useful technique in reducing the effects of sustained attention work on muscular activity. This research can be applied to highly-automated manufacturing industries, where prolonged monitoring of work is widespread and could, in its role as a stressor, be a potential contributor to WRMSDs.

Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions.

PubMed

Castelein, Birgit; Cagnie, Barbara; Parlevliet, Thierry; Danneels, Lieven; Cools, Ann

2015-10-01

To identify maximum voluntary isometric contraction (MVIC) test positions for the deeper-lying scapulothoracic muscles (ie, levator scapulae, pectoralis minor, rhomboid major), and to provide a standard set of a limited number of test positions that generate an MVIC in all scapulothoracic muscles. Cross-sectional study. Physical and rehabilitation medicine department. Healthy subjects (N=21). Not applicable. Mean peak electromyographic activity from levator scapulae, pectoralis minor, and rhomboid major (investigated with fine-wire electromyography) and from upper trapezius, middle trapezius, lower trapezius, and serratus anterior (investigated with surface electromyography) during the performance of 12 different MVICs. The results indicated that various test positions generated similar high mean electromyographic activity and that no single test generated maximum activity for a specific muscle in all subjects. The results of this study support using a series of test positions for normalization procedures rather than a single exercise to increase the likelihood of recruiting the highest activity in the scapulothoracic muscles. A standard set of 5 test positions was identified as being sufficient for generating an MVIC of all scapulothoracic muscles: seated T, seated U 135°, prone T-thumbs up, prone V-thumbs up, and supine V-thumbs up. A standard set of test positions for normalization of scapulothoracic electromyographic data that also incorporates the levator scapulae, pectoralis minor, and rhomboid major muscles is 1 step toward a more comprehensive understanding of normal and abnormal muscle function of these muscles and will help to standardize the presentation of scapulothoracic electromyographic muscle activity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A comparison of hemisphere-specific training pattern in Inter-limb Learning Transfer (ILT) for stroke patients with hemiparesis.

PubMed

Yoo, In-gyu; Jung, Min-ye; Yoo, Eun-young; Park, Ji-hyuk; Kang, Dae-hyuk; Lee, Jin

2014-01-01

Stroke patients have major problems with impaired upper-extremity function. Unfortunately, many patients do not experience a full recovery from movement deficits in the upper extremities. The purpose of this study was to compare the effectiveness of inter-limb learning transfer (ILT) to the contralateral upper limb after both hemisphere-specific and -unspecific ipsilateral upper limb training for stroke patients with hemiparesis. Twenty-four stroke patients with hemiparesis participated. The hemisphere-specific training group performed reaching movements in a customized training setting in which non-dominant limb training participants began from a single starting location and proceeded to one of three target locations (1S3T condition); the dominant limb training participants started from one of three starting locations and proceeded to a single target location (3S1T condition). The hemisphere-unspecific training group performed these movements starting under reverse-start and target conditions. The non-dominant to dominant limb transfer, the hemisphere-specific training group performance time decreased significantly as compared with the pre-training session (p < 0.05). Also, the isolation contraction ratio was decreased significantly from that of the pre-training session in the biceps brachii muscles and increased significantly in the upper trapezius muscles (p < 0.05). And, dominant to non-dominant limb transfer in the hemisphere-specific training group significantly increased RMS amplitudes from the pre-training session in the biceps brachii and triceps muscles (p < 0.05). Also, the isolation contraction ratio was increased significantly from that of the pre-training session in the biceps brachii muscles and decreased significantly in the upper trapezius muscles (p < 0.05). However, the hemisphere-unspecific training group showed no significant differences in inter-limb learning transfer (ILT). The transfer of hemisphere-specific training from one arm to the other had a more positive influence on functional recovery than did hemisphere-unspecific training for patients with stroke and hemiparesis.

Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

PubMed

Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

2012-12-01

Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

Spinal muscle activity in simulated rugby union scrummaging is affected by different engagement conditions.

PubMed

Cazzola, D; Stone, B; Holsgrove, T P; Trewartha, G; Preatoni, E

2016-04-01

Biomechanical studies of rugby union scrummaging have focused on kinetic and kinematic analyses, while muscle activation strategies employed by front-row players during scrummaging are still unknown. The aim of the current study was to investigate the activity of spinal muscles during machine and live scrums. Nine male front-row forwards scrummaged as individuals against a scrum machine under "crouch-touch-set" and "crouch-bind-set" conditions, and against a two-player opposition in a simulated live condition. Muscle activities of the sternocleidomastoid, upper trapezius, and erector spinae were measured over the pre-engagement, engagement, and sustained-push phases. The "crouch-bind-set" condition increased muscle activity of the upper trapezius and sternocleidomastoid before and during the engagement phase in machine scrummaging. During the sustained-push phase, live scrummaging generated higher activities of the erector spinae than either machine conditions. These results suggest that the pre-bind, prior to engagement, may effectively prepare the cervical spine by stiffening joints before the impact phase. Additionally, machine scrummaging does not replicate the muscular demands of live scrummaging for the erector spinae, and for this reason, we advise rugby union forwards to ensure scrummaging is practiced in live situations to improve the specificity of their neuromuscular activation strategies in relation to resisting external loads. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Changes in shoulder muscle size and activity following treatment for breast cancer.

PubMed

Shamley, Delva R; Srinanaganathan, Ragavan; Weatherall, Rosamund; Oskrochi, Reza; Watson, Marion; Ostlere, Simon; Sugden, Elaine

2007-11-01

Morbidity of the shoulder after breast cancer is a well-known phenomenon. MRI studies have shown muscle morbidity in cervical cancer and prostate cancer. In breast cancer clinical observations and patient reports include muscle morbidity in a number of muscles acting at the shoulder. Several of these muscles lie in the field of surgery and radiotherapy. Timed interaction between muscles that stabilise the shoulder and those acting as prime movers is essential to achieve a smooth scapulohumeral rthythm during functional elevation of the arm. CROSS-SECTIONAL STUDY: Seventy-four women treated for unilateral carcinoma of the breast were included in the study. All patients filled out the Shoulder Pain and Disability Index (SPADI). EMG activity of four muscles was recorded during scaption on the affected and unaffected side. Muscle cross sectional area and signal intensity was determined from MRI scans. The association between EMG and covariates was determined using multiple linear regression techniques. Three of the 4 muscles on the affected side demonstrated significantly less EMG activity, particularly when lowering the arm. Upper trapezius demonstrated the greatest loss in activity. Decreased activity in both upper trapezius and rhomboid were significantly associated with an increase in SPADI score and increased time since surgery. Pectoralis major and minor were significantly smaller on the affected side. Muscles affected in the long term are the muscles associated with pain and disability yet are not in the direct field of surgery or radiotherapy. Primary muscle shortening and secondary loss of muscle activity may be producing a movement disorder similar to the 'Dropped Shoulder Syndrome'. Exercise programmes should aim not only for range of movement but also for posture correction and education of potential long-term effects.

A comparison of trapezius muscle activities of different shoulder abduction angles and rotation conditions during prone horizontal abduction

PubMed Central

Lim, Jin Yong; Lee, Jung Seok; Mun, Byeong Mu; Kim, Tae Ho

2015-01-01

[Purpose] This study examined the differences in the activities of three parts of the trapezius muscle—the upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT)—among three different rotation conditions of the shoulders, while subjects performed prone horizontal abduction (PHA) at 30°, 60°, 90°, and 120° of abduction. [Subjects and Methods] The subjects of this experimental study were 16 healthy male adults. Surface electromyography was used to collect data on the activity of each part of the trapezius. A two-way analysis of variance was used to compare the activities of each area of the trapezius—the UT, MT, and LT—among internal rotation (IR), the neutral position (NP), and external rotation (ER) of the shoulders during PHA with shoulder abduction of 30°, 60°, 90°, and 120°. [Results] Activity of the UT, MT, and LT significantly increased as the shoulder abduction angle increased during PHA. There was a significant difference only in the activity of the LT, with change in shoulder rotation. In addition, the muscle activity of the LT was highest during shoulder IR at 120°. [Conclusion] Although activity of the LT was the highest during IR at 120 abduction, PHA accompanied by ER at an abduction angle of 120° would be effective at eliciting high activity in the LT when PHA is performed. Nonetheless, at an early stage of rehabilitation, PHA accompanied by ER at low abduction angles of 30° and 60° would be desirable to elicit low activity of the UT and high activity of the LT. PMID:25642047

Pressure pain sensitivity maps of the neck-shoulder and the low back regions in men and women.

PubMed

Binderup, Asbjørn T; Arendt-Nielsen, Lars; Madeleine, Pascal

2010-10-12

Musculoskeletal pain in the low back and neck-shoulder regions is a major problem among the working population all over the world. The prevalence of musculoskeletal pain is found to be higher among women. Women also have lower pressure pain thresholds (PPTs) than men. Pressure pain topography aims at mapping the spatial distribution of PPT within a muscle in an attempt to track changes in mechanical sensitivity. In order to assess gender differences in the pain topography, it is necessary to map the distribution in both healthy men and women. The aim of this study was to assess PPT maps from the cervico-thoracic and lumbar regions in men and women. Eleven men and eleven women without any known musculoskeletal disorders participated in the study. PPT was measured twice at 36 points over the trapezius muscle of the dominant arm, at 36 points over the trapezius muscle on the contralateral side and at 12 points over the spine between the left and right trapezius. Further, 11 points were measured over the erector spinae muscle on the left side of the spine between the first and the fifth lumbar vertebrae, 11 on the right side and 5 points on the spine itself. The measurements on each trapezius muscle were divided according to anatomical subdivisions. Three-way and two-way ANOVAs were used to analyse the differences in PPTs with the following factors: gender, locations and sub-divisions (only for cervico-thoracic region). There were no differences between left and right side in neither the cervico-thoracic nor the lumbar region, but there were (large effect) differences between the subdivisions in the trapezius with the lowest values in the upper part (P < 0.001; partial η2 = 0.19). Women had (small effect) lower PPT in both cervico-thoracic and lumbar regions (P ≤ 0.001; partial η2 = 0.02 for both regions), but gender had no effect on neither location nor subdivisions. The pain topography was not found to be different between genders in the cervico-thoracic and lumbar regions. This study can be used as basis for further clinical studies on musculoskeletal disorders.

Effects of scapular taping on the activity onset of scapular muscles and the scapular kinematics in volleyball players with rotator cuff tendinopathy.

PubMed

Leong, Hio Teng; Ng, Gabriel Yin-Fat; Fu, Siu Ngor

2017-06-01

To examine the effect of scapular taping on the activity onset of scapular muscles and the scapular kinematics during arm elevation in volleyball players with rotator cuff (RC) tendinopathy. Randomized placebo-controlled repeated measures METHODS: Twenty-six male volleyball players with RC tendinopathy (mean age=23.6±3.3years) participated in the study. Electromyography (EMG) activity onset of upper trapezius (UT), middle trapezius (MT), lower trapezius (LT) and serratus anterior (SA) and the three-dimensional scapular kinematics quantified by using an acromial marker cluster method were compared with three scapular taping protocols, namely, no taping, therapeutic taping, and placebo taping. The MT, LT and SA activated significantly earlier in both therapeutic taping (all p<0.005) and placebo taping conditions than no taping conditions (all p<0.002). There was a small increase in the scapular upward rotation when therapeutic taping and no taping conditions were compared (p=0.007). Scapular taping may enhance the neuromotor control of the scapular muscles. Whether it provides adequate support for normal scapular kinematics during arm movement in athletes with RC tendinopathy await for further studies. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Scapular kinematics and muscle activities during pushing tasks.

PubMed

Huang, Chun-Kai; Siu, Ka-Chun; Lien, Hen-Yu; Lee, Yun-Ju; Lin, Yang-Hua

2013-01-01

Pushing tasks are functional activities of daily living. However, shoulder complaints exist among workers exposed to regular pushing conditions. It is crucial to investigate the control of shoulder girdles during pushing tasks. The objective of the study was to demonstrate scapular muscle activities and motions on the dominant side during pushing tasks and the relationship between scapular kinematics and muscle activities in different pushing conditions. Thirty healthy adults were recruited to push a four-wheel cart in six pushing conditions. The electromyographic signals of the upper trapezius (UT) and serratus anterior (SA) muscles were recorded. A video-based system was used for measuring the movement of the shoulder girdle and scapular kinematics. Differences in scapular kinematics and muscle activities due to the effects of handle heights and weights of the cart were analyzed using two-way ANOVA with repeated measures. The relationships between scapular kinematics and muscle activities were examined by Pearson's correlation coefficients. The changes in upper trapezius and serratus anterior muscle activities increased significantly with increased pushing weights in the one-step pushing phase. The UT/SA ratio on the dominant side decreases significantly with increased handle heights in the one-step pushing phase. The changes in upward rotation, lateral slide and elevation of the scapula decreased with increased pushing loads in the trunk-forward pushing phase. This study indicated that increased pushing loads result in decreased motions of upward rotation, lateral slide and elevation of the scapula; decreased handle heights result in relatively increased activities of the serratus anterior muscles during pushing tasks.

Hand rest and wrist support are effective in preventing fatigue during prolonged typing.

PubMed

Callegari, Bianca; de Resende, Marília Maniglia; da Silva Filho, Manoel

Case series (longitudinal). Only few reports concerning the efficacy of commonly used strategies for preventing upper limb occupational disorders associated with prolonged typing exist. We aimed to investigate whether the duration of typing and the use of 2 strategies (hand rest and wrist support) changes muscle physiological response and therefore the electromyography records. We enrolled 25 volunteers, who were unfamiliar with the task and did not have musculoskeletal disorders. The subjects underwent 3 prolonged typing protocols to investigate the efficacy of the 2 adopted strategies in reducing the trapezius, biceps brachii, and extensor digitorum communis fatigue. Typing for 1 hour induced muscular fatigue (60%-67% of the subjects). The extensor digitorum communis muscle exhibited the highest percentage of fatigue (72%-84%) after 1 and 4 hours of typing (1 hour, P = .04; 4 hours, P = .02). Fatigue levels in this muscle were significantly reduced (24%) with the use of pause typing (4 hours, P = .045), whereas biceps brachii muscle fatigue was reduced (32%) only with the use of wrist supports (P = .02, after 4 hours). Trapezius muscle fatigue was unaffected by the tested occupational strategies (1 hour, P = .62; 4 hours, P = .85). Despite presenting an overall tendency for fatigue detected during the application of the protocols, the assessed muscles exhibited different behavior patterns, depending on both the preventive strategy applied and the muscle mechanical role during the task. Hand rest and wrist support can successfully reduce muscle fatigue in specific upper limb muscles during prolonged typing, leading to a muscle-selective reduction in the occurrence of fatigue and thus provide direct evidence that they may prevent work-related musculoskeletal disorders. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point.

PubMed

Yassin, Marzieh; Talebian, Saeed; Ebrahimi Takamjani, Ismail; Maroufi, Nader; Ahmadi, Amir; Sarrafzadeh, Javad; Emrani, Anita

2015-01-01

Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. There was significant differences in motor time and reaction time between active and control groups (p< 0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p< 0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG).

Diagnosis of unilateral trapezius muscle palsy: 54 Cases.

PubMed

Seror, Paul; Stojkovic, Tanya; Lefevre-Colau, Marie Martine; Lenglet, Timothée

2017-08-01

We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n = 22), idiopathic unilateral TM palsy (n = 5), regional neck radiotherapy for different conditions (n = 2), facioscapulohumeral dystrophy (FSH) (n = 4), abnormal loop of the jugular vein (n = 1), or basilar impression (n = 1). Other etiologies were neck surgery (n = 16), cervicofacial lift (n = 2), or trauma (n = 1). There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017. © 2016 Wiley Periodicals, Inc.

Exposure-response relationships for work-related neck and shoulder musculoskeletal disorders--Analyses of pooled uniform data sets.

PubMed

Nordander, Catarina; Hansson, Gert-Åke; Ohlsson, Kerstina; Arvidsson, Inger; Balogh, Istvan; Strömberg, Ulf; Rittner, Ralf; Skerfving, Staffan

2016-07-01

There is a lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal disorders in the neck and shoulders. We explored such relationships in pooled data from a series of our cross-sectional studies. We recorded the prevalence of complaints/discomfort (Nordic Questionnaire) and diagnoses (physical examination) in 33 groups (24 female and 9 male) within which the workers had similar work tasks (3141 workers, of which 817 were males). In representative sub-groups, we recorded postures and velocities of the head (N = 299) and right upper arm (inclinometry; N = 306), right wrist postures and velocities (electrogoniometry; N = 499), and muscular activity (electromyography) in the right trapezius muscle (N = 431) and forearm extensors (N = 206). We also assessed the psychosocial work environment (Job Content Questionnaire). Uni- and multivariate linear meta-regression analysis revealed several statistically significant group-wise associations. Neck disorders were associated with head inclination, upper arm elevation, muscle activity of the trapezius and forearm extensors and wrist posture and angular velocity. Right-side shoulder disorders were associated with head and upper arm velocity, activity in the trapezius and forearm extensor muscles and wrist posture and angular velocity. The psychosocial work environment (low job control, job strain and isostrain) was also associated with disorders. Women exhibited a higher prevalence of neck and shoulder complaints and tension neck syndrome than men, when adjusting for postures, velocities, muscular activity or psychosocial exposure. In conclusion, the analyses established quantitative exposure-response relationships between neck and shoulder disorders and objective measures of the physical workload on the arm. Such information can be used for risk assessment in different occupations/work tasks, to establish quantitative exposure limits, and for the evaluation of preventive measures. Copyright © 2016 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Congenital Partial Absence of Trapezius with Variant Pattern of Rectus Sheath.

PubMed

Tigga, Sarika Rachel; Goswami, Preeti; Khanna, Jugesh

2016-04-01

Musculocutaneous pedicled/free flaps are an essential prerequisite for reconstructive surgery. Amongst the trunk muscles commonly harvested for flaps, the trapezius and rectus abdominis provide satisfactory coverage for cranial and trunk defects. unilateral/bilateral or partial congenital absence of trapezius muscle is well documented and may result in muscular imbalances compromising posture and limb movements. During routine cadaveric dissection, we encountered a case of bilateral partial absence of occipital part of the trapezius muscle. Concurrently, the ventral abdominal musculature displayed the aponeurosis of transversus abdominis muscle solely forming the posterior wall of the rectus sheath. These conjointly occurring anomalies advocate a compensatory strengthening of the anterior wall of rectus sheath in response to the congenital absence of occipital part of the trapezius, probably to counteract the postural instability. The present study focuses on recognition of compensatory mechanisms resulting from congenital variations as identification of such processes may prevent chronic debilitating conditions.

Physiological Strain During Load Carrying: Effects of Mass and Type of Backpack

DTIC Science & Technology

2001-05-01

load did not significantly increase the EMG signal of the trapezius shoulder muscle (pars descenders). While walking, load carrying significantly...descending part of the right trapezius muscle was measured with two surface silver-silver chloride electrodes (PPG, Hellige), positioned on the distal...values using a previously determined RMS versus force relationship. This calibration curve between RMS of the EMG of the trapezius muscle and the force

Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial

PubMed Central

Słupska, Lucyna; Paprocka-Borowicz, Małgorzata; Taradaj, Jakub; Bidzińska, Gabriela; Marczyński, Daniel; Cynarska, Aleksandra; Rosińczuk, Joanna

2015-01-01

Kinesio taping (KT) may be a new treatment in patients with myofascial trigger points (MTrPs). A new method available for taping practitioners is cross taping (CT). The main objective was to determine how CT, KT, and medical adhesive tape (sham group) affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT) in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG) in each group and pain intensity on a visual analog scale (VAS). Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p < 0.001, KT—p < 0.001, and sham—p < 0.01). The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs. PMID:26491458

Protein differences between human trapezius and vastus lateralis muscles determined with a proteomic approach.

PubMed

Hadrévi, Jenny; Hellström, Fredrik; Kieselbach, Thomas; Malm, Christer; Pedrosa-Domellöf, Fatima

2011-08-10

The trapezius muscle is a neck muscle that is susceptible to chronic pain conditions associated with repetitive tasks, commonly referred to as chronic work-related myalgia, hence making the trapezius a muscle of clinical interest. To provide a basis for further investigations of the proteomic traits of the trapezius muscle in disease, two-dimensional difference gel electrophoresis (2D-DIGE) was performed on the healthy trapezius using vastus lateralis as a reference. To obtain as much information as possible from the vast proteomic data set, both one-way ANOVA, with and without false discovery rate (FDR) correlation, and partial least square projection to latent structures with discriminant analysis (PLS-DA) were combined to compare the outcome of the analysis. The trapezius and vastus lateralis showed significant differences in metabolic, contractile and regulatory proteins, with different results depending on choice of statistical approach and pre-processing technique. Using the standard method, FDR correlated one-way ANOVA, 42 protein spots differed significantly in abundance between the two muscles. Complementary analysis using immunohistochemistry and western blot confirmed the results from the 2D-DIGE analysis. The proteomic approach used in the present study combining 2D-DIGE and multivariate modelling provided a more comprehensive comparison of the protein profiles of the human trapezius and vastus lateralis muscle, than previously possible to obtain with immunohistochemistry or SDS-PAGE alone. Although 2D-DIGE has inherent limitations it is particularly useful to comprehensively screen for important structural and metabolic proteins, and appears to be a promising tool for future studies of patients suffering from chronic work related myalgia or other muscle diseases.

Motor control and cardiovascular responses during isoelectric contractions of the upper trapezius muscle: evidence for individual adaptation strategies.

PubMed

Mathiassen, S E; Aminoff, T

1997-01-01

Ten females (25-50 years of age) performed isometric shoulder flexions, holding the right arm straight and in a horizontal position. The subjects were able to see the rectified surface electromyogram (EMG) from either one of two electrode pairs above the upper trapezius muscle and were instructed to keep its amplitude constant for 15 min while gradually unloading the arm against a support. The EMG electrodes were placed at positions representing a "cranial" and a "caudal" region of the muscle suggested previously to possess different functional properties. During the two contractions, recordings were made of: (1) EMG root mean square-amplitude and zero crossing (ZC) frequency from both electrode pairs on the trapezius as well as from the anterior part of the deltoideus, (2) supportive force, (3) heart rate (HR) and mean arterial blood pressure (MAP), and (4) perceived fatigue. The median responses during the cranial isoelectric contraction were small as compared to those reported previously in the literature: changes in exerted glenohumeral torque and ZC rate of the isoelectric EMG signal of -2.81% x min(-1) (P = 0.003) and 0.03% x min(-1) (P = 0.54), respectively, and increases in HR and MAP of 0.14 beats x min(-2) (P = 0.10) and 0.06 mmHg x min(-1) (P = 0.33), respectively. During the contraction with constant caudal EMG amplitude, the corresponding median responses were -2.51% x min(-1) (torque), 0.01% x min(-1) (ZC rate), 0.31 beats x min(-2) (HR), and 0.93 mmHg x min(-1) (MAP); P = 0.001, 0.69, 0.005, and 0.003, respectively. Considerable deviations from the "isoelectric" target amplitude were common for both contractions. Individuals differed markedly in response, and three distinct subgroups of subjects were identified using cluster analysis. These groups are suggested to represent different motor control scenarios, including differential engagement of subdivisions of the upper trapezius, alternating motor unit recruitment and, in one group, a gradual transition towards a greater involvement of type II motor units. The results indicate that prolonged low-level contractions of the shoulder muscles may in general be accomplished with a moderate metabolic stress, but also that neuromuscular adaptation strategies differ significantly between individuals. These results may help to explain why occupational shoulder-neck loads of long duration cause musculoskeletal disorders in some subjects but not in others.

The Effects of Bag Style on Muscle Activity of the Trapezius, Erector Spinae and Latissimus Dorsi During Walking in Female University Students

PubMed Central

Hardie, Rebecca; Haskew, Rachel; Harris, Joel; Hughes, Gerwyn

2015-01-01

Back pain is common in adolescents which has been associated with carrying a bag. However, there is little research examining the effects of bag style in female adolescents. The aim of the study was to investigate the effects of different bag conditions on muscle activity of the trapezius, erector spinae and latissimus dorsi muscles in female university students during walking. Twelve female university students walked on a treadmill for 5 minutes at 1.1 m/s during five conditions; control, 1 strapped rucksack, 2 strapped rucksack, ipsilateral shoulder strap and contralateral shoulder strap, each containing 10% bodyweight. Electromyography for the trapezius, erector spinae and latissimus dorsi was recorded for the last 30 s of each condition. Two-way ANOVA and paired t-tests were used to identify differences between right and left muscles and between bag conditions. Results showed that muscle activity of the left trapezius was significantly higher than the right trapezius during the 1 strap rucksack condition. For the left trapezius, the 2 strapped rucksack and the control condition had significantly lower muscle activity compared to the 1 strapped rucksack and the ipsilateral shoulder strap. For the left erector spinae muscle, there was significantly greater muscle activity when wearing the contralateral shoulder strap compared to the control. For the right erector spinae, significantly lower muscle activity was observed when wearing the 2 strapped rucksack compared to the ipsilateral shoulder strap and contralateral shoulder strap. There were no significant differences in muscle activity of the latissimus dorsi muscles between any of the bag conditions. These findings suggest that a two strapped rucksack should be used when carrying loads to reduce spinal muscle activity which may, in turn, reduce reports of back pain in female adolescents. PMID:25964808

Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task

PubMed Central

Zetterberg, Camilla; Richter, Hans O.; Forsman, Mikael

2015-01-01

Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanism is still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapezius muscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target. PMID:25961299

Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task.

PubMed

Zetterberg, Camilla; Richter, Hans O; Forsman, Mikael

2015-01-01

Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanism is still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapezius muscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.

Effects of visually demanding near work on trapezius muscle activity.

PubMed

Zetterberg, C; Forsman, M; Richter, H O

2013-10-01

Poor visual ergonomics is associated with visual and neck/shoulder discomfort, but the relation between visual demands and neck/shoulder muscle activity is unclear. The aims of this study were to investigate whether trapezius muscle activity was affected by: (i) eye-lens accommodation; (ii) incongruence between accommodation and convergence; and (iii) presence of neck/shoulder discomfort. Sixty-six participants (33 controls and 33 with neck pain) performed visually demanding near work under four different trial-lens conditions. Results showed that eye-lens accommodation per se did not affect trapezius muscle activity significantly. However, when incongruence between accommodation and convergence was present, a significant positive relationship between eye-lens accommodation and trapezius muscle activity was found. There were no significant group-differences. It was concluded that incongruence between accommodation and convergence is an important factor in the relation between visually demanding near work and trapezius muscle activity. The relatively low demands on accommodation and convergence in the present study imply that visually demanding near work may contribute to increased muscle activity, and over time to the development of near work related neck/shoulder discomfort. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

An electromyography study of muscular endurance during the posterior shoulder endurance test.

PubMed

Evans, Neil A; Dressler, Emily; Uhl, Tim

2018-05-31

The primary purpose was to determine if there is a difference between the median frequency slopes of 5 posterior shoulder muscles during the initial portion of the Posterior Shoulder Endurance Test (PSET) at the 90° and 135° shoulder abduction positions. Fifty-five healthy volunteers (31 females) participated. The median frequency of the posterior deltoid (PD), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and infraspinatus (INF) was measured during the PSET at 90° and 135° of shoulder abduction. External torque of 13 ± 1 Nm was used for females and 21 ± 1 Nm for males. A fixed effect multi-variable regression model was used to investigate the median frequency slopes. Males and females were analyzed separately. Median frequency slopes demonstrated fatigue in all 5 of the muscles. The PD fatigued greater than the UT in males (p = 0.0215) and greater than the LT in females (p = 0.008). The time to task failure (TTF) was greater at 90° than 135° for females and males (p = 0.016; p = 0.0193) respectively. The PSET causes fatigue in all of the muscles that were tested, with the PD fatiguing at a greater rate compared to one muscle for each sex. This investigation supports using TTF as a clinical measure of shoulder girdle endurance at 90° shoulder abduction. Copyright © 2018. Published by Elsevier Ltd.

Which causes more ergonomic stress: Laparoscopic or open surgery?

PubMed

Wang, Robert; Liang, Zhe; Zihni, Ahmed M; Ray, Shuddhadeb; Awad, Michael M

2017-08-01

There is increasing awareness of potential ergonomic challenges experienced by the laparoscopic surgeon. The purpose of this study is to quantify and compare the ergonomic stress experienced by a surgeon while performing open versus laparoscopic portions of a procedure. We hypothesize that a surgeon will experience greater ergonomic stress when performing laparoscopic surgery. We designed a study to measure upper-body muscle activation during the laparoscopic and open portions of sigmoid colectomies in a single surgeon. A sample of five cases was recorded over a two-month time span. Each case contained significant portions of laparoscopic and open surgery. We obtained whole-case electromyography (EMG) tracings from bilateral biceps, triceps, deltoid, and trapezius muscles. After normalization to a maximum voltage of contraction (%MVC), these EMG tracings were used to calculate average muscle activation during the open and laparoscopic segments of each procedure. Paired Student's t test was used to compare the average muscle activation between the two groups (*p < 0.05 considered statistically significant). Significant reductions in mean muscle activation in laparoscopic compared to open procedures were noted for the left triceps (4.07 ± 0.44% open vs. 2.65 ± 0.54% lap, 35% reduction), left deltoid (2.43 ± 0.45% open vs. 1.32 ± 0.16% lap, 46% reduction), left trapezius (9.93 ± 0.1.95% open vs. 4.61 ± 0.67% lap, 54% reduction), right triceps (2.94 ± 0.62% open vs. 1.85 ± 0.28% lap, 37% reduction), and right trapezius (10.20 ± 2.12% open vs. 4.69 ± 1.18% lap, 54% reduction). Contrary to our hypothesis, the laparoscopic approach provided ergonomic benefit in several upper-body muscle groups compared to the open approach. This may be due to the greater reach of laparoscopic instruments and camera in the lower abdomen/pelvis. Patient body habitus may also have less of an effect in the laparoscopic compared to open approach. Future studies with multiple subjects and different types of procedures are planned to further investigate these findings.

Rehabilitation Exercises to Induce Balanced Scapular Muscle Activity in an Anti-gravity Posture

PubMed Central

Ishigaki, Tomonobu; Yamanaka, Masanori; Hirokawa, Motoki; Tai, Keita; Ezawa, Yuya; Samukawa, Mina; Tohyama, Harukazu; Sugawara, Makoto

2014-01-01

[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively. PMID:25540485

Rehabilitation Exercises to Induce Balanced Scapular Muscle Activity in an Anti-gravity Posture.

PubMed

Ishigaki, Tomonobu; Yamanaka, Masanori; Hirokawa, Motoki; Tai, Keita; Ezawa, Yuya; Samukawa, Mina; Tohyama, Harukazu; Sugawara, Makoto

2014-12-01

[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively.

Integration of active pauses and pattern of muscular activity during computer work.

PubMed

St-Onge, Nancy; Samani, Afshin; Madeleine, Pascal

2017-09-01

Submaximal isometric muscle contractions have been reported to increase variability of muscle activation during computer work; however, other types of active contractions may be more beneficial. Our objective was to determine which type of active pause vs. rest is more efficient in changing muscle activity pattern during a computer task. Asymptomatic regular computer users performed a standardised 20-min computer task four times, integrating a different type of pause: sub-maximal isometric contraction, dynamic contraction, postural exercise and rest. Surface electromyographic (SEMG) activity was recorded bilaterally from five neck/shoulder muscles. Root-mean-square decreased with isometric pauses in the cervical paraspinals, upper trapezius and middle trapezius, whereas it increased with rest. Variability in the pattern of muscular activity was not affected by any type of pause. Overall, no detrimental effects on the level of SEMG during active pauses were found suggesting that they could be implemented without a cost on activation level or variability. Practitioner Summary: We aimed to determine which type of active pause vs. rest is best in changing muscle activity pattern during a computer task. Asymptomatic computer users performed a standardised computer task integrating different types of pauses. Muscle activation decreased with isometric pauses in neck/shoulder muscles, suggesting their implementation during computer work.

Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial.

PubMed

Pecos-Martín, Daniel; Montañez-Aguilera, F Javier; Gallego-Izquierdo, Tomás; Urraca-Gesto, Alicia; Gómez-Conesa, Antonia; Romero-Franco, Natalia; Plaza-Manzano, Gustavo

2015-05-01

To evaluate the effect of dry needling into a myofascial trigger point (MTrP) in the lower trapezius muscle of patients with mechanical idiopathic neck pain. A single-center, randomized, double-blinded controlled study. Patients were recruited from the student population of a local hospital by advertisement in the university clinic from January 2010 to December 2011. Patients (N=72) with unilateral neck pain, neck pain for ≥3 months, and active trigger points in the lower trapezius muscle were randomly assigned to 1 of 2 treatment groups. All the patients completed the study. Dry needling in an MTrP in the lower trapezius muscle, or dry needling in the lower trapezius muscle but not at an MTrP. The visual analog scale (VAS), Neck Pain Questionnaire (NPQ), and pressure-pain threshold (PPT) were assessed before the intervention and 1 week and 1 month postintervention. Treatment with dry needling of the lower trapezius muscle close to the MTrP showed decreases in pain and PPT as well as an improvement in the degree of disability (P<.001) compared with the baseline and control group measurements (P<.001). The dry-needling technique performed in the MTrP showed more significant therapeutic effects (P<.001). The application of dry needling into an active MTrP of the lower trapezius muscle induces significant changes in the VAS, NPQ, and PPT levels compared with the application of dry needling in other locations of the same muscle in patients with mechanical neck pain. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Topographical and functional anatomy of trapezius muscle innervation by spinal accessory nerve and C2 to C4 nerves of cervical plexus.

PubMed

Gavid, M; Mayaud, A; Timochenko, A; Asanau, A; Prades, J M

2016-10-01

The aim of this study was to determine the existence and the frequency of communicating branches between the spinal accessory nerve (SAN) and the C2, C3 and C4 roots of the cervical plexus. The present study also aimed to elucidate whether these branches contain motor fibers or not. Dissection of the cervical region was performed on twelve adult cadavers. A powered operating microscope was necessary to dissect the SAN and its branches and also to dissect C2, C3 and C4 nerve branches. In a second step, data from 13 patients who underwent 25 modified neck dissections under trapezius muscle's monitoring were collected. At the end of surgery, intraoperative stimulation on the SAN, C2, C3 and C4 nerve branches was performed. Registered potentials in the three parts of the trapezius muscle, using the NIM Medtronic system, were analyzed. During cadaver dissection, 18 (78 %) communicating branches were identified between the SAN and C2, 11 (48 %) between the SAN and C3, 12 (52 %) between the SAN and C4. Intraoperative stimulation of the SAN and its branch for the trapezius muscle provided a significant electroneurographic response in the three parts of the trapezius muscle in all subjects. Intraoperative stimulation of C3 led to recordable contractions of the trapezius muscle in 5 (20 %) modified neck surgeries, stimulation of C4 led to recordable contractions during 5 (20 %) modified neck dissections. One case of contraction was recorded after intraoperative stimulation of C2 (7 %). Although we were able to identify at least one communicating branch between the SAN and the roots of the cervical plexus in each cadaver dissection, the cervical plexus is not always involved in trapezius motor innervation. Intraoperative electroneurography demonstrated that a motor input from the cervical plexus to the trapezius muscle was provided in only 32 % of cases. Therefore, SAN trunk and C3-C4 roots should be carefully preserved during modified neck dissection to protect trapezius and shoulder functions.

Effect of Direct Glare on Orbicularis Oculi and Trapezius During Computer Reading.

PubMed

Mork, Randi; Bruenech, Jan Richard; Thorud, Hanne Mari Schiøtz

2016-07-01

Unfavorable visual conditions during computer work may affect development of both eyestrain and musculoskeletal pain in the neck and shoulder area. The aim of the study was to investigate how direct glare affects symptom development, muscle activity, and muscle blood flow in m. orbicularis oculi and m. trapezius during reading on a computer screen. Fifteen healthy young adults with normal binocular vision read text on a computer screen at an optimized computer workplace, 30 minutes with glare exposure and 30 minutes with appropriate lighting. Postural angles were continuously registered. Development of eye symptoms and musculoskeletal pain in the neck and shoulder area were recorded using VAS scales. Muscle activity and muscle blood flow were measured continuously using electromyography and photoplethysmography, respectively. Glare exposure resulted in significantly more pronounced eye pain, increased orbicularis muscle activity, and increased trapezius blood flow compared to reading with appropriate lighting. There were no significant differences in posture between the two light conditions. There were also significant associations between orbicularis oculi activity and both trapezius blood flow and neck pain during both conditions. Results from the current study show that direct glare conditions cause increased eyestrain and orbicularis oculi contraction during reading on a computer screen. This study also indicates that exposure to direct glare affects the trapezius muscle, possibly by an interaction between the visual system, sympathetic nervous system, and head-stabilizing muscles. In addition, there were associations between the use of orbicularis oculi, trapezius blood flow, and development of neck pain independent of the lighting.

The "chimeric" trapezius muscle and fasciocutaneous flap (dorsal scapular artery perforator flap): a new design for complex 3-dimensional defects.

PubMed

Rozen, Warren M; Fox, Carly M; Leong, James; Morsi, Adel

2013-11-01

Multiple variations of the musculocutaneous trapezius flap have been described, each of which use a single composite musculocutaneous unit in their designs. The limitation of such designs is the ability to use the components in a 3-dimensional manner, with only 1 vector existing in the geometry of the musculocutaneous unit. A review of the literature was undertaken with regard to designs of the musculocutaneous trapezius flap, and we present a new technique for flap design. With identification of individual perforators to each of the muscle and fasciocutaneous portions of the trapezius flap, the 2 components can act in a chimeric fashion, able to fill both a deep and complex 3-dimensional space while covering the wound with robust skin. A range of flap designs have been described, including transverse, oblique, and vertical skin paddles accompanying the trapezius muscle. We describe a technique with which a propeller-style skin paddle based on a cutaneous perforator can be raised in any orientation with respect to the underlying muscle. In a presented case, separation of the muscular and fasciocutaneous components of the trapezius flap was able to obliterate dead space around exposed cervicothoracic spinal metalwork and obtain robust wound closure in a patient with previous radiotherapy. This concomitant use of a muscle and fasciocutaneous perforator flap based on a single perforator, a so-called chimeric perforator flap, is a useful modification to trapezius musculocutaneous flap design.

Monitoring recovery from rocuronium-induced neuromuscular block using acceleromyography at the trapezius versus the adductor pollicis muscle: an observational trial.

PubMed

Soltesz, Stefan; Stark, Christian; Noé, Karl G; Anapolski, Michael; Mencke, Thomas

2016-06-01

Positioning for surgery can restrict access to the patient's hand, thereby limiting assessment of the response at the adductor pollicis muscle to ulnar nerve stimulation. We evaluated a novel site to assess neuromuscular block by stimulating the accessory nerve and measuring the acceleromyographic response at the trapezius muscle. In this prospective non-blinded observational study, we assessed neuromuscular transmission in anesthetized adult female patients undergoing elective laparoscopic gynecological surgery. We performed the assessment by simultaneous recording acceleromyographic responses with the TOF-Watch(®) SX monitor at both the right adductor pollicis and left trapezius muscles. The neuromuscular block was achieved using rocuronium 0.3 mg·kg(-1), and the repeatability, time course, and limits of agreement (Bland-Altman) of responses were compared at the two recording sites. The primary endpoint was the 90% train-of-four (TOF) recovery time with other endpoints included the onset time of the block, maximum T1 depression, time to 25% T1 recovery, and recovery time course of the T1 response and TOF ratio. Thirty-six patients were enrolled with responses obtained from 27 subjects. The variability of baseline responses recorded at the trapezius muscle was larger than that recorded at the adductor pollicis muscle, as determined by their mean (SD) repeatability coefficients [twitch height T1, 6.1 (1.9)% and 4.2 (1.6)%, respectively; P = 0.001; TOF ratio, 6.2 (2.1)% and 4.3 (1.7)%, respectively; P = 0.001]. The recorded responses showed relatively narrow limits of agreement. The onset time of the block was 0.3 min earlier at the trapezius muscle than at the adductor pollicis muscle [2.3 (0.8) min and 2.6 (0.7) min, respectively; P = 0.007], with limits of agreement ranging from 1.6 min earlier to 1.0 min later. The time to 25% T1 recovery was 1.8 min earlier at the trapezius muscle than at the adductor pollicis muscle [18.2 (5.7) min and 20.0 (5.2) min, respectively; P = 0.039], with limits of agreement ranging from 11.1 min earlier to 7.5 min later. Additionally, the time to achieve 90% TOF ratio was 4.4 min earlier at the trapezius muscle than at the adductor pollicis muscle [32.6 (7.9) min and 37 (9.1) min, respectively; P = 0.004], with limits of agreement ranging from 18.4 min earlier to 9.7 min later. We conclude that recording evoked acceleromyographic responses at the trapezius muscle is an acceptable alternative when monitoring from the adductor pollicis muscle is compromised. Nevertheless, we caution that recording a 90% TOF response at the trapezius muscle may overestimate functional recovery from the neuromuscular blockade. This trial was registered at ClinicalTrials.gov identifier, NCT01849198.

The Development of Vibration System for Applying Magnetic Resonance Elastography (MRE) to the Supraspinatus Muscle.

PubMed

Ito, Daiki; Numano, Tomokazu; Mizuhara, Kazuyuki; Takamoto, Kouichi; Onishi, Takaaki; Nishijo, Hisao

2016-01-01

Palpation is a standard clinical tool to diagnose abnormal stiffness changes in soft tissues. However, it is difficult to palpate the supraspinatus muscle because it locates under the trapezius muscle. The magnetic resonance elastography (MRE) uses harmonic mechanical excitation to quantitatively measure the stiffness (shear modulus) of both the superficial and deep tissues. The purpose of this study was to build a vibration system for applying the MRE to the supraspinatus muscle. In this study, a power amplifier and a pneumatic pressure generator were used to supply vibrations to a vibration pad. Six healthy volunteers underwent MRE. We investigated the effects of position (the head of the humerus and the trapezius muscle) of the vibration pad on the patterns of wave propagation (wave image). When the vibration pad was placed in the trapezius muscle, the wave images represented clear wave propagation. On the other hand, when the vibration pad was placed in the head of the humerus, the wave images represented unclear wave propagation. This result might be caused by wave interferences resulting from the vibrations from bones and an intramuscular tendon of the supraspinatus muscle. The mean shear modulus also was 8.12 ± 1.83 (mean ± SD) kPa, when the vibration pad was placed in the trapezius muscle. Our results demonstrated that the vibration pad should be placed in the trapezius muscle in the MRE of the supraspinatus muscle.

Multivariate Modeling of Proteins Related to Trapezius Myalgia, a Comparative Study of Female Cleaners with or without Pain

PubMed Central

Hadrevi, Jenny; Ghafouri, Bijar; Larsson, Britt; Gerdle, Björn; Hellström, Fredrik

2013-01-01

The prevalence of chronic trapezius myalgia is high in women with high exposure to awkward working positions, repetitive movements and movements with high precision demands. The mechanisms behind chronic trapezius myalgia are not fully understood. The purpose of this study was to explore the differences in protein content between healthy and myalgic trapezius muscle using proteomics. Muscle biopsies from 12 female cleaners with work-related trapezius myalgia and 12 pain free female cleaners were obtained from the descending part of the trapezius. Proteins were separated with two-dimensional differential gel electrophoresis (2D-DIGE) and selected proteins were identified with mass spectrometry. In order to discriminate the two groups, quantified proteins were fitted to a multivariate analysis: partial least square discriminate analysis. The model separated 28 unique proteins which were related to glycolysis, the tricaboxylic acid cycle, to the contractile apparatus, the cytoskeleton and to acute response proteins. The results suggest altered metabolism, a higher abundance of proteins related to inflammation in myalgic cleaners compared to healthy, and a possible alteration of the contractile apparatus. This explorative proteomic screening of proteins related to chronic pain in the trapezius muscle provides new important aspects of the pathophysiology behind chronic trapezius myalgia. PMID:24023854

Multivariate modeling of proteins related to trapezius myalgia, a comparative study of female cleaners with or without pain.

PubMed

Hadrevi, Jenny; Ghafouri, Bijar; Larsson, Britt; Gerdle, Björn; Hellström, Fredrik

2013-01-01

The prevalence of chronic trapezius myalgia is high in women with high exposure to awkward working positions, repetitive movements and movements with high precision demands. The mechanisms behind chronic trapezius myalgia are not fully understood. The purpose of this study was to explore the differences in protein content between healthy and myalgic trapezius muscle using proteomics. Muscle biopsies from 12 female cleaners with work-related trapezius myalgia and 12 pain free female cleaners were obtained from the descending part of the trapezius. Proteins were separated with two-dimensional differential gel electrophoresis (2D-DIGE) and selected proteins were identified with mass spectrometry. In order to discriminate the two groups, quantified proteins were fitted to a multivariate analysis: partial least square discriminate analysis. The model separated 28 unique proteins which were related to glycolysis, the tricaboxylic acid cycle, to the contractile apparatus, the cytoskeleton and to acute response proteins. The results suggest altered metabolism, a higher abundance of proteins related to inflammation in myalgic cleaners compared to healthy, and a possible alteration of the contractile apparatus. This explorative proteomic screening of proteins related to chronic pain in the trapezius muscle provides new important aspects of the pathophysiology behind chronic trapezius myalgia.

Measurement of muscle thickness of the serratus anterior and lower trapezius using ultrasound imaging in competitive recreational adult swimmers, with and without current shoulder pain.

PubMed

McKenna, Leanda J; de Ronde, Mandy; Le, Minyang; Burke, William; Graves, Anna; Williams, Sian A

2018-02-01

To compare serratus anterior and lower trapezius muscle thickness between swimmers with and without current shoulder pain, and between sides when measured by real-time ultrasound imaging. A single blinded age and gender-matched case-control study with 26 symptomatic and 26 asymptomatic recreational swimmers. Muscle thickness of serratus anterior and lower trapezius were measured using previously validated real-time ultrasound imaging protocols. Serratus anterior thickness was measured in side lying with 90° of glenohumeral flexion at rest and during a scapular protraction contraction. Lower trapezius thickness was measured in prone with 145° of glenohumeral abduction whilst at rest and when holding the weight of the arm. There was no statistically significant difference between the muscle thickness of serratus anterior and lower trapezius between the symptomatic shoulder and the dominance-matched shoulder in the asymptomatic group of swimmers. There was also no significant difference in muscle thickness between the symptomatic side and asymptomatic side within the symptomatic group. There appears to be no difference in serratus anterior and lower trapezius thickness between swimmers who have mild to moderate shoulder pain, who continue to swim and those who do not have shoulder pain. When imaging the serratus anterior and lower trapezius in swimmers with mild shoulder pain, clinicians should expect no differences between sides. If muscle thickness differences between sides are detected in recreational swimmers, this may indicate that the swimmer is participating in other asymmetrical activities or has a higher level of shoulder pain. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Measurements of the trapezius and erector spinae muscles using virtual touch imaging quantification ultrasound-Elastography: a cross section study.

PubMed

Heizelmann, Anne; Tasdemir, Sümeyra; Schmidberger, Julian; Gräter, Tilmann; Kratzer, Wolfgang; Grüner, Beate

2017-08-25

This study uses virtual touch imaging quantification (VTIQ) technology for the first time to conduct measurements of the trapezius and erector spinae muscles in a large study population. The significance of various influencing factors, such as age and sex, are also examined. The study population comprised 278 subjects. The Siemens Acuson S3000 and VTIQ technology were used for measurements of the trapezius and erector spinae muscles (Siemens Healthcare, Erlangen, Germany). The following mean values ± standard deviation were calculated: left trapezius: males 2.89 ± 0.38 m/s, females 2.71 ± 0.37 m/s; right trapezius: males 2.84 ± 0.41 m/s, females 2.70 ± 0.38 m/s; left erector spinae: males 2.97 ± 0.50 m/s, females 2.81 ± 0.57 m/s; right erector spinae: males 3.00 ± 0.52 m/s, females 2.77 ± 0.59 m/s. A significant difference between male and female subjects was demonstrated both for the shear wave velocities of the trapezius and erector spinae as well as for the thickness of the trapezius muscle (p < 0.05). There was also a significant difference in muscle elasticity between subjects over 60 years of age and those under 60 (p < 0.05). Furthermore, the results indicate that regular physical activity has an effect on muscle elasticity. Our results demonstrate significantly different results between male and female subjects and between under- and over-sixty-year-old subjects. This means that sex-related and age-adapted considerations are obviously needed for further studies.

Impact of Workstation Accommodation on Fatigue and Performance

DTIC Science & Technology

2006-12-01

Surface electromyography was collected on the left and right trapezius and deltoid muscles. Cerebral oxygenation levels were monitored via non... trapezius muscles using a static contraction testing device that consisted of a load cell to which the subject’s right arm was tethered and an output...experimental conditions. Surface electromyography (EMG) signals of the deltoid and trapezius were recorded during the contractions. In addition to

A comparison of muscular activity during single and double mouse clicks.

PubMed

Thorn, Stefan; Forsman, Mikael; Hallbeck, Susan

2005-05-01

Work-related musculoskeletal disorders (WMSDs) in the neck/shoulder region and the upper extremities are a common problem among computer workers. Occurrences of motor unit (MU) double discharges with very short inter-firing intervals (doublets) have been hypothesised as a potential additional risk for overuse of already exhausted fibres during long-term stereotyped activity. Doublets are reported to be present during double-click mouse work tasks. A few comparative studies have been carried out on overall muscle activities for short-term tasks with single types of actions, but none on occurrences of doublets during double versus single clicks. The main purpose of this study was to compare muscle activity levels of single and double mouse clicks during a long-term combined mouse/keyboard work task. Four muscles were studied: left and right upper trapezius, right extensor digitorum communis (EDC) and right flexor carpi ulnaris. Additionally, MU activity was analysed through intramuscular electromyography in the EDC muscle for a selection of subjects. The results indicate that double clicking produces neither higher median or 90th percentile levels in the trapezius and EDC muscles, nor a higher disposition for MU doublets, than does single clicking. Especially for the 90th percentile levels, the indications are rather the opposite (in the EDC significantly higher during single clicks in 8 of 11 subjects, P < 0.05). Although it cannot be concluded from the present study that double clicks are harmless, there were no signs that double clicks during computer work generally constitute a larger risk factor for WMSDs than do single clicks.

Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels

NASA Astrophysics Data System (ADS)

Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

2010-10-01

A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

Eye-lens accommodation load and static trapezius muscle activity.

PubMed

Richter, H O; Bänziger, T; Forsman, M

2011-01-01

The purpose of this experimental study was to investigate if sustained periods of oculomotor load impacts on neck/scapular area muscle activity. The static trapezius muscle activity was assessed from bipolar surface electromyography, normalized to a submaximal contraction. Twenty-eight subjects with a mean age of 29 (range 19-42, SD 8) viewed a high-contrast fixation target for two 5-min periods through: (1) -3.5 dioptre (D) lenses; and (2) 0 D lenses. The target was placed 5 D away from the individual's near point of accommodation. Each subject's ability to compensate for the added blur was extracted via infrared photorefraction measurements. Subjects whose accommodative response was higher in the -D blur condition (1) showed relatively more static bilateral trapezius muscle activity level. During no blur (2) there were no signs of relationships. The results indicate that sustained eye-lens accommodation at near, during ergonomically unfavourable viewing conditions, could possibly represent a risk factor for trapezius muscle myalgia.

Metastasis of osteosarcoma to the trapezius muscle: a case report

PubMed Central

2014-01-01

Metastasis of a primary osteosarcoma to the muscles is extremely rare. As there have been few reported cases, the necessity of surgical treatment for such metastatic lesions remains controversial. We present the case of a primary osteosarcoma with development of a solitary metastasis to the trapezius muscle during chemotherapy for pulmonary metastasis. The patient was a 51-year-old man diagnosed with osteosarcoma of the right tibia. After undergoing chemotherapy and femoral amputation, he developed pulmonary metastasis. Chemotherapy was reinitiated, however, after approximately 1 year a palpable tumor was identified in the patient’s right shoulder. This tumor grew and was associated with pain in the right shoulder. It was surgically removed 3 years after the re-initiation of chemotherapy. The pathological diagnosis was osteosarcoma with metastasis to the trapezius muscle. Although the patient died of respiratory failure due to pulmonary metastasis 14 months after resection of the metastatic lesion in the trapezius muscle, no new extrapulmonary metastasis was observed after the resection. PMID:24893571

Metastasis of osteosarcoma to the trapezius muscle: a case report.

PubMed

Sakamoto, Yuichiro; Yokouchi, Masahiro; Nagano, Satoshi; Shimada, Hirofumi; Nakamura, Shunsuke; Setoguchi, Takao; Kawamura, Ichiro; Ishidou, Yasuhiro; Tanimoto, Akihide; Komiya, Setsuro

2014-06-04

Metastasis of a primary osteosarcoma to the muscles is extremely rare. As there have been few reported cases, the necessity of surgical treatment for such metastatic lesions remains controversial. We present the case of a primary osteosarcoma with development of a solitary metastasis to the trapezius muscle during chemotherapy for pulmonary metastasis. The patient was a 51-year-old man diagnosed with osteosarcoma of the right tibia. After undergoing chemotherapy and femoral amputation, he developed pulmonary metastasis. Chemotherapy was reinitiated, however, after approximately 1 year a palpable tumor was identified in the patient's right shoulder. This tumor grew and was associated with pain in the right shoulder. It was surgically removed 3 years after the re-initiation of chemotherapy. The pathological diagnosis was osteosarcoma with metastasis to the trapezius muscle. Although the patient died of respiratory failure due to pulmonary metastasis 14 months after resection of the metastatic lesion in the trapezius muscle, no new extrapulmonary metastasis was observed after the resection.

Muscle recruitment patterns of the subscapularis, serratus anterior and other shoulder girdle muscles during isokinetic internal and external rotations.

PubMed

Gaudet, Sylvain; Tremblay, Jonathan; Begon, Mickael

2018-05-01

The aims of this study were to investigate the differences in peak muscle activity and recruitment patterns during high- and low-velocity, concentric and eccentric, internal and external isokinetic shoulder rotations. Electromyographic activity of the rotator cuff and eight superficial muscles of the shoulder girdle was recorded on 25 healthy adults during isokinetic internal and external shoulder rotation at 60°/s and 240°/s. Peak muscle activity, electromyographic envelopes and peak isokinetic moments were analyzed using three-factor ANOVA and statistical parametric mapping. The subscapularis and serratus anterior showed moderate to high peak activity levels during each conditions, while the middle and posterior deltoids, upper, middle and lower trapezius, infraspinatus and supraspinatus showed higher peak activity levels during external rotations (+36.5% of maximum voluntary activation (MVA)). The pectoralis major and latissimus dorsi were more active during internal rotations (+40% of MVA). Only middle trapezius and pectoralis major electromyographic activity decreased with increasing velocity. Peak muscle activity was similar or lower during eccentric contractions, although the peak isokinetic moment increased by 35% on average. The subscapularis and serratus anterior appear to be important stabilizers of the glenohumeral joint and scapula. Isokinetic eccentric training at high velocities may allow for faster recruitment of the shoulder girdle muscles, which could improve joint stability during shoulder internal and external rotations.

Changes in H reflex and neuromechanical properties of the trapezius muscle after 5 weeks of eccentric training: a randomized controlled trial.

PubMed

Vangsgaard, Steffen; Taylor, Janet L; Hansen, Ernst A; Madeleine, Pascal

2014-06-15

Trapezius muscle Hoffman (H) reflexes were obtained to investigate the neural adaptations induced by a 5-wk strength training regimen, based solely on eccentric contractions of the shoulder muscles. Twenty-nine healthy subjects were randomized into an eccentric training group (n = 15) and a reference group (n = 14). The eccentric training program consisted of nine training sessions of eccentric exercise performed over a 5-wk period. H-reflex recruitment curves, the maximal M wave (Mmax), maximal voluntary contraction (MVC) force, rate of force development (RFD), and electromyographic (EMG) voluntary activity were recorded before and after training. H reflexes were recorded from the middle part of the trapezius muscle by electrical stimulation of the C3/4 cervical nerves; Mmax was measured by electrical stimulation of the accessory nerve. Eccentric strength training resulted in significant increases in the maximal trapezius muscle H reflex (Hmax) (21.4% [5.5-37.3]; P = 0.01), MVC force (26.4% [15.0-37.7]; P < 0.01), and RFD (24.6% [3.2-46.0]; P = 0.025), while no significant changes were observed in the reference group. Mmax remained unchanged in both groups. A significant positive correlation was found between the change in MVC force and the change in EMG voluntary activity in the training group (r = 0.57; P = 0.03). These results indicate that the net excitability of the trapezius muscle H-reflex pathway increased after 5 wk of eccentric training. This is the first study to investigate and document changes in the trapezius muscle H reflex following eccentric strength training. Copyright © 2014 the American Physiological Society.

Quantify work load and muscle functional activation patterns in neck-shoulder muscles of female sewing machine operators using surface electromyogram.

PubMed

Zhang, Fei-Ruo; He, Li-Hua; Wu, Shan-Shan; Li, Jing-Yun; Ye, Kang-Pin; Wang, Sheng

2011-11-01

Work-related musculoskeletal disorders (WMSDs) have high prevalence in sewing machine operators employed in the garment industry. Long work duration, sustained low level work and precise hand work are the main risk factors of neck-shoulder disorders for sewing machine operators. Surface electromyogram (sEMG) offers a valuable tool to determine muscle activity (internal exposure) and quantify muscular load (external exposure). During sustained and/or repetitive muscle contractions, typical changes of muscle fatigue in sEMG, as an increase in amplitude or a decrease as a shift in spectrum towards lower frequencies, can be observed. In this paper, we measured and quantified the muscle load and muscular activity patterns of neck-shoulder muscles in female sewing machine operators during sustained sewing machine operating tasks using sEMG. A total of 18 healthy women sewing machine operators volunteered to participate in this study. Before their daily sewing machine operating task, we measured the maximal voluntary contractions (MVC) and 20%MVC of bilateral cervical erector spinae (CES) and upper trapezius (UT) respectively, then the sEMG signals of bilateral UT and CES were monitored and recorded continuously during 200 minutes of sustained sewing machine operating simultaneously which equals to 20 time windows with 10 minutes as one time window. After 200 minutes' work, we retest 20%MVC of four neck-shoulder muscles and recorded the sEMG signals. Linear analysis, including amplitude probability distribution frequency (APDF), amplitude analysis parameters such as roof mean square (RMS) and spectrum analysis parameter as median frequency (MF), were used to calculate and indicate muscle load and muscular activity of bilateral CES and UT. During 200 minutes of sewing machine operating, the median load for the left cervical erector spinae (LCES), right cervical erector spinae (RCES), left upper trapezius (LUT) and right upper trapezius (RUT) were 6.78%MVE, 6.94%MVE, 6.47%MVE and 5.68%MVE, respectively. Work load of right muscles are significantly higher than that of the left muscles (P < 0.05); sEMG signal analysis of isometric contractions indicated that the amplitude value before operating was significantly higher than that of after work (P < 0.01), and the spectrum value of bilateral CES and UT were significantly lower than those of after work (P < 0.01); according to the sEMG signal data of 20 time windows, with operating time pass by, the muscle activity patterns of bilateral CES and UT showed dynamic changes, the maximal amplitude of LCES, RCES, LUT occurred at the 20th time window, RUT at 16th time window, spectrum analysis showed that the lower value happened at 7th, 16th, 20th time windows. Female sewing machine operators were exposed to high sustained static load on bilateral neck-shoulder muscles; left neck and shoulder muscles were held in more static positions; the 7th, 16th, and 20th time windows were muscle fatigue period that ergonomics intervention can protocol at these periods.

Bilateral responses of upper limb muscles to transcranial magnetic stimulation in human subjects.

PubMed

Bawa, P; Hamm, J D; Dhillon, P; Gross, P A

2004-10-01

Anatomical and behavioural work on primates has shown bilateral innervation of axial and proximal limb muscles, and contralateral control of distal limb muscles. The following study examined if a clear boundary exists between the distal and proximal upper limb muscles that are controlled contralaterally or bilaterally. The right motor cortical area representing the upper limb was stimulated, while surface EMG was recorded bilaterally from various upper limb muscles during rest and phasic voluntary contractions. Peak-to-peak amplitude of motor evoked potential (MEP) was measured for each muscle on both sides. The ratio R = (ipsilateral MEP: contralateral MEP) was calculated for seven pairs of muscles. For each of the seven pairs, R was less than 1.0, implying that for each muscle and subject, the contralateral control is stronger. The boundary where R changed from almost zero to a clearly measurable magnitude depended on the subject. Ipsilateral MEPs from trapezius and pectoralis could be recorded with a small background contraction from almost all subjects; on the other hand, in deltoid and biceps brachii, ipsilateral MEPs were observed only with bimanual phasic contractions. The forearm and hand muscles, in general, did not show any ipsilateral MEPs. Major differences between subjects lay in the presence or the absence of ipsilateral MEPs in biceps brachii and deltoid, without defining a sharp boundary between proximal and distal muscles.

Helicopter cockpit seat side and trapezius muscle metabolism with night vision goggles.

PubMed

Harrison, Michael F; Neary, J Patrick; Albert, Wayne J; Veillette, Dan W; McKenzie, Neil P; Croll, James C

2007-10-01

Documented neck strain among military helicopter aircrew is becoming more frequent and many militaries use helicopters that provide pilots with the option of sitting in the left or right cockpit seat during missions. The purpose of this study was to use near infrared spectroscopy (NIRS) to investigate the physiological changes in trapezius muscle oxygenation and blood volume during night vision goggle (NVG) flights as a function of left and right cockpit seating. There were 25 pilots who were monitored during NVG flight simulator missions (97.7 +/- 16.1 min). Bilateral NIRS probes attached to the trapezius muscles at C7 level recorded total oxygenation index (TOI, %), total hemoglobin (tHb), oxyhemoglobin (Hbo2), and deoxyhemo-globin (HHb). No significant differences existed between variables for pilots seated in the right cockpit seat as compared with the pilots seated in the left cockpit seat in either trapezius muscle (pTOI = 0.72; ptHb = 0.72; pHbo2 = 0.57; pHHb = 0.21). Alternating cockpit seats on successive missions is not a means to decrease metabolic stress for helicopter pilots using NVG. This suggests that cockpit layout and location of essential instruments with respect to the horizontal and the increased head supported mass of the NVG may be important factors influencing metabolic stress of the trapezius muscle.

Disability self-assessment and upper quarter muscle balance between female dental hygienists and non-dental hygienists.

PubMed

Johnson, Eric G; Godges, Joseph J; Lohman, Everett B; Stephens, Joni A; Zimmerman, Grenith J; Anderson, Sharon P

2003-01-01

The purpose of this pilot study was to compare disability self-assessment and upper quarter muscle balance female dental hygienists and non dental hygienist females. The upper quarter was operationally defined as the shoulder and neck region. Muscle balance was operationally defined as muscle flexibility and muscle performance. A convenience sample of 41 working dental hygienists and 46 non dental hygienists participated in the study. Muscle flexibility of the upper quarter was measured by inclinometry or standard muscle length testing. Muscle performance was measured by timing the duration of four statically maintained positions. Subjects filled out the Northwick Park Neck Pain Questionnaire (NPNPQ), which is a disability self-assessment. Analysis of Covariance (ANCOVA) was used during data analysis to adjust for the mean age difference between the dental hygienist group (38.0 years) and the non-dental hygienist group (29.3 years). The results of this pilot study suggest that female dental hygienists are more likely than non dental hygienist females to develop tightness in the upper trapezius (p = 0.007) and the levator scapula (p = 0.01) of the non dominant upper quarter and lower fibers of the pectoralis major of the dominant upper quarter (p = 0.03) Muscle performance trends in the dental hygienist group supported muscle balance theory that short muscles remain strong while lengthened muscles become weak. The dental hygienist group had higher disability scores in all nine parts of the NPNPQ compared to the non-dental hygienist group, five of which were statistically significant (p < 0.05). The results of this pilot study suggest that muscle imbalances in the upper quarter are more common in female dental hygienists than in female non dental hygienists and may contribute to the numerous upper quarter pathologies associated with the practice of dental hygiene. Further research is needed to determine if upper quarter strengthening and flexibility exercises performed by dental hygienists can reduce disability self-assessment.

Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation.

PubMed

Acero, C O; Kuboki, T; Maekawa, K; Yamashita, A; Clark, G T

1999-10-01

The aim was to compare haemodynamic responses in trapezius muscles to cold pressor stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold pressor and mock) trials were performed in a randomly assigned sequence. In the cold pressor trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold pressor stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold pressor stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold pressor stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia.

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

PubMed Central

León-Hernández, Jose V.; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G.; Alguacil-Diego, Isabel M.; de la Llave-Rincón, Ana I.; Fernandez-Carnero, Josue

2016-01-01

ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain. PMID:27410163

Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study.

PubMed

Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Ikumi, Akira; Abe, Tetsuya; Marushima, Aiki; Ueno, Tomoyuki; Endo, Ayumu; Kawamoto, Hiroaki; Saotome, Kousaku; Matsushita, Akira; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

2017-07-01

Patients with complete quadriplegia after high cervical spinal cord injury are fully dependent with activities of daily living. Assistive technology can improve their quality of life. We examined the use of a hybrid assistive limb for single joints (HAL-SJ) in a 19-year-old man with complete C4 quadriplegia due to chronic spinal cord injury to restore function of active elbow flexion. This is the first report on the use of the HAL-SJ in a patient with spinal cord injury. The HAL-SJ intervention for each elbow was administered in 10 sessions. Clinical assessment using surface EMG was conducted to evaluate muscle activity of the trapezius, biceps brachii, infraspinatus, and triceps brachii muscle before, and during the 2nd, 3rd, 6th, and 9th interventions. Surface electromyography (EMG) before intervention showed no contraction in the upper arms, but in the bilateral trapezius. The HAL-SJ used motion intention from the right trapezius for activation. After the 6th and 7th session, respectively, biceps EMG showed that voluntary contraction and right elbow flexion could be performed by motion intention from the right biceps. After the 10th session, voluntary bicep contraction was possible. HAL-SJ treatment on the left elbow was performed using the same protocol with a similar outcome. After completing treatment on both upper extremities, both biceps contracted voluntarily, and he could operate a standard wheelchair for a short distance independently. HAL-SJ intervention is feasible and effective in restoring elbow flexor function in a patient with C4 chronic spinal cord injury and complete quadriplegia.

The effect of trunk rotation during shoulder exercises on the activity of the scapular muscle and scapular kinematics.

PubMed

Yamauchi, Taishi; Hasegawa, Satoshi; Matsumura, Aoi; Nakamura, Masatoshi; Ibuki, Satoko; Ichihashi, Noriaki

2015-06-01

In patients with shoulder disease, kinetic chain exercises including hip or trunk movement are recommended. However, the actual muscle activation and scapular kinematics of these exercises are not known. The purpose of this study was to examine the effect of trunk rotation on shoulder exercises that are devised to improve scapular function. Thirteen healthy young men participated in this study. Scaption, external rotation in the first and second positions, and prone scapular retraction at 45°, 90°, and 145° of shoulder abduction were performed with and without trunk rotation. Electromyography was used to assess the scapular muscle activity of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA), and electromagnetic motion capture was used to assess scapular motion. The muscle activity ratio, which is the activity of the UT to the MT, LT, and SA, was calculated. These data were compared between 2 conditions (with and without trunk rotation) for each exercise. Adding trunk rotation to scaption, the first external rotation, and the second external rotation significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation. In addition, trunk rotation with scapular retraction at 90° and 145° of shoulder abduction significantly decreased the UT/LT ratio. Our findings suggest that shoulder exercises with trunk rotation in this study may be effective in patients who have difficulty in enhancing LT activity and suppressing excessive activation of the UT or in cases in which a decreased scapular external rotation or posterior tilt is observed. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Between-day reliability of the trapezius muscle H-reflex and M-wave.

PubMed

Vangsgaard, Steffen; Hansen, Ernst A; Madeleine, Pascal

2015-12-01

The aim of this study was to investigate the between-day reliability of the trapezius muscle H-reflex and M-wave. Sixteen healthy subjects were studied on 2 consecutive days. Trapezius muscle H-reflexes were evoked by electrical stimulation of the C3/4 cervical nerves; M-waves were evoked by electrical stimulation of the accessory nerve. Relative reliability was estimated by intraclass correlation coefficients (ICC2,1 ). Absolute reliability was estimated by computing the standard error of measurement (SEM) and the smallest real difference (SRD). Bland-Altman plots were constructed to detect any systematic bias. Variables showed substantial to excellent relative reliability (ICC = 0.70-0.99). The relative SEM ranged from 1.4% to 34.8%; relative SRD ranged from 3.8% to 96.5%. No systematic bias was present in the data. The amplitude and latency of the trapezius muscle H-reflex and M-wave in healthy young subjects can be measured reliably across days. © 2015 Wiley Periodicals, Inc.

Measurement of the trapezius muscle volume: A new assessment strategy of shoulder dysfunction after neck dissection for the treatment of head and neck cancers.

PubMed

Cho, Jae-Gu; Lee, Naree; Park, Min-Woo; Baek, Seung-Kuk; Kwon, Soon-Young; Jung, Kwang-Yoon; Woo, Jeong-Soo

2015-05-01

The purpose of this study was to determine the actual degree of shoulder muscle change and its relation to symptoms after neck dissection for head and neck cancers. Forty-two patients who underwent unilateral neck dissection were selected. Data obtained from each subject were trapezius muscle volume ratio and a Shoulder Disability Questionnaire (SDQ) score. Patients who had undergone neck dissection with spinal accessory nerve (SAN) preservation were compared with those who had received radical neck dissection. The preservation group was further separated into subgroups by the extent of neck dissection. Trapezius muscle volume ratio was higher and SDQ score was significantly lower in the SAN preservation group compared to the radical neck dissection group. However, the SAN preservation subgroups did not differ from each other. In addition, a good correlation between the muscle volume ratio and SDQ score was observed. With trapezius muscle volume ratio, clinicians may be able to diagnose shoulder dysfunction after neck dissection. Further research on the subject is warranted. This suggests a novel strategy for assessing the degree of shoulder dysfunction. © 2014 Wiley Periodicals, Inc.

Increased (18)F-FDG uptake in the trapezius muscle in patients with spinal accessory neuropathy.

PubMed

Lee, Seung Hak; Seo, Han Gil; Oh, Byung-Mo; Choi, Hongyoon; Cheon, Gi Jeong; Lee, Shi-Uk

2016-03-15

To investigate (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) signal changes of denervated muscles in patients with electrophysiologically confirmed neuropathy. This is a case series of three cancer patients who were referred to the electromyography laboratory in 2013 due to shoulder discomfort after surgery including neck dissection. Spinal accessory neuropathy was diagnosed based on electrophysiological studies. Patients' medical history, electrophysiological data, and FDG-PET images were reviewed retrospectively. Mean standard uptake values (SUV) of trapezius muscles were measured. The patients (3 men, aged 61-78years) showed spinal accessory neuropathy with different degrees of severity. In all patients, preoperative or postoperative FDG-PET showed increased FDG uptake in the ipsilateral trapezius muscle. These results were compatible with previously reported glucose hypermetabolism in denervated skeletal muscles. This is the first clinical report of increased FDG uptake by denervated muscles in electrophysiologically confirmed neuropathy. Copyright © 2016 Elsevier B.V. All rights reserved.

Visual and psychological stress during computer work in healthy, young females-physiological responses.

PubMed

Mork, Randi; Falkenberg, Helle K; Fostervold, Knut Inge; Thorud, Hanne Mari S

2018-05-30

Among computer workers, visual complaints, and neck pain are highly prevalent. This study explores how occupational simulated stressors during computer work, like glare and psychosocial stress, affect physiological responses in young females with normal vision. The study was a within-subject laboratory experiment with a counterbalanced, repeated design. Forty-three females performed four 10-min computer-work sessions with different stress exposures: (1) minimal stress; (2) visual stress (direct glare); (3) psychological stress; and (4) combined visual and psychological stress. Muscle activity and muscle blood flow in trapezius, muscle blood flow in orbicularis oculi, heart rate, blood pressure, blink rate and postural angles were continuously recorded. Immediately after each computer-work session, fixation disparity was measured and a questionnaire regarding perceived workstation lighting and stress was completed. Exposure to direct glare resulted in increased trapezius muscle blood flow, increased blink rate, and forward bending of the head. Psychological stress induced a transient increase in trapezius muscle activity and a more forward-bent posture. Bending forward towards the computer screen was correlated with higher productivity (reading speed), indicating a concentration or stress response. Forward bent posture was also associated with changes in fixation disparity. Furthermore, during computer work per se, trapezius muscle activity and blood flow, orbicularis oculi muscle blood flow, and heart rate were increased compared to rest. Exposure to glare and psychological stress during computer work were shown to influence the trapezius muscle, posture, and blink rate in young, healthy females with normal binocular vision, but in different ways. Accordingly, both visual and psychological factors must be taken into account when optimizing computer workstations to reduce physiological responses that may cause excessive eyestrain and musculoskeletal load.

Upper Girdle Imaging in Facioscapulohumeral Muscular Dystrophy

PubMed Central

Tasca, Giorgio; Monforte, Mauro; Iannaccone, Elisabetta; Laschena, Francesco; Ottaviani, Pierfrancesco; Leoncini, Emanuele; Boccia, Stefania; Galluzzi, Giuliana; Pelliccioni, Marco; Masciullo, Marcella; Frusciante, Roberto; Mercuri, Eugenio; Ricci, Enzo

2014-01-01

Background In Facioscapulohumeral muscular dystrophy (FSHD), the upper girdle is early involved and often difficult to assess only relying on physical examination. Our aim was to evaluate the pattern and degree of involvement of upper girdle muscles in FSHD compared with other muscle diseases with scapular girdle impairment. Methods We propose an MRI protocol evaluating neck and upper girdle muscles. One hundred-eight consecutive symptomatic FSHD patients and 45 patients affected by muscular dystrophies and myopathies with prominent upper girdle involvement underwent this protocol. Acquired scans were retrospectively analyzed. Results The trapezius (100% of the patients) and serratus anterior (85% of the patients) were the most and earliest affected muscles in FSHD, followed by the latissimus dorsi and pectoralis major, whilst spinati and subscapularis (involved in less than 4% of the patients) were consistently spared even in late disease stages. Asymmetry and hyperintensities on short-tau inversion recovery (STIR) sequences were common features, and STIR hyperintensities could also be found in muscles not showing signs of fatty replacement. The overall involvement appears to be disease-specific in FSHD as it significantly differed from that encountered in the other myopathies. Conclusions The detailed knowledge of single muscle involvement provides useful information for correctly evaluating patients' motor function and to set a baseline for natural history studies. Upper girdle imaging can also be used as an additional tool helpful in supporting the diagnosis of FSHD in unclear situations, and may contribute with hints on the currently largely unknown molecular pathogenesis of this disease. PMID:24932477

Compression of high-density EMG signals for trapezius and gastrocnemius muscles.

PubMed

Itiki, Cinthia; Furuie, Sergio S; Merletti, Roberto

2014-03-10

New technologies for data transmission and multi-electrode arrays increased the demand for compressing high-density electromyography (HD EMG) signals. This article aims the compression of HD EMG signals recorded by two-dimensional electrode matrices at different muscle-contraction forces. It also shows methodological aspects of compressing HD EMG signals for non-pinnate (upper trapezius) and pinnate (medial gastrocnemius) muscles, using image compression techniques. HD EMG signals were placed in image rows, according to two distinct electrode orders: parallel and perpendicular to the muscle longitudinal axis. For the lossless case, the images obtained from single-differential signals as well as their differences in time were compressed. For the lossy algorithm, the images associated to the recorded monopolar or single-differential signals were compressed for different compression levels. Lossless compression provided up to 59.3% file-size reduction (FSR), with lower contraction forces associated to higher FSR. For lossy compression, a 90.8% reduction on the file size was attained, while keeping the signal-to-noise ratio (SNR) at 21.19 dB. For a similar FSR, higher contraction forces corresponded to higher SNR CONCLUSIONS: The computation of signal differences in time improves the performance of lossless compression while the selection of signals in the transversal order improves the lossy compression of HD EMG, for both pinnate and non-pinnate muscles.

Compression of high-density EMG signals for trapezius and gastrocnemius muscles

PubMed Central

2014-01-01

Background New technologies for data transmission and multi-electrode arrays increased the demand for compressing high-density electromyography (HD EMG) signals. This article aims the compression of HD EMG signals recorded by two-dimensional electrode matrices at different muscle-contraction forces. It also shows methodological aspects of compressing HD EMG signals for non-pinnate (upper trapezius) and pinnate (medial gastrocnemius) muscles, using image compression techniques. Methods HD EMG signals were placed in image rows, according to two distinct electrode orders: parallel and perpendicular to the muscle longitudinal axis. For the lossless case, the images obtained from single-differential signals as well as their differences in time were compressed. For the lossy algorithm, the images associated to the recorded monopolar or single-differential signals were compressed for different compression levels. Results Lossless compression provided up to 59.3% file-size reduction (FSR), with lower contraction forces associated to higher FSR. For lossy compression, a 90.8% reduction on the file size was attained, while keeping the signal-to-noise ratio (SNR) at 21.19 dB. For a similar FSR, higher contraction forces corresponded to higher SNR Conclusions The computation of signal differences in time improves the performance of lossless compression while the selection of signals in the transversal order improves the lossy compression of HD EMG, for both pinnate and non-pinnate muscles. PMID:24612604

The influence of seat height, trunk inclination and hip posture on the activity of the superior trapezius and longissimus

PubMed Central

Bertolaccini, Guilherme da Silva; Nakajima, Rafael Kendi; Filho, Idinei Francisco Pires de Carvalho; Paschoarelli, Luis Carlos; Medola, Fausto Orsi

2016-01-01

[Purpose] This study was aimed at investigating the influence of seat height and body posture on the activity of the superior trapezius and longissimus muscles. [Subjects and Methods] Twenty two healthy subjects were instructed to perform a total of eight different body postures, varying according three main factors: seat height (low and high seat); trunk inclination (upright and leaning forward at 45°); and the hips in abduction and adduction. Electromyography of the superior trapezius and longissimus was collected bilaterally, and the average values were obtained and compared across all the postures. [Results] The activity of the superior trapezius and longissimus significantly changes according to the seat height and trunk inclination. For both seat heights, sitting with trunk leaning forward resulted in a significant increase in the activity of both muscles. When sitting in a high seat and the trunk leaning forward, the superior trapezius activity was significantly reduced when compared to the same posture in a low seat. [Conclusion] This study contributes to the knowledge on the influence of the body posture and seat configuration on the activity of postural muscles. Reducing the biomechanical loads on the postural muscles must be targeted in order to improve users’ comfort and safety. PMID:27313381

Analysis of proximal and distal muscle activity during handwriting tasks.

PubMed

Naider-Steinhart, Shoshana; Katz-Leurer, Michal

2007-01-01

In this study we sought to describe upper-extremity proximal and distal muscle activity in typically developing children during a handwriting task and to explore the relationship between muscle activity and speed and quality of writing. We evaluated 35 third- and fourth-grade Israeli children using the Alef-Alef Ktav Yad Hebrew Handwriting Test. Simultaneously, we recorded the participants' upper trapezius and thumb muscle activity by surface electromyography. Using the coefficient of variation (standard deviation divided by mean amplitude) as a measure of variability within each muscle, we analyzed differences in muscle activity variability within and between muscles. The proximal muscle displayed significantly less variability than the distal muscles. Decreased variability in proximal muscle activity was associated with decreased variability in distal muscle activity, and decreased variability in the distal muscles was significantly associated with faster speed of writing. The lower amount of variability exhibited in the proximal muscle compared with the distal muscles seems to indicate that the proximal muscle functions as a stabilizer during a handwriting task. In addition, decreased variability in both proximal and distal muscle activity appears to be more economical and is related to faster writing speed. Knowledge of the type of proximal and distal muscle activity used during handwriting can help occupational therapists plan treatment for children with handwriting disabilities.

Comparison of Muscle Activation during Dominant Hand Wrist Flexion when Writing.

PubMed

Park, Soohee

2013-12-01

[Purpose] This study investigated the difference in muscle activation of the dominant upper extremity in right-handed and left-handed persons during writing. [Subjects] There were 36 subjects (16 left- handers/ 20 right- handers), and the study was conducted from 03/01/2012 to 30/3/2012. [Methods] Six electrodes were attached to the FCU (flexor carpi ulnaris), FCR (flexor carpi radialis), ECU (extensor carpi ulnaris), ECR (extensor carpi radialis), and both UT (upper trapezius) muscles. [Results] FCU muscle activation was 16.77±9.12% in left-handers and 10.29±4.13% (%MVIC) in right-handers. FCR muscle activation was 19.09±9.43% in left-handers and 10.64±5.03% in right-handers. In addition, the UT muscle activation on the writing hand side was 11.91±5.79% in left-handers and 1.66±1.19% in right-handers. [Conclusion] As a result of this study, it was discovered that left-handers used more wrist flexion in performance of the writing task with the dominant upper extremity than right-handers, and that the left-handers activated the wrist and shoulder muscles more than the right-handers. These results indicate a potential danger of musculoskeletal disease in left-hander.

Strength training increases the size of the satellite cell pool in type I and II fibres of chronically painful trapezius muscle in females.

PubMed

Mackey, Abigail L; Andersen, Lars L; Frandsen, Ulrik; Sjøgaard, Gisela

2011-11-15

While strength training has been shown to be effective in mediating hypertrophy and reducing pain in trapezius myalgia, responses at the cellular level have not previously been studied. This study investigated the potential of strength training targeting the affected muscles (SST, n = 18) and general fitness training (GFT, n = 16) to augment the satellite cell (SC) and macrophage pools in the trapezius muscles of women diagnosed with trapezius myalgia. A group receiving general health information (REF, n = 8) served as a control. Muscle biopsies were collected from the trapezius muscles of the 42 women (age 44 ± 8 years; mean ± SD) before and after the 10 week intervention period and were analysed by immunohistochemistry for SCs, macrophages and myonuclei. The SC content of type I and II fibres was observed to increase significantly from baseline by 65% and 164%, respectively, with SST (P < 0.0001), together with a significant correlation between the baseline number of SCs and the extent of hypertrophy (r = -0.669, P = 0.005). SST also resulted in a 74% enhancement of the trapezius macrophage content (P < 0.01), accompanied by evidence for the presence of an increased number of actively dividing cells (Ki67(+)) post-SST (P < 0.001). GFT resulted in a significant 23% increase in the SC content of type II fibres, when expressed relative to myonuclear number only (P < 0.05). No changes in the number of myonuclei per fibre or myonuclear domain were detected in any group. These findings provide strong support at the cellular level for the potential of SST to induce a strong myogenic response in this population.

Effects of scapula-upward taping using kinesiology tape in a patient with shoulder pain caused by scapular downward rotation

PubMed Central

Kim, Byeong-Jo; Lee, Jung-Hoon

2015-01-01

[Purpose] The aim of this study was to evaluate the effects of scapula-upward taping (SUT) in a patient with shoulder pain caused by scapular downward rotation (SDR). [Subject] A 26-year-old male with SDR experienced severe pain in the left shoulder when he lifted his left upper extremity to hold the handle in a bus and during and after push-up exercise. [Methods] The patient underwent SUT for a period of 1 month, 5 times per week, for an average of 9 h/d. [Results] The patient’s radiographs showed that the degree of SDR had decreased; the left shoulder pain also decreased in the resting state and during and after push-up exercise. The manual muscle strength test grades of the upper trapezius, lower trapezius, and serratus anterior had increased. The patient was able to lift the left upper extremity to hold the handle in a bus and perform the push-up exercise without experiencing any pain. [Conclusion] Repeated SUT application may be a beneficial treatment method for alleviating the degree of SDR and shoulder pain in SDR patients. PMID:25729213

Effects of height and load weight on shoulder muscle work during overhead lifting task.

PubMed

Blache, Y; Desmoulins, L; Allard, P; Plamondon, A; Begon, M

2015-01-01

Few musculoskeletal models are available to assess shoulder deeper muscle demand during overhead lifting tasks. Our objective was to implement a musculoskeletal model to assess the effect of lifting height and load on shoulder muscle work. A musculoskeletal model scaled from 15 male subjects was used to calculate shoulder muscle work during six lifting tasks. Boxes containing three different loads (6, 12 and 18 kg) were lifted by the subjects from the waist to shoulder or eye level. After optimisation of the maximal isometric force of the model's muscles, the bio-fidelity of the model was improved by 19%. The latter was able to reproduce the subjects' lifting movements. Mechanical work of the rotator cuff muscles, upper trapezius and anterior deltoid was increased with lifting load and height augmentation. In conclusion, the use of a musculoskeletal model validated by electromyography enabled to evaluate the muscle demand of deep muscles during lifting tasks.

Gender differences between muscle activation and onset timing of the four subdivisions of trapezius during humerothoracic elevation.

PubMed

Szucs, Kimberly A; Borstad, John D

2013-12-01

The aim of this study was to provide a description of gender differences of the normal muscle activation patterns of the four subdivisions of the trapezius (clavicular, descending, transverse, ascending) during arm elevation. Surface EMG was collected from these four subdivisions from twenty-two healthy subjects (12 females, 10 males) during arm elevation in the scapular plane. Percent activation (RMS) of each subdivision was compared between genders across arm angles and elevation phase and onset time of each subdivision was compared between genders. Females demonstrated significantly higher % activation levels for each subdivision (p<.05), except transverse trapezius (p=.36). A statistically significant difference for onset time was observed between gender for the descending trapezius, with a slower onset time for females (p<.05). Findings from this study support the theory that subdivisions within descending trapezius are preferentially activated and demonstrate that gender differences are present within the fourth subdivision of trapezius. As subjects were without shoulder pathology, the observed gender differences may be explained by normal motor control variations. However, as coordinated activation of trapezius is required for normal shoulder motion, it is recommended to include all four subdivisions of trapezius and address gender differences in future studies. Copyright © 2013 Elsevier B.V. All rights reserved.

Surgical anatomy of the lower trapezius tendon transfer.

PubMed

Omid, Reza; Cavallero, Matthew J; Granholm, Danielle; Villacis, Diego C; Yi, Anthony M

2015-09-01

The precise surgical anatomy of the lower trapezius tendon transfer has not been well described. A precise anatomic description of the different trapezius segments and the associated neurovascular structures is crucial for operative planning and execution. We aimed (1) to establish a reliable demarcation between the middle and lower trapezius, (2) to establish the precise relationship of the main neurovascular pedicle to the muscle belly, and (3) to evaluate the utility of the relationships established in (1) and (2) by using the results of this study to perform cadaveric lower trapezius tendon harvest. In phase 1, a single surgeon performed all measurements using 10 cadavers. In phase 2, 10 cadaveric shoulders were used to harvest the tendon by using the relationships established in phase 1. We found anatomically distinct insertion sites for the lower and middle trapezius. The lower trapezius inserted at the scapular spine dorsum and the middle trapezius inserted broadly along the superior surface of the scapular spine. The distance from tip of tendon insertion to the nearest nerve at the most superior portion of the lower trapezius was 58 mm (standard deviation ± 18). By use of these relationships, there were no cases of neurovascular injury during our cadaveric tendon harvests. The lower trapezius can be reliably and consistently identified without violating fibers of the middle trapezius. Muscle splitting can be performed safely without encountering the spinal accessory nerve (approximately 2 cm medial to the medial scapular border). Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Alterations in the trapezius muscle in young patients with migraine--a pilot case series with MRI.

PubMed

Landgraf, M N; Ertl-Wagner, B; Koerte, I K; Thienel, J; Langhagen, T; Straube, A; von Kries, R; Reilich, P; Pomschar, A; Heinen, F

2015-05-01

Migraine is frequent in young adults and adolescents and often associated with neck muscle tension and pain. Common pathophysiological pathways, such as reciprocal cervico-trigeminal activation, are assumed. Tense areas within the neck muscles can be clinically observed many patients with migraine. The aim of this pilot case study was to visualize these tense areas via magnet resonance imaging (MRI). Three young patients with migraine were examined by an experienced investigator. In all three patients tense areas in the trapezius muscles were palpated. These areas were marked by nitroglycerin capsules on the adjacent skin surface. The MRI showed focal signal alterations at the marked locations within the trapezius muscles. Visualization of palpable tense areas by MRI may be usefully applied in the future to help elucidate the underlying pathophysiological processes of migraine. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

High-Intensity Strength Training Improves Function of Chronically Painful Muscles: Case-Control and RCT Studies

PubMed Central

Andersen, Christoffer H.; Skotte, Jørgen H.; Suetta, Charlotte; Søgaard, Karen; Saltin, Bengt; Sjøgaard, Gisela

2014-01-01

Aim. This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions. Methods. Women with trapezius myalgia (MYA, n = 42) and healthy controls (CON, n = 20) participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 16), or a reference group without physical training (REF, n = 8). Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC) of shoulder elevation followed by 2 s relaxation at baseline and 10-week follow-up. Results. In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between MYA and CON. In the intervention study, SST improved all force parameters significantly more than the two other groups, to levels comparable to that of CON. This was seen along with muscle fiber hypertrophy and increased capillarization. Conclusion. Women with trapezius myalgia have lower strength capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle. PMID:24707475

Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

PubMed Central

Anshul

2011-01-01

ABSTRACT Purpose: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP). Methods: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups. Results: The difference in the strength measurements between the two groups was not statistically significant (p=0.59). Conclusions: The presence of latent MTrPs may not affect the strength of the upper trapezius. PMID:22942517

Muscle activation behavior in a swimming exergame: Differences by experience and gaming velocity.

PubMed

Soltani, Pooya; Figueiredo, Pedro; Fernandes, Ricardo J; Vilas-Boas, João Paulo

2017-11-01

The effects of playing intensity and prior exergame and sport experience on the activation patterns of upper limb muscles during a swimming exergame were investigated. Surface electromyography of Biceps Brachii, Triceps Brachii, Latissimus Dorsi, Upper Trapezius, and Erector Spinae of twenty participants was recorded, and the game play was divided into normal and fast. Mean muscle activation, normalized to maximum voluntary isometric contraction (MVIC), ranged from 4.9 to 95.2%MVIC and differed between normal and fast swimming for all techniques (p<0.05), except for Latissimus Dorsi during backstroke. After normalizing the %MVIC to playing velocity, selective behaviors were observed between muscles which were sufficient for pragmatic game play. Moreover, prior exergame and real sport experience did not have any effect on the muscle activation changes between normal and fast swimming. These behaviors are likely to happen when players understand the game mechanics, even after a short exposure. Such evaluation might help in adjusting the physical demands of sport exergames, for safe and meaningful experiences. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of upper limb muscles behaviour for skilled and recreational archers using compound bow

NASA Astrophysics Data System (ADS)

Ariffin, Muhammad Shahimi; Rambely, Azmin Sham

2017-04-01

The purpose of this study was to investigate muscles activity during archery by carrying out an electromyography (EMG) experiment towards 12 muscles and six joints involving two types of subject (skilled and recreational). EMG is used to detect muscle signals during any particular activity. There were two types of data recorded which were maximum voluntary contraction (MVC) and archery activity. The skilled archer was found to produce 280 N of biceps brachii, 213.9 N of the deltoid, 123.4 N of trapezius forces compare to that of the recreational archer with 371.1 N, 164.9 N and 163.8 N, respectively for the draw arm during drawing phase. It is concluded that the recreational archer tends to a muscle fatigue phenomenon thus may contribute to possible serious injuries.

Electromyographic activity of selected scapular stabilizers during glenohumeral internal and external rotation contractions.

PubMed

Schachter, Aaron K; McHugh, Malachy P; Tyler, Timothy F; Kreminic, Ian J; Orishimo, Karl F; Johnson, Christopher; Ben-Avi, Simon; Nicholas, Stephen J

2010-09-01

An important synergistic relationship exists between the scapular stabilizers and the glenohumeral rotators. Information on the relative contribution of the scapular stabilizers to glenohumeral rotation would be useful for exercise prescription for overhead athletes and for patients with shoulder pathology. We hypothesized that the scapular stabilizers would be highly active during both maximal and submaximal internal and external rotation. Eight healthy male volunteers (16 shoulders) performed internal and external glenohumeral rotation testing at maximal and submaximal intensities. They also performed a scapular retraction rowing exercise at maximal and submaximal levels. Electromyographic (EMG) signals were recorded from the infraspinatus, pectoralis major, serratus anterior, and middle trapezius. Values were compared among muscle groups, among individual muscles at different intensity levels, and among individual muscles at different points in the arc of motion. For submaximal glenohumeral internal rotation, activity in the scapular stabilizers was not different (P = .1-.83) from activity in the internal rotator throughout the range of motion. For the initial two-thirds of maximal internal rotation, middle trapezius activity and pectoralis major activity were higher (P < .05) than serratus anterior activity. For submaximal external rotation, activity in the scapular stabilizers during the middle phase of the motion was higher (P < .05) than activity in the external rotators. For maximal external rotation these differences were present throughout the motion with middle trapezius activity exceeding 100% maximal voluntary contraction. The scapular stabilizers functioned at a similar or higher intensity than the glenohumeral rotators during internal and external rotation. This highlights the importance of training the scapular stabilizers in upper extremity athletes and in patients with shoulder pathology. (c) 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Muscle Activity in Upper-Body Single-Joint Resistance Exercises with Elastic Resistance Bands vs. Free Weights

PubMed Central

Bergquist, Ronny; Iversen, Vegard Moe; Mork, Paul J; Fimland, Marius Steiro

2018-01-01

Abstract Elastic resistance bands require little space, are light and portable, but their efficacy has not yet been established for several resistance exercises. The main objective of this study was to compare the muscle activation levels induced by elastic resistance bands versus conventional resistance training equipment (dumbbells) in the upper-body resistance exercises flyes and reverse flyes. The level of muscle activation was measured with surface electromyography in 29 men and women in a cross-over design where resistance loadings with elastic resistance bands and dumbbells were matched using 10-repetition maximum loadings. Elastic resistance bands induced slightly lower muscle activity in the muscles most people aim to activate during flyes and reverse flies, namely pectoralis major and deltoideus posterior, respectively. However, elastic resistance bands increased the muscle activation level substantially in perceived ancillary muscles, that is deltoideus anterior in flyes, and deltoideus medius and trapezius descendens in reverse flyes, possibly due to elastic bands being a more unstable resistance modality. Overall, the results show that elastic resistance bands can be considered a feasible alternative to dumbbells in flyes and reverse flyes. PMID:29599855

Muscle thickness measurements of the lower trapezius with rehabilitative ultrasound imaging are confounded by scapular dyskinesis.

PubMed

Seitz, Amee L; Baxter, Caralyn J; Benya, Kristen

2015-08-01

Alterations in scapular muscle activity have been theorized to contribute to abnormal scapular motion and shoulder pain, but pose challenges to quantify in the clinic. Rehabilitative Ultrasound Imaging (RUSI) has proved useful identifying dysfunction of lumbar regional stabilizing muscle activity, specifically contractile behavior. Although, recent examinations of scapular stabilizing trapezius muscle function using RUSI did not detect alterations individuals with shoulder pain or differences in muscle thickness between varying external loads in asymptomatic individuals, a potential confounder to prior results, scapular dyskinesis has not been controlled. It is unknown if dyskinesis alters scapular muscle thickness during activation measured with RUSI. Thus, the purpose of this study was to compare change in scapular muscle thickness between individuals with and without scapular dyskinesis. Thirty-nine asymptomatic adults with (n = 19) and without (n = 20) scapular dyskinesis, defined with a reliable and validated method, participated. Two separate ultrasound images of the serratus anterior (SA) and lower trapezius (LT) were captured under two randomized conditions, rest and isometric contraction against gravity, and saved for blinded measurement. Change in thickness with contraction was calculated and expressed as a percentage. The dyskinesis group demonstrated a greater increase (p = 0.005) in LT thickness with the isometric contraction than the group without (mean difference = 31.6%; 95%CI = 10.3, 53.0). No differences in SA or resting thickness of either muscle were found between groups. The presence of scapular dyskinesis alters thickness changes of the lower trapezius during activation. Furthermore, potential underlying reasons beyond muscle contractile behavior must be considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

Serratus anterior and lower trapezius muscle activities during multi-joint isotonic scapular exercises and isometric contractions.

PubMed

Tsuruike, Masaaki; Ellenbecker, Todd S

2015-02-01

Proper scapular function during humeral elevation, such as upward rotation, external rotation, and posterior tilting of the scapula, is necessary to prevent shoulder injury. However, the appropriate intensity of rehabilitation exercise for the periscapular muscles has yet to be clarified. To identify the serratus anterior, lower trapezius, infraspinatus, and posterior deltoid muscle activities during 2 free-motion exercises using 3 intensities and to compare these muscle activities with isometric contractions during quadruped shoulder flexion and external rotation and abduction of the glenohumeral joint. Cross-sectional study. Health Science Laboratory. A total of 16 uninjured, healthy, active, male college students (age = 19.5 ± 1.2 years, height = 173.1 ± 6.5 cm, weight = 68.8 ± 6.6 kg). Mean electromyographic activity normalized by the maximal voluntary isometric contraction was analyzed across 3 intensities and 5 exercises. Intraclass correlation coefficients were calculated for electromyographic activity of the 4 muscles in each free-motion exercise. Significant interactions in electromyographic activity were observed between intensities and exercises (P < .05). The quadruped shoulder-flexion exercise activated all 4 muscles compared with other exercises. Also, the modified robbery free-motion exercise activated the serratus anterior, lower trapezius, and infraspinatus compared with the lawn-mower free-motion exercise. However, neither exercise showed a difference in posterior deltoid electromyographic activity. Three intensities exposed the nature of the periscapular muscle activities across the different exercises. The free-motion exercise in periscapular muscle rehabilitation may not modify serratus anterior, lower trapezius, and infraspinatus muscle activities unless knee-joint extension is limited.

p38 phosphorylation in medullary microglia mediates ectopic orofacial inflammatory pain in rats.

PubMed

Kiyomoto, Masaaki; Shinoda, Masamichi; Honda, Kuniya; Nakaya, Yuka; Dezawa, Ko; Katagiri, Ayano; Kamakura, Satoshi; Inoue, Tomio; Iwata, Koichi

2015-08-12

Orofacial inflammatory pain is likely to accompany referred pain in uninflamed orofacial structures. The ectopic pain precludes precise diagnosis and makes treatment problematic, because the underlying mechanism is not well understood. Using the established ectopic orofacial pain model induced by complete Freund's adjuvant (CFA) injection into trapezius muscle, we analyzed the possible role of p38 phosphorylation in activated microglia in ectopic orofacial pain. Mechanical allodynia in the lateral facial skin was induced following trapezius muscle inflammation, which accompanied microglial activation with p38 phosphorylation and hyperexcitability of wide dynamic range (WDR) neurons in the trigeminal spinal subnucleus caudalis (Vc). Intra-cisterna successive administration of a p38 mitogen-activated protein kinase selective inhibitor, SB203580, suppressed microglial activation and its phosphorylation of p38. Moreover, SB203580 administration completely suppressed mechanical allodynia in the lateral facial skin and enhanced WDR neuronal excitability in Vc. Microglial interleukin-1β over-expression in Vc was induced by trapezius muscle inflammation, which was significantly suppressed by SB203580 administration. These findings indicate that microglia, activated via p38 phosphorylation, play a pivotal role in WDR neuronal hyperexcitability, which accounts for the mechanical hypersensitivity in the lateral facial skin associated with trapezius muscle inflammation.

The effects of smartphone use on upper extremity muscle activity and pain threshold

PubMed Central

Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

2015-01-01

[Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20–22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

Protein alterations in women with chronic widespread pain--An explorative proteomic study of the trapezius muscle.

PubMed

Olausson, Patrik; Gerdle, Björn; Ghafouri, Nazdar; Sjöström, Dick; Blixt, Emelie; Ghafouri, Bijar

2015-07-07

Chronic widespread pain (CWP) has a high prevalence in the population and is associated with prominent negative individual and societal consequences. There is no clear consensus concerning the etiology behind CWP although alterations in the central processing of nociception maintained by peripheral nociceptive input has been suggested. Here, we use proteomics to study protein changes in trapezius muscle from 18 female patients diagnosed with CWP compared to 19 healthy female subjects. The 2-dimensional gel electrophoresis (2-DE) in combination with multivariate statistical analyses revealed 17 proteins to be differently expressed between the two groups. Proteins were identified by mass spectrometry. Many of the proteins are important enzymes in metabolic pathways like the glycolysis and gluconeogenesis. Other proteins are associated with muscle damage, muscle recovery, stress and inflammation. The altered expressed levels of these proteins suggest abnormalities and metabolic changes in the myalgic trapezius muscle in CWP. Taken together, this study gives further support that peripheral factors may be of importance in maintaining CWP.

Protein alterations in women with chronic widespread pain – An explorative proteomic study of the trapezius muscle

PubMed Central

Olausson, Patrik; Gerdle, Björn; Ghafouri, Nazdar; Sjöström, Dick; Blixt, Emelie; Ghafouri, Bijar

2015-01-01

Chronic widespread pain (CWP) has a high prevalence in the population and is associated with prominent negative individual and societal consequences. There is no clear consensus concerning the etiology behind CWP although alterations in the central processing of nociception maintained by peripheral nociceptive input has been suggested. Here, we use proteomics to study protein changes in trapezius muscle from 18 female patients diagnosed with CWP compared to 19 healthy female subjects. The 2-dimensional gel electrophoresis (2-DE) in combination with multivariate statistical analyses revealed 17 proteins to be differently expressed between the two groups. Proteins were identified by mass spectrometry. Many of the proteins are important enzymes in metabolic pathways like the glycolysis and gluconeogenesis. Other proteins are associated with muscle damage, muscle recovery, stress and inflammation. The altered expressed levels of these proteins suggest abnormalities and metabolic changes in the myalgic trapezius muscle in CWP. Taken together, this study gives further support that peripheral factors may be of importance in maintaining CWP. PMID:26150212

Scapulothoracic muscle activity and recruitment timing in patients with shoulder impingement symptoms and glenohumeral instability.

PubMed

Struyf, Filip; Cagnie, Barbara; Cools, Ann; Baert, Isabel; Brempt, Jolien Van; Struyf, Pieter; Meeus, Mira

2014-04-01

Various studies have investigated scapulothoracic muscle activity and recruitment patterns in relation to shoulder complaints in different populations, but a consensus review is lacking. To systematically review the state of the art regarding scapulothoracic muscle activity and recruitment timing in subjects with shoulder pain compared to pain free controls. Systematic review. The search for relevant articles was performed in Pubmed and Web of Science, including Web of Knowledge, using key words related to shoulder pain, scapulothoracic muscle activity or recruitment timing. Articles were included till November 2012. Case-control studies concerning the scapulothoracic region and muscle recruitment using electromyography (EMG) were included. Articles regarding rotator cuff muscles or neck-shoulder pathologies or studies handling a treatment outcome, were excluded. The methodological quality of the articles was assessed using appropriate risk of bias criteria for case-control studies. A total of 12 articles were included in the systematic review, containing patients with Shoulder Impingement Syndrome (SIS) or glenohumeral instability. In patients with SIS 3 out of 6 articles showed increased upper trapezius muscle (UT) activity, 3 out of 5 studies showed decreased lower trapezius muscle (LT) activity and 3 out of 5 articles showed decreased serratus anterior muscle (SA) activity. Patients with glenohumeral instability showed contradictory results on scapulothoracic muscle activity patterns. In both SIS and glenohumeral instability patients, no consensus was found on muscle recruitment timing. Patients with SIS and glenohumeral instability display numerous variations in scapulothoracic muscle activity compared to healthy controls. In the SIS-group, the LT and SA muscle activity is decreased. In addition, the UT muscle activity is increased among the SIS patients, whereas no clear change is seen among patients with glenohumeral instability. Although the scapulothoracic muscle activity changed, no consensus could be made regarding muscle recruitment timing. Copyright © 2013 Elsevier Ltd. All rights reserved.

The change in spatial distribution of upper trapezius muscle activity is correlated to contraction duration.

PubMed

Farina, Dario; Leclerc, Frédéric; Arendt-Nielsen, Lars; Buttelli, Olivier; Madeleine, Pascal

2008-02-01

The aim of the study was to confirm the hypothesis that the longer a contraction is sustained, the larger are the changes in the spatial distribution of muscle activity. For this purpose, surface electromyographic (EMG) signals were recorded with a 13 x 5 grid of electrodes from the upper trapezius muscle of 11 healthy male subjects during static contractions with shoulders 90 degrees abducted until endurance. The entropy (degree of uniformity) and center of gravity of the EMG root mean square map were computed to assess spatial inhomogeneity in muscle activation and changes over time in EMG amplitude spatial distribution. At the endurance time, entropy decreased (mean+/-SD, percent change 2.0+/-1.6%; P<0.0001) and the center of gravity moved in the cranial direction (shift 11.2+/-6.1mm; P<0.0001) with respect to the beginning of the contraction. The shift in the center of gravity was positively correlated with endurance time (R(2)=0.46, P<0.05), thus subjects with larger shift in the activity map showed longer endurance time. The percent variation in average (over the grid) root mean square was positively correlated with the shift in the center of gravity (R(2)=0.51, P<0.05). Moreover, the shift in the center of gravity was negatively correlated to both initial and final (at the endurance) entropy (R(2)=0.54 and R(2)=0.56, respectively; P<0.01 in both cases), indicating that subjects with less uniform root mean square maps had larger shift of the center of gravity over time. The spatial changes in root mean square EMG were likely due to spatially-dependent changes in motor unit activation during the sustained contraction. It was concluded that the changes in spatial muscle activity distribution play a role in the ability to maintain a static contraction.

A slouched body posture decreases arm mobility and changes muscle recruitment in the neck and shoulder region.

PubMed

Malmström, Eva-Maj; Olsson, Joakim; Baldetorp, Johan; Fransson, Per-Anders

2015-12-01

Long-term use of unfavorable postures, congenital deformations and degenerative processes associated with aging or disease may generate an increased thoracic curvature resulting in pain and disability. We wanted to examine whether a slouched postural alignment with increased thoracic kyphosis changes the shoulder kinematics and muscle activity in upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) during arm elevation. The aim was to determine if a slouched posture influences range of motion, muscle activation patterns, maximal muscle activity and the total muscle work required when performing arm elevations. Twelve male subjects (23.3 ± 1.5 years) performed maximum arm elevations in upright and slouched postures. A combined 3D movement and EMG system recorded arm movements and spine curvature simultaneously with EMG activity in the UT, LT and SA. Slouched posture affected the biomechanical conditions by significantly decreasing maximum arm elevation by ~15° (p < 0.001) and decreasing arm movement velocity by ~8 % during movements upwards (p < 0.001) and downwards (p = 0.034). The peak muscle activity increased in all muscles: UT (p = 0.034, +32.3 %), LT (p = 0.001, +48.6 %) and SA (p = 0.007, +20.9 %). The total muscle work increased significantly in the slouched posture during movements upwards: UT (p = 0.003, +36.6 %), LT (p < 0.001, +89.0 %), SA (p = 0.002, +19.4 %) and downwards: UT (p = 0.012, +29.8 %) and LT (p < 0.001, +122.5 %). An increased thoracic kyphosis was found associated with marked increased physical costs when performing arm movements. Hence, patients suffering from neck-shoulder pain and disability should be investigated and treated for defective thoracic curvature issues.

The effects of whole body vibration on EMG activity of the upper extremity muscles in static modified push up position.

PubMed

Ashnagar, Zinat; Shadmehr, Azadeh; Hadian, Mohammadreza; Talebian, Saeed; Jalaei, Shohreh

2016-08-10

Whole Body Vibration (WBV) has been reported to change neuromuscular activity which indirectly assessed by electromyography (EMG). Although researches regarding the influence of WBV on EMG activity of the upper extremity muscles are in their infancy, contradictory findings have been reported as a result of dissimilar protocols. The purpose of this study was to investigate the effects of WBV on electromyography (EMG) activity of upper extremity muscles in static modified push up position. Forty recreationally active females were randomly assigned in WBV and control groups. Participants in WBV group received 5 sets of 30 seconds vibration at 5 mm (peak to peak) and 30 Hz by using vibratory platform. No vibration stimulus was used in the control group. Surface EMG was recorded from Upper Trapezius (UT), Serratus Anterior (SA), Biceps Brachii (BB) and Triceps Brachii (TB) muscles before, during and after the vibration protocol while the subjects maintained the static modified push up position. EMG signals were expressed as root mean square (EMGrms) and normalized by maximum voluntary exertion (MVE). EMGrms activity of the studied muscles increased significantly during the vibration protocol in the WBV group comparing to the control group (P ≤ 0.05). The results indicated that vibration stimulus transmitting via hands increased muscle activity of UT, SA, BB and TB muscles by an average of 206%, 60%, 106% and 120%, respectively, comparing to pre vibration values. These findings suggest that short exposure to the WBV could increase the EMGrms activity of the upper extremity muscles in the static modified push-up position. However, more sessions of WBV application require for a proper judgment.

Children with migraine: Provocation of headache via pressure to myofascial trigger points in the trapezius muscle? - A prospective controlled observational study.

PubMed

Landgraf, M N; Biebl, J T; Langhagen, T; Hannibal, I; Eggert, T; Vill, K; Gerstl, L; Albers, L; von Kries, R; Straube, A; Heinen, F

2018-02-01

The objective was to evaluate a supposed clinical interdependency of myofascial trigger points and migraine in children. Such interdependency would support an interaction of spinal and trigeminal afferences in the trigemino-cervical complex as a contributing factor in migraine. Children ≤18 years with the confirmed diagnosis of migraine were prospectively investigated. Comprehensive data on medical history, clinical neurological and psychological status were gathered. Trigger points in the trapezius muscle were identified by palpation and the threshold of pressure pain at these points was measured. Manual pressure was applied to the trigger points, and the occurrence and duration of induced headache were recorded. At a second consultation (4 weeks after the first), manual pressure with the detected pressure threshold was applied to non-trigger points within the same trapezius muscle (control). Headache and related parameters were again recorded and compared to the results of the first consultation. A total of 13 girls and 13 boys with migraine and a median age of 14.5 (Range 6.3-17.8) years took part in the study. Manual pressure to trigger points in the trapezius muscle led to lasting headache after termination of the manual pressure in 13 patients while no patient experienced headache when manual pressure was applied to non-trigger points at the control visit (p < 0.001). Headache was induced significantly more often in children ≥12 years and those with internalizing behavioural disorder. We found an association between trapezius muscle myofascial trigger points and migraine, which might underline the concept of the trigemino-cervical complex, especially in adolescents. In children with migraine headache can often be induced by pressure to myofascial trigger points, but not by pressure to non-trigger points in the trapezius muscle. This supports the hypothesis of a trigemino-cervical-complex in the pathophysiology of migraine, which might have implications for innovative therapies in children with migraine. © 2017 European Pain Federation - EFIC®.

Serratus Anterior and Lower Trapezius Muscle Activities During Multi-Joint Isotonic Scapular Exercises and Isometric Contractions.

PubMed

Tsuruike, Masaaki; Ellenbecker, Todd

2014-11-14

Context :  Proper scapular function during humeral elevation, such as upward rotation, external rotation, and posterior tilting of the scapula, is necessary to prevent shoulder injury. However, the appropriate intensity of rehabilitation exercise for the periscapular muscles has yet to be clarified. Objective :  To identify the serratus anterior, lower trapezius, infraspinatus, and posterior deltoid muscle activities during 2 free-motion exercises using 3 intensities and to compare these muscle activities with isometric contractions during quadruped shoulder flexion and external rotation and abduction of the glenohumeral joint. Design :  Cross-sectional study. Setting :  Health Science Laboratory. Patients or Other Participants :  A total of 16 uninjured, healthy, active, male college students (age = 19.5 ± 1.2 years, height = 173.1 ± 6.5 cm, weight = 68.8 ± 6.6 kg). Main Outcome Measure(s) :  Mean electromyographic activity normalized by the maximal voluntary isometric contraction was analyzed across 3 intensities and 5 exercises. Intraclass correlation coefficients were calculated for electromyographic activity of the 4 muscles in each free-motion exercise. Results :  Significant interactions in electromyographic activity were observed between intensities and exercises (P < .05). The quadruped shoulder-flexion exercise activated all 4 muscles compared with other exercises. Also, the modified robbery free-motion exercise activated the serratus anterior, lower trapezius, and infraspinatus compared with the lawn-mower free-motion exercise. However, neither exercise showed a difference in posterior deltoid electromyographic activity. Conclusions :  Three intensities exposed the nature of the periscapular muscle activities across the different exercises. The free-motion exercise in periscapular muscle rehabilitation may not modify serratus anterior, lower trapezius, and infraspinatus muscle activities unless knee-joint extension is limited.

Serratus Anterior and Lower Trapezius Muscle Activities During Multi-Joint Isotonic Scapular Exercises and Isometric Contractions

PubMed Central

Tsuruike, Masaaki; Ellenbecker, Todd S.

2015-01-01

Context: Proper scapular function during humeral elevation, such as upward rotation, external rotation, and posterior tilting of the scapula, is necessary to prevent shoulder injury. However, the appropriate intensity of rehabilitation exercise for the periscapular muscles has yet to be clarified. Objective: To identify the serratus anterior, lower trapezius, infraspinatus, and posterior deltoid muscle activities during 2 free-motion exercises using 3 intensities and to compare these muscle activities with isometric contractions during quadruped shoulder flexion and external rotation and abduction of the glenohumeral joint. Design: Cross-sectional study. Setting: Health Science Laboratory. Patients or Other Participants: A total of 16 uninjured, healthy, active, male college students (age = 19.5 ± 1.2 years, height = 173.1 ± 6.5 cm, weight = 68.8 ± 6.6 kg). Main Outcome Measure(s): Mean electromyographic activity normalized by the maximal voluntary isometric contraction was analyzed across 3 intensities and 5 exercises. Intraclass correlation coefficients were calculated for electromyographic activity of the 4 muscles in each free-motion exercise. Results: Significant interactions in electromyographic activity were observed between intensities and exercises (P < .05). The quadruped shoulder-flexion exercise activated all 4 muscles compared with other exercises. Also, the modified robbery free-motion exercise activated the serratus anterior, lower trapezius, and infraspinatus compared with the lawn-mower free-motion exercise. However, neither exercise showed a difference in posterior deltoid electromyographic activity. Conclusions: Three intensities exposed the nature of the periscapular muscle activities across the different exercises. The free-motion exercise in periscapular muscle rehabilitation may not modify serratus anterior, lower trapezius, and infraspinatus muscle activities unless knee-joint extension is limited. PMID:25689561

[A case of chronic multifocal myositis].

PubMed

Maruyama, T; Kondo, K; Tabata, K; Yanagisawa, N

1992-11-01

A 61-year-old civil engineer began to have slowly progressive muscle atrophy in the right shoulder and the left arm at 56 years of age. Muscle wasting became manifest in the left thigh at 59 years and in the right thigh at 60 years. He had mild difficulty in climbing and descending stairs. On examination, although he had notable muscle atrophy in the right trapezius and proximal muscles in the upper and lower extremities, his muscle strength was relatively well preserved. The muscle atrophy was asymmetrical; the right periscapular region and the left upper and lower extremities were more markedly atrophic. In addition, multiple foci of the striking muscle atrophy were noted in the upper trunk and the proximal limb muscles. Fasciculation was not present. Deep tendon reflexes were normal with no pathologic reflexes. Except for a moderately elevated serum creatine kinase level of 709 Ul/l (normal 40-170) and mildly elevated serum myoglobin level of 100 ng/ml (normal < 60), no laboratory tests showed abnormal values suggesting an inflammatory process. Motor and sensory nerve conduction velocities were within normal limits. Electromyography disclosed myopathic and neuropathic changes. Computed tomography (CT) of skeletal muscles showed asymmetrical muscle atrophy and patchy low-density foci. In biopsied left quadriceps and right gastrocnemius muscles which showed partially low density on CT, there was marked variation in muscle fiber size, with necrotic and regenerating fibers, an increased number of centrally placed nuclei, and interstitial fibrosis. There were numerous foci of mononuclear inflammatory cellular infiltration, especially around the blood vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective Activation of Shoulder, Trunk, and Arm Muscles: A Comparative Analysis of Different Push-Up Variants.

PubMed

Marcolin, Giuseppe; Petrone, Nicola; Moro, Tatiana; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio

2015-11-01

The push-up is a widely used exercise for upper limb strengthening that can be performed with many variants. A comprehensive analysis of muscle activation during the ascendant phase (AP) and descendant phase (DP) in different variants could be useful for trainers and rehabilitators. To obtain information on the effect of different push-up variants on the electromyography (EMG) of a large sample of upper limb muscles and to investigate the role of the trunk and abdomen muscles during the AP and DP. Cross-sectional study. University laboratory. Eight healthy, young volunteers without a history of upper extremity or spine injury. Participants performed a set of 10 repetitions for each push-up variant: standard, wide, narrow, forward (FP), and backward (BP). Surface EMG of 12 selected muscles and kinematics data were synchronously recorded to describe the AP and DP. Mean EMG activity of the following muscles was analyzed: serratus anterior, deltoideus anterior, erector spinae, latissimus dorsi, rectus abdominis, triceps brachii caput longus, triceps brachii caput lateralis, obliquus externus abdominis, pectoralis major sternal head, pectoralis major clavicular head, trapezius transversalis, and biceps brachii. The triceps brachii and pectoralis major exhibited greater activation during the narrow-base variant. The highest activation of abdomen and back muscles was recorded for the FP and BP variants. The DP demonstrated the least electrical activity across all muscles, with less marked differences for the abdominal and erector spinae muscles because of their role as stabilizers. Based on these findings, we suggest the narrow-base variant to emphasize triceps and pectoralis activity and the BP variant for total upper body strength conditioning. The FP and BP variants should be implemented carefully in participants with low back pain because of the greater activation of abdominal and back muscles.

A reliable approach to the closure of large acquired midline defects of the back

DOE Office of Scientific and Technical Information (OSTI.GOV)

Casas, L.A.; Lewis, V.L. Jr.

1989-10-01

A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with onemore » layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described.« less

Unilateral hypoplasia of the trapezius muscle in a 10-year-old boy: a case report.

PubMed

Witbreuk, Melinda M; Lambert, Simon M; Eastwood, Deborah M

2007-05-01

We present a 10-year-old boy with a partial absence of or a hypoplastic right trapezius. At present, his only concern is shoulder asymmetry. No family history of significance and no history of trauma exist. His radiographs confirm changes in bony anatomy secondary to the altered balance of muscle forces on the skeleton. We have not identified any other clinical report of a partial or total absence of the trapezius although it has been defined in cadaveric cases. Similarly, some papers have described an absence of trapezius in combination with other abnormalities. In these cases, an abnormal blood supply has been described in contrast to the normal neurovascular anatomy identified in the cadaveric cases with partial absence. If this patient develops painful disability, the Eden-Lange procedure may be an appropriate treatment as for patients with spinal accessory nerve palsies.

Muscle MRI findings in facioscapulohumeral muscular dystrophy.

PubMed

Gerevini, Simonetta; Scarlato, Marina; Maggi, Lorenzo; Cava, Mariangela; Caliendo, Giandomenico; Pasanisi, Barbara; Falini, Andrea; Previtali, Stefano Carlo; Morandi, Lucia

2016-03-01

Facioscapulohumeral muscular dystrophy (FSHD) is characterized by extremely variable degrees of facial, scapular and lower limb muscle involvement. Clinical and genetic determination can be difficult, as molecular analysis is not always definitive, and other similar muscle disorders may have overlapping clinical manifestations. Whole-body muscle MRI examination for fat infiltration, atrophy and oedema was performed to identify specific patterns of muscle involvement in FSHD patients (30 subjects), and compared to a group of control patients (23) affected by other myopathies (NFSHD). In FSHD patients, we detected a specific pattern of muscle fatty replacement and atrophy, particularly in upper girdle muscles. The most frequently affected muscles, including paucisymptomatic and severely affected FSHD patients, were trapezius, teres major and serratus anterior. Moreover, asymmetric muscle involvement was significantly higher in FSHD as compared to NFSHD patients. In conclusion, muscle MRI is very sensitive for identifying a specific pattern of involvement in FSHD patients and in detecting selective muscle involvement of non-clinically testable muscles. Muscle MRI constitutes a reliable tool for differentiating FSHD from other muscular dystrophies to direct diagnostic molecular analysis, as well as to investigate FSHD natural history and follow-up of the disease. Muscle MRI identifies a specific pattern of muscle involvement in FSHD patients. Muscle MRI may predict FSHD in asymptomatic and severely affected patients. Muscle MRI of upper girdle better predicts FSHD. Muscle MRI may differentiate FSHD from other forms of muscular dystrophy. Muscle MRI may show the involvement of non-clinical testable muscles.

Scapulothoracic Muscle Activity during Use of a Wall Slide Device (WSD), a Comparison with the General Wall Push up Plus

PubMed Central

Park, Se-yeon; Ahn, Tae-kyung; Eom, Ji-hwan; Youn, Hyun-ji; Kim, In-kwang; Yoo, Won-gyu

2014-01-01

[Purpose] The purpose of this study was to evaluate the effect of the wall slide device on activation of the scapulothoracic musculature. [Subjects] We recruited 15 healthy male subjects. [Methods] The subjects performed the general wall push-up plus (WPUP) and the wall slide with device (WSD) exercises. During the exercises, the muscle activities of the upper and lower trapezius (UT, LT), middle and lower serratus anterior (MSA, LSA), and pectoralis major (PM) were measured. [Results] The normalized muscle activity data of the WSD were significantly higher in UT, MSA and LSA than the WPUP. [Conclusion] Our results suggest that exercise using the WSD can more effectively activate the scapulothoracic musculature than the general WPUP. PMID:25013271

Genetic contribution of catechol-O-methyltransferase polymorphism (Val158Met) in children with chronic tension-type headache.

PubMed

Fernández-de-las-Peñas, César; Ambite-Quesada, Silvia; Rivas-Martínez, Inés; Ortega-Santiago, Ricardo; de-la-Llave-Rincón, Ana Isabel; Fernández-Mayoralas, Daniel M; Pareja, Juan A

2011-10-01

Our aim was to investigate the relationship between Val158Met polymorphisms, headache, and pressure hypersensitivity in children with chronic tension-type headache (CTTH). A case-control study with blinded assessor was conducted. Seventy children with CTTH associated with pericranial tenderness and 70 healthy children participated. After amplifying Val158Met polymorphism by polymerase chain reactions, we assessed genotype frequencies and allele distributions. We classified children according to their Val158Met polymorphism: Val/Val, Val/Met, Met/Met. Pressure pain thresholds (PPT) were bilaterally assessed over the temporalis, upper trapezius, second metacarpal, and tibialis anterior muscles. The distribution of Val158Met genotypes was not significantly different (p = 0.335), between children with CTTH and healthy children, and between boys and girls (p = 0.872). Children with CTTH with the Met/Met genotype showed a longer headache history compared with those with Met/Val (p = 0.001) or Val/Val (p = 0.002) genotype. Children with CTTH with Met/Met genotype showed lower PPT over upper trapezius and temporalis muscles than children with CTTH with Met/Val or Val/Val genotype (p < 0.01). The Val158Met catechol-O-methyltransferase (COMT) polymorphism does not appear to be involved in predisposition to suffer from CTTH in children; nevertheless, this genetic factor may be involved in the phenotypic expression, as pressure hypersensitivity was greater in those CTTH children with the Met/Met genotype.

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia.

PubMed

Wang, Chaoliang; Huang, Sufang; Wang, Yingzhen; Sun, Xuesheng; Zhu, Tao; Li, Qiang; Lin, Chu

2015-01-01

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

PubMed Central

Wang, Chaoliang; Huang, Sufang; Wang, Yingzhen; Sun, Xuesheng; Zhu, Tao; Li, Qiang; Lin, Chu

2015-01-01

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries. PMID:28352721

Reduction of the subacromial space in athletes with and without rotator cuff tendinopathy and its association with the strength of scapular muscles.

PubMed

Leong, Hio Teng; Tsui, Sammi Sin Mei; Ng, Gabriel Yin-Fat; Fu, Siu Ngor

2016-12-01

To compare the reduction of subacromial space (SAS) during arm abduction between overhead athletes with and without rotator cuff (RC) tendinopathy, and to explore the relationship between the strength of scapular muscles with the SAS. Cross-sectional study. Sixty-six athletes (33 healthy and 33 with RC tendinopathy, mean age=22.3 years) participated in the study. Ultrasound measurement of the SAS with arm at 0°, 30° and 60° of shoulder abduction were taken, and the maximal isometric force in upper, middle and lower trapezius, and serratus anterior with manual muscle tests (MMT) were assessed using a handheld dynamometer. The change in SAS during arm abduction from 0° to 30° (SAS 0°-30° ), 30° to 60° (SAS 30°-60° ) and 0° to 60° (SAS 0°-60° ) was compared between groups. Differences in force produced with scapular muscles MMT between groups and relationships with reduction in SAS were explored. We found more reduction of the SAS during SAS 0°-30° in athletes with RC tendinopathy (0.44±1.22mm) than healthy athletes (-0.06±1.41mm) (p=0.045). Athletes with RC tendinopathy demonstrated significant decrease in all scapular muscles MMT strength when compared to their healthy counterparts (p<0.05). In healthy athletes, a lower middle and lower trapezius MMT strength were moderately associated with a greater reduction in SAS during 0° to 30° (r=-0.445, p=0.016 and r=-0.423, p=0.022, respectively) and 0° to 60° of shoulder abduction (r=-0.415, p=0.018 and r=-0.504, p=0.003, respectively). Athletes with RC tendinopathy demonstrated more reduction in the SAS during early arm abduction. Decreased strength of middle and lower trapezius was related to reduction of the SAS. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Muscle oxygenation and glycolysis in females with trapezius myalgia during stress and repetitive work using microdialysis and NIRS.

PubMed

Sjøgaard, Gisela; Rosendal, Lars; Kristiansen, Jesper; Blangsted, Anne K; Skotte, Jørgen; Larsson, Britt; Gerdle, Björn; Saltin, Bengt; Søgaard, Karen

2010-03-01

The aim of this investigation was to study female workers active in the labour market for differences between those with trapezius myalgia (MYA) and without (CON) during repetitive pegboard (PEG) and stress (STR) tasks regarding (1) relative muscle load, (2) trapezius muscle blood flow, (3) metabolite accumulation, (4) oxygenation, and (5) pain development. Among 812 female employees (age 30-60 years) at 7 companies with high prevalence of neck/shoulder complaints, clinical examination identified 43 MYA and 19 CON. At rest, during PEG, and STR the trapezius muscle was measured using (1) EMG and MMG, (2) microdialysis, and (3) NIRS. Further, subjective pain ratings were scored (VAS). EMGrms in %MVE (Maximal Voluntary EMG-activity), was significantly higher among MYA than CON during PEG (11.74 +/- 9.09 vs. 7.42 +/- 5.56%MVE) and STR (5.47 +/- 5.00 vs. 3.28 +/- 1.94%MVE). MANOVA showed a group and time effect regarding data from the microdialysis: for MYA versus CON group differences demonstrated lower muscle blood flow and higher lactate and pyruvate concentrations. Potassium and glucose only showed time effects. NIRS showed similar initial decreases in oxygenation with PEG in both groups, but only in CON a significant increase back to baseline during PEG. VAS score at rest was highest among MYA and increased during PEG, but not for CON. The results showed significant differences between CON and MYA regarding muscle metabolism at rest and with PEG and STR. Higher relative muscle load during PEG and STR, insufficient muscle blood flow and oxygenation may account for the higher lactate, pyruvate and pain responses among MYA versus CON.

Effects of aging on mechanical properties of sternocleidomastoid and trapezius muscles during transition from lying to sitting position-A cross-sectional study.

PubMed

Kocur, Piotr; Grzeskowiak, Marcin; Wiernicka, Marzena; Goliwas, Magdalena; Lewandowski, Jacek; Łochyński, Dawid

The aim of this study was to analyze the effects of aging on the viscoelastic properties of the upper trapezius (UT) and the sternocleidomastoid (SCM) muscle during transition from lying to sitting position. The study included 39 older (mean age 67±5.9years) and 36 younger (21.1±1.8years) women. Tone, stiffness and elasticity of the UT and the SCM were measured by means of myotonometry (MyotonPRO) in lying and then, in sitting position. The results were compared using two-way analysis of variance. Irrespective of the position, older women presented with significantly higher muscle tone, stiffness and elasticity than younger subjects (P<0.05). In both groups, the transition from lying to sitting position resulted in a decrease (P<0.05) in the tone and stiffness, but not the elasticity (P>0.05) of the SCM, and stimulated an increase in the tone, stiffness and elasticity of the UT (P<0.05). The degree of changes in both study groups was similar, except from the absolute value of the UT elasticity, significantly higher increase in older women than in younger subjects (P<0.05). Age contributes to an increase in the stiffness and tone of the UT and the SCM, as well as to a decrease in the elasticity of these muscles in female subjects. In contrast, age exerts only a slight effect on the mechanical properties of both muscles during transition from lying to sitting position. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Muscular patterns and activation levels of auxiliary breathing muscles and thorax movement in classical singing.

PubMed

Pettersen, Viggo

2005-01-01

The aim of this paper is to present an overview of the findings in seven studies exploring muscular patterns and muscle activation levels in selected muscles by classical singers. In addition, the relationship of these muscles to thorax (TX) movement was investigated. Loading levels and respiratory phasing of upper trapezius (TR), sternocleidomastoideus (STM) and the scalenes (SC) were investigated in vocalization tasks with variation in vocal loudness and pitch. Further, muscle activity in the posterior neck (PN) was investigated in inhalation and phonation and, finally, TR, intercostal (INT), lateral abdominal (OBL) and anterior abdominal (RC) muscle loading in student and professional singers was examined. Muscle activity was recorded by use of an ambulatory four-channel monitoring system (Physiometer PHY 400, Premed, Norway). TX movement was traced with two strain gauge sensors (RES-117) placed around the upper TX and lower TX. A phasing of upper TR activity to INT and OBL activity was discovered, all muscles supporting the expiration phase. During phonation, TR contributes in the compression of the upper TX, thus serving as an accessory muscle of expiration. TR activity is reduced with short breathing cycles and is mostly inactive in simplified speaking tasks. During phonation, professional opera singers activate the expiratory-phased TR, INT, OBL and RC muscles to higher levels than student singers do. STM and SC show correlated activity patterns during inhalation and phonation by classical singers. During demanding singing, expiratory-phased STM and SC activity peaks produce a counterforce to the compression of upper TX at high pitches. As breathing demands are lowered, STM and SC activity are reduced and attain inspiratory phasing. Substantial muscle activity is observed in PN during inhalation and phonation. EMG biofeedback performed on TR and STM have a secondary effect of lowering EMG activity in PN. (c) 2005 S. Karger AG, Basel

Serratus anterior and trapezius muscle activity during knee push-up plus and knee-plus exercises performed on a stable, an unstable surface and during sling-suspension.

PubMed

Horsak, Brian; Kiener, Marion; Pötzelsberger, Andreas; Siragy, Tarique

2017-01-01

Push-up plus variations are commonly prescribed to clients during shoulder rehabilitation. The purpose of this study was to compare electromyographic (EMG) activities of the serratus anterior (SA), upper (UT), and lower trapezius (LT) during a knee push-up plus and knee-plus exercise performed on various surfaces. Within-subjects Repeated-Measure Design. 19 healthy, young female participants performed both exercises on a stable and unstable surface and during sling-suspension. Surface EMG activities were recorded and average amplitudes were presented as a percentage of the maximal voluntary contraction. A two-way repeated-measures ANOVA was performed to determine differences in activity for each muscle. SA showed no significant differences between exercises and was independent of the base of support (p > 0.05). Muscle activity of UT (95% CI [1.2, 1.4]) and LT (95% CI [2.4, 3.5]) showed slightly greater values when performing the knee push-up plus compared to the knee-plus exercise. The isolated protraction of the shoulder girdle in a kneeling position is as sufficient as the push-up plus in activating the SA selectively. Therefore, we recommended this exercise for clients who are unable to perform an entire push-up or should avoid detrimental stress on the shoulder joint. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction.

PubMed

Jang, Hyun-jeong; Kim, Suhn-yeop; Oh, Duck-won

2015-04-01

The aim of the present study was to investigate the effects of augmented trunk stabilization with external compression support (ECS) on the electromyography (EMG) activity of shoulder and scapular muscles and shoulder abductor strength during isometric shoulder abduction. Twenty-six women volunteered for the study. Surface EMG was used to monitor the activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and middle deltoid (MD), and shoulder abductor strength was measured using a dynamometer during three experimental conditions: (1) no external support (condition-1), (2) pelvic support (condition-2), and (3) pelvic and thoracic supports (condition-3) in an active therapeutic movement device. EMG activities were significantly lower for UT and higher for MD during condition 3 than during condition 1 (p < 0.05). The MD/UT ratio was significantly higher during condition 3 than during conditions 1 and 2, and higher during condition 2 than during condition 1 (p < 0.05). Shoulder abductor strength was significantly higher during condition 3 than during condition 1 (p < 0.05). These findings suggest that augmented trunk stabilization with the ECS may be advantageous with regard to reducing the compensatory muscle effort of the UT during isometric shoulder abduction and increasing shoulder abductor strength. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment.

PubMed

Thuresson, Marcus; Ang, Björn; Linder, Jan; Harms-Ringdahl, Karin

2003-05-01

Helicopter pilots usually work in unfavorable ergonomic positions, often with bulky head-worn equipment during flying missions. The purpose of this study was to evaluate and compare immediate muscle response in the dorsal neck muscles to different positions with a variety of head-worn equipment. Fourteen healthy male helicopter pilots volunteered for this study. EMG activity in the upper and lower dorsal neck muscles and the trapezius muscle was measured in a laboratory situation for 5 s in different sitting positions (neutral, trunk inclined 20 degrees, neck flexed 20 degrees), including registration of a 30 degrees left and right rotation in every position; all measurements were performed while wearing a helmet, a helmet and night vision goggles (hNVG), and a helmet, night vision goggles, and counterweight (hCW), in random order. There was significant higher EMG activity in the upper neck with hNVG and hCW than with the helmet only when comparing the mean activity level of all positions. However, there was no significant difference in EMG activity between any variations of head-worn equipment when comparing activity levels during each position separately. In the upper and lower neck, respectively, there was significantly higher muscle activity during the ipsilateral rotated positions plus neck flexion and trunk inclination than in most other positions. The increased load caused by different positions seems to have a greater influence on muscle activity than the increased load of the head-worn equipment, which must be considered when designing helicopter work-places.

Trapezius muscle activity in using ordinary and ergonomically designed dentistry chairs.

PubMed

Haddad, O; Sanjari, M A; Amirfazli, A; Narimani, R; Parnianpour, M

2012-04-01

Most dentists complain of musculoskeletal disorders which can be caused by prolonged static posture, lack of suitable rest and other physical and psychological problems. We evaluated a chair with a new ergonomic design which incorporated forward leaning chest and arm supports. The chair was evaluated in the laboratory during task simulation and EMG analysis on 12 students and subjectively assessed by 30 professional dentists using an 18-item questionnaire. EMG activity of right and left trapezius muscles for 12 male students with no musculoskeletal disorders was measured while simulating common tasks like working on the teeth of the lower jaw. Normalized EMG data showed significant reduction (p<0.05) in all EMG recordings of the trapezius muscle. Dentists also unanimously preferred the ergonomically designed chair. Such ergonomically designed chairs should be introduced as early as possible in student training before bad postural habits are acquired.

Vaginismus, a component of a general defensive reaction. an investigation of pelvic floor muscle activity during exposure to emotion-inducing film excerpts in women with and without vaginismus.

PubMed

van der Velde, J; Laan, E; Everaerd, W

2001-01-01

This study investigates the mechanism underlying vaginismus, which may be part of a general defense mechanism. Exposure to a threatening situation will evoke an increase in muscle activity. This muscle reaction will not be restricted to the pelvic floor but will also occur in postural muscles, such as in the trapezius region. Women with and without vaginismus were exposed to four stimuli: excerpts from threatening, erotic, neutral and sexual-threatening films. Subjects were 45 physician- or self-referred patients with vaginismus and 32 controls with no sexual or pelvic floor complaints. The activity of the pelvic floor muscles and of the muscles in the trapezius region was recorded with surface electrodes. There were no differences between women with and without vaginistic reactions. EMG measurement of both the pelvic floor muscles and the trapezius muscle showed an increase in muscle activity during the threatening and sexual-threatening excerpts in women with and without vaginismus. This increase of involuntary pelvic floor muscle activity is part of a general defense mechanism that occurs during exposure to threatening situations. This reaction is not restricted to a situation with a sexual content. The results of this study shed new light on the concept of vaginismus as a primarily sexual dysfunction.

Job enlargement and mechanical exposure variability in cyclic assembly work.

PubMed

Möller, Therése; Mathiassen, Svend Erik; Franzon, Helena; Kihlberg, Steve

2004-01-15

Cyclic assembly work is known to imply a high risk for musculoskeletal disorders. To have operators rotate between work tasks is believed to be one way of decreasing this risk, since it is expected to increase variation in mechanical and psychological exposures (physical and mental loads). This assumption was investigated by assessing mechanical exposure variability in three assembly tasks in an electronics assembly plant, each on a separate workstation, as well as in a 'job enlargement' scenario combining all three stations. Five experienced operators worked for 1 h on each station. Data on upper trapezius and forearm extensor muscle activity were obtained by means of electromyography (EMG), and working postures of the head and upper arms were assessed by inclinometry. The cycle-to-cycle variance of parameters representing the three exposure dimensions: level, frequency and duration was estimated using ANOVA algorithms for each workstation separately as well as for a balanced combination of all three. For a particular station, the variability of trapezius EMG activity levels relative to the mean was higher than for extensor EMG: between-cycles coefficients of variation (CV) about 0.15 and 0.10, respectively. A similar relationship between CV applied to the parameter describing frequency of EMG activity. Except for head inclination levels, the between-cycles CV was larger for posture parameters than for EMG. The between-cycles variance increased up to six fold in the job enlargement scenario, as compared to working at only one station. The difference in mean exposure between workstations was larger for trapezius EMG parameters than for forearm extensor EMG and postures, and hence the effect of job enlargement on exposure variability was more pronounced for the trapezius. For some stations, job enlargement even implied less cycle-to-cycle variability in forearm extensor EMG parameters than working at that station only. Whether the changes in exposure variability associated with job enlargement were sufficient to imply a decreased risk for musculoskeletal disorders is not known.

Immediate effects on electromyographic activity and pressure pain thresholds after a cervical manipulation in mechanical neck pain: a randomized controlled trial.

PubMed

de Camargo, Viviane Maduro; Alburquerque-Sendín, Francisco; Bérzin, Fausto; Stefanelli, Vinicius Cobos; de Souza, Daiana P Rodrigues; Fernández-de-las-Peñas, César

2011-05-01

The purpose of this study was to identify the immediate effects of a manipulation of C5/C6 level on electromyography (EMG) of the deltoid muscle and in pressure pain thresholds (PPTs) in patients with mechanical neck pain. Thirty-seven subjects with mechanical neck pain were randomly divided into 2 groups: manipulative group, which received a cervical spine manipulation targeted to C5/C6 segment, and a control group, which did not receive any procedure. Outcomes were EMG data of the deltoid muscle (rest, isometric contraction for 5 or 30 seconds, and isotonic contraction) and PPT over upper trapezius and deltoid muscles and C5 spinous process. They were assessed before and 5 minutes after treatment by a blinded assessor. A 3-way repeated-measures analysis of variance was used to examine the effects of the manipulation. A significant group time interaction for MF at the beginning of isometric contraction for 30 seconds (F = 7.957, P = .006) was also found: the manipulative group experienced a greater increase in MF at the beginning of the isometric contraction than did the control group. A significant group time interaction was also found for root mean square during isometric contraction for 30 seconds (P = .003); however, changes were small. Patients within the manipulative group experienced an increase on PPT over the deltoid (P = .010) and C5 spinous process (P = .025), but not over upper trapezius (P = .776). Manipulation at C5/C6 level in the study participants seemed to increase EMG amplitude signal and fatigue resistance in a nonspinal (deltoid) muscle innervated by the same segment in patients with mechanical neck pain. However, these changes were relative small. An increase on PPT over those tissues innervated by the manipulated segment was also found after the manipulative procedure. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Upper limb muscular activity and perceived workload during laryngoscopy: comparison of Glidescope(R) and Macintosh laryngoscopy in manikin: an observational study.

PubMed

Caldiroli, D; Molteni, F; Sommariva, A; Frittoli, S; Guanziroli, E; Cortellazzi, P; Orena, E F

2014-03-01

The interaction between operators and their working environment during laryngoscopy is poorly understood. Numerous studies have focused on the forces applied to the patient's airway during laryngoscopy, but only a few authors have addressed operator muscle activity and workload. We tested whether different devices (Glidescope(®) and Macintosh) use different muscles and how these differences affect the perceived workload. Ten staff anaesthetists performed three intubations with each device on a manikin. Surface electromyography was recorded for eight single muscles of the left upper limb. The NASA Task Load Index (TLX) was administered after each experimental session to evaluate perceived workload. A consistent reduction in muscular activation occurred with Glidescope(®) compared with Macintosh for all muscles tested (mean effect size d=3.28), and significant differences for the upper trapezius (P=0.002), anterior deltoid (P=0.001), posterior deltoid (P=0.000), and brachioradialis (P=0.001) were observed. The overall NASA-TLX workload score was significantly lower for Glidescope(®) than for Macintosh (P=0.006), and the factors of physical demand (P=0.008) and effort (P=0.006) decreased significantly. Greater muscular activity and workload were observed with the Macintosh laryngoscope. Augmented vision and related postural adjustments related to using the Glidescope(®) may reduce activation of the operator's muscles and task workload.

Evaluation of document location during computer use in terms of neck muscle activity and neck movement.

PubMed

Goostrey, Sonya; Treleaven, Julia; Johnston, Venerina

2014-05-01

This study evaluated the impact on neck movement and muscle activity of placing documents in three commonly used locations: in-line, flat desktop left of the keyboard and laterally placed level with the computer screen. Neck excursion during three standard head movements between the computer monitor and each document location and neck extensor and upper trapezius muscle activity during a 5 min typing task for each of the document locations was measured in 20 healthy participants. Results indicated that muscle activity and neck flexion were least when documents were placed laterally suggesting it may be the optimal location. The desktop option produced both the greatest neck movement and muscle activity in all muscle groups. The in-line document location required significantly more neck flexion but less lateral flexion and rotation than the laterally placed document. Evaluation of other holders is needed to guide decision making for this commonly used office equipment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Muscle activation patterns in acceleration-based phases during reach-to-grasp movement.

PubMed

Tokuda, Keisuke; Lee, Bumsuk; Shiihara, Yasufumi; Takahashi, Kazuhiro; Wada, Naoki; Shirakura, Kenji; Watanabe, Hideomi

2016-11-01

[Purpose] An earlier study divided reaching activity into characteristic phases based on hand velocity profiles. By synchronizing muscle activities and the acceleration profile, a phasing approach for reaching movement, based on hand acceleration profiles, was attempted in order to elucidate the roles of individual muscle activities in the different phases of the acceleration profile in reaching movements. [Subjects and Methods] Ten healthy volunteer subjects participated in this study. The aim was to electromyographically evaluate muscles around the shoulder, the upper trapezius, the anterior deltoid, the biceps brachii, and the triceps brachii, most of which have been used to evaluate arm motion, as well as the acceleration of the upper limb during simple reaching movement in the reach-to-grasp task. [Results] Analysis showed the kinematic trajectories of the acceleration during a simple biphasic profile of the reaching movement could be divided into four phases: increasing acceleration (IA), decreasing acceleration (DA), increasing deceleration (ID), and decreasing deceleration (DD). Muscles around the shoulder showed different activity patterns, which were closely associated with these acceleration phases. [Conclusion] These results suggest the important role of the four phases, derived from the acceleration trajectory, in the elucidation of the muscular mechanisms which regulate and coordinate the muscles around the shoulder in reaching movements.

Activation of selected shoulder muscles during unilateral wall and bench press tasks under submaximal isometric effort.

PubMed

Tucci, Helga T; Ciol, Marcia A; de Araújo, Rodrigo C; de Andrade, Rodrigo; Martins, Jaqueline; McQuade, Kevin J; Oliveira, Anamaria S

2011-07-01

Controlled laboratory study. To assess the activation of 7 shoulder muscles under 2 closed kinetic chain (CKC) tasks for the upper extremity using submaximal isometric effort, thus providing relative quantification of muscular isometric effort for these muscles across the CKC exercises, which may be applied to rehabilitation protocols for individuals with shoulder weakness. CKC exercises favor joint congruence, reduce shear load, and promote joint dynamic stability. Additionally, knowledge about glenohumeral and periscapular muscle activity elicited during CKC exercises may help clinicians to design protocols for shoulder rehabilitation. Using surface electromyography, activation level was measured across 7 shoulder muscles in 20 healthy males, during the performance of a submaximal isometric wall press and bench press. Signals were normalized to the maximal voluntary isometric contraction, and, using paired t tests, data were analyzed between the exercises for each muscle. Compared to the wall press, the bench press elicited higher activity for most muscles, except for the upper trapezius. Levels of activity were usually low but were above 20% maximal voluntary isometric contraction for the serratus anterior on both tasks, and for the long head triceps brachii on the bench press. Both the bench press and wall press, as performed in this study, led to relatively low EMG activation levels for the muscles measured and may be considered for use in the early phases of rehabilitation.

Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome: A Randomized Controlled Trial.

PubMed

Haik, Melina N; Alburquerque-Sendín, Francisco; Camargo, Paula R

2017-08-01

To investigate the short-term effects of thoracic spine manipulation (TSM) on pain, function, scapular kinematics, and scapular muscle activity in individuals with shoulder impingement syndrome. Randomized controlled trial with blinded assessor and patient. Laboratory. Patients with shoulder impingement syndrome (N=61). Participants were randomly allocated to TSM group (n=30) or sham-TSM group (n=31) and attended 2 intervention sessions over a 1-week period. Scapular kinematics and muscle activity were measured at day 1 (baseline, before the first intervention), day 2 preintervention (before second intervention), day 2 postintervention (after the second intervention), and day 3 (follow-up). Shoulder pain and function were assessed by the Disability of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff Index at baseline, day 2 preintervention, and follow-up. An assessor blinded to group assignment measured all outcomes. Pain decreased by 0.7 points (95% confidence interval, 1.3-0.1 points) at day 2 preintervention and 0.9 points (95% confidence interval, 1.5-0.3 points) at day 2 postintervention in the TSM group. The Disability of the Arm, Shoulder and Hand questionnaire (P=.01) and Western Ontario Rotator Cuff Index (P=.02) scores improved in both groups. Scapular upward rotation increased during arm lowering (P<.01) at day 2 postintervention (5.3°) and follow-up (3.5°) in the TSM group. Upper trapezius activity increased (P<.05) in the sham-TSM group. Middle trapezius, lower trapezius, and serratus anterior decreased activities in both groups during elevation and lowering of the arm. TSM may increase scapular upward rotation during arm lowering. TSM does not seem to influence activity of the scapular muscles. The results concerning shoulder pain, function, scapular tilt, and internal rotation are not conclusive. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Biomechanical comparison between the trapezius transfer and latissimus transfer for irreparable posterosuperior rotator cuff tears.

PubMed

Omid, Reza; Heckmann, Nathanael; Wang, Lawrence; McGarry, Michelle H; Vangsness, C Thomas; Lee, Thay Q

2015-10-01

The purpose of this study was to characterize the biomechanical effects of the lower trapezius transfer and to compare it with the latissimus dorsi transfer in a cadaveric model of a massive posterosuperior rotator cuff tear. Eight cadaveric shoulders were tested at 0°, 30°, and 60° of shoulder abduction. Range of motion, humeral rotational position due to muscle loading, joint reaction forces, and kinematics were measured. All specimens were tested in 4 conditions: intact, massive posterosuperior cuff tear, lower trapezius transfer, and latissimus dorsi transfer. A repeated-measures analysis of variance was used for statistical analysis. Internal rotation due to muscle loading increased with massive cuff tear compared with the intact condition (P < .05). The latissimus transfer corrected this change at 0° abduction, whereas the trapezius transfer corrected this at all abduction angles. The massive cuff tear decreased glenohumeral joint compression forces at all abduction angles; these forces were restored by the lower trapezius transfer (P < .05). At maximum humeral internal rotation and 0° of abduction, the humeral head apex shifted superiorly and laterally with massive cuff tear (P < .05); this shift was more closely restored to intact values by the trapezius transfer compared with the latissimus transfer (P < .05). The lower trapezius transfer is superior to the latissimus transfer at restoring native glenohumeral kinematics and joint reaction forces in our cadaveric model. It may be a promising treatment option for patients with a massive irreparable rotator cuff tear. Published by Elsevier Inc.

Muscle trigger point therapy in tension-type headache.

PubMed

Alonso-Blanco, Cristina; de-la-Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César

2012-03-01

Recent evidence suggests that active trigger points (TrPs) in neck and shoulder muscles contribute to tension-type headache. Active TrPs within the suboccipital, upper trapezius, sternocleidomastoid, temporalis, superior oblique and lateral rectus muscles have been associated with chronic and episodic tension-type headache forms. It seems that the pain profile of this headache may be provoked by referred pain from active TrPs in the posterior cervical, head and shoulder muscles. In fact, the presence of active TrPs has been related to a higher degree of sensitization in tension-type headache. Different therapeutic approaches are proposed for proper TrP management. Preliminary evidence indicates that inactivation of TrPs may be effective for the management of tension-type headache, particularly in a subgroup of patients who may respond positively to this approach. Different treatment approaches targeted to TrP inactivation are discussed in the current paper, focusing on tension-type headache. New studies are needed to further delineate the relationship between muscle TrP inactivation and tension-type headache.

Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius.

PubMed

Kim, H A; Hwang, U J; Jung, S H; Ahn, S H; Kim, J H; Kwon, O Y

2017-11-01

This study was conducted in order to compare the strength of scapular elevator and shoulder abductor with and without restricted scapular elevation between male subjects with and without myofascial trigger points in the upper trapezius. In total, 15 male subjects with myofascial trigger points, and 15age- and weight-matched male subjects without myofascial trigger points in the upper trapezius. Each subject was measured in the strength of maximum isometric scapular elevation and shoulder abduction with and without restricted scapular elevation. Maximum isometric contractions were measured using the Smart KEMA strength measurement system. Independent t-tests were used to compare shoulder strength values between the myofascial trigger points and non- myofascial trigger points groups. The results showed that shoulder abductor strength in the group with myofascial trigger points (5.64kgf) was significantly lower than in the group without myofascial trigger points (11.96kgf) when scapular elevation was restricted (p<0.05). However, there was no significant difference in the strength of the scapular elevator or shoulder abductor between groups (p>0.05). These findings suggest that decreased strength in the shoulder abductor with restricted scapular elevation should be considered in evaluating and treating individuals with myofascial trigger points of the upper trapezius. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Pattern of paralysis and reconstructive operations after traumatic brachial plexus lesions].

PubMed

Rühmann, O; Schmolke, S; Carls, J; Wirth, C J

2002-12-01

The aim of this study was to evaluate persistent patterns of paralysis after traumatic brachial plexus lesions. As a result, consecutive reconstructive operations according to our differential therapy concept are presented. Between 04/1994 and 12/2000 in 104 patients with brachial plexus palsy, the grade of muscle power of the affected upper extremities was evaluated prospectively. The neuromuscular patterns of defect showed, in most cases, insufficient muscle power grades of 0-2 for the deltoid muscle (90%), supraspinatus muscle (82%), infraspinatus muscle (93%), elbow flexors (67% to 77%), hand and finger extensors (69% to 71%), and the abductor and extensors of the thumb (67% to 70%). In corresponding frequency, the following operations were performed between 04/1994 and 06/2002: shoulder arthrodesis (n 26), trapezius transfer (n 80), rotation osteotomy of humerus (n 10), triceps to biceps transposition (n 11), transposition of forearm flexors or extensors/Steindler operation (n 12), latissimus transfer (n 7), pectoralis transfer (n 1), teres major transfer (n 1), transposition of forearm flexors to the tendons of extensor digitorum (n 19) and of the extensor pollicis longus (n 9), and wrist arthrodesis (n 5). On malfunction of muscles following brachial plexus lesions, taking into account the individual neuromuscular defect, passive joint function, and bony deformities, different procedures such as muscle transposition, arthrodesis, and corrective osteotomy can be performed to improve function of the upper extremity.

Development of the shoulder girdle musculature.

PubMed

Pu, Qin; Huang, Ruijin; Brand-Saberi, Beate

2016-03-01

The muscles of the shoulder region are important for movements of the upper limbs and for stabilizing the girdle elements by connecting them to the trunk. They have a triple embryonic origin. First, the branchiomeric shoulder girdle muscles (sternocleidomastoideus and trapezius muscles) develop from the occipital lateral plate mesoderm using Tbx1 over the course of this development. The second population of cells constitutes the superficial shoulder girdle muscles (pectoral and latissimus dorsi muscles), which are derived from the wing premuscle mass. This muscle group undergoes a two-step development, referred to as the "in-out" mechanism. Myogenic precursor cells first migrate anterogradely into the wing bud. Subsequently, they migrate in a retrograde manner from the wing premuscle mass to the trunk. SDF-1/CXCR4 signaling is involved in this outward migration. A third group of shoulder muscles are the rhomboidei and serratus anterior muscles, which are referred to as deep shoulder girdle muscles; they are thought to be derived from the myotomes. It is, however, not clear how myotome cells make contact to the scapula to form these two muscles. In this review, we discuss the development of the shoulder girdle muscle in relation to the different muscle groups. © 2015 Wiley Periodicals, Inc.

Assessment of forearm and plantar foot load in the elderly using a four-wheeled walker with armrest and the effect of armrest height.

PubMed

Ko, Chang-Yong; Kim, Sol-Bi; Choi, Hyuk-Jae; Chang, Yunhee; Kang, Sungjae; Heo, Yoon; Ryu, Jeicheong; Kim, Gyoosuk; Mun, Museong

2014-01-01

Patients with hand and/or wrist pathology are recommended to have a four-wheeled walker with an arm rest (FWW-AR) rather than a standard walker or a standard four-wheeled walker (FWW). However, only a few quantitative studies have been performed to compare upper and lower extremity weight bearing. The aim of this study was to evaluate forearm and foot weight bearing using a FWW-AR and the effect of the armrest height. Eleven elderly women (mean age 80.1±5.3 years; mean height 148.5±4.0 cm; mean weight 51.2±9.0 kg) were enrolled. The subjects walked with an FWW-AR, with the elbow in either 90 degree (D90) or 130 degree (D130) flexion, for a distance of 10 m. Surface electromyographic signals were recorded for the upper, middle, and lower trapezius, anterior deltoid, and erector spinae muscles; walking velocity was measured with the subjects weight bearing on their feet and forearms while walking. Simultaneously, the maximum plantar and forearm loads during walking with an FWW-AR were measured. The normalized foot plantar loads were lower at D90 than at D130, while the normalized forearm load was higher at D90 than at D130 (all P<0.05; left foot, 7.9±0.1 N/kg versus 8.8±0.1 N/kg; right foot, 8.6±0.2 N/kg versus. 9.6±0.1 N/kg; left forearm, 1.8±0.5 N/kg versus 0.8±0.2 N/kg; and right forearm, 2.0±0.5 N/kg versus 1.0±0.2 N/kg, respectively). The surface electromyographic activity of the muscles involved in shoulder elevation and the walking velocity were both lower with the elbow at D90 than at D130 (all P<0.05; left upper trapezius, 98.7%±19.5% versus 132.6%±16.9%; right upper trapezius, 83.4%±10.6% versus 108.1%±10.5%; left anterior deltoid, 94.1%±12.8% versus 158.6%±40.4%; right anterior deltoid, 99.1%±15.0% versus 151.9%±19.4%; and velocity, 0.6±0.1 m/sec versus 0.7±0.1 m/sec, respectively). Weight bearing on the lower extremities is significantly reduced when the upper extremities are supported during walking with an FWW-AR. Furthermore, the weight bearing profile is dependent on the armrest height.

Selective Activation of Shoulder, Trunk, and Arm Muscles: A Comparative Analysis of Different Push-Up Variants

PubMed Central

Marcolin, Giuseppe; Petrone, Nicola; Moro, Tatiana; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio

2015-01-01

Context The push-up is a widely used exercise for upper limb strengthening that can be performed with many variants. A comprehensive analysis of muscle activation during the ascendant phase (AP) and descendant phase (DP) in different variants could be useful for trainers and rehabilitators. Objective To obtain information on the effect of different push-up variants on the electromyography (EMG) of a large sample of upper limb muscles and to investigate the role of the trunk and abdomen muscles during the AP and DP. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Eight healthy, young volunteers without a history of upper extremity or spine injury. Intervention(s) Participants performed a set of 10 repetitions for each push-up variant: standard, wide, narrow, forward (FP), and backward (BP). Surface EMG of 12 selected muscles and kinematics data were synchronously recorded to describe the AP and DP. Main Outcome Measure(s) Mean EMG activity of the following muscles was analyzed: serratus anterior, deltoideus anterior, erector spinae, latissimus dorsi, rectus abdominis, triceps brachii caput longus, triceps brachii caput lateralis, obliquus externus abdominis, pectoralis major sternal head, pectoralis major clavicular head, trapezius transversalis, and biceps brachii. Results The triceps brachii and pectoralis major exhibited greater activation during the narrow-base variant. The highest activation of abdomen and back muscles was recorded for the FP and BP variants. The DP demonstrated the least electrical activity across all muscles, with less marked differences for the abdominal and erector spinae muscles because of their role as stabilizers. Conclusions Based on these findings, we suggest the narrow-base variant to emphasize triceps and pectoralis activity and the BP variant for total upper body strength conditioning. The FP and BP variants should be implemented carefully in participants with low back pain because of the greater activation of abdominal and back muscles. PMID:26488636

Carbachol injection into the pontine reticular formation depresses laryngeal muscle activities and airway reflexes in decerebrate cats.

PubMed

Adachi, Masaaki; Nonaka, Satoshi; Katada, Akihiro; Arakawa, Takuya; Ota, Ryo; Harada, Hirofumi; Takakusaki, Kaoru; Harabuchi, Yasuaki

2010-05-01

To understand the role of cholinoceptive, medial pontine reticular formation (mPRF) neurons in the control of upper airway, pharyngolaryngeal reflexes, we measured activities of intrinsic laryngeal muscles (posterior cricoarytenoid, PCA; thyroarytenoid, TA), diaphragm (DIA), genioglossus (GG) and a neck muscle (trapezius) in unanesthetized, decerebrated, spontaneously breathing cats with and without mPRF carbachol injections. The ethimoidal nerve was electrically stimulated to evoke sneezing, and the superior laryngeal nerve to evoke the laryngeal reflex, swallowing, and coughing. Carbachol reduced the amplitudes of the spontaneous electromyographic activities in the neck, TA, PCA, GG, and DIA to 7%, 30%, 54%, 45% and 71% of control, respectively, reduced the respiratory rate to 53% without changes in expiratory CO(2) concentration; the magnitude of the laryngeal reflex in the TA muscle to 56%; increased its latency by 13%; and reduced the probability of stimulus-induced sneezing, swallowing, and coughing to less than 40%. These changes lasted more than 1h. These data demonstrate that important upper airway reflexes are suppressed by increasing cholinergic neurotransmission in the mPRF. Because acetylcholine release in the mPRF changes in accordance with sleep-wake cycles, the present findings are relevant to the control of upper airway reflexes during various vigilance states. 2010 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

Neck and shoulder muscle activity and thorax movement in singing and speaking tasks with variation in vocal loudness and pitch.

PubMed

Pettersen, Viggo; Bjørkøy, Kåre; Torp, Hans; Westgaard, Rolf Harald

2005-12-01

The aim of this study was to examine respiratory phasing and loading levels of sternocleidomastoideus (STM), scalenus (SC), and upper trapezius (TR) muscles in vocalization tasks with variation in vocal loudness and pitch. Eight advanced singing students, aged 22 to 28 years, participated. Surface electromyographic (EMG) activity was recorded from STM, SC, and TR. Thorax movement was detected by two strain gauge sensors placed around the upper (upper TX) and lower (lower TX) thorax. A glissando and simplified singing and speaking tasks were performed. Sustained vowels /a:-i-ae-o:/ were sung in a glissando from lowest to highest pitch (mixed voice/falsetto) back to lowest pitch and in short singing sequences at comfortable, low, and high pitches. The same vowels were spoken softly and loudly for about the same length. The subjects inhaled between the vowels. It was concluded that the inspiratory phased STM and SC muscles produced a counterforce to compression of upper TX at high pitches in glissando. STM and SC were activated to higher levels during phonation than in inhalation. As breathing demands were reduced, STM and SC activity was lowered and the respiratory phasing of peak amplitude changed to inhalation. TR contributed to exhalation in demanding singing with long breathing cycles, but it was less active in singing tasks with short breathing cycles and was essentially inactive in simplified speaking tasks.

The influence of scapular depression on upper limb neurodynamic test responses

PubMed Central

Legakis, Allison; Boyd, Benjamin S

2012-01-01

Objectives Upper limb neurodynamic testing (ULNT) can be used clinically to assist in identifying neural tissue involvement in patients with upper quarter pain and dysfunction. Consideration for scapular positioning is a crucial component of ULNT standardization, as variations in positioning may dramatically impact sensory and motor responses. This study aimed to determine if there was a meaningful difference in test outcomes when the ULNT was performed in alternative scapular positions. Methods This cross-sectional study included 40 asymptomatic individuals. Repeated ULNT testing was performed on the dominant limb with the scapula blocked in neutral (ULNTb) and in scapular depression (ULNTd). Sensory responses, muscle activity, and range of motion outcomes were compared between the two test variations. Results Pre-positioning in scapular depression (ULNTd) led to reduced elbow extension range of motion, provoked greater upper trapezius muscle activity and an earlier onset and broader area of sensory responses compared to ULNTb. Discussion During ULNTb, the limbs were taken further into range and elicited reduced muscle activation and more localized sensory response providing a less vigorous version of the test. This study demonstrates that scapular positioning has a meaningful impact on ULNT test outcomes in healthy, asymptomatic individuals. The ULNTd can be considered a more vigorous version that may be appropriate when the cervical motions commonly utilized for structural differentiation are limited or contraindicated. PMID:23633886

Scapular instability associated with brachial plexus irritation: a proposed causative relationship with treatment implications.

PubMed

Langley, P

1997-01-01

Brachial plexus irritation and other compression neuropathies can be diverse in their presentations and can cause a myriad of signs and symptoms. The purpose of this paper is to review the pertinent anatomy, kinesiology, and neurophysiology and to outline one possible cascade of events that may contribute to more diffuse upper extremity symptoms. Scapular instability and local myofascial trigger points resulting in possible secondary muscle imbalances are described. Their possible relationship to brachial plexus irritation in addition to the implications of the irritation are also discussed. The author postulates that proximal nerve irritation in the region of the thoracic outlet and shoulder may help to account for diffuse or unrelieved symptoms following conventional treatment of distal extremity problems in patients with occupational or cumulative trauma disorders. This paper outlines specific examination procedures for the therapist, which include upper limb tension testing, extensibility testing of the pectoralis minor, and gross manual muscle testing of the lower trapezius.

[EMG activities of the head, neck and upper trunk muscles with mandibular movements in healthy adults and mandibular asymmetry patients].

PubMed

Jiang, Ting; Zhang, Zhenkang; Yang, Zhaohui; Yi, Biao; Feng, Hailan; Wang, Xing

2002-03-25

To study the activities of head, neck and upper trunk muscles during mandibular movements in healthy adults and mandibular asymmetry patients. Electromyographic integrogram was used to record and analyze the electromyographic activities of the anterior temporal (Ta), posterior temporal (Tp), sternocleidomastoid (SCM), and trapezius (TRAP) muscles in rest position and during mandibular movement among 10 normal adults and 10 mandibular asymmetry patients. All the four muscles showed constant electromyographic activities when the mandible was in the rest position. The activities of Ta, Tp, and SCM muscles increased with protrusion of mandible, mouth opening, tapping, maximum clenching, and chewing. The activities of Ta and Tp muscles of the patients were 1.7 times greater than that of the normal adults during mandibular movement without occlusion, and were weaker by 50% during mandibular movement with occlusion. The difference between electromyographic activities during mandibular movement and in rest position was less among patients than among normal adults. The TRAP muscle of the patients showed constant electromyographic activities with the activity volume nearly 1.8 times that of the normal adults. The difference between the muscle and its namesake at the opposite side was greater among the patients (21%) than among the normal adults (8%). All the four muscles participate in the maintenance of rest position of mandible and the realization of mandibular movements. The coordination of muscular activities among mandibular asymmetry patients is poorer than that among normal adults.

The Effect of Functional Mandibular Shift on the Muscle Spindle Systems in Head-Neck Muscles and the Related Neurotransmitter Histamine.

PubMed

Du, Bing-Li; Li, Jiang-Ning; Guo, Hong-Ming; Li, Song; Liu, Biao

2017-09-01

The aim of this study is to explore the effects of abnormal occlusion and functional recovery caused by functional mandible deviation on the head and neck muscles and muscle spindle sensory-motor system by electrophysiological response and endogenous monoamine neurotransmitters' distribution in the nucleus of the spinal tract. Seven-week-old male Wistar rats were randomly divided into 7 groups: normal control group, 2W experimental control group, 2W functional mandible deviation group, 2W functional mandible deviation recovery group, 4W experimental control group, 4W functional mandible deviation group, 4W functional mandible deviation recovery group. Chewing muscles, digastric muscle, splenius, and trapezius muscle spindles electrophysiological response activities at the opening and closing state were recorded. And then the chewing muscles, digastric, splenius, trapezius, and neck trigeminal nucleus were taken for histidine decarboxylase (HDC) detection by high performance liquid chromatography (HPLC), immunofluorescence, and reverse-transcription polymerase chain reaction (RT-PCR). Histamine receptor proteins in the neck nucleus of the spinal tract were also examined by immunofluorescence and RT-PCR. Electromyography activity of chewing muscles, digastric, and splenius muscle was significantly asymmetric; the abnormal muscle electromyography activity was mainly detected at the ipsilateral side. After functional mandibular deviation, muscle sensitivity on the ipsilateral sides of the chewing muscle and splenius decreased, muscle excitement weakened, modulation depth decreased, and the muscle spindle afferent impulses of excitation transmission speed slowed down. Changes for digastric muscle electrical activity were contrary. The functions recovered at different extents after removing the deflector. However, trapezius in all the experimental groups and recovery groups exhibited bilateral symmetry electrophysiological responses, and no significant difference compared with the control group. After functional mandibular deviation, HDC protein and messenger ribonucleic acid (mRNA) levels on the ipsilateral sides of the chewing muscle and splenius increased significantly. HDC level changes for digastric muscle were contrary. After the removal of the mandibular position deflector, HDC protein and mRNA levels decreased on the ipsilateral sides of the chewing muscle and splenius while they increased in the digastric muscle. The difference of histamine decarboxylase content in the bilateral trapezius in each experimental group was small. After functional mandibular deviation, the temporomandibular joint mechanical receptors not only caused the fusimotor fiber hypoallergenic fatigue slow response on the ipsilateral sides of splenius, but also increased the injury neurotransmitter histamine release. The authors' results further support the opinion that the temporomandibular joint receptors may be involved in the mechanical theory of the head and neck muscles nervous system regulation.

Effects of standing on typing task performance and upper limb discomfort, vascular and muscular indicators.

PubMed

Fedorowich, Larissa M; Côté, Julie N

2018-10-01

Standing is a popular alternative to traditionally seated computer work. However, no studies have described how standing impacts both upper body muscular and vascular outcomes during a computer typing task. Twenty healthy adults completed two 90-min simulated work sessions, seated or standing. Upper limb discomfort, electromyography (EMG) from eight upper body muscles, typing performance and neck/shoulder and forearm blood flow were collected. Results showed significantly less upper body discomfort and higher typing speed during standing. Lower Trapezius EMG amplitude was higher during standing, but this postural difference decreased with time (interaction effect), and its variability was 68% higher during standing compared to sitting. There were no effects on blood flow. Results suggest that standing computer work may engage shoulder girdle stabilizers while reducing discomfort and improving performance. Studies are needed to identify how standing affects more complex computer tasks over longer work bouts in symptomatic workers. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of two different specific neck exercise interventions on palmitoylethanolamide and stearoylethanolamide concentrations in the interstitium of the trapezius muscle in women with chronic neck shoulder pain.

PubMed

Ghafouri, Nazdar; Ghafouri, Bijar; Fowler, Christopher J; Larsson, Britt; Turkina, Maria V; Karlsson, Linn; Gerdle, Björn

2014-08-01

Chronic neck/shoulder pain (CNSP) is one of the most common pain conditions. The understanding of mechanisms, including the peripheral balance between nociceptive and antinociceptive processes, is incomplete. N-acylethanolamines (NAEs) are a class of endogenous compounds that regulate inflammation and pain. The aim of this study was to investigate the levels of two NAEs: the peroxisome proliferator-activated receptor type-α ligand palmitoylethanolamide (PEA) and stearoylethanolamide (SEA) in the muscle interstitium of the trapezius muscle in women with CNSP randomized to two different neck specific training programs and in a healthy pain-free control group (CON). Fifty-seven women with CNSP were randomized to strength + stretch or stretch alone exercise programs. Twenty-nine subjects underwent microdialysis procedure before and after 4-6 months of exercise. Twenty-four CON subjects underwent microdialysis procedure before and after 4-6 months without any intervention in between. Microdialysate samples were collected from the trapezius muscle and analyzed by mass spectrometry for PEA and SEA levels. PEA and SEA levels were significantly higher in CNSP patients compared with CON. PEA was significantly higher in CNSP than in CON after both training programs. SEA was significantly higher in CNSP than in CON after stretch alone but not after strength + stretch training. A significant positive correlation was found between changes in pain intensity and in SEA levels in the strength + stretch group, but not in the stretch alone group. Our results indicate that exercise interventions differentially affect the levels of the bioactive lipids PEA and SEA in the interstitium of the trapezius muscle in women with CNSP. Wiley Periodicals, Inc.

Physical workload, trapezius muscle activity, and neck pain in nurses' night and day shifts: a physiological evaluation.

PubMed

Nicoletti, Corinne; Spengler, Christina M; Läubli, Thomas

2014-05-01

The purpose of this study was to compare physical workload, electromyography (EMG) of the trapezius muscle, neck pain and mental well-being at work between night and day shifts in twenty Swiss nurses. Work pulse (average increase of heart rate over resting heart rate) was lower during night (27 bpm) compared to day shifts (34 bpm; p < 0.01). Relative arm acceleration also indicated less physical activity during night (82% of average) compared to day shifts (110%; p < 0.01). Rest periods were significantly longer during night shifts. Trapezius muscle rest time was longer during night (13% of shift duration) than day shifts (7%; p < 0.01) and the 50th percentile of EMG activity was smaller (p = 0.02), indicating more opportunities for muscle relaxation during night shifts. Neck pain and mental well-being at work were similar between shifts. Subjective perception of burden was similar between shifts despite less physical burden at night, suggesting there are other contributing factors. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Increased sternocleidomastoid, but not trapezius, muscle activity in response to increased chewing load.

PubMed

Häggman-Henrikson, Birgitta; Nordh, Erik; Eriksson, Per-Olof

2013-10-01

Previous findings, during chewing, that boluses of larger size and harder texture result in larger amplitudes of both mandibular and head-neck movements suggest a relationship between increased chewing load and incremental recruitment of jaw and neck muscles. The present report evaluated jaw (masseter and digastric) and neck [sternocleidomastoid (SCM) and trapezius] muscle activity during the chewing of test foods of different sizes and textures by 10 healthy subjects. Muscle activity was recorded by surface electromyography and simultaneous mandibular and head movements were recorded using an optoelectronic technique. Each subject performed continuous jaw-opening/jaw-closing movements whilst chewing small and large boluses of chewing gum and rubber silicone (Optosil). For jaw opening/jaw closing without a bolus, SCM activity was recorded for jaw opening concomitantly with digastric activity. During chewing, SCM activity was recorded for jaw closing concomitantly with masseter activity. Trapezius activity was present in some, but not all, cycles. For the masseter and SCM muscles, higher activity was seen with larger test foods, suggesting increased demand and recruitment of these muscles in response to an increased chewing load. This result reinforces the previous notion of a close functional connection between the jaw and the neck motor systems in jaw actions and has scientific and clinical significance for studying jaw function and dysfunction. © 2013 Eur J Oral Sci.

Differences in muscle load between computer and non-computer work among office workers.

PubMed

Richter, J M; Mathiassen, S E; Slijper, H P; Over, E A B; Frens, M A

2009-12-01

Introduction of more non-computer tasks has been suggested to increase exposure variation and thus reduce musculoskeletal complaints (MSC) in computer-intensive office work. This study investigated whether muscle activity did, indeed, differ between computer and non-computer activities. Whole-day logs of input device use in 30 office workers were used to identify computer and non-computer work, using a range of classification thresholds (non-computer thresholds (NCTs)). Exposure during these activities was assessed by bilateral electromyography recordings from the upper trapezius and lower arm. Contrasts in muscle activity between computer and non-computer work were distinct but small, even at the individualised, optimal NCT. Using an average group-based NCT resulted in less contrast, even in smaller subgroups defined by job function or MSC. Thus, computer activity logs should be used cautiously as proxies of biomechanical exposure. Conventional non-computer tasks may have a limited potential to increase variation in muscle activity during computer-intensive office work.

Reference Values for Shear Wave Elastography of Neck and Shoulder Muscles in Healthy Individuals.

PubMed

Ewertsen, Caroline; Carlsen, Jonathan; Perveez, Mohammed Aftab; Schytz, Henrik

2018-01-01

to establish reference values for ultrasound shear-wave elastography for pericranial muscles in healthy individuals (m. trapezius, m. splenius capitis, m. semispinalis capitis, m. sternocleidomastoideus and m. masseter). Also to evaluate day-to-day variations in the shear-wave speeds and evaluate the effect of the pennation of the muscle fibers, ie scanning parallel or perpendicularly to the fibers. 10 healthy individuals (5 males and 5 females) had their pericranial muscles examined with shear-wave elastography in two orthogonal planes on two different days for their dominant and non-dominant side. Mean shear wave speeds from 5 ROI's in each muscle, for each scan plane for the dominant and non-dominant side for the two days were calculated. The effect of the different parameters - muscle pennation, gender, dominant vs non-dominant side and day was evaluated. The effect of scan plane in relation to muscle pennation was statistically significant (p<0.0001). The mean shear-wave speed when scanning parallel to the muscle fibers was significantly higher than the mean shear-wave speed when scanning perpendicularly to the fibers. The day-to-day variation was statistically significant (p=0.0258), but not clinically relevant. Shear-wave speeds differed significantly between muscles. Mean shear wave speeds (m/s) for the muscles in the parallel plane were: for masseter 2.45 (SD:+/-0.25), semispinal 3.36 (SD:+/-0.75), splenius 3.04 (SD:+/-0.65), sternocleidomastoid 2.75 (SD:+/-0.23), trapezius 3.20 (SD:+/-0.27) and trapezius lateral 3.87 (SD:+/-3.87). The shear wave speed variation depended on the direction of scanning. Shear wave elastography may be a method to evaluate muscle stiffness in patients suffering from chronic neck pain.

Spatial distribution of surface EMG on trapezius and lumbar muscles of violin and cello players in single note playing.

PubMed

Afsharipour, Babak; Petracca, Francesco; Gasparini, Mauro; Merletti, Roberto

2016-12-01

Musicians activate their muscles in different patterns, depending on their posture, the instrument being played, and their experience level. Bipolar surface electrodes have been used in the past to monitor such activity, but this method is highly sensitive to the location of the electrode pair. In this work, the spatial distribution of surface EMG (sEMG) of the right trapezius and right and left erector spinae muscles were studied in 16 violin players and 11 cello players. Musicians played their instrument one string at a time in sitting position with/without backrest support. A 64 sEMG electrode (16×4) grid, 10mm inter-electrode distance (IED), was placed over the middle and lower trapezius (MT and LT) of the bowing arm. Two 16×2 electrode grids (IED=10mm) were placed on the left and right erector spinae muscles. Subjects played each of the four strings of the instrument either in large (1bow/s) or detaché tip/tail (8bows/s) bowing in two sessions (two days). In each of two days, measurements were repeated after half an hour of exercise to see the effect of exercise on the muscle activity and signal stability. A "muscle activity index" (MAI) was defined as the spatial average of the segmented active region of the RMS map. Spatial maps were automatically segmented using the watershed algorithm and thresholding. Results showed that, for violin players, sliding the bow upward from the tip toward the tail results in a higher MAI for the trapezius muscle than a downward bow. On the contrary, in cello players, higher MAI is produced in the tail to tip movement. For both instruments, an increasing MAI in the trapezius was observed as the string position became increasingly lateral, from string 1 (most medial) toward string 4 (most lateral). Half an hour of performance did not cause significant differences between the signal quality and the MAI values measured before and after the exercise. The MAI of the left and right erector spinae was smaller in the case of backrest support, especially for violin players. Back muscles of violin and cello players were activated asymmetrically, specifically in fast movements (detaché tip/tail). These findings demonstrate the sensitivity and stability of the technique and justify more extensive investigation following this proof of concept. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of working technique on physical loads - an exposure profile among newspaper editors.

PubMed

Lindegård, A; Wahlström, J; Hagberg, M; Hansson, G-A; Jonsson, P; Wigaeus Tornqvist, E

2003-05-15

The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p=0.006, peak force p=0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.

Increased Upper Trapezius Muscle Stiffness in Overhead Athletes with Rotator Cuff Tendinopathy

PubMed Central

Leong, Hio Teng; Hug, François; Fu, Siu Ngor

2016-01-01

Although excessive tension of the upper trapezius (UT) is thought to contribute to rotator cuff tendinopathy, no study examined UT tension in athletes with and without rotator cuff tendinopathy. Here we used UT shear modulus measured using ultrasound shear wave elastography as an index of muscle stiffness/tension. The aims of this study were twofold: 1) to determine whether the UT muscle shear modulus is altered in athletes with rotator cuff tendinopathy compared to asymptomatic athletes, and 2) to detect optimal cut-off points of UT shear modulus in identifying athletes with rotator cuff tendinopathy. Forty-three male volleyball players (17 asymptomatic and 26 with rotator cuff tendinopathy, mean age = 22.9±3.5 years) participated in the study. UT shear modulus was quantified during active arm holding at 30° and 60° of shoulder abduction and passive arm positioning at 0°, 30° and 60° of shoulder abduction. During the active tasks, the UT shear modulus was higher in athletes with rotator cuff tendinopathy than the asymptomatic athletes (p = 0.002), regardless the arm position. During the passive tasks, athletes with rotator cuff tendinopathy exhibited a higher UT shear modulus than asymptomatic athletes only at 0° of shoulder abduction (13.0±2.5 kPa vs 10.2±1.8 kPa, p = 0.001). When considering the active task, an optimal cut-off shear modulus of 12.0 kPa at 30° of shoulder abduction (sensitivity = 0.84, specificity = 0.57, AUC = 0.757, p = 0.008) and 9.5 kPa at 60° of shoulder abduction (sensitivity = 0.88, specificity = 0.67, AUC = 0.816, p = 0.002) was detected. When considering the passive task at 0° of shoulder abduction, a cut-off of 12.2 kPa was found (sensitivity = 0.73, AUC = 0.817, p = 0.001). Findings from the present study show that monitoring passive and active UT muscle shear modulus may provide important information for the prevention/rehabilitation of rotator cuff tendinopathy. PMID:27159276

Increased Upper Trapezius Muscle Stiffness in Overhead Athletes with Rotator Cuff Tendinopathy.

PubMed

Leong, Hio Teng; Hug, François; Fu, Siu Ngor

2016-01-01

Although excessive tension of the upper trapezius (UT) is thought to contribute to rotator cuff tendinopathy, no study examined UT tension in athletes with and without rotator cuff tendinopathy. Here we used UT shear modulus measured using ultrasound shear wave elastography as an index of muscle stiffness/tension. The aims of this study were twofold: 1) to determine whether the UT muscle shear modulus is altered in athletes with rotator cuff tendinopathy compared to asymptomatic athletes, and 2) to detect optimal cut-off points of UT shear modulus in identifying athletes with rotator cuff tendinopathy. Forty-three male volleyball players (17 asymptomatic and 26 with rotator cuff tendinopathy, mean age = 22.9±3.5 years) participated in the study. UT shear modulus was quantified during active arm holding at 30° and 60° of shoulder abduction and passive arm positioning at 0°, 30° and 60° of shoulder abduction. During the active tasks, the UT shear modulus was higher in athletes with rotator cuff tendinopathy than the asymptomatic athletes (p = 0.002), regardless the arm position. During the passive tasks, athletes with rotator cuff tendinopathy exhibited a higher UT shear modulus than asymptomatic athletes only at 0° of shoulder abduction (13.0±2.5 kPa vs 10.2±1.8 kPa, p = 0.001). When considering the active task, an optimal cut-off shear modulus of 12.0 kPa at 30° of shoulder abduction (sensitivity = 0.84, specificity = 0.57, AUC = 0.757, p = 0.008) and 9.5 kPa at 60° of shoulder abduction (sensitivity = 0.88, specificity = 0.67, AUC = 0.816, p = 0.002) was detected. When considering the passive task at 0° of shoulder abduction, a cut-off of 12.2 kPa was found (sensitivity = 0.73, AUC = 0.817, p = 0.001). Findings from the present study show that monitoring passive and active UT muscle shear modulus may provide important information for the prevention/rehabilitation of rotator cuff tendinopathy.

Development of a clinical prediction rule for identifying women with tension-type headache who are likely to achieve short-term success with joint mobilization and muscle trigger point therapy.

PubMed

Fernández-de-las-Peñas, César; Cleland, Joshua A; Palomeque-del-Cerro, Luis; Caminero, Ana Belén; Guillem-Mesado, Amparo; Jiménez-García, Rodrigo

2011-02-01

To identify prognostic factors from the history and physical examination in women with tension-type headache (TTH) who are likely to experience self-perceived clinical improvement following a multimodal physical therapy session including joint mobilization and muscle trigger point (TrP) therapies. No definitive therapeutic intervention is available for TTH. It would be useful for clinicians to have a clinical prediction rule for selecting which TTH patients may experience improved outcomes following a multimodal physical therapy program. Women diagnosed with pure TTH by 3 experienced neurologists according to the International Headache Society criteria from different neurology departments were included. They underwent a standardized examination (neck mobility, pressure pain thresholds, total tenderness score, presence of muscle TrPs, Medical Outcomes Study 36-Item Short Form, the Neck Disability Index [NDI], the Beck Depression Inventory, and the Headache Disability Inventory) and then a multimodal physical therapy session including joint mobilization and TrP therapies. The treatment session included a 30-second grade III or IV central posterior-anterior nonthrust mobilization applied from T4 to T1 thoracic vertebrae, at C7-T1 cervico-thoracic junction and C1-C2 vertebrae for an overall intervention time of 5 minutes Different TrP techniques, particularly soft tissue stroke, pressure release, or muscle energy were applied to head and neck-shoulder muscles (temporalis, suboccipital, upper trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid) to inactivate active muscle TrPs. Participants were classified as having achieved a successful outcome 1 week after the session based on their self-perceived recovery. Potential prognostic variables were entered into a stepwise logistic regression model to determine the most accurate set of variables for prediction of success. Data for 76 subjects were included in the analysis, of which 36 experienced a successful outcome (48%). Eight prognostic variables were retained in the regression model: mean age <44.5 years, presence of left sternocleidomastoid TrP, presence of suboccipital TrP, presence of left superior oblique muscle TrP, cervical rotation to the left > 69°, total tenderness score <20.5, NDI <18.5, referred pain area of right upper trapezius muscle TrP >42.23. The current clinical prediction rule may allow clinicians to make an a priori identification of women with TTH who are likely to experience short-term self-report improvement with a multimodal session including joint mobilizations and TrP therapies. Future studies are necessary to validate these findings. © 2010 American Headache Society.

Trains of electrical stimulation of the trapezius muscles redistribute the frequencies of body oscillations during stance.

PubMed

Nhouvannasak, V; Clément, S; Manto, M

2015-09-01

We investigated the postural effects of trains of electrical stimulation (TES) applied unilaterally or bilaterally on the trapezius muscle in 20 healthy subjects (mean age: 23.1 ± 1.33 years; F/M: 8/12). The anterior-posterior (AP) displacements (AP axis), medio-lateral displacements (ML axis) and total travelled distances (TTW) of the centre of pressure (COP) remained unchanged with TES. However, detailed spectral analysis of COP oscillations revealed a marked decrease of the magnitudes of peak power spectral density (peak PSD) following application of TES. Peak PSD was highly correlated with the intensity of stimulation (P < 0.001 both the AP and ML axes). For the AP axis, the integrals of the sub-bands 0-0.4, 0.4-1.5, 1.5-3 Hz were significantly decreased (P < 0.001), the integrals of the sub-bands 3-5 and 5-8 Hz were not significantly affected (P>0.30) and the integrals of the sub-band 8-10 Hz were significantly increased (P < 0.001). The ratios of the integrals of sub-bands 8-10 Hz/0-3 Hz were markedly enhanced with bilateral TES (P < 0.001). For the ML axis, the effects were striking (P < 0.001) for the sub-bands 0-0.4, 0.4-1.5 and 8-10 Hz. For both the AP and ML axes, a significant inverse linear relationship was found between the intensity of TES and the average speed of COP. We show that TES applied over the trapezius muscles exerts significant and so far unrecognised effects upon oscillations of the COP, decreasing low-frequency oscillations and enhancing high-frequency oscillations. Our data unravel a novel property of the trapezius muscles upon postural control. We suggest that this muscle plays a role of a distributor of low-frequency versus high-frequency sub-bands of frequency during stance. Previous studies have shown that patients with supra-tentorial stroke show an increased peak PSD in low frequencies of body oscillations. Therefore, our findings provide a rationale to assess neurostimulation of the trapezius muscle in the rehabilitation of postural deficits in supra-tentorial stroke.

Biomechanical analysis of the circular friction hand massage.

PubMed

Ryu, Jeseong; Son, Jongsang; Ahn, Soonjae; Shin, Isu; Kim, Youngho

2015-01-01

A massage can be beneficial to relieve muscle tension on the neck and shoulder area. Various massage systems have been developed, but their motions are not uniform throughout different body parts nor specifically targeted to the neck and shoulder areas. Pressure pattern and finger movement trajectories of the circular friction hand massage on trapezius, levator scapulae, and deltoid muscles were determined to develop a massage system that can mimic the motion and the pressure of the circular friction massage. During the massage, finger movement trajectories were measured using a 3D motion capture system, and finger pressures were simultaneously obtained using a grip pressure sensor. Results showed that each muscle had different finger movement trajectory and pressure pattern. The trapezius muscle experienced a higher pressure, longer massage time (duration of pressurization), and larger pressure-time integral than the other muscles. These results could be useful to design a better massage system simulating human finger movements.

The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial

PubMed Central

Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

2013-01-01

Introduction Dry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs. Methods and analysis A prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention. Ethics and dissemination This study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses. PMID:23793673

Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points.

PubMed

Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

2017-01-01

Dry needling (DN) is a widely used in treatment of myofascial trigger points (MTrPs). The purpose of this pretest-posttest clinical trial was to investigate the neurophysiological and clinical effects of DN in patients with MTrPs. A sample of 20 patients (3 man, 17 women; mean age 31.7 ± 10.8) with upper trapezius MTrPs received one session of deep DN. The outcomes of neuromuscular junction response (NMJR), sympathetic skin response (SSR), pain intensity (PI) and pressure pain threshold (PPT) were measured at baseline and immediately after DN. There were significant improvements in SSR latency and amplitude, pain, and PPT after DN. The NMJR decreased and returned to normal after DN. A single session of DN to the active upper trapezius MTrP was effective in improving pain, PPT, NMJR, and SSR in patients with myofascial trigger points. Further studies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Algogenic substances and metabolic status in work-related Trapezius Myalgia: a multivariate explorative study.

PubMed

Gerdle, Björn; Kristiansen, Jesper; Larsson, Britt; Saltin, Bengt; Søgaard, Karen; Sjøgaard, Gisela

2014-10-28

This study compares the levels of algesic substances between subjects with trapezius myalgia (TM) and healthy controls (CON) and explores the multivariate correlation pattern between these substances, pain, and metabolic status together with relative blood flow changes reported in our previous paper (Eur J Appl Physiol 108:657-669, 2010). 43 female workers with (TM) and 19 females without (CON) trapezius myalgia were - using microdialysis - compared for differences in interstitial concentrations of interleukin-6 (IL-6), bradykinin (BKN), serotonin (5-HT), lactate dehydrogenas (LDH), substance P, and N-terminal propeptide of procollagen type I (PINP) in the trapezius muscle at rest and during repetitive/stressful work. These data were also used in multivariate analyses together with previously presented data (Eur J Appl Physiol 108:657-669, 2010): trapezius muscle blood flow, metabolite accumulation, oxygenation, and pain development and sensitivity. Substance P was significantly elevated in TM (p=0.0068). No significant differences were found in the classical algesic substances (p: 0.432-0.926). The multivariate analysis showed that blood flow related variables, interstitial concentrations of metabolic (pyruvate), and algesic (BKN and K+) substances were important for the discrimination of the subjects to one of the two groups (R2: 0.19-0.31, p<0.05). Pain intensity was positively associated with levels of 5-HT and K+ and negatively associated with oxygenation indicators and IL-6 in TM (R2: 0.24, p<0.05). A negative correlation existed in TM between mechanical pain sensitivity of trapezius and BKN and IL-6 (R2: 0.26-0.39, p<0.05). The present study increased understanding alterations in the myalgic muscle. When considering the system-wide aspects, increased concentrations of lactate, pyruvate and K+ and decreased oxygenation characterized TM compared to CON. There are three major possible explanations for this finding: the workers with pain had relatively low severity of myalgia, metabolic alterations preceded detectable alterations in levels of algesics, or peripheral sensitization and other muscle alterations existed in TM. Only SP of the investigated algesic substances was elevated in TM. Several of the algesics were of importance for the levels of pain intensity and mechanical pain sensitivity in TM. These results indicate peripheral contribution to maintenance of central nociceptive and pain mechanisms and may be important to consider when designing treatments.

Effects of manual lymph drainage on cardiac autonomic tone in healthy subjects.

PubMed

Kim, Sung-Joong; Kwon, Oh-Yun; Yi, Chung-Hwi

2009-01-01

This study was designed to investigate the effects of manual lymph drainage on the cardiac autonomic tone. Thirty-two healthy male subjects were randomly assigned to manual lymph drainage (MLD) (experimental) and rest (control) groups. Electrocardiogram (ECG) parameters were recorded with bipolar electrocardiography using standard limb lead positions. The pressure-pain threshold (PPT) was quantitatively measured using an algometer. Heart rate variability differed significantly between the experimental and control groups (p < 0.05), but the PPT in the upper trapezius muscle did not (p > 0.05). These findings indicate that the application of MLD was effective in reducing the activity of the sympathetic nervous system.

STRENGTH PROFILES IN HEALTHY INDIVIDUALS WITH AND WITHOUT SCAPULAR DYSKINESIS

PubMed Central

Scibek, Jason S.; Carcia, Christopher R.

2017-01-01

Background Muscular weakness of the shoulder complex is commonly found in patients presenting with scapular dyskinesis; however, little is known regarding muscular performance in healthy individuals with scapular dyskinesis. Purpose To compare isometric strength measures of the shoulder complex between healthy individuals with and without scapular dyskinesis. It was hypothesized that healthy individuals with scapular dyskinesis would demonstrate decreased isometric strength of the scapular stabilizers and rotator cuff when compared to healthy individuals without scapular dyskinesis. Study Design Cross-sectional study. Methods Forty healthy, college-aged participants were recruited. Sixty-eight percent of subjects (27 of 40) presented with scapular dyskinesis. Thus, a matched-pairs analysis was conducted with 26 subjects (age: 22.00 ± 2.06 y; height: 168.77 ± 8.07 cm; mass: 70.98 ± 13.14 kg; BMI: 24.75 ± 3.04 kg/m2; 6 males; 20 females). The presence of scapular dyskinesis was determined visually using the scapular dyskinesis test with a dichotomous outcome (yes/no). Strength of the scapular stabilizers and rotator cuff was assessed via manual muscle testing using a handheld dynamometer. Force measures obtained with the handheld dynamometer were used to quantify strength. For each muscle tested, the mean peak force of three trials were normalized to body weight and used for data analysis. Additionally, strength ratios were calculated and analyzed. Differences in strength and strength ratios between those with and without scapular dyskinesis were compared using separate two-way mixed ANOVAs with repeated measures. Results No significant differences for either strength (F1.83,43.92 = 1.10, p = .34) or strength ratios (F1.83,44.02 = 1.93, p = .16) were observed between those with and without scapular dyskinesis. A significant main effect (F1.83,43.92 = 239.32, p < .01) for muscles tested was observed, and post-hoc analysis revealed significant trends resulting in a generalized order: the upper trapezius generated the greatest amount of force, followed by serratus anterior and middle trapezius, lower trapezius, supraspinatus, medial rotators, and lateral rotators. Conclusion The results of this study indicate that differences in shoulder muscle strength do not exist between healthy subjects with and without scapular dyskinesis. Additionally, scapular dyskinesis appears to be prevalent in healthy populations. Level of Evidence Level 3 PMID:28593084

Surface electromyographic patterns of masticatory, neck, and trunk muscles in temporomandibular joint dysfunction patients undergoing anterior repositioning splint therapy.

PubMed

Tecco, Simona; Tetè, Stefano; D'Attilio, Michele; Perillo, Letizia; Festa, Felice

2008-12-01

The aim of this study was to investigate the surface electromyographic (sEMG) activity of neck, trunk, and masticatory muscles in subjects with temporomandibular joint (TMJ) internal derangement treated with anterior mandibular repositioning splints. sEMG activities of the muscles in 34 adult subjects (22 females and 12 males; mean age 30.4 years) with TMJ internal derangement were compared with a control group of 34 untreated adults (20 females and 14 males; mean age 31.8 years). sEMG activities of seven muscles (anterior and posterior temporalis, masseter, posterior cervicals, sternocleidomastoid, and upper and lower trapezius) were studied bilaterally, with the mandible in the rest position and during maximal voluntary clenching (MVC), at the beginning of therapy (T0) and after 10 weeks of treatment (T1). Paired and Student's t-tests were undertaken to determine differences between the T0 and T1 data and in sEMG activity between the study and control groups. At T0, paired masseter, sternocleidomastoid, and cervical muscles, in addition to the left anterior temporal and right lower trapezius, showed significantly greater sEMG activity (P = 0.0001; P = 0.0001; for left cervical, P = 0.03; for right cervical, P = 0.0001; P = 0.006 and P = 0.007 muscles, respectively) compared with the control group. This decreased over the remaining study period, such that after treatment, sEMG activity revealed no statistically significant difference when compared with the control group. During MVC at T0, paired masseter and anterior and posterior temporalis muscles showed significantly lower sEMG activity (P = 0.03; P = 0.005 and P = 0.04, respectively) compared with the control group. In contrast, at T1 sEMG activity significantly increased (P = 0.02; P = 0.004 and P = 0.04, respectively), but no difference was observed in relation to the control group. Splint therapy in subjects with internal disk derangement seems to affect sEMG activity of the masticatory, neck, and trunk muscles.

Selective activation of the latissimus dorsi and the inferior fibers of trapezius at various shoulder angles during isometric pull-down exertion.

PubMed

Park, Se-yeon; Yoo, Won-gyu

2013-12-01

The aim of this study was to determine the effect of isometric pull down exercise on muscle activity with shoulder elevation angles of 60°, 90°, and 120° and sagittal, scapular, and frontal movement planes, by electromyography (EMG) of the latissimus dorsi, inferior fibers of trapezius, and latissimus dorsi/inferior fibers of trapezius activity ratio. Fourteen men performed nine conditions of isometric pull down exercise (three conditions of shoulder elevation × three conditions of movement planes). Surface EMG was used to collect data from the latissimus dorsi and inferior fibers of trapezius during exercise. Two-way repeated analysis of variance with two within-subject factors (shoulder elevation angles and planes of movement) was used to determine the significance of the latissimus dorsi and inferior fibers of trapezius activity and latissimus dorsi/inferior fibers of trapezius activity ratio. The latissimus dorsi activity and ratio between the latissimus dorsi and the inferior fibers of trapezius were significantly decreased as shoulder elevation angle increased from 60° to 120°. The inferior fibers of trapezius activity was significantly increased with shoulder elevation angle. The EMG activity and the ratios were not affected by changes in movement planes. This study suggests that selective activation of the latissimus dorsi is accomplished with a low shoulder elevation angle, while the inferior fibers of the trapezius are activated with high shoulder elevation angles. Copyright © 2013 Elsevier Ltd. All rights reserved.

Different weight bearing push-up plus exercises with and without isometric horizontal abduction in subjects with scapular winging: A randomized trial.

PubMed

Choi, Woo-Jeong; Yoon, Tae-Lim; Choi, Sil-Ah; Lee, Ji-Hyun; Cynn, Heon-Seock

2017-07-01

The aim of the present study was to determine whether the application of isometric horizontal abduction (IHA) differentially affected two weight-bearing push-up plus exercises by examining activation of the scapulothoracic muscles in subjects with scapular winging. Fifteen male subjects performed standard push-up plus (SPP) and wall push-up plus (WPP), with and without IHA. Two-way analyses of variance using two within-subject factors were used to determine the statistical significance of observed differences in upper trapezius (UT), pectoralis major (PM), and serratus anterior (SA) muscle activities and UT/SA and PM/SA muscle activity ratios. UT and SA muscle activities were greater during SPP than WPP. PM muscle activity was lower with IHA application. The UT/SA and PM/SA muscle activity ratios were lower during SPP than WPP. The PM/SA muscle activity ratio was lower with IHA application. The results suggest that IHA application using a Thera-Band can effectively reduce PM muscle activity during SPP and WPP exercises. Moreover, the SPP exercise can be used to increase UT and SA muscle activity and reduce the UT/SA and PM/SA muscle activity ratios in subjects with scapular winging. Copyright © 2016 Elsevier Ltd. All rights reserved.

Distal Traditional Acupuncture Points of the Large Intestinal Meridian and the Stomach Meridian Differently Affect Heart Rate Variability and Oxygenation of the Trapezius Muscle

PubMed Central

Shiro, Yukiko; Arai, Young-Chang P.; Ikemoto, Tatsunori; Kawai, Takashi; Ikeuchi, Masahiko; Ushida, Takahiro

2014-01-01

Physicians in traditional Chinese medicine have found that acupoints and meridians have effects on specific parts of the body. The aim of this study was to see how acupressure at distal acupuncture points of a specific meridian affects heart rate variability (HRV) and oxygenation of the trapezius muscle. Forty-one female participants were randomly allocated to three groups. Subjects in the Stomach Meridian acupuncture point (ST) group received acupressure at ST 34, ST 36, and ST 41, subjects in the Large Intestinal Meridian acupuncture point (LI) group received acupressure at LI 4, LI 10, and LI 11, and subjects in the control group did not receive any stimuli. HRV and oxygenation of the trapezius muscles were measured. The high frequency components of HRV in the control and LI groups tended to be higher than those in the ST group. Total hemoglobin in the control and LI groups eventually reached significantly higher levels than in the ST group. While oxyhemoglobin (ΔO2Hb) in the control and LI groups did not change, ΔO2Hb in the ST significantly decreased temporarily. PMID:24696701

Interbrachial Pinch by Trapezius Transfer in Amyoplasia Congenita: A Case Report

PubMed Central

Thione, Alessandro; Cavadas, Pedro C.; Rubi, Carlo G.

2017-01-01

Summary: Amyoplasia congenita, or “classic distal arthrogryposis,” is the most common disorder among the congenital, non-progressive, multiple joint contractural conditions named arthrogryposis. The cause remains unknown, and it occurs sporadically. Abnormal neurological examination indicates that movement in utero was diminished as a result of an abnormality of the central or peripheral nervous system, the motor end plate, or muscle. The absence of central neural pathology indicates the origin in akinetic fetal condition. Three weeks are enough to cause muscle weakness and joint fibrosis. Joint contractures in amyoplasia are often rigid and refractory to nonoperative treatment such as passive stretching. Surgery is focused on each patient's need respecting adaptive maneuvers to accomplish daily tasks. We present a case in which pectoral major muscle had no strength for pinching; a trapezius muscle transfer was planned to obtain an interbrachial pinch useful for grasping. PMID:28607845

Reconstruction of posterior neck and skull with vertical trapezius musculocutaneous flap

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mathes, S.J.; Stevenson, T.R.

1988-10-01

The vertical trapezius musculocutaneous flap has been successfully utilized for reconstruction in 13 patients with complex posterior skull and neck defects. This flap based on its vascular pedicle, the descending branch of the transverse cervical artery, provides well-vascularized tissue for coverage of defects related to chronic osteomyelitis, tumor extirpation, osteoradionecrosis, and dehisced cervical laminectomy wounds. Emphasis on flap design, including the location of the skin island, allows adequate wound coverage, direct donor site closure, and muscle function preservation. With its large size and wide arc of rotation, the vertical trapezius musculocutaneous flap provides reliable coverage for posterior trunk, cervical, andmore » skull defects.« less

Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders

PubMed Central

Silveira, A.; Gadotti, I. C.; Armijo-Olivo, S.; Biasotto-Gonzalez, D. A.; Magee, D.

2015-01-01

Purpose. Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability. Methods. Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer. Results. The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32–0.65). Conclusion. High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD. PMID:25883963

Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders.

PubMed

Silveira, A; Gadotti, I C; Armijo-Olivo, S; Biasotto-Gonzalez, D A; Magee, D

2015-01-01

Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability. Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer. The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32-0.65). High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.

Changes in respiratory activity induced by mastication during oral breathing in humans.

PubMed

Daimon, Shigeru; Yamaguchi, Kazunori

2014-06-01

We examined the effect of oral breathing on respiratory movements, including the number of respirations and the movement of the thoracic wall at rest and while chewing gum. Forty normal nose breathers were selected by detecting expiratory airflow from the mouth using a CO2 sensor. Chest measurements were recorded using a Piezo respiratory belt transducer, and electromyographic (EMG) activity of the masseter and trapezius muscles were recorded at rest and while chewing gum during nasal or oral breathing. Oral breathing was introduced by completely occluding the nostrils with a nose clip. During oral breathing, the respiration rate was significantly lower while chewing gum than while at rest (P < 0.05). While chewing gum, the respiration rate was significantly lower during oral breathing than during nasal breathing (P < 0.05). During oral breathing, thoracic movement was significantly higher while chewing gum than while at rest (P < 0.05). Thoracic movement was significantly greater during oral breathing than during nasal breathing (P < 0.05). The trapezius muscle exhibited significant EMG activity when chewing gum during oral breathing. The activity of the trapezius muscle coincided with increased movement of the thoracic wall. Chewing food while breathing through the mouth interferes with and decreases the respiratory cycle and promotes unusual respiratory movement of the thoracic wall, which is directed by the activity of accessory muscles of respiration. Copyright © 2014 the American Physiological Society.

Influence of stabilization occlusal splint on craniocervical relationships. Part I: Cephalometric analysis.

PubMed

Moya, H; Miralles, R; Zuñiga, C; Carvajal, R; Rocabado, M; Santander, H

1994-01-01

This study was conducted in order to determine the effect of an occlusal splint on craniocervical relationships, in subjects with muscle spasms in the sternocleidomastoid and trapezius muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. Two lateral craniocervical radiographs were taken for each subject, with and without an occlusal splint. Cephalometric analysis showed that the splint caused a significant extension of the head on the cervical spine. There was also a significant decrease in the cervical spine lordosis in the first, second and third cervical segment. These cervical changes could be a compensation mechanism caused by the extension of the cranium on the upper cervical spine. The change in the curvature implies that it is necessary to periodically evaluate the changes occurring in the craniocervical relationships after the occlusal splint has been inserted.

Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises

PubMed Central

Luczak, Joshua; Bosak, Andy; Riemann, Bryan L.

2013-01-01

Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG) activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals (n = 12) and novice female resistance trained exercisers (n = 12) from which average EMG amplitude for each repetition phase (concentric, eccentric) was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases). While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs. PMID:26464884

Upper Extremity Muscle Activity During In-Phase and Anti-Phase Continuous Pushing Tasks.

PubMed

Gruevski, Kristina M; Hodder, Joanne N; Keir, Peter J

2017-11-01

To determine the effect of anti-phase, in-phase bimanual and unimanual simulated industrial pushing tasks and frequency on upper extremity muscle activity. Research investigating symmetrical (in-phase) and asymmetrical (anti-phase) pushing exertions is limited despite a high prevalence in industry. Fifteen female participants completed five pushing tasks using a dual handle apparatus at three frequencies: 15 cycles per minute (cpm), 30 cpm, and self-selected. Tasks included two bimanual symmetrical pushes (constrained and unconstrained), two bimanual asymmetrical pushes (reciprocating and continuous), and one right unimanual push. Surface electromyography (EMG) from the right anterior, middle, and posterior deltoid (AD, MD, and PD); right and left trapezius (RT and LT); right pectoralis major (PM); and right and left external obliques (REO and LEO) was collected and normalized to maximum voluntary effort. There was a task by frequency interaction in the AD, MD, PD, and RT ( p < .005), where activity in AD, MD, and PD was highest in the continuous task at 15 cpm, but activity was similar across task in 30 cpm and self-selected. Muscle activity coefficient of variation was lowest during continuous task across all frequencies. Continuous, anti-phase pushes and constrained, in-phase pushes had the highest muscle activity demands and the least amount of variability in muscle activity and therefore may present the greatest risk of injury. Anti-phase pushing is known to have a greater cognitive demand, and this study demonstrated that it also has a greater physical demand when performed continuously.

Mental practice and mirror therapy associated with conventional physical therapy training on the hemiparetic upper limb in poststroke rehabilitation: a preliminary study.

PubMed

de Almeida Oliveira, Rafael; Cintia Dos Santos Vieira, Paula; Rodrigues Martinho Fernandes, Luciane Fernanda; Patrizzi, Lislei Jorge; Ferreira de Oliveira, Sabrina; Pascucci Sande de Souza, Luciane Aparecida

2014-01-01

The presence of sensory and motor deficits is common in patients post stroke. Mental practice (MP) and mirror therapy (MT) can be used as therapeutic techniques for poststroke rehabilitation. Important results have been demonstrated, although they have not established the patients' functional gain or related results of muscle electromyographic (EMG) data to functionality. The aim was to investigate EMG activity and sensory, motor, and functional performance in hemiparetic limbs of patients with stroke after intervention with MP and MT associated with conventional physical therapy training (CPTT). Seven patients were treated twice weekly during 8 weeks with MP and MT associated with CPTT of the affected upper limb. The Fugl-Meyer scale and the Barthel Index (BI) were applied to assess sensorimotor ability and independence of patients. Activation of the upper trapezius, biceps brachii, triceps brachii, flexor carpi ulnaris, and extensor carpi radialis was evaluated by means of EMG symmetry index and muscle co-activation measurements. There were statistically significant differences between pre- and postassessment findings for the motor, sensory, and mobility domains of the Fugl-Meyer scale, as well as for BI evaluation. No statistically significant differences were observed when the pre- and posttest symmetry and co-activation data were compared, although there were qualitative changes. The protocol was effective for improving motor, sensory, and mobility aspects, as well as function involved in activities of daily living. Qualitative changes in symmetry and muscle co-contraction were found, indicating a possible improvement in upper limb rehabilitation of patients with stroke.

Sitting and standing postures are corrected by adjustable furniture with lowered muscle tension in high-school students.

PubMed

Koskelo, R; Vuorikari, K; Hänninen, O

2007-10-01

This study compared the effect of 24 months of adjustable school desks and chairs usage (the intervention) and traditional non-adjustable usage (the control condition) on sitting and standing postures, muscle strength, classroom muscle tension, pain and learning in 15 (8 female and 7 male) high-school students and 15 anthropometrically and gender matched control students from neighbouring schools. It was assessed whether any responses took place after growth cessation. In comparison with controls, the intervention group of students' sitting postures standing kyphosis, scoliosis and lordosis became significantly better, both before and after growth cessation. Trunk muscle strength increased in the intervention students whose muscle tension during classes fell significantly in the trapezius and lumbar muscles, whereas in control students' lumbar tension increased. Headache and low-back pain correlated with neck-shoulder pain and trapezius muscle tension. Intervention students reported that they experienced benefits from the adjustable tables and chairs. They also received significantly better overall marks than the controls at the end of high school. It is concluded that the adjustable school desks and chairs promoted better sitting and standing postures, increased muscle strength, alleviated pain and appeared to be associated with better overall academic marks.

Reconstructive operations for the upper limb after brachial plexus palsy.

PubMed

Rühmann, Oliver; Schmolke, Stephan; Bohnsack, Michael; Carls, Jörg; Flamme, Christian; Wirth, Carl Joachim

2004-07-01

Limited function due to paralysis following brachial plexus lesions can be improved by secondary operations of the bony and soft tissue. Between April 1994 and December 2000, 109 patients suffering from arm-plexus lesions underwent a total of 144 reconstructive operations guided by our concept of integrated therapy. The average age at the time of surgery was 32 years (range: 15-59). The following operations were performed: shoulder arthrodesis (23), trapezius transfer (74), rotation osteotomy of humerus (9), triceps to biceps transposition (9), transposition of forearm flexors or extensors (8), latissimus transfer (7), pectoralis transfer (1), teres major transfer (1), transposition of flexor carpi ulnaris to the tendons of extensor digitorum (10), and wrist arthrodesis (2). Prospectively, in all patients, the grade of muscle power of the affected upper extremity was evaluated prior to surgery. The follow-up period for all 144 operations was, on average, 22 months (range: 6-74). By means of operative measures, almost all patients obtained an improvement of shoulder function (100%) and stability (>90%), elbow flexion (85%), and hand, finger, and thumb (100%). When muscles malfunction after brachial plexus lesions, one should take into account the individual neuromuscular defect, passive joint function, and bony deformities; different procedures such as muscle transpositions, arthrodeses, and corrective osteotomies can then be performed to improve function of the upper extremity. Each form of operative treatment presents patients with certain benefits and all are integrated into a total treatment plan for the affected extremity.

Impact of early life adversity on EMG stress reactivity of the trapezius muscle.

PubMed

Luijcks, Rosan; Vossen, Catherine J; Roggeveen, Suzanne; van Os, Jim; Hermens, Hermie J; Lousberg, Richel

2016-09-01

Human and animal research indicates that exposure to early life adversity increases stress sensitivity later in life. While behavioral markers of adversity-induced stress sensitivity have been suggested, physiological markers remain to be elucidated. It is known that trapezius muscle activity increases during stressful situations. The present study examined to what degree early life adverse events experienced during early childhood (0-11 years) and adolescence (12-17 years) moderate experimentally induced electromyographic (EMG) stress activity of the trapezius muscles, in an experimental setting. In a general population sample (n = 115), an anticipatory stress effect was generated by presenting a single unpredictable and uncontrollable electrical painful stimulus at t = 3 minutes. Subjects were unaware of the precise moment of stimulus delivery and its intensity level. Linear and nonlinear time courses in EMG activity were modeled using multilevel analysis. The study protocol included 2 experimental sessions (t = 0 and t = 6 months) allowing for examination of reliability.Results show that EMG stress reactivity during the stress paradigm was consistently stronger in people with higher levels of early life adverse events; early childhood adversity had a stronger moderating effect than adolescent adversity. The impact of early life adversity on EMG stress reactivity may represent a reliable facet that can be used in both clinical and nonclinical studies.

Anthropometric Survey (ANSUR) II Pilot Study: Methods and Summary Statistics

DTIC Science & Technology

2009-04-01

laptop computer. At the end of each day, data from the laptop hard drive was backed up on a thumb drive and also e-mailed back to the Anthrotech...superior point on the juncture of the cartilaginous flap (tragus) of the ear with the head. Trapezius point, right and left: The point at...which the anterior border of the trapezius muscle crosses the lateral neck landmark. Trochanter: A point at the center of the lateral

The effectiveness of manual versus algometer pressure release techniques for treating active myofascial trigger points of the upper trapezius.

PubMed

Abu Taleb, Walaa; Rehan Youssef, Aliaa; Saleh, Amir

2016-10-01

Manual pressure release (MPR) is a popular treatment of trigger points. Yet, treatment response may be influenced by inconsistent application of pressure. Further, it may contribute to increased risk of work-related musculoskeletal disorders of the wrist and hand in therapists. Therefore, this study aimed at introducing a novel method to apply pressure using the algometer and to compare its effectiveness to MPR. Forty-five volunteers with active trigger points of the upper trapezius received algometer pressure release (APR), MPR, or sham ultrasound (US). Pain pressure threshold (PPT) and contralateral active and passive neck side-bending ranges were assessed at baseline and immediately after a single session. Results showed no significant differences in post-treatment PPT between the study groups (p > 0.05). The APR group showed a significant increase in passive side-bending range compared with the two other groups, whereas active range improved in the APR compared with the US group (p < 0.05). Our results show that using algometer to apply pressure release to upper trapezius trigger points is more effective compared with manual release and sham US. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reinvestigation of the dysfunction in neck and shoulder girdle muscles as the reason of cervicogenic headache among office workers.

PubMed

Huber, Juliusz; Lisiński, Przemysław; Polowczyk, Agnieszka

2013-05-01

Dysfunction of cervical and shoulder girdle muscles as reason of cervicogenic headache (CEH) was reinvestigated with clinical and neurophysiological studies. Forty office workers were randomized into two groups to verify efficiency of supervised kinesiotherapy (N = 20) aimed with improvement of muscle's activity and headache symptoms releasing. Headache intensity was evaluated with visual analog scale (VAS), range of cervical movement (ROM) with goniometer, trigger points (TrPs) incidence with palpation and muscle's strength with Lovett's scale. Reaction of patients for muscle's elongation was also evaluated. Surface electromyographical recordings were bilaterally analyzed at rest (rEMG) and during maximal contraction (mcEMG). Deficits of cervical flexion and muscles strength were found in all patients. TrPs occurred predominantly in painful trapezius muscle. Incidence of trigger points coexisted with intensity of CEH. Results indicated on muscles dysfunction which improved only after supervised therapy. Positive correlations between increase in rEMG amplitudes and high VAS scores, high-amplitude rEMG recordings incidence and increased number of TrPs were found. Negative correlation was detected between amplitude in mcEMG and amplitude of rEMG recordings. Dysfunction of trapezius muscle was most responsible for CEH etiology. Proposed algorithm of kinesiotherapy was effective as complementary method of the CEH patients treatment.

Observed differences in upper extremity forces, muscle efforts, postures, velocities and accelerations across computer activities in a field study of office workers.

PubMed

Bruno Garza, J L; Eijckelhof, B H W; Johnson, P W; Raina, S M; Rynell, P W; Huysmans, M A; van Dieën, J H; van der Beek, A J; Blatter, B M; Dennerlein, J T

2012-01-01

This study, a part of the PRedicting Occupational biomechanics in OFfice workers (PROOF) study, investigated whether there are differences in field-measured forces, muscle efforts, postures, velocities and accelerations across computer activities. These parameters were measured continuously for 120 office workers performing their own work for two hours each. There were differences in nearly all forces, muscle efforts, postures, velocities and accelerations across keyboard, mouse and idle activities. Keyboard activities showed a 50% increase in the median right trapezius muscle effort when compared to mouse activities. Median shoulder rotation changed from 25 degrees internal rotation during keyboard use to 15 degrees external rotation during mouse use. Only keyboard use was associated with median ulnar deviations greater than 5 degrees. Idle activities led to the greatest variability observed in all muscle efforts and postures measured. In future studies, measurements of computer activities could be used to provide information on the physical exposures experienced during computer use. Practitioner Summary: Computer users may develop musculoskeletal disorders due to their force, muscle effort, posture and wrist velocity and acceleration exposures during computer use. We report that many physical exposures are different across computer activities. This information may be used to estimate physical exposures based on patterns of computer activities over time.

Thumb postures and physical loads during mobile phone use - a comparison of young adults with and without musculoskeletal symptoms.

PubMed

Gustafsson, Ewa; Johnson, Peter W; Hagberg, Mats

2010-02-01

The aim of this study was to evaluate thumb postures, thumb movements and muscle activity when using mobile phones for SMS messaging and to determine whether there were differences in these exposures (a) across various mobile phone tasks, (b) between gender and (c) between subjects with and without musculoskeletal symptoms in shoulders and upper extremities. Fifty-six young adults (15 healthy and 41 with musculoskeletal symptoms) performed a series of distinct tasks on a mobile phone. Muscular load in four forearm/hand muscles in the right arm and the right and left trapezius muscles were measured using electromyography (EMG). Thumb movements were registered using an electrogoniometer. The results showed that postures (sitting or standing) and the type of mobile phone task (holding the phone versus texting) affected muscle activity and thumb positions. Females compared to males had higher muscle activity in the extensor digitorum and the abductor pollicis longus when entering SMS messages and tended to have greater thumb abduction, higher thumb movement velocities and fewer pauses in the thumb movements. Subjects with symptoms had lower muscle activity levels in the abductor pollicis longus and tended to have higher thumb movement velocities and fewer pauses in the thumb movements compared to those without symptoms.

[Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study].

PubMed

Molina Rueda, F; Rivas Montero, F M; Pérez de Heredia Torres, M; Alguacil Diego, I M; Molero Sánchez, A; Miangolarra Page, J C

2012-01-01

As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System(®) and surface electromyography equipment ZeroWire Aurion(®). We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Acromiohumeral Distance During Neuromuscular Electrical Stimulation of the Lower Trapezius and Serratus Anterior Muscles in Healthy Participants.

PubMed

Bdaiwi, Alya H; Mackenzie, Tanya Anne; Herrington, Lee; Horsley, Ian; Cools, Ann M

2015-07-01

Compromise to the acromiohumeral distance has been reported in participants with subacromial impingement syndrome compared with healthy participants. In clinical practice, patients with subacromial shoulder impingement are given strengthening programs targeting the lower trapezius (LT) and serratus anterior (SA) muscles to increase scapular posterior tilt and upward rotation. We are the first to use neuromuscular electrical stimulation to stimulate these muscle groups and evaluate how the muscle contraction affects the acromiohumeral distance. To investigate if electrical muscle stimulation of the LT and SA muscles, both separately and simultaneously, increases the acromiohumeral distance and to identify which muscle-group contraction or combination most influences the acromiohumeral distance. Controlled laboratory study. Human performance laboratory. Twenty participants (10 men and 10 women, age = 26.9 ± 8.0 years, body mass index = 23.8) were screened. Neuromuscular electrical stimulation of the LT and SA. Ultrasound measurement of the acromiohumeral distance. Acromiohumeral distance increased during contraction via neuromuscular electrical stimulation of the LT muscle (t(19) = -3.89, P = .004), SA muscle (t(19) = -7.67, P = .001), and combined LT and SA muscles (t(19) = -5.09, P = .001). We observed no differences in the increased acromiohumeral distance among the 3 procedures (F(2,57) = 3.109, P = .08). Our results supported the hypothesis that the muscle force couple around the scapula is important in rehabilitation and scapular control and influences acromiohumeral distance.

Anthropometric Survey of U.S. Army Personnel: Methods and Summary Statistics 1988

DTIC Science & Technology

1989-09-01

The II between the neck " anterior point halfway (right trapezius point) I between the top and and the tip of the ’ bottom of the right ,. shoulder...point on the Thumbtip: The tip of head when the head is the right thumb . in the Frankfort plane. Tragion, right and Trapezis point, right left: The...superior and left: The point at point on the juncture which the anterior of the cartilaginous border of the trapezius flap (trag..) of the • muscle crosses

Ergonomic analysis of primary and assistant surgical roles.

PubMed

Zihni, Ahmed M; Cavallo, Jaime A; Ray, Shuddhadeb; Ohu, Ikechukwu; Cho, Sohyung; Awad, Michael M

2016-06-15

Laparoscopic surgery is associated with a high degree of ergonomic stress. However, the stress associated with surgical assisting is not known. In this study, we compare the ergonomic stress associated with primary and assistant surgical roles during laparoscopic surgery. We hypothesize that higher ergonomic stress will be detected in the primary operating surgeon when compared with the surgical assistant. One right-hand dominant attending surgeon performed 698 min of laparoscopic surgery over 13 procedures (222 min primary and 476 min assisting), whereas electromyography data were collected from bilateral biceps, triceps, deltoids, and trapezius muscles. Data were analyzed in 1-min segments. Average muscle activation as quantified by maximal voluntary contraction (%MVC) was calculated for each muscle group during primary surgery and assisting. We compared mean %MVC values with unpaired t-tests. Activation of right (R) biceps and triceps muscle groups is significantly elevated while operating when compared with assisting (R biceps primary: 5.47 ± 0.21 %MVC, assistant: 3.93 ± 0.11, P < 0.001; R triceps primary: 6.53 ± 0.33 %MVC, assistant: 5.48 ± 0.18, P = 0.002). Mean activation of the left trapezius muscle group is elevated during assisting (primary: 4.33 ± 0.26 %MVC, assistant: 5.70 ± 0.40, P = 0.024). No significance difference was noted in the other muscle groups (R deltoid, R trapezius, left [L] biceps, L triceps, and L deltoid). We used surface electromyography to quantify ergonomic differences between operating and assisting. Surgical assisting was associated with similar and occasionally higher levels of muscle activation compared with primary operating. These findings suggest that surgical assistants face significant ergonomic stress, just as operating surgeons do. Steps must be taken to recognize and mitigate this stress in both operating surgeons and assistants. Copyright © 2016 Elsevier Inc. All rights reserved.

Music performance anxiety in skilled pianists: effects of social-evaluative performance situation on subjective, autonomic, and electromyographic reactions.

PubMed

Yoshie, Michiko; Kudo, Kazutoshi; Murakoshi, Takayuki; Ohtsuki, Tatsuyuki

2009-11-01

Music performance anxiety (MPA), or stage fright in music performance, is a serious problem for many musicians, because performance impairment accompanied by MPA can threaten their career. The present study sought to clarify on how a social-evaluative performance situation affects subjective, autonomic, and motor stress responses in pianists. Measurements of subjective state anxiety, heart rate (HR), sweat rate (SR), and electromyographic (EMG) activity of upper extremity muscles were obtained while 18 skilled pianists performed a solo piano piece(s) of their choice under stressful (competition) and non-stressful (rehearsal) conditions. Participants reported greater anxiety in the competition condition, which confirmed the effectiveness of stress manipulation. The HR and SR considerably increased from the rehearsal to competition condition reflecting the activation of sympathetic division of the autonomic nervous system. Furthermore, participants showed higher levels of the EMG magnitude of proximal muscles (biceps brachii and upper trapezius) and the co-contraction of antagonistic muscles in the forearm (extensor digitorum communis and flexor digitorum superficialis) in the competition condition. Although these responses can be interpreted as integral components of an adaptive biological system that creates a state of motor readiness in an unstable or unpredictable environment, they can adversely influence pianists by disrupting their fine motor control on stage and by increasing the risk of playing-related musculoskeletal disorders.

The effect of breast support on upper body muscle activity during 5 km treadmill running.

PubMed

Milligan, Alexandra; Mills, Chris; Scurr, Joanna

2014-12-01

Breast support has previously been shown to influence surface EMG of the pectoralis major during running. Reductions in muscle activity have previously been associated with a reduction in energy cost, which may be advantageous for female runners. Ten female participants performed two self-paced (average pace 9 km h(-1)) 5 km treadmill runs under two breast support conditions (low and high); an additional bare-breasted 2 min run was also conducted. Surface EMG electrodes were positioned on the pectoralis major, anterior deltoid, medial deltoid, and upper trapezius, with data collected during the first 2 min of running and each kilometer interval thereafter. Reductions in peak EMG of the pectoralis major, anterior and medial deltoid were reported when participants ran in the high breast support during the initial intervals of the run (up to the second kilometer). The increased activation in the pectoralis major, anterior and medial deltoid in the low breast support may be due to increased tension within these muscles, induced by the greater breast pain experienced in the low breast support. This may be a strategy to reduce the independent breast movement causing the pain through increased muscular activation. This study further promotes the use of a high breast support during running with potential benefits for treadmill running associated with reductions in muscular demand during a 5 km run. Copyright © 2014 Elsevier B.V. All rights reserved.

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

PubMed Central

2011-01-01

Background Neck-shoulder pain conditions, e.g., chronic trapezius myalgia, have been associated with sensory disturbances such as increased sensitivity to experimentally induced pain. This study investigated pain sensitivity in terms of bilateral pressure pain thresholds over the trapezius and tibialis anterior muscles and pain responses after a unilateral hypertonic saline infusion into the right legs tibialis anterior muscle and related those parameters to intensity and area size of the clinical pain and to psychological factors (sleeping problems, depression, anxiety, catastrophizing and fear-avoidance). Methods Nineteen women with chronic non-traumatic neck-shoulder pain but without simultaneous anatomically widespread clinical pain (NSP) and 30 age-matched pain-free female control subjects (CON) participated in the study. Results NSP had lower pressure pain thresholds over the trapezius and over the tibialis anterior muscles and experienced hypertonic saline-evoked pain in the tibialis anterior muscle to be significantly more intense and locally more widespread than CON. More intense symptoms of anxiety and depression together with a higher disability level were associated with increased pain responses to experimental pain induction and a larger area size of the clinical neck-shoulder pain at its worst. Conclusion These results indicate that central mechanisms e.g., central sensitization and altered descending control, are involved in chronic neck-shoulder pain since sensory hypersensitivity was found in areas distant to the site of clinical pain. Psychological status was found to interact with the perception, intensity, duration and distribution of induced pain (hypertonic saline) together with the spreading of clinical pain. The duration and intensity of pain correlated negatively with pressure pain thresholds. PMID:21992460

Impact of early life adversity on EMG stress reactivity of the trapezius muscle

PubMed Central

Luijcks, Rosan; Vossen, Catherine J.; Roggeveen, Suzanne; van Os, Jim; Hermens, Hermie J.; Lousberg, Richel

2016-01-01

Abstract Human and animal research indicates that exposure to early life adversity increases stress sensitivity later in life. While behavioral markers of adversity-induced stress sensitivity have been suggested, physiological markers remain to be elucidated. It is known that trapezius muscle activity increases during stressful situations. The present study examined to what degree early life adverse events experienced during early childhood (0–11 years) and adolescence (12–17 years) moderate experimentally induced electromyographic (EMG) stress activity of the trapezius muscles, in an experimental setting. In a general population sample (n = 115), an anticipatory stress effect was generated by presenting a single unpredictable and uncontrollable electrical painful stimulus at t = 3 minutes. Subjects were unaware of the precise moment of stimulus delivery and its intensity level. Linear and nonlinear time courses in EMG activity were modeled using multilevel analysis. The study protocol included 2 experimental sessions (t = 0 and t = 6 months) allowing for examination of reliability. Results show that EMG stress reactivity during the stress paradigm was consistently stronger in people with higher levels of early life adverse events; early childhood adversity had a stronger moderating effect than adolescent adversity. The impact of early life adversity on EMG stress reactivity may represent a reliable facet that can be used in both clinical and nonclinical studies. PMID:27684800

Clinical Muscle Testing Compared with Whole-Body Magnetic Resonance Imaging in Facio-scapulo-humeral Muscular Dystrophy.

PubMed

Regula, J U; Jestaedt, L; Jende, F; Bartsch, A; Meinck, H-M; Weber, M-A

2016-12-01

The objective of this study was to evaluate the clinical usefulness of whole-body magnetic resonance imaging (MRI) in facio-scapulo-humeral muscular dystrophy (FSHD). In 20 patients with genetically proven FSHD1, we prospectively assessed muscular involvement and correlated the results of semi-quantitative manual muscle testing and other parameters such as disease duration, creatine kinase (CK) levels and repeat length of the D4Z4 locus with whole-body MRI. Clinical muscle testing revealed the trapezius, pectoralis and infraspinatus as the most severely affected muscles in the shoulder, and the knee flexors and gluteus medius in the hip girdle. MRI revealed the trapezius and serratus anterior muscles in the shoulder, and the hamstrings and adductor muscles in the hip girdle, as the most severely affected muscle groups. Overall, degrees of fatty degeneration on MRI scans correlated significantly with clinical weakness. Moreover, we could detect clear affection of the trunk muscles. Corresponding to earlier reports, asymmetric involvement was frequent in both clinical examination and MRI scoring. Moreover, MRI revealed inhomogeneous muscle degeneration in a considerable proportion of both, muscles and patients. Both clinical and MRI scores significantly correlated to disease duration, but not to fragment size or CK levels. Fatty degeneration in whole-body MRI correlates well to clinical muscle testing of the extremities but gives more information on deeper or trunk muscles. It shows structural changes in muscular disorders and may become an excellent tool for assessment of muscle involvement and follow-up studies.

Difference in muscle activation patterns during high-speed versus standard-speed yoga: A randomized sequence crossover study.

PubMed

Potiaumpai, Melanie; Martins, Maria Carolina Massoni; Wong, Claudia; Desai, Trusha; Rodriguez, Roberto; Mooney, Kiersten; Signorile, Joseph F

2017-02-01

To compare the difference in muscle activation between high-speed yoga and standard-speed yoga and to compare muscle activation of the transitions between poses and the held phases of a yoga pose. Randomized sequence crossover trial SETTING: A laboratory of neuromuscular research and active aging Interventions: Eight minutes of continuous Sun Salutation B was performed, at a high speed versus a standard-speed, separately. Electromyography was used to quantify normalized muscle activation patterns of eight upper and lower body muscles (pectoralis major, medial deltoids, lateral head of the triceps, middle fibers of the trapezius, vastus medialis, medial gastrocnemius, thoracic extensor spinae, and external obliques) during the high-speed and standard-speed yoga protocols. Difference in normalized muscle activation between high-speed yoga and standard-speed yoga. Normalized muscle activity signals were significantly higher in all eight muscles during the transition phases of poses compared to the held phases (p<0.01). There was no significant interaction between speed×phase; however, greater normalized muscle activity was seen for highspeed yoga across the entire session. Our results show that transitions from one held phase of a pose to another produces higher normalized muscle activity than the held phases of the poses and that overall activity is greater during highspeed yoga than standard-speed yoga. Therefore, the transition speed and associated number of poses should be considered when targeting specific improvements in performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clonal analysis reveals a common origin between nonsomite-derived neck muscles and heart myocardium

PubMed Central

Lescroart, Fabienne; Hamou, Wissam; Francou, Alexandre; Théveniau-Ruissy, Magali; Kelly, Robert G.; Buckingham, Margaret

2015-01-01

Neck muscles constitute a transition zone between somite-derived skeletal muscles of the trunk and limbs, and muscles of the head, which derive from cranial mesoderm. The trapezius and sternocleidomastoid neck muscles are formed from progenitor cells that have expressed markers of cranial pharyngeal mesoderm, whereas other muscles in the neck arise from Pax3-expressing cells in the somites. Mef2c-AHF-Cre genetic tracing experiments and Tbx1 mutant analysis show that nonsomitic neck muscles share a gene regulatory network with cardiac progenitor cells in pharyngeal mesoderm of the second heart field (SHF) and branchial arch-derived head muscles. Retrospective clonal analysis shows that this group of neck muscles includes laryngeal muscles and a component of the splenius muscle, of mixed somitic and nonsomitic origin. We demonstrate that the trapezius muscle group is clonally related to myocardium at the venous pole of the heart, which derives from the posterior SHF. The left clonal sublineage includes myocardium of the pulmonary trunk at the arterial pole of the heart. Although muscles derived from the first and second branchial arches also share a clonal relationship with different SHF-derived parts of the heart, neck muscles are clonally distinct from these muscles and define a third clonal population of common skeletal and cardiac muscle progenitor cells within cardiopharyngeal mesoderm. By linking neck muscle and heart development, our findings highlight the importance of cardiopharyngeal mesoderm in the evolution of the vertebrate heart and neck and in the pathophysiology of human congenital disease. PMID:25605943

Clonal analysis reveals a common origin between nonsomite-derived neck muscles and heart myocardium.

PubMed

Lescroart, Fabienne; Hamou, Wissam; Francou, Alexandre; Théveniau-Ruissy, Magali; Kelly, Robert G; Buckingham, Margaret

2015-02-03

Neck muscles constitute a transition zone between somite-derived skeletal muscles of the trunk and limbs, and muscles of the head, which derive from cranial mesoderm. The trapezius and sternocleidomastoid neck muscles are formed from progenitor cells that have expressed markers of cranial pharyngeal mesoderm, whereas other muscles in the neck arise from Pax3-expressing cells in the somites. Mef2c-AHF-Cre genetic tracing experiments and Tbx1 mutant analysis show that nonsomitic neck muscles share a gene regulatory network with cardiac progenitor cells in pharyngeal mesoderm of the second heart field (SHF) and branchial arch-derived head muscles. Retrospective clonal analysis shows that this group of neck muscles includes laryngeal muscles and a component of the splenius muscle, of mixed somitic and nonsomitic origin. We demonstrate that the trapezius muscle group is clonally related to myocardium at the venous pole of the heart, which derives from the posterior SHF. The left clonal sublineage includes myocardium of the pulmonary trunk at the arterial pole of the heart. Although muscles derived from the first and second branchial arches also share a clonal relationship with different SHF-derived parts of the heart, neck muscles are clonally distinct from these muscles and define a third clonal population of common skeletal and cardiac muscle progenitor cells within cardiopharyngeal mesoderm. By linking neck muscle and heart development, our findings highlight the importance of cardiopharyngeal mesoderm in the evolution of the vertebrate heart and neck and in the pathophysiology of human congenital disease.

Shoulder Kinematics and Spatial Pattern of Trapezius Electromyographic Activity in Real and Virtual Environments

PubMed Central

Samani, Afshin; Pontonnier, Charles; Dumont, Georges; Madeleine, Pascal

2015-01-01

The design of an industrial workstation tends to include ergonomic assessment steps based on a digital mock-up and a virtual reality setup. Lack of interaction and system fidelity is often reported as a main issue in such virtual reality applications. This limitation is a crucial issue as thorough ergonomic analysis is required for an investigation of the biomechanics. In the current study, we investigated the biomechanical responses of the shoulder joint in a simulated assembly task for comparison with the biomechanical responses in virtual environments. Sixteen male healthy novice subjects performed the task on three different platforms: real (RE), virtual (VE), and virtual environment with force feedback (VEF) with low and high precision demands. The subjects repeated the task 12 times (i.e., 12 cycles). High density electromyography from the upper trapezius and rotation angles of the shoulder joint were recorded and split into the cycles. The angular trajectories and velocity profiles of the shoulder joint angles over a cycle were computed in 3D. The inter-subject similarity in terms of normalized mutual information on kinematics and electromyography was investigated. Compared with RE the task in VE and VEF was characterized by lower kinematic maxima. The inter-subject similarity in RE compared with intra-subject similarity across the platforms was lower in terms of movement trajectories and greater in terms of trapezius muscle activation. The precision demand resulted in lower inter- and intra-subject similarity across platforms. The proposed approach identifies biomechanical differences in the shoulder joint in both VE and VEF compared with the RE platform, but these differences are less marked in VE mostly due to technical limitations of co-localizing the force feedback system in the VEF platform. PMID:25768123

Can exposure variation be promoted in the shoulder girdle muscles by modifying work pace and inserting pauses during simulated assembly work?

PubMed

Januario, Leticia Bergamin; Madeleine, Pascal; Cid, Marina Machado; Samani, Afshin; Oliveira, Ana Beatriz

2018-01-01

This study investigated the acute effects of changing the work pace and implementing two pause types during an assembly task. Eighteen healthy women performed a simulated task in four different conditions: 1) slow or 2) fast work pace with 3) passive or 4) active pauses every two minutes. The root mean square (RMS) and exposure variation analysis (EVA) from the trapezius and serratus anterior muscles, as well as the rate of perceived exertion (RPE) from the neck-shoulder region, were observed. Decreased RMS and RPE as well as more variable muscle activity (EVA) were observed in the slow work pace compared with the fast one. The pause types had a limited effect, but active pauses resulted in increased RMS of the clavicular trapezius. The findings revealed the importance of work pace in the reduction of perceived exertion and promotion of variation in muscle activation during assembly tasks. However, the pause types had no important effect on the evaluated outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The myocutaneous trapezius flap revisited: a treatment algorithm for optimal surgical outcomes based on 43 flap reconstructions.

PubMed

Can, Anil; Orgill, Dennis P; Dietmar Ulrich, J O; Mureau, Marc A M

2014-12-01

Because the vascular anatomy of the trapezius flap is highly variable, choosing the most appropriate flap type and design is essential to optimize outcomes and minimize postoperative complications. The aim of this study was to develop a surgical treatment algorithm for trapezius flap transfers. The medical files of all consecutive patients with a myocutaneous trapezius flap reconstruction of the head, neck, and upper back area treated at three different university medical centers between July 2001 and November 2012 were reviewed. There were 43 consecutive flaps performed in 38 patients with a mean follow-up time of 15 months (range, 1-48 months). Eleven patients had a mentosternal burn scar contracture (12 flaps), 12 patients (13 flaps) presented with cancer, and 15 patients (18 flaps) were suffering from chronic wounds due to failed previous reconstruction (n = 6), osteoradionecrosis (n = 1), chronic infection (n = 3), bronchopleural fistula (n = 3), and pressure sores (n = 2). The mean defect size was 152 cm(2). Sixteen flaps were based on the superficial cervical artery (SCA; type 2), 16 were based on the dorsal scapular artery (DSA; type 3), one was based on the intercostal arteries (type 4), and 10 flaps were based on both the DSA and SCA. Recipient-site complications requiring reoperation occurred in 16.3%, including one total flap failure (2.6%). The trapezius myocutaneous flap is a valuable option to reconstruct various head and neck and upper back defects. Based on our data, a surgical treatment algorithm was developed in an attempt to reduce variation in care and improve clinical outcomes. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Surface EMG of shoulder and back muscles and posture analysis in secretaries typing at visual display units.

PubMed

Kleine, B U; Schumann, N P; Bradl, I; Grieshaber, R; Scholle, H C

1999-09-01

A study was carried out to investigate temporal changes of activation of shoulder and back muscles in workers at visual display units by means of surface EMG. Moreover, postural parameters were recorded to distinguish fatigue-related from posture-related changes of the myoelectrical activity. Nine healthy female office workers typed texts spoken from tape during three 1-h-long sessions. After the first and again after the second hour there was a break of 15 min. Sixteen-channel surface EMG was bipolarly recorded from the erector spinae, trapezius, deltoid and sternocleidomastoid muscles. Root mean square (RMS) and power spectrum median frequency of the EMG were calculated. Sitting posture was assessed using an eight-channel movement analysis system with ultrasound markers. The position of the seventh cervical spinous process and the left and the right acromion were analysed synchronously with the EMG characteristics using regression analysis. The normalised RMS of the left and right trapezius muscle increased, while the median frequency did not change. The increase of the normalised RMS was significantly lower when the linear influence of posture was excluded. On average, the distance between C7 and the left and right acromion decreased within each working an hour. C7 became lower on average by 5.5 mm within an hour, whereas the acromions became lower by only 1.7 mm (left) and 3.3 mm (right). The increase in trapezius muscle activity was partly related to a lifting of the shoulders to compensate a slight slumping of the back. Another part of the EMG activity increase has to be attributed to fatigue, to attention-related activity or to the combination of both. Therefore, training of the back muscles and a varied organisation of work might have a preventive effect with respect to musculoskeletal complaints in VDU workers.

Musculoskeletal disorders among female and male air traffic controllers performing identical and demanding computer work.

PubMed

Arvidsson, I; Arvidsson, M; Axmon, A; Hansson, G-A; Johansson, C R; Skerfving, S

2006-09-15

Operators with identical, demanding computer work (90 female and 97 male air traffic controllers) were found to have high prevalences of disorders (assessed by questionnaire and physical examination) in neck, shoulders and upper back. In spite of the identical work, the women displayed higher prevalences than the men (e.g. neck diagnoses 21% vs. 4%). Disorders in elbows, wrists and hands were less common, with similar rates in both genders. Generally, the psychosocial work environment (assessed by questionnaire) was found to be good, but with large inter-individual variation. Women experienced lower decision latitude than men, particularly regarding influence and freedom at work, but perceived higher social support. Physically, the work was characterized by relatively low angular velocities of upper arms (measured by inclinometry) and wrists (right: < 1 degrees/s during 19% of time, measuring by goniometry), dynamic muscular activities and high time fractions of rest in the trapezius and forearm extensor muscles (measuring by electromyography). There were only minor differences between the genders.

Fetal development of deep back muscles in the human thoracic region with a focus on transversospinalis muscles and the medial branch of the spinal nerve posterior ramus

PubMed Central

Sato, Tatsuo; Koizumi, Masahiro; Kim, Ji Hyun; Kim, Jeong Hyun; Wang, Bao Jian; Murakami, Gen; Cho, Baik Hwan

2011-01-01

Fetal development of human deep back muscles has not yet been fully described, possibly because of the difficulty in identifying muscle bundle directions in horizontal sections. Here, we prepared near-frontal sections along the thoracic back skin (eight fetuses) as well as horizontal sections (six fetuses) from 14 mid-term fetuses at 9–15 weeks of gestation. In the deep side of the trapezius and rhomboideus muscles, the CD34-positive thoracolumbar fascia was evident even at 9 weeks. Desmin-reactivity was strong and homogeneous in the superficial muscle fibers in contrast to the spotty expression in the deep fibers. Thus, in back muscles, formation of the myotendinous junction may start from the superficial muscles and advance to the deep muscles. The fact that developing intramuscular tendons were desmin-negative suggested little possibility of a secondary change from the muscle fibers to tendons. We found no prospective spinalis muscle or its tendinous connections with other muscles. Instead, abundant CD68-positive macrophages along the spinous process at 15 weeks suggested a change in muscle attachment, an event that may result in a later formation of the spinalis muscle. S100-positive intramuscular nerves exhibited downward courses from the multifidus longus muscle in the original segment to the rotatores brevis muscles in the inferiorly adjacent level. The medial cutaneous nerve had already reached the thoracolumbar fascia at 9 weeks, but by 15 weeks the nerve could not penetrate the trapezius muscle. Finally, we propose a folded myotomal model of the primitive transversospinalis muscle that seems to explain a fact that the roofing tile-like configuration of nerve twigs in the semispinalis muscle is reversed in the multifidus and rotatores muscles. PMID:21954879

Effects of the antigravitary modification of the myotension of asset (MAGMA) therapy on myogenic cranio-cervical-mandibular dysfunction: a longitudinal surface electromyography analysis.

PubMed

D'Attilio, Michele; Di Meo, Silvio; Perinetti, Giuseppe; Filippi, Maria Rita; Tecco, Simona; D'Alconzo, Francesco; Festa, Felice

2003-01-01

This study was aimed at evaluating the effects of a novel physiotherapy machine called MAGMA (AntiGravitary Modification of the Myotensions of Asset) on postural and masticatory muscles of subjects with myogenic cranio-cervical-mandibular dysfunction (CMD), by using surface electromyography (sEMG). Fifteen subjects, nine males and six females (mean age 27.6 years), with CMD were included in the study. The bilaterally monitored muscles were: masseter, anterior and posterior temporalis, digastric, posterior cervical, sternocleidomastoid, and upper and lower trapezius. All muscles were monitored at rest, with a second record of maximal voluntary clenching (MVC) for both the masseter and anterior temporalis. Patients were subjected to MAGMA therapy for one session/week of 30 min over ten weeks. The surface EMG activity was recorded twice, at the baseline and at the end of the therapy. After MAGMA therapy, the sEMG activity at rest of the monitored muscles was significantly better when compared to the baseline; the only exception was the anterior and posterior temporalis muscles which did not improve. On the contrary, with the MVC, all the monitored muscles (masseter and anterior temporalis) significantly improved their sEMG activity. Although more investigations are needed, these results indicate that the use of such antigravitary therapy can provide a tool for resolving myogenic CMD.

Direction-specific recruitment of rotator cuff muscles during bench press and row.

PubMed

Wattanaprakornkul, Duangjai; Halaki, Mark; Cathers, Ian; Ginn, Karen A

2011-12-01

Recent studies indicate that rotator cuff (RC) muscles are recruited in a reciprocal, direction-specific pattern during shoulder flexion and extension exercises. The main purpose of this study was to determine if similar reciprocal RC recruitment occurs during bench press (flexion-like) and row (extension-like) exercises. In addition, shoulder muscle activity was comprehensively compared between bench press and flexion; row and extension; and bench press and row exercises. Electromyographic (EMG) activity was recorded from 9 shoulder muscles sites in 15 normal volunteers. All exercises were performed at 20, 50 and 70% of subjects' maximal load. EMG data were normalized to standard maximal voluntary contractions. Infraspinatus activity was significantly higher than subscapularis during bench press, with the converse pattern during the row exercise. Significant differences in activity levels were found in pectoralis major, deltoid and trapezius between the bench press and flexion exercises and in lower trapezius between the row and extension exercises. During bench press and row exercises, the recruitment pattern in each active muscle did not vary with load. During bench press and row exercises, RC muscles contract in a reciprocal direction-specific manner in their role as shoulder joint dynamic stabilizers to counterbalance antero-posterior translation forces. Copyright © 2011 Elsevier Ltd. All rights reserved.

Totally implanted ports: the trapezius approach in practice.

PubMed

Hill, Steve

Implanted ports (IPs) are an essential device for many patients who require long-term vascular access. IPs offer some advantages over other central venous access devices, such as lifestyle, body image benefits and lower infection rates. A typical implantation site for a port is the anterior chest wall. For some patients with breast cancer who have metastatic chest wall disease this site may lead to problems with the function of the device if disease spreads to the port site. One option for this patient group is to place the implanted port over the trapezius muscle. This article discusses six patients, all of whom had metastatic breast cancer with some degree of subcutaneous disease on the anterior chest wall. Three patients had received trapezius port placements and three had anterior chest wall placements. A retrospective review of the patients' medical records was undertaken from the time of insertion until removal or until the patient died. The anterior chest wall group of patients had their devices in for an average of 368 days vs 214 in the trapezius group. The total complications were higher in the anterior chest wall group (7 vs 2 in the trapezius group). Disease spread to two of the devices in the anterior chest wall group meaning the devices could no longer be used. The trapezius approach appears to be a safe and a reliable form of vascular access and may offer fewer complications than the traditional method of anterior chest wall placement when standard anterior chest wall approach is not suitable.

Noonan Syndrome: Symptoms and Causes

MedlinePlus

... prominent neck muscles (trapezius) Deformities of the spine Learning disabilities Intelligence isn't affected for most people with ... However, individuals may have: An increased risk of learning disabilities and mild intellectual disability A wide range of ...

Trapezius muscle metabolism measured with NIRS in helicopter pilots flying a simulator.

PubMed

Harrison, Michael F; Neary, J Patrick; Albert, Wayne J; Veillette, Dan W; McKenzie, Neil P; Croll, James C

2007-02-01

This study examined metabolic and hemodynamic responses during night vision goggle (NVG) induced neck strain among military helicopter pilots. We hypothesized that near infrared spectroscopy (NIRS) would be capable of identifying metabolic differences in the trapezius muscles of pilots between simulated flights with and without NVG. There were 33 pilots who were monitored on consecutive days during Day and NVG flight simulator missions. NIRS probes were attached bilaterally to the trapezius muscles at the C7 level to record total oxygenation index (TOI, %), total hemoglobin (tHb), oxyhemoglobin (HbO2), and deoxyhemoglobin (HHb). Significant differences in tHb were found between Day (0.51+/-2.31 micromol x cm (-1)) and NVG (4.14 +/- 2.74 micromol x cm(-1)) missions, and for HbO2 (Dayend 2.63+/-1.64 micromol x cm(-1); NVGend 5.77+/-1.98 micromol x cm(-1)). Significant left and right side differences between Day and NVG were found for tHb (NVGleit -1.83+/-2.55; NVGright 10.45+/-2.86 micromol x cm(-1)), HbO2 (NVGleft 1.77+/-1.90; NVGright 9.95+/-2.07 micromol x cm(-1)), and HHb (Dayleft -1.84+/-0.95; Dayright -2.32+/-0.87 micromol x cm (-1); NVGleft -3.60+/-1.05 micromol x cm(-1); NVGright 0.49+/-1.16 micromol x cm(-1). These results support NIRS's utility in assessing the significant metabolic and hemodynamic effects of NVG on neck musculature during real-time missions for 1) left and right side differences; and 2) Day vs. NVG missions. The additional mass of the NVG equipment does increase the metabolic stress of these muscles during simulated missions.

Shoulder range of motion and strength in young competitive tennis players with and without history of shoulder problems.

PubMed

Gillet, Benoît; Begon, Mickaël; Diger, Marine; Berger-Vachon, Christian; Rogowski, Isabelle

2018-05-01

To assess the effect of a history of shoulder problems on the shoulder flexibility and strength in young competitive tennis players. Cross-sectional study. Ninety-one competitive and asymptomatic tennis players aged between 8 and 15 years old were divided into two groups according to the presence or absence of a history of shoulder problems. Glenohumeral joint ranges of motion and the strength of eight shoulder muscles were bilaterally assessed. Five agonist/antagonist muscle strength ratios were also reported. Ranges of motion, strengths and strength ratios were bilaterally compared between the two groups. Players with a history of shoulder problems presented a higher total arc of rotation for both glenohumeral joints (p = 0.02) and a lower external/internal glenohumeral rotator muscle strength ratio (p = 0.02) for both sides. They also presented stronger upper trapezius (p = 0.03) and dominant serratus anterior (p = 0.008) muscles than players without a history of shoulder problems. Having a history of shoulder problems may alter the balance between mobility and stability within the shoulder complex suggesting that particular attention should be given to dominant and non-dominant shoulder functions by coaches and clinicians. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quality assessment of shoulder plyometric exercises: Examining the relationship to scapular muscle activity.

PubMed

Calé-Benzoor, Maya; Maenhout, Annelies; Arnon, Michal; Tenenbaum, Gershon; Werrin, Mia; Cools, Ann

2017-07-01

The purpose of the study was to evaluate performance quality of shoulder plyometric exercises, and examine the relationship to scapular muscle activation during an intense exercise bout. Observational study. University laboratory. 32 healthy university students (male/female: 14/18) volunteers. Subjects performed 10 plyometric exercises. Surface EMG of upper (UT), middle (MT) and lower (LT) trapezius and serratus anterior (SA) was registered. A quality assessment questionnaire was administered at the beginning and end of the exercise bout. Muscle activation at the beginning and end was evaluated by t-test. Mixed repeated measures ANOVA was conducted to test the effects of criterion-quality, time, muscles, exercises, and their interactions. Increased EMG activation was noted in 34/40 cases, (21/40 significant (p < 0.05) changes). Quality assessment revealed a decline in the ability to maintain initial position (43% of subjects), failure to keep a consistent and symmetrical arc of motion (62% of subjects), and performance with trick movements (48% of subjects). Inability to keep a consistent arc of motion was significant in 4 exercises. The novel questionnaire may aid quality assessment during plyometric exercises. Ability to keep a consistent arc of motion was the most sensitive marker of decline of performance quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Acromiohumeral Distance During Neuromuscular Electrical Stimulation of the Lower Trapezius and Serratus Anterior Muscles in Healthy Participants

PubMed Central

Bdaiwi, Alya H.; Mackenzie, Tanya Anne; Herrington, Lee; Horsley, Ian; Cools, Ann M.

2015-01-01

Context Compromise to the acromiohumeral distance has been reported in participants with subacromial impingement syndrome compared with healthy participants. In clinical practice, patients with subacromial shoulder impingement are given strengthening programs targeting the lower trapezius (LT) and serratus anterior (SA) muscles to increase scapular posterior tilt and upward rotation. We are the first to use neuromuscular electrical stimulation to stimulate these muscle groups and evaluate how the muscle contraction affects the acromiohumeral distance. Objective To investigate if electrical muscle stimulation of the LT and SA muscles, both separately and simultaneously, increases the acromiohumeral distance and to identify which muscle-group contraction or combination most influences the acromiohumeral distance. Design Controlled laboratory study. Setting Human performance laboratory. Patients or Other Participants Twenty participants (10 men and 10 women, age = 26.9 ± 8.0 years, body mass index = 23.8) were screened. Intervention(s) Neuromuscular electrical stimulation of the LT and SA. Main Outcome Measure(s) Ultrasound measurement of the acromiohumeral distance. Results Acromiohumeral distance increased during contraction via neuromuscular electrical stimulation of the LT muscle (t19 = −3.89, P = .004), SA muscle (t19 = −7.67, P = .001), and combined LT and SA muscles (t19 = −5.09, P = .001). We observed no differences in the increased acromiohumeral distance among the 3 procedures (F2,57 = 3.109, P = .08). Conclusions Our results supported the hypothesis that the muscle force couple around the scapula is important in rehabilitation and scapular control and influences acromiohumeral distance. PMID:25933249

Tendon transfer options about the shoulder in patients with brachial plexus injury.

PubMed

Elhassan, Bassem; Bishop, Allen T; Hartzler, Robert U; Shin, Alexander Y; Spinner, Robert J

2012-08-01

The purpose of this study was to evaluate the early outcome of shoulder tendon transfer in patients with brachial plexus injury and to determine the factors associated with favorable outcomes. Fifty-two patients with traumatic brachial plexus injury and a paralytic shoulder were included in the study. All patients were evaluated at a mean of nineteen months (range, twelve to twenty-eight months) postoperatively. Twelve patients had a C5-6 injury, twenty-two had a C5-7 injury, five had a C5-8 injury, and thirteen had a C5-T1 injury. Transfer of the lower portion of the trapezius muscle was performed either in isolation or as part of multiple tendon transfers to improve shoulder function. Additional muscles transferred included the middle and upper portions of the trapezius, levator scapulae, upper portion of the serratus anterior, teres major, latissimus dorsi, and pectoralis major. All patients had a stable shoulder postoperatively. Shoulder external rotation improved substantially in all patients from no external rotation (hand-on-belly position) to a mean of 20° (p = 0.001). Patients who underwent additional transfers had marginal improvement of shoulder flexion, from a mean of 10° preoperatively to 60° postoperatively, and of shoulder abduction, from a mean of 10° to 50° (p = 0.01 for each). Mean pain on a visual analog scale improved from 6 points preoperatively to 2 points postoperatively. The mean Disabilities of the Arm, Shoulder and Hand (DASH) score improved from 59 to 47 points (p = 0.001). The mean Subjective Shoulder Value improved from 5% to 40% (p = 0.001). Greater age, higher body mass index, and more extensive nerve injury were associated with a poorer DASH score in a multivariate analysis (p = 0.003). Tendon transfers about the shoulder can improve shoulder function in patients with brachial plexus injury resulting in a paralytic shoulder. Significant improvement of shoulder external rotation but only marginal improvements of shoulder abduction and flexion can be achieved. The outcome can be expected to be better in patients with less severe nerve injury.

SPARTEN (Scientific Program of Aerobic and Resistance Training Exercise in the Navy): A Total Body Fitness Program for Health and Physical Readiness.

DTIC Science & Technology

1984-08-01

Conditioned- o latissimus dorsi o trapezius Training Recommendations - When adjusting for proper lat bar height, place pin in slot from a kneeling posi...Olattismus dorsi Training Recommendations -it is recommended that women hang from the chin handles and bring knees to chest. .. 19 - Arm-Curl Fig. 17...UPS (Posterior) trapezius ’IN ~ lover back muscles *lotiesimaus dorsi glutealS B-2 e-72-,- !.5 1, r. - U> r r-rrr r fl r rr r rrr rrr~ p... p... p p p

Shoulder muscle activation during stable and suspended push-ups at different heights in healthy subjects.

PubMed

Borreani, Sebastien; Calatayud, Joaquin; Colado, Juan C; Tella, Victor; Moya-Nájera, Diego; Martin, Fernando; Rogers, Michael E

2015-08-01

To analyze shoulder muscle activation when performing push-ups under different stability conditions and heights. Comparative study by repeated measures. Valencia University laboratory. 29 healthy males participated. Subjects performed 3 push-ups each with their hands at 2 different heights (10 vs. 65 cm) under stable conditions and using a suspension device. Push-up speed was controlled and the testing order was randomized. The average amplitudes of the electromyographic root mean square of the long head of the triceps brachii (TRICEP), upper trapezius (TRAPS), anterior deltoid (DELT) and clavicular pectoralis (PEC) were recorded. The electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Suspended push-ups at 10 cm resulted in greater activation in the TRICEP (17.14 ± 1.31 %MVIC vs. 37.03 ± 1.80 %MVIC) and TRAPS (5.83 ± 0.58 %MVIC vs. 14.69 ± 1.91 %MVIC) than those performed on the floor. For DELT and PEC similar or higher activation was found performing the push-ups on the floor, respectively. Height determines different muscle activation patterns. Stable push-ups elicit similar PEC and higher DELT muscle activation, being greater at 10 cm; whereas suspended push-ups elicit greater TRAPS and TRICEP muscle activation, being greater at 65 cm. Copyright © 2014 Elsevier Ltd. All rights reserved.

The trapezius perforator flap: an underused but versatile option in the reconstruction of local and distant soft-tissue defects.

PubMed

Sadigh, Parviz L; Chang, Li-Ren; Hsieh, Ching-Hua; Feng, Wen-Jui; Jeng, Seng-Feng

2014-09-01

The trapezius myocutaneous flap is an established reconstructive option in head and neck cases The authors present their experience with 10 trapezius perforator flaps, all raised using a freestyle technique of perforator dissection, to successfully reconstruct both local and distant soft-tissue defects. Ten patients underwent soft-tissue reconstruction using trapezius perforator flaps. After mapping the perforator with a handheld Doppler device at the intersection of a horizontal line drawn 6 to 8 cm inferior to the scapular spine and a vertical line drawn 8 to 9 cm lateral to the midline of the back, perforator flaps were raised in a freestyle fashion, with complete preservation of the trapezius muscle. The flap can be pedicled into local defects or transferred as a free flap. Six flaps were elevated as pedicled flaps and four were transferred as free flaps. Flap size ranged from 6 × 4 cm to 25 × 15 cm. The pedicle length ranged from 4 to 14 cm. The pedicle originated from the dorsal scapular artery. In one case, the authors converted from a pedicled flap to a free flap secondary to insufficient pedicle length. All donor sites were closed directly. The follow-up period ranged from 4 months to 4 years. All of the flaps survived completely with no major complications, and no patients developed any shoulder dysfunction. The trapezius perforator flap is a reliable and versatile reconstructive option that can be used to repair both local and distant soft-tissue defects. The donor-site morbidity is minimal. Therapeutic, IV.

Neuronal Nitric Oxide Synthase Is Dislocated in Type I Fibers of Myalgic Muscle but Can Recover with Physical Exercise Training

PubMed Central

Jensen, L.; Andersen, L. L.; Schrøder, H. D.; Frandsen, U.; Sjøgaard, G.

2015-01-01

Trapezius myalgia is the most common type of chronic neck pain. While physical exercise reduces pain and improves muscle function, the underlying mechanisms remain unclear. Nitric oxide (NO) signaling is important in modulating cellular function, and a dysfunctional neuronal NO synthase (nNOS) may contribute to an ineffective muscle function. This study investigated nNOS expression and localization in chronically painful muscle. Forty-one women clinically diagnosed with trapezius myalgia (MYA) and 18 healthy controls (CON) were included in the case-control study. Subsequently, MYA were randomly assigned to either 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 15), or health information (REF, n = 8). Distribution of fiber type, cross-sectional area, and sarcolemmal nNOS expression did not differ between MYA and CON. However, MYA showed increased sarcoplasmic nNOS localization (18.8 ± 12 versus 12.8 ± 8%, P = 0.049) compared with CON. SST resulted in a decrease of sarcoplasm-localized nNOS following training (before 18.1 ± 12 versus after 12.0 ± 12%; P = 0,027). We demonstrate that myalgic muscle displays altered nNOS localization and that 10 weeks of strength training normalize these disruptions, which supports previous findings of impaired muscle oxygenation during work tasks and reduced pain following exercise. PMID:25853139

Middle and lower trapezius strengthening for the management of lateral epicondylalgia: a case report.

PubMed

Bhatt, Jiten B; Glaser, Randal; Chavez, Andre; Yung, Emmanuel

2013-11-01

Case report. Addressing weakness of the shoulder region, especially the rotator cuff and scapular musculature, is often suggested clinically for the treatment of individuals with lateral epicondylalgia. However, to our knowledge, the clinical effectiveness of this approach has not been established. The patient was a 54-year-old woman with a 5-month history of right lateral elbow pain, whose symptoms were reproduced with clinical tests typically used to diagnose lateral elbow tendinopathy. The patient also demonstrated weakness in her middle and lower trapezius muscles, and the medial border of her scapula, measured with a tape measure, was 11 cm lateral from the spinous processes of the thoracic spine with the patient standing in relaxed stance. Based on improved grip strength and reduced associated elbow pain when tested with the scapula manually corrected in a more adducted position, treatment focused solely on strengthening of the middle and lower trapezius muscles over a 10-week period. Following the intervention, the patient presented with improved scapular position, with the medial border of the scapula being 9 cm lateral to the midthoracic spine. The patient's middle and lower trapezius strength improved from 3+/5 and 4-/5, respectively, to 5/5, and her grip strength from 26.1 to 42.2 kg. The patient's scores on the Disabilities of the Arm, Shoulder and Hand questionnaire also improved from 44.2 at the initial evaluation to 0 at the completion of therapy, with the patient being able to perform all of her daily activities in a pain-free manner. The results of this case report suggest that assessment and treatment of scapular musculature warrant consideration in the management of individuals with lateral epicondylalgia. Therapy, level 4.

Specific neck training induces sustained corticomotor hyperexcitability as assessed by motor evoked potentials.

PubMed

Rittig-Rasmussen, Bjarne; Kasch, Helge; Fuglsang-Frederiksen, Anders; Jensen, Troels S; Svensson, Peter

2013-07-15

Experimental investigation of short-term and long-term corticomotor effects of specific neck training, coordination training, and no training. To determine the effects of different training programs on the motor neurons controlling the neck muscles as well as the effects of training on muscle strength and muscle fatigue, and the correlations between corticomotor control and motor learning. Training is usually recommended for unspecific neck pain and consists of neck and upper body coordination, strengthening, and endurance exercises. However, it is unclear which type of training is the most effective. No studies have previously investigated the neural effect of neck training and the possible differential effect of specific versus coordination training on corticomotor control. Transcranial magnetic stimulation and electromyography were used to elicit and monitor motor evoked potentials (MEPs) from the trapezius and thumb muscles before and 30 minutes, 1 hour, and 7 days after training. Parameters measured were MEP amplitude, MEP latency, strength, learning effects, and muscle fatigue. Only specific neck training yielded a 67% increase in MEP amplitudes for up to 7 days after training compared with baseline (P < 0.001). No significant changes were seen after coordination training, no training, and in the within-subject control muscle. The mean muscle strength increased immediately after specific neck training from 56.6 to 61 kg (P < 0.001). No subjective or objective measures of fatigue were observed. Specific neck training induced a sustained hyperexcitability of motor neurons controlling the neck muscles compared with coordination training and controls. These findings may prove valuable in the process of developing more effective clinical training programs for unspecific neck pain.

Trampoline exercise vs. strength training to reduce neck strain in fighter pilots.

PubMed

Sovelius, Roope; Oksa, Juha; Rintala, Harri; Huhtala, Heini; Ylinen, Jari; Siitonen, Simo

2006-01-01

Fighter pilots' muscular strength and endurance are subjected to very high demands. Pilots' fatigued muscles are at higher risk for injuries. The purpose of this study was to compare the effects of two different training methods in reducing muscular loading during in-flight and cervical loading testing (CLT). There were 16 volunteer Finnish Air Force cadets who were divided into 2 groups: a strength training group (STG) and a trampoline training group (TTG). During the 6-wk training period, the STG performed dynamic flexion and extension and isometric rotation exercises, and the TTG performed trampoline bouncing exercises. During in-flight and CLT, muscle strain from the sternocleidomastoid, cervical erector spinae, trapezius, and thoracic erector spinae muscles was recorded with EMG. In-flight muscle strain in the STG after the training period decreased in the sternocleidomastoid 50%, cervical erector spinae 3%, trapezius 4%, and thoracic erector spinae 8%. In the TTG, the decrease was 41%, 30%, 20%, and 6%, respectively. In CLT, the results were similar. After a 3-mo follow-up period with intensive high +Gz flying, EMG during CLT was still lower than in baseline measurements. Both training methods were found to be effective in reducing muscle strain during in-flight and CLT, especially in the cervical muscles. There was no statistically significant difference between the training groups. Introduced exercises expand muscles' capacities in different ways and the authors recommend both strength and trampoline training programs to be included in fighter pilots' physical education programs.

Neck movement and muscle activity characteristics in female office workers with neck pain.

PubMed

Johnston, V; Jull, G; Souvlis, T; Jimmieson, N L

2008-03-01

Cross-sectional study. To explore aspects of cervical musculoskeletal function in female office workers with neck pain. Evidence of physical characteristics that differentiate computer workers with and without neck pain is sparse. Patients with chronic neck pain demonstrate reduced motion and altered patterns of muscle control in the cervical flexor and upper trapezius (UT) muscles during specific tasks. Understanding cervical musculoskeletal function in office workers will better direct intervention and prevention strategies. Measures included neck range of motion; superficial neck flexor muscle activity during a clinical test, the craniocervical flexion test; and a motor task, a unilateral muscle coordination task, to assess the activity of both the anterior and posterior neck muscles. Office workers with and without neck pain were formed into 3 groups based on their scores on the Neck Disability Index. Nonworking women without neck pain formed the control group. Surface electromyographic activity was recorded bilaterally from the sternocleidomastoid, anterior scalene (AS), cervical extensor (CE) and UT muscles. Workers with neck pain had reduced rotation range and increased activity of the superficial cervical flexors during the craniocervical flexion test. During the coordination task, workers with pain demonstrated greater activity in the CE muscles bilaterally. On completion of the task, the UT and dominant CE and AS muscles demonstrated an inability to relax in workers with pain. In general, there was a linear relationship between the workers' self-reported levels of pain and disability and the movement and muscle changes. These results are consistent with those found in other cervical musculoskeletal disorders and may represent an altered muscle recruitment strategy to stabilize the head and neck. An exercise program including motor reeducation may assist in the management of neck pain in office workers.

Musculoskeletal alterations associated factors physical and environmental in dental students.

PubMed

Fals Martínez, Juntzo; González Martínez, Farith; Orozco Páez, Jennifer; Correal Castillo, Sandra Patricia; Pernett Gómez, Cindy Vanessa

2012-12-01

To describe the musculoskeletal disorders and association with physical and environmental in students of Dentistry. Cross sectional study. Simple random sampling was conducted obtaining a proportional sample of 182 students per semester. Collecting information from physical and environmental exposures related to different clinical practice and this was assessed by a structured survey questionnaire type. The valuation muscle was performed by visual analysis with Scan-test. To assess factors related to working position, the instrument was used RULA. For the analysis of the association were used odds ratios with confidence intervals of 95%. For the multivariate analysis using logistic regression. 58.2% of students had pain tenderness in upper trapezius and 45.6% in area cervical. Lateral movements in the cervical found pain in 35.7%, with the bending cervical 35.1% related to all these factors own dental practice and not to other factors external. The onset of muscle pain in this population is influenced by multiple variables, most of them, related to dental practice of students to interact with each other can trigger symptoms at neck and back.

Causes of Hand Tingling in Visual Display Terminal Workers

PubMed Central

Oh, Sein; Kim, Hyung Kuk; Kwak, Jehwan; Kim, Taikon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog

2013-01-01

Objective To offer the basic data about the causes and distribution of hand tingling, symptoms and physical findings, and pressure pain threshold in desk workers. Methods Five physiatrists participated in the screening test composed of history and physical examination. A total of 876 desk workers were evaluated and of them 37 subjects with hand tingling were selected. For further analyzing, detailed history taking and meticulous physical examination were taken. Pressure pain threshold (PPT) at the infraspinatus, upper trapezius, flexor carpi radialis, rhomboideus, and flexor pollicis longus were examined. PPT measurements were repeated three times with two minute intervals by a pressure algometer. Electrodiagnostic study was done to detect potential neurologic abnormalities. Results The causes of hand tingling in order of frequency were: myofascial pain syndrome, 68%; cervical radiculopathy, 27%; rotator cuff syndrome, 11%; tenosynovitis, 8%; and carpal tunnel syndrome, 5%. The location of trigger points in the myofascial pain syndrome, which were proven to evoke a tingling sensation to the hand in order of frequency were: infraspinatus, 65.4%; upper trapezius, 57.7%; flexor carpi radialis, 38.5%; rhomboideus 15.4%; and flexor pollicis longus 11.5%. The PPT of the affected side was significantly lower than that of the unaffected side in myofascial pain syndrome (p<0.05). Conclusion The most common cause of hand tingling in desk workers was myofascial pain syndrome rather than carpal tunnel syndrome. Common trigger points to evoke hand tingling were in the infraspinatus and upper trapezius. PMID:23705117

Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study.

PubMed

Dissanayaka, Thusharika Dilrukshi; Pallegama, Ranjith Wasantha; Suraweera, Hilari Justus; Johnson, Mark I; Kariyawasam, Anula Padma

2016-09-01

The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation and interferential therapy (IFT) both in combination with hot pack, myofascial release, active range of motion exercise, and a home exercise program on myofascial pain syndrome patients with upper trapezius myofascial trigger point. A total of 105 patients with an upper trapezius myofascial trigger point were recruited to this single-blind randomized controlled trial. Following random allocation of patients to three groups, three therapeutic regimens-control-standard care (hot pack, active range of motion exercises, myofascial release, and a home exercise program with postural advice), transcutaneous electrical nerve stimulation-standard care and IFT-standard care-were administered eight times during 4 wks at regular intervals. Pain intensity and cervical range of motions (cervical extension, lateral flexion to the contralateral side, and rotation to the ipsilateral side) were measured at baseline, immediately after the first treatment, before the eighth treatment, and 1 wk after the eighth treatment. Immediate and short-term improvements were marked in the transcutaneous electrical nerve stimulation group (n = 35) compared with the IFT group (n = 35) and the control group (n = 35) with respect to pain intensity and cervical range of motions (P < 0.05). The IFT group showed significant improvement on these outcome measurements than the control group did (P < 0.05). Transcutaneous electrical nerve stimulation with standard care facilitates recovery better than IFT does in the same combination.

Can grip strength be used as a surrogate marker to monitor recovery from shoulder fatigue?

PubMed

Hawkes, David; Grant, Michael; McMahon, Jessica; Horsley, Ian; Khaiyat, Omid

2018-06-06

Muscular fatigue impacts on normal shoulder function, which is particularly pertinent to throwing athletes. This study aimed to investigate the relationship between grip strength and shoulder muscle fatigue to evaluate the role of grip strength as a surrogate measure for upper limb performance. Twenty healthy participants were recruited. EMG was recorded from 15 shoulder muscles during different fatiguing contractions: an initial baseline recording (Fat-Baseline); after a shoulder exhausting exercise regime (Fat-Exhaustion); and after a 10 min rest period (Fat-Recovery). Grip strength was similarly measured in the same conditions. Grip strength differed significantly across the testing scenarios (p = 0.012-<0.001). Greater fatigue was seen in anterior deltoid, middle deltoid, posterior deltoid and supraspinatus in the Fat-Exhaustion contraction as compared to the Fat-Baseline contraction (p = <0.001-0.043). Greater fatigue was seen during the Fat-Recovery contraction for the trapezius, serratus anterior and biceps brachii as compared to the Fat-Exhaustion contraction (p = 0.008-0.038). Grip strength decreased following an exhausting exercise protocol but recovered to baseline following a rest period. Conversely, EMG indices of fatigue did not recover. Additional fatigue was seen reflecting a reorganisation of movement strategy. Therefore, susceptibility to injury still exists if grip strength alone is used as a barometer of upper limb performance. Copyright © 2018. Published by Elsevier Ltd.

Effects of Dual Monitor Computer Work Versus Laptop Work on Cervical Muscular and Proprioceptive Characteristics of Males and Females.

PubMed

Farias Zuniga, Amanda M; Côté, Julie N

2017-06-01

The effects of performing a 90-minute computer task with a laptop versus a dual monitor desktop workstation were investigated in healthy young male and female adults. Work-related musculoskeletal disorders are common among computer (especially female) users. Laptops have surpassed desktop computer sales, and working with multiple monitors has also become popular. However, few studies have provided objective evidence on how they affect the musculoskeletal system in both genders. Twenty-seven healthy participants (mean age = 24.6 years; 13 males) completed a 90-minute computer task while using a laptop or dual monitor (DualMon) desktop. Electromyography (EMG) from eight upper body muscles and visual strain were measured throughout the task. Neck proprioception was tested before and after the computer task using a head-repositioning test. EMG amplitude (root mean square [RMS]), variability (coefficients of variation [CV]), and normalized mutual information (NMI) were computed. Visual strain ( p < .01) and right upper trapezius RMS ( p = .03) increased significantly over time regardless of workstation. Right cervical erector spinae RMS and cervical NMI were smaller, while degrees of overshoot (mean = 4.15°) and end position error (mean = 1.26°) were larger in DualMon regardless of time. Effects on muscle activity were more pronounced in males, whereas effects on proprioception were more pronounced in females. Results suggest that compared to laptop, DualMon work is effective in reducing cervical muscle activity, dissociating cervical connectivity, and maintaining more typical neck repositioning patterns, suggesting some health-protective effects. This evidence could be considered when deciding on computer workstation designs.

Activity of periscapular muscles and its correlation with external oblique during push-up: Does scapular dyskinesis change the electromyographic response?

PubMed

de Araújo, Rodrigo Cappatode; Pirauá, André Luiz Torres; Beltrão, Natália Barros; Pitangui, Ana Carolina Rodarti

2018-03-01

Scapular dyskinesis is the term used to describe changes in the positioning or movement of the scapula. Such dysfunction is associated with changes in the activation of the scapular muscles. However, the influence of the axial muscles on the scapular muscles activity of subjects with scapular dyskinesis is unknown. This study aimed to compare the electromyography (EMG) activity of periscapular muscles and its correlation with the external oblique muscle during the execution of push-up performed in different surfaces, in volunteers with and without scapular dyskinesis. Thirty-six men, divided in two groups (control and dyskinesis), performed push-up on stable and unstable surface. The EMG activity of serratus anterior (SA_5th and SA_7th fibers), upper (UT) and lower (LT) trapezius, external oblique (EO) was recorded during execution of each task condition. Statistical analyzes were performed using two way ANOVA repeated measures and Pearson correlation. It was observed effect of interaction between factors, being evidenced increased activity of UT, SA_7th and OE for the control group and decreased activity of SA_5th, SA_7th and EO for dyskinesis group during execution of push-up on unstable surface. In both groups positive correlations (r > 0.47) were observed between EMG activity of SA and EO. In the exercises tested, there seems to be an anatomical and functional relationship between the SA and EO muscles. The use of the unstable surface promotes increased neuromuscular demand, but the neuromuscular strategies appear to differ between groups.

Efficacy Study of a Fully Implanted Neuroprosthesis for Functional Benefit to Individuals with Tetraplegia

DTIC Science & Technology

2016-10-01

platysma muscle (top red) and trapezius muscle (bottom blue). Bottom Clamshell Side View Cooled water flows through tubing Rubber Tubing Plastic...Enclosure Top View Top Clamshell Top View Side View Top View Cooled water flows through tubing Rubber Tubing Plastic Enclosure Figure 3. Descriptive...typical of the uptake of implanted neuromodulation devices [e.g. cochlear implants, bladder implants, hand neuroprosthesis]. This approach maximizes

Cellular properties of extensor carpi radialis brevis and trapezius muscles in healthy males and females.

PubMed

Green, Howard J; Ranney, Don; Burnett, Margaret; Iqbal, Sobia; Kyle, Natasha; Lounsbury, David; Ouyang, Jing; Tupling, A Russell; Smith, Ian C; Stewart, Riley; Tick, Heather

2015-11-01

In this study, we sought to determine whether differences in cellular properties associated with energy homeostasis could explain the higher incidence of work-related myalgia in trapezius (TRAP) compared with extensor carpi radialis brevis (ECRB). Tissue samples were obtained from the ECRB (n = 19) and TRAP (n = 17) of healthy males and females (age 27.9 ± 2.2 and 28.1 ± 1.5 years, respectively; mean ± SE) and analyzed for properties involved in both ATP supply and utilization. The concentration of ATP and the maximal activities of creatine phosphokinase, phosphorylase, and phosphofructokinase were higher (P < 0.05) in ECRB than TRAP. Succinic dehydrogenase, citrate synthase, and cytochrome c oxidase were not different between muscles. The ECRB also displayed a higher concentration of Na(+)-K(+)-ATPase and greater sarcoplasmic reticulum Ca(2+) release and uptake. No differences existed between muscles for either monocarboxylate transporters or glucose transporters. It is concluded that the potentials for high-energy phosphate transfer, glycogenolysis, glycolysis, and excitation-contraction coupling are higher in ECRB than TRAP. Histochemical measurements indicated that the muscle differences are, in part, related to differing amounts of type II tissue. Depending on the task demands, the TRAP may experience a greater metabolic and excitation-contraction coupling strain than the ECRB given the differences observed.

An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines

PubMed Central

Horwitz, Simone

2015-01-01

ABSTRACT Purpose: To determine whether an association between cervical dysfunction and perimenstrual migraines exists. Methods: Forty perimenstrual migraine sufferers and 46 controls were compared. Information on the participants' ages and perceptions of neck pain and stiffness were solicited. The blinded physical examination of the cervical area consisted of postural, range of motion, muscle strength, muscle length, trigger point, neural mobility, and segmental cervical joint movement assessment. Results: The migraine group had increased perception of neck pain and stiffness (p<0.001); reduced bilateral rotation (p=0.013); decreased muscle length in both trapezii, left sternocleidomastoid, and right occipitals (p=0.045); more pain on muscle stretch in both levator scapulae, both trapezii, left sternocleidomastoid, and both occipitals (p=0.013); increased trigger points bilaterally in the left trapezius (p=0.021), right trapezius (p=0.023), left sternocleidomastoid (p=0.0.004), and right sternocleidomastoid (p=0.021); reduced neural mobility with bilateral elbow lag (p=0.043); greater C4–C6 pain (p=0.045); and increased cervical stiffness in C5–C7 (p=0.023). There were no differences in posture and muscle strength. Decreased muscle length increased the risk of perimenstrual migraines 2.4–6.7 fold, reduced neural mobility 5.8–10.7 fold, and increased C7 stiffness 17.0 fold. Conclusion: The results suggest that an association between cervical dysfunction and perimenstrual headaches should be further explored. PMID:25931651

Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome

PubMed Central

2010-01-01

Background Chronic problems from whiplash trauma generally include headache, pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported, such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck, or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who present with chronic whiplash syndrome, the clinical findings suggest an affliction of the spinal accessory nerve (CN XI, SAN) by entrapment under the fascia of the trapezius muscle. The present study was undertaken to assess the effectiveness of SAN neurolysis in chronic whiplash syndrome. Methods A standardized questionnaire and a linear visual-analogue scale graded 0-10 was used to assess disability related to five symptoms (pain, headache, insomnia, weakness, and stiffness) before, and one year after surgery in a series of thirty consecutive patients. Results The preoperative duration of symptoms ranged from seven months to 13 years. The following changes in disability scores were documented one year after surgery: Overall pain decreased from 9.5 +/- 0.9 to 3.2 +/- 2.6 (p < 0.001); headaches from 8.2 +/- 2.9 to 2.3 +/- 2.8 (p < 0.001); insomnia from 7.5 +/- 2.4 to 3.8 +/- 2.8 (p < 0.001); weakness from 7.6 +/- 2.6 to 3.6 +/- 2.8 (p < 0.001); and stiffness from 7.0 +/- 3.2 to 2.6 +/- 2.7 (p < 0.001). Conclusions Entrapment of the spinal accessory nerve and/or chronic compartment syndrome of the trapezius muscle may cause chronic debilitating pain after whiplash trauma, without radiological or electrodiagnostic evidence of injury. In such cases, surgical treatment may provide lasting relief. PMID:20374624

The Intramuscular Course of the Greater Occipital Nerve: Novel Findings with Potential Implications for Operative Interventions and Occipital Neuralgia

PubMed Central

Tubbs, R. Shane; Watanabe, Koichi; Loukas, Marios; Cohen-Gadol, Aaron A.

2014-01-01

Background: A better understanding of the etiologies of occipital neuralgia would help the clinician treat patients with this debilitating condition. Since few studies have examined the muscular course of the greater occipital nerve (GON), this study was performed. Methods: Thirty adult cadaveric sides underwent dissection of the posterior occiput with special attention to the intramuscular course of the GON. Nerves were typed based on their muscular course. Results: The GON traveled through the trapezius (type I; n = 5, 16.7%) or its aponeurosis (type II; n = 15, 83.3%) to become subcutaneous. Variations in the subtrapezius muscular course were found in 10 (33%) sides. In two (6.7%) sides, the GON traveled through the lower edge of the inferior capitis oblique muscle (subtype a). On five (16.7%) sides, the GON coursed through a tendinous band of the semispinalis capitis, not through its muscular fibers (subtype b). On three (10%) sides the GON bypassed the semispinalis capitis muscle to travel between its most medial fibers and the nuchal ligament (subtype c). For subtypes, eight were type II courses (through the aponeurosis of the trapezius), and two were type I courses (through the trapezius muscle). The authors identified two type IIa courses, four type IIb courses, and two type IIc courses. Type I courses included one type Ib and one type Ic courses. Conclusions: Variations in the muscular course of the GON were common. Future studies correlating these findings with the anatomy in patients with occipital neuralgia may elucidate nerve courses vulnerable to nerve compression. This enhanced classification scheme describes the morphology in this region and allows more specific communications about GON variations. PMID:25422783

Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain.

PubMed

Johnston, V; Jull, G; Darnell, R; Jimmieson, N L; Souvlis, T

2008-06-01

This study determined differences between computer workers with varying levels of neck pain in terms of work stressors, employee strain, electromyography (EMG) amplitude and heart rate response to various tasks. Participants included 85 workers (33, no pain; 38, mild pain; 14, moderate pain) and 22 non-working controls. Work stressors evaluated were job demands, decision authority, and social support. Heart rate was recorded during three tasks: copy-typing, typing with superimposed stress and a colour word task. Measures included electromyography signals from the sternocleidomastoid (SCM), anterior scalene (AS), cervical extensor (CE) and upper trapezius (UT) muscles bilaterally. Results showed no difference between groups in work stressors or employee strain measures. Workers with and without pain had higher measured levels of EMG amplitude in SCM, AS and CE muscles during the tasks than controls (all P < 0.02). In workers with neck pain, the UT had difficulty in switching off on completion of tasks compared with controls and workers without pain. There was an increase in heart rate, perceived tension and pain and decrease in accuracy for all groups during the stressful tasks with symptomatic workers producing more typing errors than controls and workers without pain. These findings suggest an altered muscle recruitment pattern in the neck flexor and extensor muscles. Whether this is a consequence or source of the musculoskeletal disorder cannot be determined from this study. It is possible that workers currently without symptoms may be at risk of developing a musculoskeletal disorder.

Effects of far-infrared irradiation on myofascial neck pain: a randomized, double-blind, placebo-controlled pilot study.

PubMed

Lai, Chien-Hung; Leung, Ting-Kai; Peng, Chih-Wei; Chang, Kwang-Hwa; Lai, Ming-Jun; Lai, Wen-Fu; Chen, Shih-Ching

2014-02-01

The objective of this study was to determine the relative efficacy of irradiation using a device containing a far-infrared emitting ceramic powder (cFIR) for the management of chronic myofascial neck pain compared with a control treatment. This was a randomized, double-blind, placebo-controlled pilot study. The study comprised 48 patients with chronic, myofascial neck pain. Patients were randomly assigned to the experimental group or the control (sham-treatment) group. The patients in the experimental group wore a cFIR neck device for 1 week, and the control group wore an inert neck device for 1 week. Quantitative measurements based on a visual analogue scale (VAS) scoring of pain, a sleep quality assessment, pressure-pain threshold (PPT) testing, muscle tone and compliance analysis, and skin temperature analysis were obtained. Both the experimental and control groups demonstrated significant improvement in pain scores. However, no statistically significant difference in the pain scores was observed between the experimental and control groups. Significant decreases in muscle stiffness in the upper regions of the trapezius muscles were reported in the experimental group after 1 week of treatment. Short-term treatment using the cFIR neck device partly reduced muscle stiffness. Although the differences in the VAS and PPT scores for the experimental and control groups were not statistically significant, the improvement in muscle stiffness in the experimental group warrants further investigation of the long-term effects of cFIR treatment for pain management.

Conduction velocity of antigravity muscle action potentials.

PubMed

Christova, L; Kosarov, D; Christova, P

1992-01-01

The conduction velocity of the impulses along the muscle fibers is one of the parameters of the extraterritorial potentials of the motor units allowing for the evaluation of the functional state of the muscles. There are no data about the conduction velocities of antigravity muscleaction potentials. In this paper we offer a method for measuring conduction velocity of potentials of single MUs and the averaged potentials of the interference electromiogram (IEMG) lead-off by surface electrodes from mm. sternocleidomastoideus, trapezius, deltoideus (caput laterale) and vastus medialis. The measured mean values of the conduction velocity of antigravity muscles potentials can be used for testing the functional state of the muscles.

Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

PubMed Central

Aranha, Maria F. M.; Müller, Cristina E. E.; Gavião, Maria B. D.

2015-01-01

BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly. PMID:25714602

Effect of an Unstable Load on Primary and Stabilizing Muscles During the Bench Press.

PubMed

Ostrowski, Stephanie J; Carlson, Lara A; Lawrence, Michael A

2017-02-01

Ostrowski, SJ, Carlson, LA, and Lawrence, MA. Effect of an unstable load on primary and stabilizing muscles during the bench press. J Strength Cond Res 31(2): 430-434, 2017-Unstable resistance exercises are performed to increase activity of stabilizing muscles. The premise is that this increase in activity will yield greater strength gains than traditional resistance exercises. The purpose of this study was to determine if an unstable load increases muscle activity of stabilizing muscles during a bench press as compared with a standard bench press with a typical load. Fifteen resistance-trained males (age 24.2 ± 2.7 years, mass 84.8 ± 12.0 kg, height 1.77 ± 0.05 m, weight lifting experience 9.9 ± 3.4 years, and bench press 1 repetition maximum [1RM] 107.5 ± 25.9 kg) volunteered for this study. Subjects pressed 2 sets of 5 repetitions in both stable (75% 1RM) and unstable (60% 1RM) conditions using a standard barbell and a flexible Earthquake bar, respectively. Surface electromyography was used to detect muscle activity of primary movers (pectoralis major, anterior deltoid, and triceps) and stabilizing musculature (latissimus dorsi, middle and posterior deltoid, biceps brachii, and upper trapezius). Muscle activity was compared using a multivariate analysis of variance to determine significant (p ≤ 0.05) phase and condition differences. The right and left biceps and the left middle deltoid were significantly more active in the unstable condition. Some of the stabilizing muscles were found to be significantly more active in the unstable condition with 15% less weight. Therefore, bench pressing with an unstable load appears promising in activating stabilizing musculature compared with pressing a typical barbell.

Office-Based Elastographic Technique for Quantifying Mechanical Properties of Skeletal Muscle

PubMed Central

Ballyns, Jeffrey J.; Turo, Diego; Otto, Paul; Shah, Jay P.; Hammond, Jennifer; Gebreab, Tadesse; Gerber, Lynn H.; Sikdar, Siddhartha

2012-01-01

Objectives Our objectives were to develop a new, efficient, and easy-to-administer approach to ultrasound elastography and assess its ability to provide quantitative characterization of viscoelastic properties of skeletal muscle in an outpatient clinical environment. We sought to show its validity and clinical utility in assessing myofascial trigger points, which are associated with myofascial pain syndrome. Methods Ultrasound imaging was performed while the muscle was externally vibrated at frequencies in the range of 60 to 200 Hz using a handheld vibrator. The spatial gradient of the vibration phase yielded the shear wave speed, which is related to the viscoelastic properties of tissue. The method was validated using a calibrated experimental phantom, the biceps brachii muscle in healthy volunteers (n = 6), and the upper trapezius muscle in symptomatic patients with axial neck pain (n = 13) and asymptomatic (pain-free) control participants (n = 9). Results Using the experimental phantom, our method was able to quantitatively measure the shear moduli with error rates of less than 20%. The mean shear modulus ± SD in the normal biceps brachii measured 12.5 ± 3.4 kPa, within the range of published values using more sophisticated methods. Shear wave speeds in active myofascial trigger points and the surrounding muscle tissue were significantly higher than those in normal tissue at high frequency excitations (>100 Hz; P < .05). Conclusions Off-the-shelf office-based equipment can be used to quantitatively characterize skeletal muscle viscoelastic properties with estimates comparable to those using more sophisticated methods. Our preliminary results using this method indicate that patients with spontaneous neck pain and symptomatic myofascial trigger points have increased tissue heterogeneity at the trigger point site and the surrounding muscle tissue. PMID:22837285

Office-based elastographic technique for quantifying mechanical properties of skeletal muscle.

PubMed

Ballyns, Jeffrey J; Turo, Diego; Otto, Paul; Shah, Jay P; Hammond, Jennifer; Gebreab, Tadesse; Gerber, Lynn H; Sikdar, Siddhartha

2012-08-01

Our objectives were to develop a new, efficient, and easy-to-administer approach to ultrasound elastography and assess its ability to provide quantitative characterization of viscoelastic properties of skeletal muscle in an outpatient clinical environment. We sought to show its validity and clinical utility in assessing myofascial trigger points, which are associated with myofascial pain syndrome. Ultrasound imaging was performed while the muscle was externally vibrated at frequencies in the range of 60 to 200 Hz using a handheld vibrator. The spatial gradient of the vibration phase yielded the shear wave speed, which is related to the viscoelastic properties of tissue. The method was validated using a calibrated experimental phantom, the biceps brachii muscle in healthy volunteers (n = 6), and the upper trapezius muscle in symptomatic patients with axial neck pain (n = 13) and asymptomatic (pain-free) control participants (n = 9). Using the experimental phantom, our method was able to quantitatively measure the shear moduli with error rates of less than 20%. The mean shear modulus ± SD in the normal biceps brachii measured 12.5 ± 3.4 kPa, within the range of published values using more sophisticated methods. Shear wave speeds in active myofascial trigger points and the surrounding muscle tissue were significantly higher than those in normal tissue at high frequency excitations (>100 Hz; P < .05). Off-the-shelf office-based equipment can be used to quantitatively characterize skeletal muscle viscoelastic properties with estimates comparable to those using more sophisticated methods. Our preliminary results using this method indicate that patients with spontaneous neck pain and symptomatic myofascial trigger points have increased tissue heterogeneity at the trigger point site and the surrounding muscle tissue.

Objective measurement of tissue tension in myofascial trigger point areas before and during the administration of anesthesia with complete blocking of neuromuscular transmission.

PubMed

Buchmann, Johannes; Neustadt, Beate; Buchmann-Barthel, Katharina; Rudolph, Soeren; Klauer, Thomas; Reis, Olaf; Smolenski, Ulrich; Buchmann, Hella; Wagner, Klaus F; Haessler, Frank

2014-03-01

Myofascial trigger points (MTPs) are extremely frequent in the human musculoskeletal system. Despite this, little is known about their etiology. Increased muscular tension in the trigger point area could be a major factor for the development of MTPs. To investigate the impact of muscular tension in the taut band with an MTP and thereby, the spinal excitability of associated segmental neurons, we objectively measured the tissue tension in MTPs before and during the administration of anesthesia using a transducer. Three target muscles (m. temporalis, upper part of m. trapezius, and m. extensor carpi radialis longus) with an MTP and 1 control muscle without an MTP were examined in 62 patients scheduled for an operation. We found significant 2-way interactions (ANOVA, P<0.05) between the analyzed regions of the target muscles dependent on the time of measurement, that is, before and during a complete blocking of neuromuscular transmission. These effects could be demonstrated for each target muscle separately. An increased muscle tension in MTPs, and not a primary local inflammation with enhanced viscoelasticity, was the main result of our investigation. We interpret this increased muscular tension in the taut band with an MTP as increased spinal segmental excitability. In line with this, we assume a predominant, but not unique, impact of increased spinal excitability resulting in an augmented tension of segmental-associated muscle fibers for the etiology of MTP. Consequently, postisometric relaxation might be a promising therapeutic option for MTPs.

[EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Wang, Chaoliang; Wang, Yingzhen; Zhu, Tao; Sun, Xuesheng; Lin, Chu; Gao, Bo; Li, Xinxia

2015-02-01

To explore the effectiveness of the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments to treat acute complete acromioclavicular dislocations. Between January 2008 and April 2012, 66 patients with acromioclavicular dislocation were treated with the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments in 32 cases (experimental group) and with the clavicular hook plate in 34 cases (control group). There was no significant difference in gender, age, injured side, the cause of injury, and the time from injury to operation between 2 groups (P > 0.05). Visual analogue scale (VAS), Constant shoulder scores, and coracoid clavi-cledistance (CC. Dist) were measured at preoperation and at 2 years after operation. Signal/noise quotiem (SNQ) was measured by MRI at 2 years after operation. The operation complications were observed. The patients of 2 groups obtained primary healing of incision. The morbidity of complication in experimental group (12.5%, 4/32) was significantly lower than that in control group (91.2%, 31/34) (Χ2 = 40.96, P = 0.00). All the cases were followed up 2.8 years on average (range, 2 to 4 years). VAS scores and CC.Dist significantly decreased at 2 years after operation when compared with preoperative values in the 2 groups (P < 0.05). VAS scores and CC.Dist of the experimental group were significantly lower than those in the control group (P < 0.05). According to Constant shoulder scores at 2 years after operation, the results were excellent in 19 cases, good in 11 cases, and general in 2 cases with an excellent and good rate of 93.75% in the experimental group; the results were excellent in 7 cases, good in 8 cases, general in 16 cases, and poor in 3 cases with an excellent and good rate of 44.11% in the control group; and significant difference was shown between 2 groups (t = 2.30, P = 0.03). SNQ was significantly lower in experimental group than in control group at 2 years after operation (t = 55.03, P = 0.00), indicating that ligament healing was better in experimental group than control group. Compared with simple clavicular hook plate fixation, the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments is successful in treating acute complete acromioclavicular dislocations, with the advantages of higher ligament healing, less complication, and early improvement of shoulder functions.

Injections of Local Anesthetics into the Pharyngeal Region Reduce Trapezius Muscle Tenderness.

PubMed

Weinschenk, Stefan; Hollmann, Markus W; Göllner, Richard; Picardi, Susanne; Strowitzki, Thomas; Diehl, Leon; Hotz, Lorenz; Meuser, Thomas

2016-01-01

Neck pain is a frequent reason for seeking medical advice. Neuroanatomical findings suggest a close connection between the pharynx and the trapezius region. Irritation of the pharynx may induce tenderness of this area. Specific tender points, called neck reflex points (NRPs), can be identified here with high reproducibility. We hypothesized that therapeutic local anesthesia (TLA; or neural therapy, NT) in the pharyngeal region can reduce tenderness in patients with therapy-resistant neck pain. 17 consecutive female patients with chronic cervical pain and positive trapezius NRPs received bilateral injections of 0.5 ml 1% procaine into the palatine velum. The NRPs were assessed using a 3-level pain index (PI = 0, 1, or 2) before and 3-5 min after each injection. We found a significant reduction in tenderness of the NRP of the trapezius region (NRP C7) immediately after TLA/NT. 30 positive NRPs were found before therapy and only 13 after therapy (p < 0.01). The average PI of the NRP C7 was 1.24 ± 0.77 before and 0.35 ± 0.59 after therapy (right side), and 1.34 ± 0.59 before and 0.59 ± 0.69 after therapy (left side). The pre- and post-therapy PI values were significantly different on both the right and left sides of the trapezius region (p < 0.01). No adverse effects were observed. Pharyngeal irritation may induce and maintain therapy-resistant cervical pain in patients with chronic pharyngeal disease. These patients could benefit from remote TLA/NT injections in the pharyngeal region. © 2016 S. Karger GmbH, Freiburg.

Stabilization of flail chest injuries: minimized approach techniques to treat the core of instability.

PubMed

Schulz-Drost, S; Grupp, S; Pachowsky, M; Oppel, P; Krinner, S; Mauerer, A; Hennig, F F; Langenbach, A

2017-04-01

Stabilizing techniques of flail chest injuries usually need wide approaches to the chest wall. Three main regions need to be considered when stabilizing the rib cage: median-anterior with dissection of pectoral muscle; lateral-axillary with dissection of musculi (mm) serratus, externus abdominis; posterior inter spinoscapular with division of mm rhomboidei, trapezius and latissimus dorsi. Severe morbidity due to these invasive approaches needs to be considered. This study discusses possibilities for minimized approaches to the shown regions. Fifteen patients were stabilized by locked plate osteosynthesis (MatrixRib ® ) between May 2012 and April 2014 and prospectively followed up. Flail chest injuries were managed through limited incisions to the anterior, the lateral, and the posterior parts of the chest wall or their combinations. Each approach was 4-10 cm using Alexis ® retractor. One minimized approach offered sufficient access at least to four ribs posterior and laterally, four pairs of ribs anterior in all cases. There was no need to divide latissimus dorsi muscle. Trapezius und rhomboid muscles were only limited divided, whereas a subcutaneous dissection of serratus and abdominis muscles was necessary. A follow-up showed sufficient consolidation. pneumothorax (2) and seroma (2). Minimized approaches allow sufficient stabilization of severe dislocated rib fractures without extensive dissection or division of the important muscles. Keeping the arm and, thus, the scapula mobile is very important for providing the largest reachable surface of the rib cage through each approach.

Can Cognitive Activities during Breaks in Repetitive Manual Work Accelerate Recovery from Fatigue? A Controlled Experiment

PubMed Central

Mathiassen, Svend Erik; Hallman, David M.; Lyskov, Eugene; Hygge, Staffan

2014-01-01

Neurophysiologic theory and some empirical evidence suggest that fatigue caused by physical work may be more effectively recovered during “diverting” periods of cognitive activity than during passive rest; a phenomenon of great interest in working life. We investigated the extent to which development and recovery of fatigue during repeated bouts of an occupationally relevant reaching task was influenced by the difficulty of a cognitive activity between these bouts. Eighteen male volunteers performed three experimental sessions, consisting of six 7-min bouts of reaching alternating with 3 minutes of a memory test differing in difficulty between sessions. Throughout each session, recordings were made of upper trapezius muscle activity using electromyography (EMG), heart rate and heart rate variability (HRV) using electrocardiography, arterial blood pressure, and perceived fatigue (Borg CR10 scale and SOFI). A test battery before, immediately after and 1 hour after the work period included measurements of maximal shoulder elevation strength (MVC), pressure pain threshold (PPT) over the trapezius muscles, and a submaximal isometric contraction. As expected, perceived fatigue and EMG amplitude increased during the physical work bouts. Recovery did occur between the bouts, but fatigue accumulated throughout the work period. Neither EMG changes nor recovery of perceived fatigue during breaks were influenced by cognitive task difficulty, while heart rate and HRV recovered the most during breaks with the most difficult task. Recovery of perceived fatigue after the 1 hour work period was also most pronounced for the most difficult cognitive condition, while MVC and PPT showed ambiguous patterns, and EMG recovered similarly after all three cognitive protocols. Thus, we could confirm that cognitive tasks between bouts of fatiguing physical work can, indeed, accelerate recovery of some factors associated with fatigue, even if benefits may be moderate and some responses may be equivocal. Our results encourage further research into combinations of physical and mental tasks in an occupational context. PMID:25375644

An ergonomic study of the optimum operating table height for laparoscopic surgery.

PubMed

Berquer, R; Smith, W D; Davis, S

2002-03-01

Laparoscopic surgery requires the use of longer instruments than open surgery, thus changing the relation between the height of the surgeon's hands and the desirable height of the operating room table. The optimum height of the operating room table for laparoscopic surgery is investigated in this study. Twenty-one surgeons performed a two-handed, one-fourth circle cutting task using a laparoscopic video system and laparoscopic instruments positioned at five instrument handle heights relative to subjects' elbow height (-20, -10, 0, +10, and +20 cm) by adjusting the height of the trainer box. Subjects rated the difficulty and discomfort experienced during each task on a visual analog scale. Skin conductance (SC) was measured in Micromhos via paired surface electrodes placed near the ulnar edge of the palm of the right (cutting) hand. The mean electromyographic (EMG) signal from the right deltoid and trapezius muscles was measured. Arm orientation was measured in three dimensions using a magnetometer/accelerometer. Signals were acquired using analog circuitry and digitally sampled using a National Instruments DAQCard 700 connected to a Macintosh PowerBook 5300c running LabVIEW software. Statistical analysis was carried out by analysis of variance and post hoc testing. Statistically significant changes were found in the subjective rating of discomfort (p <0.002), deltoid EMG (p <0.0006), trapezius EMG (p <0.0001), and arm elevation (p <0.0001) between instrument handle heights. SC values and task times did not change significantly. Discomfort and difficulty ratings were lowest when instrument handles were positioned at elbow height. EMG values and arm elevation all decreased with lower instrument height. This study suggests that the optimum table height for laparoscopic surgery should position the laparoscopic instrument handles close to surgeons' elbow level to minimize discomfort and upper arm and shoulder muscle work. This corresponds to an approximate table height of 64 to 77 cm above floor level. A redesign of current operating room tables may be required to meet these ergonomic guidelines.

A pilot study to determine whether differences exist in histochemical properties between the trapezius and extensor carpi radialis brevis muscles in women with work-related myalgia.

PubMed

Green, Howard J; Ranney, Don; Burnett, Margaret; Galvin, Patti; Kyle, Natasha; Iqbal, Sobia; Lounsbury, David; Ouyang, Jing; Smith, Ian C; Stewart, Riley; Tick, Heather; Tupling, A Russell

2014-04-01

To investigate fibre-type abnormalities in women with work-related myalgia (WRM), tissue samples were extracted from their trapezius (TRAP) and the extensor carpi radialis brevis (ECRB) muscles and compared with healthy controls (CON). For the ECRB samples (CON, n = 6; WRM, n = 11), no differences (P > 0.05) were found between groups for any of the properties examined, namely fibre-type (I, IIA, IIX, IIAX) distribution, cross-sectional fibre area, capillary counts (CC), capillary to fibre area ratio, and succinic dehydrogenase activity. For the TRAP samples (CON, n = 6; WRM, n = 8), the only difference (P < 0.05) observed between groups was for CC (CON > WRM), which was not statistically significant (P > 0.05) when age was used a covariant. A comparison of the properties of these 2 muscles in the CON group indicated a higher (P < 0.05) and lower (P < 0.05) percentage of type I and type IIA fibres, respectively, in the TRAP as well as higher (P < 0.05) CC, which was not specific to fibre type. These preliminary results suggest that the properties employed to characterize fibre types do not differentiate CON from WRM for either the TRAP or ECRB. As a consequence, the role of inherent fibre-type differences between these muscles in the pathogenesis of WRM remains uncertain.

Effects of intramuscular morphine in men and women with temporomandibular disorder with myofascial pain.

PubMed

Kang, Soo-Kyung; Lee, Yeon-Hee; Park, Hyeji; Ro, Jin Y; Auh, Q-Schick

2018-06-19

This placebo-controlled randomized double-blinded clinical study assessed the analgesic efficacy of intramuscular morphine in TMD patients with myofascial pain and sex dependent responses of the morphine treatment. Men and women with TMD were treated with morphine (1.5 or 5 mg), lidocaine or saline in the masseter muscle. VAS of pain intensity, PPT and PPtol were compared between treatment groups and gender. An additional group was treated with morphine in the trapezius muscle to evaluate the systemic effect of morphine that may reduce pain in the masseter muscle. There was a significant difference in VAS scores between the morphine 5 mg group and the saline group favoring morphine, but not between the morphine 5 mg and lidocaine. Morphine 1.5 mg and 5 mg treatments led to consistently and significantly elevated PPT and PPtol measures in men, but not in women. Morphine administered in the trapezius muscle did not affect the outcome measures. A single dose intramuscular morphine produced analgesic effects up to 48 hrs in patients with myofascial pain. Intramuscular morphine elevated mechanical pain threshold and tolerance in the masseter only in male patients, suggesting sex differences in local morphine effects. No systemic effect of intramuscular morphine was detected. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Nonlinear Analysis of an Unstable Bench Press Bar Path and Muscle Activation.

PubMed

Lawrence, Michael A; Leib, Daniel J; Ostrowski, Stephanie J; Carlson, Lara A

2017-05-01

Lawrence, MA, Leib, DJ, Ostrowski, SJ, and Carlson, LA. Nonlinear analysis of an unstable bench press bar path and muscle activation. J Strength Cond Res 31(5): 1206-1211, 2017-Unstable resistance exercises are typically performed to improve the ability of stabilizing muscles to maintain joint integrity under a load. The purpose of this study was to examine the effects of an unstable load (as provided by a flexible barbell and a load suspended by elastic bands) on the bar path, the primary musculature, and stabilizing musculature while bench pressing using nonlinear analyses. Fifteen resistance-trained men (age 24.2 ± 2.7 years, mass 84.1 ± 12.0 kg, height 1.77 ± 0.05 m, 9.9 ± 3.4 years of lifting experience, and bench press 1 repetition maximum (RM) 107.5 ± 25.9 kg) volunteered for this study. Subjects pressed 2 sets of 5 repetitions in both stable (total load 75% 1RM) and unstable (total load 60% 1RM) conditions using a standard barbell and a flexible Earthquake bar, respectively. Surface electromyography was used to detect muscle activity of primary movers (pectoralis major, anterior deltoid, and triceps) and bar stabilizing musculature (latissimus dorsi, middle and posterior deltoid, biceps brachii, and upper trapezius). During the unstable condition, the bar moved in more ways and was less predictable in the mediolateral and anteroposterior directions. However, the muscle activation patterns of all muscles were more constrained with the unstable barbell. These findings suggest that the unstable condition was more challenging to control, but subjects controlled the instability by contracting their muscles in a more stable pattern or "staying tight" throughout the exercise.

The effects of cervical traction, cranial rhythmic impulse, and Mckenzie exercise on headache and cervical muscle stiffness in episodic tension-type headache patients.

PubMed

Choi, Sung-Yong; Choi, Jung-Hyun

2016-03-01

[Purpose] The purpose of this study was to examine the effects of cervical traction treatment, cranial rhythmic impulse treatment, a manual therapy, and McKenzie exercise, a dynamic strengthening exercise, on patients who have the neck muscle stiffness of the infrequent episodic tension-type (IETTH) headache and frequent episodic tension-type headache(FETTH), as well as to provide the basic materials for clinical interventions. [Subjects] Twenty-seven subjects (males: 15, females: 12) who were diagnosed with IETTH and FETTH after treatment by a neurologist were divided into three groups: (a cervical traction group (CTG, n=9), a cranial rhythmic contractiongroup (CRIG, n=9), and a McKenzie exercise group (MEG, n=9). An intervention was conducted for each group and the differences in their degrees of neck pain and changes in muscle tone were observed. [Results] In the within-group comparison of each group, headache significantly decreased in CTG. According to the results of the analysis of the muscle tone of the upper trapezius, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. According to the results of the analysis of the muscle tone of the sternocleidomastoid muscle, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. [Conclusion] In the comparison of the splenius capitis muscle between the groups, there was a statistically significant difference on the right side. Hence, compared to the other methods, cervical traction is concluded to be more effective at reducing headaches in IETTH and FETTH patients.

Widespread Pressure Pain Hyperalgesia in Chronic Nonspecific Neck Pain with Neuropathic Features: A Descriptive Cross-Sectional Study.

PubMed

Lopez-de-Uralde-Villanueva, Ibai; Beltran-Alacreu, Hector; Fernandez-Carnero, Josue; Kindelan-Calvo, Paula; La Touche, Roy

2016-02-01

Neck pain has an elevated prevalence worldwide. Most people with neck pain are diagnosed as nonspecific neck pain patients. Poor recovery in neck disorders, as well as high levels of pain and disability, are associated with widespread sensory hypersensitivity. Nevertheless, there is controversy regarding the presence of widespread hyperalgesia in chronic nonspecific neck pain (CNSNP); this lack of agreement could be due to the presence of different pathophysiological mechanisms in CNSNP. To determinate differences in pressure pain thresholds (PPTs) over extracervical and cervical regions, and differences in cervical range of motion (ROM) between patients with CNSNP with and without neuropathic features (NF and No-NF, respectively). In addition, this study expected to observe correlations in these 2 types of CNSNP of psychosocial factors with PPTs and with cervical ROM separately. Descriptive, cross-sectional study. A hospital physiotherapy outpatient department. This research involved 53 patients with CNSNP that had obtained a Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) score = 12 (pain with NF, NF group); 54 that had obtained a S-LANSS score < 12 (pain with No-NF, No-NF group), and 53 healthy controls (control group, CG). Measures included: PPTs (suboccipital muscle, upper fibers trapezius muscle, lateral epicondyle, and anterior tibial muscle), cervical ROM (flexion, extension, rotation, and latero-flexion), pain intensity (Visual Analog Scale [VAS]), neck disability index (NDI), kinesiophobia (Tampa Scale of Kinesiophobia-11 [TSK-11]), and Pain Catastrophizing Scale (PCS). A statistically significant effect was observed for the group factor in all assessed measures (P < 0.01). Both CNSNP groups showed statistically significant differences compared to the CG for PPTs in the cervical region (suboccipital and upper fibers trapezius muscles), but only the NF group demonstrated statistically significant differences for PPTs in the lateral epincondyle and anterior tibial muscle when compared to the CG or No-NF group. The largest statistically significant correlation found in the NF group was between PPT in the anterior tibial muscle and TSK-11 (r = -0.372; P < 0.01), while in the No-NF group it was between PPT in the suboccipital muscle and NDI (r = -0.288; P < 0.05). Statistically significant differences were found between the 2 CNSNP groups and CG in all cervical ROMs, but not between both CNSNP groups. The largest statistically significant correlation observed in the NF group was between cervical total rotation and TSK-11 (r = -0.473; P < 0.01), while in the No-NF group it was between cervical total latero-flexion and PCS (r = -0.532; P < 0.01). Although the S-LANSS scale has been validated as a screening tool for pain with NF, currently there is no "gold standard," so these findings should be interpreted with caution. Widespread pressure pain hyperalgesia was detected in patients with CNSNP with NF, but not in patients with CNSNP with No-NF. Patients with CNSNP presented bilateral pressure pain hyperalgesia over the cervical region and a decreased cervical ROM compared to healthy controls. However, no differences were found between the 2 CNSNP groups. These findings suggest differences in the mechanism of pain processing between patients with CNSNP with NF and No-NF.

Anticipatory postural adjustments during sitting reach movement in post-stroke subjects.

PubMed

Pereira, Soraia; Silva, Cláudia C; Ferreira, Sílvia; Silva, Cláudia; Oliveira, Nuno; Santos, Rubim; Vilas-Boas, John P; Correia, Miguel V

2014-02-01

The study assessed the effect of velocity of arm movement on anticipatory postural adjustments (APAs) generation in the contralateral and ipsilateral muscles of individuals with stroke in seating. Ten healthy and eight post-stroke subjects were studied in sitting. The task consisted in reaching an object placed at scapular plane and mid-sternum height at self-selected and fast velocities. Electromyography was recorded from anterior deltoid (AD), upper (UT) and lower trapezius (LT) and latissimus dorsi (LD). While kinematic analysis was used to assess peak velocity and trunk displacement. Differences were found between the timing of APAs on ipsi and contralateral LD and LT in both movement speeds and in ipsilateral UT during movement of the non-affected arm at a self-selected velocity. A delay on the contralateral LD to reach movement with the non-affected arm at fast velocity was also observed. The trunk displacement was greater in post-stroke subjects. Individuals with stroke demonstrated a delay of APAs in the muscles on both sides of the body compared to healthy subjects. The delay was observed during performance of the reaching task with the fast and self-selected velocity. Copyright © 2013 Elsevier Ltd. All rights reserved.

CERVICAL SPINE SIGNS AND SYMPTOMS: PERPETUATING RATHER THAN PREDISPOSING FACTORS FOR TEMPOROMANDIBULAR DISORDERS IN WOMEN

PubMed Central

Bevilaqua-Grossi, Débora; Chaves, Thaís Cristina; de Oliveira, Anamaria Siriani

2007-01-01

Aim: The purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (TMD) and vice-versa. Material and Methods: One hundred women (aged 18-26 years) clinically diagnosed with TMD signs and symptoms and cervical spine disorders were randomly selected from a sample of college students. Results: 43% of the volunteers demonstrated the same severity for TMD and cervical spine disorders (CSD). The increase in TMD signs and symptoms was accompanied by increase in CSD severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe CSD group. However, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of TMD severity. Conclusion: The increase in cervical symptomatology seems to accompany TMD severity; nonetheless, the inverse was not verified. Such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for TMD. PMID:19089141

Muscular Activation During Plyometric Exercises in 90° of Glenohumeral Joint Abduction

PubMed Central

Ellenbecker, Todd S.; Sueyoshi, Tetsuro; Bailie, David S.

2015-01-01

Background: Plyometric exercises are frequently used to increase posterior rotator cuff and periscapular muscle strength and simulate demands and positional stresses in overhead athletes. The purpose of this study was to provide descriptive data on posterior rotator cuff and scapular muscle activation during upper extremity plyometric exercises in 90° of glenohumeral joint abduction. Hypothesis: Levels of muscular activity in the posterior rotator cuff and scapular stabilizers will be high during plyometric shoulder exercises similar to previously reported electromyographic (EMG) levels of shoulder rehabilitation exercises. Study Design: Descriptive laboratory study. Methods: Twenty healthy subjects were tested using surface EMG during the performance of 2 plyometric shoulder exercises: prone external rotation (PERP) and reverse catch external rotation (RCP) using a handheld medicine ball. Electrode application included the upper and lower trapezius (UT and LT, respectively), serratus anterior (SA), infraspinatus (IN), and the middle and posterior deltoid (MD and PD, respectively) muscles. A 10-second interval of repetitive plyometric exercise (PERP) and 3 repetitions of RCP were sampled. Peak and average normalized EMG data were generated. Results: Normalized peak and average IN activity ranged between 73% and 102% and between 28% and 52% during the plyometric exercises, respectively, with peak and average LT activity measured between 79% and 131% and between 31% and 61%. SA activity ranged between 76% and 86% for peak and between 35% and 37% for average activity. Muscular activity levels in the MD and PD ranged between 49% and 72% and between 12% and 33% for peak and average, respectively. Conclusion: Moderate to high levels of muscular activity were measured in the rotator cuff and scapular stabilizers during these plyometric exercises with the glenohumeral joint abducted 90°. PMID:25553216

Muscular activation during plyometric exercises in 90° of glenohumeral joint abduction.

PubMed

Ellenbecker, Todd S; Sueyoshi, Tetsuro; Bailie, David S

2015-01-01

Plyometric exercises are frequently used to increase posterior rotator cuff and periscapular muscle strength and simulate demands and positional stresses in overhead athletes. The purpose of this study was to provide descriptive data on posterior rotator cuff and scapular muscle activation during upper extremity plyometric exercises in 90° of glenohumeral joint abduction. Levels of muscular activity in the posterior rotator cuff and scapular stabilizers will be high during plyometric shoulder exercises similar to previously reported electromyographic (EMG) levels of shoulder rehabilitation exercises. Descriptive laboratory study. Twenty healthy subjects were tested using surface EMG during the performance of 2 plyometric shoulder exercises: prone external rotation (PERP) and reverse catch external rotation (RCP) using a handheld medicine ball. Electrode application included the upper and lower trapezius (UT and LT, respectively), serratus anterior (SA), infraspinatus (IN), and the middle and posterior deltoid (MD and PD, respectively) muscles. A 10-second interval of repetitive plyometric exercise (PERP) and 3 repetitions of RCP were sampled. Peak and average normalized EMG data were generated. Normalized peak and average IN activity ranged between 73% and 102% and between 28% and 52% during the plyometric exercises, respectively, with peak and average LT activity measured between 79% and 131% and between 31% and 61%. SA activity ranged between 76% and 86% for peak and between 35% and 37% for average activity. Muscular activity levels in the MD and PD ranged between 49% and 72% and between 12% and 33% for peak and average, respectively. Moderate to high levels of muscular activity were measured in the rotator cuff and scapular stabilizers during these plyometric exercises with the glenohumeral joint abducted 90°.

Stress Management as an Adjunct to Physical Therapy for Chronic Neck Pain

PubMed Central

Bruflat, Angela K.; Balter, Jaclyn E.; McGuire, Denise; Fethke, Nathan B.

2012-01-01

Background and Purpose Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment. Case Description A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation. Outcomes Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment. Discussion A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress. PMID:22700538

Neck and shoulder muscle activity and posture among helicopter pilots and crew-members during military helicopter flight.

PubMed

Murray, Mike; Lange, Britt; Chreiteh, Shadi Samir; Olsen, Henrik Baare; Nørnberg, Bo Riebeling; Boyle, Eleanor; Søgaard, Karen; Sjøgaard, Gisela

2016-04-01

Neck pain among helicopter pilots and crew-members is common. This study quantified the physical workload on neck and shoulder muscles using electromyography (EMG) measures during helicopter flight. Nine standardized sorties were performed, encompassing: cruising from location A to location B (AB) and performing search and rescue (SAR). SAR was performed with Night Vision Goggles (NVG), while AB was performed with (AB+NVG) and without NVG (AB-NVG). EMG was recorded for: trapezius (TRA), upper neck extensors (UNE), and sternocleido-mastoid (SCM). Maximal voluntary contractions (MVC) were performed for normalization of EMG (MVE). Neck posture of pilots and crew-members was monitored and pain intensity of neck, shoulder, and back was recorded. Mean muscle activity for UNE was ∼10% MVE and significantly higher than TRA and SCM, and SCM was significantly lower than TRA. There was no significant difference between AB-NVG and AB+NVG. Muscle activity in the UNE was significantly higher during SAR+NVG than AB-NVG. Sortie time (%) with non-neutral neck posture for SAR+NVG and AB-NVG was: 80.4%, 74.5% (flexed), 55.5%, 47.9% (rotated), 4.5%, 3.7% (lateral flexed). Neck pain intensity increased significantly from pre- (0.7±1.3) to post-sortie (1.6±1.9) for pilots (p=0.028). If sustained, UNE activity of ∼10% MVE is high, and implies a risk for neck disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Predictors of upper trapezius pain with myofascial trigger points in food service workers: The STROBE study.

PubMed

Hwang, Ui-Jae; Kwon, Oh-Yun; Yi, Chung-Hwi; Jeon, Hye-Seon; Weon, Jong-Hyuck; Ha, Sung-Min

2017-06-01

Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs.In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a visual analog scale (VAS) pain score, age, sex, Borg rating of perceived exertion (BRPE) scale, beck depression inventory, forward head posture angle, rounded shoulder angle (RSA), shoulder slope angle, scapular downward rotation ratio, cervical lateral-bending side difference angle, cervical rotation side difference angle, glenohumeral internal rotation angle, shoulder horizontal adduction angle, serratus anterior (SA) strength, lower trapezius (LT) strength, bicep strength, and glenohumeral external rotator strength, in 163 FSWs with UT pain due to MTrPs.The model for factors influencing UT pain with MTrPs included SA strength, age, BRPE, LT strength, and RSA as predictor variables that accounted for 68.7% of the variance in VAS (P < .001) in multiple regression models with a stepwise selection procedure. The following were independent variables influencing the VAS in the order of standardized coefficients: SA strength (β = -0.380), age (β = 0.287), BRPE (β = 0.239), LT strength (β = -0.195), and RSA (β = 0.125).SA strength, age, BRPE, LT strength, and RSA variables should be considered when evaluating and intervening in UT pain with MTrPs in FSWs.

Predictors of upper trapezius pain with myofascial trigger points in food service workers

PubMed Central

Hwang, Ui-Jae; Kwon, Oh-Yun; Yi, Chung-Hwi; Jeon, Hye-Seon; Weon, Jong-Hyuck; Ha, Sung-Min

2017-01-01

Abstract Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs. In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a visual analog scale (VAS) pain score, age, sex, Borg rating of perceived exertion (BRPE) scale, beck depression inventory, forward head posture angle, rounded shoulder angle (RSA), shoulder slope angle, scapular downward rotation ratio, cervical lateral-bending side difference angle, cervical rotation side difference angle, glenohumeral internal rotation angle, shoulder horizontal adduction angle, serratus anterior (SA) strength, lower trapezius (LT) strength, bicep strength, and glenohumeral external rotator strength, in 163 FSWs with UT pain due to MTrPs. The model for factors influencing UT pain with MTrPs included SA strength, age, BRPE, LT strength, and RSA as predictor variables that accounted for 68.7% of the variance in VAS (P < .001) in multiple regression models with a stepwise selection procedure. The following were independent variables influencing the VAS in the order of standardized coefficients: SA strength (β = −0.380), age (β = 0.287), BRPE (β = 0.239), LT strength (β = −0.195), and RSA (β = 0.125). SA strength, age, BRPE, LT strength, and RSA variables should be considered when evaluating and intervening in UT pain with MTrPs in FSWs. PMID:28658117

Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points

PubMed Central

Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

2017-01-01

Background Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs. Objective To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs. Methods This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention. Results At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001). Conclusions The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed. Trial registration number IRCT20130316128. PMID:27697768

Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points.

PubMed

Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

2017-04-01

Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs. To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs. This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention. At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001). The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed. IRCT20130316128. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Botulinum toxin in myotonia congenita: it does not help against rigidity and pain.

PubMed

Dressler, Dirk; Adib Saberi, Fereshte

2014-05-01

Botulinum toxin (BT) is a potent local muscle relaxant with analgetic properties. Myotonia congenita (MC) is a genetic disorder producing muscle rigidity and pain. BT injected into the trapezius produced mild paresis, but no effect on rigidity and pain. There were no signs of systemic effects. Lack of BT efficacy on MC rigidity confirms its origin from muscle membrane dysfunction rather than from inappropriate neuromuscular activation. Lack of BT efficacy on pain could be caused by lack of anti-rigidity effect. It could also be due to separate non-muscular pain mechanisms unresponsive to BT.

Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

PubMed

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-04-01

Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p < 0.001), and (2) increased EMG activity in the ipsilateral erector spinae muscle during slow and fast movements (p < 0.02), and in the contralateral erector spinae muscle during all but fast up and slow-resisted down movements (p < 0.007). The PPTs in the painful condition increased at the head and arm compared with post measurements and the control condition (p < 0.001). In the post-pain condition, the neck PPT was decreased compared with the control condition (p < 0.001). Acute bilateral neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity. © 2016 European Pain Federation - EFIC®.

Outcome of triple-tendon transfer, an Eden-Lange variant, to reconstruct trapezius paralysis.

PubMed

Elhassan, Bassem T; Wagner, Eric R

2015-08-01

This study describes the technique and evaluates the outcome of the triple-tendon (T3) transfer, an Eden-Lange variant, to the scapula to stabilize the scapulothoracic articulation in the treatment of symptomatic trapezius paralysis. T3 transfers were performed in 22 patients with a history of persistent trapezius paralysis secondary to spinal accessory nerve injury. The indications for surgery included shoulder pain and weakness and limited range of motion of the shoulder. The T3 transfer included transfer of the levator scapulae to the lateral aspect of the spine of the scapula, the rhomboid minor to the spine of the scapula just medial to the levator scapulae insertion, and the rhomboid major to the medial spine of the scapula, including all muscles bony insertions. At an average follow-up of 35 months, winging was corrected in all patients, with improvement of shoulder asymmetry. All patients had significant improvement of pain (P < .01) and range of motion, including active shoulder abduction that improved from an average of 71° preoperatively to 118° postoperatively (P < .02) and shoulder flexion from an average of 102° to 150° (P < .01). There were also significant improvements in aggregate Constant Shoulder Score (P < .01), subjective shoulder value (P < .01), and Disabilities of the Arm, Shoulder and Hand score (P < .01). All patients were very satisfied with the outcome of surgery. This study shows that the T3 transfer is effective in stabilizing the scapulothoracic articulation and restoring the function of the trapezius, and thus, in improving pain and shoulder function in patients with symptomatic trapezius paralysis. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Combining microdialysis and near-infrared spectroscopy for studying effects of low-load repetitive work on the intramuscular chemistry in trapezius myalgia.

PubMed

Flodgren, Gerd M; Crenshaw, Albert G; Hellström, Fredrik; Fahlström, Martin

2010-01-01

Epidemiological research provides strong evidence for a link between repetitive work (RW) and the development of chronic trapezius myalgia (TM). The aims were to further elucidate if an accumulation of sensitising substances or impaired oxygenation is evident in painful muscles during RW. Females with TM (n = 14) were studied during rest, 30 minutes RW and 60 minutes recovery. Microdialysate samples were obtained to determine changes in intramuscular microdialysate (IMMD) [glutamate], [PGE(2)], [lactate], and [pyruvate] (i.e., [concentration]) relative to work. Muscle oxygenation (%StO(2)) was assessed using near-infrared spectroscopy. During work, all investigated substances, except PGE(2), increased significantly: [glutamate] (54%, P < .0001), [lactate] (26%, P < .005), [pyruvate] (19%, P < .0001), while the %StO(2) decreased (P < .05). During recovery [PGE(2)] decreased (P < .005), [lactate] remained increased (P < .001), [pyruvate] increased progressively (P < .0001), and %StO(2) had returned to baseline. Changes in substance concentrations and oxygenation in response to work indicate normal increase in metabolism but no ongoing inflammation in subjects with TM.

Scapular muscle activity in a variety of plyometric exercises.

PubMed

Maenhout, Annelies; Benzoor, Maya; Werin, Maria; Cools, Ann

2016-04-01

Plyometric shoulder exercises are commonly used to progress from slow analytical strength training to more demanding high speed power training in the return to play phase after shoulder injury. The aim of this study was first, to investigate scapular muscle activity in plyometric exercises to support exercise selection in practice and second, to enhance understanding of how scapular muscles are recruited during the back and forth movement phase of these exercises. Thirty-two healthy subjects performed 10 plyometric exercises while surface EMG-activity of the scapular muscles (upper (UT), middle (MT) and lower trapezius (LT) and serratus anterior (SA)) was registered. A high speed camera tracked start and end of the back and forth movement. Mean scapular EMG activity during the 10 exercises ranged from 14.50% to 76.26%MVC for UT, from 15.19% to 96.55%MVC for MT, from 13.18% to 94.35%MVC for LT and from 13.50% to 98.50%MVC for SA. Anova for repeated measures showed significant differences in scapular muscle activity between exercises (p<0.001) and between the back and forth movement (p<0.001) within exercises. Plyometric shoulder exercises require moderate (31-60%MVC) to high (>60%MVC) scapular muscle activity. Highest MT/LT activity was present in prone plyometric external rotation and flexion. Highest SA activity was found in plyometric external rotation and flexion with Xco and plyometric push up on Bosu. Specific exercises can be selected that recruit minimal levels of UT activity (<15%): side lying plyometric external rotation and horizontal abduction or plyometric push up on the Bosu. The results of this study support exercise selection for clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

FLS tasks can be used as an ergonomic discriminator between laparoscopic and robotic surgery.

PubMed

Zihni, Ahmed M; Ohu, Ikechukwu; Cavallo, Jaime A; Ousley, Jenny; Cho, Sohyung; Awad, Michael M

2014-08-01

Robotic surgery may result in ergonomic benefits to surgeons. In this pilot study, we utilize surface electromyography (sEMG) to describe a method for identifying ergonomic differences between laparoscopic and robotic platforms using validated Fundamentals of Laparoscopic Surgery (FLS) tasks. We hypothesize that FLS task performance on laparoscopic and robotic surgical platforms will produce significant differences in mean muscle activation, as quantified by sEMG. Six right-hand-dominant subjects with varying experience performed FLS peg transfer (PT), pattern cutting (PC), and intracorporeal suturing (IS) tasks on laparoscopic and robotic platforms. sEMG measurements were obtained from each subject's bilateral bicep, tricep, deltoid, and trapezius muscles. EMG measurements were normalized to the maximum voluntary contraction (MVC) of each muscle of each subject. Subjects repeated each task three times per platform, and mean values used for pooled analysis. Average normalized muscle activation (%MVC) was calculated for each muscle group in all subjects for each FLS task. We compared mean %MVC values with paired t tests and considered differences with a p value less than 0.05 to be statistically significant. Mean activation of right bicep (2.7 %MVC lap, 1.3 %MVC robotic, p = 0.019) and right deltoid muscles (2.4 %MVC lap, 1.0 %MVC robotic, p = 0.019) were significantly elevated during the laparoscopic compared to the robotic IS task. The mean activation of the right trapezius muscle was significantly elevated during robotic compared to the laparoscopic PT (1.6 %MVC lap, 3.5 %MVC robotic, p = 0.040) and PC (1.3 %MVC lap, 3.6 %MVC robotic, p = 0.0018) tasks. FLS tasks are validated, readily available instruments that are feasible for use in demonstrating ergonomic differences between surgical platforms. In this study, we used FLS tasks to compare mean muscle activation of four muscle groups during laparoscopic and robotic task performance. FLS tasks can serve as the basis for larger studies to further describe ergonomic differences between laparoscopic and robotic surgery.

Genetic parameters for image analysis traits on M. longissimus thoracis and M. trapezius of carcass cross section in Japanese Black steers.

PubMed

Osawa, T; Kuchida, K; Hidaka, S; Kato, T

2008-01-01

In Japan, the degree of marbling in ribeye (M. longissimus thoracis) is evaluated in the beef meat grading process. However, other muscles (e.g., M. trapezius) are also important in determining the meat quality and carcass market prices. The purpose of this study was to estimate genetic parameters for M. longissimus thoracis (M-LONG) and M. trapezius (M-TRAP) of carcass cross section of Japanese Black steers by computer image analysis. The number of records of Japanese Black steers and the number of pedigree records were 2,925 and 10,889, respectively. Digital images of the carcass cross section were taken between the sixth and seventh ribs by photographing equipment. Muscle area (MA), fat area ratio (FAR), overall coarseness of marbling particles (OCM), and coarseness of maximum marbling particle (MMC) in M-LONG and M-TRAP were calculated by image analysis. Genetic parameters for these traits were estimated using the AIREMLF90 program with an animal model. Fixed effects that were included in the model were dates of arrival at the carcass market and slaughter age (mo), and random effects of fattening farms, additive genetic effects and residuals were included in the model. For M-LONG, heritability estimates (+/-SE) were 0.46 +/- 0.06, 0.59 +/- 0.06, 0.47 +/- 0.06, and 0.20 +/- 0.05 for MA, FAR, OCM, and MMC, respectively. Heritability estimates (+/-SE) in M-TRAP were 0.47 +/- 0.06, 0.57 +/- 0.07, 0.49 +/- 0.07, and 0.13 +/- 0.04 for the same traits. Genetic correlations between subcutaneous fat thickness and FAR for M-LONG and M-TRAP were negative (-0.21 and -0.19, respectively). Those correlations between M-LONG and M-TRAP were moderate to high for MA, FAR, OCM, and MMC (0.38, 0.52, 0.39, and 0.60, respectively). These results indicate that other muscles including M-LONG should be evaluated for more efficient genetic improvement.

Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula.

PubMed

Leong, Hio Teng; Ng, Gabriel Yin-Fat; Chan, Shing Chung; Fu, Siu Ngor

2017-08-01

Athletes with rotator cuff (RC) tendinopathy demonstrate an aberrant pattern of scapular motion which might relate to deficits in the scapular muscles. This study aimed to determine whether alteration in scapular kinematics is associated with deficits in the activity onset of scapular muscles. Forty-three male volleyball players (17 asymptomatic and 26 with RC tendinopathy) joined the study. Three-dimensional scapular kinematics was quantified using an acromial marker cluster method. The activity onset of the upper (UT), middle (MT), and lower trapezius (LT), and serratus anterior (SA) during arm abduction was assessed with electromyography. Athletes with RC tendinopathy demonstrated less scapular upward rotation (6.6±2.3 vs. 8.2±1.1°, p=0.021) in the early phase of shoulder abduction from 0° to 30° when compared to asymptomatic athletes. The tendinopathy group had delayed activity onset of LT (14.1±31.4ms vs. 74.4±45.1ms, p<0.001) and SA (-44.9±26.0ms vs. 23.0±25.2ms, p<0.001) relative to UT when compared to the asymptomatic group. In asymptomatic athletes, earlier activity onset of MT and LT relative to UT was associated with more scapular upward rotation during 0-30° of abduction (r=0.665, p=0.021) and 30-60° of abduction (r=0.680, p=0.015), respectively. Our findings showed the control of the scapular upward rotation is related to the activity onset of the scapular muscles in athletes. Copyright © 2017 Elsevier Ltd. All rights reserved.

During computing tasks symptomatic female office workers demonstrate a trend towards higher cervical postural muscle load than asymptomatic office workers: an experimental study.

PubMed

Szeto, Grace P Y; Straker, Leon M; O'Sullivan, Peter B

2009-01-01

Do symptomatic female office workers perform computing tasks with higher cervical postural muscle loads (in terms of higher amplitudes and less muscular rest) and more discomfort compared with asymptomatic individuals? Are these differences in postural muscle loads consistent across bilateral (typing) and unilateral (mousing) conditions? an experimental case-control study. 18 symptomatic female office workers and 21 asymptomatic female office workers. Three conditions (typing, mousing, and type-and-mouse) were performed in random order. Muscle load was measured as median amplitude and gap frequency using surface EMG of bilateral cervical erector spinae and upper trapezius. Discomfort was measured using a numerical rating scale. The case group demonstrated 4.3% (95% CI 0.1 to 8.4) higher amplitude during typing and 3.5% (95% CI 0.1 to 6.9) higher amplitude during type-and-mouse in the right cervical erector spinae compared with the control group. There was a similar difference between groups in the left cervical erector spinae which also demonstrated a 1.2 gaps/min (95% CI -2.3 to 0.0) lower frequency during typing. The case group had significantly higher discomfort during all conditions compared with the control group. The case group demonstrated higher median amplitudes and lower gap frequencies than the control group during bilateral conditions (typing and type-and-mouse) compared with unilateral conditions (mousing) for both muscle groups. There was increased amplitude and decreased muscular rest in the cervical erector spinae of office workers performing typing and mousing tasks. These findings may represent a mechanism underlying computer-related musculoskeletal disorders.

Influence of Body Position on Shoulder and Trunk Muscle Activation During Resisted Isometric Shoulder External Rotation.

PubMed

Krause, David A; Dueffert, Lucas G; Postma, Jaclyn L; Vogler, Eric T; Walsh, Amy J; Hollman, John H

External rotation (ER) strengthening of the shoulder is an integral component of rehabilitative and preventative programs for overhead athletes. A variety of shoulder ER strengthening exercises are reported, including those intended to integrate the core musculature. The purpose of this study was to examine ER torque and electromyographic (EMG) activation of shoulder and trunk muscles while performing resisted isometric shoulder ER in 3 positions (standing, side lying, and side plank). Significantly greater force and shoulder muscle activation would be generated while side lying given the inherent stability of the position, and greater trunk muscle activation would be generated in the less stable plank position. Quasi-experimental repeated-measures study. Level 5. A convenience sample of 25 healthy overhead recreational athletes (9 men, 16 women) participated in this study. EMG electrodes were placed on the infraspinatus, posterior deltoid, middle trapezius, multifidi, internal obliques, and external obliques. EMG signals were normalized to a maximal isometric contraction. Participants performed resisted isometric ER in standing, side-lying, and side plank positions. Results were analyzed using a repeated-measures analysis of variance with post hoc Bonferroni corrections (α = 0.05). There was no significant difference in ER torque between positions (α = 0.05). A significant difference in EMG activity of shoulder and trunk musculature between positions was found in 7 of the 8 muscles monitored. Significantly greater EMG activity in the infraspinatus, middle trapezius, and the nondominant external and internal obliques was found in the side plank position as compared with standing and side lying. While there was no difference in ER torque between the 3 exercise positions, EMG activity of the shoulder and trunk muscles was dependent on body position. If a clinician is seeking to integrate trunk muscle activation while performing shoulder ER strengthening, the side plank position is preferred as compared with standing or side lying.

Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peynircioglu, Bora, E-mail: borapeynir@gmail.com; Arslan, E. Bengi; Cil, Barbaros E.

2007-06-15

The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time ofmore » surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up.« less

The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

PubMed

Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

2015-04-01

Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Electromyographic assessment of apple bucket intervention designed to reduce back strain.

PubMed

Earle-Richardson, Giulia; Jenkins, Paul L; Strogatz, David; Bell, Erin M; Freivalds, Andris; Sorensen, Julie A; May, John J

2008-06-01

The authors previously developed an apple bucket that was modified by use of a hip belt to reduce muscle fatigue. The intervention of belt use was accepted by workers and shown not to interfere with productivity. However, use of this intervention did not appear to reduce muscle fatigue when measured by tests of voluntary muscle strength. The purpose of the present study was to evaluate the intervention's effect on muscle fatigue employing surface electromyographic (EMG) amplitude. Amplitude measurements on 15 muscles were taken from 10 laboratory volunteers who were carrying a full bucket of apples, once while wearing the intervention belt and once without the intervention. These measurements were taken for seven different postures (four angles of trunk flexion (0 degrees , 20 degrees , 45 degrees , 90 degrees ) and three raised-arm positions (both up, dominant up, non-dominant up)) common to apple harvest work. Participants were measured in these conditions both with the bucket carried in front and with the bucket carried to the side. Significant reductions in amplitude favouring the intervention were seen for 11 of the 15 muscles in models considering the four body flexion angles. Ten of these were of the middle and lower back. These control/intervention differences were seen with both bucket-carrying positions (front vs. side) and tended to increase with increasing flexion angle. In contrast, no significant intervention effects were observed in models considering treatment by arm-raised position. One significant main effect (upper trapezius, side bucket) showed an amplitude reduction in the treatment condition. Another main effect showing increased amplitude in the intervention condition use was observed in the dominant levator scapulae (side bucket). Thus, the use of the intervention belt reduces EMG amplitude among a number of mid- and lower-back muscles. This is suggestive of a protective effect against back strain.

ULTRASONOGRAPHIC ASSESSMENT OF NECK MUSCULAR SIZE AND RANGE OF MOTION IN RUGBY PLAYERS.

PubMed

Hemelryck, Walter; Calistri, Josselin; Papadopoulou, Virginie; Theunissen, Sigrid; Dugardeyn, Christian; Balestra, Costantino

2018-02-01

World Rugby Union laws are constantly evolving towards stringent injury-prevention, particularly for contested scrums, since front row players are most at risk of cervical spine injuries. Recently, some countries have also introduced tailored training programs and minimum performance requirements for playing in the front row. Nevertheless, these approaches lack an objective assessment of each cervical muscle that would provide protective support. Since front row players are the most at risk for cervical spine injuries due to the specific type of contact during scrums, the purpose of this study was to ascertain whether significant differences exist in neck muscle size and range of motion between front row players and players of other positions, across playing categories. Cross-sectional controlled laboratory study. 129 sub-elite male subjects from various first-team squads of Belgian Rugby clubs were recruited. Subjects were grouped according to age: Junior (J) < 19 years old, Senior (S) 19 to 35 years old and Veteran (V) > 35 years old; as well as playing position: Front row players (J = 10, S = 12, V = 11 subjects), (Rest of the) pack (J = 12, S = 12, V = 10), backs (J = 10, S = 11, V = 11). An age-matched control group of non-rugby players was also recruited (J = 10, S = 10, V = 10).For each subject, the total neck circumference (NC) and the cervical range of motion (CROM) were measured. In addition, the thickness of the trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb), semispinalis cervicis (SPC), sternocleidomastoid muscles (SCOM), and the total thickness of all four structures (TT), were measured using ultrasonography. In each age category, compared to controls, rugby players were found to have decreased CROM, an increase in neck circumference (NC), and increased total thickness (TT), trapezius (T), semispinalis capitis (SCb) and sternocleidomastoid muscles (SCOM) sizes. For junior players, the thickness of the semispinalis cervicis (SPC) was also increased compared to controls. The CROM was decreased in front row players compared to pack and back players for all age categories; Front row seniors also showed an increase in trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb) and total thickness (TT), compared to back players. In regard of the differences in cervical values found between player positions, the implementation of both range of motion and echography muscle thickness assessments could serve to create an additional measurement for all front row players, that could complement current pre-participation screening used by rugby federations by objectively monitoring muscular size and motion amplitude around the cervical spine.

Posterior Bilateral Intermuscular Approach for Upper Cervical Spine Injuries.

PubMed

Xu, Yong; Xiong, Wei; Han, Sung I I; Fang, Zhong; Li, Feng

2017-08-01

To investigate a novel intermuscular surgical approach for posterior upper cervical spine fixation. Twenty-three healthy volunteers underwent magnetic resonance imaging. By using the magnetic resonance imaging scans in transverse view at the level of lower edge of atlas, the distances from the posterior midline to lateral margin of trapezius, to the medial margin of splenius capitis, and to middle line of semispinalis capitis were recorded. The angle between posterior middle line and the line crossing the lateral margin of trapezius and middle point of ipsilateral pedicles. From October 2009 to May 2013, 12 patients with upper cervical spine injuries were operated via the bilateral intermuscular approach. The time required for surgery, blood loss, and pre- and postoperative visual analogue scale scores were analyzed. The average distance of 0-T was 39.2 ± 7.5 mm, the angle between the approach and posterior middle line was 33.2 ± 8.4°. The surgical time was 78.3 ± 22.5 minutes (45-140 minutes), and the mean intraoperative blood loss was 87.5 ± 44.2 mL (30-200 mL). Preoperative and postoperative visual analogue scale scores were 6.4 ± 0.8 and 1.8 ± 0.7, respectively. The average follow-up time was 19.7 ± 11.5 months (9-48 months). The posterior bilateral intermuscular approach for upper cervical spine injuries is a valid alternative for Hangmans' fractures type I, type II, and type Ia according to Levine and Edwards classification as well as atlantoaxial subluxation caused by upper cervical spine trauma. Copyright © 2017 Elsevier Inc. All rights reserved.

Quantitative Ultrasound Using Texture Analysis of Myofascial Pain Syndrome in the Trapezius.

PubMed

Kumbhare, Dinesh A; Ahmed, Sara; Behr, Michael G; Noseworthy, Michael D

2018-01-01

Objective-The objective of this study is to assess the discriminative ability of textural analyses to assist in the differentiation of the myofascial trigger point (MTrP) region from normal regions of skeletal muscle. Also, to measure the ability to reliably differentiate between three clinically relevant groups: healthy asymptomatic, latent MTrPs, and active MTrP. Methods-18 and 19 patients were identified with having active and latent MTrPs in the trapezius muscle, respectively. We included 24 healthy volunteers. Images were obtained by research personnel, who were blinded with respect to the clinical status of the study participant. Histograms provided first-order parameters associated with image grayscale. Haralick, Galloway, and histogram-related features were used in texture analysis. Blob analysis was conducted on the regions of interest (ROIs). Principal component analysis (PCA) was performed followed by multivariate analysis of variance (MANOVA) to determine the statistical significance of the features. Results-92 texture features were analyzed for factorability using Bartlett's test of sphericity, which was significant. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.94. PCA demonstrated rotated eigenvalues of the first eight components (each comprised of multiple texture features) explained 94.92% of the cumulative variance in the ultrasound image characteristics. The 24 features identified by PCA were included in the MANOVA as dependent variables, and the presence of a latent or active MTrP or healthy muscle were independent variables. Conclusion-Texture analysis techniques can discriminate between the three clinically relevant groups.

Nerve transfers in tetraplegia I: Background and technique

PubMed Central

Brown, Justin M.

2011-01-01

Background: The recovery of hand function is consistently rated as the highest priority for persons with tetraplegia. Recovering even partial arm and hand function can have an enormous impact on independence and quality of life of an individual. Currently, tendon transfers are the accepted modality for improving hand function. In this procedure, the distal end of a functional muscle is cut and reattached at the insertion site of a nonfunctional muscle. The tendon transfer sacrifices the function at a lesser location to provide function at a more important location. Nerve transfers are conceptually similar to tendon transfers and involve cutting and connecting a healthy but less critical nerve to a more important but paralyzed nerve to restore its function. Methods: We present a case of a 28-year-old patient with a C5-level ASIA B (international classification level 1) injury who underwent nerve transfers to restore arm and hand function. Intact peripheral innervation was confirmed in the paralyzed muscle groups corresponding to finger flexors and extensors, wrist flexors and extensors, and triceps bilaterally. Volitional control and good strength were present in the biceps and brachialis muscles, the deltoid, and the trapezius. The patient underwent nerve transfers to restore finger flexion and extension, wrist flexion and extension, and elbow extension. Intraoperative motor-evoked potentials and direct nerve stimulation were used to identify donor and recipient nerve branches. Results: The patient tolerated the procedure well, with a preserved function in both elbow flexion and shoulder abduction. Conclusions: Nerve transfers are a technically feasible means of restoring the upper extremity function in tetraplegia in cases that may not be amenable to tendon transfers. PMID:21918736

Study of cervical muscle response and injury of driver during a frontal vehicle collision.

PubMed

Gao, Zhenhai; Li, Chuzhao; Hu, Hongyu; Zhao, Hui; Chen, Chaoyang; Yu, Huili

2015-01-01

Frontal vehicle collisions can cause injury to a driver's cervical muscles resulting from intense changes in muscle strain and muscle load. This study investigated the influence of collision forces in a sled test environment using a modified Hybrid III 50th percentile dummy equipped with simulated spring-type muscles. Cervical muscle responses including strain and load of the sternocleidomastoid (SCM), splenius capitis (SPL), and trapezius (TRP) were analyzed, and muscle injury was assessed. The SCM, SPL, and TRP suffered average peak muscle strains of 21%, 40%, and 23%, respectively, exceeding the injury threshold. The average peak muscle loads of the SCM, SPL and TRP were 11 N, 25 N, and 25 N, respectively, lower than the ultimate failure load. The SPL endured the largest injury, while the injuries to the SCM and TRP were relatively small. This is a preliminary study to assess the cervical muscle of driver during a frontal vehicle collision. This study provides a foundation for investigating the muscle response and injury in sled test environments, which can lead to the improvement of occupant protections.

Scapular muscle performance in individuals with lateral epicondylalgia.

PubMed

Day, Joseph M; Bush, Heather; Nitz, Arthur J; Uhl, Tim L

2015-05-01

Descriptive, laboratory-based, cross-sectional study. To describe scapular musculature strength, endurance, and change in thickness in individuals with unilateral lateral epicondylalgia (LE) compared to the uninvolved limb and the corresponding limb of a matched comparison group. Reported poor long-term outcomes for the nonsurgical management of individuals with LE suggest a less-than-optimal rehabilitation process. Knowledge of scapular muscle function in a working population of individuals with LE may help to further refine conservative management of this condition. Twenty-eight patients with symptomatic LE and 28 controls matched by age and sex were recruited to participate in the study. Strength of the middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) was measured with a handheld dynamometer. A scapular isometric muscle endurance task was performed in prone. Changes in muscle thickness of the SA and LT were measured with ultrasound imaging. Analysis-of-variance models were used to determine within- and between-group differences. The involved side of the group with LE had significantly lower values for MT strength (P = .031), SA strength (P<.001), LT strength (P = .006), endurance (P = .003), and change in SA thickness (P = .028) when compared to the corresponding limb of the control group. The involved side of the group with LE had significantly lower strength of the LT (P = .023) and SA (P = .016) when compared to the uninvolved limb; however, these differences were small and of potentially limited clinical significance. When compared to a matched comparison group, there were impairments of scapular musculature strength and endurance in patients with LE, suggesting that the scapular musculature should be assessed and potentially treated in this population. Cause and effect cannot be established, as the weakness of the scapular musculature could be a result of LE.

Long periods with uninterrupted muscle activity related to neck and shoulder pain.

PubMed

Hanvold, Therese N; Wærsted, Morten; Veiersted, Kaj Bo

2012-01-01

The aim was to analyze the relationship between periods with uninterrupted neck muscle activity for ≥ 4 min and neck and shoulder pain. The trapezius muscle activity was recorded bilaterally on 40 young workers and students during a full shift. Neck and shoulder pain, mechanical work load and decision control were reported at the same time as the muscle activity recording and 6 months later. A dose-response relationship was found between uninterrupted muscle activity and neck and shoulder pain, with a ten-fold higher risk for the group with more than half, compared to less than a third, of the shift with uninterrupted muscle activity. Self-reported mechanical work load showed a small but protective effect related to pain. Gender and decision control did not emerge as important risk factors in this model. In conclusion, this study indicates that work or other exposures that contains long periods with uninterrupted neck muscle activity of 4 min duration or longer should be minimized to reduce risk of neck and shoulder pain.

Outcome of lower trapezius transfer to reconstruct massive irreparable posterior-superior rotator cuff tear.

PubMed

Elhassan, Bassem T; Wagner, Eric R; Werthel, Jean-David

2016-08-01

Management of massive irreparable posterior-superior rotator cuff tear can be very challenging. This study reports the outcome of the lower trapezius transfer to reconstruct massive irreparable posterior-superior rotator cuff tear. Included were 33 patients with an average age of 53 years (range, 31-66 years). All patients had symptomatic massive irreparable rotator cuff tear that failed conservative or prior surgical treatment and underwent reconstruction with lower trapezius transfer prolonged by Achilles tendon allograft. The tear was considered irreparable based on the magnetic resonance imaging finding of ≥2 full-thickness rotator cuff tears associated with shortening and retraction of the tendon to the level of the glenoid and a high grade of fatty infiltration of the muscles. This was confirmed at the time of the surgery. At an average follow-up of 47 months, 32 patients had significant improvement in pain, subjective shoulder value, and Disabilities of the Arm, Shoulder and Hand score and shoulder range of motion, including flexion, 120°; abduction, 90°; and external rotation 50°. One patient, with a body mass index of 36 kg/m(2), required débridement for an infection and then later underwent shoulder fusion. Patients with >60° of preoperative flexion had more significant gains in their range of motion. Shoulder external rotation improved in all patients regardless of the extent of the preoperative loss of motion. Transfer of the lower trapezius prolonged with Achilles tendon allograft to reconstruct massive irreparable posterior-superior rotator cuff tear may lead to good outcome in most patients, specifically for those who have preoperative flexion of >60°. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Scapular Stabilization and Muscle Strength in Manual Wheelchair Users with Spinal Cord Injury and Subacromial Impingement.

PubMed

Wilbanks, Susan R; Bickel, C Scott

2016-01-01

Background: Manual wheelchair users with spinal cord injury (SCI) are frequently diagnosed with subacromial impingement. Objective: To determine whether the pattern of muscle imbalance and impaired scapular stabilization in able-bodied (AB) adults with impingement is different from that in manual wheelchair users with SCI and impingement. Methods: The following measurements were collected from 22 adults with subacromial impingement (11 SCI, 11 AB): ratio of normalized muscle electrical activity of upper and lower trapezius (UT:LT) during arm abduction; force during abduction, adduction, internal rotation, external rotation, and push and pull; ratios of force for abduction to adduction (AB:ADD), internal to external rotation (IR:ER), and push to pull (PUSH:PULL). Results: Shoulders with impingement had significantly higher UT:LT activation (1.46 ± 0.52) than shoulders without impingement (0.93 ± 0.45) ( P = .006), regardless of wheelchair user status. Significant differences between AB participants and those with SCI were observed for ABD:ADD ( P = .005), PUSH:PULL ( P = .012), and pull strength ( P = .043). Participants with SCI had a significantly greater ABD:ADD (1.37 ± 0.36) than AB participants (1.04 ± 0.22) ( P = .002) and a significantly greater PUSH:PULL (1.53 ± 0.36) than AB participants (1.26 ± 0.18) ( P = .005) because of decreased strength in adduction ( P = .021) and pull ( P = .013). Conclusions: Strategies targeting the posterior shoulder girdle for AB adults are appropriate for manual wheelchair users with SCI and impingement and should focus on scapular retractors and arm adductors with emphasis on scapular depression and posterior tilting.

Comparison of isometric exercises for activating latissimus dorsi against the upper body weight.

PubMed

Park, Se-yeon; Yoo, Won-gyu; An, Duk-hyun; Oh, Jae-seop; Lee, Jung-hoon; Choi, Bo-ram

2015-02-01

Because there is little agreement as to which exercise is the most effective for activating the latissimus dorsi, and its intramuscular components are rarely compared, we investigated the intramuscular components of the latissimus dorsi during both trunk and shoulder exercises. Sixteen male subjects performed four isometric exercises: inverted row, body lifting, trunk extension, and trunk lateral bending. Surface electromyography (sEMG) was used to collect data from the medial and lateral components of the latissimus dorsi, lower trapezius, and the erector spinae at the 12th thoracic level during the isometric exercises. Two-way repeated analysis of variance with two within-subject factors (muscles and exercise conditions) was used to determine the significance of differences between the muscles and differences between exercise variations. The inverted row showed the highest values for the medial latissimus dorsi, which were significantly higher than those of the body lifting or trunk extension exercises. For the lateral latissimus dorsi, lateral bending showed significantly higher muscle activity than the inverted row or trunk extension. During body lifting, the % maximum voluntary isometric contraction (MVIC) of the erector spinae showed the lowest value, significantly lower than those of the other isometric exercises. The inverted row exercise was effective for activating the medial latissimus dorsi versus the shoulder depression and trunk exertion exercises. The lateral bending and body lifting exercises were favorable for activating the lateral component of the latissimus dorsi. Evaluating trunk lateral bending is essential for examining the function of the latissimus dorsi. Copyright © 2014 Elsevier Ltd. All rights reserved.

The lower trapezius island myocutaneous flap in tunnelled technique to cover complicated tissue defects located between the craniocervical and cervicothoracic junction following spinal surgery.

PubMed

Raguse, Jan D; Czabanka, Marcus; Voss, Jan Oliver; Hartwig, Stefan; Vajkoczy, Peter; Voss, Pit; Doll, Christian

2016-08-01

Stable coverage of complicated defects located between the craniocervical and cervicothoracic junction following wound healing disturbance after spinal surgery can be challenging. Especially in cases where devices are exposed, well-vascularized coverage is required to achieve stable wound conditions. Therefore, the aim of the present study was to evaluate the clinical outcome of the lower trapezius island myocutaneous flap (LTIMF) as a possible treatment option. Four patients with a mean age of 68.8 years (ranging from 50 to 93 years) with wound healing disturbance following spinal surgery leading to defects of the dorsal neck/upper back refractory to conservative treatment and surgical debridement were included. All defects were reconstructed with a LTIMF based on the transverse cervical artery. Mean follow-up was 16.5 months (ranging from 5 to 30 months). No major flap failure occurred; minor complications in three patients including lateral superficial skin necrosis were easily handled. In all patients, excellent functional and aesthetic results were achieved. The lower trapezius island myocutaneous flap represents a reliable treatment option to cover complicated defects located between the craniocervical and cervicothoracic junction following wound disturbance after spinal surgery. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

ULTRASONOGRAPHIC ASSESSMENT OF NECK MUSCULAR SIZE AND RANGE OF MOTION IN RUGBY PLAYERS

PubMed Central

Calistri, Josselin; Papadopoulou, Virginie; Theunissen, Sigrid; Dugardeyn, Christian; Balestra, Costantino

2018-01-01

Background World Rugby Union laws are constantly evolving towards stringent injury-prevention, particularly for contested scrums, since front row players are most at risk of cervical spine injuries. Recently, some countries have also introduced tailored training programs and minimum performance requirements for playing in the front row. Nevertheless, these approaches lack an objective assessment of each cervical muscle that would provide protective support. Objective Since front row players are the most at risk for cervical spine injuries due to the specific type of contact during scrums, the purpose of this study was to ascertain whether significant differences exist in neck muscle size and range of motion between front row players and players of other positions, across playing categories. Study Design Cross-sectional controlled laboratory study Methods 129 sub-elite male subjects from various first-team squads of Belgian Rugby clubs were recruited. Subjects were grouped according to age: Junior (J) < 19 years old, Senior (S) 19 to 35 years old and Veteran (V) > 35 years old; as well as playing position: Front row players (J = 10, S = 12, V = 11 subjects), (Rest of the) pack (J = 12, S = 12, V = 10), backs (J = 10, S = 11, V = 11). An age-matched control group of non-rugby players was also recruited (J = 10, S = 10, V = 10). For each subject, the total neck circumference (NC) and the cervical range of motion (CROM) were measured. In addition, the thickness of the trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb), semispinalis cervicis (SPC), sternocleidomastoid muscles (SCOM), and the total thickness of all four structures (TT), were measured using ultrasonography. Results In each age category, compared to controls, rugby players were found to have decreased CROM, an increase in neck circumference (NC), and increased total thickness (TT), trapezius (T), semispinalis capitis (SCb) and sternocleidomastoid muscles (SCOM) sizes. For junior players, the thickness of the semispinalis cervicis (SPC) was also increased compared to controls. The CROM was decreased in front row players compared to pack and back players for all age categories; Front row seniors also showed an increase in trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb) and total thickness (TT), compared to back players. Conclusion In regard of the differences in cervical values found between player positions, the implementation of both range of motion and echography muscle thickness assessments could serve to create an additional measurement for all front row players, that could complement current pre-participation screening used by rugby federations by objectively monitoring muscular size and motion amplitude around the cervical spine. PMID:29484239

Metformin increases pressure pain threshold in lean women with polycystic ovary syndrome.

PubMed

Kiałka, Marta; Milewicz, Tomasz; Sztefko, Krystyna; Rogatko, Iwona; Majewska, Renata

2016-01-01

Despite the strong preclinical rationale, there are only very few data considering the utility of metformin as a potential pain therapeutic in humans. The aim of this study was to determine the association between metformin therapy and pressure pain threshold (PPT) in lean women with polycystic ovary syndrome (PCOS). We hypothesized that metformin therapy in lean PCOS women increases PPT. Twenty-seven lean PCOS women with free androgen index phenotype >5 and 18 lean healthy controls were enrolled in the study. Fifteen of the PCOS women were randomly assigned to be treated with metformin 1,500 mg daily for 6 months. PPT and plasma β-endorphin levels were measured in all women at the beginning of the study and after 6 months of observation. We observed an increase in PPT values measured on deltoid and trapezius muscle in the PCOS with metformin group after 6 months of metformin administration (4.81±0.88 kg/cm(2), P<0.001 on deltoid muscle, and 5.71±1.16 kg/cm(2) on trapezius muscle). We did not observe any significant changes in PPT values in the PCOS without treatment group and in controls. We did not observe any significant changes in serum β-endorphin levels in any studied groups during the 6-month observation. We conclude that metformin therapy increases PPT in lean PCOS women, without affecting plasma β-endorphin concentration. Our results may suggest the potential role of metformin in pain therapy. We propose that larger, randomized studies on metformin impact on pain perception should be performed.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arnold, P.G.; Pairolero, P.C.

In the patient with a radiation ulcer of the chest wall, the first question is whether the lesion contains persistent or recurrent cancer. It is also important to determine whether any other local problems such as mediastinal abscess may interfere with the reconstruction. Whether or not cancer is present, all nonviable tissue must be removed. If cancer is not present, and a partial thickness of the chest remains, the authors prefer transposition of the greater omentum for repair. If cancer is present, the physiologic defect resulting from cancer resection and wound debridement is far more severe, and a muscle ormore » musculocutaneous flap usually is appropriate. The pectoralis major, latissimus dorsi, external oblique, rectus abdominis, and trapezius muscles have been utilized; the authors most often use the pectoralis or latissimus muscles. 27 references.« less

Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

PubMed Central

2011-01-01

Introduction It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern. The current study investigated whether the overall spontaneous FM pain pattern can be reproduced by local and referred pain from active MTPs located in different muscles. Methods A spontaneous pain pattern in FM was recorded in 30 FM patients and 30 healthy subjects served as controls. Local and referred pain patterns induced from active (patients) and latent (controls) MTPs were recorded following manual stimulation. The existence of MTPs was confirmed by intramuscular electromyographical registration of spontaneous electrical activity. Results Local and referred pain areas induced from key active MTPs in FM were larger than pain areas from latent MTPs in healthy controls (P < 0.001), but were similar to the overall spontaneous FM pain area in FM (P > 0.05). The induced pain area was positively associated with current spontaneous pain intensity in FM (P < 0.01). The locations of key active MTPs in FM patients were found to have latent MTPs in healthy subjects. The muscles containing key active MTPs in FM are often observed in the muscles of extensor digitorum, trapezius, infraspinatus in the upper part of the body and of quadratus lumborum, gluteus medius in the lower part of the body. Conclusions The overall spontaneous FM pain pattern can be reproduced by mechanical stimulation of active MTPs located in different muscles, suggesting that fibromyalgia pain is largely composed of pain arising from muscle pain and spasm. Targeting active MTPs and related perpetuating factors may be an important strategy in FM pain control. Trial registration ISRCTN ISRCTN43167547. PMID:21426569

Working spectacles for sorting mail.

PubMed

Hemphälä, Hillevi; Dahlqvist, Camilla; Nordander, Catarina; Gao, Chuansi; Kuklane, Kalev; Nylén, Per; Hansson, Gert-Åke

2014-01-01

Sorting mail into racks for postmen is visually demanding work. This can result in backward inclination of their heads, especially more pronounced for those who use progressive addition lenses. To evaluate the effects of customized working spectacles on the physical workload of postmen. Twelve male postmen sorted mail on two occasions: once using their private progressive spectacles and once using customized sorting spectacles with inverted progressive lenses. Postures and movements of the head, upper back, neck, and upper arms were measured by inclinometry. The muscular load of the trapezius was measured by surface electromyography. With the customized sorting spectacles, both the backward inclination of the head and backward flexion of the neck were reduced (3°), as well as the muscular load of the right upper trapezius, compared to sorting with private spectacles. However, with the sorting spectacles, there was a tendency for increased neck forward flexion, and increased sorting time. The reduction in work load may reduce the risk for developing work-related musculoskeletal disorders due to the positive reduction of the backward inclination of the head. But the tendency for increased neck forward flexion may reduce the positive effects. However, the magnitude of the possible reduction is difficult to predict, especially since quantitative data on exposure-response relationships are unknown. Alternative working spectacles with inverted near progressive lenses ought to be evaluated. They should still result in a positive reduced backward inclination of the head and may not cause any increased forward flexion.

Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve.

PubMed

Yang, Ming-liang; Li, Jian-jun; Zhang, Shao-cheng; Du, Liang-jie; Gao, Feng; Li, Jun; Wang, Yu-ming; Gong, Hui-ming; Cheng, Liang

2011-08-01

The authors report a case of functional improvement of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization using a functional spinal accessory nerve. Complete spinal cord injury at the C-2 level was diagnosed in a 44-year-old man. Left diaphragm activity was decreased, and the right diaphragm was completely paralyzed. When the level of metabolism or activity (for example, fever, sitting, or speech) slightly increased, dyspnea occurred. The patient underwent neurotization of the right phrenic nerve with the trapezius branch of the right spinal accessory nerve at 11 months postinjury. Four weeks after surgery, training of the synchronous activities of the trapezius muscle and inspiration was conducted. Six months after surgery, motion was observed in the previously paralyzed right diaphragm. The lung function evaluation indicated improvements in vital capacity and tidal volume. This patient was able to sit in a wheelchair and conduct outdoor activities without assisted ventilation 12 months after surgery.

Ipsilateral EEG mu rhythm reflects the excitability of uncrossed pathways projecting to shoulder muscles.

PubMed

Hasegawa, Keita; Kasuga, Shoko; Takasaki, Kenichi; Mizuno, Katsuhiro; Liu, Meigen; Ushiba, Junichi

2017-08-25

Motor planning, imagery or execution is associated with event-related desynchronization (ERD) of mu rhythm oscillations (8-13 Hz) recordable over sensorimotor areas using electroencephalography (EEG). It was shown that motor imagery involving distal muscles, e.g. finger movements, results in contralateral ERD correlating with increased excitability of the contralateral corticospinal tract (c-CST). Following the rationale that purposefully increasing c-CST excitability might facilitate motor recovery after stroke, ERD recently became an attractive target for brain-computer interface (BCI)-based neurorehabilitation training. It was unclear, however, whether ERD would also reflect excitability of the ipsilateral corticospinal tract (i-CST) that mainly innervates proximal muscles involved in e.g. shoulder movements. Such knowledge would be important to optimize and extend ERD-based BCI neurorehabilitation protocols, e.g. to restore shoulder movements after stroke. Here we used single-pulse transcranial magnetic stimulation (TMS) targeting the ipsilateral primary motor cortex to elicit motor evoked potentials (MEPs) of the trapezius muscle. To assess whether ERD reflects excitability of the i-CST, a correlation analysis between between MEP amplitudes and ipsilateral ERD was performed. Experiment 1 consisted of a motor execution task during which 10 healthy volunteers performed elevations of the shoulder girdle or finger pinching while a 128-channel EEG was recorded. Experiment 2 consisted of a motor imagery task during which 16 healthy volunteers imagined shoulder girdle elevations or finger pinching while an EEG was recorded; the participants simultaneously received randomly timed, single-pulse TMS to the ipsilateral primary motor cortex. The spatial pattern and amplitude of ERD and the amplitude of the agonist muscle's TMS-induced MEPs were analyzed. ERDs occurred bilaterally during both execution and imagery of shoulder girdle elevations, but were lateralized to the contralateral hemisphere during finger pinching. We found that trapezius MEPs increased during motor imagery of shoulder elevations and correlated with ipsilateral ERD amplitudes. Ipsilateral ERD during execution and imagery of shoulder girdle elevations appears to reflect the excitability of uncrossed pathways projecting to the shoulder muscles. As such, ipsilateral ERD could be used for neurofeedback training of shoulder movement, aiming at reanimation of the i-CST.

Are chronic neck pain, scapular dyskinesis and altered scapulothoracic muscle activity interrelated?: A case-control study with surface and fine-wire EMG.

PubMed

Castelein, Birgit; Cools, Ann; Parlevliet, Thierry; Cagnie, Barbara

2016-12-01

The function of the scapula is important in normal neck function and might be disturbed in patients with neck pain. The surrounding muscular system is important for the function of the scapula. To date, it is not clear if patients with idiopathic neck pain show altered activity of these scapulothoracic muscles. Therefore, the objective of this study was to investigate differences in deeper and superficial lying scapulothoracic muscle activity between patients with idiopathic neck pain and healthy controls during arm elevation, and to identify the influence of scapular dyskinesis on muscle activity. Scapular dyskinesis was rated with the yes/no method. The deeper lying (Levator Scapulae, Pectoralis Minor (Pm) and Rhomboid major) and superficial lying (Trapezius and Serratus Anterior) scapulothoracic muscles' activity was investigated with fine-wire and surface EMG, respectively, in 19 female subjects with idiopathic neck pain (age 28.3±10.1years, average duration of neck pain 45.6±36.3months) and 19 female healthy control subjects (age 29.3±11.7years) while performing scaption and towel wall slide. Possible interactions or differences between subject groups, scapular dyskinesis groups or phases of the task were studied with a linear mixed model. Higher Pm activity during the towel wallslide (p=0.024, mean difference 8.8±3.3% MVIC) was shown in patients with idiopathic neck pain in comparison with healthy controls. For the MT, a significant group∗dyskinesis interaction effect was found during scaption which revealed that patients with neck pain and scapular dyskinesis showed lower Middle Trapezius (MT) activity in comparison with healthy controls with scapular dyskinesis (p=0.029, mean difference 5.1±2.2% MVIC). In the presence of idiopathic neck pain, higher Pm activity during the towel wallslide was found. Patients with neck pain and scapular dyskinesis showed lower MT activity in comparison with healthy controls with scapular dyskinesis during scaption. Scapular dyskinesis did not have a significant influence on scapulothoracic muscle activity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Changes in muscle activity determine progression of clinical symptoms in patients with chronic spine-related muscle pain. A complex clinical and neurophysiological approach

PubMed Central

Wytra̦żek, Marcin; Huber, Juliusz; Lisiński, Przemysław

Summary Spine-related muscle pain can affect muscle strength and motor unit activity. This study was undertaken to investigate whether surface electromyographic (sEMG) recordings performed during relaxation and maximal contraction reveal differences in the activity of muscles with or without trigger points (TRPs). We also analyzed the possible coexistence of characteristic spontaneous activity in needle electromyographic (eEMG) recordings with the presence of TRPs. Thirty patients with non-specific cervical and back pain were evaluated using clinical, neuroimaging and electroneurographic examinations. Muscle pain was measured using a visual analog scale (VAS), and strength using Lovett’s scale; trigger points were detected by palpation. EMG was used to examine motor unit activity. Trigger points were found mainly in the trapezius muscles in thirteen patients. Their presence was accompanied by increased pain intensity, decreased muscle strength, increased resting sEMG amplitude, and decreased sEMG amplitude during muscle contraction. eEMG revealed characteristic asynchronous discharges in TRPs. The results of EMG examinations point to a complexity of muscle pain that depends on progression of the myofascial syndrome PMID:22152435

Preliminary observations on high energy phosphates and metabolic pathway and transporter potentials in extensor carpi radialis brevis and trapezius muscles of women with work-related myalgia.

PubMed

Green, Howard J; Ranney, Don; Burnett, Margaret; Galvin, Patti; Kyle, Natasha; Lounsbury, David; Ouyang, Jing; Smith, Ian C; Stewart, Riley; Tick, Heather; Tupling, A Russell

2014-11-01

This study compared both the extensor carpi radialis brevis (ECRB) and the trapezius (TRAP) muscles of women with work-related myalgia (WRM) with healthy controls (CON) to determine whether abnormalities existed in cellular energy status and the potentials of the various metabolic pathways and segments involved in energy production and substrate transport. For both the ECRB (CON, n = 6-9; WRM, n = 13) and the TRAP (CON, n = 6-7; WRM, n = 10), no differences (P > 0.05) were found for the concentrations (in millimoles per kilogram of dry mass) of ATP, PCr, lactate, and glycogen. Similarly, with one exception, the maximal activities (in moles per milligram of protein per hour) of mitochondrial enzymes representative of the citric acid cycle (CAC), the electron transport chain (ETC), and β-oxidation, as well as the cytosolic enzymes involved in high energy phosphate transfer, glycogenolysis, glycolysis, lactate oxidation, and glucose phosphorylation were not different (P > 0.05). The glucose transporters GLUT1 and GLUT4, and the monocarboxylate transporters MCT1 and MCT4, were also normal in WRM. It is concluded that, in general, abnormalities in the resting energy and substrate state, the potential of the different metabolic pathways and segments, as well as the glucose and monocarboxylate transporters do not appear to be involved in the cellular pathophysiology of WRM.

Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system.

PubMed

Rochcongar, Goulven; Emily, Sébastien; Lebel, Benoit; Pineau, Vincent; Burdin, Gilles; Hulet, Christophe

2012-09-01

Surgical versus orthopedic treatments of acromioclavicular disjunction are still debated. The aim of this study was to measure horizontal and vertical acromion's displacement after cutting the ligament using standard X-ray and an opto-electronic system on cadaver. Ten cadaveric shoulders were studied. A sequential ligament's section was operated by arthroscopy. The sequence of cutting was chosen to fit with Rockwood's grade. The displacement of the acromion was measured on standard X-ray and with an opto-electronic system allowing measuring of the horizontal displacement. Statistical comparisons were performed using a paired Student's t test with significance set at p < 0.05. Cutting the coracoclavicular ligament and delto-trapezius muscles cause a statistical downer displacement of the acromion, but not after sectioning the acromioclavicular ligament. The contact surface between the acromion and the clavicle decreases statistically after sectioning the acromioclavicular ligament and the coracoclavicular ligament with no effect of sectioning the delto-trapezius muscles. Those results are superposing with those dealing with the anterior translation. The measure concerning the acromioclavicular distance and the coracoclavicular distance are superposing with those of Rockwood. However, there is a significant horizontal translation after cutting the acromioclavicular ligament. Taking into account this displacement, it may be interesting to choose either surgical or orthopedic treatment. There is a correlation between anatomical damage and importance of instability. Horizontal instability is misevaluated in clinical practice.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments.

PubMed

Pasternak, Braulio; Sousa Neto, Manoel Damião de; Dionísio, Valdeci Carlos; Pécora, Jesus Djalma; Silva, Ricardo Gariba

2012-02-01

This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

PubMed Central

PASTERNAK-JÚNIOR, Braulio; de SOUSA NETO, Manoel Damião; DIONÍSIO, Valdeci Carlos; PÉCORA, Jesus Djalma; SILVA, Ricardo Gariba

2012-01-01

Objective This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques. PMID:22437679

Relationship between scapular muscle and core endurance in healthy subjects.

PubMed

Hazar Kanik, Zeynep; Pala, Omer Osman; Gunaydin, Gurkan; Sozlu, Ugur; Alkan, Zeynep Beyza; Basar, Selda; Citaker, Seyit

2017-01-01

Scapular muscle endurance and core endurance reportedly influence shoulder injury risk. The exact relationship between scapular muscle endurance and core endurance, and how they impact one another in the healthy subjects remain unclear. To investigate the relationship between scapular muscle endurance and core endurance in healthy subjects. Fifty healthy volunteers (23 males, 27 females; mean age 20.42 ± 1.04 years) were participated in this study. Endurance of the serratus anterior and trapezius muscles was assessed using the scapular muscle endurance test. Sorensen test (endurance of trunk extensor muscles), trunk flexor endurance test, and side bridge test (endurance of lateral core muscles) were conducted to assess the core endurance. Pearson's product moment correlations examined relationships between scapular muscle endurance and each of the core endurance tests scores. Scapular muscle endurance test scores showed a positive correlation with the side bridge test scores (r = 0.414; p = 0.003). No significant correlation was found between scapular muscle endurance test scores and the other core endurance tests scores (p > 0.05). There appears to be a link between the scapular muscle endurance and lateral core muscles in healthy subjects; however, more research is needed to provide a definitive answer on the nature of this relationship. Further studies involving patients with shoulder pathology are warranted.

Ergonomic comparison of operating a built-in touch-pad pointing device and a trackball mouse on posture and muscle activity.

PubMed

Lee, Tzu-Hsien

2005-12-01

This study examined the effects of operating a built-in touch-pad pointing device and a trackball mouse on participants' completion times, hand positions during operation, postural angles, and muscle activities. 8 young men were asked to perform a cursor travel task on a notebook computer using both 60- and 80-cm high table conditions. Analysis showed that the trackball mouse significantly decreased completion times. Participants selected a hand position farther from the table edge and larger elbow angle for the trackball mouse than for the built-in touch-pad pointing device. Participants' neck, thoracic, and arm angles, or splenius capitis, trapezius, deltoid, and erector spinae muscle activities were not significantly affected by the devices, but table height significantly affected participants' completion times, hand positions, and postural angles.

Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: A randomized, placebo-controlled clinical trial

PubMed Central

Moraska, Albert F.; Stenerson, Lea; Butryn, Nathan; Krutsch, Jason P.; Schmiege, Sarah J.; Mann, J. Douglas

2014-01-01

Objective Myofascial trigger points (MTrPs) are focal disruptions in skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type headache (TTH). The present study applied massage focused on MTrPs of subjects with TTH in a placebo-controlled, clinical trial to assess efficacy on reducing headache pain. Methods Fifty-six subjects with TTH were randomized to receive 12 massage or placebo (detuned ultrasound) sessions over six weeks, or to wait-list. Trigger point release (TPR) massage focused on MTrPs in cervical musculature. Headache pain (frequency, intensity and duration) was recorded in a daily headache diary. Additional outcome measures included self-report of perceived clinical change in headache pain and pressure-pain threshold (PPT) at MTrPs in the upper trapezius and sub-occipital muscles. Results From diary recordings, group differences across time were detected in headache frequency (p=0.026), but not for intensity or duration. Post hoc analysis indicated headache frequency decreased from baseline for both massage (p<0.0003) and placebo (p=0.013), but no difference was detected between massage and placebo. Subject report of perceived clinical change was a greater reduction in headache pain for massage than placebo or wait-list groups (p=0.002). PPT improved in all muscles tested for massage only (all p's<0.002). Discussion Two findings from this study are apparent: 1) MTrPs are important components in the treatment of TTH, and 2) TTH, like other chronic conditions, is responsive to placebo. Clinical trials on headache that do not include a placebo group are at risk for overestimating the specific contribution from the active intervention. PMID:25329141

Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial.

PubMed

Moraska, Albert F; Stenerson, Lea; Butryn, Nathan; Krutsch, Jason P; Schmiege, Sarah J; Mann, John D

2015-02-01

Myofascial trigger points (MTrPs) are focal disruptions in the skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type HA (TTH). The present study applied massage focused on MTrPs of patients with TTH in a placebo-controlled, clinical trial to assess efficacy on reducing headache (HA) pain. Fifty-six patients with TTH were randomized to receive 12 massage or placebo (detuned ultrasound) sessions over 6 weeks, or to wait-list. Trigger point release massage focused on MTrPs in cervical musculature. HA pain (frequency, intensity, and duration) was recorded in a daily HA diary. Additional outcome measures included self-report of perceived clinical change in HA pain and pressure-pain threshold at MTrPs in the upper trapezius and suboccipital muscles. From diary recordings, group differences across time were detected in HA frequency (P=0.026), but not for intensity or duration. Post hoc analysis indicated that HA frequency decreased from baseline for both massage (P<0.0003) and placebo (P=0.013), but no difference was detected between massage and placebo. Patient report of perceived clinical change was greater reduction in HA pain for massage than placebo or wait-list groups (P=0.002). Pressure-pain threshold improved in all muscles tested for massage only (all P's<0.002). Two findings from this study are apparent: (1) MTrPs are important components in the treatment of TTH, and (2) TTH, like other chronic conditions, is responsive to placebo. Clinical trials on HA that do not include a placebo group are at risk for overestimating the specific contribution from the active intervention.

Biomechanical and ergonomic assessment of urban transit operators.

PubMed

Albert, Wayne J; Everson, Donald; Rae, Michelle; Callaghan, Jack P; Croll, Jim; Kuruganti, Usha

2014-01-01

The prevalence of neck and low back musculoskeletal injuries in transit operators has been shown to be high; with work absences exceeding double the National average. There is a lack of biomechanical data generated from field researches to inform on musculoskeletal risk associated with transportation and driving occupations. Instead there has been a reliance on simulated driving and questionnaire-based research. This study was designed to examine the musculoskeletal and biomechanical stresses experienced by urban bus drivers. The main objective was to obtain a baseline understanding of sitting posture, muscle activiation and subjective ratings of stress during regular driving tasks. Fifteen urban city bus drivers were recruited for this study. Bus drivers drove the same 65-minute bus route once, at the same time of day, in the same preselected bus. Wireless surface electromyography monitored muscular activity of the drivers' neck, upper trapezius, and erector spinae and video analysis and seat pressure mapping was used to monitor changes in driving posture. A health and lifestyle questionnaire was administered to record specific neck and back pain experienced by drivers as well as to provide lifestyle habits. Drivers were found to exhibit non-neutral postures for less than 30% of the time while conducting routine tasks of turning and stopping for passenger loading and unloading. The neck posture was the greatest concern in terms of non-neutral posture and this was supported by the higher muscle activation to the neck musculature. There was significant posture adjustment made during the one-hour driving period with the adjustments increasing with driving time. Activities associated with bus driving appear to require the use of non-neutral postures an increase in muscle activation. Significant postural adjustments were needed over the one-hour observation period suggesting that the musculoskeletal demands may increase over a regular 12-hour shift.

The immediate effect of muscle release intervention on muscle activity and shoulder kinematics in patients with frozen shoulder: a cross-sectional, exploratory study.

PubMed

Shih, Yi-Fen; Liao, Pei-Wen; Lee, Chun-Shou

2017-11-28

Contractile tissue plays an important role in mobility deficits in frozen shoulder (FS). However, no study has assessed the effect of the muscle release technique on the muscle activation and kinematics in individuals with FS. The purposes of this study were to assess the differences in shoulder muscle activity and kinematics between the FS and asymptomatic groups; and to determine the immediate effects of muscle release intervention in the FS group. Twenty patients with FS and 20 asymptomatic controls were recruited. The outcome measures included muscle activity of the upper and lower trapezius (UT and LT), infraspinatus (ISp), pectoralis major (PM), and teres major (TM), shoulder kinematics (humeral elevation, scapular posterior tilt (PT) and upward rotation (UR), shoulder mobility, and pain. Participants in the FS group received one-session of heat and manual muscle release. Measurements were obtained at baseline, and immediately after intervention. Multivariate analysis of variance was used for data analysis. The level of significance was set at α=0.05. Compared to the controls, the FS group revealed significantly decreased LT (difference =55.89%, P=0.001) and ISp muscle activity (difference =26.32%, P =0.043) during the scaption task, and increased PM activity (difference =6.31%, P =0.014) during the thumb to waist task. The FS group showed decreased humeral elevation, scapular PT, and UR (difference = 35.36°, 10.18°, 6.73° respectively, P <0.05). Muscle release intervention immediately decreased pain (VAS drop 1.7, P <0.001); improved muscle activity during scaption (UT: 12.68% increase, LT: 35.46% increase, P <0.05) and hand to neck (UT: 12.14% increase, LT: 34.04% increase, P <0.05) task; and increased peak humeral elevation and scapular PT during scaption (95.18°±15.83° to 98.24°±15.57°, P=0.034; 11.06°±3.94° to 14.36°±4.65°, P=0.002), and increased scapular PT during the hand to neck (9.47°±3.86° to 12.80°±8.33°, P=0.025) task. No statistical significance was found for other group comparisons or intervention effect. Patients with FS presented with altered shoulder muscle activity and kinematics, and one-session of heat and manual muscle release showed beneficial effects on shoulder muscle performance, kinematics, mobility, and pain. Retrospectively registered on Jan 18, 2016 (ACTRN 12616000031460 ).

Pressure pain threshold and β-endorphins plasma level are higher in lean polycystic ovary syndrome women.

PubMed

Kiałka, Marta; Milewicz, Tomasz; Mrozińska, Sandra; Rogatko, Iwona; Sztefko, Krystyna; Majewska, Renata

2017-12-01

Despite some evidence that indicates that the evolution of polycystic ovary syndrome (PCOS) is related to the activity of the endogenous opioid system, and that concentration of plasma β-endorphin levels can increase pain threshold, there are no studies which evaluate pressure pain threshold in the PCOS women population. In 48 lean women with PCOS and 38 lean women without this disorder plasma β-endorphins and PPT were measured. The β-endorphins level was higher in the PCOS group compared to the controls (15.28±2.49 pg/mL vs. 6.33±1.71 pg/mL, P<0.001). In PCOS group PPTs measured on deltoid and trapezius muscles were higher compared to the controls (9.33±1.3 kg/cm² vs. 5.19±0.57 kg/cm², P<0.001; 8.23±1.04 kg/cm² vs. 4.79±0.55 kg/cm², P<0.001). The β-endorphin levels positively correlated with PPTs in PCOS group. Increase in β-endorphin level of 1 pg/mL was associated with increase of PPT value on deltoid muscle of 0.23 kg/cm² (R=0.632, P=0.011) and of 0.18 kg/cm² on trapezius muscle (R=0.588, P=0.037). There were no correlations between testosterone level and PPT in PCOS group. β-endorphin serum level as well as PPT are higher in lean PCOS group than in controls. We found correlations between β-endorphin levels and PPT in the PCOS group. It may suggest the role of endogenous opioids in the pathogenesis of PCOS and also that the increases in circulating plasma β-endorphins concentration can increases PPT in this group.

Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders.

PubMed

Peolsson, Anneli; Peterson, Gunnel; Trygg, Johan; Nilsson, David

2016-08-03

Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD.

Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders

PubMed Central

Peolsson, Anneli; Peterson, Gunnel; Trygg, Johan; Nilsson, David

2016-01-01

Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD. PMID:27484361

Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders

NASA Astrophysics Data System (ADS)

Peolsson, Anneli; Peterson, Gunnel; Trygg, Johan; Nilsson, David

2016-08-01

Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD.

Psychophysiological patterns during cell phone text messaging: a preliminary study.

PubMed

Lin, I-Mei; Peper, Erik

2009-03-01

This study investigated the psychophysiological patterns associated with cell phone text messaging (texting). Twelve college students who were very familiar with texting were monitored with surface electromyography (SEMG) from the shoulder (upper trapezius) and thumb (abductor pollicis brevis/opponens pollicis); blood volume pulse (BVP) from the middle finger, temperature from the index finger, and skin conductance (SC) from the palm of the non-texting hand; and respiration from the thorax and abdomen. The counter-balanced procedure consisted of a 2 min pre-baseline, 1 min receiving text messages, 2 min middle baseline, 1 min sending text messages and 2 min post-baseline. The results indicated that all subjects showed significant increases in respiration rate, heart rate, SC, and shoulder and thumb SEMG as compared to baseline measures. Eighty-three percentage of the participants reported hand and neck pain during texting, and held their breath and experienced arousal when receiving text messages. Subjectively, most subjects were unaware of their physiological changes. The study suggests that frequent triggering of these physiological patterns (freezing for stability and shallow breathing) may increase muscle discomfort symptoms. Thus, participants should be trained to inhibit these responses to prevent illness and discomfort.

Sports injuries in an America's Cup yachting crew: A 4-year epidemiological study covering the 2007 challenge.

PubMed

Hadała, Michał; Barrios, Carlos

2009-05-01

The aim of this study was to describe the injuries sustained by an America's Cup crew during eight preparatory competitions of the 32nd America's Cup 2007 and the Louis Vuitton Cup (from October 2004 to June 2007). The anatomical location, type of injury, and mechanism of injury were recorded. The injuries were categorized based on each sailor's position on the boat according to three intensities of physical demands. The injury rates per sailor and per 1000 h of competition were determined. In total, 90 injuries were registered. The overall incidence was 10 injuries per 1000 competition hours. Overuse injuries accounted for 76.6% of all lesions. The most common anatomical location of injuries was the upper limb (36.6%), followed by the upper dorsal and cervical spine (34.4%). Frequency of injury was related to the sailor's position on the boat, being higher in the group with more demanding activities (grinder, bowman, and mastman). Most injuries (67%) were sustained by this group of sailors. The most common injuries in this group were muscle contractures of the quadratus lumborum (11), trapezius (8), and rhomboid (7). There were eight cases of elbow epicondylitis, four cases of tendinopathy of the supraspinous tendon, and three cases of tendinopathy of the biceps brachii. An America's Cup yachting crew is exposed to a high risk of overuse injuries, especially those sailors whose boat position involves high-intensity activity.

Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

PubMed

Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

2011-02-01

Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

Additional Effect of Static Ultrasound and Diadynamic Currents on Myofascial Trigger Points in a Manual Therapy Program for Patients With Chronic Neck Pain: A Randomized Clinical Trial.

PubMed

Dibai-Filho, Almir Vieira; de Oliveira, Alessandra Kelly; Girasol, Carlos Eduardo; Dias, Fabiana Rodrigues Cancio; Guirro, Rinaldo Roberto de Jesus

2017-04-01

To assess the additional effect of static ultrasound and diadynamic currents on myofascial trigger points in a manual therapy program to treat individuals with chronic neck pain. A single-blind randomized trial was conducted. Both men and women, between ages 18 and 45, with chronic neck pain and active myofascial trigger points in the upper trapezius were included in the study. Subjects were assigned to 3 different groups: group 1 (n = 20) was treated with manual therapy; group 2 (n = 20) was treated with manual therapy and static ultrasound; group 3 (n = 20) was treated with manual therapy and diadynamic currents. Individuals were assessed before the first treatment session, 48 hours after the first treatment session, 48 hours after the tenth treatment session, and 4 weeks after the last session. There was no group-versus-time interaction for Numeric Rating Scale, Neck Disability Index, Pain-Related Self-Statement Scale, pressure pain threshold, cervical range of motion, and skin temperature (F-value range, 0.089-1.961; P-value range, 0.106-0.977). Moreover, we found no differences between groups regarding electromyographic activity (P > 0.05). The use of static ultrasound or diadynamic currents on myofascial trigger points in upper trapezius associated with a manual therapy program did not generate greater benefits than manual therapy alone.

Septic abortion presenting as a right lower trapezius abscess secondary to Bacteroides fragilis bacteraemia.

PubMed

Yamanaka, Yusuke; Shimabukuro, Akira

2017-08-21

A 43-year-old Japanese woman was evaluated in the outpatient department for right shoulder pain and fever, which began 5 days earlier. MRI of the right shoulder revealed a high-intensity area deep in the right trapezius muscle. Aspiration revealed purulent fluid, and Gram staining of the fluid showed Gram-negative bacilli. The patient was also found to be profoundly anaemic and to have a positive urine pregnancy test. On admission, we initiated intravenous ampicillin-sulbactam and aztreonam. She underwent dilatation and curettage for septic abortion and surgical drainage of the right shoulder abscess. Bacteroides fragilis was isolated from the blood, uterine aspiration and abscess samples. On hospital day 4, a whole-body CT scan revealed no other abscesses, and ampicillin-sulbactam was continued for 28 days. The patient was discharged on hospital day 29. Gram staining is an important tool for evaluating infectious aetiologies. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

PubMed Central

2011-01-01

Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72) for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ) was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active MTrPs) and 4 (latent MTrPs). Active MTrPs were most prevalent in the infraspinatus (77%) and the upper trapezius muscles (58%), whereas latent MTrPs were most prevalent in the teres major (49%) and anterior deltoid muscles (38%). The number of muscles with active MTrPs was only moderately correlated with the DASH score. Conclusion The prevalence of muscles containing active and latent MTrPs in a sample of patients with chronic non-traumatic shoulder pain was high. PMID:21711512

Optical characteristics of modified fiber tips in single fiber, laser Doppler flowmetry

NASA Astrophysics Data System (ADS)

Oberg, P. Ake; Cai, Hongming; Rohman, Hakan; Larsson, Sven-Erik

1994-02-01

Percutaneous laser Doppler flowmetry (LDF) and bipolar surface electromyography (EMG) were used simultaneously for measurement of skeletal muscle (trapezius) perfusion in relation to static load and fatigue. On-line computer (386 SX) processing of the LDF- and EMG- signals made possible interpretation of the relationship between the perfusion and the activity of the muscle. The single fiber laser Doppler technique was used in order to minimize the trauma. A ray-tracing program was developed in the C language by which the optical properties of the fiber and fiber ends could be simulated. Isoirradiance graphs were calculated for three fiber end types and the radiance characteristics were measured for each fiber end. The three types of fiber-tips were evaluated and compared in flow model measurements.

Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.

PubMed

von Piekartz, Harry; Pudelko, Ani; Danzeisen, Mira; Hall, Toby; Ballenberger, Nikolaus

2016-12-01

There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. Cross-sectional survey. Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain].

PubMed

Antúnez Sánchez, Leonardo Gregorio; de la Casa Almeida, María; Rebollo Roldán, Jesús; Ramírez Manzano, Antonio; Martín Valero, Rocío; Suárez Serrano, Carmen

To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Randomised clinical trial. Health Area of University Hospital Virgen del Rocío, Seville, Spain. A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Skin Resistivity Value of Upper Trapezius Latent Trigger Points

PubMed Central

Skorupska, Elżbieta; Zawadziński, Jarosław

2015-01-01

Introduction. The skin resistivity (SkR) measurement is commonly recommended for acupoints measurement, but for trigger points (TrPs) only one study is available. The purpose of the study was to evaluate SkR for latent TrPs compared to non-TrPs and the surrounding tissue. Material and Methods. Forty-two healthy volunteers with unilateral latent upper trapezius TrPs (12 men, 30 women) aged 21–23 (mean age: 22.1 ± 0.6 y) participated in the study. Keithley electrometer 610B was used for measuring SkR (Ag/AgCl self-adhesive, disposable ground electrode: 30 mm diameter). SkR was measured for latent TrPs and compared to opposite non-TrPs sites and the surrounding tissue. Results. The SkR decrease of TrPs-positive sites as compared to TrPs-negative sites and the surrounding tissue was confirmed. However, no statistically significant difference in the SkR value occurred when all data were analyzed. The same was confirmed after gender division and for TrPs-positive subjects examined for referred pain and twitch response presence. Conclusion. SkR reactive changes at latent TrPs are possible but the results were not consistent with the previous study. Thus, caution in applying SkR to latent TrPs isolation is recommended and its clinical use should not be encouraged yet. Further studies, especially on active TrPs, are yet required. PMID:26180796

Real-time implementation of electromyogram pattern recognition as a control command of man-machine interface.

PubMed

Chang, G C; Kang, W J; Luh, J J; Cheng, C K; Lai, J S; Chen, J J; Kuo, T S

1996-10-01

The purpose of this study was to develop a real-time electromyogram (EMG) discrimination system to provide control commands for man-machine interface applications. A host computer with a plug-in data acquisition and processing board containing a TMS320 C31 floating-point digital signal processor was used to attain real-time EMG classification. Two-channel EMG signals were collected by two pairs of surface electrodes located bilaterally between the sternocleidomastoid and the upper trapezius. Five motions of the neck and shoulders were discriminated for each subject. The zero-crossing rate was employed to detect the onset of muscle contraction. The cepstral coefficients, derived from autoregressive coefficients and estimated by a recursive least square algorithm, were used as the recognition features. These features were then discriminated using a modified maximum likelihood distance classifier. The total response time of this EMG discrimination system was achieved about within 0.17 s. Four able bodied and two C5/6 quadriplegic subjects took part in the experiment, and achieved 95% mean recognition rate in discrimination between the five specific motions. The response time and the reliability of recognition indicate that this system has the potential to discriminate body motions for man-machine interface applications.

Spinal Accessory Motor Neurons in the Mouse: A Special Type of Branchial Motor Neuron?

PubMed

Watson, Charles; Tvrdik, Petr

2018-04-16

The spinal accessory nerve arises from motor neurons in the upper cervical spinal cord. The axons of these motor neurons exit dorsal to the ligamentum denticulatum and form the spinal accessory nerve. The nerve ascends in the spinal subarachnoid space to enter the posterior cranial fossa through the foramen magnum. The spinal accessory nerve then turns caudally to exit through the jugular foramen alongside the vagus and glossopharyngeal nerves, and then travels to supply the sternomastoid and trapezius muscles in the neck. The unusual course of the spinal accessory nerve has long prompted speculation that it is not a typical spinal motor nerve and that it might represent a caudal remnant of the branchial motor system. Our cell lineage tracing data, combined with images from public databases, show that the spinal accessory motor neurons in the mouse transiently express Phox2b, a transcription factor that is required for development of brain stem branchial motor nuclei. While this is strong prima facie evidence that the spinal accessory motor neurons should be classified as branchial motor, the evolutionary history of these motor neurons in anamniote vertebrates suggests that they may be considered to be an atypical branchial group that possesses both branchial and somatic characteristics. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Following ergonomics guidelines decreases physical and cardiovascular workload during cleaning tasks.

PubMed

Samani, Afshin; Holtermann, Andreas; Søgaard, Karen; Holtermann, Andreas; Madeleine, Pascal

2012-01-01

The aim was to investigate the effect of ergonomics guidelines on muscular activity, postural and cardiovascular load during cleaning. Eighteen cleaners performed 10 min of cleaning tasks in two locations; three min in a laboratory and seven min in a lecture room. All participants performed the task with or without focusing on ergonomics guidelines (ergonomics/non-ergonomics session). Bipolar surface electromyography was recorded bilaterally from upper trapezius and erector spinae muscles. A tri-axial accelerometer package was mounted on the low back (L5-S1) to measure postural changes, and the cardiovascular load was estimated by electrocardiogram. Ergonomics sessions resulted in lower muscular load, a more complex pattern of muscular activity, lower range of motion and angular velocity of the trunk as well as lower cardiovascular load compared with non-ergonomics sessions (p < 0.05). The study highlighted the multiple musculoskeletal and cardiovascular benefits of following ergonomics guidelines during cleaning tasks. This study investigated the effects of following instructive ergonomics guidelines during cleaning tasks (daily curriculum of cleaning including mopping, sweeping, changing trash bins and cleaning of desks and blackboards). Following the ergonomics guidelines reduces the general workload and induces a more complex pattern of muscular activity. The study contributes with novel knowledge concerning ergonomics guidelines and work techniques.

Characterizing the SEMG patterns with myofascial pain using a multi-scale wavelet model through machine learning approaches.

PubMed

Lin, Yu-Ching; Yu, Nan-Ying; Jiang, Ching-Fen; Chang, Shao-Hsia

2018-06-02

In this paper, we introduce a newly developed multi-scale wavelet model for the interpretation of surface electromyography (SEMG) signals and validate the model's capability to characterize changes in neuromuscular activation in cases with myofascial pain syndrome (MPS) via machine learning methods. The SEMG data collected from normal (N = 30; 27 women, 3 men) and MPS subjects (N = 26; 22 women, 4 men) were adopted for this retrospective analysis. SMEGs were measured from the taut-band loci on both sides of the trapezius muscle on the upper back while he/she conducted a cyclic bilateral backward shoulder extension movement within 1 min. Classification accuracy of the SEMG model to differentiate MPS patients from normal subjects was 77% using template matching and 60% using K-means clustering. Classification consistency between the two machine learning methods was 87% in the normal group and 93% in the MPS group. The 2D feature graphs derived from the proposed multi-scale model revealed distinct patterns between normal subjects and MPS patients. The classification consistency using template matching and K-means clustering suggests the potential of using the proposed model to characterize interference pattern changes induced by MPS. Copyright © 2018. Published by Elsevier Ltd.

Isometric Shoulder Strength Reference Values for Physically Active Collegiate Males and Females

PubMed Central

Westrick, Richard B.; Duffey, Michele L.; Cameron, Kenneth L.; Gerber, J. Parry; Owens, Brett D.

2013-01-01

Background: It is common clinical practice to assess muscle strength during examination of patients following shoulder injury or surgery. Strength comparisons are often made between the patient’s injured and uninjured shoulders, with the uninjured side used as a reference without regard to upper extremity dominance. Despite the importance of strength measurements, little is known about expected normal baselines of the uninjured shoulder. The purpose of this study was to report normative values for isometric shoulder strength for physically active college-age men and women without history of shoulder injury. Methods: University students—546 males (18.8 ± 1.0 years, 75.3 ± 12.2 kg) and 73 females (18.7 ± 0.9 years, 62.6 ± 7.0 kg)—underwent thorough shoulder evaluations by an orthopaedic surgeon and completed bilateral isometric strength measurements with a handheld dynamometer. Variables measured included internal rotation, external rotation, abduction, supine internal rotation and external rotation at 45°, and lower trapezius in prone flexion. Results: Significant differences were found between the dominant and nondominant shoulder for internal rotation, internal rotation at 45°, abduction, and prone flexion in males and in internal rotation at 45° and prone flexion for females (P ≤ 0.01). PMID:24381696

Motor unit recruitment and derecruitment induced by brief increase in contraction amplitude of the human trapezius muscle

PubMed Central

Westad, C; Westgaard, R H; De Luca, C J

2003-01-01

The activity pattern of low-threshold human trapezius motor units was examined in response to brief, voluntary increases in contraction amplitude (‘EMG pulse’) superimposed on a constant contraction at 4–7% of the surface electromyographic (EMG) response at maximal voluntary contraction (4–7% EMGmax). EMG pulses at 15–20% EMGmax were superimposed every minute on contractions of 5, 10, or 30 min duration. A quadrifilar fine-wire electrode recorded single motor unit activity and a surface electrode recorded simultaneously the surface EMG signal. Low-threshold motor units recruited at the start of the contraction were observed to stop firing while motor units of higher recruitment threshold stayed active. Derecruitment of a motor unit coincided with the end of an EMG pulse. The lowest-threshold motor units showed only brief silent periods. Some motor units with recruitment threshold up to 5% EMGmax higher than the constant contraction level were recruited during an EMG pulse and kept firing throughout the contraction. Following an EMG pulse, there was a marked reduction in motor unit firing rates upon return of the surface EMG signal to the constant contraction level, outlasting the EMG pulse by 4 s on average. The reduction in firing rates may serve as a trigger to induce derecruitment. We speculate that the silent periods following derecruitment may be due to deactivation of non-inactivating inward current (‘plateau potentials’). The firing behaviour of trapezius motor units in these experiments may thus illustrate a mechanism and a control strategy to reduce fatigue of motor units with sustained activity patterns. PMID:14561844

Evaluation of Myoelectric Activity of Paraspinal Muscles in Adolescents with Idiopathic Scoliosis during Habitual Standing and Sitting.

PubMed

Kwok, Garcia; Yip, Joanne; Cheung, Mei-Chun; Yick, Kit-Lun

2015-01-01

There is a number of research work in the literature that have applied sEMG biofeedback as an instrument for muscle rehabilitation. Therefore, sEMG is a good tool for this research work and is used to record the myoelectric activity in the paraspinal muscles of those with AIS during habitual standing and sitting. After the sEMG evaluation, the root-mean-square (RMS) sEMG values of the paraspinal muscles in the habitual postures reflect the spinal curvature situation of the PUMC Type Ia and IIc subjects. Both groups have a stronger average RMS sEMG value on the convex side of the affected muscle regions. Correction to posture as instructed by the physiotherapist has helped the subjects to achieve a more balanced RMS sEMG ratio in the trapezius and latissimus dorsi regions; the erector spinae in the thoracic region and/or erector spinae in the lumbar region. It is, therefore, considered that with regular practice of the suggested positions, those with AIS can use motor learning to achieve a more balanced posture. Consequently, the findings can be used in less intrusive early orthotic intervention and provision of care to those with AIS.

Effects of physical and mental stressors on muscle pain.

PubMed

Westgaard, R H

1999-01-01

Physical and mental stressors as risk factors for pain development are discussed. These multifaceted stressor terms are narrowed down so that physical stressors are represented by muscle activity recorded by electromyography (EMG), while mental stress is considered synonymous with psychosocial stress in vocational studies; in experimental studies cognitive stress is used as a model. Pain in the shoulder and neck are focused and related to EMG recordings of activity in the trapezius muscle. Major challenges in this field include proper risk assessment at low physical work loads and criteria for evaluating stress as a risk factor. A 3-factor conceptual model is presented in which the independent dimensions physical work load, mental stress, and individual sensitivity determine the risk of shoulder and neck complaints. It is pointed out that a predominant reduction in physical work load for many jobs and an increasing interaction between work conditions and the general life situation of workers pose particular challenges for risk assessment.

Biochemical and physical factors affecting discoloration characteristics of 19 bovine muscles.

PubMed

McKenna, D R; Mies, P D; Baird, B E; Pfeiffer, K D; Ellebracht, J W; Savell, J W

2005-08-01

Steaks from muscles (n=19 from nine beef carcasses) were evaluated over the course of retail display (0-, 1-, 2-, 3-, 4- or 5-d) for objective measures of discoloration (metmyoglobin, oxymyoglobin, L*-, a*-, and b*-values), reducing ability (metmyoglobin reductase activity (MRA), resistance to induced metmyoglobin formation (RIMF), and nitric oxide metmyoglobin reducing ability (NORA)), oxygen consumption rate (OCR), oxygen penetration depth, myoglobin content, oxidative rancidity, and pH. Muscles were grouped according to objective color measures of discoloration. M. longissimus lumborum, M. longissimus thoracis, M. semitendinosus, and M. tensor fasciae latae were grouped as "high" color stability muscles, M. semimembranosus, M. rectus femoris, and M. vastus lateralis were grouped as "moderate" color stability muscles, M. trapezius, M. gluteus medius, and M. latissimus dorsi were grouped as "intermediate" color stability muscles, M. triceps brachi - long head, M. biceps femoris, M. pectoralis profundus, M. adductor, M. triceps brachi - lateral head, and M. serratus ventralis were grouped as "low" color stability muscles, and M. supraspinatus, M. infraspinatus, and M. psoas major were grouped as "very low" color stability muscles. Generally, muscles of high color stability had high RIMF, nitric oxide reducing ability, and oxygen penetration depth and possessed low OCRs, myoglobin content, and oxidative rancidity. In contrast, muscles of low color stability had high MRA, OCRs, myoglobin content, and oxidative rancidity and low RIMF, NORA, and oxygen penetration depth. Data indicate that discoloration differences between muscles are related to the amount of reducing activity relative to the OCR.

[Women boxing athletes' EMG of upper limbs and lumbar muscles in the training of air striking of straight punch].

PubMed

Zhang, Ri-Hui; Kang, Zhi-Xin

2011-05-01

To study training effect of upper limbs and lumbar muscles in the proceed of air striking of straight punch by analyzing boxing athletes' changes of electromyogram (EMG). We measured EMG of ten women boxing athletes' upper arm biceps (contractor muscle), upper arm triceps (antagonistic muscle), forearm flexor muscle (contractor muscle), forearm extensor muscle (antagonistic muscle), and lumbar muscles by ME6000 (Mega Electronics Ltd.). The stipulated exercise was to do air striking of straight punch with loads of 2.5 kg of dumbbell in the hand until exhausted. In the proceed of exercise-induce exhausted, the descend magnitude and speed of median frequency (MF) in upper limb antagonistic muscle exceeded to contracting muscle, moreover, the work percentage showed that contractor have done a larger percentage of work than antagonistic muscle. Compared with world champion's EMG, the majority of ordinary athletes' lumbar muscles MF revealed non-drop tendency, and the work percentage showed that lumbar muscles had a very little percentage of work. After comparing the EMG test index in upper limb and lumbar muscle of average boxing athletes with that of the world champion, we find the testees lack of the training of upper limb antagonistic muscle and lumbar muscle, and more trainings aimed at these muscles need to be taken.

Effect of aerobic fitness on the physiological stress responses at work.

PubMed

Ritvanen, Tiina; Louhevaara, Veikko; Helin, Pertti; Halonen, Toivo; Hänninen, Osmo

2007-01-01

The aim of the present study was to examine the effects of aerobic fitness on physiological stress responses experienced by teachers during working hours. Twenty-six healthy female and male teachers aged 33-62 years participated in the study. The ratings of perceived stress visual analogue scale (VAS), and the measurement of physiological responses (norepinephrine, epinephrine, cortisol, diastolic and systolic blood pressure, heart rate (HR), and trapezius muscle activity by electromyography (EMG), were determined. Predicted maximal oxygen uptake (VO(2)max) was measured using the submaximal bicycle ergometer test. The predicted VO(2)max was standardized for age using residuals of linear regression analyses. Static EMG activity, HR and VAS were associated with aerobic fitness in teachers. The results suggest that a higher level of aerobic fitness may reduce muscle tension, HR and perceived work stress in teachers.

Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain.

PubMed

Muñoz-Muñoz, Sonsoles; Muñoz-García, María T; Alburquerque-Sendín, Francisco; Arroyo-Morales, Manuel; Fernández-de-las-Peñas, César

2012-10-01

The purpose of this study was to investigate the presence of active myofascial trigger points (MTrPs) in a greater number of muscles than previous studies and the relation between the presence of MTrPs, the intensity of pain, disability, and sleep quality in mechanical neck pain. Fifteen patients with mechanical neck pain (80% women) and 12 comparable controls participated. Myofascial trigger points were bilaterally explored in the upper trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid, levator scapulae, and scalene muscles in a blinded design. Myofascial trigger points were considered active if the subject recognized the elicited referred pain as a familiar symptom. Myofascial trigger points were considered latent if the elicited referred pain was not recognized as a symptom. Pain was collected with a numerical pain rate scale (0-10); disability was assessed with Neck Disability Index; and sleep quality, with the Pittsburgh Sleep Quality Index. Patients exhibited a greater disability and worse sleep quality than controls (P < .001). The Pittsburgh Sleep Quality Index score was associated with the worst intensity of pain (r = 0.589; P = .021) and disability (r = 0.552; P = .033). Patients showed a greater (P = .002) number of active MTrPs (mean, 2 ± 2) and similar number (P = .505) of latent MTrPs (1.6 ± 1.4) than controls (latent MTrPs, 1.3 ± 1.4). No significant association between the number of latent or active MTrPs and pain, disability, or sleep quality was found. The referred pain elicited by active MTrPs in the neck and shoulder muscles contributed to symptoms in mechanical neck pain. Patients exhibited higher disability and worse sleep quality than controls. Sleep quality was associated with pain intensity and disability. No association between active MTrPs and the intensity of pain, disability, or sleep quality was found. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

A three-compartment thermometry model for the improved estimation of changes in body heat content.

PubMed

Jay, Ollie; Gariépy, Louise M; Reardon, Francis D; Webb, Paul; Ducharme, Michel B; Ramsay, Tim; Kenny, Glen P

2007-01-01

The aim of this study was to use whole body calorimetry to directly measure the change in body heat content (DeltaH(b)) during steady-state exercise and compare these values with those estimated using thermometry. The thermometry models tested were the traditional two-compartment model of "core" and "shell" temperatures, and a three-compartment model of "core," "muscle," and "shell" temperatures; with individual compartments within each model weighted for their relative influence upon DeltaH(b) by coefficients subject to a nonnegative and a sum-to-one constraint. Fifty-two participants performed 90 min of moderate-intensity exercise (40% of Vo(2 peak)) on a cycle ergometer in the Snellen air calorimeter, at regulated air temperatures of 24 degrees C or 30 degrees C and a relative humidity of either 30% or 60%. The "core" compartment was represented by temperatures measured in the esophagus (T(es)), rectum (T(re)), and aural canal (T(au)), while the "muscle" compartment was represented by regional muscle temperature measured in the vastus lateralis (T(vl)), triceps brachii (T(tb)), and upper trapezius (T(ut)). The "shell" compartment was represented by the weighted mean of 12 skin temperatures (T(sk)). The whole body calorimetry data were used to derive optimally fitting two- and three-compartment thermometry models. The traditional two-compartment model was found to be statistically biased, systematically underestimating DeltaH(b) by 15.5% (SD 31.3) at 24 degrees C and by 35.5% (SD 21.9) at 30 degrees C. The three-compartment model showed no such bias, yielding a more precise estimate of DeltaH(b) as evidenced by a mean estimation error of 1.1% (SD 29.5) at 24 degrees C and 5.4% (SD 30.0) at 30 degrees C with an adjusted R(2) of 0.48 and 0.51, respectively. It is concluded that a major source of error in the estimation of DeltaH(b) using the traditional two-compartment thermometry model is the lack of an expression independently representing the heat storage in muscle during exercise.

Characteristics of referred muscle pain to the head from active trigger points in women with myofascial temporomandibular pain and fibromyalgia syndrome.

PubMed

Alonso-Blanco, Cristina; Fernández-de-Las-Peñas, César; de-la-Llave-Rincón, Ana Isabel; Zarco-Moreno, Pedro; Galán-Del-Río, Fernando; Svensson, Peter

2012-11-01

Our aim was to compare the differences in the prevalence and the anatomical localization of referred pain areas of active trigger points (TrPs) between women with myofascial temporomandibular disorder (TMD) or fibromyalgia (FMS). Twenty women (age 46 ± 8 years) with TMD and 20 (age 48 ± 6 years) with FMS were recruited from specialized clinic. Bilateral temporalis, masseter, sternocleidomastoid, upper trapezius, and suboccipital muscles were examined for TrPs. TrPs were identified by palpation and considered active when the pain reproduced familiar pain symptom experienced by the patient. The referred pain areas were drawn on anatomical maps, digitalized and also measured. A new analysis technique based on a center of gravity (COG) method was used to quantitative estimate of the localization of the TrP referred pain areas. Women with FMS exhibited larger areas of usual pain symptoms than women with myofascial TMD (P < 0.001). The COG coordinates of the usual pain on the frontal and posterior pain maps were located more superior in TMD than in FMS. The number of active TrPs was significantly higher in TMD (mean ± SD 6 ± 1) than in FMS (4 ± 1) (P = 0.002). Women with TMD exhibited more active TrPs in the temporalis and masseter muscles than FMS (P < 0.01). Women with FMS had larger referred pain areas than those with TMD for sternocleidomastoid and suboccipital muscles (P < 0.001). Significant differences within COG coordinates of TrP referred pain areas were found in TMD, the referred pain was more pronounced in the orofacial region, whereas the referred pain in FMS was more pronounced in the cervical spine. This study showed that the referred pain elicited from active TrPs shared similar patterns as usual pain symptoms in women with TMD or FMS, but that distinct differences in TrP prevalence and location of the referred pain areas could be observed. Differences in location of referred pain areas may help clinicians to determine the most relevant TrPs for each pain syndrome in spite of overlaps in pain areas.

SEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture

NASA Astrophysics Data System (ADS)

Qianxiang, Zhou; Chao, Ma; Xiaohui, Zheng

sEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture*1 Introduction Now the research on the isotonic muscle actions by using Surface Electromyography (sEMG) is becoming a pop topic in fields of astronaut life support training and rehabilitations. And researchers paid more attention on the sEMG signal processes for reducing the influence of noise which is produced during monitoring process and the fatigue estimation of isotonic muscle actions with different force levels by using the parameters which are obtained from sEMG signals such as Condition Velocity(CV), Median Frequency(MDF), Mean Frequency(MNF) and so on. As the lucubrated research is done, more and more research on muscle fatigue issue of isotonic muscle actions are carried out with sEMG analysis and subjective estimate system of Borg scales at the same time. In this paper, the relationship between the variable for fatigue based on sEMG and the Borg scale during the course of isotonic muscle actions of the upper arm with different contraction levels are going to be investigated. Methods 13 young male subjects(23.4±2.45years, 64.7±5.43Kg, 171.7±5.41cm) with normal standing postures were introduced to do isotonic actions of the upper arm with different force levels(10% MVC, 30%MVC and 50%MVC). And the MVC which means maximal voluntary contraction was obtained firstly in the experiment. Also the sEMG would be recorded during the experiments; the Borg scales would be recorded for each contraction level. By using one-third band octave method, the fatigue variable (p) based on sEMG were set up and it was expressed as p = i g(fi ) · F (fi ). And g(fi ) is defined as the frequent factor which was 0.42+0.5 cos(π fi /f0 )+0.08 cos(2π fi /f0 ), 0 < FI fi 0, orf0 ≤> f0 . According to the equations, the p could be computed and the relationship between variable p and the Borg scale would be investigated. Results In the research, three kinds of fitted curves between variable p and Borg scale were done, which were the quadratic curve, quintic curve and exponent curve. And 1 * Foundation Item: Supported by National Nature Science Foundation (60673013) the results showed that the relationship could be expressed as quadratic curve curves in certain scales. From the results it could concluded that the variable based on sEMG with one-third band octave method could really reflected the changes of fatigue caused by different isotonic contraction force levels; the variable and the Borg scale could be fitted with conic curves. And the continuous study could be done for learning the numerical relations between fatigue and sEMG during isometric actions with different force levels. Also it would be better for the supports training and rehabilitation training and other involved issues. References 1. Coorevits P, Danneels L, Cambier D, et al. Correlations between short-time Fourier-and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions[J]. Journal of Electromyography and Kinesiology. 2008, 18(??): 637-644. 2. Ryan E D, Cramer J T, Egan A D, et al. Time and frequency domain responses of the mechanomyogram and electromyogram during isometric ramp contractions: A comparison of the short-time Fourier and continuous wavelet transforms[J]. Journal of Electromyog-raphy and Kinesiology. 2008, 18(??): 54-67. 3. Coorevits P,danneels L, Cambier D E A. Correlations between short-time Fourier-and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions[J]. Journal of Electromyography and Kinesiology. 2008, 18(??): 637-644. 4. Dimitrova N A, Arabadzhiev T I, Hogrel J Y E A. Fatigue analysis of interference EMG signals obtained from biceps brachii during isometric voluntary contraction at various force levels[J]. Journal of Electromyography and Kinesiology. 2009, 19(??): 252-258. 5. Troiano A, Mesin L, Naddeo F, et al. Assessment of force and fatigue in isometric contractions of upper trapezius muscle by perceived exertion scale and EMG signal[J]. Gait & Posture 6. Eighth Congress of the Italian Society for Clinical Movement Analysis (SIAMOC-Societ?Italiana di Movimento in Clinica). 2008, 28(Supplement 1): 37-38. 7. Strimpakos N, Georgios G, Eleni K, et al. Issues in relation to the repeatability of and correlation between EMG and Borg scale assessments of neck muscle fatigue[J]. Journal of Electromyography and Kinesiology. 2005, 15(??): 452-465. 8. Zhan Benqing, Zhou Qianxiang, Influence of Multi-factors on Fatigue Evaluation of Typ-ical upper Extremity Operation, Space Medicine & Medical Engineering, 2009, 22(??): 313-316.

Handwriting performance versus arm forward reach and grasp abilities among post-stroke patients, a case-control study.

PubMed

Israely, Sharon; Carmeli, Eli

2017-01-01

Evidence-based studies regarding deficits in handwriting performance relative to hand reaching and grasping after a stroke are lacking. To evaluate the extent of damage to handwriting skills compared to arm reach and grasp task among post-stroke patients. Eighteen patients and 19 healthy subjects were recruited to this case-control study. Patients were evaluated 15.2 days (±6.5) after the stroke using a Computerized Penmanship Evaluation Tool, surface Electromyography and Fugl-Meyer assessment. This study compared motor deficits in hand reaching and grasping and in handwriting between stroke patients and healthy subjects. Damage to handwriting performance relative to hand reaching and grasping skills was also evaluated. Significant differences were found between groups in handwriting performance (p < 0.05). The performance of the trapezius, biceps, and triceps muscles can predict 63.5% of the variance in the ability to write a short sentence (p < 0.023). Pen pressure can predict 74.9% of the hand motor performance from Fugl-Meyer assessment (p < 0.05). Handwriting was more damaged than was the pattern of activation of the proximal muscles of the shoulder and arm (p < 0.05). FM scores were highly, negatively correlated with the in-air writing time across tasks (r = -0.819, p < 0.004). This study confirms the clinical observation that dexterity skills are more damaged than are arm forward reach after a stroke. However, these differences in motor performance were not significant in mildly disabled patients, demonstrating the feasibility of handwriting rehabilitation in these patients. Therefore, we modestly recommend focusing on handwriting rehabilitation of the hemiparetic upper extremity in mildly impaired patients after a stroke.

Age-Related, Sport-Specific Adaptions of the Shoulder Girdle in Elite Adolescent Tennis Players

PubMed Central

Cools, Ann M.; Palmans, Tanneke; Johansson, Fredrik R.

2014-01-01

Context: Tennis requires repetitive overhead movements that can lead to upper extremity injury. The scapula and the shoulder play a vital role in injury-free playing. Scapular dysfunction and glenohumeral changes in strength and range of motion (ROM) have been associated with shoulder injury in the overhead athlete. Objective: To compare scapular position and strength and shoulder ROM and strength between Swedish elite tennis players of 3 age categories (<14, 14–16, and >16 years). Design: Cross-sectional study. Setting: Tennis training sports facilities. Patients or Other Participants: Fifty-nine adolescent Swedish elite tennis players (ages 10–20 years) selected based on their national ranking. Main Outcome Measure(s): We used a clinical screening protocol with a digital inclinometer and a handheld dynamometer to measure scapular upward rotation at several angles of arm elevation, isometric scapular muscle strength, glenohumeral ROM, and isometric rotator cuff strength. Results: Players older than 16 years showed less scapular upward rotation on the dominant side at 90° and 180° (P < .05). Although all absolute scapular muscle strength values increased with age, there was no change in the body-weight–normalized strength of the middle (P = .9) and lower (P = .81) trapezius or serratus anterior (P = .17). Glenohumeral internal-rotation ROM and total ROM tended to decrease, but this finding was not statistically significant (P = .052 and P = .06, respectively). Whereas normalized internal-rotator strength increased from 14 to 16 years to older than 16 years (P = .009), normalized external-rotator and supraspinatus strength remained unchanged. Conclusions: Age-related changes in shoulder and scapular strength and ROM were apparent in elite adolescent tennis players. Future authors should examine the association of these adaptations with performance data and injury incidence. PMID:25098662

Age-related, sport-specific adaptions of the shoulder girdle in elite adolescent tennis players.

PubMed

Cools, Ann M; Palmans, Tanneke; Johansson, Fredrik R

2014-01-01

Tennis requires repetitive overhead movements that can lead to upper extremity injury. The scapula and the shoulder play a vital role in injury-free playing. Scapular dysfunction and glenohumeral changes in strength and range of motion (ROM) have been associated with shoulder injury in the overhead athlete. To compare scapular position and strength and shoulder ROM and strength between Swedish elite tennis players of 3 age categories (<14, 14-16, and >16 years). Cross-sectional study. Tennis training sports facilities. Fifty-nine adolescent Swedish elite tennis players (ages 10-20 years) selected based on their national ranking. We used a clinical screening protocol with a digital inclinometer and a handheld dynamometer to measure scapular upward rotation at several angles of arm elevation, isometric scapular muscle strength, glenohumeral ROM, and isometric rotator cuff strength. Players older than 16 years showed less scapular upward rotation on the dominant side at 90° and 180° (P < .05). Although all absolute scapular muscle strength values increased with age, there was no change in the body-weight-normalized strength of the middle (P = .9) and lower (P = .81) trapezius or serratus anterior (P = .17). Glenohumeral internal-rotation ROM and total ROM tended to decrease, but this finding was not statistically significant (P = .052 and P = .06, respectively). Whereas normalized internal-rotator strength increased from 14 to 16 years to older than 16 years (P = .009), normalized external-rotator and supraspinatus strength remained unchanged. Age-related changes in shoulder and scapular strength and ROM were apparent in elite adolescent tennis players. Future authors should examine the association of these adaptations with performance data and injury incidence.

The effect of psychosocial stress on muscle activity during computer work: Comparative study between desktop computer and mobile computing products.

PubMed

Taib, Mohd Firdaus Mohd; Bahn, Sangwoo; Yun, Myung Hwan

2016-06-27

The popularity of mobile computing products is well known. Thus, it is crucial to evaluate their contribution to musculoskeletal disorders during computer usage under both comfortable and stressful environments. This study explores the effect of different computer products' usages with different tasks used to induce psychosocial stress on muscle activity. Fourteen male subjects performed computer tasks: sixteen combinations of four different computer products with four different tasks used to induce stress. Electromyography for four muscles on the forearm, shoulder and neck regions and task performances were recorded. The increment of trapezius muscle activity was dependent on the task used to induce the stress where a higher level of stress made a greater increment. However, this relationship was not found in the other three muscles. Besides that, compared to desktop and laptop use, the lowest activity for all muscles was obtained during the use of a tablet or smart phone. The best net performance was obtained in a comfortable environment. However, during stressful conditions, the best performance can be obtained using the device that a user is most comfortable with or has the most experience with. Different computer products and different levels of stress play a big role in muscle activity during computer work. Both of these factors must be taken into account in order to reduce the occurrence of musculoskeletal disorders or problems.

Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

PubMed

Mejuto-Vázquez, María J; Salom-Moreno, Jaime; Ortega-Santiago, Ricardo; Truyols-Domínguez, Sebastián; Fernández-de-Las-Peñas, César

2014-04-01

Randomized clinical trial. To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle. TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes. Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed. Methods Seventeen patients (53% female) were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable. Patients treated with 1 session of TrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (P<.01 for all comparisons). Between-group effect sizes were medium to large immediately after the TrPDN session (standardized mean score differences greater than 0.56) and large at the 1-week follow-up (standardized mean score differences greater than 1.34). The results of the current randomized clinical trial suggest that a single session of TrPDN may decrease neck pain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Level of Evidence Therapy, level 1b-.

Stereotactic topography of the greater and third occipital nerves and its clinical implication.

PubMed

Kim, Hong-San; Shin, Kang-Jae; O, Jehoon; Kwon, Hyun-Jin; Lee, Minho; Yang, Hun-Mu

2018-01-17

This study aimed to provide topographic information of the greater occipital (GON) and third occipital (3ON) nerves, with the three-dimensional locations of their emerging points on the back muscles (60 sides, 30 cadavers) and their spatial relationship with muscle layers, using a 3D digitizer (Microscribe G2X, Immersion Corp, San Jose CA, USA). With reference to the external occipital protuberance (EOP), GON pierced the trapezius at a point 22.6 ± 7.4 mm lateral and 16.3 ± 5.9 mm inferior and the semispinalis capitis (SSC) at a point 13.1 ± 6.0 mm lateral and 27.7 ± 9.9 mm inferior. With the same reference, 3ON pierced, the trapezius at a point 12.9 ± 9.3 mm lateral and 44.2 ± 21.4 mm inferior, the splenius capitis at a point 10.0 ± 5.3 mm lateral and 59.2 ± 19.8 mm inferior, and SSC at a point 11.5 ± 9.9 mm lateral and 61.4 ± 15.3 mm inferior. Additionally, GON arose, winding up the obliquus capitis inferior, with the winding point located 52.3 ± 11.7 mm inferior to EOP and 30.2 ± 8.9 mm lateral to the midsagittal line. Knowing the course of GON and 3ON, from their emergence between vertebrae to the subcutaneous layer, is necessary for reliable nerve detection and precise analgesic injections. Moreover, stereotactic measurement using the 3D digitizer seems useful and accurate for neurovascular structure study.

Physiological effects of night vision goggle counterweights on neck musculature of military helicopter pilots.

PubMed

Harrison, Michael F; Neary, J Patrick; Albert, Wayne J; Veillette, Major Dan W; Forcest, Canadian; McKenzie, Neil P; Croll, James C

2007-08-01

Increased helmet-mounted mass and specific neck postures have been found to be a cause of increased muscular activity and stress. However, pilots who use night vision goggles (NVG) frequently use counterweight (CW) equipment such as a lead mass that is attached to the back of the flight helmet to provide balance to counter the weight of the NVG equipment mounted to the front of the flight helmet. It is proposed that this alleviates this stress. However, no study has yet investigated the physiological effects of CW during an extended period of time during which the pilots performed normal operational tasks. Thirty-one Canadian Forces pilots were monitored on consecutive days during a day and a NVG mission in a CH-146 flight simulator. Near infrared spectroscopy probes were attached bilaterally to the trapezius muscles and hemodynamics, i.e., total oxygenation index, total hemoglobin, oxyhemoglobin, and deoxyhemoglobin, were monitored for the duration of the mission. Pilots either wore CW (n = 25) or did not wear counterweights (nCW, n = 6) as per their usual operational practice. Levene's statistical tests were conducted to test for homogeneity and only total oxygenation index returned a significant result (p < or = 0.05). For the near infrared spectroscopy variables, significant differences were found to exist between CW and nCW pilots for total hemoglobin, deoxyhemoglobin, and oxyhemoglobin during NVG flights. The CW pilots displayed less metabolic and hemodynamic stress during simulated missions as compared to the nCW pilots. The results of this study would suggest that the use of CW equipment during NVG missions in military helicopter pilots does minimize the metabolic and hemodynamic responses of the trapezius muscles.

Clavicle fracture with osteomyelitis after neck dissection and post-operative radiotherapy: case report.

PubMed

Shodo, R; Sato, Y; Ota, H; Horii, A

2017-11-01

Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation. As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.

Effects of muscle fiber type on glycolytic potential and meat quality traits in different Tibetan pig muscles and their association with glycolysis-related gene expression.

PubMed

Shen, L Y; Luo, J; Lei, H G; Jiang, Y Z; Bai, L; Li, M Z; Tang, G Q; Li, X W; Zhang, S H; Zhu, L

2015-11-13

The myosin heavy chain (MyHC) composition, glycolytic potential, mitochondrial content, and gene expression related to energy metabolism were analyzed in eight muscles from Tibetan pigs, to study how meat quality develops in different muscle tissues. The muscles were classified into three clusters, based on MyHC composition: masseter, trapezius, and latissimus dorsi as 'slow-oxidative-type'; psoas major and semimembranosus as 'intermediate-type'; and longissimus dorsi, obliquus externus abdominis, and semitendinosus as 'fast-glycolytic-type'. The 'slow-oxidative-type' muscles had the highest MyHC I and MyHC IIA content (P < 0.01); 'intermediate-type' muscles, the highest MyHC IIx content (P < 0.01); and 'fast-glycolytic-type' muscles, the highest MyHC IIb content (P < 0.01). The pH values measured in 'slow-oxidative-type' muscles were higher than those in the other clusters were; however, the color of 'fast-glycolytic-type' muscles was palest (P < 0.01). Mitochondrial content increased in the order: fast-glycolytic-type < intermediate-type < slow-oxidative-type. In the 'slow-oxidative-type' muscles, the expression levels of genes related to ATP synthesis were higher, but were lower for those related to glycogen synthesis and glycolysis. Mitochondrial content was significantly positively correlated with MyHC I content, but negatively correlated with MyHC IIb content. MyHC I and mitochondrial content were both negatively correlated with glycolytic potential. Overall, muscles used frequently in exercise had a higher proportion of type I fibers. 'Slow-oxidative-type' muscles, rich in type I fibers with higher mitochondrial and lower glycogen and glucose contents, had a higher ATP synthesis efficiency and lower glycolytic capacity, which contributed to their superior meat quality.

Musculotendon and fascicle strains in anterior and posterior neck muscles during whiplash injury.

PubMed

Vasavada, Anita N; Brault, John R; Siegmund, Gunter P

2007-04-01

A biomechanical neck model combined with subject-specific kinematic and electromyographic data were used to calculate neck muscle strains during whiplash. To calculate the musculotendon and fascicle strains during whiplash and to compare these strains to published muscle injury thresholds. Previous work has shown potentially injurious musculotendon strains in sternocleidomastoid (SCM) during whiplash, but neither the musculotendon strains in posterior cervical muscles nor the fascicle strains in either muscle group have been examined. Experimental human subject data from rear-end automobile impacts were integrated with a biomechanical model of the neck musculoskeletal system. Subject-specific head kinematic data were imposed on the model, and neck musculotendon and fascicle strains and strain rates were computed. Electromyographic data from the sternocleidomastoid and the posterior cervical muscles were compared with strain data to determine which muscles were being eccentrically contracted. SCM experienced lengthening during the retraction phase of head/neck kinematics, whereas the posterior muscles (splenius capitis [SPL], semispinalis capitis [SEMI], and trapezius [TRAP]) lengthened during the rebound phase. Peak SCM fascicle lengthening strains averaged (+/-SD) 4% (+/-3%) for the subvolumes attached to the mastoid process and 7% (+/-5%) for the subvolume attached to the occiput. Posteriorly, peak fascicle strains were 21% (+/-14%) for SPL, 18% (+/-16%) for SEMI, and 5% (+/-4%) for TRAP, with SPL strains significantly greater than calculated in SCM or TRAP. Fascicle strains were, on average, 1.2 to 2.3 times greater than musculotendon strains. SCM and posterior muscle activity occurred during intervals of muscle fascicle lengthening. The cervical muscle strains induced during a rear-end impact exceed the previously-reported injury threshold for a single stretch of active muscle. Further, the larger strains experienced by extensor muscles are consistent with clinical reports of pain primarily in the posterior cervical region following rear-end impacts.

Winged Scapula: A Comprehensive Review of Surgical Treatment

PubMed Central

Charran, Ordessia; Yilmaz, Emre; Edwards, Bryan; Muhleman, Mitchel A; Oskouian, Rod J; Tubbs, R. Shane; Loukas, Marios

2017-01-01

Winged scapula is caused by paralysis of the serratus anterior or trapezius muscles due to damage to the long thoracic or accessory nerves, resulting in loss of strength and range of motion of the shoulder. Because this nerve damage can happen in a variety of ways, initial diagnosis may be overlooked. This paper discusses the anatomical structures involved in several variations of winged scapula, the pathogenesis of winged scapula, and several historical and contemporary surgical procedures used to treat this condition. Additionally, this review builds upon the conclusions of several studies in order to suggest areas for continued research regarding the treatment of winged scapula. PMID:29456903

Dorsal scapular neuropathy causing rhomboids palsy and scapular winging.

PubMed

Argyriou, Andreas A; Karanasios, Panagiotis; Makridou, Alexandra; Makris, Nicolaos

2015-01-01

Most cases of scapular winging (SW) are attributed to either long thoracic or spinal accessory nerve lesions. Dorsal scapular nerve lesions are quite rare and the literature contains very few case reports of SW secondary to rhomboid paralysis. We are reporting the unusual case of a young patient who developed right-side scapular winging due to dorsal scapular neuropathy and rhomboids palsy, and we highlight the role of conservative treatment and rehabilitation for cases of mild/medium injury to the dorsal scapular nerve or to the rhomboid muscles. For those cases, physiotherapy is recommended, and this is mainly aimed at strengthening the trapezius in order to compensate for rhomboids weakness.

Muscle load in reaching movements performed by a wheelchair user: a case study.

PubMed

van Drongelen, S; Wolf, S I; Fradet, L

2014-01-01

The aim of this study was to analyse the load on the shoulder muscles during reaching movements that are specific to wheelchair users in relation to the risk of impingement. Three activities of daily living were performed: putting a book on a shelf in front and at the side and putting a pack of water bottles on a table. The AnyBody shoulder model was used to calculate the activity and forces of the shoulder muscles. Handling the pack of bottles caused the highest forces in the deltoideus, trapezius, serratus anterior and rotator cuff muscles. For handling the book, the highest forces were found in the deltoideus (scapular part) and the serratus anterior, especially during the put phase. Handling heavy objects such as a pack of bottles or a wheelchair produces high forces on the rotator cuff muscles and can lead to early fatigue. Therefore, these activities seem to be associated with a high risk of developing impingement syndrome. Implications for Rehabilitation In a single patient, this study demonstrates that the load on the rotator cuff is high during reaching movements. Handling a pack of water bottles, which resembles wheelchair handling, represents an activity associated with a high risk of developing impingement syndrome. Shoulder muscles must be trained in a balanced way to provide stabilization at the shoulder joint and prevent fatigue.

An unusual presenting symptom of graves' disease: myalgia.

PubMed

Papanikolaou, N; Perros, P

2013-01-01

A 50-year-old female patient presented with severe myalgia involving her proximal muscles for 3-4 weeks. She also reported mild thyrotoxic symptoms over the same time period. Examination revealed mild thyrotoxicosis, a moderate diffuse goiter and no eye signs. The clinical picture was dominated by muscle pain and tenderness involving mainly her proximal arms and legs, her calves and her fingers, requiring opiate analgesia. Muscle power and tendon reflexes were normal. Laboratory evaluation revealed undetectable serum thyroid stimulating hormone (TSH) with raised FT4, FT3 and positive TSH receptor antibodies. Treatment with carbimazole was started. Additional laboratory investigations were negative (inflammatory markers, creatine kinase and antibodies to antinuclear antibodies, gastric parietal cell, smooth muscle, mitochondrial, dsDNA, centromere, extractable nuclear antigen (ENA) ribonucleoprotein, ENA Sm, ENA Ro, ENA Anti-La, ENA Scl70, ENA Jo-1, anti-CCP and rheumatoid factor). Further assessment in the rheumatology clinic confirmed there was no small joint tenderness or loss of range of movement of her limbs, but widespread and profound muscle tenderness of the common extensors of the forearms, biceps, trapezius, calves and thighs. She was treated symptomatically with analgesic medication and continued on carbimazole. A month later she was euthyroid and her myalgia had resolved. Hyperthyroidism has a profound effect on skeletal muscle and often leads to myopathy. Severe myalgia in association with Graves' disease is rare and resolves with the restoration of euthyroidism.

Use of Pedicled Trapezius Myocutaneous Flap for Posterior Skull Reconstruction.

PubMed

Singh, Mansher; Rios Diaz, Arturo J; Cauley, Ryan; Smith, Timothy R; Caterson, E J

2015-09-01

Soft-tissue defects in posterior skull can be challenging for reconstruction. If related to tumor resection, these wound beds are generally irradiated and can be difficult from a recipient-vessel perspective for a free tissue transfer. Locoregional flaps might prove to be important reconstructive option in such patients. There is a very limited data on the usage of pedicled trapezius myocutaneous flaps for such defects. The authors reviewed existing study for usage of trapezius flap for posterior skull repair and used pedicled trapezius myocutaneous flaps based on the descending branch of superficial cervical artery (SCA) for reconstruction of posterior skull soft-tissue defect in an irradiated and infected wound. Two patients were operated for trapezius myocutaneous flap for posterior skull defects complicated by cerebrospinal fluid (CSF) leakage and epidural abscess. There was no recipient or donor-site complication at a mean follow-up of 12.5 months. Neither of the 2 patients had any functional deficits for the entire duration of the follow-up. Although this flap was able to help in controlling the CSF leakage in the first patient, it successfully healed the cavity generated from epidural abscess drainage in the second patient. The large angle of rotation coupled with the ability to complete the procedure without repositioning the patients makes trapezius myocutaneous flap an attractive option for posterior skull reconstruction. In our limited experience, the pedicled trapezius flaps are a reliable alternative as they are well vascularized and able to obliterate the soft-tissue defect completely. The recipient site healed completely in infected as well as irradiated wound beds. In addition, the donor site can be primarily closed with minimal donor-associated complication.

Physical Abilities and Military Task Performance: A Replication and Extension

DTIC Science & Technology

2009-06-09

exertion lasted 3 s. Trapezius lift. Subject stood with feet at shoulder width grasping handles that were 38.5 cm apart to mimic the grip used in...maintained even with encouragement. Trapezius lift. The subject stood erect with his feet shoulder-width apart. He held a 20.9- kg load with his arms...static trunk extension; dynamic and static arm flexion; bench press, trapezius lift, leg extension; dynamic and static trunk flexion; right and left

Anti-MuSK myasthenia gravis with prolonged remission.

PubMed

Bouwyn, Jean Paul; Magnier, Patrick; Bédat-Millet, Anne-Laure; Ahtoy, Patrick; Maltête, David; Lefaucheur, Romain

2016-07-01

Myasthenia gravis (MG) with antibodies against muscle-specific tyrosine kinase (MuSK) is a rare disorder of neuromuscular transmission affecting preferentially bulbar, neck and respiratory muscles. We report the case of a 22-year-old man who presented with diplopia on lateral gaze to both sides, facial diplegia, nasal dysarthria and dysphagia. Repetitive nerve stimulation of the trapezius and orbicularis oculi muscles showed amplitude decrements of 19% and 41% respectively supporting the diagnosis of myasthenia gravis. MUsK antibodies were positive. Corticosteroids were introduced and then tapered and discontinued at 6 months after initiation. The patient remained in remission and asymptomatic for 4 years without ongoing treatment or prior treatment with rituximab after this first relapse of MuSK-MG. MuSK- MG is considered a hard-to-treat condition and patients generally remain dependent on immunosuppression or prior treatment with rituximab. Our observation highlights that patients with MuSK-MG can have a benign course and that continued immunosuppressive or immunomodulatory therapy may not always be required. Copyright © 2016 Elsevier B.V. All rights reserved.

On-the-Field Resistance-Tubing Exercises for Throwers: An Electromyographic Analysis

PubMed Central

Myers, Joseph B; Pasquale, Maria R; Laudner, Kevin G; Sell, Timothy C; Bradley, James P; Lephart, Scott M

2005-01-01

Context: Athletes who throw commonly use rubber-tubing resistance exercises in the field setting to assist with warm-up before throwing. Yet no researchers have described which muscles are being activated or which exercises are most effective during rubber-tubing exercises used by throwers for warm-up. Objective: To describe the effectiveness of 12 rubber-tubing resistance exercises commonly used by throwers in activating the shoulder muscles important for throwing. Design: Descriptive research design. Setting: An applied biomechanics research laboratory. Patients or Other Participants: Fifteen physically active male subjects with no history of shoulder injury. Main Outcome Measure(s): Subjects randomly performed 12 rubber-tubing resistance exercises while we assessed muscle activation of the subscapularis, supraspinatus, teres minor, and rhomboid major by indwelling electromyography. Activation of the sternal portion of the pectoralis major, anterior deltoid, middle deltoid, latissimus dorsi, serratus anterior, biceps brachii, triceps brachii, lower trapezius, and infraspinatus muscles was assessed by surface electromyography. Results: Performance of 7 exercises (external rotation at 90° of abduction, throwing deceleration, humeral flexion, humeral extension, low scapular rows, throwing acceleration, and scapular punch) resulted in the highest level of muscle activation of all muscles tested. Conclusions: These 7 exercises exhibited moderate activation (>20% maximal voluntary isometric contraction) in each muscle of the rotator cuff, the primary humeral movers, and the scapular stabilizer muscles. The results suggest that these exercises are most effective in activating the muscles important to the throwing motion and may be beneficial for throwers during their prethrowing warm-up routine. PMID:15902319

Highly favorable physiological responses to concurrent resistance and high-intensity interval training during chemotherapy: the OptiTrain breast cancer trial.

PubMed

Mijwel, Sara; Backman, Malin; Bolam, Kate A; Olofsson, Emil; Norrbom, Jessica; Bergh, Jonas; Sundberg, Carl Johan; Wengström, Yvonne; Rundqvist, Helene

2018-05-01

Advanced therapeutic strategies are often accompanied by significant adverse effects, which warrant equally progressive countermeasures. Physical exercise has proven an effective intervention to improve physical function and reduce fatigue in patients undergoing chemotherapy. Effects of high-intensity interval training (HIIT) in this population are not well established although HIIT has proven effective in other clinical populations. The aim of the OptiTrain trial was to examine the effects of concurrent resistance and high-intensity interval training (RT-HIIT) or concurrent moderate-intensity aerobic and high-intensity interval training (AT-HIIT), to usual care (UC) on pain sensitivity and physiological outcomes in patients with breast cancer during chemotherapy. Two hundred and forty women were randomized to 16 weeks of RT-HIIT, AT-HIIT, or UC. cardiorespiratory fitness, muscle strength, body mass, hemoglobin levels, and pressure-pain threshold. Pre- to post-intervention, RT-HIIT (ES = 0.41) and AT-HIIT (ES = 0.42) prevented the reduced cardiorespiratory fitness found with UC. Handgrip strength (surgery side: RT-HIIT vs. UC: ES = 0.41, RT-HIIT vs. AT-HIIT: ES = 0.28; non-surgery side: RT-HIIT vs. UC: ES = 0.35, RT-HIIT vs. AT-HIIT: ES = 0.22) and lower-limb muscle strength (RT-HIIT vs. UC: ES = 0.66, RT-HIIT vs. AT-HIIT: ES = 0.23) were significantly improved in the RT-HIIT. Increases in body mass were smaller in RT-HIIT (ES = - 0.16) and AT-HIIT (ES = - 0.16) versus UC. RT-HIIT reported higher pressure-pain thresholds than UC (trapezius: ES = 0.46, gluteus: ES = 0.53) and AT-HIIT (trapezius: ES = 0.30). Sixteen weeks of RT-HIIT significantly improved muscle strength and reduced pain sensitivity. Both exercise programs were well tolerated and were equally efficient in preventing increases in body mass and in preventing declines in cardiorespiratory fitness. These results highlight the importance of implementing a combination of resistance and high-intensity interval training during chemotherapy for women with breast cancer.

Comparison of NSAID patch given as monotherapy and NSAID patch in combination with transcutaneous electric nerve stimulation, a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome of the upper trapezius: a pilot study.

PubMed

Kim, Do-Hyeong; Yoon, Kyung Bong; Park, SangHa; Jin, Tae Eun; An, Yoo Jin; Schepis, Eric A; Yoon, Duck Mi

2014-12-01

This study compared the therapeutic effect of monotherapy with a nonsteroidal anti-inflammatory drug (NSAID) patch vs an NSAID patch combined with transcutaneous electric nerve stimulation (TENS), a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome (MPS) of the upper trapezius. A randomized, single-blind, controlled study of combination therapy for patients with MPS was performed. Ninety-nine patients were randomly assigned to one of four different self-management methods for treatment: NSAID patch (N = 25), NSAID patch + TENS (N = 24), NSAID patch + heating pad (N = 25), and NSAID patch + topical capsaicin (N = 25). The NSAID patch used in this study was a ketoprofen patch. All treatment groups were observed for 2 weeks, and the numeric rating scale (NRS) pain score, cervical active range of motion, pressure pain threshold, and Neck Disability Index were assessed. There was no significant difference between the NSAID patch alone group and the three combination therapy groups with respect to decrease in NRS score from baseline (day 0) to each period of observation. In covariate analysis, although there was no difference among the groups in most of the periods, the data at day 14 indicated a trend (P = 0.057). There were no significant differences in the other variables. We did not observe a statistical difference in improvements to the clinical variables among the four different methods. However, further studies regarding the effectiveness of a mixture of topical capsaicin and ketoprofen in patients with MPS should be considered. Wiley Periodicals, Inc.

Kinematic MRI study of upper-airway biomechanics using electrical muscle stimulation

NASA Astrophysics Data System (ADS)

Brennick, Michael J.; Margulies, Susan S.; Ford, John C.; Gefter, Warren B.; Pack, Allan I.

1997-05-01

We have developed a new and powerful method to study the movement and function of upper airway muscles. Our method is to use direct electrical stimulation of individual upper airway muscles, while performing state of the art high resolution magnetic resonance imaging (MRI). We have adapted a paralyzed isolated UA cat model so that positive or negative static pressure in the UA can be controlled at specific levels while electrical muscle stimulation is applied during MRI. With these techniques we can assess the effect of muscle stimulation on airway cross-sectional area compliance and soft tissue motion. We are reporting the preliminary results and MRI techniques which have enabled us to examine changes in airway dimensions which result form electrical stimulation of specific upper airway dilator muscles. The results of this study will be relevant to the development of new clinical treatments for obstructive sleep apnea by providing new information as to exactly how upper airway muscles function to dilate the upper airway and the strength of stimulation required to prevent the airway obstruction when overall muscle tone may not be sufficient to maintain regular breathing.

Recovery of peripheral muscle function from fatiguing exercise and daily physical activity level in patients with multiple sclerosis: a case-control study.

PubMed

Ickmans, Kelly; Simoens, Fauve; Nijs, Jo; Kos, Daphne; Cras, Patrick; Willekens, Barbara; Meeus, Mira

2014-07-01

Delayed recovery of muscle function following exercise has been demonstrated in the lower limbs of patients with multiple sclerosis (MS). However, studies examining this in the upper limbs are currently lacking. This study compared physical activity level (PAL) and recovery of upper limb muscle function following exercise between MS patients and healthy inactive controls. Furthermore, the relationship between PAL and muscle recovery was examined. PAL of 19 MS patients and 32 controls was measured using an accelerometer for 7 consecutive days. Afterwards, recovery of muscle function was assessed by performing a fatiguing upper limb exercise test with subsequent recovery measures. Muscle recovery of the upper limb muscles was similar in both groups. Average activity counts were significantly lower in MS patients than in the control group. MS patients spent significantly more time being sedentary and less time on activities of moderate intensity compared with the control group. No significant correlation between PAL and recovery of muscle function was found in MS patients. Recovery of upper limb muscle function following exercise is normal in MS patients. MS patients are less physically active than healthy inactive controls. PAL and recovery of upper limb muscle function appear unrelated in MS patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Chronic pain and difficulty in relaxing postural muscles in patients with fibromyalgia and chronic whiplash associated disorders.

PubMed

Elert, J; Kendall, S A; Larsson, B; Månsson, B; Gerdle, B

2001-06-01

To investigate if muscle tension according to the surface electromyogram (EMG) of the shoulder flexors is increased in consecutive patients with fibromyalgia (FM) or chronic whiplash associated disorders (WAD). A total of 59 consecutive patients with FM (n = 36) or chronic WAD (n = 23) performed 100 maximal isokinetic contractions combined with surface electromyography of the trapezius and infraspinatus. A randomized group of pain-free female (n = 27) subjects served as control group. Peak torque initially (Pti) and absolute and relative peak torque at endurance level (PTe, PTer) were registered as output variables, together with the EMG level of unnecessary muscle tension, i.e., the signal amplitude ratio (SAR). The patient groups had a higher level of unnecessary tension initially and at the endurance level. The patients had lower absolute output (PTi and PTe), but the relative levels (PTer) did not differ comparing all 3 groups. Subjects with FM had significantly higher body mass index (BMI) than the other groups. BMI did not influence the SAR but correlated positively with PTi. The results confirmed earlier findings that groups of patients with chronic pain have increased muscle tension and decreased output during dynamic activity compared to pain-free controls. However, the results indicated there is heterogeneity within groups of patients with the same chronic pain disorder and that not all patients with chronic pain have increased muscle tension.

Trapezius placement of implanted ports: understanding the procedure.

PubMed

Hill, Steve

Totally implantable vascular access devices (TIVADs) are indicated for intermittent long-term intravenous access. It is widely accepted within medical literature that TIVADs are associated with statistically significant lower infection rates than other central venous access devices. Typical sites for implantation are on the anterior chest wall, using the internal jugular, axillary, cephalic or a subclavian vein. This article follows on from a previous discussion of the benefits of this approach, which illustrated and examined clinical outcomes of trapezius-placement versus anterior chest wall placed ports, for patients with metastatic subcutaneous disease on the anterior chest wall. The procedure provides a unique challenge for the clinician. This article focuses on the process of trapezius port implantation, providing an illustrative guide to understand the procedure. Trapezius port placement is a viable option for patients for whom routine sites are excluded and who require long-term intermittent vascular access.

Structural and functional anatomy of the neck musculature of the dog (Canis familiaris)

PubMed Central

Sharir, Amnon; Milgram, Joshua; Shahar, Ron

2006-01-01

The morphometric properties and the anatomical relationships of the entire musculature of the canine cervical spine are reported herein. These data were obtained from the dissection of cadavers of six dogs. Total muscle length, muscle weight, fascicle length and angles of pennation were recorded for each muscle comprising the canine cervical spine. Based upon these properties, physiological cross-section area (PCSA) and architectural index were estimated. When scaled by whole body mass, the values of each of these parameters were found to be similar between all dogs. Muscles that course from the cranial neck to the shoulder girdle or the rib cage (e.g. brachiocephalicus and rhomboideus capitis) were found to have relatively long fascicles and low PCSA values and thus appear to be designed for rapid excursions. By contrast, muscles that primarily support the neck and shoulder against gravitational forces (e.g. serratus ventralis and trapezius) were found to have relatively high PCSA values and short fascicle lengths, and thus have the capacity to generate large forces. Differences of morphometry as well as nomenclature were found between the canine and human neck musculature. Nevertheless, many similarities exist; in particular, both species have similar muscles adapted to force generation or large excursions. We thus conclude that the canine neck may be used as a modelling tool for biomechanical investigations of the human cervical region as long as the differences listed are borne in mind. PMID:16533316

Is Borg's perceived exertion scale a useful indicator of muscular and cardiovascular load in blue-collar workers with lifting tasks? A cross-sectional workplace study.

PubMed

Jakobsen, Markus Due; Sundstrup, Emil; Persson, Roger; Andersen, Christoffer H; Andersen, Lars L

2014-02-01

To investigate associations between perceived exertion and objectively assessed muscular and cardiovascular load during a full working day among workers with manual lifting tasks. A total of 159 men and 41 women from 14 workplaces with manual lifting tasks participated. Participants reported perceived exertion (BORG-CR10) at midday and after work. Surface electromyography of the thigh, lower back and neck muscles were normalized to isometric voluntary contractions (MVC) to express relative muscle load during the day. Cardiovascular load was measured with electrocardiography and calculated as the average percentage of the heart rate reserve capacity (((heart rate during work - resting heart rate) / (maximum heart rate - resting heart rate)) * 100) during the day. Using linear regression, significant but weak associations (β < 0.23) were observed between perceived exertion and (1) high muscle activity (>60% of MVC) of the neck muscles and (2) inactivity (<1% of MVC) of the thigh muscles and (3) cardiovascular load, respectively. Using logistic regression, perceived exertion ≥4 (high exertion), referencing <4 (low-to-moderate exertion), was related to high activity of the trapezius muscle [OR 18 (95% CI 2-143)], i.e., the odds for experiencing high exertion during work increased 18-fold for each percentage increase in time above 60% MVC. During a full working day among blue-collar workers with lifting tasks, high neck muscle activity increases the odds for experiencing high perceived physical exertion. Perceived exertion of at least 4 on the BORG CR10 scale appears to be a good indicator that high muscular loading occurs.

The efficacy of novel anatomical sites for the assessment of muscle oxygenation during central hypovolemia.

PubMed

Sprick, Justin D; Soller, Babs R; Rickards, Caroline A

2016-11-01

Muscle tissue oxygenation (SmO 2 ) can track central blood volume loss associated with hemorrhage. Traditional peripheral measurement sites (e.g., forearm) may not be practical due to excessive movement or injury (e.g., amputation). The aim of this study was to evaluate the efficacy of three novel anatomical sites for the assessment of SmO 2 under progressive central hypovolemia. 10 male volunteers were exposed to stepwise prone lower body negative pressure to decrease central blood volume, while SmO 2 was assessed at four sites-the traditional site of the flexor carpi ulnaris (ARM), and three novel sites not previously investigated during lower body negative pressure, the deltoid, latissimus dorsi, and trapezius. SmO 2 at the novel sites was compared to the ARM sensor and to stroke volume responses. A reduction in SmO 2 was detected by the ARM sensor at the first level of lower body negative pressure (-15 mmHg; P = 0.007), and at -30 (the deltoid), -45 (latissimus dorsi), and -60 mmHg lower body negative pressure (trapezius) at the novel sites (P ≤ 0.04). SmO 2 responses at all novel sites were correlated with responses at the ARM (R ≥ 0.89), and tracked the reduction in stroke volume (R ≥ 0.87); the latissimus dorsi site exhibited the strongest linear correlations (R ≥ 0.96). Of the novel sensor sites, the latissimus dorsi exhibited the strongest linear associations with SmO 2 at the ARM, and with reductions in central blood volume. These findings have important implications for detection of hemorrhage in austere environments (e.g., combat) when use of a peripheral sensor may not be ideal, and may facilitate incorporation of these sensors into uniforms. © 2016 by the Society for Experimental Biology and Medicine.

Sex, stress and sleep apnoea: Decreased susceptibility to upper airway muscle dysfunction following intermittent hypoxia in females.

PubMed

O'Halloran, Ken D; Lewis, Philip; McDonald, Fiona

2017-11-01

Obstructive sleep apnoea syndrome (OSAS) is a devastating respiratory control disorder more common in men than women. The reasons for the sex difference in prevalence are multifactorial, but are partly attributable to protective effects of oestrogen. Indeed, OSAS prevalence increases in post-menopausal women. OSAS is characterized by repeated occlusions of the pharyngeal airway during sleep. Dysfunction of the upper airway muscles controlling airway calibre and collapsibility is implicated in the pathophysiology of OSAS, and sex differences in the neuro-mechanical control of upper airway patency are described. It is widely recognized that chronic intermittent hypoxia (CIH), a cardinal feature of OSAS due to recurrent apnoea, drives many of the morbid consequences characteristic of the disorder. In rodents, exposure to CIH-related redox stress causes upper airway muscle weakness and fatigue, associated with mitochondrial dysfunction. Of interest, in adults, there is female resilience to CIH-induced muscle dysfunction. Conversely, exposure to CIH in early life, results in upper airway muscle weakness equivalent between the two sexes at 3 and 6 weeks of age. Ovariectomy exacerbates the deleterious effects of exposure to CIH in adult female upper airway muscle, an effect partially restored by oestrogen replacement therapy. Intriguingly, female advantage intrinsic to upper airway muscle exists with evidence of substantially greater loss of performance in male muscle during acute exposure to severe hypoxic stress. Sex differences in upper airway muscle physiology may have relevance to human OSAS. The oestrogen-oestrogen receptor α axis represents a potential therapeutic target in OSAS, particularly in post-menopausal women. Copyright © 2016 Elsevier B.V. All rights reserved.

Pushup Performance by Women: Analysis of Modes of Failure.

DTIC Science & Technology

1995-08-15

without prefatigue, the following sessions prefatigued the trapezius, latissimus dorsi , deltoid, pectorals, biceps, triceps, and abdominals. Studied 25...0-29), biceps mean 17 pushups (8-29), latissimus dorsi mean 17 pushups (9-31), and the trapezius mean 19 pushups (6-32). Prefatiguing of the

Relationship of active trigger points with related disability and anxiety in people with tension-type headache

PubMed Central

Palacios-Ceña, María; Castaldo, Matteo; Wang, Kelun; Catena, Antonella; Torelli, Paola; Arendt-Nielsen, Lars; Fernández-de-las-Peñas, César

2017-01-01

Abstract To investigate the differences in the presence of trigger points (TrPs) and their association with headache-related disability and mood disorders in people with frequent episodic tension-type headache (TTH) (FETTH) and chronic TTH (CTTH). One hundred twenty-two individuals with TTH participated. Clinical features of headache (i.e., intensity, duration, and frequency) were recorded on a headache diary. Headache-related disability was assessed with the Headache Disability Inventory, trait and state anxiety levels with State-Trait Anxiety Inventory, and depression with the Hospital Anxiety and Depression Scale. TrPs were bilaterally explored in the temporalis, masseter, suboccipital, upper trapezius, splenius capitis, and sternocleidomastoid muscles. Sixty-two (51%) patients were classified as FETTH, whereas 60 (49%) were classified as CTTH. Individuals with CTTH showed higher burden of headache and depression than FETTH (P < 0.001). Subjects with FETTH showed similar number of TrPs (total number: 5.9 ± 3.1, active TrPs: 4.7 ± 2.5, and latent TrPs: 1.2 ± 1.9) than those with CTTH (total number: 5.7 ± 3.2, active TrPs: 4.2 ± 3.0, and latent TrPs: 1.5 ± 1.8). The number of active TrPs was significantly associated with the burden of headache (r = 0.189; P = 0.037) and trait anxiety (r = 0.273; P = 0.005): the higher the number of active TrPs, the greater the physical burden of headache or the more the trait anxiety level. No association with the depression was observed. The presence of active TrPs in head and neck/shoulder muscles was similar between individuals with FETTH and CTTH and associated with the physical burden of headache and trait anxiety levels independently of the subgroup of TTH. PMID:28353618

Do Subjects with Whiplash-Associated Disorders Respond Differently in the Short-Term to Manual Therapy and Exercise than Those with Mechanical Neck Pain?

PubMed

Castaldo, Matteo; Catena, Antonella; Chiarotto, Alessandro; Fernández-de-Las-Peñas, César; Arendt-Nielsen, Lars

2017-04-01

To compare the short-term effects of manual therapy and exercise on pain, related disability, range of motion, and pressure pain thresholds between subjects with mechanical neck pain and whiplash-associated disorders. Twenty-two subjects with mechanical neck pain and 28 with whiplash-associated disorders participated. Clinical and physical outcomes including neck pain intensity, neck-related disability, and pain area, as well as cervical range of motion and pressure pain thresholds over the upper trapezius and tibialis anterior muscles, were obtained at baseline and after the intervention by a blinded assessor. Each subject received six sessions of manual therapy and specific neck exercises. Mixed-model repeated measures analyses of covariance (ANCOVAs) were used for the analyses. Subjects with whiplash-associated disorders exhibited higher neck-related disability ( P  = 0.021), larger pain area ( P  = 0.003), and lower pressure pain thresholds in the tibialis anterior muscle ( P  = 0.009) than those with mechanical neck pain. The adjusted ANCOVA revealed no between-group differences for any outcome (all P  > 0.15). A significant main effect of time was demonstrated for clinical outcomes and cervical range of motion with both groups experiencing similar improvements (all P  < 0.01). No changes in pressure pain thresholds were observed in either group after treatment ( P  > 0.222). The current clinical trial found that subjects with mechanical neck pain and whiplash-associated disorders exhibited similar clinical and neurophysiological responses after a multimodal physical therapy intervention, suggesting that although greater signs of central sensitization are present in subjects with whiplash-associated disorders, this does not alter the response in the short term to manual therapy and exercises. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The relationship between latent trigger points and depression levels in healthy subjects.

PubMed

Celik, Derya; Kaya Mutlu, Ebru

2012-06-01

Our purpose was to study the relationship between latent trigger points (LTrP) and levels of depression in healthy subjects. A total of 76 healthy subjects consisting of 40 men and 36 women (mean age, 25.4 ± 4.8 years; age range, 19-42 years) from the School of Physical Therapy and Rehabilitation and the Orthopaedics and Traumatology Department of Istanbul University Medical Faculty were selected for the study. Latent trigger points on the scapular muscles of each subject were evaluated. The upper and middle trapezius, supraspinatus, serratus anterior, and rhomboideus muscles were examined respectively, by palpation with the thumb, to determine whether there was pain. The first group consisted of 30 subjects (20 men and 10 women; mean age, 24.2 ± 5.02 years) who had previously been diagnosed as negative after an LTrP examination (control group), while the second group consisted of 28 subjects (12 men and 16 women; mean age, 23.6 ± 2.24 years) who had been diagnosed with at least five LTrPs. The third group consisted of 18 subjects (8 men and 10 women; mean age, 26. 9 ± 7.23 years) who had been diagnosed with more than five LTrPs. All groups were assessed, using the Beck Depression Inventory (BDI). The mean BDI value was found to be 8.0 ± 4.2 in the first group, 10.3 ± 3.4 in the second, and 28.5 ± 4.8 in the third. A significant difference was found between the mean BDI values of the first and second groups and also between the first and third groups. The mean BDI values of the second and third groups were also found to be statistically significant (p = 0.042). We observed a close relationship between the presence of LTrPs and depression levels in healthy people.

Effect of specialized task training of each hemisphere on interlimb transfer in individuals with hemiparesis.

PubMed

Yoo, In-gyu; Jung, Min-ye; Yoo, Eun-young; Park, Soo-hyun; Park, Ji-hyuk; Lee, Jin; Kim, Han-sol

2013-01-01

Therapeutic concept of interlimb transfer provides very important information relevant to patients with stroke because it can be applied to help these patients recover movement skills disrupted following unilateral damage to the brain. The purpose of this study was to determine the transfer effects for both specialized training in each hemisphere and reversed training of a specialized task. Twenty patients (ten women and ten men) with stroke and hemiparesis participated. All participants were in Brunnstrom recovery stage five or higher for arm and hand function and had Mini-Mental State Examination scores ≥25. We used a training task involving a modified static cone, modified box and block, and modified pegboard tasks. The specified-training group performed the reaching movements (based on grip, reach, and release movements) in a modified training setting in which left-handed participants began from a single starting location and proceeded to one of three target locations (1S3T condition), and the right-handed participants started form one of three starting locations and proceeded to a single target location (3S1T condition). The unspecified training group performed these movements starting under reverse-start and target conditions. As a result of the left-to-right limb transfer in the specified-training group differed significantly in duration from that in the pre-training group. Also, the biceps brachii and triceps (lateral head) muscles were significantly more active after performing the specified training than before. On the other hand, the activity of the upper trapezius muscle did not significantly differ after specified training compared with before training. Consequently, a symmetric transfer advantage was observed that depended on the characteristic resources of each hemisphere. The transfer of specified training from one arm to the other had a more positive influence on functional recovery than did unspecified training for patients with stroke and hemiparesis.

Effectiveness of home exercise on pain, function, and strength of manual wheelchair users with spinal cord injury: a high-dose shoulder program with telerehabilitation.

PubMed

Van Straaten, Meegan G; Cloud, Beth A; Morrow, Melissa M; Ludewig, Paula M; Zhao, Kristin D

2014-10-01

To test the effectiveness of a high-dose home exercise/telerehabilitation program for manual wheelchair users who have a spinal cord injury (SCI) by determining whether the intervention would reduce pain and increase function, as we hypothesized. A pre-post trial with outcomes measured at 3 time points: baseline, postintervention (12wk), and follow-up (>24 wk). Subjects performed an exercise program at their homes using telerehabilitation for therapist monitoring of technique and exercise advancement. Baseline and postintervention data were collected at a motion analysis laboratory in a tertiary medical center. A convenience sample of manual wheelchair users (N=16, 3 women; average age, 41y; average time in a wheelchair, 16y) with shoulder pain (average pain duration, 9y) and mechanical impingement signs on physical examination. A 12-week home exercise program of rotator cuff and scapular stabilization exercises was given to each participant. The program included a high dose of 3 sets of 30 repetitions, 3 times weekly, and regular physical therapist supervision via videoconferencing. Primary outcomes of pain and function were measured with the Wheelchair User's Shoulder Pain Index (WUSPI), Disabilities of Arm, Shoulder, and Hand (DASH) Index, and Shoulder Rating Questionnaire (SRQ). Secondary outcomes of strength were measured with isometric strength tests of scapulothoracic and glenohumeral muscles, and a static fatigue test of the lower trapezius. Pain was reduced and function improved after the intervention. There was a significant main effect for pain and function between the 3 time points based on the Friedman signed-ranked test, WUSPI (χ(2)2=5.10, P=.014), DASH Index (χ(2)2=5.41, P=.012), and SRQ (χ(2)2=23.71, P≤.001). Wilcoxon signed-rank tests demonstrated that isometric strength measurements of the serratus anterior and scapular retractors increased after the exercise intervention ([t=2.42, P=.04] and [t=4.67, P=.003], respectively). Muscle impulse produced by the lower trapezius during a fatigue task also improved (t=2.2, P=.02). No differences were measured in isometric strength for the lower trapezius, glenohumeral rotators, and abductors between the baseline and 12-week time points. A high-dose scapular stabilizer and rotator cuff strengthening program using telerehabilitation for supervision holds promise for shoulder pain treatment in manual wheelchair users with SCI. Additional work is needed to determine the effectiveness compared with other interventions, as well as the potential for earlier intervention to prevent development of shoulder pain. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The effects of smart phone gaming duration on muscle activation and spinal posture: Pilot study.

PubMed

Park, Joo-Hee; Kang, Sun-Young; Lee, Sa-Gyeom; Jeon, Hye-Seon

2017-08-01

This study investigates changes in the posture angles of the neck and trunk, together with changes in the muscle activation of users, at the start of and at 5, 10, and 15 minutes of smartphone use. Eighteen males participated in this study. Surface electromyography (EMG) and a digital camera were used to measure the muscle activation and angular changes of the neck and trunk of participants during smartphone use for a period of 16 minutes. Neck and trunk flexion significantly increased at 5, 10, and 15 minutes (p < 0.05) in comparison with the neck and trunk flexion of participants at the start of smartphone usage. The EMG activation and 10th%amplitude probability distribution function (APDF) values of the bilateral cervical erector spinae at 5-6, 10-11, and 15-16 minutes of usage (p < 0.05) were also significantly greater than at the start of usage. The EMG activation of the bilateral thoracic erector spinae and lower trapezius was significantly decreased at 5-6, 10-11, and 15-16 minutes of usage (p < 0.05). Smartphone use induced more flexed posture on the neck and trunk than other visual display terminal (VDT) work. Smartphone use also changed posture and muscle activation within a relatively short amount of time, just 5 minutes. Pain after 16 minutes of smartphone use was also observed. Thus, clinicians should consider the influences of smartphone use in posture and muscle activity in evaluation, intervention, and prevention of neck and trunk conditions.

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma

PubMed Central

Waddell, Roger K.

2005-01-01

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia. PMID:19674642

Characteristics of power spectrum density function of EMG during muscle contraction below 30%MVC.

PubMed

Roman-Liu, Danuta; Konarska, Maria

2009-10-01

The aim of the study was to quantify changes in PSDF frequency bands of the EMG signal and EMG parameters such as MF, MPF and zero crossing, with an increase in the level of muscle contractions in the range from 0.5% to 30% RMS(max) and to determine the frequency bands with the lowest dependency on RMS level so that this could be used in investigating muscle fatigue. Sixteen men, aged from 23 to 33 years old (mean 26.1), who participated in the study performed two force exertion tests. Fragments of EMG which corresponded to the levels of muscle contraction of 0.5%, 1%, 2.5%, 5%, 10%, 15%, 20%, 25%, 30% RMS(max) registered from left and right trapezius pars descendents (TP) and left and right extensor digitorum superficialis (ED) muscles were selected for analysis. The analysis included changes in standard parameters of the EMG signal and changes in PSDF frequency bands, which occurred across muscle contraction levels. To analyze changes in PSDF across the level of muscle contraction, the spectrum was divided into six frequency bandwidths. The analysis of parameters focused on the differences in those parameters between the analyzed muscles, at different levels of muscle contraction. The study revealed that, at muscle contraction levels below 5% RMSmax, contraction level influences standard parameters of the EMG signal and that at such levels of muscle contraction every change in muscle contraction level (recruitment of additional MUs) is reflected in PSDF. The frequency band with the lowest dependency on contraction level was 76-140 Hz for which in both muscles no contraction level effect was detected for contraction levels above 5% RMS(max). The reproducibility of the results was very high, since the observations in of the left and right muscles were almost equal. The other factor, which strongly influences PSDF of the EMG signal, is probably the examined muscle structure (muscle morphology, size, function, subcutaneous layer, cross talk). It seems that low frequency bands up to 25 Hz are especially feasible for type of muscle.

Use of the Teager-Kaiser Energy Operator for Muscle Activity Detection in Children

PubMed Central

Lauer, Richard T.; Prosser, Laura A.

2009-01-01

The purpose of this study was to demonstrate the usefulness of the Teager-Kaiser Energy (TKE) operator to assess surface electromyographic (sEMG) activity from the hip and trunk muscles during pediatric gait in children with and without cerebral palsy (CP). Muscle activity was recorded from the trapezius, erector spinae, rectus abdominus, external oblique, gluteus maximus and medius, rectus femoris, and semitendinosus bilaterally in ten children with typical development (TD) and five children with CP ages 44.4 ± 18.6 months. Duration of muscle activity was calculated as a percentage of the gait cycle, and compared to two common onset detection methods, a standard deviation (SD) amplitude threshold method, and the visual inspection from two raters (R1, R2). Relative and absolute agreement was determined using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Of the two automated methods, the TKE method demonstrated better agreement with visual inspection (0.45–0.89) than the SD (0.11–0.76) method. The Bland-Altman plots indicated a smaller bias and 95% confidence interval for the TKE method in comparison to the raters (TKE to R1: −5, 113%; TKE to R2: 4, 95%; SD to R1: −24, 170%; SD to R2: −15, 151%). The use of the TKE operator may better detect sEMG activity in children than the standard amplitude method. PMID:19484385

Cadaveric and Ultrasonographic Validation of Needling Placement in the Cervical Multifidus Muscle.

PubMed

Fernández-de-Las-Peñas, César; Mesa-Jiménez, Juan A; Paredes-Mancilla, Jose A; Koppenhaver, Shane L; Fernández-Carnero, Samuel

2017-06-01

The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years) with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in length inserted perpendicular to the skin about 1 cm lateral to the spinous process at C3-C4. The needle was advanced from a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed transversely over C3-C4 after the insertion of the needle into the muscle. The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby guarding the sensitive underlying spinal structures from damage. This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus could be conducted clinically. Copyright © 2017. Published by Elsevier Inc.

Neural Control of the Upper Airway: Respiratory and State-Dependent Mechanisms

PubMed Central

Kubin, Leszek

2017-01-01

Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA). Although OSA is almost exclusively a human disorder, animal models help unveil the basic principles governing the impact of sleep on breathing and upper airway muscle activity. This article discusses the neuroanatomy, neurochemistry, and neurophysiology of the different neuronal systems whose activity changes with sleep-wake states, such as the noradrenergic, serotonergic, cholinergic, orexinergic, histaminergic, GABAergic and glycinergic, and their impact on central respiratory neurons and upper airway motoneurons. Observations of the interactions between sleep-wake states and upper airway muscles in healthy humans and OSA patients are related to findings from animal models with normal upper airway, and various animal models of OSA, including the chronic-intermittent hypoxia model. Using a framework of upper airway motoneurons being under concurrent influence of central respiratory, reflex and state-dependent inputs, different neurotransmitters, and neuropeptides are considered as either causing a sleep-dependent withdrawal of excitation from motoneurons or mediating an active, sleep-related inhibition of motoneurons. Information about the neurochemistry of state-dependent control of upper airway muscles accumulated to date reveals fundamental principles and may help understand and treat OSA. PMID:27783860

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

PubMed Central

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

2015-01-01

Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice. PMID:26495971

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.

The development of the cucullaris muscle and the branchial musculature in the Longnose Gar, (Lepisosteus osseus, Lepisosteiformes, Actinopterygii) and its implications for the evolution and development of the head/trunk interface in vertebrates.

PubMed

Naumann, Benjamin; Warth, Peter; Olsson, Lennart; Konstantinidis, Peter

2017-11-01

The vertebrate head/trunk interface is the region of the body where the different developmental programs of the head and trunk come in contact. Many anatomical structures that develop in this transition zone differ from similar structures in the head or the trunk. This is best exemplified by the cucullaris/trapezius muscle, spanning the head/trunk interface by connecting the head to the pectoral girdle. The source of this muscle has been claimed to be either the unsegmented head mesoderm or the somites of the trunk. However most recent data on the development of the cucullaris muscle are derived from tetrapods and information from actinopterygian taxa is scarce. We used classical histology in combination with fluorescent whole-mount antibody staining and micro-computed tomography to investigate the developmental pattern of the cucullaris and the branchial muscles in a basal actinopterygian, the Longnose gar (Lepisosteus osseus). Our results show (1) that the cucullaris has been misidentified in earlier studies on its development in Lepisosteus. (2) Cucullaris development is delayed compared to other head and trunk muscles. (3) This developmental pattern of the cucullaris is similar to that reported from some tetrapod taxa. (4) That the retractor dorsalis muscle of L. osseus shows a delayed developmental pattern similar to the cucullaris. Our data are in agreement with an explanatory scenario for the cucullaris development in tetrapods, suggesting that these mechanisms are conserved throughout the Osteichthyes. Furthermore the developmental pattern of the retractor dorsalis, also spanning the head/trunk interface, seems to be controlled by similar mechanisms. © 2017 Wiley Periodicals, Inc.

Repeatability of Computerized Tomography-Based Anthropomorphic Measurements of Frailty in Patients With Pulmonary Fibrosis Undergoing Lung Transplantation.

PubMed

McClellan, Taylor; Allen, Brian C; Kappus, Matthew; Bhatti, Lubna; Dafalla, Randa A; Snyder, Laurie D; Bashir, Mustafa R

To determine interreader and intrareader repeatability and correlations among measurements of computerized tomography-based anthropomorphic measurements in patients with pulmonary fibrosis undergoing lung transplantation. This was an institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study of 23 randomly selected subjects (19 male and 4 female; median age = 69 years; range: 66-77 years) with idiopathic pulmonary fibrosis undergoing pulmonary transplantation, who had also undergone preoperative thoracoabdominal computerized tomography. Five readers of varying imaging experience independently performed the following cross-sectional area measurements at the inferior endplate of the L3 vertebral body: right and left psoas muscles, right and left paraspinal muscles, total abdominal musculature, and visceral and subcutaneous fat. The following measurements were obtained at the inferior endplate of T6: right and left paraspinal muscles with and without including the trapezius muscles and subcutaneous fat. Three readers repeated all measurements to assess intrareader repeatability. Intrareader repeatability was nearly perfect (interclass correlation coefficients = 0.99, P < 0.001). Interreader agreement was excellent across all 5 readers (interclass correlation coefficients: 0.71-0.99, P < 0.001). Coefficients of variance between measures ranged from 3.2%-6.8% for abdominal measurements, but were higher for thoracic measurements, up to 23.9%. Correlation between total paraspinal and total psoas muscle area was strong (r 2 = 0.67, P < 0.001). Thoracic and abdominal musculature had a weaker correlation (r 2 = 0.35-0.38, P < 0.001). Measures of thoracic and abdominal muscle and fat area are highly repeatable in patients with pulmonary fibrosis undergoing lung transplantation. Measures of muscle area are strongly correlated among abdominal locations, but inversely correlated between abdominal and thoracic locations. Copyright © 2017 Elsevier Inc. All rights reserved.

Characterization of Strength and Function in Ambulatory Adults With GNE Myopathy.

PubMed

Argov, Zohar; Bronstein, Faye; Esposito, Alicia; Feinsod-Meiri, Yael; Florence, Julaine M; Fowler, Eileen; Greenberg, Marcia B; Malkus, Elizabeth C; Rebibo, Odelia; Siener, Catherine S; Caraco, Yoseph; Kolodny, Edwin H; Lau, Heather A; Pestronk, Alan; Shieh, Perry; Skrinar, Alison M; Mayhew, Jill E

2017-09-01

To characterize the pattern and extent of muscle weakness and impact on physical functioning in adults with GNEM. Strength and function were assessed in GNEM subjects (n = 47) using hand-held dynamometry, manual muscle testing, upper and lower extremity functional capacity tests, and the GNEM-Functional Activity Scale (GNEM-FAS). Profound upper and lower muscle weakness was measured using hand-held dynamometry in a characteristic pattern, previously described. Functional tests and clinician-reported outcomes demonstrated the consequence of muscle weakness on physical functioning. The characteristic pattern of upper and lower muscle weakness associated with GNEM and the resulting functional limitations can be reliably measured using these clinical outcome assessments of muscle strength and function.

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

Ultrasonographic measurements of lower trapezius muscle thickness at rest and during isometric contraction: a reliability study.

PubMed

Talbott, Nancy R; Witt, Dexter W

2014-07-01

The purpose of this study was to determine the intra-rater reliability and inter-rater reliability of ultrasound imaging (USI) thickness measurements of the lower trapezius (LT) at rest and during active contractions when the transverse process and the lamina were used as reference sites for the measurement process. Twenty healthy individuals between the ages of 22 and 32 years volunteered. With the subject prone and the shoulder in 145° of abduction, images of the LT were taken bilaterally by one examiner as the subject: (1) rested; (2) actively held the test position; and (3) actively held the test position while holding a weight. Ten subjects returned and testing was repeated by the same examiner and by a second examiner. LT thickness measurements were recorded at the level of the transverse process and at the level of the lamina. Intra-class correlation coefficients (ICC) for within session intra-rater reliability (ICC3,3) ranged from 0.951 to 0.986 for both measurement sites while between session intra-rater reliability (ICC3,2) ranged from 0.935 to 0.962. Within session inter-rater reliability (ICC2,2) ranged from 0.934 to 0.973. USI can be used to reliably measure LT thickness at rest, during active contraction and during active contraction when holding a weight. The described protocol can be utilized during shoulder examinations to provide an additional assessment tool for monitoring changes in LT thickness.

Smile analysis in rhinoplasty: a randomized study for comparing resection and transposition of the depressor septi nasi muscle.

PubMed

Kalantar-Hormozi, Abdoljalil; Beiraghi-Toosi, Arash

2014-02-01

The depressor septi nasi muscle is responsible for smiling deformity. Its manipulation is beneficial in patients with muscle hypertrophy. In addition, it enhances the smile and tip-lip relationship. In this study, depressor septi nasi muscle excision through a transfixion incision is compared with its transposition through an upper labial sulcus incision. Two techniques of depressor septi nasi muscle treatment were performed randomly for rhinoplasty cases. Smile analysis in rhinoplasty, consisting of measurements of nasal length, nasal diagonal, tip projection, and upper lip height, and noting transverse upper labial crease in repose and full smile, was performed on preoperative and postoperative photographs. One hundred patients were studied in two equal groups. Preoperatively, tip projection and upper lip height were decreased significantly with smiling. Generally, the effect of smiling on all five parameters was decreased significantly following rhinoplasty. The two different techniques were not significantly different in decreasing the effects of smiling on nasal length, nasal diagonal, tip projection, upper lip height, or transverse crease. The two different techniques were the same in decreasing the effects of smiling. The authors recommend smile analysis in rhinoplasty, consisting of measurement of nasal length, nasal diagonal, tip projection, and upper lip height, and noting transverse upper labial crease in repose and during smiling, before rhinoplasty for preoperative evaluation and after the operation for outcome assessment. Depressor septi nasi muscle treatment should be considered if a decrease in tip projection or upper lip height with smiling or a transverse upper labial crease during smiling is extraordinary or unsightly. Therapeutic, II.

Reflection of the State of Hunger in Impulse Activity of Nose Wing Muscles and Upper Esophageal Sphincter during Search behavior in Rabbits.

PubMed

Kromin, A A; Dvoenko, E E; Zenina, O Yu

2016-07-01

Reflection of the state of hunger in impulse activity of nose wing muscles and upper esophageal sphincter muscles was studied in chronic experiments on rabbits subjected to 24-h food deprivation in the absence of locomotion and during search behavior. In the absence of apparent behavioral activity, including sniffing, alai nasi muscles of hungry rabbits constantly generated bursts of action potentials synchronous with breathing, while upper esophageal sphincter muscles exhibited regular aperiodic low-amplitude impulse activity of tonic type. Latent form of food motivation was reflected in the structure of temporal organization of impulse activity of alai nasi muscles in the form of bimodal distribution of interpulse intervals and in temporal structure of impulse activity of upper esophageal sphincter muscles in the form of monomodal distribution. The latent form of food motivation was manifested in the structure of temporal organization of periods of the action potentials burst-like rhythm, generated by alai nasi muscles, in the form of monomodal distribution, characterized by a high degree of dispersion of respiratory cycle periods. In the absence of physical activity hungry animals sporadically exhibited sniffing activity, manifested in the change from the burst-like impulse activity of alai nasi muscles to the single-burst activity type with bimodal distribution of interpulse intervals and monomodal distribution of the burst-like action potentials rhythm periods, the maximum of which was shifted towards lower values, which was the cause of increased respiratory rate. At the same time, the monomodal temporal structure of impulse activity of the upper esophageal sphincter muscles was not changed. With increasing food motivation in the process of search behavior temporal structure of periods of the burst-like action potentials rhythm, generated by alai nasi muscles, became similar to that observed during sniffing, not accompanied by animal's locomotion, which is typical for the increased respiratory rhythm frequency. Increased hunger motivation was reflected in the temporal structure of impulse activity of upper esophageal sphincter muscles in the form of a shift to lower values of the maximum of monomodal distribution of interpulse intervals on the histogram, resulting in higher impulse activity frequency. The simultaneous increase in the frequency of action potentials bursts generation by alai nasi muscles and regular impulse activity of upper esophageal sphincter muscles is a reliable criterion for enhanced food motivation during search behavior in rabbits.

Gender differences in workers with identical repetitive industrial tasks: exposure and musculoskeletal disorders.

PubMed

Nordander, Catarina; Ohlsson, Kerstina; Balogh, Istvan; Hansson, Gert-Ake; Axmon, Anna; Persson, Roger; Skerfving, Staffan

2008-08-01

For unknown reasons, females run a higher risk than males of work-related musculoskeletal disorders. The aim of this study was to evaluate whether male and female workers, with identical repetitive work tasks, differ concerning risk of disorders, physical or psychosocial exposures. Employees in two industries were studied; one rubber manufacturing and one mechanical assembly plant. These industries were selected since in both, large groups of males and females worked side by side performing identical repetitive work tasks. Physical exposure was measured by technical equipment. Postures and movements were registered by inclinometry for the head and upper arms, and by electrogoniometry for the wrists. Muscular activity (muscular rest and %max) was registered by surface electromyography for m. trapezius and the forearm extensors (18 males and 19 females). Psychosocial work environment was evaluated by the demand-control-support model (85 males and 138 females). Musculoskeletal disorders were assessed (105 males and 172 females), by interview (last 7-days complaints), and by physical examination (diagnoses). Concerning physical exposure, females showed higher muscular activity related to maximal voluntary contractions [(%MVE); m. trapezius: females 18 (SD 9.2), males 12 (SD 4.3); forearm extensors: females 39 (SD 11), males 27 (SD 10), right side, 90th percentile]. Working postures and movements were similar between genders. Also, concerning psychosocial work environment, no significant gender differences were found. Females had higher prevalences of disorders [complaints: age-adjusted prevalence odds ratio (POR) 2.3 (95% CI 1.3-3.8) for neck/shoulders, 2.4 (1.4-4.0) for elbows/hands; diagnoses: neck/shoulder 1.9 (1.1-3.6), elbows/hands 4.1 (1.2-9.3)]. In 225 workers, PORs were adjusted for household work, personal recovery and exercise, which only slightly affected the risk estimates. In identical work tasks, females showed substantially higher muscular activity in relation to capacity, and higher prevalence of musculoskeletal disorders of the neck and upper extremity, than did males.

Characterization of Strength and Function in Ambulatory Adults With GNE Myopathy

PubMed Central

Argov, Zohar; Bronstein, Faye; Esposito, Alicia; Feinsod-Meiri, Yael; Florence, Julaine M.; Fowler, Eileen; Greenberg, Marcia B.; Malkus, Elizabeth C.; Rebibo, Odelia; Siener, Catherine S.; Caraco, Yoseph; Kolodny, Edwin H.; Lau, Heather A.; Pestronk, Alan; Shieh, Perry; Mayhew, Jill E.

2017-01-01

Abstract Objective: To characterize the pattern and extent of muscle weakness and impact on physical functioning in adults with GNEM. Methods: Strength and function were assessed in GNEM subjects (n = 47) using hand-held dynamometry, manual muscle testing, upper and lower extremity functional capacity tests, and the GNEM-Functional Activity Scale (GNEM-FAS). Results: Profound upper and lower muscle weakness was measured using hand-held dynamometry in a characteristic pattern, previously described. Functional tests and clinician-reported outcomes demonstrated the consequence of muscle weakness on physical functioning. Conclusions: The characteristic pattern of upper and lower muscle weakness associated with GNEM and the resulting functional limitations can be reliably measured using these clinical outcome assessments of muscle strength and function. PMID:28827485

Two- and three-dimensional ultrasound imaging to facilitate detection and targeting of taut bands in myofascial pain syndrome.

PubMed

Shankar, Hariharan; Reddy, Sapna

2012-07-01

Ultrasound imaging has gained acceptance in pain management interventions. Features of myofascial pain syndrome have been explored using ultrasound imaging and elastography. There is a paucity of reports showing the benefit clinically. This report provides three-dimensional features of taut bands and highlights the advantages of using two-dimensional ultrasound imaging to improve targeting of taut bands in deeper locations. Fifty-eight-year-old man with pain and decreased range of motion of the right shoulder was referred for further management of pain above the scapula after having failed conservative management for myofascial pain syndrome. Three-dimensional ultrasound images provided evidence of aberrancy in the architecture of the muscle fascicles around the taut bands compared to the adjacent normal muscle tissue during serial sectioning of the accrued image. On two-dimensional ultrasound imaging over the palpated taut band, areas of hyperechogenicity were visualized in the trapezius and supraspinatus muscles. Subsequently, the patient received ultrasound-guided real-time lidocaine injections to the trigger points with successful resolution of symptoms. This is a successful demonstration of utility of ultrasound imaging of taut bands in the management of myofascial pain syndrome. Utility of this imaging modality in myofascial pain syndrome requires further clinical validation. Wiley Periodicals, Inc.

Neural Network Approaches to the Processing of Experimental Electro-Myographic Data from Non-Invasive Sensors

DTIC Science & Technology

2003-07-01

14 PWFI Superior Pectoralis Distal Bicep Medial Trapezius Proximal Wrist Flexors 2 IPec 10 PTri 7 LTrp 15 DWF1 Inferior Pectoralis Proximal Tricep...Lateral Trapezius Distal Wrist Flexors 3 LPec 11 DTri 8 PBic 16 APB Lateral Pectoralis Distal Tricep Proximal Bicep Abductor Pollicus Brevis 4 LDel 12

Reliable harvest of a dorsal scapular artery perforator flap by augmenting its perfusion.

PubMed

Kim, So-Young; Lee, Kyeong-Tae; Mun, Goo-Hyun

2016-02-01

Despite confirmation of a reliable perforasome in the dorsal scapular artery in an anatomic study, a true perforator flap has not been recommended in previous clinical studies because of concerns regarding insufficient perfusion in the distal region. In this report, we present two cases of reconstruction for occipital defects caused by tumor extirpation using pedicled dorsal scapular artery perforator flaps without a muscle component. To secure the perfusion of the dorsal scapular artery perforator flap, inclusion of an additional perforator was attempted for perfusion augmentation. The second dorsal scapular artery perforator was harvested in one case. In an additional case, the sixth dorsal intercostal artery perforator with a branch that directly connected with the dorsal scapular artery within the trapezius muscle was additionally harvested. The flaps survived without any perfusion-related complications, including tip necrosis, and no donor site morbidities were observed. We suggest that a perfusion augmented dorsal scapular artery perforator flap by harvesting multiple perforators could be a safe and useful alternative for reconstructive surgery of head and neck defects. © 2014 Wiley Periodicals, Inc.

Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.

PubMed

Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias

2013-04-01

Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible.

The Influence of Altering Push Force Effectiveness on Upper Extremity Demand during Wheelchair Propulsion

PubMed Central

Rankin, Jeffery W.; Kwarciak, Andrew M.; Richter, W. Mark; Neptune, Richard R.

2010-01-01

Manual wheelchair propulsion has been linked to a high incidence of overuse injury and pain in the upper extremity, which may be caused by the high load requirements and low mechanical efficiency of the task. Previous studies have suggested that poor mechanical efficiency may be due to a low effective handrim force (i.e. applied force that is not directed tangential to the handrim). As a result, studies attempting to reduce upper extremity demand have used various measures of force effectiveness (e.g. fraction effective force, FEF) as a guide for modifying propulsion technique, developing rehabilitation programs and configuring wheelchairs. However, the relationship between FEF and upper extremity demand is not well understood. The purpose of this study was to use forward dynamics simulations of wheelchair propulsion to determine the influence of FEF on upper extremity demand by quantifying individual muscle stress, work and handrim force contributions at different values of FEF. Simulations maximizing and minimizing FEF resulted in higher average muscle stresses (23% and 112%) and total muscle work (28% and 71%) compared to a nominal FEF simulation. The maximal FEF simulation also shifted muscle use from muscles crossing the elbow to those at the shoulder (e.g. rotator cuff muscles), placing greater demand on shoulder muscles during propulsion. The optimal FEF value appears to represent a balance between increasing push force effectiveness to increase mechanical efficiency and minimizing upper extremity demand. Thus, care should be taken in using force effectiveness as a metric to reduce upper extremity demand. PMID:20674921

Compensatory strategies during manual wheelchair propulsion in response to weakness in individual muscle groups: A simulation study.

PubMed

Slowik, Jonathan S; McNitt-Gray, Jill L; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R

2016-03-01

The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness using individual muscle mechanical power and stress as measures of upper extremity demand. The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users. Copyright © 2016 Elsevier Ltd. All rights reserved.

Compensatory Strategies during Manual Wheelchair Propulsion in Response to Weakness in Individual Muscle Groups: A Simulation Study

PubMed Central

Slowik, Jonathan S.; McNitt-Gray, Jill L.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

Background The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among the individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Methods Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness, using individual muscle mechanical power and stress as measures of upper extremity demand. Findings The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. Interpretation These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users. PMID:26945719

Upper Airway Collapsibility (Pcrit) and Pharyngeal Dilator Muscle Activity are Sleep Stage Dependent

PubMed Central

Carberry, Jayne C.; Jordan, Amy S.; White, David P.; Wellman, Andrew; Eckert, Danny J.

2016-01-01

Study Objectives: An anatomically narrow/highly collapsible upper airway is the main cause of obstructive sleep apnea (OSA). Upper airway muscle activity contributes to airway patency and, like apnea severity, can be sleep stage dependent. Conversely, existing data derived from a small number of participants suggest that upper airway collapsibility, measured by the passive pharyngeal critical closing pressure (Pcrit) technique, is not sleep stage dependent. This study aimed to determine the effect of sleep stage on Pcrit and upper airway muscle activity in a larger cohort than previously tested. Methods: Pcrit and/or muscle data were obtained from 72 adults aged 20–64 y with and without OSA.Pcrit was determined via transient reductions in continuous positive airway pressure (CPAP) during N2, slow wave sleep (SWS) and rapid eye movement (REM) sleep. Genioglossus and tensor palatini muscle activities were measured: (1) awake with and without CPAP, (2) during stable sleep on CPAP, and (3) in response to the CPAP reductions used to quantify Pcrit. Results: Pcrit was 4.9 ± 1.4 cmH2O higher (more collapsible) during REM versus SWS (P = 0.012), 2.3 ± 0.6 cmH2O higher during REM versus N2 (P < 0.001), and 1.6 ± 0.7 cmH2O higher in N2 versus SWS (P = 0.048). Muscle activity decreased from wakefulness to sleep and from SWS to N2 to REM sleep for genioglossus but not for tensor palatini. Pharyngeal muscle activity increased by ∼50% by breath 5 following CPAP reductions. Conclusions: Upper airway collapsibility measured via the Pcrit technique and genioglossus muscle activity vary with sleep stage. These findings should be taken into account when performing and interpreting “passive” Pcrit measurements. Citation: Carberry JC, Jordan AS, White DP, Wellman A, Eckert DJ. Upper airway collapsibility (Pcrit) and pharyngeal dilator muscle activity are sleep stage dependent. SLEEP 2016;39(3):511–521. PMID:26612386

The influence of wheelchair propulsion technique on upper extremity muscle demand: a simulation study.

PubMed

Rankin, Jeffery W; Kwarciak, Andrew M; Richter, W Mark; Neptune, Richard R

2012-11-01

The majority of manual wheelchair users will experience upper extremity injuries or pain, in part due to the high force requirements, repetitive motion and extreme joint postures associated with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reducing upper extremity demand during propulsion. However, studies often make comparisons between populations (e.g., able-bodied vs. paraplegic) or do not investigate specific measures of upper extremity demand. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to investigate how altering cadence, peak force and contact angle influence individual muscle demand. Forward dynamics simulations of wheelchair propulsion were generated to emulate group-averaged experimental data during four conditions: 1) self-selected propulsion technique, and while 2) minimizing cadence, 3) maximizing contact angle, and 4) minimizing peak force using biofeedback. Simulations were used to determine individual muscle mechanical power and stress as measures of muscle demand. Minimizing peak force and cadence had the lowest muscle power requirements. However, minimizing peak force increased cadence and recovery power, while minimizing cadence increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscle power requirements. Minimizing cadence appears to have the most potential for reducing muscle demand and fatigue, which could decrease upper extremity injuries and pain. However, altering any of these variables to extreme values appears to be less effective; instead small to moderate changes may better reduce overall muscle demand. Copyright © 2012 Elsevier Ltd. All rights reserved.

Atypical Initial Presentation of Painful Muscle Cramps in a Patient with Amyotrophic Lateral Sclerosis: A Case Report and Brief Review of the Literature.

PubMed

Kuzel, Aaron R; Lodhi, Muhammad Uzair; Syed, Intekhab Askari; Rahim, Mustafa

2017-11-10

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized clinically by progressive muscle weakness that can occur proximally or distally in either the upper or lower extremities. It includes both upper motor neuron signs (spasticity, hyperreflexia, clonus, and Babinski sign) and lower motor neuron signs (atrophy, weakness, and muscle fasciculation). Initial presentation of progressively painful muscle cramps should lead the physician to screen for other signs of amyotrophic lateral sclerosis. We report the case of a 51-year-old male, who presented with dull muscle cramps in the right upper shoulder and arm. After a careful history and physical exam, it was found that patient had both upper and lower motor neuron signs; therefore, a diagnosis of amyotrophic lateral sclerosis was made. Amyotrophic lateral sclerosis should strongly be considered in the differential diagnosis of patients presenting with an atypical initial presentation of progressively painful muscle cramps.

Novel Imaging Method of Continuous Shear Wave by Ultrasonic Color Flow Mapping

NASA Astrophysics Data System (ADS)

Yamakoshi, Yoshiki; Yamamoto, Atsushi; Yuminaka, Yasushi

Shear wave velocity measurement is a promising method in evaluation of tissue stiffness. Several methods have been developed to measure the shear wave velocity, however, it is difficult to obtain quantitative shear wave image in real-time by low cost system. In this paper, a novel shear wave imaging method for continuous shear wave is proposed. This method uses a color flow imaging which is used in ultrasonic imaging system to obtain shear wave's wavefront map. Two conditions, shear wave frequency condition and shear wave displacement amplitude condition, are required, however, these conditions are not severe restrictions in most applications. Using the proposed method, shear wave velocity of trapezius muscle is measured. The result is consistent with the velocity which is calculated from shear elastic modulus measured by ARFI method.

Occipital neuralgia: possible failure of surgical treatment - case report.

PubMed

Andrychowski, Jarosław; Czernicki, Zbigniew; Netczuk, Tomasz; Taraszewska, Anna; Dabrowski, Piotr; Rakasz, Lukasz; Budohoski, Karol

2009-01-01

Surgical intervention in severe cases of occipital neuralgia should be considered if pharmacological and local nerve blocking treatment fail. The literature suggests two types of interventions: surgical decompression of the greater occipital nerve (GON) from the entrapment site, as a less invasive approach, and neurotomy of the nerve trunk, which results in ipsilateral sensation deficits in the GON innervated area of the skull. Due to anatomical variations in the division of the GON trunk, typical neurotomy above the line of the trapezius muscle aponeurosis (TMA) may not result in full recovery. The present study discusses a case of a female treated with GON decompression as a result of occipital neuralgia unresponsive to pharmacotherapy, who thereafter was qualified for two consecutive neurotomies due to severe relapse of pain.

Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson's disease.

PubMed

He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

2015-12-01

Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson's disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during tremor in PD patients. 11 idiopathic, tremor dominant PD subjects participated in this study. Joint kinematics during tremor in the upper extremity was recorded along with EMGs of six upper arm muscles using a novel experimental apparatus. The apparatus provided support for the upper extremity on a horizontal surface with reduced friction, so that resting tremor in the arm can be recorded with a MotionMonitor II system. In each subject, the frequencies of rhythmic firings in upper arm muscles were determined using spectral analysis. Paired and pool-averaged coherence analyses of EMGs for the group of muscles were performed to correlate the level of inter-muscular synchronization to tremor amplitudes at shoulder and elbow. The phase shift between synchronized antagonistic muscle pairs was calculated to aid coherence analysis in the muscle pool. Recorded EMG revealed that rhythmic firings were present in most recorded muscles, which were either synchronized to form phase-locked bursting cycles at a subject specific frequency, or unsynchronized with a random phase distribution. Paired coherence showed a stronger synchronization among a subset of recorded arm muscles at tremor frequency than that at double tremor frequency. Furthermore, the number of synchronized muscles in the arm was positively correlated to tremor amplitudes at elbow and shoulder. Pool-averaged coherence at tremor frequency also showed a better correlation with the amplitude of resting tremor than that of double tremor frequency, indicating that the neuromechanical coupling in peripheral neuromuscular system was stronger at tremor frequency. Both paired and pool-averaged coherences are more consistent indexes to correlate to tremor intensity in a group of upper extremity muscles of PD patients. The central drive at tremor frequency contributes mainly to synchronize peripheral muscles in the modulation of tremor intensity.

Recovery of upper limb muscle function in chronic fatigue syndrome with and without fibromyalgia.

PubMed

Ickmans, Kelly; Meeus, Mira; De Kooning, Margot; Lambrecht, Luc; Nijs, Jo

2014-02-01

Chronic fatigue syndrome (CFS) patients frequently complain of muscle fatigue and abnormally slow recovery, especially of the upper limb muscles during and after activities of daily living. Furthermore, disease heterogeneity has not yet been studied in relation to recovery of muscle function in CFS. Here, we examine recovery of upper limb muscle function from a fatiguing exercise in CFS patients with (CFS+FM) and without (CFS-only) comorbid fibromyalgia and compare their results with a matched inactive control group. In this case-control study, 18 CFS-only patients, 30 CFS+FM patients and 30 healthy inactive controls performed a fatiguing upper limb exercise test with subsequent recovery measures. There was no significant difference among the three groups for maximal handgrip strength of the non-dominant hand. A significant worse recovery of upper limb muscle function was found in the CFS+FM, but not in de CFS-only group compared with the controls (P < 0·05). This study reveals, for the first time, delayed recovery of upper limb muscle function in CFS+FM, but not in CFS-only patients. The results underline that CFS is a heterogeneous disorder suggesting that reducing the heterogeneity of the disorder in future research is important to make progress towards a better understanding and uncovering of mechanisms regarding the nature of divers impairments in these patients. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Myoelectric Response of Back Muscles to Vertical Random Whole-Body Vibration with Different Magnitudes at Different Postures

NASA Astrophysics Data System (ADS)

BLÜTHNER, R.; SEIDEL, H.; HINZ, B.

2002-05-01

Back muscle forces contribute essentially to the whole-body vibration-induced spinal load. The electromyogram (EMG) can help to estimate these forces during whole-body vibration (WBV). Thirty-eight subjects were exposed to identical random low-frequency WBV (0·7, 1·0 and 1·4 m/s-2 r.m.s. weighted acceleration) at a relaxed, erect and bent forward postures. The acceleration of the seat and the force between the seat and the buttocks were measured. Six EMGs were derived from the right side of the m. trapezius pars descendens, m. ileocostalis lumborum pars thoracis, m. ileocostalis lumborum pars lumborum; m. longissimus thoracis pars thoracis, m. longissimus thoracis pars lumborum, and lumbar multifidus muscle. All data were filtered for anti-aliasing and sampled with 1000 Hz. Artefacts caused by the ECG in the EMG were identified and eliminated in the time domain using wavelets. The individually rectified and normalized EMGs were averaged across subjects. The EMGs without WBV exhibited characteristic patterns for the three postures examined. The coherence and transfer functions indicated characteristic myoelectric responses to random WBV with several effects of posture and WBV magnitude. A comprehensive set of transfer functions from the seat acceleration or the mean normalized input force to the mean processed EMG was presented.The results can be used for the development of more sophisticated models with a separate control of various back muscle groups. However, the EMG-force relationship under dynamic conditions needs to be examined in more detail before the results can be implemented. Since different reflex mechanisms depending on the frequency of WBV are linked with different types of active muscle fibres, various time delays between the EMG and muscle force may be necessary.

Upper and Lower Limb Muscle Architecture of a 104 Year-Old Cadaver

PubMed Central

Infantolino, Benjamin

2016-01-01

Muscle architecture is an important component to typical musculoskeletal models. Previous studies of human muscle architecture have focused on a single joint, two adjacent joints, or an entire limb. To date, no study has presented muscle architecture for the upper and lower limbs of a single cadaver. Additionally, muscle architectural parameters from elderly cadavers are lacking, making it difficult to accurately model elderly populations. Therefore, the purpose of this study was to present muscle architecture of the upper and lower limbs of a 104 year old female cadaver. The major muscles of the upper and lower limbs were removed and the musculotendon mass, tendon mass, musculotendon length, tendon length, pennation angle, optimal fascicle length, physiological cross-sectional area, and tendon cross-sectional area were determined for each muscle. Data from this complete cadaver are presented in table format. The data from this study can be used to construct a musculoskeletal model of a specific individual who was ambulatory, something which has not been possible to date. This should increase the accuracy of the model output as the model will be representing a specific individual, not a synthesis of measurements from multiple individuals. Additionally, an elderly individual can be modeled which will provide insight into muscle function as we age. PMID:28033339

Upper and Lower Limb Muscle Architecture of a 104 Year-Old Cadaver.

PubMed

Ruggiero, Marissa; Cless, Daniel; Infantolino, Benjamin

2016-01-01

Muscle architecture is an important component to typical musculoskeletal models. Previous studies of human muscle architecture have focused on a single joint, two adjacent joints, or an entire limb. To date, no study has presented muscle architecture for the upper and lower limbs of a single cadaver. Additionally, muscle architectural parameters from elderly cadavers are lacking, making it difficult to accurately model elderly populations. Therefore, the purpose of this study was to present muscle architecture of the upper and lower limbs of a 104 year old female cadaver. The major muscles of the upper and lower limbs were removed and the musculotendon mass, tendon mass, musculotendon length, tendon length, pennation angle, optimal fascicle length, physiological cross-sectional area, and tendon cross-sectional area were determined for each muscle. Data from this complete cadaver are presented in table format. The data from this study can be used to construct a musculoskeletal model of a specific individual who was ambulatory, something which has not been possible to date. This should increase the accuracy of the model output as the model will be representing a specific individual, not a synthesis of measurements from multiple individuals. Additionally, an elderly individual can be modeled which will provide insight into muscle function as we age.

Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

PubMed

Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

2016-05-01

To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: a randomized controlled trial.

PubMed

Casanova-Méndez, Amaloha; Oliva-Pascual-Vaca, Angel; Rodriguez-Blanco, Cleofás; Heredia-Rizo, Alberto Marcos; Gogorza-Arroitaonandia, Kristobal; Almazán-Campos, Ginés

2014-08-01

Spinal Manipulation (SM) has been purported to decrease pain and improve function in subjects with non-specific neck pain. Previous research has investigated which individuals with non-specific neck pain will be more likely to benefit from SM. It has not yet been proven whether or not the effectiveness of thoracic SM depends on the specific technique being used. This double-blind randomized trial has compared the short-term effects of two thoracic SM maneuvers in subjects with chronic non-specific neck pain. Sixty participants were distributed randomly into two groups. One group received the Dog technique (n = 30), with the subject in supine position, and the other group underwent the Toggle-Recoil technique (n = 30), with the participant lying prone, T4 being the targeted area in both cases. Evaluations were made of self-reported neck pain (Visual Analogue Scale); neck mobility (Cervical Range of Motion); and pressure pain threshold at the cervical and thoracic levels (C4 and T4 spinous process) and over the site described for location of tense bands of the upper trapezius muscle. Measurements were taken before intervention, immediately afterward, and 20 min later. Both maneuvers improved neck mobility and mechanosensitivity and reduced pain in the short term. No major or clinical differences were found between the groups. In the between-groups comparison slightly better results were observed in the Toggle-Recoil group only for cervical extension (p = 0.009), right lateral flexion (p = 0.004) and left rotation (p < 0.05). Copyright © 2014 Elsevier Ltd. All rights reserved.

Improvement in Anxiety and Pain After Whole Body Whirlpool Hydrotherapy Among Patients With Myofascial Pain Syndrome

PubMed Central

Im, Sang Hee

2013-01-01

Objective To evaluate the effect of the Whirlpool hydrotherapy on pain and anxiety in chronic myofascial pain syndrome (MPS) patients, compared to the conventional hydrocollator pack therapy. Methods Forty-one subjects who have MPS in the upper trapezius muscles without depression were recruited. The patients were randomly assigned into two groups: the whirlpool therapy group whose bodies were immersed in a whirlpool bath at 34℃-36℃ for 30 minutes; the hydrocollator group who took a 30-minute application of a standard hot hydrocollator pack. Patients in both groups received therapy three days a week for 2 weeks and underwent several evaluations at baseline and after treatment. The variables we analyzed during evaluations were as follows: the primary outcome we considered was pain severity using a visual analogue scale. And the secondary outcomes examined included anxiety using the Korean version of the Beck Anxiety Inventory and quality of life (QoL) using the Korean version of the World Health Organization QoL Assessment, Brief Form. All follow-up values were compared with the baseline values. Results The baseline parameters did not show significant differences between two groups. And after 2-week treatment, both groups revealed significant improvement in anxiety levels and QoL, as well as in pain. However, the improvement on pain (p=0.002) and anxiety (p=0.010) was significantly greater in the whirlpool group, compared to the hydrocollator group. Conclusion The whirlpool hydrotherapy can be used as a more effective therapeutic method to reduce pain and anxiety in chronic MPS patients without depression. PMID:24020034

The effect of arm weight support on upper limb muscle synergies during reaching movements

PubMed Central

2014-01-01

Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke survivors and other patients who could benefit from upper limb rehabilitation with arm WS. PMID:24594139