The effect of electromagnetic stimulation on the parameters of muscular strength

A new way to develop muscular strength using electromagnetic stimulation (ES) of muscles during their voluntary contractions has been described. The experiment involved 18 healthy men divided into the control group (CG) and the experimental group (EG) with equal parameters of muscular strength. In performing training exercises (the foot plantar flexion), the m. gastrocnemius of the subjects of the EG was exposed to ES (1.8 T, 5 Hz). The subjects of the CG performing the same exercises did not receive ES. The power torque of the foot plantar flexion in the EG significantly increased (24%) after 10 days of training. The power torque of the foot plantar flexion in the control subjects did not significantly change. We suppose that the increase in the muscular strength in the subjects of the EG was due to the activation of high-threshold motor units effected by ES.     

Postural impairments in Parkinson’s disease are not associated with changes in circadian rhythms changes

ABSTRACT

Parkinson’s disease (PD) is a progressive neurodegenerative disease, with a worldwide incidence of 1% in individuals >60 years of age. Its primary characteristics include postural impairments and changes in circadian rhythms. The authors investigated the association between postural impairment and changes in circadian rhythms in 24 PD subjects diagnosed with stages 1 to 3 on the Hoehn-Yard (HY) scale and regularly used dopaminergic medication for at least 1 year (experimental group – EG) and 24 healthy elderly individuals without a history of neurological impairment as the control group (CG). Static balance tests using a force plate were performed, and activity/rest rhythm, according to the relative amplitude of L5 and M10 values, was monitored for seven consecutive days using actimetry. The results indicated differences in posturographic indicators of mediolateral displacement (ML) [EG, 4.71 ± 0.85 mm; CG, 2.79 ± 0.53 mm (p < .0001)] and anteroposterior displacement of the center of pressure (COP) [EG, 5.61 ± 2.43 mm; CG, 8.23 ± 1.72 mm (< 0.0001)], ML velocity of the COP [EG, 2.39 ± 0.83 mm/s; CG, 1.40 ± 0.18 mm/s (p < .0001)], and total distance of the COP in the tandem stance condition [EG, 227.6 ± 75 mm; CG, 53.4 ± 6.1 mm (p < .0001)] between the EG and CG. There was no correlation between relative amplitude and posturographic data for the EG. Postural impairments were verified in comparing the EG and CG; however, there was no association between posturographic indicators and activity/rest rhythm.     

Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia

Objective: The present study compared surface electromyographic (sEMG) activity obtained from the submental muscle group for a tongue press and a head lift exercise as potential therapeutic exercises for dysphagic elderly. Materials and methods: Fifty‐three healthy volunteers with a mean age of 35.3 participated in this study. Subjects were required to perform an isometric task, pressing their tongue against the hard palate, and an isotonic task requiring sustained lingual force against the hard palate. Pressure sensors were used to measure the amount of lingual pressure against the hard palate. Submental sEMG data from these tasks were compared with those obtained from the isometric and isotonic aspects of a head lift exercise. Results: No sEMG differences were identified between the isometric tongue press task and head lift exercise. Isotonic tongue press exercises resulted in significantly higher maximum and mean sEMG values compared with the isotonic head lift exercise (p < 0.05). The submental sEMG activity from the tongue press exercise was equal (isometric) to, or greater (isotonic) than comparable muscle activation obtained during the head lift exercise. Conclusions: The tongue press exercise may be less strenuous than the head lift exercise while achieving the same therapeutic effect.     

Combined effects of aging and obesity on postural control,muscle activity and maximal voluntary force of muscles mobilizing ankle joint

ObjectiveThe aim of the study was to investigate the influence of age and/or obesity on postural control, ankle muscle activities during balance testing and force production capacities.Materials and methods4 groups; control group (CG; n = 25; age = 31.8 ± 7.5 years; BMI = 21.4 ± 2.5 kg/m²), obese group (OG; n = 25; age = 34.4 ± 9.5 years; BMI = 39.6 ± 5.4 kg/m²), elderly group (EG; n = 15; age = 77.1 ± 8.4 years; BMI = 24.4 ± 1.3 kg/m²) and obese elderly group (ObEG; n = 12; age = 78.6 ± 6.6 years; BMI = 34.5 ± 3.1 kg/m²) performed maximal voluntary contraction (MVC) before testing to calculate the maximal relative force of ankle plantar flexor (PF) and dorsal flexor (DF) muscles. Center of pressure (CoP) parameters and the electromyography (EMG) activity of PF and DF muscles were collected during MVC, quiet standing and limit of stability (LoS) testing along antero-posterior and medio-lateral axes.ResultsMaximal relative force was higher in EG and ObEG than CG and OG, respectively (p < 0.001). CoP parameters, distance traveled along the antero-posterior axis and EMG activity of PF were higher in OG, EG and ObEG compared to CG (p < 0.001) and in EG compared to ObEG (p < 0.05).The EMG activity of PF was positively correlated with CoP parameters in OG and ObEG (r > 0.6; p < 0.05). Maximal relative force of PF (r > −0.6; p < 0.05) was negatively correlated with CoP parameters in ObEG and EG.ConclusionObesity-related postural control alteration is associated with increased activity of PF. This neuromuscular adaptation may reflect deteriorations of the proprioceptive system and is likely additional to age-related muscular impairments. This may be a mechanism by which obesity increases postural control alterations in elderly.     

Effect of exposure to high temperatures in the excretion of cadmium and lead

ObjectiveThis study aims to observe the effect on urine and sweat excretion levels of cadmium (Cd) and lead (Pb) in healthy men in a maximum incremental test until exhaustion and repeated exposure to heat.Methodstwenty-nine adult men divided into control group (CG; n = 14) and experimental group (EG; n = 15) performing two maximum tests until exhaustion in normothermia (22 °C) and hyperthermia (42 °C). EG experienced 9 sessions of heat exposure at high temperatures (100 °C) (HEHT). After the nine sessions, the initial tests were repeated in both groups. Urine samples were collected before and after each test. After the hyperthermia tests, sweat samples were gathered.ResultsUrinary Cd increased after initial tests in GC and in hyperthermia in EG (p < 0.05). Urinary excretion of Pb rose after HEHT (p < 0.05). Pb in sweat was higher in EG than in CG after HEHT (p < 0.05).ConclusionHeat exercise and constant exposure to heat can be a valid method to increase the excretion of toxic metals.     

Surface electromyograph activity of submental muscles during swallowing and expiratory muscle training tasks in Huntington’s disease patients

IntroductionHuntington’s disease (HD) patients have difficulty in swallowing, leading to aspiration pneumonia, which is a major cause of death. It seems possible that submental muscles that are crucial for preventing an escape of a bolus into the airway, are affected by HD, but no previous studies have investigated this.ObjectiveTo assess surface electromyograph (sEMG) activity of submental muscles during swallowing and expiratory muscle training (EMT) tasks in HD patients in comparison to healthy volunteers.MethodssEMG activities of submental muscles during saliva, water swallowing, EMT tasks performed at 25% and 75% of maximum expiratory pressure were recorded and normalised by the sEMG activity during an effortful swallow in 17 early to mid stage HD patients and 17 healthy volunteers.ResultssEMG activity was greater (p < 0.05) during EMT tasks than saliva and water swallowing, but was not significantly different between groups for saliva, water swallowing and EMT at 25%. HD patients had lower sEMG activity for EMT at 75% (p < 0.05).ConclusionDecreases in submental muscle activity were not evident in HD patients except during EMT at 75%. This suggests that relative submental muscle weakness is observed only during a high intensity task in early to mid stage HD patients.     

Exercise with TENS does not augment gains in balance and strength for dancers

Electrical stimulation modulates sensory feedback and improves motor performance, at least for individuals with compromised sensorimotor function. The purpose of this study was to determine the effectiveness of a 4-wk intervention with transcutaneous electrical nerve stimulation (TENS) at improving strength and balance in dancers. Nineteen dancers completed a timed, single-leg balance test, the Y-balance test, and contractions with the hip flexor and knee extensor muscles to assess maximal strength and force steadiness. They completed 4-wks of moderate-intensity bodyweight exercises (3x/wk) and were pseudo-randomized to either a Treatment or Sham group in a single-blind design. The Treatment group received constant TENS over the hamstring muscles during the exercises, whereas the Sham group was exposed to a brief TENS current. The data were pooled due to few significant between-group differences from before to after the intervention. Most outcome measures significantly improved: hip extensor muscles were stronger (P ≤ 0.01), time stood on a single-leg with eyes closed increased (P = 0.02), and the distance reached during the Y-balance test increased (P ≤ 0.001). The improvement in scores on the Y-balance test exceeded the minimal clinically significant change. Twelve sessions of moderate-intensity bodyweight exercises improved muscle strength and balance in experienced dancers. The addition of TENS, however, did not augment the gains in function.     

Flexion–relaxation ratio in computer workers with and without chronic neck pain

This study evaluated the flexion–relaxation phenomenon (FRP) and flexion–relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20–45 years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4 h/day for other purposes (CG). FRP and FR-ratios were analyzed using sEMG of the cervical extensors. Analysis of FR-ratios showed smaller values in the semispinalis capitis muscles of the two groups of workers compared to the control group. The reference FR-ratio (flexion relaxation ratio [FRR], defined as the maximum activity in 1 s of the re-extension/full flexion sEMG activity) was significantly higher in the computer workers with neck pain compared to the CG (CPG: 3.10, 95% confidence interval [CI95%] 2.50–3.70; NPG: 2.33, CI95% 1.93–2.74; CG: 1.99, CI95% 1.81–2.17; p < 0.001). The FR-ratios and FRR of sEMG in this study suggested that computer use could increase recruitment of the semispinalis capitis during neck extension (concentric and eccentric phases), which could explain our results. These results also suggest that the FR-ratios of the semispinalis may be a potential functional predictive neuromuscular marker of asymptomatic neck musculoskeletal disorders since even asymptomatic computer workers showed altered values. On the other hand, the FRR values of the semispinalis capitis demonstrated a good discriminative ability to detect neck pain, and such results suggested that each FR-ratio could have a different application.     

A Wireless Lingual Feedback Device to Reduce Overpressures in Seated Posture: A Feasibility Study

Background

Pressure sores are localized injuries to the skin and underlying tissues and are mainly resulting from overpressure. Paraplegic peoples are particularly subjects to pressure sores because of long-time seated postures and sensory deprivation at the lower limbs.

Methodology/Principal Findings

Here we report outcomes of a feasibility trial involving a biofeedback system aimed at reducing buttock overpressure whilst an individual is seated. The system consists of (1) pressure sensors, (2) a laptop coupling sensors and actuator (3) a wireless Tongue Display Unit (TDU) consisting of a circuit embedded in a dental retainer with electrodes put in contact with the tongue. The principle consists in (1) detecting overpressures in people who are seated over long periods of time, (2) estimating a postural change that could reduce these overpressures and (3) communicating this change through directional information transmitted by the TDU.Twenty-four healthy subjects voluntarily participated in this study. Twelve healthy subjects initially formed the experimental group (EG) and were seated on a chair with the wireless TDU inside their mouth. They were asked to follow TDU orders that were randomly spread throughout the session. They were evaluated during two experimental sessions during which 20 electro-stimulations were sent. Twelve other subjects, added retrospectively, formed the control group (CG). These subjects participated in one session of the same experiment without any biofeedback.Three dependent variables were computed: (1) the ability of subjects to reach target posture (EG versus CG), (2) high pressure reductions after a biofeedback (EG versus CG) and (3) the level of these reductions relative to their initial values (EG only). Results show (1) that EG reached target postures in 90.2% of the trials, against 5,3% in the CG, (2) a significant reduction in overpressures in the EG compared to the CG and (3), for the EG, that the higher the initial pressures were, the more they were decreased.

Conclusions/Significance

The findings suggest that, in this trial, subjects were able to use a tongue tactile feedback system to reduce buttock overpressure while seated. Further evaluation of this system on paraplegic subjects remains to be done.     

Influence of a high-temperature programme on serum,urinary and sweat levels of selenium and zinc

IntroductionThe effect of hyperthermia on the antioxidant system in the human organism is well known.AimThe objective of this study was to observe the effects of heat on the concentration of Se and Zn, elements related to antioxidant systems.MethodsTwenty-nine subjects voluntarily participated in this study. They were divided into a control group (CG; n = 14) and an experimental group (EG; n = 15). All of them underwent two incremental tests until exhaustion in normothermia (22 °C, 20–40%RH) and hyperthermia (42 °C, 20–40%RH). EG experienced nine sessions of repeated heat exposure at high temperatures (100 °C, 20%RH) for three weeks (HEHT). After the intervention, the initial measurements were repeated. Urine and blood samples were collected before and after each test. Additionally, sweat samples were collected after tests in hyperthermia.ResultsThere were no significant changes in serum. An increase in the elimination of Zn and Se in EG was observed in urine after HEHT (p < .05). The elimination of Zn by sweating decreased after HEHT in EG (p < .05).ConclusionsExposure to heat at high temperatures increases the urinary excretion of Se and Zn.     

舌三针联合舌下刺络放血治疗脑卒中后吞咽障碍的临床研究

摘要 目的：探讨舌三针联合舌下刺络放血治疗脑卒中后吞咽障碍的临床效果。方法：采取前瞻性随机对照的研究方法，将2018年1月至2021年1月60例脑卒中后吞咽障碍患者分为对照组（30例）与治疗组（30例）。对照组给予常规吞咽功能训练，在对照组基础上，治疗组给予"舌三针"针刺联合舌下刺络放血治疗。治疗前后采用洼田饮水试验评分系统和吞咽障碍特异性生活质量量表（SWAL-QOL）及对两组患者进行评估，评估临床疗效，并调查满意度。结果：治疗后，两组饮水试验评分均下降（P<0.05），而治疗组饮水试验评分较对照组低（P<0.05）。两组SWAL-QOL评分均明显提高（P<0.05），而治疗组SWAL-QOL评分明显高于对照组（P<0.05）。治疗组总有效率（80.00 %）明显高于对照组（56.67 %）（P<0.05）。治疗组总满意度（96.67 %）明显高于对照组（60.00 %）（P<0.05）。结论：舌三针联合舌下刺络放血治疗脑卒中后吞咽功能障碍的疗效肯定，配合吞咽功能训练具有增效作用，可有效提高患者生活质量，安全耐受，患者的满意度高，值得临床推广应用。     

Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women

ObjectiveTo compare the effect of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment for genuine stress incontinence.DesignStratified, single blind, randomised controlled trial.SettingMulticentre.Participants107 women with clinically and urodynamically proved genuine stress incontinence. Mean (range) age was 49.5 (24-70) years, and mean (range) duration of symptoms 10.8 (1-45) years.InterventionsPelvic floor exercise (n=25) comprised 8-12 contractions 3 times a day and exercise in groups with skilled physical therapists once a week. The electrical stimulation group (n=25) used vaginal intermittent stimulation with the MS 106 Twin at 50 Hz 30 minutes a day. The vaginal cones group (n=27) used cones for 20 minutes a day. The untreated control group (n=30) was offered the use of a continence guard. Muscle strength was measured by vaginal squeeze pressure once a month.ResultsImprovement in muscle strength was significantly greater (P=0.03) after pelvic floor exercises (11.0 cm H₂O (95% confidence interval 7.7 to 14.3) before v 19.2 cm H₂O (15.3 to 23.1) after) than either electrical stimulation (14.8 cm H₂O (10.9 to 18.7) v 18.6 cm H₂O (13.3 to 23.9)) or vaginal cones (11.8 cm H₂O (8.5 to 15.1) v 15.4 cm H₂O (11.1 to 19.7)). Reduction in leakage on pad test was greater in the exercise group (−30.2 g; −43.3 to 16.9) than in the electrical stimulation group (−7.4 g; −20.9 to 6.1) and the vaginal cones group (−14.7 g; −27.6 to −1.8). On completion of the trial one participant in the control group, 14 in the pelvic floor exercise group, three in the electrical stimulation group, and two in the vaginal cones group no longer considered themselves as having a problem.ConclusionTraining of the pelvic floor muscles is superior to electrical stimulation and vaginal cones in the treatment of genuine stress incontinence.

Key messages

• Training to increase the strength of pelvic floor muscles was superior to electrical stimulation and vaginal cones in treatment of genuine stress incontinence
• Adverse effects were reported with use of electrical stimulation and vaginal cones but not with exercises
• Patients’ tolerance for electrical stimulation and vaginal cones was low
• Pelvic floor exercise should be first choice of treatment for genuine stress incontinence

     

Lumbar posture and muscular activity while sitting during office work

PurposeField study, cross-sectional study to measure the posture and sEMG of the lumbar spine during office work for a better understanding of the lumbar spine within such conditions.ScopeThere is high incidence of low back pain in office workers. Currently there is little information about lumbar posture and the activity of lumbar muscles during extended office work.MethodsThirteen volunteers were examined for around 2 h of their normal office work. Typical tasks were documented and synchronised to a portable long term measuring device for sEMG and posture examination. The correlation of lumbar spine posture and sEMG was tested statistically.ResultsThe majority of time spent in office work was sedentary (82%). Only 5% of the measured time was undertaken in erect body position (standing or walking). The sEMG of the lumbar muscles under investigation was task dependent. A strong relation to lumbar spine posture was found within each task. The more the lumbar spine was flexed, the less there was activation of lumbar muscles (P < .01). Periods of very low or no activation of lumbar muscles accounted for about 30% of relaxed sitting postures.ConclusionBecause of very low activation of lumbar muscles while sitting, the load is transmitted by passive structures like ligaments and intervertebral discs. Due to the viscoelasticity of passive structures and low activation of lumbar muscles, the lumbar spine may incline into de-conditioning. This may be a reason for low back pain.     

Changes in sEMG parameters among trunk and thigh muscles during a fatiguing bilateral isometric multi-joint task in trained and untrained subjects

This study aimed to explore changes in the electrical activity distribution among synergist muscles involved in the maintenance of this bilateral multi-joint task. It also tested relations between changes in surface electromyographic (sEMG) parameters with endurance time. Eighteen subjects, trained and untrained in hiking, performed a submaximal (50% of maximal contraction) isometric hiking test until exhaustion. The electrical activity of main superficial muscles implicated in this posture was recorded bilaterally. Trained subjects sustained the hiking position for 315 ± 82 s, versus 225 ± 68 s for untrained subjects. Patterns of electrical activity and mean power frequency (MPF) were different between populations. MPF shift in abdominal muscles was higher than in other synergists for both groups. Although typical changes in sEMG parameters were observed, few relations with endurance time were found, and for untrained subjects only. Changes in the relative contribution among synergists were observed, mainly for trained subjects. It is hypothesized that the task (a complex multi-joint posture involving numerous joints and muscles) may allow some variability in the contribution of synergist muscles during fatigue especially for the trained group. This probably explains the absence of relationship between endurance time and sEMG changes for trained subjects.     

舌压抗阻反馈训练联合吞咽功能训练对甲状腺癌根治术后吞咽功能障碍患者的影响研究

摘要 目的：观察吞咽功能训练与舌压抗阻反馈训练联合应用对甲状腺癌根治术后吞咽功能障碍患者的影响。方法：选取2020年6月~2022年1月期间来湖南中医药大学第一附属医院接受诊治的100例甲状腺癌根治术后吞咽功能障碍患者,根据随机数字表法分为研究组（接受舌压抗阻反馈训练联合吞咽功能训练干预,n=50）、对照组（接受吞咽功能训练干预,n=50）。观察两组疗效、表面肌电图相关指标、吞咽障碍相关评分及并发症。结果：与对照组比较,研究组的临床总有效率较高（P<0.05）,并发症发生率较低（P<0.05）。干预1个月后,两组洼田饮水试验（WST）评分下降,吞咽功能（VFSS）、吞咽障碍特异性生活质量量表（SWAL-QOL）评分升高,研究组的变化程度大于对照组（P<0.05）。干预1个月后,两组吞咽时程缩短,最大波幅值升高,研究组的变化程度大于对照组（P<0.05）。结论：甲状腺癌根治术后吞咽功能障碍患者采用吞咽功能训练与舌压抗阻反馈训练联合干预,可缓解临床症状,提高治疗效果,降低并发症发生率。     

Normalizing surface electromyographic measures of the masticatory muscles: Comparison of two different methods for clinical purpose

PurposeTo compare a new normalization technique (wax pad, WAX) with the currently utilized cotton roll (COT) method in surface electromyography (sEMG) of the masticatory muscles.MethodssEMG of the masseter and anterior temporalis muscles of 23 subjects was recorded while performing two repetitions of 5 s maximum voluntary clenches (MVC) on COT and WAX. For each task, the mean value of sEMG amplitude and its coefficient of variation were calculated, and the differences between the two repetitions computed. The standard error of measurement (SEM) was calculated. For each subject and muscle, the COT-to-WAX maximum activity increment was computed. Participant preference between tasks was also recorded.ResultsWAX MVC tasks had larger maximum EMG amplitude than COT MVC tasks (P < 0.001), with COT-to-WAX maximum amplitude increments of 61% (temporalis) and 94% (masseter) (P = 0.006). WAX MVC had better test-retest repeatability than COT. For both MVC modalities, the mean amplitude (P > 0.391) and its coefficient of variation were unchanged (P > 0.180). The WAX task was the more comfortable for 18/23 subjects (P = 0.007).ConclusionWAX normalization ensures the same stability level of maximum EMG amplitude as COT normalization, but it is more repeatable, elicits larger maximum muscular contraction, and is felt to be more comfortable by subjects.     

An electromyographic analysis of two handwriting grasp patterns

BackgroundHandwriting is a fundamental skill needed for the development of daily-life activities during lifetime and can be performed using different forms to hold the writing object. In this study, we monitored the sEMG activity of trapezius, biceps brachii, extensor carpi radialis brevis and flexor digitorum superficialis during a handwriting task with two groups of subjects using different grasp patterns.Subjects and methodsTwenty-four university students (thirteen males and eleven females; mean age of 22.04 ± 2.8 years) were included in this study. We randomly invited 12 subjects that used the Dynamic Tripod grasp and 12 subjects that used the Static Tripod grasp.ResultsThe static tripod group showed statistically significant changes in the sEMG activity of trapezium and biceps brachii muscles during handwriting when compared to dynamic tripod group’s subjects. No significant differences were found in extensor carpi radialis brevis and flexor digitorum superficialis activities among the two groups.ConclusionThe findings in this study suggest an increased activity of proximal muscles among subjects using a transitional grasp, indicating potential higher energy expenditure and muscular harm with the maintenance of this motor pattern in handwriting tasks, especially during the progression in academic life.     

Neuromuscular fatigue following high versus low-intensity eccentric exercise of biceps brachii muscle

PurposeThis study investigated neuromuscular fatigue following high versus low-intensity eccentric exercise corresponding to the same amount of work.MethodsTen volunteers performed two eccentric exercises of the elbow flexors: a high-intensity versus a low-intensity exercise. Maximal voluntary contraction torque and surface electromyography of the biceps brachii muscle were recorded before, immediately and 48 h after exercises. Maximal voluntary activation level, neural (M-wave) and contractile (muscular twitch) properties of the biceps brachii muscle were analysed using electrical stimulation techniques.ResultsMaximal voluntary contraction torque was significantly (P < 0.01) reduced immediately and 48 h after exercise but the reduction was not different between the two conditions. Electromyography associated with maximal voluntary contraction significantly decreased (P < 0.05) immediately and 48 h after exercise for both conditions while maximal voluntary activation level was only significantly reduced immediately after the high-intensity exercise. Peak twitch alterations were observed immediately and 48 h after exercise for both conditions while M-wave did not change.ConclusionHigh and low-intensity eccentric exercises with the same amount of work induced the same reduction in maximal strength capacities of the biceps brachii muscles. The magnitude of peripheral and central fatigue was very similar in both conditions.     

Sensitivity and specificity of the flexion and extension relaxation ratios to identify altered paraspinal muscles’ flexion relaxation phenomenon in nonspecific chronic low back pain patients

BackgroundAmong the main methods used to identify an altered flexion relaxation phenomenon (FRP) in nonspecific chronic low back pain (NSCLBP), it has been previously demonstrated that flexion relaxation ratio (FRR) and extension relaxation ratio (ERR) are more objective than the visual reference method.ObjectiveTo determine the sensitivity and specificity of the different methods used to calculate the ratios in terms of their ability to identify an altered FRP in NSCLBP.MethodsForty-four NSCLBP patients performed a standing maximal trunk flexion task. Surface electromyography (sEMG) was recorded along the erector spinae longissimus (ESL) and multifidus (MF) muscles. Altered FRP based on sEMG was visually identified by three experts (current standard). Six FRR methods and five ERR methods were used both for the ESL and MF muscles. ROC curves (with areas under the curve (AUC) and sensitivity/specificity) were generated for each ratio.ResultsAll methods used to calculate these ratios had an AUC higher than 0.9, excellent sensitivity (>90 %), and good specificity (80–100 %) for both ESL and MF muscles.ConclusionBoth FRP ratios (FRR and ERR) for MF and ESL muscles, appear to be an objective, sensitive and specific method for identifying altered FRP in NSCLBP patients.     

Tennis players show a lower coactivation of the elbow antagonist muscles during isokinetic exercises

PurposePrevious studies have suggested that muscle coactivation could be reduced by a recurrent activity (training, daily activities). If this was correct, skilled athletes should show a specific muscle activation pattern with a low level of coactivation of muscles which are typically involved in their discipline. In particular, the aim of this study was to verify the hypothesis that the amount of antagonist activation of biceps brachii (BB) and triceps brachii (TB) is different between tennis players and non-players individuals during maximal isokinetic contractions.MethodsTen young healthy men and eight male tennis players participated in the study. The surface electromyographic signals (sEMG) were recorded from the BB and TB muscles during three maximal voluntary isometric contractions (MVC) of elbow flexors and extensors and a set of three maximal elbow flexions and extensions at 15°, 30°, 60°, 120°, 180° and 240°/s. Normalized root mean square (RMS) of sEMG was calculated as an index of sEMG amplitude.ResultsAntagonist activation (%RMSmax) of TB was significantly lower in tennis players (from 14.0 ± 7.9% at MVC to 16.3 ± 8.9% at 240°/s) with respect to non-players (from 27.7 ± 19.7% at MVC to 38.7 ± 17.6% at 240°/s) at all angular velocities. Contrary to non-players, tennis players did not show any difference in antagonist activation between BB and TB muscles.ConclusionsTennis players, with a constant practice in controlling forces around the elbow joint, learn how to reduce coactivation of muscles involved in the control of this joint. This has been shown by the lower antagonist muscular activity of triceps brachii muscle during isokinetic elbow flexion found in tennis players with respect to non-players.