Shoulder muscle function depends on elbow joint position: an illustration of dynamic coupling in the upper limb

Shoulder muscle function has been documented based on muscle moment arms, lines of action and muscle contributions to contact force at the glenohumeral joint. At present, however, the contributions of individual muscles to shoulder joint motion have not been investigated, and the effects of shoulder and elbow joint position on shoulder muscle function are not well understood. The aims of this study were to compute the contributions of individual muscles to motion of the glenohumeral joint during abduction, and to examine the effect of elbow flexion on shoulder muscle function. A three-dimensional musculoskeletal model of the upper limb was used to determine the contributions of 18 major muscles and muscle sub-regions of the shoulder to glenohumeral joint motion during abduction. Muscle function was found to depend strongly on both shoulder and elbow joint positions. When the elbow was extended, the middle and anterior deltoid and supraspinatus were the greatest contributors to angular acceleration of the shoulder in abduction. In contrast, when the elbow was flexed at 90°, the anterior deltoid and subscapularis were the greatest contributors to joint angular acceleration in abduction. This dependence of shoulder muscle function on elbow joint position is explained by the existence of dynamic coupling in multi-joint musculoskeletal systems. The extent to which dynamic coupling affects shoulder muscle function, and therefore movement control, is determined by the structure of the inverse mass matrix, which depends on the configuration of the joints. The data provided may assist in the diagnosis of abnormal shoulder function, for example, due to muscle paralysis or in the case of full-thickness rotator cuff tears.     

An EMG-driven musculoskeletal model to estimate muscle forces and knee joint moments in vivo

This paper examined if an electromyography (EMG) driven musculoskeletal model of the human knee could be used to predict knee moments, calculated using inverse dynamics, across a varied range of dynamic contractile conditions. Muscle-tendon lengths and moment arms of 13 muscles crossing the knee joint were determined from joint kinematics using a three-dimensional anatomical model of the lower limb. Muscle activation was determined using a second-order discrete non-linear model using rectified and low-pass filtered EMG as input. A modified Hill-type muscle model was used to calculate individual muscle forces using activation and muscle tendon lengths as inputs. The model was calibrated to six individuals by altering a set of physiologically based parameters using mathematical optimisation to match the net flexion/extension (FE) muscle moment with those measured by inverse dynamics. The model was calibrated for each subject using 5 different tasks, including passive and active FE in an isokinetic dynamometer, running, and cutting manoeuvres recorded using three-dimensional motion analysis. Once calibrated, the model was used to predict the FE moments, estimated via inverse dynamics, from over 200 isokinetic dynamometer, running and sidestepping tasks. The inverse dynamics joint moments were predicted with an average R(2) of 0.91 and mean residual error of approximately 12 Nm. A re-calibration of only the EMG-to-activation parameters revealed FE moments prediction across weeks of similar accuracy. Changing the muscle model to one that is more physiologically correct produced better predictions. The modelling method presented represents a good way to estimate in vivo muscle forces during movement tasks.     

Predictions of knee and ankle moments of force in walking from EMG and kinematic data

A deterministic model was developed and validated to calculate instantaneous ankle and knee moments during walking using processed EMG from representative muscles, instantaneous joint angle as a correlate of muscle length and angular velocity as a correlate of muscle velocity, and having available total instantaneous joint moments for derivation of certain model parameters. A linear regression of the moment on specifically processed EMG, recorded while each subject performed cycled isometric calibration contractions, yielded the constants for a basic moment-EMG relationship. Using the resultant moment for optimization, the predicted moment was proportionally augmented for longer muscle lengths and reduced for shorter lengths. Similarly, the predicted moment was reduced for shortening velocities and increased if the muscle was lengthening. The plots of moments predicted using the full model and those calculated from link segment mechanics followed each other quite closely. The range of root mean square errors were: 3.2-9.5 Nm for the ankle and 4.7-13.0 Nm for the knee.     

Moment distribution among human elbow extensor muscles during isometric and submaximal extension

To understand better how the central nervous system (CNS) distributes a joint moment among muscles, moment distribution among the three heads of the triceps and the anconeus muscles during isometric elbow extension was quantified in vivo and noninvasively. Electrical stimulation was used to activate an individual muscle selectively at various contraction levels, and the relationship between the peak M-wave amplitude and peak elbow extension moment was established across various contraction levels for each muscle. The relationship was then used to calibrate the corresponding EMG signal and determine moment distribution among the muscles during voluntary isometric elbow extension. Results showed that moment distribution among muscles was not proportional to the muscles' physiological cross-sectional areas (PCSA) and the CNS favored uniarticular muscles for the isometric task performed: the uniarticular lateral and medial heads of the triceps were dominant (contributing approximately 70-90% of the total elbow extension moment) and the anconeus contributed significantly, especially at the lower levels of elbow extension moment (up to approximately 15% of the extension moment). In contrast, the two-joint long head of the triceps contributed significantly less than the uniarticular heads of the triceps. While the absolute contributions of all the muscles increased with the total elbow extension moment, the relative contributions of the muscles may increase or decrease with the elbow extension moment. Cross-validation using fresh data (not used in determining the moment distribution) showed close match between the measured and predicted elbow extension moment except for trials in which fatigue became significant.     

Muscular resistance to varus and valgus loads at the elbow.

Although the contributions of passive structures to stability of the elbow have been well documented, the role of active muscular resistance of varus and valgus loads at the elbow remains unclear. We hypothesized that muscles: (1) can produce substantial varus and valgus moments about the elbow, and (2) are activated in response to sustained varus and valgus loading of the elbow. To test the first hypothesis, we developed a detailed musculoskeletal model to estimate the varus and valgus moment-generating capacity of the muscles about the elbow. To test the second hypothesis, we measured EMGs from 11 muscles in four subjects during a series of isometric tasks that included flexion, extension, varus, and valgus moments about the elbow. The EMG recordings were used as inputs to the elbow model to estimate the contributions of individual muscles to flexion-extension and varus-valgus moments. Analysis of the model revealed that nearly all of the muscles that cross the elbow are capable of producing varus or valgus moments; the capacity of the muscles to produce varus moment (34 Nm) and valgus moment (35 Nm) is roughly half of the maximum flexion moment (70 Nm). Analysis of the measured EMGs showed that the anconeus was the most significant contributor to valgus moments and the pronator teres was the largest contributor to varus moments. Although our results show that muscles were activated in response to static varus and valgus loads, their activations were modest and were not sufficient to balance the applied load.     

Quantitative functional anatomy of the lower limb with application to human gait

A scheme was developed to classify muscles according to their primary, secondary and tertiary functions, e.g. a muscle which produces primarily a flexion moment may also produce secondary abduction and tertiary internal rotation moments. The functions of muscles crossing the hip and knee joints were computed based upon the changing relative positions of joint centers and muscle origins and insertions during one gait cycle. The function of several of the major muscles crossing the hip and knee joints is reported for the different limb positions corresponding to normal gait. It was found that the amount of force necessary to produce a given moment about a joint was dependent upon the limb position. In addition, the muscle functions changed significantly with limb position. Electrical stimulation of muscles of a paralyzed subject gave qualitative support to the results.     

Muscle architecture and out‐force potential of the thoracic limb in the eastern mole (Scalopus aquaticus)

Moles have modified thoracic limbs with hypertrophied pectoral girdle muscles that allow them to apply remarkably high lateral out‐forces during the power stroke when burrowing. To further understand the high force capabilities of mole forelimbs, architectural properties of the thoracic limb muscles were quantified in the Eastern mole (Scalopus aquaticus). Architectural properties measured included muscle mass, moment arm, belly length, fascicle length, and pennation angle, and these were used to provide estimates of maximum isometric force, joint torque, and power. Measurements of muscle moment arms and limb lever lengths were additionally used to analyze the out‐force contributions of the major pectoral girdle muscles. Most muscles have relatively long fascicles and little‐to‐no pennation. The humeral abductor/rotators as a functional group are massive and are capable of relatively high force, power, and joint torque. Of this group, the bipennate m. teres major is the most massive and has the capacity to produce the highest force and joint torque to abduct and axially rotate the humerus. In general, the distal limb muscles are relatively small, but have the capacity for high force and mechanical work by fascicle shortening. The muscle architectural properties of the elbow extensors (e.g., m. triceps brachii) and carpal flexors (e.g., m. palmaris longus) are consistent with the function of these muscles to augment lateral out‐force application. The humeral abductor/rotators m. latissimus dorsi, m. teres major, m. pectoralis, and m. subscapularis are calculated to contribute 13.9 N to out‐force during the power stroke, and this force is applied in a ‘frontal’ plane causing abduction of the humerus about the sternoclavicular joint. Moles have several specializations of their digging apparatus that greatly enhance the application of out‐force, and these morphological features suggest convergence on limb form and burrowing function between New and Old World moles. J. Morphol. 274:1277–1287, 2013. © 2013 Wiley Periodicals, Inc.     

The role of intersegmental dynamics during rapid limb oscillations

The interactive dynamic effects of muscular, inertial and gravitational moments on rapid, multi-segmented limb oscillations were studied. Using three-segment, rigid-body equations of motion, hip, knee and ankle intersegmental dynamics were calculated for the steady-state cycles of the paw-shake response in adult spinal cats. Hindlimb trajectories were filmed to obtain segmental kinematics, and myopotentials of flexors and extensors at each of the three joints were recorded synchronously with the ciné film. The segmental oscillations that emerged during the paw-shake response were a consequence of an interplay between active and passive musculotendinous forces, inertial forces, and gravity. During steady-state oscillations, the amplitudes of joint excursions, peak angular velocities, and peak angular accelerations increased monotonically and significantly in magnitude from the proximal joint (hip) to the most distal joint (ankle). In contrast to these kinematic relationships, the maximal values of net moments at the hip and knee were equal in magnitude, but of significantly lower magnitude than the large net moment at the ankle joint. At both the ankle and the knee, the flexor and extensor muscle moments were equal, but at the hip the magnitude of the peak flexor muscle moment was significantly greater than the extensor muscle moment. Muscle moments at the hip not only acted to counterbalance accelerations of the more distal segments, but also acted to maintain the postural orientation of the hindlimb. Large muscle moments at the knee functioned to counterbalance the large inertial moments generated by the large angular accelerations of the paw. At the ankle, the muscle moments dominated the generation of the paw accelerations. At the ankle and the knee, muscle moments controlled limb dynamics by slowing and reversing joint motions, and the active muscle forces contributing to ankle and knee moments were derived from lengthening of active musculotendinous units. In contrast to the more distal joints, the active muscles crossing the hip predominantly shortened as a result of the interplay among inertial forces and gravitational moments. The muscle function and kinetic data explain key features of the complex interactions that occur between central control mechanisms and multi-segmented, oscillating limb segments during the paw-shake response.     

Muscle architecture of the upper limb in the orangutan

We dissected the left upper limb of a female orangutan and systematically recorded muscle mass, fascicle length, and physiological cross-sectional area (PCSA), in order to quantitatively clarify the unique muscle architecture of the upper limb of the orangutan. Comparisons of the musculature of the dissected orangutan with corresponding published chimpanzee data demonstrated that in the orangutan, the elbow flexors, notably M. brachioradialis, tend to exhibit greater PCSAs. Moreover, the digital II-V flexors in the forearm, such as M. flexor digitorum superficialis and M. flexor digitorum profundus, tend to have smaller PCSA as a result of their relatively longer fascicles. Thus, in the orangutan, the elbow flexors demonstrate a higher potential for force production, whereas the forearm muscles allow a greater range of wrist joint mobility. The differences in the force-generating capacity in the upper limb muscles of the two species might reflect functional specialization of muscle architecture in the upper limb of the orangutan for living in arboreal environments.     

A comparison of static and dynamic optimization muscle force predictions during wheelchair propulsion

The primary purpose of this study was to compare static and dynamic optimization muscle force and work predictions during the push phase of wheelchair propulsion. A secondary purpose was to compare the differences in predicted shoulder and elbow kinetics and kinematics and handrim forces. The forward dynamics simulation minimized differences between simulated and experimental data (obtained from 10 manual wheelchair users) and muscle co-contraction. For direct comparison between models, the shoulder and elbow muscle moment arms and net joint moments from the dynamic optimization were used as inputs into the static optimization routine. RMS errors between model predictions were calculated to quantify model agreement. There was a wide range of individual muscle force agreement that spanned from poor (26.4% F_max error in the middle deltoid) to good (6.4% F_max error in the anterior deltoid) in the prime movers of the shoulder. The predicted muscle forces from the static optimization were sufficient to create the appropriate motion and joint moments at the shoulder for the push phase of wheelchair propulsion, but showed deviations in the elbow moment, pronation–supination motion and hand rim forces. These results suggest the static approach does not produce results similar enough to be a replacement for forward dynamics simulations, and care should be taken in choosing the appropriate method for a specific task and set of constraints. Dynamic optimization modeling approaches may be required for motions that are greatly influenced by muscle activation dynamics or that require significant co-contraction.     

In vivo determination of the direction of rotation and moment-angle relationship of individual elbow muscles.

The direction of rotation (DOR) of individual elbow muscles, defined as the direction in which a muscle rotates the forearm relative to the upper arm in three-dimensional space, was studied in vivo as a function of elbow flexion and forearm rotation. Electrical stimulation was used to activate an individual muscle selectively, and the resultant flexion-extension, supination-pronation, and varus-valgus moments were used to determine the DOR. Furthermore, multi-axis moment-angle relationships of individual muscles were determined by stimulating the muscle at a constant submaximal level across different joint positions, which was assumed to result in a constant level of muscle activation. The muscles generate significant moments about axes other than flexion-extension, which is potentially important for actively controlling joint movement and maintaining stability about all axes. Both the muscle DOR and the multi axis moments vary with the joint position systematically. Variations of the DOR and moment-angle relationship across muscle twitches of different amplitudes in a subject were small, while there were considerable variations between subjects.     

Functional muscle synergies to support the knee against moment specific loads while weight bearing

ObjectiveExternally applied abduction and rotational loads are major contributors to the knee joint injury mechanism; yet, how muscles work together to stabilize the knee against these loads remains unclear. Our study sought to evaluate lower limb functional muscle synergies in healthy young adults such that muscle activation can be directly related to internal knee joint moments.MethodsConcatenated non-negative matrix factorization extracted muscle and moment synergies of 22 participants from electromyographic signals and joint moments elicited during a weight-bearing force matching protocol.ResultsTwo synergy sets were extracted: Set 1 included four synergies, each corresponding to a general anterior, posterior, medial, or lateral force direction. Frontal and transverse moments were coupled during medial and lateral force directions. Set 2 included six synergies, each corresponding to a moment type (extension/flexion, ab/adduction, internal/external rotation). Hamstrings and quadriceps dominated synergies associated with respective flexion and extension moments while quadriceps-hamstring co-activation was associated with knee abduction. Rotation moments were associated with notable contributions from hamstrings, quadriceps, gastrocnemius, and hip ab/adductors, corresponding to a general co-activation muscle synergy.ConclusionOur results highlight the importance of muscular co-activation of all muscles crossing the knee to support it during injury-inducing loading conditions such as externally applied knee abduction and rotation. Functional muscle synergies can provide new insight into the relationship between neuromuscular control and knee joint stability by directly associating biomechanical variables to muscle activation.     

Upper limb muscle volumes in adult subjects

Muscle force-generating properties are often derived from cadaveric studies of muscle architecture. While the relative sizes of muscles at a single upper limb joint have been established in cadaveric specimens, the relative sizes of muscles across upper limb joints in living subjects remain unclear. We used magnetic resonance imaging to measure the volumes of the 32 upper limb muscles crossing the glenohumeral joint, elbow, forearm, and wrist in 10 young, healthy subjects, ranging from a 20th percentile female to a 97th percentile male, based on height. We measured the volume and volume fraction of these muscles. Muscles crossing the shoulder, elbow, and wrist comprised 52.5, 31.4, and 16.0% of the total muscle volume, respectively. The deltoid had the largest volume fraction (15.2%+/-1%) and the extensor indicis propius had the smallest (0.2%+/-0.05%). We determined that the distribution of muscle volume in the upper limb is highly conserved across these subjects with a three-fold variation in total muscle volumes (1427-4426cm(3)). When we predicted the volume of an individual muscle from the mean volume fraction, on average 85% of the variation among subjects was accounted for (average p=0.0008). This study provides normative data that forms the basis for investigating muscle volumes in other populations, and for scaling computer models to more accurately represent the muscle volume of a specific individual.     

The interaction of muscle moment arm,knee laxity,and torque in a multi-scale musculoskeletal model of the lower limb

IntroductionMusculoskeletal modeling allows insight into the interaction of muscle force and knee joint kinematics that cannot be measured in the laboratory. However, musculoskeletal models of the lower extremity commonly use simplified representations of the knee that may limit analyses of the interaction between muscle forces and joint kinematics. The goal of this research was to demonstrate how muscle forces alter knee kinematics and consequently muscle moment arms and joint torque in a musculoskeletal model of the lower limb that includes a deformable representation of the knee.MethodsTwo musculoskeletal models of the lower limb including specimen-specific articular geometries and ligament deformability at the knee were built in a finite element framework and calibrated to match mean isometric torque data collected from 12 healthy subjects. Muscle moment arms were compared between simulations of passive knee flexion and maximum isometric knee extension and flexion. In addition, isometric torque results were compared with predictions using simplified knee models in which the deformability of the knee was removed and the kinematics at the joint were prescribed for all degrees of freedom.ResultsPeak isometric torque estimated with a deformable knee representation occurred between 45° and 60° in extension, and 45° in flexion. The maximum isometric flexion torques generated by the models with deformable ligaments were 14.6% and 17.9% larger than those generated by the models with prescribed kinematics; by contrast, the maximum isometric extension torques generated by the models were similar. The change in hamstrings moment arms during isometric flexion was greater than that of the quadriceps during isometric extension (a mean RMS difference of 9.8 mm compared to 2.9 mm, respectively).DiscussionThe large changes in the moment arms of the hamstrings, when activated in a model with deformable ligaments, resulted in changes to flexion torque. When simulating human motion, the inclusion of a deformable joint in a multi-scale musculoskeletal finite element model of the lower limb may preserve the realistic interaction of muscle force with knee kinematics and torque.     

Estimating the muscle forces generated in the human lower extremity when walking: a physiological solution

A model capable of estimating individual muscle activity during human lower extremity activity has been developed. This model was implemented and applied to normal gait. Both 3D cinematography and force platform records were collected to define the kinematics of the lower limb segments and the ground reaction forces. From these data the lengths, velocities, and moment arms of the muscles and the net muscle moments were calculated. These data were then used to estimate the output from a set of pattern generators which specified the neural input to and hence the force generated in each muscle. Results were obtained which demonstrate that it is feasible to construct a hierarchical physiological model which will estimate individual muscle forces. This statement must be tempered somewhat in that better anatomical and neurophysiological data must be made available and that this model, and all others attempting to estimate individual muscle forces, must be rigorously tested before being applied in a research, sports, or clinical setting.     

Identification of passive elastic joint moment-angle relationships in the lower extremity

The purpose of this study was to develop a method for identifying subject-specific passive elastic joint moment-angle relationships in the lower extremity, which could subsequently be used to estimate passive contributions to joint kinetics during gait. Twenty healthy young adults participated in the study. Subjects were positioned side-lying with their dominant limb supported on a table via low-friction carts. A physical therapist slowly manipulated the limb through full sagittal hip, knee, and ankle ranges of motion using two hand-held 3D load cells. Lower extremity kinematics, measured with a passive marker motion capture system, and load cell readings were used to compute joint angles and associated passive joint moments. We formulated a passive joint moment-angle model that included eight exponential functions to account for forces generated via the passive stretch of uni-articular structures and bi-articular muscles. Model parameters were estimated for individual subjects by minimizing the sum of squared errors between model predicted and experimentally measured moments. The model predictions closely replicated measured joint moments with average root-mean-squared errors of 2.5, 1.4, and 0.7 Nm about the hip, knee, and ankle respectively. We show that the models can be coupled with gait kinematics to estimate passive joint moments during walking. Passive hip moments were substantial from terminal stance through initial swing, with energy being stored as the hip extended and subsequently returned during pre- and initial swing. We conclude that the proposed methodology could provide quantitative insights into the potentially important role that passive mechanisms play in both normal and abnormal gait.     

Fibre operating lengths of human lower limb muscles during walking

Muscles actuate movement by generating forces. The forces generated by muscles are highly dependent on their fibre lengths, yet it is difficult to measure the lengths over which muscle fibres operate during movement. We combined experimental measurements of joint angles and muscle activation patterns during walking with a musculoskeletal model that captures the relationships between muscle fibre lengths, joint angles and muscle activations for muscles of the lower limb. We used this musculoskeletal model to produce a simulation of muscle-tendon dynamics during walking and calculated fibre operating lengths (i.e. the length of muscle fibres relative to their optimal fibre length) for 17 lower limb muscles. Our results indicate that when musculotendon compliance is low, the muscle fibre operating length is determined predominantly by the joint angles and muscle moment arms. If musculotendon compliance is high, muscle fibre operating length is more dependent on activation level and force-length-velocity effects. We found that muscles operate on multiple limbs of the force-length curve (i.e. ascending, plateau and descending limbs) during the gait cycle, but are active within a smaller portion of their total operating range.     

Peculiarities of Activation of the Shoulder Belt and Shoulder Muscles in Generation of Different-Direction Isometric Efforts by the Forearm

We studied central motor commands, CMCs, coming to the muscles that flex and extend the shoulder and elbow joints in the course of generation of voluntary isometric efforts of different directions by the forearm; the efforts were initiated according to a visual signal. Amplitudes of EMGs recorded from the muscles of the shoulder belt and shoulder and subjected to full-wave rectification and low-frequency filtration were considered correlates of the CMC intensity. An effort of the preset direction was developed within the operational space of the horizontal plane with angles 30 deg in the shoulder joint (external angle with respect to the frontal plane) and 90 deg in the elbow joint. We plotted sector diagrams of the logarithmic coefficient of the intensity increment of EMGs of the above muscles for the entire set of directions of generated efforts with a 15- or 20-deg step. Orientations of the maxima of EMG activity of the given muscles were rather close to the directions of the maxima of the force moments generated by these muscles. In most cases, a shift of the direction by one gradation with respect to the EMG maximum in the respective muscle resulted in a significant decrease in the level of EMG activity. It is shown that preferential activation of the muscles agonistic with respect to the examined direction of the generated effort was, as a rule, accompanied by coactivation of the antagonist muscles. When “two-joint” isometric efforts are formed, realization of the socalled synergic muscle tasks (where prevailing contractions of the muscles of the same functional direction for both joints coincide, i.e., flexion-flexion or extension-extension) is organized in a simpler manner. The programs of “nonsynergic” contractions (flexion of one joint and extension of another one, or vice versa) are more complex. In different subjects, considerably dissimilar patterns of EMG activity in muscles influencing these joints could be observed.     

Analysis of a muscular control system in human movements

In this work, we have studied a muscular control system under experimental conditions for analyzing the dynamic behavior of individual muscles and theoretical considerations for elucidating its control strategy. Movement of human limbs is achieved by joint torques and each torque is specified as the sum of torques generated by muscle forces. The behavior of individual muscles is controlled by the neural input which is estimated by means of an electromyogram (EMG). In this study, the EMGs for a flexor and an extensor are measured in elbow joint movements and the dynamic behavior of individual muscles is analyzed. As a result, it is verified that both a flexor and an extensor are activated throughout the entire movement and that the activation of muscles is controlled above a specific limit independent of the hand-held load. Subsequently, a system model for simulating elbow joint movements is developed which includes the muscle dynamic relationship between the neural input and the isometric force. The minimum limit of muscle activation that has been confirmed in experiments is provided as a constraint of the neural input and the criterion is defined by a derivative of the isometric force of individual muscles. The optimal trajectories formulated under these conditions are quantitatively compared with the experimentally observed trajectories, and the control strategy of a muscular control system is studied. Finally, a muscular control system in multi-joint arm movements is discussed with regard to the comparative analysis between observed and optimal trajectories. Received: 7 April 1999 / Accepted in revised form: 27 July 1999