Muscles within muscles: Coordination of 19 muscle segments within three shoulder muscles during isometric motor tasks.

The aim of the present study was to determine how the intra-muscular segments of three shoulder muscles were coordinated to produce isometric force impulses around the shoulder joint and how muscle segment coordination was influenced by changes in movement direction, mechanical line of action and moment arm (ma). Twenty male subjects (mean age 22 years; range 18-30 years) with no known history of shoulder pathologies, volunteered to participate in this experiment. Utilising an electromyographic technique, the timing and intensity of contraction within 19 muscle segments of three superficial shoulder muscles (Pectoralis Major, Deltoid and Latissimus Dorsi) were studied and compared during the production of rapid (e.g. approximately 400ms time to peak) isometric force impulses in four different movement directions of the shoulder joint (flexion, extension, abduction and adduction). The results of this investigation have suggested that the timing and intensity of each muscle segment's activation was coordinated across muscles and influenced by the muscle segment's moment arm and its mechanical line of action in relation to the intended direction of shoulder movement (e.g. flexion, extension, abduction or adduction). There was also evidence that motor unit task groups were formed for individual motor tasks which comprise motor units from both adjacent and distant muscles. It was also confirmed that for any particular motor task, individual muscle segments can be functionally classified as prime mover, synergist or antagonist - classifications which are flexible from one movement to the next.     

Effects of different movement directions on electromyography recorded from the shoulder muscles while passing the target positions

PurposeWe compared electromyography (EMG) recorded from the shoulder joint muscles in the same position for different movement directions.MethodsFifteen healthy subjects participated. They performed shoulder elevation from 0° to 120°, shoulder depression from 120° to 0°, shoulder horizontal adduction from ?15° to 105°, and shoulder horizontal abduction from 105° to ?15°. The target positions were 90° shoulder elevation in the 0°, 30°, 60°, and 90° planes (0°, 30°, 60°, and 90° positions). EMG signals were recorded from the supraspinatus (SSP) muscle by fine-wire electrodes. EMG signals from the infraspinatus (ISP), anterior deltoid, middle deltoid, and posterior deltoid muscles were recorded using active surface electrodes.ResultsDuring elevation and horizontal abduction, the SSP showed significantly higher activity than that shown during depression and during horizontal adduction in the 0°, 30°, and 60° positions. During elevation, the ISP showed significantly higher activity than during depression and during horizontal adduction in the 90° position. During horizontal abduction, the ISP showed significantly higher activity than during depression in the 90° position.ConclusionsWhen the movement tasks were performed in different movement directions at the same speed, each muscle showed characteristic activity.     

EMG and force production of some human shoulder muscles during isometric abduction

Surface EMG was recorded in four subjects on three different occasions from the three parts of the deltoid, the clavicular part of the pectoralis major and from the infraspinatus muscles at different angles of abduction, in the frontal and scapular plane. The integrated EMG was related to the maximum values found for each muscle or muscle part during test contractions (%EMG). Linear relations can be seen for abduction angle vs %EMG. During abduction in the scapular plane the middle and posterior parts of the deltoid muscle showed significantly less activity than in the frontal plane. A simple two dimensional model to calculate the deltoid force out of total external moment at the shoulder is presented. For the middle part of the deltoid an EMG-force relation is presented. The maximal deltoid forces found during test contractions are compared with the absolute muscle force. Also, the length-force relation for the middle part of the deltoid muscle is given between 30° and 90° of abduction.     

Long-term repeatability of force, endurance time and muscle activity during isometric contractions.

We determined the repeatability and correlations between force, endurance and muscle activity during isometric contractions over three years. Twenty-six subjects, with and without complaints of the shoulder and neck, performed standardized maximal and submaximal shoulder-abduction contractions and wrist extension-contractions at yearly intervals from 1997 to 1999. Peak forces developed during maximal contraction and the endurance times of submaximal contractions during shoulder abduction and wrist extension were measured. Electromyography (EMG) of muscle activity was recorded bilaterally from the upper trapezius, middle deltoid, and forearm extensor muscles. Root mean square EMG amplitudes were calculated. We found statistically significant associations between peak forces developed during wrist extension and shoulder abduction, and between endurance times of submaximal wrist extension and shoulder abduction. No statistically significant changes in peak force and EMG(peak) were found over the measurement years. The responses were not statistically significantly influenced by gender, or neck and shoulder pain. However, we observed considerable intra-individual variation in the inter-year measurements particularly for the responses to submaximal contraction. Such large variations represent a challenge when attempting to use the responses to interpret the effects of therapies.     

Static optimization underestimates antagonist muscle activity at the glenohumeral joint: A musculoskeletal modeling study

Static optimization is commonly employed in musculoskeletal modeling to estimate muscle and joint loading; however, the ability of this approach to predict antagonist muscle activity at the shoulder is poorly understood. Antagonist muscles, which contribute negatively to a net joint moment, are known to be important for maintaining glenohumeral joint stability. This study aimed to compare muscle and joint force predictions from a subject-specific neuromusculoskeletal model of the shoulder driven entirely by measured muscle electromyography (EMG) data with those from a musculoskeletal model employing static optimization. Four healthy adults performed six sub-maximal upper-limb contractions including shoulder abduction, adduction, flexion, extension, internal rotation and external rotation. EMG data were simultaneously measured from 16 shoulder muscles using surface and intramuscular electrodes, and joint motion evaluated using video motion analysis. Muscle and joint forces were calculated using both a calibrated EMG-driven neuromusculoskeletal modeling framework, and musculoskeletal model simulations that employed static optimization. The EMG-driven model predicted antagonistic muscle function for pectoralis major, latissimus dorsi and teres major during abduction and flexion; supraspinatus during adduction; middle deltoid during extension; and subscapularis, pectoralis major and latissimus dorsi during external rotation. In contrast, static optimization neural solutions showed little or no recruitment of these muscles, and preferentially activated agonistic prime movers with large moment arms. As a consequence, glenohumeral joint force calculations varied substantially between models. The findings suggest that static optimization may under-estimate the activity of muscle antagonists, and therefore, their contribution to glenohumeral joint stability.     

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

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% · min⁻¹ (P = 0.003) and 0.03% · min⁻¹ (P= 0.54), respectively, and increases in HR and MAP of 0.14 beats · min⁻² (P= 0.10) and 0.06 mmHg · min⁻¹ (P= 0.33), respectively. During the contraction with constant caudal EMG amplitude, the corresponding median responses were −2.51% · min⁻¹ (torque), 0.01% · min⁻¹ (ZC rate), 0.31 beats · min⁻² (HR), and 0.93 mmHg · 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. Accepted: 1 March 1997     

In vivo pediatric shoulder muscle volumes and their relationship to 3D strength

In the pediatric shoulder, injury and pathology can disrupt the muscle force balance, resulting in severe functional losses. As little data exists pertaining to in vivo pediatric shoulder muscle function, musculoskeletal data are crucially needed to advance the treatment of pediatric shoulder pathology/injury. Therefore, the purpose of this study was to develop a pediatric database of in vivo volumes for the major shoulder muscles and correlate these volumes with maximum isometric flexion/extension, internal/external rotation, and abduction/adduction joint moments. A methodology was developed to derive 3D shoulder muscle volumes and to divide the deltoid into sub-units with unique torque producing capabilities, based on segmentation of three-dimensional magnetic resonance images. Eleven typically developing children/adolescents (4F/7M, 12.0±3.2 years, 150.8±16.7 cm, 49.2±16.4 kg) participated. Correlation and regression analyses were used to evaluate the relationship between volume and maximum, voluntary, isometric joint torques. The deltoid demonstrated the largest (30.4±1.2%) and the supraspinatus the smallest (4.8±0.5%) percent of the total summed volume of all six muscles evaluated. The anterior and posterior deltoid sections were 43.4±3.9% and 56.6±3.9% of the total deltoid volume. The percent volumes were highly consistent across subjects. Individual muscle volumes demonstrated moderate-high correlations with torque values (0.70–0.94, p<0.001). This study presents a comprehensive database documenting normative pediatric shoulder muscle volume. Using these data a clear relationship between shoulder volume and the torques they produce was established in all three rotational degrees-of-freedom. This study furthers the understanding of shoulder muscle function and serves as a foundation for evaluating shoulder injury/pathology in the pediatric/adolescent population.     

Bilateral impairments of shoulder abduction in chronic hemiparesis: Electromyographic patterns and isokinetic muscle performance

ObjectiveTo analyze electromyographic (EMG) patterns and isokinetic muscle performance of shoulder abduction movement in individuals who sustained a cerebrovascular accident (CVA).DesignTwenty-two individuals who sustained a CVA and 22 healthy subjects volunteered for EMG activity and isokinetic shoulder abduction assessments. EMG onset time, root mean square (RMS) for upper trapezius and deltoid muscles, as well as the isokinetic variables of peak torque, total work, average power and acceleration time were compared between limbs and groups.ResultsThe paretic side showed a different onset activation pattern in shoulder abduction, along with a lower RMS for both muscles (21.8 ± 13.4% of the maximal voluntary isometric contraction (MVIC) for the deltoid and 25.9 ± 15.3% MVIC for the upper trapezius, about 50% lower than the control group). The non-paretic side showed a delay in both muscles activation and a lower RMS for the deltoid (32.2 ± 13.7% MVIC, about 25% lower than the control group). Both sides of the group of individuals who sustained a CVA presented a significantly lower isokinetic performance compared to the control group (paretic side ～60% lower; non-paretic side ～35% lower).ConclusionsShoulder abduction muscle performance is impaired in both paretic and non-paretic limbs of individuals who sustained a CVA.     

Reduction in subluxation and improved muscle function of the hemiplegic shoulder joint after therapeutic electrical stimulation.

Seventeen hemiplegic patients with chronic shoulder subluxation secondary to a cerebrovascular accident (CVA) were divided into three groups, two of which were subjected to 6 weeks of therapeutic electrical stimulation (TES) for 15 minutes twice a day, in order to assess the effectiveness of the treatment in reducing subluxation, and in improving shoulder abduction function. The third group was used as a control (C group). After 6 weeks of electrical stimulation of the supraspinatus (S group) and deltoid (D group), a significant (p<0.05) reduction in subluxation was observed in both groups when compared to the C group. The maximal force of shoulder abduction showed a tendency to increase in the S group (p<0.10). A significant increase in maximal force was also observed in the D group. In most of the TES-treated muscles, the interference pattern of EMG at maximum voluntary contraction increased. The amplitude of the EMG activity of the stimulated muscle also increased. Thus, we concluded that electrical stimulation therapy of the supraspinatus and the deltoid muscle is an effective treatment modality for shoulder subluxation and shoulder abduction function in hemiplegic patients.     

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.     

The upper and lower segments of subscapularis muscle have different roles in glenohumeral joint functioning

Subscapularis muscle is divided into two independent segments, upper and lower (USUB and LSUB), but the role of each segment in glenohumeral functioning is unclear. We compared the electromyographic (EMG) activity of USUB and LSUB during a variety of shoulder movements, with and without an external translation force. Intramuscular electrodes were inserted in USUB and LSUB segments of 20 adults without pathology and EMG activity was measured in stabilization trials (with and without an anterior or posterior directed force at the humerus and isometric rotations) and two shoulder positions (shoulder neutral, abduction). Maximal voluntary isometric contraction (MVIC) trials were performed in abduction, internal and external rotation of the shoulder. In MVIC trials, USUB showed higher activity during internal rotation (p = 0.03), whereas LSUB showed higher activity during external rotation (p < 0.01). In stabilization trials, the interaction effects were significant for muscle segment × condition (p < 0.01), and approached significance for muscle segment × position (p = 0.06). In the neutral position, the pattern of activity for LSUB was similar to USUB. In the abducted position the LSUB, unlike USUB, was more active during external rotation (p = 0.06) and also showed increased activity in response to the posterior directed force at the humerus (p = 0.04). Our results suggest that USUB primarily acts as an agonist for internal rotation. In contrast LSUB was particularly active in external rotation in the abducted position and demonstrated increased EMG activity in response to the posteriorly directed force at the humerus in that position, suggesting more of a role in glenohumeral stabilization.     

Quantifying ‘normal’ shoulder muscle activity during abduction

The purpose of this experiment was to obtain electromyographic (EMG) activity from a sample of healthy shoulders to allow a reference database to be developed and used for comparison with pathological shoulders. Temporal and intensity shoulder muscle activation characteristics during a coronal plane abduction/adduction movement were evaluated in the dominant healthy shoulder of 24 subjects. Surface and intramuscular fine wire electrodes recorded EMG activity from 15 shoulder muscles (deltoid × 3, trapezius × 3, subscapularis × 2, latissimus dorsi, pectoralis major, pectoralis minor, supraspinatus, infraspinatus, serratus anterior and rhomboids) at 2000 Hz for 10 s whilst each subject performed 10 dynamic coronal plane abduction/adduction movements from 0° to 166° to 0° with a light dumbbell. Results revealed that supraspinatus (?.102 s before movement onset) initiated the movement with middle trapezius (?.019 s) and middle deltoid (?.014 s) also activated before the movement onset. Similar patterns were also found in the time of peak amplitude and %MVC with a pattern emerging where the prime movers (supraspinatus and middle deltoid) were among the first to reach peak amplitude or display the highest %MVC values. In conclusion, the most reproducible patterns of activation arose from the more prime mover muscle sites in all EMG variables analysed and although variability was present, there emerged ‘invariant characteristics’ that were considered ‘normal’ for this group of non pathological shoulders. The authors believe that the methodology and certain parts of the analysis in this study can be duplicated and used by future researchers who require a reference database of muscle activity for use as a control group in comparisons to their respective pathological shoulder group.     

Worsening of neck and shoulder complaints in humans are correlated with frequency parameters of electromyogram recorded 1-year earlier

The aim was to investigate whether output and electromyogram (EMG) variables obtained from an isokinetic endurance test of the shoulder flexor muscles of 23 women with neck and shoulder problems in a car and truck industry correlated with improvement or worsening of complaints 1 year later. Each subject performed 100 maximal isokinetic shoulder forward flexions at 60° · s⁻¹. Surface EMG of the trapezius, deltoid, biceps brachii and infraspinatus muscles and mechanical output (peak torque) were determined for each contraction. The EMG was used to determine mean frequency f _mean and the ratio between the signal amplitudes of the EMG of the passive relaxation and active flexion parts of each contraction cycle (SAR). The subjects also rated the degree of fatigue they experienced throughout the test. The magnitude of the shift in f _mean was correlated with whether improvement or worsening occurred for complaints in the neck and or shoulders; a significant relationship (r ² = 0.44; P = 0.001) existed between the total frequency shift of the four muscles and the variables measuring improvement in complaints. In the multivariate predictions other f _mean variables and perception of fatigue were also of significance. The present study would indicate that a high degree of f _mean shift correlates with improvement in neck and shoulder complaints 1 year later. One possible reason could be that f _mean reflects the muscle morphology and/or a pathological situation for the type-1 muscle fibres. Accepted: 27 May 1998     

Assessing the validity of surface electromyography for recording muscle activation patterns from serratus anterior

PurposeNo direct evidence exists to support the validity of using surface electrodes to record muscle activity from serratus anterior, an important and commonly investigated shoulder muscle. The aims of this study were to determine the validity of examining muscle activation patterns in serratus anterior using surface electromyography and to determine whether intramuscular electromyography is representative of serratus anterior muscle activity.MethodsSeven asymptomatic subjects performed dynamic and isometric shoulder flexion, extension, abduction, adduction and dynamic bench press plus tests. Surface electrodes were placed over serratus anterior and around intramuscular electrodes in serratus anterior. Load was ramped during isometric tests from 0% to 100% maximum load and dynamic tests were performed at 70% maximum load. EMG signals were normalised using five standard maximum voluntary contraction tests.ResultsSurface electrodes significantly underestimated serratus anterior muscle activity compared with the intramuscular electrodes during dynamic flexion, dynamic abduction, isometric flexion, isometric abduction and bench press plus tests. All other test conditions showed no significant differences including the flexion normalisation test where maximum activation was recorded from both electrode types. Low correlation between signals was recorded using surface and intramuscular electrodes during concentric phases of dynamic abduction and flexion.ConclusionsIt is not valid to use surface electromyography to assess muscle activation levels in serratus anterior during isometric exercises where the electrodes are not placed at the angle of testing and dynamic exercises. Intramuscular electrodes are as representative of the serratus anterior muscle activity as surface electrodes.     

The contribution of the supraspinatus muscle at sub-maximal contractions

During maximum effort, the supraspinatus muscle contributes approximately 50% of the torque need to elevate the arm, but this has not been examined at sub-maximal levels. The purpose of this study was to determine the contribution of the supraspinatus muscle to shoulder elevation at sub-maximal levels. Seven healthy subjects (four males, three females) performed isometric ramp contractions at the shoulder. Middle deltoid electromyography (EMG) and force applied at the wrist were collected before and after a suprascapular nerve block. For the same level of deltoid EMG, less external force will be measured after the nerve block as the supraspinatus muscle no longer contributes. The difference between the EMG/force curve was the contribution of the supraspinatus muscle. The supraspinatus contributed 40%, 95% CI [32%–48%], to shoulder elevation. The effect of angle (p = .67) and % maximal voluntary contraction (p = .13) on supraspinatus contribution were not significant. The maximum is slightly less than reported in a previous suprascapular nerve block study using maximal contractions. The results from this study can be used to assess supraspinatus contribution in rotator cuff tears, after rehabilitation interventions, and as a restraint in computation modelling.     

Differences in stretch reflex responses of elbow flexor muscles during shortening, lengthening and isometric contractions

Stretch reflexes were evoked in elbow flexor muscles undergoing three different muscle contractions, i.e. isotonic shortening (SHO) and lengthening (LEN), and isometric (ISO) contractions. The intermuscle relationships for the magnitude of the stretch reflex component in the eletromyographic (EMG) activities of two main elbow flexor muscles, i.e. the biceps brachii (BB) and the brachioradialis (BRD), were compared among the three types of contractions. The subjects were requested to move their forearms sinusoidally (0.1 Hz) against a constant pre-load between elbow joint angles of 10° (0° = full extension) and 80° during SHO and LEN, and to keep an angle of 45° during the ISO. The perturbations were applied at the elbow angle of 45° in pseudo-random order. The EMG signals were rectified and averaged over a period of 100 ms before and 400 ms after the onset of the perturbation 40–50 times. From the ensemble averaged EMG waveform, the background activity (BGA), short (20–50 ms) and long latency (M2, 50–80, M3, 80–100 ms) reflex and voluntary activity (100–150 ms) components were measured. The results showed that both BGA and reflex EMG activity of the two elbow flexor muscles were markedly decreased during the lengthening contraction compared to the SHO and ISO contractions. Furthermore, the changes of reflex EMG components in the BRD muscle were more pronounced than those in the BB muscle, i.e. the ratios of M2 and M3 magnitudes between BRD and BB (BRD:BB) were significantly reduced during the LEN contractions. These results would suggest that the gain of long latency stretch reflex EMG activities in synergistic muscles might be modulated independently according to the model of muscle contraction. Accepted: 1 September 1997     

The pattern of sensory discharge can determine the motor response in young Xenopus tadpoles

Young Xenopus tadpoles were used to test whether the pattern of discharge in specific sensory neurons can determine the motor response of a whole animal. Young Xenopus tadpoles show two main rhythmic behaviours: swimming and struggling. Touch-sensitive skin sensory neurons in the spinal cord of immobilised tadpoles were penetrated singly or in pairs using microelectrodes to allow precise control of their firing patterns. A single impulse in one Rohon-Beard neuron (= light touch) could sometimes trigger “fictive” swimming. Two to six impulses at 30–50 Hz (= a light stroke) reliably triggered fictive swimming. Neither stimulus evoked fictive struggling. Twenty-five or more impulses at 30–50 Hz (= pressure) could evoke a pattern of rhythmic bursts, distinct from swimming and suitable to drive slower, stronger movements. This pattern showed some or all the characteristics of “fictive” struggling. These results demonstrate clearly that sensory neurons can determine the pattern of motor output simply by their pattern of discharge. This provides a simple form of behavioural selection according to stimulus. Accepted: 28 November 1996     

Functional subdivision of the upper trapezius muscle during maximal isometric contractions

The electromyographic (EMG) activity pattern across the upper trapezius of 22 healthy subjects was investigated during maximal isometric contractions. Eight bipolar surface electrodes with 10 mm distance between adjacent electrode pairs were placed on a line from the clavicle to the scapula. At the region near the clavicle the highest EMG amplitudes were recorded during 90 ° arm abduction. At the more posterior parts the highest amplitudes were found both during arm abduction and shoulder elevation. A double differential recording technique which reduced the EMG cross-talk contribution supported the finding that the upper trapezius was differently activated when the arm posture was changed. The normalized EMG amplitude-force relationship during the shoulder elevation showed a curvilinear relationship on the anterior part of the upper trapezius with a slower increase in EMG amplitude than force at low force. The slope of the curve, at low force, increased gradually in the posterior direction on the upper trapezius. The EMG activity patterns across the upper trapezius indicate a flexibility in motor activation which maybe reflects a functional optimization of the contractions performed by this muscle.     

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

The estimation of muscle forces in musculoskeletal shoulder models is still controversial. Two different methods are widely used to solve the indeterminacy of the system: electromyography (EMG)-based methods and stress-based methods. The goal of this work was to evaluate the influence of these two methods on the prediction of muscle forces, glenohumeral load and joint stability after total shoulder arthroplasty. An EMG-based and a stress-based method were implemented into the same musculoskeletal shoulder model. The model replicated the glenohumeral joint after total shoulder arthroplasty. It contained the scapula, the humerus, the joint prosthesis, the rotator cuff muscles supraspinatus, subscapularis and infraspinatus and the middle, anterior and posterior deltoid muscles. A movement of abduction was simulated in the plane of the scapula. The EMG-based method replicated muscular activity of experimentally measured EMG. The stress-based method minimised a cost function based on muscle stresses. We compared muscle forces, joint reaction force, articular contact pressure and translation of the humeral head. The stress-based method predicted a lower force of the rotator cuff muscles. This was partly counter-balanced by a higher force of the middle part of the deltoid muscle. As a consequence, the stress-based method predicted a lower joint load (16% reduced) and a higher superior–inferior translation of the humeral head (increased by 1.2 mm). The EMG-based method has the advantage of replicating the observed cocontraction of stabilising muscles of the rotator cuff. This method is, however, limited to available EMG measurements. The stress-based method has thus an advantage of flexibility, but may overestimate glenohumeral subluxation.     

Non-uniform mechanical activity of quadriceps muscle during fatigue by repeated maximal voluntary contraction in humans

To determine the non-uniform surface mechanical activity of human quadriceps muscle during fatiguing activity, surface mechanomyogram (MMG), or muscle sound, and surface electromyogram (EMG) were recorded from the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles of seven subjects during unilateral isometric knee extension exercise. Time- and frequency-domain analyses of MMG and of EMG fatigued by 50 repeated maximal voluntary contractions (MVC) for 3 s, with 3-s relaxation in between, were compared among the muscles. The mean MVC force fell to 49.5 (SEM 2.0)% at the end of the repeated MVC. Integrated EMG decreased in a similar manner in each muscle head, but a marked non-uniformity was found for the decline in integrated MMG (iMMG). The fall in iMMG was most prominent for RF, followed by VM and VL. Moreover, the median frequency of MMG and the relative decrease in that of EMG in RF were significantly greater (P < 0.05) than those recorded for VL and VM. These results would suggest a divergence of mechanical activity within the quadriceps muscle during fatiguing activity by repeated MVC. Accepted: 19 January 1999