Biceps tenotomy in the presence of a supraspinatus tear alters the adjacent intact tendons and glenoid cartilage

A rotator cuff tear is a common injury in athletes and workers who repeatedly perform overhead movements, and it is not uncommon for this demographic to return to activity shortly after treatment. A biceps tenotomy is often performed in the presence of a rotator cuff tear to help reduce pain and improve joint function. However, the effect of this procedure on the surrounding tissues in the glenohumeral joint is unknown. Therefore, the purpose of this study was to investigate the effect of a biceps tenotomy in the presence of a supraspinatus rotator cuff tear followed by overuse activity on ambulatory function and mechanical and histologic properties of the remaining rotator cuff tendons and glenoid cartilage. 46 rats underwent 4 weeks of overuse activity to create a tendinopathic condition, then were randomized into two groups: unilateral detachment of the supraspinatus tendon or detachment of the supraspinatus and long head of the biceps tendons. Ambulatory measurements were performed throughout the 8 weeks prior to euthanasia, followed by analysis of the properties of the remaining intact tendons and glenoid cartilage. Results demonstrate that shoulder function was not effected in the biceps tenotomy group. However, the intact tendons and glenoid cartilage showed altered mechanical and histologic properties. This study provides evidence from an animal model that does not support the use of tenotomy in the presence of a supraspinatus tendon rotator cuff tear, and provides a framework for physicians to better prescribe long-term treatment strategies for patients.     

On the suitability of using surface electrode placements to estimate muscle activity of the rotator cuff as recorded by intramuscular electrodes

BackgroundElectromyography (EMG) is commonly used to assess muscle activity. Although previous studies have had moderate success in predicting individual intramuscular muscle activity from surface electrodes, extensive data does not exist for the rotator cuff. This study aimed to determine how reliably surface electrodes represent rotator cuff activity during 20 maximal exertions.MethodsFive channels of EMG were recorded on the following rotator cuff muscles: supraspinatus and infraspinatus intramuscular and surface recordings, and teres minor intramuscular recordings. An additional 3 surface electrodes were placed over the upper and middle trapezius and posterior deltoid. Subjects performed ramped maximal voluntary contractions (MVCs) for each muscle, followed by 20 isometric maximal exertions. Linear least squares best fit regressions (unconstrained and constrained with zero-intercept) were used to compare: intramuscular and surface supraspinatus and infraspinatus signals, respectively, and intramuscular teres minor and surface infraspinatus signals.FindingsRelationships existed between wire and surface electrode measurements for all rotator cuff muscles: supraspinatus (r² = 0.73); teres minor (r² = 0.61); infraspinatus (r² = 0.40), however prediction equations indicated large overestimations and offsets.InterpretationWhen appropriate multiplicative coefficients are considered, surface supraspinatus and infraspinatus electrodes may be used to estimate intramuscular supraspinatus and teres minor activations, respectively, in maximal exertions similar to those tested. However, until these relationships are better defined in other postures, intensities and exertion types, the use of surface electrodes to estimate indwelling rotator cuff activity is cautioned against.     

Scapular orientation following repetitive prone rowing: Implications for potential subacromial impingement mechanisms

While fatigue of the rotator cuff demonstrably causes superior humeral head migration and concomitant risk of impingement, the relationship between specific muscular fatigue, scapular dyskinesis and impingement risk is less clear. The purpose of this study was to examine changes in scapular orientation following a simulated prone rowing fatiguing protocol that targeted the scapula stabilizing muscles while attempting to alleviate rotator cuff muscular demands. Scapular orientation and muscle activity were collected from participants before and immediately after the fatiguing task. This task fatigued both the stabilizing (upper and middle trapezius, and latissimus dorsi) and rotator cuff (supraspinatus, and infraspinatus) muscles. The upper extremity muscle fatigue pattern caused by the protocol did not elicit any significantly changes in three-dimensional scapular position with all post-fatigue changes being ?1° (p = 0.17–0.58). These results indicated that scapular reorientation is likely not the dominant mechanism of fatigue-induced subacromial impingement development. However, the substantial variability present in the kinematics prevents complete exclusion of scapular dyskinesis as a secondary causal mechanism of impingement.     

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.     

Electromyographic analysis during pull,forward punch,elevation and overhead throw after conservative treatment or capsular shift at patient with multidirectional shoulder joint instability

PurposeThe aim of this study was to compare the muscle activity of patients with multidirectional instability treated in a conservative or complex manner (capsular shift with postoperative rehabilitation) and the muscle activity of stable shoulder joints before and after treatment during pull, push, and elevation of upper extremities and during overhead throw.ScopeThe study was carried out on 34 patients with multidirectional shoulder instability treated non-operatively, on 31 patients with multidirectional shoulder instability treated operatively, and on 50 healthy subjects. Signals were recorded by surface EMG from eight different muscles. The mean and standard deviation of the maximum amplitude of normalized voluntary electrical activity for the different movement types and time broadness values during overhead throw were determined for each muscle in all groups and compared with each other.ConclusionThe centralization of the glenohumeral joint and the reduction of instability is attempted to be ensured by the organism through increasing the role of rotator cuff muscles (p = 0.009) and decreasing the role of the deltoid, biceps brachii, and pectoralis maior muscles (p = 0.007). At patients after short-term and long-term conservative treatment, the maximum amplitude of normalized voluntary electrical activity of stabilizer muscles is significantly higher (p = 0.006), and that of accelerator muscles is significantly lower (p = 0.005) and the time broadness is significantly longer (p = 0.01) than that of the control group. At patients after complex treatment (open capsular shift with postoperative conservative rehabilitation) the characteristic of the muscle pattern is similar (p = 0.19) to the control group.The complex treatment resolves the labral ligamentous abnormalities by operative treatment and restores the impaired muscular control by postoperative rehabilitation, whereas the conservative treatment restores only the muscular control.     

Shear wave elastography of the supraspinatus muscle and tendon: Repeatability and preliminary findings

Shear wave elastography (SWE) is a promising tool for estimating musculoskeletal tissue properties, but few studies have rigorously assessed its repeatability and sources of error. The objectives of this study were to assess: (1) the extent to which probe positioning error and human user error influence measurement accuracy, (2) intra-user, inter-user, and day-to-day repeatability, and (3) the extent to which active and passive conditions affect shear wave speed (SWS) repeatability. Probe positioning and human usage errors were assessed by acquiring SWE images from custom ultrasound phantoms. Intra- and inter-user repeatability were assessed by two users acquiring five trials of supraspinatus muscle and tendon SWE images from ten human subjects. To assess day-to-day repeatability, five of the subjects were tested a second time, approximately 24 h later. Imaging of the phantoms indicated high inter-user repeatability, with intraclass correlation coefficient (ICC) values of 0.68–0.85, and RMS errors of no more than 4.1%. SWE imaging of the supraspinatus muscle and tendon had high repeatability, with intra- and inter-user ICC values of greater than 0.87 and 0.73, respectively. Day-to-day repeatability demonstrated ICC values greater than 0.33 for passive muscle, 0.48 for passive tendon, 0.65 for active muscle, and 0.94 for active tendon. This study indicates the technique has good to very good intra- and inter-user repeatability, and day-to-day repeatability is appreciably higher when SWE images are acquired under a low level of muscle activation. The findings from this study establish the feasibility and repeatability of SWE for acquiring data longitudinally in human subjects.     

The effects of wrist motion and hand orientation on muscle forces: A physiologic wrist simulator study

Although the orientations of the hand and forearm vary for different wrist rehabilitation protocols, their effect on muscle forces has not been quantified. Physiologic simulators enable a biomechanical evaluation of the joint by recreating functional motions in cadaveric specimens. Control strategies used to actuate joints in physiologic simulators usually employ position or force feedback alone to achieve optimum load distribution across the muscles. After successful tests on a phantom limb, unique combinations of position and force feedback – hybrid control and cascade control – were used to simulate multiple cyclic wrist motions of flexion-extension, radioulnar deviation, dart thrower’s motion, and circumduction using six muscles in ten cadaveric specimens. Low kinematic errors and coefficients of variation of muscle forces were observed for planar and complex wrist motions using both novel control strategies. The effect of gravity was most pronounced when the hand was in the horizontal orientation, resulting in higher extensor forces (p < 0.017) and higher out-of-plane kinematic errors (p < 0.007), as compared to the vertically upward or downward orientations. Muscle forces were also affected by the direction of rotation during circumduction. The peak force of flexor carpi radialis was higher in clockwise circumduction (p = 0.017), while that of flexor carpi ulnaris was higher in anticlockwise circumduction (p = 0.013). Thus, the physiologic wrist simulator accurately replicated cyclic planar and complex motions in cadaveric specimens. Moreover, the dependence of muscle forces on the hand orientation and the direction of circumduction could be vital in the specification of such parameters during wrist rehabilitation.     

Influence of muscle activity on musculotendinous stiffness quantification in stunted,prepubertal children

The quick-release technique to estimate musculotendinous (MT) stiffness has been extensively used over the last years, in both animals and humans, to gain insights in the adaptive process of the series elastic component (SEC). Recently, MT stiffness quantification, i.e., SEC behavior, has been revisited for subjects not able to fully activate their muscles (effects of long-term spaceflight or non-mature muscles). Such a phenomenon can also be encountered in stunted children. So, the aim of the present study was to analyze the effect of stunting on MT stiffness taking into account possible defect in muscle activation. For this study, 20 eutrophic children (EU) with an average age of 9 years ± 4 months were compared to 11age matched stunted children (S) evaluated by the height-to-age index. The MT stiffness index was obtained with regard to stiffness–torque and stiffness–soleus EMG relationships. The children of the S group presented a significantly lower Maximal Voluntary Contraction (MVC) in plantar flexion in comparison with children of the EU group (?37.8%). The significantly lower MT stiffness index for S children (?42.6%) was evidenced only when quantified with regard to the stiffness–soleus EMG relationship (66.5 ± 42.8 vs. 38.2 ± 19.9 Nm rad^?1%^?1). Possible delay in fiber type differentiation or tendinous structure maturation can account for the lower MT stiffness index in S children. In conclusion, stunting during early childhood delays the differentiation and maturation processes of musculotendinous structures as shown by the lower MT stiffness quantified with regards to muscle activity, also altered for stunted prepubertal children.     

Sub-regional activation of supraspinatus and infraspinatus muscles during activities of daily living is task dependent

The supraspinatus and infraspinatus muscles each have multiple sub-regions that may activate differentially in activities of daily living. Awareness of these differential demands critically informs rehabilitation of rotator cuff muscle following injury, particularly if centered on recovering and strengthening the rotator cuff to perform daily tasks. This study quantified muscle activation of supraspinatus and infraspinatus sub-regions during the performance of six activities of daily living. Twenty-three participants (mean: 22.6 ± 2.6 years) completed the following tasks: opening a jar, reaching at shoulder height, overhead reaching, pouring water from a pitcher, eating with a spoon, and combing hair. Indwelling electromyography was collected from the anterior and posterior supraspinatus and superior, middle, and inferior infraspinatus. Tasks requiring high arm elevations (e.g. reaching at shoulder and overhead height) activated anterior supraspinatus between 21 and 28% MVC. The posterior supraspinatus consistently activated between 10 and 30% MVC across all tasks. All sub-regions of infraspinatus activated highly (between 18 and 25% MVC) in tasks requiring high arm elevations in flexion. These findings may be leveraged to define effective measures to increase rotator cuff function in daily tasks.     

The range of axial rotation of the glenohumeral joint

There is a paucity of data in the literature on the restraining effects of the glenohumeral (GH) ligaments; cadaveric testing is one of the best methods for determining the function of these types of tissues. The aim of this work was to commission a custom-made six degrees of freedom (dof) joint loading apparatus and to establish a protocol for laxity testing of cadaveric shoulder specimens. Nine cadaveric shoulder specimens were used in this study and each specimen had all muscle resected leaving the scapula, humerus (transected at mid-shaft) and GH capsule. Specimens were mounted on the testing apparatus with the joint in the neutral position and at 30°, 60° and 90° GH abduction in the coronal, scapula and 30° forward flexion planes. For each orientation, 0–1 N m in 0.1 N m increments was applied in internal/external rotation and the angular displacement recorded. The toe-region of the moment–displacement curves ended at approximately ±0.5 N m. The highest rotational range of motion for the joint was 140° for ±1.0 N m at 30° GH abduction in the scapula plane. The range of motion shifted towards external rotation with increasing levels of abduction. The results provide the optimum loading regime to pre-condition shoulder specimens and minimise viscoelastic effects in the ligaments prior to laxity testing (>0.5 N m at 30° GH abduction in any of the three planes). Knowledge of the mechanical properties of the GH capsuloligamentous complex has implications for modelling of the shoulder as well surgical planning and intervention.     

Motion of the shoulder complex in individuals with isolated acromioclavicular osteoarthritis and associated with rotator cuff dysfunction: Part 1 – Three-dimensional shoulder kinematics

This study described the three-dimensional shoulder motion during the arm elevation in individuals with isolated acromioclavicular osteoarthritis (ACO) and ACO associated with rotator cuff disease (RCD), as compared to controls. Seventy-four participants (ACO = 23, ACO + RCD = 25, Controls = 26) took part of this study. Disability was assessed with the DASH, three-dimensional kinematics were collected during arm elevation in the sagittal and scapular planes, and pain was assessed with the 11-point numeric pain rating scale. For each kinematic variable and demographic variables, separate linear mixed-model 2-way ANOVAs were performed to compare groups. Both ACO groups had higher DASH and pain scores. At the scapulothoracic joint, the isolated ACO group had greater internal rotation than control, and the ACO + RCD group had greater upward rotation than both other groups. At the sternoclavicular joint, both groups with ACO had less retraction, and the isolated ACO group had less elevation and posterior rotation. At the acromioclavicular joint, the isolated ACO group had greater upward rotation, and both ACO groups had greater posterior tilting. Patients with ACO had altered shoulder kinematics, which may represent compensatory responses to reduce pain and facilitate arm motion during arm elevation and lowering.     

Investigation of 3D glenohumeral displacements from 3D reconstruction using biplane X-ray images: Accuracy and reproducibility of the technique and preliminary analysis in rotator cuff tear patients

Rotator cuff (RC) tears may be associated with increased glenohumeral instability; however, this instability is difficult to quantify using currently available diagnostic tools. Recently, the three-dimensional (3D) reconstruction and registration method of the scapula and humeral head, based on sequences of low-dose biplane X-ray images, has been proposed for glenohumeral displacement assessment. This research aimed to evaluate the accuracy and reproducibility of this technique and to investigate its potential with a preliminary application comparing RC tear patients and asymptomatic volunteers. Accuracy was assessed using CT scan model registration on biplane X-ray images for five cadaveric shoulder specimens and showed differences ranging from 0.6 to 1.4 mm depending on the direction of interest. Intra- and interobserver reproducibility was assessed through two operators who repeated the reconstruction of five subjects three times, allowing defining 95% confidence interval ranging from ±1.8 to ±3.6 mm. Intraclass correlation coefficient varied between 0.84 and 0.98. Comparison between RC tear patients and asymptomatic volunteers showed differences of glenohumeral displacements, especially in the superoinferior direction when shoulder was abducted at 20° and 45°. This study thus assessed the accuracy of the low-dose 3D biplane X-ray reconstruction technique for glenohumeral displacement assessment and showed potential in biomechanical and clinical research.     

The architecture and contraction time of intrinsic foot muscles

Although critical for effective human locomotion and posture, little data exists regarding the segmentation, architecture and contraction time of the human intrinsic foot muscles. To address this issue, the Abductor Hallucis (AH), Abductor Digiti Minimi (ADM), Flexor Digitorum Brevis (FDB) and Extensor Digitorum Brevis (EDB) were investigated utilizing a cadaveric dissection and a non-invasive whole muscle mechanomyographic (wMMG) technique. The segmental structure and architecture of formaldehyde-fixed foot specimens were determined in nine cadavers aged 60–80 years. The wMMG technique was used to determine the contraction time (Tc) of individual muscle segments, within each intrinsic foot muscle, in 12 volunteers of both genders aged between 19 and 24 years.While the pattern of segmentation and segmental –architecture (e.g. fibre length) and –Tc of individual muscle segments within the same muscle were similar, they varied between muscles. Also, the average whole muscle Tc of FDB was significantly (p < 0.05) shorter (faster) (Tc = 58 ms) than in all other foot muscles investigated (ADM Tc = 72 ms, EDB Tc = 72 ms and ABH Tc = 69 ms). The results suggest that the architecture and contraction time of the FDB reflect its unique direct contribution, through toe flexion, to postural stability and the rapid development of ground reaction forces during forceful activities such as running and jumping.     

Muscle architecture variations along the human semitendinosus and biceps femoris (long head) length

The purpose of this study was to examine whether muscle architecture of the long head of biceps femoris (BF) and semitendinosus (ST) muscles varies along their length. The ST and BF muscles were dissected and removed from their origins in eight cadaveric specimens (age range 67.8–73.4 years). One-way analysis of variance designs were used to compare fascicle length (FL), pennation angle (PA) and muscle thickness (MT) between proximal, mid-belly and distal positions. Tendon and muscle length properties were also quantified. For the BF muscle, one-way analysis of variance tests showed a higher PA (23.96 ± 3.82°) and FL (7.12 ± 0.48 cm) proximally than distal positions (PA = 17.78 ± 1.95° and FL = 6.35 ± 0.89 cm, respectively). For the ST, there was a significantly (p < 0.05) lower PA (8.81 ± 1.22°) and FL (13.10 ± 1.54 cm) proximally than distally (PA = 14.69 ± 1.09° and FL = 15.49 ± 2.30 cm, respectively). Muscle thickness significantly increased from distal to more proximal positions (p < 0.05). These data suggest that the ST and BF architecture is not uniform and that measurement of these parameters largely depends on the measurement site. Modeling these muscles by assuming a uniform architecture along muscle length may yield less accurate representation of human hamstring muscle function.     

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

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

Voluntary activation of trapezius measured with twitch interpolation

This study investigated the feasibility of measuring voluntary activation of the trapezius muscle with twitch interpolation. Subjects (n = 8) lifted the right shoulder or both shoulders against fixed force transducers. Stimulation of the accessory nerve in the neck was used to evoke maximal twitches in right trapezius. The twitch-like increments in force (superimposed twitches) evoked during different strength voluntary contractions were linearly related to voluntary force (r = ?0.82 to ?0.99). Hence, voluntary activation could be quantified by twitch interpolation with this stimulus. Comparison of unilateral and bilateral MVCs showed that maximal voluntary force was greater in unilateral than bilateral efforts (92.7 ± 2.9% and 82.3 ± 5.8% MVC, respectively) but voluntary activation was similar (88.6 ± 9.6% and 91.7 ± 5.2%). Trapezius is commonly affected in work-related musculoskeletal disorders. Measurement of voluntary activation will be a useful technique to demonstrate whether the reduced maximal voluntary force reported in such disorders is due to muscular or neural factors.     

Validity of resting myotonometric assessment of lower extremity muscles in chronic stroke patients with limited hypertonia: A preliminary study

The aim of this preliminary study was to examine the validity of a recently-introduced tool (MyotonPRO) for the assessment of mechanical parameters of the main lower extremity muscles in patients with chronic stroke. Thigh and shank muscles of 20 stroke patients with limited hypertonia (11 men and 9 women; mean age: 52 ± 11 yrs) and 20 healthy controls (11 men and 9 women; mean age: 53 ± 10 yrs) were bilaterally evaluated with (i) MyotonPRO for muscle stiffness, tone and elasticity, (ii) ultrasonography for muscle and subcutaneous thickness, and (iii) dynamometry for isometric muscle strength. MyotonPRO parameters of stroke patients were reassessed a week later (inter-day test-retest design). For all the investigated muscles, MyotonPRO variables did not differ between the more affected and the less affected side of patients (P > 0.05 for main side effect), and neither differed between patients and controls (P > 0.05 for main group effect), except for gastrocnemius medialis stiffness that was higher in patients (300 ± 51 N/m) than in controls (281 ± 29 N/m; P < 0.05). Thigh muscle stiffness was negatively correlated to subcutaneous thickness (r = −0.84 for the vastus lateralis; P < 0.001), while only tibialis anterior stiffness and tone correlated positively with muscle thickness (both r = 0.46; P < 0.01). Test-retest reliability of MyotonPRO parameters was adequate, except for muscle elasticity. The validity of MyotonPRO for the evaluation of thigh muscles in chronic stroke patients is partially challenged by the poor discriminant ability and by the considerable impact of subcutaneous tissue thickness (sex-dependent) on mechanical parameters. The potential validity of MyotonPRO for the assessment of shank muscles requires further investigation.     

Multi-channel electromyography during maximal isometric and dynamic contractions

Motor unit behavior differs between contraction types at submaximal contraction levels, however is challenging to study during maximal voluntary contractions (MVCs). With multi-channel surface electromyography (sEMG), mean physiological characteristics of the active motor units can be extracted. Two 8-electrode sEMG arrays were attached on biceps brachii muscle (one on each head) to examine behavior of sEMG variables during isometric, eccentric and concentric MVCs of elbow flexors in 36 volunteers.On average, isometric (364 ± 88 N) and eccentric (353 ± 74 N) MVCs were higher than concentric (290 ± 73 N) MVC (p < 0.001). Mean muscle fiber conduction velocity (CV) was highest during eccentric MVC (4.42 ± 0.49 m/s) than concentric (4.25 ± 0.49 m/s, p < 0.01) and isometric (4.14 ± 0.45 m/s, p < 0.001) MVCs. Furthermore, eccentric MVC showed lower sEMG amplitude at the largest elbow joint angles (120–170°) and higher CV at the smallest (70–150°) elbow joint angles (p < 0.05–0.001) than concentric MVC.The differences in CV and sEMG amplitude between the MVCs suggest that the control strategy of motor units differs between the contraction types during MVCs, and is dependent on the muscle length between the dynamic MVCs.     

Corrective sitting strategies: An examination of muscle activity and spine loading

The purpose of this study was to quantify the load on the lumbar spine of subjects when they are asked to adjust from a slouched sitting posture into an upright posture with one of three different strategies: “free” (no instruction) and two coached patterns: “lumbopelvic” dominant and “thoracic” dominant. The activity of selected muscles and kinematic data was recorded from 20 volunteers while performing the three movement patterns to adjust sitting posture. Moments and forces at the lumbar spine were computed from an anatomically detailed model that uses kinematics and muscle activation as input variables.The lumbopelvic pattern produces less joint moment on the lumbar spine (on average 31.2 ± 3.9 N m) when compared to the thoracic pattern (43.8 ± 5.8 N m). However, the joint compression force was similar for these two patterns, but it was smaller in the free pattern, when no coaching was given (lumbopelvic: 1279 ± 112 N, thoracic: 1367 ± (125 N, free: 1181 ± 118 N). Lower thoracic erector muscle activity and higher lumbar erector activity were measured in the lumbopelvic pattern in comparison with the other two. In summary the lumbopelvic pattern strategy using predominantly the movement of anterior pelvic tilt results in smaller joint moments on the lumbar spine and also positions the lumbar spine closest to the neutral posture minimizing passive tissue stress. This may be the strategy of choice for people with low back flexion intolerance.     

Sex differences in jaw muscle duty factors during exercise in two environments: A pilot study

It is unknown if females and males use jaw muscles similarly during exercise. This pilot study assessed jaw elevator muscle duty factors (DFs = time of muscle activity/total recording time) at repeated sessions to test if DFs are reliable and different between sexes during exercises in two environments. Ten female and seven male subjects recruited from university soccer teams provided informed consent. Surface electromyography was recorded from masseter and temporalis muscles during biting and leg-extension laboratory exercises. Average activities to produce 20 N bite-forces for each muscle and subject determined thresholds (5–80%·T20 N) for subject-specific DF calculations during exercises performed in laboratory and natural environments. Subjects self-recorded via portable electromyography equipment during in-field leg-extension and weight-lifting exercises. Effects of variables on DFs were assessed via ANOVA (α = 0.05) and simple effects testing (Bonferroni-adjusted p ⩽ 0.012). All subjects used jaw muscles during exercises in both environments. DFs between laboratory sessions were reliable (R = 0.84). During laboratory exercises, male temporalis DFs were significantly higher than female DFs from both muscles (p ⩽ 0.001). During in-field exercises females had higher DFs during weight-lifting while males had higher DFs during leg-extensions. In-field sex differences were significant at most thresholds and showed larger effect sizes for leg-extension compared to weight-lifting exercises.