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.     

EMG of upper trapezius − Electrode sites and association with clavicular kinematics

The upper trapezius (UT) has been widely studied and related to alterations in clavicular kinematics in subject with shoulder disorders. However, the most common electrode site used to capture UT EMG is between C7 and the acromion, placing the electrodes over the acromial fibers rather than clavicular ones. Therefore, this study aimed to investigate the relationship between clavicular movements (elevation and retraction) and UT EMG recorded from three electrode sites (traditional electrode positioning and two different sites proposed for clavicular fibers evaluation). Furthermore, the position associated with the highest EMG during maximal isometric voluntary contractions (MVIC), for each electrode site, was determined for normalization purposes. EMG was simultaneously captured in the three electrode sites of 20 healthy subjects, during MVIC at five different positions and during shoulder elevation and abduction in scapular plane. Clavicular kinematics was recorded using an electromagnetic tracking system during the dynamic contractions. Shoulder abduction with head rotation and lateral flexion elicited the highest EMG amplitude on the three electrode sites and was used to normalize the signals. A cross-correlation analysis showed high correlations between all electrode sites and clavicular movements. However, the traditional electrode site seems to record more informative signals in healthy subjects.     

Variation of muscle recruitment during exercises performed below horizontal arm elevation that target the lower trapezius: A repeated measures cross-sectional study on asymptomatic individuals

The gold standard exercise for recruitment of the lower trapezius is the Y prone exercise which is performed above 90° of shoulder elevation. However, clinicians often prescribe exercises that avoid high elevation postures during early stages of rehabilitation. Comparatively little data exists on relative muscle recruitment during lower arm elevation exercises. This study examined the EMG activity of four shoulder girdle muscles during four exercises accomplished below 90° of shoulder elevation and compared them to the Y prone while considering sex effects. Variance across exercises of the ratio between upper trapezius and lower trapezius was also explored. 32 healthy participants completed standardized muscle-specific MVCs and two repetitions of each exercise. The side lying external rotation and the wall slide exercises produced the highest peak EMG for the lower trapezius, both 33 and 29% lower than the Y Prone. For the upper trapezius to lower trapezius ratio, the side lying external rotation elicited the lowest value, followed by the Y prone and wall slide (53 and 59% respectively higher). Sex influenced some EMG values, typically interacting with exercise type. Thus, side lying external rotation and the wall slide are recommended for targeting the lower trapezius muscle during early rehabilitation.     

Normalization of electromyogram in the neck-shoulder region

Linear and curvilinear electromyogram (EMG) normalization methods were compared among ten healthy men during a simulated work cycle demanding attention and static holding of the arm (Solitaire test). Maximal voluntary contractions (MVC) and gradually increasing contractions up to 70% of MVC were used for normalization in different arm postures. The test contractions studied included inward and outward rotations, abduction, shoulder elevation, and flexion in different arm positions. The shoulder load moment was calculated for the flexion tests using a simple two-dimensional model. The effect of arm posture on the EMG versus shoulder load moment relationship was studied on the following muscles: supraspinatus, infraspinatus, trapezius (three parts), deltoid (two parts) and pectoralis major. All muscles participated in the MVC tests performed, and its was not possible to suggest a single recommended test for each muscle. Differences in normalized EMG median values ranging up to 30% of MVC were found between linear and curvilinear normalization methods. Short-term repeatability of normalization based on a contraction with gradually increasing force was good. Arm posture affected the relationships between shoulder load moment and EMG activity of all muscles studied. Arm posture did not, however, have a significant effect on the estimated amplitude probability distribution functions during the simulated work task. Therefore, at least for the tasks studied, the principle of normalizing in the middle position of the range of movement was deemed acceptable.     

The effect of handedness on electromyographic activity of human shoulder muscles during movement.

The aim of the study was to investigate whether there was a difference in the electromyographic (EMG) activity of human shoulder muscles between the dominant and nondominant side during movement and to explore whether a possible side-difference depends on the specific task. We compared the EMG activity with surface and intramuscular electrodes in eight muscles of both shoulders in 20 healthy subjects whose hand preference was evaluated using a standard questionnaire. EMG signals were recorded during abduction and external rotation. During abduction, the normalized EMG activity was significantly smaller on the dominant side compared to the nondominant side for all the muscles except for infraspinatus and lower trapezius (P 相似文献   

Intramuscular pressure and EMG relate during static contractions but dissociate with movement and fatigue.

Intramuscular pressure (IMP) and electromyography (EMG) mirror muscle force in the nonfatigued muscle during static contractions. The present study explores whether the constant IMP-EMG relationship with increased force may be extended to dynamic contractions and to fatigued muscle. IMP and EMG were recorded from shoulder muscles in three sessions: 1). brief static arm abductions at angles from 0 to 90 degrees, with and without 1 kg in the hands; 2). dynamic arm abductions at angular velocities from 9 to 90 degrees /s, with and without 1 kg in the hands; and 3). prolonged static arm abduction at 30 degrees for 30 min followed by recovery. IMP and EMG increased in parallel with increasing shoulder torque during brief static tasks. During dynamic contractions, peak IMP and EMG increased to values higher than those during static contractions, and EMG, but not IMP, increased significantly with speed of abduction. In the nonfatigued supraspinatus muscle, a linear relationship was found between IMP and EMG; in contrast, during fatigue and recovery, significant timewise changes of the IMP-to-EMG ratio occurred. The results indicate that IMP should be included along with EMG when mechanical load sharing between muscles is evaluated during dynamic and fatiguing contractions.     

Normalizing upper trapezius EMG amplitude: Comparison of different procedures

Different procedures have been used for normalization of upper trapezius electromyographic (EMG) amplitudes. This complicates comparisons between studies. The present study aimed at investigating the influence of some commonly used trapezius EMG normalization procedures on the results of ergonomic analyses, as well as the test-retest repeatability of these procedures. EMG activity from the upper trapezius was recorded during an occupational task. The EMG activity was then normalized by seven different normalization procedures. It was shown that at the group level, a unilateral shoulder elevation maximal voluntary electrical (MVE) activation procedure gave 1.2 times higher occupational load estimates than a corresponding bilateral MVE. At the group level, the median load during the occupational task was 1.6 times higher when expressed as %MVC (maximal voluntary contraction) obtained from a power regression of relative force on EMG amplitude than when expressed as %MVE determined from a single maximal shoulder elevation. Normalizations in terms of a submaximal reference voluntary electrical (RVE) activation had similar test-retest repeatability in terms of the coefficient of variation (CV: 11–13%) as normalizations in terms of an MVE (CV: 11–15%), but the power regression procedures had considerably larger CVs (21–36%). The paper provides a basis for comparing previous studies using different normalization methods, as well as a qualitative evaluation of normalization methods for future use.     

Quantitative Estimation of Muscle Shear Elastic Modulus of the Upper Trapezius with Supersonic Shear Imaging during Arm Positioning

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87–0.97) and inter-observer (ICC = 0.78–0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders.     

The influence of posture variation on electromyographic signals in females obtained during maximum voluntary isometric contractions: A shoulder example

Surface electromyography (sEMG) is commonly used to estimate muscle demands in occupational tasks. To allow for comparisons, sEMG amplitude is normalized to muscle specific maximum voluntary contractions (MVCs) performed in a standardized set of postures. However, maximal sEMG amplitude in shoulder muscles is highly dependent on arm posture and therefore, normalizing task related muscular activity to standard MVCs may lead to misinterpretation of task specific muscular demands. Therefore, the purpose of this study was to investigate differences in commonly monitored shoulder muscles using normalized sEMG amplitude between maximal exertions at different hand locations and across force exertion directions relative to standard MVCs. sEMG was recorded from the middle deltoid, pectoralis major sternal head, infraspinatus, latissimus dorsi, and upper trapezius. Participants completed standardized muscle-specific MVCs and two maximal exertions in 5 hand locations (low left, low right, high left, high right, and central) in each of the four force directions (push, pull, up, and down). Peak sEMG was analyzed in the direction(s) that elicited the highest signal for each muscle. All muscles differed by location (p < 0.05). Latissimus dorsi had the greatest activation during pulls (32–135% MVC); upper trapezius and middle deltoid while exerting upwards (73–103% and 42–78% MVC, respectively); infraspinatus while pushing (38–79% MVC); and pectoralis major activation was the highest during downwards exertions (48–84% MVC). Normalization of location specific maximal exertions to standard muscle specific MVCs underestimated maximal activity across 90% of the tasks in all shoulder muscles tested, except for latissimus dorsi where amplitudes were overestimated in low right hand location. Normalization of location specific muscle activity to standard muscle specific MVCs often underestimates muscle activity in task performance and is cautioned against if the goal is to accurately estimate muscle demands.     

Normalization of surface EMG amplitude from the upper trapezius muscle in ergonomic studies — A review

Surface electromyographic (EMG) amplitude from the upper trapezius muscle is widely used as a measure of shoulder-neck load in ergonomic studies. A variety of methods for normalizing EMG amplitude from the upper trapezius (EMGamp_ut) have been presented in the literature. This impedes meta-analyses of, for instance, upper trapezius load in relation to development of shoulder-neck disorders. The review offers a thorough discussion of different normalization procedures for EMGamp_ut. The following main issues are focused: output variable, location of electrodes, posture and attempted movement during normalization, load and duration of reference contractions, signal processing and test-retest repeatability. It is concluded that translations of EMGamp_ut into biomechanical variables, for example relative force development in the shoulder or in the upper trapezius itself, suffer from low validity, especially if used in work tasks involving large and/ or fast arm movements. The review proposes a standard terminology relating to normalization of EMGamp_ut and concludes in a concrete suggestion for a normalization procedure generating bioelectrical variables which reflect upper trapezius activation.     

Effects of shoulder muscle fatigue caused by repetitive overhead activities on scapulothoracic and glenohumeral kinematics.

The purpose of this study was to determine the effects of shoulder muscle fatigue on three dimensional scapulothoracic and glenohumeral kinematics. Twenty healthy subjects participated in this study. Three-dimensional scapulothoracic and glenohumeral kinematics were determined from electromagnetic sensors attached to the scapula, humerus, and thorax. Surface electromyographic (EMG) data were collected from the upper and lower trapezius, serratus anterior, anterior and posterior deltoid, and infraspinatus muscles. Median power frequency (MPF) values were derived from the raw EMG data and were used to indicate the degree of local muscle fatigue. Kinematic and EMG measures were collected prior to and immediately following the performance of a shoulder elevation fatigue protocol. Following the performance of the fatigue protocol subjects demonstrated more upward and external rotation of the scapula, more clavicular retraction, and less humeral external rotation during arm elevation. All muscles with the exception of the lower trapezius showed EMG signs of fatigue, the most notable being the infraspinatus and deltoid muscles. In general, greater scapulothoracic motion and less glenohumeral motion was observed following muscle fatigue. Further studies are needed to determine what effects these changes have on the soft tissues and mechanics of the shoulder complex.     

Upper trapezius muscle activity patterns during repetitive manual material handling and work with with a computer mouse.

Firstly, upper trapezius EMG activity patterns were recorded on the dominant side of 6 industrial production workers and on the side operating a computer mouse of 14 computer-aided design (CAD) operators to study differences in acute muscular response related to the repetitiveness of the exposure. The work tasks were performed with median arm movement frequencies ranging from 5 min(-1) to 13 min(-1) and were characterized by work cycle times ranging from less than 30 sec to several days. However, the static and median EMG levels and EMG gap frequencies were similar for all work tasks indicating that shoulder muscle loads may be unaffected by large variations in arm movement frequencies and work cycle times. An exposure variation analyses (EVA) showed that the EMG activity patterns recorded during production work were more repetitive than during CAD work, whereas CAD work was associated with more static muscle activity patterns, both may be associated with a risk of developing musculoskeletal symptoms. Secondly, upper trapezius EMG activity patterns recorded on the mouse side of the CAD operators were compared with those recorded on the non-mouse side to study differences in muscular responses potentially related to the risk of developing shoulder symptoms which were more prevalent on the mouse side. The number of EMG gaps on the mouse side were significantly lower than the values for the upper trapezius on the non-mouse side indicating that more continuous activity was present in the upper trapezius muscle on the mouse side and EVA analyses showed a more repetitive muscle activity pattern on the mouse side. These findings may be of importance to explain differences in the prevalence of shoulder symptoms.     

Muscular fatigue during repeated isokinetic shoulder forward flexions in young females

Peak torque, work, mean power and electromyographic (EMG) activity were recorded for each of 150 repeated isokinetic maximal shoulder flexions (45 degrees-90 degrees) in 23 healthy females. From the EMG signals of trapezius, deltoid, infraspinatus and biceps brachii the mean power frequency and the signal amplitude were determined in real time. The mechanical output showed a steep decrease during the first 40 contractions, followed by a plateau maintained until the end. In all muscles, except the biceps brachii, significant decreases in mean power frequency occurred during the first 40 contractions, showing a tendency to stabilize around the same absolute frequency value. Signal amplitude increased in the trapezius, the deltoid and the infraspinatus, but was constant in the biceps brachii. For some individuals rather high EMG activity was recorded in the muscles during the time the arm was supposed to be passively extended to the starting position, and this was found to be associated with lower strength and endurance levels. Longitudinal analyses showed that the mean power frequencies correlated better than the signal amplitudes with the three mechanical variables. The results suggest that the initial steep decrease in mechanical performance and mean power frequency is caused by fatiguing of type 2 motor units.     

Torque-EMG-velocity relationship in female workers with chronic neck muscle pain

The present study investigated the effect of chronic neck muscle pain (defined as trapezius myalgia) on neck/shoulder muscle function during concentric, eccentric and static contraction. Forty-two female office workers with trapezius myalgia (MYA) and 20 healthy matched controls (CON) participated. Isokinetic (-60, 60 and 180 degrees s(-1)) and static maximal voluntary shoulder abductions were performed in a Biodex dynamometer, and electromyography (EMG) obtained in the trapezius and deltoideus muscles. Muscle thickness in the trapezius was measured with ultrasound. Pain and perceived exertion were registered before and after the dynamometer test. The main findings were that shoulder abduction torque (at -60 and 60 degrees s(-1)) and trapezius EMG amplitude (at -60, 0 and 60 degrees s(-1)) were significantly lower in MYA compared with CON (p<0.001-0.05). Deltoideus EMG and trapezius muscle thickness were not significantly different between the groups. While perceived exertion increased in both groups in response to the test (p<0.0001), pain increased in MYA only (p<0.0001). In conclusion, having trapezius myalgia was associated with decreased strength capacity and lowered activity of the painful trapezius muscle. The most consistent differences-in terms of both torque and EMG-were found during slow concentric and eccentric contractions. Activity of the synergistic pain free deltoideus muscle was not significantly lower, indicating specific inhibitory feedback of the painful trapezius muscle only. Parallel increase in pain and perceived exertion among MYA were observed in response to the maximal contractions, emphasizing that heavy physical exertion provokes pain increase only in conditions of myalgia.     

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

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

Shoulder muscular activity during isometric three-point kneeling exercise on stable and unstable surfaces

The purpose of this study was to determine if performing isometric 3-point kneeling exercises on a Swiss ball influenced the isometric force output and EMG activities of the shoulder muscles when compared with performing the same exercises on a stable base of support. Twenty healthy adults performed the isometric 3-point kneeling exercises with the hand placed either on a stable surface or on a Swiss ball. Surface EMG was recorded from the posterior deltoid, pectoralis major, biceps brachii, triceps brachii, upper trapezius, and serratus anterior muscles using surface differential electrodes. All EMG data were reported as percentages of the average root mean square (RMS) values obtained in maximum voluntary contractions for each muscle studied. The highest load value was obtained during exercise on a stable surface. A significant increase was observed in the activation of glenohumeral muscles during exercises on a Swiss ball. However, there were no differences in EMG activities of the scapulothoracic muscles. These results suggest that exercises performed on unstable surfaces may provide muscular activity levels similar to those performed on stable surfaces, without the need to apply greater external loads to the musculoskeletal system. Therefore, exercises on unstable surfaces may be useful during the process of tissue regeneration.     

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Background  The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method  An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results  All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion  In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.     

Adaptations of upper trapezius muscle activity during sustained contractions in women with fibromyalgia

The study compared the distribution of electromyographic (EMG) signal amplitude in the upper trapezius muscle in 10 women with fibromyalgia and in 10 healthy women before and after experimentally-induced muscle pain. Surface EMG signals were recorded over the right upper trapezius muscle with a 10 × 5 grid of electrodes during 90° shoulder abduction sustained for 60 s. The control subjects repeated the abduction task following injections of isotonic and hypertonic (painful) saline into the upper trapezius muscle. The EMG amplitude was computed for each electrode pair and provided a topographical map of the distribution of muscle activity. The pain level rated by the patients at the beginning of the sustained contraction was 5.9 ± 1.5. The peak pain intensity for the control group following the injection of hypertonic saline was 6.0 ± 1.6. During the sustained contractions, the EMG amplitude increased relatively more in the cranial than caudal region of the upper trapezius muscle for the control subjects (shift in the distribution of EMG amplitude: 2.3 ± 1.3 mm; P < 0.01). The patient group showed lower average EMG amplitude than the controls during the contraction (P < 0.05) and did not show different changes in EMG amplitude between different regions of the upper trapezius. A similar behavior was observed for the control group following injection of hypertonic saline. The results indicate that muscle pain prevents the adaptation of upper trapezius activity during sustained contractions as observed in non-painful conditions, which may induce overuse of similar muscle compartments with fatigue.     

The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome

PurposeThis study aimed to investigate the effect of elastic taping on kinematics, muscle activity and strength of the scapular region in baseball players with shoulder impingement.ScopeSeventeen baseball players with shoulder impingement were recruited from three amateur baseball teams. All subjects received both the elastic taping (Kinesio Tex^TM) and the placebo taping (3 M Micropore tape) over the lower trapezius muscle. We measured the 3-dimensional scapular motion, electromyographic (EMG) activities of the upper and lower trapezius, and the serratus anterior muscles during arm elevation. Strength of the lower trapezius was tested prior to and after each taping application. The results of the analyses of variance (ANOVA) with repeated measures showed that the elastic taping significantly increased the scapular posterior tilt at 30° and 60° during arm raising and increased the lower trapezius muscle activity in the 60–30° arm lowering phase (p < 0.05) in comparison to the placebo taping.ConclusionsThe elastic taping resulted in positive changes in scapular motion and muscle performance. The results supported its use as a treatment aid in managing shoulder impingement problems.