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.     

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.     

The use of EMG biofeedback for learning of selective activation of intra-muscular parts within the serratus anterior muscle: A novel approach for rehabilitation of scapular muscle imbalance

Motor control and learning possibilities of scapular muscles are of clinical interest for restoring scapular muscle balance in patients with neck and shoulder disorders. The aim of the study was to investigate whether selective voluntary activation of intra-muscular parts within the serratus anterior can be learned with electromyographical (EMG) biofeedback, and whether the lower serratus anterior and the lower trapezius muscle comprise the lower scapula rotation force couple by synergistic activation. Nine healthy males practiced selective activation of intra-muscular parts within the serratus anterior with visual EMG biofeedback, while the activity of four parts of the serratus anterior and four parts of the trapezius muscle was recorded. One subject was able to selectively activate both the upper and the lower serratus anterior respectively. Moreover, three subjects managed to selectively activate the lower serratus anterior, and two subjects learned to selectively activate the upper serratus anterior. During selective activation of the lower serratus anterior, the activity of this muscle part was 14.4 ± 10.3 times higher than the upper serratus anterior activity (P < 0.05). The corresponding ratio for selective upper serratus vs. lower serratus anterior activity was 6.4 ± 1.7 (P < 0.05). Moreover, selective activation of the lower parts of the serratus anterior evoked 7.7 ± 8.5 times higher synergistic activity of the lower trapezius compared with the upper trapezius (P < 0.05). The learning of complete selective activation of both the lower and the upper serratus anterior of one subject, and selective activation of either the upper or lower serratus anterior by five subjects designates the promising clinical application of EMG biofeedback for restoring scapular muscle balance. The synergistic activation between the lower serratus anterior and the lower trapezius muscle was observed in only a few subjects, and future studies including more subjects are required before conclusions of a lower scapula rotation couple can be drawn.     

Ciliary muscle contraction force and trapezius muscle activity during manual tracking of a moving visual target

Previous studies have shown an association of visual demands during near work and increased activity of the trapezius muscle. Those studies were conducted under stationary postural conditions with fixed gaze and artificial visual load. The present study investigated the relationship between ciliary muscle contraction force and trapezius muscle activity across individuals during performance of a natural dynamic motor task under free gaze conditions. Participants (N = 11) tracked a moving visual target with a digital pen on a computer screen. Tracking performance, eye refraction and trapezius muscle activity were continuously measured. Ciliary muscle contraction force was computed from eye accommodative response. There was a significant Pearson correlation between ciliary muscle contraction force and trapezius muscle activity on the tracking side (0.78, p < 0.01) and passive side (0.64, p < 0.05). The study supports the hypothesis that high visual demands, leading to an increased ciliary muscle contraction during continuous eye–hand coordination, may increase trapezius muscle tension and thus contribute to the development of musculoskeletal complaints in the neck–shoulder area. Further experimental studies are required to clarify whether the relationship is valid within each individual or may represent a general personal trait, when individuals with higher eye accommodative response tend to have higher trapezius muscle activity.     

Active pauses induce more variable electromyographic pattern of the trapezius muscle activity during computer work

The aim of this laboratory study was to evaluate effects of active and passive pauses and investigate the distribution of the trapezius surface electromyographic (SEMG) activity during computer mouse work. Twelve healthy male subjects performed four sessions of computer work for 10 min in one day, with passive (relax) and active (30% maximum voluntary contraction of shoulder elevation) pauses given every 2 min at two different work paces (low/high). Bipolar SEMG from four parts of the trapezius muscle was recorded. The relative rest time was higher for the lower parts compared with the upper of the trapezius (p < 0.01). The centroid of exposure variation analysis (EVA) along the time axis was lower during the computer work with active pause compared with passive one (p < 0.05). The results of this study revealed (i) lower rest time for the upper parts of trapezius compared with the lower parts, in line with previous clinical findings, (ii) active pauses contributed to a more variable muscle activity pattern during computer work that might have functional implications with respect to work-related musculoskeletal disorders.     

Associations between cervical and scapular posture and the spatial distribution of trapezius muscle activity

The first aim of this investigation was to quantify the distribution of trapezius muscle activity with different scapular postures while seated. The second aim of this investigation was to examine the association between changes in cervical and scapular posture when attempting to recruit different subdivisions of the trapezius muscle. Cervical posture, scapular posture, and trapezius muscle activity were recorded from 20 healthy participants during three directed shoulder postures. Planar angles formed by reflective markers placed on the acromion process, C7, and tragus were used to quantify cervical and scapular posture. Distribution of trapezius muscle activity was recorded using two high-density surface electromyography (HDsEMG) electrodes positioned over the upper, middle, and lower trapezius. Results validated the assumption that directed scapular postures preferentially activate different subdivisions of the trapezius muscle. In particular, scapular depression was associated with a more inferior location of trapezius muscle activity (r = 0.53). Scapular elevation was coupled with scapular abduction (r = 0.52). Scapular adduction was coupled with cervical extension (r = 0.35); all other changes in cervical posture were independent of changes in scapular posture. This investigation provides empirical support for reductions in static loading of the upper trapezius and improvements in neck posture through verbal cueing of scapular posture.     

Reliability and minimal detectable change in scapulothoracic neuromuscular activity

Alterations in scapular muscle activity, including excess activation of the upper trapezius (UT) and onset latencies of the lower trapezius (LT) and serratus anterior (SA) muscles, are associated with abnormal scapular motion and shoulder impingement. Limited information exists on the reliability of neuromuscular activity to demonstrate the efficacy of interventions. The purpose of this study was to characterize the reproducibility of scapular muscle activity (mean activity, relative onset timing) over time and establish the minimal detectable change (MDC). Surface electromyography (sEMG) of the UT, LT, SA and anterior deltoid (AD) muscles in 16 adults were captured during an overhead lifting task in two sessions, one-week apart. sEMG data were also normalized to maximum isometric contraction and the relative onset and mean muscle activity during concentric and eccentric phases of the scapular muscles were calculated. Additionally, reliability of the absolute sEMG data during the lifting task and MVIC was evaluated. Both intrasession and intersession reliability of normalized and absolute mean scapular muscle activity, assessed with intraclass correlation coefficients (ICC), ranged from 0.62 to 0.99; MDC values were between 1.3% and 11.7% MVIC and 24 to 135 mV absolute sEMG. Reliability of sEMG during MVIC was ICC = 0.82–0.99, with the exception of intersession upper trapezius reliability (ICC = 0.36). Within session reliability of muscle onset times was ICC = 0.88–0.97, but between session reliability was lower with ICC = 0.43–0.73; MDC were between 39 and 237 ms. Small changes in scapular neuromuscular mean activity (>11.7% MVIC) can be interpreted as meaningful change, while change in muscle onset timing in light of specific processing parameters used in this study is more variable.     

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.     

The role of biceps brachii and brachioradialis for the control of elbow flexion and extension movements

How do synergistic muscles interact, when their contraction aims at stabilizing and fine-tuning a movement, which is induced by the antagonistic muscle? The aim of the study was to analyze the interaction of biceps and brachioradialis during fine-tuning control tasks in comparison to load bearing ones. The surface electromyogram of biceps, brachioradialis and triceps were examined in 15 healthy subjects in dynamic flexion and extension movements with different combinations of contraction levels, joint angles and angular velocities. The measurements were conducted in two configurations, where the torque due to an external load opposes the rotational direction of the elbow flexion (load bearing tasks) or the elbow extension (fine-tuning tasks).Whereas during load bearing control tasks, similar muscular activation of biceps and brachioradialis was observed for all joint angles, angular velocities and external loads, during fine-tuning control tasks a significant difference of the muscular activation of both flexors was observed for 1 kg, F(3.639, 47.305) = 2.864, p = 0.037, and 5 kg of external load, F(1.570, 21.976) = 6.834, p = 0.008.The results confirm the synergistic muscular activation of both flexors during load bearing tasks, but suggest different control strategies for both flexors when they comprise a fine-tuning control task.     

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

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

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.     

Neck and shoulder muscle activity of orthodontists in natural environments

Work related musculoskeletal disorders (WMSDs) are common among dentists and possibly caused by prolonged static load. The aim of this study was to assess the contraction pattern of neck and shoulder muscles of orthodontists in natural environments.Electromyographic (EMG) activity of right sternocleidomastoid and trapezius muscles were recorded by means of portable recorders in eight orthodontists during working conditions, and both active and resting non-working conditions. Recordings were analysed in terms of contraction episode (CE) count, amplitude, and duration.The sternocleidomastoid and trapezius muscles contracted about 40–70 times per hour in the natural environment. Their EMG activity pattern mainly consisted of short-lasting, low-amplitude CEs. The counts and amplitude of sternocleidomastoid CEs did not differ across vocational and non-vocational conditions. The number and amplitude of trapezius CEs were slightly but significantly higher during the vocational condition. There were highly significant (p < 0.001) differences in duration of CEs across conditions, with two to threefold increase in the average duration of trapezius muscle contractions found in the vocational setting.During orthodontic work, operators commonly hold muscular contractions for significantly longer periods than are encountered in non-vocational settings. This behaviour may be associated causally with the increases seen in WMSDs through proposed pathophysiological mechanisms occurring at the motor unit level. Our findings may also be valid for other occupations characterised by seated static postures with precision hand and wrist movements.     

Effects of posture,movement and hand load on shoulder muscle activity

The influence of external factors such as arm posture, hand loading and dynamic exertion on shoulder muscle activity is needed to provide insight into the relationship between internal and external loading of the shoulder joint. Surface electromyography was collected from 8 upper extremity muscles on 16 participants who performed isometric and dynamic shoulder exertions in three shoulder planes (flexion, mid-abduction and abduction) covering four shoulder elevation angles (30°, 60°, 90° and 120°). Shoulder exertions were performed under three hand load conditions: no load, holding a 0.5 kg load and 30% grip. It was found that adding a 0.5 kg load to the hand increased shoulder muscle activity by 4% maximum voluntary excitation (MVE), across all postures and velocities. Performing a simultaneous shoulder exertion and hand grip led to posture specific redistribution of shoulder muscle activity that was consistent for both isometric and dynamic exertions. When gripping, anterior and middle deltoid activity decreased by 2% MVE, while posterior deltoid, infraspinatus and trapezius activity increased by 2% MVE and biceps brachii activity increased by 6% MVE. Increased biceps brachii activity with gripping may be an initiating factor for the changes in shoulder muscle activity. The finding that hand gripping altered muscle activation, and thus the internal loading, of the shoulder may play an important role in shoulder injury development and rehabilitation.     

An electromyographic analysis of two handwriting grasp patterns

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

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.     

Muscular activation patterns during active prone hip extension exercises

BackgroundChanges in activation patterns of hip extensors and pelvic stabilizing muscles are recognized as factors that cause low back disorders and these disturbances could have an impact on the physiological loading and alter the direction and magnitude of joint reaction forces.ObjectiveTo investigate activation patterns of the gluteus maximus, semitendinosus and erector spinae muscles with healthy young individuals during four different modalities of therapeutic exercise.MethodsThirty-one volunteers were selected: (16 men and 15 women), age (24.5 ± 3.47 years), body mass of 66.89 ± 11.89 kg and a height of 1.70 ± 0.09 m). They performed four modalities of therapeutic exercise while the electromyographic activity of the investigated muscles was recorded to determine muscle pattern activation for each exercise.ResultsRepeated measure ANOVA revealed that muscle activation patterns were similar for the four analyzed exercises, starting with the semitendinosus, followed by the erector spinae, and then, the gluteus maximus. The gluteus maximus was the last activated muscle during hip extension associated with knee flexion (p < 0.0001), knee extension (p < 0.0001), and with lateral rotation and knee flexion (p < 0.05).ConclusionFindings of the present study suggested that despite individual variability, the muscle firing order was similar for the four therapeutic exercises.     

Electromyographic analysis of the serratus anterior and trapezius muscles during push-ups on stable and unstable bases in subjects with scapular dyskinesis

The present study was performed to assess the electromyographic activity of the scapular muscles during push-ups on a stable and unstable surface, in subjects with scapular dyskinesis. Muscle activation (upper trapezius [UT]; lower trapezius [LT]; upper serratus anterior [SA_5th]; lower serratus anterior [SA_7th]) and ratios (UT/LT; UT/SA_5th; UT/ SA_7th) levels were determined by surface EMG in 30 asymptomatic men with scapular dyskinesis, during push-up performed on a stable and unstable surface. Multivariate analysis of variance with repeated measures was used for statistical analyses. The unstable surface caused a decrease in the EMG activity of the serratus anterior and an increase in EMG activity of the trapezius (p = 0.001). UT/SA_5th and UT/ SA_7th ratios were higher during unstable push-ups (p = 0.001). The results suggest that, in individuals with scapular dyskinesis, there is increased EMG activity of the trapezius and decreased EMG activity of the serratus anterior in response to an unstable surface. These results suggest that the performance of the push up exercise on an unstable surface may be more favorable to produce higher levels of trapezius activation and lower levels of serratus anterior activation. However, if the goal of the exercise program is the strengthening of the SA muscle, it is suggested to perform the push up on a stable surface.     

Timing of muscle activation of the lower limbs can be modulated to maintain a constant pedaling cadence

This study investigated changes in muscle activity when subjects are asked to maintain a constant cadence during an unloaded condition. Eleven subjects pedaled for five loaded conditions (220 W, 190 W, 160 W, 130 W, 100 W) and one unloaded condition at 80 rpm. Electromyographic (EMG) activity of six lower limb muscles, pedal forces and oxygen consumption were calculated for every condition. Muscle activity was defined by timing (EMG onset and offset) and level (integrated values of EMGrms calculated between EMG onset and EMG offset) of activation, while horizontal and vertical impulses were computed to characterize pedal forces. Muscle activity, pedal forces and oxygen consumption variables measured during the unloaded condition were compared with those extrapolated to 0 W from the loaded conditions, assuming a linear relationship. The muscle activity was changed during unloaded condition: EMG onset and/or offset of rectus femoris, biceps femoris, vastus medialis, and gluteus maximus muscles were delayed (p < 0.05); iEMGrms values of rectus femoris, biceps femoris, gastrocnemius medialis and tibialis anterior muscles were higher than those extrapolated to 0 W (p < 0.05). Vertical impulse over the extension phase was lower (p < 0.05) while backward horizontal impulse was higher (p < 0.05) during unloaded condition than those extrapolated to 0 W. Oxygen consumptions were higher during unloaded condition than extrapolated to 0W (750 ± 147 vs. 529 ± 297 mLO₂.min^?1; p < 0.05). Timing of activation of rectus femoris and biceps femoris was dramatically modified to optimize pedal forces and maintain a constant cadence, while systematic changes in the activation level of the bi-articular muscles induced a relative increase in metabolic expenditure when pedaling during an unloaded condition.     

Micro movements of the upper limb in fibromyalgia: The relation to proprioceptive accuracy and visual feedback

The purpose of this study was to explore the role of visual and proprioceptive feedback in upper limb posture control in fibromyalgia (FM) and to assess the coherence between acceleration measurements of upper limb micro movements and surface electromyography (sEMG) of shoulder muscle activity (upper trapezius and deltoid). Twenty-five female FM patients and 25 age- and sex-matched healthy controls (HCs) performed three precision motor tasks: (1) maintain a steady shoulder abduction angle of 45° while receiving visual feedback about upper arm position and supporting external loads (0.5, 1, or 2 kg), (2) maintain the same shoulder abduction angle without visual feedback (eyes closed) and no external loading, and (3) a joint position sense test (i.e., assessment of proprioceptive accuracy). Patients had more extensive increase in movement variance than HCs when visual feedback was removed (P < 0.03). Proprioceptive accuracy was related to movement variance in HCs (R ⩾ 0.59, P ⩽ 0.002), but not in patients (R ⩽ 0.25, P ⩾ 0.24). There was no difference between patients and HCs in coherence between sEMG and acceleration data. These results may indicate that FM patients are more dependent on visual feedback and less reliant on proprioceptive information for upper limb posture control compared to HCs.