Motor unit activity during stereotyped finger tasks and computer mouse work.

Motor unit (MU) activity pattern was examined in the right-hand extensor digitorum communis muscle (EDC) during standardised finger movements simulating actual computer mouse tasks. Intramuscular recordings were performed with a quadripolar needle electrode. Nine women performed four lifts of their right-hand index finger, middle finger or both as well as a number of double clicks. Additionally, the subjects performed contra lateral activity with their left-hand fingers and for three subjects recordings were also obtained during an interview with no physical activity. Besides the expected close coupling of MU activity with finger movement, activity was observed in three different situations with no physical requirements. Attention related activity was found before or after performance of the finger movement task, contra lateral activity in right EDC during left-hand finger tasks, and activity during mental activity without any finger movements involved. A relatively large number of doublet occurrences suggest they are a natural part of the activation pattern during performance of the rapid finger movement required to perform an efficient double click on the computer mouse.     

Fatigue effects on tracking performance and muscle activity

It has been suggested that fatigue affects proprioception and consequently movement accuracy, the effects of which may be counteracted by increased muscle activity. To determine the effects of fatigue on tracking performance and muscle activity in the M. extensor carpi radialis (ECR), 11 female participants performed a 2-min tracking task with a computer mouse, before and immediately after a fatiguing wrist extension protocol. Tracking performance was significantly affected by fatigue. Percentage time on target was significantly lower in the first half of the task after the fatigue protocol, but was unaffected in the latter half of the task. Mean distance to target and the standard deviation of the distance to target were both increased after the fatigue protocol. The changed performance was accompanied by higher peak EMG amplitudes in the ECR, whereas the static and the median EMG levels were not affected.

The results of this study showed that subjects changed tracking performance when fatigued in order to meet the task instruction to stay on target. Contrary to our expectations, this did not lead to an overall higher muscle activity, but to a selective increase in peak muscle activity levels of the ECR.     

The effect of forearm support on children’s head, neck and upper limb posture and muscle activity during computer use

Use of computers by children has increased rapidly, however few studies have addressed factors which may reduce musculoskeletal stress during computer use by children. This study quantified the postural and muscle activity effects of providing forearm support when children used computers. Twelve male and 12 female children (10–12 years) who regularly used computers were recruited. Activities were completed using a computer with two workstation configurations, one of which provided for forearm support on the desk surface. 3D posture was analysed using an infra-red motion analysis system. Surface EMG was collected from five muscle groups in the neck/shoulder region and right upper limb. Providing a support surface resulted in more elevated and flexed upper limbs. The use of forearm or wrist support was associated with reduced muscle activity for most muscle groups. Muscle activity reductions with support were of sufficient magnitude to be clinically meaningful. The provision of a supporting surface for the arm is therefore likely to be useful for reducing musculoskeletal stresses associated with computing tasks for children.     

Evaluating protocols for normalizing forearm electromyograms during power grip

Many studies use a reference task of an isometric maximum voluntary power grip task in a mid-pronated forearm posture to normalize their forearm electromyographic (EMG) signal amplitude. Currently there are no recommended protocols to do this. In order to provide guidance on the topic, we examined the EMG amplitude of six forearm muscles (three flexors and three extensors) during twenty different maximal voluntary efforts that included various gripping postures, force and moment exertions and compared them to a frequently used normalization task of exerting a maximum grip force, termed the reference task. 16 participants (8 male and 8 female, aged 18–26) were recruited for this study. Overall, maximal muscle activity was produced during the resisted moment tasks. When contrasted with the reference task, the resisted moment tasks produced EMG activity that was up to 2.8 times higher (p < 0.05). Although there was no one task that produced greater EMG values than the reference task for all forearm muscles, the resisted flexor and extensor moment tasks produced similar, if not higher EMG activity than the reference task for the three flexors and three extensor muscles, respectively. This suggests that researchers wishing to normalize forearm EMG activity during power gripping prehensile tasks should use resisted flexor and extensor moment tasks to obtain better estimates of the forearm muscles’ maximum electrical activation magnitudes.     

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.     

Low-level activity of the trunk extensor muscles causes electromyographic manifestations of fatigue in absence of decreased oxygenation

This study was designed to determine whether trunk extensor fatigue occurs during low-level activity and whether this is associated with a drop in muscle tissue oxygenation. Electromyography (EMG) feedback was used to impose constant activity in a part of the trunk extensor muscles. We hypothesized that electromyographic manifestations of fatigue and decreased oxygenation would be observed at the feedback site and that EMG activity at other sites would be more variable without fatigue manifestations. Twelve volunteers performed 30-min contractions at 2% and 5% of the maximum EMG amplitude (EMGmax) at the feedback site. EMG was recorded from six sites over the lumbar extensor muscles and near-infrared spectroscopy was used to measure changes in oxygenation at the feedback site (left L3 level, 3 cm paravertebral). In both conditions, mean EMG activity was not significantly different between electrode sites, whereas the coefficient of variation was lower at the feedback site compared to other recording sites. The EMG mean power frequency (MPF) decreased consistently at the feedback site only. At 5% EMGmax, the decrease in MPF was significant at the group level at all sites ipsilateral to the feedback site. These results suggest that the limited variability of muscle activity at the EMG feedback site and at ipsilateral locations enhances fatigue development. No decreases in tissue oxygenation were detected. In conclusion, even at mean activity levels as low as 2% EMGmax, fatigue manifestations were found in the trunk extensors. These occured in absence of changes in oxygenation of the muscle tissue.     

The effects of precision demands during a low intensity pinching task on muscle activation and load sharing of the fingers.

High precision demands in manual tasks can be expected to cause more selective use of a part of the muscular synergy involved. To test this expectation, load sharing of the index finger and middle finger was investigated during a pinching task. Myoelectric activation of lower arm and neck-shoulder muscles was measured to see if overall level of effort was affected by precision demands. Ten healthy female subjects performed pinching tasks with three levels of force and three levels of precision demands. The force level did not significantly affect the relative contribution of the index and middle finger to the force. Higher precision demands, however, led to higher contribution of the index finger to the pinch force. Consequently, a more selective load of the forearm and hand occurs during tasks with high precision demands. The variability of the force contribution of the fingers increased during the task. No effects of precision demand on the activation of forearm and neck-shoulder muscles were found. Force level did affect the EMG parameters of several muscles. The effects were most apparent in the muscles responsible for the pinch force, the forearm muscles. Activation of these muscles was higher at higher force levels. In the trapezius muscle at the dominant side EMG amplitudes were lower at the high pinch force compared to the low force and median force conditions.     

Upper-limb surface electro-myography at maximum supination and pronation torques: the effect of elbow and forearm angle.

Forearm pronation and supination, and increased muscular activity in the wrist extensors have been both linked separately to work-related injuries of the upper limb, especially humeral epicondylitis. However, there is a lack of information on forearm torque strength at ranges of elbow and forearm angles typical of industrial tasks. There is a need for strength data on forearm torques at different upper limb angles to be investigated. Such a study should also include the measurement of muscular activity for the prime torque muscles and also other muscles at possible risk of injury due to high exertion levels during tasks requiring forearm torques.Twenty-four male subjects participated in the study that involved maximum forearm torque exertions for the right arm, in the pronation and supination directions, and at four elbow and three forearm rotation angles. Surface EMG (SEMG) was used to evaluate the muscular activity of the pronator teres (PT), pronator quadratus (PQ), biceps brachi (BB), brachioradialis (BR), mid deltoid (DT) and the extensor carpi radialis brevis (ECRB) during maximum torque exertions. Repeated measures ANOVA indicated that both direction and forearm angle had a significant effect on the maximum torques (p<0.05) while elbow angle and the interactions were highly significant (p<0.001). The results revealed that supination torques were stronger overall with a mean maximum value of 16.2 Nm recorded for the forearm 75% prone. Mean maximum pronation torque was recorded as 13.1 Nm for a neutral forearm with the elbow flexed at 45 degrees. The data also indicated that forearm angle had a greater effect on supination torque than pronation torque. Supination torques were stronger for the mid-range of elbow flexion, but pronation torques increased with increasing elbow extension. The strength profiles for the maximum torque exertions were reflected in the EMG changes in the prime supinators and pronators. In addition, the EMG data expressed as the percentage of Maximum Voluntary Electrical activity (MVE), revealed high muscular activity in the ECRB for both supination (26-43% MVE) and pronation torques (17-55% MVE). The results suggest that the ECRB acts as a stabiliser to the forearm flexors for gripping during pronation torques depending on forearm angle, but acts as a prime mover in wrist extension for supination torques with little effect of elbow and forearm angle. This indicates a direct link between forearm rotations against resistance and high muscular activity in the wrist extensors, thereby increasing stress on the forearm musculo-skeletal system, especially the lateral epicondyle.     

Influence of fatigue on upper limb muscle activity and performance in tennis

The study examined the fatigue effect on tennis performance and upper limb muscle activity. Ten players were tested before and after a strenuous tennis exercise. Velocity and accuracy of serve and forehand drives, as well as corresponding surface electromyographic (EMG) activity of eight upper limb muscles were measured. EMG and force were also evaluated during isometric maximal voluntary contractions (IMVC). Significant decreases were observed after exercise in serve accuracy (−11.7%) and velocity (−4.5%), forehand accuracy (−25.6%) and consistency (−15.6%), as well as pectoralis major (PM) and flexor carpi radialis (FCR) IMVC strength (−13.0% and −8.2%, respectively). EMG amplitude decreased for PM and FCR in serve, forehand and IMVC, and for extensor carpi radialis in forehand. No modification was observed in EMG activation timing during strokes or in EMG frequency content during IMVC. Several hypotheses can be put forward to explain these results. First, muscle fatigue may induce a reduction in activation level of PM and forearm muscles, which could decrease performance. Second, conscious or subconscious strategies could lead to a redistribution of muscle activity to non-fatigued muscles in order to protect the organism and/or limit performance losses. Otherwise, the modifications of EMG activity could also illustrate the strategies adopted to manage the speed-accuracy trade-off in such a complex task.     

Crosstalk in surface electromyography of the proximal forearm during gripping tasks.

Electromyographic (EMG) crosstalk was systematically analyzed to evaluate the magnitude of common signal present between electrode pairs around the forearm. Surface EMG was recorded and analyzed from seven electrode pairs placed circumferentially around the proximal forearm in six healthy individuals. The cross-correlation function was used to determine the amount of common signal, which was found to decrease as the distance between electrode pairs increased, but was not significantly altered by forearm posture (pronation, neutral, supination). Overall, approximately 40% common signal was detected between adjacent electrode pairs (3 cm apart), dropping to about 10% at 6 cm spacing and 2.5% at 9 cm. The magnitude of common signal approached 50% between adjacent electrode pairs over the extensor muscles, while over 60% was observed between neighbouring sites on the flexor aspect of the forearm. Although flexor and extensor EMG amplitude was similar, less than 2% common signal was present between flexor and extensor electrode pairs during both pinch and grasp tasks. Maximum grip force production was not affected by forearm rotation for pinch, but reduced 18% from neutral (mid-prone) to pronation during grasp (p=0.01). In spite of differences in grip force, mean muscle activity did not vary between the three forearm postures during maximum pinch or grasp trials. While this study improved our knowledge of crosstalk and electrode spacing issues, further examination of forearm EMG is required to improve understanding of muscle loading, EMG properties and motor control during gripping tasks.     

Posture-dependent trunk extensor EMG activity during maximum isometrics exertions in normal male and female subjects.

Posture-dependent trunk function data are important for appropriate normalization of submaximal trunk exertions, and is also necessary to define a more precise and specific use for strength testing in the prevention and diagnosis of spinal disorders. The aim of the current study was to quantify maximal effort trunk muscle extensor activity and trunk isometric extension torque over a functional range of sagittal standing postures. Twenty healthy, young adult male and female subjects performed isometric extension tasks over a sagittal posture range of -20 degrees extension to +50 degrees flexion, in 10 degrees increments. Erector spinae muscle activity was recorded bilaterally at the level of L3 using surface EMG electrodes. Isometric trunk extension torque was measured using a trunk dynamometer. EMG and trunk torque differed significantly between genders, but there were no differences between male and female subjects when the data were normalized with respect to the upright posture. For the combined male and female population, upright posture normalized L3 EMG activity (EMGn) and trunk extension torque (Tn) increased 1.7-fold and 3.5-fold, respectively, over the 70 degrees range of sagittal postures examined. The ratio (Tn/EMGn) increased two-fold (0.83 to 1.67) from -20 degrees extension to +50 degrees flexion, indicating that the neuromuscular efficiency increases with flexion. Trunk extension torque normalized with respect to the upright posture was linearly and positively correlated (r = 0.59, P < 0.001) to similarly normalized L3 EMG activity. This relatively weak correlation suggests that trunk muscle synergism and/or intrinsic muscle length-tension relationships are also modulated by posture. This study provides data that can be used to estimate trunk extensor muscle function over a broad range of sagittal postures. Our findings indicate that appropriate postural normalization of trunk extensor EMG activity is necessary for studies where submaximal trunk exertions are performed over a range of upright postures.     

Cardiovascular adjustments to rhythmic handgrip exercise: relationship to electromyographic activity and post-exercise hyperemia

The purpose of this study was to examine the association among electromyographic (EMG) activity, recovery blood flow, and the magnitude of the autonomic adjustments to rhythmic exercise in humans. To accomplish this, 10 healthy subjects (aged 23-37 y) performed rhythmic handgrip exercise for 2 min at 5, 15, 25, 40, and 60% of maximal voluntary force. Heart rate and arterial blood pressure were measured at rest (control), during each level of exercise, and for 2 min following exercise (recovery). The rectified, filtered EMG activity of the exercising forearm was measured continuously during each level of exercise and was used as an index of the level of central command. Post-exercise hyperemia was calculated as the difference between the control and the average recovery (2 min) forearm blood flows (venous occlusion plethysmography) and was examined as a possible index of the stimulus for muscle chemoreflex activation. Heart rate, arterial pressure, forearm EMG activity, and post-exercise hyperemia all increased progressively with increasing exercise intensity. The magnitudes of the increases in heart rate and arterial pressure from control to exercise were directly related to both the level of EMG activity and the degree of post-exercise hyperemia across the five exercise intensities (delta heart rate vs EMG activity: r = 0.99; delta arterial pressure vs EMG activity: r = 0.99; delta heart rate vs hyperemia: r = 0.99; and delta arterial pressure vs hyperemia: r = 0.98; all p less than 0.01). Furthermore, the level of EMG activity was directly related (r = 0.99) to the corresponding degree of hyperemia.(ABSTRACT TRUNCATED AT 250 WORDS)     

The impact of localized fatigue on contralateral tremor and muscle activity is exacerbated by standing posture

Physiological tremor is an inherent feature of the motor system that is influenced by intrinsic (neuromuscular) and/or extrinsic (task) factors. Given that tremor must be accounted for during the performance of many fine motor skills; there is a requirement to clarify how different factors interact to influence tremor. This study was designed to assess the impact localized fatigue of a single arm and stance position had on bilateral physiological tremor and forearm muscle activity. Results demonstrated that unilateral fatigue produced bilateral increases in tremor and wrist extensor activity. For example, fatigue resulted in increases in extensor activity across both exercised (increased 8–10% MVC) and the non-exercised arm (increased 3–7% MVC). The impact of fatigue was not restricted to changes in tremor/EMG amplitude, with altered hand–finger coupling observed within both arms. Within the exercised arm, cross-correlation values decreased (pre-exercise r = 0.62–0.64; post-exercise r = 0.37–0.43) while coupling increased within the non-exercised arm (pre-exercise r = 0.51–0.55; post-exercise r = 0.62–0.67). While standing posture alone had no significant impact on tremor/EMG dynamics, the tremor and muscle increases seen with fatigue were more pronounced when standing. Together these results demonstrate that the combination of postural and fatigue factors can influence both tremor/EMG outputs and the underlying coordinative coupling dynamics.     

Can forearm muscle activity be selectively recorded using conventional surface EMG-electrodes in transcranial magnetic stimulation? A feasibility study

ObjectivesThis feasibility study evaluates the effect of varying the position of conventional surface EMG-electrodes on the forearm when using Transcranial Magnetic Stimulation (TMS). The aim was to find optimal bipolar electrode positions for forearm extensor muscles, which would be clinically relevant to predict motor recovery after stroke.MethodsIn a healthy female subject, three rings of surface EMG-electrodes were placed around the dominant forearm, leading to 200 different electrode pairs. Both peripheral electrical stimulation and TMS were applied at suprathreshold intensities.ResultsWith electrical stimulation of the median and radial nerve, similar waveform morphology was found for all electrode pairs, covering both flexors and extensors. Also with TMS, remarkable similarities between all electrode pairs were found, suggesting minimal selectivity. In both peripheral electrical stimulation and TMS, the curves became more irregular with decreasing inter-electrode distances.ConclusionNeither with peripheral electrical stimulation nor with TMS it was possible to selectively record extensor or flexor forearm muscle activity using conventional surface EMG-electrodes.SignificanceDespite this negative result, the important role of the forearm extensor muscles in the prognosis of motor recovery after stroke warrants further research into novel methods for selectively recording muscle activity in TMS other than by conventional surface EMG.     

Encoding strategies dissociate prefrontal activity from working memory demand

It is often proposed that prefrontal cortex is important in organization and control of working memory contents. In some cases, effective reorganization can decrease task difficulty, implying a dissociation between frontal activity and basic memory demand. In a spatial working memory task, we studied the improvement of performance that occurs when materials can be reorganized into higher level groups or chunks. Structured sequences, encouraging reorganization and chunking, were compared with unstructured sequences. Though structured sequences were easier to remember, event-related functional magnetic resonance imaging (fMRI) showed increased activation of lateral frontal cortex, in particular during memory encoding. The results show that, even when memory demand decreases, organization of working memory contents into higher level chunks is associated with increased prefrontal activity.     

Continuous, intermitted and sporadic motor unit activity in the trapezius muscle during prolonged computer work.

The Cinderella hypothesis postulates the continuous activity of specific motor units (MUs) during low-level muscle contraction. The MUs may become metabolically overloaded, with the subject developing muscle pain and strain. The hypothesis requires MUs that are active for a time long enough to actually damage muscle fibers. The aim of this study was to determine if there are continuously active MUs in the right trapezius muscle during normal computer work using a computer mouse. Fourteen healthy subjects executed an interactive computer-learning program (ErgoLight) for 30 min. Six-channel intramuscular EMG and two-channel surface EMG signals were recorded from two positions of the trapezius muscle. Decomposition was achieved with automated, multi-channel, long-term decomposition software (EMG-LODEC). In two out of the 14 subjects, three MUs were continuously active throughout the 30 min. Although the majority of the MUs were active during only part of the experimental session, an ordered on-off behavior (e.g. substitution) pattern was not observed. As long-lasting activity was verified in some subjects, the results support the Cinderella hypothesis. However, it cannot be concluded here how long the MUs could stay active. If continuous activity overloads low threshold MUs, the potential exists for selective fibre injuries in low threshold MUs of the trapezius muscle in subjects exposed to long-term computer work.     

A new technique for the selective recording of extensor carpi radialis longus and brevis EMG.

Tennis Elbow or Lateral Epicondylalgia is manifested by pain over the region of the lateral epicondyle of the humerus, related to use of the wrist extensor muscles. Extensor carpi radialis longus (ECRL) and brevis (ECRB) have been implicated in the dysfunction associated with Lateral Epicondylalgia. For muscles in the human forearm, particularly those in close proximity, selective recordings are nearly impossible without the use of fine wire, indwelling electrodes. These can be inserted in precise locations and have small recording areas. Standard electromyography texts indicate, however, that the activity of ECRL and ECRB cannot be distinguished, even with intramuscular electrodes. We present a new technique for determining the most appropriate sites at which to insert intramuscular electrodes for selective recordings of ECRB and ECRL. The location of ECRB and ECRL was measured on 10 cadaver specimens, 5 right arms and 5 left arms. The distance from the muscle origin to (1) insertion, (2) largest portion of the muscle belly, (3) most proximal fibres and (4) most distal fibres were measured and expressed relative to forearm length. The mean distance and 95% confidence interval was calculated for each of the four measures. These data indicated a significant separation of the belly of each muscle along the length of the forearm. These relative distances were used to mark electrode insertion points on three volunteers. Fine wire electrodes were used to record the electromyogram in three participants. Each participant was required to perform isometric contractions to produce (1) wrist extension torque, (2) radial deviation torque, (3) elbow flexion torque and (4) finger extension. The electromyographic recordings show clear differentiation of ECRB and ECRL with the relative activation patterns reflecting the underlying anatomical organisation of the two muscles. This technique provides an important objective method that can be used in conjunction with manual muscle testing to provide a means of ensuring accurate intramuscular electromyographic recording from these two muscles.     

Postural taping applied to the low back influences kinematics and EMG activity during patient transfer in physical therapists with chronic low back pain

We examined the influence of the application of postural taping on the kinematics of the lumbo–pelvic–hip complex, electromyographic (EMG) activity of back extensor muscles, and the rating of perceived exertion (RPE) in the low back during patient transfer. In total, 19 male physical therapists with chronic low back pain performed patient transfers with and without the application of postural taping on the low back. The kinematics of the lumbo–pelvic–hip complex and EMG activity of the erector spinae were recorded using a synchronized 3-D motion capture system and surface EMG. RPE was measured using Borg’s CR-10 scale. Differences in kinematic data, EMG activity, and RPE between the two conditions were analyzed using a paired t-test. Peak angle and range of motion (ROM) of lumbar flexion, EMG activity of the erector spinae, and RPE decreased significantly, while peak angle and ROM of pelvic anterior tilt and hip flexion increased significantly during patient transfer under the postural taping condition versus no taping (p < 0.05). These findings suggest that postural taping can change back extensor muscle activity and RPE as well as the kinematics of the lumbo–pelvic–hip complex in physical therapists with chronic low back pain during patient transfer.     

The use and utility of EMG biofeedback with chronic schizophrenic patients

This study examined the efficacy of muscle relaxation training via electromyographic (EMG) biofeedback from the frontalis and forearm extensor muscles of schizophrenic inpatients. Thirty chronically hospitalized patients were randomly assigned to one of three conditions: EMG biofeedback from the forearm extensor and frontalis muscles, progressive relaxation, and a control group. Treatment consisted of one session of orientation and baseline, and six sessions of training. The results indicated that the schizophrenic patients receiving EMG training had significantly lower EMG recordings than the progressive relaxation group, which, in turn, was significantly lower than the control group. Analyses of covariance on the Tension-Anxiety scale from the Profile of Mood States revealed no significant effects, while finger-tapping rates were significantly improved only for the arm receiving feedback training in the EMG group. On the Nurses Observation Scale for Inpatient Evaluation the biofeedback group significantly improved on the Social Competence and Social Interest factors.     

The effects of repetitive contractions and ischemia on the ability to discriminate intramuscular sensation

In order to investigate whether repetitive, low-level, muscular contractions or ischemia affect the ability of subjects to discriminate electrical stimuli delivered to the forearm musculature, a total of 25 experiments was performed on a group of five healthy subjects utilizing signal detection methodology. EMG needle electrodes were inserted into the forearm extensor musculature and the discriminability of two different pairs of constant current electrical stimuli were measured for sequential blocks of 100 trials, before and after the experimental interventions. Repetitive muscular activity consisting of a 15-min typing intervention at a rate of 60-80 wpm using a numeric keypad led to a significant decrease in the ability to discriminate the non-noxious stimulus pair in the block of trials immediately following the typing intervention, which then returned to pre-intervention discrimination levels following a 5-min break. The forearm ischemia significantly impaired the ability to discriminate both the noxious and non-noxious stimulus pair in the blocks of trials during and immediately after ischemia, which then returned to pre-intervention discrimination levels following a 5-min break. These experiments demonstrate that both repetitive muscular activity and ischemia acutely decrease the ability to discriminate intramuscular sensation. The mechanism may be due to decreased cortical processing, spinal cord sensitization or peripheral ischemia of large diameter afferents. These findings may be relevant to the physiological mechanisms underlying the development of overuse injuries.