Kinematics,kinetics and muscle activation patterns of the upper extremity during simulated forward falls

The purpose of this study was to explore the effects of fall type and fall height on the kinematics, kinetics, and muscle activation of the upper extremity during simulated forward falls using a novel fall simulation method.Twenty participants were released in a prone position from a Propelled Upper Limb Fall ARrest Impact System. Impacts occurred to the hands from two fall heights (0.05 m and 0.10 m) and three fall types (straight-arm, bent-arm, self-selected). Muscle activation from six muscles (biceps brachii, brachioradialis, triceps brachii, anconeus, flexor carpi radialis and extensor carpi radialis) was collected and upper extremity joint kinematics were calculated.Peak Fx (medio-lateral), as well as Fx and Fz (inferior–superior) load rate increased between the 0.05 m and 0.10 m heights. With respect to fall type, the straight-arm falls resulted in significantly greater Fy (anterior–posterior) impulse and Fy and Fz load rates. The change in elbow flexion angle was greater during the self-selected and bent-arm falls compared to the straight-arm falls; a pattern also seen in the wrist flexion/extension angles. All muscles experienced peak % MVIC prior to the time of the peak force.The results of this study suggest that, to some extent, individuals are capable of selecting an upper extremity posture that allows them to minimize the effects of an impact and it has confirmed the presence of a preparatory muscle activation response.     

Changes of agonist and synergist muscles activity during a sustained submaximal brake-pulling gesture

We analyzed the time course of changes in muscle activity of the prime mover and synergist muscles during a sustained brake-pulling action and investigated the relationship between muscle activity and braking force fluctuation (FF). Thirty-two participants performed a continuous fatiguing protocol (CFP) at 30% of maximal voluntary contraction (MVC) until failure. Surface electromyography was used to analyze root mean square (RMS) values in the flexor digitorum superficialis (FD), flexor carpi radialis (FC), extensor digitorum communis (ED), extensor carpi radialis (EC), brachioradialis (BR), biceps brachii (BB), and triceps brachii (TB). The FF and RMS in all muscles increased progressively (P<0.01) during the CFP, with sharp increments at time limit particularly in FD and FC (P<0.001). The RMS of the FD and FC were comparable to the baseline MVC values at time limit, in comparison to the other muscles that did not reach such levels of activity (P<0.003). The three flexor/extensor ratios used to measure coactivation levels decreased significantly (P<0.001). In contrast to RMS, MVC was still depressed at the minute 10 of recovery. The results suggest that the time limit was mainly constrained by fatigue-related mechanisms of the FD and FC but not by those of other synergist and antagonist muscles.     

Identifying tasks to elicit maximum voluntary contraction in the muscles of the forearm

Maximum voluntary contractions (MVCs) are often used for the normalisation of electromyography data to enable comparison of signal patterns within and between study participants. Recommendations regarding the types of tasks that are needed to collect MVCs for the muscles of the forearm have been made, specifically advocating the use of resisted moment tasks to get better estimates of forearm MVCs. However, a protocol detailing which specific tasks to employ has yet to be published. Furthermore, the effects of limb dominance on the collection of MVCs have not been considered previously. Muscle activity was monitored while 23 participants performed nine isometric, resisted tasks. The tasks that are likely to elicit MVC in the flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis, extensor carpi ulnaris, extensor carpi radialis, extensor digitorum communis, and pronator teres were identified. Thus, targeted protocols can be designed to mitigate against fatigue. Hand dominance had limited effect, with differences being found only in the finger flexors and extensors (p< 0.03). Thus, use of the contralateral flexor digitorum superficialis and extensor digitorum communis muscles to obtain baselines for activation levels and patterns may not be appropriate.     

Fatigue effect on cross-talk in mechanomyography signals of extensor and flexor forearm muscles during maximal voluntary isometric contractions

Objective:This paper presents the analyses of the fatigue effect on the cross-talk in mechanomyography (MMG) signals of extensor and flexor forearm muscles during pre- and post-fatigue maximum voluntary isometric contraction (MVIC).Methods:Twenty male participants performed repetitive submaximal (60% MVIC) grip muscle contractions to induce muscle fatigue and the results were analyzed during the pre- and post-fatigue MVIC. MMG signals were recorded on the extensor digitorum (ED), extensor carpi radialis longus (ECRL), flexor digitorum superficialis (FDS) and flexor carpi radialis (FCR) muscles. The cross-correlation coefficient was used to quantify the cross-talk values in forearm muscle pairs (MP1, MP2, MP3, MP4, MP5 and MP6). In addition, the MMG RMS and MMG MPF were calculated to determine force production and muscle fatigue level, respectively.Results:The fatigue effect significantly increased the cross-talk values in forearm muscle pairs except for MP2 and MP6. While the MMG RMS and MMG MPF significantly decreased (p<0.05) based on the examination of the mean differences from pre- and post-fatigue MVIC.Conclusion:The presented results can be used as a reference for further investigation of cross-talk on the fatigue assessment of extensor and flexor muscles’ mechanic.     

Forearm compartment syndrome: anatomical analysis of surgical approaches to the deep space

Forearm compartment syndrome is a surgical emergency that usually requires release of the superficial muscle compartments. In some clinical situations it is imperative to also explore the deep muscle compartments. There are no anatomical guides for surgical exploration of the deep compartments that would minimize collateral damage to surrounding vessels, nerves, and muscles. Surgical injury in the setting of ischemia, especially vascular injury, compounds the tissue damage that has already occurred. The authors evaluated four surgical approaches (three volar and one dorsal) to the deep forearm by performing detailed anatomical dissections on 10 embalmed and plastinated cadavers. They used a scoring system to rate the approaches for their ability to visualize the deep space without causing iatrogenic injury to superficial muscles, arteries, and nerves. In the volar forearm, an ulnar approach to the deep space is simple, causes the least iatrogenic surgical injury, and provides access to the deep volar forearm structures. The plane of dissection is between the flexor carpi ulnaris and the flexor digitorum superficialis. Dividing one or two distal segmental branches of the ulnar artery to the distal flexor digitorum superficialis exposes the pronator quadratus. Lifting the ulnar neurovascular bundle with the flexor digitorum superficialis in the middle third of the forearm exposes the flexor digitorum profundus and the flexor pollicis longus. This approach to the deep space requires no sharp dissection. In the dorsal forearm, a midline approach between the extensor digitorum communis and the extensor carpi radialis brevis is simple and safe.     

The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot

Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n = 10) in this work. All subjects attended a 20-session training (3–5 times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p < 0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p < 0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p < 0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p < 0.05) and a significant decrease of ED and FD co-contraction during the training (p < 0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p < 0.05).     

Quantitative assessment of upper limb muscle fatigue depending on the conditions of repetitive task load

The aim of this study was to discriminate fatigue of upper limb muscles depending on the external load, through the development and analysis of a muscle fatigue index. Muscle fatigue is expressed by a fatigue index based on an amplitude parameter (calculated in the time domain) and a fatigue index based on a frequency parameter (a parameter calculated in the frequency domain). The fatigue index involves a regression function that describes changes in the EMG signal parameter, time elapsing before muscle fatigue and the probability of specific trends in changes in EMG parameters for the population under study.

The experimental study covered a group of 10 young men. During the study, they exerted force at a specific level and for a specific time in 12 load variants. During the study, EMG signals from four muscles of the upper limb were recorded (trapezius pars descendents, biceps brachii caput breve, extensor carpi radialis brevis, flexor carpi ulnaris). For each variant and for each examined muscles, the value of the fatigue index was calculated. Values of that index quantitatively expressed fatigue of a specific muscle in a specific load variant.

A statistical analysis indicated variation in the fatigue of the biceps brachii caput breve, extensor carpi radialis brevis, and flexor carpi ulnaris muscles depending on the external load (load variant) according to the task performed with the upper limb.

The study demonstrated usefulness of the fatigue index in expressing quantitatively muscle fatigue and in discriminating muscle fatigue depending on the external load.     

Tennis players show a lower coactivation of the elbow antagonist muscles during isokinetic exercises

PurposePrevious studies have suggested that muscle coactivation could be reduced by a recurrent activity (training, daily activities). If this was correct, skilled athletes should show a specific muscle activation pattern with a low level of coactivation of muscles which are typically involved in their discipline. In particular, the aim of this study was to verify the hypothesis that the amount of antagonist activation of biceps brachii (BB) and triceps brachii (TB) is different between tennis players and non-players individuals during maximal isokinetic contractions.MethodsTen young healthy men and eight male tennis players participated in the study. The surface electromyographic signals (sEMG) were recorded from the BB and TB muscles during three maximal voluntary isometric contractions (MVC) of elbow flexors and extensors and a set of three maximal elbow flexions and extensions at 15°, 30°, 60°, 120°, 180° and 240°/s. Normalized root mean square (RMS) of sEMG was calculated as an index of sEMG amplitude.ResultsAntagonist activation (%RMSmax) of TB was significantly lower in tennis players (from 14.0 ± 7.9% at MVC to 16.3 ± 8.9% at 240°/s) with respect to non-players (from 27.7 ± 19.7% at MVC to 38.7 ± 17.6% at 240°/s) at all angular velocities. Contrary to non-players, tennis players did not show any difference in antagonist activation between BB and TB muscles.ConclusionsTennis players, with a constant practice in controlling forces around the elbow joint, learn how to reduce coactivation of muscles involved in the control of this joint. This has been shown by the lower antagonist muscular activity of triceps brachii muscle during isokinetic elbow flexion found in tennis players with respect to non-players.     

Functional anatomy of the hand of Australopithecus africanus

The Sterkfontein hand bones, attributed to Australopithecus africanus, were analysed to determine potential hand function of the power grip type of this species. The metacarpus is as stable as that of modern humans, as indicated by the depth of the groove on the base of metacarpal 2, the styloid process of metacarpal 3, the base articular surface areas, and the ligament markings on the bases of the metacarpals. The flexion and rotation of metacarpal 5 might have been less than that of modern humans, due to a more marked ventral articular lip on the base. The metacarpus acts as a lever, acting in various planes. The extensor carpi ulnaris and extensor carpi radialis longus muscles were probably better developed than in modern humans. The extensor carpi radialis brevis and flexor carpi radialis muscles would probably have been as well developed as in modern humans. None of the long tendons have a mechanical disadvantage as compared to modern humans. The metacarpals have a high robusticity index. The proximal phalanges show some midshaft swelling, slightly greater curvature than in modern humans, and some side to side bowing: pongid features. The fibrous flexor sheath markings are well developed, but resemble those of modern humans rather than those of the pongids. A single middle phalanx resembles that of modern humans, and has well developed ridges for insertion of the flexor digitorum superficialis muscle. The distal phalanx of the thumb has a well developed region for insertion of the flexor pollicis longus muscle, and has a mechanical advantage over modern humans for action of this muscle at the interphalangeal joint. The features indicate that the hand of A. africanus was well adapted to powerful hand use, as in hammering, striking, chopping, scraping, and gouging actions, as well as for throwing and climbing activities.     

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

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

Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

The aim of this study was to assess whether cerebral palsy patients can use biceps brachii for supination during movement tasks requiring supination and pronation. 3D upper extremity kinematic and EMG-data of 12 patients (mean age 13 y 8 mo ± 36 mo) were compared to 10 healthy age-matched controls. Significant difference in biceps brachii activation between maximal isolated pronation and supination in both groups showed that it is possible for CP patients to use biceps brachii for supination. Performance of reach-to-grasp with either pronation or supination showed similar activation patterns as during isolated tasks in both groups, although increased biceps brachii activation likely also hampered performance of reach-to-grasp in the patient group by causing increased, and possibly unwanted elbow flexion. However, the functional effect of this flexion for supination purposes cannot be ruled out. Therefore, one should be cautious with simply weakening biceps brachii when the purpose is to improve functional reach. Ideally treatment might focus more on changing the flexion moment/supination moment ratio of biceps toward a stronger supination function.     

A physio-anthropological study of the POS system space scanner

1. 1. We compared the functions of POS system scanners by measuring electromyograms and joint angles during scanning in this paper.

2. 2. We have demonstrated that the space scanner is physically easy to use, movement of the wrist is natural and easy, the most suitable method for scanning perishable foods which spill easily or are fragile.

3. 3. A space scanner can be used with a bar code.

4. 4. Electromyograms were taken from M. deltoideus, M. biceps brachii, M. extensor carpi radialis longus and brevis, M. flexor carpi ulnaris muscles.

Detection of surface electromyography recording time interval without muscle fatigue effect for biceps brachii muscle during maximum voluntary contraction

The effects of fatigue on maximum voluntary contraction (MVC) parameters were examined by using force and surface electromyography (sEMG) signals of the biceps brachii muscles (BBM) of 12 subjects. The purpose of the study was to find the sEMG time interval of the MVC recordings which is not affected by the muscle fatigue. At least 10 s of force and sEMG signals of BBM were recorded simultaneously during MVC. The subjects reached the maximum force level within 2 s by slightly increasing the force, and then contracted the BBM maximally. The time index of each sEMG and force signal were labeled with respect to the time index of the maximum force (i.e. after the time normalization, each sEMG or force signal’s 0 s time index corresponds to maximum force point). Then, the first 8 s of sEMG and force signals were divided into 0.5 s intervals. Mean force, median frequency (MF) and integrated EMG (iEMG) values were calculated for each interval. Amplitude normalization was performed by dividing the force signals to their mean values of 0 s time intervals (i.e. ?0.25 to 0.25 s). A similar amplitude normalization procedure was repeated for the iEMG and MF signals. Statistical analysis (Friedman test with Dunn’s post hoc test) was performed on the time and amplitude normalized signals (MF, iEMG). Although the ANOVA results did not give statistically significant information about the onset of the muscle fatigue, linear regression (mean force vs. time) showed a decreasing slope (Pearson-r = 0.9462, p < 0.0001) starting from the 0 s time interval. Thus, it might be assumed that the muscle fatigue starts after the 0 s time interval as the muscles cannot attain their peak force levels. This implies that the most reliable interval for MVC calculation which is not affected by the muscle fatigue is from the onset of the EMG activity to the peak force time. Mean, SD, and range of this interval (excluding 2 s gradual increase time) for 12 subjects were 2353, 1258 ms and 536–4186 ms, respectively. Exceeding this interval introduces estimation errors in the maximum amplitude calculations of MVC–sEMG studies for BBM. It was shown that, simultaneous recording of force and sEMG signals was required to calculate the maximum amplitude of the MVC–sEMG more accurately.     

The effects of upper limb posture and a sub-maximal gripping task on corticospinal excitability to muscles of the forearm

Variations in handgrip force influences shoulder muscle activity, and this effect is dependent upon upper limb position. Previous work suggests that neural coupling between proximal and distal muscles with changes in joint position is a possible mechanism but these studies tend to use artificially constrained postures that do not reflect activities of daily living. The purpose of this study was to examine the effects of upper limb posture on corticospinal excitability to the forearm muscles during workplace relevant arm positions. Motor evoked potentials (MEPs) were elicited in four forearm muscles via transcranial magnetic stimulation at six arm positions (45°, 90° and 120° of humeral elevation in both the flexion and abduction planes). MEPs were delivered as stimulus–response curves (SRCs) at rest and at constant intensity during two gripping tasks. Boltzmann plateau levels were smaller for the flexor carpi radialis in flexion at 45° versus 90° (p = 0.0008). Extensor carpi radialis had a greater plateau during flexion than abduction (p = 0.0042). Corticospinal excitability to the forearm muscles were influenced by upper limb posture during both the resting and gripping conditions. This provides further evidence that upper limb movements are controlled as a whole rather than segmentally and is relevant for workplace design considerations.     

Muscular forearm activation in hand-grip tasks with superimposition of mechanical vibrations

The purpose of this paper is to evaluate the muscular activation of the forearm, with or without vibration stimuli at different frequencies while performing a grip tasks of 45 s at various level of exerted force. In 16 individuals, 9 females and 7 males, the surface electromyogram (EMG) of extensor carpi radialis longus and the flexor carpi ulnari muscles were assessed. At a short latency from onset EMG, RMS and the level of MU synchronization were assessed to evaluate the muscular adaptations. Whilst a trend of decay of EMG Median frequency (MDF_d) was employed as an index of muscular fatigue. Muscular tasks consists of the grip of an instrumented handle at a force level of 20%, 30%, 40%, 60% of the maximum voluntary force. Vibration was supplied by a shaker to the hand in mono-frequential waves at 20, 30, 33 and 40 Hz. In relation to EMG, RMS and MU synchronization, the muscular activation does not seem to change with the superimposition of the mechanical vibrations, on the contrary a lower MDF_d was observed at 33 Hz than in absence of vibration. This suggests an early muscular fatigue induced by vibration due to the fact that 33 Hz is a resonance frequency for the hand-arm system.     

Distribution of motor unit potential velocities in the biceps brachii muscle of sprinters and endurance athletes during prolonged dynamic exercises at low force levels

In surface electromyography (sEMG), the distribution of motor unit potential (MUP) velocities has been shown to reflect the proportion of faster and slower propagating MUPs. This study investigated whether the distribution of MUP velocities could distinguish between sprinters (n = 11) and endurance athletes (n = 12) in not-specifically trained muscle (biceps brachii) during prolonged dynamic exercises at low forces. sEMG was acquired during 4 min’ exercises: unloaded, 5%, 10% and 20% of maximal voluntary contraction (MVC). The features extracted from the sEMG were: the mean muscle conduction velocity – estimated using the inter-peak latency and cross-correlation methods, the within-subject skewness (expressing the proportions of faster and slower propagating MUPs) and the within-subject standard deviation of MUP velocities (SD-mup). Sprinters showed a greater proportion of faster propagating MUPs than endurance athletes. During fatigue, the SD-mup of sprinters broadened progressively, whereas that of endurance athletes did not. The findings suggest that sprinters conveyed a greater proportion of faster motor units than endurance athletes and that motor unit behavior during fatigue differed between groups. Thus, the distribution of MUP velocities enables distinction between a muscle of sprinters and endurance athletes during prolonged dynamic exercises at low forces.     

Biceps brachii myoelectric and oxygenation changes during static and sinusoidal isometric exercises

Surface myoelectric signal changes occurring during sustained isometric contractions have been extensively studied with quantitative surface electromyography (sEMG) and are described by means of some sEMG global variables in time and frequency domain (such as the median power spectral frequency). Recently, the possibility of studying local muscle O₂ saturation during exercise using non-invasive methods has been enhanced thanks to the use of near-infrared spectroscopy (NIRS). The purpose of this work was to combine NIRS and sEMG techniques to analyze the relationship between modifications of sEMG parameters and the underlying metabolic status of the exercising biceps brachii muscle. This relationship was tested under different isometric contraction modalities, namely static (ST) at 20, 40, 60 and 80%MVC and sinusoidal (SIN) at 40 ± 20 and 60 ± 20%MVC. Results clearly indicated the presence of an initial fast phase of muscle O₂ desaturation followed by a slow phase, regardless of the contraction modality. Moreover, the initial rate of muscle O₂ desaturation was related to the level of force output (R = 0.92), but it was independent on the contraction modality (p < 0.05). Similarly, changes in sEMG parameters were related to force level (Conduction Velocity-CV vs. Force: R = 0.87; sEMG Median Frequency-MDF vs. Force: R = 0.86). The high correlation found between CV-MDF and Tissue Oxygenation Index (TOI) slope (R = 0.73 and 0.72, respectively) suggests a strong relationship between NIRS and sEMG data. This study indicates that muscle O₂ demand during isometric contractions from low to high force levels is influenced by the type of active motor units and not from the type of isometric exercise modality.     

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.     

EMG amplitude and frequency parameters of muscular activity: Effect of resistance training based on electromyographic fatigue threshold

The present study aimed to evaluate the effect of a resistance training program based on the electromyographic fatigue threshold (EMG_FT, defined as the highest exercise intensity performed without EMG alterations), on the EMG amplitude (root mean square, RMS) and frequency (median frequency, MF) values for biceps brachii (BB), brachioradialis (BR), triceps brachii (TB) and multifidus (MT). Twenty healthy male subjects, (training group [TG], n = 10; control group [CG], n = 10), firstly performed isometric contractions, and after this, dynamic biceps curl at four different loads to determine the EMG_FT. The TG training program used the BB EMG_FT value (8 weeks, 2 sessions/week, 3 exhaustive bouts/session, 2 min rest between bouts). No significant differences were found for the isometric force after the training. The linear regression slopes of the RMS with time during the biceps curl presented significant decrease after training for the BB, BR and TB muscles. For the MT muscle, the slope and MF intercept values changed with training. The training program based on the EMG_FT influenced EMG the amplitude more than EMG frequency, possibly related to the recruitment patterns of the muscles, although the trunk extensor muscles presented changes in the frequency parameter, showing adaptation to the training program.