Electromyographic patterns of upper extremity muscles during sitting pivot transfers performed by individuals with spinal cord injury

Although substantial upper extremity (U/E) muscular efforts are required when individuals with spinal cord injury (SCI) perform sitting pivot transfers, little is known about the electromyographic (EMG) activation patterns of key shoulder and elbow muscles solicited during the performance of this functional task. The aims of this study were to examine the EMG activation patterns of U/E muscles in 10 males with SCI, and to compare them across sitting pivot transfers performed toward seats of different heights (low, same, high). EMG data from the biceps, triceps, deltoid, pectoralis major and latissimus dorsi were recorded bilaterally. Transfers were divided into pre-lift, lift, and post-lift phases. Each phase was time- and amplitude-normalized using a mean dynamic EMG approach. Similar EMG activation patterns were found across the different transfers for all muscles (r_mean = 0.942–0.991), whereas moderate to high inter-subject variability (CV: 20.9–70.6%) was reported for the different muscles and transfers. Peak EMG occurred earlier at the trailing U/E compared to the leading one, and was observed around seat-off for most of the muscles. When transfer to a high target seat was compared to transfer to one of the same height, significantly higher relative EMG values were observed at the biceps (mean: 1.64 vs. 1.00) of the leading U/E as well as the deltoid (mean: 1.20 vs. 1.00) and pectoralis major (mean: 1.20 vs. 1.00; peak: 2.27 vs. 1.79) of the trailing U/E. Transferring to a low target seat did not lead to lower muscular demand than transferring to one of the same height (P > 0.05). These results indicate that coordinated and higher muscular efforts were generated at the trailing deltoid and pectoralis major when transferring to a high target seat compared to one of similar height. Higher muscular efforts were also developed at the leading biceps when transferring to a high target seat compared to a leveled one. Lowering the target seat with respect to the initial seat had no favorable effect on muscular demand.     

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.     

Upper limb joint kinetics during manual wheelchair propulsion in patients with different levels of spinal cord injury

The purpose of this study was to compare the forces and moments of the whole upper limb, analyzing forces and moments at the shoulder, elbow and wrist joints simultaneously during manual wheelchair propulsion of persons with different levels of spinal cord injury (SCI) on a treadmill. Fifty-one people participated in this study and were grouped by their level of SCI: C6 tetraplegia (G1), C7 tetraplegia (G2), high paraplegia (G3), and low paraplegia (G4). An inverse dynamic model was defined to compute net joint forces and moments from segment kinematics, the forces acting on the pushrim, and subject anthropometrics. Right side, upper limb kinematic data were collected with four camcorders (Kinescan–IBV). Kinetic data were recorded by replacing the wheels with SmartWheels (Three Rivers Holdings, LLC). All participants propelled the wheelchair at 3 km/h for 1 min. The most noteworthy findings in both our tetraplegic groups in relation to paraplegic groups were increased superior joint forces in the shoulder (G1 and G2 vs G3 p<0.001; G1 and G2 vs G4 p<0.01), elbow (G1 vs G3 p<0.001; G1 vs G4 p<0.05) and wrist (G1 vs G4 p<0.001), an increased adduction moment in the shoulder (G1 vs G3 p<0.001; G1 vs G4 p<0.01; G2 vs G3 and G4 p<0.05) and the constancy of the moments of force of the wrist the fact that they reached their lowest values in the tetraplegic groups. This pattern may increase the risk of developing upper limb overuse injuries in tetraplegic subjects.     

Reduced scapular muscle control and impaired shoulder joint position sense in subjects with chronic shoulder stiffness

The purpose of the present study was to determine (1) if joint position sense (JPS) in subjects with shoulder stiffness (SS) differs from that in controls; (2) if, when JPS is reduced in SS, it is related to scapular muscular activities in the mid/end ranges of motion; and (3) if a person’s function is associated with his or her level of JPS. Eighteen subjects with unilateral SS and 18 controls were included. Each subject performed abduction by self-selecting an end/mid range position. The electromagnetic motion-capturing system collected kinematic data while surface electromyography collected muscle activities (upper trapezius, lower trapezius, and serratus anterior muscles). Subjects were asked to move the upper limb to the target position (end/mid range) accurately without visual guidance. Reduced JPS was observed in subjects with SS (2.7 degrees in mid range, p < 0.05). The JPS was enhanced by an increased scapula muscular activation level in the end range of motion (R = ?0.61 for SS and ?0.41 for controls) and by coordination among muscles’ activation in the mid-range of motion (R = ?0.87 for SS and R = ?0.53 for controls). Impaired JPS was also related to self-reported functional status (R = ?0.56) in subjects with SS. Shoulder JPS in subjects with chronic SS is impaired in comparison with controls. In the mid-range motion, the coordination of scapula muscular activation is related to shoulder JPS. Impaired JPS is also function-related in subjects with SS. These findings suggest that the coordination among scapula muscles’ activation were important to consider in the rehabilitation of patients with chronic SS.     

The upper and lower segments of subscapularis muscle have different roles in glenohumeral joint functioning

Subscapularis muscle is divided into two independent segments, upper and lower (USUB and LSUB), but the role of each segment in glenohumeral functioning is unclear. We compared the electromyographic (EMG) activity of USUB and LSUB during a variety of shoulder movements, with and without an external translation force. Intramuscular electrodes were inserted in USUB and LSUB segments of 20 adults without pathology and EMG activity was measured in stabilization trials (with and without an anterior or posterior directed force at the humerus and isometric rotations) and two shoulder positions (shoulder neutral, abduction). Maximal voluntary isometric contraction (MVIC) trials were performed in abduction, internal and external rotation of the shoulder. In MVIC trials, USUB showed higher activity during internal rotation (p = 0.03), whereas LSUB showed higher activity during external rotation (p < 0.01). In stabilization trials, the interaction effects were significant for muscle segment × condition (p < 0.01), and approached significance for muscle segment × position (p = 0.06). In the neutral position, the pattern of activity for LSUB was similar to USUB. In the abducted position the LSUB, unlike USUB, was more active during external rotation (p = 0.06) and also showed increased activity in response to the posterior directed force at the humerus (p = 0.04). Our results suggest that USUB primarily acts as an agonist for internal rotation. In contrast LSUB was particularly active in external rotation in the abducted position and demonstrated increased EMG activity in response to the posteriorly directed force at the humerus in that position, suggesting more of a role in glenohumeral stabilization.     

Assessment of functional recovery in tennis elbow

Objectives: (a) To investigate changes in muscular strength, fatigue and activity in recovered tennis elbow (RTE); (b) to assess the appropriateness of EMG and strength measurements in monitoring functional recovery in tennis elbow (TE).Methods: Study included three age-matched female groups of Control (C) (n = 8, no history of musculoskeletal problems), TE (n = 7, local tenderness at the lateral epicondyle and pain with resisted wrist and middle finger extension) and RTE (n = 6, asymptomatic for at least 6 months, no lateral epicondyle tenderness). Measurements included metacarpophalangeal (MCP), wrist, shoulder and grip isometric strength and EMG measures of muscle fatigue and activity for five forearm muscles (wrist extensors and flexors).Results: Strength was greater (p < 0.05) for all measurements in C compared to RTE and TE except for MCP extension. Only MCP extension was stronger in RTE than TE. EMG revealed increased activity of extensor carpi radialis (ECR) in RTE, decreased in TE.Conclusions: Despite attenuation of pain, global upper limb weakness in RTE indicated incomplete functional recovery. Increased strength of MCP extension may protect weakened wrist extensors from further injury. Monitoring the ECR activity as well as strength measurements may provide a useful assessment of functional recovery in TE.     

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.     

Alternating stimulation of synergistic muscles during functional electrical stimulation cycling improves endurance in persons with spinal cord injury

Therapeutic effects of functional electrical stimulation (FES) cycling for persons with spinal cord injury (SCI) are limited by high rates of muscular fatigue. FES-cycling performance limits and surface mechanomyography (MMG) of 12 persons with SCI were compared under two different stimulation protocols of the quadriceps muscles. One strategy used the standard “co-activation” protocol from the manufacturer of the FES cycle which involved intermittent simultaneous activation of the entire quadriceps muscle group for 400 ms. The other strategy was an “alternation” stimulation protocol which involved alternately stimulating the rectus femoris (RF) muscle for 100 ms and the vastus medialis (VM) and vastus lateralis (VL) muscles for 100 ms, with two sets with a 400 ms burst. Thus, during the alternation protocol, each of the muscle groups rested for two 100 ms “off” periods in each 400 ms burst. There was no difference in average cycling cadence (28 RPM) between the two protocols. The alternation stimulation protocol produced longer ride times and longer virtual distances traveled and used lower stimulation intensity levels with no differences in average MMG amplitudes compared to the co-activation protocol. These results demonstrate that FES-cycling performance can be enhanced by a synergistic muscle alternation stimulation strategy.     

Differential patterns of muscle modification in women with episodic and chronic tension-type headache revealed using surface electromyographic analysis

Tension-type headache (TTH) is a prototypical disorder in which muscular factors play a key role in the pathogenesis. This study was designed to understand muscular dysfunction in patients with episodic (ETTH) and chronic TTH (CTTH) using surface electromyography analysis (SEMG). Women with frequent ETTH (n = 14), CTTH (n = 14) and age-matched controls (n = 13) were recruited. SEMG data were recorded from the masseter, sternocleidomastoid, and upper trapezius muscles during maximum voluntary contraction and sustained voluntary isometric clenching, the neck flexion endurance test and shoulder elevation for 30 s. The root mean square (RMS) and median frequency (MDF) of the SEMG signal were measured throughout the test. The fatigue index, which is the MDF slope during sustained muscle contraction, decreased significantly faster in the ETTH and CTTH groups compared with that in the control (p < 0.05). The mean absolute RMS and relative percentage values at the initial and final period during sustained isometric contraction decreased significantly in the CTTH group (p < 0.05). Furthermore, headache clinical parameters (frequency and duration) were negatively correlated with the amplitude values (p < 0.05). A different muscle firing pattern or some muscle modifications in patients with CTTH may reflect reorganization of the motor-control strategy.     

Voluntary activation of trapezius measured with twitch interpolation

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

Secondary motions of the shoulder during arm elevation in patients with shoulder tightness

An analysis of secondary shoulder motions (humeral rotation, humeral head anterior/posterior translation, scapular tipping, and scapular upward/downward rotation) in subjects with anterior/posterior shoulder tightness provides the opportunity to examine the role of tightness as a means of affecting shoulder motions. Subjects with shoulder tightness (anterior, n = 12; posterior, n = 12) elevated their arms in the scapular plane. Three replicated movements were performed to the maximum motions. Kinematics data were collected by FASTRAK 3D electromagnetic system. To determine if a significant difference of the secondary motions existed between anterior/posterior shoulder tightness, two-factor mixed ANOVA models with the repeated factor of elevation angle (five elevation angles) and the independent factor of group were calculated. The relationships between the self-reported functional scores (Flexilevel Scale of Shoulder Function, FLEX-SF) and abnormal shoulder kinematics were assessed. For humeral head anterior/posterior translation, the subjects with posterior tightness demonstrated anterior humeral head translation (10 mm, p = 0.019) compared to subjects with anterior tightness. The subjects with anterior tightness demonstrated less posterior tipping (2.2°, p = 0.045) compared to subjects with posterior tightness. The humeral anterior translation had moderate relationships with FLEX-SF scores (r = ?0.535) in subjects with posterior tightness. The scapular tipping had moderate relationships with FLEX-SF scores (r = 0.432) in subjects with anterior tightness. In conclusion, the secondary motions were different between subjects with anterior and posterior shoulder tightness. During arm elevation, less scapular posterior tipping and less posterior humeral head translation in subjects with anterior and posterior shoulder tightness, respectively, are significantly related to self-reported functional disability in these subjects.     

Towards an anthropometric history of latin America in the second half of the twentieth century

We examine the evolution of adult female heights in twelve Latin American countries during the second half of the twentieth century based on demographic health surveys and related surveys compiled from national and international organizations. Only countries with more than one survey were included, allowing us to cross-examine surveys and correct for biases. We first show that average height varies significantly according to location, from 148.3 cm in Guatemala to 158.8 cm in Haiti. The evolution of heights over these decades behaves like indicators of human development, showing a steady increase of 2.6 cm from the 1950s to the 1990s. Such gains compare favorably to other developing regions of the world, but not so much with recently developed countries. Height gains were not evenly distributed in the region, however. Countries that achieved higher levels of income, such as Brazil, Chile, Colombia and Mexico, gained on average 0.9 cm per decade, while countries with shrinking economies, such as Haiti and Guatemala, only gained 0.25 cm per decade.     

Effect of changes in orientation and position of external loads on trunk muscle activity and kinematics in upright standing

Forces at different heights and orientations are often carried by hands while performing occupational tasks. Trunk muscle activity and spinal loads are likely dependent on not only moments but also the orientation and height of these forces. Here, we measured trunk kinematics and select superficial muscle activity of 12 asymptomatic subjects while supporting forces in hands in upright standing. Magnitude of forces in 5 orientations (−25°, 0°, 25°, 50° and 90°) and 2 heights (20 cm and 40 cm) were adjusted to generate flexion moments of 15, 30 and 45 N m at the L5-S1 disc centre. External forces were of much greater magnitude when applied at lower elevation or oriented upward at 25°. Spinal kinematics remained nearly unchanged in various tasks.Changes in orientation and elevation of external forces substantially influenced the recorded EMG, despite similar trunk posture and identical moments at the L5-S1. Greater EMG activity was overall recorded under larger forces albeit constant moment. Increases in the external moment at the L5-S1 substantially increased EMG in extensor muscles (p < 0.001) but had little effect on abdominals; e.g., mean longissimus EMG for all orientations increased by 38% and 75% as the moment level altered from 15 N m to 30 N m and to 45 N m while that in the rectus abdominus increased only by 2% and 4%, respectively. Under 45 N m moment and as the load orientation altered from 90° to 50°, 25°, 0° and −25°, mean EMG dropped by 3%, 12%, 12% and 1% in back muscles and by 17%, 17%, 19% and 13% in abdominals, respectively. As the load elevation increased from 20 cm to 40 cm, mean EMG under maximum moment decreased by 21% in back muscles and by 17% in abdominals.Due to the lack of EMG recording of deep lumbar muscles, changes in relative shear/compression components and different net moments at cranial discs despite identical moments at the caudal L5-S1 disc, complementary model studies are essential for a better comprehension of neuromuscular strategies in response to alterations in load height and orientation.     

The effects of muscle architectural change with a pre-motion silent period on the subsequent muscular output during rapid voluntary movement

This study aimed to determine the characteristics of the in vivo behaviour of human muscle architecture during a pre-motion silent period (PMSP) using ultrasonography. Subjects were requested to perform rapid knee extension with vertical jumping. Electromyographic signals were recorded from the vastus lateralis (VL), vastus medialis, and biceps femoris muscles. Ultrasonic images were recorded from the VL. We found that the cross point between the fascicle and deep aponeurosis in the VL moved to the distal side before the rapid vertical jumps with PMSP. This cross point movement with PMSP was of low amplitude (mean: 1.0 ± 0.3 mm) and velocity (22.2 ± 6.1 mm/s). The amplitude and velocity of the cross point movement were significantly positively related to the angular peak velocity of knee extensor during rapid vertical jumping in trials with PMSP. These results suggest that although low levels of pre-movement muscle architectural change with PMSP may be the result of muscle relaxation behaviour rather than the result of muscle stretching behaviour, this pre-movement effect can influence subsequent muscular performance during a rapid voluntary movement. PMSP may allow pre-movement muscle architectural change to generate a better muscular condition to increase neural activation during the subsequent rapid voluntary contraction.     

Influence of additional load on the moments of the agonist and antagonist muscle groups at the knee joint during closed chain exercise

The present study investigated the influence of additional loads on the knee net joint moment, flexor and extensor muscle group moments, and cocontraction index during a closed chain exercise. Loads of 8, 28, or 48 kg (i.e., respectively, 11.1 ± 1.5%, 38.8 ± 5.3%, and 66.4 ± 9.0% of body mass) were added to subjects during dynamic half squats. The flexor and extensor muscular moments and the amount of cocontraction were estimated at the knee joint using an EMG-and-optimization model that includes kinematics, ground reaction, and EMG measurements as inputs. In general, our results showed a significant influence of the Load factor on the net knee joint moment, the extensor muscular moment, and the flexor muscle group moment (all Anova p < .05). Hence we confirmed an increase in muscle moments with increasing load and moreover, we also showed an original “more than proportional” evolution of the flexor and extensor muscle group moments relative to the knee net joint moment. An influence of the Phase (i.e., descent vs. ascent) factor was also seen, revealing different activation strategies from the central nervous system depending on the mode of contraction of the agonist muscle group. The results of the present work could find applications in clinical fields, especially for rehabilitation protocols.     

Vitamin D sufficiency associates with an increase in anti-inflammatory cytokines after intense exercise in humans

The purpose of this study was to identify the influence of vitamin D status (insufficient vs. sufficient) on circulating cytokines and skeletal muscle strength after muscular injury. To induce muscular injury, one randomly selected leg (SSC) performed exercise consisting of repetitive eccentric–concentric contractions. The other leg served as the control. An averaged serum 25(OH)D concentration from two blood samples collected before exercise and on separate occasions was used to establish vitamin D insufficiency (<30 ng/mL, n = 6) and sufficiency (>30 ng/mL, n = 7) in young, adult males. Serum cytokine concentrations, single-leg peak isometric force, and single-leg peak power output were measured before and during the days following the exercise protocol. The serum IL-10 and IL-13 responses to muscular injury were significantly (both p < 0.05) increased in the vitamin D sufficient group. The immediate and persistent (days) peak isometric force (p < 0.05) and peak power output (p < 0.05) deficits in the SSC leg after the exercise protocol were not ameliorated with vitamin D sufficiency. We conclude that vitamin D sufficiency increases the anti-inflammatory cytokine response to muscular injury.     

Heavy-intensity aerobic exercise affects the isokinetic torque and functional but not conventional hamstrings:quadriceps ratios

Running exercises are frequently related to muscular injuries, which may be a result of muscular imbalance. The present study aimed to verify the effects of heavy-intensity continuous running exercise on the functional and conventional hamstrings:quadriceps ratios, and also in the knee flexors and extensors EMG activity in active non-athletic individuals. Sixteen active males performed maximal isokinetic concentric and eccentric knee flexions and extensions at 60° s^?1 and 180° s^?1. In another session, the same procedure was conducted after a continuous running exercise at 95% onset of blood lactate accumulation. Torque and electromyographic ratios were calculated from peak torque and integrated electromyographic activity (knee flexor and extensors). Creatine kinase was measured before and 24 h after running exercise. Eccentric torque (knee flexion and extension) decreased significantly after running only at 180° s^?1 (p < 0.05). No differences were found for the conventional torque ratios (p > 0.05), however, the functional torque ratios at 180° s^?1 decreased significantly after running (p < 0.05). No effects on the electromyographic activity and electromyographic ratios were found (p > 0.05). Creatine kinase increased slightly 24 h after running (p < 0.05). Heavy-intensity continuous running exercise decreased knee flexor and extensor eccentric torque, and functional torque ratios under fast velocities (180° s^?1), probably as result of peripheral fatigue.     

Upper limb and trunk muscle activation during an unexpected descent on the outstretched hands in young and older women

Falling on the outstretched hands (FOOSH), a protective mechanism to arrest the body and avoid injury, requires upper limb and trunk motor control for effective body descent. The purpose of this study was to investigate muscle activity during three phases of an unexpected FOOSH in healthy older and younger women. Twenty young (mean age 22.9 yrs, SD ± 3.7) and 20 older females (mean age 68.1 yrs, SD ± 5.0) performed five trials of unexpected FOOSHs. Surface electromyography (EMG) determined muscle activations for left shoulder girdle, elbow and abdominal muscles during an unexpected FOOSH. Root mean squared EMG data were calculated during three phases: (1) baseline (BL; 500 ms prior to release), (2) the preparatory phase (PRE; time between release and impact) (mean 257 ± 37 ms) and post-impact (POST; 200 ms after impact). A mixed MANOVA determined differences between phases and age groups. There was a significant multivariate interaction effect of age and time phase on muscle activity (p = 0.001). Younger women had significantly higher internal oblique/transversus abdominus activity during PRE (p = 0.006) as well as variations in muscle activity of shoulder girdle and elbow muscles. The age differences observed may lead to poorer preliminary trunk activation and greater arm bracing in older women, potentially increasing risk of fallrelated injury.     

Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy

Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of ?7 Nm that was higher for these children (0.75 Nm/° vs. 0.48 Nm/°; p < 0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p < 0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait.     

Posture-movement changes following repetitive motion-induced shoulder muscle fatigue

Repetitive motion-induced fatigue not only alters local motion characteristics but also provokes global reorganization of movement. However, the three-dimensional (3D) characteristics of these reorganization patterns have never been documented in detail. The goal of this study was to assess the effects of repetitive reaching-induced arm fatigue on the whole-body, 3D biomechanical task characteristics. Healthy subjects (N = 14) stood and performed a continuous reaching task (RRT) between two targets placed at shoulder height to fatigue. Whole-body kinematic (Vicon^©), kinetic (AMTI^© force platforms) and electromyographic (EMG, Noraxon^©) characteristics were recorded. Maximal voluntary isometric efforts (MVIE) of the shoulder and elbow were measured pre- and post-RRT. Post-RRT shoulder elevation MVIE was reduced by 4.9 ± 8.3% and trapezius EMG amplitude recorded during the RRT increased by 46.9 ± 49.9% from the first to last minute of the RRT, indicating that arm fatigue was effectively induced. During fatigued reaching, subjects elevated their shoulder (11.7 ± 10.5 mm) and decreased their average shoulder abduction angle by 8.3 ± 4.4°. These changes were accompanied by a lateral shift of the body’s center of mass towards the non-reaching arm. These findings suggest a compensatory strategy to decrease the load on the fatigued shoulder musculature.