Corticospinal Excitability of Trunk Muscles during Different Postural Tasks

Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs to trunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscle activity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function.     

Test-retest reliability of EMG and peak torque during repetitive maximum concentric knee extensions.

The aim of this study was to investigate the reliability of peak torque and surface electromyography (EMG) variable's root mean square (RMS) and mean frequency (MNF) during an endurance test consisting of repetitive maximum concentric knee extensions. Muscle fatigue has been quantified in several ways, and in isokinetic testing it is based on a set of repetitive contractions. To assess test-retest reliability, two sets of 100 dynamic maximum concentric knee extensions were performed using an isokinetic dynamometer. The two series were separated by 7-8 days. The subjects relaxed during the passive flexion phase. Twenty (10 men and 10 women) clinically healthy subjects volunteered.Peak torque and EMG from rectus femoris, vastus medialis, vastus lateralis and biceps femoris were recorded. RMS and MNF were calculated from the EMG signal. The reliability was calculated with intraclass correlation coefficient ICC (1.1) and standard error of measurements (SEM). The reliability of peak torque was good (ICC=0.93) and SEM showed low values. ICC was good for absolute RMS of rectus femoris (ICC>/=0.80), vastus medialis (ICC>/=0.88) and vastus lateralis (ICC>/=0.82) and MNF of rectus femoris (ICC>/=0.82) and vastus medialis (ICC>/=0.83). Peak torque, and MNF and RMS of rectus femoris and vastus medialis are reliable variables obtained from an isokinetic endurance test of the knee extensors.     

Reproducibility of surface EMG variables and peak torque during three sets of ten dynamic contractions.

The interpretation of the electromyogram (EMG) of dynamic contractions might be difficult because the movement per se introduces additional factors that could affect its characteristics. There is a lack of studies concerning the reproducibility of surface EMG registrations during dynamic contractions. The aim was to investigate the during-the-day reproducibility (using intra-class correlation; ICC) of the peak torque (PT) and the EMG variables (without removing the electrodes) of dynamic contractions. Ten healthy subjects performed three sets of 10 dynamic maximum right-knee extensions with a one-hour interval in between, using an isokinetic dynamometer and the PT was determined. EMG signals were recorded from the right vastus lateralis, rectus femoris and vastus medialis muscles using surface electrodes and the mean frequency of the power spectrum (MNF [Hz]) and the signal amplitude (RMS [microV]), were computed. The ability to relax in-between the maximum extensions was calculated as a ratio of the RMS during the passive flexion phase and the RMS during the active extension phase of each contraction cycle: the signal amplitude ratio (SAR). Both PT (ICC = 0.99) and RMS (ICC = 0.83-0.98) had good reproducibility. The reproducibility of MNF was good for all muscles when the mean of contraction nos.: 1-10 was used. Vastus lateralis had the highest ICC among the three muscles. The reproducibility of SAR was generally poor (ICC < 0.60). The present study showed good reproducibility for common EMG variables (MNF and RMS) obtained during maximum isokinetic contractions.     

Within-day and between-days reliability of quadriceps isometric muscle fatigue using mechanomyography on healthy subjects

This study aimed to examine within-day and between-days intratester reliability of mechanomyography (MMG) in assessing muscle fatigue. An accelerometer was used to detect the MMG signal from rectus femoris. Thirty one healthy subjects (15 males) with no prior knee problems initially performed three maximum voluntary contractions (MVCs) using an ISOCOM dynamometer. After 10 min rest, subjects performed a fatiguing protocol in which they performed three isometric knee extensions at 75% MVC for 40 s. The fatiguing protocol was repeated on two other days, two to four days apart for between-days reliability. MMG activity was determined by overall root mean squared amplitude (RMS), mean power frequency (MPF) and median frequency (MF) during a 40 s contraction. RMS, MPF and MF linear regression slopes were also analysed. Intraclass Correlation Coefficients (ICC); ICC1,1 and ICC1,2 were used to assess within-day reliability and between-days reliability respectively. Standard error of measurement (SEM) and smallest detectable difference (SDD) described the within-subjects variability. MMG fatigue measures using linear regression slopes showed low reliability and large between-days error (ICC1,2 = 0.43–0.46; SDD = 306.0–324.8% for MPF and MF slopes respectively). Overall MPF and MF, on the other hand, were reliable with high ICCs and lower SDDs compared to linear slopes (ICC1,2 = 0.79–0.83; SDD = 21.9–22.8% for MPF and MF respectively). ICC1,2 for overall MMG RMS and linear RMS slopes were 0.81 and 0.66 respectively; however, the SDDs were high (56.4% and 268.8% respectively). The poor between-days reliability found in this study suggests caution in using MMG RMS, MPF and MF and their corresponding slopes in assessing muscle fatigue.     

Inhibition of gut pacemaker cell formation from mouse ES cells by the c-kit inhibitor

Using an embryoid body (EB) culture system, we developed a functional organ-like cluster, a "gut", from mouse embryonic stem (ES) cells (ES gut). Each ES gut exhibited various types of spontaneous movements. In these spontaneously contracting ES guts, dense distributions of interstitial cells of Cajal (ICC) (c-kit, a transmembrane receptor that has tyrosine kinase activity, positive cells; gut pacemaker cells) and smooth muscle cells were discernibly identified. By adding Glivec 10(-5)M, a tyrosine kinase receptor c-kit inhibitor, only during EB formation, we for the first time succeeded in suppressing in vitro formation of ICC in the ES gut. The ES gut without ICC did not exhibit any movements. However, it appeared that Glivec 10(-6)-10(-7)M rather increased number of ES guts with spontaneous movements associated with increase of intracellular Ca(2+) concentration ([Ca(2+)](i)). These results suggest ICC is critical for in vitro formation of ES guts with spontaneous movements.     

Test–retest reliability of subjective supra-threshold scaling of multiple pressure-pain sensations among healthy individuals: a study using hydraulic pressure algometry

Abstract

Background: Supra-threshold scaling of multiple pressure-pain sensations involves delivery of varied stimulus intensities, either via stimulus-dependent or response-dependent manner, and recording of subjective pain ratings by participants. The focus of this study was to determine the intra- and inter-session reliability of pain intensity and pain unpleasantness ratings related to pressure-pain thresholds (PPTs) of just noticeable pain (JNP), weak pain (WP) and moderate pain (MP) among healthy individuals.

Methods: Fourteen healthy participants (eight women, six men) participated in three sessions of testing at varied intervals over the course of 72?h. In session one, a multiple random staircase method using hydraulic pressure algometry was used to measure PPT of JNP, WP and MP on thumbnail bed. In session 2, ratings of pain intensity and pain unpleasantness were recorded when stimuli at levels corresponding to PPT of JNP, WP and MP were repeatedly applied before and after 20?min of no intervention.

Results: Interclass correlation coefficient (ICC) values for pain ratings of JNP, WP and MP in intra-session reliability were 0.810, 0.826 and 0.881, respectively, whereas the values were 0.817, 0.792 and 0.910, respectively, for inter-session reliability. ICC values for pain unpleasantness were also highly consistent and repeatable. Temporal summation of pain intensity and pain unpleasantness were not related to the repeated application of pressure stimuli.

Conclusions: The findings indicate that the pain intensity and pain unpleasantness ratings for stimuli at levels equal to the thresholds of JNP, WP and MP have good intra- and inter-session reliability.

Significance: This study showed that both pain intensity and pain unpleasantness of JNP, WP and MP have good intra- and inter-session reliability and agreement. Furthermore, the temporal summation of pain or unpleasantness is not related to repeated application of pressure stimuli.

Abbreviations: JNP: Just noticeable pain; WP: Weak pain; MP: Moderate pain; PPTs: pressure-pain thresholds; HPA: Hydraulic pressure algometry; MRSM: multiple random staircase method     

Repeatability assessment of functional methods to estimate the glenohumeral joint centre

Functional methods can be used to determine the centre of rotation (CoR) of a ball-and-socket joint. The algorithms are used to locate rather the hip joint centre than the glenohumeral joint centre. The choice of the most suitable method depends especially on the intra- and inter-session repeatability of these methods. This paper aims at evaluating the intra- and inter-session repeatability of functional methods with which the glenohumeral joint rotation centre (GHRC) can be estimated in vivo. It also estimates the most suitable amplitude of functional movements. Five functional methods were tested: the algorithms of Gamage and Lasenby, bias compensation, symmetrical CoR estimation, normalisation method and helical axis. Ten subjects performed three cycles of three different movements (flexion–extension, abduction–adduction and circumduction). These movements were repeated three times with three different ranges of motion. Six subjects came back in order to evaluate the inter-session repeatability. For each test, the location of the GHRC was estimated by the five methods. The method to solve the functional problem and the range of functional movement affected the GHRC location. The results showed a good to excellent intra-session repeatability. The lowest repeatability error was found for the high amplitude whatever the methods used. The inter-session reliability was moderate. Finally, we suggest the use of functional methods with high amplitude movement in order to locate the GHRC with the best reliability.     

Evaluating the validity and reliability of inertial measurement units for determining knee and trunk kinematics during athletic landing and cutting movements

Inertial Measurement Units (IMUs) are promising alternatives to laboratory-based motion capture methods in biomechanical assessment of athletic movements. The aim of this study was to investigate the validity of an IMU system for determining knee and trunk kinematics during landing and cutting tasks for clinical and research applications in sporting populations. Twenty-seven participants performed five cutting and landing tasks while being recorded using a gold-standard optoelectronic motion capture system and an IMU system. Intra-class coefficients, Pearson’s r, root-mean-square error (RMSE), bias, and Bland-Altman limits of agreements between the motion capture and IMU systems were quantified for knee and trunk sagittal- and frontal-plane range-of-motion (ROM) and peak angles. Our results indicate that IMU validity was task-, joint-, and plane-dependent. Based on good-to-excellent (ICC) correlation, reasonable accuracy (RMSE < 5°), bias within 2°, and limits of agreements within 10°, we recommend the use of this IMU system for knee sagittal-plane ROM estimations during cutting, trunk sagittal-plane peak angle estimation during the double-leg landing task, trunk sagittal-plane ROM estimation for almost all tasks, and trunk frontal-plane peak angle estimation for the right single-leg landing task. Due to poor comparisons with the optoelectronic system, we do not recommend this IMU system for knee frontal-plane kinematic estimations.     

Reliability of electromyographic amplitude values of the upper limb muscles during closed kinetic chain exercises with stable and unstable surfaces

The purpose of the present study was to evaluate the intra and interday reliability of surface electromyographic amplitude values of the scapular girdle muscles and upper limbs during 3 isometric closed kinetic chain exercises, involving upper limbs with the fixed distal segment extremity on stable base of support and on a Swiss ball (relatively unstable). Twenty healthy adults performed the exercises push-up, bench-press and wall-press with different effort levels (80% and 100% maximal load). Subjects performed three maximal voluntary contractions (MVC) in muscular testing position of each muscle to obtain a reference value for root mean square (RMS) normalization. Individuals were instructed to randomly perform three isometric contraction series, in which each exercise lasted 6 s with a 2-min resting-period between series and exercises. Intra and interday reliabilities were calculated through the intraclass correlation coefficient (ICC 2.1), standard error of the measurement (SEM). Results indicated an excellent intraday reliability of electromyographic amplitude values (ICC ? 0.75). The interday reliability of normalized RMS values ranged between good and excellent (ICC 0.52–0.98). Finally, it is suggested that the reliability of normalized electromyographic amplitude values of the analyzed muscles present better values during exercises on a stable surface. However, load levels used during the exercises do not seem to have any influence on variability levels, possibly because the loads were quite similar.     

Trunk muscle activation during golf swing: Baseline and threshold

There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000 ms before the 500 ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability.Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295 ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent.     

Reflex delays of the trunk muscles in response to postural perturbations: A reliability study

It has been reported that altered neuromuscular control of the trunk is associated with lower back pain. In this context reflex delays of the trunk muscles have often been assessed but the reliability of the tests has not been well established. The aim of this study was to test the reliability of measuring reflex delays of the trunk muscles after two types of postural perturbations. 24 Healthy subjects participated in the intra-session study and 13 of them repeated the test protocol within 1–3 weeks, to determine inter-session reliability. Postural reflex delays to unexpected loading and unloading of the arms were assessed in a standing unrestrained position. Each subject performed 40 trials of each test in order to evaluate muscle responses of 5 trunk muscles using surface electromyography. Overall reliability increased with higher number of the averaged trials. Good intra-session (ICC_3,1>0.75) and moderate (ICC_3,1>0.60) inter-session reliability were reached in most of the monitored trunk muscles. Within the performed number of trials we did not observe any significant systematic intra- or inter-session bias effect. Averaging a higher number of consecutive trials would be recommended in future research and clinical practice.     

Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests

Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects.     

Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients.

The purpose of this study was to compare the reliability of trunk muscle activity measured by means of surface electromyography (EMG) during maximal and sub-maximal voluntary isometric contractions (MVC/sub-MVC) over repeated trials within-day and between-days in healthy controls and patients with chronic low back pain (CLBP). Eleven volunteers (six controls and five CLBP patients) were assessed twice with a 1-week interval. Surface EMG signals were recorded bilaterally from six trunk muscles. Intra-class correlation coefficients (ICC) and standard error of measurement as a percentage of the grand mean (%SEM) were calculated. MVC and sub-MVC showed excellent within-day reliability in both healthy controls and CLBP patients (ICC mean 0.91; range 0.75-0.98; %SEM mean 4%; range 1-12%). Sub-MVC for both groups between-days showed excellent reliability (ICC mean 0.88; range 0.78-0.97; %SEM mean 7%; range 3-11%). The between-days MVC for both groups showed trends towards lower levels of reliability (ICC mean 0.70; range 0.19-0.99; %SEM mean 17%; range 4-36%) when compared to sub-MVC. Findings of the study provide evidence that sub-MVC are preferable for amplitude normalisation when assessing EMG signals of trunk muscles between-days.     

Reliability of techniques to assess human neuromuscular function in vivo.

The purpose of this study was to comprehensively evaluate the reliability of a large number of commonly utilized experimental tests of in vivo human neuromuscular function separated by 4-weeks. Numerous electrophysiological parameters (i.e., voluntary and evoked electromyogram [EMG] signals), contractile properties (i.e., evoked forces and rates of force development and relaxation), muscle morphology (i.e., MRI-derived cross-sectional area [CSA]) and performance tasks (i.e., steadiness and time to task failure) were assessed from the plantarflexor muscle group in 17 subjects before and following 4-weeks where they maintained their normal lifestyle. The reliability of the measured variables had wide-ranging levels of consistency, with coefficient of variations (CV) ranging from approximately 2% to 20%, and intraclass correlation coefficients (ICC) between 0.53 and 0.99. Overall, we observed moderate to high-levels of reliability in the vast majority of the variables we assessed (24 out of the 29 had ICC>0.70 and CV<15%). The variables demonstrating the highest reliability were: CSA (ICC=0.93-0.98), strength (ICC=0.97), an index of nerve conduction velocity (ICC=0.95), and H-reflex amplitude (ICC=0.93). Conversely, the variables demonstrating the lowest reliability were: the amplitude of voluntary EMG signal (ICC=0.53-0.88), and the time to task failure of a sustained submaximal contraction (ICC=0.64). Additionally, relatively little systematic bias (calculated through the limits of agreement) was observed in these measures over the repeat sessions. In conclusion, while the reliability differed between the various measures, in general it was rather high even when the testing sessions are separated by a relatively long duration of time.     

Between-session reliability of opto-electronic motion capture in measuring sagittal posture and 3-D ranges of motion of the thoracolumbar spine

This study evaluated between-session reliability of opto-electronic motion capture to measure trunk posture and three-dimensional ranges of motion (ROM). Nineteen healthy participants aged 24–74 years underwent spine curvature, pelvic tilt and trunk ROM measurements on two separate occasions. Rigid four-marker clusters were attached to the skin overlying seven spinous processes, plus single markers on pelvis landmarks. Rigid body rotations of spine marker clusters were calculated to determine neutral posture and ROM in flexion, extension, total lateral bending (left-right) and total axial rotation (left-right). Segmental spine ROM values were in line with previous reports using opto-electronic motion capture. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were calculated as measures of between-session reliability and measurement error, respectively. Retroreflective markers showed fair to excellent between-session reliability to measure thoracic kyphosis, lumbar lordosis, and pelvic tilt (ICC = 0.82, 0.63, and 0.54, respectively). Thoracic and lumbar segments showed highest reliabilities in total axial rotation (ICC = 0.78) and flexion-extension (ICC = 0.77–0.79) ROM, respectively. Pelvic segment showed highest ICC values in flexion (ICC = 0.78) and total axial rotation (ICC = 0.81) trials. Furthermore, it was estimated that four or fewer repeated trials would provide good reliability for key ROM outcomes, including lumbar flexion, thoracic and lumbar lateral bending, and thoracic axial rotation. This demonstration of reliability is a necessary precursor to quantifying spine kinematics in clinical studies, including assessing changes due to clinical treatment or disease progression.     

Criterion validation of surface EMG variables as fatigue indicators using peak torque: a study of repetitive maximum isokinetic knee extensions.

A number of studies have been published that have used variables of the electromyogram (EMG) power spectrum during dynamic exercise. Despite these studies there is a shortage of studies of the validity of surface EMG registrations during repetitive dynamic contractions with respect to fatigue. The aim of this study was to investigate if the surface EMG variables mean frequency (MNF [Hz]) and the signal amplitude (RMS [microV]) are valid indicators of muscular fatigue (defined as "any exercise-induced reduction in the capacity to generate force or power output") during maximum repeated isokinetic knee extensions (i.e. criterion validity using peak torque). Twenty-one healthy volunteers performed 100 isokinetic knee extensions at 90 degrees s(-1). EMG signals were recorded from the vastus lateralis, the rectus femoris and the vastus medialis of the right thigh by surface electrodes. MNF and RMS of the EMG together with peak torque (PT [Nm]) were determined for each contraction. MNF showed consequently higher correlation coefficients with PT than RMS did. Positive correlations generally existed between MNF and PT. The majority of the subjects had positive correlations between RMS and PT (i.e. decreases both in PT and in RMS).In conclusion, at the individual level MNF generally - in contrast to RMS - showed good criterion validity with respect to biomechanical fatigue during dynamic maximum contractions.     

Comparison of Trunk Activity during Gait Initiation and Walking in Humans

To understand the role of trunk muscles in maintenance of dynamic postural equilibrium we investigate trunk movements during gait initiation and walking, performing trunk kinematics analysis, Erector spinae muscle (ES) recordings and dynamic analysis. ES muscle expressed a metachronal descending pattern of activity during walking and gait initiation. In the frontal and horizontal planes, lateroflexion and rotation occur before in the upper trunk and after in the lower trunk. Comparison of ES muscle EMGs and trunk kinematics showed that trunk muscle activity precedes corresponding kinematics activity, indicating that the ES drive trunk movement during locomotion and thereby allowing a better pelvis mobilization. EMG data showed that ES activity anticipates propulsive phases in walking with a repetitive pattern, suggesting a programmed control by a central pattern generator. Our findings also suggest that the programs for gait initiation and walking overlap with the latter beginning before the first has ended.     

Reliability of assessing trunk motor control using position and force tracking and stabilization tasks

System-based methods have been applied to assess trunk motor control in people with and without back pain, although the reliability of these methods has yet to be established. Therefore, the goal of this study was to quantify within- and between-day reliability using systems-based methods involving position and force tracking and stabilization tasks. Ten healthy subjects performed six tasks, involving tracking and stabilizing of trunk angular position in the sagittal plane, and trunk flexion and extension force. Tracking tasks involved following a one-dimensional, time-varying input signal displayed on a screen by changing trunk position (position tracking) or trunk force (force tracking). Stabilization tasks involved maintaining a constant trunk position (position stabilization) or constant trunk force (force stabilization) while a sagittal plane disturbance input was applied to the pelvis using a robotic platform. Time and frequency domain assessments of error (root mean square and H₂ norm, respectively) were computed for each task on two separate days. Intra-class correlation coefficients (ICC) for error and coefficients of multiple correlations (CMC) for frequency response curves were used to quantify reliability of each task. Reliability for all tasks was excellent (between-day ICC≥0.8 and CMC>0.75, within-day CMC>0.85). Therefore, position and force control tasks used to assess trunk motor control can be deemed reliable.     

Evaluating the effect of electrode location on surface EMG amplitude of the m. erector spinae p. longissimus dorsi

Variations in surface electromyography (SEMG) amplitude have been shown to be dependent on the dislocation of recording electrodes. Yet no literature is available about the effect of electrode dislocation on SEMG amplitude of the lower back muscles. In this project, the aim was to determine this effect by investigating changes in the SEMG root mean square (RMS), induced by a well-defined dislocation of the recording electrodes. Bipolar SEMG of the longissimus dorsi (LD) muscles was measured in 16 healthy subjects undertaking five functional tasks (standing, forward flexion, re-extension, unsupported sitting and arm/leg lifting), and for eight of those subjects the experiment was repeated within two weeks. Intra-class correlation coefficients (ICCs) were used to show the reliability of the RMS in relation to electrode dislocation, the repeatability of the tasks, and the test–retest reliability. Results showed that: (1) lateral dislocation causes a significant decrease (18%, p < 0.001) in RMS; (2) longitudinal dislocation does not change the RMS; and (3) the variability caused by electrode dislocation is comparable to the variability caused by repetitions of tasks or by electrode repositioning. Our conclusion is that positioning in the mediolateral direction should be exact to minimize changes in SEMG amplitude due to dislocation. However, precise longitudinal electrode positioning seems to be less critical in experimental setups which measure the SEMG of the lower back muscles.     

New insights into pain-related changes in muscle activation revealed by high-density surface electromyography

High-density surface electromyography (HDEMG) is an electrophysiological technique that can be used to quantify the spatial distribution of activity within muscles. When pain-free individuals perform sustained or repetitive tasks, different regions within a muscle become progressively more active; this is thought to reflect a strategy to redistribute the load to different regions, thus limiting localised muscle fatigue. The use of HDEMG has revealed that when people with musculoskeletal pain perform the same tasks, the distribution of activity within the same muscle is usually different, and the same muscle region tends to be active throughout the whole task without progressive activation of different muscle regions. This potentially results in a focal overload of a muscle region, and may contribute to fatigue, localised muscle pain and potentially pain persistence and/or recurrence over time. Interestingly, not all patients with musculoskeletal pain present with this regional alteration in muscle activation, reflecting the heterogeneity of patient presentations. This article will briefly review the technique of HDEMG followed by a review of studies demonstrating spatial redistribution of muscle activity in asymptomatic people during both isometric and dynamic conditions, including functional tasks. Lastly, the article will provide a review of HDEMG studies with a focus on changes in the behaviour of the lumbar erector spine and upper trapezius in people with spinal pain. These studies have revealed subtle changes in the distribution of muscle activity in people with spinal pain, which may have relevance for onset, persistence or recurrence of symptoms and could become a target of novel therapeutic approaches.