Intra-session and inter-day reliability of forearm surface EMG during varying hand grip forces

Surface electromyography (EMG) is widely used to evaluate forearm muscle function and predict hand grip forces; however, there is a lack of literature on its intra-session and inter-day reliability. The aim of this study was to determine reliability of surface EMG of finger and wrist flexor muscles across varying grip forces. Surface EMG was measured from six forearm flexor muscles of 23 healthy adults. Eleven of these subjects undertook inter-day test–retest. Six repetitions of five randomized isometric grip forces between 0% and 80% of maximum force (MVC) were recorded and normalized to MVC. Intra- and inter-day reliability were calculated through the intraclass correlation coefficient (ICC) and standard error of measurement (SEM).Normalized EMG produced excellent intra-session ICC of 0.90 when repeated measurements were averaged. Intra-session SEM was low at low grip forces, however, corresponding normalized SEM was high (23–45%) due to the small magnitude of EMG signals. This may limit the ability to evaluate finer forearm muscle function and hand grip forces in daily tasks. Combining EMG of functionally related muscles improved intra-session SEM, improving within-subject reliability without taking multiple measurements. Removing and replacing electrodes inter-day produced poor ICC (ICC < 0.50) but did not substantially affect SEM.     

Functional Corticospinal Projections from Human Supplementary Motor Area Revealed by Corticomuscular Coherence during Precise Grip Force Control

The purpose of the present study was to investigate whether corticospinal projections from human supplementary motor area (SMA) are functional during precise force control with the precision grip (thumb-index opposition). Since beta band corticomuscular coherence (CMC) is well-accepted to reflect efferent corticospinal transmission, we analyzed the beta band CMC obtained with simultaneous recording of electroencephalographic (EEG) and electromyographic (EMG) signals. Subjects performed a bimanual precise visuomotor force tracking task by applying isometric low grip forces with their right hand precision grip on a custom device with strain gauges. Concurrently, they held the device with their left hand precision grip, producing similar grip forces but without any precision constraints, to relieve the right hand. Some subjects also participated in a unimanual control condition in which they performed the task with only the right hand precision grip while the device was held by a mechanical grip. We analyzed whole scalp topographies of beta band CMC between 64 EEG channels and 4 EMG intrinsic hand muscles, 2 for each hand. To compare the different topographies, we performed non-parametric statistical tests based on spatio-spectral clustering. For the right hand, we obtained significant beta band CMC over the contralateral M1 region as well as over the SMA region during static force contraction periods. For the left hand, however, beta band CMC was only found over the contralateral M1. By comparing unimanual and bimanual conditions for right hand muscles, no significant difference was found on beta band CMC over M1 and SMA. We conclude that the beta band CMC found over SMA for right hand muscles results from the precision constraints and not from the bimanual aspect of the task. The result of the present study strongly suggests that the corticospinal projections from human SMA become functional when high precision force control is required.     

Evaluating protocols for normalizing forearm electromyograms during power grip

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

Changes in muscle geometry during forearm pronation and supination and their relationships to EMG cross-correlation measures

Geometric artifact may alter the amplitude and frequency of the electromyography (EMG) signal. Artifacts include the changing geometry of muscles with respect to electrodes and potential crosstalk from adjacent muscles. This study addresses: (1) the geometrical relationships between common electrode placement sites for six forearm muscles, (2) the geometrical change of forearm muscles in pronation and supination, and (3) the relationships between EMG cross-correlation and muscle geometry. EMG and ultrasonography images were recorded during pronation, supination, and neutral forearm postures while exerting 20% maximum grip strength. Proportions of anatomical structures were then calculated for 15 mm, 20 mm, and 25 mm radial pick-up zone distances, representing greater than 90% of observed myoelectrical signal energy. We found that guidelines for electrode placements were supported and no single posture maximized the proportion of the target muscle detected. Secondly, other muscles were present in the most conservative 15 mm radius pick up zone; it is unlikely that surface EMG can completely differentiate between forearm muscle activities. Thirdly, forearm orientation did not appear to be an important factor in changing the geometrical relationships between surface electrodes and the muscles studied, and fourthly, certain muscles (e.g., FDS) may be more vulnerable to EMG crosstalk.     

Effect of object width on muscle and joint forces during thumb-index finger grasping

The objective of this study was to identify the impact of modifying the object width on muscle and joint forces while gripping objects. The experimental protocol consisted to maintain horizontally five objects of different widths (3.5, 4.5, 5.5, 6.5, and 7.5 cm) with a thumb-index finger grip. Subjects were required to grasp spontaneously the object without any instruction regarding the grip force (GF) to apply. A biomechanical model of thumb-index finger pinch was developed to estimate muscle and joint forces. This model included electromyography, fingertip force, and kinematics data as inputs. The finger joint postures and the GF varied across the object widths. The estimated muscle forces also varied significantly according to the object width. Interestingly, we observed that the muscle force/GF ratios of major flexor muscles remain particularly stable with respect to the width whereas other muscle ratios differed largely. This may argue for a control strategy in which the actions of flexors were preserved in spite of change in joint postures. The estimated joint forces tended to increase with object width and increased in the distal-proximal sense. Overall, these results are of importance for the ergonomic design of handheld objects and for clinical applications.     

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

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

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.     

Learning to produce predicted static handgrip forces

The objective of this study was to prove the hypothesis that kinaesthetic sensations, without visual or verbal guidance, give sufficient information to produce predictive handgrip forces. The ability of 70 girls and 70 boys aged 11 to 17 years to produce predicted static handgrip force was examined. The subjects were requested to produce 50% of their individual maximum handgrip force and maintain it for 2 seconds without visual control. Ten trials were done first by the right-hand and then by the left-hand. The maximum grip strength increased parallel with age, but significant differences were found between both the right and the left-hand, and the genders. Close correlations were found between the desired and the exerted forces. The differences between the desired forces and the exerted forces produced by the fifth trials were significantly smaller than that of the first trials. The verbal information about each exerted force contributed to the learning with right-hand since it caused a further decrease in the difference between the desired force and the exerted force. In contrast, the learning with left-hand was not enhanced by verbal feedback. These results suggest that kinaesthetic feedback information from the hand plays an effective role in learning to produce predicted grip strengths without visual and verbal information.     

Wrist splint effects on muscle activity and force during a handgrip task

Wrist splints are commonly prescribed to limit wrist motion and provide support at night and during inactive periods but are often used in the workplace. In theory, splinting the wrist should reduce wrist extensor muscle activity by stabilizing the joint and reducing the need for co-contraction to maintain posture. Ten healthy volunteers underwent a series of 24 10-s gripping trials with surface electromyography on 6 forearm muscles. Trials were randomized between splinted and nonsplinted conditions with three wrist postures (30 degrees flexion, neutral, and 30 degrees extension) and four grip efforts. Custom-made Plexiglas splints were taped to the dorsum of the hand and wrist. It was found that when simply holding the dynamometer, use of a splint led to a small (<1% MVE) but significant reduction in activity for all flexor muscles and extensor carpi radialis (all activity <4% maximum). At maximal grip, extensor muscle activity was significantly increased with the splints by 7.9-23.9% MVE. These data indicate that splinting at low-to-moderate grip forces may act to support the wrist against external loading, but appears counterproductive when exerting maximal forces. Wrist bracing should be limited to periods of no to light activity and avoided during tasks that require heavy efforts.     

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

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

The effect of handgrip position on upper extremity neuromuscular responses to arm cranking exercise.

The purpose of this study was to determine if handgrip position during arm cranking exercise influences the neuromuscular activity of muscles biceps brachii (BB), lateral head of triceps brachii (TB), middle deltoid (DT), infraspinatus (IS) and brachioradialis (BR). Fifteen participants cranked an arm ergometer using three different handgrip positions (supinated, pronated, and neutral). Electromyographic (EMG) data were recorded from the aforementioned muscles, and relative duration of EMG activation and amplitude were quantified for the first and second 180 degrees of crank angle. EMG measures were analyzed with MANOVA and follow-up univariate procedures; alpha was set at 0.01. The relative durations of EMG activation did not differ between handgrip positions. Muscle IS exhibited 36% less amplitude in the supinated versus neutral handgrip position (second half-cycle), and muscle BR displayed 63% greater amplitude across cycles in the neutral versus supinated and pronated handgrip positions. The greater BR activity displayed in the neutral handgrip position may reflect its anatomical advantage as an elbow flexor when the forearm is in neutral position. Muscle IS exhibited less activity in the supinated position and may be clinically relevant if it allows arm cranking to occur without subsequent shoulder pain, which is often the aim of shoulder rehabilitation.     

Influence of puberty on muscle development at the forearm

Despite its fundamental importance for physical development, the growth of the muscle system has received relatively little consideration. In this study, we analyzed the relationship between cross-sectional area (CSA) of forearm muscles and maximal isometric grip force with age and pubertal stage. The study population comprised 366 children, adolescents, and young adults from 6 to 23 yr of age (185 female) and 107 adults (88 female) aged 29 to 40 yr. By use of peripheral quantitative computed tomography, muscle CSA was determined at the site of the forearm, whose distance to the ulnar styloid process corresponded to 65% of forearm length. Both muscle CSA and grip force were higher in prepubertal boys than in girls. The gender differences decreased until pubertal stage 3 and reincreased thereafter. In girls at pubertal stage 5, muscle CSA no longer increased with age (P > 0.4), whereas there was still some age-related increase in grip force (P = 0.02). In boys at pubertal stage 5, both muscle CSA and grip force continued to increase significantly with age (P < 0.005 each). Specific grip force (grip force per muscle CSA) adjusted for forearm length increased by almost one-half between 6 and 20 yr of age, with no difference between the genders. In conclusion, forearm muscle growth takes a gender-specific course during puberty, indicating that it is influenced by hormonal changes. However, the increase in specific grip force is similar in both genders and thus appears to be independent of sex hormones.     

A single-spring model predicts the majority of variance in impact force during a fall onto the outstretched hand

The objective of this study was to validate a single-spring model in predicting measured impact forces during an outstretched arm falling scenario. Using an integrated force plate, impact forces were assessed from 10 young adults (5 males; 5 females), falling from planted knees onto outstretched arms, from a random order of drop heights: 3, 5, 7, 10, 15, 20, and 25 cm. A single-spring model incorporating body mass, drop height plus the estimated linear stiffness of the upper extremity (hand, wrist and arm) was used to predict impact force on the hand. We used an analysis of variance linearity test to test the validity of using a linear stiffness coefficient in the model. We used linear regression to assess variance (R²) in experimental impact force predicted by the single-spring model. We derived optimum linear stiffness coefficients for male, female and sex-combined. Our results indicated that the association between experimental and predicted impact forces was linear (P < 0.05). Explain variance in experimental impact force was R² = 0.82 for sex-combined, R² = 0.88 for males and R² = 0.84 for females. Optimum stiffness coefficients were 7436 N/m for sex-combined, 8989 N/m for males and 4527 N/m for females. In conclusion, a linear spring coefficient used in the single-spring model proved valid for predicting impact forces from fall heights up to 25 cm. Results also suggest the use of sex-specific spring coefficients when estimating impact force using the single-spring model. This model may improve impact force to bone strength ratios (factor-of-risk) and prediction of forearm and wrist fracture.     

A systematic method to quantify the presence of cross-talk in stimulus-evoked EMG responses: implications for TMS studies

Surface electromyography (EMG) responses to noninvasive nerve and brain stimulation are routinely used to provide insight into neural function in humans. However, this could lead to erroneous conclusions if evoked EMG responses contain significant contributions from neighboring muscles (i.e., due to "cross-talk"). We addressed this issue with a simple nerve stimulation method to provide quantitative information regarding the size of EMG cross-talk between muscles of the forearm and hand. Peak to peak amplitude of EMG responses to electrical stimulation of the radial, median, and ulnar nerves (i.e., M-waves) were plotted against stimulation intensity for four wrist muscles and two hand muscles (n = 12). Since electrical stimulation can selectively activate specific groups of muscles, the method can differentiate between evoked EMG arising from target muscles and EMG cross-talk arising from nontarget muscles. Intramuscular EMG responses to nerve stimulation and root mean square EMG produced during maximal voluntary contractions (MVC) of the wrist were recorded for comparison. Cross-talk was present in evoked surface EMG responses recorded from all nontarget wrist (5.05-39.38% Mmax) and hand muscles (1.50-24.25% Mmax) and to a lesser degree in intramuscular EMG signals (～3.7% Mmax). The degree of cross-talk was comparable for stimulus-evoked responses and voluntary activity recorded during MVC. Since cross-talk can make a considerable contribution to EMG responses in forearm and hand muscles, care is required to avoid misinterpretation of EMG data. The multiple nerve stimulation method described here can be used to quantify the potential contribution of EMG cross-talk in transcranial magnetic stimulation and reflex studies.     

A new methodology to measure load transfer through the forearm using multiple universal force sensors

Previous approaches to measuring forces in the forearm have made the assumption that forces acting in the radius and ulna are uniaxial near the wrist and elbow. To accurately describe forces in the forearm and the forces in the interosseous ligament, we have developed a new methodology to quantitatively determine the 3-D force vectors acting in forearm structures when a compressive load is applied to the hand. A materials testing machine equipped with a six degree-of-freedom universal force–moment sensor (UFS) was employed to apply a uniaxial compressive force to cadaveric forearms gripped at the hand and humerus. Miniature UFSs were implanted into the distal radius and proximal ulna to measure force vectors there. A 3-D digitizing device was used to measure transformations between UFS coordinate systems, utilized for calculating the force vectors in the distal ulna, proximal radius, and the interosseous ligament (IOL). This method was found to be repeatable to within 3 N, and accurate to within 2 N for force magnitudes. Computer models of the forearm, generated from CT scans, were used to visualize the force vectors in 3-D. Application of this methodology to eight forearm specimens showed that the radius carries most of the load at the wrist while force in the IOL relieves load acting in the radius at the mid-forearm. For a 136 N applied hand force, the force in the IOL was 36±21 N. Advantages of this methodology include the determination of 3-D force vectors, especially those in the IOL, as well as computer generated 3-D visualization of results.     

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

Background

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies.

Methods

Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity.

Results

Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001).

Conclusions

Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.     

Strategies used to stabilize the elbow joint challenged by inverted pendulum loading

The stiffness of activated muscles may stabilize a loaded joint by preventing perturbations from causing large displacements and injuring the joint. Here the elbow muscle recruitment patterns were compared with the forearm loaded vertically (a potentially unstable inverted pendulum configuration) and with horizontal loading. Eighteen healthy subjects were studied with the forearm vertical and supinated and the elbow flexed approximately 90 degrees. In the first experiment EMG electrodes recorded activity of biceps, triceps, and brachioradialis muscles for joint torques produced (a) by voluntarily exerting a horizontal force isometrically (b) by voluntarily flexing and extending the elbow while the forearm was loaded vertically with 135N. The relationship between the EMG and the torque generated was quantified by the linear regression slope and zero-torque intercept. In a second experiment a vertical load increasing linearly with time up to 300N was applied.In experiment 1 the EMG-torque relationships for biceps and triceps had an intercept about 10% of maximum voluntary effort greater with the vertical compared to the horizontal force, the inverse was found for Brachioradialis, but the EMG-torque slopes for both agonist and antagonistic muscles were not different. In experiment 2 there were 29 trials with minimal elbow displacement and all the three muscles activated on the order of 11% of maximum activation to stabilize the elbow; 19 trials had small elbow extension and 14 trials small flexion requiring altered muscle forces for equilibrium; 7 trials ended in large unstable displacement or early termination of the test. An analysis indicate that the observed levels of muscle activation would only provide stability if the muscles' short-range stiffness was at the high end of the published range, hence the elbow was marginally stable. The stability analysis also indicated that the small elbow extension increased stability and flexion decreased stability.     

An EMG-CT method using multiple surface electrodes in the forearm

Electromyography computed tomography (EMG-CT) method is proposed for visualizing the individual muscle activities in the human forearm. An EMG conduction model was formulated for reverse-estimation of muscle activities using EMG signals obtained with multi surface electrodes. The optimization process was calculated using sequential quadratic programming by comparing the estimated EMG values from the model with the measured values. The individual muscle activities in the deep region were estimated and used to produce an EMG tomographic image. For validation of the method, isometric contractions of finger muscles were examined for three subjects, applying a flexion load (4.9, 7.4 and 9.8 N) to the proximal interphalangeal joint of the middle finger. EMG signals in the forearm were recorded during the tasks using multiple surface electrodes, which were bound around the subject’s forearm. The EMG-CT method illustrates the distribution of muscle activities within the forearm. The change in amplitude and area of activated muscles can be observed. The normalized muscle activities of all three subjects appear to increase monotonically with increases in the load. Kinesiologically, this method was able to estimate individual muscle activation values and could provide a novel tool for studying hand function and development of an examination for evaluating rehabilitation.     

EMG study of hand muscle recruitment during hard hammer percussion manufacture of Oldowan tools

The activity of 17 hand muscles was monitored by electromyography (EMG) in three subjects during hard hammer percussion manufacture of Oldowan tools. Two of the subjects were archaeologists experienced in the replication of prehistoric stone tools. Simultaneous videotapes recorded grips associated with the muscle activities. The purpose of the study was to identify the muscles most likely to have been strongly and repeatedly recruited by early hominids during stone tool-making. This information is fundamental to the identification of skeletal features that may reliably predict tool-making capabilities in early hominids. The muscles most frequently recruited at high force levels for strong precision pinch grips required to control the hammerstone and core are the intrinsic muscles of the fifth finger and the thumb/index finger regions. A productive search for skeletal evidence of habitual Oldowan tool-making behavior will therefore be in the regions of the hand stressed by these intrinsic muscles and in the joint configurations affecting the relative lengths of their moment arms. Am J Phys Anthropol 105:315–332, 1998. © 1998 Wiley-Liss, Inc.     

Elbow and wrist joint contact forces during occupational pick and place activities

A three-dimensional, mathematical model of the elbow and wrist joints, including 15 muscle units, 3 ligaments and 4 joint forces, has been developed. A new strain gauge transducer has been developed to measure functional grip forces. The device measures radial forces divided into six components and forces of up to 250N per segment can be measured with an accuracy of +/-1%. Ten normal volunteers were asked to complete four tasks representing occupational activities, during which time their grip force was monitored. Together with kinematic information from the six-camera Vicon data, the moment effect of these loads at the joints was calculated. These external moments are assumed to be balanced by the internal moments, generated by the muscles, passive soft tissue and bone contact. The effectiveness of the body's internal structures in generating joint moments was assessed by studying the geometry of a simplified model of the structures, where information about the lines of action and moment arms of muscles, tendons and ligaments is contained. The assumption of equilibrium between these external and internal joint moments allows formulation of a set of equations from which muscle and joint forces can be calculated. A two stage, linear optimisation routine minimising the overall muscle stress and the sum of the joint forces has been used to overcome the force-sharing problem. Humero-ulnar forces of up to 1600N, humero-radial forces of up to 800N and wrist joint forces of up to 2800N were found for moderate level activity. The model was validated by comparison with other studies.