Adaptations to isolated shoulder fatigue during simulated repetitive work. Part I: Fatigue

Upper extremity muscle fatigue is challenging to identify during industrial tasks and places changing demands on the shoulder complex that are not fully understood. The purpose of this investigation was to examine adaptation strategies in response to isolated anterior deltoid muscle fatigue while performing simulated repetitive work. Participants completed two blocks of simulated repetitive work separated by an anterior deltoid fatigue protocol; the first block had 20 work cycles and the post-fatigue block had 60 cycles. Each work cycle was 60 s in duration and included 4 tasks: handle pull, cap rotation, drill press and handle push. Surface EMG of 14 muscles and upper body kinematics were recorded. Immediately following fatigue, glenohumeral flexion strength was reduced, rating of perceived exertion scores increased and signs of muscle fatigue (increased EMG amplitude, decreased EMG frequency) were present in anterior and posterior deltoids, latissimus dorsi and serratus anterior. Along with other kinematic and muscle activity changes, scapular reorientation occurred in all of the simulated tasks and generally served to increase the width of the subacromial space. These findings suggest that immediately following fatigue people adapt by repositioning joints to maintain task performance and may also prioritize maintaining subacromial space width.     

Effects of shoulder muscle fatigue caused by repetitive overhead activities on scapulothoracic and glenohumeral kinematics.

The purpose of this study was to determine the effects of shoulder muscle fatigue on three dimensional scapulothoracic and glenohumeral kinematics. Twenty healthy subjects participated in this study. Three-dimensional scapulothoracic and glenohumeral kinematics were determined from electromagnetic sensors attached to the scapula, humerus, and thorax. Surface electromyographic (EMG) data were collected from the upper and lower trapezius, serratus anterior, anterior and posterior deltoid, and infraspinatus muscles. Median power frequency (MPF) values were derived from the raw EMG data and were used to indicate the degree of local muscle fatigue. Kinematic and EMG measures were collected prior to and immediately following the performance of a shoulder elevation fatigue protocol. Following the performance of the fatigue protocol subjects demonstrated more upward and external rotation of the scapula, more clavicular retraction, and less humeral external rotation during arm elevation. All muscles with the exception of the lower trapezius showed EMG signs of fatigue, the most notable being the infraspinatus and deltoid muscles. In general, greater scapulothoracic motion and less glenohumeral motion was observed following muscle fatigue. Further studies are needed to determine what effects these changes have on the soft tissues and mechanics of the shoulder complex.     

Relation between differences in electromyographic adaptations during static contractions and the muscle function.

This study determines whether changes in the EMG values of two important muscles of the shoulder and neck region, the anterior deltoid and the upper trapezius, are due to changes in torque production or due to fatigue processes during sustained activity. Contractions at 20, 40, 60, 80 and 100% MVC were performed during a flexion of the arm in the sagittal plane at 90 degrees, to examine the relation between torque and EMG. A sustained contraction at 20% MVC was performed to endurance point in the same position. RMS, a new parameter called activity, (ACT), and MPF of the deltoid anterior and the upper trapezius were analysed. The amplitude values correlated highly with increasing torque production, both for the deltoid muscle (range r = 0.95-0.96), and the trapezius muscle (range r = 0.83-0.87), whereas no significant difference was found for MPF. For the endurance task, the decrease in MPF was far more pronounced for the deltoid than for the trapezius, whereas the opposite occurred with RMS (P < or = 0.01). Furthermore, there was no significant difference over time for the ACT values of the deltoid, whereas there were significant increases in ACT for the trapezius (P < or = 0.01). The RMS/ACT ratio correlated highly (r = 0.81) with the MPF. Regression coefficients of these parameters differed significantly for the trapezius muscle but not for the deltoid muscle. Therefore, the RMS/ACT ratio may be extremely important in analysing the fatigue effects during sustained efforts, independent of torque variations, which can influence indicators of fatigue.     

Muscle fatigue does not lead to increased instability of upper extremity repetitive movements

Muscle fatigue alters neuromuscular responses. This may lead to increased sensitivity to perturbations and possibly to subsequent injury risk. We studied the effects of muscle fatigue on movement stability during a repetitive upper extremity task. Twenty healthy young subjects performed a repetitive work task, similar to sawing, synchronized with a metronome before and after performing each of two fatiguing tasks. The first fatigue task (LIFT) primarily fatigued the shoulder flexor muscles, while the second fatigue task (SAW) fatigued all of the muscles of the arm. Subjects performed each task in random order on two different days at least seven days apart. Instantaneous mean EMG frequencies (IMNF) decreased over both fatiguing tasks indicating that subjects did experience significant muscle fatigue. The slopes of the IMNF over time and the decreases in maximum force measurements demonstrated that the LIFT fatigue task successfully fatigued the shoulder flexors to a greater extent than any other muscle. On average, subjects exhibited more locally stable shoulder movements after the LIFT fatigue task (p=0.035). They also exhibited more orbitally stable shoulder (p=0.021) and elbow (p=0.013) movements after the SAW fatigue task. Subjects also had decreased cocontraction at the wrist post-fatigue for both tasks (p=0.001) and at the shoulder (p<0.001) for the LIFT fatigue task. Therefore, increased dynamic stability of these repeated movements cannot be explained by increased muscle cocontraction. Possible alternative mechanisms are discussed.     

Changes in movement variability and task performance during a fatiguing repetitive pointing task

Changes in neuromuscular strategies employed with fatigue during multi-joint movements are still poorly understood. Studies have shown that motor variability of individual joints increases when performing upper limb tasks to fatigue, while movement parameters related to the task goal remain constant. However, how the inter-limb coordination and its variability change during specific movement phases with fatigue is still unclear. The aim of this study was to assess the effects of neck-shoulder fatigue on shoulder and elbow kinematic variabilities, shoulder-elbow coordination and its variability, and endpoint characteristics during different phases of a forward pointing movement. Nineteen healthy young adults continuously performed a repetitive pointing task until fatigue (Borg rating of 8/10). Changes in elbow-shoulder coordination through the movement were assessed using the continuous relative phase and statistical nonparametric mapping methods. At the end of the task, muscle fatigue was evidenced by significant increases in anterior deltoid (+13%) and biceps brachii (+30%) activity. Shoulder horizontal abduction, elbow flexion variability and shoulder-elbow coordination variability were increased with fatigue at different moments of the movement cycle (shoulder: during the first 17% and most of the second half movement, elbow: from 73% to 91%, coordination: almost the whole movement). However, movement timing errors and endpoint spatial variability were mostly preserved, even with fatigue. We showed that increased variability with fatigue is not only observed in the fatigued joint (shoulder), but also in the elbow and shoulder-elbow coordination, and may have a goal of preserving global task performance.     

Upper extremity kinematic and kinetic adaptations during a fatiguing repetitive task

Repetitive low-force contractions are common in the workplace and yet can lead to muscle fatigue and work-related musculoskeletal disorders. The current study aimed to investigate potential motion adaptations during a simulated repetitive light assembly work task designed to fatigue the shoulder region, focusing on changes over time and age-related group differences. Ten younger and ten older participants performed four 20-min task sessions separated by short breaks. Mean and variability of joint angles and scapular elevation, joint net moments for the shoulder, elbow, and wrist were calculated from upper extremity kinematics recorded by a motion tracking system. Results showed that joint angle and joint torque decreased across sessions and across multiple joints and segments. Increased kinematic variability over time was observed in the shoulder joint; however, decreased kinematic variability over time was seen in the more distal part of the upper limb. The changes of motion adaptations were sensitive to the task-break schedule. The results suggested that kinematic and kinetic adaptations occurred to reduce the biomechanical loading on the fatigued shoulder region. In addition, the kinematic and kinetic responses at the elbow and wrist joints also changed, possibly to compensate for the increased variability caused by the shoulder joint while still maintaining task requirements. These motion strategies in responses to muscle fatigue were similar between two age groups although the older group showed more effort in adaptation than the younger in terms of magnitude and affected body parts.     

Muscular load characterization during isometric shoulder abductions with varying force.

This study sought to characterize muscle loading and fatigue during static shoulder abductions with varying force. In a supine posture, participants maintained fixed shoulder abductions against a time-varying external resistance, generated by a dynamometer-spring mechanism. Patterns (cumulative distribution) of the external resistance were varied by selecting different 10th and 90th percentiles of the distribution. Dynamometer angular velocities were also varied, to reflect different rates of cyclic muscle contraction. The degree of local fatigue development was assessed by common measures, including endurance time, strength reduction, and perceived discomfort. Myoelectric (EMG) signals were continuously obtained from the middle deltoid muscle throughout experimental exercise (60min max). Changes in EMG root-mean-square (RMS) and spectral measures (derived from 1-s windows at peaks in the cyclic contractions) were used as manifestations of muscle fatigue. For each minute, the RMS signal was further reduced using two methods, the cumulative probability distribution of EMG (CPDE) and exposure variation analysis (EVA). The former resulted in three percentile values (10th, 50th, and 90th), whereas the latter method resulted in 10 different measures (grouped by EMG activity level and duration). A main finding of the study was the applicability of several common fatigue indicators for these cyclic, repetitive exertions. Overall, the use of CPDE and EVA to characterize task differences and predict muscle fatigue was found to have limited value.     

Sex-specific myoelectric manifestations of localized fatigue during a multi-joint repetitive task

We have previously demonstrated that fatigue at different locations impacts joint angles, angular variability, and coordination variability differently. However, the neuromuscular control aspects underlying these kinematic changes have never been demonstrated. Seventeen young adults (8 males) were recruited. Electromyographic electrodes were placed on: upper trapezius, pectoralis major, anterior and middle deltoid, biceps and triceps brachii, and left and right erector spinae. Subjects performed the repetitive pointing task (RPT) at 1 Hz for 30 s before and after localized fatigue tasks, which consisted of one shoulder, one elbow and one lower back isometric fatiguing protocols until exhaustion in randomized order. Electromyographic amplitude (RMS), variability (SD) and mean power frequency (MnPF) were calculated for each of the pre-fatigue and post-fatigue RPT trials. There were sex × fatigue location interaction effects on upper trapezius RMS (p = 0.038) with males’ values increasing the most after shoulder fatigue. Females’ triceps brachii RMS was greater compared to males after shoulder, elbow, and trunk fatigue (p = 0.003, p = 0.001 and p = 0.007 respectively). There were sex × fatigue location effects on left erector spinae MnPF (p = 0.011) with males and females’ values decreasing the most after trunk fatigue, but more so in males. Results demonstrate that males and females compensate differently during a repetitive pointing task when their elbows, shoulders and trunks are locally fatigued, which could have implications on sex-specific workplace injury risks. See Table 1 for acronyms.     

Assessment of work-related muscle strain by using surface EMG during test contractions interposed between work periods of simulateted mushroom picking

Surface electromyograms(EMG) during test contractions (TCs) were studied to assess the muscle strain in simulated mushroom picking. Additionally, the duration of the TC for the effective assessment was investigated. Nine female subjects performed standardized shoulder abduction and a stooped posture for one minute as TCs. Each experiment consisted of a 60-min rest, three work periods (W1-W3), a 30-min rest, and two work periods (W4 and W5) separated by a 30-min rest period. The duration of each work period was about 20 min. A total of 18 TCs was performed between the work periods and every 10 minutes in the rest periods. EMGs were recorded from the trapezius, infraspinatus, deltoid, and erector spinae muscles. The amplitude of EMG (AEMG) and mean power frequency (MPF) of EMG were calculated. Each TC was divided equally into three parts. Ratings of perceived exertion (RPE) in the neck, shoulder and low-back were reported during TCs. The work increased RPE of all the parts. AEMG and RPE were increased and MPF was decreased by W1, W2 and W3 in the neck and shoulder muscles. MPF of the erector spinae was increased by the work. The results were not affected by the duration of TCs and the parts during the TCs. AEMG and MPF fluctuated before W1 although the changes of RPE were small. Averaging several TCs was recommended to get stable results from TCs. EMG changes and appropriate TC conditions were discussed in relation to the adaptation in fatiguing contractions.     

Effect of arm-shoulder fatigue on carpenters at work

The purpose of the study was to analyse the effect of arm-shoulder fatigue on manual performance. Ten experienced carpenters performed three standardized tasks (nailing, sawing and screwing). Electromyographic activity was recorded from six arm-shoulder muscles and the performances were video-filmed. After 45 min of standardized arm-cranking (arm-shoulder-fatiguing exercise of approximately 70%-80% maximal oxygen consumption), the tasks were repeated. The number of work movements and the time taken for each task were recorded and the quality of the work performed was compared. After the fatiguing exercise, only nailing was perceived as being harder and more mistakes were made during nailing and sawing. Movement performance was not influenced during nailing but was slightly slower during sawing and faster during screwing. However, there were increased mean EMG amplitudes in the upper trapezius and biceps muscles during nailing, in the upper trapezius, anterior deltoid and infraspinatus muscles during sawing and in the anterior deltoid muscle during screwing. Of the muscles studied the upper trapezius and anterior deltoid muscles increased their activity most after the arm-shoulder-fatiguing exercise.     

Assessment of muscle fatigue in low level monotonous task performance during car driving.

Knowledge of the muscle activation and the development of muscle fatigue may provide more inside in the effects of long-term driving in the occurrence of health problems in the neck/shoulder/back area. The basic assumption behind fatigue detection with electromyography (EMG) is an increase in the EMG amplitude and a decrease of the mean frequency (MF). This study aimed at checking this assumption in monotonous task performance with low level activity during car driving. Surface electromyography was captured from left and right trapezius and deltoid muscles, during a repetitive, non-continuous, driving task (gearing and steering) and the active parts were separated from the non-active parts. Muscle stiffness was reported by more than half of the subjects after a 1 h drive. Only for the active parts a significant decrease of the MF was seen. But also the EMG amplitude decreased significantly. Two possible mechanisms are posted in literature for this finding: no extra recruitment of motor units (MU) and potentiation of muscle fibers. Literature also hypothesizes that low-force occupational work engages only a fraction of the MU available for recruitment and that these units are selectively type I muscle fibers (Cinderella fibers). Initiators of this phenomenon are probably the time lag between activations and the stress from driving and vibration exposure.     

Shoulder and elbow muscle activity during fully supported trajectory tracking in neurologically intact older people

An inability to perform tasks involving reaching is a common problem for stroke patients. Knowledge of normal muscle activation patterns during these tasks is essential to the identification of abnormal patterns in post-stroke hemiplegia. Findings will provide insight into changes in muscle activation patterns associated with recovery of upper limb function.In this study with neurologically intact participants the co-ordination of shoulder and elbow muscle activity during two dimensional reaching tasks is explored. Eight participants undertook nine tracking tasks in which trajectory (orientation and length), duration, speed and resistance to movement were varied. The participants’ forearm was supported using a hinged arm-holder, which constrained their hand to move in a two dimensional plane. EMG signals were recorded from triceps, biceps, anterior deltoid, upper, middle and lower trapezius and pectoralis major.A wide variation in muscle activation patterns, in terms of timing and amplitude, was observed between participants performing the same task. EMG amplitude increased significantly with length, duration and resistance of the task for all muscles except anterior deltoid. Co-activation between biceps and triceps was significantly dependent on both task and trajectory orientation. Activation pattern of pectoralis major was dependent on trajectory. Neither trajectory orientation nor task condition affected the activation pattern of anterior deltoid. Normal ranges of timing of muscle activity during the tasks were identified.     

Local state space temporal fluctuations: a methodology to reveal changes during a fatiguing repetitive task

The effect of muscular fatigue on temporal and spectral features of muscle activities and motor performance, i.e., kinematics and kinetics, has been studied. It is of value to quantify fatigue related kinematic changes in biomechanics and sport sciences using simple measurements of joint angles. In this work, a new approach was introduced to extract kinematic changes from 2D phase portraits to study the fatigue adaptation patterns of subjects performing elbow repetitive movement. This new methodology was used to test the effect of load and repetition rate on the temporal changes of an elbow phase portrait during a dynamic iso-inertial fatiguing task. The local flow variation concept, which quantifies the trajectory shifts in the state space, was used to track the kinematic changes of an elbow repetitive fatiguing task in four conditions (two loads and two repetition rates). Temporal kinematic changes due to muscular fatigue were measured as regional curves for various regions of the phase portrait and were also expressed as a single curve to describe the total drift behavior of trajectories due to fatigue. Finally, the effect of load and repetition rate on the complexity of kinematic changes, measured by permutation entropy, was tested using analysis of variance with repeated measure design. Statistical analysis showed that kinematic changes fluctuated more (showed more complexity) under higher loads (p=0.014), but did not differ under high and low repetition rates (p=0.583). Using the proposed method, new features for complexity of kinematic changes could be obtained from phase portraits. The local changes of trajectories in epochs of time reflected the temporal kinematic changes in various regions of the phase portrait, which can be used for qualitative and quantitative assessment of fatigue adaptation of subjects and evaluation of the influence of task conditions (e.g., load and repetition rate) on kinematic changes.     

Shoulder muscle load and muscle fatigue among industrial sewing-machine operators

Physiological responses to physical work were assessed for 29 female industrial sewing-machine operators during an 8-h working day under ordinary working conditions. During sewing-machine work, the average (left and right) static load in the trapezius muscle was 9% of the maximal electromyogram (EMG) amplitude (% EMG_max), while the average mean load was 15% EMG_max, and the average peak load was 23% EMG_max. The static load level was unrelated to the muscle strength of the sewing-machine operators, which for the group as a whole was within the normal range. The load levels remained unchanged during the working day, while changes in the EMG mean power frequency and zero crossing frequency rate occurred, both indicating the development of muscle fatigue in left and right trapezius muscle during the working day. In line with this, the rating of perceived exertion in the shoulder and neck region increased during. the working day. Dividing the group of sewing-machine operators into two groups, those with the highest frequency and those with the lowest frequency of shoulder/neck troubles showed that the former group had significantly lower muscle strength, despite the fact that no differences in the surface EMG during sewing were found between the two groups. It was concluded that industrial sewing-machine work involves a pattern of shoulder muscle activity which induces fatiguing processes in the shoulder and neck regions. Furthermore, since the static shoulder muscle load was independent of muscle strength, factors other than working posture may be of significance for the static shoulder muscle load.     

Scapular orientation following repetitive prone rowing: Implications for potential subacromial impingement mechanisms

While fatigue of the rotator cuff demonstrably causes superior humeral head migration and concomitant risk of impingement, the relationship between specific muscular fatigue, scapular dyskinesis and impingement risk is less clear. The purpose of this study was to examine changes in scapular orientation following a simulated prone rowing fatiguing protocol that targeted the scapula stabilizing muscles while attempting to alleviate rotator cuff muscular demands. Scapular orientation and muscle activity were collected from participants before and immediately after the fatiguing task. This task fatigued both the stabilizing (upper and middle trapezius, and latissimus dorsi) and rotator cuff (supraspinatus, and infraspinatus) muscles. The upper extremity muscle fatigue pattern caused by the protocol did not elicit any significantly changes in three-dimensional scapular position with all post-fatigue changes being ?1° (p = 0.17–0.58). These results indicated that scapular reorientation is likely not the dominant mechanism of fatigue-induced subacromial impingement development. However, the substantial variability present in the kinematics prevents complete exclusion of scapular dyskinesis as a secondary causal mechanism of impingement.     

Yawning: a possible confounding variable in EMG biofeedback studies

An elderly hemiplegic patient participating in an EMG biofeedback training program was observed to produce a synergistic flexion movement of the plegic (determined by functional evaluations) upper limb while yawning. In the course of the training sessions the electrical activity of the anterior deltoid (the target muscle) was recorded during yawning. These peak EMG values were greatly facilitated in comparison with the session mean peak values obtained during an attempted maximum voluntary isometric contraction (shoulder flexion) of the same limb (e.g., Trial 1: 85.00 vs. 4.33 microV). The possibility of yawning as a confounding variable in EMG biofeedback studies is presented and discussed.     

Interfering effects of multitasking on muscle activity in the upper extremity.

Multitasking, where workers are required to perform multiple physical tasks with various levels of cognitive load is common in today's workplace. Simultaneous physical and mental demands are thought to cause task interference and likely increase muscle activity. To test the interfering effects of multitasking, 16 healthy participants performed hand and shoulder exertions with combinations of four grip conditions (no grip, 30% grip with low precision, 30% grip with high precision, and maximal grip) and three shoulder conditions at 90 degrees abduction (maintaining posture, 40% force-controlled moment, 40% posture-controlled moment), with and without the Stroop test while surface EMG was recorded from eight upper extremity muscles. Both 40% MVC shoulder moments increased extrinsic forearm muscle activity by 2-4% MVE (p<0.01). Grip exertion at 30% MVC reduced anterior and middle deltoid activity by 2% MVE (p<0.01). Exerting a constant force against the transducer (force-controlled) required 3-4% MVE greater middle and posterior deltoid activity (p<0.001) compared to supporting an equivalent inertial load at the same shoulder angle (posture-controlled). Performing the mental task (Stroop test) concurrently with either 40% MVC shoulder moments significantly increased trapezius activity by nearly 2% MVE (p<0.05). Interestingly, the Stroop test also reduced all deltoid activity by 1% MVE (p<0.05). The addition of both the Stroop test and force-control shoulder exertion independently reduced maximal grip force by 7% and 10% MVC, respectively. These results suggest that more complex workplace tasks may act to increase muscle load or interfere with task performance. These small but significant findings may play a role in the development of long-term musculoskeletal disorders in the workplace.     

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

The estimation of muscle forces in musculoskeletal shoulder models is still controversial. Two different methods are widely used to solve the indeterminacy of the system: electromyography (EMG)-based methods and stress-based methods. The goal of this work was to evaluate the influence of these two methods on the prediction of muscle forces, glenohumeral load and joint stability after total shoulder arthroplasty. An EMG-based and a stress-based method were implemented into the same musculoskeletal shoulder model. The model replicated the glenohumeral joint after total shoulder arthroplasty. It contained the scapula, the humerus, the joint prosthesis, the rotator cuff muscles supraspinatus, subscapularis and infraspinatus and the middle, anterior and posterior deltoid muscles. A movement of abduction was simulated in the plane of the scapula. The EMG-based method replicated muscular activity of experimentally measured EMG. The stress-based method minimised a cost function based on muscle stresses. We compared muscle forces, joint reaction force, articular contact pressure and translation of the humeral head. The stress-based method predicted a lower force of the rotator cuff muscles. This was partly counter-balanced by a higher force of the middle part of the deltoid muscle. As a consequence, the stress-based method predicted a lower joint load (16% reduced) and a higher superior–inferior translation of the humeral head (increased by 1.2 mm). The EMG-based method has the advantage of replicating the observed cocontraction of stabilising muscles of the rotator cuff. This method is, however, limited to available EMG measurements. The stress-based method has thus an advantage of flexibility, but may overestimate glenohumeral subluxation.     

Spatial dependency of trapezius muscle activity during repetitive shoulder flexion.

The purpose of this study was to explore changes in spatial muscle activation within the three divisions of the trapezius muscle during a dynamic, cyclic task of the upper limb. Surface EMG signals were detected from thirteen healthy subjects from the upper, middle and lower divisions of the trapezius muscle at multiple electrode sites in the cephalad-caudal direction during a repetitive shoulder flexion task. Initial values and rate of change of average rectified value (ARV) and of instantaneous mean power spectral frequency (iMNF) were estimated at 45 degrees , 90 degrees and 120 degrees of shoulder flexion throughout the 5-min task. The location of the electrodes had a significant effect on initial EMG ARV for both the upper and middle division of the trapezius muscle (P<0.05). Both the rate of change and normalized rate of change of ARV were greatest for the most cranial muscle fibers of the upper division (P<0.05). Initial values and rates of change of iMNF were also affected by electrode location for the upper and lower divisions of the trapezius muscle (P<0.05). These results demonstrate that muscle activity and its changes over time depend on position within the three divisions of the trapezius muscle during a dynamic, cyclic task of the upper limb. This suggests non-uniform muscle fiber distribution and/or recruitment. The results also highlight the importance of multiple recording sites when investigating trapezius muscle function in dynamic tasks.     

Normalization of electromyogram in the neck-shoulder region

Linear and curvilinear electromyogram (EMG) normalization methods were compared among ten healthy men during a simulated work cycle demanding attention and static holding of the arm (Solitaire test). Maximal voluntary contractions (MVC) and gradually increasing contractions up to 70% of MVC were used for normalization in different arm postures. The test contractions studied included inward and outward rotations, abduction, shoulder elevation, and flexion in different arm positions. The shoulder load moment was calculated for the flexion tests using a simple two-dimensional model. The effect of arm posture on the EMG versus shoulder load moment relationship was studied on the following muscles: supraspinatus, infraspinatus, trapezius (three parts), deltoid (two parts) and pectoralis major. All muscles participated in the MVC tests performed, and its was not possible to suggest a single recommended test for each muscle. Differences in normalized EMG median values ranging up to 30% of MVC were found between linear and curvilinear normalization methods. Short-term repeatability of normalization based on a contraction with gradually increasing force was good. Arm posture affected the relationships between shoulder load moment and EMG activity of all muscles studied. Arm posture did not, however, have a significant effect on the estimated amplitude probability distribution functions during the simulated work task. Therefore, at least for the tasks studied, the principle of normalizing in the middle position of the range of movement was deemed acceptable.