Influence of test position on neck muscle fatigue in healthy controls

BackgroundIt has been suggested that increased fatigue of neck muscles could be related to neck pain. However, studies on the matter present contradicting results which could be explained by the different test positions used.PurposeThe purpose of this study was to investigate the influence of test position on muscle fatigue of neck flexor and extensor muscles in healthy controls.MethodsTwenty-five women without neck pain sustained neck flexion and neck extension isometric contractions at 25% and 75% of their maximal voluntary contraction (MVC) in two test positions: sitting and supine lying. Using surface electromyography, the change over time of the median frequency of the power spectrum (MDF slope) of the myoelectric signal of the sternocleidomastoid and splenius capitis muscles was measured and compared between both positions.ResultsAt 75% MVC, splenius capitis muscles presented higher fatigue in lying compared to sitting, while sternocleidomastoid demonstrated no difference between positions. No statistically significant effect of test position was found at 25% MVC for both sternocleidomastoid and splenius capitis muscles as they generally did not present myoelectric manifestations of fatigue.ConclusionThese results underline the need to standardise the test position when investigating neck muscle fatigue, especially for neck extensors at high loads.     

Similarities and Differences of the Soleus and Gastrocnemius H-reflexes during Varied Body Postures, Foot Positions, and Muscle Function: Multifactor Designs for Repeated Measures

Background  

Although the soleus (Sol), medial gastrocnemius (MG), and lateral gastrocnemius (LG) muscles differ in function, composition, and innervations, it is a common practice is to investigate them as single H-reflex recording. The purpose of this study was to compare H-reflex recordings between these three sections of the triceps surae muscle group of healthy participants while lying and standing during three different ankle positions.     

On the edema-preventing effect of the calf muscle pump

During motionless standing an increased hydrostatic pressure leads to increased transcapillary fluid filtration into the interstitial space of the tissues of the lower extremities. The resulting changes in calf volume were measured using a mercury-in-silastic strain gauge. Following a change in body posture from lying to standing or sitting a two-stage change in calf volume was observed. A fast initial filling of the capacitance vessels was followed by a slow but continuous increase in calf volume during motionless standing and sitting with the legs dependent passively. The mean rates of this slow increase were about 0.17%.min-1 during standing and 0.12%.min-1 during sitting, respectively. During cycle ergometer exercise the plethysmographic recordings were highly influenced by movement artifacts. These artifacts, however, were removed from the recordings by low-pass filtering. As a result the slow volume changes, i.e. changes of the extravascular fluid were selected from the recorded signal. Contrary to the increases during standing and sitting the calf volumes of all 30 subjects decreased during cycle ergometer exercise. The mean decrease during 18 min of cycling (2-20 min) was -1.6% at 50 W work load and -1.9% at 100 W, respectively. This difference was statistically significant (p less than or equal to 0.01). The factors which may counteract the development of an interstitial edema, even during quiet standing and sitting, are discussed in detail. During cycling, however, three factors are most likely to contribute to the observed reduction in calf volume: (1) The decrease in venous pressure, which in turn reduces the effective filtration pressure.(ABSTRACT TRUNCATED AT 250 WORDS)     

Renal sympathetic nerve activity and arterial pressure responses to changes in postural position of conscious dogs

Experiments were conducted in conscious dogs to determine the relationships between postural position, arterial pressure, and renal sympathetic nerve activity. Observations of the changes in arterial pressure and renal nerve activity were made when animals spontaneously changed postural position from lying to sitting, sitting to standing, standing to sitting, and sitting to lying. Rising to sit from lying down increased arterial pressure from 109 +/- 5 to 125 +/- 3 mm Hg and increased renal nerve activity by 96 +/- 58 microV/sec (61% of control). Movement from the sitting to standing position decreased renal nerve activity by 90 +/- 39 microV/sec (48% of control) without changing mean arterial pressure. Sitting down from standing also did not change arterial pressure, whereas renal nerve activity increased by 56 +/- 17 microV/sec (33% of control). Returning to the lying position (from sitting) decreased arterial pressure, and this hypotension was associated with significant reductions in renal nerve activity. These results indicate that nonuniform changes in sympathetic outflow from the central nervous system must occur to various vascular beds during changes in postural position of conscious dogs. Thus, renal sympathetic outflow may or may not reflect changes in nerve traffic which contribute to alterations in arterial pressure.     

Influence of high ambient temperatures on the physiological responses and body sway in healthy young adults after quickly standing

This study was aimed to compare the variations in cerebral oxygenation, blood pressure and center-of-foot pressure after standing from sitting and supine positions at normal (22 degrees C) and high (32 degrees C) room temperatures. Thirty young adults stood up from a resting posture (sitting or supine position) and kept the static standing posture for 90 sec. Meanwhile, their center-of-foot pressure (COP), blood pressure, and cerebral oxygenation kinetics were measured in continuity. The change of the frequency domain low-to-high frequency (LF/HF) ratio of the R-R interval before and after standing from a supine position was significantly higher than that from a sitting position under both temperature conditions. Blood pressure as well as total and oxygenated hemoglobin levels decreased immediately after standing up and the ratio of blood pressure change when moving from a supine position to standing at high room temperature was the largest as compared with the other conditions. Total hemoglobin (Hb) volume was found to temporarily decrease after standing and required 22-24 sec to recover when the subject started from the sitting position and 33-36 sec when the subject started from the supine position. Cerebral oxygenation kinetics tended to be larger under high, rather than normal, temperature conditions. All COP parameters after standing were significantly larger in the high temperature condition than in the normal temperature condition. Body sway after standing was larger in the high temperature condition than in the normal temperature condition and after standing from a supine position than from a sitting position. In conclusion, cerebral oxygenation kinetics and blood pressure measured after the subject moved to the standing position changed dramatically under high temperature conditions, and variations in this parameter may influence body sway.     

Evaluation of limb compartments with increased interstitial pressure. An improved noninvasive method for determining quantitative hardness

The purpose of this project was to study a noninvasive method of evaluating limbs at risk of compartment syndrome. Untreated limb compartment syndrome may lead to irreversible dysfunction, chronic pain and contracture. An improved means of obtaining quantitative hardness measurements is reported. The handheld noninvasive compartment syndrome evaluator (NCSE) device formulates a quantitative hardness curve of force verse depth of indentation by applying a 5.0 mm diameter indenter to a limb muscle compartment. Eighteen volunteers (9 men, 9 women) had elevated intracompartmental interstitial pressures by application of custom-made tourniquets. Comparison of interstitial pressure to quantitative hardness measurements in 71 compartments tested showed a statistically significant strong linear relationship with an average Pearson correlation coefficient of .84 (range .78-.9 P<.0001). In addition, for all compartments tested, the mean hardness value for the group with interstitial pressure greater than 50 mmHg (considered compartment syndrome) was close to 2x greater and was statistically different than the mean hardness for the group with interstitial pressure less than 30 mmHg (no compartment syndrome, t-test: P<.0001). This study utilizes a device that has improved upon previous quantitative hardness measurement techniques. In addition, by utilizing a tourniquet model to create elevated interstitial intracompartmental pressure in volunteers, data collection was easier and faster. In the future, quantitative hardness measurements may accurately predict interstitial intracompartmental pressure for most patients. This technique may greatly enhance the medical community's ability to diagnose compartment syndrome with a noninvasive means.     

Calf blood flow and posture: Doppler ultrasound measurements during and after exercise.

To investigate the joint effects of body posture and calf muscle pump, the calf blood flow of eight healthy volunteers was measured with pulsed Doppler equipment during and after 3 min of rhythmic exercise on a calf ergometer in the supine, sitting, and standing postures. Muscle contractions seriously impeded calf blood flow. Consequently, blood flow occurred mainly between contractions and reached a plateau that lasted at least the final 100 s of each exercise series. After exercise the blood flow decreased much faster in the sitting and standing postures than in the supine posture. There was no difference in blood flow between various postures during the same submaximal exercise. However, subjects in the standing posture were able to perform exercise with a higher load than in the supine posture, and blood flow in the standing posture could become twice as high as in the supine posture. We conclude that calf blood flow is regulated according to needs; available perfusion pressure determined maximal blood flow and exercise; and compared with the supine posture, the standing posture and calf muscle pump increase the perfusion pressure.     

Acute hand compartment syndromes after closed crush: a reappraisal

Severe crush to the hand is associated with a poor prognosis. The authors investigated the hypothesis that compartment syndrome complicates such injuries. From 1996 to 2000, the authors retrospectively identified 11 patients who, after sustaining a closed crush injury, developed acute hand compartment syndrome. Diagnosis was made on clinical grounds in two patients (the intracompartmental pressure was not measured) and after clinical examination plus measurement of intracompartmental pressure in nine patients. In all cases, the muscle burst out once the fascia was released from the affected compartment. Clinical clues to elicit the diagnoses were massive hand swelling and tenseness to palpation. Classic symptoms, such as excruciating pain, were absent or their intensity was attributed to the trauma event (in six patients). Classic signs such as intrinsic muscle minus position and pain on stretching were absent in six and three patients, respectively. In addition, the latter stretch test could not be properly judged in five more patients because of interference by the associated injuries. None of the patients developed contracture or sequela that could be attributed to compartment syndrome. On the basis of this experience, it was concluded that crush injury does not in itself carry a poor functional prognosis, provided that attention is paid to the often-concomitant compartment syndrome. Elevated subfascial pressure may be present despite the absence of classic signs and symptoms.     

Effects of room temperature and body position change on cerebral blood volume and center-of-foot pressure in healthy young adults

This study aimed to examine the effects of room temperature and body position changes on cerebral blood volume, blood pressure and center-of-foot pressure (COP). Cerebral oxygenation kinetics and blood pressure were measured by near infrared spectroscopy (NIRS) and volume-compensation, respectively, in 9 males and 9 females after rapid standing from sitting and supine positions in low (12 degrees C) or normal (22 degrees C) room temperatures. COP was also measured in a static standing posture for 90 s after rapid standing. The total hemoglobin (Hb) decreased just after standing. Blood pressure after standing at normal temperature tended to decrease immediately but at low temperature tended to decrease slightly and then to increase greatly. The decreasing ratio of total Hb and blood pressure upon standing from a supine position at normal room temperatures was the largest of any condition. Total Hb recovered to a fixed level approximately 25 sec after standing from a sitting position and approximately 35 sec after standing from a supine position. All COP parameters after standing tended to change markedly in the supine position compared to the sitting position, especially at normal temperatures. The COP parameters after standing in any condition were not significantly related to the decreasing ratio of total Hb but were related to the recovery time of total Hb after standing. In conclusion, decreasing ratios of total Hb and blood pressure after standing from a supine position at normal temperatures were large and may affect body sway.     

Effect of body and foot positions on the somatosensory evoked potentials

Somatosensory evoked potentials in response to stimulation of the posterior tibial nerve at the ankle were recorded during sitting and standing with variable foot positions. During standing a decrease in the amplitude of the early positive component was observed. The deviation of the foot from a horizontal position was associated with an increase in the amplitude of the early negative component. The combined influence of body and foot positions showed a decrease in the amplitude of both early and late components. The standing position induced changes in more components than the varied foot positions. This suggests that maintenance of the standing posture is a more complex task than the maintenance of the foot position itself.     

Estimation of passive ankle joint moment during standing and walking

This study estimated the passive ankle joint moment during standing and walking initiation and its contribution to total ankle joint moment during that time. The decrement of passive joint moment due to muscle fascicle shortening upon contraction was taken into account. Muscle fascicle length in the medial gastrocnemius, which was assumed to represent muscle fascicle length in plantarflexors, was measured using ultrasonography during standing, walking initiation, and cyclical slow passive ankle joint motion. Total ankle joint moment during standing and walking initiation was calculated from ground reaction forces and joint kinematics. Passive ankle joint moment during the cyclical ankle joint motion was measured via a dynamometer. Passive ankle joint moment during standing and at the time (Tp) when the MG muscle-tendon complex length was longest in the stance phase during walking initiation were 2.3 and 5.4 Nm, respectively. The muscle fascicle shortened by 2.9 mm during standing compared with the length at rest, which decreased the contribution of passive joint moment from 19.9% to 17.4%. The muscle fascicle shortened by 4.3 mm at Tp compared with the length at rest, which decreased the contribution of passive joint moment from 8.0% to 5.8%. These findings suggest that (a) passive ankle joint moment plays an important role during standing and walking initiation even in view of the decrement of passive joint moment due to muscle fascicle shortening upon muscle contraction, and (b) muscle fascicle shortening upon muscle contraction must be taken into account when estimating passive joint moment during movements.     

A Multidisciplinary Approach to Assess the Welfare of Weaned Pigs During Transport at Three Space Allowances

Transport can be a stressful experience for pigs, especially in pigs simultaneously experiencing weaning stress. The objective of this study was to use a multidisciplinary approach to assess the welfare of weaned pigs during transport at 3 space allowances. A commercial semitrailer, fitted with compartments, provided 0.05, 0.06, and 0.07 m²/pig. The study recorded frequency of standing, lying, sitting, and standing-rearing on another pig during the entire duration of transport. Blood samples, body weights, and lesion scores were collected from a subset of pigs (n = 48 per space allowance) in each experimental compartment. Transport time for the pigs was 148.0 ± 10.0 min to the wean-to-finishing site. Total white blood cell counts, cortisol, and several blood chemistry values increased (p < .05) after transport regardless of space allowance. Glucose and body weight decreased (p < .05) after transport regardless of space allowance. Space allowance influenced stand-rearing, sitting, standing, and lying behaviors in pigs. Combining behavioral and physiological measures of stress provides a robust picture of piglet welfare during transport at different space allowances.     

Human diaphragmatic EMG: changes with lung volume and posture during supramaximal phrenic stimulation

If esophageal and chest wall recordings of diaphragmatic electromyographic activity (EMG) accurately reflect neural drive to this muscle, then compound muscle action potentials (CMAPs) produced by supramaximal stimulation of the phrenic nerve should not alter with changes in diaphragmatic position. Maximal CMAPs were therefore recorded 1) during changes in lung volume from near residual volume to near total lung capacity, 2) during isovolume maneuvers at different lung volumes, and 3) while subjects were lying, sitting, and standing. The areas of maximal CMAPs recorded with the gastroesophageal catheter increased 5.1 +/- 3.6 times (mean +/- SD) between these volumes, increased 2.4 +/- 1.3 times as the diaphragm descended during an isovolume maneuver (at functional residual capacity), and increased 4.4 +/- 2.4 times between the lying and standing positions. Because the stimuli were supramaximal, these changes in EMG reflect changes in the relationship between the esophageal electrodes and the diaphragmatic muscle fibers. Artifactual changes were also documented for surface electrodes on the chest wall. Because of these positional changes in maximal CMAPs, previous studies, which used integrated diaphragmatic EMG to document "reflex" changes in neural drive, should be reevaluated.     

The effect of posture on respiratory activity of the abdominal muscles

The purpose of this study was to determine the influence of posture on the expiratory activity of the abdominal muscles. Fifteen young adult men participated in the study. Activities of the external oblique abdominis, internal oblique abdominis, and rectus abdominis muscles were measured electromyographically in various postures. We used a pressure threshold in order to activate the abdominal muscles as these muscles are silent at rest. A spirometer was used to measure the lung volume in various postures. Subjects were placed in the supine, standing, sitting, and sitting-with-elbow-on-the-knee (SEK) positions. Electromyographic activity and mouth pressure were measured during spontaneous breathing and maximal voluntary ventilation under the respiratory load. We observed that the lung volume changed with posture; however, the breathing pattern under respiratory load did not change. During maximal voluntary ventilation, internal oblique abdominis muscle expiratory activity was lower in the SEK position than in any other position, external oblique abdominis muscle inspiratory activity was lower in the supine position than in any other position, and internal oblique abdominis muscle activity was higher in the standing position than in any other position. During spontaneous breathing, external oblique abdominis muscle activity was higher during expiration and inspiration in the SEK position than in any other position. The internal oblique abdominis muscle activity was higher during both inspiration and expiration in the standing position than in any other position. The rectus abdominis muscle activity did not change with changes in posture during both inspiration and expiration. Increase in the external oblique abdominis activity in the SEK position was due to anatomical muscle arrangement that was consistent with the direction of lower rib movement. On the other hand, increase in the internal oblique abdominis activity in the standing position was due to stretching of the abdominal wall by the viscera. We concluded that differences in activity were due to differences in the anatomy of the abdominal muscles and the influence of gravity.     

The influence of pauses on the fatigue of upper limb muscles during the task of ironing

The aim of this study was to analyze the influence of position and pauses on muscle activity and fatigue during the task of ironing. Ten female participants performed the task of ironing in two different positions (standing and sitting) for 10?min each with a 1-min pause at the end of each task. Muscle activity and fatigue from the upper trapezium, anterior deltoid, and pectoralis major were analyzed using surface electromyography. The results showed that the positions had no significant influence on muscle activity; nevertheless, they had significant influence on muscular fatigue. In addition, the pauses were possibly beneficial in decreasing the muscle fatigue, but the results were not conclusive.     

Slow volume changes in calf and thigh during cycle ergometer exercise

To study the transcapillary fluid movements in the human lower limb in the upright body position and during muscle exercise, the slow changes in thigh and calf volumes were measured by mercury-in-rubber-strain gauge plethysmography. Measurements were carried out on 20 healthy volunteers while sitting, standing and doing cycle ergometer exercise at intensities of 50 and 100-W. A plethysmographic recording of slow extravascular volume changes during muscle exercise was possible because movement artefacts were eliminated by low-pass filtering. While standing and sitting the volumes of both thigh and calf increased due to enhanced transcapillary filtration. While standing the mean rate of increase was 0.13%.min-1 in the calf and 0.09%.min-1 in the thigh. During cycle ergometer exercise at 50 and 100 W, the calf volume decreased with a mean rate of -0.09.min-1. In contrast, the thigh volume did not change significantly during exercise at 50 W and increased at 100 W. Most of the increase occurred during the first half of the experimental period i.e. between min 2 and 12, amounting to +0.6%. Thus, simultaneous measurements revealed opposite changes in the thigh and calf. This demonstrates that the conflicting findings reported in the literature may have occurred because opposite changes can occur in different muscle groups of the working limb at the same time. Lowered venous pressure, increased lymph flow and increased tissue pressure in the contracting muscle are considered to have caused the reduction in calf volume during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oxygen uptake/heart rate relationship in leg and arm exercise, sitting and standing.

The effect of leg exercise and of arm exercise in sitting and standing body positions on energy output and on some cardiorespiratory parameters was studied in seven male subjects. Oxygen uptake (VO2), heart rate (fH), pulmonary ventilation (VE) and respiratory frequency were measured at rest, in the 7-8th min of submaximal work (300, 600, 900 kpm/min), and at maximal effort. Significantly higher Vo2, fH, and VE in arm cranking than in cycling were found at submaximal work loads above 300 kpm/min. Though the maximal work load in arm exercise was 50-60% of that in cycling, Vo2 in arm work was at maximal effort only 22% lower than in leg exercise while the difference in fH was insignificant. No differences were found in arm work between the results obtained at any work level in sitting and standing body positions. The only postural difference in arm work was a 13% higher work load achieved at maximal effort when standing than when sitting. Differences in fH between arm and leg exercise were much smaller for the same Vo2 than for the same work load and were time dependent. While fH quickly leveled off in leg exercise, fH in arm cranking rose steadily during the first 6 min of work which created the fH differences observed in the 7-8 min of submaximal arm arm and leg exercise. At submaximal work levels a tendency to synchronize the respiratory frequency with the frequency of the rotatory movements was more apparent in arm cranking than in cycling.     

The erect posture as an aid to the circulation in the feet in the presence of arterial obstruction

When the main artery in the lower limb is occluded and narrow collateral vessels by-passing the obstruction offer the limiting resistance to blood flow, the increase in arterial pressure at the ankle on assuming the erect posture is greater than would be predicted by consideration of the hydrostatic factors. In seven patients with femoral artery occlusion the pressure at the ankle was greater than expected in all and on the average by 8.0 mm. Hg±1.5 S.E. when sitting, (P<0.01) and in the four patients tested, by 12.4 mm. Hg±0.5 S.E. when standing (P<0.01). Rate of blood flow in subdermal tissue of the forefoot estimated by xenon-133 clearance was an average of 21% less when sitting than when supine in five limbs of four normal subjects while in five limbs with occlusion or severe stenosis of the superficial femoral artery the rate of flow was an average of 44% greater.     

Accelerometer-based body-position sensing for ambulatory electrocardiographic monitoring

Our objective is to validate the ability of 3 appropriately placed accelerometers to determine body position during ambulatory electrocardiographic (ECG) monitoring and to demonstrate the clinical applicability of this method. During ambulatory (Holter) monitoring, the ability to know a patient's position (lying down, sitting, standing, or changing from one position to another) is important in the evaluation of common symptoms such as dizziness, palpitations, and syncope. Changes in body position are also known to alter the electrical axis of the heart, resulting in artifactual changes in QRS amplitude and ST-segment morphology. We have developed an ambulatory patient-monitoring instrument that, through the use of microfabricated accelerometers, can simultaneously record body-position information and 2 channels of ECG data. The accelerometers measure the effects of gravity and dynamic acceleration, allowing determination of a patient's orientation and movements. The accelerometer and ECG signals are input to a portable recorder and are filtered and digitized. Algorithms were developed to automatically determine body position. Ten healthy volunteers wore the device for 1 hour and followed a protocol of standing, sitting, walking, lying supine, and lying in the left and right lateral decubitus positions. An observer manually recorded times of position changes. Data were recorded and analyzed using software designed with MATLAB. The ability of the accelerometers and computer algorithms to determine body position was analyzed in terms of the sensitivity and specificity for each body position. The sensitivities for sitting, standing, walking, lying supine, lying right, and lying left were 98.8%, 99.2%, 95.5%, 99.1%, 98.9%, and 94.8%, respectively. The specificities were 99.7%, 99.4%, 99.6%, 99.0%, 99.8%, and 99.9%, respectively. The use of microfabricated accelerometers is a clinically feasible method to determine body position and can be applied to future studies correlating body position with ECG or other physiologic data.     

Relation between the ankle joint angle and the maximum isometric force of the toe flexor muscles

The purpose of this study was to investigate the relationships between the ankle joint angle and maximum isometric force of the toe flexor muscles. Toe flexor strength and electromyography activity of the foot muscles were measured in 12 healthy men at 6 different ankle joint angles with the knee joint at 90 deg in the sitting position. To measure the maximum isometric force of the toe flexor muscles, subjects exerted maximum force on a toe grip dynamometer while the activity levels of the intrinsic and extrinsic plantar muscles were measured. The relation between ankle joint angle and maximum isometric force of the toe flexor muscles was determined, and the isometric force exhibited a peak when the ankle joint was at 70–90 deg on average. From this optimal neutral position, the isometric force gradually decreased and reached its nadir in the plantar flexion position (i.e., 120 deg). The EMG activity of the abductor hallucis (intrinsic plantar muscle) and peroneus longus (extrinsic plantar muscle) did not differ at any ankle joint angles. The results of this study suggest that the force generation of toe flexor muscles is regulated at the ankle joint and that changes in the length-tension relations of the extrinsic plantar muscle could be a reason for the force-generating capacity at the metatarsophalangeal joint when the ankle joint angle is changed.