Precision of measurements of physical workload during standardised manual handling. Part I: surface electromyography of m. trapezius, m. infraspinatus and the forearm extensors.

Though surface electromyography (EMG) has been widely used in studies of occupational exposure, its precision in terms of the variance between-days and between-subjects has seldom been evaluated. This study aimed at such an evaluation. Six women performed three different work tasks: 'materials picking', 'light assembly', and 'heavy assembly', repeated on 3 different days. EMG was recorded from m. trapezius, m. infraspinatus and the forearm extensors. Normalisation was made to a maximal (MVE), and a submaximal (RVE), reference contraction. Variance components between days (within subjects) and between subjects were derived for the 10th, 50th and 90th percentiles, as well as for muscular rest parameters. For the task 'heavy assembly', the coefficient of variation between days (CV(BD)) was 8% for m. trapezius (right side, 50th percentile, MVE normalised values). Larger variabilities were found for m. infraspinatus (CV(BD) 15%), and the forearm extensors (CV(BD) 33%). Between-subjects variability (CV(BS)) was greater, 16% for m. trapezius and 57% for m. infraspinatus, 29% for the forearm extensors. RVE normalisation resulted in larger CV(BD), while reducing CV(BS). The between-days and between-subjects variability may be used to optimise sampling strategy, and to assess the bias in epidemiological studies. The bias caused by measurement procedures per se is acceptable.     

Methodological variance associated with normalization of occupational upper trapezius EMG using sub-maximal reference contractions

ObjectivesTo quantify the variance introduced to trapezius electromyography (EMG) through normalization by sub-maximal reference voluntary exertions (RVE), and to investigate the effect of increased normalization efforts as compared to other changes in data collection strategy on the precision of occupational EMG estimates.MethodsWomen performed four RVE contractions followed by 30 min of light, cyclic assembly work on each of two days. Work cycle EMG was normalized to each of the RVE trials and seven exposure parameters calculated. The proportions of exposure variance attributable to subject, day within subject, and cycle and normalization trial within day were determined. Using this data, the effect on the precision of the exposure mean of altering the number of subjects, days, cycles and RVEs during data collection was simulated.ResultsFor all exposure parameters a unique component of variance due to normalization was present, yet small: less than 4.4% of the total variance. The resource allocation simulations indicated that marginal improvements in the precision of a group exposure mean would occur above three RVE repeats for EMG collected on one day, or beyond two RVEs for EMG collected on two or more days.     

Continuous, intermitted and sporadic motor unit activity in the trapezius muscle during prolonged computer work.

The Cinderella hypothesis postulates the continuous activity of specific motor units (MUs) during low-level muscle contraction. The MUs may become metabolically overloaded, with the subject developing muscle pain and strain. The hypothesis requires MUs that are active for a time long enough to actually damage muscle fibers. The aim of this study was to determine if there are continuously active MUs in the right trapezius muscle during normal computer work using a computer mouse. Fourteen healthy subjects executed an interactive computer-learning program (ErgoLight) for 30 min. Six-channel intramuscular EMG and two-channel surface EMG signals were recorded from two positions of the trapezius muscle. Decomposition was achieved with automated, multi-channel, long-term decomposition software (EMG-LODEC). In two out of the 14 subjects, three MUs were continuously active throughout the 30 min. Although the majority of the MUs were active during only part of the experimental session, an ordered on-off behavior (e.g. substitution) pattern was not observed. As long-lasting activity was verified in some subjects, the results support the Cinderella hypothesis. However, it cannot be concluded here how long the MUs could stay active. If continuous activity overloads low threshold MUs, the potential exists for selective fibre injuries in low threshold MUs of the trapezius muscle in subjects exposed to long-term computer work.     

Isotonic and isoelectric endurance tests for the upper trapezius muscle

As an alternative to a conventional endurance electromyogram (EMG) test for assessment of muscle capacity in the upper trapezius muscle (isotonic test, IT), an isoelectric test (IE) has been investigated. Nine subjects performed the two endurance tests. The tests were performed with a straight horizontal arm in the plane of the scapula. In IE, EMG amplitude was fed back to the subject and the subject was instructed to maintain a constant EMG activity equal to the level with the arm unsupported. Subjective ratings of local fatigue were obtained during the experiments. The EMG recordings from both tests were analysed for the root mean square value as well as according to the mean power frequency (MPF) technique. All the subjects endured maximal 15 min IE while in IT the median endurance was 11.9 min. Average subjective ratings of perceived fatigue increased more in IT compared to IE. The average normalised MPF curve from IT increased while that from IE was unaffected. There was a significant difference between the MPF results at 6 and 8 min. It is noteworthy that the MPF was higher in IT in spite of a higher accumulated biomechanical load. It was concluded from these studies that the interpretation of decreased MPF as an indicator of increased local muscle fatigue is doubtful at low contraction levels. It is suggested that an IE is a more appropriate method for the functional evaluation of low threshold motor units of the upper trapezius muscle in research into occupational disorders. Accepted: 15 October 1996     

Long-term electromyographic activity in upper trapezius and low back muscles of women with moderate physical activity.

The habitual activity patterns of trapezius and postural back muscles (multifidus, iliocostalis, longissimus) of 23 female subjects with moderate physical activity were studied. Bilateral surface electromyographic (sEMG) recordings from start of work until bedtime were analyzed. The activity level was calibrated as percentage of root mean square-detected muscle activity at maximal voluntary contraction (EMG(max)). Sixty-six previous trapezius recordings of women with moderate physical activity were included in some analyses to pursue the full range of variation in trapezius activity. Twenty-six of these were recorded twice, separated by 16-28 mo. Median activity level and duration of periods with sEMG activity of <0.5% EMG(max) ("rest time"; only trapezius) and exceeding 2 ("burst time"), 10, 30, and 50% EMG(max) was determined. The trapezius median activity level ranged from 0.6 to 8.8% EMG(max), burst time from 9 to 84%, and rest time from 2 to 84%. The activity patterns of the back muscles showed similar large interindividual variation. Repeated trapezius recordings of the same subject showed high consistency; intraclass correlation coefficients ranged from 0.62 to 0.79 for different sEMG variables. Periods with high sEMG amplitude were of short duration; 7% of the trapezius recordings did not present time intervals (0.2-s duration) above 50% EMG(max). The activity patterns of the postural muscles, despite large interindividual variability, were distinctly different from activity patterns of upper and lower limb muscles reported by others (e.g., mean burst time 40-50 vs. 10-20%). We conclude that postural trunk muscles show idiosyncratic activity patterns with large interindividual variation. High-threshold motor units are activated to a very minor extent.     

The effect of sampling frequency on EMG measures of occupational mechanical exposure.

The purpose of the present study was to determine how much it is possible to downsample EMG without loosing the accuracy of some EMG measures of occupational mechanical exposure frequently used in the literature. The EMG signals of four muscles (two trapezius, right deltoid and right extensor digitorum) were collected (sampling frequency: 1024 Hz) from 20 subjects while performing a 20 min computer work task. The EMG RMS amplitude was computed from 0.125 s successive time-windows for the original (1024 Hz) and four additional digitally resampled (at 512, 256, 128 and 64 Hz) EMG signals. Three of the most frequently used data reduction methods (1. gaps analysis, 2. amplitude probability distribution function and 3. exposure variation analysis) were used to summarise the 20 min EMG activation profiles. The results from the exposure variation analysis were summarized into three variables using a new method detailed here. In general, the ANOVA for repeated measures demonstrated that a decrease of the sampling frequency significantly changed the EMG measures (relative to the 1024 Hz sampling condition) most of the time at 64 and 128 Hz, occasionally at 256 Hz, but practically never at 512 Hz. An analysis of the maximal errors (relative to the 1024 Hz condition) across all subjects supported these findings. Consequently, it was concluded that 512 Hz is quite conservative and should practically never lead to invalid EMG parameters estimations. Conversely, 256 Hz represents the lowest limit tolerable for some EMG parameters (gaps analysis, amplitude probability distribution function) while it is unacceptable for others (modified exposure variation analysis).     

Spectral profile of superficial cervical muscles.

The objective of the study was to determine the median frequency (MF) and mean power frequency (MPF) of the stermodeidomastorial, splenius capitis and trapezius in progressively and linearly increasing isometric cervical flexion and extension. There is a dearth of data on spectral parameters of cervical muscles. Such data have been generated from 40 young adult subjects (21 male and 19 female). The subjects were seated upright in an individually adjusted chair and stabilized with a 4-point Velcro restraint system to stabilize the torso. These subjects exerted isometric flexor and extensor forces in a random sequence on an instrumented resistance device (specifically designed for the study) in a gradual and linearly increasing manner with a visual feedback to their maximal voluntary contraction (MVC) within a 5 s period. Surface EMG was sampled from the sternocleidomastoid, the splenius capitis and the trapezius muscles bilaterally at 1 kHz. The EMG signals were subjected to Fast Fourier Transform (FFT) analysis. Spectral profiles of all muscles in the dimensions of frequency, power, and grade of contraction were plotted. The mean median frequency (MF), mean power frequency (MPF), peak power and total power were analyzed. In the sternocleidomastoid, and the splenius the MF increased with the grade of contraction, widening its bandwidth at higher grades. The trapezius maintained a narrow bandwidth and its MF declined with the grade of contraction.     

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.     

Fat adaptation followed by carbohydrate loading compromises high-intensity sprint performance.

The aim of this study was to investigate the effect of a high-fat diet (HFD) followed by 1 day of carbohydrate (CHO) loading on substrate utilization, heart rate variability (HRV), effort perception [rating or perceived exertion (RPE)], muscle recruitment [electromyograph (EMG)], and performance during a 100-km cycling time trial. In this randomized single-blind crossover study, eight well-trained cyclists completed two trials, ingesting either a high-CHO diet (HCD) (68% CHO energy) or an isoenergetic HFD (68% fat energy) for 6 days, followed by 1 day of CHO loading (8-10 g CHO/kg). Subjects completed a 100-km time trial on day 1 and a 1-h cycle at 70% of peak oxygen consumption on days 3, 5, and 7, during which resting HRV and resting and exercising respiratory exchange ratio (RER) were measured. On day 8, subjects completed a 100-km performance time trial, during which blood samples were drawn and EMG was recorded. Ingestion of the HFD reduced RER at rest (P < 0.005) and during exercise (P < 0.01) and increased plasma free fatty acid levels (P < 0.01), indicating increased fat utilization. There was a tendency for the low-frequency power component of HRV to be greater for HFD-CHO (P = 0.056), suggestive of increased sympathetic activation. Overall 100-km time-trial performance was not different between diets; however, 1-km sprint power output after HFD-CHO was lower (P < 0.05) compared with HCD-CHO. Despite a reduced power output with HFD-CHO, RPE, heart rate, and EMG were not different between trials. In conclusion, the HFD-CHO dietary strategy increased fat oxidation, but compromised high intensity sprint performance, possibly by increased sympathetic activation or altered contractile function.     

Upper trapezius muscle activity patterns during repetitive manual material handling and work with with a computer mouse.

Firstly, upper trapezius EMG activity patterns were recorded on the dominant side of 6 industrial production workers and on the side operating a computer mouse of 14 computer-aided design (CAD) operators to study differences in acute muscular response related to the repetitiveness of the exposure. The work tasks were performed with median arm movement frequencies ranging from 5 min(-1) to 13 min(-1) and were characterized by work cycle times ranging from less than 30 sec to several days. However, the static and median EMG levels and EMG gap frequencies were similar for all work tasks indicating that shoulder muscle loads may be unaffected by large variations in arm movement frequencies and work cycle times. An exposure variation analyses (EVA) showed that the EMG activity patterns recorded during production work were more repetitive than during CAD work, whereas CAD work was associated with more static muscle activity patterns, both may be associated with a risk of developing musculoskeletal symptoms. Secondly, upper trapezius EMG activity patterns recorded on the mouse side of the CAD operators were compared with those recorded on the non-mouse side to study differences in muscular responses potentially related to the risk of developing shoulder symptoms which were more prevalent on the mouse side. The number of EMG gaps on the mouse side were significantly lower than the values for the upper trapezius on the non-mouse side indicating that more continuous activity was present in the upper trapezius muscle on the mouse side and EVA analyses showed a more repetitive muscle activity pattern on the mouse side. These findings may be of importance to explain differences in the prevalence of shoulder symptoms.     

Differential activation of parts of the serratus anterior muscle during push-up variations on stable and unstable bases of support

No studies have examined the effects of an unstable surface on push-up and push-up plus exercises in terms of the two parts of the serratus anterior muscle. We hypothesized that the lower part of the serratus anterior would have greater activity with an unstable surface, which requires stabilizing the scapular position. The present study was performed to investigate the intramuscular differences between parts of the serratus anterior muscle during push-up and push-up plus exercises. Twelve healthy subjects were included in the study. The upper and lower parts of the serratus anterior and upper and lower parts of the trapezius were investigated by surface EMG during four types of exercise. Repeated one-way ANOVA was used for statistical analyses. Maintaining the push-up plus phase caused significant increases in EMG activity of the upper serratus anterior compared with the push-up ascending phase on both of stable and unstable bases (P < 0.05). The lower serratus anterior showed increased activation on an unstable surface, which required more joint stability than did the stable base. Upper trapezius/upper serratus anterior ratio was significantly lower in the PUP than in the PUA phase with both stable and unstable bases of support (P < 0.05).Further studies are required to investigate the intramuscular variation in activation of the serratus anterior during exercises for rehabilitation.     

Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: interpretation from voluntary response index.

Altered motor control of the shoulder muscles during performance of a specific motor task in patients with shoulder disorders (SDs) has been an interesting subject to researchers. This study compared shoulder muscle activation patterns by surface electromyography (sEMG), including the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) muscles, during four functional tasks in 25 patients with SDs and controls. A voluntary response index (VRI) was calculated, including magnitude and similarity index (SI), to quantify sEMG patterns during four functional tasks. Responsiveness and clinically meaningful levels of discrimination between patients and control for EMG magnitude and SI were determined. An altered pattern of motor control during four functional tasks was evident in the patients, in which greater EMG amplitude and abnormal EMG patterns were found. For SI among four functional tasks, normal subjects ranged from 0.80 to 1.00 while patients ranged from 0.70 to 0.99. High probabilities (97%) of discrimination between patients and normal subjects were found by SI method during an overhead height task (patients: 0.85-0.96, normal subjects: 0.95-1.00). Our results also suggest that an individual can be estimated to be abnormal when lower SI values are observed during the four functional tasks.     

Generalization of EMG biofeedback training

Five young adults received audio biofeedback training to reduce trapezius EMG levels while they engaged in reading in an office, seated at a table. A multiple-baseline-across subjects design was employed in two separate studies. After training, all subjects demonstrated reduced EMG levels while reading in a home or library setting. The first study suggested that subjects reduced EMG levels by minimizing movements and altering their postures; the second study systematically demonstrated changes in such behavior, which was correlated with EMG levels. The data provide evidence that EMG biofeedback resulted in response generalization across several motoric classes, and in stimulus generalization from the training setting to the natural environment. The importance of assessing generalization is discussed.     

Generalization of EMG biofeedback training

Five young adults received audio biofeedback training to reduce trapezius EMG levels while they engaged in reading in an office, seated at a table. A multiple-baseline-across subjects design was employed in two separate studies. After training, all subjects demonstrated reduced EMG levels while reading in a home or library setting. The first study suggested that subjects reduced EMG levels by minimizing movements and altering their postures; the second study systematically demonstrated changes in such behavior, which was correlated with EMG levels. The data provide evidence that EMG biofeedback resulted in response generalization across several motoric classes, and in stimulus generalization from the training setting to the natural environment. The importance of assessing generalization is discussed.     

Muscle activity and fatigue in the shoulder muscles during repetitive work. An electromyographic study

The amplitude distribution probability function (ADPF) and the power spectrum of the surface electromyogram from m. deltoideus anterior, m. infraspinatus and m. trapezius pars descendens were analyzed from 7 persons working at a pillar drill. Recordings were performed 6 times during a working day. The ADPF was analyzed from 2-3 work-cycles from each recording. The static contraction level was 11.0% MCV in m. deltoideus anterior, 8.5% MVC in m. infraspinatus, and 20.5% MCV in m. trapezius, without any change occuring throughout the day. When compared to previous suggested upper limits of ADPF levels, both the static and the medium contraction levels were too high in the performance of this particular task. The power spectrum of the EMG was analyzed during isometric contractions of the shoulder muscles. The mean power frequency decreased during the day in m. trapezius only, suggesting muscular fatigue in this area.     

Surface EMG amplitude and frequency dependence on exerted force for the upper trapezius muscle: a comparison between right and left sides

Surface electromyographic (EMG) amplitude and mean power frequency (MPF) were used to study the isometric muscular activity of the right versus the left upper trapezius muscles in 14 healthy right-handed women. The EMG activity was recorded simultaneously with force signals during a 10-15 s gradually increasing exertion of force, up to maximal force. Only one side at a time was tested. On both sides there was a significant increase in EMG amplitude (microV) during the gradually increasing force from 0% to 100% maximal voluntary contraction (MVC). The right trapezius muscle showed significantly less steep slopes for regression of EMG amplitude versus force at low force levels (0%-40% MVC) compared intra-individually with high force levels (60%-100% MVC). This was not found for the left trapezius muscle. At 40% MVC a significantly lower MPF value was found for the right trapezius muscle intra-individually compared with the left. An increase in MPF between 5% and 40% MVC was statistically significant when both sides were included in the test. The differences in EMG activity between the two sides at low force levels could be due to more slow-twitch (type I fibres) motor unit activity in the right trapezius muscles. It is suggested that this is related to right-handed activity.     

Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis.

The serratus anterior and trapezius muscles are considered to be the only upward rotators of the scapula and are very important for normal shoulder function. A variety of methods have been used to produce a maximum voluntary isometric contraction (MVIC) of these muscles for normalization of EMG data. The purpose of this study was to quantify the surface EMG activity of the serratus anterior muscle and the upper, middle, and lower parts of the trapezius during 9 manual muscle tests performed with maximum effort in 30 subjects. It was found that no one muscle test produced a MVIC for all individuals. Therefore, to perform normalization within each subject, it is suggested that the 2 or 3 tests identified in this study that produce high levels of EMG activity for each muscle be performed. The scapular protraction muscle test that is often used to normalize data for the serratus anterior muscle produced relatively low levels of EMG activity and was not found to be an optimal test. Muscle tests in which an attempt was made to de-rotate the scapula from an upwardly rotated position produced much higher levels of EMG activity in the serratus anterior muscle.     

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.     

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

An inability to perform tasks involving reaching is a common problem for stroke patients. This paper provides an insight into mechanisms associated with recovery of upper limb function by examining how stroke participants’ upper limb muscle activation patterns differ from those of neurologically intact participants, and how they change in response to an intervention.In this study, five chronic stroke participants undertook nine tracking tasks in which trajectory (orientation and length), speed and resistance to movement were varied. During these tasks, EMG signals were recorded from triceps, biceps, anterior deltoid, upper, middle and lower trapezius and pectoralis major. Data collection was performed in sessions both before, and after, an intervention in which participants performed a similar range of tracking tasks with the addition of responsive electrical stimulation applied to their triceps muscle. The intervention consisted of eighteen one hour treatment sessions, with two participants attending an additional seven sessions. During all sessions, each participant’s arm was supported by a hinged arm-holder which constrained their hand to move in a two dimensional plane.Analysis of the pre intervention EMG data showed that timing and amplitude of peak EMG activity for all stroke participants differed from neurologically intact participants. Analysis of post intervention EMG data revealed that statistically significant changes in these quantities had occurred towards those of neurologically intact participants.     

Myofascial trigger point development from visual and postural stressors during computer work.

The mechanism of musculoskeletal pain underlying low level static exertions, such as those experienced during computer work, is poorly understood. It was hypothesized that static postural and visual stress experienced during computer work might contribute to trigger point development in the trapezius muscles, resulting in myofascial pain. A study was conducted to observe the development of myofascial trigger points while 16 female subjects used a computer under conditions of high and low postural and visual stress. Trigger point development was monitored via expert opinion, subject self-report, and electromyographic activity. Only the high visual stress conditions resulted in greater trigger point sensitivity as reported by subjects and the myofascial specialist. Cyclic trends in median frequency of the EMG signal were assessed for the trapezius muscle. When high visual stress was combined with low postural stress condition there were significantly fewer cycles (1.6 cycles) as compared to the condition of low visual and low postural stress (2.8 cycles), and the condition of high visual and high postural stress (3.5 cycles). These significant differences between conditions were found for the right trapezius but not for the left. The findings suggest that high visual stress may be involved in the development of the myofascial pain response.