Between-day reliability of the trapezius muscle H-reflex and M-wave

Differences in Trapezius Muscle H-Reflex between Asymptomatic Subjects and Symptomatic Shoulder Pain Subjects

In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of both the H reflex and M-wave, as well as the ratio between these two variables, were calculated. The percentage of responses was considered. Overall, M-waves were elicited in most participants, while the H reflex was elicited only in 58-75% or in 42-58% of the asymptomatic and symptomatic participants, respectively. A comparison between groups revealed that the symptomatic group presented a smaller maximum H reflex as a percentage of M-wave from upper trapezius and longer maximal H reflex latency from the lower trapezius (p < 0.05). Subjects with chronic shoulder pain present changes in trapezius H reflex parameters, highlighting the need to consider trapezius neuromuscular control in these individuals' rehabilitation.

Absolute and relative reliability of pain sensitivity and functional outcomes of the affected shoulder among women with pain after breast cancer treatment

OBJECTIVE

Breast cancer survivors (BCS) are often characterized by decreased pressure pain thresholds (PPT), range of motion (ROM) and strength in and around the shoulder affected by the treatment. This intra-rater reliability study was to establish the relative and absolute reliability of PPT's, active ROM and maximal isokinetic muscle strength (MIMS) of the affected shoulder in BCS with persistent pain after treatment.

METHODS

Twenty-one BCS participated in the study. The PPTs of 17 locations and pain intensity were assessed using a pressure algometer and a numeric rating scale. The ROM was measured using a universal goniometer and MIMS was measured using an isokinetic dynamometer. Relative reliability was estimated using intra class correlation coefficient (ICC), and absolute reliability using standard error of measurement (SEM). Minimum detectable change (MDC) was calculated from SEM.

RESULTS

The ICCs for PPTs ranged from 0.88-0.97, with SEM values ranging from 12.0 to 28.2 kPa and MDC ranging from 33.2 to 78.2 kPa. The ICCs for ROM ranged from 0.66-0.97, with SEM values ranging from 3.0 to 7.5° and MDC ranging from 8.4 to 20.8°. Finally, ICCs for MIMS ranged from 0.62-0.92, with SEM values ranging from 0.03 to 0.07 Nm/Kg FFM and MDC ranging from 0.09 to 0.19 Nm/kg FFM.

CONCLUSION

The results of this study indicate that PPTs, ROM and MIMS can be measured reliably on the affected shoulder in BCS with pain after treatment. This offer the possibility of using these measures to assess the effectiveness of interventions in this population.

Prediction of walk-to-run transition using stride frequency: A test-retest reliability study

The transition from walking to running has previously been predicted to occur at a point where the stride frequency starts getting closer to the running attractor than to the walking attractor. The two behavioural attractors were considered to be represented by the freely chosen stride frequencies during unrestricted treadmill walking and running. The aim of the present study was to determine the relative and absolute test-retest reliability of the predicted walk-to-run transition stride frequency. Healthy individuals (n=25) performed walking and running on a treadmill in a day-to-day test-retest design. The two behavioral attractors were determined during walking and running at freely chosen velocities and stride frequencies. Subsequently, the walk-to-run transition stride frequency was predicted using camera recordings and a previously reported equation for prediction. The walk-to-run transition occurred at a velocity of 7.7±0.5kmh^-1 at day 1 as well as at day 2. Besides, the predicted walk-to-run transition stride frequencies were 69.7±3.3 strides min^-1 and 70.5±3.4 strides min^-1 on day 1 and day 2, respectively (p=0.08). A further comparison between the predicted walk-to-run transition stride frequencies at day 1 and day 2 showed an ICC_3,1 of 0.89, which indicated almost perfect relative reliability. The absolute reliability was reflected by a%-value of the standard error of the measurement (SEM%) of 1.6% and a%-value of the smallest real difference (SRD%) of 4.4%. In conclusion, the predicted walk-to-run transition stride frequency can be considered reliable across days.