Estimating maximal EMG amplitude for the trapezius muscle: On the optimization of experimental procedure and electrode placement for improved reliability and increased signal amplitude

Consistency between the ACGIH TLV for hand activity and proposed action levels for wrist velocity and forearm muscular load based on objective measurements: an example from the assembly industry

Objectives. This study aimed to investigate the consistency between results of the American Conference for Governmental Occupational Hygienists (ACGIH) threshold limit value (TLV) for hand activity and proposed action levels of objective measurements in risk assessments of work-related musculoskeletal disorders. Methods. Wrist velocities and forearm muscular load were measured for 11 assemblers during one working day. Simultaneously, each assembler's hand activity level (HAL) during three sub-cycles was rated twice on two separate occasions by two experts, using a HAL scale. Arm/hand exertion was also rated by the assemblers themselves using a Borg scale. In total, 66 sub-cycles were assessed and assigned to three exposure categories: A) below ACGIH action limit (AL) (green); B) between AL and TLV (yellow); and C) above TLV (red). The median wrist velocity and the 90th percentile of forearm muscular load obtained from the objective measurements corresponding to the sub-cycles were calculated and assigned to two exposure categories: A) below or C) above the proposed action level. Results. The agreement between ACGIH TLV for hand activity and the proposed action level for wrist velocity was 87%. Conclusions. The proposed action level for wrist velocity is highly consistent with the TLV. Additional studies are needed to confirm the results.

A comparison of nocturnal upper trapezius muscle activity between chronic neck pain patients with sleep disturbance and healthy participants

BACKGROUND

Sleep disturbances frequently occur in patients with chronic neck pain. In these patients, upper trapezius muscle dysfunction is observed during sleep. This study aimed to evaluate the trapezius muscle activity during sleep among patients with chronic neck pain and sleep disturbances for comparison with healthy subjects.  STUDY DESIGN: Cross-sectional study.

METHODS

Patients with chronic neck pain and healthy subjects participated in the study. Two overnight polysomnography recordings were conducted for each subject. Surface electromyography was utilized to record the nocturnal activity of the right and left upper trapezius muscles throughout the night. The nocturnal upper trapezius activity recording was divided into the following parts: wakefulness, rapid eye movement sleep (REM), and non-rapid eye movement sleep (NREM). The nocturnal activity during NREM sleep was further divided into three parts (stage I NREM sleep, stage II NREM, and stage III NREM. Normalization of EMG signals was performed. The normalized value of nocturnal activity was derived for analysis.

RESULTS

Among 15 patients with chronic neck pain and 15 healthy subjects, statistically significant differences were observed in the nocturnal activity of the upper trapezius. Compared to healthy subjects, the nocturnal activity of the upper trapezius was significantly higher during wakefulness, REM sleep, and NREM II and III sleep in patients with chronic neck pain and sleep disturbances.

CONCLUSION

There was higher nocturnal upper trapezius activity in patients with chronic neck pain compared to healthy controls. The findings suggest a possible pathophysiological mechanism that may relate to chronic neck pain.

TRIAL REGISTRATION

CTRI/2019/09/021028.

Development and Assessment of a Method to Estimate the Value of a Maximum Voluntary Isometric Contraction Electromyogram from Submaximal Electromyographic Data

The electromyographic (EMG) normalization (often to maximum voluntary isometric contraction [MVIC]) is used to control for interparticipant and day-to-day variations. Repeated MVIC exertions may be inadvisable from participants' safety perspective. This study developed a technique to predict the MVIC EMG from submaximal isometric voluntary contraction EMG. On day 1, 10 participants executed moment exertions of 100%, 60%, 40%, and 20% of the maximum (biceps brachii, rectus femoris, neck flexors, and neck extensors) as the EMG data were collected. On day 2, the participants replicated the joint moment values from day 1 (60%, 40%, and 20%) and also performed MVIC exertions. Using the ratios between the MVIC EMGs and submaximal isometric voluntary contraction EMG data values established on day 1, and the day 2 submaximal isometric voluntary contraction EMG data values, the day 2 MVIC EMGs were predicted. The average absolute percentage error between the predicted and actual MVIC EMG values for day 2 were calculated: biceps brachii, 45%; rectus femoris, 27%; right and left neck flexors, 27% and 33%, respectively; and right and left neck extensors, both 29%. There will be a trade-off between the required accuracy of the MVIC EMG and the risk of injury due to exerting actual MVIC. Thus, using the developed predictive technique may depend on the study circumstances.

The effect of two types of maximal voluntary contraction and two electrode positions in field recordings of forearm extensor muscle activity during hotel room cleaning

Purpose. This study aimed to investigate the effects of using hand grip or resisted wrist extension as the reference contraction, and two electrode positions, on field recordings of forearm extensor muscle activity. Materials and methods. Right forearm extensor muscle activity was recorded using two electrode pairs (over the most prominent part (position 2) and proximal to that (position 1)) during one working day in 13 female hotel housekeepers. Each subject performed the two maximal voluntary contractions (MVCs), and the electrical activity obtained during these (maximal voluntary electrical activity (MVE)) was used for normalization. Each set of recordings was analysed twice, once using hand grip as the MVC and once using resisted wrist extension. Results. Resisted wrist extension showed a higher group mean MVE than hand grip. Position 2 had higher correlation between MVE and force during the MVCs. The workload during cleaning was lower when using resisted wrist extension as reference than when using hand grip (24%MVE vs 46%MVE; p = 0.002 at position 2) for the 90th percentile. The workload (99th percentile) was overestimated in two subjects when using hand grip as reference. Conclusions. Problems associated with poorly activated forearm extensors can be overcome by using resisted wrist extension as reference.

Prevalence of musculoskeletal disorders among Indian railway sahayaks

Railway sahayak or also known as coolie is one of the oldest occupations in India. This occupational group is continuously subjected to various musculoskeletal problems due to repetitive load exertion in unnatural postures. The present research aims to examine the prevalence of musculoskeletal disorders (MSDs) among Indian railway sahayaks. A cross-sectional study has been conducted on a sample of 51 male sahayaks. With a modified Nordic questionnaire, data were collected on their demographics, work, and musculoskeletal pain history. Electromyography (EMG) of the upper trapezius muscle of selected 12 healthy sahayaks having no history of neck-shoulder complaints were analyzed under different load lifting and carrying conditions. Additionally, ergonomic risk levels were recorded using Rapid Entire Body Assessment method. The questionnaire revealed that for the past 1 year prevalence, the most affected body regions of railway sahayaks were neck (47%), shoulder (51%), lower back (43%), and knee (47%). The association between age group and MSDs in different body regions were found significant (p = 0.012 for neck, p = 0.017 for shoulder, etc.). Work experience also had a significant relation to the MSDs in different body regions (p = 0.013 for shoulder,p = 0.023 for calf, etc.). Analysis of variance reveals high significance level between EMG values and tasks performed by the sahayaks. In conclusion, railway sahayaks were found to have high rate of MSDs which may be associated with lifting/carrying heavy loads in awkward postures. Ergonomic interventions must be implemented to reduce the risk level on this group of workers.

Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders

BACKGROUND:

Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable.

OBJECTIVE:

To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning.

METHODS:

Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions.

RESULTS:

The group mean EMG amplitudes for resisted wrist extension were 1.2–1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip.

CONCLUSIONS:

The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

Trapezius activity of fibromyalgia patients is enhanced in stressful situations, but is similar to healthy controls in a quiet naturalistic setting: a case-control study

Background

Muscle activity and pain development of fibromyalgia (FM) patients in response to mental stress show inconsistent results, when compared to healthy controls (HCs). A possible reason for the inconsistent results is the large variation in stress exposures in different studies. This study compares muscle responses of FM patients and HCs for different modes and levels of imposed stress, to elucidate features in stress exposures that distinguish stress responses of FM patients from HCs.

Methods

Upper trapezius (clavicular and acromial fibers), deltoid, and biceps surface electromyographic (sEMG) activity was recorded in FM patients (n=26) and HCs (n=25). Heart rate (HR) was recorded and used as indicator of autonomic activation. Tests included inspiratory breath holding (sympathetic activation procedure), mental stress tests (color-word test and backward counting; 28 min), instructed rest prior to stress test (30 min TV watching), and controlled arm movement. sEMG and HR was also recorded during an unrestrained evening stay at a patient hotel. The 5-min period with lowest trapezius muscle activity was determined. Pain (shoulder/neck, low back pain) and perceived tension were scored on VAS scales at the start and the end of the stress test and at bedtime.

Results

Trapezius sEMG responses of FM patients were significantly higher than HCs during sympathetic activation, mental stress, and instructed rest, but similar during arm movement and unrestrained evening activity. HR of FM patients and HCs was similar during mental stress and in the evening, including the 5-min period with lowest trapezius activity. Muscle activity of FM patients during the stress test (with shoulder/neck pain development) and the evening stay (no pain development) was similar.

Conclusions

FM patients show elevated muscle activity (in particular trapezius activity) in situations with imposed stress, including sympathetic activation, and putative anticipatory stress. Muscle activity and HR were similar to HCs in instructed arm movement and in a situation approaching low-stress daily living. Pain development of FM patients during the stress test may be due to activation of several stress-associated physiological systems, and not obviously caused by muscle activity in isolation.

Changes in mechanical load and extensor muscle activity in the cervico-thoracic spine induced by sitting posture modification

The influence of whole body sitting posture on cervico-thoracic posture, mechanical load and extensor muscle activity was examined in 23 asymptomatic adults. Cervical and upper thoracic extensor muscle activity measured in guided slouched and lumbo-pelvic neutral postures was normalised to that measured in a self-selected habitual posture. Head and neck posture and gravitational load moment measurements were obtained in each posture. Sagittal head translation, upper cervical extension and load moment were significantly greater in the slouched posture (p < 0.001). Contrasting patterns of cervical and thoracic extensor activity were observed in the slouched and neutral postures, with cervical extensor activity 40% higher in the slouched posture (p < 0.0001). Thoracic extensor activity was significantly higher in the lumbo-pelvic neutral posture than the habitual posture (p = 0.002). The significant changes in extensor muscle activity with postural modification appear to be induced by the associated change in mechanical load moment of the head. STATEMENT OF RELEVANCE: More neutral sitting postures reduce the demand on the cervical extensor muscles and modify the relative contribution of cervical and thoracic extensors to the control of head and neck posture. Postures that promote these patterns of muscular activity may reduce cervical spine loading and the development of posture-related neck pain.

Muscle activity in professional classical singing: a study on muscles in the shoulder, neck and trunk

This study aimed to examine whether changes in the activity of shoulder and neck muscles have consequences for the activation of primary breathing muscles. It further aimed to compare muscle loading levels of professional and student singers. Four professional opera singers participated in the study. Previous unpublished recordings of 4 to 16 student singers and one opera singer were included to allow comparison of EMG loading levels between student and professional singers. Electromyographic (EMG) recordings of trapezius (TR), sternocleidomastoideus (STM), intercostals (INT), rectus abdominis (RC) and the lateral abdominal muscles (OBL) were performed. EMG biofeedback (BF) was performed on TR and STM to lower the activity in these two muscles and the potential change in EMG activity of INT, RC and OBL were examined. Three singing tasks were performed: aria, sustained tones and extreme tones. Each task was performed three times with variation in volume or pitch. Following the first performance of the singing tasks, the BF session was carried out and muscle activity recorded in a repeat performance of the same tasks. The EMG activity levels of all muscles were compared before and after BF. We found no significant effect of reduced TR/STM activity on the activation of INT, RC and OBL. Professional opera singers activated the TR, INT, RC and OBL muscles to higher levels than the student singers did. Another finding was large inter-subject variation in muscle usage, showing an idiosyncratic composition of the muscle contribution to subglottal pressure.

Examination of EMG normalisation methods for the study of the posterior and posterolateral neck muscles in healthy controls

The purpose of this study was to examine the reliability of normalisation methods used in the study of the posterior and posterolateral neck muscles in a group of healthy controls. Six asymptomatic male subjects performed a total of 12 maximum voluntary isometric contractions (MVIC) and 60%-submaximal isometric contractions (60%-MVIC) against the torque arm of an isokinetic dynamometer whilst surface and intramuscular electromyography (EMG) was recorded unilaterally from representative posterior and posterolateral locations. Reliability was calculated using intra-class correlation coefficient (ICC), relative standard error of measurement (%SEM) and relative coefficient of variation (%CV). Maximal torque output was found to be highly reliable in the directions of extension and right lateral bending when the first of three MVIC contractions was excluded. When averaged across contraction direction, high reliability was found for both surface (MVIC: ICC=0.986, %SEM=7.5, %CV=9.2; 60%-MVIC: ICC=0.975, %SEM=10, %CV=13.7) and intramuscular (MVIC: ICC=0.910, %SEM=20, %CV=19.1; 60%-MVIC: ICC=0.952, %SEM=16.5, %CV=13.5) electrodes. Intramuscular electrodes displayed the least reliability in right lateral bending. The use of visual feedback markedly increased the reliability of 60%-MVIC contractions.

EMG sensor location: Does it influence the ability to detect differences in muscle contraction conditions?

Even though it is well known that electromyography (EMG) characteristics are influenced by electrode placement it is common to use a single pair of sensors per muscle for EMG. This study was designed to determine if the ability to distinguish between contraction conditions was influenced by sensor location. Subjects (n = 10; 27+/-5.3 years; 82+/-13.4 kg; 178+/-7.1 cm) completed six elbow flexor conditions: three isometric contraction intensities (100% maximum effort, 80%, 50%) and three isotonic contraction intensities (heavy weight, 80% and 50% of the weight). Three pairs of electrodes were placed centrally, medially and laterally on the biceps brachii belly in line with the muscle fibers. Isometric contractions were held for 5s, with the middle 3 s analyzed. Isotonic exercises included five repetitions of elbow flexion-extension, with the middle three repetitions analyzed. Average EMG (EMG(AVG)), root mean square EMG (EMG(RMS)) and mean power frequency (MPF) were calculated for each extracted data set. Dependent variables were analyzed using 2 (contraction type) x 3 (intensity) repeated measures ANOVAs per sensor. EMG(AVG) was influenced by the interaction between contraction type and intensity for all sensors (p < 0.05). EMG(RMS) as well as MPF were influenced by the interaction between contraction type and intensity for the lateral and central leads (p < 0.05) but not the medial leads (p > 0.05). Different conclusions could have been reached from the same experiment due to different sensor locations. These differences were primarily related to comparing contraction types (i.e., isotonic vs. isometric).

Cervicobrachial muscle response to cognitive load in a dual-task scenario

People working in an office environment often have to deal with significant cognitive workload due to the coordination of multiple, simultaneous tasks. The objective of this research was to examine the impact of cognitive load in office-type tasks on physical-stress response, using a dual-task paradigm involving a primary cognitive task and secondary typing task. The central hypothesis of this research was that altering the demands of the cognitive task would lead to a difference in physical stress-level and performance. Cognitive load was manipulated by presenting participants with three different types of cognitive tasks described in taxonomy, including skill-, rule-, and knowledge-based tasks. Dependent variables examined in the study included: (1) electromyographic activity of the upper trapezius (pars descendens) and cervical erector spinae muscles, (2) performance in a secondary typing task, and (3) subjective measures of stress and cognitive workload. The results of this study revealed that the primary task causing the highest level of perceived workload also produced 61% higher muscle activity in the right trapezius, and 6 and 11% higher activity in the left and right cervical erector spinae, respectively, in comparison to muscle activity associated with the cognitive task causing the lowest perceived workload. With respect to performance, a 23% decrease was observed in typing productivity when the rule-based task was completed simultaneously vs. typing in the absence of any additional cognitive task (the baseline condition). This information may be used to better organize work activities in office environments to increase performance and reduce stress.

The effect of scapula taping on electromyographic activity and musical performance in professional violinists

Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. These factors have been linked to neck and arm problems in violinists. The purpose of this study was to evaluate the effects of taping the scapulae of violinists into a position that prevented excessive elevation and protraction whilst playing. Eight professional violinists played three different musical excerpts with and without scapula taping applied in random order. Electromyographic activity was recorded from the upper trapezii, the scapula retractors and the right sternocleidomastoid muscles. Performances were recorded onto videotape and audiocassette, and self-report data collected for later analysis. Compared with the control condition, scapula taping increased electromyographic activity in the left upper trapezius muscle during playing by 49% as an overall effect, with a 60% increase in the most physically demanding piece played. Lower music quality was detected in the same piece by raters blinded to performance conditions. Taping also had significant negative effects on subjects' reports of concentration and comfort. Short-term application of scapula taping did not enhance selected scapula stabilising muscles during playing and was not well tolerated by professional violinists.

Low-frequency oscillations (<0.3 Hz) in the electromyographic (EMG) activity of the human trapezius muscle during sleep

The surface electromyographic (EMG) signal from right and left trapezius muscles and the heart rate were recorded over 24 h in 27 healthy female subjects. The root-mean-square (RMS) value of the surface EMG signals and the heartbeat interval time series were calculated with a time resolution of 0.2 s. The EMG activity during sleep showed long periods with stable mean amplitude, modulated by rhythmic components in the frequency range 0.05-0.2 Hz. The ratio between the amplitude of the oscillatory components and the mean amplitude of the EMG signal was approximately constant over the range within which the phenomenon was observed, corresponding to a peak-to-peak oscillatory amplitude of approximately 10% of the mean amplitude. The duration of the periods with stable mean amplitude ranged from a few minutes to approximately 1 h, usually interrupted by a sudden change in the activity level or by cessation of the muscle activity. Right and left trapezius muscles presented the same pattern of FM. In supplementary experiments, rhythmic muscle activity pattern was also demonstrated in the upper extremity muscles of deltoid, biceps, and forearm flexor muscles. There was no apparent association between the rhythmic components in the muscle activity pattern and the heart rate variability. To our knowledge, this is the first time that the above-described pattern of EMG activity during sleep is documented. On reanalysis of earlier recorded trapezius motor unit firing pattern in experiments on awake subjects in a situation with mental stress, low-FM of firing with similar frequency content was detected. Possible sources of rhythmic excitation of trapezius motoneurons include slow-wave cortical oscillations represented in descending cortico-spinal pathways, and/or activation by monoaminergic pathways originating in the brain stem reticular formation. The analysis of muscle activity patterns may provide an important new tool to study neural mechanisms in human sleep.

Daytime trapezius muscle activity and shoulder-neck pain of service workers with work stress and low biomechanical exposure

AIM

The study aims to look for an association between trapezius muscle activity and shoulder-neck pain in work situations characterized by work stress and low biomechanical exposure.

METHODS

Female subjects (n = 93) were recruited from four occupational groups: health care, shop assistants, banking, and university secretaries. Thirty-eight workers were interviewed and classified as pain-afflicted by their shoulder-neck pain score in the last 6 months; 55 were pain-free. Shoulder-neck pain, bodily state of tension and fatigue, and subjective exposure assessments were monitored by repeated hourly measurements over 24 hr. Trapezius muscle activity was recorded bilaterally by surface EMG.

RESULTS

Shoulder-neck pain, perceived tension, work stress ("stressful environment"), and mental fatigue was augmented over the workday and reduced leisure time. Physical fatigue was low and stable. Thus, work stress appeared to be the dominant exposure associated with shoulder-neck pain. Muscle activity was low and similar for pain-afflicted and pain-free subjects during working hours. It was unchanged from work to leisure for the pain-afflicted workers and was significantly reduced for the pain-free group.

CONCLUSIONS

Stress-induced shoulder and neck pain is not necessarily associated with elevated trapezius muscle activity, but pain-free workers may benefit from better muscle relaxation in leisure.

Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure

Electromyographic activity of the upper trapezius muscles was recorded over the workday for two groups of service workers, shopping centre (n = 22) and healthcare workers (n = 44), both with low observed biomechanical exposure. Static and median EMG activity level, number of EMG gaps and gap time were determined. The variability of these variables over the workday was examined by calculating the coefficient of variation (CV) and the intraclass correlation coefficient (ICC) of 1-h consecutive recording periods. All variables except gap time showed acceptable reliability (ICC = 0.69-0.78), i.e. the largest fraction of variance in the data set was due to intersubject variance, despite relatively large hour-to-hour variation (CV = 0.21 0.62). The EMG activity level in the trapezius muscles was low (static activity level < 1% EMGmax), despite the high prevalence of shoulder and neck pain for both groups of workers. In addition to the work recordings, tests were performed to determine intersubject variation in muscle activity when adopting a standardized resting posture, and in a dynamic muscle activity pattern during paced arm movement. Neither the EMG variables from the work recordings nor the tests with EMG recording indicated higher trapezius EMG activity levels for workers with pain in the shoulders and neck in this study. The low EMG levels are interpreted to indicate a low risk of developing shoulder and neck complaints due to biomechanical exposure for both groups of workers. The possibility of pain-initiating mechanisms, associated with stress and not mediated through muscle activity, is considered in the discussion.

Use of surface electromyography to estimate neck muscle activity

This paper reviews the literature concerning the use of surface electromyography (sEMG) for the study of the neck musculature in response to work and workplace design during light work and semi-static tasks. The paper also draws upon basic research and biomechanical modeling in order to provide methodological recommendations for the use of surface electromyography in this region of the body and to identify areas which require further investigation. The paper includes review and discussion of electrode site location, methods of normalization, data reliability, and factors that can affect sEMG signals from this region, including noise, physiologic artifact, stress, visual deficiencies, and pain. General guidance for maximum exertions with the neck musculature, for sEMG normalization or other purposes, is also included.