Applicability of the coactivation method in assessing synergies of the scapular stabilizing muscles

Quantification of muscle coordination underlying basic shoulder movements using muscle synergy extraction

Numerous muscles around the shoulder joint are required to work in a coordinated manner, even when a basic shoulder movement is executed. Muscle synergy can be utilized as an index to determine muscle coordination. The purpose of the present study was to investigate the muscle coordination among different shoulder muscles underlying basic shoulder movements based on muscle synergy. Thirteen men performed 14 multiplanar shoulder movements; five movements were associated with elevation and lowering, while five were associated with horizontal abduction and adduction. The four additional movements were simple rotations at different positions. Muscle activity was measured from 12 muscle portions using surface electromyography. Using the dimensionality reduction technique, synergies were extracted first for each movement separately ("separate" synergies), and then for the global dataset (containing all movements; "global" synergies). The least number that provided 90% of the variance accounted for was selected as the optimal number of synergies. For each subject, approximately two separate synergies and approximately six global synergies with small residual values were extracted from the separate and global electromyography datasets, respectively. Specific patterns of these muscle synergies in each task were observed during each movement. In the cross-validation method, six global synergies explained 88.0 ± 1.3% of the global dataset. These findings indicate that muscle activities underlying basic shoulder movements are expressed as six units, and these units could be proxies for shoulder muscle coordination.

Shoulder muscle activation strategies differ when lifting or lowering a load

PURPOSE

Lowering a load could be associated with abnormal shoulder and scapular motion. We tested the hypothesis that lowering a load involves different shoulder muscle coordination strategies compared to lifting a load.

METHODS

EMG activity of 13 muscles was recorded in 30 healthy volunteers who lifted and lowered a 6, 12 or 18 kg box between three shelves. Kinematics, EMG levels and muscle synergies, extracted using non-negative matrix factorization, were analyzed.

RESULTS

We found greater muscle activity level during lowering in four muscles (+ 1-2% MVC in anterior deltoid, biceps brachii, serratus anterior and pectoralis major). The movements were performed faster during lifting (18.2 vs. 15.9 cm/s) but with similar hand paths and segment kinematics. The number of synergies was the same in both tasks. Two synergies were identified in ~ 75% of subjects, and one synergy in the others. Synergy #1 mainly activated prime movers' muscles, while synergy #2 co-activated several antagonist muscles. Synergies' structure was similar between lifting and lowering (Pearson's r ≈ 0.9 for synergy #1 and 0.7-08 for synergy #2). Synergy #2 was more activated during lowering and explained the greater activity observed in anterior deltoid, serratus anterior and pectoralis.

CONCLUSION

Lifting and lowering a load were associated with similar synergy structure. In 3/4 of subjects, lowering movements involved greater activation of a "multiple antagonists" synergy. The other subjects co-contracted all shoulder muscles as a unit in both conditions. These inter-individual differences should be investigated in the occurrence of shoulder musculoskeletal disorders.

Strength deficits of the shoulder complex during isokinetic testing in people with chronic stroke

OBJECTIVES

To examine the strength deficits of the shoulder complex after stroke and to characterize the pattern of weakness according to type of movement and type of isokinetic parameter.

METHOD

Twelve chronic stroke survivors and 12 age-matched healthy controls had their shoulder strength measured using a Biodex isokinetic dynamometer. Concentric measures of peak torque and work during shoulder movements were obtained in random order at speeds of 60°/s for both groups and sides. Type of movement was defined as scapulothoracic (protraction and retraction), glenohumeral (shoulder internal and external rotation) or combined (shoulder flexion and extension). Type of isokinetic parameter was defined as maximum (peak torque) or sustained (work). Strength deficits were calculated using the control group as reference.

RESULTS

The average strength deficit for the paretic upper limb was 52% for peak torque and 56% for work. Decreases observed in the non-paretic shoulder were 21% and 22%, respectively. Strength deficit of the scapulothoracic muscles was similar to the glenohumeral muscles, with a mean difference of 6% (95% CI -5 to 17). Ability to sustain torque throughout a given range of motion was decreased as much as the peak torque, with a mean difference of 4% (95% CI -2 to 10).

CONCLUSIONS

The findings suggest that people after stroke might benefit from strengthening exercises directed at the paretic scapulothoracic muscles in addition to exercises of arm elevation. Clinicians should also prescribe different exercises to improve the ability to generate force and the ability to sustain the torque during a specific range of motion.