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Depreli O, Erden Z. The effects of shoulder stabilization exercises on muscle strength, proprioceptive sensory ability and performance in office workers with shoulder protraction. Int J Occup Saf Ergon 2024; 30:599-610. [PMID: 38533585 DOI: 10.1080/10803548.2024.2326358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
Objectives. Shoulder protraction is frequently seen in office workers because of working with excessive trunk flexion for a long time. This study aimed to compare the effectiveness of stabilization exercises (SE) given in addition to office exercises (OE). Methods. Sixty office workers with shoulder protraction were divided into SE + OE (n = 30) and OE (n = 30) groups by stratified random sampling for 8 weeks and followed up for 4 weeks. Shoulder protraction was assessed with a caliper, muscle strength with a hand-held dynamometer, proprioception with an isokinetic dynamometer, vibration sense with a vibrometer and upper extremity functional performance with the closed kinetic chain upper extremity stability test. Results. There were significant improvements in all parameters in the OE + SE group, while increases in the strength of the upper trapezius, pectoralis major and infraspinatus muscles and in upper extremity functional performance were also found in the OE group (p < 0.05). During detraining, shoulder protraction, muscle strength, proprioception and upper extremity performance showed longer-term improvement with SE + OE (p < 0.05). Conclusion. The results obtained with the exercises demonstrate the importance of SE + OE in terms of maintaining proper posture and improving shoulder proprioception, muscle strength and functional performance.
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Affiliation(s)
- O Depreli
- Eastern Mediterranean University, Health Sciences Faculty, Physiotherapy and Rehabilitation Department, Famagusta, North Cyprus, via Mersin 10 Turkey
| | - Z Erden
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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2
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Naczk A, Brzenczek-Owczarzak W, Adach Z, Gramza P, Forjasz J, Gajewska E, Naczk M. The impact of inertial exercises performed in the workplace on shoulder muscles' strength and muscles' fatigue resistance in women with disabilities. Med Pr 2024; 75:113-122. [PMID: 38529799 DOI: 10.13075/mp.5893.01503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Workers who do monotonous and repetitive work in a static position often complain about fatigue and decreased work efficiency. Some studies indicate that to improve muscle fatigue, resistance strength training can be used. MATERIAL AND METHODS To investigate the effect of 4-week inertial training on shoulder muscles' strength and muscles' fatigue resistance 44 female workers with disabilities were examined. The participants were randomized into the training group (T) (N = 32) and the control group (C) (N = 12). Before the training and after that shoulder muscles' strength were tested at the start and at the end of the workday (Monday and Friday). The participants were asked to complete questionnaire concerning their fatigue at work (T and C), inertial training and work efficiency (T). RESULTS The work performed during the last day of the workweek, i.e., Friday (before training) resulted in a significant decrease in shoulder muscles' strength in T and C. Muscle strength achieved at the end of the workweek (Friday afternoon) was significantly lower than achieved at the start of the workweek (Monday morning) in both tested groups (before training). Moreover, inertial training resulted in a significant increase in shoulder muscles' strength in T; 34-74% for different muscles. No changes in muscles' strength were noted in C. Increased muscle strength in T following inertial training effectively prevented muscle fatigue. After training the differences in shoulder muscles' strength noted in T during different times of the workday and workweek were insignificant. Moreover, 4-week inertial training increased significantly the work efficiency of women from T by 4%; no changes were noted in C. Inertial training was well tolerated by the participants. CONCLUSIONS Using inertial training in women with disabilities to prevent shoulder muscles' fatigue during the workday and workweek is recommended. Med Pr Work Health Saf. 2024;75(2):113-122.
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Affiliation(s)
- Alicja Naczk
- Poznan University of Physical Education, Poznań, Poland (Department of Physical Education and Sport, Faculty in Gorzow Wielkopolski)
| | | | - Zdzisław Adach
- Poznan University of Physical Education, Poznań, Poland (Department of Physical Education and Sport, Faculty in Gorzow Wielkopolski)
| | - Piotr Gramza
- Association of Lubusz Innovation Network, Gorzów Wielkopolski, Poland (Department of Innovation)
| | - Justyna Forjasz
- Poznan University of Physical Education, Poznań, Poland (Department of Biological Sciences, Faculty in Gorzow Wielkopolski)
| | - Ewa Gajewska
- Poznan University of Medical Sciences, Poznań, Poland (Department of Developmental Neurology)
| | - Mariusz Naczk
- University of Zielona Gora, Zielona Góra, Poland (Institute of Health Sciences)
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3
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Ito D, Fukuda M, Hosoi Y, Hirose R, Teramae T, Kamimoto T, Yamada Y, Tsuji T, Noda T, Kawakami M. Optimizing shoulder elevation assist rate in exoskeletal rehabilitation based on muscular activity indices: a clinical feasibility study. BMC Neurol 2024; 24:144. [PMID: 38724916 PMCID: PMC11080160 DOI: 10.1186/s12883-024-03651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Restoring shoulder function is critical for upper-extremity rehabilitation following a stroke. The complex musculoskeletal anatomy of the shoulder presents a challenge for safely assisting elevation movements through robotic interventions. The level of shoulder elevation assistance in rehabilitation is often based on clinical judgment. There is no standardized method for deriving an optimal level of assistance, underscoring the importance of addressing abnormal movements during shoulder elevation, such as abnormal synergies and compensatory actions. This study aimed to investigate the effectiveness and safety of a newly developed shoulder elevation exoskeleton robot by applying a novel optimization technique derived from the muscle synergy index. METHODS Twelve chronic stroke participants underwent an intervention consisting of 100 robot-assisted shoulder elevation exercises (10 × 10 times, approximately 40 min) for 10 days (4-5 times/week). The optimal robot assist rate was derived by detecting the change points using the co-contraction index, calculated from electromyogram (EMG) data obtained from the anterior deltoid and biceps brachii muscles during shoulder elevation at the initial evaluation. The primary outcomes were the Fugl-Meyer assessment-upper extremity (FMA-UE) shoulder/elbow/forearm score, kinematic outcomes (maximum angle of voluntary shoulder flexion and elbow flexion ratio during shoulder elevation), and shoulder pain outcomes (pain-free passive shoulder flexion range of motion [ROM] and visual analogue scale for pain severity during shoulder flexion). The effectiveness and safety of robotic therapy were examined using the Wilcoxon signed-rank sum test. RESULTS All 12 patients completed the procedure without any adverse events. Two participants were excluded from the analysis because the EMG of the biceps brachii was not obtained. Ten participants (five men and five women; mean age: 57.0 [5.5] years; mean FMA-UE total score: 18.7 [10.5] points) showed significant improvement in the FMA-UE shoulder/elbow/forearm score, kinematic outcomes, and pain-free passive shoulder flexion ROM (P < 0.05). The shoulder pain outcomes remained unchanged or improved in all patients. CONCLUSIONS The study presents a method for deriving the optimal robotic assist rate. Rehabilitation using a shoulder robot based on this derived optimal assist rate showed the possibility of safely improving the upper-extremity function in patients with severe stroke in the chronic phase.
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Affiliation(s)
- Daisuke Ito
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mori Fukuda
- Graduate School of Science and Technology, Keio University, Tokyo, Kanagawa, Japan
| | - Yuichiro Hosoi
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryotaro Hirose
- Graduate School of Science and Technology, Keio University, Tokyo, Kanagawa, Japan
| | - Tatsuya Teramae
- Department of Brain Robot Interface, Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Takayuki Kamimoto
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuka Yamada
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomoyuki Noda
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Brain Robot Interface, Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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4
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Roggio F, Di Grande S, Cavalieri S, Falla D, Musumeci G. Biomechanical Posture Analysis in Healthy Adults with Machine Learning: Applicability and Reliability. Sensors (Basel) 2024; 24:2929. [PMID: 38733035 PMCID: PMC11086111 DOI: 10.3390/s24092929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
Posture analysis is important in musculoskeletal disorder prevention but relies on subjective assessment. This study investigates the applicability and reliability of a machine learning (ML) pose estimation model for the human posture assessment, while also exploring the underlying structure of the data through principal component and cluster analyses. A cohort of 200 healthy individuals with a mean age of 24.4 ± 4.2 years was photographed from the frontal, dorsal, and lateral views. We used Student's t-test and Cohen's effect size (d) to identify gender-specific postural differences and used the Intraclass Correlation Coefficient (ICC) to assess the reliability of this method. Our findings demonstrate distinct sex differences in shoulder adduction angle (men: 16.1° ± 1.9°, women: 14.1° ± 1.5°, d = 1.14) and hip adduction angle (men: 9.9° ± 2.2°, women: 6.7° ± 1.5°, d = 1.67), with no significant differences in horizontal inclinations. ICC analysis, with the highest value of 0.95, confirms the reliability of the approach. Principal component and clustering analyses revealed potential new patterns in postural analysis such as significant differences in shoulder-hip distance, highlighting the potential of unsupervised ML for objective posture analysis, offering a promising non-invasive method for rapid, reliable screening in physical therapy, ergonomics, and sports.
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Affiliation(s)
- Federico Roggio
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy;
| | - Sarah Di Grande
- Department of Electrical Electronic and Computer Engineering, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.D.G.); (S.C.)
| | - Salvatore Cavalieri
- Department of Electrical Electronic and Computer Engineering, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (S.D.G.); (S.C.)
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy;
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
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5
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Assila N, Begon M, Duprey S. Finite Element Model of the Shoulder with Active Rotator Cuff Muscles: Application to Wheelchair Propulsion. Ann Biomed Eng 2024; 52:1240-1254. [PMID: 38376768 DOI: 10.1007/s10439-024-03449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
The rotator cuff is prone to injury, remarkably so for manual wheelchair users. To understand its pathomechanisms, finite element models incorporating three-dimensional activated muscles are needed to predict soft tissue strains during given tasks. This study aimed to develop such a model to understand pathomechanisms associated with wheelchair propulsion. We developed an active muscle model associating a passive fiber-reinforced isotropic matrix with an activation law linking calcium ion concentration to tissue tension. This model was first evaluated against known physiological muscle behavior; then used to activate the rotator cuff during a wheelchair propulsion cycle. Here, experimental kinematics and electromyography data was used to drive a shoulder finite element model. Finally, we evaluated the importance of muscle activation by comparing the results of activated and non-activated rotator cuff muscles during both propulsion and isometric contractions. Qualitatively, the muscle constitutive law reasonably reproduced the classical Hill model force-length curve and the behavior of a transversally loaded muscle. During wheelchair propulsion, the deformation and fiber stretch of the supraspinatus muscle-tendon unit pointed towards the possibility for this tendon to develop tendinosis due to the multiaxial loading imposed by the kinematics of propulsion. Finally, differences in local stretch and positions of the lines of action between activated and non-activated models were only observed at activation levels higher than 30%. Our novel finite element model with active muscles is a promising tool for understanding the pathomechanisms of the rotator cuff for various dynamic tasks, especially those with high muscle activation levels.
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Affiliation(s)
- Najoua Assila
- School of Kinesiology and Exercise Sciences, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
- Research Center of the Sainte-Justine University Hospital Center, Montréal, QC, Canada.
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, 69622, Lyon, France.
| | - Mickaël Begon
- School of Kinesiology and Exercise Sciences, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
- Research Center of the Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Sonia Duprey
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, 69622, Lyon, France
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6
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Valencia OD, Danes-Daetz C, Haro S, Didyk MP, Rossato M, Benavides P, Guzman-Venegas R. Electromyographic and kinematic parameters of the shoulder in wheelchair rugby players: case reports. Res Sports Med 2024; 32:537-544. [PMID: 36578156 DOI: 10.1080/15438627.2022.2161903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022]
Abstract
Wheelchair rugby was created as part of the rehabilitation for patients with spinal cord injury. The biomechanical analysis of wheelchair propulsion (WP) in these athletes seems to be a key element to understand the reasons behind musculoskeletal injuries. This case reports study aimed to describe the electromyographic activity and kinematic parameters of the shoulder during the propulsion phases on the wheelchair in two Paralympic rugby players (A1 and A2) with spinal cord injury. Myoelectric activity (three portions of the deltoid, biceps and triceps brachii) and kinematics of the shoulder were assessed during the push (PP) and recovery (RP) phases. These variables were calculated considering ten propulsion cycles by each athlete. The results showed a different muscle activation between players, A1 described a high average amplitude of the anterior deltoid (PP = 58.44 ± 16.35%MVC; RP = 43.16 ± 13.48%MVC) in both propulsion phases, while A2 generated high average activity of triceps brachii (29.28 ± 10.63%MVC) and middle deltoid (46.53 ± 14.48%MVC), during PP and RP, respectively. At the same time, the player with a C7-T1 spinal cord injury (A2) showed a higher range of motion in the three plans, considering both propulsion phases.
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Affiliation(s)
- Oscar D Valencia
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - Claudia Danes-Daetz
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
- Institute of Sport, Exercise and Health, UCL, London, UK
| | - Sofía Haro
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - M Pía Didyk
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - M Rossato
- Human Performance Laboratory, Physical Education and Physiotherapy Faculty, Federal University of Amazonas, Manaus, Brazil
| | - Pablo Benavides
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andrés Bello, Chile
| | - Rodrigo Guzman-Venegas
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
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7
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Yasar MN, Sica M, O'Flynn B, Tedesco S, Menolotto M. A dataset for fatigue estimation during shoulder internal and external rotation movements using wearables. Sci Data 2024; 11:433. [PMID: 38678019 PMCID: PMC11055894 DOI: 10.1038/s41597-024-03254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Wearable sensors have recently been extensively used in sports science, physical rehabilitation, and industry providing feedback on physical fatigue. Information obtained from wearable sensors can be analyzed by predictive analytics methods, such as machine learning algorithms, to determine fatigue during shoulder joint movements, which have complex biomechanics. The presented dataset aims to provide data collected via wearable sensors during a fatigue protocol involving dynamic shoulder internal rotation (IR) and external rotation (ER) movements. Thirty-four healthy subjects performed shoulder IR and ER movements with different percentages of maximal voluntary isometric contraction (MVIC) force until they reached the maximal exertion. The dataset includes demographic information, anthropometric measurements, MVIC force measurements, and digital data captured via surface electromyography, inertial measurement unit, and photoplethysmography, as well as self-reported assessments using the Borg rating scale of perceived exertion and the Karolinska sleepiness scale. This comprehensive dataset provides valuable insights into physical fatigue assessment, allowing the development of fatigue detection/prediction algorithms and the study of human biomechanical characteristics during shoulder movements within a fatigue protocol.
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Affiliation(s)
- Merve Nur Yasar
- Tyndall National Institute, University College Cork, Cork, T12 R5CP, Ireland.
| | - Marco Sica
- Tyndall National Institute, University College Cork, Cork, T12 R5CP, Ireland.
| | - Brendan O'Flynn
- Tyndall National Institute, University College Cork, Cork, T12 R5CP, Ireland
| | - Salvatore Tedesco
- Tyndall National Institute, University College Cork, Cork, T12 R5CP, Ireland
| | - Matteo Menolotto
- Tyndall National Institute, University College Cork, Cork, T12 R5CP, Ireland
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8
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Harrison KL, Henderson Z, Rochon J, Bohunicky S, Scribbans T. Excitation distribution of the trapezius changes in response to increasing contraction intensity, but not repeated contractions. J Electromyogr Kinesiol 2024; 75:102866. [PMID: 38367546 DOI: 10.1016/j.jelekin.2024.102866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/19/2024] Open
Abstract
Upper trapezius (UT) excitation redistributes with experimentally-induced muscle pain, fatigue, and repeated contractions. Excitation distribution variability is proposed to reduce the likelihood of shoulder pain and pathology by reducing cumulative stress on musculoskeletal structures. While the middle (MT) and lower (LT) trapezius are pivotal in scapular stabilization, it remains unclear whether they display similar excitation distribution variability with repeated or increasing contraction intensity. We determined if excitation distribution of the UT, MT, and LT differ: 1) during isometric contractions at different intensities (30 % and 60 % of maximum voluntary isometric contraction (MVIC)); and 2) with repeated contractions at 60 % MVIC. Nineteen individuals completed MVICs and submaximal contractions for the UT, MT, and LT while high-density electromyography was collected. Statistical parametric mapping t-tests were performed between intensities and the 1st and 5th repetition at 60 % MVIC. UT, MT, and LT excitation distribution changed with increasing contraction intensity in 358 (∼92 % of the map), 54 (∼14 %), and 270 pixels (∼70 %), respectively. No pixels exceeded significance with repeated contractions for any muscle. Barycentre analyses revealed no significant results. These results suggest that regions of the trapezius muscle use different neuromuscular strategies in response to changes in contraction intensity and repeated contractions.
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Affiliation(s)
- Kara-Lyn Harrison
- Integrative Musculoskeletal Research Lab, University of Manitoba, Faculty of Kinesiology and Recreation Management, Winnipeg, Manitoba, Canada
| | - Zachariah Henderson
- Integrative Musculoskeletal Research Lab, University of Manitoba, Faculty of Kinesiology and Recreation Management, Winnipeg, Manitoba, Canada
| | - Josée Rochon
- Integrative Musculoskeletal Research Lab, University of Manitoba, Faculty of Kinesiology and Recreation Management, Winnipeg, Manitoba, Canada
| | - Sarah Bohunicky
- Integrative Musculoskeletal Research Lab, University of Manitoba, Faculty of Kinesiology and Recreation Management, Winnipeg, Manitoba, Canada
| | - Trisha Scribbans
- Integrative Musculoskeletal Research Lab, University of Manitoba, Faculty of Kinesiology and Recreation Management, Winnipeg, Manitoba, Canada.
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9
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Saez-Berlanga A, Babiloni-Lopez C, Ferri-Caruana A, Jiménez-Martínez P, García-Ramos A, Flandez J, Gene-Morales J, Colado JC. A new sports garment with elastomeric technology optimizes physiological, mechanical, and psychological acute responses to pushing upper-limb resistance exercises. PeerJ 2024; 12:e17008. [PMID: 38464757 PMCID: PMC10924454 DOI: 10.7717/peerj.17008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
This study aimed to compare the mechanical (lifting velocity and maximum number of repetitions), physiological (muscular activation, lactate, heart rate, and blood pressure), and psychological (rating of perceived exertion) responses to upper-body pushing exercises performed wearing a sports elastomeric garment or a placebo garment. Nineteen physically active young adults randomly completed two training sessions that differed only in the sports garment used (elastomeric technology or placebo). In each session, subjects performed one set of seated shoulder presses and another set of push-ups until muscular failure. The dependent variables were measured immediately after finishing the set of each exercise. Compared to the placebo garment, the elastomeric garment allowed participants to obtain greater muscular activation in the pectoralis major (push-ups: p = 0.04, d = 0.49; seated shoulder press: p < 0.01, d = 0.64), triceps brachialis (push-ups, p < 0.01, d = 0.77; seated shoulder press: p < 0.01, d = 0.65), and anterior deltoid (push-ups: p < 0.01, d = 0.72; seated shoulder press: p < 0.01, d = 0.83) muscles. Similarly, participants performed more repetitions (push-ups: p < 0.01; d = 0.94; seated shoulder press: p = 0.03, d = 0.23), with higher movement velocity (all p ≤ 0.04, all d ≥ 0.47), and lower perceived exertion in the first repetition (push-ups: p < 0.01, d = 0.61; seated shoulder press: p = 0.05; d = 0.76) wearing the elastomeric garment compared to placebo. There were no between-garment differences in most cardiovascular variables (all p ≥ 0.10). Higher diastolic blood pressure was only found after the seated shoulder press wearing the elastomeric garment compared to the placebo (p = 0.04; d = 0.49). Finally, significantly lower blood lactate levels were achieved in the push-ups performed wearing the elastomeric garment (p < 0.01; d = 0.91), but no significant differences were observed in the seated shoulder press (p = 0.08). Overall, the findings of this study suggest that elastomeric technology integrated into a sports garment provides an ergogenic effect on mechanical, physiological, and psychological variables during the execution of pushing upper-limb resistance exercises.
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Affiliation(s)
- Angel Saez-Berlanga
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Carlos Babiloni-Lopez
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Ana Ferri-Caruana
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Pablo Jiménez-Martínez
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
- ICEN Institue, Madrid, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Jorge Flandez
- Institute of Education Sciences, Austral University of Chile, Ciudad de Valdivia, Chile
| | - Javier Gene-Morales
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Juan C. Colado
- Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
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10
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Genter J, Croci E, Oberreiter B, Eckers F, Bühler D, Gascho D, Müller AM, Mündermann A, Baumgartner D. The influence of rotator cuff tear type and weight bearing on shoulder biomechanics in an ex vivo simulator experiment. J Biomech 2024; 166:112055. [PMID: 38522362 DOI: 10.1016/j.jbiomech.2024.112055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
Glenohumeral biomechanics after rotator cuff (RC) tears have not been fully elucidated. This study aimed to investigate the muscle compensatory mechanism in weight-bearing shoulders with RC tears and asses the induced pathomechanics (i.e., glenohumeral translation, joint instability, center of force (CoF), joint reaction force). An experimental, glenohumeral simulator with muscle-mimicking cable system was used to simulate 30° scaption motion. Eight fresh-frozen shoulders were prepared and mounted in the simulator. Specimen-specific scapular anthropometry was used to test six RC tear types, with intact RC serving as the control, and three weight-bearing loads, with the non-weight-bearing condition serving as the control. Glenohumeral translation was calculated using instantaneous helical axis. CoF, muscle forces, and joint reaction forces were measured using force sensors integrated into the simulator. Linear mixed effects models (RC tear type and weight-bearing) with random effects (specimen and sex) were used to assess differences in glenohumeral biomechanics. RC tears did not change the glenohumeral translation (p > 0.05) but shifted the CoF superiorly (p ≤ 0.005). Glenohumeral translation and joint reaction forces increased with increasing weight bearing (p < 0.001). RC and deltoid muscle forces increased with the presence of RC tears (p ≤ 0.046) and increased weight bearing (p ≤ 0.042). The synergistic muscles compensated for the torn RC tendons, and the glenohumeral translation remained comparable to that for the intact RC tendons. However, in RC tears, the more superior CoF was close to where glenoid erosion occurs in RC tear patients with secondary osteoarthritis. These findings underscore the importance of early detection and precise management of RC tears.
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Affiliation(s)
- Jeremy Genter
- IMES Institute of Mechanical Systems, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
| | - Eleonora Croci
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Birgit Oberreiter
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Franziska Eckers
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Dominik Bühler
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Dominic Gascho
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Andreas M Müller
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Daniel Baumgartner
- IMES Institute of Mechanical Systems, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
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Melo AS, Montóia B, Cruz EB, Vilas-Boas JP, Sousa AS. Scapular muscle dynamic stiffness of asymptomatic subjects and subjects with chronic shoulder pain, at rest and isometric contraction conditions. Proc Inst Mech Eng H 2024; 238:288-300. [PMID: 38403635 DOI: 10.1177/09544119241228082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Muscle stiffness had a crucial role in joint stability, particularly, at the shoulder complex. Although changes in upper trapezius muscle stiffness have been described for shoulder pain, contradictory findings have been obtained. Also, existing data regarding scapular muscles are, majorly, about trapezius. Myotonometry is a method used to assess stiffness; however, the reliability values of scapular muscle stiffness through this method have not been assessed in shoulder pain conditions. The present study aims to compare scapular muscles' stiffness (trapezius, serratus anterior, and levator scapulae) between subjects with and without chronic shoulder pain and to evaluate the related test-retest reliability. Twenty-two symptomatic and twenty-two asymptomatic subjects participated in a cross-sectional study. The dynamic muscular stiffness of scapular muscles, at rest and during an isometric contraction, was measured bilaterally with myotonometry, in two moments. The differences in bilateral averaged values between symptomatic and asymptomatic subjects and the effect of the group (group presenting pain in the dominant or non-dominant side, and asymptomatic group) and of the limb (unilateral painful or asymptomatic limb, and bilateral asymptomatic limbs) were investigated. Test-retest intra-rater reliability was determined. An effect of the group was observed at rest, for middle trapezius stiffness, and during contraction, for middle and lower trapezius stiffness. For middle trapezius, increased values were observed in the group presenting pain in non-dominant side comparing to both groups or to group presenting pain in dominant side. The intraclass correlation coefficient, majorly, ranged between 0.775 and 0.989. Participants with pain in the non-dominant side presented an increased middle trapezius' stiffness. Globally, high reliability was observed for scapular muscles dynamic stiffness.
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Affiliation(s)
- Ana Sc Melo
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Bárbara Montóia
- Escola Superior de Saúde, Politécnico do Porto, Porto, Portugal
| | - Eduardo B Cruz
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
- Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - J Paulo Vilas-Boas
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Andreia Sp Sousa
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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12
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Lee HH, Yoon KT, Lim HH, Lee WK, Jung JH, Kim SB, Choi YM. A Novel Passive Shoulder Exoskeleton Using Link Chains and Magnetic Spring Joints. IEEE Trans Neural Syst Rehabil Eng 2024; 32:708-717. [PMID: 38285587 DOI: 10.1109/tnsre.2024.3359658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Work-related musculoskeletal disorders represent a major occupational disability issue, and 53.4% of these disorders occur in the back or shoulders. Various types of passive shoulder exoskeletons have been introduced to support the weight of the upper arm and work tools during overhead work, thereby preventing injuries and improving the work environment. The general passive shoulder exoskeleton is constructed with rigid links and joints to implement shoulder rotation, but there exists a challenge to align with the flexible joint movements of the human shoulder. Also, a force-generating part using mechanical springs require additional mechanical components to generate torque similar to the shoulder joint, resulting in increased overall volume and inertia to the upper arm. In this study, we propose a new type of passive shoulder exoskeleton that uses magnetic spring joint and link chain. The redundant degrees of freedom in the link chains enables to follow the shoulder joint movement in the horizontal direction, and the magnetic spring joint generates torque without additional parts in a compact form. Conventional exoskeletons experience a loss in the assisting torque when the center of shoulder rotation changed during arm elevation. Our exoskeleton minimizes the torque loss by customizing the installation height and initial angle of the magnetic spring joint. The performances of the proposed exoskeleton were verified by an electromyographic evaluation of shoulder-related muscles in overhead work and box lifting task.
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13
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Sciascia AD. Rehabilitation of the painful shoulder. J Shoulder Elbow Surg 2024; 33:494-506. [PMID: 37573929 DOI: 10.1016/j.jse.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/05/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023]
Abstract
Managing the painful shoulder in overhead athletes can be difficult because of a lack of time-loss injuries in overhead sports and focusing primarily on either pathoanatomic causes or movement impairments. Although managing the painful shoulder can be challenging, the combination of identifying pathoanatomic causes with movement impairments can provide a more focused rehabilitation approach directed at the causes of shoulder pain. Understanding the potential influence of scapular positioning as well as mobility and/or strength impairments on shoulder pain can help clinicians develop more directed rehabilitation programs. Furthermore, sports-specific methods such as long toss or the use of weighted balls for achieving physiological or performance-based gains have limited empirical evidence regarding their clinical and performance-based benefits, which may impede the rehabilitation process. Applying a comprehensive evaluation approach prior to and throughout the treatment process can assist clinicians with selecting the most appropriate treatment based on patient need. Reconsidering traditional treatments based on existing evidence may help refine the treatment process for overhead athletes with shoulder pain.
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Affiliation(s)
- Aaron D Sciascia
- Institute for Clinical Outcomes and Research, Lexington Clinic, Lexington, KY, USA.
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14
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Cooper JL, Karduna AR. Experimentally Induced Pain Results in Reduced Activity of the Rotator Cuff Muscles in Healthy Subjects. J Appl Biomech 2024; 40:73-80. [PMID: 37935173 DOI: 10.1123/jab.2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/10/2023] [Accepted: 09/29/2023] [Indexed: 11/09/2023]
Abstract
Shoulder pain is a complex, prevalent problem that is multifactorial in nature. While there are many potential causes, one common suspect is the rotator cuff musculature. The purpose of the present study was to induce pain in the supraspinatus muscle of healthy subjects and observe the resulting changes in muscle activity. Eight muscles on 23 subjects were assessed using electromyography: anterior, middle, and posterior deltoid; pectoralis major; upper trapezius; latissimus dorsi; serratus anterior; supraspinatus; and infraspinatus. It was hypothesized that the rotator cuff muscles would display reduced activity during pain, and that reductions in activity would remain after the pain had dissipated. Both of the rotator cuff muscles measured did indeed display reduced activity in a majority of the dynamic, isometric, and maximal contractions. Many of those reductions remained after the pain had subsided.
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Affiliation(s)
- Jennifer L Cooper
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Andrew R Karduna
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
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15
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Can EN, Harput G, Turgut E. Shoulder and Scapular Muscle Activity During Low and High Plank Variations With Different Body-Weight-Bearing Statuses. J Strength Cond Res 2024; 38:245-252. [PMID: 37815235 DOI: 10.1519/jsc.0000000000004622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Can, EN, Harput, G, and Turgut, E. Shoulder and scapular muscle activity during low and high plank variations with different body-weight-bearing statuses. J Strength Cond Res 38(2): 245-252, 2024-This study investigated the activation levels and activation ratios of shoulder and scapular muscles during low plank (LP) and high plank (HP) variations, with varying levels of body-mass support, including 4-point, 3-pod, and 2-point body-weight-bearing (BWB) statuses. The study was conducted with 21 healthy men (mean ± SD , 26 ± 6.5 years of age and 24.4 ± 2.4 kg·m -2 BMI). Ten different plank exercises were performed in a mixed order by changing elbow joint positions (LP and HP) and BWB statuses (2-point, 3-pod, and 4-point). Activation levels of the lower trapezius (LT), middle trapezius (MT), upper trapezius (UT), biceps brachii, triceps brachii, infraspinatus, and serratus anterior (SA) muscles were assessed with a surface electromyography device. Results of this study showed that elbow position changes resulted in higher LT ( p = 0.01) and TB ( p = 0.001) activation in HP exercises. In general, it was observed that an increase in BWB status was effective in increasing activation for the scapula and shoulder girdle muscles. The ratios of the UT muscle to the SA, LT, and MT muscles were less than 1 during side plank, bird dog, front reach, shoulder taps, and plank with shoulder external rotation exercises. High plank with toe touch exercise resulted in a marked increase in the UT activation. Therefore, it was concluded plank variations alter activation levels and activation ratios of shoulder and scapular muscles. Plank exercises may be used in shoulder rehabilitation and the progression in plank variations can be achieved by changing elbow position and BWB status based on individual requirements.
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Affiliation(s)
- Ezgi Nur Can
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
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16
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Kibler WB, Sciascia AD, Grantham WJ. The shoulder joint complex in the throwing motion. J Shoulder Elbow Surg 2024; 33:443-449. [PMID: 37499784 DOI: 10.1016/j.jse.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 07/29/2023]
Abstract
The shoulder joint complex in the overhead athlete is organized to effectively transfer the proximally generated forces distally into the arm. The organization also protects the joints and anatomic structures against the repetitive high velocities, large ranges of motions, and compressive, shear, translational, and distraction loads in the overhead motion while placing the hand in the "launch window." Coupling of the movements of the scapula, clavicle, and humerus results in scapulohumeral rhythm (SHR). Effective SHR requires the clavicle and scapula-and, at times, the mechanically linked claviscapular segment-to move the arm into the task-specific position and motion and requires the humerus to move through the ranges of motion to achieve the specific task in the throwing motion. Alterations in SHR can negatively affect effective shoulder joint complex function in the overhead throwing motion and increase injury risk. There are 4 phases of clavicular, scapular, and claviscapular motion that are coupled with arm motion in SHR. The first 3 phases occur in arm elevation motions from 0°-90° and result in the claviscapula and humerus being placed in task-specific positions. The fourth phase is coupling of claviscapular motion with humeral motion to maintain ball-and-socket kinematics throughout the throwing motion. Alterations in this composite motion are termed "scapular dyskinesis." The dyskinesis is considered an impairment of the efficient mobility of the claviscapular segment of the shoulder complex. The most prevalent problem with scapular dyskinesis is the association of scapular protraction and consequent glenoid antetilt with alterations in humeral rotation and posterior humeral head translation to produce shoulder joint internal impingement. Task effectiveness in overhead throwing is also based on and determined by humeral range of motion, precision of humeral motion, and velocity of humeral motion, as well as humeral and arm position in 3-dimensional space. This activity requires maximum ball-and-socket kinematics to create the highest amount of concavity-compression that creates stability for the joint. There are bony and soft-tissue contributions to this stability. Injuries to the glenoid labrum are among the most common deficits that alter concavity-compression. Clinical evaluation of the shoulder joint complex in the injured throwing athlete should be comprehensive and systematic, following an evaluation pathway for proximal and distal causative factors and including observation of humeral motion. This type of evaluation can result in intervention protocols that address the pathoanatomic, pathophysiological, and pathomechanical deficits identified.
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Affiliation(s)
- W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA
| | - Aaron D Sciascia
- Institute for Clinical Outcomes and Research, Lexington Clinic, Lexington, KY, USA.
| | - W Jeff Grantham
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA
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17
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Boden SA, Arner JW, Bradley JP. Understanding Shoulder and Elbow Injuries in the Windmill Softball Pitcher. J Am Acad Orthop Surg 2024; 32:e53-e62. [PMID: 37852241 DOI: 10.5435/jaaos-d-22-00944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/20/2023] [Indexed: 10/20/2023] Open
Abstract
Although pitching-related injuries in the overhead athlete have been studied extensively, injuries associated with windmill pitching are not as clearly elucidated. Windmill pitching produces high forces and torques in the upper extremity, and studies have shown it creates similar shoulder and elbow joint loads to those reported in baseball pitchers. Studies have shown that the windmill pitching motion generates high levels of biceps activation with an eccentric load, placing the biceps at increased risk for overuse injuries. Although the American Orthopaedic Society for Sports Medicine published prevention guidelines including recommendations for maximum pitch counts in softball, these recommendations have not been adopted by most United States softball governing bodies. The repetitive windmill motion in conjunction with high pitch count demands in competitive softball creates notable challenges for the sports medicine physician. As with overhead throwing athletes, identifying and preventing overuse is crucial in preventing injuries in the windmill pitcher, and prevention and rehabilitation should focus on optimizing mechanics and kinematics, core, hip, and lower body strength, and recognition of muscle fatigue. With more than two million fastpitch softball participants in the United States, it is essential to better understand the etiology, evaluation, and prevention of injuries in the windmill pitching athlete.
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Affiliation(s)
- Stephanie A Boden
- From the Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University, Chicago, IL (Boden), Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (Amer), Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (Bradley)
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18
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Musso M, Oliveira AS, Bai S. Influence of an upper limb exoskeleton on muscle activity during various construction and manufacturing tasks. Appl Ergon 2024; 114:104158. [PMID: 37890312 DOI: 10.1016/j.apergo.2023.104158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/31/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Musculoskeletal disorders (MSDs) significantly impact workers in the manufacturing and construction sectors. One solution that has gained interest to reduce MSDs incidence is the use of exoskeletons. In this study, the influence of an upper limb exoskeleton on muscle activity was investigated experimentally for three commonly performed tasks in the manufacturing and construction sectors. The tasks tested were overhead assembly, bricklaying, and box moving tasks. Eighteen males participated in the tests. The results showed a reduction in shoulder flexor muscle activation during all three tasks (up to -45.46 ± 4.52% for the anterior deltoid), but increased extensor activation (up to 15.47 ± 8.01% for the latissimus dorsi) was observed when the task was not primarily performed above shoulder level. The results revealed the dependence of the upper-body exoskeleton on tasks and arm posture, which should be considered for both in-field applications and designing new exoskeletons for performance enhancement.
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Affiliation(s)
- Matteo Musso
- Department of Material and Production, Aalborg University, Fredrik Bajers Vej 7K, Aalborg, 9220, Denmark.
| | - Anderson Souza Oliveira
- Department of Material and Production, Aalborg University, Fredrik Bajers Vej 7K, Aalborg, 9220, Denmark.
| | - Shaoping Bai
- Department of Material and Production, Aalborg University, Fredrik Bajers Vej 7K, Aalborg, 9220, Denmark.
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19
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Matz OC, Gustafson HC, Hartwell LE, Rudberg-Post LJ, Woolley AL. Supine counterstrain technique for rhomboid tender point. J Osteopath Med 2024; 124:35-38. [PMID: 37698674 DOI: 10.1515/jom-2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/14/2023] [Indexed: 09/13/2023]
Abstract
Because poor posture is a common instigating factor in back, shoulder, and neck pain, the rhomboid muscles should be considered in a complete physical evaluation. Previous techniques for treating a rhomboid tender point have addressed only one of the two main actions of the muscle, specifically retraction of the scapula utilizing shoulder abduction. This modified supine counterstrain technique for the rhomboid tender point incorporates both scapular retraction as well as superior, medial rotation of the inferior border of the scapula without abduction, providing a comprehensive treatment to accommodate patients with shoulder movement restrictions. This article discusses indications, contraindications, treatment, and a list of problem-solving strategies for the rhomboid tender point.
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Affiliation(s)
- Olivia C Matz
- Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
| | - Hannah C Gustafson
- Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
| | - Lauren E Hartwell
- Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
| | | | - Adrian L Woolley
- Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
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Chen Y, Yang C, Côté JN. Few sex-specific effects of fatigue on muscle synergies in a repetitive pointing task. J Biomech 2024; 163:111905. [PMID: 38183760 DOI: 10.1016/j.jbiomech.2023.111905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 10/30/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024]
Abstract
Previous studies have identified some sex differences in how individual muscles change their activation during repetitive multi-joint arm motion-induced fatigue. However, little is known about how indicators of multi-muscle coordination change with fatigue in males and females. Fifty-six (29 females) asymptomatic young adults performed a repetitive, forward-backward pointing task until scoring 8/10 on a Borg CR10 scale while surface electromyographic activity of upper trapezius, anterior deltoid, biceps brachii, and triceps brachii was recorded. Activation coefficient, synergy structure, and relative weight of each muscle within synergies were calculated using the non-negative matrix factorization method. Two muscle synergies were extracted from the fatiguing task. The synergy structures were mostly preserved after fatigue, while the activation coefficients were altered. A significant Sex × Fatigue interaction effect showed more use of the anterior deltoid in males especially before fatigue in synergy 1 during shoulder stabilization (p = 0.04). As for synergy 2, it was characterized by variations in the relative weight of biceps, which was higher by 16 % in females compared to males (p = 0.04), and increased with fatigue (p = 0.03) during the elbow flexion acceleration phase and the deceleration phase of the backward pointing movement. Findings suggest that both sexes adapted to fatigue similarly, using fixed synergy structures, with alterations in synergy activation patterns and relative weights of individual muscles. Results support previous findings of an important role for the biceps and anterior deltoid in explaining sex differences in patterns of repetitive motion-induced upper limb fatigue.
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Affiliation(s)
- Yiyang Chen
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada; CRIR Research Centre, Jewish Rehabilitation Hospital, 3205 Alton-Goldbloom Place, Laval, QC H7V 1R2, Canada.
| | - Chen Yang
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada; CRIR Research Centre, Jewish Rehabilitation Hospital, 3205 Alton-Goldbloom Place, Laval, QC H7V 1R2, Canada; Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL 60611, United States
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada; CRIR Research Centre, Jewish Rehabilitation Hospital, 3205 Alton-Goldbloom Place, Laval, QC H7V 1R2, Canada
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Mänttäri S, Rauttola AP, Halonen J, Karkulehto J, Säynäjäkangas P, Oksa J. Effects of an exoskeleton on muscle activity in tasks requiring arm elevation: Part I - Experiments in a controlled laboratory setting. Work 2024; 77:1179-1188. [PMID: 37980590 DOI: 10.3233/wor-230217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Long-term work with elevated arms, or overhead work, is a risk factor for musculoskeletal complaints and disorders. Upper-limb exoskeletons are a promising tool for reducing occupational workload when working with hands above shoulder level. OBJECTIVE The purpose of this study was to assess the effects of upper-limb exoskeleton on muscular and physical strain and perceived exertion during dynamic work at four different shoulder joint angles. Further, we evaluated if there are any negative effects associated with the use of exoskeleton. METHODS A total of 15 student participants performed dynamic work in laboratory setting with and without an exoskeleton at four different shoulder angles: 60, 90, 120 and 150 degrees. Muscle electrical activity from 8 muscles of the upper body, perceived exertion, and heart rate were measured during the work task, and grip strength, muscle stiffness, tone, and elasticity from six muscles, m. deltoideus physiological cross-sectional area and muscle fiber pennation angle, and nerve conduction velocity were measured before and after the work task. RESULTS Based on the results, the use of exoskeleton significantly reduced the muscle activity of the upper limb, shoulder, and back muscles. The reduction was most significant when the arm elevation was 120°, and in m. deltoideus muscle activity. RPE was also positively affected indicating reduction in workload when using exoskeleton. CONCLUSION The results suggest that the use of upper limb exoskeleton has potential to reduce physical workload during overhead work and, consequently, reduce the risk for work-related musculoskeletal disorders.
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Affiliation(s)
- Satu Mänttäri
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Finland
| | - Ari-Pekka Rauttola
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Janne Halonen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jutta Karkulehto
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Finland
| | - Pihla Säynäjäkangas
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Finland
| | - Juha Oksa
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Finland
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Dalbøge A, Frost J, Grytnes R, Roy JS, Samani A, Høyrup Christiansen D. Effects of a passive shoulder exoskeleton on muscle activity among Danish slaughterhouse workers. Appl Ergon 2024; 114:104111. [PMID: 37611536 DOI: 10.1016/j.apergo.2023.104111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 07/02/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
AIM To evaluate the effect of a shoulder exoskeleton on muscle activity and to compare the effect with a lifting glove among slaughterhouse workers in occupational settings. MATERIALS AND METHODS We conducted a crossover study of 26 workers measured during two work days with and without the use of a passive shoulder exoskeleton and a lifting glove at a Danish slaughterhouse. Electromyography sensors were placed bilateral on 5 shoulder muscles. The 10th, 50th, and 90th percentiles of muscle activity normalized by maximal voluntary contractions were measured and analyzed using mixed effect models. RESULTS For the 50th percentiles of the agonist muscles, the exoskeleton reduced muscle activity bilaterally for deltoid anterior with up to 29.47%, deltoid middle with 10.22%, and upper trapezius with 22.21%. The lifting glove only reduced muscle activity for right deltoid anterior (36.59%) and upper trapezius (7.11%), but generally increased left muscle activity with up to 15.58%. DISCUSSION The exoskeleton showed larger reductions in muscle activity compared to the lifting glove.
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Affiliation(s)
- Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.
| | - Jeppe Frost
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400, Herning, Denmark
| | - Regine Grytnes
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400, Herning, Denmark
| | - Jean-Sebastian Roy
- Faculty of Medicine, Laval University, 1050 Avenue de la Médecine, Quebec City, QC, G1 V 0A6, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525 Boulevard Wilfrid-Hamel, Quebec City, QC, G1 M 2S8, Canada
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400, Herning, Denmark; Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark; Research, Regional Hospital Central Jutland, Viborg, Denmark
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23
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Joffrey D, Gauthier A. Should we consider the isokinetic eccentric-to-concentric strength ratio of shoulder rotator muscles to identify risk factors for shoulder injuries in competitive swimmers? Scand J Med Sci Sports 2024; 34:e14547. [PMID: 38050763 DOI: 10.1111/sms.14547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Drigny Joffrey
- Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie Univ, Caen, France
| | - Antoine Gauthier
- UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie Univ, Caen, France
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24
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Özçadırcı A, Doğan Y, Öztürk F, Cinemre ŞA, Coşkun G, Özçakar L. Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study. PM R 2024; 16:47-53. [PMID: 37294616 DOI: 10.1002/pmrj.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Repetitive shoulder movements during competitive training may cause changes in the strength of periarticular shoulder structures in preadolescent swimmers. OBJECTIVE To prospectively determine the effects of training on shoulder periarticular structures and muscle strength in preadolescent swimmers. DESIGN Prospective cohort study. SETTING Community-based natatorium. PARTICIPANTS Twenty-four preadolescent swimmers aged 10-12 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Measurements were repeated in three periods as preseason, midseason, and postseason. Ultrasonographic measurements (supraspinatus tendon thickness, humeral head cartilage thickness, deltoid muscle thickness, and acromiohumeral distance) were performed using a portable device and a linear probe. Shoulder (flexion, extension, abduction, internal and external rotation) and back (serratus anterior, lower, and middle trapezius) isometric muscle strength were measured with a handheld dynamometer. RESULTS Supraspinatus tendon thickness and acromiohumeral distance were similar in all periods (all p > .05); however, deltoid muscle and humeral head cartilage thicknesses increased throughout the season (p = .002, p = .008, respectively). Likewise, whereas shoulder muscle strength increased (all p < .05), back muscle strength was similar in all periods (all p > .05). CONCLUSIONS In preadolescent swimmers, acromiohumeral distance and supraspinatus tendon thickness seem to not change; but humeral head cartilage and deltoid muscle thicknesses as well as shoulder muscle strength increase throughout the season.
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Affiliation(s)
- Aykut Özçadırcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yahya Doğan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ferhat Öztürk
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | | | - Gürsoy Coşkun
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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25
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Pan F, Khoo K, Maso Talou GD, Song F, McGhee D, Doyle AJ, Nielsen PMF, Nash MP, Babarenda Gamage TP. Quantifying changes in shoulder orientation between the prone and supine positions from magnetic resonance imaging. Clin Biomech (Bristol, Avon) 2024; 111:106157. [PMID: 38103526 DOI: 10.1016/j.clinbiomech.2023.106157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Predicting breast tissue motion using biomechanical models can provide navigational guidance during breast cancer treatment procedures. These models typically do not account for changes in posture between procedures. Difference in shoulder position can alter the shape of the pectoral muscles and breast. A greater understanding of the differences in the shoulder orientation between prone and supine could improve the accuracy of breast biomechanical models. METHODS 19 landmarks were placed on the sternum, clavicle, scapula, and humerus of the shoulder girdle in prone and supine breast MRIs (N = 10). These landmarks were used in an optimization framework to fit subject-specific skeletal models and compare joint angles of the shoulder girdle between these positions. FINDINGS The mean Euclidean distance between joint locations from the fitted skeletal model and the manually identified joint locations was 15.7 mm ± 2.7 mm. Significant differences were observed between prone and supine. Compared to supine position, the shoulder girdle in the prone position had the lateral end of the clavicle in more anterior translation (i.e., scapula more protracted) (P < 0.05), the scapula in more protraction (P < 0.01), the scapula in more upward rotation (associated with humerus elevation) (P < 0.05); and the humerus more elevated (P < 0.05) for both the left and right sides. INTERPRETATION Shoulder girdle orientation was found to be different between prone and supine. These differences would affect the shape of multiple pectoral muscles, which would affect breast shape and the accuracy of biomechanical models.
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Affiliation(s)
- Fangchao Pan
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | - Kejia Khoo
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | | | - Freda Song
- Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Deirdre McGhee
- Biomechanics Research Laboratory, University of Wollongong, NSW, Australia
| | - Anthony J Doyle
- Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; Te Whatu Ora, Health New Zealand, New Zealand
| | - Poul M F Nielsen
- Auckland Bioengineering Institute, University of Auckland, New Zealand; Department of Engineering Science and Biomedical Engineering, University of Auckland, New Zealand
| | - Martyn P Nash
- Auckland Bioengineering Institute, University of Auckland, New Zealand; Department of Engineering Science and Biomedical Engineering, University of Auckland, New Zealand
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26
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Wagner ER, Karzon AL, Hussain ZB, Warner JJP, Elhassan BT, Sanchez-Sotelo J. Scapular Dyskinesia: How to Differentiate
Between Etiologies. Instr Course Lect 2024; 73:609-624. [PMID: 38090928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
It is important to discuss the importance of synchronous balance between periscapular muscles for scapulothoracic motion and resultant scapulohumeral rhythm. Abnormalities in this balance can lead to scapular dyskinesia and winging, affecting shoulder motion and leading to impingement. Strategies exist to diagnose and differentiate between pathologies such as muscle paralysis (eg, trapezius or serratus anterior) or overactivity (eg, pectoralis minor). The physician should be aware of the role of diagnostic imaging, as well as the unique considerations for patients with Ehlers-Danlos syndrome. Overall, a comprehensive physical examination to accurately diagnose and treat scapular pathologies is particularly important.
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27
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Wagner ER, Hussain ZB, Karzon AL, Warner JJP, Elhassan BT, Sanchez-Sotelo J. The Scapula: The Greater Masquerader of
Shoulder Pathologies. Instr Course Lect 2024; 73:587-607. [PMID: 38090927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
A comprehensive review of scapular pathologies and their effect on shoulder function is necessary to determine the best treatment options. The coordinated motion between the scapulothoracic and glenohumeral joints is essential for shoulder motion and depends on the balanced activity of the periscapular muscles. Disruption in these muscles can cause abnormal scapular motion and compensatory glenohumeral movements, leading to misdiagnosis or delayed diagnosis. Scapular pathologies can arise from muscle overactivity or underactivity/paralysis, resulting in a range of scapulothoracic abnormal motion (STAM). STAM can lead to various glenohumeral pathologies, including instability, impingement, or nerve compression. It is important to highlight the critical periscapular muscles involved in scapulohumeral rhythm (such as the upper, middle, and lower trapezius; rhomboid major and minor; serratus anterior; levator scapulae; and pectoralis minor). A discussion of the different etiologies of STAM should include examples of muscle dysfunction, such as overactivity of the pectoralis minor, underactivity or paralysis of the serratus anterior or trapezius muscles, and dyskinesis resulting from compensatory mechanisms in patients with recurrent glenohumeral instability due to Ehlers-Danlos syndrome. The evaluation and workup of STAM has shown that patients typically present with radiating shoulder pain, especially in the posterior aspect of the shoulder and scapula, and limitations in active shoulder overhead motion associated with glenohumeral pain, instability, or rotator cuff pathologies.
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28
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McKenzie A, Hams A, Headrick J, Whiteley R, Duhig S. Response to the letter to editor by Drigny and Gauthier "should we consider the isokinetic eccentric-to-concentric strength ratio of shoulder rotator muscles to identify risk factors for shoulder injuries in competitive swimmers?". Scand J Med Sci Sports 2024; 34:e14548. [PMID: 38050775 DOI: 10.1111/sms.14548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Alec McKenzie
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Queensland Academy of Sport, Brisbane, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Australia
| | - Andrea Hams
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Australia
| | - Jonathon Headrick
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Rod Whiteley
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Steven Duhig
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Australia
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29
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Dos Santos YS, Carneiro NB, Souza BCDS, Franken M, de Jesus K, de Jesus K. Benefits and limitations of isokinetic force assessments in swimmer's shoulders: A systematic review. J Bodyw Mov Ther 2024; 37:121-130. [PMID: 38432793 DOI: 10.1016/j.jbmt.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 09/12/2023] [Accepted: 11/15/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To indicate the benefits and limitations of the isokinetic test results for the performance of the main shoulder joint movements in swimmers, considering the different competitive levels, swimming techniques, race distances, and sex. METHODS Search on the PubMed, CENTRAL, Medline, LILACS, and SCOPUS databases for the oldest records up to October 2022. Risk of bias, methodological quality, and level of evidence were evaluated based on the NHLBI checklist. RESULTS 29 articles met the criteria and were included in this study. The quality analysis classified three as "good" and 26 as "regular", with a KAPPA index of 0.87. The main benefits found involved assessments of the clinical condition of the shoulder joint complex, relationships with performance, and reliability studies. The limitations found point to the participant's positioning in the instrument, use of angular velocity above 180°/s, and sample size. CONCLUSION The use of the isokinetic dynamometer allows verifying the levels of strength, endurance, balance, and asymmetries among swimmers of different techniques, distances, competitive levels, and sex. Thus, it helps in the analysis and monitoring of the clinical conditions of swimmers' shoulder joints, contributing to the decision-making process of physiotherapists and coaches.
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Affiliation(s)
- Yves Simões Dos Santos
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Amazonas, Manaus, Brazil; Human Performance Studies Laboratory, Federal University of Amazonas, Amazonas, Manaus, Brazil
| | - Neice Bahia Carneiro
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Amazonas, Manaus, Brazil; Human Performance Studies Laboratory, Federal University of Amazonas, Amazonas, Manaus, Brazil
| | - Brian Charlesson da Silva Souza
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Amazonas, Manaus, Brazil; Human Performance Studies Laboratory, Federal University of Amazonas, Amazonas, Manaus, Brazil
| | - Marcos Franken
- Health Sciences Department, Integrated Regional University of Alto Uruguay and the Missions, Rio Grande do Sul, Santiago, Brazil
| | - Kelly de Jesus
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Amazonas, Manaus, Brazil; Human Performance Studies Laboratory, Federal University of Amazonas, Amazonas, Manaus, Brazil
| | - Karla de Jesus
- Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Amazonas, Manaus, Brazil; Human Performance Studies Laboratory, Federal University of Amazonas, Amazonas, Manaus, Brazil.
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30
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Vetter S, Hepp P, Schleichardt A, Schleifenbaum S, Witt M, Roth C, Köhler HP. Effect of isokinetic eccentric training on the human shoulder strength, flexibility, and muscle architecture in physically active men: A preliminary study. PLoS One 2023; 18:e0293439. [PMID: 38113203 PMCID: PMC10729965 DOI: 10.1371/journal.pone.0293439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
Strengthening the rotator cuff muscles is important for injury prevention and rehabilitation. Since muscle fascicle length improves motor performance and is suggested to reduce the risk of injury for the hamstring, it may be an important variable to promote multidirectional changes in the function and macroscopic structure for the shoulder. Recent literature reviews overwhelmingly suggest that eccentric exercises improve fascicle length and functional measures for the lower limb. However, there is a research gap for the shoulder. Since ultrasound imaging is the most commonly used imaging technique to quantify muscle structure, but has yielded heterogeneous results in different studies, there is another issue and a research gap for the imaging method. Based on the research gaps, the purpose of this study was to evaluate the effects of standardized eccentric strength training on the function and structure of the external rotator cuff muscles using an isokinetic dynamometer and MRI. Therefore, a preliminary pre-post intervention study was conducted and 16 physically active men were recruited in October 2021. For the right shoulder, an eccentric isokinetic training was performed twice a week for almost six weeks. The primary outcome measures (external rotators) were active and passive range of motion, eccentric and concentric torque at 30, 60, and 180°/s isokinetic speed, and fascicle length and fascicle volume for the supraspinatus and infraspinatus muscles. The findings show a training effect for the absolute mean values of eccentric strength (+24%, p = .008). The torque-angle relationship increased, especially in the final phase of range of motion, although a 4% (p = .002) decrease in passive range of motion was found in the stretch test. Positive changes in muscle structure were shown for the supraspinatus muscle fascicle length (+16%, p = .003) and fascicle volume (+19%, p = .002). Based on the study results, we can conclude that eccentric isokinetic training has a significant positive effect on the shoulder. To our knowledge, this is the first eccentric training study using both isokinetic dynamometer and muscle diffusion tensor imaging to access functional and structural changes in the human shoulder rotator cuff muscles. The methods were shown to be applicable for interventional studies. Based on these results, populations such as high-performance handball players with highly trained shoulders should be included in future studies.
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Pierre Hepp
- Department for Orthopedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig Germany
| | - Stefan Schleifenbaum
- Department for Orthopedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Christian Roth
- Department of Pediatric Radiology, Leipzig University, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
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31
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Pan J, Astarita D, Baldoni A, Dell'Agnello F, Crea S, Vitiello N, Trigili E. A Self-Aligning Upper-Limb Exoskeleton Preserving Natural Shoulder Movements: Kinematic Compatibility Analysis. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4954-4964. [PMID: 38064320 DOI: 10.1109/tnsre.2023.3341219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
NESM- γ is an upper-limb exoskeleton to train motor functions of post-stroke patients. Based on the kinesiology of the upper limb, the NESM- γ includes a four degrees-of-freedom (DOF) active kinematic chain for the shoulder and elbow, along with a passive chain for self-aligning robotic joint axes with the glenohumeral (GH) joint's center of rotation. The passive chain accounts for scapulohumeral rhythm and trunk rotations. To assess self-aligning performance, we analyzed the kinematic and electromyographic data of the shoulder in eight healthy subjects performing reaching tasks under three experimental conditions: moving without the exoskeleton (baseline), moving while wearing the exoskeleton with the passive DOFs properly functioning, i.e., unlocked (human-in-the-loop(HIL)-unlocked), and with the passive DOFs locked (HIL-locked). Comparison of baseline and HIL-unlocked conditions showed nearly unchanged anatomical movement patterns, with a root-mean-square error of shoulder angle lower than 5 deg and median deviations of the GH center of rotation below 20 mm. Peak muscle activations showed no significant differences. In contrast, the HIL-locked condition deviated significantly from the baseline, as observed by the trunk and GH trajectory deviations up to 50 mm, accompanied by increased peak muscle activations in the Deltoid and Upper Trapezius muscles. These findings highlight the need for kinematic solutions in shoulder exoskeletons that can accommodate the movements of the entire shoulder complex and trunk to achieve kinematic compatibility.
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32
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Matsuura Y, Fujimoto T, Koizumi K, Mise T, Edama M, Shimoyama Y. Posterior deltoid shoulder tightness and greater contralateral lower limb muscle strength are associated with swimmers' shoulder pain. J Sci Med Sport 2023; 26:694-699. [PMID: 37845159 DOI: 10.1016/j.jsams.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/18/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To identify factors associated with shoulder pain in swimmers based on elastic muscle modulus, joint range of motion, and isometric muscle strength. DESIGN Cohort study. METHODS Forty-eight competitive swimmers without shoulder pain (age: 18-28 years; men: 29) were followed-up for 6 months. Baseline measurements of the elastic modulus of the pectoralis minor, supraspinatus, infraspinatus, posterior deltoid, and pectoralis minor muscles were obtained using shear wave elastography. Range of motion and isometric strength were measured using a goniometer and a hand-held dynamometer, respectively. A questionnaire was administered weekly for 6 months to determine shoulder pain occurrence. Each item was compared between shoulders with and without pain at baseline. For participants with shoulder pain exceeding 2 weeks, shear wave elastography and range of motion at baseline (pre pain) and during follow-up (post pain) were compared. RESULTS Of 46 swimmers followed-up for 6 months, 20 reported shoulder pain. 14 swimmers with pain were evaluated twice. Participants with shoulder pain during follow-up had significantly higher posterior deltoid and pectoralis minor stiffness at baseline and high lower extremity isometric muscle strength contralateral to the shoulder with pain compared to those without pain (p < 0.05). Swimmers with pain exceeding 2 weeks exhibited no differences in ultrasound shear wave elastography and range of motion at baseline and after pain onset. CONCLUSIONS Posterior deltoid and pectoralis minor muscle stiffness, and high isometric lower extremity strength contralateral to the shoulder with pain may be associated with shoulder pain development, thereby indicating the importance of maintaining posterior deltoid and pectoralis minor muscle flexibility during conditioning.
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Affiliation(s)
- Yuiko Matsuura
- Department of Health and Sports, Niigata University of Health and Welfare, Japan.
| | - Tomomi Fujimoto
- Department of Health and Sports, Niigata University of Health and Welfare, Japan
| | - Keisuke Koizumi
- Makuhari Human Care Faculty, Department of Physical Therapy, Tohto University, Japan
| | - Takao Mise
- Department of Health and Sports, Niigata University of Health and Welfare, Japan
| | - Mutsuaki Edama
- Department of Physical Therapy, Niigata University of Health and Welfare, Japan
| | - Yoshimitsu Shimoyama
- Department of Health and Sports, Niigata University of Health and Welfare, Japan
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33
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Kunze KN, Moran J, Taylor SA, Fu MC, Rodeo SA, Warren RF, Dines DM, Gulotta LV, Dines JS. Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears Is Associated With Restoration of the Acromiohumeral Interval and Glenohumeral Center of Pressure: A Systematic Review and Meta-Analysis of Controlled Laboratory Studies. Am J Sports Med 2023; 51:3870-3879. [PMID: 36883577 DOI: 10.1177/03635465221150652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND Biodegradable subacromial balloon spacers (SBSs) have become increasingly used for the treatment of massive irreparable rotator cuff tears given their theorized clinical benefits; however, the relationship between biomechanical functions of the balloon spacer and clinical benefits remains unclear. PURPOSE To perform a systematic review and meta-analysis of controlled laboratory studies investigating the use of SBSs for massive irreparable rotator cuff tears. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 4. METHODS PubMed, OVID/Medline, and Cochrane databases were queried in July 2022 for biomechanical data pertaining to SBS implantation in cadaveric models of irreparable rotator cuff tears. Random-effects meta-analysis of continuous outcomes using the DerSimonian-Laird method was performed to estimate pooled-treatment effect sizes between the irreparable rotator cuff tear state and the state in which an SBS was implanted. Data reported variably or in formats not amenable to analysis were presented descriptively. RESULTS Five studies involving 44 cadaveric specimens were included. At 0° of shoulder abduction, SBS implantation resulted in a mean inferior humeral head translation of 4.80 mm (95% CI, 3.20-6.40; P < .001) relative to the irreparable rotator cuff tear state. This decreased to 4.39 mm and 4.35 mm at 30° and 60° of abduction, respectively. At 0° of abduction, implantation of an SBS was associated with a 5.01-mm (95% CI, 3.56-6.46, P < .001) anterior translation of the glenohumeral center of contact pressure relative to the irreparable tear state. This translation changed to 5.11 mm and 5.49 mm at 30° and 60° of abduction. In 2 studies, SBS implantation restored the glenohumeral contact pressure to that of the intact state and significantly reduced subacromial pressure distribution over a rotator cuff repair state. In 1 study, a high balloon fill volume (40 mL) resulted in a significant 10.3 ± 1.4-mm more anterior humeral head position relative to the intact cuff state. CONCLUSION SBS implantation in cadaveric models of irreparable rotator cuff tears results in significant improvements in humeral head position at 0°, 30°, and 60° of shoulder abduction. Balloon spacers may also improve glenohumeral and subacromial contact pressures, although insufficient evidence currently exists to corroborate these findings. High balloon fill volumes (40 mL) may confer supraphysiologic anteroinferior translation of the humeral head.
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Affiliation(s)
- Kyle N Kunze
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Jay Moran
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Samuel A Taylor
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Michael C Fu
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Scott A Rodeo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Russell F Warren
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - David M Dines
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Lawrence V Gulotta
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
| | - Joshua S Dines
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine and Shoulder Institute, Hospital for Special Surgery, New York, New York, USA
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Wolfram S, Lipps DB. The in vivo passive stretch response of the pectoralis major is region-specific. J Biomech 2023; 161:111856. [PMID: 37939425 DOI: 10.1016/j.jbiomech.2023.111856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
The pectoralis major (PM) is a broad muscle commonly divided into three regions, which contribute uniquely to shoulder stability and movement. The PM muscle regions likely respond differently to stretch, but this has never been shown in vivo. We used shear wave elastography to assess the stretch response of different PM muscle regions during shoulder abduction and external rotation in 20 healthy male participants. Participants' shoulder was passively rotated through their range of motion in 5.7° increments and shear wave velocities (SWV) were obtained for each muscle region. A piece-wise model was fitted to the SWV-joint angle data, from which slack angle, slack stiffness and elasticity coefficient were determined. For shoulder abduction, we found that the sternocostal region had a significantly smaller slack angle (p = 0.049) and greater slack stiffness (p = 0.005) than the abdominal region, but there was no difference for elasticity coefficient (p = 0.074). For external rotation, only slack stiffness was greater for the sternocostal than the abdominal region (p < 0.001) with no differences found for slack angle (p = 0.18) and elasticity coefficient (p = 0.74). However, our data indicates that neither region was slack in this condition. These findings indicate that the sternocostal and abdominal regions respond differently to passive stretch, highlighting the PM's functional differentiation. This differentiation should be considered during treatment interventions such as PM muscle harvesting or treatments for breast cancer.
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Affiliation(s)
- Susann Wolfram
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, United States
| | - David B Lipps
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States.
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Marina M, Torrado P, Ferrer-Uris B, Busquets A. Benefits of Training the Iron Cross With Herdos Devices and External Load Added to Body Weight for Young Nonachiever Gymnasts. Int J Sports Physiol Perform 2023; 18:1380-1389. [PMID: 37734741 DOI: 10.1123/ijspp.2023-0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE To verify whether training the iron cross (IC) with assistive devices (herdos; HIC) and added external load (LHIC) to equate the moments of force developed on the rings could be considered an intermediate step between the nonoverloaded herdos situation (HIC) and the IC performed on the rings. METHODS Relative levels of surface electromyography (sEMG) activity were normalized with respect to a standing IC before comparing gymnasts who can perform the IC on the rings (achievers) and gymnast who cannot (nonachievers) in the 2 herdos conditions (HIC and LHIC). Seven muscles were chosen for sEMG analysis, namely, pectoralis major (PM), latissimus dorsi, teres major, lower trapezius, serratus anterior, biceps brachii (BB), and triceps brachii. Additionally, 3 indices were calculated to measure levels of coactivation: Elbowidx, Scapulaidx, and Shoulderidx. RESULTS The bigger magnitude of differences in sEMG activity among situations was found for the PM and BB (F ≥ 30.7; P < .001). When comparing the global and the PM, teres major, BB, and triceps brachii activity across groups, nonachievers activated their musculature to a greater extent than the achievers independently of the herdos situation (P ≤ .046). Achievers' Elbowidx was the only index that was significantly higher (P ≤ .005) in the IC in comparison to LHIC and HIC. CONCLUSION sEMG activity of PM and BB was particularly sensitive between situations, independently of the level of achievement. We recommend training the IC by adding external load in the herdos situation to increase muscle activity to levels closer to the rings situation but avoiding the potential factor of injuries.
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Affiliation(s)
- Michel Marina
- Research Group in Physical Activity Nutrition and Health (GRAFAiS), Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Priscila Torrado
- Research Group in Physical Activity Nutrition and Health (GRAFAiS), Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Blai Ferrer-Uris
- Research Group in Physical Activity Nutrition and Health (GRAFAiS), Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Albert Busquets
- Research Group in Physical Activity Nutrition and Health (GRAFAiS), Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
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Renda E, Lamanuzzi S, Dal Maso F, Côté JN. The effects of hand dominance, fatigue, and sex on muscle activation during a repetitive overhead fatiguing task. Hum Mov Sci 2023; 92:103149. [PMID: 37741198 DOI: 10.1016/j.humov.2023.103149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/08/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
Previous studies have shown that the dominant arm is generally stronger and more resistant to fatigue. However, whether there are side differences in shoulder muscle activation during a fatiguing upper limb task, and whether this varies according to sex, is unknown. Thirty right-handed adults (15 females) were recruited to complete two sessions of an overhead repetitive fatiguing task (shoulder flexion between 90 and 135° at 1 Hz), performed in two separate sessions with their dominant arm (DA) and non-dominant arm (NDA) until exhaustion. Electromyographic (EMG) data was collected from 11 shoulder muscles of the moving arm, and their activation amplitude (RMS) and activation variability (SD) were assessed. Results show that time to exhaustion was not affected by arm or by sex. There were some main arm effects on EMG activity amplitude, with higher activity on the DA's pectoralis major (p < 0.001), and on the NDA's middle (p = 0.009) and posterior deltoid (p = 0.001) and infraspinatus (p < 0.001). The pectoralis major was affected by arm and fatigue mostly in males. Their DA's pectoralis major activity amplitude was higher, and the amplitude variability was lower, compared to the NDA, with both parameters showing fatigue-dependent decreases at the NDA only (arm x sex x fatigue: RMS: p = 0.007; SD: p = 0.001). As for females, the DA variability of their lower trapezius was smaller, and that of their subscapularis was higher, compared to the NDA (sex x arm, p = 0.028, p = 0.05). There was also more EMG variability on the supraspinatus' dominant side, and on the posterior deltoid and infraspinatus ND side. Results show an overhead shoulder flexion task dependency on pectoralis major control in males, and on lower trapezius and shoulder girdle stabilizers in females, which could be related to both sex- and gender-based factors. This knowledge can help identify side-specific injury risk factors due to overhead work in males and females, and help determine the appropriateness of implementing sex-specific workplace protocols, including alternating arms as fatigue compensatory and recovery strategies.
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Affiliation(s)
- Erika Renda
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada.
| | - Samuel Lamanuzzi
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
| | - Fabien Dal Maso
- School of Kinesiology and Physical Education, University of Montreal, Montreal, Quebec H3T 1J4, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
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Belli I, Joshi S, Prendergast JM, Beck I, Della Santina C, Peternel L, Seth A. Does enforcing glenohumeral joint stability matter? A new rapid muscle redundancy solver highlights the importance of non-superficial shoulder muscles. PLoS One 2023; 18:e0295003. [PMID: 38033021 PMCID: PMC10688910 DOI: 10.1371/journal.pone.0295003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
The complexity of the human shoulder girdle enables the large mobility of the upper extremity, but also introduces instability of the glenohumeral (GH) joint. Shoulder movements are generated by coordinating large superficial and deeper stabilizing muscles spanning numerous degrees-of-freedom. How shoulder muscles are coordinated to stabilize the movement of the GH joint remains widely unknown. Musculoskeletal simulations are powerful tools to gain insights into the actions of individual muscles and particularly of those that are difficult to measure. In this study, we analyze how enforcement of GH joint stability in a musculoskeletal model affects the estimates of individual muscle activity during shoulder movements. To estimate both muscle activity and GH stability from recorded shoulder movements, we developed a Rapid Muscle Redundancy (RMR) solver to include constraints on joint reaction forces (JRFs) from a musculoskeletal model. The RMR solver yields muscle activations and joint forces by minimizing the weighted sum of squared-activations, while matching experimental motion. We implemented three new features: first, computed muscle forces include active and passive fiber contributions; second, muscle activation rates are enforced to be physiological, and third, JRFs are efficiently formulated as linear functions of activations. Muscle activity from the RMR solver without GH stability was not different from the computed muscle control (CMC) algorithm and electromyography of superficial muscles. The efficiency of the solver enabled us to test over 3600 trials sampled within the uncertainty of the experimental movements to test the differences in muscle activity with and without GH joint stability enforced. We found that enforcing GH stability significantly increases the estimated activity of the rotator cuff muscles but not of most superficial muscles. Therefore, a comparison of shoulder model muscle activity to EMG measurements of superficial muscles alone is insufficient to validate the activity of rotator cuff muscles estimated from musculoskeletal models.
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Affiliation(s)
- Italo Belli
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Sagar Joshi
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - J. Micah Prendergast
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Irene Beck
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Cosimo Della Santina
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Robotics and Mechatronics Department, German Aerospace Center (DLR), Munich, Germany
| | - Luka Peternel
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Ajay Seth
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
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Rodrigues da Silva Barros B, Dal’Ava Augusto D, de Medeiros Neto JF, Michener LA, Silva RS, Sousa CDO. Isometric versus isotonic exercise in individuals with rotator cuff tendinopathy-Effects on shoulder pain, functioning, muscle strength, and electromyographic activity: A protocol for randomized clinical trial. PLoS One 2023; 18:e0293457. [PMID: 37956135 PMCID: PMC10642785 DOI: 10.1371/journal.pone.0293457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/08/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Rotator cuff tendinopathy is a common shoulder disorder in which the primary treatment is resistance exercises. Isometric exercises are being studied for lower limb tendinopathies but not for rotator cuff tendinopathy. This protocol for a randomized clinical trial aims to compare the effects of two types of exercise (isometric and isotonic) on shoulder pain, functioning, muscle strength, and electromyographic activity in individuals with rotator cuff tendinopathy. METHODS Forty-six individuals (18 to 60 years old) with shoulder pain for more than three months and unilateral supraspinatus and/or infraspinatus tendinopathy will participate in this trial. Individuals will be randomized into two exercise groups: isometric or isotonic. The following outcomes will be evaluated before and after the first session and after six weeks of intervention: shoulder pain and functioning; isometric strength of shoulder elevation and lateral and medial rotation; and electromyographic activity of medial deltoid, infraspinatus, serratus anterior, and lower trapezius. Groups will perform stretching and strengthening of periscapular muscles. The isometric group will perform three sets of 32 s, at 70% of maximal isometric strength. The isotonic group will perform concentric and eccentric exercises (2 s for each phase) in three sets of eight repetitions at a load of eight repetition maximum. The total time under tension of 96 s will be equal for both groups, and load will be adjusted in weeks three and five of the protocol. Treatment effect between groups will be analyzed using linear mixed model. TRIAL REGISTRATION Trial registration number: Universal Trial Number (UTN) code U1111-1284-7528 and Brazilian Clinical Trials Registry platform-RBR-3pvdvfk.
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Affiliation(s)
- Bianca Rodrigues da Silva Barros
- Department of Physical Therapy, Postgraduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, State of Rio Grande do Norte, Brazil
| | - Denise Dal’Ava Augusto
- Department of Physical Therapy, Postgraduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, State of Rio Grande do Norte, Brazil
| | | | - Lori Ann Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, United States of America
| | - Rodrigo Scattone Silva
- Faculty of Health Sciences of Trairi, Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte, Santa Cruz, State of Rio Grande do Norte, Brazil
| | - Catarina de Oliveira Sousa
- Department of Physical Therapy, Postgraduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, State of Rio Grande do Norte, Brazil
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Wałecka J, Lubiatowski P, Bręborowicz E, Kaczmarek P, Grygorowicz M, Romanowski L. Isometric Shoulder Testing Using a Forcemeter Is a Reliable Method of Strength Evaluation. Sensors (Basel) 2023; 23:9106. [PMID: 38005493 PMCID: PMC10674994 DOI: 10.3390/s23229106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023]
Abstract
Isometric strength testing using a digital dynamometer is reliable for muscle function evaluation. It allows us to objectify manual strength assessment measurement. We tested intra- and inter-observer reliability of a user-friendly efficient digital dynamometer-the Forcemeter-equipped with a computer program to monitor the measurements and to store the data. Abduction, forward flexion, and external and internal rotation of both shoulders were tested three times in 20 healthy volunteers with no record of shoulder trauma. Isometric contracture was recorded in newtons. The first and the third test were carried out by Examiner A (intra-rater reliability); the second test, by Examiner B (inter-rater reliability). Good reliability was shown for intra-class correlation coefficient (ICC) values which mean moderate to high correlations (r = 0.66-0.93) for both examiners. Moderate to high correlations (r = 0.72-0.91) were found for comparisons between the results obtained by Examiner A.
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Affiliation(s)
- Joanna Wałecka
- Rehasport Clinic, 60-201 Poznań, Poland; (P.L.); (P.K.); (M.G.)
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, 61-545 Poznań, Poland; (E.B.); (L.R.)
| | - Przemysław Lubiatowski
- Rehasport Clinic, 60-201 Poznań, Poland; (P.L.); (P.K.); (M.G.)
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, 61-545 Poznań, Poland; (E.B.); (L.R.)
| | - Ewa Bręborowicz
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, 61-545 Poznań, Poland; (E.B.); (L.R.)
| | - Piotr Kaczmarek
- Rehasport Clinic, 60-201 Poznań, Poland; (P.L.); (P.K.); (M.G.)
| | | | - Leszek Romanowski
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, 61-545 Poznań, Poland; (E.B.); (L.R.)
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Schrøder Jakobsen L, de Zee M, Samani A, Desbrosses K, Madeleine P. Biomechanical changes, acceptance, and usability of a passive shoulder exoskeleton in manual material handling. A field study. Appl Ergon 2023; 113:104104. [PMID: 37531933 DOI: 10.1016/j.apergo.2023.104104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023]
Abstract
Occupational exoskeletons contribute to diminish the biomechanical load during manual work. However, familiarization to the use of exoskeletons is rarely considered, which may lead to failure of acceptance and implementation. In this study, ten logistic workers underwent a 5-week progressive familiarization to a passive shoulder exoskeleton, while ten workers acted as controls. Tests pre and post the familiarization applied measurements of muscle activity and kinematics of back, neck, and shoulder, perceived effort, and usability-ratings of the exoskeleton. Exoskeleton use resulted in lower muscle activity of anterior deltoid (13-39%) and upper trapezius (16-60%) and reduced perceived effort. Additionally, it induced an offset in shoulder flexion and abduction during resting position (8-10°). No conclusions on familiarization could be drawn due to low adherence to the protocol. However, the emotions of the workers towards using the exoskeleton decreased making it questionable whether the shoulder exoskeleton is suitable for use in the logistics sector.
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Affiliation(s)
- Lasse Schrøder Jakobsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Denmark.
| | - Mark de Zee
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Denmark
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Denmark
| | - Kévin Desbrosses
- INRS, French National Research and Safety Institute for the Prevention of Occupational Accidents and Diseases, Nancy, France
| | - Pascal Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Denmark
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Tyagi O, Rana Mukherjee T, Mehta RK. Neurophysiological, muscular, and perceptual adaptations of exoskeleton use over days during overhead work with competing cognitive demands. Appl Ergon 2023; 113:104097. [PMID: 37506618 DOI: 10.1016/j.apergo.2023.104097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/09/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
This study captured neurophysiological, muscular, and perceptual adaptations to shoulder exoskeleton use during overhead work with competing physical-cognitive demands. Twenty-four males and females, randomly divided into control and exoskeleton groups, performed an overhead reaching and pointing task over three days without (single task) and with (dual task) a working memory task. Task performance, electromyography (EMG), neural activity, heart rate, and subjective responses were collected. While task completion time reduced for both groups at the same rate over days, EMG activity of shoulder muscles was lower for the exoskeleton group for both tasks, specifically for females during the dual task. Dual task reduced the physiological benefits of exoskeletons and neuromotor strategies to adapt to the dual task demands differed between the groups. Neuromuscular benefits of exoskeleton use were immediately realized irrespective of cognitive demand, however the perceptual, physiological, and neural adaptations with exoskeleton use were task- and sex-specific.
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Affiliation(s)
- Oshin Tyagi
- Wm. Michael Barnes '64 Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, 77843, USA
| | - Tiash Rana Mukherjee
- J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, TX, 77843, USA
| | - Ranjana K Mehta
- Wm. Michael Barnes '64 Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, 77843, USA; J. Mike Walker '66 Department of Mechanical Engineering, Texas A&M University, College Station, TX, 77843, USA.
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Piatti M, Mosca A, Omeljaniuk RJ, Turati M, Gaddi D, Bigoni M. Comparison of isometric strength in rotator cuff and scapulothoracic muscles between elite volleyball athletes versus non-athletes. J Sports Med Phys Fitness 2023; 63:1138-1145. [PMID: 37539668 DOI: 10.23736/s0022-4707.23.14912-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Volleyball is an exceptionally popular global sport that involves repetitive, rapid, powerful and wide overhead movements, which can seriously alter normal shoulder kinematics. A recognized hallmark of shoulder muscle balance is the ratio of shoulder external (ER) and internal (IR) rotators. By extension, objective measurement of shoulder muscles' strength could help identify at risk athletes and preempt those injuries by engaging in prescriptive strength training programs. METHODS This cross-sectional study measured the isometric strengths of 1) shoulder internal and external rotator muscles, as well as the 2) supraspinatus, 3) rhomboid, and 4) middle and inferior trapezius muscles, in addition to calculation of ER:IR ratios, in professional volleyball players as well as in non-athletes. Measurements were made for dominant- and non-dominant upper limbs, in different position of the body (supine and orthostatic) and in different position of upper limb (adducted and abducted position). Our subject population included 11 male professional volleyball players as well as 14 healthy male orthopedic interns from Orthopedics and Trauma school of University of Milano Bicocca. Strengths were assessed by a handheld dynamometer. Each subject's isometric strength was assessed in triplicate in each limb position through a "make test" procedure; the greatest of each triplicate value was the accepted measure of isometric strength. RESULTS We observed a gradient in muscle strength in the scapulothoracic complex in both groups; the rhomboid, middle trapezius, and lower trapezius ranked from greatest to least strength, respectively. The data suggest also that intrarotators are stronger in rotation adducted position than in rotation abducted position; however, extrarotators seem to be weaker in rotation adducted position than in rotation abducted position. There is also some indication that force development is enhanced in the supine position compared with the orthostatic position. CONCLUSIONS Our findings indicate a scapulothoracic strength gradient with a rank order of strength of the rhomboid>middle trapezius>lower trapezius. The data further suggest that volleyball players have stronger intrarotation in rotation adducted position than in the rotation abducted position, while extra rotation shows the opposite trend. Finally, our data suggest that force development is greater in the supine position compared to the orthostatic position.
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Affiliation(s)
- Massimiliano Piatti
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
- Powervolley Milano, Milan, Italy
| | - Angelo Mosca
- Powervolley Milano, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | | | - Marco Turati
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy -
- Powervolley Milano, Milan, Italy
- Department of Pediatric Orthopedic Surgery, University Hospital Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
- Department of Orthopedics, IRCCS San Gerardo dei Tentori, Monza, Monza-Brianza, Italy
| | - Diego Gaddi
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Marco Bigoni
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
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Kia K, Hwang J, Kim JH. Effects of error rates and target sizes on neck and shoulder biomechanical loads during augmented reality interactions. Appl Ergon 2023; 113:104107. [PMID: 37523813 DOI: 10.1016/j.apergo.2023.104107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/07/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
Augmented reality (AR) interactions have been associated with increased biomechanical loads on the neck and shoulders. To provide a better understanding of the factors that may impact such biomechanical loads, this repeated-measures laboratory study evaluated the effects of error rates and target sizes on neck and shoulder biomechanical loads during two standardized AR tasks (omni-directional pointing and cube placing). Twenty participants performed the two AR tasks with different error rates and target sizes. During the tasks, angles, moments, and muscle activity in the neck and shoulders were measured. The results showed that the target sizes and error rates significantly affected angles, moments, and muscle activity in the neck and shoulder regions. Specifically, the presence of errors increased neck extension, shoulder flexion angles and associated moments. Muscle activity in the neck (splenius capitis) and shoulder (anterior and medial deltoids) also increased when the errors were introduced. Moreover, interacting with larger targets resulted in greater neck extension moments and shoulder abduction angles along with higher muscle activity in the splenius capitis and upper trapezius muscles. These findings indicate the importance of reducing errors and incorporating appropriate target sizes in the AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders.
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Affiliation(s)
- Kiana Kia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jaejin Hwang
- Department of Industrial and Systems Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - Jeong Ho Kim
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
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Pan JW, Mei Q, Fernandez J, Song H, Komar J, Kong PW. Computer simulation on the cueing movements in cue sports: a validation study. PeerJ 2023; 11:e16180. [PMID: 37842036 PMCID: PMC10576500 DOI: 10.7717/peerj.16180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background Simulation models have been applied to analyze daily living activities and some sports movements. However, it is unknown whether the current upper extremity musculoskeletal models can be utilized for investigating cue sports movements to generate corresponding kinematic and muscle activation profiles. This study aimed to test the feasibility of applying simulation models to investigate cue sports players' cueing movements with OpenSim. Preliminary muscle forces would be calculated once the model is validated. Methods A previously customized and validated unimanual upper extremity musculoskeletal model with six degrees of freedom at the scapula, shoulder, elbow, and wrist, as well as muscles was used in this study. Two types of cueing movements were simulated: (1) the back spin shot, and (2) 9-ball break shot. Firstly, kinematic data of the upper extremity joints were collected with a 3D motion capture system. Using the experimental marker trajectories of the back spin shot on 10 male cue sports players, the simulation on the cueing movements was executed. The model was then validated by comparing the model-generated joint angles against the experimental results using statistical parametric mapping (SPM1D) to examine the entire angle-time waveform as well as t-tests to compare the discrete variables (e.g., joint range of motion). Secondly, simulation of the break shot was run with the experimental marker trajectories and electromyographic (EMG) data of two male cue sports players as the model inputs. A model-estimated muscle activation calculation was performed accordingly for the upper extremity muscles. Results The OpenSim-generated joint angles for the back spin shot corresponded well with the experimental results for the elbow, while the model outputs of the shoulder deviated from the experimental data. The discrepancy in shoulder joint angles could be due to the insufficient kinematic inputs for the shoulder joint. In the break shot simulation, the preliminary findings suggested that great shoulder muscle forces could primarily contribute to the forward swing in a break shot. This suggests that strengthening the shoulder muscles may be a viable strategy to improve the break shot performance. Conclusion It is feasible to cater simulation modeling in OpenSim for biomechanical investigations of the upper extremity movements in cue sports. Model outputs can help better understand the contributions of individual muscle forces when performing cueing movements.
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Affiliation(s)
- Jing Wen Pan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Qichang Mei
- Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Justin Fernandez
- Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Hesheng Song
- Department of Physical Education, Guizhou Normal University, Guiyang, Guizhou, China
| | - John Komar
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Pui Wah Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
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Manzano M, Guegan S, Le Breton R, Devigne L, Babel M. Model-Based Upper-Limb Gravity Compensation Strategies for Active Dynamic Arm Supports. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941294 DOI: 10.1109/icorr58425.2023.10304711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
NeuroMuscular Disorders (NMDs) may induce difficulties to perform daily life activities in autonomy. For people with NMDs affecting the upper-limb mobility, Dynamic Arm Supports (DASs) turn out to be relevant assistive devices. In particular, active DASs benefit from an external power source to support severely impaired people. However, commercially available active devices are controlled with push buttons, which add cognitive load and discomfort. To alleviate this issue, we propose a new force-based assistive control framework. In this preliminary work, we focus on the computation of a feedforward force to compensate upper-limb gravity. Four strategies based on a biomechanical model of the upper limb, tuned using anthropometric measurements, are proposed and evaluated. The first one is based on the potential energy of the upper-limb, the second one makes a compromise between the shoulder and elbow torques, the third one minimizes the sum of the squared user joint torques and the last one uses a probabilistic approach to minimize the expected torque norm in the presence of model uncertainties. These strategies have been evaluated quantitatively through an experiment including nine participants with an active DAS prototype. The activity of six muscles was measured and used to compute the Mean Effort Index (MEI) which represents the global effort required to maintain the pose. A statistical analysis shows that the four strategies significantly lower the MEI (p-value < 0.001).
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Toledano N, Dar G. Ultrasonographic measurements of the omohyoid muscle during shoulder muscles contraction. J Ultrasound 2023; 26:711-716. [PMID: 36437441 PMCID: PMC10468463 DOI: 10.1007/s40477-022-00754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The main function of the omohyoid muscle is to depress and withdraw the hyoid bone. This is an integral part of the swallowing process facilitating hyoid stabilization for tongue movement. Although the muscle is inferiorly attached to the scapula bone, its function during shoulder or scapula muscles contraction has yet not been studied. AIM To investigate whether changes occur in omohyoid muscle morphology during shoulder muscles contraction. METHODS The study included 40 healthy subjects (20 males and 20 females, Mean age: 25.68 (± 2.90) years) examined via diagnostic ultrasound. Omohyoid muscle morphology measurements (thickness and cross-sectional area) during different shoulder position (0°, 90° abduction and elevation) in rest and during isomteric contraction were evaluated. RESULTS The omohyoid muscle was activated when the shoulder was isometrically abducted at 90° abduction. Thickness and the cross-sectional area of the lower belly increased during contractions at 90° abduction compared with a resting position at 90° (p value < 0.01). No changes occurred at 0° isometric abduction. The CSA of the muscle was found to be significantly larger (p < 0.001) during contraction at 90° abduction compared with contraction at 0° abduction. CONCLUSION Omohyoid muscle was most contracted during abduction position with abduction shoulder muscles isometric contraction. Changes of the scapula position might influence omohyoid muscle function.
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Affiliation(s)
- Nadav Toledano
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 3498838, Haifa, Israel
| | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 3498838, Haifa, Israel.
- Physical Therapy Clinic, The Ribstein Center for Sport Medicine Sciences and Research, Wingate Institute, Netanya, Israel.
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Croci E, Warmuth F, Baum C, Kovacs BK, Nüesch C, Baumgartner D, Müller AM, Mündermann A. Load-induced increase in muscle activity during 30° abduction in patients with rotator cuff tears and control subjects. J Orthop Traumatol 2023; 24:41. [PMID: 37542140 PMCID: PMC10403481 DOI: 10.1186/s10195-023-00720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/20/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Rotator cuff muscles stabilise the glenohumeral joint and contribute to the initial abduction phase with other shoulder muscles. This study aimed to determine if the load-induced increase in shoulder muscle activity during a 30° abduction test is influenced by asymptomatic or symptomatic rotator cuff pathologies. MATERIALS AND METHODS Twenty-five patients with unilateral rotator cuff tears (age, 64.3 ± 10.2 years), 25 older control subjects (55.4 ± 8.2 years) and 25 younger control subjects (26.1 ± 2.3 years) participated in this study. Participants performed a bilateral 30° arm abduction and adduction movement in the scapular plane with handheld weights (0-4 kg). Activity of the deltoid, infraspinatus, biceps brachii, pectoralis major, latissimus dorsi and upper trapezius muscles was analysed at maximum abduction angle after normalisation to maximum voluntary contraction. Shoulders were classified into rotator cuff tendinopathy, asymptomatic and symptomatic rotator cuff tears, and healthy based on magnetic resonance images. A linear mixed model (loads, shoulder types) with random effects (shoulder identification) was applied to the log-transformed muscle activities. RESULTS Muscle activity increased with increasing load in all muscles and shoulder types (P < 0.001), and 1-kg increments in additional weights were significant (P < 0.001). Significant effects of rotator cuff pathologies were found for all muscles analysed (P < 0.05). In all muscles, activity was at least 20% higher in symptomatic rotator cuff tears than in healthy shoulders (P < 0.001). Symptomatic rotator cuff tears showed 20-32% higher posterior deltoid (P < 0.05) and 19-25% higher pectoralis major (P < 0.01) activity when compared with asymptomatic tears. CONCLUSIONS Rotator cuff pathologies are associated with greater relative activity of shoulder muscles, even with low levels of additional load. Therefore, the inclusion of loaded shoulder tests in the diagnosis and rehabilitation of rotator cuff pathologies can provide important insight into the functional status of shoulders and can be used to guide treatment decisions. LEVEL OF EVIDENCE Level 2. TRIAL REGISTRATION Ethical approval was obtained from the regional ethics committee (Ethics Committee Northwest Switzerland EKNZ 2021-00182), and the study was registered at clinicaltrials.gov on 29 March 2021 (trial registration number NCT04819724, https://clinicaltrials.gov/ct2/show/NCT04819724 ).
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Affiliation(s)
- Eleonora Croci
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
| | - Fabian Warmuth
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Cornelia Baum
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Research and Development, Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland
| | | | - Corina Nüesch
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Daniel Baumgartner
- IMES Institute of Mechanical Systems, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Andreas Marc Müller
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Dickerson CR, McDonald AC, Chopp-Hurley JN. Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders. Hum Factors 2023; 65:879-890. [PMID: 31961724 DOI: 10.1177/0018720819896191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. BACKGROUND Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. METHOD This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. RESULTS Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. CONCLUSION A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. APPLICATION This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.
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Kisa EP, Kaya BK. Does Taping Have an Immediate Effect on Shooting the Target? Percept Mot Skills 2023; 130:1609-1623. [PMID: 37130195 DOI: 10.1177/00315125231174080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In overhead shooting athletes may have increased activity of the upper trapezius and inhibition of other shoulder muscles active during upper extremity elevation. In this study, we aimed to increase target retention and shoulder proprioception sense accuracy by taping in a way that would activate the lower trapezius muscle in elite adolescent archers. Our participants were 43 elite young athletes, aged 11-14 years, from the Archers Foundation Sports Club. We gathered athletes' sociodemographic information (age, height, weight, gender, the time they were engaged in archery, and other sports they were involved in), and we assessed their posture via the New York Posture Scale (NYPS) before taping. We evaluated them for the presence of scapular asymmetry using the Lateral Scapular Slide Test (LSST) and assessed their proprioception with the active displacement test and their target-reaching performances with the Archery Shooting Score (ASS). Since testing and scoring with the ASS is different for 11-12 and 13-14 age groups, we divided this sample into two different age groups for all analyses. There were significant changes in ASS and proprioception in both age groups, with medium to large effect sizes. There were between intragroup pre- and post-taping changes in classification according to the presence of scapular asymmetry, and there were significant changes in the archery shooting score and proprioception in both groups, with medium to large effect sizes (p < 0.05). Thus, taping applied to the lower part of the trapezius had a large to medium effect on proprioception and shooting accuracy improvement in these young archers.
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Affiliation(s)
- Eylul Pinar Kisa
- Division of Physiotherapy and Rehabilitation, Faculty of Health Science, Biruni University, Istanbul, Turkey
| | - Begum Kara Kaya
- Division of Physiotherapy and Rehabilitation, Faculty of Health Science, Biruni University, Istanbul, Turkey
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Haupmann M, Huang M, Selly G, Bagesterio L, Quintero D. Identifying a Upper-Limb Phase-Dependent Variable under Perturbations for Powered Prosthesis Arm Control. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-5. [PMID: 38082582 DOI: 10.1109/embc40787.2023.10340763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
This paper investigates upper-limb kinematic reaching responses during a mechanical perturbation to understand interjoint arm coordination used towards powered prosthesis control development. Common prosthesis arm controllers use electromyography sensors with data-driven models to decode muscle activation signals in controlling prosthesis joint movements. However, these control approaches produce non-natural, discrete movements with no guarantee the controller can react to unexpected disturbances during continuous task motion. Determining a continuous phase-dependent variable for measuring a human's progression during reaching can derive a time-invariant kinematic function to control the prosthesis joint in a natural, continuous manner. A perturbation experimental study was conducted across three participants in evaluating the shoulder and elbow joint kinematics to examine the existence of a phase shift during reaching. Experimental results demonstrated the effects of arm proximal-distal interjoint coordination that validated the proposed mechanical phase variable of the shoulder used in parameterizing elbow joint kinematic for reaching. This could allow for a continuous phase-based control strategy that can handle disturbances to achieve arm reaching in prosthesis control.
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