Barbro Larsson

Test–retest reliability of EMG and peak torque during repetitive maximum concentric knee extensions

The aim of this study was to investigate the reliability of peak torque and surface electromyography (EMG) variables root mean square (RMS) and mean frequency (MNF) during an endurance test consisting of repetitive maximum concentric knee extensions. Muscle fatigue has been quantified in several ways, and in isokinetic testing it is based on a set of repetitive contractions. To assess test-retest reliability, two sets of 100 dynamic maximum concentric knee extensions were performed using an isokinetic dynamometer. The two series were separated by 7-8 days. The subjects relaxed during the passive flexion phase. Twenty (10 men and 10 women) clinically healthy subjects volunteered. Peak torque and EMG from rectus femoris, vastus medialis, vastus lateralis and biceps femoris were recorded. RMS and MNF were calculated from the EMG signal. The reliability was calculated with intraclass correlation coefficient ICC (1.1) and standard error of measurements (SEM). The reliability of peak torque was good (ICC=0.93) and SEM showed low values. ICC was good for absolute RMS of rectus femoris (ICC>/=0.80), vastus medialis (ICC>/=0.88) and vastus lateralis (ICC>/=0.82) and MNF of rectus femoris (ICC>/=0.82) and vastus medialis (ICC>/=0.83). Peak torque, and MNF and RMS of rectus femoris and vastus medialis are reliable variables obtained from an isokinetic endurance test of the knee extensors.

The prevalences of cytochrome c oxidase negative and superpositive fibres and ragged-red fibres in the trapezius muscle of female cleaners with and without myalgia and of female healthy controls.

Abstract The association of cytochrome c oxidase negative fibres (COX‐negative) and ragged‐red fibres (RR‐fibres) with work related trapezius myalgia has been proposed. Hitherto studies have been small or without control groups. The aim of the present study was to investigate the prevalences of RR‐fibres and COX‐negative fibres in female cleaners with (n=25) and without (n=23) trapezius myalgia and in clinically healthy female teachers (n=21). The cleaners did mainly floor cleaning requiring monotonous loading on the trapezius muscle. A questionnaire covering background data and aspects of pain (prevalence, duration, intensity and influence on daily living) was answered. Biopsies were obtained from the trapezius muscle by an open surgical technique. The three groups did not differ in prevalence of COX‐negative or COX‐superpositive (i.e. type‐I fibres with extremely strong brownish reaction in both the COX and SDH/COX stainings) fibres. The prevalence of COX‐negative fibres was age dependent. Two subgroups of RR‐fibres were present when stained for COX; COX‐negative (73%) and COX‐superpositive (26%) fibres. Forty‐two percent of the COX‐negative fibres were RR‐fibres and 79% of the COX‐superpositive were RR‐fibres. A significantly (P=0.002) higher proportion of the COX‐superpositive fibres in the cleaners were RR‐fibres compared to the teachers. Multivariate regression analysis revealed that age, occupation as cleaner and a tender point in the trapezius were significantly associated with increased prevalences of RR‐fibres; a cleaner with a tender point had a 4.35 higher prevalence of RR‐fibres compared to a teacher without a tender point. No correlations between other pain related variables and prevalence of RR‐fibres were noted. In conclusion, RR‐fibres but not COX‐negative or COX‐superpositive fibres were correlated with cleaning work tasks and with a tender point in the trapezius.

An estimation of the influence of force decrease on the mean power spectral frequency shift of the EMG during repetitive maximum dynamic knee extensions

Frequency analysis of myoelectric (ME) signals, using the mean power spectral frequency (MNF), has been widely used to characterize peripheral muscle fatigue during isometric contractions assuming constant force. However, during repetitive isokinetic contractions performed with maximum effort, output (force or torque) will decrease markedly during the initial 40-60 contractions, followed by a phase with little or no change. MNF shows a similar pattern. In situations where there exist a significant relationship between MNF and output, part of the decrease in MNF may per se be related to the decrease in force during dynamic contractions. This study estimated force effects on the MNF shifts during repetitive dynamic knee extensions. Twenty healthy volunteers participated in the study and both surface ME signals (from the right vastus lateralis, vastus medialis, and rectus femoris muscles) and the biomechanical signals (force, position, and velocity) of an isokinetic dynamometer were measured. Two tests were performed: (i) 100 repetitive maximum isokinetic contractions of the right knee extensors, and (ii) five gradually increasing static knee extensions before and after (i). The corresponding ME signal time-frequency representations were calculated using the continuous wavelet transform. Compensation of the MNF variables of the repetitive contractions was performed with respect to the individual MNF-force relation based on an average of five gradually increasing contractions. Whether or not compensation was necessary was based on the shape of the MNF-force relationship. A significant compensation of the MNF was found for the repetitive isokinetic contractions. In conclusion, when investigating maximum dynamic contractions, decreases in MNF can be due to mechanisms similar to those found during sustained static contractions (force-independent component of fatigue) and in some subjects due to a direct effect of the change in force (force-dependent component of fatigue). In order to compare MNF shifts during sustained static and repetitive dynamic contractions it is necessary to estimate the force-dependent component of fatigue of dynamic contractions. Our results are preliminary and have to be confirmed in larger experiments using single dynamic contractions when determining the MNF-force relationship of the unfatigued situation.

Reproducibility of surface EMG variables and peak torque during three sets of ten dynamic contractions

The interpretation of the electromyogram (EMG) of dynamic contractions might be difficult because the movement per se introduces additional factors that could affect its characteristics. There is a lack of studies concerning the reproducibility of surface EMG registrations during dynamic contractions. The aim was to investigate the during-the-day reproducibility (using intra-class correlation; ICC) of the peak torque (PT) and the EMG variables (without removing the electrodes) of dynamic contractions. Ten healthy subjects performed three sets of 10 dynamic maximum right-knee extensions with a one-hour interval in between, using an isokinetic dynamometer and the PT was determined. EMG signals were recorded from the right vastus lateralis, rectus femoris and vastus medialis muscles using surface electrodes and the mean frequency of the power spectrum (MNF [Hz]) and the signal amplitude (RMS [microV]), were computed. The ability to relax in-between the maximum extensions was calculated as a ratio of the RMS during the passive flexion phase and the RMS during the active extension phase of each contraction cycle: the signal amplitude ratio (SAR). Both PT (ICC = 0.99) and RMS (ICC = 0.83-0.98) had good reproducibility. The reproducibility of MNF was good for all muscles when the mean of contraction nos.: 1-10 was used. Vastus lateralis had the highest ICC among the three muscles. The reproducibility of SAR was generally poor (ICC < 0.60). The present study showed good reproducibility for common EMG variables (MNF and RMS) obtained during maximum isokinetic contractions.

Mechanical performance and electromyography during repeated maximal isokinetic shoulder forward flexions in female cleaners with and without myalgia of the trapezius muscle and in healthy controls.

Abstract This cross-sectional study aimed at investigating the influence of occupational exposure to static and highly repetitive work involving the neck and shoulder muscles, myalgia of and tender point in the trapezius muscle on biomechanical output, and electromyogram (EMG) variables (mean frequency MNF, signal amplitude and ability to relax) during maximal forward flexions of the shoulder muscles. Groups of 25 cleaners suffering from chronic myalgia of the trapezius muscle, 25 cleaners free from myalgia of the trapezius muscle and 21 teachers performed 150 forward flexions using an isokinetic dynamometer. Perception of fatigue was reported and surface EMG was recorded from four muscles during the endurance test. The cleaners were stronger than the teachers. Myalgia was associated with lower levels of endurance and a high degree of perceived fatigue. The ability to relax the trapezius muscle decreased with age and was even lower in cleaners with and without myalgia. Higher MNF of the deltoid muscle but not of the trapezius muscle was found in the group suffering from myalgia compared to the groups free from myalgia. This cross-sectional study indicated that myalgia of the trapezius muscle did not influence the strength but did influence the endurance of the forward flexor muscles of cleaners. The observed decrease in the ability to relax the trapezius muscle in cleaners compared to healthy teachers might be indicative of a future insufficiency in the muscle. Prospective studies are needed to define the significance of the results presented here.

Intramuscular pain modulatory substances before and after exercise in women with chronic neck pain

In peripheral tissue, several substances influence pain and pain modulation. Exercise has been found to decrease pain and improve function for chronic pain conditions, but how and why exercise produces beneficial effects remains unclear. This study investigates whether aspects of pain and concentrations of substances with algesic, analgesic and metabolic functions differ between women with chronic neck shoulder pain (CNSP) and healthy women (CON) and whether changes are found after an exercise intervention for CNSP.

Movement-evoked breakthrough cancer pain despite intrathecal analgesia: a prospective series.

Intrathecal analgesia (ITA) is a valuable treatment option for intractable cancer‐related pain. However, the issue of movement‐evoked breakthrough pain (BTP) has not been specifically investigated in the ITA setting. The aim of the study was to evaluate the effect of ITA on spontaneous resting pain intensity (SRPI), doses of non‐ITA opioids, and specifically on movement‐evoked pain intensity (MEPI).