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Low back pain (LBP) patients show reorganized trunk muscle activity but if similar changes are manifest in recurrent LBP (R-LBP) patients during asymptomatic periods remains unknown. In 26 healthy and 27 currently asymptomatic R-LBP participants electromyographic activity (EMG) was recorded from trunk and gluteal muscles during series of stepping up and down on a step bench before and during experimentally intramuscular induced unilateral and bilateral LBP. Pain intensity was assessed using numeric rating scale (NRS) scores. Root mean square EMG (RMS-EMG) normalized to maximal voluntary contraction EMG and pain-evoked differences from baseline (ΔRMS-EMG) were analyzed. Step task duration was calculated from foot sensors. R-LBP compared with controls showed higher baseline RMS-EMG and NRS scores of experimental pain (P < .05). In both groups, bilateral compared with unilateral experimental NRS scores were higher (P < .001) and patients compared with controls reported higher NRS scores during both pain conditions (P < .04). In patients, unilateral pain decreased ΔRMS-EMG in the Iliocostalis muscle and bilateral pain decreased ΔRMS-EMG in all back and gluteal muscles during step tasks (P < .05) compared with controls. In controls, bilateral versus unilateral experimental pain induced increased step task duration and trunk RMS-EMG whereas both pain conditions decreased step task duration and trunk RMS-EMG in R-LBP patients compared with controls (P < .05)., Perspective: Task duration and trunk muscle activity increased in controls and decreased in R-LBP patients during experimental muscle LBP. These results indicate protective strategies in controls during acute pain whereas R-LBP patients showed higher pain intensity and altered strategies that may be caused by the higher pain intensity, but the long-term consequence remains unknown., (Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.)

Experimental muscle pain typically reorganizes the motor control. The pain effects may decrease when the three-dimensional force components are voluntarily adjusted, but it is not known if this could have negative consequences on other structures of the motor system. The present study assessed the effects of acute pain on the force variability during sustained elbow flexion when controlling task-related (one-dimensional) and all (three-dimensional) contraction force components via visual feedback. Experimental muscle pain was induced by bolus injection of hypertonic saline into m. biceps brachii, and isotonic saline was used as control. Twelve subjects performed sustained elbow flexion at different levels of the maximal voluntary contraction (5-30% MVC) before, during, and after the injections. Three-dimensional force components were measured simultaneously with surface electromyography (EMG) from elbow flexors and auxiliary muscles. Results showed that force variability was increased during pain compared to baseline for contractions using one-dimensional feedback (P<.05), but no significant differences were found for three-dimensional feedback. During painful contractions (1) EMG activity from m. trapezius was increased during contractions using both one-dimensional and three-dimensional feedback (P<.05), and (2) the complexity of EMG from m. triceps brachii and m. deltoid was higher for the three-dimensional feedback (P<.05). In conclusion, the three-dimensional feedback reduced the pain-related functional distortion at the cost of a more complex control of synergistic muscles., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The aim of this study was to quantify the effects of spatial reorganisation of muscle activity on task-related and tangential components of force variability during sustained contractions. Three-dimensional forces were measured from isometric elbow flexion during submaximal contractions (50s, 5-50% of maximal voluntary contraction (MVC)) and total excursion of the centre of pressure was extracted. Spatial electromyographic (EMG) activity was recorded from the biceps brachii muscle. The centroids of the root mean square (RMS) EMG and normalised mutual information (NMI) maps were computed to assess spatial muscle activity and spatial relationship between EMG and task-related force variability, respectively. Result showed that difference between the position of the centroids at the beginning and at the end of the contraction of the RMS EMG and the NMI maps were different in the medial-lateral direction (P<0.05), reflecting that muscle regions modulate their activity without necessarily modulating the contribution to the task-related force variability over time. Moreover, this difference between shifts of the centroids was positively correlated with the total excursion of the centre of pressure at the higher levels of contractions (>30% MVC, R(2)>0.30, P<0.05), suggesting that changes in spatial muscle activity could impact on the modulation of tangential forces. Therefore, within-muscle adaptations do not necessarily increase force variability, and this interaction can be quantified by analysing the RMS EMG and the NMI map centroids., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Unlabelled: The aim of this study was to evaluate intramuscular muscle activity from a latent myofascial trigger point (MTP) in a synergistic muscle during isometric muscle contraction. Intramuscular activity was recorded with an intramuscular electromyographic (EMG) needle inserted into a latent MTP or a non-MTP in the upper trapezius at rest and during isometric shoulder abduction at 90° performed at 25% of maximum voluntary contraction in 15 healthy subjects. Surface EMG activities were recorded from the middle deltoid muscle and the upper, middle, and lower parts of the trapezius muscle. Maximal pain intensity and referred pain induced by EMG needle insertion and maximal pain intensity during contraction were recorded on a visual analog scale. The results showed that higher visual analog scale scores were observed following needle insertion and during muscle contraction for latent MTPs than non-MTPs (P < .01). The intramuscular EMG activity in the upper trapezius muscle was significantly higher at rest and during shoulder abduction at latent MTPs compared with non-MTPs (P < .001). This study provides evidence that latent MTPs are associated with increased intramuscular, but not surface, EMG amplitude of synergist activation. The increased amplitude of synergistic muscle activation may result in incoherent muscle activation pattern of synergists inducing spatial development of new MTPs and the progress to active MTPs., Perspective: This article presents evidence of increased intramuscular, but not surface, muscle activity of latent MTPs during synergistic muscle activation. This incoherent muscle activation pattern may overload muscle fibers in synergists during muscle contraction and may contribute to spatial pain propagation., (Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Synchronization between single motor unit (SMU) discharges in separate muscles has been estimated from peaks in averaged electromyographic (EMG) recordings from one muscle triggered from SMU discharge in another. This study evaluated the effect of EMG signal cancellation on this measure of synchronization. SMU activity was recorded with 8 fine-wire electrodes in vastus medialis obliquus (VMO) and vastus lateralis (VL) during gentle isometric knee extension in 7 subjects. Data from 5 VL recordings were summed then rectified, or rectified then summed, to produce multi-unit recordings with and without cancellation, respectively. Averages of summed VL data were triggered from VMO SMUs. Synchronization, defined as a peak >3 SD above the triggered average mean, occurred in 73.68% and 78.95% of recordings with and without cancellation, respectively. To further investigate the effect of cancellation on synchronization, 250 "virtual" EMG recordings were created from VL data. VL SMUs were sorted and modified with respect to discharge rate, amplitude and polarity to create a collection of possible SMU discharge patterns. Virtual recordings were added one-by-one to VL recordings that showed synchronization. Virtual channels were rectified then added or added then rectified, to create data with and without cancellation. Identification of synchronization decreased similarly in both conditions with addition of virtual data. Our data show estimation of synchronization from triggered averages is more likely to detect synchronization in recordings with fewer SMUs, but cancellation has little effect. Synchronization must be interpreted with caution if number of SMUs changes between conditions.

The motor unit twitch torque is modified by sustained contraction, but the association to changes in muscle fiber electrophysiological properties is not fully known. Thus twitch torque, muscle fiber conduction velocity, and action potential properties of single motor units were assessed in 11 subjects following an isometric submaximal contraction of the tibialis anterior muscle until endurance. The volunteers activated a target motor unit at the minimum discharge rate in eight 3-min-long contractions, three before and five after an isometric contraction at 40% of the maximal torque, sustained until endurance. Multichannel surface electromyogram signals and joint torque were averaged with the target motor unit potential as trigger. Discharge rate (mean +/- SE, 6.6 +/- 0.2 pulses/s) and interpulse interval variability (33.3 +/- 7.0%) were not different in the eight contractions. Peak twitch torque and recruitment threshold increased significantly (93 +/- 29 and 12 +/- 5%, P <0.05) in the contraction immediately after the endurance task with respect to the preendurance values (0.94 +/- 0.26 mN.m and 3.7 +/- 0.5% of the maximal torque), whereas time to peak of the twitch torque did not change (74.4 +/- 10.1 ms). Muscle fiber conduction velocity decreased and action potential duration increased in the contraction after the endurance (6.3 +/- 1.8 and 9.8 +/- 1.8%, respectively, P <0.05; preendurance values, 3.9 +/- 0.2 m/s and 11.1 +/- 0.8 ms), whereas the surface potential peak-to-peak amplitude did not change (27.1 +/- 3.1 microV). There was no significant correlation between the relative changes in muscle fiber conduction velocity or surface potential duration and in peak twitch torque (R2= 0.04 and 0.10, respectively). In conclusion, modifications in peak twitch torque of low-threshold motor units with sustained contraction are mainly determined by mechanisms not related to changes in action potential shape and in its propagation velocity.

The aim of this human study was to investigate the effect of experimentally induced muscle pain on the modifications of motor unit discharge rate during sustained, constant-force contractions. Intramuscular and multichannel surface electromyographic (EMG) signals were collected from the right and left tibialis anterior muscle of 11 volunteers. The subjects performed two 4-min-long isometric contractions at 25% of the maximal dorsiflexion torque, separated by a 20-min rest. Before the beginning of the second contraction, hypertonic (painful; right leg) or isotonic (nonpainful; left leg) saline was injected into the tibialis anterior. Pain intensity scores did not change significantly in the first 150 s of the painful contraction. Exerted torque and its coefficient of variation were the same for the painful and nonpainful contractions. Motor unit discharge rate was higher in the beginning of the nonpainful contraction than the painful contraction on the right side [means +/- SE, 11.3 +/- 0.2 vs. 10.6 +/- 0.2 pulses/s (pps); P < 0.01] whereas it was the same for the two contractions on the left side (11.6 +/- 0.2 vs. 11.5 +/- 0.2 pps). The decrease in discharge rate in 4 min was smaller for the painful (0.4 +/- 0.1 pps) than for the control contractions (1.3 +/- 0.1 pps). Initial value and decrease in motor unit conduction velocity were not different in the four contractions (right leg, 4.0 +/- 0.1 m/s with decrease of 0.6 +/- 0.1 m/s in 4 min; left leg, 4.1 +/- 0.1 m/s with 0.7 +/- 0.1 m/s decrease). In conclusion, stimulation of nociceptive afferents by injection of hypertonic saline did not alter motor unit conduction velocity but reduced the initial motor unit discharge rates and the difference between initial and final discharge rates during sustained contraction.

The objectives of this work were to determine optimal surface electromyogram (EMG) electrode locations, and inter-electrode distance (IED), when assessing activity and fatigue in the human upper trapezius muscle. Surface EMG signals were recorded from the upper trapezius muscle of 11 healthy male subjects using a linear array of 16 surface electrodes. Five arm positions were investigated (arms at the side of the body, 45 degrees and 90 degrees flexion, 45 degrees and 90 degrees abduction). Fatiguing (1 kg hand load held for 3 min) and non-fatiguing (no load, 0.5 kg and 1 kg hand load held for 3 s) contractions were made. The variabilities of the average rectified value, root mean square, mean and median power spectral frequency and slope over time of these parameters as functions of electrode location and IED (from 5 mm over a range of 35 mm in steps of 5 mm) were quantitatively evaluated. A criterion for selecting the optimal electrode position was applied. This criterion indicated an optimal location measured from the acromion (38% of the distance from the lateral edge of acromion to the spine of the seventh cervical vertebra) which was statistically the same for all the EMG descriptors, arm positions and IED investigated. Finally, it was found that both EMG variables and indexes of muscle fatigue depended on IED which should thus be properly standardised. On the basis of the sensitivity of the EMG descriptors to electrode location and cross-talk reduction, an IED of 20 mm is suggested when a global analysis of activity in the upper trapezius muscle is made using a single pair of electrodes. This study emphasises that a surface EMG analysis of the upper trapezius muscle, following a proper placement of the electrodes and selection of IED, can give reliable indications of muscle activity and fatigue. Data on the myoelectric manifestations of muscle fatigue of the upper trapezius muscle are provided for the optimal electrode location.

Unlabelled: Low back pain changes trunk muscle activity after external perturbations but the relationship between pain intensities and distributions and their effect on trunk muscle activity remains unclear. The effects of unilateral and bilateral experimental low back pain on trunk muscle activity were compared during unpredictable multidirectional surface perturbations in 19 healthy participants. Pain intensity and distribution were assessed using a visual analogue scale (VAS) and pain drawings. Root mean square (RMS) of the electromyographic (EMG) signals from 6 trunk muscles bilaterally after each perturbation was extracted and averaged across perturbations. The difference (ΔRMS-EMG) and absolute difference (absolute ΔRMS-EMG) RMS from baseline conditions were extracted for each muscle during pain conditions and averaged bilaterally for back and abdominal muscle groups. Bilateral compared with unilateral pain induced higher VAS scores (P < .005) and larger pain areas (P < .001). Significant correlation was present between VAS scores and muscle activity during unilateral (P < .001) and bilateral pain (P < .001). Compared with control injections ΔRMS-EMG increased in the back (P < .03) and abdominal (P < .05) muscles during bilateral and decreased in the back (P < .01) and abdominal (P < .01) muscles during unilateral pain. Bilateral pain caused greater absolute ΔRMS-EMG changes in the back (P < .01) and abdominal (P < .01) muscle groups than unilateral pain.Perspective: This study provided novel observations of differential trunk muscle activity in response to perturbations dependent on pain intensity and/or pain distribution. Because of complex and variable changes the relevance of clinical examination of muscle activity during postural tasks is challenged. [ABSTRACT FROM AUTHOR]

Pain elicits complex adaptations of motor strategy, leading to impairments in the generation and control of steady forces, which depend on muscle architecture. The present study used a cross-over design to assess the effects of muscle pain on the stability of multidirectional (task-related and tangential) forces during sustained dorsiflexions, elbow flexions, knee extensions, and plantarflexions. Fifteen healthy subjects performed series of isometric contractions (13-s duration, 2.5, 20, 50, 70% of maximal voluntary force) before, during, and after experimental muscle pain. Three-dimensional force magnitude, angle and variability were measured while the task-related force was provided as feedback to the subjects. Surface electromyography was recorded from agonist and antagonist muscles. Pain was induced in agonist muscles by intramuscular injections of hypertonic (6%) saline with isotonic (0.9%) saline injections as control. The pain intensity was assessed on an electronic visual analogue scale. Experimental muscle pain elicited larger ranges of force angle during knee extensions and plantarflexions ( P < 0.03) and higher normalized fluctuations of task-related ( P < 0.02) and tangential forces ( P < 0.03) compared with control assessments across force levels, while the mean force magnitudes, mean force angle and the level of muscle activity were non-significantly affected by pain. Increased multidirectional force fluctuations probably resulted from multiple mechanisms that, acting together, balanced the mean surface electromyography. Although pain adaptations are believed to aim at the protection of the painful site, the current results show that they result in impairments in steadiness of force. [ABSTRACT FROM AUTHOR]

Abstract: The orientation of the resultant force during a given contraction depends on the architecture of the muscles involved, and cooperation among muscles may induce force fluctuations in multiple directions. A novel setup for recording three-dimensional forces was developed to assess the effects of muscle fatigue on submaximal contractions. Fifteen subjects performed isometric dorsiflexions, elbow flexions, knee extensions, plantarflexions, and trunk extensions (12s, 2.5–80% of maximal voluntary force) before and after a fatigue protocol. Electromyography (EMG) was recorded from relevant muscles. The standard deviation of force in the three directions and the agonist EMG amplitude increased with target force (p <.045), while the coefficient of variation of force and total excursions of the center of pressure showed maximal values at low target forces, reaching a plateau at moderate forces. Fatigue induced higher force fluctuations in task-related and tangential directions and increased agonist EMG amplitude for all muscle groups (p <.04). Fluctuations of tangential forces were greater during knee extensions compared with other muscle groups (p <.007). The present data demonstrate that fatigue increases the amplitude of force fluctuations in task-related and tangential forces. Moreover, alternation of activity between multiple synergist muscles is associated with increased fluctuations of tangential forces, especially during fatigue. [Copyright &y& Elsevier]

The objective of this study was to examine the effect of experimental knee-related pain on postural control. Twelve healthy subjects stood as quietly as possible on a movable force platform (that measured the centre of pressure and provided fast perturbations) before, during, and after experimental knee-related pain. Lower limb electromyographic (EMG) activity and joint angles were measured. Experimental pain was induced by injecting hypertonic saline into the infrapatellar fat pad (unilateral and bilateral) and isotonic saline was used for control sessions. Compared with the baseline and control sessions, unilateral and bilateral knee-related pain during quiet standing evoked (1) an increased sway displacement in the anterior-posterior direction ( P < 0.05), (2) larger knee flexion ( P < 0.05), and (3) larger EMG changes. Bilateral pain also induced (1) larger medial-lateral sway displacement and speed ( P < 0.05) and (2) larger left hip flexion ( P < 0.05). During forward perturbations, subjects leaned forward during both painful conditions when compared with baseline ( P < 0.05). The additional impairment by bilateral pain suggests that the non-painful limb in unilateral pain conditions compensates for the impaired postural control. These results show that knee-related pain impairs postural stability during quiet standing, indicating the vulnerability of patients with knee pain to falls. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient's postural control and stability during quiet standing. [ABSTRACT FROM AUTHOR]

Background Achilles tendinopathies are characterised by pain and reduced function, and heavy-load exercises have been shown to be effective in the treatment of painful chronic Achilles tendinopathies. However, basic information is needed on how the biomechanics and neuromuscular control of the exercise are affected by Achilles tendon pain. Objective The authors aimed to determine the effects of experimental Achilles tendon pain on motor function during one-legged weight bearing ankle plantar and dorsal flexion exercises. Methods In a crossover study, with 16 healthy subjects tested on two different days separated by 1 week, three-dimensional ground reaction forces, ankle joint kinematics and surface electromyography (EMG) of the lower leg muscles were recorded during one-legged full weight-bearing ankle plantar (concentric) and dorsal (eccentric) flexion exercises. Measurements were done before, during and after either experimental Achilles tendon pain or a non-painful control condition. Pain was induced by intratendinous injections of hypertonic saline with isotonic saline injections as control. Joint kinematics, ground reaction force frequency contents and average EMG amplitudes were calculated. Results Compared with the control condition experimental Achilles tendon pain reduced the EMG activity in agonistic, synergistic and antagonistic muscles, and increased the ground reaction force frequency content around 10 Hz, during both eccentric and concentric movement phases. Conclusions These data show that experimental Achilles tendon pain causes widespread and reduced motor responses with functional effects on the ground reaction force. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to investigate the force and electromyographic (EMG) signal recorded from the muscles immediately after a sustained fatiguing contraction with or without muscle pain. Ten subjects performed sustained dorsi- and plantarflexions at two contraction levels (50 and 80% of maximum voluntary contraction) until exhaustion with or without muscle pain induced by injection of 6% hypertonic saline in one of the torque producing muscles. The muscle pain intensity was scored on a visual analogue scale (VAS, 0–10 cm). The root mean square (RMS) of the surface EMG signal from plantarflexors and dorsiflexors were estimated during maximum voluntary contractions (MVC) and ramp contractions before and after the fatiguing task at 0, 5, 10 and 15 min during the recovery phase. VAS scores immediately after the contractions with hypertonic saline (on average 3.2 ± 1.1 cm) progressively decreased during recovery and no pain was experienced 15 min after the contraction. After the painful contraction the RMS-EMG during MVC was on average decreased (23.4 ± 7.4%) compared to the non-painful condition both in muscles where pain was previously induced and in non-painful synergists. During recovery, the slope of the torque–EMG curve during ramp contraction was significantly decreased (28.4 ± 8.1%) after the painful contraction compared to the control contraction both for the muscle previously exposed to pain and also the other active synergists. The decreased EMG during recovery after painful contractions compared with control was not accompanied by significant reductions in force during MVC indicating a change in the strategy for motor unit recruitment. This study shows that localized muscle pain inhibits muscle activation and increases the effects of fatigue on EMG recovery curves both for painful and non-painful synergists probably by a central effect. These effects can modify the normal patterns of synergistic activation and can also generate overload problems in muscle pain patients if compensatory motor control strategies are applied. [ABSTRACT FROM AUTHOR]

The aim of the study was to jointly analyze temperature-induced changes in low-threshold single motor unit twitch torque and action potential properties. Joint torque, multichannel surface, and intramuscular electromyographic signals were recorded from the tibialis anterior muscle of 12 subjects who were instructed to identify the activity of a target motor unit using intramuscular electromyographic signals as feedback. The target motor unit was activated at the minimum stable discharge rate in seven 3-min-long contractions. The first three contractions (C1-C3) were performed at 33°C skin temperature. After 5 min, the subject performed three contractions at 33°C (T1), 39°C (T2), and 45°C (T3), followed by a contraction at 33°C (C4) skin temperature. Twitch torque and multichannel surface action potential of the target motor unit were obtained by spike-triggered averaging. Discharge rate (mean ± SE, 7.1 ± 0.5 pulses/s), interpulse interval variability (35.8 ± 9.2%), and recruitment threshold (4.5 ± 0.4% of the maximal voluntary torque) were not different among the seven contractions. None of the investigated variables were different among C1-C3, T1, and C4. Conduction velocity and peak twitch torque increased with temperature (P < 0.05; T1: 3.53 ± 0.21 m/s and 0.82 ± 0.23 mN·m, T2: 3.93 ± 0.24 m/s and 1.17 ± 0.36 mN·m, T3: 4.35 ± 0.25 m/s and 1.46 ± 0.40 mN·m, respectively). Twitch time to peak and surface action potential peak-to-peak amplitude were smaller in T3 (61.8 ± 2.0 ms and 27.4 ± 5.1 ±V, respectively) than in T1 (71.9 ± 4.1 ms and 35.0 ± 6.5 µV, respectively) (P < 0.05). The relative increase in conduction velocity between T1 and T3 was positively correlated (P < 0.05) with the increase in twitch peak amplitude (r² = 0.48), with the decrease in twitch time to peak (r² = 0.43), and with the decrease in action potential amplitude (r² = 0.50). In conclusion, temperature-induced modifications in fiber membrane conduction properties may have a direct effect on contractile motor unit properties. [ABSTRACT FROM AUTHOR]

The aim of this human study was to investigate the relationship between experimentally induced muscle pain intensity (i.e., amount of nociceptive activity) and motor unit (MU) firing decrease and MU conduction velocity (CV). In 12 healthy subjects, nociceptive afferents were stimulated in the right tibialis anterior muscle by three intramuscular injections of hypertonic saline (0.2, 0.5, and 0.9 ml) separated by 140 s. The subjects performed six isometric contractions (20 s long) at 10% of the maximal voluntary contraction during the experimental muscle pain. The same set of six contractions was performed without any infusion before the painful condition on the right leg. The procedure was repeated for the left leg with infusion of isotonic (nonpainful) saline. Intramuscular and surface electromyographic (EMG) signals were collected to assess MU firing rate and CV. The firing rate of the active MUs [range: 7.4-14.8 pulses/s (pps)] did not change significantly in the three control conditions (without infusion for the right and left leg and with infusion of isotonic saline in the left leg). There was, on the contrary, a significant decrease (on average, mean +/- SE, 1.03 +/- 0.21 pps) of the firing rates during the painful condition. Moreover, MU firing rates were inversely significantly correlated with the subjective scores of pain intensity. Single MU CV was 3.88 +/- 0.03 m/s (mean +/- SE, over all the MUs) with no statistical difference among any condition, i.e., the injection of hypertonic saline did not alter the muscle fiber membrane properties of the observed MUs. Progressively increased muscle pain intensity causes a gradual decrease of MU firing rates. This decrease is not associated with a change in MU membrane properties, indirectly assessed by CV. This study demonstrates a central inhibitory motor control mechanism with an efficacy correlated to the nociceptive activity. [ABSTRACT FROM AUTHOR]

Many spatial filters have been proposed for surface electromyographic (EMG) signal detection. Although theoretical and modeling predictions on spatial selectivity are available, there are no extensive experimental validations of these techniques based on single motor unit (MU) activity detection. The aim of this study was to compare spatial selectivity of one- and two-dimensional (1-D and 2-D) spatial filters for EMG signal detection. Intramuscular and surface EMG signals were recorded from the tibialis anterior muscle of ten subjects. The simultaneous use of intramuscular wire and surface recordings (with the spike triggered averaging technique) allowed investigation of the activity of single MUs at the skin surface. The surface EMG signals were recorded with a grid of point electrodes (3 × 3 electrodes) and a ring electrode system at 15 locations over the muscle, with the wires detecting signals from the same intramuscular location. For most subjects, it was possible to classify, from the intramuscular recordings, the activity of the same MUs for all the contractions. The surface EMG signals were averaged with the intramuscularly detected MU action potentials as triggers. In this way, eight spatial filter—longitudinal and transversal, single and double differential (LSD, TSD, LDD, TDD), Laplacian (NDD), inverse binomial filter of the second order (IB2), inverse rectangle filter (IR), and differential ring system (C1)-could be compared on the basis of their spatial selectivity. The distance from the source (transversal with respect to the muscle fiber orientation) after which the surface detected potential did not exceed ±5% of the maximal peak-to-peak amplitude (detection distance) was statistically smaller for the 2-D systems and TDD than for the other filters. The MU action potential duration was significantly shorter with LDD and with the 2-D systems than with the other filters. The 2-D filters investigated (including C1) showed very... [ABSTRACT FROM AUTHOR]

A heteronymous H reflex in the temporalis muscle can be elicited by selective stimulation of the masseteric nerve. The present study aimed at defining the optimal amplitude of the H reflex to detect inhibitory changes induced by stimulation of the perioral afferents and at providing new information on the control of masticatory muscles. Sixteen healthy volunteers participated in the experiment. A conditioning stimulus (CS) to the perioral skin was applied at various delays before an ipsilateral selective masseteric nerve stimulation (test stimulus: TS) while the subject was clenching the teeth at 25% of the maximal voluntary contraction. Two intensities of CS and TS were employed, high and low. The peak-to-peak amplitude of the H reflex (TS) and the root-mean-square value of the preceding electromyography were measured and the data analyzed by three-way analysis of variance and Tukey's posthoc tests. For both intensities used the heteronymous H reflex in the temporalis muscle was significantly decreased by prior activation of perioral afferents for delays from 5 to 60 ms. With a delay of 5 and 35 ms the preceding EMG level was not changed, while it was reduced at 20 and 60 ms delay. The intensities used to elicit the heteronymous H reflex of the temporalis muscle were appropriate to detect a reduction in motoneuron excitability. The reduction in the H reflex without a change in the preceding EMG at 5 and 35 ms delays could be due to presynaptic inhibition of the masseteric afferents exerted by the ipsilateral perioral afferents. [ABSTRACT FROM AUTHOR]

The aim was to investigate the influence of experimental muscle pain on performance and upper extremity muscle activity during occupational work requiring different levels of precision. Experimental muscle pain was induced by infusing hypertonic saline (0.3 ml, 5% NaCl) into the extensor carpi ulnaris (ECU) muscle. The same amount of isotonic saline was infused on a separate day to act as a control. Tasks requiring use of a computer mouse with high and low levels of precision were performed during the two sessions. Electromyographic (EMG) activity was measured from the ECU, the flexor carpi radialis (FCR) and the trapezius muscles. A group of 13 men participated in the study. Performance measured as work cycle time, cursor movements on the screen, and velocity of cursor movement were unaffected by muscle pain. The ECU muscle pain did not modulate EMG profiles of either the trapezius or FCR muscles – either during high or during low precision work. During the low precision work the painful ECU muscle showed lower EMG activity in specific phases of the work cycle (highest activity phases) compared to the control session (P < 0.05), whereas during the high precision work, experimental pain had no effect on the activity of the ECU muscle. In conclusion experimental muscle pain seems to modulate motor control differently depending on the precision level of the task. This may be of importance for our understanding of why some tasks lead to chronic musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Abstract: Automated movements adjusting postural control may be hampered during musculoskeletal pain leaving a risk of incomplete control of balance. This study investigated the effect of experimental muscle pain on anticipatory postural adjustments by reaction task movements. While standing, nine healthy males performed two reaction time tasks (shoulder flexion of dominant side and bilateral heel lift) before, during and after experimental muscle pain. On two different days experimental pain was induced in the m. vastus medialis (VM) or the m. tibialis anterior (TA) of the dominant side by injections of hypertonic saline (1ml, 5.8%). Isotonic saline (1ml, 0.9%) was used as control injection. Electromyography (EMG) was recorded from 13 muscles. EMG onset, EMG amplitude, and kinematic parameters (shoulder and ankle joint) were extracted. During shoulder flexion and VM pain the onset of the ipsilateral biceps femoris was significantly faster than baseline and post injection sessions. During heels lift in the VM and TA pain conditions the onset of the contralateral TA was significantly faster than baseline and post injection sessions in bilateral side. VM pain significantly reduced m. quadriceps femoris activity and TA pain significantly reduced ipsilateral VM activity and TA activity during bilateral heel lift. The EMG reaction time was delayed in bilateral soleus muscles during heels lift with VM and TA pain. The faster onset of postural muscle activity during anticipatory postural adjustments may suggest a compensatory function to maintain postural control whereas the reduced postural muscle activity during APAs may indicate a pain adaptation strategy to avoid secondary damage. [Copyright &y& Elsevier]

Background: The purpose of this study was to evaluate how acute pain changes the postural control and stability during quiet standing and after unexpected perturbations. Methods: Nine subjects stood as quiet as possible on a movable force platform that recorded the centre of pressure position and provided unexpected floor perturbations, before, during and after experimental calf muscle pain. Bilateral surface electromyography from the tibialis anterior and medial gastrocnemius muscles was recorded. The foot pressure distributions were measured using pressure insoles. Intramuscular injections of hypertonic saline were administrated (right leg) to induce acute pain in the tibialis anterior and/or medial gastrocnemius muscles, and an isotonic injection was used as control. Findings: Simultaneous pain in tibialis anterior and medial gastrocnemius altered the postural control. During quiet standing: higher medial-lateral centre of pressure speed and increased total sway displacement (P <0.05), weight moved to the non-painful side, (P <0.05) and plantar centre of pressure of the left foot was shifted towards the heel’s direction (P <0.05). During forward perturbation: higher mean displacement in the medial-lateral direction (P <0.05). After the perturbation: larger sway area (P <0.05). Pain only in the medial gastrocnemius muscle increased medial-lateral centre of pressure speed (P <0.05) during the quiet standing. Pain only in the tibialis anterior muscle increased peak pressure on the contralateral foot (P <0.05). Interpretation: These findings suggest that large acute painful areas on the calf muscles impair the postural control and potentially increase the risk factors for falls. Further strategies aiming to reduce pain in patients may lead to improvement in balance. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this human study was to investigate if voluntary EMG activity and supra-maximal M-wave are affected by injection of hypertonic saline to experimentally induce muscle pain. Methods: Surface EMG signals were recorded with an electrode array from the tibialis anterior muscle of 12 subjects. Two sets of 6 contractions, 3 electrically elicited and 3 voluntary (30% of the maximal force), alternated, were performed with each leg. During the second set of 6 contractions, hypertonic (painful; right leg) or isotonic (non-painful; left leg) saline was injected 3 times (0.2, 0.5, 0.9ml), separated by 140s, into the tibialis anterior. Results: In the voluntary contractions, EMG average rectified value (ARV) significantly decreased (mean±SE, 13.2±4.2%) with increasing pain, although the exerted torque was unaltered. Conduction velocity (CV) (4.2±0.2 and 4.4±0.3m/s, right and left leg, respectively) and mean power spectral frequency (MPF) (119.0±8.4 and 119.5±8.9Hz) were not affected by the injection of hypertonic saline. In the electrically elicited contractions, M-wave CV (4.6±0.3 and 4.7±0.2m/s), ARV (748.6±101.8 and 822.3±104.4μV), and MPF (72.0±5.1 and 76.9±4.8Hz) did not change with pain. Conclusions: Injection of hypertonic saline did not change muscle fiber conduction velocity or impaire neuromuscular transmission. The decrease in voluntary EMG activity with injection of hypertonic saline was thus due to central factors. Significance: The injection of hypertonic saline provides a model for exciting nociceptive afferents without affecting muscle fiber electrophysiological properties. [Copyright &y& Elsevier]

Musculoskeletal pain is associated with altered motor control that, despite short-term benefit, is hypothesised to have long-term consequences, contributing to the development of chronic pain. However, data on how motor control is altered when pain is sustained beyond a transient event are scarce. Here, we investigated motor adaptation, and its relationship with corticomotor excitability, in the transition to sustained muscle pain. Twenty-eight healthy individuals were injected with nerve growth factor into the right extensor carpi radialis brevis muscle on days 0 and 2. Motor adaptation and corticomotor excitability were assessed on day -2, before injection on days 0 and 2, and again on days 4 and 14. Motor adaptation was quantified during a radial-ulnar movement as kinematic variability of wrist flexion-extension and pronation-supination, and as electromyographic (EMG) variability of extensor carpi radialis brevis activity. Pain, muscle soreness, and functional limitation were assessed from days 0 to 14. Pain, muscle soreness, and functional limitation were evident at days 2 and 4 (P < 0.001). Electromyographic variability reduced at days 4 and 14 (P < 0.04), with no change in kinematic variability (P = 0.9). However, data revealed variation in EMG and kinematic variability between individuals: some displayed increased motor variability, whereas others a decrease. Individuals who displayed an increase in EMG variability after 4 days of pain also displayed an increase in corticomotor excitability (r = 0.43, P = 0.034). These findings suggest individual adaptation of the motor system in the transition to sustained pain that could have implications for clinical musculoskeletal pain disorders. [ABSTRACT FROM AUTHOR]

Sitting posture may contribute to spinal pain. Effects of postures on pain, sensitivity and muscle activity during computer tasks were investigated. Twenty-five healthy participants, seated at a workstation without backrest, completed four, 15-min typing tasks: A)Upright with forearm-support; B)Upright without forearm-support; C)Slumped with forearm-support; D)Slumped without forearm-support. Participants rated pain every minute on a numerical rating scale (NRS). RMS-EMG was recorded from upper/lower trapezius (UT, LT), serratus anterior and anterior/middle deltoid. At baseline and after tasks, pressure pain thresholds (PPTs) were recorded bilaterally over the head, UT, and leg. All tasks caused clinically relevant increased NRS (≥2/10) compared to baseline (P < 0.001). NRS was higher in Task-D (P < 0.003) and lower in Task-B (P < 0.005) than others. PPTs did not change from baseline. Task-D caused higher UT and LT RMS-EMG (P < 0.02) than other tasks. A 15-min task caused pain irrespective of posture with some causing larger changes than others. • A standardized computer task caused pain irrespective of posture. • Some postures increased pain and muscle activity more than others. • Time in a given posture may be of greater importance than the posture itself. [ABSTRACT FROM AUTHOR]