Effects of low load exercise with and without blood-flow restriction on microvascular oxygenation, muscle excitability and perceived pain.

This paper aimed to examine the acute effect of low-load (LL) exercise with blood-flow restriction (LL-BFR) on microvascular oxygenation and muscle excitability of the vastus medialis (VM) and vastus lateralis (VL) muscles during a single bout of unilateral knee extension exercise performed to task failure. Seventeen healthy recreationally resistance-trained males were enrolled in a within-group randomized cross-over study design. Participants performed one set of unilateral knee extensions at 20% of one-repetition maximum (1RM) to task failure, using a LL-BFR or LL free-flow (LL-FF) protocol in a randomized order on separate days. Changes in microvascular oxygenation and muscle excitability in VL and VM were assessed using near-infrared spectroscopy (NIRS) and surface electromyography (sEMG), respectively. Pain measures were collected using the visual analog scale (VAS) before and following set completion. Within- and between- protocol comparisons were performed at multiple time points of set completion for each muscle. During LL-BFR, participants performed 43% fewer repetitions and reported feeling more pain compared to LL-FF (p<0.05). Normalized to time to task failure, LL-BFR and LL-FF generally demonstrated similar progression in microvascular oxygenation and muscle excitability during exercise to task failure. The present results demonstrate that LL-BFR accelerates time to task failure, compared with LL-FF, resulting in a lower dose of mechanical work to elicit similar levels of oxygenation, blood-pooling, and muscle excitability. LL-BFR may be preferable to LL-FF in clinical settings where high workloads are contraindicated, although increased pain experienced during BFR may limit its application.HighlightsCompared to free flow (FF), neuromuscular fatigue mechanisms are accelerated during blood flow restricted (BFR) training. This can be observed as changes in microvascular oxygenation and muscle excitability occurring at a ∼43% faster mean rate during BFR compared to FF.BFR exercise seems to elicit the same level of neuromuscular fatigue as FF training within a shorter timeframe. This reduces total joint load and may be especially helpful in cases where high training volumes may be contraindicated (e.g. recovering from a sports injury or orthopedic surgery).

Assessment of shoulder rotation strength, muscle co-activation and shoulder pain in tetraplegic wheelchair athletes - A methodological study.

Objective: To develop a feasible protocol for testing maximum shoulder rotation strength in tetraplegic wheelchair athletes, and investigate concurrent validity of maximum isometric handheld dynamometer (HHD) towards maximum isokinetic dynamometer (ID) strength measurements; secondly, to study shoulder muscle activation during maximum shoulder rotation measurements, and the association between shoulder strength and shoulder pain.Design: Descriptive methodological.Setting: Danish Wheelchair Rugby (WCR) association for WCR tetraplegic athletes from local WCR-clubs.Participants: Twelve adult tetraplegics.Interventions: N/A.Outcome measures: Wheelchair User's Shoulder Pain Index (WUSPI) and Visual Analog Scale (VAS) measured shoulder pain, isometric HHD and ID (60°/s) measured maximum internal (IR) and external (ER) shoulder rotation strength. Surface Electromyography normalized to maximum EMG measured muscle activity (mm Infraspinatus and Latissimus Dorsi) during maximum shoulder rotation strength.Results: Concurrent validity of isometric HHD towards ID showed Concordance Correlation Coefficients of left and right arms 0.90 and 0.86 (IR), and 0.89 and 0.91 (ER), with no difference in muscle activity between isometric HHD and ID, but larger co-activation during ER. There was no association between shoulder strength and pain, except for significantly weak negative associations between ID and pain during ER for left and right arms (P = 0.03; P = 0.04).Conclusion: Standardized feasible protocol for tetraplegic wheelchair athletes for measuring maximum shoulder rotation strength was established. Isometric HHD is comparable with ID on normalized peak torques and muscle activity, but with larger co-activation. Strength was not clearly associated with shoulder pain.

Effect of physical training on pain sensitivity and trapezius muscle morphology.

The objective of this study was to investigate morphological and physiological characteristics of painful muscles in women with (MYA, n= 42) and without (CON, n = 20) trapezius myalgia, and assess changes in response to a 10-week, randomized, controlled trial. MYA accomplished: (1) specific strength training (SST); (2) general fitness training (GFT); or (3) reference intervention (REF). Differences in muscle morphology could not be detected by ultrasound imaging. Significantly lower pressure pain threshold (PPT) and shoulder torque were observed for MYA, indicating pain-related lack of full activation. After 10 weeks, increased shoulder torque and PPT of the painful trapezius were observed in SST solely. The PPT of a pain-free reference muscle was increased in response to both SST and GFT, indicating a general effect of physical activity on pain perception. This study shows clinically relevant improvement in pain sensitivity and muscle strength capacity in response to SST.

Short-term effects of implemented high intensity shoulder elevation during computer work.

BACKGROUND: Work-site strength training sessions are shown effective to prevent and reduce neck-shoulder pain in computer workers, but difficult to integrate in normal working routines. A solution for avoiding neck-shoulder pain during computer work may be to implement high intensity voluntary contractions during the computer work. However, it is unknown how this may influence productivity, rate of perceived exertion (RPE) as well as activity and rest of neck-shoulder muscles during computer work. The aim of this study was to investigate short-term effects of a high intensity contraction on productivity, RPE and upper trapezius activity and rest during computer work and a subsequent pause from computer work. METHODS: 18 female computer workers performed 2 sessions of 15 min standardized computer mouse work preceded by 1 min pause with and without prior high intensity contraction of shoulder elevation. RPE was reported, productivity (drawings per min) measured, and bipolar surface electromyography (EMG) recorded from the dominant upper trapezius during pauses and sessions of computer work. Repeated measure ANOVA with Bonferroni corrected post-hoc tests was applied for the statistical analyses. RESULTS: The main findings were that a high intensity shoulder elevation did not modify RPE, productivity or EMG activity of the upper trapezius during the subsequent pause and computer work. However, the high intensity contraction reduced the relative rest time of the uppermost (clavicular) trapezius part during the subsequent pause from computer work (p < 0.04). CONCLUSION: Since a preceding high intensity shoulder elevation did not impose a negative impact on perceived effort, productivity or upper trapezius activity during computer work, implementation of high intensity contraction during computer work to prevent neck-shoulder pain may be possible without affecting the working routines. However, the unexpected reduction in clavicular trapezius rest during a pause with preceding high intensity contraction requires further investigation before high intensity shoulder elevations can be recommended as an integrated part of computer work.

Single motor unit firing behavior in the right trapezius muscle during rapid movement of right or left index finger.

BACKGROUND: Computer work is associated with low level sustained activity in the trapezius muscle that may cause development of trapezius myalgia. Such a low level activity may be attention related or alternatively, be part of a general multi joint motor program providing stabilization of the shoulder joint as a biomechanical prerequisite for precise finger manipulation. This study examines single motor unit (MU) firing pattern in the right trapezius muscle during fast movements of ipsilateral or contralateral index finger. A modulation of the MU firing rate would support the existence of a general multi joint motor program, while a generally increased and continuous firing rate would support the attention related muscle activation. METHOD: Twelve healthy female subjects were seated at a computer work place with elbows and forearms supported. Ten double clicks (DC) were performed with right and left index finger on a computer mouse instrumented with a trigger. Surface electromyographic signals (EMG) was recorded from right and left trapezius muscle. Intramuscular EMG was recorded with a quadripolar wire electrode inserted into the right trapezius. Surface EMG was analyzed as RMS and presented as %MVE. The intramuscular EMG signals were decomposed into individual MU action potential trains using a computer algorithm based on signal shape recognition and manual editing. Instantaneous firing rate (IFR) was calculated as the inverse of each inter-spike interval (ISI). All ISI shorter than 20 ms were defined as doublets. For all MU IFR was spike triggered averaged across the 10 DC to show the modulation during DC as well as for calculation of the cross correlation coefficient (CCC). RESULTS: All subjects showed surface EMG activity in both right and left trapezius ranging from 1.8 %MVE to 2.5 %MVE. Regarding intramuscular EMG during right hand DC a total of 32 MUs were identified. Four subjects showed no MU activity. Four showed MU activity with low mean firing rate (MFR) with weak or no variations related to the timing of DC. Four subjects showed firing patterns with large modulation in IFR with a clear temporal relation to the DC. During left hand DC 15 MUs were identified in four subjects, for two of the subjects with IFR modulations clearly related to DC. During both ipsi- and contralateral DC, doublets occurred sporadically as well as related to DC Conclusion: In conclusion, DC with ipsi- and contralateral fast movements of the index finger was found to evoke biomechanically as well as attention related activity pattern in the trapezius muscle. Doublets were for three of the subjects found as an integrated part of MU activation in the trapezius muscle and for one subject temporarily related to DC.