Effects of health qigong exercise on upper extremity muscle activity, balance function, and quality of life in stroke patients.

Introduction: This study explored the effects of Qigong exercises on upper extremity muscle activity, balance function, and quality of life in stroke patients. Methods: A total of 30 stroke patients were randomly allocated to either control group or Qigong group. In the Qigong group, participants completed an intervention of Qigong Baduanjin over 8 weeks. Data on the electromyographic activities of the biceps brachii muscle, triceps brachii muscle, and muscle coordination were obtained using surface electromyography and the co-contraction ratio (CCR). Data on balance were obtained using the PK254P balance function detection system. Quality of life was measured using the brief version of the World Health Organization Quality of Life scale. Results: The results for the Qigong group showed a significant difference in CCR of the triceps brachii muscle (p < 0.01). Concerning balance (assessed using the open-eye test), there was a significant decrease (p < 0.05) in Y-axis trajectory deviations and the Y-axis speed in the Qigong group. In the closed-eye test, the peripheral area of the Qigong group was significantly lower than that of the control group (p < 0.05). Significant differences were also observed in physical health (p < 0.05), psychological health (p < 0.01), environment (p < 0.01), and the total scores for quality of life (p < 0.01) in the Qigong group. Discussion: We conclude that Qigong exercises improve the quality of life in stroke patients and have positive effects on the coordination of limb extremities and balance function.

Changes in sensorimotor cortex oscillatory activity by orexin-A in the ventrolateral preoptic area of the hypothalamus reflect increased muscle tone.

Orexin-A (OXA) is a hypothalamic neuropeptide implicated in the regulation of wakefulness, appetite, reward processing, muscle tone, motor activity, and other physiological processes. The broad range of systems affected stems from the widespread projections of orexin neurons toward multiple brain regions regulating numerous physiological processes. Orexin neurons integrate nutritional, energetic, and behavioral cues and modulate the functions of target structures. Orexin promotes spontaneous physical activity (SPA), and we recently showed that orexin injected into the ventrolateral preoptic area (VLPO) of the hypothalamus increases behavioral arousal and SPA in rats. However, the specific mechanisms underlying the role of orexin in physical activity are unknown. Here we tested the hypothesis that OXA injected into the VLPO alters the oscillatory activity in the electroencephalogram (EEG) to reflect an increased excitability of the sensorimotor cortex, which may explain the associated increase in SPA. The results showed that OXA increased wakefulness following injections into the VLPO. In addition, OXA altered the power spectrum of the EEG during the awake state by decreasing the power of 5-19 Hz oscillations and increasing the power of >35 Hz oscillations, which are markers of increased sensorimotor excitability. Consistently, we found that OXA induced greater muscle activity. Furthermore, we found a similar change in power spectrum during slow-wave sleep, which suggests that OXA altered the EEG activity in a fundamental way, even in the absence of physical activity. These results support the idea that OXA increases the excitability of the sensorimotor system, which may explain the corresponding increase in awake time, muscle tone, and SPA.

Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy-A Randomized Clinical Trial.

Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS (n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching (n = 10), an isometric contraction (3-5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: -8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.

Analysis of Muscle Activity Following the Application of Myofascial Release Techniques for Low-Back Pain-A Randomized-Controlled Trial.

INTRODUCTION: Lumbosacral dysfunctions and the resulting pain syndromes, such as low-back pain (LBP), are one of the most common musculoskeletal problems being faced by society around the world. So far, a contributory role of thoracolumbar fascia (TLF) dysfunction in some cases of LBP has been suggested. Research also confirms that muscle resting activity level in the TLF area is increased in people with LBP. Myofascial release (MFR) is a therapeutic option offered to patients with chronic low-back pain (CLBP). The therapy aims to improve flexibility and sliding between layers of soft tissue, and thus decrease muscle activity, reduce pain intensity, and improve functional performance. OBJECTIVE: This study aims to assess changes in resting activity of selected muscles within the TLF in a group of patients with CLBP immediately after a single MFR treatment and one month after the intervention. METHODS: A total of 113 patients with CLBP completed the study. Simple randomization was applied to assign subjects to study groups. The experimental group (n = 59) underwent a single session of MFR therapy. No therapeutic intervention was applied to the control group (n = 54). Surface electromyography was used to evaluate positive treatment effects in patients immediately after receiving the therapy (experimental group) and after one month (experimental and control group). RESULTS: A statistically reliable decrease in the activity of erector spinae (ES) and multifidus muscles (MF) was observed after a single session of MFR therapy. Effects of the treatment were present immediately after receiving the therapy and one month after the intervention. CONCLUSIONS: A single MFR treatment in patients with CLBP immediately reduces the resting activity levels of ES and MF. Results of measurements carried out one month after the treatment confirm that the therapeutic effects were maintained.

The role of chronic muscle (in)activity on carnosine homeostasis: a study with spinal cord-injured athletes.

To examine the role of chronic (in)activity on muscle carnosine (MCarn) and how chronic (in)activity affects MCarn responses to ß-alanine supplementation in spinal cord-injured athletes, 16 male athletes with paraplegia were randomized (2:1 ratio) to receive ß-alanine (n = 11) or placebo (PL, n = 5). They consumed 6.4 g/day of ß-alanine or PL for 28 days. Muscle biopsies of the active deltoid and the inactive vastus lateralis (VL) were taken before and after supplementation. MCarn in the VL was also compared with the VL of a group of individuals without paraplegia (n = 15). MCarn was quantified in whole muscle and in pools of individual fibers by high-performance liquid chromatography. MCarn was higher in chronically inactive VL vs. well-trained deltoid (32.0 ± 12.0 vs. 20.5 ± 6.1 mmol/kg DM; P = 0.018). MCarn was higher in inactive vs. active VL (32.0 ± 12.0 vs. 21.2 ± 7.5 mmol/kg DM; P = 0.011). In type-I fibers, MCarn was significantly higher in the inactive VL than in the active deltoid (38.3 ± 4.7 vs. 27.3 ± 11.8 mmol/kg DM, P = 0.014). MCarn increased similarly between inactive VL and active deltoid in the ß-alanine group (VL: 68.9 ± 55.1%, P = 0.0002; deltoid: 90.5 ± 51.4%, P < 0.0001), with no changes in the PL group. MCarn content was higher in the inactive VL than in the active deltoid and the active VL, but this is probably a consequence of fiber type shift (type I to type II) that occurs with chronic inactivity. Chronically inactive muscle showed an increase in MCarn after BA supplementation equally to the active muscle, suggesting that carnosine accretion following ß-alanine supplementation is not influenced by muscle inactivity.

Improvements in Lower-Extremity Function Following a Rehabilitation Program With Patterned Electrical Neuromuscular Stimulation in Females With Patellofemoral Pain: A Randomized Controlled Trial.

CONTEXT: Patellofemoral pain (PFP) is a challenging condition, with altered kinematics and muscle activity as 2 common impairments. Single applications of patterned electrical neuromuscular stimulation (PENS) have improved both kinematics and muscle activity in females with PFP; however, the use of PENS in conjunction with a rehabilitation program has not been evaluated. OBJECTIVE: To determine the effects of a 4-week rehabilitation program with PENS on lower-extremity biomechanics and electromyography (EMG) during a single-leg squat (SLS) and a step-down task (SDT) in individuals with PFP. STUDY DESIGN: Double-blinded randomized controlled trial. SETTING: Laboratory. Patients of Other Participants: Sixteen females with PFP (age 23.3 [4.9] y, mass 66.3 [13.5] kg, height 166.1 [5.9] cm). INTERVENTION: Patients completed a 4-week supervised rehabilitation program with or without PENS. MAIN OUTCOME MEASURES: Curve analyses for lower-extremity kinematics and EMG activity (gluteus maximus, gluteus medius, vastus medialis oblique, vastus lateralis, biceps femoris, and adductor longus) were constructed by plotting group means and 90% confidence intervals throughout 100% of each task, before and after the rehabilitation program. Mean differences (MDs) and SDs were calculated where statistical differences were identified. RESULTS: No differences at baseline in lower-extremity kinematics or EMG were found between groups. Following rehabilitation, the PENS group had significant reduction in hip adduction between 29% and 47% of the SLS (MD = 4.62° [3.85°]) and between 43% and 69% of the SDT (MD = 6.55° [0.77°]). Throughout the entire SDT, there was a decrease in trunk flexion in the PENS group (MD = 10.91° [1.73°]). A significant decrease in gluteus medius activity was seen during both the SLS (MD = 2.77 [3.58]) and SDT (MD = 4.36 [5.38]), and gluteus maximus during the SLS (MD = 1.49 [1.46]). No differences were seen in the Sham group lower-extremity kinematics for either task. CONCLUSION: Rehabilitation with PENS improved kinematics in both tasks and decreased EMG activity. This suggests that rehabilitation with PENS may improve muscle function during functional tasks.

Investigation the EMG Activities of Lower Limb Muscles When Doing Squatting Exercise in Water and on Land.

(1) Background: Squatting is one of the common closed-kinetic chain (CKC) exercises for knee rehabilitation. Some patients cannot perform squatting exercises on land occasionally due to knee pain. Several studies had suggested that lower limb muscle activities are lower in water than on land while performing CKC exercises. The purpose of this study is to investigate the surface electromyography (sEMG) activities of Rectus femoris (RF) and Biceps femoris (BF) muscles when doing a squatting exercise in water and on land. (2) Methods: This was a cross-sectional experimental study. A total of 20 healthy participants (10 males, 10 females) were recruited by convenience sampling. The sEMG of RF and BF muscles in water and on land were collected and the knee motions were videotaped. Participants were instructed to perform closed kinetic-chain back squatting exercises at a specific speed (30 beats per minute) in water and on land at angular speed of 45°/s. Eight repetitions of the squatting exercise (0-90° knee flexion) were performed. The mean percentage maximal voluntary contraction (%MVC) between two muscles was compared in two conditions. The %MVC of RF and BF muscles at different specific knee flexion angles (30°, 60° and 90° knee flexion) was also identified. (3) Result: Muscle activities of RF (p = 0.01) and BF (p < 0.01) muscles were significantly lower in water than on land. The %MVC of RF and BF muscles was found to be 15.01% and 10.68% lower in water than on land respectively. For different knee angle phases, the differences in %MVC between land and water had significant difference for both RF muscles and BF muscles. (4) Conclusion: This study found a difference of mean percentage MVC of RF and BF muscles between land and water in different phases of squatting. The water medium reduced the two muscles' activities to a similar extent. The result showed that the aquatic environment allows an individual to perform squatting with less muscle activation which may serve as an alternative knee exercise option for patients who encounter difficulty in land squatting due to lower limb muscle weakness or a high level of knee pain.

The effects of the neck stabilization exercise on the muscle activity of trunk respiratory muscles and maximum voluntary ventilation of chronic stroke patients.

BACKGROUND: Unstable neck posture, muscle imbalance, and segmental instability can cause neck pain and decrease the respiratory function. OBJECTIVE: To examine effects of a neck stabilization exercise on respiratory muscle activity and maximal voluntary ventilation (MVV) in patients with a chronic stroke. METHODS: A total of 40 patients with a chronic stroke participated in this study. They were randomly divided into two groups (20 in each group). However, ten patients dropped out of the experiment (5 in each group). The experimental group (n= 15) performed a 15-minute neck stabilization exercise and a 15-minute breathing retraining exercise in addition to a rehabilitation exercise treatment. The control group (n= 15) completed a 30-minute breathing retraining exercise in addition to a rehabilitation exercise treatment. Exercises were conducted for 30 minutes a day, five times a week, for a total of six weeks. Activities of major respiratory muscles and MVV were measured before and after the experiment. RESULTS: Both the experimental group and the control group showed significant difference in activities of major respiratory muscles and MVV before and after the experiment (p< 0.05). The experimental group showed a significantly higher increase compared to the control group (p< 0.05). CONCLUSIONS: The application of a combination of a neck stabilization exercise and a breathing retraining exercise to patients with a chronic stroke can increase activity of respiratory muscles and MVV.

Creatine supplementation can improve impact control in high-intensity interval training.

OBJECTIVES: This study aimed to investigate the effects of creatine (Cr) supplementation on biomechanical parameters related to shock attenuation during a session of high-intensity interval training (HIIT). METHODS: A single-blinded, placebo-controlled, crossover design was adopted to test eight male elite soccer players during HIIT sessions under two conditions: after placebo supplementation and after Cr supplementation. HIIT test sessions consisted of an intermittent test (five bouts of running) with a constant load applied until exhaustion was reached. The vertical component of ground reaction force and electromyography data were recorded by Gaitway and Lynx-EMG Systems, respectively. Heart rate, rated perceived exertion (Borg's Scale) and lactate concentration information were also obtained. RESULTS: Cr supplementation did not affect heart rate, rated perceived exertion, and lactate concentration. Decreased values of magnitude of the first peak of the vertical component of ground reaction force (17.2-24.2%) and impulse of the first 50 ms (Imp50; 34.3%) were observed for Cr, but higher values of time to reach the first peak were detected for Cr compared with placebo. Significant modifications in muscle activation were also observed, mainly in the pre-activation phase, and changes were observed in intermediary bouts. CONCLUSIONS: Cr supplementation has the potential to influence biomechanical parameters related to impact control during a single session of HIIT based on running. In particular, the findings of the current study indicate possible improvements in shock attenuation and a safer practice of HIIT under Cr supplementation.

Effects of tactile feedback on lumbar multifidus muscle activity in asymptomatic healthy adults and patients with low back pain.

BACKGROUND: Reduced lumbar multifidus (LM) muscle contraction has been observed in patients with low back pain (LBP). Clinicians often use various strategies to ensure LM activation, including tactile feedback and verbal instruction. However, the effects of tactile feedback on muscle activation have not been studied previously. Therefore, the purpose of this study was to investigate whether or not tactile feedback would increase LM muscle activity in adults with and without LBP. METHODS: Twenty asymptomatic adults and 20 patients with existing LBP completed the study. Two electromyographic (EMG) electrodes were applied to both sides of the LM at the L5 segment. EMG activity was collected three times at rest with and without tactile feedback, then five times during contralateral arm lifts with and without tactile feedback. The tactile feedback was applied by direct and continuous hand contact to the bilateral LM over the lumbosacral area. Lastly, two 5-second trials of maximum voluntary isometric contraction (MVIC) during a bilateral arm lift were performed. EMG activity collected at rest and during contralateral arm lifts was normalized to that collected during MVIC. Normalized EMG values of the right side of the asymptomatic group and the painful side of the LBP group were used for data analysis. RESULTS: Statistical analysis showed significantly decreased LM EMG activity with tactile feedback both at rest and during contralateral arm lifts compared to LM EMG activity without tactile feedback. There was no difference in LM EMG between the asymptomatic and the LBP groups. CONCLUSIONS: The results of the study showed that adding tactile stimulation to verbal instruction appeared to provide an inhibitory effect on LM activity in both asymptomatic healthy adults and patients with LBP. Contrary to common belief, tactical feedback via direct hand contact may reduce LM muscle recruitment, and may lessen the desired treatment effect.

Validation of A New Judo-Specific Ergometer System in Male Elite and Sub-Elite Athletes.

Our experimental approach included two studies to determine discriminative validity and test-retest reliability (study 1) as well as ecological validity (study 2) of a judo ergometer system while performing judo-specific movements. Sixteen elite (age: 23 ± 3 years) and 11 sub-elite (age: 16 ± 1 years) athletes participated in study 1 and 14 male sub-elite judo athletes participated in study 2. Discriminative validity and test-retest reliability of sport-specific parameters (mechanical work, maximal force) were assessed during pulling movements with and without tsukuri (kuzushi). Ecological validity of muscle activity was determined by performing pulling movements using the ergometer without tsukuri and during the same movements against an opponent. In both conditions, electromyographic activity of trunk (e.g., m. erector spinae) and upper limb muscles (e.g., m. biceps brachii) were assessed separately for the lifting and pulling arm. Elite athletes showed mostly better mechanical work, maximal force, and power (0.12 ≤ d ≤ 1.80) compared with sub-elite athletes. The receiver operating characteristic analysis revealed acceptable validity of the JERGo© system to discriminate athletes of different performance levels predominantly during kuzushi without tsukuri (area under the curve = 0.27-0.90). Moreover, small-to-medium discriminative validity was found to detect meaningful performance changes for mechanical work and maximal force. The JERGo© system showed small-to-high relative (ICC = 0.37-0.92) and absolute reliability (SEM = 10.8-18.8%). Finally, our analyses revealed acceptable correlations (r = 0.41-0.88) between muscle activity during kuzushi performed with the JERGo© system compared with a judo opponent. Our findings indicate that the JERGo© system is a valid and reliable test instrument for the assessment and training of judo-specific pulling kinetics particularly during kuzushi movement without tsukuri.

The immediate effect of muscle release intervention on muscle activity and shoulder kinematics in patients with frozen shoulder: a cross-sectional, exploratory study.

BACKGROUND: Contractile tissue plays an important role in mobility deficits in frozen shoulder (FS). However, no study has assessed the effect of the muscle release technique on the muscle activation and kinematics in individuals with FS. The purposes of this study were to assess the differences in shoulder muscle activity and kinematics between the FS and asymptomatic groups; and to determine the immediate effects of muscle release intervention in the FS group. METHODS: Twenty patients with FS and 20 asymptomatic controls were recruited. The outcome measures included muscle activity of the upper and lower trapezius (UT and LT), infraspinatus (ISp), pectoralis major (PM), and teres major (TM), shoulder kinematics (humeral elevation, scapular posterior tilt (PT) and upward rotation (UR), shoulder mobility, and pain. Participants in the FS group received one-session of heat and manual muscle release. Measurements were obtained at baseline, and immediately after intervention. Multivariate analysis of variance was used for data analysis. The level of significance was set at α=0.05. RESULTS: Compared to the controls, the FS group revealed significantly decreased LT (difference =55.89%, P=0.001) and ISp muscle activity (difference =26.32%, P =0.043) during the scaption task, and increased PM activity (difference =6.31%, P =0.014) during the thumb to waist task. The FS group showed decreased humeral elevation, scapular PT, and UR (difference = 35.36°, 10.18°, 6.73° respectively, P <0.05). Muscle release intervention immediately decreased pain (VAS drop 1.7, P <0.001); improved muscle activity during scaption (UT: 12.68% increase, LT: 35.46% increase, P <0.05) and hand to neck (UT: 12.14% increase, LT: 34.04% increase, P <0.05) task; and increased peak humeral elevation and scapular PT during scaption (95.18°±15.83° to 98.24°±15.57°, P=0.034; 11.06°±3.94° to 14.36°±4.65°, P=0.002), and increased scapular PT during the hand to neck (9.47°±3.86° to 12.80°±8.33°, P=0.025) task. No statistical significance was found for other group comparisons or intervention effect. CONCLUSION: Patients with FS presented with altered shoulder muscle activity and kinematics, and one-session of heat and manual muscle release showed beneficial effects on shoulder muscle performance, kinematics, mobility, and pain. TRIAL REGISTRATION: Retrospectively registered on Jan 18, 2016 (ACTRN 12616000031460 ).

Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial.

BACKGROUND: Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. METHODS: The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. DISCUSSION: Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. TRIAL REGISTRATION: NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).

Vibro-tactile and auditory balance biofeedback changes muscle activity patterns: Possible implications for vestibular implants.

BACKGROUND: The two different types of balance prostheses being developed, implants and vibro-tactile/auditory feedback prostheses, rely on different measures to prove efficacy (those based on vestibular ocular reflexes versus balance control, respectively). Here we provide evidence that examining muscle activity might provide a useful alternative for both. METHODS: The muscle activity of 6 bilateral vestibular loss (BVL) and 7 age-matched healthy controls (HC) was examined while standing eyes closed on a foam support surface. Pelvis and upper trunk angular movements were recorded in the roll and pitch planes. Surface EMG was recorded from the lower leg, trunk and upper arm muscles. BVL subjects were first assessed without feedback of pelvis sway, then received training with combined vibro-tactile and auditory feedback, before being re-assessed with feedback. RESULTS: Feedback reduced the amplitudes of pelvis and shoulder sway to values of HC without feedback. Both the level of background EMG activity and the EMG area amplitudes changed when feedback was provided in a manner consistent with the reduced amplitude modulation of muscle synergies of HC. CONCLUSIONS: The results of this study indicate that changed muscle synergy amplitudes underlie improvements in sway achieved by BVL subjects. The concept of this investigation may provide a means to prove efficacy for different types of balance prostheses, including implants.

Augmented effects of EMG biofeedback interfaced with virtual reality on neuromuscular control and movement coordination during reaching in children with cerebral palsy.

BACKGROUND: The purpose of the present study was to compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps (T:B) muscle activity imbalance and elbow joint movement coordination during a reaching motor taskOBJECTIVE: To compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps muscle activity imbalance and elbow joint movement coordination during a reaching motor task in normal children and children with spastic cerebral palsy (CP). METHODS: 18 children with spastic CP (2 females; mean±standard deviation = 9.5 ± 1.96 years) and 8 normal children (3 females; mean ± standard deviation = 9.75 ± 2.55 years) were recruited from a local community center. All children with CP first underwent one intensive session of EMG feedback (30 minutes), followed by one session of the EMG-VR feedback (30 minutes) after a 1-week washout period. Clinical tests included elbow extension range of motion (ROM), biceps muscle strength, and box and block test. EMG triceps and biceps (T:B) muscle activity imbalance and reaching movement acceleration coordination were concurrently determined by EMG and 3-axis accelerometer measurements respectively. Independent t-test and one-way repeated analysis of variance (ANOVA) were performed at p < 0.05. RESULTS: The one-way repeated ANOVA was revealed to be significantly effective in elbow extension ROM (p = 0.01), biceps muscle strength (p = 0.01), and box and block test (p = 0.03). The one-way repeated ANOVA also revealed to be significantly effective in the peak triceps muscle activity (p = 0.01). However, one-way repeated ANOVA produced no statistical significance in the composite 3-dimensional movement acceleration coordination data (p = 0.12). CONCLUSIONS: The present study is a first clinical trial that demonstrated the superior benefits of the EMG biofeedback when augmented by virtual reality exercise games in children with spastic CP. The augmented EMG and VR feedback produced better neuromuscular balance control in the elbow joint than the EMG biofeedback alone.

Difference in muscle activation patterns during high-speed versus standard-speed yoga: A randomized sequence crossover study.

OBJECTIVES: To compare the difference in muscle activation between high-speed yoga and standard-speed yoga and to compare muscle activation of the transitions between poses and the held phases of a yoga pose. DESIGN: Randomized sequence crossover trial SETTING: A laboratory of neuromuscular research and active aging Interventions: Eight minutes of continuous Sun Salutation B was performed, at a high speed versus a standard-speed, separately. Electromyography was used to quantify normalized muscle activation patterns of eight upper and lower body muscles (pectoralis major, medial deltoids, lateral head of the triceps, middle fibers of the trapezius, vastus medialis, medial gastrocnemius, thoracic extensor spinae, and external obliques) during the high-speed and standard-speed yoga protocols. MAIN OUTCOME MEASURES: Difference in normalized muscle activation between high-speed yoga and standard-speed yoga. RESULTS: Normalized muscle activity signals were significantly higher in all eight muscles during the transition phases of poses compared to the held phases (p<0.01). There was no significant interaction between speed×phase; however, greater normalized muscle activity was seen for highspeed yoga across the entire session. CONCLUSIONS: Our results show that transitions from one held phase of a pose to another produces higher normalized muscle activity than the held phases of the poses and that overall activity is greater during highspeed yoga than standard-speed yoga. Therefore, the transition speed and associated number of poses should be considered when targeting specific improvements in performance.

Effect of Sling Exercise on Muscle Activity and Pain in Patients with Rotator Cuff Repair

PURPOSE: This study was conducted to determine the effects of sling exercise on muscle activity and pain in patients with rotator cuff repair. METHODS: This research evaluated 20 rotator cuff repair patients, divided randomly between 10 controls and 10 in an experimental group who performed a sling exercise. Both the experimental and control groups underwent transcutaneous electrical nerve stimulation and performed continuous passive motion. Muscle activity was measured with a surface electromyograph and pain was measured with the visual analogue scale. The paired t-test was used to compare groups before and after the experiment. The independent t-test was conducted to assess differences in the degree of change between the two groups before and after the experiment. RESULTS: Within-group comparison of both the experimental and control group showed significant differences in muscle activity and pain. Comparison of the groups revealed significant differences in muscle activity between groups group, but not in pain. CONCLUSION: These results indicate that sling exercise is effective for improving muscle activity of rotator cuff repair patients.

Cutaneous Recording and Stimulation of Muscles Using Organic Electronic Textiles.

Electronic textiles are an emerging field providing novel and non-intrusive solutions for healthcare. Conducting polymer-coated textiles enable a new generation of fully organic surface electrodes for electrophysiological evaluations. Textile electrodes are able to assess high quality muscular monitoring and to perform transcutaneous electrical stimulation.

Explanation of timing of botulinum neurotoxin effects, onset and duration, and clinical ways of influencing them.

While the steps in the action of botulinum neurotoxin (BoNT) are well known, the factors underlying the timing of these steps are not fully understood. After toxin is injected into a muscle, it resides in the extracellular space and must be taken up into the nerve terminals. More toxin will be taken up if near the endplate. Toxin is distributed mainly by convection and there is likely little diffusion. Toxin that is not taken up will go into the general circulation where it may have a slight systemic effect. The uptake is activity and temperature dependent. Encouraging the unwanted muscle contractions after injection should be helpful. Cooling will decrease the uptake. The times for washout from the extracellular space and uptake of the toxin are not well established, but are likely measured in minutes. Toxin in the general circulation has a long half time. The time from injection to weakness is determined by how long it takes to get sufficient damage of the SNARE proteins to interfere with synaptic release. Toxins are zinc dependent proteases, and supplemental zinc may produce a greater effect. There will be weakness as long as there is residual toxin in the nerve ending.

Kinesiologic taping and muscular activity: a myofascial hypothesis and a randomised, blinded trial on healthy individuals.

BACKGROUND: During recent years scientific research has demonstrated a growing interest in elastic and anaelastics adhesive taping techniques. However, only a few studies investigating the principles behind the effects of taping. At present, the action mechanisms of kinesiology taping remain speculative. OBJECTIVES: To investigate the effects of taping application on the tone of the pectoralis major muscle at rest, in absence of any relevant pathologies. METHODS AND MEASURES: The study involved a prospective, randomised and blinded clinical trial on healthy individuals and a repeated measures study design. Two different taping techniques (facilitatory and inhibitory) were applied over the pectoralis major of 24 healthy volunteers. The outcome measure was passive range of motion of external rotation of the glenohumeral joint. RESULTS: Facilitatory taping significatively enhanced the activity of the underlying muscle. Results showed a negative correlation between facilitatory taping application and the contralateral pectoralis major length, indicating a possible effect on the muscle tone of areas outside the site of direct application. The inhibitory taping application did not produce significant results. CONCLUSIONS: effects on ipsilateral and contralateral muscle physiology could be interpreted through the initial hypothesis of taping inducing changes in fascial stiffness. These could be transmitted along the continuing system. Further studies are needed to inform the possible uses of taping in clinical practice.