Different discrete motor-unit activation patterns in the flexor carpi radialis in boys and men.

BACKGROUND: Lower activation of higher threshold (type-II) motor units (MUs) has been suggested in children compared with adults. We examined child-adult differences in discrete MU activation of the flexor carpi radialis (FCR). METHODS: Fifteen boys (10.2 ± 1.4 years), and 17 men (25.0 ± 2.7 years) completed 2 laboratory sessions. Following a habituation session, maximal voluntary isometric wrist flexion torque (MVIC) was determined before completing trapezoidal isometric contractions at 70%MVIC. Surface electromyography was captured by Delsys Trigno Galileo sensors and decomposed into individual MU action potential trains. Recruitment threshold (RT), and MU firing rates (MUFR) were calculated. RESULTS: MVIC was significantly greater in men (10.19 ± 1.92 Nm) than in boys (4.33 ± 1.47 Nm) (p < 0.05), but not statistically different after accounting for differences in body size. Mean MUFR was not different between boys (17.41 ± 7.83 pps) and men (17.47 ± 7.64 pps). However, the MUFR-RT slope was significantly (p < 0.05) steeper (more negative) in boys, reflecting a progressively greater decrease in MUFR with increasing RT. Additionally, boys recruited more of their MUs early in the ramped contraction. CONCLUSION: Compared with men, boys tended to recruit their MUs earlier and at a lower percentage of MVIC. This difference in MU recruitment may explain the greater decrease in MUFR with increasing RT in boys compared with men. Overall, these findings suggest an age-related difference in the neural strategy used to develop moderate-high torque in wrist flexors, where boys recruit more of their MUs earlier in the force gradation process, possibly resulting in a narrower recruitment range.

Neuromechanical Differences between Pronated and Supinated Forearm Positions during Upper-Body Wingate Tests.

Arm-cycling is a versatile exercise modality with applications in both athletic enhancement and rehabilitation, yet the influence of forearm orientation remains understudied. Thus, this study aimed to investigate the impact of forearm position on upper-body arm-cycling Wingate tests. Fourteen adult males (27.3 ± 5.8 years) underwent bilateral assessments of handgrip strength in standing and seated positions, followed by pronated and supinated forward arm-cycling Wingate tests. Electromyography (EMG) was recorded from five upper-extremity muscles, including anterior deltoid, triceps brachii lateral head, biceps brachii, latissimus dorsi, and brachioradialis. Simultaneously, bilateral normal and propulsion forces were measured at the pedal-crank interface. Rate of perceived exertion (RPE), power output, and fatigue index were recorded post-test. The results showed that a pronated forearm position provided significantly (p < 0.05) higher normal and propulsion forces and triceps brachii muscle activation patterns during arm-cycling. No significant difference in RPE was observed between forearm positions (p = 0.17). A positive correlation was found between seated handgrip strength and peak power output during the Wingate test while pronated (dominant: p = 0.01, r = 0.55; non-dominant: p = 0.03, r = 0.49) and supinated (dominant: p = 0.03, r = 0.51; don-dominant: p = 0.04, r = 0.47). Fatigue changed the force and EMG profile during the Wingate test. In conclusion, this study enhances our understanding of forearm position's impact on upper-body Wingate tests. These findings have implications for optimizing training and performance strategies in individuals using arm-cycling for athletic enhancement and rehabilitation.

Influence of Neck Pain, Cervical Extensor Muscle Fatigue, and Manual Therapy on Wrist Proprioception.

OBJECTIVE: The purpose of this study was to examine the effects of submaximal isometric neck muscle fatigue and manual therapy on wrist joint position sense (JPS) within healthy individuals and individuals with subclinical neck pain (SCNP). METHODS: Twelve healthy participants and 12 participants with SCNP were recruited. Each group completed 2 sessions, with 48 hours between sessions. On day 1, both groups performed 2 wrist JPS tests using a robotic device. The tests were separated by a submaximal isometric fatigue protocol for the cervical extensor muscles (CEM). On day 2, both groups performed a wrist JPS test, followed by a cervical treatment consisting of manual therapy (SCNP) or neck rest (20 minutes, control group) and another wrist JPS test. Joint position sense was measured as the participant's ability to recreate a previously presented wrist angle. Each wrist JPS test included 12 targets, 6 into wrist flexion and 6 into wrist extension. Kinematic data from the robot established absolute, variability, and constant error. RESULTS: Absolute error significantly decreased (P = .01) from baseline to post-fatigue in the SCNP group (baseline = 4.48 ± 1.58°; post-fatigue = 3.90 ± 1.45°) and increased in the control group (baseline = 3.12 ± 0.98°; post-fatigue = 3.81 ± 0.90°). The single session of manual cervical treatment significantly decreased absolute error in participants with SCNP (P = .004). CONCLUSION: This study demonstrated that neck pain or fatigue can lead to altered afferent input to the central nervous system and can affect wrist JPS. Our findings demonstrate that acute wrist proprioception may be improved in individuals with SCNP by a single cervical manual therapy session.

The effects of local forearm heating and cooling on motor unit properties during submaximal contractions.

NEW FINDINGS: What is the central question of this study? How do temperature manipulations affect motor unit (MU) properties during submaximal contractions to the same relative percentage of maximal force? What is the main finding and its importance? MU recruitment patterns are affected by temperature manipulations at the forearm. However, the relationship between MU potential amplitude and recruitment threshold indicates no change to the order or recruitment. Additionally, the MU potential amplitude and firing rate relationship was affected by temperature, suggesting that smaller MUs are more affected by temperature changes than larger MUs. ABSTRACT: Temperature impacts muscle contractile properties, such that experiments with workloads based on thermoneutral values will produce different relative intensities if maximal force changes due to muscle temperature. We investigated how temperature affected motor unit (MU) properties with contractions performed at the same normalized percentage of maximal force. Twenty participants (10 females) completed evoked, maximal, and trapezoidal voluntary contractions during thermoneutral-, hot-, and cold-temperature conditions. Forearm temperature was established using 25 min of neutral (∼32°C), hot (∼44°C) or cold (∼13°C) water circulated through a tube-lined sleeve. Flexor carpi radialis MU properties were assessed with contractions at 30% and 60% MVC relative to each temperature using surface electromyography decomposition. Changes to contractile properties and electromechanical delay from the evoked twitch suggest that muscle contractility was changed from the thermal manipulations (effect size (d) ≥ 0.42, P < 0.05). Maximal force was not different between neutral and hot conditions (d = 0.16, P > 0.05) but decreased in the cold (d ≥ 0.34, P < 0.05). For both contraction intensities, MU potential (MUP) amplitude was larger and duration was longer in the cold compared to neutral and hot conditions (d ≥ 1.24, P < 0.05). Cumulative probability density for the number of MUs recruited revealed differences in MU recruitment patterns among temperature conditions. The relationship between MU recruitment threshold and firing rate or MUP amplitude was not different among temperature conditions (P > 0.05); however, the relationship between MUP amplitude and firing rate was (P < 0.05). Local temperature manipulations appear to affect MU recruitment patterns, which may act as compensatory mechanisms to the changes in muscle viscosity and contractile properties due to local temperature changes.

Wrist extensor muscle activity is less task-dependent than wrist flexor muscle activity while simultaneously performing moderate-to-high handgrip and wrist forces.

The aim of this study was to characterise wrist extensor and flexor muscle activity during combinations of moderate-to-high handgrip and wrist forces that are similar to actions and intensities used in many workplace settings. Surface electromyography was recorded from three wrist flexors and three wrist extensors while participants performed simultaneous handgrip forces and wrist forces ranging in intensities from 15% to 60% of maximum. While the wrist flexors were highly task-dependent, in that their activity significantly changed between conditions, wrist extensor activity was consistently high throughout the experiment. Wrist joint co-contraction was also significantly higher when the wrist extensors were functioning as the antagonists. These findings suggest that the wrist extensors likely demonstrate consistently higher muscleactivity during most tasks of the hand and wrist, which is likely a leading mechanism behind why they develop chronic overuse injuries more frequently than the wrist flexors. Practitioner Summary: This study was conducted to identify forearm muscle activity patterns that might help explain why the wrist extensors develop overuse injuries more frequently than the flexors. Results demonstrated that the wrist extensors are consistently, highly active during combined handgrip and wrist forces and exhibit no periods of low muscle activity.Abbreviations: BB: biceps brachii; ECR: extensor carpi radialis; ECU: extensor carpi ulnaris; ED: extensor digitorum; EMG: electromyography; ES: effect size; FCR: flexor carpi radialis; FCU: flexor carpi ulnaris; FDS: flexor digitorum superficialis; MVC: maximal voluntary contraction; MVE: maximal voluntary excitation; SD: standard deviation; SE: standard error; TB: triceps brachii.

Muscle length and joint angle influence spinal but not corticospinal excitability to the biceps brachii across forearm postures.

Forearm rotation (supination/pronation) alters corticospinal excitability to the biceps brachii, but it is unclear whether corticospinal excitability is influenced by joint angle, muscle length, or both. Thus the purpose of this study was to separately examine elbow joint angle and muscle length on corticospinal excitability. Corticospinal excitability to the biceps and triceps brachii was measured using motor evoked potentials (MEPs) elicited via transcranial magnetic stimulation. Spinal excitability was measured using cervicomedullary motor evoked potentials (CMEPs) elicited via transmastoid electrical stimulation. Elbow angles were manipulated with a fixed biceps brachii muscle length (and vice versa) across five unique postures: 1) forearm neutral, elbow flexion 90°; 2) forearm supinated, elbow flexion 90°; 3) forearm pronated, elbow flexion 90°; 4) forearm supinated, elbow flexion 78°; and 5) forearm pronated, elbow flexion 113°. A musculoskeletal model determined biceps brachii muscle length for postures 1-3, and elbow joint angles (postures 4-5) were selected to maintain biceps length across forearm orientations. MEPs and CMEPs were elicited at rest and during an isometric contraction of 10% of maximal biceps muscle activity. At rest, MEP amplitudes to the biceps were largest during supination, which was independent of elbow joint angle. CMEP amplitudes were not different when the elbow was fixed at 90° but were largest in pronation when muscle length was controlled. During an isometric contraction, there were no significant differences across forearm postures for either MEP or CMEP amplitudes. These results highlight that elbow joint angle and biceps brachii muscle length can each independently influence spinal excitability. NEW & NOTEWORTHY Changes in upper limb posture can influence the responsiveness of the central nervous system to artificial stimulations. We established a novel approach integrating neurophysiology techniques with biomechanical modeling. Through this approach, the effects of elbow joint angle and biceps brachii muscle length on corticospinal and spinal excitability were assessed. We demonstrate that spinal excitability is uniquely influenced by joint angle and muscle length, and this highlights the importance of accounting for muscle length in neurophysiological studies.

The effects of local muscle temperature on force variability.

PURPOSE: Force variability is affected by environmental temperature, but whether the changes are from altered muscle temperature or proprioception are unclear. We tested how forearm muscle warming and cooling affected a force tracking task. METHODS: Twelve males and four females completed evoked, maximal, and isometric wrist flexion contractions (0-30% maximal) during thermoneutral-, warm-, and cold-muscle conditions. Forearm muscle temperature was manipulated using neutral (~ 33 °C), hot (~ 44 °C), or cold (~ 13 °C) water circulated through a tube-lined sleeve. Evoked and voluntary contractions were performed before and after thermal manipulations. RESULTS: Thermal manipulations altered contractile properties as evident in the twitch half-relaxation time, rate of force development, and duration (all P < 0.05), suggesting that muscle temperature was successfully altered. Changes in surface electromyography of the flexor carpi radialis root-mean-square amplitude and mean power frequency between temperature conditions (all P < 0.05) also indicate muscle temperature changes. No changes to root-mean-square error or variance ratio of the force trace were observed with muscle temperature changes (both P > 0.05). Muscle temperature changes did not have a consistent effect on coefficient of variation during each plateau of the staircase contraction. CONCLUSIONS: Our results suggest that the ability to perform a multi-plateaued isometric force task is not affected by changes to forearm muscle temperature. As the thermal manipulation was limited to the forearm, changes to hand temperature would be minimal, thus, proprioception in the wrist and hand was preserved allowing performance to be maintained. Therefore, modest changes to forearm muscle temperature are not likely to affect force variability if proprioception is maintained.

Difference Between Male and Female Ice Hockey Players in Muscle Activity, Timing, and Head Kinematics During Sudden Head Perturbations.

This study examined sex differences in head kinematics and neck muscle activity during sudden head perturbations. Sixteen competitive ice hockey players participated. Three muscles were monitored bilaterally using surface electromyography: sternocleidomastoid, scalene, and splenius capitis. Head and thorax kinematics were measured. Head perturbations were induced by the release of a 1.5-kg weight attached to a wire wrapped around an adjustable pulley secured to the participant's head. Perturbations were delivered in 4 directions (flexion, extension, right lateral bend, and left lateral bend). Muscle onset times, muscle activity, and head kinematics were examined during 3 time periods (2 preperturbation and 1 postperturbation). Females had significantly greater head acceleration during left lateral bend (31.4%, P < .05) and flexion (37.9%, P = .01). Females had faster muscle onset times during flexion (females = 51 ± 11 ms; males = 61 ± 10 ms; P = .001) and slower onset times during left lateral bend and extension. Females had greater left/right sternocleidomastoid and scalene activity during extension (P = .01), with no difference in head acceleration. No consistent neuromuscular strategy could explain all directional sex differences. Females had greater muscle activity postperturbation during extension, suggesting a neuromuscular response to counter sudden acceleration, possibly explaining the lack of head acceleration differences.

Influence of Subclinical Neck Pain on the Ability to Perform a Mental Rotation Task: A 4-Week Longitudinal Study With a Healthy Control Group Comparison.

OBJECTIVE: Mental rotation of objects and the frame of reference of those objects are critical for executing correct and skillful movements and are important for object recognition, spatial navigation, and movement planning. The purpose of this longitudinal study was to compare the mental rotation ability of those with subclinical neck pain (SCNP) to healthy controls at baseline and after 4 weeks. METHODS: Twenty-six volunteers (13 SCNP and 12 healthy controls) were recruited from a university student population. Subclinical neck pain participants had scores of mild to moderate on the Chronic Pain Grade Scale, and controls had minimal or no pain. For the mental rotation task, participants were presented with an object (letter "R") on a computer screen presented randomly in either normal or backwards parity at various orientations (0°, 45°, 90°, 135°, 180°, 225°, 270°, and 315°). Participants indicated the object's parity by pressing "N" for normal or "B" for backwards. Each orientation for normal and backward parities was presented 5 times, and the average response time for all letter presentations was calculated for each participant, at baseline and 4 weeks later. RESULTS: Both groups had overall improved response times from baseline to 4 weeks. Healthy participants had significantly improved response times compared to SCNP, both at baseline (P < .05) and 4 weeks (P < .05). CONCLUSIONS: Healthy participants performed better than the SCNP group at both time points. Subclinical neck pain may impair the ability to perform a complex mental rotation task involving cerebellar connections, possibly due to altered body schema.

Neck muscle fatigue alters upper limb proprioception.

Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18 = 19.41, p ≤ 0.0001) for absolute error. No significant differences were found for variable error (F 2, 18 = 0.27, p = 0.76) or constant error (F 2, 18 = 1.16 of time, p ≤ 0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception.

Evaluating Abdominal and Lower-Back Muscle Activity While Performing Core Exercises on a Stability Ball and a Dynamic Office Chair.

OBJECTIVE: The purpose of this study was to evaluate the ability of a dynamic office chair to activate the core muscles while participants performed exercises sitting on the chair compared to a stability ball. BACKGROUND: Prolonged sitting has become an accepted part of the modern office. However, epidemiological evidence suggests that sedentary postures are linked to many adverse effects on health. The concept of dynamic or active sitting is intended to promote movement while sitting to reduce the time spent in prolonged, static postures. METHODS: Sixteen participants performed four pelvic rotation exercises (front-back, side-side, circular, and leg lift) on both a dynamic office chair and a stability ball. Muscle activity from 12 torso muscles were evaluated with surface electromyography. RESULTS: For all exercises, trunk muscle activity on the chair was comparable to that on a stability ball. The right external oblique was the only muscle to produce greater peak activity (p = .019) when using the ball compared to the chair (21.4 ± 14.0 percent maximal voluntary excitations (%MVE) and 14.7 ± 10.8 %MVE for the ball and chair, respectively). The left thoracic erector spinae produced greater average activity (p = .044) on the chair than on the ball. CONCLUSION: These findings suggest that this dynamic sitting approach could be an effective tool for core muscle activation while promoting movement and exercise while sitting at work. APPLICATION: Muscle activations on the dynamic chair are comparable to those on a stability ball, and dynamic office chairs can promote movement and exercise while sitting at work.

Cycle to cycle variability in a repetitive upper extremity task.

The purpose of this study was to examine the variability in muscle activity at rest and work during a repetitive task. A total of 20 participants performed a bimanual push task using three frequencies (4, 8, 16 pushes/min), three loads (1 kg, 2 kg, 4 kg) and two grip conditions (no grip, 30% maximum). The coefficient of variation (CoV) of muscle activity was determined for the anterior deltoid, biceps brachii, extensor digitorum and flexor digitorum superficialis. Faster push frequencies and heavier loads had lower work-rest ratio CoV and higher mean muscle activity (p < 0.01). Sixteen pushes per minute produced the lowest CoV for the anterior deltoid (p < 0.01), while the 1- kg load produced the lowest CoV for the extensor digitorum and flexor digitorum superficialis (p < 0.01). Changes were driven by the rest phase rather than by the work phase, except for grip decreasing forearm muscle CoV. These findings underscore the importance of variability at rest and indicate that low variability of muscle activity is associated with ergonomic risk factors. PRACTITIONER SUMMARY: Decreased motor variability has been associated with pain and injury. A cyclical push task, evaluated in terms of work and rest phases, found that greater workloads increased variability primarily due to changes in the rest phase. Muscle variability, especially for the rest phase, may provide insight into injury risk.

Muscle contributions to elbow joint rotational stiffness in preparation for sudden external arm perturbations.

Understanding joint stiffness and stability is beneficial for assessing injury risk. The purpose of this study was to examine joint rotational stiffness for individual muscles contributing to elbow joint stability. Fifteen male participants maintained combinations of three body orientations (standing, supine, sitting) and three hand preloads (no load, solid tube, fluid filled tube) while a device imposed a sudden elbow extension. Elbow angle and activity from nine muscles were inputs to a biomechanical model to determine relative contributions to elbow joint rotational stiffness, reported as percent of total stiffness. A body orientation by preload interaction was evident for most muscles (P<.001). Brachioradialis had the largest change in contribution while standing (no load, 18.5%; solid, 23.8%; fluid, 26.3%). Across trials, the greatest contributions were brachialis (30.4±1.9%) and brachioradialis (21.7±2.2%). Contributions from the forearm muscles and triceps were 5.5±0.6% and 9.2±1.9%, respectively. Contributions increased at time points closer to the perturbation (baseline to anticipatory), indicating increased neuromuscular response to resist rotation. This study quantified muscle contributions that resist elbow perturbations, found that forearm muscles contribute marginally and showed that orientation and preload should be considered when evaluating elbow joint stiffness and safety.

Time-varying changes in median nerve deformation and position in response to quantified pinch and grip forces.

The ability of the median nerve (MN) to adapt in response to altered carpal tunnel conditions is important to mitigate compressive stress on the nerve. We assessed changes in MN deformation and position throughout the entire time course of hand force exertions. Fourteen right-handed participants ramped up force from 0% to 50% of maximal voluntary force (MVF) before ramping force back down in three different hand force exertion tasks (pulp pinch, chuck pinch, power grip). Pinch and grip forces were measured with a digital dynamometer, which were time synchronized with transverse carpal tunnel images obtained via ultrasound. Ultrasound images were extracted in 10% increments between 0% and 50% MVF while ramping force up (loading phase) and down (unloading phase). MN deformation and position relative to the flexor digitorum superficialis tendon of the long finger were assessed in concert. During loading, the nerve became more circular while displacing dorsally and ulnarly. These changes primarily occurred at the beginning of the hand force exertions while ramping force up from 0% to 20%, with very little change between 20% and 50% MVF. Interestingly, deformation and position changes during loading were not completely reversed during unloading while ramping force down. These findings indicate an initial reorganization of carpal tunnel structures. Mirrored changes in nerve deformation and position may also reflect strain-related characteristics of adjoining subsynovial connective tissue. Regardless, time-varying changes in nerve deformation and position appear to be an important accommodative mechanism in the healthy carpal tunnel in response to gripping and pinching tasks.

Impact of repetitive mouse clicking on forearm muscle fatigue and mouse aiming performance.

Exercise induced performance fatigue has been shown to impair many aspects of fine motor function in the distal upper limb. However, most fatiguing protocols do not reflect the conditions experienced with computer use. The purpose of this study was to determine how a prolonged, low-force mouse clicking fatigue protocol impacts performance fatigue of the distal upper limb for gamers and non-gamers. Participants completed a total of 1 h of mouse clicking at 5 clicks per second. Muscle fatigue and performance were intermittently assessed. RMS amplitude increased for the forearm flexors throughout the fatigue protocol. Accuracy decreased following the first bout of clicking and returned to baseline values after 40-min. EDC and ECU displayed the greatest muscle activity while aiming, producing 11.4% and 12.9% of MVC, respectively. These findings indicate that mouse clicking may not result in performance fatigue, however, high levels of extensor activity may explain common injuries among gamers.

Sex differences in strength at the shoulder: a systematic review.

Background: Understanding differential strength capability between sexes is critical in ergonomics and task design. Variations in study designs and outcome measures generates challenges in establishing workplace guidelines for strength requirements to minimize upper extremity risk for workers. The purpose of this systematic review was to collate and summarize sex differences in strength at the shoulder across movement directions and contraction types. Methods: A total of 3,294 articles were screened from four databases (Embase, Medline, SCOPUS, and Web of Science). Eligibility criteria included observational studies, direct measurement of muscular joint, and healthy adult participants (18-65 years old). Strength outcome measures were normalized to percentages of male outputs to allow comparisons across articles. Results: A total of 63 studies were included within the final review. Majority of articles observed increased strength in males; the gap between male-female strength was greater in flexion and internal/external rotation, with females generating ~30% of male strength; scaption strength ratios were most consistent of the movement groups, with females generating 55-62% of male strength. Conclusion: Sex strength differences should be considered as an important factor for workplace task design as women are more at risk for occupational-related injuries than men in equivalent strength requirements. Differences in strength were not synonymous across motions; females demonstrated increased disparity relative to male strength in horizontal flexion/extension, forward flexion and internal/external rotation. Some movements had an extremely limited pool of available studies for examination which identified critical research gaps within the literature. Collating and quantifying strength differences is critical for effective workstation design with a range of users to mitigate potential overexertion risk and musculoskeletal injury.

The Effects of Load, Crank Position, and Sex on the Biomechanics and Performance during an Upper Body Wingate Anaerobic Test.

INTRODUCTION: The upper body Wingate Anaerobic Test (WAnT) is a 30-s maximal effort sprint against a set load (percentage of body mass). However, there is no consensus on the optimal load and no differential values for males and females, even when there are well-studied anatomical and physiological differences in muscle mass for the upper body. Our goal was to describe the effects of load, sex, and crank position on the kinetics, kinematics, and performance of the upper body WAnT. METHODS: Eighteen participants (9 females) performed three WAnTs at 3%, 4%, and 5% of body mass. Arm crank forces, 2D kinematics, and performance variables were recorded during each WAnT. RESULTS: Our results showed an increase of ~49% effective force, ~36% peak power, ~5° neck flexion, and ~30° shoulder flexion from 3% to 5% load ( P < 0.05). Mean power and anaerobic capacity decreased by 15%, with no changes in fatigue index ( P < 0.05). The positions of higher force efficiency were at 12 and 6 o'clock. The least force efficiency occurred at 3 o'clock ( P < 0.05). Sex differences showed that males produced 97% more effective force and 109% greater mean power than females, with 11.7% more force efficiency ( P < 0.001). Males had 16° more head/neck flexion than females, and females had greater elbow joint variability with 17° more wrist extension at higher loads. Males cycled ~32% faster at 3% versus 5% WAnT load with a 65% higher angular velocity than females. Grip strength, maximal voluntary isometric contraction, mass, and height positively correlated with peak and mean power ( P < 0.001). CONCLUSIONS: In conclusion, load, sex, and crank position have a significant impact on performance of the WAnT. These factors should be considered when developing and implementing an upper body WAnT.

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments.

The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.

The effects of COVID-19 related shutdowns on perceived lifestyle and prevalence of musculoskeletal discomfort.

BACKGROUND: COVID-19 caused a transition to work-from-home conditions, closures of recreation facilities and cancelation of social events. OBJECTIVE: This study sought to characterize and quantify the impact COVID-19 related shutdowns had on perceptions of health and wellbeing, musculoskeletal discomfort, and physical characteristics of workstation set-up in full time workers who transitioned to working from home. METHODS: 297 participants from 8 countries completed a retrospective pre/post survey design that assessed outcomes prior to COVID-19 shutdowns and when each participant was experiencing peak pandemic-related restrictions. There were 3 categories including, health and wellbeing, musculoskeletal discomfort, and workplace ergonomics. RESULTS: General discomfort on a scale from 1 to 100 increased from 31.4 pre to 39.9 during COVID-19. Notable areas increasing in severity of discomfort from pre to during included the neck (41.8 to 47.7), upper back (36.3 to 41.3) and right wrist (38.7 to 43.5). The percentage of the population experiencing discomfort increased from pre to during in the low back (41.5% to 55.2%), upper back (28.7% to 40.9%), neck (45.5% to 60.9%) and right wrist (16.1% to 23.7%). CONCLUSION: There were three distinct groups for physical activity one group including, one maintaining and one that decreased, which did not have an impact on perceived general discomfort. There was a significant decrease in usage of a desk and adjustable chair and an increase in laptop use. Working from home in some capacity will likely be a more common occurrence which will require further ergonomic assessments and considerations to keep a healthy workforce.

Sex differences in wrist strength: a systematic review.

Sex differences in strength have been attributed to differences in body anthropometrics and composition; these factors are often ignored when generating workplace guidelines. These differences directly impact the upper extremity, leaving female workers exposed to injury risk. The wide range of tools and techniques for measuring upper extremity strength presents a challenge to ergonomists and work task designers; collating outcomes to provide a clear outlook of differences between males and females is essential and the purpose of this work. Four online databases were searched (PROSPERO ID: CRD42022339023) with a focus on articles assessing sex differences in wrist strength. A total of 2,378 articles were screened for relevancy; 25 full-text articles were included in this systematic review. Articles examined movement pairs (ulnar/radial deviation, pronation/supination, and flexion/extension), as well as contraction types (isometric and isokinetic) to observe sex differences in wrist strength. Across all articles, females produced ∼60-65% of male flexion/extension strength, ∼55-60% pronation/supination strength, and ∼60-70% ulnar/radial deviation strength. Overall, females presented lower strength-producing abilities than males, but when considering strength relative to body mass, male-female differences were less pronounced and occasionally females surpassed male strength metrics; typically, this occurred during flexion/extension, particularly in isokinetic contractions. This review has identified a scarcity of articles examining ulnar/radial deviation, pronation/supination, as well as isokinetic contractions; these are needed to supplement workplace exposure guidelines.