Objective-Evidence for effective management of shoulder impingement is limited. The present study aimed to quantify the clinical, neurophysiological, and biomechanical effects of a scapular motor control retraining for young individuals with shoulder impingement signs.Method-Sixteen adults with shoulder impingement signs (mean age 22 ± 1.6 years) underwent the intervention and 16 healthy participants (24.8 ± 3.1years) provided reference data. Shoulder function and pain were assessed using the Shoulder Pain and Disability Index (SPADI) and other questionnaires. Electromyography (EMG) and 3-dimensional motion analysis was used to record muscle activation and kinematic data during arm elevation to 90° and lowering in three planes. Patients were assessed pre and post a 10-week motor control based intervention, utilising scapular orientation retraining.Results-Pre-intervention, patients reported pain and reduced function compared to the healthy participants (SPADI in patients 20 ± 9.2; healthy 0±0). Post-intervention the SPADI scores reduced significantly (p<0.001) by a mean of 10 points (±4). EMG showed delayed onset and early termination of serratus anterior and lower trapezius muscle activity pre-intervention, which improved significantly post-intervention (p<0.05-0.01). Pre-intervention, patients exhibited on average 4.6-7.4° less posterior tilt, which was significantly less in two arm elevation planes (p<0.05) than healthy participants. Post-intervention, upward rotation and posterior tilt increased significantly (p<0.05) during two arm movements, approaching the healthy values.Conclusions-A 10 week motor control intervention for shoulder impingement increased function and reduced pain. Recovery mechanisms were indicated by changes in muscle recruitment and scapular kinematics. The efficacy of the intervention requires further examined in a randomised control trial.

Study Design Cross-sectional, case-control study. Objectives To measure and compare the resting thickness of the 4 abdominal wall muscles, their associated perimuscular connective tissue (PMCT), and interrecti distance (IRD) in persons with and without lumbopelvic pain (LPP), using ultrasound imaging. Background The muscles and PMCT of the abdominal wall assist in controlling the spine. Functional deficits of the abdominal wall muscles have been detected in populations with LPP. Investigations of the abdominal wall in those with LPP are primarily concerned with muscle, most commonly the transversus abdominis (TrA) and internal oblique (IO). Because the abdominal wall functions as a unit, all 4 abdominal muscles and their associated connective tissues should be considered concurrently. Methods B-mode ultrasound imaging was used to measure the resting thickness of the rectus abdominis (RA), external oblique, IO, and TrA muscles; the PMCT planes; and IRD in 50 male and female subjects, 25 with and 25 without LPP (mean ± SD age, 36.3 ± 9.4 and 46.6 ± 8.0 years, respectively). Univariate correlation analysis was used to identify covariates. Analyses of covariance (ANCOVAs) and the Kruskal-Wallis test (IRD) were used to compare cohorts (α = .05). Results The LPP cohort had less total abdominal muscle thickness (LPP mean ± SD, 18.9 ± 3.0 mm; control, 20.3 ± 3.0 mm; ANCOVA adjusted for body mass index, P = .03), thicker PMCT (LPP, 5.5 ± 0.2 mm; control, 4.3 ± 0.2 mm; ANCOVA adjusted for body mass index, P = .007), and wider IRD (LPP, 11.5 ± 2.0 mm; control, 8.4 ± 1.8 mm; Kruskal-Wallis, P = .005). Analysis of individual muscle thickness revealed no difference in the external oblique, IO, and TrA, but a thinner RA in the LPP cohort (LPP mean ± SD, 7.8 ± 1.5 mm; control, 9.1 ± 1.2 mm; ANCOVA adjusted for body mass index, P<.001). Conclusion To our knowledge, this is the first study to investigate the morphological characteristics of all 4 abdominal muscles and PMCT in individuals with LPP. The results suggest that there may be altered loading of the PMCT and linea alba secondary to an altered motor control strategy involving a reduced contribution of the RA. Further, the change in RA and connective tissue morphology may be more evident than changes in external oblique, IO, and TrA thickness in persons with LPP. The causes and functional implications of these changes warrant further investigation, as does the role of the RA muscle in the development and persistence of LPP. J Orthop Sports Phys Ther 2013;43(1):11–19. Epub 16 November 2012. doi:10.2519/jospt.2013.4450

Please cite this article as: Agyapong-Badu, Sandra, Warner, Martin, Samuel, Dinesh, Stokes, Maria, Measurement of ageing effects on muscle tone and mechanical properties of rectus femoris and biceps brachii in healthy males and females using a novel hand-held myometric device.Archives of Gerontology and Geriatrics http://dx.doi.org/10. 1016/j.archger.2015.09.011 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Monitoring changes in muscle properties with ageing in community settings may provide a valuable assessment tool for detecting those at risk of premature decline and sarcopenia.Objective: This study aimed to provide objective data on the effects of ageing and gender on muscle tone and mechanical properties of quadriceps (rectus femoris) and biceps brachii muscles.Methods: In a comparative study of 123 healthy males and females (aged 18-90 years; n=61 aged18-35; n=62 aged 65-90) muscle tone, elasticity and stiffness were measured using the MyotonPRO device.Results: Stiffness was greater and elasticity lower in older adults for BB and RF (p<0.001). Tone was significantly greater in older adults for BB but not for RF when data for males and females were combined (p=0.28). There were no gender differences for BB in either age group. In RF, males had greater stiffness (young males 292 vs females 233 N/m; older males 328 vs females 311 N/m) and tone (young 16.4 vs 13.6 Hz; older 16.7 vs 14.9 Hz).Elasticity in RF was lower in young males than females but did not differ between the older groups (both males and females log decrement 1.6).Conclusions: Stiffness and tone increased with ageing and elasticity decreased. These findings have implications for detecting frailty using a novel biomarker. Age and gender differences are important to consider when assessing effects of pathological conditions on muscle properties in older people.

Background. Many stroke patients exhibit excessive compensatory trunk movements during reaching. Compensatory movement behaviors may improve upper extremity function in the short-term but be detrimental to long-term recovery. Objective. To evaluate the evidence that trunk restraint limits compensatory trunk movement and/or promotes better upper extremity recovery in stroke patients. Methods. A search was conducted through electronic databases from January 1980 to June 2013. Only randomized controlled trials (RCTs) comparing upper extremity training with and without trunk restraint were selected for review. Three review authors independently assessed the methodological quality and extracted data from the studies. Meta-analysis was conducted when there was sufficient homogenous data. Results. Six RCTs involving 187 chronic stroke patients were identified. Meta-analysis of key outcome measures showed that trunk restraint has a moderate statistically significant effect on improving Fugl-Meyer Upper Extremity (FMA-UE) score, active shoulder flexion, and reduction in trunk displacement during reaching. There was a small, nonsignificant effect of trunk restraint on upper extremity function. Conclusion. Trunk restraint has a moderate effect on reduction of upper extremity impairment in chronic stroke patients, in terms of FMA-UE score, increased shoulder flexion, and reduction in excessive trunk movement during reaching. There is insufficient evidence to demonstrate that trunk restraint improves upper extremity function and reaching trajectory smoothness and straightness in chronic stroke patients. Future research on stroke patients at different phases of recovery and with different levels of upper extremity impairment is recommended.

Muscle dimension changes on ultrasound imaging (USI) indicate contractile activity. Quadriceps force and rectus femoris (RF) dimensions were examined to assess USI for estimating contraction level. In 15 healthy males, mean age 24.8 years, isometric quadriceps force was measured in 90° knee flexion during submaximal and maximal voluntary contractions (MVCs) and at MVC in extension. Mid-thigh cross-sectional area (CSA), depth and width, and surface electromyography (EMG) of RF were recorded. Muscle width decreased curvilinearly as both force and EMG increased. At MVC, width was 3.2 ± 0.5 cm, 25% smaller than at rest (4.4 ± 0.7 cm), and similar to MVC in extension (-23%). CSA decreased linearly to -18% at MVC. RF thickness increased by only 10% (at 30% to MVC). Similar width changes at MVC in flexion and extension indicate the clinical potential of USI for assessing quadriceps contractility. Sensitivity is limited to assessing strength to within 25% of MVC in young males.