Activation of Forearm Muscles for Wrist Extension in Patients Affected by Lateral Epicondylitis

Rojas, Mónica; Mañanas, Miguel Ángel; Muller, Bart; Chaler, Joaquim

doi:10.1109/iembs.2007.4353428

Cited by 15 publications

(40 citation statements)

References 11 publications

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“…Furthermore, recent research in non-tennis populations has also theorised that impaired activation of 100 forearm muscles may contribute to the development of LE by altering normal agonist-antagonist relationship (muscle imbalance) and subsequent joint misalignment (Alizadehkhaiyat et al, 2007a;Alizadehkhaiyat et al, 2007b;Blanchette and Normand, 2011;Rojas et al, 2007). Encouraging clinical outcome of wrist muscle strengthening programmes designed to restore the balance between wrist extensor and flexor groups has supported this theory (Cullinane et al, 2014;Raman et al, 2012;105 Tyler et al, 2014).…”

Section: Implications For the Assessment Of Forearm Muscle Function 70mentioning

confidence: 86%

“…As a matter of fact, isometric strength tests only partially relate to functional muscle activity, kinematics, and joint forces during (Wilson and Murphy, 1996). A substantial body of research has emerged to address this issue using EMG examination of the forearm muscles particularly in non-tennis populations (Alizadehkhaiyat et al, 2007a;Alizadehkhaiyat et al, 2007b;Blanchette and Normand, 2011;Rojas et al, 2007;Wilson and Murphy, 1996). The first 115 reports describing the use of surface and fine-wire EMG were published in the (Tönnis, 1965) and since then research in the field has continued to offer sports professionals and clinicians with in depth knowledge of relevant muscle activity primarily focusing on the function of wrist extensors and flexors.…”

Section: Implications For the Assessment Of Forearm Muscle Function 70mentioning

confidence: 99%

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Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

Alizadehkhaiyat

Frostick

2015

Journal of Electromyography and Kinesiology

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There is no consensus about the main aetiology of Lateral Epicondylitis (LE) or Tennis Elbow. While electromyographic assessment of alterations in neuromuscular control and activation patterns of forearm muscles has received increasing interest as potential intrinsic factors in non-tennis players, there has been insufficient attention in tennis players. The purpose of present review was to search the 5 literature for the electromyographic studies of forearm muscles in tennis players in order to 1) identify related implications for LE, 2) highlight key technical and methodological shortcomings, and 3) suggest potential pathways for future research.An electronic search of PubMed, Scopus, Web of Science, and Google Scholars (1980 to October 2014) was conducted. Titles, abstracts, and full-text articles were screened to identify "peer-reviewed" 10 studies specifically looking into "electromyographic assessment of forearm muscles" in "tennis players". After screening 104 articles, 13 original articles were considered in the main review involving a total of 216 participants (78% male, 22% female). There were indications of increased extensor activity in all tennis strokes and less experiences single-handed players, however with insufficient evidence to support their relationship with the development of LE. Studies varied widely 15 in study population, sample size, gender, level of tennis skills, electrode type, forearm muscles studied, EMG recording protocol, EMG normalisation, and reported parameters. As a result, it was not possible to present combined results of existing studies and draw concrete conclusions in terms of clinical implications of findings. There is a need for establishment of specific guidelines and recommendations for EMG assessment of forearm musculature in terms of electrode and muscle 20 selection. Further studies of both healthy controls and tennis players suffering from TE with adequate sample sizes and well-defined demographics are warranted.3

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Section: Implications For the Assessment Of Forearm Muscle Function 70mentioning

confidence: 86%

Section: Implications For the Assessment Of Forearm Muscle Function 70mentioning

confidence: 99%

Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

Alizadehkhaiyat

Frostick

2015

Journal of Electromyography and Kinesiology

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“…Activation of ECR was also reduced in Rojas et al (2007). In this study, activity of the wrist extensor muscles (i.e.…”

Section: Changes To Muscle Activationmentioning

confidence: 98%

“…The NGF model of sustained elbow pain can also be applied more broadly. For instance, to investigate whether the altered patterns of forearm muscle activation in chronic LE (Alizadehkhaiyat et al 2007; Rojas et al 2007) are also found when at the onset of elbow pain and when it is sustained for several days.…”

Section: What Is the Relationship Between Changes To Varelements In Amentioning

confidence: 99%

Movement variability and pain: Searching for a solution

Bergin¹

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Human movement is inherently variable. In the performance of complex, multi-joint tasks, it is possible to consistently achieve an accurate outcome (i.e. low variability of the goal: VARgoal), with many different combinations of joint movements and patterns of muscle activation (i.e. variability in the elements of the movement: VARelements). It has been proposed that when the nervous system is challenged by acute experimental pain, VARelements might increase to search for a new, less painful movement strategy and then decrease if a less painful solution is found. The changes to VARelements found in situations of chronic musculoskeletal pain are more diverse. In chronic pain VARelements might be reduced, increased, not changed, or a complex interaction of these possible adaptations. All previous studies that investigated VARelements during pain evaluated multi-joint tasks (e.g. walking, pointing) that involve multiple elements. It was unclear whether VARelements would be altered in a similar manner for simple tasks with fewer elements and thus limited potential for VARelements to change.For the series of studies included in this thesis, a simple movement task was developed that involved radial-ulnar deviation of the wrist between two target angle regions. Kinematic data were collected with 3-dimensional recording systems and VARelements were considered in wrist flexionextension and forearm pronation-supination. The effect of pain on VARelements during performance of the radial-ulnar deviation task was evaluated in Studies 1-3, under various pain conditions. Study 1 investigated the influence of acute experimental pain, induced with injection of hypertonic saline, on VARelements during performance of the repetitive radial-ulnar deviation task. This study showed that, unlike that observed in more complex multi-joint systems, VARelements was reduced during acute pain in the simple task with limited elements that could change. The most likely explanation was that the motor system constrained movement in an attempt to reduce pain or exert greater control over joint motion.On the foundation of differences in the changes to VARelements for complex and simple tasks during acute pain, Study 2 investigated whether VARelements would initially increase during acute pain to gain exposure to different movement options in a search for a less painful solution. An experimental paradigm was developed where the simple task provoked moderate pain for most movements, but a less painful or non-painful solution was available that was likely to be experienced as a result of VARelements with repetition of the task. We found participants searched for, and found, a less painful movement strategy, but VARelements was not used as part of this search. Participants did not select III the strategy provided as the least painful solution by the experimental paradigm, but found a less painful strategy with gradual changes to wrist/forearm position over multiple repetitions to explore alternative movement options. The changes to VAReleme...

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“…Of the nine included studies, seven investigated individuals with current symptoms of LE with comparison against data for pain-free controls (Alizadehkhaiyat et al, 2007;Bauer & Murray, 1999;Calder et al, 2008;Chourasia et al, 2012;Dessureault et al, 2008a;Kelley, Lombardo, Pink, Perry, & Giangarra, 1994;Schabrun et al, 2014), and two investigated individuals who had recovered from LE and LE-free controls (Alizadehkhaiyat et al, 2009;Rojas, Mañanas, Müller, & Chaler, 2007). Only two outcomes were investigated by more than one study that investigated the same muscles, but these studies included the same sample group and were written by the same author, therefore meta-analysis was not possible.…”

Section: Neuromuscular Controlmentioning

confidence: 99%

Towards an understanding of motor system impairments in individuals with unilateral lateral epicondylalgia

Heales¹

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Human grip is commonly used in sport and recreational activities and involves the coordinated activation of forearm muscles. Lateral epicondylalgia (LE) is a common musculoskeletal disorder that involves pathology of the tendon of extensor carpi radialis brevis (ECRB) at its insertion onto the lateral epicondyle of the humerus. LE presents clinically as pain provoked by gripping activities and has a major impact on function. This results in days off work and time off sport. Despite considerable research into the pathophysiology of LE, it remains poorly understood whether forearm muscles activity is altered during gripping in individuals with LE. This thesis aimed to comprehensively understand the extent of current knowledge and provide new data of activity of the wrist/forearm muscles in LE.Study 1 clarifies the current understanding of muscle activity in LE by way of systematic review with quantitative analysis. This review identified that studies of individuals with LE revealed altered motor unit morphology, abnormal patterns of muscle activity during resisted wrist extension and tennis strokes, fewer cortical peaks and less distance between cortical representation of muscles (mapped with transcranial magnetic stimulation), and delayed activation of wrist extensor muscles during gripping, when contrasted to pain-free controls. The latter finding was also present on the asymptomatic limb.Importantly, this systematic review identified limited understanding of gripping despite the clinical importance of this task in provocation of LE. The only study that had investigated muscle activity during this task had severe limitations that compromise the interpretation of the results. Limitations included the use of surface electromyography (which does not record from individual muscles), and performance of sustained contraction with high grip force (50% maximum voluntary contraction), which is likely to be provocative of pain in some individuals with LE.On the basis of some evidence of sensorimotor changes in the asymptomatic limb of individuals with unilateral LE, Study 2 was conducted as a systematic review with meta-analysis to determine the extent bilateral differences in sensorimotor function between individuals with unilateral tendinopathy and pain-free controls. Study 2 identified evidence for several sensory and motor system differences, ii and evidence for tendon pathology in the asymptomatic limb of individuals with other unilateral tendinopathies (Achilles tendinopathy) but not LE when contrasted to pain-free controls.On the foundation that tendon pathology was present in asymptomatic limb of individuals with Achilles tendinopathy, Study 3 investigated whether there was a greater prevalence of tendon pathology of the asymptomatic common extensor tendon of individuals with LE than pain-free controls. Unlike the findings in the Achilles tendon, Study 3 did not identify greater tendon pathology in the asymptomatic limb of individuals with unilateral LE than that present in the tendons of pain-free individ...

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Activation of Forearm Muscles for Wrist Extension in Patients Affected by Lateral Epicondylitis

Cited by 15 publications

References 11 publications

Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

Movement variability and pain: Searching for a solution

Towards an understanding of motor system impairments in individuals with unilateral lateral epicondylalgia

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