Verification of intramuscular electromyography electrode placement for neuromuscular partitions of infraspinatus

Kim, Soo Y.; Shakeri, Shayan; Dickerson, Clark R.; Agur, Anne

doi:10.1016/j.jelekin.2019.102354

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…Currently, ER at 0° of elevation is recommended to isolate and strengthen the infraspinatus muscle, 15,33 but is predicated on data from the middle infraspinatus region. 24 Current data suggest that this approach ineffectively engages the inferior infraspinatus region. Standing ER exertions at higher elevations (ie, 90°) elicit moderate to high or very high levels of activity in all 3 infraspinatus muscle regions (Table 1).…”

Section: Discussionmentioning

confidence: 95%

“…8,27,28,30,31,34 However, most available rotator cuff EMG data have used single electrode pairs to represent entire anatomic muscles. Distinct anatomic, artchitectural, and innervational regions exist in the infraspinatus (superior, middle, inferior) 7,14,24 and supraspinatus (anterior, posterior) muscles. 17,21,22 Recent regional EMG studies verified differences during rehabilitation exercises, supporting varied regional function.…”

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confidence: 99%

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Regional Electromyography of the Infraspinatus and Supraspinatus Muscles During Standing Isometric External Rotation Exercises

Whittaker

Alenabi

Kim

2021

Sports Health: A Multidisciplinary Approach

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Background: Whole-muscle electromyography (EMG) data of the rotator cuff support external rotation (ER) strengthening exercises during shoulder rehabilitation. However, distinct neuroanatomic regions in the supraspinatus and infraspinatus exist. Differences in regional muscle activity occur during rehabilitation exercises, but little information is available for ER exertions. Hypothesis: Regional infraspinatus and supraspinatus muscle activity during standing ER exertions will differ with posture and intensity. Study Design: Descriptive laboratory study. Level of Evidence: Level 5. Methods: Twenty healthy individuals (12 men, 8 women) participated. Fine wire electrodes were inserted into 2 supraspinatus and 3 infraspinatus muscle regions. EMG data were recorded during standing isometric ER exertions at 2 intensities (maximal, submaximal) and in 7 postures defined by the angle (0°, 30°, 90°) and plane (abduction, scaption, flexion) of arm elevation. EMG data were normalized to maximum voluntary isometric contraction (% MVIC) to examine the influences of posture, intensity and their interaction on muscle activity. Results: Superior infraspinatus activity was higher in 0° of elevation (50.9% ± 5.7% MVIC) versus 30° of flexion (37.4% ± 3.9% MVIC) at maximal intensity. Inferior infraspinatus activity was higher in 90° of scaption (max = 59.8% ± 2.8% MVIC, submax = 29.4% ± 1.9% MVIC) versus 0° of elevation (max = 42.3% ± 4.5% MVIC, submax = 22.4% ± 2.8% MVIC) ( P = 0.02, P = 0.05, respectively). Anterior supraspinatus activity was highest in 90° of adbuction (max = 61.6% ± 3.1% MVIC; submax = 39.1% ± 3.8% MVIC) and lowest in 30° of flexion (max = 29.0% ± 3.4% MVIC, submax = 15.6% ± 1.7% MVIC) and 90° of flexion (max = 34.6% ± 2.4% MVIC, submax = 14.8% ± 1.9% MVIC). Posterior suprasptinatus activity was lowest in 0° of elevation (34.2% ± 3.0% MVIC), 30° of flexion (33.0% ± 3.6% MVIC) and highest in 90° of abduction (56.2% ± 4.1% MVIC) and 90° of scaption (46.7% ± 2.8% MVIC) (all Ps < 0.04). Conclusion: Regional infraspinatus and supraspinatus muscle activity differed with posture and intensity. Superior and middle infraspinatus muscle activities were similar across postures, but inferior infraspinatus activity was highest in 90° of arm elevation. Anterior and posterior supraspinatus activities were higher in the abduction and scaption planes, especially at 90° of elevation, as compared with the flexion plane. Clinical Relevance: In shoulder rehabilitation of supraspinatus tendon injuries, ER exercises in the flexion plane challenge the whole infraspinatus muscle and require lower supraspinatus muscle activity.

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Regional Electromyography of the Infraspinatus and Supraspinatus Muscles During Standing Isometric External Rotation Exercises

Whittaker

Alenabi

Kim

2021

Sports Health: A Multidisciplinary Approach

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“…Intramuscular electrode insertion was performed by a single researcher and followed previously published protocols for supraspinatus (Kim et al 2017 ) and infraspinatus (Alenabi et al 2018 ; Kim et al 2019 ) sub-regions. Given the target depth for anterior and posterior supraspinatus, custom-made bipolar electrodes were required and ultrasound guidance (12 MHz linear array transducer; GE Logic E, GE Medical Systems, Milwaukee, Wisconsin, USA) was used to confirm placement.…”

Section: Methodsmentioning

confidence: 99%

A comparison of isometric and isokinetic normalization methods for electromyographic data from sub-regions of supraspinatus and infraspinatus during dynamic tasks

Calver

Cudlip

Dickerson

et al. 2023

International Biomechanics

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This study explored effects of using isometric versus isokinetic maximal voluntary contractions (MVCs) to normalize EMG data from supraspinatus and infraspinatus subregions during isokinetic tasks. Participants performed submaximal isokinetic external rotation (ER) and scaption tasks at two speeds. Three isometric MVCs were used: seated ER; side-lying scaption; side-lying abduction. Isokinetic MVCs were performed in the same position and speeds as the experimental tasks. Data were normalized using peak EMG from reference tasks: MVC which produced the greatest amplitude overall (MEA), isometric MVC with greatest amplitude (isometric best), isokinetic MVC with greatest amplitude (isokinetic best), and the greatest amplitude from the isokinetic MVC that matched the experimental task (isokinetic matched). Mean %MVC from each experimental task/ sub-region were compared by normalization method. The isokinetic matched method versus the MEA method was significantly different in all comparisons with isokinetic matched resulting in relative normalized task values up to 162% greater. The isometric best method resulted in significantly greater %MVC 37% of the time compared to the MEA method, whereas there were no differences when using isokinetic best compared to MEA. Isokinetic MVCs are less likely to overestimate %MVC than isometric and their use should be considered when normalizing data from dynamic tasks.

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“…26 A limitation of this study is that comparisons of sEMG was made to iEMG, which can be regarded as a good representation of the level of muscle activation, but it cannot be regarded as a ''criterion standard,'' since placement of intramuscular electrodes cannot be done in a perfect reproducible way. 28 We optimized the reliability of the placement of the needle position to the best of our possibilities by using ultrasound guidance of the needle to position the iEMG. Future studies may focus on inclusion of LBP patients to test whether the construct measured with healthy participants are also valid in patient samples.…”

Section: Cross-talkmentioning

confidence: 99%

Intramuscular EMG Versus Surface EMG of Lumbar Multifidus and Erector Spinae in Healthy Participants

Hofste

Soer

Salomons

et al. 2020

Spine

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Verification of intramuscular electromyography electrode placement for neuromuscular partitions of infraspinatus

Cited by 6 publications

References 15 publications

Regional Electromyography of the Infraspinatus and Supraspinatus Muscles During Standing Isometric External Rotation Exercises

Regional Electromyography of the Infraspinatus and Supraspinatus Muscles During Standing Isometric External Rotation Exercises

A comparison of isometric and isokinetic normalization methods for electromyographic data from sub-regions of supraspinatus and infraspinatus during dynamic tasks

Intramuscular EMG Versus Surface EMG of Lumbar Multifidus and Erector Spinae in Healthy Participants

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