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Biomedical subjects

M Pink

Publications and source records attributed to M Pink.

At least 55 records · Page 3Linked to original sources

Dynamic stability of the elbow: electromyographic analysis of the flexor pronator group and the extensor group in pitchers with valgus instability.

The medical collateral ligament is a common site of injury in baseball pitchers, causing substantial morbidity and loss of pitching time. Twenty-six skilled baseball pitchers with medial collateral ligament insufficiency were studied before surgery with high-speed cinematography and fine-wire electromyography of eight muscles around the elbow. Data from the pitchers with injured elbows were compared with data obtained from uninjured pitchers. The flexor carpi radialis muscle in the pitchers with medial collateral ligament deficiencies revealed significantly decreased firing during the acceleration and deceleration phase of the fastball when compared with that of the pitchers with normal elbows, and the flexor carpi radialis muscle was significantly depressed during the early cocking and deceleration phases. The extensor muscles revealed slightly increased activity in the injured elbows; however, this was not statistically significant. Although the muscles of the flexor pronator group (especially the flexor carpi ulnaris muscle and the flexor digitorum superficialis muscles) are anatomically positioned to provide dynamic stability of the elbow, they did not demonstrate increased electrical activity in pitchers with medial collateral ligament deficiencies. This finding suggests that the muscles on the medial side of the elbow do not supplant the role of the medial collateral ligament during the fastball pitch.

Baseball↗

Electromyographic and nerve block analysis of the subscapularis liftoff test.

The inability to perform the "liftoff" test has been attributed to a subscapularis muscle or tendon injury. The goals of this study were to evaluate the activity of the glenohumeral muscles during performance of the "liftoff" maneuver and to identify the most effective initial upper extremity placement that isolates the subscapularis musculotendinous unit. In the first phase of this study 15 subjects accomplished four proposed versions to the "liftoff" test while their intramuscular electromyographic activity in select glenohumeral muscles was recorded. The second phase of this study assessed the ability of five subjects with a nonfunctional subscapularis musculotendinous unit to perform the same proposed versions. On the basis of electromyographic data none of the proposed versions to the "liftoff" maneuver isolated the upper and lower subscapularis muscle from either the teres major, latissimus dorsi, posterior deltoid, or rhomboid muscles (p > 0.05). In the presence of a nonfunctional subscapularis musculotendinous unit, the subjects were able to perform all of the proposed versions of the "liftoff" maneuver except one: elevation of the dorsum of the hand from the posterior-inferior border of the scapula (maximum internal rotation test). Although significant electromyographic activity was generated in the potentially confounding shoulder girdle muscles during the maximum internal rotation "liftoff" test, a successful test appears to be dependent on the isolated glenohumeral internal rotation function of the subscapularis muscle.

Adult↗

Electromyographic analysis of elbow function in tennis players.

Muscle activity about the elbow during tennis strokes in nine professional and collegiate level players was studied using indwelling EMG and high speed photography. Eight muscles were evaluated for the serve, forehand, and backhand strokes. The serve was divided into six stages and the ground strokes into four stages. EMG tracings were subjected to analog-to-digital conversion and a relative measure of quantity was obtained. Analysis of variance and Turkey tests were then done to assess statistical significance (P less than 0.05). The ground strokes showed low activity in all muscles tested during the preparation phase. During the acceleration phase, both the backhand and forehand showed a generalized increase in all muscle activity. Both strokes showed marked activity of the wrist extensors and, in addition, the forehand showed high activity in the brachialis and biceps. In the follow-through phase, there was a generalized decrease in muscle activity. The serve showed low activity in all muscles tested during the wind-up phase. The wrist extensors increased their activity in the cooking phase, with marked activity in late cooking. The pronator teres and the triceps showed increased activity in the acceleration phase. Follow-through phase showed low muscle activity except for the biceps, which increased in late follow-through. In conclusion, the muscles of the elbow help stabilize the elbow as a unit during the ground strokes in these high level players. Power in the serve comes from increased activity in the triceps and pronator teres. The predominant activity of the wrist extensors in all strokes may be one explanation for predisposition to injury.

Athletic Injuries↗

Electromyographic shoulder activity in men and women professional golfers.

Men and women both enjoy the game of golf. Special considerations are made for women, such as the courses on the professional tours. Thus, one can ask what differences might exist between men and women golfers. This study compares the electromyographic firing patterns of normal shoulder musculature in men and women professional golfers. Eight shoulder muscles (pectoralis major, latissimus dorsi, supraspinatus, infraspinatus, subscapularis, anterior, middle and posterior deltoids) were studied using indwelling electromyography. A visual analysis revealed that women tended to have slightly more activity during the takeaway and forward swing phases, and the men tended to have more activity during acceleration and follow-through. However, an independent two-tailed t-test (P = 0.05) showed these differences not to be statistically significant. This finding is in keeping with injury incidence data from the LPGA Tour, PGA Tour, and Senior PGA Tour, which showed that all three tours have a similar incidence of shoulder injuries. This study does not compare the relative strength of men and women, however.

Adult↗

Electromyographic analysis of the shoulder during the golf swing.

Golf is a popular sport throughout the world, yet there is little in the literature that discusses the mechanics of the swing. The purpose of this study is to analyze the EMG activity in eight shoulder muscles of both the right and left arms during the golf swing. The results reveal that the infraspinatus and supraspinatus act predominantly at the extremes of shoulder range of motion, the subscapularis and pectoralis major during acceleration, the latissimus dorsi during forward swing, and the anterior deltoid during forward swing and follow-through. The middle and posterior deltoids appear to be relatively noncontributory, without any specific timing patterns. This data is an expansion of an earlier pilot study and allows us to more accurately develop an exercise program for optimal performance as well as for prevention and rehabilitation.

Adult↗

Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program.

Many exercises are used to strengthen the glenohumeral muscles, but there have been limited studies to evaluate the exercises. Thus, the purpose of this study was to decide how the muscles responsible for humeral motion can best be exercised in a rehabilitation program for the throwing athlete. Dynamic, fine wire, intramuscular electromyography was carried out in 15 normal male volunteers performing 17 shoulder exercises derived from a shoulder rehabilitation program used by professional baseball clubs. The four rotator cuff muscles were studied, as well as other positioners of the humerus, including the pectoralis major, latissimus dorsi, and three portions of the deltoid. The electromyographic activity was synchronized with cinematography and averaged over 30 degrees arcs of motion. An exercise was considered to be a significant challenge for a muscle if it generated at least 50% of its predetermined maximum contraction over three consecutive arcs (i.e., a 90 degrees range). Four exercises were consistently found to be among the most challenging exercises for every muscle. These shoulder exercises consisted of 1) elevation in the scapular plane with thumbs down, 2) flexion, 3) horizontal abduction with arms externally rotated, and 4) press-up. This study documents that the minimum for an effective and succinct rehabilitation protocol for the glenohumeral muscles would include these exercises.

Adult↗

The normal shoulder during freestyle swimming. An electromyographic and cinematographic analysis of twelve muscles.

The shoulder in swimming is subjected to multiple factors that can lead to a high injury rate. To prevent injury, one must understand the biomechanics of swimming. This paper describes the electromyographic and cinematographic findings of 12 shoulder muscles in competitive swimmers without shoulder pain. The results show the three heads of the deltoid and the supraspinatus functioning in synchrony to place the arm at hand entry and exit, the rhomboids and upper trapezius to position the scapula for the arm, the pectoralis major and latissimus dorsi to propel the body, the subscapularis and serratus anterior as muscles with constant muscle activity, the teres minor functioning with the pectoralis major, and the infraspinatus active only to externally rotate the arm at midrecovery. This information is important to design optimal preventative and rehabilitative exercise programs.

Adult↗

The painful shoulder during freestyle swimming. An electromyographic cinematographic analysis of twelve muscles.

The purpose of this paper is to describe the patterns of activity of 12 shoulder muscles in painful shoulders, and compare those patterns of activity with normal shoulders. The results show significant differences in 7 of the 12 muscles. Those muscles included the anterior deltoid, middle deltoid, infraspinatus, subscapularis, upper trapezius, rhomboids, and the serratus anterior. There were no significant differences between muscle activity patterns of normal versus painful shoulders in the latissimus dorsi, pectoralis major, teres minor, supraspinatus, or the posterior deltoid. This information will contribute to the development of muscle conditioning programs to optimize performance and prevent injury, as well as develop programs for scientific rehabilitation strengthening.

Adult↗

EMG analysis of the scapular muscles during a shoulder rehabilitation program.

The purpose of this study was to determine which exercises most effectively use the scapular muscles. Eight muscles in 9 healthy subjects were studied with indwelling electromyographic electrodes and cinematography while performing 16 exercises. The 8 muscles studied were the upper, middle, and lower trapezius; levator scapula; rhomboids; pectoralis minor; and the middle and lower serratus anterior. Each exercise was divided into arcs of motion and the electromyographic activity was quantified as a percentage of the maximal manual muscle test. The optimal exercises for each muscle were identified based on intensity (greater than 50% maximal manual muscle test) and duration (over at least 3 consecutive arcs of motion) of the muscle activity. Twelve of the exercises qualified as top exercises for all of the muscles. On further analysis, a group of 4 exercises was shown to make up the core of a scapular muscle strengthening program. Those 4 exercises include scaption (scapular plane elevation), rowing, push-up with a plus, and press-up.

Adult↗

An electromyographic analysis of the elbow in normal and injured pitchers with medial collateral ligament insufficiency.

Electromyography and high-speed film were used to examine the muscle activity in the elbows of pitchers with medial collateral ligament insufficiency compared to the activity in uninjured elbows. Ten competitive baseball pitchers with medial collateral insufficiency and 30 uninjured competitive pitchers were tested while throwing the fastball and the curveball. The extensor carpi radialis brevis and longus in the injured pitchers showed greater activity than in the uninjured pitchers for both pitches. The triceps, flexor carpi radialis, and pronator teres all showed less activity in the injured pitchers during the fastball, but only the triceps had less activity during the curveball. The differences were seen during the late cocking and acceleration phases, which place the greatest stress on the medial collateral ligament. If the flexor carpi radialis and pronator teres were substituting for the deficient medial collateral ligament and functioning as dynamic stabilizers, one would expect enhanced muscle activity. However, the opposite was found. This pattern of asynchronous muscle action with medial collateral ligament injury may predispose the joint to further injury. The muscular differences seen are critical to the understanding of the pathomechanics of patients with medial collateral ligament deficiency, and provide a basis for rehabilitation.

Adolescent↗

Electromyographic analysis of the trunk in golfers.

Golf is a popular sport for both men and women. The trunk is the most common area of injury during the golf swing. The purpose of this study was to describe and compare the muscle firing patterns in the trunk during the golf swing. Twenty-three golfers with handicaps of five or below volunteered for this study. Surface electromyographic electrodes were placed on the abdominal oblique and erector spinae muscles bilaterally. High-speed cinematography was used in conjunction with the electromyographic electrodes. The results demonstrated relatively low activity in all muscles during takeaway (below 30% of maximal muscle test), and relatively high and constant activity throughout the rest of the swing (above 30% maximal muscle test, with the exception of the contralateral erector spinae during late follow-through, which was 28% maximal muscle test). This high and constant activity demonstrated the importance of the trunk muscles during a golf swing. These results indicate the need for an effective preventive and rehabilitative exercise program for the golfer.

Abdominal Muscles↗

Electromyographic and cinematographic analysis of elbow function in tennis players using single- and double-handed backhand strokes.

It is generally believed that tennis players using a double-handed backhand rarely develop lateral epicondylitis since the helping arm appears to absorb more energy and changes the mechanics of the swing. The purpose of this paper was to compare muscle activity about the elbow in single- and double-handed backhand strokes in competitive tennis players. Muscle activity in 3 elbow extensors, a wrist flexor, and a forearm pronator of the dominant arm was compared during the single-handed (N = 14) and double-handed (N = 13) backhand ground strokes using indwelling electromyography and high-speed cinematography. Significantly higher activity was seen in the double-handed technique in the flexor carpi radialis muscle in the preparation phase and in the pronator teres muscle in the acceleration phase. Higher flexor carpi radialis muscle activity in preparation of the double-handed stroke appeared to be a function of the double-handed grip used on the racquet, and the increased pronator teres muscle activity in acceleration indicated maintenance of greater pronation provided by the grip of the non-dominant hand. The decreased occurrence of lateral epicondylitis in players using a double-handed backhand may not be caused by decreased extensor activity, but rather by factors associated with flawed stroke mechanics more often seen in the single-handed technique.

Elbow↗

Muscular control of the ankle in running.

The purpose of this study was to describe and compare the muscle firing patterns of the muscles controlling the ankle during running. Fine-wire electrodes monitored the activity of the gastrocnemius, soleus, peroneus brevis, tibialis posterior, and tibialis anterior muscles during 3 paces of running. High-speed film was used to synchronize the electromyographic data with the phases of running. The subjects were 15 recreational and competitive runners who were injury-free. There were 3 significant findings. First, the firing patterns of all of the posterior muscles demonstrated peak activity during midstance phase. Thus, these muscles were contracting in an eccentric fashion to control ankle dorsiflexion as the center of gravity passed over the ankle. Second, the tibialis anterior muscle fired above the fatigue threshold for 85% of the time. This may account for the high number of fatigue-related injuries to the tibialis anterior muscle seen in runners. Third, there was a significant increase of activity in the peroneus brevis muscle as the pace increased. This indicates the importance of training this muscle when pace is increased. Using this information, a sport-specific effective and efficient exercise program for runners can be developed.

Adult↗

Electromyographic analysis of hip and knee musculature during running.

The purpose of this study was to describe the firing pattern of 11 hip and knee muscles during running. Thirty recreational runners volunteered to run at 3 different paces with indwelling electromyographic electrodes while being filmed at 100 frames per second. Results demonstrated that medial and lateral vasti muscles acted together for knee extension during terminal swing and loading response, possibly providing a patella stabilizing role. The vastus intermedius muscle functioned with the other vasti, plus eccentrically controlled knee flexion during swing phase. The rectus femoris muscle fired with the vastus intermedius muscle and assisted the iliacus muscle with hip flexion. The hamstrings fired primarily to eccentrically control hip flexion. The adductor magnus, tensor fascia lata, and gluteus maximus muscles afforded pelvic stabilization while assisting with hip flexion and extension. Forward propulsion was provided mainly by hip flexion and knee extension, which is contrary to the view that posterior calf muscles provide propulsion during toe off. Faster running paces lead to increased activity in the muscles. This may lead to more injuries, primarily in the muscles that were contracting eccentrically.

Adult↗

Electromyographic and cinematographic analysis of elbow function in tennis players with lateral epicondylitis.

Lateral epicondylitis occurs frequently in tennis players and appears to be caused by tears in the extensor aponeurosis. The purpose of this study was to compare the electromyographic activities of 5 muscles in players with lateral epicondylitis with those of injury-free players during the single-handed backhand tennis stroke. Finewire electrodes were placed into the extensor digitorum communis, extensor carpi radialis longus and brevis, pronator teres, and flexor carpi radialis muscles in competitive tennis players; 8 players had lateral epicondylitis and 14 had normal upper extremities. The backhand stroke then was recorded on high-speed film and synchronized with the electromyographic signal. The injured players had significantly greater activity for the wrist extensors and pronator teres muscles during ball impact and early follow-through. This activity increase may have been caused by the abnormal mechanics evident on film, including a "leading elbow," wrist extension and an open racquet face near the time of ball impact, and ball contact in the lower half of the strings. These mechanics not only result in a lower level of play but also leave the wrist extensors and the pronator teres muscles vulnerable to injury. This is the first study that documents increased activity in muscles that have been previously injured.

Acceleration↗

Lower extremity range of motion in the recreational sport runner.

The purposes of this study in the recreational runner were to describe and compare lower extremity sagittal range of motion and vertical body displacement for slow and fast paces during treadmill and overground running, and to compare timing of the running phases at the two paces. Vertical displacement of the body, and flexion and extension of the hip, knee, and ankle were measured with a motion analysis system at 200 hertz as the subjects self-selected the two paces. No statistically significant differences were seen when comparing sagittal motion on a treadmill with overground running. Statistically more vertical displacement during overground running was recorded when compared with treadmill running. Peak vertical force was near midstance when the ankle, knee, and hip approached maximum flexion. Results demonstrated that during a slow pace the approximate arcs of motion were: ankle, 50 degrees; knee, 95 degrees; and hip, 40 degrees. During running at a fast pace, the hip required more extension in early swing; the hip and knee required more flexion in middle and late swings. The fact that ankle motion did not change with the different speeds gave credence to the belief that push-off, or toe-off, is not the source of power in running.

Adult↗

An electromyographic analysis of the knee during functional activities. I. The normal profile.

This study describes the fine-wire electromyographic profile of the normal knee. Twenty-two subjects with no prior history of knee injury volunteered for the study. Each subject had fine-wire electromyographic evaluation of 8 muscles (vastus medialis oblique, vastus lateralis, rectus femoris, semimembranosus, biceps femoris, tibialis anterior, gastrocnemius, and soleus muscles) while performing 7 functional activities. The percentage of maximum manual test for each muscle during each phase of the activities was used to determine means and standard deviations for the group. Walking and ramp and stair ascending and descending produced similar electromyographic profiles. Running and cross-cutting demonstrated unique electromyographic profiles with an overall higher muscle activity than the previous 5 activities. A quadriceps-hamstrings muscles' coordinated response was identified consistently in each activity. These findings illustrate the integral nature of each of the 8 examined muscles in knee motion. Furthermore, this study demonstrates a coordinated response of quadriceps-hamstrings muscles in the normal knee and may more thoroughly define the coordinated activity of these 2 antagonist muscle groups. Finally, this study provides a framework within which various knee conditions can be compared and from which specific rehabilitation recommendations can be generated.

Activities of Daily Living↗

An electromyographic analysis of the knee during functional activities. II. The anterior cruciate ligament-deficient and -reconstructed profiles.

This study compared the electromyographic activity of normal (N = 22), rehabilitated anterior cruciate ligament-deficient (N = 8), and -reconstructed knees (N = 10) while subjects performed activities. Each subject had evaluation of 8 muscles during 7 functional activities. Sixty-seven percent of the differences in the quadriceps muscle reflected increased activity in the vastus lateralis muscle of the rehabilitated group; 75% of the differences in the hamstrings muscles noted increased biceps femoris muscle activity in the rehabilitated group; 56% of the differences in the lower leg musculature showed increased tibialis anterior muscle activity in the rehabilitated group. Eighty-six percent of the statistically different intervals involved rehabilitated subjects demonstrating increased activity over reconstructed or normal subjects or both. The presence of a quadriceps-hamstrings muscles coordinated response was identified consistently in all 3 groups in each activity. This study supports surgical reconstruction for the anterior cruciate ligament-deficient knee. It also demonstrates the importance of the vastus lateralis, biceps femoris, and tibialis anterior musculature in the rehabilitation of the anterior cruciate ligament-deficient patient. The presence of a quadriceps-hamstrings muscles coordinated response indicates that mechanoreceptors mediating this reflex arc exist in structures other than the cruciate ligament.

Adolescent↗