Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial.

The aim of this randomized controlled trial was to assess changes in myalgic trapezius activation, muscle oxygenation, and pain intensity during repetitive and stressful work tasks in response to 10 weeks of training. In total, 39 women with a clinical diagnosis of trapezius myalgia were randomly assigned to: (1) general fitness training performed as leg-bicycling (GFT); (2) specific strength training of the neck/shoulder muscles (SST) or (3) reference intervention without physical exercise. Electromyographic activity (EMG), tissue oxygenation (near infrared spectroscopy), and pain intensity were measured in trapezius during pegboard and stress tasks before and after the intervention period. During the pegboard task, GFT improved trapezius oxygenation from a relative decrease of -0.83 ± 1.48 µM to an increase of 0.05 ± 1.32 µM, and decreased pain development by 43%, but did not affect resting levels of pain. SST lowered the relative EMG amplitude by 36%, and decreased pain during resting and working conditions by 52 and 38%, respectively, without affecting trapezius oxygenation. In conclusion, GFT performed as leg-bicycling decreased pain development during repetitive work tasks, possibly due to improved oxygenation of the painful muscles. SST lowered the overall level of pain both during rest and work, possibly due to a lowered relative exposure as evidenced by a lowered relative EMG. The results demonstrate differential adaptive mechanisms of contrasting physical exercise interventions on chronic muscle pain at rest and during repetitive work tasks.

Biofeedback effectiveness to reduce upper limb muscle activity during computer work is muscle specific and time pressure dependent.

UNLABELLED: Continuous electromyographic (EMG) activity level is considered a risk factor in developing muscle disorders. EMG biofeedback is known to be useful in reducing EMG activity in working muscles during computer work. The purpose was to test the following hypotheses: (1) unilateral biofeedback from trapezius (TRA) can reduce bilateral TRA activity but not extensor digitorum communis (EDC) activity; (2) biofeedback from EDC can reduce activity in EDC but not in TRA; (3) biofeedback is more effective in no time constraint than in the time constraint working condition. Eleven healthy women performed computer work during two different working conditions (time constraint/no time constraint) while receiving biofeedback. Biofeedback was given from right TRA or EDC through two modes (visual/auditory) by the use of EMG or mechanomyography as biofeedback source. During control sessions (no biofeedback), EMG activity was (mean ± SD): 2.4 ± 1.1, 2.5 ± 2.1, and 9.1 ± 3.1%max-EMGrms for right and left TRA and EDC, respectively. During biofeedback from TRA, activity was reduced in right TRA (1.7 ± 1.6%max-EMGrms) and left TRA (1.2 ± 2.0%max-EMGrms) compared to control. During biofeedback from EDC, activity in EDC was reduced (8.3 ± 3.3%max-EMGrms) compared with control. During time constraint, activity was reduced in right TRA (1.9 ± 1.3%max-EMGrms), left TRA (1.5 ± 1.5%max-EMGrms), and EDC (8.4 ± 3.2%max-EMGrms), during biofeedback compared to control. CONCLUSION: biofeedback reduced muscle activity in TRA by ∼ 30-50% and in EDC by ∼ 10% when given from the homologous or bilateral muscle but not from the remote muscle, and was significant in the time constraint condition; while feedback source and presentation mode showed only minor differences in the effect on reducing homologous muscle activity. This implies that biofeedback should be given from the most affected muscle in the occupational setting for targeting relief and prevention of muscle pain most effectively.

Effect of cycling on oxygenation of relaxed neck/shoulder muscles in women with and without chronic pain.

Work-related neck/shoulder muscle pain has been associated with increased anaerobic muscle metabolism. Thus, interventions to enhance oxygenation of painful muscles seem relevant. While cycling with relaxed shoulders has been shown to result in acute neck/shoulder muscle pain reduction, the effect on tissue oxygenation remains unknown. The aim of the present study was to investigate tissue oxygenation of the passive trapezius muscle during and after cycling in female workers with (MYA) and without (CON) trapezius myalgia. Eligible participants (n = 17 MYA, n = 8 CON) performed 20 min sub-maximal cycling in an upright position with relaxed shoulders. Near-infrared spectroscopy was used to measure trapezius muscle oxygenation during and 2 min after the cycling period. For both MYA and CON, oxygenation of the passive trapezius increased in a linear fashion over time, to values approximately 5 microM above baseline at the end of the cycling period, with no significant group difference (CON 5.2, MYA 4.9 microM). Two min after termination of exercise, oxygenation was increased further in both groups, but significantly more in CON (8.8 microM) than in MYA (7.0 microM) (P = 0.05). In conclusion, cycling increases oxygenation of resting neck/shoulder muscles in women with and without trapezius myalgia, indicating acute positive effects of either neural or humoral factors on vascular beds of distant relaxed muscles. Although this beneficial response was observed in both groups, the post-exercise response was lower in women with trapezius myalgia.

Effects of electromyographic and mechanomyographic biofeedback on upper trapezius muscle activity during standardized computer work.

The purpose of this laboratory study was to investigate the effects of surface electromyography (EMG)- and mechanomyography (MMG)-based audio and visual biofeedback during computer work. Standardized computer work was performed for 3 min with/without time constraint and biofeedback in a randomized order. Biofeedback was given on the basis of an individual preset threshold value for the right trapezius EMG and MMG signal and a time factor (repetition of events above the threshold). The duration of muscle activity above the preset threshold, the right trapezius EMG and MMG root mean square (RMS) values as well as the work performance in terms of number of completed graph/mouse clicks/errors, the rating of perceived exertion (RPE) and the usefulness of the biofeedback were assessed. The duration of muscle activity above the threshold was significantly lower with MMG compared with EMG as source of biofeedback (p < 0.05). Biofeedback led to a significant decrease in the right trapezius EMG RMS, lower RPE and decreased number of errors and mouse clicks, but also decreased number of completed graphs (p < 0.05). Audio and visual biofeedbacks were as effective. MMG-based biofeedback is a potential reliable alternative to EMG in ergonomics. A lowering of the trapezius muscle activity may contribute to diminish the risk of work related musculoskeletal disorders development.

Muscle tissue oxygenation, pressure, electrical, and mechanical responses during dynamic and static voluntary contractions.

Dynamic muscle contractions have been shown to cause greater energy turnover and fatigue than static contractions performed at a corresponding force level. Therefore, we hypothesized that: (1) electro- (EMG) and mechanomyography (MMG), intramuscular pressure (IMP), and reduction in muscle oxygen tension (rTO(2)) would be larger during dynamic (DYN) than intermittent static (IST) low force contractions; and that (2) oxygen tension would remain lower in the resting periods subsequent to DYN as compared to those following IST. Eight subjects performed elbow flexions with identical time-tension products: (1) DYN as a 20 degrees elbow movement of 2 s concentric and 2 s eccentric followed by a 4 s rest; and (2) IST with a 4 s contraction followed by a 4 s rest. Each session was performed for 1 min at 10 and 20% of the maximal voluntary contraction (MVC). The force, bipolar surface EMG, MMG, IMP, rTO(2) were measured simultaneously from the biceps brachii, and the data presented as the mean values together with the standard error of the means. Comparison of the corresponding time periods showed the EMG(rms) and MMG(rms) values to be larger during DYN than IST (concentric phase: DYN vs IST were 14.2 vs 9.4, and 22.0 vs 15.9%(max)-EMG(rms); eccentric phase: in DYN, the MMG was approximately 1.5 and approximately 2.0-fold IST at 10 and 20%MVC, respectively). In contrast, the IMP of the concentric phase in DYN was lower than in IST (2.3 vs 29.5 and 10.9 vs 42.0 mmHg at 10 and 20%MVC, respectively), and a similar picture was seen for the eccentric phase. However, no differences were seen in rTO(2) in either the contraction or the rest periods. In a prolonged rest period (8 s) after the sessions, DYN but not IST showed rTO(2) above baseline level. In conclusion, rTO(2) in DYN and IST were similar in spite of major differences in the MMG and EMG responses of the muscle during contraction periods. This may relate to the surprisingly lower IMP in DYN than IST.