The influence of proximal motor strategies on pianists' upper-limb movement variability.

Repetitive movements are considered a risk factor for developing practice-related musculoskeletal disorders. Intra-participant kinematic variability might help musicians reduce the risk of injury during repetitive tasks. No research has studied the effects of proximal motion (i.e., trunk and shoulder movement) on upper-limb movement variability in pianists. The first objective was to determine the effect of proximal movement strategies and performance tempo on both intra-participant joint angle variability of upper-limb joints and endpoint variability. The second objective was to compare joint angle variability between pianist's upper-limb joints. As secondary objectives, we assessed the relationship between intra-participant joint angle variability and task range of motion (ROM) and documented inter-participant joint angle variability. The upper body kinematics of 9 expert pianists were recorded using an optoelectronic system. Participants continuously performed two right-hand chords (lateral leap motions) while changing movements based on trunk motion (with and without) and shoulder motion (counter-clockwise, back-and-forth, and clockwise) at two tempi (slow and fast). Trunk and shoulder movement strategies collectively influenced variability at the shoulder, elbow and, to a lesser extent, the wrist. Slow tempi led to greater variability at wrist and elbow flexion/extension compared to fast tempi. Endpoint variability was influenced only along the anteroposterior axis. When the trunk was static, the shoulder had the lowest joint angle variability. When trunk motion was used, elbow and shoulder variability increased, and became comparable to wrist variability. ROM was correlated with intra-participant joint angle variability, suggesting that increased task ROM might result in increased movement variability during practice. Inter-participant variability was approximately six times greater than intra-participant variability. Pianists should consider incorporating trunk motion and a variety of shoulder movements as performance strategies while performing leap motions at the piano, as they might reduce exposure to risks of injury.

Neurophysiological Changes Induced by Music-Supported Therapy for Recovering Upper Extremity Function after Stroke: A Case Series.

Music-supported therapy (MST) follows the best practice principles of stroke rehabilitation and has been proven to instigate meaningful enhancements in motor recovery post-stroke. The existing literature has established that the efficacy and specificity of MST relies on the reinforcement of auditory-motor functional connectivity in related brain networks. However, to date, no study has attempted to evaluate the underlying cortical network nodes that are key to the efficacy of MST post-stroke. In this case series, we evaluated changes in connectivity within the auditory-motor network and changes in upper extremity function following a 3-week intensive piano training in two stroke survivors presenting different levels of motor impairment. Connectivity was assessed pre- and post-training in the α- and the ß-bands within the auditory-motor network using magnetoencephalography while participants were passively listening to a standardized melody. Changes in manual dexterity, grip strength, movement coordination, and use of the upper extremity were also documented in both stroke survivors. After training, an increase in the clinical measures was accompanied by enhancements in connectivity between the auditory and motor network nodes for both the α- and the ß-bands, especially in the affected hemisphere. These neurophysiological changes associated with the positive effects of post-stroke MST on motor outcomes delineate a path for a larger scale clinical trial.

Unilateral Conditioning Contractions Enhance Power Output in Elite Short Track Speed Skaters.

The objective of the present study was to assess the effect of unilateral lower-body-conditioning muscle contractions during multiple sets of fatiguing repeated jumps in elite athletes. Five elite short-track speed-skating athletes performed 9 sets of 6 maximal consecutive jumps on 2 separate occasions: with (COND) and without (CTRL) preliminary voluntary conditioning contractions (CC) 5 min before the beginning of the sets. The CC consisted of 2 consecutive 3 s maximal unilateral isometric squats against a fixed bar, resulting in a 6 s overall isometric contraction per leg. For each set, power output (PO) was measured using a linear position transducer and averaged over the 6 corresponding repeated jumps. The results showed that PO was significantly greater during the test in COND than in CTRL ( p <0.01). PO significantly decreased with sets, by 19.4±4.7 and 15.2±7.6% ( p <0.001) between the first and last set in COND and CTRL, respectively. A 2×3 s maximal unilateral isometric CC, performed 5 min before unloaded repeated jumps, significantly increased mean PO. These results suggest that unilateral conditioning contractions can enhance performance in subsequent bilateral repeated jumps.

Intra- and Intersession Reliability of Surface Electromyography on Muscles Actuating the Forearm During Maximum Voluntary Contractions.

The aim of this study is to determine the intra- and intersession reliability of nonnormalized surface electromyography (sEMG) on the muscles actuating the forearm during maximum voluntary isometric contractions (MVIC). A subobjective of this study is to determine the intra- and intersession reliability of forearm MVIC force or torque, which is a prerequisite to assess sEMG reliability. Eighteen healthy adults participated at 4 different times: baseline, 1-h post, 6-h post, and 24-h post. They performed 3 MVIC trials of forearm flexion, extension, pronation, and supination. sEMG of the biceps brachii short head, brachialis, brachioradialis, triceps brachii long head, pronator teres, and pronator quadratus were measured. The intraclass correlation coefficient (ICC) on MVIC ranged from 0.36 to 0.99. Reliability was excellent for flexion, extension, and supination MVIC for both intra- and intersession. The ICC on sEMG ranged from 0.58 to 0.99. sEMG reliability was excellent for brachialis, brachioradialis, and pronator quadratus, and good to excellent for triceps brachii, biceps brachii, and pronator teres. This study shows that performing 3 MVICs is sufficient to obtain highly reliable maximal sEMG over 24 h for the main muscles actuating the forearm. These results confirm the potential of sEMG for muscle motor functional monitoring.