The Shoulder and Elbow Joints and Right and Left Sides Demonstrate Similar Joint Position Sense

Proper orientation of the shoulder and elbow is necessary for accurate and precise positioning of the hand. The authors’ goal was to compare these joints with an active joint position sense task, while also taking into account the effects of joint flexion angle and arm dominance. Fifteen healthy subjects were asked to replicate presented joint angles with a single degree of freedom active positioning protocol. There were no significant differences in angular joint position sense errors with respect to joint (shoulder vs. elbow) and side (left vs. right). However, when considering linear positioning, errors were lower for the elbow, due to a shorter lever arm. Also, as flexion angles increased toward 90°, there was a consistent pattern of lower errors for both joints.     

Shoulder joint position sense is not enhanced at end range in an unconstrained task

Shoulder joint position sense (JPS) is important for maintaining stability and contributing to coordinated movements. It is provided by afferent and centrally-derived signals interpreted and integrated by the central nervous system (CNS) for subsequent use. Shoulder JPS is enhanced as the joint approaches end range of motion (ROM) in studies involving internal and external rotation with the arm supported, but this finding has not been confirmed in unconstrained movements. To address this issue, the present study examined the effect of shoulder position in the horizontal plane on JPS at a constant elevation. Twenty-three healthy individuals were recruited from a university campus. Subjects attempted to actively replicate various target positions in both plane and elevation. Target positions consisted of five positions in the horizontal plane, normalized to individual horizontal abduction ROM, at 90° of arm elevation. All target positions were tested three times, and average absolute and variable errors were analyzed for each position. No differences in either absolute (p = .312) or variable (p = .185) errors were observed between positions. These results further support the contention that the muscle spindles are a dominant source of afferent feedback regarding shoulder JPS in unconstrained movements, even approaching end ROM, when the capsuloligamentous receptors are active.     

Shoulder joint position sense improves with external load

Joint position sense (JPS) is important in the maintenance of optimal movement coordination of limb segments in functional activities. Researchers have shown that the sensitivity of musculotendinous mechanoreceptors increases as muscle activation levels increase. In the present study, when 25 participants tried to replicate the same presented position, both vector and elevation angle repositioning errors decreased linearly as the external load increased up to 40% above unloaded shoulder torque. However, external load had no effect on plane repositioning error. The results indicated that JPS increased under conditions of increasing external load but only in the direction of the applied load. That finding indicates that JPS acuity improves as muscle activation levels increase.     

Shoulder Joint Position Sense Improves With External Load

Joint position sense (JPS) is important in the maintenance of optimal movement coordination of limb segments in functional activities. Researchers have shown that the sensitivity of musculotendinous mechanoreceptors increases as muscle activation levels increase. In the present study, when 25 participants tried to replicate the same presented position, both vector and elevation angle repositioning errors decreased linearly as the external load increased up to 40% above unloaded shoulder torque. However, external load had no effect on plane repositioning error. The results indicated that JPS increased under conditions of increasing external load but only in the direction of the applied load. That finding indicates that JPS acuity improves as muscle activation levels increase.     

Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects

Proprioception is essential for shoulder neuromuscular control and shoulder stability. Exercise of the rotator cuff and scapulothoracic muscles is an important part of shoulder rehabilitation. The purpose of this study was to investigate the effect of rotator cuff and scapulothoracic muscle exercises on shoulder joint position sense. Thirty-six healthy subjects were recruited and randomly assigned into either a control or training group. The subjects in the training group received closed-chain and open-chain exercises focusing on rotator cuff and scapulothoracic muscles for four weeks. Shoulder joint position sense errors in elevation, including the humerothoracic, glenohumeral and scapulothoracic joints, was measured. After four weeks of exercise training, strength increased overall in the training group, which demonstrated the effect of exercise on the muscular system. However, the changes in shoulder joint position sense errors in any individual joint of the subjects in the training group were not different from those of the control subjects. Therefore, exercises specifically targeting individual muscles with low intensity may not be sufficient to improve shoulder joint position sense in healthy subjects. Future work is needed to further investigate which types of exercise are more effective in improving joint position sense, and the mechanisms associated with those changes.     

Effects of concurrent physical and cognitive demands on arm movement kinematics in a repetitive upper-extremity precision task

The effect of concurrent physical and cognitive demands on arm motor control is poorly understood. This exploratory study compared movement kinematics in a repetitive high-precision pipetting task with and without additional concurrent cognitive demands in the form of instructions necessary to locate the correct target tube. Thirty-five healthy female subjects performed a standardized pipetting task, transferring liquid repeatedly from one pick-up tube to different target tubes. In the reference condition, lights indicated the target tube in each movement cycle, while the target tube had to be deciphered from a row and column number on a computer screen in the condition with additional cognitive demands. Kinematics of the dominant arm was assessed using the central tendency and variability of the pipette-tip end-point trajectory and joint kinematics properties of the shoulder and elbow. Movements slowed down (lower velocities and higher area under the movement curves) and trajectory variability increased in the condition with additional cognitive demands, but there were no changes in the kinematics properties such as joint range of motion, times of acceleration and deceleration (as indicated by the time to peak velocity), average angles, or phase relationships between angle and angular velocity of shoulder or elbow movements between the two conditions. Further, there were also no differences in the size or structure of variability of the shoulder and elbow joint angles, suggesting that subjects could maintain the motor repertoire unaltered in the presence of these specific additional cognitive demands. Further studies should address motor control at other levels of concurrent cognitive demands, and with motor tasks that are less automated than the pipetting task used in the present study, so as to gain an increased understanding of the effect of concurrent cognitive demands for other activities of relevance to daily life.     

Comparative study of the differences in shoulder muscle activation according to arm rotation angle

BackgroundScapular muscle exercise is important for patients with shoulder disorders. Distal variance leads to changes in shoulder muscle activation. Here, we aimed to determine whether scapular muscle activation is affected by different arm rotation angles.MethodsOverall, 30 healthy men participated in this study. The subjects were asked to keep their arms at 120 degrees of shoulder flexion while holding a 1.0-kg dumbbell in palms down (pronation) and palms up (supination) positions. Electromyography was used to measure anterior, middle, posterior deltoid, serratus anterior, upper, and lower trapezius muscle activation during the task. The muscle activations of each shoulder were compared between the pronation and supination positions.ResultsAnterior deltoid and serratus anterior activations were significantly higher in supination than in pronation (p < .05). Alternatively, posterior deltoid and lower trapezius muscles were significantly more activated in pronation than in supination (p < .05).ConclusionScapular muscle activation changed with arm rotation angle. Arm rotation angle should be assessed to estimate scapular muscle activation during exercise and motion analysis in clinical practice.     

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.     

Uncontrolled manifold analysis of joint angle variability during table tennis forehand

This study was conducted with the objective of evaluating the variance structure of the trunk and racket arm joint angles in table tennis topspin forehand using the uncontrolled manifold (UCM) approach, regarding racket orientation as the task variable. Nine advanced and eight intermediate male collegiate table tennis players performed the topspin strokes against backspin balls. The trunk, upper limb, and racket were modeled as six rigid-link segments with a total of 16 rotation degrees of freedom. The UCM analysis was conducted using 30 trial datasets per participant to quantify the degree of redundancy exploitation needed to stabilize the vertical and horizontal angles of the racket. Irrespective of the performance level, the variance of the joint angle vector increased towards ball impact. The degree of redundancy exploitation increased towards ball impact. As a result, the variability of the racket angles was minimal at impact. Both groups of players used the relative movement between the racket and the hand to stabilize the racket angles at ball impact. The variance of the joint angle vector that affected the vertical racket face angle at ball impact was significantly smaller for advanced players than for intermediate players, and the degree of redundancy exploitation to stabilize that angle at impact tended to be larger for the advanced players. The ability to use the redundancy of the joint configuration to stabilize the vertical racket face angle at impact may be a critical factor that affects performance level.     

No Relationship Between Joint Position Sense and Force Sense at the Shoulder

In practice, a single test is used to quantify an individual's proprioception. Previous studies have not found a correlation between joint position sense (JPS) and force sense (FS), which are submodalities of proprioception. The purpose of the present study is to determine if root mean square (RMS) error in JPS and FS are related at the shoulder, controlling for external load and elevation angle. Active shoulder angle and force reproduction protocols were performed. No correlation was found between JPS and FS (r = –.019, p = .941) nor were any individual angle and load combinations significant. The main effect for angle in JPS was significant (p < .001). Follow-up contrast demonstrated a significant (p < .001) decrease in RMS error with increased elevation. A significant load by angle interaction was found for FS (p = .014). Follow-up simple effects tests by angle demonstrated RMS error decreased with load at 50° and 70° but not at 90°. By load, RMS error only decreased for 120% between 50° and 90°. JPS and FS demonstrate different behavior with load and angle. This differing behavior is more likely responsible for the lack of correlation than angle and load differences in JPS and FS protocols.     

Does Object Height Affect the Dart Throwing Motion Angle during Seated Activities of Daily Living?

Abstract

Complex wrist motions are needed to complete various daily activities. Analyzing the multidimensional motion of the wrist is crucial for understanding our functional movement. Several studies have shown that numerous activities of daily livings (ADLs) are performed using an oblique plane of wrist motion from radial-extension to ulnar-flexion, named the Dart Throwing Motion (DTM) plane. To the best of our knowledge, the DTM plane angle performed during ADLs has not been compared between different heights (e.g. table, shoulder and head height), as is common when performing day-to-day tasks. In this study, we compared DTM plane angles when performing different ADLs at three different heights and examined the relationship between DTM plane angles and limb position. We found that height had a significant effect on the DTM plane angles - the mean DTM plane angle was greater at the lower level compared to the mid and higher levels. A significant effect of shoulder orientation on mean DTM plane angles was shown in the sagittal and coronal planes. Our findings support the importance of training daily tasks at different heights during rehabilitation following wrist injuries, in order to explore a large range of DTM angles, to accommodate needs of common ADLs.     

Shifts in kinesthesis through time and after active and passive movement.

The position sense of a stationary arm was investigated subsequent to an horizontally adductive movement with axis the shoulder joint. The right arm was the treated arm: it reached a test position actively, using minimal voluntary effort, or passively from each of 10 starting positons. The blind-folded S localized the index finger of the treated arm by attempting to touch it with the index finger of his left hand. The results indicate that subsequent to active movement the final position of a limb is more accurately known than a position resulting from passive movement. A second finding is that concomitant with both forms of limb placement there is a unidirectional drift of perceived limb position over trials.     

Measurement of forearm rotation: The technique,and its reproducibility and validity

Forearm rotation is a point of interest in the study of human movement. For the most part, earlier methods for determining this joint rotation could be applied only in restricted situations. In this paper, a new technique is described, which involves the use of a three-dimensional opto-electronic motion registration system. With only two cameras, the supination angle in almost every position can be determined. A bracelet is attached to the subject’s forearm and fixed to the radius. Wrist points are defined in relation to this bracelet (in its local coordinate system). The properties of the bracelet allow the motion-registration system to calculate its position in the global coordinate system. Given the position of the bracelet, the shoulder, and the elbow, the rotation angle can be determined. The reproducibility (error less than 2^o) of and validity of the technique are also discussed.     

Limb and gender differences in the development of coordination in early infancy

Young infants produce a variety of spontaneous arm and leg movements in the first few months of life. Coordination of leg joints has been extensively investigated, whereas arm joint coordination has mainly been investigated in the sitting position in the context of early reaching and grasping. The current study investigated arm and leg joint coordination of movements produced in the supine position in 10 fullterm infants aged 6, 12 and 18 weeks. Longitudinal comparisons within limbs (intralimb) as well as between limbs (interlimb, ipsilateral and contralateral) were made as well as an exploration of differences in the development for boys and girls. The relationship between the joint angles was examined by measuring pair-wise cross-correlation functions for the angular displacement curves of the leg (hip, knee and ankle) and arm (shoulder, elbow and wrist) joints of both the right and left side. Both the arms and legs were found to follow a similar pattern of intralimb coordination, although the leg joints were more tightly coupled than the arm joints, particularly the proximal with the middle joint. In support of earlier findings, differences in the development of the right and left side were identified. In addition, gender differences in joint coordination were found for both intralimb and interlimb coordination. This contrasts with the view that gender differences in motor development may be primarily a result of environmental influences.     

Effects of scapular retraction/protraction position and scapular elevation on shoulder girdle muscle activity during glenohumeral abduction

According to scapulohumeral rhythm, shoulder abduction is followed through scapular upward rotation to ensure joint mobility and stability. Of interest, the shoulder abduction can be performed holding the scapula in different positions and in association with scapular elevation, with possible effects on shoulder muscle activity. Therefore, the aim of the study was to analyze the activity of relevant shoulder muscles and the activity ratios between the scapulothoracic muscles, during shoulder abduction performed in different combinations of scapular position (neutral, retracted, protracted) and scapular elevation.The electromyographic activity of middle deltoid, serratus anterior, upper, middle and lower fibers of trapezius was recorded during shoulder abduction movements executed holding the scapula in neutral, retracted and protracted position, and subsequently a shoulder elevation movement. The activation of each muscle and the scapulothoracic muscles activity ratios were determined every 15 degrees, from 15° to 120° of abduction.Scapular retraction led to higher activation of the entire trapezius muscle, whereas protraction induced higher upper trapezius, middle deltoid and serratus anterior activity, along with lower activity of middle and lower trapezius. Shoulder elevation led to higher activity of the upper trapezius and middle deltoid. Moreover, it induced lower activation of the serratus anterior and middle and lower trapezius, thus leading to high ratios between the upper trapezius and the other scapulothoracic muscles, especially between 15 and 75 degrees of abduction.This study highlights that shoulder abduction performed with scapular protraction and in combination with scapular elevation leads to increased activity of the middle deltoid and upper trapezius, resulting in imbalances between the scapulothoracic muscles that could hamper the optimal scapulohumeral rhythm. The abduction performed in the aforementioned scapular conditions also induce potential reciprocal inhibition effects between the movers and stabilizers muscles of scapula, suggesting different motor control strategies of integrating a common shoulder movement with various modification of the scapular position.     

Effect of viewing angle on arm reaching while standing in a virtual environment: Potential for virtual rehabilitation

Functional arm movements, such as reaching while standing, are planned and executed according to our perception of body position in space and are relative to environmental objects. The angle under which the environment is observed is one component used in creating this perception. This suggests that manipulation of viewing angle may modulate whole body movement to affect performance. We tested this by comparing its effect on reaching in a virtually generated environment. Eleven young healthy individuals performed forward and lateral reaches in the virtual environment, presented on a flat screen in third-person perspective. Participants saw a computer-generated model (avatar) of themselves standing in a courtyard facing a semi-circular hedge with flowers. The image was presented in five different viewing angles ranging from seeing the avatar from behind (0°), to viewing from overhead (90°). Participants attempted to touch the furthest flower possible without losing balance or stepping. Kinematic data were collected to analyze endpoint displacement, arm-postural coordination and center of mass (COM) displacement. Results showed that reach distance was greatest with angular perspectives of approximately 45-77.5°, which are larger than those used in analogous real world situations. Larger reaches were characterized by increased involvement of leg and trunk body segments, altered inter-segmental coordination, and decreased inter-segmental movement time lag. Thus a viewing angle can be a critical visuomotor variable modulating motor coordination of the whole body and related functional performance. These results can be used in designing virtual reality games, in ergonomic design, teleoperation training, and in designing virtual rehabilitation programs that re-train functional movement in vulnerable individuals.     

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.     

The relation between preparatory stance and trunk rotation movements

The influence of preparatory stance on rotation movement reaction time of the trunk by bending of the knee and hip joint(s) was examined in 12 subjects. Four preparatory stances were examined: straight knee and hip extension (STAND), slight flexion of knee joints and hip joint (LIGHT), deep flexion (DEEP), and free initial position, i.e. that felt to be the most comfortable and effective (FREE). There was no significant influence of the preparatory stance on hip latency, but there were significant differences between the preparatory stances on response time (RT) and movement time (MT). Furthermore, using a quadratic curve fitting technique, knee joint angles of 24.8 degrees and a hip joint angle of 23.3 degrees were shown to be the optimum flexion angles in the preparatory stance for the initiation of quick trunk rotation movements. It is proposed that mechanical factors have considerably more effects on trunk rotation movements than does the nervous system.     

Multi-body dynamic coupling mechanism for generating throwing arm velocity during baseball pitching

The purpose of this study was to identify the detailed mechanism how the maximum throwing arm endpoint velocity is determined by the muscular torques and non-muscular interactive torques from the perspective of the dynamic coupling among the trunk, thorax and throwing and non-throwing arm segments. The pitching movements of ten male collegiate baseball pitchers were measured by a three-dimensional motion capture system. Using the induced-segmental velocity analysis (IVA) developed in this study, the maximum fingertip velocity of the throwing arm (MFV) was decomposed into each contribution of the muscular torques, passive motion-dependent torques due to gyroscopic moment, Coriolis force and centrifugal force, and other interactive torque components. The results showed that MFV (31.6 ± 1.7 m/s) was mainly attributed to two different mechanisms. The first is the passive motion-dependent effect on increasing the angular velocities of three joints (thorax rotation, elbow extension and wrist flexion). The second is the muscular torque effect of the shoulder internal rotation (IR) torque on generating IR angular velocity. In particular, the centrifugal force-induced elbow extension motion, which was the greatest contributor among individual joint contributions, was caused primarily by the angular velocity-dependent forces associated with the humerus, thorax, and trunk rotations. Our study also found that a compensatory mechanism was achieved by the negative and positive contributions of the muscular torque components. The current IVA is helpful to understand how the rapid throwing arm movement is determined by the dynamic coupling mechanism.