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Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls

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Abstract

This study aimed at investigating whether patients with neck–shoulder complaints from different aetiologies (work-related musculo-skeletal disorders, WMSD; whiplash associated disorders, WAD) show comparable muscle activation patterns, characterised by higher activation and lower relaxation levels of the trapezius muscles compared to healthy controls. Twenty healthy controls, 21 WMSD and 20 WAD patients with non-acute neck-shoulder pain were recruited for this cross-sectional study. Surface electromyography (sEMG) recordings were performed at the upper trapezius muscles during reference contractions, standardised computer tasks (typing and unilateral stress task), and rest measurements. sEMG was continuously recorded during these measurements. Outcome measures were root mean square (RMS) to study muscle activity, and relative rest time (RRT) to study muscle relaxation. Statistical analysis comprised the bootstrap technique and Kruskall–Wallis tests. Results showed no clear evidence for abnormal muscle activation patterns in WMSD and WAD patients compared to healthy controls. However, a tendency was observed for higher RMS levels during the reference contractions and computer tasks in both patient groups compared to healthy controls, and lower RRT levels at the non-dominant side during stress. Both patient groups also showed larger variability in RMS and RRT values. This variability has more often been reported in literature and may suggest the existence of subgroups of pain patients with corresponding different muscle activation patterns not related to aetiology. Future research may focus on identifying these subgroups of patients with neck-shoulder pain.

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References

  • Barr AE, Barbe MF (2002) Pathophysiological tissue changes associated with repetitive movement: a review of the evidence. Phys Ther 82(2):173–187

    PubMed  Google Scholar 

  • Basmajian J, de Luca C (1985) Muscles alive. Their functions revealed by electromyography, 5 edn. Williams & Wilkins, Baltimore

    Google Scholar 

  • Blatter B, Bongers PM (1999) Work related neck and upper limb symptoms (RS): high risk occupations and risk factors in the Dutch working population. Report 4070117/r9800293. TNO Work and Employment, Hoofddorp

  • Blatter B, van den Heuvel SG, Bongers PM, Picavet HSJ, Schoemaker CG (2001) De omvang van verzuim en arbeidsongeschiktheid door RSI. Report R2014889/1020123. TNO Work and Employment, Hoofddorp

  • Brandt LP, Andersen JH, Lassen CF, Kryger A, Overgaard E, Vilstrup I, Mikkelsen S (2004) Neck and shoulder symptoms and disorders among Danish computer workers. Scand J Work Environ Health 30(5):399–409

    PubMed  Google Scholar 

  • Brault JR, Siegmund GP, Wheeler JB (2000) Cervical muscle response during whiplash: evidence of a lengthening muscle contraction. Clin Biomech 15(6):426–435

    Article  CAS  Google Scholar 

  • Elert J, Kendall SA, Larsson B, Mansson B, Gerdle B (2001) Chronic pain and difficulty in relaxing postural muscles in patients with fibromyalgia and chronic whiplash associated disorders. J Rheumatol 28(6):1361–1368

    CAS  PubMed  Google Scholar 

  • Efron B, Tibshirani RJ (1993) An introduction to the Bootstrap. Chapman and Hall, New York

    Google Scholar 

  • Falla D, Bilenkij G, Jull G (2004) Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine 29(13):1436–1440

    Article  PubMed  Google Scholar 

  • Faucett J, Rempel D (1994) VTD-related musculo-skeletal symptoms: interaction between work posture and psychosocial workfactors. Am J Indus Med 26:597–612

    Article  CAS  Google Scholar 

  • Hägg GM (1991) Static workloads and occupational myalgia: a new explanation model. In: Anderson P, Hobart D, Danoff J (eds) Electromyographical kinesiology. Elsevier, Amsterdam, pp 141–143

    Google Scholar 

  • Hägg GM, Åström A (1997) Load pattern and pressure pain threshold in the upper trapezius muscle and psychosocial factors in medical secretaries with and without shoulder/neck disorders. Int Arch Occup Environ Health 69:423–432

    Article  PubMed  Google Scholar 

  • Hasenbring M (1999) Wenn die seele auf die bandscheiben drückt. Medizin 43–48

  • Health Council of the Netherlands (2000) RSI. The Hague. Health Council of the Netherlands, publication no 2000/22. ISBN 90-5549-347-3

  • Hermens HJ, Freriks B, Merletti R, et al (1999) European Recommandations for Surface ElectroMyography, Results of the SENIAM project. Roessingh Research and Development, Enschede

  • Hermens HJ, Vollenbroek-Hutten MMR (2004) Effects of electrode dislocation on electromyographic activity and relative rest time: effectiveness of compensation by a normalisation procedure. Med Biol Eng Comput 42(4):502–508

    Article  CAS  PubMed  Google Scholar 

  • Hildebrandt VH, Bongers PM, van Dijk FJ, Kemper HC, Dul J (2001) Dutch musculoskeletal questionnaire: description and basic qualities. Ergon 44(12):1038–1055

    Article  CAS  Google Scholar 

  • Holte KA, Westgaard RH (2002) Daytime trapezius muscle activity and shoulder-neck pain of service workers with work stress and low biomechanical exposure. Am J Ind Med 41(5):393–405

    Article  PubMed  Google Scholar 

  • Johansson H, Sojka P (1991) Pathophysiological mechanisms involved in genesis and spread of muscular tension in occupational muscle pain and chronic musculoskeletal pain syndromes: a hypothesis. Med Hypothesis 35:196–203

    Article  CAS  Google Scholar 

  • Jull G, Kristjansson E, Dall’Alba P (2004) Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther 9(2):89–94

    Article  CAS  PubMed  Google Scholar 

  • Kristjansson E, DallÁlba P, Jull G (2003) A study of five cervicocephalic relocation tests in three different subject groups. Clin Rehabil 17:768–774

    Article  PubMed  Google Scholar 

  • Larsson SE, Alund M, Cai H, Oberg PA (1994) Chronic pain after soft-tissue injury of the cervical spine: trapezius muscle blood flow and electromyography at static loads and fatigue. Pain 57(2):173–180

    Article  CAS  PubMed  Google Scholar 

  • Lundberg U, Kadefors R, Melin B, Palmerud G, Hassmén P, Engström M, Elfsberg I, Dohns E (1994) Psychophysiological stress and EMG activity of the trapezius muscle. Int J Behav Med 4:354–370

    Article  Google Scholar 

  • Mathiassen SE, Winkel J, Hägg GM (1995) Normalization of surface EMG amplitude from the upper trapezius muscle in ergonomic studies: a review. J Electromyogr Kinesiol 4:197–226

    Article  Google Scholar 

  • Nederhand MJ, Hermens HJ, Ijzerman MJ, Turk DC, Zilvold G (2002) Cervical muscle dysfunction in chronic whiplash disorder grade-II—the relevance of the trauma. Spine 27:1056–1061

    Article  PubMed  Google Scholar 

  • Nederhand MJ, Hermens HJ, Ijzerman MJ, Turk DC, Zilvold G (2003) Chronic neck pain disability duet o an acute whilplash injury. Pain:102:63–71

    Article  PubMed  Google Scholar 

  • Nordander C, Hansson GA, Rylander L, Asterland P, Bystrom JU, Ohlsson K, Balogh I, Skerfving S (2000) Muscular rest and gap frequency as EMG measures of physical exposure: the impact of work tasks and individual related factors. Ergonomics 43(11):1904–1919

    Article  CAS  PubMed  Google Scholar 

  • Roe C, Brox JI, Saugen E, Vollestad NK (2000) Muscle activation in the contralateral passive shoulder during isometric shoulder abduction in patients with unilateral shoulder pain. J Electromyogr Kinesiol 10(2):69–77

    Article  CAS  PubMed  Google Scholar 

  • Sandsjö L, Melin B, Rissen D, Dohns I, Lundberg U (2000) Trapezius muscle activity, neck and shoulder pain, and subjective experiences during monotonous work in women. Eur J Appl Physiol 83(2–3):235–238

    Article  PubMed  Google Scholar 

  • Sjölander P (2004) Motor dysfunction in chronic neck pain patients. In: Proceedings of international congress on chronic pain and dysfunction after whiplash and other traumatic neck injuries. ISBN 91-974948-4-4, Gefle University Press

  • Spitzer WO, Skovron ML, Salmi LR et al (1995) Scientific monograph of the Quebec Task Force on Whiplash-associated disorders. Spine 20:1–73

    Article  Google Scholar 

  • Veiersted KB, Westgaard RH, Andersen P (1990) Pattern of muscle activity during stereotyped work and its relation to muscle pain. Int Arch Occup Environ Health 62(1):31–41

    Article  CAS  PubMed  Google Scholar 

  • Veiersted KB, Westgaard RH, Andersen P (1993) Electromyographic evaluation of muscular work pattern as a predictor of trapezius myalgia. Scand J Work Environ Health 19(4):284–290

    CAS  PubMed  Google Scholar 

  • Versteegen G (2001) Sprain in the neck and Whiplash associated disorder. A study from epidemiological and psychological perspective. Thesis. Groningen

  • Wærsted M, Westgaard RH (1997) An experimental study of shoulder muscle activity and posture in a paper version versus a VDU version of a monotonous task. Int J Indus Ergon 19:175–185

    Article  Google Scholar 

  • Westgaard RH, Vasseljen O, Holte KA (2001) Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure. Ergonomics 44(3):339–353

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The present study was performed with financial support provided by Stichting St. Hubertus.

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Authors and Affiliations

  1. Roessingh Research and Development, P.O. Box 310, 7500 AH, Enschede, The Netherlands

    G. E. Voerman, M. M. R. Vollenbroek-Hutten & H. J. Hermens

  2. Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands

    H. J. Hermens

Authors
  1. G. E. Voerman
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  2. M. M. R. Vollenbroek-Hutten
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  3. H. J. Hermens
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Correspondence to G. E. Voerman.

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Voerman, G.E., Vollenbroek-Hutten, M.M.R. & Hermens, H.J. Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls. Eur J Appl Physiol 102, 1–9 (2007). https://doi.org/10.1007/s00421-006-0215-8

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  • DOI: https://doi.org/10.1007/s00421-006-0215-8

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