A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study ...

Duquesne University

Scapular muscles precisely move the scapulothoracic articulation and if fatigued may contribute to pathology. Fatigue of serratus anterior may be a mechanism for shoulder pathology by altering scapula motions and requiring compensation by other shoulder muscles. A total of 28 asymptomatic subjects performed a task to fatigue the serratus anterior, while muscle activity was recorded from three muscles. Mean normalized activation levels and activation ratios were examined before and after the fatigue task during arm elevation and lowering. All muscles demonstrated meaningful declines in the median frequency of the electromyographic signal during the task. Following the task, only the upper trapezius had higher mean activation levels (mean difference 10.79% MVIC), while the serratus anterior/lower trapezius activation ratio was altered (mean difference -0.3). Higher mean upper trapezius activation may be compensatory for fatigue of other shoulder muscles and may reflect fiber type or central control mechanisms. Serratus anterior eccentric endurance training may be beneficial for the prevention of shoulder pathology.

Scapular muscle activation and co-activation following a fatigue task.

Scapular kinematic and muscle activity alterations have been identified in individuals with subacromial impingement syndrome of the shoulder, including workers and athletes who regularly perform overhead activities. Serratus anterior fatigue is a proposed mechanism for these kinematic alterations, although no direct evidence supports such a relationship. The purpose of this study was to examine three-dimensional scapula kinematics in asymptomatic participants before and after a task intended to preferentially fatigue serratus anterior. Twenty-eight participants completed the study. The experimental task consisted of five repetitions of scapular plane arm elevation and the fatigue task was the isometric hold of scapular protraction in the push-up position. Electromyography of four shoulder muscles was collected during the task to determine level of muscle fatigue, and the Borg CR10 scale was used to assess subjective fatigue. The fatigue task resulted in decreased median power frequency in all four muscles and significantly increased Borg scores. Scapula posterior tilting and internal rotation were most impacted by muscle fatigue, with decreased posterior tilting and increased internal rotation after the task. There was no effect on scapular upward rotation. Effect sizes were low to moderate (.13-.51) where these kinematic alterations reached statistical significance. Shoulder muscle fatigue contributes to scapular kinematic alterations and is a plausible risk factor for subacromial impingement syndrome.

Scapula kinematic alterations following a modified push-up plus task.

Shoulder motion loss following surgical treatment of breast cancer is common and may be associated with surgery-related soft tissue changes and altered shoulder kinematics. Knowledge of short term biomechanical changes at the shoulder will inform treatment decisions and may help prevent the development of shoulder pathology. Shoulder motion loss following surgery also impacts quality of life and shoulder function, and measuring function with a shoulder-specific tool may direct rehabilitation. This study examined the short term effects of surgery on scapula kinematics and function in breast cancer survivors. Bilateral three-dimensional scapular kinematics were quantified before and after surgery for unilateral breast cancer and analyzed with repeated measures ANOVA. Shoulder function was assessed with the Shoulder Rating Questionnaire (SRQ) and analyzed with ANOVA. Subjects (n = 11) demonstrated statistically significant increases in scapula internal rotation on their involved side following surgery. An intention to treat analysis on all enrolled subjects supported this finding. The findings suggest that soft tissues restrictions impact short-term scapula motion following surgery for breast cancer. Significantly poorer shoulder function was reported for pain, recreation/athletic activities and total SRQ score after surgery. The SRQ appears sensitive enough to identify areas of life affected by changes in shoulder function following surgical intervention for breast cancer.

Three-dimensional scapula kinematics and shoulder function examined before and after surgical treatment for breast cancer.

ABSTRACT This paper examines the outcomes of an experiential learning lab embedded in a didactic course. Program evaluation results were derived from student surveys and reflective journaling. The outcomes indicate that students valued the opportunity for experiential learning citing the primary benefits as the opportunity to, apply and manipulate knowledge, build clinical reasoning skills, and develop the professional skills to engage in and effectively manage an intervention session.

An experiential learning lab embedded in a didactic course: outcomes from a pediatric intervention course.

The aim of this study was to provide a description of gender differences of the normal muscle activation patterns of the four subdivisions of the trapezius (clavicular, descending, transverse, ascending) during arm elevation. Surface EMG was collected from these four subdivisions from twenty-two healthy subjects (12 females, 10 males) during arm elevation in the scapular plane. Percent activation (RMS) of each subdivision was compared between genders across arm angles and elevation phase and onset time of each subdivision was compared between genders. Females demonstrated significantly higher % activation levels for each subdivision (p<.05), except transverse trapezius (p=.36). A statistically significant difference for onset time was observed between gender for the descending trapezius, with a slower onset time for females (p<.05). Findings from this study support the theory that subdivisions within descending trapezius are preferentially activated and demonstrate that gender differences are present within the fourth subdivision of trapezius. As subjects were without shoulder pathology, the observed gender differences may be explained by normal motor control variations. However, as coordinated activation of trapezius is required for normal shoulder motion, it is recommended to include all four subdivisions of trapezius and address gender differences in future studies.

Gender differences between muscle activation and onset timing of the four subdivisions of trapezius during humerothoracic elevation.

To assess student perception of learning and use of a student response system (SRS) as a teaching/learning strategy. Survey methods were used to explore student perceptions of learning and use of student response systems as a pedagogical strategy. Fifty-nine graduate students participated in the survey post completion of two graduate intervention courses. Overall, there was a positive response to the use of SRS's in the classroom. All of the students (100%) recommended the continued use of the clickers for various reasons. The primary benefit reported by students related to providing immediate feedback, the opportunity to manipulate and revisit the content, and the ability to check for understanding within a class session. Students recommended the continued use of the SRS in classes to support acquisition of content and exam preparation. The student reported technology difficulties as the only the negative to SRS use in the classroom. Instructor perception was that the addition of the SRS devices added a new way to interact with the students. Suggestions for incorporating the use of a SRS devices into classroom instruction are offered.

Kimberly Szucs

Chronic Pain Research Consortium,
Department of Occupational Therapy

Duquesne University

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Kimberly Szucs

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Chronic Pain Research Consortium,Department of Occupational Therapy

Duquesne University

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Chronic Pain Research Consortium,
Department of Occupational Therapy