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Effects of repetitive work on proprioception and of stretching on sensory mechanisms: implications for work-related neuromuscular disorders
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.ORCID iD: 0000-0001-7543-4397
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of the thesis were (i) to investigate the impact of repetitive low-intensity work exposure on proprioception and (ii) to examine effects of muscle stretching (especially sensory effects and effects on muscle nociception) and to relate its application to the prevention, alleviation and/or treatment of work-related neuromuscular disorders.

The effects of low-intensity repetitive work on the shoulder proprioception were tested in healthy subjects. The effect of working time on the retention of subjective fatigue and their relation to changes in proprioception, and the immediate effect of stretching on shoulder proprioception were investigated. A new method to test the stretchability of the rectus femoris muscle was investigated for reliability and validity and used to assess the effects of a two-week stretching regimen on range of motion and on subjective stretch sensation. Finally, the interactions between innocuous muscle stretch and nociceptive chemical stimulation on discharge behavior of nociceptive dorsal horn neurons in the feline spinal cord were explored.

The main findings were as follows: 1) The repetitive low-intensity work to fatigue diminished the shoulder proprioception; the working time as well as the retention of subjective fatigue were partly related to the extent of changed proprioception. 2) There was no effect of acute muscle stretching on the proprioception. 3) The new method for testing muscle stretchability proved valid and reliable. A two-week stretching regimen increased the tolerance to stretch torque, but the range of motion remained unchanged. 4) Half of the nociceptive dorsal horn neurons that responded to close arterial injections of bradykinin were modulated by muscle stretching applied directly after the injections.

Altogether, the results give credence to the hypothesis of an involvement of sensory information distortion due to repetitive low-intensity work exposure in the development of work-related neuromuscular disorders. Increased tolerance to stretch torque may be an important mechanism in explaining improvements following stretch treatment. The spinal interactions between innocuous stretch and nociceptive muscle afferent inputs indicate a possible mechanism involved in stretching-induced pain alleviation.

Place, publisher, year, edition, pages
Umeå: Kirurgisk och perioperativ vetenskap , 2004. , 87 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 877
Keyword [en]
Medicine, Repetitive motions, Muscle fatigue, Proprioception, Muscle stretching, Work-related musculoskeletal disorders, Nociception, Ergonomics
Keyword [sv]
Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Medicine
Identifiers
URN: urn:nbn:se:umu:diva-211ISBN: 91-7305-604-9 (print)OAI: oai:DiVA.org:umu-211DiVA: diva2:142662
Public defence
2004-03-19, Stora föreläsningssalen, Arbetslivsinstitutet, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2015-01-20Bibliographically approved
List of papers
1. Position sense acuity is diminished following repetitive low-intensity work to fatigue in a simulated occupational setting.
Open this publication in new window or tab >>Position sense acuity is diminished following repetitive low-intensity work to fatigue in a simulated occupational setting.
2000 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 81, no 5, 361-367 p.Article in journal (Refereed) Published
Abstract [en]

Repetitive work to fatigue is soundly associated with work-related musculoskeletal disorders (WMSD), although the underlying mechanisms are poorly understood. In the present study, we tested the hypothesis that fatiguing work leads to proprioceptive deficits, which can be an initiating factor for the occurrence of WMSD. Thus, the position sense of the shoulder was determined for 13 males and 13 females before and after performing repetitive low-intensity arm work to fatigue in a simulated occupational setting. From a starting position of 45° to the sagittal plane, position sense tests consisted of subjects attempting to actively reproduce target positions of horizontal movements to 15° and 30° (shoulder adduction) and to 60° and 75° (shoulder abduction). An analysis of variance revealed that the absolute error was significantly increased following fatigue for the subjects as a group (P < 0.001). Furthermore, females had an overall higher error than males (P < 0.01). No difference in error was detected for the shorter movements versus the longer movements. However, the overall absolute error for adduction was significantly higher than for abduction (P < 0.001). The results of the present study support the hypothesis of diminished proprioceptive acuity following low-intensity work to fatigue. A reduction in position sense acuity could lead to impairment in motor control, which would further impact on position sense. Thus, a vicious cycle may be activated that might result in WMSD. The poorer position sense acuity observed for females may contribute to the explanation of why females demonstrate a higher incidence of WMSD than males.

Keyword
Fatigue, Glenohumeral joint, Human, Occupational musculoskeletal problems, Proprioception
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-3784 (URN)10.1007/s004210050055 (DOI)10751096 (PubMedID)
Note
Appendix to the paper: Letter to the editor. Eur J Appl Physiol. 2003, 88:485-486. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-48059 Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2017-12-14Bibliographically approved
2. Effects of working time and retention of subjective fatigue on proprioception in a low-intensity repetitive work task.
Open this publication in new window or tab >>Effects of working time and retention of subjective fatigue on proprioception in a low-intensity repetitive work task.
Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-3785 (URN)
Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2010-01-13Bibliographically approved
3. Acute muscle stretching and shoulder position sense
Open this publication in new window or tab >>Acute muscle stretching and shoulder position sense
2006 (English)In: Journal of athletic training, ISSN 1062-6050, E-ISSN 1938-162X, Vol. 41, no 3, 270-274 p.Article in journal (Refereed) Published
Abstract [en]

Context: Stretching is common among athletes as a potential method for injury prevention. Stretching-induced changes in the muscle spindle properties are a suggested mechanism, which may imply reduced proprioception after stretching; however, little is known of this association.

Objective: To evaluate whether acute stretching of the shoulder muscles affects position sense.

Design: A crossover design with subjects randomized to 3 groups.

Setting: A university human research laboratory. Patients or Other Participants: Nine male (age = 24 +/- 3 years) and 9 female (age = 21 +/- 2 years) healthy volunteers.

Intervention(s): Stretching of shoulder (1) agonists or (2) antagonists or (3) nonstretching control.

Main Outcome Measure(s): We determined position sense acuity of the right shoulder before and after the interventions by having subjects attempt to reproduce arm positions of 15 degrees and 30 degrees (shoulder adduction) while starting at 45 degrees to the sagittal plane. The outcome variables were response variability (variable error) and overall accuracy (absolute error).

Results: The relative change in variable error (ie, variable error after/variable error before) was not significantly different between the interventions ( P = .38). Similarly, no change in absolute error was found ( P = .76). Furthermore, no differences were noted regarding test sequence or the interaction of intervention x sequence for either variable error ( P = .73 and .53, respectively) or absolute error ( P = .71 and .67, respectively).

Conclusions: We found no effect on shoulder position sense after an acute bout of stretching of either agonist or antagonist shoulder muscles.

Keyword
contract-relax stretch, performance, proprioception, sports, injury prevention
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-3786 (URN)17043694 (PubMedID)
Note
I avhandlingen med titeln "Acute muscle stretching does not alter position sense acuity"Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2017-12-14Bibliographically approved
4. Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including x-ray analysis of pelvic tilt.
Open this publication in new window or tab >>Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including x-ray analysis of pelvic tilt.
1993 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 74, no 3, 263-270 p.Article in journal (Refereed) Published
Abstract [en]

Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.

National Category
Physiology
Identifiers
urn:nbn:se:umu:diva-3787 (URN)8439253 (PubMedID)
Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2017-12-14Bibliographically approved
5. Sensory adaptation after a 2-week stretching regimen of the rectus femoris muscle
Open this publication in new window or tab >>Sensory adaptation after a 2-week stretching regimen of the rectus femoris muscle
2001 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 82, no 9, 1245-1250 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study the effects of a muscle stretching regimen for the rectus femoris muscle on subjective stretch sensation and range of motion (ROM). DESIGN: A 2 x 2 crossover design comprising 2 treatments and 2 intervention periods. SETTING: A military base in Sweden. PARTICIPANTS: A volunteer sample of 29 male military conscripts divided into 2 groups, with each group subjected to both experimental and control treatments at different time periods. INTERVENTION: Two weeks of supervised stretching (4 times/wk) of the rectus femoris muscle (experimental treatment) and the calf muscles (control treatment). MAIN OUTCOME MEASURES: Subjective rating of the stretch sensation for the anterior aspect of the thigh determined on a category ratio scale. Passive knee flexion ROM determined on each test with the same applied torque, specific for each subject. RESULTS: An additive analysis of variance revealed that the stretch sensation after the experimental treatment was decreased, compared with the control treatment (p <.01). The knee flexion, however, remained the same regardless of the treatment. CONCLUSION: Sensory adaptation seems to be an important mechanistic factor in the effect stretching has on ROM changes. The lack of change in knee flexion suggests that the stretching, as performed in this study, did not influence stiffness of the rectus femoris muscle. Sensory adaptation may also be an underlying mechanism in the alleviating effect of stretching when applied to tired, tender, and painful muscles.

Keyword
knee, muscles, range of motion, articular, rehabilitation
National Category
Physiology
Identifiers
urn:nbn:se:umu:diva-3788 (URN)10.1053/apmr.2001.24224 (DOI)000170873900016 ()11552198 (PubMedID)
Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2017-12-14Bibliographically approved
6. Muscle stretch-induced modulation of noxiously activated dorsal horn neurons of feline spinal cord
Open this publication in new window or tab >>Muscle stretch-induced modulation of noxiously activated dorsal horn neurons of feline spinal cord
Show others...
2004 (English)In: Neuroscience research, ISSN 0168-0102, E-ISSN 1872-8111, Vol. 48, no 2, 175-184 p.Article in journal (Refereed) Published
Abstract [en]

The present work was designed to check for the possibility of interactions between mechanical innocuous and chemically induced noxious muscle afferent inputs on discharge behavior of nociceptive superficial dorsal horn neurons (SDHNs) of the spinal cord in decerebrated cats. The innocuous and noxious stimuli were applied separately and in combination, so that the effects of the innocuous stimulus on nociceptive processing could be evaluated. The innocuous stimulus consisted of ramp-and-hold stretches of the gastrocnemius muscles, whereas the noxious stimulus consisted of i.a. injections of bradykinin (BK; 0.5-1 ml, 50 microg/ml) into the arterial circulation of same muscles. Only neurons up to approximately 1mm depth and those that responded to noxious pinch of the gastrocnemius muscles were selected for further analysis. The activity of 16 dorsal horn neurons was recorded extracellularly with high-impedance glass microelectrodes, out of which seven responded to stretch, while 12 neurons responded to bradykinin injections. The bradykinin injections induced three types of responses: excitatory, inhibitory and mixed. The majority of the neurons that showed excitatory and mixed responses to bradykinin were also influenced by stretches applied directly after the bradykinin injection. In these neurons, the stretch usually counteracted the bradykinin-induced response, i.e. shortening and reducing bradykinin-induced excitation and re-exciting the cells after bradykinin-induced inhibition. The mechanism of the stretch modulation is proposed to reside in a segmental spinal control of the nociceptive transmission.

Keyword
Action Potentials/drug effects/*physiology, Animals, Bradykinin/pharmacology, Cats, Muscle Contraction/drug effects/*physiology, Muscle Spindles/drug effects/*physiology, Muscle; Skeletal/drug effects/*physiology, Physical Stimulation/methods, Posterior Horn Cells/drug effects/*physiology, Stimulation; Chemical
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-16900 (URN)10.1016/j.neures.2003.10.009 (DOI)14741392 (PubMedID)
Available from: 2007-10-18 Created: 2007-10-18 Last updated: 2017-12-14Bibliographically approved

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Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
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  • Other style
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  • nn-NO
  • nn-NB
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  • Other locale
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Output format
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