Gender differences in sensorimotor characteristics associated with the performance of a manual dexterity task at shoulder height

Comparing gender differences in activation of the sternocleidomastoid muscle during the simulation of a repetitive industrial activity: a cross-sectional study

Objectives. Neck and shoulder problems are increasing among workers, particularly during low-level repetitive tasks. Considering the interaction between neck and shoulder muscles during these tasks, studying the sternocleidomastoid muscle (SCM) activity pattern is crucial. This study aimed to investigate SCM activity during a simulated repetitive task involving muscle fatigue and upper limb elevation. Methods. Nineteen females and 20 males aged 18-35 years with body mass index 18.5-28 participated. Exclusions included musculoskeletal problems within the past 7 days, circulatory/rheumatic/inflammatory disorders, routine engagement in overhead sports or expertise in repetitive movements. Surface electromyography was used to record SCM activity, normalized using maximum voluntary contractions and converted into the root mean square (rms) and median frequency (MF). Pre-fatigue and post-fatigue periods were the first and last 30 s of the task. The craniocervical flexion test assessed deep cervical flexors and their interaction with SCM activity. Results. The rms of SCMs increased bilaterally post fatigue, regardless of sex. Females showed lower MF values in the SCM left side than males, independent of task duration. Conclusion. There were no gender differences. However, SCM changes during upper limb fatigue may indicate overuse of neck muscles during repetitive tasks involving fatigue and upper limb elevation.

The effects of hand dominance, fatigue, and sex on muscle activation during a repetitive overhead fatiguing task

Previous studies have shown that the dominant arm is generally stronger and more resistant to fatigue. However, whether there are side differences in shoulder muscle activation during a fatiguing upper limb task, and whether this varies according to sex, is unknown. Thirty right-handed adults (15 females) were recruited to complete two sessions of an overhead repetitive fatiguing task (shoulder flexion between 90 and 135° at 1 Hz), performed in two separate sessions with their dominant arm (DA) and non-dominant arm (NDA) until exhaustion. Electromyographic (EMG) data was collected from 11 shoulder muscles of the moving arm, and their activation amplitude (RMS) and activation variability (SD) were assessed. Results show that time to exhaustion was not affected by arm or by sex. There were some main arm effects on EMG activity amplitude, with higher activity on the DA's pectoralis major (p < 0.001), and on the NDA's middle (p = 0.009) and posterior deltoid (p = 0.001) and infraspinatus (p < 0.001). The pectoralis major was affected by arm and fatigue mostly in males. Their DA's pectoralis major activity amplitude was higher, and the amplitude variability was lower, compared to the NDA, with both parameters showing fatigue-dependent decreases at the NDA only (arm x sex x fatigue: RMS: p = 0.007; SD: p = 0.001). As for females, the DA variability of their lower trapezius was smaller, and that of their subscapularis was higher, compared to the NDA (sex x arm, p = 0.028, p = 0.05). There was also more EMG variability on the supraspinatus' dominant side, and on the posterior deltoid and infraspinatus ND side. Results show an overhead shoulder flexion task dependency on pectoralis major control in males, and on lower trapezius and shoulder girdle stabilizers in females, which could be related to both sex- and gender-based factors. This knowledge can help identify side-specific injury risk factors due to overhead work in males and females, and help determine the appropriateness of implementing sex-specific workplace protocols, including alternating arms as fatigue compensatory and recovery strategies.

Changes in normalized mutual information in response to strength training: An ancillary analysis of a quasi-randomized controlled trial

The aim of the present investigation was twofold. (1) to assess test-retest reliability of normalized mutual information (NMI) values extracted from the surface electromyography (sEMG) signal of muscles pairs of the upper body during dynamic bench press at a high load, and (2) to assess changes in NMI values from before to after a five-week quasi-randomized controlled bench press training intervention. For test-retest reliability, 20 strength trained males (age 25 ± 2 years, height 1.81 ± 0.07 m) performed two three-repetition maximum (3RM) tests in bench press, while sEMG was recorded from six upper body muscles. Tests were separated by 8.2 ± 2.9 days. For the training intervention, 17 male participants (age 26 ± 5 years, height 1.80 ± 0.07 m) trained bench press specific strength training for 5 weeks (TRA), while 13 male participants (age 23 ± 3 years, height 1.80 ± 0.08 m) constituted a control group (CON). 3RM bench press test and sEMG recordings were carried out before and after the intervention period. The NMI values ranged from poor to almost perfect reliability, with the majority displaying substantial reliability. TRA displayed a significant decrease in NMI values during the concentric phase for two agonist-agonist muscle pairs, while one agonist-agonist and two agonist-antagonist muscle pairs increased the NMI values during the eccentric phase. The observed changes did not exceed the minimal detectable threshold, and we therefore cannot surely ascertain that the changes observed in NMI values reflect genuine neural adaptations.

Sex differences in torque steadiness, accuracy and activation of the shoulder girdle muscles during isometric shoulder scaption

Females present more neck/shoulder musculoskeletal disorders and have different activation strategies of the shoulder girdle muscles than males. However, the sensorimotor performance and potential sex differences are still largely unexplored. The aim of this study was to investigate sex differences in torque steadiness and accuracy during isometric shoulder scaption. We also examined the amplitude and variability of the activation of the trapezius, serratus anterior (SA), and anterior deltoid muscles during torque output evaluation. Thirty-four asymptomatic adults (17 females) participated. Torque steadiness and accuracy were evaluated during submaximal contractions at 20 % and 35 % of peak torque (PT). There was no sex difference in torque coefficient of variation, but females had significantly lower torque standard deviation (SD) values than males at the two intensities evaluated (p < 0.001) and lower torque median frequency values compared to males, regardless of intensity (p < 0.01). Females had significantly lower absolute error values than males for torque output at 35 %PT (p < 0.01) and lower constant error values compared to males, regardless of intensity (p = 0.01). Females had significantly higher muscle amplitude values than males, except for SA (p = 0.10) and in general, females showed higher muscle activation SD values compared to males (p < 0.05). Females may require more complex muscle activation patterns to achieve a more stable and accurate torque output. Therefore, these sex differences may reflect control mechanisms that may also be at play when explaining the greater risk of neck/shoulder musculoskeletal disorders in females than males.

The Effect of Cycling While Typing on Patterns of Upper Body Muscle Activation

OBJECTIVE

To investigate the effect of one's sex and pedaling intensity on upper body muscle activation patterns during typing while cycling.

BACKGROUND

Females are at a higher risk for computer work-related musculoskeletal disorders, and mobile workstations have been suggested to induce healthier muscular patterns compared with sitting. However, the neuromuscular characteristics of performing computer work in a cycling workstation have not been investigated.

METHOD

Twenty-two participants (10 females) completed a 60-min computer typing task while pedaling on a cycle ergometer at two different intensities (25%, 4% heart rate reserve). Surface electromyography (EMG) was recorded from seven muscles of the upper body. Effects of time, sex, and intensity were assessed for muscle activation (RMS), activation variability (CV), and normalized mutual information (NMI) via generalized estimating equations.

RESULTS

With time, neck/shoulder CV increased in males during higher pedaling intensity, whereas in females it decreased during lower intensity. In females, RMS of neck/shoulder and NMI of neck/shoulder muscle pairs were lower, whereas forearm RMS was 34.2% higher with higher intensity cycling compared with lower intensity. Lower back RMS decreased 28.3% in the initial half of the task in females, but in males it increased 14.4% in the later half.

CONCLUSION AND APPLICATION

Cycling workstation showed a sex- and intensity-specific EMG response. These differing responses should be considered when implementing the use of cycling workstation and may be important for preventing/managing sex-specific muscle fatigue and musculoskeletal disorders.

Sex-specific myoelectric manifestations of localized fatigue during a multi-joint repetitive task

We have previously demonstrated that fatigue at different locations impacts joint angles, angular variability, and coordination variability differently. However, the neuromuscular control aspects underlying these kinematic changes have never been demonstrated. Seventeen young adults (8 males) were recruited. Electromyographic electrodes were placed on: upper trapezius, pectoralis major, anterior and middle deltoid, biceps and triceps brachii, and left and right erector spinae. Subjects performed the repetitive pointing task (RPT) at 1 Hz for 30 s before and after localized fatigue tasks, which consisted of one shoulder, one elbow and one lower back isometric fatiguing protocols until exhaustion in randomized order. Electromyographic amplitude (RMS), variability (SD) and mean power frequency (MnPF) were calculated for each of the pre-fatigue and post-fatigue RPT trials. There were sex × fatigue location interaction effects on upper trapezius RMS (p = 0.038) with males' values increasing the most after shoulder fatigue. Females' triceps brachii RMS was greater compared to males after shoulder, elbow, and trunk fatigue (p = 0.003, p = 0.001 and p = 0.007 respectively). There were sex × fatigue location effects on left erector spinae MnPF (p = 0.011) with males and females' values decreasing the most after trunk fatigue, but more so in males. Results demonstrate that males and females compensate differently during a repetitive pointing task when their elbows, shoulders and trunks are locally fatigued, which could have implications on sex-specific workplace injury risks. See Table 1 for acronyms.

Sex-specific effects of localized muscle fatigue on upper body kinematics during a repetitive pointing task

BACKGROUND

Females are reported to have a higher risk of musculoskeletal disorders than males. Repetitive motions can lead to muscle fatigue, which may play a mediator role in the development of musculoskeletal disorders. However, sex differences in adaptations to localized fatigue at different joints are poorly understood. We examined the sex-specific effects of fatigue location on shoulder, elbow and spinal joint angles, and angular variabilities during a repetitive pointing task.

METHODS

Seven males and ten females performed a 30-s standing repetitive pointing task with their right upper limb when they were non-fatigued (NF), elbow-fatigued (EF), shoulder-fatigued (SF) and trunk-fatigued (TF), while trunk and upper body tridimensional kinematic data was recorded. Joint angles and angular variabilities of shoulder, elbow, upper thoracic spine, lower thoracic spine, and lumbar spine were calculated.

RESULTS

Results showed that shoulder angles changed the most after EF in males, but after SF in females. The similarities between sexes were that SF increased the variabilities at upper (lateral flexion: 0.15° greater than NF, rotation: 0.26° greater than all other conditions) and lower thoracic spine (lateral flexion: 0.13° greater than NF, rotation: averagely 0.1° greater than all other condition) in both sexes. TF altered upper thoracic spine variability (0.36° smaller than SF), lower thoracic spine angle (lateral flexion: 3.00° greater than NF, rotation: 1.68° greater than SF), and lumbar angle (averagely 1.8° smaller than all other conditions) in both sexes. However, females had greater lower thoracic spine angle (lateral flexion: 8.3° greater, p = 0.005) as well as greater upper (rotation: 0.53° greater, p = 0.006) and lower thoracic spine (rotation: 0.5° greater, p = 0.007; flexion: 0.6° greater, p = 0.014) angular variabilities than males.

CONCLUSIONS

Results suggest that females' fatigue responses focused on the trunk and spine. Results highlight a few sex differences in adapting to localized muscle fatigue, which may help explain how sex differences in repetitive motion-related injuries differ between joints.

Investigation of the Association Between Surgeon Sex and Laparoscopic Device Ergonomic Strain in Gynecologic Surgery

STUDY OBJECTIVE

To assess if female compared to male sex is associated with greater ergonomic strain with use of 4 advanced energy laparoscopic devices (LigaSure, HALO PKS, ENSEAL, and Harmonic scalpel).

DESIGN

Online survey distributed by e-mail using the REDCap platform. All responses were anonymous.

SETTING

Nationwide survey in the United States.

PARTICIPANTS

Gynecologic surgeons were surveyed through the Society of Gynecologic Surgeons listserv and 4 Obstetrics and Gynecology departmental listservs.

INTERVENTIONS

The survey was distributed between 5/01/2020-11/01/2020. The primary outcome was the presence of physical complaints due to laparoscopic devices. Descriptive statistics compared surgeon characteristics and ergonomic symptoms. Logistic regression was performed, adjusted for surgeon characteristics.

MEASUREMENTS AND MAIN RESULTS

The response rate was 39%, comprising 149 women (78%) and 41 men (22%). Women compared to men had a significantly younger age (mean 34 vs 44 years old, p<.01), smaller glove size (mean 6.5 vs 7.5, p<.01), shorter height (median 66 vs 71 in, p<.01), and were less frequently in practice for >10 years (19% vs 49%, p<.01). Women significantly more often reported physical complaints related to use of laparoscopic devices (79% vs 41%, p<.01). Women reported all devices had too large a fit for appropriate use (p<.01). Women were found to have 5.37 times the odds of physical complaints attributed to the use of laparoscopic instruments (cOR 5.37, 95% CI 2.56-11.25); with adjustment for glove size, age, and laparoscopic case volume and duration, this was no longer significant (aOR 2.02, 95% 0.59-6.93).

CONCLUSION

Women significantly more often report physical complaints and inappropriate fit of the LigaSure, HALO PKS, ENSEAL, and Harmonic scalpel. Female sex is associated with fivefold greater odds of physical complaints with laparoscopic device use. Further investigation of the surgeon factors underlying device-related strain is a critical next step to understanding and reducing surgeon ergonomic injury.

Sex-specific muscle activation and oxygenation kinetics during a repetitive forward pointing task

We compared the minute-by-minute muscle activity and oxygenation responses to a repetitive arm motion-induced fatiguing task between the sexes in order to address the literature gap on these time-dependent fatigue responses. Twenty-six (13 females) healthy adults performed a repetitive pointing task (RPT) with the arm moving forward/backward at shoulder height until reaching 8/10 (Borg CR10) for neck/shoulder perceived exertion (RPE). Neck/shoulder RPE, oxygenation and electromyography were recorded every minute and compared between first and second half of the task and between the sexes. Greater changes in oxygen supply and activation amplitude occurred during the second half of the task. Despite similar time to fatigue-terminal (p > 0.05), females showed greater anterior deltoid activation amplitude at all time points than males, and only the males showed increases in anterior and posterior deltoid activation amplitudes. In females, middle (ρ = -0.34, p = 0.04) and posterior (ρ = -0.44, p = 0.01) deltoid amplitudes were negatively correlated with perceived exertion during the first half of the task. Results suggest that reduced modulation of anterior deltoid activation amplitude in females may reflect a sub-optimal fatigue-mitigation mechanism compared with males and may help explain their greater susceptibility to neck/shoulder musculoskeletal disorders. Novelty: Despite similar fatigability and trapezius oxygenation, females showed greater deltoid activation throughout the task. Deltoid activation increased in males but not in females. The results support the important role of the deltoid in sex-specific neck/shoulder injury mechanisms.

The role of at home workstation ergonomics and gender on musculoskeletal pain

BACKGROUND

The recent mandate for university faculty and staff to work-from-home (WFH) during the COVID-19 pandemic has forced employees to work with sub-optimal ergonomic workstations that may change their musculoskeletal discomfort and pain. As women report more work-related musculoskeletal discomfort (WMSD), this effect may be exacerbated in women.

OBJECTIVE

The purpose of this study was to describe university employee at-home office workstations, and explore if at-home workstation design mediates the effect of gender on musculoskeletal pain.

METHODS

University employees completed a survey that focused on the WFH environment, at home workstation design and musculoskeletal pain. Descriptive statistics and regression analysis were used to analyze the responses.

RESULTS

61% of respondents reported an increase in musculoskeletal pain, with the neck, shoulders and lower back being reported most frequently. Women reported significantly greater musculoskeletal pain, but this relationship was significantly mediated by poor ergonomic design of the home workstation. Improper seat-height and monitor distance were statistically associated with total-body WMSD.

CONCLUSIONS

WFH has worsened employee musculoskeletal health and the ergonomic gap between women and men in the workspace has persisted in the WFH environment, with seat height and monitor distance being identified as significant predictors of discomfort/pain.

Age-Dependent Control of Shoulder Muscles During a Reach-and-Lift Task

Aging affects fatigability and is a risk factor for incurring a fatigue-related injury in the neck/shoulder region. Age-related changes in the electromyographical features of motor control may be partly responsible. Young (N = 17) and older (N = 13) adults completed a reach-and-lift task at their self-selected speed, before and after a fatiguing task targeting the neck/shoulder. Electromyography amplitude (root mean square), amplitude variability (root mean square coefficient of variation [CV]), functional connectivity (normalized mutual information [NMI]), and functional connectivity variability (NMI CV) were extracted from several muscles and analyzed for effects and interactions of age using general estimating equation models. Root mean square CV and deltoid NMI CV increased from pre- to postfatigue (ps < .05). Upper trapezius-deltoid NMI decreased for young, but increased for older adults, while the opposite response was found for lower trapezius-deltoid NMI (ps < .05). Older adults seem to adapt to fatigue in reach-and-lift movement with a cranial shift in control of the scapula.

Effect of fatigue and the absence of visual feedback on shoulder motor control in an healthy population during a reaching task

INTRODUCTION

The main role of the upper limb is to position the hand in order to carry out varied activities requiring coordinated multi-joint movement, which requires mobility and stability at the glenohumeral joint. This is made possible by the interaction between active and passive structures as well as the integration of information coming from multiple systems. This interaction can be compromised by factors such as muscle fatigue and lack of visual feedback, leading to decreased performance. Several studies have investigated their isolated effect without looking at their combined effect.

OBJECTIVE

To measure the specific and the combined effects of shoulder muscles fatigue and of lack of visual feedback on shoulder motor control during a reaching task with the arm in an elevated position.

METHODS

60 healthy participants were randomly assigned to one of four experimental groups: 1) control with visual feedback; 2) control without visual feedback; 3) fatigue with visual feedback; 4) fatigue without visual feedback. Subjects had to perform 10 trials of a reaching task in the KINARM robotic arm. Kinematic variables of interest were time taken to complete the task, final error, initial angle of deviation and area under curve. Non-parametric ANOVAs were used.

RESULTS

Analyses showed that there were statistically significant differences (p < 0,01) for the time taken to complete the task (1.15 s compared to 0.70 s), the area under the curve (0.015m² compared to 0.009m²) and the final error (0.025 m compared to 0,011 m) between those who had visual feedback and those who did not. No statistically significant fatigue or feedback X fatigue interaction effects were found for all kinematic variables.

CONCLUSION

Findings show that lack of visual feedback had an impact on the reaching task performance while fatigue did not. In addition, fatigue did not increase the effect of the lack of visual feedback.