The aim of this paper is to analyze muscle load-sharing in patients with Lateral Epicondylitis during dynamic endurance contractions by means of nonlinear prediction of surface EMG signals. The proposed nonlinear cross-prediction scheme was used to predict the envelope of an EMG signal and is based on locally linear models built in a lag-embedded Euclidean space. The results were compared with a co-activation index, a common measure based on the activation of a muscle pair. Nonlinear prediction revealed changes in muscle coupling, that is load-sharing, over time both in a control group and Lateral Epicondylitis (p<0.05), even when subjects did not report pain at the end of the exercise. These changes were more pronounced in patients, especially in the first part of the exercise and up to 50% of the total endurance time (p<0.05). By contrast, the co-activation index showed no differences between groups. Results reflect the changing nature of muscular activation strategy, presumably because of the mechanisms triggered by fatigue. Strategies differ between controls and patients, pointing to an altered coordination in Lateral Epicondylitis.
Background: Performance-based tests (PBTs) objectively assess functional capacity and are increasingly applied in fibromyalgia (FM) to complement patient-reported outcomes (PROMs). However, evidence regarding their reliability, especially considering patients’ socio-occupational status, is limited. This study aimed to determine test–retest reliability of a standardized PBT battery in women with FM and to examine the influence of employment status on measurement stability. Methods: A total of 119 women were assessed (89 with FM). The battery included the 6 min walk test (6MWT), handgrip strength test (HST), and 8 feet up and go test (8FUGT). Test–retest reliability was examined using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Analyses were conducted for the total FM group and socio-occupational subgroups (actively working, claiming disability, and permanent disability). Results: All PBTs demonstrated excellent test–retest reliability. Measurement stability was consistently higher in controls. Absolute reliability indices confirmed acceptable measurement stability. However, the claiming disability group showed markedly higher SEM% and SRD% for HST, suggesting reduced reproducibility. The 6MWT and 8FUGT maintained excellent reliability and stability across all groups. PROMs showed good-to-excellent reliability. Conclusions: PBTs showed excellent reliability in women with FM. However, reliability varied across socio-occupational groups, particularly for HST in patients claiming disability. PROMSs showed lower reliability than PBTs.
An isokinetic-related parameter termed the difference between eccentric-concentric strength ratios at two distinct test velocities (DEC) based on 60° (standard) range of motion (RoM) has been proven to be highly efficient detecting feigned muscular efforts. This study aimed to verify whether a DEC derived from a much shorter test RoM (20°) was equally useful than a long RoM–derived one. Eighteen healthy men (32.4 ± 6.4 years old) took part in a study focusing on shoulder external rotation isokinetic strength. Participants performed a genuine shoulder external rotator maximal effort (eight pairs of concentric and eccentric contractions at high and low velocities at short and long RoM) and then instructed to feign maximal effort. Contraction velocities were adjusted accordingly by applying a 1:4 gradient and peak moments registered. Both condition DEC was then calculated by subtracting the eccentric and concentric strength ratios at low velocities from those at high velocities. DEC scores in the feigned effort were significantly higher than maximal effort ones in both conditions in men. It enabled the setting of specific cutoff levels for separating the efforts. Both approaches revealed a coincident sensitivity (78%) whereas short RoM showed an even higher specificity: 88% versus 78%. Thus, the short RoM protocol provides clinically acceptable detection power.