Neuromotor Characteristics of Lateral Epicondylalgia
Author(s)
Primary Supervisor
Kavanagh, Justin
Bisset, Leanne
Other Supervisors
Yelland, Michael
Ryan, Michael
Year published
2017
Metadata
Show full item recordAbstract
Neuromotor dysfunction such as delayed upper extremity reaction time and altered wrist posture during gripping, are considered part of the pathophysiology in lateral epicondylalgia (LE). This might manifest as changes in the forearm muscle activity patterns in LE. In addition to a systematic review (Study 1) of the current literatures of forearm muscle activity in LE, this thesis presents three case-control studies that provide new insights into: the timing of forearm muscle activity during wrist extension reaction time (RT) (Study 2), the magnitude of forearm muscle activity during isometric gripping with different wrist ...
View more >Neuromotor dysfunction such as delayed upper extremity reaction time and altered wrist posture during gripping, are considered part of the pathophysiology in lateral epicondylalgia (LE). This might manifest as changes in the forearm muscle activity patterns in LE. In addition to a systematic review (Study 1) of the current literatures of forearm muscle activity in LE, this thesis presents three case-control studies that provide new insights into: the timing of forearm muscle activity during wrist extension reaction time (RT) (Study 2), the magnitude of forearm muscle activity during isometric gripping with different wrist postures (Study 3), and forearm muscle synergies during ramp and steady-state phases of isometric gripping (Study 4) in individuals with LE. This thesis also presents the association of forearm muscle activity with the clinical, sensory and tendon structural changes associated with LE. The systematic review identified consistent evidence of increased electromechanical delay and altered cortical excitability associated with the forearm extensor muscles in LE. These findings suggest both peripheral and central contribution to altered motor control in LE. The second study, which used intramuscular electromyography (EMG), provided evidence that delayed RT in LE is due to prolonged extensor carpi radialis brevis (ECRB) and extensor digitorum communicis (EDC) motor time, with no between-group differences in premotor time. Wrist extension RT was associated only with ECRB and EDC premotor time but not with extensor carpi ulnaris (ECU) premotor in LE. Increased duration of LE symptoms was associated with shorter RT, as well as shorter ECRB and anconeus premotor time.
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View more >Neuromotor dysfunction such as delayed upper extremity reaction time and altered wrist posture during gripping, are considered part of the pathophysiology in lateral epicondylalgia (LE). This might manifest as changes in the forearm muscle activity patterns in LE. In addition to a systematic review (Study 1) of the current literatures of forearm muscle activity in LE, this thesis presents three case-control studies that provide new insights into: the timing of forearm muscle activity during wrist extension reaction time (RT) (Study 2), the magnitude of forearm muscle activity during isometric gripping with different wrist postures (Study 3), and forearm muscle synergies during ramp and steady-state phases of isometric gripping (Study 4) in individuals with LE. This thesis also presents the association of forearm muscle activity with the clinical, sensory and tendon structural changes associated with LE. The systematic review identified consistent evidence of increased electromechanical delay and altered cortical excitability associated with the forearm extensor muscles in LE. These findings suggest both peripheral and central contribution to altered motor control in LE. The second study, which used intramuscular electromyography (EMG), provided evidence that delayed RT in LE is due to prolonged extensor carpi radialis brevis (ECRB) and extensor digitorum communicis (EDC) motor time, with no between-group differences in premotor time. Wrist extension RT was associated only with ECRB and EDC premotor time but not with extensor carpi ulnaris (ECU) premotor in LE. Increased duration of LE symptoms was associated with shorter RT, as well as shorter ECRB and anconeus premotor time.
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Thesis Type
Thesis (PhD Doctorate)
Degree Program
Doctor of Philosophy (PhD)
School
School of Allied Health
Copyright Statement
The author owns the copyright in this thesis, unless stated otherwise.
Subject
Lateral epicondylalgia
Neuromotor dysfunction
Gripping
Forearm muscles
Extensor carpi radialis brevis
Extensor digitorum communicis