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  • Neuromotor Characteristics of Lateral Epicondylalgia

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    Manickaraj,Nagarajan_Final Thesis_Redacted.pdf (10.85Mb)
    Author(s)
    Manickaraj, Nagarajan
    Primary Supervisor
    Kavanagh, Justin
    Bisset, Leanne
    Other Supervisors
    Yelland, Michael
    Ryan, Michael
    Year published
    2017
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    Abstract
    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 ...
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    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
    DOI
    https://doi.org/10.25904/1912/2766
    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
    Publication URI
    http://hdl.handle.net/10072/365841
    Collection
    • Theses - Higher Degree by Research

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