Upper-limb surface electro-myography at maximum supination and pronation torques: the effect of elbow and forearm angle

Abstract

Forearm pronation and supination, and increased muscular activity in the wrist extensors have been both linked separately to work-related injuries of the upper limb, especially humeral epicondylitis. However, there is a lack of information on forearm torque strength at ranges of elbow and forearm angles typical of industrial tasks. There is a need for strength data on forearm torques at different upper limb angles to be investigated. Such a study should also include the measurement of muscular activity for the prime torque muscles and also other muscles at possible risk of injury due to high exertion levels during tasks requiring forearm torques. Twenty-four male subjects participated in the study that involved maximum forearm torque exertions for the right arm, in the pronation and supination directions, and at four elbow and three forearm rotation angles. Surface EMG (SEMG) was used to evaluate the muscular activity of the pronator teres (PT), pronator quadratus (PQ), biceps brachi (BB), brachioradialis (BR), mid deltoid (DT) and the extensor carpi radialis brevis (ECRB) during maximum torque exertions. Repeated measures ANOVA indicated that both direction and forearm angle had a significant effect on the maximum torques ( p<0.05) while elbow angle and the interactions were highly significant ( p<0.001). The results revealed that supination torques were stronger overall with a mean maximum value of 16.2 Nm recorded for the forearm 75% prone. Mean maximum pronation torque was recorded as 13.1 Nm for a neutral forearm with the elbow flexed at 45°. The data also indicated that forearm angle had a greater effect on supination torque than pronation torque. Supination torques were stronger for the mid-range of elbow flexion, but pronation torques increased with increasing elbow extension. The strength profiles for the maximum torque exertions were reflected in the EMG changes in the prime supinators and pronators. In addition, the EMG data expressed as the percentage of Maximum Voluntary Electrical activity (MVE), revealed high muscular activity in the ECRB for both supination (26–43% MVE) and pronation torques (17–55% MVE). The results suggest that the ECRB acts as a stabiliser to the forearm flexors for gripping during pronation torques depending on forearm angle, but acts as a prime mover in wrist extension for supination torques with little effect of elbow and forearm angle. This indicates a direct link between forearm rotations against resistance and high muscular activity in the wrist extensors, thereby increasing stress on the forearm musculo-skeletal system, especially the lateral epicondyle.