Differences In Moment Arm Research Articles

Impact of Reverse Shoulder Arthroplasty Design and Patient Shoulder Size on Moment Arms and Muscle Fiber Lengths in Shoulder Abductors.

Reverse shoulder arthroplasty (RSA) increases the moment arm of the deltoid, however there is limited knowledge on the accompanying changes in muscle architecture that play a role in muscle force production. The purpose of our study is to use a geometric shoulder model to evaluate the anterior deltoid, middle deltoid, and supraspinatus regarding 1) differences in moment arms and muscle-tendon lengths in small, medium, and large native shoulders, and 2) impact of three RSA designs on moment arms, muscle fiber lengths, and force-length (F-L) curves. A geometric model of a native glenohumeral joint was developed, validated, and adjusted to represent small, medium, and large shoulders. Moment arms, muscle-tendon lengths, and normalized muscle fiber lengths were assessed for the supraspinatus, anterior deltoid, and middle deltoid from 0 to 90 degrees abduction. RSA designs were modeled and virtually implanted, including a lateralized glenosphere with an inlay-135-degree humeral component (LGMH), a medialized glenosphere with an onlay-145-degree humeral component (MGLH), and a medialized glenosphere with an inlay-155-degree humeral component (MGMH). Descriptive statistics were used to compare moment arms and normalized muscle fiber lengths. As shoulder size increased, moment arms and muscle-tendon lengths for the anterior deltoid, middle deltoid, and supraspinatus increased. All RSA designs achieved greater moment arms for the anterior and middle deltoid, with MGLH achieving the largest increase. The resting normalized muscle fiber length of the anterior and middle deltoid was substantially increased in the MGLH (1.29) and MGMH (1.24), shifting the operating ranges of these muscles to the descending portions of their F-L curves, while LGMH maintained a resting deltoid fiber length (1.14) and operating range similar to the native shoulder. All RSA designs demonstrated a decrease in native supraspinatus moment arm in early abduction, with the largest decrease in MGLH (-59%) and minimal decrease in LGMH (-14%). The supraspinatus operated on the ascending limb of its F-L curve in the native shoulder and remained on this portion of the F-L curve for all RSAs. Although MGLH maximizes abduction moment arm for the anterior and middle deltoid, overlengthening of the muscle may compromise deltoid muscle force production by forcing the muscle to operate on the descending portion of its F-L curve. In contrast, the LGMH design increases the abduction moment arm for the anterior and middle deltoid more modestly, while allowing the muscle to operate near the plateau of its F-L curve and maximizing its force producing potential.

Moment arms of the anatomical subregions of the rotator cuff muscles during shoulder rotation

BackgroundRotator cuff muscles are responsible for humeral rotation. Moment arms of different regions of these muscles during humeral rotation were analyzed in neutral and abducted positions. MethodsIn eight cadaveric shoulders, subregions of the rotator cuff muscles were identified and their excursion during humeral rotation was measured in neutral and abducted positions from an internal rotation of 30° to an external rotation of 45°, with 15° increments, using a 3-D digitizing system. Statistical tests were used to assess differences between subregions within a single muscle. FindingsThe posterior-deep subregion of the supraspinatus muscle had greater moment arms compared to the anterior-superficial and anterior-middle subregions in both positions (p < 0.001). The middle and inferior subregions of the infraspinatus muscle and the teres minor muscle showed differences in moment arms compared to the superior region in an abducted position (p < 0.042). The superior subregion of the subscapularis muscle showed differences in moment arms compared to the middle and inferior subregions in an abducted position (p < 0.001). InterpretationThe posterior-deep subregion of the supraspinatus muscle behaved similar to the infraspinatus muscle, as an external rotator. The anterior-superficial and anterior-middle subregions of the supraspinatus muscle showed a biphasic behavior during rotation at a neutral position, but acted as pure external rotators during rotation at an abducted position. Inferior subregions of the infraspinatus and subscapularis muscles showed the largest moment arms compared to superior subregions. These findings support distinct functional roles of the rotator cuff muscle subregions.

Do MRI-derived muscle moment-arms in patients with chronic low back pain differ from healthy individuals? A comparative study.

The present study aimed to estimate the trunk muscles moment-arms in low back pain (LBP) patients and compare this data to those of healthy individuals. This research further explored whether the difference of the moment-arms between these two is a contributing factor to LBP. Fifty patients with CLBP (group A) and 25 healthy controls (group B) were enrolled. All participants were subjected to magnetic resonance imaging of lumbar spine. Muscle moment-arms were estimated on a T2W axial section parallel to the disc. There was statistically significant differences (p < 0.05) in the sagittal plane moment-arms at L1-L2 for right erector spinae (ES), bilateral psoas and rectus abdominis (RA), right quadratus lumborum (QL), and left obliques; bilateral ES, QL, RA, and right psoas at L2-L3; bilateral QL, RA, and obliques at L3-L4; bilateral RA and obliques at L4-L5; and bilateral psoas, RA, and obliques at L5-S1. There was no statistically significant difference (p < 0.05) in the coronal plane moment-arms except for left ES and QL at L1-L2; left QL and right RA at L3-L4; right RA and obliques at L4-L5; and bilateral ES and right RA at L5-S1. There was a significant difference in muscle moment-arms of the lumbar spine's prime stabilizer (psoas) and primary locomotors (rectus abdominis and obliques) between LBP patients and healthy individuals. This difference in the moment-arms leads to altered compressive forces at intervertebral discs and may be one of the risk factors for LBP.

Moment arms from the anatomical subregions of the rotator cuff muscles during flexion

Rotator cuff (RC) muscles act as force couples to stabilize the glenohumeral joint and enable shoulder motion. We investigated the moment arms of anatomical subregions of the supraspinatus (SSP), infraspinatus (ISP), subscapularis (SSC), and the teres minor muscles during flexion. Eight fresh-frozen cadaveric shoulders were obtained and the anatomical subregions of the RC muscles were identified. Sutures were secured for each subregion at the musculotendinous junction and excursion during flexion from 30° to 90° at 10° increments was measured using a 3-D digitizing system. Kruskal-Wallis test followed by the Bonferroni post-hoc test was used to assess differences from subregions within a single muscle. There were significant differences in moment arms between the subregions from each RC muscle (P < 0.001). The anterior-superficial and -middle subregions of the SSP muscle presented positive (flexor) and decreasing moment arms with increasing flexion. The posterior-deep subregion showed moment arms with positive but decreasing values up to 65°, and negative (extensor) moment arms at larger angles. Subregions from the ISP showed positive and almost constant moment arms throughout range of motion, while the teres minor presented negative and almost unaltered moment arms. The superior and middle subregions of the SSC showed positive, but decreasing, moment arms with increasing angles up to 75° flexion, with negative moment arms towards end-range. The inferior subregion presented negative moment arms throughout flexion. Our results indicated that the posterior deep subregion of SSP muscle seems to act as a flexor at early range and as a stabilizer at mid-to-end range of flexion.

Infraspinatus Muscle Fiber Moment Arms During Abduction: A Biomechanical Comparison of Values for Intact Rotator Cuff, Supraspinatus Tear, Superior Capsular Reconstruction, and Reverse Total Shoulder Arthroplasty.

Background:Lines of action of the superior, middle, and inferior infraspinatus muscle fibers work together to produce moment arms that change throughout abduction in an intact shoulder, after a supraspinatus tear, and after superior capsular reconstruction (SCR) and reverse total shoulder arthroplasty (rTSA).Purpose:To use moment arm values to indicate the efficacy of SCR and rTSA to restore infraspinatus function during shoulder abduction.Study Design:Descriptive laboratory study.Methods:A total of 5 human cadaveric shoulders placed in a testing apparatus were each actively abducted (0°-90°) under the following 4 conditions: intact, complete supraspinatus tear, SCR, and rTSA. The 3-dimensional coordinates of points were tracked along the origin and insertion of the superior, middle, and inferior infraspinatus fibers during abduction. Moment arm values were calculated using the origin-insertion method to determine abduction contribution of infraspinatus fiber sections. Analysis of variance and post hoc Tukey testing were used to compare differences in moment arms between the 4 conditions and between fiber sections.Results:In the intact condition, the superior infraspinatus fibers had an abduction moment that decreased with elevation until shifting to adduction. Conversely, the middle and inferior fibers had an adduction moment that turned to abduction (mean moment arm values from 0° to 90°: inferior, from –5.9 to 19.4 mm; middle, from –4.7 to 15.9 mm; superior, from 5.6 to –5.1 mm; P < .05). After a supraspinatus tear, superior fibers lacked any torque, and inferior and middle fibers lost adduction potential (inferior, from 4.8 to 14.0 mm; middle, from –0.2 to 9.6 mm; superior, from 1.0 to 0.7 mm; P < .05). SCR restored the initial superior fiber abduction moment (5.6 mm at 0°; P < .05); middle and inferior fibers had some restoration but were weaker than intact fibers. Loss of abduction moment in all fibers was seen with rTSA (inferior, from –9.6 to –1.6 mm; middle, from –10.5 to –3.6 mm; superior, from –1.7 to –4.6 mm; P < .05).Conclusion:Infraspinatus fiber groups had different and inverse moment arms during scapular plane elevation. SCR most closely resembled the intact shoulder, whereas rTSA transformed the infraspinatus into an adductor.Clinical Relevance:These results support the efficacy of SCR at restoring biomechanical muscle function and suggest that the changes in moment arms for each fiber group be considered when choosing treatment modalities and rehabilitation protocols after rotator cuff tear.

Muscle Fiber Contribution to Rotator Cuff Moment Arms During Abduction for Intact Rotator Cuff, Complete Supraspinatus Tear, Superior Capsular Reconstruction, and Reverse Shoulder Arthroplasty. (225)

Objectives:The Rotator Cuff (RC) is formed from the subscapularis, supraspinatus, infraspinatus, and teres minor muscles and their tendinous extensions. The 4 RC tendons insert on the humeral head such that they contribute to the dynamic stability of the glenohumeral joint along with their rotational actions on the shoulder. The moment arm can be used to demonstrate the work effort potential that a specific muscle is contributing to a musculoskeletal joint rotation. The objective of this study was to break out RC muscles into multiple fibers, providing more clarity as to how individual fibers contribute to a muscle’s overall moment arm during abduction.The aims of this study are: 1.) to illustrate within each RC muscle how multiple muscle fiber lines of action work together to produce abduction in an intact shoulder 2.) to estimate the moment arm changes that take place when the intact rotator cuff goes through surgical repair with either SCR or RSA after complete supraspinatus tear. We hypothesized that the rotator cuff muscles work differently and in combination at the fiber level to bring about a resultant movement that can be assessed through the proposed method of moment arm calculation for intact RC, complete supraspinatus tear, SCR and RSA.Methods:Five fresh cadaveric shoulder specimens were used in an apparatus where each muscle was maintained in tension with the line of action towards its origin on the scapula (Figure 1). An Optotrack camera kept track of digitized points along both the origin and insertion of the rotator cuff muscles as the shoulder was abducted. Using these digitized points, multiple lines of action were created across the breadth of each muscle. Each muscle force action line was then used to calculate moment arm values during 0-90º abduction (Figure 2).Results:Moment arms calculated for multiple fiber lines spanning the tendon attachment site displayed the variance of fiber contribution and function within each muscle during abduction. Our results indicate that rather than providing a return to anatomical shoulder muscle function, RSA and SCR models produce moment arms that vary between muscles, with some contributing more to abduction and some contributing less. Highlighted below are the infraspinatus results for moment arms of individual fiber lines of action (Figure 3) and calculated mean moment arms (Figure 4) over abduction.ANOVA testing demonstrated a significant difference (p<0.001) when analyzing moment arms of intact, complete supraspinatus tear, SCR, and RSA models in teres minor and infraspinatus. There was no significant difference in moment arm values between the models in the subscapularis (p=0.148). Highlighted in Table 1 are the ANOVA testing results for infraspinatus.Conclusions:Our biomechanical analysis demonstrated sufficient sensitivity to detect differences in moment arms of the four rotator cuff muscles across a variety of models, suggesting changes to even one muscle of the shoulder will have significant implications on the function of other shoulder muscles. Furthermore, our analysis of fiber divisions within the same muscle illustrates the complex nature of the shoulder muscles themselves, and future studies should aim to better explore and model their function. The calculated percent differences from intact beautifully illustrated this complexity, as corrective RSA and SCR procedures provided better resemblance of intact anatomy within some rotator cuff muscles while creating a larger percent difference in other muscle groups.By breaking out RC muscles into multiple fibers, more clarity can be gained as to how individual fibers contribute to a muscle’s overall moment arm during abduction. This may further aid surgical decision-making, specifically for RSA where there is continued debate about whether to reconstruct portions of the RC. Given that the supraspinatus tendon is the most frequently torn tendon in the rotator cuff, especially for athletes who apply repetitive stress to the tendon, the results of this study may help inform post-operative rehabilitation by illustrating how abduction and stability are achieved after SCR and RSA.

Evaluation of rotator cuff abduction moment arms for superior capsular reconstruction and reverse total shoulder arthroplasty.

The rotator cuff (RC) muscles contribute to dynamic stability and rotational actions of the glenohumeral joint. Moment arm can be used to demonstrate the potential work a muscle contributes to a musculoskeletal joint rotation. This study aimed to understand the moment arm contributions of the RC muscles and explore changes following a complete supraspinatus tear treated with either superior capsular reconstruction (SCR) or reverse total shoulder arthroplasty (rTSA). Five fresh-frozen cadaveric specimens were prepared and mounted in an apparatus where each intact RC muscle was held in tension with a line of action toward its origin on the scapula. Mean moment arms for each muscle were determined experimentally based on Optotrak data collected during cadaveric shoulder arm abduction. Using ANOVA testing, our analysis demonstrated significant differences (p < 0.001) in infraspinatus and teres minor moment arms after rTSA compared to the intact shoulder model. After SCR, significant differences (p < 0.001) were seen in teres minor, with these differences being statistically similar to the changes seen in teres minor after rTSA. Subscapularis showed no significant difference in moment arm values between the models (p = 0.148). Our results illustrate that mean moment arms were preserved in the RC muscles after complete supraspinatus tear. This study also shows evidence that subscapularis function may be maintained after SCR or rTSA. After SCR, infraspinatus may maintain similar abduction ability compared to the anatomical shoulder, while teres minor ability may increase. Infraspinatus may have decreased abduction ability after rTSA while teres minor may have increased ability.

Impact of two postural assist exoskeletons on biomechanical loading of the lumbar spine

This study evaluated loading on the low back while wearing two commercially available postural assist exoskeletons. Ten male subjects lifted a box from multiple lift origins (combinations of vertical height and asymmetry) to a common destination using a squatting lifting technique with and without the use of either exoskeleton. Dependent measures included subject kinematics, moment arms between the torso or weight being lifted and the lumbar spine, and spinal loads as predicted by an electromyography-driven spine model. One of the exoskeletons tested (StrongArm Technologies™ FLx) reduced peak torso flexion at the shin lift origin, but differences in moment arms or spinal loads attributable to either of the interventions were not observed. Thus, industrial exoskeletons designed to control posture may not be beneficial in reducing biomechanical loads on the lumbar spine. Interventions altering the external manual materials handling environment (lift origin, load weight) may be more appropriate when implementation is fesible.

The effects of grip width on sticking region in bench press

The aim of this study was to examine the occurrence of the sticking region by examining how three different grip widths affect the sticking region in powerlifters’ bench press performance. It was hypothesised that the sticking region would occur at the same joint angle of the elbow and shoulder independent of grip width, indicating a poor mechanical region for vertical force production at these joint angles. Twelve male experienced powerlifters (age 27.7 ± 8.8 years, mass 91.9 ± 15.4 kg) were tested in one repetition maximum (1-RM) bench press with a narrow, medium and wide grip. Joint kinematics, timing, bar position and velocity were measured with a 3D motion capture system. All participants showed a clear sticking region with all three grip widths, but this sticking region was not found to occur at the same joint angles in all three grip widths, thereby rejecting the hypothesis that the sticking region would occur at the same joint angle of the elbow and shoulder independent of grip width. It is suggested that, due to the differences in moment arm of the barbell about the elbow joint in the sticking region, there still might be a poor mechanical region for total force production that is joint angle-specific.

Moment arms of the muscles crossing the anatomical shoulder

The objective of the present study was to determine the instantaneous moment arms of 18 major muscle sub-regions crossing the glenohumeral joint during coronal-plane abduction and sagittal-plane flexion. Muscle moment-arm data for sub-regions of the shoulder musculature during humeral elevation are currently not available. The tendon-excursion method was used to measure instantaneous muscle moment arms in eight entire upper-extremity cadaver specimens. Significant differences in moment arms were reported across sub-regions of the deltoid, pectoralis major, latissimus dorsi, subscapularis, infraspinatus and supraspinatus (P < 0.01). The most effective abductors were the middle and anterior deltoid, whereas the most effective adductors were the teres major, middle and inferior latissimus dorsi (lumbar vertebrae and iliac crest fibers, respectively), and middle and inferior pectoralis major (sternal and lower-costal fibers, respectively). In flexion, the superior pectoralis major (clavicular fibers), anterior and posterior supraspinatus, and anterior deltoid were the most effective flexors, whereas the teres major and posterior deltoid had the largest extensor moment arms. Division of multi-pennate shoulder muscles of broad origins into sub-regions highlighted distinct functional differences across those sub-regions. Most significantly, we found that the superior sub-region of the pectoralis major had the capacity to exert substantial torque in flexion, whereas the middle and inferior sub-regions tended to behave as a stabilizer and extensor, respectively. Knowledge of moment arm differences between muscle sub-regions may assist in identifying the functional effects of muscle sub-region tears, assist surgeons in planning tendon reconstructive surgery, and aid in the development and validation of biomechanical computer models used in implant design.

Implications of Muscle Relative Position as a Co-Determinant of Isometric Muscle Force

Force is transmitted from muscle fiber to bone via several pathways: (1) via the tendons (i.e. myotendinous force transmission), (2) via intermuscular connective tissue to adjacent muscles (i.e. intermuscular myofascial force transmission), (3) via structures other than muscles (i.e. extramuscular myofascial force transmission). In vivo, the position of a muscle relative to adjacent muscles changes due to differences in moment arm between synergists as well as due to the fact that some muscles span only one joint and other muscles more than one joint. The position of a muscle relative to non-muscular structures within a compartment is altered with each change of the length of the muscle.The aim of this article is to describe recent experimental results, as well as some new experimental data, that have elucidated the role of muscle relative position on force transmission from muscle. Furthermore, relevant literature is discussed, taking into consideration these new insights of muscle functioning. It is concluded that the position of a muscle relative to surrounding tissues is a major co-determinant of isometric muscle force. For muscles operating within their in vivo context of connective tissue, such position effects should be taken into account.

MRI-derived moment-arms of the female and male spine loading muscles

Objective. Develop a comprehensive gender-specific database of trunk muscle moment-arms across multiple levels of the lower thoracic and lumbar spine, determine if gender differences exist across the different vertebral levels, and develop prediction equations for the moment-arms as a function of external anthropometric measures. Design. This study quantified trunk muscle moment-arms relative to the spine from T 8 to S 1 of male and female spine loading muscles. Background. Knowledge of trunk muscle geometry is important for biomechanical modeling of the low back and for understanding of spinal loading. However, there currently is a lack of comprehensive data regarding the moment-arms of the female spine loading muscles. Additionally, little is known regarding gender differences in moment-arms for the same muscles. Methods. Magnetic resonance imaging scans through the vertebral bodies from T 8 through S 1 were performed on 20 females and 10 males. Moment-arms in the coronal and sagittal plane between the muscle centroid and vertebral body centroid were recorded at each vertebral level. Linear regression techniques taking into account anthropometric measures were utilized to develop prediction equations for the moment-arms for each muscle. Results. Anthropometric measures were better predictors of coronal plane moment-arms than sagittal plane moment-arms for both genders. Measures consisting of height and weight were consistent predictors of female moment-arms. Measures about the xyphoid process and combinations of height and weight were consistent predictors of coronal plane moment-arms for males at several lower lumbar levels. Males exhibited larger moment-arms than for females, for most muscles at most levels. Conclusions. Trunk muscle moment-arms of females and males are different, and should be considered in the development of biomechanical models of the torso. Similar to other studies, external anthropometric measures were better predictors of coronal plane moment-arms than sagittal plane moment-arms. Relevance Gender specific moment-arms of spine loading muscles are needed to estimate the moments produced by the trunk muscles during trunk motion.

The moment arms of 23 muscle segments of the upper limb with varying elbow and forearm positions: Implications for motor control

In this study we examined moment arms of the complete muscle system of the elbow, including the wrist flexors that have their proximal attachment point on the humerus. This study was performed with the aim to identify the synergistic mover functions of the muscles as an anatomical basis for the study of motor control of the elbow. The upper limbs of three cadaver specimens were dissected. Muscles were replaced by elastic strings. The relationship between muscle length and joint angles (elbow flexion–extension (F–E) and forearm pronation–supination (P–S)) were determined. The first derivation of the relationship revealed the moment arms. The results confirmed the literature with respect to the major elbow flexors, extensors, pronators and supinators. Two wrist muscles had a substantial moment arm at the elbow: The flexor carpi radialis appears to be a pronator of the forearm, and the extensor carpi radialis longus is an elbow flexor. The ratios of moment arm between muscles and between the two orthogonal actions were relatively constant among the specimens. A mechanical explanation for the existence of subpopulations of motor units (i.e. differences in moment arm for the subpopulations) is viable for supinator, brachialis, and brachioradialis, whereas it is less viable for biceps brachii. PsychINFO classification: 2330

A comparison of jaw muscle cross-sections of long-face and normal adults.

Long-face subjects have smaller maximum molar bite forces than do normal individuals. This has been attributed both to differences in moment arms and size of the jaw muscles. In this study, a comparison was made between the mid-belly cross-sectional areas of the jaw muscles of 13 long-face and 35 normal adults by means of serial MRI scans. The subjects were selected on the basis of anterior lower face height as a percentage of anterior total face height. These and other cephalometric variables were measured from lateral radiographs. In the long-face group, the cross-sectional areas of the masseter, medial pterygoid, and anterior temporal muscles were, respectively, 30%, 22%, and 15% smaller than in the control group. By a discriminant analysis and a multivariate analysis of variance, these differences were found to be significant (p less than 0.001). The findings of this study hint that differences in the sizes of the jaw muscles of long-face and normal subjects might explain, in part, the observed differences in maximum molar bite force.