First In Vivo Electromyographic Analysis of Mechanical Load Scenarios of the Cervicothoracic Junction During Daily Activities as a Basis for Future Postoperative Behavioral Instructions.

STUDY

DESIGN

Clinical Research.

OBJECTIVES

Study participants were twenty- eigth healty volunteers.

BACKGROUND

Soft tissue complications after posterior cervicothoracic fusion surgery occur frequently. Postoperative myofascial dehiscence (PMD) can cause disability and pain. So far, it is unknown whether patients can affect PMD development through behavioral adjustment. Consequently, this study aimed to analyze how much mechanical stress daily activities exert on the posterior muscles and fascia at the cervicothoracic junction.

MATERIALS AND

METHODS

Surface electromyography was applied next to the upper thoracic spine at the trapezius muscle. All volunteers performed 22 different daily activities, such as tooth brushing, dressing, standing up, and different horizontal positions. During the exercises, the electromyographic activity was measured. For each volunteer, root mean square values were determined. All exercises were then repeated with the use of a clavicular bandage to unload the shoulder and cervicothoracic muscles. Afterwards, the rankings were statistically compared interindividually.

RESULTS

Among the different tasks, significant differences in regard to the root mean square values were noted. For instance, horizontal positions caused significantly lower muscle activation compared with all other exercises ( P ≤ 0.001). Notably, no relevant electromyographic differences were detected between the tasks with and without a clavicular bandage.

CONCLUSIONS

This in vivo electromyographic analysis of cervicothoracic muscle activity during daily activities demonstrates that myofascial strain differs among various daily activities. Data indicate that potential postoperative mobilization protocols and behavioral instructions may have the potential to reduce the biomechanical load and consequently the risk of PMD and, therefore, may reduce the risk for surgical wound-related complications, disability, and need for revision surgery.