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  • Author: Alison H. McGregor x
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Alex V. Nowicky, Alison H. McGregor and Nick J. Davey

We used transcranial magnetic stimulation (TMS) to study corticospinal excitability to erector Spinae (ES) muscles during graded voluntary contractions in bilateral trunk extension (BTE) and forced expiratory breath holding (FEBH) in normal individuals. Motor evoked potentials (MEPs) could be produced in all subjects in the absence of voluntary activation. At maximum voluntary contraction, levels of surface electromyographic (EMG) activity were 4 times greater during BTE than FEBH. When EMG was normalized to maximum. MEP amplitudes increased in proportion to contraction in both tasks. MEPs in FEBH were compared with extrapolated values at similar EMG levels in BTE and were found to be larger. EMG and MEPs in left and right ES were symmetrical throughout the range of contractions in both tasks. ES muscles have a facilitation pattern similar to that previously shown in leg muscles, but subtle differences at low levels of EMG suggest that the facilitation is dependent on the task.

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Robert A. Weinert-Aplin, Anthony M.J. Bull and Alison H. McGregor

Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges works remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. A musculoskeletal modeling approach was used to quantify changes in lower limb mechanics when walking due to the introduction of 12-mm orthotic heel wedges. Nineteen healthy volunteers walked on an inclinable walkway while optical motion, force plate, and plantar pressure data were recorded. Walking with heel wedges increased ankle dorsiflexion moments and reduced plantar flexion moments; this resulted in increased peak ankle dorsiflexor muscle forces during early stance and reduced tibialis posterior and toe flexor muscle forces during late stance. Heel wedges did not reduce overall Achilles tendon force during any walking condition, but did redistribute load from the medial to lateral triceps surae during inclined walking. These results add to the body of clinical evidence confirming that heel wedges do not reduce Achilles tendon load and our findings provide an explanation as to why this may be the case.