Effect of load level and muscle pain intensity on the motor control of elbow-flexion movements

This study assessed interactions between mild/moderate muscle pain and inertial load on the control of human elbow-flexion movements. It is hypothesized that high inertial load combined with moderate muscle pain intensity affect the motor control more than for low inertial-load combined with low-intensity pain. Fifteen subjects performed horizontal pointing movements (70° range) under three load conditions: 0, 4, and 10 kg. Pain was induced by injection of 0.5 ml and 1.5 ml hypertonic saline into the biceps muscle. Subjects scored the muscle pain intensity on a visual analogue scale (VAS). Elbow joint position, VAS, and the electromyograms (EMG, m. biceps brachii, m. triceps brachii, m. brachioradialis, and m. trapezius) were recorded. Mild and moderate muscle pain attenuated acceleration profiles [6.1(0.9)%], effective movement amplitude [3.2 (0.7)%], peak velocity [5.8 (0.9)%] and prolonged the reaction time [21 (5)%]. No interaction between muscle pain intensity and inertial load was found for the kinematic parameters. EMG profiles from m. biceps brachii, m. triceps brachii, and m. brachioradialis were similarly attenuated [10.2 (0.80)%] by mild and moderate muscle pain in all inertial load conditions. For high inertial load, the initial agonist EMG burst activity was more attenuated [50 (5.3)%] by moderate muscle pain compared with mild muscle pain [34 (4.2)%]. These data suggest that for high effort-demanding tasks muscle pain differently affects the motor planning according to the pain-intensity level. Perturbations of motor planning lead to changes on movement strategies, which might be a potential cause of musculoskeletal problems.