Serratus anterior weakness is a key determinant of arm-assisted standing difficulties
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Accepted version
Accepted version
Author(s)
Smith, Samuel HL
Reilly, Peter
Bull, Anthony MJ
Type
Journal Article
Abstract
The ageing population has led to recent increases in musculoskeletal conditions, with muscle weakness a major contributor to functional decline. Understanding the early phases of muscle weakness will help devise treatments to extend musculoskeletal health. Little is understood of the effects of muscle weakness on everyday activities such as sit-to-stand, a determinant of mobility that, in the early stages of weakness, requires upper limb compensation. This experimental and computational modelling study investigated the effects of muscle weakness on upper-extremity muscle forces of 27 healthy adults when using arm rests. Weakness of 29 upper limb muscles was simulated by individually removing each from a musculoskeletal model. Serratus anterior weakness was highlighted as detrimental, with the model unable to fully solve the loadsharing redundancy in its absence, and forces at the elbow and glenohumeral joint and in other muscles were found to be profoundly increased. Its large number of fast-twitch muscle fibres, predisposed to atrophy with age, highlight the centrality of the serratus anterior as a key determinant of mobility in this critical task and a potential source of early immobility through its preferential loss of strength and thus point to the requirement for early clinical interventions to mitigate loss.
Date Issued
2019-12
Date Acceptance
2019-09-29
Citation
Medical Engineering and Physics, 2019, 74, pp.41-48
ISSN
1350-4533
Publisher
Elsevier
Start Page
41
End Page
48
Journal / Book Title
Medical Engineering and Physics
Volume
74
Copyright Statement
© 2019 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
Engineering and Physical Sciences Research Council
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31623943
PII: S1350-4533(19)30203-6
Grant Number
EP/M507878/1
Subjects
Ageing population
Muscle fibres
Muscle weakness
Musculoskeletal modelling
Sit-to-stand
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-10-14