Publications
74 results found
Bates AV, McGregor AH, Alexander CM, 2016, Reliability and minimal detectable change of gait kinematics in people who are hypermobile, GAIT & POSTURE, Vol: 44, Pages: 37-42, ISSN: 0966-6362
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- Citations: 14
Alexander C, 2015, The difference of Park and Streitberger single-blind needles from Takakura double-blind needle Author response, JOURNAL OF INTEGRATIVE MEDICINE-JIM, Vol: 13, Pages: 214-214, ISSN: 2095-4964
To M, Alexander C, 2015, AB1237-HPR Do People with Joint Hypermobility Syndrome and Anterior Knee Pain Struggle to Strengthen their Quadriceps at the Same Rate As People Who Are Equally Flexible? Preliminary Results, WCPT 2015, Publisher: BMJ Publishing Group, Pages: 1348-1348, ISSN: 0003-4967
Navsaria R, Ryder DM, Lewis JS, et al., 2015, The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population, BRITISH JOURNAL OF SPORTS MEDICINE, Vol: 49, Pages: 318-+, ISSN: 0306-3674
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- Citations: 2
Bates AV, Alexander CM, 2015, Kinematics and kinetics of people who are hypermobile. A systematic review, GAIT & POSTURE, Vol: 41, Pages: 361-369, ISSN: 0966-6362
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- Citations: 12
Shaheen AF, Bull AMJ, Alexander CM, 2015, Rigid and Elastic taping changes scapular kinematics and pain in subjects with shoulder impingement syndrome; an experimental study, JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY, Vol: 25, Pages: 84-92, ISSN: 1050-6411
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- Citations: 28
To M, Alexander C, 2015, The effects of Park sham needles: a pilot study, JOURNAL OF INTEGRATIVE MEDICINE-JIM, Vol: 13, Pages: 20-24, ISSN: 2095-4964
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- Citations: 9
Alexander C, Schabrun S, 2015, Non-invasive brain stimulation in the measurement and treatment of musculoskeletal disorders., Grieve’s Modern Musculoskeletal Physiotherapy
Kassam J, Alexander C, 2014, A PILOT STUDY TO PREPARE FOR AN INVESTIGATION OF CORTICOSPINAL EXCITABILITY IN PEOPLE WITH JOINT HYPERMOBILITY SYNDROME, 15th Annual European Congress of Rheumatology (EULAR), Publisher: BMJ PUBLISHING GROUP, Pages: 1088-1089, ISSN: 0003-4967
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- Citations: 1
Matthews D, Murtagh P, Risso A, et al., 2013, Does interhemispheric communication relate to the bilateral function of muscles? A study of scapulothoracic muscles using transcranial magnetic stimulation, JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY, Vol: 23, Pages: 1370-1374, ISSN: 1050-6411
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- Citations: 9
Duffell L, Alexander C, Greenwood N, et al., 2013, Re: Electromyographic activity of pelvic and lower limb muscles during postural tasks in people with benign joint hypermobility syndrome and non hypermobile people. A pilot study Greenwood NL, Duffell LD, Alexander CM & McGregor AH. Man Ther 2011;16:p. 623-628, MANUAL THERAPY, Vol: 18, Pages: E10-E10, ISSN: 1356-689X
Shaheen AF, Villa C, Lee Y-N, et al., 2013, Scapular taping alters kinematics in asymptomatic subjects, JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY, Vol: 23, Pages: 326-333, ISSN: 1050-6411
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- Citations: 28
MacDonald R, Tanner J, Alexander CM, et al., 2012, Order and Disorder ‐ Unravelling Motor Function and Dysfunction., International Musculoskeletal Medicine, Vol: 2, Pages: 76-82
Greenwood NL, Duffell LD, Alexander CM, et al., 2011, Electromyographic activity of pelvic and lower limb muscles during postural tasks in people with benign joint hypermobility syndrome and non hypermobile people. A pilot study, Man Ther
Benign joint hypermobility syndrome (BJHS) is associated with the early development of certain degenerative conditions, which may be associated with altered muscle activity. This pilot study compared muscle activation patterns during postural tasks between people with BJHS who do not have pain and people with normal flexibility (control group). Sixteen subjects aged 22-45 years (8 with BJHS) were selected from a population recruited to a larger study. Electromyographic activity of erector spinae (ES), gluteus medius (GM), and lower limb (rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA) and gastrocnemius lateralis) muscles was assessed, and chosen based on the muscles being tested in the larger study. Subjects carried out 30 s of quiet standing (QS) and one-leg standing (OLS), both with eyes open (EO) and eyes closed (EC). Both groups had significantly more TA activity, and control subjects had significantly more GM activity, during OLS EC compared with QS. GM activity was not significantly different between groups. Compared with the BJHS group, control subjects had significantly less ST activation overall, significantly more ES activity during OLS EC and significantly less RF-ST co-contraction during QS. This study has noted differences in muscle activation patterns between pain-free hypermobile people and control subjects, specifically involving muscles surrounding the pelvis and hip. This pilot data suggests that strategies for stabilising the body during balancing tasks may be relevant to injury risk in people with BJHS. While results need to be verified with a larger subject sample, this study is important in developing new treatments for hypermobile people
Elliott SC, Hanson JR, Wellington J, et al., 2011, Reflex control of posterior shoulder muscles from arm afferents in healthy people, J Electromyogr.Kinesiol., Vol: 21, Pages: 1087-1091
In order to position the hand during functional tasks, control of the shoulder is required. Heteronymous reflexes from the upper limb to shoulder muscles are used to assist in this control. To investigate this further, the radial and ulnar nerves were stimulated at elbow level whilst surface electromyographic activity of posterior deltoid, infraspinatus and latissimus dorsi muscles were recorded. In addition, the cutaneous branch of the radial nerve and the skin of the fifth digit were stimulated in order to investigate any cutaneous contribution to reflex activity. Reflexes were evoked in all three of these shoulder muscles from hand and/or forearm afferents. However, the reflexes differed; whereas both excitatory and inhibitory reflexes were evoked in posterior deltoid and infraspinatus, the reflexes in latissimus dorsi were mainly excitatory. Cutaneomuscular reflexes were seldom evoked here, but when they were present they were generally evoked at longer latencies than the reflexes evoked by mixed nerve stimulation. The results suggest a role for reflexes originating from the forearm and/or hand in the control of the shoulder
Wightman F, Delves S, Alexander CM, et al., 2011, Differences in descending control of external oblique and latissimus dorsi muscles in humans: a preliminary study, Motor Control, Vol: 15, Pages: 405-418
Descending bilateral control of external oblique (EO) and latissimus dorsi (LD) was investigated using transcranial magnetic stimulation. Contralateral (CL) motor evoked potential (MEP) thresholds were lower and latencies were shorter than for ipsilateral (IL) MEPs. Hotspots for EO were symmetrical; this was not the case for LD. The volumes of drive to the left and right muscles were not different. The laterality index was not different between the left and right muscles. The average index for the EO muscles was closer to zero than that for LD, suggesting a stronger IL drive to EO. The symmetry of drive to each muscle did not differ; however, the symmetry of drive varies within a subject for different muscles and between subjects for the same muscle. The findings may be useful in understanding a number of clinical conditions relating to the trunk and also for predicting the outcome of rehabilitative strategies
Shaheen AF, Alexander CM, Bull AM, 2011, Tracking the scapula using the scapula locator with and without feedback from pressure-sensors: A comparative study, J Biomech., Vol: 44, Pages: 1633-1636
BACKGROUND: The scapula locator method has associated intra-observer and inter-observer errors caused by the dependency on the observer to locate the scapular landmarks. The potential effect of the pressures applied by the observer on the measured scapular kinematics when this method is used has also been overlooked so far. The aim of this study was to investigate the effect of using feedback on the pressures applied on the scapula using the locator on the intra-observer and inter-observer reliabilities of the method as well as on the kinematics obtained using this method. METHODS: Three observers tracked the scapular motion of the dominant shoulder of each subject using the locator with no reference to pressure-feedback for three trials of bilateral elevation in the scapular plane and using the locator with pressure-feedback for three other trials. Variations between the measurements obtained were used to calculate the intra-observer errors and variations between the measurements obtained by the three observers for the same subject were used to calculate inter-observer errors. Repeated-measures ANOVA tests were used to look at differences between the two methods in terms of intra-observer and inter-observer errors and scapular kinematics. FINDINGS: Using pressure-feedback reduced the intra-observer errors but had no effect on the inter-observer errors. Different scapular kinematics was measured using the two methods. INTERPRETATIONS: Pressure-feedback improves the reliability of the scapula locator method. Differences in the scapular kinematics suggest that unregulated pressures have an effect on the physiological scapular motion
Shaheen AF, Alexander CM, Bull AM, 2011, Effects of attachment position and shoulder orientation during calibration on the accuracy of the acromial tracker, J Biomech., Vol: 44, Pages: 1410-1413
The acromial tracker is used to measure scapular rotations during dynamic movements. The method has low accuracy in high elevations and is sensitive to its attachment location on the acromion. The aim of this study was to investigate the effect of the attachment position and shoulder orientation during calibration on the tracker accuracy. The tracker was attached to one of three positions: near the anterior edge of the acromion process, just above the acromial angle and the meeting point between the acromion and the scapular spine. The scapula locator was used to track the scapula during bilateral abduction simultaneously. The locator was used to calibrate the tracker at: no abduction, 30 degrees , 60 degrees , 90 degrees and 120 degrees humerothoracic abduction. ANOVA tests compared RMS errors for different attachment positions and calibration angles. The results showed that attaching the device at the meeting point between the acromion and the scapular spine gave the smallest errors and it was best to calibrate the device at 60 degrees for elevations </=90 degrees , at 120 degrees for elevations >90 degrees and at 90 degrees or 120 degrees for the full range of abduction. The accuracy of the tracker is significantly improved if attached appropriately and calibrated for the range of movement being measured
Alexander CM, 2011, Shoulder girdle control; some mechanisms of function to dysfunction, Man Ther, Vol: 16, Pages: 42-43
Firth BL, Dingley P, Davies ER, et al., 2010, The effect of kinesiotape on function, pain, and motoneuronal excitability in healthy people and people with Achilles tendinopathy, Clin J Sport Med., Vol: 20, Pages: 416-421
OBJECTIVE: To investigate the effect of kinesiotape on hop distance, pain, and motoneuronal excitability in healthy people and people with Achilles tendinopathy (AT). DESIGN: Within-subject design. SETTING: An academic health science center, which is an acute London National Health Service trust. PARTICIPANTS: With ethical approval and informed consent, a convenience sample of 26 healthy people and 29 people with AT were recruited. Seven participants were lost after functional testing, leaving 24 participants in each group. INTERVENTIONS: Kinesiotape applied over the Achilles tendon. MAIN OUTCOME MEASURES: The single-leg hop test and visual analog scale were measured with and without the tape. Using the Hoffman (H) reflex, change in motoneuronal excitability of calf muscles was measured before tape application, with the tape on and after its removal. RESULTS: There were no changes to hop distance when tape was applied (P = 0.55). Additionally, there were no changes to pain (P = 0.74). The H reflex amplitude of soleus and gastrocnemius increased in the healthy group after its removal (P = 0.01 and P = 0.03, respectively), whereas the H reflex remained unchanged in people with AT (P = 0.43 and 0.16, respectively). CONCLUSIONS: Calf muscles were facilitated by kinesiotape in healthy participants. Despite this, there was no change to hop distance. Kinesiotape had no effect on hop distance, pain, or motoneuronal excitability in people with AT. These results do not support the use of kinesiotape applied in this way for this condition
Jeremiah HM, Alexander CM, 2010, Do hypermobile subjects without pain have alteration to the feedback mechanisms controlling the shoulder girdle?, Musculoskeletal Care, Vol: 8, Pages: 157-163
OBJECTIVES: It has been reported that hypermobile subjects have proprioceptive deficits. However, it remains unclear whether pain-free subjects with hypermobility also have deficits. METHODS: Ten subjects with hypermobility and nine without hypermobility were recruited following ethical approval and informed consent. Shoulder mobility, joint position sense (JPS) and a reflex of trapezius evoked from arm afferents were compared. RESULTS: There was greater shoulder mobility in the hypermobile group (p = 0.004). There were no differences in shoulder JPS between the groups (p = 0.27), although, the hypermobile group displayed a larger degree of variability (p = 0.014). Finally, there were no differences in the latency of upper and lower trapezius reflexes evoked from arm afferents (p = 0.86 and 0.98, respectively). CONCLUSIONS: In a group of people with hypermobility without shoulder problems, there was no difference in either shoulder JPS or reflex latency when compared with a non- hypermobile group. The relevance of pain to proprioceptive deficits is discussed
Hamm K, Alexander CM, 2010, Challenging presumptions: is reciprocal inhibition truly reciprocal? A study of reciprocal inhibition between knee extensors and flexors in humans, Man Ther, Vol: 15, Pages: 388-393
Reciprocal inhibition (RI) between different muscles has been used as an explanation for the effect of some treatments. Consequently, there may be a presumption that RI is bi-directional and equal between every agonist antagonist muscle pair. That is, the strength of RI from agonist to antagonist is equal to that from antagonist to agonist. With this in mind we investigated RI between quadriceps and hamstrings using 2 techniques to explore if a) it is evoked between this agonist antagonist pair and b) if it is equal and opposite in strength. Firstly, electromygraphic (EMG) activity of one muscle was recorded whilst stimulating group Ia afferents from the other. The second approach involved conditioning a reflex evoked in one muscle by stimulating Ia afferents from the other. Using the first approach, short-latency inhibition thought to be RI, was observed more frequently (p<0.000) and was larger (p<0.05) from femoral nerve stimulation to hamstrings than the inhibition evoked in quadriceps by sciatic nerve stimulation. The second approach revealed a similar pattern. RI between quadriceps and hamstrings is not actually reciprocal i.e. not equal in both directions. Our presumptions about the frequency and strength of other pathways between different agonist antagonist pairs need to be assessed
Potier TG, Alexander CM, Seynnes OR, 2009, Effects of eccentric strength training on biceps femoris muscle architecture and knee joint range of movement, Eur J Appl.Physiol, Vol: 105, Pages: 939-944
The aim was to determine whether eccentric strengthening changed the muscle architecture of human biceps femoris and consequently, knee range of motion. Twenty-two subjects were randomly assigned to control and experimental groups. The experimental group completed an eccentric strengthening programme for 8 weeks. Outcome measures included hamstring muscle strength (one repetition maximum), the passive knee extension test (PKE) (knee joint angle at which the onset of passive tension occurs), fascicle length (FL) and pennation angle (PA). One repetition maximum increased by 34% (P < 0.01), the PKE test revealed a 5% increase in joint range of motion (P = 0.01), FL increased by 34% (P = 0.01) and PA did not change (P = 0.38). This is the first report of an increase in FL in the biceps femoris following eccentric resistance training. In addition, the results might imply that this fascicle lengthening could lead to an increase in the range of motion of the knee. Clinical implications for rehabilitation and injury prevention are discussed
Alexander CM, McMullan M, Harrison PJ, 2008, What is the effect of taping along or across a muscle on motoneurone excitability? A study using triceps surae, Man.Ther., Vol: 13, Pages: 57-62
Taping along the skin overlying lower trapezius reduces motoneurone excitability in healthy subjects [Alexander, C.M., Stynes, S., Thomas, A., Lewis, J., Harison, P.J., 2003. Does tape facilitate or inhibit the lower fibres of trapezius? Manual Therapy 8, 37-41]. It remains unclear whether this effect is: (a) specific to trapezius and (b) specific to the direction of application of the tape. In light of this, the excitability of another muscle was measured in order to see if these results were repeatable and independent of the muscle taped. Thus, the excitability of the medial and lateral gastrocnemius (MG and LG) and soleus (Sol) motoneurone pool was assessed using the Hoffman reflex (H reflex). The amplitude of this reflex was measured with the tape aligned across and then along the direction of the MG muscle fibres. Tape aligned across the fibres failed to affect motoneurone excitability (MG P=0.61, LG P=0.69, Sol P=0.17). Under tape and sports tape applied together aligned along the MG muscle reduced the excitability of both MG and LG (19% (P=0.01) and 13% (P=0.01), respectively). These observations suggest that any change to movement patterns with tape application cannot be explained by facilitation of the motoneurone excitability
Alexander CM, Bodycombe S, Wightman F, et al., 2008, The symmetry of bilateral control of external oblique and latissimus dorsi muscles in humans, Washington, USA, Publisher: Society for neuroscience
Roberts L, Wellington J, Harrison A, et al., 2008, Reflex connections of the infraspinatus muscle in healthy humans., Dunedin, New Zealand
Alexander CM, 2007, Altered control of the trapezius muscle in subjects with non-traumatic shoulder instability, Clinical Neurophysiology, Vol: 118, Pages: 2664-2671
Objective: Reflexes of shoulder girdle muscles such as trapezius are evoked from muscle afferents supplying the forearm and hand in healthy subjects. These reflexes are thought to aid the stability of the shoulder during use of the arm and hand [Alexander CM, Harrison PJ. Reflex connections from forearm and hand afferents to shoulder girdle muscles in humans. Exp Brain Res 2003;148: 277-282.]. With this in mind, the objective of this investigation was to examine this trapezius reflex in subjects with non-traumatic shoulder instability (NTSI). Methods: The occurrence and alteration to this supraspinal reflex pathway were investigated using electrical stimulation of the ulnar and the spinal accessory nerves as well as magnetic stimulation of the trapezius motor cortex. These results were compared to a healthy group. Results: The reflexes to lower trapezius were not usually observed in subjects with NTSI. When evoked, the frequency of occurrence was 27% compared to 87% in a healthy population (p<0.002). When present, the latency of this lower trapezius reflex was later than that evoked in the healthy group (62.8ms+/-28.1ms and 38.4ms+/-3.6ms, respectively; p<0.009). Although both the conduction velocity of the effective afferents and the latency of the M response to lower trapezius did not differ to the healthy group (p<0.24 and 0.54, respectively), the latency and threshold of the corticospinal evoked potential of lower trapezius did differ (16.7ms+/-4.7ms vs 11.2ms+/-1.8ms; p=0.006; 57%+/-15.8% vs 36%+/-7.6%, p=0.003). Overall, these results contrast to these measures of control of upper trapezius, which did not differ to a healthy group. Conclusions: The delay or absence of these reflexes and the delay and change in threshold of the corticospinal response in lower trapezius in subjects with NTSI indicate that the feedback mechanisms that aid shoulder girdle stability, and the voluntary control of lower trapezius are not as proficient in these subjects. Sign
Alexander C, Miley R, Stynes S, et al., 2007, Differential control of the scapulothoracic muscles in humans., J Physiol, Vol: 580, Pages: 777-786, ISSN: 0022-3751
The control of the scapulothoracic muscles trapezius (Tr) and serratus anterior (SA) has been examined in normal human subjects. Electromyographic recordings were made from the SA and Tr muscles (upper trapezius UTr, lower trapezius LTr) using surface electrodes placed bilaterally. Magnetic stimulation of the motor cortex and electrical stimulation of peripheral nerves were used to examine their descending and reflex control. The average optimal site of cortical stimulation was found to be the same for SA, UTr and LTr (an approximate centre of gravity of -0.6 cm, 3.7 cm where the centre of gravity is expressed as the mean anterio-posterior position, the mean medio-lateral position). Some asymmetry in the cortical representation of UTr was found in each individual tested. Magnetic stimulation evoked bilateral MEPs in Tr (latency contralateral (c) UTr 8.5 +/- 1.6 ms, ipsilateral (i) UTr 19.0 +/- 2.7 ms) but only contralateral responses were evoked in SA (11.2 +/- 2.6 ms). Electrical stimulation of the long thoracic nerve at two sites was used to examine homonymous and heteronymous reflexes of SA, while electrical stimulation of cervical nerve of C3/4 was used to examine the heteronymous reflexes of Tr. Ipsilateral SA H reflexes were evoked at a latency of 9.9 +/- 0.8 ms (proximal site) and 10.8 +/- 1.2 ms (distal site). No group I reflexes were evoked from SA to its contralateral homologue. No group I reflexes were evoked between Tr and SA. Finally, cross-correlation of activity from the Tr muscle pairs and the SA muscle pair revealed that the motoneurones of the Tr muscles share some common presynaptic input whereas there was no detectable common presynaptic input to the SA muscle pair. This study extends and consolidates knowledge regarding the neural control of trapezius and for the first time explores the neural control of SA. The study demonstrates a contrasting bilateral control of Tr and SA. These patterns of connections are discussed in relation to the contras
Alexander CM, Miley R, Stynes S, et al., 2007, Differential control of the scapulothoracic muscles in humans, J.Physiol, Vol: 580, Pages: 777-786
The control of the scapulothoracic muscles trapezius (Tr) and serratus anterior (SA), has been examined in normal human subjects. Electromyographic recordings were made from the SA and Tr muscles (upper trapezius UTr, lower trapezius LTr) using surface electrodes placed bilaterally. Magnetic stimulation of the motor cortex and electrical stimulation of peripheral nerves were used to examine their descending and reflex control. The average optimal site of cortical stimulation was found to be the same for SA, UTr and LTr (an approximate centre of gravity of -0.6cm, 3.7cm where the centre of gravity is expressed as the mean anterio-posterior position, the mean medio-lateral position). Some asymmetry in the cortical representation of UTr was found in each individual tested. Magnetic stimulation evoked bilateral MEPs in Tr (latency contralateral (c) UTr 8.5ms +/- 1.6ms, ipsilateral (i) UTr 19.0ms +/- 2.7ms) but only contralateral responses were evoked in SA (11.2ms +/- 2.6ms). Electrical stimulation of the long thoracic nerve at two sites was used to examine homonymous and heteronymous reflexes of SA, while electrical stimulation of cervical nerve of C3/4 was used to examine the heteronymous reflexes of Tr. Ipsilateral SA H reflexes were evoked at a latency of 9.9ms +/- 0.8ms (proximal site) and 10.8ms +/- 1.2ms (distal site). No group I reflexes were evoked from SA to its contralateral homologue. No group I reflexes were evoked between Tr and SA. Finally, cross correlation of activity from the Tr muscle pairs and the SA muscle pair revealed that the motoneurones of the Tr muscles share some common presynaptic input whereas there was no detectable common presynaptic input to the SA muscle pair. This study extends and consolidates knowledge regarding the neural control of trapezius and for the first time explores the neural control of SA. The study demonstrates a contrasting bilateral control of Tr and SA. These patterns of connections are discussed in relation to the con
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