Eur J Appl Physiol (2009) 106:857–866
DOI 10.1007/s00421-009-1083-9
O R I G I N A L A R T I CL E
Experimental pain leads to reorganisation of trapezius
electromyography during computer work with active and passive
pauses
Afshin Samani · Andreas Holtermann · Karen Søgaard ·
Pascal Madeleine
Accepted: 5 May 2009 / Published online: 29 May 2009
© Springer-Verlag 2009
Abstract The aim of this laboratory study was to investi-
gate acute eVects of experimental muscle pain on spatial
electromyographic (EMG) activity of the trapezius muscle
during computer work with active and passive pauses.
Twelve healthy male subjects performed four sessions of
computer work for 2 min in one day, with passive (relax)
and active (30% maximum voluntary contraction of shoul-
der elevation) pauses given every 40 s without and with
presence of experimental pain. Surface EMG signals were
recorded from four parts of the trapezius. The centroid of
exposure variation analysis along the time axis was lower
during computer work with active pauses when compared
with passive one in all muscle parts (P < 0.05). In presence
of experimental pain, EMG amplitude increased in trans-
verse and ascending parts and relative rest time decreased
in ascending part. The results of this study showed a more
variable trapezius activity pattern and increased activity
A. Samani · P. Madeleine (&)
Laboratory for Ergonomics and Work-related Disorders,
Center for Sensory-Motor Interaction (SMI),
Department of Health Science and Technology,
Aalborg University, Fredrik Bajers Vej 7 D-3,
9220 Aalborg East, Denmark
e-mail: pm@hst.aau.dk
A. Samani · A. Holtermann
National Research Centre for the Working Environment,
Lersø Parkallé 105, 2100 Copenhagen, Denmark
K. Søgaard
Institute of Sports Science and Clinical Biomechanics,
University of Southern Denmark, Campusvej 55,
5230 Odense M, Denmark
with active compared with passive pauses, a lowered trape-
zius rest with presence of experimental pain, and increased
activity in the transverse and ascending parts of trapezius
due to experimental pain during computer work. Acute pain
led to muscle activation pattern during computer work con-
sidered to increase the risk of developing work-related
musculoskeletal disorders.
Keywords Work-related musculoskeletal disorders ·
Muscle spatial organization · Relative rest time · Exposure
variation analysis · Neck–shoulder pain
Introduction
Computer usage is associated with high prevalence of
work-related musculoskeletal disorders (WMSD), e.g.
among secretary staV has been reported up to 60%
(Kamwendo et al. 1991; Tittiranonda et al. 1999). WMSD
cause a huge burden for medical care and insurance sys-
tems (Herman and JeVress 2000), and are associated with
discomfort and pain widely reported in upper trapezius
muscle (Andersen et al. 2008; Juul-Kristensen et al. 2006).
Further, the basic knowledge regarding the aetiology of
WMSDs is still lacking and to date there is no well-docu-
mented eVective treatment for these disorders. Ergonomic
studies have often examined muscle activity in healthy
workers, and assumed that higher levels of muscle activity
during work represented higher risks for developing
WMSD (Aarås et al. 1997; Bansevicius et al. 1997; Cooper
and Straker 1998; Kleine et al. 1999). Most cross-sectional
studies comparing EMG activities between symptomatic and
asymptomatic workers have found increased activity level
among symptomatic group (Elert et al. 1992; Kallenberg
and Hermens 2006; Madeleine et al. 1999).
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It is generally assumed that recurrent acute pain episodes
may induce sensitization and lead to chronic work-related
pain (Madeleine 2008; Visser and van Dieën 2006). Experi-
mental muscle pain models are of great interest because they
cause transitory well-controlled muscle pain that can mimic
clinical conditions despite important diVerences. Recent
studies have shown a reorganization of the spatio-temporal
activity patterns of the upper trapezius muscle during
experimental pain (Falla et al. 2007; Madeleine and Arendt-
Nielsen 2005). The knowledge about muscle pain and motor
control interaction in occupational settings is limited, actu-
ally only a few studies have addressed this issue during
computer work (Birch et al. 2000a, b; Kallenberg and
Hermens 2006; Strøm et al. 2008; Szeto et al. 2005).
Experimental muscle pain normally reduces muscle
activity (Lund et al. 1991), but no changes in EMG ampli-
tude of the upper trapezius muscle have been reported dur-
ing computer work (Birch et al. 2000b). An explanation for
this lack of changes could be due to the fact that spatial
activity of the entire trapezius was not assessed.
Positive eVect of applying pause within the working time
has been addressed in several studies (Balci and Aghazadeh
2003; Galinsky et al. 2000; Henning et al. 1997; McLean
et al. 2001) while passive pauses are not found eVective for
preventing neck–shoulder pain (Brewer et al. 2006). How-
ever, passive pauses may also have protective eVect as the
muscle load is decreased during break even though a
decreased ability to relax has been reported among patients
with chronic neck–shoulder pain during computer work
(Falla et al. 2004; Szeto et al. 2005). This calls for studies
investigating the eVects of pause types in presence of mus-
cle pain during computer work.
Recently, potential beneWcial eVects of active pauses
are indicated in terms of increased muscle oxygenation
(Crenshaw et al. 2006) and more variable activation pattern
of the trapezius muscle during computer work (Samani
et al. 2009). Further, brief increase in the exerted force has
been shown to result in motor unit recruitment and dere-
cruitment in the trapezius muscle (Westad et al. 2003). This
may prevent overloading of type I muscle Wbres mainly
involved in low load work, e.g. computer work (Visser and
van Dieën 2006). However, only a few studies have investi-
gated active pauses compared with passive ones during
computer work (Crenshaw et al. 2006; Samani et al. 2009;
Sundelin and Hagberg 1989). Crenshaw et al. (2006)
recorded EMG of the forearm extensor carpi radialis muscle
and they deWned active pause as ten dynamic wrist exten-
sions against resistance. Henning et al. (1997) assessed the
eVect of stretching exercise during short breaks in terms of
productivity and well-being and reported some positive
eVect in small work sites. Sundelin and Hagberg (1989)
reported a slight improvement in discomfort ratings for
pauses with activity entailing gymnastic movements while
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Eur J Appl Physiol (2009) 106:857–866
sitting and/or for diverging pauses (i.e. subjects walking
away from the work area) as compared to a passive pause.
The large variety of active pauses’ types argues for stan-
dardization in terms of contraction type and level.
In this study, we assessed the acute eVects of experimen-
tal muscle pain on spatial electromyographic (EMG) activ-
ity of the trapezius muscle with active and passive pauses
during computer work. For this purpose, we recorded EMG
from the clavicular, descending, transverse and ascending
parts of trapezius during computer work in non-painful and
painful conditions with both passive (relax) and active
[30% maximum voluntary contraction (MVC) shoulder
elevation] pauses.
Methods and subjects
Subjects
Twelve subjects participated in the study [mean age 22 (SD
3) years, height 183 (SD 9) cm and body mass 77 (SD
9) kg]. All participants were healthy, right-handed male
volunteers experienced with computer use and no history of
chronic pain or diseases in the shoulder and neck region.
The subject population was the same as in the study of
Samani et al. (2009). The study was conducted in confor-
mity with the declaration of Helsinki, and experimental
procedures were approved by the local ethics committee
(N-20070004MCH).
Experimental procedures
Experimental protocol
Once the subjects had received instructions and SEMG
electrodes were placed (see below), the computer work-
place was individually adapted according to guidelines
(Kroemer et al. 2001). The recordings were sequentially
performed as follows: (1) Reference contraction: The sub-
jects were seated upright on a comfortable chair with their
palms towards the ground looking straight forward. In this
position, they were asked to perform one reference con-
traction consisting of bilateral arm abduction at 90° in the
frontal plane for 5 s. (2) MVC: Three maximum bilateral
isometric shoulder elevations were performed for 5 s
while upright seated with hand-held straps Wxed to the
legs of the chair. The subjects rested 2 min between trials.
Verbal encouragement was given and visual feedback of
exerted force was provided for the subjects on a monitor.
The force was measured using a piezoelectric force trans-
ducer (Kistler type 9311A, Bern, Switzerland), hooked to
the right strap and held in subject’s hand with a handle.
The maximum exerted force averaged over 250 ms
Eur J Appl Physiol (2009) 106:857–866
epochs, from the three MVCs, was used to set the relative
contraction level during the active pauses. (3) Resting
contraction: After 5 min rest, the resting level of SEMG
was calculated from 1 min of instructed rest with both
hands on the laps. The period of 5 s with lowest root mean
square (RMS) value during the instructed rest was qua-
dratically subtracted as deWned in the study of Blangsted
et al. (2004) from all other EMG signals. (4) Computer
work: Four sequences of 2 min computer mouse work
were performed in one day. Thirty seconds separated two
successive sequences. The standardized computer mouse
work is previously described in the study of Birch et al.
(2001). It consists of duplicating various graphs showing
six circular targets linked to each other by straight lines
including a start target (bold circle) displayed on the
upper right corner of a computer screen (pixel resolution:
0.3 mm, screen resolution: 1024 £ 768 pixels). Once the
two graphs were identical, a new graph appeared. The
time allowed for completing a graph was 8 s and after that
a new graph popped up. Productivity was calculated as
the number of completed graphs multiplied by the ratio of
correct clicks to the total number of clicks.
Two diVerent types of pause (randomized order) without
and then with muscle pain were used. Passive pauses con-
sisted of relaxation for approximately 8 s with palms of the
hands on the table with full arm support (passive), whereas
active pauses were deWned as isometric bilateral shoulder
elevation at 30% MVC in upright sitting position for
approximately 8 s and visual feedback of exerted force
was provided for the subjects on a multimeter (Fluke 37,
Tilburg, The Netherlands). Pauses were given every 40 s
(two pauses for each recording).
After completing the Wrst two non-painful sessions, one
0.5-ml bolus of hypertonic saline (5.8%) was injected into
the belly of the right upper trapezius muscle with a 27 G
¾ in. cannula over 15 s. The injection point was 2-cm lat-
eral to the halfway point between the spinous process of the
seventh cervical vertebra (C7) and the lateral edge of the
acromion. Saline mostly spreads along the muscle Wbre
direction and minimally in the transversal direction
(Graven-Nielsen et al. 1997), thus after the bolus injection
it was mostly concentrated along the C7-acromion line. The
pain intensity following intra-muscular injection of a bolus
of hypertonic saline lasts for approximately 5 min (Madeleine
et al. 1998, 1999). The two computer sequences with
muscle pain were performed right after the injection. Sub-
jects rated continuously their pain intensity in the shoulder
region with their left hand using an electronic visual
analogue scale (Aalborg University, Aalborg, Denmark)
during mouse work. The VAS was anchored with “0: no
pain” and “10: maximum imaginable pain”. Subjects were
regularly reminded (approximately every 10 s) to report
changes in pain intensity.
859
Data acquisition and processing
Data recordings
Pain level (see above), mouse click and SEMG signals
were recorded synchronously.
For mouse click recording, a force sensing resistor
device was (Toptronic, Echternach, Luxembourg) placed
on the mouse click button. The signal was used to deWne
the period of computer mouse work and pauses. A detec-
tion threshold (0.1 V) was applied to deWne the onset/oVset
of mouse click. Time >7 s without mouse click was consid-
ered as pause.
SEMG was collected from four parts of the right trape-
zius muscle. Bipolar surface electrodes (Ambu A/S, Neur-
oline 720 01-K/12, Ballerup, Denmark) were aligned with
an inter-electrodes distance of 2 cm on abraded ethanol-
cleaned skin along the direction of the muscle Wbres. Elec-
trodes were placed: (i) On the main superior muscle bulk
»20% lateral to the midpoint between the cervical spine
(C4) and posterior lateral third of the clavicle for the
uppermost (clavicular) part, (ii) »20% medial to the mid-
point between the acromion and the C7 vertebra for the
second upper (descending) part, (iii) »20% medial to
the midpoint between the medial border of the scapula and
the T3 vertebra for the uppermost lower (transverse) sub-
division and (iv) »33% medial to the midpoint between
the medial scapular and the T8 vertebra for the lowest
(ascending) subdivision (Holtermann et al. 2008). The ref-
erence electrode was placed on the C7 vertebra. The
SEMG signals were ampliWed 2,000 times and band-pass
Wltered (5–1000 Hz).
Pain level, mouse click and SEMG signals were
digitized at 3 kHz, with a 12-bit A/D converter (NiDaq
6024 E, National Instrument, Austin, TX, USA). SEMG
signals were digitally band-pass Wltered (Butterworth,
fourth-order, 10–1000 Hz). Furthermore, a notch Wlter
(fourth-order Butterworth band stop with rejection width
1 Hz centred at four-Wrst harmonics of the power line
frequency) was used when necessary to remove line inter-
ference.
Estimated measures
Short-term eVect RMS values were estimated over 0.5 s
epochs in three windows of equal length (8 s, i.e. duration
of the active and passive pauses), namely, before/during/
after pause. The averaged RMS values were selected to rep-
resent ‘before’, ‘during’ and ‘after’ (deWned as stages)
pause instances.
Global eVect The Wrst and last seconds of all sequences
were discarded to avoid possible transient eVect of the
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860 Eur J Appl Physiol (2009) 106:857–866

SEMG signals. The parts of signal recorded during active Results

and passive pauses were removed from signal. RMS val-
ues were estimated for 1 s non-overlapping epochs. RMS Productivity and pain intensity
values from three consecutive epochs centred at every
15 s were averaged. Thus, six values described the record- Productivity during computer work across both pause type
ing session. Each value is called a time window. Relative and pain status was not diVerent (P > 0.3).
resting time (RRT) and exposure variation analysis The mean and standard deviation of pain intensity during
(EVA) which have closed ties with EMG gap concept muscle pain was 4.9 § 1.5 and 0.2 § 0.1 during non-pain-
(Hägg 1991; Mathiassen and Winkel 1991) were exam- ful condition. No signiWcant diVerence (P = 0.6) was found
ined. RRT over 15 s non-overlapping epochs was com- in pain intensity among active and passive pause record-
puted as previously (Hermens and Vollenbroek-Hutten ings. Figure 1 shows levels of pain intensity § SE during
2004), with the exception of a heuristic threshold deWni- computer work with active and passive pauses.
tion. On the basis of the SEMG signals recorded during
the instructed rest, RRT was estimated using an arbitrary Absolute RMS values
level of 6
V (Hermens and Vollenbroek-Hutten 2004).
The threshold was adjusted with increase or decrease in Short-term eVect
5% step until RRT in the rest period was at least 99%
(EVA), representing joint density estimate of repetitive- For passive pause in the clavicular part, stage played a signiW-
ness and load was implemented (Mathiassen and Winkel cant role for RMS values (F2,22 = 7.0, P = 0.004). RMS values
1991). All samples of absolute RMS values were catego- were lower during passive pause compared with after taking
rized in time periods of (0–1.5), [1.5–4.5), [4.5–12), [12– the pause (Fig. 2). In all other parts of the trapezius, stage
25), [25–40) and [¸40) (s) and amplitude levels of [0–1), played a signiWcant role for RMS values (F2,22 = 9.16, P =
[1–3), [3–10), [10–23), [23–50), [50–103), [103–200) and 0.001; F2,22 = 9.37, P = 0.001 and F2,22 = 8.95, P = 0.001),
(>200%) of average RMS from the reference contraction respectively, for descending, transverse and ascending parts.
(Fjellman-Wiklund et al. 2004). This resulted in matrices RMS values during pause instance decreased compared with
in which each element represents percentage of time in a both before and after pause instances. In descending and
“period per amplitude category”. Thus, six levels along transverse parts pain played a signiWcant role for RMS values
the time axis and eight levels along the amplitude axis (F1,11 = 8.05, P = 0.016; F1,11 = 4.8, P = 0.049, respectively).
were generated. The centroid of the map in an 8 £ 6 plane RMS values increased during the painful condition. The inter-
was extracted, providing information about the general action of pain and stages played also a signiWcant role in
tendency towards a displacement of exposure into diVer- ascending part (F2,22 = 3.6, P = 0.04). The decrease in RMS
ent period length classes. values during pause instance in non-painful condition was not
signiWcant, whereas it was signiWcant during painful condi-
Statistical analysis To assess the short-term eVect of tion. Pain tended also to play a signiWcant role in this part
pause instances, pain (no pain and pain) and stages
(before, during and after), pause instances introduced as
within subject independent factors in a full-factorial
repeated measure analysis of variance for RMS values
before, during and after pause instances. To asses the glo-
bal eVects, pause types and pain status were introduced as
within subject factors in the same type of statistical analy-
sis for productivity, absolute RMS, RRT, EVA centroid
along both amplitude and time levels as dependent vari-
ables for each one of muscle parts. The within subject
independent factors were pause types (passive and active),
stages (before, during and after) and pain status (no pain
and pain).
If the assumption of sphericity was not met, a correc-
tion was applied (Greenhouse Geisser with epsilon value
below 0.75). In all tests, P < 0.05 was considered signiW-
cant. If a factor with more than two levels was deWned as
signiWcant, the corrected Bonferroni post hoc test was Fig. 1 Mean + SE pain intensity level during the time comparing
applied. passive versus active pauses during painful sessions

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Eur J Appl Physiol (2009) 106:857–866
Fig. 2 Mean § SE RMS (
V)
comparing the short term eVect
of pause type before, during and
after pause instances for the
clavicular (Clavc), descending
(Descend), transverse (Trvrs)
and ascending (Ascend) parts of
the trapezius muscle.
* 0.001 < P < 0.05 and
**P < 0.001
(F1,11 = 3.6, P = 0.08) and the RMS values tended to increase
during painful condition (Fig. 2). For active pause and for all
muscle parts, stages played a signiWcant role for RMS values
(F2,22 = 22.8, P < 0.001; F2,22 = 133.9, P < 0.001; F2,22 =
34.27, P < 0.001 and F2,22 = 19.23, P < 0.001), respectively,
for clavicular, descending, transverse and ascending parts.
RMS values during pause instance increased compared with
both before and after pause instances. Pain played a signiW-
cant role in clavicular, transverse and ascending parts for
RMS values (F1,11 = 10.76, P = 0.007; F1,11 = 8.8, P = 0.012
and F1,11 = 8.7, P = 0.013, respectively).The RMS values
decreased in clavicular part and increased in transverse and
ascending parts during painful condition (Fig. 2).
Global eVect
During the computer work in the clavicular and descending
parts of the trapezius, pause type played a signiWcant role for
861
the muscle activity (respectively, F1,11 = 6.9, P = 0.023 and
F1,11 = 6.9, P = 0.024). Higher absolute RMS values were
observed for active pauses compared with passive ones. Addi-
tionally, muscle pain tended to play a signiWcant role
(F1,11 = 4.7, P = 0.05) in the descending part. A tendency
towards higher absolute RMS values was observed in pain
compared with non-pain condition. Moreover, the presence of
muscle pain signiWcantly increased absolute RMS in both the
transverse and ascending parts of the trapezius (respectively,
F1,11 = 6.2, P = 0.03 and F1,11 = 5.7, P = 0.036; Fig. 3).
Relative resting time
During the computer work in the clavicular, descending
and transverse parts, muscle pain tended to play a signiW-
cant role (F1,11 = 4.4, P = 0.06; F1,11 = 4.3, P = 0.06 and
F1,11 = 4.7, P = 0.05). Tendencies towards lower RRT
values for these three muscle parts were observed in pain
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862
Fig. 3 Mean + SE absolute
RMS (
V) comparing the pause
eVect with/without experimental
muscle pain for the clavicular
(Clavc), descending (Descend),
transverse (Trvrs) and ascending
(Ascend) parts of the trapezius
muscle. *P < 0.05
compared with non-pain condition. In the ascending part,
muscle pain played a signiWcant role for RRT (F1,11 = 6.5,
P = 0.027). The RRT decreased in pain compared with
non-pain condition. The role of pause type tended to be
signiWcant in the transverse part (F1,11 = 3.8, P = 0.077).
A tendency towards higher RRT values was observed for
active compared with passive pauses. Figure 4 illustrates
the eVect of pain and pause type on RRT.
EVA along time levels
During the computer work in the clavicular, descending,
transverse and ascending parts, pause type played a
signiWcant role for the EVA centroid along the time levels
(respectively, F1,11 = 5.05, P = 0.046; F1,11 = 8.6, P = 0.014;
F1,11 = 7.3, P = 0.02 and F1,11 = 9.3, P = 0.01). Active
pauses contributed to shift the EVA centroid to lower
values.
In the transverse part, the interaction between pain and
pause types tended to be signiWcant (F1,11 = 4.7, P = 0.05).
Within the non-painful condition, pause type played a sig-
niWcant role (P = 0.003) to shift the centroid to lower val-
ues with active pauses, whereas this role was not signiWcant
for the painful condition.
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Eur J Appl Physiol (2009) 106:857–866
EVA along amplitude levels
During the computer work in the clavicular and descending
parts, pause type had signiWcant role on EVA along the
amplitude levels (F1,11 = 13.5, P = 0.004 and F1,11 = 9.4,
P = 0.011). Higher values of EVA centroid were found in
active compared with passive pauses. Additionally, muscle
pain played a signiWcant role for the descending and
ascending parts (respectively, F1,11 = 4.989, P = 0.047 and
F1,11 = 5.569, P = 0.038), shifting the EVA centroid
towards higher values. EVA centroid on time-amplitude
plane is depicted in Fig. 5.
Discussion
Acute muscle pain following hypertonic saline injection in
the descending part of the trapezius increased the activity of
the transverse and ascending parts of trapezius during com-
puter work and tended to decrease RRT in the whole trape-
zius. This highlights a reorganization of the trapezius
muscle activity during muscle pain and computer work.
Active pauses compared with passive ones contributed to
shift of EVA centroid along the time levels towards lower
Eur J Appl Physiol (2009) 106:857–866
Fig. 4 Mean § SE RRT (%)
comparing the pause type eVect
with/without experimental
muscle pain for the clavicular
(Clavc), descending (Descend),
transverse (Trvrs) and ascending
(Ascend) parts of the trapezius
muscle. *P < 0.05
values suggesting a more variable activity pattern of the
trapezius. However, the eVect of active pauses on muscle
activation pattern was less potent in presence of acute
muscle pain.
EVects of acute experimental pain on trapezius muscle
activity during computer work
Acute experimental pain was induced by intramuscular
injection of hypertonic saline bolus in the descending part
of the trapezius muscle. This painful condition of the
descending part of trapezius increased the EMG amplitude
of the transverse and ascending parts, while no signiWcant
changes were found for clavicular and descending parts.
Reorganizing role of pain in transverse and ascending part
to increase the EMG activity could also be observed in
short-term eVect of pause type.
SEMG activity is generally decreased around the injec-
tion site in presence of acute pain during both static and
dynamic contractions (Graven-Nielsen and Arendt-Nielsen
2008). However, at low contraction levels these changes
are not always found (Birch et al. 2000a; Madeleine and
Arendt-Nielsen 2005). More speciWcally during computer
work, a decrease in EMG amplitude due to acute pain has
been reported with low precision while no modulation of
EMG occurs with high precision demand (Birch et al.
2000b).
863
Increase in amplitude in transverse and ascending parts
of trapezius likely implied a functional reorganization of
muscle activity. Such functional reorganization of muscle
activity indicates an ability of the motor system to recruit
synergistic muscles, e.g. the lower trapezius assists in rota-
tion of the scapula mainly carried out by the upper trapezius
(Inman et al. 1996). The observed functional reorganization
of activity within the trapezius is in line with a previous
study investigating the eVects of acute pain during repeti-
tive movements (Falla et al. 2007). Falla et al. (2007)
reported similar EMG amplitude increase in ascending part
of trapezius with a decreased activity for the descending
part. For the upper trapezius muscle, short-term reorganiza-
tion during a sustained contraction has demonstrated spatial
changes in surface EMG activity caused by inhibitory
reXex mechanisms moving the muscular activity towards
the middle part of trapezius (Madeleine et al. 2006). How-
ever, this reorganization may be detrimental in case of
recurrent pain as it contributes to increase the load to other
parts of the same muscle and/or other muscles and could
explain the spreading of pain seen in clinical conditions
(Madeleine et al. 1998).
Further, the absence of expected decrease in SEMG
amplitude at the site of injection is probably not a favour-
able trait. Actually, this may point towards a lack of protec-
tive response in the painful region during computer work
(Lund et al. 1991). Moreover, acute pain was associated
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864 Eur J Appl Physiol (2009) 106:857–866

Fig. 5 Mean + SE EVA cen-

troid in time-amplitude levels
plane in time (horizontal seg-
ment) and amplitude (vertical
segment) comparing the eVects
of experimental muscle pain and
pause type (active, blue dia-
mond; and passive, red circle)
for the clavicular (Clavc),
descending (Descend), trans-
verse (Trvrs) and ascending
(Ascend) parts of the trapezius
muscle. *P < 0.05 along ampli-
tude domain and #P < 0.05
along time domain

with less RRT although mainly in the ascending part of the
trapezius. This corresponds to the observed inability to
relax the trapezius muscle during repetitive movements in
patients (Elert et al. 1992; Madeleine et al. 1999). Since it
is known that lack of muscle rest is a predictive factor for
developing WMSD (Veiersted et al. 1993), the present
lower ability to relax the muscle during acute pain would
increase the risk for WMSD.
Pause type
As expected, active pauses resulted in more variable muscle
activity pattern, i.e. shifting of EVA centroid along time
levels to lower values, of the trapezius during computer
work. In parallel, passive pauses resulted in a short-term
decrease in trapezius activity that may imply a positive
eVect of passive pause in terms of WMSD development
risk as the overall load on the trapezius muscle decreased.
We recently reported a similar eVect of active pauses
compared with passive ones in non-painful condition
(Samani et al. 2009). In this study, we found that the mus-
cular activity increased with active pauses during computer
work. This Wnding is in contradiction with our previous
Wndings where longer time intervals between successive
active pauses were applied (Samani et al. 2009). Therefore,
the observed increased muscle activity in this study may be
a result of muscle fatigue, caused by the relatively short-
time interval between the active pauses. Apparently this
Wnding does not support the potential advantage of active
compared with passive pause but further studies should aim

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Eur J Appl Physiol (2009) 106:857–866
at delineate positive and negative eVects in terms of muscle
fatigue development of active pauses and implemented
during computer work. In this context, deWning the proper
timing between active pauses and possible combination
between active/passive pauses will be of importance.
With acute pain, this possible beneWt of a more variable
activation pattern with active pauses during computer work
seemed to be less potent in the transverse part. This is illus-
trated by the closer centroids of EVA during active and pas-
sive pauses during acute pain condition (Fig. 4). In acute
painful condition, the muscle activation pattern is adjusted
by the central nervous system and complies with the inte-
gration of sensory information from group III and IV aVer-
ents. The nociceptive inXux presumably resulted in a more
restricted motor strategy (Madeleine et al. 2008). Thus,
with active pauses the activation pattern became less vari-
able during pain suggesting a decreased ability to modulate
muscle activity pattern in experimentally painful condition.
Methodological considerations
The type of mouse work in this laboratory study intended to
simulate main features of computer mouse work, e.g. repe-
titions of mouse click in a quasi-static posture. Thus, fac-
tors like work organization and work place physical factors
were not taken into consideration. Productivity was not sig-
niWcantly diVerent during acute muscle pain. Additionally,
the sample population is not representative for workers
suVering from WMSDs. However, for delineating the acute
eVect of experimental muscle pain, it was of importance to
study young healthy subjects without WMSD. A limitation
of the experimental pain induced by intramuscular bolus is
the short duration which restricts computer work to only
2-min sessions. Further, the present Wndings should be
interpreted carefully especially with respect to clinical con-
ditions as discrepancies between experimental and clinical
pain are reported (Arendt-Nielsen et al. 1996; Madeleine
et al. 1999). Moreover, no control session (isotonic injection)
was made as it has no eVect on EMG activity compared
with baseline recording (Birch et al. 2000b; Falla et al.
2007; Madeleine et al. 2006).
In conclusion, this study indicated a similar eVect of
active pauses towards a more variable activation pattern of
the experimental painful trapezius during computer work as
previously shown in a non-painful condition (Samani et al.
2009). Further, we showed for the Wrst time during com-
puter work a functional reorganization of the trapezius
muscle activity in presence of acute experimental muscle
pain. In experimental painful condition, the amplitude of
SEMG increased for the ascending and transverse parts,
whereas the RRT tended to decrease in the entire trapezius.
Further studies are required to reveal the dependence of
physiological responses of the timing of repetitive pauses,
865
and investigate potential beneWcial eVect on muscle pain
of active pauses in preventive and rehabilitation settings
of computer workers with diVerent degrees of WMSD
disorders.
Acknowledgments The authors are grateful to Hongling Nie for his
help during data collecting. This study was Wnancially supported by
Det Obelske Familiefond and the Danish Agency for Science, Tech-
nology and Innovation.
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