title: Issues in relation to the repeatability of and correlation between EMG and Borg scale assessments of neck muscle fatigue.
abstract: BACKGROUND
  The repeatability of subjective and objective assessments of neck muscle fatigue is very important with regard to the clinical applicability of these methods.
  
  
  METHODS
  To establish between-days reliability, 33 healthy volunteers performed a 60% maximum voluntary isometric contraction test from a standing position in all neck movements. Cervical muscle fatigue was assessed on three separate occasions from the spectral (median frequency, MF) and amplitude (root mean square, RMS) analysis of the electromyogram (EMG) signal recorded from the cervical paraspinal group, splenius capitis, levator scapulae and sternocleidomastoid. Subjective assessment of fatigue was rated by employing the Borg scale. Intraclass correlation coefficient ICC((1,1)), standard error of measurement (SEM), smallest detectable difference (SDD) indices and Pearson's correlation co-efficient were calculated for the analysis of the results.
  
  
  RESULTS
  Normalised median frequency (MF) slope had low repeatability and large between-day error (ICC((1,1))=0.28-0.61; SEM=0.33-0.60%/s; SDD=132.7-703.2%) for the protagonist muscles of each movement. Initial median frequency (IMF) had moderate to good reliability and small error (ICC((1,1))=0.64-0.81; SEM=2.8-8.8Hz; SDD=19.9-38.5%). The RMS slope yielded also poor repeatability. The Borg assessment was more reliable than the EMG estimate though variability between sessions was still quite high (SDD=29.2-136.5%). No correlation was found between the EMG and Borg assessment of neck muscle fatigue (r=-0.01-0.39).
  
  
  CONCLUSIONS
  The protocol used for assessing neck muscle fatigue proved to be reliable only for the IMF but the clinical usefulness of this measure remains questionable. The lack of correlation between objective and subjective estimation of neck muscle fatigue was possibly a consequence of the poor measurement repeatability. Further research is needed to identify the factors responsible for these results on neck area.
authors.affiliation: Centre for Rehabilitation Science, Central Manchester and Manchester Children's Hospital's NHS Trust, University of Manchester, Oxford Road, Manchester M13 9WL, UK. nikstrimp@yahoo.com
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Strimpakos
authors.forename: Gioftsos
authors.initials: G
authors.lastname: Georgios
authors.forename: Kapreli
authors.initials: K
authors.lastname: Eleni
authors.forename: Kalapotharakos
authors.initials: K
authors.lastname: Vasilios
authors.forename: Oldham
authors.initials: O
authors.lastname: Jacqueline
mesh_terms: D000328:Adult; D000465:Algorithms; D003627:Data Interpretation, Statistical; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology*; D009334:Neck Muscles / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology*; D005082:Physical Exertion / Q000502:physiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic