Muscle strength, rate of torque development and neuromuscular activation of the upper arm muscles in children and adolescents with spina bifida

Background: The use of locomotive devices requires sufficient levels of upper limb strength. Therefore, it is important to evaluate the maximal isometric torque, rate of torque development and neuromuscular activation in youth with spina bifida. The objective was to investigate these parameters in the elbow muscles of youth with spina bifida versus healthy age-matched peers. Methods: Forty-eight participants (8-17 years) were recruited: Spina Bifida (n = 23) and non-affected Controls (n = 25). Maximal isometric elbow flexor/extensor contractions were performed to assess maximal muscle strength (peak torque) and rate of torque development, along with synchronized electromyography recording in the biceps and triceps brachii muscles. Findings: During elbow flexor contractions, Spina Bifida showed reduced rate of torque development in the early contraction phase (0-50 ms) along with lowered relative rate of torque development in the later rate of torque development phase (0-100/200/300 ms) compared to controls. Spina Bifida showed reduced rate of torque development for the elbow extensors in the later phase of rising muscle force (0-200/300 ms) compared to controls. Lower isometric peak torque and smaller triceps brachii electromyography amplitudes (0-200/300 ms) were observed during elbow extensor contractions in Ambulatory spina bifida participants vs. controls. Interpretation: Although a majority of peak torque and rate of torque development parameters did not differ, significant impairments in maximal and rapid elbow muscle force characteristics were noted in Spina Bifida compared to non-affected Controls. Ambulatory and Non-ambulatory spina bifida participants demonstrated similar rate of torque development in their upper arm muscles.