Krvavi Prdez

Mechanisms that influence accuracy of the soccer
kick
Author links open overlay panelAthanasiosKatisa
EmmanouilGiannadakisaTheodorosKannasaIoannisAmiridisaEleftheriosKellisaAdrianLeesb
https://doi.org/10.1016/j.jelekin.2012.08.020Get rights and content
Abstract
Goal scoring represents the ultimate purpose of soccer and this is achieved when players perform accurate
kicks. The purpose of the present study was to compare accurate and inaccurate soccer kicks aiming to top
and bottom targets. Twenty-one soccer players performed consecutive kicks against top and bottom targets
(0.5 m2) placed in the center of the goal. The kicking trials were categorized as accurate or inaccurate. The
activation of tibialis anterior (TA), rectus femoris (RF), biceps femoris (BF) and gastrocnemius muscle
(GAS) of the swinging leg and the ground reaction forces (GRFs) of the support leg were analyzed. The
GRFs did not differ between kicking conditions (P > 0.05). There was significantly higher TA and BF and
lower GAS EMG activity during accurate kicks to the top target (P < 0.05) compared with inaccurate kicks.
Furthermore, there was a significantly lower TA and RF activation during accurate kicks against the bottom
target (P < 0.05) compared with inaccurate kicks. Enhancing muscle activation of the TA and BF and
reducing GAS activation may assist players to kick accurately against top targets. In contrast, players who
display higher TA and RF activation may be less accurate against a bottom target. It was concluded that
muscle activation of the kicking leg represents a significant mechanism which largely contributes to soccer
kick accuracy.
Electromyography of selected lower-limb muscles

fatigued by exercise at the intensity of soccer
match-play☆
Author links open overlay panelNaderRahnamaab
AdrianLeesaThomasReillya
Abstract
Surface electromyography has been useful in comparing muscular activity among different sports
movements and it is a valuable technique for evaluating muscle activation, co-ordination and fatigue. Since
these important variables have not been investigated during the full game in soccer, the present study aimed
to investigate the activity of major muscles of the lower extremity during a soccer-simulation fatiguing
protocol. Ten amateur soccer players (age 21.40 ± 3.13 years; height 1.77 ± 0.06 m; mass 74.55 ± 8.5 kg)
were tested. The exercise protocol, performed on a programmable motorised treadmill, consisted of the
different intensities observed during soccer match-play (walking, jogging, running, sprinting).
Electromyographic activity was recorded from the rectus femoris (RF), biceps femoris (BF), tibialis anterior
(TA) and gastrocnemius (GC) muscles before exercise, at half-time and immediately after the 90-min
exercise protocol. The EMG data were analysed using custom-written software to compute the root mean
square (RMS) value over ten gait cycles. With regard to RF, BF and TA, a significant main effect (P < 0.05)
was found for condition (pre-game, half-time and post-game), speed (6, 12, 15 and 21 km h−1) (P < 0.05)
and interaction between condition and speed (P < 0.05). For GC, a significant effect was not found for
condition or interaction between condition and speed, but a significant main effect (P < 0.001) was found for
speed, with the RMS value increasing continually with increasing speed from 6 to 21 km h−1. The results
indicated that after a simulation of the exercise intensity of soccer-play the EMG activity in major lower-
limb muscles was less than before. This decrease indicated that prolonged intermittent exercise had an effect
on muscle activity even when work-rate was sustained.
Tensiomyography of selected lower-limb muscles

in professional soccer players
Author links open overlay panelEzequielRey
CarlosLago-PeñasJoaquínLago-Ballesteros
Abstract
Tensiomyography is a non-invasive method of neuromuscular assessment used to measure muscle action
characteristics, muscle tone, and muscle fiber type, and provides information on acute and chronic responses
of muscle to different training loads. The aims of the present study were: to analyse differences in muscle
response and mechanical characteristics of two major muscles of the lower extremity in a large group of
Spanish soccer players according to playing position, and to provide group norms against which clinical
findings may be compared. Data were collected from 78 professional soccer players (age 26.6 ± 4.4 years;
height: 179.2 ± 5.3 cm; body mass: 75.8 ± 5.3 kg). Tensiomyography was recorded from the rectus femoris
(RF) and biceps femoris (BF) muscles after 2 days without take part in any strenuous exercise or training.
Five tensiomyographic parameters were analyzed: maximal displacement (Dm), contraction time (Tc), sustain
time (Ts), delay time (Td), and half-relaxation time (Tr). A good to excellent intra-session reliability was
found for all contractile parameters (ICC ranged from 0.78 to 0.95). No significant differences between
players of any position were observed in absolute values of BF. However, significant differences were
observed for Tc, Tr and Ts between the different playing positions on RF (P < 0.05, effect size ranged from
1.3 to 1.6). Professional soccer players showed muscles with ability to rapidly generate force during
contractions. The neuromuscular profile provided could help in identifying the normative data that are
important for the different positions in order to optimize the training and recovery process of each individual
player.
Can ankle imbalance be a risk factor for tensor

fascia lata muscle weakness?
Author links open overlay panelMaria L.ZampagniadI.Corazzab
A. PaladiniMolgoracM.Marcaccia
Abstract
Risk factors that can determine knee and ankle injuries have been investigated and causes are probably
multifactorial. A possible explanation could be related by the temporary inhibition of muscular control
following an alteration of proprioceptive regulation due to the ankle imbalance pathology. The purpose of
our study was to validate a new experimental set up to quantify two kinesiologic procedures (Shock
Absorber Test (SAT) and Kendall and Kendall‘s Procedure (KKP)) to verify if a subtalus stimulus in an
ankle with imbalance can induce a non-appropriate response of controlateral tensor fascia lata muscle (TFL).
Fifteen male soccer players with ankle imbalance (AIG) and 14 healthy (CG) were tested after (TEST)
before (NO-TEST) a manual percussion in subtalus joint (SAT). A new tailor-made device equipped with a
load cell was used to quantify TFL‘s strength activation in standardized positions. Two trials for each
subject were performed, separated by at least one 4-min resting interval. In NO-TEST conditions both AIG
and CG showed a progressive adaptation of the subject to the force imposed by operator. No reduction in
mean force, mean peak force, and muscle force duration (p > 0.5). AIG presented significant differences
(mean difference 0.92 ± 0.46 s; p = 0.000) in muscle force duration in TEST conditions. Our results
indicated that “wrong” proprioceptive stimuli coming from the subtalus joint in AIG might induce inhibition
in terms of duration of TFL muscle altering the knee stability. This kinesiological evaluation might be useful
to prevent ankle and knee injuries.
The role of neuromuscular inhibition in hamstring

strain injury recurrence
Author links open overlay panelJackson J.FyfeadDavid A.OparabMorgan D.WilliamscAnthony J.Shielde
Abstract
Hamstring strain injuries are amongst the most common and problematic injuries in a wide range of sports
that involve high speed running. The comparatively high rate of hamstring injury recurrence is arguably the
most concerning aspect of these injuries. A number of modifiable and nonmodifiable risk factors are
proposed to predispose athletes to hamstring strains. Potentially, the persistence of risk factors and the
development of maladaptations following injury may explain injury recurrence. Here, the role of
neuromuscular inhibition following injury is discussed as a potential mechanism for several maladaptations
associated with hamstring re-injury. These maladaptations include eccentric hamstring weakness, selective
hamstring atrophy and shifts in the knee flexor torque-joint angle relationship. Current evidence indicates
that athletes return to competition after hamstring injury having developed maladaptations that predispose
them to further injury. When rehabilitating athletes to return to competition following hamstring strain
injury, the role of neuromuscular inhibition in re-injury should be considered.
Kinematic and electromyographic analysis of the

Nordic Hamstring Exercise
Author links open overlay panelMassimilianoDitroiloa
GiuseppeDe VitobcEamonnDelahuntbc
Abstract
The Nordic Hamstring Exercise (NHE) has been introduced as a training tool to improve the efficiency of
eccentric hamstring muscle contraction. The aim of this study was to perform a biomechanical analysis of
the NHE. Eighteen participants (20.4 ± 1.9 years) performed two sets of five repetitions each of the NHE
and maximal eccentric voluntary contraction (MEVC) of the knee flexors on an isokinetic dynamometer
whilst knee angular displacement and electrical activity (EMG) of biceps femoris were measured. EMG was
on average higher during the NHE (134.3% of the MEVC). During the forward fall of the NHE, the angle at
which a sharp increase in downward velocity occurred varied between 47.9 and 80.5 deg, while the peak
knee angular velocity (pVelocity) varied between 47.7 and 132.8 deg s−1. A significant negative correlation
was found between pVelocity and peak EMG (r = −0.62, p < 0.01) and EMG at 45 deg (r = −0.75, p < 0.01)
expressed as a percentage of peak MEVC EMG. Some of the variables analyzed exhibited good to excellent
levels of intra- and inter-session reliability. This type of analysis could be used to indirectly monitor the
level of eccentric strength of the hamstring muscles while performing the NHE and potentially any training-
or injury-related changes.
Heavy-intensity aerobic exercise affects the

isokinetic torque and functional but not
conventional hamstrings:quadriceps ratios
Author links open overlay panelAnderson de Souza CasteloOliveirabFabrizioCaputoaMauroGonçalvesbBenedito SérgioDenadaia
Abstract
Running exercises are frequently related to muscular injuries, which may be a result of muscular imbalance.
The present study aimed to verify the effects of heavy-intensity continuous running exercise on the
functional and conventional hamstrings:quadriceps ratios, and also in the knee flexors and extensors EMG
activity in active non-athletic individuals. Sixteen active males performed maximal isokinetic concentric and
eccentric knee flexions and extensions at 60° s−1 and 180° s−1. In another session, the same procedure was
conducted after a continuous running exercise at 95% onset of blood lactate accumulation. Torque and
electromyographic ratios were calculated from peak torque and integrated electromyographic activity (knee
flexor and extensors). Creatine kinase was measured before and 24 h after running exercise. Eccentric torque
(knee flexion and extension) decreased significantly after running only at 180° s−1 (p < 0.05). No differences
were found for the conventional torque ratios (p > 0.05), however, the functional torque ratios at 180° s−1
decreased significantly after running (p < 0.05). No effects on the electromyographic activity and
electromyographic ratios were found (p > 0.05). Creatine kinase increased slightly 24 h after running
(p < 0.05). Heavy-intensity continuous running exercise decreased knee flexor and extensor eccentric torque,
and functional torque ratios under fast velocities (180° s−1), probably as result of peripheral fatigue.
Forearm electromyographic activity during the

deadlift exercise is affected by grip type and sex
Author links open overlay panelJeddPrattaAriannaHoffmanaAdamGraingerabMassimilianoDitroiloa
https://doi.org/10.1016/j.jelekin.2020.102428Get rights and content
Under a Creative Commons license
open access
Abstract
Muscle activation, peak velocity (PV) and perceived technical difficulty while using three grip variations
and three loads during a deadlift exercise (DL) were examined. Twenty-nine resistance-trained athletes (15
males, age: 22.2 ± 2.7 years; 14 females, age: 24.8 ± 7.0 years) performed the DL with 50%, 70% and 90%
of their one repetition maximum (1RM) using hook grip (HG), mixed grip (MG) and double overhand
(DOH) grip. Surface electromyography (EMG) of the brachialis (BS), brachioradialis (BR) and flexor carpi
ulnaris (FCU) was recorded. PV and perceived technical difficulty of each grip were also measured.
Regardless of load and grip, females exhibited greater BS activation compared to males (p < 0.05;
ES = 0.69) while males displayed greater BR activation, significant at 90% load (p < 0.01; ES = 1.01). MG
elicited the least BR and FCU activation regardless of load and sex (p < 0.01; ES = 0.64–0.68) and was
consistently ranked as the easiest grip for any load. Males achieved significantly greater PV than females at
50% and 70% (p < 0.01; ES = 1.72–1.92). Hand orientation did not significantly impact PV. A MG may be
beneficial in reducing the overall perceived technical difficulty when performing a maximal DL. Athletes
aiming to maximise muscle activation and potentially develop their grip strength should utilise a DOH grip
or HG.
Sex differences in the kinematics and

neuromuscular control of landing: Biological,
environmental and sociocultural factors
Author links open overlay panelMichaela R.BrutonaNicholasO’Dwyerab
RogerAdamsc
Abstract
Potential sex differences in patterns of movement of recreational and competitive athletes were investigated
in a systematic review of lower limb kinematics, muscle activation and stiffness during landing and hopping
tasks. Little support for sex-specific lower limb kinematic patterns was found in 17 studies retrieved on
landing and hopping. Ten studies retrieved on muscle activation during landing provided no support for sex-
specific patterns. Four articles retrieved on leg stiffness established that absolute stiffness was lower in
females, but differences in stiffness normalized to body mass were less clear. The wider literature indicates
that a combination of biological, environmental and sociocultural constraints may shape movement patterns
differently in females and males. Sociocultural factors differentially affect accumulated motor experience,
practice opportunities and focus of attention in females, leading to differences in motor skill that confound
the comparison of female and male movements. The findings of the review support the hypothesis that such
sex differences in athletic performance are likely to diminish or disappear with increasing skill. In everyday
movement tasks, however, where level of skill is a less meaningful dimension than in sport, differences in
movement patterns observed between females and males point instead to the influence of subtle societal
expectations on movement patterns.
Characteristics of human knee muscle

coordination during isometric contractions in a
standing posture: The effect of limb task
Author links open overlay panelToran D.MacLeodKurtManalKarin GrävareSilbernagelLynnSnyder-
MacklerThomas S.Buchanan
Abstract
Different functional roles for the hands have been demonstrated, however leg control is not as well
understood. The purpose of the present study was to evaluate bilateral knee neuromuscular control to
determine if the limb receiving greater attention would have more well-tuned control compared to an
unattended limb. Surface electrodes were placed on seven muscles of each limb, before standing on two
force platforms. Visual feedback was given of the forces and moments of the “focus limb,” but not the
“unattended limb.” Static isometric forces were matched with their focus limb, requiring their unattended
limb to push in the opposite direction, using a combination of forward–backward–medial–lateral shear
forces while muscle activity was collected bilaterally. There was a significant main effect for limb task
(p = 0.02), with the medial hamstrings being more specific (p = 0.001) while performing the unattended
limb and the lateral hamstring being more well-tuned (p = 0.007) while performing the focus limb task. The
focus limb’s medial and lateral gastrocnemius were principally active in the forwards direction, but only the
unattended limb’s lateral gastrocnemius was active in the backwards direction. Findings suggest unique
neuromuscular control strategies are used for the legs depending on limb task.
Effects of fatigue and gender on peroneal reflexes

elicited by sudden ankle inversion
Author links open overlay panelErin L.WilsonaMichael L.Madiganab
Abstract
The purpose of this study was to investigate the effects of neuromuscular fatigue and gender on peroneus
brevis muscle (PB) and peroneus longus muscle (PL) reflexes elicited by sudden ankle inversion. Sixteen
males and fifteen females stood on a “trap-door” platform that suddenly inverted the ankle 20° when
released. The resulting movement elicited peroneal reflexes. Reflex measurements were collected both
before and after fatiguing the ankle evertors. Reflex delay in the PB and PL was not affected by fatigue,
gender, or their interaction. Reflex amplitude in the PL exhibited no main effect of fatigue or gender, but
their interaction was significant. Pairwise comparisons revealed PL reflex amplitude decreased by 11.3% in
males (p = 0.008) and increased 22.1% in females (p = 0.003) with fatigue. A similar trend was found in the
PB, but was not statistically significant. This opposite effect in females and males may be due to differences
in how males and females compensate for fatigue, and may be related to the gender difference in ankle
injury rate.
Hip and knee joint kinematics during a diagonal

jump landing in anterior cruciate ligament
reconstructed females
Author links open overlay panelEamonnDelahuntab
AnnaPrendivilleaLaurenSweeneyaMarkChawkeaJudyKelleheraMattPattersonaKatieMurphya
Abstract
Anterior cruciate ligament (ACL) injury is a common injury encountered by sport medicine clinicians.
Surgical reconstruction is the recommended treatment of choice for those athletes wishing to return to full-
contact sports participation and for sports requiring multi-directional movement patterns. The aim of ACL
reconstruction is to restore knee joint mechanical stability such that the athlete can return to sporting
participation. However, knowledge regarding the extent to which lower limb kinematic profiles are restored
following ACL reconstruction is limited. In the present study the hip and knee joint kinematic profiles of 13
ACL reconstructed (ACL-R) and 16 non-injured control subjects were investigated during the performance
of a diagonal jump landing task. The ACL-R group exhibited significantly less peak knee joint flexion
(P = 0.01). Significant between group differences were noted for time averaged hip joint sagittal plane
(P < 0.05) and transverse plane (P < 0.05) kinematic profiles, as well as knee joint frontal plane (P < 0.05)
and sagittal plane (P < 0.05) kinematic profiles. These results suggest that aberrant hip and knee joint
kinematic profiles are present following ACL reconstruction, which could influence future injury risk.
Antagonist co-activation during short and medium

latency responses in subjects with chronic ankle
instability
Author links open overlay panelAndreia S.P.Sousa
Abstract
Purpose
This study aims to evaluate bilateral ankle antagonist co-activation during compensatory postural responses,
including short latency responses (SLR) and medium latency responses (MLR), in response to a unilateral
sudden ankle inversion in subjects with chronic ankle instability (CAI).
Methods
Twenty-four participants with CAI and 20 controls participated in the present study. Bilateral
eletromyography of peroneus longus (PL), peroneus brevis (PB), tibialis anterior (TA) and soleus (SOL)
muscles was collected during a unilateral sudden inversion perturbation (30°) to assess antagonist co-
activation of SOL/TA and TA/P pairs during SLR and MLR in both support and perturbed positions.
Results
Compared to control group, participants with CAI presented: (1) bilateral increased antagonist co-activation
of SOL/TA MLR in the support position; and (2) decreased antagonist co-activation of TA/P MLR of
uninjured limb in the support position and of injured limb in the perturbed position.
Conclusions
CAI involves deregulation of ankle antagonist co-activation of MLR in both injured and uninjured limbs.
Assessment of neuromuscular response
characteristics at the knee following a functional
perturbation
Author links open overlay panelSandra JShultz
David HPerrinJ.MiltonAdamsBrent LArnoldBruce MGansnederKevin PGranata
https://doi.org/10.1016/S1050-6411(00)00002-XGet rights and content
Abstract
Previous research indicates that both the extent and timing of muscular activation at the knee can be
influenced by muscle activity state, joint angle, weight-bearing status and trunk position. However, little
research to date has evaluated protective neuromuscular response times and activation patterns to an
imposed perturbation with the knee joint in a functional, weight-bearing stance. Hence, we designed a lower
extremity perturbation device to produce a sudden, forward and either internal or external rotation moment
of the trunk and femur relative to the weight-bearing tibia. Surface electromyography (EMG) recorded long
latency reflex times of the medial and lateral quadriceps, hamstring and gastrocnemius muscles in 64
intercollegiate lacrosse and soccer players in response to both internal and external rotation perturbation. We
found the gastrocnemius fired significantly faster that the hamstring, which in turn fired significantly faster
than the quadriceps. There was also a significant difference in activation times of the medial and lateral
hamstring not found for the quadriceps or gastrocnemius muscles. Our findings confirmed that reactive
neuromuscular responses following this functional perturbation differ markedly from those previously
reported using seated, partial weight-bearing and/or uni-planar models under relaxed conditions.
Development of dynamic knee stability after acute

ACL injury☆
Author links open overlay panelTerese L.ChmielewskiKatherine S.RudolphLynnSnyder-Mackler
https://doi.org/10.1016/S1050-6411(02)00013-5Get rights and content
Abstract
Recently, a training program that includes perturbation of support surfaces has been shown to allow most
active individuals with ACL injury who pass a screening examination to successfully return to high level
activities. The purpose of this study was to identify the effect of this rehabilitation program on involved side
muscle activation during walking in subjects with acute ACL rupture and to determine if the activation
changes were coincident with improved function. Nine subjects with an acute, unilateral ACL injury or
rupture of an ACL graft, who met the screening examination criteria, received ten sessions of rehabilitation
that included perturbation training. Motion analysis of five self-paced walking trials were performed before
and after training. Electromyographic (EMG) data were collected during stance. After training during
walking, the vastus lateralis (VL) integral of activity increased, and relationships between muscles were
significantly altered. During walking, VL activation variables were dependent on lateral hamstrings (LH)
and/or the soleus (SOL) activation, while no relationships were found before training. Function improved
after training, and all subjects returned to their pre-injury activities without experiencing instability. The
relationships formed between muscles post-training suggests that perturbation training enhances dynamic
knee stability by inducing a well-coordinated strategy among muscles that affect tibial translation
Knee flexor strength and bicep femoris
electromyographical activity is lower in previously
strained hamstrings
Author links open overlay panelDavid A.Opara
Morgan D.WilliamsbRyan G.TimminsaNuala M.DearaAnthony J.Shielda
Abstract
The aim of this study was to determine if athletes with a history of hamstring strain injury display lower
levels of surface EMG (sEMG) activity and median power frequency in the previously injured hamstring
muscle during maximal voluntary contractions. Recreational athletes were recruited, 13 with a history of
unilateral hamstring strain injury and 15 without prior injury. All athletes undertook isokinetic dynamometry
testing of the knee flexors and sEMG assessment of the biceps femoris long head (BF) and medial
hamstrings (MHs) during concentric and eccentric contractions at ±180 and ±60° s−1. The knee flexors on
the previously injured limb were weaker at all contraction speeds compared to the uninjured limb (+180° s−1
p = 0.0036; +60° s−1 p = 0.0013; −60° s−1 p = 0.0007; −180° s−1 p = 0.0007) whilst sEMG activity was only
lower in the BF during eccentric contractions (−60° s−1 p = 0.0025; −180° s−1 p = 0.0003). There were no
between limb differences in MH sEMG activity or median power frequency from either BF or MH in the
injured group. The uninjured group showed no between limb differences in any of the tested variables.
Secondary analysis comparing the between limb difference in the injured and the uninjured groups,
confirmed that previously injured hamstrings were mostly weaker (+180° s−1 p = 0.2208; +60° s−1
p = 0.0379; −60° −1 p = 0.0312; −180° s−1 p = 0.0110) and that deficits in sEMG were confined to the BF
during eccentric contractions (−60° s−1 p = 0.0542; −180° s−1 p = 0.0473). Previously injured hamstrings
were weaker and BF sEMG activity was lower than the contralateral uninjured hamstring. This has
implications for hamstring strain injury prevention and rehabilitation which should consider altered neural
function following hamstring strain injury.
Quadriceps and hamstrings prelanding

myoelectric activity during landing from different
heights among male and female athletes
Author links open overlay panelMorgana Alvesde BrittoaFelipe P.CarpesaGeorgiosKoutrasbEvangelosPappascd
Abstract
ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the athlete
away from training and competition, ACL tear is a risk factor for early-onset of knee osteoarthritis, and,
therefore addressing strategies to avoid such injury is pertinent not only for competitive athletes, but for all
physically active subjects. Imbalances in the prelanding myoelectric activity of the hamstrings and
quadriceps muscles have been linked to ACL injuries. We investigated the effect of landing from different
heights on prelanding myoelectric activity of the hamstrings and quadriceps muscles in recreational athletes.
Thirty recreational athletes (15 male and 15 female) performed three bilateral drop jumps from two different
heights; 20 cm and 40 cm while myoelectric activity of the vastus medialis, rectus femoris, biceps femoris
and medial hamstrings were collected. When increasing the height of drop landing tasks prelanding
normalized myoelectric activity of the quadriceps was increased by 15–20% but no significant changes were
found for the hamstrings. Female athletes exhibited higher activity of the medial hamstrings compared to
their male counterparts. We concluded that increasing the height of drop landing tasks is associated with
increased myoelectric activity of the quadriceps but not the hamstrings in recreational athletes. These
differences in muscle activity may be related to increased risk for ACL injury when the height is increased.
Female athletes demonstrated higher recruitment of the medial hamstrings.
Single leg jumping neuromuscular control is

improved following whole body, long-axis
rotational training
Author links open overlay panelJohnNyland
RobertBurdenRyanKruppDavid N.M.Caborn
Abstract
Improved lower extremity neuromuscular control during sports may decrease injury risk. This prospective
study evaluated progressive resistance, whole body, long-axis rotational training on the Ground Force 360
device. Our hypothesis was that device training would improve lower extremity neuromuscular control
based on previous reports of kinematic, ground reaction force (GRF) or electromyographic (EMG) evidence
of safer or more efficient dynamic knee stability during jumping. Thirty-six healthy subjects were randomly
assigned to either training (Group 1) or control (Group 2) groups. Using a pre-test, post-test study design
data were collected from three SLVJ trials. Unpaired t-tests with adjustments for multiple comparisons were
used to evaluate group mean change differences (P ⩽ 0.05/25 ⩽ 0.002). During propulsion Group 1
standardized EMG amplitude mean change differences for gluteus maximus (−21.8% vs. +17.4%), gluteus
medius (−28.6% vs. +15.0%), rectus femoris (−27.1% vs. +11.2%), vastus medialis (−20.2% vs. +9.1%),
and medial hamstrings (−38.3% vs. +30.3%) differed from Group 2. During landing Group 1 standardized
EMG amplitude mean change differences for gluteus maximus (−32.9% vs. +11.1%) and rectus femoris
(−33.3% vs. +29.0%) also differed from Group 2. Group 1 peak propulsion vertical GRF (+0.24 N/kg vs.
−0.46 N/kg) and landing GRF stabilization timing (−0.68 vs. +0.05 s) mean change differences differed
from Group 2. Group 1 mean hip (−16.3 vs. +7.8°/s) and knee (−21.4 vs. +18.5°/s) flexion velocity mean
change differences also differed from Group 2. Improved lower extremity neuromuscular efficiency,
increased peak propulsive vertical GRF, decreased mean hip and knee flexion velocities during landing, and
earlier landing stabilization timing in the training group suggests improved lower extremity neuromuscular
control.
Contraction intensity and sex differences in knee-

extensor fatigability
Author links open overlay panelPaulAnsdellaKevinThomasaGlynHowatsonabSandraHuntercStuartGoodalla
Abstract
Females are less fatigable than males during isometric contractions across various muscles and intensities.
However, sex differences in knee-extensor fatigability remain relatively unexplored. Purpose: To determine
the sex difference in performance fatigability for intermittent, isometric contractions of the knee-extensor
muscles. Methods: Eighteen participants (10 males, 8 females) performed intermittent, isometric, knee-
extensor contractions at 30% of their maximal voluntary force (MVC) for 30 min and in a separate session at
50% MVC until task-failure. During both fatiguing protocols a MVC was performed every 60 s and
electromyography (EMG) was recorded during all contractions. Results: At task completion males had a
larger reduction in MVC force for the 30% MVC task (−32 ± 15% vs. −15 ± 16%, P = 0.042) and the 50%
MVC task (−34 ± 8% vs. −24 ± 1%, P = 0.045). Furthermore, for the 50% MVC task, females had a longer
task duration (937 ± 525 s vs. 397 ± 153 s, P = 0.007). The rise in EMG activity and force fluctuations were
more rapid for the males than females (P < 0.05). When participants were matched for strength post hoc
(n = 10), a sex difference in fatigability for both tasks was still evident. Conclusions: Females were less
fatigable than males during intermittent, isometric, knee-extensor contractions at moderate relative forces
and this difference was independent of strength.
Timing of neuromuscular activation of the

quadriceps and hamstrings prior to landing in
high school male athletes, female athletes, and
female non-athletes
Author links open overlay panelJennifer M.Medinaa
Tamara C.Valovich McLeodbSuzanne K.HowellcJackie J.Kingmab
Abstract
There is a discrepancy between males and females in regards to lower extremity injury rates, particularly at
the knee [Agel, J., Arendt, E.A., Bershadsky, B., 2005. Anterior cruciate ligament injury in National
Collegiate Athletic Association basketball and soccer: a 13-year review. American Journal of Sports
Medicine 33, (4) 524–530]. Gender differences in neuromuscular recruitment characteristics of the muscles
that stabilize the knee are often implicated as a factor in this discrepancy. There is considerable research in
the area of gender differences in regards to neuromuscular characteristics of the lower extremity in response
to perturbation; however, most studies have been performed on the adult population only. Additionally,
there is no consensus as to the gender differences that have been demonstrated. The purpose of this study
was to compare muscular preactivation of selected lower extremity muscles (vastus medialis, rectus femoris,
and medial/lateral hamstrings) in adolescent female basketball athletes, male basketball athletes, and female
non-athletes in response to a drop landing. Subjects in the female non-athlete group recruited rectus femoris
significantly slower than both the female athlete and male athlete groups (619.9 = 588.5 > 200.1 ms prior to
ground contact). The female non-athlete group also demonstrated a significantly slower vastus medialis
compared to the female athlete group (127.1 vs 408.1 ms), but not significantly slower than the male athlete
group (127.1 vs 275.7 ms). There were no differences between female athletes and male athletes for time to
initial contraction of any muscle groups. No differences were found among the groups for medial or lateral
hamstring activation. This study demonstrates that physical conditioning due to basketball participation
appears to affect neuromuscular recruitment in adolescents and reveals a necessity to find alternate methods
of training the hamstrings for improved neuromuscular capabilities to prevent injury.
The influence of gender on neuromuscular pre-
activity during side-cutting
Author links open overlay panelJesperBenckea
Mette K.Zebisab
Abstract
It is well established that female athletes are at increased risk for sustaining ACL injuries in sports, where
sudden changes of direction are a frequent movement pattern. The underlying neuromuscular mechanisms
related to the elevated ACL injury rate in female athletes has yet to be fully investigated. This cross-
sectional study aimed to examine gender differences in neuromuscular pre-activity during a maneuver that
mimics a movement associated with the incidence of ACL injuries. Twenty-four team handball players (12
male and 12 female) with no history of ACL injury were tested for EMG pre-activity of vastus lateralis,
vastus medialis, semitendinosus, and biceps femoris during a side-cutting maneuver. Mean EMG amplitude
50 ms prior to toe down was normalized to maximal EMG obtained during maximal isometric contraction.
The results showed that females had significantly lower hamstring EMG pre-activity 50 ms prior to toe-
down than males (P < 0.01). No gender difference was present in quadriceps EMG pre-activity during side-
cutting.
Lower hamstring activation prior to toe-down may result in lower hamstring contraction force during the
initial part of the ground contact, and thus lesser knee joint stability compared to males. Specific training
should be employed to alter the neuromuscular coordination towards a more stabilizing motor pattern.
Does chronic ankle instability influence lower

extremity muscle activation of females during
landing?
Author links open overlay panelYumengLia
JupilKobMarika A.WalkercCathleen N.BrowndJulianne D.SchmidtcSeock-HoKimeKathy J.Simpsonc
Abstract
Much remains unclear about how chronic ankle instability (CAI) could affect knee muscle activations and
interact with knee biomechanics. Therefore, the purpose of this study was to assess the influence of CAI on
the lower extremity muscle activation at the ankle and knee joints during landings on a tilted surface. A
surface electromyography system and two force plates were used to collect lower extremity muscle
activation of 21 young female individuals with CAI and 21 pair-matched controls during a double-leg
landing with test limb landing on the tilted surface. In the pre-landing phase, compared to controls, CAI
participants displayed a reduced ankle evertor activation that could place CAI at a high risk of giving way or
sprain injury. In the landing phase, an increased tibialis anterior activation of CAI led to increased co-
contraction of ankle muscles in the sagittal and frontal plane. A greater ankle muscle co-contraction could
increase the ankle stability during landings but may adversely influence the knee muscle activations (e.g., a
greater co-contraction ratio of quadriceps to hamstrings). Relevant training programs (e.g., increasing pre-
landing peroneal activation, and optimizing activation ratio of quadriceps to hamstrings) may help
individuals with CAI improving ankle stability and reduce atypical knee loading during landings.
A comparison of muscle stiffness and

musculoarticular stiffness of the knee joint in
young athletic males and females
Author links open overlay panelDanWangab
GiuseppeDe VitoacMassimilianoDitroilodDaniel T.P.FongeEamonnDelahuntac
Abstract
The objective of this study was to investigate the gender-specific differences in peak torque (PT), muscle
stiffness (MS) and musculoarticular stiffness (MAS) of the knee joints in a young active population.
Twenty-two male and twenty-two female recreational athletes participated. PT of the knee joint extensor
musculature was assessed on an isokinetic dynamometer, MS of the vastus lateralis (VL) muscle was
measured in both relaxed and contracted conditions, and knee joint MAS was quantified using the free
oscillation technique. Significant gender differences were observed for all dependent variables. Females
demonstrated less normalized PT (mean difference (MD) = 0.4 N m/kg, p = 0.005, η2 = 0.17), relaxed MS
(MD = 94.2 N/m, p < .001, η2 = 0.53), contracted MS (MD = 162.7 N/m, p < .001, η2 = 0.53) and MAS
(MD = 422.1 N/m, p < .001, η2 = 0.23) than males. MAS increased linearly with the external load in both
genders with males demonstrating a significantly higher slope (p = 0.019) than females. The observed
differences outlined above may contribute to the higher knee joint injury incidence and prevalence in
females when compared to males.
Kinesiotaping enhances the rate of force

development but not the neuromuscular efficiency
of physically active young men
Author links open overlay panelIgorMagalhãesaMartimBottaroaRinaldo AndréMezzaranebFrederico RibeiroNetoaBruno A.RodriguescJoão B.Ferreira-
JúniordRodrigo LuizCarregaroac
Abstract
Introduction: Investigations on the effects of KT on human performance have been increasing in the last few
years. However, there is a paucity of studies investigating its effects on neuromuscular efficiency (NME)
and rate of force development (RFD). Objective: To evaluate the NME and RFD of the soleus and
gastrocnemius muscles in physically active individuals under KT application. Method: Twenty young males
(79.7 ± 8.2 kg; 1.78 ± 0.05 m; 24.7 ± 4.4 years) performed three conditions in a randomized order: (1)
Baseline (BL, no tape); (2) Activation (ACTIKT, tape for muscle activation); and (3) Inhibition (INHIKT, tape
for muscle inhibition). The tape was applied along the lateral and medial border of gastrocnemius with 30%
tension for 48 h. Peak torque (PT), RFD and NME were measured at BL and 48 h after ACTIKT and INHIKT
by performing a maximum isometric contraction. Results: The RFD was significantly higher in ACTIKT
compared to BL at 0–30 (P = 0.010), 0–50 (P = 0.008) and 0–100 ms (P = 0.007). The PT and NME did not
differ among conditions (P > 0.05). Conclusion: KT applied for muscle activation yielded a higher RFD
during the initial phase of the muscle contraction. However, KT has no enhancement effect on NME and
peak torque.
Acute neuromechanical modifications and 24-h

recovery in quadriceps muscle after maximal
stretch-shortening cycle exercise
Author links open overlay panelMárkVáczia
DanRío-RodríguezbJánosNégyesicMiguelFernández del Olmob
Abstract
In the present study we investigated the acute and the delayed changes in corticospinal excitability and in the
neuromechanical properties of the quadriceps muscle after maximal intensity stretch-shortening cycle
exercise. Ten young males performed 150 jumps to provoke fatigue and muscle damage. Voluntary force,
various electrically evoked force variables, and corticospinal excitability were measured at baseline,
immediately (IP) and at 24 h post-exercise. Voluntary force, single twitch force, and low frequency force
decreased at IP (p < 0.05) but recovered at 24 h, although mild soreness developed in the quadriceps. High
frequency force, voluntary activation, and corticospinal excitability remained unchanged. However, vastus
lateralis myoelectric activity increased from baseline to IP (p < 0.05). The jumps selectively induced low
frequency peripheral fatigue, and central mechanisms did not mediate the acute loss of voluntary force.
Because soreness developed at 24 h post-exercise, all force variables recovered, and vastus lateralis electric
activity increased, we argue that a dual process of muscle damage, and early neural adaptation as a
compensation mechanism took place after the maximal stretch-shortening cycle exercise.
Effects of fatigue on ankle biomechanics during

jumps: A systematic review
Author links open overlay panelJ. Lakshmi R.Jayalathac
Marcosde NoronhaaNivanWeerakkodybRodrigoBinia
Abstract
Fatigue is common during physical activity and can have an effect on ankle biomechanics during different
actions, such as a jump. Yet current research on the topic is very heterogeneous and hinders clarity on what
changes are actually due to fatigue. Therefore, the aim of this review was to summarise and analyse the
current literature that investigates the effects of fatigue on ankle biomechanics during a jump. Searches were
conducted in five databases and studies with activities eliciting fatigue and comparing outcomes under a
fatigue and non-fatigue conditions were selected. Twelve studies were included, six analysed double legged
jumps and six single legged jump. When comparing ankle biomechanics between a fatigued condition and a
non-fatigued condition, findings suggested that at initial contact at landing, dorsiflexion increased in single
legged jump and plantarflexion increased in double legged jump; at maximum knee flexion after landing,
dorsiflexion decreased in double legged jumps and plantarflexion increased at full foot contact in single
legged jumps. Also, ankle power (for double legged jump) and ground reaction force (for double and single
legged jump) reduced at initial contact to maximum knee flexion at landing after fatigue and ankle power
also reduced at takeoff in single legged jumps. The current review shows that fatigue affect ankle
biomechanics by reducing dorsiflexion, from initial contact to maximum knee flexion at landing, and power
during the jump takeoff. Such information could have implications for injury prevention.
Use of muscle synergies and wavelet transforms to

identify fatigue during squatting
Author links open overlay panelKenneth B.SmaleaMohammad S.ShourijehabDaniel L.Benoitab
Abstract
The objective of this study was to supplement continuous wavelet transforms with muscle synergies in a
fatigue analysis to better describe the combination of decreased firing frequency and altered activation
profiles during dynamic muscle contractions. Nine healthy young individuals completed the dynamic tasks
before and after they squatted with a standard Olympic bar until complete exhaustion. Electromyography
(EMG) profiles were analyzed with a novel concatenated non-negative matrix factorization method that
decomposed EMG signals into muscle synergies. Muscle synergy analysis provides the activation pattern of
the muscles while continuous wavelet transforms output the temporal frequency content of the EMG signals.
Synergy analysis revealed subtle changes in two-legged squatting after fatigue while differences in one-
legged squatting were more pronounced and included the shift from a general co-activation of muscles in the
pre-fatigue state to a knee extensor dominant weighting post-fatigue. Continuous wavelet transforms showed
major frequency content decreases in two-legged squatting after fatigue while very few frequency changes
occurred in one-legged squatting. It was observed that the combination of methods is an effective way of
describing muscle fatigue and that muscle activation patterns play a very important role in maintaining the
overall joint kinetics after fatigue.
The influence of hip strength on gluteal activity

and lower extremity kinematics
Author links open overlay panelKatie J.HomanaMarc F.NorcrossbBenjamin M.GoergercWilliam E.PrenticecJ.TroyBlackburnd
Abstract
The effects of hip muscle strength and activation on anterior cruciate ligament injury biomechanics,
particularly knee valgus loading, have been reported in isolation and with equivocal results. However, the
combination of these factors influences joint biomechanics. This investigation evaluated the influence of hip
strength on gluteal activation and knee valgus motion. Maximal isometric hip abduction (ABD) and external
rotation (ER) contractions were used to define High and Low strength groups. Knee kinematics and gluteus
maximus (GMax) and medius (GMed) EMG amplitudes obtained during landing were compared between
High and Low strength groups after controlling for the potential confounding influence of sex. Knee valgus
motion did not differ between the High and Low hip ABD and ER strength groups. However, the Low ABD
and ER strength groups displayed greater GMed and GMax EMG amplitudes, respectively, compared to the
High strength groups. These findings suggest that weaker individuals compensate for a lack of force
production via heightened neural drive. As such, hip muscle strength influences knee valgus motion
indirectly by determining neural drive requirements.
Is the coactivation of biceps femoris during

isometric knee extension affected by adiposity in
healthy young humans?
Author links open overlay panelG.De Vito
D.McHughA.MacalusoP.E.Riches
Abstract
This study aimed to verify if the level of biceps femoris antagonist activity measured during isometric knee
extension was affected by the individual degree of adiposity in 14 young healthy subjects of both genders
aged between 18 and 24. Surface EMG signals were recorded from the biceps femoris muscle of the
dominant leg during isometric knee extension at three levels of voluntary contraction: maximum (MVC),
80% MVC and 200 N, respectively. In addition, whole-body percentage of fat, volume of the thigh and
skinfold thickness below the electrodes were achieved. Biceps femoris coactivation values were:
28.5±17.9%, 30.9±17.7% and 25.3±17.5% for MVC, 80% MVC and 200N trials, respectively (NS). Neither
the whole-body percentage of fat nor the skinfold thickness influenced percentage coactivation, irrespective
of the intensity of contraction. However, an increase in the whole-body percentage of fat showed a tendency
to augment the biceps femoris coactivation (PI=0.079; PII=0.575). No differences in coactivation were
observed between genders. In addition, the duration of contraction did not affect the level of coactivation.
Massage and stretching reduce spinal reflex

excitability without affecting twitch contractile
properties
Author links open overlay panelDavid G.Behma
AshleyPeachaMeaghanMaddiganaSaied JalalAboodardaaMario C.DiSantobDuane C.ButtonaNicola A.Maffiulettic
Abstract
Both stretching and massage can increase range of motion. Whereas the stretching-induced increases in
ROM have been attributed to changes in neural and muscle responses, there is no literature investigating the
ROM mechanisms underlying the interaction of stretch and massage. The objective of this paper was to
evaluate changes in neural and evoked muscle responses with two types of massage and static stretching.
With this repeated measures design, 30 s of plantar flexors musculotendinous junction (MTJ) and
tapotement (TAP) massage were implemented either with or without 1 min of concurrent stretching as well
as a control condition. Measures included the soleus maximum H-reflex/M-wave (H/M) ratio, as well as
electromechanical delay (EMD), and evoked contractile properties of the triceps surae. With the exception
of EMD, massage and stretch did not significantly alter triceps surae evoked contractile properties. Massage
with and without stretching decreased the soleus H/M ratio. Both TAP conditions provided greater H/M
ratio depression than MTJ massage while the addition of stretch provided the greatest inhibition. Both
massage types when combined with stretching increased the duration of the EMD. In conclusion, MTJ and
TAP massage as well as stretching decreased spinal reflex excitability, with TAP providing the strongest
suppression. While static stretching prolongs EMD, massage did not affect contractile properties.
Effects of countermovement depth on kinematic

and kinetic patterns of maximum vertical jumps
Author links open overlay panelRadivojMandicaSasaJakovljevicaSlobodanJaricbc
Abstract
Although maximum height (Hmax), muscle force (F), and power output (P), have been routinely obtained
from maximum vertical jumps for various purposes, a possible role of the countermovement depth (Hcmd) on
the same variables remains largely unexplored. Here we hypothesized that (1) the optimum Hcmd for
maximizing Hmax exists, while (2) an increase in Hcmd would be associated with a decrease in both F and P.
Professional male basketball players (N = 11) preformed maximum countermovement jumps with and
without arm swing while varying Hcmd ± 25 cm from its preferred value. Although regression models
revealed a presence of optimum Hcmd for maximizing Hmax, Hmax revealed only small changes within a wide
range of Hcmd. The preferred Hcmd was markedly below its optimum value (p < .05). However, both F and P
sharply decreased with Hcmd, while F also revealed a minimum for Hcmd close to its highest values. Therefore,
we conclude that although the optimum Hcmd should exists, the magnitude of its effect on Hmax should be
only minimal within a typical Hcmd range. Conversely, F and P of leg muscles assessed through maximum
vertical jumps should be taken with caution since both of them could be markedly confounded by Hcmd.
Different hip rotations influence hip abductor

muscles activity during isometric side-lying hip
abduction in subjects with gluteus medius
weakness
Author links open overlay panelJi-hyunLeea12
Heon-SeockCynnaOh-YunKwonb13Chung-HwiYib14Tae-LimYoona12Woo-JeongChoia12Sil-AhChoia12
Abstract
The purpose of this study was to establish the effects of different hip rotations during isometric side-lying
hip abduction (SHA) in subjects with gluteus medius (Gmed) weakness by investigating the
electromyographic (EMG) amplitude of the Gmed, tensor fasciae latae (TFL) activity, and gluteus maximus
(Gmax), and the activity ratio of the Gmed/TFL, Gmax/TFL, and Gmed/Gmax. Nineteen subjects with
Gmed weakness were recruited for this study. Subjects performed three isometric hip abductions: frontal
SHA with neutral hips (SHA-N), frontal SHA with hip medial rotation (SHA-MR), and frontal SHA with
hip lateral rotation (SHA-LR). Surface EMG amplitude was measured to collect the EMG data from the
Gmed, TFL, and Gmax. A one-way repeated-measures analysis of variance was used to determine the
statistical significance of the Gmed, TFL, and Gmax EMG activity and the Gmed/TFL, Gmax/TFL, and
Gmed/Gmax EMG activity ratios. Gmed EMG activity was significantly greater in SHA-MR than in SHA-
N. TFL EMG activity was significantly greater in SHA-LR than in SHA-N. The Gmed/TFL and
Gmed/Gmax EMG activity ratios were also significantly greater in SHA-MR than in SHA-N or SHA-LR.
The results of this study suggest that SHA-MR can be used as an effective method to increase Gmed
activation and to decrease TFL activity during SHA exercises.
Effect of knee joint cooling on the

electromyographic activity of lower extremity
muscles during a plyometric exercise
Author links open overlay panelStefanSchmida
MarilynMoffatbGregory M.Gutierrezb
Abstract
During sporting events, injured athletes often return to competition after icing because of the reduction in
pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle
activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to
investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg
muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and
a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental
group subjects for 20 min, while the control group subjects rested for 20 min. All subjects were retested
immediately after this period and retested again after another 20 min of rest. Average electromyographic
activity and ground contact time were calculated for the pre- and post-test sessions. Decreases in
electromyographic activity of the lower extremity musculature were found in pre-activation, eccentric
(braking), and concentric (push-off) phases immediately after the icing, and after 20 min of rest. The results
lend support to the suggestion that cryotherapy during sporting events may place the individuals in a
vulnerable position.
Reliability of the knee muscle co-contraction index

during gait in young adults with and without knee
injury history
Author links open overlay panelMauriceMohrab
KristinLorenzenbLuzPalacios-DerflingherbcCarolynEmeryabcdBenno M.Nigga

Abstract
Despite the frequent use of the electromyography-based muscle co-contraction index (CCI) to examine
muscular control of the knee joint in young adults with and without knee injury history, the reliability of the
CCI in this population is unknown. The purpose of this study was to quantify within-day and between-day
reliability of the knee muscle CCI during gait in young adults with and without knee injury history. Twenty
young adults (10 males, 10 females) with and without history of intra-articular knee injury performed
repeated gait analyses on two different days. Surface electromyography of periarticular knee muscles was
performed to determine CCIs for medial and lateral knee extensor – flexor pairs. Absolute (Bland-Altman
ratio limits of agreement) and relative (ICCs) reliability were determined between two sessions on the same
day as well as on different days. Within-day reliability was good to excellent for most analyzed co-
contraction outcomes (ICCs > 0.9) and was deemed acceptable in the context of clinically relevant changes
in co-contraction in response to interventions. Between two separate days, the CCI showed poor reliability
with measurement errors of up to 300% and was consequently not recommended as a tool to monitor long-
term changes or group differences in knee muscular control.
In vivo vastus lateralis force–velocity relationship

at the fascicle and muscle tendon unit level
Author links open overlay panelHeilianede Brito Fontanaabc
HelioRoeslerbWalterHerzogc
Abstract
The force velocity relationship of in vivo human muscle fibers has often been derived from the torque-
angular speed relationship during maximal voluntary isokinetic contractions. However, the assumption of a
close association between joint performance and muscle mechanics is questionable. We aimed to determine
the relationship between knee extension angular speeds, vastus lateralis fascicle and muscle tendon unit
(MTU) shortening speeds, and maximal knee extensor force for the entire range of knee joint movement, for
the isokinetic range, and for the ranges before, after and at peak torque occurrence, with different commonly
used pre-loading conditions. Higher peak forces were observed when knee extensions were preceded by a
pre-load, despite the similarity in fascicle shortening speeds. For the entire and the isokinetic range, MTU
always shortened faster than fascicles, and this difference increased as joint speed increased. Interestingly,
fascicle shortening velocities were greater before compared to after peak torque occurrence while the
opposite happened at the MTU level. Assuming a close relationship between joint and fascicle dynamics
results in an overestimation of muscle contractile component shortening velocity or force production at peak
torque. The force velocity relationships obtained in vivo depend crucially on the test conditions, and the
movement range used for analysis.
Test–retest reliability of cardinal plane isokinetic

hip torque and EMG
Author links open overlay panelTina L.ClaiborneaMark K.TimmonsbDanny M.Pinciverob
Abstract
The objective of the present study was to establish test–retest reliability of isokinetic hip torque and prime
mover electromyogram (EMG) through the three cardinal planes of motion. Thirteen healthy young adults
participated in two experimental sessions, separated by approximately one week. During each session,
isokinetic hip torque was evaluated on the Biodex Isokinetic Dynamometer at a velocity of 60 deg/s.
Subjects performed three maximal-effort concentric and eccentric contractions, separately, for right and left
hip abduction/adduction, flexion/extension, and internal/external rotation. Surface EMGs were sampled
from the gluteus maximus, gluteus medius, adductor, medial and lateral hamstring, and rectus femoris
muscles during all contractions. Intraclass correlation coefficients (ICC – 2,1) and standard errors of
measurement (SEM) were calculated for peak torque for each movement direction and contraction mode,
while ICCs were only computed for the EMG data. Motions that demonstrated high torque reliability
included concentric hip abduction (right and left), flexion (right and left), extension (right) and internal
rotation (right and left), and eccentric hip abduction (left), adduction (left), flexion (right), and extension
(right and left) (ICC range = 0.81–0.91). Motions with moderate torque reliability included concentric hip
adduction (right), extension (left), internal rotation (left), and external rotation (right), and eccentric hip
abduction and adduction (right), flexion (left), internal rotation (right and left), and external rotation (right
and left) (ICC range = 0.49–0.79). The majority of the EMG sampled muscles (n = 12 and n = 11 for
concentric and eccentric contractions, respectively) demonstrated high reliability (ICC = 0.81–0.95).
Instances of low, or unacceptable, EMG reliability values occurred for the medial hamstring muscle of the
left leg (both contraction modes) and the adductor muscle of the right leg during eccentric internal rotation.
The major finding revealed high and moderate levels of between-day reliability of isokinetic hip peak torque
and prime mover EMG. It is recommended that the day-to-day variability estimates concomitant with
acceptable levels of reliability be considered when attempting to objectify intervention effects on hip muscle
performance.
Gender differences in active musculoskeletal

stiffness. Part I.: Quantification in controlled
measurements of knee joint dynamics
Author links open overlay panelKevin P.Granata
Sara E.WilsonDarin A.Padua
Abstract
Active females demonstrate increased risk for musculoskeletal injuries relative to equivalently-trained
males. Although gender differences in factors such as passive laxity, skeletal geometry and kinematics have
been examined, the effect of gender on active muscle stiffness has not been reported. Stiffness of the active
quadriceps and hamstrings musculature were recorded during isometric knee flexion and extension exertions
from twelve male and eleven female subjects. A second-order biomechanical model of joint dynamics was
used to quantify stiffness from the transient motion response to an angular perturbation of the lower-leg.
Female subjects demonstrated reduced active stiffness relative to male subjects at all torque levels, with
levels 56–73% of the males. Effective stiffness increased linearly with the torque load, with stiffness
increasing at a rate of 3.3 Nm/rad per unit of knee moment in knee flexion exertions (hamstrings) and 6.6
Nm/rad per unit of knee moment extension exertions (quadriceps). To account for gender differences in
applied moment associated with leg mass, regressions analyses were completed that demonstrated a gender
difference in the slope of stiffness-versus-knee moment relation. Further research is necessary to identify the
cause of the observed biomechanical difference and implications for controlling injury.
The effect of anterior cruciate ligament rupture on
the timing and amplitude of gastrocnemius muscle
activation: A study of alterations in EMG
measures and their relationship to knee joint
stability
Author links open overlay panelDavid M.Klynea
Susan L.KeaysaJoanne E.Bullock-SaxtonaPeter A.Newcombeb
Abstract
Changes in hamstring and quadriceps activity are well known in individuals with anterior cruciate ligament
deficiency (ACLD) to potentially compensate for knee joint instability. However, few studies have explored
gastrocnemius activity or its relationship to knee stability. The purpose of this study was therefore to
examine the activation characteristics of medial gastrocnemius (MG) in ACLD subjects and relate any
changes to knee joint laxity. Two subject cohorts were assessed: those with unilateral ACLD (n = 15) and
uninjured control subjects (n = 11). Surface EMG of the left and right MG were recorded during a controlled
single leg hop on each limb. Onset and offset of MG activation relative to take-off, during flight and landing
were calculated as well as muscle activity (RMS). Passive antero-posterior knee laxity was measured with a
KT1000 arthrometer during a maximal manual displacement test. Medial gastrocnemius activity on the
injured side of ACLD participants demonstrated significantly prolonged activation in preparation to hop,
minimal muscle inactivity prior to take-off, and increased duration of overall muscle activity when
compared to the uninjured side and control subjects (p < 0.05). Significant positive correlations were found
between passive knee joint laxity and prolonged activation prior to knee bend. RMS of the muscle signal
was not significantly different between limbs. Overall, MG on the ACLD side demonstrated longer
activation, with minimal rest during the hop test, which may be an attempt to maintain knee stability.
Furthermore, the strong relationship between knee laxity and prolonged muscle activation suggests that
individuals with a loss of knee stability are more reliant on active control of the gastrocnemius muscle.
Mini-trampoline exercise related to mechanisms of

dynamic stability improves the ability to regain
balance in elderly
Author links open overlay panelFernando AmâncioAragãoacKirosKaramanidisbMarco AurélioVazcAdamantiosArampatzisde
Abstract
Falls have been described by several studies as the major cause of hip and femur fractures among the
elderly. Therefore, interventions to reduce fall risks, improve dynamic stability and the falling recovery
strategies in the elderly population are highly relevant. This study aimed at investigating the effects of a 14-
week mini-trampoline exercise intervention regarding the mechanisms of dynamic stability on elderly
balance ability during sudden forward falls. Twenty-two elderly subjects participated on mini-trampoline
training and 12 subjects were taken as controls. The subjects of the experimental group were evaluated
before and after the 14-week trampoline training (exercised group), whereas control subjects were evaluated
twice in the forward fall task with a three-month interval. The applied exercise intervention increased the
plantarflexors muscle strength (∼10%) as well as the ability to regain balance during the forward falls
(∼35%). The 14-week mini-trampoline training intervention increased elderly abilities to recover balance
during forward falls; the improvement was attributed to the higher rate of hip moment generation.
Gender differences in active musculoskeletal

stiffness. Part II. Quantification of leg stiffness
during functional hopping tasks
Author links open overlay panelK.P.Granata
D.A.PaduaS.E.Wilson
Abstract
Leg stiffness was compared between age-matched males and females during hopping at preferred and
controlled frequencies. Stiffness was defined as the linear regression slope between the vertical center of
mass (COM) displacement and ground-reaction forces recorded from a force plate during the stance phase of
the hopping task. Results demonstrate that subjects modulated the vertical displacement of the COM during
ground contact in relation to the square of hopping frequency. This supports the accuracy of the spring–mass
oscillator as a representative model of hopping. It also maintained peak vertical ground-reaction load at
approximately three times body weight. Leg stiffness values in males
were significantly (p<0.01) greater than in females at each of three hopping frequencies, 3.0, 2.5 Hz, and a
preferred hopping rate. In the spring–mass oscillator model leg stiffness and body mass are related to the
frequency of motion. Thus male subjects necessarily recruited greater leg stiffness to drive their heavier
body mass at the same frequency as the lighter female subjects during the controlled frequency trials.
However, in the preferred hopping condition the stiffness was not constrained by the task because frequency
was self-selected. Nonetheless, both male and female subjects hopped at statistically similar preferred
frequencies , therefore, the females continued to demonstrate less leg stiffness. Recognizing the active
muscle stiffness contributes to biomechanical stability as well as leg stiffness, these results may provide
insight into the gender bias in risk of musculoskeletal knee injury.
Diagnostic accuracy, validity, and reliability of

Tensiomyography to assess muscle function and
exercise-induced fatigue in healthy participants. A
systematic review with meta-analysis☆
Author links open overlay panelC.Lohrab
T.SchmidtabcdI.Medina-PorquereseK.-M.BraumannaR.ReeraJ.Porthunf
Abstract
Tensiomyography™ (TMG) is a non-invasive method to monitor skeletal muscle mechanical characteristics.
This systematic review and meta-analysis reports on diagnostic accuracy, validity, and reliability of TMG
(maximal radial displacement [Dm], contraction time [Tc], delay time [Td], and velocity of contraction
[Vc]) to assess exercise-induced fatigue in healthy volunteers, with the specific aim to determine the current
level of supporting evidence. Systematic literature searches within Medline, Embase and Sportdiscus
databases were conducted from January 1990 through November 2018. Methodological quality was
evaluated by the Assessment of Diagnostic Accuracy Studies (QUADAS) tool or the Validity and Reliability
Critical Appraisal Tool (CAT) or the Quality Appraisal of Diagnostic Reliability checklist (QAREL). Meta-
analytical methods were utilised to summarize relative reliabilities of Dm, Tc, Td (95%, CI). The
methodological quality of the 19 included studies (n = 373; female = 13.0%) ranged from low to high
quality. The analysis revealed insufficient diagnostic accuracy and validity, mixed results regarding absolute
reliability, and high to excellent relative reliability for the assessed measures. To conclude, robust evidence
for diagnostic accuracy/validity of TMG has yet to be determined, whereas there is substantial evidence for
its reliability. Higher methodological standards need to be established, including the avoidance of gender
bias.
Knee joint laxity affects muscle activation patterns

in the healthy knee
Author links open overlay panelSandra J.Shultza
Christopher R.CarciabDavid H.Perrina
Abstract
This study investigated the effects of anterior knee joint laxity on muscle activation patterns prior to and
following a lower extremity perturbation. Participants were subjected to a forward and either internal (IR) or
external (ER) rotation perturbation of the trunk and thigh on the weight-bearing shank. Pre-activity
(%MVIC) before the perturbation, and reflex time (ms) and mean reflex amplitude (%MVIC) following the
perturbation were recorded via surface electromyography (sEMG) in the medial and lateral gastrocnemius,
hamstring and quadriceps muscles. Twenty-one NCAA DI intercollegiate female athletes with below
average anterior knee laxity (3–5 mm) were compared to 21 with above average anterior knee laxity (7–14
mm) as measured by a standard knee arthrometer. Groups differed in reflex timing by muscle (P=0.013),
with females with above average knee laxity (KT(>7mm)) demonstrating a 16 ms greater delay in biceps
femoris reflex timing compared to females with below average knee laxity (KT(<5mm)). Groups also differed
in muscle activation amplitude by response, muscle and direction of rotation (i.e. a 4-way interaction;
P=0.027). The magnitude of change from pre to post perturbation was significantly less in KT(>7mm) vs.
KT(<5mm) for the medial (MG) and lateral (LG) gastrocnemius muscles, primarily due to higher levels of
muscle preactivity while awaiting the perturbation (MG=20% vs. 12% MVIC, P=0.05; LG=33% vs. 21%
MVIC, P=0.11). Further, KT(>7mm) demonstrated higher activation levels in the biceps femoris than KT(<5mm)
(47% vs. 27% MVIC; P=0.025) regardless of response (pre vs. post perturbation) or direction of rotation.
These findings suggest females with increased knee laxity may be less sensitive to joint displacement or
loading (delayed reflex), and are more reliant on active control of the gastrocnemius and biceps femoris
muscles to potentially compensate for reduced passive joint stability.
Spectral EMG changes in vastus medialis muscle
following short range of motion isokinetic training
Author links open overlay panelYaronBarakaMosheAyalonbZeeviDvirc
Abstract
This study was aimed at exploring the carryover effect of short range of motion (RoM) isokinetic
conditioning on vastus medialis (VM) motor unit recruitment (MUR) across the full RoM. Fifty-five women
were randomly assigned to one of four groups: G1 (n = 14) and G2 (n = 14) trained concentrically at 30 and
90°/s, respectively whereas G3 (n = 13) and G4 (n = 14) trained similarly but using the eccentric mode. All
4 groups trained within 30–60° of knee flexion. The training protocol consisted of 4 sets of 10 maximal
repetitions, 3 times a week for 6 weeks. sEMG was recorded from the VM for analysis of mean frequency of
the EMG power spectrum prior to the training period and 2 days after its termination. The EMG assessments
took place during dynamic contractions within 3 angular RoM’s: 85–60° (R1), 60–30° (R2) and 30–5° (R3).
In addition MUR was evaluated during isometric contractions at 10°, 45° and 80°. Significant increases were
observed in the MUR at R1, R2, and R3 during dynamic contractions as well as in all 3 angles during
isometric contractions. These findings applied equally regardless of the mode of contraction and motion
speed during training. The fact that MUR increased significantly within untrained RoM’s may point out to
the potential benefits of short RoM conditioning, particularly in those cases where, during specific phases of
rehabilitation, a wider RoM may be contraindicative.
Agonist versus antagonist muscle fatigue effects on

thigh muscle activity and vertical ground reaction
during drop landing
Author links open overlay panelEleftheriosKellis
VasilikiKouvelioti
Abstract
Background
Agonist and antagonist co-activation plays an important role for stabilizing the knee joint, especially after
fatigue. However, whether selective fatigue of agonists or antagonist muscles would cause different changes
in muscle activation patterns is unknown.
Hypothesis
Knee extension fatigue would have a higher influence on landing biomechanics compared with a knee
flexion protocol.
Study design
Repeated-measures design.
Methods
Twenty healthy subjects (10 males and 10 females) performed two sets of repeated maximal isokinetic
concentric efforts of the knee extensors (KE) at 120° s−1 until they could no longer consistently produce 30%
of maximum torque. On a separate day, a similar knee flexion (KF) fatigue protocol was also performed.
Single leg landings from 30 cm drop height were performed before, in the middle and after the end of the
fatigue test. The mean normalized electromyographic (EMG) signal of the vastus medialis (VM), vastus
lateralis (VL), biceps femoris (BF) and gastrocnemius (GAS) at selected landing phases were determined
before, during and after fatigue. Quadriceps:hamstrings (Q:H) EMG ratio as well as sagittal hip and knee
angles and vertical ground reaction force (GRF) were also recorded.
Results
Two-way analysis of variance designs showed that KE fatigue resulted in significantly lower GRF and
higher knee flexion angles at initial contact while maximum hip and knee flexion also increased (p < 0.05).
This was accompanied by a significant decline of BF EMG, unaltered EMG of vastii and GAS muscles and
increased Q:H ratio. In contrast, KF fatigue had no effects on vGRFs but it was accompanied by increased
activation of VM, BF and GAS while the Q:H increased during before landing and decreased after impact.
Conclusion
Fatigue responses during landing are highly dependent on the muscle which is fatigued.
Neuromuscular and psychological influences on

range of motion recovery in anterior cruciate
ligament reconstruction patients
Author links open overlay panelKathrynHemsleyab
MichaelSitlerbRayMoyeraCarolOatisc
Abstract
To identify distinguishing characteristics for knee surgery patients who experience a protracted recovery
process, we sought to determine if there is an association between the neuromuscular stretch reflex and
psychological factors of pain perception and anxiety on the range of motion (ROM) recovery rate of post-
operative anterior cruciate ligament reconstruction (ACLR) rehabilitation patients. The ACLR participants
were categorized into a slow recovery group (SRG: >6 weeks to recover 0–125° knee flexion [n = 10]) and a
normal recovery group (NRG: <6 weeks to recovery 0–125° knee flexion [n = 12]). Control participants
(n = 22) were age, gender and activity-level matched to the surgical participants. Neuromuscular testing
consisted of sagittal plane video kinematics of the Wartenberg Pendulum Test for determining lower limb
stiffness indices and electromyography-monitored patellar tendon tap reflex responses. Psychological and
health status assessments consisted of the State–Trait Anxiety Inventory and SF-36™ Health Survey. Data
revealed that neuromuscular reflex profiles, lower limb stiffness indices, pain, anxiety and SF-36™ indices
of function were not significantly different between the two surgical groups (SRG and NRG). The surgical
groups exhibited significantly greater pain (2.67 ± 2.27 SRG, 1.49 ± 1.15 NRG) than the control group
(p ⩽ .05). SF-36™ indices were significantly lower for the surgical groups for total score (546.55 ± 94.70
SRG, 577.57 ± 125.58 NRG), function 69.00 ± 20.24 SRG, 67.08 ± 19.12 NRG), role physical
(53.75 ± 22.85 SRG, 53.12 ± 23.15 NRG), social (76.24 ± 25.31 SRG, 65.62 ± 27.24 NRG), and emotional
(82.49 ± 19.81 SRG, 81.38 ± 23.02 NRG) subscales (p ⩽ .05). These results suggest that neuromuscular
reflex responses, visual analogue scale (VAS) pain, and anxiety are not distinguishing factors for ROM
recovery rate between the SRG and NRG. Decreased SF-36™ indices, including pain as it influences
function, though clinically relevant factors, were not statistically associated with post-operative ROM
recovery rate.
Successful feed-forward strategies following ACL

injury and reconstruction
Author links open overlay panelAdam L.Bryanta
Robert U.NewtonbJulieSteelec
Abstract
The purpose of this study was to elucidate the most successful feed-forward strategies responsible for
enhancing dynamic restraint following anterior cruciate ligament (ACL) injury and ACL reconstruction
(ACLR). Ten male ACL deficient (ACLD) subjects (18–35 years) together with 27 matched males who had
undergone ACLR (14 using a patella tendon graft and 13 using a combined semitendinosus and gracilis
graft) and 22 matched-control subjects were recruited. After their knee functionality (0- to 100-point scale)
was rated using the Cincinnati Knee Rating System, each subject performed a maximal, countermovement
hop for distance on their involved limb while EMG data were collected from the vastus lateralis (VL), vastus
medialis (VM), semitendinosus (ST) and biceps femoris (BF) muscles. Acceleration transients at the
proximal tibia were recorded using a uniaxial accelerometer mounted at the level of the tibial tuberosity.
Whilst pre-programmed muscle activation strategies and tibial acceleration transients when landing from a
single-leg long hop for distance were not contingent upon ACL status, a number of significant correlations
were identified between neuromuscular variables and knee functionality of ACLD and ACLR subjects.
Increased hamstring preparatory activity together with a greater ability to control tibial motion during
dynamic deceleration was associated with higher levels of knee functionality in the ACLD subjects.
Successful feed-forward strategies following ACLR were related to graft selection; STGT subjects with
superior knee function activated their quadriceps earlier and were better able to synchronise peak hamstring
muscle activity closer to initial ground contact whilst more functional PT subjects demonstrated enhanced
tibial control despite a lack of evidence supporting modified pre-programmed muscular activation patterns.
Our conclusion was that more functional individuals used sensory feedback to build treatment-specific, feed-
forward strategies to enhance dynamic restraint when performing a task known to stress the ACL.
Effect of dynamic stability on a step task in ACL

deficient individuals
Author links open overlay panelKatherine S.Rudolphab
LynnSnyder-Macklerab
Abstract
Stair ascent and descent requires large knee motions and muscle forces that can be challenging for people
with anterior cruciate ligament (ACL) deficiency. Movement and muscle activity patterns were compared in
two groups of ACL deficient subjects and a group of uninjured subjects. The ACL deficient subjects were
prospectively classified according to functional ability. “Copers” were defined as individuals with complete
ACL rupture and no symptoms of knee instability and participated in high-level sports without difficulty.
“Non-copers” were defined as ACL deficient individuals who had instability with low-level daily activities
and were not able to participate in sports. Sagittal plane kinematic and kinetic data from the hip, knee and
ankle and electromyographic data from the vastus lateralis, lateral hamstring, medial gastrocnemius, and
soleus were collected as subjects stepped up and over a 26 cm high step. Both coper and non-coper subjects
had altered movement patterns as they controlled the rapid movement from step ascent to descent with their
involved limbs. Only non-copers used significantly different movement patterns on their involved limb
compared to controls after they had descended from the step and their involved side accepted the weight of
the body. Classifying subjects by functional ability resulted in more pronounced differences in movement
patterns between non-copers and copers. Copers moved more like uninjured subjects.
Quantification of human dynamic muscle fatigue

by electromyography and kinematic profiles
Author links open overlay panelLarsArendt-NielsenPh.D
ThomasSinkjærPh.D.
https://doi.org/10.1016/1050-6411(91)90021-VGet rights and content
Abstract
We wished to quantify the dynamic muscle fatigue by electromyographic (EMG) and kinematic parameters
during uphill walking (5 km/h, 25%). The muscle coordination between biceps femoris, semitendinosus,
vastus lateralis, gastrocnemius medialis, soleus, and tibialis anterior was evaluated by measuring (a) the
period from onset of the EMG burst to heel contact, and (b) duration of the EMG burst. The muscle activity
of the individual bursts was evaluated by the root mean-square (RMS), the mean power frequency (MPF),
and the averaged EMG profile during one stride cycle. The most pronounced differences at the start and end
of the endurance test were observed in the semitendinosus and the biceps femoris. The gastrocnemius was
recruited substantially closer to heel contact, but no changes were noted in the soleus. The RMS and
duration of the EMG burst were changed significantly for the vastus lateralis. The overall pattern of the
kinematic profiles (position, and velocity) for the upper and lower leg remained constant, although the
muscle activity and coordination changed. During dynamic muscle fatigue, a complex interaction between
muscle coordination and muscle performance was noted, but how the central nervous system control this
interaction is not known.
Can muscle coordination be precisely studied by

surface electromyography?
Author links open overlay panelFrançoisHug
Abstract
Despite the many reviews and research papers on the limitations of surface electromyography (EMG), there
are relatively few that address this issue by considering dynamic contractions and specifically from the point
of view of muscle coordination. Nevertheless, whether muscle coordination can be precisely studied using
surface EMG signals is still a matter of discussion in the scientific community. In other words, it is uncertain
whether neural control strategies of movement can be inferred from EMG. This review article discusses the
appropriateness of using EMG recordings for studying muscle coordination. First, the main uses of surface
EMG for studying muscle coordination are depicted. Then, the main intrinsic drawbacks of the EMG
technique (i.e., amplitude cancellation, crosstalk and spatial variability of muscle activity) and of EMG
processing (i.e., smoothing of the linear envelope, normalization of the time scale and the amplitude and
timing of muscle activation) are described and discussed. Finally, three other factors (i.e., variability,
electromechanical delay and neuromuscular fatigue), which can affect the interpretation of EMG and have
received little attention in the literature, are presented and discussed. All of this information is crucial to the
proper interpretation of muscle coordination from EMG signals.
Muscle mechanical properties of strength and

endurance athletes and changes after one week of
intensive training
Author links open overlay panelRauno Álvarode Paula Simolaa
ChristianRaederaThimoWiewelhoveaMichaelKellmannbcTimMeyerdMarkPfeiffereAlexanderFerrautia
Abstract
The study investigates whether tensiomyography (TMG) is sensitive to differentiate between strength and
endurance athletes, and to monitor fatigue after either one week of intensive strength (ST) or endurance
(END) training. Fourteen strength (24.1 ± 2.0 years) and eleven endurance athletes (25.5 ± 4.8 years)
performed an intensive training period of 6 days of ST or END, respectively. ST and END groups completed
specific performance tests as well as TMG measurements of maximal radial deformation of the muscle belly
(Dm), deformation time between 10% and 90% Dm (Tc), rate of deformation development until 10% Dm
(V10) and 90% Dm (V90) before (baseline), after training period (post1), and after 72 h of recovery (post2).
Specific performance of both groups decreased from baseline to post1 (P < 0.05) and returned to baseline
values at post2 (P < 0.05). The ST group showed higher countermovement jump (P < 0.05) and shorter Tc
(P < 0.05) at baseline. After training, Dm, V10, and V90 were reduced in the ST (P < 0.05) while TMG
changes were less pronounced in the END. TMG could be a useful tool to differentiate between strength and
endurance athletes, and to monitor fatigue and recovery especially in strength training.
Effects of loading on maximum vertical jumps:

Selective effects of weight and inertia
Author links open overlay panelBojanLeontijevicaNemanjaPazinaPredrag R.BozicabMilosKukoljaDusanUgarkovicaSlobodanJaricc
Abstract
A novel loading method was applied to explore selective effects of externally added weight (W), weight and
inertia (W + I), and inertia (I) on maximum counter-movement jumps (CMJ) performed with arm swing.
Externally applied extended rubber bands and/or loaded vest added W, W + I, and I corresponding to 10–
40% of subjects’ body mass. As expected, an increase in magnitude of all types of load was associated with
an increase in ground reaction forces (GRF), as well as with a decrease in both the jumping performance and
power output. However, of more importance could be that discernible differences among the effects of W,
W + I, and I were recorded despite a relatively narrow loading range. In particular, an increase in W was
associated with the minimal changes in movement kinematic pattern and smallest reduction of jumping
performance, while also allowing for the highest power output. Conversely, W + I was associated with the
highest ground reaction forces. Finally, the lowest maxima of GRF and power were associated with I.
Although further research is apparently needed, the obtained finding could be of potential importance not
only for understanding fundamental properties of the neuromuscular system, but also for optimization of
loading in standard athletic training and rehabilitation procedures.
Hip and knee muscle function following aerobic

exercise in individuals with patellofemoral pain
syndrome
Author links open overlay panelBrittanyOttaNicole L.Cosbyb
Terry L.GrindstaffcJoseph M.Hartb

Referred to by
Brittany Ott, Nicole L. Cosby, Terry L. Grindstaff, Joseph M. Hart
Corrigendum to ‘Hip and knee muscle function following aerobic exercise in individuals with
patellofemoral pain syndrome’ [JJEK 21/4 (2011) 631–637]
Journal of Electromyography and Kinesiology, Volume 22, Issue 1, February 2012, Pages 153
Download PDF
Abstract
Patellofemoral pain syndrome (PFPS) is a commonly experienced knee disorder that can result in altered
muscle activation of the surrounding musculature. There is little evidence on effects of aerobic exercise on
quadriceps torque and EMG activation of the vastus medialis obliquus (VMO), vastus lateralis (VL), and
gluteus medius (GM). In this study 20 healthy individuals and 20 patients with PFPS had measures of torque
and muscle activation taken following aerobic exercise. A modified Balke–Ware protocol was used for the
exercise intervention. Baseline and post-aerobic measurements of knee extension torque and VMO, VL, and
GM activation during a single leg anterior reaching task. These measurements were only taken on the
injured limb. Following exercise, knee extension torque was lower in PFPS patients when compared to
controls (p = 0.03). Patients reporting no pain after exercise experienced decreases (p = 0.021) in GM
activation following exercise. There was a decrease in VMO (p = 0.010) and VL (p = 0.021) activation in
PFPS patients with elevated knee pain. Recreationally active individuals with PFPS may experience
different responses in the quadriceps and GM after exercise. Responses may be confounded by whether or
not pain is exacerbated by exercise.
Effects of paraspinal fatigue on lower extremity
motoneuron excitability in individuals with a
history of low back pain
Author links open overlay panelElizabeth A.BunnaTerry L.Grindstaffb
Joseph M.HartcJayHerteldChristopher D.Ingersolle
Abstract
Individuals with low back pain (LBP) have been shown to demonstrate decreased quadriceps activation
following lumbar paraspinal fatigue. The response of other lower extremity muscles is unknown. The
purpose of this study was to determine changes in motoneuron pool excitability of the vastus medialis,
fibularis longus, and soleus following lumbar paraspinal fatigue in individuals with and without a history of
LBP. A controlled laboratory study was used to compare motoneuron pool excitability before and after a
lumbar paraspinal fatiguing exercise. Twenty individuals (10 with history of LBP) performed isometric
lumbar paraspinal exercise until a 25% shift in paraspinal muscle surface electromyography median
frequency occurred. Motoneuron pool excitability, using H/M ratios of the vastus medialis, fibularis longus,
and soleus before and immediately after a lumbar paraspinal fatiguing exercise. There was a significant
(P = .03) increase of 15% in soleus H/M ratio in both groups following lumbar paraspinal fatigue. Neither
group demonstrated changes in vastus medialis (P = .80) or fibularis longus (P = .86). Soleus motoneuron
pool excitability increased following lumbar paraspinal fatigue independent of group allocation and occurred
in the absence of changes in vastus medialis or fibularis longus muscles. Increased soleus motoneuron pool
excitability may be a postural response to preserve lower extremity function.
Exercise and dehydration: A possible role of inner

ear in balance control disorder
Author links open overlay panelAlexisLionabGillesBosserabcGérome C.GauchardabKarimDjaballahdJean-PierreMalliéePhilippe P.Perrinabf
Abstract
To study the effect of exercise and dehydration on the postural sensory-motor strategies, 10 sportsmen
performed a 45 min-exercise on a cycle ergometer at intensity just below the ventilatory threshold without
fluid intake. They performed, before, immediately and 20 min after exercise, a sensory organization test to
evaluate balance control in six different sensory situations, that combine three visual conditions (eyes open,
eyes closed and sway-referenced visual surround motion) with two platform conditions (stable platform,
sway-referenced platform motion). Blood samples were collected before and after exercise. Exercise
induced a mild dehydration, characterized by body mass loss and increase in proteinemia. Postural
performances decreased immediately after exercise, mainly in the standard situation (eyes open, stable
visual surround and platform) and when only the vestibular cue was reliable (eyes closed and sway-
referenced platform). Moreover, the decreased use of vestibular input was correlated with the dehydration
level. Finally, postural performances normalized 20 min after exercise. Even though muscular fatigue could
explain the decrease in postural performances, vestibular fluid modifications may also be involved by its
influence on the intralabyrinthine homeostasis, lowering thus the contribution of vestibular information on
balance control.
Duration of differential activations is functionally
related to fatigue prevention during low-level
contractions
Author links open overlay panelA.Holtermannab
C.GrönlundcJ.IngebrigtsenaJ.S.KarlssoncK.Roelevelda
Abstract
The aim of this study was to investigate the importance of duration of differential activations between the
heads of the biceps brachii on local fatigue during prolonged low-level contractions. Fifteen subjects carried
out isometric elbow flexion at 5% of maximal voluntary contraction (MVC) for 30 min. MVCs were
performed before and at the end of the prolonged contraction. Surface electromyographic (EMG) signals
were recorded from both heads of the biceps brachii. Differential activation was analysed based on the
difference in EMG amplitude (activation) between electrodes situated at the two heads. Differential
activations were quantified by the power spectral median frequency of the difference in activation between
the heads throughout the contraction. The inverse of the median frequency was used to describe the average
duration of the differential activations. The relation between average duration of the differential activations
and the fatigue-induced reduction in maximal force was explored by linear regression analysis. The main
finding was that the average duration of differential activation was positively associated to relative maximal
force at the end of the 30 min contraction (R2 = 0.5, P < 0.01). The findings of this study highlight the
importance of duration of differential activations for local fatigue, and support the hypothesis that long term
differential activations prevent fatigue during prolonged low-level contractions.
The activity pattern of shoulder muscles in

subjects with and without subacromial
impingement
Author links open overlay panelLouise PyndtDiederichsena
JesperNørregaardbPoulDyhre-PoulsencAnnikaWintheraGoranTufekovicaThomasBandholmaLars RaundalRasmussenaMichaelKrogsgaardd
Abstract
Altered shoulder muscle activity is frequently believed to be a pathogenetic factor of subacromial
impingement (SI) and therapeutic interventions have been directed towards restoring normal motor patterns.
Still, there is a lack of scientific evidence regarding the changes in muscle activity in patients with SI. The
aim of the study was to determine and compare the activity pattern of the shoulder muscles in subjects with
and without SI. Twenty-one subjects with SI and 20 healthy controls were included. Electromyography
(EMG) was assessed from eight shoulder muscles from both shoulders during motion. In the symptomatic
shoulder, there was a significantly greater EMG activity during abduction in the supraspinatus and
latissimus muscles and less activity in serratus anterior compared to the healthy subjects. During external
rotation, there was significantly less activity of the infraspinatus and serratus anterior muscles on the
symptomatic side compared to the healthy subjects. On the asymptomatic side, the groups showed different
muscle activity during external rotation. Our findings of an altered shoulder muscle activity pattern on both
the symptomatic and asymptomatic side in patients indicate that the different motor patterns might be a
pathogenetic factor of SI, perhaps due to inappropriate neuromuscular strategies affecting both shoulders.
The effect of fatigue and habituation on the stretch

reflex of the ankle musculature
Author links open overlay panelNicole D.JacksonGregory M.GutierrezThomasKaminski
Abstract
Many ankle injuries are said to occur when athletes are in a fatigued state; therefore, studies investigating
the role that fatigue plays in ankle injuries are warranted. Furthermore, the contributions of the stretch reflex
in countering the injury mechanism are still unclear. We hypothesized that (1) fatigue would impair the
reflex response, (2) there would be no differences between genders, (3) habituation would be present, and
(4) fatigue would exacerbate the effect of habituation. Forty healthy subjects participated and were divided
into treatment and control groups. Stretch reflex measurements were taken for the tibialis anterior (TA),
peroneus longus (PL), and peroneus brevis (PB) muscles in response to a rapid inversion perturbation. A
fatigue intervention was administered to the treatment group, while the control group sat quietly. Post-test
measurements were recorded within 5 min and reflex latency (RL) and amplitude (RA) were calculated. RA
decreased significantly, however a significant improvement was noted in RL in the PL and PB muscles. The
effect that peripheral fatigue has on RL should not be considered a cause of ankle injuries. However, the
diminished RA may suggest reduced dynamic stability after fatigue. Habituation was present and was
exacerbated by fatigue, indicating that reflex testing is affected by fatigue and habituation, which must be
taken into consideration in future studies.
Quadriceps and hamstring isokinetic strength and

electromyographic activity measured at different
ranges of motion: A reproducibility study
Author links open overlay panelJ.L.CroisieraM.MalnatiaL.B.ReichardbC.PeretzbZ.Dvirb
Abstract
Isokinetic strength measurements of the quadriceps and hamstring that are commonly conducted using a 90°
range of motion (RoM) may involve some risk to specific knee patient groups. Testing these muscles at a
much shorter RoM may reduce the risk but in order to render this method clinically acceptable the
reproducibility of the derived test findings has to be established. Therefore the main objective of this study
was to assess the reproducibility of isokinetic peak torque and normalized EMG scores of these muscles
based on 90° (0–90° flexion, LR) and three successive short RoMs: 0–30° (SR1), 30–60° (SR2) and 60–90°
(SR3). Eight healthy subjects were tested three times with a 2 week between-session interval. All tests were
performed on the dominant limb and consisted of maximal concentric and eccentric exertions. The velocities
applied were 90°/s for LR and 30°/s for each of the SRs. Findings indicated no between-session
improvement in strength. Based on the coefficient of variation the measurement error for all isokinetic
strength scores remained stable throughout the testing sessions ranging 0.6–13.9% with the absolute
majority of instances less than 10%. The reproducibility of the EMG scores was poorer ranging 1.5–25%
and 0.5–19% for the quadriceps and hamstring, respectively. It is concluded that testing of knee muscles at
short (30°) RoMs does not compromise the reproducibility of the strength or EMG scores derived from the
commonly used RoM of 90°. However, whereas strength was reproducible to within the accepted clinical
standards, the corresponding EMG scores were characterized by a wider error band.
Differential control during maximal concentric

and eccentric loading revealed by characteristics
of the electromyogram
Author links open overlay panelMark DBishopa
Mark HTrimbleaJeffery ABauerbThomas WKaminskib
https://doi.org/10.1016/S1050-6411(00)00016-XGet rights and content
Abstract
Maximal eccentric loading has been associated with higher levels of spindle afferent activity but lower
levels of integrated EMG as compared to maximal concentric loading. Elbow flexor EMG was recorded
from 17 subjects during concentric (CONC) and eccentric (ECC) elbow flexion at 70° s−1 using a Kin-Com
dynamometer. We hypothesized that peak EMG amplitude would be more sensitive to fluctuations in
facilitation by the spindle primary afferents via the segmental stretch reflex pathway, and that the mean
EMG would be more reflective of the ongoing level of muscle activation. A ratio of peak to mean EMG
(P/M EMG ratio) was predicted to be larger during maximal eccentric loading than maximal concentric
loading. The peak EMG (P<0.013) and the P/M EMG ratio (P<0.001) were significantly greater during the
ECC condition than the CONC condition. In a subgroup of three subjects who underwent 3 weeks of
eccentrically biased weight training, EMG, peak torque and torque variability were assessed before and after
training. P/M EMG ratio decreased, while peak torque and torque variability increased following the
training. Differences in the P/M EMG ratio appear to reflect differences in the way eccentric and concentric
muscle actions are controlled and do not simply represent less control during the eccentric task.
Cost of walking and locomotor impairment

Author links open overlay panelM.Bernardiab
A.MacalusoaE.SprovieroaV.CastellanobD.CoratellabF.FeliciaA.RodioaM.F.PiacentiniaM.MarchettiaJ.F.Dit
unnoJrc
Abstract
The aim of the present study was to evaluate the importance and the necessity of metabolic measurements to
quantify locomotor impairment in a clinical context. Oxygen consumption, heart rate, pulmonary ventilation
and walking speed were measured during locomotion in 14 normal subjects, used as a control group, and 82
patients with different pathologies [hemiparetic, paraparetic, tetraparetic, orthopaedic and paraplegic
patients, who walked using a reciprocating gait orthosis (RGO)]. The subjects were characterized on the
basis of a cumulative impairment score (CIS), based on clinical scales commonly used to evaluate
impairment and disability in locomotion. Appropriate indices of energy, cardiac and ventilatory costs
expressed per metre walked, globally called physiological costs, were obtained. It resulted that the most
comfortable speed (MCS) of normal subjects was significantly higher than that of each group of patients.
Normal subjects' physiological costs were found to be significantly lower than those of patients who needed
either a device or the help of a person to walk. All measured parameters correlated significantly with each
other. The MCS was found to be the most correlated parameter with the CIS (r=0.8), and therefore it must
be considered the best single measurement, if only one is to be used. Measurements more precise than MCS,
such as the physiological costs, may be necessary in clinical trials.
Between session reliability of intramuscular

electromyography for segments of gluteus medius
and minimus during gait and stepping tasks
Author links open overlay panelR.A.Greenab
T.PizzaribcJ.McClellandbcA.ZachariasabP.HuynhdN.WeerakkodyabA.I.Semciwbc
Abstract
Between-session reliability of electromyographic data is important for confidence in interpreting the role of
muscles in functional tasks but critical if these data are to be compared before and after an intervention that
seeks to change pathological patterns of muscle activity. The gluteus medius (GMed) and minimus (GMin)
are known to have functionally discrete segments that are highly active during stance phase of gait and
stepping tasks. This study measured the between-session reliability of activity patterns, mean amplitudes and
time to peak (TTP) activity of these muscle segments. Intramuscular electrodes were placed in 3 segments of
GMed and 2 segments of GMin in 10 healthy young adults for each of two testing sessions held two weeks
apart. Participants completed six repetitions of comfortable speed walking trials, step-up and step-down
tasks with activity patterns for each muscle segment time- and amplitude-normalized and averaged across
trials. Re-test reliability for was high for activity patterns (coefficient of mean correlation ranging from
0.890 to 0.998) across all tasks and muscle segments and only two pairwise comparisons showing
differences in amplitude between sessions. With standardized data collection and analysis procedures, GMed
and GMin muscle segment activity patterns show good between-session reliability for weightbearing tasks.

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