A method for positioning electrodes during surface EMG recordings in lower limb muscles

PURPOSE: The aim of this work is to provide information about the degree of inter-subject uniformity of location of innervation zone (IZ) in 13 superficial muscles of the lower limb. The availability of such information will allow researchers to standardize and optimize their electrode positioning procedure and to obtain accurate and repeatable estimates of surface electromyography (sEMG) signal amplitude, spectral variables and muscle fiber conduction velocity. METHODS: Surface EMG signals from gluteus maximus, gluteus medius, tensor faciae latae, biceps femoris, semitendinosus, vastus medialis obliquus, vastus lateralis, rectus femoris, tibialis anterior, peroneus longus, soleus, gastrocnemius medialis and lateralis muscles of ten healthy male subjects aged between 25 and 34 years (average = 29.2 years, S.D. = 2.5 years) were recorded to assess individual IZ location and signal quality. RESULTS: Tensor faciae latae, biceps femoris, semitendinosus, vastus lateralis, gastrocnemius medialis and lateralis showed a high level of both signal quality and IZ location uniformity. In contrast, rectus femoris, gluteus medius and peroneus longus were found to show poor results for both indexes. Gluteus maximus, vastus medialis obliquus and tibialis anterior were found to show high signal quality but low IZ location uniformity. Finally, soleus muscle was found to show low signal quality but high IZ location uniformity. CONCLUSIONS: This study identifies optimal electrode sites for muscles in the lower extremity by providing a standard landmarking technique for the localization of the IZ of each muscle so that surface EMG electrodes can be properly positioned between the IZ and a tendon.     

The role of the biarticular agonist and cocontracting antagonist pair in isometric muscle fatigue

Isometric knee extensions until exhaustion at 30%, 50%, and 70% of maximum voluntary contraction were performed by 18 healthy subjects. During muscle fatigue, surface electromyographic activity was recorded from the knee-extensors vastus lateralis, vastus medialis, and rectus femoris, and the coactive antagonistic biceps femoris. The electromyographic parameter median frequency (MF) served as a measure of fatigue. Coefficients of regression of the MF fatigue changes were analyzed statistically. MF fatigue occurred within the coactive biceps femoris and was significantly more pronounced than in the quadriceps. When the MF fatigue shifts of the coactive biceps femoris were compared with each of the three investigated parts of the quadriceps separately, MF fatigue shifts were similar in shape for the biarticular coactive biceps femoris and the biarticular rectus femoris, but differed significantly between the biceps femoris and the two monoarticular muscles, vastus medialis and vastus lateralis. As both the biarticular agonist and coactive antagonist muscles fatigued at a higher rate than the two monoarticular muscles, it seems likely that this biarticular agonist/antagonist pair determines the time to the limit of endurance. © 1998 John Wiley & Sons, Inc. Muscle Nerve 21: 1706–1713, 1998     

Response synergies over a single leg when it is perturbed during the complex rhythmic movement of pedalling

Previous studies report that perturbing the posture of humans evokes specific patterns of muscular synergies in the legs. This study investigated the pattern of muscular responses of a whole limb when it was rapidly perturbed in the phase of extending during stationary pedalling. Subjects were instructed to resist. Accordingly, we anticipated increased extensor activity at knee and ankle to overcome the perturbation. This did not occur in the initial responses, appearing at latencies of 85-132 ms (mean = 104 ms). In contrast, there was facilitation in tibialis anterior, and the knee extensors vastus medialis and rectus femoris, together with profound inhibition of the ankle extensors soleus and lateral gastrocnemius. The anticipated extensor response across the limb appeared in the subsequent pattern of electromyogram (EMG) activity, with latencies ranging from 121 to 195 ms (mean = 168 ms), together with a large increase in propulsive force on the pedal. The difference in EMG patterns and latencies between initial and subsequent synergies was used to separate the responses into an earlier 'prevolitional' and a later 'volitional' component.     

Muscle MRI findings of X-linked spinal and bulbar muscular atrophy

We report here muscle MRI findings of the lower limb in X-linked spinal and bulbar muscular atrophy (SBMA). T1-weighted imaging of muscle MRI disclosed that the thigh muscles, including the semimembranosus, biceps femoris longus and the vastus lateralis muscles, showed high intensity signals with atrophy. Contrarily, the sartorius, gracilis and rectus femoris muscles were comparably preserved. Not only the thigh muscles, but also the calf muscles including the gastrocnemius medialis and lateralis, and soleus muscles showed high intensity signals. In amyotrophic lateral sclerosis (ALS), the leg muscles are generally atrophic, but the selective pattern of fatty degeneration, seen in SBMA was not observed. Muscle MRI is a useful method of estimating the distribution and severity of SBMA in affected muscles.     

Reliability of the log‐transformed EMG amplitude‐power output relationship for incremental knee‐extensor ergometry

Introduction: The purpose of this investigation was to determine the reproducibility of the log‐transformed model for electromyography (EMG) amplitude during incremental single‐leg knee‐extensor exercise. Methods: Eight healthy college‐aged men performed 3 incremental tests on separate occasions on a knee‐extensor ergometer. EMG amplitude was analyzed for each participant on each occasion for the rectus femoris and vastus medialis muscles at 4 different exercise power outputs (30%, 50%, 70%, and 90%) corresponding to each participant's maximal power output. Intraclass correlation coefficients (ICC) were determined for the slope and y‐intercept terms derived from the log‐transformed EMG amplitude‐power output relationship for each muscle. Results: The ICC values for the rectus femoris (slope = 0.779; y‐intercept = 0.787) and vastus medialis (slope = 0.756; y‐intercept = 0.763) muscles were high. Conclusions: The log‐transformed EMG amplitude‐power output relationship is a reliable index for measuring motor unit activation. Muscle Nerve 52:428–434, 2015     

Reliability of surface electromyographic measurements.

OBJECTIVES: The aim of the study was to investigate short-term, intermediate-term and long-term reliability of surface electromyographic (EMG) measurements. METHODS: Eighteen healthy subjects performed 810 isometric knee extension tests. Reliability for maximum voluntary contraction (MVC) and 50% MVC was assessed with retest intervals of 3 min, 90 min and 6 weeks. Reliability for sustained contractions was assessed with retest intervals of 90 min and 6 weeks. EMG was recorded from the rectus femoris, vastus lateralis and vastus medialis muscles. The root mean square (RMS) and the median frequency (MF) parameters were extracted. At sustained contraction tasks, estimated linear regression values of both parameters were analyzed. Bland-Altman-plots, coefficient of repeatability, Pearson's coefficient of correlation and intra class correlation (ICC) procedures were applied to assess test-retest reliability. RESULTS: EMG recordings taken at short-term intervals were generally better reproducible than those of the longer-term intervals. Moreover, 50% MVC EMG recordings demonstrated better reproducibility than 100% MVC measurements, and EMG recorded from the rectus femoris were more constant than that from the vastus lateralis or vastus medialis. The MF parameter recorded from the rectus femoris was the only reliable parameter of EMG fatigue change. CONCLUSION: In our set up, EMG measurement is best suited for clinical applications if submaximal MVC measurements are performed and signal is taken from rectus femoris muscle.     

Modular organization of human leg withdrawal reflexes elicited by electrical stimulation of the foot sole.

Human withdrawal reflex receptive fields were determined for leg muscles by randomized, electrical stimulation at 16 different positions on the foot sole. Tibialis anterior, gastrocnemius medialis, peroneus longus, soleus, rectus femoris, and biceps femoris reflexes, and ankle joint angle changes were recorded from 14 subjects in sitting position. Tibialis anterior reflexes were evoked at the medial, distal foot and correlated well with ankle dorsal flexion. Gastrocnemius medialis reflexes were evoked on the heel and correlated with plantar flexion. Stimulation on the distal, medial sole resulted in inversion (correlated best with tibialis anterior activity), whereas stimulation of the distal, lateral sole evoked eversion. Biceps femoris reflexes were evoked on the entire sole followed by a small reflex in rectus femoris. A detailed withdrawal reflex organization, in which each lower leg muscle has its own receptive field, may explain the ankle joint responses. The thigh activity consisted primarily of flexor activation.     

Activation linearity and parallelism of the superficial quadriceps across the isometric intensity spectrum

The purpose of this study was to assess neuromuscular activation of the three superficial portions of the quadriceps femoris muscles during linearly increasing isometric contraction intensities. Thirty healthy volunteers were assessed for isometric electromyographic (EMG) activity of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) muscles with the knee at 60 degrees of flexion. For 5 s, subjects performed isometric contractions equivalent to 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% of the average of three maximal voluntary contractions (MVC), in random order. Full-wave rectified and integrated EMG signals over the middle 3 s of each contraction were expressed as a percentage of the activity recorded during the three averaged MVCs. One sample t-tests and 95% confidence intervals were calculated at each relative torque level. A two-factor analysis of variance (muscle by intensity) with repeated measures was performed to evaluate parallel activation across the intensity levels. Activation linearity was assessed via regression analysis for each muscle. VM activation was shown to be significantly lower than expected at 20-70% MVC. VL and RF activations were significantly higher than expected at 10% MVC, and RF EMG was less than expected at 40-70% MVC. EMG of VM was shown to increase significantly more than VL and RF from 80% to 90% MVC. Significant linear and quadratic relations were also demonstrated for all three muscles. Parallel activation of the superficial quadriceps muscles occurred from low to moderate intensities, whereas convergence was noted at near maximal intensities.     

Knee extensor torque,work, and EMG during subjectively graded dynamic contractions

We examined knee extensor peak torque, work, and electromyogram (EMG) during dynamic contractions to perceived exertion levels in men and women. Thirty subjects performed three maximal effort isokinetic knee extensions (60 deg x s(-1)), followed by three contractions to each of nine separate levels of perceived exertion. Surface EMG of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF), and knee extensor peak torque and work were normalized to a percent of each respective value obtained during the maximal effort contractions. The results demonstrated a significant linear increase in voluntary knee extensor peak torque and work across perceived exertion levels. Knee extensor peak torque and work were less than 70%, 80%, and 90% maximal voluntary contraction (MVC) at perceived exertion levels 7, 8, and 9, respectively. A significant increase in VM, VL, and RF muscle EMG was observed across perceived exertion levels 1 through 9, with EMG increase highest for the VL. The findings demonstrate that dynamic contractions guided by perceived exertion are underproduced at relatively high perceptual intensities, and that reliance on VL activation occurs across submaximal torque levels. The overestimation of knee extensor peak torque and work at relatively high perceptual intensities may suggest the presence of a subconscious mechanism aiming to reduce high muscle and joint forces.     

Congenital focal muscle dysplasia in the lower extremities from probable abnormal innervation: a case report.

A two-year-seven-month-old girl with pes equinovarus congenita, muscle hypotonia and weakness limited to the lower extremities is presented. Upon admission to our hospital, she could stand with support but could not walk alone. Serum creatine kinase level was normal and the electromyogram was nondiagnostic. The muscle CT disclosed an almost total absence of bilateral vastus lateralis and medialis, rectus femoris and gastrocnemius muscles. The biopsied vastus lateralis muscle was almost completely replaced by fat tissue, and a small amount of muscle tissue showed uniform type 1 fiber and an aggregate of atrophic fibers in one fascicle. Because of an absence of progressive muscle weakness and neurogenic EMG findings, the authors conclude that the muscle pathology was due to the congenital anomalous condition of probable abnormal innervation to developing muscles.     

Soleus and vastus medialis H-reflexes: similarities and differences while standing or lying during varied knee flexion angles

The H-reflex may be a useful measure to examine the lower extremity muscles activation and inhibition following an injury. Recording the vastus medialis H-reflex amplitudes in healthy subjects while standing or lying during varied knee flexion angles may establish a reference for comparison for patients with ACL injury. Vastus medialis and soleus H-reflexes were recorded from 14 healthy subjects while lying and standing during 0, 30, 45, and 60 degrees knee flexion. EMG unit was used to electrically stimulate the tibial and femoral nerves (using 0.5 ms pulses at 0.2 pps of H-maximum amplitude) and to record four traces of the soleus and vastus medialis H-wave and one trace of the M-wave peak-to-peak amplitudes. Repeated measures three-way ANOVAs were calculated with the global alpha=0.05. Results showed that (1) the average soleus H-reflex amplitude was significantly less during standing than lying across all knee flexion conditions, (2) the average vastus medialis H-reflex amplitudes showed no measurable significant differences between neutral standing compared with lying, (3) the average vastus medialis H-reflex amplitudes were significantly greater during standing knee flexion conditions (30, 45, and 60 degrees ) than lying or neutral standing, and (4) there were no differences between soleus and vastus medialis H-reflex amplitudes during lying across all knee flexion conditions. Data from H/M ratio follow the same pattern of H-amplitude. Recording the vastus medialis H-reflex amplitude during standing and knee flexion may be a reflective of the knee function. It is more specific than the soleus H-reflex because it reflects the changes in the excitability of the quadriceps motoneurons acting directly around the knee joint.     

Inverse activation between the deeper vastus intermedius and superficial muscles in the quadriceps during dynamic knee extensions

Introduction: We sought to determine the neuromuscular activation patterns of 4 synergistic muscles of the quadriceps femoris (QF), including the vastus intermedius (VI) muscle, during dynamic knee extensions. Methods: Nine healthy men performed dynamic knee extensions in the range of 20–100% of the one‐repetition maximum (1RM) load. Surface electromyography (EMG) was recorded from the 4 muscles of the QF. Results: The normalized EMG amplitude of the VI was significantly higher at knee joint angles between 90° and 115° during both the concentric and eccentric phases, and it was significantly lower between 140° and 165° during concentric and eccentric phases, compared with those of vastus lateralis at 60–100% of 1RM load (P < 0.05). Conclusions: These results suggest that the VI plays a key role during dynamic knee extension with flexed joint angles and specifically contributes to the initial concentric and final eccentric phases of knee joint movements. Muscle Nerve 47: 682–690, 2013     

Comparison of electromyographic responses for the superficial quadriceps muscles: Cycle versus knee‐extensor ergometry

The purpose of this study was to compare the electromyographic (EMG) amplitude and mean power frequency (MPF) versus power output relationships for the three superficial quadriceps muscles during incremental cycle (CE) and knee‐extensor (KE) ergometry in the same subjects. Eight men performed incremental CE and KE tests to exhaustion. Surface EMG signals were recorded simultaneously from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM). Polynomial regression analyses on a subject‐by‐subject basis indicated that the relationship between EMG amplitude versus power output was best‐fit with either a linear, quadratic, or cubic model for CE, whereas the relationship was best‐fit with a linear model for all subjects for the KE test. No consistent relationship was found for EMG MPF within subjects and between muscle groups for CE or KE. Compared with CE, however, the EMG amplitude during KE exercise was, on average, approximately 87% and 30% higher for the RF and VM muscles, respectively. These results suggest that KE exercise may be a better mode of examining EMG amplitude in the quadriceps muscle during incremental exercise than traditional CE. Muscle Nerve, 2009     

MRI in DNM2-related centronuclear myopathy: evidence for highly selective muscle involvement

Dynamin 2 has recently been recognized as a causative gene for the autosomal dominant form of centronuclear myopathy (dominant centronuclear myopathy). Here we report an affected father and daughter with dynamin 2 related AD CNM with predominantly distal onset of weakness. In addition to the diagnostic central location of myonuclei the muscle biopsy also showed core-like structures. Muscle MRI in the lower leg revealed prominent involvement of the soleus, but also of the gastrocnemius and the tibialis anterior whereas in the thigh there was a consistent pattern of selective involvement of adductor longus, semimembranosus, biceps femoris, rectus femoris, and vastus intermedius with relative sparing of vastus lateralis and medialis, sartorius, gracilis, and partly of the semitendinosus. These characteristic findings on muscle MRI confirm similar findings reported for CT imaging in dynamin 2 related dominant centronuclear myopathy and may help to differentiate this disorder from central core disease and other myopathies.     

Shifts in EMG spectral power during fatiguing dynamic contractions

Introduction: We examined the etiology of the electromyographic (EMG) spectral shift during dynamic fatigue. Methods: Nineteen subjects (mean ± SD age = 22.4 ± 1.6 years) performed 50 consecutive maximal concentric isokinetic contractions of dominant leg extensors. Surface EMG signals were detected from the vastus lateralis, rectus femoris, and vastus medialis during each contraction, processed with a wavelet analysis, and the resulting spectra were decomposed with a nonparametric spectral decomposition procedure. Results: The results indicated that the decreases in EMG frequency during the 50 contractions were generally due to reductions in high‐frequency power and increases in low‐frequency power. In addition, the spectral shifts were most pronounced for the rectus femoris, followed by the vastus lateralis, and then the vastus medialis. Conclusions: The spectral decomposition procedure is much more sensitive for tracking dynamic fatigue than is EMG mean frequency or median frequency. Muscle Nerve 50 : 95–102, 2014     

Surface EMG crosstalk between knee extensor muscles: experimental and model results

Surface electromyographic (EMG) crosstalk between vastus lateralis, vastus medialis, and rectus femoris muscles was evaluated by selective electrical stimulation of one muscle and recording from the stimulated and another muscle with linear surface arrays of eight electrodes. The ratio between the amplitude of the signals recorded over nonstimulated and stimulated muscles and their correlation coefficient were used as indices to quantify crosstalk. Single-differential and double-differential detection systems were used with interelectrode distances in the range 10-40 mm. The multichannel EMG signals clearly showed that crosstalk is largely due to nonpropagating potentials that correspond in time to the end of the propagation of the action potentials generated by the stimulated muscle. The crosstalk signal increased with increasing interelectrode distance and was statistically higher for single- than for double-differential recordings. The correlation-based indices of crosstalk were poorly correlated with the amplitude-based indices. Moreover, the characteristic spectral frequencies of the signals detected over the nonstimulated muscles were statistically higher than those from the stimulated muscles. A mathematical model of signal generation was used to explain the experimental findings. This study clarifies many controversial findings of past investigations and creates the basis for crosstalk interpretation, simulation, and reduction.     

The action of the rectus femoris muscle following distal tendon transfer: does it generate knee flexion moment?

Rectus femoris transfer surgery involves detaching the rectus femoris from the patella and reattaching it posterior to the knee. While this procedure is thought to convert the rectus femoris from a knee extensor to a knee flexor, the moments generated by this muscle after transfer have never been measured. We used intramuscular electrodes to stimulate the rectus femoris in four subjects, two after transfer to the semitendinosus and two after transfer to the iliotibial band, while measuring the resultant knee moment.
Electromyographic activity was monitored in the quadriceps, hamstrings, and gastrocnemius muscles to verify that the rectus femoris was the only muscle activated by the stimulus. We found that the rectus femoris generated a knee extension moment in all of the subjects tested. This finding suggests that transfer surgery does not convert the rectus femoris to a knee flexor, and that a mechanism exists which may transmit the force generated by the rectus femoris anterior to the knee joint center after distal tendon transfer.     

Inhibition of dynamic thigh muscle contraction by electrical stimulation of the posterior cruciate ligament in humans.

We investigated the influence of electrical stimulation of the posterior cruciate ligament (PCL) on the motoneuron pool of the thigh muscle during voluntary static and dynamic muscle contraction. The study group comprised nine young men with no history of injury to the knee joints. Multistranded Teflon-insulated stainless-steel wires were inserted into the PCL guided by ultrasound. In three subjects wires were also inserted into the fat pad of the knee. The PCL was electrically stimulated during static, concentric, or eccentric muscle contraction with a constant load of 20% of the maximal voluntary contraction of either the quadriceps or the hamstrings. Electromyographic signals were recorded with bipolar surface electrodes placed over the vastus medialis, rectus femoris, vastus lateralis, biceps femoris caput longum, and semitendinosus muscles. The stimuli consisted of four pulses delivered at 200 HZ; the stimulus amplitude was two to three times the sensory threshold. The electrical stimulation of the PCL inhibited the ongoing muscle activity in both the quadriceps and hamstrings with latencies of 114-150 ms and 99-130 ms, respectively. Stimulation of the fat pad of the knee did not influence the muscle activity. The study suggests that the mechanoreceptors in the PCL are involved in controlling muscle activity during both static and active muscle contractions. The relative long latency of the reflex makes it unlikely that it can serve as a directly protective reflex for the cruciate ligaments.     

EMG spectral differences among the quadriceps femoris during the stretch reflex

Introduction: The purpose of this study was to examine the electromyographic (EMG) spectral characteristics of the quadriceps femoris muscles during tendon tap stretch reflexes. Methods: Sixteen healthy subjects (mean ± SD age = 21.2 ± 2.8 years) performed tendon tap reflexes of the leg extensors as surface EMG signals were detected from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles of the dominant thigh. All EMG signals were processed with a wavelet analysis, and the resulting spectra were decomposed with nonparametric spectral decomposition. Results: The results showed that the spectra for the VL had significantly more high‐frequency power than those for the RF and VM, with similar spectral shapes for the RF and VM. Conclusions: These findings could be due to differences in the width of the innervation zone, or the fiber type composition of the muscles, although the latter seems to be more likely. Muscle Nerve 52 : 826–831, 2015     

Control of fast squatting movements after stroke

ObjectiveLittle is known about how residual motor impairments after stroke affect the motor control of fast movements, particularly those that combine postural control and limb movement. The purpose of this study was to examine the influence of stroke on the motor control of fast squatting movements.MethodsSeventeen individuals with hemiparesis and seventeen age- and sex-matched controls performed fast squatting movements. Force platform data, knee acceleration, and electromyographic activity from rectus femoris, biceps femoris, tibialis anterior, soleus, were collected.ResultsSubjects after stroke performed the squats asymmetrically, with reduced velocity and acceleration compared to controls. Subjects with low motor recovery depended on the non-paretic leg to compensate for poor paretic muscle activation whereas subjects with high motor recovery activated muscles in the paretic leg in an adaptive manner, making the movement more symmetrical. Difficulty with postural control was evident by reduced coupling of the timing of the knee movement with the center of pressure excursion.ConclusionsSlow performance of squatting movements was accompanied by altered muscle activation, coupled with impaired postural control.SignificanceFast squatting movements in standing require appropriate muscle activation and postural control, the latter of which can be measured easily with force platform and accelerometer data.