开链和闭链训练治疗膝关节半月板损伤

背景:开链训练和闭链训练均可应用于膝关节半月板损伤,然而两种方法的机制不一样,临床未见两种训练方法改善膝关节半月板损伤的报道。目的:观察开链训练和闭链训练对青年人膝关节半月板损伤疗效的影响。方法:49例青年人膝关节半月板损伤采用康复保守治疗的患者,随机数字表法将入选患者分为2组,生物反馈开链组(n=25)采用基础治疗联合终末伸膝生物反馈训练,蹬踏闭链组(n=24)采用基础治疗联合单侧下肢蹬踏训练。其中基础治疗包括电针、手法治疗、徒手运动疗法;生物反馈开链训练采用加拿大Thought公司生产的Myotrac infiniti生物反馈仪进行刺激训练;蹬踏闭链训练采用德国GYM80智能力量训练系统蹬踏配件进行训练。1次/d,连续3周。使用膝关节屈、伸、全关节活动度,目测类比评定级法评分、改良Lysholm膝关节评分、日常生活活动能力评分进行疗效评价。研究方案的实施符合四川省骨科医院的相关伦理要求,患者对试验过程完全知情同意。结果与结论:①在关节活动度方面:生物反馈开链组屈、伸、全关节活动度优于治疗前(P<0.05);蹬踏闭链组伸、全关节活动度优于治疗前(P<0.05);生物反馈开链组较蹬踏闭链组改善关节活动度较好,但组间差异无显著性意义(P>0.05);②在疼痛和功能方面:2组治疗后目测类比评定级法评分、改良Lysholm膝关节评分、日常生活活动能力评分优于治疗前(P<0.05);蹬踏闭链组治疗后日常生活活动能力评分好于生物反馈开链组(P<0.05);2组在改善膝关节活动度、疼痛和功能方面均有效果;③结果说明,生物反馈开链组在改善关节活动度方面疗效较好;在控制疼痛的基础上,蹬踏闭链组在改善膝关节功能和日常生活活动能力方面疗效较好。     

Electromyographic Analysis of Single-Leg,Closed Chain Exercises: Implications for Rehabilitation After Anterior Cruciate Ligament Reconstruction

OBJECTIVE: Many knee rehabilitation studies have examined open and closed kinetic chain exercises. However, most studies focus on 2-legged, closed chain exercise. The purpose of our study was to characterize 1-legged, closed chain exercise in young, healthy subjects. SUBJECTS: Eighteen normal subjects (11 men, 7 women; age, 24.6 +/- 1.6 years) performed unsupported, 1-legged squats and step-ups to approximately tibial height. MEASUREMENTS: Knee angle data and surface electromyographic activity from the thigh muscles were recorded. RESULTS: The maximum angle of knee flexion was 111 +/- 23 degrees for squats and 101 +/- 16 degrees for step-ups. The peak quadriceps activation was 201 +/- 66% maximum voluntary isometric contraction, occurring at an angle of 96 +/- 16 degrees for squats. Peak quadriceps activation was 207 +/- 50% maximum voluntary isometric contraction and occurred at 83 +/- 12 degrees for step-ups. CONCLUSIONS: The high and sustained levels of quadriceps activation indicate that 1-legged squats and step-ups would be effective in muscle rehabilitation. As functional, closed chain activities, they may also be protective of anterior cruciate ligament grafts. Because these exercises involve no weights or training equipment, they may prove more cost effective than traditional modes of rehabilitation.     

The role of limb torque, muscle action and proprioception during closed kinetic chain rehabilitation of the lower extremity

This paper defines the differences between open and closed kinetic chain exercise and explains the role of limb torque, muscle action, and proprioception during rehabilitation of the lower extremity. Closed kinetic chain rehabilitation is shown to decrease shear forces, increase proprioception, and increase muscle group coordination through examples of progressive exercises. The authors conclude that closed kinetic chain rehabilitation is an economical, efficient, and effective means of rehabilitation, with the ultimate goal of enhancing proprioception, thus gaining lower extremity joint stability.     

Fast voluntary trunk flexion movements in standing: motor patterns

The electromyographical (EMG) activity was studied during voluntary flexion movements of the trunk in erect standing man. The movements were performed at maximal velocity with successively increasing amplitude to cover the whole range of motion. The EMG activity was recorded from agonist-antagonist pairs of muscles at the ankle, knee, hip and trunk. The angular displacements at the corresponding joints were recorded using a Selspot optoelectronic system. The duration of initiating activity in prime movers (rectus abdominis and rectus femoris) as well as time to onset of activity in muscles braking the primary movement (erector spinae, gluteus maximus and hamstrings) were highly correlated with amplitude, duration, peak velocity and time to peak velocity of the movement (r = 0.59-0.91). The corresponding correlations for peak acceleration and deceleration of the movement were low (r = 0.03-0.38), indicating that acceleration and deceleration of a movement was not coded in the temporal aspects of the EMG. Onset of activity in rectus abdominis and rectus femoris as well as an early appearing burst of activity in vastus lateralis were invariant in relation to start of movement over the whole movement range. In the initial phase of a fast trunk flexion, activity in tibialis anterior appeared successively earlier with increasing movement amplitude. This resulted in a changed order of activation for the muscles from proximal to distal (rectus abdominis first) to distal to proximal (tibialis anterior first). Two different forms of associated postural adjustments are present during a fast trunk flexion, one early fast knee flexion and a later slower angle extension. Prior to knee flexion, no activity was recorded from muscles flexing at the knee implying that some other force must create a flexing torque around the knee. It is suggested that activity in rectus abdominis initiating the primary movement also initiates knee flexion through the upward pulling of pelvis. This would be possible since rectus femoris stabilizes the pelvis in relation to the leg, allowing the force in rectus abdominis to be transmitted below the hip joint and act extending around the ankle joint. However, when tibialis anterior is activated it stabilizes the shank which in turn will cause a knee flexion controlled by a lengthening contraction in vastus lateralis. During the subsequent ankle extension activity appears in lateral gastrocnemius and soleus causing the associated postural adjustment at the ankle. It can be concluded that activation of postural muscles prior to prime mover muscles is not always necessary.(ABSTRACT TRUNCATED AT 400 WORDS)     

EMG activities in mono- and bi-articular thigh muscles in combined hip and knee extension

Summary 8 male subjects were tested to elucidate the organization of EMG activities in mono- and bi- articular thigh muscles when hip and knee extension are combined. 2 types of isometric movement, single and dual joint movements, were studied: 1) 20% of maximal voluntary contraction (MVC) in separate hip extension (HE20) and knee extension (KE20), 2) simultaneous HE20 and KE20, combined voluntarily (HE20 · KE20). In HE20 · KE20, the value of the integrated EMG (IEMG) from the muscles tested was normalized as a percentage (%IEMG) of the IEMG of each muscle in HE20 for gluteus maximus (GM) and semimembranosus (SM), and in KE20 for vastus medialis (VM) and rectus femoris (RF). The average %IEMG was 50.5±16.9% for GM, 42.1±6.1% for SM, 153.4±22.8% for VM and 66.6±18.7% for RF. These data suggest that the EMG activities of GM, SM and RF are inhibited and the EMG activity of VM is facilitated by combining hip extension with knee extension.     

Reliability of leg muscle electromyography in vertical jumping

In this study we aimed to determine the reliability of the surface electromyography (EMG) of leg muscles during vertical jumping between two test sessions, held 2 weeks apart. Fifteen females performed three maximal vertical jumps with countermovement. The displacement of the body centre of mass (BCM), duration of propulsion phase (time), range of motion (ROM) and angular velocity of the knee and surface EMG of four leg muscles (rectus femoris, vastus medialis, biceps femoris and gastrocnemius) were recorded during the jumps. All variables were analysed throughout the propulsion and mid-propulsion phases. Intraclass correlation coefficients (ICC) for the rectus femoris, vastus medialis, biceps femoris and gastrocnemius were calculated to be 0.88, 0.70, 0.24 and 0.01, respectively. BCM, ROM and time values all indicated ICC values greater than 0.90, and the mean knee angular velocity was slightly lower, at 0.75. ICCs between displacement of the BCM and integrated EMG (IEMG) of the muscles studied were less than 0.50. The angular velocity of the knee did not correlate well with muscle activity. Factors that may have affected reliability were variations in the position of electrode replacement, skin resistance, cross-talk between muscles and jump mechanics. The results of this study suggest that while kinematic variables are reproducible over successive vertical jumps, the degree of repeatability of an IEMG signal is dependent upon the muscle studied.     

Neuromuscular Evaluation of Trunk-Training Exercises

OBJECTIVE: To evaluate the neuromuscular activation profiles of trunk muscles in commonly used gymnastic strength exercises with a polymyographic set-up and to describe the training effects of each exercise. DESIGN AND SETTING: Subjects performed 9 repetitions of each of 12 gymnastic exercises. Variations of 5 trunk flexions, 5 extensions, and 2 lateral-flexion movements were performed under standardized test conditions. SUBJECTS: Ten healthy subjects (men and women) who were familiar with the exercises participated in the study. MEASUREMENTS: We recorded surface electromyograms (EMGs) from the rectus abdominis, external oblique, rectus femoris, middle trapezius, erector spinae at T12 and L3, gluteus maximus, and semitendinosus and semimembranosus muscles. Recording of each repetition cycle was triggered by a flexible electronic goniometer attached to the trunk. The raw EMG signals were rectified, smoothed, amplitude normalized to maximal voluntary contraction (MVC), and averaged for the last 8 repetitions. RESULTS: Pure spine-flexion exercises, such as a curl-up, produced sufficient and isolated activation (greater than 50% MVC) of the abdominal muscles. When flexion of the spine was combined with hip flexion (sit-up), the peak activation was increased. Lateral-flexion tasks targeted primarily the external oblique muscle, which demonstrated high activity in side-lying flexion tasks. Back- and hip-extension exercises, such as bridging and diagonal hip and shoulder extension, produced only moderate mean activities (less than 35% MVC) in the trunk-extensor muscles. Trunk-extension exercises with combined hip extension increased the EMG activity to 50% MVC but only at the end of the extension. CONCLUSIONS: Individual responses to each exercise varied markedly, which complicated the classification of exercise effects. However, within the limitations of the study, we found that the chosen abdominal exercises provided an effective training stimulus for the trunk-flexor muscles, whereas in the back- and hip-extension exercises, the neuromuscular activation tended to be too low or unspecific to qualify as muscle-specific training.     

Lower extremity neuromuscular recovery following anterior cruciate ligament reconstruction; a 2-week case study

The lower extremity neuromuscular recovery of a 31-year-old male physical therapy student during the initial 2-weeks following anterior cruciate ligament reconstruction was evaluated by measuring involved side vastus medialis (VM), gluteus maximus (GMAX) and gastrocnemius (GASTROC) electromyographic (EMG) signals (1000 Hz), plantar forces (50 Hz), and knee pain as the subject performed a series of volitional, maximal effort unilateral, isometric leg presses (6 sec) in a modified continuous passive motion device. Data were standardized to pre-operative values and graphically plotted for split middle technique, celeration line assessment. From 1-8 hours post-surgery, EMG amplitudes and plantar forces decreased, pain increased, and plantar force location shifted toward the forefoot. From 9-12 hours post-surgery, EMG amplitudes and plantar forces increased and pain decreased. By 24 hours post-surgery, pain decreased to pre-operative levels. From 24-72 hours post-surgery, EMG amplitudes and plantar forces increased. From 1-2 weeks post-surgery, EMG amplitudes and plantar forces increased. From 9 hours-2 weeks post-surgery, plantar force location shifted toward the pre-operative location. Sequential increases were observed for GMAX, GASTROC, and VM EMG amplitudes. By 2 weeks post-surgery, plantar forces and VM EMG amplitudes remained reduced. Reduced plantar forces and VM EMG amplitude at 2 weeks post-surgery suggest a need for greater focus on restoring VM function before attempting closed kinetic chain exercises that require the full shock absorption capabilities of the quadriceps femoris muscle group.     

EMG differences between concentric and eccentric maximum voluntary contractions are evident prior to movement onset

This investigation addressed the question of whether the muscle activation signal prior to movement onset, as measured by surface EMG, differs if the contraction to be performed is concentric (shortening) or eccentric (lengthening). Specifically, the purpose was to determine if differences in knee extensor muscle EMG prior to voluntary maximum concentric and eccentric contractions and initiated from the same knee joint angle are evident at a time before muscle length changes could be influential. A protocol was designed using isokinetic knee extensions. The EMG of the vastus lateralis, vastus medialis, rectus femoris, and hamstrings muscles and the associated knee extension moment were measured during the isometric phase preceding the onset of dynamometer motion. During this isometric phase the muscles initially contracted under identical conditions, irrespective of whether the contraction was to be concentric or eccentric. The EMG of the eccentric contractions was significantly smaller than that of the concentric contractions. However, the rate of change of knee extension moment generally did not differ between the two conditions. This was found for both the monoarticular and multiarticular knee extensor muscles. The results suggest that initial differences between the EMG of maximum voluntary concentric and eccentric knee extensor contractions are selected a priori and support the contention that the central nervous system distinguishes between maximum eccentric and concentric contractions. The emergence of differences in activation prior to muscle length changes suggests supraspinal influences.     

膝骨关节炎患者肌电标准化方法的信度研究

目的 评估标准等长收缩(standard isometric contraction, SIC)与最大随意等长收缩(maximum voluntary isometric contraction, MVIC)应用于膝骨关节炎(knee osteoarthritis, KOA)患者肌电标准化的重测信度。方法 采用无线肌电测试系统收集KOA患者患侧腿在慢跑、SIC测试和MVIC测试时臀大肌、半腱肌、股直肌、股外侧肌、胫骨前肌、外侧腓肠肌和比目鱼肌的肌电数据。使用组内相关系数和95%置信区间评估重测信度。结果 KOA患者执行SIC测试时7块肌肉的重测信度均较好,执行MVIC测试时5块肌肉重测信度一般,2块肌肉重测信度较好,7块肌肉在SIC测试中的重测信度均高于MVIC测试;KOA患者慢跑时7块肌肉经SIC标准化后的重测信度均高于经MVIC标准化的重测信度,且股直肌经SIC标准化后的重测信度显著高于经MVIC标准化的重测信度。结论 对于KOA患者,SIC是一种比MVIC更为可靠的表面肌电标准化方案,具有较好的临床推广潜力。     

搂膝拗步膝踝关节预激活与共收缩的表面肌电分析

目的 分析长期太极拳练习者进行搂膝拗步和正常行走时下肢膝、踝关节肌群预激活与共收缩的表面肌电（surface electromyography, sEMG）特征,探讨太极预防跌倒的神经肌肉控制策略。方法 采用Vicon运动捕捉系统、Kistler测力板和Noraxon表面肌电图系统同步采集搂膝拗步和正常行走时股直肌、股二头肌、胫骨前肌、外侧腓肠肌的sEMG信号和体位信息。通过股直肌和股二头肌、胫骨前肌和外侧腓肠肌两对肌肉的积分肌电分别计算膝、踝关节预激活和共收缩。结果 与正常行走相比,搂膝拗步在4个阶段的平均用时显著增加;搂膝拗步在4个阶段内时间百分比存在显著性差异;搂膝拗步膝关节共收缩水平和预激活水平降低,踝关节共收缩水平和预激活水平升高。结论 长期的太极拳练习可能使膝关节周围肌肉的激活水平提高,增强肌肉群之间的协同作用,以帮助稳定关节。研究结果为神经肌肉控制障碍疾病的康复评估和训练提供参考。     

A biomechanical investigation of a single-limb squat: implications for lower extremity rehabilitation exercise

CONTEXT: Single-limb squats on a decline angle have been suggested as a rehabilitative intervention to target the knee extensors. Investigators, however, have presented very little empirical research in which they have documented the biomechanics of these exercises or have determined the optimum angle of decline used. OBJECTIVE: To determine the involvement of the gastrocnemius and rectus femoris muscles and the external ankle and knee joint moments at 60 degrees of knee flexion while performing a single-limb squat at different decline angles. DESIGN: Participants acted as their own controls in a repeated-measures design. PATIENTS OR OTHER PARTICIPANTS: We recruited 10 participants who had no pain, injury, or neurologic disorder. INTERVENTION(S): Participants performed single-limb squats at different decline angles. MAIN OUTCOME MEASURE(S): Angle-specific knee and ankle moments were calculated at 60 degrees of knee flexion. Angle-specific electromyography (EMG) activity was calculated at 60 degrees of knee flexion. Integrated EMG also was calculated to determine the level of muscle activity over the entire squat. RESULTS: An increase was seen in the knee moments (P < .05) and integrated EMG in the rectus femoris (P < .001) as the decline angle increased. A decrease was seen in the ankle moments as the decline angle increased (P = .001), but EMG activity in the gastrocnemius increased between 16 degrees and 24 degrees (P = .018). CONCLUSIONS: As the decline angle increased, the knee extensor moment and EMG activity increased. As the decline angle increased, the ankle plantar-flexor moments decreased; however, an increase in the EMG activity was seen with the 24 degrees decline angle compared with the 16 degrees decline angle. This indicates that decline squats at an angle greater than 16 degrees may not reduce passive calf tension, as was suggested previously, and may provide no mechanical advantage for the knee.     

The normal peak of electromyographic activity of the quadriceps femoris muscle in the stair cycle

The quadriceps femoris muscles of 18 subjects with no history of knee joint pathology were analysed climbing stairs. Temporal data was obtained from bilateral contact closing footswitches. Knee joint data was measured using a specially constructed flexible linkage-bar electrogonimeter. Electromyographic activity was obtained from bipolar Beckman surface electrodes placed on four components of the quadriceps femoris, vastus medialis oblique, vastus medialis longus, vastus lateralis and rectus femoris. Results showed that within the stair cycle, stance occupied 60% and swing 40%. Cadence values were greater during descending than ascending stairs. Joint angle data demonstrated 2 changes in direction of the angular motion of the knee joint in both ascending and descending. Electromyographic analysis identified a peak of EMG activity for each component of the quadriceps femoris in both ascending and descending stairs. Results identified the location of peak EMG activity at specific knee joint angles. The quadriceps components also demonstrated a regular sequence of recruitment. EMG amplitude levels obtained were higher in ascending than descending stairs. The results have clinical implications in the design of lower extremity prostheses and in the application of functional electrical stimulation.     

Adaptation of a foot plate for use in an isokinetic and isotonic leg press

The use of isokinetic equipment and the leg press exercise have been major components of rehabilitation for the past several years when redeveloping muscular strength. Recently, closed kinetic chain exercises have been shown to be more beneficial and have less adverse affects on the knee when rehabilitating a patient's lower extremity. The purpose of this article is to introduce the leg press foot plate to the rehabilitative community. This foot plate is a versatile piece of equipment that has been adapted for use with various isokinetic, isometric, and isotonic devices in order to do leg press exercises. The device allows for closed kinetic chain strengthening and testing from equipment typically used only for open kinetic chain activities.     

Dynamic and isometric protocols of knee extension: effect of fatigue on the EMG signal

The objective of this study was to analyze the electromyographic (EMG) signal behavior of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL) and biceps femoris (caput longum) (BFCL) from nine women during fatiguing dynamic and isometric knee extensions tests and to determine their EMGFT (Electromyographic Fatigue Threshold). Surface electrodes, biological signal acquisition module, analogical-digital converter board and specific software were used. The RMS (Root Mean Square) values obtained from concentric phase (80 to 30 degrees) of the dynamic knee extension and from isometric contraction were correlated with time on each load by linear regression analysis. The respective slopes were correlated with the correspondent load to determine the EMGFT. Force (Kgf) and median frequency--MF (Hz) obtained during MIVC (Maximal Isometric Voluntary Contraction) performed before and after the fatiguing tests were calculated in Matlab environment. The results demonstrated that the endurance time decreases with higher loads, the EMG amplitude increase with time and was greater at higher loads, between muscles in dynamic exercise the RF and VL showed higher slopes, and in isometric exercise the VL showed the same behavior. The EMGFT values were similar in both exercises; the force values predominantly decreased after fatiguing tests; however the MF only decreased after some loads. The protocols proposed allowed standardizing protocols at least to induce the fatigue process and to determine the EMGFT as an endurance indicative, which may be used to evaluate the effectiveness of rehabilitative or training interventions indicated to reduce muscle weakness and fatigue.     

Swimming in the rat: Analysis of locomotor performance in comparison to stepping

Summary Swimming in a mammalian quadruped, the rat, is analyzed in kinematic (joint angles) and electromyographic (EMG) terms. Data were collected on the movements of the hip, knee, ankle, and toe joints and three principle extensors and three flexors of the right hindlimb and compared with similar data collected on the same rats during treadmill stepping. The flexion, or protraction phase of swimming and stepping had many elements in common, including a similarity of EMG activity patterns and corresponding limb movements. However, in the extension, or retraction phase, there were notable differences. Although joint-extensor muscles were all coactive in both conditions, the brevity of the swimming extensor phase precluded the characteristic variation in EMG activity levels seen in the extensors in stepping. The flexors, in particular semitendinosus (ST), exhibited bursts of activity at the end of the extensor phase of swimming which were not present during the comparable period of stepping. The extra burst in ST produced a very rapid knee flexion at this time. Whereas the range of hip joint movement was similar in the two conditions, the ranges of the knee and ankle joints were expanded during swimming.Overall, the evidence suggests that swimming is a very rapid form of a basic locomotor pattern in which the extensors are driven to their maximum contraction rate. The extra extension of the limb derives from the absence of ground reaction forces, allowing the knee and ankle joints to fully extend. The added bursts in the flexors remain to be explained. A discussion of these results in terms of current theories of single limb locomotor pattern generation is presented.     

Tibial displacement and rotation during seated knee extension and wall squatting: A comparative study of tibiofemoral kinematics between chronic unilateral anterior cruciate ligament deficient and healthy knees

BackgroundFollowing anterior cruciate ligament (ACL) rupture, the knee becomes unstable with alterations in joint kinematics including anterior tibial displacement (ATD), and internal tibial rotation. Therapeutic exercises that promote faulty kinematics should be discouraged, especially early post-reconstruction, to avoid graft stretching and possibly longer-term osteoarthritis. Our study aimed to compare ATD and tibial rotation during two commonly prescribed exercises, namely: open kinetic chain (OKC) seated extension and closed kinetic chain (CKC) single leg wall squatting in ACL-deficient and healthy knees.MethodsEight ACL-deficient patients and eight healthy subjects matched for age, gender and sports history were assessed using Qualisys 3D-Motion Analysis System to track 17 infrared markers while performing a seated knee extension with 3 kg weight and a unilateral wall squat. We developed a model to measure joint kinematics through 70° of knee flexion and extension. ANOVA and paired t-tests compared relative ATD and tibial rotation between exercises and groups at 10° increments of flexion and extension.ResultsWe found increased ATD in the wall squat compared to the seated extension (p = 0.049). There was no difference in ATD between the healthy and ACL-deficient knees but overall the tibia was significantly more internally rotated (p = 0.003) in ACL-deficient knees, irrespective of the exercise, possibly interfering with the screw-home mechanism.ConclusionsCKC exercises, in particular wall squats, are not necessarily safer for patients with ACL-deficiency and possibly ACL-reconstruction; although generalization should only be made with appropriate caution. Clinicians require a detailed knowledge of the effect of exercise on knee joint kinematics.     

Electromyographic validation of the double pulley equipment during movements of the lower limbs

The double pulley equipment was tested on ten male volunteers during contraction of the semitendinosus and biceps femoris (caput longum) muscles in the following movements of the lower limbs: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. The myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. The semitendinosus and biceps femoris muscles presented the highest potentials in movements 1; 2; 7, 8 and 9, whereas the potentials in the remaining movements were negligible. The pattern of activity of the semitendinosus and the biceps femoris was similar in exercises 1, 2, 3, 4 and 8. The potentials of the semitendinosus prevailed in movements 5, 6 and 7, and the strongest potentials observed in movement 9 were those of the biceps femoris.     

Activation of agonist and antagonist muscles at different joint angles during maximal isometric efforts

The purpose of this study was to investigate the influence of different angles of the knee joint on the activation level of an agonist (quadriceps femoris muscle) and antagonist (biceps femoris muscle) from electromyographic activities and activation levels (twitch interpolation). Isometric torque measurements were performed on 23 healthy subjects at 10° intervals between 40° and 110° of knee joint flexion. Superimposed twitches at maximal voluntary contraction were applied and the voluntary activation estimated. To quantify the antagonist muscle activity, we normalized its integrated EMG (iEMG) value at each joint angle with respect to its iEMG value at the same angle when acting as an agonist at maximal effort. The activation levels at the knee-flexed position (80–110°) were higher than that at the knee-extended position (40–70°). The co-activation levels at 90, 100, and 110° were significantly higher than that the other knee angle. These results suggest that the activation level of an agonist (quadriceps femoris) muscle and the co-activation level of an antagonist (biceps femoris) muscle were higher in longer muscles than in shorter muscles. It was also concluded that the risk of knee injuries could be reduced by applying these mutual relationships between activation levels of agonist and antagonist muscles.     

Synergists activation pattern of the quadriceps muscle differs when performing sustained isometric contractions with different EMG biofeedback

The aims of the present study were to examine (1) endurance time and (2) activation pattern of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles during fatiguing isometric knee extensions performed with different EMG biofeedbacks. Thirteen men (27 ± 5 year) volunteered to participate in three experimental sessions. Each session involved a submaximal isometric contraction held until failure at an EMG level corresponding to 40% maximal voluntary contraction torque (MVC), with visual EMG biofeedback provided for either (1) RF muscle (RF task), (2) VL and VM muscles (Vasti task) or (3) the sum of the VL, VM and RF muscles (Quadriceps task). EMG activity of VL, VM and RF muscles was recorded during each of the three tasks and further analyzed. Time to task failures and MVC loss (P < 0.001) after exercises were similar (P > 0.05) between the three sessions (182 s and ∼28%, respectively) (P > 0.05). Moreover, the magnitude of central and peripheral fatigue was not different at failure of the three tasks. Activation pattern was similar for knee extensors at the beginning of each task (P > 0.05). However, RF EMG activity decreased (P < 0.05) during the Vasti and the Quadriceps tasks (from ∼33 to ∼25% maximal EMG), whereas vasti EMG activity remained constant during the RF task (∼41% maximal EMG). These findings suggest that (1) task failure occurs when sustaining a submaximal level of EMG activity for as long as possible and (2) CNS is not able to differentiate descending drive to the different heads of the quadriceps at the beginning of a sustained contraction, despite a different activation pattern for the bi-articular RF muscle compared to the mono-articular vasti muscles during fatigue.