Magnetic resonance imaging of the tensor vastus intermedius: A topographic study based on anatomical dissections

The tensor of the vastus intermedius (TVI) is a newly described component of the extensor apparatus of the knee joint. The objective of this study was to evaluate the appearance of the TVI on magnetic resonance (MR) imaging and its association with the adjacent vastus lateralis (VL) and vastus intermedius (VI) muscles and to compare these findings with the corresponding anatomy. MR images were analyzed from a cadaveric thigh where the TVI, as part of the extensor apparatus of the knee joint, had been dissected. The course of the TVI in relation to the adjacent VL and VI was studied. The anatomic dissection and MR imaging revealed a multilayered organization of the lateral extensor apparatus of the knee joint. The TVI is an intervening muscle between the VL and VI that combined into a broad flat aponeurosis in the midthigh and merged into the quadriceps tendon. Dorsally, the muscle fibers of the TVI joined those of the VL and VI and blended into the attachment at the lateral lip of the linea aspera. In this area, distinguishing between these three muscles was not possible macroscopically or virtually by MR imaging. In the dorsal aspect, the onion‐like muscle layers of the VL, TVI, and VI fuse to a hardly separable muscle mass indicating that these muscles work in conjunction to produce knee extension torque when knee joint action is performed. Clin. Anat. 30:1096–1102, 2017. © 2017 Wiley Periodicals, Inc.     

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.     

Human skeletal muscle fibre types and force: velocity properties

It has been reported that there is a relationship between power output and fibre type distribution in mixed muscle. The strength of this relationship is greater in the range of 3–8 rad · s^–1 during knee extension compared to slower or faster angular knee extensor speeds. A mathematical model of the force: velocity properties of muscle with various combinations of fast- and slow-twitch fibres may provide insight into why specific velocities may give better predictions of fibre type distribution. In this paper, a mathematical model of the force: velocity relationship for mixed muscle is presented. This model demonstrates that peak power and optimal velocity should be predictive of fibre distribution and that the greatest fibre type discrimination in human knee extensor muscles should occur with measurement of power output at an angular velocity just greater than 7 rad · s^–1. Measurements of torque: angular velocity relationships for knee extension on an isokinetic dynamometer and fibre type distribution in biopsies of vastus lateralis muscles were made on 31 subjects. Peak power and optimal velocity were determined in three ways: (1) direct measurement, (2) linear regression, and (3) fitting to the Hill equation. Estimation of peak power and optimal velocity using the Hill equation gave the best correlation with fibre type distribution (r > 0.5 for peak power or optimal velocity and percentage of fast-twitch fibres). The results of this study confirm that prediction of fibre type distribution is facilitated by measurement of peak power at optimal velocity and that fitting of the data to the Hill equation is a suitable method for evaluation of these parameters.     

Growth trend of the quadriceps femoris muscle in junior Olympic weight lifters: an 18-month follow-up survey

Isometric torque and the cross-sectional area (CSA) of the quadriceps femoris muscle (QF) were measured twice at an interval of 18 months in seven junior Olympic weight lifters (aged 15.5–17.1 years at the start of the study) to investigate the growth trend of this muscle group in junior athletes specializing in strength and power events. The CSAs of the QF and its four constituent muscles were determined at 30% (proximal to the knee), 50%, and 70% of femur length (Fl) using a magnetic resonance imaging method. Only at 30%Fl were significant increases found in the CSAs of the QF and all constituent muscles, except for the rectus femoris. At this level, the CSA of the vastus medialis relative to the QF decreased significantly, suggesting a predominant hypertrophy in the vastus intermedius and vastus lateralis muscles. Isometric torque during knee extension increased significantly compared, to the CSA for the QF measured at the three levels. Thus, the present results indicate that, at least at high school age, the QF for junior Olympic weight lifters is characterized by a preferential hypertrophy at the level proximal to the knee joint, with an increase in knee extension torque relative to the CSA. Electronic Publication     

A method for the determination of the force-length relation of selected in-vivo human skeletal muscles

In this paper a method is presented to determine force-length relations of in-vivo human skeletal muscles. The method is experimental and can be used for selected multi-joint muscles. It contains three basic assumptions: (a) the maximal, isometric force a muscle can exert is constant for a given muscle length, (b) antagonistic muscle activity for the experimental contractions is constant, and (c) resultant joint moments obtained during the experiments are produced by muscular forces exclusively. Experimentally determined force-length relations of intact in-vivo human skeletal muscles have not been determined yet. Application of this method will allow the comparison of actual force-length relations of selected human skeletal muscles to force-length relations used previously. Proposed mechanisms responsible for the force-length characteristics of a muscle, such as the cross-bridge theory, may be critically evaluated. Differences of force-length relations obtained under in vivo and in vitro conditions may be quantified.     

Motor patterns of a fast voluntary postural task in man: trunk extension in standing

The co-ordination between muscles controlling the primary movement and associated postural adjustments during fast trunk extension movements was studied in six male subjects. Myoelectrical activity (EMG) was recorded from antagonistic muscle pairs at the trunk, hip, knee and ankle. Horizontal displacements of the upper trunk, hip and knee were recorded with an opto-electronic system (Selspot). A backward displacement of the trunk was accompanied by a forward displacement of the hip and knee. In general, the trunk started to move 30 ms before the hip and knee. Muscle activity first appeared in the ankle extensors (soleus/gastrocnemius) up to 150 ms prior to onset of prime mover muscles (trunk extensor, erector spinae; and hip extensors/knee flexors, hamstrings). This pre-activation was seldom followed by any detectable ankle joint movement. Prime mover muscles were activated simultaneously followed by the hip extensor gluteus maximus. Time to activation of muscles braking the movement (rectus abdominis, rectus femoris and vastus lateralis) was correlated with the amplitude of the primary movement (r = 0.63 0.75, P less than 0.01). Onset of activity in vastus lateralis was highly correlated with the amplitude of the forward displacement of the knee (r = 0.93, P less than 0.01). An associated postural adjustment appeared as an ankle flexion accompanied by activity in the ankle flexor tibialis anterior, and often also in the ankle extensors. This co-activation of antagonistic ankle muscles can under certain conditions have interesting functional implications for the control of posture.     

Antagonist moment of force during maximal knee extension in pubertal boys: effects of quadriceps fatigue

The examination of the moment exerted by the hamstrings during maximum isokinetic knee extensor tests is useful when comparing isokinetic strength and muscle activity patterns between children and adults. The purpose of this study was to examine the effect of antagonist moment of the hamstrings on the isokinetic moment of the knee extensors in pubertal children and to determine whether this effect is altered following a fatigue task. Eighteen healthy pubertal males [age 14.3 (0.5) years] performed 34 maximal isokinetic concentric efforts of the knee extensors at 60°·s⁻¹. The average moment of force and electromyographic (aEMG) signal of vastus medialis (VM), vastus lateralis (VL) and biceps femoris (BF) at 11–30°, 31–50°, 51–70° and 71–90° of knee flexion were calculated for each repetition. The hamstrings antagonist moment was determined before and after the fatigue task by fitting the aEMG–moment relationship at different levels of muscle effort using second-degree polynomials. The percentage contribution of the antagonist moment to the resultant joint moment ranged from 7.1 % to 60.4 % throughout the range of motion, with the highest percentage observed close to full knee extension (11–30°). The antagonist effect was significantly greater during concentric tests of the knee extensors compared to the corresponding eccentric tests (p<0.05). Following the fatigue test, there was an overall decline of the resultant joint moment, but no changes in the predicted hamstrings moment were observed. These results indicate that when testing maximal knee extensor isokinetic strength in pubertal boys, activity of the hamstrings implies a reduction of the net extensor moment as compared to the isolated capacity of the knee extensors. However, this antagonist effect is not altered following the performance of an isokinetic fatigue knee extension task. Electronic Publication     

髌腱末端病运动员膝关节屈伸峰力矩和表面肌电图的特征☆

背景：髌腱末端病是腱止点部位的微细损伤,股四头肌群中的股内侧肌与股外侧肌之间的力量平衡发生变化,可直接导致髌骨产生异常运动从而对腱止点部位产生影响。 目的：分析髌腱末端病发生机制和髌腱末端病对膝关节及其周围肌肉活动产生的影响。 方法：选择10名患有髌骨肌腱病的男运动员及10名运动项目、身高和年龄匹配的正常男运动员,采用瑞士CON-TREX等速肌力测试与训练系统,分别进行膝关节力量和表面肌电图的测试,比较与分析膝关节屈肌力矩、伸肌力矩和股四头肌表面肌电图的变化。 结果与结论：发现在等长运动时,末端病组的伸肌伸肌峰力矩明显小于对照组、峰值转矩比比值明显大于对照组;在等速运动时,末端病组的伸肌伸肌峰力矩明显小于对照组,并随着运动角速度增加而变化显著,而峰值转矩比比值均不同程高于对照组;末端病组的股内侧肌/股外侧肌的整合肌电图比值在等长运动和等速运动时,均明显低于对照组。提示髌腱末端病运动员膝关节屈肌与伸肌的力量差距较为突出,存在股内侧肌活动低下和股内侧肌与股外侧肌之间不平衡的现象。     

Patterning of muscle activity in static knee extension

Activity patterning of the three agonist muscles (rectus femoris, vastus medialis, vastus lateralis) and one antagonist muscle (semimembranosus) was investigated during static knee extension. Male physical education students performed maximal and submaximal exertions in two test postures with different hip and knee positions corresponding to the postures used in our previous leg extension study. The character of the force curves was found in both postures to be convex with maximum peak force at 120 degrees. The supine posture changed the length of the two-joint muscles so as to produce an ordinary type of force curve. In the recumbent posture the efficient angles of the hip and knee joints did not match, thereby causing more plateau-like maximum peak force. All the agonists worked as a group and were highly activated throughout the entire range of the extension movement. The influence of postural variation also on the activity patterning could be seen in the latter half of the knee extension movement. The recumbent posture decreased whereas the supine posture maintained or tended even to increase the agonist activity. The difference is possibly due to the changing length of the two-joint muscles (rectus femoris and semimembranosus). Though the IEMG-force ratio of the agonist muscles was always nonlinear, the increased curvilinear relationship of the rectus femoris in the recumbent posture fits in with the view that in such conditions the central control system attempts to extend the hip joint. The results indicated that the two-joint muscles work like a single-joint muscle but, at the same time, control muscle coordination in single-joint knee extension movement.     

Maximal isometric strength and fiber type composition in power and endurance athletes

Summary The relationship between maximum isometric strength and muscle fiber type composition was examined in seven endurance and eight power trained athletes. Knee extension strength and ankle extension strength was assessed on 10 separate days and muscle biopsies were taken from the vastus lateralis and gastrocnemius muscles. The percent composition of slow twitch (ST) fibers and fast twitch (FT) fibers was determined from the biopsy samples. Correlation between maximal knee extension strength and percent ST fibers of the vastus lateralis was found to be 0.80 (n=8, p<0.05) for the power group and 0.63 (n=7, N.S.) for the endurance group. Corresponding correlation coefficients for the relationship between ankle extension strength and gastrocnemius percent ST fibers were –0.94 (p<0.01) and –0.19 (N.S.), respectively. The results suggest that the relationship to be expected between muscle fiber type composition and maximum isometric strength may well depend upon the muscle group under study as well as the type of athlete in terms of specific training adaptations.     

Effect of Strength Training on EMG of Human Skeletal Muscle

The effects of an 8 weeks period of systematic progressive strength training on the EMG activity of the leg extensor muscles (vastus lateralis and rectus fernoris) were investigated in 8 healthy male subjects (22–31 yrs). After training there were indications (n.s.) of a decline in integrated EMG (IEMG) during maximal isometric knee extension as well as in the IEMG vs isometric force relationship. The averaged motor unit potential (AMUP) did not demonstrate any significant changes due to the strength training regimen. In conformity with earlier findings no or only minor alterations were observed in anthropometrics, muscle enzyme activities and fibre composition. The fibre area ratio indicated a specific effect of the training stimuli on the fast twitch muscle fibres. Thus, EMG-analyses, as employed in the present study, did not provide any conclusive additional explanation as to the mechanisms behind the well established gains in niuscle strength performance induced by the applied strength training program.     

Effects of previous muscle contractions on cyclic movement dynamics

Summary In addition to muscle elastic energy, enhancement of movement performance in a stretch-shortening cycle could also be due to an increase in initial muscle force during the stretching phase. This hypothesis was tested by examining 9 male physical education students during maximum voluntary knee extensions performed with and without previous knee flexion. In both conditions movements were performed with various external loads. In addition, the force-velocity curve (FVC) parameters of the knee extensor muscles were also determined. As simple model of a muscle impulse was constructed in order to select independent biomechanical variables relevant to movement dynamics. The experimental results demonstrated that previous knee flexion enhanced the maximum angular velocity of knee extension. This effect decreased with increasing movement duration (i.e. increased external load), as well as giving positive correlation coefficients between the magnitude of this effect and the rate of development of knee extensor tension. These results are discussed in relation to a model of the dynamics. It is shown that previous muscle contractions performed during braking in the negative movement phase might play an important role in enhancing performance in cyclic movements. This role would be especially important in transient contractions of primarily slow twitch fiber muscles.     

Adaptive control for backward quadrupedal walking. II. Hindlimb muscle synergies

1. To compare the basic hindlimb synergies for backward (BWD) and forward (FWD) walking, electromyograms (EMG) were recorded from selected flexor and extensor muscles of the hip, knee, and ankle joints from four cats trained to perform both forms of walking at a moderate walking speed (0.6 m/s). For each muscle, EMG measurements included burst duration, burst latencies referenced to the time of paw contact or paw off, and integrated burst amplitudes. To relate patterns of muscle activity to various phases of the step cycle, EMG records were synchronized with kinematic data obtained by digitizing high-speed ciné film. 2. Hindlimb EMG data indicate that BWD walking in the cat was characterized by reciprocal flexor and extensor synergies similar to those for FWD walking, with flexors active during swing and extensors active during stance. Although the underlying synergies were similar, temporal parameters (burst latencies and durations) and amplitude levels for specific muscles were different for BWD and FWD walking. 3. For both directions, iliopsoas (IP) and semitendinosus (ST) were active as the hip and knee joints flexed at the onset of swing. For BWD walking, IP activity decreased early, and ST activity continued as the hip extended and the knee flexed. For FWD walking, in contrast, ST activity ceased early, and IP activity continued as the hip flexed and the knee extended. For both directions, tibialis anterior (TA) was active throughout swing as the ankle flexed and then extended. A second ST burst occurred at the end of swing for FWD walking as hip flexion and knee extension slowed for paw contact. 4. For both directions, knee extensor (vastus lateralis, VL) activity began at paw contact. Ankle extensor (lateral gastrocnemius, LG) activity began during midswing for BWD walking but just before paw contact for FWD walking. At the ankle joint, flexion during the E2 phase (yield) of stance was minimal or absent for BWD walking, and ankle extension during BWD stance was accompanied by a ramp increase in LG-EMG activity. At the knee joint, the yield was also small (or absent) for BWD walking, and increased VL-EMG amplitudes were associated with the increased range of knee extension for BWD stance. 5. Although the uniarticular hip extensor (anterior biceps femoris, ABF) was active during stance for both directions, the hip flexed during BWD stance and extended during FWD stance.(ABSTRACT TRUNCATED AT 400 WORDS)     

Leg-press resistance training during 20 days of 6° head-down-tilt bed rest prevents muscle deconditioning

The purpose of this study was to investigate the effects of resistance training on the morphological and functional properties of human lower limb muscles during 20 days of 6° head-down-tilt bed rest. Nine men were randomly assigned to the resistance training group (BR-Tr, n=5) or the non-training, control group (BR-Cont, n=4). Isometric leg-press exercises were performed: 3 s × 30 repetitions (30 s rest between repetitions) daily for 20 days during the bed-rest period. Serial axial magnetic resonance images were taken from the right thigh and leg muscles, and muscle volume, muscle length, and fibre length were estimated. The physiological cross-sectional areas (PCSAs) of the knee extensor, knee flexor, ankle plantarflexor, and ankle dorsiflexor (tibialis anterior) muscle groups were determined as muscle volume multiplied by the cosine of the angle of fibre pennation divided by fibre length. Maximum voluntary contraction (MVC) during knee extension was measured. No significant changes were observed in the PCSA of the knee extensor muscles in BR-Tr group, whereas the PCSA in the BR-Cont group decreased by 7.8%. The PCSA of the knee flexor and plantarflexor muscles in the BR-Tr group and BR-Cont group significantly decreased after bed rest (knee flexors, 10.2% and 11.5%; plantarflexors, 13.0% and 12.8%, respectively). However, in both groups bed rest had no effect on the muscle volume and PCSA of the tibialis anterior. MVC was maintained by resistance training in the BR-Tr group (decreased by 1%). In contrast, a decline of strength was observed in the BR-Cont group (−16%), but this result was not statistically significant. These results suggest that isometric leg-press training prevents the deconditioning (i.e. atrophy and decline of strength) of the knee extensor muscle group. Accepted: 23 December 1999     

Muscle moment arms of pelvic limb muscles of the ostrich (Struthio camelus)

Muscle moment arms were measured for major muscles of the pelvic limb of the ostrich (Struthio camelus) in order to assess specific functional behaviour and to apply this to locomotor performance. Pelvic limbs of six juvenile ostriches were used for this study. The tendon travel technique was used to measure moment arms of 21 muscles at the hip, knee, ankle and metatarsophalangeal joints throughout the ranges of motion observed during level running. Six of the 21 muscles measured were found to have moment arms that did not change with joint angle, whilst the remainder all demonstrated angle-dependent changes for at least one of the joints crossed. Moment arm lengths tended to be longest for the large proximal muscles, whilst the largest relative changes were found for the moment arms of the distal muscles. For muscles where moment arm varied with joint angle: all hip muscles were found to have increasing moment arms with extension of the joint, knee flexors were found to have moment arms that increased with extension, knee extensor moment arms were found to increase with flexion and ankle extensor moment arms increased with extension. The greatest relative changes were observed in the flexors of the metatarsophalangeal joint, for which a three-fold increase in moment arm was observed from flexion to full extension. Changes in muscle moment arm through the range of motion studied appear to optimize muscle function during stance phase, increasing the effective mechanical advantage of these muscles.     

Contribution of sensory feedback to the generation of extensor activity during walking in the decerebrate Cat

In this investigation we have estimated the afferent contribution to the generation of activity in the knee and ankle extensor muscles during walking in decerebrate cats by loading and unloading extensor muscles, and by unilateral deafferentation of a hind leg. The total contribution of afferent feedback to extensor burst generation was estimated by allowing one hind leg to step into a hole in the treadmill belt on which the animal was walking. In the absence of ground support the level of activity in knee and ankle extensor muscles was reduced to approximately 70% of normal. Activity in the ankle extensors could be restored during the "foot-in-hole" trials by selectively resisting extension at the ankle. Thus feedback from proprioceptors in the ankle extensor muscles probably makes a large contribution to burst generation in these muscles during weight-bearing steps. Similarly, feedback from proprioceptors in knee extensor appears to contribute substantially to the activation of knee extensor muscles because unloading and loading these muscles, by lifting and dropping the hindquarters, strongly reduced and increased, respectively, the level of activity in the knee extensors. This conclusion was supported by the finding that partial deafferentation of one hind leg by transection of the L4-L6 dorsal roots reduced the level of activity in the knee extensors by approximately 50%, but did not noticeably influence the activity in ankle extensor muscles. However, extending the deafferentation to include the L7-S2 dorsal roots decreased the ankle extensor activity. We conclude that afferent feedback contributes to more than one-half of the input to knee and ankle extensor motoneurons during the stance phase of walking in decerebrate cats. The continuous contribution of afferent feedback to the generation of extensor activity could function to automatically adjust the intensity of activity to meet external demands.     

坐位伸膝伴髋内收动作对髌股疼痛综合征患者股四头肌表面肌电信号的影响

目的 利用表面肌电图(surface electromyography, sEMG) 评估坐位伸膝伴或不伴髋内收动作下髌股疼痛综合征（patellofemoral pain syndrome,PFPS）患者股四头肌失衡程度。方法 PFPS病例组及正常对照组各30人,分别在坐位伸膝伴或不伴髋内收动作时检测股外侧肌(vastus lateralis,VL)及股内斜肌（vastus medialis oblique, VMO）表面肌电图,分析时域指标均方根振幅(root mean square,RMS)、积分肌电值（integrated EMG,IEMG）,比较其平衡关系。结果 坐位伸膝伴或不伴髋内收动作时病例组VL时域指标无显著性差异;VMO时域指标有统计学差异,伴髋内收时RMS、IEMG指标值较高,说明伴髋内收时VMO的肌肉募集增强。结论 坐位伸膝动作伴髋内收的动作可以对髌股疼痛综合征患者VMO肌电活动产生促进作用,从而使VL、VMO之间达到更好的平衡状态。     

Effect of muscle strengthening exercises on the muscle strength in patients with osteoarthritis of the knee

The purpose of the present study was to investigate the short-term effects of muscle strengthening exercises on the muscle strength in patients with osteoarthritis (OA) of the knee, and to determine whether the beneficial effects of the exercises on the muscles strength, if any, would be maintained over the long-term. Twenty-six patients (mean: 62.8 years) with mild-to-moderate OA of the knee were instructed to perform the exercises, which consisted of once-weekly facility-based strengthening exercises of the knee extensor and flexor muscles with a Medx knee machine at the intensity of 50% of the maximum peak torque (MPT) measured at the baseline (20 timesx3 sets per week), together with daily home-based isometric strengthening exercises (setting and straight leg raising) of the extensor and flexor muscles of the knee (30 times per day). The beneficial effects of the exercises on the MPT values of both the extensor and flexor muscles of the knee that began to be observed from 3 to 6 months after the start of the exercise regimen, regardless of the gender, age, body mass index, or baseline MPT values of the muscles, were maintained for up to 1-3 years, but tended to be no longer observed at 5 years. The present study showed the short-term efficacy of combined facility- and home-based muscle strengthening exercises for the muscle strength in patients with mild-to-moderate OA of the knee, as well as the loss of the beneficial effect of the exercise regimen on the muscle strength over the long-term.     

膝骨关节炎与膝关节伸、屈肌群肌力的相关性研究

目的通过研究膝骨关节炎(knee osteoarthritis,KOA)症状及病变阶段与膝关节伸、屈肌群肌力的相关性,探讨KOA患者肌力训练的关键肌群。方法社区募集健康老年人、单膝KOA患者、双膝KOA患者共99位志愿者,应用膝关节等速肌力测试、WOMAC评分、6 min步行测试、CS-30测试,分析志愿者膝关节伸、屈肌群峰力矩与KOA症状、全身有氧运动能力、关节功能等的相关性。结果单膝KOA组患者患侧膝关节伸肌群等速峰力矩显著低于健侧。双膝KOA组患者症状严重侧和症状较轻侧膝关节伸、屈肌群等速峰力矩差异均有统计学意义。双膝KOA组患者膝关节伸肌群等速峰力矩显著低于健康组。KOA患者膝关节伸、屈肌群等速峰力矩与CS-30测试、6 min步行测试均呈正相关,均与年龄呈负相关;膝关节伸肌群等速峰力矩与WOMAC评分的疼痛和功能障碍项呈负相关。结论膝关节伸、屈肌群均与KOA相关,KOA康复过程中不仅需重视股四头肌等伸肌群的训练,而且要兼顾腘绳肌、腓肠肌等屈肌群的训练。     

Evaluation of the walking pattern in two types of patients with anterior cruciate ligament deficiency: copers and non-copers

The purpose of the present study was to investigate whether different walking patterns in healthy subjects and in coper and non-coper subjects with deficient anterior cruciate ligaments could be quantified. An inverse dynamics approach was used to calculate joint kinematics and kinetics for flexion and extension. EMG signals of the hamstrings and quadriceps muscles were recorded. The results showed that the peak knee flexion angle was greater in the copers than in the controls. There was a positive correlation between the peak knee extensor moment and peak knee flexion angle. Furthermore, at a given peak knee flexion angle, the peak knee extensor moment was significantly larger in the controls than in the non-copers. The hip extensor moment in the copers was significantly larger than that of the non-copers and the controls. In conclusion, the three groups walked according to different patterns. It is suggested that the copers stabilized their knee joint by co-contraction of the hamstrings and quadriceps muscles, while the non-copers lacked this ability. Instead, the non-copers reduced the knee extensor moment in order to decrease anterior displacement of the tibia. The walking pattern differences observed between the copers and non-copers may explain their different post-injury activity levels. Electronic Publication