The effects of antagonist moment on the resultant knee joint moment during isokinetic testing of the knee extensors

The purpose of this study was to examine the effects of moment of antagonistic muscle on the resultant joint moment during isokinetic eccentric and concentric efforts of the knee extensors. Ten males performed maximum eccentric and concentric knee extension and flexion efforts on a Biodex dynamometer at 0.52 rad · s⁻¹ (30° · s⁻¹). Electromyographic (EMG) activity of vastus medialis and biceps femoris (hamstrings) was also recorded. The antagonistic moment of the hamstrings was determined by recording the integrated EMG (iEMG)/moment relationship at different levels of muscle effort. The iEMG/moment curves were fitted using second-degree polynomials. The polynomials were then used to predict the antagonistic moment exerted by the hamstrings from the antagonist iEMG. The antagonistic moment had a maximum of 42.92 Nm and 28.97 Nm under concentric and eccentric conditions respectively; paired t-tests indicated that this was a significant difference (P < 0.05). These results indicate that the resultant joint moment of knee extensors is the result of both agonist and antagonist muscle activation. The greater antagonist muscle activity under concentric activation conditions may be partly responsible for the lower resultant joint concentric moment of knee extensors compared with the corresponding eccentric activation. The antagonist moment significantly affects comparisons between the isokinetic moments and agonist EMG and in vitro force measurements under different testing (muscle action and angular velocity) conditions. Accepted: 25 February 1997     

膝关节最大和次最大等速运动至疲劳过程中主动肌与拮抗肌肌电特征分析

背景：人体关节力量输出主要取决于关节周围主动肌与拮抗肌的激活效果,而拮抗肌通过共激活形式参与肢体活动,从而协助维持关节稳定性。但是肌肉不同收缩模式下拮抗肌共激活的不同中枢策略的报道较少。目的：观察健康受试者膝关节伸肌在最大和次最大等速运动至疲劳过程中主动肌与拮抗肌表面肌电信号的特征与差别。方法：对16名在校学生使用Biodex等速训练仪诱发下肢右侧膝关节伸肌等速屈伸运动直至疲劳,同时使用表面肌电仪采集单侧股内侧肌、股外侧肌以及股二头肌的表面肌电信号。分析时域指标均方根振幅百分比以及频域指标平均频率的变化规律。结果与结论：在膝关节最大等速屈伸运动中峰值力矩下降了40.3%(P < 0.05),主动肌活动先增加后下降(P < 0.05),而拮抗肌电活动保持不变。在次最大等速运动中峰值力矩平均下降了40.0%(P < 0.05),主动肌肌电活动逐渐增加(P < 0.05),而拮抗肌电活动先增加随后又降低。在指定的交互收缩屈伸运动中作为拮抗肌的股内和股外侧肌的均方根振幅和平均频率没有显著变化(P > 0.05)。结果提示,在不同强度的等速疲劳运动中中枢神经系统对主动肌和拮抗肌采取了不同神经支配策略。中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Antagonist muscle moment is increased in ACL deficient subjects during maximal dynamic knee extension

IntroductionCoactivation of the hamstring muscles during dynamic knee extension may compensate for increased knee joint laxity in anterior cruciate ligament (ACL) deficient subjects. This study examined if antagonist muscle coactivation during maximal dynamic knee extension was elevated in subjects with anterior cruciate ligament (ACL) deficiency compared to age-matched healthy controls.MethodsElectromyography (EMG) and net knee joint moments were recorded during maximal concentric quadriceps and eccentric hamstring contractions, performed in an isokinetic dynamometer (ROM: 90–10°, angular speed: 30°/s). Hamstring antagonist EMG recorded during concentric quadriceps contraction was converted into antagonist moment based on the EMG–moment relationship observed during eccentric agonist contractions.ResultsThe magnitude of antagonist hamstring EMG was 65.5% higher in ACL deficient subjects compared to healthy controls (p < 0.05). Likewise, antagonist hamstring moment expressed in percentage of the measured net extension moment was elevated in ACL deficient subjects (56 ± 8 to 30 ± 6%) compared to controls (36 ± 5 to 19 ± 2%) at 20–50° of knee flexion (0° = full extension) (p < 0.05).DiscussionThe results showed a marked increase in hamstring coactivation towards more extended joint positions. Notably, this progressive rise in coactivation was greater in ACL deficient subjects, which may reflect a compensatory strategy to provide stability to the knee joint in the anterior–posterior plane during isolated knee extension. The present study encourages further investigations of hamstring coactivation in ACL deficient subjects.     

Differences in strength and surface electromyogram characteristics between pre-pubertal gymnasts and untrained boys during brief and maintained maximal isometric voluntary contractions

The present study was aimed at investigating differences of maximal strength (F _max) of the elbow flexors and characteristics of the surface electromyogram (EMG) between six gymnasts (G) and six untrained (UT) 10-year-old boys during brief and maintained maximal voluntary isometric contraction (MVC). The F _max was estimated during 5 s MVC (maximal test, MT) and normalized to the cross sectional area (CSA) of the arm. The EMG signal of the biceps brachii was recorded during MT and during a 25 s maintained MVC (fatigue test). Values were calculated for root-mean-square (rms_MT) and mean power frequency (MPF_MT) of the EMG signal for the duration of the MT. For the fatigue test, MPF were normalized to the initial value (MPF_n) and kinetics were expressed by the slope coefficient of linear regression. Although F _max and F _max/CSA tended to be higher for G than UT, the differences did not reach significance. The MPF_MT was significantly higher for G [mean (SD)][136 (8) Hz] than for UT [125 (9) Hz]. The MPF_n slope coefficients were significantly greater for G than for UT [–1.0 (0.2) and –0.5 (0.3), respectively]. When all the children were considered, F _max was significantly correlated to MPF_MT (r=0.61). These results showed that gymnasts tend to have higher F _max and F _max/CSA accompanied by a significantly higher MPF_MT and a steeper MPF downshift. Moreover, children with greater strength tended to have higher MPF_MT. It is suggested that spatial and/or temporal recruitment of more fatigable fast motor units could have been enhanced in G and more generally, that it could be a mechanism that would explains, in part, the level of force production in children. Electronic Publication     

Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females

The objectives of the present study were to: (1) examine perceived exertion across different target voluntary-contraction intensities; (2) compare perceived exertion ratings with actual target intensities, and (3) compare perceived exertion ratings between males and females. Subjects for this study included 30 healthy, college-aged male (n=15) and female (n=15) volunteers. All subjects were free of orthopedic, cardiopulmonary, systemic and neurological disease. Subjects were evaluated for their one-repetition maximum (1-RM) during inertial knee extension exercise. All subjects then completed, in a random order, two sub-maximal inertial contractions at 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% of their 1-RM. Perceived exertion was measured by asking subjects to provide a number that corresponded to the feelings in their quadriceps after completion of the two repetitions, by viewing a modified category-ratio (CR-10) scale. The results showed that males lifted a significantly greater absolute (P<0.05) and relative (P<0.05) amount of mass than females; allometric-modeled strength values also demonstrated significant sex differences. The results revealed a significant intensity main effect (P<0.001) but no significant gender main effect (P=0.97) nor intensity-by-gender interactions (P=0.50) for the perceived exertion responses. The findings demonstrated that perceived exertion was significantly (P<0.05) lower than the specific expected values on the CR-10 scale from 10% to 60% of 1-RM, but was not different from 70% to 90% 1-RM. The results revealed that the increase in perceived exertion was fit to both linear and quadratic trends, and that the exponent of the power function was found to be 1.437 (SD 0.22) for the males, and 1.497 (0.295) for the females. The major findings demonstrate that although males were able to lift more absolute and relative mass than females, the perceptual response to relative load was similar between genders. The increase in perceived exertion, as a function of relative load, showed a strong linear trend; however, enhanced perceptual sensitivity at high contraction intensities was evident from the positively accelerating power function. Electronic Publication     

A mathematical modelling study investigating the influence of knee joint flexion angle and extension moment on patellofemoral joint reaction force and stress

BackgroundPatellofemoral pain (PFP) is the most common orthopaedic condition among runners. Individuals with PFP exhibit greater patellofemoral joint (PFJ) reaction force and stress when compared with pain-free controls. However, it is not clear whether PFJ reaction force and stress are the highest (or lowest) when knee joint flexion angle and extension moment are in which combinations. We aimed to investigate the influence of knee joint flexion angle and extension moment on PFJ reaction force and stress.MethodsA PFJ sagittal model was used to quantify PFJ reaction force and stress. Based on the public dataset of the previous study, peak knee joint flexion angle and extension moment at various running speeds was calculated. Based on the calculated peak value, simulation ranges were set to knee joint flexion angle of 10–45° and extension moment of 0–240 Nm. The quadriceps force, effective lever arm length at quadriceps muscle, and PFJ contact area were determined as a function of the knee joint flexion angle and extension moment, and finally PFJ forces and stress were estimated.ResultsPFJ reaction force increased as the knee flexion angle and extension moment increased. Although PFJ stress also increased as the knee extension moment increased, it was at the highest and lowest at 10° and about 30° knee joint flexion angles, respectively.ConclusionsIncorporating knee flexion posture (approximately 30°) during running may help in reducing PFJ stress, which would be useful in the prevention of pain and act as an optimal treatment program for PFP.     

Effects of knee and ankle muscle fatigue on postural control in the unipedal stance

The aim of this study was to compare the effects of acute muscle fatigue of the ankle and knee musculature on postural control by immediate measures after performing fatiguing tasks (POST condition). One group of subjects (n = 8) performed a fatiguing task by voluntary contractions of the triceps surae (group TRI) and the other (n = 9) performed a fatiguing task by voluntary contractions of the quadriceps femoris (group QUA). Each muscle group was exercised until the loss of maximal voluntary contraction torque reached 50% (isokinetic dynamometer). Posture was assessed by measuring the centre of foot pressure (COP) with a force platform during a test of unipedal quiet standing posture with eyes closed. Initially (in PRE condition), the mean COP velocity was not significantly different between group TRI and group QUA. In POST condition, the mean COP velocity increased more in group QUA than in group TRI. The postural control was more impaired by knee muscle fatigue than by ankle muscle fatigue.     

Central fatigue explains sex differences in muscle fatigue and contralateral cross-over effects of maximal contractions

A sustained voluntary contraction increases central fatigue and produces a ‘cross-over’ of fatigue during a subsequent contraction of the contralateral limb. These studies compared the magnitude of these changes for men and women. Force and electromyographic responses from dominant (study 1; n = 8 men, 8 women) or non-dominant (study 2; n = 7 men, 8 women) leg extensors to nerve stimulation were recorded at rest and during brief maximal voluntary contractions (MVCs), before and after 100-s sustained MVCs performed with the dominant leg. For the dominant leg, force was reduced more for men (by ∼24%) than women (by ∼16%, P < 0.05) after the sustained contractions. Similarly, voluntary activation during these contractions was reduced more for men (by ∼22%) than women (by ∼9%, P < 0.05). Conversely, resting twitches changed similarly for both sexes (P > 0.05). For the non-dominant leg, men experienced a reduction in force (by ∼13%, P < 0.001) and had greater deficits in activation than women (∼9% vs ∼3%, P < 0.05), after sustained contractions of the dominant leg. Therefore, sustained MVCs produce greater central fatigue and a more pronounced ‘cross-over’ of effects to the contralateral limb for men compared to women. These findings demonstrate distinct differences between sexes in the way the nervous system adapts to changes associated with fatigue.     

Voluntary drive-dependent changes in vastus lateralis motor unit firing rates during a sustained isometric contraction at 50% of maximum knee extension force

The purpose of the present study was to relate the expected inter-subject variability in voluntary drive of the knee extensor muscles during a sustained isometric contraction to the changes in firing rates of single motor units. Voluntary activation, as established with superimposed electrical stimulation was high (range: 91–99%, n=8) during a short maximal contraction, but was lower (range: 69–100%) in most subjects at the point of force failure during a sustained (49.1±10.1 s) fatiguing contraction at 50% of maximum force. On a different experimental day the firing behaviour of 27 single motor units was recorded with wire electrodes in the vastus lateralis muscle, 24 of which could be monitored from the time of recruitment to the point of force failure (53.6±9.8 s). Motor unit firing behaviour differed considerably among subjects. During the second half of the sustained, fatiguing contraction the changes in firing rate firing rate variability of early recruited units ranged from –10% to +100% and from –50% to +160% respectively among subjects. There were significant positive linear relations between voluntary activation, on the one hand, and rectified surface electromyogram (rsEMG, r=0.82), the changes in motor unit firing rate (r=0.49) and firing rate variability (r=0.50) towards the point of force failure on the other. The present data suggest that differences in voluntary drive that appear among subjects during fatigue may be an important determinant of motor unit firing behaviour.Abbreviations EMG electromyogram - ER unit early recruited unit - MFGC maximal force-generating capacity - MPF mean power frequency - MVC maximum voluntary contraction - NR unit newly recruited unit - rsEMG rectified surface electromyogram - SMUAP single motor unit action potential     

Effect of mechanical compression due to load carrying on shoulder muscle fatigue during sustained isometric arm abduction: an electromyographic study

The use of surface electromyography (EMG) for studying the effect of mechanical compression of occupational origin on muscle fatigue has been the subject of poor attention in ergonomic research. This study examined the effect of backpack carrying on fatigue of two shoulder muscles during sustained low force static contraction: the middle deltoid (MD) muscle and the upper trapezius (UT) muscle on which the backpack strap exerted direct compressive force. EMG activities of MD and UT muscles, of the dominant and non-dominant sides, were studied on eight subjects during two tasks, a maximal and an exhausting submaximal bilateral isometric 90° arm abduction, which were performed while carrying a backpack load of 0, 10, and 20 kg, respectively. EMG amplitude (root mean square, RMS) and spectral (mean power frequency, MPF) parameters were computed from the recorded signals. No significant differences between the dominant and non-dominant sides were found for none of the parameters whatever the load-carrying mass. Load-carrying masses which were tested did not influence significantly the maximal bilateral arm abduction performance contrary to the time to exhaustion during the submaximal task, which decreased significantly with increasing load-carrying mass. A significant increase in fatigability, defined by the slope of MPF decrease, was observed for both muscles when load-carrying mass increased; but only UT presented a significant increase in muscle fatigue level, defined by the MPF value with respect to its initial value, at the end of the exhausting submaximal task. Furthermore, the increase in muscle activation of UT, quantified by RMS, during the exhausting task was not significantly higher with increasing load-carrying mass. So, the increased signs of local fatigue of UT may be interpreted by a localised blood flow impairment resulting from the direct compressive force exerted by backpack on this muscle.     

Non-uniform mechanical activity of quadriceps muscle during fatigue by repeated maximal voluntary contraction in humans

To determine the non-uniform surface mechanical activity of human quadriceps muscle during fatiguing activity, surface mechanomyogram (MMG), or muscle sound, and surface electromyogram (EMG) were recorded from the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles of seven subjects during unilateral isometric knee extension exercise. Time- and frequency-domain analyses of MMG and of EMG fatigued by 50 repeated maximal voluntary contractions (MVC) for 3?s, with 3-s relaxation in between, were compared among the muscles. The mean MVC force fell to 49.5 (SEM 2.0)% at the end of the repeated MVC. Integrated EMG decreased in a similar manner in each muscle head, but a marked non-uniformity was found for the decline in integrated MMG (iMMG). The fall in iMMG was most prominent for RF, followed by VM and VL. Moreover, the median frequency of MMG and the relative decrease in that of EMG in RF were significantly greater (P?) than those recorded for VL and VM. These results would suggest a divergence of mechanical activity within the quadriceps muscle during fatiguing activity by repeated MVC.     

Analysis of the factors that correlate with increased knee adduction moment during gait in the early postoperative period following total knee arthroplasty

Background

Analysis of dynamic knee loading during gait is essential to prevent mechanical failures following total knee arthroplasty. External knee adduction moment during gait is the primary factor producing medial joint reaction force, and an increase in the moment is directly related to an increase in the medial compartment load on the knee.

Hippocampal electrical activity during long-continued avoidance performance: effects of fatigue

Rats were trained to avoid electric shock by jumping out of a box to a height of 35.5 or 48 cm. Hippocampal slow wave activity was then recorded continuously during a single session in which avoidance testing was continued to the point of extreme fatigue. Rhythmical slow activity (RSA) always appeared prior to a successful avoidance response and rose in frequency as the instant of jump initiation approached. As the rats became fatigued and failed to avoid, this anticipatory upward shift in frequency failed to occur.     

Hand digit control in children: age-related changes in hand digit force interactions during maximum flexion and extension force production tasks

We studied the finger interactions during maximum voluntary force (MVF) production in flexion and extension in children and adults. The goal of this study was to investigate the age-related changes and flexion–extension differences of MVF and finger interaction indices, such as finger inter-dependency (force enslaving (FE): unintended finger forces produced by non-instructed fingers during force production of an instructed finger), force sharing (FS; percent contributions of individual finger forces to the total force at four-finger MVF), and force deficit (FD; force difference between single-finger MVF and the force of the same finger at four-finger MVF). Twenty-five right-handed children of 6–10 years of age and 25 adults of 20–24 years of age participated as subjects in this study (five subjects at each age). During the experiments, the subjects had their forearms secured in armrests. The subjects inserted the distal phalanges of the right hand into C-shaped aluminum thimbles affixed to small force sensors with 20° of flexion about the metacarpophalangeal (MCP) joint. The subjects were instructed to produce their maximum isometric force with a single finger or all four fingers in flexion or extension. In order to examine the effects of muscle–force relationship on MVF and other digit interaction indices, six subjects were randomly selected from the group of 25 adult subjects and asked to perform the same experimental protocol described above. However, the MCP joint was at 80° of flexion. The results from the 20° of MCP joint flexion showed that (1) MVF increased and finger inter-dependency decreased with children’s age, (2) the increasing and decreasing absolute slopes (N/year) from regression analysis were steeper in flexion than extension while the relative slopes (%/year) with respect to adults’ maximum finger forces were higher in extension than flexion, (3) the larger MVF, FE, and FD were found in flexion than in extension, (4) the finger FS was very similar in children and adults, (5) the FS pattern of individual fingers was different for flexion and extension, and (6) the differences between flexion and extension found at 20° MCP joint conditions were also valid at 80° MCP joint conditions. We conclude that (a) the finger strength and independency increase from 6 to 10 years of age, and the increasing trends are more evident in flexion than in extension as indexed by the absolute slopes, (b) the finger strength and finger independency is greater in flexion than in extension, and (c) the sharing pattern in children appears to develop before 6 years of age or it is an inherent property of the hand neuromusculoskletal system. One noteworthy observation, which requires further investigation, was that FE was slightly smaller in the 80° condition than in the 20° condition for flexion, but larger for extension for all subjects. This may be interpreted as a greater FE when flexor or extensor muscles are stretched.     

Electromyogram and force during stimulated fatigue tests of muscles in dominant and non-dominant hands

Summary Mechanical and electrical properties were studied for the first dorsal interosseous muscle of the dominant (d-FDI) and non-dominant hand (nd-FDI). Observations were made before, during and after a fatigue test, fatigue being evoked by percutaneous electrical stimulation of the ulnar nerve. The test consisted of 30 Hz bursts of ten supramaximal 0.1 ms pulses, repeated once a second for 5 min. The measurements included the amplitude of the first and fifth compound muscle action potentials (M-waves) within bursts, the peak burst force and the amplitude and time course of single twitches. At the end of the fatigue test, burst force had decreased to about the same extent in the FDI of both hands. The final decline in first M-wave amplitude was, however, significantly more pronounced for the nd-FDI than for the d-FDI. There were no longer any significant discrepancies between the two muscles after a subsequent recovery-period of 15 min. Comparisons among nd-FDI of various individuals demonstrated the presence of significant inter-individual differences in fatigue-related force-drop without any associated differences in M-wave decline. Intra-individual variability was similar for fatigue-related force-drop and M-wave decline.     

Relaxation and force during fatigue and recovery of the human quadriceps muscle: relations to metabolite changes

Force and relaxation were measured during electrical stimulation of the quadriceps muscle of 14 volunteers. Stimulation produced 51.2 s of intermittent ischaemic contractions either as 16 3.2-s tetani or as 64 0.8-s tetani. Changes during recovery were followed for 180 s. On 8 subjects muscle biopsies were taken during work and after the rest period for determination of ATP, phosphocreatine and intermediates in glucolysis. The stimulation using 0.8-s contractions gave more pronounced fatigue and slowing of relaxation. There was a good correlation between force and relaxation during work but this relation changed during recovery, indicating that no general relation exists between these two contraction characteristics. In the 0.8-s stimulation more ATP was utilized and there were more profound changes in metabolite levels. We found a correlation between estimated [H₂PO ₄ ^– ] and relaxation covering both work and recovery and hypothesize that inorganic phosphate and its removal by phosphocreatine resynthesis during recovery might be important. Since stimulation patterns differ in force and relaxation even after the recovery period we suggest that additional factors, such as pH, are of importance in this work model.     

Mechanomyographic and electromyographic responses during fatigue in humans: influence of muscle length

Mechanomyography (MMG) provides a measure of muscle mechanical changes during contractions. The purpose of this study was to quantify alterations in MMG signals during fatigue at two muscle lengths. Comparisons with electromyographic (EMG) recordings were made. A group of 13 subjects performed isometric dorsiflexions (50% of maximum for 60 s) at 40° of plantarflexion (long, l _l) and 5° of dorsiflexion (short, l _s). The mean power frequency of the EMG (fˉ _EMG) and MMG (fˉ _MMG) signals and the mean rectified MMG () and EMG () were determined over each 1-s period, normalized to the respective maximal value, regressed against time, and the resulting slopes (units = %max · s⁻¹) were analyzed. The slopes were larger (P = 0.007) at l _l compared to l _s [mean l _l 0.50 (SD 0.26), mean l _s 0.27 (SD 0.16)], however there were no differences (P = 0.24) between mean fˉ _MMG slopes [l _l−0.10 (SD 0.16), l _s−0.16 (SD 0.11)]. Similarly, slopes were larger (P = 0.001) at l _l versus l _s [l _l 0.26 (SD 0.13), l _s 0.08 (SD 0.15)] and there were no differences (P=0.89) between mean fˉ _EMG slopes [l _l−0.15 (SD 0.14), l _s−0.14 (SD 0.12)]. At 5 s following the exercise to fatigue mean MVC (units = %max) were not significantly different between l _l and l _s [P = 0.08; l _l 78.8 (SD 9.1), l _s 85.2 (SD 6.0)]. These results showed that during fatiguing contractions, MMG and EMG amplitudes increased while frequency characteristics decreased at both muscle lengths. The change in and was greater at l _l but no differences in fˉ _MMG or fˉ _EMG slopes occurred between lengths. These results would suggest that larger increases in motor unit recruitment occur with time during fatigue at l _l compared to l _s. Accepted: 6 September 1999     

The association of external knee adduction moment with biomechanical variables in osteoarthritis: A systematic review

ContextOsteoarthritis (OA) is a musculoskeletal disorder primarily affecting the older population and resulting in chronic pain and disability. Biomechanical variables, associated with OA severity such as external knee adduction moment (KAM) and joint malalignment, may affect the disease process by altering the bone-on-bone forces during gait.ObjectiveTo investigate the association between biomechanical variables and KAM in knee OA.MethodA systematic search for published studies' titles and abstracts was performed on Ovid Medline^®, Cumulative index to Nursing and Allied Health, PREMEDLINE, EBM reviews and SPORTDiscus. Fourteen studies met the inclusion criteria and were considered for the review.ResultsThe magnitude and time course of KAM during gait appeared to be consistent across laboratories and computational methods. Only two of the included studies that compared patients with OA to a control group reported a higher peak KAM for the OA group. Knee adduction moment increased with OA severity and was directly proportional to varus malalignment. Classifying the patients on the basis of disease severity decreased the group variability, permitting the differences to be more detectable.ConclusionsBiomechanical variables such as varus malalignment are associated with KAM and therefore may affect the disease process. These variables should be taken into considerations when developing therapeutic interventions for individuals suffering from knee OA.     

Effect of functional weightbearing versus non-weightbearing quadriceps strengthening exercise on contact force in varus-malaligned medial knee osteoarthritis: A secondary analysis of a randomized controlled trial

BackgroundKnee osteoarthritis progression may be related to altered knee loads, particularly in those with varus malalignment. Using randomized controlled trial data, this secondary analysis of complete datasets (n = 67) compared the effects of a functional weightbearing (WB) and non-weightbearing quadriceps strengthening exercise (NWB) program on measures of medial tibiofemoral joint contact force (MTCF) during walking.MethodsParticipants aged ≥50 years and with medial knee osteoarthritis and varus malalignment were randomly allocated to a 12-week, home-based, physiotherapist-prescribed exercise program comprised of WB exercises (n = 31), or NWB exercise (n = 36). Three-dimensional lower-body motion, ground reaction forces, and surface electromyograms from six lower-limb muscles were acquired during walking at baseline and at 12-weeks follow-up. An electromyogram-informed neuromusculoskeletal model estimated bodyweight (BW) normalized MTCF (peak and impulse), including external and muscular contributions to MTCF.ResultsThere was no between-group difference in the change in peak MTCF (−0.02 [−0.12, 0.09] BW) or MTCF impulse (−0.01 [−0.06, 0.03] BW·s). There was a between-group difference in the muscle contribution to peak MTCF (−0.08 [−0.15, −0.00] BW) and MTCF impulse (−0.04 [−0.08, −0.00] BW·s), whereby the muscle contribution reduced more in the NWB group over time compared to the WB group. There was also a between group-difference in the external contribution to peak MTCF (0.09 [0.01, 0.18] BW), but this reduced more in the WB group than in the NWB group.ConclusionsOur findings suggest no difference in MTCF between the two exercise programs, but differences in the contribution to MTCF between the two exercise programs were observed in those with medial knee osteoarthritis and varus malalignment.     

Periodic increases in force during sustained contraction reduce fatigue and facilitate spatial redistribution of trapezius muscle activity

This study compared fatigue and the spatial distribution of upper trapezius electromyographic (EMG) amplitude during a 6-min constant force shoulder elevation task at 20% of the maximal voluntary contraction force (MVC) (constant force) and during the same task interrupted by brief (2 s) periodic increases in force to 25% MVC every 30 s (variable force). Surface EMG signals were recorded with a 13 × 5 grid of electrodes from the upper trapezius muscle of nine healthy subjects. The centroid (center of activity) of the EMG root mean square map was computed to assess changes over time in the spatial distribution of EMG amplitude. MVC force decreased by (mean ± SD) 9.0 ± 3.9% after the constant force task (P < 0.05) but was unchanged following the variable force contraction. The centroid of EMG amplitude shifted in the cranial direction across the duration of the variable force contraction (P < 0.05) but not during the constant force contraction (shift of 2.9 ± 2.3 mm and 1.4 ± 1.1 mm, respectively). The results demonstrate that periodic increases in force during a sustained contraction enhance the modifications in spatial distribution of upper trapezius EMG amplitude and reduce fatigue compared to a constant force contraction performed at a lower average load. The change in spatial distribution of EMG amplitude over time during a sustained contraction may reflect a mechanism to counteract fatigue during prolonged muscle activity.