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Cederbaum LA, Yoon S, Côté JN. Males and females have similar neuromuscular coordination strategies of the quadriceps during fatiguing repeated all-out cycling. Front Sports Act Living 2023; 5:1248303. [PMID: 37780119 PMCID: PMC10541224 DOI: 10.3389/fspor.2023.1248303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction An imbalance of vastus medialis (VM) and vastus lateralis (VL) muscle activation and patterns of dyscoordination may contribute to the sex discrepancy in the incidence of patellofemoral pain syndrome (PFPS). While some studies have examined sex-specific VM/VL coordination strategies in some tasks, no previous studies have examined sex-specific VM/VL coordination strategies during repeated sprint exercise (RSE). Methods In this study, asymptomatic young adults (N = 39, 19 females) completed a RSE protocol consisting of 10 × 10 s all-out cycling interspersed by 30 s of passive rest. Electromyographic (EMG) signals from the VM and VL muscles were recorded throughout exercise. Results VM:VL ratio did not change with fatigue and was not different between the sexes. From sprint 1 to 10, VM-VL onset delay increased from 9.62 to 16.95 ms and from 19.28 to 45.09 ms in males and females, respectively (p < 0.001); however, no sex difference was found (p = 0.524). Muscle activation amplitude plateaued at different sprint repetitions in males and females while mechanical work plateaued at similar repetitions. Discussion These findings suggest that sex differences in the incidence of PFPS may not be influenced by VM/VL muscle coordination as assessed by EMG.
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Affiliation(s)
- Lauren A. Cederbaum
- Department of Kinesiology and Physical Education, Biomechanics of Occupation and Sport Laboratory, McGill University, Montreal, QC, Canada
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Sex differences in neuromuscular control of quadriceps. Eur J Appl Physiol 2020; 120:2193-2202. [PMID: 32712701 DOI: 10.1007/s00421-020-04443-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Patellofemoral pain syndrome (PFPS) is twice as prevalent in females as males, yet a few studies have evaluated differences in quadriceps muscle control between sexes or across force levels. This study investigated sex differences in quadriceps EMG onset times and amplitude at different force levels during isometric knee extension in asymptomatic males and females and in females with PFPS. METHODS Thirteen healthy males, 12 healthy females, and 10 females with PFPS performed isometric knee extension ramp contractions at 25%, 50%, and 75% of maximal voluntary contraction (MVC). Surface EMG was recorded from the vastus lateralis (VL), vastus medialis oblique (VMO), vastus medialis (VM), and rectus femoris (RF). RESULTS Healthy females showed delayed VL (222 ± 67 ms, p = 0.002), VMO (357 ± 101 ms, p = 0.001), and VM (258 ± 62 ms, p < 0.001) recruitment in comparison with healthy males. Healthy males activated the VL earlier than the VM (156 ± 51 ms, p = 0.02) and RF (379 ± 74 ms, p < 0.001), and at a similar time as the VMO; healthy females activated the VL earlier than the VM (192 ± 53 ms, p = 0.004) and VMO (239 ± 73 ms, p = 0.01). A lower VMO:VL activation ratio was found at 25% MVC (p < 0.001) than at higher force levels. CONCLUSIONS Delayed activation of the VMO relative to the VL has been proposed as a risk factor for PFPS. This study confirms a delay in VMO onset time in females.
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Samani M, Kordi Yoosefinejad A, Campos MH, de Lira CAB, Motealleh A. Changes in Knee Vastii Muscle Activity in Women with Patellofemoral Pain Syndrome During the Menstrual Cycle. PM R 2019; 12:382-390. [PMID: 31408276 DOI: 10.1002/pmrj.12239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/29/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Changes in hormonal levels during the menstrual cycle are known to affect muscle electromyographic (EMG) activity, but no studies have investigated the effect of hormonal changes on the EMG activity of muscles around the knee in patients with patellofemoral pain syndrome (PFPS). OBJECTIVE To evaluate the EMG activity of the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles during toe rise and heel rock tasks in different phases of the menstrual cycle in women with PFPS. DESIGN Cross sectional study. SETTING Rehabilitation Research Center at the School of Rehabilitation Sciences of Shiraz University of Medical Sciences. PARTICIPANTS Ten women with PFPS between 18 and 40 years of age. INTERVENTION Not applicable. MAIN OUTCOME MEASURES The VL/VMO amplitude ratio and differences between onset (onset VL-onset VMO) of vastii muscle activity were measured in the affected limb during rise and rock tasks in the follicular and ovulatory phases of the menstrual cycle. The signals were analyzed with MATLAB software. RESULTS During both tasks, there were no significant changes in onset differences in vastii muscles between the ovulatory and follicular phases. However, the amplitude ratio (VL/VMO) was significantly lower in the ovulatory phase compared to the follicular phase (P = .035 for rise tasks and .010 for rock tasks). CONCLUSION The menstrual cycle may affect some EMG parameters. These factors can be taken into account when planning sports and rehabilitation training programs.
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Affiliation(s)
- Mahbobeh Samani
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Kordi Yoosefinejad
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mario H Campos
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Claudio A B de Lira
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Alireza Motealleh
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Farrag A. Comparison of stair walking mechanics between adult males and females. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2016. [DOI: 10.4103/1110-6611.196781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Stracciolini A, Yen YM, d'Hemecourt PA, Lewis CL, Sugimoto D. Sex and growth effect on pediatric hip injuries presenting to sports medicine clinic. J Pediatr Orthop B 2016; 25:315-21. [PMID: 27058819 PMCID: PMC4889549 DOI: 10.1097/bpb.0000000000000315] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED To compare sports-related hip injuries on the basis of sex and age in a cohort of young athletes. A 5% random probability sample of all new patients' charts over a 10-year time period was selected for investigation. The most common hip injury diagnoses, sport at time of injury, mechanism (acute/traumatic vs. overuse), and types (bony vs. soft tissue) were compared by sex and age (preadolescent vs. adolescent). Descriptive and χ-analyses were carried out. The interaction of sex and age with respect to hip injury over time was examined by two-way (sex, age) analysis of variance. A total of 2133 charts were reviewed; N=87 hip injuries. The main diagnoses for males included labral tear (23.1%), avulsion fracture (11.5%), slipped capital femoral epiphysis (11.5%), dislocation (7.7%), and tendonitis (7.7%). The main diagnoses for females were labral tear (59.0%), tendonitis (14.8%), snapping hip syndrome (6.6%), strain (4.9%), and bursitis (4.9%). The five most common sports/activities at the time of hip injury were dancing/ballet (23.0%), soccer (18.4%), gymnastics (9.2%), ice hockey (8.1%), and track and field (6.9%). Age by sex comparisons showed a greater proportion of the total hip injuries (38.5%) in males compared with females (8.2%) during preadolescence (5-12 years). However, in adolescence (13-17 years), the hip injury proportion was significantly higher in females (91.8%) compared with males (61.5%; P<0.001). Injury mechanism and type differed by sex, with females sustaining more chronic/overuse (95.1%) and soft tissue type injuries (93.4%) compared with males (50.0 and 53.8%, respectively; P<0.001). Females were found to have a sharper increase in hip injury proportion as they progressed through puberty compared with males (analysis of variance sex-by-age interaction; P<0.001). Hip injury mechanism and type differed significantly between males and females during growth. Notably, the proportion of hip injuries in the young female athletes showed a significantly greater increase with advancing age compared with males. Hip injuries in children and the interplay with growth, as it relates to injury predisposition, require further investigation to facilitate efforts aimed at prevention. LEVEL OF EVIDENCE III Cross-sectional epidemiological study.
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Affiliation(s)
- Andrea Stracciolini
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Yi-Meng Yen
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Pierre A. d'Hemecourt
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Cara L. Lewis
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
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Stefanik JJ, Gross KD, Guermazi A, Felson DT, Roemer FW, Niu J, Lynch JA, Segal NA, Lewis CE, Lewis CL. Relation of Step Length to Magnetic Resonance Imaging-Detected Structural Damage in the Patellofemoral Joint: The Multicenter Osteoarthritis Study. Arthritis Care Res (Hoboken) 2015; 68:776-83. [PMID: 26413842 DOI: 10.1002/acr.22738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 08/13/2015] [Accepted: 09/15/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the relationship of step length to the sex-specific prevalence and worsening of magnetic resonance imaging (MRI)-detected structural damage in the patellofemoral (PF) joint among a cohort of older women and men with or at risk of knee osteoarthritis (OA). METHODS The Multicenter Osteoarthritis Study is a cohort study of persons ages 50-79 years with or at risk of knee OA. Step length was assessed using the GAITRite walkway (CIR Systems) at the 60-month visit, and cartilage damage and bone marrow lesions (BMLs) were graded on MRI at the 60- and 84-month visits. Step length was divided into sex-specific quintiles, and the relationship of step length to the prevalence and worsening of cartilage damage and BMLs in the PF joint was examined using logistic regression, adjusting for age, body mass index (BMI), leg length, and tibiofemoral joint structural damage. RESULTS In 1,053 knees, 4,094 and 4,083 PF joint subregions were studied for the cartilage and BML analyses, respectively. Mean ± SD age was 65.6 ± 8.1 years and mean ± SD BMI was 29.1 ± 4.7 kg/m(2) ; 62% of participants were female. In women, compared to those with the shortest step length, those with the longest step length had 0.62 (95% confidence interval [95% CI] 0.43-0.88) and 0.59 (95% CI 0.40-0.87) times the odds of cartilage damage and BMLs, respectively. There was no cross-sectional association in men, and no longitudinal association in either sex. CONCLUSION Women with PF joint structural damage may adapt their gait by shortening their step length, but this may not be sufficient to reduce the risk of worsening damage over time.
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Affiliation(s)
| | - K Douglas Gross
- Boston University and MGH Institute of Health Professions, Boston, Massachusetts
| | | | | | | | - Jingbo Niu
- Boston University, Boston, Massachusetts
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Powers CM, Bolgla LA, Callaghan MJ, Collins N, Sheehan FT. Patellofemoral pain: proximal, distal, and local factors, 2nd International Research Retreat. J Orthop Sports Phys Ther 2012; 42:A1-54. [PMID: 22660660 PMCID: PMC9909566 DOI: 10.2519/jospt.2012.0301] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Patellofemoral pain (PFP) is one of the most common lower extremity conditions seen in orthopaedic practice. The mission of the second International Patellofemoral Pain Research Retreat was to bring together scientists and clinicians from around the world who are conducting research aimed at understanding the factors that contribute to the development and, consequently, the treatment of PFP. The format of the 2.5-day retreat included 2 keynote presentations, interspersed with 6 podium and 4 poster sessions. An important element of the retreat was the development of consensus statements that summarized the state of the research in each of the 4 presentation categories. In this supplement, you will find the consensus documents from the meeting, as well as the keynote addresses, schedule, and platform and poster presentation abstracts.
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Semciw A, Green R, Pizzari T, Briggs C. Verification of a standardized method for inserting intramuscular EMG electrodes into uniquely oriented segments of gluteus minimus and gluteus medius. Clin Anat 2012; 26:244-52. [DOI: 10.1002/ca.22055] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 01/27/2012] [Accepted: 02/04/2012] [Indexed: 11/08/2022]
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Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med 2011; 39:866-73. [PMID: 21335344 DOI: 10.1177/0363546510395456] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Contemporary clinical expertise and emerging research in anterior knee pain indicate that treatment of hip muscle function will result in greater effects, if such treatments can be provided to those with hip muscle dysfunction. Thus, it is imperative to develop and evaluate a clinical assessment tool that is capable of identifying people with poor hip muscle function. HYPOTHESIS The clinical assessment of single-leg squat performance will have acceptable inter- and intrarater reliability. Furthermore, people with good performance on the single-leg squat will have better hip muscle function (earlier onset of gluteus medius activity and greater lateral trunk, hip abduction, and external rotation strength) than people with poor performance. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 2. METHODS A consensus panel of 5 experienced clinicians developed criteria to rate the performance of a single-leg squat task as "good," "fair," or "poor." The panel rated the performance of 34 asymptomatic participants (mean ± SD: age, 24 ± 5 y; height, 1.69 ± 0.10 m; weight, 65.0 ± 10.7 kg), and these ratings served as the standard. The ratings of 3 different clinicians were compared with those of the consensus panel ratings (interrater reliability) and to their own rating on 2 occasions (intrarater reliability). For the participants rated as good performers (n = 9) and poor performers (n = 12), hip muscle strength (hip abduction, external rotation, and trunk side bridge) and onset timing of anterior (AGM) and posterior gluteus medius (PGM) electromyographic activity were compared. RESULTS Concurrency with the consensus panel was excellent to substantial for the 3 raters (agreement 87%-73%; κ = 0.800-0.600). Similarly, intrarater agreement was excellent to substantial (agreement 87%-73%; κ = 0.800-0.613). Participants rated as good performers had significantly earlier onset timing of AGM (mean difference, -152; 95% confidence interval [CI], -258 to -48 ms) and PGM (mean difference, -115; 95% CI, -227 to -3 ms) electromyographic activity than those who were rated as poor performers. The good performers also exhibited greater hip abduction torque (mean difference, 0.47; 95% CI, 0.10-0.83 N·m·Bw(-1)) and trunk side flexion force (mean difference, 1.08; 95% CI, 0.25-1.91 N·Bw(-1)). There was no difference in hip external rotation torque (P > .05) between the 2 groups. CONCLUSION Targeted treatments, although considered ideal, rely on the capacity to identify subgroups of people with chronic anterior knee pain who might respond optimally to a given treatment component. Clinical assessment of performance on the single-leg squat task is a reliable tool that may be used to identify people with hip muscle dysfunction.
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Affiliation(s)
- Kay M Crossley
- Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia.
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Herrington L, Munro A. Drop jump landing knee valgus angle; normative data in a physically active population. Phys Ther Sport 2010; 11:56-9. [DOI: 10.1016/j.ptsp.2009.11.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 11/10/2009] [Accepted: 11/30/2009] [Indexed: 11/28/2022]
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