Absolute and Normalized Normative Torque Values of Knee Extensors and Flexors in Healthy Trained Subjects: Asymmetry Questions the Classical Use of Uninjured Limb as Reference

Purpose

To provide normative values of maximal isometric torque of knee extensors and flexors measured at 80° of knee flexion and to characterize the results in healthy subjects practicing activities at risk of anterior cruciate ligament rupture.

Methods

Seventy-four trained volunteers (35 male and 39 female) aged 18 to 41 years were recruited. They alternately performed 3 maximal voluntary isometric contractions of knee extension and flexion. The maximal voluntary isometric contraction net torque was computed as the mean value of the peak torques recorded over the 3 trials.

Results

For women, the absolute torque for extensors was 143.5 ± 34.4 N⋅m (range, 87.7-253.1 N⋅m) and 66.8 ± 13.8 N⋅m (range, 37.5-93.1) for flexors. For men, the absolute torque for extensors was 199.8 ± 47.3 N⋅m (range, 99.3-311.5 N⋅m) and 89.8 ± 21.0 N⋅m (range, 51.8-137.2 N⋅m) for flexors. For women, the body mass normalized torque for extensors was 2.20 ± 0.51 N⋅m.kg-1 (range, 1.22-3.74 N⋅m.kg-1) and 1.04 ± 0.26 N⋅m.kg-1 (range, 0.41-1.50 N⋅m.kg-1) for flexors. For men, the normalized torque for extensors was 2.74 ± 0.58 N⋅m.kg-1 (range, 1.51-4.08 N⋅m.kg-1) and 1.24 ± 0.30 N⋅m.kg-1 (range, 0.64-2.05 N⋅m.kg-1) for flexors.

Conclusions

This study provides absolute and normalized normative values of maximal isometric torque measured at 80° of knee flexion for extensors and flexors in a series of healthy trained subjects practicing activities at risk of anterior cruciate ligament rupture. The considerable level of interlimb asymmetry and the weak association between dominance and strength observed in uninjured subjects call into question the classical use of contralateral side as reference for injured patients.

Clinical Relevance

Patients with anterior cruciate ligament (ACL) injuries are the most represented subjects using isokinetic dynamometers in many sport medicine and rehabilitation departments. Clinicians need reference values to compare patients with ACL injuries with comparable healthy subjects. This study may provide this information.

Can photobiomodulation improve quadriceps strength and endurance outcomes in asymptomatic adults? A double-blind randomized controlled trial

AIM

To explore the effect of photobiomodulation on quadriceps strength and endurance torques in asymptomatic adults.

METHODS

Twenty-eight asymptomatic adults were randomized to one of two interventions: photobiomodulation (n = 14) or sham (n = 14). Quadriceps strength was evaluated by maximum voluntary isometric contraction test (60°) and endurance by an elastic resistance in multiple-set knee extension/flexion repetitions using a traction dynamometer. The outcomes were measured at three time points: pre-baseline; baseline and; final assessment. The photobiomodulation was applied to the quadriceps and triceps surae muscles of each participant's dominant lower limb, using a cluster with 1 infrared laser diode and 3 led amber of 170 mW for 240 s over four consecutive days. The sham group went through the same procedures, but the equipment was off, and patients and assessors were blinded to the intervention. Reliability and minimal detectable change of the measures were obtained from the pre-baseline and baseline time points. Differences between interventions were tested by an analysis of covariance.

RESULTS AND DISCUSSION

There was no difference between photobiomodulation compared to sham in maximum isometric torque (mean difference (95% CI) = 0.008 (-0.29 to 0.31) and endurance torques (mean difference (95% CI) = 0.04 (-0.03 to 0.12). The mean difference was lower than the minimal detectable change for the maximum isometric torque (1.02 Nm.kg-1) and endurance torque (0.49 Nm.kg-1).

CONCLUSION

Photobiomodulation does not improve quadriceps strength and endurance outcomes in asymptomatic adults.

The effects of regional quadriceps architecture on angle-specific rapid force expression

Evaluating anatomical contributions to performance can increase understanding of muscle mechanics and guide physical preparation. While the impact of anatomy on muscular performance is well studied, the effects of regional quadriceps architecture on rapid torque or force expression are less clear. Regional (proximal, middle, and distal) quadriceps (vastus lateralis, rectus femoris, and vastus intermedius) thickness (MT), pennation angle (PA), and fascicle length (FL) of 24 males (48 limbs) were assessed via ultrasonography. Participants performed maximal isometric knee extensions at 40°, 70°, and 100° of knee flexion to evaluate rate of force development from 0 to 200 ms (RFD0-200). Measurements were repeated on three occasions with the greatest RFD0-200 and mean muscle architecture measures used for analysis. Linear regression models predicting angle-specific RFD0-200 from regional anatomy provided adjusted correlations (√adjR2) with bootstrapped compatibility limits. Mid-rectus femoris MT (√adjR2 = 0.41-0.51) and proximal vastus lateralis FL (√adjR2 = 0.42-0.48) were the best single predictors of RFD0-200, and the only measures to reach precision with 99% compatibility limits. Small simple correlations were found across all regions and joint angles between RFD0-200 and vastus lateralis MT (√adjR2 = 0.28 ± 0.13; mean ± SD), vastus lateralis FL (√adjR2 = 0.33 ± 0.10), rectus femoris MT (√adjR2 = 0.38 ± 0.10), and lateral vastus intermedius MT (√adjR2 = 0.24 ± 0.10). Between-correlation comparisons are reported within the article. Researchers should measure mid-region rectus femoris MT and vastus lateralis FL to efficiently and robustly evaluate potential anatomical contributions to rapid knee extension force changes, with distal and proximal measurements providing little additional value. However, correlations were generally small to moderate, suggesting that neurological factors may be critical in rapid force expression.

Eccentric Cycling Is an Alternative to Nordic Hamstring Exercise to Increase the Neuromuscular Function of Knee Flexors in Untrained Men

ABSTRACT

Valdes, O, Inzulza, S, Collao, N, Garcia-Vicencio, S, Tufano, JJ, Earp, J, Venegas, M, and Peñailillo, L. Eccentric cycling is an alternative to Nordic hamstring exercise to increase the neuromuscular function of knee flexors in untrained men. J Strength Cond Res 37(11): 2158-2166, 2023-Nordic hamstring exercise (NHE) has been proposed to reduce knee flexor (KF) injuries. However, submaximal alternatives to NHE are necessary for the clinical or weaker population. The aim of this study was to compare the effects of Nordic hamstring training (NHT) and eccentric cycling (ECC) training on the neuromuscular function of the KF. Twenty healthy men (27.7 ± 3.5 years) were randomly assigned into 2 groups that performed 10 training sessions (2-3 sessions·week-1) of either NHT (n = 10) or ECC (n = 10). Maximal voluntary isometric contraction of the KF and knee extensor (KE) muscles (MVICKF and MVICKE) was measured, and the hamstring/quadriceps strength (H/Q) ratio was calculated. Furthermore, changes in NHE maximum reaction force (NHE-MRFKF), NHE break-point angle (NHE-BPA), and muscle activity of the semitendinosus (STEMG) and biceps femoris (BFEMG) during the NHE after the interventions were compared. Although no group × time effects were observed (p = 0.09-0.70), but time effects were found for all variables. Pairwise comparisons revealed that MVICKF (+16.9%; p = 0.02), H/Q ratio (+11.8%; p = 0.01), NHE-MRFKF (+19.8%; p = 0.005), and NHE-BPA (+30.8%; p = 0.001) increased after ECC, whereas NHE-MRFKF (+9.7%; p = 0.003), NHE-BPA (+35.5%; p = 0.0002), and STEMG (+33.7%; p = 0.02) increased after NHT. A group × time effect was observed (p = 0.003) in BFEMG, revealing an increase only after ECC (+41.1%; p < 0.0001). Similar neuromuscular adaptations were found after both training modalities. Therefore, ECC provides similar adaptations as NHT and may serve as an alternative form of KF training for those unable to perform NHE.

The Influence of Hip and Knee Joint Angles on Quadriceps Muscle-Tendon Unit Properties during Maximal Voluntary Isometric Contraction

Determining how the quadriceps femoris musculotendinous unit functions, according to hip and knee joint angles, may help with clinical decisions when prescribing knee extension exercises. We aimed to determine the effect of hip and knee joint angles on structure and neuromuscular functioning of all constituents of the quadriceps femoris and patellar tendon properties. Twenty young males were evaluated in four positions: seated and supine in both 20° and 60° of knee flexion (SIT20, SIT60, SUP20, and SUP60). Peak knee extension torque was determined during maximal voluntary isometric contraction (MVIC). Ultrasound imaging was used at rest and during MVIC to characterize quadriceps femoris muscle and tendon aponeurosis complex stiffness. We found that peak torque and neuromuscular efficiency were higher for SUP60 and SIT60 compared to SUP20 and SIT20 position. We found higher fascicle length and lower pennation angle in positions with the knee flexed at 60°. The tendon aponeurosis complex stiffness, tendon force, stiffness, stress, and Young's modulus seemed greater in more elongated positions (60°) than in shortened positions (20°). In conclusion, clinicians should consider positioning at 60° of knee flexion rather than 20°, regardless if seated or supine, during rehabilitation to load the musculotendinous unit enough to stimulate a cellular response.

Normalization of the electromyography amplitude during a multiple-set resistance training protocol: Reliability and differences between approaches

The first aim was to investigate the impact of different electromyography (EMG) parameters as a reference to normalize the EMG amplitude of the superficial quadriceps femoris muscles across different sets of a knee extension exercise. The second aim is to examine the reliability between days of the EMG parameters used as a reference. Eleven young males attended the laboratory on 4 different days and performed one repetition maximum test, maximumvoluntary isometric contractions, and a resistance training protocol until failure. Surface EMG was placed over the rectus femoris, vastus lateralis, and vastus medialis muscles. Seven EMG parameters were calculated from the tasks and used to normalize EMG amplitude measured during the resistance training protocol. A repeated-measures two-way ANOVA was used (normalized EMG amplitude × set) to compare normalized EMG across sets, while an intraclass correlation coefficient, coefficient of variation, and Bland-Altman plots were used to calculate the intra-day reliability of the EMG parameters. The present investigation showed that normalized EMG amplitude of the superficial muscles of the quadriceps measured during a knee extension exercise is influenced by the EMG parameter and depends on the muscle. While rectus femoris and vastus lateralis normalized EMG amplitude presented one parameter among seven showing similar value to the other parameters, VM showed two. Lastly, all EMG parameters for all muscles presented an overall excellent reliability and agreement between days.

The Validity of Ultrasonographic Measurements of the Rectus Femoris Muscle in Older Adults with Sarcopenia in Thai Population

Purpose

This study aimed to determine the validity of ultrasonographic measurement of the rectus femoris muscle (RFM) thickness as a screening tool for low appendicular muscle mass (ASM) to diagnose sarcopenia and to determine the cut-off point of RFM thickness in the Thai population.

Patients and methods

We enrolled 857 community-dwelling adults aged 60 years and older who were diagnosed with sarcopenia using the Asian Working Group for Sarcopenia-2019 algorithm. The RFM thickness was measured using ultrasonography and compared with bioelectrical impedance analysis (BIA) data. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated, and the area under the receiver operating curve (AUROC) was used to determine the accuracy of the test.

Results

A total of 857 participants were included in the study. Overall, when the cut-off values of RFM thickness of ≤1.1 cm were used for male and ≤1 cm for female, the highest sensitivity for sarcopenia diagnosis was 90.9% and specificity was 92.2%. The PPV was 76.6, and the NPV was the highest at 97.3. The highest sensitivity for the diagnosis of severe sarcopenia was 92.5% and specificity was 97.4%. The AUROC of the cut-off point of RFM thickness for the diagnosis of sarcopenia was 0.92 (95% confidence interval [CI], 0.89−0.94); for severe sarcopenia, it was 0.95 (95% CI, 0.92−0.98).

Conclusion

Measuring RFM thickness using ultrasonography is a feasible and reliable screening test for sarcopenia, and the cut-off values of ≤1.1 cm for male and ≤1 cm for female showed the highest accuracy for confirming low ASM in the Thai population.

Muscle volume vs. anatomical cross-sectional area: Different muscle assessment does not affect the muscle size-strength relationship

Muscle volume (MV) and anatomical cross-sectional area (CSA) are used as measures of muscle-size, but determining these from magnetic resonance imaging (MRI) is a very time-consuming process. Additionally, it is unclear if the use of different muscle size assessments (all vs. reduced number of slices images) would impact the muscle size-strength relationship. Thus, this study aimed to investigate if muscle size calculation by using a reduced or all slices images from pectoralis major (PM) would maintain a similar muscle size-strength relationship with bilateral maximal dynamic and isometric contractions on a bench press exercise. Twenty-four healthy males underwent an MRI examination to measure PM muscle size, and maximal isometric and dynamic contractions (by one repetition maximum, 1RM) were performed. Correlations between maximal isometric voluntary force (MVF) and dynamic strength (1RM) with muscle size variables [three images from the largest part of PM (CSA_3MAX), three images accounting for the shape -first image, middle image, final image- of the PM (CSA₃), and MV] were performed. The correlation between 1RM with MV, CSA₃, and CSA_3MAX were 0.84, 0.832, and 0.727 (p < 0.001), respectively. The correlation between MVF with MV, CSA₃, and CSA_3MAX were 0.738, 0.733, and 0.604 (p < 0.001), respectively. Overall, PM MV and CSA₃ exhibit a stronger and similar muscle size-strength relationship during maximal dynamic and isometric tests than CSA_3MAX. Therefore, a reduced number of slices (CSA₃) could be used as an alternative to considerably reduce the time of analysis without compromise muscle size-strength relationship.

Longing for a Longitudinal Proxy: Acutely Measured Surface EMG Amplitude is not a Validated Predictor of Muscle Hypertrophy

Surface electromyography amplitudes are commonly measured in acute sports and exercise science studies to make inferences about muscular strength, performance, and hypertrophic adaptations that may result from different exercises or exercise-related variables. Here, we discuss the presumptive logic and assumptions underlying these inferences, focusing on hypertrophic adaptations for simplicity's sake. We present counter-evidence for each of its premises and discuss evidence both for and against the logical conclusion. Given the limited evidence validating the amplitude of surface electromyograms as a predictor of longitudinal hypertrophic adaptations, coupled with its weak mechanistic foundation, we suggest that acute comparative studies that wish to assess stimulus potency be met with scrutiny.

Fatigue-induced changes in knee-extensor torque complexity and muscle metabolic rate are dependent on joint angle

Purpose

Joint angle is a significant determinant of neuromuscular and metabolic function. We tested the hypothesis that previously reported correlations between knee-extensor torque complexity and metabolic rate (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2) would be conserved at reduced joint angles (i.e. shorter muscle lengths).

Methods

Eleven participants performed intermittent isometric knee-extensor contractions at 50% maximum voluntary torque for 30 min or until task failure (whichever occurred sooner) at joint angles of 30º, 60º and 90º of flexion (0º = extension). Torque and surface EMG were sampled continuously. Complexity and fractal scaling of torque were quantified using approximate entropy (ApEn) and detrended fluctuation analysis (DFA) α. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 was determined using near-infrared spectroscopy.

Results

Time to task failure/end increased as joint angle decreased (P < 0.001). Over time, complexity decreased at 90º and 60º (decreased ApEn, increased DFA α, both P < 0.001), but not 30º. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 increased at all joint angles (P < 0.001), though the magnitude of this increase was lower at 30º compared to 60º and 90º (both P < 0.01). There were significant correlations between torque complexity and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 at 90º (ApEn, r =  − 0.60, P = 0.049) and 60º (ApEn, r =  − 0.64, P = 0.035; DFA α, ρ = 0.68, P = 0.015).

Conclusion

The lack of correlation between \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 and complexity at 30º was likely due to low relative task demands, given the similar kinetics of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 and torque complexity. An inverse correlation between \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text{m}\dot{\text{V}}\text{O}}_{{2}}$$\end{document}mV˙O2 and knee-extensor torque complexity occurs during high-intensity contractions at intermediate, but not short, muscle lengths.

Resistance training intervention performed with different muscle action durations influences the maximal dynamic strength without promoting joint-angle specific strength gains

The present study investigated the effect of 10-week matched (range of motion, volume, intensity, rest, and repetition duration) training protocols with varying muscle action duration (MAD) on maximal voluntary isometric contraction (MVIC) test at eight different knee angles and one-repetition maximum (1RM) test after in seated knee extensor machine. Forty women were allocated into one control and three training groups with varying MAD: 5C1E (5s concentric action [CON] and 1s eccentric action [ECC]), 3C3E (3s CON and 3s ECC), and 1C5E (1s CON and 5s ECC). All training groups (5C1E, 3C3E, and 1C5E) showed a greater relative response in 1RM performance than the control group (0.1 ± 3.5%, p ≤ 0.05). The 1C5E group presented greater relative increases in the 1RM performance (22.1 ± 11.6%) compared to 5C1E (13.6 ± 9.2%; p ≤ 0.05) and 3C3E (14.1 ± 5.5%, p ≤ 0.05) groups. The training groups increased the MVIC performance more than the control group (p ≤ 0.05), although there were no significant differences between the training groups. This study demonstrated that isoinertial resistance training protocols with shorter CON MAD showed greater maximum dynamic strength performance response than matched training protocols with other MAD configurations. However, the configuration of MAD did not induce angle-specificity to increase the maximum isometric strength.

Low-cost electromyography: validity against a commercial system depends on exercise type and intensity

The aim of this study was to assess the validity of a custom-made low cost (LC) and a commercial surface EMG apparatus in controlled experimental conditions and different exercise types: maximal voluntary contractions (MVC) at 105, 90, 75, 60, 45 and 30° knee angle and explosive fix-end contractions of the knee extensors (75°) at an isometric dynamometer. sEMG of vastus lateralis was recorded from the same electrodes simultaneously, then analyzed in the same way; sEMG were finally expressed in percentage of those collected at 75°MVC. LC underestimated the sEMG signal at the more extended knee angles (30-60°), significant difference was observed only at 30°. In the explosive contractions no differences between devices were observed in average and peak sEMG, as well as in the time to peak and the activation time. Bland-Altman tests and correlation parameters indicate the LC device is not sensible enough to detect the time to peak and the peak values of the sEMG signal properly. Results suggest low-cost systems might be a valid alternative to commercial ones, but attention must be paid when analyzing rapid events.

The effect of different resistance training protocols equalized by time under tension on the force-position relationship after 10 weeks of training period

This study investigated the impact of performing two equalized resistance training (RT) protocols for 10 weeks that differ only by repetition duration and number in the force-position and EMG-position relationship. Participants performed an equalized (36 s of time under tension; 3-4 sets; 3 min between sets; 50-55% of one-repetition maximum; 3× week) RT intervention on the bench press and the only different change between protocols was repetition number (RN; 12 vs.6) or duration (RD; 3 s vs. 6 s). Two experimental groups (RN₁₂RD₃, n = 12; and RN₆RD₆, n = 12) performed the RT, while one group was the control (Control, n = 11). Maximal isometric contractions at 10%, 50% and 90% of total bench press range of motion were performed pre- and post-RT, while electromyography was recorded. It demonstrated an increase in isometric force (+14% to 24%, P < 0.001) shifting up the force-position relationship of the training groups after RT, although no difference was between training groups compared to the Control. Neuromuscular activation from pectoralis major presented an increase after training for both RT groups (+44%; P < 0.001) compared to the Control. However, although not significantly different, triceps brachii also presented an increase depending on the protocol (+25%). In conclusion, 10 weeks of an equalized RT with longer RN and shorter RD (or opposite) similarly increases the ability to produce maximal isometric force during the bench exercise across different angles, while neuromuscular activation of the pectoralis major partially explained the shift-up of the force-position relationship after training.

The effect of regional quadriceps anatomical parameters on angle-specific isometric torque expression

The length–tension relationship affects knee extension performance; however, whether anatomical variations in different quadriceps regions affect this relationship is unknown. Regional (proximal, middle, distal) quadriceps thickness (MT), pennation angle, and fascicle length of 24 males (48 limbs) were assessed via ultrasonography. Participants also performed maximal voluntary isometric torque (MVIT) assessments at 40°, 70°, and 100° of knee flexion. Measures were recorded on 3 separate occasions. Linear regression models predicting angle-specific torque from regional anatomy provided adjusted simple and multiple correlations (√adjR2) with bootstrapped compatibility limits to assess magnitude. Middle vastus lateralis MT and MVIT at 100° (√adjR2 = 0.64) was the largest single correlation, with distal vastus lateralis MT having the greatest mean correlations regardless of angle (√adjR2 = 0.61 ± 0.05, mean ± SD). Lateral distal MT and architecture had larger (Δ√adjR2 = 0.01 to 0.43) single and multiple correlations with MVIT than the lateral proximal (√adjR2 = 0.15 to 0.69 vs −0.08 to 0.65). Conversely, middle anterior MT had greater (Δ√adjR2 = 0.08 to 0.38) single and multiple correlations than proximal MT (√adjR2 = 0.09 to 0.49 vs −0.21 to 0.14). The length–tension relationship was trivially affected by regional quadriceps architecture. The middle and distal quadriceps were the strongest predictors of MVIT at all joint angles. Therefore, researchers may wish to focus on middle and distal lateral quadriceps anatomy when performing ultrasonographic evaluations.

Novelty: The length–tension relationship is minimally affected by regional quadriceps anatomical parameters. Middle and distal vastus lateralis and lateral vastus intermedius anatomy were consistently the best predictors of torque. Practitioners may focus their assessments on the middle and distal regions of the lateral quadriceps’ musculature.

Voluntary activation of knee extensor muscles with transcranial magnetic stimulation

We examined if transcranial magnetic stimulation (TMS) is a valid tool for assessment of voluntary activation of the knee extensors in healthy individuals. Maximal M-waves (M_max) of vastus lateralis (VL) were evoked with electrical stimulation of femoral nerve (FNS); M_max of medial hamstrings (HS) was evoked with electrical stimulation of sciatic nerve branches; motor evoked potentials (MEPs) of VL and HS were evoked with TMS; superimposed twitches (SIT) of knee extensors were evoked with FNS and TMS. In study 1, TMS intensity [69% output (SD: 5)] was optimized for MEP sizes, but guidelines for test validity could not be met. Agonist VL MEPs were too small [51.4% M_max (SD: 11.9); guideline ≥70% M_max] and antagonist HS MEPs were too big [16.5% M_max (SD: 10.3); guideline <10% M_max]. Consequently, the TMS estimated resting twitch [99.1 N (SD: 37.2)] and FNS resting twitch [142.4 N (SD: 41.8)] were different. In study 2, SITs at 90% maximal voluntary contraction (MVC) were similar between TMS [16.1 N (SD: 10.3)] and FNS [20.9 N (SD: 16.7)], when TMS intensity was optimized for this purpose, suggesting a procedure that combines TMS SITs with FNS resting twitches could be valid. In study 3, which tested the TMS intensity [56% output (SD: 18)] that evoked the largest SIT at 90% MVC, voluntary activation from TMS [87.3% (SD: 7.1)] and FNS [84.5% (SD: 7.6)] was different. In sum, the contemporary procedure for TMS-based voluntary activation of the knee extensors is invalid. A modified procedure improves validity but only in individuals who meet rigorous inclusion criteria for SITs and MEPs.NEW & NOTEWORTHY We discovered that the contemporary procedure for assessing voluntary activation of the knee extensor muscles with transcranial magnetic stimulation (TMS) is invalid. TMS activates too few agonist quadriceps motoneurons and too many antagonist hamstrings motoneurons to estimate the resting twitch accurately. A modified procedure, in which TMS-evoked superimposed twitches are considered together with the resting twitch from femoral nerve stimulation, is valid but only in select individuals who meet rigorous eligibility criteria.

Reference Values for Isometric, Dynamic, and Asymmetry Leg Extension Strength in Patients with Multiple Sclerosis

Having recognized the value of resistance training in patients with multiple sclerosis (PwMS), there are a lack of lower limb normative reference values for one repetition maximum (1RM) and maximal voluntary isometric contraction (MVIC) in this population. Hence, the purposes of this study were to provide reference values for 1RM and MVIC of knee extensors in PwMS across the disability spectrum and to examine knee extension strength asymmetry. Three hundred and ninety PwMS participated in the study, performing MVIC and 1RM tests of bilateral (both legs together at once) and unilateral (each leg singly) knee extensors. There was no difference in 1RM according to the disease course of MS, but there was according to the degree of neurological disability, being more preserved in those with a lower degree of disability. MVIC tends to be higher in patients with relapsing-remitting MS respect those with progressive MS, and in patients with lower levels of neurological disability. Asymmetry above the values considered normal in 1RM was present in 20-60% of patients and 56-79% in the MVIC test, depending on the type of MS and tended to be lower in those with less disability. Reference values are given by quartiles for 1RM, MVIC, and asymmetry.

An Electromyographic Analysis of Lateral Raise Variations and Frontal Raise in Competitive Bodybuilders

The present study examined the muscle activation in lateral raise with humerus rotated externally (LR-external), neutrally (LR-neutral), internally (LR-internal), with flexed elbow (LR-flexed) and frontal raise during both the concentric and eccentric phase. Ten competitive bodybuilders performed the exercises. Normalized surface electromyographic root mean square (sEMG RMS) was obtained from anterior, medial, and posterior deltoid, pectoralis major, upper trapezius, and triceps brachii. During the concentric phase, anterior deltoid and posterior deltoid showed greater sEMG RMS in frontal raise (effect size (ES)-range: 1.78/9.25)) and LR-internal (ES-range: 10.79/21.34), respectively, vs. all other exercises. Medial deltoid showed greater sEMG RMS in LR-neutral than LR-external (ES: 1.47 (95% confidence-interval—CI: 0.43/2.38)), frontal raise (ES: 10.28(95% CI: 6.67/13.01)), and LR-flexed (ES: 6.41(95% CI: 4.04/8.23)). Pectoralis major showed greater sEMG RMS in frontal raise vs. all other exercises (ES-range: 17.2/29.5), while upper trapezius (ES-range: 2.66/7.18) and triceps brachii (ES-range: 0.41/3.31) showed greater sEMG RMS in LR-internal vs. all other exercises. Similar recruitment patterns were found during the eccentric phase. When humerus rotates internally, greater activation of posterior deltoid, triceps brachii, and upper trapezius occurs. Humerus external rotation increases the activation of anterior and medial deltoid. Frontal raise mainly activates anterior deltoid and pectoralis major. LR variations and frontal raise activate specifically shoulders muscles and should be proposed accordingly.

Is there an intermuscular relationship in voluntary activation capacities and contractile kinetics?

PURPOSE

The force-generating capacities of human skeletal muscles are interrelated, highlighting a common construct of limb strength. This study aimed to further determine whether there is an intermuscular relationship in maximal voluntary activation capacities and contractile kinetics of human muscles.

METHODS

Twenty-six young healthy individuals participated in this study. Isometric maximal voluntary contraction (MVC) torque, voluntary activation level (VAL), and doublet twitch contractile kinetics (contraction time and half-relaxation time) evoked by a paired supramaximal peripheral nerve stimulation at 100 Hz were obtained in elbow flexors, knee extensors, plantar flexors and dorsiflexors of the dominant limb.

RESULTS

Peak MVC torque had significant positive correlations between all muscle group pairs (all P values < 0.01). A significant positive correlation for VAL was found only between knee extensors and plantar flexors (r = 0.60, P < 0.01). There were no significant correlations between all muscle group pairs for doublet twitch contraction time and doublet twitch half-relaxation time.

DISCUSSION

These results show that there is a partial common construct of maximal voluntary activation capacities that only concerns muscle groups that have incomplete activation during MVC (i.e., knee extensors and plantar flexors). This suggests that the common construct of MVC strength between these two muscle groups is partly influenced by neural mechanisms. The lack of intermuscular relationship of contractile kinetics showed that there is no common construct of muscle contractile kinetics, as assessed in vivo by investigating the time-course of evoked doublet twitch contractions.

Badminton players show a lower coactivation and higher beta band intermuscular interactions of ankle antagonist muscles during isokinetic exercise

Previous studies have suggested that skilled athletes may show a specific muscle activation pattern with a lower antagonist coactivation level. Based on the point, we hypothesize that the coupling of antagonistic muscles may be different between badminton players and non-skilled individuals during exercises. The current work was designed to verify the hypothesis. Ten male college students and eight male badminton players performed three maximal voluntary isometric contractions (MVC) and a set of three maximal concentric ankle dorsiflexion and plantar flexions at an angular velocity of 30°, 60°, 120°, and 180°/s. Surface electromyography (EMG) was recorded from the tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during the test. Normalized average EMG amplitude and phase synchronization index (PSI) between surface EMG of TA and LG were calculated. Antagonist muscle coactivation was significantly lower (from 22.1% ± 9.4 and 10.7% ± 3.7 at 30°/s to 22.4% ± 9.7 and 10.6% ± 2.5 at 180°/s for non-players and badminton players group, respectively), and PSI in beta frequency band was significantly higher (from 0.42 ± 0.06 and 0.47 ± 0.15 at 30°/s to 0.35 ± 0.12 and 0.49 ± 0.14 at 180°/s) in the badminton player group compared with the non-player group during isokinetic ankle dorsiflexion contraction. No significant difference was found in antagonist muscle coactivation and PSI between two group subjects during ankle plantar flexion. The decrease of antagonist coactivation may indicate an optimal motor control style to increase the contraction efficiency, while the increase coupling of antagonistic muscles may help to ensure joint stability to compensate for the decrease of antagonist coactivation. Graphical abstract Significant difference of observed indexes between non-players and badminton players.

Neuromuscular Properties of the Human Wrist Flexors as a Function of the Wrist Joint Angle

The joint angle dependence of voluntary activation and twitch properties has been investigated for several human skeletal muscles. However, although they play a key role for hand function and possess a unique neural control compared to muscles surrounding other joint complexes, little is known about the wrist flexors innervated by the median nerve. Therefore, isometric voluntary and electrically evoked contractions of the wrist flexors were analyzed at three wrist joint angles (extension: -30°, neutral: 0°, flexion: 30°) to quantify the joint angle dependence of (i) voluntary activation (assessed via peripheral nerve stimulation and electromyography [EMG]), (ii) unpotentiated twitch torques, and (iii) potentiated twitch torques. Maximum voluntary torque was lower in extension compared to neutral and flexion. Although voluntary activation was generally high, data indicate that voluntary activation of the wrist flexors innervated by the median nerve was lower and the antagonist·agonist^-1 EMG ratio was higher with the wrist joint in flexion compared to extension. Peak twitch torque, rate of twitch torque development, and twitch half-relaxation time increased, whereas electromechanical delay decreased from flexion to extension for the unpotentiated twitch torques. Activity-induced potentiation partly abolished these differences and was higher in short than long wrist flexors. Different angle-dependent excitatory and inhibitory inputs to spinal and supraspinal centers might be responsible for the altered activation of the investigated wrist muscles. Potential mechanisms were discussed and might have operated conjointly to increase stiffness of the flexed wrist joint. Differences in twitch torque properties were probably related to angle-dependent alterations in series elastic properties, actin-myosin interaction, Ca²⁺ sensitivity, and phosphorylation of myosin regulatory light chains. The results of the present study provide valuable information about the contribution of neural and muscular properties to changes in strength capabilities of the wrist flexors at different wrist joint angles. These data could help to understand normal wrist function, which is a first step in determining mechanisms underlying musculoskeletal disorders and in giving recommendations for the restoration of musculoskeletal function after traumatic or overuse injuries.

Explosive strength: effect of knee-joint angle on functional, neural, and intrinsic contractile properties

Purpose

The present study compared knee extension explosive isometric torque, neuromuscular activation, and intrinsic contractile properties at five different knee-joint angles (35°, 50°, 65°, 80°, and 95°; 0° = full knee extension).

Methods

Twenty-eight young healthy males performed two experimental sessions each involving: 2 maximum, and 6–8 explosive voluntary contractions at each angle; to measure maximum voluntary torque (MVT), explosive voluntary torque (EVT; 50–150 ms after contraction onset) and quadriceps surface EMG (QEMG, 0–50, 0–100, and 0–150 ms after EMG onset during the explosive contractions). Maximum twitch and M-wave (M_MAX) responses as well as octet contractions were evoked with femoral nerve stimulation at each angle.

Results

Absolute MVT and EVT showed an inverted ‘U’ relationship with higher torque at intermediate angles. There were no differences between knee-joint angles for relative EVT (%MVT) during the early phase (≤ 75 ms) of contraction and only subtle differences during the late phase (≥ 75 ms) of contraction (≤ 11%). Neuromuscular activation during explosive contractions was greater at more flexed than extended positions, and this was also the case during MVT. Whilst relative twitch torque (%MVT) was higher at knee flexed positions (P ≤ 0.001), relative octet torque (%MVT) was higher at knee extended positions (P ≤ 0.001).

Conclusion

Relative EVT was broadly similar between joint angles, likely because neuromuscular activation during both explosive and plateau (maximum) phases of contraction changed proportionally, and due to the opposing changes in twitch and octet evoked responses with joint angle.

CORP: Measurement of upper and lower limb muscle strength and voluntary activation

Muscle strength, the maximal force-generating capacity of a muscle or group of muscles, is regularly assessed in physiological experiments and clinical trials. An understanding of the expected variation in strength and the factors that contribute to this variation is important when designing experiments, describing methodologies, interpreting results, and attempting to replicate methods of others and reproduce their findings. In this review (Cores of Reproducibility in Physiology), we report on the intra- and inter-rater reliability of tests of upper and lower limb muscle strength and voluntary activation in humans. Isometric, isokinetic, and isoinertial strength exhibit good intra-rater reliability in most samples (correlation coefficients ≥0.90). However, some tests of isoinertial strength exhibit systematic bias that is not resolved by familiarization. With the exception of grip strength, few attempts have been made to examine inter-rater reliability of tests of muscle strength. The acute factors most likely to affect muscle strength and serve as a source of its variation from trial-to-trial or day-to-day include attentional focus, breathing technique, remote muscle contractions, rest periods, temperature (core, muscle), time of day, visual feedback, body and limb posture, body stabilization, acute caffeine consumption, dehydration, pain, fatigue from preceding exercise, and static stretching >60 s. Voluntary activation, the nervous system’s ability to drive a muscle to create its maximal force, exhibits good intra-rater reliability when examined with twitch interpolation (correlation coefficients >0.80). However, inter-rater reliability has not been formally examined. The methodological factors most likely to influence voluntary activation are myograph compliance and sensitivity; stimulation location, intensity, and inadvertent stimulation of antagonists; joint angle (muscle length); and the resting twitch.