Acute changes in knee-extensors torque, fiber pennation, and tendon characteristics

The aim of the current study was to examine the relationships between quadriceps torque, vastus lateralis pennation angle (theta), and patella tendon stiffness (K) at 07:45 and 17:45 h. Using short-duration static contractions, simultaneous recordings were made of vastus lateralis (VL) electromyograph (EMG), theta and patella tendon K. Peak isometric extension torque (Peak torque Ext(corr)) increased by 29.4+/-6.5% at a knee angle of 70 degrees (p=0.03) in the evening compared to the morning. In the contracted muscle, a 35.0+/-11.0% (p=0.02) time-of-day (TOD)-related change in theta (to a greater evening compared to morning theta) was observed. Morning and evening measures of theta were also made, both at rest and at a standardized force level (250 N), to separate architecture change effects from increased torque capacity effects. Significant increments in theta in both the resting muscle (13.0+/-5.1%, p=0.046) and during the standardized exertions (8.0+/-3.1%, p=0.04) were observed in the evening versus the morning. Increases in theta with TOD were significantly correlated with the 40% (p=0.018) decrease in K both during the standardized contractions (r=0.788, p<0.001) and at rest (r=0.77, p=0.026). These data show that TOD affects K and theta and that these two important factors involved in in-vivo muscle torque generation capacity are associated. The data also show that despite the potentially deleterious effects of the direction of the changes in both K and theta with TOD, peak torque Ext(corr) still shows a significant upward shift in the evening relative to the morning.     

Acute Changes In Knee‐Extensors Torque,Fiber Pennation,and Tendon Characteristics

The aim of the current study was to examine the relationships between quadriceps torque, vastus lateralis pennation angle (θ), and patella tendon stiffness (K) at 07:45 and 17:45 h. Using short‐duration static contractions, simultaneous recordings were made of vastus lateralis (VL) electromyograph (EMG), θ and patella tendon K. Peak isometric extension torque (Peak torque Ext_corr) increased by 29.4±6.5% at a knee angle of 70° (p=0.03) in the evening compared to the morning. In the contracted muscle, a 35.0±11.0% (p=0.02) time‐of‐day (TOD)‐related change in θ (to a greater evening compared to morning θ) was observed. Morning and evening measures of θ were also made, both at rest and at a standardized force level (250 N), to separate architecture change effects from increased torque capacity effects. Significant increments in θ in both the resting muscle (13.0±5.1%, p=0.046) and during the standardized exertions (8.0±3.1%, p=0.04) were observed in the evening versus the morning. Increases in θ with TOD were significantly correlated with the 40% (p=0.018) decrease in K both during the standardized contractions (r=0.788, p<0.001) and at rest (r=0.77, p=0.026). These data show that TOD affects K and θ and that these two important factors involved in in‐vivo muscle torque generation capacity are associated. The data also show that despite the potentially deleterious effects of the direction of the changes in both K and θ with TOD, peak torque Ext_corr still shows a significant upward shift in the evening relative to the morning.     

The effects of antagonist prefatigue on agonist torque and electromyography

This study assessed the effects of hamstring prefatigue on peak torque, peak power, time to peak torque, knee angle of peak torque, and electromyography (EMG) activity of the hamstrings and quadriceps group during knee extensions at angular velocities of 60 degrees, 180 degrees, and 300 degrees.s(-1). Twenty Division I wrestlers performed 5 maximal knee extensions in prefatigued and nonfatigued conditions of the hamstring group. This study demonstrated that when the hamstrings were prefatigued, the quadriceps produced significant decreases in peak torque of 1.7% (p < 0.05), peak power of 11% (p < 0.05), and rate to peak torque of 6.4% (p < 0.01) as compared with the nonfatigued state. When the hamstrings were prefatigued, they produced a 25% greater amount of EMG activity during knee extension (p < 0.01) than when not prefatigued. There was no significant difference in quadriceps EMG activity whether the hamstring group was prefatigued or not (p > 0.05). The decrease in quadriceps peak torque during the prefatigued condition was more pronounced (p < 0.01) at an angular velocity of 60 degrees.s(-1) than at 180 degrees or 300 degrees.s(-1). In other words, prefatiguing the antagonist appears to be most detrimental to torque output of the quadriceps in the condition that most closely replicates the speed at which "isotonic" weight training occurs (60 degrees.s(-1)) and suggests a limitation to agonist-antagonist superset training.     

Time-of-day effects on myoelectric and mechanical properties of muscle during maximal and prolonged isokinetic exercise

The aim of this study was to examine the time-of-day (TOD) effects in myoelectric and mechanical properties of muscle during a maximal and prolonged isokinetic exercise. Twelve male subjects were asked to perform 50 maximal voluntary contractions (MVC) of the knee extensor muscles at a constant angular velocity of 2.09 rad . sec(-1), at 06 : 00 and 18 : 00 h. Torque and electromyographic (EMG) parameters were recorded for each contraction, and the ratio between these values was calculated to evaluate variations of the neuromuscular efficiency (NME) with fatigue and with TOD. The results indicated that maximal torque values (T(45)Max) was significantly higher (7.73%) in the evening than in the morning (p<0.003). The diurnal variation in torque decrease was used to define two phases. During the first phase (1st to the 26th repetition), torque values decreased fast and values were higher in the evening than in the morning, and during the second phase (27th to the 50th repetition), torque decreased slightly and reached a floor value that appeared constant with TOD. The EMG parameters (Root Mean Square; RMS) were modified with fatigue, but were not TOD dependent. The NME decrease-significantly with fatigue, showing that peripheral factors were mainly involved in the torque decrease. Furthermore, NME decrease was greater at 18 : 00 than at 06 : 00 h for the vastus medialis (p<0.05) and the vastus lateralis muscles (p<0.002), and this occurred during the first fatigue phase of the exercise. In conclusion, the diurnal variation of the muscle fatigue observed during a maximal and prolonged isokinetic exercise seems to reflect on the muscle, with a greater contractile capacity but a higher fatigability in the evening compared to the morning.     

Fascicle behavior of medial gastrocnemius muscle in extended and flexed knee positions

The present study tested the hypotheses that Achilles tendon forces during fast concentric actions do not differ between extended and flexed knee positions, and this phenomenon is attributable to the force-length characteristics and electromyograms (EMGs) of gastrocnemius muscle. Seven healthy men performed static and concentric plantarflexions at fully extended (K0) and 0.785 rad (45 degrees ) flexed (K45) knee positions with the maximal effort. In concentric actions, the angular velocities were set at 0.524 (slow) and 6.109 rad s(-1) (fast). Fascicle length of medial gastrocnemius (MG) was determined with ultrasonography. Surface EMGs of the MG were recorded during each action. Achilles tendon force was calculated from the torque and moment arm of the tendon. Peak tendon forces in fast concentric actions were similar in K0 and in K45, but those in static and slow concentric actions significantly (P<0.05) differed between the two positions. When the tendon force peaked, the fascicle lengths in each action and fascicle velocities in both concentric actions were significantly (P<0.05) greater in K0 than in K45. The EMGs were significantly (P<0.05) higher in K0 than K45 during each action. The results suggest that (1) the difference in the tendon forces between the two positions can be explained by the force-length and -velocity characteristics and the EMGs of the MG, and (2) the contribution of the MG to the tendon force in flexed knee positions is greater in concentric actions than expected from the results in static actions.     

Effects of isometric training on the elasticity of human tendon structures in vivo.

The present study aimed to investigate the effect of isometric training on the elasticity of human tendon structures. Eight subjects completed 12 wk (4 days/wk) of isometric training that consisted of unilateral knee extension at 70% of maximal voluntary contraction (MVC) for 20 s per set (4 sets/day). Before and after training, the elongation of the tendon structures in the vastus lateralis muscle was directly measured using ultrasonography while the subjects performed ramp isometric knee extension up to MVC. The relationship between the estimated muscle force and tendon elongation (L) was fitted to a linear regression, the slope of which was defined as stiffness of the tendon structures. The training increased significantly the volume (7.6+/-4.3%) and MVC torque (33.9+/-14.4%) of quadriceps femoris muscle. The L values at force production levels beyond 550 N were significantly shorter after training. The stiffness increased significantly from 67.5+/-21.3 to 106.2+/-33.4 N/mm. Furthermore, the training significantly increased the rate of torque development (35.8 +/- 20.4%) and decreased electromechanical delay (-18.4+/-3.8%). Thus the present results indicate that isometric training increases the stiffness and Young's modulus of human tendon structures as well as muscle strength and size. This change in the tendon structures would be assumed to be an advantage for increasing the rate of torque development and shortening the electromechanical delay.     

Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions

The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90° flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30° plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15° of dorsiflexion with an isokinetic dynamometer at 30°/s and 150°/s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force–length relations and/or to the slackness of tendinous tissues.     

Initial phase of maximal voluntary and electrically stimulated knee extension torque development at different knee angles.

We investigated the capacity for torque development and muscle activation at the onset of fast voluntary isometric knee extensions at 30, 60, and 90 degrees knee angle. Experiments were performed in subjects (n = 7) who had high levels (>90%) of activation at the plateau of maximal voluntary contractions. During maximal electrical nerve stimulation (8 pulses at 300 Hz), the maximal rate of torque development (MRTD) and torque time integral over the first 40 ms (TTI40) changed in proportion with torque at the different knee angles (highest values at 60 degrees ). At each knee angle, voluntary MRTD and stimulated MRTD were similar (P < 0.05), but time to voluntary MRTD was significantly longer. Voluntary TTI40 was independent (P > 0.05) of knee angle and on average (all subjects and angles) only 40% of stimulated TTI40. However, among subjects, the averaged (across knee angles) values ranged from 10.3 +/- 3.1 to 83.3 +/- 3.2% and were positively related (r2 = 0.75, P < 0.05) to the knee-extensor surface EMG at the start of torque development. It was concluded that, although all subjects had high levels of voluntary activation at the plateau of maximal voluntary contraction, among subjects and independent of knee angle, the capacity for fast muscle activation varied substantially. Moreover, in all subjects, torque developed considerably faster during maximal electrical stimulation than during maximal voluntary effort. At different knee angles, stimulated MRTD and TTI40 changed in proportion with stimulated torque, but voluntary MRTD and TTI40 changed less than maximal voluntary torque.     

Patella tendon moment arm function considerations for human vastus lateralis force estimates

In vivo muscle forces are typically estimated using literature-based or subject-specific moment arms (MAs) because it is not possible to measure in vivo muscle forces non-invasively. However, even subject-specific muscle-tendon MAs vary across contraction levels and are impossible to determine at high contraction levels without techniques that use ionized radiation. Therefore, different generic MA functions are often used to estimate in vivo muscle forces, which may alter force predictions and the shape of the muscle’s force-length relationship. The aim of this study was to examine the influence of different literature-based patella tendon MA functions on the vastus lateralis (VL) force-angle relationship. Participants (n = 11) performed maximum voluntary isometric knee extension contractions at six knee flexion angles, ranging from 40° to 90°. To estimate in vivo VL muscle force, the peak knee extension torque at each joint angle was multiplied by the VL’s physiological cross-sectional area (PCSA) relative to the quadriceps’ PCSA (34%) and then divided by the angle-specific patella tendon MA for 19 different functions. Maximum VL force was significantly different across MA functions (p ≤ 0.039) and occurred at different knee flexion angles. The shape of the VL force-angle relationship also differed significantly (p < 0.01) across MA functions. According to the maximum force generated by VL based on its literature-derived PSCA, only the VL force-angle relationships estimated using geometric imaging-based MA functions are feasible across the knee angles studied here. We therefore recommend that an average of these MA functions is calculated to estimate quadriceps muscle forces if subject-specific MAs cannot be determined.     

Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

Aim

To investigate whether there is a sex difference in exercise induced muscle damage.

Materials and Method

Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage.

Results

Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p<0.05). There was no sex difference in isometric torque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05), and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05).

Conclusion

Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.     

Accessory muscle activation during the superimposed burst technique

Quadriceps muscle activation is assessed using the superimposed burst technique. This technique involves percutaneous muscle stimulation superimposed during maximal isometric volitional knee extension. It is unknown whether accessory muscle activation during maximal knee extension influences estimates of quadriceps muscle activation. Our aim was to compare accessory muscle activation while performing the superimposed burst technique using investigator delivered verbal instruction to constrain the system (CS) and a participant preferred (PP) technique. Twenty five healthy, active individuals (13M/12F, age=23.8 ± 3.35, height=72.73 ± 14.51 cm, and weight=175.29 ± 9.59 kg) were recruited for this study. All participants performed superimposed burst testing with (CS) and without (PP) verbal instruction to encourage isolated quadriceps activation during maximal isometric knee extension. The main outcome variables measured were knee extension torque, quadriceps central activation ratio and mean EMG of vastus lateralis, biceps femoris, and lumbar paraspinal muscles. There were significant differences in knee extension torque (CS=2.87 ± 0.93 Nm/kg, PP=3.40 ± 1.12 Nm/kg, p<0.001), superimposed burst torque (CS=3.40 ±0.98 Nm/kg, PP=3.75 ± 1.11 Nm/kg, p=0.002) and quadriceps CAR (CS=84.1 ± 12.0%, PP=90.2 ± 9.9%, p<0.001) between the techniques. There was also a significant difference in lumbar paraspinal EMG (CS=6.40 ± 8.52%, PP=11.86 ± 14.89%, p=0.043) between the techniques however vastus lateralis EMG was not significantly different. Patient instruction via verbal instruction to constrain proximal structures may help patient minimize confounders to knee extension torque generation while maximizing quadriceps activation.     

Age-related fatigability in knee extensors and knee flexors during dynamic fatiguing contractions

This study investigated the effects of dynamic knee extension and flexion fatiguing task on torque and neuromuscular responses in young and older individuals. Eighteen young (8 males; 25.1 ± 3.2 years) and 17 older (8 males; 69.7 ± 3.7 years) volunteered. Following a maximal voluntary isometric contraction test, participants performed a fatiguing task involving 22 maximal isokinetic (concentric) knee extension and flexion contractions at 60°/s, while surface EMG was recorded simultaneously from the knee extensors (KE) and flexors (KF). Fatigue-induced relative torque reductions were similar between age groups for KE (peak torque decrease: 25.15% vs 26.81%); however, KF torque was less affected in older individuals (young vs older peak torque decrease: 27.6% vs 11.5%; p < 0.001) and this was associated with greater increase in hamstring EMG amplitude (p < 0.001) and hamstrings/quadriceps peak torque ratio (p < 0.01). Furthermore, KE was more fatigable than KF only among older individuals (peak torque decrease: 26.8% vs 11.5%; p < 0.001). These findings showed that the age-related fatigue induced by a dynamic task was greater for the KE, with greater age-related decline in KE compared to KF.     

Time-of-day effect on the torque and neuromuscular properties of dominant and non-dominant quadriceps femoris

The study was conducted first, to determine the possibility of a dichotomy between circadian rhythm of maximal torque production of the knee extensors of the dominant and non-dominant legs, and second, to determine whether the possible dichotomy could be linked to a change in the downward drive of the central nervous system and/or to phenomena prevailing at the muscular level. The dominant leg was defined as the one with which subjects spontaneously kick a football. Tests were performed at 06:00, 10:00, 14:00, 18:00, and 22:00 h. To distinguish the neural and muscular mechanisms that influence muscle strength, the electromyographic and mechanical muscle responses associated with electrically evoked and/or voluntary contractions of the human quadriceps and semi-tendinosus muscles for each leg were recorded and compared. The main finding was an absence of interaction between time-of-day and dominance effects on the torque associated with maximal voluntary contraction (MVC) of both quadriceps. A significant time-of-day effect on MVC torque of the knee extensors was observed for the dominant and non-dominant legs when the data were collapsed, with highest values occurring at 18:00 h (p < 0.01). From cosinor analysis, a circadian rhythm was documented (p < 0.001) with the peak (acrophase) estimated at 18:18 +/- 00:12 h and amplitude (one-half the peak-to-trough variation) of 3.3 +/- 1.1%. Independent of the leg tested, peripheral mechanisms demonstrated a significant time-of-day effect (p < 0.05) on the peak-torque of the single and doublet stimulations, with maximal levels attained at 18:00 h. The central activation of the quadriceps muscle of each leg remained unchanged during the day. The present results confirmed previous observations that muscle torque changes in a predictable manner during the 24 h period, and that the changes are linked to modifications prevailing at the muscular, rather than the neural, level. The similar rhythmicity observed in this study between the dominant and non-dominant legs provides evidence that it is not essential to test both legs when simple motor tasks are investigated as a function of the time of day.     

Experimental determination of forces transmitted through the patello-femoral joint

Tensions in the quadriceps tendon and infrapatellar ligament were measured as a function of flexion angle in eight cadaver knees using a load cell of a materials tester to determine the quadriceps force and a spring balance to quantify the patellar tendon force. The ratio between the tensions in the quadriceps tendon and the patellar tendon (FQ/FP) ranged from 1.55 at 70 degrees of flexion to 0.86 at 10 degrees of flexion. The patello-femoral joint reaction (PFJR) force for extension against resistance was maximal at 60 degrees. No change in the quadriceps force required to extend the knee occurred with changes of the Q-angle of +/- 5 degrees. This study demonstrates that FQ does not equal FP as several authors have reported (Bandi, 1972; Barry, 1979; Ficat and Hungerford, 1977; Hungerford and Barry, 1979; Reilly and Martens, 1972; Smidt, 1973). Furthermore, the difference in FQ and FP influences both the magnitude and direction of PFJR. Studies that assess the influence of surgical procedures which alter the patello-femoral joint or the extensor mechanism must take these differences into account.     

Test–retest reliability of quadriceps muscle function outcomes in patients with knee osteoarthritis

Quadriceps muscle weakness and the underlying neuromuscular deficits have been increasingly studied over the last few years in patients with knee osteoarthritis, but the applied methodologies have never been validated for this specific population. The aim of this study was to investigate test–retest reliability of several quadriceps muscle function outcomes in patients with knee osteoarthritis both before and after knee arthroplasty surgery. Ten preoperative and 20 postoperative patients participated in two identical testing sessions. A series of voluntary and/or electrically stimulated contractions of the involved quadriceps with concomitant torque and electromyographic recordings were used to characterize muscle strength, muscle activation and muscle contraction properties. Vastus lateralis morphology (thickness and fascicle pennation angle) was also assessed using ultrasonography. Overall, good reliability scores were observed for the majority of the 13 assessed variables (nine variables with intraclass correlation coefficients >0.75, 12 variables with coefficients of variation <15%). The most reliable testing protocol for patients with knee osteoarthritis would entail the assessment of (1) isometric maximal voluntary torque for evaluating muscle strength, with (2) simultaneous vastus lateralis electromyographic activity for evaluating muscle activation, (3) potentiated (resting) doublet peak torque for evaluating muscle contractility, and (4) vastus lateralis thickness for evaluating muscle size.     

Effects of low-load resistance training with vascular occlusion on the mechanical properties of muscle and tendon

The present study aimed to investigate the effects of low-load resistance training with vascular occlusion on the specific tension and tendon properties by comparing with those of high-load training. Nine participants completed 12 weeks (3 days/week) of a unilateral isotonic training program on knee extensors. One leg was trained using low load (20% of 1 RM) with vascular occlusion (LLO) and other leg using high load (80% of 1 RM) without vascular occlusion (HL). Before and after training, maximal isometric knee extension torque (MVC) and muscle volume were measured. Specific tension of vastus lateralis muscle (VL) was calculated from MVC, muscle volume, and muscle architecture measurements. Stiffness of tendon-aponeurosis complex in VL was measured using ultrasonography during isometric knee extension. Both protocols significantly increased MVC and muscle volume of quadriceps femoris muscle. Specific tension of VL increased significantly 5.5% for HL, but not for LLO. The LLO protocol did not alter the stiffness of tendon-aponeurosis complex in knee extensors, while the HL protocol increased it significantly. The present study demonstrated that the specific tension and tendon properties were found to remain following low-load resistance training with vascular occlusion, whereas they increased significantly after high-load training.     

Time‐of‐Day Effects on Myoelectric and Mechanical Properties of Muscle During Maximal and Prolonged Isokinetic Exercise

The aim of this study was to examine the time‐of‐day (TOD) effects in myoelectric and mechanical properties of muscle during a maximal and prolonged isokinetic exercise. Twelve male subjects were asked to perform 50 maximal voluntary contractions (MVC) of the knee extensor muscles at a constant angular velocity of 2.09 rad · sec^?1, at 06∶00 and 18∶00 h. Torque and electromyographic (EMG) parameters were recorded for each contraction, and the ratio between these values was calculated to evaluate variations of the neuromuscular efficiency (NME) with fatigue and with TOD. The results indicated that maximal torque values (T₄₅Max) was significantly higher (7.73%) in the evening than in the morning (p<0.003). The diurnal variation in torque decrease was used to define two phases. During the first phase (1st to the 26th repetition), torque values decreased fast and values were higher in the evening than in the morning, and during the second phase (27th to the 50th repetition), torque decreased slightly and reached a floor value that appeared constant with TOD. The EMG parameters (Root Mean Square; RMS) were modified with fatigue, but were not TOD dependent. The NME decrease–significantly with fatigue, showing that peripheral factors were mainly involved in the torque decrease. Furthermore, NME decrease was greater at 18∶00 than at 06∶00 h for the vastus medialis (p<0.05) and the vastus lateralis muscles (p<0.002), and this occurred during the first fatigue phase of the exercise. In conclusion, the diurnal variation of the muscle fatigue observed during a maximal and prolonged isokinetic exercise seems to reflect on the muscle, with a greater contractile capacity but a higher fatigability in the evening compared to the morning.     

Musculo-skeletal modelling of NMES-evoked knee extension in spinal cord injury

The objective of this study was to explore relationships among constants used in musculo-skeletal models predicting torque generated about the knee by the quadriceps muscles. A model was developed and matched to data collected from individuals with spinal cord injury performing quadriceps contractions evoked using neuromuscular electrical stimulation. After fitting tendon slack lengths to the quadriceps muscles, the model was able to accurately match experimentally measured knee extension torques using previously reported values for the moment arm-knee angle and force-velocity relationships. Fitting new constants to these relationships did not improve the match between measured and modelled knee extension torques. There was significant interaction between variables used within the model. Using a narrower active force-length relationship for the muscles required the model to have smaller moment arms about the knee to accurately match measured torque across the full range of motion. Reduced moment arms, however, lowered the model's linear velocity of muscle shortening for each angular velocity of the knee, requiring different constants within the force-velocity relationship to predict the appropriate amount of torque decline. The present study demonstrates that, when a model does not fit the observed data, it is difficult to determine exactly which components are responsible because of the interdependent nature of parameters.     

Quadriceps cross-sectional area changes in young healthy men with different magnitude of Q angle

Knee pain and dysfunction have been often associated with an ineffective pull of the patella by the vastus medialis (VM) relative to the vastus lateralis (VL), particularly in individuals with knee joint malalignment. Such changes in muscular behavior may be attributed to muscle inhibition and/or atrophy that precedes the onset of symptoms. The aim of this study was to investigate possible effects of knee joint malalignment, indicated by a high quadriceps (Q) angle (HQ angle >15 degrees ), on the anatomic cross-sectional area (aCSA) of the entire quadriceps and its individual parts, in a group of 17 young asymptomatic men compared with a group of 19 asymptomatic individuals with low Q angle (LQ angle <15 degrees ). The aCSA of the entire quadriceps (TQ), VM, VL, vastus intermedius (VI), rectus femoris (RF), and patellar tendon (PT) were measured during static and dynamic magnetic resonance imaging (MRI) with the quadriceps relaxed and under contraction, respectively. A statistically significant lower aCSA was obtained in the HQ angle group, compared with the LQ angle group, for the TQ, VL, and VI in both static (TQ = 9.9%, VL = 12.9%, and VI = 9.1%; P < 0.05) and dynamic imaging (TQ = 10.7%, P < 0.001; VL = 13.4%, P < 0.01; and VI = 9.8%, P < 0.05) and the aCSA of the VM in dynamic MRI (11.9%; P < 0.01). The muscle atrophy obtained in the HQ angle group may be the result of a protective mechanism that inhibits and progressively adapts muscle behavior to reduce abnormal loading and wear of joint structures.     

Bilateral deficit in plantar flexion: relation to knee joint position, muscle activation, and reflex excitability

Six male subjects made maximal isometric plantar flexions unilaterally (UL) and bilaterally (BL), with the knee joint angle positioned at 90° and 0° (full extension) and the ankle joint kept at 90°. Plantar flexion torque and electromyogram (EMG) of the lateral gastrocnemius (LG) and the soleus (Sol) muscles were recorded. There was a deficit in torque in BL compared to UL (P<0.05), and the deficit was greater when the knee was extended than when bent to 90° (13.9% vs 6.6%). The integrated EMG (iEMG) of UL and BL did not differ when the knee was at 90°. On the other hand, when the knee was extended iEMG of LG was smaller for BL than for UL, suggesting that the larger bilateral deficit when the knee was extended was due to a reduced activity of the LG motor units. In addition, the H-reflex recorded from Sol when the contralateral leg was performing a maximal unilateral plantarflexion was reduced. This would indicate that the force deficit was associated with a reduction of motoneuron excitability. Accepted: 18 August 1997