Patellar taping increases vastus medialis oblique activity in the presence of patellofemoral pain.

A common rehabilitation strategy for patellofemoral pain syndrome (PFPS), which lacks scientific evidence, includes pulling the patella medially with tape to reduce pain and increase the vastus medialis oblique (VMO) muscle activity. The purpose of this study was to examine the effect of various patellar taping procedures on force production, EMG activity of the VMO and vastus lateralis (VL) muscles, and perceived pain experienced by 30 women (27.3 +/- 1.53), half diagnosed with PFPS. The perceived pain, force, and EMG of the VMO and VL, were recorded while subjects performed maximal isokinetic leg presses at 30 degrees /s for each of the following patellar taping conditions: no tape (control), no glide (placebo), medial and lateral glide (experimental). The medial and placebo procedures significantly (P < 0.01) reduced perceived pain (70-80%) in PFPS subjects. Although patellar taping did not influence leg press force (P > 0.05), it increased the VMO activity and decreased the VL activity in PFPS subjects but had the opposite effect in healthy subjects. The findings suggest that taping the patella medially can contribute positively to PFPS rehabilitation. Because the medial glide and placebo taping conditions had similar effects, it is proposed that the benefits of patellar taping are not due to a change in patellar position but rather due to enhanced support of the patellofemoral ligaments and/or pain modulation via cutaneous stimulation.     

The effects of an isometric knee extension with hip adduction (KEWHA) exercise on selective VMO muscle strengthening

We investigated the effects of four weeks of training using a knee extension with hip adduction (KEWHA) exercise in asymptomatic participants. In addition, we compared different methods of electromyographic (EMG) onset-time detection. Eighteen participants who achieved earlier activation of the vastus lateralis (VL) muscle compared to that of the vastus medialis obliquus (VMO) muscle performed the isometric KEWHA exercise in the sitting position for four weeks. A 15° hip adduction was added to the existing knee extension in the KEWHA exercise. EMG onset times were detected using a computer-analyzed system and evaluated using two methods in which the thresholds for activity onset were set at two and three standard deviations (SDs) of the mean baseline activity. No significant difference in the EMG onset-time for the VMO muscle was observed compared to that of the VL muscle between the pre- and post-tests (p > 0.05) when data at 2 SDs of the mean baseline activity were analyzed. However, a significant difference in the onset times for the VMO muscle and VL muscle was found between the pre- and post-tests (p < 0.05) when data at 3 SDs of the mean baseline activity were analyzed. In addition, less variation was observed in data analyzed at 3 SDs compared to that of the data at 2 SDs. The normalized VMO:VL muscle ratio was not significantly different between the pre- and post-tests. These findings show that the KEWHA exercise may decrease the difference between the onset times of VMO and VL muscles. In addition, we suggest that task-specific EMG onset-time detection methods are required to minimize variations in the data obtained during the recording of muscle activation.     

Influence of infrapatellar and suprapatellar straps on quadriceps muscle activity and onset timing during the body-weight squat

The use of knee braces for the treatment of patellofemoral pain syndrome (PFPS) is widely documented, yet the mechanism by which such braces alleviate knee pain remains unclear. This study attempted to clarify this issue by simplifying the brace to the level of only straps. The effectiveness of an infrapatellar strap for PFPS remains controversial, and the use of a suprapatellar strap has not yet been studied. Quadriceps muscle activity and onset timing parameters were measured with surface electromyography (EMG) during a body-weight squat in 19 healthy subjects during 4 different knee-strapping conditions (infra, supra, both, and none). No differences in normalized mean or peak EMG activity in any part of the quadriceps were found. The onset timing of the vastus lateralis (VL) was significantly delayed when using an infrapatellar strap (p < 0.05) or both straps (p < 0.05) and marginally delayed when using a suprapatellar strap (p < 0.10) in comparison with the no-strap (control) condition. No differences in the vastus medialis oblique (VMO) onset timing or VMO-VL onset timing difference were found among the strapping conditions, although an improvement in timing was noted with the suprapatellar condition. The results provide novel evidence that the application of an infrapatellar strap, suprapatellar strap, or both straps improves quadriceps muscle timing imbalances by delaying VL onset. Because the largest delay in VL onset occurred when wearing both straps, the combined application of an infrapatellar and suprapatellar strap may be the most beneficial in managing patellofemoral pain. Knee straps, unlike braces, are cost effective, nonrestrictive, and can be universally fitted to any knee and based on the results deserve further study in the patellofemoral pain population.     

The effect of back squat depth on the EMG activity of 4 superficial hip and thigh muscles

The purpose of this study was to measure the relative contributions of 4 hip and thigh muscles while performing squats at 3 depths. Ten experienced lifters performed randomized trials of squats at partial, parallel, and full depths, using 100-125% of body weight as resistance. Electromyographic (EMG) surface electrodes were placed on the vastus medialis (VMO), the vastus lateralis, (VL), the biceps femoris (BF), and the gluteus maximus (GM). EMG data were quantified by integration and expressed as a percentage of the total electrical activity of the 4 muscles. Analysis of variance (ANOVA) and Tukey post hoc tests indicated a significant difference (p < 0.001*, p = 0.056**) in the relative contribution of the GM during the concentric phases among the partial- (16.9%*), parallel- (28.0%**), and full-depth (35.4%*) squats. There were no significant differences between the relative contributions of the BF, the VMO, and the VL at different squatting depths during this phase. The results suggest that the GM, rather than the BF, the VMO, or the VL, becomes more active in concentric contraction as squat depth increases.     

Preferential vastus medialis oblique activation achieved as a treatment for knee disorders

The purpose of this study was to compare the effect of an open-stance cycling protocol (OSCP) with the traditional cycling foot position (TCFP) for preferential vastus medialis oblique (VMO) muscle activation, measured by surface electromyography (SEMG), and preferential VMO activation as defined by achieving significantly increased VMO/VL (vastus lateralis muscle) ratio values. Forty subjects of both sexes participated, 18 symptomatic with patellofemoral pain and 22 control subjects; ages ranged from 18 to 60 years (mean = 28.7 +/- 8 years). The OSCP and TCFP were ridden in randomized order while SEMG recordings were taken of the VMO and VL muscles, collecting the mean of peak amplitudes to calculate VMO/VL ratio values. The SEMG readings were taken 4 times per testing session with randomized resistance and a consistent cycling cadence of 85 rpm. The OSCP displayed preferential VMO activation for all subject groups (F = 40.47, p = 0.0001), and this study revealed a protocol that effectively treats patellofemoral pain.     

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.     

Activation of the VMO and VL during dynamic mini-squat exercises with and without isometric hip adduction

Objective: the purpose of this study was to compare vastus medialis obliquus (VMO) and vastus lateralis (VL) activity while performing a mini-squat with and without isometric hip adduction.

Design and setting: a repeated measures within subjects design was used. Subjects performed two sets of three repetitions of a traditional mini-squat and a mini-squat with concurrent hip adduction (squeeze).

Subjects: 20 recreationally active subjects (10 men, 10 women AGE=28.10±5.91 years, HEIGHT=170.94±11.03 cm, MASS=72.32±16.66 kg) with no history of patellofemoral pain (PFP), quadriceps injury, or other knee injury participated in the study.

Measurements: the EMG signal of the VMO and VL was recorded bilaterally during both exercises. EMG data were normalized to the maximal voluntary isometric contraction (MVIC) of the quadriceps produced during seated, isometric knee extension.

Results: results of repeated measures ANOVA's revealed that the squeeze squat produced significantly greater VMO and VL activity than the traditional squat (p=0.02). For both the traditional and squeeze squats, intrasession reliability from the first to the second set was calculated using intraclass correlation coefficient (ICC) formula (3:1) bilaterally for both the VMO and the VL. All ICC values were greater than 0.9.

Conclusion: combining isometric hip adduction with a mini-squat exercise significantly increases the activity of the quadriceps. Performing mini-squats with isometric hip adduction will be beneficial to patellofemoral patients as they increase quadriceps activity, however, based on our data we cannot conclude that this exercise preferentially recruits the VMO. Further research is needed to determine the exact mechanism by which quadriceps function is altered.     

Quadriceps femoris electromyogram during concentric, isometric and eccentric phases of fatiguing dynamic knee extensions

The objective of this study was to examine the superficial quadriceps femoris (QF) muscle electromyogram (EMG) during fatiguing knee extensions. Thirty young adults were evaluated for their one-repetition maximum (1RM) during a seated, right-leg, inertial knee extension. All subjects then completed a single set of repeated knee extensions at 50% 1RM, to failure. Subjects performed a knee extension (concentric phase), held the weight with the knee extended for 2s (isometric phase), and lowered the weight in a controlled manner (eccentric phase). Raw EMG of the vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) muscles were full-wave rectified, integrated and normalized to the 1RM EMG, for each respective phase and repetition. The EMG median frequency (f(med)) was computed during the isometric phase. An increase in QF muscle EMG was observed during the concentric phase across the exercise duration. VL EMG was greater than the VM and RF muscles during the isometric phase, in which no significant changes occurred in any of the muscles across the exercise duration. A significant decrease in EMG across the exercise duration was observed during the eccentric phase, with the VL EMG greater than the VM and RF muscles. A greater decrease in VL and RF muscle f(med) during the isometric phase, than the VM muscle, was observed with no gender differences. The findings demonstrated differential recruitment of the superficial QF muscle, depending on the contraction mode during dynamic knee extension exercise, where VL muscle dominance appears to manifest across the concentric-isometric-eccentric transition.     

Reliability of electromyographic methods used for assessing hip and knee neuromuscular activity in females diagnosed with patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is one of the most common, yet misunderstood, knee pathologies. PFPS is thought to result from abnormal patella tracking caused from altered neuromuscular control. Researchers have investigated neuromuscular influences from the gluteus medius (GM), vastus medialis (VM), and vastus lateralis (VL) but with inconsistent findings. A reason for these discrepancies may be from varying methodology. The purpose of this study was to determine the reliability of electromyographic (EMG) methods used to assess amplitudes and timing differences of the GM, VM, and VL in subjects with PFPS. Seven females with PFPS participated. GM, VM, and VL activity was assessed during the stance phase of a stair descent task on two separate occasions. Amplitudes during the different intervals of stance were recorded and expressed as a percent of each muscle’s maximum voluntary isometric contraction. Muscle onsets at the beginning of stair descent were also determined. VM–GM, VL–GM, and VL–VM onset timing differences were quantified. Intraclass correlation coefficients (ICCs) and standard errors of measurement (SEMs) were calculated to assess between-day reliability. Most EMG measures had acceptable reliability (ICC_3,5 ? 0.70). Although some measures had moderate reliability (ICC < 0.70), they had low SEMs, which suggested high measurement precision. These findings support using these methods for examining neuromuscular activity in subjects with PFPS.     

The addition of synchronous whole-body vibration to battling rope exercise increases skeletal muscle activity

Objectives:

To evaluate the effects of performing battling rope exercise with and without the addition of whole-body vibration (WBV) on muscle activity of the leg, trunk, and upper body.

Methods:

Twenty-eight recreationally active university students completed 20-s of battling rope undulation for 6 separate conditions: 1) alternating arm motion no WBV -Alt_NoWBV; 2) alternating arm motion 30 Hz low amplitude WBV -Alt_30 Hz-L; 3) alternating arm motion 50 Hz high amplitude -Alt_50 Hz-H; 4) double arm motion no WBV -Double_NoWBV; 5) double arm motion 30Hz low amplitude WBV -Double_30Hz-L; 6) double arm motion 50 `Hz high amplitude -Double_50 Hz-H. Electromyography (EMG) was measured for the gastrocnemius medialis (GM), vastus medialis oblique (VMO), vastus lateralis (VL), rectus abdominis (RA), multifidus (MF), biceps brachii (BB), and triceps brachii (TB) muscles.

Results:

The double arm motion during undulation resulted in greater (p<0.05) muscle activity in the VMO, VL, RA, and MF muscles while the GM was more active during the alternating arm motion. WBV at 50Hz increased EMG in all muscles measured vs NoWBV and the 30 Hz condition.

Conclusion:

These results are the first to demonstrate that the exercise stimulus of performing battling rope exercise can be augmented by completing the exercise while being exposed to WBV from a ground-based platform.     

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.The authors wish to express thanks to Dr. Karen Gil for her helpful comments on a draft of this article, and Christianne Herman and Allison Roodman for their help in data collection and entry.     

How changing the inversion/eversion foot angle affects the nondriving intersegmental knee moments and the relative activation of the vastii muscles in cycling

Nondriving intersegmental knee moment components (i.e., varus/valgus and internal/external axial moments) are thought to be primarily responsible for the etiology of overuse knee injuries such as patellofermoral pain syndrome in cycling because of their relationship to muscular imbalances. However the relationship between these moments and muscle activity has not been studied. Thus the four primary objectives of this study were to test whether manipulating the inversion/eversion foot angle alters the varus/valgus knee moment (Objective 1) and axial knee moment (Objective 2) and to determine whether activation patterns of the vastus medialis oblique (VMO), vastus lateralis (VL), and tensor fascia latae (TFL) were affected by changes in the varus/valgus (Objective 3) and axial knee moments (Objective 4). To fulfill these objectives, pedal loads and lower limb kinematic data were collected from 15 subjects who pedaled with five randomly assigned inversion/eversion angles: 10 deg and 5 deg everted and inverted and 0 deg (neutral). A previously described mathematical model was used to compute the nondriving intersegmental knee moments throughout the crank cycle. The excitations of the VMO, VL, and TFL muscles were measured with surface electromyography and the muscle activations were computed. On average, the 10-deg everted position decreased the peak varus moment by 55% and decreased the peak internal axial moment by 53% during the power stroke (crank cycle region where the knee moment is extensor). A correlation analysis revealed that the VMO/VL activation ratio increased significantly and the TFL activation decreased significantly as the varus moment decreased. For both the VMO/VL activation ratio and the TFL activation, a path analysis indicated that the varus/valgus moment was highly correlated to the axial moment but that the correlation between muscle activation and the varus moment was due primarily to the varus/valgus knee moment rather than the axial knee moment. The conclusion from these results is that everting the foot may be beneficial towards either preventing or ameliorating patellofemoral pain syndrome in cycling.     

Electromyographic normalization procedures for determining exercise intensity of closed chain exercises for strengthening the quadriceps femoris muscles

The purpose of this study was to compare the electromyographic (EMG) amplitudes of the quadriceps femoris (QF) muscles during a maximum voluntary isometric contraction (MVIC) to submaximal and maximal dynamic concentric contractions during active exercises. A secondary purpose was to provide information about the type of contraction that may be most appropriate for normalization of EMG data if one wants to determine if a lower extremity closed chain exercise is of sufficient intensity to produce a strengthening response for the QF muscles. Sixty-eight young healthy volunteers (39 female, 29 male) with no lower extremity pain or injury participated in the study. Surface electrodes recorded EMG amplitudes from the vastus medialis obliquus (VMO), rectus femoris (RF), and vastus lateralis (VL) muscles during 5 different isometric and dynamic concentric exercises. The last 27 subjects performed an additional 4 exercises from which a second data set could be analyzed. Maximum isokinetic knee extension and moderate to maximum closed chain exercises activated the QF significantly more than a MVIC. A 40-cm. lateral step-up exercise produced EMG amplitudes of the QF muscles of similar magnitude as the maximum isokinetic knee extension exercises and would be an exercise that could be considered for strengthening the QF muscles. Most published EMG studies of exercises for the QF have been performed by comparing EMG amplitudes during dynamic exercises to a MVIC. This procedure can lead one to overestimate the value of a dynamic exercise for strengthening the QF muscles. We suggest that when studying the efficacy of a dynamic closed chain exercise for strengthening the QF muscles, the exercise be normalized to a dynamic maximum muscle contraction such as that obtained with knee extension during isokinetic testing.     

Analysis on the activation of the VMO and VLL muscles during semisquat exercises with and without hip adduction in individuals with patellofemoral pain syndrome

Objective: The purpose of this study was to investigate the effect of hip adduction on the activity of the Vastus Medialis Obliquus (VMO) and Vastus Lateralis Longus (VLL) muscles during semisquat exercises.

Methods: Twenty female subjects, divided into two groups comprising healthy and patellofemoral pain syndrome (PFPS) subjects (ten volunteers for each group), performed three double-leg semisquat exercise trials with maximum hip adduction isometric contraction (DLSS-HA) and three double-leg semisquat exercise trials without hip adduction (DLSS). The normalized electromyographic muscle data were analysed using Repeated Measure ANOVA (p  0.05).

Results: The electrical activity of both VMO and VLL muscles was significantly greater during DLSS-HA exercise than during DLSS (p = 0.0002) for both groups. Additionally, an independent Repeated Measure ANOVA revealed that the electric activity of the VLL muscle was significantly greater (p = 0.0149) than that of the VMO muscle during DLSS exercises only for the PFPS group. However, no differences were found during DLSS-HA exercises.

Conclusions: Although there was no preferential VMO muscle activation, the association of hip adduction with squat exercise promoted a greater balance between the medial and lateral portions of the quadriceps femoris muscle and could be indicated for the conservatory treatment of PFPS patients. The association of isometric hip adduction with isometric semisquat exercises produced a more overall quadriceps activity and could be indicated for clinical rehabilitation or muscle strengthening programs.     

Activation of vastus medialis obliquus among individuals with patellofemoral pain syndrome

The purpose of this study was to determine whether various positions of the lower extremity affect the muscle activity of the vastus medialis obliquus (VMO) differently during both open and closed kinetic chain exercise conditions among patients with patellofemoral pain syndrome (PFPS). Patients who presented with symptoms consistent with PFPS completed a series of open kinetic chain and closed kinetic chain exercises in which VMO activity was measured and compared. Statistical analysis revealed that there is less than a 0.001% (open kinetic chain) or 0.005% (closed kinetic chain) chance that all positions activate the VMO equally. In open kinetic exercise, maximum VMO activity was achieved with terminal knee extension with medial tibial rotation. During closed kinetic exercises, squats with external rotation were preferred for maximum VMO activation. Therefore, our results highlight the importance of including both the open and closed kinetic chain exercises into rehabilitation programs for patients with PFPS.     

Muscle activation profiles about the knee during Tai-Chi stepping movement compared to the normal gait step.

The purpose of this study was to investigate knee muscle activity patterns in experienced Tai-Chi (TC) practitioners during normal walking and TC stepping. The electromyographic (EMG) activity of vastus lateralis (VL), vastus medialis (VM), bicep femoris (BF), and gastrocnemius (GS) muscles of 11 subjects (five females and six males) during the stance phase of normal walking was compared to stance phase of a TC step. Knee joint motion was also monitored by using an Optotrak motion analysis system. Raw EMG was processed by root-mean-square (RMS) technique using a time constant of 50 ms, and normalized to maximum of voluntary contraction for each muscle, referred to as normalized RMS (nRMS). Peak nRMS and co-contraction (quantified by co-contraction index) during stance phase of a gait cycle and a TC step were calculated. Paired t-tests were used to compare the difference for each muscle group peak and co-contraction pair between the tasks. The results showed that only peak values of nRMS in quadriceps and co-contraction were significantly greater in TC stepping compared to normal walking (Peak values of nRMS for VL were 26.93% for normal walking and 52.14% for TC step, p=0.001; VM are 29.12% for normal walking and 51.93% for TC stepping, p=0.028). Mean co-contraction index for VL-BF muscle pairs was 13.24+/-11.02% during TC stepping and 9.47+/-7.77% in stance phase of normal walking (p=0.023). There was no significant difference in peak values of nRMS in the other two muscles during TC stepping compared to normal walking. Preliminary EMG profiles in this study demonstrated that experienced TC practitioners used relatively higher levels of knee muscle activation patterns with greater co-contraction during TC exercise compared to normal walking.     

The effect of patella taping on vastus medialis oblique and vastus laterialis EMG activity and knee kinematic variables during stair descent

The purpose of this study was to evaluate the effect of patella taping in normal subjects. Previous work has established positive effects of patella taping on patellofemoral pain syndrome patients, but the mode of action remains unclear. It has been hypothesized that taping brings about subtle changes in the internal physiological environment of the joint. It could be expected that in normal joints taping would bring about a measurable change in function, as the joint is no longer operating in an optimal physiological environment. 10 normal female subject’s (21.4 ± 1.2 years) vastus medialis oblique (VMO) and vastus laterialis (VL) EMG activity and knee kinematics (peak stance flexion angle and angular velocity) were assessed during a step descent, with and without a taped patella. The effect of taping was to significantly decrease VMO and VL EMG activity. Taping also significantly reduced peak stance phase knee flexion and peak stance phase knee flexion angular velocity. In normal asymptomatic subjects patella taping created a situation in which their performance was changed to one similar to that of the pathological patellofemoral pain syndrome population. It would appear that taping caused the joint to function sub-optimally supporting the hypothesis that taping could change the functioning of the patellofemoral joint.     

Upward squatting in individuals with and without patellofemoral pain syndrome: a biomechanical study

The purpose of the study was to test the hypothesis on whether individuals with patellofemoral pain syndrome (PFPS) try to avoid knee position during upward squatting so as not to aggravate this syndrome. Also, we tested whether PFPS would generate changes in the kinetic and electromyographic (EMG) strategies used to perform this task. Eight healthy subjects and 8 subjects with PFPS, but without a history of pain for at least 30 days, took part in the experiment. They were asked to perform upward squatting with knees initially flexed at 60° (very flexed) until reaching an upright position. Angle, velocity, and acceleration (kinematic) were reconstructed for knee and ankle joints. The torques at these joints were calculated using inverse dynamics, taking into account anthropometric and inertial characteristics of each subject, including records from force data. Only activities of major muscles were recorded. The kinetic and EMG profiles were quantified during acceleration and deceleration phases of the upward squatting. Both healthy and PFPS subjects used the same kinetic and EMG strategies to perform the upward squatting, even though the magnitude of the muscle activities were decreased for the latter group. Compared to the control group, the PFPS subjects presented larger joint ankle torques and smaller knee joint torques. However, the subjects avoided keeping their knees very flexed at the initial position. Group differences in the kinetic and EMG strategies can be explained by differences in the initial position, suggesting a protective strategy used by subjects with PFPS. Therefore, for these subjects, coaches and therapists should avoid using this exercise when the knee is required to move above 40° flexion.     

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

To determine the non-uniform surface mechanical activity of human quadriceps muscle during fatiguing activity, surface mechanomyogram (MMG), or muscle sound, and surface electromyogram (EMG) were recorded from the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles of seven subjects during unilateral isometric knee extension exercise. Time- and frequency-domain analyses of MMG and of EMG fatigued by 50 repeated maximal voluntary contractions (MVC) for 3 s, with 3-s relaxation in between, were compared among the muscles. The mean MVC force fell to 49.5 (SEM 2.0)% at the end of the repeated MVC. Integrated EMG decreased in a similar manner in each muscle head, but a marked non-uniformity was found for the decline in integrated MMG (iMMG). The fall in iMMG was most prominent for RF, followed by VM and VL. Moreover, the median frequency of MMG and the relative decrease in that of EMG in RF were significantly greater (P < 0.05) than those recorded for VL and VM. These results would suggest a divergence of mechanical activity within the quadriceps muscle during fatiguing activity by repeated MVC. Accepted: 19 January 1999     

Repeatability of maximal voluntary force and of surface EMG variables during voluntary isometric contraction of quadriceps muscles in healthy subjects

The repeatability of initial values and rate of change of EMG signal mean spectral frequency (MNF), average rectified values (ARV), muscle fiber conduction velocity (CV) and maximal voluntary contraction (MVC) was investigated in the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles of both legs of nine healthy male subjects during voluntary, isometric contractions sustained for 50 s at 50% MVC. The values of MVC were recorded for both legs three times on each day and for three subsequent days, while the EMG signals have been recorded twice a day for three subsequent days. The degree of repeatability was investigated using the Fisher test based upon the ANalysis Of VAriance (ANOVA), the Standard Error of the Mean (SEM) and the Intraclass Correlation Coefficient (ICC).

Data collected showed a high level of repeatability of MVC measurement (normalized SEM from 1.1% to 6.4% of the mean). MNF and ARV initial values also showed a high level of repeatability (ICC>70% for all muscles and legs except right VMO). At 50% MVC level no relevant pattern of fatigue was observed for the VMO and VL muscles, suggesting that other portions of the quadriceps might have contributed to the generated effort. These observations seem to suggest that in the investigation of muscles belonging to a multi-muscular group at submaximal level, the more selective electrically elicited contractions should be preferred to voluntary contractions.