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1.
The change in median frequency of the power spectrum of the electromyographic (EMG) signal may be used as a measure of muscle fatigue. The reliability of the median frequency parameters was investigated for EMG-recording sites at L1 and L5 right and left on the erector spinae. The reliability of subjective fatigue ratings of the back muscles (Borg CR-10 scale) and of maximal trunk extension torque (MVC) was also investigated. Eleven subjects with healthy backs performed a 45-s isometric trunk extension at 80% of MVC twice a day, on three different days. Two-factor analysis of variance was made to obtain the different variances from which the standard error of measurement (SEM) and the intra class correlation coefficient (ICC) were calculated. The SEM within-day was somewhat lower than that between-days. Both were about the same at all four electrode sites. The 95% confidence interval for the studied variables was for the initial median frequency +/- 10 Hz, for the slope +/- 0.4-0.5%/s, for the MVC +/- 36 Nm and for the Borg ratings +/- 1.6. We conclude that, with the presently used method, changes or differences within these limits should be regarded as normal variability. The slope may be of limited value because of its large variability. Whether the low intraclass correlation coefficient for the EMG parameters in the presently studied test group implies a low potential in discriminating subjects with back pain can not be decisively concluded.  相似文献   

2.
The purpose of the study was to compare the electromyographic (EMG) activity of the trunk muscles between normal subjects and chronic low back pain (CLBP) patients during standardized trunk movements. Thirty-three male subjects (18 normals, 15 suffering from non specific CLBP) aged between 35 and 45 yr participated. A biomechanical analysis involving the recording of EMG signals from 12 trunk muscles, the kinematics of trunk segments and the computation of L5/S1 moments was performed. The subjects performed flexion-extension and lateral bending (left and right) tasks (three complete cycles) with and without a 12 kg load. Between group comparisons were performed on the full cycle average pattern of all biomechanical variables for each task. The reliability of EMG variables was evaluated for 10 subjects (5 normals and 5 CLBP) who performed the tasks on three different days. The reliability of EMG amplitude values was generally excellent for agonist muscles but poor to moderate for antagonists. The EMG amplitude analysis revealed significant differences between groups for some muscles (left lumbar and thoracic erector spinae). The abnormal (asymmetric) EMG patterns detected among CLBP patients were not explained by postural asymmetries.  相似文献   

3.
The purpose of this study was to assess different measurement strategies to increase the reliability of different electromyographic (EMG) indices developed for the assessment of back muscle impairments. Forty male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three sessions at least 2 days apart within 2 weeks. Surface EMG signals were recorded from four pairs (bilaterally) of back muscles (multifidus at the L5 level, iliocostalis lumborum at L3, and longissimus at L1 and T10) while the subjects performed, in a static dynamometer, two static trunk extension tasks at 75% of the maximal voluntary contraction separated by a 60 s rest period: (1) a 30 s fatigue task and (2) a 5 s recovery task. Different EMG indices (based on individual muscles or averaged across bilateral homologous muscles or across all muscles) were computed to evaluate muscular fatigue and recovery. Intra-class correlation coefficient (ICC) and standard error of measurement (SEM) in percentage of the grand mean were calculated for each EMG variable. Reliable EMG indices are achieved for both healthy and chronic low back pain subjects when (1) electrodes are positioned on medial back muscles (multifidus at the L5 level and longissimus at L1) and (2) measures are averaged across bilateral muscles and/or across two fatigue tests performed within a session. The most reliable EMG indices were the bilateral average of medial back muscles (ICC range: 0.68-0.91; SEM range: 5-35%) and the average of all back muscles (ICC range: 0.77-0.91; SEM range: 5-30%). The averaging of measures across two fatigue tests is predicted to increase the reliability by about 13%. With regards to EMG indices of fatigue, the identification of the most fatigable muscle also lead to satisfactory results (ICC range: 0.74-0.79; SEM range: 21-26%). The assessment of back muscle impairments through EMG analysis necessitates the use of multiple electrodes to achieve reliable results.  相似文献   

4.
This study aimed to examine within-day and between-days intratester reliability of mechanomyography (MMG) in assessing muscle fatigue. An accelerometer was used to detect the MMG signal from rectus femoris. Thirty one healthy subjects (15 males) with no prior knee problems initially performed three maximum voluntary contractions (MVCs) using an ISOCOM dynamometer. After 10 min rest, subjects performed a fatiguing protocol in which they performed three isometric knee extensions at 75% MVC for 40 s. The fatiguing protocol was repeated on two other days, two to four days apart for between-days reliability. MMG activity was determined by overall root mean squared amplitude (RMS), mean power frequency (MPF) and median frequency (MF) during a 40 s contraction. RMS, MPF and MF linear regression slopes were also analysed. Intraclass Correlation Coefficients (ICC); ICC1,1 and ICC1,2 were used to assess within-day reliability and between-days reliability respectively. Standard error of measurement (SEM) and smallest detectable difference (SDD) described the within-subjects variability. MMG fatigue measures using linear regression slopes showed low reliability and large between-days error (ICC1,2 = 0.43–0.46; SDD = 306.0–324.8% for MPF and MF slopes respectively). Overall MPF and MF, on the other hand, were reliable with high ICCs and lower SDDs compared to linear slopes (ICC1,2 = 0.79–0.83; SDD = 21.9–22.8% for MPF and MF respectively). ICC1,2 for overall MMG RMS and linear RMS slopes were 0.81 and 0.66 respectively; however, the SDDs were high (56.4% and 268.8% respectively). The poor between-days reliability found in this study suggests caution in using MMG RMS, MPF and MF and their corresponding slopes in assessing muscle fatigue.  相似文献   

5.
Maximum voluntary isometric contractions (MVCs) are commonly used to normalize electromyography (EMG) data and must be reliable even if the individual has no prior experience performing MVCs. This study explored the effect of familiarization over three testing sessions on MVC performance and reliability by comparing muscle activation during standardized maximal and sub-maximal muscle contractions. Participants were recruited into two groups: (1) individuals who regularly engaged in upper body resistance training; (2) individuals with little or no prior experience in upper body resistance training. EMG was collected from two pairs of muscles; biceps brachii and triceps brachii from the arm, and erector spinae and external oblique from the trunk. The trunk muscles were chosen as muscles that are less frequently activated in isolation in day-to-day life. It was found that there were no significant improvements in MVC performance or within-day reliability over the three testing sessions for both resistance trained and non-resistance trained groups. Resistance-trained individuals showed a trend to be more reliable within-day than non-resistance trained participants. Day-to-day MVC reliability, particularly of the erector spinae muscle, was limited in some participants. This suggests that further efforts are needed to improve our capability of reliably eliciting muscle activation MVCs for EMG normalization, especially for muscles that are less frequently activated in isolation.  相似文献   

6.
The purpose of this study was to examine the reliability of normalisation methods used in the study of the posterior and posterolateral neck muscles in a group of healthy controls. Six asymptomatic male subjects performed a total of 12 maximum voluntary isometric contractions (MVIC) and 60%-submaximal isometric contractions (60%-MVIC) against the torque arm of an isokinetic dynamometer whilst surface and intramuscular electromyography (EMG) was recorded unilaterally from representative posterior and posterolateral locations. Reliability was calculated using intra-class correlation coefficient (ICC), relative standard error of measurement (%SEM) and relative coefficient of variation (%CV). Maximal torque output was found to be highly reliable in the directions of extension and right lateral bending when the first of three MVIC contractions was excluded. When averaged across contraction direction, high reliability was found for both surface (MVIC: ICC=0.986, %SEM=7.5, %CV=9.2; 60%-MVIC: ICC=0.975, %SEM=10, %CV=13.7) and intramuscular (MVIC: ICC=0.910, %SEM=20, %CV=19.1; 60%-MVIC: ICC=0.952, %SEM=16.5, %CV=13.5) electrodes. Intramuscular electrodes displayed the least reliability in right lateral bending. The use of visual feedback markedly increased the reliability of 60%-MVIC contractions.  相似文献   

7.
Surface electromyography (EMG) is widely used to evaluate forearm muscle function and predict hand grip forces; however, there is a lack of literature on its intra-session and inter-day reliability. The aim of this study was to determine reliability of surface EMG of finger and wrist flexor muscles across varying grip forces. Surface EMG was measured from six forearm flexor muscles of 23 healthy adults. Eleven of these subjects undertook inter-day test–retest. Six repetitions of five randomized isometric grip forces between 0% and 80% of maximum force (MVC) were recorded and normalized to MVC. Intra- and inter-day reliability were calculated through the intraclass correlation coefficient (ICC) and standard error of measurement (SEM).Normalized EMG produced excellent intra-session ICC of 0.90 when repeated measurements were averaged. Intra-session SEM was low at low grip forces, however, corresponding normalized SEM was high (23–45%) due to the small magnitude of EMG signals. This may limit the ability to evaluate finer forearm muscle function and hand grip forces in daily tasks. Combining EMG of functionally related muscles improved intra-session SEM, improving within-subject reliability without taking multiple measurements. Removing and replacing electrodes inter-day produced poor ICC (ICC < 0.50) but did not substantially affect SEM.  相似文献   

8.
The purpose of the study was twofold: (1) to evaluate the reliability of distance measures computed from a principal component analysis (PCA) of electromyographic (EMG) waveforms of trunk muscles recorded during standardized trunk movements and (2) to evaluate their sensitivity to the load lifted, the trunk range of motion (ROM) and to low back status. Thirty-three male subjects (18 normals, 15 suffering from non specific CLBP) aged between 35-45 years participated. The EMG signals from 12 trunk muscles and the kinematics of trunk segments were recorded during 12 tasks. The subjects performed flexion-extension and lateral bending (left and right) tasks (three complete cycles) with and without a 12 kg load and at different trunk ROM (maximal or at defined submaximal angles). Distance measures locating each subject relative to a reference PCA model were computed for each muscle and task. The reliability of these distance measures was evaluated for 10 subjects (five normals and five CLBP) who performed two tasks on three different days. The reliability of distance measures was acceptable for agonist muscles only. The distance measures were sensitive to the load lifted and to the trunk ROM for different muscles and tasks but poorly sensitive to low back status. Several reasons that could explain the low sensitivity of these measures to low back status are discussed and potential solutions are proposed. A procedure based on a reliability analysis is proposed to select the number of principal components to include in the reference PCA model. It is expected that the refinement of the method used in this study could provide an effective clinical tool to assess EMG waveforms of trunk muscles during dynamic tasks.  相似文献   

9.
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.  相似文献   


10.
Paraspinal electromyographic (EMG) activity was recorded bilaterally from three lumbar levels during 30-s isometric trunk extensions [40 and 80% of maximum voluntary contraction (MVC)] in 20 healthy men and 14 chronic low back pain patients in pain. EMG parameters indicating neuromuscular fatigue and contralateral imbalances in EMG root-mean-square amplitude and median frequency were analyzed. Patients in pain showed less fatigue than controls at both contraction levels and produced only 55% of their MVC. Patients in pain likely did not produce a "true" maximum effort. A low MVC estimate would mean lower absolute contraction levels and less neuromuscular fatigue, thus explaining lower scores in the patients. Contralateral root-mean-square amplitude imbalances were present in both categories of subjects although such imbalances, when averaged across lumbar levels, were significantly larger in patients. Median frequency imbalances were significantly larger in the patients, at segmental as well as across lumbar levels. These results suggest that the presence of pain in these patients caused a redistribution of the activation behavior between synergistic muscles of the lumbar back.  相似文献   

11.
The purpose of this study was to determine test-retest reliability for median frequency (MDF) and amplitude of surface EMG during sustained fatiguing contractions of the quadriceps. Twenty-two healthy subjects (11 males and 11 females) were tested on two days held one week apart. Surface EMG was recorded from rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) during sustained isometric contractions at 80% and 20% of maximal voluntary contraction (MVC) held to exhaustion. Quadriceps fatigue was described using four measures for both MDF and amplitude of EMG: initial, final, normalized final and slope. For both MDF and amplitude, the initial, final and normalized EMG showed moderate to high reliability for all three muscle groups at both contraction levels (ICC=0.59-0.88 for MDF; ICC=0.58-0.99 for amplitude). Slope of MDF and amplitude was associated with a large degree of variability and low ICCs for the 80% but not the 20% MVC. MDF and amplitude of EMG during sustained contractions of the quadriceps are reproducible; normalized final values of MDF and amplitude show better reliability than slope.  相似文献   

12.
The purposes of this study were to examine the mechanomyographic (MMG) and electromyographic (EMG) time and frequency domain responses of the vastus lateralis (VL) and rectus femoris (RF) muscles during isometric ramp contractions and compare the time-frequency of the MMG and EMG signals generated by the short-time Fourier transform (STFT) and continuous wavelet transform (CWT). Nineteen healthy subjects (mean+/-SD age=24+/-4 years) performed two isometric maximal voluntary contractions (MVCs) before and after completing 2-3, 6-s isometric ramp contractions from 5% to 100% MVC with the right leg extensors. MMG and surface EMG signals were recorded from the VL and RF muscles. Time domains were represented as root mean squared amplitude values, and time-frequency representations were generated using the STFT and CWT. Polynomial regression analyses indicated cubic increases in MMG amplitude, MMG frequency, and EMG frequency, whereas EMG amplitude increased quadratically. From 5% to 24-28% MVC, MMG amplitude remained stable while MMG frequency increased. From 24-28% to 76-78% MVC, MMG amplitude increased rapidly while MMG frequency plateaued. From 76-78% to 100% MVC, MMG amplitude plateaued (VL) or decreased (RF) while MMG frequency increased. EMG amplitude increased while EMG frequency changed only marginally across the force spectrum with no clear deflection points. Overall, these findings suggested that MMG may offer more unique information regarding the interactions between motor unit recruitment and firing rate that control muscle force production during ramp contractions than traditional surface EMG. In addition, although the STFT frequency patterns were more pronounced than the CWT, both algorithms produced similar time-frequency representations for tracking changes in MMG or EMG frequency.  相似文献   

13.
Surface electromyographic (EMG) amplitude and mean power frequency (MPF) were used to study the isometric muscular activity of the right versus the left upper trapezius muscles in 14 healthy right-handed women. The EMG activity was recorded simultaneously with force signals during a 10-15 s gradually increasing exertion of force, up to maximal force. Only one side at a time was tested. On both sides there was a significant increase in EMG amplitude (microV) during the gradually increasing force from 0% to 100% maximal voluntary contraction (MVC). The right trapezius muscle showed significantly less steep slopes for regression of EMG amplitude versus force at low force levels (0%-40% MVC) compared intra-individually with high force levels (60%-100% MVC). This was not found for the left trapezius muscle. At 40% MVC a significantly lower MPF value was found for the right trapezius muscle intra-individually compared with the left. An increase in MPF between 5% and 40% MVC was statistically significant when both sides were included in the test. The differences in EMG activity between the two sides at low force levels could be due to more slow-twitch (type I fibres) motor unit activity in the right trapezius muscles. It is suggested that this is related to right-handed activity.  相似文献   

14.
The changes in the soundmyogram (SMG) and electromyogram (EMG) frequency content during exhausting contractions at 20%, 40%, 60% and 80% of the maximal voluntary contraction (MVC) were investigated by the spectral analysis of the SMG and EMG detected from the biceps brachii muscles of 13 healthy men. The root mean squares (rms) of the two signals were also calculated. Throughout contraction the EMG rms always increased while this was true only at 20% MVC for the SMG. A marked decrease was detected at 60% and 80% MVC. With fatigue the EMG spectra presented a compression towards the lower frequencies at all exercise intensities. The SMG showed a more complex behaviour with a transient increase in its frequency content, followed by a continuous compression of the spectra, at 60% and 80% MVC, and a nearly stable frequency content at lower contraction intensities. This study suggested that different aspects of the changes in the motor unit's activation strategy at different levels of exhausting contractions can be monitored by SMG and EMG signals.  相似文献   

15.
BACKGROUND: It is important to evaluate the reliability of common used methods of examining muscle fatigue from the lower back since the methods are used in patient evaluation. METHODS: To establish between-days reliability, ten subjects without lower-back pain performed a Sorensen test, a prone test for back extensor muscles against gravity, on three separate days. EMG was recorded from the L1 and L5 of the back extensor muscles. Fatigue was subjectively rated using a Borg CR-10 scale. Intraclass correlation coefficient, standard error of measurement and coefficient of variation were calculated from a one-way ANOVA. Percent agreement was also calculated. RESULTS: The study revealed good reliability for the slope for the total time (ICC 0.65-0.90), the initial and end median frequency (ICC 0.75-0.89), median frequencies at Borg ratings of three (ICC 0.63-0.88), five (ICC 0.62-0.84) and seven (ICC 0.67-0. 87), endurance time (ICC 0.89). The Borg ratings of the first minute agreed better than those of the second and the third. The Borg ratings at the second and the third test agreed to 40-80%, indicating a need for a practice session. CONCLUSION: The protocol used for assessing fatigue in the back extensor muscles proved to be reliable and is recommended for further use.  相似文献   

16.
Appropriate reliability is a necessary condition for the use of surface EMG for evaluation of hamstring muscle function in cases of knee joint pathologies or ligament injuries. The aim of the study was to investigate the test-retest reliability of power spectrum and amplitude of surface electromyographic (EMG) measurements of semitendinosus (ST) and biceps femoris (BF) during ramp isometric contractions. Eleven males performed maximum isometric contractions (MVC) of the knee flexors in two sessions, a week apart with simultaneous recording of surface EMG of the BF and ST. Intra class correlation (ICC) and standard error measurements (SEM) were applied to assess test-retest reliability of the averaged EMG (aEMG) and the median frequency (MF) over 10 levels of force, from 0% to 100% of the maximum. The ICC values ranged from 0.38 to 0.96 for the aEMG with SEM values reaching 11.37% of MVC. For the MF, the ICCs ranged from 0.44 to 0.98 (SEM range 4.49–18.19 Hz). In our set up, ramp contractions can be used to examine hamstring EMG patterns with acceptable reliability.  相似文献   

17.
In this study, we aimed to compare the intrarater reliability and validity of muscle thickness measured using ultrasonography (US) and muscle activity via electromyography (EMG) during manual muscle testing (MMT) of the external oblique (EO) and lumbar multifidus (MF) muscles. The study subjects were 30 healthy individuals who underwent MMT at different grades. EMG was used to measure the muscle activity in terms of ratio to maximum voluntary contraction (MVC) and root mean square (RMS) metrics. US was used to measure the raw muscle thickness, the ratio of muscle thickness at MVC, and the ratio of muscle thickness at rest. One examiner performed measurements on each subject in 3 trials. The intrarater reliabilities of the % MVC RMS and raw RMS metrics for EMG and the % MVC thickness metrics for US were excellent (ICC = 0.81–0.98). There was a significant difference between all the grades measured using the % MVC thickness metric (p < 0.01). Further, this % MVC thickness metric of US showed a significantly higher correlation with the EMG measurement methods than with the others (r = 0.51–0.61). Our findings suggest that the % MVC thickness determined by US was the most sensitive of all methods for assessing the MMT grade.  相似文献   

18.
This study was designed to determine trial-to-trial and day-to-day reproducibility of isometric force and electromyogram activity (EMG) of the knee extensor muscles in water and on dry land as well as to make comparisons between the two training conditions in muscle activity and force production. A group of 20 healthy subjects (12 women and 8 men) were tested three times over 2 weeks. A measurement session consisted of recordings of maximal and submaximal isometric knee extension force with simultaneous recording of surface EMG from the vastus medialis, vastus lateralis and biceps femoris muscles. To ensure identical measurement conditions the same patient elevator chair was used in both the dry and the wet environment. Intraclass correlation coefficients (ICC) and coefficients of variation (CV) showed high trial-to-trial (ICC = 0.95-0.99, CV = 3.5%-11%) and day-to-day reproducibility (ICC=0.85-0.98, CV=11%-19%) for underwater and dry land measurements of force and EMG in each muscle during maximal contractions. The day-to-day reproducibility for submaximal contractions was similar. The interesting finding was that underwater EMG amplitude decreased significantly in each muscle during maximal (P < 0.01-P < 0.001) and submaximal contractions (P < 0.05-P < 0.001). However, the isometric force measurements showed similar values in both wet and dry conditions. The water had no disturbing effect on the electrodes as shown by slightly lowered interelectrode resistance values, the absence of artefacts and low noise levels of the EMG signals. It was concluded that underwater force and EMG measurements are highly reproducible. The significant decrease of underwater EMG could have electromechanical and/or neurophysiological explanations.  相似文献   

19.
INTRODUCTION: The repeatability of subjective and objective assessments of neck muscle fatigue is very important with regard to the clinical applicability of these methods. METHOD: To establish between-days reliability, 33 healthy volunteers performed a 60% maximum voluntary isometric contraction test from a standing position in all neck movements. Cervical muscle fatigue was assessed on three separate occasions from the spectral (median frequency, MF) and amplitude (root mean square, RMS) analysis of the electromyogram (EMG) signal recorded from the cervical paraspinal group, splenius capitis, levator scapulae and sternocleidomastoid. Subjective assessment of fatigue was rated by employing the Borg scale. Intraclass correlation coefficient ICC((1,1)), standard error of measurement (SEM), smallest detectable difference (SDD) indices and Pearson's correlation co-efficient were calculated for the analysis of the results. RESULTS: Normalised median frequency (MF) slope had low repeatability and large between-day error (ICC((1,1))=0.28-0.61; SEM=0.33-0.60%/s; SDD=132.7-703.2%) for the protagonist muscles of each movement. Initial median frequency (IMF) had moderate to good reliability and small error (ICC((1,1))=0.64-0.81; SEM=2.8-8.8Hz; SDD=19.9-38.5%). The RMS slope yielded also poor repeatability. The Borg assessment was more reliable than the EMG estimate though variability between sessions was still quite high (SDD=29.2-136.5%). No correlation was found between the EMG and Borg assessment of neck muscle fatigue (r=-0.01-0.39). CONCLUSION: The protocol used for assessing neck muscle fatigue proved to be reliable only for the IMF but the clinical usefulness of this measure remains questionable. The lack of correlation between objective and subjective estimation of neck muscle fatigue was possibly a consequence of the poor measurement repeatability. Further research is needed to identify the factors responsible for these results on neck area.  相似文献   

20.
The aim of the study was to investigate EMG signal features during fatigue and recovery at three locations of the vastus medialis and lateralis muscles. Surface EMG signals were detected from 10 healthy male subjects with six 8-electrode arrays located at 10%, 20%, and 30% of the distance from the medial (for vastus medialis) and lateral (vastus lateralis) border of the patella to the anterior superior spine of the pelvic. Subjects performed contractions at 40% and 80% of the maximal force (MVC) until failure to maintain the target force, followed by 20 2-s contractions at the same force levels every minute for 20 min (recovery). Average rectified value, mean power spectral frequency, and muscle fiber conduction velocity were estimated from the EMG signals in 10 epochs from the beginning of the contraction to task failure (time to task failure, mean ± SD, 70.7 ± 25.8 s for 40% MVC; 27.4 ± 16.8 s for 80% MVC) and from the 20 2 s time intervals during recovery. During the fatiguing contraction, the trend over time of EMG average rectified value depended on location for both muscles (P < 0.05). After 20-min recovery, mean frequency and conduction velocity of both muscles were larger than in the beginning of the fatigue task (P < 0.05) (supernormal values). Moreover, the trend over time of mean frequency during recovery was affected by location and conduction velocity values depended on location for both muscles (P < 0.05). The results indicate spatial dependency of EMG variables during fatigue and recovery and thus the necessity of EMG spatial sampling for global muscle assessment.  相似文献   

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