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1.
Vaginal probes may induce changes in pelvic floor muscle (PFM) recruitment by the very presence of the probes. Fine-wire electrodes allow us to detect muscle activation parameters without altering the natural position and shape of the PFMs. The purpose of this study was to determine whether PFM activation is altered by changes in sensory feedback, muscle length or tissue position caused by two different vaginal probes used to record surface electromyography (EMG). Twelve continent women (30.1 ± 5.4 years), performed PFM maximal voluntary contractions (MVCs) in supine while fine-wire EMG was recorded bilaterally from the PFMs under three conditions: (a) without any probe inserted into the vagina, (b) while a Femiscan? probe was in situ, and (c) while a Periform? vaginal probe was in situ. The reliability of the fine wire EMG data was assessed using intra-class correlation coefficients (ICCs) and coefficients of variation (CV). A repeated measures analysis of variance (ANOVA) model was used to determine if there were differences in EMG amplitude recorded when the different vaginal probes were in situ. For each condition the between-trial reliability was excellent, ICC(3,1) = 0.93–0.96, (p < 0.001) and CV = 11.2–21.8%. There were no differences in peak EMG amplitude recorded during the MVCs across the three conditions (no probe 63.4 ± 48.4 μV, Femiscan? 55.3 ± 42.4 μV, Periform? 59.4 ± 42.2 μV, p = 0.178). These results suggest that women produce consistent MVCs over multiple contractions, and that PFM muscle activation is not affected by different probes inserted into the vagina.  相似文献   

2.
The relative levels of pelvic floor muscle (PFM) activation and pressure generated by maximum voluntary PFM contractions were investigated in healthy continent women. The normal sequence of abdominal and PFM activation was determined.Fifteen women performed single and repeated maximum voluntary PFM contractions in supine, sitting and standing. PFM electromyographic (EMG) signals and associated intra-vaginal pressure data were recorded simultaneously. Surface EMG data were recorded from rectus abdominus (RA), external obliques (EO), internal obliques (IO) and transversus abdominus (TA).Abdominal and PFM EMG and intra-vaginal pressure amplitudes generated during voluntary PFM contractions were not different among the positions. Muscle activation sequence differed by position. In supine, EO activation preceded all other muscles by 27 ms (p = 0.043). In sitting, all of the muscles were activated simultaneously. In standing, RA and EO were activated 11 and 17 ms, respectively, prior to the PFMs and TA and IO were activated 10 and 12 ms, respectively, after the PFMs (p  0.001).The results suggest that women are able to perform equally strong PFM contractions in supine, sitting and standing, however the pattern of abdominal and PFM activation varies by position. These differences may be related to position-dependent urine leakage in women with stress incontinence.  相似文献   

3.
The aim of this study was to present a new methodology for evaluating the pelvic floor muscle (PFM) passive properties. The properties were assessed in 13 continent women using an intra-vaginal dynamometric speculum and EMG (to ensure the subjects were relaxed) in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) forces and passive elastic stiffness (PES) evaluated during five lengthening and shortening cycles; and (4) percentage loss of resistance after 1 min of sustained stretch. The PFMs and surrounding tissues were stretched, at constant speed, by increasing the vaginal antero-posterior diameter; different apertures were considered. Hysteresis was also calculated. The procedure was deemed acceptable by all participants. The median passive forces recorded ranged from 0.54 N (interquartile range 1.52) for minimal aperture to 8.45 N (interquartile range 7.10) for maximal aperture while the corresponding median PES values were 0.17 N/mm (interquartile range 0.28) and 0.67 N/mm (interquartile range 0.60). Median hysteresis was 17.24 N1mm (interquartile range 35.60) and the median percentage of force losses was 11.17% (interquartile range 13.33). This original approach to evaluating the PFM passive properties is very promising for providing better insight into the patho-physiology of stress urinary incontinence and pinpointing conservative treatment mechanisms.  相似文献   

4.
PurposeThis study attempted to assess if the resisted contraction of medial rotators of the tibia increases the ratio between the activity of vastus medialis (VM) and vastus lateralis (VL) during maximal isometric contractions (MIC) of the quadriceps femoral (QF) muscle at 90° of knee flexion.MethodsAbout 24 female subjects participated in this study, performing four series MIC of the QF. In the first series subjects performed only MIC of the QF muscle, whereas in the other three there was MIC of the QF with resisted contraction of medial rotators of the tibia, with the tibia positioned in medial, neutral and lateral rotation. During each contraction, VM and VL electromyographic signal (EMGs) and QF force were collected, being the EMGs root mean square (RMS) used to access the activity level of these muscles.ResultsThe use of the General Linear Model (GLM) test showed that for α = 0.05 there was a significant increase in the VM:VL ratio when the resisted contraction of medial rotators of the tibia was performed with the tibia in medial (p = <0.0001), neutral (p = <0.0001) and lateral rotation (p = 0.001). The same test showed that during MIC of the QF associated to resisted contraction of medial rotators of the tibia there were no significant differences in the VM:VL ratio between the three tibial rotation positions adopted (p = 0.866 [medial–neutral]; p = 0.106 [medial–lateral]; p = 0.068 [neutral–lateral]).ConclusionsThe resisted contraction of medial rotators of the tibia increases the VM:VL ratio during MIC of the QF and the tibial rotation position does not influence the VM:VL ratio during MIC associated to resisted contraction of medial rotators of the tibia.  相似文献   

5.
Concomitant hip adduction during squatting has long been advocated as a rehabilitative method to preferentially activate the VMO in persons with patellofemoral pain. This practice however has been based on research using surface electrodes which are prone to crosstalk from neighboring muscles (i.e., adductor magnus). This study sought to determine whether activation levels of the VMO relative to the VL while squatting with hip adduction would differ based on the choice of recording electrode. Ten healthy subjects performed a maneuver with hip adduction and without hip adduction. The mean VMO and VL activation levels were recorded simultaneously with surface and indwelling fine-wire electrodes. For both recording electrodes, the VMO and VL activity increased significantly with the addition of hip adduction (p < 0.05). However, the increase in VMO activation was more pronounced with surface electrodes, resulting in a significantly higher VMO:VL ratio with the incorporation of hip adduction compared to without hip adduction (p < 0.05). No difference in the VMO:VL ratio was observed between the two squat conditions for the fine-wire electrodes (p > 0.05). Our findings suggest that the VMO:VL activation ratio when squatting with hip adduction is influenced by electrode choice.  相似文献   

6.
The aim of this study was to investigate the effects of additional isometric hip adduction during the plank exercise on the abdominal muscles. Twenty healthy young men participated in this study. Surface electromyography (EMG) was used to monitor the activity of the bilateral rectus abdominis (RA), the internal oblique (IO), and the external oblique (EO) muscles. The participants performed three types of plank exercise; the standard plank exercise, the plank exercise with bilateral isometric hip adduction, and the plank exercise with unilateral isometric hip adduction. All abdominal muscle activity was significantly increased during the plank exercise combined with the bilateral and unilateral isometric hip adduction compared with the standard plank exercise (p < 0.05). Bilateral IO, EO, and left RA muscle activity was significantly increased during the unilateral isometric hip adduction compared with the bilateral isometric hip adduction (p < 0.05). These findings suggest that additional isometric hip adduction during the plank exercise could be a useful method to enhance abdominal muscle activity. In particular, the unilateral isometric hip adduction is a more beneficial exercise than the bilateral isometric hip adduction.  相似文献   

7.
This study quantified the relationship between EMG signals recorded by surface and indwelling electrodes for the infraspinatus and supraspinatus during submaximal axial humeral rotation. Muscular activity was measured on 20 participants during 82 submaximal isometric internal or external axial humeral rotations in a range of postures and intensities. Equations to predict indwelling magnitudes from surface data were generated and the effects of humeral angle and intensity on this relationship were also evaluated.Supraspinatus surface data explained 72–76% of the variance in the indwelling data. Surface data overestimated indwelling data by up to 30% of maximal voluntary contraction (MVC). Infraspinatus surface data explained 62–64% of the variance in the indwelling data, but overestimated by 72% and 400% MVC in external and internal axial humeral rotation trials, respectively. Humeral abduction angle and exertion intensity both altered the relationship between electrode types modestly (p < 0.01) for most muscles and exertions. Better variance explanation was achieved for these submaximal exertions than previously reported values for maximal exertions.These results help inform electrode type selection for the recording of supraspinatus and infraspinatus EMG. Caution is recommended when interpreting surface recordings as indicators of indwelling recordings for exertions where the muscle studied is not a primary mover.  相似文献   

8.
The aim of the current study was to analyze the activation characteristics and potential compartmentalization of the latissimus dorsi (LD) muscle during common maximal voluntary isometric contractions (MVICs) and functional dynamic tasks. Surface electromyography (sEMG) was used to measure activation magnitudes from four electrode sites (referenced to the T10, T12, L1 & L4 LD vertebral origins) across the fanning muscle belly of the LD. In addition, EMG waveforms were cross-correlated to study temporal activation timing between electrode sites (T10-T12, T12-L1, L1-L4 & T10-L4). The MVICs that were tested included a humeral adduction, humeral adduction with internal rotation, a chest-supported row and a humeral extension. Dynamic movements included sagittal lift/lowers from the floor to knee, knee to hip and hip to shoulder. No magnitude-based (p = 0.6116) or temporal-based differences were observed between electrode sites during the MVIC trials. During dynamic movements no temporal-based, but some magnitude-based differences between electrode sites were observed to be present; these differences were small in magnitude and were observed for both the maximum (p = 0.0002) and mean (p = 0.0002) EMG magnitudes. No clear pattern of compartmentalization was uncovered in the contractions studied here. In addition to these findings, it was determined that the most effective MVIC technique for LD EMG normalization purposes was a chest-supported row MVIC, paired with a T12 electrode site.  相似文献   

9.
Electromyographic (EMG) studies into gluteus medius (GMed) typically involve surface EMG electrodes. Previous comparisons of surface and fine wire electrode recordings in other muscles during high load isometric tasks suggest that recordings between electrodes are comparable when the muscle is contracting at a high intensity, however, surface electrodes record additional activity when the muscle is contracting at a low intensity. The purpose of this study was to compare surface and fine wire recordings of GMed at high and low intensities of muscle contractions, under high load conditions (maximum voluntary isometric contractions, MVICs). Mann–Whitney U tests compared median electrode recordings during three MVIC hip actions; abduction, internal rotation and external rotation, in nine healthy adults. There were no significant differences between electrode recordings in positions that evoked a high intensity contraction (internal rotation and abduction, fine wire activity >77% MVIC; effect size, ES < 0.42; p > 0.277). During external rotation, the intensity of muscle activity was low (4.2% MVIC), and surface electrodes recorded additional myoelectric activity (ES = 0.67, p = 0.002). At low levels of muscle activity during high load isometric tasks, the use of surface electrodes may result in additional myoelectric recordings of GMed, potentially reflective of cross-talk from surrounding muscles.  相似文献   

10.
The objective of this study was to determine the magnitude and phasic relationship of the torso muscles in rotation–flexion of varying degree of asymmetries of the trunk. Nineteen normal young subjects (7 males and 12 females) were stabilized on a posture stabilizing platform and instructed to assume a flexed and right rotated posture. A combination 20°, 40° and 60° of rotation and 20°, 40° and 60° of flexion resulted in nine postures. These postures were assumed in a random order. The subjects were asked to exert their maximal voluntary isometric contraction (MVC) in the plane of rotation of the posture assumed for a period of 5 s. The surface EMG from the external and internal obliques, rectus abdominis, latissimus dorsi and erector spinae at the 10th thoracic and 3rd lumbar vertebral levels was recorded. The abdominal muscles had the least response at 40° of flexion, the dorsal muscles had the highest magnitude.With increasing right rotation, the left external oblique continued to decrease its activity. The ANOVA revealed that rotation and muscles had a significant main effect on normalized peak EMG (p < 0.02) in both genders. There was a significant interaction between rotation and flexion in both genders (p < 0.02) and rotation and muscle in females. The erector spinae activity was highest at 40° flexion, due to greater mechanical disadvantage and having not reached the state of flexion–relaxation. The abdominal muscle activity declined with increasing asymmetry, due to the decreasing initial muscle length. The EMG activity was significantly affected by rotation than flexion (p < 0.02).  相似文献   

11.
The sternocostal and clavicular regions of the pectoralis major are independently harvested to provide shoulder stability, but surgical decision making does not consider the biomechanical consequences that disinsertion of one fiber region over the other has on shoulder function. Differences in material properties between the fiber regions could influence which tissue is more optimal for surgical harvesting. The current study utilized ultrasound shear wave elastography (SWE) to investigate whether the in vivo material properties differ between the fiber regions. Shear wave velocities (SWVs) were collected from the sternocostal and clavicular fiber regions of the pectoralis major from ten healthy young male participants. Participants produced isometric shoulder torques of varying magnitudes (passive, 15%, and 30% MVC) and directions (horizontal and vertical adduction). Four shoulder positions encompassing different vertical abduction and external rotation angles were examined. One-way ANOVAs tested the hypotheses that differences in SWVs during rest existed between the fiber regions as a function of shoulder position, and differences in SWVs during contraction existed as a function of shoulder position and torque direction. In all shoulder positions, the clavicular region exhibited greater SWVs during rest than the sternocostal region (P < 0.001). In shoulder positions that did not include external rotation, the clavicular region exhibited greater SWVs during contraction when producing horizontal adduction torques (P < 0.001), while the sternocostal region exhibited greater SWVs during contraction when producing vertical adduction torques at 30% MVC (P < 0.01). Our results suggest that each fiber region of the pectoralis major provides unique contributions to passive and active shoulder function.  相似文献   

12.
Subscapularis muscle is divided into two independent segments, upper and lower (USUB and LSUB), but the role of each segment in glenohumeral functioning is unclear. We compared the electromyographic (EMG) activity of USUB and LSUB during a variety of shoulder movements, with and without an external translation force. Intramuscular electrodes were inserted in USUB and LSUB segments of 20 adults without pathology and EMG activity was measured in stabilization trials (with and without an anterior or posterior directed force at the humerus and isometric rotations) and two shoulder positions (shoulder neutral, abduction). Maximal voluntary isometric contraction (MVIC) trials were performed in abduction, internal and external rotation of the shoulder. In MVIC trials, USUB showed higher activity during internal rotation (p = 0.03), whereas LSUB showed higher activity during external rotation (p < 0.01). In stabilization trials, the interaction effects were significant for muscle segment × condition (p < 0.01), and approached significance for muscle segment × position (p = 0.06). In the neutral position, the pattern of activity for LSUB was similar to USUB. In the abducted position the LSUB, unlike USUB, was more active during external rotation (p = 0.06) and also showed increased activity in response to the posterior directed force at the humerus (p = 0.04). Our results suggest that USUB primarily acts as an agonist for internal rotation. In contrast LSUB was particularly active in external rotation in the abducted position and demonstrated increased EMG activity in response to the posteriorly directed force at the humerus in that position, suggesting more of a role in glenohumeral stabilization.  相似文献   

13.
The aim of this study was to assess H-reflex plasticity and activation pattern of the plantar flexors during a sustained contraction where voluntary EMG activity was controlled via an EMG biofeedback. Twelve healthy males (28.0 ± 4.8 yr) performed a sustained isometric plantar flexion while instructed to maintain summed EMG root mean square (RMS) of gastrocnemius lateralis (GL) and gastrocnemius medialis (GM) muscles fixed at a target corresponding to 80% maximal voluntary contraction torque via an EMG biofeedback. Transcutaneous electrical stimulation of the posterior tibial nerve was evoked during the contraction to obtain the maximal H-reflex amplitude to maximal M-wave amplitude ratio (Hsup/Msup ratio) from GL, GM and soleus (SOL) muscles. Neuromuscular function was also assessed before and immediately after exercise. Results showed a decrease in SOL activation during sustained flexion (from 65.5 ± 6.4% to 42.3 ± 3.8% maximal EMG, p < 0.001), whereas summed EMG RMS of GL and GM remained constant (59.7 ± 4.8% of maximal EMG on average). No significant change in the Hsup/Msup ratio was found for SOL, GL and GM muscles. Furthermore, it appears that the decrease in maximal voluntary contraction torque (?20.4 ± 2.9%, p < 0.001) was related to both neural and contractile impairment. Overall, these findings indicate that the balance between excitation and inhibition affecting the motoneuron pool remains constant during a sustained contraction where myoelectrical activity is controlled via an EMG biofeedback or let free to vary.  相似文献   

14.
The aims of this study were to assess the effect of the pelvic compression belt on the electromyographic (EMG) activities of gluteus medius (GM), quadratus lumborum (QL), and lumbar multifidus (LM) during side-lying hip abduction. Thirty-one volunteers (15 men and 16 women) with no history of pathology volunteered for this study. Subjects were instructed to perform hip abduction in side-lying position with and without applying the pelvic compression belt. The pelvic compression belt was adjusted just below the anterior superior iliac spines with the stabilizing pressure using elastic compression bands. Surface EMG data were collected from the GM, QL, and LM of the dominant limb. Significantly decreased EMG activity in the QL (without the pelvic compression belt, 60.19 ± 23.66% maximal voluntary isometric contraction [MVIC]; with the pelvic compression belt, 51.44 ± 23.00% MVIC) and significantly increased EMG activity in the GM (without the pelvic compression belt, 26.71 ± 12.88% MVIC; with the pelvic compression belt, 35.02 ± 18.28% MVIC) and in the LM (without the pelvic compression belt, 30.28 ± 14.60% MVIC; with the pelvic compression belt, 37.47 ± 18.94% MVIC) were found when the pelvic compression belt was applied (p < 0.05). However, there were no significant differences of the EMG activity between male and female subjects. The findings suggest that the pelvic compression belt may be helpful to prevent unwanted substitution movement during side-lying hip abduction, through increasing the GM and LM and decreasing the QL.  相似文献   

15.
There are no direct recordings of obturator internus muscle activity in humans because of difficult access for electromyography (EMG) electrodes. Functions attributed to this muscle are based on speculation and include hip external rotation/abduction, and a role in stabilization as an “adjustable ligament” of the hip. Here we present (1) a technique to insert intramuscular EMG electrodes into obturator internus plus (2) the results of an investigation of obturator internus activity relative to that of nearby hip muscles during voluntary hip efforts in two hip positions and a weight-bearing task. Fine-wire electrodes were inserted with ultrasound guidance into obturator internus, gluteus maximus, piriformis and quadratus femoris in ten participants. Participants performed ramped and maximal isometric hip efforts (open kinetic chain) into flexion/extension, abduction/adduction, and internal/external rotation, and hip rotation to end range in standing. Analysis of the relationship between activity of the obturator internus and the other hip muscles provided evidence of limited contamination of the recordings with crosstalk. Obturator internus EMG amplitude was greatest during hip extension, then external rotation then abduction, with minimal to no activation in other directions. Obturator internus EMG was more commonly the first muscle active during abduction and external rotation than other muscles. This study describes a viable and valid technique to record obturator internus EMG and provides the first evidence of its activation during simple functions. The observation of specificity of activation to certain force directions questions the hypothesis of a general role in hip stabilisation regardless of force direction.  相似文献   

16.
MVC techniques to normalize trunk muscle EMG in healthy women   总被引:1,自引:0,他引:1  
Normalization of the surface electromyogram (EMG) addresses some of the inherent inter-subject and inter-muscular variability of this signal to enable comparison between muscles and people. The aim of this study was to evaluate the effectiveness of several maximal voluntary isometric contraction (MVC) strategies, and identify maximum electromyographic reference values used for normalizing trunk muscle activity. Eight healthy women performed 11 MVC techniques, including trials in which thorax motion was resisted, trials in which pelvis motion was resisted, shoulder rotation and adduction, and un-resisted MVC maneuvers (maximal abdominal hollowing and maximal abdominal bracing). EMG signals were bilaterally collected from upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, latissimus dorsi, and erector spinae at T9 and L5. A 0.5 s moving average window was used to calculate the maximum EMG amplitude of each muscle for each MVC technique. A great inter-subject variability between participants was observed as to which MVC strategy elicited the greatest muscular activity, especially for the oblique abdominals and latissimus dorsi. Since no single test was superior for obtaining maximum electrical activity, it appears that several upper and lower trunk MVC techniques should be performed for EMG normalization in healthy women.  相似文献   

17.
The aim of this study was to investigate the importance of duration of differential activations between the heads of the biceps brachii on local fatigue during prolonged low-level contractions. Fifteen subjects carried out isometric elbow flexion at 5% of maximal voluntary contraction (MVC) for 30 min. MVCs were performed before and at the end of the prolonged contraction. Surface electromyographic (EMG) signals were recorded from both heads of the biceps brachii. Differential activation was analysed based on the difference in EMG amplitude (activation) between electrodes situated at the two heads. Differential activations were quantified by the power spectral median frequency of the difference in activation between the heads throughout the contraction. The inverse of the median frequency was used to describe the average duration of the differential activations. The relation between average duration of the differential activations and the fatigue-induced reduction in maximal force was explored by linear regression analysis. The main finding was that the average duration of differential activation was positively associated to relative maximal force at the end of the 30 min contraction (R2 = 0.5, P < 0.01). The findings of this study highlight the importance of duration of differential activations for local fatigue, and support the hypothesis that long term differential activations prevent fatigue during prolonged low-level contractions.  相似文献   

18.
This study investigated the effect of water immersion on surface electromyography (EMG) signals recorded from the brachioradial muscle of 11 healthy subjects, both in a dry environment and a thermo-neutral forearm bath (36 °C). EMG measurements were registered in a sitting position, using waterproof electrodes under 3 conditions: relaxed muscle, maximum voluntary isometric contraction (MVC, 1 s, grip test) and 70% of the MVC (5 s). In relaxed muscle, mean EMG values were significantly higher under immersion compared to the dry conditions (dry: 5.4 ± 3.6 μV; water: 19.5 ± 14.9 μV; p = 0.014). In maximum voluntary isometric contraction, there was a significant difference, though not in the same direction (dry: 145.9 ± 58.9 μV; water: 73.2 ± 35.0 μV; p = 0.003). Under 70% MVC, there was no difference between wet and dry conditions (dry: 102.4 ± 75.0 μV; water: 100.4 ± 65.3 μV; p = 0.951). Results suggest that dry and underwater conditions influence EMG readings; however, the results are inconsistent. These findings indicate additional influences on resting muscle activity, as well as MVC. Further measurements with other muscle groups and different types of immersion are needed to clarify conflicting observations.  相似文献   

19.
Residual force enhancement (RFE) and force depression (FD) refer to an increased or decreased force following an active lengthening or shortening contraction, respectively, relative to the isometric force produced at the same activation level and muscle length. Our intent was to determine if EMG characteristics differed in the RFE or FD states compared with a purely isometric reference contraction for maximal and submaximal voluntary activation of the adductor pollicis muscle. Quantifying these alterations to EMG in history-dependent states allows for more accurate modeling approaches for movement control in the future. For maximal voluntary contractions (MVC), RFE was 6–15% (P < 0.001) and FD was 12–19% (P < 0.001). The median frequency of the EMG was not different between RFE, FD and isometric reference contractions for the 100% and 40% MVC intensities (P > 0.05). However, root mean square EMG (EMGRMS) amplitude for the submaximal contractions was higher in the FD and lower in the RFE state, respectively (P < 0.05). For maximal contractions, EMGRMS was lower for the FD state but was the same for the RFE state compared to the isometric reference contractions (P > 0.05). Neuromuscular efficiency (NME; force/EMG) was lower in the force depressed state and higher in the force enhanced state (P < 0.05) compared to the isometric reference contractions. EMG spectral properties were not altered between the force-enhanced and depressed states relative to the isometric reference contractions, while EMG amplitude measures were.  相似文献   

20.
Normalization of electromyographic (EMG) amplitudes is necessary in the study of human motion. However, there is a lack of agreement on the most reliable and appropriate normalization method. This study evaluated the reliability of single leg stance (SLS) and maximal voluntary isometric contraction (MVIC) normalization methods and the relationship between these measures for the gluteus maximus (GMax), gluteus medius (GMed), rectus femoris (RF), vastus lateralis (VL), hip adductor group (ADD), and biceps femoris (BF). Surface EMG was recorded in 20 subjects during three 5 s trials of SLS and MVIC. SLS and MVIC methods both demonstrated good-to-excellent reliability in all muscles (ICCs > 0.80). Intrasubject coefficients of variation were lower for the MVIC method (9–36%) than for the SLS method (20–59%). EMG amplitudes during MVIC and SLS were significantly correlated for all muscles (Pearson r’s = 0.604–0.905, p < 0.005) except GMax (r = 0.250, p = 0.288). Use of SLS normalization for the RF, VL, and BF is not recommended due to a lack of measurement precision. However, this method is justified in the GMax, GMed, and ADD and may provide a better representation of coordinated muscle function during a functional task.  相似文献   

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