The role of co-activation in strength and force modulation in the elbow of children with unilateral cerebral palsy

To study the role of coactivation in strength and force modulation in the elbow joint of children and adolescents with cerebral palsy (CP), we investigated the affected and contralateral arm of 21 persons (age 8-18) with spastic unilateral CP in three tasks: maximal voluntary isokinetic concentric contraction and passive isokinetic movement during elbow flexion and extension, and sub-maximal isometric force tracing during elbow flexion. Elbow flexion-extension torque and surface electromyography (EMG) of the biceps brachii (BB) and triceps brachii (TB) muscles were recorded. During the maximal contractions, the affected arm was weaker, had decreased agonist and similar antagonist EMG amplitudes, and thus increased antagonist co-activation (% of maximal activity as agonist) during both elbow flexion and extension, with higher coactivation levels of the TB than the BB. During passive elbow extension, the BB of the affected arm showed increased resistance torque and indication of reflex, and thus spastic, activity. No difference between the two arms was found in the ability to modulate force, despite increased TB coactivation in the affected arm. The results indicate that coactivation plays a minor role in muscle weakness in CP, and does not limit force modulation. Moreover, spasticity seems particularly to increase coactivation in the muscle antagonistic to the spastic one, possibly in order to increase stability.     

Control of the Elbow Extensor Muscles in Slow Targeted Extensions of the Arm in Humans

Relations between the kinematic parameters of slow (non-ballistic) targeted extension movements in the elbow joint of humans and characteristics of the movement-related EMG activity in the two heads of the m. triceps brachii were analyzed. Test movements were performed under conditions of application of non-inertional external loadings directed toward flexion. It was shown that the movement-related EMG activity of the elbow extensors, similarly to what was observed in the flexors at flexion movements with the same parameters, demonstrates a complex structure and includes dynamic and stationary phases. In the former phase, in turn, initial and main components can be differentiated. The rising edge and decay of the main component of the dynamic extensor EMG phase could be approximated by exponential functions; this component was never split into a few subcomponents. Dependences between the amplitudes of m. triceps brachii EMG phases and the amplitude of the movement (or external loading) were, as a rule, nonlinear but monotonic. An increase in the test movement velocity led to an increase in the rate of rise of the rising edge of the dynamic EMG phase, while an increment in the amplitude was less significant. Under the used test conditions, the activity of the elbow extensors was usually accompanied by some coactivation of the antagonists (m. biceps brachii). It is concluded that motor commands coming to the elbow extensors at performance of the extension test movements differ from motor commands to the flexors at analogous flexion test movements by a simpler structure and more tonic pattern. Biomechanical specificities of fixation of the mentioned muscle groups to the arm bones (stability of the moment for application of the extensor force under conditions of changing the joint angle vs variable moment of the flexor force) are considered one of the main reasons for such specificity of the patterns of the extensor and flexor motor commands.     

The effects of electromechanical wrist robot assistive system with neuromuscular electrical stimulation for stroke rehabilitation

An electromyography (EMG)-driven electromechanical robot system integrated with neuromuscular electrical stimulation (NMES) was developed for wrist training after stroke. The performance of the system in assisting wrist flexion/extension tracking was evaluated on five chronic stroke subjects, when the system provided five different schemes with or without NMES and robot assistance. The tracking performances were measured by range of motion (ROM) of the wrist and root mean squared error (RMSE). The performance is better when both NMES and robot assisted in the tracking than those with either NMES or robot only (P<0.05). The muscle co-contractions in the upper limb measured by EMG were reduced when NMES provided assistance (P<0.05). All subjects also attended a 20-session wrist training for evaluating the training effects (3-5 times/week). The results showed improvements on the voluntary motor functions in the hand, wrist and elbow functions after the training, as indicated by the clinical scores of Fugl-Meyer Assessment, Action Research Arm Test, Wolf Motor Function Test; and also showed reduced spasticity in the wrist and the elbow as measured by the Modified Ashworth Score of each subject. After the training, the co-contractions were reduced between the flexor carpi radialis and extensor carpi radialis, and between the biceps brachii and triceps brachii. Assistance from the robot helped improve the movement accuracy; and the NMES helped increase the muscle activation for the wrist joint and suppress the excessive muscular activities from the elbow joint. The NMES-robot assisted wrist training could improve the hand, wrist, and elbow functions.     

Modulation of slow and fast elbow extensor EMG tonic activity by stretch reflexes in man

Reflex EMG responses to sudden passive flexion of the elbow were recorded from anconeus and triceps brachii in 5 human volunteers. While the subjects were required not to resist the flexion movement, they were required to maintain an extension torque of 3.5 or 7.0 Nm prior to its onset. Under these isotonic conditions, the latency and amplitude of the reflex activities from anconeus and triceps brachii did not differ significantly, in contrast to the findings of Le Bozec (1986) in actively relaxed subjects. The myotatic/postmyotatic EMG amplitude ratio did not provide a further quantitative way to distinguish between these muscles. The absence of a difference between the reflex activities of a slow (anconeus) and a fast (triceps brachii) muscle is interpreted as resulting from a strong drive of spindle activity on the whole extensor motoneuron pool, which outweights the differences in recruitment due to the differing relative amounts of type I and type II fibres in the two muscles. Differences like those described between finger and calf muscles by other authors are thought to be due to the relative degree of corticalization of these muscles. All short and long latency responses of the muscles increased in magnitude and decreased in latency with increasing background EMG activity as well as with increasing initial length. The position and tonic activity dependency of these responses is explained in terms of alpha-gamma coactivation.     

A motion of forearm supination with maintenance of elbow flexion produced by electrical stimulation to two elbow flexors in humans.

Motions of the forearm induced by electrical stimulation to two elbow flexors (brachioradialis: BR, biceps brachii: BB) were examined in five healthy human subjects. Stainless steel wire electrodes were implanted percutaneously into each motor point of the muscles. The muscles were stimulated separately with a computer-controlled multi-channel stimulator. The motions were taken with a digital video system. Angular changes of the motions in elbow flexion/extension and forearm pronation/supination were measured. Electromyograms (EMG) of BR, BB, and the triceps brachii (TB) were recorded. Electrical stimulation to BR induced a motion of flexion and that to BB motions of flexion and supination. The stimulation to BR with an adequate intensity provided holding of flexion with the prone forearm in all the subjects. In this situation, additional stimulation to BB resulted in motions of flexion and supination. However, the additional stimulation accompanied with a decrease of the stimulation intensity for BR provided a motion of supination with maintenance of the flexion in all the subjects. Since during the stimulation BR, BB, and TB showed no voluntary contraction in EMG, it is suggested that modulation of contraction between BR and BB by the stimulation can produce force in supination with keeping constant force in flexion to support the weight below the elbow.     

Wrist stabilisation and forearm muscle coactivation during freestyle swimming.

The aim of this study was to evaluate the stabilisation of the wrist joint and the ad hoc wrist muscles activations during the two principal phases of the freestyle stroke. Seven male international swimmers performed a maximal semi-tethered power test. A swimming ergometer fixed on the start area of the pool was used to collect maximal power. The electromyography signal (EMG) of the right flexor carpi ulnaris (FCU) and extensor carpi ulnaris (ECU) was recorded with surface electrodes and processed using the integrated EMG (IEMG). Frontal and sagittal video views were digitised frame by frame to determine the wrist angle in the sagittal plane and the principal phases of the stroke (insweep, outsweep). Important stabilisation of the wrist and high antagonist muscle activity were observed during the insweep phase due to the great mechanical constraints. In outsweep, less stabilisation and lower antagonist activities were noted. Factors affecting coactivations in elementary movements, e.g. intensity and instability of the load, accuracy and economy of the movement were confirmed in complex aquatic movement.     

Surface EMG force modeling with joint angle based calibration

In this paper, a calibration method to compensate for changes in SEMG amplitude with joint angle is introduced. Calibration factors were derived from constant amplitude surface electromyogram (SEMG) recordings from the biceps brachii (during elbow flexion) and the triceps brachii (during elbow extension) across seven elbow joint angles. SEMG data were then recorded from the elbow flexors (biceps brachii and brachioradialis) and extensors (triceps brachii) during isometric, constant force flexion and extension contractions at the same joint angles. The resulting force at the wrist was measured. The fast orthogonal search method was used to find a mapping between the system inputs – estimated SEMG amplitudes and joint angle – and the system output – measured force, for both calibrated and non-calibrated SEMG data. Models developed with calibrated data yielded a statistically significant improvement in force estimation compared to models developed with non-calibrated data, suggesting that the calibration method can compensate for changes in the SEMG–force relationship with changing joint angle. It was also found that the number of non-linear, joint angle-dependent terms used in the SEMG–force model was reduced with calibration. Additionally, initial inter-session analysis performed for four subjects suggests that calibration values can be used for subsequent recording sessions, and different output force levels.     

Effect of muscle length on surface EMG wave forms in isometric contractions

To elucidate the influence of muscle length on surface EMG wave form, comparisons were made of surface EMGs of the biceps and triceps brachii muscles during isometric contractions at different muscle lengths. Muscle lengths were altered by setting the elbow joint angle at several intervals between the limits of extension and flexion. The intensity of the isometric contractions was 25% of maximum voluntary contraction at the individual joint angles. Slowing was obvious in the EMG wave forms of biceps as muscle length increased. The so-called 'Piper rhythm' appeared when the muscle was more than moderately lengthened. The slowing trend with muscle lengthening, though less marked, was also seen in triceps. Zero-cross analysis revealed quasi-linear relationships between muscle length and slowing. Frequency analysis confirmed the development of 'Piper rhythm'. An attempt was made to interpret the slowing associated with muscle lengthening in terms of the propagation of myoelectric signals in muscle fibers. given the effect of muscle length on EMG wave forms, a careful control of joint angle may be required in assessing local making fatigue when using EMG spectral indices.     

Feasibility of using EMG driven neuromusculoskeletal model for prediction of dynamic movement of the elbow.

Neuromusculoskeletal (NMS) modeling is a valuable tool in orthopaedic biomechanics and motor control research. To evaluate the feasibility of using electromyographic (EMG) signals with NMS modeling to estimate individual muscle force during dynamic movement, an EMG driven NMS model of the elbow was developed. The model incorporates dynamical equation of motion of the forearm, musculoskeletal geometry and musculotendon modeling of four prime elbow flexors and three prime elbow extensors. It was first calibrated to two normal subjects by determining the subject-specific musculotendon parameters using computational optimization to minimize the root mean square difference between the predicted and measured maximum isometric flexion and extension torque at nine elbow positions (0-120 degrees of flexion with an increment of 15 degrees ). Once calibrated, the model was used to predict the elbow joint trajectories for three flexion/extension tasks by processing the EMG signals picked up by both surface and fine electrodes using two different EMG-to-activation processing schemes reported in the literature without involving any trajectory fitting procedures. It appeared that both schemes interpreted the EMG somewhat consistently but their prediction accuracy varied among testing protocols. In general, the model succeeded in predicting the elbow flexion trajectory in the moderate loading condition but over-drove the flexion trajectory under unloaded condition. The predicted trajectories of the elbow extension were noted to be continuous but the general shape did not fit very well with the measured one. Estimation of muscle activation based on EMG was believed to be the major source of uncertainty within the EMG driven model. It was especially so apparently when fine wire EMG signal is involved primarily. In spite of such limitation, we demonstrated the potential of using EMG driven neuromusculoskeletal modeling for non-invasive prediction of individual muscle forces during dynamic movement under certain conditions.     

Force-length, torque-angle and EMG-joint angle relationships of the human in vivo biceps brachii

The relationships of EMG and muscle force with elbow joint angle were investigated for muscle modelling purposes. Eight subjects had their arms fixed in an isometric elbow jig where the biceps brachii was electrically stimulated (30 Hz) and also in maximum voluntary contraction (MVC). Biceps EMG and elbow torque transduced at the wrist were recorded at 0.175 rad intervals through 1.75 rad of elbow extension. The results revealed that while the torque-length relationship displayed the classic inverted U pattern in both evoked and MVC conditions, the force-length relationship displayed a monotonically increasing pattern. Analyses of variance of the EMG data showed that there were no significant changes in the EMG amplitudes for the different joint angles during evoked or voluntary contractions. The result also showed that electrical stimulation can effectively isolated the torque-angle and force-length relationships of the biceps brachii and that the myoelectric signal during isometric contraction is uniform regardless of the length of the muscle or the joint angle.     

Neuromuscular fatigue during maximal concurrent hand grip and elbow flexion or extension.

The objective was to investigate muscle fatigue measuring changes in force output and force tremor and electromyographic activity (EMG) during two sustained maximal isometric contractions for 60s: (1) concurrent hand grip and elbow flexion (HG and EF); or (2) hand grip and elbow extension (HG and EE). Each force tremor amplitude was decomposed into four frequency bands (1-3, 4-10, 11-20, and 21-50Hz). Surface EMGs were recorded from the flexor digitorum superficialis (FDS), extensor digitorum (ED), biceps brachii (BB) and lateral head of triceps brachii (TB). The HG and EF forces for the HG and EF and the HG force for the HG and EE declined rapidly, whereas the EE force remained almost constant near to the initial value for the first 40s and then declined. The decrease in EMG amplitude was observed not for the FDS muscle but for the ED muscle. The HG tremor amplitude for each frequency band showed similar decreasing rate, whereas the decreases in EF and EE tremor amplitudes for the lower band (below 10Hz) were slower than those for the higher band (above 11Hz). The neuromuscular mechanisms underlying muscle fatigue during sustained maximal concurrent contractions of hand grip and elbow flexion or extension are discussed.     

Motor unit firing rates during isometric voluntary contractions performed at different muscle lengths

Firing rates of motor units and surface EMG were measured from the triceps brachii muscles of able-bodied subjects during brief submaximal and maximal isometric voluntary contractions made at 5 elbow joint angles that covered the entire physiological range of muscle lengths. Muscle activation at the longest, midlength, and shortest muscle lengths, measured by twitch occlusion, averaged 98%, 97%, and 93% respectively, with each subject able to achieve complete activation during some contractions. As expected, the strongest contractions were recorded at 90 degrees of elbow flexion. Mean motor unit firing rates and surface EMG increased with contraction intensity at each muscle length. For any given absolute contraction intensity, motor unit firing rates varied when muscle length was changed. However, mean motor unit firing rates were independent of muscle length when contractions were compared with the intensity of the maximal voluntary contraction (MVC) achieved at each joint angle.     

Olympic weightlifting training causes different knee muscle-coactivation adaptations compared with traditional weight training

The purpose of this study was to compare the effects of an Olympic weightlifting (OL) and traditional weight (TW) training program on muscle coactivation around the knee joint during vertical jump tests. Twenty-six men were assigned randomly to 3 groups: the OL (n = 9), the TW (n = 9), and Control (C) groups (n = 8). The experimental groups trained 3 d · wk(-1) for 8 weeks. Electromyographic (EMG) activity from the rectus femoris and biceps femoris, sagittal kinematics, vertical stiffness, maximum height, and power were collected during the squat jump, countermovement jump (CMJ), and drop jump (DJ), before and after training. Knee muscle coactivation index (CI) was calculated for different phases of each jump by dividing the antagonist EMG activity by the agonist. Analysis of variance showed that the CI recorded during the preactivation and eccentric phases of all the jumps increased in both training groups. The OL group showed a higher stiffness and jump height adaptation than the TW group did (p < 0.05). Further, the OL showed a decrease or maintenance of the CI recorded during the propulsion phase of the CMJ and DJs, which is in contrast to the increase in the CI observed after TW training (p < 0.05). The results indicated that the altered muscle activation patterns about the knee, coupled with changes of leg stiffness, differ between the 2 programs. The OL program improves jump performance via a constant CI, whereas the TW training caused an increased CI, probably to enhance joint stability.     

Fatigue and muscle activation during submaximal elbow flexion in children with cerebral palsy

The purpose of this study was to investigate whether children with cerebral palsy (CP), like typically developing peers, would compensate for muscle fatigue by recruiting additional motor units during a sustained low force contraction until task failure.Twelve children with CP and 17 typically developing peers performed one submaximal isometric elbow flexion contraction until the task could no longer be sustained at on average 25% (range 10–35%) of their maximal voluntary torque. Meanwhile surface electromyography (EMG) was measured from the biceps brachii and triceps brachii, and acceleration variations of the forearm were detected by an accelerometer. Slopes of the change in EMG amplitude and median frequency and accelerometer variation during time normalised to their initial values were calculated.Strength and time to task failure were similar in both groups. Children with CP exhibited a lower increase in EMG amplitude of the biceps brachii and triceps brachii during the course of the sustained elbow flexion task, while there were no significant group differences in median frequency decrease or acceleration variation increase. This indicates that children with CP do not compensate muscle fatigue with recruitment of additional motor units during sustained low force contractions.     

Influence of force tremor on mechanomyographic signals recorded with an accelerometer and a condenser microphone during measurement of agonist and antagonist muscles in voluntary submaximal isometric contractions

The purpose of this study was to investigate the influence of force tremor (FT) on the mechanomyogram (MMG) recorded by a condenser microphone (MIC) and an accelerometer (ACC) for the measurement of agonist and antagonist muscles during submaximal isometric contractions. Following determination of the isometric maximum voluntary contraction (MVC), 10 male subjects were asked to perform elbow flexion and extension at 20%, 40%, 60%, and 80% MVC. Surface electromyogram (EMG) and MMG of the biceps brachii (BB) and triceps brachii (TB) were recorded simultaneously using a MIC (MMG-(MIC)) and an ACC (MMG-(ACC)). We analyzed the root mean square (RMS) for all signals and compared the sum of the power spectrum amplitude (SPA) at 3-6 Hz and 8-12 Hz between the MMG-(MIC) and the MMG-(ACC). During elbow flexion and extension, the RMS of the EMG and the MMG-(MIC) of the agonist were significantly (p<0.05) higher than those of the antagonist in each contraction level. The RMS of the MMG-(ACC) of the antagonist showed no significant (p>0.05) difference from that of the agonist, or tended to be higher than the agonist. The SPA of the MMG-(MIC) of the agonist at 3-6 Hz and 8-12 Hz tended to be higher than the antagonist in elbow flexion and extension at each contraction level. The SPA of the MMG-(ACC) of the agonist and that of the antagonist showed no significant (p>0.05) difference, or the antagonist MMG-(ACC) tended to be higher than that of the agonist. These results suggest the MMG detected by a MIC appears to be less affected by FT than is the ACC because of its inherent characteristic to reduce FT in simultaneously evaluated agonist and antagonist muscles by means of MMG during submaximal isometric contraction.     

Activation of the Shoulder Belt and Shoulder Muscles of Humans Related to Different Rates of Generation of Two-Joint Efforts by the Forearm

We studied coordination of central motor commands (CMCs) coming to the muscles that flex and extend the shoulder and elbow joints in the course of generation of voluntary isometric efforts of different directions by the forearm. Dependences of the characteristics of these commands on the direction of the effort and rate of its generation were analyzed. Amplitudes of rectified and averaged EMGs recorded from a number of shoulder belt and shoulder muscles were considered correlates of the CMC intensity. The development of the effort of a given direction and rate of rise was realized in the horizontal-plane operational space; the arm position corresponded to the 30 deg angle in the shoulder joint (external angle with respect to the frontal plane) and 90 deg angle in the elbow joint. We plotted sector diagrams of the relative changes in the level of dynamic and stationary phases of EMG activity of the studied muscles for the entire set of directions of the efforts generated with different rates of rise. In the course of formation of rapid two-joint isometric efforts, realization of nonsynergic motor tasks (extension of one joint and flexion of another one, and vice versa) required significant activation of muscles of different functional directions for both joints. Time organization of EMG activity of extensors and flexors of the shoulder and elbow joints related to the maximum and relatively rapid generation of the effort (rise time 0.12 to 0.13 and 0.25 sec, respectively) was rather complex and included dynamic and stationary phases. With these time parameters of generation of the efforts (both flexion and extension), the appearance at the stationary effort of 40 N was controlled based on coordinated interaction of dynamic phases of the activation of agonistic and antagonistic muscles. It is concluded that CMCs coming to extensors and flexors of both joints upon generation of rapid isometric efforts are rather similar in their parameters to those under conditions of realization of the forearm movements in the space in an isotonic mode.     

Eccentric exercise increases EMG amplitude and force fluctuations during submaximal contractions of elbow flexor muscles.

The purpose of this study was to determine the effect of eccentric exercise on the ability to exert steady submaximal forces with muscles that cross the elbow joint. Eight subjects performed two tasks requiring isometric contraction of the right elbow flexors: a maximum voluntary contraction (MVC) and a constant-force task at four submaximal target forces (5, 20, 35, 50% MVC) while electromyography (EMG) was recorded from elbow flexor and extensor muscles. These tasks were performed before, after, and 24 h after a period of eccentric (fatigue and muscle damage) or concentric exercise (fatigue only). MVC force declined after eccentric exercise (45% decline) and remained depressed 24 h later (24%), whereas the reduced force after concentric exercise (22%) fully recovered the following day. EMG amplitude during the submaximal contractions increased in all elbow flexor muscles after eccentric exercise, with the greatest change in the biceps brachii at low forces (3-4 times larger at 5 and 20% MVC) and in the brachialis muscle at moderate forces (2 times larger at 35 and 50% MVC). Eccentric exercise resulted in a twofold increase in coactivation of the triceps brachii muscle during all submaximal contractions. Force fluctuations were larger after eccentric exercise, particularly at low forces (3-4 times larger at 5% MVC, 2 times larger at 50% MVC), with a twofold increase in physiological tremor at 8-12 Hz. These data indicate that eccentric exercise results in impaired motor control and altered neural drive to elbow flexor muscles, particularly at low forces, suggesting altered motor unit activation after eccentric exercise.     

The flexor function of the m. pronator teres in man: a quantitative electromyographic study

The muscle pronator teres was studied by surface electromyography during elbow flexion in a horizontal plane. The forearm was in semi-pronation and movement was performed at various velocities. A quantitative comparison was made between pronator teres activity and two main elbow flexors, biceps brachii and brachioradialis. The mean timing of the onset of activity was constant: biceps brachii was activated first followed by pronator teres and brachioradialis, and the lower the velocity of flexion, the earlier was the onset of biceps brachii activity. There was a linear relationship between the integrated EMG from each muscle and the work done. However, this relationship was less exact for pronator teres and brachioradialis at low values of work, a finding which opens questions about the generality of this relationship and about the "muscle equivalent" concept. Pronator teres appears to participate in elbow flexion besides its role in pronation. Despite similar anatomical peculiarities, pronator teres does not behave in the same way as anconaeus or popliteus and, above all, it is not the sole muscle active in slow movement. Thus, all the stocky muscles lying close to an articulation do not behave in the same way.     

Muscle activity patterns during quick increase of movement amplitude in rapid elbow extensions

In this study, we investigated a motor strategy for increasing the amplitude of movement in rapid extensions at the elbow joint. This study focused on the changes in a triphasic electromyographic (EMG) pattern, i.e., the first agonist burst (AG1), the second agonist burst (AG2) and the antagonist burst (ANT), for increasing the amplitude of movement required after the initiation of movement. Subjects performed 40° (Basic task) and 80° of extension (Wide task). These tasks were performed under two conditions; performing a predetermined task (SF condition) and performing a task in response to a visual stimulus immediately after movement commencement (ST condition). Kinematic parameters and EMG activity from the agonist (triceps brachii) and the antagonist (biceps brachii) muscles were recorded. As a result, the onset latency of AG1 and AG2 and the duration of AG1 were longer under the ST condition than the SF condition. No difference was observed between the SF and ST condition with respect to ANT activity. It is concluded that the motor strategy for increasing the amplitude of movement after the initiation of movement was to control the movement velocity and the timing to stop movement by the coactivation duration of AG1 and ANT and to stop the desired position accurately by AG2 activity.     

Effects of mechanical assistance on muscle activity and motor performance during isometric elbow flexion

Mechanical assistance on joint movement is generally beneficial; however, its effects on cooperative performance and muscle activity needs to be further explored. This study examined how motor performance and muscle activity are altered when mechanical assistance is provided during isometric force control of ramp-down and hold phases. Thirteen right-handed participants (age: 24.7 ± 1.8 years) performed trajectory tracking tasks. Participants were asked to maintain the reference magnitude of 47 N (REF) during isometric elbow flexion. The force was released to a step-down magnitude of either 75% REF or 50% REF and maintained, with and without mechanical assistance. The ramp-down durations of force release were set to 0.5, 2.5, or 5.0 s. Throughout the experiment, we measured the following: (1) the force output using load cells to compute force variability and overshoot ratio; (2) peak perturbation on the elbow movement using an accelerometer; (3) the surface electromyography (sEMG) from biceps brachii and triceps brachii muscles; and (4) EMG oscillation from the biceps brachii muscle in the bandwidth of 15–45 Hz. Our results indicated that mechanical assistance, which involved greater peak perturbation, demonstrated lower force variability than non-assistance (p < 0.01), while EMG oscillation in the biceps brachii muscle from 15 to 45 Hz was increased (p < 0.05). These findings imply that if assistive force is provided during isometric force control, the central nervous system actively tries to stabilize motor performance by controlling specific motor unit activity in the agonist muscle.