Effects of the pelvic compression belt on gluteus medius,quadratus lumborum,and lumbar multifidus activities during side-lying hip abduction

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.     

Reliability and interpretation of single leg stance and maximum voluntary isometric contraction methods of electromyography normalization

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.     

A comparison of surface and fine wire EMG recordings of gluteus medius during selected maximum isometric voluntary contractions of the hip

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.     

Reliability and minimal detectable change in scapulothoracic neuromuscular activity

Alterations in scapular muscle activity, including excess activation of the upper trapezius (UT) and onset latencies of the lower trapezius (LT) and serratus anterior (SA) muscles, are associated with abnormal scapular motion and shoulder impingement. Limited information exists on the reliability of neuromuscular activity to demonstrate the efficacy of interventions. The purpose of this study was to characterize the reproducibility of scapular muscle activity (mean activity, relative onset timing) over time and establish the minimal detectable change (MDC). Surface electromyography (sEMG) of the UT, LT, SA and anterior deltoid (AD) muscles in 16 adults were captured during an overhead lifting task in two sessions, one-week apart. sEMG data were also normalized to maximum isometric contraction and the relative onset and mean muscle activity during concentric and eccentric phases of the scapular muscles were calculated. Additionally, reliability of the absolute sEMG data during the lifting task and MVIC was evaluated. Both intrasession and intersession reliability of normalized and absolute mean scapular muscle activity, assessed with intraclass correlation coefficients (ICC), ranged from 0.62 to 0.99; MDC values were between 1.3% and 11.7% MVIC and 24 to 135 mV absolute sEMG. Reliability of sEMG during MVIC was ICC = 0.82–0.99, with the exception of intersession upper trapezius reliability (ICC = 0.36). Within session reliability of muscle onset times was ICC = 0.88–0.97, but between session reliability was lower with ICC = 0.43–0.73; MDC were between 39 and 237 ms. Small changes in scapular neuromuscular mean activity (>11.7% MVIC) can be interpreted as meaningful change, while change in muscle onset timing in light of specific processing parameters used in this study is more variable.     

Electromyographic assessment of isometric and dynamic activation characteristics of the latissimus dorsi muscle

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.     

The upper and lower segments of subscapularis muscle have different roles in glenohumeral joint functioning

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.     

Parkinson’s disease and sex-related differences in electromyography during daily life

Scope: Daily bilateral electromyography (EMG) recordings reveal muscle activation patterns implicated in asymmetric Parkinson’s disease (PD)-related functional decline. Also, daily EMG recordings reveal sex-differences in muscle activity that give rise to unique PD presentation in males and females. Purpose: Quantify handgrip strength and daily muscle quiescence through analysis of gaps in the EMG signal in males and females with PD. Bilateral daily EMG was recorded and normalized to maximal voluntary exertions (MVE). EMG gap was defined as <1% amplitude of MVE for >0.1 s and characterized as number, duration and time occupied by gaps. A dynamometer evaluated maximal grip-strength. Three-way repeated measures ANOVA examined differences in gap characteristics and strength. Gap duration was shorter (p = 0.04) and occupied less time (p = 0.02) in PD than controls. Females had fewer gaps with shorter duration (p = 0.004), occupying less time (p = 0.004) compared with males. Gaps were fewer (p = 0.04) and occupied less time (p = 0.01) on more-affected than less-affected side. PD was weaker than controls (p = 0.04), females were weaker than males (p = 0.00), and the more-affected PD side was weaker than less-affected (p = 0.04). Conclusions: Quantification of muscle quiescence through gaps in the EMG signal recorded during daily life provides insight into mechanisms underlying differential change in functional performance in males and females with PD.     

The highest antagonistic coactivation of the vastus intermedius muscle among quadriceps femoris muscles during isometric knee flexion

Although the possibility that the vastus intermedius (VI) muscle contributes to flexion of the knee joint has been suggested previously, the detail of its functional role in knee flexion is not well understood. The purpose of this study was to examine the antagonist coactivation of VI during isometric knee flexion. Thirteen men performed 25–100% of maximal voluntary contraction (MVC) at 90°, 120°, and 150° knee joint angles. Surface electromyography (EMG) of the four individual muscles in the quadriceps femoris (QF) was recorded and normalized by the EMG signals during isometric knee extension at MVC. Cross-talk on VI EMG signal was assessed based on the median frequency response to selective cooling of hamstring muscles. Normalized EMG of the VI was significantly higher than that of the other synergistic QF muscles at each knee joint angle (all P < 0.05) with minimum cross-talk from the hamstrings to VI. There were significant correlations between the EMG signal of the hamstrings and VI (r = 0.55–0.85, P < 0.001). These results suggest that VI acts as a primary antagonistic muscle of QF during knee flexion, and that VI is presumably a main contributor to knee joint stabilization.     

Bilateral impairments of shoulder abduction in chronic hemiparesis: Electromyographic patterns and isokinetic muscle performance

ObjectiveTo analyze electromyographic (EMG) patterns and isokinetic muscle performance of shoulder abduction movement in individuals who sustained a cerebrovascular accident (CVA).DesignTwenty-two individuals who sustained a CVA and 22 healthy subjects volunteered for EMG activity and isokinetic shoulder abduction assessments. EMG onset time, root mean square (RMS) for upper trapezius and deltoid muscles, as well as the isokinetic variables of peak torque, total work, average power and acceleration time were compared between limbs and groups.ResultsThe paretic side showed a different onset activation pattern in shoulder abduction, along with a lower RMS for both muscles (21.8 ± 13.4% of the maximal voluntary isometric contraction (MVIC) for the deltoid and 25.9 ± 15.3% MVIC for the upper trapezius, about 50% lower than the control group). The non-paretic side showed a delay in both muscles activation and a lower RMS for the deltoid (32.2 ± 13.7% MVIC, about 25% lower than the control group). Both sides of the group of individuals who sustained a CVA presented a significantly lower isokinetic performance compared to the control group (paretic side ～60% lower; non-paretic side ～35% lower).ConclusionsShoulder abduction muscle performance is impaired in both paretic and non-paretic limbs of individuals who sustained a CVA.     

Quantifying thigh muscle co-activation during isometric knee extension contractions: Within- and between-session reliability

Muscle co-activation around the knee is important during ambulation and balance. The wide range of methodological approaches for the quantification of co-activation index (CI) makes comparisons across studies and populations difficult. The present study determined within- and between-session reliability of different methodological approaches for the quantification of the CI of the knee extensor and flexor muscles during maximum voluntary isometric contractions (MVICs). Eight healthy volunteers participated in two repeated testing sessions. A series of knee extension MVICs of the dominant leg with concomitant torque and electromyographic (EMG) recordings were captured. CI was calculated utilizing different analytical approaches. Intraclass correlation coefficient (ICC) showed that within-session measures displayed higher reliability (ICC > 0.861) and lower variability (Coefficient of variation; CV < 21.8%) than between-session measures (ICC < 0.645; CV > 24.2%). A selection of a 500 ms or larger window of RMS EMG activity around the PT delivered more reliable and less variable results than other approaches. Our findings suggest that the CI can provide a reliable measure for comparisons among conditions and is best utilized for within-session experimental designs.     

Differences among lower leg muscles in long-term activity during ambulatory condition without any moderate to high intensity exercise

The present study aimed to investigate differences among the soleus (Sol), medial gastrocnemius (MG) and tibialis anterior (TA) in electromyogram (EMG) activities during ambulatory condition without any moderate to high intensity exercise. From 10:00 to 17:00, seven healthy graduate students participated in EMG recordings, which included the measurements during maximal voluntary efforts. During the long-term EMG recoding, the subjects were instructed to perform normal daily routines, including desk work and the attendance of lectures. EMG signals from the three muscles were averaged every 0.1 s and expressed as a percentage (%MVE) of those obtained with maximal voluntary efforts, averaged over 1 s. An EMG burst which had an amplitude >2%MVE and a duration >0.1 s was defined as muscular activity. Regardless of muscles examined, the amplitude of the greater part of all bursts observed over the recording time was less than 30%MVE. The summed duration of all bursts over the recording time was significantly greater in Sol than in MG and TA, without a significant difference in the summed number of all bursts among the three muscles. The percentage of the summed duration of bursts at less than 10%MVE to that over the recording time was significantly higher in Sol and TA than in MG, but the corresponding value at 20 ≦ %MVE < 30 was lower. Thus, EMG responses during ambulatory condition without any moderate to high intensity exercise differed among the three muscles, even between synergists: Sol was predominantly activated with low burst amplitudes as compared to MG.     

Knee angle-specific MVIC for triceps surae EMG signal normalization in weight and non weight-bearing conditions

Varying the degree of weight-bearing (WB) and/or knee flexion (KF) angle during a plantar-flexion maximal voluntary isometric contraction (MVIC) has been proposed to alter soleus and/or gastrocnemius medialis and lateralis activation. This study compared the surface EMG signals from the triceps surae of 27 men and 27 women during WB and non weight bearing (NWB) plantar-flexion MVICs performed at 0° and 45° of KF. The aim was to determine which condition was most effective at eliciting the greatest EMG signals from soleus, gastrocnemius medialis, and gastrocnemius lateralis, respectively, for subsequent use for the normalization of EMG signals. WB was more effective than NWB at eliciting the greatest signals from soleus (p = 0.0021), but there was no difference with respect to gastrocnemius medialis and lateralis (p ? 0.2482). Although the greatest EMG signals during MVICs were more frequently elicited at 0° of KF from gastrocnemius medialis and lateralis, and at 45° from soleus (p < 0.001); neither angle consistently captured peak gastrocnemius medialis, gastrocnemius lateralis or soleus activity. The present findings encourage more consistent use of WB plantar flexion MVICs for soleus normalization; confirm that both WB and NWB procedures can elicit peak gastrocnemius activity; and emphasize the fact that no single KF angle consistently evokes selective maximal activity of any individual triceps surae muscle.     

Effects of two neuromuscular fatigue protocols on landing performance

The purpose of the study was to investigate the effects of two fatigue protocols on landing performance. A repeated measures design was used to examine the effects of fatigue and fatigue protocol on neuromuscular and biomechanical performance variables. Ten volunteers performed non-fatigued and fatigued landings on two days using different fatigue protocols. Repeated maximum isometric squats were used to induce fatigue on day one. Sub-maximum cycling was used to induce fatigue on day two. Isometric squat maximum voluntary contraction (MVC) was measured before and after fatigued landings on each day. During the landings, ground reaction force (GRF), knee kinematics, and electromyographic (EMG) data were recorded. Isometric MVC, GRF peaks, loading rates, impulse, knee flexion at contact, range of motion, max angular velocity, and EMG root mean square (RMS) values were compared pre- and post-fatiguing exercise and between fatigue protocols using repeated ANOVA. Fatigue decreased MVC strength (p ? 0.05), GRF second peak, and initial impulse (p ? 0.01), but increased quadriceps medium latency stretch reflex EMG activity (p ? 0.012). Knee flexion at contact was 5.2° greater (p ? 0.05) during fatigued landings following the squat exercise compared to cycling. Several variables exhibited non-significant but large effect sizes when comparing the effects of fatigue and fatigue protocol. In conclusion, fatigue alters landing performance and different fatigue protocols result in different performance changes.     

Knee joint angle affects EMG–force relationship in the vastus intermedius muscle

It is not understood how the knee joint angle affects the relationship between electromyography (EMG) and force of four individual quadriceps femoris (QF) muscles. The purpose of this study was to examine the effect of the knee joint angle on the EMG–force relationship of the four individual QF muscles, particularly the vastus intermedius (VI), during isometric knee extensions. Eleven healthy men performed 20–100% of maximal voluntary contraction (MVC) at knee joint angles of 90°, 120° and 150°. Surface EMG of the four QF synergists was recorded and normalized by the root mean square during MVC. The normalized EMG of the four QF synergists at a knee joint angle of 150° was significantly lower than that at 90° and 120° (P < 0.05). Comparing the normalized EMG among the four QF synergists, a significantly lower normalized EMG was observed in the VI at 150° as compared with the other three QF muscles (P < 0.05). These results suggest that the EMG–force relationship of the four QF synergists shifted downward at an extended knee joint angle of 150°. Furthermore, the neuromuscular activation of the VI was the most sensitive to change in muscle length among the four QF synergistic muscles.     

Muscular activity during isometric incisal biting

This study attempted to estimate TMJ loading during incisal loading using a custom load-cell device and surface electromyographic (sEMG) recordings of the main jaw closers to assess the outcome correlation. Study participants were 23 healthy volunteers. The incisal loads having submaximal and mean intensity were recorded using a calibrated electronic load cell; simultaneously, surface electromyography (sEMG) of the right and left masseter and temporalis muscles was recorded. Readings of the resting, clenching in maximal and submaximal intercuspal positions and mean (50%) incisal loads were recorded. Clenching sEMG activity was used as a reference for normalization. The mean (SD) submaximal incisal load recorded was 498 (305.78) N, and the mean at 50% of the submaximal load was 268.93 (147.37) N. Mean (SD) sEMG activity during submaximal clenching was 141.23 (87.76) μV, with no significant differences between the four muscles. During submaximal voluntary incisal loading, the normalized mean sEMG activity was 49.99 (34.54) µV %, and 27.17(15.29) µV % during mean (50%) effort. The incisal load was generated mainly by the masseter muscles, as these showed a positive correlation during mean but not during submaximal effort. In the edge-to-edge jaw position, the mean incisal load effort seems to be physiological, but excessive TMJ loads can be expected from chronic or excessive incisal loading. In conclusion, incisal loads require the activity of the masseter muscles, which show a positive correlation between sEMG activity and effective incisal loads during mean, but not during submaximal, effort, and the masseter muscles are dominant over the temporalis muscles during submaximal incisal biting.     

History dependence of the electromyogram: Implications for isometric steady-state EMG parameters following a lengthening or shortening contraction

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 (EMG_RMS) amplitude for the submaximal contractions was higher in the FD and lower in the RFE state, respectively (P < 0.05). For maximal contractions, EMG_RMS 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.     

Reliability and precision of EMG in leg,torso, and arm muscles during running

Changes in electromyographic (EMG) parameters are used to evaluate timing, amplitude, and fatigue of muscle actions during movement. Little published data describe the reliability and precision of multiple EMG parameters, how these parameters compare to one another, and how these parameters vary between muscles. The purpose of this study was to determine the reliability and precision of four EMG parameters recorded from the legs, torso, and arm muscles during running. Fifteen well-trained male runners performed moderate-intensity treadmill running while EMG data were collected from thirteen muscles. Integrated EMG (iEMG), root mean square EMG (RMS), maximum M-wave, and median power frequency (MPF) were calculated for 25 consecutive strides. Intra-class correlation coefficients (ICC) and standard error of measurement (SEM) for each parameter were calculated for each muscle. Seven muscles displayed good reliability (ICC > 0.80) for all parameters studied. MPF was the most reliable variable, with 12 muscles having ICC > 0.80 and <6% normalized SEM. Reliability and precision differed between muscles of similar function and anatomic region. These data emphasize the need for researchers and clinicians to have reliability and precision measures for all parameters of each muscle, and demonstrates that generalizations must be used cautiously when interpreting EMG data collected during running.     

Measuring voluntary quadriceps activation: Effect of visual feedback and stimulus delivery

Introduction: Quadriceps voluntary activation, assessed via the superimposed burst technique, has been extensively studied in a variety of populations as a measure of quadriceps function. However, a variety of stimulus delivery techniques have been employed, which may influence the level of voluntary activation as calculated via the central activation ratio (CAR). The purpose was to determine the effect of visual feedback, stimulus delivery, and perceived discomfort on maximal voluntary isometric contraction (MVIC) peak torque and the CAR. Methods: Quadriceps CAR was assessed in 14 individuals on two days using three stimulus delivery methods; (1) manual without visual feedback, (2) manual with visual feedback, and (3) automated with visual feedback. Results: MVIC peak torque and the CAR were not different between the automated with visual feedback (MVIC = 3.25, SE = 0.14 N m/kg; CAR = 88.63, SE = 1.75%) and manual with visual feedback (MVIC = 3.26, SE = 0.13 N m/kg, P = 0.859; CAR = 89.06, SE = 1.70%, P = 0.39) stimulus delivery methods. MVIC (2.99, SE = 0.12 N m/kg) and CAR (85.32, SE = 2.10%) were significantly lower using manual without visual feedback compared to manual with visual feedback and automated with visual feedback (CAR P < 0.001; MVIC P < 0.001). Perceived discomfort was lower in the second session (P < 0.05). Conclusion: Utilizing visual feedback ensures participant MVIC, and may provide a more accurate assessment of quadriceps voluntary activation.     

On the effect of thermal agents in the response of the brachial biceps at different contraction levels

The objective of this study was to assess electromyographic features of the brachial biceps muscle after the application of cryotherapy and short-wave diathermy. Sixty healthy volunteers participated in the study and were equally divided into three groups: cryotherapy – application of ice packs for 30 min; short-wave diathermy for 20 min; and control. The thermal agents were applied to the anterior and posterior regions of the non-dominant arm. The electromyographic (EMG) signal from the brachial biceps was recorded before and after the application of thermal agents during flexion of the elbow joint at 25%, 50%, 75% of a maximum voluntary isometric contraction defined at least two days before the actual experiments (MVIC_bl). The volunteers also were asked to execute a free MVIC before and after the application of the thermal agents (MVIC_free). A linear regression model with mixed effects (random and fixed) was used. Intra-group analysis showed a reduction in root mean square (RMS) at MVIC_free, with no change in the median frequency of the EMG signal at any contraction level for the short-wave diathermy group. An increase on RMS values and a decrease on median frequencies were found after the application of cryotherapy for all contraction levels. The results imply that cryotherapy plays an important role on changing neuromuscular responses at various levels of muscle contraction. Therapists should be aware of that and carefully consider its use prior to activities in which neuromuscular precision is required.     

Unchanged H-reflex during a sustained isometric submaximal plantar flexion performed with an EMG biofeedback

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 (H_sup/M_sup 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 H_sup/M_sup 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.