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.     

Changes in lower limb muscle activity after walking on a split-belt treadmill in individuals post-stroke

Background: There is growing evidence that stroke survivors can adapt and improve step length symmetry in the context of split-belt treadmill (SBT) walking. However, less knowledge exists about the strategies involved for such adaptations. This study analyzed lower limb muscle activity in individuals post-stroke related to SBT-induced changes in step length. Methods: Step length and surface EMG activity of six lower limb muscles were evaluated in individuals post-stroke (n = 16) during (adaptation) and after (after-effects) walking at unequal belt speeds. Results: During adaptation, significant increases in EMG activity were mainly found in proximal muscles (p ⩽ 0.023), whereas after-effects were observed particularly in the distal muscles. The plantarflexor EMG increased after walking on the slow belt (p ⩽ 0.023) and the dorsiflexors predominantly after walking on the fast belt (p ⩽ 0.017) for both, non-paretic and paretic-fast conditions. Correlation analysis revealed that after-effects in step length were mainly associated with changes in distal paretic muscle activity (0.522 ⩽ r ⩽ 0.663) but not with functional deficits. Based on our results, SBT walking could be relevant for training individuals post-stroke who present shorter paretic step length combined with dorsiflexor weakness, or individuals with shorter nonparetic step length and plantarflexor weakness.     

An effective balancing response to lateral perturbations at pelvis level during slow walking requires control in all three planes of motion

In this study we investigated balancing responses to lateral perturbations during slow walking (0.85 m/s). A group of seven healthy individuals walked on an instrumented treadmill while being perturbed at the level of waist at left heel strike in outward and inward lateral directions. Centre of mass (COM) and centre of pressure (COP), rotation of pelvis around vertical axis, step lengths, step widths and step times were assessed. The results have shown that beside control of COP in lateral direction, facilitated by adequate step widths, control of COP in sagittal direction, slowing down movement of COM was present after commencement of lateral perturbations. Sagittal component of COM was significantly retarded as compared to unperturbed walking for both inward (4.32 ± 1.29 cm) and outward (9.75 ± 2.17 cm) perturbations. This was necessary since after an inward perturbation first step length (0.29 ± 0.04 m compared to 0.52 ± 0.02 m in unperturbed walking) and step time (0.45 ± 0.05 s compared to 0.61 ± 0.04 s in unperturbed walking) were shortened while after an outward perturbation first two step lengths (0.36 ± 0.05 m and 0.32 ± 0.11 m compared to 0.52 ± 0.03 m in unperturbed walking) were shortened that needed to be accommodated by the described modulation of COP in sagittal plane. In addition pronounced pelvis rotation assisted in bringing swing leg to new location. The results of this study show that counteracting lateral perturbations at slow walking requires adequate response in all three planes of motion.     

Motor unit discharge pattern and conduction velocity in patients with upper motor neuron syndrome

Motor unit properties were analyzed in patients with upper motor neuron syndrome (UMNS). Multi-channel surface electromyographic (EMG) signals were recorded for 300 s from the biceps brachii muscle of seven male subacute patients (time from lesion, mean ± SE, 4.9 ± 1.0 months). In three patients, both arms were investigated, leading to 10 recorded muscles. Patients were analyzed in rest-like condition with motor units activated due to pathological muscle overactivity. For a total of 12 motor units, the complete discharge pattern was extracted from EMG decomposition. Interpulse interval variability was 7.8 ± 0.9%. At minimum discharge rate (6.4 ± 0.4 pulses per second, pps), conduction velocity was smaller than at maximum discharge rate (12.0 ± 0.9 pps) in all motor units (3.60 ± 0.21 m/s vs. 3.84 ± 0.20 m/s). Conduction velocity changed by 1.35 ± 0.48% (different from zero, P < 0.01) for each increase of 1 pps in discharge rate. It was concluded that conduction velocity of low-threshold motor units in subacute patients with UMNS had similar values as reported in healthy subjects and was positively correlated to instantaneous discharge rate (velocity recovery function of muscle fibers).     

Lower limb joint work and joint work contribution during downhill and uphill walking at different inclinations

Work performance and individual joint contribution to total work are important information for creating training protocols, but were not assessed so far for sloped walking. Therefore, the purpose of this study was to analyze lower limb joint work and joint contribution of the hip, knee and ankle to total lower limb work during sloped walking in a healthy population. Eighteen male participants (27.0 ± 4.7 yrs, 1.80 ± 0.05 m, 74.5 ± 8.2 kg) walked on an instrumented ramp at inclination angles of 0°, ±6°, ±12° and ±18° at 1.1 m/s. Kinematic and kinetic data were captured using a motion-capture system (Vicon) and two force plates (AMTI). Joint power curves, joint work (positive, negative, absolute) and each joint’s contribution to total lower limb work were analyzed throughout the stance phase using an ANOVA with repeated measures. With increasing inclination positive joint work increased for the ankle and hip joint and in total during uphill walking. Negative joint work increased for each joint and in total work during downhill walking. Absolute work was increased during both uphill (all joints) and downhill (ankle & knee) walking. Knee joint contribution to total negative and absolute work increased during downhill walking while hip and ankle contributions decreased. This study identified, that, when switching from level to a 6° and from 6° to a 12° inclination the gain of individual joint work is more pronounced compared to switching from 12° to an 18° inclination. The results might be used for training recommendations and specific training intervention with respect to sloped walking.     

Cortical motor representation of the rectus femoris does not differ between the left and right hemisphere

Transcranial magnetic stimulation (TMS) involves non-invasive magnetic stimulation of the brain, and can be used to explore the corticomotor excitability and motor representations of skeletal muscles. However there is a lack of motor mapping studies in the lower limb and few conducted in healthy cohorts. The cortical motor representations of muscles can vary between individuals in terms of center position and area despite having a general localized region within the motor cortex. It is important to characterize the normal range for these variables in healthy cohorts to be able to evaluate changes in clinical populations. TMS was used in this cross-sectional study to assess the active motor threshold (AMT) and cortical representation area for rectus femoris in 15 healthy individuals (11 M/4F 27.3 ± 5.9 years). No differences were found between hemispheres (Left vs. Right P = 0.130) for AMT. In terms of y-axis center position no differences were found between hemispheres (Left vs. Right P = 0.539), or for the x-axis center position (Left vs. Right P = 0.076). Similarly, no differences in calculated area of the motor representation were found (Left vs. Right P = 0.699) indicating symmetry between hemispheres.     

Are regions of the lumbar multifidus differentially activated during walking at varied speed and inclination?

PurposeLumbar multifidus is a complex muscle with multi-fascicular morphology shown to be differentially controlled in healthy individuals during sagittal-plane motion. The normal behaviour of multifidus muscle regions during walking has only received modest attention in the literature. This study aimed to determine activation patterns for deep and superficial multifidus in young adults during walking at different speeds and inclination.MethodsThis observational cohort study evaluated ten healthy volunteers in their twenties (three women, seven men) as they walked on a treadmill in eight conditions; at 2 km/h and 4 km/h, each at 0, 1, 5, and 10% inclination. Intramuscular EMG was recorded from the deep and superficial multifidus unilaterally at L5. Activity was characterized by: amplitude of the peak of activation, position of peak within the gait cycle (0–100%), and duration relative to the full gait cycle.ResultsAcross all conditions superficial multifidus showed higher normalised EMG amplitude (p < 0.01); superficial multifidus peak amplitude was 232 ± 115% higher when walking at 4 km/h/10%, versus only 172 ± 77% higher for deeper region (p < 0.01). The percentage of the gait cycle where peak EMG amplitude was detected did not differ between regions (49 ± 13%). Deep multifidus duration of activation was longer when walking at the faster vs slower speed at all inclinations (p < 0.01), which was not evident for superficial multifidus (p < 0.05). Thus, a significantly longer activation of deep multifidus was observed compared to superficial multifidus when walking at 4 km/h (p < 0.05).ConclusionsDifferential activation within lumbar multifidus was shown in young adults during walking. The prolonged, more tonic activation of deep relative to superficial regions of multifidus during gait supports a postural function of deeper fibres.     

EMG normalization to study muscle activation in cycling

The value of electromyography (EMG) is sensitive to many physiological and non-physiological factors. The purpose of the present study was to determine if the torque–velocity test (T–V) can be used to normalize EMG signals into a framework of biological significance. Peak EMG amplitude of gluteus maximus (GMAX), vastus lateralis (VL), rectus femoris (RF), biceps femoris long head (BF), gastrocnemius medialis (GAS) and soleus (SOL) was calculated for nine subjects during isometric maximal voluntary contractions (IMVC) and torque–velocity bicycling tests (T–V). Then, the reference EMG signals obtained from IMVC and T–V bicycling tests were used to normalize the amplitude of the EMG signals collected for 15 different submaximal pedaling conditions. The results of this study showed that the repeatability of the measurements between IMVC (from 10% to 23%) and T–V (from 8% to 20%) was comparable. The amplitude of the peak EMG of VL was 99 ± 43% higher (p < 0.001) when measured during T–V. Moreover, the inter-individual variability of the EMG patterns calculated for submaximal cycling exercises differed significantly when using T–V bicycling normalization method (GMAX: 0.33 ± 0.16 vs. 1.09 ± 0.04, VL: 0.07 ± 0.02 vs. 0.64 ± 0.14, SOL: 0.07 ± 0.03 vs. 1.00 ± 0.07, RF: 1.21 ± 0.20 vs. 0.92 ± 0.13, BF: 1.47 ± 0.47 vs. 0.84 ± 0.11). It was concluded that T–V bicycling test offers the advantage to be less time and energy-consuming and to be as repeatable as IMVC tests to measure peak EMG amplitude. Furthermore, this normalization method avoids the impact of non-physiological factors on the amplitude of the EMG signals so that it allows quantifying better the activation level of lower limb muscles and the variability of the EMG patterns during submaximal bicycling exercises.     

On the usability of intramuscular EMG for prosthetic control: A Fitts’ Law approach

Previous studies on intramuscular EMG based control used offline data analysis. The current study investigates the usability of intramuscular EMG in two degree-of-freedom using a Fitts’ Law approach by combining classification and proportional control to perform a task, with real time feedback of user performance. Nine able-bodied subjects participated in the study. Intramuscular and surface EMG signals were recorded concurrently from the right forearm. Five performance metrics (Throughput, Path efficiency, Average Speed, Overshoot and Completion Rate) were used for quantification of usability. Intramuscular EMG based control performed significantly better than surface EMG for Path Efficiency (80.5 ± 2.4% vs. 71.5 ± 3.8%, P = 0.004) and Overshoot (22.0 ± 3.0% vs. 45.1 ± 6.6%, P = 0.01). No difference was found between Throughput and Completion Rate. However the Average Speed was significantly higher for surface (51.8 ± 5.5%) than for intramuscular EMG (35.7 ± 2.7%). The results obtained in this study imply that intramuscular EMG has great potential as control source for advanced myoelectric prosthetic devices.     

Effect of prolonged walking with backpack loads on trunk muscle activity and fatigue in children

This study investigated the effect of prolonged walking with load carriage on muscle activity and fatigue in children. Fifteen Chinese male children (age = 6 years, height = 120.0 ± 5.4 cm, mass = 22.9 ± 2.6 kg) performed 20-min walking trials on treadmill (speed = 1.1 m s⁻¹) with different backpack loads (0%, 10%, 15% and 20% body weight). Electromyography (EMG) signals from upper trapezius (UT), lower trapezius (LT) and rectus abdominis (RA) were recorded at several time intervals (0, 5, 10, 15 and 20 min), and were normalized to the signals collected during maximum voluntary contraction. Integrated EMG signal (IEMG) was calculated to evaluate the muscle activity. Power spectral frequency analysis was applied to evaluate muscle fatigue by the shift of median power frequency (MPF). Results showed that a 15% body weight (BW) load significantly increased muscle activity at lower trapezius when the walking time reached 15 min. When a 20% BW load was being carried, increase in muscle activity was found from 5 min, and muscle fatigue was found from 15 min. In upper trapezius, increase of muscle activity was not found within the 20-min period, however, muscle fatigue was found from 10 min. No increased muscle activity or muscle fatigue was found in rectus abdominis. It is suggested that backpack loads for children should be restricted to no more than 15% body weight for walks of up to 20 min duration to avoid muscle fatigue.     

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.     

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.     

Effect of functional electrical stimulation on the effort and walking speed,surface electromyography activity,and metabolic responses in stroke subjects

ObjectiveTo investigate the effects of functional electrical stimulation (FES) combined with conventional rehabilitation program on the effort and speed of walking, the surface electromyographic (sEMG) activity and metabolic responses in the management of drop foot in stroke subjects.MethodsFifteen patients with a drop foot resulting from stroke at least 3 months prior to the start of the trial took part in this study. All subjects were treated 1 h a day, 5 days a week, for 12 weeks, including conventional stroke rehabilitation program and received 30 min of FES to the tibialis anterior (TA) muscle of the paretic leg in clinical settings. Baseline and post-treatment measurements were made for temporal and spectral EMG parameters of TA muscle, walking speed, the effort of walking as measured by physiological cost index (PCI) and metabolic responses.ResultsThe experimental results showed a significant improvement in mean-absolute-value (21.7%), root-mean-square (66.3%) and median frequency (10.6%) of TA muscle EMG signal, which reflects increased muscle strength. Mean increase in walking speed was 38.7%, and a reduction in PCI of 34.6% between the beginning and at end of the trial. Improvements were also found in cardiorespiratory responses with reduction in oxygen consumption (24.3%), carbon dioxide production (19.9%), heart rate (7.8%) and energy cost (22.5%) while walking with FES device.ConclusionsThe results indicate that the FES may be a useful therapeutic tool combined with conventional rehabilitation program to improve the muscle strength, walking ability and metabolic responses in the management of drop foot with stroke patients.     

Decreased lower limb muscle recruitment contributes to the inability of older adults to recover with a single step following a forward loss of balance

In response to a balance disturbance, older individuals often require multiple steps to prevent a fall. Reliance on multiple steps to recover balance is predictive of a future fall, so studies should determine the mechanisms underlying differences between older adults who can and cannot recover balance with a single step. This study compared neural activation parameters of the major leg muscles during balance recovery from a sudden forward loss of balance in older individuals capable of recovering with a single step and those who required multiple steps to regain balance. Eighty-one healthy, community dwelling adults aged 70 ± 3 participated. Loss of balance was induced by releasing participants from a static forward lean. Participants performed four trials at three initial lean magnitudes and were subsequently classified as single or multiple steppers. Although step length was shorter in multiple compared to single steppers (F = 9.64; p = 0.02), no significant differences were found between groups in EMG onset time in the step limb muscles (F = 0.033–0.769; p = 0.478–0.967). However, peak EMG normalised to values obtained during maximal voluntary contraction was significantly higher in single steppers in 6 of the 7 stepping limb muscles (F = 1.054–4.167; p = 0.045–0.024). These data suggest that compared to multiple steppers, single steppers recruit a larger proportion of the available motor unit pool during balance recovery. Thus, modulation of EMG amplitude plays a larger role in balance recovery than EMG timing in this context.     

Effect of kinesthetic illusion induced by visual stimulation on muscular output function after short-term immobilization

Kinesthetic illusions by visual stimulation (KiNVIS) enhances corticomotor excitability and activates motor association areas. The purpose of this study was to investigate the effect of KiNVIS induction on muscular output function after short-term immobilization. Thirty subjects were assigned to 3 groups: an immobilization group, with the left hand immobilized for 12 h (immobilization period); an illusion group, with the left hand immobilized and additionally subjected to KiNVIS of the immobilized part during the immobilization period; and a control group with no manipulation. The maximum voluntary contraction (MVC), fluctuation of force (force fluctuation) during a force modulation task, and twitch force were measured both before (pre-test) and after (post-test) the immobilization period. Data were analyzed by performing two-way (TIME × GROUP) repeated measures ANOVA. The MVC decreased in the immobilization group only (pre-test; 37.8 ± 6.1 N, post-test; 32.8 ± 6.9 N, p < 0.0005) after the immobilization period. The force fluctuation increased only in the immobilization group (pre-test; 2.19 ± 0.54%, post-test; 2.78 ± 0.87%, p = 0.007) after the immobilization period. These results demonstrate that induction of KiNVIS prevents negative effect on MVC and force fluctuation after 12 h of immobilization.     

Does local immersion in thermo-neutral bath influence surface EMG measurements? Results of an experimental trial

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.     

Electrode placement over the innervation zone affects the low-, not the high-frequency portion of the EMG frequency spectrum

The purpose of this study was to use a wavelet-based signal processing technique to examine the influence of electrode placement over the innervation zone (IZ) on the shape of the electromyographic (EMG) frequency spectrum. Ten healthy males (mean ± SD age = 23.6 ± 3.0 years) performed isometric muscle actions of the dominant leg extensors at 10%, 40%, 70%, and 100% of the maximum voluntary contraction (MVC). Surface EMG signals were detected simultaneously from the vastus lateralis with two bipolar electrode arrangements. One of the electrode arrangements had its center point located directly over the IZ, while the other arrangement had its center point distal to the IZ (i.e., 20 mm away). All EMG signals were processed with a wavelet-based procedure. The results showed that for all isometric torque levels, the EMG signals from the distal electrode arrangement demonstrated greater total intensity values than those for the IZ arrangement for frequencies ranging from approximately 2 to 110 Hz. There were no consistent differences, however, between the IZ and distal electrode arrangements for total EMG intensity values above 110 Hz. Thus, these findings indicated that electrode placement over the IZ affected primarily the low-, rather than the high-frequency portion of the EMG frequency spectrum.     

Pre-swing deficits in forward propulsion,swing initiation and power generation by individual muscles during hemiparetic walking

Clinical studies of hemiparetic walking have shown pre-swing abnormalities in the paretic leg suggesting that paretic muscle contributions to important biomechanical walking subtasks are different than those of non-disabled individuals. Three-dimensional forward dynamics simulations of two representative hemiparetic subjects with different levels of walking function classified by self-selected walking speed (i.e., limited community=0.4–0.8 m/s and community walkers=>0.8 m/s) and a speed-matched control were generated to quantify individual muscle contributions to forward propulsion, swing initiation and power generation during the pre-swing phase (i.e., double support phase proceeding toe-off). Simulation analyses identified decreased paretic soleus and gastrocnemius contributions to forward propulsion and power generation as the primary impairment in the limited community walker compared to the control subject. The non-paretic leg did not compensate for decreased forward propulsion by paretic muscles during pre-swing in the limited community walker. Paretic muscles had the net effect to absorb energy from the paretic leg during pre-swing in the community walker suggesting that deficits in swing initiation are a primary impairment. Specifically, the paretic gastrocnemius and hip flexors (i.e., iliacus, psoas and sartorius) contributed less to swing initiation and the paretic soleus and gluteus medius absorbed more power from the paretic leg in the community walker compared to the control subject. Rehabilitation strategies aimed at diminishing these deficits have much potential to improve walking function in these hemiparetic subjects and those with similar deficits.     

Effect of pain location on spatial reorganisation of muscle activity

IntroductionWe aimed to determine whether the changes in muscle activity (in terms of both gross electromyography (EMG) and motor unit (MU) discharge characteristics) observed during pain are spatially organized with respect to pain location within a muscle which is the main contributor of the task.MethodsSurface and fine-wire EMG was recorded during matched low-force isometric plantarflexion from soleus (from four quadrants with fine-wire EMG and from the medial/lateral sides with surface EMG), both gastrocnemii heads, peroneus longus, and tibialis anterior. Four conditions were tested: two control conditions that each preceded contractions with pain induced in either the lateral (Pain_L) or medial (Pain_M) side of soleus.ResultsNeither the presence (p = 0.28) nor location (p = 0.19) of pain significantly altered gross muscle activity of any location (lateral/medial side of soleus, gastrocnemii, peroneus longus and tibialis anterior). Group data from 196 MUs show redistribution of MU activity throughout the four quadrants of soleus, irrespective of pain location. The significant decrease of MU discharge rate during pain (p < 0.0001; Pain_L: 7.3 ± 0.9–6.9 ± 1.1 Hz, Pain_M: 7.0 ± 1.1 to 6.6 ± 1.1 Hz) was similar for all quadrants of the soleus (p = 0.43), regardless of the pain location (p = 0.98). There was large inter-participant variation in respect to the characteristics of the altered MU discharge with pain.ConclusionResults from both surface and fine-wire EMG recordings do not support the hypothesis that muscle activity is reorganized in a simple systematic manner with respect to pain location.