In vivo changes in the human patellar tendon moment arm length with different modes and intensities of muscle contraction

The purpose of this study was to examine the effect of different muscle contraction modes and intensities on patellar tendon moment arm length (d(PT)). Five men performed isokinetic concentric, eccentric and passive knee extensions at an angular velocity of 60 deg/s and six men performed gradually increasing to maximum effort isometric muscle contractions at 90( composite function) and 20( composite function) of knee flexion. During the tests, lateral X-ray fluoroscopy imaging was used to scan the knee joint. The d(PT) differences between the passive state and the isokinetic concentric and extension were quantified at 15( composite function) intervals of knee joint flexion angle. Furthermore, the changes of the d(PT) as a function of the isometric muscle contraction intensities were determined during the isometric knee extension at 90( composite function) and 20( composite function) of knee joint flexion. Muscle contraction-induced changes in knee joint flexion angle during the isometric muscle contraction were also taken into account for the d(PT) measurements. During the two isometric knee extensions, d(PT) increased from rest to maximum voluntary muscle contraction (MVC) by 14-15%. However, when changes in knee joint flexion angle induced by the muscle contraction were taken into account, d(PT) during MVC increased by 6-26% compared with rest. Moreover, d(PT) increased during concentric and eccentric knee extension by 3-15%, depending on knee flexion angle, compared with passive knee extension. These findings have important implications for estimating musculoskeletal loads using modelling under static and dynamic conditions.     

Force depression in human quadriceps femoris following voluntary shortening contractions.

The purpose of this study was to investigate whether the isometric muscle force, redeveloped following maximal-effort voluntary shortening contractions in human skeletal muscle, is smaller than the purely isometric muscle force at the corresponding length. Isometric knee extensor moments, surface electromyographic (EMG) signals of quadriceps femoris, and interpolated twitch moments (ITMs) were measured while 10 subjects performed purely isometric knee extensor contractions at a 60 degrees knee angle and isometric knee extensor contractions at a 60 degrees knee angle preceded by maximal-effort voluntary shortening of the quadriceps muscles. It was found that the knee extensor moments were significantly decreased for the isometric-shortening-isometric contractions compared with the isometric contractions for the group as a whole, whereas the corresponding EMG and ITM values were the same. This study is the first to demonstrate force depression following muscle shortening for voluntary contractions. We concluded that force depression following muscle shortening is an actual property of skeletal muscle rather than a stimulation artifact and that force depression during voluntary contraction is not accompanied by systematic changes in muscle activation as evaluated by EMG and ITM.     

The interaction of muscle moment arm,knee laxity,and torque in a multi-scale musculoskeletal model of the lower limb

IntroductionMusculoskeletal modeling allows insight into the interaction of muscle force and knee joint kinematics that cannot be measured in the laboratory. However, musculoskeletal models of the lower extremity commonly use simplified representations of the knee that may limit analyses of the interaction between muscle forces and joint kinematics. The goal of this research was to demonstrate how muscle forces alter knee kinematics and consequently muscle moment arms and joint torque in a musculoskeletal model of the lower limb that includes a deformable representation of the knee.MethodsTwo musculoskeletal models of the lower limb including specimen-specific articular geometries and ligament deformability at the knee were built in a finite element framework and calibrated to match mean isometric torque data collected from 12 healthy subjects. Muscle moment arms were compared between simulations of passive knee flexion and maximum isometric knee extension and flexion. In addition, isometric torque results were compared with predictions using simplified knee models in which the deformability of the knee was removed and the kinematics at the joint were prescribed for all degrees of freedom.ResultsPeak isometric torque estimated with a deformable knee representation occurred between 45° and 60° in extension, and 45° in flexion. The maximum isometric flexion torques generated by the models with deformable ligaments were 14.6% and 17.9% larger than those generated by the models with prescribed kinematics; by contrast, the maximum isometric extension torques generated by the models were similar. The change in hamstrings moment arms during isometric flexion was greater than that of the quadriceps during isometric extension (a mean RMS difference of 9.8 mm compared to 2.9 mm, respectively).DiscussionThe large changes in the moment arms of the hamstrings, when activated in a model with deformable ligaments, resulted in changes to flexion torque. When simulating human motion, the inclusion of a deformable joint in a multi-scale musculoskeletal finite element model of the lower limb may preserve the realistic interaction of muscle force with knee kinematics and torque.     

Relation between the ankle joint angle and the maximum isometric force of the toe flexor muscles

The purpose of this study was to investigate the relationships between the ankle joint angle and maximum isometric force of the toe flexor muscles. Toe flexor strength and electromyography activity of the foot muscles were measured in 12 healthy men at 6 different ankle joint angles with the knee joint at 90 deg in the sitting position. To measure the maximum isometric force of the toe flexor muscles, subjects exerted maximum force on a toe grip dynamometer while the activity levels of the intrinsic and extrinsic plantar muscles were measured. The relation between ankle joint angle and maximum isometric force of the toe flexor muscles was determined, and the isometric force exhibited a peak when the ankle joint was at 70–90 deg on average. From this optimal neutral position, the isometric force gradually decreased and reached its nadir in the plantar flexion position (i.e., 120 deg). The EMG activity of the abductor hallucis (intrinsic plantar muscle) and peroneus longus (extrinsic plantar muscle) did not differ at any ankle joint angles. The results of this study suggest that the force generation of toe flexor muscles is regulated at the ankle joint and that changes in the length-tension relations of the extrinsic plantar muscle could be a reason for the force-generating capacity at the metatarsophalangeal joint when the ankle joint angle is changed.     

Recruitment,force and fatigue characteristics of quadriceps muscles of paraplegics isometrically activated by surface functional electrical stimulation

This study deals with the recruitment characteristics of unfatigued electrically stimulated quadriceps muscles of paraplegic subjects and with the time-dependent force output of these muscles under sustained stimulation conditions. Both these aspects of the performance of paralysed stimulated muscles were studied under isometric conditions and at different muscle lengths. The forces in the knee joint resulting from stimulation of the quadriceps were also calculated. Recruitment force curves due to a ramp-like stimulation function indicated a strong dependence on muscle length and demonstrated a sigmoid-shaped curve with three distinct regions: negligible force up to threshold stimulation intensity; rapid force increase; and levelling-off of the curve after which the force remains constant even though intensity is further increased. When normalized to the maximal force, recruitment was found to be independent of muscle length, generating a typical recruitment curve for every patient, under isometric stimulation. The peak forces were obtained at the same flexion angles previously published for normal subjects, but with much lower values. Muscle fatigue in tetanic isometric conditions, defined as the decrease in force due to sustained stimulation with fixed parameters, was found to be length dependent and to have a double exponential decay. The first is the acute force loss and is the more significant for functional purposes; the second is the more moderate and asymptotic region, in which partial force receovery in the form of bursts is observed.     

The influence of stimulation frequency and ankle joint angle on the moment exerted by human dorsiflexor muscles.

The purpose of this study was to investigate the force-frequency relationships and the post-tetanic twitch potentiation as a function of joint angle (i.e. muscle length) in human skeletal muscles under isometric conditions. The dorsiflexor muscles of healthy subjects were stimulated at different ankle joint angles by means of constant frequency bursts at seven submaximal frequencies (50, 33, 25, 20, 16, 12, 8 Hz) with a duration of two seconds. Particular attention has been focused on the stability of recruitment in the range of joint angles examined. The results show that moment-frequency curves of human dorsiflexors change as a function of ankle angle: especially for the lower stimulation frequency range (8, 12, 16, 20 Hz), the normalized moment increases from dorsiflexion to plantar flexion (i.e. with increasing muscle length) resulting in a leftward shift of the normalized moment-frequency curves. Post-tetanic twitch potentiation is shown to be ankle joint dependent as well.     

Measurement of human Gracilis muscle isometric forces as a function of knee angle,intraoperatively

The goals of the present study were (1) to measure the previously unstudied isometric forces of activated human Gracilis (G) muscle as a function of knee joint angle and (2) to test whether length history effects are important also for human muscle. Experiments were conducted intraoperatively during anterior cruciate ligament (ACL) reconstruction surgery (n=8). Mean peak G muscle force, mean peak G tendon stress and mean optimal knee angle equals 178.5±270.3 N, 24.4±20.6 MPa and 67.5±41.7°, respectively. The substantial inter-subject variability found (e.g., peak G force ranges between 17.2 and 490.5 N) indicate that the contribution of the G muscle to knee flexion moment may vary considerably among subjects. Moreover, typical subject anthropometrics did not appear to provide a sound estimate of the peak G force: only a limited insignificant correlation was found between peak G force and subject mass as well as mid-thigh perimeter and no correlation was found between peak G force and thigh length. The functional joint range of motion for human G muscle was determined to be at least as wide as full knee extension to 120° of knee flexion. However; the portion of the knee angle–muscle force relationship operationalized is not unique but individual specific: our data suggest for most subjects that G muscle operates in both ascending and descending limbs of its length–force characteristics whereas, for the remainder of the subjects, its function is limited to the descending limb, exclusively. Previous activity of G muscle at high muscle length attained during collection of a complete set of knee angle–force data showed for the first time that such length history effects are important also for human muscles: a significant correlation was found between optimal knee angle and absolute value of % force change. Except for two of the subjects, G muscle force measured at low length was lower than that measured during collection of knee joint–force data (maximally by 42.3%).     

Whole-body vibration induced adaptation in knee extensors; consequences of initial strength, vibration frequency, and joint angle

It was hypothesized that both vibration frequency and muscle length modulate the strengthening of muscles that is assumed to result from whole-body vibration (WBV). Length of knee extensor muscles during vibration is affected by the knee joint angle; the lengths of the knee extensors increase with more flexed knee joint angles. In an intervention study 28 volunteers were randomly assigned to 1 of 4 groups. Each group received 4 weeks of WBV at 1 of 3 different frequencies (20, 27, or 34 Hz) or 1 of 2 different lengths of knee extensors. Voluntary, isometric knee extension moment-angle relationship was determined. Initially, stronger subjects reacted differently to WBV than weaker participants. In stronger subjects knee extension moment did not improve; in the weaker subjects considerable improvements were observed ranging from 10 to 50%. Neither vibration frequency nor muscle length during the intervention affected the improvements. In addition to strength, the knee joint angle at which the maximal joint moment was generated (optimal joint angle) was affected. When trained at short muscle lengths, optimal angle shifted to more extend joint position. WBV training at long muscle lengths tended to induce an opposite shift. The amount of this shift tended to be influenced by vibration frequency; the lower the vibration frequency the larger the shift. Shifts of optimal lengths occurred in both weaker and stronger subjects. This study shows that muscle length during training affects the angle of knee joint at which the maximal extension moment was generated. Moreover, in weaker subjects WBV resulted in higher maximal knee joint extension moments. Vibration frequency and muscle length during vibration did not affect this joint moment gain.     

EMG-angle relationship of the hamstring muscles during maximum knee flexion.

The aim of the present study was to investigate the EMG-joint angle relationship during voluntary contraction with maximum effort and the differences in activity among three hamstring muscles during knee flexion. Ten healthy subjects performed maximum voluntary isometric and isokinetic knee flexion. The isometric tests were performed for 5 s at knee angles of 60 and 90 degrees. The isokinetic test, which consisted of knee flexion from 0 to 120 degrees in the prone position, was performed at an angular velocity of 30 degrees /s (0.523 rad/s). The knee flexion torque was measured using a KIN-COM isokinetic dynamometer. The individual EMG activity of the hamstrings, i.e. the semitendinosus, semimembranosus, long head of the biceps femoris and short head of the biceps femoris muscles, was detected using a bipolar fine wire electrode. With isometric testing, the knee flexion torque at 60 degrees knee flexion was greater than that at 90 degrees. The mean peak isokinetic torque occurred from 15 to 30 degrees knee flexion angle and then the torque decreased as the knee angle increased (p<0.01). The EMG activity of the hamstring muscles varied with the change in knee flexion angle except for the short head of the biceps femoris muscle under isometric condition. With isometric contraction, the integrated EMGs of the semitendinosus and semimembranosus muscles at a knee flexion angle of 60 degrees were significantly lower than that at 90 degrees. During maximum isokinetic contraction, the integrated EMGs of the semitendinosus, semimembranosus and short head of the biceps femoris muscles increased significantly as the knee angle increased from 0 to 105 degrees of knee flexion (p<0.05). On the other hand, the integrated EMG of the long head of the biceps femoris muscle at a knee angle of 60 degrees was significantly greater than that at 90 degrees knee flexion with isometric testing (p<0.01). During maximum isokinetic contraction, the integrated EMG was the greatest at a knee angle between 15 and 30 degrees, and then significantly decreased as the knee angle increased from 30 to 120 degrees (p<0.01). These results demonstrate that the EMG activity of hamstring muscles during maximum isometric and isokinetic knee flexion varies with change in muscle length or joint angle, and that the activity of the long head of the biceps femoris muscle differs considerably from the other three heads of hamstrings.     

Knee and ankle joint torque-angle relationships of multi-joint leg extension

The force-length-relation (F-l-r) is an important property of skeletal muscle to characterise its function, whereas for in vivo human muscles, torque-angle relationships (T-a-r) represent the maximum muscular capacity as a function of joint angle. However, since in vivo force/torque-length data is only available for rotational single-joint movements the purpose of the present study was to identify torque-angle-relationships for multi-joint leg extension. Therefore, inverse dynamics served for calculation of ankle and knee joint torques of 18 male subjects when performing maximum voluntary isometric contractions in a seated leg press. Measurements in increments of 10° knee angle from 30° to 100° knee flexion resulted in eight discrete angle configurations of hip, knee and ankle joints. For the knee joint we found an ascending-descending T-a-r with a maximum torque of 289.5° ± 43.3 Nm, which closely matches literature data from rotational knee extension. In comparison to literature we observed a shift of optimum knee angle towards knee extension. In contrast, the T-a-r of the ankle joint vastly differed from relationships obtained for isolated plantar flexion. For the ankle T-a-r derived from multi-joint leg extension subjects operated over different sections of the force-length curve, but the ankle T-a-r derived from isolated joint efforts was over the ascending limb for all subjects. Moreover, mean maximum torque of 234.7 ± 56.6 Nm exceeded maximal strength of isolated plantar flexion (185.7 ± 27.8 Nm). From these findings we conclude that muscle function between isolated and more physiological multi-joint tasks differs. This should be considered for ergonomic and sports optimisation as well as for modelling and simulation of human movement.     

Muscle-damaging exercise affects isokinetic torque more at short muscle length

The aim of this study was to investigate the differences in the length-dependent changes in quadriceps muscle torque during voluntary isometric and isokinetic contractions performed after severe muscle-damaging exercise. Thirteen physically active men (age = 23.8 ± 3.2 years, body weight = 77.2 ± 4.5 kg) performed stretch-shortening cycle (SSC) exercise comprising 100 drop jumps with 30-second intervals between each jump. Changes in the voluntary and electrically evoked torque in concentric and isometric conditions at different muscle lengths, muscle soreness, and plasma creatine kinase (CK) activity were assessed within 72 hours after SSC exercise. Isokinetic knee extension torque decreased significantly (p < 0.05) at all joint angles after SSC exercise. At 2 minutes and at 72 hours after SSC exercise, the changes in knee torque were significantly smaller at 80° (where 180° = full knee extension) than at 110-130°. At 2 minutes after SSC exercise, the optimal angle for isokinetic knee extension torque shifted by 9.5 ± 8.9° to a longer muscle length (p < 0.05). Electrically induced torque at low-frequency (20-Hz) stimulation decreased significantly more at a knee joint angle of 130° than at 90°. The subjects felt acute muscle pain and CK activity in the blood increased to 1,593.9 ± 536.2 IU·L?1 within 72 hours after SSC exercise (p < 0.05). This study demonstrates that the effect of muscle-damaging exercise on isokinetic torque is greatest for contractions at short muscle lengths. These findings have practical importance because the movements in most physical activities are dynamic in nature, and the decrease in torque at various points in the range of motion during exercise might affect overall performance.     

Maximum voluntary joint torque as a function of joint angle and angular velocity: model development and application to the lower limb

Measurements of human strength can be important during analyses of physical activities. Such measurements have often taken the form of the maximum voluntary torque at a single joint angle and angular velocity. However, the available strength varies substantially with joint position and velocity. When examining dynamic activities, strength measurements should account for these variations. A model is presented of maximum voluntary joint torque as a function of joint angle and angular velocity. The model is based on well-known physiological relationships between muscle force and length and between muscle force and velocity and was tested by fitting it to maximum voluntary joint torque data from six different exertions in the lower limb. Isometric, concentric and eccentric maximum voluntary contractions were collected during hip extension, hip flexion, knee extension, knee flexion, ankle plantar flexion and dorsiflexion. Model parameters are reported for each of these exertion directions by gender and age group. This model provides an efficient method by which strength variations with joint angle and angular velocity may be incorporated into comparisons between joint torques calculated by inverse dynamics and the maximum available joint torques.     

Role of gastrocnemius activation in knee joint biomechanics: gastrocnemius acts as an ACL antagonist

Gastrocnemius is a premier muscle crossing the knee, but its role in knee biomechanics and on the anterior cruciate ligament (ACL) remains less clear when compared to hamstrings and quadriceps. The effect of changes in gastrocnemius force at late stance when it peaks on the knee joint response and ACL force was initially investigated using a lower extremity musculoskeletal model driven by gait kinematics—kinetics. The tibiofemoral joint under isolated isometric contraction of gastrocnemius was subsequently analyzed at different force levels and flexion angles (0°–90°). Changes in gastrocnemius force at late stance markedly influenced hamstrings forces. Gastrocnemius acted as ACL antagonist by substantially increasing its force. Simulations under isolated contraction of gastrocnemius confirmed this role at all flexion angles, in particular, at extreme knee flexion angles (0° and 90°). Constraint on varus/valgus rotations substantially decreased this effect. Although hamstrings and gastrocnemius are both knee joint flexors, they play opposite roles in respectively protecting or loading ACL. Although the quadriceps is also recognized as antagonist of ACL, at larger joint flexion and in contrast to quadriceps, activity in gastrocnemius substantially increased ACL forces (anteromedial bundle). The fact that gastrocnemius is an antagonist of ACL should help in effective prevention and management of ACL injuries.     

Mathematical model that predicts lower leg motion in response to electrical stimulation

Electrical stimulation of skeletal muscles of patients with upper motor neuron lesions can be used to restore functional movements such as standing or walking. Mathematical muscle models can assist in designing stimulation patterns that will enable patients to perform particular tasks more efficiently. In this study we extend our previous model to allow us to predict changes in knee joint angle in response to electrical stimulation of the human quadriceps femoris muscle. The model was tested both with and without inertial loads placed around the ankle joints of healthy subjects. Results showed that the model predicted the knee extensions with a RMS angle error that was generally 相似文献   

A predictive model of fatigue in human skeletal muscles.

Fatigue is a major limitation to the clinical application of functional electrical stimulation. The activation pattern used during electrical stimulation affects force and fatigue. Identifying the activation pattern that produces the greatest force and least fatigue for each patient is, therefore, of great importance. Mathematical models that predict muscle forces and fatigue produced by a wide range of stimulation patterns would facilitate the search for optimal patterns. Previously, we developed a mathematical isometric force model that successfully identified the stimulation patterns that produced the greatest forces from healthy subjects under nonfatigue and fatigue conditions. The present study introduces a four-parameter fatigue model, coupled with the force model that predicts the fatigue induced by different stimulation patterns on different days during isometric contractions. This fatigue model accounted for 90% of the variability in forces produced by different fatigue tests. The predicted forces at the end of fatigue testing differed from those observed by only 9%. This model demonstrates the potential for predicting muscle fatigue in response to a wide range of stimulation patterns.     

Predictions of knee and ankle moments of force in walking from EMG and kinematic data

A deterministic model was developed and validated to calculate instantaneous ankle and knee moments during walking using processed EMG from representative muscles, instantaneous joint angle as a correlate of muscle length and angular velocity as a correlate of muscle velocity, and having available total instantaneous joint moments for derivation of certain model parameters. A linear regression of the moment on specifically processed EMG, recorded while each subject performed cycled isometric calibration contractions, yielded the constants for a basic moment-EMG relationship. Using the resultant moment for optimization, the predicted moment was proportionally augmented for longer muscle lengths and reduced for shorter lengths. Similarly, the predicted moment was reduced for shortening velocities and increased if the muscle was lengthening. The plots of moments predicted using the full model and those calculated from link segment mechanics followed each other quite closely. The range of root mean square errors were: 3.2-9.5 Nm for the ankle and 4.7-13.0 Nm for the knee.     

Are hamstrings activated to counteract shear forces during isometric knee extension efforts in healthy subjects?

The hamstring muscles have the potential to counteract anterior shear forces at the knee joint by co-contracting during knee extension efforts. Such a muscle recruitment pattern might protect the anterior cruciate ligament (ACL) by reducing its strain. In this study we investigated to what extent co-activation of the knee flexors during extension efforts is compatible with the hypothesis that this co-activation serves to counteract anterior tibial shear forces during isometric knee extension efforts in healthy subjects. To this aim, it is investigated whether co-activation varies with the required knee extension moment, with the knee joint angle, and with the position of the external flexing force relative to the knee joint. With unaltered moment and muscle activation, distal positioning of the flexing force on the tibia causes higher resultant (muscular plus external) forward shear forces at the knee as compared to proximal positioning. In ten subjects, knee flexor and extensor EMG was measured during a quasi-isometric positioning task for a range (5-50 degrees) of knee flexion angles. It was found that the co-activation of the knee flexors increased with the extension moment, but this increase was less than proportional (p<0.001). The extension moment increased 2.7 to 3.4 times, whereas the activation of Biceps Femoris and Semitendinosus increased only a factor 1.3 to 2.0 (joint angle dependent). Furthermore, a strong increase in co-activation was seen near full extension of the knee joint. The position of the external extension load on the tibia did not affect the level of co-contraction. It is argued that these results do not suggest a recruitment pattern that is directed at reduction of anterior shear forces in the knee joint during sub-maximal isometric knee extension efforts in healthy subjects.     

Residual force enhancement after lengthening is present during submaximal plantar flexion and dorsiflexion actions in humans.

Stretch of an activated muscle causes a transient increase in force during the stretch and a sustained, residual force enhancement (RFE) after the stretch. The purpose of this study was to determine whether RFE is present in human muscles under physiologically relevant conditions (i.e., when stretches were applied within the working range of large postural leg muscles and under submaximal voluntary activation). Submaximal voluntary plantar flexion (PF(v)) and dorsiflexion (DF(v)) activation was maintained by providing direct visual feedback of the EMG from soleus or tibialis anterior, respectively. RFE was also examined during electrical stimulation of the plantar flexion muscles (PF(s)). Constant-velocity stretches (15 degrees /s) were applied through a range of motion of 15 degrees using a custom-built ankle torque motor. The muscles remained active throughout the stretch and for at least 10 s after the stretch. In all three activation conditions, the stable joint torque measured 9-10 s after the stretch was greater than the isometric joint torque at the final joint angle. When expressed as a percentage of the isometric torque, RFE values were 7, 13, and 12% for PF(v), PF(s), DF(v), respectively. These findings indicate that RFE is a characteristic of human skeletal muscle and can be observed during submaximal (25%) voluntary activation when stretches are applied on the ascending limb of the force-length curve. Although the underlying mechanisms are unclear, it appears that sarcomere popping and passive force enhancement are insufficient to explain the presence of RFE in these experiments.     

The influence of lower leg configurations on muscle force variability

The maintenance of steady contractions is required in many daily tasks. However, there is little understanding of how various lower limb configurations influence the ability to maintain force. The purpose of the current investigation was to examine the influence of joint angle on various lower-limb constant force contractions. Nineteen adults performed knee extension, knee flexion, and ankle plantarflexion isometric force contractions to 11 target forces, ranging from 2 to 95% maximal voluntary contraction (MVC) at 2 angles. Force variability was quantified with mean force, standard deviation, and the coefficient of variation of force output. Non-linearities in force output were quantified with approximate entropy. Curve fitting analyses were performed on each set of data from each individual across contractions to further examine whether joint angle interacts with global functions of lower-limb force variability. Joint angle had significant effects on the model parameters used to describe the force-variability function for each muscle contraction (p < 0.05). Regularities in force output were more explained by force level in smaller angle conditions relative to the larger angle conditions (p < 0.05). The findings support the notion that limb configuration influences the magnitude and regularities in force production. Biomechanical factors, such as joint angle, along with neurophysiological factors should be considered together in the discussion of the dynamics of constant force production.