More studies are needed to compare the effect of voluntary contraction, electrical stimulation, and electrical stimulation superimposed onto voluntary contraction in improving trained and untrained homolog muscle strength and lower-extremity endurance. Seventy-six healthy young adults (age = 20.41 [3.07]y, 61 females and 15 males) were included in the study. Subjects were randomly divided into 3 groups as voluntary isometric contraction (IC) group, Russian current (RC) group, and superimposed Russian current (SRC) group. All training regimens were performed under physiotherapist supervision for a total of 18 sessions (3 times per week for 6wk). In each session, 10 ICs were achieved with voluntary isometric exercise only, RC only, or RC superimposed onto ICs. Main outcome measures were trained and untrained quadriceps strength (maximal voluntary isometric contraction [MVIC]) and lower-extremity endurance (sit-to-stand test). After 6weeks of training, all outcome measures improved in all groups (P < .05), except the untrained quadriceps MVIC score of RC group (P = .562). The trained quadriceps MVIC score (P < .001, η2 = .478), untrained quadriceps MVIC score (P = .011, η2 = .115), and sit-to-stand test score (P < .001, η2 = .357) differed significantly among the 3 groups; post hoc analysis revealed that the trained quadriceps MVIC score was higher in SRC and RC groups than in the IC group, untrained quadriceps MVIC score was higher in SRC group than in the RC group, and sit-to-stand test score was higher in SRC group than in the RC group and IC group. RC and RC superimposed onto IC are superior to IC in improving quadriceps muscle strength, and RC superimposed onto IC is superior to RC and IC in improving lower-extremity endurance. RC superimposed onto IC and voluntary IC created cross-education effect on untrained quadriceps.
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