Submaximal Voluntary Contractions Research Articles

Regional changes in the free Achilles tendon volume in response to repeated submaximal contractions

IntroductionThe Achilles tendon (AT) may become smaller in volume following acute bouts of heavy and sustained loading likely because of transient fluid exudation to the periphery and this could augment cellular mechanotransduction and tendon adaptation. Given the structure of the AT is distinct across its length, regional changes in the free AT volume may occur in response to loading. This study aimed to investigate whether the change in tendon volume in response to repeated submaximal loading is distinct across the free AT length. MethodsSixteen ATs of healthy males and females (age 24.4 ± 9.4 years, body mass 70.9 ± 16.1 kg, height 1.7 ± 0.1 m) were scanned at rest using freehand 3D ultrasound. Scanning was done before and immediately after submaximal (75 %) voluntary isometric plantarflexion contractions (8 s) involving four sets of ten repetitions. Regional volumetric changes were assessed across the free AT length by dividing the tendon into distal, mid, and proximal regions. ResultsSignificant reduction in the free AT volume occurred across all tendon regions in response to the intervention, however, the mid- region exhibited the greatest reduction in volume compared to the proximal region (P = 0.025). DiscussionThe fact that volume reduction was greatest in the mid-region compared to the proximal region of the free AT may suggest greater tendon adaptation, via mechanotransduction pathways, in the mid-region and this may be important for tendon health and injury prevention.

Assessment of arthrogenic quadriceps muscle inhibition by physical examination in the supine position during isometric contraction is feasible as demonstrated by electromyography: a cross-sectional study

BackgroundPreventing severe arthrogenic muscle inhibition (AMI) after knee injury is critical for better prognosis. The novel Sonnery-Cottet classification of AMI enables the evaluation of AMI severity but requires validation. This study aimed to investigate the electromyography (EMG) patterns of leg muscles in the examination position from the classification during isometric contraction to confirm its validity. We hypothesised that the AMI pattern, which is characterised by quadriceps inhibition and hamstring hypercontraction, would be detectable in the supine position during isometric contraction.MethodsPatients with meniscal or knee ligament injuries were enrolled between August 2023 and May 2024. Surface EMG was assessed during submaximal voluntary isometric contractions (sMVIC) at 0° extension in the supine position for the vastus medialis (VM) and vastus lateralis (VL) muscles and at 20° flexion in the prone position for the semitendinosus (ST) and biceps femoris (BF) muscles. Reference values for normalisation were obtained from the EMG activity during the gait of the uninjured leg. The Kruskal–Wallis test was used to compare the activation patterns of the muscle groups within the same leg, and the post-hoc tests were conducted using the Mann–Whitney U test and Bonferroni correction.ResultsElectromyographic data of 40 patients with knee injuries were analyzed. During sMVIC, the extensor and flexor muscles of the injured leg showed distinct behaviours (P < 0.001), whereas the uninjured side did not (P = 0.144). In the injured leg, the VM differed significantly from the ST (P = 0.018), and the VL differed significantly from the ST and BF (P = 0.001 and P = 0.026, respectively). However, there were no statistically significant differences within the extensor muscle groups (VM and VL, P = 0.487) or flexor muscle groups (ST and BF, P = 0.377).ConclusionAMI was detectable in the examination position suggested by the Sonnery-Cottet classification. The flexor and extensor muscles of the injured leg exhibited distinct activation behaviours, with inhibition predominantly occurring in the quadriceps muscles, whereas the hamstrings showed excitation.

Gauging force by tapping tendons? Inaccurately in the human patellar tendon

Accurately estimating in vivo tendon load non-invasively remains a major challenge in biomechanics, which might be overcome by shear-wave tensiometry. Shear-wave tensiometry measures the speed of mechanically induced tendon shear waves by skin-mounted accelerometers. To gauge the feasibility and accuracy of this novel technique, we obtained patellar tendon shear wave speeds via shear-wave tensiometry during sustained or ramp voluntary contractions of the knee extensors in two experiments (n = 8 in both). In experiment one, participants produced a constant knee extension torque of ∼ 50 Nm at five different knee joint angles (i.e. variable tendon load), which resulted in estimated patellar tendon forces between 1005 ± 6N and 1182 ± 16 N. However, wave speed squared did not correlate with estimated tendon force within participants (rrm(31) = -0.19, p = 0.278). In experiment two, averaged correlation coefficients between normalized wave speed squared and torque of maximal and submaximal voluntary contractions across participants ranged between r = 0.43 and r = 0.94, while the time-varying correlation between these normalized signals ranged from r = -0.99 to r = 1.00. Further, the mean absolute errors (MAEs) between normalized wave speed squared and normalized torque across participants ranged between 0.03 and 0.54, which were larger than the MAEs between normalized torque and normalized summed EMG amplitude from the superficial quadriceps muscles (0.03–0.54 versus 0.06–0.26, respectively). In conclusion, there was no simple relation between shear wave speed squared and patellar tendon load, which severely limits the feasibility of shear-wave tensiometry for accurately estimating in vivo tendon load at the knee joint.

SEX DIFFERENCE IN ABSOLUTE AND NORMALIZED FORCE AT FOUR DIFFERENT ISOMETRIC CONTRACTION INTENSITIES

Purpose: When measuring isometric contractions, providing real-time visual feedback differs from the practices in general clinical environment. In addition, even though men and women have clear physical and physiological differences, most of the existing studies analyzed absolute muscle contractions with no distinction between men and women. The aim of this study was to investigate whether there are differences in absolute and normalized hip extension forces measured without visual feedback between men and women. Methods: Twenty-eight healthy adults participated (13 men and 15 women; age=- 22.00±11.44 years; height=165.86±18.30 cm; and weight=61.91±12.34 kg) in the study. Maximum (MVC) and submaximal voluntary contraction forces (75%, 50%, and 25% of MVC, in a random order) of hip extension were measured using a wireless strain gauge and with no visual feedback. Results: Absolute contraction forces measured at four target intensities were significantly greater in men (p

Residual force depression is not related to positive muscle fascicle work during submaximal voluntary dorsiflexion contractions in humans.

Residual force depression (rFD) following active muscle shortening is assumed to correlate most strongly with muscle work, but this has not been tested during voluntary contractions in humans. Using dynamometry, we compared steady-state ankle joint torques (N=16) following tibialis anterior (TA) muscle-tendon unit (MTU) lengthening and shortening to the time-matched torque during submaximal voluntary fixed-end dorsiflexion reference contractions (REF) at a matched MTU length and EMG amplitude. Ultrasound revealed significantly reduced (P<0.001) TA fascicle shortening amplitudes during MTU lengthening without a preload over small and medium amplitudes, respectively, relative to REF. MTU lengthening with a preload over a large amplitude significantly (P<0.001) increased fascicle shortening relative to REF, as well as stretch amplitudes relative to MTU lengthening without a preload (P=0.001). Significant (P=0.028) steady-state fascicle force enhancement relative to REF was observed following MTU lengthening, and was similar among MTU lengthening-hold conditions (3-5%). MTU shortening with and without a preload over small and large amplitudes significantly (P<0.001) increased positive fascicle and MTU work relative to REF, but significant (P=0.006) rFD was observed following MTU shortening with a preload (7-10%) only. rFD was linearly related to positive MTU work [rrm (47)=0.48, P<0.001], but not positive fascicle work [rrm (47)=0.16, P=0.277]. Our findings indicate that MTU lengthening without substantial fascicle stretch enhances steady-state force output, which might arise from less shortening-induced rFD. Our findings also indicate similar rFD following different amounts of positive fascicle/MTU work, which cautions against using work to predict rFD during submaximal voluntary contractions. KEY POINTS: Accurately predicting muscle force is challenging because active muscle shortening depresses force output. The residual force depression (rFD) that exists following active muscle shortening is commonly assumed to correlate strongly and positively with muscle work. We found that tibialis anterior muscle fascicle work and muscle-tendon unit work did not accurately predict rFD during submaximal voluntary dorsiflexion contractions. Fascicle shortening during fixed-end reference contractions also potentially induced rFD of 3-5%, which was similar to the rFD following muscle-tendon unit shortening without a preload. A higher number of active muscle fibres during shortening probably increased rFD, which suggests that motor unit recruitment during shortening might predict rFD.

A new methodological approach to characterize selective motor control in children with cerebral palsy.

Despite being a primary impairment in individuals with cerebral palsy (CP), selective motor control (SMC) is not routinely measured. Personalized treatment approaches in CP will be unattainable without the ability to precisely characterize the types and degrees of impairments in motor control. The objective of this study is to report the development and feasibility of a new methodological approach measuring muscle activation patterns during single-joint tasks to characterize obligatory muscle co-activation patterns that may underly impaired SMC. Muscle activation patterns were recorded during sub-maximal voluntary isometric contraction (sub-MVIC) tasks at the hip, knee, and ankle with an interactive feedback game to standardize effort across participants. We calculated indices of co-activation, synergistic movement, mirror movement, and overflow (indices range 0-2, greater scores equal to greater impairment in SMC) for each isolated joint task in 15 children - 8 with typical development (TD) (mean age 4.7 ± 1.0 SD years) and 7 with CP (mean age 5.8 ± 0.7 SD years). Indices were compared with Mann-Whitney tests. The relationships between the indices and gross motor function (GMFM-66) were examined with Pearson's r. Mean indices were higher in the CP vs. the TD group for each of the six tasks, with mean differences ranging from 0.05 (abduction and plantarflexion) to 0.44 (dorsiflexion). There was great inter-subject variability in the CP group such that significant group differences were detected for knee flexion mirroring (p = 0.029), dorsiflexion coactivation (p = 0.021), and dorsiflexion overflow (p = 0.014). Significant negative linear relations to gross motor function were found in all four indices for knee extension (r = -0.56 to -0.75), three of the indices for ankle dorsiflexion (r = -0.68 to -0.78) and in two of the indices for knee flexion (r = -0.66 to -0.67), and ankle plantarflexion (r = -0.53 to -0.60). Indices of coactivation, mirror movement, synergy, and overflow during single-joint lower limb tasks may quantify the type and degree of impairment in SMC. Preliminary concurrent validity between several of the indices of SMC and gross motor function was observed. Our findings established the feasibility of a new methodological approach that quantifies muscle activation patterns using electromyography paired with biofeedback during single-joint movement.

Reliability of Surface Electromyography From the Lower-limb Muscles During Maximal and Submaximal Voluntary Isometric Contractions in In-bed Healthy Individuals and Patients With Subacute Stroke.

This study aims to develop maximal voluntary isometric contraction (MVIC) and submaximal voluntary isometric contraction (subMVIC) methods and to assess the reliability of the developed methods for in-bed healthy individuals and patients with subacute stroke. The electromyography (EMG) activities from the lower-limb muscles including the tensor fascia lata (TFL), rectus femoris (RF), tibialis anterior (TA), and gastrocnemius (GC) on both sides were recorded during MVIC and subMVIC using surface EMG sensors in 20 healthy individuals and 20 subacute stroke patients. In inter-trial reliability, both MVIC and subMVIC methods demonstrated excellent reliability for all the measured muscles at baseline and follow-up evaluations in both healthy individuals and stroke patients. In inter-day reliability, MVIC showed good reliability for the TFL and moderate reliability for the RF, TA, and GC, while subMVIC showed good reliability for the TFL, RF, and GC and poor reliability for the TA in healthy individuals. In conclusion, the MVIC and subMVIC methods of EMG activities were feasible in in-bed healthy individuals and patients with subacute stroke. The results can serve as a basis for the clinical evaluation of muscular activities using quantitative EMG signals on the lower-limb muscles in stroke patients with impaired mobility.

Changes in mechanical properties at the muscle level could be detected by Nakagami imaging during in-vivo fixed-end contractions.

In this study, we investigated the capability of the Nakagami transformation to detect changes in vastus lateralis muscle-tendon stiffness (k) during dynamic (and intense) contractions. k was evaluated in eleven healthy males using the gold-standard method (a combination of ultrasound and dynamometric measurements) during maximal and sub-maximal voluntary fixed-end contractions of the knee extensors (20, 40, 60, 80, and 100% of maximum voluntary force), while Nakagami parameters were analysed using the Nakagami transformation during the same contractions. Muscle-belly behaviour was investigated by means of B-mode ultrasound analysis, while Nakagami parameters were obtained in post-processing using radiofrequency data. k was calculated as the slope of the force-muscle-belly elongation relationship. Three contractions at each intensity were performed to calculate the intra-trial reliability and the coefficient of variation (CV) of the Nakagami parameters. At all contraction intensities, high values of intra-trial reliability (range: 0.92-0.96) and low CV (<9%) were observed. k and Nakagami parameters increased as a function of contraction intensity, and significant positive correlations were observed between these variables. These data suggest that changes in mechanical properties (e.g., stiffness) at the muscle level could be investigated by means of Nakagami parameters.

Relationships between trunk muscle activation and thoraco-lumbar kinematics in non-specific chronic low back pain subgroups during a forward bending task

BackgroundTrunk muscle activity and thoraco-lumbar kinematics can discriminate between non-specific chronic low back pain (NSCLBP) subgroups and healthy controls. However, research commonly focuses on lumbar kinematics, with limited understanding of relationships between kinematics and muscle activity across clinical subgroups. Similarly, the thoracic spine, whilst intuitively associated with NSCLBP, has received less attention and potential relationships between spinal regions and muscle activity requires exploration. Research questionIs there a relationship between trunk muscle activation and regional thoracic and lumbar kinematics in NSCLBP subgroups during a forward bending task? MethodsObservational, case-control study. Fifty subgrouped NSCLBP motor control impairment participants (27 Flexion Pattern (FP-MCI), 23 Active Extension Pattern (AEP-MCI)) and 28 pain-free controls were evaluated using 3D motion analysis (Vicon™) and surface electromyography during a forward bending and return to upright task. Mean sagittal angles for the upper-thoracic (UTx), lower-thoracic (LTx), upper-lumbar (ULx) and lower-lumbar (LLx) regions were compared with normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and erector spinae (longissimus thoracis) muscles between groups. Pearson correlations were computed to assess relationships (significance p < 0.01). ResultsAEP-MCI individuals demonstrated statistically significant relationships between superficial lumbar multifidus and ULx and LLx kinematics (−.812 to.659). FP-MCI individuals exhibited statistically significant relationships between erector spinae and superficial lumbar multifidus and LLx and LTx kinematics (−.686 to.664) in both task phases, and between external oblique and LTx during forward bending) (−.459 to.572). Correlations were moderate to strong for all significant relationships (−.812 to .664). SignificanceRelationships between muscle activity and regional spinal kinematics varied between NSCLBP subgroups, suggesting that those with flexion- or extension-related LBP adopt different motor control strategies when performing a bending task. As effectively mechanical biomarkers, these findings may inform treatment by improving understanding of varied motor strategies in subgroups.

Effect of knee joint angle on vastus medialis and vastus lateralis rigidity during isometric submaximal voluntary knee extensions

The use of shear wave elastography during voluntary contraction has enabled the non-invasive assessment of load sharing strategies between agonist muscles. However, the change in joint angle and voluntary contraction intensity can modify contribution between muscles. The aim of this study was to investigate the effect of knee joint angle on the local mechanical properties of the vastus medialis (VM) and the vastus lateralis (VL) during isometric submaximal voluntary contractions from shear wave elastography mapping. The VM and VL Young’s modulus at rest and during constant isometric submaximal voluntary contractions (i.e., 25%, 50% and 75% of maximal voluntary contraction [MVC]) were assessed for two knee angles (50° and 100° | knee fully extended = 0°) in twelve participants. No significant difference was found in the VM Young’s modulus among all torque levels and knee angles (p > 0.05). VL Young’s modulus was significantly higher at 25% MVC for a knee angle of 100° than at 75% MVC for the same knee angle and was greater at 25% MVC for a knee angle of 100° than for 50° (p < 0.05). In contrast to the VM, the contribution of the VL to the knee joint torque production during isometric voluntary contraction appears to depend on the muscle length and the relative knee extension torque level.

Influence of temperature on twitch potentiation following submaximal voluntary contractions in human plantar flexor muscles.

This study aimed to clarify the influence of temperature on post-activation twitch potentiation, a possible indicator of fast-twitch fiber activation during a preceding voluntary contraction. Ten healthy males immersed their left lower leg in water of different temperatures (cold: 0°C, neutral: 32-35°C, hot: ~43°C) for 20 min each. In each temperature condition, they performed submaximal (10%-50% of maximal voluntary contraction torque measured before water immersion) and maximal plantar flexions. Immediately after each voluntary contraction, twitch contractions were evoked with supramaximal stimulation of the posterior tibial nerve. The magnitude of twitch potentiation, defined as a percent increase in twitch torque following a voluntary contraction, increased with the intensity of the preceding voluntary contraction. The magnitude of twitch potentiation after the maximal voluntary contraction was smaller in Cold than in the other temperature conditions. However, temperature had no influence on the relative magnitude of twitch potentiation following the submaximal contractions. In addition, there was no difference in electromyographic activity between the gastrocnemius and soleus muscles in any temperature conditions. Collectively, the temperature dependence was not observed when using twitch potentiation or electromyographic amplitude as an indicator of fast-twitch fiber activation during brief submaximal voluntary contractions.

Acute effects of neuromuscular electrical stimulation on contralateral plantar flexor neuromuscular function

Introduction&#x0D; Neuromuscular electrical stimulation (NMES) is used in athletes to enhance muscle strength (Filipovic et al., 2012) or in patients to restore muscle strength (Nussbaum et al., 2017). The increased maximal voluntary contraction (MVC) torque of one limb (e.g. right leg) while transcutaneous NMES is concomitantly applied to the contralateral limb (e.g. left leg) has been termed contralateral facilitation. This effect has previously been reported for the knee extensors (Cattagni et al., 2018; Minetto et al., 2018) but the underlying mechanisms remain to be investigated. It is also not known whether or not other muscle groups may show contralateral facilitation.&#x0D; The aim of this study was to compare plantar flexor contralateral facilitation between a submaximal voluntary contraction (~10% MVC torque) and two evoked contractions with presumably distinct motor unit recruitment patterns (conventional and wide-pulse high-frequency [WPHF] NMES; Bergquist et al., 2011) of the ipsilateral plantar flexors, with respect to a resting condition.&#x0D; Methods&#x0D; Twenty-two healthy volunteers (4 women: mean ± SD, 26 ±4 yrs, 162 ±7 cm, 65 ±9 kg and 18 men: 26 ±6 yrs, 180 ±5 cm, 76 ±6 kg) took part to the experiments. Contralateral MVC torque and maximal voluntary activation level were measured in 4 different conditions: while the ipsilateral plantar flexors were at rest, voluntarily contracted at 10% of MVC torque or stimulated with conventional (0.1 ms, 30 Hz) and wide-pulse high frequency (1 ms, 100 Hz) NMES for 15 s at a pre-determined intensity to evoke 10% of MVC torque. Additional neurophysiological parameters (soleus H-reflex and V-wave amplitude and tibialis anterior coactivation level) were quantified in a subgroup of 12 participants (4 women and 8 men).&#x0D; Results&#x0D; Conventional and WPHF NMES of the ipsilateral plantar flexors did not induce any contralateral facilitation of MVC torque with respect to the resting condition (respectively: mean ± SD, 133 ±44, 133 ±43 and 135 ±39 Nm) as well as maximal voluntary activation level, while an ipsilateral voluntary contraction of the same intensity resulted in lower contralateral strength than conventional NMES. Moreover, no alteration in the neurophysiological parameters was observed in the different conditions.&#x0D; Discussion/Conclusion&#x0D; The absence of contralateral facilitation contrasts with the results obtained on the knee extensors and can be attributed to the absence of neural changes observed on the contralateral side. These findings should be considered by clinicians/researchers in lower limb rehabilitation settings, as it seems easier to induce contralateral facilitation in proximal vs. distal lower limbs.&#x0D; References&#x0D; Bergquist, A. J., Clair, J. M., Lagerquist, O., Mang, C. S., Okuma, Y., &amp; Collins, D. F. (2011). Neuromuscular electrical stimulation: Implications of the electrically evoked sensory volley. European Journal of Applied Physiology, 111, 2409–2426. https://doi.org/10.1007/s00421-011-2087-9&#x0D; Cattagni, T., Lepers, R., &amp; Maffiuletti, N. A. (2018). Effects of neuromuscular electrical stimulation on contralateral quadriceps function. Journal of Electromyography and Kinesiology, 38, 111-118. https://doi.org/10.1016/j.jelekin.2017.11.013&#x0D; Filipovic, A., Kleinöder, H., Dörmann, U., &amp; Mester, J. (2012). Electromyostimulation: A systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. Journal of Strength and Conditioning Research, 26(9), 2600-2614. https://doi.org/10.1519/JSC.0b013e31823f2cd1&#x0D; Minetto, M., Botter, A., Gamerro, G., Varvello, I., Massazza, G., Bellomo, R., Maffiuletti, N., &amp; Saggini, R. (2018). Contralateral effect of short-duration unilateral neuromuscular electrical stimulation and focal vibration in healthy subjects. European Journal of Physical and Rehabilitation Medicine, 54(6), 911-920.&#x0D; Nussbaum, E., Houghton, P., Anthony, J., Rennie, S., Shay, B., &amp; Hoens, A. (2017). Neuromuscular electrical stimulation for treatment of muscle impairment: Critical review and recommendations for clinical practice. Physiotherapy Canada, 69(5), 1-76. https://doi.org/10.3138/ptc.2015-88

Validation of an EMG submaximal method to calibrate a novel dynamic EMG-driven musculoskeletal model of the trunk: Effects on model estimates.

Multijoint EMG-assisted optimization models are reliable tools to predict muscle forces as they account for inter- and intra-individual variations in activation. However, the conventional method of normalizing EMG signals using maximum voluntary contractions (MVCs) is problematic and introduces major limitations. The sub-maximal voluntary contraction (SVC) approaches have been proposed as a remedy, but their performance against the MVC approach needs further validation particularly during dynamic tasks. To compare model outcomes between MVC and SVC approaches, nineteen healthy subjects performed a dynamic lifting task with two loading conditions. Results demonstrated that these two approaches produced highly correlated results with relatively small absolute and relative differences (<10%) when considering highly-aggregated model outcomes (e.g. compression forces, stability indices). Larger differences were, however, observed in estimated muscle forces. Although some model outcomes, e.g. force of abdominal muscles, were statistically different, their effect sizes remained mostly small (ηG2≤0.13) and in a few cases moderate (ηG2≤0.165). The findings highlight that the MVC calibration approach can reliably be replaced by the SVC approach when the true MVC exertion is not accessible due to pain, kinesiophobia and/or the lack of proper training.

Distal overactivation of gastrocnemius medialis in persistent plantarflexion weakness following Achilles tendon repair

Structural alterations of the triceps surae and Achilles tendon (AT) can promote plantarflexion weakness one-year following an AT repair, influencing the activation strategies of the Gastrocnemius Medialis (GM) muscle. However, this is yet to be demonstrated. We aimed to determine whether patients with plantar flexion weakness one-year after AT repair show altered GM spatial activation. In this cross-sectional and case-control study, ten middle-aged men (age 34 ± 7 years old, and 12.9 ± 1.1 months post-surgery) with a high AT total rupture score who attended conventional physiotherapy for six months after surgery, and ten healthy control men (age 28 ± 9 years old), performed maximal and submaximal (40, 60 and 90%) voluntary isometric plantarflexion contractions on a dynamometer. The peak plantar flexor torque was determined by isokinetic dynamometry and the GM neuromuscular activation was measured with a linear surface-electromyography (EMG) array. Overall EMG activation (averaged channels) increased when the muscle contraction levels increased for both groups. EMG spatial analysis in AT repaired group showed an increased activation located distally at 85–99%, 75–97%, and 79–97% of the electrode array length for 40%, 60%, and 90% of the maximal voluntary isometric contractions, respectively. In conclusion, patients with persistent plantar flexion weakness after AT rupture showed higher distal overactivation in GM.

Reliability of the active knee joint position sense test and influence of limb dominance and sex

The output of a sensorimotor performance can be measured with the joint position sense (JPS) test. However, investigations of leg dominance, sex and quality measures on this test are limited. Therefore, these potential influencing factors as well as reliability and consistency measures were evaluated for angular reproduction performance and neuromuscular activity during the active knee JPS test in healthy participants. Twenty healthy participants (10 males; 10 females; age 29 ± 8 years; height 165 ± 39 cm; body mass 69 ± 13 kg) performed a seated knee JPS test with a target angle of 50°. Measurements were conducted in two sessions separated by two weeks and consisted of two blocks of continuous angular reproduction (three minutes each block). The difference between reproduced and target angle was identified as angular error measured by an electrogoniometer. During reproduction, the neuromuscular activity of the quadriceps muscle was assessed by surface electromyography. Neuromuscular activity was normalized to submaximal voluntary contraction (subMVC) and displayed per muscle and movement phase. Differences between leg dominance and sex were calculated using Friedman-test (α = 0.05). Reliability measures including intraclass correlation coefficient (ICC), Bland–Altman analysis (bias ± limits of agreement (LoA)) and minimal detectable change (MDC) were analysed. No significant differences between leg dominance and sex were found in angular error and neuromuscular activity. Angular error demonstrated inter-session ICC scores of 0.424 with a bias of 2.4° (± 2.4° LoA) as well as MDC of 6.8° and moderate intra-session ICC (0.723) with a bias of 1.4° (± 1.65° LoA) as well as MDC of 4.7°. Neuromuscular activity for all muscles and movement phases illustrated inter-session ICC ranging from 0.432 to 0.809 with biases between − 2.5 and 13.6% subMVC and MDC from 13.4 to 63.9% subMVC. Intra-session ICC ranged from 0.705 to 0.987 with biases of − 7.7 to 2.4% subMVC and MDC of 2.7 to 46.5% subMVC. Leg dominance and sex seem not to influence angular reproduction performance and neuromuscular activity. Poor to excellent relative reliability paired with an acceptable consistency confirm findings of previous studies. Comparisons to pathological populations should be conducted with caution.

Acute Effects of Neuromuscular Electrical Stimulation on Contralateral Plantar Flexor Neuromuscular Function.

Contralateral facilitation, i.e., the increase in contralateral maximal voluntary strength that is observed when neuromuscular electrical stimulation (NMES) is applied to the ipsilateral homonymous muscle, has previously been reported for the knee extensors but the neurophysiological mechanisms remain to be investigated. The aim of this study was to compare plantar flexor contralateral facilitation between a submaximal voluntary contraction (~10% MVC torque) and two evoked contractions (conventional and wide-pulse high-frequency NMES) of the ipsilateral plantar flexors, with respect to a resting condition. Contralateral MVC torque and voluntary activation level were measured in 22 healthy participants while the ipsilateral plantar flexors were at rest, voluntarily contracted or stimulated for 15 s. Additional neurophysiological parameters (soleus H-reflex and V-wave amplitude and tibialis anterior coactivation level) were quantified in a subgroup of 12 participants. Conventional and wide-pulse high-frequency NMES of the ipsilateral plantar flexors did not induce any contralateral facilitation of maximal voluntary strength and activation with respect to the resting condition. Similarly, no alteration of neurophysiological parameters was observed in the different conditions. This absence of contralateral facilitation contrasts with some results previously obtained on the knee extensors but is consistent with the absence of neurophysiological changes on the contralateral soleus.

Cervical spine and muscle adaptation after spaceflight and relationship to herniation risk: protocol from ‘Cervical in Space’ trial

BackgroundAstronauts have a higher risk of cervical intervertebral disc herniation. Several mechanisms have been attributed as causative factors for this increased risk. However, most of the previous studies have examined potential causal factors for lumbar intervertebral disc herniation only. Hence, we aim to conduct a study to identify the various changes in the cervical spine that lead to an increased risk of cervical disc herniation after spaceflight.MethodsA cohort study with astronauts will be conducted. The data collection will involve four main components: a) Magnetic resonance imaging (MRI); b) cervical 3D kinematics; c) an Integrated Protocol consisting of maximal and submaximal voluntary contractions of the neck muscles, endurance testing of the neck muscles, neck muscle fatigue testing and questionnaires; and d) dual energy X-ray absorptiometry (DXA) examination. Measurements will be conducted at several time points before and after astronauts visit the International Space Station. The main outcomes of interest are adaptations in the cervical discs, muscles and bones.DiscussionAstronauts are at higher risk of cervical disc herniation, but contributing factors remain unclear. The results of this study will inform future preventive measures for astronauts and will also contribute to the understanding of intervertebral disc herniation risk in the cervical spine for people on Earth. In addition, we anticipate deeper insight into the aetiology of neck pain with this research project.Trial registrationGerman Clinical Trials Register, DRKS00026777. Registered on 08 October 2021.

Residual force enhancement is affected more by quadriceps muscle length than stretch amplitude.

Little is known about how muscle length affects residual force enhancement (rFE) in humans. We therefore investigated rFE at short, long, and very long muscle lengths within the human quadriceps and patellar tendon (PT) using conventional dynamometry with motion capture (rFETQ) and a new, non-invasive shear-wave tensiometry technique (rFEWS). Eleven healthy male participants performed submaximal (50% max.) EMG-matched fixed-end reference and stretch-hold contractions across these muscle lengths while muscle fascicle length changes of the vastus lateralis (VL) were captured using B-mode ultrasound. We found significant rFETQ at long (7±5%) and very long (12±8%), but not short (2±5%) muscle lengths, whereas rFEWS was only significant at the very long (38±27%), but not short (8±12%) or long (6±10%) muscle lengths. We also found significant relationships between VL fascicle length and rFETQ (r=0.63, p=0.001) and rFEWS (r=0.52, p=0.017), but relationships were not significant between VL fascicle stretch amplitude and rFETQ (r=0.33, p=0.126) or rFEWS (r=0.29, p=0.201). Squared PT shear-wave-speed-angle relationships did not agree with estimated PT force-angle relationships, which indicates that estimating PT loads from shear-wave tensiometry might be inaccurate. We conclude that increasing muscle length rather than stretch amplitude contributes more to rFE during submaximal voluntary contractions of the human quadriceps.

Halo Sport Transcranial Direct Current Stimulation Improved Muscular Endurance Performance and Neuromuscular Efficiency During an Isometric Submaximal Fatiguing Elbow Flexion Task.

The present study examined the effects of transcranial direct current stimulation (tDCS) using Halo Sport on the time to exhaustion (TTE) in relation with muscle activities and corticomuscular coupling of agonist and antagonist muscles during a sustained isometric fatiguing contraction performed with the elbow flexors. Twenty healthy male college students were randomly assigned to tDCS group and control group. The two group participants performed two experimental sessions which consisted of pre-fatigue isometric maximal voluntary contraction (MVC), sustained submaximal voluntary contractions (30% maximal torque) performed to exhaustion, and post-fatigue MVC with the right elbow flexor muscles. Sham stimulation (90 s) and tDCS (20 min) were applied for control and tDCS group participants 20 min prior to the second session test, respectively. MVC strength in pre- and post-fatigue test, TTE, electroencephalogram (EEG), and electromyography (EMG) of biceps brachii (BB) and triceps brachii (TB) were recorded during the tests. It was found that tDCS using the Halo Sport device significantly increased TTE and thus improved muscular endurance performance. The improvement may be partly related to the improvement of neuromuscular efficiency as reflected by decrease of antagonistic muscle coactivation activities, which may be related to cortical originated central processing mechanism of neuromuscular activities.

Normalisation of a biarticular muscle EMG signal using a submaximal voluntary contraction: Choice of the standardised isometric task for the rectus femoris, a pilot study

BackgroundElectromyography (EMG) signal amplitude is often altered by factors related to the participants and the measurement system. To overcome this issue, a normalisation of the EMG signal amplitude can be performed. Recently, it has been demonstrated that a submaximal voluntary contraction (subMVC) normalisation approach, inspired by grade 3 of manual muscle testing, could produce reliable results. However, rectus femoris (RF) normalisation resulted in low reliability. While the normalisation task chosen for this biarticular muscle was to maintain a knee extension against gravity (ISO-K), a hip flexion isometric task (ISO-H) could also be applied. Research questionThis pilot study aimed to assess the impact of the normalisation task on the RF EMG signal quality and related intra‐rater within-day reliability during ISO-K and ISO-H, and intra‐rater between-day reliability of the EMG signal amplitude during gait. MethodsTwenty-four asymptomatic participants were asked to perform ISO-K and ISO-H tasks with both legs and then to walk at self-spontaneous speed, in two identical sessions one week apart. A wireless EMG system was used to record the EMG signal of bilateral RF during each task. ResultsSignal-to-noise ratio during ISO-K and ISO-H was ≥ 15 dB in respectively 51% and 98% of all task repetitions. Intra‐rater within-day reliability was acceptable using ISO-K (ICC = 0.71 (0.57; 0.83)) with high %SEM of 35%, and excellent using ISO-H (ICC = 0.94 (0.90; 0.96)) with high %SEM of 34%. Intra‐rater between‐day reliability during gait was acceptable using ISO-K (ICC = 0.74 (0.61; 0.81)) with a high %SEM of 49%, and excellent using ISO-H (ICC = 0.87 (0.76; 0.93)) with a high %SEM of 38%. SignificanceThe reliability (ICC) of RF EMG signal normalisation was higher using ISO-H than using ISO-K. However, even if signal-to-noise ratio was notably improved using ISO-H, %SEM remains high whatever the normalisation task used. Some additional improvements might thus still be needed to obtain a normalisation protocol allowing more reproducible measurements.