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To give people more specific information on the quality of their daily motion, it is necessary to continuously measure muscular activity during everyday occupations in an easy way. The traditional methods to measure muscle activity using a combination of surface electromyography (sEMG) sensors and optical motion capture system are expensive and not suitable for non-technical users and unstructured environment. For this reason, in our group we are researching methods to estimate leg muscle activity using non-contact wearable sensors, improving ease of movement and system usability. In a previous study, we developed a method to estimate muscle activity via only a single inertial measurement unit (IMU) on the shank. In this study, we describe a method to estimate muscle activity during walking via two IMU sensors, using an original sensing system and specifically developed estimation algorithms based on ANN techniques. The muscle activity estimation results, estimated by the proposed algorithm after optimization, showed a relatively high estimation accuracy with a correlation efficient of R2 = 0.48 and a standard deviation STD = 0.10, with a total system average delay of 192 ms. As the average interval between different gait phases in human gait is 250–1000 ms, a 192 ms delay is still acceptable for daily walking requirements. For this reason, compared with the previous study, the newly proposed system presents a higher accuracy and is better suitable for real-time leg muscle activity estimation during walking.

Objective Quadriceps dysfunction has been suggested as a complication after medial patellofemoral ligament (MPFL) reconstruction. The purpose of this study was to investigate changes in knee extensor strength before and after MPFL reconstruction. Methods Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%). Results The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively. Conclusions Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery.

The study aimed to determine the effect of 8-week unilateral electrical muscle stimulation (EMS) training of leg muscles: vastus lateralis, vastus medialis and biceps femoris with the same number of muscle contractions in comparison to controls. Contractile properties were monitored by measuring the maximal voluntary isometric contraction (MVC) and the rate of force development in first 50 ms (RFD50) of knee extensors and flexors and tensiomyography of stimulated muscles. In addition, we also investigated the retained effect after 8 weeks without EMS training. Nineteen healthy young female athletes aged 15 to 18 years (average 16.4 ± .9 years) were randomly divided in a control group (CG; N=8) and experimental group (EG; N=11). CG performed maximal unilateral voluntary contractions while the EG performed also EMS training of the same leg by stimulating both vasti muscles and biceps femoris. There were no changes in CG after 8-weeks of maximal unilateral voluntary training; however, EG improved MVC in knee extensors (12.6%; P =.085) and RFD50 (142.1%; P =.049) where RFD50 retained increased also 8 weeks after EMS training (73%; P =.090). Tensiomyography revealed decreased amplitude (13.2%; P=.011) only in EG, representing higher muscle tone after 8-weeks of EMS in comparison to CG. Our findings indicate that EMS training has a positive effect on muscle contractile properties in young female athletes even after comparing to matched controls by the number of contractions. Keywords: EMS, muscle strength, tensiomiography, rate of force development

The current study aimed to examine the effect of verbal instruction on explosive force production and between-session measurement reliability during maximal voluntary contractions of knee extensors. Following familiarization, 20 healthy males performed 3 maximal contractions with a “hard-and-fast” instruction and 3 maximal contractions with a “fast” instruction during 2 test-retest sessions. Knee extension maximal voluntary force (Fmax) and the maximal rate of force development (RFDmax) were measured. Maximal electromechanical delay (EMDmax), and the maximal rate of muscle activation (RMAmax) of quadriceps muscles were determined. No significant effect of instruction was observed on Fmax (p > 0.05). The RFDmax and RMAmax were significantly higher with the “fast” compared to the “hard-and-fast” instruction (36.07%, ES = 1.99 and 37.24%, ES = 0.92, respectively), whereas EMDmax was significantly lower with the “fast” instruction compared to the “hard-and-fast” instruction (-3.79%, ES = - 0.29). No significant differences between test and retest measurements were found (p < 0.05). However, the reliability of the RFDmax was higher with the fast instruction compared to the hard-and-fast instruction (CV: 7.3 vs. 16.2%; ICC: 0.84 vs. 0.56). Besides, the RFDmax was associated with the RMAmax and EMDmax with a significant effect of instruction. Data showed that the instruction given prior contracting muscle affected explosive force production and associated neuromuscular variables. As a result, the “fast” instruction may be preferred in the assessment of explosive force capacity of skeletal muscle during maximal efforts.

Mat Pilates has become an attractive alternative exercise among older women, however, despite knowing the importance of regular exercise, interrupting training is a common issue in this population. The aim of the current study was to evaluate the effects of 6-weeks of detraining after a period of 12-weeks of training with Mat Pilates on the functional capacity and neuromuscular performance of the knee extensor muscles in older women. Ten older women (62.6 ± 2.6 years; 1.57 ± 0.05 m height; 69.3 ± 9.2 kg; 27.8 kg/m2 body mass index) volunteered to participate in this study. The study was divided into three periods: a 4-week control period, followed by 12 weeks of Mat Pilates intervention, and a 6-week detraining period. During the intervention, the results showed significant improvements in functional capacity tests (time up and go, time up stairs, time down stairs, and chair sit-and-reach), rate of torque development, and impulse (p

The aim of this study was to assess the validity of a custom-made low cost (LC) and a commercial surface EMG apparatus in controlled experimental conditions and different exercise types: maximal voluntary contractions (MVC) at 105, 90, 75, 60, 45 and 30° knee angle and explosive fix-end contractions of the knee extensors (75°) at an isometric dynamometer. sEMG of vastus lateralis was recorded from the same electrodes simultaneously, then analyzed in the same way; sEMG were finally expressed in percentage of those collected at 75°MVC. LC underestimated the sEMG signal at the more extended knee angles (30-60°), significant difference was observed only at 30°. In the explosive contractions no differences between devices were observed in average and peak sEMG, as well as in the time to peak and the activation time. Bland-Altman tests and correlation parameters indicate the LC device is not sensible enough to detect the time to peak and the peak values of the sEMG signal properly. Results suggest low-cost systems might be a valid alternative to commercial ones, but attention must be paid when analyzing rapid events.

Resistance exercise training is a cornerstone in preventing age-related declines in muscle mass and strength, and fatigability of limb muscle is important to this adaptive response. It is unknown, however, whether fatigability and the underlying mechanisms differ between different resistance exercise protocols in young and older adults. The purpose of this study was to quantify the fatigability of the knee extensors and identify the mechanisms in 20 young (22.2 ± 1.3 yr, 10 women) and 20 older adults (73.8 ± 5.4 yr, 10 women) elicited by a single session of high- and low-load resistance exercise. One leg completed a high-load protocol with contractions performed as fast as possible (HL-fast, ~80% 1 Repetition Max, 1RM), and the contralateral leg a low-load protocol performed with slow contractions (LL-slow, ~30% 1RM, 6 s concentric, 6 s eccentric). Each exercise involved four sets of eight repetitions. Before and immediately following each set, maximal voluntary isometric contractions (MVC) were performed, and voluntary activation and contractile properties quantified using electrical stimulation. The reduction in MVC was greater following the LL-slow (20%) than the HL-fast (12%, P = 0.004), with no age or sex differences. Similarly, the reduction in the amplitude of the involuntary electrically-evoked twitch was greater in the LL-slow (14%) than the HL-fast (7%, P = 0.014) and correlated with the reduction in MVC (r = 0.546, P 0.001), whereas voluntary activation decreased only for the LL-slow protocol (5%, P 0.001). Thus, low-load resistance exercise with slow contractions induced greater fatigability within the muscle than a more traditional high-load resistance protocol for both young and older men and women.

Quadriceps tendon ruptures compromise the knee extensor mechanism and cause an inability to ambulate and significant functional limitations. Therefore, the vast majority of quadriceps tendon ruptures are indicated for operative intervention to restore patient mobility and function. Although these injuries were traditionally repaired using a transosseous repair technique, recent literature has shown that suture anchor repair may offer biomechanical advantages. Additionally, research in other areas of orthopaedics has found that a double-row suture anchor construct can offer additional biomechanical strength to tendinous repair. This technical note describes a safe and effective quadriceps tendon repair using a double-row suture anchor construct., Technique Video Video 1 Repair of a right quadriceps tendon rupture with the patient in the supine position. The tear is identified and mobilized, and the superior pole of the patella is prepared with a burr. Two suture anchors double loaded with suture tape (PEEK Corkscrew FT) are placed into the superior pole, and the suture ends are passed through the tendon in Krackow fashion. A double-row construct is then created using 2 sutures from the contralateral anchor and 1 from the ipsilateral anchor loaded into an additional anchor (3.5-mm PEEK SwiveLock) and impacted into the patella to create a double-row construct. This is repeated on both the medial and lateral sides of the patella. The extensor retinaculum is then repaired to complete the fixation.

Background: Both muscle fatigability and walking fatigability are prevalent in persons with MS (pwMS), but their associations remains unclear. The aim of this study was to examine the association of muscle strength and fatigability from both isometric and concentric protocols of three different muscle groups, and their association to walking capacity and walking fatigability. Methods: Twenty-seven pwMS and 13 Healthy Controls (HC) were included in this exploratory study. All participants performed a six-minute walking test (6MWT), where the distance walked index (DWI) was calculated to measure walking fatigability with a cut-off score of -10%. In three different muscle groups (knee extensors (KE), knee flexors (KF), ankle dorsiflexors (DF)), isometric and concentric muscle fatigability protocols (FIisometric or FIconcentric) were used to quantify maximal voluntary contraction (MVC) and muscle fatigability. Pearson or Spearman correlation coefficients and linear regression models were calculated to establish the association between muscle strength/fatigability and walking capacity/fatigability. Results: Higher MVCs values for all muscle groups were found in HC compared to pwMS (mainly those having walking fatigability) (p < 0.05). FIisometric of DF was lower in pwMS having walking fatigability compared to no walking fatigability. MVC of KE, KF and DF had a low to moderate association with walking capacity (range r = 0.52-0.56; p < 0.05) and walking fatigability in pwMS (range r-rs: 0.39-0.50; pconcentric of KF and DF, but not of KE, were associated with walking fatigability (r = 0.39 and rs = 0.47, respectively; p < 0.05). In contrast, FIisometric for all muscle groups were not related to walking capacity or walking fatigability. Conclusion: MVC of KE, KF and DF are associated with walking capacity and walking fatigability, while concentric (but not isometric) muscle fatigability of KF and DF are associated with walking fatigability.

The effects of muscle contractions on muscle fibre conduction velocity have normally been investigated for contractions of a given duration and intensity, with most studies being focused on the decline on conduction velocity during/after prolonged contractions. Herein, we perform a systematic analysis of the changes in conduction velocity after voluntary contractions of different durations and intensities. Conduction velocity was estimated in the vastus lateralis before and after knee extensor isometric maximal voluntary contractions (MVCs) of 1, 3, 6, 10, 30 and 60 s, and after brief (3 s) contractions at 10, 30, 50, 70, and 90% of MVC force. Measurements were made during the 10-min period following each contraction. (1) Conduction velocity was increased immediately after (1 s) the MVCs of brief (≤ 10 s) duration (12 ± 2%, P < 0.05), and then returned rapidly (within 15 s) to control levels; (2) the extent of the increase in conduction velocity was similar after the 3-s, 6-s, and 10-s MVCs (P > 0.05); (3) the magnitude of the increase in conduction velocity after a brief contraction augmented with the intensity of the contraction (increases of 4.6, 7.7, 11.4, 14.8, and 15.2% for contractions at 10, 30, 50, 70, and 90% of MVC force, respectively); (4) conduction velocity was not decreased immediately after the 30-s MVC (P > 0.05); and (5) conduction velocity did not reach its minimum 1 s after the long (≥ 30 s) MVCs. Brief (≤ 10 s) muscle contractions induce a short-term increase in conduction velocity, lasting 15 s, while long (≥ 30 s) contractions produce a long-term decrease in conduction velocity, lasting more than 2 min.

The purpose of this study was to examine age-related differences in muscle performance in women divided into young (YW, 20–39 years, n = 29) middle-aged (MAW, 40–59 years, n = 33), and older (OW, ≥60 years, n = 40) age groups. Methods: Hand grip strength, vertical jump performance, and knee extensor (KE) strength (0 deg/s, 60 deg/s, and 240 deg/s), speed of movement (SoM, at 1 Nm, 20%, 40%, and 60% isometric strength), and endurance (30-repetition test at 60 degs/s and 240 deg/s) were assessed. Computed tomography-acquired muscle cross-sectional area (mCSA) was measured and included to determine specific strength (KE strength/mCSA). Results: Hand grip strength was similar across groups, while jump performance declined with age (YW and MAW &gt, OW, p &lt, 0.001). KE strength declined significantly with age (all conditions p &lt, 0.01), while specific strength was similar across groups. SoM was significantly higher for YW and MAW compared to OW (both p &lt, 0.01). An age × velocity interaction revealed YW KE endurance was similar between conditions, whereas MAW and OW displayed significantly better endurance during the 60 deg/s condition. OW displayed impaired KE endurance at 240 deg/s (vs. YW and MAW, p &lt, 0.01) but improved at 60 deg/s (vs. YW, p &lt, 0.01). Dynamic torque decline increased with age (YW &lt, OW, p = 0.03) and was associated with intramuscular adipose tissue (r = 0.21, p = 0.04). Conclusions: Performance declines were most evident among OW, but few performance deficits had emerged in MAW. Interestingly, strength declines disappeared after normalizing to mCSA and endurance appears to be velocity-dependent.

Purpose: It is unclear whether biarticular hamstring muscles (HAM) can act as knee extensors or not. The purpose of this study is to identify the conditions that HAM can act as a knee extensor by using a computational simulation approach.Methods: The modified Gait2392 musculoskeletal model was used in this study. The posture was determined with a hip flexion angle that ranged from -30° to 90° and a knee flexion angle that ranged from -10 ° to 90 °. The simulations were executed under two conditions: all segments are free to move, non-contact with the ground (nCG), and the foot is constrained on the ground, contact with the ground (CG). Induced acceleration analysis was applied to determine the contribution of the HAM to the knee angular acceleration.Results: Three key findings were discovered. 1) HAM can act as knee extensors that have CG condition as well as nCG condition. 2) The HAM function changes depending on the posture. 3) The range of the hip joint that HAM was able to act as a knee extensor was expanded for the CG condition from the nCG condition.Conclusions: We identified the situations in which HAM can act as knee extensors and demonstrated that the HAM function on the knee joint changes depending on the posture and the foot contact condition. Our findings suggest that HAM can be used as compensatory movement strategy for patients with a reduced capacity to generate knee extension if the patients have enough HAM strength.

The aim of the study was to evaluate the association between physical activity, knee extensors (KE) performance (ie, isometric strength and fatigability), and biological parameters (ie, muscle structural, microvascular, and metabolic properties) in healthy very old men and women. Thirty very old adults (82 ± 1 years, 15 women) performed an isometric Quadriceps Intermittent Fatigue (QIF) test for the assessment of KE maximal force, total work (index of absolute performance), and fatigability. Muscle biopsies from the vastus lateralis muscle were collected to assess muscle fibers type and morphology, microvasculature, and enzymes activity. Correlation analyses were used to investigate the relationships between physical activity (steps/day, actimetry), KE performance, and biological data for each sex separately. Men, compared to women, showed greater total work at the QIF test (44 497 ± 8 629 Ns vs 26 946 ± 4 707 Ns; p < .001). Steps per day were correlated with total work only for women (r = 0.73, p = .011). In men, steps per day were correlated with the percentage (r = 0.57, p = .033), shape factor (r = 0.75, p = .002), and capillary tortuosity of type IIX fibers (r = 0.59, p = .035). No other relevant correlations were observed for men or women between steps per day and biological parameters. Physical activity level was positively associated with the capacity of very old women to perform a fatiguing test, but not maximal force production capacity of the KE. Physical activity of very old men was not correlated with muscle performance. We suggest that very old women could be at higher risk of autonomy loss and increasing the steps per day count could provide a sufficient stimulus for adaptations in less active women.

Background. Motor fatigability (i.e. contraction-induced reduction in muscle strength) from a concentric task associatestronger to walking and perception of fatigue in persons with multiple sclerosis (pwMS), compared with an isometric task.However, the central and peripheral contributions of motor fatigability between these tasks have not been investigated.Objective. Compare the central and peripheral contributions of motor fatigability in the knee extensors in a sustainedisometric fatigability protocol versus a concentric fatigability protocol and in pwMS versus healthy controls (HCs).Methods. Participants (n=31 pwMS; n=15 HCs) underwent neuromuscular testing before and immediately after twoknee extensor fatigability tasks (sustained isometric and concentric) in an isokinetic dynamometer. Neuromuscular testingof fatigability consisted of maximal voluntary contraction, voluntary activation (central/neural contributor), and restingtwitch (peripheral/muscular contributor) determined by the interpolated twitch technique. Results. Sustained isometricand concentric fatigability protocols resulted in motor fatigability for both pwMS and HCs, with no between-protocolsdifferences for either group. Regression analysis showed that motor fatigability variance in pwMS was mainly attributedto central fatigability in the sustained isometric protocol and to both central and peripheral fatigability in the concentricprotocol. In HCs, the variance in sustained isometric and concentric fatigability were attributed to both peripheral andcentral fatigability. Conclusion. Central and peripheral contributions of motor fatigability differed between sustainedisometric and concentric protocols as well as between pwMS and HCs. These between-protocol differences in pwMSprovide a neuromuscular dimension to the reported difference in the strength of associations of concentric and isometrictasks to walking and perception of fatigue in pwMS. BACKGROUND: Motor fatigability (i.e. contraction-induced reduction in muscle strength) from a concentric task associate stronger to walking and perception of fatigue in persons with multiple sclerosis (pwMS), compared with an isometric task. However, the central and peripheral contributions of motor fatigability between these tasks have not been investigated.OBJECTIVE: Compare the central and peripheral contributions of motor fatigability in the knee extensors in a sustained isometric fatigability protocol versus a concentric fatigability protocol and in pwMS versus healthy controls (HCs).METHODS: Participants (n=31 pwMS; n=15 HCs) underwent neuromuscular testing before and immediately after two knee extensor fatigability tasks (sustained isometric and concentric) in an isokinetic dynamometer. Neuromuscular testing of fatigability consisted of maximal voluntary contraction, voluntary activation (central/neural contributor), and resting twitch (peripheral/muscular contributor) determined by the interpolated twitch technique.RESULTS: Sustained isometric and concentric fatigability protocols resulted in motor fatigability for both pwMS and HCs, with no between-protocols differences for either group. Regression analysis showed that motor fatigability variance in pwMS was mainly attributed to central fatigability in the sustained isometric protocol and to both central and peripheral fatigability in the concentric protocol. In HCs, the variance in sustained isometric and concentric fatigability were attributed to both peripheral and central fatigability.CONCLUSION: Central and peripheral contributions of motor fatigability differed between sustained isometric and concentric protocols as well as between pwMS and HCs. These between-protocol differences in pwMS provide a neuromuscular dimension to the reported difference in the strength of associations of concentric and isometric tasks to walking and perception of fatigue in pwMS.

Objectives Tai Chi (TC) has shown beneficial effects on joint function in knee osteoarthritis (OA). Biomechanical mechanisms of knee joint contact load (JCL) and muscle activations during TC are less understood. The purpose of this biomechanical simulation study was to examine JCL of TC gait, the most common used TC from and its causal interactions with muscle activations in knee OA. Design Six knee OA and five healthy participants were recruited. Their full body motion of TC gait was collected. The JCL and muscle forces were quantified using a musculoskeletal simulation approach based on collected kinematics and kinetics. The JCL and muscle activations were compared between knee OA and healthy control group. In addition, the muscle contributions to the JCL were determined and compared between the two groups. Results Knee OA subjects had lower peak anterior-posterior shear forces and higher lateral shear forces than healthy control subjects during TC gait. Knee OA subjects also showed higher activations of knee flexor muscles than control subjects. Both knee extensor and flexors of the knee OA group were contributing to JCL and in the control group mainly the knee extensors. Conclusions Our simulation results showed the JCL, muscle forces profiles, and muscle contributions to the JCL during TC gait in knee OA. The findings of this study provided a direct scientific link between JCL and muscle forces during TC gait in knee OA. This would allow us to develop more effective TC interventions for knee OA in the future.

Relatively few investigations have reported purposeful overfeeding in resistance-trained adults. This preliminary study examined potential predictors of resistance training (RT) adaptations during a period of purposeful overfeeding and RT. Resistance-trained males (n = 28; n = 21 completers) were assigned to 6 weeks of supervised RT and daily consumption of a high-calorie protein/carbohydrate supplement with a target body mass (BM) gain of ≥0.45 kg·wk−1. At baseline and post-intervention, body composition was evaluated via 4-component (4C) model and ultrasonography. Additional assessments of resting metabolism and muscular performance were performed. Accelerometry and automated dietary interviews estimated physical activity levels and nutrient intake before and during the intervention. Bayesian regression methods were employed to examine potential predictors of changes in body composition, muscular performance, and metabolism. A simplified regression model with only rate of BM gain as a predictor was also developed. Increases in 4C whole-body fat-free mass (FFM; (mean ± SD) 4.8 ± 2.6%), muscle thickness (4.5 ± 5.9% for elbow flexors; 7.4 ± 8.4% for knee extensors), and muscular performance were observed in nearly all individuals. However, changes in outcome variables could generally not be predicted with precision. Bayes R2 values for the models ranged from 0.18 to 0.40, and other metrics also indicated relatively poor predictive performance. On average, a BM gain of ~0.55%/week corresponded with a body composition score ((∆FFM/∆BM)*100) of 100, indicative of all BM gained as FFM. However, meaningful variability around this estimate was observed. This study offers insight regarding the complex interactions between the RT stimulus, overfeeding, and putative predictors of RT adaptations.

Males have larger blood pressure (BP) responses to relative-intensity static handgrip exercise compared with females. Controlling for absolute load (maximal voluntary contraction (MVC)) abolishes these differences. Whether similar observations exist during large muscle mass exercise or dynamic contractions, and the mechanisms involved, remains unknown.BP, heart rate, muscle oxygenation (near-infrared spectroscopy), and rectus femoris EMG were recorded in 28 males and 17 females during 10% and 30% MVC static (120 s) and isokinetic dynamic (180 s; 1:2 work-to-rest ratio; angular velocity, 60°·s-1) knee extensor exercise. Static and dynamic exercises were completed on separate visits, in a randomized order. Sex differences were examined with and without statistical adjustment of MVC (ANCOVA).Males had larger systolic BP responses (interaction, P0.0001) and muscle deoxygenation (interaction, P0.01) than did females during 10% static exercise, with no difference in EMG (interaction, P = 0.67). Peak systolic BP was correlated with MVC (r = 0.55, P = 0. 0001), and adjustment for MVC abolished sex differences in systolic BP (interaction, P = 0.3). BP, heart rate, muscle oxygenation/deoxygenation, and EMG responses were similar between sexes during 30% static exercise (interaction; all, P0.2), including following adjustment for MVC (all, P0.1). Males had larger systolic BP responses during dynamic exercise at 10% and 30% (interaction; both, P = 0.01), which were abolished after adjustment for MVC (interaction; both, P0.08). Systolic BP responses were correlated with absolute MVC and stroke volume responses during 10% (r = 0.31, P = 0.04; r = 0.61, P0.0001, respectively) and 30% (r = 0.48, P = 0.001; r = 0.59, P0.0001, respectively).Absolute contraction intensity can influence systolic BP responses to 10% but not 30% MVC static, as well as 10% and 30% MVC dynamic knee extensor exercise, and should be considered in cross-sectional comparisons of exercise BP.

Biomechanical modeling shows that archosaur leg muscle leverage evolved gradually, yet with a Jurassic pulse of specialization., Bipedal locomotion evolved along the archosaurian lineage to birds, shifting from “hip-based” to “knee-based” mechanisms. However, the roles of individual muscles in these changes and their evolutionary timings remain obscure. Using 13 three-dimensional musculoskeletal models of the hindlimbs of bird-line archosaurs, we quantify how the moment arms (i.e., leverages) of 35 locomotor muscles evolved. Our results support two hypotheses: From early theropod dinosaurs to birds, knee flexors’ moment arms decreased relative to knee extensors’, and medial long-axis rotator moment arms for the hip increased (trading off with decreased hip abductor moment arms). Our results reveal how, from the Triassic Period, bipedal theropod dinosaurs gradually modified their hindlimb form and function, shifting more from hip-based to knee-based locomotion and hip-abductor to hip-rotator balancing mechanisms inherited by birds. Yet, we also discover unexpected ancestral specializations in larger Jurassic theropods, lost later in the bird-line, complicating the paradigm of gradual transformation.

Objectives: This study was done to investigate the influences of cryotherapy on the joint position sense (JPS) and extensor muscles torque of the knee. Methods: Forty healthy volunteers (20 men, 20 women; age range, 21 – 30 y) participated. Two cooling pads were applied to the knee and anterior thigh for 15 minutes at 4°C. The accuracy of the knee JPS was evaluated before and after cooling in two angles, including 45° and 60° flexion. Extensor muscles torque of the knee was obtained in two velocities of 30°/s and 120°/s. Results: The effect of time and the interaction between the group and time were not significant for both active and passive repositioning error tests of the knee joint angles (P ≥ 0.05). The knee extensor's muscle torque increased significantly during both velocities of 30°/s and 120°/s, immediately and 30 minutes after the cryotherapy in the experimental group (P ≤ 0.01). Cooling for 15 minutes made a higher knee extensor muscle torque and did not change the JPS. Conclusions: These findings should be considered for therapeutic programs that involve exercise immediately after a period of cryotherapy.

Underloading the surgical limb has been described in biomechanical studies across recovery time points following anterior cruciate ligament reconstruction (ACLr). This study aimed to examine the extent to which laboratory findings translate to daily activities. Limb loading was quantified during a sit-to-stand task in laboratory testing and throughout 2 days of daily activity in 15 individuals 114.8 (17.2) days post-ACLr and 15 controls. Vertical force impulse calculated from force platform (laboratory) and pressure insoles (daily) was used to quantify limb loading. Between-limb symmetry was calculated for limb loading and knee strength measures, 2 × 2 GLM repeated measures determined a significant group-by-limb interaction on daily limb loading. Surgical limb daily loading was lower compared to nonsurgical (p < .001; effect sizes [ES] = 0.63), and control matched limbs (surgical: p = .037, ES = 0.80 and nonsurgical: p = .02, ES = 0.89). No group differences were found in total daily loading (summed loading between limbs; p = .18; ES = 0.50) and time performing weight-bearing activities (p = .32; ES = 0.36). Pearson's correlation determined that between-limb symmetry in daily loading was related to sit-to-stand loading (r = .62; p = .01) and knee extensor strength symmetry (r = .6; p = .02) in the ACLr group. These data support the presence of underloading behaviors in individuals 10-14 weeks following ACLr that are consistent with previous biomechanical studies and current biomechanical data. Knee extensor weakness was related to greater underloading. Asymmetrical loading quantified in the laboratory is practiced throughout the day in individuals post-ACLr. Practice afforded by daily activities represents powerful contributors to learning of a pattern that contrasts the goal of rehabilitation exercises.

Skeletal muscle plasticity in response to countless conditions and stimuli mediates concurrent functional adaptation, both negative and positive. In the clinic and the research laboratory, maximal muscular strength is widely measured longitudinally in humans, with knee extensor musculature the most reported functional outcome. Pathology of the knee extensor muscle complex is well documented in aging, orthopedic injury, disease, and disuse; knee extensor strength is closely related to functional capacity and injury risk, underscoring the importance of reliable measurement of knee extensor strength. Repeatable, in vivo assessment of knee extensor strength in pre-clinical rodent studies offers valuable functional endpoints for studies exploring osteoarthritis or knee injury. We report an in vivo and non-invasive protocol to repeatedly measure isometric peak tetanic torque of the knee extensors in mice across time. We demonstrate consistency using this novel method to measure knee extensor strength with repeated assessment in multiple mice producing similar results.

We studied the effect of pennate vs. fusiform muscle architecture on the rate of torque development (RTD) by examining the predominately fusiform elbow flexors (EF) and highly-pennate knee extensors (KE). Seventeen male volunteers (28.4 ± 6.2 years) performed explosive isometric EF and KE contractions (MVCs). Biceps brachii and vastus lateralis fascicle angles were measured to confirm their architecture, and both the rate of voluntary muscle activation (root-mean-square EMG in the 50 ms before contraction onset; EMG-50) and electromechanical delay (EMD; depicting muscle-tendon series elasticity) were assessed as control variables to account for their influence on RTD. MVC torque, early (RTD50) and late (RTD200) RTDs were calculated and expressed as absolute and normalized values. Absolute MVC torque (+412%), RTD50 (+215%), and RTD200 (+427%) were significantly (p

The purpose of our study was to investigate peak torque (PT) of knee extensors (KE) and knee flexors (KF), bilateral and unilateral strength asymmetries in isokinetic testing and vertical jump height (JH), vertical ground reaction force (VGRF), and force differences (ΔVGRF) between legs during different jump tests in professional first-line firefighters (n = 15) competing in fire sports disciplines. There was a significant effect of jump type on JH (F2,44 = 7.23, p &lt, 0.05), VGRF (F2,44 = 16.03, p &lt, 0.05), and ΔVGRF (F2,44 = 3.45, p &lt, 0.05). Professional firefighters achieved a mean JH of 50.17 cm in the countermovement jump free arms and high PT of KEs (3.15 Nm/kg). No significant differences (p &gt, 0.05) and small effect sizes (d &lt, 0.3) were found between the legs when PTs were assessed. We found a slightly higher (d = 0.53) unilateral strength ratio in non-dominant legs (58.12 ± 10.26%) compared to dominant legs (55.31 ± 7.51%). No effect of laterality was found among limb comparisons, but a higher unilateral isokinetic strength ratio was found in non-dominant legs of firefighters. A high level of strength (PT of KEs &gt, 3 times body weight) and vertical jump performance is comparable to the performance of elite athletic populations.

Brief submaximal actions are important for wide range of functional movements. Until now, rate of force development and relaxation scaling factor (RFD-SF and RFR-SF) have been used for neuromuscular assessment using 100–120 isometric pulses which requires a high level of attention from the participant and may be influenced by physiological and/or psychological fatigue. All previous studies have been conducted on a smaller number of participants which calls into question the eligibility of some of the outcome measures reported to date. Our aims were: (1) to find the smallest number of rapid isometric force pulses at different force amplitudes is still valid and reliable for RFD-SF slope (kRFD–SF) and RFR-SF slope (kRFR–SF) calculation, (2) to introduce a new outcome measure – theoretical peak of rate of force development/relaxation (TPRFD and TPRFR) and (3) to investigate differences and associations between kRFD–SF and kRFR–SF. A cross-sectional study was conducted on a group of young healthy participants; 40 in the reliability study and 336 in the comparison/association study. We investigated the smallest number of rapid isometric pulses for knee extensors that still provides excellent reliability of the calculated kRFD–SF and kRFR–SF (ICC2,1 ≥ 0.95, CV < 5%). Our results showed excellent reliability of the reduced protocol when 36 pulses (nine for each of the four intensity ranges) were used for the calculations of kRFD–SF and kRFR–SF. We confirmed the negligibility of the y-intercepts and confirmed the reliability of the newly introduced TPRFD and TPRFR. Large negative associations were found between kRFD–SF and kRFR–SF (r = 0.502, p < 0.001), while comparison of the absolute values showed a significantly higher kRFD–SF (8.86 ± 1.0/s) compared to kRFR–SF (8.03 ± 1.3/s) (p < 0.001). The advantage of the reduced protocol (4 intensities × 9 pulses = 36 pulses) is the shorter assessment time and the reduction of possible influence of fatigue. In addition, the introduction of TPRFD and TPRFR as an outcome measure provides valuable information about the participant’s maximal theoretical RFD/RFR capacity. This can be useful for the assessment of maximal capacity in people with various impairments or pain problems.

Made available in DSpace on 2021-06-25T10:18:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objectives: To compare trunk and knee biomechanics of women with and without patellofemoral pain (PFP) and knee crepitus during stair ascent. Design: Cross-sectional. Setting: Laboratory-based study. Participants: 29 women with PFP and knee crepitus (PFPCrepitus); 28 women with PFP and no knee crepitus (PFPNOCrepitus); 17 pain-free women with knee crepitus (Pain-freeCrepitus); and 29 pain-free women without knee crepitus (Pain-freeNOCrepitus). Main outcome measures: Peak trunk flexion, peak knee flexion, mean knee angular velocity, knee extensor moment at peak knee flexion, peak and impulse of the knee extensor moment. Results: PFPCrepitus group performed the stair ascent task with reduced peak knee flexion compared to Pain-freeCrepitus (p = 0.04; Effect size = −0.85) and Pain-freeNOCrepitus (p = 0.03; Effect size = −0.75). No significant differences among groups were found for peak trunk flexion (p = 0.979), knee angular velocity (p = 0.420), knee extensor moment at peak knee flexion (p = 0.933), peak (p = 0.290) and impulse (p = 0.122) of the knee extensor moment. Conclusion: Women with concomitant PFP and knee crepitus demonstrated reduced knee flexion during stair ascent, but no significant differences for trunk flexion and knee extensor moment variables were found. Sao Paulo State University (UNESP) School of Science and Technology Physical Therapy Department University of Toledo School of Exercise and Rehabilitation Sciences La Trobe Sports and Exercise Medicine Research Centre (LASEM) School of Allied Health La Trobe University Sao Paulo State University (UNESP) School of Science and Technology Physical Therapy Department FAPESP: 2019/03214-8

The quadriceps-intermittent-fatigue (QIF) test assesses knee extensors strength, endurance and performance fatigability in isometric condition. We aimed to assess reliability and agreement for this test in dynamic conditions and with the use of transcranial magnetic stimulation. On two separate sessions, 20 young adults (25 ± 4 yr, 10 women) performed stages of 100 knee extensors concentric contractions at 120°/s (60° range-of-motion) with 10% increments of the initial maximal concentric torque until exhaustion. Performance fatigability across the test was quantified as maximal isometric and concentric torque loss, and its mechanisms were investigated through the responses to transcranial magnetic and electrical stimulations. Reliability and agreement were assessed using ANOVAs, coefficients of variation (CVs) and intra-class correlation coefficients (ICCs) with 95% CI. Good inter-session reliability and high agreement were found for number of contractions [489 ± 75 vs. 503 ± 95; P = 0.20; ICC = 0.85 (0.66; 0.94); CV = 5% (3; 7)] and total work [11,285 ± 4,932 vs. 11,792 ± 5838 Nm.s; P = 0.20; ICC = 0.95 (0.87; 0.98); CV = 8% (5; 11)]. Poor reliability but high agreement were observed for isometric [–33 ± 6 vs. −31 ± 7%; P = 0.13; ICC = 0.47 (0.05; 0.75); CV = 6% (4;8)] and concentric [−20 ± 11% vs. −19 ± 9%; P = 0.82; ICC = 0.26 (−0.22; 0.63); CV = 9% (6; 12)] torque loss. The dynamic QIF test represents a promising tool for neuromuscular evaluation in isokinetic mode.

Given that increased use of the knee extensors relative to the hip extensors may contribute to various knee injuries, there is a need for a practical method to characterize movement behavior indicative of how individuals utilize the hip and knee extensors during dynamic tasks. The purpose of the current study was to determine whether the difference between sagittal plane trunk and tibia orientations obtained from 2D video (2D trunk–tibia) could be used to predict the average hip/knee extensor moment ratio during athletic movements. Thirty-nine healthy athletes (15 males and 24 females) performed 6 tasks (step down, drop jump, lateral shuffle, deceleration, triple hop, and side-step-cut). Lower-extremity kinetics (3D) and sagittal plane video (2D) were collected simultaneously. Linear regression analysis was performed to determine if the 2D trunk–tibia angle at peak knee flexion predicted the average hip/knee extensor moment ratio during the deceleration phase of each task. For each task, an increase in the 2D trunk–tibia angle predicted an increase in the average hip/knee extensor moment ratio when adjusted for body mass (all P R2 = .17–.77). The 2D trunk–tibia angle represents a practical method to characterize movement behavior that is indicative of how individuals utilize the hip and knee extensors during dynamic tasks.

The aim of the present study was to investigate the effect of the application of neuromuscular electrical stimulation to the quadriceps muscle of the paretic limb during externally induced stance perturbations on reactive balance control and on fall outcomes in people with chronic stroke. Ten participants experienced 12 stance treadmill perturbation trails, 6 forward balance perturbation trials and 6 backward balance perturbation trials. For each perturbation condition, three perturbation trials were delivered synchronized with neuromuscular electrical stimulation applied to the quadriceps of the paretic limb and three perturbation trials were delivered without stimulation. Behavioral outcome measures, such as incidence of laboratory falls and number of compensatory steps, kinematic outcome measures, such as margin of stability and minimum hip high values after the perturbation, step initiation time, step execution time and step length of the stepping leg were analyzed. The application of neuromuscular electrical stimulation on the paretic quadriceps between the range of 50 and 500 ms after stance forward and backward perturbations reduced the laboratory falls incidence (p

Introduction The aim of this study was to evaluate the intra and inter-rater and inter-analyzer reliability of neuromuscular variables and functional tests. Methods Cross-sectional crossover design. Two independent raters and analyzers evaluated twenty-two healthy subjects. Knee-extensor strength was assessed from three maximal voluntary isometric contractions. Muscle activation was obtained from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles. VL and RF muscles’ architecture [fascicle length (FL), pennation angle (PA), muscle thickness (MT)] was obtained at rest by ultrasound. The time from five sit-to-stand (STS) trials, and the distance from the 6-min walk test (6MWT) were obtained. Intraclass correlation coefficient was determined and classified as strong (r = 0.75–1.00), moderate (r = 0.40–0.74), and weak (r Results Strong intra-rater reliability values were observed for strength (r = 0.97), muscle activation [VL (r = 0.91); RF (r = 0.92); VM (r = 0.80)], VL [FL (r = 0.90); PA (r = 0.94); MT (r = 0.99)] and RF [MT (r = 0.85)] muscle architecture, STS (r = 0.95), and 6MWT (r = 0.98). Inter-rater reliability also presented strong values for strength (r = 0.97), muscle activation [VL (r = 0.94); RF (r = 0.79); VM (r = 0.78)], muscle architecture VL [PA (r = 0.81) and MT (r = 0.88)] and RF [MT (r = 0.80)], STS (r = 0.93), and 6MWT (r = 0.98). A moderate correlation VL muscle architecture [FL (r = 0.69)]. Inter-analyzer muscle architecture reliability presented strong VL [FL (r = 0.77); PA (r = 0.76); MT (r = 0.91)] and RF [MT (r = 0.99)]. Conclusion The high intra and inter-rater and inter-analyzer reliability values for most variables is evidence that they can be used for clinical evaluation. Muscle architecture might need a longer training period by different raters and analyzers to increase reliability.

This study compared the kinetics, barbell, and joint kinematics and muscle activation patterns between a one-repetition maximum (1-RM) Smith machine squat and isometric squats performed at 10 different heights from the lowest barbell height. The aim was to investigate if force output is lowest in the sticking region, indicating that this is a poor biomechanical region. Twelve resistance trained males (age: 22 ± 5 years, mass: 83.5 ± 39 kg, height: 1.81 ± 0.20 m) were tested. A repeated two-way analysis of variance showed that Force output decreased in the sticking region for the 1-RM trial, while for the isometric trials, force output was lowest between 0–15 cm from the lowest barbell height, data that support the sticking region is a poor biomechanical region. Almost all muscles showed higher activity at 1-RM compared with isometric attempts (p &lt, 0.05). The quadriceps activity decreased, and the gluteus maximus and shank muscle activity increased with increasing height (p ≤ 0.024). Moreover, the vastus muscles decreased only for the 1-RM trial while remaining stable at the same positions in the isometric trials (p = 0.04), indicating that potentiation occurs. Our findings suggest that a co-contraction between the hip and knee extensors, together with potentiation from the vastus muscles during ascent, creates a poor biomechanical region for force output, and thereby the sticking region among recreationally resistance trained males during 1-RM Smith machine squats.

WOS:000731456300036 PubMed ID:34565133 Background/aim: This study was conducted to compare the effects of conventional physiotherapy and two different 'proprioceptive neuromuscular facilitation' (PNF) techniques on knee muscle strength, knee muscular endurance, and proprioception in knee osteoarthritis (KOA). Materials and methods: The study included 35 patients between the ages of 47 and 62 who were diagnosed with stage 1-2 KOA. The patients were divided into three groups with block randomization method as Repeated Stretching Group (N = 12) With Repeated Stretching Technique, Combined Isotonic Contraction Group (N = 11) With Combined Isotonic Contractions (CIC) Technique, And Conventional Physiotherapy Group (n = 12). PNF was applied to all patterns of the lower extremity in full pattern and patients in all groups were treated for 6 weeks, 3 days a week. Muscle strength, muscle endurance, and proprioception were evaluated with Biodex System Pro3 (Biodex Corp. Shirley NY, USA). Results: Knee extensor muscle strength showed more improvement at CIC group than the other groups, and CIC group showed more improvement compared to the conventional physiotherapy in terms of knee joint position sensation evaluated at 60 degrees (p < 0.05). Conclusion: All methods were effective in patients with early-stage knee osteoarthritis; however, the most effective results were obtained by PNF using CIC technique.

BACKGROUND Due to the large number of jumping and landing movements, volleyball exerts a high demand on lower limbs, causing a high incidence of injuries. On average, 52% of volleyball injuries occur in lower limbs. Y Balance-test (YBT) is widely used to predict lower limb injury in athletes who jump, so it is important to identify whether the hip and knee stabilizer muscle strength is related to the performance of this test, since muscle strength is important for injury prevention, given the possibility of modifying these factors. The aim of this cross-sectional study was to correlate the strength of the knee and hip stabilizing muscles with YBT in adolescent volleyball athletes. METHODS A study including 25 young volleyball players (aged 15.3 [0.85] years), was evaluated. The isometric strength of knee extensor muscles, abductors, extensors and lateral hip rotators were assessed by using the manual isometric dynamometer (Lafaytte Instrument Company®, Lafayette, IN, USA). YBT was performed three times on each posterolateral (PL), anterior (ANT) and posteromedial (PM) direction to evaluate the dominant leg. The average of 3 repetitions of isometric strength tests of tested muscles and YBT was analyzed. Pearson's Correlation test was used for the correlation of the variables, considering as strong correlation values (0.5≤r

IntroductionInjuries to the quadriceps extensor mechanism are rare in patients with Osteogenesis Imperfecta (OI). To the best of our knowledge, non-union of the patella in OI, either as an isolated problem or in combination with an acute fracture, has not been previously reported.Case reportWe describe how we surgically approached both the fracture and the non-union simultaneously. The surgical technique and steps are described in detail. Post-operative course was uneventful and the outcome was favorable, with full return of function for the patient.ConclusionA review of various knee extensor mechanism injuries in OI is described as illustrated in a single patient. The unusual simultaneous surgical treatment of a non-union and an acute fracture in the same patella shows that despite the severely compromised bone in this rare bone disease the bone still has a capacity to heal with a functional outcome.