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Cameron Haun, Cathleen N. Brown, Kimberly Hannigan and Samuel T. Johnson

, Hertel J . Intrinsic foot muscle activation during specific exercises: a T2 time magnetic resonance imaging study . J Athl Train . 2016 ; 51 ( 8 ): 644 – 650 . PubMed ID: 27690528 doi: 10.4085/1062-6050-51.10.07 27690528 9. Lynn SK , Padilla RA , Tsang KKW . Differences in static- and

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Taylor Meier, Brice Snyder, Jennifer W. Cuchna and Johanna M. Hoch

Clinical Question:

In a healthy adult population, which push-up position produces the greatest mean serratus anterior (SA) activation, expressed as a percentage of maximum voluntary isometric contraction (MVIC)?

Clinical Bottom Line:

In a healthy population, there is moderate evidence to support the use of the standard push-up on an unstable surface, elbow push-ups on stable and unstable surfaces, wall push-ups on an unstable surface, the full weight-bearing position using the Cuff Link system, and all three hand positions (shoulder width, wide base, and narrow base) with and without the use of the Perfect Pushup™ handgrips for the purpose of SA strengthening. These exercises produced a mean SA activation of at least 50% of the MVIC in the four cross-sectional studies that were reviewed for this critically appraised topic.

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Tom G. Welter and Maarten F. Bobbert

It has been shown in previous research that the initial phase of EMG for a punching movement remained almost unchanged regardless of whether an external force was applied to the arm. The purpose of the present study was to explain this finding with the help of simulations. A two-dimensional model of me arm actuated by 6 Hill-type muscles was used to simulate a punching movement in the horizontal plane from a prescribed starting position with 90° elbow flexion. Input to the model was the stimulation of me muscles, and output were, among others, muscle forces and segmental accelerations. A genetic algorithm was used to determine the muscle onset times mat minimized movement duration and targeting error. In a subsequent forward simulation, the optimized muscle onset times for an unloaded punching movement were superimposed on the isometric stimulation necessary to hold me arm in the starting position while an external force was applied to the arm. The resulting movement was only slightly different from the unloaded movement. It appeared that because of the low level of isometric muscle force prior to the movement, and the high level of stimulation during the movement, muscle force was increased at a rate mat was almost independent of the prior force level. These results confirmed the suggestion that the initial phase of EMG in ballistic movements is more related to the rate of change of force than to the absolute force level. It is hypothesized mat this may simplify the task of the nervous system in the choice of initial muscle activity in ballistic arm movements because no adjustments to varying external forces are required.

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Elisabeth Macrum, David Robert Bell, Michelle Boling, Michael Lewek and Darin Padua


Limitations in gastrocnemius/soleus flexibility that restrict ankle dorsiflexion during dynamic tasks have been reported in individuals with patellofemoral pain (PFP) and are theorized to play a role in its development.


To determine the effect of restricted ankle-dorsiflexion range of motion (ROM) on lower extremity kinematics and muscle activity (EMG) during a squat. The authors hypothesized that restricted ankle-dorsiflexion ROM would alter knee kinematics and lower extremity EMG during a squat.




30 healthy, recreationally active individuals without a history of lower extremity injury.


Each participant performed 7 trials of a double-leg squat under 2 conditions: a nowedge condition (NW) with the foot flat on the floor and a wedge condition (W) with a 12° forefoot angle to simulate reduced plantar-flexor flexibility.

Main Outcome Measures:

3-dimensional hip and knee kinematics, medial knee displacement (MKD), and ankle-dorsiflexion angle. EMG of vastus medialis oblique (VMO), vastus lateralis (VL), lateral gastrocnemius (LG), and soleus (SOL). One-way repeated-measures ANOVAs were performed to determine differences between the W and NW conditions.


Compared with the NW condition, the wedge produced decreased peak knee flexion (P < .001, effect size [ES] = 0.81) and knee-flexion excursion (P < .001, ES = 0.82) while producing increased peak ankle dorsiflexion (P = .006, ES = 0.31), ankle-dorsiflexion excursion (P < .001, ES = 0.31), peak knee-valgus angle (P = .02, ES = 0.21), and MKD (P < .001, ES = 2.92). During the W condition, VL (P = 0.002, ES = 0.33) and VMO (P = .049, ES = 0.20) activity decreased while soleus activity increased (P = .03, ES = 0.64) compared with the NW condition. No changes were seen in hip kinematics (P > .05).


Altering ankle-dorsiflexion starting position during a double-leg squat resulted in increased knee valgus and MKD, as well as decreased quadriceps activation and increased soleus activation. These changes are similar to those seen in people with PFP.

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Boris I. Prilutsky

In this response, the major criticisms of the target article are addressed. Terminology from the target article that may have caused some confusion is clarified. In particular, the tasks that have the basic features of muscle coordination, as identified in the target article, have been limited in scope. Anew metabolic optimization criterion suggested by Alexander (2000) is examined for its ability to predict muscle coordination in walking. Issues concerning the validation of muscle force predictions, the rules of muscle coordination, and the role of directional constraints in coordination of two-joint muscles are discussed. It is shown in particular that even in one-joint systems, the forces predicted by the criterion of Crowninshield and Brand (1981) depend upon the muscle moment arms and the physiological cross-sectional areas in much more complex ways than either previously assumed in the target article, or incorrectly derived by Herzog and Ait-Haddou (2000). It is concluded that the criterion of Crowninshield and Brand qualitatively predicts the basic coordination features of the major one- and two-joint muscles in a number of highly skilled, repetitive motor tasks performed by humans under predictable conditions and little demands on stability and accuracy. A possible functional significance of such muscle coordination may be the minimization of perceived effort, muscle fatigue, and/or energy expenditure.

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Lilian F. Wallerstein, Renato Barroso, Valmor Tricoli, Marco T. Mello and Carlos Ugrinowitsch

Ramp isometric contractions determine peak torque (PT) and neuromuscular activation (NA), and ballistic contractions can be used to evaluate rate of torque development (RTD) and electrical mechanical delay (EMD). The purposes of this study were to assess the number of sessions required to stabilize ramp and ballistic PT and to compare PT and NA between contractions in older adults. Thirty-five older men and women (age 63.7 ± 3.7 yr, body mass 64.3 ± 10.7 kg, height 159.2 ± 6.6 cm) performed 4 sessions of unilateral ramp and ballistic isometric knee extension, 48 hr apart. PT significantly increased (main time effect p < .05) from the first to the third session, with no further improvements thereafter. There was a trend toward higher PT in ballistic than in ramp contractions. No difference between contraction types on EMG values was observed. Therefore, the authors suggest that 3 familiarization sessions be performed to correctly assess PT. In addition, PT, NA, RTD, and EMD can be assessed with ballistic contraction in older adults.

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Luciana Brondino, Esther Suter, Hae-Dong Lee and Walter Herzog

Muscle inhibition (MI) in human knee extensors increases with increasing maximal voluntary force as a function of knee angle. It was speculated that this angle-dependent MI was modulated by force-dependent feedback, likely Golgi tendon organ pathways. Such angle-dependent MI is of clinical and theoretical importance. The purpose of this study was to determine MI in human elbow flexors for maximal voluntary contractions. Muscle inhibition, elbow flexor force, and electromyographic (EMG) activity were measured in 31 volunteers at elbow angles between 30º and 120º. MI and elbow flexor EMG were the same at all elbow angles. Maximal isometric forces were greatest at the 70º angle, and never fell below 70% of the peak force at any of the tested angles. From these results it is concluded that force-dependent modulation of MI did not occur in the elbow flexors, possibly because maximal isometric force remained relatively close (within 30%) to the peak force. In contrast, force-dependent modulation of MI occurred in the knee extensors at the most extended angles, when the average knee extensor force had dropped to 50% or less of the maximal knee extensor force. It is likely that human maximal voluntary contractions are not associated with a given activation. Rather, activation appears to be modulated by force-dependent feedback at force levels below 70% of the absolute peak force, which manifests itself in a change of MI that parallels the level of maximal isometric force in voluntary contractions.

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Alan Hreljac, Alan Arata, Reed Ferber, John A. Mercer and Brandi S. Row

Previous research has demonstrated that the preferred transition speed during human locomotion is the speed at which critical levels of ankle angular velocity and acceleration (in the dorsiflexor direction) are reached, leading to the hypothesis that gait transition occurs to alleviate muscular stress on the dorsiflexors. Furthermore, it has been shown that the metabolic cost of running at the preferred transition speed is greater than that of walking at that speed. This increase in energetic cost at gait transition has been hypothesized to occur due to a greater demand being placed on the larger muscles of the lower extremity when gait changes from a walk to a run. This hypothesis was tested by monitoring electromyographic (EMG) activity of the tibialis anterior, medial gastrocnemius, vastus lateralis, biceps femoris, and gluteus maximus while participants (6 M, 3 F) walked at speeds of 70, 80, 90, and 100% of their preferred transition speed, and ran at their preferred transition speed. The EMG activity of the tibialis anterior increased as walking speed increased, then decreased when gait changed to a run at the preferred transition speed. Concurrently, the EMG activity of all other muscles that were monitored increased with increasing walking speed, and at a greater rate when gait changed to a run at the preferred transition speed. The results of this study supported the hypothesis presented.