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Chang-Hee Ko, Heon-Seock Cynn, Ji-Hyun Lee, Tae-Lim Yoon and Sil-Ah Choi

Context:

Scapular bracing can correct scapular kinematics and restore normal scapular-muscle activity. However, there is little evidence to support the beneficial effects of a figure-8 strap, a type of scapular bracing, on muscle length, scapular alignment, and muscle activity during arm-lifting exercise.

Objective:

To investigate the immediate effect of a figure-8 strap on pectoralis minor length, scapular alignment, and scapular upward-rotator-muscle activity.

Design:

Cross-sectional study.

Setting:

Research laboratory.

Participants:

Fifteen male participants (age 22.1 ± 1.9 y, weight 68.2 ± 5.7 kg, height 176.2 ± 3.3 cm) with forward shoulder posture (FSP) were examined for pectoralis minor length and scapular alignment with and without the application of a figure-8 strap.

Main Outcome Measures:

Pectoralis minor length was measured using the Pectoralis Minor Index (PMI), scapular alignment was measured with FSP, and upper trapezius, lower trapezius, and serratus anterior muscle activity were measured using surface electromyography while participants performed an arm-lifting exercise. Data collected with and without applying a figure-8 strap were compared using a paired t-test.

Results:

Applying a figure-8 strap significantly decreased the PMI (P = .005) and scapular anterior tilting (P = .000). There were no differences in the muscle activity of the upper trapezius (P = .784), lower trapezius (P = .241), and serratus anterior muscles (P = .639).

Conclusions:

A figure-8 strap resulted in positive changes in pectoralis minor length and scapular alignment. The results support its use as a treatment aid in managing pectoralis minor length and scapular alignment during arm-lifting exercises.

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Kevin McCurdy and John Walker

Context: Within each hamstring muscle, there are segments with separate nerve innervation. However, a better understanding of activation levels within these regions during resistance exercise could lead to region-specific training for improved performance and injury prevention. Objective: To compare muscle activation levels within regions of the hamstrings during various resistance exercises. Design: Within-subjects repeated measures. Setting: Biomechanics laboratory. Participants: Eighteen young adult females with previous competitive sport participation and resistance training experience. Intervention: One set of 3 repetitions with an 8RM load on the bilateral squat, modified single-leg squat, stiff-legged dead lift, and leg curl (LC). Main Outcome Measures: Normalized surface electromyography of 4 hamstring regions (proximal-medial, proximal-lateral, distal-medial, and distal-lateral). Results: For LC only, electromyography measures for the proximal-lateral location were significantly lower than for the distal-lateral, t 18 = 5.6, P < .001, and proximal-medial, t 18 = 2.4, P = .01 locations for concentric contractions. Similar results were observed for eccentric contractions. No other exercises revealed regional activation differences. When comparing the pooled proximal (medial and lateral) region across exercises, the LC demonstrated significantly greater activation than the modified single-leg squat, t 18 = 5.20, P < .001, stiff-legged dead lift, t 18 = 7.311, P < .001, and bilateral squat, F 3,54 = 49.8, P < .001. Similar significantly greater levels were also found during the LC for the pooled distal, medial, and lateral regions. In addition, the modified single-leg squat electromyography was significantly greater at all regions in comparison with the stiff-legged dead lift and bilateral squat. Conclusions: The data did not reveal consistent regional differences within the different exercises included in this study. However, the data indicate that the LC produces the highest hamstring activation in all regions across exercises. Inclusion of single-joint knee-flexion exercises would appear to be most beneficial for hamstrings development in a resistance-training program.

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Michael Sanders, Anton E. Bowden, Spencer Baker, Ryan Jensen, McKenzie Nichols and Matthew K. Seeley

Context: Foot and ankle injuries are common and often require a nonweight-bearing period of immobilization for the involved leg. This nonweight-bearing period usually results in muscle atrophy for the involved leg. There is a dearth of objective data describing muscle activation for different ambulatory aids that are used during the aforementioned nonweight-bearing period. Objective: To compare activation amplitudes for 4 leg muscles during (1) able-bodied gait and (2) ambulation involving 3 different ambulatory aids that can be used during the acute phase of foot and ankle injury care. Design: Within-subject, repeated measures. Setting: University biomechanics laboratory. Participants: Sixteen able-bodied individuals (7 females and 9 males). Intervention: Each participant performed able-bodied gait and ambulation using 3 different ambulatory aids (traditional axillary crutches, knee scooter, and a novel lower-leg prosthesis). Main Outcome Measure: Muscle activation amplitude quantified via mean surface electromyography amplitude throughout the stance phase of ambulation. Results: Numerous statistical differences (P < .05) existed for muscle activation amplitude between the 4 observed muscles, 3 ambulatory aids, and able-bodied gait. For the involved leg, comparing the 3 ambulatory aids: (1) knee scooter ambulation resulted in the greatest vastus lateralis activation, (2) ambulation using the novel prosthesis and traditional crutches resulted in greater biceps femoris activation than knee scooter ambulation, and (3) ambulation using the novel prosthesis resulted in the greatest gastrocnemius activation (P < .05). Generally speaking, muscle activation amplitudes were most similar to able-bodied gait when subjects were ambulating using the knee scooter or novel prosthesis. Conclusions: Type of ambulatory aid influences muscle activation amplitude. Traditional axillary crutches appear to be less likely to mitigate muscle atrophy during the nonweighting, immobilization period that often follows foot or ankle injuries. Researchers and clinicians should consider these results when recommending ambulatory aids for foot or ankle injuries.

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Mohammad H. Izadi Farhadi, Foad Seidi, Hooman Minoonejad and Abbey C. Thomas

Context: Many factors have been reported contributing to altering the neuromuscular function of hip and knee muscles. The lumbar hyperlordosis, as a poor posture in some athletes, is thought to be associated with the alteration of the hip and knee muscles activity. Objective: To examine the activation of selected hip and knee muscles in athletes with and without lumbar hyperlordosis during functional activities. Design: Case-control study. Setting: University laboratory. Participants: Twenty-six college male athletes (n = 13 with and n = 13 without lumbar hyperlordosis). Interventions: Surface electromyography of gluteus maximus (GMAX), gluteus medius (GMED), vastus medialis oblique (VMO), and vastus lateralis (VL) were recorded during single-leg squat and single-leg jump landing (SLJL) tasks. Main Outcome Measure: Preactivity; reactivity; and onset muscle during SLJL and eccentric activity during single-leg squat (GMAX, GMED, VMO, and VL along with the ratio of VMO:VL) were assessed. Results: Athletes with lumbar hyperlordosis had a higher level of activity in their GMAX (P = .003), VMO (P = .04), and VL (P = .01) muscles at the moment before foot contact during SLJL. These athletes also demonstrated a higher level of GMAX activity (P = .01) immediately after foot contact. Finally, athletes with lumbar hyperlordosis activated their GMAX sooner (P = .02) during the SLJL. Athletes with normal lumbar lordosis had more activity in their GMED muscle (P = .001) in the descending phase of the single-leg squat task and a higher VMO:VL (P = .01) at the moment after the foot contact during the SLJL. Conclusion: The altered activation of GMAX, GMED, VMO, VL, and VMO:VL can reveal the role of lumbar hyperlordosis in the knee and hip muscles’ alteration in athletes. Further study is needed to identify whether these alterations in the hip and knee muscles contribute to injury in athletes.

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Cindy Y. Lin, Liang-Ching Tsai, Joel Press, Yupeng Ren, Sun G. Chung and Li-Qun Zhang

Context:

Gluteal-muscle strength has been identified as an important component of injury prevention and rehabilitation in several common knee injuries. However, many conventionally prescribed gluteal-strengthening exercises are not performed during dynamic weight-bearing activities, which is when most injuries occur.

Objectives:

To compare lower-limb muscle-activation patterns between conventional gluteal-strengthening exercises and off-axis elliptical exercises with motorized foot-plate perturbations designed to activate gluteal muscles during dynamic exercise.

Evidence Acquisition:

Twelve healthy volunteers (26.1 ± 4.7 y) participated in the study. They performed 3 conventional exercises (single-leg squat, forward lunge, and clamshell) and 3 elliptical exercises (regular, while resisting an adduction force, and while resisting an internal-rotation torque). Gluteus medius (GMed) and maximus (GMax), quadriceps, hamstrings, and gastrocnemius muscle activations during each exercise were recorded using surface electromyography (EMG) and normalized to maximal voluntary isometric contraction (MVIC).

Evidence Synthesis:

Normalized GMed EMG was the highest during the adduction-resistance elliptical exercise (22.4% ± 14.8% MVIC), significantly greater than forward lunge (8.2% ± 3.8% MVIC) and regular elliptical (6.4% ± 2.5% MVIC) and similar to clamshell (19.1% ± 8.8% MVIC) and single-leg squat (18.4% ± 7.9% MVIC). Normalized GMax EMG during adduction-resistance (11.1% ± 7.6% MVIC) and internal-rotation-resistance elliptical (7.4% ± 3.8% MVIC) was significantly greater than regular elliptical (4.4% ± 2.4% MVIC) and was similar to conventional exercises. The single-leg squat required more muscle activation from the quadriceps and gastrocnemius than the elliptical exercises.

Conclusions:

Off-axis elliptical exercise while resisting an adduction force or internal-rotation torque activates gluteal muscles dynamically while avoiding excessive quadriceps activation during a functional weight-bearing activity compared with conventional gluteal-strengthening exercises.

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Paul Comfort, Amy Regan, Lee Herrington, Chris Thomas, John McMahon and Paul Jones

Context:

Regular performance (~2×/wk) of Nordic curls has been shown to increase hamstring strength and reduce the risk of hamstring strain injury, although no consensus on ankle position has been provided.

Objective:

To compare the effects of performing Nordic curls, with the ankle in a dorsiflexed (DF) or plantar-flexed (PF) position, on muscle activity of the biceps femoris (BF) and medial gastrocnemius (MG).

Participants:

15 male college athletes (age 22.6 ± 2.1 y, height 1.78 ± 0.06 m, body mass 88.75 ± 8.95 kg).

Design:

A repeated-measures design was used, with participants performing 2 sets of 3 repetitions of both variations of Nordic curls, while muscle activity was assessed via surface electromyography (EMG) of the BF and MG. Comparisons of muscle activity were made by examining the normalized EMG data as the percentage of their maximum voluntary isometric contraction.

Results:

Paired-samples t test revealed no significant difference in normalized muscle activity of the BF (124.5% ± 6.2% vs 128.1 ± 5.0%, P > .05, Cohen d = 0.64, power = .996) or MG (82.1% ± 3.9% vs 83.5 ± 4.8%, P > .05, Cohen d = 0.32, power = .947) during the Nordic curls in a PF or DF position, respectively.

Conclusion:

Ankle position does not influence muscle activity during the Nordic curl; however, performance of Nordic curls with the ankle in a DF position may be preferential, as this replicates the ankle position during terminal leg swing during running, which tends to be the point at which hamstring strains have been reported.

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In-cheol Jeon, Oh-yun Kwon, Jong-hyuck Weon, Ui-jae Hwang and Sung-hoon Jung

Context:

Prone hip extension has been recommended for strengthening the back and hip muscles. Previous studies have investigated prone hip extension conducted with subjects on the floor in the prone position. However, no study has compared 3 different table hip-extension (THE) positions in terms of the activities of the back- and hip-joint muscles with lumbopelvic motion.

Objective:

To identify more effective exercises for strengthening the gluteus maximus (GM) by comparing 3 different exercises (THE alone, THE with the abdominal drawing-in maneuver [THEA], and THEA with chair support under the knee [THEAC]) based on electromyographic muscle activity and pelvic compensation.

Design:

Repeated-measure within-subject intervention.

Setting:

University research laboratory.

Participants:

16 healthy men.

Main Outcome Measures:

Surface electromyography (EMG) was used to obtain data on the GM, erector spinae (ES), multifidus, biceps femoris (BF), and semitendinosus (ST). Pelvic compensation was monitored using an electromagnetic motion-tracking device. Exertion during each exercise was recorded. Any significant difference in electromyographic muscle activity and pelvic motion among the 3 conditions (THE vs THEA vs THEAC) was assessed using a 1-way repeated-measures analysis of variance (ANOVA) with Bonferroni post hoc test.

Results:

The muscle activities recorded by EMG differed significantly among the 3 exercises (P < .01). GM activity was increased significantly during THEAC (P < .01). There was a significant difference in lumbopelvic kinematics in terms of anterior tilting (F = 19.49, P < .01) and rotation (F= 27.38, P < .01) among the 3 exercises.

Conclusions:

The THEAC exercise was the most effective for strengthening the GM without overactivity of the ES, BF, and ST muscles and lumbopelvic compensation compared with THE and THEA.

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Gulcan Harput, A. Ruhi Soylu, Hayri Ertan, Nevin Ergun and Carl G. Mattacola

Context:

Coactivation ratio of quadriceps to hamstring muscles (Q:H) and medial to lateral knee muscles (M:L) contributes to the dynamic stability of the knee joint during movement patterns recommended during rehabilitation and important for daily function.

Objective:

To compare the quadriceps-to-hamstring and medial-to-lateral knee muscles' coactivation ratios between men and women during the following closed kinetic chain exercises performed on a balance board: forward lunge, side lunge, single-leg stance, and single-leg squat.

Design:

Cross-sectional.

Participants:

20 healthy subjects (10 female and 10 male).

Main Outcome Measures:

Surface electromyography was used to measure the activation level of quadriceps (vastus lateralis and medialis) and hamstrings (biceps femoris and medial hamstrings) during forward- and side-lunge, single-leg-stance, and single-leg-squat exercises. Subjects were instructed during each exercise to move into the test position and to hold that position for 15 s. EMG was recorded during the 15-s isometric period where subjects tried to maintain a “set” position while the foot was on a balance board. Analysis of variance was used for statistical analysis.

Results:

There was a significant exercise-by-gender interaction for Q:H ratio (F 3,48 = 6.63, P = .001), but the exercise-by-gender interaction for M:L ratio was not significant (F 3,48 = 1.67, P = .18). Women showed larger Q:H ratio in side-lunge exercises than men (P = .002). Both genders showed larger M:L and lower Q:H ratio in a single-leg-stance exercise than in the other exercises.

Conclusions:

The results indicate that the forward- and side-lunge and single-leg-squat exercises should not be recommended as exercise where a balanced coactivation between quadriceps and hamstring muscles is warranted. Single-leg-stance exercise could be used when seeking an exercise where the ratio is balanced for both women and men.

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Damien Moore, Tania Pizzari, Jodie McClelland and Adam I. Semciw

Context: Many different rehabilitation exercises have been recommended in the literature to target the gluteus medius (GMed) muscle based mainly on single-electrode, surface electromyography (EMG) measures. With the GMed consisting of 3 structurally and functionally independent segments, there is uncertainty on whether these exercises will target the individual segments effectively. Objective: To measure individual GMed segmental activity during 6 common, lower-limb rehabilitation exercises in healthy young adults, and determine if there are significant differences between the exercises for each segment. Method: With fine-wire EMG electrodes inserted into the anterior, middle, and posterior segments of the GMed muscle, 10 healthy young adults performed 6 common, lower-limb rehabilitation exercises. Main Outcome Measures: Recorded EMG activity was normalized, then reported and compared with median activity for each of the GMed segments across the 6 exercises. Results: For the anterior GMed segment, high activity was recorded for the single-leg squat (48% maximum voluntary isometric contraction [MVIC]), the single-leg bridge (44% MVIC), and the resisted hip abduction–extension exercise (41% MVIC). No exercises recorded high activity for the middle GMed segment, but for the posterior GMed segment very high activity was recorded by the resisted hip abduction–extension exercise (69% MVIC), and high activity was generated by the single-leg squat (48% MVIC) and side-lie hip abduction (43% MVIC). For each of the GMed segments, there were significant differences (P < .05) in the median EMG activity levels between some of the exercises and the side-lie clam with large effect sizes favoring these exercises over the side-lie clam. Conclusions: Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual GMed segments with selection dependent on individual requirements. However, the side-lie clam does not appear to be effective at recruiting the GMed segments, particularly the anterior and middle segments.

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Bjørn Harald Olstad, Christoph Zinner, João Rocha Vaz, Jan M.H. Cabri and Per-Ludvik Kjendlie

Purpose:

To investigate the muscle-activation patterns and coactivation with the support of kinematics in some of the world’s best breaststrokers and identify performance discriminants related to national elites at maximal effort.

Methods:

Surface electromyography was collected in 8 muscles from 4 world-class (including 2 world champions) and 4 national elite breaststroke swimmers during a 25-m breaststroke at maximal effort.

Results:

World-class spent less time during the leg recovery (P = .043), began this phase with a smaller knee angle (154.6° vs 161.8°), and had a higher median velocity of 0.18 m/s during the leg glide than national elites. Compared with national elites, world-class swimmers showed a difference in the muscle-activation patterns for all 8 muscles. In the leg-propulsion phase, there was less triceps brachii activation (1 swimmer 6% vs median 23.0% [8.8]). In the leg-glide phase, there was activation in rectus femoris and gastrocnemius during the beginning of this phase (all world-class vs only 1 national elite) and a longer activation in pectoralis major (world champions 71% [0.5] vs 50.0 [4.3]) (propulsive phase of the arms). In the leg-recovery phase, there was more activation in biceps femoris (50.0% [15.0] vs 20.0% [14.0]) and a later and quicker activation in tibialis anterior (40.0% [7.8] vs 52.0% [6.0]). In the stroke cycle, there was no coactivation in tibialis anterior and gastrocnemius for world champions.

Conclusion:

These components are important performance discriminants. They can be used to improve muscle-activation patterns and kinematics through the different breaststroke phases. Furthermore, they can be used as focus points for teaching breaststroke to beginners.