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Abbey C. Thomas, Brian G. Pietrosimone and Carter J. Bayer

Context: Transcranial magnetic stimulation (TMS) may provide important information regarding the corticospinal mechanisms that may contribute to the neuromuscular activation impairments. Paired-pulse TMS testing is a reliable method for measuring intracortical facilitation and inhibition; however, little evidence exists regarding agreement of these measures in the quadriceps. Objective: To determine the between-sessions and interrater agreement of intracortical excitability (short- and long-interval intracortical inhibition [SICI, LICI] and intracortical facilitation [ICF]) in the dominant-limb quadriceps. Design: Reliability study. Setting: Research laboratory. Participants: 13 healthy volunteers (n = 6 women; age 24.7 ± 2.1 y; height 1.7 ± 0.1 m; mass 77.1 ± 17.4 kg). Intervention: Participants completed 2 TMS sessions separated by 1 wk. Main Outcome Measures: Two investigators measured quadriceps SICI, LICI, and ICF at rest and actively (5% of maximal voluntary isometric contraction). All participants were seated in a dynamometer with the knee flexed to 90°. Intracortical-excitability paradigm and investigator order were randomized. Bland-Altman analyses were used to establish agreement. Results: Agreement was stronger between sessions within a single investigator than between investigators and for active than resting measures. Agreement was strongest for resting SICI and active ICF and LICI between sessions for each investigator. Conclusions: Quadriceps intracortical excitability may be measured longitudinally by a single investigator, though active muscle contraction should be elicited during testing.

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Grant E. Norte, Katherine R. Knaus, Chris Kuenze, Geoffrey G. Handsfield, Craig H. Meyer, Silvia S. Blemker and Joseph M. Hart

estimates of force production and may be insufficient to detect subtle changes among individual muscle properties. For example, the individual muscles of the quadriceps femoris are reported to contribute differently to maximum knee extension torque in patients following ACL-R. 17 Timing from surgery may

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Yuya Ueda, Takehiko Matsushita, Yohei Shibata, Kohei Takiguchi, Akihiro Kida, Daisuke Araki, Noriyuki Kanzaki, Yuichi Hoshino, Rei Ono, Yoshitada Sakai and Ryosuke Kuroda

Anterior cruciate ligament (ACL) reconstruction has been widely performed to treat patients with ACL injuries, and the overall outcomes were satisfactory in previous reports. 1 Although most patients regain knee stability and functional recovery after ACL reconstruction, 2 , 3 quadriceps strength

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Özlem Aslan, Elif Balevi Batur and Jale Meray

intensive mechanical stress and impaired muscle functions—can be responsible for the development of knee OA. 4 – 7 Most of the studies showed that the lower-extremity muscle, especially quadriceps, weakness results in knee OA. These studies defined correlations between quadriceps weakness, knee pain, and

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Jill Alexander and David Rhodes

AvT quadriceps strength compared with baseline measurements following a 20-minute crushed ice application to the knee did not fully recover at 20-minute postcooling intervention in a recent study. 27 The authors suggest reductions in concentric strength can still occur even when indirectly cooled

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Katie J. Lyman, Michael McCrone, Thomas A. Hanson, Christopher D. Mellinger and Kara Gange

subjects had experienced any injury to the quadriceps in the 6 months prior to participation. Procedures Each participant reported for 2 sessions, scheduled 1 week apart, and was randomly assigned to receive Kinesio ® Tape in one of the 2 sessions. The self-determined dominant leg of each participant was

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Nicola Marotta, Andrea Demeco, Gerardo de Scorpio, Angelo Indino, Teresa Iona and Antonio Ammendolia

demonstrated that girls after menarche increase their quadriceps strength greater than their hamstring strength, which may put them at risk for ACL injury. Joint compression through muscular co-contraction allows valgus load to be carried by articular contact forces, protecting the ligaments. Several authors

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Gulcan Harput, Volga B. Tunay and Matthew P. Ithurburn

subsequent physical activity, several musculoskeletal impairments are observed during rehabilitation, including deficits in knee range of motion, 3 knee joint laxity, 4 and, most commonly, quadriceps and hamstring muscle weakness. 5 – 8 Often, strength recovery of the involved limb quadriceps and

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Lauren Anne Lipker, Caitlyn Rae Persinger, Bradley Steven Michalko and Christopher J. Durall

Clinical Scenario Quadriceps atrophy and weakness are common after anterior cruciate ligament reconstruction (ACLR). 1 , 2 Blood flow restriction (BFR) therapy, alone or in combination with exercise, has shown some promise in promoting muscular hypertrophy. 1 – 3 This review was conducted to

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Erik H. Arve, Emily Madrak and Aric J. Warren

common for patients to struggle with long-lasting impairments postoperation. One of these is quadriceps strength impairment, which may be as high as 18% at 2 years post ACL repair. 2 Quadriceps strength is strongly associated with athletic performance and likelihood of re-injury after the athlete