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Agreement Between Investigators Using Paired-Pulse Transcranial Magnetic Stimulation to Assess Quadriceps Intracortical Excitability

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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MRI-Based Assessment of Lower-Extremity Muscle Volumes in Patients Before and After ACL Reconstruction

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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Effects of Whole-Body Vibration Training on Knee Muscle Strength After Anterior Cruciate Ligament Reconstruction: A Critically Appraised Topic

Bensu Sogut, Habib Ozsoy, Recep Baloglu, and Gulcan Harput

consequence of ACL reconstruction, quadriceps and hamstring strength weakness is the most commonly seen impairment. 4 Even following advanced and accelerated rehabilitation programs, strength decrement in knee muscles could persist at the time of return to sport. 5 In the early phase of rehabilitation

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Kinesio® Tape Barrier Does Not Inhibit Intramuscular Cooling During Cryotherapy

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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Temporal Patterns of Knee-Extensor Isokinetic Torque Strength in Male and Female Athletes Following Comparison of Anterior Thigh and Knee Cooling Over a Rewarming Period

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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Late Activation of the Vastus Medialis in Determining the Risk of Anterior Cruciate Ligament Injury in Soccer Players

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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Longitudinal Quadriceps Strength Recovery After Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: Patients Stratified by Preoperative Quadriceps Strength Deficit

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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Quadriceps Function and Athletic Performance in Highly Trained Female Athletes

Frederick J. Henderson, Wakana Sasakabe, Kuwano Satoshi, Norihiro Shima, and Yohei Shimokochi

The quadriceps femoris—the main knee-extensor muscles—accelerate and decelerate the center of mass of the body during weight-bearing motions such as walking, running, jumping, or landing. 1 , 2 In athletic populations, quadriceps strength is important to sport performance because higher knee

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Alterations in Quadriceps Neurologic Complexity After Anterior Cruciate Ligament Reconstruction

Steven M. Davi, Colleen K. Woxholdt, Justin L. Rush, Adam S. Lepley, and Lindsey K. Lepley

Unresolved alterations in quadriceps neural activity are common after anterior cruciate ligament reconstruction (ACLR) and clinically significant, as depressed neural activity interferes with recovery. 1 – 3 To estimate incomplete neural activation, traditionally, quadriceps activation failure has

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The Importance of Functional Hamstring/Quadriceps Ratios in Knee Osteoarthritis

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