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Agres AN, Brisson NM, Duda GN, Jung TM. Activity-Dependent Compensation at the Hip and Ankle at 8 Years After the Reconstruction of Isolated and Combined Posterior Cruciate Ligament Injuries. Am J Sports Med 2024; 52:1804-1812. [PMID: 38761007 PMCID: PMC11143757 DOI: 10.1177/03635465241248819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/29/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND After posterior cruciate ligament reconstruction (PCLR), functional deficits at the knee can persist. It remains unclear if neighboring joints compensate for the knee during demanding activities of daily living. PURPOSE To assess long-term alterations in lower limb mechanics in patients after PCLR. STUDY DESIGN Descriptive laboratory study. METHODS A total of 28 patients who had undergone single-bundle unilateral isolated or combined PCLR performed stair navigation, squat, sit-to-stand, and stand-to-sit tasks at 8.2 ± 2.2 years after surgery. Motion capture and force plates were used to collect kinematic and kinetic data. Then, 3-dimensional hip, knee, and ankle kinematic data of the reconstructed limb were compared with those of the contralateral limb using statistical parametric mapping. RESULTS Side-to-side differences at the knee were primarily found during upward-driven movements at 8 years after surgery. The reconstructed knee exhibited lower internal rotation during the initial loading phase of stair ascent versus the contralateral knee (P = .005). During the sit-to-stand task, higher flexion angles during the midcycle (P = .017) and lower external rotation angles (P = .049) were found in the reconstructed knee; sagittal knee (P = .001) and hip (P = .016) moments were lower in the reconstructed limb than the contralateral limb. In downward-driven movements, side-to-side differences were minimal at the knee but prominent at the ankle and hip: during stair descent, the reconstructed ankle exhibited lower dorsiflexion and lower external rotation during the midcycle versus the contralateral ankle (P = .006 and P = .040, respectively). Frontal hip moments in the reconstructed limb were higher than those in the contralateral limb during the stand-to-sit task (P = .010); during squats, sagittal hip angles in the reconstructed limb were higher than those in the contralateral limb (P < .001). CONCLUSION Patients after PCLR exhibited compensations at the hip and ankle during downward-driven movements, such as stair descent, squats, and stand-to-sit. Conversely, residual long-term side-to-side differences at the knee were detected during upward-driven movements such as stair ascent and sit-to-stand. CLINICAL RELEVANCE After PCLR, side-to-side differences in biomechanical function were activity-dependent and occurred either at the knee or neighboring joints. When referring to the contralateral limb to assess knee function in the reconstructed limb, concentric, upward-driven movements should be prioritized. Compensations at the hip and ankle during downward-driven movements lead to biases in long-term functional assessments.
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Affiliation(s)
- Alison N. Agres
- Julius Wolff Institute, Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Nicholas M. Brisson
- Julius Wolff Institute, Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N. Duda
- Julius Wolff Institute, Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias M. Jung
- Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
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Watanabe K, Vieira TM, Gallina A, Kouzaki M, Moritani T. Novel Insights Into Biarticular Muscle Actions Gained From High-Density Electromyogram. Exerc Sport Sci Rev 2021; 49:179-187. [PMID: 33927163 PMCID: PMC8191471 DOI: 10.1249/jes.0000000000000254] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
Biarticular muscles have traditionally been considered to exhibit homogeneous neuromuscular activation. The regional activation of biarticular muscles, as revealed from high-density surface electromyograms, seems however to discredit this notion. We thus hypothesize the regional activation of biarticular muscles may contribute to different actions about the joints they span. We then discuss the mechanistic basis and methodological implications underpinning our hypothesis.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University, Nagoya, Japan
| | - Taian Martins Vieira
- Laboratory for Engineering of the Neuromuscular System, Electronics and Telecommunication Department, Politecnico di Torino
- PoliToBIOMed Lab, Politecnico di Torino, Torino, Italy
| | - Alessio Gallina
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Motoki Kouzaki
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University
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Ema R, Nosaka K, Kawashima R, Kanda A, Ikeda K, Akagi R. Muscle length influence on rectus femoris damage and protective effect in knee extensor eccentric exercise. Scand J Med Sci Sports 2020; 31:597-609. [PMID: 33249658 PMCID: PMC7986188 DOI: 10.1111/sms.13890] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/31/2020] [Accepted: 11/24/2020] [Indexed: 01/18/2023]
Abstract
This study tested the hypothesis that the magnitude of rectus femoris (RF) damage and the repeated bout effect (RBE) would be greater after knee extensor eccentric exercise performed in a supine (long RF lengths) than a sitting (short RF lengths) position, and the muscle length effects would be more prominent at the proximal than distal RF. Young untrained men were placed to one of the two groups (n = 14 per group). S group performed the knee extensor eccentric exercise in the sitting position for the first bout and the supine position for the second bout, and L group performed the exercise in the supine position for two bouts, with 4 weeks between bouts. Dependent variables included evoked and maximal voluntary isometric contraction (MVC) torque, electromyography (EMG) during MVC, muscle soreness, and shear modulus, which were measured before and 1‐3 days after each exercise bout. After the first bout, L group in comparison with S group showed greater (P < .05) changes in hip flexor MVC torque (average of 1‐3 days post‐exercise: −11.1 ± 9.4% vs −5.0 ± 7.5%), proximal RF EMG (−22.4 ± 16% vs −9.0 ± 21.9%), and proximal RF shear modulus (33.2 ± 22.8% vs 16.9 ± 13.5%). No significant differences between groups were evident for any of other variables after the first bout including knee extensor MVC torque, and for the changes in all variables after the second bout. These results supported the hypothesis that RF damage would be greater for the spine than sitting position especially at the proximal region, but did not support the hypothesis about the RBE.
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Affiliation(s)
- Ryoichi Ema
- School of Management, Shizuoka Sangyo University, Iwata, Japan
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Centre for Exercise and Sports Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Ryosuke Kawashima
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Akihiro Kanda
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.,Mizuno Corporation, Osaka, Japan
| | - Koya Ikeda
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.,Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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Comparison of Regional Hamstrings Activation During Resistance Exercises in Females With Prior Athletic Experience. J Sport Rehabil 2020; 29:813-819. [PMID: 31553950 DOI: 10.1123/jsr.2019-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/17/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022]
Abstract
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, t18 = 5.6, P < .001, and proximal-medial, t18 = 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, t18 = 5.20, P < .001, stiff-legged dead lift, t18 = 7.311, P < .001, and bilateral squat, F3,54 = 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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Watanabe K. Relationship Between Toe Clearance Strategy and Regional Regulation of Rectus Femoris Muscle During Swing Phase in Prolonged Walking in Young and Older Adults. Front Physiol 2018; 9:1274. [PMID: 30237768 PMCID: PMC6136235 DOI: 10.3389/fphys.2018.01274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/21/2018] [Indexed: 11/25/2022] Open
Abstract
The toe clearance strategy during leg swinging while walking is closely associated with the risk of tripping and/or falling and is influenced by aging and a fall history. However, it remains unclear how the toe clearance strategy is regulated by the neuromuscular system. The present study investigated the effect of aging and fall/tripping history in the older adults on the toe clearance strategy and neuromuscular regulation of the rectus femoris (RF) muscle, which plays an important role in leg swinging, during prolonged walking. Thirteen older adults (age: 71.3 ± 5.7 years) and nine young adults (age: 20.9 ± 0.8 years) men volunteered for the present study. The older adults were divided into those with (n = 6) and without (n = 7) a fall/tripping history. Subjects walked on a treadmill at their preferred gait speed for 20 min, and lower extremity kinematics and multi-channel surface electromyography along the RF muscle were recorded. Variability of the minimum toe clearance (MTC) and central locus activation (CLA) of the RF muscle in older adults was significantly greater than in the young adults (p < 0.05). MTC significantly decreased with time in the older adults (p < 0.05), but not in the young adults (p > 0.05). There were no significant correlations between any parameters of MTC and CLA in the older adults or young adults (p > 0.05). MTC and variability of CLA significantly decreased with time in the older adults without a fall/tripping history (p < 0.05), but not in the older adults with such a history (p > 0.05). These results suggest that aging and a fall/tripping history in the older adults alter the toe clearance strategy and regional neural regulation of the RF muscle during prolonged walking.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
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Hagio S, Kouzaki M. Action Direction of Muscle Synergies in Three-Dimensional Force Space. Front Bioeng Biotechnol 2015; 3:187. [PMID: 26618156 PMCID: PMC4643182 DOI: 10.3389/fbioe.2015.00187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/30/2015] [Indexed: 12/20/2022] Open
Abstract
Redundancy in the musculoskeletal system was supposed to be simplified by muscle synergies, which modularly organize muscles. To clarify the underlying mechanisms of motor control using muscle synergies, it is important to examine the spatiotemporal contribution of muscle synergies in the task space. In this study, we quantified the mechanical contribution of muscle synergies as considering spatiotemporal correlation between the activation of muscle synergies and endpoint force fluctuations. Subjects performed isometric force generation in the three-dimensional force space. The muscle-weighting vectors of muscle synergies and their activation traces across different trials were extracted from electromyogram data using decomposing technique. We then estimated mechanical contribution of muscle synergies across each trial based on cross-correlation analysis. The contributing vectors were averaged for all trials, and the averaging was defined as action direction (AD) of muscle synergies. As a result, we extracted approximately five muscle synergies. The ADs of muscle synergies mainly depended on the anatomical functions of their weighting muscles. Furthermore, the AD of each muscle indicated the synchronous activation of muscles, which composed of the same muscle synergy. These results provide the spatiotemporal characteristics of muscle synergies as neural basis.
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Affiliation(s)
- Shota Hagio
- Japan Society for the Promotion of Science , Tokyo , Japan ; Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University , Kyoto , Japan
| | - Motoki Kouzaki
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University , Kyoto , Japan
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Hagio S, Kouzaki M. Recruitment of muscle synergies is associated with endpoint force fluctuations during multi-directional isometric contractions. Exp Brain Res 2015; 233:1811-23. [PMID: 25795080 DOI: 10.1007/s00221-015-4253-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/10/2015] [Indexed: 11/27/2022]
Abstract
It has long been assumed that the human central nervous system uses flexible combinations of several muscle synergies to effortlessly and efficiently control redundant movements. However, whether muscle synergies exist in the neural circuit remains controversial, and it is critical to examine the association between the recruitment pattern of synergies and motor output. In this study, we examined the relationship between the activation of muscle synergies and endpoint force fluctuations in the presence of signal-dependent noise. Subjects performed multi-directional isometric force generations around the right ankle on the sagittal plane. We then extracted muscle synergies from measured electromyogram (EMG) data using nonnegative matrix factorization. As a result, the sum of the activation of muscle synergies was correlated with the endpoint force variability from the desired directions. Furthermore, we determined that the activation trace of each synergy reflected the endpoint force fluctuations using cross-correlation analysis. Therefore, these results suggest that muscle synergies statistically calculated from EMG data should be related to the motor output.
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Affiliation(s)
- Shota Hagio
- Japan Society for the Promotion of Science, Tokyo, Japan
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Watanabe K, Kouzaki M, Moritani T. Heterogeneous neuromuscular activation within human rectus femoris muscle during pedaling. Muscle Nerve 2015; 52:404-11. [DOI: 10.1002/mus.24544] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics; School of International Liberal Studies, Chukyo University; Yagotohonmachi Showa-ku Nagoya 466-8666 Japan
| | - Motoki Kouzaki
- Laboratory of Neurophysiology; Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
| | - Toshio Moritani
- Laboratory of Applied Physiology; Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
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Regional neuromuscular regulation within human rectus femoris muscle during gait. J Biomech 2014; 47:3502-8. [DOI: 10.1016/j.jbiomech.2014.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/29/2014] [Accepted: 09/03/2014] [Indexed: 11/20/2022]
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Watanabe K, Kouzaki M, Moritani T. Non-uniform surface electromyographic responses to change in joint angle within rectus femoris muscle. Muscle Nerve 2014; 50:794-802. [DOI: 10.1002/mus.24232] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 02/25/2014] [Accepted: 02/28/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Kohei Watanabe
- School of International Liberal Studies, Chukyo University, Nagoya; Yagotohonmachi, Showa-ku Nagoya 466-8666 Japan
| | - Motoki Kouzaki
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
| | - Toshio Moritani
- Laboratory of Applied Physiology, Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
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Hagio S, Kouzaki M. The flexible recruitment of muscle synergies depends on the required force-generating capability. J Neurophysiol 2014; 112:316-27. [DOI: 10.1152/jn.00109.2014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To simplify redundant motor control, the central nervous system (CNS) may modularly organize and recruit groups of muscles as “muscle synergies.” However, smooth and efficient movements are expected to require not only low-dimensional organization, but also flexibility in the recruitment or combination of synergies, depending on force-generating capability of individual muscles. In this study, we examined how the CNS controls activations of muscle synergies as changing joint angles. Subjects performed multidirectional isometric force generations around right ankle and extracted the muscle synergies using nonnegative matrix factorization across various knee and hip joint angles. As a result, muscle synergies were selectively recruited with merging or decomposition as changing the joint angles. Moreover, the activation profiles, including activation levels and the direction indicating the peak, of muscle synergies across force directions depended on the joint angles. Therefore, we suggested that the CNS selects appropriate muscle synergies and controls their activation patterns based on the force-generating capability of muscles with merging or decomposing descending neural inputs.
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Affiliation(s)
- Shota Hagio
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan; and
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University, Yoshida-nihonmatsu, Kyoto, Japan
| | - Motoki Kouzaki
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University, Yoshida-nihonmatsu, Kyoto, Japan
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Watanabe K, Kouzaki M, Moritani T. Region-specific myoelectric manifestations of fatigue in human rectus femoris muscle. Muscle Nerve 2013; 48:226-34. [DOI: 10.1002/mus.23739] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 11/06/2022]
Affiliation(s)
- Kohei Watanabe
- School of International Liberal Studies; Chukyo University; Yagotohonmachi, Showa-ku Nagoya Japan 466-8666
| | - Motoki Kouzaki
- Laboratory of Neurophysiology; Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
| | - Toshio Moritani
- Laboratory of Applied Physiology; Graduate School of Human and Environmental Studies, Kyoto University; Kyoto Japan
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Miyamoto N, Wakahara T, Kawakami Y. Task-dependent inhomogeneous muscle activities within the bi-articular human rectus femoris muscle. PLoS One 2012; 7:e34269. [PMID: 22479583 PMCID: PMC3313973 DOI: 10.1371/journal.pone.0034269] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 02/28/2012] [Indexed: 11/28/2022] Open
Abstract
The motor nerve of the bi-articular rectus femoris muscle is generally split from the femoral nerve trunk into two sub-branches just before it reaches the distal and proximal regions of the muscle. In this study, we examined whether the regional difference in muscle activities exists within the human rectus femoris muscle during maximal voluntary isometric contractions of knee extension and hip flexion. Surface electromyographic signals were recorded from the distal, middle, and proximal regions. In addition, twitch responses were evoked by stimulating the femoral nerve with supramaximal intensity. The root mean square value of electromyographic amplitude during each voluntary task was normalized to the maximal compound muscle action potential amplitude (M-wave) for each region. The electromyographic amplitudes were significantly smaller during hip flexion than during knee extension task for all regions. There was no significant difference in the normalized electromyographic amplitude during knee extension among regions within the rectus femoris muscle, whereas those were significantly smaller in the distal than in the middle and proximal regions during hip flexion task. These results indicate that the bi-articular rectus femoris muscle is differentially controlled along the longitudinal direction and that in particular the distal region of the muscle cannot be fully activated during hip flexion.
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Affiliation(s)
- Naokazu Miyamoto
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.
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