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This investigation addressed the question of whether the muscle activation signal prior to movement onset, as measured by surface EMG, differs if the contraction to be performed is concentric (shortening) or eccentric (lengthening). Specifically, the purpose was to determine if differences in knee extensor muscle EMG prior to voluntary maximum concentric and eccentric contractions and initiated from the same knee joint angle are evident at a time before muscle length changes could be influential. A protocol was designed using isokinetic knee extensions. The EMG of the vastus lateralis, vastus medialis, rectus femoris, and hamstrings muscles and the associated knee extension moment were measured during the isometric phase preceding the onset of dynamometer motion. During this isometric phase the muscles initially contracted under identical conditions, irrespective of whether the contraction was to be concentric or eccentric. The EMG of the eccentric contractions was significantly smaller than that of the concentric contractions. However, the rate of change of knee extension moment generally did not differ between the two conditions. This was found for both the monoarticular and multiarticular knee extensor muscles. The results suggest that initial differences between the EMG of maximum voluntary concentric and eccentric knee extensor contractions are selected a priori and support the contention that the central nervous system distinguishes between maximum eccentric and concentric contractions. The emergence of differences in activation prior to muscle length changes suggests supraspinal influences.

Background: Inappropriate control of the vastus medialis oblique and vastus lateralis muscles by the central nervous system can contribute to maltracking of the patella., Hypothesis: The activation timing and amplitude of the vastus medialis oblique and vastus lateralis muscles will be different between normal subjects and patients with patellofemoral pain., Study Design: Controlled laboratory study., Methods: Subjects with patellofemoral pain and asymptomatic control subjects performed maximum voluntary knee extension contractions initiated from a flexed and an extended position. The activation timing and amplitude of the vastus lateralis and vastus medialis oblique muscles were quantified from the recorded electromyographic signals., Results: There were no between-group differences in activation timing. The activation amplitude of the vastus medialis oblique and vastus lateralis muscles of the patellofemoral pain subjects was altered to the greatest extent during eccentric contractions and differed significantly from that of control subjects., Conclusions: The activation amplitudes of the vastus medialis oblique and vastus lateralis muscles of subjects with patellofemoral pain are consistent with a laterally tracking patella during eccentric contractions., Clinical Relevance: The findings suggest the clinical importance of determining whether altered activation patterns are sensitive to rehabilitation, and, if so, if subjective reports of knee joint pain and function parallel changes in the activation patterns as a result of rehabilitation.

Objectives: To determine whether decreased lower extremity strength contributes to trip-related falls in older adults., Design: A cross-sectional sample of older adults were safety-harnessed and tripped while walking using a concealed, mechanical obstacle. Lower extremity strength was compared between trip outcome groups., Setting: A biomechanics research laboratory., Participants: Seventy-nine healthy, community-dwelling adults aged 65 and older (50 women)., Measurements: Ankle, knee, and hip flexion and extension strength were measured isometrically and isokinetically. Measured strengths were subjected to a factor analysis. Strength factor scores were compared between those who recovered from the trip and those who fell by three previously identified mechanisms: during-step, after-step, and elevating-response falls., Results: Seven common factors, one associated with each direction of exertion at each joint and one with the time rate of moment increase, explained 88% of the variance in measured strength. The during-step (n=5) fallers were significantly stronger in the ankle extension (plantarflexion), knee flexion, overall extension, and total strength factors than those who successfully recovered using a similar, lowering strategy (n=26). The elevating-response faller (n=1) was stronger in the plantarflexion and overall extension factors than most of those who recovered using a similar, elevating strategy (n=11). Two of three after-step fallers were among the weakest subjects tested., Conclusion: Weak older adults and the strongest older adults may be at greater risk of falling from a trip, although by different mechanisms. High strength may increase the likelihood of a during-step or elevating-response fall; decreased strength may increase the likelihood of an after-step fall.

In this study the functional abilities of eight one-stage bilateral total knee replacement (TKR) patients were compared to five two-stage bilateral TKR and nine control subjects. The TKR individuals were an average of 62 months post-operative. Based on gait analysis, ground reaction force profiles during walking and isometric knee strength assessment, the one-stage individuals did not differ significantly from the control subjects. The two-stage individuals had significantly less knee range of motion during gait and smaller vertical ground reaction forces during the braking phase than the control and one-stage individuals. To compare left and right sides, a symmetry index was computed and there were no significant differences among the three groups. Based on the variables tested in this biomechanical evaluation it can be concluded that for individuals facing bilateral knee replacement a one-stage procedure can result in functional capabilities at least comparable to a two-stage procedure.

Purpose: The bilateral deficit is characterized by a decrease in maximum voluntary contraction (MVC) force during bilateral activation of homologous muscles compared with sum of the forces produced during unilateral MVC of the muscles. A proposed relationship between the bilateral deficit and the ability to activate high threshold motor units was investigated. The effects of muscle fatigue, induced using two contraction speeds, on the size of the bilateral deficit were measured. Based on previously published findings, it was expected that fast velocity isokinetic contractions compared with slow velocity isokinetic contractions would produce a larger bilateral deficit. It was hypothesized that following a unilateral fatigue protocol, the size of the bilateral deficit at the fast and slow velocities would be comparable., Methods: The bilateral deficit was measured for isokinetic knee extension in 20 men (age:25 +/- 3 yr) before and after a fatigue protocol performed at 30 and 150 degreesxs(-1)., Results: The size of the bilateral deficit was initially the same at both velocities. The fatigue protocol at each contraction speed significantly decreased the maximum voluntary knee extension moment. The size of the bilateral deficit was not influenced by the 150 degrees fatigue protocol (pretest: -14.0% post-test: -12.5%; P > 0.05). However, the size of the bilateral deficit increased following the 30 degreesxs(-1) fatigue protocol (pretest: -13.7%; post-test: -21.9%; P < 0.05)., Conclusions: The failure of the size of the bilateral deficit to be comparable at 30 and 150 degreesxs(-1) following fatigue is contrary to previous published reports that suggested reduced activation of high threshold motor unit is the primary mechanism underlying the bilateral deficit.