Vasilios Baltzopoulos

In vivo measurements of the triceps surae complex architecture in man: implications for muscle function

1 The objectives of this study were to (1) quantify experimentally in vivo changes in pennation angle, fibre length and muscle thickness in the triceps surae complex in man in response to changes in ankle position and isometric plantarflexion moment and (2) compare changes in the above muscle architectural characteristics occurring in the transition from rest to a given isometric plantarflexion intensity with the estimations of a planimetric muscle model assuming constant thickness and straight muscle fibres. 2 The gastrocnemius medialis (GM), gastrocnemius lateralis (GL) and soleus (SOL) muscles of six males were scanned with ultrasonography at different sites along and across the muscle belly at rest and during maximum voluntary contraction (MVC) trials at ankle angles of −15 deg (dorsiflexed direction), 0 deg (neutral position), +15 deg (plantarflexed direction) and +30 deg. Additional images were taken at 80, 60, 40 and 20 % of MVC at an ankle angle of 0 deg. 3 In all three muscles and all scanned sites, as ankle angle increased from −15 to +30 deg, pennation increased (by 6–12 deg, 39–67 %, P < 0.01 at rest and 9–16 deg, 29–43 %, P < 0.01 during MVC) and fibre length decreased (by 15–28 mm, 32–34 %, P < 0.01 at rest and 8–10 mm, 27–30 %, P < 0.05 during MVC). Thickness in GL and SOL increased during MVC compared with rest (by 5–7 mm, 36–47 %, P < 0.01 in GL and 6–7 mm, 38–47 %, P < 0.01 in SOL) while thickness of GM did not differ (P > 0.05) between rest and MVC. 4 At any given ankle angle the model underestimated changes in GL and SOL occurring in the transition from rest to MVC in pennation angle (by 9–12 deg, 24–38 %, P < 0.01 in GL and 9–14 deg, 25–28 %, P < 0.01 in SOL) and fibre length (by 6–15 mm, 22–39 %, P < 0.01 in GL and 6–8 mm, 23–24 %, P < 0.01 in SOL). 5 The findings of the study indicate that the mechanical output of muscle as estimated by the model used may be unrealistic due to errors in estimating the changes in muscle architecture during contraction compared with rest.

Time and frequency domain analysis of ground reaction forces during walking: an investigation of variability and symmetry

Abstract The purpose of this study was to investigate the variability and symmetry of ground reaction force (GRF) measurements during walking, using time and frequency domain analysis. Means and standard deviations of selected GRF time and frequency domain parameters for the left and right sides were calculated from 10 trials of each side. The results showed that a 10-trial mean GRF frequency content meets acceptable variability limits (

Isokinetic dynamometry. Applications and limitations.

SummaryIsokinetic contraction is the muscular contraction that accompanies constant velocity limb movements around a joint. The velocity of movement is maintained constant by a special dynamometer. The resistance of the dynamometer is equal to the muscular forces applied throughout the range of movement. This method allows the measurement of the muscular forces in dynamic conditions and provides optimal loading of the muscles.However, during movements in the vertical plane, the torque registered by the dynamometer is the resultant torque produced by the muscular and gravitational forces. The error depends on the angular position and the torque potential of the tested muscle group. Several methods have been developed for the correction of gravitational errors in isokinetic data.The torque output also contains artefacts that are associated with the inertial forces during acceleration and deceleration periods before the development of the constant preset angular velocity. For an accurate assessment of muscle function, only constant velocity data should be analysed.The most frequently used isokinetic parameters are the maximum torque and the angular position where it was recorded, the torque output at different angular velocities of movement, the torque ratio of reciprocal muscle groups and the torque output during repeated contractions.The unique features of isokinetic dynamometry are optimal loading of the muscles in dynamic conditions and constant preselected velocity of movement. These features provide safety in the rehabilitation of patients with muscular and ligamentous injuries. Isokinetic dynamometry has also been used for the training of various muscle groups in order to improve the muscular performance in dynamic conditions. The movement velocity of different activities can be simulated during training in order to improve the training effect.Data acquisition and analysis have been improved by using computer systems interfaced to isokinetic dynamometers. Recently developed computer systems provide correction for gravitational and inertial errors, accurate computation of isokinetic parameters and real-time display of the torque output.

Changes in Achilles tendon moment arm from rest to maximum isometric plantarflexion: in vivo observations in man

1 The purpose of the present study was to examine the effect of a plantarflexor maximum voluntary contraction (MVC) on Achilles tendon moment arm length. 2 Sagittal magnetic resonance (MR) images of the right ankle were taken in six subjects both at rest and during a plantarflexor MVC in the supine position at a knee angle of 90 deg and at ankle angles of ‐30 deg (dorsiflexed direction), ‐15 deg, 0 deg (neutral ankle position), +15 deg (plantarflexed direction), +30 deg and +45 deg. A system of mechanical stops, support triangles and velcro straps was used to secure the subject in the above positions. Location of a moving centre of rotation was calculated for ankle rotations from ‐30 to 0 deg, ‐15 to +15 deg, 0 to +30 deg and +15 to +45 deg. All instant centres of rotation were calculated both at rest and during MVC. Achilles tendon moment arms were measured at ankle angles of ‐15, 0, +15 and +30 deg. 3 At any given ankle angle, Achilles tendon moment arm length during MVC increased by 1‐1.5 cm (22‐27 %, P < 0.01) compared with rest. This was attributed to a displacement of both Achilles tendon by 0.6‐1.1 cm (P < 0.01) and all instant centres of rotation by about 0.3 cm (P < 0.05) away from their corresponding resting positions. 4 The findings of this study have important implications for estimating loads in the musculoskeletal system. Substantially unrealistic Achilles tendon forces and moments generated around the ankle joint during a plantarflexor MVC would be calculated using resting Achilles tendon moment arm measurements.

Normalisation of gait EMGs: a re-examination

The purpose of this study was to compare four different methods of normalising electromyograms (EMGs) recorded during normal gait. Comparisons were made between the amplitude, intra-individual variability and inter-individual variability of EMGs. Surface EMGs were recorded from the biceps femoris, semitendinosus, vastus lateralis and vastus medialis of ten males and two females while they walked on a treadmill at a self-selected speed. EMGs from the same muscles were subsequently recorded during isometric maximal voluntary contractions (MVCs) and concentric, isokinetic MVCs that were performed between 0.52 and 7.85 rad x s(-1) on a BIODEX dynamometer. EMGs were also recorded during eccentric, isokinetic MVCs between 0.52 and 2.62 rad x s(-1). Gait EMGs were then normalised at 2% intervals of the gait cycle by expressing them as a percentage of the following reference values: the mean (mean dynamic method) and the peak (peak dynamic method) EMG from the intra-individual ensemble average; the EMG from an isometric MVC (isometric MVC method); and the EMG from an isokinetic MVC that occurred with the same muscle action, length and velocity of musculotendinous unit as the gait EMGs (isokinetic MVC method). The isokinetic MVC method produced significantly greater (P<0.05) intra-individual variability compared to the other methods when it was measured using the variance ratio. Inter-individual variability of gait EMGs, again measured using the variance ratio, was also greatest when they were normalised using the isokinetic MVC method. The pattern and amplitude of EMGs normalised using the isometric MVC method and the isokinetic MVC method were very similar (root mean square difference and absolute difference both less than 3%). It was concluded that the isokinetic MVC method should not be adopted by gait researchers or clinicians as it does not reduce intra- or inter-individual variability anymore than existing normalisation methods, nor does it provide a more representative measure of muscle activation during gait than the isometric MVC method.

Muscle activation differences between eccentric and concentric isokinetic exercise

PURPOSE The purpose of this study was to compare electromyographic (EMG) activity and joint moment of agonists and antagonists between isokinetic eccentric and concentric knee muscle actions. METHODS Twelve females (20.5 +/- 2.9 yr) performed maximum knee extension and flexion effort on a Biodex dynamometer isometrically and at concentric and eccentric angular velocities ranging from 30 degrees.s-1 to 150 degrees.s-1. EMG activity of vastus lateralis, rectus femoris, vastus medialis, and hamstrings was also recorded. The moment and agonist EMG values were normalized as a percentage of the maximum isometric values. The antagonist EMG was normalized as a percentage of the IEMG activity of the same muscle group when acting as agonist at the same angular velocity and angular position and taking into consideration the effects of muscle action. RESULTS Three-way ANOVA designs indicated significantly greater normalized eccentric moments compared with concentric moments (P < 0.05), whereas the eccentric normalized integrated EMG (IEMG) of agonists and antagonists was significantly lower compared with the respective concentric IEMG values (P < 0.05). These differences were more evident at fast angular velocities. CONCLUSIONS The present results demonstrate that neural activation and the resulting muscular action are different between isokinetic eccentric and concentric tests and depend also on the angular velocity of the movement. The antagonist IEMG activity is different depending on the muscle examined. The IEMG activity of the antagonists in this study indicate that the antagonist activity is an important factor that affects the resultant joint moment during isolated isokinetic maximum voluntary joint movements.

In vivo specific tension of human skeletal muscle

In this study, we estimated the specific tensions of soleus (Sol) and tibialis anterior (TA) muscles in six men. Joint moments were measured during maximum voluntary contraction (MVC) and during electrical stimulation. Moment arm lengths and muscle volumes were measured using magnetic resonance imaging, and pennation angles and fascicular lengths were measured using ultrasonography. Tendon and muscle forces were modeled. Two approaches were followed to estimate specific tension. First, muscle moments during electrical stimulation and moment arm lengths, fascicular lengths, and pennation angles during MVC were used (data set A). Then, MVC moments, moment arm lengths at rest, and cadaveric fascicular lengths and pennation angles were used (data set B). The use of data set B yielded the unrealistic specific tension estimates of 104 kN/m(2) in Sol and 658 kN/m(2) in TA. The use of data set A, however, yielded values of 150 and 155 kN/m(2) in Sol and TA, respectively, which agree with in vitro results from fiber type I-predominant muscles. In fact, both Sol and TA are such muscles. Our study demonstrates the feasibility of accurate in vivo estimates of human muscle intrinsic strength.

Isokinetic Eccentric Exercise

SummaryThe development of active isokinetic dynamometers has allowed the assessment of muscular moment under eccentric activations that have different characteristics to concentric actions. It is well documented that at a given angular velocity the eccentric moment is greater than the corresponding concentric moment. The moment-velocity relationship under eccentric conditions has been investigated, with conflicting results. Particularly, eccentric moment was reported to remain similar to, or to increase or decrease with, increasing angular velocity. As with concentric actions, the reliability of isokinetic eccentric measurements is influenced by a number of factors such as gravity, preload force and testing position.The velocity-specific effects of eccentric training have not been extensively investigated. Based on current knowledge, eccentric exercise does not appear to be velocity-specific. Although the mode specificity of both concentric and eccentric exercises have been investigated, the resultant observations are conflicting. Eccentric training has been found to improve both concentric and eccentric strength; yet, it has also been reported to improve only concentric or eccentric strength. The reciprocal muscle group ratios under eccentric actions were found not to be influenced by angular velocity, but the significant role of the eccentric/concentric moment ratio of each muscle has not been examined thoroughly. It is well documented that eccentric activations are associated with delayed muscle soreness and muscle damage. A limited number of studies have reported that isokinetic eccentric efforts may result in a lower amount of muscle soreness compared with other exercise modalities.Isokinetic dynamometers provide some unique characteristics for rehabilitation applications. Examination of the clinical application of eccentric exercise is limited. Consequently, the use of this exercise modality in prevention and assessment of musculoskeletal injuries should be investigated further.

Muscle tenderness and peak torque changes after downhill running following a prior bout of isokinetic eccentric exercise

Unaccustomed exercise (usually of an eccentric nature) is often followed by delayed onset muscle soreness (DOMS). Previous studies have found that prior eccentric activity produces a training effect which reduces DOMS and morphological changes. The aim of this study was to examine the effects of a prior bout of maximal isokinetic eccentric exercise on DOMS, strength loss and plasma creatine kinase (CK) changes following a downhill run. Ten male subjects with a mean (+/- S.D.) age of 22.5 +/- 2.8 years, body mass of 62.67 +/- 0.05 kg and height of 176 +/- 3 cm were allocated to either a treatment group or a control group. The treatment group performed 100 maximal eccentric activations of the knee extensors in the dominant leg at 0.52 rad s-1. Two weeks later, the downhill run was performed on a motor-driven treadmill. This consisted of five bouts of 8 min at a gradient of -10% at a speed corresponding to 80% of the predicted maximal heart rate. The untrained group performed the downhill run as above but without the prior isokinetic session. Tenderness measurements, plasma CK activity and concentric and eccentric isokinetic peak torque measurements of the knee extensors at 0.52 and 2.83 rad s-1 were recorded prior to, immediately following and 2, 4 and 7 days after each protocol. The isokinetic protocol caused an increase (P < 0.01) in CK and tenderness and a decrease (P < 0.05) in concentric and eccentric torque at both speeds in the treatment group. Following the downhill run, a reduction in peak torque (P < 0.01) was observed in the eccentric and concentric modes at both isokinetic speeds in the control group. For the treatment group, the decrease in peak torque occurred only at the faster eccentric speed. With the exception of the faster eccentric speed, the decrement in peak torque was greater in the control group in all post-exercise isokinetic strength tests. There was less tenderness (P < 0.01) in the trained knee extensor muscle group. Peak torque also returned to pre-downhill values earlier for the trained group. Although plasma CK activity increased in both groups after downhill running, it was much lower (P < 0.01) in the trained group. The results suggest that a prior bout of isokinetic eccentric training reduces muscle damage, reduces the amount of strength loss and decreases the sensation of DOMS after downhill running.

A videofluoroscopy method for optical distortion correction and measurement of knee-joint kinematics

Image distortion in video and image intensifier X-ray systems requires appropriate distortion correction methods to obtain accurate biomechanical quantitative measurements for joint kinematics applications. This paper presents an algorithm for coordinate reconstruction and distortion correction using a modified polynomial method. This algorithm was used for the measurement of patellar tendon moment arm, tibial plateau-tibial axis angle and patellar tendon-tibial axis angle during knee extension using videofluoroscopy in vivo. These parameters allow the determination of a two-dimensional biomechanical model of the knee for the measurement of muscle and joint forces during dynamic activities. Five males without knee joint injury history participated in the study. The mean measurement error obtained using an image intensifier-video system was 0.246 +/- 0.111 mm over a 180-mm x 180-mm field of view. The mean maximum patellar tendon moment arm was 39.87 mm at 44.9 degrees of knee flexion. The patellar tendon-tibial plateau angle was 112.9 degrees at full extension and decreased linearly to 87.6 degrees at 90 degrees of knee flexion. The mean angle between the tibial plateau and the tibial long axis was 84.8 degrees. Applications of the method include motion analysis using video and X-ray fluoroscopy systems with non-linear distortion problems. RELEVANCE: Accurate measurement of anatomical parameters from videofluoroscopy systems is important for the determination of joint biomechanical models and measurement of muscular and joint forces.