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1.  MUSCLE ACTIVITY DURING KNEE‐EXTENSION STRENGTHENING EXERCISE PERFORMED WITH ELASTIC TUBING AND ISOTONIC RESISTANCE 
Background/Purpose:
While elastic resistance training, targeting the upper body is effective for strength training, the effect of elastic resistance training on lower body muscle activity remains questionable. The purpose of this study was to evaluate the EMG‐angle relationship of the quadriceps muscle during 10‐RM knee‐extensions performed with elastic tubing and an isotonic strength training machine.
Methods:
7 women and 9 men aged 28‐67 years (mean age 44 and 41 years, respectively) participated. Electromyographic (EMG) activity was recorded in 10 muscles during the concentric and eccentric contraction phase of a knee extension exercise performed with elastic tubing and in training machine and normalized to maximal voluntary isometric contraction (MVC) EMG (nEMG). Knee joint angle was measured during the exercises using electronic inclinometers (range of motion 0‐90°).
Results:
When comparing the machine and elastic resistance exercises there were no significant differences in peak EMG of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) during the concentric contraction phase. However, during the eccentric phase, peak EMG was significantly higher (p<0.01) in RF and VM when performing knee extensions using the training machine. In VL and VM the EMG‐angle pattern was different between the two training modalities (significant angle by exercise interaction). When using elastic resistance, the EMG‐angle pattern peaked towards full knee extension (0°), whereas angle at peak EMG occurred closer to knee flexion position (90°) during the machine exercise. Perceived loading (Borg CR10) was similar during knee extensions performed with elastic tubing (5.7±0.6) compared with knee extensions performed in training machine (5.9±0.5).
Conclusion:
Knee extensions performed with elastic tubing induces similar high (>70% nEMG) quadriceps muscle activity during the concentric contraction phase, but slightly lower during the eccentric contraction phase, as knee extensions performed using an isotonic training machine. During the concentric contraction phase the two different conditions displayed reciprocal EMG‐angle patterns during the range of motion.
Level of Evidence:
5
PMCID: PMC3537465  PMID: 23316424
Electromyography; strength training; quadriceps; perceived exertion
2.  Trunk muscle activity during bridging exercises on and off a Swissball 
Background
A Swiss ball is often incorporated into trunk strengthening programs for injury rehabilitation and performance conditioning. It is often assumed that the use of a Swiss ball increases trunk muscle activity. The aim of this study was to determine whether the addition of a Swiss ball to trunk bridging exercises influences trunk muscle activity.
Methods
Surface electrodes recorded the myoelectric activity of trunk muscles during bridging exercises. Bridging exercises were performed on the floor as well as on a labile surface (Swiss ball).
Results and Discussion
During the prone bridge the addition of an exercise ball resulted in increased myoelectric activity in the rectus abdominis and external oblique. The internal oblique and erector spinae were not influenced. The addition of a swiss ball during supine bridging did not influence trunk muscle activity for any muscles studied.
Conclusion
The addition of a Swiss ball is capable of influencing trunk muscle activity in the rectus abdominis and external oblique musculature during prone bridge exercises. Modifying common bridging exercises can influence the amount of trunk muscle activity, suggesting that exercise routines can be designed to maximize or minimize trunk muscle exertion depending on the needs of the exercise population.
doi:10.1186/1746-1340-13-14
PMCID: PMC1187901  PMID: 16053529
EMG; trunk stability; exercise; swiss ball; rehabilitation
3.  Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises 
Background
The addition of Swiss balls to conventional exercise programs has recently been adopted. Swiss balls are an unstable surface which may result in an increased need for force output from trunk muscles to provide adequate spinal stability or balance. The aim of the study was to determine whether the addition of a Swiss ball to upper body strength exercises results in consistent increases in trunk muscle activation levels.
Methods
The myoelectric activity of four trunk muscles was quantified during the performance of upper body resistance exercises while seated on both a stable (exercise bench) and labile (swiss ball) surface. Participants performed the supine chest press, shoulder press, lateral raise, biceps curl and overhead triceps extension. A repeated measures ANOVA with post-hoc Tukey test was used to determine the influence of seated surface type on muscle activity for each muscle.
Results & Discussion
There was no statistically significant (p < .05) difference in muscle activity between surface conditions. However, there was large degree of variability across subjects suggesting that some individuals respond differently to surface stability. These findings suggest that the incorporation of swiss balls instead of an exercise bench into upper body strength training regimes may not be justified based only on the belief that an increase spinal stabilizing musculature activity is inherent. Biomechanically justified ground based exercises have been researched and should form the basis for spinal stability training as preventative and therapeutic exercise training regimes.
Conclusion
Selected trunk muscle activity during certain upper limb strength training exercises is not consistently influenced by the replacement of an exercise bench with a swiss ball.
doi:10.1186/1476-5918-4-6
PMCID: PMC1177975  PMID: 15935097
EMG; exercise; spine stability; swiss balls; rehabilitation; low back pain
4.  Electromyographic Activity and Applied Load During High Intensity Elastic Resistance and Nautilus Machine Exercises 
This study was designed to quantify and compare Electromyographic activity (EMG) and applied load in quadriceps muscle within performing high intensity knee extension exercises by Elastic Resistance (ER) and Nautilus Machine (NM). Sixteen male and female subjects (22.4 ± 4.7 yrs) completed 8 RM seated knee extension by NM, elastic tubing with original length (E0) and elastic tubing with 30% decrement of original length (E30). The mean value of EMG and external force were calculated and synchronized across various segments of motion for the three modes of training. The results demonstrated that in the early concentric and late eccentric segments of contraction, NM elicited significantly higher muscle activation than both E30 and E0 (p < 0.05). However, in the mid-concentric and mid-eccentric as well as late concentric and early eccentric segments no significant differences were observed between NM and E30. These findings supported the approach that developing external recoil of force in ER device by reducing 30% of initial length of elastic material can offer similar neuromuscular activation compared with NM. On this basis, E30 can be suggested as an affordable and non-gym based exercise device which has the capacity to provide an appropriate high resistance stimulus to meet the training requirement of athletes.
doi:10.2478/v10078-011-0067-0
PMCID: PMC3588628  PMID: 23487250
electromyogram; elastic tubing; variable resistance training; multiple repetitions maximum
5.  Shoulder muscle EMG activity during push up variations on and off a Swiss ball 
Dynamic Medicine  2006;5:7.
Background
Surface instability is a common addition to traditional rehabilitation and strength exercises with the aim of increasing muscle activity, increasing exercise difficulty and improving joint proprioception. The aim of the current study was to determine if performing upper body closed kinetic chain exercises on a labile surface (Swiss ball) influences myoelectric amplitude when compared with a stable surface.
Methods
Thirteen males were recruited from a convenience sample of college students. Surface electromyograms were recorded from the triceps, pectoralis major, latissimus dorsi, rectus abdominis and external oblique while performing push up exercises with the feet or hands placed on a bench and separately on a Swiss ball. A push up plus exercise was also evaluated with hands on the support surface.
Results and discussion
Not all muscles responded with an increase in muscle activity. The pectoralis major muscle was not influenced by surface stability. The triceps and rectus abdominis muscles showed increases in muscle activity only when the hands were on the unstable surface. The external oblique muscle was only influenced by surface stability during the performance of the push up plus exercise. No muscle showed a change in activation level when the legs were supported by the Swiss ball instead of the bench.
Conclusion
Muscle activity can be influenced by the addition of surface instability however an increase in muscle activity does not influence all muscles in all conditions. The relationship between the participant's center of mass, the location of the unstable surface and the body part contacting the Swiss ball may be important factors in determining the muscle activation changes following changes in surface stability.
doi:10.1186/1476-5918-5-7
PMCID: PMC1508143  PMID: 16762080
6.  An electromyographic analysis of shoulder muscle activation during push-up variations on stable and labile surfaces 
Background:
Numerous exercises are used to strengthen muscles around the shoulder joint including the push-up and the push-up plus. An important consideration is the addition of surface instability in the form of swiss ball for rehabilitation and strength. The justification for the use of the swiss ball is based on its potential for increasing muscular demand required to maintain postural stability and for improving joint proprioception. Evidence for this is lacking in literature.
Purpose of the Study:
To compare the myoelectric amplitude of shoulder muscles during push-ups on labile and stable surface.
Study Design:
Same subject experimental study.
Materials and Methods:
Thirty healthy male subjects in the age group 20-30 years with a mean height of 173.65 cm (± SD 2.56) and a mean weight of 69.9 kg (±SD 0.2) were taken. Surface electromyogram was recorded from triceps, pectoralis major, serratus anterior and upper trapezius while performing push-up and push-up plus exercises, both on labile and stable surface.
Results:
Significant increase in muscle activity was observed in pectoralis major and triceps muscle (only during eccentric phase of elbow pushups), while serratus anterior and upper trapezius showed no change in activation level on swiss ball.
Conclusion:
The addition of a swiss ball is capable of influencing shoulder muscle activity during push-up variations, although the effect is task and muscle dependent.
doi:10.4103/0973-6042.40456
PMCID: PMC2840817  PMID: 20300308
Electromyography; labile; rehabilitation; stable; strength; swiss ball
7.  Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries 
Background
Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand injuries due to electric circular saws.
Methods
Patients treated from 1999 through 2007 for circular saw-related hand injuries were contacted and asked for clinical follow-up assessment. The clinical follow-up protocol consisted of a physical examination and an assessment of static muscle power (grip and pinch strength). For assessment of the subjective experience of the patients regarding their injury-related disability and impairment, the DASH follow-up questionnaire was used. The occupational impact of these injuries was measured by number of lost working days. Finally, safety-related behaviour of the patients was investigated.
Results
114 Patients were followed-up on average 52 months after the injury. Average in-house treatment was 8.8 days. Average time lost from work was 14.8 weeks. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed for grip strength, tip pinch, key pinch, and palmar pinch. Average DASH score was 17.4 (DASH work 15.8, DASH sports/music 17.7). Most patients had more than ten years experience in using these power tools.
Conclusion
The everyday occurrence of circular saw-related hand injuries followed by relatively short periods of in-house treatment might distort the real dimension of the patients' remaining disability and impairment. While the trauma surgeon's view is generally confined to the patients' clinical course, the outcome parameters in this follow-up investigation, with loss of working time as the key factor, confirm that the whole socioeconomic burden is much greater than the direct cost of treatment.
doi:10.1186/1752-2897-4-11
PMCID: PMC2939582  PMID: 20819215
8.  The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women 
Korean Diabetes Journal  2010;34(2):101-110.
Background
Our goal was to investigate the effects of low intensity resistance training on body fat, muscle mass and strength, cardiovascular fitness, and insulin sensitivity in type 2 diabetes.
Methods
Twenty-eight overweight women with type 2 diabetes were randomly assigned to a resistance training group (RG, n = 13) or a control group (CG, n = 15). RG performed resistance training using elastic bands, of which strength was equal to 40 to 50% of one repetition maximum (1RM), for three days per week. Each exercise consisted of three sets for 60 minutes. We assessed abdominal fat using computed tomography, muscle mass using dual-energy X-ray absorptiometry, and muscle strength using Keiser's chest and leg press. Insulin sensitivity was measured using the insulin tolerance test, and aerobic capacity was expressed as oxygen uptake at the anaerobic threshold (AT-VO2) before and after the 12-week exercise program.
Results
The age of participants was 56.4 ± 7.1 years, duration of diabetes was 5.9 ± 5.5 years, and BMI was 27.4 ± 2.5 kg/m2, without significant differences between two groups. During intervention, a greater increase in muscle mass and greater decreases in both total fat mass and abdominal fat were observed in RG compared to those of CG (P = 0.015, P = 0.011, P = 0.010, respectively). Increase in 1RM of upper and lower extremities was observed in the RG (P = 0.004, P = 0.040, respectively), without changes in AT-VO2 and insulin resistance in either group.
Conclusion
In conclusion, the low intensity resistance training was effective in increasing muscle mass and strength and reducing total fat mass without change of insulin sensitivity in type 2 diabetic patients.
doi:10.4093/kdj.2010.34.2.101
PMCID: PMC2883348  PMID: 20548842
Abdominal fat; Type 2 diabetes mellitus; Muscle strength; Resistance training
9.  Abdominal Muscle Activity While Performing Trunk-Flexion Exercises Using the Ab Roller, ABslide, FitBall, and Conventionally Performed Trunk Curls 
Journal of Athletic Training  2004;39(1):37-43.
Objective:
To compare the surface electromyographic activity of the abdominal musculature and rectus femoris (RF) muscle during trunk-flexion exercises using 3 abdominal exercise devices (Ab Roller, ABslide, and FitBall) and the traditional trunk curl.
Design and Setting:
Each subject performed approximately 15 repetitions for each exercise condition. A repeated-measures, one-way multivariate analysis of variance was used to compare the mean integrated electric activity value for each muscle during each exercise condition.
Subjects:
A total of 10 male and 13 female collegiate undergraduate students.
Measurements:
Surface electromyographic activity was recorded for the upper rectus abdominis (URA), lower rectus abdominis (LRA), external oblique (EO), and RF during 5 consecutive repetitions of each exercise bout. The signal was amplified by a factor of 1000, rectified, and integrated. These integrated values were then divided by the time value for each exercise to give the mean integrated electromyography value.
Results:
A significant difference existed among exercise conditions for the RF (P < .0001), with the ABslide and the FitBall having greater electric activity than the other exercise conditions. Activity was significantly different (P < .0009) for the URA, with the ABslide having the least electric activity. For the EO, exercising with the ABslide produced significantly greater electric activity (P < .0001) than all other exercise conditions. No significant difference was found across exercise conditions for the LRA (P < .051).
Conclusions:
Performing abdominal exercises with the Ab Roller, ABslide, and FitBall did not elicit greater activity of the URA and LRA than performing traditional trunk curls. Use of the ABslide elicited greater EO activity and significantly less URA activity than the other 3 modes. Both the ABslide and FitBall resulted in greater involvement of the hip flexors, an undesirable feature of abdominal exercises.
PMCID: PMC385260  PMID: 15085210
electromyography; fitness; rehabilitation; sit-ups; abdominal crunches
10.  Knee Extensor Electromyographic Activity-to-Work Ratio is Greater With Isotonic Than Isokinetic Contractions 
Journal of Athletic Training  2001;36(4):384-387.
Objective:
To determine whether isotonic or isokinetic contractions produced greater electromyographic (EMG) activity per unit of work during isotonic and isokinetic knee-extension exercise.
Design and Setting:
Subjects performed three 3-second maximal voluntary isometric contractions of the dominant knee extensors for EMG normalization. Exercise testing performed on the Biodex System 3 Dynamometer involved 10 isokinetic contractions at 180°·s−1 and 10 isotonic contractions with the resistance set at 50% of the previously recorded maximal voluntary isometric contraction.
Subjects:
Recreationally active college students (10 men and 11 women).
Measurements:
Surface EMG signals were collected from the vastus medialis and lateralis muscles and then integrated (IEMG) over the concentric phase of each repetition for both exercises. The IEMG was divided by the total work performed during the concentric phase for each exercise (IEMG/W).
Results:
We analyzed the IEMG/W data using a 1-between (sex), 2-within (exercise and muscle) repeated-measures analysis of variance. There was a significant main effect for exercise, with the isotonic IEMG/W value being significantly greater than the isokinetic IEMG/W value. Additionally, the IEMG/W relationship did not appear to be affected by sex or individual muscle tested.
Conclusions:
Per unit of work performed, the isotonic contractions resulted in greater motor unit recruitment or an increased rate of firing, or both. This finding may have implications for the early phase of rehabilitation, when goals include complete motor unit recruitment of injured or atrophied muscles.
PMCID: PMC155433  PMID: 12937480
rehabilitation; IEMG; dynamometry
11.  Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial 
The aim of this randomized controlled trial was to assess changes in myalgic trapezius activation, muscle oxygenation, and pain intensity during repetitive and stressful work tasks in response to 10 weeks of training. In total, 39 women with a clinical diagnosis of trapezius myalgia were randomly assigned to: (1) general fitness training performed as leg-bicycling (GFT); (2) specific strength training of the neck/shoulder muscles (SST) or (3) reference intervention without physical exercise. Electromyographic activity (EMG), tissue oxygenation (near infrared spectroscopy), and pain intensity were measured in trapezius during pegboard and stress tasks before and after the intervention period. During the pegboard task, GFT improved trapezius oxygenation from a relative decrease of −0.83 ± 1.48 μM to an increase of 0.05 ± 1.32 μM, and decreased pain development by 43%, but did not affect resting levels of pain. SST lowered the relative EMG amplitude by 36%, and decreased pain during resting and working conditions by 52 and 38%, respectively, without affecting trapezius oxygenation. In conclusion, GFT performed as leg-bicycling decreased pain development during repetitive work tasks, possibly due to improved oxygenation of the painful muscles. SST lowered the overall level of pain both during rest and work, possibly due to a lowered relative exposure as evidenced by a lowered relative EMG. The results demonstrate differential adaptive mechanisms of contrasting physical exercise interventions on chronic muscle pain at rest and during repetitive work tasks.
doi:10.1007/s00421-011-1964-6
PMCID: PMC3253274  PMID: 21512799
Electromyography; Exercise; Stress task; RCT; Trapezius; NIRS; Aerobic training; Strength training
12.  Effects of Blood Flow Restricted Low-Intensity Concentric or Eccentric Training on Muscle Size and Strength 
PLoS ONE  2012;7(12):e52843.
We investigated the acute and chronic effects of low-intensity concentric or eccentric resistance training with blood flow restriction (BFR) on muscle size and strength. Ten young men performed 30% of concentric one repetition maximal dumbbell curl exercise (four sets, total 75 reps) 3 days/week for 6 weeks. One arm was randomly chosen for concentric BFR (CON-BFR) exercise only and the other arm performed eccentric BFR (ECC-BFR) exercise only at the same exercise load. During the exercise session, iEMG for biceps brachii muscles increased progressively during CON-BFR, which was greater (p<0.05) than that of the ECC-BFR. Immediately after the exercise, muscle thickness (MTH) of the elbow flexors acutely increased (p<0.01) with both CON-BFR and ECC-BFR, but was greater with CON-BFR (11.7%) (p<0.01) than ECC-BFR (3.9%) at 10-cm above the elbow joint. Following 6-weeks of training, MRI-measured muscle cross-sectional area (CSA) at 10-cm position and mid-upper arm (12.0% and 10.6%, respectively) as well as muscle volume (12.5%) of the elbow flexors were increased (p<0.01) with CON-BFR. Increases in muscle CSA and volume were lower in ECC-BFR (5.1%, 0.8% and 2.9%, respectively) than in the CON-BFR and only muscle CSA at 10-cm position increased significantly (p<0.05) after the training. Maximal voluntary isometric strength of elbow flexors was increased (p<0.05) in CON-BFR (8.6%), but not in ECC (3.8%). These results suggest that CON-BFR training leads to pronounced acute changes in muscle size, an index of muscle cell swelling, the response to which may be an important factor for promoting muscle hypertrophy with BFR resistance training.
doi:10.1371/journal.pone.0052843
PMCID: PMC3534116  PMID: 23300795
13.  Surface Electromyographic Amplitude-to-Work Ratios During Isokinetic and Isotonic Muscle Actions 
Journal of Athletic Training  2006;41(3):314-320.
Context: Isokinetic and isotonic resistance training exercises are commonly used to increase strength during musculoskeletal rehabilitation programs. Our study was designed to examine the efficacy of isokinetic and isotonic muscle actions using surface electromyographic (EMG) amplitude-to-work ratios (EMG/WK) and to extend previous findings to include a range of isokinetic velocities and isotonic loads.
Objective: To examine work (WK), surface EMG amplitude, and EMG/WK during concentric-only maximal isokinetic muscle actions at 60, 120, 180, 240, and 300°/s and isotonic muscle actions at 10%, 20%, 30%, 40%, and 50% of the maximal voluntary isometric contraction (MVIC) torque during leg extension exercises.
Design: A randomized, counterbalanced, cross-sectional, repeated-measures design.
Setting: A university-based human muscle physiology research laboratory.
Patients or Other Participants: Ten women (mean age = 22.0 ± 2.6 years) and 10 men (mean age = 20.8 ± 1.7 years) who were apparently healthy and recreationally active.
Intervention(s): Using the dominant leg, each participant performed 5 maximal voluntary concentric isokinetic leg extension exercises at randomly ordered angular velocities of 60, 120, 180, 240, and 300°/s and 5 concentric isotonic leg extension exercises at randomly ordered loads of 10%, 20%, 30%, 40%, and 50% of the isometric MVIC.
Main Outcome Measure(s): Work was recorded by a Biodex System 3 dynamometer, and surface EMG was recorded from the superficial quadriceps femoris muscles (vastus lateralis, rectus femoris, and vastus medialis) during the testing and was normalized to the MVIC. The EMG/WK ratios were calculated as the quotient of EMG amplitude (μVrms) and WK (J) during the concentric phase of each exercise.
Results: Isotonic EMG/WK remained unchanged ( P > .05) from 10% to 50% MVIC, but isokinetic EMG/WK increased ( P < .05) from 60 to 300°/s. Isotonic EMG/WK was greater ( P < .05) than isokinetic EMG/WK for 50% MVIC versus 60°/s, 40% MVIC versus 120°/s, and 30% MVIC versus 180°/s; however, no differences were noted ( P > .05) between 20% MVIC versus 240°/s or 10% MVIC versus 300°/s. An 18% decrease in active range of motion was seen for the isotonic muscle actions, from 10% to 50% MVIC, and a 3% increase in range of motion for the isokinetic muscle actions from 60 to 300°/s was also observed. Furthermore, the peak angular velocities for the isotonic muscle actions ranged from 272.9 to 483.0°/s for 50% and 10% MVIC, respectively.
Conclusions: When considering EMG/WK, peak angular velocity, and range of motion together, our data indicate that maximal isokinetic muscle actions at 240°/s or controlled-velocity isotonic muscle actions at 10%, 20%, or 30% MVIC may maximize the amount of muscle activation per unit of WK done during the early stages of musculoskeletal rehabilitation. These results may be useful to allied health professionals who incorporate open-chain resistance training exercises during the early phases of rehabilitation and researchers who use isotonic or isokinetic modes of resistance exercise to examine muscle function.
PMCID: PMC1569550  PMID: 17043700
range of motion; angular velocity; muscle activation; leg extension; rehabilitation
14.  Quantitative EMG Changes During 12-Week DeLorme's Axiom Strength Training 
Yonsei Medical Journal  2006;47(1):93-104.
Strength training is one of the most common exercises practiced in the field of physical therapy or sports training. However, limited methodology is available to evaluate its effect on the target muscle. This study aimed to test the hypothesis that surface electromyographic (EMG) data from both isometric and isotonic exercise can express changes within the muscle during a 12-week strength training program. Ten healthy male volunteer students (5 for training, 5 for controls) from Yonsei University were recruited for evaluation in this study. DeLorme's axiom was practiced for 12 weeks in the dominant elbow flexors and knee extensors of the training group. Tension for 1 repetition maximum and maximal voluntary isometric contraction, and surface EMG information such as the integrated EMG and three variables from the regression line of median frequency (MDF) data were measured at weeks 0, 3, 6, 9, and 12. The limb circumference was measured at weeks 0 and 12. During the strength training, which was enough for the increment of muscle strength and limb circumference, the rectified-integrated EMG and initial MDF increased with a significant linear pattern in both types of contraction. The two surface EMG variables were able to monitor the physiologic muscle changes during the training. Based on these results, we propose that these two surface EMG variables can be used for monitoring electrophysiological changes in the specific muscle that is undergoing the training program, under conditions where the contraction mode for EMG data collection is either static or dynamic.
doi:10.3349/ymj.2006.47.1.93
PMCID: PMC2687586  PMID: 16502490
Surface EMG; fast Fourier transformation; integrated EMG; median frequency; strength training
15.  Stability Ball Training on Lower Back Strength has Greater Effect in Untrained Female Compared to Male 
Journal of Human Kinetics  2012;33:133-141.
The purpose of this study was to evaluate the effectiveness of short-term stability ball (SB) training on males and females by comparing the strength changes produced in the core muscles. Forty-two previously untrained subjects, mean age = 23.62 ± 2.89 years were matched by their maximum strength (back strength: male = 190–200 kg, female = 45–50 kg and abdominal strength: male = 110–120 kg, female = 35–40 kg 1RM) and randomly placed in either one of these 3 groups; unstable SB group (n = 14), stable floor group (n = 14) and control group (n = 14) who did no exercise. SB training showed greatest improvement (p < 0.001) in back and abdominal strength (25.79 % and 29.51 % respectively), compared with the gain in floor training (FT) back and abdominal strength (10.28 % and 8.47 % respectively). Untrained female subjects achieved a higher percentage of improvement in strength compared to males in both back and abdominal muscles, and this is most evident in the SB training group. It is apparent that performing core training exercises on unstable surfaces stressed the musculature, possibly activating the neuro-adaptive mechanisms that led to the early phase gains in strength.
doi:10.2478/v10078-012-0052-2
PMCID: PMC3588679  PMID: 23487252
stability ball (SB) training; back strength (BS); abdominal strength (AS)
16.  Symptomatic and Functional Responses to Concentric-Eccentric Isokinetic Versus Eccentric-Only Isotonic Exercise 
Journal of Athletic Training  2009;44(5):462-468.
Abstract
Context:
Rehabilitation protocols involving eccentric resistance exercise performed with loading more than 100% concentric 1-repetition maximum are effective in increasing muscle function in both healthy and injured populations. The mode of eccentric exercise (isokinetic versus isotonic) may be an important factor in limiting symptoms of delayed-onset muscle soreness and in improving muscle function after training.
Objective:
To compare functional and symptomatic responses after an eccentric-only (ECC) isotonic exercise protocol and after a combined concentric-eccentric (CON-ECC) isokinetic exercise protocol matched for total exercise volume.
Design:
Observational study.
Setting:
Controlled research laboratory.
Patients or Other Participants:
Twenty-four healthy, untrained, college-aged men (n  =  12) and women (n  =  12).
Intervention(s):
Participants were randomly assigned to the ECC isotonic or CON-ECC isokinetic exercise group and performed a single bout of resistance exercise involving the elbow flexors.
Main Outcome Measure(s):
Measurements of elbow flexion and extension, isometric strength, and muscle point tenderness were obtained before exercise (baseline) and during follow-up sessions (days 2, 4, 7, and 14). Separate 1-way analyses of variance and repeated-measures analyses of variance were used to determine outcome differences. Tukey post hoc testing was performed when indicated.
Results:
At baseline, no differences were present between groups for any measure. The ECC isotonic exercise protocol resulted in a 30% to 36% deficit in muscle strength, a 5% to 7% reduction in elbow flexion, and a 6% to 8% reduction in elbow extension at follow-up days 2 and 4 (P < .01). The CON-ECC isokinetic exercise protocol did not alter muscle strength or range of motion at any time when compared with baseline. Muscle point tenderness increased from baseline on days 2 and 4 in both groups (P < .05) but was not different between groups throughout the recovery period.
Conclusions:
Our results indicated more pronounced functional deficits occurred after a single bout of ECC isotonic exercise than with a CON-ECC isokinetic exercise protocol matched for training volume.
doi:10.4085/1062-6050-44.5.462
PMCID: PMC2742454  PMID: 19771283
muscle soreness; enhanced eccentric exercises; rehabilitation
17.  Is glucose/amino acid supplementation after exercise an aid to strength training? 
Background—The precise timing of carbohydrate and amino acid ingestion relative to a bout of resistance exercise may modulate the training effect of the resistance exercise.
Objective—To assess whether regular glucose/amino acid supplementation immediately after resistance exercise could enhance the gain in muscle strength brought about by resistance training.
Methods—Seven untrained participants with a median age of 23 years and mean (SD) body mass 68.9 (13.5) kg resistance trained on a leg extension machine for five days a week for 10 weeks, using four sets of 10 repetitions. Alternate legs were trained on successive days, one leg each day. Subjects ingested either a supplement including 0.8 g glucose/kg and 0.2 g amino acids/kg, or placebo, on alternate training days immediately after training. Therefore the supplement was always ingested after training the same leg (supplement leg). Isometric, isokinetic, and 1 repetition maximum (RM) strength were measured before, during, and after training. Blood samples were analysed to determine the acute responses of insulin and glucose to resistance exercise and supplementation or placebo.
Results—Serum insulin concentration peaked 20 minutes after supplement ingestion at ninefold the placebo level, and remained significantly elevated for at least 80 minutes (p<0.01). Isometric, isokinetic, and 1 RM strength improved on both supplement and placebo legs (p<0.05). There were no significant differences in the gain in strength between the supplement leg and the placebo leg (p>0.05).
Conclusion—Regular glucose/amino acid supplementation immediately after resistance exercise is unlikely to enhance the gain in muscle strength brought about by resistance training.
Key Words: strength training; nutrition; amino acids; carbohydrate
doi:10.1136/bjsm.35.2.109
PMCID: PMC1724313  PMID: 11273972
18.  Effect of Eccentric Isotonic Quadriceps Muscle Exercises on Patellofemoral Pain Syndrome: An Exploratory Pilot Study 
Asian Journal of Sports Medicine  2011;2(4):227-234.
Purpose
There is a decrease in quadriceps muscle strength in subjects with patellofemoral pain syndrome. Various types of strengthening exercises of the quadriceps are done as part of its management, but the effect of isotonic eccentric quadriceps muscle exercises on patellofemoral pain syndrome has not been studied. Hence the aim of this exploratory pilot study was to evaluate the effect of eccentric quadriceps training in patients with patellofemoral pain.
Methods
Twenty patients (12 female and 8 male, mean ages, 27.50 +/- 6.6 years) with patellofemoral pain syndrome were treated. The eccentric training of the quadriceps was given using a Baltimore Therapeutic Equipment (BTE) Primus machine. The main outcome measures used were percentage time on target as shown by the BTE primus machine, SF-36 Health questionnaire and patellofemoral pain severity scale. Statistical analysis was performed using SPSS 13.
Results
All the outcome measures showed significant improvements (P<0.05). Percentage time on target improved with a mean difference of 23.6, the SF-36 questionnaire showed an improvement in physical component score, mental component score and bodily pain with a mean difference of 10.9, 2.6 and 29.2 respectively and pain score when taken using patellofemoral severity scale also improved with a mean difference of 3.4.
Conclusion
Isotonic eccentric training of quadriceps muscles was found to be effective in reducing pain and improving the functional status of patients with patellofemoral pain syndrome and can be suggested as part of the treatment.
PMCID: PMC3289225  PMID: 22375243
Quadriceps Muscle; Patellofemoral Pain Syndrome; Isotonic Contraction; Eccentric Exercises; Muscle Strength
19.  A study of passive weight-bearing lower limb exercise effects on local muscles and whole body oxidative metabolism: a comparison with simulated horse riding, bicycle, and walking exercise 
Background
We have developed an exercise machine prototype for increasing exercise intensity by means of passively exercising lower limb muscles. The purpose of the present study was to compare the passive exercise intensity of our newly-developed machine with the intensities of different types of exercises. We also attempted to measure muscle activity to study how these forms of exercise affected individual parts of the body.
Methods
Subjects were 14 healthy men with the following demographics: age 30 years, height 171.5 cm, weight 68.3 kg. They performed 4 types of exercise: Passive weight-bearing lower limb exercise (PWLLE), Simulated horse riding exercise (SHRE), Bicycle exercise, and Walking exercise, as described below at an interval of one week or longer. Oxygen uptake, blood pressure, heart rate, and electromyogram (EMG) were measured or recorded during exercise. At rest prior to exercise and immediately after the end of each exercise intensity, the oxygenated hemoglobin levels of the lower limb muscles were measured by near-infrared spectroscopy to calculate the rate of decline. This rate of decline was obtained immediately after exercise as well as at rest to calculate oxygen consumption of the lower limb muscles as expressed as a ratio of a post-exercise rate of decline to a resting one.
Results
The heart rate and oxygen uptake observed in PWLLE during maximal intensity were comparable to that of a 20-watt bicycle exercise or 2 km/hr walking exercise. Maximal intensity PWLLE was found to provoke muscle activity comparable to an 80-watt bicycle or 6 km/hr walking exercise. As was the case with the EMG results, during maximal intensity PWLLE, the rectus femoris muscle consumed oxygen in amounts identical to that of an 80-watt bicycle or a 6 km/hr walking exercise.
Conclusion
Passive weight-bearing lower limb exercise using our trial machine could provide approximately 3 MET of exercise and the thigh exhibited muscle activity equivalent to that of 80-watt bicycle or 6 km/hr walking exercise. Namely, given the same oxygen uptake, PWLLE exceeded bicycle or walking exercise in muscle activity, thus PWLLE is believed to strengthen muscle power while reducing the load imposed on the cardiopulmonary system.
doi:10.1186/1476-5918-8-4
PMCID: PMC2780382  PMID: 19900292
20.  Pre‐ and post‐impact muscle activation in the tennis volley: effects of ball speed, ball size and side of the body 
British Journal of Sports Medicine  2007;41(11):754-759.
Aim
To examine the pre‐ and post‐impact activation of five upper extremity muscles in the tennis volley across conditions of ball speed, ball type and side of the body.
Methods
A repeated measures design in a biomechanics laboratory setting was used. A total of 24 recreational tennis players (mean (SD) age 24 (5) years, height 176 (10) cm, mass 76 (13) kg) were recruited from a university. Participants performed tennis volleys under 18 ball conditions: three ball speeds (slow, medium and fast), with three ball types (two oversize and one regular size) each from two sides (forehand and backhand). Average normalised electromyographic levels of the flexor carpi radialis, extensor carpi radialis, triceps brachii, anterior/middle deltoid and posterior/middle deltoid of the hitting arm during pre‐ and post‐impact phases (200 ms before and after ball–racquet impact, respectively) were assessed.
Results
For the pre‐impact phase, a significant muscle and side interaction (p<0.001) and significant main effects for speed (p = 0.002) and muscle (p<0.001) were observed. For the post‐impact phase, significant interactions were observed for ball type and side (p = 0.002), ball speed and side (p = 0.011) and muscle and side (p = 0.001), as well significant main effects for muscle (p<0.001), speed (p = 0.035) and side (p<0.001).
Conclusion
Oversize tennis balls do not significantly increase upper extremity muscle activation compared to regular size balls during a tennis volley. The highest post‐impact activation was observed in the ECR indicating a vigorous wrist stabilisation role that could irritate players with lateral epicondylalgia.
doi:10.1136/bjsm.2007.037184
PMCID: PMC2465297  PMID: 17957013
21.  Associations Between Rate of Force Development Metrics and Throwing Velocity in Elite Team Handball Players: a Short Research Report 
Journal of Human Kinetics  2011;29A:53-57.
Performance assessment has become an invaluable component of monitoring participant’s development in distinct sports, yet limited and contradictory data are available in trained subjects. The purpose of this study was to examine the relationship between ball throwing velocity during a 3-step running throw in elite team handball players and selected measures of rate of force development like force, power, velocity, and bar displacement during a concentric only bench press exercise in elite male handball players. Fitteen elite senior male team handball players volunteered to participate. Each volunteer had power and bar velocity measured during a concentric only bench press test with 25, 35, and 45 kg as well as having one-repetition maximum strength determined. Ball throwing velocity was evaluated with a standard 3-step running throw using a radar gun. The results of this study indicated significant associations between ball velocity and time at maximum rate of force development (0, 66; p<0.05) and rate of force development at peak force (0,56; p<0.05) only with 25kg load. The current research indicated that ball velocity was only median associated with maximum rate of force development with light loads. A training regimen designed to improve ball-throwing velocity in elite male team handball players should emphasize bench press movement using light loads.
doi:10.2478/v10078-011-0059-0
PMCID: PMC3588902  PMID: 23487363
rate of force development; velocity; throwing; elite; team handball
22.  An Electromyographic Investigation of 4 Elastic-Tubing Closed Kinetic Chain Exercises After Anterior Cruciate Ligament Reconstruction 
Journal of Athletic Training  1998;33(4):328-335.
Objective:
To determine the electromyographic (EMG) activity of the vastus medialis oblique (VMO), vastus lateralis (VL), semitendinosus and semimembranosus (ST), and biceps femoris (BF) muscles during 4 elastic-tubing closed kinetic chain exercises in postoperative patients with anterior cruciate ligament (ACL)-reconstructed knees.
Design and Setting:
A 4 × 4 repeated-measures analysis of variance design guided this study. Independent variables were type of exercise and muscle; the dependent variable was EMG activity.
Subjects:
Fifteen patients, 5 to 24 weeks after ACL reconstruction.
Measurements:
Subjects performed 4 exercises (front pull, back pull, crossover, reverse crossover) with elastic tubing attached to the foot of the uninjured leg. Time-and amplitude- normalized EMG activity was recorded from the VMO, VL, ST, and BF muscles of the injured leg. The hamstrings: quadriceps ratio was calculated.
Results:
The normalized VMO, VL, and BF EMG activity ranged from 25% to 50% of maximum voluntary isometric contraction for the 4 exercises. The ST ranged from 12% on the back pull to 58% on the front pull. The hamstrings: quadriceps ratios were 137% (front pull), 115% (crossover), 70% (back pull), and 60% (reverse crossover).
Conclusions:
We suggest that clinicians use these exercises during early ACL rehabilitation since they incorporate early weightbearing with hamstring and quadriceps coactivation.
Images
PMCID: PMC1320583  PMID: 16558530
EMG; ACL rehabilitation; knee rehabilitation
23.  Exercise-Induced Muscle Damage and Running Economy in Humans 
The Scientific World Journal  2013;2013:189149.
Running economy (RE), defined as the energy demand for a given velocity of submaximal running, has been identified as a critical factor of overall distance running performance. Plyometric and resistance trainings, performed during a relatively short period of time (~15–30 days), have been successfully used to improve RE in trained athletes. However, these exercise types, particularly when they are unaccustomed activities for the individuals, may cause delayed onset muscle soreness, swelling, and reduced muscle strength. Some studies have demonstrated that exercise-induced muscle damage has a negative impact on endurance running performance. Specifically, the muscular damage induced by an acute bout of downhill running has been shown to reduce RE during subsequent moderate and high-intensity exercise (>65% VO2max). However, strength exercise (i.e., jumps, isoinertial and isokinetic eccentric exercises) seems to impair RE only for subsequent high-intensity exercise (~90% VO2max). Finally, a single session of resistance exercise or downhill running (i.e., repeated bout effect) attenuates changes in indirect markers of muscle damage and blunts changes in RE.
doi:10.1155/2013/189149
PMCID: PMC3575608  PMID: 23431253
24.  The relative timing of trunk muscle activation is retained in response to unanticipated postural-perturbations during acute low back pain 
The purpose of this study was to assess the activation of the erector spinae (ES) and external oblique (EO) in response to unanticipated, bi-directional postural perturbations before and after the induction of acute low back pain (LBP) in healthy individuals. An experimental session consisted of a baseline, control, and an acute LBP condition. For the control and acute LBP condition, isotonic or hypertonic saline (HS), respectively, was injected into the right ES muscle. In each condition, participants stood on a moveable platform during which 32 randomized postural perturbations (8 repetitions of 4 perturbation types: 8 cm anterior slides, 8 cm posterior slides, 10° anterior tilts, and 10° posterior tilts) with varying inter-perturbation time intervals were performed over a period of 4–5 min. Bilateral surface electromyography (EMG) was recorded from the ES and EO in addition to subjective pain records. During the acute LBP condition: (1) the onset time of the ES and EO was delayed for the forward and backward sliding perturbations (P < 0.05); (2) EMG amplitude was reduced bilaterally for all perturbations (P < 0.05); (3) the order of activation and interval between the onset times of the ES and EO were unaltered and (4) ES, but not EO, activity was adjusted to account for the directional differences between the perturbations. This study revealed that re-establishment of posture and balance was a result of the individuals’ ability to rapidly modulate ES with respect to EO activity and that the bi-directional postural responses, although shifted in time and amplitude, retained temporal features in the presence of acute LBP.
doi:10.1007/s00221-011-2629-8
PMCID: PMC3066398  PMID: 21442223
Low back pain; Perturbation; Motor control; Balance
25.  Anaerobic and Aerobic Performance of Elite Female and Male Snowboarders 
Journal of Human Kinetics  2012;34:81-88.
The physiological adaptation to training is specific to the muscle activity, dominant energy system involved, muscle groups trained, as well as intensity and volume of training. Despite increasing popularity of snowboarding only little scientific data is available on the physiological characteristics of female and male competitive snowboarders. Therefore, the purpose of this study was to compare the aerobic capacity and maximal anaerobic power of elite Polish snowboarders with untrained subjects. Ten snowboarders and ten aged matched students of Physical Education performed two exercise tests. First, a 30-second Wingate test was conducted and next, a cycle ergometer exercise test with graded intensity. In the first test, peak anaerobic power, the total work, relative peak power and relative mean power were measured. During the second test, relative maximal oxygen uptake and lactate threshold were evaluated. There were no significant differences in absolute and relative maximal oxygen uptake between snowboarders and the control group. Mean maximal oxygen uptake and lactate threshold were significantly higher in men than in women. Significant differences were found between trained men and women regarding maximal power and relative maximal power. The elite snowboarders demonstrated a high level of anaerobic power. The level of relative peak power in trained women correlated negatively with maximal oxygen uptake. In conclusion, our results seem to indicate that the demanding competition program of elite snowboarders provides a significant training stimulus mainly for anaerobic power with minor changes in anaerobic performance.
doi:10.2478/v10078-012-0066-9
PMCID: PMC3590835  PMID: 23487498
maximal oxygen uptake; anaerobic power; exercise training; snowboarding

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