The management of proximal rectus femoris avulsion injuries

Injuries to the quadriceps muscle group are commonly seen in sporting activities that involve repetitive kicking and high-speed sprinting, including football (soccer), rugby and athletics. The proximal rectus femoris is prone to avulsion injuries as rapid eccentric muscle contraction leads to asynchronous muscle activation and different force vectors through the straight and reflected heads. Risk factors for injury include previous rectus femoris muscle or hamstring injury, reduced flexibility of the quadriceps complex, injury to the dominant leg, and dry field playing conditions. Magnetic resonance imaging (MRI) is the preferred imaging modality as it enables the site of injury to be accurately located, concurrent injuries to be identified, preoperative grading of the injury, and aids surgical planning. Non-operative management is associated with highly variable periods of convalescence, poor return to preinjury level of function and high risk of injury recurrence. Operative treatment of proximal rectus femoris avulsion injuries with surgical repair or surgical tenodesis enables return to preinjury level of sporting activity and high functional outcomes. Surgical tenodesis of proximal rectus femoris avulsion injuries may offer an avenue for further reducing recurrence rates compared to direct suture anchor repair of these injuries. Cite this article: EFORT Open Rev 2020;5:828-834. DOI: 10.1302/2058-5241.5.200055

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Static vs. Dynamic Acute Stretching Effect on Quadriceps Muscle Activity during Soccer Instep Kicking

Journal of Human Kinetics ◽

10.2478/hukin-2013-0066 ◽

2013 ◽

Vol 39 (1) ◽

pp. 37-47 ◽

Cited By ~ 10

Author(s):

Mohammadtaghi Amiri-Khorasani ◽

Eleftherios Kellis

Keyword(s):

Angular Velocity ◽

Muscle Activity ◽

High Speed ◽

Muscle Activation ◽

Body Height ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Knee Extension ◽

Emg Activity ◽

Dynamic Stretching

Abstract The purpose of this study was to compare the effects of static and dynamic stretching on quadriceps muscle activation during maximal soccer instep kicking. The kicking motion of twelve male college soccer players (body height: 174.66 ± 5.01 cm; body mass: 72.83 ± 4.83 kg; age: 18.83 ± 0.75 years) was captured using six synchronized high-speed infra-red cameras whilst electromyography (EMG) signals from vastus medialis (VM), lateralis (VL) and rectus femoris (RF) were recorded before and after static or dynamic stretching. Analysis of variance designs showed a higher increase in knee extension angular velocity (9.65% vs. -1.45%, p < 0.001), RF (37.5% vs. -8.33%, p < 0.001), VM (12% vs. - 12%, p < 0.018), and VL EMG activity (20% vs. -6.67%, p < 0.001) after dynamic stretching exercises. Based on these results, it could be suggested that dynamic stretching is probably more effective in increasing quadriceps muscle activity and knee extension angular velocity during the final swing phase of a maximal soccer instep kick than static stretching.

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Evaluation of the Lower Limb Muscles’ Electromyographic Activity during the Leg Press Exercise and Its Variants: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134626 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4626

Author(s):

Isabel Martín-Fuentes ◽

José M. Oliva-Lozano ◽

José M. Muyor

Keyword(s):

Muscle Activation ◽

Vastus Lateralis ◽

Muscular Activity ◽

Rectus Femoris ◽

Biceps Femoris ◽

Quadriceps Muscle ◽

Electromyographic Activity ◽

Full Extension ◽

Cross Sectional ◽

Leg Press

The aim of this study was to analyze the literature on muscle activation measured by surface electromyography (sEMG) of the muscles recruited when performing the leg press exercise and its variants. The Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to report this review. The search was carried out using the PubMed, Scopus, and Web of Science electronic databases. The articles selected met the following inclusion criteria: (a) a cross-sectional or longitudinal study design; (b) neuromuscular activation assessed during the leg press exercise, or its variants; (c) muscle activation data collected using sEMG; and (d) study samples comprising healthy and trained participants. The main findings indicate that the leg press exercise elicited the greatest sEMG activity from the quadriceps muscle complex, which was shown to be greater as the knee flexion angle increased. In conclusion, (1) the vastus lateralis and vastus medialis elicited the greatest muscle activation during the leg press exercise, followed closely by the rectus femoris; (2) the biceps femoris and the gastrocnemius medialis showed greater muscular activity as the knee reached full extension, whereas the vastus lateralis and medialis, the rectus femoris, and the tibialis anterior showed a decreasing muscular activity pattern as the knee reached full extension; (3) evidence on the influence of kinematics modifications over sEMG during leg press variants is still not compelling as very few studies match their findings.

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Assessment of Hamstring: Quadriceps Coactivation without the Use of Maximum Voluntary Isometric Contraction

Applied Sciences ◽

10.3390/app10051615 ◽

2020 ◽

Vol 10 (5) ◽

pp. 1615

Author(s):

Gonzalo Torres ◽

David Chorro ◽

Archit Navandar ◽

Javier Rueda ◽

Luís Fernández ◽

...

Keyword(s):

Isometric Contraction ◽

Muscle Activation ◽

Vastus Lateralis ◽

Rectus Femoris ◽

Biceps Femoris ◽

Quadriceps Muscle ◽

Activation Pattern ◽

Post Injury ◽

Male Youth ◽

Maximum Voluntary Isometric Contraction

This study aimed to study the coactivation patterns of the hamstring and quadriceps muscle groups during submaximal strength exercises commonly used in injury prevention in soccer without the use of maximum voluntary isometric contraction testing. This was used to compare: (i) the inter-limb differences in muscle activation; (ii) the intra-muscular group activation pattern and (iii) the activation pattern during different phases of the exercise. Muscle activation was recorded by surface electromyography in 19 elite, male, youth soccer players. Participants performed the following: Bulgarian squat, lunge and squat. Electrical activity was recorded for the rectus femoris, vastus medialis, vastus lateralis, biceps femoris and semitendinosus. No significant inter-limb differences were found (F1, 13 = 619; p = 0.82; η2 = 0.045). Significant differences were found in the muscle activation between individual muscles within the quadriceps and hamstrings muscle group for each of the exercises: Bulgarian squat (F1,18 = 331: p < 0.001; η2 = 0.80), lunge (F4,72 = 114.5; p < 0.001; η2 = 0.86) and squat (F1,16 = 247.31; p < 0.001; η2 = 0.93). Differences were found between the different phases of each of the exercises (F2,26 = 52.27; p = 0.02; η2 = 0.80). The existence of an activation pattern of each of the muscles in the three proposed exercises could be used for muscle assessment and as a tool for reconditioning post-injury.

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Comparison of quadriceps muscle activation in exercises with different duration of concentric and eccentric contractions

Archivos de Medicina del Deporte ◽

10.18176/archmeddeporte.0002 ◽

2020 ◽

Vol 37 (5) ◽

pp. 291-297

Author(s):

G Freire da Silva ◽

F Douglas Tourino ◽

RC Ribeiro Diniz ◽

L Túlio de Lacerda ◽

HC Martins Costa ◽

...

Keyword(s):

Degrees Of Freedom ◽

Muscle Activation ◽

Vastus Lateralis ◽

Knee Extensor ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Knee Extension ◽

Muscle Action ◽

Emg Signal ◽

Knee Extension Exercise

Aim: The objective of the present study was to compare the amplitude of the electromyographic (EMG) signal of the quadriceps muscle portions vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) and the activation ratio (VM/VL, VM/RF and VL/RF) in protocols with different durations of concentric and eccentric muscular actions. Material and method: Twelve female volunteers performed the knee extensor exercise with two different protocols [1s for concentric muscle action and 5s for eccentric muscle action (1:5); 5s of concentric muscle action and 1s of eccentric muscle action (5:1)] and 3 sets of 6 repetitions, 180s of pause between each sets and a intensity of 50% of 1RM. The root mean square of the amplitude of the normalized EMG signal was calculated for each repetition in each series. Results: it was observed an increase in the activation of the VM and VL portions in equivalent repetitions of each series and for the VL portion, the 1: 5 protocol provided greater activation compared to the other protocol. No differences were found for muscles activation ratios VM/RF and VL/RF, being that for the VM/VL ratio there was only change at one repetition. Conclusion: The results suggest that the portions of the quadriceps muscle may present different EMG responses in similar protocols, but this fact may not interfere in the synergism between them. The reduced degrees of freedom of the knee extension exercise and the characteristics of the protocols adopted may be the elements that contributed to the limited alterations that occurred in the present study.

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Differences of Thigh Muscle Activation During Various Squat Exercise on Stable and Unstable Surfaces

Exercise Science ◽

10.15857/ksep.2021.30.3.387 ◽

2021 ◽

Vol 30 (3) ◽

pp. 387-395

Author(s):

Soojin Kim ◽

Joo-Hyun Lee ◽

Jihye Heo ◽

Eunwook Chang

Keyword(s):

Muscle Activity ◽

Repeated Measures ◽

Muscle Activation ◽

Vastus Lateralis ◽

Rectus Femoris ◽

Biceps Femoris ◽

Quadriceps Muscle ◽

Thigh Muscle ◽

Unstable Surface ◽

Co Activation

PURPOSE: The purpose of this study was to compare thigh muscle activities and muscle co-activation when performing squats, wall squats, and Spanish squats on stable and unstable ground.METHODS: Twenty-two healthy male subjects (age: 22.50±2.70 years, height: 178.72±6.04 cm, mass: 76.50±6.80 kg, body mass index: 24.00±2.10 kg/m2, and Godin activity questionnaire: 56.30±24.10) voluntarily participated in the study. All of the participants performed three different squat exercises on the floor and the BOSU ball with an electromyograph attached to each participant’s quadriceps (rectus femoris, RF; vastus lateralis, VL; and vastus medialis, VM) and hamstrings (biceps femoris, BF; semitendinosus, ST; and semimembranosus, SM). Repeated measures of analysis of variance were utilized to compare muscle activity during the three squats exercises by floor type.RESULTS: RF (p<.001, η2=.689), VL (p<.001, η2=.622), and VM (p=.002, η2=.375) showed significant differences between exercises. Spanish squats yielded greater BF activity than did wall squats (p=.018, η2=.269). ST yielded greater muscle activity with the BOSU ball than on the floor (p=.018, η2=.269). Finally, there was a significant ground exercise interaction effect on the co-activation, showing greater muscle co-activation with Spanish squats on the BOSU ball compared to squats, squats on the BOSU ball, and wall squat on the BOSU ball.CONCLUSIONS: The findings of this study indicate that Spanish squats could be an effective exercise option for the facilitation of RF, VL, VM, and BF muscle activation. In particular, performing Spanish squats on an unstable surface could be useful for patients who need to improve their quadriceps muscle activation.

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One Session Effects of Knee Motion Visualization Using Immersive Virtual Reality in Patients with Hemophilic Arthropathy

Journal of Clinical Medicine ◽

10.3390/jcm10204725 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4725

Author(s):

Roberto Ucero-Lozano ◽

Raúl Pérez-Llanes ◽

José Antonio López-Pina ◽

Rubén Cuesta-Barriuso

Keyword(s):

Muscle Activation ◽

Vastus Lateralis ◽

Joint Damage ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Knee Extension ◽

Post Intervention ◽

Specific Protocol ◽

Rectus Femoris Muscle ◽

Femoris Muscle

(1) Background: Hemophilic knee arthropathy is characterized by a loss of muscle mass and decreased strength of the quadriceps muscle. The visualization of movement aims to favor the recruitment of the motor system in the same premotor and parietal areas, as would happen with the active execution of the observed action. The aim was to evaluate changes in quadriceps activation in patients with hemophilic knee arthropathy following immersive VR visualization of knee extension movements. (2) Methods: We recruited 13 patients with severe hemophilia A and knee arthropathy. Patients underwent a 15 min session of immersive VR visualization of knee extension movements. The quadriceps muscle activation was evaluated by surface electromyography. (3) Results: After the intervention, there were no changes in the muscle activation of vastus medialis, vastus lateralis, or rectus femoris muscles. There was a large effect size of changes in rectus femoris muscle activation. Age and knee joint damage did not correlate with changes in quadriceps activation. Dominance, inhibitor development, and type of treatment were not related with post-intervention muscle activation. (4) Conclusions: A session of immersive VR visualization of knee extension movement does not modify quadriceps muscle activation. A specific protocol for patients with hemophilic knee arthropathy may be effective in improving the activation of the rectus femoris muscle.

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Comparison of Hamstrings and Quadriceps Muscle Activation in Male and Female Professional Soccer Players

Applied Sciences ◽

10.3390/app11020738 ◽

2021 ◽

Vol 11 (2) ◽

pp. 738

Author(s):

Gonzalo Torres ◽

Estrella Armada-Cortés ◽

Javier Rueda ◽

Alejandro F. San Juan ◽

Enrique Navarro

Keyword(s):

Muscle Activation ◽

Vastus Lateralis ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Soccer Players ◽

Vastus Lateralis Muscle ◽

Vastus Medialis ◽

Hamstring Muscle ◽

Male And Female ◽

Professional Soccer

(1) Background: this study aimed to determine if there are differences in quadriceps and hamstring muscle activation in professional male and female soccer players. (2) Methods: muscle activation was recorded by surface electromyography in 27 professional soccer players (19 male and 8 female). The players performed the Bulgarian squat and lunge exercises. Vastus medialis, vastus lateralis, rectus femoris, semitendinosus, and biceps femoris were the muscles analyzed. (3) Results: The statistical analysis of the hamstring:quadriceps ratio showed no significant differences (p > 0.05). Significant differences were found in the vastus medialis:vastus lateralis ratio for both the lunge exercise (t20 = 3.35; p = 0.001; d = 1.42) and the Bulgarian squat (t23 = 4.15; p < 0.001; d = 1.76). For the intragroup muscular pattern in the lunge and Bulgarian squat exercises, the female players showed higher activation for the vastus lateralis muscle (p < 0.001) than the male players and lower muscle activation in the vastus medialis. No significant differences were found in the rectus femoris, biceps remoris, and semitendinosus muscles (p > 0.05). (4) Conclusions: Differences were found in the medial ratio (vastus medialis: vastus lateralis). Moreover, regarding the intramuscular pattern, very consistent patterns have been found. In the quadriceps muscle: VM>VL>RF; in the hamstring muscle: ST>BF. These patterns could be very useful in the recovery process from an injury to return players to their highest performance.

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Passive knee exoskeletons in functional tasks: Biomechanical effects of a SpringExo coil-spring on squats

Wearable Technologies ◽

10.1017/wtc.2021.6 ◽

2021 ◽

Vol 2 ◽

Author(s):

Rand Hidayah ◽

Dongbao Sui ◽

Kennedi A. Wade ◽

Biing-Chwen Chang ◽

Sunil Agrawal

Keyword(s):

Outcome Measures ◽

Muscle Activation ◽

Rectus Femoris ◽

Knee Extension ◽

Lower Limbs ◽

Flexion Angle ◽

Coil Spring ◽

Foot Pressure ◽

Low Profile ◽

Muscle Activations

Abstract Passive wearable exoskeletons are desirable as they can provide assistance during user movements while still maintaining a simple and low-profile design. These can be useful in industrial tasks where an ergonomic device could aid in load lifting without inconveniencing them and reducing fatigue and stress in the lower limbs. The SpringExo is a coil-spring design that aids in knee extension. In this paper, we describe the muscle activation of the knee flexors and extensors from seven healthy participants during repeated squats. The outcome measures are the timings of the key events during squat, flexion angle, muscle activation of rectus femoris and bicep femoris, and foot pressure characteristics of the participants. These outcome measures assess the possible effects of the device during lifting operations where reduced effort in the muscles is desired during ascent phase of the squat, without changing the knee and foot kinematics. The results show that the SpringExo significantly decreased rectus femoris activation during ascent (−2%) without significantly affecting either the bicep femoris or rectus femoris muscle activations in descent. This implies that the user could perform a descent without added effort and ascent with reduced effort. The exoskeleton showed other effects on the biomechanics of the user, increasing average squat time (+0.02 s) and maximum squat time (+0.1 s), and decreasing average knee flexion angle (−4°). The exoskeleton has no effect on foot loading or placement, that is, the user did not have to revise their stance while using the device.

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EXTH-30. EXPANDING THE UTILITY OF PRE-CLINICAL CONTRAST ENHANCED CT (CE-CT) FOR TUMOR DETECTION IN ORTHOTOPIC GBM MODELS USING RADIOMICS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.384 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii93-ii93

Author(s):

Kate Connor ◽

Emer Conroy ◽

Kieron White ◽

Liam Shiels ◽

William Gallagher ◽

...

Keyword(s):

Imaging Modality ◽

Texture Features ◽

Tumor Detection ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

Magnetic Resonance Imaging Mri ◽

Work Supports ◽

Selection Of

Abstract Despite magnetic resonance imaging (MRI) being the gold-standard imaging modality in the glioblastoma (GBM) setting, the availability of rodent MRI scanners is relatively limited. CT is a clinically relevant alternative which is more widely available in the pre-clinic. To study the utility of contrast-enhanced (CE)-CT in GBM xenograft modelling, we optimized CT protocols on two instruments (IVIS-SPECTRUM-CT;TRIUMPH-PET/CT) with/without delivery of contrast. As radiomics analysis may facilitate earlier detection of tumors by CT alone, allowing for deeper analyses of tumor characteristics, we established a radiomic pipeline for extraction and selection of tumor specific CT-derived radiomic features (inc. first order statistics/texture features). U87R-Luc2 GBM cells were implanted orthotopically into NOD/SCID mice (n=25) and tumor growth monitored via weekly BLI. Concurrently mice underwent four rounds of CE-CT (IV iomeprol/iopamidol; 50kV-scan). N=45 CE-CT images were semi-automatically delineated and radiomic features were extracted (Pyradiomics 2.2.0) at each imaging timepoint. Differences between normal and tumor tissue were analyzed using recursive selection. Using either CT instrument/contrast, tumors > 0.4cm3 were not detectable until week-9 post-implantation. Radiomic analysis identified three features (waveletHHH_firstorder_Median, original_glcm_Correlation and waveletLHL_firstorder_Median) at week-3 and -6 which may be early indicators of tumor presence. These features are now being assessed in CE-CT scans collected pre- and post-temozolomide treatment in a syngeneic model of mesenchymal GBM. Nevertheless, BLI is significantly more sensitive than CE-CT (either visually or using radiomic-enhanced CT feature extraction) with luciferase-positive tumors detectable at week-1. In conclusion, U87R-Luc2 tumors > 0.4cm3 are only detectable by Week-8 using CE-CT and either CT instrument studied. Nevertheless, radiomic analysis has defined features which may allow for earlier tumor detection at Week-3, thus expanding the utility of CT in the preclinical setting. Overall, this work supports the discovery of putative prognostic pre-clinical CT-derived radiomic signatures which may ultimately be assessed as early disease markers in patient datasets.

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Spatial muscle activation patterns during different leg exercise protocols in physically active adults using muscle functional MRI: a systematic review

Journal of Applied Physiology ◽

10.1152/japplphysiol.00290.2020 ◽

2020 ◽

Vol 129 (4) ◽

pp. 934-946

Author(s):

Katherine Dooley ◽

Suzanne J. Snodgrass ◽

Peter Stanwell ◽

Samantha Birse ◽

Adrian Schultz ◽

...

Keyword(s):

Muscle Activation ◽

Assessment Tool ◽

Meta Analysis ◽

Lumbar Vertebra ◽

Rectus Femoris ◽

Physically Active ◽

Activation Patterns ◽

Muscle Activation Patterns ◽

Research Questions ◽

Active Adults

An emerging method to measure muscle activation patterns is muscle functional magnetic resonance imaging (mfMRI), where preexercise and postexercise muscle metabolism differences indicate spatial muscle activation patterns. We evaluated studies employing mfMRI to determine activation patterns of lumbar or lower limb muscles following exercise in physically active adults. Electronic systematic searches were conducted until March 2020. All studies employing ≥1.5 Tesla MRI scanners to compare spatial muscle activation patterns at the level of or inferior to the first lumbar vertebra in healthy, active adults. Two authors independently assessed study eligibility before appraising methodological quality using a National Institutes of Health assessment tool. Because of heterogeneity, findings were synthesized without meta-analysis. Of the 1,946 studies identified, seven qualified for inclusion and pertained to hamstring ( n = 5), quadriceps ( n = 1) or extrinsic foot ( n = 1) muscles. All included studies controlled for internal validity, with one employing assessor blinding. MRI physics and differing research questions explain study methodology heterogeneity. Significant mfMRI findings were: following Nordic exercise, hamstrings with previous trauma (strain or surgical autograft harvest) demonstrated reduced activation compared with unharmed contralateral muscles, and asymptomatic individuals preferentially activated semitendinosus; greater biceps femoris long head to semitendinosus ratios reported following 45° hip extension over Nordic exercise; greater rectus femoris activation occurred in “flywheel” over barbell squats. mfMRI parameters differ on the basis of individual research questions. Individual muscles show greater activation following specific exercises, suggesting exercise specificity may be important for rehabilitation, although evidence is limited to single cohort studies comparing interlimb differences preexercise versus postexercise.

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