Correlation between contractile properties of quadriceps muscle and functional performance in runners with patellofemoral pain syndrome
Abstract
Background: Long distance runners commonly complain from patellofemoral pain syndrome (PFPS) that limits their performance and return to sport. Abnormal neuromuscular control of the quadriceps has been demonstrated to cause patellar mal-tracking and hence PFPS. Changes in muscle morphology and neural activity have a role in neuromuscular changes, a key contributor to either primary or secondary injuries. Poor landing mechanics, impaired postural control, as well as changed peripheral muscle activation are all clinical manifestations of neuromuscular control deficiencies caused by central nervous system defects that have a deleterious effect on the contractile characteristics of skeletal muscle. Objectives: The purpose of this study was to investigate the correlation between contractile properties of quadriceps muscle and functional performance in long distance runners with PFPS. Study design: Cross-sectional study. Methods: Thirty runners were recruited form multiple Egyptian clubs. Tensiomyography (TMG) Parameters were assessed regarding Contraction time (Tc), Maximal displacement (Dm), Sustain time (Ts), Relaxion time (Tr) and Delay time (Td) in Rectus femoris (RF), Vastus medialis (VM) and Vastus lateralis (VL) separately and correlated with functional performance; number of repetitions in 30 seconds for anteromedial lunge test, balance and reach test and step-down test. Outcome measures: Functional performance was measured using functional performance tests; anteromedial lunge test, balance and reach test and step-down test. Results: It was found that VM Tc, VL Dm, were moderately positively correlated with anteromedial lunge (r = 0.583, 0.404, p<0.05) respectively. In contrast, RF Tr was negatively correlated with anteromedial lunge (-0.364, p<0.05); VM Ts,Tr,Dm; VL Td were moderately negatively correlated with balance and reach (r = --0.577, -0.388, 0.655 and -0.385, respectively, p<0.05). In contrast, VL Tc was moderately positively correlated with step-down (r = 0.424, p = 0.019). Conclusion: All contractile properties of quadriceps muscle are significantly correlated with functional performance in long distance runners with PFPS. Future studies should address these properties, using proper rehabilitation strategies, to improve performance of runners with PFPS.
Downloads
References
Allen, D. G. (2009). Fatigue in working muscles. Journal of applied physiology (Bethesda, Md.: 1985), 106(2), 358–359. doi.org/10.1152/japplphysiol.91599.2008
Arampatzis, A., Schade, F., Walsh, M., & Brüggemann, G. P. (2001). Influence of leg stiffness and its effect on myodynamic jumping performance. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 11(5), 355–364. doi.org/10.1016/s1050-6411(01)00009-8
Boling, M. C., Bolgla, L. A., Mattacola, C. G., Uhl, T. L., & Hosey, R. G. (2006). Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome. Archives of physical medicine and rehabilitation, 87(11), 1428–1435. doi.org/10.1016/j.apmr.2006.07.264
Bompa, T. O., & Buzzichelli, C. (2019). Periodization-: theory and methodology of training. Human kinetics.
Byrne, C., Twist, C., & Eston, R. (2004). Neuromuscular function after exercise-induced muscle damage: theoretical and applied implications. Sports medicine (Auckland, N.Z.), 34(1), 49–69. doi.org/10.2165/00007256-200434010-00005
Chang, W. L., Shih, Y. F., & Chen, W. Y. (2012). Running injuries and associated factors in participants of ING Taipei Marathon. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 13(3), 170–174. doi.org/10.1016/j.ptsp.2011.08.001
Chelly, S. M., & Denis, C. (2001). Leg power and hopping stiffness: relationship with sprint running performance. Medicine and science in sports and exercise, 33(2), 326–333. doi.org/10.1097/00005768-200102000-00024
Costa, P. B., Ryan, E. D., Herda, T. J., Walter, A. A., Hoge, K. M., & Cramer, J. T. (2012). Acute effects of passive stretching on the electromechanical delay and evoked twitch properties: a gender comparison. Journal of applied biomechanics, 28(6), 645–654. doi.org/10.1123/jab.28.6.645
Cowan, S. M., Bennell, K. L., & Hodges, P. W. (2002). Therapeutic patellar taping changes the timing of vasti muscle activation in people with patellofemoral pain syndrome. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 12(6), 339–347. doi.org/10.1097/00042752-200211000-00004
Cowan, S. M., Bennell, K. L., Hodges, P. W., Crossley, K. M., & McConnell, J. (2001). Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Archives of physical medicine and rehabilitation, 82(2), 183–189. doi.org/10.1053/apmr.2001.19022
Dahmane, R., Djordjevic, S., Simunic, B., & Valencic, V. (2005). Spatial fiber type distribution in normal human muscle Histochemical and tensiomyographical evaluation. Journal of biomechanics, 38(12), 2451–2459. doi.org/10.1016/j.jbiomech.2004.10.020
Dahmane, R., Valen i, V., Knez, N., & Er en, I. (2001). Evaluation of the ability to make non-invasive estimation of muscle contractile properties on the basis of the muscle belly response. Medical & biological engineering & computing, 39(1), 51–55. doi.org/10.1007/BF02345266
Davies, G., Riemann, B. L., & Manske, R. (2015). Current concepts of plyometric exercise. International journal of sports physical therapy, 10(6), 760–786.
Davis, I. S., & Powers, C. M. (2010). Patellofemoral pain syndrome: proximal, distal, and local factors, an international retreat, April 30-May 2, 2009, Fells Point, Baltimore, MD. The Journal of orthopaedic and sports physical therapy, 40(3), A1–A16. doi.org/10.2519/jospt.2010.0302
de Paula Simola, R. Á., Harms, N., Raeder, C., Kellmann, M., Meyer, T., Pfeiffer, M., & Ferrauti, A. (2015). Assessment of neuromuscular function after different strength training protocols using tensiomyography. Journal of strength and conditioning research, 29(5), 1339–1348. doi.org/10.1519/JSC.0000000000000768
Dogramaci, S. N., Watsford, M. L., & Murphy, A. J. (2011). Time-motion analysis of international and national level futsal. Journal of strength and conditioning research, 25(3), 646–651. doi.org/10.1519/JSC.0b013e3181c6a02e
Đorđević, S., Rozman, S., Zupet, P., Dopsaj, M., & Maffulli, N. (2022). Tensiomyography Allows to Discriminate between Injured and Non-Injured Biceps Femoris Muscle. Biology, 11(5), 746. doi.org/10.3390/biology11050746
García-Manso, J. M., Rodríguez-Matoso, D., Rodríguez-Ruiz, D., Sarmiento, S., de Saa, Y., & Calderón, J. (2011). Effect of cold-water immersion on skeletal muscle contractile properties in soccer players. American journal of physical medicine & rehabilitation, 90(5), 356–363. doi.org/10.1097/PHM.0b013e31820ff352
García-Manso, J. M., Rodríguez-Matoso, D., Sarmiento, S., de Saa, Y., Vaamonde, D., Rodríguez-Ruiz, D., & Da Silva-Grigoletto, M. E. (2012). Effect of high-load and high-volume resistance exercise on the tensiomyographic twitch response of biceps brachii. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 22(4), 612–619. doi.org/10.1016/j.jelekin.2012.01.005
Georgoulis, A. D., Ristanis, S., Papadonikolakis, A., Tsepis, E., Moebius, U., Moraiti, C., & Stergiou, N. (2005). Electromechanical delay of the knee extensor muscles is not altered after harvesting the patellar tendon as a graft for ACL reconstruction: implications for sports performance. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 13(6), 437–443. doi.org/10.1007/s00167-005-0656-3
Gil, S., Loturco, I., Tricoli, V., Ugrinowitsch, C., Kobal, R., Abad, C. C., & Roschel, H. (2015). Tensiomyography parameters and jumping and sprinting performance in Brazilian elite soccer players. Sports biomechanics, 14(3), 340–350. doi.org/10.1080/14763141.2015.1062128
Grabiner, M. D., Koh, T. J., & Draganich, L. F. (1994). Neuromechanics of the patellofemoral joint. Medicine and science in sports and exercise, 26(1), 10–21.
Greig M. (2008). The influence of soccer-specific fatigue on peak isokinetic torque production of the knee flexors and extensors. The American journal of sports medicine, 36(7), 1403–1409. doi.org/10.1177/0363546508314413
Grob, K., Manestar, M., Filgueira, L., Kuster, M. S., Gilbey, H., & Ackland, T. (2018). The interaction between the vastus medialis and vastus intermedius and its influence on the extensor apparatus of the knee joint. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 26(3), 727–738. doi.org/10.1007/s00167-016-4396-3
Grosset, J. F., Piscione, J., Lambertz, D., & Pérot, C. (2009). Paired changes in electromechanical delay and musculo-tendinous stiffness after endurance or plyometric training. European journal of applied physiology, 105(1), 131–139. doi.org/10.1007/s00421-008-0882-8
Heiderscheit B. C. (2010). Lower extremity injuries: is it just about hip strength? The Journal of orthopaedic and sports physical therapy, 40(2), 39–41. doi.org/10.2519/jospt.2010.0102
Hunter, A. M., Galloway, S. D., Smith, I. J., Tallent, J., Ditroilo, M., Fairweather, M. M., & Howatson, G. (2012). Assessment of eccentric exercise-induced muscle damage of the elbow flexors by tensiomyography. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 22(3), 334–341. doi.org/10.1016/j.jelekin.2012.01.009
Jackman, S. R., Witard, O. C., Jeukendrup, A. E., & Tipton, K. D. (2010). Branched-chain amino acid ingestion can ameliorate soreness from eccentric exercise. Medicine and science in sports and exercise, 42(5), 962–970. doi.org/10.1249/MSS.0b013e3181c1b798
Kamatsuki, Y., Furumatsu, T., Fujii, M., Kodama, Y., Miyazawa, S., Hino, T., & Ozaki, T. (2018). Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees. Journal of orthopaedic research: official publication of the Orthopaedic Research Society, 36(7), 1894–1900. doi.org/10.1002/jor.23861
Kaneko, F., Onari, K., Kawaguchi, K., Tsukisaka, K., & Roy, S. H. (2002). Electromechanical delay after ACL reconstruction: an innovative method for investigating central and peripheral contributions. The Journal of orthopaedic and sports physical therapy, 32(4), 158–165. doi.org/10.2519/jospt.2002.32.4.158
Kim, H., & Song, C. H. (2012). Comparison of the VMO/VL EMG ratio and onset timing of VMO relative to VL in subjects with and without patellofemoral pain syndrome. Journal of Physical Therapy Science, 24(12), 1315-1317.
Krizaj, D., Simunic, B., & Zagar, T. (2008). Short-term repeatability of parameters extracted from radial displacement of muscle belly. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 18(4), 645–651. doi.org/10.1016/j.jelekin.2007.01.008
Kubo, K., Kanehisa, H., Ito, M., & Fukunaga, T. (2001). Effects of isometric training on the elasticity of human tendon structures in vivo. Journal of applied physiology (Bethesda, Md.: 1985), 91(1), 26–32. doi.org/10.1152/jappl.2001.91.1.26
LaBella C. (2004). Patellofemoral pain syndrome: evaluation and treatment. Primary care, 31(4), 977–1003. https://doi.org/10.1016/j.pop.2004.07.006
Linford, C. W., Hopkins, J. T., Schulthies, S. S., Freland, B., Draper, D. O., & Hunter, I. (2006). Effects of neuromuscular training on the reaction time and electromechanical delay of the peroneus longus muscle. Archives of physical medicine and rehabilitation, 87(3), 395–401. doi.org/10.1016/j.apmr.2005.10.027
Lopes, A. D., Hespanhol Júnior, L. C., Yeung, S. S., & Costa, L. O. (2012). What are the main running-related musculoskeletal injuries? A Systematic Review. Sports medicine (Auckland, N.Z.), 42(10), 891–905. doi.org/10.1007/BF03262301
Loturco, I., Pereira, L. A., Kobal, R., Abad, C. C. C., Komatsu, W., Cunha, R., Arliani, G., Ejnisman, B., Pochini, A. C., Nakamura, F. Y., & Cohen, M. (2018). Functional Screening Tests: Interrelationships and Ability to Predict Vertical Jump Performance. International journal of sports medicine, 39(3), 189–197. doi.org/10.1055/s-0043-122738
Loudon, J. K., Wiesner, D., Goist-Foley, H. L., Asjes, C., & Loudon, K. L. (2002). Intrarater Reliability of Functional Performance Tests for Subjects with Patellofemoral Pain Syndrome. Journal of athletic training, 37(3), 256–261.
MacDonald, G. Z., Penney, M. D., Mullaley, M. E., Cuconato, A. L., Drake, C. D., Behm, D. G., & Button, D. C. (2013). An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. Journal of strength and conditioning research, 27(3), 812–821. doi.org/10.1519/JSC.0b013e31825c2bc1
Macgregor, L. J., Hunter, A. M., Orizio, C., Fairweather, M. M., & Ditroilo, M. (2018). Assessment of Skeletal Muscle Contractile Properties by Radial Displacement: The Case for Tensiomyography. Sports medicine (Auckland, N.Z.), 48(7), 1607–1620. doi.org/10.1007/s40279-018-0912-6
Makhsous, M., Lin, F., Koh, J. L., Nuber, G. W., & Zhang, L. Q. (2004). In vivo and noninvasive load sharing among the vasti in patellar malalignment. Medicine and science in sports and exercise, 36(10), 1768–1775. doi.org/10.1249/01.mss.0000142302.54730.7f
Marinšek, M., & Pavletič, M. S. (2020). Association between muscles’contractile properties and jumping performance in gymnasts. Science of Gymnastics Journal, 12(1), 75-86.
Martín-Rodríguez, S., Alentorn-Geli, E., Tous-Fajardo, J., Samuelsson, K., Marín, M., Álvarez-Díaz, P., & Cugat, R. (2017). Is tensiomyography a useful assessment tool in sports medicine? Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 25(12), 3980–3981. doi.org/10.1007/s00167-017-4600-0
Morales-Artacho, A. J., Padial, P., Rodríguez-Matoso, D., Rodríguez-Ruiz, D., García-Ramos, A., García-Manso, J. M., Calderón, C., & Feriche, B. (2015). Assessment of Muscle Contractile Properties at Acute Moderate Altitude Through Tensiomyography. High altitude medicine & biology, 16(4), 343–349. doi.org/10.1089/ham.2015.0078
Muraoka, T., Muramatsu, T., Fukunaga, T., & Kanehisa, H. (2004). Influence of tendon slack on electromechanical delay in the human medial gastrocnemius in vivo. Journal of applied physiology (Bethesda, Md.: 1985), 96(2), 540–544. doi.org/10.1152/japplphysiol.01015.2002
Murayama, M., Nosaka, K., Yoneda, T., & Minamitani, K. (2000). Changes in hardness of the human elbow flexor muscles after eccentric exercise. European journal of applied physiology, 82(5-6), 361–367. doi.org/10.1007/s004210000242
Myer, G. D., Ford, K. R., Barber Foss, K. D., Goodman, A., Ceasar, A., Rauh, M. J., Divine, J. G., & Hewett, T. E. (2010). The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clinical biomechanics (Bristol, Avon), 25(7), 700–707. doi.org/10.1016/j.clinbiomech.2010.04.001
Neptune, R. R., Wright, I. C., & van den Bogert, A. J. (2000). The influence of orthotic devices and vastus medialis strength and timing on patellofemoral loads during running. Clinical biomechanics (Bristol, Avon), 15(8), 611–618. doi.org/10.1016/s0268-0033(00)00028-0
Ng, G. Y., & Wong, P. Y. (2009). Patellar taping affects vastus medialis obliquus activation in subjects with patellofemoral pain before and after quadriceps muscle fatigue. Clinical rehabilitation, 23(8), 705–713. doi.org/10.1177/0269215509334835
Ng, G. Y., Zhang, A. Q., & Li, C. K. (2008). Biofeedback exercise improved the EMG activity ratio of the medial and lateral vasti muscles in subjects with patellofemoral pain syndrome. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 18(1), 128–133. doi.org/10.1016/j.jelekin.2006.08.010
Piqueras-Sanchiz, F., Martín-Rodríguez, S., Pareja-Blanco, F., Baraja-Vegas, L., Blázquez-Fernández, J., Bautista, I. J., & García-García, Ó. (2020). Mechanomyographic Measures of Muscle Contractile Properties are Influenced by Electrode Size and Stimulation Pulse Duration. Scientific reports, 10(1), 8192. doi.org/10.1038/s41598-020-65111-z
Powers C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. The Journal of orthopaedic and sports physical therapy, 40(2), 42–51. doi.org/10.2519/jospt.2010.3337
Rey, E., Lago-Peñas, C., & Lago-Ballesteros, J. (2012). Tensiomyography of selected lower-limb muscles in professional soccer players. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 22(6), 866–872. doi.org/10.1016/j.jelekin.2012.06.003
Ristanis, S., Tsepis, E., Giotis, D., Stergiou, N., Cerulli, G., & Georgoulis, A. D. (2009). Electromechanical delay of the knee flexor muscles is impaired after harvesting hamstring tendons for anterior cruciate ligament reconstruction. The American journal of sports medicine, 37(11), 2179–2186. doi.org/10.1177/0363546509340771
Rodríguez Matoso, D. (2013). Application of tensiomyography in the evaluation of muscle response in acute and chronic adaptations to physical exercise. Doctoral dissertation.
Rusu, L. D., Cosma, G. G., Cernaianu, S. M., Marin, M. N., Rusu, P. F., Ciocănescu, D. P., & Neferu, F. N. (2013). Tensiomyography method used for neuromuscular assessment of muscle training. Journal of neuroengineering and rehabilitation, 10, 67. doi.org/10.1186/1743-0003-10-67
Samozino, P., Horvais, N., & Hintzy, F. (2007). Why does power output decrease at high pedaling rates during sprint cycling? Medicine and science in sports and exercise, 39(4), 680–687. doi.org/10.1249/MSS.0b013e3180315246
Sánchez-Sánchez, J., Bishop, D., García-Unanue, J., Ubago-Guisado, E., Hernando, E., López-Fernández, J., Colino, E., & Gallardo, L. (2018). Effect of a Repeated Sprint Ability test on the muscle contractile properties in elite futsal players. Scientific reports, 8(1), 17284. doi.org/10.1038/s41598-018-35345-z
Simunic, B., Degens, H., Zavrsnik, J., Koren, K., Volmut, T., & Pisot, R. (2017). Tensiomyographic Assessment of Muscle Contractile Properties in 9- to 14-Year Old Children. International journal of sports medicine, 38(9), 659–665. doi.org/10.1055/s-0043-110679
Skurvydas, A., Brazaitis, M., Streckis, V., & Rudas, E. (2010). The effect of plyometric training on central and peripheral fatigue in boys. International journal of sports medicine, 31(7), 451–457. doi.org/10.1055/s-0030-1251991
Small, K., McNaughton, L., Greig, M., & Lovell, R. (2010). The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. Journal of science and medicine in sport, 13(1), 120–125. doi.org/10.1016/j.jsams.2008.08.005
Soderberg, G. L., & Knutson, L. M. (2000). A guide for use and interpretation of kinesiologic electromyographic data. Physical therapy, 80(5), 485–498.
Souza, R. B., Draper, C. E., Fredericson, M., & Powers, C. M. (2010). Femur rotation and patellofemoral joint kinematics: a weight-bearing magnetic resonance imaging analysis. The Journal of orthopaedic and sports physical therapy, 40(5), 277–285. doi.org/10.2519/jospt.2010.3215
Stemper, B. D., Yoganandan, N., Cusick, J. F., & Pintar, F. A. (2006). Stabilizing effect of precontracted neck musculature in whiplash. Spine, 31(20), E733–E738. doi.org/10.1097/01.brs.0000240210.23617.e7
Thomas, M. J., Wood, L., Selfe, J., & Peat, G. (2010). Anterior knee pain in younger adults as a precursor to subsequent patellofemoral osteoarthritis: a systematic review. BMC musculoskeletal disorders, 11, 201. doi.org/10.1186/1471-2474-11-201
Tous-Fajardo, J., Moras, G., Rodríguez-Jiménez, S., Usach, R., Doutres, D. M., & Maffiuletti, N. A. (2010). Inter-rater reliability of muscle contractile property measurements using non-invasive tensiomyography. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 20(4), 761–766. doi.org/10.1016/j.jelekin.2010.02.008
Utting, M. R., Davies, G., & Newman, J. H. (2005). Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis? The Knee, 12(5), 362–365. doi.org/10.1016/j.knee.2004.12.006
Valenčič, V. (1990). Direct measurement of the skeletal muscle tonus. Advances in external control of human extremities, 575-584.
Valle, X., Alentorn-Geli, E., Tol, J. L., Hamilton, B., Garrett, W. E., Jr, Pruna, R., Til, L., Gutierrez, J. A., Alomar, X., Balius, R., Malliaropoulos, N., Monllau, J. C., Whiteley, R., Witvrouw, E., Samuelsson, K., & Rodas, G. (2017). Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application. Sports medicine (Auckland, N.Z.), 47(7), 1241–1253. doi.org/10.1007/s40279-016-0647-1
van der Worp, M. P., ten Haaf, D. S., van Cingel, R., de Wijer, A., Nijhuis-van der Sanden, M. W., & Staal, J. B. (2015). Injuries in runners; a systematic review on risk factors and sex differences. PloS one, 10(2), e0114937. doi.org/10.1371/journal.pone.0114937
van Gent, R. N., Siem, D., van Middelkoop, M., van Os, A. G., Bierma-Zeinstra, S. M., & Koes, B. W. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. British journal of sports medicine, 41(8), 469–480. doi.org/10.1136/bjsm.2006.033548
Van Hespen, A., Stubbe, J., Stege, S., & Ooijendijk, W. (2012). Injury Free Running? Leiden: TNO KvL. Injury information system, 1986-2012.
Van Middelkoop, M., Kolkman, J., Van Ochten, J., Bierma-Zeinstra, S. M., & Koes, B. (2008). Prevalence and incidence of lower extremity injuries in male marathon runners. Scandinavian journal of medicine & science in sports, 18(2), 140–144. doi.org/10.1111/j.1600-0838.2007.00683.x
Van Middelkoop, M., Kolkman, J., Van Ochten, J., Bierma-Zeinstra, S. M., & Koes, B. W. (2008). Risk factors for lower extremity injuries among male marathon runners. Scandinavian journal of medicine & science in sports, 18(6), 691–697. doi.org/10.1111/j.1600-0838.2007.00768.x
van Poppel, D., Scholten-Peeters, G. G., van Middelkoop, M., & Verhagen, A. P. (2014). Prevalence, incidence and course of lower extremity injuries in runners during a 12-month follow-up period. Scandinavian journal of medicine & science in sports, 24(6), 943–949. doi.org/10.1111/sms.12110
Voight, M. L., & Wieder, D. L. (1991). Comparative reflex response times of vastus medialis obliquus and vastus lateralis in normal subjects and subjects with extensor mechanism dysfunction. An electromyographic study. The American journal of sports medicine, 19(2), 131–137. doi.org/10.1177/036354659101900207
Warren, G. L., Ingalls, C. P., Lowe, D. A., & Armstrong, R. B. (2001). Excitation-contraction uncoupling: major role in contraction-induced muscle injury. Exercise and sport sciences reviews, 29(2), 82–87. doi.org/10.1097/00003677-200104000-00008
Watsford, M., Ditroilo, M., Fernández-Peña, E., D'Amen, G., & Lucertini, F. (2010). Muscle stiffness and rate of torque development during sprint cycling. Medicine and science in sports and exercise, 42(7), 1324–1332. doi.org/10.1249/MSS.0b013e3181ce509d
Wilson, H. V., Johnson, M. I., & Francis, P. (2018). Repeated stimulation, inter-stimulus interval and inter-electrode distance alters muscle contractile properties as measured by Tensiomyography. PloS one, 13(2), e0191965. doi.org/10.1371/journal.pone.0191965
Wong Y. M. (2009). Recording the vastii muscle onset timing as a diagnostic parameter for patellofemoral pain syndrome: fact or fad? Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 10(2), 71–74. doi.org/10.1016/j.ptsp.2009.02.001
Yavuz, S. U., Sendemir-Urkmez, A., & Türker, K. S. (2010). Effect of gender, age, fatigue and contraction level on electromechanical delay. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology, 121(10), 1700–1706. doi.org/10.1016/j.clinph.2009.10.039
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.
