Quadriceps muscles activation in anterior knee pain during isokinetic exercise

The aim of this paper is to study the femoral quadriceps muscles activation in patients suffering from anterior knee pain (AKP) during an isokinetic exercise. AKP is a common pathological condition, associated to an abnormal motion of the patella. It possibly depends on a muscular or structural imbalance. A lack of synergy in the quadriceps muscles results in a dynamic misalignment of the patella, which in turn produces pain. A quantitative analysis of the muscle activation strategy is important for an objective measurement of the knee functionality in that it helps to diagnose and monitor the rehabilitative treatment. Surface electromyography (EMG) from the three superficial muscles of the femoral quadriceps during a concentric isokinetic exercise has been analysed. A group of AKP patients has been compared with a control group of healthy subjects. Ensemble average of the EMG linear envelopes reveals significant modifications in Vastus Medialis activity in AKP patients. In order to quantify the synergy of the muscles, different parameters have been associated to EMG linear envelopes significant features. A decomposition in gaussian pulses and an asymmetry coefficient have been utilised. The results relative to these concise parameters highlight an appreciable delay and a modification in the activation of the Vastus Medialis in AKP patients.