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Updated: Aug 6, 2026
Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
Electromyographic reliability and analysis of selected lower extremity muscles during lateral step-up conditions
T W Worrell1, E Crisp, C Larosa
1Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN 46227.
Objective:
To determine 1) the electromyographic (EMG) reliability within and between testing sessions; 2) the effect of sex on the EMG activity of the vastus medialis oblique (VMO), vastus lateralis (VL), hamstring (HS), and gluteus maximus (GM) and VMO:VL ratios during maximal voluntary isometric contraction (MVIC) and lateral step-up (LSU) conditions; and 3) the muscle recruitment and VMO:VL ratios during MVIC and LSU conditions.
Design And Setting:
Subjects participated in a familiarization session and two testing sessions in which they performed a 20.32-cm (8-in) LSU with and without resistance while the EMG activity was monitored for the VMO, VL, HS, and GM muscles.
Subjects:
Nineteen subjects performed LSUs holding 25% body weight (Group 25%), and 13 subjects performed LSUs holding 10% body weight (Group 10%). There were 32 subjects total: 19 males and 13 females.
Measurements:
Statistical analyses included a two-way analysis of variance (ANOVA) to compare sex and testing conditions for percentage of MVIC and VMO:VL ratios; three-way repeated-measures ANOVA to compare muscle, resistance, and session factors for percentage of MVIC; and a two-way repeated-measures ANOVA to compare conditions and session factors for VMO:VL ratios. These analyses were performed for both groups.
Results:
Reliability results revealed good intrasession and poor intersession intraclass correlation coefficients. No difference existed in muscle recruitment or VMO:VL ratios between males and females for either group. The three-way ANOVA revealed a significant two-way interaction (muscle x resistance) for both groups. Post hoc testing revealed the following EMG recruitment patterns: VMO > HS, GM, VL;VL > HS, GM; HS = GM for both groups. For Group 25%, the two-way ANOVA revealed greater VMO:VL ratios during MVIC for session one than for LSU.
Conclusions:
Intrasession reliability was higher than intersession reliability, but similar conclusions were reached concerning muscle recruitment in both testing situations. No sex differences existed in recruitment patterns. The LSU requires greater VMO and VL recruitment than HS and GM recruitment. In addition, VMO:VL ratios varied tremendously in a group of asymptomatic subjects, which challenges the theory of a "normal" VMO:VL ratio of 1:1 in asymptomatic subjects.
