The effect of an inverted body position on lower limb muscle force and activation

Complete inversion of the body in a seated position may occur in exceptional circumstances such as in overturned vehicles and during military maneuvers, with direct consequences on health and fatalities. However, the physiological responses to this condition have not been published previously. The purpose of this study was to compare neuromuscular responses to upright and inverted seated positions. Sixteen subjects performed maximal voluntary contraction (MVC) and submaximal voluntary contraction knee extensions (25%, 50%, and 75% of MVC) under upright and inverted seated positions. Force, quadriceps activation as measured by the interpolated twitch technique, electromyographic (EMG) activity of the vastus lateralis, and semitendenosis and evoked contractile properties of the quadriceps were measured. Results demonstrated that MVC force (p = 0.01, 6.1%) and vastus lateralis EMG (p = 0.009, 29.6%) decreased in the inverted compared with the upright position. Instantaneous strength in the inverted position was 19.3% lower than in the upright position (p = 0.005). Heart rate and diastolic and systolic blood pressures were 12.4%, 9.2%, and 10.7% lower (p < 0.0001), respectively, in the inverted position. In conclusion, a seated inverted position impaired MVC force and EMG activity, which could not be attributed to evoked contractile properties. The changes in heart rate and blood pressure may suggest inversion-induced alterations to the sympathetic nervous stimulation.