Related Experiment Video
Updated: Aug 20, 2025

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Muscle electromyographic activity normalized to maximal muscle activity, not to Mmax, better represents voluntary
Joanna Diong1,2, Kenzo C Kishimoto3, Jane E Butler2,4
1School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Abstract:
In human applied physiology studies, the amplitude of recorded muscle electromyographic activity (EMG) is often normalized to maximal EMG recorded during a maximal voluntary contraction. When maximal contractions cannot be reliably obtained (e.g. in people with muscle paralysis, anterior cruciate ligament injury, or arthritis), EMG is sometimes normalized to the maximal compound muscle action potiential evoked by stimulation, the Mmax. However, it is not known how these two methods of normalization affect the conclusions and comparability of studies. To address this limitation, we investigated the relationship between voluntary muscle activation and EMG normalized either to maximal EMG or to Mmax. Twenty-five able-bodied adults performed voluntary isometric ankle plantarflexion contractions to a range of percentages of maximal voluntary torque. Ankle torque, plantarflexor muscle EMG, and voluntary muscle activation measured by twitch interpolation were recorded. EMG recorded at each contraction intensity was normalized to maximal EMG or to Mmax for each plantarflexor muscle, and the relationship between the two normalization approaches quantified. A slope >1 indicated EMG amplitude normalized to maximal EMG (vertical axis) was greater than EMG normalized to Mmax (horizontal axis). Mean estimates of the slopes were large and had moderate precision: soleus 8.7 (95% CI 6.9 to 11.0), medial gastrocnemius 13.4 (10.5 to 17.0), lateral gastrocnemius 11.4 (9.4 to 14.0). This indicates EMG normalized to Mmax is approximately eleven times smaller than EMG normalized to maximal EMG. Normalization to maximal EMG gave closer approximations to the level of voluntary muscle activation assessed by twitch interpolation.
Related Concept Videos
Motor Unit Stimulation
The latent period of contraction marks the onset of excitation-contraction coupling, when the action potential propagates across the sarcolemma, preparing the muscle fibers for contraction. As the fibers enter the contraction phase, the...
Generation of Action Potential in Skeletal Muscles
Like neurons, muscle cells are also regarded as excitable due to their capacity to change in response to stimuli, primarily due to voltage-gated ion channels embedded in their plasma membranes, which get activated by alterations in the...
Muscle Stimulation Frequency
Wave summation
At low firing rates, motor neurons induce individual twitch contractions in muscle fibers. These twitches...
Relaxation of Skeletal Muscles
When an action potential reaches the axon terminal, it depolarizes the membrane and opens voltage-gated sodium channels. Sodium ions enter the cell, further depolarizing the presynaptic membrane. This depolarization causes voltage-gated calcium channels to open....

