Professional Documents
Culture Documents
Burden 1999
Burden 1999
www.elsevier.com/locate/medengphy
Received 15 April 1998; received in revised form 22 June 1999; accepted 6 July 1999
Abstract
The purpose of this study was to evaluate and compare four different methods of normalising the amplitude of electromyograms
(EMGs), from the biceps brachii. Five males performed isotonic contractions of the elbow flexors with an external force of 50 N,
100 N, 150 N and 200 N. These were followed by a single isometric maximal voluntary contraction (MVC) and ten isokinetic
MVCs at 0.35 rad s⫺1 intervals between 0.35 rad s⫺1 and 3.50 rad s⫺1. The processed EMGs recorded from the isotonic contractions
were normalised by expressing them as a percentage of: (i) the mean (Dynamic Mean Method) and (ii) the peak EMG from the
same contraction (Dynamic Peak Method), (iii) the EMG from the isometric MVC (Isometric MVC Method), and (iv) the EMG
from an isokinetic MVC at the same elbow angle and angular velocity (Isokinetic MVC Method). The root mean square difference
(RMSD) between the outputs of the Isokinetic MVC and Dynamic Mean methods was significantly greater (P⬍0.05) than between
the Isokinetic MVC method and the Dynamic Peak and the Isometric MVC methods. The small (10%) difference between the
Isokinetic MVC and the Isometric MVC Methods was a consequence, firstly, of the lack of difference in EMG recorded from the
isometric and isokinetic MVCs and, secondly, the consistency in EMG over the range of motion and at different angular velocities
of isokinetic MVC. We conclude that only the Isometric and Isokinetic MVC methods should be used to normalise the amplitude
of EMGs from the biceps brachii. 1999 IPEM. Published by Elsevier Science Ltd. All rights reserved.
Keywords: Electromyography; Normalisation; Biceps brachii; Isotonic contraction; Isometric contraction; Isokinetic contraction
1350-4533/99/$ - see front matter. 1999 IPEM. Published by Elsevier Science Ltd. All rights reserved.
PII: S 1 3 5 0 - 4 5 3 3 ( 9 9 ) 0 0 0 5 4 - 5
248 A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257
greatest reduction in inter-subject variability during [20]. Research into the factors that affect the magnitude
walking. The use of either the mean or the peak linear of the EMG recorded from the elbow flexors during iso-
envelope from the ensemble average of at least six kinetic MVCs is, therefore, sparse and disagrees with the
strides reduced the inter-subject coefficient of variation more recent and abundant research undertaken using the
in relation to the un-normalised data in all five lower knee extensor muscle group.
limb muscles analysed. In comparison, the inter-subject The overall aim of this study was to investigate the
coefficient of variation was generally increased by using relationship between EMG and joint angle, angular velo-
either 50% of the isometric MVC or the mean EMG city and type of muscle action in the biceps brachii, and
per unit of isometric moment as the reference values. to use this muscle to evaluate and compare a number
A reduced inter-subject coefficient of variation was also of EMG amplitude normalisation methods. The specific
demonstrated for the biceps brachii during isotonic objectives were:
elbow flexions and extensions [11] and for the gastro-
cnemius during a balancing task [3] by using the peak 1. To determine, experimentally, the effect that joint
or mean ensemble value in comparison to the EMG from angle, angular velocity, and type of muscle action
an isometric submaximal [11] or MVC [3,11]. Although has on EMGs from isokinetic MVCs of the biceps
the peak and mean ensemble methods are the only feas- brachii. Previous research which addressed a similar
ible ways of normalising EMGs from patients with neur- objective [12,13] was undertaken over 25 years ago
ologic disorders [5], they tend to produce a normal EMG and used an isokinetic dynamometer which claimed
template for a particular task and, therefore, may remove to maintain constant linear velocity of muscle con-
the true biological variation within a group [3,11]. How- traction rather than angular velocity of forearm
ever, normalisation of EMGs using an isometric MVC rotation. The biceps was, therefore, selected in order
has been shown to increase the intra-class correlation to corroborate, or otherwise, the early findings of
coefficient between trials, in comparison to the peak and Komi and colleagues [12,13]. This would also help
mean dynamic values, thereby improving the reproduci- to ascertain whether the non-uniform relationships
bility of the data [3]. Although the isometric MVC discovered between EMG and joint angle [14–16],
method is the only one that aims to reveal the percentage angular velocity and type of muscle action [15,17–
of the maximum activation capacity of the muscle 19], for the knee extensors, were muscle dependant.
required to perform a specific task [5], all other methods 2. To compare the magnitude of EMGs normalised by
mentioned above generally reflect changes in the un-nor- expressing them as a percentage of the EMGs
malised data as a consequence of changes in load and recorded from isokinetic MVCs at the identical
velocity of movement [11]. angle and angular velocity, and from the same type
Early studies have shown that the EMG from the of muscle action, with those normalised using other
elbow flexors is largely unaffected by joint angle [12], normalisation methods that have previously been
type of muscle action (i.e. concentric or eccentric), or evaluated and compared.
angular velocity [13] during isokinetic MVCs. Con- 3. To compare the inter-subject variability of EMGs
versely, it has been well established that the EMG normalised by the same methods as expressed in the
recorded during isokinetic MVCs of knee extensor second objective.
muscles is largest in the mid range of motion [14–16], 4. To determine how the magnitude of force set for a
is greater for concentric in comparison to eccentric con- submaximal isotonic task, and type of muscle action,
tractions [15,17–19], and increases with increasing angu- affected the comparisons between normalisation
lar velocity during concentric contractions [15,17–19]. methods.
The EMG from an isometric MVC may not, therefore,
represent the maximum activation capacity of the muscle
either at lengths other than those at which the MVC was
performed, or under non-isometric conditions. Evidence
of this was partially provided by Mirka [4], who normal- 2. Methods
ised trunk muscle EMGs from dynamic flexions using
isometric MVCs, which were performed at the same 2.1. Subjects
trunk angle and at an arbitrary trunk angle. Mean differ-
ences of between 15 and 50% were reported between Five males ((mean±SD) age 23.3±3.8 yrs; height
the two methods, depending on the muscle involved. 1.78±0.06 m; mass 84.2±6.2 kg) took part in the investi-
Furthermore, Kellis and Baltzopoulos reported signifi- gation after reading and signing an informed consent
cant differences between EMGs from the hamstrings, document. All volunteers had recently taken part in
normalised using either a single angle isometric MVC experiments which had required them to perform iso-
or isokinetic MVCs performed at the same angular velo- metric and isokinetic MVCs of the elbow flexor muscles
city, a similar angle and with same type of muscle action using identical equipment to that used in this study.
A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257 249
3. Results
Fig. 2. EMG in relation to angle of elbow flexion for the concentric phase of all isokinetic MVCs for one subject. EMG appears more smoothed
at higher angular velocities due to less data points being available for presentation.
the concentric phase, in relation to the eccentric phase, ence in RMSD between the three comparisons
of each isotonic trial. However, as a consequence of (F1,5=19.19, P⬍0.05) was observed regardless of force
using a different denominator for each trial, these or type of muscle action. Post hoc comparisons, using
methods were unable to mirror the increase in muscle the Games and Howell [23] procedure, revealed that the
activity observed in the unnormalised EMGs as the comparison with the Dynamic Mean Method resulted in
external force was increased. In comparison, the Iso- a significantly (P⬍0.05) greater RMSD (38±23%) than
metric MVC Method and Isokinetic MVC Method were the comparisons with the Dynamic Peak (17±18%) and
able to mirror the changes seen in the unnormalised the Isometric MVC (10±8%) methods. The RMSD was
EMGs both between concentric and eccentric muscle also significantly greater (F1,4=13.59, P⬍0.05) for con-
actions and as the external force increased. centric rather the eccentric contractions, irrespective of
Fig. 6 shows the RMSD between the same EMGs nor- force magnitude or comparative normalisation method.
malised using the Isokinetic MVC Method and the other In addition, a statistically significant difference in RMSD
three methods, for both types of muscle action and at was observed between force magnitudes (F1,6=8.28,
each magnitude of force. A statistically significant differ- P⬍0.05) regardless of normalisation methods compared
252 A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257
Fig. 3. EMG in relation to angle of elbow flexion for the eccentric phase of all isokinetic MVCs for one subject. EMG appears more smoothed
at higher angular velocities due to less data points being available for presentation.
or the type of muscle action. However, a significant inter-subject variability in relation to the unnormalised
interaction, clearly shown in Fig. 6, existed between the EMGs. Over most conditions of force and muscle action,
magnitude of force and the methods that were being the Dynamic Mean Method produced the lowest coef-
compared (F4,18=29.86, P⬍0.05). In the comparisons ficient of variation. Greater inter-subject variability
involving the Isokinetic MVC Method with both the resulted from the use of the other normalisation methods,
Dynamic Peak and Isometric MVC methods, the RMSD in particular the Isometric MVC Method.
rose as the force was increased. In contrast, for the com-
parison between the Isokinetic MVC and Dynamic Mean
4. Discussion
methods, the RMSD decreased as the force was
increased. 4.1. EMG-angle and EMG-angular velocity
The inter-subject coefficients of variation for the out- relationship
put of the four normalisation methods are shown in
Table 1, for each magnitude of force and for both types The finding that the electrical activity in the biceps
of muscle action. All normalisation methods reduced brachii was independent of the angle of elbow flexion
A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257 253
Fig. 4. Mean (±SD) EMG, expressed as a percentage of the EMG from an isometric MVC (%MVC), from the concentric and eccentric phases
of isokinetic MVCs at different angular velocities.
Fig. 5. Mean (+SD) output from the four normalisation methods for concentric and eccentric phases of isotonic contractions at four different forces.
during most of the concentric and eccentric isokinetic motion for isokinetic MVCs, but offered no explanation
MVCs agrees both with earlier research [12] on the same for this. It is unlikely that this contention is due to dif-
muscle, and a study [24] of the vastus lateralis, albeit fering subject familiarisation, as both sets of studies
only at 0.52 rad s⫺1. In contrast, most of the more recent [12,15] have reported extensive periods of practice
studies [14–16] reported that the EMG from knee exten- before testing. However, it is possible that the way in
sor muscles was greatest in the middle of the range of which subjects were instructed to perform the MVCs
254 A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257
Table 1
Inter-subject coefficients of variation for each method of normalising EMGs for different forces and concentric (CON) and eccentric (ECC) mus-
cle actionsa
Force
Normalisation method 50 N 100 N 150 N 200 N
CON ECC CON ECC CON ECC CON ECC
a
The CVs presented in Table 1 were calculated using a single trial from each subject rather than an ensemble average as in other studies
referred to in the text [3,5,11].
both from each other and from the Isometric and Isoki- agreement with Mirka [4], two subjects consistently pro-
netic MVC methods by virtue of the different denomi- duced higher outputs when the EMGs were normalised
nators used in the normalisation equation. The magni- using the Isometric MVC Method than when the Isoki-
tude of the outputs from the Isometric and Isokinetic netic MVC Method was used (represented by a negative
MVC methods were similar, as reinforced by the small percentage difference). In comparison, Kellis and
RMSDs shown in Fig. 6. This is unsurprising given the Baltzopoulos [20] discovered that the output from a nor-
uniform EMG-angle and angular velocity relationships malisation method, similar to the Isokinetic MVC
reported for the biceps in this and previous [12,13] stud- Method, was significantly greater than the output from
ies, which were discussed above. The power of the stat- the Isometric MVC Method, by up to 127%. Differences
istical tests and the validity of our findings would obvi- between the two methods would be expected owing to
ously be improved by increasing the number of subjects the non-uniform EMG-angle and angular velocity
and also assessing the reliability of the results. However, relationships reported for the knee extensor muscles.
the five subjects who did take part in this investigation However, to produce differences of this magnitude, the
all exhibited similar, uniform EMG-angle and angular EMGs obtained from the isometric MVC must have
velocity relationships. As a consequence of this all sub- been, in some cases, twice as large as those obtained
jects displayed a minimal difference between the output from the isokinetic MVCs. This suggests that the isoki-
of the Isometric MVC and Isokinetic MVC methods. netic MVCs undertaken by Kellis and Baltzopoulos [20]
Had this study used knee extensor muscles, instead of yielded EMGs that were far from maximal. Comparison
an elbow flexor muscle, a larger difference might have between studies must be viewed with caution as the
been seen between the two normalisation methods, magnitude of the normalised EMG can be affected by
because of the different EMG-angle and EMG-angular the method used to process the denominator of the nor-
velocity relationships that have previously been reported malisation equation, as well as the nature of the denomi-
for that muscle group [14–19]. nator, especially when normalising EMGs from different
Only two studies [4,20] have previously compared angular velocities of motion [11]. However, the findings
EMGs normalised using the Isometric MVC Method of this study are worthy of comparison with those of
with methods similar to the Isokinetic MVC Method. Mirka [4] and Kellis and Baltzopoulos [20] as their
Unfortunately, neither study used the RMSD to compare EMGs were also processed using the mean absolute
methods. Therefore, it is difficult to compare them value, albeit with a smaller averaging window of 20 ms
directly with the findings of the present study. However, and 10 ms respectively.
if the percentage difference method, as used by Mirka The assumption that the Isokinetic MVC Method pro-
[4], is used to compare the outputs from the Isokinetic vides the most accurate representation of the percentage
and Isometric MVC methods, values of between ⫺15% of the muscle’s maximal activation capacity required to
and 18% are obtained for concentric and eccentric con- perform a particular task, may be challenged by evidence
tractions at all forces. These values are less than the which has frequently been used to criticise the Isometric
average 15 to 50% and maximum 68 to 689% differ- MVC Method. That is, isokinetic MVCs may also pro-
ences reported by Mirka [4] for trunk muscles. The dis- duce EMGs that are unreliable and do not represent the
crepancy between the investigations could be due firstly maximal activation capacity of the muscle. The findings
to the different muscles used and, secondly, because from the present investigation cannot answer the first
Mirka [4] normalised EMGs from dynamic contractions criticism, as only one contraction was performed at each
with EMGs from isometric MVCs taken at the same angular velocity to prevent fatigue. In partial response to
trunk angle but not the same angular velocity. In partial the second criticism, Fig. 4 shows that, for some angular
256 A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257
velocities, the mean EMGs for both the concentric and Hence, it is unsurprising that the output of the Dynamic
eccentric contractions were less than the EMG recorded Peak and, in particular, the Dynamic Mean normalisation
from the isometric MVC. Further evidence that the isoki- methods were unable to reflect the increase in EMG that
netic and isometric MVCs were not truly maximal, occurred in response to the increase in force. This dis-
despite “maximal” effort being used, is given in Fig. 5, agrees with the findings of Allison et al. [11] that nor-
which shows that the concentric EMGs normalised by malisation methods which used either the mean or the
both methods were in excess of 100% for some subjects peak EMG from the ensemble average were able to dis-
when moving the 200 N load. tinguish between load and no-load conditions for the
same muscle. In view of our findings, this is particularly
4.3. Effect of normalisation method on inter-subject surprising considering that the difference between the
variability of EMGs load and no-load conditions was only 2.3 kg. As pre-
viously stated, Allison et al. [11] reported that the magni-
The use of normalisation methods similar to the tude of the normalised EMG may be affected by the way
Dynamic Mean and Dynamic Peak methods has success- in which the denominator of the normalisation equation
fully reduced inter-subject variability [5,10]. The coef- is processed. Thus, it is possible that this discrepancy
ficients of variation presented in Table 1 lend support to exists due to the different processing methods used by
the already strong evidence that use of the Dynamic Allison et al. [11] and ourselves. However, this is
Mean Method reduces the inter-subject variability in unlikely as Allison et al. [11] found that processing
relation to other normalisation methods [3,5,11] and the method did not affect the ability of the Isometric MVC
un-normalised EMG [5,11]. In agreement with Allison method to distinguish between load and no-load con-
et al. [11], the coefficient of variation was also generally ditions. In addition, by virtue of the nature of the
higher for eccentric contractions when the EMGs were denominator used in their normalisation equations,
normalised using this method. Thus, if researchers or neither the Dynamic Peak nor Dynamic Mean method
clinicians wish to retain the homogeneity of task-specific would be expected to reflect changes in muscle acti-
EMGs for a group of individuals, they should avoid use vation levels between tasks.
of the Dynamic Peak and, in particular, the Dynamic The trend of the RMSD between the two MVC
Mean normalisation methods, as suggested elsewhere methods to increase slightly as the external force
[3,11]. The Isometric MVC Method also reduced inter- increased, in both concentric and eccentric contractions,
subject variability in relation to the un-normalised EMG, can be explained using the following simple hypothetical
as did the Isokinetic MVC Method. Therefore, even example. With a 50 N external load, the magnitude of
these two methods falsely improved group homogeneity the EMG at a particular angle and angular velocity dur-
albeit to a lesser degree. This is in comparison to Allison ing an isotonic contraction is 0.5 mV. The magnitudes
et al. [11], who found that the Isometric MVC method of the EMG from an isokinetic MVC at the same angle
increased the coefficient of variation in relation to the and angular velocity, and an isometric MVC at an arbi-
un-normalised EMGs. The disagreement is unlikely to trary angle, are 3.2 mV and 3.0 mV respectively. If the
be due to the different methods of processing used by EMG from the 50 N trial is normalised using the Isoki-
Allison et al. [11] (root mean square) and ourselves netic MVC and Isometric MVC methods they produce
(mean absolute value), as these authors also reported that outputs of 15.6% and 16.6% respectively, a difference
the coefficient of variation was largely unaffected by the of 1%. With a 200 N external load, the magnitude of
way in which the isometric MVC was processed. the EMG at the same angle and angular velocity rises
to 2.8 mV. If this EMG is normalised, an output of
4.4. Ability of normalisation method to detect changes 87.5% is produced by the Isokinetic MVC Method and
in external force 93.3% by the Isometric MVC Method, a larger differ-
ence of 5.8%. Thus, regardless of the effect of the EMG-
The Isometric and Isokinetic MVC methods did reflect angle and EMG-angular velocity relationships, the absol-
the increase in EMG that occurred in response to the ute difference between the two methods will always be
three increments in external force. This supports the greater for higher muscle activation.
findings of Allison et al. [11] that the Isometric MVC
method was able to distinguish between load and no-
load conditions, in both concentric and eccentric con- 5. Conclusions
tractions of the biceps brachii, regardless of the way in
which the EMG from the isometric MVC was processed. The following conclusions were drawn from this
Unlike the MVC methods, the Dynamic Mean and study:
Dynamic Peak methods are not designed to provide the
percentage of the maximal activation capacity of the 1. Biceps brachii EMGs recorded during concentric
muscle required to perform the isotonic contractions. and eccentric isokinetic MVCs of the forearm
A. Burden, R. Bartlett / Medical Engineering & Physics 21 (1999) 247–257 257
flexors were found to be largely unaffected by the [4] Mirka GA. The quantification of EMG normalization error. Ergo-
angle or angular velocity of flexion, or the type of nomics 1991;34:343–52.
[5] Yang JF, Winter DA. Electromyographic amplitude normaliz-
muscle action involved. This agreed with early find- ation methods: improving their sensitivity as diagnostic tools in
ings for the same muscle [12,13], but was not in gait analysis. Arch Phys Med Rehabil 1984;65:517–21.
agreement with more recent work involving the knee [6] Arsenault AB, Winter DA, Marteniuk RG. Is there a “normal”
extensor muscle group [14–19]. profile of EMG activity in gait? Med Biol Engng Comput
2. The Isokinetic MVC and Isometric MVC methods 1986;24:337–43.
[7] Dubo HIC, Peat M, Winter DA, Quanbury AO, Hobson DA, Ste-
produced normalised EMGs which had a similar inke T, Reimer G. Electromyographic temporal analysis of nor-
magnitude of output, as a consequence of the uni- mal gait: normal human locomotion. Arch Phys Med Rehabil
form EMG-angle and EMG-angular velocity 1976;57:415–20.
relationships that were discovered for the biceps bra- [8] Yang JF, Winter DA. Electromyography reliability in maximal
chii. This disagreed with recent investigations of the and submaximal isometric contractions. Arch Phys Med Rehabil
1983;64:417–20.
trunk [4] and knee extensor [20] muscles that com- [9] Enoka RM, Fuglevand AJ. Neuromuscular basis of the maximum
pared normalisation methods which were similar to voluntary force capacity of muscle. In: Grabiner M, editor. Cur-
the MVC methods. rent issues in biomechanics. Champaign: Human Kinetics,
3. Both of the MVC methods also displayed slightly 1993:215–35.
lower inter-subject coefficients of variation than [10] Winter DA, Yack HJ. EMG profiles during normal human walk-
ing: stride-to-stride and inter-subject variability. Electromyogr
those observed in the un-normalised EMGs. By con- Clin Neurophysiol 1987;67:402–11.
trast, and in agreement with previous findings [11] Allison GT, Marshall RN, Singer KP. EMG signal amplitude nor-
[3,5,11], both the Dynamic Mean and the Dynamic malization technique in stretch-shortening cycle movements. J
Peak methods displayed smaller coefficients of vari- Electromyogr Kinesiol 1993;3:236–44.
ation and, therefore, falsely improved group hom- [12] Komi PV, Buskirk ER. Effect of eccentric and concentric muscle
conditioning on tension and electrical activity of human muscle.
ogeneity. Ergonomics 1972;15:417–34.
4. Both the MVC methods were able to distinguish [13] Komi PV. Relationship between muscle tension, EMG and velo-
between changes in muscle activation in response to city of contraction under concentric and eccentric work. In:
differing magnitudes of force. In comparison, both Desmedt JE, editor. Basel: Karger, 1973:597–605.
Dynamic methods were unable to distinguish [14] Bobbert MF, Harlaar J. Evaluation of moment-angle curves in
isokinetic knee extension. Med Sci Sports Exerc 1992;25:251–9.
between the same changes in force. Thus, the Iso- [15] Eloranta V, Komi PV. Function of the quadriceps femoris muscle
metric or Isokinetic MVC, and not the Dynamic under maximal concentric and eccentric contractions. Electromy-
Peak or Dynamic Mean, methods should be used to ogr Clin Neurophysiol 1980;20:159–74.
normalise the amplitude of EMGs if the objectives [16] Kellis E, Baltzopoulos V. Agonist and antagonist moment and
are to compare them between muscles, tasks and EMG-angle relationship during isokinetic eccentric and concen-
tric exercise. Isokin Exercise Sci 1996;6:79–87.
individuals, or to retain the natural variation between [17] Amiridis IG, Martin A, Morlon B, Martin L, Cometti G, Pousson
those individuals. M, van Hoecke J. Co-activation and tension-regulating phenom-
ena during isokinetic knee extension in sedentary and highly
skilled humans. Eur J Appl Physiol 1996;73:149–56.
However, owing to the apparent differences in maximal [18] Seger JY, Thortensen A. Muscle strength and myoelectric activity
EMG-angle and angular velocity relationships between in prepubertal and adult males and females. Eur J Appl Physiol
muscles, recommendation of either MVC related nor- 1994;69:81–7.
malisation method is, at present, only advocated for the [19] Westing SH, Cresswell AG, Thorstensson A. Muscle activation
biceps brachii. Future studies should, therefore, investi- during maximal voluntary eccentric and concentric knee exten-
sion. Eur J Appl Physiol 1991;62:104–8.
gate the EMG-angle and angular velocity relationship in [20] Kellis E, Baltzopoulos V. The effects of normalization method
other muscles, and continue to evaluate and compare the on antagonistic activity patterns during eccentric and concentric
Isometric and Isokinetic MVC normalisation methods. isokinetic knee extension and flexion. J Electromyogr Kinesiol
1996;6:235–45.
[21] Clarys JP, Cabri J. Electromyography and the study of sports
movements: a review. J Sports Sci 1993;11:379–448.
References [22] Okamoto T, Tsutsumi H, Goto Y, Andrew P. A simple procedure
to attenuate artefacts in surface electrode recordings by painlessly
lowering skin impedance. Electromyogr Clin Neurophysiol
[1] De Luca CJ. The use of surface electromyography in biomechan- 1987;27:173–6.
ics. J Appl Biomechanics 1997;13:135–63. [23] Games PA, Howell JF. Pairwise multiple comparison procedures
[2] Mathiassen SE, Winkel J, Hagg GM. Normalization of surface with unequal n’s and/or variances: A Monte Carlo study. J Educat
EMG amplitude from the upper trapezius muscle in ergonomic Stat 1976;1:113–25.
studies — a review. J Electromyogr Kinesiol 1995;5:197–226. [24] Ghori GMU, Donne B, Luckwill RG. Relationship between
[3] Knutson LM, Sodberg GL, Ballantyne BT, Clarke WR. A study torque and EMG activity of a knee extensor muscle during isoki-
of various normalization procedures for within day electromyo- netic concentric and eccentric actions. J Electromyogr Kinesiol
graphic data. J Electromyogr Kinesiol 1994;4:47–59. 1995;5:109–15.