Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2019) 18, 674 - 679

Research article
Effect of the Anode Placement on the Antagonist Muscles Recruitment: Implication for the Interpolated Twitch Technique Outcome
Enzo Piponnier1, , Ashref Thorkani2, Firas Zghal3, François Cottin4, Vincent Martin1
Author Information
1 Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l’Exercice en conditions Physiologiques et Pathologiques (AME2P), Clermont-Ferrand, France
2 Université d’Evry-Val-d’Essonne/Genopole, Unité de Biologie Intégrative des Adaptations à l’Exercice, Evry, France
3 Université Nice Sofia Antipolis, Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Nice, France
4 Université Paris-Sud, Laboratoire Complexité, Innovations, Activités Motrices et Sportives (CIAMS), Orsay, France

Enzo Piponnier
✉ Université Clermont Auvergne - Laboratoire AME2P, 3 rue de la Chébarde, 63178 Aubiere Cedex, France
Publish Date
Received: 05-07-2019
Accepted: 21-08-2019
Published (online): 19-11-2019
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The aim of the present study was to compare the recruitment of the antagonist muscles and its effect on the measurement of the voluntary activation level (VA) of the knee extensor (KE) muscles for different anode placements used to stimulate the femoral nerve. We hypothesized that when the anode is positioned over the gluteal fold (GF), the antagonist muscles recruitment would be greater and, thus the VA overestimated, than when the anode is placed midway between the greater trochanter and the lower border of the iliac crest (Midtroc-iliac). Thirteen healthy men (23 ± 4 yr) were tested in both conditions (GF vs. Midtroc-iliac) in a randomized order. Recruitment curves were performed to determine the optimal stimulus intensity (Iopt) and quantify antagonist muscles recruitment (i.e. biceps femoris M-wave). Participants performed maximal voluntary isometric contractions (MVIC) and the interpolated twitch technique was used to measured VA. Antagonist muscles recruitment was greater when the anode was placed over the GF than Midtroc-iliac. The Iopt was also lower for GF than Midtroc-iliac placement. However, no significant effect of anode placement was found for the interpolated twitch technique outcome. When the anode was placed over the GF, antagonist muscles recruitment was greater, inducing optimal stimulus intensity underestimation. However, it did not affect VA assessment. To fully avoid this potential limitation, Midtroc-iliac anode placement should nevertheless be preferred for the KE neuromuscular function assessment, owing to the reduced recruitment of the antagonist muscles.

Key words: Voluntary activation level, electrical nerve stimulation, recruitment curve, knee extensors, knee flexors, electromyography

           Key Points
  • Stimulation of the femoral nerve is commonly used to assess the neuromuscular function of the knee extensor muscles.
  • Anode placement over the gluteal fold favors the recruitment of the antagonist muscles (knee flexors) as compared to a placement midway between the iliac crest and the greater trochanter.
  • Anode placement over the gluteal fold induces an underestimation of the optimal stimulation intensity but as no effect on the determination of the maximal voluntary activation level.
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