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Authors:
Anna Mika, PhD
Piotr Mika, PhD
Bo Fernhall, PhD
Viswanath B. Unnithan, PhD
Affiliations:
From the Department of
Rehabilitation, Academy of Physical
Education, Krako´w, Poland (AM, PM);
College of Applied Health Sciences,
University of Illinois at Urbana-
Champaign, Champaign, Illinois (BF);
and Sport Department, Liverpool
Hope University, Liverpool, United
Kingdom (VBU).
Correspondence:
All correspondence and requests for
reprints should be address to Anna
Mika, Katedra Rehabilitacji
Klinicznej, Wydzial Rehabilitacji
Ruchowej, Akademia Wychowania
Fizycznego, Al. Jana Pawla II 78,
31-571 Krako´w, Poland.
0894-9115/07/8606-0474/0
American Journal of Physical
Medicine & Rehabilitation
Copyright © 2007 by Lippincott
Williams & Wilkins
DOI: 10.1097/PHM.0b013e31805b7c79
Comparison of Recovery Strategies
on Muscle Performance After
Fatiguing Exercise
ABSTRACT
Mika A, Mika P, Fernhall B, Unnithan VB: Comparison of recovery strategies on
muscle performance after fatiguing exercise. Am J Phys Med Rehabil 2007;86:
474– 481.
Objective: The objective of this study was to assess the influence of
different relaxation modes: stretching (ST), active recovery (AR), and
passive recovery (PR) on muscle relaxation after dynamic exercise of the
quadriceps femoris.
Design: Ten healthy male volunteers between 24 and 38 yrs of age
participated in this study. After the warm-up, subjects performed three sets
of dynamic leg extension and flexion (at an angle of 20–110 degrees) at
50% of previously determined maximal voluntary contraction (MVC), with
30 secs of rest between sets. Immediately after completing the leg
exercise, one of the relaxation methods was applied, in a randomized
order (AR, PR, ST). Then, subjects performed isometric knee extension at
50% of MVC to the point of fatigue, and surface electromyogram (EMG)
of the vastus lateralis muscle was measured.
Results: After AR, the mean MVC was significantly (
P
⬍0.05) higher
than after PR and ST. Moreover, there was no difference in MVC between
AR and baseline (
P
⬎0.05). Total time of the effort during EMG
measurement was significantly lower for all three recovery modes than at
baseline. During the effort after both PR and ST, there was no significant
increase in motor unit activation, but a significant increase was noted after
AR (
P
⬍0.05). There was no difference in frequency between any of the
recovery modes and baseline (
P
⬎0.05).
Conclusion: The results of this study suggest that the most appropriate
and effective recovery mode after dynamic muscle fatigue involves light,
active exercises, such as cycling with minimal resistance.
Key Words: Active, Passive, Stretching, Relaxation, EMG, Strength
474 Am. J. Phys. Med. Rehabil. ●Vol. 86, No. 6
RESEARCH ARTICLE
Strength
Muscle fatigue can be defined as any exercise-
induced reduction in the ability to exert muscle
force or power, regardless of whether the task can
be sustained or whether it has peripheral or central
causes.
1
Exercise-induced alterations in muscle ho-
meostasis, including hydrogen ion accumulation,
potassium loss, depletion of high-energy phos-
phates (ATP and creatine phosphate) and glycogen,
loss of calcium homeostasis, or local ischemia may
be some of the causative factors associated with
disruption of the muscle excitation– contraction
cycle during intense exercise and in postexercise
muscle fatigue.
2–5
Muscle recovery after physical activity is very
important, especially in the field of sport and re-
habilitation. In many events such as weight lifting
or the jumping and throwing events in track and
field, interbout rest periods are short, and fast
muscle recovery is an important factor leading to
better performance. In many of these activities,
repeated muscle performance is required after fa-
tiguing exercise with only a short rest period. A
similar situation occurs in rehabilitation, particu-
larly for rheumatologic and orthopedic problems,
where increased muscle tension causes faster mus-
cle fatigue, defined as a loss of ability to maintain
the expected force or power,
1
leading to joint in-
stability, which limits the rehabilitative process.
Moreover, better muscle recovery leads to reduced
risk of injury during sport activity and to lower
increases in muscle tension in pathologic joints.
The benefits of appropriate muscle recovery are
important in both sport and rehabilitation.
6,7
Therefore, there is a need to develop a suitable
method to enhance the rate of recovery after fa-
tiguing exercise. It has been suggested that various
forms of muscle relaxation may improve muscle
blood flow and enhance recovery by augmenting
removal of exercise metabolites—for instance,
ADP, free radicals, carbon dioxide, or hydrogen
ions
2–5,7
One of the methods commonly used for
muscle recovery augmentation is massage.
2
It is a
popular technique, purported to provide more ben-
efits, but the scientific literature does not support
the efficacy of manual massage after exercise as a
means to improve performance or to shorten the
time needed for muscle relaxation.
2
It seems that
light exercise is more effective than manual
massage in improving blood flow.
7–9
However,
Rodenburg et al.
10
have reported positive effects
from a combination of stretching and massage,
although they attributed those benefits more to
stretching than to massage. Therefore, it is possible
that postisometric relaxation, a modified form of
stretching (based on gentle, alternant isometric
contraction and muscle stretch) widely used in
rehabilitation,
11,12
may reduce elevated muscle
tension and may also be useful in muscle recovery
after dynamic exercise. Postisometric relaxation
may enhance muscle blood flow by lowering pe-
ripheral resistance. Increasing blood flow could
improve oxygen delivery and the efflux of noxious
substances, theoretically enhancing recovery.
Previous studies have indicated that light ex-
ercise (AR) increases blood velocity
7
and removal of
metabolites after exercise.
9
Limited evidence exists
to suggest that passive rest and massage are bene-
ficial for muscle relaxation.
9
To our knowledge, the
efficacy of postisometric relaxation on muscle re-
covery after dynamic exercise has not been deter-
mined. Information regarding other modes of re-
covery has been found to be inadequate.
The objective of this study was to assess the
influence of different relaxation modes (postiso-
metric relaxation, active recovery, and passive re-
covery) on muscle recovery after dynamic exercise
of the quadriceps femoris.
METHODS
Subjects
Ten healthy male volunteers (age 24 –38 yrs,
height 174.7 ⫾4.66 cm, body mass 77.5 ⫾11.16
kg) were recruited for this study. All were healthy,
recreationally active nonsmokers who were not en-
gaged in a systematic exercise program. Subjects
were asked to abstain from food and caffeine bev-
erages for 2 hrs before testing and to not perform
heavy exercise during the 8 hrs preceding the tests.
After being fully informed of the purpose of the
experiments, each subject signed a statement of
informed consent. Local ethical committee ap-
proval was obtained for the study.
Experimental Procedures
All subjects reported to the laboratory for five
visits. The experiments were all performed in the
morning to control for circadian variation in a
laboratory at an ambient temperature of 22–24°C.
Visit 1
During the first visit, all subjects were shown
the equipment to be used in the following visits,
and all of them were given an opportunity to be-
come familiar with the test protocol. During this
visit, after warm-up (5 mins of cycling at 30 W on
the stationary ergometer [Monark Exercise AB]),
subjects performed one isometric effort for a max-
imal voluntary contraction (MVC) measurement of
the quadriceps femoris (knee extension) (MedX
Knee Extension Dynamometer). After 2 mins of
rest, subjects performed one set (to the inability to
maintain defined workload) of dynamic leg exten-
sion and flexions at 50% of MVC. After 3 mins of
rest, an electromyogram of vastus lateralis was
June 2007 Muscle Recovery Strategies 475
measured during isometric knee extension at 50%
MVC, which was performed for 15 secs. The famil-
iarization with postisometric relaxation was per-
formed in a supine position for 2 mins.
Visit 2 (baseline)
There was a 1-wk gap between visits to avoid
the influence of muscle fatigue on the measure-
ments. At the beginning of the second visit, sub-
jects performed a standard warm-up of 5 mins of
cycling on the stationary ergometer at 30 W. After
the warm-up, MVC was determined. After 5 mins of
rest in a sitting position, subjects were required to
perform isometric knee extension at 50% of MVC
to inability to maintain defined workload, despite
verbal encouragement. During this effort, EMG of
the vastus lateralis muscle was measured (Fig. 1A).
Visits 3–5
At the beginning of each visit, subjects per-
formed a standard warm-up as described previ-
ously. After the warm-up, subjects performed three
sets (during each set, subjects performed as many
repetitions as possible, and the set was terminated
when the subjects could no longer complete the
full range of motion) of dynamic leg extension and
flexion (at an angle of 20 –110 degrees) at 50% of
previously determined MVC, with 30 secs of rest
between sets, using MedX equipment (MedX Knee
Extension Dynamometer). Immediately after com-
pleting the leg exercise, one of the following relax-
ation methods was applied, in a randomized order.
a. Postisometric relaxation (stretching, ST). To per-
form postisometric relaxation, the muscles of the
quadriceps femoris were passively stretched to a
point of onset of resistance, “soft end filling.”
10,12
From this position, the subject performed a pro-
longed, gentle, isometric contraction against re-
sistance (applied by certified physiotherapist) for
about 5 secs. Then subjects were told to relax, take
a deep breath and exhale completely. During ex-
halation, the muscle was gently stretched. From
this new position, the procedure was repeated
within 5 mins, according to the method of Levit
and Simons.
12
The procedure was performed in a
supine position.
b. Active recovery (AR): light pedaling on the cycle
ergometer (10 W) at 60 rpm for 5 mins.
c. Passive recovery (PR): subject was required to
lie down in a relaxed position as a passive rest
period for 5 mins.
After each of the relaxation techniques, MVC
was reassessed. After 5 mins of rest in a sitting
position, each subject was required to perform an
isometric knee extension at 50% of MVC, which
had been determined at the second visit. The in-
ability to maintain the defined workload was used
as the end point of the test. During this effort, EMG
was measured (Fig. 1B).
Measurements
MVC
The subjects performed a maximal isometric
right knee extension (static, at an angle of 78
degrees) in a sitting position with the trunk sup-
ported by the chair back, using the MedX leg-
extension dynamometer. The inferior third of the
leg was attached to the distal end of the movable
lever arm. The pelvic girdle of each individual was
stabilized by an immobilization strap. MVC was
determined as the highest torque of three trials.
Visual feedback and verbal encouragement were
provided throughout.
EMG
The skin was gently shaved, scratched, and
cleaned with ethyl alcohol. Bipolar surface elec-
FIGURE 1 Diagram of the experimental procedure, showing the time line of the various activities during visits 2–5. A, Diagram of
time line of activities during visit 2. B, Diagram of the order and time line of activities during visits 3, 4, and 5.
476 Mika et al. Am. J. Phys. Med. Rehabil. ●Vol. 86, No. 6
trodes (Ag/AgCl, 4-cm diameter, 25-mm interelec-
trode distance) were applied to the belly of the
vastus lateralis muscle. The electrodes’ placement
was marked for the following assessments. Sub-
jects were asked not to remove these marks until
the end of the program. EMG was measured during
an isometric knee extension at 50% MVC (at an
angle of 54 degrees) performed to the point of
inability to maintain the defined workload, despite
verbal encouragement on the MedX equipment.
The task was terminated when the subject could
not maintain the knee extension at the 54-degree
angle. All subjects were given the opportunity of
visual feedback to maintain a constant level of
isometric effort. During the EMG measurements,
changes in frequency (F) and root mean square
(RMS) of the power spectrum were calculated us-
ing the MP 150 equipment (Biopac Systems Inc.). F
(frequency domain) and RMS (time domain) are
considered parameters describing the motor unit–
activation pattern.
13–18
Total time of the effort dur-
ing EMG measurement was analyzed. To avoid
transient phenomena from rest to exertion, and
vice versa, the first and the last seconds were not
considered. The change in mean value of RMS
(change in muscle unit activation) from the first to
second half of the effort time after recovery mode
applied was evaluated.
Statistical Analysis
The data are expressed as means ⫾SD. Statis-
tical significance was tested and accepted at the
␣
⫽0.05 level of probability. Changes within
groups were examined by paired ttests or, when data
were not normally distributed, by the nonparametric
Wilcoxon signed rank test. Differences between
groups (recovery modes) were determined with a
repeated-measures ANOVA. The results were analyzed
using a statistical program (STATISTICA 95).
RESULTS
After AR, the mean MVC was significantly (P⬍
0.05) higher (213.7 ⫾50.2) than after PR (206.8 ⫾
28.4) and ST (205.5 ⫾40.5). Moreover, there was
no statistically significant difference in MVC be-
tween AR (213.7 ⫾50.2) and baseline (223.1 ⫾
36.1) (measured during visit 2) (Fig. 2). Total time
for the effort during EMG measurement was sig-
nificantly lower for all three recovery modes (25.4 ⫾
6.5, 23.6 ⫾5.3, and 25.0 ⫾5.1 for AR, PR, and ST,
respectively) than for baseline (31.5 ⫾7.4) (Fig. 3).
During the effort after both PR and ST, there was
no significant increase in the activation of motor
units, but a significant increase was noted after AR
(P⬍0.05) (Table 1). There was no statistically
significant difference in F between any of the re-
covery modes and baseline (P⬎0.05).
DISCUSSION
The results of this study suggest that the most
appropriate and effective recovery mode after dy-
namic muscle fatigue is light, active exercise, such
as cycling with minimal resistance. Only after AR
was the mean MVC value similar to baseline; this
mode of recovery also led to an increase in the
activation rate of motor units. The implications of
these findings are that the quadriceps muscle gen-
erated more force after AR than after PR or ST. The
findings from this study are in agreement with
previous research.
2,8,9
The accumulation of an excess amount of ex-
ercise metabolites in muscles under stress is a
FIGURE 2 Mean MVC value at baseline and after each of the recovery modes. The passive and stretching
recovery modes were significantly different from baseline. ††P⬍0.001, recovery mode to baseline.
June 2007 Muscle Recovery Strategies 477
contributing factor to fatigue.
2–5,9
The removal
rate of these substances after heavy exercise is
higher during light aerobic exercise than during a
period of resting recovery.
19,20
If improved circu-
lation could enhance efflux of metabolites from
muscle, this also might speed recovery.
2
Continu-
ing light exercise immediately after intense activity
will have a positive effect on muscle blood flow.
7,8
For example, the study by Gupta et al.
9
confirms
that after supramaximal cycling exercise, blood lac-
tate was cleared more quickly by light exercise than
by passive rest, and that 20 mins of massage during
passive rest did not affect the lactate-clearance rate
at all.
It was also postulated that heavy exercise
might lead to exercise-induced injury, postexercise
degeneration, and subsequent muscle repair, all of
which may be prime factors in prolonged postex-
ercise loss of muscle-force production.
7
Improved
blood and lymph flow in injured muscle has been
suggested to enhance recovery by improving mi-
crocirculation,
21
helping reduce edema and accu-
mulation of exercise metabolites, and by enhancing
the regenerative process.
22,23
Hence, if enhanced
muscle blood flow does, in fact, improve the heal-
ing process, light muscle contractions may be the
most effective.
7
After heavy exercise, the benefits of light, ac-
tive exercise in comparison with those of passive
rest may be marginal, because the HR remains
above resting levels for some time, thus ensuring
good circulation in muscles that were exercised.
Also, the increased local muscle temperature helps
to maintain a higher rate of circulation.
24
Gupta et
al.
9
found the highest lactate value at 3 mins after
the end of exercise in all modes of recovery (active,
passive, and massage). The half-life of lactate in AR
was shortest because of better oxidation during
increased cardiac output, so the first detectable
difference in the removal of lactate was found in AR
at 10 mins after the end of exercise. Among the
three recovery modes, AR may be considered a
TABLE 1 Change in muscle unit activation (root mean square [RMS]) from first to second half of
effort time at baseline and after each of the recovery modes applied
Baseline Active Recovery Passive Recovery Stretching
First half of effort time, mV (mean ⫾SD) 0.22 ⫾0.06 0.30 ⫾0.09 0.29 ⫾0.09 0.31 ⫾0.09
Second half of effort time, mV (mean ⫾SD) 0.25 ⫾0.09 0.35 ⫾0.13 0.32 ⫾0.13 0.35 ⫾0.14
⌬RMS (mV) 0.038 0.047 0.030 0.032
P⬍0.05 ⬍0.05 NS NS
P⬍0.05 comparing first with second half mean value of RMS.
NS, nonsignificant.
FIGURE 3 Total time of the effort during EMG measurement at baseline and after each of the recovery modes.
There was a significant decrease in the time of contraction at 50% of MVC during all of the recovery
modes, but there was no difference between modes. *P⬍0.05, recovery mode to baseline; †P⬍0.01,
recovery mode to baseline.
478 Mika et al. Am. J. Phys. Med. Rehabil. ●Vol. 86, No. 6
much better recovery process than massage and
passive rest, particularly when a faster rate of lactate
elimination is the main criterion.
9
The different cri-
teria used for the recovery process evaluation em-
ployed in our study (MVC and EMG analysis) support
those metabolic observations.
7,8,19,20,24
Stretching was recommended as a popular re-
covery strategy after muscle fatigue in the sporting
and rehabilitation domains.
25,26
But, there is a lack
of substantive information regarding the efficacy of
stretching, and the information supporting its ad-
visability in muscle recovery has been found to be
inadequate. Moreover, some authors have sug-
gested that intense, unaccustomed muscular exer-
cise, particularly that which involves eccentric
muscle contraction, will induce muscle damage
and may slow the speed of relaxation.
25–27
The
mechanisms associated with prolonged disruption
of maximum voluntary muscle-contraction force
generation after eccentric exercise may be associ-
ated with mechanical disruption of the sarcomeres
and sarcolemma.
28 –29
It has been suggested that
eccentric exercise results in the nonuniform over-
stretching of some sarcomeres, leading to injury,
possibly because of the inability of cross-bridge
cycling to keep pace with lengthening speed.
21,30
In the present study, the minor decrease in the
time of the effort after AR and ST than after PR in
comparison with the baseline value (Fig. 3) seems
to suggest that passive rest is not a recommended
option in muscle relaxation after fatiguing exer-
cise. The results from the present study are in
agreement with previous research
2,8,9
that has
demonstrated advantages of those two forms of
muscle relaxation. However, light aerobic exercise
was considered more effective
2,9
than stretching,
which has had demonstrable positive effects in
some studies
26
but not in others.
28,29
In sports per
se, warm-up and stretching exercise are often rou-
tinely performed and are accepted as preventing
muscle injury.
10
But, in the scientific literature,
stretching has yielded equivocal results.
10
A crucial question concerns the recovery time
between muscular efforts. In the present study, 5
mins of rest was applied. Only after AR was there a
lack of difference in the measured MVC compared
with the baseline value. Therefore, we may hypoth-
esize that only this kind of recovery allowed fa-
tigued muscle to recover sufficiently during this
time period. Moreover, the EMG data are in agree-
ment with the MVC data. RMS increased signifi-
cantly during the effort only after AR (Table 1); this
suggests that the muscle recovered sufficiently to
recruit more motor units. After ST and PR, RMS
was stable; this may suggest that the maximal
amount of motor units was recruited at the begin-
ning of the effort.
The lowering of the MVC in the present study
after fatiguing exercise is in agreement with previ-
ous reports.
31,32
Esposito et al.
13
have reported that
even after 10 mins of PR, exercise-induced muscle
fatigue led to only a 26% decrease in MVC. Similar
results have been reported by Persson et al.
33
in a
static endurance test, which consisted of a sub-
maximal unilateral activation of the right trapezius
and deltoid muscles for as long as possible. The
subjects developed significant signs of fatigue, as
defined by EMG criteria, in both muscles on the
right side during the test. The recovery from fa-
tigue was approximately half-complete 15 secs after
the end of the test and was complete or almost
complete 10 mins thereafter. Esposito et al.
13
also
evaluated, by EMG, the degree of alteration of elec-
trical activity of the motor units, suggesting that
they may still be present within a period of recov-
ery (10 mins) after a fatiguing exercise. Similarly,
Lariviere et al.
34
used EMG to evaluate passive rest
intervals of 10 or 15 mins after fatiguing back
exercise. Their results suggest that complete mus-
cle recovery was achieved with 10- to 15-min rest
periods. These results support the use of rest peri-
ods of 10 –15 mins between multiple fatigue tests.
In the present study, the subjects performed three
sets of flexion– extension exercise to the point of
fatigue, with 5 mins of rest between the three sets
and the MVC test. The shorter recovery time may
be the reason for the significant decrease in MVC.
This type of recovery duration is commonly used in
interval training programs that incorporate fatigu-
ing exercise. On the basis of these data, short rest
periods
35
seem insufficient to allow full MVC re-
covery; longer rest periods of 10 –15 mins would be
more appropriate.
34
Garland et al.
15
have demonstrated that the
discharge rate of most motor units (measured by
RMS) that were active from the beginning of a
contraction declined during a fatiguing contrac-
tion. The discharge rates of more recently re-
cruited units were either constant or increased
slightly. The mechanism of the alteration of motor
unit activation during muscle work is partly attrib-
utable to the linear increase in the RMS during the
first part of the exercise.
13,36
This has been found to
be mainly dependent on (1) changes in the muscle
fiber action potential, with a decrease in the con-
duction velocity and an enrichment in the low-
frequency content of the signal, and (2) recruit-
ment of additional motor units, coupled with an
increase in their average firing frequency to main-
tain a constant force and synchronization of active
motor units.
13,36
Several limitations of this study need to be
addressed. First, the study population was rela-
tively small, so future research should be con-
ducted with a bigger group. Further, the surface
June 2007 Muscle Recovery Strategies 479
EMG signals may vary depending on electrode
placement, so it is very important to mark the
electrodes’ location. Moreover, circadian variation
of the EMG signal is the reason that the EMG data
in the assessment of muscle unit activity should be
considered with caution.
A decrease of the EMG power spectrum to
lower frequencies during sustained isometric con-
traction has generally been accepted as a sign of
muscle fatigue.
2,7,16,17
A number of authors have
analyzed the EMG power spectrum during dynamic
exercise.
37– 42
In a few cases, decreases in frequency
during dynamic exercise have been found during
ergometer cycling,
37
in isokinetic dynamometer
exercise,
38,39
and in running.
40
Others have found
no change of frequency during ergometer cycling
41
and running.
42
As has been postulated by previous
research,
43
fatigue during dynamic exercise is ac-
companied by a decrease of electromyographic me-
dian power frequency; this might be attributable to
intramuscular factors. An insufficient muscle
blood supply under these circumstances might be
the decisive factor. These circumstances have been
found at extremely high exercise intensities.
43
In
the present study, no systematic decline of fre-
quency during exercise was found.
Considering that MVC decreased after PR and
ST but was unchanged after AR, AR seems to be the
best method of recovery after fatiguing, dynamic
exercise. ST and PR did not significantly increase
activation of muscle fibers (RMS) during the sec-
ond part of the effort, whereas RMS was signifi-
cantly increased during AR. The results of this
study suggest that the most appropriate and effec-
tive recovery mode after dynamic muscle fatigue
involves light, active exercises such as cycling with
minimal resistance.
Because this study has pertinence to athletes
as well as rehabilitation patient populations, future
research should address additional questions such
as the influence of sex, physical activity level, or
age on recovery.
REFERENCES
1. Gandevia SC: Spinal and supraspinal factors in human
muscle fatigue. Physiol Rev 2001;81:1725–89
2. Tiidus PM: Manual massage and recovery of muscle func-
tion following exercise: a literature review. J Orthop Sports
Phys Ther 1997;25:107–12
3. Begum G, Cunliffe A, Leveritt M: Physiological role of
carnosine in contracting muscle. Int J Sport Nutr Exerc
Metab 2005;15:493–514
4. Suzuki Y, Ito O, Mukai N, Takahashi H, Takamaatsu K: High
level of skeletal muscle carnosine contributes to the latter
half of exercise performance during 30-s maximal cycle
ergometer sprinting. Jpn J Physiol 2002;52:199–205
5. Steele DS, Duke AM: Metabolic factors contributing to
altered Ca2⫹regulation in skeletal muscle fatigue. Acta
Physiol Scand 2003;179:39–48
6. Lehman M, Foster C, Keul J: Overtraining in endurance
athletes: a brief review. Med Sci Sports Exerc 1993;25:
854–62
7. Tiidus PM, Shoemaker JK: Effulage massage, muscle blood
flow and long-term post-exercise strength recovery. Int
J Sports Med 1995;16:478–83
8. Shoemaker JK, Tiidus PM, Mader R: Failure of manual
massage to alter limb blood flow: measures by Doppler
ultrasound. Med Sci Sports Exerc 1997;29:610–4
9. Gupta S, Goswami A, Sadhukhan AK, Mathur DN: Compar-
ative study of lactate removal in short term massage of
extremities, active recovery and a passive recovery period
after supramaximal exercise sessions. Int J Sports Med
1996;17:106–10
10. Rodenburg JB, Steenbeek D, Schiereck P, Bar PR: Warm-
up, stretching and massage diminish harmful effects of
eccentric exercise. Int J Sports Med 1994;15:414–9
11. Toft E, Espersen GT, Kalund S, Sinkjaer T, Hornemann BC:
Passive tension of the ankle before and after stretching.
Am J Sports Med 1989;17:489–94
12. Levit K, Simons DG: Myofascial pain: relief by post-isomet-
ric relaxation. Arch Phys Med Rehabil 1984;65:452–6
13. Esposito F, Orizio C, Veicsteinas A: Electromyogram and
mechanomyogram changes in fresh and fatigued muscle
during sustained contraction in men. Eur J Appl Physiol
1998;78:494–501
14. Linsen WHJP Stegeman DF, Joosten EMG: Variability and
interrelationships of surface EMG parameters during local
muscle fatigue. Muscle Nerve 1993;16:849–56
15. Garland SJ, Enoka RM, Serrano LP, Robinson GA: Behavior
of motor units in human biceps brachii during a submaxi-
mal fatiguing contraction. J Appl Physiol 1994;76:2411–9
16. Clark BC, Manini TM, The DJ, Doldo NA, Ploutz-Snyder L:
Gender differences in skeletal muscle fatigability are related
to contraction type and EMG spectral compression. J Appl
Physiol 2003;94:2263–72
17. Farina D, Merletti R, Enoka RM: The extraction of neural
strategies from the surface EMG. J Appl Physiol 2004;96:
1486–95
18. Linssen WHJP, Stegeman DF, Joosten EMG, Van’t Hof MA,
Binkhorst RA, Notermans SLH: Variability and interrela-
tionships of surface EMG parameters during local muscle
fatigue. Muscle Nerve 1993;16:849–56
19. Bulbulian R, Darabos B, Nauta S: Supine rest and removal
of lactate following maximal exercise. J Sports Med Phys
Fitness 1987;27:151–6
20. Rontoyannis PG: Lactate elimination from blood during
active recovery. J Sports Med Phys Fitness 1988;28:115–23
21. Kuipers H: Exercise-induced muscle damage. Int J Sports
Med 1994;15:132–5
22. Callaghan MJ: The role of massage in the management of
the athlete: a review. Br J Sports Med 1993;27:28–33
23. Lehn C, Prentice WE: Massage. Therapeutic Modalities in
Sports Medicine. St. Louis, Mosby-Year Book Inc., 1994, pp
335–63
24. Cafarelli E, Flint F: The role of massage in preparation for
and recovery from exercise. Sports Med 1992;14:1–9
25. Guissard N, Duchateau J, Hainaut K: Mechanisms of de-
creased motoneurone excitation during passive muscle
stretching. Exp Brain Res 2001;13:163–9
26. Rodenburg JB, Bar PR, DeBoer RW: Relations between
muscle soreness and biochemical and functional outcomes
of eccentric exercise. J Appl Physiol 1993;74:2976–83
27. Armstrong RB: Mechanisms of exercise-induced delayed
onset muscular soreness: a brief review. Med Sci Sports
Exerc 1984;16:529–38
28. Linnamo V, Bottas R, Komi PV: Force and EMG power
spectrum during and after eccentric and concentric fatigue.
J Electromyogr Kinesiol 2000;10:293–300
29. Hamlin MJ, Quigley BM: Quadriceps concentric and eccen-
480 Mika et al. Am. J. Phys. Med. Rehabil. ●Vol. 86, No. 6
tric exercise 1: changes in contractile and electrical activity
following eccentric and concentric exercise. J Sci Med Sport
2001;4:88–103
30. Wood SA, Morgan DL, Proske U: Effects of repeated eccen-
tric contractions on structure and mechanical properties of
toad sartorius muscle. Am J Physiol 1993;265:792–800
31. Bigland-Ritche B, Woods JJ: Changes in muscle contractile
properties and neural control during human muscular fa-
tigue. Muscle Nerve 1984;7:691–9
32. Cady EB, Jones DA, Lynn J, Newham DJ: Changes in force
and intracellural metabolites during fatigue of human skel-
etal muscle. J Physiol 1989;418:311–25
33. Persson AL, Hannson GA, Kalliomaki A, Moritz U, Sjolund
BH: Pressure pain thresholds and electromyographically
defined muscular fatigue induced by a muscular endurance
test in normal women. Clin J Pain 2000;16:155–63
34. Lariviere C, Gravel D, Arsenault AB, Gagnon D, Loisel P:
Muscle recovery from a short fatigue test and consequence
on the reliability of EMG indices of fatigue. Eur J Appl
Physiol 2003;89:171–6
35. Seiler S, Hetlelid KJ: The impact of rest duration on work
intensity and RPE during interval training. Med Sci Sports
Exerc 2005;37:1601–7
36. Vaz MA, Zhang YT, Herzog W, Guimaraes AC, Macintosh
BR: The behaviour of rectus femoris and vastus lateralis
during fatigue and recovery: an electromyographic and vi-
bromyographic study. Electromyogr Clin Neurophysiol
1996;36:221–30
37. Bouissou PH, Estrade PY, Goubel F, Guezennec CY,
Serrurier B: Surface EMG power spectrum and intramus-
cular pH in human vastus lateralis muscle during dynamic
exercise. J Appl Physiol 1989;67:1245–9
38. Tesch PA, Komi PV, Jacobs I, Karlsson J, Viitasalo JT:
Influence of lactate accumulation of EMG frequency spec-
trum during repeated concentric contractions. Acta Physiol
Scand 1983;119:61–7
39. Horita T, Ishoki T: Relationship between lactate accumula-
tion and surface EMG activities during isokinetic contrac-
tions in man. Eur J Appl Physiol 1987;56:18–23
40. Ament W, Bonga GJJ, Hof AL, Verkerke GJ: EMG median
power frequency in an exhausting exercise. J Electromyogr
Kinesiol 1993;3:214–20
41. Gamet D, Duchene J, Gaparon-Bar C, Goubel F: Electro-
myogram power spectrum during dynamic contractions at
different intensities of exercise. Eur J Appl Physiol 1990;61:
331–7
42. Arendt-Nielsen L, Mills KR: The relationship between mean
power frequency of the EMG spectrum and muscle fiber
velocity. Electroencephalogr Clin Neurophysiol 1985;60:
130–4
43. Ament W, Bonga GJJ, Hof AL, Verkerke GJ: Electromyo-
gram median power frequency in dynamic exercise at
medium exercise intensities. Eur J Appl Physiol 1996;74:
180–6
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