PTRCTAmerican journal of physical medicine & rehabilitation2019

Electromyography Evaluation of Bodyweight Exercise Progression in a Validated Anterior Cruciate Ligament Injury Rehabilitation Program: A Cross-Sectional Study.

Mette Kreutzfeldt Zebis, Mads Hjorth Sørensen, Hanne Bloch Lauridsen and 6 others

PMID 31626021

WHAT IT FOUND

In healthy athletes, hamstring activity did not increase from early to late phases, and late-phase hamstring activity was 26% to 45% of maximum voluntary isometric contraction.

Cook hip lift reached high hamstring activity, about 64% of maximum voluntary isometric contraction in both hamstring muscles.

Key findings

01Cook hip lift produced high hamstring activity, 64% of maximum voluntary isometric contraction in both hamstring muscles.

02Quadriceps activity increased across phases, and phase 3 exercises produced vastus lateralis and vastus medialis activity above 60% of maximum voluntary isometric contraction.

03Prone leg curl and Cook hip lift were hamstring dominant exercises, while box squat, standing knee extension, bodyweight squat, Bulgarian split squat, lunges with rotation, and forward jump with ball were quadriceps dominant exercises.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The participants were healthy athletes, not people with ACL injury, so the muscle activity may differ in injured or recovering knees. The study tested only bodyweight exercises from an appendix, not the full ACL rehabilitation protocol or exercises using weights or machines. Muscle activity was measured as a percentage of maximum voluntary isometric contraction; it did not measure strength gains, function, pain, return to sport, or injury outcomes. The original five-phase protocol was evaluated as three phases, so the findings do not describe every phase or every exercise. Participants and the test leader were not blinded, although the exercise order was randomized and the statistician was blinded to exercises. No familiarization visit was provided, though only trials with proper technique were analyzed. Twenty participants were tested on one occasion, so individual variation and day-to-day variability cannot be assessed.

Declared interests

The supplied text says financial disclosure statements were obtained, but it does not report a specific funding source or author conflicts. There is no statement that a sponsor designed or wrote the study.

The easy way to misread this

Do not read these muscle activity levels as proof that the exercises improve strength or recovery after ACL injury. The study measured muscle activation in healthy athletes, not patient outcomes, and it evaluated only selected bodyweight exercises.

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