A comparison of running and contact loads in U18 and U20 international rugby union competition.

The purpose of the present study was to characterize and compare locomotor and contact loads in U18 and U20 international rugby union competition during matches, and specifically during peak match-play phases using short rolling epochs and continuous ball-in-play (BIP) sequences. 20 international matches from French national teams were analysed in the U18 and U20 Six Nations Tournament respectively and World Rugby U20 Championship. Running loads were quantified using global positioning devices (16 Hz) and contact loads via video match analysis software. Players were split into forward (U18, n = 29; U20, n = 32) and back positional groups (U18, n = 20; U20, n = 24). Compared with U20 peers, U18 players covered a higher total distance (effect size (ES) = -0.76 ± 0.25) and at high-speeds per minute (> 4 m · s-1; ES = -0.55 ± 0.25) and performed more accelerations (ES = -0.71 ± 0.25). While a greater frequency of BIP sequences > 90 s duration was observed in U20s versus U18s match-play, U18s covered more total distance and high-speed distance (ES = -0.42 ± 0.13 and -0.33 ± 0.13 respectively) per minute during these longer sequences. During peak rolling phases shorter than 4 minutes, no clear differences existed between age categories in running activity, while U20 forwards performed more contact actions than U18 peers. The match-play loads observed in the present international U18 players suggest that they are ready to respond to the overall and peak demands observed in U20 competition. Moreover, the present information on peak activity phases can aid design of overload high-intensity conditioning sessions to respond to the running- and contact-demands identified in those competitions.

Typical weekly physical periodization in French academy soccer teams: a survey.

In elite-level youth soccer players, weekly training periodization is of paramount importance to plan for short- and long-term physical development. The present study investigated current practices for physical periodization strategies in elite male French academies. An online survey was completed by elite French academies strength and conditioning coaches to determine the typical weekly periodization with particular reference to daily training in relation to match day (MD) in youth soccer players. The survey attempted to characterize the importance of physical development compared to match result, and practices used (expected difficulty and content) for each training session according to duration, exercises, and objective. The frequency rates of the responses were compared using two-tailed Chi-square tests with the significance level set at p < 0.05. Fortyfive questionnaires were analyzed. Respondents indicated that their training sessions focused mainly on physical development (95.6%) rather than match result. Active recovery (34.2%) and aerobic conditioning exercises (40.8%) were primarily conducted on MD+1 and MD+2 using passing circuits and aerobic technical drills. Physical development was mostly pursued during sessions on MD-4 (38.8%) and MD-3 (37.3%). The number of large-sided games was highest on MD-3 (58.1%). On MD-2 and MD-1, a decrease in the training load was highlighted, with speed (40.4%) and tapering sessions (52.4%) mostly implemented. Intensive use of small-sided games (92.3%) and reactivity exercises was observed at MD-1 (100.0%). Our results revealed discrepancies between the physical objectives set for each day and the content implemented, which could potentially be more physically demanding than expected.

Positional Differences in Absolute vs. Relative Training Loads in Elite Academy Soccer Players.

Weekly training loads are typically reported using absolute values and are not individualized according to competition positional demands (relative values). The aim of this study was to evaluate absolute and relative training loads and compare across playing positions during a full in-season in an elite soccer academy. 24 elite academy soccer players, categorized into five positions (CD: central defender [n = 4]; FB: full back [n = 5]; CM: central midfielder [n = 6]; WM: wide midfielder [n = 5]; FW: forward [n = 4]), were monitored using a global positioning system. Absolute training load was calculated using the total distance, the distance at moderate-speed ([15-20[ km·h-1), high-speed ([20-25[ km·h-1), sprint (> 25 km·h-1), the total number of accelerations (> 3 m·s-2) and decelerations (< -3 m·s-2). Relative training load was calculated by dividing absolute training loads by mean values from the competitive matches. Training loads were determined daily according to their distance from match day (MD). One-way ANOVAs were performed to evaluate differences between playing positions. Absolute moderate-speed distance was greater for WM compared to CD (p = 0.015, and p = 0.017), while the opposite was shown for relative values (p = 0.014, and p < 0.001) on MD-4 and MD-3, respectively. The absolute moderate-speed distance was not different between CD, FB, CM, and FW, whereas relative values were greater for CD on MD+2 and MD-4 (p < 0.05). FB and WM performed greater absolute high-speed distance than CD on MD-4 and MD-3 (p < 0.05) while no difference was highlighted for relative values.Our results demonstrated that in the present academy players, training load for CD was underestimated using absolute training loads for moderate and high-speed distances. In contrast, relative training loads highlighted WM as an underloaded position. Therefore, relative training loads are recommended as they contextualize training loads according to competitive demands and favor training individualization.

Acute effects of dynamic stretching on neuromechanical properties: an interaction between stretching, contraction, and movement.

PURPOSE: The present study aimed to investigate the acute effects of dynamic stretching on neurophysiological and mechanical properties of plantar flexor muscles and to test the hypothesis that dynamic stretching resulted from an interaction between stretching, movement, and contraction. METHODS: The dynamic stretching conditioning activity (DS) was compared to static stretching (SS), passive cyclic stretching (PCS), isometric contractions (IC), static stretching followed by isometric contractions (SSIC), and control (CO) conditions. Stretching amplitude (DS, SS, PCS and SSIC), contraction intensity (DS, IC and SSIC) and duration (all 6 conditions) were matched. Thirteen volunteers were included. Passive torque, fascicle length, and stiffness were evaluated from a dynamometer and ultrasonography during passive dorsiflexion. Neuromuscular electrical stimulation was used to investigate contractile properties [peak twitch torque (PTT), and rate of torque development (RTD)] and muscle voluntary activation (%VA). Gastrocnemius lateralis electromyographic activity (GL EMG/Mwave) was obtained during maximal voluntary contraction. All of these parameters were measured immediately before and 10 s after each experimental condition. RESULTS: Peak twitch torque, RTD, %VA, GL EMG/Mwave remained unaltered, while passive torque was significantly reduced after DS (- 8.14 ± 2.21%). SS decreased GL EMG/Mwave (- 7.83 ± 12.01%) and passive torque (- 2.16 ± 7.25%). PCS decreased PTT (- 3.40 ± 6.03%), RTD (- 2.96 ± 5.16%), and passive torque (- 2.16 ± 2.05%). IC decreased passive torque (- 7.72 ± 1.97%) and enhanced PTT (+ 5.77 ± 5.19%) and RTD (+ 7.36 ± 8.35%). However, SSIC attenuated PTT and RTD improvements as compared to IC. CONCLUSION: These results suggested that dynamic stretching is multi-component and would result from an interaction between stretching, contraction, and movement.

Spatially constrained tandem bromodomain inhibition bolsters sustained repression of BRD4 transcriptional activity for TNBC cell growth.

The importance of BET protein BRD4 in gene transcription is well recognized through the study of chemical modulation of its characteristic tandem bromodomain (BrD) binding to lysine-acetylated histones and transcription factors. However, while monovalent inhibition of BRD4 by BET BrD inhibitors such as JQ1 blocks growth of hematopoietic cancers, it is much less effective generally in solid tumors. Here, we report a thienodiazepine-based bivalent BrD inhibitor, MS645, that affords spatially constrained tandem BrD inhibition and consequently sustained repression of BRD4 transcriptional activity in blocking proliferation of solid-tumor cells including a panel of triple-negative breast cancer (TNBC) cells. MS645 blocks BRD4 binding to transcription enhancer/mediator proteins MED1 and YY1 with potency superior to monovalent BET inhibitors, resulting in down-regulation of proinflammatory cytokines and genes for cell-cycle control and DNA damage repair that are largely unaffected by monovalent BrD inhibition. Our study suggests a therapeutic strategy to maximally control BRD4 activity for rapid growth of solid-tumor TNBC cells.

Russian and Low-Frequency Currents Induced Similar Neuromuscular Adaptations in Soccer Players: A Randomized Controlled Trial.

CONTEXT: Neuromuscular electrical stimulation is widely used to induce muscular strength increase; however, no study has compared Russian current (RC) with pulsed current (PC) effects after a training program. OBJECTIVES: We studied the effects of different neuromuscular electrical stimulation currents, RC, and PC on the neuromuscular system after a 6-week training period. DESIGN: Blinded randomized controlled trial. SETTING: Laboratory. PATIENTS: A total of 27 male soccer players (age 22.2 [2.2] y, body mass 74.2 [10.0] kg, height 177 [0] cm, and body mass index 23.7 [2.9] kg/cm2 for the control group; 22.1 [3.1] y, 69.7 [5.7] kg, 174 [0] cm, and 23.0 [2.5] kg/cm for the PC group; and 23.0 [3.4] y, 72.1 [10.7] kg, 175 [0] cm, and 23.5 [3.4] kg/cm for the RC group) were randomized into 3 groups: (1) control group; (2) RC (2500 Hz, burst 100 Hz, and phase duration 200 µs); and (3) PC (100 Hz and 200 µs). INTERVENTION: The experimental groups trained for 6 weeks, with 3 sessions per week with neuromuscular electrical stimulation. MAIN OUTCOME MEASURES: Maximal voluntary isometric contraction and evoked torque, muscle architecture, sensory discomfort (visual analog scale), and electromyographic activity were evaluated before and after the 6-week period. RESULTS: Evoked torque increased in the RC (169.5% [78.2%], P < .01) and PC (248.7% [81.1%], P < .01) groups. Muscle thickness and pennation angle increased in the RC (8.7% [3.8%] and 16.7% [9.0%], P < .01) and PC (16.1% [8.0%] and 27.4% [11.0%], P < .01) groups. The PC demonstrated lower values for visual analog scale (38.8% [17.1%], P < .01). There was no significant time difference for maximal voluntary isometric contraction and root mean square values (P > .05). For all these variables, there was no difference between the RC and PC (P > .05). CONCLUSION: Despite the widespread use of RC in clinical practice, RC and PC training programs produced similar neuromuscular adaptations in soccer players. Nonetheless, as PC generated less perceived discomfort, it could be preferred after several training sessions.

Acute Effects of Dynamic Stretching on Mechanical Properties Result From both Muscle-Tendon Stretching and Muscle Warm-Up.

We investigated the acute effects of dynamic stretching on mechanical properties of plantar flexor muscles and tested the hypothesis that it would result from an interaction between muscle-tendon stretching and muscle warm-up. To test the stretching effect, dynamic stretching (DS) was compared to static stretching (SS). To test the warm-up effect, DS was compared to submaximal isometric muscle activity (SIMA) with similar contraction intensity. A control condition served as reference. These four conditioning activities were time matched (2×20s) and tested on separate days on 13 volunteers. Electrical neurostimulation was applied to investigate muscle mechanical properties (peak doublet torque (PDT) and rate of torque development (RTD)), before assessing maximal voluntary isometric torque (MVIT). Passive torque and muscle fascicles length, were measured respectively with a dynamometer and ultrasonography during a maximal passive dorsiflexion. These parameters were recorded before and after each conditioning activities. MVIT, PDT, RTD and fascicles length remained unaffected, while passive torque was significantly reduced (-11.6 ± 14.8%) after DS. SS significantly decreased MVIT (-7.7 ± 3.8%) and enhanced fascicles length (45.3 ± 49.2%), whereas SIMA increased PDT (5.8 ± 5.2%) and RTD (7.4 ± 8.3%) without affecting passive torque or fascicles length. These results may suggest that, during dynamic stretching, muscle-tendon stretching effects would partly counteract muscle warm-up effects.

Neuromuscular fatigue after low- and medium-frequency electrical stimulation in healthy adults.

INTRODUCTION: In this study we investigated fatigue origins induced by low-frequency pulsed current (PC) and medium-frequency current (MF) neuromuscular electrical stimulation (NMES) after a clinical-like session. METHODS: Eleven healthy men randomly underwent 2 NMES sessions, PC and MF, on quadriceps muscle (15-minute duration, 6 seconds on and 18 seconds off). Maximal voluntary contraction (MVC), central activation ratio (CAR), vastus lateralis electromyographic activity (EMG), and evoked contractile properties were determined before and after the sessions. Evoked torque and discomfort during the sessions were also measured. RESULTS: Both currents produced decreases in MVC, EMG, and evoked contractile properties after the sessions. No difference was found between currents for all variables (P > 0.05). Evoked torque during sessions decreased (P < 0.05). No difference was observed in mean evoked torque and discomfort (P > 0.05). DISCUSSION: Both currents induced similar neuromuscular fatigue. Clinicians can choose either PC or MF and expect similar treatment effects when the goal is to generate gains in muscle strength. Muscle Nerve 58: 293-299, 2018.

Training Effects of Alternated and Pulsed Currents on the Quadriceps Muscles of Athletes.

The aim of the study was to evaluate the effects of 6 weeks training with different neuromuscular electrical stimulation (NMES) currents (medium alternated and low-frequency pulsed current) on muscle architecture and neuromuscular performance of competitive athletes. A double-blind controlled and randomized experimental study was carried out with 33 athletes (22.2±2.6 yrs, 74.7±9.8 kg, 176.8±6.0 cm), divided into 3 groups: mid-frequency current (MF, n=12), pulsed current (PC, n=11) and the control group (CG, n=10). Quadriceps maximal voluntary peak torque (PT) and corresponding vastus lateralis electromyographic activity, evoked torque (PT-NMES), vastus lateralis muscle thickness, fascicle length, pennation angle, and level of discomfort were assessed before and after the interventions. NMES training was performed 3 times per week and consisted of 18 sessions, 15 min/session, 6 s duration in each contraction interspersed with 18 s rest. After the training period, muscle thickness increased in the MF and PC groups (p<0.05). PT-NMES increased only in the PC group (p<0.05). All currents produced similar levels of discomfort (p>0.05). Quadriceps NMES training applied through alternated or pulsed currents produced similar effects in architecture and neuromuscular performance in competitive athletes.

Structure-activity relationship studies of G9a-like protein (GLP) inhibitors.

Given the high homology between the protein lysine methyltransferases G9a-like protein (GLP) and G9a, it has been challenging to develop potent and selective inhibitors for either enzyme. Recently, we reported two quinazoline compounds, MS0124 and MS012, as GLP selective inhibitors. To further investigate the structure-activity relationships (SAR) of the quinazoline scaffold, we designed and synthesized a range of analogs bearing different 2-amino substitutions and evaluated their inhibition potencies against both GLP and G9a. These studies led to the identification of two new GLP selective inhibitors, 13 (MS3748) and 17 (MS3745), with 59- and 65-fold higher potency for GLP over G9a, which were confirmed by isothermal titration calorimetry (ITC). Crystal structures of GLP and G9a in complex with 13 and 17 provide insight into the interactions of the inhibitors with both proteins. In addition, we generated GLP selective inhibitors bearing a quinoline core instead of the quinazoline core.

Acute effects of static stretching on muscle-tendon mechanics of quadriceps and plantar flexor muscles.

PURPOSE: This study aimed to determine the acute effects of static stretching on stiffness indexes of two muscle groups with a contrasting difference in muscle-tendon proportion. METHODS: Eleven active males were tested on an isokinetic dynamometer during four sessions randomly presented. Two sessions were dedicated to quadriceps and the two others to triceps surae muscles. Before and immediately after the stretching procedure (5 × 30 s), gastrocnemius medialis and rectus femoris fascicle length and myotendinous junction elongation were determined using ultrasonography. Passive and maximal voluntary torques were measured. Fascicle and myotendinous junction stiffness indexes were calculated. RESULTS: After stretching, maximal voluntary torque similarly decreased for both muscle groups. Passive torque significantly decreased on triceps surae and remained unchanged on quadriceps muscles. Fascicle length increased similarly for both muscles. However, myotendinous junction elongation remained unchanged for gastrocnemius medialis and increased significantly for rectus femoris muscle. Fascicle stiffness index significantly decreased on medial gastrocnemius and remained unchanged on rectus femoris muscle. In contrast, myotendinous junction stiffness index similarly decreased on both muscles. CONCLUSION: Depending on the muscle considered, the present results revealed different acute stretching effects. This muscle dependency appeared to affect primarily fascicle stiffness index rather than the myotendinous junction.

Specific Training Effects of Concurrent Aerobic and Strength Exercises Depend on Recovery Duration.

This study aimed to determine whether the duration (0, 6, or 24 hours) of recovery between strength and aerobic sequences influences the responses to a concurrent training program. Fifty-eight amateur rugby players were randomly assigned to control (CONT), concurrent training (C-0h, C-6h, or C-24h), or strength training (STR) groups during a 7-week training period. Two sessions of each quality were proposed each week with strength always performed before aerobic training. Neuromuscular and aerobic measurements were performed before and immediately after the overall training period. Data were assessed for practical significance using magnitude-based inference. Gains in maximal strength for bench press and half squat were lower in C-0h compared with that in C-6h, C-24h, and STR. The maximal voluntary contraction (MVC) during isokinetic knee extension at 60°·s(-1) was likely higher for C-24h compared with C-0h. Changes in MVC at 180°·s(-1) was likely higher in C-24h and STR than in C-0h and C-6h. Training-induced gains in isometric MVC for C-0h, C-6h, C-24h, and STR were unclear. V[Combining Dot Above]O2peak increased in C-0h, C-6h, and C-24h. Training-induced changes in V[Combining Dot Above]O2peak were higher in C-24h than in C-0h and C-6h. Our study emphasized that the interference on strength development depends on the recovery delay between the 2 sequences. Daily training without a recovery period between sessions (C-0h) and, to a lesser extent, training twice a day (C-6h), is not optimal for neuromuscular and aerobic improvements. Fitness coaches should avoid scheduling 2 contradictory qualities, with less than 6-hour recovery between them to obtain full adaptive responses to concurrent training.

Effects of electrical stimulation pattern on quadriceps isometric force and fatigue in individuals with spinal cord injury.

INTRODUCTION: Variable frequency trains (VFT) or train combinations have been suggested as useful strategies to offset the rapid fatigue induced by constant frequency trains (CFT) during electrical stimulation. However, most studies have been of short duration with limited functional application in those with spinal cord injury (SCI). We therefore tested force and fatigue in response to VFT, CFT, and combined patterns in strength training-like conditions (6-s contractions). METHODS: Ten SCI individuals underwent either CFT or VFT patterns until target torque was no longer produced and then switched immediately to the other pattern. RESULTS: Target torque was reached more times when VFT was used first (VFT: 6.7 ± 0.8 vs. CFT: 3.5 ± 0.2 contractions, P < 0.05) and when it was followed by the CFT pattern (VFT-CFT: 10.3 ± 1.2 vs. CFT-VFT: 6.9 ± 1.2 contractions, P < 0.05). CONCLUSIONS: These findings suggest that for the same initial forces the VFT pattern is less fatiguing than CFT and that when combining train types, VFT should be used first.

Effects of electrical stimulation pattern on quadriceps force production and fatigue.

INTRODUCTION: Mixed stimulation programs (MIX) that switch from constant frequency trains (CFT) to variable frequency trains have been proposed to offset the rapid fatigue induced by CFT during electrical stimulation. However, this has never been confirmed with long stimulation patterns, such as those used to evoke functional contractions. The purpose of this study was to test the hypothesis that MIX programs were less fatiguing than CFTs in strength training-like conditions (6-s contractions, 30-min). METHODS: Thirteen healthy subjects underwent 2 sessions corresponding to MIX and CFT programs. Measurements included maximal voluntary isometric torque and torque evoked by each contraction. RESULTS: There were greater decreases of voluntary and evoked torque (P < 0.05) after CFT than MIX, and mean torque was 13 ± 1% higher during the MIX session (P < 0.05). CONCLUSIONS: These findings confirm that combining train types might be a useful strategy to offset rapid fatigue during electrical stimulation sessions with long-duration contractions.

Could Low-Frequency Electromyostimulation Training be an Effective Alternative to Endurance Training? An Overview in One Adult.

This preliminary study aimed to investigate the effects of a six-week low-frequency electromyostimulation training (10Hz) on the cardiovascular, respiratory and muscular systems. To that purpose, aerobic capacity, knee extensor muscles strength and architecture, muscle sympathetic nervous activity, blood pressure and heart rate have been evaluated in one healthy male subject (33 year-old, 1.73 m, 73 kg). Results showed improvement of aerobic capacity (+4.5% and +11.5% for maximal oxygen uptake and ventilatory threshold) and muscle strength (+11% and +16% for voluntary and evoked force). Moreover, for the first time, this study demonstrated low-frequency training effects on muscle architecture (+3%, +12% and -11% for muscle thickness, pennation angle and fascicle length) and cardiovascular parameters (-22%, -18% and -21% for resting muscle sympathetic nervous activity, heart rate and mean blood pressure). Interestingly, these results suggest that this method may have beneficial effects on all systems of the body. The investigation of training effects on muscle architecture and cardiovascular parameters should therefore be pursued since highly deconditioned subjects are likely to fully benefit from these adaptations. Key pointsThese results confirmed that 5 weeks of low-frequency electrical stimulation have beneficial effects on aerobic capacity and muscle strength.This study demonstrated that low-frequency electrical stimulation applied for as short as 5 weeks have a great impact on muscle architecture and cardiovascular parameters and control.This type of training might therefore be interesting for rehabilitation of patients who are unable to perform endurance exercises.

Impact of the Menstrual Cycle on Physical Performance and Subjective Ratings in Elite Academy Women Soccer Players.

Our study aimed to combine psychological and physical factors to explore the impact of the menstrual cycle on performance in elite academy women soccer players through weekly monitoring. Eighteen elite academy women soccer players were monitored. Players reported daily through an online anonymous survey if they were in menstruation. Players answered the Hooper Questionnaire daily, performed an Illinois Agility Test (IAT) twice a week, and rated their perceived exertion (RPE) after every training session. Tests were associated with a complete menstrual cycle reported through the online anonymous survey to determine the two weeks of the follicular phase and the two weeks of the luteal phase. Of the 18 players, 10 completed all requirements and were retained for analyses. IAT did not show significant differences throughout the menstrual cycle (p = 0.633). Fatigue (p = 0.444), Stress (p = 0.868), Sleep (p = 0.398), DOMS (delayed onset muscle soreness; p = 0.725), and Hooper Index (p = 0.403) did not show significant differences either. RPE was also comparable across the cycle (p = 0.846). Our results failed to demonstrate that hormonal variation during the menstrual cycle influenced psychological and physical markers of performance.

Influence of a Modified versus a Typical Microcycle Periodization on the Weekly External Loads and Match Day Readiness in Elite Academy Soccer Players.

A typical weekly periodization strategy in soccer positions the most demanding sessions four and three days before the match-day (MD-4/MD-3). However, a modified periodization strategy could intersperse the two most demanding sessions with a low-load training session. This study aimed to investigate the impact of these periodizations on external loads and MD readiness. Twenty academy players were tested. The modified weekly periodization strategy included a low-load training session between the two most demanding sessions, while the typical periodization implemented them consecutively. Players wore a GPS and rated their perceived exertion (RPE) during the most demanding sessions. Players were also tested using a CMJ, a 20-m sprint, the Illinois agility test (IAT), and the Hooper questionnaire on MD-4 to obtain baseline values (CONTROL) and on the match-day (TEST). CONTROL values were similar during experimental weeks. During the second most demanding session, players covered greater distances for the modified versus the typical periodization in the 20-25 km/h (306.3 ± 117.1 m vs. 223.5 ± 92.2 m, p < 0.05) and >25 km/h speed zones (89.5 ± 44.8 m vs. 67.2 ± 44.5 m, p < 0.05). On the MD, CMJ, 20-m sprint, and IAT performances were similar between both periodizations. However, 10-m time (1.89 ± 0.10 s vs. 1.92 ± 0.09 s, p < 0.05) and the Hooper index score (7.90 ± 2.14 a.u. vs. 9.50 ± 3.44 a.u., p < 0.05) were significantly lower during the modified periodization strategy. A decreased training load session positioned between the most demanding sessions may be of interest in elite academy soccer players as it can lead to increased weekly external loads and readiness on the MD.

Effect of muscle length on maximum evoked torque, discomfort, contraction fatigue, and strength adaptations during electrical stimulation in adult populations: A systematic review.

Neuromuscular electrical stimulation (NMES) can improve physical function in different populations. NMES-related outcomes may be influenced by muscle length (i.e., joint angle), a modulator of the force generation capacity of muscle fibers. Nevertheless, to date, there is no comprehensive synthesis of the available scientific evidence regarding the optimal joint angle for maximizing the effectiveness of NMES. We performed a systematic review to investigate the effect of muscle length on NMES-induced torque, discomfort, contraction fatigue, and strength training adaptations in healthy and clinical adult populations (PROSPERO: CRD42022332965). We conducted searches across seven electronic databases: PUBMED, Web of Science, EMBASE, PEDro, BIREME, SCIELO, and Cochrane, over the period from June 2022 to October 2023, without restricting the publication year. We included cross-sectional and longitudinal studies that used NMES as an intervention or assessment tool for comparing muscle lengths in adult populations. We excluded studies on vocalization, respiratory, or pelvic floor muscles. Data extraction was performed via a standardized form to gather information on participants, interventions, and outcomes. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for cross-over trials and the Physiotherapy Evidence Database scale. Out of the 1185 articles retrieved through our search strategy, we included 36 studies in our analysis, that included 448 healthy young participants (age: 19-40 years) in order to investigate maximum evoked torque (n = 268), contraction fatigability (n = 87), discomfort (n = 82), and muscle strengthening (n = 22), as well as six participants with spinal cord injuries, and 15 healthy older participants. Meta-analyses were possible for comparing maximal evoked torque according to quadriceps muscle length through knee joint angle. At optimal muscle length 50° - 70° of knee flexion, where 0° is full extension), there was greater evoked torque during nerve stimulation compared to very short (0 - 30°) (p<0.001, CI 95%: -2.03, -1.15 for muscle belly stimulation, and -3.54, -1.16 for femoral nerve stimulation), short (31° - 49°) (p = 0.007, CI 95%: -1.58, -0.25), and long (71° - 90°) (p<0.001, CI 95%: 0.29, 1.02) muscle lengths. At long muscle lengths, NMES evoked greater torque than very short (p<0.001, CI 95%: -2.50, -0.67) and short (p = 0.04, CI 95%: -2.22, -0.06) lengths. The shortest quadriceps length generated the highest perceived discomfort for a given current amplitude. The amount of contraction fatigability was greater when muscle length allowed greater torque generation in the pre-fatigue condition. Strength gains were greater for a protocol at the optimal muscle length than for short muscle length. The quality of evidence was very high for most comparisons for evoked torque. However, further studies are necessary to achieve certainty for the other outcomes. Optimal muscle length should be considered the primary choice during NMES interventions, as it promotes higher levels of force production and may facilitate the preservation/gain in muscle force and mass, with reduced discomfort. However, a longer than optimal muscle length may also be used, due to possible muscle lengthening at high evoked tension. Thorough understanding of these physiological principles is imperative for the appropriate prescription of NMES for healthy and clinical populations.

Correction: Babault et al. Usefulness of Surface Electromyography Complexity Analyses to Assess the Effects of Warm-Up and Stretching during Maximal and Sub-Maximal Hamstring Contractions: A Cross-Over, Randomized, Single-Blind Trial. Biology 2022, 11, 1337.

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