title: Relationship between transcranial magnetic stimulation and percutaneous electrical stimulation in determining the quadriceps central activation ratio.
abstract: OBJECTIVE
  To determine the relationship between quadriceps central activation ratios (CARs) derived from a percutaneous electrical stimulation (CAR(SIB)) and a transcranial magnetic stimulation (CAR(TMS)) in healthy participants.
  
  
  METHODS
  Nineteen healthy participants (5 men, 14 women, 23.7 ± 4.8 yrs, 66.8 ± 10.0 kg, and 170.1 ± 7.0 cm) qualified for this descriptive study. Muscle activation, using both methods (CAR(SIB) and CAR(TMS)), was measured at days 1, 14, and 28. All participants performed both methods in a counterbalanced order. Correlation coefficients and Bland-Altman plots were used to assess relationships and agreement between the two methods. For both methods, reliability was assessed at 14 and 28 days using Bland-Altman plots and intraclass correlation coefficients.
  
  
  RESULTS
  CAR(TMS) scores were higher than CAR(SIB) scores for all three sessions, with mean differences between CAR scores of -0.06 (95% confidence interval, -0.19-0.07), -0.03 (95% confidence interval, -0.14-0.08), and -0.03 (95% confidence interval, -0.11-0.05). There was a significant moderate positive correlation between CAR(SIB) and CAR(TMS) at 14 days from baseline (ρ = 0.45, P = 0.05). Intersession reliability was strong for CAR(SIB) at 14 and 28 days from baseline (intraclass correlation coefficients = 0.80 [P = 0.001] and 0.85 [P < 0.001], respectively). Intersession reliability for CAR(TMS) was moderate from baseline to 14 days (intraclass correlation coefficients = 0.68 [P = 0.01]).
  
  
  CONCLUSIONS
  It does not seem that the CAR(TMS) and CAR(SIB) methods are interchangeable measurements for evaluating volitional quadriceps activation; however, both measurements seem to have acceptable agreement at 14 and 28 days compared with day 1.
authors.affiliation: Exercise and Sport Injury Laboratory, Department of Human Services, University of Virginia, Charlottesville, USA.
authors.forename: Grant E
authors.initials: GE
authors.lastname: Norte
authors.forename: Brian G
authors.initials: BG
authors.lastname: Pietrosimone
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Hart
authors.forename: Jay
authors.initials: J
authors.lastname: Hertel
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Ingersoll
mesh_terms: D000328:Adult; D004558:Electric Stimulation; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000502:physiology*; D015203:Reproducibility of Results; D050781:Transcranial Magnetic Stimulation