Changes in mechanical leverage of muscles occur as a result of contraction making modelling uncertain


Part of an important series of research publications by the talented Costis Maganaris (now a deservedly full professor in his own right) as part of his PhD which was supervised by Professors Anthony Sargeant and Vasilios Baltzopoulos

Changes in the tibialis anterior tendon moment arm from rest to maximum isometric dorsiflexion: in vivo observations in man

Costis N Maganaris, Vassilios Baltzopoulos, Anthony J Sargeant.

Clinical Biomechanics
Clin Biomech (Bristol, Avon). 1999 Nov;14(9):661-6
OBJECTIVE: In the present study, we examined the hypothesis that the tibialis anterior tendon moment arm increases during maximum isometric dorsiflexion as compared with rest.
BACKGROUND: In musculoskeletal modelling applications, moment arms from passive muscles at rest are assumed representative of those measured during isometric muscle contraction. The validity of this assumption is questionable in musculotendon actuators enclosed by retinacular systems as in tibialis anterior.
DESIGN AND METHODS: Sagittal-plane magnetic resonance images of the right ankle were taken in six subjects at rest and during maximum isometric dorsiflexion at six ankle angles between dorsiflexion and plantarflexion having the body placed in the supine position and the knee flexed at 90 degrees. Instant centres of rotation in the tibio-talar joint, tibialis anterior tendon action lines and moment arms were identified in the sagittal plane at ankle angles of -15 degrees, 0 degrees,+15 degrees and +30 degrees at rest and during maximum isometric dorsiflexion.
RESULTS: At any given ankle angle, the tibialis anterior tendon moment arm during maximum isometric dorsiflexion increased by 0.9-1.5 cm (P<0.01) compared with rest. This was attributed to a displacement of both tibialis anterior tendon action line by 0.8-1.2 cm (P<0.01) and all instant centres of rotation by 0.3-0.4 cm (P<0. 01) distally in relation to their corresponding resting positions.
CONCLUSIONS AND IMPLICATIONS: The assumption that the tibialis anterior tendon moment arm does not change from rest to maximum isometric dorsiflexion is invalid. Erroneous tendon forces, muscle stresses and joint moments by as much as 30% would be calculated using resting tibialis anterior tendon moment arms in the moment equilibrium equation around the ankle joint during maximum isometric dorsiflexion. RELEVANCE: A substantial increase in the tibialis anterior tendon moment arm occurs from rest to maximum isometric dorsiflexion. This needs to be taken into consideration when using planimetric musculoskeletal modelling for analysing maximal static ankle dorsiflexion loads.

Measurement of high-energy phosphates in tiny fragments of human muscle fibres


This research method was  developed in the group headed by Professor Anthony J Sargeant in Amsterdam. Arnold de Haan had developed the basis of the technique in the 1980s as part of his own PhD work. This was subsequently refined to enable very small fragments of human muscle fibre obtained by needle biopsy to be analysed. The present research paper describes that refined techniques and its sensitivity. The work formed part of the PhD thesis the outstanding Greek PhD student, Christina Karatzaferi, who was supervised by Tony Sargeant and Arnold de Haan.

Improved high-performance liquid chromatographic assay for the determination of “high-energy” phosphates in mammalian skeletal muscle. Application to a single-fibre study in man

Christina Karatzaferi, Arnold de Haan, Carla Offringa, Anthony J Sargeant.

Journal of Chromotography

J Chromatogr B Biomed Sci Appl. 1999 Jul 9;730(2):183-91
A sensitive and reproducible method for the determination of adenine nucleotides (ATP, IMP) and creatine compounds [creatine (Cr), phosphocreatine (PCr)] in freeze-dried single human muscle fibre fragments is presented. The method uses isocratic reversed-phase high-performance liquid chromatography of methanol extracts. Average retention times (min) of ATP, IMP and PCr, Cr from standard solutions were 10.6+/-0.42, 2.11+/-0.06 (n=6) and 10.5+/-0.31 and 1.19+/-0.02 (n=9), respectively. Detection limits in extracts from muscle fibre fragments were 2.0, 1.0, 3.0 and 2.0 mmol/kg dm, respectively. The assay was found successful for analysis of fibre-fragments weighing > or = 1 microg.

Post-Polio Syndrome


The data collection and analysis of this research study was largely the work of Frans Nollet and Anita Beelen. Other senior authors provided input at various stages of planning and writing. Professor Anthony J Sargeant was the supervisor for the PhD thesis of which this work formed a part.

Disability and functional assessment in former polio patients with and without postpolio syndrome

Frans Nollet, Anita Beelen, Prins MH, Marianne de Visser, Anthony J Sargeant, Lankhorst GJ, de Jong BA 

Archives of Physical Medicine and Rehabilitation

Arch Phys Med Rehabil. 1999 Feb;80(2):136-143
OBJECTIVES: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength.
DESIGN: Cross-sectional survey; partially blinded data collection.
SUBJECTS: One hundred three former polio subjects, aged 32 to 60yrs. This volunteer sample came from referrals and patient contacts. Criterion for PPS: new muscle weakness among symptoms.
MAIN OUTCOME MEASURES: Nottingham Health Profile (NHP), adapted D-code of the International Classification of Impairments, Disabilities and Handicaps, performance test, and muscle strength assessment.
RESULTS: PPS subjects (n = 76) showed higher scores (p < .001) than non-PPS subjects (n = 27) within the NHP categories of physical mobility, energy, and pain. On a 16-item Polio Problems List, 78% of PPS subjects selected fatigue as their major problem, followed by walking outdoors (46%) and climbing stairs (41%). The disabilities of PPS subjects were mainly seen in physical and social functioning. No differences in manually tested strength were found between patient groups. PPS subjects needed significantly more time for the performance test than non-PPS subjects and their perceived exertion was higher. Perceived health problems (NHP-PhysMobility) correlated significantly with physical disability (r = .66), performance-time (r = .54), and muscle strength (r = .38). With linear regression analysis, 54% of the NHP-PhysMobility score could be explained by the performance test (time and exertion), presence of PPS, and muscle strength, whereas strength itself explained only 14% of the NHP-PhysMobility score.
CONCLUSIONS: PPS subjects are more prone to fatigue and have more physical mobility problems than non-PPS subjects. In former polio patients, measurements of perceived health problems and performance tests are the most appropriate instruments for functional evaluation

Strength of leg muscles in human – effects of coactivation of antagonistic muscles


This research was part of work completed by the brilliant PhD student, Costis Maganaris (now a full Professor in Liverpool), who was supervised by Professor Vasilios Baltzopoulos and Anthony Sargeant.

Differences in human antagonistic ankle dorsiflexor coactivation between legs; can they explain the moment deficit in the weaker plantarflexor leg


Experimental Physiology
Exp Physiol. 1998 Nov;83(6):843-55
The present study examined the hypothesis that the antagonistic ankle dorsiflexor coactivation level during maximum isometric voluntary plantarflexion (MVC) is a function of ankle angle.
Six male subjects generated plantarflexion and dorsiflexion MVC trials at ankle angles of -15 deg (dorsiflexed direction), 0 deg (neutral position), +15 deg (plantarflexed direction) and +30 deg having the knee flexed at an angle of 90 deg. In all contractions surface EMG measurements were taken from tibialis anterior and soleus which were considered representative muscles of all dorsiflexors and plantarflexors, respectively. Antagonistic dorsiflexor coactivation was expressed as normalized EMG and moment. Calculations of the antagonistic dorsiflexor moment were based on the tibialis anterior EMG-dorsiflexor moment relationship from contractions at 50, 40, 30, 20 and 10 % of the dorsiflexion MVC moment.
In both legs dorsiflexor coactivation level followed an open U-shaped pattern as a function of ankle angle. Differences of 9 and 14 % (P < 0.05) were found in the measured net plantarflexion MVC moment between legs at ankle angles of -15 and +30 deg, respectively. No difference (P > 0.05) was found in the calf circumference between legs. Differences were found in the antagonistic dorsiflexor coactivation between legs at ankle angles of -15 and +30 deg. In the weaker leg the antagonistic EMG measurements were higher by 100 and 45 % (P < 0.01) and the estimated antagonistic moments were higher by 70 and 43 % (P < 0.01) compared with the weaker leg at -15 and +30 deg, respectively. This finding was associated with a decreased range of motion (ROM) in the weaker leg (14 %, P < 0.01), such that no difference (P > 0.05) was found in dorsiflexor antagonistic coactivation between legs at end-range ankle angles.
The findings of the study
(i) have to be taken into consideration when estimating musculoskeletal loads in the lower extremity,
(ii) imply that stretching training can result in a stronger plantarflexion at end-range ankle angles through inhibition of the dorsiflexors, and
(iii) imply a neural drive inadequacy during a plantarflexion MVC at end-range angles

In vivo measurements of the triceps surae complex architecture in man: implications for muscle function


Costis Maganaris was a brilliant PhD student (now Professor) supervised by Vasilios Baltzopoulos and Professor Anthony J Sargeant. This important study published in Journal of Physiology investigated how changes in muscle architecture during muscle contraction of human triceps surae muscle complex can distort calculations of mechanical output.

In vivo measurements of the triceps surae complex architecture in man: implications for muscle function

Constantinos N Maganaris, Vasilios Baltzopoulos, Anthony J Sargeant.

Journal of Physiology
J Physiol. 1998 Oct 15;512 ( Pt 2):603-14
1. The objectives of this study were to (1) quantify experimentally in vivo changes in pennation angle, fibre length and muscle thickness in the triceps surae complex in man in response to changes in ankle position and isometric plantarflexion moment and (2) compare changes in the above muscle architectural characteristics occurring in the transition from rest to a given isometric plantarflexion intensity with the estimations of a planimetric muscle model assuming constant thickness and straight muscle fibres.
2. The gastrocnemius medialis (GM), gastrocnemius lateralis (GL) and soleus (SOL) muscles of six males were scanned with ultrasonography at different sites along and across the muscle belly at rest and during maximum voluntary contraction (MVC) trials at ankle angles of -15 deg (dorsiflexed direction), 0 deg (neutral position), +15 deg (plantarflexed direction) and +30 deg. Additional images were taken at 80, 60, 40 and 20% of MVC at an ankle angle of 0 deg.
3. In all three muscles and all scanned sites, as ankle angle increased from -15 to +30 deg, pennation increased (by 6-12 deg, 39-67%, P < 0.01 at rest and 9-16 deg, 29-43%, P < 0.01 during MVC) and fibre length decreased (by 15-28 mm, 32-34%, P < 0.01 at rest and 8-10 mm, 27-30%, P < 0.05 during MVC). Thickness in GL and SOL increased during MVC compared with rest (by 5-7 mm, 36-47%, P < 0.01 in GL and 6-7 mm, 38-47%, P < 0.01 in SOL) while thickness of GM did not differ (P > 0.05) between rest and MVC.
4. At any given ankle angle the model underestimated changes in GL and SOL occurring in the transition from rest to MVC in pennation angle (by 9-12 deg, 24-38%, P < 0.01 in GL and 9-14 deg, 25-28%, P < 0.01 in SOL) and fibre length (by 6-15 mm, 22-39%, P < 0.01 in GL and 6-8 mm, 23-24%, P < 0.01 in SOL).
5. The findings of the study indicate that the mechanical output of muscle as estimated by the model used may be unrealistic due to errors in estimating the changes in muscle architecture during contraction compared with rest

Research into human tendon properties by Costis Maganaris, Vassilios Baltzopolous and Anthony J Sargeant


Changes in Achilles tendon moment arm from rest to maximum isometric plantarflexion: In vivo observations in man

Article (PDF Available)inThe Journal of Physiology 510 ( Pt 3)(3):977-85 · August 1998with85 Reads

DOI: 10.1111/j.1469-7793.1998.977bj.x · Source: PubMed
  • 35.76 · Liverpool John Moores University
  • 38.82 · Liverpool John Moores University
  • 41.33 · VU University Amsterdam
    1. The purpose of the present study was to examine the effect of a plantarflexor maximum voluntary contraction (MVC) on Achilles tendon moment arm length.
    2. Sagittal magnetic resonance (MR) images of the right ankle were taken in six subjects both at rest and during a plantarflexor MVC in the supine position at a knee angle of 90 deg and at ankle angles of -30 deg (dorsiflexed direction), -15 deg, 0 deg (neutral ankle position), +15 deg (plantarflexed direction), +30 deg and +45 deg. A system of mechanical stops, support triangles and velcro straps was used to secure the subject in the above positions. Location of a moving centre of rotation was calculated for ankle rotations from -30 to 0 deg, -15 to +15 deg, 0 to +30 deg and +15 to +45 deg. All instant centres of rotation were calculated both at rest and during MVC. Achilles tendon moment arms were measured at ankle angles of -15, 0, +15 and +30 deg.
    3. At any given ankle angle, Achilles tendon moment arm length during MVC increased by 1-1.5 cm (22-27 %, P < 0.01) compared with rest. This was attributed to a displacement of both Achilles tendon by 0.6-1.1 cm (P < 0.01) and all instant centres of rotation by about 0.3 cm (P < 0.05) away from their corresponding resting positions.
    4. The findings of this study have important implications for estimating loads in the musculoskeletal system. Substantially unrealistic Achilles tendon forces and moments generated around the ankle joint during a plantarflexor MVC would be calculated using resting Achilles tendon moment arm measurements.

    Changes in Achilles tendon moment arm from rest to maximum isometric plantarflexion: In vivo observations in man (PDF Download Available). Available from: [accessed May 1, 2017].

Functional and structural changes after disuse of human muscle – first study to quantify disuse muscle atrophy at fibre level in humans


Clinical Science and Molecular Medicine (1977) 52, 337-342. Functional and structural changes after disuse of human muscle – Authors: ANTHONY J SARGEANT,* C. T. M. DAVIES,* R. H. T. EDWARDS, C. MAUNDER AND A. YOUNG *Medical Research Council Environmental Physiology Unit, London School of Hygiene and Tropical Medicine, University of London, and Jerry Lewis Muscle Research Centre, Royal Postgraduate Medical School, Hammersmith Hospital, London


1. Seven patients who had suffered unilateral leg fracture were studied after removal of immobilizing plaster casts.

2. Leg volume measured anthropometrically was reduced by 12% in the injured leg (5.68 f 1.05 litres) compared with the uninjured (6.43 f 0.87 litres). Associated with this loss was a similar reduction in the net maximum oxygen uptake achieved in one-leg cycling, from 1.89 k 0.21 l/min in the uninjured leg to 1.57+0.18 l/min in the injured.

3. Measured by a percutaneous needle biopsy technique, a reduction of 42% was found in the cross-sectional area of the muscle fibres sampled from the vastus lateralis of the injured compared with the uninjured leg.

4. Staining for myosin adenosine triphosphatase activity showed that both type I and I1 fibres were affected, being reduced respectively from 3410 to 1840 pm2 and from 3810 to 2390 pm2 cross-sectional area.

5. Possible reasons and implications are discussed for the discrepancy between the magnitude of the difference observed in the gross measurement of leg function (maximum oxygen uptake) and structure (leg volume) as compared with the cellular level (cross-sectional fibre area).


Correspondence: Dr A. J. Sargeant, MRC Environmental Physiology Unit, London School of Hygiene and Tropical Medicine, University of London, Keppel Street (Gower Street), London WClE 7HT.


Atrophy of the affected limb and loss of muscle power follows bone fracture and subsequent immobilization. Years of experience have enabled the rehabilitation professions to develop empirical programmes to reverse these changes. However, the efficacy of such programmes may be further improved if we can increase our understanding of the atrophic response to disuse in human muscle. Recent studies showed that 15 weeks immobilization in a long-leg plaster cast after fracture reduced the fat-free volume of the affected leg by 12%, which was accompanied by a similar fall in the maximum oxygen uptake ( ~oz,,,,=.) achieved with oneleg pedalling (Davies & Sargeant, 1975a,b). However, it was not known how far these changes in gross structure and function were reflected at a cellular level within the affected muscles. Since the work of pedalling is performed mainly by the leg extensors (A. J. Sargeant & C. T. M. Davies, unpublished work) needle biopsy was used (Edwards, Maunder, Lewis & Pearse, 1973) to study fibre atrophy in the quadriceps femoris muscle and to compare this with measurements of the gross leg volume and maximal oxygen uptake of patients recovering from unilateral leg fracture.