Conventionally assessed voluntary activation does not represent relative voluntary torque production

The ability to voluntarily activate a muscle is commonly assessed by some variant of the twitch interpolation technique (ITT), which assumes that the stimulated force increment decreases linearly as voluntary force increases. In the present study, subjects (n = 7) with exceptional ability for maximal voluntary activation (VA) of the knee extensors were used to study the relationship between superimposed and voluntary torque. This includes very high contraction intensities (90-100%VA), which are difficult to consistently obtain in regular healthy subjects (VA of 90%). Subjects were tested at 30, 60, and 90 degrees knee angles on two experimental days. At each angle, isometric knee extensions were performed with supramaximal superimposed nerve stimulation (triplet: three pulses at 300 Hz). Surface EMG signals were obtained from rectus femoris, vastus lateralis, and medialis muscles. Maximal VA was similar and very high across knee angles: 97 +/- 2.3% (mean SD). At high contraction intensities, the increase in voluntary torque was far greater than would be expected based on the decrement of superimposed torque. When voluntary torque increased from 79.6 +/- 6.1 to 100%MVC, superimposed torque decreased from 8.5 +/- 2.6 to 2.8 +/- 2.3% of resting triplet. Therefore, an increase in VA of 5.7% (from 91.5 +/- 2.6 to 97 +/- 2.3%) coincided with a much larger increase in voluntary torque (20.4 +/- 6.1%MVC) and EMG (33.9 +/- 6.6%max). Moreover, a conventionally assessed VA of 91.5 +/- 2.6% represented a voluntary torque of only 79.6 +/- 6.1%MVC. In conclusion, when maximal VA is calculated to be similar to 90% (as in regular healthy subjects), this probably represents a considerable overestimation of the subjects' ability to maximally drive their quadriceps muscles.