Science & Sports (2015) 30, e65e72

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ORIGINAL ARTICLE

Evaluation of two muscle training programs

by assessment of the muscle tone
valuation de deux programmes dentranement musculaire
par dtermination du tonus musculaire
L. Rusu a,, G. Cosma b, M.L. Calina a, M.M. Dragomir a, M. Marin c
a

Sports Medicine and Kinesiology Department, University of Craiova, Street Brestei Nr.156, Craiova,
Romania
b
Motricity and Theory Department, University of Craiova, Street Brestei Nr. 156, Craiova, Romania
c
Applied Mechanic Department, University of Craiova, Street A.I.Cuza, Nr.13, Craiova, Romania
Received 30 December 2013; accepted 22 May 2015
Available online 16 July 2015

KEYWORDS
Elasticity;
Decrement;
Stiffness;
Assessment

Summary
Background. Muscle parameters like muscle tone and elasticity are important for development
of the training program in relationship with speed reaction and to maintain the body position.
Objectives. We propose to make a comparative study between two types of muscle training
using myotonometry to estimate the muscle tone.
Equipment and methods. We make a comparison between two types of muscle training for
two athletes (age 18 years) that participate at two different muscle training programs. The
assessment of muscle parameters included: muscle tone (frequency F), elasticity (decrement),
stiffness and index force, by myotonometry for rectus femoris (RF) and tibialis anterior (TA).
The training program: develop the execution speed by increasing explosive strength-training
program T1 of the lower limbs versus the training program which aims to develop the maxim
force by isometric exercises T2.
Results. We observe that for RF, F has a symmetry right/left for T1 and very close to norms,
but at the same time for T2 we observe a high difference between right/left side, and high
value for RF left side, that means an overuse of muscle group and an important decrease of the
RF right side, that means muscle fatigue.
Conclusions. The results of muscle tone assessment by myotonometry can be an indicator
for fatigue. The training program based on plyometry, stretching and development of speed,
improve the muscle parameters and reduce the risk of muscle fatigue and muscle injury. At the

Corresponding author. Parcul Campul Libertatii 1848 Nr.22 Vila E 37, Craiova, Romania.
E-mail address: ligiarusu@hotmail.com (L. Rusu).

http://dx.doi.org/10.1016/j.scispo.2015.05.005
0765-1597/ 2015 Elsevier Masson SAS. All rights reserved.

e66

L. Rusu et al.
same time the T2 training program, based on isometric contraction and static strength training,
increase the asymmetry between right and left side and also decrease the elasticity.
2015 Elsevier Masson SAS. All rights reserved.

MOTS CLS
lasticit ;
Dcroissance ;
La rigidit ;
Lvaluation

Rsum
Contexte. Paramtres musculaires comme le tonus musculaire et llasticit sont importants
pour le dveloppement du programme de formation en relation avec la raction de vitesse et
pour maintenir la position du corps.
Objectifs. Nous proposons de faire une tude comparative entre les deux types de prparation/entranement de muscle en utilisant myotonomtrie pour estimation des mthodes de
tonus musculaire. Nous faisons une comparaison entre les deux types de formation de muscle
de deux athltes (ge : 18 annes) qui participent deux diffrents programme de formation
de muscles. Lvaluation des paramtres musculaires inclut : tonus musculaire (frquence de
F), llasticit (dcrmentation), la rigidit et la force de lindex, par myotonomtrie pour
rectus femoris (RF) et tibial antrieur (TA). Le programme de formation : dvelopper la vitesse
dexcution en augmentant de fac
on explosive le programme de musculation T1 des membres
infrieurs par rapport au programme de formation qui vise dvelopper la force de maxime
par des exercices isomtriques T2.
Rsultats. Nous observons que pour RF, F a une symtrie droite/gauche pour T1 et trs proche
des normes, mais en mme temps pour T2, nous observons une grande diffrence entre le
ct droite/gauche, et de grande valeur pour RF ct gauche, qui signie une sur-utilisation du
groupe musculaire et une diminution importante de RF droite qui signie la fatigue musculaire.
Conclusions. Les rsultats de lvaluation de tonus musculaire par myotonomtrie peuvent
tre un indicateur de la fatigue. Le programme de formation, sur la base de pliomtrie,
dtirement et de dveloppement de la vitesse, amliore les paramtres musculaires et rduit
le risque de fatigue musculaire et blessures musculaires. En mme temps, le programme de formation sur la base de contraction isomtrique T2 et de la formation de force statique augmente
lasymtrie entre droite et gauche et aussi diminue llasticit.
2015 Elsevier Masson SAS. Tous droits rservs.

1. Abbreviations
RF
TA
T1
T2

rectus femoris
tibialis anterior
training program 1
training program 2

2. Introduction
Most of physical activity, especially sports activities, require
muscle balance and muscle strength to increase stability. These aspects need a perfect physical preparation
because some of the actions are explosive actions and
the struggle occurs when the athlete tries to overcome
his partner through rapid execution, based on isolated
or chained technical manoeuvres [1]. In order to obtain
greater stability and development, the explosive muscle
force in explosive actions, the required means to have a
combination of strength, speed and synchronized movement
of the lower limb joints. For the throwing technique to
be effective, it must be executed both very quickly [2],
and with great muscular strength [1]. During some sport
competition the actions must perform quick and sudden
changes. From this point of view some authors consider
that is important to have the following phases: well-timed

pre-activation of the muscle, before the onset of the eccentric phase, a short and fast eccentric phase, an immediate
transition between the eccentric and concentric phases of
action.
These aspects must be understood for muscle preparation to be effectively delivered during the training process
and in order to increase the mechanical muscle properties
focused on elasticity, important in the development of the
elastic-explosive phase that can involve the performance
of a reactive task the countermovement jump. In other
words, it is important to develop these properties in order
to increase the high force impulse action [3], or the capacity
to move quickly from the eccentric to the concentric phase
of muscular action.
Muscle tone is the result of nervous system action and
is also based on the muscle structure, but not only muscle
bres, because conjunctive tissue affects the muscle tone
and elasticity. Muscle tone has an indirect [3] effect on muscle vascularisation (vessels) but the effect is also reciprocal,
from the vessels onto muscle. One of the methods of muscle tone assessment is myotonometry and this allows having
numeric values for stiffness, decrement, frequency and elasticity. Muscle tone reects the possibility to restore the
physiological properties of muscle between effort stages.
Stiffness is a muscle property that constitutes the response
to an external force and is associated with antagonists muscle resistance. Skeletal muscles are a viscoelastic material,
that support mechanic [4] tasks and store the elastic energy

Evaluation of two muscle training programs by assessment of the muscle tone

which is transformed in kinetic energy. These elements are
involved in the overtraining process.
Viscoelasticity is a muscle propriety that is related to
muscle mass deformation and can be assessed by myotonometry across the muscle bre.
The aim of this study is to compare two types of training
programs by myotonometry assessment method and so to
conclude about the role of this assessment at two personsathletes, for monitoring the muscle prepare. We present the
results of myotonometry assessment and create a muscle
prole of anterior lower limb muscle groups: rectus femoris
(RF) and tibialis anterior (TA). The research is developed
in Research Center for Study Human Body Motricity-Sports
Medicine and Kinesiology Department, University of Craiova,
Romania. All procedures used for this study were completed in accordance with the Declaration of Helsinki of
1975 revised 1983 and were approved by the Committee
for Human Experimentation within the Sports Medicine and
Kinesiology Department and Ethics Committee of University of Craiova. We completed and obtained the informed
consent from participants, who are volunteers, according
to the ethical regulations and afterwards we presented the
methodologies of evaluation.

3. Methods
3.1. Study design
For muscle tone assessment Myoton 3 was used, produced by
a research team from Tartu University, Estonia. This method
allows us to obtain information about muscle tone, by elasticity, stiffness and force index, all of these parameters can
tell us whether there are overtraining indicators or not, and
the risk of injury. This method is a non-invasive method and
the basic principle is based on mechanic impulse [5] on the
muscle group, that involves a muscle response like acceleration, speed and amplitude curves. From these we have
information about elasticity, stiffness [6] starting the measurements in the mechanic oscillations of muscle tissue. As
measurements we have used Triple-Scan.
Participant: athletes from local sport club, multiple
national champions and medallists in the Balkan junior
championships.
Age: 18 years, weight: 56 kg, height: 170 cm, BMI (N/m2 ):
19,38, category 55 kg.
Research activity was made in accordance with the
Helsinki Declaration and rules of the university ethics committee. Institutional review board approved the research
and we have informed consent from both athletes.

3.2. Recording data

The equipment has a support and sensor to collect the information after mechanical stimulation. It has a dedicated
software and requires information about age, weight and
height of the athletes. Also before the measurements we
choose the assessment protocol, as in the muscle group that
is to be assessed. Afterwards the measurements data analysis will be performed (Fig. 1).

e67

Figure 1

Myoton equipment.

We make bilateral measurements 3 times and the time

for impulse is 15 ms, by using the specic pattern for lower
limb, for RF and TA.
Recording:
introduction of the personal information of the persons
name, birth date, height, weight;
choice of the pattern for lower limb;
transfer the protocol from PC into Myoton 3;
measurements;
download the data from Myoton 3 and create the report.
The measurement is made by putting the sensor in light
contact with the skin, until it generates an impulse that activates the sensor. The operation is performed three times.
The methodology of assessment respects some rules like:
the sensor is applied on the high region of muscle group
at 90 degrees;
during the measurement no horizontal movement of the
sensor is allowed;
if we need a complex evaluation near the maximal region
of muscle, only a 30-degree variation from the standard
position is allowed.
The athlete has to be in the relaxed position, in the
horizontal position and we make the measurements during muscle relaxation and during isometric contraction. The
muscle groups studied are rectus femoris (RF) (Fig. 2), tibialis anterior (TA) (Fig. 3) under the maximal point of muscle
mass. We begin on the left side and then follow up with the
right side.
The athlete is in prone position, with knee extension;
the point of sensor application is the third distal side of the
muscle group rectus femoris (RF).
The athlete is in prone position; knee extension, the
point of sensor application is the proximal third side of
tibia, 10 mm, in the maxim prominence of the muscle
group.

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L. Rusu et al.
potential pathologies; a great difference may indicate a
heightened risk of pathological states.

3.4. Evaluation criteria [7]

Evaluation criteria are:

Figure 2
sensor).

Assessment of rectus femoris muscle (position of

3.3. Parameters
Muscle tone (frequency: Hz) means the muscle tension in
relaxed and contraction mode and gives information about
muscle restoration after effort and also about muscle weakness.
Stiffness (stiffness: N/m) represents the ability of muscle
to resist deformation. It is important in the evaluation of
right/left symmetry.
Elasticity (decrement) expresses the restoration of
muscle shape after muscle contraction. It describes the conditions of the muscles blood supply during the effort and the
ability to increase the speed of the movement. Decreased
elasticity brings on quicker muscle fatigue and the speed of
a movement is limited if the muscle is less elastic.
Symmetry index between right and left side depends
on the context of the work/training. Comparison of the
parameters characterizing muscle condition for different body sides is particularly informative in considering

a difference up to 5% between body sides is normal;

510% difference needs special attention to the muscle
condition;
a difference of over 10%: the testing should be repeated
to see if the result is persistent. If the difference persists,
this can indicate abnormal muscle condition, possible reasons for this should be claried by anamnesis and possibly
by other tests;
a difference up to 5% is exhibited in black colour;
510% difference is exhibited in yellow colour;
over 10% difference is exhibited in red colour;
force index, decrement index, stiffness index.
The individual norm report shows ve evaluation scales
for muscle condition parameters:

low;
less than average;
average (describes the best scores);
above average;
high.

Lower than average scores can in certain cases indicate

decreased muscle strength. On the other side, low scores in
a physically active person indicate very good muscle condition and prove that the risk of overtraining is absent [7].
Coloured indicators are compared to norms the average
value of the population.
Blue: the result of the subject will fall into the 1st or the
2nd segment, the point indicating the placement is coloured
in blue.

270,0 376,4 453,5

There is no risk of development of physical overload.
Green: the result of the subject will fall into the 3rd segment, the point indicating the placement is coloured green.

17,30 15,3 18,2

The value is close to the mean value and the subject has
no risk of developing a physical overload.
Red: the result of the subject will fall into the 4th or
5th segment, the point indicating the placement is coloured
red.

Figure 3
sensor).

Assessment of tibialis anterior muscle (position of

19,50 16,4 1,3

Besides the statistical interpretation, it can be inferred
that measurement results that fall into segments coloured
red can be considered an indication of physical overload.

Evaluation of two muscle training programs by assessment of the muscle tone

3.5. Muscle training program

The rst muscle training programs (T1) aim is to increase
execution speed by increasing explosive strength of the
lower limbs. Besides specic physical preparation, during
his training programme, the athlete performs non-specic
exercises based on plyometric and stretching. The exercises
are applied 4 times a week in the general physical training
period with a programme lasting 40 minutes.
Ballistic exercises are used with a smaller load (< 60% of
1RM) in strength training, but with a greater speed of execution, using the medicine balls in the plyometric and agility
exercises.
3.5.1. Examples of exercises used for T1
Examples of exercises used for T1 are:
long jump on two feet 3 sets 10 reps;
on a line with a length of 1 meter jumping back and forth
on one foot for 20 seconds, then switch leg;
the same exercise by jumping left and right;
jumping over a gym bench on one foot, then switch leg 2
sets 10 reps;
sitting with knees bent, with a medicine ball between
ankles; extend legs at 45 3 sets 20 reps;
one legged jump over the gymnastics bench, alternating
legs 2 sets 15 reps.
The second training programme (T2) aims to develop
maximum strength and it uses isometric exercises (static
strength training). These exercises are applied 2 times a
week in the general physical training period with a duration
of 30 min for each program.
3.5.2. Examples of exercises used for T2
Examples of exercises used for T2 are:
standing on tiptoe, maintain position until fatigue. The
two methods are: on one leg without weight and after, on
two legs with a weight of 4 kg for each leg (4 reps);
squat position; hold for 40 s. Then increase the difculty
by means of weights (a bar held on the upper thigh). The
position must be maintained above 30 s (4 reps);
maintain a one leg exion for 30 s. Then change legs
(4 reps).

4. Results
We compare the results of myotonometry between two types
of muscle training.
As we see in Tables 1 and 2, the recording results show:
for RF: the norm values for RF and TA in relaxed muscle
for muscle tone (frequency: F), elasticity (decrement: D),
stiffness: S and index symmetry [SI].
The norms are: F = 13. 54; D = 1.79, S = 191 for RF.
F = 18.72; D = 0.7; S = 346 for TA.
We observed that for RF muscle tone (F) there is
right/left symmetry for T1 and very close to norms values,
but in the same time for T2, we observe a high difference between the right and left side, and high value for
RF left side, which implies an overuse of the muscle group

e69

and an important decrease of muscle tone at RF right side,

which indicates muscle fatigue. Also during isometric muscle contraction in T1, the F increase for RF and decrease for
T2 and this aspect correlates with the relaxed state.
Elasticity (D) is normal for T1 and decreased for T2, an
aspect that can be correlated with relaxed muscle tone and
again we observe the presence of muscle fatigue.
During muscle contraction, we observe that D decreases
at T1 and increases for T2 at RF left side.
Stiffness records close to normal values for T1 and bilateral decrease for T2 and an important right/left asymmetry
for T2.
Lower values for S at T2 are consistent with decreased
elasticity which emphasizes the presence of muscle fatigue
and decreased reaction speed.
For TA: we observe high values of F for both athletes
and this aspect shows an overloading of the muscle group,
probably produced in a reex way to increase body stability
and ankle stability. Also we observe a right/left asymmetry
for T2. D has lower values then normal, more visible for
T1 because of the training program based on stretching and
exercises to increase elasticity and muscle resistance.
Stiffness is high for both athletes and it can be correlated
with increase of F. This aspect shows again the development
of mechanisms to increase foot stability, balance and place
the body mass centre close to the support. During the isometric muscle contraction, we observe an increase of F for
both athletes, maintenance of the elasticity but an increase
of S, more visible for T1.
With regards to the symmetry index, we observe an asymmetry at T2 for both muscle groups, see Table 2 in red; the
value is above 5%, so we can infer muscle fatigue.
Also at TA there is an overtraining and right/left asymmetry for S (6,37 N/m) for T1. At T2, we note an overuse
and overtraining bilaterally for TA and decrease of elasticity
for both muscle groups, because D is 10.20 for RF and 10.09
for TA.

5. Discussions
Physical training has as its main target the maintenance
of performance during competitive periods. The plasticity
of the muscular skeletal tissue allows its adaptation to
several states upon functional demands [8] that along with
the training corresponds to the increase in the tolerance to
exercise, provoking adaptation processes in the mechanical,
metabolic and electrophysiological features [9], according
to the specicities of each modality. Muscle fatigue is a
parameter that has to be monitored during training because
it can limit the performance. The results of muscle tone
assessment by myotonometry can be an indicator for fatigue
when correlated with some enzymes and this gives us information about the muscle metabolic processes and recovery
[10]. As we can see in T1, the training programme is based
on plyometry, stretching and development of speed. This
type of training allows time for muscle recovery, and it
increases the blood supply [11]. At the same time at T2, the
training program based on isometric contraction and static
strength training increases the asymmetry between right
and left side and also decreases elasticity. Our observations
match the literature that speaks about the measurement of

e70

Table 1

Measurements of Myoton 3 for T1.

Measurement prole
Tissue

Object

Muscle

Relaxed
Pos

Side

Loc

Contracted

Freq Hz

Decr

Stiff
N/m

Freq Hz

Decr

Stiff
N/m

Force index

Decr index

Stiff index

Rect
Femoris
Muscle
Rect femoris
Symmetry index (%)
Muscle
Tibialis ant

Lying right central

14.2

1.32

283

18.0

1.04

491

0.27

1.10

0.73

Lying left central

1.34
0.75
0.44

278
0.89
602

18.0
0.00
38.6

0.95
4.52
0.40

467
2.51
910

0.28

1.20

0.68

Lying right central

14.1
0.35
23.0

0.68

1.49

0.51

Muscle

Lying left central

24.1

0.46

605

35.6

0.41

801

0.48

1.49

0.32

2.34

2.22

0.25

4.04

1.23

6.37

Tibialis ant

Symmetry index (%)

Average right side: 0.47, 1.29, 0.62; average left side: 0.38, 1.34, 0.50; overall average: 0.42, 1.32, 0.56.

L. Rusu et al.

Measurements of Myoton 3 for T2.

Measurement prole
Tissue

Object

Relaxed
Pos

Side

Contracted

Force index

Loc

Freq Hz

Decr

Stiff N/m

Freq Hz

Decr

Stiff N/m

Muscle
Rect femoris
Muscle
Rect femoris
Symmetry index (%)
Muscle
Tibialis ant

Lying right central

Lying left central
Lying right central

12.5
20.0
23.08
24.1

1.21
0.58
35.20
0.50

261
224
7.63
638

12.6
13.1
1.95
33.0

0.88
1.08
10.20
0.49

4317
317
0.00
781

Muscle

Lying left central

21.1

0.64

569

27.8

0.60

750

6.64

12.28

5.72

8.55

10.09

2.02

Tibialis ant

Symmetry index (%)

Decr index

Stiff index

0.01
0.35

1.22
0.66

0.21
0.42

0.37

1.35

0.22

0.32

1.28

0.32

Evaluation of two muscle training programs by assessment of the muscle tone

Table 2

Average right side: 0.19, 1.29, 0.22; average left side: 0.01, 0.97, 0.37; overall average: 0.09, 1.13, 0.29.

e71

e72
the variables that indicates fatigue in sports. These parameters have been strongly investigated, and amongst them,
of particular importance is the plasmatic serum levels of the
muscular enzymes used as an indicator for the injury state
and/or damage in the muscular tissue after training periods
[3,12], or indicators of the exercise intensity [5,12]. We also
nd that a strength optimization aims to activate the agonist muscles with or without low antagonist co-activations.
The combination of these aspects allows us to discuss the
co-contraction of both muscle group by reex mechanisms
that are important for the maintenance of the body position
and of body stability during competition. Any damage in
the muscle structure or physiology involves a disturbance
of motor action and damages functional performance.
In some sport competition, the number of ghts that
athletes undertake and their respective endurances and
intervals are randomized factors that may inuence performance in every ght. This aspect is relevant for us because
at T1 we observe an increase of speed reaction, based on the
intervention of neural factors and this supports the hypothesis that there are adaptations in the electrical muscular
activity during the development of physical strength. For T1,
the development of strength for explosive attacks with integration of responses, needs intramuscular/intermuscular
coordination, and correct timing is necessary for the effective application of techniques [12]. From our point of view,
we believe that the development of muscle explosive force
and increased reaction speed are based on the involvement
of many motor units that is made possible by increased
stimulation and involves the post-activation potentiation.
Furthermore, the plyometric exercises initiate fast muscular strength potentiation [11]. These aspects can be assessed
by myotonometry, because there is not a wealth of information on sports, such, where the power development is very
important.

6. Conclusions
We conclude that a complex monitoring of muscle performance regarding muscle tone is important for an informed
view on muscle recovery, muscle damage and risk of injury.
Myotonometry is a non-invasive method that helps us
assess muscle power and speed reaction.
The development of muscle explosive force by stretching and plyometric exercises increase the elasticity, stiffness
and blood supply that involve an increase in muscle recovery
after training.
Training based on isometric contractions decreases the
elasticity and increases the asymmetry probably because of
a decrease in muscle recovery ability.
We conclude that the most appropriate evaluation criteria are: indicator of fatigue, risk of overload or indicator of
overload. By monitoring the trends of the muscle condition
parameters by myotonometry, it is possible to predict the

L. Rusu et al.
overload and design an appropriate training programme or
to improve the worsening physical condition of the athlete.
The limitation of the study is related to difference
regarding weight and participation in training program. Also
another problem was the presence of joint injuries during
the research and another limitation is given by the methodological factors like sensor position relative to the muscle,
but we consider that we minimize this aspect.
Future of this type of assessment consists in build the
training and rehabilitation program. The coach has the possibility to know more about the functional muscle symmetry
and to determine what differences exist between playing
positions.

Disclosure of interest
The authors declare that they have no conicts of interest
concerning this article.
Contribution of authors: All authors read and approved
the nal manuscript.

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