Proton magnetic resonance spectroscopy in skeletal muscle: Experts' consensus recommendations

1 H-MR spectroscopy of skeletal muscle provides insight into metabolism that is not available noninvasively by other methods. The recommendations given in this article are intended to guide those who have basic experience in general MRS to the special application of 1 H-MRS in skeletal muscle. The highly organized structure of skeletal muscle leads to effects that change spectral features far beyond simple peak heights, depending on the type and orientation of the muscle. Specific recommendations are given for the acquisition of three particular metabolites (intramyocellular lipids, carnosine and acetylcarnitine) and for preconditioning of experiments and instructions to study volunteers.

Spermidine is not an independent factor regulating limb muscle mass in mice following androgen deprivation

Maintaining a critical amount of skeletal muscle mass is linked to reduced morbidity and mortality. In males, testicular androgens regulate muscle mass with a loss of androgens being critical as it is associated with muscle atrophy. Atrophy of the limb muscles is particularly important, but the pathways by which androgens regulate limb muscle mass remain equivocal. We used microarray analysis to identify changes to genes involved with polyamine metabolism in the tibialis anterior (TA) muscle of castrated mice. Of the polyamines, the concentration of spermidine (SPD) was significantly reduced in the TA of castrated mice. To assess whether SPD was an independent factor by which androgens regulate limb muscle mass, we treated castrated mice with SPD for 8 weeks and compared them with sham operated mice. Though this treatment paradigm effectively restored SPD concentrations in the TA muscles of castrated mice, mass of the limb muscles (i.e., TA, gastrocnemius, plantaris, and soleus) were not increased to the levels observed in sham animals. Consistent with those findings, muscle force production was also not increased by SPD treatment. Overall, these data demonstrate for the first time that SPD is not an independent factor by which androgens regulate limb skeletal muscle mass. Novelty: Polyamines regulate growth in various cells/tissues. Spermidine concentrations are reduced in the limb skeletal muscle following androgen depletion. Restoring spermidine concentrations in the limb skeletal muscle does not increase limb muscle mass or force production.

Effects of a high-volume static stretching programme on plantar-flexor muscle strength and architecture

PURPOSE

Static stretching (SS) is performed in various settings, but there is no consensus about the effects of SS programmes on changes in muscle morphofunction. This study aimed to investigate the effects of a high-volume SS programme on muscle strength and architecture.

METHODS

Sixteen healthy young male adults participated, and the dominant leg was defined as the intervention side, with the non-dominant leg as the control side. Stretching exercises were performed two times per week (6 sets of 5 min, totally 30 min per session,) for 5-week using a stretching board under the supervision of the research team. Before and after SS intervention programme, plantar-flexor strength (maximum voluntary isometric contraction, MVC-ISO; maximum voluntary concentric contraction, MVC-CON) and architecture (muscle thickness, pennation angle, and fascicle length) were measured via dynamometer and ultrasound, respectively.

RESULTS

Following the SS-training programme, significant increases were observed for stretching side in MVIC-ISO at neutral ankle position (p = 0.02, d = 0.31, Δ = 6.4 ± 9.9%) and MVC-CON at 120°/s (p = 0.02, d = 0.30, Δ = 7.8 ± 9.1%), with no significant change on the control side. There was no significant change in any measure of muscle architecture for both intervention and control sides.

CONCLUSION

Five-week high-volume SS induced positive changes on some measures of muscle strength but not hypertrophy of plantar-flexor muscles. Even with a volume much greater than already tested, the low strain offered by the SS per set seems be insufficient to induce architectural changes on skeletal muscle.

The Muscle Morphology of Elite Sprint Running

PURPOSE

This study aimed to investigate the differences in muscle volumes and strength between male elite sprinters, sub-elite sprinters, and untrained controls and to assess the relationships of muscle volumes and strength with sprint performance.

METHODS

Five elite sprinters (100-m season's best equivalent [SBE100], 10.10 ± 0.07 s), 26 sub-elite sprinters (SBE100, 10.80 ± 0.30 s), and 11 untrained control participants underwent 1) 3-T magnetic resonance imaging scans to determine the volume of 23 individual lower limb muscles/compartments and 5 functional muscle groups and 2) isometric strength assessment of lower body muscle groups.

RESULTS

Total lower body muscularity was distinct between the groups (controls < sub-elite +20% < elite +48%). The hip extensors exhibited the largest muscle group differences/relationships (elite, +32% absolute and +15% relative [per kg] volume, vs sub-elite explaining 31%-48% of the variability in SBE100), whereas the plantarflexors showed no differences between sprint groups. Individual muscle differences showed pronounced anatomical specificity (elite vs sub-elite absolute volume range, +57% to -9%). Three hip muscles were consistently larger in elite vs sub-elite (tensor fasciae latae, sartorius, and gluteus maximus; absolute, +45%-57%; relative volume, +25%-37%), and gluteus maximus volume alone explained 34%-44% of the variance in SBE100. The isometric strength of several muscle groups was greater in both sprint groups than controls but similar for the sprint groups and not related to SBE100.

CONCLUSIONS

These findings demonstrate the pronounced inhomogeneity and anatomically specific muscularity required for fast sprinting and provides novel, robust evidence that greater hip extensor and gluteus maximus volumes discriminate between elite and sub-elite sprinters and are strongly associated with sprinting performance.

Muscle Typology of World-Class Cyclists across Various Disciplines and Events

PURPOSE

Classic track-and-field studies demonstrated that elite endurance athletes exhibit a slow muscle typology, whereas elite sprint athletes have a predominant fast muscle typology. In elite cycling, conclusive data on muscle typology are scarce, which may be due to the invasive nature of muscle biopsies. The noninvasive estimation of muscle typology through the measurement of muscle carnosine enabled to explore the muscle typology of 80 world-class cyclists of different disciplines.

METHODS

The muscle carnosine content of 80 cyclists (4 bicycle motor cross racing [BMX], 33 track, 8 cyclo-cross, 24 road, and 11 mountain bike) was measured in the soleus and gastrocnemius by proton magnetic resonance spectroscopy and expressed as a z-score relative to a reference population. Track cyclists were divided into track sprint and endurance cyclists based on their Union Cycliste Internationale (UCI) ranking. Moreover, road cyclists were further characterized based on the percentage of UCI points earned during either single and multistage races.

RESULTS

BMX cyclists (carnosine aggregate z-score of 1.33) are characterized by a faster muscle typology than track, cyclo-cross, road, and mountain bike cyclists (carnosine aggregate z-score of -0.08, -0.76, -0.96, and -1.02, respectively; P < 0.05). Track cyclists also possess a faster muscle typology compared with mountain bikers (P = 0.033) and road cyclists (P = 0.005). Moreover, track sprinters show a significant faster muscle typology (carnosine aggregate z-score of 0.87) compared with track endurance cyclists (carnosine aggregate z-score of -0.44) (P < 0.001). In road cyclists, the higher the carnosine aggregate z-score, the higher the percentage of UCI points gained during single-stage races (r = 0.517, P = 0.010).

CONCLUSIONS

Prominent differences in the noninvasively determined muscle typology exist between elite cyclists of various disciplines, which opens opportunities for application in talent orientation and transfer.

Impact of intertendinous connections between the flexor digitorum brevis and longus on percutaneous tenotomy for the treatment of claw toes: an anatomic and ultrasound study

PURPOSE

Selective percutaneous tenotomy of the flexor digitorum longus (FDL) is a treatment for claw toes that gives astonishingly good functional results despite tendon sacrifice. However, the involution of the FDL tendon stump after tenotomy is unknown. The aim of our study was to assess the involution of the tendon stump after selective percutaneous tenotomy of the FDL.

METHODS

The study included two parts. In the clinical part, an ultrasound analysis of 15 FDL tenotomies in 7 patients was carried out 3 months post-surgery. In the anatomic part, the feet of 10 bodies donated to science were dissected and examined anatomically.

RESULTS

The proximal stump of the FDL was located near the base of the proximal phalanx and moved synchronously with the flexor digitorum brevis (FDB).Separating the FDB and FDL revealed a large tissue connection between the plantar surface of the tendinous chiasm of the FDB and the dorsal part of the FDL. These connections had significant resistance ranging from 2 to 9 Newtons depending on the toe. Tenotomy of the FDL followed by proximal traction of it led to retraction of the stump up to the base of the proximal phalanx and transfer of its action to the FDB by tensioning the intertendinous structure. Histologically, these structures were mostly comprised of tendon connective tissue. Their vascular component was small.

CONCLUSION

The presence of this intertendinous connection leads, in the case of isolated tenotomy of the FDL, to equivalent transfer of the latter to the FDB.

Anisotropic effect on the predictability of intramuscular fat content in pork by hyperspectral imaging and chemometrics

The fibrous structure of meat muscle makes it an anisotropic optical material. As such, spectral information varies with the orientation of the muscle. In this study, spectral data from pork cuts were obtained by a transverse scan (TRANSCAN), radial scan (RADISCAN), and longitudinal scan (LONGSCAN) by using hyperspectral imaging. The information was used to develop and compare the prediction models for intramuscular (IMF) content prediction by partial least square regression (PLSR), support vector machines regression (SVMR), and backpropagation artificial neural network (BPANN). The three modeling algorithms showed equal capability for modeling IMF in pork. The accuracy of the prediction models from the three scans was in the order of TRANSCAN ≥ RADISCAN ≥ LONGSCAN. Successive projection algorithm reduced the wavelengths to 93%. The reduced wavelengths were used to build new models that showed similar accuracy to the models of the original wavelengths. This study shows that muscle orientation influences the accuracy of the prediction models.

Role of PDK1 in skeletal muscle hypertrophy induced by mechanical load

Phosphatidylinositol 3-kinase (PI3K) plays an important role in protein metabolism and cell growth. We here show that mice (M-PDK1KO mice) with skeletal muscle-specific deficiency of 3'-phosphoinositide-dependent kinase 1 (PDK1), a key component of PI3K signaling pathway, manifest a reduced skeletal muscle mass under the static condition as well as impairment of mechanical load-induced muscle hypertrophy. Whereas mechanical load-induced changes in gene expression were not affected, the phosphorylation of ribosomal protein S6 kinase (S6K) and S6 induced by mechanical load was attenuated in skeletal muscle of M-PDK1KO mice, suggesting that PDK1 regulates muscle hypertrophy not through changes in gene expression but through stimulation of kinase cascades such as the S6K-S6 axis, which plays a key role in protein synthesis. Administration of the β₂-adrenergic receptor (AR) agonist clenbuterol activated the S6K-S6 axis in skeletal muscle and induced muscle hypertrophy in mice. These effects of clenbuterol were attenuated in M-PDK1KO mice, and mechanical load-induced activation of the S6K-S6 axis and muscle hypertrophy were inhibited in mice with skeletal muscle-specific deficiency of β₂-AR. Our results suggest that PDK1 regulates skeletal muscle mass under the static condition and that it contributes to mechanical load-induced muscle hypertrophy, at least in part by mediating signaling from β₂-AR.

The ulnar nerve is surrounded by the tendon expansion of the flexor carpi ulnaris muscle at the wrist: an anatomical study of Guyon's canal

The ulnar tunnel (Guyon's canal) is an osseofibrous tunnel for the ulnar nerve and artery. With regard to the proximal palmar wall (palmar carpal ligament) of the ulnar tunnel, detailed anatomical data such as attachment sites, fibrous continuity to surroundings, and variations have not been clearly described. In this study, topology of Guyon's canal was examined, especially to the palmar side of the ulnar nerve, focusing on the continuity of tendinous structures to reveal a more detailed constitution of Guyon's canal. The palmar wall of Guyon's canal was investigated in 113 forearms of 57 cadavers. The dorsal wall of the canal was also investigated in 25 subjects. The ulnar nerve passed lateral to the pisiform and the flexor carpi ulnaris tendon. At the level of the pisiform, except for one, the ulnar nerve passed dorsal to the aponeurosis expanding from the flexor carpi ulnaris tendon and the periosteum of the pisiform, and this aponeurosis laterally merged with the palmar aspect of the flexor retinaculum. Moreover, the ulnar nerve ran palmar to the pisohamate ligament and the flexor retinaculum extended from the same tendon. The present study suggests that the aponeurosis of palmar side to the ulnar nerve connected with the flexor carpi ulnaris tendon, the periosteum of the pisiform, and the palmar surface of the flexor retinaculum. These findings indicate that the ulnar nerve is surrounded by the aponeurotic portion expanding from the flexor carpi ulnaris tendon at the wrist, which is a new insight of Guyon's canal.

Reliability and Validity of Panoramic Ultrasound Imaging for Evaluating Muscular Quality and Morphology: A Systematic Review

Panoramic ultrasound (US) is a novel method used to assess linear dimensions, cross-sectional area, fatty infiltrate and echo-intensity features of muscles that cannot be measured with B-mode US. However, a structured overview of its validity and reliability is lacking. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically searched for studies evaluating reliability or validity data on panoramic US imaging to determine the muscular morphology and/or quality of skeletal muscles. Most studies had acceptable methodological quality. Seventeen studies analyzing reliability (n = 16) or validity (n = 5) were included. Twelve studies assessed cross-sectional area, seven studies assessed echo-intensity, five assessed linear dimensions (fascicle/tendon length, muscle/subcutaneous adipose thickness or between-structure distance) and one assessed intramuscular fat. Panoramic US seems to be a reliable and valid tool for the assessment of muscle morphology and quality in healthy populations at specific locations, particularly the lower extremities. Studies including scanning procedures are needed to confirm these findings in locations not included in this revision and in both clinical and healthy populations.

Homology and osteological correlates of pedal muscles among extant sauropsids

Archosaurs displayed an evolutionary trend toward increasing bipedalism in their evolutionary history, that is, forelimbs tend to be reduced in contrast to the development of hindlimbs becoming major weight-bearing and locomotor appendages. The archosaurian locomotion has been extensively discussed based on their limb morphology because the latter reflects their locomotor modes very well. However, despite some attempts of reconstructing the hindlimb musculature in Archosauria, that of the most distal portion, the pes, has often been neglected. In order to rectify this trend, detailed homologies of pedal muscles among sauropsids were established based on dissections and literature reviews of adult conditions. As a result, homologies of some pedal muscles between non-avian sauropsids and avians were revised, challenging classical hypotheses. The present new hypothesis postulates that the avian m. tibialis cranialis and non-avian m. extensor digitorum longus, as well as the avian m. extensor digitorum longus and non-avian m. tibialis anterior, are homologous with each other, respectively. This is more plausible because it requires no drastical change in the attachment sites between the avian and non-avian homologues unlike the classical hypothesis. Many interosseous muscles in non-archosaurian sauropsids that have long been regarded as a part of short digital extensors or flexors are also divided into multiple distinct muscles so that they can be homologized with short pedal muscles among all sauropsids. In addition, osteological correlates of attachments are identified for most of the pedal muscles, contributing to future attempts of reconstruction of this muscle system in fossil archosaurs.

Exercise interventions for older adults: A systematic review of meta-analyses

BACKGROUND

The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented. We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of meta-analyses of exercise interventions in older adults.

METHODS

We searched the Cochrane Database of Systematic Reviews, PsycInfo, MEDLINE, Embase, CINAHL, AMED, SPORTDiscus, and Web of Science for articles that met the following criteria: (1) meta-analyses that synthesized measures of improvement (e.g., effect sizes) on any outcome identified in studies of exercise interventions; (2) participants in the studies meta-analyzed were adults aged 65+ or had a mean age of 70+; (3) meta-analyses that included studies of any type of exercise, including its duration, frequency, intensity, and mode of delivery; (4) interventions that included multiple components (e.g., exercise and cognitive stimulation), with effect sizes that were computed separately for the exercise component; and (5) meta-analyses that were published in any year or language. The characteristics of the reviews, of the interventions, and of the parameters improved through exercise were reported through narrative synthesis. Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews. The study included 56 meta-analyses that were heterogeneous in relation to population, sample size, settings, outcomes, and intervention characteristics.

RESULTS

The largest effect sizes for improvement were found for resistance training, meditative movement interventions, and exercise-based active videogames.

CONCLUSION

The review identified important gaps in research, including a lack of studies investigating the benefits of group interventions, the characteristics of professionals delivering the interventions associated with better outcomes, and the impact of motivational strategies and of significant others (e.g., carers) on intervention delivery and outcomes.

MRI-based anatomical characterisation of lower-limb muscles in older women

The ability of muscles to produce force depends, among others, on their anatomical features and it is altered by ageing-associated weakening. However, a clear characterisation of these features, highly relevant for older individuals, is still lacking. This study hence aimed at characterising muscle volume, length, and physiological cross-sectional area (PCSA) and their variability, between body sides and between individuals, in a group of post-menopausal women. Lower-limb magnetic resonance images were acquired from eleven participants (69 (7) y. o., 66.9 (7.7) kg, 159 (3) cm). Twenty-three muscles were manually segmented from the images and muscle volume, length and PCSA were calculated from this dataset. Personalised maximal isometric force was then calculated using the latter information. The percentage difference between the muscles of the two lower limbs was up to 89% and 22% for volume and length, respectively, and up to 84% for PCSA, with no recognisable pattern associated with limb dominance. Between-subject coefficients of variation reached 36% and 13% for muscle volume and length, respectively. Generally, muscle parameters were similar to previous literature, but volumes were smaller than those from in-vivo young adults and slightly higher than ex-vivo ones. Maximal isometric force was found to be on average smaller than those obtained from estimates based on linear scaling of ex-vivo-based literature values. In conclusion, this study quantified for the first time anatomical asymmetry of lower-limb muscles in older women, suggesting that symmetry should not be assumed in this population. Furthermore, we showed that a scaling approach, widely used in musculoskeletal modelling, leads to an overestimation of the maximal isometric force for most muscles. This heavily questions the validity of this approach for older populations. As a solution, the unique dataset of muscle segmentation made available with this paper could support the development of alternative population-based scaling approaches, together with that of automatic tools for muscle segmentation.

Effects of marketable ages on meat quality through fiber characteristics in the goose

Goose meat is increasingly popular among consumers because of its good quality. The fiber characteristics have been well demonstrated to be key contributing factors of meat quality, and the marketable ages are also closely related to meat quality. However, little is known about the effect of different marketable ages on the quality of goose meat through its fiber characteristics. Here, fiber characteristics of Yangzhou geese of different marketable ages (70, 90, and 120 d) and their effect on meat quality were investigated. The results showed that only fast-twitch fibers were present in breast muscle, irrespective of age, and that few slow-twitch fibers could be identified in leg muscle, especially in gastrocnemius and extensor digitorum longus. Fiber diameter in breast muscle increased rapidly from age 70 d to 90 d, from 19.88 to 26.27 μm, and remained stable for 90 d thereafter. The diameter and cross-sectional area of muscle fiber continue to grow with day increasing in leg muscle. In addition, we measured the proximate composition and physical properties at different ages. Among the 3 marketable ages investigated, the 120-day-old geese had higher intramuscular fat and protein content, as well as lower moisture content, both in breast and leg meat. Greater lightness and pressing loss, with lower redness and shear force, were observed in the breast and leg meat of 70-day-old geese when compared with 90- or 120-day-old geese. Taken together, although older marketable age hardly affected muscle fiber type in geese, it would contribute to larger muscle fiber area, higher intramuscular fat and protein content, as well as redder and chewier meat. As a result, the reasonable marketable age should be taken into account to improve quality in goose meat production, and the marketable age of 90 or 120 d was recommended and it could potentially improve meat quality in goose meat production.

Estimation of skeletal muscle mass by bioimpedance and differences among skeletal muscle mass indices for assessing sarcopenia

BACKGROUND

It is crucial to assess age-related muscle mass changes and derived indices differences in geriatric medicine. We aimed to develop and validate four bioimpedance analysis (BIA) prediction equations against dual-energy X-ray absorptiometry (DEXA) and magnetic resonance image (MRI) in estimating skeletal muscle mass and to compare the differences among skeletal muscle mass indices, cutoff values, and corresponding prevalence rates of low muscle mass for assessing sarcopenia in Chinese adults.

METHODS

We measured the height (Ht), weight (Wt), appendicular lean mass (ALM) or skeletal muscle mass (ASM), total lean body mass (LBM) or skeletal muscle mass (TSM) obtained using DEXA or MRI, and a multi-frequency BIA (BCA _II;50, 250 kHz), in 371 adults aged 18.0-87.0 years. We also collected gender, age, Ht, Wt, and impedance indexes (Ht²/R₅₀, Ht²/R₂₅₀, R₅₀/Ht², R₂₅₀/Ht²) from 30,500 adults aged 18-96 years living in China. Multiple regression analyses were used to derive four prediction equations by BIA, and double cross-validation techniques and Bland-Altman analyses were used to test agreement. Various muscle mass indices and prevalence rates were depicted by line plots in regard to age trends.

RESULTS

Satisfactory results were found in the four prediction models as they had the larger R² (0.833-0.930) values and low SEE (1.409-2.335 kg) values. The predictive variables included impedance indexes (Ht²/R₅₀, R₅₀/Ht², R₂₅₀/Ht²), gender, age, Wt, and Ht. The corresponding prevalence rates of low muscle mass exhibited significant differences according to the various muscle mass indices adjusted for Ht, Wt, or body mass index (BMI), in addition to the cutoff values based on two standard deviations (2SD) of young people or the lower 20% of the study group.

CONCLUSIONS

The BIA equations have the potential to be applied as a practical method of quantifying skeletal muscle mass in Chinese adults. However, the operational methods that are most appropriate for determining the degree of low muscle mass that actually contributes to sarcopenia remains inconclusive.

Lower Dietary and Circulating Vitamin C in Middle- and Older-Aged Men and Women Are Associated with Lower Estimated Skeletal Muscle Mass

BACKGROUND

Age-related loss of skeletal muscle mass contributes to poor outcomes including sarcopenia, physical disability, frailty, type 2 diabetes, and mortality. Vitamin C has physiological relevance to skeletal muscle and may protect it during aging, but few studies have investigated its importance in older populations.

OBJECTIVES

We aimed to investigate cross-sectional associations of dietary and plasma vitamin C with proxy measures of skeletal muscle mass in a large cohort of middle- and older-aged individuals.

METHODS

We analyzed data from >13,000 men and women in the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, aged 42-82 y. Fat-free mass (FFM), as a proxy for skeletal muscle mass, was estimated using bioelectrical impedance analysis and expressed as a percentage of total mass (FFM%) or standardized by BMI (FFMBMI). Dietary vitamin C intakes were calculated from 7-d food diary data, and plasma vitamin C was measured in peripheral blood. Multivariable regression models, including relevant lifestyle, dietary, and biological covariates, were used to determine associations between FFM measures and quintiles of dietary vitamin C or insufficient compared with sufficient plasma vitamin C (<50 μmol/L and ≥50 μmol/L).

RESULTS

Positive trends were found across quintiles of dietary vitamin C and FFM measures for both sexes, with interquintile differences in FFM% and FFMBMI of 1.0% and 2.3% for men and 1.9% and 2.9% for women, respectively (all P < 0.001). Similarly, FFM% and FFMBMI measures were higher in participants with sufficient than with insufficient plasma vitamin C: by 1.6% and 2.0% in men, and 3.4% and 3.9% in women, respectively (all P < 0.001). Associations were also evident in analyses stratified into <65-y and ≥65-y age groups.

CONCLUSIONS

Our findings of positive associations, of both dietary and circulating vitamin C with measures of skeletal muscle mass in middle- and older-aged men and women, suggest that dietary vitamin C intake may be useful for reducing age-related muscle loss.

Intrinsic Muscle Flaps for Coverage of Small Defects in the Foot

Exposure of critical structures such as joints, bones, ligaments, and tendons necessitates expeditious closure. The longer these structures remain open to the environment, the higher the risk is for that patient developing osteomyelitis and an amputation. Muscle flaps remain often first choice when dealing with bone infections associated with osteomyelitis, soft tissue infections, and large cavities. Foot defects are a challenge especially in the absence of microsurgical expertise. Intrinsic local flaps of the foot can be an option to cover defects. This article describes local intrinsic muscle flaps for coverage of foot defects.

Different amount of training affects body composition and performance in High-Intensity Functional Training participants

The effects of High-Intensity Functional Training (HIFT) on body composition and the relationship of the latter with performance are not well defined. In this work we investigated, by means of Dual-energy X-ray Absorptiometry, the relative proportions of fat-, lean soft tissue-, and mineral mass in CrossFit^® (CF, a popular mode of HIFT) participants (n = 24; age, 28.2 ± 3.39 y; BMI, 25.3 ± 2.04 kg/m²) with at least 1 year of CF training experience and weekly amount of training > 10 h/w (n = 13; Higher Training, HT) or < 10 h/w (n = 11; Lower Training, LT) as well as age- matched and BMI-matched physically active controls (CHT, CLT). Performance was assessed in the “Fran” workout. Data were analyzed by one-way or repeated measures ANOVA where needed. Association between variables was assessed with the Pearson’s correlation coefficient r. Partial correlation was used where needed. Results showed that HT performed better than LT in the “Fran” (P < 0.001) and they had higher whole-body bone mineral density (P = 0.026) and higher lean soft mass (P = 0.002), and borderline lower percent fat mass (P = 0.050). The main difference between CF participants (HT, LT) and their respective controls (CHT, CLT) was a lower adiposity in the former. In CF participants, performance positively correlated with appendicular lean soft tissue mass (P = 0.030). It can be concluded that, in CF participants, a higher amount of weekly training improves most notably lean body mass and increases performance in association with increased skeletal muscle mass. CF participation is especially effective in reducing fat mass vs. age- and BMI-matched physically active controls.

Posterior Ankle Impingement and Flexor Hallucis Longus Pathology

Posterior ankle pain is a common complaint, and the potential causative pathologic processes are diverse. The constellation of these numerous etiologies has been collectively referred to as posterior ankle impingement syndrome. The pain associated with posterior ankle impingement is caused by bony or soft tissue impingement of the posterior ankle while in terminal plantar flexion. This condition is most frequently encountered in athletes who participate in sports that involve forceful, or repetitive, ankle plantar flexion. This article discusses the associated pathology, diagnosis, conservative treatment, and surgical techniques associated with flexor hallucis longus and posterior ankle impingement syndrome.

Prediction Equations of the Multifrequency Standing and Supine Bioimpedance for Appendicular Skeletal Muscle Mass in Korean Older People

Bioimpedance analysis (BIA) has been demanded for the assessment of appendicular skeletal muscle mass (ASM) in clinical and epidemiological settings. This study aimed to validate BIA equations for predicting ASM in the standing and supine positions; externally to cross-validate the new and published and built-in BIA equations for group and individual predictive accuracy; and to assess the overall agreement between the measured and predicted ASM index as sarcopenia diagnosis. In total, 199 healthy older adults completed the measurements of multifrequency BIA (InBody770 and InBodyS10) and dual-energy X-ray absorptiometry (DXA). Multiple regression analysis was used to validate the new multifrequency bioelectrical impedance analysis (MF-BIA) prediction equations. Each MF-BIA equation in the standing and supine position developed in the entire group included height²/resistance, sex, and reactance as predictors (R² = 92.7% and 92.8%, SEE = 1.02 kg and 1.01 kg ASM for the standing and supine MF-BIA). The new MF-BIA equations had a specificity positive predictive value and negative predictive value of 85% or more except for a sensitivity of about 60.0%. The new standing and supine MF-BIA prediction equation are useful for epidemiological and field settings as well as a clinical diagnosis of sarcopenia. Future research is needed to improve the sensitivity of diagnosis of sarcopenia using MF-BIA.

Creatinine/(cystatin C × body weight) ratio is associated with skeletal muscle mass index

We have previously reported that the creatinine (Cre) to cystatin C (CysC) ratio is associated with height-adjusted skeletal muscle mass index (SMI). However, weight-adjusted SMI is reported to be a more useful marker of insulin sensitivity than height-adjusted SMI. Thus, we hypothesized that the creatinine to (cystatin C × body weight [BW]) relationship (Cre/[CysC × BW]) might be associated with weight-adjusted SMI. In this cross-sectional study of 169 males and 132 females, a body composition analyzer was used and the weight-adjusted SMI was calculated as (absolute muscle mass [kg]/BW [kg]) × 100. The cut-off of low muscle mass was defined as weight-adjusted SMI <37.0% for males and <28.0% for females. The Cre/(CysC × BW) was correlated with weight-adjusted SMI in both males (r = 0.484, p < 0.001) and females (r = 0.538, p < 0.001). In addition, Cre/(CysC × BW) was associated with weight-adjusted SMI in both males (standardized β = 0.493, p < 0.001) and females (standardized β = 0.570, p < 0.001) after adjusting for covariates. According to the receiver operator characteristic (ROC) curve analysis, the optimal cut-off point of Cre/(CysC × BW) for low muscle mass was 0.0145 (area under the ROC curve [AUC] 0.756 [95% confidence interval {95% CI} 0.644-0.842], sensitivity = 0.96, specificity = 0.47, p < 0.001) in males and 0.0090 (AUC 0.976 [95% CI 0.894-0.995], sensitivity = 1.00, specificity = 0.93, p < 0.001) in females. There is a correlation between Cre/(CysC × BW) and weight-adjusted SMI. The Cre/(CysC × BW) could be a practical screening marker for low muscle mass.

The effects of static stretching programs on muscle strength and muscle architecture of the medial gastrocnemius

Introduction

Static stretching (SS) program are widely used in clinical and athletic settings. Many previous studies investigate the effect of SS program on muscle strength and muscle architecture (muscle thickness, and pennation angleh). However, no consensus has been reached about the effect of SS programs on muscle strength and muscle architecture. The aim of this study was to investigate the effects of 6-week SS programs performed at different weekly frequencies on muscle strength, muscle thickness and pennation angle at different ankle joint positions.

Methods

A total of 24 healthy male volunteers were performed 6-week SS programs (2,160 s of SS: 360 s/week*6 weeks) and were randomized to a group that performed SS once a week, or a group that performed SS three times per week. Total time under stretching was equated between groups. The muscle strength (maximum voluntary isometric contraction) at three different ankle joints were assessed before and after the 6-week SS program. In addition, muscle thickness and pennation angle were assessed by ultrasonography before and after 6-week SS program.

Results

There were no significant changes in all variables before and after the 6-week SS program, regardless of weekly frequency (p > 0.05).

Conclusions

Our results suggest that 6-week SS programs do not increase muscle strength or muscle architecture at different ankle joint positions, regardless of stretching frequency; however, no negative effect on these outcomes was observed, contrary to evidence on the immediate, detrimental effects of SS.

Nutritional interventions during bed rest and spaceflight: prevention of muscle mass and strength loss, bone resorption, glucose intolerance, and cardiovascular problems

Bed rest is necessary for many medical conditions but also used as a ground-based model for space flight (along with head-down tilt to simulate fluid shifts in microgravity). The purpose of this review is to examine nutritional interventions during bed rest and spaceflight for prevention of muscle and strength loss, glucose intolerance, bone resorption, and cardiovascular problems. Increased dietary protein intake and supplementation with amino acids, β-hydroxy-β-methylbutyrate, or cofactors with antioxidant properties are effective for ameliorating bed rest-induced loss of muscle mass and strength. Previous literature involving bed rest with dietary protein/amino acid supplementation had mixed findings, likely due to differences in dosage. Although high protein intake in some studies prevents bed rest-induced muscle loss, it also increases bone resorption. High calcium intake and vitamin D supplementation are not beneficial for preventing bone degradation during bed rest or spaceflight. Very few studies investigated countermeasures to prevent glucose intolerance and cardiovascular risks during bed rest/spaceflight. Low-glycemic index diets might be beneficial for the prevention of bed rest-induced glucose intolerance and cardiovascular problems. The present evidence warrants additional studies on the exact threshold of protein/amino acid intake to prevent the loss of muscle mass and strength during bed rest/spaceflight specifically to maintain the beneficial effects of proteins on muscle mass and function without increasing bone resorption. Furthermore, it is suggested to study the effects of vitamin K supplementation on bone health during bed rest/spaceflight and determine the role of long-term low-glycemic index diets on glucose regulation and cardiovascular health during extended bed rest.

The Water-Fat Separation Method for Determining the Fat-free Component of Subcutaneous Adipose Tissue in Humans: A Brief Review

Fat-free mass as well as lean soft tissue mass is a surrogate for skeletal muscle mass and is often used for the normalization of several physiological variables or for the diagnosing of low muscle mass in older adults. However, both fat-free mass and lean tissue mass include nonskeletal muscle components such as the fat-free component of adipose tissue fat cells. A technique known as water-fat MRI provides a noninvasive and radiation-free assessment of the fat-free component of adipose tissue in humans. However, if this method is impractical or unavailable, some authors suggest that a constant value for the fat-free component of adipose tissue can be used as an indirect estimate. The purpose of this review is to examine the fat fraction percentage of white (subcutaneous) adipose tissue in adolescents and young/middle-aged/older adults measured by water-fat MRI and provide discussion on how the fat-free adipose tissue values from the water-fat separation method compare with the constant value used in previous studies. Calculated mean values for the percentage of fat fraction in subcutaneous adipose tissue were 86.9% in the overall sample, 86.4% in adolescents (3 studies), and 87.1% in young, middle-aged and older adults (7 studies). This is similar to the 85% value proposed in the classical studies but in the majority of studies the 85% estimate was outside of the 95% confidence interval (CI) of the water-fat MRI estimate. There may be several factors to consider that may affect the fat fraction percentage (e.g. reliability of the MRI estimate, age, sex, obesity, etc.), however, at this time there is insufficient evidence to determine the effect of each of these variables. If the measurement is reliable, then this might suggest that the 85% constant may need to be altered to better reflect the water-fat MRI estimate.

Relative Brain Size Is Predicted by the Intensity of Intrasexual Competition in Frogs

Competition over mates is a powerful force shaping trait evolution. For instance, better cognitive abilities may be beneficial in male-male competition and thus be selected for by intrasexual selection. Alternatively, investment in physical attributes favoring male performance in competition for mates may lower the resources available for brain development, and more intense male mate competition would coincide with smaller brains. To date, only indirect evidence for such relationships exists, and most studies are heavily biased toward primates and other homoeothermic vertebrates. We tested the association between male brain size (relative to body size) and male-male competition across N=30 species of Chinese anurans. Three indicators of the intensity of male mate competition-operational sex ratio (OSR), spawning-site density, and male forelimb muscle mass-were positively associated with relative brain size, whereas the absolute spawning group size was not. The relationship with the OSR and male forelimb muscle mass was stronger for the male than for the female brains. Taken together, our findings suggest that the increased cognitive abilities of larger brains are beneficial in male-male competition. This study adds taxonomic breadth to the mounting evidence for a prominent role of sexual selection in vertebrate brain evolution.