In vivo human muscle structure and function: adaptations to resistance training in old age

Does knee joint cooling change in vivo patellar tendon mechanical properties?

Purpose

This study aimed to assess the influence of knee joint cooling on the in vivo mechanical properties of the patellar tendon.

Methods

Twenty young, healthy women volunteered for the study. B-mode ultrasonography was used to record patellar tendon elongation during isometric ramp contraction of the knee extensors (5–7 s, 90° knee angle) and calculate tendon stiffness. Skin temperature was measured by infrared thermometry. Data were acquired before and after 30 min of local icing of the knee joint and compared by paired samples t-tests.

Results

After cold exposure, skin temperature as measured over the patellar tendon dropped by 16.8 ± 2.0 °C. Tendon stiffness increased from 2189 ± 551 to 2705 ± 902 N mm⁻¹ (+25 %, p = 0.007). Tendon strain decreased by 9 % (p = 0.004). A small, albeit significant reduction in maximum tendon force was observed (−3.3 %, p = 0.03).

Conclusions

Knee cooling is associated with a significant increase in patellar tendon stiffness. The observed tendon stiffening may influence the operating range of sarcomeres, possibly limiting the maximal force generation capacity of knee extensor muscles. In addition, a stiffer tendon might benefit rate of force development, thus countering the loss in explosiveness typically described for cold muscles.

Resistance exercise training increases lower limb speed of strength generation during stair ascent and descent in people with diabetic peripheral neuropathy

AIM

To examine the effects of a 16-week resistance exercise training intervention on the speed of ankle and knee strength generation during stair ascent and descent, in people with neuropathy.

METHODS

A total of 43 people: nine with diabetic peripheral neuropathy, 13 with diabetes but no neuropathy and 21 healthy control subjects ascended and descended a custom-built staircase. The speed at which ankle and knee strength were generated, and muscle activation patterns of the ankle and knee extensor muscles were analysed before and after a 16-week intervention period.

RESULTS

Ankle and knee strength generation during both stair ascent and descent were significantly higher after the intervention than before the intervention in the people with diabetes who undertook the resistance exercise intervention (P < 0.05). Although muscle activations were altered by the intervention, there were no observable patterns that underpinned the observed changes.

CONCLUSIONS

The increased speed of ankle and knee strength generation observed after the intervention would be expected to improve stability during the crucial weight acceptance phase of stair ascent and descent, and ultimately contribute towards reducing the risk of falling. Improvements in muscle strength as a result of the resistance exercise training intervention are likely to be the most influential factor for increasing the speed of strength generation. It is recommended that these exercises could be incorporated into a multi-faceted exercise programme to improve safety in people with diabetes and neuropathy.

Dose-Response Relationships of Resistance Training in Healthy Old Adults: A Systematic Review and Meta-Analysis

BACKGROUND

Resistance training (RT) is an intervention frequently used to improve muscle strength and morphology in old age. However, evidence-based, dose-response relationships regarding specific RT variables (e.g., training period, frequency, intensity, volume) are unclear in healthy old adults.

OBJECTIVES

The aims of this systematic review and meta-analysis were to determine the general effects of RT on measures of muscle strength and morphology and to provide dose-response relationships of RT variables through an analysis of randomized controlled trials (RCTs) that could improve muscle strength and morphology in healthy old adults.

DATA SOURCES

A computerized, systematic literature search was performed in the electronic databases PubMed, Web of Science, and The Cochrane Library from January 1984 up to June 2015 to identify all RCTs related to RT in healthy old adults.

STUDY ELIGIBILITY CRITERIA

The initial search identified 506 studies, with a final yield of 25 studies. Only RCTs that examined the effects of RT in adults with a mean age of 65 and older were included. The 25 studies quantified at least one measure of muscle strength or morphology and sufficiently described training variables (e.g., training period, frequency, volume, intensity).

STUDY APPRAISAL AND SYNTHESIS METHODS

We quantified the overall effects of RT on measures of muscle strength and morphology by computing weighted between-subject standardized mean differences (SMDbs) between intervention and control groups. We analyzed the data for the main outcomes of one-repetition maximum (1RM), maximum voluntary contraction under isometric conditions (MVC), and muscle morphology (i.e., cross-sectional area or volume or thickness of muscles) and assessed the methodological study quality by Physiotherapy Evidence Database (PEDro) scale. Heterogeneity between studies was assessed using I2 and χ2 statistics. A random effects meta-regression was calculated to explain the influence of key training variables on the effectiveness of RT in terms of muscle strength and morphology. For meta-regression, training variables were divided into the following subcategories: volume, intensity, and rest. In addition to meta-regression, dose-response relationships were calculated independently for single training variables (e.g., training frequency).

RESULTS

RT improved muscle strength substantially (mean SMDbs = 1.57; 25 studies), but had small effects on measures of muscle morphology (mean SMDbs = 0.42; nine studies). Specifically, RT produced large effects in both 1RM of upper (mean SMDbs = 1.61; 11 studies) and lower (mean SMDbs = 1.76; 19 studies) extremities and a medium effect in MVC of lower (mean SMDbs = 0.76; four studies) extremities. Results of the meta-regression revealed that the variables "training period" (p = 0.04) and "intensity" (p < 0.01) as well as "total time under tension" (p < 0.01) had significant effects on muscle strength, with the largest effect sizes for the longest training periods (mean SMDbs = 2.34; 50-53 weeks), intensities of 70-79% of the 1RM (mean SMDbs = 1.89), and total time under tension of 6.0 s (mean SMDbs = 3.61). A tendency towards significance was found for rest in between sets (p = 0.06), with 60 s showing the largest effect on muscle strength (mean SMDbs = 4.68; two studies). We also determined the independent effects of the remaining training variables on muscle strength. The following independently computed training variables are most effective in improving measures of muscle strength: a training frequency of two sessions per week (mean SMDbs = 2.13), a training volume of two to three sets per exercise (mean SMDbs = 2.99), seven to nine repetitions per set (mean SMDbs = 1.98), and a rest of 4.0 s between repetitions (SMDbs = 3.72). With regard to measures of muscle morphology, the small number of identified studies allowed us to calculate meta-regression for the subcategory training volume only. No single training volume variable significantly predicted RT effects on measures of muscle morphology. Additional training variables were independently computed to detect the largest effect for the single training variable. A training period of 50-53 weeks, a training frequency of three sessions per week, a training volume of two to three sets per exercise, seven to nine repetitions per set, a training intensity from 51 to 69% of the 1RM, a total time under tension of 6.0 s, a rest of 120 s between sets, and a rest of 2.5 s between repetitions turned out to be most effective.

LIMITATIONS

The current results must be interpreted with caution because of the poor overall methodological study quality (mean PEDro score 4.6 points) and the considerable large heterogeneity (I2) = 80%, χ2 = 163.1, df = 32, p < 0.01) for muscle strength. In terms of muscle morphology, our search identified nine studies only, which is why we consider our findings preliminary. While we were able to determine a dose-response relationship based on specific individual training variables with respect to muscle strength and morphology, it was not possible to ascertain any potential interactions between these variables. We recognize the limitation that the results may not represent one general dose-response relationship.

CONCLUSIONS

This systematic literature review and meta-analysis confirmed the effectiveness of RT on specific measures of upper and lower extremity muscle strength and muscle morphology in healthy old adults. In addition, we were able to extract dose-response relationships for key training variables (i.e., volume, intensity, rest), informing clinicians and practitioners to design effective RTs for muscle strength and morphology. Training period, intensity, time under tension, and rest in between sets play an important role in improving muscle strength and morphology and should be implemented in exercise training programs targeting healthy old adults. Still, further research is needed to reveal optimal dose-response relationships following RT in healthy as well as mobility limited and/or frail old adults.

Angle-torque relationship of the subtalar pronators and supinators in younger and elderly males and females

BACKGROUND

The angle-dependent torque capacity of the subtalar pronators and supinators is important to maintain dynamic ankle stabilisation. Based on the peak torques during maximum voluntary isometric pronation and supination across the subtalar range of motion, the strength curves of younger and elderly males and females were investigated.

METHODS

Maximum voluntary isometric subtalar pronator and supinator strength tests were administered to 30 younger and 30 elderly volunteers (each 15 male and 15 female subjects). Total active subtalar range of motion and peak pronator and supinator torques were measured in five anatomical subtalar joint angles using a custom-built apparatus with two force transducers. Furthermore, relative torques (normalised to the individual peak torque) and pronator-to-supinator strength-ratios were also calculated.

RESULTS

Pronator-to-supinator strength ratio, and peak pronator and supinator torques are affected by age and by joint angle x age interactions. All supinator strength curves show a steadily descending characteristic from the pronated to the supinated positions. The pronator strength curve had an inverted U-shaped characteristic, except for younger women of whom 47 % exert highest peak values in the end-range pronation angle. Both relative pronator and supinator strength are dependent on sex (P < 0.05). Relative pronator strength is also affected by joint angle x sex (P < 0.0001) and joint angle x sex x age (P < 0.05) interactions. Beside age effects on all range of motion parameters, pronation range of motion is influenced by a sex x age interaction (P < 0.05).

CONCLUSIONS

Age- and sex-related differences in both subtalar strength profile and range of motion have to be considered when testing strength across subtalar range of motion. Younger females have higher pronator strength capacity in the most pronated joint angle, which may be due in part to their greater subtalar joint range of motion compared to the other groups. In the most supinated position both pronator and supinator strength capacity is reduced in younger females compared to younger males.

FAST CP: protocol of a randomised controlled trial of the efficacy of a 12-week combined Functional Anaerobic and Strength Training programme on muscle properties and mechanical gait deficiencies in adolescents and young adults with spastic-type cerebral palsy

INTRODUCTION

Individuals with cerebral palsy (CP) have muscles that are smaller, weaker and more resistant to stretch compared to typically developing people. Progressive resistance training leads to increases in muscle size and strength. In CP, the benefits of resistance training alone may not transfer to improve other activities such as walking; however, the transfer of strength improvements to improved mobility may be enhanced by performing training that involves specific functional tasks or motor skills. This study aims to determine the efficacy of combined functional anaerobic and strength training in (1) influencing muscle strength, structure and function and (2) to determine if any changes in muscle strength and structure following training impact on walking ability and gross motor functional capacity and performance in the short (following 3 months of training) and medium terms (a further 3 months post-training).

METHODS AND ANALYSIS

40 adolescents and young adults with CP will be recruited to undertake a 12-week training programme. The training programme will consist of 3 × 75 min sessions per week, made up of 5 lower limb resistance exercises and 2-3 functional anaerobic exercises per session. The calf muscles will be specifically targeted, as they are the most commonly impacted muscles in CP and are a key muscle group involved in walking. If, as we believe, muscle properties change following combined strength and functional training, there may be long-term benefits of this type of training in slowing the deterioration of muscle function in people with spastic-type CP.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the ethics committees at The University of Queensland (2014000066) and Children's Health Queensland (HREC/15/QRCH/30). The findings will be disseminated by publications in peer-reviewed journals, conferences and local research organisations' media.

TRIAL REGISTRATION NUMBER

Australian and New Zealand Clinical Trials Registry (ACTRN12614001217695).

Plantar flexor muscle architecture changes as a result of eccentric exercise in patients with Achilles tendinosis

Eccentric training for Achilles tendinosis (AT) has been reported to significantly improve patient symptoms. There has been no biomechanical explanation on the mechanism for specific rehabilitation technique. The purpose of this study was to determine changes in muscle architecture that occurred as a result of Achilles tendinosis injury and a subsequent eccentric rehabilitation program. Twenty-five patients (age, 53.3 ± 17.5 years) diagnosed with AT participated in 6 weeks of rehabilitation. Specific exercises for the ankle plantar flexors consisted of maximal load eccentric muscle action using 3 sets of 15 repetitions. Patients also completed a protocol for AT, which consisting of traditional rehabilitation. Medial gastrocnemius (GM) and lateral gastrocnemius (GL) muscle fascicle length and thickness were measured with ultrasound at 2-week intervals from initial treatment day to the end of 6 weeks of rehabilitation. Medial gastrocnemius fascicle length increased (45.1 ± 10.5 mm to 51.4 ± 10.5 mm; P = .22) between the initial day of rehabilitation and after 6 weeks of rehabilitation. But, GM thickness (16.3 ± 3.5 mm to 16.8 ± 2.0 mm), GL fascicle length (47.2 ± 10.0 mm to 47.1 ± 7.4 mm), and GL thickness (14.9 ± 5.2 mm to 14.4 ± 2.7 mm) did not change as a result of rehabilitation. A 6-week eccentric-biased exercise increased the GM muscle fascicle length by 12%, but GM thickness, GL fascicle length, and GL thickness did not change as a result of rehabilitation. Eccentric training for the treatment of AT is well recognized, but the mechanism of action has not been previously reported. A 6-week eccentric training protocol increased the GM muscle fascicle length by 12%, and this correlated with improvement in a validated patient outcome scoring system. Further study is warranted to determine a predictive relationship between improvement of GM fascicle length and outcome scores.

LEVELS OF EVIDENCE

Therapeutic, Level IV: Case series.

Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy

OBJECTIVE

Although patients with diabetic peripheral neuropathy (DPN) are more likely to fall than age-matched controls, the underlying causative factors are not yet fully understood. This study examines the effects of diabetes and neuropathy on strength generation and muscle activation patterns during walking up and down stairs, with implications for fall risk.

RESEARCH DESIGN AND METHODS

Sixty-three participants (21 patients with DPN, 21 diabetic controls, and 21 healthy controls) were examined while walking up and down a custom-built staircase. The speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles were analyzed.

RESULTS

Patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P < 0.05). During ascent, the ankle and knee extensor muscles were activated significantly later by patients with neuropathy and took longer to reach peak activation (P < 0.05). During descent, neuropathic patients activated the ankle extensors significantly earlier, and the ankle and knee extensors took significantly longer to reach peak activation (P < 0.05).

CONCLUSIONS

Patients with DPN are slower at generating strength at the ankle and knee than control participants during walking up and down stairs. These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling. Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk.

Effects of single vs. multiple-set short-term strength training in elderly women

The strength training has been shown to be effective for attenuating the age-related physiological decline. However, the adequate volume of strength training volume adequate to promote improvements, mainly during the initial period of training, still remains controversial. Thus, the purpose of this study was to compare the effects of a short-term strength training program with single or multiple sets in elderly women. Maximal dynamic (1-RM) and isometric strength, muscle activation, muscle thickness (MT), and muscle quality (MQ = 1-RM and MT quadriceps quotient) of the knee extensors were assessed. Subjects were randomly assigned into one of two groups: single set (SS; n = 14) that performed one set per exercise or multiple sets (MS; n = 13) that performed three-sets per exercise, twice weekly for 6 weeks. Following training, there were significant increases (p ≤ 0.05) in knee extension 1-RM (16.1 ± 12 % for SS group and 21.7 ± 7.7 % for MS group), in all MT (p ≤ 0.05; vastus lateralis, rectus femoris, vastus medialis, and vastus intermedius), and in MQ (p ≤ 0.05); 15.0 ± 12.2 % for SS group and 12.6 ± 7.2 % for MS group), with no differences between groups. These results suggest that during the initial stages of strength training, single- and multiple-set training demonstrate similar capacity for increasing dynamic strength, MT, and MQ of the knee extensors in elderly women.

Effects of isometric training on the knee extensor moment-angle relationship and vastus lateralis muscle architecture

PURPOSE

To analyse the muscle adaptations induced by two protocols of isometric training performed at different muscle lengths.

METHODS

Twenty-eight subjects were divided into three groups: one (K90) performed isometric training of the knee extensors at long muscle lengths (90° of knee flexion) for 8 weeks, and the second group (K50) at short muscle lengths (50°). The subjects of the third group acted as controls. Isokinetic dynamometry was utilized to analyse the net moment-angle relationship and vastus lateralis muscle thickness at three different locations, and pennation angles and fascicle length at 50 % of thigh length were measured at rest with ultrasonography.

RESULTS

Only subjects from K90 group showed significant increases in isokinetic strength (23.5%, P < 0.001), while K50 group showed no increases in isokinetic strength: (10%, P > 0.05). There was a shift in the angle of peak torque of the K90 group to longer muscle lengths (+14.6%, P = 0.002) with greater increases in isokinetic strength, while the K50 angle shifted to shorter muscle lengths (-7.3%, P = 0.039). Both training groups showed significant increases in muscle thickness, (K90 9-14% vs. K50 5-9%) but only K90 significantly increased their pennation angles (11.7%, P = 0.038). Fascicle lengths remained unchanged.

CONCLUSIONS

Isometric training at specific knee angles led to significant shifts of peak torque in the direction of the training muscle lengths. The greater strength gains and the architectural changes with training at long muscle lengths probably come from a combination of different factors, such as the different mechanical stresses placed upon the muscle-tendon complex.

Effects of load magnitude, muscle length and velocity during eccentric chronic loading on the longitudinal growth of the vastus lateralis muscle

The present study investigated the longitudinal growth of the vastus lateralis muscle using four eccentric exercise protocols with different mechanical stimuli by modifying the load magnitude, lengthening velocity and muscle length at which the load was applied. Thirty-one participants voluntarily participated in this study in two experimental and one control group. The first experimental group (N=10) exercised the knee extensors of one leg at 65% (low load magnitude) of the maximum isometric voluntary contraction (MVC) and the second leg at 100% MVC (high load magnitude) with 90 deg s(-1) angular velocity, from 25 to 100 deg knee angle. The second experimental group (N=10) exercised one leg at 100% MVC, 90 deg s(-1), from 25 to 65 deg knee angle (short muscle length). The other leg was exercised at 100% MVC, 240 deg s(-1) angular velocity (high muscle lengthening velocity) from 25 to 100 deg. In the pre- and post-intervention measurements, we examined the fascicle length of the vastus lateralis at rest and the moment-angle relationship of the knee extensors. After 10 weeks of intervention, we found a significant increase (~14%) of vastus lateralis fascicle length compared with the control group, yet only in the leg that was exercised with high lengthening velocity. The findings provide evidence that not every eccentric loading causes an increase in fascicle length and that the lengthening velocity of the fascicles during the eccentric loading, particularly in the phase where the knee joint moment decreases (i.e. deactivation of the muscle), seems to be an important factor for longitudinal muscle growth.

Electromechanical delay of the knee extensor muscles: comparison among young, middle-age and older individuals

The aim of this study was to investigate the effects of the ageing process in the electromechanical delay (EMD), rate of torque development (RTD) and peak torque (PT) of the knee extensor muscles. The volunteers were assigned to three groups: young group (YG - 23·44 ± 4·74 years, 78·14 ± 15·11 kg, 1·72 ± 0·05 m), middle-aged group (MAG - 49·56 ± 6·06 years, 72·01 ± 14·07 kg, 1·67 ± 0·06 m) and elderly group (EG - 68·67 ± 9·06 years, 67·96 ± 7·60 kg, 1·64 ± 0·07 m). The PT and RTD were assessed during maximal voluntary ballistic isometric contractions (MVBIC) in the isokinetic dynamometer. Muscle electrical activity was recorded (EMG) during MVBIC in the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles. The EMD was calculated during the MVBIC, through the time interval between the EMG onset and torque onset. The PT and RTD were higher in the YG than in the MAG (P = 0·02; P = 0·01, respectively) and in the EG (P = 0·002; P = 0·0004, respectively). There were no significant differences in EMD among the three age groups for the VL, VM and RF (P>0·05) muscles. We conclude that age affects the PT and RTD, but not EMD of the VL, VM and RF muscles.

The contribution of muscle hypertrophy to strength changes following resistance training

PURPOSE

Whilst skeletal muscle hypertrophy is considered an important adaptation to resistance training (RT), it has not previously been found to explain the inter-individual changes in strength after RT. This study investigated the contribution of hypertrophy to individual gains in isometric, isoinertial and explosive strength after 12 weeks of elbow flexor RT.

METHODS

Thirty-three previously untrained, healthy men (18-30 years) completed an initial 3-week period of elbow flexor RT (to facilitate neurological responses) followed by 6-week no training, and then 12-week elbow flexor RT. Unilateral elbow flexor muscle strength [isometric maximum voluntary force (iMVF), single repetition maximum (1-RM) and explosive force], muscle volume (V(m)), muscle fascicle pennation angle (θ(p)) and normalized agonist, antagonist and stabilizer sEMG were assessed pre and post 12-week RT.

RESULTS

Percentage gains in V(m) correlated with percentage changes in iMVF (r = 0.527; P = 0.002) and 1-RM (r = 0.482; P = 0.005) but not in explosive force (r ≤ 0.243; P ≥ 0.175). Percentage changes in iMVF, 1-RM, and explosive force did not correlate with percentage changes in agonist, antagonist or stabilizer sEMG (all P > 0.05). Percentage gains in θ(p) inversely correlated with percentage changes in normalized explosive force at 150 ms after force onset (r = 0.362; P = 0.038).

CONCLUSIONS

We have shown for the first time that muscle hypertrophy explains a significant proportion of the inter-individual variability in isometric and isoinertial strength gains following 12-week elbow flexor RT in healthy young men.

Influence of simulated microgravity on mechanical properties in the human triceps surae muscle in vivo. I: effect of 120 days of bed-rest without physical training on human muscle musculo-tendinous stiffness and contractile properties in young women

Purpose

The aim of this study was to investigate the effect of a 120-day 5° head-down tilt (HDT) bed-rest on the mechanical properties of the human triceps surae muscle in healthy young women subjects.

Methods

Measurements included examination of the properties of maximal voluntary contractions (MVC), twitch contractions (P_t) and tetanic contractions (P_o). The difference between P_o and MVC expressed as a percentage of P_o and referred to as force deficiency (P_d), was calculated. Electromyographic (EMG) activity in the soleus muscle, electromechanical delay (EMD) and total reaction time (TRT) were also calculated. EMD was the time interval between the change in EMG and the onset of muscle tension. Premotor time (PMT) was taken to be the time interval from the delivery of the signal to change in EMG.

Results

After HDT P_t, MVC and P_o had decreased by 11.5, 36.1, 24.4 %, respectively, P_d had increased by 38.8 %. Time-to-peak tension had increased by 13.6 %, but half-relaxation time had decreased by 19.2 %. The rate of rise in isometric voluntary tension development had reduced, but no changes were observed in the electrically evoked contraction. EMD had increased by 27.4 %; PMT and TRT decreased by 21.4, and 13.7 %, respectively.

Conclusion

The experimental findings indicated that neural as well as muscle adaptation occurred in response to HDT. EMD is a simple and quick method for evaluation of muscle stiffness changes and can serve as an indicator of the functional condition of the neuromuscular system.

Age-related greater Achilles tendon compliance is not associated with larger plantar flexor muscle fascicle strains in senior women

The aim of the present study was to test the hypothesis that the age-associated decrease of tendon stiffness would necessitate greater muscle fascicle strains to produce similar levels of force during isometric contraction. Greater fascicle strains could force sarcomeres to operate in less advantageous regions of their force-length and force-velocity relationships, thus impairing the capacity to generate strong and explosive contractions. To test this hypothesis, sagittal-plane dynamic velocity-encoded phase-contrast magnetic resonance images of the gastrocnemius medialis (GM) muscle and Achilles tendon (AT) were acquired in six young (YW; 26.1 ± 2.3 yr) and six senior (SW; 76.7 ± 8.3 yr) women during submaximal isometric contraction (35% maximum voluntary isometric contraction) of the plantar flexor muscles. Multiple GM fascicle lengths were continuously determined by automatically tracking regions of interest coinciding with the end points of muscle fascicles evenly distributed along the muscle's proximo-distal length. AT stiffness and Young's modulus were measured as the slopes of the tendon's force-elongation and stress-strain curves, respectively. Despite significantly lower AT stiffness at older age (YW: 120.2 ± 52.3 N/mm vs. SW: 53.9 ± 44.4 N/mm, P = 0.040), contraction-induced changes in GM fascicle lengths were similar in both age groups at equal levels of absolute muscular force (4-5% fascicle shortening in both groups), and even significantly larger in YW (YW: 11-12% vs. SW: 6-8% fascicle shortening) at equal percentage of maximum voluntary contraction. These results suggest that factors other than AT stiffness, such as age-associated changes in muscle composition or fascicle slack, might serve as compensatory adaptations, limiting the degree of fascicle strains upon contraction.

An efficient framework for estimation of muscle fiber orientation using ultrasonography

BACKGROUND

Muscle fiber orientation (MFO) is an important parameter related to musculoskeletal functions. The traditional manual method for MFO estimation in sonograms was labor-intensive. The automatic methods proposed in recent years also involved voting procedures which were computationally expensive.

METHODS

In this paper, we proposed a new framework to efficiently estimate MFO in sonograms. We firstly employed Multi-scale Vessel Enhancement Filtering (MVEF) to enhance fascicles in the sonograms and then the enhanced images were binarized. Finally, line-shaped patterns in the binary map were detected one by one, according to their shape properties. Specifically speaking, for the long-and-thinner regions, the orientation of the targeted muscle fibre was directly computed, without voting procedures, as the orientation of the ellipse that had the same normalized second central moments as the region. For other cases, the Hough voting procedure might be employed for orientation estimation. The performance of the algorithm was evaluated using four various group of sonograms, which are a dataset used in previous reports, 33 sonograms of gastrocnemius from 11 young healthy subjects, one sonogram sequence including 200 frames from a subject and 256 frames from an aged subject with cerebral infarction respectively.

RESULTS

It was demonstrated in the experiments that measurements of the proposed method agreed well with those of the manual method and achieved much more efficiency than the previous Re-voting Hough Transform (RVHT) algorithm.

CONCLUSIONS

Results of the experiments suggested that, without compromising the accuracy, in the proposed framework the previous orientation estimation algorithm was accelerated by reduction of its dependence on voting procedures.

The manipulation of strain, when stress is controlled, modulates in vivo tendon mechanical properties but not systemic TGF-β1 levels

Modulators of loading-induced in vivo adaptations in muscle–tendon complex (MTC) mechanical properties remain unclear. Similarly contentious, is whether changes in MTC characteristics are associated with growth factor levels. Four groups were subjected to varying magnitudes of stress/strain: Group 1 trained with the MTC at a shortened position (MTCS; n = 10); Group 2 at a lengthened position (MTCL; n = 11; stress levels matched to MTCS); Group 3 over a wide range of motion (MTCX; n = 11); and Group 4 (n = 10) was the control population (no training). Patella tendon Stiffness (P < 0.001), Young's modulus, and quadriceps torque (P < 0.05) increments (only seen in the training groups), showed MTCL and MTCX groups responses to be superior to those of MTCS (P < 0.05). In addition, MTCL and MTCX better maintained adaptations compared to MTCS (P < 0.05) following detraining, with a pattern of slower loss of improvements at the early phase of detraining in all training groups. There were no significant changes (P > 0.05) in antagonist cocontraction, patella tendon dimensions or circulating transforming growth factor beta (TGF-β1) levels following training or detraining in any of the groups. We conclude that chronically loading the MTC in a relatively lengthened position (which involves greater strains) enhances its mechanical properties, more so than loading in a shortened position. This is true even after normalizing for internal stress. The underlying endocrine mechanisms do not appear to be mediated via TGF-β1, at least not at the systemic level. Our findings have implications with regard to the effectiveness of eccentric loading on improved tendon structural and mechanical properties.

Patellar tendon adaptation in relation to load-intensity and contraction type

BACKGROUND

Loading leads to tendon adaptation but the influence of load-intensity and contraction type is unclear. Clinicians need to be aware of the type and intensity of loading required for tendon adaptation when prescribing exercise. The aim of this study was to investigate the influence of contraction type and load-intensity on patellar tendon mechanical properties.

METHOD

Load intensity was determined using the 1 repetition maximum (RM) on a resistance exercise device at baseline and fortnightly intervals in four randomly allocated groups of healthy, young males: (1) control (no training); (2) concentric (80% of concentric-eccentric 1RM, 4×7-8); (3) standard load eccentric only (80% of concentric-eccentric 1RM, 4×12-15 repetitions) and (4) high load eccentric (80% of eccentric 1RM, 4×7-8 repetitions). Participants exercised three times a week for 12 weeks on a leg extension machine. Knee extension maximum torque, patellar tendon CSA and length were measured with dynamometry and ultrasound imaging. Patellar tendon force, stress and strain were calculated at 25%, 50%, 75% and 100% of maximum torque during isometric knee extension contractions, and stiffness and modulus at torque intervals of 50-75% and 75-100%. Within group and between group differences in CSA, force, elongation, stress, strain, stiffness and modulus were investigated. The same day reliability of patellar tendon measures was established with a subset of eight participants.

RESULTS

Patellar tendon modulus increased in all exercise groups compared with the control group (p<0.05) at 50-75% of maximal voluntary isometric contraction (MVIC), but only in the high eccentric group compared with the control group at 75-100% of MVIC (p<0.05). The only other group difference in tendon properties was a significantly greater increase in maximum force in the high eccentric compared with the control group (p<0.05). Five repetition maximum increased in all groups but the increase was significantly greater in the high load eccentric compared with the other exercise groups (p<0.05).

CONCLUSION

Load at different intensity levels and contraction types increased patellar tendon modulus whereas muscle strength seems to respond more to load-intensity. High load eccentric was, however, the only group to have significantly greater increase in force, stiffness and modulus (at the highest torque levels) compared with the control group. The effects and clinical applicability of high load interventions needs to be investigated further.

Changes in muscle architecture and performance during a competitive season in female softball players

The purpose of this research was (a) to examine the performance changes that occur in elite female softball players during 20 weeks of softball training (that included 14 weeks of periodized resistance training [RT]) and (b) to examine the relationship between percent change (%change) in muscle architecture variables and %change in strength, speed, and change of direction performance. Ten female softball players (age = 18.1 ± 1.6 years, height = 166.5 ± 8.9 cm, weight = 72.4 ± 10.8 kg) from a state Australian Institute of Sport softball team were tested for maximal lower-body strength using a 3 repetition maximum for a predicted 1 repetition maximum (1RM) and peak force, peak velocity (PV), and peak power (PP) were measured during jump squats (JS) unloaded and loaded. In addition, the first base (1B) and the second base (2B) sprint performance, change of direction (505) on dominant (D) and nondominant (ND) sides, aerobic capacity, and muscle architecture characteristics of vastus lateralis (VL) including muscle thickness (MT), fascicle length (FL), and pennation angle (θp) were examined. The testing sessions occurred pre, mid, and post training (total 20 week pre- and in-season training period). Changes over time were analyzed by repeated-measures analysis of variance. The relationship between %change in muscle architecture variables and strength, speed, and change of direction variables from pre to post were assessed by Pearson product-moment correlation coefficient. Significant improvements in PV and PP occurred at all JS loads pre- to mid-testing and pre- to post-testing. Significant increases occurred pre-post in absolute 1RM, relative 1RM, 505 ND, and 2B sprint. The strongest relationships were found between %change in VL MT and 1B sprint (r = -0.80, p = 0.06), %change in VL FL and 2B sprint (r = -0.835, p = 0.02), and %change in relative 1RM and 505 D (r = -0.70, p = 0.04). In conclusion, gains in strength, power, and performance can occur during the season in elite softball players who are also engaged in a periodized RT program. Furthermore, changes in performance measures are associated with changes in muscle architecture.

Functional and morphological adaptations to aging in knee extensor muscles of physically active men

It is not known if a physically active lifestyle, without systematic training, is sufficient to combat age-related muscle and strength loss. Therefore, the purpose of this study was to evaluate if the maintenance of a physically active lifestyle prevents muscle impairments due to aging. To address this issue, we evaluated 33 healthy men with similar physical activity levels (IPAQ = 2) across a large range of ages. Functional (torque-angle and torque-velocity relations) and morphological (vastus lateralis muscle architecture) properties of the knee extensor muscles were assessed and compared between three age groups: young adults (30 ± 6 y), middle-aged subjects (50 ± 7 y) and elderly subjects (69 ± 5 y). Isometric peak torques were significantly lower (30% to 36%) in elderly group subjects compared with the young adults. Concentric peak torques were significantly lower in the middle aged (18% to 32%) and elderly group (40% to 53%) compared with the young adults. Vastus lateralis thickness and fascicles lengths were significantly smaller in the elderly group subjects (15.8 ± 3.9 mm; 99.1 ± 25.8 mm) compared with the young adults (19.8 ± 3.6 mm; 152.1 ± 42.0 mm). These findings suggest that a physically active lifestyle, without systematic training, is not sufficient to avoid loss of strength and muscle mass with aging.

Circulating hormone and cytokine response to low-load resistance training with blood flow restriction in older men

It has been suggested that circulating hormones and cytokines are important in the adaptive response to low-load resistance training (LLRT) with blood flow restriction (BFR); however, their response following this type of training in older men is unclear. Seven healthy older men (age 71.0 ± 6.5 year, height 1.77 ± 0.05 m, body mass 80.0 ± 7.5 kg; mean ± SD) performed five sets of unilateral LLRT knee extensions (20 % 1-RM) of both limbs, with or without BFR in a counterbalanced order. For the BFR condition, a pressure cuff was applied on the upper thigh and inflated to ~110 mmHg. Venous blood samples were taken at rest and 30-, 60- and 120-min post-exercise and measured for plasma concentrations of growth hormone (GH), insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), cortisol and interleukin-6 (IL-6). GH increased (P < 0.05) from rest to 30-min post-exercise and was greater (P < 0.05) during LLRT with BFR than without. VEGF was significantly (P < 0.05) elevated from resting levels at 30-, 60- and 120-min post-exercise following LLRT with BFR with no change seen following LLRT without BFR. IL-6 increased (P < 0.05) from 30- to 60-min post-exercise and remained elevated at 120-min post-exercise in both conditions. Cortisol and IGF-1 were unaffected following exercise. In conclusion, a single bout of LLRT with BFR increases the circulating concentrations of GH and VEGF in older men and may explain the skeletal muscle and peripheral vascular adaptations observed following training with BFR.

Effect of strength training on rate of force development in older women

We analyzed the effect of an 8-week strength training (ST) program on the rate of force development (RFD) and electromyographic activity (EMG) in older women. Seventeen women (M age = 63.4 years, SD = 4.9) without previous ST experience were randomly assigned to either a control (n=7) or training (n=10) group. A leg-press isometric test was used for assessment. ST (three sessions/ week, three sets of 10-12 repetition maximum, five different exercises) induced significant increases (p < .05) on peak RPD (48.4%) and on RFD) and EMG of vastus medialis at time intervals of 0-50, 0-100, 0-150, and 0-200 ms (41.1-69.2% and 43.8-64.3%, respectively). Therefore, ST resulted in favorable changes in neuromuscular responses in older women.

Sarcopenia in the elderly: basic and clinical issues

The original definition of sarcopenia refers to the age-related loss of muscle mass. The literature suggests that the prevalence of sarcopenia in 60- to 70-year-olds is in the range of 5-13%. Prevalence estimates increase to 11-50% for the population aged 80 years or older. Estimates by the World Health Organization suggest that there were 600 million people aged 60 years or older in the year 2000, and that this number will increase to 1.2 billion by the year 2025. There are, however, limited published data on serial measures of muscle mass in older subjects to establish the age-related changes in muscle mass and to relate this change with adverse health consequences. This review is focused on the definition, prevalence, symptoms, pharmacy and physical therapy of sarcopenia in older subjects with the aim of promoting the recognition and treatment of age-related sarcopenia in the clinical setting.

Reliability of ultrasonographic measurement of the architecture of the vastus lateralis and gastrocnemius medialis muscles in older adults

OBJECTIVE

To determine the test-retest reliability of measurements of thickness, fascicle length (L(f)) and pennation angle (θ) of the vastus lateralis (VL) and gastrocnemius medialis (GM) muscles in older adults.

PARTICIPANTS

Twenty-one healthy older adults (11 men and ten women; average age 68·1 ± 5·2 years) participated in this study.

METHODS

Ultrasound images (probe frequency 10 MHz) of the VL at two sites (VL site 1 and 2) were obtained with participants seated with knee at 90º flexion. For GM measures, participants lay prone with ankle fixed at 15º dorsiflexion. Measures were taken on two separate occasions, 7 days apart (T1 and T2).

RESULTS

The ICCs (95% CI) were: VL site 1 thickness = 0·96 (0·90-0·98); VL site 2 thickness = 0·96 (0·90-0·98), VL θ = 0·87 (0·68-0·95), VL L(f) = 0·80 (0·50-0·92), GM thickness = 0·97 (0·92-0·99), GM θ = 0·85 (0·62-0·94) and GM L(f) = 0·90 (0·75-0·96). The 95% ratio limits of agreement (LOAs) for all measures, calculated by multiplying the standard deviation of the ratio of the results between T1 and T2 by 1·96, ranged from 10·59 to 38·01%.

CONCLUSION

The ability of these tests to determine a real change in VL and GM muscle architecture is good on a group level but problematic on an individual level as the relatively large 95% ratio LOAs in the current study may encompass the changes in architecture observed in other training studies. Therefore, the current findings suggest that B-mode ultrasonography can be used with confidence by researchers when investigating changes in muscle architecture in groups of older adults, but its use is limited in showing changes in individuals over time.

Developing maximal neuromuscular power: part 2 - training considerations for improving maximal power production

This series of reviews focuses on the most important neuromuscular function in many sport performances: the ability to generate maximal muscular power. Part 1, published in an earlier issue of Sports Medicine, focused on the factors that affect maximal power production while part 2 explores the practical application of these findings by reviewing the scientific literature relevant to the development of training programmes that most effectively enhance maximal power production. The ability to generate maximal power during complex motor skills is of paramount importance to successful athletic performance across many sports. A crucial issue faced by scientists and coaches is the development of effective and efficient training programmes that improve maximal power production in dynamic, multi-joint movements. Such training is referred to as 'power training' for the purposes of this review. Although further research is required in order to gain a deeper understanding of the optimal training techniques for maximizing power in complex, sports-specific movements and the precise mechanisms underlying adaptation, several key conclusions can be drawn from this review. First, a fundamental relationship exists between strength and power, which dictates that an individual cannot possess a high level of power without first being relatively strong. Thus, enhancing and maintaining maximal strength is essential when considering the long-term development of power. Second, consideration of movement pattern, load and velocity specificity is essential when designing power training programmes. Ballistic, plyometric and weightlifting exercises can be used effectively as primary exercises within a power training programme that enhances maximal power. The loads applied to these exercises will depend on the specific requirements of each particular sport and the type of movement being trained. The use of ballistic exercises with loads ranging from 0% to 50% of one-repetition maximum (1RM) and/or weightlifting exercises performed with loads ranging from 50% to 90% of 1RM appears to be the most potent loading stimulus for improving maximal power in complex movements. Furthermore, plyometric exercises should involve stretch rates as well as stretch loads that are similar to those encountered in each specific sport and involve little to no external resistance. These loading conditions allow for superior transfer to performance because they require similar movement velocities to those typically encountered in sport. Third, it is vital to consider the individual athlete's window of adaptation (i.e. the magnitude of potential for improvement) for each neuromuscular factor contributing to maximal power production when developing an effective and efficient power training programme. A training programme that focuses on the least developed factor contributing to maximal power will prompt the greatest neuromuscular adaptations and therefore result in superior performance improvements for that individual. Finally, a key consideration for the long-term development of an athlete's maximal power production capacity is the need for an integration of numerous power training techniques. This integration allows for variation within power meso-/micro-cycles while still maintaining specificity, which is theorized to lead to the greatest long-term improvement in maximal power.

Physical activity and sarcopenia

Physical activity can be a valuable countermeasure to sarcopenia in its treatment and prevention. In considering physical training strategies for sarcopenic subjects, it is critical to consider personal and environmental obstacles to access opportunities for physical activity for any patient with chronic disease. This article presents an overview of current knowledge of the effects of physical training on muscle function and the physical activity recommended for sarcopenic patients. So that this countermeasure strategy can be applied in practice, the authors propose a standardized protocol for prescribing physical activity in chronic diseases such as sarcopenia.

Mechanical correction of dynamometer moment for the effects of segment motion during isometric knee-extension tests

The purpose of this study was to determine the effect of dynamometer and joint axis misalignment on measured isometric knee-extension moments using inverse dynamics based on the actual joint kinematic information derived from the real-time X-ray video and to compare the errors when the moments were calculated using measurements from external anatomical surface markers or obtained from the isokinetic dynamometer. Six healthy males participated in this study. They performed isometric contractions at 90° and 20° of knee flexion, gradually increasing to maximum effort. For the calculation of the actual knee-joint moment and the joint moment relative to the knee-joint center, determined using the external marker, two free body diagrams were used of the Cybex arm and the lower leg segment system. In the first free body diagram, the mean center of the circular profiles of the femoral epicondyles was used as the knee-joint center, whereas in the second diagram, the joint center was assumed to coincide with the external marker. Then, the calculated knee-joint moments were compared with those measured by the dynamometer. The results indicate that 1) the actual knee-joint moment was different from the dynamometer recorded moment (difference ranged between 1.9% and 4.3%) and the moment calculated using the skin marker (difference ranged between 2.5% and 3%), and 2) during isometric knee extension, the internal knee angle changed significantly from rest to the maximum contraction state by about 19°. Therefore, these differences cannot be neglected if the moment-knee-joint angle relationship or the muscle mechanical properties, such as length-tension relationship, need to be determined.

Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure

Aging is characterized by loss of spinal motor neurons (MNs) due to apoptosis, reduced insulin-like growth factor I signaling, elevated amounts of circulating cytokines, and increased cell oxidative stress. The age-related loss of spinal MNs is paralleled by a reduction in muscle fiber number and size (sarcopenia), resulting in impaired mechanical muscle performance that in turn leads to a reduced functional capacity during everyday tasks. Concurrently, maximum muscle strength, power, and rate of force development are decreased with aging, even in highly trained master athletes. The impairment in muscle mechanical function is accompanied and partly caused by an age-related loss in neuromuscular function that comprise changes in maximal MN firing frequency, agonist muscle activation, antagonist muscle coactivation, force steadiness, and spinal inhibitory circuitry. Strength training appears to elicit effective countermeasures in elderly individuals even at a very old age (>80 years) by evoking muscle hypertrophy along with substantial changes in neuromuscular function, respectively. Notably, the training-induced changes in muscle mass and nervous system function leads to an improved functional capacity during activities of daily living.

Coactivation at the ankle joint is not sufficient to estimate agonist and antagonist mechanical contribution

The aim of this study was to assess, via an electromyographic (EMG) biofeedback method, the mechanical contribution of both agonist and antagonist muscles during maximal voluntary contraction (MVC). We compared this original method with the MVC-EMGmax ratio and the torque/EMG relationship method, both of which are commonly used to estimate antagonist torque. The plantarflexion (PF) and dorsiflexion (DF) MVCs were measured simultaneously with EMG activity of triceps surae (TS) and tibialis anterior in 15 young adults (mean age 23 years). Antagonist torques obtained from the torque/EMG relationship and EMG biofeedback methods appeared to be similar. TS antagonist torque had a major mechanical impact on DF MVC ( approximately 42%). EMG coactivation is significantly different than normalized antagonist torque. TS antagonist torque is not negligible when maximal DF is assessed, and the EMG biofeedback method is a simple method to estimate antagonist torque.

Muscle-tendon structure and dimensions in adults and children

Muscle performance is closely related to the architecture and dimensions of the muscle-tendon unit and the effect of maturation on these architectural characteristics in humans is currently unknown. This study determined whether there are differences in musculo-tendinous architecture between adults and children of both sexes. Fascicle length and pennation angle were measured from ultrasound images at three sites along the length of the vastus intermedius, vastus lateralis, vastis medialis and rectus femoris muscles. Muscle volume and muscle-tendon length were measured from magnetic resonance images. Muscle physiological cross-sectional area (PCSA) was calculated as the ratio of muscle volume to optimum fascicle length. Fascicle length was greater in the adult groups than in children (P < 0.05) but pennation angle did not differ between groups (P > 0.05). The ratios between fascicle and muscle length and between fascicle and tendon length were not different (P > 0.05) between adults and children for any quadriceps muscle. Quadriceps volume and PCSA of each muscle were greater in adults than children (P < 0.01) but the relative proportion of each head to the total quadriceps volume was similar in all groups. However, the difference in PCSA between adults and children (men approximately 104% greater than boys, women approximately 57% greater than girls) was greater (P < 0.05) than the difference in fascicle length (men approximately 37% greater than boys, women approximately 10% greater than girls). It is concluded that the fascicle, muscle and tendon lengthen proportionally during maturation, thus the muscle-tendon stiffness and excursion range are likely to be similar in children and adults but the relatively greater increase in PCSA than fascicle length indicates that adult muscles are better designed for force production than children's muscles.

Arquitetura muscular e envelhecimento: adaptação funcional e aspectos clínicos; revisão da literatura

O envelhecimento é associado a um progressivo declínio na massa muscular, conhecido como sarcopenia, que afeta diretamente a arquitetura e a capacidade de produção de força muscular. O objetivo deste artigo foi revisar a literatura sobre os efeitos do envelhecimento sobre a arquitetura muscular, bem como revisar as principais evidências dos efeitos de programas de treinamento de força nas propriedades morfológicas da musculatura esquelética, discutindo as implicações clínicas da adaptação funcional na população idosa. Foram selecionados 42 artigos publicados entre 1993 e 2008 nas bases de dados Pubmed, Science Direct e Scopus, utilizando os descritores aging, older adults, elderly, muscle architecture, strength training e resistance training. Os artigos revisados suportam a idéia de que existem diferenças na arquitetura do músculo esquelético de idosos acometidos por sarcopenia quando comparados a adultos jovens saudáveis. As evidências parecem ser unânimes quanto à redução no volume, área de seção transversa fisiológica e ângulo de penação do músculo esquelético de idosos. Além disso, também há evidências de que o envelhecimento determina uma redução do comprimento fascicular e da espessura muscular, o que gera uma redução também da área de seção transversa anatômica. Programas terapêuticos de treinamento de força têm sido utilizados com o objetivo de retardar e até mesmo reverter os efeitos do envelhecimento sobre a musculatura dos idosos.

Aging and the force-velocity relationship of muscles

Aging in humans is associated with a loss in neuromuscular function and performance. This is related, in part, to the reduction in muscular strength and power caused by a loss of skeletal muscle mass (sarcopenia) and changes in muscle architecture. Due to these changes, the force-velocity (f-v) relationship of human muscles alters with age. This change has functional implications such as slower walking speeds. Different methods to reverse these changes have been investigated, including traditional resistance training, power training and eccentric (or eccentrically-biased) resistance training. This review will summarise the changes of the f-v relationship with age, the functional implications of these changes and the various methods to reverse or at least partly ameliorate these changes.