Intra- and intermuscular variation in human quadriceps femoris architecture assessed in vivo

Mapping of spatial and temporal heterogeneity of plantar flexor muscle activity during isometric contraction: correlation of velocity-encoded MRI with EMG

The aim of this study was to assess the correlation between contraction-associated muscle kinematics as measured by velocity-encoded phase-contrast (VE-PC) magnetic resonance imaging (MRI) and activity recorded via electromyography (EMG), and to construct a detailed three-dimensional (3-D) map of the contractile behavior of the triceps surae complex from the MRI data. Ten axial-plane VE-PC MRI slices of the triceps surae and EMG data were acquired during submaximal isometric contractions in 10 subjects. MRI images were analyzed to yield the degree of contraction-associated muscle displacement on a voxel-by-voxel basis and determine the heterogeneity of muscle movement within and between slices. Correlational analyses were performed to determine the agreement between EMG data and displacements. Pearson's coefficients demonstrated good agreement (0.84 < r < 0.88) between EMG data and displacements. Comparison between different slices in the gastrocnemius muscle revealed significant heterogeneity in displacement values both in-plane and along the cranio-caudal axis, with highest values in the mid-muscle regions. By contrast, no significant differences between muscle regions were found in the soleus muscle. Substantial differences among displacements were also observed within slices, with those in static areas being only 17-39% (maximum) of those in the most mobile muscle regions. The good agreement between EMG data and displacements suggests that VE-PC MRI may be used as a noninvasive, high-resolution technique for quantifying and modeling muscle activity over the entire 3-D volume of muscle groups. Application to the triceps surae complex revealed substantial heterogeneity of contraction-associated muscle motion both within slices and between different cranio-caudal positions.

Association between walking ability and trunk and lower-limb muscle atrophy in institutionalized elderly women: a longitudinal pilot study

Background

The aim of this study was to investigate the association between walking ability and muscle atrophy in the trunk and lower limbs.

Methods

Subjects in this longitudinal study were 21 elderly women who resided in nursing homes. The thicknesses of the following trunk and lower-limb muscles were measured using B-mode ultrasound: rectus abdominis, external oblique, internal oblique, transversus abdominis, erector spinae, lumbar multifidus, psoas major, gluteus maximus, gluteus medius, gluteus minimus, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius, soleus, and tibialis anterior. Maximum walking speed was used to represent walking ability. Maximum walking speed and muscle thickness were assessed before and after a 12-month period.

Results

Of the 17 measured muscles of the trunk and lower limbs, age-related muscle atrophy in elderly women was greatest in the erector spinae, rectus femoris, vastus lateralis, vastus intermedius, and tibialis anterior muscles. Correlation coefficient analyses showed that only the rate of thinning of the vastus lateralis was significantly associated with the rate of decline in maximum walking speed (r = 0.518, p < 0.05).

Conclusions

This longitudinal study suggests that reduced walking ability may be associated with muscle atrophy in the trunk and lower limbs, especially in the vastus lateralis muscle, among frail elderly women.

The bigger, the stronger? Insights from muscle architecture and nervous characteristics in obese adolescent girls

BACKGROUND

Young obese youth are generally stronger than lean youth. This has been linked to the loading effect of excess body mass, acting as a training stimulus comparable to strength training. Whether this triggers specific adaptations of the muscle architecture (MA) and voluntary activation (VA) that could account for the higher strength of obese subjects remains unknown.

METHODS

MA characteristics (that is, pennation angle (PA), fascicle length (FL) and muscle thickness (MT)) and muscle size (that is, anatomical cross-sectional area (ACSA)) of the knee extensor (KE) and plantar flexor (PF) muscles were evaluated in 12 obese and 12 non-obese adolescent girls (12-15 years). Maximal isometric torque and VA of the KE and PF muscles were also assessed.

RESULTS

Results revealed higher PA (P<0.05), greater MT (P<0.001), ACSA (P<0.01), segmental lean mass (P<0.001) and VA (P<0.001) for KE and PF muscles in obese girls. Moreover, obese individuals produced a higher absolute torque than their lean counterparts on the KE (224.6±39.5 vs 135.7±32.7 N m, respectively; P<0.001) and PF muscles (73.3±16.5 vs 44.5±6.2 N m; P<0.001). Maximal voluntary contraction (MVC) was correlated to PA for the KE (r=0.46-0.57, P<0.05-0.01) and PF muscles (r=0.45-0.55, P<0.05-0.01). MVC was also correlated with VA (KE: r=0.44, P<0.05; PF: r=0.65, P<0.001) and segmental lean mass (KE: r=0.48, P<0.05; PF: r=0.57, P<0.01).

CONCLUSIONS

This study highlighted favorable muscular and nervous adaptations to obesity that account for the higher strength of obese youth. The excess of body mass supported during daily activities could act as a chronic training stimulus responsible for these adaptations.

Neuromuscular efficiency of the vastus lateralis and biceps femoris muscles in individuals with anterior cruciate ligament injuries

Objective

To analyze strength and integrated electromyography (IEMG) data in order to determine the neuromuscular efficiency (NME) of the vastus lateralis (VL) and biceps femoris (BF) muscles in patients with anterior cruciate ligament (ACL) injuries, during the preoperative and postoperative periods; and to compare the injured limb at these two times, using the non-operated limb as a control.

Methods

EMG data and BF and VL strength data were collected during three maximum isometric contractions in knee flexion and extension movements. The assessment protocol was applied before the operation and two months after the operation, and the NME of the BF and VL muscles was obtained.

Results

There was no difference in the NME of the VL muscle from before to after the operation. On the other hand, the NME of the BF in the non-operated limb was found to have increased, two months after the surgery.

Conclusions

The NME provides a good estimate of muscle function because it is directly related to muscle strength and capacity for activation. However, the results indicated that two months after the ACL reconstruction procedure, at the time when loading in the open kinetic chain within rehabilitation protocols is usually started, the neuromuscular efficiency of the VL and BF had still not been reestablished.

Variations in the spatial distribution of the amplitude of surface electromyograms are unlikely explained by changes in the length of medial gastrocnemius fibres with knee joint angle

This study investigates whether knee position affects the amplitude distribution of surface electromyogram (EMG) in the medial gastrocnemius (MG) muscle. Of further concern is understanding whether knee-induced changes in EMG amplitude distribution are associated with regional changes in MG fibre length. Fifteen surface EMGs were acquired proximo-distally from the MG muscle while 22 (13 male) healthy participants (age range: 23–47 years) exerted isometric plantar flexion at 60% of their maximal effort, with knee fully extended and at 90 degrees flexion. The number of channels providing EMGs with greatest amplitude, their relative proximo-distal position and the EMG amplitude averaged over channels were considered to characterise changes in myoelectric activity with knee position. From ultrasound images, collected at rest, fibre length, pennation angle and fat thickness were computed for MG proximo-distal regions. Surface EMGs detected with knee flexed were on average five times smaller than those collected during knee extended. However, during knee flexed, relatively larger EMGs were detected by a dramatically greater number of channels, centred at the MG more proximal regions. Variation in knee position at rest did not affect the proximo-distal values obtained for MG fibre length, pennation angle and fat thickness. Our main findings revealed that, with knee flexion: i) there is a redistribution of activity within the whole MG muscle; ii) EMGs detected locally unlikely suffice to characterise the changes in the neural drive to MG during isometric contractions at knee fully extended and 90 degrees flexed positions; iii) sources other than fibre length may substantially contribute to determining the net, MG activation.

Neuromuscular adaptations associated with knee joint angle-specific force change

PURPOSE

Neuromuscular adaptations to joint angle-specific force increases after isometric training have not yet been fully elucidated. This study examined angle-specific neuromuscular adaptations in response to isometric knee extension training at short (SL, joint angle 38.1° ± 3.7°) versus long (LL, 87.5° ± 6.0°) muscle lengths.

METHODS

Sixteen men trained three times a week for 6 wk either at SL (n = 8) or LL (n = 8). Voluntary maximal isometric knee extensor (MVC) force, doublet twitch force, EMG amplitudes (EMG/Mmax), and voluntary activation during MVC force (VA%) were measured at eight knee joint angles (30°-100°) at weeks 0, 3, and 6. Muscle volume and cross-sectional area (CSA) were measured from magnetic resonance imaging scans, and fascicle length (Lf) was assessed using ultrasonography before and after training.

RESULTS

Clear joint angle specificity of force increase was seen in SL but not in LL. The 13.4% ± 9.7% (P = 0.01) force increase around the training angle in SL was related to changes in vastus lateralis and vastus medialis EMG/Mmax around the training angle (r = 0.84-0.88, P < 0.05), without changes in the doublet twitch force-angle relation or muscle size. In LL, muscle volume and CSA increased and the changes in CSA at specific muscle regions were correlated with changes in MVC force. A 5.4% ± 4.9% (P = 0.001) increase in Lf found in both groups was not associated with angle-specific force changes. There were no angle-specific changes in VA%.

CONCLUSION

The EMG/Mmax, although not VA%, results suggest that neural adaptations underpinned training-related changes at short quadriceps lengths, but hypertrophic changes predominated after training at long lengths. The findings of this study should contribute to the development of more effective and evidence-based rehabilitation and strength training protocols.

The muscle stretch reflex throughout the menstrual cycle

INTRODUCTION

The significant sex disparity in sports-related knee injuries may be due to underlying differences in motor control. Although the development of sex-specific movement patterns is likely multifactorial, this study specifically focuses on the potential modulatory role of sex hormones.

PURPOSE

This study aimed to investigate the muscle stretch reflex (MSR) across the menstrual cycle. We hypothesized that the MSR would fluctuate throughout the menstrual cycle and that the lowest response would correspond with peak concentrations of estrogen.

METHODS

Nineteen healthy women age 18-35 yr participated in this study: 8 eumenorrheic women and 11 women taking oral contraceptives. Serum estradiol and progesterone concentrations, anterior knee laxity (AKL), and the MSR response of the quadriceps muscles were measured three times during the menstrual cycle.

RESULTS

The MSR response of the rectus femoris (RF) varied significantly across the menstrual cycle in both groups. Specifically, the RF MSR response was 2.4 times lower during the periovulatory phase when compared with the luteal phase (P = 0.007). The same trend was seen in the vastus medialis, but this did not reach statistical significance (P = 0.070). The MSR response of the vastus lateralis did not change significantly across the menstrual cycle (P = 0.494). A mixed model comparison did not show an association between endogenous concentrations of estradiol and progesterone, exposure to hormonal contraceptives or AKL, and the MSR response for any muscle.

CONCLUSIONS

Our results demonstrate that the RF MSR response varies throughout the menstrual cycle with the lowest response around the time of ovulation. Additional research is needed to clarify the exact relationship between sex hormones, AKL, and MSR response and to determine the specific origin of the change along the monosynaptic reflex arc.

In vivo measurement of fascicle length and pennation of the human anconeus muscle at several elbow joint angles

Ultrasound imaging has facilitated the reliable measure of the architectural variables fascicle length (LF ) and pennation angle (PA), at rest and during static and dynamic contractions in many human skeletal muscles in vivo. Despite its small size and very modest contribution to elbow extension torque, the anconeus muscle has proven a useful model for the study of neuromuscular function in health and disease. Recent single motor unit (MU) studies in the anconeus have reported discrete and identifiable individual trains of MU potentials from intramuscular electromyography (EMG) recordings during dynamic elbow extensions. It is unknown whether the anconeus has unique architectural features related to alterations in LF and PA throughout the elbow joint range of motion that may help explain these high-quality recordings. Previous anatomical studies have investigated this muscle in cadavers and at mainly one elbow joint angle. The purpose of this study was to measure in vivo PA and LF of the anconeus muscle in a relaxed state at different degrees of elbow flexion using ultrasonography. Ultrasound images were collected from 10 healthy males (25 ± 3 years) at 135°, 120°, 90°, 45°, and 0° of elbow flexion. Average values of LF decreased by 6 mm (10%), 6 mm (12%), and 4 mm (9%) from 135-120°, 120-90°, and 90-45° of elbow flexion, respectively, whereas average PA values increased by 1° (9%), 1° (8%), and 2° (14%) from 135-120°, 120-90°, and 45-0°, respectively. The results indicate that anconeus muscle architecture is dynamic, undergoing moderate changes with elbow joint excursion that are similar to other limb muscles reported elsewhere. The data obtained here are more comprehensive and representative of architectural changes at various elbow joint positions than those data reported in cadaveric studies. Furthermore, the results of this study indicate that despite experiencing similar relative changes in muscle architecture to other skeletal muscles about the elbow joint, the minimal absolute changes in LF of the anconeus likely contribute to the clarity of intramuscular EMG previously reported in this muscle.

Interaction of gender and body composition on rectus femoris morphology as measured with musculoskeletal ultrasound imaging

Background:

Quadriceps function is an important measure in patients recovering postoperatively. Traditionally, strength measures that require high levels of resistance are contraindicated during the early postoperative phase. Thus it may be helpful to evaluate the utilization of other tools, such as ultrasound imaging, that allow for assessment during a position of low resistance.

Hypothesis:

The rectus femoris cross-sectional area (CSA) is affected by sex and body composition in healthy subjects.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Thirty-two healthy subjects (16 women, 16 men), selected from a previously larger study, were chosen for analysis. All subjects underwent a maximal volitional isometric contraction protocol from 0° to 90° of knee motion controlled by an isokinetic dynamometer. In the contracted and resting positions, the rectus femoris CSA was measured at each angle using ultrasound imaging. The contractile index (contracted − resting CSA) was calculated at each position. Subjects were separated into 1 of 4 groups based on sex and fat percentage (low or high). These data were analyzed using mixed-factor analysis of variance (group × angle) for each variable, with a critical α level of 0.05.

Results:

A significant interaction was noted for the CSA of the rectus femoris at rest (P < 0.03) and during contraction (P < 0.02). For both variables, all groups performed similarly, with the exception of women with high body fat percentage. No statistically significant interaction existed for the contractile index; however, a main effect for angle (P < 0.01) was observed.

Conclusion:

Rectus femoris CSA appears to depend on sex as well as the body composition of individuals.

Clinical Relevance:

Traditional subjective assessment measures of quadriceps strength and function have low reliability and functional validity. With the improved feasibility of ultrasound imaging in the clinical setting, quadriceps size may be more accurately measured during the early postoperative stages.

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 soluble milk protein or casein supplementation on muscle fatigue following resistance training program: a randomized, double-blind, and placebo-controlled study

Background

The effects of protein supplementation on muscle thickness, strength and fatigue seem largely dependent on its composition. The current study compared the effects of soluble milk protein, micellar casein, and a placebo on strength and fatigue during and after a resistance training program.

Methods

Sixty-eight physically active men participated in this randomized controlled trial and underwent 10 weeks of lower-body resistance training. Participants were randomly assigned to the Placebo (PLA), Soluble Milk Protein (SMP, with fast digestion rate) or Micellar Casein (MC, with slow digestion rate) group. During the 10-week training period, participants were instructed to take 30 g of the placebo or protein twice a day, or three times on training days. Tests were performed on quadriceps muscles at inclusion (PRE), after 4 weeks (MID) and after 10 weeks (POST) of training. They included muscle endurance (maximum number of repetitions during leg extensions using 70% of the individual maximal load), fatigue (decrease in muscle power after the endurance test), strength, power and muscle thickness.

Results

Muscle fatigue was significantly lower (P < 0.05) in the SMP group at MID and POST (-326.8 ± 114.1 W and -296.6 ± 130.1 W, respectively) as compared with PLA (-439.2 ± 153.9 W and -479.2 ± 138.1 W, respectively) and MC (-415.1 ± 165.1 W and -413.7 ± 139.4 W, respectively). Increases in maximal muscle power, strength, endurance and thickness were not statistically different between groups.

Conclusions

The present study demonstrated that protein composition has a large influence on muscular performance after prolonged resistance training. More specifically, as compared with placebo or micellar casein, soluble milk protein (fast digestible) appeared to significantly reduce muscle fatigue induced by intense resistance exercise.

Shear modulus estimation on vastus intermedius of elderly and young females over the entire range of isometric contraction

Elderly people often suffer from sarcopenia in their lower extremities, which gives rise to the increased susceptibility of fall. Comparing the mechanical properties of the knee extensor/flexors on elderly and young subjects is helpful in understanding the underlying mechanisms of the muscle aging process. However, although the stiffness of skeletal muscle has been proved to be positively correlated to its non-fatiguing contraction intensity by some existing methods, this conclusion has not been verified above 50% maximum voluntary contraction (MVC) due to the limitation of their measurement range. In this study, a vibro-ultrasound system was set up to achieve a considerably larger measurement range on muscle stiffness estimation. Its feasibility was verified on self-made silicone phantoms by comparing with the mechanical indentation method. The system was then used to assess the stiffness of vastus intermedius (VI), one of the knee extensors, on 10 healthy elderly female subjects (56.7±4.9 yr) and 10 healthy young female subjects (27.6±5.0 yr). The VI stiffness in its action direction was confirmed to be positively correlated to the % MVC level (R² = 0.999) over the entire range of isometric contraction, i.e. from 0% MVC (relaxed state) to 100% MVC. Furthermore, it was shown that there was no significant difference between the mean VI shear modulus of the elderly and young subjects in a relaxed state (p>0.1). However, when performing step isometric contraction, the VI stiffness of young female subjects was found to be larger than that of elderly participants (p<0.001), especially at the relatively higher contraction levels. The results expanded our knowledge on the mechanical property of the elderly’s skeletal muscle and its relationship with intensity of active contraction. Furthermore, the vibro-ultrasound system has a potential to become a powerful tool for investigating the elderly’s muscle diseases.

Age-related differences in diffusion tensor indices and fiber architecture in the medial and lateral gastrocnemius

PURPOSE

To investigate age related changes in diffusion tensor indices and fiber architecture of the medial and lateral gastrocnemius (MG and LG) muscles using diffusion tensor imaging (DTI).

MATERIALS AND METHODS

The lower leg of five young and five senior subjects was scanned at 3 Tesla and DTI indices extracted using three methods: region of interest, histogram, and tract based. Tracked fibers were automatically edited to ensure physiologically relevant tracks. Pennation angles were measured with respect to the deep and superficial aponeuroses of both muscles.

RESULTS

The three methods provided internally consistent measures of the DTI indices (correlation coefficient in the range of 0.90-0.99). The primary, secondary, and tertiary eigenvalues in the MG and LG increased significantly in the senior cohort (P < 0.05), while the small increase in fractional anisotropy with age was not significant (MG/LG: P = 0.39/0.85; 95% confidence interval: [-0.059/-0.056, 0.116/0.064]). Fiber lengths of MG fibers originating distally were significantly decreased in seniors (P < 0.05) while pennation angles decreased with age in the MG and LG but this was not significant.

CONCLUSION

Fiber atrophy and increased fibrosis have opposing effects on the diffusion indices resulting in a complicated dependence with aging. Fiber architectural changes could play a role in determining aging muscle function.

Architectural, functional and molecular responses to concentric and eccentric loading in human skeletal muscle

AIM

We investigated architectural, functional and molecular responses of human skeletal muscle to concentric (CON) or eccentric (ECC) resistance training (RT).

METHODS

Twelve young males performed 10 weeks of concentric (CON) or eccentric (ECC) resistance training (RT) (n = 6 CON, 6 ECC). An additional 14 males were recruited to evaluate acute muscle fascicle behaviour and molecular signalling in biopsies collected from vastus lateralis (VL) after 30 min of single bouts of CON or ECC exercise. VL volume was measured by magnetic resonance imaging. Muscle architecture (fascicle length, Lf; pennation angle, PA) was evaluated by ultrasonography. Muscle remodelling signals to CON or ECC loading [MAPK/AKT-mammalian target of rapamycin (mTOR) signalling] and inflammatory pathway (TNFαMurf-1-MAFbx) were evaluated by immunoblotting.

RESULTS

Despite the ~1.2-fold greater load of the ECC group, similar increases in muscle volume (+8% CON and +6% ECC) and in maximal voluntary isometric contraction (+9% CON and +11% ECC) were found after RT. However, increases in Lf were greater after ECC than CON (+12 vs. +5%) while increases in PA were greater in CON than ECC (+30 vs. +5%). Distinct architectural adaptations were associated with preferential growth in the distal regions of VL for ECC (+ECC +8% vs. +CON +2) and mid belly for CON (ECC +7 vs. CON +11%). While MAPK activation (p38MAPK, ERK1/2, p90RSK) was specific to ECC, neither mode affected AKT-mTOR or inflammatory signalling 30 min after exercise.

CONCLUSION

Muscle growth with CON and ECC RT occurs with different morphological adaptations reflecting distinct fibre fascicle behaviour and molecular responses.

Effect of vastus lateralis fatigue on load sharing between quadriceps femoris muscles during isometric knee extensions

The present study aimed to investigate the effects of selective fatigue (i.e., one muscle of the quadriceps) on load sharing strategies during submaximal knee extensions. Shear wave elastography was used to measure muscle shear elastic modulus, as this is considered to be an index of individual muscle force. Sixteen participants attended two experimental sessions that each involved six 10-s knee extensions at 20% of maximal voluntary contraction (MVC) followed by a sustained submaximal isometric knee extension at 20% of MVC, until task failure (Tlim). Between the 10-s contractions and Tlim, participants were required to rest (5 min) for the control session or underwent 5 min of electromyostimulation (EMS) on vastus lateralis (EMS session). Compared with the control session, vastus lateralis shear elastic modulus values were significantly lower after EMS considering both the start of Tlim (54.6 ± 11.8 vs. 68.4 ± 19.2 kPa; P = 0.011) and the entire Tlim contraction (59.0 ± 14.0 vs. 74.4 ± 20.3 kPa; P = 0.019). However, no significant differences were observed for the other recorded muscles (vastus medialis and rectus femoris; both P = 1), i.e., different patterns of changes were found between participants. In conclusion, this study demonstrates that prefatiguing a single agonist muscle does not lead to a consistent redistribution of load sharing among the quadriceps muscles between individuals. These results suggest that the central nervous system does not use a common principle among individuals to control load sharing when neuromuscular fatigue occurs.

Muscular adaptations and insulin-like growth factor-1 responses to resistance training are stretch-mediated

INTRODUCTION

Modulation of muscle characteristics was attempted through altering muscle stretch during resistance training. We hypothesized that stretch would enhance muscle responses.

METHODS

Participants trained for 8 weeks, loading the quadriceps in a shortened (SL, 0-50° knee flexion; n=10) or lengthened (LL, 40-90°; n=11) position, followed by 4 weeks of detraining. Controls (CON; n=10) were untrained. Quadriceps strength, vastus lateralis architecture, anatomical cross-sectional area (aCSA), and serum insulin-like growth factor-1 (IGF-1) were measured at weeks 0, 8, 10, and 12.

RESULTS

Increases in fascicle length (29±4% vs. 14±4%), distal aCSA (53±12% vs. 18±8%), strength (26±6% vs. 7±3%), and IGF-1 (31±6% vs. 7±6%) were greater in LL compared with SL muscles (P<0.05). No changes occurred in CON. Detraining decrements in strength and aCSA were greater in SL than LL muscles (P<0.05).

CONCLUSIONS

Enhanced muscle in vivo (and somewhat IGF-1) adaptations to resistance training are concurrent with muscle stretch, which warrants its inclusion within training.

Interaction between gastrocnemius medialis fascicle and Achilles tendon compliance: a new insight on the quick-release method

The insufficient temporal resolution of imaging devices has made the analysis of very fast movements, such as those required to measure active muscle-tendon unit stiffness, difficult. Thus the relative contributions of tendon, aponeurosis, and fascicle to muscle-tendon unit compliance remain to be determined. The present study analyzed the dynamic interactions of fascicle, tendon, and aponeurosis in human gastrocnemius medialis during the first milliseconds of an ankle quick-release movement, using high-frame-rate ultrasonography (2,000 frames/s). Nine subjects performed the tests in random order at six levels of maximal voluntary contraction (MVC) (30% to 80% of MVC). These tests were carried out with the ultrasound probe placed on the muscle belly and on the myotendinous junction. Tendon, muscle fascicle, and aponeurosis length changes were quantified in relation to shortening of the muscle-tendon unit during the first few milliseconds following the release. The tendon was the main contributor (around 72%) to the shortening of the muscle-tendon unit, whereas the muscle fascicle and aponeurosis contributions were 18% and 10%, respectively. Because these structures can be considered in series, the quantified contributions can be regarded as relative contributions to muscle-tendon compliance. These contributions were not modified with the level of MVC or the time range used for the analysis between 10 and 25 ms. The constant contribution of tendon, muscle fascicle, and aponeurosis to muscle-tendon unit compliance may help to simplify the mechanism of compliance regulation and to maintain the important role of tendons in enhancing work output and movement efficiency.

Quantifying the passive stretching response of human tibialis anterior muscle using shear wave elastography

BACKGROUND

Quantifying passive stretching responses of individual muscles helps the diagnosis of muscle disorders and aids the evaluation of surgical/rehabilitation treatments. Utilizing an animal model, we demonstrated that shear elastic modulus measured by supersonic shear wave elastography increases linearly with passive muscle force. This study aimed to use this state-of-the-art technology to study the relationship between shear elastic modulus and ankle dorsi-plantarflexion angle of resting tibialis anterior muscles and extract physiologically meaningful parameters from the elasticity-angle curve to better quantify passive stretching responses.

METHODS

Elasticity measurements were made at resting tibialis anterior of 20 healthy subjects with the ankle positioned from 50° plantarflexion to up to 15° dorsiflexion at every 5° for two cycles. Elasticity-angle data was curve-fitted by optimizing slack angle, slack elasticity, and rate of increase in elasticity within a piecewise exponential model.

FINDINGS

Elasticity-angle data of all subjects were well fitted by the piecewise exponential model with coefficients of determination ranging between 0.973 and 0.995. Mean (SD) of slack angle, slack elasticity, and rate of increase in elasticity were 10.9° (6.3°), 5.8 (1.9) kPa, and 0.0347 (0.0082) respectively. Intraclass correlation coefficients of each parameter were 0.852, 0.942, and 0.936 respectively, indicating excellent test-retest reliability.

INTERPRETATION

This study demonstrated the feasibility of using supersonic shear wave elastography to quantify passive stretching characteristics of individual muscle and provided preliminary normative values of slack angle, slack elasticity, and rate of increase in elasticity for human tibialis anterior muscles. Future studies will investigate diagnostic values of these parameters in clinical applications.

The development, retention and decay rates of strength and power in elite rugby union, rugby league and American football: a systematic review

BACKGROUND AND AIM

Strength and power are crucial components to excelling in all contact sports; and understanding how a player's strength and power levels fluctuate in response to various resistance training loads is of great interest, as it will inevitably dictate the loading parameters throughout a competitive season. This is a systematic review of training, maintenance and detraining studies, focusing on the development, retention and decay rates of strength and power measures in elite rugby union, rugby league and American football players.

SEARCH STRATEGIES

A literature search using MEDLINE, EBSCO Host, Google Scholar, IngentaConnect, Ovid LWW, ProQuest Central, ScienceDirect Journals, SPORTDiscus and Wiley InterScience was conducted. References were also identified from other review articles and relevant textbooks. From 300 articles, 27 met the inclusion criteria and were retained for further analysis. STUDY QUALITY: Study quality was assessed via a modified 20-point scale created to evaluate research conducted in athletic-based training environments. The mean ± standard deviation (SD) quality rating of the included studies was 16.2 ± 1.9; the rating system revealed that the quality of future studies can be improved by randomly allocating subjects to training groups, providing greater description and detail of the interventions, and including control groups where possible.

DATA ANALYSIS

Percent change, effect size (ES = [Post-Xmean - Pre-Xmean)/Pre-SD) calculations and SDs were used to assess the magnitude and spread of strength and power changes in the included studies. The studies were grouped according to (1) mean intensity relative volume (IRV = sets × repetitions × intensity; (2) weekly training frequency per muscle group; and (3) detraining duration. IRV is the product of the number of sets, repetitions and intensity performed during a training set and session. The effects of weekly training frequencies were assessed by normalizing the percent change values to represent the weekly changes in strength and power. During the IRV analysis, the percent change values were normalized to represent the percent change per training session. The long-term periodized training effects (12, 24 and 48 months) on strength and power were also investigated.

RESULTS

Across the 27 studies (n = 1,015), 234 percent change and 230 ES calculations were performed. IRVs of 11-30 (i.e., 3-6 sets of 4-10 repetitions at 74-88% one-repetition maximum [1RM]) elicited strength and power increases of 0.42% and 0.07% per training session, respectively. The following weekly strength changes were observed for two, three and four training sessions per muscle region/week: 0.9%, 1.8 % and 1.3 %, respectively. Similarly, the weekly power changes for two, three and four training sessions per muscle group/week were 0.1%, 0.3% and 0.7 %, respectively. Mean decreases of 14.5% (ES = -0.64) and 0.4 (ES = -0.10) were observed in strength and power across mean detraining periods of 7.2 ± 5.8 and 7.6 ± 5.1 weeks, respectively. The long-term training studies found strength increases of 7.1 ± 1.0% (ES = 0.55), 8.5 ± 3.3% (ES = 0.81) and 12.5 ± 6.8% (ES = 1.39) over 12, 24 and 48 months, respectively; they also found power increases of 14.6% (ES = 1.30) and 12.2% (ES = 1.06) at 24 and 48 months.

CONCLUSION

Based on current findings, training frequencies of two to four resistance training sessions per muscle group/week can be prescribed to develop upper and lower body strength and power. IRVs ranging from 11 to 30 (i.e., 3-6 sets of 4-10 repetitions of 70-88% 1RM) can be prescribed in a periodized manner to retain power and develop strength in the upper and lower body. Strength levels can be maintained for up to 3 weeks of detraining, but decay rates will increase thereafter (i.e. 5-16 weeks). The effect of explosive-ballistic training and detraining on pure power development and decay in elite rugby and American football players remain inconclusive. The long-term effects of periodized resistance training programmes on strength and power seem to follow the law of diminishing returns, as training exposure increases beyond 12-24 months, adaptation rates are reduced.

Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly

The increase of elderly in our society requires simple tools for quantification of sarcopenia in inpatient and outpatient settings. The aim of this study was to compare parameters determined with musculoskeletal ultrasound (M-US) with muscle strength in young and elderly patients. In this prospective, randomised and observer blind study, 26 young (24.2 ± 3.7 years) and 26 old (age 67.8 ± 4.8 years) patients were included. Muscle thickness, pennation angle and echogenicity of all muscles of musculus quadriceps were measured by M-US and correlated with isometric maximum voluntary contraction force (MVC) of musculus quadriceps. Reproducibility of M-US measurements as well as simple and multiple regression models were calculated. Of all measured M-US variables the highest reproducibility was found for measurements of thickness (intraclass correlation coefficients, 85-97%). Simple regression analysis showed a highly significant correlation of thickness measurements of all muscles of musculus quadriceps with MVC in the elderly and in the young. Multiple regression analysis revealed that thickness of musculus vastus medialis had the best correlation with MVC in the elderly. This study showed that measurement of muscle thickness, especially of musculus vastus medialis, by M-US is a reliable, bedside method for monitoring the extent of sarcopenia.

Gender differences in tibio-femoral kinematics and quadriceps muscle force during weight-bearing knee flexion in vitro

PURPOSE

Females have a higher risk in terms of anterior cruciate ligament injuries during sports than males. Reasons for this fact may be different anatomy and muscle recruitment patterns leading to less protection for the cruciate- and collateral-ligaments. This in vitro study aims to evaluate gender differences in knee joint kinematics and muscle force during weight-bearing knee flexions.

METHODS

Thirty-four human knee specimens (17 females/17 males) were mounted on a dynamic knee simulator. Weight-bearing single-leg knee flexions were performed with different amounts of simulated body weight (BW). Gender-specific kinematics was measured with an ultrasonic motion capture system and different loading conditions were examined.

RESULTS

Knee joint kinematics did not show significant differences regarding anteroposterior and medial-lateral movement as well as tibial varus-valgus and internal-external rotation. This applied to all simulated amounts of BW. Simulating 100 N BW in contrast to AF50 led to a significant higher quadriceps overall force in female knees from 45° to 85° of flexion in contrast to BW 50 N. In these female specimens, the quadriceps overall force was about 20 % higher than in male knees being constant in higher flexion angles.

CONCLUSIONS

It is indicated by our results that in a squatting movement females compared with males produce higher muscle forces, suggesting an increased demand for muscular stabilization, whereas tibio-femoral kinematics was similar for both genders.

Twitch and M-wave potentiation induced by intermittent maximal voluntary quadriceps contractions: differences between direct quadriceps and femoral nerve stimulation

INTRODUCTION

The aim of this study was to investigate differences in twitch and M-wave potentiation in the quadriceps femoris when electrical stimulation is applied over the quadriceps muscle belly versus the femoral nerve trunk.

METHODS

M-waves and mechanical twitches were evoked using direct quadriceps muscle and femoral nerve stimulation between 48 successive isometric maximal voluntary contractions (MVC) from 10 young, healthy subjects. Potentiation was investigated by analyzing the changes in M-wave amplitude recorded from the vastus medialis (VM) and vastus lateralis (VL) muscles and in quadriceps peak twitch force.

RESULTS

Potentiation of twitch, VM M-wave, and VL M-wave were greater for femoral nerve than for direct quadriceps stimulation (P < 0.05). Despite a 50% decrease in MVC force, the amplitude of the M-waves increased significantly during exercise.

CONCLUSIONS

In addition to enhanced electrogenic Na(+) -K(+) pumping, other factors (such as synchronization in activation of muscle fibers and muscle architectural properties) may significantly influence the magnitude of M-wave enlargement.

Recruitment order of quadriceps motor units: femoral nerve vs. direct quadriceps stimulation

INTRODUCTION

To investigate potential differences in the recruitment order of motor units (MUs) in the quadriceps femoris when electrical stimulation is applied over the quadriceps belly versus the femoral nerve.

METHODS

M-waves and mechanical twitches were evoked using femoral nerve stimulation and direct quadriceps stimulation of gradually increasing intensity from 20 young, healthy subjects. Recruitment order was investigated by analysing the time-to-peak twitch and the time interval from the stimulus artefact to the M-wave positive peak (M-wave latency) for the vastus medialis (VM) and vastus lateralis (VL) muscles.

RESULTS

During femoral nerve stimulation, time-to-peak twitch and M-wave latency decreased consistently (P < 0.05) with increasing stimulus intensity, whereas, during graded direct quadriceps stimulation, time-to-peak twitch and VL M-wave latency did not show a clear trend (P > 0.05). For the VM muscle, M-wave latency decreased with increasing stimulation level for both femoral nerve and direct quadriceps stimulation, whereas, for the VL muscle, the variation of M-wave latency with stimulus intensity was different for the two stimulation geometries (P < 0.05).

CONCLUSIONS

Femoral nerve stimulation activated MUs according to the size principle, whereas the recruitment order during direct quadriceps stimulation was more complex, depending ultimately on the architecture of the peripheral nerve and its terminal branches below the stimulating electrodes for each muscle. For the VM, MUs were orderly recruited for both stimulation geometries, whereas, for the VL muscle, MUs were orderly recruited for femoral nerve stimulation, but followed no particular order for direct quadriceps stimulation.

Shortening behavior of the different components of muscle-tendon unit during isokinetic plantar flexions

The torque-velocity relationship has been widely considered as reflecting the mechanical properties of the contractile apparatus, and the influence of tendinous tissues on this relationship obtained during in vivo experiments remains to be determined. This study describes the pattern of shortening of various muscle-tendon unit elements of the triceps surae at different constant angular velocities and quantifies the contributions of fascicles, tendon, and aponeurosis to the global muscle-tendon unit shortening. Ten subjects performed isokinetic plantar flexions at different preset angular velocities (i.e., 30, 90, 150, 210, 270, and 330°/s). Ultrafast ultrasound measurements were performed on the muscle belly and on the myotendinous junction of the medial and lateral gastrocnemius muscles. The contributions of fascicles, tendon, and aponeurosis to global muscle-tendon unit shortening velocity were calculated for velocity conditions for four parts of the total range of motion. For both muscles, the fascicles' contribution decreased throughout the motion (73.5 ± 21.5% for 100–90° angular range to 33.7 ± 20.2% for 80–70°), whereas the tendon contribution increased (25.8 ± 15.4 to 55.6 ± 16.8%). In conclusion, the tendon contribution to the global muscle-tendon unit shortening is significant even during a concentric contraction. However, this contribution depends on the range of motion analyzed. The intersubject variability found in the maximal fascicle shortening velocity, for a given angular velocity, suggests that some subjects might possess a more efficient musculoarticular complex to produce the movement velocity. These findings are of great interest for understanding the ability of muscle-tendon shortening velocity.

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 role of hind limb tendons in gibbon locomotion: springs or strings?

Tendon properties have an important effect on the mechanical behaviour of muscles, with compliant tendons allowing near-isometric muscle contraction and facilitating elastic energy storage and recoil. Stiff tendons, in contrast, facilitate rapid force transfer and precise positional control. In humans, the long Achilles tendon contributes to the mechanical efficiency of running via elastic energy storage and recovery, and its presence has been linked to the evolution of habitual bipedalism. Gibbons also possess relatively long hind limb tendons; however, their role is as yet unknown. Based on their large dimensions, and inferring from the situation in humans, we hypothesize that the tendons in the gibbon hind limb will facilitate elastic energy storage and recoil during hind-limb-powered locomotion. To investigate this, we determined the material properties of the gibbon Achilles and patellar tendon in vitro and linked this with available kinematic and kinetic data to evaluate their role in leaping and bipedalism. Tensile tests were conducted on tendon samples using a material testing machine and the load-displacement data were used to calculate stiffness, Young's modulus and hysteresis. In addition, the average stress-in-life and energy absorption capacity of both tendons were estimated. We found a functional difference between the gibbon Achilles and patellar tendon, with the Achilles tendon being more suitable for elastic energy storage and release. The patellar tendon, in contrast, has a relatively high hysteresis, making it less suitable to act as elastic spring. This suggests that the gibbon Achilles tendon might fulfil a similar function as in humans, contributing to reducing the locomotor cost of bipedalism by acting as elastic spring, while the high stiffness of the patellar tendon might favour fast force transfer upon recoil and, possibly, enhance leaping performance.

Sex differences in rectus femoris morphology across different knee flexion positions

PURPOSEBACKGROUND: Quadriceps function is an important outcome following lower extremity injury and surgery. Measurements of quadriceps function are particularly helpful initially post surgery, however traditional quadriceps strength measures like isokinetic testing are contraindicated during this time period. Inclusion of dynamic musculoskeletal ultrasound imaging in the clinical setting has been beneficial in understanding quadriceps activation specifically rectus femoris (RF) contraction; however, there is a paucity of literature in this area. The purpose of the current study was to describe the cross-sectional area (CSA) of the RF across varying knee flexion angles.

METHODS

Forty-five adult recreational athletes were recruited for the study (21 males, 24 females). All subjects underwent tests of maximal volitional isometric contractions of the knee extensors at 0, 30, 60 and 90 degrees of knee flexion. During the trials, musculoskeletal ultrasound images of the RF at 15 cm from the superior pole of the patella were taken at rest and during contraction for each of the angular positions. Mixed model ANOVAs (angle x sex) were utilized to examine the differences between males and females for different angular positions. These analyses were conducted for the resting CSA, active CSA, and the contractile index (resting - active).

RESULTS

RF cross-sectional area increased with increasing angles of knee flexion for both the resting and active conditions. The contractile index consistently decreased as knee flexion angle increased. No statistically significant interactions or main effects for sex were observed, although differences were observed in the trajectories of the data sets for males and females.

CONCLUSIONS

RF CSA is dependent on knee flexion angle in both males and females. As a result, the assessment of RF CSA should be conducted in a standardized position if this variable is to be utilized as a meaningful measure of muscle size during rehabilitation. Additional research should seek out which factors are associated with clinically relevant factors that effect RF CSA across the range of knee flexion.

LEVEL OF EVIDENCE

3b.

Reliability and validity of ultrasound measurements of muscle fascicle length and pennation in humans: a systematic review

Ultrasound imaging is widely used to measure architectural features of human skeletal muscles in vivo. We systematically reviewed studies of the reliability and validity of two-dimensional ultrasound measurement of muscle fascicle lengths or pennation angles in human skeletal muscles. A comprehensive search was conducted in June 2011. Thirty-six reliability studies and six validity studies met the inclusion criteria. Data from these studies indicate that ultrasound measurements of muscle fascicle lengths are reliable across a broad range of experimental conditions [intraclass correlation coefficient (ICC) and r values were always > 0.6, and coefficient of variation values were always < 10%]. The reliability of measurements of pennation angles is broadly similar (ICC and r values were always > 0.5 and coefficient of variation values were always < 14%). Data on validity are less extensive and probably less robust, but suggest that measurement of fascicle lengths and pennation angles are accurate (ICC > 0.7) under certain conditions, such as when large limb muscles are imaged in a relaxed state and the limb or joint remains stationary. Future studies on validity should consider ways to test for the validity of two-dimensional ultrasound imaging in contracted or moving muscles and the best method of probe alignment.