Reliability and fatigue characteristics of a standing hip isometric endurance protocol

Validating the Cambridge Protocol: Reliability of Hip Muscle Strength Measurements Using a Motorized Dynamometer and Electromyography

BACKGROUND

Muscle weakness is common after injury in athletes and in the presence of hip pathology. It will cause abnormal hip biomechanics and can predict future injury. However, objective measurement of hip muscle strength is difficult to perform accurately and reliably. Therefore, it is challenging to determine when an athlete has returned to preinjury levels of strength. In addition, there is currently no standardized method of obtaining measurements, which prevents the data being compared or shared between research centers.

PURPOSE

The purpose of this study is to comprehensively assess the inter- and intraobserver reliability of our standardized muscle strength measurement protocol.

STUDY DESIGN

Descriptive laboratory study.

LEVEL OF EVIDENCE

Level 3, inception cohort study.

METHODS

A total of 16 healthy male volunteers (age = 28.3 ± 7.9 years) were recruited. Those with a previous history of hip injuries or disorders were excluded. These volunteers underwent strength testing according to the Cambridge Protocol on 4 separate occasions, performed by 2 independent assessors. Maximal voluntary contractions, fatigue torque fluctuations, and electromyography measurements were recorded. Intra- and interobserver reliability was assessed using intraclass correlation coefficient (ICC).

RESULTS

Good-to-excellent correlation was seen for both intra- and interobserver reliability across almost all hip movements for maximal contractions: ICC ranged 0.78 to 0.93 and 0.78 to 0.96, respectively. The standard error of the mean for all hip movements was also extremely low at 2% to 3%.

CONCLUSION

The Cambridge Protocol is a highly reliable method for objective measurement of hip muscle strength. We recommend future studies use this protocol, or the principles underpinning it, to enable data sharing and comparison across different studies.

CLINICAL RELEVANCE

This is a description and analysis of hip muscle strength measurement. If widely used, it will allow for accurate and objective strength assessment and closer monitoring of hip injuries and pathology.

Asymmetrical fatiguing of the gluteus maximus muscles in the elite short-track female skaters

Background

According to research, fast skating on short distances increases functional asymmetry of leg muscles. As has been proven in many sporting disciplines, this asymmetry can increase the risk of injury. The aim of the study was to analyze the level of right and left myolectrical manifestations of fatigue asymmetry of gluteus maximus muscle in elite skaters on a short track and to compare this phenomenon to a control group. The muscles were chosen deliberately, due to their influence in maintaining the right position during training on ice.

Methods

The experiment compared a group of eight members of the Polish Women’s National Team in short track with a group of eight non-training people. The subjects did the Biering-Sorensen test, in which sEMG (surface electromyography) signal frequency was measured in the gluteus maximus muscles during an isometric contraction. Myolectrical manifestations of fatigue slopes were analyzed with a ANOVA with repeated measures. In the skaters, the myolectrical manifestations of fatigue differed between the right and the left gluteus maximus muscles. All the skaters had higher myolectrical manifestations of fatigue in the right leg. This phenomenon was not observed in the non-training subjects, who on average had similar myolectrical manifestations of fatigue in both legs.

Results

Results showed that the right and the left muscles of the skaters in the experimental group differed in myolectrical manifestations of fatigue, but this difference was non-significant in the control group.

The subjects from the two groups did not differ in the myolectrical manifestations of fatigue of the left muscle, they did in the myolectrical manifestations of fatigue of the right muscle. The elite speed-track skaters had higher myolectrical manifestations of fatigue in the right muscle than the non-training subjects.

Conclusions

Training should thus be planned in a way that minimizes the risk of causing muscle myolectrical manifestations of fatigue asymmetry in skaters despite the typically asymmetrical muscle work during training on ice and competition, thus new training protocols should be developed or considered to decrease that asymmetry.

Trial registration

The tests were previously approved by the Bioethical Commission of the Chamber of Physicians in Opole. (Resolution No. 235 of 13 December 2016).

Can the Combination of Acute Alcohol Intake and One Night of Sleep Deprivation Affect Neuromuscular Performance in Healthy Male Adults? A Cross-over Randomized Controlled Trial

Rodrigues, R, Franke, RA, Teixeira, BC, Macedo, RCO, Diefenthaeler, F, Baroni, BM, and Vaz, MA. Can the combination of acute alcohol intake and one night of sleep deprivation affect neuromuscular performance in healthy male adults? A cross-over randomized controlled trial. J Strength Cond Res 33(5): 1244-1251, 2019-The aim of this work was to perform a cross-over study to compare isolated and combined effects of alcohol intake and sleep deprivation on neuromuscular responses. Ten young and physically active male subjects were allocated to 4 conditions: (a) placebo intake + normal sleep (PLA + SLE); (b) alcohol intake + normal sleep (ALC + SLE); (c) placebo intake + sleep deprivation (PLA + SDP); and (d) alcohol intake + sleep deprivation (ALC + SDP). In each condition, volunteers ingested 1 g of alcohol per kg of body mass of alcoholic beer or nonalcoholic beer (placebo), followed by one night of normal sleep or sleep deprivation. In the next morning, neuromuscular performance (knee extensor isometric and concentric peak torque and time to task failure during the endurance test) and muscle activation were assessed. No differences were observed in the neuromuscular performance. We observed a significant reduction in quadriceps activation during the knee extensor isometric test in ALC + SDP compared with PLA + SLE (-20.8%; p = 0.02; d = 0.56). Our results demonstrated that acute alcohol intake and one night of sleep deprivation reduced quadriceps muscle activation without impact on neuromuscular performance.

Immunomodulatory placental-expanded, mesenchymal stromal cells improve muscle function following hip arthroplasty

BACKGROUND

No regenerative approach has thus far been shown to be effective in skeletal muscle injuries, despite their high frequency and associated functional deficits. We sought to address surgical trauma-related muscle injuries using local intraoperative application of allogeneic placenta-derived, mesenchymal-like adherent cells (PLX-PAD), using hip arthroplasty as a standardized injury model, because of the high regenerative and immunomodulatory potency of this cell type.

METHODS

Our pilot phase I/IIa study was prospective, randomized, double blind, and placebo-controlled. Twenty patients undergoing hip arthroplasty via a direct lateral approach received an injection of 3.0 × 10⁸ (300 M, n = 6) or 1.5 × 10⁸ (150 M, n = 7) PLX-PAD or a placebo (n = 7) into the injured gluteus medius muscles.

RESULTS

We did not observe any relevant PLX-PAD-related adverse events at the 2-year follow-up. Improved gluteus medius strength was noted as early as Week 6 in the treatment-groups. Surprisingly, until Week 26, the low-dose group outperformed the high-dose group and reached significantly improved strength compared with placebo [150 M vs. placebo: P = 0.007 (baseline adjusted; 95% confidence interval 7.6, 43.9); preoperative baseline values mean ± SE: placebo: 24.4 ± 6.7 Nm, 150 M: 27.3 ± 5.6 Nm], mirrored by an increase in muscle volume [150 M vs. placebo: P = 0.004 (baseline adjusted; 95% confidence interval 6.0, 30.0); preoperative baseline values GM volume: placebo: 211.9 ± 15.3 cm³ , 150 M: 237.4 ± 27.2 cm³ ]. Histology indicated accelerated healing after cell therapy. Biomarker studies revealed that low-dose treatment reduced the surgery-related immunological stress reaction more than high-dose treatment (exemplarily: CD16+ NK cells: Day 1 P = 0.06 vs. placebo, P = 0.07 vs. 150 M; CD4+ T-cells: Day 1 P = 0.04 vs. placebo, P = 0.08 vs. 150 M). Signs of late-onset immune reactivity after high-dose treatment corresponded to reduced functional improvement.

CONCLUSIONS

Allogeneic PLX-PAD therapy improved strength and volume of injured skeletal muscle with a reasonable safety profile. Outcomes could be positively correlated with the modulation of early postoperative stress-related immunological reactions.

A Comparative Study of EMG Indices in Muscle Fatigue Evaluation Based on Grey Relational Analysis during All-Out Cycling Exercise

The increased popularization of cycling has brought an increase in cycling-related injuries, which has been suggested to be associated with muscle fatigue. However, it still remains unclear on the utility of different EMG indices in muscle fatigue evaluation induced by cycling exercise. In this study, ten cyclist volunteers performed a 30-second all-out cycling exercise after a warm-up period. Surface electromyography (sEMG) from vastus lateralis muscle (VL) and power output and cadence were recorded and EMG RMS, MF and MPF based on Fourier Transform, MDF and MNF based on wavelet packet transformation, and C(n) based on Lempel–Ziv complexity algorithm were calculated. Utility of the indices was compared based on the grey rational grade of sEMG indices and power output and cadence. The results suggested that MNF derived from wavelet packet transformation was significantly higher than other EMG indices, indicating the potential application for fatigue evaluation induced by all-out cycling exercise.

Predicting muscle fatigue: a response surface approximation based on proper generalized decomposition technique

A novel technique is proposed to predict force reduction in skeletal muscle due to fatigue under the influence of electrical stimulus parameters and muscle physiological characteristics. Twelve New Zealand white rabbits were divided in four groups ([Formula: see text]) to obtain the active force evolution of in vitro Extensor Digitorum Longus muscles for an hour of repeated contractions under different electrical stimulation patterns. Left and right muscles were tested, and a total of 24 samples were used to construct a response surface based in the proper generalized decomposition. After the response surface development, one additional rabbit was used to check the predictive potential of the technique. This multidimensional surface takes into account not only the decay of the maximum repeated peak force, but also the shape evolution of each contraction, muscle weight, electrical input signal and stimulation protocol. This new approach of the fatigue simulation challenge allows to predict, inside the multispace surface generated, the muscle response considering other stimulation patterns, different tissue weight, etc.