Group III and IV muscle afferents: Role on central motor drive and clinical implications

Blood flow restriction increases necessary muscle excitation of the elbow flexors during a single high-load contraction

PURPOSE

To investigate the effects of blood flow restriction (BFR) on electromyographic amplitude (EMGRMS)-force relationships of the biceps brachii (BB) during a single high-load muscle action.

METHODS

Twelve recreationally active males and eleven recreationally active females performed maximal voluntary contractions (MVCs), followed by an isometric trapezoidal muscle action of the elbow flexors at 70% MVC. Surface EMG was recorded from the BB during BFR and control (CON) visits. For BFR, cuff pressure was 60% of the pressure required to completely occlude blood at rest. Individual b (slope) and a terms (gain) were calculated from the log-transformed EMGRMS-force relationships during the linearly increasing and decreasing segments of the trapezoid. EMGRMS during the steady force segment was normalized to MVC EMGRMS.

RESULTS

For BFR, the b terms were greater during the linearly increasing segment than the linearly decreasing segment (p < 0.001), and compared to the linearly increasing segment for CON (p < 0.001). The a terms for BFR were greater during the linearly decreasing than linearly increasing segment (p = 0.028). Steady force N-EMGRMS was greater for BFR than CON collapsed across sex (p = 0.041).

CONCLUSION

BFR likely elicited additional recruitment of higher threshold motor units during the linearly increasing- and steady force-segment. The differences between activation and deactivation strategies were only observed with BFR, such as the b terms decreased and the a terms increased for the linearly decreasing segment in comparison to the increasing segment. However, EMGRMS-force relationships during the linearly increasing- and decreasing-segments were not different between sexes during BFR and CON.

Ischemic preconditioning increases spinal excitability and voluntary activation during maximal plantar flexion contractions in men

The enigmatic benefits of acute limb ischemic preconditioning (IP) in enhancing muscle force and exercise performance have intrigued researchers. This study sought to unravel the underlying mechanisms, focusing on increased neural drive and the role of spinal excitability while excluding peripheral factors. Soleus Hoffmann (H)-reflex /M-wave recruitment curves and unpotentiated supramaximal responses were recorded before and after IP or a low-pressure control intervention. Subsequently, the twitch interpolation technique was applied during maximal voluntary contractions to assess conventional parameters of neural output. Following IP, there was an increase in both maximum normalized force and voluntary activation (VA) for the plantar flexor group, with negligible peripheral alterations. Greater benefits were observed in participants with lower VA levels. Despite greater H-reflex gains, soleus volitional (V)-wave and sEMG amplitudes remained unchanged. In conclusion, IP improves muscle force via enhanced neural drive to the muscles. This effect appears associated, at least in part, to reduced presynaptic inhibition and/or increased motoneuron excitability. Furthermore, the magnitude of the benefit is inversely proportional to the skeletal muscle's functional reserve, making it particularly noticeable in under-recruited muscles. These findings have implications for the strategic application of the IP procedure across diverse populations.

Involvement of the Transient Receptor Channels in Preclinical Models of Musculoskeletal Pain

BACKGROUND

Musculoskeletal pain is a condition that affects bones, muscles, and tendons and is present in various diseases and/or clinical conditions. This type of pain represents a growing problem with enormous socioeconomic impacts, highlighting the importance of developing treatments tailored to the patient's needs. TRP is a large family of non-selective cation channels involved in pain perception. Vanilloid (TRPV1 and TRPV4), ankyrin (TRPA1), and melastatin (TRPM8) are involved in physiological functions, including nociception, mediation of neuropeptide release, heat/cold sensing, and mechanical sensation.

OBJECTIVE

In this context, we provide an updated view of the most studied preclinical models of muscle hyperalgesia and the role of transient receptor potential (TRP) in these models.

METHODS

This review describes preclinical models of muscle hyperalgesia induced by intramuscular administration of algogenic substances and/or induction of muscle damage by physical exercise in the masseter, gastrocnemius, and tibial muscles.

RESULTS

The participation of TRPV1, TRPA1, and TRPV4 in different models of musculoskeletal pain was evaluated using pharmacological and genetic tools. All the studies detected the antinociceptive effect of respective antagonists or reduced nociception in knockout mice.

CONCLUSION

Hence, TRPV1, TRPV4, and TRPA1 blockers could potentially be utilized in the future for inducing analgesia in muscle hypersensitivity pathologies.

The role of clinical neurophysiology in the definition and assessment of fatigue and fatigability

Though a common symptom, fatigue is difficult to define and investigate, occurs in a wide variety of neurological and systemic disorders, with differing pathological causes. It is also often accompanied by a psychological component. As a symptom of long-term COVID-19 it has gained more attention. In this review, we begin by differentiating fatigue, a perception, from fatigability, quantifiable through biomarkers. Central and peripheral nervous system and muscle disorders associated with these are summarised. We provide a comprehensive and objective framework to help identify potential causes of fatigue and fatigability in a given disease condition. It also considers the effectiveness of neurophysiological tests as objective biomarkers for its assessment. Among these, twitch interpolation, motor cortex stimulation, electroencephalography and magnetencephalography, and readiness potentials will be described for the assessment of central fatigability, and surface and needle electromyography (EMG), single fibre EMG and nerve conduction studies for the assessment of peripheral fatigability. The purpose of this review is to guide clinicians in how to approach fatigue, and fatigability, and to suggest that neurophysiological tests may allow an understanding of their origin and interactions. In this way, their differing types and origins, and hence their possible differing treatments, may also be defined more clearly.

The neural pathway of the hyperthermic response to antagonists of the transient receptor potential vanilloid-1 channel

We identified the neural pathway of the hyperthermic response to TRPV1 antagonists. We showed that hyperthermia induced by i.v. AMG0347, AMG 517, or AMG8163 did not occur in rats with abdominal sensory nerves desensitized by pretreatment with a low i.p. dose of resiniferatoxin (RTX, TRPV1 agonist). However, neither bilateral vagotomy nor bilateral transection of the greater splanchnic nerve attenuated AMG0347-induced hyperthermia. Yet, this hyperthermia was attenuated by bilateral high cervical transection of the spinal dorsolateral funiculus (DLF). To explain the extra-splanchnic, spinal mediation of TRPV1 antagonist-induced hyperthermia, we proposed that abdominal signals that drive this hyperthermia originate in skeletal muscles - not viscera. If so, in order to prevent TRPV1 antagonist-induced hyperthermia, the desensitization caused by i.p. RTX should spread into the abdominal-wall muscles. Indeed, we found that the local hypoperfusion response to capsaicin (TRPV1 agonist) in the abdominal-wall muscles was absent in i.p. RTX-desensitized rats. We then showed that the most upstream (lateral parabrachial, LPB) and the most downstream (rostral raphe pallidus) nuclei of the intrabrain pathway that controls autonomic cold defenses are also required for the hyperthermic response to i.v. AMG0347. Injection of muscimol (inhibitor of neuronal activity) into the LPB or injection of glycine (inhibitory neurotransmitter) into the raphe blocked the hyperthermic response to i.v. AMG0347, whereas i.v. AMG0347 increased the number of c-Fos cells in the raphe. We conclude that the neural pathway of TRPV1 antagonist-induced hyperthermia involves TRPV1-expressing sensory nerves in trunk muscles, the DLF, and the same LPB-raphe pathway that controls autonomic cold defenses.

Fatigue and Human Performance: An Updated Framework

Fatigue has been defined differently in the literature depending on the field of research. The inconsistent use of the term fatigue complicated scientific communication, thereby limiting progress towards a more in-depth understanding of the phenomenon. Therefore, Enoka and Duchateau (Med Sci Sports Exerc 48:2228-38, 2016, [3]) proposed a fatigue framework that distinguishes between trait fatigue (i.e., fatigue experienced by an individual over a longer period of time) and motor or cognitive task-induced state fatigue (i.e., self-reported disabling symptom derived from the two interdependent attributes performance fatigability and perceived fatigability). Thereby, performance fatigability describes a decrease in an objective performance measure, while perceived fatigability refers to the sensations that regulate the integrity of the performer. Although this framework served as a good starting point to unravel the psychophysiology of fatigue, several important aspects were not included and the interdependence of the mechanisms driving performance fatigability and perceived fatigability were not comprehensively discussed. Therefore, the present narrative review aimed to (1) update the fatigue framework suggested by Enoka and Duchateau (Med Sci Sports Exerc 48:2228-38, 2016, [3]) pertaining the taxonomy (i.e., cognitive performance fatigue and perceived cognitive fatigue were added) and important determinants that were not considered previously (e.g., effort perception, affective valence, self-regulation), (2) discuss the mechanisms underlying performance fatigue and perceived fatigue in response to motor and cognitive tasks as well as their interdependence, and (3) provide recommendations for future research on these interactions. We propose to define motor or cognitive task-induced state fatigue as a psychophysiological condition characterized by a decrease in motor or cognitive performance (i.e., motor or cognitive performance fatigue, respectively) and/or an increased perception of fatigue (i.e., perceived motor or cognitive fatigue). These dimensions are interdependent, hinge on different determinants, and depend on body homeostasis (e.g., wakefulness, core temperature) as well as several modulating factors (e.g., age, sex, diseases, characteristics of the motor or cognitive task). Consequently, there is no single factor primarily determining performance fatigue and perceived fatigue in response to motor or cognitive tasks. Instead, the relative weight of each determinant and their interaction are modulated by several factors.

Enhanced nociceptive behavior and expansion of associated primary afferents in a rabbit model of cerebral palsy

Spastic cerebral palsy (CP) is a movement disorder marked by hypertonia and hyperreflexia; the most prevalent comorbidity is pain. Since spinal nociceptive afferents contribute to both the sensation of painful stimuli as well as reflex circuits involved in movement, we investigated the relationship between prenatal hypoxia-ischemia (HI) injury which can cause CP, and possible changes in spinal nociceptive circuitry. To do this, we examined nociceptive afferents and mechanical and thermal sensitivity of New Zealand White rabbit kits after prenatal HI or a sham surgical procedure. As described previously, a range of motor deficits similar to spastic CP was observed in kits born naturally after HI (40 min at ~70%-80% gestation). We found that HI caused an expansion of peptidergic afferents (marked by expression of calcitonin gene-related peptide) in both the superficial and deep dorsal horn at postnatal day (P)5. Non-peptidergic nociceptive afferent arborization (labeled by isolectin B4) was unaltered in HI kits, but overlap of the two populations (peptidergic and non-peptidergic nociceptors) was increased by HI. Density of glial fibrillary acidic protein was unchanged within spinal cord white matter regions important in nociceptive transmission at P5. We found that mechanical and thermal nociception was enhanced in HI kits even in the absence of motor deficits. These findings suggest that prenatal HI injury impacts spinal sensory pathways in addition to the more well-established disruptions to descending motor circuits. In conclusion, changes to spinal nociceptive circuitry could disrupt spinal reflexes and contribute to pain experienced by individuals with CP.

Disparate Mechanisms of Fatigability in Response to Prolonged Running versus Cycling of Matched Intensity and Duration

INTRODUCTION

Running and cycling represent two of the most common forms of endurance exercise. However, a direct comparison of the neuromuscular consequences of these two modalities after prolonged exercise has never been made. The aim of this study was to compare the alterations in neuromuscular function induced by matched-intensity and duration cycling and running exercise.

METHODS

During separate visits, 17 endurance-trained male participants performed 3 h of cycling and running at 105% of the gas exchange threshold. Neuromuscular assessments were taken are preexercise, midexercise, and postexercise, including knee extensor maximal voluntary contractions (MVC), voluntary activation (VA), high- and low-frequency doublets (Db100 and Db10, respectively), potentiated twitches (Qtw,pot), motor evoked potentials (MEP), and thoracic motor evoked potentials (TMEP).

RESULTS

After exercise, MVC was similarly reduced by ~25% after both running and cycling. However, reductions in VA were greater after running (-16% ± 10%) than cycling (-10% ± 5%; P < 0.05). Similarly, reductions in TMEP were greater after running (-78% ± 24%) than cycling (-15% ± 60%; P = 0.01). In contrast, reductions in Db100 (running vs cycling, -6% ± 21% vs -13% ± 6%) and Db10:100 (running vs cycling, -6% ± 16% vs -19% ± 13%) were greater for cycling than running (P ≤ 0.04).

CONCLUSIONS

Despite similar decrements in the knee extensor MVC after running and cycling, the mechanisms responsible for force loss differed. Running-based endurance exercise is associated with greater impairments in nervous system function, particularly at the spinal level, whereas cycling-based exercise elicits greater impairments in contractile function. Differences in the mechanical and metabolic demands imposed on the quadriceps could explain the disparate mechanisms of neuromuscular impairment after these two exercise modalities.

Brain oxygenation during multiple sets of isometric and dynamic resistance exercise of equivalent workloads: Association with systemic haemodynamics

Brain function relies on sufficient blood flow and oxygen supply. Changes in cerebral oxygenation during exercise have been linked to brain activity and central command. Isometric- and dynamic-resistance exercise-(RE) may elicit differential responses in systemic circulation, neural function and metabolism; all important regulators of cerebral circulation. We examined whether (i) cerebral oxygenation differs between isometric- and dynamic-RE of similar exercise characteristics and (ii) cerebral oxygenation changes relate to cardiovascular adjustments occurring during RE. Fourteen men performed, randomly, an isometric-RE and a dynamic-RE of similar characteristics (bilateral-leg-press, 2-min×4-sets, 30% of maximal-voluntary-contraction, equivalent tension-time-index/workload). Cerebral-oxygenation (oxyhaemoglobin-O₂Hb; total haemoglobin-tHb/blood-volume-index; deoxyhemoglobin-HHb) was assessed by NIRS and beat-by-beat haemodynamics via photoplethysmography. Cerebral-O₂Hb and tHb progressively increased from the 1st to 4th set in both RE-protocols (p < 0.05); HHb slightly decreased (p < 0.05). Changes in NIRS-parameters were similar between RE-protocols within each exercise-set (p = 0.91-1.00) and during the entire protocol (including resting-phases) (p = 0.48-0.63). O₂Hb and tHb changes were not correlated with changes in systemic haemodynamics. In conclusion, cerebral oxygenation/blood-volume steadily increased during multiple-set RE-protocols. Isometric- and dynamic-RE of matched exercise characteristics resulted in similar prefrontal oxygenation/blood volume changes, suggesting similar cerebral haemodynamic and possibly neuronal responses to maintain a predetermined force.

Effects of low load exercise with and without blood-flow restriction on microvascular oxygenation, muscle excitability and perceived pain

This paper aimed to examine the acute effect of low-load (LL) exercise with blood-flow restriction (LL-BFR) on microvascular oxygenation and muscle excitability of the vastus medialis (VM) and vastus lateralis (VL) muscles during a single bout of unilateral knee extension exercise performed to task failure. Seventeen healthy recreationally resistance-trained males were enrolled in a within-group randomized cross-over study design. Participants performed one set of unilateral knee extensions at 20% of one-repetition maximum (1RM) to task failure, using a LL-BFR or LL free-flow (LL-FF) protocol in a randomized order on separate days. Changes in microvascular oxygenation and muscle excitability in VL and VM were assessed using near-infrared spectroscopy (NIRS) and surface electromyography (sEMG), respectively. Pain measures were collected using the visual analog scale (VAS) before and following set completion. Within- and between- protocol comparisons were performed at multiple time points of set completion for each muscle. During LL-BFR, participants performed 43% fewer repetitions and reported feeling more pain compared to LL-FF (p<0.05). Normalized to time to task failure, LL-BFR and LL-FF generally demonstrated similar progression in microvascular oxygenation and muscle excitability during exercise to task failure. The present results demonstrate that LL-BFR accelerates time to task failure, compared with LL-FF, resulting in a lower dose of mechanical work to elicit similar levels of oxygenation, blood-pooling, and muscle excitability. LL-BFR may be preferable to LL-FF in clinical settings where high workloads are contraindicated, although increased pain experienced during BFR may limit its application.HighlightsCompared to free flow (FF), neuromuscular fatigue mechanisms are accelerated during blood flow restricted (BFR) training. This can be observed as changes in microvascular oxygenation and muscle excitability occurring at a ∼43% faster mean rate during BFR compared to FF.BFR exercise seems to elicit the same level of neuromuscular fatigue as FF training within a shorter timeframe. This reduces total joint load and may be especially helpful in cases where high training volumes may be contraindicated (e.g. recovering from a sports injury or orthopedic surgery).

Is there Evidence for the Suggestion that Fatigue Accumulates Following Resistance Exercise?

It has been suggested that improper post-exercise recovery or improper sequence of training may result in an 'accumulation' of fatigue. Despite this suggestion, there is a lack of clarity regarding which physiological mechanisms may be proposed to contribute to fatigue accumulation. The present paper explores the time course of the changes in various fatigue-related measures in order to understand how they may accumulate or lessen over time following an exercise bout or in the context of an exercise program. Regarding peripheral fatigue, the depletion of energy substrates and accumulation of metabolic byproducts has been demonstrated to occur following an acute bout of resistance training; however, peripheral accumulation and depletion appear unlikely candidates to accumulate over time. A number of mechanisms may contribute to the development of central fatigue, postulating the need for prolonged periods of recovery; however, a time course is difficult to determine and is dependent on which measurement is examined. In addition, it has not been demonstrated that central fatigue measures accumulate over time. A potential candidate that may be interpreted as accumulated fatigue is muscle damage, which shares similar characteristics (i.e., prolonged strength loss). Due to the delayed appearance of muscle damage, it may be interpreted as accumulated fatigue. Overall, evidence for the presence of fatigue accumulation with resistance training is equivocal, making it difficult to draw the conclusion that fatigue accumulates. Considerable work remains as to whether fatigue can accumulate over time. Future studies are warranted to elucidate potential mechanisms underlying the concept of fatigue accumulation.

Plasticity in Cervical Motor Circuits following Spinal Cord Injury and Rehabilitation

Simple Summary

Spinal cord injury results in a decreased quality of life and impacts hundreds of thousands of people in the US alone. This review discusses the underlying cellular mechanisms of injury and the concurrent therapeutic hurdles that impede recovery. It then describes the phenomena of neural plasticity—the nervous system’s ability to change. The primary focus of the review is on the impact of cervical spinal cord injury on control of the upper limbs. The neural plasticity that occurs without intervention is discussed, which shows new connections growing around the injury site and the involvement of compensatory movements. Rehabilitation-driven neural plasticity is shown to have the ability to guide connections to create more normal functions. Various novel stimulation and recording technologies are outlined for their role in further improving rehabilitative outcomes and gains in independence. Finally, the importance of sensory input, an often-overlooked aspect of motor control, is shown in driving neural plasticity. Overall, this review seeks to delineate the historical and contemporary research into neural plasticity following injury and rehabilitation to guide future studies.

Abstract

Neuroplasticity is a robust mechanism by which the central nervous system attempts to adapt to a structural or chemical disruption of functional connections between neurons. Mechanical damage from spinal cord injury potentiates via neuroinflammation and can cause aberrant changes in neural circuitry known as maladaptive plasticity. Together, these alterations greatly diminish function and quality of life. This review discusses contemporary efforts to harness neuroplasticity through rehabilitation and neuromodulation to restore function with a focus on motor recovery following cervical spinal cord injury. Background information on the general mechanisms of plasticity and long-term potentiation of the nervous system, most well studied in the learning and memory fields, will be reviewed. Spontaneous plasticity of the nervous system, both maladaptive and during natural recovery following spinal cord injury is outlined to provide a baseline from which rehabilitation builds. Previous research has focused on the impact of descending motor commands in driving spinal plasticity. However, this review focuses on the influence of physical therapy and primary afferent input and interneuron modulation in driving plasticity within the spinal cord. Finally, future directions into previously untargeted primary afferent populations are presented.

The influence of rotational movement exercise on the abdominal muscle thickness and trunk mobility - Randomized control trial

BACKGROUND

Trunk rotations are important functional movements which form the foundations of human motion pattern, especially in the functions of walking and running. They prevent the functional impairments and structural lesions resulting from axial overloading in static positions such as sitting.

OBJECTIVES

The aim of the study was to assess the influence of rotational movement training exercises on the abdominal muscle thickness and spinal mobility range.

STUDY DESIGN

Randomized controlled trial.

METHODS

The study involved 73 individuals aged 18-45. The subjects were randomly divided into two groups. The study group (TG) comprised 40 people who performed rotational movement exercises over the period of 4 weeks (16 training sessions). In the control group (CG) the training was not applied. Changes in the thickness of selected abdominal muscles on ultrasound imaging were evaluated, as well as trunk mobility, based on the trunk lateral flexion test.

RESULTS

The analysis of the obtained data has demonstrated a statistically significant increase in the thickness of the abdominal internal (IO) (p < 0.05) and external oblique muscles (EO) (p < 0.001) in the study group (TG) between measurements I and II, and measurements I and III. A similar increase in the thickness was found in the summation measurement of TrA + IO + EO. Bilateral increase in the trunk lateral flexion range in the frontal plane has also been noted.

CONCLUSIONS

Rotational movement training of the trunk leads to an increase in the thickness of the abdominal oblique muscles. Rotational movement exercise training increases trunk mobility in the frontal plane.

Effects of experimentally induced muscle pain on endurance performance: A proof-of-concept study assessing neurophysiological and perceptual responses

Pain arising from exercise potentiates fatigue and impairs the performance of endurance exercise. We assessed neurophysiological and perceptual responses to endurance exercise performed under experimentally induced muscle pain by a model that separates muscle pain from muscle fatigue. After a series of pilot studies investigating different hypertonic saline volumes, 17 healthy males performed a preliminary VO_2PEAK test before performing a familiarization of the cycling time-to-exhaustion exercise (80% of the peak power output in the VO_2PEAK test). Participants, performed a baseline exercise session before the sessions with hypertonic and isotonic saline injections in the vastus lateralis of both legs, in a crossover and counterbalanced design. Neurophysiological and perceptual responses such as electroencephalography (EEG) in frontal, prefrontal, parietal, and motor cortex, electromyography (EMG) of the vastus lateralis and biceps femoris muscles, ratings of perceived exertion (RPE), pain sensation, and affective valence were measured at rest and during exercise. The hypertonic injection reduced the resting EEG alpha-beta ratio in the frontal and prefrontal cortex. When compared to exercise performed after the isotonic injection (430.5 ± 152.6 s), hypertonic injection shortened the time-to-exhaustion (357.5 ± 173.0 s), reduced the EMG of the assessed muscles, and increased the muscle co-contraction during exercise. The hypertonic injection also reduced the EEG alpha-beta ratio in the prefrontal and parietal cortex, increased RPE and pain sensation, and reduced affective valence during exercise. This proof-of-concept study showed that hypertonic injection-induced muscle pain reduced endurance performance, promoting centrally mediated alterations in motor command and cortical activation, as well as an interplay of perceptual responses.

Effects of Lactate on One Class of Group III (CT3) Muscle Afferents

A class of Group III muscle afferent neurons has branching sensory terminals in the connective tissue between layers of mouse abdominal muscles (“CT3 muscle afferents”). These sensory endings are both mechanosensitive and metabosensitive. In the present study, responses of CT3 afferents to lactate ions and changes in temperature were recorded. Raising muscle temperature from 32.7°C to 37°C had no consistent effects on CT3 afferent basal firing rate or responses to either von Frey hair stimulation or to an applied load. Superfusion with lactate ions (15 mM, pH 7.4) was associated with an increase in firing from 6 ± 0.7 Hz to 11.7 ± 6.7 Hz (14 units, n = 13, P < 0.05, P = 0.0484) but with considerable variability in the nature and latency of response. Reducing the concentration of extracellular divalent cations, which mimicked the chelating effects of lactate, did not increase firing. Raised concentrations of divalent cations (to compensate for chelation) did not block excitatory effects of lactate on CT3 afferents, suggesting that effects via ASIC3 were not involved. Messenger RNA for the G-protein coupled receptor, hydroxyl carboxylic acid receptor 1 (HCAR1) was detected in dorsal root ganglia and HCAR1-like immunoreactivity was present in spinal afferent nerve cell bodies retrogradely labeled from mouse abdominal muscles. HCAR1-like immunoreactivity was also present in axons in mouse abdominal muscles. This raises the possibility that some effects of lactate on group III muscle afferents may be mediated by HCAR1.

Impact of Experimental Tonic Pain on Corrective Motor Responses to Mechanical Perturbations

Movement is altered by pain, but the underlying mechanisms remain unclear. Assessing corrective muscle responses following mechanical perturbations can help clarify these underlying mechanisms, as these responses involve spinal (short-latency response, 20-50 ms), transcortical (long-latency response, 50-100 ms), and cortical (early voluntary response, 100-150 ms) mechanisms. Pairing mechanical (proprioceptive) perturbations with different conditions of visual feedback can also offer insight into how pain impacts on sensorimotor integration. The general aim of this study was to examine the impact of experimental tonic pain on corrective muscle responses evoked by mechanical and/or visual perturbations in healthy adults. Two sessions (Pain (induced with capsaicin) and No pain) were performed using a robotic exoskeleton combined with a 2D virtual environment. Participants were instructed to maintain their index in a target despite the application of perturbations under four conditions of sensory feedback: (1) proprioceptive only, (2) visuoproprioceptive congruent, (3) visuoproprioceptive incongruent, and (4) visual only. Perturbations were induced in either flexion or extension, with an amplitude of 2 or 3 Nm. Surface electromyography was recorded from Biceps and Triceps muscles. Results demonstrated no significant effect of the type of sensory feedback on corrective muscle responses, no matter whether pain was present or not. When looking at the effect of pain on corrective responses across muscles, a significant interaction was found, but for the early voluntary responses only. These results suggest that the effect of cutaneous tonic pain on motor control arises mainly at the cortical (rather than spinal) level and that proprioception dominates vision for responses to perturbations, even in the presence of pain. The observation of a muscle-specific modulation using a cutaneous pain model highlights the fact that the impacts of pain on the motor system are not only driven by the need to unload structures from which the nociceptive signal is arising.

Total Knee Arthroplasty with a Ti6Al4V/PEEK Prosthesis on an Osteoarthritis Rat Model: Behavioral and Neurophysiological Analysis

Arthroplasty is a surgical procedure to restore the function of the joint of patient suffering from knee osteoarthritis. However, postoperative functional deficits are reported even after a rehabilitation program. In order to determine the origin of functional deficits of patient suffering from knee osteoarthritis and total knee arthroplasty, we developed a rodent model including a chemically-induced-osteoarthritis and designed a knee prosthesis (Ti6Al4V/PEEK) biomechanically and anatomically adapted to rat knee joint. Dynamic Weight-Bearing, gait kinematics, H-reflex from vastus medialis muscle and activities from metabosensitive III and IV afferent fibers in femoral nerve were assessed at 1 and 3 months post-surgery. Results indicate that knee osteoarthritis altered considerably the responses of afferent fibers to their known activators (i.e., lactic acid and potassium chloride) and consequently their ability to modulate the spinal sensorimotor loop, although, paradoxically, motor deficits seemed relatively light. On the contrary, results indicate that, after the total knee arthroplasty, the afferent responses and the sensorimotor function were slightly altered but that motor deficits were more severe. We conclude that neural changes attested by the recovery of the metabosensitive afferent activity and the sensorimotor loop were induced when a total knee replacement was performed and that these changes may disrupt or delay the locomotor recovery.

Exercise intolerance and fatigue in chronic heart failure: is there a role for group III/IV afferent feedback?

Exercise intolerance and early fatiguability are hallmark symptoms of chronic heart failure. While the malfunction of the heart is certainly the leading cause of chronic heart failure, the patho-physiological mechanisms of exercise intolerance in these patients are more complex, multifactorial and only partially understood. Some evidence points towards a potential role of an exaggerated afferent feedback from group III/IV muscle afferents in the genesis of these symptoms. Overactivity of feedback from these muscle afferents may cause exercise intolerance with a double action: by inducing cardiovascular dysregulation, by reducing motor output and by facilitating the development of central and peripheral fatigue during exercise. Importantly, physical inactivity appears to affect the progression of the syndrome negatively, while physical training can partially counteract this condition. In the present review, the role played by group III/IV afferent feedback in cardiovascular regulation during exercise and exercise-induced muscle fatigue of healthy people and their potential role in inducing exercise intolerance in chronic heart failure patients will be summarised.

Effect of fatigue-related group III/IV afferent firing on intracortical inhibition and facilitation in hand muscles

Fatiguing exercise causes a reduction in motor drive to the muscle. Group III/IV muscle afferent firing is thought to contribute to this process; however, the effect on corticospinal and intracortical networks is poorly understood. In two experiments, participants performed sustained maximal isometric finger abductions of the first dorsal interosseous (FDI) muscle, with postexercise blood flow occlusion (OCC) to maintain the firing of group III/IV afferents or without occlusion (control; CON). Before and after exercise, single- and paired-pulse transcranial magnetic stimulation (TMS) tested motor evoked potentials (MEPs), intracortical facilitation [ICF (12 ms)], and short-interval intracortical inhibition [SICI₂ (2 ms), SICI₃ (3 ms)]. Ulnar nerve stimulation elicited maximal M waves (M_MAX). For experiment 1 (n = 16 participants), TMS intensities were 70% and 120% of resting motor threshold (RMT) for the conditioning and MEP stimuli, respectively. For experiment 2 (n = 16 participants), the MEP was maintained at 1 mV before and after exercise and the conditioning stimulus individualized. In experiment 1, MEP/M_MAX was reduced after exercise (~48%, P = 0.007) but was not different between conditions. No changes occurred in ICF or SICI. In experiment 2, MEP/M_MAX increased (~27%, P = 0.027) and less inhibition (SICI₂: ~21%, P = 0.021) occurred after exercise for both conditions, whereas ICF decreased for CON only (~28%, P = 0.006). MEPs and SICI₂ were modulated by fatiguing contractions but not by group III/IV afferent firing, whereas sustained afferent firing appeared to counteract postexercise reductions in ICF in FDI. The findings do not support the idea that actions of group III/IV afferents on motor cortical networks contribute to the reduction in voluntary activation observed in other studies.NEW & NOTEWORTHY This is the first study to investigate, in human hand muscles, the action of fatigue-related group III/IV muscle afferent firing on intracortical facilitation and inhibition. In fatigued and nonexercised hand muscles, intracortical inhibition is reduced after exercise but is not modulated differently by the firing of group III/IV afferents. However, facilitation is maintained for the fatigued muscle when group III/IV afferents fire, but these results are unlikely to explain the reduction in voluntary activation observed in other studies.

Effects of intracerebroventricular injection of vitamin B12 on formalin-induced muscle pain in rats: Role of cyclooxygenase pathway and opioid receptors

Vitamin B₁₂ modulates pain at the local and peripheral levels. This study has investigated the effects of intracerebroventricular (ICV) injection of vitamin B₁₂ on themuscle pain. We used diclofenac (cyclooxygenase inhibitor) and naloxone (opioid receptors antagonist) to clarify the possible mechanisms. For ICV injections, a guide cannula was implanted in the left lateral ventricle of the brain. Muscle pain was induced by intramuscular injection of formalin (2.50%; 50 µl) in the right gastrocnemius muscle and the number of paw flinching was recorded at 5-min blocks for 60 min. Locomotor activity was performed using an open-field test. Formalin induced a biphasic pain. Vitamin B₁₂ (1.25, 2.50, 5.00 and 10.00 µg per rat) and diclofenac (12.50 and 25.00 µg per rat) significantly reduced both phases pain intensity. Significant antinociceptive effects were observed after combined treatments of diclofenac (6.25 and 12.50 µg per rat) with vitamin B₁₂ (0.63 and 2.50 µg per rat), respectively. Prior ICV injection of naloxone (10.00 µg per rat) prevented vitamin B₁₂ (10.00 µg per rat) and diclofenac (25.00 µg per rat) induced antinociceptive effects. All the above-mentioned chemicals did not alter locomotor behavior in an open-field test. The present results showed that the cyclooxygenase pathway and opioid receptors may be involved in the central antinociceptive effect of vitamin B₁₂. In addition, opioid receptors might be involved in diclofenac-induced antinociception.

Alteration of Metabosensitive Afferent Response With Aging: Exercised versus Non-exercised Rats

This study was designed to evaluate the effect of aging on the activity of metabosensitive afferent fibers (thin muscle afferents from group III and IV) and to determine if physical activity performed at old age may influence the afferent discharge. Afferents from tibialis anterior and soleus muscles were recorded on non-exercised rats aged of 3, 6, 12, and 20 months and on animals aged of 12 and 20 months performing a daily incremental treadmill exercise protocol during the last 8 weeks preceding the recordings. Metabosensitive afferent fibers were activated with potassium chloride (KCl) and lactic acid (LA) injections into the blood stream or by muscle electrically-induced fatigue (EIF). Results indicated that aging is associated to a decrease in the magnitude of the responses to chemical injections and EIF. Unfortunately, physical activity did not allow restoring the metabosensitive afferents responses. These results indicate an alteration of the thin afferent fibers with aging and should be taken into account regarding the management of muscle fatigue and potential alterations of exercise pressor reflex (EPR) occurring with aging.

Cerebral Ischemia Changed the Effect of Metabosensitive Muscle Afferents on Somatic Reflex Without Affecting Thalamic Activity

The purpose of the present study was to examine the contribution of group III and IV metabosensitive afferents at spinal and supraspinal levels in rats subjected to middle cerebral artery occlusion (MCAO) with reperfusion during the acute phase. Animals were randomized in Control (n = 23), SHAM (n = 18), MCAO-D1 (n = 10), and MCAO-D7 (n = 20) groups. Rats performed the Electrical Von Frey and the Adhesive removal tests before the surgery and at day 1 (D1), D3, and D7 after MCAO. Animals were subjected to electrophysiological recordings including the responses of group III/IV metabosensitive afferents to combinations of chemical activators and the triceps brachii somatic reflex activity at D1 or D7. The response of ventral posterolateral (VPL) thalamic nuclei was also recorded after group III/IV afferent activation. Histological measurements were performed to assess the infarct size and to confirm the location of the recording electrodes into the VPL. Behavioral results indicated that MCAO induced disorders of both mechanical sensibility and motor coordination of paretic forepaw during 7 days. Moreover, injured animals exhibited an absence of somatic reflex inhibition from the group III/IV afferents at D1, without affecting the response of both these afferents and the VPL. Finally, the regulation of the central motor drive by group III/IV afferents was modified at spinal level during the acute phase of cerebral ischemia and it might contribute to the observed behavioral disturbances.

Do metabolites that are produced during resistance exercise enhance muscle hypertrophy?

Many reviews conclude that metabolites play an important role with respect to muscle hypertrophy during resistance exercise, but their actual physiologic contribution remains unknown. Some have suggested that metabolites may work independently of muscle contraction, while others have suggested that metabolites may play a secondary role in their ability to augment muscle activation via inducing fatigue. Interestingly, the studies used as support for an anabolic role of metabolites use protocols that are not actually designed to test the importance of metabolites independent of muscle contraction. While there is some evidence in vitro that metabolites may induce muscle hypertrophy, the only study attempting to answer this question in humans found no added benefit of pooling metabolites within the muscle post-exercise. As load-induced muscle hypertrophy is thought to work via mechanotransduction (as opposed to being metabolically driven), it seems likely that metabolites simply augment muscle activation and cause the mechanotransduction cascade in a larger proportion of muscle fibers, thereby producing greater muscle growth. A sufficient time under tension also appears necessary, as measurable muscle growth is not observed after repeated maximal testing. Based on current evidence, it is our opinion that metabolites produced during resistance exercise do not have anabolic properties per se, but may be anabolic in their ability to augment muscle activation. Future studies are needed to compare protocols which produce similar levels of muscle activation, but differ in the magnitude of metabolites produced, or duration in which the exercised muscles are exposed to metabolites.

H-reflex and M-wave recordings: effect of pressure application to the stimulation electrode on the assessment of evoked potentials and subject's discomfort

This study aimed to compare the effect of different types of pressure applied to the stimulation electrode on assessing the efficiency of Ia-α-motoneuron transmission of the soleus muscle and the associated discomfort using electrical nerve stimulation. Twelve healthy young adults participated in three experimental sessions (one for each knee angle). The amplitudes of the maximal Hoffmann reflex (H_max ) and motor potential (M_max ) were recorded from the soleus muscle at 0°, 30° and 90° knee angles (0° full extension) through three pressure applications to the stimulation electrode: no pressure, pressure with manual application and pressure using adhesive tape. The soleus H_max /M_max were calculated to assess the efficiency of Ia-α-motoneuron transmission during varied knee angles and pressure application to the stimulation electrode. At the stimulation intensity evoking soleus H_max and M_max , subjects were asked to orally provide a value between 'no discomfort' (0) and 'worst possible discomfort' (10). The application of pressure on the stimulation electrode, particularly using adhesive tape, decreased both the stimulation intensity needed to evoke an electrophysiological response and the associated self-reported discomfort (P<0·05), while the H_max /M_max remained constant. At the stimulation intensity evoking M_max , the electrical stimulation appeared to be more painful at 0° knee angle compared with 30° and 90° angles (P<0·01). To conclude, this study showed that a knee flexion and a pressure application to the stimulation electrode, especially using tape pressure, are recommended in the objective to reduce the patient/subjects' discomfort when eliciting evoked potentials on soleus muscle.

Plantarflexor passive-elastic properties related to BMI and walking performance in older women

The objective of this study was to examine the influence of BMI on the passive-elastic properties of the ankle plantarflexors in older women. Twenty-three women, 65-80 yr, were separated into normal weight (NW, BMI <25.0kgm-2, n=11) and overweight-obese (OW, BMI≥25.0kgm-2, n=12) groups. Resistive torque of the ankle plantarflexors was recorded on an isokinetic dynamometer by passively moving the ankle into dorsiflexion. Stiffness, work absorption, and hysteresis were calculated across an ankle dorsiflexion angle of 10-15°. Maximal plantarflexor strength was assessed, then participants walked at maximal speed on an instrumented gait analysis treadmill while muscle activation (EMG) was recorded. Plantarflexor stiffness was 34% lower in OW (26.4±12.7Nmrad-1) than NW (40.0±15.7Nmrad-1, p=0.032). Neither work absorption nor hysteresis were different between OW and NW. Stiffness per kg was positively correlated to strength (r=0.66, p<0.001), peak vertical ground reaction force during walking (r=0.72, p<0.001), weight acceptance rate of force (r=0.51, p=0.007), push-off rate of force (r=0.41, p=0.026), maximal speed (r=0.61, p=0.001), and inversely correlated to BMI (r=-0.61, p=0.001), and peak plantarflexor EMG (r=-0.40, p=0.046). Older women who are OW have low plantarflexor stiffness, which may limit propulsive forces during walking and necessitate greater muscle activation for active force generation.

Are There Critical Fatigue Thresholds? Aggregated vs. Individual Data

The mechanisms underlying task failure from fatiguing physical efforts have been the focus of many studies without reaching consensus. An attractive but debated model explains effort termination with a critical peripheral fatigue threshold. Upon reaching this threshold, feedback from sensory afferents would trigger task disengagement from open-ended tasks or a reduction of exercise intensity of closed-ended tasks. Alternatively, the extant literature also appears compatible with a more global critical threshold of loss of maximal voluntary contraction force. Indeed, maximal voluntary contraction force loss from fatiguing exercise realized at a given intensity appears rather consistent between different studies. However, when looking at individual data, the similar maximal force losses observed between different tasks performed at similar intensities might just be an “artifact” of data aggregation. It would then seem possible that such a difference observed between individual and aggregated data also applies to other models previously proposed to explain task failure from fatiguing physical efforts. We therefore suggest that one should be cautious when trying to infer models that try to explain individual behavior from aggregated data.

Central and Peripheral Fatigue During Resistance Exercise - A Critical Review

Resistance exercise is a popular form of conditioning for numerous sport disciplines, and recently different modes of strength training are being evaluated for health benefits. Resistance exercise differs significantly in nature, and several variables determine the direction and range of adaptive changes that occur in the muscular and skeletal system of the body. Some modes of resistance training can also be effective in stimulating the cardiovascular system. These variables include exercise selection (general, specific, single or multi joint, dynamic, explosive), type of resistance (free weights, variable resistance, isokinetics), order of exercise (upper and lower body or push and pull exercises), and most of all the training load which includes intensity expressed as % of 1RM, number of repetitions, number of sets and the rest interval between sets. Manipulating these variables allows for specific adaptive changes which may include gains in muscle mass, muscle strength or muscle endurance. It has been well established that during resistance exercise fatigue occurs, regardless of the volume and intensity of work applied. The peripheral mechanisms of fatigue have been studied and explained in more detail than those related to the CNS. This review is an attempt to bring together the latest knowledge regarding fatigue, both peripheral and central, during resistance exercise. The authors of this review concentrated on physiological and biochemical mechanisms underlying fatigue in exercises performed with maximal intensity, as well as those performed to exhaustion with numerous repetitions and submaximal load.