Angle-specific impairment of elbow flexors strength after isometric exercise at long muscle length

Acute effects of Nordic hamstring exercise on hip and knee joints proprioception

BACKGROUND AND OBJECTIVES

Nordic Hamstring Exercise (NHE) is one of the best exercises proposed for injury prevention of hamstring muscles. However, its effects on lower extremity proprioception are unclear. The aim of this study was to investigate the immediate effects of a single bout of NHE on hip and knee joints' proprioception.

METHODS

Forty collegiate male soccer players participated in this study with a mean age of 22.85 ± 1.82 years and were randomized into either control (n = 20) or experimental (n = 20) groups. Each subject participated in pre-test measurements in which hip and knee active joints position sense (JPS) were assessed in standing and lying tasks using the image-capturing method. The experimental group then performed three sets of NHE with 10 repetitions in each set, while the control group rested for 10 min. Paired and independent t-tests were used for calculating the differences within and between groups on SPSS software, respectively. The level of significance was P ≤ 0.05.

RESULTS

Hip JPS in the lying task and knee JPS in both of the standing and lying tasks were impaired significantly after performing a single bout of NHE (P ≤ 0.05). However, the effects of this exercise on hip JPS in the standing task were not significant (P ≥ 0.05).

CONCLUSIONS

NHE performing with three sets of 10 repetitions can significantly impair hip and knee JPS immediately after exercise and reduce the proprioception acuity of the lower limbs. It is recommended to perform this exercise at a time rather than before training or match sessions.

Joint angle-specific neuromuscular time course of recovery after isometric resistance exercise at shorter and longer muscle lengths

Resistance training at longer muscle lengths induces greater muscle hypertrophy and different neuromuscular functional adaptations than training at shorter muscle lengths. However, the acute time course of recovery of neuromuscular characteristics after resistance exercise at shorter and longer muscle lengths in the quadriceps has never been described. Eight healthy young participants (4 M, 4 F) were randomly assigned to perform four sets of eight maximal isometric contractions at shorter (SL; 50° knee flexion) or longer (LL; 90° knee flexion) muscle lengths in a crossover fashion. During exercise, peak torque (PT), muscle activity [electromyogram (EMG)], and internal muscle forces were assessed. PT and EMG at shorter (PT50, EMG50) and longer (PT90, EMG90) muscle lengths, creatine kinase (CK), and muscle soreness were measured at baseline, immediately after exercise (Post), after 24 h (24 h), and after 48 h (48 h). During exercise, EMG (P = 0.002) and internal muscle forces (P = 0.017) were greater in LL than in SL. During recovery, there was a main effect of exercise angle, with PT50 (P = 0.002), PT90 (P = 0.016), and EMG50 (P = 0.002) all significantly reduced to a greater degree in LL compared with SL. CK and muscle soreness increased after resistance exercise, but there were no differences between SL and LL. The present results suggest that if the preceding isometric resistance exercise is performed at longer muscle lengths, function and muscle activity at shorter and longer muscle lengths are inhibited to a larger degree in the subsequent recovery period. This information can be used by practitioners to manipulate exercise prescription.NEW & NOTEWORTHY Despite the established long-term benefits of training at longer muscle lengths for muscle size and strength, acutely performing resistance exercise at longer muscle lengths may require a longer time course of neuromuscular recovery compared with performing resistance exercises at shorter muscle lengths. Furthermore, there appear to be different joint angle-specific recovery profiles, depending on the muscle length of the preceding exercise.

Contractile properties are less affected at long than short muscle length after eccentric exercise

PURPOSE

The aim of the present study was to investigate whether the electrically evoked muscle responses are differently affected over time by the knee joint angle after an exercise-induced muscle damage (EIMD). We hypothesized that low-frequency-evoked responses would be less affected at long than short muscle length, and that mechanisms located within the muscle and tendinous tissues would be involved.

METHODS

Fifteen males performed 45 min loaded downhill walking (DW) exercise. Maximal voluntary contraction torque (MVC), optimal angle for torque production, voluntary activation level (VAL), twitch, doublet at 10 and 100 Hz (Db10 and Db100, respectively), rate of torque development (RTD), post-activation potentiation (PAP), muscle shear elastic modulus (µ) and aponeurosis stiffness were assessed before, after, and 4, 24, 48, 72 and 168 h after the exercise at a knee angle of 40°, 90° and 120° (0°: full extension).

RESULTS

MVC, VAL and Db100 were similarly decreased across joint angles after the DW and optimal angle was not affected. Twitch, Db10, Db10/Db100, PAP and RTD were less affected and muscle µ more increased at long than short muscle lengths (p < 0.05), especially during the first 24 h after the DW exercise.

CONCLUSION

Low-frequency-evoked responses were more preserved at long than short muscle length the first 24 h after the DW exercise, suggesting that joint angle should be taken into account to assess muscular alterations after EIMD. This length-dependence could be associated to the higher sensitivity to Ca²⁺ and the higher increase in muscle stiffness at long than short muscle length.

The effects of blood flow restriction resistance training on indices of delayed onset muscle soreness and peak power

BACKGROUND: Low-load resistance training with blood flow restriction (LL + BFR) attenuated delayed onset muscle soreness (DOMS) under some conditions. OBJECTIVE: The purpose of this study examined the effects of reciprocal concentric-only elbow flexion-extension muscle actions at 30% of peak torque on indices of DOMS. METHODS: Thirty untrained women (mean ± SD; 22 ± 2.4 years) were randomly assigned to 6 training days of LL + BFR (n= 10), low-load non-BFR (LL) (n= 10), or control (n= 10). Participants completed 4 sets (1 × 30, 3 × 15) of submaximal (30% of peak torque), unilateral, isokinetic (120∘s-1) muscle actions. Indices of DOMS including peak power, resting elbow joint angle (ROM), perceived muscle soreness (VAS), and pain pressure threshold (PPT) were assessed. RESULTS: There were no changes in peak power, ROM, or VAS. There was a significant interaction for PPT. Follow-up analyses indicated PPT increased for the LL + BFR condition (Day 5 > Day 2), but did not decrease below baseline. The results of the present study indicated LL + BFR and LL did not induce DOMS for the elbow extensors in previously untrained women. CONCLUSION: These findings suggested LL + BFR and LL concentric-only resistance training could be an effective training modality to elicit muscular adaptation without inducing DOMS.

Cyclic eccentric stretching induces more damage and improved subsequent protection than stretched isometric contractions in the lower limb

PURPOSE

Controversy remains about whether exercise-induced muscle damage (EIMD) and the subsequent repeated bout effect (RBE) are caused by the stretching of an activated muscle, or the production of high force at long, but constant, muscle lengths. The aim of this study was to determine the influence of muscle fascicle stretch elicited during different muscle contraction types on the magnitude of EIMD and the RBE.

METHODS

Fourteen participants performed an initial bout of lower limb exercise of the triceps surae. One leg performed sustained static contractions at a constant long muscle length (ISO), whereas the contralateral leg performed a bout of eccentric heel drop exercise (ECC). Time under tension was matched between the ECC and ISO conditions. Seven days later, both legs performed ECC. Plantar flexor twitch torque, medial gastrocnemius (MG) fascicle length and muscle soreness were assessed before, 2 h and 2 days after each exercise bout. MG fascicle length and triceps surae surface electromyography were examined across the bouts of exercise.

RESULTS

We found that both ECC and ISO conditions elicited EIMD and a RBE. ISO caused less damage 2 h after the initial bout (14% less drop in twitch torque, P = 0.03) and less protection from soreness 2 days after the repeated bout (56% higher soreness, P = 0.01). No differences were found when comparing neuromechanical properties across exercise bouts.

CONCLUSION

For MG, the action of stretching an active muscle seems to be more important for causing damage than a sustained contraction at a long length.

Expression of tissue remodelling, inflammation- and angiogenesis-related factors after eccentric exercise in humans

Eccentric exercise has been extensively used as a model to study the contraction-induced muscle damage and its consequent processes. This study aimed at examining molecular responses associated with tissue remodelling, inflammation and angiogenesis in skeletal muscle during the recovery period after eccentric exercise in humans. Ten healthy men performed 50 maximal eccentric muscle actions with the knee extensors and muscle biopsies were collected from the vastus lateralis before and 6 h, 48 h and 120 h post eccentric exercise. Real Time-PCR was utilized to investigate alterations in gene expression of various tissue remodelling-, inflammation- and angiogenesis-related factors: uPA, uPA-R, TGF-β1, MMP-9, TNF-α, IL-6, IL-8, VEGF, VEGFR-2, HIF-1a, Ang-1, Ang-2 and Tie-2. The uPA/uPA-R system exhibited a similar time-expression pattern increasing 6 h post exercise (p < 0.05), while the other tissue remodelling factors TGF-β1 and MMP-9 did not change significantly over time. Transcriptional responses of inflammatory factors TNF-α and IL-8 increased significantly and peaked 6 h post eccentric exercise (p < 0.05), while IL-6 exhibited a similar, though not statistically significant, expression profile (p > 0.05). Similarly, the expression of angiopoietin receptor Tie-2 showed an early increase only at 6 h after the completion of exercise (p < 0.05), while the other angiogenic factors failed to reach statistical significance due a high interindividual variability in the gene expression responses. The early transcriptional upregulation of tissue remodelling, inflammation- and angiogenesis-related factors post eccentric exercise may indicate the acute intramuscular activation of these processes functionally related to muscle damage-induced adaptation.

Heart Failure-Induced Skeletal Muscle Wasting

PURPOSE OF REVIEW

Heart failure (HF) is a structural or functional cardiac abnormality which leads to failure of the heart to deliver oxygen commensurately with the requirements of the tissues and it may progress to a generalized wasting of skeletal muscle, fat tissue, and bone tissue (cardiac cachexia). Clinically, dyspnea, fatigue, and exercise intolerance are some typical signs and symptoms that characterize HF patients. This review focused on the phenotypic characteristics of HF-induced skeletal myopathy as well as the mechanisms of muscle wasting due to HF and highlighted possible therapeutic strategies for skeletal muscle wasting in HF.

RECENT FINDINGS

The impaired exercise capacity of those patients is not attributed to the reduced blood flow in the exercising muscles, but rather to abnormal metabolic responses, myocyte apoptosis and atrophy of skeletal muscle. Specifically, the development of skeletal muscle wasting in chronic HF is characterized by structural, metabolic, and functional abnormalities in skeletal muscle and may be a result not only of reduced physical activity, but also of metabolic or hormonal derangements that favour catabolism over anabolism. In particular, abnormal energy metabolism, mitochondrial dysfunction, transition of myofibers from type I to type II, muscle atrophy, and reduction in muscular strength are included in skeletal muscle abnormalities which play a central role in the decreased exercise capacity of HF patients. Skeletal muscle alterations and exercise intolerance observed in HF are reversible by exercise training, since it is the only demonstrated intervention able to improve skeletal muscle metabolism, growth factor activity, and functional capacity and to reverse peripheral abnormalities.

Marine phytoplankton improves recovery and sustains immune function in humans and lowers proinflammatory immunoregulatory cytokines in a rat model

Purpose

This study investigated the effects of marine phytoplankton supplementation (Oceanix®, Tetraselmis chuii) on 1) maximal isometric strength and immune function in healthy humans following a oneweek high-intensity resistance-training program and 2) the proinflammatory cytokine response to exercise in a rat model.

Methods

In the human trial, 22 healthy male and female participants were randomly divided into marine phytoplankton and placebo groups. Following baseline testing, participants underwent a 14-day supplement loading phase before completing five consecutive days of intense resistance training. In the rat model, rats were randomly divided into four groups (n=7 per condition): (i) control, (ii) exercise, (iii) exercise + marine phytoplankton (2.55 mg/kg/day), or (iv) exercise + marine phytoplankton (5.1 mg/kg/day). Rats in the exercising groups performed treadmill exercise 5 days per week for 6 weeks.

Results

In the human model, marine phytoplankton prevented significant declines in the isometric peak rate of force development compared to placebo. Additionally, salivary immunoglobulin A concentration was significantly lower following the resistance training protocol in the placebo group but not in the marine phytoplankton group. Marine phytoplankton in exercising rats decreased intramuscular levels and serum concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) and intramuscular concentrations of malondialdehyde.

Conclusion

Marine phytoplankton prevented decrements in indices of functional exercise recovery and immune function. Mechanistically, these outcomes could be prompted by modulating the oxidative stress and proinflammatory cytokine response to exercise.

Effect of a strength or hypertrophy training protocol, each performed using two different modes of resistance, on biomechanical, biochemical and anthropometric parameters

The study aimed to analyse the effectiveness of two variants of 8-week strength training (hypertrophy, strength) with different modes of resistance. Healthy male subjects (n=75) were allocated to five groups of equal size: hypertrophy training with a variable cam (Hyp-Cam), hypertrophy training with disc plates (Hyp-Disc), maximal strength training with a variable cam (Str-Cam), maximal strength training with disc plates (Str-Disc), and a control group (CG). The Hyp-Cam and Str-Cam groups trained with a machine where the load was adjusted to the strength capabilities of the elbow flexors. The Hyp-Disc and Str-Disc groups trained on a separate machine in which a load was applied with disc plates. The CG did not train. All groups were assessed for changes and differences in one-repetition (1RM) lifts, isokinetic muscle torque, arm circumference and arm skinfold thickness, and plasma creatine kinase (CK) activity. Within the 8-week training period the 1RM increased (p<.001) in all groups by over 20%, without significant between-group differences. Muscle torque increased significantly (p<.001) only in the Hyp-Cam group (by 13.7%). Arm circumference at rest increased by 1.7 cm (p<.001) and 1.1 cm (p<.001) in the Hyp-Cam and Hyp-Disc groups, respectively, but not in the Str-Cam (0.3 cm; p>.05) or Str-Disc (0.2 cm; p>.05) group. Skinfold thickness of the biceps and triceps decreased more within the 8-week period in Str-Cam (by 1.1 and 2.1 cm; p<.001 and p<.001 respectively) and Str-Disc (0.7 and 1.5 cm; p<.001 and p<.01 respectively) than in Hyp-Cam (by 0.4 and 1.8 cm; p>.05 and p<.01 respectively) and Hyp-Disc groups (by 0.2 and 1.4 cm; p>.05 and p<.05 respectively). CK activity was significantly (p<.05) elevated in each training group except Hyp-Cam (p>.05). The 8-week hypertrophy training with a variable cam results in greater peak muscle torque improvement than in the other examined protocols, with an insignificant increase in training-induced muscle damage indices.

Normative values and affecting factors for the elbow range of motion

INTRODUCTION

Abnormalities in the elbow range of motion (ROM) can be subtle; therefore, it is important that the examiner can compare findings with reliable reference values, matching the patients' characteristics. Primarily, we aimed to provide normative values for the elbow ROM in subpopulations based on age, sex, dominance and body mass index (BMI). The secondary objective was to determine intra- and inter-rater reliability.

METHODS

aROM (active range of motion) and pROM (passive range of motion) were measured bilaterally in healthy adults using a universal goniometer. The influence of factors affecting the ROM was calculated using Pearson's correlation coefficient. In two samples of subjects, intra-rater and inter-rater reliability were determined.

RESULTS

The study population (n = 352) consisted of 47.2% male and 52.8% female subjects. For aROM (dominant hand), mean flexion was 146°, extension -2°, pronation 80° and supination 87°. Male subjects had smaller ROM compared to females (p < 0.001). Differences between dominant and nondominant hand were less than one degree. pROMs were 3° to 5° larger than aROMs (p < 0.001). Intra- and inter-rater reliability was good.

CONCLUSIONS

Elbow ROM is influenced by age, sex and BMI. In the general population, the ROM of the uninjured side can serve as a reference in case of an injured elbow.

Validity and Reliability of Elbow Range of Motion Measurements Using Digital Photographs, Movies, and a Goniometry Smartphone Application

INTRODUCTION

Range of motion (ROM) is closely monitored before and after surgery for stiff elbow and during rehabilitation. Measurements in the home environment may be helpful to increase involvement and adherence of the patient. Therefore, our objective is to investigate the validity and inter- and intraobserver reliability of 3 alternative methods to assess the ROM by the patient in a home-based situation, in comparison to the universal goniometer (UG). We hypothesize that all 3 alternative methods will be valid alternatives and show a level of reliability equivalent to UG.

METHODS

Goniometric measurements of elbow flexion, extension, pronation and supination using photography, movie, and a smartphone application were obtained. The validity of these measurement methods was compared to UG. The interobserver and intraobserver reliability were calculated for all measurement methods.

RESULTS

Photography and movie based goniometry of the elbow showed good validity in flexion and extension. The interobserver and intraobserver reliability were found to be good to excellent for photo and movie but moderate to poor for UG and the smartphone application.

CONCLUSIONS

Photo or movie based goniometry seems to be a useful option for initial and follow-up measurement of the elbow ROM, both in the outpatient clinic and in a home environment. Based on our study, the smartphone application we used is not recommended.

Muscle damage produced by isometric contractions in human elbow flexors

Isometric exercise is often prescribed during rehabilitation from injury to maintain muscle condition and prevent disuse atrophy. However, such exercise can lead to muscle soreness and damage. Here we investigate which parameters of isometric contractions are responsible for the damage. Bouts of 30 repetitions of maximum voluntary contractions of elbow flexors in 38 subjects were carried out and peak force, soreness, and tenderness were measured before the exercise, immediately afterwards, at 2 h, and at 24 h postexercise. When one arm was held near the optimum angle for force generation (90°), the force it produced was greater by 28% than by the other arm held at a longer length (155°). However, despite the smaller contraction forces of the muscle held at the longer length, after the exercise it exhibited a greater fall in force that persisted out to 24 h (20% fall) and more delayed soreness than the muscle exercised at 90° (7% fall at 24 h). The result indicates a length dependence of the damage process for isometric contractions at maximum effort. In four additional experiments, evidence was provided that the damage occurred during the plateau of the contraction and not the rising or relaxation phases. The damage had a prompt onset and was cumulative, continuing for the duration of the contraction. We interpret our findings in terms of the nonuniform lengthening of sarcomeres during the plateau of the contractions and conclude that muscle damage from isometric exercise is minimized if carried out at lengths below the optimum, using half-maximum or smaller contractions. NEW & NOTEWORTHY Isometric exercise, where muscle contracts while the limb is held fixed, is often possible for individuals rehabilitating from injury and can help maintain muscle condition. Such exercise has been reported to cause some muscle damage and soreness. We confirm this and show that to minimize damage, exercising muscles should be held at shorter than the optimum length for force and carried out at half-maximum effort or less.

Identification of the IGF-1 processing product human Ec/rodent Eb peptide in various tissues: Evidence for its differential regulation after exercise-induced muscle damage in humans

OBJECTIVE

Insulin-like growth factor-1 (IGF-1) is a pleiotropic factor expressed in various tissues and plays a critical role in skeletal muscle physiology. Alternative splicing of the IGF-1 gene gives rise to different precursor polypeptides (isoforms) which could undergo post-translational cleavage, generating the common mature IGF-1 peptide and different carboxyl terminal extension (E-) peptides, with the fate of the latter being, so far, unknown. The objective if this study was to identify the IGF-1Ec forms or processing product(s), other than mature IGF-1, generated in different human and rodent tissues and particularly in human skeletal muscle after exercise-induced damage.

DESIGN

Protein lysates from a wide range of human and rodent tissues were immunoblotted with a rabbit anti-human Ec polyclonal antibody raised against the last 24 amino acids of the C-terminal of the Ec peptide. This antibody can recognize the Ec peptide, both as part of IGF-1Ec and alone, and also the corresponding rodent forms, due to the high homology that the human Ec shares with the rodent Eb.

RESULTS

We were able to confirm, for the first time, that the human Ec peptide and its rodent homologous Eb peptide are produced simultaneously with their precursor protein (pro-IGF-1Ec/Eb) in vivo, in a wide range of tissues (e.g. muscle, liver, heart). Proprotein convertase furin digestion of human muscle and liver protein lysates confirmed that the higher molecular form, pro-IGF-1Ec, can be cleaved to produce the free Ec peptide. Furthermore, initial evidence is provided that Ec peptide is differentially regulated during the process of muscle regeneration after exercise-induced damage in humans.

CONCLUSIONS

The findings of this study possibly imply that the post-translational modification of the IGF-1Ec pro-peptide may regulate the bioavailability and activity of the processing product(s).

Changes in muscle fiber contractility and extracellular matrix production during skeletal muscle hypertrophy

Skeletal muscle can adapt to increased mechanical loads by undergoing hypertrophy. Transient reductions in whole muscle force production have been reported during the onset of hypertrophy, but contractile changes in individual muscle fibers have not been previously studied. Additionally, the extracellular matrix (ECM) stores and transmits forces from muscle fibers to tendons and bones, and determining how the ECM changes during hypertrophy is important in understanding the adaptation of muscle tissue to mechanical loading. Using the synergist ablation model, we sought to measure changes in muscle fiber contractility, collagen content, and cross-linking, and in the expression of several genes and activation of signaling proteins that regulate critical components of myogenesis and ECM synthesis and remodeling during muscle hypertrophy. Tissues were harvested 3, 7, and 28 days after induction of hypertrophy, and nonoverloaded rats served as controls. Muscle fiber specific force (sF_o), which is the maximum isometric force normalized to cross-sectional area, was reduced 3 and 7 days after the onset of mechanical overload, but returned to control levels by 28 days. Collagen abundance displayed a similar pattern of change. Nearly a quarter of the transcriptome changed over the course of overload, as well as the activation of signaling pathways related to hypertrophy and atrophy. Overall, this study provides insight into fundamental mechanisms of muscle and ECM growth, and indicates that although muscle fibers appear to have completed remodeling and regeneration 1 mo after synergist ablation, the ECM continues to be actively remodeling at this time point.NEW & NOTEWORTHY This study utilized a rat synergist ablation model to integrate changes in single muscle fiber contractility, extracellular matrix composition, activation of important signaling pathways in muscle adaption, and corresponding changes in the muscle transcriptome to provide novel insight into the basic biological mechanisms of muscle fiber hypertrophy.

Ambulatory assessment of shoulder abduction strength curve using a single wearable inertial sensor

The aim of the present article was to assess the reliability of strength curves as determined from tridimensional linear accelerations and angular velocities measured by a single inertial measurement unit (IMU) fixed on the upper arm during a shoulder abduction movement performed holding a 1 kg dumbbell in the hand. Within-subject repeatability of the task was assessed on 45 subjects performing four trials consisting of one maximal shoulder abduction-adduction movement. Intraclass correlation coefficient (ICC) was computed on the average movement angular velocity (VEL) and range of movement (ROM) across the four trials. Within-subject repeatability of torque curves was assessed in terms of waveform similarities by computing the coefficient of multiple determination (CMD). Accuracy of the estimated ROM was assessed using an isokinetic dynamometer. High ICC values of ROM (0.955) and VEL (0.970) indicated a high within-subject repeatability of the task. A high waveform similarity of torque curves was also found between trials (CMD = 0.867). Accuracy with respect to isokinetic dynamometer in estimating ROM was always <1 degree (p = 0.37). This study showed the effectiveness of using a single wearable IMU for the assessment of strength curve during isoinertial movements in a way that complies with the needs of clinicians in an ambulatory setting.

Changes in kinematic variables at various muscle lengths of human elbow flexors following eccentric exercise

Exercise-induced muscle damage causes a disproportionally larger drop in maximal force when measured at short versus optimal or long muscle lengths, resulting in a shift of the length (angle)-force relationship towards longer lengths. However, little attention has been given to the potential effect of this shift on the rate of force development (RFD) and isotonic function at different muscle lengths. This study examined RFD at various elbow angles and kinematic variables at two different ranges of elbow flexion, so as to include mainly the ascending (S condition) or the descending limb (L condition) of the angle-force curve, following eccentric exercise. Seven male volunteers performed an eccentric exercise protocol with the elbow flexors, which caused significant changes in indicators of muscle damage (P < 0.05-0.001). Optimum angle for force generation was significantly shifted towards longer elbow flexors lengths post exercise (P < 0.05-0.01). RFD was significantly decreased at all the angles tested but no differences were revealed between angles (P < 0.05-0.001). The kinematic variables measured were also significantly impaired following eccentric damage (P < 0.05-0.001). Maximal isotonic force showed a greater impairment in the S condition, however no significant differences between the S and L condition were found in maximal angular velocity (MAV) and time, angle and isotonic force needed to achieve MAV. These results suggest that impairment of RFD following muscle damage is not muscle-length dependent and the rightward shift of the angle-force curve is not the determinant of the decline in either RFD or the isotonic performance at the different ranges of the elbow flexion movement.

Cytokines in muscle damage

Multiple cellular and molecular processes are rapidly activated following skeletal muscle damage to restore normal muscle structure and function. These processes typically involve an inflammatory response and potentially the consequent occurrence of secondary damage before their resolution and the completion of muscle repair or regeneration. The overall outcome of the inflammatory process is potentially divergent, with the induction of prolonged inflammation and further muscle damage, or its active termination and the promotion of muscle repair and regeneration. The final, detrimental, or beneficial effect of the inflammatory response on muscle repair is influenced by specific interactions between inflammatory and muscle cell-derived cytokines that act as positive and/or negative regulators to coordinate local and systemic inflammatory-related events and modulate muscle repair process. A crucial balance between proinflammatory and anti-inflammatory cytokines appears to attenuate an excessive inflammatory reaction, prevent the development of muscle fibrosis, and adequately promote the regenerative process. In this review, we address the interactive cytokine responses following muscle damage, in the context of induction and progression, or resolution of muscle inflammation and the promotion of muscle repair.

Comparison in muscle damage between maximal voluntary and electrically evoked isometric contractions of the elbow flexors

This study compared between maximal voluntary (VOL) and electrically stimulated (ES) isometric contractions of the elbow flexors for changes in indirect markers of muscle damage to investigate whether ES would induce greater muscle damage than VOL. Twelve non-resistance-trained men (23-39 years) performed VOL with one arm and ES with the contralateral arm separated by 2 weeks in a randomised, counterbalanced order. Both VOL and ES (frequency 75 Hz, pulse duration 250 μs, maximally tolerated intensity) exercises consisted of 50 maximal isometric contractions (4-s on, 15-s off) of the elbow flexors at a long muscle length (160°). Changes in maximal voluntary isometric contraction torque (MVC), range of motion, muscle soreness, pressure pain threshold and serum creatine kinase (CK) activity were measured before, immediately after and 1, 24, 48, 72 and 96 h following exercise. The average peak torque over the 50 isometric contractions was greater (P < 0.05) for VOL (32.9 ± 9.8 N m) than ES (16.9 ± 6.3 N m). MVC decreased greater and recovered slower (P < 0.05) after ES (15% lower than baseline at 96 h) than VOL (full recovery). Serum CK activity increased (P < 0.05) only after ES, and the muscles became more sore and tender after ES than VOL (P < 0.05). These results showed that ES induced greater muscle damage than VOL despite the lower torque output during ES. It seems likely that higher mechanical stress imposed on the activated muscle fibres, due to the specificity of motor unit recruitment in ES, resulted in greater muscle damage.

Neuromuscular dysfunction with the experimental arm acting as its own reference following eccentric and isometric exercise

Eccentric exercise has been extensively used as a model to study muscle damage-induced neuromuscular impairment, adopting mainly a bilateral matching task between the reference (unexercised) arm and the indicator (exercised) arm. However, little attention has been given to the muscle proprioceptive function when the exercised arm acts as its own reference. This study investigated muscle proprioception and motor control, with the arm acting both as reference and indicator, following eccentric exercise and compared them with those observed after isometric exercise. Fourteen young male volunteers were equally divided into two groups and performed an eccentric or isometric exercise protocol with the elbow flexors of the non-dominant arm on an isokinetic dynamometer. Both exercise protocols induced significant changes in indicators of muscle damage, that is, muscle soreness, range of motion and maximal isometric force post-exercise (p < 0.05-0.001), and neuromuscular function was similarly affected following both protocols. Perception of force was impaired over the 4-day post-exercise period (p < 0.001), with the applied force being systematically overestimated. Perception of joint position was significantly disturbed (i.e., target angle was underestimated) only at one elbow angle on day 4 post-exercise (p < 0.05). The misjudgements and disturbed motor output observed when the exercised arm acted as its own reference concur with the view that they could be a result of a mismatch between the central motor command and an impaired motor control after muscle damage.

Systemic cytokine response following exercise-induced muscle damage in humans

BACKGROUND

Muscle adaptation which occurs following eccentric exercise-induced muscle damage has been associated with an acute inflammatory response. The purpose of this study was to investigate serum interleukin-6 (IL-6), osteoprotegerin and receptor activator of nuclear factor kB ligand (OPG/RANKL) concentrations following muscle damage. We measured changes for several days following muscle damage.

METHODS

Ten healthy young males performed an eccentric exercise protocol using their quadriceps. Blood samples were withdrawn before and at 6 h, 2 days, 5 days and 16 days post-exercise. Functional and clinical measurements were performed before, and on days 1, 2, 5, 8, 12 and 16 post-exercise.

RESULTS

The exercise protocol resulted in muscle damage, indicated by changes in biochemical markers. An increase in IL-6 and OPG, and a decrease in RANKL concentrations were seen at 6 h and on day 2 post-exercise; the OPG:RANKL ratio was increased at 6 h post-exercise (p < 0.05).

CONCLUSIONS

Changes in IL-6 and OPG/RANKL system may represent systemic responses in muscle inflammation and repair processes. However, further studies are needed to elucidate a potential systemic and/or local role of the OPG/RANKL system in skeletal muscle repair.

Evidence of skeletal muscle damage following electrically stimulated isometric muscle contractions in humans

It is unknown whether muscle damage at the level of the sarcomere can be induced without lengthening contractions. To investigate this, we designed a study where seven young, healthy men underwent 30 min of repeated electrical stimulated contraction of m. gastrocnemius medialis, with the ankle and leg locked in a fixed position. Two muscle biopsies were collected 48 h later: one from the stimulated muscle and one from the contralateral leg as a control. The biopsies were analyzed immunohistochemically for inflammatory cell infiltration and intermediate filament disruption. Ultrastructural changes at the level of the z-lines were investigated by transmission electron microscopy. Blood samples were collected for measurement of creatine kinase activity, and muscle soreness was assessed in the days following stimulation. The biopsies from the stimulated muscle revealed macrophage infiltration and desmin-negative staining in a small percentage of myofibers in five and four individuals, respectively. z-Line disruption was evident at varying magnitudes in all subjects and displayed a trend toward a positive correlation ( r = 0.73, P = 0.0663) with the force produced by stimulation. Increased muscle soreness in all subjects, combined with a significant increase in creatine kinase activity ( P < 0.05), is indirectly suggestive of muscle damage, and the novel findings of the present study, i.e., 1) macrophages infiltration, 2) lack of desmin staining, and 3) z-line disruption, provide direct evidence of damage at the myofiber and sarcomere levels. These data support the hypothesis that muscle damage at the level of the sarcomere can be induced without lengthening muscle contractions.

Impaired neuromuscular function during isometric, shortening, and lengthening contractions after exercise-induced damage to elbow flexor muscles

The purpose of this study was to examine the effect of exercise-induced damage of the elbow flexor muscles on steady motor performance during isometric, shortening, and lengthening contractions. Ten healthy individuals (age 22 ± 4 yr) performed four tasks with the elbow flexor muscles: a maximum voluntary contraction, a one repetition maximum (1 RM), an isometric task at three joint angles (short, intermediate, and long muscle lengths), and a constant-load task during slow (∼7°/s) shortening and lengthening contractions. Task performance was quantified as the fluctuations in wrist acceleration (steadiness), and electromyography was obtained from the biceps and triceps brachii muscles at loads of 10, 20, and 40% of 1 RM. Tasks were performed before, immediately after, and 24 h after eccentric exercise that resulted in indicators of muscle damage. Maximum voluntary contraction force and 1-RM load declined by ∼45% immediately after exercise and remained lower at 24 h (∼30% decrease). Eccentric exercise resulted in reduced steadiness and increased biceps and triceps brachii electromyography for all tasks. For the isometric task, steadiness was impaired at the short compared with the long muscle length immediately after exercise ( P < 0.01). Furthermore, despite no differences before exercise, there was reduced steadiness for the shortening compared with the lengthening contractions after exercise ( P = 0.01), and steadiness remained impaired for shortening contractions 24 h later ( P = 0.01). These findings suggest that there are profound effects for the performance of these types of fine motor tasks when recovering from a bout of eccentric exercise.

Test-retest reproducibility of elbow goniometric measurements in a rigid double-blinded protocol: intervals for distinguishing between measurement error and clinical change

Increasingly, goniometry of elbow motion is used for qualification of research results. Expression of reliability is in parameters not suitable for comparison of results. We modified Bland and Altman's method, resulting in the smallest detectable differences (SDDs). Two raters measured elbow excursions in 42 individuals (144 ratings per test person) with an electronic digital inclinometer in a classical test-retest crossover study design. The SDDs were 0 +/- 4.2 degrees for active extension; 0 +/- 8.2 degrees for active flexion, both without upper arm fixation; 0 +/- 6.3 degrees for active extension; 0 +/- 5.7 degrees for active flexion; 0 +/- 7.4 degrees for passive flexion with upper arm fixation; 0 +/- 10.1 degrees for active flexion with upper arm retroflexion; and 0 +/- 8.5 degrees and 0 +/- 10.8 degrees for active and passive range of motion. Differences smaller than these SDDs found in clinical or research settings are attributable to measurement error and do not indicate improvement.

Changes in the angle-force curve of human elbow flexors following eccentric and isometric exercise

The aim of this study was to explore and compare the magnitude and time-course of the shift in the angle-force curves obtained from maximal voluntary contractions of the elbow flexors, both before and 4 consecutive days after eccentric and isometric exercise. The maximal isometric force of the elbow flexors of fourteen young male volunteers was measured at five different elbow angles between 50 degrees and 160 degrees . Subjects were then divided into two groups: the eccentric group (ECC, n=7) and the isometric group (ISO, n=7). Subjects in the ECC group performed 50 maximal voluntary eccentric contractions of the elbow flexors on an isokinetic dynamometer (30 degrees x s(-1)), while subjects in the ISO group performed 50 maximal voluntary isometric muscle contractions with the elbow flexors at a lengthened position. Following the ECC and ISO exercise protocols, maximal isometric force at the five angles, muscle soreness, and the relaxed (RANG) and flexed (FANG) elbow angles were measured at 24 h intervals for 4 days. All results were presented as the mean and standard error, and a quadratic curve was used to model the maximal isometric force data obtained at the five elbow angles. This approach not only allowed us to mathematically describe the angle-force curves and estimate the peak force and optimum angle for peak force generation, but also enabled us to statistically compare the shift of the angle-force curves between and within groups. A large and persistent shift of the angle-force curve towards longer muscle lengths was observed 1 day after eccentric exercise ( P<0.01). This resulted in a approximately 16 degrees shift of the optimum angle for force generation, which remained unchanged for the whole observation period. A smaller but also persistent shift of the angle-force curve was seen after isometric exercise at long muscle length ( P<0.05; shift in optimum angle approximately 5 degrees ). ECC exercise caused more muscle damage than ISO exercise, as indicated by the greater changes in RANG and ratings of muscle soreness ( P<0.05). It was suggested that the shift in the angle-force curve was proportional to the degree of muscle damage and may be explained by the presence of overstretched sarcomeres that increased in series compliance of the muscle.