Knee joint neuromuscular activation performance during muscle damage and superimposed fatigue

Timing of Lower Extremity Injuries in Competition and Practice in High School Sports

Background:

Laboratory-based experiments demonstrate that fatigue may contribute to lower extremity injury (LEI). Few studies have examined the timing of LEIs during competition and practice, specifically in high school athletes across multiple sports, to consider the possible relationship between fatigue and LEIs during sport events.

Hypothesis:

The purpose of this study was to describe the timing of LEIs in high school athletes within games and practices across multiple sports, with a hypothesis that more and severe injuries occur later in games and practices.

Study Design:

Descriptive epidemiologic study.

Level of Evidence:

Level 4.

Methods:

Using the National High School RIO (Reporting Information Online) sport injury surveillance system, LEI severity and time of occurrence data during practice and competition were extracted for 9 high school sports.

Results:

During the school years 2005-2006 through 2013-2014, 16,967,702 athlete exposures and 19,676 total LEIs were examined. In all sports surveyed, there was a higher LEI rate, relative risk for LEI, and LEI requiring surgery during competition than practice. During practice, the majority of LEIs occurred over an hour into practice in all sports. In quarter-based competition, more LEIs occurred in the second (31% to 32%) and third quarters (30% to 35%) than in the first (11% to 15%) and fourth quarters (22% to 26%). In games with halves, the majority (53% to 66%) of LEIs occurred in the second half. The greater severity LEIs tended to occur earlier in games.

Conclusion:

Fatigue may play a role in the predominance of injuries in the second half of games, though various factors may be involved. Greater severity of injuries earlier in games may be because of higher energy injuries when athletes are not fatigued.

Clinical Relevance:

These findings can help prepare sports medicine personnel and guide further related research to prevent LEIs.

A Systematic Review of the Role of Vitamin D on Neuromuscular Remodelling Following Exercise and Injury

Vitamin D is important for skeletal muscle health and deficiency is associated with clinical neuromuscular symptoms of poor strength and gait. Supplementation can independently increase muscle strength in chronically deficient populations. However, the regulatory role of vitamin D on neuromuscular remodelling and adaptation subsequent to exercise conditioning or injury has not been systematically reviewed.

OBJECTIVE

to systematically review the available evidence of the role of vitamin D on neuromuscular remodelling following exercise conditioning, exercise- or experimentally induced injury. We searched Medline (OVID platform), PubMed, Embase and Web of Science for randomised controlled trials (RCTs) including measures of neuromuscular function, injury and/or inflammation; a physiologically stressful intervention involving exercise conditioning, exercise- or experimentally induced injury and; vitamin D supplementation. Nine RCTs met the inclusion criteria. Significant heterogeneity of methodological approaches and outcomes meant that meta-analysis of data was limited. Qualitative findings indicated that vitamin D may be an effective accelerant of neuromuscular remodelling in animal models (24-140 % improved recovery vs. control); the effects in humans are inconclusive and likely influenced by baseline vitamin D and supplementation strategy. Results of the meta-analyses indicated no effect of vitamin D supplementation on muscle strength adaptation following resistance training [standardised mean difference (SMD): 0.74, P = 0.42] or muscle damage (SMD: -0.03, P = 0.92), although inflammatory markers were elevated in the latter (SMD: 0.56, P = 0.04). Data from animal models offer promising and plausible mechanisms for vitamin D as an agent for neuromuscular adaptation. Further high-quality research is needed to offer clearer insight into the influential role of vitamin D in human populations.

Effects of neuromuscular fatigue on electromechanical delay of the leg extensors and flexors in young men and women

INTRODUCTION

We examined the effects of neuromuscular fatigue on volitional electromechanical delay (EMD) of leg extensors and flexors between genders.

METHODS

Twenty-one men and 20 women performed 2 maximal voluntary contractions (MVCs), followed by intermittent isometric contractions of leg extensors and flexors using a 0.6 duty cycle (6-s contraction, 4-s relaxation) at 50% of MVC until volitional fatigue was achieved. MVCs were again performed at 0, 7, 15, and 30 min post-fatigue.

RESULTS

EMD was greater compared with baseline at all post-fatigue time phases for the leg flexors (P = 0.001-0.007), while EMD was greater at Post0, Post15 and Post30 (P = 0.001-0.023) for the leg extensors. EMD was also greater for leg extensors compared with leg flexors only at Post0.

CONCLUSION

No differential gender-related fatigue effects on EMD were shown. There were different fatigue-induced responses between leg extensors and flexors, with leg extensors exhibiting higher EMD immediately post-fatigue.

Rate of force development as a measure of muscle damage

This study tested the hypothesis that rate of force development (RFD) would be a more sensitive indirect marker of muscle damage than maximum voluntary isometric contraction (MVC) peak torque. Ten men performed one concentric cycling and two eccentric cycling (ECC1, ECC2) bouts for 30 min at 60% of maximal concentric power output with 2 weeks between bouts. MVC peak torque, RFD, and vastus lateralis electromyogram amplitude and mean frequency were measured during a knee extensor MVC before, immediately after and 1-2 days after each bout. The magnitude of decrease in MVC peak torque after exercise was greater (P < 0.05) for ECC1 (11-25%) than concentric cycling (2-12%) and ECC2 (0-16%). Peak RFD and RFD from 0-30 ms, 0-50 ms, 0-100 ms, to 0-200 ms decreased (P < 0.05) immediately after all cycling bouts without significant differences between bouts, but RFD at 100-200 ms interval (RFD(100-200)) decreased (P < 0.05) at all time points after ECC1 (24-32%) and immediately after ECC2 (23%), but did not change after CONC. The magnitude of decrease in RFD(100-200) was 7-19% greater than that of MVC peak torque after ECC1 (P < 0.05). It is concluded that RFD(100-200) is a more specific and sensitive indirect marker of eccentric exercise-induced muscle damage than MVC peak torque.

Effects of neuromuscular fatigue on the electromechanical delay of the leg extensors and flexors in young and old men

PURPOSE

The purpose of this study was to investigate the effects of a fatigue-inducing bout of submaximal, intermittent isometric contractions on the electromechanical delay (EMD) of the leg extensors and flexors in young and old men.

METHODS

Twenty young (mean ± SD: age = 25 ± 2.8 years) and sixteen old (age = 70.8 ± 3.8) recreationally active men performed maximal voluntary contractions (MVCs) followed by a fatigue-inducing protocol consisting of intermittent isometric contractions of the leg extensors or flexors using a 0.6 duty cycle (6 s contraction, 4 s relaxation) at 60 % of MVC until volitional fatigue. MVCs were again performed at 0, 7, 15, and 30 min post fatigue. A three-way mixed factorial ANOVA was used to analyze the EMD data.

RESULTS

There was a two-way muscle × time interaction (P = 0.039) where the EMD of the leg flexors was greater (P = 0.001-0.034) compared with baseline at all post fatigue time periods, but was only greater at immediately post fatigue for the extensors (P = 0.001). A significant two-way interaction for muscle × age (P = 0.009) revealed that the EMD was greater (P = 0.003) for the extensors for the old compared with the young men, but not different for the flexors (P = 0.506).

CONCLUSIONS

These findings showed differential fatigue-induced EMD recovery patterns between the leg extensors and flexors with the flexors being slower to recover and also that age-related increases of EMD are muscle group specific. The sustained increased EMD of the flexors during recovery may have important injury and performance implications in a variety of populations and settings.

Effect of serum from sub-healthy subjects with fatigue on the gene expression profile of skeletal muscle cells

To investigate the effect of serum from sub-healthy subjects with fatigue on the gene expression profile of skeletal muscle cells (HSkMCs), HSkMCs were cultured in vitro and treated with serum from healthy and sub-healthy subjects independently. Total RNA was extracted, purified and used for reverse transcription into cDNA. This was labeled with one of two fluorescence dyes, Cy3 or Cy5, and hybridized with a Human Genome Array carrying 8064 target genes. The differentially expressed genes were selected with the aid of software. There were 86 differentially expressed genes identified between the sub-healthy subjects and the healthy individuals, of which 60 were upregulated and 26 were downregulated compared with those of the healthy individuals. These genes were mainly associated with the cell cycle, membrane channels, protein transport, energy metabolism and apoptosis. Our results suggest that serum from sub-healthy subjects with fatigue may change the gene expression profile of HSkMCs.

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.