Dietary creatine supplementation and muscular adaptation to resistive overload

Enhancing Adaptations to Neuromuscular Electrical Stimulation Training Interventions

Neuromuscular electrical stimulation (NMES) applied to skeletal muscles is an effective rehabilitation and exercise training modality. However, the relatively low muscle force and rapid muscle fatigue induced by NMES limit the stimulus provided to the neuromuscular system and subsequent adaptations. We hypothesize that adaptations to NMES will be enhanced by the use of specific stimulation protocols and adjuvant interventions.

Effects of neuromuscular electrical stimulation training on muscle size in collegiate track and field athletes

The purpose of this study was to examine the effects of neuromuscular electrical stimulation training for 12 weeks on the abdominal muscle size in trained athletes. Male collegiate track and field athletes participated in the present study and were randomly allocated to either training or control groups. Eleven participants of the training group completed a 60-session training program over a 12-week period (23 min/session, 5 days/week) involving neuromuscular electrical stimulation (mostly 20 Hz) for the abdominal muscles in addition to their usual training for the own events. The participants of the control group (n = 13) continued their usual training. Before and after the intervention period, cross-sectional areas of the rectus abdominis and abdominal oblique muscles (the internal and external obliques and transversus abdominis) and subcutaneous fat thickness were measured with magnetic resonance and ultrasound imaging. There were no significant changes in cross-sectional area of the rectus abdominis or abdominal oblique muscles or in subcutaneous fat thickness in the training or control groups after the intervention period. The change in cross-sectional area of the rectus abdominis in each participant was not significantly correlated with pre-training cross-sectional area and neither was the mean value of fat thickness at pre- and post-training. These results suggest that low-frequency (20 Hz) neuromuscular electrical stimulation training for 12 weeks is ineffective in inducing hypertrophy of the abdominal muscles in trained athletes, even when they have a thin layer of subcutaneous fat.

Effects of training intensity in electromyostimulation on human skeletal muscle

PURPOSE

High-intensity neuromuscular electrical stimulation (NMES) training can induce muscle hypertrophy at the whole muscle and muscle fiber levels. However, whether low-intensity NMES training has a similar result is unknown. This study aimed to investigate whether low-intensity NMES training could elicit muscle hypertrophy at the whole muscle and muscle fiber levels in the human skeletal muscle.

METHODS

Eight untrained young males were subjected to 18 min of unilateral NMES training for 8 weeks. One leg received NMES at maximal tolerable intensity (HIGH); the other leg received NMES at an intensity half of that in the HIGH condition (LOW). Quadriceps muscle thickness (MT), muscle fiber cross-sectional area (CSA), and knee extension strength were measured before and after the training period.

RESULTS

The average training intensity throughout the intervention period in the HIGH and LOW conditions were 62.5 ± 4.6% maximal voluntary contraction (MVC) and 32.6 ± 2.6% MVC, respectively. MT, CSA, and muscle strength increased in both exercise conditions (p < 0.05); however, training effects in the LOW condition were lower than those in the HIGH condition (p < 0.05). The average training intensity showed a positive correlation with percent changes in muscle strength (r = 0.797, p = 0.001), MT (r = 0.876, p = 0.001), type I fiber CSA (r = 0.730, p = 0.01), and type II fiber CSA (r = 0.899, p = 0.001).

CONCLUSIONS

Low-intensity NMES could increase MT, muscle fiber CSA, and muscle strength in healthy human skeletal muscles. However, the magnitude of increase is lower in low-intensity than in high-intensity NMES training.

Neuromuscular Electrical Stimulation-Induced Resistance Training After SCI: A Review of the Dudley Protocol

BACKGROUND

Neuromuscular electrical stimulation (NMES), often referred to as functional electrical stimulation (FES), has been used to activate paralyzed skeletal muscle in people with spinal cord injury (SCI). The goal of NMES has been to reverse some of the dramatic losses in skeletal muscle mass, to stimulate functional improvements in people with incomplete paralysis, and to produce some of the health benefits associated with exercise.

OBJECTIVE

The purpose of this brief review is to describe a quantifiable resistance training form of NMES developed by Gary A. Dudley.

METHODS

People with motor complete SCI were first tested to confirm that an NMES-induced muscle contraction of the quadriceps muscle could be achieved. The contraction stimulus consisted of biphasic pulses at 35 Hz performed with increasing current up to what was needed to produce full knee extension. Four sets of 10 knee extensions were elicited, if possible. Training occurred biweekly for 3 to 6 months, with ankle weights being increased up to an added weight of 9.1 kg if the 40 repetitions could be performed successfully for 2 sessions.

RESULTS

Many participants have performed this protocol without adverse events, and all participants showed progression in the number of repetitions and/or the amount of weight lifted. Large increases in muscle mass occur, averaging 30% to 40%. Additional physiological adaptations to stimulated muscle have also been reported.

CONCLUSIONS

These results demonstrate that the affected skeletal muscle after SCI responds robustly to progressive resistance training many years after injury. Future work with NMES should determine whether gains in lean mass translate to improved health, function, and quality of life.

Effects of creatine supplementation on oxidative stress profile of athletes

Background

Creatine (Cr) supplementation has been widely used among athletes and physically active individuals. Secondary to its performance-enhancing ability, an increase in oxidative stress may occur, thus prompting concern about its use. The purpose of this study is to investigate the effects of Cr monohydrate supplementation and resistance training on muscle strength and oxidative stress profile in healthy athletes.

Methods

A randomized, double-blind, placebo-controlled method was used to assess twenty-six male elite Brazilian handball players divided into 3 groups: Cr monohydrate supplemented group (GC, N = 9), placebo group (GP, N = 9), no treatment group (COT, N = 8) for 32 days. All subjects underwent a resistance training program. Blood samples were drawn on 0 and 32 days post Cr supplementation to analyze the oxidative stress markers, thiobarbituric acid reactive species (TBARS), total antioxidant status (TAS), and uric acid. Creatine phosphokinase, urea, and creatinine were also analyzed, as well. Fitness tests (1 repetition maximum - 1RM and muscle endurance) were performed on the bench press. Body weight and height, body fat percentage (by measuring skin folds) and upper muscular area were also evaluated. Statistical analysis was performed using ANOVA.

Results

Only GC group showed increase in 1RM (54 ± 9 vs. 63 ± 10 kg; p = 0.0356) and uric acid (4.6 ± 1.0 vs. 7.4 ± 1.6 mg/dl; p = 0.025), with a decrease in TAS (1.11 ± 0.34 vs. 0.60 ± 0.19 mmol/l; p = 0.001). No differences (pre- vs. post-training) in TBARS, creatine phosphokinase, urea, creatinine, body weight and height, body fat percentage, or upper muscular area were observed in any group. When compared to COT, GC group showed greater decrease in TAS (−0.51 ± 0.36 vs. -0.02 ± 0.50 mmol/l; p = 0.0268), higher increase in 1RM (8.30 ± 2.26 vs. 5.29 ± 2.36 kg; p = 0.0209) and uric acid (2.77 ± 1.70 vs. 1.00 ± 1.03 mg/dl; p = 0.0276).

Conclusion

We conclude that Cr monohydrate supplementation associated with a specific resistance program promoted a meaningful increase in muscle strength without inducing changes in body composition. The observed significant increase in uric acid and the decrease in TAS suggest that creatine supplementation, despite promoting acute effects on muscle strength improvement, might induce oxidative stress and decreases total antioxidant status of subjects.

Creatine does not promote hypertrophy in skeletal muscle in supplemented compared with nonsupplemented rats subjected to a similar workload

The purpose of this study was to test the hypothesis that creatine (Cr) supplementation may promote an additional hypertrophic effect on skeletal muscle independent of a higher workload on Cr-supplemented trained muscle compared with Cr-nonsupplemented trained muscle. Male Wistar rats (2-3 months old, 250-300 g) were divided randomly into 4 groups (n = 8 per group): nontrained without Cr supplementation (CO), nontrained with Cr supplementation (CR), trained without Cr supplementation (TR), and trained with Cr supplementation (TRCR). Creatine supplementation was given at 0.5 g/kg per day. Trained groups were submitted to a 5-week resistance training program (5 d/wk). The progressive workloads were similar between the Cr-supplemented (TRCR) and Cr-nonsupplemented (TR) trained groups; the only difference between groups was the Cr treatment. After the 5-week experiment, the soleus muscle was dissected to analyze the cross-sectional area (CSA) of the muscle fibers. Resistance training promoted a significant (P < .05) increase in the muscle fibers CSA in the TR group compared with the CO group. However, no additional hypertrophic effect was found when Cr supplementation was added to training (TRCR vs TR comparison, P > .05). In addition, Cr supplementation alone did not promote significant alterations in muscle fiber CSA (CR vs CO comparison, P > .05). We conclude that Cr supplementation does not promote any additional hypertrophic effect on skeletal muscle area when Cr-supplemented trained muscles are submitted to same training regimen than Cr-nonsupplemented trained muscles. Specifically, any benefits of Cr supplementation on hypertrophy gains during resistance training may not be attributed to a direct anabolic effect on the skeletal muscle.

Motor unit recruitment during neuromuscular electrical stimulation: a critical appraisal

Neuromuscular electrical stimulation (NMES) is commonly used in clinical settings to activate skeletal muscle in an effort to mimic voluntary contractions and enhance the rehabilitation of human skeletal muscles. It is also used as a tool in research to assess muscle performance and/or neuromuscular activation levels. However, there are fundamental differences between voluntary- and artificial-activation of motor units that need to be appreciated before NMES protocol design can be most effective. The unique effects of NMES have been attributed to several mechanisms, most notably, a reversal of the voluntary recruitment pattern that is known to occur during voluntary muscle contractions. This review outlines the assertion that electrical stimulation recruits motor units in a nonselective, spatially fixed, and temporally synchronous pattern. Additionally, it synthesizes the evidence that supports the contention that this recruitment pattern contributes to increased muscle fatigue when compared with voluntary actions and provides some commentary on the parameters of electrical stimulation as well as emerging technologies being developed to facilitate NMES implementation. A greater understanding of how electrical stimulation recruits motor units, as well as the benefits and limitations of its use, is highly relevant when using this tool for testing and training in rehabilitation, exercise, and/or research.

Transcutaneous neuromuscular electrical stimulation: influence of electrode positioning and stimulus amplitude settings on muscle response

The aim of the study was to investigate the influence of two different transcutaneous neuromuscular electrical stimulation procedures on evoked muscle torque and local tissue oxygenation. In the first one (MP mode), the cathode was facing the muscle main motor point and stimulus amplitude was set to the level eliciting the maximal myoelectrical activation according to the amplitude of the evoked electromyogram (EMG); in the second one (RC mode), the electrodes were positioned following common reference charts for electrode placement while stimulus amplitude was set according to subject tolerance. Tibialis Anterior (TA) and Vastus Lateralis (VL) muscles of 10 subjects (28.4 ± 8.2 years) were tested in specific dynamometers to measure the evoked isometric torque. The EMG and near-infrared spectroscopy probes were placed on muscle belly to detect the electrical activity and local metabolic modifications of the stimulated muscle, respectively. The stimulation protocol consisted of a gradually increasing frequency ramp from 2 to 50 Hz in 7.5 s. Compared to RC mode, in MP mode the contractile parameters (peak twitch, tetanic torque, area under the torque build-up) and the metabolic solicitation (oxygen consumption and hyperemia due to metabolites accumulation) resulted significantly higher for both TA and VL muscles. MP mode resulted also to be more comfortable for the subjects. Based on the assumption that proper mechanical and metabolic stimuli are necessary to induce muscle strengthening, our results witness the importance of an optimized, i.e., comfortable and effective, stimulation to promote the aforementioned muscle adaptive modifications.

Neural adaptations to electrical stimulation strength training

This review provides evidence for the hypothesis that electrostimulation strength training (EST) increases the force of a maximal voluntary contraction (MVC) through neural adaptations in healthy skeletal muscle. Although electrical stimulation and voluntary effort activate muscle differently, there is substantial evidence to suggest that EST modifies the excitability of specific neural paths and such adaptations contribute to the increases in MVC force. Similar to strength training with voluntary contractions, EST increases MVC force after only a few sessions with some changes in muscle biochemistry but without overt muscle hypertrophy. There is some mixed evidence for spinal neural adaptations in the form of an increase in the amplitude of the interpolated twitch and in the amplitude of the volitional wave, with less evidence for changes in spinal excitability. Cross-sectional and exercise studies also suggest that the barrage of sensory and nociceptive inputs acts at the cortical level and can modify the motor cortical output and interhemispheric paths. The data suggest that neural adaptations mediate initial increases in MVC force after short-term EST.

The effect of creatine supplementation on mass and performance of rat skeletal muscle

This study investigated the effect of dietary creatine supplementation on hypertrophy and performance of rat skeletal muscle. Male Sprague-Dawley rats underwent either tibialis anterior ablation or partial ablation of the plantaris/gastrocnemius to induce compensatory hypertrophy of the extensor digitorum longus (EDL) or soleus respectively, or sham surgery. Creatine (300 mg/kg) was administered to one half of each group for 5 weeks, after which force production was measured. With the leg fixed at the knee and ankle, the distal tendon of the EDL or soleus was attached to a force transducer and the muscle was electrically stimulated via the sciatic nerve. Synergist ablation resulted in a significant increase in EDL mass and in soleus mass relative to control muscles. However, no effect of creatine supplementation on muscle mass or performance was found between control and either group of creatine-treated rats. Despite an apparent increase in muscle creatine content, creatine supplementation did not augment muscle hypertrophy or force production in rat EDL or soleus muscle, providing evidence that the potential benefits of creatine supplementation are not due to a direct effect on muscle but rather to an enhanced ability to train.

The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans

Strength training is an important component in sports training and rehabilitation. Quantification of the dose-response relationships between training variables and the outcome is fundamental for the proper prescription of resistance training. The purpose of this comprehensive review was to identify dose-response relationships for the development of muscle hypertrophy by calculating the magnitudes and rates of increases in muscle cross-sectional area induced by varying levels of frequency, intensity and volume, as well as by different modes of strength training. Computer searches in the databases MEDLINE, SportDiscus and CINAHL were performed as well as hand searches of relevant journals, books and reference lists. The analysis was limited to the quadriceps femoris and the elbow flexors, since these were the only muscle groups that allowed for evaluations of dose-response trends. The modes of strength training were classified as dynamic external resistance (including free weights and weight machines), accommodating resistance (e.g. isokinetic and semi-isokinetic devices) and isometric resistance. The subcategories related to the types of muscle actions used. The results demonstrate that given sufficient frequency, intensity and volume of work, all three types of muscle actions can induce significant hypertrophy at an impressive rate and that, at present, there is insufficient evidence for the superiority of any mode and/or type of muscle action over other modes and types of training. Tentative dose-response relationships for each variable are outlined, based on the available evidence, and interactions between variables are discussed. In addition, recommendations for training and suggestions for further research are given.

Nutritional strategies to influence adaptations to training

This article highlights new nutritional concerns or practices that may influence the adaptation to training. The discussion is based on the assumption that the adaptation to repeated bouts of training occurs during recovery periods and that if one can train harder, the adaptation will be greater. The goal is to maximize with nutrition the recovery/adaptation that occurs in all rest periods, such that recovery before the next training session is complete. Four issues have been identified where recent scientific information will force sports nutritionists to embrace new issues and reassess old issues and, ultimately, alter the nutritional recommendations they give to athletes. These are: (1) caffeine ingestion; (2) creatine ingestion; (3) the use of intramuscular triacylglycerol (IMTG) as a fuel during exercise and the nutritional effects on IMTG repletion following exercise; and (4) the role nutrition may play in regulating the expression of genes during and after exercise training sessions. Recent findings suggest that low doses of caffeine exert significant ergogenic effects by directly affecting the central nervous system during exercise. Caffeine can cross the blood-brain barrier and antagonize the effects of adenosine, resulting in higher concentrations of stimulatory neurotransmitters. These new data strengthen the case for using low doses of caffeine during training. On the other hand, the data on the role that supplemental creatine ingestion plays in augmenting the increase in skeletal muscle mass and strength during resistance training remain equivocal. Some studies are able to demonstrate increases in muscle fibre size with creatine ingestion and some are not. The final two nutritional topics are new and have not progressed to the point that we can specifically identify strategies to enhance the adaptation to training. However, it is likely that nutritional strategies will be needed to replenish the IMTG that is used during endurance exercise. It is not presently clear whether the IMTG store is chronically reduced when engaging in daily sessions of endurance training or if this impacts negatively on the ability to train. It is also likely that the increased interest in gene and protein expression measurements will lead to nutritional strategies to optimize the adaptations that occur in skeletal muscle during and after exercise training sessions. Research in these areas in the coming years will lead to strategies designed to improve the adaptive response to training.

Voluntary Muscle Function after Creatine Supplementation in Acute Hypobaric Hypoxia

PURPOSE

To determine whether creatine (Cr) supplementation improves muscle performance during exposure to acute hypobaric hypoxia.

METHODS

Seven healthy men (28 +/- 6 yr, mean +/- SD) performed submaximal intermittent static knee contractions interspersed with maximal voluntary contractions (MVCs) every minute to exhaustion (approximately 50% of rested MVC force) in normoxia and hypobaric hypoxia (separated by 3 d) after supplementation with Cr (20 g.d(-1) for 7 d then 5 g.d(-1) for 4-7 d) or placebo (Pla) in a double-blind, randomized crossover study. A 5-wk period without supplementation separated treatments. Each test day, subjects performed two bouts (separated by 2 min) at their preset submaximal force, 32 +/- 4% rested MVC).

RESULTS

Rested MVC force (860 +/- 66 N) and MVC force at exhaustion (396 +/- 27 N; 47 +/- 3% rested MVC) did not differ among treatments or environments (P > 0.05). For bout 1, endurance time was shorter in hypobaria (26 +/- 3 min) than normoxia (34 +/- 2 min) (P < 0.01), but did not differ between Cr (27 +/- 3 min) and Pla (33 +/- 3 min) (P > 0.05). MVC force returned to similar levels (P >0.05) in bout 2 after recovery in all four sessions (to approximately 615 N). For bout 2, endurance time also was shorter in hypobaria (7 +/- 1 min) than normoxia (9 +/- 1 min) (P < 0.03) but did not differ between Cr and Pla (P > 0.05).

CONCLUSION

This study, which used an exercise model designed to impose the same target contraction force under all experimental conditions, found no effect of Cr on maximal force, muscle endurance, or recovery in normoxia or hypobaric hypoxia.

Risk assessment for creatine monohydrate

Creatine monohydrate (creatine) has become an increasingly popular ingredient in dietary supplements, especially sports nutrition products. A large body of human and animal research suggests that creatine does have a consistent ergogenic effect, particularly with exercises or activities requiring high intensity short bursts of energy. Human data are primarily derived from three types of studies: acute studies, involving high doses (20 g/d) with short duration (< or = 1 week), chronic studies involving lower doses (3-5 g/d) and longer duration (1 year), or a combination of both. Systematic evaluation of the research designs and data do not provide a basis for risk assessment and the usual safe Upper Level of Intake (UL) derived from it unless the newer methods described as the Observed Safe Level (OSL) or Highest Observed Intake (HOI) are utilized. The OSL risk assessment method indicates that the evidence of safety is strong at intakes up to 5 g/d for chronic supplementation, and this level is identified as the OSL. Although much higher levels have been tested under acute conditions without adverse effects and may be safe, the data for intakes above 5 g/d are not sufficient for a confident conclusion of long-term safety.

Neuromuscular Adaptations to Electrostimulation Resistance Training

A combination of in vivo and in vitro analyses was performed to investigate muscular and neural adaptations of the weaker (nondominant) quadriceps femoris muscle of one healthy individual to short-term electrostimulation resistance training. The increase in maximal voluntary strength (+12%) was accompanied by neural (cross-education effect and increased muscle activation) and muscle adaptations (impairment of whole-muscle contractile properties). Significant changes in myosin heavy chain (MHC) isoforms relative content (+22% for MHC-2A and -28% for MHC-2X), single-fiber cross-sectional area (+27% for type 1 and +6% for type 2A muscle fibers), and specific tension of type 1 (+67%) but not type 2A fibers were also observed after training. Plastic changes in neural control confirm the possible involvement of both spinal and supraspinal structures to electrically evoked contractions. Changes at the single muscle fiber level induced by electrostimulation resistance training were significant and preferentially affected slow, type 1 fibers.

Creatine supplementation and exercise performance: recent findings

Creatine monohydrate (Cr) is perhaps one of the most widely used supplements taken in an attempt to improve athletic performance. The aim of this review is to update, summarise and evaluate the findings associated with Cr ingestion and sport and exercise performance with the most recent research available. Because of the large volume of scientific literature dealing with Cr supplementation and the recent efforts to delineate sport-specific effects, this paper focuses on research articles that have been published since 1999.Cr is produced endogenously by the liver or ingested from exogenous sources such as meat and fish. Almost all the Cr in the body is located in skeletal muscle in either the free (Cr: approximately 40%) or phosphorylated (PCr: approximately 60%) form and represents an average Cr pool of about 120-140 g for an average 70 kg person. It is hypothesised that Cr can act though a number of possible mechanisms as a potential ergogenic aid but it appears to be most effective for activities that involve repeated short bouts of high-intensity physical activity. Additionally, investigators have studied a number of different Cr loading programmes; the most common programme involves an initial loading phase of 20 g/day for 5-7 days, followed by a maintenance phase of 3-5 g/day for differing periods of time (1 week to 6 months). When maximal force or strength (dynamic or isotonic contractions) is the outcome measure following Cr ingestion, it generally appears that Cr does significantly impact force production regardless of sport, sex or age. The evidence is much more equivocal when investigating isokinetic force production and little evidence exists to support the use of Cr for isometric muscular performance. There is little benefit from Cr ingestion for the prevention or suppression of muscle damage or soreness following muscular activity. When performance is assessed based on intensity and duration of the exercises, there is contradictory evidence relative to both continuous and intermittent endurance activities. However, activities that involve jumping, sprinting or cycling generally show improved sport performance following Cr ingestion. With these concepts in mind, the focus of this paper is to summarise the effectiveness of Cr on specific performance outcomes rather than on proposed mechanisms of action. The last brief section of this review deals with the potential adverse effects of Cr supplementation. There appears to be no strong scientific evidence to support any adverse effects but it should be noted that there have been no studies to date that address the issue of long-term Cr usage.

Metabolic and phenotypic characteristics of human skeletal muscle fibers as predictors of glycogen utilization during electrical stimulation

Characteristics of skeletal muscle such as fiber type composition and activities of key metabolic enzymes have been purported to affect glycogen utilization. However, the relative importance individual factors may have in predicting glycogen utilization of individual muscle fibers has not been addressed. Thus, we sought to determine the relative importance that metabolic characteristics and phenotypic expression of individual fibers have in predicting fiber specific glycogen utilization during neuromuscular electrical stimulation (NMES) exercise. Biopsies were taken from the m, vastus lateralis (VL) of eight recreationally active males before and immediately after 30 min of non-fatiguing NMES and analyzed for type (I, IIa and IIx), succinate dehydrogenase activity (SDH), glycerol-phosphate dehydrogenase activity (GPDH), quantitative-actomyosin adenosine triphosphatase activity (qATPase), and glycogen content. Our results demonstrate that a ratio of enzyme activities representing pathways for energy supply and energy demand (SDH: qATPase) accounted for more of the variance in glycogen utilization (y=0.2091 e(-0.0329x ), R2=0.622, P< or = 0.0001) than SDH (R2=0.321) or qATPase (R2=0.365) alone. Fiber phenotype was also a significant predictor of glycogen utilization, but to a lesser extent than the other variables studied (R2=0.201). A ratio of the activities of enzymes representing pathways of energy supply and energy demand, represented by SDH:qATPase, is a better predictor of glycogen utilization than either of its components independently while fiber phenotype, although a statistically significant predictor of glycogen utilization, may not be the most appropriate determinate of the functional characteristics of an individual fiber.

Electromyostimulation Training Effects on Neural Drive and Muscle Architecture

PURPOSE

The purpose of the study was to investigate the effect of 4 and 8 wk of electromyostimulation (EMS) training on both muscular and neural adaptations of the knee extensor muscles.

METHODS

Twenty males were divided into the electrostimulated group (EG, N = 12) and the control group (CG, N = 8). The training program consisted of 32 sessions of isometric EMS over an 8-wk period. All subjects were tested at baseline (B) and retested after 4 (WK4) and 8 (WK8) wk of EMS training. The EMG activity and muscle activation obtained under maximal voluntary contractions (MVC) was used to assess neural adaptations. Torque and EMG responses obtained under electrically evoked contractions, muscle anatomical cross-sectional area (ACSA), and vastus lateralis (VL) pennation angle, both measured by ultrasonography imaging, were examined to analyze muscular changes.

RESULTS

At WK8, knee extensor MVC significantly increased by 27% (P < 0.001) and was accompanied by an increase in muscle activation (+6%, P < 0.01), quadriceps muscle ACSA (+6%, P < 0.001), and VL pennation angle (+14%, P < 0.001). A significant increase in normalized EMG activity of both VL and vastus medialis (VM) muscles (+69 and +39%, respectively, P < 0.001) but not of rectus femoris (RF) muscle was also found at WK8. The ACSA of the VL, VM, and vastus intermedius muscles significantly increased at WK8 (5-8%, P < 0.001) but not at WK4, whereas no changes occurred in the RF muscle.

CONCLUSION

We concluded that the voluntary torque gains obtained after EMS training could be attributed to both muscular and neural adaptations. Both changes selectively involved the monoarticular vastii muscles.

Recruitment Patterns in Human Skeletal Muscle During Electrical Stimulation

Electromyostimulation (EMS) incorporates the use of electrical current to activate skeletal muscle and facilitate contraction. It is commonly used in clinical settings to mimic voluntary contractions and enhance the rehabilitation of human skeletal muscles. Although the beneficial effects of EMS are widely accepted, discrepancies concerning the specific responses to EMS versus voluntary actions exist. The unique effects of EMS have been attributed to several mechanisms, most notably a reversal of the recruitment pattern typically associated with voluntary muscle activation. This perspective outlines the authors' contention that electrical stimulation recruits motor units in a nonselective, spatially fixed, and temporally synchronous pattern. Furthermore, it synthesizes the evidence that supports the contention that this recruitment pattern contributes to increased muscle fatigue when compared with voluntary actions. The authors believe the majority of evidence suggests that EMS-induced motor unit recruitment is nonselective and that muscle fibers are recruited without obvious sequencing related to fiber types.

Scientific basis and practical aspects of creatine supplementation for athletes

A large number of studies have been published on creatine supplementation over the last decade. Many studies show that creatine supplementation in conjunction with resistance training augments gains in muscle strength and size. The underlying physiological mechanism(s) to explain this ergogenic effect remain unclear. Increases in muscle fiber hypertrophy and myosin heavy chain expression have been observed with creatine supplementation. Creatine supplementation increases acute weightlifting performance and training volume, which may allow for greater overload and adaptations to training. Creatine supplementation may also induce a cellular swelling in muscle cells, which in turn may affect carbohydrate and protein metabolism. Several studies point to the conclusion that elevated intramuscular creatine can enhance glycogen levels but an effect on protein synthesis/degradation has not been consistently detected. As expected there is a distribution of responses to creatine supplementation that can be largely explained by the degree of creatine uptake into muscle. Thus, there is wide interest in methods to maximize muscle creatine levels. A carbohydrate or carbohydrate/protein-induced insulin response appears to benefit creatine uptake. In summary, the predominance of research indicates that creatine supplementation represents a safe, effective, and legal method to enhance muscle size and strength responses to resistance training.

Metabolic modulation of muscle fiber properties unrelated to mechanical stimuli

The effects of chronically increasing (creatine-fed) or decreasing (beta-guanidinopropionic acid [beta-GPA]-fed) high-energy phosphates for up to 8 weeks on daily voluntary activity levels, swimming endurance capacity, electromyogram (EMG) activity, and the morphological and metabolic properties of single fibers in the soleus and extensor digitorum longus (EDL) muscles in young rats were determined. High-energy phosphate, voluntary activity, and soleus-integrated EMG levels were lower in beta-GPA-fed rats than in control rats. Endurance capacity was higher at a relatively low intensity of swimming and lower at a relatively high intensity in beta-GPA-fed rats than in control rats. Muscle mass and fiber size were smaller, and the percentage of slow fibers was higher in the soleus and EDL of beta-GPA-fed rats than in control rats. Succinate dehydrogenase activity was higher in both the fast and slow fibers of the EDL of beta-GPA-fed rats than in control rats. Thus, a reduction in high-energy phosphates transformed some fast fibers toward a slow phenotype. Creatine supplementation had minimal effects: The only significant change was an increase in alpha-glycerophosphate dehydrogenase activity in the fast fibers of the EDL. These results indicate that the metabolic environment of a muscle fiber can influence the prominence of a given muscle fiber independent of the activity level of muscle.

Long-term spinal cord injury increases susceptibility to isometric contraction-induced muscle injury

Complete spinal cord injury (SCI) results in inactivation and unloading of affected skeletal muscles. Unloading causes an increased susceptibility of muscle to contraction-induced injury. This study used magnetic resonance imaging (MRI) to test the hypothesis that isometric contractions would evoke greater muscle damage to the quadriceps femoris muscle (mQF) of SCI subjects than that of able-bodied (AB) controls. MR images were taken of the mQF prior to, immediately post, and 3 days post electromyostimulation (EMS). EMS consisted of five sets of ten isometric contractions (2 s on/6 s off, 1 min between sets) followed by another three sets of ten isometric contractions (1 s on/1 s off, 30 s between sets). Average muscle cross-sectional area (CSA) and the relative areas of stimulated and injured muscle were obtained from MR images by quantifying the number of pixels with an elevated T2 signal. SCI subjects had significantly greater relative area [90 (2)% versus 66 (4)%, P<0.05; mean (SE)] but a lesser absolute area [16 (3) cm(2) versus 44 (6) cm(2), P<0.05] of mQF stimulated than AB controls. During EMS, peak torque was reduced by 66% and 37% for SCI and control subjects, respectively. Three days post EMS, there was a greater relative area of stimulated mQF injured for the SCI subjects [25 (6)% versus 2 (1)%, P<0.05]. Peak torque remained decreased by 22% on day 3 in the SCI group only. These results indicate that affected muscle years after SCI is more susceptible to contraction-induced muscle damage, as determined by MRI, compared to AB controls. They also support the contention that electrically elicited isometric contractions are sufficient to cause muscle damage after a prolonged period of inactivity.

Variable frequency trains enhance torque independent of stimulation amplitude

AIM

Variable frequency trains have been reported to enhance force of fatigued human skeletal muscle. More rapid calcium turnover and/or enhanced stiffness may be responsible for the augmented torque-time integral during surface stimulation at moderate amplitude. In contrast, it has recently been suggested that variable frequency train enhancement occurs only at low forces as a result of preferential stimulation of fast fibres and/or altered motor unit recruitment. If correct, this would limit the practical benefit of variable frequency trains. Accordingly, we tested the hypothesis that torque augmentation by variable frequency trains in fatigued skeletal muscle was independent of stimulation amplitude.

METHODS

The m. quadriceps femoris of six males was stimulated with constant frequency trains (six 200-micros square waves separated by 70 ms) or variable frequency trains (first interpulse interval 5 ms) at an amplitude that initially evoked approximately 25 or approximately 50% of maximal voluntary isometric torque.

RESULTS

After 180 constant frequency trains (50% duty cycle), isometric peak torque decreased approximately 63%. In fatigued muscle, variable frequency trains enhanced the torque-time integral by approximately 23% over that for constant frequency trains and this effect was independent of stimulation amplitude. This was due to greater peak torque and less slowing of rise time.

CONCLUSION

These responses show that the torque-time integral can be enhanced at both moderate and high stimulation amplitudes. As such, it is suggested that neither recruitment nor preferential activation of fast muscle is responsible for the "catch-like" property that can be demonstrated in fatigued human skeletal muscle.