Popping sarcomere hypothesis explains stretch-induced muscle damage

Youths Are Less Susceptible to Exercise-Induced Muscle Damage Than Adults: A Systematic Review With Meta-Analysis

PURPOSE

This meta-analysis aimed to (1) provide a comparison of peak changes in indirect markers of exercise-induced muscle damage (EIMD) in youths versus adults and (2) determine if the involved limb moderated this effect.

METHOD

Studies were eligible for inclusion if they (1) provided a human youth versus adult comparison; (2) provided data on muscle strength, soreness, or creatine kinase markers beyond ≥24 hours; and (3) did not provide a recovery treatment. Effect sizes (ES) were presented alongside 95% confidence intervals.

RESULTS

EIMD exhibited larger effects on adults than in youths for muscle strength (ES = -2.01; P < .001), muscle soreness (ES = -1.52; P < .001), and creatine kinase (ES = -1.98; P < .001). The random effects meta-regression indicated that the effects of upper- and lower-limb exercise in youths and adults were significant for muscle soreness (coefficient estimate = 1.11; P < .001) but not for muscle strength or creatine kinase (P > .05). As such, the between-group effects for muscle soreness (ES = -2.10 vs -1.03; P < .05) were greater in the upper than lower limbs.

CONCLUSION

The magnitude of EIMD in youths is substantially less than in their adult counterparts, and this effect is greater in upper than lower limbs for muscle soreness. These findings help guide practitioners who may be concerned about the potential impact of EIMD when training youth athletes.

Nutritional interventions for exercise-induced muscle damage: an umbrella review of systematic reviews and meta-analyses of randomized trials

CONTEXT

Several meta-analyses have been conducted on the effect of nutritional interventions on various factors related to muscle damage. However, the strength of the evidence and its clinical significance are unclear.

OBJECTIVES

This umbrella review aimed to provide an evidence-based overview of nutritional interventions for exercise-induced muscle damage (EIMD).

DATA SOURCES

PubMed, Scopus, and ISI Web of Science were systematically searched up to May 2022.

DATA EXTRACTION

Systematic reviews and meta-analyses of randomized controlled trials investigating nutritional interventions' effects on recovery following EIMD were included. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

Fifty-three randomized controlled trial meta-analyses were included, evaluating 24 nutritional interventions on 10 different outcomes. The results revealed a significant effect of hydroxymethylbutyrate (HMB) supplementation and l-carnitine supplementation for reducing postexercise creatine kinase; HMB supplementation for reducing lactate dehydrogenase; branched-chain amino acids and leaf extract supplementation for reducing the delayed onset of muscle soreness; and l-carnitine, curcumin, ginseng, polyphenols, and anthocyanins for reducing muscle soreness, all with moderate certainty of evidence.

CONCLUSIONS

Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes.

PROTOCOL REGISTRATION

PROSPERO registration no. CRD42022352565.

Relationships Between Modifiable Risk Factors of Hamstring Strain Injury

ABSTRACT

Ripley, NJ, Comfort, P, and McMahon, JJ. Relationships between modifiable risk factors of hamstring strain injury. J Strength Cond Res 38(3): 510-516, 2024-The aims of this study were to determine whether any relationship exists between eccentric hamstring strength and isokinetic strength imbalances and bicep femoris long head (BF LH ) architecture. Eighteen physically active men (age 24.7 ± 4.3 years, height 181.9 ± 7.2 cm, mass 84.9 ± 12.9 kg) had resting BF LH muscle architecture assessed using ultrasound, with images taken at the midmuscle belly. Measures of isokinetic strength of the knee extensors and flexors involved subjects performing 3 maximal effort repetitions of concentric knee extension and eccentric knee flexion at 60°·s -1 . Good-excellent relative reliability (intraclass correlation coefficient ≥0.86) and low variability (coefficient of variation <10%) were observed for all variables. Relative BF LH fascicle length (FL) demonstrated significant moderate-to-nearly-perfect associations with isokinetic measures identified as hamstring strain injury risk factors ( p < 0.05, r = 0.38-0.92), whereas absolute BF LH FL was not significantly or meaningfully associated with isokinetic measures ( p = 0.07-0.961, r = 0.01-0.30). Relative BF LH FL should be considered when assessing resting BF LH muscle architecture because it is potentially a more appropriate measure of injury risk because of its greater association with strength measures. However, absolute BF LH FL may have a greater usefulness during growth, maturation, and individual proportions.

Gaining new understanding of sarcomere length non-uniformities in skeletal muscles

Sarcomere lengths are non-uniform on all structural levels of mammalian skeletal muscle. These non-uniformities have been associated with a variety of mechanical properties, including residual force enhancement and depression, creep, increased force capacity, and extension of the plateau of the force-length relationship. However, the nature of sarcomere length non-uniformities has not been explored systematically. The purpose of this study was to determine the properties of sarcomere length non-uniformities in active and passive muscle. Single myofibrils of rabbit psoas (n = 20; with 412 individual sarcomeres) were subjected to three activation/deactivation cycles and individual sarcomere lengths were measured at 4 passive and 3 active points during the activation/deactivation cycles. The myofibrils were divided into three groups based on their initial average sarcomere lengths: short, intermediate, and long average sarcomere lengths of 2.7, 3.2, and 3.6 µm. The primary results were that sarcomere length non-uniformities did not occur randomly but were governed by some structural and/or contractile properties of the sarcomeres and that sarcomere length non-uniformities increased when myofibrils went from the passive to the active state. We propose that the mechanisms that govern the systematic sarcomere lengths non-uniformities observed in active and passive myofibrils may be associated with the variable number of contractile proteins and the variable number and the adjustable stiffness of titin filaments in individual sarcomeres.

Re‑examining the mechanism of eccentric exercise‑induced skeletal muscle damage from the role of the third filament, titin (Review)

Intense and unaccustomed eccentric exercise has been extensively studied for its ability to induce muscle damage. However, the underlying mechanism of this phenomenon still requires further clarification. This knowledge gap arises from the need for explanation of the eccentric contraction through the sliding filament theory. The two-filament sarcomere model, which is consisted of thin and thick filaments, forms the basis of the sliding filament theory. The mechanisms of concentric and isometric contractions at the cellular and molecular levels are effectively described by this model. However, when relying solely on the cross-bridge swing, the sliding filament theory fails to account for specific observations, such as the stability of the descending limb of the force-length relationship curve. Recent evidence indicated that titin and the extracellular matrix (ECM) may play a protective role by interacting with the thick and thin filaments. During an eccentric contraction, titin serves as a third filament in the sarcomere, which helps regulate changes in passive force. The two-filament sarcomere model has limitations in explaining eccentric contraction, thus this compensates for those shortcomings. The present review explored the potential of replacing the two-filament sarcomere model with a three-filament sarcomere model, incorporating thin filaments, thick filaments and titin. This revised model offers a more comprehensive explanation of eccentric contraction phenomena. Furthermore, the sliding filament theory was investigated in the context of the three-filament sarcomere model. The double-layer protection mechanism, which involves increased titin stiffness and the ECM during eccentric contraction was explored. This mechanism may enhance lateral force transmission between muscle fibers and the ECM, resulting in sarcolemma and ECM shear deformation. These findings provided insight into the mechanism of eccentric exercise-induced skeletal muscle damage. Considering the three-filament sarcomere model and the double-layer protection mechanism, the present review offered a more logical and comprehensive understanding of the mechanism behind eccentric exercise-induced muscle damage.

Effectiveness of 448-kHz Capacitive Resistive Monopolar Radiofrequency Therapy After Eccentric Exercise-Induced Muscle Damage to Restore Muscle Strength and Contractile Parameters

CONTEXT

Exercise-induced muscle damage (EIMD) is prevalent especially in sports and rehabilitation. It causes loss in skeletal muscle function and soreness. As there are no firm preventive strategies, we aimed to evaluate the preventive efficacy of nonthermal 448-kHz capacitive resistive monopolar radiofrequency (CRMRF) therapy after eccentric bouts of EIMD response in knee flexors.

DESIGN

Twenty-nine healthy males (age: 25.2 [4.6] y) were randomized in control group (CG; n = 15) and experimental group (EG; n = 14) where EG followed 5 daily 448-kHz CRMRF therapies. All assessments were performed at baseline and post EIMD (EIMD + 1, EIMD + 2, EIMD + 5, and EIMD + 9 d). We measured tensiomyography of biceps femoris and semitendinosus to calculate contraction time, the maximal displacement and the radial velocity of contraction, unilateral isometric knee flexors maximal voluntary contraction torque, and rate of torque development in first 100 milliseconds.

RESULTS

Maximal voluntary contraction torque and rate of torque development in first 100 milliseconds decreased more in CG than in EG and recovered only in EG. Biceps femoris contraction time increased only in CG (without recovery), whereas in semitendinosus contraction time increased in EG (only at EIMD + 1) and in CG (without recovery). In both muscles, tensiomyographic maximal displacement decreased in EG (in EIMD + 1 and EIMD + 2) and in CG (without recovery). Furthermore, in both muscles, radial velocity of contraction decreased in EG (from EIMD + 1 until EIMD + 5) and in CG (without recovery).

CONCLUSION

The study shows beneficial effect of CRMRF therapy after inducing EIMD in skeletal muscle strength and contractile parameters in knee flexors.

Effects of a Football Simulated Exercise on Injury Risk Factors for Anterior Cruciate Ligament (ACL) Injury in Amateur Female Players

Females are more at risk of Anterior Cruciate Ligament (ACL) injuries than males; however, there is limited literature on neuromuscular risk factors such as angle-specific hamstring/quadriceps functional strength ratios (H_ecc/Q_con) and rate of torque development (RTD) in female footballers. The aim of this study was to investigate the effects of fatigue on these neuromuscular risk factors. Thirty-three amateur players (20.3 ± 2.0 years old, 1.67 ± 9.31 m, 63.4 ±8.1 kg, 23.6 ± 5.7% body fat) performed strength assessments of the quadriceps (concentrically, Q_con) and hamstrings (eccentrically, H_ecc) on both legs on an isokinetic dynamometer, before and immediately after a football-specific exercise. Results showed significantly lower peak H_ecc (-15.1 to -15.5%), peak H_ecc/Q_con (-8.8 to -12.9%) and RTD (-14.0 to -17.0%) for hamstring eccentric contractions after fatigue in the dominant and non-dominant legs. Furthermore, significant decreases in H_ecc/Q_con were observed at 10° only in the dominant leg (-15.5%), and at 10°, 20° and 30° in the non-dominant leg (-15.1 to -21.8%). These results suggest a reduced capacity of the hamstrings to stabilise the knee joint with fatigue. Unlike results previously shown on men, the non-dominant leg seemed more affected, highlighting the need to consider specific prevention measures in females.

Biceps femoris long head sarcomere and fascicle length adaptations after 3 weeks of eccentric exercise training

BACKGROUND

Eccentric exercise increases muscle fascicle lengths; however, the mechanisms behind this adaptation are still unknown. This study aimed to determine whether biceps femoris long head (BFlh) fascicle length increases in response to 3 weeks of eccentric exercise training are the result of an in-series addition of sarcomeres within the muscle fibers.

METHODS

Ten recreationally active participants (age = 27 ± 3 years; mass = 70 ± 14 kg; height = 174 ± 9 cm; mean ± SD) completed 3 weeks of Nordic hamstring exercise (NHE) training on a custom exercise device that was instrumented with load cells. We collected in vivo sarcomere and muscle fascicle images of the BFlh in 2 regions (central and distal) by using microendoscopy and 3 dimension ultrasonography. We then estimated sarcomere length, sarcomere number, and fascicle length before and after the training intervention.

RESULTS

Eccentric knee flexion strength increased after the training (15%; p < 0.001; η_p² = 0.75). Further, we found a significant increase in fascicle length (21%; p < 0.001; η_p² = 0.81) and sarcomere length (17%; p < 0.001; η_p² = 0.90) in the distal but not in the central portion of the muscle. The estimated number of sarcomeres in series did not change in either region.

CONCLUSION

Fascicle length adaptations appear to be heterogeneous in the BFlh in response to 3 weeks of NHE training. An increase in sarcomere length, rather than the addition of sarcomeres in series, appears to underlie increases in fascicle length in the distal region of the BFlh. The mechanism driving regional increases in fascicle and sarcomere length remains unknown, but we speculate that it may be driven by regional changes in the passive tension of muscle or connective tissue adaptations.

The Effect of Exercise Compliance on Risk Reduction for Hamstring Strain Injury: A Systematic Review and Meta-Analyses

Eccentric strength training can reduce the risk of hamstring strain injury (HSI) occurrence; however, its implementation can be impacted by athlete compliance and prescription. The aim of this review was to investigate the effects of intervention compliance, consistency and modality, on the prevention of HSIs among athletes. A literature search was conducted. 868 studies were identified prior to the application of the exclusion criteria which resulted in 13 studies identified. Random effects models were used to produce log odds ratios and 95% confidence intervals. Very high (>75.1%), moderate-high (50.1-75%), low-moderate (25.1-50%) and very low (<25%) and <1-, 1.01-3.00-, >3.01-weeks/session were used as thresholds of compliance and consistency, respectively. Modality was also observed. A positive effect on HSI incidence -0.61 (-1.05 to -0.17), favoring the intervention treatments (Z = -2.70, p = 0.007). There were non-significant, large differences between compliance (p = 0.203, Z = -1.272) and consistency (p = 0.137, Z = -1.488), with increased compliance and consistency showing greater effectiveness. A significant difference between intervention modalities was observed (p < 0.001, Z = -4.136), with eccentric interventions being superiorly effective. Compliance of >50.1% and consistent application with <3 weeks/session having positive effects on HSI incidence. Training interventions that can achieve high levels of compliance, and can be consistently performed, should be the objective of future practice.

Investigation of the Sympathetic Regulation in Delayed Onset Muscle Soreness: Results of an RCT

Sports-related pain and injury is directly linked to tissue inflammation, thus involving the autonomic nervous system (ANS). In the present experimental study, we disable the sympathetic part of the ANS by applying a stellate ganglion block (SGB) in an experimental model of delayed onset muscle soreness (DOMS) of the biceps muscle. We included 45 healthy participants (female 11, male 34, age 24.16 ± 6.67 years [range 18-53], BMI 23.22 ± 2.09 kg/m2) who were equally randomized to receive either (i) an SGB prior to exercise-induced DOMS (preventive), (ii) sham intervention in addition to DOMS (control/sham), or (iii) SGB after the induction of DOMS (rehabilitative). The aim of the study was to determine whether and to what extent sympathetically maintained pain (SMP) is involved in DOMS processing. Focusing on the muscular area with the greatest eccentric load (biceps distal fifth), a significant time × group interaction on the pressure pain threshold was observed between preventive SGB and sham (p = 0.034). There was a significant effect on pain at motion (p = 0.048), with post hoc statistical difference at 48 h (preventive SGB Δ1.09 ± 0.82 cm VAS vs. sham Δ2.05 ± 1.51 cm VAS; p = 0.04). DOMS mediated an increase in venous cfDNA -as a potential molecular/inflammatory marker of DOMS- within the first 24 h after eccentric exercise (time effect p = 0.018), with a peak at 20 and 60 min. After 60 min, cfDNA levels were significantly decreased comparing preventive SGB to sham (unpaired t-test p = 0.008). At both times, 20 and 60 min, cfDNA significantly correlated with observed changes in PPT. The 20-min increase was more sensitive, as it tended toward significance at 48 h (r = 0.44; p = 0.1) and predicted the early decrease of PPT following preventive stellate blocks at 24 h (r = 0.53; p = 0.04). Our study reveals the broad impact of the ANS on DOMS and exercise-induced pain. For the first time, we have obtained insights into the sympathetic regulation of pain and inflammation following exercise overload. As this study is of a translational pilot character, further research is encouraged to confirm and specify our observations.

Effect of Polyphenol-Rich Foods, Juices, and Concentrates on Recovery from Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis

Objectives. To determine the effects of consuming polyphenol-rich foods, juices and concentrates on recovery from exercise-induced muscle damage (EIMD). Method. Eligibility criteria. Randomised and quasi-randomised placebo-controlled trials with a parallel or cross-over design evaluating the effects of consuming polyphenol-rich foods, juices and concentrates on recovery from EIMD in humans. Eligible studies included at least one of the primary outcome measures: maximal isometric voluntary contraction; MIVC, delayed onset muscle soreness; DOMS, or countermovement jump; CMJ. Information sources. AMED, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, PUBMED, SCOPUS (Elsevier), SPORTDiscus (EBSCO), and the UK Clinical Trials Gateway were searched from inception to September 2020. Risk of bias and quality of evidence. Risk of bias was assessed using Cochrane Risk of Bias 2 tool. Quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Synthesis of results. Random effects models were used to determine the effect of polyphenol supplementation on recovery from EIMD. Data are presented as standardised mean differences (SMD) with 95% confidence intervals (CI). Results. Included studies. Twenty-five studies were included; 15 had a parallel, and 10 had a cross-over design. A total of 527 participants (male: n = 425; female: n = 102) were included in the meta-analysis. Synthesis of results. Consumption of polyphenol-rich foods, juices and concentrates accelerated recovery of MIVC immediately post-exercise (SMD = 0.23, 95% CI 0.04, 0.42; p = 0.02; low-quality evidence), 24 h (SMD = 0.39, 95% CI 0.15, 0.62; p = 0.001; low-quality evidence), 48 h (SMD = 0.48, 95% CI 0.28, 0.67; p < 0.001; moderate-quality evidence), 72 h (SMD = 0.29, 95% CI 0.11, 0.46; p = 0.001; low-quality evidence) and 96 h post-exercise (SMD = 0.50, 95% CI 0.16, 0.83; p = 0.004; very low-quality evidence). DOMS was reduced at 24 h (SMD = −0.29, 95% CI −0.47, −0.11; p = 0.002; low-quality evidence), 48 h (SMD = −0.28, 95% CI −0.46, −0.09; p = 0.003; low-quality evidence) and 72 h post-exercise (SMD = −0.46, 95% CI −0.69, −0.24; p < 0.001; very low-quality evidence). CMJ height was greater immediately post-exercise (SMD = 0.27, 95% CI 0.01, 0.53; p = 0.04; low-quality evidence), at 24 h (SMD = 0.47, 95% CI 0.11, 0.83; p = 0.01; very low-quality evidence), 48 h (SMD = 0.58, 95% CI 0.24, 0.91; p < 0.001; very low-quality evidence) and 72 h post-exercise (SMD = 0.57, 95% CI 0.03, 1.10; p = 0.04; very low-quality evidence). Polyphenol supplementation did not alter creatine kinase, c-reactive protein, and interleukin−6 at any time points. At 72 h post-exercise, protein carbonyls (SMD = −0.64, 95% CI −1.14, −0.14; p = 0.01) were reduced. Discussion. Limitations of evidence. Risk of bias was high for 10 studies and moderate for 15. Sensitivity analyses excluding the high risk of bias studies reduced the SMDs for MIVC and DOMS, and for CMJ effects at 24 and 48 h were no longer statistically significant. Interpretation. Consuming polyphenol-rich foods, juices and concentrates accelerated recovery of muscle function while reducing muscle soreness in humans. Maximal benefit occurred 48–72 h post-exercise, however, the certainty of the evidence was moderate to very low. Supplementation could be useful when there is limited time between competitive events and impaired recovery could negatively impact performance.

Moderate intensity cycling is better than running on recovery of eccentric exercise-induced muscle damage

OBJECTIVE

To compare the effects of moderate intensity running and cycling on markers of exercise-induced muscle damage in men.

STUDY DESIGN

Randomized controlled trial.

SETTING

Laboratory.

PARTICIPANTS

Thirty volunteers were randomized in three groups [running (RG; n = 10), cycling (CG; n = 10) and control (CON; n = 10)] and were evaluated at baseline, post 24, 48 and 72 h of knee extensors' muscle damage protocol. CON performed passive recovery, while RG and CG performed active recovery immediately after the protocol, as well as 24 h and 48 h afterwards.

MAIN OUTCOMES

(i) maximal voluntary isometric contraction (MVIC); (ii) delayed-onset muscle soreness (DOMS); (iii) plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels.

RESULTS

No group-by-time interaction was found in any outcome evaluated (p > 0.05). All groups presented decreases in MVIC and increases in DOMS (p < 0.001), without differences in CK and LDH. Compared with CON, exercise groups presented likely beneficial effects for LDH, while only CG had a likely beneficial effect for DOMS. Lastly, CG presented likely/very likely beneficial effects for MVIC and DOMS compared to RG.

CONCLUSION

Although the null hypothesis analysis did not find differences, the magnitude-based inference analysis suggested that moderate intensity cycling have likely beneficial effects on knee extensor muscle recovery after eccentric exercise protocol.

Markers of muscle damage and strength performance in professional football (soccer) players during the competitive period

Background

The present study investigated the impact of competitive soccer on the short-term changes in isometric strength of the adductor muscle group during the competitive season.

Methods

In this cohort study we evaluated the association between a serum marker of muscle damage [creatine phosphokinase (CPK)] and isometric strength of the adductor muscles of the hip in 30 professional football players (age: 26.7±2.9 years) during two seasons of the national top-level championship. Serum CPK level was determined the day before the match, 12–20, 36–48, 60–72 h after the match. The maximum voluntary isometric contraction force of the adductor muscles complex was determined immediately after having taken blood samples.

Results

There was evidence of a statistically significant positive association between age, body mass index (BMI), percentage of body fat, and muscle strength, and between weight and muscle strength. There was evidence of a statistically significant negative association between the level of CPK and the maximum isometric strength of the adductors of soccer players. Changes in CPK levels were associated with the muscle strength recovery trend (P<0.001). The strength/CPK ratio at different time points had a U-shaped curve.

Conclusions

Exercise induced muscle damage significantly affects the strength of the adductor muscle group of professional soccer players during the competitive period. The lower the CPK level, the greater the athletes' strength at a given time point. Also, the greater the decrease in CPK level, the greater the rate of strength restoration.

Aging and Recovery After Resistance-Exercise-Induced Muscle Damage: Current Evidence and Implications for Future Research

Aging is anecdotally associated with a prolonged recovery from resistance training, though current literature remains equivocal. This brief review considers the effects of resistance training on indirect markers of muscle damage and recovery (i.e., muscle soreness, blood markers, and muscle strength) in older males. With no date restrictions, four databases were searched for articles relating to aging, muscle damage, and recovery. Data from 11 studies were extracted for review. Of these, four reported worse symptoms in older compared with younger populations, while two have observed the opposite, and the remaining studies (n = 6) proposed no differences between age groups. It appears that resistance training can be practiced in older populations without concern for impaired recovery. To improve current knowledge, researchers are urged to utilize more ecologically valid muscle-damaging bouts and investigate the mechanisms which underpin the recovery of muscle soreness and strength after exercise in older populations.

Cold-Water Immersion Has No Effect on Muscle Stiffness After Exercise-Induced Muscle Damage

OBJECTIVE

To analyze the effect of cryotherapy on muscle stiffness after exercise-induced muscle damage.

DESIGN

A leg-to-leg comparison model.

SETTING

University research laboratory.

PARTICIPANTS

Thirty (30) untrained men (21.1 ± 1.6 years, 177.6 ± 6.4 cm, 75.9 ± 10.0 kg, and 15.9 ± 2.9% fat mass) with no history of lower-limb injury and no experience in resistance training.

INTERVENTION

All participants underwent a plyometric exercise program to induce muscle damage; however, randomly, one leg was assigned to a treatment condition and subjected twice to cold-water immersion of the lower limb at 10°C (±1°C) for 10 minutes, while the other leg was assigned to control.

MAIN OUTCOMES MEASURES

Longitudinal stiffness and passive transverse stiffness were evaluated on the soleus and gastrocnemius muscles at 4 moments: pre-exercise, immediately after exercise, 24 hours, and 72 hours after the damage protocol. Furthermore, pressure pain threshold (PPT) and maximal voluntary isometric contraction (MVIC) were also assessed in the same periods.

RESULTS

No significant differences between control and cryotherapy were observed in regard to MVIC (P = 0.529), passive longitudinal stiffness (P = 0.315), and passive transverse stiffness (P = 0.218). Only a significant decrease was observed in PPT on the soleus muscle in the cryotherapy compared with the control leg immediately after exercise (P = 0.040).

CONCLUSIONS

The results show that cryotherapy had no influence on muscle stiffness. However, cryotherapy had a positive effect on PPT immediately after exercise.

The bite force-gape relationship as an avenue of biomechanical adaptation to trophic niche in two salmonid fishes

All skeletal muscles produce their largest forces at a single optimal length, losing force when stretched or shortened. In vertebrate feeding systems, this fundamental force-length relationship translates to variation in bite force across gape, which affects the food types that can be eaten effectively. We measured the bite force-gape curves of two sympatric species: king salmon (Oncorhynchus tshawytscha) and pink salmon (Oncorhynchusgorbuscha). Cranial anatomical measurements were not significantly different between species; however, peak bite forces were produced at significantly different gapes. Maximum bite force was achieved at 67% of maximum gape for king salmon and 43% of maximum gape for pink salmon. This may allow king salmon to use greater force when eating large or elusive prey. In contrast, pink salmon do not require high forces at extreme gapes for filter feeding. Our results illustrate that the bite force-gape relationship is an important ecophysiological axis of variation.

Association of facial type with possible bruxism and its related clinical features in adolescents: A cross-sectional study

OBJECTIVES

The assessment of bruxism and its clinical characteristics is acknowledged in literature. This study aimed to evaluate the association of adolescents' facial patterns with bruxism and its related clinical features in the form of signs and symptoms.

MATERIALS AND METHODS

Four hundred and three adolescents answered a questionnaire evaluating sleep bruxism (SB) and awake bruxism (AB). Parents/caregivers answered a questionnaire evaluating the adolescents' sleep features (drooling on the pillow, snoring). Adolescents' facial (dolichofacial/brachyfacial/mesofacial) and clinical features (pain in masseter/temporal muscle, indentations marks on the tongue, linea alba, tooth attrition, mouth's maximum opening and masseter electrical activity) were evaluated. Multinomial regression was performed. Odds ratio (OR) and confidence intervals (CI) were provided.

RESULTS

Brachyfacial adolescents were less likely to present possible AB compared to mesofacials (OR=0.46, CI=0.21-0.98). Brachyfacial adolescents were more likely to present pain in the temporal muscle (OR=6.59, CI=2.18-19.87) and a higher number of posterior teeth with attrition (OR=1.25, CI=1.02-1.57) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the masseter muscle (OR=2.23, CI=1.03-4.83), had a higher mouth's maximum opening (OR=1.43, CI=1.04-1.97), had a higher number of posterior teeth with attrition (OR=1.17, CI=1.00-1.37) and were more likely to drool on the pillow (OR=2.05, CI=1.15-3.67) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the temporal muscle (OR=6.36, CI=2.30-17.54), to present themselves without marks on the tongue (OR=2.26, CI=1.09-4.69) and present a higher mouth's maximum opening (OR=2.09, CI=1.40-3.13) compared to brachyfacials.

CONCLUSION

Bruxism and its clinical features differ among dolichofacial, brachyfacial and mesofacial adolescents.

Effect of Eccentric Strength Training on Elbow Flexor Spasticity and Muscle Weakness in People With Multiple Sclerosis: Proof-of-Concept Single-System Case Series

OBJECTIVE

To date, no attention has been devoted to the employment of eccentric contractions to manage spasticity in multiple sclerosis. This single-system case series aimed to explore the effects of eccentric training on spasticity-related resistance to passive motion in people with multiple sclerosis with elbow flexor spasticity.

METHODS

Six people with multiple sclerosis (median Expanded Disability Status Scale score = 4.8, range = 2.0-5.5; Modified Ashworth Scale [MAS] score ≤ 3) underwent a 6-week eccentric strength training of the spastic muscles. Before and after the intervention, the following outcomes were assessed: resistive peak torque (RPT), isometric strength, resting limb position, passive range of motion and active range of motion, severity of hypertonia by MAS, and numerical rating scale. At baseline, the primary outcome (RPT) was tested over 3 time points to ensure a stable measurement. The 2-SD method was used to test pre-post training effects at individual level. Group-level analyses were also performed.

RESULTS

Following the intervention RPT decreased by at least 2 SDs in all participants but 1, with a significant reduction at group level of 41.6 (29.6)%. Four people with multiple sclerosis reported a reduction in perceived spasticity severity. No changes in MAS score were detected. Group-level analyses revealed that maximal strength increased significantly in the trained elbow flexors (+30.9 [9.1]%). Elbow flexion at rest was found to be significantly reduced (-35.5 [12.4]%), whereas passive range of motion (+4.6%) and active range of motion (+11.8%) significantly increased.

CONCLUSION

Eccentric training is feasible and safe to manage spasticity in people with multiple sclerosis. Preliminary data showed that this protocol can reduce resistance to passive motion, also improving strength, spasticity-free range of motion, and limb positioning.

IMPACT

Patients with multiple sclerosis-related spasticity and moderate-to-severe disability can benefit from adding slow submaximal eccentric contractions to the conventional management of spasticity.

Consumption of An Anthocyanin-Rich Antioxidant Juice Accelerates Recovery of Running Economy and Indirect Markers of Exercise-Induced Muscle Damage Following Downhill Running

This study examined the effects of anthocyanin-rich antioxidant juice (AJ) on the recovery of exercise-induced muscle damage (EIMD) and the running economy (RE) following downhill running (DHR). Thirty healthy young men were randomly divided into two blinded groups and consumed either AJ or placebo (PLA) for nine days (240 mL twice-a-day). On day 5, the participants from both groups ran downhill (-15%) for 30 min at 70% of their maximal oxygen uptake (VO₂max) speeds. The changes in RE (oxygen uptake (VO₂) and perceived effort (PE) during 5-min runs at 80%VO₂max) and EIMD (isometric peak torque (IPT), muscle soreness (SOR) and serum creatine kinase activity (CK)) were compared over time and between the groups on the 4 days following DHR. VO₂ and PE increased (p < 0.05) immediately following DHR for both groups and remained elevated for PLA until 48h post-DHR while fully recovering 24 h post-DHR for AJ. SOR was greater (p < 0.05) for PLA throughout the study. CK increased for both groups and was greater (p < 0.05) for PLA at 96 h post-DHR. IPT decreased for both groups but recovered faster for AJ (72 h) compared to PLA (no full recovery). AJ accelerated recovery of RE and EIMD and should be used in specific contexts, but not chronically.

Influence of fascicle strain and corticospinal excitability during eccentric contractions on force loss

NEW FINDINGS

What is the central question of this study? Do neural and/or mechanical factors determine the extent of muscle damage induced by eccentric contractions? What is the main finding and its importance? The extent of muscle damage induced by eccentric contractions is related to both mechanical strain and corticospinal excitability measured at long muscle lengths during eccentric contractions.

ABSTRACT

In this study, we investigated whether the mechanical and neural characteristics of maximal voluntary eccentric contractions would determine the extent of change in postexercise maximal voluntary isometric contraction (MVC) torque and muscle soreness. Eleven men performed 10 sets of 15 isokinetic (45 deg s^-1 ) maximal voluntary eccentric knee extensions. Knee-extension torque and vastus lateralis fascicle length were assessed at sets 1, 5 and 9. Vastus lateralis motor evoked potential, maximal M wave (MEP/M) and the cortical silent period (CSP) were measured at 75 and 100 deg of knee flexion (0 deg = full extension) during contractions and were normalized to MEP/M (MEP/M_ecc/iso ) and CSP (CSP_ecc/iso ) recorded during isometric MVC at each angle. The MVC torque and muscle soreness of the knee extensors were assessed before, 24, 48 and 96 h after the eccentric contractions. The extent of relative decrease in MVC torque at 24 h postexercise (r²  = 0.38) and peak muscle soreness (r²  = 0.69) were correlated (P < 0.05) with MEP/M_ecc/iso measured at 100 deg, but not at 75 deg. The average torque on the descending limb of the torque-angle relationship (r²  = 0.16), fascicle elongation (r²  = 0.18) and CSP_ecc/iso at both 75 (r²  = 0.00) and 100 deg (r²  = 0.02) were not significantly correlated with the relative decrease in MVC torque. The relative decrease in MVC torque was best predicted by a combination of mean torque on the descending limb, fascicle elongation and MEP/M_ecc/iso (R²  = 0.93). It is concluded that the extent of muscle damage based on the reduction in MVC torque is determined by mechanical strain and corticospinal excitability at long muscle lengths during maximal voluntary eccentric contractions.

Isokinetic strength differences between elite senior and youth female soccer players identifies training requirements

OBJECTIVES

To compare traditional and angle-specific isokinetic strength of eccentric knee flexors and concentric knee extensors in female senior professional and youth soccer players.

DESIGN

Cross-sectional study design.

SETTING

University's Laboratory.

PARTICIPANTS

A total of 34 players (17 seniors [age 25.31 ± 4.51 years; height 167.89 ± 7.04 cm; mass 63.12 ± 7.79 kg] and 17 youths [16.91 ± 1.16 years; height 165.92 ± 4.42 cm; mass 60.07 ± 4.48 kg]) from the Women's Super League 1 completed strength assessments at 180, 270 and 60°∙s^-1.

MAIN OUTCOME MEASURES

Peak torque (PT), dynamic control ratio (DCR), angle of peak torque (APT), functional range (FR), angle-specific torque (AST) and angle-specific DCR (DCR_AST) were compared between age groups.

RESULTS

The PT (P = 0.016) AST (P = 0.041) were significantly higher in seniors compared to youths; however APT (P = 0.141), DCR (P = 0.524) FR (P = 0.821) and DCR_AST (P = 0.053) were not significant between playing age.

CONCLUSION

The use of absolute and angle-specific strength measures were able to distinguish between female playing ages, whereas DCR and DCR_AST was unable to identify differences. The PT and AST metrics may be the most useful metrics to help identify and inform training needs, particularly in youths.

Effects of Small-Sided Game Variation on Changes in Hamstring Strength

Madison, G, Patterson, SD, Read, P, Howe, L, and Waldron, M. Effects of small-sided game variation on changes in hamstring strength. J Strength Cond Res 33(3): 839-845, 2019-Small-sided games (SSGs) are commonly used by soccer practitioners to condition players. This form of exercise can result in fatigue, potentially exposing the muscle to injury risk. The purpose of this study was to determine the effects of SSG variations on hamstring torque in semiprofessional soccer players. In a counterbalanced cross-over design, 10 male semiprofessional soccer players took part in both small relative area (3 vs. 3; 300 m) and large relative area (4 vs. 4; 1000 m) SSGs. The games comprised 6 × 4-minute bouts, with 90-second recovery. Both movement and heart rate responses were monitored by global positioning systems (GPS) and hamstring isometric torque was measured pre-training and post-training using a NordBord. There were differences (p < 0.05) between the small and large relative area games for peak hamstring force decrement (5.78 N and -13.62 N, respectively) and mean hamstring force decrement at 90° (11.11 N and -4.78 N, respectively). The number of accelerations was related to (r = 0.46, p = 0.039) reduced hamstring peak torque at 90°. In conclusion, larger relative area SSGs elicited the greatest internal and external loads, resulting in decrements in hamstring force. The number of accelerations performed in the session increases the likelihood of hamstring fatigue and can be controlled with the relative pitch area.

Acute Effects and Perceptions of Deep Oscillation Therapy for Improving Hamstring Flexibility

Context:Hamstring inflexibility is typically treated using therapeutic massage, stretching, and soft tissue mobilization. An alternative intervention is deep oscillation therapy (DOT). Currently, there is a lack of evidence to support DOT’s effectiveness to improve flexibility.Objective:To explore the effectiveness of DOT to improve hamstring flexibility.Design:Randomized single-cohort design.Setting:Research laboratory.Participants:Twenty-nine healthy, physically active individuals (self-reported activity of a minimum 200 min/wk).Interventions:All participants received a single session of DOT with randomization of the participant’s leg for the intervention. The DOT intervention parameters included a 1∶1 mode and 70% to 80% dosage at various frequencies for 28 minutes. Hamstring flexibility was assessed using passive straight leg raise for hip flexion using a digital inclinometer. Patient-reported outcomes were evaluated using the Copenhagen Hip and Groin Outcome Score and the Global Rating of Change (GRoC).Main Outcome Measure:The independent variable was time (pre and post). The dependent variables included passive straight leg raise, the GRoC, and the participant’s perceptions of the intervention. Statistical analyses included a dependentttest and a Pearson correlation.Results:Participants reported no issues with sport, activities of daily living, or quality of life prior to beginning the intervention study on the Copenhagen Hip and Groin Outcome Score. Passive straight leg raise significantly improved post-DOT (95% confidence interval, 4.48°–7.85°,P < .001) with a mean difference of 6.17 ± 4.42° (pre-DOT = 75.43 ± 21.82° and post-DOT = 81.60 ± 23.17°). A significant moderate positive correlation was identified (r = .439,P = .02) among all participants between the GRoC and the mean change score of hamstring flexibility. Participants believed that the intervention improved their hamstring flexibility (5.41 ± 1.02 points) and was relaxing (6.21 ± 0.86).Conclusions:DOT is an effective intervention to increase hamstring flexibility.

Single sarcomere contraction dynamics in a whole muscle

The instantaneous sarcomere length (SL) is regarded as an important indicator of the functional properties of striated muscle. Previously, we found greater sarcomere elongations at the distal end compared to the mid-portion in the mouse tibialis anterior (TA) when the muscle was stretched passively. Here, we wanted to see if SL dispersions increase with activation, as has been observed in single myofibrils, and if SL dispersions differ for different locations in a muscle. Sarcomere lengths were measured at a mid- and a distal location of the TA in live mice using second harmonic generation imaging. Muscle force was measured using a tendon force transducer. We found that SL dispersions increased substantially from the passive to the active state, and were the same for the mid- and distal portions of TA. Sarcomere length non-uniformities within a segment of ~30 serial sarcomeres were up to 1.0 µm. We conclude from these findings that passive, mean SLs obtained from a single location are not necessarily representative of the distribution of SL in active muscle, and thus may be misinterpreted when deriving muscle mechanical properties, such as the force-length relationship. In view of these findings, it seems crucial to determine how SL distributions within a muscle relate to the most fundamental properties of muscle, such as the maximal isometric force.

Effects of myostatin on the mechanical properties of muscles during repeated active lengthening in the mouse

The aim of the present study was to investigate how myostatin dysfunction affects fast and slow muscle stiffness and viscosity during severe repeated loading. Isolated extensor digitorum longus (EDL) and soleus muscles of young adult female mice of the BEH (dysfunctional myostatin) and BEH+/+ (functional myostatin) strains were subjected to 100 contraction-stretching loading cycles during which contractile and mechanical properties were assessed. BEH mice exhibited greater exercise-induced muscle damage, although the effect was muscle- and age-dependent and limited to the early phases of simulated exercise. The relative reduction of the EDL muscle isometric force recorded during the initial 10-30 loading cycles was greater in BEH mice than in BEH+/+ mice and exceeded that of the soleus muscle of either strain. The induced damage was associated with lower muscle stiffness. The effects of myostatin on the mechanical properties of muscles depend on muscle type and maturity.

The multiple roles of titin in muscle contraction and force production

Titin is a filamentous protein spanning the half-sarcomere, with spring-like properties in the I-band region. Various structural, signaling, and mechanical functions have been associated with titin, but not all of these are fully elucidated and accepted in the scientific community. Here, I discuss the primary mechanical functions of titin, including its accepted role in passive force production, stabilization of half-sarcomeres and sarcomeres, and its controversial contribution to residual force enhancement, passive force enhancement, energetics, and work production in shortening muscle. Finally, I provide evidence that titin is a molecular spring whose stiffness changes with muscle activation and actin-myosin-based force production, suggesting a novel model of force production that, aside from actin and myosin, includes titin as a "third contractile" filament. Using this three-filament model of sarcomeres, the stability of (half-) sarcomeres, passive force enhancement, residual force enhancement, and the decrease in metabolic energy during and following eccentric contractions can be explained readily.

The Efficacy of Intermittent Long-term Bell Boot Application for the Correction of Muscle Asymmetry in Equine Subjects

It has been proposed that manipulating proprioceptive signals of the equine distal limb as part of a rehabilitation process in cases of musculoskeletal pain or neurologic deficits can be used to correct postural control and restore normal motor programs. This trial has examined the effect of treatment with a light-weight and loose-fitting bell boot (82 g) on an imbalance of muscle gluteus superficialis function in horses as measured using acoustic myography (AMG). Eight horses were trained over a 60-minute period every 3 days for 6 weeks, a protocol based on preliminary findings. Acoustic myography measurements, recording the coordination, spatial and temporal summation of muscle contractions, were made at the start (baseline) and at the finish (week 6) after a warmup period and following a set procedure of physical activity. Walking, trotting, and cantering during a left-hand circle at the start of the trial revealed a slight but significant asymmetry between the left and right hind limb muscle, which improved successfully after 6 weeks of proprioception training. Data for the right-hand circle, which revealed no significant asymmetry, during walk, trot, and canter at the start, showed no change after 6 weeks of training at the walk and trot but developed an imbalance during cantering, the result of overcompensation. This study demonstrates that functional musculoskeletal asymmetry measured during periods of activity can not only be accurately detected using AMG but it also reveals an association between the program of proprioceptive training adopted and an improvement in muscular imbalance.

Two repetitive bouts of intense eccentric-concentric jaw exercises reduce experimental muscle pain in healthy subjects

High-intensity eccentric-concentric contractions of the jaw-closing muscles induce muscle soreness, fatigue and functional impairment of the jaw, resembling the symptoms of myalgia, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). However, it is claimed that repetition of similar exercises can minimise these detrimental effects. This study aimed to evaluate the response of jaw-closing muscles following two series of intense eccentric-concentric exercises of the masticatory muscles in healthy subjects. Twelve pain-free participants underwent 2 sessions of intense eccentric-concentric jaw exercises, with 1-week interval in between. Each session of jaw exercises comprises 6 sets of 5-minute-long bouts of concentric-eccentric contractions. Self-reported muscle fatigue and pain, maximum mouth opening without pain (MMO), pain pressure thresholds (PPTs) of temporalis and masseter muscles and maximum voluntary bite force (MVBF) were recorded before, immediately after, 24 and 48 hours after each bout of exercises. ANOVA for repeated measurements was used to analyse the data. During session 2, muscle pain and fatigue were statistically significantly decreased (P < .05) as compared to session 1. Furthermore, statistically significant increases of MVBF (P < .005), MMO (P < .005) and PPTs (P < .005) were found at session 2 as compared to session 1. Within the limitations of the study, is can be concluded that the repetition of eccentric-concentric jaw-closing exercises results in signs of muscle training. Future studies can elucidate whether this motor training might be useful for the treatment of myalgia.

Neuromuscular Changes and Damage after Isoload versus Isokinetic Eccentric Exercise

PURPOSE

This study compared the effects of isoload (IL) and isokinetic (IK) knee extensor eccentric exercises on changes in muscle damage and neuromuscular parameters to test the hypothesis that the changes would be different after IL and IK exercises.

METHODS

Twenty-two young men were paired based on their strength and placed in the IL (N = 11) or the IK (N = 11) group. The IL group performed 15 sets of 10 eccentric contractions with a 150% of predetermined one-repetition maximum load. The IK group performed 15 sets of several maximal eccentric contractions matched set by set for the total amount of work and mean angular velocity with the IL group. Muscle damage markers (voluntary isometric peak torque, muscle soreness, and creatine kinase activity) and neuromuscular variables (e.g., voluntary activation, H-reflex, M-wave, and evoked torque) were measured before, immediately after, and 24, 48, 72, and 96 h postexercise.

RESULTS

Voluntary isometric peak torque decreased to the same extent (P = 0.94) in both groups immediately after (IL = -40.6% ± 13.8% vs IK = -42.4% ± 10.2%) to 96 h after the exercise (IL = -21.8% ± 28.5% vs IK = -26.7% ± 23.5%). Neither peak muscle soreness (IL = 48.1 ± 28.2 mm vs IK = 54.7 ± 28.9 mm, P = 0.57) nor creatine kinase activity (IL = 12,811 ± 22,654 U·L vs IK = 15,304 ± 24,739 U·L, P = 0.59) significantly differed between groups. H-reflex (IL = -23% vs IK = -35%) and M-wave (IL = -10% vs IK = -17%) significantly decreased immediately postexercise similarly between groups.

CONCLUSION

The changes in muscle damage and neuromuscular function after the exercise are similar between IL and IK, suggesting that resistance modality has little effects on acute muscle responses.

Exertional Rhabdomyolysis in a 21-Year-Old Healthy Woman: A Case Report

McKay, BD, Yeo, NM, Jenkins, NDM, Miramonti, AA, and Cramer, JT. Exertional rhabdomyolysis in a 21-year-old healthy woman: a case report. J Strength Cond Res 31(5): 1403-1410, 2017-The optimal resistance training program to elicit muscle hypertrophy has been recently debated and researched. Although 3 sets of 10 repetitions at 70-80% of the 1 repetition maximum (1RM) are widely recommended, recent studies have shown that low-load (∼30% 1RM) high-repetition (3 sets of 30-40 repetitions) resistance training can elicit similar muscular hypertrophy. Incidentally, this type of resistance training has gained popularity. In the process of testing this hypothesis in a research study in our laboratory, a subject was diagnosed with exertional rhabdomyolysis after completing a resistance training session that involved 3 sets to failure at 30% 1RM. Reviewed were the events leading up to and throughout the diagnosis of exertional rhabdomyolysis in a healthy recreationally-trained 21-year-old woman who was enrolled in a study that compared the acute effects of high-load low-repetition vs. low-load high-repetition resistance training. The subject completed a total of 143 repetitions of the bilateral dumbbell biceps curl exercise. Three days after exercise, she reported excessive muscle soreness and swelling and sought medical attention. She was briefly hospitalized and then discharged with instructions to take acetaminophen for soreness, drink plenty of water, rest, and monitor her creatine kinase (CK) concentrations. Changes in the subject's CK concentrations, ultrasound-determined muscle thickness, and echo intensity monitored over a 14-day period are reported. This case illustrates the potential risk of developing exertional rhabdomyolysis after a low-load high-repetition resistance training session in healthy, young, recreationally-trained women. The fact that exertional rhabdomyolysis is a possible outcome may warrant caution when prescribing this type of resistance exercise.

Effects of a systemic enzyme therapy in healthy active adults after exhaustive eccentric exercise: a randomised, two-stage, double-blinded, placebo-controlled trial

Background

Systemic enzyme therapy may improve symptoms of exhaustive eccentric exercise due to anti-inflammatory properties.

Methods

In a randomised, placebo-controlled, two-stage clinical trial, systemic enzyme therapy (Wobenzym) was administered for 72 hours before and 72 hours following a day on which subjects performed an exhaustive eccentric exercise (isokinetic loading of the quadriceps). Efficacy criteria (maximal strength and pain) and time points were selected to account for the multidimensional nature of exercise-induced muscle damage symptoms. Subjects were randomised in a crossover (stage I, n=28) and parallel group design (stage II, n=44).

Results

Analysis of stage I data demonstrated a significant superiority (Mann-Whitney=0.6153; p=0.0332; one sided) for systemic enzyme therapy compared with placebo. Stage II was designed as a randomised controlled parallel group comparison. Heterogeneity (I²>0.5) between stages led to separate analyses of stage I (endurance-trained subjects) and stage II (strength-trained subjects). Combined analysis resulted in no evidence for corresponding treatment effects. Analysis of pooled biomarker data, however, demonstrated significant favourable effects for systemic enzyme therapy in both stages.

Conclusion

Systemic enzyme therapy before and after exhaustive eccentric exercise resulted in higher maximal concentric strength in the less strength-trained subjects (stage I) and in significant favourable effects on biomarkers (inflammatory, metabolic and immune) in all subjects. The application of these findings needs further evaluation.

Non-uniform muscle fat replacement along the proximodistal axis in Duchenne muscular dystrophy

The progressive replacement of muscle tissue by fat in Duchenne muscular dystrophy (DMD) has been studied using quantitative MRI between, but not within, individual muscles. We studied fat replacement along the proximodistal muscle axis using the Dixon technique on a 3T MR scanner in 22 DMD patients and 12 healthy controls. Mean fat fractions per muscle per slice for seven lower and upper leg muscles were compared between and within groups assuming a parabolic distribution. Average fat fraction for a small central slice stack and a large coverage slice stack were compared to the value when the stack was shifted one slice (15 mm) up or down. Higher fat fractions were observed in distal and proximal muscle segments compared to the muscle belly in all muscles of the DMD subjects (p <0.001). A shift of 15 mm resulted in a difference in mean fat fraction which was on average 1-2% ranging up to 12% (p <0.01). The muscle end regions are exposed to higher mechanical strain, which points towards mechanical disruption of the sarcolemma as one of the key factors in the pathophysiology. Overall, this non-uniformity in fat replacement needs to be taken into account to prevent sample bias when applying quantitative MRI as biomarker in clinical trials for DMD.

Specific joint angle dependency of voluntary activation during eccentric knee extensions

INTRODUCTION

This study compared voluntary activation during isometric, concentric, and eccentric maximal knee extensions at different joint angles.

METHODS

Fifteen participants performed isometric, concentric, and eccentric protocols (9 contractions each). For each protocol, the central activation ratio (CAR) was randomly measured at 50°, 75°, or 100° of knee joint angle (0° = full knee extension) using superimposed supramaximal paired nerve stimulations during contractions.

RESULTS

CAR increased between 50° and 100° during isometric (93.6 ± 3.1 vs. 98.5 ± 1.4%), concentric (92.4 ± 5.4 vs. 99.2 ± 1.2%), and eccentric (93.0 ± 3.5 vs. 96.6 ± 3.8%) contractions. CAR was lower during eccentric than both isometric and concentric contractions at 75° and 100°, but similar between contraction types at 50°.

CONCLUSIONS

The ability to activate muscle maximally is impaired during eccentric contractions compared with other contraction types at 75° and 100°, but not at 50°. Muscle Nerve 56: 750-758, 2017.

Minimal muscle damage after a marathon and no influence of beetroot juice on inflammation and recovery

This study examined whether beetroot juice (BTJ) would attenuate inflammation and muscle damage following a marathon. Using a double blind, independent group design, 34 runners (each having completed ca. ∼16 previous marathons) consumed either BTJ or an isocaloric placebo (PLA) for 3 days following a marathon. Maximal isometric voluntary contractions (MIVC), countermovement jumps (CMJ), muscle soreness, serum cytokines, leucocytosis, creatine kinase (CK), high sensitivity C-reactive protein (hs-CRP), and aspartate aminotransferase (AST) were measured pre, post, and 2 days after the marathon. CMJ and MIVC were reduced after the marathon (P < 0.05), but no group differences were observed (P > 0.05). Muscle soreness was increased in the day after the marathon (BTJ; 45 ± 48 vs. PLA; 46 ± 39 mm) and had returned to baseline by day 2, irrespective of supplementation (P = 0.694). Cytokines (interleukin-6; IL-6, interleukin-8, tumour necrosis factor-α) were increased immediately post-marathon but apart from IL-6 had returned to baseline values by day 1 post. No interaction effects were evident for IL-6 (P = 0.213). Leucocytes increased 1.7-fold after the race and remained elevated 2 days post, irrespective of supplement (P < 0.0001). CK peaked at 1 day post marathon (BTJ: 965 ± 967, and PLA: 1141 ± 979 IU·L^-1) and like AST and hs-CRP, was still elevated 2 days after the marathon (P < 0.05); however, no group differences were present for these variables. Beetroot juice did not attenuate inflammation or reduce muscle damage following a marathon, possibly because most of these indices were not markedly different from baseline values in the days after the marathon.

Preventive effects of stretching and stabilization exercises on muscle fatigue in mobile phone users

[Purpose] The purpose of this study was to investigate the preventive effects of stretching and stabilization exercises on muscle fatigue of the neck erector spine and upper trapezius muscles. [Subjects and Methods] The subjects of this study were 26 healthy university students (14 males and 12 females). Each subject was assigned randomly to each of three study groups in order to prevent order effect. The three groups included in this study were the no-exercise, stretching exercise, and neck stabilization exercise groups. The median electromyographic frequency was used as a gauge of muscle fatigue. [Results] Decreased muscle fatigue was demonstrated by an increase in the median electromyographic frequency values in all the four muscle groups in the comparison between conditions 1 and 3. In particular, statistically significant differences were found between the two conditions in the right upper trapezius muscle group. [Conclusion] These findings suggest that the effect of stretching and stabilization exercises can reduce muscle fatigue in mobile phone users.

No Effect of Acupuncture in the Relief of Delayed-Onset Muscle Soreness: Results of a Randomized Controlled Trial

BACKGROUND

Delayed-onset muscle soreness (DOMS) is a common symptom in people participating in exercise, sport, or recreational physical activities. Several remedies have been proposed to prevent and alleviate DOMS.

DESIGN AND METHODS

A five-arm randomized controlled study was conducted to examine the effects of acupuncture on eccentric exercise-induced DOMS of the biceps brachii muscle. Participants were recruited through convenience sampling of students and general public. Participants were randomly allocated to needle, laser, sham needle, sham laser acupuncture, and no intervention. Outcome measures included pressure pain threshold (PPT), pain intensity (visual analog scale), and maximum isometric voluntary force.

RESULTS

Delayed-onset muscle soreness was induced in 60 participants (22 females, age 23.6 ± 2.8 years, weight 66.1 ± 9.6 kg, and height 171.6 ± 7.9 cm). Neither verum nor sham interventions significantly improved outcomes within 72 hours when compared with no treatment control (P > 0.05).

CONCLUSIONS

Acupuncture was not effective in the treatment of DOMS. From a mechanistic point of view, these results have implications for further studies: (1) considering the high-threshold mechanosensitive nociceptors of the muscle, the cutoff for PPT (5 kg/cm) chosen to avoid bruising might have led to ceiling effects; (2) the traditional acupuncture regimen, targeting muscle pain, might have been inappropriate as the DOMS mechanisms seem limited to the muscular unit and its innervation. Therefore, a regionally based regimen including an intensified intramuscular needling (dry needling) should be tested in future studies, using a higher cutoff for PPT to avoid ceiling effects.

Early structural remodeling and deuterium oxide-derived protein metabolic responses to eccentric and concentric loading in human skeletal muscle

We recently reported that the greatest distinguishing feature between eccentric (ECC) and concentric (CON) muscle loading lays in architectural adaptations: ECC favors increases in fascicle length (Lf), associated with distal vastus lateralis muscle (VL) hypertrophy, and CON increases in pennation angle (PA). Here, we explored the interactions between structural and morphological remodeling, assessed by ultrasound and dual x-ray absorptiometry (DXA), and long-term muscle protein synthesis (MPS), evaluated by deuterium oxide (D₂O) tracing technique. Ten young males (23 ± 4 years) performed unilateral resistance exercise training (RET) three times/week for 4 weeks; thus, one-leg trained concentrically while the contralateral performed ECC exercise only at 80% of either CON or ECC one repetition maximum (1RM). Subjects consumed an initial bolus of D₂O (150 mL), while a 25-mL dose was thereafter provided every 8 days. Muscle biopsies from VL midbelly (MID) and distal myotendinous junction (MTJ) were collected at 0 and 4-weeks. MPS was then quantified via GC–pyrolysis–IRMS over the 4-week training period. Expectedly, ECC and CON RET resulted in similar increases in VL muscle thickness (MT) (7.5% vs. 8.4%, respectively) and thigh lean mass (DXA) (2.3% vs. 3%, respectively), albeit through distinct remodeling: Lf increasing more after ECC (5%) versus CON (2%) and PA increasing after CON (7% vs. 3%). MPS did not differ between contractile modes or biopsy sites (MID-ECC: 1.42 vs. MID-CON: 1.4% day⁻¹; MTJ-ECC: 1.38 vs. MTJ-CON: 1.39% day⁻¹). Muscle thickness at MID site increased similarly following ECC and CON RET, reflecting a tendency for a contractile mode-independent correlation between MPS and MT (P = 0.07; R² = 0.18). We conclude that, unlike MT, distinct structural remodeling responses to ECC or CON are not reflected in MPS; the molecular mechanisms of distinct protein deposition, and/or the role of protein breakdown in mediating these responses remain to be defined.

Early changes in Achilles tendon behaviour in vivo following downhill backwards walking

Downhill backwards walking causes repeated, cyclical loading of the muscle-tendon unit. The effect this type of repeated loading has on the mechanical behaviour of the Achilles tendon is presently unknown. This study aimed to investigate the biomechanical response of the Achilles tendon aponeurosis complex following a downhill backwards walking protocol. Twenty active males (age: 22.3 ± 3.0 years; mass: 74.7 ± 5.6 kg; height: 1.8 ± 0.7 m) performed 60 min of downhill (8.5°), backwards walking on a treadmill at -0.67 m · s(-1). Data were collected before, immediately post, and 24-, 48- and 168-h post-downhill backwards walking. Achilles tendon aponeurosis elongation, strain and stiffness were measured using ultrasonography. Muscle force decreased immediately post-downhill backward walking (P = 0.019). There were increases in Achilles tendon aponeurosis stiffness at 24-h post-downhill backward walking (307 ± 179.6 N · mm(-1), P = 0.004), and decreases in Achilles tendon aponeurosis strain during maximum voluntary contraction at 24 (3.8 ± 1.7%, P = 0.008) and 48 h (3.9 ± 1.8%, P = 0.002) post. Repeated cyclical loading of downhill backwards walking affects the behaviour of the muscle-tendon unit, most likely by altering muscle compliance, and these changes result in tendon stiffness increases.

The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions

[Purpose]

The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise.

[Methods]

Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise.

[Results]

The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index.

[Conclusion]

CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.

Revisiting the Force-Joint Angle Relationship After Eccentric Exercise

The purpose of this study was to evaluate force-angle curve fitting techniques pre-eccentric exercise, quantify changes in curve characteristics postexercise, and examine the relationship between curve changes and markers of muscle damage. Fourteen males unaccustomed to eccentric exercise performed 60 eccentric muscle actions of the elbow flexors. Maximal voluntary isometric force was measured throughout a range of angles pre- (Pre1 and Pre2), immediately post (IP), and 1, 2, 4, and 7 days postexercise. Force-angle curves for each visit were constructed using second-order polynomials. Changes in curve characteristics (optimal angle, peak force, curve height), range of motion, soreness, and creatine kinase activity were quantified. Optimal joint angle and force at optimal angle were significantly correlated from Pre1 to Pre2 (ICC = 0.821 and 0.979, respectively). Optimal angle was significantly right shifted (p = 0.035) by 10.4 ± 12.9° from Pre2 to IP and was restored by 1 day post exercise. Interestingly, the r value for curve fit was significantly decreased (p < 0.001) from Pre2 (r = 0.896) to IP (r = 0.802) and 1 day post exercise (r = 0.750). Curve height was significantly decreased (39%) IP and restored to pre-exercise height by 4 days postexercise. There was no correlation between optimal angle or curve height and other damage markers. In conclusion, force-angle relationships can be accurately described using second-order polynomials. After eccentric exercise, the force-angle curve is flattened and shifted (downward and rightward), but these changes are not correlated to other markers of muscle damage. Changes in the force-angle relationship are multifaceted, but determining the physiological significance of these changes requires further investigation.

Angle-Specific Eccentric Hamstring Fatigue After Simulated Soccer

Purpose:

To evaluate the effect of simulated soccer on the hamstrings eccentric torque-angle profile and angle of peak torque (APTeccH), and on the hamstrings:quadriceps torque ratio at specific joint angles (ASHecc:Qcon).

Methods:

The authors assessed dominant-limb isokinetic concentric and eccentric knee flexion and concentric knee extension at 120°/s in 9 semiprofessional male soccer players immediately before and after they completed the Loughborough Intermittent Shuttle Test (LIST).

Results:

The LIST resulted in significant decreases in eccentric hamstrings torque at 60°, 50°, and 10° and a significant (21.8%) decrease in ASHecc:Qcon at 10° (P < .05). APTeccH increased from 7.1° ± 1.0° to 18.8° ± 4.2° (P < .05). Eccentric hamstrings peak torque significantly declined from 185.1 ± 70.4 N·m pre-LIST to 150.9 ± 58.5 N·m post-LIST (P = .002), but there were no significant changes in hamstrings or quadriceps concentric peak torque (P = .312, .169, respectively).

Conclusions:

Simulated soccer results in a selective loss of eccentric hamstrings torque and hamstrings-to-quadriceps muscle balance at an extended joint position and a shift in the eccentric hamstrings APT to a shorter length, changes that could increase vulnerability to hamstrings injury. These findings suggest that injury-risk screening could be improved by evaluating the eccentric hamstrings torque-angle profile and hamstrings strength-endurance and that the development of hamstrings fatigue resistance and long-length eccentric strength may reduce injury incidence.

Reduced muscle lengthening during eccentric contractions as a mechanism underpinning the repeated-bout effect

This study investigated biceps brachii distal myotendinous junction (MTJ) displacement during maximal eccentric elbow flexor contractions to test the hypothesis that muscle length change would be smaller (less MTJ displacement) during the second than the first exercise bout. Ten untrained men performed two eccentric exercise bouts (ECC1 and ECC2) with the same arm consisting of 10 sets of six maximal isokinetic (60°/s) eccentric elbow flexor contractions separated by 4 wk. Biceps brachii distal MTJ displacement was assessed using B-mode ultrasonography, and changes in the displacement (muscle length change) from the start to the end of each contraction during each set and over 10 sets were compared between bouts by two-way repeated-measures ANOVA. Several indirect muscle damage markers were also measured and compared between bouts by two-way repeated-measures ANOVA. The magnitude of MTJ displacement (average of six contractions) increased from set 1 (8.2 ± 4.7 mm) to set 10 (16.4 ± 4.7 mm) during ECC1 (P < 0.05), but no significant changes over sets were evident during ECC2 (set 1: 8.5 ± 4.0 mm; set 10: 9.3 ± 3.1 mm). Changes in maximal voluntary isometric contraction strength, range of motion, muscle thickness, ultrasound echo intensity, serum creatine kinase activity, and muscle soreness (visual analog scale) were smaller (P < 0.05) following ECC2 than ECC1, showing less damage in the repeated bout. These results indicate that the magnitude of muscle lengthening was less during the second than the first eccentric exercise bout, which appears to be a mechanism underpinning the repeated-bout effect.