Adaptive conditioning of skeletal muscle in a large animal model (Sus domesticus)

The adaptive response of skeletal muscle: What is the evidence?

Adult skeletal muscle is capable of adapting its properties in response to changing functional demands. This now sounds like a statement of the obvious, and many people assume it has always been this way. A mere 40 years ago, however, the picture was entirely different. In this Review and personal memoir, I outline the scientific context in which the theory was generated, the objections to it from entrenched opinion, and the way those objections were progressively met. The material should be of some historical interest, but, more importantly, it collects together the full range of evidence on which the current paradigm is based. Muscle Nerve 57: 531-541, 2018.

CIR-Myo News: Proceedings of the 2014 Spring Padua Muscle Days: Terme Euganee and Padova (Italy), April 3-5, 2014

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Practical and effective stomal sphincter creation: evaluation in pigs

PURPOSE

Stoma creation frequently presents complications for which there is no satisfactory surgical solution. We reexamined the feasibility of managing stoma continence with an artificial sphincter, addressing the outstanding issues of geometry, electrode disposition, and fatigue resistance.

METHODS

In 6 pigs, 1 rectus abdominis muscle was preconditioned with electric stimulation for 4 weeks by an implanted stimulator. A sphincter was then constructed and tested for its ability to provide continence against saline at a typical intestinal pressure. The result was compared with a sphincter fashioned from the unconditioned contralateral (control) muscle. In each case, stimulation was applied alternately to longitudinal segments.

RESULTS

A 2-layered wrap was required to achieve continence. Sphincters created from the preconditioned muscles could sustain continence continuously for at least 90 minutes.

CONCLUSION

This study establishes a practical approach to the creation of a sphincter from the rectus abdominis muscle in stoma patients. Continence can be achieved only with a double-layered wrap. Fatigue during long-term operation can be avoided by a combination of preconditioning and segmental stimulation of intramuscular nerve branches.

Adaptive change in electrically stimulated muscle: a framework for the design of clinical protocols

Adult mammalian skeletal muscles have a remarkable capacity for adapting to increased use. Although this behavior is familiar from the changes brought about by endurance exercise, it is seen to a much greater extent in the response to long-term neuromuscular stimulation. The associated phenomena include a markedly increased resistance to fatigue, and this is the key to several clinical applications. However, a more rational basis is needed for designing regimes of stimulation that are conducive to an optimal outcome. In this review I examine relevant factors, such as the amount, frequency, and duty cycle of stimulation, the influence of force generation, and the animal model. From these considerations a framework emerges for the design of protocols that yield an overall functional profile appropriate to the application. Three contrasting examples illustrate the issues that need to be addressed clinically.

A mathematical analysis of obstructed diffusion within skeletal muscle

Molecules are transported through the myofilament lattice of skeletal muscle fibers during muscle activation. The myofilaments, along with the myosin heads, sarcoplasmic reticulum, t-tubules, and mitochondria, obstruct the diffusion of molecules through the muscle fiber. In this work, we studied the process of obstructed diffusion within the myofilament lattice using Monte Carlo simulation, level-set and homogenization theory. We found that these intracellular obstacles significantly reduce the diffusion of material through skeletal muscle and generate diffusion anisotropy that is consistent with experimentally observed slower diffusion in the radial than the longitudinal direction. Our model also predicts that protein size has a significant effect on the diffusion of material through muscle, which is consistent with experimental measurements. Protein diffusion on the myofilament lattice is also anomalous (i.e., it does not obey Brownian motion) for proteins that are close in size to the myofilament spacing. The obstructed transport of Ca2+ and ATP-bound Ca2+ through the myofilament lattice also generates smaller Ca2+ transients. In addition, we used homogenization theory to discover that the nonhomogeneous distribution in the troponin binding sites has no effect on the macroscopic Ca2+ dynamics. The nonuniform sarcoplasmic reticulum Ca2+-ATPase pump distribution also introduces small asymmetries in the myoplasmic Ca2+ transients.

A control system for automatic electrical stimulation of abdominal muscles to assist respiratory function in tetraplegia

This letter refers to a paper published by Gollee et al. [Gollee H, Hunt KJ, Allan DB, Fraser MH, McLean AN. A control system for automatic electrical stimulation of abdominal muscles to assist respiratory function in tetraplegia. Med Eng Phys 2007;29:799-807]. We address here the consequences of continuous use and suggest a refinement that may improve the cough peak flow under more chronic conditions.

Anomalous ion diffusion within skeletal muscle transverse tubule networks

BACKGROUND

Skeletal muscle fibres contain transverse tubular (t-tubule) networks that allow electrical signals to rapidly propagate into the fibre. These electrical signals are generated by the transport of ions across the t-tubule membranes and this can result in significant changes in ion concentrations within the t-tubules during muscle excitation. During periods of repeated high-frequency activation of skeletal muscle the t-tubule K+ concentration is believed to increase significantly and diffusive K+ transport from the t-tubules into the interstitial space provides a mechanism for alleviating muscle membrane depolarization. However, the tortuous nature of the highly branched space-filling t-tubule network impedes the diffusion of material through the network. The effective diffusion coefficient for ions in the t-tubules has been measured to be approximately five times lower than in free solution, which is significantly different from existing theoretical values of the effective diffusion coefficient that range from 2-3 times lower than in free solution. To resolve this discrepancy, in this paper we study the process of diffusion within electron microscope scanned sections of the skeletal muscle t-tubule network using mathematical modelling and computer simulation techniques. Our model includes t-tubule geometry, tautness, hydrodynamic and non-planar network factors.

RESULTS

Using our model we found that the t-tubule network geometry reduced the K+ diffusion coefficient to 19-27% of its value in free solution, which is consistent with the experimentally observed value of 21% and is significantly smaller than existing theoretical values that range from 32-50%. We also found that diffusion in the t-tubules is anomalous for skeletal muscle fibres with a diameter of less than approximately 10-20 microm as a result of obstructed diffusion. We also observed that the [K+] within the interior of the t-tubule network during high-frequency activation is greater for fibres with a larger diameter. Smaller skeletal muscle fibres are therefore more resistant to membrane depolarization. Because the t-tubule network is anisotropic and inhomogeneous, we also found that the [K+] distribution generated within the network was irregular for fibres of small diameter.

CONCLUSION

Our model explains the measured effective diffusion coefficient for ions in skeletal muscle t-tubules.