Ageing and skeletal muscle force control: current perspectives and future directions

Long-chain n-3 polyunsaturated fatty acid supplementation and neuromuscular function in older adults

PURPOSE OF REVIEW

This review aims to explore the latest research investigating the effects of marine-derived long-chain n -3 polyunsaturated fatty acid (LC n -3 PUFA) supplementation on neuromuscular function in older adults.

RECENT FINDINGS

Ageing results in a decline in skeletal muscle strength and mass. There is growing evidence that LC n -3 PUFA supplementation increases muscle strength and mass in healthy older adults, yet the mechanisms underlying these effects remain elusive. Recent studies investigating LC n -3 PUFA supplementation have demonstrated effects on neuromuscular function such as increases in the compound muscle action potential (M-wave) amplitude and surface electromyography alongside increases in muscular strength. Therefore, evidence suggests that LC n -3 PUFA may elicit a beneficial effect at the neuromuscular junction and possess neuroprotective properties in older adults.

SUMMARY

LC n -3 PUFA supplementation may increase or maintain neuromuscular function throughout the ageing process. Further research is warranted to investigate the long-term effects LC n -3 PUFA supplementation on neuromuscular outcomes such as single motor unit properties and cortical/supraspinal networks, utilizing state-of-the-art techniques in neuromuscular physiology.

Force control of pinch grip: Normative data of a holistic evaluation

BACKGROUND

Pulp pinch (PP) is a vital hand movement involving muscle strength and sensory integration. Previous research has primarily focused on Maximal Voluntary Contraction, but PP encompasses broader parameters.

PURPOSE

This study aims to establish normative data for a comprehensive evaluation of thumb and index force control during PP, including endurance, precision, accuracy in unilateral PP, and force coordination in bilateral PP.

STUDY DESIGN

A cross-sectional study.

METHODS

Three hundred and twenty eight healthy Italian cis-gender participants (169 females, 159 males) were enrolled in a multiparametric force control evaluation of pinch grip, consisting in: sustained contraction (SC: ability to maintain a stable contraction at 40% MVC, measured as the time until exhaustion), dynamic contraction (DC: the ability to modulate precisely and accurately force output to follow a dynamic force trace), bimanual strength coordination (BSC: the ability to coordinate in-phase bimanual forces at different combined magnitudes) tasks. The sample was divided per sex and stratified in five age groups taking into account hand dominance. Differences in tasks' results between age, sex and hand-dominance were analysed.

RESULTS

Endurance (SC) was similar between younger and older adults (η2 =0.047 (Females) and η2 < 0.007 (Males)). Older adults exhibited lower precision (DC) and coordination (BSC) compared to young adults in both sexes (η2 >0.16). Females demonstrated greater endurance (SC) but lower precision and coordination (BSC) compared to males (0.01 <η2 <0.1). No hand dominance effect emerged in SC and DC.

CONCLUSIONS

Force accuracy and precision to modulate pinch force to perform a visual feedback force-matching task (DC) and force coordination between hands (BSC) worsen at increasing age. Hand dominance did not influence either endurance or precision of pinch grip in visual-feedback guided task.

Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness

The purpose was to identify the variables that can explain the variance in the grooved pegboard times of older adults categorized as either fast or slow performers. Participants (n = 28; 60-83 years) completed two experimental sessions, before and after 6 practice sessions of the grooved pegboard test. The 2 groups were identified based on average pegboard times during the practice sessions. Average pegboard time during practice was 73 ± 11 s for the fast group and 85 ± 13 s for the slow group. Explanatory variables for the pegboard times before and after practice were the durations of 4 peg-manipulation phases and 12 measures of force steadiness (coefficient of variation [CV] for force) during isometric contractions with the index finger abductor and wrist extensor muscles. Time to complete the grooved pegboard test after practice decreased by 25 ± 11% for the fast group and by 28 ± 10% for the slow group. Multiple regression models explained more of the variance in the pegboard times for the fast group before practice (Adjusted R2 = 0.85) than after practice (R2 = 0.51), whereas the variance explained for the slow group was similar before (Adjusted R2 = 0.67) and after (Adjusted R2 = 0.64) practice. The explanatory variables differed between before and after practice for the fast group but only slightly for the slow group. These findings indicate that performance-based stratification of older adults can identify unique adjustments in motor function that are independent of chronological age.

Reduced rate of force development under fatigued conditions is associated to the decline in force complexity in adult males

PURPOSE

This study aimed to verify whether the slowing of muscle contraction quickness, typically observed in states of fatigue, may worsen force control by decreasing the rate with which force fluctuations are modulated. Therefore, we investigated the relationship between rate of force development (RFD), and force fluctuations' magnitude (Coefficient of variation, CoV) and complexity (Approximate Entropy, ApEn; Detrended fluctuation analysis, DFAα).

METHODS

Fourteen participants performed intermittent ballistic isometric contractions of the plantar dorsiflexors at 70% of maximal voluntary force until task failure (under 60% twice).

RESULTS

Indices of RFD (RFDpeak, RFD50, RFD100, and RFD150) decreased over time by approximately 46, 32, 44, and 39%, respectively (p all ≤ 0.007). DFAα increased by 10% (p < 0.001), and CoV increased by 15% (p < 0.001), indicating decreased force complexity along with increased force fluctuations, respectively. ApEn decreased by just over a quarter (28%, p < 0.001). The linear hierarchical models showed negative associations between RFDpeak and DFAα (β =  - 3.6 10-4, p < 0.001), CoV (β =  - 1.8 10-3, p < 0.001), while ApEn showed a positive association (β = 8.2 × 10-5, p < 0.001).

CONCLUSION

The results suggest that exercise-induced reductions in contraction speed, lead to smoother force complexity and diminished force control due to slower adjustments around the target force. The fatigued state resulted in worsened force producing capacity and overall force control.

Skeletal muscle dysfunction with advancing age

As a result of advances in medical treatments and associated policy over the last century, life expectancy has risen substantially and continues to increase globally. However, the disconnect between lifespan and 'health span' (the length of time spent in a healthy, disease-free state) has also increased, with skeletal muscle being a substantial contributor to this. Biological ageing is accompanied by declines in both skeletal muscle mass and function, termed sarcopenia. The mechanisms underpinning sarcopenia are multifactorial and are known to include marked alterations in muscle protein turnover and adaptations to the neural input to muscle. However, to date, the relative contribution of each factor remains largely unexplored. Specifically, muscle protein synthetic responses to key anabolic stimuli are blunted with advancing age, whilst alterations to neural components, spanning from the motor cortex and motoneuron excitability to the neuromuscular junction, may explain the greater magnitude of function losses when compared with mass. The consequences of these losses can be devastating for individuals, their support networks, and healthcare services; with clear detrimental impacts on both clinical (e.g., mortality, frailty, and post-treatment complications) and societal (e.g., independence maintenance) outcomes. Whether declines in muscle quantity and quality are an inevitable component of ageing remains to be completely understood. Nevertheless, strategies to mitigate these declines are of vital importance to improve the health span of older adults. This review aims to provide an overview of the declines in skeletal muscle mass and function with advancing age, describes the wide-ranging implications of these declines, and finally suggests strategies to mitigate them, including the merits of emerging pharmaceutical agents.

Resistance band training with functional electrical stimulation improves force control capabilities in older adults: a preliminary study

Resistance band training (RBT) with functional electrical stimulation (FES) may be an effective exercise regimen for improving age-related motor impairments. This preliminary study investigated the potential effects of bimanual RBT with FES on upper limb motor functions in older adults. This study randomly assigned 22 elderly people to the bimanual RBT with FES (Bi-RBT+FES) group and the RBT without FES (Bi-RBT) group. All participants performed isometric hand-grip force control tasks in unimanual (dominant and non-dominant) and bimanual conditions before and after four weeks of exercise for each group. We quantified the mean force, force accuracy, force variability, and force regularity at two targeted force levels (i.e., 10 % and 40 % of maximum voluntary contraction; MVC) to estimate changes in force control capabilities. The results revealed that the Bi-RBT+FES group demonstrated a greater force accuracy in the dominant hand at 10 % of MVC after training. Non-dominant hands in the Bi-RBT+FES group increased force accuracy at 40 % of MVC and reduced force variability collapsed across two targeted force levels. Both groups showed a decrease in force regularity after training. These preliminary results indicate that Bi-RBT+FES may be a viable option to facilitate functional recovery of the upper limbs in older adults.

Sex differences in knee extensor torque control

There is currently equivocal evidence regarding sex-related differences in measures of muscle force and torque control. To that end, we investigated sex differences in knee extensor muscle torque control, using both magnitude- and complexity-based measures, across contraction intensities typical of activities of daily living. 50 participants (25 male, median age [and interquartile range] 23.0 [20.0-33.0]; 25 female, median age [and interquartile range] 21.0 [20.0-40.5]) performed a series of intermittent isometric knee extensor contractions at 10, 20 and 40% maximal voluntary contraction (MVC). Torque was measured in N·m and torque control was quantified according to the magnitude (standard deviation [SD], coefficient of variation [CV]) and complexity (approximate entropy [ApEn], detrended fluctuation analysis [DFA] α) of torque fluctuations. Males exhibited a significantly greater absolute magnitude (i.e., SD) of knee extensor torque fluctuations during contractions at 10% (P = 0.011), 20% (P = 0.002) and 40% MVC (P = 0.003), though no sex differences were evident when fluctuations were normalised to mean torque output (i.e., CV). Males exhibited significantly lower ApEn during contractions at 10% (P = 0.002) and 20% MVC (P = 0.024) and significantly greater DFA α during contractions at 10% (P = 0.003) and 20% MVC (P = 0.001). These data suggest sex differences in muscle torque control strategies and highlight the need to consider both the magnitude and complexity of torque fluctuations when examining sex differences in muscle force control.

Prolonged static stretching increases the magnitude and decreases the complexity of knee extensor muscle force fluctuations

Static stretching decreases maximal muscle force generation in a dose-response manner, but its effects on the generation of task-relevant and precise levels of submaximal force, i.e. force control, is unclear. We investigated the effect of acute static stretching on knee extensor force control, quantified according to both the magnitude and complexity of force fluctuations. Twelve healthy participants performed a series of isometric knee extensor maximal voluntary contractions (MVCs) and targeted intermittent submaximal contractions at 25, 50 and 75% MVC (3 x 6 seconds contraction separated by 4 seconds rest, with 60 seconds rest between each intensity) prior to, and immediately after, one of four continuous static stretch conditions: 1) no stretch; 2) 30-second stretch; 3) 60-second stretch; 4) 120-second stretch. The magnitude of force fluctuations was quantified using the standard deviation (SD) and coefficient of variation (CV), while the complexity of fluctuations was quantified using approximate entropy (ApEn) and detrended fluctuation analysis (DFA) α. These measures were calculated using the steadiest 5 seconds of the targeted submaximal contractions at each intensity (i.e., that with the lowest SD). Significant decreases in MVC were evident following the 30, 60 and 120-second stretch conditions (all P < 0.001), with a significant correlation observed between stretch duration and the magnitude of decrease in MVC (r = -0.58, P < 0.001). The 120-second stretch resulted in significant increases in SD at 50% MVC (P = 0.007) and CV at 50% (P = 0.009) and 75% MVC (P = 0.005), and a significant decrease in ApEn at 75% MVC (P < 0.001). These results indicate that the negative effects of prolonged static stretching extend beyond maximal force generation tasks to those involving generation of precise levels of force during moderate- to high-intensity submaximal contractions.

Torque complexity of maximal knee extensor isometric contraction in individuals following anterior cruciate ligament reconstruction

BACKGROUND

Current rehabilitation goals following anterior cruciate ligament reconstruction are structured around the maximal force generating capabilities of the muscle. Force fluctuations, an index of force control, have been observed to alter post- anterior cruciate ligament reconstruction. The temporal structure, or "complexity" of force fluctuations may provide important insight into the post-operative muscular recovery. The aims of this study were 1) to compare quadriceps torque complexity in anterior cruciate ligament reconstructed patients to the contralateral limb and to healthy, controls and 2) to assess the relationships between torque complexity to patient outcomes.

METHODS

Data from 120 anterior cruciate ligament reconstructed participants (65 Females, 21.0 ± 8.3 years, 5.96 ± 0.48-months post-surgery) and 95 healthy controls (50 Females, 21.5 ± 2.9 years) were collected. A 30-s knee extensor maximal isometric contraction was completed to calculate approximate entropy, a measure of torque complexity.

FINDINGS

Approximate entropy was found to decrease throughout the 30-s trial (P < .001, Cohen's d = 1.87 [1.64,2.10]). The anterior cruciate ligament reconstructed limb demonstrated greater approximate entropy compared to the contralateral limb or to healthy controls (P < .001, Cohen's d = 0.64 [0.38,0.90]). approximate entropy at the end of the trial demonstrated weak, negatively relationships with peak torque, patient reported outcome measures, and knee extensor fatigue (r = -0.21 to -0.32, P < .05).

INTERPRETATION

A greater torque complexity in individuals following anterior cruciate ligament reconstruction was weakly related to lower quadriceps strength, lower subjective function, and quadriceps fatigue resistance. The complexity of force fluctuations during a sustained maximal task may draw clinical insight into the recovery of motor function following anterior cruciate ligament reconstruction.

Measuring complexity of muscle force control: Theoretical principles and clinical relevance in musculoskeletal research and practice

Musculoskeletal conditions affect bones, joints, and muscles of the locomotor system and are a leading cause of disability worldwide. This suggests that current musculoskeletal rehabilitation techniques fail to target the characteristics (e.g., physiological/physical/psychological) most influential for long-term musculoskeletal health. To identify whether a physiological characteristic is impaired, it must be measured. In neuromuscular control, traditional research approaches use magnitude-based measurements (e.g., peak force/standard deviation of force/coefficient of variation of force). However, magnitude-based measurements miss 'hidden information' regarding a physiological system's status across time. To better identify physiological characteristics that are clinically-important for long-term musculoskeletal health, other measurement approaches currently less applied in musculoskeletal research may be helpful. The purpose of this article is to present an introduction to technical and measurement principles for quantifying the 'complexity' of muscle force control as one representation of peripheral joint neuromuscular control. Complexity measurements are time-based and consider the irregular temporal structure of physiological signals. We review theoretical principles underlying measuring complexity of muscle force control and explain its clinical relevance for musculoskeletal scientists and clinicians. The principles include sensorimotor control of peripheral joints, muscle force signal construction and features, muscle force control measurement procedures, and variability and complexity variables. We propose the potential utility of measuring the complexity of muscle force control for diagnosing sensorimotor system impairment and prognosis following musculoskeletal disease or injury. This article will serve as an educational asset and a scientific resource that will inform future research directions to optimise rehabilitation for people with peripheral joint disease and injury.

Altered neuromuscular control in the vastus medialis following anterior cruciate ligament injury: A recurrence quantification analysis of electromyogram recruitment

BACKGROUND

Neuromuscular deficits exist following anterior cruciate ligament (ACL) injury. To observe these deficits, we examined nonlinear characteristics of vastus medialis electromyography (EMG) signals during submaximal isometric knee extensor contractions. Our purpose was to examine if determinism and entropy in EMG signals reflected neuromuscular control deficits in individuals with ACL-deficient limbs.

METHODS

24 participants (12 male, 12 female, mean age = 18.8 ± 3.1 years) with unilaterally injured ACLs and 25 age-similar healthy controls (11 male, 14 female, mean age = 18.8 ± 3.1 years) volunteered. Isometric knee extensions were tested at 10%, 25%, 35%, and 50% maximum voluntary contractions. Surface electrodes adhered over the vastus medialis captured EMG signals. EMG data were processed with recurrence quantification analyses. Specifically, determinism (an index of system predictability) and entropy (an index of system disorder) were calculated from recurrence plots.

FINDINGS

Determinism and entropy in EMG signals were lower in the injured than uninjured limb, and lower than that from healthy controls (P < .05).

INTERPRETATION

Vastus medialis EMG signals from the injured limb were less predictable and less complex than those from healthy limbs. The findings reflect impaired neuromuscular control in the injured limb's quadriceps and are consistent with a 'loss of complexity' hypothesis in physiologic signals emanating from pathologic states. Determinism and entropy in EMG signals may represent biomarkers of one's neuromuscular control system.

The Neuromuscular Fatigue-Induced Loss of Muscle Force Control

Neuromuscular fatigue is characterised not only by a reduction in the capacity to generate maximal muscle force, but also in the ability to control submaximal muscle forces, i.e., to generate task-relevant and precise levels of force. This decreased ability to control force is quantified according to a greater magnitude and lower complexity (temporal structure) of force fluctuations, which are indicative of decreased force steadiness and adaptability, respectively. The "loss of force control" is affected by the type of muscle contraction used in the fatiguing exercise, potentially differing between typical laboratory tests of fatigue (e.g., isometric contractions) and the contractions typical of everyday and sporting movements (e.g., dynamic concentric and eccentric contractions), and can be attenuated through the use of ergogenic aids. The loss of force control appears to relate to a fatigue-induced increase in common synaptic input to muscle, though the extent to which various mechanisms (afferent feedback, neuromodulatory pathways, cortical/reticulospinal pathways) contribute to this remains to be determined. Importantly, this fatigue-induced loss of force control could have important implications for task performance, as force control is correlated with performance in a range of tasks that are associated with activities of daily living, occupational duties, and sporting performance.

The Effect of Breaking Up Sedentary Time with Calisthenics on Neuromuscular Function: A Preliminary Study

The ageing process results in reduced neuromuscular function. This alongside prolonged sedentary behaviour is associated with decreased muscle strength, force control and ability to maintain balance. Breaking up sedentary time with regular bouts of physical activity has numerous health benefits, though the effects on neuromuscular function are unknown. This study investigated the effect of breaking up sedentary time with calisthenic exercise on neuromuscular function. 17 healthy adults (33 ± 13.1 years), who spent ≥6 h/day sitting, were assigned to a four-week calisthenics intervention (n = 8) or control group (n = 9). The calisthenics intervention involved performing up to eight sets of exercises during the working day (09:00-17:00); with one set consisting of eight repetitions of five difference exercises (including squats and lunges). Before and immediately after the intervention, measures of knee extensor maximal voluntary contraction (MVC) and submaximal force control (measures of the magnitude and complexity of force fluctuations), and dynamic balance (Y balance test) were taken. The calisthenics intervention resulted in a significant increase in knee extensor MVC (p = 0.036), significant decreases in the standard deviation (p = 0.031) and coefficient of variation (p = 0.016) of knee extensor force fluctuations during contractions at 40% MVC, and a significant increase in Y balance test posterolateral reach with left leg stance (p = 0.046). These results suggest that breaking up sedentary time with calisthenics may be effective at increasing muscle strength, force steadiness and dynamic balance all of which might help reduce the effects of the ageing process.