Effects of minute oscillation stretching training on muscle and tendon stiffness and walking capability in people with type 2 diabetes

AIM

we investigated the effects of a 10 week training program (i.e., minute oscillatory stretching; MOS) on the mechanical responses and walking capability in people with type 2 diabetes (T2D).

METHODS

seventeen T2D patients performed maximum voluntary contractions of the plantar flexor muscles during which Achilles tendon stiffness (kT) and muscle-tendon stiffness (kM) were evaluated at different percentages of the maximum voluntary force (MVC). In addition, each participant was requested to walk at different walking speeds (i.e. 2, 3, 4, 5, and 6 kmh-1) while their net energy cost of walking (Cnet), cumulative EMG activity per distance travelled (CMAPD) and kinematic parameters (step length, step frequency, the ankle/knee range of motion) were evaluated.

RESULTS

maximum tendon elongation increased after MOS training, and kT significantly decreased (between 0 and 20% of MVC). No differences were observed for muscle elongation or kM after training. Cnet decreased after training (at the slowest tested speeds) while no changes in CMAPD were observed. Step length and ankle ROM during walking increased after training at the slowest tested speeds, while step frequency decreased; no significant effects were observed for knee ROM.

CONCLUSION

these results indicate the effectiveness of 10 weeks of MOS training in reducing tendon stiffness and the energy cost during walking in people with T2D. This training protocol requires no specific instrumentation, can be easily performed at home, and has a high adherence (92 ± 9%). It could, thus, be useful to mitigate mechanical tendon deterioration and improve physical behaviour in this population.

The role of pennation angle and architectural gearing to rate of force development in dynamic and isometric muscle contractions

BACKGROUND

Associations between muscle architecture and rate of force development (RFD) have been largely studied during fixed-end (isometric) contractions. Fixed-end contractions may, however, limit muscle shape changes and thus alter the relationship between muscle architecture an RFD.

AIM

We compared the correlation between muscle architecture and architectural gearing and knee extensor RFD when assessed during dynamic versus fixed-end contractions.

METHODS

Twenty-two recreationally active male runners performed dynamic knee extensions at constant acceleration (2000°s-2) and isometric contractions at a fixed knee joint angle (fixed-end contractions). Torque, RFD, vastus lateralis muscle thickness, and fascicle dynamics were compared during 0-75 and 75-150 ms after contraction onset.

RESULTS

Resting fascicle angle was moderately and positively correlated with RFD during fixed-end contractions (r = 0.42 and 0.46 from 0-75 and 75-150 ms, respectively; p < 0.05), while more strongly (p < 0.05) correlated with RFD during dynamic contractions (r = 0.69 and 0.73 at 0-75 and 75-150 ms, respectively; p < 0.05). Resting fascicle angle was (very) strongly correlated with architectural gearing (r = 0.51 and 0.73 at 0-75 ms and 0.50 and 0.70 at 75-150 ms; p < 0.05), with gearing in turn also being moderately to strongly correlated with RFD in both contraction conditions (r = 0.38-0.68).

CONCLUSION

Resting fascicle angle was positively correlated with RFD, with a stronger relationship observed in dynamic than isometric contraction conditions. The stronger relationships observed during dynamic muscle actions likely result from different restrictions on the acute changes in muscle shape and architectural gearing imposed by isometric versus dynamic muscle contractions.

Coronal As Well As Sagittal Fascicle Dynamics Can Bring About a Gearing Effect in Muscle Elongation by Passive Lengthening

PURPOSE

The amount of muscle belly elongation induced by passive lengthening is often assumed to be equal to that of fascicles. But these are different if fascicles shorter than the muscle belly rotate around their attachment sites. Such discrepancy between fascicles and muscle belly length changes can be considered as gearing. As the muscle fascicle arrangement is 3D, the fascicle rotation by passive lengthening may occur in the coronal as well as the sagittal planes. Here we examined the fascicle 3D dynamics and resultant gearing during passive elongation of human medial gastrocnemius in vivo .

METHODS

For 16 healthy adults, we reconstructed fascicles three-dimensionally using diffusion tensor imaging and evaluated the change in fascicle length and angles in the sagittal and coronal planes during passive ankle dorsiflexion (from 20° plantar flexion to 20° dorsiflexion).

RESULTS

Whole muscle belly elongation during passive ankle dorsiflexion was 38% greater than the fascicle elongation. Upon passive lengthening, the fascicle angle in the sagittal plane in all regions (-5.9°) and that in the coronal plane in the middle-medial (-2.7°) and distal-medial (-4.3°) regions decreased significantly. Combining the fascicle coronal and sagittal rotation significantly increased the gearing effects in the middle-medial (+10%) and distal-medial (+23%) regions. The gearing effect by fascicle sagittal and coronal rotations corresponded to 26% of fascicle elongation, accounting for 19% of whole muscle belly elongation.

CONCLUSIONS

Fascicle rotation in the coronal and sagittal planes is responsible for passive gearing, contributing to the whole muscle belly elongation. Passive gearing can be favorable for reducing fascicle elongation for a given muscle belly elongation.

Impairments in muscle shape changes affect metabolic demands during in-vivo contractions

The uncoupling behaviour between muscle belly and fascicle shortening velocity (i.e. belly gearing), affects mechanical output by allowing the muscle to circumvent the limits imposed by the fascicles' force-velocity relationship. However, little is known about the 'metabolic effect' of a decrease/increase in belly gearing. In this study, we manipulated the plantar flexor muscles' capacity to change in shape (and hence belly gearing) by using compressive multidirectional loads. Metabolic, kinetic, electromyography activity and ultrasound data (in soleus and gastrocnemius medialis) were recorded during cyclic fixed-end contractions of the plantar flexor muscles in three different conditions: no load, +5 kg and +10 kg of compression. No differences were observed in mechanical power and electrophysiological variables as a function of compression intensity, whereas metabolic power increased as a function of it. At each compression intensity, differences in efficiency were observed when calculated based on fascicle or muscle behaviour and significant positive correlations (R2 range: 0.7-0.8 and p > 0.001) were observed between delta efficiency (ΔEff: Effmus-Efffas) and belly gearing (Vmus/Vfas) or ΔV (Vmus-Vfas). Thus, changes in the muscles' capacity to change in shape (e.g. in muscle stiffness or owing to compressive garments) affect the metabolic demands and the efficiency of muscle contraction.

Muscle shape changes in Parkinson's disease impair function during rapid contractions

AIM

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized, among the others, by muscle weakness. PD patients reach lower values of peak torque during maximal voluntary contractions but also slower rates of torque development (RTD) during explosive contractions. The aim of this study was to better understand how an impairment in structural/mechanical (peripheral) factors could explain the difficulty of PD patients to raise torque rapidly.

METHODS

Participants (PD patients and healthy matched controls) performed maximum voluntary explosive fixed-end contraction of the knee extensor muscles during which dynamic muscle shape changes (in muscle thickness, pennation angle, and belly gearing: the ratio between muscle belly velocity and fascicle velocity), muscle-tendon unit (MTU) stiffness and EMG activity of the vastus lateralis (VL) were investigated. Both the affected (PDA) and less affected limb (PDNA) were investigated in patients.

RESULTS

Control participants reached higher values of peak torque and showed a better capacity to express force rapidly compared to patients (PDA and PDNA). EMG activity was observed to differ between patients (PDA) and controls, but not between controls and PDNA. This suggests a specific neural/nervous effect on the most affected side. On the contrary, MTU stiffness and dynamic muscle shape changes were found to differ between controls and patients, but not between PDA and PDNA. Both sides are thus similarly affected by the pathology.

CONCLUSION

The higher MTU stiffness in PD patients is likely responsible for the impaired muscle capability to change in shape which, in turn, negatively affects the torque rise.

Contribution of stroke-related changes in neuromuscular factors to gear ratio during isometric contraction of medial gastrocnemius muscle: A simulation study

BACKGROUND

It is not clear which neuromuscular factors are most closely associated with the loss of variable fascicle gearing after chronic stroke. The purpose of this simulation study is to determine the effects of stroke-related changes in key neuromuscular factors on the gear ratio.

METHODS

A modified Hill-type model of the medial gastrocnemius was developed to determine the gear ratio for a given muscle activation level and musculotendon length. Model parameters were then systematically adjusted to simulate known stroke-related changes in neuromuscular factors, and the gear ratio was computed for each change in the parameters. A Monte Carlo simulation was performed to understand which neuromuscular factors and fiber behavior-related parameters are most relevant to the loss of variable gearing. Dominance analyses were also conducted to quantify the relative importance of fiber behavior-related parameters on the gear ratio.

FINDINGS

The gear ratio decreases significantly with smaller pennation angle and with shorter optimal fiber length. In addition, muscle thickness and pennation angle at optimal fiber length appear to be the most important muscle architectural parameters. Dominance analyses further suggest that primary determinants of gear ratio include initial pennation angle, fiber rotation-shortening ratio, initial muscle thickness, and fiber rotation.

INTERPRETATION

Our findings provide insight that the pennation angle may play an important role for efficient muscular contraction, implying that maintaining muscle architecture and/or improving fiber/fascicle rotation could a key goal in rehabilitation interventions. Our findings will help us to better interpret altered gearing behavior in aging and pathological muscles.

Muscle Belly Gearing Positively Affects the Force-Velocity and Power-Velocity Relationships During Explosive Dynamic Contractions

Changes in muscle shape could play an important role during contraction allowing to circumvent some limits imposed by the fascicle force–velocity (F–V) and power–velocity (P–V) relationships. Indeed, during low-force high-velocity contractions, muscle belly shortening velocity could exceed muscle fascicles shortening velocity, allowing the muscles to operate at higher F–V and P–V potentials (i.e., at a higher fraction of maximal force/power in accordance to the F–V and P–V relationships). By using an ultrafast ultrasound, we investigated the role of muscle shape changes (vastus lateralis) in determining belly gearing (muscle belly velocity/fascicle velocity) and the explosive torque during explosive dynamic contractions (EDC) at angular accelerations ranging from 1000 to 4000°.s^–2. By means of ultrasound and dynamometric data, the F–V and P–V relationships both for fascicles and for the muscle belly were assessed. During EDC, fascicle velocity, belly velocity, belly gearing, and knee extensors torque data were analysed from 0 to 150 ms after torque onset; the fascicles and belly F–V and P–V potentials were thus calculated for each EDC. Absolute torque decreased as a function of angular acceleration (from 80 to 71 Nm, for EDC at 1000 and 4000°.s^–1, respectively), whereas fascicle velocity and belly velocity increased with angular acceleration (P < 0.001). Belly gearing increased from 1.11 to 1.23 (or EDC at 1000 and 4000°.s^–1, respectively) and was positively corelated with the changes in muscle thickness and pennation angle (the changes in latter two equally contributing to belly gearing changes). For the same amount of muscle’s mechanical output (force or power), the fascicles operated at higher F–V and P–V potential than the muscle belly (e.g., P–V potential from 0.70 to 0.56 for fascicles and from 0.65 to 0.41 for the muscle belly, respectively). The present results experimentally demonstrate that belly gearing could play an important role during explosive contractions, accommodating the largest part of changes in contraction velocity and allowing the fascicle to operate at higher F–V and P–V potentials.

Muscle and tendon stiffness and belly gearing positively correlate with rate of torque development during explosive fixed end contractions

We combined ultrafast-ultrasound with dynamometric measurements to assess the associations between muscle structural properties and the rate of torque development (RTD) during isometric explosive fixed-end plantar flexor contractions. The torque-time signal was recorded for the plantaflexor muscles in fifteen men and the peak value of RTD was obtained. Tendon stiffness (kT) and muscle stiffness (kM) of the Gastrocnemius Medialis (GM) were assessed during maximal isometric voluntary contractions (MVC) and quick release using ultrafast ultrasound (1000 Hz). During the explosive contraction, the GM geometrical changes were recorded and the belly gearing (belly velocity/fascicle velocity) was calculated. Pearson's correlation coefficient was used to assess the correlation between variables, whereas equality of correlation coefficients between RTD and kT and kM was tested by means of the Hotelling's statistics. During explosive contraction, kT was higher than kM (~55 and ~30 N⋅mm^-1, respectively). RTD positively correlated with kM (r = 0.75, p < 0.001), kT (r = 0.58, p = 0.044) and belly gearing (r = 0.78, p < 0.001). However, Hotelling's test showed no significant differences between the correlation coefficients between RTD and muscle and tendon stiffness. Further, belly gearing was significantly positively correlated with kM only (r = 0.79, p < 0.001). Our data suggest that muscle and tendon stiffness are similarly associated with RTD. Given the association with belly gearing, muscle stiffness seems to play an important role in determining the muscle length changes, thereby affecting the muscle force transmission capacity during the transient phases.