Gamma loop contributing to maximal voluntary contractions in man

Can isometric testing substitute for the one repetition maximum squat test?

When measuring maximum strength, a high accuracy and precision is required to monitor the training adaptations. Based on available reliability parameters, the literature suggests the replacement of the one repetition maximum (1RM) by isometric testing to save testing time. However, from a statistical point of view, correlation coefficients do not provide the required information when aiming to replace one test by another. Therefore, the literature suggests the inclusion of the mean absolute error (MAE), the mean absolute percentage error (MAPE) for agreement analysis. Consequently, to check the replaceability of 1RM testing methods, the current study examined the agreement of isometric and dynamic testing methods in the squat and the isometric mid-thigh pull. While in accordance with the literature, correlations were classified high r = 0.638-0.828 and ICC = 0.630-0.828, the agreement analysis provided MAEs of 175.75-444.17 N and MAPEs of 16.16-57.71% indicating an intolerable high measurement error between isometric and dynamic testing conditions in the squat and isometric mid-thigh pull. In contrast to previous studies, using MAE, MAPE supplemented by CCC and BA analysis highlights the poor agreement between the included strength tests. The recommendation to replace 1RM testing with isometric testing routines in the squat does not provide suitable concordance and is not recommended.

Tactile stimulation restores inhibited stretch reflex attributable to attenuation of Ia afferents during surprise landing

Arthrogenic muscle inhibition (AMI) is induced by pathological knee conditions. The present study aimed to investigate the effect of tactile stimulation on reflex changes induced by simulated AMI during unpredictable landing performances. Twenty participants performed six unilateral landing tasks: 15 cm normal landing (15NL), 30 cm normal landing (30NL), surprise landing (SL), 30 cm normal landing following vibration (30NLV), SL following vibration (SLV), and SL following vibration with Kinesiology tape (SLK). For SL, the solid landing platform (15 cm) was removed and replaced by a false floor. Since the false floor dislodged easily under load, participants unpredictably fell through the platform to the actual landing surface 15 cm below. After completing 15NL, 30NL, and SL, vibration was applied to participants' knees to induce neurological changes similar to AMI. After vibration, participants performed 30NLV, SLV, and SLK in a random order. EMG signals in the post-landing short latency (31-60 ms) and medium latency (61-90 ms) periods were examined. EMG signals from the vastus lateralis (VL), vastus medialis (VM), and biceps femoris (BF) were recorded and compared between tasks. EMG signals of all muscles in SL were significantly enhanced in the medium latency period as compared with 30NL. Enhanced EMG signals in SL were suppressed by vibration stimulation in the VL, but the suppressed EMG signals were restored after cutaneous stimulation with Kinesiology tape (p < 0.01). Our findings suggest that AMI could alter motor control patterns during unpredictable landing and that tactile stimulation could restore the altered motor control to a normal state.

Human muscle spindles are wired to function as controllable signal-processing devices

Muscle spindles are encapsulated sensory organs found in most of our muscles. Prevalent models of sensorimotor control assume the role of spindles is to reliably encode limb posture and movement. Here, I argue that the traditional view of spindles is outdated. Spindle organs can be tuned by spinal γ motor neurons that receive top-down and peripheral input, including from cutaneous afferents. A new model is presented, viewing γ motor activity as an intermediate coordinate transformation that allows multimodal information to converge on spindles, creating flexible coordinate representations at the level of the peripheral nervous system. That is, I propose that spindles play a unique overarching role in the nervous system: that of a peripheral signal-processing device that flexibly facilitates sensorimotor performance, according to task characteristics. This role is compatible with previous findings and supported by recent studies with naturalistically active humans. Such studies have so far shown that spindle tuning enables the independent preparatory control of reflex muscle stiffness, the selective extraction of information during implicit motor adaptation, and for segmental stretch reflexes to operate in joint space. Incorporation of advanced signal-processing at the periphery may well prove a critical step in the evolution of sensorimotor control theories.

Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles

Ongoing motor deficits are routinely present following anterior cruciate ligament (ACL) reconstruction, including the ability to regulate muscle force. While such deficits are known, it is unclear why this occurs. The goal of the current study was to investigate the potential influence of muscle spindle input on submaximal force regulation and muscle activity at the knee in people following ACL reconstruction. Fourteen participants (8 female) who were 6-24 months post-ACL reconstruction and 15 control participants (8 female) undertook submaximal force matching and force modulation tasks before and after 20 min of vibration applied to the patella tendon. Across all tasks, the ACL reconstruction participants were poorer at force matching (P=0.007). The effect of vibration was not significant in either group for the force matching tasks (P=0.06), although there was a reduction in maximum voluntary contraction post-vibration in the control group (P<0.001). The ACL reconstruction group also showed evidence of greater activation of the medial hamstring muscles in comparison to controls (P=0.04). Individuals who have undergone ACL reconstruction have a diminished ability to accurately match and regulate submaximal muscle force, but this does not appear to be related to impaired muscle spindle input. Neuromuscular retraining programs that involve force regulation tasks may be necessary to optimize rehabilitation after ACL reconstruction.

The Recovery of Muscle Spindle Sensitivity Following Stretching Is Promoted by Isometric but Not by Dynamic Muscle Contractions

It is often suggested that stretching-related changes in performance can be partially attributed to stretching-induced neural alterations. Recent evidence though shows that neither spinal nor cortico-spinal excitability are susceptible of a long-lasting effect and only the amplitude of stretch or tap reflex (TR) is reduced up to several minutes. Since afferents from muscle spindles contribute to voluntary muscle contractions, muscle stretching could be detrimental to muscle performance. However, the inhibition of muscle spindle sensitivity should be reversed as soon as the stretched muscle contracts again, due to α-γ co-activation. The present work evaluated which type of muscle contraction (static or dynamic) promotes the best recovery from the inhibition in spindle sensitivity following static stretching. Fifteen students were tested for TR at baseline and after 30 s maximal individual static stretching of the ankle plantar flexors followed by one of three randomized interventions (isometric plantar flexor MVC, three counter movement jumps, and no contraction/control). Ten TRs before and 20 after the procedures were induced with intervals of 30 s up to 10 min after static stretching. The size of the evoked TRs (peak to peak amplitude of the EMG signal) following stretching without a subsequent contraction (control) was on average reduced by 20% throughout the 10 min following the intervention and did not show a recovery trend. Significant decrease in relation to baseline were observed at 9 of the 20 time points measured. After MVC of plantar flexors, TR recovered immediately showing no differences with baseline at none of the investigated time points. Following three counter movement jumps it was observed a significant 34.4% group average inhibition (p < 0.0001) at the first time point. This effect persisted for most of the participants for the next measurement (60 s after intervention) with an average reduction of 23.4% (p = 0.008). At the third measurement, 90 s after the procedure, the reflexes were on average still 21.4% smaller than baseline, although significant level was not reached (p = 0.053). From 120 s following the intervention, the reflex was fully recovered. This study suggests that not every type of muscle contraction promotes a prompt recovery of a stretch-induced inhibition of muscle spindle sensitivity.

A Randomized Controlled Pilot Study Comparing the Efficacy of Pulsed Radiofrequency Combined With Exercise Versus Exercise Alone in Pain Relief and Functional Improvement for Chronic Knee Osteoarthritis

OBJECTIVES

To compare the long-term efficacy between pulsed radiofrequency (PRF) combined with passive stretching (PRF-PS) exercise and PS exercise alone in reducing pain and improving quadriceps muscle strength and knee function.

METHODS

Sixty-two participants were randomly assigned with a 1:1 allocation to the PRF-PS exercise group or the PS exercise group. Level of pain, muscle strength, and knee function were assessed from baseline to the first, third, and sixth months after treatment using the VAS, peak torque (PT), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively.

RESULTS

There were no significant differences at baseline between the 2 groups. Compared to exercise alone, participants achieved superior efficacy with PRF-PS in pain relief, improvement of muscle strength, and knee function. Moreover, the improvement of all variables was maintained for a longer period of time in the PRF-PS group. The reduction in participants' VAS pain intensity scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: -1.85 cm; 95% confidence interval [CI] -2.25, -1.45 cm; P = 0.000). The increase in participants' PT scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: 15.53 N. m; 95% CI 7.07, 23.98 N. m; P = 0.000; and 12.62 N. m; 95% CI 0.96, 24.28 N. m; P = 0.000 for PT 60 degrees/s and PT 180 degrees/s, respectively). The reduction in participants' WOMAC scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: -16.43; 95% CI -22.22, -10.64; P = 0.000).

DISCUSSION

The improvement in pain relief and knee function might be associated with restoration of muscle strength after PRF-PS exercise by overcoming muscle inhibition.

Immediate effect of kinesio taping on knee extensor torque of children with Cerebral Palsy: Three case reports

BACKGROUND

Kinesiotaping (KT) has been commonly used in clinical setting. However, beneficial KT effects have not been proved yet.

OBJECTIVE

We aimed to verify the effects of KT in knee extensor torque in children with CP.

METHODS

We evaluated three children diagnosed as spastic CP, classified as level I, II and III, according with GMFCS. Knee extensor peak torque was analyzed by isokinetic evaluation (Biodex Multi Joint System). The test was performed at 60°/s in the concentric passive mode and the children performed maximal contractions. Children with CP were evaluated with and without KT under rectus femoris.

RESULTS

After KT application, knee peak torque of the affected limb increased in children with CP.

CONCLUSION

KT may increase muscle strength in children with CP.

Myogenic and Central Neurogenic Factors in Fatigue in Multiple Sclerosis

Short episodes of electrical stimulation were applied to the right quadriceps muscle of patients with multiple sclerosis (MS) and healthy subjects at different times during 60 sec sustained voluntary muscle contractions at 0 to 100% levels of maximal voluntarily generated joint torque. The amplitude of electrically induced increments of torque (ΔT) has been shown to depend upon both the level of muscular contraction and time from the beginning of the contraction. The dependence of ΔT upon the time from the beginning of contraction has been assumed to reflect muscle fatigue. Patients with MS demonstrated an apparent involvement of central neurogenic mechanisms in fatigue manifested as a drop in muscle torque during sustained contractions at 75 and 100% levels when electrical stimulation was able to induce considerable increments in muscle torque. These patients also demonstrated a dependence of ΔT upon the contraction level suggesting that they did not produce maximal voluntary contraction torque in the pre-trial. Fatigue in MS is due to central, neurogenic factors and does not seem to involve any myogenic factors such as might be related to secondary muscle changes due to the long-standing disorder. The subjective feeling of tiredness (‘fatigue’) may be related to a dissociation between central motor commands (‘effort’) and their mechanical consequences.

Acute and chronic neuromuscular adaptations to local vibration training

Vibratory stimuli are thought to have the potential to promote neural and/or muscular (re)conditioning. This has been well described for whole-body vibration (WBV), which is commonly used as a training method to improve strength and/or functional abilities. Yet, this technique may present some limitations, especially in clinical settings where patients are unable to maintain an active position during the vibration exposure. Thus, a local vibration (LV) technique, which consists of applying portable vibrators directly over the tendon or muscle belly without active contribution from the participant, may present an alternative to WBV. The purpose of this narrative review is (1) to provide a comprehensive overview of the literature related to the acute and chronic neuromuscular changes associated with LV, and (2) to show that LV training may be an innovative and efficient alternative method to the 'classic' training programs, including in the context of muscle deconditioning prevention or rehabilitation. An acute LV application (one bout of 20-60 min) may be considered as a significant neuromuscular workload, as demonstrated by an impairment of force generating capacity and LV-induced neural changes. Accordingly, it has been reported that a training period of LV is efficient in improving muscular performance over a wide range of training (duration, number of session) and vibration (frequency, amplitude, site of application) parameters. The functional improvements are principally triggered by adaptations within the central nervous system. A model illustrating the current research on LV-induced adaptations is provided.

A distinct functional distribution of α and γ motoneurons in the rat trigeminal motor nucleus

Gamma-motoneurons (γMNs) play a crucial role in regulating isometric muscle contraction. The slow jaw-closing during mastication is one of the most functional isometric contractions, which is developed by the rank-order recruitment of alpha-motoneurons (αMNs) in a manner that reflects the size distribution of αMNs. In a mouse spinal motor nucleus, there are two populations of small and large MNs; the former was identified as a population of γMNs based on the positive expression of the transcription factor estrogen-related receptor 3 (Err3) and negative expression of the neuronal DNA-binding protein NeuN, and the latter as that of αMNs based on the opposite pattern of immunoreactivity. However, the differential identification of αMNs and γMNs in the trigeminal motor nucleus (TMN) remains an assumption based on the size of cell bodies that were retrogradely stained with HRP. We here examined the size distributions of αMNs and γMNs in the dorsolateral TMN (dl-TMN) by performing immunohistochemistry using anti-Err3 and anti-NeuN antibodies. The dl-TMN was identified by immunopositivity for vesicular glutamate transporter-1. Immunostaining for choline acetyltransferase and Err3/NeuN revealed that the dl-TMN is composed of 65% αMNs and 35% γMNs. The size distribution of αMNs was bimodal, while that of γMNs was almost the same as that of the population of small αMNs, suggesting the presence of αMNs as small as γMNs. Consistent with the size concept of motor units, the presence of smaller jaw-closing αMNs was coherent with the inclusion of jaw-closing muscle fibers with smaller diameters compared to limb muscle fibers.

The influence of prolonged vibration on motor unit behavior

INTRODUCTION

The purpose of this study was to determine the effects of vibration (VIB) on motor unit (MU) behavior of the vastus lateralis (VL) muscle during a 40% maximal voluntary contraction (MVC).

METHODS

Eleven healthy (age 21.3 ± 2.6 years) individuals participated in the study. Surface electromyography (EMG) data were recorded from the VL during isometric trapezoidal muscle contractions at 40% MVC. Firing events of single MUs and EMG amplitude were reported for the first, middle, and final seconds of a 12-second steady force segment at 40% MVC. VIB was applied at 55 Hz to the patellar tendon for 15 minutes before and continued throughout the remainder of testing (VIB) or remained off (CON).

RESULTS

There were significant increases in MU firing rates during VIB in comparison to CON and no differences in EMG amplitude between VIB and CON.

CONCLUSION

The VIB-mediated reduction in muscle spindle function altered MU behavior at 40% MVC. Muscle Nerve 55: 500-507, 2017.

The representation of egocentric space in the posterior parietal cortex

The posterior parietal cortex (PPC) is the most likely site where egocentric spatial relationships are represented in the brain. PPC cells receive visual, auditory, somaesthetic, and vestibular sensory inputs; oculomotor, head, limb, and body motor signals; and strong motivational projections from the limbic system. Their discharge increases not only when an animal moves towards a sensory target, but also when it directs its attention to it. PPC lesions have the opposite effect: sensory inattention and neglect. The PPC does not seem to contain a "map" of the location of objects in space but a distributed neural network for transforming one set of sensory vectors into other sensory reference frames or into various motor coordinate systems. Which set of transformation rules is used probably depends on attention, which selectively enhances the synapses needed for making a particular sensory comparison or aiming a particular movement.

Alteration of synergistic muscle activity following neuromuscular electrical stimulation of one muscle

The aim of the study was to determine muscle activation of the m. triceps surae during maximal voluntary contractions (MVCs) following neuromuscular electrical stimulation (NMES) of the m. gastrocnemius lateralis (GL). The participants (n = 10) performed three MVC during pretest, posttest, and recovery, respectively. Subsequent to the pretest, the GL was stimulated by NMES. During MVC, force and surface electromyography (EMG) of the GL, m. gastrocnemius medialis (GM), and m. soleus (SOL) were measured. NMES of GL induced no significant decline (3%) in force. EMG activity of the GL decreased significantly to 81% (P < 0.05), whereas EMG activity of the synergistic SOL increased to 112% (P < 0.01). The GM (103%, P = 1.00) remained unaltered. Decreased EMG activity in the GL was most likely caused by failure of the electrical propagation at its muscle fiber membrane. The decline of EMG activity in GL was compensated by increased EMG activity of SOL during MVC. It is suggested that these compensatory effects are caused by central contributions induced by NMES.

Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects

INTRODUCTION

A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA.

METHODS

Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration.

RESULTS

Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P < 0.001) and EMG amplitude (P ≤0.001) decreased significantly in the control group but did not change in the OA group (all P > 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P < 0.011). No between-group differences were observed for the change in hamstrings torque or EMG (all P > 0.554).

CONCLUSIONS

γ-loop dysfunction may contribute to AMI in individuals with knee joint OA, partially explaining the marked quadriceps weakness and atrophy that is often observed in this population.

Does the nervous system depend on kinesthetic information to control natural limb movements?

This target article draws together two groups of experimental studies on the control of human movement through peripheral feedback and centrally generated signals of motor commands. First, during natural movement, feedback from muscle, joint, and cutaneous afferents changes; in human subjects these changes have reflex and kinesthetic consequences. Recent psychophysical and microneurographic evidence suggests that joint and even cutaneous afferents may have a proprioceptive role. Second, the role of centrally generated motor commands in the control of normal movements and movements following acute and chronic deafferentation is reviewed. There is increasing evidence that subjects can perceive their motor commands under various conditions, but that this is inadequate for normal movement; deficits in motor performance arise when the reliance on proprioceptive feedback is abolished either experimentally or because of pathology. During natural movement, the CNS appears to have access to functionally useful input from a range of peripheral receptors as well as from internally generated command signals. The unanswered questions that remain suggest a number of avenues for further research.

Implications of neural networks for how we think about brain function

Engineers use neural networks to control systems too complex for conventional engineering solutions. To examine the behavior of individual hidden units would defeat the purpose of this approach because it would be largely uninterpretable. Yet neurophysiologists spend their careers doing just that! Hidden units contain bits and scraps of signals that yield only arcane hints about network function and no information about how its individual units process signals. Most literature on single-unit recordings attests to this grim fact. On the other hand, knowing a system's function and describing it with elegant mathematics tell one very little about what to expect of interneuronal behavior. Examples of simple networks based on neurophysiology are taken from the oculomotor literature to suggest how single-unit interpretability might decrease with increasing task complexity. It is argued that trying to explain how any real neural network works on a cell-by-cell, reductionist basis is futile and we may have to be content with trying to understand the brain at higher levels of organization.

The potential neural mechanisms of acute indirect vibration

There is strong evidence to suggest that acute indirect vibration acts on muscle to enhance force, power, flexibility, balance and proprioception suggesting neural enhancement. Nevertheless, the neural mechanism(s) of vibration and its potentiating effect have received little attention. One proposal suggests that spinal reflexes enhance muscle contraction through a reflex activity known as tonic vibration stretch reflex (TVR), which increases muscle activation. However, TVR is based on direct, brief, and high frequency vibration (>100 Hz) which differs to indirect vibration, which is applied to the whole body or body parts at lower vibration frequency (5-45 Hz). Likewise, muscle tuning and neuromuscular aspects are other candidate mechanisms used to explain the vibration phenomenon. But there is much debate in terms of identifying which neural mechanism(s) are responsible for acute vibration; due to a number of studies using various vibration testing protocols. These protocols include: different methods of application, vibration variables, training duration, exercise types and a range of population groups. Therefore, the neural mechanism of acute vibration remain equivocal, but spinal reflexes, muscle tuning and neuromuscular aspects are all viable factors that may contribute in different ways to increasing muscular performance. Additional research is encouraged to determine which neural mechanism(s) and their contributions are responsible for acute vibration. Testing variables and vibration applications need to be standardised before reaching a consensus on which neural mechanism(s) occur during and post-vibration. Key pointsThere is strong evidence to suggest that acute indirect vibration acts on muscle to enhance force, power, flexibility, balance and proprioception, but little attention has been given to the neural mechanism(s) of acute indirect vibration.Current findings suggest that acute vibration exposure may cause a neural response, but there is little consensus on identifying which neural mechanism(s) are specifically responsible. This is due to a number of studies using various vibration testing protocols (i.e.varying frequencies, amplitudes, durations, and methods of application).Spinal reflexes, muscle tuning and neuromuscular aspects and central motor command are all viable neuromechanical factors that may contribute at different stages to transiently increasing muscular performance.Additional research is encouraged to determine when (pre, during and post) the different neural mechanism(s) respond to direct and indirect vibration stimuli.

The potential neural mechanisms of acute indirect vibration

There is strong evidence to suggest that acute indirect vibration acts on muscle to enhance force, power, flexibility, balance and proprioception suggesting neural enhancement. Nevertheless, the neural mechanism(s) of vibration and its potentiating effect have received little attention. One proposal suggests that spinal reflexes enhance muscle contraction through a reflex activity known as tonic vibration stretch reflex (TVR), which increases muscle activation. However, TVR is based on direct, brief, and high frequency vibration (>100 Hz) which differs to indirect vibration, which is applied to the whole body or body parts at lower vibration frequency (5-45 Hz). Likewise, muscle tuning and neuromuscular aspects are other candidate mechanisms used to explain the vibration phenomenon. But there is much debate in terms of identifying which neural mechanism(s) are responsible for acute vibration; due to a number of studies using various vibration testing protocols. These protocols include: different methods of application, vibration variables, training duration, exercise types and a range of population groups. Therefore, the neural mechanism of acute vibration remain equivocal, but spinal reflexes, muscle tuning and neuromuscular aspects are all viable factors that may contribute in different ways to increasing muscular performance. Additional research is encouraged to determine which neural mechanism(s) and their contributions are responsible for acute vibration. Testing variables and vibration applications need to be standardised before reaching a consensus on which neural mechanism(s) occur during and post-vibration. Key pointsThere is strong evidence to suggest that acute indirect vibration acts on muscle to enhance force, power, flexibility, balance and proprioception, but little attention has been given to the neural mechanism(s) of acute indirect vibration.Current findings suggest that acute vibration exposure may cause a neural response, but there is little consensus on identifying which neural mechanism(s) are specifically responsible. This is due to a number of studies using various vibration testing protocols (i.e.varying frequencies, amplitudes, durations, and methods of application).Spinal reflexes, muscle tuning and neuromuscular aspects and central motor command are all viable neuromechanical factors that may contribute at different stages to transiently increasing muscular performance.Additional research is encouraged to determine when (pre, during and post) the different neural mechanism(s) respond to direct and indirect vibration stimuli.

Vibration as an exercise modality: how it may work, and what its potential might be

Whilst exposure to vibration is traditionally regarded as perilous, recent research has focussed on potential benefits. Here, the physical principles of forced oscillations are discussed in relation to vibration as an exercise modality. Acute physiological responses to isolated tendon and muscle vibration and to whole body vibration exercise are reviewed, as well as the training effects upon the musculature, bone mineral density and posture. Possible applications in sports and medicine are discussed. Evidence suggests that acute vibration exercise seems to elicit a specific warm-up effect, and that vibration training seems to improve muscle power, although the potential benefits over traditional forms of resistive exercise are still unclear. Vibration training also seems to improve balance in sub-populations prone to fall, such as frail elderly people. Moreover, literature suggests that vibration is beneficial to reduce chronic lower back pain and other types of pain. Other future indications are perceivable.

Effects of prolonged tendon vibration stimulation on eccentric and concentric maximal torque and emgs of the knee extensors

The purpose of present study was to compare the effect of Ia afferent attenuation on the activity of alpha motor neuron (MN) during concentric and eccentric action. Eight male subjects were enrolled in the present study. The experiments consisted of two sessions of MVC measurements, since all subjects performed both maximal concentric and eccentric action. EMG signals were simultaneously measured. To establish the baseline of strength, subjects were asked to perform MVC of knee extension in each session. After finishing the measurements, 20 min of vibration stimulation was applied. Immediately after finishing vibration stimulation, the MVC and AEMG were again measured. The means of MVC for concentric knee extension at pre and post- vibration stimulation were 192.2 ± 49.3 Nm and 162.3 ± 47.9 Nm, respectively. The means of MVC for eccentric knee extension at pre and post-vibration stimulation were 299.7 ± 77.0 Nm and 247.3 ± 88. 6 Nm, respectively. Two-factor repeated ANOVA detected significant differences in the MVC. Both main effects for pre-post condition (F(1,7)=, p = 0.0033) and action (F(1,7)=26.35, p = 0.0013) were noted. No interaction effect (action x condition) was noted. The means of AEMG (vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF)) at pre and post -vibration stimulation were decreased. Two-factor repeated ANOVA detected significant differences in AEMG (VM and VL). Both main effects for pre-post condition (VL;F(1,7)=7.27, p = 0.0308, VM; F(1,7)=9.55, p = 0.0175) and action (F(1,7)=12.40, p = 0.0097) were noted in the VL and the VM but not in the RF. Furthermore, significant interaction (action x condition) effect was noted in the VM (F(1,7)=7.03, p = 0.0328) but not in the VL. The MVC and the EMG activity of the VL in response to the prolonged vibration stimulation were significantly reduced in eccentric contraction over concentric contraction. These results represented that a deactivation effect on the alpha MN of the VL during eccentric action was greater than that of concentric action. Key pointsA deactivation effect on the alpha motor neuron of the vastus lateralis during eccentric action was greater than that of maximal concentric action.

The impact of latent trigger points on regional muscle function

To date, most investigation of latent myofascial trigger points (LTrPs) has occurred in pain populations. Many have thought that LTrPs are clinically relevant as -potential precursors to developing active myofascial trigger points and spontaneous pain. Nociceptive substances have been found in greater concentrations at LTrP sites compared with non-TrP sites, indicating the potential for group III and IV afferent fibers to provide input to the central nervous system from affected peripheral sites. Fatigue and neurophysiologic studies provide evidence as to the pathways via which group III and IV afferents can alter activity of the motoneuron pool and therefore affect muscle activation and performance. This article offers suggestions as to the mechanisms via which LTrP-related pathophysiology may explain the clinical examination findings associated with LTrP-containing and functionally related muscles.

Isokinetic Dynamometry in Anterior Cruciate Ligament Injury and Reconstruction

The use of isokinetic dynamometry has often been criticised based on the face-validity argument that isokinetic movements poorly resemble the everyday multi-segmented, dynamic activities of human movements. In the anterior cruciate ligament (ACL) reconstruction or deficiency population where muscle deficits are ubiquitous, this review paper has made a case for using isokinetic dynamometry to isolate and quantify these deficits in a safe and controlled manner. More importantly, the usefulness of isokinetic dynamometry, as applied in individuals with ACL reconstruction or deficiency, is attested by its established known-group and convergent validity. Known-group validity is demonstrated by the extent to which a given isokinetic measure is able to identify individuals who could and could not resume pre-morbid athletic or strenuous activities with minimal functional limitations following an ACL injury. Convergent validity is demonstrated by the extent to which a given isokinetic measure closely associates with self-report measures of knee function in individuals with ACL reconstruction. A basic understanding of the measurement properties of isokinetic dynamometry will guide the clinicians in providing reasoned interventions and advancing the clinical care of their clients. Key words: Biomechanics, Knee, Validity

Treatment of posttraumatic arthrofibrosis of the radioulnar joint with vibration therapy (VMTX Vibromax Therapeutics): a case report and narrative review of literature

OBJECTIVE

To present the clinical features of post traumatic arthrofibrosis and response to treatment with Vibromax Therapeutics (VMTX) in 28 year old male soccer player.

RATIONALE

Many studies have reported an increase in muscle performance after whole-body vibration, but to date none have evaluated the possibility of vibration application as a therapy for functional restoration after injury.

CONCLUSIONS

Vibration training is being utilized in, strength training, performance enhancement and rehabilitation. Despite the lack of research in this area, the literature that is currently available and the results of this case study imply that vibration therapy has the potential to aid in the management of acute soft tissue injury and the sequela of disuse and immobilization.

Gamma loop dysfunction of the quadriceps femoris of elderly patients hospitalized after fall injury

BACKGROUND AND PURPOSE

Gamma loop dysfunction may increase the risk of falls. Therefore, we evaluated gamma loop function in subjects hospitalized after fall injury and examined whether aging affects the gamma loop.

METHODS

Maximal voluntary contraction (strength) of knee extension and integrated electromyography (I-EMG) of the quadriceps femoris were examined to evaluate the activities of alpha motoneurons before and after 20-min vibration applied to the quadriceps femoris. Mean percentage changes were calculated as: (previbration value-postvibration value)/previbration valuex100). As strength and I-EMG of both uninjured (UG) and injured limbs (IG) of patients with a history of falls resulting in hospitalization were examined in each group, the mean percentage changes of the 4 groups were compared with those of controls [young control group (YCG) and elderly control group (ECG)].

RESULTS

Mean percentage changes in strength of UG and IG were significantly different from YCG but not the ECG. Mean percentage changes in I-EMG for VL (vastus lateralis) and VM (vastus medialis)in IG were significantly different from YCG. However, I-EMG of RF of IG were not significantly different from YCG. Although mean percentage changes in I-EMG of UG were not significantly different from ECG, those for VL and VM of IG were different from ECG.

CONCLUSIONS

As the gamma loop dysfunction exited in the uninjured limbs of subjects with a history of falls resulting in hospitalization, a dysfunctional gamma loop could be a risk factor for falling. Further studies are needed to identify the effects of aging on gamma loop function.

Effect of vibration training in maximal effort (70% 1RM) dynamic bicep curls

PURPOSE

To examine (i) the acute effect of direct vibration on neuromuscular performance with a maximal-effort dynamic resistance exercise and (ii) the acute residual effect of direct vibration training both with and without the resistance exercise.

METHODS

Fourteen subjects were exposed to four training conditions in random order: exercise with vibration (E + V); exercise with sham vibration (E + SV); no exercise with vibration (NE + V); and no exercise with sham vibration (NE + SV). The exercise comprised three sets of maximal-effort bicep curls with a load of 70% 1RM. A portable vibrator was strapped onto the skin over the bicep tendon to apply vibration with an amplitude and frequency of 1.2 mm and 65 Hz. Elbow joint angle and bicep EMG were measured both during training and in pre- and posttraining tests. Angular velocity, moment, power, and bicep root mean squared value of EMG (EMG(rms)) and mean power frequency of EMG (EMG(mpf)) were determined for the concentric phase. Interday reliability ranged from 0.69 to 0.99.

RESULTS

During training (acute effect) vibration did not enhance mean angular velocity (1.5 vs 1.5 rad.s(-1), P = 0.86), peak angular velocity (2.7 vs 2.7 rad.s(-1), P = 0.90), mean moment (27.3 vs 27.4 N.m, P = 0.83), peak moment (39.8 vs 39.4 N.m, P = 0.53), mean power (40.3 vs 41.1 W, P = 0.72), peak power (91.9 vs 90.2 W, P = 0.77), or bicep EMG(rms) (73.9 vs 71.9, P = 0.78). Similarly, after training (acute residual effect) there was no enhancement from vibration in the mechanical and EMG output when the muscle was trained or was rested (P > 0.05).

CONCLUSION

These findings suggest that direct vibration, with an amplitude of 1.2 mm and frequency of 65 Hz, applied to the bicep muscle tendon, does not enhance neuromuscular performance in maximal-effort contractions during or immediately after training.

Strength training effects of whole-body vibration?

Whole-body vibration (WBV) has been suggested to have a beneficial effect on muscle strength. Manufacturers of vibration platforms promote WBV as an effective alternative or complement to resistance training. This study aimed to review systematically the current (August 2005) scientific support for effects of WBV on muscle strength and jump performance. MEDLINE and SPORT DISCUS were searched for the word vibration in combination with strength or training. Twelve articles were included in the final analysis. In four of the five studies that used an adequate design with a control group performing the same exercises as the WBV group, no difference in performance improvement was found between groups, suggesting no or only minor additional effects of WBV as such. Proposed neural mechanisms are discussed.

Gamma loop dysfunction in the quadriceps femoris of patients who underwent anterior cruciate ligament reconstruction remains bilaterally

Purpose of this study was to investigate the effects of anterior cruciate ligament (ACL) repair on the gamma loop of the bilateral quadriceps femoris (QF). Maximal voluntary contraction (MVC) of knee extension and integrated electromyogram (I-EMG) of vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) were examined in uninjured and injured limbs of 18 patients and 10 normal subjects, before and after 20-min vibration applied to the QF. Mean percentage changes were calculated as: (pre-vibration value-post-vibration value)/pre-vibration value x 100. Patients were divided into two groups: short-term-group (tested </=12 months after ACL repair, n=8), long-term-group (tested >/=18 months after ACL repair, n=10). Mean percentage changes of the four groups were compared with those of controls. Results indicated that changes of MVC and I-EMG on the uninjured and injured sides in short-term-group in response to vibration were significantly different from those of controls. There were no significant differences between uninjured sides in long-term and control groups. MVC and I-EMG of VM and RF of injured side in patients in the long-term-group in response to vibration were not different from those of controls. From these results, we concluded that this abnormality of the gamma loop in both injured and uninjured sides did not recover despite ACL reconstruction. However, the abnormality in uninjured side might recover >/=18 months after repair.

The Stretch-Shortening Cycle

Neuromuscular fatigue has traditionally been examined using isolated forms of either isometric, concentric or eccentric actions. However, none of these actions are naturally occurring in human (or animal) ground locomotion. The basic muscle function is defined as the stretch-shortening cycle (SSC), where the preactivated muscle is first stretched (eccentric action) and then followed by the shortening (concentric) action. As the SSC taxes the skeletal muscles very strongly mechanically, its influence on the reflex activation becomes apparent and very different from the isolated forms of muscle actions mentioned above. The ground contact phases of running, jumping and hopping etc. are examples of the SSC for leg extensor muscles; similar phases can also be found for the upper-body activities. Consequently, it is normal and expected that the fatigue phenomena should be explored during SSC activities. The fatigue responses of repeated SSC actions are very versatile and complex because the fatigue does not depend only on the metabolic loading, which is reportedly different among muscle actions. The complexity of SSC fatigue is well reflected by the recovery patterns of many neuromechanical parameters. The basic pattern of SSC fatigue response (e.g. when using the complete exhaustion model of hopping or jumping) is the bimodality showing an immediate reduction in performance during exercise, quick recovery within 1-2 hours, followed by a secondary reduction, which may often show the lowest values on the second day post-exercise when the symptoms of muscle soreness/damage are also greatest. The full recovery may take 4-8 days depending on the parameter and on the severity of exercise. Each subject may have their own time-dependent bimodality curve. Based on the reviewed literature, it is recommended that the fatigue protocol is 'completely' exhaustive to reduce the important influence of inter-subject variability in the fatigue responses. The bimodality concept is especially apparent for stretch reflex responses, measured either in passive or active conditions. Interestingly, the reflex responses follow parallel changes with some of the pure mechanical parameters, such as yielding of the braking force during an initial ground contact of running or hopping. The mechanism of SSC fatigue and especially the bimodal response of performance deterioration and its recovery are often difficult to explain. The immediate post-exercise reduction in most of the measured parameters and their partial recovery 1-2 hours post-exercise can be explained primarily to be due to metabolic fatigue induced by exercise. The secondary reduction in these parameters takes place when the muscle soreness is highest. The literature gives several suggestions including the possible structural damage of not only the extrafusal muscle fibres, but also the intrafusal ones. Temporary changes in structural proteins and muscle-tendon interaction may be related to the fatigue-induced force reduction. Neural adjustments in the supraspinal level could naturally be operative, although many studies quoted in this article emphasise more the influences of exhaustive SSC fatigue on the fusimotor-muscle spindle system. It is, however, still puzzling why the functional recovery lasts several days after the disappearance of muscle soreness. Unfortunately, this and many other possible mechanisms need more thorough testing in animal models provided that the SSC actions can be truly performed as they appear in normal human locomotion.

Task failure during fatiguing contractions performed by humans

By comparing the physiological adjustments that occur when two similar fatiguing contractions are performed to failure, it is possible to identify mechanisms that limit the duration of the more difficult task. This approach has been used to study two fatiguing contractions, referred to as the force and position tasks, which differed in the type of feedback given to the subject and the amount of support provided by the surroundings. Even though the two tasks required a similar net muscle torque during submaximal isometric contractions, the duration that the position task could be sustained was consistently much briefer than that for the force task. The position task involved a greater rate of increase in EMG activity and more marked changes in motor unit recruitment and rate coding compared with the force task. These observations are consistent with the hypothesis that the motor unit pool was recruited more rapidly during the position task. The difference in motor unit behavior appeared to be caused by variation in synaptic input, likely involving heightened sensitivity of the stretch reflex during the position task. Upon repeat performances of the two fatiguing contractions, some subjects were able to increase the time to failure for the force task but not the position task. Furthermore, the time to failure for the position task could be influenced by the postural demands associated with maintaining the position of the limb, and the difference in the two durations was enhanced when the postural activity evoked a pressor response. These observations indicate that the difference in the duration of the two fatiguing contractions was attributable to differences in the control strategy used to sustain the tasks and the magnitude of the associated postural activity.

Difference in aftereffects following prolonged Achilles tendon vibration on muscle activity during maximal voluntary contraction among plantar flexor synergists

It has been suggested that a suppression of maximal voluntary contraction (MVC) induced by prolonged vibration is due to an attenuation of Ia afferent activity. The purpose of the present study was to test the hypothesis that aftereffects following prolonged vibration on muscle activity during MVC differ among plantar flexor synergists owing to a supposed difference in muscle fiber composition. The plantar flexion MVC torque and surface electromyogram (EMG) of the medial head of gastrocnemius (MG), the lateral head of gastrocnemius (LG), and the soleus (Sol) were recorded in 13 subjects before and after prolonged vibration applied to the Achilles tendon at 100 Hz for 30 min. The maximal H reflexes and M waves were also determined from the three muscles, and the ratio between H reflexes and M waves (H/Mmax) was calculated before and after the vibration. The MVC torque was decreased by 16.6 ± 3.7% after the vibration ( P < 0.05; ANOVA). The H/Mmax also decreased for all three muscles, indicating that Ia afferent activity was successfully attenuated by the vibration in all plantar flexors. However, a reduction of EMG during MVC was observed only in MG (12.7 ± 4.0%) and LG (11.4 ± 3.9%) ( P < 0.05; ANOVA), not in Sol (3.4 ± 3.0%). These results demonstrated that prolonged vibration-induced MVC suppression was attributable mainly to the reduction of muscle activity in MG and LG, both of which have a larger proportion of fast-twitch muscle fibers than Sol. This finding suggests that Ia-afferent activity that reinforces the recruitment of high-threshold motor units is necessary to enhance force exertion during MVC.

The acute effects of static stretching on peak torque, mean power output, electromyography, and mechanomyography

The purpose of this study was to examine the acute effects of static stretching on peak torque (PT), the joint angle at PT, mean power output (MP), electromyographic (EMG) amplitude, and mechanomyographic (MMG) amplitude of the vastus lateralis (VL) and rectus femoris (RF) muscles during maximal, voluntary concentric isokinetic leg extensions at 60 and 240 degrees x s(-1) of the stretched and unstretched limbs. Twenty-one volunteers [mean age (SD) 21.5 (1.3) years] performed maximal, voluntary concentric isokinetic leg extensions for the dominant and non-dominant limbs at 60 and 240 degrees x s(-1). Surface EMG (muVrms) and MMG (mVrms) signals were recorded from the VL and RF muscles during the isokinetic tests. PT (Nm), the joint angle at PT, and MP (W) were calculated by a dynamometer. Following the initial isokinetic tests, the dominant leg extensors were stretched using four static stretching exercises. After the stretching, the isokinetic tests were repeated. PT decreased (P< or =0.05) from pre- to post-stretching for the stretched limb at 60 and 240 degrees x s(-1) and for the unstretched limb at 60 degrees x s(-1). EMG amplitude of the VL and RF also decreased (P< or =0.05) from pre- to post-stretching for the stretched and unstretched limbs. There were no stretching-induced changes (P>0.05) for the joint angle at PT, MP, or MMG amplitude. These findings indicated stretching-induced decreases in force production and muscle activation. The decreases in PT and EMG amplitude for the unstretched limb suggested that the stretching-induced decreases may be due to a central nervous system inhibitory mechanism.

Motor-unit activity differs with load type during a fatiguing contraction

Despite a similar rate of change in average electromyographic (EMG) activity, previous studies have observed different rates of change in mean arterial pressure, heart rate, perceived exertion, and fluctuations in motor output during the performance of fatiguing contractions that involved different types of loads. To obtain a more direct measure of the motor output from the spinal cord, the purpose of this study was to compare the discharge characteristics of the same motor unit in biceps brachii during the performance of two types of fatiguing contractions. In separate tests with the upper arm vertical and the elbow flexed to 1.57 rad, the seated subjects maintained either a constant upward force at the wrist (force task) or a constant elbow angle (position task) for a prescribed duration. The force and position tasks were performed in random order at a target force equal to 3.5 +/- 2.1% (mean +/- SD) of the maximal voluntary contraction (MVC) force above the recruitment threshold of the isolated motor unit. Each subject maintained the two tasks for an identical duration (161 +/- 96 s) at a mean target force of 22.2 +/- 13.4% MVC (range: 3-49% MVC). The dependent variables included the discharge characteristics of the same motor unit in biceps brachii, fluctuations in motor output (force or acceleration), mean arterial pressure, heart rate, and rating of perceived exertion. Despite similar increases in the amplitude of the averaged EMG (% MVC) for the elbow flexor muscles during both tasks (P = 0.60), the rates of increase in mean arterial pressure (P < 0.001), rating of perceived exertion (P = 0.023), and fluctuations in motor output (P = 0.003) were greater during the position task compared with the force task. Consistent with these differences, mean discharge rate declined at a greater rate during the position task (P = 0.03), and the coefficient of variation for discharge rate increased only during the position task (P = 0.02). Furthermore, more motor units were recruited during the position task compared with the force task (P = 0.01). These findings indicate that despite a comparable net muscle torque, the rate of increase in the motor output from the spinal cord was greater during the position task.

Changes in voluntary torque and electromyographic activity following oral baclofen

The consequences of baclofen intake on voluntary motor behaviors remain unclear. We studied the effects of single oral doses of baclofen on voluntary, isometric knee extension torques and surface and single motor unit (MU) electromyographic (EMG) activity from the vastus lateralis in 11 individuals without neurological injury. Examination of submaximal to maximal contractions of varying duration performed pre- and post-baclofen ingestion revealed significant decreases in maximal knee torques and EMG magnitude, accompanied by an increase in slope of the torque-EMG relation. A decreased slope of the torque-MU firing rate relation was also demonstrated post-baclofen, but without changes in minimal firing rates or recruitment forces. During sustained contractions at < or =25% of maximal voluntary torque elicited after baclofen ingestion, increased EMG activity was observed without significant differences in MU firing rates. Our results demonstrate a clear reduction in the maximal torque-generating ability following baclofen. Specific changes in MU firing patterns indicate that weakness may be due partly to reduced motoneuronal excitability, although use of MU discharge patterns to assess these effects is limited in its sensitivity.

Gamma loop dysfunction in quadriceps on the contralateral side in patients with ruptured ACL

PURPOSE

The aim of our study was to test for any neurophysiological abnormality in the gamma loop in the quadriceps femoris muscle on the uninjured side of patients with unilateral rupture of the anterior cruciate ligament (ACL).

METHODS

Maximal voluntary contraction of knee extension and integrated electromyography (I-EMG) of the vastus medialis, vastus lateralis, and rectus femoris were measured in the uninjured limb of 13 patients with unilateral ACL rupture and 10 normal subjects, before and after 20-min vibration stimulation applied to the infrapatellar tendon.

RESULTS

The mean percentage changes of maximal voluntary contraction and I-EMG in quadriceps femoris of the uninjured side of patients with ACL rupture were significantly different from those of the control group. Maximal voluntary contraction and I-EMG after prolonged vibration stimulation did not decrease as much as those of the control group even though the same protocol of vibration stimulation was applied.

CONCLUSION

The abnormal response to prolonged vibration stimulation could represent abnormal gamma loop in the quadriceps femoris muscle of the uninjured side in patients with ACL rupture since the normal response of maximal voluntary contraction and I-EMG to prolonged vibration stimulation could not be evoked without normal function of the gamma loop.

Mechanism of quadriceps femoris muscle weakness in patients with anterior cruciate ligament reconstruction

The purpose of this study was to investigate gamma loop function in the quadriceps femoris muscle in patients who with less than 6 month-history of anterior cruciate ligament (ACL) reconstruction. For this purpose, we compared the response to vibration stimulation in 10 patients with ACL repair and 12 normal healthy subjects, by measuring the maximal voluntary isometric contraction (MVC) and integrated electromyograms (I-EMG) of the quadriceps muscles. Pre-vibration data were obtained from each subject by measuring the MVC of the knee extension and the I-EMG from the vastus medialis, vastus lateralis, and rectus femoris muscles. Vibration stimulation was applied to the infrapatellar tendons, followed immediately by repeating the MVC and I-EMG recording. Prolonged vibration resulted in a significant decrease of both MVC and I-EMG in the control group. In contrast, the same stimulus failed to elicit changes in ACL-repair group. Our results suggest the presence of abnormal gamma loop function in the quadriceps femoris muscle of patients with ACL repair, which may explain the muscle weakness often described in such patients.