Resistance training and human cervical muscle recruitment plasticity

Physical exercise improved muscle strength and pain on neck and shoulder in military pilots

Purpose: To evaluate the effects of physical exercise on neck and shoulder muscle strength and pain in military pilots.

Method: Embase, PubMed, and Cochrane Library databases were searched studies published up to April 1, 2022. Studies that met the screening criteria were included in the final meta-analysis. We calculated neck and shoulder maximal voluntary isometric contractions (MVICs), prevalence of pain, and pain intensity. Heterogeneity was explored by subgroup and sensitivity analyses.

Result: A total of 15 studies with 907 participants were included. In the exercise group, muscle strength was significantly increased in four directions of neck motion: flexion (standardized mean difference (SMD) = 0.45; 95% CI, 0.08–0.82), extension (SMD = 0.63; 95% CI, 0.27–1.00), right lateral flexion (Rtflx) (SMD = 0.53; 95% CI, 0.12–0.94), and left lateral flexion (Ltflx) (SMD = 0.50; 95% CI, 0.09–0.91). Subgroup analysis showed that fighter pilots, strength plus endurance training, and a follow-up period <20 weeks exhibited more significant muscle strength improvements than helicopter pilots, simple strength training, and a follow-up period ≥20 weeks. Overall, the pooled odds ratio (OR) for the effect of physical exercise on the prevalence of neck pain was not statistically significant (I² = 60%). Sensitivity analysis revealed that the heterogeneity was restored after removing each of two studies (I² = 47%), and the pooled OR was statistically significant (OR = 0.46; 95% CI, 0.23 to 0.94, or OR = 0.47; 95% CI, 0.24–0.91). Furthermore, compared with observational studies (OS), the reduction in the prevalence of neck pain was more significant in randomized controlled trials (RCTs) (OR = 0.37; 95% CI, 0.18–0.78). No significant differences in the effects of exercise on shoulder muscle strength and neck and shoulder pain intensity were observed.

Conclusion: Physical exercise can improve neck muscle strength in military pilots. After removing studies that may be the source of heterogeneity, exercise showed a protective effect on neck pain, especially in RCTs. The conclusion that exercise had no effects on shoulder muscle strength and pain intensity should be taken with caution.

Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial

BACKGROUND

Greater neck strength is associated with fewer head and neck injuries. Neck-strengthening programs are commonly burdensome, requiring specialist equipment or significant time commitment, which are barriers to implementation.

HYPOTHESIS

Completing a neck-strengthening program will increase isometric neck strength in age-group rugby players.

STUDY DESIGN

A pilot randomized controlled exercise intervention study.

LEVEL OF EVIDENCE

Level 2.

METHODS

Twenty-eight U18 (under 18) male regional age-group rugby union players were randomized (intervention n =15/control n = 13). An 8-week exercise program was supervised during preseason at the regional training center. Control players continued their "normal practice," which did not include neck-specific strengthening exercises. The 3-times weekly trainer-led intervention program involved a series of 15-second self-resisted contractions, where players pushed maximally against their own head, in forward, backward, left, and right directions.

OUTCOME MEASURE

Peak isometric neck strength (force N) into neck flexion, extension, and left and right side flexion was measured using a handheld dynamometer.

RESULTS

Postintervention between-group mean differences (MDs) in isometric neck strength change were adjusted for baseline strength and favored the intervention for total neck strength (effect size [ES] = 1.2, MD ± 95% CI = 155.9 ± 101.9 N, P = 0.004) and for neck strength into extension (ES = 1.0, MD ± 95% CI = 59.9 ± 45.4 N, P = 0.01), left side flexion (ES = 0.7, MD ± 95% CI = 27.5 ± 26.9 N, P = 0.05), and right side flexion (ES = 1.3, MD ± 95% CI = 50.5 ± 34.4 N, P = 0.006).

CONCLUSION

This resource-efficient neck-strengthening program has few barriers to implementation and provides a clear benefit in U18 players' neck strength. While the present study focused on adolescent rugby players, the program may be appropriate across all sports where head and neck injuries are of concern and resources are limited.

CLINICAL RELEVANCE

Greater neck strength is associated with fewer head and neck injuries, including concussion. Performing this neck exercise program independently, or as part of a whole-body program like Activate, an interactive guide for players and coaches, could contribute to lower sports-related head and neck injuries.

Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review

Neck pain is very common, but most of the causes are unknown, making diagnosis and treatment extremely challenging. Current studies have found that one of the main problems in patients with neck pain is the impairment of cervical proprioception, which subsequently leads to cervical sensorimotor control disturbances. Cervical spine has a very delicate proprioceptive system that plays a crucial role in controlling posture and balance. Cervical proprioceptive impairment in neck pain occurs through a variety of mechanisms. Experimental neck muscle pain induced by injection of hypertonic saline results in inhibition of the activation of painful muscle; chronic neck pain causes structural and functional impairment of cervical muscles; excessive activation of mechanoreceptors in degenerative cervical discs and facet joints produces a large number of erroneous sensory signals. Clinical examinations to assess the link between structural pathology and neck pain have been unsuccessful, opening the way for the development of function-based tests. To date, eight neck sensorimotor control tests have been reported to evaluate patients with chronic neck pain. Although some tests may involve different subsystems (such as oculomotor system and vestibular system), all tests measure sensorimotor control in the neck, and the most commonly used is cervical joint position error (JPE) test. Current studies support the effectiveness of exercises targeting different aspects of sensorimotor function, in particular retraining aimed at improving cervical proprioception and muscle coordination. Based on the available evidence, it is recommended that patients with neck pain should be assessed and managed for cervical proprioceptive impairment and sensorimotor control disturbances.

Head Injury in Soccer: From Science to the Field; summary of the head injury summit held in April 2017 in New York City, New York

There has been an increased focus and awareness of head injury and sport-related concussion (SRC) across all sports from the medical and scientific communities, sports organisations, legislators, the media and the general population. Soccer, in particular, has been a focus of attention due to the popularity of the game, the frequency of SRC and the hypothesised effects of repetitive heading of the ball. Major League Soccer, US Soccer and the National Women’s Soccer League jointly hosted a conference entitled, ‘Head Injury in Soccer: From Science to the Field’, on 21–22 April 2017 in New York City, New York. The mission of this conference was to identify, discuss and disseminate evidence-based science related to the findings and conclusions of the fifth International Conference on Concussion in Sport held by the Concussion in Sport Group and apply them to the sport of soccer. In addition, we reviewed information regarding the epidemiology and mechanism of head injuries in soccer at all levels of play, data regarding the biomechanics and effects of repetitive head impacts and other soccer-specific considerations. We discussed how to release the information raised during the summit to key stakeholders including athletes, parents, coaches and healthcare providers. We identified future areas for research and collaboration to enhance the health and safety of soccer (football) players.

The Role of Neck Muscle Activities on the Risk of Mild Traumatic Brain Injury in American Football

Concussion, or mild traumatic brain injury (mTBI), is frequently associated with sports activities. It has generally been accepted that neck strengthening exercises are effective as a preventive strategy for reducing sports-related concussion risks. However, the interpretation of the link between neck strength and concussion risks remains unclear. In this study, a typical helmeted head-to-head impact in American football was simulated using the head and neck complex finite element (FE) model. The impact scenario selected was previously reported in lab-controlled incident reconstructions from high-speed video footages of the National Football League using two head-neck complexes taken from Hybrid III dummies. Four different muscle activation strategies were designed to represent no muscle response, a reactive muscle response, a pre-activation response, and response due to stronger muscle strength. Head kinematics and various head/brain injury risk predictors were selected as response variables to compare the effects of neck muscles on the risk of sustaining the concussion. Simulation results indicated that active responses of neck muscles could effectively reduce the risk of brain injury. Also, anticipatory muscle activation played a dominant role on impact outcomes. Increased neck strength can decrease the time to compress the neck and its effects on reducing brain injury risks need to be further studied.

Evaluating serratus anterior muscle function in neck pain using muscle functional magnetic resonance imaging

OBJECTIVE

Muscle functional magnetic resonance imaging (mfMRI) quantifies exercise-induced alterations in soft-aqueous skeletal muscle as a surrogate measure of muscle activity. Because of its excellent spatiotemporal resolution, mfMRI can be used as a noninvasive evaluation of the function of muscles that are challenging to evaluate, such as the serratus anterior (SA) muscle. The purpose of this preliminary study was to investigate the feasibility of evaluating SA muscle function in individuals with neck pain compared with healthy controls using mfMRI.

METHODS

Muscle functional magnetic resonance imaging scans of the SA muscle were obtained before and immediately after an isometric upper limb exercise in 10 subjects with chronic ipsilateral mechanical neck pain and scapular dysfunction (scan on symptomatic side) and in 10 age- and sex-matched healthy subjects. Scans were recorded at 4 intervertebral levels (T6-7, T7-8, T8-9, and T9-10). Differences in water relaxation values (T2 relaxation) quantified from scans before and after exercise were calculated (T2 shift) as a measure of SA muscle activity at each level and compared between groups.

RESULTS

There were significant effects for level (P = .03) and significant group × level interactions (P = .04) but no significant main effect for group (P = .59). Post hoc tests revealed that significant differences in T2 shift values between levels were only evident in the healthy control group.

CONCLUSIONS

This study demonstrated that despite some inherent challenges associated with imaging the SA muscle, mfMRI appears to have adequate spatiotemporal resolution to effectively evaluate SA muscle activity and function in healthy and clinical populations.

Lumbar Muscle Activity During Common Lifts: A Preliminary Study Using Magnetic Resonance Imaging

The purpose of this preliminary study was to assess lumbar multifidus, erector spinae, and quadratus lum-borum muscle activity during lifts as measured by changes in transverse relaxation time (T2) from magnetic resonance imaging (MRI). Thirteen healthy adults performed dynamic squat, stoop, and asymmetric stoop lifts at a standard load, with each lift followed by MRI. Increase in T2 for the multifidus and erector spinae was greater for the stoop than squat. No difference in T2 increase was noted between the multifidus and erector spinae for the squat or stoop. Increase in T2 for the contralateral multifidus was less for the asymmetric stoop than stoop. Future research using MRI and other biomechanical techniques is needed to fully characterize lumbar muscle activity during lifts for various populations, settings, postures, and loads.

Quantitative MRI of vastus medialis, vastus lateralis and gluteus medius muscle workload after squat exercise: comparison between squatting with hip adduction and hip abduction

The aim of the present study was to evaluate the use MRI to quantify the workload of gluteus medius (GM), vastus medialis (VM) and vastus lateralis (VL) muscles in different types of squat exercises. Fourteen female volunteers were evaluated, average age of 22 ± 2 years, sedentary, without clinical symptoms, and without history of previous lower limb injuries. Quantitative MRI was used to analyze VM, VL and GM muscles before and after squat exercise, squat associated with isometric hip adduction and squat associated with isometric hip abduction. Multi echo images were acquired to calculate the transversal relaxation times (T2) before and after exercise. Mixed Effects Model statistical analysis was used to compare images before and after the exercise (ΔT2) to normalize the variability between subjects. Imaging post processing was performed in Matlab software. GM muscle was the least active during the squat associated with isometric hip adduction and VM the least active during the squat associated with isometric hip abduction, while VL was the most active during squat associated with isometric hip adduction. Our data suggests that isometric hip adduction during the squat does not increase the workload of VM, but decreases the GM muscle workload. Squat associated with isometric hip abduction does not increase VL workload.

Muscle functional MRI as an imaging tool to evaluate muscle activity

Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique that offers a noninvasive method to quantify changes in muscle physiology following the performance of exercise. The mfMRI technique is based on signal intensity changes due to increases in the relaxation time of tissue water. In contemporary practice, mfMRI has proven to be an excellent tool for assessing the extent of muscle activation following the performance of a task and for the evaluation of neuromuscular adaptations as a result of therapeutic interventions. This article focuses on the underlying mechanisms and methods of mfMRI, discusses the validity and advantages of the method, and provides an overview of studies in which mfMRI is used to evaluate the effect of exercise and exercise training on muscle activity in both experimental and clinical studies.

Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects

OBJECTIVE

To evaluate the activity of neck extensor muscles during different extension exercises with muscle functional magnetic resonance imaging (mfMRI).

DESIGN

Cross-sectional.

SETTING

University laboratory.

PARTICIPANTS

Healthy subjects (N=11; 7 men, mean age +/- SD, 34+/-5.6y; 4 women, mean age +/- SD, 23.3+/-5.2y; group mean age +/- SD, 30.1+/-7.5y).

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

mfMRI measures of T2 relaxation were made for the multifidus (Mul), the semispinalis cervicis (SCe), the semispinalis capitis (SCa), and the splenius capitis (SpC) at C2-3, C5-6, and C7-T1 in response to 2 head/neck orientations: craniocervical neutral (CCN) and craniocervical extension (CCE). Subjects performed three 1-minute repetitions of each condition at 20% maximum voluntary contraction.

RESULTS

Significant shifts were observed in all muscle groups at the C5-6 and C7-T1 levels after both conditions (P=.04) except the SpC muscle at C5-6 with CCN (P=.17). T2 shifts in the SCa were significantly greater in response to CCE than CCN at C2-3 (P=.03) and C5-6 (P=.02). Similarly, CCE resulted in larger shifts than CCN in the Mul/SCe at C7-T1 (P=.003). No segmental differences were observed between exercises for SpC (P=.25).

CONCLUSIONS

The results of this study provide some preliminary insight into the impact of craniocervical orientation on the differential response of the deep and superficial cervical extensor muscles during the performance of cervical extensor exercises.

Increased jump height and reduced EMG activity with an external focus

Jump height is increased when performers are given external focus instructions, relative to an internal focus or no focus instructions (Wulf & Dufek, 2009; Wulf, Zachry, Granados, & Dufek, 2007). The purpose of present study was to examine possible underlying neurophysiological mechanisms of this effect by using electromyography (EMG). Participants performed a vertical jump-and-reach task under two conditions in a counterbalanced order: external focus (i.e., focus on the rungs of the measurement device) and internal focus (i.e., focus on the fingers with which the rungs were to be touched). EMG activity of various muscles (anterior tibialis, biceps femoris, vastus lateralis, rectus femoris, gastrocnemius) was measured during jumps. Jump height was greater with an external compared to an internal focus. While there were no differences in muscle onset times between attentional focus conditions, EMG activity was generally lower with an external focus. These results suggest that neuromuscular coordination is enhanced by an external focus of attention. The present findings add to the evidence that an external focus facilitates the production of effective and efficient movement patterns.

Reliability of a new virtual reality test to measure cervicocephalic kinaesthesia

The aim of this study was to investigate the cervicocephalic kinaesthesia of healthy subjects for gender and age effects and its reliability in a new virtual reality test procedure. 57 healthy subjects (30 male, 27 females; 18-64 years) were immersed into a virtual 3D scene via a headmounted display, which generated specific head movements. The joint repositioning error was determined in a static and dynamic test at the times T0, T1 (T0+10 minutes) and T2 (T0+24 hours). The intrasession reliability (T0-T1) and the intersession reliability (T0-T2) were analysed. In both tests no gender- or age-specific effects were found. In the overall group the means of the static test were 6.2 degrees -6.9 degrees and of the dynamic test were 4.5 degrees -4.9 degrees . The intratest difference in the static test was -0.16 degrees and the intertest difference was 0.47 degrees . The intratest difference in the dynamic test was 0.42 degrees and the intertest difference was 0.37 degrees . The static and dynamic test was reproducible in healthy subjects, with minor deviations, irrespective of gender and age. The smaller interindividual differences in the dynamic test could be beneficial in the comparison of healthy individuals and individuals with cervical spine disorders.

The use of functional MRI to evaluate cervical flexor activity during different cervical flexion exercises

The purpose of this study was to investigate the recruitment pattern of deep and superficial neck flexors evoked by three different cervical flexion exercises using muscle functional MRI. In 19 healthy participants, transverse relaxation time (T2) values were calculated for the longus colli (Lco), longus capitis (Lca), and sternocleidomastoid (SCM) at rest and following three exercises: conventional cervical flexion (CF), craniocervical flexion (CCF), and a combined craniocervical flexion and cervical flexion (CCF-CF). CCF-CF gave the highest T2 increase for all muscles. CCF displayed a significantly higher T2 increase for the Lca compared with the Lco and the SCM. When comparing the CCF and CF, no significant difference was found for the Lca, whereas the Lco and SCM displayed a higher T2 increase during CF compared with CCF. This study shows that muscle functional MRI can be used to characterize the specific activation levels and recruitment patterns of the superficial and deep neck flexors during different cervical flexion exercises. During CCF-CF, all synergists are maximally recruited, which makes this exercise useful for high-load training. CCF may provide a more specific method to assess and retrain Lca muscle performance compared with CF and CCF-CF. This study highlights the need to differentiate between the Lco and Lca when evaluating their function, since these results demonstrate a clear difference in activation of both muscles.

Magnetic resonance imaging study of cross-sectional area of the cervical extensor musculature in an asymptomatic cohort

Magnetic Resonance Imaging (MRI) can be regarded as the gold standard for muscle imaging; however there is little knowledge about in vivo morphometric features of neck extensor muscles in healthy subjects and how muscle size alters across vertebral segments. It is not known how body size and activity levels may influence neck muscle cross-sectional area (CSA) or if the muscles differ from left and right. The purpose of this study was to establish relative CSA (rCSA) data for the cervical extensor musculature with a reliable MRI measure in asymptomatic females within a defined age range and to determine if side-side and vertebral level differences exist. MRI of the cervical spine was performed on 42 asymptomatic female subjects within the age range of 18-45. The rCSA values for the cervical extensor muscles were measured from axial T1-weighted images. We found significant side-side rCSA differences for the rectus capitis posterior minor, major (P < 0.001), multifidus (P = 0.002), and the semispinalis cervicis/capitis (P = 0.001, P < 0.001). There were significant vertebral level differences in rCSA of the semispinalis cervicis/capitis, multifidus, splenius capitis, and upper trapezius (P < 0.001). Activity levels were shown to impact on the size of semispinalis cervicis (P = 0.027), semispinalis capitis (P = 0.003), and the splenius capitis (P = 0.004). In conclusion, measuring differences in neck extensor muscle rCSA with MRI in an asymptomatic population provides the basis for future study investigating relationships between muscular atrophy and symptoms in patients suffering from persistent neck pain. Clin.

Mapping activation levels of skeletal muscle in healthy volunteers: an MRI study

PURPOSE

To use muscle functional MRI (mfMRI) to compare activation levels within and among triceps surae (TS) muscles.

MATERIALS AND METHODS

Seven healthy males performed five sets of 10 repetitions of a unilateral heel-raise exercise. T2-weighted images were obtained before and immediately after the exercise. Pixels that showed T2 greater than the mean +1 SD of the region of interest (ROI) in pre-exercise images and lower than the mean +1 SD of the ROI in post-exercise images were identified. The remaining T2 values in the post-exercise images were assigned to five categories indicated by color: red (highest level of activation), yellow, green, sky blue, and blue (lowest level of activation). The images were then used to construct three-dimensional (3D) images from which the volumes at each level of activation were determined.

RESULTS

Within each of the TS muscles the % activated volumes with low and moderate levels of activation were larger than those with a high level of activation (P < 0.05). The % activated volumes with a high level of activation were larger in the medial gastrocnemius than the soleus (Sol; P < 0.05). The Sol had a larger % activated volume with a low level of activation than the lateral gastrocnemius (P < 0.05). Each activation level was nonuniformly distributed along the length within each TS muscle.

CONCLUSION

There is substantial variation in the level of activation within and among the TS muscles; however, the activation level is mainly in the moderate to low range in all three muscles.

Specificity in retraining craniocervical flexor muscle performance

STUDY DESIGN

A multivariate repeated-measures independent-group study design.

OBJECTIVES

To compare the effect of a craniocervical flexion exercise (CCFEx) program to that of a conventional cervical flexion exercise (CFEx) program in training isometric craniocervical flexor muscle performance.

BACKGROUND

The craniocervical flexor muscles are important muscles of the cervical spine, as they have been shown to be impaired in persons with chronic neck pain. While both CCFEx and CFEx protocols have been advocated to train craniocervical flexor muscle performance, at present there is no consensus as to the most effective method.

METHODS AND MEASURES

Fiftyfemales with chronic mild neck pain and disability status were randomly allocated into a 6-week program of either CCFEx (n = 27) or CFEx (n = 23). Isometric dynamometry measurements of craniocervical flexor muscle performance (maximal voluntary contraction, endurance at 50%'of maximal voluntary contraction) were recorded before and following the exercise program. Changes in craniocervical flexor muscle performance (pretraining-posttraining) within and between exercise groups were analyzed with analysis of variance models.

RESULTS

Both exercise interventions significantly improved isometric craniocervical flexor muscle performance (P<.02). No significant differences in improvement of muscle performance were observed between the2 exercise interventions.

CONCLUSION

It appearsthat isometric craniocervical flexor muscle performance can be Strained with either a CCFEx protocol or a conventional CFEx protocol in patients with mild neck pain and disability.

Diagnosis and management of cervicogenic headache

Upper cervical pain and/or headaches originating from the C0 to C3 segments are pain-states that are commonly encountered in the clinic. The upper cervical spine anatomically and biomechanically differs from the lower cervical spine. Patients with upper cervical disorders fall into two clinical groups: (1) local cervical syndrome; and (2) cervicocephalic syndrome. Symptoms associated with various forms of both disorders often overlap, making diagnosis a great challenge. The recognition and categorization of specific provocation and limitation patterns lend to effective and accurate diagnosis of local cervical and cervicocephalic conditions.

The use of magnetic resonance imaging to evaluate lumbar muscle activity during trunk extension exercise at varying intensities

STUDY DESIGN

Descriptive, repeated measures analysis of exercise-induced changes in lumbar muscle transverse relaxation time (T2).

OBJECTIVES

To use muscle functional magnetic resonance imaging (MRI) to characterize the activity levels and recruitment patterns of the lumbar extensor muscles during trunk extension exercise over 3 intensities.

SUMMARY OF BACKGROUND DATA

Contrast shifts in T2 are indicative of skeletal muscle activity during resistance exercise and are used to characterize the function of a variety of muscles. The use of muscle functional MRI for the lumbar muscles has been limited.

METHODS

In 11 healthy participants, T2 was calculated for the lumbar quadratus lumborum, iliocostalis lumborum, longissimus thoracis, and multifidus at rest and following dynamic trunk extension exercise at 3 exercise intensities (40%, 50%, and 70% peak intensity).

RESULTS

The multifidus displayed the largest T2 increase at each of the 3 exercise intensities, followed by the erector spinae and, finally, the quadratus lumborum. At the lowest intensity, the medial erector spinae (longissimus thoracis) displayed a higher T2 increase than the lateral group (iliocostalis lumborum), while at the higher intensities, this pattern was reversed. In general, the T2 increase was higher during exercise at 50% and 70% intensities than at 40%, while there was no difference in T2 increase between 50% and 70%.

CONCLUSIONS

Muscle functional MRI can be used to characterize lumbar muscle function during trunk extension exercise. The levels and recruitment patterns of the lumbar extensors, as measured by muscle T2 shifts, vary with exercise intensity. Future research is needed to assess the mechanism of the nonlinear relationship between T2 shifts and exercise intensity, and to clarify the effects of fatigue and the order of exercise presentation on the T2 response of the lumbar extensors.

Skin Cooling Alters the Activation Patterns of Different Heads of the Quadriceps

The purpose of this study was to examine the effect of selective skin cooling over m. vastus lateralis (VL) on the activation patterns of quadriceps femoris muscle during knee extension exercise (KEE) using muscle function magnetic resonance imaging (mfMRI). The isometric force production of the right thigh was tested in 7 healthy young men at maximum voluntary contraction (MVC), and the transverse relaxation time (T2) value was taken from mfMR images at rest and immediately after KEE with 4 sets of 10 repetitions at a load equal to 60% of their 10-rep maximum, with and without skin cooling. The cooling was carried out by ice pack on the surface of the skin of the VL for 3 min before resting mfMRI and MVC tests, and before KEE, during KEE, and during the KEE rest intervals. The percent change in T2 of the m. vastus intermedius was significantly increased by skin cooling in comparison to the change without skin cooling, p < 0.05. This result suggests that skin cooling alters the activation pattern of the different heads of the quadriceps. Key words: cold, mfMRI, synergy, recruitment, neuromuscular plasticity

Short-term creatine supplementation does not improve muscle activation or sprint performance in humans

The purpose of this study was to examine the influence of short-term creatine (Cr) supplementation on exercise-induced transverse relaxation time (T2) and sprint performance during maximum intermittent cycling exercise using the muscle functional magnetic resonance imaging (mfMRI) technique. Twelve men were divided into a Cr supplementation group [the Cr group, taking 4 x (5 g Cr monohydrate + 2.5 g maltodextrin)/day], or a placebo supplementation group (the P group, taking 4 x 7.5 g maltodextrin/day). The allocation to the groups was based on cycling tests and the subject's physical characteristics, and thus was not randomized. A double-blind research design was employed for a 5-day supplementation period. mfMR images of the right thigh were collected at rest and immediately after two, five, and ten 6-s sprint bouts of maximum intermittent cycling exercise with a 30-s recovery interval between sets. Before and after supplementation, blood was taken to calculate lactate accumulation, and the muscle volume of the thigh was determined by MRI. Following supplementation, there was significant body mass gain in the Cr group ( P<0.05), whereas the P group did not change. The exercise-induced T2, blood lactate levels and sprint performance were not affected by Cr supplementation in any sprint bouts. These results suggest that short-term Cr supplementation does not influence short duration repetitive sprint performance and muscle activation and/or metabolic state during sprint cycling evaluated by mfMRI of the skeletal muscle in humans.

Guidelines for the intramuscular positioning of EMG electrodes in the semispinalis capitis and cervicis muscles

The objective of the study was to establish guidelines for the application of fine-wire or needle electrodes in the semispinalis cervicis and semispinalis capitis muscles. First of all, measured data for the puncture angle and puncture depth of each muscle were determined in CT scans. Using a regression approach, a model relation of these data with the neck circumference was established. This made it possible to accurately determine the puncture angle and puncture depth on the basis of the known neck circumference. In a further step, the neck muscles of seven human cadavers were punctured with wires in order to check the workability of these guidelines. At the same time, the wires' positions in relation to important structures (nerves, vessels) were studied. Both muscles can be punctured with a high degree of reliability. However, when puncturing the semispinalis cervicis muscle, one has to pass through a layer that contains vessels, nevertheless the risk of injury is regarded as very small. The technique enables intramuscular EMG measurements of the two muscles in manifold clinical problems.

Resistance training during unweighting maintains muscle size and function in human calf

PURPOSE

A 20-d 6 degrees head-down tilt bed rest project was conducted to evaluate the effect of dynamic leg press and plantar flexion resistance training on muscle size and function in human plantar flexors (PF) throughout the prolonged bed rest.

METHODS

Twelve healthy men participated in this study and were divided two groups: resistance training (BR-Tr group: N = 6, age: 23 +/- 2 yr, height: 170 +/- 3 cm, weight: 66 +/- 7 kg) and nontraining (BR-Cont group: N = 6, age: 23 +/- 1 yr, height: 170 +/- 3 cm, weight: 67 +/- 6 kg) during the bed rest. Physiological cross-sectional area (PCSA) and peak torque of the PF muscle group was determined. Spin-spin relaxation times (T2) of the medial (MG) and lateral gastrocnemius (LG) and soleus (Sol) muscle was measured at rest and immediately after unilateral calf-raising exercise (5 sets of 10 reps).

RESULTS

PCSA of the PF muscle group did not show any significant change in BR-Tr group; however, for the BR-Cont group, PCSA decreased by 13% after bed rest (P < 0.05). There was no significant change in exercise-induced T2 change of the MG, LG, or Sol muscles between before and after the bed rest in BR-Tr group; however, in the BR-Cont group, significant increases in T2 were found in these three muscles after the bed rest (P < 0.05 to 0.01).

CONCLUSION

We conclude that dynamic leg press and plantar flexion resistance training during bed rest maintains muscle size and function (torque and T2), and that this training could be useful for prevention of progressive muscle deconditioning during spaceflight.

Imaging of sports-related muscle injuries

Muscle derangements in athletes have a wide variety of causes, treatments, and prognoses. Given that the cause and severity of sports-related injuries may be difficult to determine clinically in some cases, MR imaging is utilized increasingly to evaluate muscle injuries in athletes. After reviewing useful MR imaging techniques, this article focuses on MR imaging of the most common causes of muscle pain and disability in athletes, including myotendinous strain, delayed onset muscle soreness, muscle contusion, myositis ossificans, muscle laceration, muscle herniation, and compartment syndrome. The differential diagnosis of various signal intensity abnormalities in muscle also is reviewed.

Vastus lateralis fatigue alters recruitment of musculus quadriceps femoris in humans

This study tested the hypothesis that fatigue of a single member of musculus quadriceps femoris (QF) would alter use of the other three muscles during knee extension exercise (KEE). Six men performed KEE with the left QF at a load equal to 50% of the 4 x 10 repetitions maximum. Subsequently, electromyostimulation (EMS), intended to stimulate and fatigue the left m. vastus lateralis (VL), was applied for 30 min. Immediately after EMS, subjects repeated the KEE. Transverse relaxation time (T2)-weighted magnetic resonance images were taken before and after each bout of KEE and at 3 and 30 min of EMS to assess use and stimulation, respectively, of the QF. T2 of each of the QF muscles was increased 8-13% after the first KEE. During EMS, T2 increased (P < 0.05) even more in VL (10%), whereas it decreased (P < 0.05) to pre-KEE levels in m. vastus medials (VM) and m. rectus femoris (RF). The VL and, to some extent, the m. vastus intermedius were stimulated, whereas the VM and RF were not, thereby recovering from the first bout of KEE. Isometric torque, initially 30% of maximal voluntary, was reduced to 13% at 3 min and 7% at 30 min. T2 was greater (P < 0.05) after the second than the first bout of KEE, especially the increase for the VM and RF. These results suggest that subjects were able to perform the second bout with little contribution of the VL by greater use of the other QF muscles. The simplest explanation is increased central command to the QF such that the intended act could be accomplished despite acute fatigue of one of its synergists.

Three-dimensional isometric strength of neck muscles in humans

STUDY DESIGN

Three-dimensional moments were measured experimentally during maximum voluntary contractions of neck muscles in humans.

OBJECTIVES

To characterize the maximum moments with attention paid to subject size and gender, to calculate moments at different locations in the neck, and to quantify the relative magnitudes of extension, flexion, lateral bending, and axial rotation moments.

SUMMARY OF BACKGROUND DATA

Few studies of neck strength have measured moments in directions other than extension, and it is difficult to compare results among studies because moments often are resolved at different locations in the cervical spine. Further, it is not clear how subject size, gender, and neck geometry relate to variations in the moment-generating capacity of neck muscles.

METHODS

Maximum moments were measured in 11 men and 5 women with an average age of 31 years (range, 20-42 years). Anatomic landmarks were digitized to resolve moments at different locations in the cervical spine.

RESULTS

When moments were resolved about axes through the midpoint of the line between the C7 spinous process and the sternal notch, the maximum moments were as follows: extension (men, 52 +/- 11 Nm; women, 21 +/- 12 Nm), flexion (men, 30 +/- 5 Nm; women, 15 +/- 4 Nm), lateral bending (men, 36 +/- 8 Nm; women, 16 +/- 8 Nm), and axial rotation (men 15 +/- 4; women, 6 +/- 3) Nm). The magnitudes of extension, flexion, and lateral bending moments decreased linearly with vertical distance from the lower cervical spine to the mastoid process.

CONCLUSIONS

Moments in three dimensions were quantified with regard to subject size and location along the cervical spine. These data are needed to characterize neck strength for biomechanical analysis of normal and pathologic conditions.