The combined deleterious effects of multiple sclerosis and ageing on neuromuscular function

BACKGROUND

The prevalence of older (>60 years) people with multiple sclerosis (pwMS) is increasing. This introduces numerous challenges, as both MS and ageing independently contribute to the deterioration of neuromuscular function.

AIM

The aim was to compare the neuromuscular function in pwMS and healthy controls (HC) across three age groups: young, middle-aged, and old.

METHODS

Using a cross-sectional study design, the maximal muscle strength (Fmax) and rate of force development (RFD) of the knee extensors (KE) and plantar flexors (PF) were assessed using an isokinetic dynamometer. In addition, voluntary activation (VA) and resting twitch (RT) were measured using the interpolated twitch technique.

RESULTS

The Fmax, RFD, and VA of the KE were reduced in pwMS compared to HC across age groups. In pwMS, reductions were observed in PF Fmax, RFD, and RT, predominantly in the middle-aged and old age groups. Reductions increased with age in KE for both groups (except for VA) but in PF only for pwMS. The "trajectory" differed between pwMS and HC, as pwMS showed reductions from young to middle age, while HC showed reductions from middle to old age in KE.

CONCLUSION

The combined negative effects of MS and ageing on neuromuscular function were especially present in the PF but also substantial in the KE. RFD showed large deficits for pwMS compared to HC across age groups. The findings can partly be explained by a reduction in VA and RT, but further investigations of neural regulation are needed to explain large RFD deficits.

Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation

The main goal of musculoskeletal rehabilitation is to achieve the pre-injury and/or pre-surgery physical function level with a low risk of re-injury. Blood flow restriction (BFR) training is a promising alternative to conventional therapy approaches during musculoskeletal rehabilitation because various studies support its beneficial effects on muscle mass, strength, aerobic capacity, and pain perception. In this perspective article, we used an evidence-based progressive model of a rehabilitative program that integrated BFR in 4 rehabilitation phases: (1) passive BFR, (2) BFR combined with aerobic training, (3) BFR combined with low-load resistance training, and (4) BFR combined with low-load resistance training and traditional high-load resistance training. Considering the current research, we propose that a BFR-assisted rehabilitation has the potential to shorten the time course of therapy to reach the stage where the patient is able to tolerate resistance training with high loads. The information and arguments presented are intended to stimulate future research, which compares the time to achieve rehabilitative milestones and their physiological bases in each stage of the musculoskeletal rehabilitation process. This requires the quantification of BFR training-induced adaptations (eg, muscle mass, strength, capillary-to-muscle-area ratio, hypoalgesia, molecular changes) and the associated changes in performance with a high measurement frequency (≤1 week) to test our hypothesis. This information will help to quantify the time saved by BFR-assisted musculoskeletal rehabilitation. This is of particular importance for patients, because the potentially accelerated recovery of physical functioning would allow them to return to their work and/or social life earlier. Furthermore, other stakeholders in the health care system (eg, physicians, nurses, physical therapists, insurance companies) might benefit from that with regard to work and financial burden.

Caffeine increases peripheral fatigue in low- but not in high-performing cyclists

The influence of cyclists’ performance levels on caffeine-induced increases in neuromuscular fatigue after a 4-km cycling time trial (TT) was investigated. Nineteen cyclists performed a 4-km cycling TT 1 h after ingesting caffeine (5 mg·kg−1) or placebo (cellulose). Changes from baseline to after exercise in voluntary activation (VA) and potentiated 1 Hz force twitch (Qtw,pot) were used as markers of central and peripheral fatigue, respectively. Participants were classified as “high performing” (HP, n = 8) or “low performing” (LP, n = 8) in accordance with their performance in a placebo trial. Compared with placebo, caffeine increased the power, anaerobic mechanical power, and anaerobic work, reducing the time to complete the trial in both groups (p < 0.05). There was a group versus supplement and a group versus supplement versus trial interaction for Qtw,pot, in which the postexercise reduction was greater after caffeine compared with placebo in the LP group (Qtw,pot = −34% ± 17% vs. −21% ± 11%, p = 0.02) but not in the HP group (Qtw,pot = −22% ± 8% vs. −23% ± 10%, p = 0.64). There was no effect of caffeine on VA, but there was a group versus trial interaction with lower postexercise values in the LP group than in the HP group (p = 0.03). Caffeine-induced improvement in 4-km cycling TT performance seems to come at the expense of greater locomotor muscle fatigue in LP but not in HP cyclists.

Novelty Caffeine improves exercise performance at the expense of a greater end-exercise peripheral fatigue in low-performing athletes. Caffeine-induced improvement in exercise performance does not affect end-exercise peripheral fatigue in high-performing athletes. High-performing athletes seem to have augmented tolerance to central fatigue during a high-intensity time trial.

Is there an intermuscular relationship in voluntary activation capacities and contractile kinetics?

PURPOSE

The force-generating capacities of human skeletal muscles are interrelated, highlighting a common construct of limb strength. This study aimed to further determine whether there is an intermuscular relationship in maximal voluntary activation capacities and contractile kinetics of human muscles.

METHODS

Twenty-six young healthy individuals participated in this study. Isometric maximal voluntary contraction (MVC) torque, voluntary activation level (VAL), and doublet twitch contractile kinetics (contraction time and half-relaxation time) evoked by a paired supramaximal peripheral nerve stimulation at 100 Hz were obtained in elbow flexors, knee extensors, plantar flexors and dorsiflexors of the dominant limb.

RESULTS

Peak MVC torque had significant positive correlations between all muscle group pairs (all P values < 0.01). A significant positive correlation for VAL was found only between knee extensors and plantar flexors (r = 0.60, P < 0.01). There were no significant correlations between all muscle group pairs for doublet twitch contraction time and doublet twitch half-relaxation time.

DISCUSSION

These results show that there is a partial common construct of maximal voluntary activation capacities that only concerns muscle groups that have incomplete activation during MVC (i.e., knee extensors and plantar flexors). This suggests that the common construct of MVC strength between these two muscle groups is partly influenced by neural mechanisms. The lack of intermuscular relationship of contractile kinetics showed that there is no common construct of muscle contractile kinetics, as assessed in vivo by investigating the time-course of evoked doublet twitch contractions.

Leg muscle activation patterns during walking and leg lean mass are different in children with and without developmental coordination disorder

BACKGROUND

Previous studies have shown that children with developmental coordination disorder (DCD) have a higher body fat and greater gait variability. Little research has investigated the gait muscle activity and lean mass measures in children with DCD.

AIMS

To compare the leg muscle activation patterns of the gait cycle and leg lean mass between children with and without DCD.

METHODS

Fifty-one children were in the DCD group (38 males and 13 females; 7.95 ± 1.04 years) and fifty-two in the control group (34 males and 18 females; 8.02 ± 1.00 years). Peak muscle activation patterns of treadmill walking in the right leg for the eight-gait phases were measured by means of surface electromyography, an electrogoniometer, and foot contact switches. Leg lean mass measures were evaluated using a whole-body dual energy X-ray absorptiometry scan.

RESULTS

Children with DCD had a lower leg lean mass and appendicular lean mass index compared to the control group. Furthermore, they exhibited a less-pronounced peak muscle activation during the heel strike (gastrocnemius medialis), early swing (biceps femoris) and late swing phases (gastrocnemius medialis) of gait.

CONCLUSIONS AND IMPLICATIONS

Although lower limb total mass was similar between groups, the DCD group displayed lower lean mass measures than controls. Furthermore, children with DCD illustrated a lower leg peak muscle activation during the heel strike, early swing and late swing phases of gait when walking on a treadmill. Our results emphasize the need to incorporate lower limb phasic muscle strengthening components into gait rehabilitation programs for children with DCD.

Weekly Time Course of Neuro-Muscular Adaptation to Intensive Strength Training

Detailed description of the time course of muscular adaptation is rarely found in literature. Thus, models of muscular adaptation are difficult to validate since no detailed data of adaptation are available. In this article, as an initial step toward a detailed description and analysis of muscular adaptation, we provide a case report of 8 weeks of intense strength training with two active, male participants. Muscular adaptations were analyzed on a morphological level with MRI scans of the right quadriceps muscle and the calculation of muscle volume, on a voluntary strength level by isometric voluntary contractions with doublet stimulation (interpolated twitch technique) and on a non-voluntary level by resting twitch torques. Further, training volume and isokinetic power were closely monitored during the training phase. Data were analyzed weekly for 1 week prior to training, pre-training, 8 weeks of training and 2 weeks of detraining (no strength training). Results show a very individual adaptation to the intense strength training protocol. While training volume and isokinetic power increased linearly during the training phase, resting twitch parameters decreased for both participants after the first week of training and stayed below baseline until de-training. Voluntary activation level showed an increase in the first 4 weeks of training, while maximum voluntary contraction showed only little increase compared to baseline. Muscle volume increased for both subjects. Especially training status seemed to influence the acute reaction to intense strength training. Fatigue had a major influence on performance and could only be overcome by one participant. The results give a first detailed insight into muscular adaptation to intense strength training on various levels, providing a basis of data for a validation of muscle fatigue and adaptation models.

Relationship between muscle volume and contractile properties of the human knee extensors

The present study was designed to investigate the relationship between volume and electrically evoked twitch properties of the quadriceps muscle. Supramaximal single and doublet stimulation of the femoral nerve was used to assess contractile properties at 45° and 80° knee flexion. Muscle volume was measured using a 1.5-Tesla magnetic resonance imaging scanner. Quadriceps muscle volume was only significantly correlated (r = 0.629) with peak twitch torque induced by doublet stimulation at 80° but not at 45° knee flexion.