Low-volume muscular endurance and strength training during 3-week forearm immobilization was effective in preventing functional deterioration

Omega-3 Fatty Acids and Vitamin D in Immobilisation: Part A- Modulation of Appendicular Mass Content, Composition and Structure

OBJECTIVES

Muscle size decreases in response to short-term limb immobilisation. This study set out to determine whether two potential protein-sparing modulators (eicosapentaenoic acid and vitamin D) would attenuate immobilisation-induced changes in muscle characteristics.

DESIGN

The study used a randomised, double-blind, placebo-controlled design.

SETTING

The study took part in a laboratory setting.

PARTICIPANTS

Twenty-four male and female healthy participants, aged 23.0±5.8 years.

INTERVENTION

The non-dominant arm was immobilised in a sling for a period of nine waking hours a day over two continuous weeks. Participants were randomly assigned to one of three groups: placebo (n=8, Lecithin, 2400 mg daily), omega-3 (ω-3) fatty acids (n=8, eicosapentaenoic acid (EPA); 1770 mg, and docosahexaenoic acid (DHA); 390 mg, daily) or vitamin D (n=8, 1,000 IU daily).

MEASUREMENTS

Muscle and sub-cutaneous adipose thickness (B-mode ultrasonography), body composition (DXA) and arm girth (anthropometry) were measured before immobilisation, immediately on removal of the sling and two weeks after re-mobilisation.

RESULTS

Muscle thickness (-5.4±4.3%), upper and lower arm girth (-1.3±0.4 and -0.8±0.8%, respectively), lean mass (-3.6±3.7%) and bone mineral content (BMC) (-2.3±1.5%) decreased significantly with limb immobilisation in the placebo group (P<0.05). Despite no significant effect of group, ω-3 and vitamin D supplementation showed trends (p>0.05) towards attenuating the decreases in muscle thickness, upper/lower arm girths and BMC observed in the placebo group. The ω-3 supplementation group demonstrated a non-significant attenuation of the decrease in DXA quantified lean mass observed in the placebo group. Sub-cutaneous adipose thickness increased in the placebo group (P<0.05). ω-3 and vitamin D both blunted this response, with ω-3 having a greater effect (P<0.05). All parameters had returned to baseline values at the re-mobilisation phase of the study.

CONCLUSION

Overall, at the current doses, ω-3 and vitamin D supplementation only attenuated one of the changes associated with non-injurious limb immobilisation. These findings would necessitate further research into either a) supplementation linked to injury-induced immobilisation, or b) larger doses of these supplements to confirm/refute the physiological reserve potential of the two supplements.

Once-weekly muscle endurance and strength training prevents deterioration of muscle oxidative function and attenuates the degree of strength decline during 3-week forearm immobilization

PURPOSE

Muscle unloading causes muscle function deterioration, but the extent to which training frequency or volume can be reduced while preserving muscle function during muscle unloading is unknown. We examined the effects of low-volume muscle endurance and strength training on forearm muscle oxidative capacity, endurance, and strength during a 3-week immobilization.

METHODS

Twenty-seven, healthy, male volunteers were divided into four groups: immobilization only (IMM); immobilization with endurance and strength training, once-weekly (IMM + EST1) or twice-weekly (IMM + EST2); and control, without immobilization or training (CNT). Endurance training involved dynamic handgrip exercise, at 30% of maximal voluntary contraction (MVC), until exhaustion (~60 s). Strength training involved intermittent isometric handgrip exercise at 70% MVC (40 s). Muscle oxidative capacity was evaluated after exercise using the phosphocreatine recovery time constant using (31)phosphorus magnetic resonance spectroscopy. Endurance performance was evaluated according to the total work during dynamic handgrip exercise at 30% MVC at 1 Hz until exhaustion.

RESULTS

Muscle oxidative capacity and total work deterioration was restricted to the IMM (P < 0.05) group. MVC decreased in the IMM and IMM + EST1 (P < 0.05) groups. However, the MVC amplitude decrease in the IMM + EST1 group was smaller than that in the IMM (P < 0.05) group. MVC remained unchanged in the other groups.

CONCLUSION

During the 3-week immobilization, twice-weekly low-volume muscle endurance and strength training prevented deterioration in muscle strength, oxidative capacity, and endurance performance. Moreover, once-weekly muscle endurance and strength training prevented the deterioration of muscle oxidative capacity and endurance performance, and attenuated the degree of muscle strength decline.

Self-reported work-related musculoskeletal injuries and isometric handgrip strength

BACKGROUND

Musculoskeletal injuries are common in car assembly workers, causing significant morbidity. There is evidence that increased muscle strength reduces musculoskeletal injury risk and that handgrip strength is a predictor of general muscle strength. Aims To investigate whether isometric handgrip strength (IHGS) is a predictor of increased musculoskeletal injury risk in automotive assembly workers.

METHODS

We measured IHGS in a cross-sectional survey of final assembly line workers in an automotive manufacturing plant. Weak handgrip was defined as two standard deviations below the normative mean value for age and gender. Self-reported musculoskeletal injury/accident data and recent musculoskeletal symptoms were recorded using a modified Nordic musculoskeletal questionnaire.

RESULTS

Of 445 final assembly line workers, 206 (46%) participated. Sixty participants (29%) reported a musculoskeletal injury/accident at work in the preceding 5 years. Mean IHGS in this population was lower than international normative values. Odds ratios for self-reported injury (adjusted for gender and recent musculoskeletal symptoms) were 0.62 (95% CI 0.28-1.35) for left weak handgrip and 0.57 (95% CI 0.31-1.1) for right weak handgrip.

CONCLUSIONS

In this study, weak handgrip did not predict increased risk of musculoskeletal injuries/accidents.

Preventive effect of nucleoprotein on hindlimb unloading-induced capillary regression in rat soleus muscle

We investigated the preventive effects of nucleoprotein on capillary regression and mitochondrial dysfunction induced by unloading in the soleus muscle of rats. Nucleoprotein is a supplement made from soft roe of salmon, and its major components are nucleotides and protamine. Adult male Sprague-Dawley rats were divided randomly into control, hindlimb unloading (HU), and hindlimb unloading plus nucleoprotein administration (HU+ NP) groups. Hindlimb unloading was carried out for 2 weeks in the rats belonging to the HU and the HU+ NP groups. The rats of the HU+ NP group were administered nucleoprotein (500 mg/kg) using a feeding needle twice a day for 2 weeks. Hindlimb unloading resulted in capillary regression, decreased succinate dehydrogenase activity of the muscle fiber, and decreased PGC-1α expression in the soleus muscle. These effects were prevented by administration of nucleoprotein. Nucleoprotein appears to prevent capillary regression and mitochondrial dysfunction caused by unloading of the skeletal muscle. Therefore, nucleoprotein supplementation may be an effective therapy for maintaining capillary network and mitochondrial metabolism of the muscle fiber during an unloading period.

Nutritional strategies to attenuate muscle disuse atrophy

Situations such as recovery from injury or illness require otherwise healthy humans to undergo periods of disuse, which lead to considerable losses of skeletal muscle mass and, subsequently, numerous negative health consequences. It has been established that prolonged disuse (>10 days) leads to a decline in basal and postprandial rates of muscle protein synthesis, without an apparent change in muscle protein breakdown. It also seems, however, that an early and transient (1-5 days) increase in basal muscle protein breakdown may also contribute to disuse atrophy. A period of disuse reduces energy requirements and appetite. Consequently, food intake generally declines, resulting in an inadequate dietary protein consumption to allow proper muscle mass maintenance. Evidence suggests that maintaining protein intake during a period of disuse attenuates disuse atrophy. Furthermore, supplementation with dietary protein and/or essential amino acids can be applied to further aid in muscle mass preservation during disuse. Such strategies are of particular relevance to the older patient at risk of developing sarcopenia. More work is required to elucidate the impact of disuse on basal and postprandial rates of muscle protein synthesis and breakdown. Such information will provide novel targets for nutritional interventions to further attenuate muscle disuse atrophy and, as such, support healthy aging.

Low-volume strength and endurance training prevent the decrease in exercise hyperemia induced by non-dominant forearm immobilization

We examined the effect of 3-week upper limb immobilization on conduit artery cross-sectional area and peak hyperemia (BF(peak)) after exhaustive dynamic handgrip exercise (Ex(dyn)), and that of low-volume strength and endurance training during immobilization. Healthy volunteers (n = 21; mean age, 22 years) were divided into 3 groups: immobilization only (IMM; n = 7), immobilization with training (STR + END; n = 7), and control (no immobilization or training, CNT; n = 7). Endurance training comprised Ex(dyn) at 30% maximum voluntary contraction (MVC) (duration of each session, ~60 s; twice weekly). Strength training involved intermittent isometric handgrip exercise at 70% MVC (duration of each session, 40 s; twice weekly), repeated 10 times. We used ultrasound methods to measure the brachial artery cross-sectional area and the BF(peak) after Ex(dyn) for 5 min pre- and post-immobilization. We found a significant group by time interaction in BF(peak) (p < 0.05). A significant decrease was found in BF(peak) in the IMM (p < 0.05) between pre- and post-immobilization and a protective effect in the STR + END. The 3-week upper limb immobilization did not influence the baseline artery cross-sectional area. In conclusion, BF(peak) decreased after 3-week upper limb immobilization and a combination of strength training and endurance training preserved the blunted BF(peak).

Strength training the free limb attenuates strength loss during unilateral immobilization

The objective was to determine if strength training the free limb during a 3-wk period of unilateral immobilization attenuates strength loss in the immobilized limb through cross-education. Thirty right-handed participants were assigned to three groups. One group (n = 10) wore a cast and trained the free arm (Cast-Train). A second group (n = 10) wore a cast and did not train (Cast). A third group (n = 10) received no treatment (control). Casts were applied to the nondominant (left) wrist and hand by a physician. Strength training was maximal isometric ulnar deviation (right hand) 5 days/wk. Peak torque (dynamometer), electromyography (EMG), and muscle thickness (ultrasound) were assessed in both arms before and after the intervention. Cast-Train improved right arm strength [14.3 (SD 5.0) to 17.7 (SD 4.8) N x m; P < 0.05] with no significant muscle hypertrophy [3.73 (SD 0.43) to 3.84 (SD 0.52) cm; P = 0.09]. The immobilized arm of Cast-Train did not change in strength [13.9 (SD 4.3) to 14.2 (SD 4.6) N x m] or muscle thickness [3.61 (SD 0.51) to 3.57 (SD 0.43) cm]. The immobilized arm of Cast decreased in strength [12.2 (SD 3.8) to 10.4 (SD 2.5) N x m; P < 0.05] and muscle thickness [3.47 (SD 0.59) to 3.32 (SD 0.55) cm; P < 0.05]. Control showed no changes in the right arm [strength: 15.3 (SD 6.1) to 14.3 (SD 5.8) N x m; muscle thickness: 3.57 (SD 0.68) to 3.52 (SD 0.75) cm] or left arm [strength: 14.5 (SD 5.3) to 13.7 (SD 6.1) N x m; muscle thickness: 3.55 (SD 0.77) to 3.51 (SD 0.70) cm]. Agonist muscle activation remained unchanged after the intervention for both arms [right: 302 (SD 188) to 314 (SD 176) microV; left: 261 (SD 139) to 288 (SD 151) microV] with no group differences. Strength training of the free limb attenuated strength loss in the immobilized limb during unilateral immobilization. Strength training may have prevented muscle atrophy in the immobilized limb.