Reduced Active Muscle Stiffness after Intermittent Submaximal Isometric Contractions

Hamstrings passive and active shear modulus: Implications of conventional static stretching and warmup

PURPOSE

This study compares the acute effects of a static stretching and a warmup protocol on the active and passive shear modulus of the hamstring muscles.

METHODS

Muscle shear modulus was assessed at rest and during isometric contractions at 20 % of maximal voluntary isometric contraction (MVIC).

RESULTS

After stretching, the passive shear modulus pattern was not altered, while at 20 % MVIC the biceps femoris short head (BFsh) and semimembranosus showed a shear modulus increase and decrease, respectively, which resulted on BFsh-SM pair differences (pre: 3.8 ± 16.8 vs. post: 39.3 ± 25.1 kPa; p < 0.001; d = 1.66) which was accompanied by a decrease of 18.3 % on MVIC. Following the warmup protocol, passive shear modulus remained unchanged, while active shear modulus was decreased for the semitendinosus (pre: 65.3 ± 13.5 vs. post: 60.3 ± 12.3 kPa; p = 0.035; d = 0.4). However, this difference was within the standard error of measurement (10.54 kPa), and did not impact the force production, since it increased only 1.4 % after the warmup.

CONCLUSIONS

The results of this study suggest that the passive and active shear modulus responses of the individual hamstring muscles to static stretching are muscle-specific and that passive and active hamstring shear modulus are not changed by a standard warmup intervention.

Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis

BACKGROUND

Low back pain (LBP) is one of the most common musculoskeletal conditions. People with LBP often display changes of neuromuscular control and trunk mechanical properties, including trunk stiffness. Although a few individual studies have examined back muscle stiffness in individuals with LBP, a synthesis of the evidence appears to be lacking. Therefore, the aim of this systematic review with meta-analysis was to synthesize and evaluate the available literature investigating back muscle stiffness in association with LBP.

METHODS

We conducted a systematic review of the literature according to the PRISMA guidelines. We searched Pubmed, Scopus, Web of Science and ScienceDirect for studies, that compared back muscle stiffness, measured either by ultrasound-based elastography or myotonometry, between individuals with and without LBP. Pooled data of the included studies were presented descriptively. Additionally, we performed two meta-analyses to calculate the standardized mean difference between the two groups for resting stiffness of the multifidus and erector spinae muscle. For both meta-analyses, the random effect model was used and the weight of individual studies was calculated using the inverse-variance method. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional studies. Furthermore, the certainty of evidence was evaluated using the GRADE approach.

RESULTS

Nine studies were included in our systematic review. Our results suggest that individuals with LBP have higher stiffness of the multifidus (SMD = 0.48, 95% CI: 0.15 - 0.81, p < 0.01; I2 = 48 %, p = 0.11) and erector spinae at rest (SMD = 0.37, 95% CI: 0.11 - 0.62, p < 0.01; I2 = 39 %, p = 0.14) compared to asymptomatic controls. On the other hand, the evidence regarding muscle stiffness during submaximal contractions is somewhat contradictory.

CONCLUSIONS

Based on the findings of this systematic review we conclude that people with LBP may have higher back muscle stiffness compared to asymptomatic controls. Addressing muscle stiffness might represent an important goal of LBP treatment. Nevertheless, our findings should be interpreted with extreme caution due to a limited quality of evidence, small number of included studies and differences in measurement methodology.

In vivo human medial gastrocnemius fascicle behaviour and belly gear during submaximal eccentric contractions are not affected by concentric fatiguing exercise

Changes in muscle geometry and belly gearing during eccentric contractions influence fibre strain and susceptibility to muscle damage. They are modulated by the interaction between connective tissues and intracellular-intrafascicular fluid pressures and external pressures from neighbouring structures. Fatiguing exercise triggers fluid shifts (muscle swelling) and muscle activation changes that may influence these modulators. Our purpose was to measure medial gastrocnemius (MG) geometric changes in vivo during eccentric contractions before and after maximal concentric muscle work to test the hypothesis that fatigue would reduce fascicle rotation and muscle gear and provoke greater fascicle strain. Submaximal eccentric plantar flexor contractions at 40% and 60% of maximal eccentric torque were performed on an isokinetic dynamometer at 5°.s-1 before and immediately after the fatiguing exercise. MG fascicles and muscle-tendon junction were captured using ultrasonography during contractions, allowing quantification of geometric changes, whole-MG length, and belly gear (Δmuscle length/Δfascicle length). Triceps surae (TS) activation was estimated using surface electromyography and the distribution of activations between synergistic muscles was then determined. After exercise, concentric torque decreased ∼39% and resting muscle thickness increased by 4%, indicating muscle fatigue and swelling, respectively. While soleus (Sol) activation and the Sol/TS ratio increased, no changes in MG, MG/TS ratio or fascicle rotation during the contraction were detected. Thus, fascicle lengthening and belly gear remained unaltered. Changes in muscle thickness during contraction was also similar before and after exercise, suggesting that changes in muscle shape were relatively unaffected by the exercise. Consequently, the muscle maintained mechanical integrity after the fatiguing muscle work.

Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury

BACKGROUND

The effect of 10 × 30 m repeated sprints on passive and active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh), and knee flexor maximal voluntary isometric contraction (MVIC) and rate of force development (RFD), and whether athletes with previous hamstring injury have a different response, is unknown.

HYPOTHESIS

Repeated sprints would (1) increase BFlh stiffness and decrease ST stiffness and knee flexors MVIC and RFD in healthy participants; and (2) greater magnitude of response would be seen in athletes with previous hamstring injury.

STUDY DESIGN

Case series (experiment I) and case control (experiment II) study designs.

LEVEL OF EVIDENCE

Level 3.

METHODS

Healthy nonathletes attended 2 replicated sessions (experiment I, n = 18), while soccer players with (n = 38) and without (n = 67) previous hamstring injury attended 1 testing session (experiment II).

RESULTS

In both experiments, the knee flexors MVIC and RFD decreased after the sprints (P < 0.05). In experiment I, the ST and BFlh passive stiffness reduced after the sprints (P < 0.02), while a small BFlh active stiffness increase was noted (P = 0.02); however, no correlation was observed between the 2 testing sessions for the postsprint muscle stiffness responses (r = -0.07-0.44; P > 0.07). In experiment II, only an ST passive stiffness reduction was observed after the sprints (P < 0.01). No differences were noted between injured and noninjured lower limbs for any variable (P > 0.10).

CONCLUSION

Repeated sprints are likely to decrease the knee flexor's maximal and rapid strength, and to alter the hamstring stiffness in the nonathlete population. Previous hamstring injury does not apparently affect the footballer's hamstring functional and mechanical responses to repeated sprints.

CLINICAL RELEVANCE

The responses of hamstring stiffness and knee flexor strength to repeated sprints are unlikely to be associated with hamstring injury.

Effects of repeated sprinting on hamstring shear modulus pattern and knee flexor neuromuscular parameters

The purpose of the present study was to examine the acute effects of a maximum repeated sprint protocol on (1) hamstring shear modulus and (2) knee flexor neuromuscular parameters such as peak torque (PT) and rate of torque development (RTD). Muscle shear modulus was assessed in 18 healthy males using shear wave elastography at rest and during 30° isometric knee flexion at 20% of maximal voluntary isometric contraction, before and after a 10 × 30 m repeated sprint protocol. There was a 9% decrease in average speed between the fastest and slowest sprint (p < 0.001; d = 2.27). A pre-post decrease was observed in PT (p = 0.004; η2p = 0.399) and in the 0-50 ms (p = 0.042; η2p = 0.222), and 50-100 ms (p = 0.028; η2p = 0.254) RTD periods. For the active shear modulus, the only significant change after the sprint task was in the biceps femoris long head (BFlh) with an increase of 10% (Pre: 26.29 ± 8.89 kPa; Post: 28.93 ± 8.31 kPa; p = 0.015; d = 0.31). The present study provides evidence that repeated sprinting leads to significant decreases in average speed, PT, early RTD (0-50 ms; 50-100 ms), and to an increase in BFlh active shear modulus without changing the shear modulus of the other hamstrings muscles.

Shear wave imaging the active constitutive parameters of living muscles

Shear wave elastography (SWE) of human skeletal muscles allows for measurement of muscle elastic properties in vivo and has important applications in sports medicine and for the diagnosis and treatment of muscle-related diseases. Existing methods of SWE for skeletal muscles rely on the passive constitutive theory and have so far been unable to provide constitutive parameters describing muscle active behavior. In the present paper, we overcome this limitation by proposing a SWE method for quantitative inference of active constitutive parameters of skeletal muscles in vivo. To this end, we investigate the wave motion in a skeletal muscle described by a constitutive model in which muscle active behavior has been defined by an active parameter. An analytical solution relating shear wave velocities to both passive and active material parameters of muscles is derived, based upon which an inverse approach has been developed to evaluate these parameters. To demonstrate the usefulness of the reported method, in vivo experiments were carried out on 10 volunteers to obtain constitutive parameters, particularly those describing active deformation behaviors of living muscles. The results reveal that the active material parameter of skeletal muscles varies with warm-up, fatigue and rest. STATEMENT OF SIGNIFICANCE: Existing shear wave elastography methods are limited to imaging the passive parameters of muscles. This limitation is addressed in the present paper by developing a method to image the active constitutive parameter of living muscles using shear waves. We derived an analytical solution demonstrating the relationship between constitutive parameters of living muscles and shear waves. Relying on the analytical solution, we proposed an inverse method to infer active parameter of skeletal muscles. We performed in vivo experiments to demonstrate the usefulness of the theory and method; the quantitative variation of the active parameter with muscle states such as warm-up, fatigue and rest has been reported for the first time.

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (-8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006-0.022; Cohen's d = 0.40-46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697-0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29-0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain.

Verification of surface electromyographic activity of the oblique externus abdominis using ultrasound shear wave elastography

This study used ultrasound shear wave elastography (SWE) to revalidate whether surface electromyographic (EMG) electrodes placed on the oblique externus abdominis (OE) can detect only the OE activity without the confounding activity of the underlying oblique internus abdominis (OI). During left and right trunk rotations, the EMG activity was acquired using surface EMG electrodes placed on the right OE. Shear wave velocity (V_s ) values of the right OE and OI were acquired using SWE. The EMG activity during the left and right trunk rotations significantly increased as the level of exertion increased (25%, 50%, 75%, and 100% of the one-repetition maximum [1RM]). The V_s of the right OE was significantly different only between 25% and 75% 1RM in the right trunk rotation, but significantly increased from 25% to 75% 1RM during the left trunk rotation. The V_s of the right OI during the right trunk rotation significantly increased with increased levels of exertion, except between 50% and 75% 1RM. The results for the V_s of the OE and OI in the right trunk rotation suggest that surface EMG electrodes placed on the OE would detect not only the antagonistic OE activity but also the agonistic OI activity.

Ultrasound Shear Modulus and Thickness of Lateral Abdominal Muscles in Different Contractile States in Relation to Self‐ Reported Hip/Groin Problems in Youth Soccer Players

To date, no studies have assessed lateral abdominal muscles’ (LAM) elasticity and thickness in relation to hip and groin symptoms in any population. The objectives were to a) assess the relationship between LAM ultrasound measurements (elasticity and thickness) and self-reported subscales of the Copenhagen Hip and Groin Outcome Score (HAGOS) and b) compare LAM elasticity and thickness between asymptomatic and symptomatic sides. Shear modulus and thickness of the oblique external (OE), internal (OI) and transversus abdominis (TrA) muscles in 25 young soccer players were assessed at rest and during isometric contraction using ultrasound shear wave elastography. HAGOS subscales were used to assess self-reported hip/groin problems. There was a significant (p < 0.05) moderate correlation between allometric-scaled OI resting thickness (mean of right and left) and the Activities of Daily Living (r = 0.40), Sport (r = 0.57) and Quality of Life (QOL) (r = 0.41) HAGOS subscales. Also, a moderate significant correlation was found between allometric-scaled TrA resting thickness and the QOL subscale (r = 0.47). Moderate correlations were found between resting OI shear modulus and the QOL (r = 0.44), between right TrA shear modulus during contraction and Symptoms (r = 0.57), and between the left TrA shear modulus during contraction and Physical Activity (r = 0.41) subscales. No differences were found between the symptomatic and asymptomatic side in thickness and elasticity measurements among soccer players with unilateral symptoms (p > 0.05). The relationships found between LAM and hip/groin problems in youth male soccer players indicate that muscles are thinner and more elastic (less stiff) in more symptomatic athletes.

Low-Frequency Vibration Facilitates Post-Exercise Cardiovascular Autonomic Recovery

It is important to use short breaks to accelerate post-exercise recovery in sports. Previous studies have revealed that vibration can reduce post-exercise muscle soreness. However, there is still high heterogeneity in the effects of vibration on cardiovascular autonomic activities, and most studies to date have focused on high-frequency vibration. This study aimed to investigate the effect of low-frequency lower-body vibration (LBV) on post-exercise changes in heart rate variability and peripheral arterial tone. Ten men and 9 women aged 20 to 25 were recruited for this study. Each subject visited the testing room three times with at least 2 days in between. Each time, the subject received one of the three different vibration frequencies (0, 5, and 15 Hz) in a random order in the sitting position for 10 minutes. LBV was performed immediately after a static standing (control) test and 3-min-step test. Heart rate variability and digital volume pulse wave were recorded during the vibration phase (V1: vibration 0-5 minutes; V2: 6-10 minutes) and the recovery phase (Rc1: recovery phase 11-15 minutes; Rc2: 16-20 minutes). The result of digital pulse wave analysis showed that the reflection index (RI) under 15 Hz decreased during V1. Heart rate of the 15-Hz group also decreased during Rc1 and Rc2. According to the analysis of heart rate variability, low-frequency power/high-frequency power (LF/HF) decreased and normalized high-frequency power (nHF) increased during V2, Rc1 and Rc2 under 15 Hz and, during Rc2 under 5 Hz vibration. This study confirmed that the application of low-frequency LBV after exercise can reduce peripheral vascular tone, accelerate heart rate recovery, decrease cardiac sympathetic nerve activity, and promote parasympathetic nerve activity. The effect was more pronounced at 15 Hz than at 5 Hz. The findings provide a method to accelerate cardiovascular autonomic recovery after exercise.

Acute Effects of a High Volume vs. High Intensity Bench Press Protocol on Electromechanical Delay and Muscle Morphology in Recreationally Trained Women

The purpose of the present investigation was to compare the acute responses on muscle architecture, electromechanical delay (EMD) and performance following a high volume (HV: 5 sets of 10 reps at 70% of 1 repetition maximum (1RM)) and a high intensity (HI: 5 sets of 3 reps at 90% of 1RM) bench press protocol in women. Eleven recreationally trained women (age = 23.3 ± 1.8 y; body weight = 59.7 ± 6.0 kg; height = 164.0 ± 6.3 cm) performed each protocol in a counterbalanced randomized order. Muscle thickness of pectoral (PEC MT) and triceps muscles (TR MT) were collected prior to and 15 min post each trial. In addition, EMD of pectoral (PEC EMD) and triceps (TR EMD) muscles were calculated during isometric bench press maximum force tests performed at the same timepoints (IBPF). Significantly greater increases in PEC MT (p < 0.001) and TR MT (p < 0.001) were detected following HV compared to HI. PEC EMD showed a significantly greater increase following HV compared to HI (p = 0.039). Results of the present study indicate that the HV bench press protocol results in greater acute morphological and neuromuscular changes compared to a HI protocol in women. Evaluations of muscle morphology and electromechanical delay appear more sensitive to fatigue than maximum isometric force assessments.

Muscle size-scaled shear elastic modulus: A muscle force index independent of maximal voluntary contraction, assessed during elbow extension

Shear elastic modulus (G) can differ among individuals due to muscle size and other factors, even for constant muscle force. Inter-individual comparisons of G usually require normalization by maximal voluntary contraction (MVC), but MVC procedures may not be appropriate for certain clinical populations including those presenting with pain or other compromised functionality. This study aimed to test whether muscle size-scaled G, which does not require MVC testing, would yield stronger correlation with absolute torque than unscaled G. Twelve-healthy males performed isometric elbow extension across a range of torque magnitudes (from 5 Nm until 60% MVC). G of the triceps brachii was measured using shear wave elastography during each trial. Cross-sectional area (CSA) and muscle thickness (MT) of the triceps brachii were measured at rest. Scaled G was calculated as a product of G and CSA or MT ("G-CSA" and "G-MT", respectively). Within-individual linear regressions were conducted between absolute torque and the three force indicator variables. The regression slopes' coefficient of variation (CV) was calculated for each indicator across individuals. Between-individual correlation coefficients were calculated, after pooling all data across individuals into a single regression analysis for each indicator. Linear regression found that inter-individual slope variation increased in the following order: G-CSA, G-MT, and unscaled G (CV = 0.15, 0.18, and 0.29, respectively). Pooled-individual correlation coefficients were significantly higher in G-CSA and G-MT than in unscaled G (r = 0.948, 0.924, and r = 0.783, respectively). These results suggest that muscle size-scaled G may be more appropriate than unscaled G when comparing shear moduli across individuals.

Effects of knee flexor submaximal isometric contraction until exhaustion on semitendinosus and biceps femoris long head shear modulus in healthy individuals

This study examined whether a knee flexor isometric contraction at 20% of maximal voluntary isometric contraction until exhaustion would alter the biceps femoris long head (BFlh) and semitendinosus (ST) active stiffness, assessed using ultrasound-based shear wave elastography. Twelve healthy individuals participated in 2 sessions separated by 7 days. Time to exhaustion was similar in both sessions (day 1: 443.8 ± 192.5 s; day 2: 474.6 ± 131.7 s; p = 0.323). At the start of the fatigue task, the ST showed greater active stiffness than the BFlh (p < 0.001), with no differences between days (p = 0.08). The ST active stiffness then decreased from 40% of the task time to exhaustion (− 2.2 to − 13.3%, p = 0.027) until the end of the task (− 16.1 to − 22.9%, p = 0.012), while no significant changes were noted in the BFlh (p = 0.771). Immediately after the fatigue task, a decrease in active stiffness was observed in the ST (− 11.8 to − 17.8%, p < 0.001), but not in the BFlh (p = 0.551). Results were consistent between the 2 testing sessions (p = 0.07–0.959). The present results indicate that fatigue alters the hamstring active stiffness pattern.

Changes in the Viscoelastic Properties of the Vastus Lateralis Muscle With Fatigue

We investigated the in vivo effects of voluntary fatiguing isometric contractions of the knee extensor muscles on the viscoelastic properties of the vastus lateralis (VL). Twelve young males (29.0 ± 4.5 years) performed an intermittent voluntary fatigue protocol consisting of 6 sets × 10 repetitions of 5-s voluntary maximal isometric contractions with 5-s passive recovery periods between repetitions. Voluntary and evoked torque were assessed before, immediately after, and 20 min after exercise. The shear modulus (μ) of the VL muscle was estimated at rest and during a ramped isometric contraction using a conventional elastography technique. An index of active muscle stiffness was then calculated (slope from the relationship between shear modulus and absolute torque). Resting muscle viscosity (η) was quantified using a shear-wave spectroscopy sequence to measure the shear-wave dispersion. Voluntary and evoked torque decreased by ∼37% (P < 0.01) immediately after exercise. The resting VL μ was lower at the end of the fatigue protocol (-57.9 ± 5.4%, P < 0.001), whereas the resting VL η increased (179.0 ± 123%, P < 0.01). The active muscle stiffness index also decreased with fatigue (P < 0.05). By 20 min post-fatigue, there were no significant differences from the pre-exercise values for VL η and the active muscle stiffness index, contrary to the resting VL μ. We show that the VL μ is greatly reduced and η greatly enhanced by fatigue, reflecting a more compliant and viscous muscle. The quantification of both shear μ and η moduli in vivo may contribute to a better understanding of the mechanical behavior of muscles during fatigue in sports medicine, as well as in clinical situations.

Medial Gastrocnemius Muscle Architecture Is Altered After Exhaustive Stretch-Shortening Cycle Exercise

Muscle architecture is an important component of muscle function, and recent studies have shown changes in muscle architecture with fatigue. The stretch-shortening cycle is a natural way to study human locomotion, but little is known about how muscle architecture is affected by this type of exercise. This study investigated potential changes in medial gastrocnemius (MG) muscle architecture after exhaustive stretch-shortening cycle exercise. Male athletes (n = 10) performed maximal voluntary contractions (MVC) and maximal drop jump (DJ) tests before and after an exercise task consisting of 100 maximal DJs followed by successive rebound jumping to 70% of the initial maximal height. The exercise task ceased upon failure to jump to 50% of maximal height or volitional fatigue. Muscle architecture of MG was measured using ultrasonography at rest and during MVC, and performance variables were calculated via a force plate and motion analysis. After SSC exercise, MVC (−13.1%; p = 0.005; d_z = 1.30), rebound jump height (−14.8%, p = 0.004; d_z = 1.32), and ankle joint stiffness (−26.3%; p = 0.008; d_z = 1.30) decreased. Ankle joint range of motion (+20.2%; p = 0.011; d_z = 1.09) and MG muscle-tendon unit length (+12.0%; p = 0.037; d_z = 0.91) during the braking phase of DJ, the immediate drop-off in impact force (termed peak force reduction) (Δ27.3%; p = 0.033; d_z = 0.86), and lactate (+9.5 mmol/L; p < 0.001; d_z = 3.58) increased. Fascicle length increased at rest (+4.9%; p = 0.013; d_z = 1.16) and during MVC (+6.8%; p = 0.048; d_z = 0.85). Pennation angle decreased at rest (−6.5%; p = 0.034, d_z = 0.93) and during MVC (−9.8%; p = 0.012; d_z = 1.35). No changes in muscle thickness were found at rest (−2.6%; p = 0.066; d_z = 0.77) or during MVC (−1.6%; p = 0.204; d_z = 0.49). The greater MG muscle-tendon stretch during the DJ braking phase after exercise indicates that muscle damage likely occurred. The lower peak force reduction and ankle joint stiffness, indicative of decreased active stiffness, suggests activation was likely reduced, causing fascicles to shorten less during MVC.