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Nevanperä S, Hu N, Walker S, Avela J, Piirainen JM. Modulation of H-reflex and V-wave responses during dynamic balance perturbations. Exp Brain Res 2023; 241:1599-1610. [PMID: 37142781 DOI: 10.1007/s00221-023-06625-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/25/2023] [Indexed: 05/06/2023]
Abstract
Motoneuron excitability is possible to measure using H-reflex and V-wave responses. However, it is not known how the motor control is organized, how the H-reflex and V-wave responses modulate and how repeatable these are during dynamic balance perturbations. To assess the repeatability, 16 participants (8 men, 8 women) went through two, identical measurement sessions with ~ 48 h intervals, where maximal isometric plantar flexion (IMVC) and dynamic balance perturbations in horizontal, anterior-posterior direction were performed. Soleus muscle (SOL) neural modulation during balance perturbations were measured at 40, 70, 100 and 130 ms after ankle movement by using both H-reflex and V-wave methods. V-wave, which depicts the magnitude of efferent motoneuronal output (Bergmann et al. in JAMA 8:e77705, 2013), was significantly enhanced as early as 70 ms after the ankle movement. Both the ratio of M-wave-normalized V-wave (0.022-0.076, p < 0.001) and H-reflex (0.386-0.523, p < 0.001) increased significantly at the latency of 70 ms compared to the latency of 40 ms and remained at these levels at latter latencies. In addition, M-wave normalized V-wave/H-reflex ratio increased from 0.056 to 0.179 (p < 0.001). The repeatability of V-wave demonstrated moderate-to-substantial repeatability (ICC = 0.774-0.912) whereas the H-reflex was more variable showing fair-to-substantial repeatability (ICC = 0.581-0.855). As a conclusion, V-wave was enhanced already at 70 ms after the perturbation, which may indicate that increased activation of motoneurons occurred due to changes in descending drive. Since this is a short time-period for voluntary activity, some other, potentially subcortical responses might be involved for V-wave increment rather than voluntary drive. Our results addressed the usability and repeatability of V-wave method during dynamic conditions, which can be utilized in future studies.
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Affiliation(s)
- Samuli Nevanperä
- Sports Technology Program, Faculty of Sport and Health Sciences, University of Jyväskylä, Kidekuja 2, 88610, Vuokatti, Finland.
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PL35, 40700, Jyväskylä, Finland.
| | - Nijia Hu
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PL35, 40700, Jyväskylä, Finland
| | - Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PL35, 40700, Jyväskylä, Finland
| | - Janne Avela
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PL35, 40700, Jyväskylä, Finland
| | - Jarmo M Piirainen
- Sports Technology Program, Faculty of Sport and Health Sciences, University of Jyväskylä, Kidekuja 2, 88610, Vuokatti, Finland
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PL35, 40700, Jyväskylä, Finland
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Hadjizadeh Anvar S, Kordi MR, Alizadeh S, Ramsay E, Shabkhiz F, Behm DG. Lack of Evidence for Crossover Fatigue with Plantar Flexor Muscles. J Sports Sci Med 2022; 21:214-223. [PMID: 35719232 PMCID: PMC9157513 DOI: 10.52082/jssm.2022.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
The occurrence and mechanisms underlying non-local or crossover muscle fatigue is an ongoing issue. This study aimed to investigate crossover fatigue of the plantar flexor muscles. Sixteen recreationally active males (n = 6) and females (n = 10) visited the laboratory for four sessions and performed a single 5-s pre-test maximal voluntary isometric contraction (MVIC) with each plantar flexors muscle. Thereafter, the fatigue intervention involved two 100-s MVICs (60-s recovery) with their dominant plantar flexors or rested for 260-s (control). Subsequently, in two separate sessions, Hoffman reflexes (H-reflex) were evoked in the non-dominant, non-exercised, leg before and following the dominant leg fatigue or control intervention (Fatigue-Reflex and Control-Reflex conditions). MVIC forces and volitional (V)-waves were monitored in the non-dominant leg in the other two sessions (Fatigue-MVIC and Control-MVIC) before and after the intervention (fatigue or control) as well as during 12 repeated MVICs and immediately thereafter. Despite the force reduction in the dominant leg (42.4%, p = 0.002), no crossover force deficit with single (F(1,9) = 0.02, p = 0.88, pƞ2 = 0.003) or repeated (F(1,9) = 0.006, p = 0.93, pƞ2 = 0.001) MVIC testing were observed. The H-reflex did not change after the fatigue (F(1,7) = 0.51; p = 0.49; pƞ2 = 0.06) or repeated MVICs (F(1,8) = 0.27; p = 0.61; pƞ2 = 0.03). There were also no crossover effects of fatigue on the V-wave with single (F(1,8) = 3.71, p = 0.09, pƞ2 = 0.31) or repeated MVICs (F(1,6) = 1.45, p = 0.27, pƞ2 = 0.19). Crossover fatigue was not evident with the plantar flexors nor any significant changes in H-reflex and V-waves in the soleus muscle. This finding suggests that crossover fatigue may not necessarily occur in slow-twitch predominant muscle groups.
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Affiliation(s)
- Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador (NL), Canada
- Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran
| | - Mohammad Reza Kordi
- Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador (NL), Canada
| | - Emma Ramsay
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador (NL), Canada
| | - Fatemeh Shabkhiz
- Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador (NL), Canada
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Bouguetoch A, Martin A, Grosprêtre S. Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach. Eur J Appl Physiol 2021; 121:941-55. [PMID: 33417035 DOI: 10.1007/s00421-020-04582-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
Introduction Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared. Methods Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography. Results MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only. Conclusion Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.
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Al-Sadawi M, Ortega RR, Ariyaratnam J, Battisha A, Madoukh B, Bukharovich I. State-of-the-Art Review of Current Therapies for HFpEF: An Overview of Interatrial Septal Device Therapy in Heart Failure. Curr Cardiol Rev 2020; 17:e230421189012. [PMID: 33305708 PMCID: PMC8950450 DOI: 10.2174/1573403x16999201210195455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/17/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
Heart failure (HF) affects an increasing number of geriatric patients. The condition is classified according to whether the left ventricular ejection fraction (EF) is reduced or preserved. Many patients have heart failure with preserved ejection fraction (HFpEF) and face a shortage of effective therapeutic strategies. However, an emerging mechanical strategy for treatment is gaining momentum. Interatrial septal connection devices, i.e. V-wave device and Interatrial septal device, are new devices for patients with heart failure with preserved ejection fraction. We review the function of these systems and the data from the recent clinical trials. Interatrial septal connection device therapy provided favorable efficacy and safety profile applicable to a wide range of patients with HFpEF. However, the long-term effects of these devices on morbidity and mortality merits longitudinal studies and large multicenter randomized controlled trials.
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Affiliation(s)
- Mohammed Al-Sadawi
- Division of Cardiology, Stony Brook University Hospital, Stony Brook, NY 11720, United States
| | - Romy R Ortega
- Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, United States
| | - Jonathan Ariyaratnam
- Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, United States
| | - Ayman Battisha
- Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA 01199, United States
| | - Bader Madoukh
- Department of Internal Medicine, Overland Park Regional Medical Center-HCA Midwest Health, Overland Park, KS 66215, United States
| | - Inna Bukharovich
- Department of Cardiovascular Medicine, Kings County Medical Center, Brooklyn, NY 11203, United States
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Ema R, Kanda A, Shoji M, Iida N, Akagi R. Age-Related Differences in the Effect of Prolonged Vibration on Maximal and Rapid Force Production and Balance Ability. Front Physiol 2020; 11:598996. [PMID: 33192615 PMCID: PMC7659521 DOI: 10.3389/fphys.2020.598996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022] Open
Abstract
We tested the hypothesis that older adults would not likely experience deficits in maximal and explosive plantar flexion strength and standing balance performance induced by prolonged Achilles tendon vibration compared with young adults. Fifteen older men (OM, 73 ± 5 years) and 15 young men (YM, 24 ± 4 years) participated in two interventions on different days: lying in a quiet supine position for 30 min with or without prolonged vibration to the Achilles tendon. Before and after the interventions, maximal voluntary contraction (MVC) torque during plantar flexion, rate of torque development (RTD), and center of pressure (COP) speed during single-leg standing were measured. The root mean square of the electromyogram (RMS-EMG) during performance and V-wave and voluntary activation during MVC were assessed. The MVC torque (7 ± 7%) and RTD (16 ± 15%) of YM but not OM significantly decreased after vibration. In addition, the relative changes observed in YM positively correlated with changes in RMS-EMG of the medial gastrocnemius (MG) (MVC torque and RTD) and in MG V-wave and voluntary activation (MVC torque). COP speed significantly increased (16 ± 20%) in YM only after vibration and was accompanied by increased activation of the lateral gastrocnemius. This is the first study to show that the effects of prolonged Achilles tendon vibration on strength and balance performances were apparent in young adults only. The differences between the age groups may be related to the attenuated gastrocnemius neuromuscular function in older adults.
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Affiliation(s)
- Ryoichi Ema
- School of Management, Shizuoka Sangyo University, Iwata, Japan
| | - Akihiro Kanda
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- Mizuno Corporation, Osaka, Japan
| | - Mikio Shoji
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Natsuki Iida
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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Helgerud J, Thomsen SN, Hoff J, Strandbråten A, Leivseth G, Unhjem R, Wang E. Maximal strength training in patients with Parkinson's disease: impact on efferent neural drive, force-generating capacity, and functional performance. J Appl Physiol (1985) 2020; 129:683-690. [PMID: 32790593 DOI: 10.1152/japplphysiol.00208.2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Parkinson's disease (PD) is characterized by progressive neurological deterioration, typically accompanied by reductions in skeletal muscle force-generating capacity (FGC) and functional performance. Physical activity has the potential to counteract this debilitating outcome, however, it is elusive if high-intensity strength training included in conventional treatment may improve results. Therefore, we randomly assigned 22 PD patients (74 ± 9 yr) to conventional rehabilitation with or without maximal strength training (MST) performed as leg press and chest press at ~90% of one repetition maximum (1RM), five times per week for 4 wk. FGC, physical performance, and efferent neural drive assessed as evoked potentials (V-wave normalized to M-wave in m. soleus) were measured following training. Results revealed that only MST improved 1RM leg press (101 ± 23 to 118 ± 18 kg) and chest press (36 ± 15 to 41 ± 15 kg), plantar flexion maximal voluntary contraction (235 ± 125 to 293 ± 158 N·m), and rate of force development (373 ± 345 to 495 ± 446 N·m·s-1; all P < 0.05; different from controls P < 0.05). FGC improvements were accompanied by an increased efferent neural drive to maximally contracting musculature (V-to-M ratio: 0.17 ± 0.12 to 0.24 ± 0.15; P < 0.05; different from controls P < 0.05), improved physical performance (stair climbing: 21.0 ± 9.2 to 14.4 ± 5.2 s; timed up and go: 7.8 ± 3.3 to 6.2 ± 2.5 s; both P < 0.05), and self-perceived improvement in health (3.1 ± 0.5 to 2.6 ± 0.9) and social activities functioning (2.2 ± 1.0 to 1.5 ± 1.1; both P < 0.05). No changes were observed in the control group. In conclusion, this study shows that MST improves FGC, neuromuscular function, and functional performance and advocates that high-intensity strength training should be implemented as an adjunct therapy in the treatment of PD patients.NEW & NOTEWORTHY This randomized, controlled trial documents that supervised high-intensity strength training improves efferent neural drive, maximal muscle strength, rate of force development, and functional performance in patients with Parkinson's disease (PD). In contrast, no differences were observed in these outcome variables in patients receiving conventional treatment consisting of recreational physical activity with low-to-medium intensity. Consequently, this study advocates that high-intensity strength training should be implemented in the clinical treatment of PD patients.
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Affiliation(s)
- J Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - S N Thomsen
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J Hoff
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs University Hospital, Trondheim, Norway
| | - A Strandbråten
- Hokksund Medical Rehabilitation Center, Hokksund, Norway
| | - G Leivseth
- Department of Clinical Medicine, Arctic University of Norway, Tromsø, Norway
| | - R Unhjem
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Rehabilitation, Rīga Stradiņš University, Riga, Latvia
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Abstract
Aims The diastolic pressure gradient (DPG) has been proposed as a marker pulmonary vascular disease in the setting of left heart failure (HF). However, its diagnostic utility is compromised by the high prevalence of physiologically incompatible negative values (DPGNEG) and the contradictory evidence on its prognostic value. Pressure pulsatility impacts on DPG measurements, thus conceivably, pulmonary artery wedge pressure (PAWP) measurements insusceptible to the oscillatory effect of the V-wave might yield a more reliable DPG assessment. We set out to investigate how the instantaneous PAWP at the trough of the Y-descent (PAWPY) influences the prevalence of DPGNEG and the prognostic value of the resultant DPGY. Methods Hundred and fifty-three consecutive HF patients referred for right heart catheterisation were enrolled prospectively. DPG, as currently recommended, was calculated. Subsequently, PAWPY was measured and the corresponding DPGY was calculated. Results DPGY yielded higher values (median, IQR: 3.2, 0.6–5.7 mmHg) than DPG (median, IQR: 0.9, − 1.7–3.8 mmHg); p < 0.001. Conventional DPG was negative in 45% of the patients whereas DPGY in only 15%. During follow-up (22 ± 14 months) 58 patients have undergone heart-transplantation or died. The predictive ability of DPGY ≥ 6 mmHg for the above defined end-point events was significant [HR 2.1; p = 0.007] and independent of resting mean pulmonary artery pressure (PAPM). In contrast, conventional DPG did not comprise significant prognostic value following adjustment for PAPM. Conclusion Instantaneous pressures at the trough of Y-descent yield significantly fewer DPGNEG than conventional DPG and entail superior prognostic value in HF patients with and without PH. Graphic abstract ![]()
Electronic supplementary material The online version of this article (10.1007/s00392-020-01641-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aristomenis Manouras
- Department of Medicine, Karolinska Institute, Solna, Stockholm, Sweden.,Theme of Heart and Vessels, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas Johnson
- Centre for Fetal Medicine Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars H Lund
- Department of Medicine, Karolinska Institute, Solna, Stockholm, Sweden.,Theme of Heart and Vessels, Karolinska University Hospital, Stockholm, Sweden
| | - Anikó Ilona Nagy
- Department of Medicine, Karolinska Institute, Solna, Stockholm, Sweden. .,Heart and Vascular Center, Semmelweis University, 68. Városmajor u., Budapest, 1026, Hungary.
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Aagaard P. Spinal and supraspinal control of motor function during maximal eccentric muscle contraction: Effects of resistance training. J Sport Health Sci 2018; 7:282-293. [PMID: 30356634 PMCID: PMC6189238 DOI: 10.1016/j.jshs.2018.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 03/22/2018] [Accepted: 03/24/2018] [Indexed: 06/08/2023]
Abstract
Neuromuscular activity is suppressed during maximal eccentric (ECC) muscle contraction in untrained subjects owing to attenuated levels of central activation and reduced spinal motor neuron (MN) excitability indicated by reduced electromyography signal amplitude, diminished evoked H-reflex responses, increased autogenic MN inhibition, and decreased excitability in descending corticospinal motor pathways. Maximum ECC muscle force recorded during maximal voluntary contraction can be increased by superimposed electrical muscle stimulation only in untrained individuals and not in trained strength athletes, indicating that the suppression in MN activation is modifiable by resistance training. In support of this notion, maximum ECC muscle strength can be increased by use of heavy-load resistance training owing to a removed or diminished suppression in neuromuscular activity. Prolonged (weeks to months) of heavy-load resistance training results in increased H-reflex and V-wave responses during maximal ECC muscle actions along with marked gains in maximal ECC muscle strength, indicating increased excitability of spinal MNs, decreased presynaptic and/or postsynaptic MN inhibition, and elevated descending motor drive. Notably, the use of supramaximal ECC resistance training can lead to selectively elevated V-wave responses during maximal ECC contraction, demonstrating that adaptive changes in spinal circuitry function and/or gains in descending motor drive can be achieved during maximal ECC contraction in response to heavy-load resistance training.
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Christiansen TL, Niazi IK, Holt K, Nedergaard RW, Duehr J, Allen K, Marshall P, Türker KS, Hartvigsen J, Haavik H. The effects of a single session of spinal manipulation on strength and cortical drive in athletes. Eur J Appl Physiol 2018; 118:737-749. [PMID: 29327170 PMCID: PMC5843672 DOI: 10.1007/s00421-018-3799-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/01/2018] [Indexed: 11/11/2022]
Abstract
Purpose The primary purpose of this study was to investigate whether a single session of spinal manipulation (SM) increases strength and cortical drive in the lower limb (soleus muscle) of elite Taekwondo athletes. Methods Soleus-evoked V-waves, H-reflex and maximum voluntary contraction (MVC) of the plantar flexors were recorded from 11 elite Taekwondo athletes using a randomized controlled crossover design. Interventions were either SM or passive movement control. Outcomes were assessed at pre-intervention and at three post-intervention time periods (immediate post, post 30 min and post 60 min). A multifactorial repeated measures ANOVA was conducted to assess within and between group differences. Time and session were used as factors. A post hoc analysis was carried out, when an interactive effect was present. Significance was set at p ≤ 0.05. Results SM increased MVC force [F(3,30) = 5.95, p < 0.01], and V-waves [F(3,30) = 4.25, p = 0.01] over time compared to the control intervention. Between group differences were significant for all time periods (p < 0.05) except for the post60 force measurements (p = 0.07). Conclusion A single session of SM increased muscle strength and corticospinal excitability to ankle plantar flexor muscles in elite Taekwondo athletes. The increased MVC force lasted for 30 min and the corticospinal excitability increase persisted for at least 60 min.
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Affiliation(s)
- Thomas Lykke Christiansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Imran Khan Niazi
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand. .,SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - Kelly Holt
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand
| | - Rasmus Wiberg Nedergaard
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand
| | - Jens Duehr
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand
| | - Kathryn Allen
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand
| | - Paul Marshall
- School of Science and Health, Western Sydney University, Sydney, Australia
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Heidi Haavik
- Center for Chiropractic Research, New Zealand College of Chiropractic, 6 Harrison Road, Mount Wellington, Auckland, New Zealand
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Behrens M, Müller K, Kilb JI, Schleese L, Herlyn PKE, Bruhn S, Mittlmeier T, Schober HC, Fischer DC. Modified step aerobics training and neuromuscular function in osteoporotic patients: a randomized controlled pilot study. Arch Orthop Trauma Surg 2017; 137:195-207. [PMID: 27987182 PMCID: PMC5250667 DOI: 10.1007/s00402-016-2607-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Training programs directed to improve neuromuscular and musculoskeletal function of the legs are scarce with respect to older osteoporotic patients. We hypothesized that a modified step aerobics training program might be suitable for this purpose and performed a randomized controlled pilot study to assess the feasibility of conducting a large study. Here we report on the training-related effects on neuromuscular function of the plantar flexors. PATIENTS AND METHODS Twenty-seven patients with an age of at least 65 years were enrolled and randomized into control and intervention group. The latter received supervised modified step aerobics training (twice weekly, 1 h per session) over a period of 6 months. At baseline, and after 3 and 6 months neuromuscular function of the plantar flexors, i.e., isometric maximum voluntary torque, rate of torque development and twitch torque parameters were determined in detail in all patients of both groups. RESULTS Twenty-seven patients (median age 75 years; range 66-84 years) were randomized (control group n = 14; intervention group n = 13). After 3 and 6 months of training, maximum voluntary contraction strength in the intervention group was significantly higher by 7.7 Nm (9.1%; 95% CI 3.3-12.2 Nm, P < 0.01) and 12.4 Nm (14.8%; 95% CI 6.4-18.5 Nm, P < 0.01) compared to controls. These changes were most probably due to neural and muscular adaptations. CONCLUSION It is worthwhile to investigate efficacy of this training program in a large randomized trial. However, a detailed neuromuscular assessment appears feasible only in a subset of participants.
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Affiliation(s)
- Martin Behrens
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Karoline Müller
- Department of Traumatology, Hand- and Reconstructive Surgery, University Medicine Rostock, Rostock, Germany
| | - Jill-Isabel Kilb
- Department of Internal Medicine, Klinikum Südstadt, Rostock, Germany
| | - Lennart Schleese
- Department of Pediatrics, University Medicine Rostock, Ernst-Heydemann-Str. 8, 18057, Rostock, Germany
| | - Philipp K E Herlyn
- Department of Traumatology, Hand- and Reconstructive Surgery, University Medicine Rostock, Rostock, Germany
| | - Sven Bruhn
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand- and Reconstructive Surgery, University Medicine Rostock, Rostock, Germany
| | | | - Dagmar-C Fischer
- Department of Pediatrics, University Medicine Rostock, Ernst-Heydemann-Str. 8, 18057, Rostock, Germany.
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Nagy AI, Venkateshvaran A, Merkely B, Lund LH, Manouras A. Determinants and prognostic implications of the negative diastolic pulmonary pressure gradient in patients with pulmonary hypertension due to left heart disease. Eur J Heart Fail 2016; 19:88-97. [PMID: 27748008 DOI: 10.1002/ejhf.675] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 08/14/2016] [Accepted: 09/08/2016] [Indexed: 11/11/2022] Open
Abstract
AIMS The diastolic pulmonary pressure gradient (DPG) has recently been introduced as a specific marker of combined pre-capillary pulmonary hypertension (Cpc-PH) in left heart disease (LHD). However, its diagnostic and prognostic superiority compared with traditional haemodynamic indices has been challenged lately. Current recommendations explicitly denote that in the normal heart, DPG values are greater than zero, with DPG ≥7 mmHg indicating Cpc-PH. However, clinicians are perplexed by the frequent observation of DPG <0 mmHg (DPGNEG ), as its physiological explanation and clinical impact are unclear to date. We hypothesized that large V-waves in the pulmonary artery wedge pressure (PAWP) curve yielding asymmetric pressure transmission might account for DPGNEG and undertook this study to clarify the physiological and prognostic implications of DPGNEG . METHODS AND RESULTS Right heart catheterization and echocardiography were performed in 316 patients with LHD due to primary myocardial dysfunction or valvular disease. A total of 256 patients had PH-LHD, of whom 48% demonstrated DPGNEG . The V-wave amplitude inversely correlated with DPG (r = -0.45, P < 0.001) in patients with low pulmonary vascular resistance (PVR), but not in those with elevated PVR (P > 0.05). Patients with large V-waves had negative and lower DPG than those without augmented V-waves (P < 0.001) despite similar PVR (P >0.05). Positive, but normal DPG (0-6 mmHg) carried a worse 2-year prognosis for death and/or heart transplantation than DPGNEG (hazard ratio 2.97; P < 0.05). CONCLUSION Our results advocate against DPGNEG constituting a measurement error. We propose that DPGNEG can partially be ascribed to large V-waves and carries a better prognosis than DPG within the normal positive range.
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Affiliation(s)
- Anikó Ilona Nagy
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ashwin Venkateshvaran
- School for Technology and Health, Royal Institute of Technology, Stockholm, Sweden.,Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Lars H Lund
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aristomenis Manouras
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Unhjem R, Flemmen G, Hoff J, Wang E. Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial. BMC Sports Sci Med Rehabil 2016; 8:7. [PMID: 27042312 PMCID: PMC4818502 DOI: 10.1186/s13102-016-0032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/29/2016] [Indexed: 12/30/2022]
Abstract
Background Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength training intervention for SUD patients in clinical treatment. Methods 16 males and 8 females were randomized into a training group (TG) and a control group (CG). The TG performed lower extremities maximal strength training (85-90 % of 1 repetition maximum (1RM)) 3 times a week for 8 weeks, while the CG participated in conventional clinical activities. Results The TG increased hack squat 1RM (88 ± 54 %), plantar flexion 1RM (26 ± 20 %), hack squat rate of force development (82 ± 29 %) and peak force (11 ± 5 %). Additionally, the TG improved neural function, expressed as voluntary V-wave (88 ± 83 %). The CG displayed no change in any physical parameters. The TG also reduced anxiety and insomnia, while the CG reduced anxiety. Conclusion Maximal strength training was feasible for SUD patients in treatment, and improved multiple risk factors for falls, fractures and lifestyle related diseases. As conventional treatment appears to have no effect on muscle strength, systematic strength training should be implemented as part of clinical practice. Trial regestration ClinicalTrials.gov Identifier: NCT02218970 (August 14, 2014).
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Affiliation(s)
- Runar Unhjem
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway
| | - Grete Flemmen
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Jan Hoff
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Physical Medicine and Rehabilitation, St. Olav University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Division of Psychiatry, Department of Østmarka, St. Olav University Hospital, Trondheim, Norway ; Department of Internal Medicine, University of Utah, Salt Lake City, Utah USA
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Stutzig N, Siebert T. Reproducibility of electromyographic and mechanical parameters of the triceps surae during submaximal and maximal plantar flexions. Muscle Nerve 2016; 53:464-70. [PMID: 26173034 DOI: 10.1002/mus.24767] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Neuromuscular parameters must be reproducible to examine neuromuscular adaptations in interventional and clinical studies. The reproducibility of neuromuscular parameters for the soleus (SOL), lateral gastrocnemius (LG), and medial gastrocnemius (MG) was assessed over a period of 2 weeks. METHODS Thirteen subjects (27.4 years, 69.5 kg) were tested for numerous electromyographic (e.g., voluntary and electrical evoked EMG) and mechanical (e.g., voluntary activation level) parameters in 3 test sessions. RESULTS The majority of the data (28 of 34) revealed moderate and substantial reproducibility. Hmax20% /Mmax20% and Vsup /Msup were less reproducible in LG than in MG and SOL. Muscle activity and M-waves did not differ between muscles. The ICC for the mechanical data was >0.79. CONCLUSIONS The H-reflex during voluntary contraction of the LG should be considered with caution. Mechanical data on muscle activation level are reproducible. The reproducibility of neuromuscular parameters is sufficient for interventional studies.
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Affiliation(s)
- Norman Stutzig
- Institute of Sport and Movement Science, University of Stuttgart, Allmandring 28, 70569, Stuttgart, Germany
| | - Tobias Siebert
- Institute of Sport and Movement Science, University of Stuttgart, Allmandring 28, 70569, Stuttgart, Germany
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Behrens M, Weippert M, Wassermann F, Bader R, Bruhn S, Mau-Moeller A. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training. Front Physiol 2015; 6:145. [PMID: 26029114 PMCID: PMC4429572 DOI: 10.3389/fphys.2015.00145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 04/21/2015] [Indexed: 12/02/2022] Open
Abstract
Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0–100, 100–200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance.
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Affiliation(s)
- Martin Behrens
- Institute of Sport Science, University of Rostock Rostock, Germany
| | - Matthias Weippert
- Institute of Sport Science, University of Rostock Rostock, Germany ; Institute of Exercise Physiology and Public Health Rostock, Germany
| | | | - Rainer Bader
- Department of Orthopaedics, University Medicine Rostock Rostock, Germany
| | - Sven Bruhn
- Institute of Sport Science, University of Rostock Rostock, Germany
| | - Anett Mau-Moeller
- Department of Orthopaedics, University Medicine Rostock Rostock, Germany
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Abstract
The responsiveness of the human central nervous system can change profoundly with exercise, injury, disuse, or disease. Changes occur at both cortical and spinal levels but in most cases excitability of the motoneuron pool must be assessed to localize accurately the site of adaptation. Hence, it is critical to understand, and employ correctly, the methods to test motoneuron excitability in humans. Several techniques exist and each has its advantages and disadvantages. This review examines the most common techniques that use evoked compound muscle action potentials to test the excitability of the motoneuron pool and describes the merits and limitations of each. The techniques discussed are the H-reflex, F-wave, tendon jerk, V-wave, cervicomedullary motor evoked potential (CMEP), and motor evoked potential (MEP). A number of limitations with these techniques are presented.
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Affiliation(s)
- Chris J McNeil
- Neuroscience Research Australia Randwick, NSW, Australia ; School of Health and Exercise Sciences, University of British Columbia Kelowna, BC, Canada
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