Sex Differences in Muscle Morphology between Male and Female Sprinters

There is a marked difference between males and females in sprint running performance, yet a comprehensive investigation of sex differences in the muscle morphology of sprinters remains to completed. This study compared muscle volumes of 23 individual leg muscles/compartments and five functional muscle groups, assessed with 3T magnetic resonance imaging, between male (n=31) and female (n=22) sprinters, and sub-groups of elite males (EM, n=5), elite females (EF, n=5), and performance matched (to elite females) males (PMMEF, n=6). Differences in muscle volume distribution between EM, EF and unathletic male controls (UM) were also assessed. For the full sprint cohorts, males were more muscular than females, but the differences were non-uniform and anatomically variable, with the largest differences in the hip extensors and flexors. However, amongst elite sprinters the sex differences in the volume of the functional muscle groups were almost uniform (absolute volume +47-53%), and the muscle volume distribution of EM was more similar to EF than UM (P<0.039). For PMMEF relative hip extensor volume, but not stature or percent body fat, differentiated for performance (PMMEF and EF < EM) rather than sex. In conclusion, whilst the full cohorts of sprinters showed a marked sex difference in the amount and distribution of muscle mass, elite sprinters appeared to be selected for a common muscle distribution phenotype that for these elite sub-groups was a stronger effect than that of sex. Relative hip extensor muscle volume appeared to be the primary determinant of the sex difference in performance.

Plantar intrinsic foot muscle activity and its relationship with postural sway during tiptoe standing in ballet dancers and non-dancers

BACKGROUND

Minimizing postural sway during tiptoe standing is essential for ballet dancers. Investigation of the activity of the plantar intrinsic foot muscles (PIFMs) may provide insight into postural sway in dancers. Herein, we compared PIFM activity during tiptoe standing between dancers and non-dancers and examined its relationship with postural sway.

METHODS

We enrolled 14 female ballet dancers and 13 female non-dancers. Electromyography (EMG) amplitudes of 64 channels of PIFMs and center of pressure (COP) data were recorded during bipedal tiptoe standing tasks performed with ankle plantarflexion angles of 20°, 40°, and 60° (dancers only). The EMG amplitudes were normalized to those during the maximum voluntary contraction, and the muscle activity level and its coefficient of variation over time (EMG-CVtime) during the task were assessed. Standard deviations in the anteroposterior and mediolateral directions, velocity, and area were calculated from the COP data.

RESULTS

Most COP and EMG variables were significantly lower in dancers than in non-dancers in both the 20° and 40° tasks (p < 0.05). Significant correlations were found between most combinations of the COP and EMG variables in both the 20° and 40° tasks in the whole cohort (r = 0.468-0.807, p ≤ 0.014). In the 60° task in dancers, COP velocity was strongly correlated with EMG-CVtime (r = 0.700, p = 0.005).

CONCLUSION

These results provide novel evidence that the PIFMs do not require high activity, but rather that its low, steady activity is the key, to achieve less postural sway during bipedal tiptoe standing in dancers.

Triceps surae muscle hypertrophy is greater after standing versus seated calf-raise training

Background: The triceps surae muscle plays important roles in fundamental human movements. However, this muscle is relatively unresponsive to resistance training (difficult to hypertrophy) but prone to atrophy with inactivity compared with other muscles. Thus, identifying an effective training modality for the triceps surae is warranted. This study compared triceps surae muscle hypertrophy after standing/knee-extended versus seated/knee-flexed plantarflexion (calf-raise) training, where the gastrocnemius is lengthened and shortened, respectively. Methods: Fourteen untrained adults conducted calf-raise training with one leg in a standing/knee-extended position and the other leg in a seated/knee 90°-flexed position at 70% of one-repetition maximum. Each leg performed 10 repetitions/set, 5 sets/session, 2 sessions/week for 12 weeks. Before and after the intervention, magnetic resonance imaging scans were obtained to assess muscle volume of each and the whole triceps surae. Results: Muscle volume significantly increased in all three muscles and the whole triceps surae for both legs (p ≤ 0.031), except for the gastrocnemius muscles of the seated condition leg (p = 0.147-0.508). The changes in muscle volume were significantly greater for the standing than seated condition leg in the lateral gastrocnemius (12.4% vs. 1.7%), medial gastrocnemius (9.2% vs. 0.6%), and whole triceps surae (5.6% vs. 2.1%) (p ≤ 0.011), but similar between legs in the soleus (2.1% vs. 2.9%, p = 0.410). Conclusion: Standing calf-raise was by far more effective, therefore recommended, than seated calf-raise for inducing muscle hypertrophy of the gastrocnemius and consequently the whole triceps surae. This result and similar between-condition hypertrophy in the soleus collectively suggest that training at long muscle lengths promotes muscle hypertrophy.

A classification of the plantar intrinsic foot muscles based on the physiological cross-sectional area and muscle fiber length in healthy young adult males

BACKGROUND

Plantar intrinsic foot muscles (PIFMs) are composed of 10 muscles and play an essential role in achieving functional diversity in the foot. Previous studies have identified that the morphological profiles of PIFMs vary between individuals. The morphological profiles of a muscle theoretically reflect its output potentials: the physiological cross-sectional area (PCSA) of a muscle is proportional to its maximum force generation, and the muscle fiber length (FL) is its shortening velocity. This implies that the PCSA and FL may be useful variables for characterizing the functional diversity of the individual PIFM. The purpose of this study was to examine how individual PIFMs can be classified based on their PCSA and FL.

METHODS

In 26 healthy young adult males, the muscle volume and muscle length of seven PIFMs (abductor hallucis, ABDH; abductor digiti minimi, ABDM; adductor hallucis oblique head, ADDH-OH; ADDH transverse head, ADDH-TH; flexor digitorum brevis, FDB; flexor hallucis brevis, FHB; quadratus plantae, QP) were measured using magnetic resonance imaging. The PCSA and FL of each of the seven PIFMs were then estimated by combining the data measured from the participants and those of muscle architectural parameters documented from cadavers in previous studies. A total of 182 data samples (26 participants × 7 muscles) were classified into clusters using k-means cluster analysis. The optimal number of clusters was evaluated using the elbow method.

RESULTS

The data samples of PIFMs were assigned to four clusters with different morphological profiles: ADDH-OH and FHB, characterised by large PCSA and short FL (high force generation and slow shortening velocity potentials); ABDM and FDB, moderate PCSA and moderate FL (moderate force generation and moderate shortening velocity potentials); QP, moderate PCSA and long FL (moderate force generation and rapid shortening velocity potentials); ADDH-TH, small PCSA and moderate FL (low force generation and moderate shortening velocity potentials). ABDH components were assigned equivalently to the first and second clusters.

CONCLUSIONS

The approach adopted in this study may provide a novel perspective for interpreting the PIFMs' function based on their maximal force generation and shortening velocity potentials.

Non-invasive estimation of muscle fibre size from high-density electromyography

Because of the biophysical relation between muscle fibre diameter and the propagation velocity of action potentials along the muscle fibres, motor unit conduction velocity could be a non-invasive index of muscle fibre size in humans. However, the relation between motor unit conduction velocity and fibre size has been only assessed indirectly in animal models and in human patients with invasive intramuscular EMG recordings, or it has been mathematically derived from computer simulations. By combining advanced non-invasive techniques to record motor unit activity in vivo, i.e. high-density surface EMG, with the gold standard technique for muscle tissue sampling, i.e. muscle biopsy, here we investigated the relation between the conduction velocity of populations of motor units identified from the biceps brachii muscle, and muscle fibre diameter. We demonstrate the possibility of predicting muscle fibre diameter (R2  = 0.66) and cross-sectional area (R2  = 0.65) from conduction velocity estimates with low systematic bias (∼2% and ∼4% respectively) and a relatively low margin of individual error (∼8% and ∼16%, respectively). The proposed neuromuscular interface opens new perspectives in the use of high-density EMG as a non-invasive tool to estimate muscle fibre size without the need of surgical biopsy sampling. The non-invasive nature of high-density surface EMG for the assessment of muscle fibre size may be useful in studies monitoring child development, ageing, space and exercise physiology, although the applicability and validity of the proposed methodology need to be more directly assessed in these specific populations by future studies. KEY POINTS: Because of the biophysical relation between muscle fibre size and the propagation velocity of action potentials along the sarcolemma, motor unit conduction velocity could represent a potential non-invasive candidate for estimating muscle fibre size in vivo. This relation has been previously assessed in animal models and humans with invasive techniques, or it has been mathematically derived from simulations. By combining high-density surface EMG with muscle biopsy, here we explored the relation between the conduction velocity of populations of motor units and muscle fibre size in healthy individuals. Our results confirmed that motor unit conduction velocity can be considered as a novel biomarker of fibre size, which can be adopted to predict muscle fibre diameter and cross-sectional area with low systematic bias and margin of individual error. The proposed neuromuscular interface opens new perspectives in the use of high-density EMG as a non-invasive tool to estimate muscle fibre size without the need of surgical biopsy sampling.

Heavy Resistance Training Versus Plyometric Training for Improving Running Economy and Running Time Trial Performance: A Systematic Review and Meta-analysis

BACKGROUND

As an adjunct to running training, heavy resistance and plyometric training have recently drawn attention as potential training modalities that improve running economy and running time trial performance. However, the comparative effectiveness is unknown. The present systematic review and meta-analysis aimed to determine if there are different effects of heavy resistance training versus plyometric training as an adjunct to running training on running economy and running time trial performance in long-distance runners.

METHODS

Electronic databases of PubMed, Web of Science, and SPORTDiscus were searched. Twenty-two studies completely satisfied the selection criteria. Data on running economy and running time trial performance were extracted for the meta-analysis. Subgroup analyses were performed with selected potential moderators.

RESULTS

The pooled effect size for running economy in heavy resistance training was greater (g = - 0.32 [95% confidence intervals [CIs] - 0.55 to - 0.10]: effect size = small) than that in plyometric training (g = -0.13 [95% CIs - 0.47 to 0.21]: trivial). The effect on running time trial performance was also larger in heavy resistance training (g = - 0.24 [95% CIs - 1.04 to - 0.55]: small) than that in plyometric training (g = - 0.17 [95% CIs - 0.27 to - 0.06]: trivial). Heavy resistance training with nearly maximal loads (≥ 90% of 1 repetition maximum [1RM], g = - 0.31 [95% CIs - 0.61 to - 0.02]: small) provided greater effects than those with lower loads (< 90% 1RM, g = - 0.17 [95% CIs - 1.05 to 0.70]: trivial). Greater effects were evident when training was performed for a longer period in both heavy resistance (10-14 weeks, g = - 0.45 [95% CIs - 0.83 to - 0.08]: small vs. 6-8 weeks, g = - 0.21 [95% CIs - 0.56 to 0.15]: small) and plyometric training (8-10 weeks, g = 0.26 [95% CIs - 0.67 to 0.15]: small vs. 4-6 weeks, g = - 0.06 [95% CIs 0.67 to 0.55]: trivial).

CONCLUSIONS

Heavy resistance training, especially with nearly maximal loads, may be superior to plyometric training in improving running economy and running time trial performance. In addition, running economy appears to be improved better when training is performed for a longer period in both heavy resistance and plyometric training.

Associations of muscle volume of individual human plantar intrinsic foot muscles with morphological profiles of the foot

Human plantar intrinsic foot muscles consist of 10 muscles that originate and insert within the sole of the foot. It is known that the anatomical cross‐sectional area (ACSA) and muscle thickness of two plantar intrinsic foot muscles, the flexor hallucis brevis (FHB) and abductor hallucis (ABH), associate with morphological parameters of the foot, such as total and truncated foot length and navicular height. However, it is unclear how the size for each of the plantar intrinsic foot muscles associates with various morphological profiles of the foot. This study aimed to elucidate this subject. By using magnetic resonance imaging (MRI), serial images of the right foot were obtained in 13 young adult men without foot deformities. From the obtained MR images, ACSA for each of the individual plantar intrinsic foot muscles was analyzed along the foot length, and then its muscle volume (MV) was calculated. The analyzed muscles were the abductor digiti minimi (ABDM), ABH, adductor hallucis oblique head (ADDH‐OH), adductor hallucis transverse head (ADDH‐TH), flexor digitorum brevis (FDB), FHB, and quadratus plantae (QP). Furthermore, MV of the whole plantar intrinsic foot muscle (WHOLE) was defined as the total MVs of all the analyzed muscles. As morphological parameters, total foot length, truncated foot length, forefoot width, ball circumference, instep circumference, navicular height, great toe eversion angle, and little toe inversion angle were measured using a laser three‐dimensional foot scanner in standing and sitting conditions. In addition, navicular drop (ND) and normalized truncated navicular height (NTNH) were also calculated as medial longitudinal arch (MLA) height indices. The MV of WHOLE was significantly associated with the forefoot width, ball circumference, and instep circumference (r = 0.647–0.711, p = 0.006–0.013). Positive correlations were found between the forefoot width and MV of FHB, FDB, and QP (r = 0.564–0.653, p = 0.015–0.045), between the ball circumference and MV of QP (r = 0.559, p = 0.047), between the instep circumference and MV of FHB (r = 0.609, p = 0.027), and between the little toe inversion angle and MV of QP (r = 0.570, p = 0.042). The MVs of ABH, ABDM, and ADDH‐OH were not significantly correlated with any morphological parameters of the foot. Similarly, no significant correlations were found between MV of each muscle and either of the MLA height indices (ND and NTNH). Thus, the current results indicate that forefoot width and circumferential parameters (instep and ball circumference), not MLA height, associate with the size of the whole plantar intrinsic foot muscles, especially those specialized in toe flexion (FHB, FDB, and QP).

Neural decoding from surface high-density EMG signals: influence of anatomy and synchronization on the number of identified motor units

OBJECTIVE

High-density surface electromyography (HD-sEMG) allows the reliable identification of individual motor unit (MU) action potentials. Despite the accuracy in decomposition, there is a large variability in the number of identified MUs across individuals and exerted forces. Here we present a systematic investigation of the anatomical and neural factors that determine this variability.

APPROACH

We investigated factors of influence on HD-sEMG decomposition, such as synchronization of MU discharges, distribution of MU territories, muscle-electrode distance (MED - subcutaneous adipose tissue thickness), maximum anatomical cross-sectional area (ACSA_max), and fiber CSA. For this purpose, we recorded HD-sEMG signals, ultrasound and, magnetic resonance images, and took a muscle biopsy from the biceps brachii muscle from 30 male participants drawn from two groups to ensure variability within the factors - untrained-controls (UT=14) and strength-trained individuals (ST=16). Participants performed isometric ramp contractions with elbow flexors (at 15, 35, 50 and 70% maximum voluntary torque - MVT). We assessed the correlation between the number of accurately detected MUs by HD-sEMG decomposition and each measured parameter, for each target force level. Multiple regression analysis was then applied.

MAIN RESULTS

ST subjects showed lower MED (UT=5.1±1.4 mm; ST=3.8±0.8 mm) and a greater number of identified motor units (UT:21.3±10.2 vs ST:29.2±11.8 MUs/subject across all force levels). The entire cohort showed a negative correlation between MED and the number of identified MUs at low forces (r= -0.6, p=0.002 at 15%MVT). Moreover, the number of identified MUs was positively correlated to the distribution of MU territories (r=0.56, p=0.01) and ACSA_max(r=0.48, p=0.03) at 15%MVT. By accounting for all anatomical parameters, we were able to partly predict the number of decomposed MUs at low but not at high forces.

SIGNIFICANCE

Our results confirmed the influence of subcutaneous tissue on the quality of HD-sEMG signals and demonstrated that MU spatial distribution and ACSA_maxare also relevant parameters of influence for current decomposition algorithms.

Triceps brachii hypertrophy is substantially greater after elbow extension training performed in the overhead versus neutral arm position

The biarticular triceps brachii long head (TB_Long) is lengthened more in the overhead than neutral arm position. We compared triceps brachii hypertrophy after elbow extension training performed in the overhead vs. neutral arm position. Using a cable machine, 21 adults (14 males and 7 females, age: 23.4 ± 1.6 y, height: 1.69 ± 0.09 m, body mass: 64.5 ± 12.4 kg) conducted elbow extensions (90-0°) with one arm in the overhead (Overhead-Arm) and the other arm in the neutral (Neutral-Arm) position at 70% one-repetition maximum (1RM), 10 reps/set, 5 sets/session, 2 sessions/week for 12 weeks. Training load was gradually increased (+5% 1RM/session) when the preceding session was completed without repetition failure. 1RM of the assigned condition and MRI-measured muscle volume of the TB_Long, monoarticular lateral and medial heads (TB_Lat+Med), and whole triceps brachii (Whole-TB) were assessed pre- and post-training. Training load and 1RM increased in both arms similarly (+62-71% at post, P = 0.285), while their absolute values/weights were always lower in Overhead-Arm (-34-39%, P < 0.001). Changes in muscle volume in Overhead-Arm compared to Neutral-Arm were 1.5-fold greater for the TB_Long (+28.5% vs. +19.6%, Cohen's d = 1.272, P < 0.001), 1.4-fold greater for the TB_Lat+Med (+14.6% vs. +10.5%, d = 1.106, P = 0.002), and 1.4-fold greater for the Whole-TB (+19.9% vs. +13.9%, d = 1.427, P < 0.001). In conclusion, triceps brachii hypertrophy was substantially greater after elbow extension training performed in the overhead versus neutral arm position, even with lower absolute loads used during the training.

Associations between the size of individual plantar intrinsic and extrinsic foot muscles and toe flexor strength

Background

The size of the plantar intrinsic and extrinsic foot muscles has been shown to be associated with toe flexor strength (TFS). Previous studies adopted the size of limited plantar intrinsic foot muscles or a compartment containing several muscles as an independent variable for TFS. Among the plantar intrinsic and extrinsic foot muscles, therefore, it is unclear which muscle(s) primarily contributes to TFS production. The present study aimed to clarify this subject.

Methods

In 17 young adult men, a series of anatomical cross-sectional area of individual plantar intrinsic and extrinsic foot muscles was obtained along the foot length and the lower leg length, respectively, using magnetic resonance imaging. Maximal anatomical cross-sectional area (ACSA_max) and muscle volume (MV) for each constituent muscle of the plantar intrinsic foot muscles (flexor hallucis brevis; flexor digitorum brevis, FDB; abductor hallucis; adductor hallucis oblique head, ADDH-OH; adductor hallucis transverse head, ADDH-TH; abductor digiti minimi; quadratus plantae) and extrinsic foot muscles (flexor hallucis longus; flexor digitorum longus) were measured. TFS was measured with a toe grip dynamometry.

Results

TFS was significantly associated with the ACSA_max for each of the ADDH-OH (r = 0.674, p = 0.003), ADDH-TH (r = 0.523, p = 0.031), and FDB (r = 0.492, p = 0.045), and the MV of the ADDH-OH (r = 0.582, p = 0.014). As for the ADDH-OH, the correlation coefficient with TFS was not statistically different between ACSA_max and MV (p = 0.189). Stepwise multiple linear regression analysis indicated that ACSA_max and MV of the ADDH-OH alone explained 42 and 29%, respectively, of the variance in TFS.

Conclusion

The ADDH-OH is the primary contributor to TFS production among the plantar intrinsic and extrinsic foot muscles as the result of the stepwise multiple linear regression analysis.

Effects of age and sex on association between toe muscular strength and vertical jump performance in adolescent populations

Toe muscular strength plays an important role in enhancing athletic performance because the forefoot is the only part of the body touching the ground. In general, muscular strength increases with age throughout adolescence, and sex-related difference in muscular strength becomes evident during childhood and adolescence. However, toe muscular strength is known to be levelled off after late adolescence in both sexes. For adolescent populations, therefore, the association of toe muscular strength with physical performance might differ with age and/or sex. This study aimed to investigate differences in relationships between toe muscular strength and vertical jump performance across sex and age in adolescent populations. The maximum isometric strength of the toe muscles and vertical jump height (VJ) were assessed in 479 junior high school students (JH) aged 12–14 years (243 boys and 236 girls) and 465 high school students (HS) aged 15–18 years (265 boys and 200 girls). Two types of measurements were performed to evaluate the toe muscular strength: toe gripping strength (TGS) with the metatarsophalangeal joint in the plantar flexed position and toe push strength (TPS) with the metatarsophalangeal joint in the dorsiflexed position. TGS and TPS were normalized to body weight. Two-way ANOVA showed that TGS had significant main effects of sex (boys > girls) and age (HS > JH) while TPS only had a significant main effect of sex (boys > girls). When the effects of sex and age were separately analyzed, VJ was significantly correlated with TGS in JH girls, HS girls, and JH boys (r = 0.253–0.269, p < 0.05), but not in HS boys (r = 0.062, p = 0.3351). These results suggest that toe muscular strength is relatively weakly associated with vertical jump performance in adolescent boys and girls, but the association would not be established in high school boys.

Behavior of motor units during submaximal isometric contractions in chronically strength-trained individuals

Neural and morphological adaptations combine to underpin the enhanced muscle strength following prolonged exposure to strength training, although their relative importance remains unclear. We investigated the contribution of motor unit (MU) behavior and muscle size to submaximal force production in chronically strength-trained athletes (ST) versus untrained controls (UT). Sixteen ST (age: 22.9 ± 3.5 yr; training experience: 5.9 ± 3.5 yr) and 14 UT (age: 20.4 ± 2.3 yr) performed maximal voluntary isometric force (MViF) and ramp contractions (at 15%, 35%, 50%, and 70% MViF) with elbow flexors, whilst high-density surface electromyography (HDsEMG) was recorded from the biceps brachii (BB). Recruitment thresholds (RTs) and discharge rates (DRs) of MUs identified from the submaximal contractions were assessed. The neural drive-to-muscle gain was estimated from the relation between changes in force (ΔFORCE, i.e. muscle output) relative to changes in MU DR (ΔDR, i.e. neural input). BB maximum anatomical cross-sectional area (ACSA_MAX) was also assessed by MRI. MViF (+64.8% vs. UT, P < 0.001) and BB ACSA_MAX (+71.9%, P < 0.001) were higher in ST. Absolute MU RT was higher in ST (+62.6%, P < 0.001), but occurred at similar normalized forces. MU DR did not differ between groups at the same normalized forces. The absolute slope of the ΔFORCE - ΔDR relationship was higher in ST (+66.9%, P = 0.002), whereas it did not differ for normalized values. We observed similar MU behavior between ST athletes and UT controls. The greater absolute force-generating capacity of ST for the same neural input demonstrates that morphological, rather than neural, factors are the predominant mechanism for their enhanced force generation during submaximal efforts.NEW & NOTEWORTHY In this study, we observed that recruitment strategies and discharge characteristics of large populations of motor units identified from biceps brachii of strength-trained athletes were similar to those observed in untrained individuals during submaximal force tasks. We also found that for the same neural input, strength-trained athletes are able to produce greater absolute muscle forces (i.e., neural drive-to-muscle gain). This demonstrates that morphological factors are the predominant mechanism for the enhanced force generation during submaximal efforts.

Neural adaptations to long-term resistance training: evidence for the confounding effect of muscle size on the interpretation of surface electromyography

This study compared elbow flexor (EF; experiment 1) and knee extensor (KE; experiment 2) maximal compound action potential (M_max) amplitude between long-term resistance trained (LTRT; n = 15 and n = 14, 6 ± 3 and 4 ± 1 yr of training) and untrained (UT; n = 14 and n = 49) men, and examined the effect of normalizing electromyography (EMG) during maximal voluntary torque (MVT) production to M_max amplitude on differences between LTRT and UT. EMG was recorded from multiple sites and muscles of EF and KE, M_max was evoked with percutaneous nerve stimulation, and muscle size was assessed with ultrasonography (thickness, EF) and magnetic resonance imaging (cross-sectional area, KE). Muscle-electrode distance (MED) was measured to account for the effect of adipose tissue on EMG and M_max. LTRT displayed greater MVT (+66%-71%, P < 0.001), muscle size (+54%-56%, P < 0.001), and M_max amplitudes (+29%-60%, P ≤ 0.010) even when corrected for MED (P ≤ 0.045). M_max was associated with the size of both muscle groups (r ≥ 0.466, P ≤ 0.011). Compared with UT, LTRT had higher absolute voluntary EMG amplitude for the KE (P < 0.001), but not the EF (P = 0.195), and these differences/similarities were maintained after correction for MED; however, M_max normalization resulted in no differences between LTRT and UT for any muscle and/or muscle group (P ≥ 0.652). The positive association between M_max and muscle size, and no differences when accounting for peripheral electrophysiological properties (EMG/M_max), indicates the greater absolute voluntary EMG amplitude of LTRT might be confounded by muscle morphology, rather than providing a discrete measure of central neural activity. This study therefore suggests limited agonist neural adaptation after LTRT.NEW & NOTEWORTHY In a large sample of long-term resistance-trained individuals, we showed greater maximal M-wave amplitude of the elbow flexors and knee extensors compared with untrained individuals, which appears to be at least partially mediated by differences in muscle size. The lack of group differences in voluntary EMG amplitude when normalized to maximal M-wave suggests that differences in muscle morphology might impair interpretation of voluntary EMG as an index of central neural activity.

Change of Direction Speed Tests in Basketball Players: A Brief Review of Test Varieties and Recent Trends

Change of direction speed (CODS) is essential for basketball performance, extensively assessed by various tests. This review aimed to summarize the CODS test varieties for basketball players on publications until 2019 and identify recent trends regarding what types of tests have gained attention in the 2010s. Electronic literature searches were conducted using three databases with relevant keywords. 104 studies were found eligible, conducting CODS tests 159 times in total with 48 test varieties. To facilitate distinctions between the tests, each test was categorized into one of three types based on the distinctive movement characteristics and changing angles as follows: Defensive (involving lateral shuffling), 180°-turn (exerting only 180°-turns), and Cutting (performing diagonal- or side-cut). We then counted the number of publications and adopted times reported per year for each test, and calculated the adoption rate for each categorized test type. The first CODS test performed in basketball players was the T-Test, reported in 1991, and this was the most commonly adopted test (44/159 times). The 2010s saw abrupt increases in the number of publications (1990s-2000s-2010s: 5-9-90) and test varieties (4-7-44). The adoption rates in the 2010s were similar among the three types (i.e., Defensive/180°-turn/Cutting: 37%/30%/33%), with the Cutting type gradually increasing over the last three decades (1990s-2000s-2010s: 0%-9%-33%). These results suggest that while CODS performances in basketball players are increasingly studied with various tests, recent studies give equal weight to all of the three categorized test types, with increasing adoption of the Cutting type, to assess specific CODS performances.

Corticospinal excitability and motor representation after long-term resistance training

It is poorly understood how the central nervous system adapts to resistance training, especially after years of exposure. We compared corticospinal excitability and motor representation assessed with transcranial magnetic stimulation (TMS) between long-term resistance trained (LRT, ≥3 years) versus untrained (UNT) males (n = 15/group). Motor-evoked potentials (MEPs) were obtained from the biceps brachii during isometric elbow flexion. Stimulus-response curves were created at the hotspot during 10% maximum voluntary torque (MVT) contractions. Maximum peak-to-peak MEP amplitude (MEPmax) was acquired with 100% stimulator output intensity, whilst 25%-100% MVT was produced. Maps were created during 10% MVT contractions, with an individualised TMS intensity eliciting 20% MEPmax at the hotspot. LRT had a 48% lower stimulus-response curve slope than UNT (p < .05). LRT also had a 66% larger absolute map size, although TMS intensity used for mapping was greater in LRT versus UNT (48% vs. 26% above active motor threshold) to achieve a target 20% MEPmax at the hotspot, due to the lower slope of LRT. Map size was strongly correlated with the TMS intensity used for mapping (r = 0.776, p < .001). Once map size was normalised to TMS intensity, there was no difference between the groups (p = .683). We conclude that LRT had a lower stimulus-response curve slope/excitability, suggesting higher neural efficiency. TMS map size was overwhelmingly determined by TMS intensity, even when the MEP response at the hotspot was matched among individuals, likely due to larger current spread with higher intensities. Motor representation appears similar between LRT and UNT given no difference in the normalised map size.

Greater Hamstrings Muscle Hypertrophy but Similar Damage Protection after Training at Long versus Short Muscle Lengths

PURPOSE

We investigated the effects of seated versus prone leg curl training on hamstrings muscle hypertrophy and susceptibility to eccentric exercise-induced muscle damage.

METHODS

Part 1: Twenty healthy adults conducted seated leg curl training with one leg (Seated-Leg) and prone with the other (Prone-Leg), at 70% one-repetition maximum (1RM), 10 repetitions per set, 5 sets per session, 2 sessions per week for 12 wk. Magnetic resonance imaging (MRI)-measured muscle volume of the individual and whole hamstrings was assessed pre- and posttraining. Part 2: Nineteen participants from part 1 and another 12 untrained controls (Control-Leg) performed eccentric phase-only leg curl exercise at 90% 1RM, 10 repetitions per set, 3 sets for each of the seated/prone conditions with each leg. MRI-measured transverse relaxation time (T2) and 1RM of seated/prone leg curl were assessed before, 24, 48, and 72 h after exercise.

RESULTS

Part 1: Training-induced increases in muscle volume were greater in Seated-Leg versus Prone-Leg for the whole hamstrings (+14% vs +9%) and each biarticular (+8%-24% vs +4%-19%), but not monoarticular (+10% vs +9%), hamstring muscle. Part 2: After eccentric exercise, Control-Leg had greater increases in T2 in each hamstring muscle (e.g., semitendinosus at 72 h: +52%) than Seated-Leg (+4%) and Prone-Leg (+6%). Decreases in 1RM were also greater in Control-Leg (e.g., seated/prone 1RM at 24 h: -12%/-24%) than Seated-Leg (0%/-3%) and Prone-Leg (+2%/-5%). None of the changes significantly differed between Seated-Leg and Prone-Leg at any time points.

CONCLUSION

Hamstrings muscle size can be more effectively increased by seated than prone leg curl training, suggesting that training at long muscle lengths promotes muscle hypertrophy, but both are similarly effective in reducing susceptibility to muscle damage.

The Muscle Morphology of Elite Sprint Running

PURPOSE

This study aimed to investigate the differences in muscle volumes and strength between male elite sprinters, sub-elite sprinters, and untrained controls and to assess the relationships of muscle volumes and strength with sprint performance.

METHODS

Five elite sprinters (100-m season's best equivalent [SBE100], 10.10 ± 0.07 s), 26 sub-elite sprinters (SBE100, 10.80 ± 0.30 s), and 11 untrained control participants underwent 1) 3-T magnetic resonance imaging scans to determine the volume of 23 individual lower limb muscles/compartments and 5 functional muscle groups and 2) isometric strength assessment of lower body muscle groups.

RESULTS

Total lower body muscularity was distinct between the groups (controls < sub-elite +20% < elite +48%). The hip extensors exhibited the largest muscle group differences/relationships (elite, +32% absolute and +15% relative [per kg] volume, vs sub-elite explaining 31%-48% of the variability in SBE100), whereas the plantarflexors showed no differences between sprint groups. Individual muscle differences showed pronounced anatomical specificity (elite vs sub-elite absolute volume range, +57% to -9%). Three hip muscles were consistently larger in elite vs sub-elite (tensor fasciae latae, sartorius, and gluteus maximus; absolute, +45%-57%; relative volume, +25%-37%), and gluteus maximus volume alone explained 34%-44% of the variance in SBE100. The isometric strength of several muscle groups was greater in both sprint groups than controls but similar for the sprint groups and not related to SBE100.

CONCLUSIONS

These findings demonstrate the pronounced inhomogeneity and anatomically specific muscularity required for fast sprinting and provides novel, robust evidence that greater hip extensor and gluteus maximus volumes discriminate between elite and sub-elite sprinters and are strongly associated with sprinting performance.

Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

Background

Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women.

Methods

Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-s chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group.

Results

TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = − 0.32, p = 0.07) and supinated (r = − 0.56, p = 0.08) groups, and positively correlate with 30-s chair stand score in the pronated group (r = 0.31, p = 0.08).

Conclusions

The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

Relationship between Trunk Muscularity and Club Head Speed in Male Golfers

This study examined how the volume of trunk muscles and its bilateral asymmetry are related to club head speed in golfers. Fourteen right-handed male golfers performed five driver shots, and the club head speed for each trial was calculated from a three-dimensional reflective marker position of the club head immediately before impact. The volume of each side of the rectus abdominis, erector spinae, psoas major, quadratus lumborum, lateral abdominal wall muscle, and multifidus was determined using magnetic resonance imaging. For each muscle, the ratio of the larger to smaller side in muscle volume was calculated to assess bilateral asymmetry. The club head speed correlated positively with the volume of each side of the rectus abdominis and erector spinae, left quadratus lumborum, and the asymmetric ratio of the psoas major (r=0.595-0.747), but negatively with the asymmetric ratio of the quadratus lumborum (r=-0.641). Multiple regression analysis revealed that the right erector spinae volume and the asymmetric ratio of the psoas major were significant contributors for the club head speed (R²=0.797). These results indicate that the variation in the club head speed can be strongly explained by the absolute volume and bilateral asymmetry of specific trunk muscles.

Suspended Push-up Training Augments Size of not only Upper Limb but also Abdominal Muscles

We investigated the effects of sling-based, suspended push-up training on muscle size and function of upper limb and abdominal muscles. Eight men conducted suspended push-ups to failure 3 sets/session, 3 sessions/week, for 8 weeks. The maximum number of push-ups during training gradually and significantly increased from the first to last training session (+92%), suggesting improved muscle endurance. After the training, muscle thickness of the elbow extensors (+16%) and flexors (+3%), as well as abdominal muscles (rectus abdominis: RA,+27%; external oblique: EO,+14%) significantly increased. No changes occurred in maximum isometric strength of elbow extension or flexion, nor in 1-repetition maximum bench press. In a follow-up experiment, electromyograms (EMGs) of RA, EO and internal oblique (IO) during suspended push-ups to failure were measured and normalized to those during maximum voluntary contraction of each muscle (% EMGmvc) in six men. EMG significantly increased when reaching failure in all muscles (RA: 46-88%, EO: 32-50%, IO: 19-52%, start-end), and was particularly high in RA. These results suggest that suspended push-up training can augment size of not only upper limb but also abdominal muscles, likely attributable to high muscle activities during exercise; however, this does not necessarily improve maximum strength after training thus warrants careful interpretation/application.

Neuromuscular Adaptations to Work-matched Maximal Eccentric versus Concentric Training

It is unclear whether the superiority of eccentric over concentric training on neuromuscular improvements is due to higher torque (mechanical loading) achievable during eccentric contractions or due to resulting greater total work.

Efficacy of downhill running training for improving muscular and aerobic performances

This study investigated effects of downhill (DR) versus level (LR) running training on various muscular and aerobic performances. Eighteen healthy young males conducted either DR (DR group (DRG), n = 10: -10% slope) or LR (LR group (LRG), n = 8) training at a target heart rate (HR) associated with lactate threshold (LT) for 20 min·session^-1, 3 sessions·week^-1, for 5 weeks. Before and after the interventions, the following variables were measured: knee extension torque (-150, -30, 0, 30, 150°·s^-1), leg extension power (simultaneous hip and knee extension: 0.8 m·s^-1), squat and countermovement jump height, rebound jump index (jump height·contact time^-1), 20-m linear sprint and change-of-direction (Pro-agility and V-cut tests) time, and aerobic capacity (maximal oxygen uptake, energy cost at LT, and velocity at maximal oxygen uptake and LT) on a level surface. Throughout the training sessions, HR during running did not differ between the groups (DRG: 77.7% ± 4.6% vs LRG: 76.4% ± 4.6% of maximal HR; average across all sessions), while velocity was significantly higher for DRG (14.5 ± 1.1 vs 12.0 ± 1.9 km·h^-1). After the training, DRG significantly improved knee extension torque at all angular velocities (9%-24%) and change-of-direction time for both tests (2%-3%), with no changes in other parameters. LRG significantly improved maximal oxygen uptake (5%), energy cost at LT (3%), and velocity at maximal oxygen uptake (7%), without changes in others. These results suggest that DR training has a greater potential to improve the knee extension strength and change-of-direction ability, but has little effect on the aerobic capacity, compared with HR-matched LR training.

Localization of damage in the human leg muscles induced by downhill running

We investigated localization of damage within the knee extensors (KEs) and plantar flexors (PFs) induced by downhill running (DR) by using transverse relaxation time (T₂)-weighted magnetic resonance imaging (MRI). Fourteen young adults performed 45-min DR (-15% slope) at their maximal tolerable velocity. At pre- and 24, 48, and 72 h post-exercise, T₂-MRI was scanned and T₂ values for each muscle composing KEs and PFs at proximal, middle, and distal sites were calculated. Maximal isometric torque and rate of torque development (RTD: 0-30, 0-50, 0-100, 0-200 ms) were also measured. Maximal torque significantly decreased in KEs (14-17%) and PFs (6-8%) at 24-48 h post-exercise, with greater reductions for KEs. RTD in all phases, except for 0-200 ms in PFs, significantly decreased in KEs (11-42%) and PFs (13-23%) at least at one time point post-exercise. T₂ significantly increased at several sites (3-5%) in both muscle groups at 24 and/or 48 h post-exercise. Among the T₂-increased sites, the peak effect size (Cohen's d) regarding T₂ change was pronounced at proximal (1.05) and middle (1.64) vastus intermedius compared to the other sites (0.72-0.77). These results suggest that DR induces damage in both KEs and PFs, and especially affects proximal-middle sites of the vastus intermedius.

Anatomical cross-sectional area of the quadriceps femoris and sit-to-stand test score in middle-aged and elderly population: development of a predictive equation

BACKGROUND

Although the sit-to-stand (STS) test score has been shown to relate to the strength and size of the quadriceps femoris (QF) for elderly population, it is unknown whether this relationship is influenced by a posture (i.e., the trunk being allowed to stoop or not) during the STS test. The present study investigated the relationship between STS test score and QF anatomical cross-sectional area (ACSA) in the middle-aged and elderly population with regard to the difference in the posture during STS test, and aimed to develop an accurate predicting equation of the QF ACSA from the STS test score.

METHODS

105 males (40-81 years) and 113 females (41-79 years) participated in the present study, then the subjects were divided at random as validation and cross-validation groups. Mid-thigh QF ACSA was determined by magnetic resonance imaging. Subjects performed a 10-repeated STS as fast as possible in two conditions: (1) with the trunk being allowed to stoop during the sitting phases, and (2) kept upright throughout the test. A power index of the STS test score was calculated based on an equation obtained in a previous study using the time taken for each test condition, the thigh and shank lengths, and body mass. In the validation group (n = 109), a stepwise multiple linear regression analysis was performed to create a predictive model of the ACSA with sex, age, the STS time, and power for both conditions as independent variables. The formulated predictive equation was examined in the cross-validation group (n = 109).

RESULTS

In the validation group, a stepwise regression analysis revealed that STS power with upright trunk condition, sex, and age but not with the stooping condition, were selected as variables to predict QF ACSA (R (2) = 0.64, P < 0.001). There was no systematic error for the relationship between predicted and measured values in the cross-validation group.

CONCLUSIONS

These results indicate that STS test score with upright trunk condition is one of the indices of QF muscle size of the middle-aged and elderly population. The estimated predicting equation should be useful in clinical and practical settings for the health promotion.

Downhill walking training with and without exercise-induced muscle damage similarly increase knee extensor strength

This study examined whether avoiding or experiencing exercise-induced muscle damage (EIMD) influences strength gain after downhill walking training. Healthy young males performed treadmill downhill walking (gradient: -28%, velocity: 5 km · h(-1) and load: 10% of body mass) 1 session per week for four weeks using either a ramp-up protocol (n = 16), where exercise duration was gradually increased from 10 to 30, 50 and 70 min over four sessions, or a constant protocol (n = 14), where exercise duration was 40 min for all four sessions. Indirect markers of EIMD were measured throughout the training period. Maximal knee extension torque in eccentric (-1.05 rad·s(-1)), isometric and concentric (1.05 rad·s(-1)) conditions were measured at pre- and post-training. The ramp-up group showed no indications of EIMD throughout the training period (e.g., plasma creatine kinase (CK) activity: always <185 U · L(-1)) while EIMD was evident after the first session in the constant group (CK: peak 485 U · L(-1)). Both groups significantly increased maximal knee extension torque in all conditions with greater gains in eccentric (ramp-up: +19%, constant: +21%) than isometric (+16%, +15%) and concentric (+12%, +10%) strength without any significant group-difference. The current results suggest that EIMD can be avoided by the ramp-up protocol and is not a major determinant of training-induced strength gain.

Low-load Slow Movement Squat Training Increases Muscle Size and Strength but Not Power

We tested a hypothesis that low-load squat training with slow movement and tonic force generation (LST) would increase muscle size and strength but not necessarily power. Healthy young men were assigned to LST [50% one-repetition maximum (1-RM) load, 3 s for lowering/lifting without pause: n=9] or low-load normal speed (LN: 50% 1-RM load, 1 s for lowering/lifting with 1-s pause; n=7) groups. Both groups underwent an 8-week squat training program (10 repetitions/set, 3 sets/day, and 3 days/week) using the assigned methods. Before and after the intervention, quadriceps femoris muscle thickness, maximal torque during isometric hip extension and knee extension, 1-RM squat, lifting power from squatting position and rate of electromyography rise (RER) in knee extensors during the task, leg extension power and vertical jump height were measured. After the intervention, the LN group showed no changes in all the variables. The LST group significantly (P<0.05) increased muscle thickness (6-10%), isometric hip extension torque (18%) and 1-RM squat (10%), but not isometric knee extension torque, lifting power and RER, leg extension power and vertical jump height. These results suggest that LST can increase muscle size and task-related strength, but has little effect on power production during dynamic explosive movements.

Effect of a prior bout of preconditioning exercise on muscle damage from downhill walking

This study investigated whether reduced-duration downhill walking (DW) would confer a protective effect against muscle damage induced by a subsequent bout of longer duration DW performed 1 week or 4 weeks later. Healthy young adults were allocated to a control or one of the preconditioning exercise (PRE-1wk or PRE-4wk) groups (10 men and 4 women per group). PRE-1wk and PRE-4wk groups performed 20-min DW (-28% slope, 5 km/h, 10% body mass added to a backpack) 1 week and 4 weeks before 40-min DW, respectively, and the control group performed 40-min DW only. Maximal voluntary contraction (MVC) knee extension torque, plasma creatine kinase (CK) activity, and muscle soreness (100-mm visual analog scale) were measured before, immediately after, and 24, 48, and 72 h after DW, and the changes in these variables were compared among groups. The control group showed symptoms of muscle damage (e.g., prolonged decrease in MVC: -14% ± 10% at 48 h post-DW) after 40-min DW. Changes in all variables after 40-min DW of PRE-1wk and PRE-4wk groups were 54%-61% smaller (P < 0.05) than the control group, without significant differences between PRE-1wk and PRE-4wk groups for MVC and plasma CK activity. Importantly, changes after the preconditioning exercise (20-min DW) were 67%-69% smaller (P < 0.05) than those after the 40-min DW of the control group. These findings suggest that 20-min DW resulting in minor muscle damage conferred a protective effect against subsequent 40-min DW, and its effect could last for more than 4 weeks.

Muscular adaptations to short-term low-frequency downhill walking training

This study examined muscular adaptations of knee extensors following short-term low-frequency downhill walking training. 22 young males (training group: TG, n=12; control group: CG, n=10) participated. TG conducted 40-min downhill treadmill walking (load: 10% of body mass, gradient: 28%, velocity: 5 km/h) 1 session/week for 4 weeks. Before and after the intervention, muscle thickness of knee extensors and maximal knee extension torques in eccentric (- 120, - 60, - 30°/s), isometric (0°/s), and concentric (30, 60, 120, 240°/s) conditions were measured. For TG, muscle damage markers were also measured before and up to 72 h following each session. After the intervention, CG did not show any changes in all variables. TG had significant increases in maximal knee extension torques at all angular velocities, with higher relative gains in eccentric torques (+ 24% on average) than isometric (+ 13%) and concentric (+ 12% on average) torques. No changes were found in the muscle thickness. Although considerable muscle damage was observed after the first training session in TG, the magnitudes of changes in all markers following the second to fourth sessions were minimal. These results indicate that even with relatively short-term and low-frequency, downhill walking training can increase the strength capacity of knee extensors, especially in eccentric strength.

Muscular activities during sling- and ground-based push-up exercise

Background

This study aimed to clarify the characteristics of muscle activities during push-up exercises performed under sling condition by comparison with those performed under ground condition. We hypothesized that sling-based push-ups induce higher muscle activities than the ground-based push-ups, and its effects are more prominent in dynamic compared to static exercise owing to increased demands of stabilization.

Findings

Twenty young males performed sling- and ground-based push-ups in each of static (maintaining the posture with the elbow joint angle at 90 deg) and dynamic (repeating push-ups at a rate of 45 per minute) exercises. Surface electromyograms (EMGs) of the pectoralis major, latissimus dorsi, triceps brachii, biceps brachii, rectus abdominis, external oblique, internal oblique, and erector spinae muscles were recorded during the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). In the static exercise, sling condition showed significantly higher % EMGmax values than the ground condition in the triceps brachii (+27%: relative to ground condition) and biceps brachii (+128%) as well as the three abdominal muscles (+15% to +27%). In the dynamic exercise, such condition-related differences were more prominent and those in the pectoralis major (+29%) in addition to the aforementioned five muscles (+19% to +144%) were significant.

Conclusion

These results supported the hypothesis and indicate that sling-based push-up exercise can provide greater activation in upper limb and anterior trunk muscles than the ground-based push-up exercise.

Trainability of muscular activity level during maximal voluntary co-contraction: comparison between bodybuilders and nonathletes

Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE). Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes). The electromyograms (EMGs) of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE). The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (P<0.01) than those for nonathletes (biceps brachii: 66±14% in bodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%). There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03). Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction.

Trunk muscle activities during abdominal bracing: comparison among muscles and exercises

Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements. Key PointsTrunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences.Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements.Abdominal bracing should be included in exercise programs when the goal is to improve spine stability.

Effect of short-term maximal voluntary co-contraction training on neuromuscular function

The present study aimed to examine the effect of short-term training utilizing voluntary co-contraction with maximal efforts. 23 healthy young men (training group: TG, n = 13; control group: CG, n = 10) participated in this study. TG conducted a 4-week training program (3 days/week), which consisted of 4 s simultaneous maximal voluntary contractions of elbow flexors and extensors at 90° of the elbow joint, followed by 4 s muscle relaxation (10 repetitions/set, 5 sets/day). Before and after the intervention, maximal voluntary isometric and isokinetic torques and the muscle thicknesses of the elbow flexors and extensors were determined. The electromyograms (EMGs) of the 2 muscle groups during isometric maximal voluntary contraction (MVC) were also recorded. After the intervention, CG did not show any significant changes in all measured variables. In TG, significant increases were found in the agonist EMG activities during MVC, and maximal isometric and isokinetic torques of the elbow flexors and extensors, without significant changes in the muscle thicknesses and involuntary coactivation levels during MVC. The current results indicate that the training mode with maximal voluntary co-contraction is effective for improving the force-generating capabilities of the exercising muscles, without any increases in the level of involuntary coactivation during MVC.

Characterization and sensitivity to interleukin 2 and interferon alpha of leukemic cells from a patient with large granular lymphocytic leukemia associated with chronic active Epstein-Barr virus infection

A patient presented with chronic large granular lymphocyte leukemia associated with chronic active Epstein-Barr virus infection (CAEBV). Cell cycle analysis revealed a minimal growth compatible with chronic lymphocytic leukemia After 5 months of treatment, the patient died from acute transformation of the leukemia. Cell harvested during chronic phase were analyzed for sensitivity to interleukin 2 (IL-2) and interferon alpha (IFN alpha) in vitro by means of surface phenotyping and cell cycle assay. IL-2 induced remarkable growth of the cells, whereas IFN alpha did not confer a growth advantage. Since IFN alpha was expected to have no growth induction effect on the leukemia cells, it was administered to the patient to treat the CAEBV.

Laparoscopic repair of a colonic perforation sustained during colonoscopy

A patient who sustained a colonic perforation during therapeutic colonoscopy was treated successfully by laparoscopic repair. Laparoscopy was performed 5 h after polypectomy. Fecal matter was not identified in the peritoneal cavity. Local peritonitis was mild. The laceration was oversewn with five sutures using the extracorporeal endoscopic knot technique. The appendix epiploica was then anchored over the lesion. The postoperative recovery was rapid and uneventful. Laparoscopic surgery may become a useful tool for the safe, effective, and minimally invasive management of iatrogenic colonic perforation.

The proliferating cell nuclear antigen (PCNA) index correlates with the grade of cytologic atypia in well-differentiated early adenocarcinomas of the large intestine

Well-differentiated colorectal adenocarcinomas are subclassified into carcinoma with high-grade atypia (CAH) and carcinoma with low-grade atypia (CAL) based on their cellular atypia. It is proposed that CAH and CAL are different in histologic prognostic factors and that the former should be regarded as carcinoma with high-grade malignancy and the latter as low-grade malignancy. In this study, the differences in cell-proliferative activity between CAH and CAL were examined using a monoclonal antibody to the proliferating cell nuclear antigen (PCNA). The PCNA index and mitotic index of 27 early colorectal carcinomas (9 CAL, 5 CAH, and 13 carcinomas with mixed low- and high-grade atypia) was evaluated in relation to their depth of invasion. In intramucosal lesions, both indices were higher in CAH (78%, 0.89%) than in CAL (68%, 0.47%; P < 0.01). In lesions invading into the submucosa, the PCNA and mitotic indices were also higher in CAH (75%, 0.65%) than in CAL (35%, 0.19%; P < 0.01). A significant correlation was observed between the PCNA index and the mitotic index in the mucosal lesions (P < 0.05). These results indicate that CAH has a higher proliferative activity than CAL, and support the current authors' proposal that CAH is a high-grade malignancy and CAL low-grade malignancy.

Laparoscopically assisted distal partial gastrectomy for early-stage gastric carcinomas

Endoscopic mucosal resection (EMR) is now in clinical use for the management of small, early-stage gastric, carcinomas, although some patients are treated via laparotomy when the lesions are not suitable for, EMR due to their size, depth, and location. In many cases of invasive mucosal carcinoma with submucosal involvement, the regional lymph nodes along with the distal portion of the stomach must also be resected. In order to remove the whole resected specimen, a mini-laparotomy of appropriate length (5 cm) is performed which can be located at the optical port site after removing the laparoscope. By applying an abdominal wall elevator through the mini-laparotomy, direct vision is possible which facilitates resection of the regional lymph nodes and intestinal anastomosis. We describe our technique for laparoscopically assisted distal gastrectomy and present our early clinical results.

[Panpleuropneumonectomy for primary lung cancer patients with pleural dissemination]

Twelve patients of non-small cell lung cancer with carcinomatous pleuritis were subjected to panpleuropneumonectomy between June 1981 and December 1988. The median survival time was 13 months. One-year and 3-year survival rates were 52% and 26%, respectively. There was no significant difference in prognosis compared with the results of other modality therapies such as pleurodesis with talc and tube drainage for pleural effusion. After panpleuropneumonectomy the patients were divided into the group with only pleural dissemination and the one with pleural effusion. The median survival time in the group of pleural dissemination was 14 months. The three-year survival rate was 50%. The one patient survived for 51 months and the other for 45 months. The median survival time of patients with pleural effusion was 4 months without over 1-year survivor. The statistically significant difference was found between the two groups (p less than 0.05). We concluded that panpleuropneumonectomy is indicated only for the patients of non-small cell lung cancer with diffuse pleural dissemination and no pleural effusion.