Greater Strength Gains after Training with Accentuated Eccentric than Traditional Isoinertial Loads in Already Strength-Trained Men

As training experience increases it becomes more challenging to induce further neuromuscular adaptation. Consequently, strength trainers seek alternative training methods in order to further increase strength and muscle mass. One method is to utilize accentuated eccentric loading, which applies a greater external load during the eccentric phase of the lift as compared to the concentric phase. Based upon this practice, the purpose of this study was to determine the effects of 10 weeks of accentuated eccentric loading vs. traditional isoinertial resistance training in strength-trained men. Young (22 ± 3 years, 177 ± 6 cm, 76 ± 10 kg, n = 28) strength-trained men (2.6 ± 2.2 years experience) were allocated to concentric-eccentric resistance training in the form of accentuated eccentric load (eccentric load = concentric load + 40%) or traditional resistance training, while the control group continued their normal unsupervised training program. Both intervention groups performed three sets of 6-RM (session 1) and three sets of 10-RM (session 2) bilateral leg press and unilateral knee extension exercises per week. Maximum force production was measured by unilateral isometric (110° knee angle) and isokinetic (concentric and eccentric 30°.s⁻¹) knee extension tests, and work capacity was measured by a knee extension repetition-to-failure test. Muscle mass was assessed using panoramic ultrasonography and dual-energy x-ray absorptiometry. Surface electromyogram amplitude normalized to maximum M-wave and the twitch interpolation technique were used to examine maximal muscle activation. After training, maximum isometric torque increased significantly more in the accentuated eccentric load group than control (18 ± 10 vs. 1 ± 5%, p < 0.01), which was accompanied by an increase in voluntary activation (3.5 ± 5%, p < 0.05). Isokinetic eccentric torque increased significantly after accentuated eccentric load training only (10 ± 9%, p < 0.05), whereas concentric torque increased equally in both the accentuated eccentric load (10 ± 9%, p < 0.01) and traditional (9 ± 6%, p < 0.01) resistance training groups; however, the increase in the accentuated eccentric load group was significantly greater (p < 0.05) than control (1 ± 7%). Knee extension repetition-to-failure improved in the accentuated eccentric load group only (28%, p < 0.05). Similar increases in muscle mass occurred in both intervention groups. In summary, accentuated eccentric load training led to greater increases in maximum force production, work capacity and muscle activation, but not muscle hypertrophy, in strength-trained individuals.

Activation deficit correlates with weakness in chronic stroke: evidence from evoked and voluntary EMG recordings

OBJECTIVE

To use evoked (M-wave) and voluntary (during maximal voluntary contraction (MVC)) EMG recordings to estimate the voluntary activation level in chronic stroke.

METHODS

Nine chronic hemiparetic stroke subjects participated in the experiment. M-wave (EMGM-wave) and MVC (EMGMVC) EMG values of the biceps brachii muscles were recorded.

RESULTS

Peak torque was significantly smaller on the impaired than non-impaired side. EMGM-wave was also significantly smaller on the impaired than non-impaired side. However, the normalized EMGM-wave/TorqueMVC ratio was not significantly different between two sides. In contrast, both absolute EMGMVC and normalized EMGMVC/TorqueMVC were smaller on the impaired than non-impaired side. The voluntary activation level, EMGMVC/M-wave, was also smaller on the impaired than non-impaired side. The voluntary activation level on the impaired side was highly correlated with weakness (R=0.72), but very low (R=0.32) on the non-impaired side.

CONCLUSION

Collectively, our findings suggest that both peripheral and central factors contribute to post-stroke weakness, but activation deficit correlates most closely with weakness as estimated from maximum voluntary torque generation.

SIGNIFICANCE

These findings serve to highlight the potential benefit from high-intensity exercises to enhance central activation for facilitation of motor recovery.

Effect of eicosapentaenoic acids-rich fish oil supplementation on motor nerve function after eccentric contractions

Background

This study investigated the effect of supplementation with fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the M-wave latency of biceps brachii and muscle damage after a single session of maximal elbow flexor eccentric contractions (ECC).

Methods

Twenty-one men were completed the randomized, double-blind, placebo-controlled, and parallel-design study. The subjects were randomly assigned to the fish oil group (n = 10) or control group (n = 11). The fish oil group consumed eight 300-mg EPA-rich fish oil softgel capsules (containing, in total, 600 mg EPA and 260 mg DHA) per day for 8 weeks before the exercise, and continued this for a further 5 days. The control group consumed an equivalent number of placebo capsules. The subjects performed six sets of ten eccentric contractions of the elbow flexors using a dumbbell set at 40% of their one repetition maximum. M-wave latency was assessed as the time taken from electrical stimulation applied to Erb’s point to the onset of M-wave of the biceps brachii. This was measured before and immediately after exercise, and then after 1, 2, 3, and 5 days. Changes in maximal voluntary isometric contraction (MVC) torque, range of motion (ROM), upper arm circumference, and delayed onset muscle soreness (DOMS) were assessed at the same time points.

Results

Compared with the control group, M-wave latency was significantly shorter in the fish oil group immediately after exercise (p = 0.040), MVC torque was significantly higher at 1 day after exercise (p = 0.049), ROM was significantly greater at post and 2 days after exercise (post; p = 0.006, day 2; p = 0.014), and there was significantly less delayed onset muscle soreness at 1 and 2 days after exercise (day 1; p = 0.049, day 2; p = 0.023).

Conclusion

Eight weeks of EPA and DHA supplementation may play a protective role against motor nerve function and may attenuate muscle damage after eccentric contractions.

Trial registration

This trial was registered on July 14th 2015 (https://upload.umin.ac.jp/cgi-open-bin/ctr/index.cgi).

Depression of corticomotor excitability after muscle fatigue induced by electrical stimulation and voluntary contraction

In this study, we examined the effect of muscle fatigue induced by tetanic electrical stimulation (ES) and submaximal isometric contraction on corticomotor excitability. Experiments were performed in a cross-over design. Motor-evoked potentials (MEPs) were elicited by transcranial magnetic stimulation (TMS). Corticomotor excitability was recorded before and after thumb opposition muscle fatigue tasks, in which 10% of the maximal tension intensity was induced by tetanic ES or voluntary contraction (VC). The participants were 10 healthy individuals who performed each task for 10 min. Surface electrodes placed over the abductor pollicis brevis (APB) muscle recorded MEPs. F- and M-waves were elicited from APB by supramaximal ES of the median nerve. After the tetanic ES- and VC tasks, MEP amplitudes were significantly lower than before the task. However, F- and M-wave amplitudes remained unchanged. These findings suggest that corticospinal excitability is reduced by muscle fatigue as a result of intracortical inhibitory mechanisms. Our results also suggest that corticomotor excitability is reduced by muscle fatigue caused by both VC and tetanic ES.

Interleaved neuromuscular electrical stimulation reduces muscle fatigue

INTRODUCTION

Neuromuscular electrical stimulation (NMES) can be delivered over a muscle belly (mNMES) or nerve trunk (nNMES). Both methods generate contractions that fatigue rapidly due, in part, to non-physiologically high motor unit (MU) discharge frequencies. In this study we introduce interleaved NMES (iNMES), whereby stimulus pulses are alternated between mNMES and nNMES. iNMES was developed to recruit different MU populations with every other stimulus pulse, with a goal of reducing discharge frequencies and muscle fatigue.

METHODS

Torque and electromyography were recorded during fatigue protocols (12 min, 240 contractions) delivered using mNMES, nNMES, and iNMES.

RESULTS

Torque declined significantly 3 min into iNMES and 1 min into both mNMES and nNMES. Torque decreased by 39% during iNMES and by 67% and 58% during mNMES and nNMES, respectively.

CONCLUSIONS

iNMES resulted in less muscle fatigue than mNMES and nNMES. Delivering NMES in ways that reduce MU discharge frequencies holds promise for reducing muscle fatigue during NMES-based rehabilitation. Muscle Nerve, 2016 Muscle Nerve 55: 179-189, 2017.

Direct current stimulation modulates the excitability of the sensory and motor fibres in the human posterior tibial nerve, with a long-lasting effect on the H-reflex

Several studies demonstrated that transcutaneous direct current stimulation (DCS) may modulate central nervous system excitability. However, much less is known about how DC affects peripheral nerve fibres. We investigated the action of DCS on motor and sensory fibres of the human posterior tibial nerve, with supplementary analysis in acute experiments on rats. In forty human subjects, electric pulses at the popliteal fossa were used to elicit either M-waves or H-reflexes in the Soleus, before (15 min), during (10 min) and after (30 min) DCS. Cathodal or anodal current (2 mA) was applied to the same nerve. Cathodal DCS significantly increased the H-reflex amplitude; the post-polarization effect lasted up to ~ 25 min after the termination of DCS. Anodal DCS instead significantly decreased the reflex amplitude for up to ~ 5 min after DCS end. DCS effects on M-wave showed the same polarity dependence but with considerably shorter after-effects, which never exceeded 5 min. DCS changed the excitability of both motor and sensory fibres. These effects and especially the long-lasting modulation of the H-reflex suggest a possible rehabilitative application of DCS that could be applied either to compensate an altered peripheral excitability or to modulate the afferent transmission to spinal and supraspinal structures. In animal experiments, DCS was applied, under anaesthesia, to either the exposed peroneus nerve or its Dorsal Root, and its effects closely resembled those found in human subjects. They validate therefore the use of the animal models for future investigations on the DCS mechanisms.

Time course of interlimb strength transfer after unilateral handgrip training

"Cross-education" is the increase in strength or functional performance of an untrained limb after unilateral training. A major limitation for clinical translation from unilateral injury includes knowledge on the minimum time for the emergence of crossed effects. Therefore, the primary purpose was to characterize the time course of bilateral strength changes during both "traditional" ( n = 11) and "daily" ( n = 8) unilateral handgrip training in neurologically intact participants. Traditional training included five sets of five maximal voluntary handgrip contractions 3 times/wk for 6 wk whereas daily training included the same number of sessions and contractions but over 18 consecutive days. Three pre- and one posttest session evaluated strength, muscle activation, and reflex excitability bilaterally. Time course information was assessed by recording handgrip force for every contraction in the trained limb and from a single contraction on every third training session in the untrained limb. Six weeks of traditional training increased handgrip strength in the trained limb after the 9th session whereas the untrained limb was stronger after the 12th session. This was accompanied by increased peak muscle activation and bilateral alterations in Hoffmann reflex excitability. Daily training revealed a similar number of sessions (15) were required to induce significant strength gains in the untrained limb (7.8% compared with 12.5%) in approximately half the duration of traditional training. Therefore, minimizing rest days may improve the efficiency of unilateral training when the trained limb is not the focus. Establishing a "dose" for the time course of adaptation to strength training is paramount for effective translation to rehabilitative interventions. NEW & NOTEWORTHY Unilateral handgrip training using a "traditional" protocol (3 times/wk; 6 wk) increased strength bilaterally after 9 (trained arm) and 12 (untrained arm) sessions. "Daily" training (18 consecutive days) increased strength in the untrained limb in a similar number of training sessions, which was accomplished in approximately half the time. Within clinical populations when the focus is on the untrained limb, reducing rest days may optimize the recovery of strength.

Increases in M-wave latency of biceps brachii after elbow flexor eccentric contractions in women

PURPOSE

Eccentric contractions (ECCs) induce muscle damage that is indicated by prolonged loss of muscle function and delayed onset muscle soreness. It is possible that ECCs affect motor nerves, and this may contribute to the prolonged decreases in force generating capability. The present study investigated the hypothesis that M-wave latency of biceps brachii would be increased after maximal elbow flexor ECCs resulting in prolonged loss of muscle strength.

METHODS

Fifteen women performed exercise consisting of 60 maximal ECCs of the elbow flexors using their non-dominant arm. M-wave latency was assessed by the time taken from electrical stimulation applied to the Erb's point to the onset of M-wave of the biceps brachii before, immediately after, and 1-4 days after exercise. Maximal voluntary isometric contraction (MVC) torque, range of motion (ROM) and muscle soreness using a numerical rating scale were also assessed before and after exercise.

RESULTS

Prolonged decreases in MVC torque (1-4 days post-exercise: -54 to -15 %) and ROM (1-2 days: -32 to -22 %), and increased muscle soreness (peak: 4.2 out of 10) were evident after exercise (p < 0.05). The M-wave latency increased (p < 0.01) from 5.8 ± 1.0 ms before exercise to 6.5 ± 1.7 ms at 1 day and 7.2 ± 1.5 ms at 2 days after exercise for the exercised arm only. No significant changes in M-wave amplitude were evident after exercise.

CONCLUSION

The increased M-wave latency did not fully explain the prolonged decreases in MVC torque after eccentric exercise, but may indicate reversible motor nerve impairment.

Muscle Fatigue Affects the Interpolated Twitch Technique When Assessed Using Electrically-Induced Contractions in Human and Rat Muscles

The interpolated twitch technique (ITT) is the gold standard to assess voluntary activation and central fatigue. Yet, its validity has been questioned. Here we studied how peripheral fatigue can affect the ITT. Repeated contractions at submaximal frequencies were produced by supramaximal electrical stimulations of the human adductor pollicis muscle in vivo and of isolated rat soleus fiber bundles; an extra stimulation pulse was given during contractions to induce a superimposed twitch. Human muscles fatigued by repeated 30-Hz stimulation trains (3 s on–1 s off) showed an ~80% reduction in the superimposed twitch force accompanied by a severely reduced EMG response (M-wave amplitude), which implies action potential failure. Subsequent experiments combined a less intense stimulation protocol (1.5 s on–3 s off) with ischemia to cause muscle fatigue, but which preserved M-wave amplitude. However, the superimposed twitch force still decreased markedly more than the potentiated twitch force; with ITT this would reflect increased “voluntary activation.” In contrast, the superimposed twitch force was relatively spared when a similar protocol was performed in rat soleus bundles. Force relaxation was slowed by >150% in fatigued human muscles, whereas it was unchanged in rat soleus bundles. Accordingly, results similar to those in the human muscle were obtained when relaxation was slowed by cooling the rat soleus muscles. In conclusion, our data demonstrate that muscle fatigue can confound the quantification of central fatigue using the ITT.

H-reflexes reduce fatigue of evoked contractions after spinal cord injury

INTRODUCTION

Neuromuscular electrical stimulation (NMES) over a muscle belly (mNMES) generates contractions predominantly through M-waves, while NMES over a nerve trunk (nNMES) can generate contractions through H-reflexes in people who are neurologically intact. We tested whether the differences between mNMES and nNMES are present in people with chronic motor-complete spinal cord injury and, if so, whether they influence contraction fatigue.

METHODS

Plantar-flexion torque and soleus electromyography were recorded from 8 participants. Fatigue protocols were delivered using mNMES and nNMES on separate days.

RESULTS

nNMES generated contractions that fatigued less than mNMES. Torque decreased the least when nNMES generated contractions, at least partly through H-reflexes (n = 4 participants; 39% decrease), and torque decreased the most when contractions were generated through M-waves, regardless of NMES site (nNMES 71% decrease, n = 4; mNMES, 73% decrease, n = 8).

CONCLUSIONS

nNMES generates contractions that fatigue less than mNMES, but only when H-reflexes contribute to the evoked contractions.

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.

Wide-pulse, high-frequency, low-intensity neuromuscular electrical stimulation has potential for targeted strengthening of an intrinsic foot muscle: a feasibility study

Background

Strengthening the intrinsic foot muscles is a poorly understood and largely overlooked area. In this study, we explore the feasibility of strengthening m. abductor hallucis (AH) with a specific paradigm of neuromuscular electrical stimulation; one which is low-intensity in nature and designed to interleave physiologically-relevant low frequency stimulation with high-frequencies to enhance effective current delivery to spinal motoneurones, and enable a proportion of force produced by the target muscle to be generated from a central origin. We use standard neurophysiological measurements to evaluate the acute (~ 30 min) peripheral and central adaptations in healthy individuals.

Methods

The AH in the dominant foot of nine healthy participants was stimulated with 24 × 15 s trains of square wave (1 ms), constant current (150% of motor threshold), alternating (20 Hz–100 Hz) neuromuscular electrical stimulation interspersed with 45 s rest. Prior to the intervention, peripheral variables were evoked from the AH compound muscle action potential (M_wave) and corresponding twitch force in response to supramaximal (130%) medial plantar nerve stimulation. Central variables were evoked from the motor evoked potential (MEP) in response to suprathreshold (150%) transcranial magnetic stimulation of the motor cortex corresponding to the AH pathway. Follow-up testing occurred immediately, and 30 min after the intervention. In addition, the force-time-integrals (FTI) from the 1st and 24th WPHF trains were analysed as an index of muscle fatigue. All variables except FTI (T-test) were entered for statistical analysis using a single factor repeated measures ANOVA with alpha set at 0.05.

Results

FTI was significantly lower at the end of the electrical intervention compared to that evoked by the first train (p < 0.01). Only significant peripheral nervous system adaptations were observed, consistent with the onset of low-frequency fatigue in the muscle. In most of these variables, the effects persisted for 30 min after the intervention.

Conclusions

An acute session of wide-pulse, high-frequency, low-intensity electrical stimulation delivered directly to abductor hallucis in healthy feet induces muscle fatigue via adaptations at the peripheral level of the neuromuscular system. Our findings would appear to represent the first step in muscle adaptation to training; therefore, there is potential for using WPHF for intrinsic foot muscle strengthening.

Electronic supplementary material

The online version of this article (10.1186/s13047-018-0258-1) contains supplementary material, which is available to authorized users.

Neural and contractile determinants of burst-like explosive isometric contractions of the knee extensors

Walking and running are based on rapid burst-like muscle contractions. Burst-like contractions generate a Gaussian-shaped force profile, in which neuromuscular determinants have never been assessed. We investigated the neural and contractile determinants of the rate of force development (RFD) in burst-like isometric knee extensions. Together with maximal voluntary force (MVF), voluntary and electrically evoked (8 stimuli at 300 Hz, octets) forces were measured in the first 50, 100, and 150 ms of burst-like quadriceps contractions in 24 adults. High-density surface electromyography (HDsEMG) was adopted to measure the root mean square (RMS) and muscle fiber conduction velocity (MFCV) from the vastus lateralis and medialis. The determinants of voluntary force at 50, 100, and 150 ms were assessed by stepwise multiple regression analysis. Force at 50 ms was explained by RMS (R²  = 0.361); force at 100 ms was explained by octet (R²  = 0.646); force at 150 ms was explained by MVF (R²  = 0.711) and octet (R²  = 0.061). Peak RFD (which occurred at 60 ± 10 ms from contraction onset) was explained by MVF (R²  = 0.518) and by RMS₅₀ (R²  = 0.074). MFCV did not emerge as a determinant of RFD. Muscle excitation was the sole determinant of early RFD (50 ms), while contractile characteristics were more relevant for late RFD (≥100 ms). As peak RFD is mostly determined by MVF, it may not be more informative than MVF itself. Therefore, a time-locked analysis of RFD provides more insights into the neuromuscular characteristics of explosive contractions.

Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

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.

Intramuscular Contributions to Low-Frequency Force Potentiation Induced by a High-Frequency Conditioning Stimulation

Electrically-evoked low-frequency (submaximal) force is increased immediately following high-frequency stimulation in human skeletal muscle. Although central mechanisms have been suggested to be the major cause of this low-frequency force potentiation, intramuscular factors might contribute. Thus, we hypothesized that two intramuscular Ca²⁺-dependent mechanisms can contribute to the low-frequency force potentiation: increased sarcoplasmic reticulum Ca²⁺ release and increased myofibrillar Ca²⁺ sensitivity. Experiments in humans were performed on the plantar flexor muscles at a shortened, intermediate, and long muscle length and electrically evoked contractile force and membrane excitability (i.e., M-wave amplitude) were recorded during a stimulation protocol. Low-frequency force potentiation was assessed by stimulating with a low-frequency tetanus (25 Hz, 2 s duration), followed by a high-frequency tetanus (100 Hz, 2 s duration), and finally followed by another low-frequency (25 Hz, 2 s duration) tetanus. Similar stimulation protocols were performed on intact mouse single fibers from flexor digitorum brevis muscle, whereby force and myoplasmic free [Ca²⁺] ([Ca²⁺]_i) were assessed. Our data show a low-frequency force potentiation that was not muscle length-dependent in human muscle and it was not accompanied by any increase in M-wave amplitude. A length-independent low-frequency force potentiation could be replicated in mouse single fibers, supporting an intramuscular mechanism. We show that at physiological temperature (31°C) this low-frequency force potentiation in mouse fibers corresponded with an increase in sarcoplasmic reticulum (SR) Ca²⁺ release. When mimicking the slower contractile properties of human muscle by cooling mouse single fibers to 18°C, the low-frequency force potentiation was accompanied by minimally increased SR Ca²⁺ release and hence it could be explained by increased myofibrillar Ca²⁺ sensitivity. Finally, introducing a brief 200 ms pause between the high- and low-frequency tetanus in human and mouse muscle revealed that the low-frequency force potentiation is abolished, arguing that increased myofibrillar Ca²⁺ sensitivity is the main intramuscular mechanism underlying the low-frequency force potentiation in humans.

Non-uniform recruitment along human rectus femoris muscle during transcutaneous electrical nerve stimulation

PURPOSE

To test the hypothesis that motor units with different axonal excitability levels are localized in specific portions of the rectus femoris (RF) muscle using transcutaneous electrical nerve stimulation.

METHODS

M-waves were elicited by transcutaneous electrical nerve stimulation and detected from 24 sites along longitudinal line of the muscle. The stimulation was applied to the femoral nerve, and the current level was gradually increased.

RESULTS

The central locus activation, which is calculated from the spatial distribution of M-waves, appeared at the proximal regions at low stimulation level and then moved to the middle site of the muscle with an increase in the stimulation level. The results reveal that groups of motor units activated at different stimulation levels are located in different positions in the proximal-distal muscle direction.

CONCLUSION

Our results suggest that motor unit properties in proximal and other regions are not uniform within the RF muscle.

Interleaved neuromuscular electrical stimulation after spinal cord injury

INTRODUCTION

Neuromuscular electrical stimulation (NMES) over a muscle belly (mNMES) recruits superficial motor units (MUs) preferentially, whereas NMES over a nerve trunk (nNMES) recruits MUs evenly throughout the muscle. We performed tests to determine whether "interleaving" pulses between the mNMES and nNMES sites (iNMES) reduces the fatigability of contractions for people experiencing paralysis because of chronic spinal cord injury.

METHODS

Plantar flexion torque and soleus electromyography (M-waves) were recorded from 8 participants. A fatigue protocol (75 contractions; 2 s on/2 s off for 5 min) was delivered by iNMES. The results were compared with previously published data collected with mNMES and nNMES in the same 8 participants.

RESULTS

Torque declined ∼40% more during mNMES than during nNMES or iNMES. M-waves declined during mNMES but not during nNMES or iNMES.

DISCUSSION

To reduce fatigability of electrically evoked contractions of paralyzed plantar flexors, iNMES is equivalent to nNMES, and both are superior to mNMES. Muscle Nerve 56: 989-993, 2017.

Knee joint angle and vasti muscle electromyograms during fatiguing contractions

We compared vasti muscle electromyograms for two knee joint angles during fatiguing tetanic contractions. Tetanic contraction of the knee extensors was evoked for 70 s by electrical stimulation of the femoral nerve at knee joint angles of 60° (extended, with 0° indicating full extension) and 110° (flexed) in eight healthy men. Surface electromyography was recorded from the vastus intermedius (VI), vastus lateralis (VL) and vastus medialis (VM) muscles. Knee extension force and M-wave amplitudes and durations were calculated every 7 s, which were normalized by the initial value. Normalized knee extension force was decreased at the flexed knee joint angle compared with that of the extended knee joint angle (P<0·05). Decreased normalized M-wave amplitude and increased normalized M-wave duration of the VI were greater at the flexed knee joint angle than the extended knee joint angle (P<0·05), whereas those for the VL and VM were similar (P>0·05). These results suggest that peripheral fatigue profiles of the VI might be greater at the flexed than the extended knee joint angles, but that of VL and VM might be similar in the tested range of knee joint angles (i.e. 60°-110°) during continuous tetanic contraction induced by electrical stimulation. Therefore, greater reduction of knee extension force at the flexed knee joint angle than the extended knee joint angle may reflect fatigue development of the VI more than other quadriceps femoris components.

Effect of Ankle Angles on the Soleus H-Reflex Excitability During Standing

This study investigated effects of ankle joint angle on the Hoffman's reflex (H-reflex) excitability during loaded (weight borne with both legs) and unloaded (full body weight borne with the contralateral leg) standing in people without neurological injuries. Soleus H-reflex/M-wave recruitment curves were examined during upright standing on three different slopes that imposed plantar flexion (-15°), dorsiflexion (+15°), and neutral (0°) angles at the ankle, with the test leg loaded and unloaded. With the leg loaded and unloaded, maximum H-reflex/maximum M-wave ratio of -15° was significantly larger than those of 0° and +15° conditions. The maximum H-reflex/maximum M-wave ratios were 51%, 43%, and 41% with loaded and 56%, 46%, and 44% with unloaded for -15°, 0°, and +15° slope conditions, respectively. Thus, limb loading/unloading had limited impact on the extent of influence that ankle angles exert on the H-reflex excitability. This suggests that task-dependent central nervous system control of reflex excitability may regulate the influence of sensory input on the spinal reflex during standing.

Eccentric contraction-induced muscle damage in human flexor pollicis brevis is accompanied by impairment of motor nerve

BACKGROUND

Eccentric contractions (ECCs) cause muscle damage. In addition, we showed that ECCs induce nerve dysfunction and damage with rats and human.

PURPOSE

We aimed to evaluate motor nerve conduction velocity (MCV) for flexor pollicis brevis muscle (FPBM) after ECCs.

METHODS

Twelve men (years, 19.8 ± 1.7 years; height, 172.4 ± 7.0 cm; weight, 64.0 ± 8.6 kg) performed maximal 100 ECCs on their FPBM of non-dominant hands with torque dynamometer. The dominant hands were control (CON). Maximal voluntary contraction (MVC), range of motion (ROM), DOMS, and MCV were assessed before, immediately post, and 1, 2, and 5 days after ECCs. MCV was calculated as the distance by stimulation divided by the latencies of the waveforms generated. Values were statistically analyzed by two-way ANOVA, and the significance level was set at P < .05.

RESULTS

Decreases in MVC immediately (-32.9%) to 5 days after ECCs were significantly greater (P < .05) than for the CON group. ROM showed a significant decrease immediately (-21.6%) after ECCs compared with before ECCs and CON group (P < .05). DOMS after ECCs increased at 1 and 2 days (5.0 cm) after ECCs compared with before ECCs and CON (P < .05). Also, MCV after ECCs delayed significantly from immediately (-36.4%), 1, 2, and 5 days after ECCs compared with CON (P < .05), while no significant change in M-wave amplitude was observed over time for both ECCs and CON.

CONCLUSION

The present study showed that ECCs of the FPBM cause a significant delay in MCV of median nerve.

Muscle fibre conduction velocity varies in opposite directions after short- vs. long-duration muscle contractions

INTRODUCTION

The effects of muscle contractions on muscle fibre conduction velocity have normally been investigated for contractions of a given duration and intensity, with most studies being focused on the decline on conduction velocity during/after prolonged contractions. Herein, we perform a systematic analysis of the changes in conduction velocity after voluntary contractions of different durations and intensities.

METHODS

Conduction velocity was estimated in the vastus lateralis before and after knee extensor isometric maximal voluntary contractions (MVCs) of 1, 3, 6, 10, 30 and 60 s, and after brief (3 s) contractions at 10, 30, 50, 70, and 90% of MVC force. Measurements were made during the 10-min period following each contraction.

RESULTS

(1) Conduction velocity was increased immediately after (1 s) the MVCs of brief (≤ 10 s) duration (12 ± 2%, P < 0.05), and then returned rapidly (within 15 s) to control levels; (2) the extent of the increase in conduction velocity was similar after the 3-s, 6-s, and 10-s MVCs (P > 0.05); (3) the magnitude of the increase in conduction velocity after a brief contraction augmented with the intensity of the contraction (increases of 4.6, 7.7, 11.4, 14.8, and 15.2% for contractions at 10, 30, 50, 70, and 90% of MVC force, respectively); (4) conduction velocity was not decreased immediately after the 30-s MVC (P > 0.05); and (5) conduction velocity did not reach its minimum 1 s after the long (≥ 30 s) MVCs.

CONCLUSIONS

Brief (≤ 10 s) muscle contractions induce a short-term increase in conduction velocity, lasting 15 s, while long (≥ 30 s) contractions produce a long-term decrease in conduction velocity, lasting more than 2 min.

Neuromuscular recruitment pattern in motor point stimulation

BACKGROUND

Transcutaneous electrical stimulation on the motor points over muscle belly, i.e., motor point stimulation (MPS), is widely used in clinical settings, however it is not fully understood how MPS recruits motor nerves. Here we investigated the recruitment pattern of the motor nerve and twitch force during MPS and compared to the recruitment during peripheral nerve stimulation (PNS).

METHODS

Ten healthy individuals participated in this study. Using MPS on the soleus muscle and PNS on the tibial nerve, a single pulse stimulation was applied with various stimulation intensities from subthreshold to the maximum intensity. We measured the evoked potentials in the lower leg muscles and twitch force. Between MPS and PNS, we compared the recruitment curves of M-waves and the dynamics of twitch force such as duration from force onset to peak (time-to-peak).

RESULTS

The maximum M-wave was not different between MPS and PNS in the soleus muscle, while it was much smaller in MPS than in PNS in the other lower leg muscles. This reflected the smaller twitch force of plantarflexion in MPS than PNS. In addition, the slope of the recruitment curve for the soleus M-wave was smaller in MPS than PNS.

CONCLUSION

Therefore, unlike PNS, MPS can efficiently and selectively recruit motor nerves of the target muscle and gradually increase the recruitment of the motor nerve.

Sub-threshold depolarizing pre-pulses can enhance the efficiency of biphasic stimuli in transcutaneous neuromuscular electrical stimulation

There is multiple evidence in the literature that a sub-threshold pre-pulse, delivered immediately prior to an electrical stimulation pulse, can alter the activation threshold of nerve fibers and motor unit recruitment characteristics. So far, previously published works combined monophasic stimuli with sub-threshold depolarizing pre-pulses (DPPs) with inconsistent findings—in some studies, the DPPs decreased the activation threshold, while in others it was increased. This work aimed to evaluate the effect of DPPs during biphasic transcutaneous electrical stimulation and to study the possible mechanism underlying those differences. Sub-threshold DPPs between 0.5 and 15 ms immediately followed by biphasic or monophasic pulses were administered to the tibial nerve; the electrophysiological muscular responses (motor-wave, M-wave) were monitored via electromyogram (EMG) recording from the soleus muscle. The data show that, under the specific studied conditions, DPPs tend to lower the threshold for nerve fiber activation rather than elevating it. DPPs with the same polarity as the leading phase of biphasic stimuli are more effective to increase the sensitivity. This work assesses for the first time the effect of DPPs on biphasic pulses, which are required to achieve charge-balanced stimulation, and it provides guidance on the effect of polarity and intensity to take full advantage of this feature.

Graphical abstract

Comparisons in muscle compound action potential parameters measured during standing, walking, and running

The muscle compound action potential (M-wave) has been used as an indicator of peripheral muscle conditions during rest or on isometric muscle contraction. The present study aimed to compare the M-wave parameters during standing, walking, and running. Seventeen young males performed four sets of repeated maximal isometric plantar flexion. Before, after, and between the repeated contraction tasks, M-waves in the soleus muscle were measured during standing, walking, and running. M-waves on walking and running were elicited at the beginning of the swing phase when the soleus muscle was not voluntarily activated. From the detected M-waves, the amplitude, area, and latency for first and second phases were calculated. Amplitudes for first and second phases were not significantly different between standing and walking/running. The area and latency for both phases during walking/running were significantly lower than those during standing (p < 0.05). Significant correlations in amplitude and area were found between standing and walking/running for the first phase (p < 0.05), but not for the second phase (p > 0.05). These results suggest that assessments of the M-wave amplitude for the first phase can be applied to walking and running in the same way as for standing in the soleus muscle.

Myoelectric alterations after voluntary induced high - and low - frequency fatigue

The aim of the study was to find whether voluntary induced high- and low-frequency peripheral fatigue exhibit specific alteration in surface EMG signal (SEMG) during evoked and maximum voluntary contractions. Ten male students of physical education performed 60 s long stretch-shortening cycle (SSC) exercise with maximal intensity and 30 s long concentric (CON) exercise with maximal intensity. To verify voluntary induced peripheral fatigue, knee torques during low- (T20) and high-frequency electrical stimulation (T100) of relaxed vastus lateralis muscle (VL) were obtained. Contractile properties of the VL were measured with passive twitch and maximal voluntary knee extension test (MVC). Changes in M-waves and SEMG during MVC test were used to evaluate the differences in myoelectrical signals. T100/T20 ratio decreased by 10.9 ± 8.4 % (p < 0.01) after the SSC exercise and increased by 35.9 ± 17.5 % (p < 0.001) after the CON exercise. Significant SEMG changes were observed only after the CON exercise where peak to peak time of the M-waves increased by 9.2 ± 13.3 % (p < 0.06), SEMG amplitude during MVC increased by 32.9 ± 21.6 % (p < 0.001) and SEMG power spectrum median frequency decreased by 11.0 ± 10.5 % (p < 0.05). It is concluded that high frequency fatigue wasn't reflected in SEMG, however the SEMG changes after the CON seemed to reflect metabolic changes due to acidosis. Key pointsThe SSC exercise induced high-frequency fatigue which was not reflected in any SEMG change.The CON exercise induced dominantly low-frequency fatigue where only SEMG during MVC changedMuscle fibre membrane excitability was not changed due to low- and high-frequency fatigue but mainly reflected metabolic changes.Changes in muscle compound action potential did not follow those changes seen after electrically elicited HF and LF fatigue.