Fat-free Cross-sectional Area Research Articles

Local heating and cooling with isometric exercise training as a strategy to improve size and performance

The purpose of this study was to explore the effects of local heating and cooling with isometric exercise training of upper arm and forearm. College-aged (n=12; 21±1 y) volunteers performed 4-wk isometric exercise training of the non-dominant arm (upper arm, isometric bicep curl; forearm, handgrip), while the dominant arm served as the control. Training was performed 3x/wk and consisted of 1 set of isometric handgrip and bicep curl until volitional exhaustion at 60% pre-training MVC for the forearm (handgrip) and 1RM for the upper arm (bicep curl). Randomized ordering of heating (40°C; 15 min) and cooling (12°C; 15 min) preceded each training session. Indirect assessment of muscle size (fat-free cross-sectional area [FFCSA]) was made before and after the training period via skin fold and limb circumference measures. Biceps 1RM increased significantly (p < 0.05) after the intervention in both conditions (trained: +6%; control: +7%), whereas only the control arm increased time to fatigue (+40%; p < 0.05). FFSCA of the upper arm remained unchanged (p>0.05) in both conditions. An effect of time was noted for forearm MVC (+8%; p < 0.05), while both groups increased (p < 0.05) time to fatigue (trained: +82%; control: +64%). A trend toward an effect of time was also noted for FFCSA of the forearm (+3%; p <.10). While the intervention employed here led to many notable adaptations, the thermal stress did not appear to exert a clear benefit. Coupled with the practicality and feasibility, improving size and performance in such a short time frame has therapeutic and ergogenic aid implications.

Population-based cohort imaging: skeletal muscle mass by magnetic resonance imaging in correlation to bioelectrical-impedance analysis.

BackgroundSkeletal muscle mass is subjected to constant changes and is considered a good predictor for outcome in various diseases. Bioelectrical‐impedance analysis (BIA) and magnetic resonance imaging (MRI) are approved methodologies for its assessment. However, muscle mass estimations by BIA may be influenced by excess intramuscular lipids and adipose tissue in obesity. The objective of this study was to evaluate the feasibility of quantitative assessment of skeletal muscle mass by MRI as compared with BIA.MethodsSubjects from a population‐based cohort underwent BIA (50 kHz, 0.8 mA) and whole‐body MRI including chemical‐shift encoded MRI (six echo times). Abdominal muscle mass by MRI was quantified as total and fat‐free cross‐sectional area by a standardized manual segmentation‐algorithm and normalized to subjects' body height2 (abdominal muscle mass indices: AMMIMRI).ResultsAmong 335 included subjects (56.3 ± 9.1 years, 56.1% male), 95 (28.4%) were obese (BMI ≥ 30 kg/m2). MRI‐based and BIA‐based measures of muscle mass were strongly correlated, particularly in non‐obese subjects [r < 0.74 in non‐obese (P < 0.001) vs. r < 0.56 in obese (P < 0.001)]. Median AMMITotal(MRI) was significantly higher in obese as compared with non‐obese subjects (3246.7 ± 606.1 mm2/m2 vs. 2839.0 ± 535.8 mm2/m2, P < 0.001, respectively), whereas the ratio AMMIFat‐free/AMMITotal (by MRI) was significantly higher in non‐obese individuals (59.3 ± 10.1% vs. 53.5 ± 10.6%, P < 0.001, respectively). No significant difference was found regarding AMMIFat‐free(MRI) (P = 0.424). In analyses adjusted for age and sex, impaired glucose tolerance and measures of obesity were significantly and positively associated with AMMITotal(MRI) and significantly and inversely with the ratio AMMIFat‐free(MRI)/AMMITotal(MRI) (P < 0.001).ConclusionsMRI‐based assessment of muscle mass is feasible in population‐based imaging and strongly correlated with BIA. However, the observed weaker correlation in obese subjects may explain the known limitation of BIA in obesity and promote MRI‐based assessments. Thus, skeletal muscle mass parameters by MRI may serve as practical imaging biomarkers independent of subjects' body weight.

P.277Muscle contractility in spinobulbar muscular atrophy

Spinobulbar muscular atrophy (SBMA) is caused by a trinucleotide repeat expansion in the androgen receptor gene on the X chromosome. There is a toxic effect of the mutant receptor on muscle and neurons resulting in muscle weakness and atrophy. The weakness can be explained by wasting due to loss of muscle cells, but it is unknown whether weakness also relates to poor muscle contractility of the remaining musculature. In this study, we investigated the muscle contractility in SBMA. We used stationary dynamometry and quantitative MRI to assess muscle strength and absolute and fat-free, cross-sectional areas. Specific muscle force (strength per cross-sectional area) and contractility (strength per fat-free cross-sectional area) were compared with healthy controls and their relation to walking distance and disease severity was investigated. Specific force was reduced by 14–49% in SBMA patients compared to healthy controls. Contractility was reduced by 22–39% in elbow flexion, knee extension, ankle dorsi- and plantarflexion in SBMA patients. The contractility decreased with increasing muscle fat content in muscles with affected contractility in SBMA. The decreased muscle contractility in SBMA may relate to motor neuron degeneration and changed fibre type distribution and muscle architecture.

Muscle contractility in spinobulbar muscular atrophy

Spinobulbar muscular atrophy (SBMA) is caused by a trinucleotide repeat expansion in the androgen receptor gene on the X chromosome. There is a toxic effect of the mutant receptor on muscle and neurons resulting in muscle weakness and atrophy. The weakness can be explained by wasting due to loss of muscle cells, but it is unknown whether weakness also relates to poor muscle contractility of the remaining musculature. In this study, we investigated the muscle contractility in SBMA. We used stationary dynamometry and quantitative MRI to assess muscle strength and absolute and fat-free, cross-sectional areas. Specific muscle force (strength per cross-sectional area) and contractility (strength per fat-free cross-sectional area) were compared with healthy controls and their relation to walking distance and disease severity was investigated. Specific force was reduced by 14–49% in SBMA patients compared to healthy controls. Contractility was reduced by 22–39% in elbow flexion, knee extension, ankle dorsi- and plantarflexion in SBMA patients. The contractility decreased with increasing muscle fat content in muscles with affected contractility in SBMA. The decreased muscle contractility in SBMA may relate to motor neuron degeneration and changed fibre type distribution and muscle architecture.

Comparison of MRI-defined back muscles volume between patients with ankylosing spondylitis and control patients with chronic back pain: age and spinopelvic alignment matched study.

To compare MRI-defined back muscle volume between AS patients and age, and spinopelvic alignment matched control patients with chronic back pain. 51 male patients with AS were enrolled. Age and spinopelvic alignment matched controls (male) were found among non-AS patients with chronic back pain. After matching procedure, fully matched controls were found in 31 of 51 AS patients (60.8%), who represent AS patients without deformity. However, matched controls were not found in 20 of 51 AS patients (39.2%), who represent AS patients with deformity. MRI parameters of back muscle (paraspinal muscle and psoas muscle) at L4/5 disc level including cross-sectional area (CSA) and fat-free cross-sectional area (FCSA) were compared between AS patients and matched controls. Covariates, including BMI, self-reported physical activity, and the presence of chronic disease, which can influence back muscle volume, were also investigated. There were no statistical differences in age, body mass index, score of back pain (NRS), and spinopelvic alignment, and physical activity between matched AS patients and control patients except for duration of back pain. All MRI parameters for paraspinal muscle volume in matched AS patients (without deformity) were significantly less than those of control patients, and significantly larger than those of non-matched AS patients (with deformity). Body size adjusted MRI parameters (relative CSA and relative FCSA) of paraspinal muscle showed strong correlations with lumbar lordosis and sacral slope. Such relationship between paraspinal muscle and spinopelvic parameters remained significant even after multivariate adjustment. AS patients without deformity already have decreased paraspinal muscle volume compared with age and spinopelvic alignment matched non-AS patients with chronic back pain. Such decrease in paraspinal muscle volume was significantly associated with kyphotic deformity of AS patients even after multivariate adjustment. Although the result of our study supports the causal relationship between muscle degeneration and kyphotic deformity in AS patients, further study is required to prove the causality.

Computed tomographic analysis of the quality of trunk muscles in asymptomatic and symptomatic lumbar discectomy patients

BackgroundNo consensus exists on how rehabilitation programs for lumbar discectomy patients with persistent complaints after surgery should be composed. A better understanding of normal and abnormal postoperative trunk muscle condition might help direct the treatment goals.MethodsA three-dimensional CT scan of the lumbar spine was obtained in 18 symptomatic and 18 asymptomatic patients who had undergone a lumbar discectomy 42 months to 83 months (median 63 months) previously. The psoas muscle (PS), the paraspinal muscle mass (PA) and the multifidus muscle (MF) were outlined at the L3, L4 and L5 level. Of these muscles, fat free Cross Sectional Area (CSA) and fat CSA were determined. CSA of the lumbar erector spinae (LES = longissimus thoracis + iliocostalis lumborum) was calculated by subtracting MF CSA from PA CSA. Mean muscle CSA of the left and right sides was calculated at each level. To normalize the data for interpersonal comparison, the mean CSA was divided by the CSA of the L3 vertebral body (mCSA = normalized fat-free muscle CSA; fCSA = normalized fat CSA). Differences in CSA between the pain group and the pain free group were examined using a General Linear Model (GLM). Three levels were examined to investigate the possible role of the level of operation.ResultsIn lumbar discectomy patients with pain, the mCSA of the MF was significantly smaller than in pain-free subjects (p = 0.009) independently of the level. The mCSA of the LES was significantly smaller in pain patients, but only on the L3 slice (p = 0.018). No significant difference in mCSA of the PS was found between pain patients and pain-free patients (p = 0.462). The fCSA of the MF (p = 0.186) and of the LES (p = 0.256) were not significantly different between both populations. However, the fCSA of the PS was significantly larger in pain patients than in pain-free patients. (p = 0.012).The level of operation was never a significant factor.ConclusionsCT comparison of MF, LES and PS muscle condition between lumbar discectomy patients without pain and patients with protracted postoperative pain showed a smaller fat-free muscle CSA of the MF at all levels examined, a smaller fat- free muscle CSA of the LES at the L3 level, and more fat in the PS in patients with pain. The level of operation was not found to be of importance. The present results suggest a general lumbar muscle dysfunction in the pain group, in particular of the deep stabilizing muscle system.

Functional relationships of central and peripheral muscle alterations in multiple sclerosis.

The functional implications of central motor impairment and peripheral muscle alterations in multiple sclerosis are unclear. Muscle strength, central and peripheral activation, and symptomatic fatigue were investigated in 16 patients with multiple sclerosis (MS) and 18 control subjects. Voluntary and electrically stimulated isometric contractions were obtained from the ankle dorsiflexor muscles. Maximal voluntary contraction (MVC) was 27% lower in MS patients than controls, although electrically stimulated force was similar. Muscle fat-free cross-sectional area (CSA) was similar in both groups. These data indicate central activation impairment in MS. Such impairment in MS was further demonstrated by decreased foot-tap speed, rate of voluntary force development, and central activation ratio. Peripheral activation changes in MS patients were modest. Although stimulated tetanic force was similar, force relaxation was slower in MS patients compared to controls, resulting in a left-shifted force-frequency relationship in MS. Motor function changes were not associated with fatigue but were associated with impaired ambulation. Thus, weakness and walking impairment, but not fatigue, were related to impaired central activation in MS. These findings may help optimize rehabilitation strategies designed to improve function in persons with MS.

Muscle energy metabolism and nutritional status in patients with chronic obstructive pulmonary disease. A 31P magnetic resonance study.

We investigated the relationship between nutritional status and muscle energy metabolism during exercise in 18 male patients with chronic obstructive pulmonary disease (COPD) and 15 male control subjects using 31P nuclear magnetic resonance spectroscopy (31P-MRS). The patients and control subjects were further categorized as in either a well-nourished (% ideal body weight, % IBW > or = 90) or malnourished (% IBW < 90) state. Muscle energy metabolism was evaluated by determining the ratios PCr/(PCr + Pi) (PCr, phosphocreatine; Pi, inorganic phosphate), and ATP/(PCr + Pi + ATP). The exercise consisted of repetitive hand grips performed against a load. The work rate was normalized for the individual's lean muscle mass by dividing work performed by the forearm fat-free cross-sectional area, which was calculated using 1H-MRS. The PCr/(PCr + Pi) values during exercise did not correlate with the % IBW in any of the groups of control subjects or COPD patients. Furthermore, the PCr/(PCr + Pi) did not correlate with the normalized work rate in either the well-nourished or malnourished subject groups. However, there were correlations within the groups of control subjects and COPD patients. The PCr/(PCr + Pi) values for the normalized work rate were consistently lower in the COPD patients than in the control subjects. These findings suggest that the altered muscle metabolism in COPD patients is not affected by their nutritional status.

Impact of anthropometric and personal variables on grip strength.

This paper presents the results of a study to evaluate the effects of personal and anthropometric variables on grip strength. Weight, height, frame size, and Fat-Free Cross-Sectional Area (FFCSA) were the anthropometric variables included in the study. Sex and the amount of exercise were the personal variables included. A group of 33 female and 59 male students were used as subjects. A stepwise regression analysis was performed to find a model which can be used to predict grip strength. It was found that the sex and weight are two variables which account for maximum variation in grip strength among these variables. Although, FFCSA (r2 = 0.788) correlated strongly with grip strength but was not chosen in the model, possibly because of lower correlation between FFCSA and sex. Height and weight also seem to correlate with grip strength, but to a lesser extent.