Maximal Isometric Contraction Research Articles

Reliability of ankle dorsiflexor muscle strength, rate of force development, and tibialis anterior electromyography after stroke

Background Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%). Results Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.8 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%). Conclusion The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.

Influence of floor inclination on handle push and pull forces production of the upper limb

Floor inclination can alter hand force production, and lower limb kinetics, affecting control operations, and threatening operator safety in various domains, such as aviation, naval, construction industry, or agriculture. This study investigates the effects of different floor inclinations, on handle push or pull force production. Participants performed maximal isometric contraction tasks requiring to exert a maximal voluntary force either by pulling or pushing a handle, at different floor inclinations from −30° to +30° about the transverse and longitudinal axes. Maximal hand force and Ground Reaction Forces about both feet were recorded. The results revealed non-equivalent variations in hand and feet responses as a function of inclination angle. Specifically, there was a significant reduction in handle push-pull force production, up to 70% (p < 0.001) for extreme inclinations, around both axes. This study provides critical data for design engineers, highlighting the challenge of production forces at steep angles.

Examining Changes in Shoulder Strength, Lower Body Power, and Body Composition among Collegiate Baseball Players after Completion of a Summer Baseball League Season.

The strength of the shoulder musculature involved with internal rotation and arm extension plays an important role in the overhead throwing motion for baseball athletes, both for throwing-related performance and injury risk. The maintenance of shoulder strength is a high priority for baseball athletes throughout a season; however, little is known in regards to the expected changes in strength throughout a season. To examine pre-post changes in shoulder strength, lower body power, and body composition among collegiate baseball players after the completion of a summer baseball league season. Amateur baseball players (n = 12; age: 20.9 ± 1.0 years.; height: 181.6 ± 5.6 cm; body mass: 86.4 ± 11.1 kg; BMI: 26.0 ± 2.6 kg/m2) participated in the current study. Pre- and post-competitive season, the participants completed shoulder strength assessments and body composition and countermovement vertical jump (CMJ) tests. An upper-body isometric test (athletic shoulder [ASH] test) was used to evaluate shoulder strength for each arm. Each subject completed maximal isometric contractions for both the throwing and non-throwing arms at four separate angles of abduction (180°, 'I'; 135°, 'Y'; 90°, 'T'; and -180°, 'A') while lying in a prone position. For shoulder strength, the primary dependent variable of interest was a composite measure that represented the average of the forces produced across all four positions of the ASH test (I, Y, T, A). For the ASH test composite measure, there was a trend toward a significant arm-by-time interaction effect (p = 0.08), as shoulder strength decreased by 9.03% for the throwing arm (ES = 0.72; 95% CI = [-0.27, -0.01]), compared to only 2.03% for the non-throwing arm (ES = 0.15; 95% CI = [-0.16, 0.09]), over the course of the season. The main effects of time (p = 0.16) and arm (p = 0.58) were not significant for the ASH test composite measure. There was no relationship between lower body power and throwing arm strength at baseline (r = 0.20, p = 0.56), and only a non-significant weak relationship at post-test (r = 0.28, p = 0.41). Throughout a season, baseball players may experience reductions in shoulder strength of the throwing arm with minimal changes in shoulder strength in the non-throwing arm.

#2786 Effect of intradialytic virtual reality exercise program on lower limb muscle strength in patients on hemodialysis

Abstract Background and Aims In patients on hemodialysis, muscle weakness is highly prevalent and may lead to frailty, limitation of mobility and functional impairment. Moreover, low muscle strength was associated with an increase in mortality risk in these patients. Despite the fact that some studies showed that resistance training improves muscle strength in patients on hemodialysis, the effects of virtual reality (VR) exercise should be confirmed. Therefore, the aim of this study was to evaluate the effects of an intradialytic non-immersive VR exercise program, performed at different times during the hemodialysis session, on lower limb muscle strength in patients on hemodialysis. Method A randomized clinical trial was conducted with patients aged ≥18 years who were undergoing hemodialysis treatment for at least 3 months. Patients were randomized into 2 protocols of exercise at different times during the hemodialysis session (first 2 hours and last two hours) for 3 months. The intradialytic exercise program in both groups consisted of a non-immersive VR game (Treasure Hunting) in which the patients try to catch treasures and avoid bombs by moving their lower limbs (hip flexion, abduction and adduction, and knee flexion and extension), with a progressive duration of 6 to 36 minutes. The difficulty level of the game was graduated according to the characteristics of each patient. The muscle strength of the hip flexion (HF), hip abduction (HA) and ankle extension (AE) was evaluated using a portable handheld dynamometer during hemodialysis session. Patients were advised to perform a 5 s maximum isometric contraction, and the peak values were recorded for 3 repetitions in both lower limbs. The mean muscle strength of 3 trials was recorded. Data were expressed as the median (interquartile range). The Mann‒Whitney U test was used for between-group comparisons. The Friedman test was conducted to evaluate the differences in medians among the muscle strength data at baseline, after 1, 2 and 3 months of exercise program. Results This study included 11 patients in the exercise within the first 2 hours group [50 (55-75) years, 55% male] and 11 patients in the exercise within the last 2 hours group [64 (58-72) years, 64% male]. Table 1 shows that muscle strength of the HA and AE increased significantly in the exercise within the first 2 hours group. Muscle strength of HF, HA and AE improved significantly in the exercise within the last 2 hours group. There were no significant differences between two groups. Conclusion This study suggests that an intradialytic non-immersive VR exercise program can improve lower limb muscle strength in patients on hemodialysis.

Supraspinal, spinal, and motor unit adjustments to fatiguing isometric contractions of the knee extensors at low and high submaximal intensities in males.

Contraction intensity is a key factor determining the development of muscle fatigue, and it has been shown to induce distinct changes along the motor pathway. The role of cortical and spinal inputs that regulate motor unit (MU) behavior during fatiguing contractions is poorly understood. We studied the cortical, spinal, and neuromuscular response to sustained fatiguing isometric tasks performed at 20% and 70% of the maximum isometric voluntary contraction (MVC), together with MU behavior of knee extensors in healthy active males. Neuromuscular function was assessed before and after performance of both tasks. Cortical and spinal responses during exercise were measured via stimulation of the motor cortex and spinal cord. High-density electromyography was used to record individual MUs from the vastus lateralis (VL). Exercise at 70%MVC induced greater decline in MVC (P = 0.023) and potentiated twitch force compared with 20%MVC (P < 0.001), with no difference in voluntary activation (P = 0.514). Throughout exercise, corticospinal responses were greater during the 20%MVC task (P < 0.001), and spinal responses increased over time in both tasks (P ≤ 0.042). MU discharge rate increased similarly after both tasks (P ≤ 0.043), whereas recruitment and derecruitment thresholds were unaffected (P ≥ 0.295). These results suggest that increased excitability of cortical and spinal inputs might be responsible for the increase in MU discharge rate. The increase in evoked responses together with the higher MU discharge rate might be required to compensate for peripheral adjustments to sustain fatiguing contractions at different intensities.NEW & NOTEWORTHY Changes in central nervous system and muscle function occur in response to fatiguing exercise and are specific to exercise intensity. This study measured corticospinal, neuromuscular, and motor unit behavior to fatiguing isometric tasks performed at different intensities. Both tasks increased corticospinal excitability and motor unit discharge rate. Our findings suggest that these acute adjustments are required to compensate for the exercise-induced decrements in neuromuscular function caused by fatiguing tasks.

The effect of high intensity interval training on muscle contractile function 8 weeks following chemically-induced ovarian failure

The negative effects of ovariectomy on muscle contractile function have been well-characterized, however, the effects of gradual ovarian failure (i.e., perimenopausal transition into late-stage menopause) on muscle function over the lifespan have received less attention. Furthermore, whether exercise training can mitigate changes in muscle contractile function associated with menopause is unclear. The objective of this study, using a chemically-induced ovarian failure mouse model (4-vinylcyclohexene diepoxide; VCD), was to investigate time-course changes in muscle contractility of sedentary controls and the potential of high intensity interval training to mitigate any deleterious effects of ovarian failure. Starting at 11wks old, mice were injected with 160mg/kg/day of VCD for 15 days. Twenty-eight (VCD-trained: n=10, VCD-sedentary: n=10, control: n=8) CD1 female mice were used in this study, with the VCD-trained group beginning training at the onset of ovarian failure for a total of 8 weeks. Contractile properties of the plantar flexors were assessed using an in-vivo set-up 8 weeks following the onset of ovarian failure. As well, a fatigue task (repeated maximal isometric contractions until torque decreased by 60%) was performed. Recovery was measured immediately after, and up to 10min following task termination. Upon completion of mechanical testing, mice were sacrificed and intact muscle fibres were isolated from the flexor digitorum brevis, and myoplasmic free Ca2+ (tetanic [Ca2+]i) concentrations were measured across stimulation frequencies of 10-200 Hz and throughout 50 tetanic contractions (70Hz) to replicate our fatigue task. There was no difference in pre-fatigue values across groups for peak twitch torque, peak 100Hz torque, RTD, 10:100Hz torque, tetanic [Ca2+]i during low (10Hz) and high Hz (100Hz) stimulation, and all were reduced similarly immediately following the fatigue task. Repetitions to task failure was similar across groups and tetanic [Ca2+]i during repetitive contractions (n=50) was reduced similarly across groups. As well, all groups recovered similarly across these measures. Torque and RTD did not recover fully by 10min for either measure, while 10Hz, 100Hz and 10:100Hz tetanic [Ca2+]i was recovered immediately following the fatigue task. Given 10Hz torque was relatively maintained following the fatigue task, and there was a ~40% decline in 100Hz torque, the 10:100Hz ratio increased throughout recovery — this, combined with the [Ca2+] data indicate that calcium sensitivity and release are unlikely contributors to impaired force production following the fatigue task across groups. The present study aimed to assess the impact of training on muscle contractility using a mouse model of gradual ovarian failure. Unlike other models of ovarian failure, there does not seem to be any impairment in muscular performance at the joint level in our VCD-mice, and they responded similarly across groups in response to repetitive fatiguing contractions and exercise training. Supported by NSERC. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The impact of cerebellar transcranial direct current stimulation on isometric bench press performance in trained athletes

Athletic development centers on optimizing performance, including technical skills and fundamental motor abilities such as strength and speed. Parameters such as maximum contraction force and rate of force development, influence athletic success, although performance gains become harder to achieve as athletic abilities increase. Non-invasive transcranial direct current stimulation of the cerebellum (CB-tDCS) has been used successfully to increase force production in novices, although the potential effects in athletes remain unexplored. The present study examined the effects of CB-tDCS on maximum isometric voluntary contraction force (MVCiso) and isometric rate of force development (RFDiso) during a bench press task in well-trained athletes. 21 healthy, male, strength-trained athletes participated in a randomized, sham-controlled, double-blinded crossover design. Each participant completed the isometric bench press (iBP) task on two separate days, with at least 5 days between sessions, while receiving either CB-tDCS or sham stimulation. Electromyography (EMG) recordings of three muscles involved in iBP were acquired bilaterally to uncover differences in neuromuscular activation and agonist-antagonist co-contraction between conditions. Contrary to our hypothesis, no significant differences in MVCiso and RFDiso were observed between CB-tDCS and sham conditions. Furthermore, no tDCS-induced differences in neuromuscular activation or agonist-antagonist co-contraction were revealed. Here, we argue that the effects of CB-tDCS on force production appear to depend on the individual's training status. Future research should study individual differences in tDCS responses between athletes and novices, as well as the potential of high-definition tDCS for precise brain region targeting to potentially enhance motor performance in athletic populations.

Walking net O2 rises with advancing age in older women: where to go from here?

Walking net O2 tends to increase with advancing age; however, factors contributing to this relationship have not been widely described. The implications of such findings could inform targeted strategies to promote independent mobility in older adults. Herein, we evaluated the relationship between net O2 and age at two submaximal workloads while exploring potential moderators of this relationship. Secondary analyses were performed on 35 older (65 ± 3years) women who completed a battery of physical assessments including fixed-speed, non-graded and graded (+ 2.5%) treadmill walking with indirect calorimetry to determine net O2. Maximal oxygen uptake ( O2max), knee extensor maximal isometric voluntary contraction (MVC), peak rate of torque development (RTD), and plantar flexor range-of-motion (PFROM) were also measured. Bivariate correlations showed non-graded (r = 0.403, p = 0.017) and graded (r = 0.413, p = 0.014) net O2 were positively related to age. Notably, these relationships strengthened after adjusting for O2max. Regression modeling showed age, RTD:MVC ratio (composite of muscle performance), and PFROM together explained 49% and 34% of the variance in non-graded and graded net O2, respectively. Further analyses suggested knee extensor MVC moderates the relationship between non-graded net O2 and age, accounting for 9% of the variance [ΔR2 = 0.090, F (1,31) = 4.13, p = 0.05]. These data support the premise that, in older women, walking net O2 rises with advancing age, and additionally, the RTD:MVC ratio and PFROM are independent correlates of non-graded net O2. Exercise interventions with a high degree of training specificity including explosive, velocity-based elements may promote independent mobility in older women.

Intramuscular injection of mesenchymal stem cells augments basal muscle protein synthesis after bouts of resistance exercise in male mice.

Skeletal muscle mass is critical for activities of daily living. Resistance training maintains or increases muscle mass, and various strategies maximize the training adaptation. Mesenchymal stem cells (MSCs) are multipotent cells with differential potency in skeletal muscle cells and the capacity to secrete growth factors. However, little is known regarding the effect of intramuscular injection of MSCs on basal muscle protein synthesis and catabolic systems after resistance training. Here, we measured changes in basal muscle protein synthesis, the ubiquitin-proteasome system, and autophagy-lysosome system-related factors after bouts of resistance exercise by intramuscular injection of MSCs. Mice performed three bouts of resistance exercise (each consisting of 50 maximal isometric contractions elicited by electrical stimulation) on the right gastrocnemius muscle every 48 h, and immediately after the first bout, mice were intramuscularly injected with either MSCs (2.0 × 106 cells) labeled with green fluorescence protein (GFP) or vehicle only placebo. Seventy-two hours after the third exercise bout, GFP was detected only in the muscle injected with MSCs with concomitant elevation of muscle protein synthesis. The injection of MSCs also increased protein ubiquitination. These results suggest that the intramuscular injection of MSCs augmented muscle protein turnover at the basal state after consecutive resistance exercise.

The Effect of Resistance Training with Outdoor Fitness Equipment on the Body Composition, Physical Fitness, and Physical Health of Middle-Aged and Older Adults: A Randomized Controlled Trial.

This study examined the effect of outdoor-fitness-equipment-based resistance training on the health parameters of middle-aged and older adults, as well as analyzing the effect of age on the results found. A total of 149 volunteers were randomly assigned to the training (TG) and control (CG) groups. The TG performed two weekly sessions of resistance training for 8 weeks using outdoor fitness equipment, while the CG continued with their regular daily activities. Body composition was measured using DXA, and the maximal isometric voluntary contraction in knee extension, elbow flexion, and hand grip were assessed, along with the 4 m walk test, the Timed Up and Go Test, and the Short Form 36 Health Survey Questionnaire. The TG showed a significant increase in the lean mass index (p = 0.002) and maximal isometric voluntary contraction in both legs (p < 0.001) and arms (p < 0.001), as well as in physical functioning (p < 0.001) and the role physical dimension (p = 0.006) of the Short Form 36 Health Survey Questionnaire, compared to the CG, which showed a decrease in all these variables. In addition, the TG showed a greater decrease in fat mass (p < 0.001), fat mass index (p = 0.003), and the Timed Up and Go Test (p < 0.001) than the CG. Age conditioned the evolution of most of the variables analyzed (p < 0.05). In conclusion, resistance training with outdoor fitness equipment may be useful for improving the health of middle-aged and older adults, although age is a factor that could influence the adaptations found.

Quadriceps composition and function influence downhill gait biomechanics >1 year following anterior cruciate ligament reconstruction

BackgroundQuadriceps dysfunction is common following anterior cruciate ligament reconstruction and contributes to aberrant gait biomechanics. Changes in quadriceps composition also occur in these patients including greater concentrations of non-contractile tissue. The purpose of this study was to evaluate associations between quadriceps composition, function, and gait biomechanics in individuals with anterior cruciate ligament reconstruction. MethodsForty-eight volunteers with anterior cruciate ligament reconstruction completed gait biomechanics and quadriceps function and composition assessments. Gait biomechanics were sampled during downhill walking (−10° slope) on an instrumented treadmill. Quadriceps function (peak torque and rate of torque development) was assessed via maximal isometric contractions, while composition was evaluated via ultrasound echo intensity. FindingsGreater quadriceps peak torque was associated with a greater peak knee extension moment (r = 0.365, p = 0.015). Greater vastus lateralis echo intensity (i.e. poorer muscle quality) was associated with less knee flexion displacement (r = −0.316, p = 0.032). Greater echo intensity of the vastus lateralis (r = −0.298, p = 0.044) and rectus femoris (r = −0.322, p = 0.029) was associated with a more abducted knee angle at heel strike. Quadriceps peak torque explained 11–16% of the variance in echo intensity. InterpretationBoth quadriceps function and composition influence aberrant gait biomechanics following anterior cruciate ligament reconstruction. Quadriceps composition appears to provide insight into quadriceps dysfunction independent of muscle strength, as they associated with different gait biomechanics outcomes and shared minimal variance. Future research is necessary to determine the influence of changes in quadriceps composition on joint health outcomes.

Postactivation Performance Enhancement With Maximal Isometric Contraction on Power-Clean Performance Across Multiple Sets.

This study investigated the postactivation performance-enhancement effect of maximal voluntary isometric contraction (MVIC) at the starting position on power-clean performance over a series of contrast sets. Eighteen male (age: 31 [3.7]y, body mass: 76.8 [9.1]kg, height: 175.0 [5.2]cm) and 2 female (age: 27.5 [3.5]y, body mass: 53.3.8 [2.0]kg, height: 158.5 [4.9]cm) resistance-trained individuals performed a contrast postactivation performance-enhancement protocol (isometric contrast training condition [ISO]) consisting of 3 sets of 3 MVICs alternated with 3 power cleans, with an intracontrast rest period of 1minute. A control protocol consisted of 3 sets of 3 power cleans were performed in a separate session. Barbell velocity during the power clean was measured as an indicator of performance. A significant time effect was observed for both mean velocity(MV; P < .001) and peak velocity(PV; P = .008). Time × group (P = .415-.444) and group (P = .158-.210) effects showed no significant difference for either MV or PV. However, differences in MV and PV between the corresponding sets of ISO and control condition exceeded the minimum worthwhile change, showing a small to moderate effect (MV: d = 0.38-0.50, PV: d = 0.35-0.50) in favor of ISO. There was no significant difference in rating of perceived exertion between conditions (P = .385, d = 0.22). Power-clean performance was potentiated after 1minute of rest following 3 repetitions of MVIC across 3 sets. Furthermore, the ISO protocol did not result in greater perception of exertion. These results indicate that coaches may incorporate MVICs as the postactivation performance-enhancement stimulus during contrast training involving the power-clean exercise.

Repeated-Sprint Training With Blood-Flow Restriction Improves Repeated-Sprint Ability Similarly to Unrestricted Training at Reduced External Loads.

This study examined performance and physiological adaptations following 3 weeks of repeated-sprint training (RST) with blood-flow restriction (BFR) or without (non-BFR). Twenty-six semiprofessional and amateur adult male team-sport players were assessed for repeated-sprint ability, anaerobic capacity, leg lean mass, neuromuscular function, and maximal aerobic capacity before and after RST. Participants completed 9 cycling RST sessions (3 sets of 5-7 × 5-s sprints, 25-s passive recovery, 3-min rest) over a 3-week period with BFR or non-BFR. During RST sessions, the BFR group demonstrated lower mean power output compared with non-BFR (-14.5%; g = 1.48; P = .001). Significant improvements (P < .05) in mean and peak power output during repeated-sprint ability (+4.1%; g = 0.42, and + 2.2%; g = 0.25, respectively) and anaerobic capacity (+4.8%; g = 0.47, and + 4.7%; g = 0.32, respectively) tests, leg lean mass (+2.0%; g = 0.16), and peak aerobic power (+3.3%; g = 0.25) were observed from pretesting to posttesting without any between-groups differences. No significant changes (P > .05) were observed for maximal isometric voluntary contraction and maximal aerobic capacity. Peak rate of force development decreased (P = .003) in both groups following RST (-14.6%; g = 0.65), without any between-groups differences. Repeated-sprint ability, anaerobic capacity, leg lean mass, and peak aerobic power improved following 3 weeks of RST; however, the addition of BFR did not further enhance adaptations. Interestingly, comparable improvements were achieved between groups despite lower external loads experienced during RST sessions with BFR.

Passive heating-induced changes in muscle contractile function are not further augmented by prolonged exposure in young males experiencing moderate thermal stress.

Background: We investigated the impact of 1) passive heating (PH) induced by single and intermittent/prolonged hot-water immersion (HWI) and 2) the duration of PH, on muscle contractile function under the unfatigued state, and during the development of muscle fatigue. Methods: Twelve young males volunteered for this study consisting of two phases: single phase (SP) followed by intermittent/prolonged phase (IPP), with both phases including two conditions (i.e., four trials in total) performed randomly: control passive sitting (CON) and HWI (44-45°C; water up to the waist level). SP-HWI included one continuous 45-min bath (from 15 to 60min). IPP-HWI included an initial 45-min bath (from 15 to 60min) followed by eight additional 15-min baths interspaced with 15-min breaks at room temperature between 75 and 300min. Intramuscular (Tmu; measured in the vastus lateralis muscle) and rectal (Trec) temperatures were determined. Neuromuscular testing (performed in the knee extensors and flexors) was performed at baseline and 60min later during SP, and at baseline, 60, 90, 150 and 300min after baseline during IPP. A fatiguing protocol (100 electrical stimulations of the knee extensors) was performed after the last neuromuscular testing of each trial. Results: HWI increased Tmu and Trec to 38°C-38.5°C (p < 0.05) during both SP and IPP. Under the unfatigued state, HWI did not affect electrically induced torques at 20Hz (P20) and 100Hz (P100). However, it induced a shift towards a faster contractile profile during both SP and IPP, as evidenced by a decreased P20/P100 ratio (p < 0.05) and an improved muscle relaxation (i.e., reduced half-relaxation time and increased rate of torque relaxation; p < 0.05). Despite a reduced voluntary activation (i.e., -2.63% ± 4.19% after SP-HWI and -5.73% ± 4.31% after IPP-HWI; condition effect: p < 0.001), HWI did not impair maximal isokinetic and isometric contraction torques. During the fatiguing protocol, fatigue index and the changes in muscle contractile properties were larger after HWI than CON conditions (p < 0.05). Finally, none of these parameters were significantly affected by the heating duration. Conclusion: PH induces changes in muscle contractile function which are not augmented by prolonged exposure when thermal stress is moderate.

Leaf spring exercise: A safe quadriceps strengthening exercise after anterior cruciate ligament reconstruction

BackgroundLeg extensions should be avoided in the early stages after anterior cruciate ligament reconstruction because the force exerted by the quadriceps muscle leads to anterior tibial displacement. To allow for safe quadriceps training in the knee extension range during this period, we devised the leaf spring exercise, which involves placing subjects in the prone position with their knee slightly flexed and instructing them to perform maximum isometric quadriceps contractions while supporting the proximal region of the lower leg's anterior surface and immobilizing the femur's posterior surface to prevent lifting. The current study aimed to examine the safety of Leaf spring exercise by determining the femur–tibia relationship using ultrasound imaging. MethodsThis controlled laboratory study included patients with unilateral anterior cruciate ligament-deficient knees (8 men and 8 women; age, 24.2 ± 8.3 years) who were instructed to perform Leaf spring exercise of both lower limbs. We measured the femur–tibia-step-off, which indicates the distance between the last point of the medial and lateral condyles of the femur and posterior margin of the tibial plateau, as a parameter to evaluate anterior tibial displacement via ultrasound diagnostic device. Further, peak torque of the quadriceps muscle was calculated using force measurement device. FindingsNo difference in anterior tibial displacement and peak torque was observed between the uninjured and injured sides during Leaf spring exercise. InterpretationLeaf spring exercise may add some strain on the reconstructed anterior cruciate ligament; hence, it can be considered a safe quadriceps exercise in the knee extension range.

Multimodal and conventional resistance training interventions improve muscle function in older adults: Findings from the Training IMCT study

Age-associated remodeling processes affect the intramuscular connective tissue (IMCT) network, which may significantly impair muscle function. Thus, we aimed to test whether including exercises shown to efficiently target the IMCT to a conventional resistance exercise intervention (CONV) would result in greater functional gains as compared to CONV alone. Fifty-three men and women (66.2 ± 3.3 years) were assigned to either CONV (n = 15), multimodal training (MULTI; n = 17) or a control (CTRL; n = 21) group. All subjects were tested at baseline, and those assigned to CONV or MULTI underwent a 16-week training intervention. The CONV group followed a progressive resistance training program, in which the number of weekly training sessions gradually increased from 1 to 3. In the MULTI group, one of these sessions was replaced with plyometric training, followed by self-myofascial release. Testing included maximal strength and power, imaging-based muscle volume, architecture, and functional performance. The intervention effects were analyzed using two- or three-way repeated measures ANOVA models (α = 0.05). Briefly, the maximal knee extension isometric contraction, one-repetition maximum, and isokinetic peak torque increased in all groups (p < 0.05), albeit to a lesser extent in CTRL. On the other hand, quadriceps femoris muscle volume (p = 0.019) and vastus lateralis pennation angle (p < 0.001) increased only in the MULTI group. Handgrip strength did not change in response to the intervention (p = 0.312), whereas Sit-to-Stand performance improved in all groups after the first 8-wks, but only in MULTI and CONV after 16-wks (all p < 0.001). In conclusion, we found that a resistance training intervention in which one weekly training session is replaced by plyometric training is feasible and as effective as a program consisting solely of conventional strength training sessions for inducing gains in muscle strength and function in older adults. Muscle size and architecture improved only in the MULTI group. German Clinical Trials: DRKS00015750.

Reduction and recovery of self-sustained muscle activity after fatiguing plantar flexor contractions.

Persistent inward calcium and sodium currents (PICs) are crucial for initiation and maintenance of motoneuron firing, and thus muscular force. However, there is a lack of data describing the effects of fatiguing exercise on PIC activity in humans. We simultaneously applied tendon vibration and neuromuscular electrical stimulation (VibStim) before and after fatiguing exercise. VibStim induces self-sustained muscle activity that is proposed to result from PIC activation. Twelve men performed 5-s maximal isometric plantar flexor contractions (MVC) with 5-s rests until joint torque was reduced to 70%MVC. VibStim trials consisted of five 2-s trains of neuromuscular electrical stimulation (20 Hz, evoking 10% MVC) of triceps surae with simultaneous Achilles tendon vibration (115 Hz) without voluntary muscle activation. VibStim was applied before (PRE), immediately (POST), 5-min (POST-5), and 10-min (POST-10) after exercise completion. Sustained torque (Tsust) and soleus electromyogram amplitudes (EMG) measured 3 s after VibStim were reduced (Tsust: -59.0%, p<0.001; soleus EMG: -38.4%, p<0.001) but largely recovered by POST-5, and changes in MVC and Tsust were correlated across the four time points (r=0.69; p<0.001). After normalisation to values obtained at the end of the vibration phase to control for changes in fibre-specific force and EMG signal characteristics, decreases in Tsust (-42.9%) and soleus EMG (-22.6%) remained significant and were each correlated with loss and recovery of MVC (r=0.41 and 0.46, respectively). The parallel changes observed in evoked self-sustained muscle activity and force generation capacity provide motivation for future examinations on the potential influence of fatigue-induced PIC changes on motoneuron output.

External Rotation Strength After TSA in Osteoarthritic Shoulders with Eccentric Deformity Is Not Impacted by Posterior Rotator Cuff Deficiency.

Patients with persistent glenohumeral osteoarthritis symptoms despite nonoperative management may pursue anatomic total shoulder arthroplasty (TSA). TSA revision rates are higher in patients with preoperative eccentric (asymmetric posterior erosion) compared with concentric (symmetric) glenoid deformity. If posterior rotator cuff deficiency demonstrated preoperatively in patients with eccentric deformity persists after TSA, it may manifest as relative weakness in external compared with internal rotation secondary to deficient activity of the shoulder external rotator muscles. Persistent posterior rotator cuff deficiency is hypothesized to contribute to TSA failures. However, it remains unknown whether rotational strength is impaired after TSA in patients with eccentric deformity. Our goal was to determine if patients with eccentric deformity exhibit relative external rotation weakness that may be explained by posterior rotator cuff deficiency after TSA. Patients who were >1 year after TSA for primary glenohumeral osteoarthritis and had had preoperative eccentric or concentric deformity were prospectively recruited. Torque was measured and electromyography was performed during maximal isometric contractions in 26 three-dimensional direction combinations. Relative strength in opposing directions (strength balance) and muscle activity of 6 shoulder rotators were compared between groups. The internal (+) and external (-) rotation component of strength balance did not differ in patients with eccentric (mean internal-external rotation component of strength balance: -7.6% ± 7.4%) compared with concentric deformity (-10.3% ± 6.8%) (mean difference: 2.7% [95% confidence interval (CI), -1.3% to 6.7%]; p = 0.59), suggesting no relative external rotation weakness. Infraspinatus activity was reduced in patients with eccentric (43.9% ± 10.4% of maximum voluntary contraction [MVC]) compared with concentric (51.3% ± 10.4% of MVC) deformity (mean difference: -7.4% [95% CI, -13.4% to -1.4%] of MVC; p = 0.04). A relative external rotation strength deficit following TSA was not found, despite evidence of reduced infraspinatus activity, in the eccentric-deformity group. Reduced infraspinatus activity suggests that posterior rotator cuff deficiencies may persist following TSA in patients with eccentric deformities. Longitudinal study is necessary to evaluate muscle imbalance as a contributor to higher TSA failure rates. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Isometric handgrip exercise training as a potential tool for identifying and regulating blood pressure in young healthy adults

Background: Isometric handgrip (IHG) exercises can be a simple tool and an effective, time-consumable test that may be beneficial for blood pressure (BP) regulation. Hypertension prevention or BP control is necessary nowadays. Isometric exercise evokes the contractions of skeletal muscle without altering their length, but changes in the tension of the muscle occur. Through lifestyle modification, static exercises maintain the desired BP in individuals other than aerobic exercises. Aims and Objectives: The aim of the study was to evaluate the effective changes of isometric handgrip exercise on young, healthy subjects and determine changes in heart rate (HR) and BP before and after exercise. Materials and Methods: A randomized controlled study has been conducted in the department of physiology at JMC Rajasthan for 3 months. The study sample included 72 volunteer subjects (40 male and 32 females) aged 19–25 years, and handgrip spring dynamometers are used for IHE exercise training. The IHE training group performed handgrip exercises for 3 months at 30% of their maximum isometric contraction, 3 times/week for five 3-min bouts with 5-min rest periods between each bout. Before and after the intervention, BP and HR were measured. The P-value was advised significantly at 0.05. Results: At the completion of 3 months of IHE exercise training, significant changes are seen in HR and BP in all healthy volunteers (P &lt; 0.001 for all forms of BP) (HR, P = 0.014). In female volunteer and diastolic BP, it decreases significantly, but no significant changes are seen in systolic BP, mean arterial pressure, and HR. Conclusion: IHG exercise training reduces or regulates baseline BP and HR and explores the potential of this intervention for managing or preventing hypertension.

Characteristics of Skeletal Muscle Strength in Subjects With Interstitial Lung Disease

ObjectivesTo investigate muscle strength and the prevalence of muscle weakness in adults with interstitial lung diseases (ILDs) compared to healthy subjects. DesignCross-sectional (description of clinical features). SettingPublic referral center (University Hospital). ParticipantsOne hundred and twelve adults with ILD (n=48, 60±10yr, 68% female) and healthy counterparts (control group, n=64, 57±10yr, 58% female) (N=112). InterventionNot applicable. Main Outcome Measure(s)Muscle strength and prevalence of muscle weakness in adults with ILD. Muscle strength was assessed via maximal isometric voluntary contraction of dominant upper and lower limb muscle groups. Data from the control group were used to generate reference equations. Muscle weakness was defined as a muscle strength value below the lower limit of normal calculated using data from the control group. Data were expressed as mean ± SD or median [interquartile range] according to the data distribution. ResultsCompared to the control group, adults with ILD had lower muscle strength for all muscle groups assessed (values presented as %predicted: pectoralis major 75[57-86]%; quadriceps 72[58-87]%; latissimus dorsi 76[57-103]%; deltoid 74[64-98]%; biceps brachii 78[64-91]%; triceps brachii 84[62-101]%; P≤.001 for all). Prevalence of muscle weakness in people with ILD was 40% for pectoralis major, 25% for latissimus dorsi, 16% for triceps brachii, 20% for biceps brachii, 27% for deltoid and 46% for quadriceps. ConclusionsAdults with ILD present a generalised reduction in peripheral Muscle strength, ranging between 20% to 46% of people depending on the muscle group assessed. and it was more prevalent in lower limb muscles.