Motor Unit Recruitment Patterns Research Articles

Motor unit properties from three synergistic muscles during ramp isometric elbow extensions

Many tasks require synergistic activation of muscles that possess different architectural, mechanical, and neural control properties. However, investigations of the motor unit (MU) mechanisms which modulate force are mostly restricted to individual muscles and low forces. To explore the pattern of MU recruitment and discharge behavior among three elbow extensors (lateral and long heads of the triceps brachii, and anconeus) during ramp isometric contractions, recruitment thresholds of 77 MUs in five young men were determined and corresponding MU discharge rates were tracked in 1-s epochs over forces ranging from 0 to 75% of maximal voluntary isometric force (MVC). Across all forces, MUs in the lateral head discharged at higher rates than those in the anconeus (p<0.001, Δ=0.23). When all MUs were considered, recruitment thresholds in the long head of the triceps brachii were higher than the lateral head (p<0.05,Δ=0.70) with a trend (p=0.08,Δ=0.48) for higher recruitment thresholds in the long head compared with the anconeus. Together, these data indicate a potential mechanical disadvantage of the long head of the triceps brachii at 0° shoulder flexion. However, among low-threshold MUs (<10% MVC), recruitment thresholds were lower in the anconeus than in both heads of the triceps brachii consistent with the expected twitch contractile and fibertype differences among these muscles. These findings illustrate the importance of considering synergistic relations among muscles used for a coordinated task, and the sensitivity of synergies to muscle architectural, mechanical, and possibly specific synaptic input factors.

Maximum number of repetitions, total weight lifted and neuromuscular fatigue in individuals with different training backgrounds.

The aim of this study was to evaluate the performance, as well as neuromuscular activity, in a strength task in subjects with different training backgrounds. Participants (n = 26) were divided into three groups according to their training backgrounds (aerobic, strength or mixed) and submitted to three sessions: (1) determination of the maximum oxygen uptake during the incremental treadmill test to exhaustion and familiarization of the evaluation of maximum strength (1RM) for the half squat; (2) 1RM determination; and (3) strength exercise, four sets at 80% of the 1RM, in which the maximum number of repetitions (MNR), the total weight lifted (TWL), the root mean square (RMS) and median frequency (MF) of the electromyographic (EMG) activity for the second and last repetition were computed. There was an effect of group for MNR, with the aerobic group performing a higher MNR compared to the strength group (P = 0.045), and an effect on MF with a higher value in the second repetition than in the last repetition (P = 0.016). These results demonstrated that individuals with better aerobic fitness were more fatigue resistant than strength trained individuals. The absence of differences in EMG signals indicates that individuals with different training backgrounds have a similar pattern of motor unit recruitment during a resistance exercise performed until failure, and that the greater capacity to perform the MNR probably can be explained by peripheral adaptations.

Muscle fatigue and muscle weakness: what we know and what we wish we did

Muscle fatigue and muscle weakness: what we know and what we wish we did

Functional adaptations in the skeletal muscle microvasculature to endurance and interval sprint training in the type 2 diabetic OLETF rat

Prevention and treatment of type 2 diabetes includes recommendation to perform aerobic exercise, but evidence indicates that high-intensity exercise training may confer greater benefit. Unique motor recruitment patterns during exercise elicit spatially focused increases in blood flow and subsequent adaptations. Therefore, using 20-wk-old Otsuka Long Evans Tokushima fatty (OLETF) rats with advanced insulin resistance, we examined whether 12 wk of exercise protocols that elicit different motor unit recruitment patterns, endurance exercise (EndEx), and interval sprint training (IST) induce spatially differential effects on endothelial-dependent dilation to acetylcholine (ACh; 1 nM-100 μM) and vasoreactivity to insulin (1-1,000 μIU/ml) in isolated, pressurized skeletal muscle resistance arterioles. Compared with sedentary OLETF rats, EndEx enhanced sensitivity to ACh in second-order arterioles perfusing the "red" (G2A-R) and "white" (G2A-W) portions of the gastrocnemius (EC(50): +36.0 and +31.7%, respectively), whereas IST only increased sensitivity to ACh in the G2A-R (+35.5%). Significant heterogeneity in the vasomotor response to insulin was observed between EndEx and IST as mean endothelin-1 contribution in EndEx was 27.3 ± 7.6 and 25.9 ± 11.0% lower in the G2A-R and G2A-W, respectively. These microvascular effects of exercise were observed in conjunction with training-related improvements in glycemic control (HbA1c: 6.84 ± 0.23, 5.39 ± 0.06, and 5.30 ± 0.14% in sedentary, EndEx, and IST, respectively). In summary, this study provides novel evidence that treatment of advanced insulin resistance in the OLETF rat with exercise paradigms that elicit diverse motor recruitment patterns produce differential adaptive responses in endothelial-dependent dilation and in the complex vascular actions of insulin.

External urethral sphincter motor unit recruitment patterns during micturition in the spinally intact and transected adult rat

In the rat, external urethral sphincter (EUS) activation during micturition consists of three sequential phases: 1) an increase in tonic EUS activity during passive filling and active contraction of the bladder (guarding reflex), 2) synchronized phasic activity (EUS bursting) associated with voiding, and 3) sustained tonic EUS activity that persists after bladder contraction. These phases are perturbed following spinal cord injury. The purpose of the present study was to characterize individual EUS motor unit (MU) patterns during micturition in the spinally intact and transected adult rat. EUS MU activity was recorded from either the L5 or L6 ventral root (intact) or EUS muscle (transected) during continuous flow cystometry in urethane-anesthetized adult female Sprague-Dawley rats. With the use of bladder pressure threshold and timing of activation, four distinct patterns of EUS MU activity were identified in the intact rat: low threshold sustained, medium/high threshold sustained, medium/high threshold not sustained, and burst only. In general, these MUs displayed little frequency modulation during active contraction, generated high-frequency bursts of action potentials during EUS bursting, and varied in terms of the duration of sustained tonic activity. In contrast, three general patterns of EUS MU activity were identified in the transected rat: low threshold, medium threshold, and high threshold. These MUs exhibited considerable frequency modulation during active contraction of the bladder, no bursting behavior and little to no sustained firing. The prominent frequency modulation of EUS MUs is likely due to the enhanced guarding reflex seen in EUS whole muscle electromyogram recordings in transected rats (D'Amico SC, Schuster IP, Collins WF 3rd. Exp Neurol 228: 59-68, 2011). In addition, EUS MU recruitment in transected rats more closely followed predictions by the size principle than in intact rats. This may reflect the influence of local synaptic circuits or intrinsic properties of EUS motoneurons that are active in intact rats but attenuated or absent in transected rats.

Spectral Properties of H-Reflex Recordings After an Acute Bout of Whole-Body Vibration

Although research supports the use of whole-body vibration (WBV) to improve neuromuscular performance, the mechanisms for these improvements remain unclear. The purpose of this study was to identify the effect of WBV on the spectral properties of electrically evoked H-reflex recordings in the soleus (SOL) muscle. The H-reflex recordings were measured in the SOL muscle of 20 participants before and after a bout of WBV. The H-reflexes were evoked every 15 seconds for 150 seconds after WBV. A wavelet procedure was used to extract spectral data, which were then quantified with a principle components analysis. Resultant principle component scores were used for statistical analysis. The analysis extracted 1 principle component associated with the intensity of the myoelectric spectra and 1 principle component associated with the frequency. The scores of the principle component that were related to the myoelectric intensity were smaller at 30 and 60 milliseconds after WBV than before WBV. The WBV transiently decreased the intensity of myoelectric spectra during electrically evoked contractions, but it did not influence the frequency of the spectra. The decrease in intensity likely indicates a smaller electrically evoked muscle twitch response, whereas the lack of change in frequency would indicate a similar recruitment pattern of motor units before and after WBV.

Shoulder muscles recruitment during a power backward giant swing on high bar: A wavelet-EMG-analysis

This study aimed at determining the upper limb muscles coordination during a power backward giant swing (PBGS) and the recruitment pattern of motor units (MU) of co-activated muscles. The wavelet transformation (WT) was applied to the surface electromyographic (EMG) signal of eight shoulder muscles. Total gymnast’s body energy and wavelet synergies extracted from the WT-EMG by using a non-negative matrix factorization were analyzed as a function of the body position angle of the gymnast. A cross-correlation analysis of the EMG patterns allowed determining two main groups of co-activated muscles. Two wavelet synergies representing the main spectral features (82% of the variance accounted for) discriminated the recruitment of MU. Although no task-group of MU was found among the muscles, it appeared that a higher proportion of fast MU was recruited within the muscles of the first group during the upper part of the PBGS. The last increase of total body energy before bar release was induced by the recruitment of the muscles of the second group but did not necessitate the recruitment of a higher proportion of fast MU. Such muscle coordination agreed with previous simulations of elements on high bar as well as the findings related to the recruitment of MU.

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion

Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation-deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks.

Spectral properties of electromyographic and mechanomyographic signals during dynamic concentric and eccentric contractions of the human biceps brachii muscle

The purpose of this study was to describe and examine the variations in recruitment patterns of motor units (MUs) in biceps brachii (BB) through a range of joint motion during dynamic eccentric and concentric contractions. Twelve healthy participants (6 females, 6 males, age = 30 ± 8.5 years) performed concentric and eccentric contractions with constant external loading at different levels. Surface electromyography (EMG) and mechanomyography (MMG) were recorded from BB. The EMGs and MMGs were decomposed into their intensities in time–frequency space using a wavelet technique. The EMG and MMG spectra were then compared using principal component analysis. Variations in total intensity, first principal component (PCI), and the angle θ formed by first component (PCI) and second component (PCII) loading scores were explained in terms of MU recruitment patterns and elbow angles. Elbow angle had a significant effect on dynamic concentric and eccentric contractions. The EMG total intensity was greater for concentric than for eccentric contractions in the present study. MMG total intensity, however, was lower during concentric than during eccentric contractions. In addition, there was no significant difference in θ between concentric and eccentric contractions for both EMG and MMG. Selective recruitment of fast MUs from BB muscle during eccentric muscle contractions was not found in the present study.

Effects of Two Different Half-Squat Training Programs on Fatigue During Repeated Cycling Sprints in Soccer Players

This study compared the effects of two different half-squat training programs on the repeated-sprint ability of soccer players during the preseason. Twenty male professional soccer players were divided into 2 groups: One group (S-group) performed 4 sets of 5 repetitions with 90% of their 1-repetition maximum (1RM), and the other group (H-group) performed 4 sets of 12 repetitions with 70% of 1RM, 3 times per week for 6 weeks, in addition to their common preseason training program. Repeated-sprint ability was assessed before and after training by 10 × 6-second cycle ergometer sprints separated by 24 seconds of passive recovery. Maximal half-squat strength increased significantly in both groups (p < 0.01), but this increase was significantly greater in the S-group compared with the H-group (17.3 ± 1.9 vs. 11.0 ± 1.9%, p < 0.05). Lean leg volume (LLV) increased only in the H-group. Total work over the 10 sprints improved in both groups after training, but this increase was significantly greater in the second half (8.9 ± 2.6%) compared with the first half of the sprint test (3.2 ± 1.7%) only in the S-group. Mean power output (MPO) expressed per liter of LLV was better maintained during the last 6 sprints posttraining only in the S-group, whereas there was no change in MPO per LLV in the H-group over the 10 sprints. These results suggest that resistance training with high loads is superior to a moderate-load program, because it increases strength without a change in muscle mass and also results in a greater improvement in repeated sprint ability. Therefore, resistance training with high loads may be preferable when the aim is to improve maximal strength and fatigue during sprinting in professional soccer players.

The Effect Of Muscle Vibration Training on Femoral Artery Blood Velocity And Oxygen Uptake Kinetics

Acute and chronic whole body and targeted muscle vibration training has been shown to increase dynamic and isometric strength (Issurin et al, 1994), most likely as a result of altered neuromuscular activation (Bosco et al, 1999). In addition, whole body vibration has been shown to increase popliteal artery blood flow (Kerschan-Schindl et al, 2001) and common femoral artery blood flow (Lythgo et al 2008). PURPOSE: The effect of knee extension exercise with and without super-imposed targeted leg vibration on pulmonary oxygen uptake (VO2 ml-1kg-1min-1) and femoral artery blood velocity (cm/s) was investigated in the present study.: METHODS: Six healthy male subjects participated in this two trial study (age: 21.7 ± 2.3 y; weight: 78.8 ± 7.0 kg; height: 174.5 ± 0.09 cm). Trials were allocated by systematic rotation. Subjects completed 6 sets of 20 repetitions at 25% of their knee extension one repetition maximum (1RM), with 4 min rest between sets. In one of the trials 10 Hz vibration was delivered to the exercising legs via a custom designed device Vibrex (Exoscience Ltd).: RESULTS: Peak force was significantly higher in the vibrated than non-vibrated trials (8.4 ± 1.32% p=0.027), however total work done was not significantly different between trials (81.4 ± 3.2 kJ non-vibration vs 79.9 ± 4.1 kJ vibration trial). Pulmonary oxygen uptake was 12 ± 1% higher in vibration than the non-vibration trials, but this did not reach statistical significance. Heart rate (HR, bpm) was more elevated during exercise and recovery in the vibration vs the non-vibration conditions (5.3 ± 0.99 % and 9.6 ± 1.71 % respectively) but only the recovery HR achieved statistical significance (p=0.016). However, normalised mean peak femoral artery blood velocity tended to be lower in the vibration than the non-vibration trials (3.35 ± 2.73%, nsd).: CONCLUSIONS: The strong tendency for increased pulmonary oxygen uptake during the vibration trials in the absence of any increase in femoral artery mean peak blood velocity could be explained either by vibration-induced improvements in micro-circulation of the quadriceps muscle or altered motor unit recruitment and/or firing patterns. In order to discriminate between these two possible mechanisms, future studies should include muscle oxygenation and EMG data capture.:

Distribution of electrical activation to the external intercostal muscles during high frequency spinal cord stimulation in dogs

In contrast to previous methods of electrical stimulation of the inspiratory muscles, high frequency spinal cord stimulation (HF-SCS) results in more physiological activation of these muscles. The spatial distribution of activation to the external intercostal muscles by this method is unknown. In anaesthetized dogs, multiunit and single motor unit (SMU) EMG activity was monitored in the dorsal portion of the 3rd, 5th and 7th interspaces and ventral portion of the 3rd interspace during spontaneous breathing and HF-SCS following C2 spinal section. Stimulus amplitude during HF-SCS was adjusted such that inspired volumes matched spontaneous breathing (Protocol 1). During HF-SCS, mean peak SMU firing frequency was highest in the 3rd interspace (dorsal) (18.8 ± 0.3 Hz) and significantly lower in the 3rd interspace (ventral) (12.2 ± 0.2 Hz) and 5th interspace (dorsal) (15.3 ± 0.3 Hz) (P <0.05 for each comparison). Similar rostrocaudal and dorsoventral gradients of activity were observed during spontaneous breathing prior to C2 section. No significant activity was observed in the 7th interspace during either spontaneous breathing or HF-SCS. Since peak discharge frequencies of the SMUs were higher and rib cage movement greater during HF-SCS compared to spontaneous breathing, stimulus amplitude during HF-SCS was adjusted such that rib cage movement matched (Protocol 2). Under these conditions, mean peak SMU frequencies and rostrocaudal and dorsoventral gradients of activity during HF-SCS were not significantly different compared to spontaneous breathing. These results indicate that (a) the topographic pattern of electrical activation of the external intercostal muscles during HF-SCS is similar to that occurring during spontaneous breathing and (b) differential descending synaptic input from supraspinal centres is not a required component of the differential spatial distribution of external intercostal muscle activation. HF-SCS may provide a more physiological method of inspiratory muscle pacing.

Neuromuscular Effects of Shifting the Focus of Attention in a Simple Force Production Task

ABSTRACT Research on the focus of attention has begun exploring the physiological changes that underlie the difference between internal and external foci of attention. However, previous electromyography studies have used dynamic tasks, making it difficult to interpret electrophysiological data. The authors analyzed how the focus of attention affects a subject's ability to perform an isometric force production task (focus was directed either at the force platform or the muscles responsible for force production). Subjects received practice without attentional focus instructions and then completed blocks of trials with an external and internal attentional focus separately. An external focus led to significantly less error overall and reduced surface electromyography activity with lower median power frequencies in the antagonist muscle, but attentional focus had no effects on the agonist muscle. Thus, an external focus of attention led to more efficient motor unit recruitment patterns (reduced cocontraction) and improved performance. Posttest surveys revealed subjects were aware of their improved performance with an external focus.

Neuromuscular Responses of the Vastus Lateralis to Slow Walking With Vascular Restriction

Motor unit recruitment of individual muscles could substantially differ with changes in speed and load. However, the recruitment patterns associated with low intensity walk training with vascular restriction at sustained loads and constant speed could be different than normal walking. Vascular restricted (VR) walk training is an effective method for increasing muscular strength; however the changes in motor unit recruitment and firing frequency have not been investigated to understand the mechanisms underlying the neuromuscular adaptations. PURPOSE: The purpose of this study was to analyze differences in electrical activity of the vastus lateralis during VR and non vascular restricted (non-VR) walking sessions. METHODS: Seven healthy males [means ± (SD): age 22.7±(6.8) yrs, height 178±(5.4) cm, weight 181.7±(16.9) lbs.] performed both a VR walking session and a non-VR walking session for 20 minutes on a treadmill at a speed of 80.4 m-min[[Unsupported Character - &#713;]]1. During each walking period the subjects wore surface EMG electrodes that were placed along the longitudinal axis of the vastus lateralis (VL) of the right thigh at a distance of 33.3% between the lateral femoral epicondyle and the greater trochanter. A repeated measures ANOVA was used to determine the differences in both EMG amplitude (RMS) and median frequency of firing (MDF). RESULTS: The VR walking session resulted in significantly greater RMS values compared to the non-VR walking session (p < 0.05); however there was no main effect for time or interaction between condition and time. For EMG MDF, there were no significant main effects for condition or time, and no significant interaction. CONCLUSIONS: The results indicate that walking during VR of the lower limbs may have a greater impact on neural adaptation of the VL due to increased motor unit activation as indicated by an increased RMS value. This might occur because blood flow restriction affects motor unit recruitment patterns resulting in the recruitment of more high-threshold, fast-twitch muscle fibers.

Twitch potentiation induced by stimulated and voluntary isometric contractions at various torque levels in human knee extensor muscles

The purpose of this study was to compare the extent of twitch potentiation (TP) after stimulated or voluntary contractions at identical intensities for the human knee extensor muscles. Isometric knee extensions of 10 s were performed at 20%, 40%, and 60% of maximal voluntary contraction (MVC) torque level, through percutaneous electrical stimulation of the quadriceps at 80 Hz or voluntary contraction. Twitch responses were evoked by stimulating the femoral nerve percutaneously with supramaximal intensity. The extent of TP after the stimulated contraction was greater than that after the voluntary contraction at the 20% MVC torque level, whereas a stimulated contraction induced a smaller extent of TP than did a voluntary contraction at contraction intensities higher than 40% MVC. We suggest that this contraction intensity dependence of differences in TP after stimulated and voluntary isometric conditioning contractions is responsible for differences in the recruitment pattern of motor units during the conditioning contractions.

Neuromuscular electrical stimulation training induces atypical adaptations of the human skeletal muscle phenotype: a functional and proteomic analysis

The aim of the present study was to define the chronic effects of neuromuscular electrical stimulation (NMES) on the neuromuscular properties of human skeletal muscle. Eight young healthy male subjects were subjected to 25 sessions of isometric NMES of the quadriceps muscle over an 8-wk period. Needle biopsies were taken from the vastus lateralis muscle before and after training. The training status, myosin heavy chain (MHC) isoform distribution, and global protein pattern, as assessed by proteomic analysis, widely varied among subjects at baseline and prompted the identification of two subgroups: an "active" (ACT) group, which performed regular exercise and had a slower MHC profile, and a sedentary (SED) group, which did not perform any exercise and had a faster MHC profile. Maximum voluntary force and neural activation significantly increased after NMES in both groups (+∼30% and +∼10%, respectively). Both type 1 and 2 fibers showed significant muscle hypertrophy. After NMES, both groups showed a significant shift from MHC-2X toward MHC-2A and MHC-1, i.e., a fast-to-slow transition. Proteomic maps showing ∼500 spots were obtained before and after training in both groups. Differentially expressed proteins were identified and grouped into functional categories. The most relevant changes regarded 1) myofibrillar proteins, whose changes were consistent with a fast-to-slow phenotype shift and with a strengthening of the cytoskeleton; 2) energy production systems, whose changes indicated a glycolytic-to-oxidative shift in the metabolic profile; and 3) antioxidant defense systems, whose changes indicated an enhancement of intracellular defenses against reactive oxygen species. The adaptations in the protein pattern of the ACT and SED groups were different but were, in both groups, typical of both resistance (i.e., strength gains and hypertrophy) and endurance (i.e., a fast-to-slow shift in MHC and metabolic profile) training. These training-induced adaptations can be ascribed to the peculiar motor unit recruitment pattern associated with NMES.

Unloaded shortening velocity of voluntarily and electrically activated human dorsiflexor muscles in vivo.

We have previously shown that unloaded shortening velocity (V 0) of human plantar flexors can be determined in vivo, by applying the “slack test” to submaximal voluntary contractions (J Physiol 567:1047–1056, 2005). In the present study, to investigate the effect of motor unit recruitment pattern on V 0 of human muscle, we modified the slack test and applied this method to both voluntary and electrically elicited contractions of dorsiflexors. A series of quick releases (i.e., rapid ankle joint rotation driven by an electrical dynamometer) was applied to voluntarily activated dorsiflexor muscles at three different contraction intensities (15, 50, and 85% of maximal voluntary contraction; MVC). The quick-release trials were also performed on electrically activated dorsiflexor muscles, in which three stimulus conditions were used: submaximal (equal to 15%MVC) 50-Hz stimulation, supramaximal 50-Hz stimulation, and supramaximal 20-Hz stimulation. Modification of the slack test in vivo resulted in good reproducibility of V 0, with an intraclass correlation coefficient of 0.87 (95% confidence interval: 0.68–0.95). Regression analysis showed that V 0 of voluntarily activated dorsiflexor muscles significantly increased with increasing contraction intensity (R 2 = 0.52, P<0.001). By contrast, V 0 of electrically activated dorsiflexor muscles remained unchanged (R 2<0.001, P = 0.98) among three different stimulus conditions showing a large variation of tetanic torque. These results suggest that the recruitment pattern of motor units, which is quite different between voluntary and electrically elicited contractions, plays an important role in determining shortening velocity of human skeletal muscle in vivo.

Electrophysiologic Activity of the Vestibular Fold

To assess the vestibular fold muscle after cordectomy and laryngeal reconstruction, the pattern of motor unit recruitment during sound emission, and the morphologic characteristics of motor unit action potentials. Prospective analysis. Tertiary academic hospital. We evaluated 11 men (mean age, 65.7 years; age range, 53-82 years) who underwent laryngofissure, cordectomy, and laryngeal reconstruction with a vestibular fold flap. Laryngeal electromyography with the insertion of a needle electrode for the assessment of the electrophysiologic activity of thyroartenoid muscle fibers and of the cricothyroid muscle on the operated on and nonoperated on sides. The thyroarytenoid muscle was evaluated by introducing a needle electrode through the thyroid cartilage and the cricothyroid membrane. Activities of needle insertion, spontaneous muscle activity during rest, and pattern of motor unit recruitment. Seven patients (64%) had vestibular fold muscle fiber, all of whom showed motor unit recruitment in response to sound emission. No neurogenic muscle injuries were observed except in 1 patient with evidence of chronic injury. After cordectomy and laryngeal reconstruction, thyroarytenoid muscle fibers are present in the vestibular fold, with motor unit recruitment during sound emission.

Physiological and methodological considerations for the use of neuromuscular electrical stimulation

The main aim of this review is to discuss some evidence-based physiological and methodological considerations for optimal use of neuromuscular electrical stimulation (NMES) in healthy and impaired skeletal muscles. After a quick overview of the main applications, interests and limits of NMES use, the first section concentrates on two crucial aspects of NMES physiology: the differences in motor unit recruitment pattern between NMES and voluntary contractions, and the involvement of the nervous system during peripheral NMES. The second section of the article focuses on the most common NMES parameters, which entail the characteristics of both the electrical current (the input) and the evoked contraction (the output).

Observations of recurrent laryngeal nerve injury and recovery using a rat model

To evaluate standardized recurrent laryngeal nerve (RLN) injuries using a rat model via minimally invasive transoral electromyography (ToL EMG) and histologic studies. Forty-two female Sprague Dawley rats weighing 200 g to 250 g underwent crush injury to the right RLN using a calibrated pressure clip (0.61 N or 1.19 N) for 60 seconds. Following injury, serial ToL EMGs were performed on abductor and adductor laryngeal muscles during respiratory cycles and spontaneous vocal fold abduction on day 4 and then weekly for 6 weeks. Vocal fold motion associated with spontaneous respiration was graded from 0 to 4. Rats were sacrificed at different time points for histologic evaluation of injured nerves. EMG signals showed fibrillation potentials on day 4 in all experimental conditions. Crushed RLN, regardless of force, exhibited polyphasic potentials at 2 weeks postinjury. Normal motor unit potentials and recruitment patterns were observed in EMG signals at 4 weeks for all 0.61 N clip animals. Six weeks following crush injury, motor unit potentials having normal appearance were observed in most animals. Synkinetic EMG signals were observed at 5 weeks and 6 weeks in the 1.19 N clip animals. Endoscopic evaluation of vocal fold mobility was consistently normal at 6 weeks only following 0.61 N crush injury. This model is useful to simulate intraoperative RLN injuries and to better understand the electrophysiologic events during nerve recovery. The severity of injury to the RLN dictates histologic, neurologic and functional recovery of the laryngeal motor system. This model is useful to evaluate the efficacy of systemic and local neurotropic agents in the treatment of RLN injury.