Motor Units In Muscle Research Articles

Increases in muscle temperature by hot water improve muscle contractile function and reduce motor unit discharge rates.

Examine the effects of 42°C hot-water immersion on muscle contraction function and motor unit discharge rates. Voluntary and evoked contraction assessments were examined first with a concomitant increase in the core and muscle temperature, and thereafter with increased muscle temperature but cooled core temperature. Fifteen participants (24.9 ± 5.6 years) performed neuromuscular assessments before, after, and ~15-min after either 90-min of 42°C (hot) or 36°C (control) water immersion. Maximal voluntary contraction (MVC) assessment of knee extension was performed along with surface electromyography (sEMG) (vastus lateralis and medialis [VL, VM]) and voluntary activation level (VAL). Resting evoked twitch was elicited for peak torque and time to peak torque analysis. In addition, the VL and VM motor unit discharge rates (MUDR) were measured. After hot-water immersion (core temperature ↑1°C; muscle temperature ↑2.4°C), MVC torque and VAL decreased (p < 0.05). The sEMG (VL and VM) and peak twitch torque did not change (p > 0.05), while time to peak torque decreased (p=0.007). The VL and VM MUDR decreased, showing a time effect, after both water immersion conditions (36 and 42°C) (p > 0.001). Fifteen minutes after the hot-water immersion (core temperature at baseline; muscle temperature ↑1.4°C), MVC torque returned to baseline, but VAL remained lower. The sEMG (VL and VM) remained unchanged. Peak twitch torque increased (p < 0.002) and time to peak torque remained lower (p=0.028). The MUDR remained lower after both water immersion conditions (p < 0.05). Increased core temperature evoked by 42°C hot-water immersion decreases MVC torque and VAL. However, a passive increase in muscle temperature improved evoked muscle contractile function (i.e., time to peak torque [after] and peak twitch torque [~15 min after]). Moreover, a passive increase in muscle temperature reduced the required MUDR to attain the same torque.

Neurophysiological Evaluation of the Functional State of Muscular and Nervous Systems in High-Maneuvering Jet Fighters

The present study aimed to assess the function of muscular and nervous systems in high-maneuvering jet fighters with the chosen method of clinical neurophysiology, which methodologically has not yet been presented in detail. Fifteen pilots with the experience of more than 1700 flying hours at 7G overloading on average and fifteen healthy subjects for the comparison of health status declared to participate in this study. The dermatomal perception from C4 to S1 was examined using von Frey’s filaments tactile method. Surface electromyography (sEMG) recordings examined the activity of proximal and distal muscles in the upper and lower extremities, the transmission of motor nerve impulses peripherally was diagnosed by electroneurography (ENG), the efferent transmission from C5–C7 and L4–L5 spinal centers to muscles was entirely verified with recordings of motor-evoked potentials induced oververtebrally with the magnetic field (MEP). The pilots estimated more lumbosacral than cervical pain at about 2 on the 10-point visual analog scale (VAS). Sensory perception studies did not reveal abnormal symptoms in the C2–S1 dermatomes innervation. Clinical neurophysiology studies indicated, in general, the lack of pathology during sEMG tests in comparison to healthy subjects or even better muscle motor unit contractile properties in pilots, both in the upper and lower extremities. In pilots, the parameters of ENG and MEP examinations show a statistically significant sensitivity for detecting the slight changes and their consequences in the transmission of neural impulses within L4–L5 ventral root fibers. The research results enable specifying the algorithm of future preventing rehabilitative treatment in high-maneuvering jet fighters with an average flight experience of 2000 h and working conditions at 7G on average. This study, for the first time, describes the application of a set of diagnostic neurophysiological methods with the particular importance of MEPs in the clinical evaluation of the jet fighters’ health status.

Influence of high-velocity low amplitude manipulation of the lumbar spine on the activity of motor units of the erector spinal muscles with functional assessment in healthy young people

Influence of high-velocity low amplitude manipulation of the lumbar spine on the activity of motor units of the erector spinal muscles with functional assessment in healthy young people

Aging affects the number and morphological heterogeneity of rat phrenic motor neurons and phrenic motor axons.

Diaphragm muscle (DIAm) motor units comprise a phrenic motor neuron (PhMN), the phrenic nerve and the muscle fibers innervated, with the size of PhMNs and axons characteristic of motor unit type. Smaller PhMNs and their axons comprise slow (type S) and fatigue-resistant (type FR) DIAm motor units, while larger PhMNs and their axons comprise more fatigable (type FF) motor units. With aging, we have shown a loss of larger PhMNs, consistent with selective atrophy of type IIx/IIb DIAm fibers and reduced maximum DIAm force. In the present study, we hypothesized that with aging there is a loss of larger myelinated phrenic α motor axons. Female and male young (6months) and old (24 months) Fischer 344 rats were studied. PhMNs were retrogradely labeled by intrapleural injection of 488-conjugated CTB. The phrenic nerves were excised ~1cm from the DIAm insertion and mounted in resin, and phrenic α motor axons were delineated based on size (i.e., >4μm diameters). In older rats, the number of larger PhMNs and larger phrenic α motor axons were reduced. There were no differences in non-α axons. In addition, there was evidence of demyelination of larger phrenic α motor axons in older rats. Together, these findings are consistent with the selective age-related vulnerability of larger PhMNs and denervation of type FF motor units, which may underlie DIAm sarcopenia.

Retrograde labeling correlates with motor unit number estimation in rapid-stretch nerve injury.

Rapid-stretch nerve injuries represent a substantial treatment challenge. No study has examined motor neuron connection after rapid-stretch injury. Our objective in this study was to characterize the electrophysiological properties of graded rapid-stretch nerve injury and assess motor neuron health using retrograde labeling and muscle adenosine triphosphatase (ATPase) histology. Male C57BL/6 mice (n=6 per group) were rapid-stretch injured at four levels of severity: sham injury, stretch within elastic modulus, inelastic deformation, and stretch rupture. Serial compound muscle action potential (CMAP) and motor unit number estimation (MUNE) measurements were made for 48 days, followed by retrograde labeling and muscle ATPase histology. Elastic injuries showed no durable abnormalities. Inelastic injury demonstrated profound initial reduction in CMAP and MUNE (P < .036) on day 2, with partial recovery by day 14 after injury (CMAP: 40% baseline, P=.003; MUNE: 55% baseline, P=.033). However, at the experimental endpoint, CMAP had recovered to baseline with only limited improvement in MUNE. Inelastic injury led to reduced retrograde-labeled neurons and grouped fiber type histology. Rupture injury had severe and nonrecovering electrophysiological impairment, dramatically reducing labeled neurons (P = .005), and atrophic or type 1 muscle fibers. There was an excellent correlation between MUNE and retrograde-labeled tibial motor neurons across injury severities (R2 =0.96). There was no significant electrophysiological derangement in low-severity injuries but there was recoverable conduction block in inelastic injury with slow recovery, potentially due to collateral sprouting. Rupture injuries yielded permanent failure of injured axons to reinnervate. These results provide insight into the pathophysiology of clinical injuries and recovery.

Association of Muscle Strength With Muscle Thickness and Motor Unit Firing Pattern of Vastus Lateralis Muscle in Youth Athletes.

Contributions of neural and muscular factors to muscle strength change with growth, but such changes remain unclear in young populations. This study aimed to clarify the association between muscle strength and neural and muscular factors in youth athletes. Maximal voluntary contraction (MVC) during isometric knee extension, the motor unit firing rate (MUFR), and muscle thickness (MT) of the vastus lateralis were measured in 70 youth male soccer players (mean [SD]; chronological age = 16.3 [0.6] y, peak height velocity age = 13.1 [1.0] y). MUFR and MT were measured with high-density surface electromyography and ultrasonography, respectively. For MUFR and MT, correlations with MVC were calculated and the values of different MVC groups were compared. A significant correlation between MVC and MT (r = .49, P < .01) was noted, but not MUFR (r = .03, P > .05). There was also no significant correlation between MT and MUFR (r = -.33, P > .05). In addition, comparison among groups (higher-/middle-/lower-strength groups) revealed that MT in the lower-strength group was significantly lower than in middle-and higher-strength groups (P < .01). In youth athletes, muscle strength is associated with muscular factors, rather than neural factors, and muscular and neural factors may independently contribute to muscle strength.

Differences in the electrical activity and the clinical performance of superficial neck flexors and extensors during the CCFT in women with migraine

IntroductionMusculoskeletal disorders in the cervical spine have been increasingly investigated and observed in patients with migraine. One of them is a poorer cervical muscle performance as assessed by the cranio-cervical flexion test (CCFT). In addition, patients with migraine have alterations in the recruitment of muscle motor units observed by surface electromyography during CCFT. ObjectiveThe aim was to verify if there are differences in the electrical activity and the clinical performance of superficial neck flexors and extensors during the CCFT in women with migraine considering the presence or absence of concomitant neck pain symptoms. MethodsA total of 100 women were assessed: 25 with migraine without neck pain, 25 with migraine and neck pain, 25 with mechanical neck pain and 25 pain-free control. Clinical and demographic data were collected, The CCFT was performed in all groups. The test assessed the deep flexors muscle by a pressure unit biofeedback placed in the posterior region of the neck and initially inflated to 20 mmHg composed by 5 stages, with increase pressure by 2 mmHg at each stage, reaching 30 mmHg, keeping the pressure for 10 seconds without resorting to compensation. Electromyography data were collected with TrignoTM Wireless System wireless surface sensors. The sensors were firmly attached bilaterally on: sternocleidomastoid (SCM); splenius capitis, anterior scalene and upper trapezius. Electromyographic activity evaluated during the CCFT was normalized by the average the root mean square (RMS) calculated for the reference voluntary contraction and expressed as a percentage. Groups comparisons were performed with non-parametric tests adopting a level of significance of 0.05. To analyze the between-groups differences on the proportion of clinical targeted performance stages reached by each participant within the CCFT, the chi-square (X2) test was calculated, and the data were submitted to a post-hoc proportion test. (To see the complete abstract, please, check out the PDF).

Modulations in motor unit discharge are related to changes in fascicle length during isometric contractions.

The integration of electromyography (EMG) and ultrasound imaging has provided important information about the mechanisms of muscle activation and contraction. Unfortunately, conventional bipolar EMG does not allow an accurate assessment of the interplay between the neural drive received by muscles, changes in fascicle length and torque. We aimed to assess the relationship between modulations in tibialis anterior muscle (TA) motor unit (MU) discharge, fascicle length, and dorsiflexion torque using ultrasound-transparent high-density EMG electrodes. EMG and ultrasound images were recorded simultaneously from TA using a 32-electrode silicon matrix while performing isometric dorsiflexion contractions at two ankle joint positions (0° or 30° plantar flexion) and torques (20% or 40% of maximum). EMG signals were decomposed into MUs and changes in fascicle length were assessed with a fascicle-tracking algorithm. MU firings were converted into a cumulative spike train (CST) that was cross-correlated with torque (CST-torque) and fascicle length (CST-length). High cross-correlations were found for CST-length (0.60, range: 0.31-0.85) and CST-torque (0.71, range: 0.31-0.88). Cross-correlation delays revealed that the delay between CST-fascicle length (∼75 ms) was smaller than CST-torque (∼150 ms, P < 0.001). These delays affected MU recruitment and de-recruitment thresholds since the fascicle length at which MUs were recruited and de-recruited was similar but MU recruitment-de-recruitment torque varied. This study demonstrates that changes in TA fascicle length are related to modulations in MU firing and dorsiflexion torque. These relationships allow assessment of the interplay between neural drive, muscle contraction and torque, enabling the time required to convert neural activity into movement to be quantified.NEW & NOTEWORTHY By employing ultrasound-transparent high-density EMG electrodes, we show that modulations in tibialis anterior muscle motor unit discharge rate were related to both changes in fascicle length and resultant torque. These relationships permitted the quantification of the relative delays between fluctuations in neural drive, muscle contraction, and transfer of torque via the tendon during sustained isometric dorsiflexion contractions, providing information on the conversion of neural activity into muscle force during a contraction.

Factors of Muscle Quality and Determinants of Muscle Strength: A Systematic Literature Review.

Muscle quality defined as the ratio of muscle strength to muscle mass disregards underlying factors which influence muscle strength. The aim of this review was to investigate the relationship of phase angle (PhA), echo intensity (EI), muscular adipose tissue (MAT), muscle fiber type, fascicle pennation angle (θf), fascicle length (lf), muscle oxidative capacity, insulin sensitivity (IS), neuromuscular activation, and motor unit to muscle strength. PubMed search was performed in 2021. The inclusion criteria were: (i) original research, (ii) human participants, (iii) adults (≥18 years). Exclusion criteria were: (i) no full-text, (ii) non-English or -German language, (iii) pathologies. Forty-one studies were identified. Nine studies found a weak–moderate negative (range r: [−0.26]–[−0.656], p < 0.05) correlation between muscle strength and EI. Four studies found a weak–moderate positive correlation (range r: 0.177–0.696, p < 0.05) between muscle strength and PhA. Two studies found a moderate-strong negative correlation (range r: [−0.446]–[−0.87], p < 0.05) between muscle strength and MAT. Two studies found a weak-strong positive correlation (range r: 0.28–0.907, p < 0.05) between θf and muscle strength. Muscle oxidative capacity was found to be a predictor of muscle strength. This review highlights that the current definition of muscle quality should be expanded upon as to encompass all possible factors of muscle quality.

Motor unit number index (MUNIX) in the D50 disease progression model reflects disease accumulation independently of disease aggressiveness in ALS.

The neurophysiological technique motor unit number index (MUNIX) is increasingly used in clinical trials to measure loss of motor units. However, the heterogeneous disease course in amyotrophic lateral sclerosis (ALS) obfuscates robust correlations between clinical status and electrophysiological assessments. To address this heterogeneity, MUNIX was applied in the D50 disease progression model by analyzing disease aggressiveness (D50) and accumulation (rD50 phase) in ALS separately. 237 ALS patients, 45 controls and 22 ALS-Mimics received MUNIX of abductor pollicis brevis (APB), abductor digiti minimi (ADM) and tibialis anterior (TA) muscles. MUNIX significantly differed between controls and ALS patients and between ALS-Mimics and controls. Within the ALS cohort, significant differences between Phase I and II revealed in MUNIX, compound muscle action potential (CMAP) and motor unit size index (MUSIX) of APB as well as in MUNIX and CMAP of TA. For the ADM, significant differences occurred later in CMAP and MUNIX between Phase II and III/IV. In contrast, there was no significant association between disease aggressiveness and MUNIX. In application of the D50 disease progression model, MUNIX can demonstrate disease accumulation already in early Phase I and evaluate effects of therapeutic interventions in future therapeutic trials independent of individual disease aggressiveness.

Interfacing Motor Units in Nonhuman Primates Identifies a Principal Neural Component for Force Control Constrained by the Size Principle.

Motor units convert the last neural code of movement into muscle forces. The classic view of motor unit control is that the CNS sends common synaptic inputs to motoneuron pools and that motoneurons respond in an orderly fashion dictated by the size principle. This view, however, is in contrast with the large number of dimensions observed in motor cortex, which may allow individual and flexible control of motor units. Evidence for flexible control of motor units may be obtained by tracking motor units longitudinally during tasks with some level of behavioral variability. Here we identified and tracked populations of motor units in the brachioradialis muscle of two macaque monkeys during 10 sessions spanning >1 month with a broad range of rate of force development (1.8-38.6 N · m · s-1). We found a very stable recruitment order and discharge characteristics of the motor units over sessions and contraction trials. The small deviations from orderly recruitment were fully predicted by the motor unit recruitment intervals, so that small shifts in recruitment thresholds happened only during contractions at a high rate of force development. Moreover, we also found that one component explained more than ∼50% of the motor unit discharge rate variance, and that the remaining components represented a time-shifted version of the first. In conclusion, our results show that the recruitment of motoneurons is determined by the interplay of the size principle and common input and that this recruitment scheme is not violated over time or by the speed of the contractions.SIGNIFICANCE STATEMENT With a new noninvasive high-density electromyographic framework, we show the activity of motor unit ensembles in macaques during voluntary contractions. The discharge characteristics of brachioradialis motor units revealed a relatively fixed recruitment order and discharge characteristics across days and rate of force developments. These results were further confirmed through invasive axonal stimulation and recordings of intramuscular electromyographic activity from 16 arm muscles. The study shows for the first time the feasibility of longitudinal noninvasive motor unit interfacing and tracking of the same motor units in nonhuman primates.

In vivo 3D imaging of human motor units in upper and lower limb muscles

ObjectiveTo assess in-vivo cross-sectional and 3D morphology of human motor units in hand, forearm and lower leg muscles using magnetic resonance imaging (MRI). MethodsDiffusion weighted MRI was used with in-scanner electrical stimulation in healthy controls to image motor units at a single slice in lower leg, forearm and hand muscles (n = 6) and multiple slices in the lower leg for 3D assessment (n = 7). ResultsMotor unit cross-sectional area (CSA) and maximum Feret diameter (FDmax) did not differ between the lower leg (CSA: 22.4 ± 8.4 mm2; FDmax: 8.7 ± 2.4 mm), forearm (CSA: 23.6 ± 14.1 mm2; FDmax: 9.0 ± 3.3 mm) and hand (CSA: 26.8 ± 12.8 mm2 and FDmax: 9.6 ± 2.7 mm) (ANOVA; p = 0.487 and p = 0.587, respectively). Lower leg motor units were 8.0 ± 3.8 cm long with largest CSA in the motor unit’s middle section. 3D motor unit imaging revealed a complex structure with several units splitting and re-forming along their length. ConclusionsMotor unit MRI (MUMRI) can be applied to upper limb muscles, and can reveal the 3D structure of human motor units in-vivo. SignificanceMUMRI provides the first in-vivo 2D images of upper limb motor units and 3D images of lower leg motor units. 3D imaging suggest a more complex human motor unit structure than previously thought.

Combinatorial ASO-mediated therapy with low dose SMN and the protective modifier Chp1 is not sufficient to ameliorate SMA pathology hallmarks

Spinal muscular atrophy (SMA) is a devastating genetically inherited neuromuscular disorder characterized by the progressive loss of motor neurons in the spinal cord, leading to muscle atrophy and weakness. Although SMA is caused by homozygous mutations in SMN1, the disease severity is mainly determined by the copy number of SMN2, an almost identical gene that produces ~10% correctly spliced SMN transcripts. Recently, three FDA- and EMA-approved therapies that either increase correctly spliced SMN2 transcripts (nusinersen and risdiplam) or replace SMN1 (onasemnogen abeparvovec-xioi) have revolutionized the clinical outcome in SMA patients. However, for severely affected SMA individuals carrying only two SMN2 copies even a presymptomatic therapy might be insufficient to fully counteract disease development. Therefore, SMN-independent compounds supporting SMN-dependent therapies represent a promising therapeutic approach. Recently, we have shown a significant amelioration of SMA disease hallmarks in a severely affected SMA mouse carrying a mutant Chp1 allele when combined with low-dose of SMN antisense oligonucleotide (ASO) treatment. CHP1 is a direct interacting partner of PLS3, a strong protective modifier of SMA. Both proteins ameliorate impaired endocytosis in SMA and significantly restore pathological hallmarks in mice.Here, we aimed to pharmacologically reduce CHP1 levels in an ASO-based combinatorial therapy targeting SMN and Chp1. Chp1 modulation is a major challenge since its genetic reduction to ~50% has shown to ameliorate SMA pathology, while the downregulation below that level causes cerebellar ataxia. Efficacy and tolerability studies determined that a single injection of 30 μg Chp1-ASO4 in the CNS is a safe dosage that significantly reduced CHP1 levels to ~50% at postnatal day (PND)14. Unfortunately, neither electrophysiological predictors such as compound muscle action potential (CMAP) or motor unit number estimation (MUNE) nor histological hallmarks of SMA in neuromuscular junction (NMJ), spinal cord or muscle were ameliorated in SMA mice treated with Chp1-ASO4 compared to CTRL-ASO at PND21. Surprisingly, CHP1 levels were almost at control level 4-weeks post injection, indicating a rather short-term effect of the ASO. Therefore, we re-administrated Chp1-ASO4 by i.c.v. bolus injection at PND28. However, no significant improvement of SMA hallmarks were seen at 2 month-of-age either.In conclusion, in contrast to the protective effect of genetically-induced Chp1 reduction on SMA, combinatorial therapy with Chp1- and SMN-ASOs failed to significantly ameliorate the SMA pathology. Chp1-ASOs compared to SMN-ASO proved to have rather short-term effect and even reinjection had no significant impact on SMA progression, suggesting that further optimization of the ASO may be required to fully explore the combination.

Motor Unit and Capillary Recruitment During Fatiguing Arm-Cycling Exercise in Spinal Muscular Atrophy Types 3 and 4.

Exercise intolerance is an important impairment in patients with SMA, but little is known about the mechanisms underlying this symptom. To investigate if reduced motor unit and capillary recruitment capacity in patients with SMA contribute to exercise intolerance. Adolescent and adult patients with SMA types 3 and 4 (n = 15) and age- and gender matched controls (n = 15) performed a maximal upper body exercise test. We applied respiratory gas analyses, non-invasive surface electromyography (sEMG) and continuous wave near-infrared spectroscopy (CW-NIRS) to study oxygen consumption, arm muscle motor unit- and capillary recruitment, respectively. Maximal exercise duration was twofold lower (p < 0.001) and work of breathing and ventilation was 1.6- and 1.8-fold higher (p < 0.05) in patients compared to controls, respectively. Regarding motor unit recruitment, we found higher normalized RMS amplitude onset values of sEMG signals from all muscles and the increase in normalized RMS amplitudes was similar in the m. triceps brachii, m. brachioradialis and m. flexor digitorum in SMA compared to controls. Median frequency, onset values were similar in patients and controls. We found a similar decrease in median frequencies of sEMG recordings from the m. biceps brachii, a diminished decrease from the m. brachioradialis and m. flexor digitorum, but a larger decrease from the m. triceps brachii. With respect to capillary recruitment, CW-NIRS recordings in m. biceps brachii revealed dynamics that were both qualitatively and quantitatively similar in patients and controls. We found no evidence for the contribution of motor unit and capillary recruitment capacity of the upper arm muscles in adolescent and adult patients with SMA types 3 and 4 as primary limiting factors to premature fatigue during execution of a maximal arm-cycling task.

Effect of nitrate supplementation on skeletal muscle motor unit activity during isometric blood flow restriction exercise

BackgroundNitrate (NO3−) supplementation has been reported to lower motor unit (MU) firing rate (MUFR) during dynamic resistance exercise; however, its impact on MU activity during isometric and ischemic exercise is unknown.PurposeTo assess the effect of NO3− supplementation on knee extensor MU activities during brief isometric contractions and a 3 min sustained contraction with blood flow restriction (BFR).MethodsSixteen healthy active young adults (six females) completed two trials in a randomized, double-blind, crossover design. Trials were preceded by 5 days of either NO3− (NIT) or placebo (PLA) supplementation. Intramuscular electromyography was used to determine the M. vastus lateralis MU potential (MUP) size, MUFR and near fibre (NF) jiggle (a measure of neuromuscular stability) during brief (20 s) isometric contractions at 25% maximal strength and throughout a 3 min sustained BFR isometric contraction.ResultsPlasma nitrite (NO2−) concentration was elevated after NIT compared to PLA (475 ± 93 vs. 198 ± 46 nmol L−1, p < 0.001). While changes in MUP area, NF jiggle and MUFR were similar between NIT and PLA trials (all p > 0.05), MUP duration was shorter with NIT compared to PLA during brief isometric contractions and the sustained ischemic contraction (p < 0.01). In addition, mean MUP duration, MUP area and NF jiggle increased, and MUFR decreased over the 3 min sustained BFR isometric contraction for both conditions (all p < 0.05).ConclusionsThese findings provide insight into the effect of NO3− supplementation on MUP properties and reveal faster MUP duration after short-term NO3− supplementation which may have positive implications for skeletal muscle contractile performance.

Motor Unit Number Estimation of the Second Lumbrical Muscle in Human Hand.

The number of motor units of the lumbrical muscles in human hand has not been explored. The objective of this study was to fill this gap by estimating the number of motor units in the second lumbrical muscle. Compound muscle action potential scan of the second lumbrical muscle was performed in 12 healthy subjects, with 10 of them being tested on two separate occasions. Motor unit number estimation (MUNE) was derived from the MScanFit program. The average MUNE of the second lumbrical muscle was 41.6 ± 2.1 (mean ± standard error) from 12 subjects in the first test, and 42.0 ± 2.2 from 10 of the 12 subjects in the retest, demonstrating excellent measurement reliability. Findings of the study provide novel information about the motor unit number of the second lumbrical muscle in human hand. The relatively low motor unit number in the muscle can facilitate motor unit investigations, especially at high level muscle activation.

The effect of small changes in rate of force development on muscle fascicle velocity and motor unit discharge behaviour

When rate of force development is increased, neural drive increases. There is presently no accepted explanation for this effect. We propose and experimentally test the theory that a small increase in rate of force development increases medial gastrocnemius fascicle shortening velocity, reducing the muscle’s force-generating capacity, leading to active motor units being recruited at lower forces and with increased discharge frequencies. Participants produced plantar flexion torques at three different rates of force development (slow: 2% MVC/s, medium: 10% MVC/s, fast: 20% MVC/s). Ultrasound imaging showed that increased rate of force development was related to higher fascicle shortening velocity (0.4 ± 0.2 mm/s, 2.0 ± 0.9 mm/s, 4.1 ± 1.9 mm/s in slow, medium, fast, respectively). In separate experiments, medial gastrocnemius motor unit recruitment thresholds and discharge frequencies were measured using fine-wire electromyography (EMG), together with surface EMG. Recruitment thresholds were lower in the fast (12.8 ± 9.2% MVC) and medium (14.5 ± 9.9% MVC) conditions compared to the slow (18.2 ± 8.9% MVC) condition. The initial discharge frequency was lower in the slow (5.8 ± 3.1 Hz) than the fast (6.7 ± 1.4 Hz), but not than the medium (6.4 ± 2.4 Hz) condition. The surface EMG was greater in the fast (mean RMS: 0.029 ± 0.017 mV) compared to the slow condition (0.019 ± 0.013 mV). We propose that the increase in muscle fascicle shortening velocity reduces the force-generating capacity of the muscle, therefore requiring greater neural drive to generate the same forces.

Advances and future directions in the care of patients with facial paralysis

Advances and future directions in the care of patients with facial paralysis

MScanFit motor unit number estimation of human anconeus muscle.

Motor unit number estimation (MUNE) studies of the anconeus muscle are very limited, although the information they provide is useful for neurophysiological investigations. The objective of this study was to estimate the number of motor units in the anconeus muscle. Compound muscle action potential scans of the anconeus muscle were recorded from 11 healthy participants, all of whom were tested on two occasions. MUNE was determined from the MScanFit program. The average MUNE of the anconeus muscle was 55.09 ± 3.27 (mean ± standard error of the mean) for the first test and 54.64 ± 3.70 for the retest, demonstrating excellent measurement reliability, with an intraclass correlation coefficient of 0.90. A relatively low motor unit number is found in the anconeus, a muscle not comprehensively studied in literature.

Post-Stroke Treatment with Neuromuscular Functional Electrostimulation of Antagonistic Muscles and Kinesiotherapy Evaluated with Electromyography and Clinical Studies in a Two-Month Follow-Up.

The aim of this study was to determine the sustained influence of personalized neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy (mainly, proprioceptive neuromuscular facilitation (PNF)) on the activity of muscle motor units acting antagonistically at the wrist and the ankle in a large population of post-stroke patients. Clinical evaluations of spasticity (Ashworth scale), manual muscle testing (Lovett scale), and surface electromyography recordings at rest (rEMG) and during attempts of maximal muscle contraction (mcEMG) were performed three times in 120 post-stroke patients (T0: up to 7 days after the incidence; T1: after 21 days of treatment; T2: after 60 days of treatment). Patients (N = 120) were divided into two subgroups—60 patients received personalized NMFES and PNF treatment (NMFES+K), and the other 60 received only PNF (K). The NMFES+K therapy resulted in a decrease in spasticity and an increase in muscle strength of mainly flexor muscles, in comparison with the K group. A positive correlation between the increase of rEMG amplitudes and high Ashworth scale scores and a positive correlation between low amplitudes of mcEMG and low Lovett scale scores were found in the wrist flexors and calf muscles on the paretic side. Negative correlations were found between the rEMG and mcEMG amplitudes in the recordings. The five-grade alternate activity score of the antagonists’ actions improved in the NMFES+K group. These improvements in the results of controlled NMFES treatment combined with PNF in patients having experienced an ischemic stroke, in comparison to the use of kinesiotherapy alone, might justify the application of conjoined rehabilitation procedures based on neurophysiological approaches. Considering the results of clinical and neurophysiological studies, we suppose that NMFES of the antagonistic muscle groups acting at the wrist and the ankle may evoke its positive effects in post-stroke patients by the modulation of the activity more in the spinal motor centers, including the level of Ia inhibitory neurons, than only at the muscular level.