Rectus Femoris Muscle Thickness Research Articles

The predictive value of GLIM criteria on clinical outcomes and responses to nutritional support in patients with neurocritical illnesses

Neurocritically ill patients frequently exhibit coma, gastroparesis, and intense catabolism, leading to an increased risk of malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition was created to achieve a consistent malnutrition diagnosis across diverse populations. This study aimed to validate the concurrent and predictive validity of GLIM criteria in patients with neurocritical illnesses. A total of 135 participants were followed from admission to the neurocritical unit (NCU) until discharge. Comparing GLIM criteria to the Subjective Global Assessment (SGA), sensitivity was 0.95 and specificity was 0.69. Predictive validity of GLIM criteria was assessed using a composite adverse clinical outcome, comprising mortality and various major complications. Adjusted hazard ratios for moderate and severe malnutrition were 2.86 (95% CI 1.45–5.67) and 3.88 (95% CI 1.51–9.94), respectively. Changes in indicators of nutritional status, including skeletal muscle mass and abdominal fat mass, within 7 days of admission were obtained for 61 participants to validate the predictive capability of the GLIM criteria for the patients’ response of standardized nutritional support. The GLIM criteria have a statistically significant predictive validity on changes in rectus femoris muscle thickness and midarm muscle circumference. In conclusion, the GLIM criteria demonstrate high sensitivity for diagnosing malnutrition in neurocritically ill patients and exhibit good predictive validity.

Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus

BackgroundFrailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters.MethodsWe conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness.ResultsIn all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty.ConclusionsUS-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

Sonographic Measurements of Rectus Femoris Muscle Thickness Strongly Predict Neutropenia in Cancer Patients Receiving Chemotherapy.

The objective of this study was to explore the possible association between low skeletal muscle mass (SMM)-assessed by computed tomography (CT) and ultrasound (US)-and hematologic toxicity in cancer patients. A prospective cohort study was conducted in cancer patients who received anthracycline-based chemotherapy between 2018 and 2020 and who had baseline abdominal CT including L3 level for measuring SMM. Regional muscle measurements were carried out using US. A total of 65 patients (14 males, 51 females) were included. ROC (receiver operating characteristic) analysis identified threshold values of 18.0 mm [AUC (area under the curve) = 0.765] for females and 20.0 mm (AUC = 0.813) for males, predicting severe neutropenia. Using these cut-offs, females with low rectus femoris (RF) thickness (<18.0 mm) had a significantly higher incidence of grade ≥3 neutropenia (50.0% vs. 10.8%, p = 0.005), and males with low RF values (<20.0 mm) had a higher incidence (80.0% vs. 22.2%, p = 0.063). A regression analysis, irrespective of age, gender, and body mass index, revealed that only low RF muscle thickness increased the risk of grade 3-4 neutropenia by 9.210 times (95% CI = 2.401-35.326, p = 0.001). Utilizing US to measure RF muscle thickness aids in identifying cancer patients at an elevated risk of developing neutropenia. Needless to say, US can serve as a convenient and easily accessible tool for assessing low SMM, providing repeat point-of-care evaluations in clinical practice.

Predictive modeling of frailty status in elderly abdominal surgery patients by preoperative quadriceps ultrasound testing.

To develop a predictive model based on preoperative quadriceps ultrasound measurements to determine frailty status in elderly patients undergoing abdominal surgery. The clinical data of 148 elderly patients who underwent abdominal surgery from July 2018 to June 2022 were retrospectively analyzed. The patients were assessed for frailty using the Fried Frailty Phenotype Assessment Scale after operation and divided into a no-frailty group (n=89) and a frailty group (n=59). The differences in the patient's clinical data, perioperative indexes, and imaging indexes were compared. The risk factors affecting the frailty status of elderly patients undergoing abdominal surgery were analyzed by logistic regression. The efficacy of the prediction model was evaluated by receiver operating characteristic (ROC) curve, with model validity confirmed through calibration curves and decision curve analysis (DCA). The proportion of patients with age ≥80 and BMI ≥23 kg/m2 in the frailty group was significantly higher than that in the no-frailty group (both P<0.01). The operation duration and postoperative hospital stay in the frail group were significantly longer the non-frail group, and the complication rate within postoperative 7 days was significantly higher than that in the non-frail group (all P<0.05). The cross-sectional area of rectus femoris muscle, vastus medialis muscle thickness, vastus intermedius muscle thickness, rectus femoris muscle thickness, and lateral femoris muscle thickness were significantly less in the frail group than those of the no-frail group (all P<0.001). Multifactorial logistic regression analysis showed that BMI, surgical duration, vastus medialis muscle thickness, vastus intermedius muscle thickness, rectus femoris muscle thickness, and lateral femoral muscle thickness were independent risk factors affecting frailty status in elderly patients undergoing abdominal surgery (all P<0.05). The predictive model demonstrated high accuracy with an AUC of 0.926. BMI and thickness of all quadriceps muscle components were significant factors affecting the frailty status of elderly patients undergoing abdominal surgery. In addition, the developed model, with excellent accuracy, offers a potential tool for preoperative risk assessment in this patient population.

Evaluation of the prognostic value of Rectus Abdominis muscle thickness and Rectus Femoris muscle thickness guided by ultrasound in intensive care patients. Observational study

Evaluation of the prognostic value of Rectus Abdominis muscle thickness and Rectus Femoris muscle thickness guided by ultrasound in intensive care patients. Observational study

The relationship between pressure injuries and ultrasonographically measured rectus femoris muscle thickness

The relationship between pressure injuries and ultrasonographically measured rectus femoris muscle thickness

Ultrasound Evaluation of Rectus Femoris Muscle Thickness as a Diagnostic Tool for Sarcopenia in Peritoneal Dialysis Patients

Ultrasound Evaluation of Rectus Femoris Muscle Thickness as a Diagnostic Tool for Sarcopenia in Peritoneal Dialysis Patients

Resistance training alters body composition in middle-aged women depending on menopause - A 20-week control trial

BackgroundResistance training (RT) is effective in counteracting the age- and menopause-related loss of muscle mass (MM) and strength in middle-aged women (40–60 years). Research on RT with free weights is limited in pre- and post-menopausal women. Based on this, a 20-week training intervention was conducted with this population to investigate the effects of systematic RT with free weights on strength capacity and body composition.MethodForty-one healthy women (52.0 ± 3.6 years) participated in this study. After 10-week control phase (no RT, T0-T1) followed by a 10-week intervention phase (T1-T2) with RT twice a week and 6–8 sets of each muscle per week. Subjects were randomly assigned to a low-intensity (50% 1-RM) or moderate-intensity (75% 1-RM) RT group and divided into pre-menopausal and post-menopausal according to their hormone profile. Fat-free mass (FFM), MM, fat mass (FM), muscle thickness (Vastus lateralis (VL), Rectus femoris (RF), Triceps brachii (TB)), grip strength, 1-RM squat and bench press were assessed before and after each phase. Statistical analysis was performed using a linear mixed model to account for fixed (time and group) and random (individual) effects.ResultsA total of 31 women successfully completed the study. No injuries occurred during the intervention. Significant increases in 1-RM squat and bench press were observed in all groups. No interaction effect was observed for the strength parameters. In pre-menopausal women, FFM, MM and RF muscle thickness increased significantly, while VL showed a trend. These effects were not present in post-menopausal women regardless of RT intensity.ConclusionRT with free weight is safe and effective for middle-aged women to increase 1-RM. Hypertrophy effects were found exclusively in pre-menopausal women. To achieve hypertrophy and/or body composition changes in post-menopausal women, larger training volumes (> 6–8 sets/muscle per week) are likely required.

Predictors of 3-month mortality with muscle ultrasound and palliative prognostic tools among patients admitted to palliative care units.

Prognostic factors are an important issue in progressive and life-limiting diseases. This study evaluate 3-month mortality in patients admitted to the palliative care unit (PCU). In this study, the patient's demographics, comorbidities, nutritional status, and laboratory values were recorded. The palliative performance scale (PPS), the palliative prognostic index (PPI), and the palliative prognostic (PaP) score were calculated. The rectus femoris (RF) cross-sectional area (CSA), RF muscle thickness, gastrocnemius (GC) medialis muscle thickness, pennation angle and fascicle length of the GC were measured by ultrasound for survival prediction. A total of 88 patients enrolled during the study period, with a mean age of 73.6 ± 13.3 years and a 3-month mortality rate of 59.1%. The findings of a multivariable Cox proportional hazards regression model based on age, gender, C-reactive protein level and Nutrition Risk Screening 2002 scores as covariates revealed the PPI and the PaP score to be significant predictors of 3-month mortality. In addition, in the unadjusted Cox proportional hazard regression analysis, the CSA of the RF muscle was also found to be a significant predictor of 3-month mortality. Findings revealed that the combined use of the CSA of the RF, the PPI, and the PaP score are reliable predictors of mortality in patients admitted to the PCU.

Association of nutritional status, frailty, and rectus femoris muscle thickness measured by ultrasound and weaning in critically ill elderly patients.

Sarcopenia and frailty are critical factors linked with poor clinical outcomes among elderly individuals. This study aims to investigate the association between nutritional assessment tests and frailty with muscle thickness measured by ultrasound and their relationship with weaning among critically ill elderly patients. Patients who were over 65 years old and required invasive ventilation were assessed for nutritional status and clinical frailty scale upon admission to the intensive care unit. Additionally, the thickness of their rectus femoris and vastus intermedius muscles were measured by ultrasound within 48 hours of intubation. Correlation analysis was conducted to examine the relationship between screening tests, frailty, and ultrasound results. The association between these parameters and weaning success was also evaluated. Between May and August 2022, 32 consecutive patients were enrolled in the study. The mean age was 79.3 ± 7.9, and 18 (56.3%) of them were female. Median APACHE-II- and first-day SOFA scores were 22.5 (16.2-29.7) and 7 (5-10.75), respectively. There was a moderate negative correlation between the thickness of the rectus femoris and frailty (r= -0.41, p= 0.036), and there was a moderate positive correlation between the rectus femoris and geriatric nutritional risk index (r= 0.45, p= 0.017). Of them, 18 (56.3%) patients were classified as weaning failure in which the mean frailty score was higher (7.6 ± 0.9 vs 6.5 ± 1.7, p= 0.035), sepsis (18 vs 7, p<0.001) and use of vasopressor (17 vs 6, p= 0.004) more common, and in-hospital mortality were higher (18 vs 5, p<0.001). Bedside ultrasound could be beneficial for detecting nutritional high-risk patients. Frailty was associated with muscle thickness, and it was also associated with weaning failure.

Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey

ObjectivesMalnutrition is a clinical condition that is frequently seen in critically ill patients in the intensive care unit (ICU). Although there are many scoring systems and tools used to determine...

Muscle Architecture and Subcutaneous Fat Measurements of Rectus Femoris and Vastus Lateralis at Optimal Length Aided by a Novel Ultrasound Transducer Attachment.

Purpose: This cross-sectional study determines the sensitivity of muscle architecture and fat measurements of the rectus femoris (RF) and vastus lateralis (VL) muscles from ultrasound images acquired with varying transducer tilt, using a novel transducer attachment, in healthy adults. Secondary objectives were to estimate intrarater and interrater reliability of image measurement and acquisition, respectively. Methods: Thirty healthy adults participated (15 women and 15 men; 25 [SD 2.5] y). Ultrasound image acquisition was conducted by two raters at different transducer tilts relative to the skin: estimated perpendicular, and five measured angles (80°, 85°, 90°, 95°, 100°) using the transducer attachment. Muscle thickness (MT), subcutaneous fat thickness (FT), pennation angle (PA), and fascicle length (FL) were measured. Sensitivity and reliability were assessed using intra-class correlation coefficients (ICCs) and standard error of measurements (SEMs). Results: MT and FT for RF and VL were not sensitive to transducer tilt. However, PA and FL were sensitive to transducer tilt. MT and FT for both muscles showed high ICCs and low SEMs for intrarater and interrater reliability. For PA of both muscles, standardizing transducer tilt improved interrater ICCs and lowered SEMs. Conclusion: MT and FT measurements of RF and VL acquired at 60° knee flexion are robust to varying transducer tilt angles. PA measurements benefit from standardizing transducer tilt.

Ultrasound Assessment of Spastic Muscles in Ambulatory Chronic Stroke Survivors Reveals Function-Dependent Changes.

To correlate ultrasound characteristics of spastic muscles with clinical and functional measurements in chronic stroke survivors. Ultrasound assessment and clinical and functional assessments were performed in 28 ambulatory stroke survivors (12 females, mean age 57.8 ± 11.8 years, 76 ± 45 months after stroke). Muscle thickness in the affected side was decreased compared with the contralateral side (p < 0.001). The decrease was more evident in the upper limb muscles. On the affected side, the Heckmatt scale score was lowest (closer to normal) in the rectus femoris (RF) muscle compared with other muscles (biceps brachii (BB), flexor carpi ulnaris (FCU) and medial gastrocnemius (MG)). Muscle thickness and echogenicity of spastic muscles did not correlate with spasticity, as measured with the modified Ashworth scale (MAS), Fugl-Meyer motor assessment scores, age, or time since stroke. There was a significant negative correlation between grip strength and percentage decrease in muscle thickness for the spastic FCU muscle (r = -0.49, p = 0.008). RF muscle thickness correlated with ambulatory function (Timed Up and Go test (r = 0.44, p = 0.021) and 6-metre walk test (r = 0.41, p = 0.032)). There was no significant correlation between echogenicity and functional assessments Conclusion: Ambulatory chronic stroke survivors had function-dependent changes in muscle thickness on the affected side. Muscle thickness and echogenicity of spastic muscles did not correlate with spasticity, Fugl-Meyer motor assessment scores, age, or time since stroke.

Ultrasonographic findings in long COVID: A cross-sectional study of 312 patients.

Fatigue and muscle weakness are common complaints in COVID-19 survivors. However, little is still known about the skeletal muscle qualitative and quantitative characteristics after hospitalization due to moderate and severe COVID-19. To assess rectus femoris and vastus intermedius muscle thickness (MT) and rectus femoris echo intensity (EI) and to establish its association with demographic, clinical, functional, and inflammatory parameters in long COVID patients after hospital discharge. Cross-sectional study with 312 COVID-19 patients (53.53% male; age: 54.59 ± 13.50 years), with a laboratory-confirmed diagnosis of COVID-19. Patients were assessed 3-11 months after hospital discharge. We evaluated MT of the right rectus femoris and vastus intermedius and EI of the right rectus femoris using a portable ultrasound system, 6-13 MHz, broadband linear transducer. We corrected EI using the subcutaneous fat thickness. Ultrasonographic parameters were tested in association with demographic (sex and age); functional (Handgrip strength measurement, Timed Up and Go, 1 min Sit-to-Stand test, EuroQoL-5 Dimensions-5 Levels, World Health Organization Disability Assessment Schedule (WHODAS 2.0), Post-COVID-19 Functional Status, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT), Medical Research Council (MRC) sum score, Borg Dyspnea Scale, MRC Dyspnea score, Visual Analogue Scale (VAS), Epworth Sleepiness Scale, Insomnia Severity Index, Functional Independence Measurement (FIM), and Functional Oral Intake Scale); clinical (length of hospital stay, intubation, and presence of comorbidities such as systemic hypertension, diabetes, obesity, chronic obstructive pulmonary disease, asthma), and inflammatory data assessed by the C-reactive protein and D-dimer serum concentrations. Rectus femoris MT was associated with age, handgrip strength, Epworth Sleepiness Scale, and subcutaneous fat thickness (r2 = 27.51%; p < 0.0001). Vastus intermedius MT was associated with age, pain intensity, handgrip strength, Epworth Sleepiness scale, FIM, and time since hospital discharge (r2 = 21.12%; p < 0.0001). Rectus femoris EI was significantly associated with the male sex, TUG, Epworth Sleepiness Scale, and C-Reactive Protein levels (r2 = 44.39%; p < 0.0001). Mean MT of rectus femoris and vastus intermedius are significantly different (p < 0.001). After hospital discharge, long COVID patients present qualitative and quantitative skeletal muscle characteristics associated with a combination of demographic, clinical, and functional parameters.

The effect of protein enriched nutrition on diaphragm function in mechanically ventilated patients

ObjectivesOur primary aim was to demonstrate the effect of high protein on diaphragm muscle thickness, our secondary aim was to evaluate the correlation of diaphragm thickness fraction with rectus femoris muscle thickness in high protein patients. Patients and methodsThis study included 49 mechanically ventilated patients who were randomly divided into a standard protein (1.2g/kg/d) group and high protein group (2.0g/kg/d). Thickness of rectus femoris, thickness of peak inspiratory diaphragm, thickness of end expiratory diaphragm were measured by ultrasonography. Thickness fraction of diaphragm was calculated. ResultsIn the high protein group, thickness of peak inspiratory diaphragm values were found to be statistically significantly higher on days 3rd, 5th, 7th, and 15th (P<0.05). Thicknesses of end-expiratory diaphragm values were found to be statistically significantly higher on the 3rd, 5th and 7th days (P<0.05). Thicknesses fraction of diaphragm values were found to be statistically significantly higher on days 3rd, 5th, 7th and 15th (P<0.05) in the high protein group. Thicknesses of rectus femoris values were higher in the high protein group compared with standard protein group on the 5th, 7th, and 15th days (P<0.005). In high protein group, statistically significant correlations were found between thickness of rectus femoris and thickness fraction of diaphragm at the 3rd day (rho=0.429, P=0.032). ConclusionThis study showed that diaphragmatic muscle thicknesses were higher in patients who received 2g/kg/d protein supplement, These findings have shown that muscle atrophy can be prevented with high protein support in the intensive care unit.

Effects of whole body vibration exercise combined with weighted vest in older adults: a randomized controlled trial

BackgroundTo evaluate the training effects of whole body vibration (WBV) combined with weighted vest (WV) in older adults.MethodsThis randomized controlled trial study was conducted in healthy older adults living in the community. Fifty-one participants were randomly allocated into 3 groups: group 1 (n = 17), WBV alone, training on WBV at a frequency 30 Hz, amplitude 2 mm, 10 sets of 1 min squats, with 60 s rest, group 2 (n = 15), WV alone, squat exercise, 10 sets of 1 min, with 60 s rest, while WV loaded with 10% body weight and group 3 (n = 19), WBV + WV, combining WBV exercise with the addition of a WV. All groups completed training 3 times per week for 8 weeks. The outcomes were total muscle mass, muscle thickness, maximal isometric strength, single-leg-stance and timed-up-and-go evaluated at baseline and after training.ResultsAs a result of training all groups improved their isometric muscle strength with little difference between groups. The single-leg-stance significantly improved only in WBV + WV group 25.1 ± 10.8 s (mean ± 95% CI, p < 0.01). The timed-up-and-go improved in all groups, but the improvement was significantly greater in the WBV + WV group (17.5 ± 6.9%) compared to the WV (8.5 ± 3.2%) and WBV groups (9.2 ± 5.4%, p = 0.043, 0.023 respectively). Rectus femoris muscle thickness and total muscle mass were significantly increased in all groups equally with little difference between groups.ConclusionThe combined WBV + WV had a greater effect on the single-leg-stance and the timed-up-and-go compared to WV or WBV alone.Trial registrationTCTR20190306001. Thai Clinical Trials Registry (www.thaiclinicaltrials.org). Date of registration: 6 March 2019.

Association Between Knee Extension Strength and Functional Capacity After Intensive Care Unit Discharge: A 6-Mo Prospective Cohort Study.

Assessing functional improvement after intensive care unit discharge is particularly challenging. The aim of this study was to measure the association between (1) changes in knee extension muscle strength or quadriceps femoris and rectus femoris muscle thickness and (2) changes in functionality/function-related measurements in post-intensive care unit patients. This prospective cohort study included adult patients without previous disability, consecutively selected after intensive care unit discharge. Some parameters, such as Short-Form 36, 6-min walking test, 1-min sit-to-stand, and Short Physical Performance Battery, were measured at baseline and 3 and 6 mos after discharge. Correlations were assessed and regression models were built to assess the association between evolution in knee extension strength or muscle thickness and evolution in functional tests. Thirty patients completed the follow-up. Moderate correlation was found between knee extension strength change and Short-Form 36 physical functioning (correlation coefficient [ ρ ] = 0.53), 6-min walking test ( ρ = 0.38), 1-min sit-to-stand ( ρ = 0.52), and Short Physical Performance Battery ( ρ = 0.38). Baseline values and changes in knee extension strength moderately predicted evolution in Short-Form 36 physical functioning ( r2 = 0.32, P = 0.006). Changes in muscle thickness were overall not associated with changes in functional variables. Changes in knee extension muscle strength may inform on functional progression over time after intensive care unit discharge, although confirmatory studies are needed.

Unilateral Strength Training Imparts a Cross-Education Effect in Unilateral Knee Osteoarthritis Patients.

Background: Worldwide, 86 million individuals over the age of 20 were diagnosed with knee osteoarthritis (KOA) in 2020. Hallmark features of KOA are the loss in knee extensor strength, increasing knee pain severity, and deficits in functional performance. There is a critical need for the investigation into potential cost-effective therapeutic interventions in the treatment of KOA. A potential therapeutic option is the cross-education phenomenon. Methods: This was a non-blinded randomized control trial, with a 4-week intervention, with a pre, post and follow-up assessment (3 months post intervention). Outcome measures of isometric knee extensor strength, rectus femoris muscle thickness and neuromuscular activation were assessed at all-time points. Results: Compared to age-matched KOA controls, 4 weeks of unilateral strength training in end-stage KOA patients increased strength of the untrained affected KOA limb by 20% (p < 0.05) and reduced bilateral hamstring co-activation in the KOA intervention group compared to the KOA control group (p < 0.05). Conclusions: A 4-week-long knee extensor strength training intervention of the contralateral limb in a cohort with diagnosed unilateral KOA resulted in significant improvements to knee extensor strength and improved neuromuscular function of the KOA limb. Importantly, these results were maintained for 3 months following the intervention.

Acute effects of electrostimulation and blood flow restriction on muscle thickness and fatigue in the lower body

ABSTRACT Neuromuscular electrical stimulation (NMES) in combination with blood flow restriction (BFR) enhances muscle hypertrophy and force-generating capacity. The present study aimed to investigate the acute effects of BFR and NMES, both in isolation and in combination, on muscle thickness (MT) and fatigue in the lower body of 20 young healthy subjects. Different stimuli were applied for 25 min, defined by the combination of BFR with high- and low-frequency NMES, and also isolated BFR or NMES. Changes in MT were then evaluated by ultrasound of the rectus femoris (RF) and vastus lateralis (VL) muscles at the end of the session (POST) and 15 min later (POST 15’). Lower limb fatigue was evaluated indirectly by strength performance. Results showed that RF MT was higher under the combined protocol (BFR + NMES) or isolated BFR than under NMES – regardless of the frequency – both at POST (p ≤ 0.018) and POST 15’ (p ≤ 0.016). No significant changes in MT were observed under isolated NMES or BFR at POST 15’ when compared with basal values (p ≥ 0.067). No significant differences were observed for VL MT between conditions (p = 0.322) or for fatigue between conditions (p ≥ 0.258). Our results indicate that a combination of BFR and NMES acutely increases MT in sedentary subjects. Also, although not significantly, BFR conditions had a greater tendency to induce fatigue than isolated NMES. Highlights The combination of blood flow restriction (BFR) and neuromuscular electrical stimulation (NMES) produces higher acute cell swelling than the isolated application of either NMES or BFR. BFR in isolation appears to produce greater cell swelling than NMES, regardless of the frequency used. BFR conditions had a greater tendency to induce fatigue than isolated NMES.

Effects Of Body Weight Resistance Training In Hypoxia On Skeletal Muscle Morphology And Function

PURPOSE: This study was to determine the effects of body weight resistance training in hypoxia for 8 weeks on the skeletal muscle morphology and function. METHODS: Fourteen college age male students with no resistance training habits were divided into a normobaric hypoxic (FiO2 = 14.5%) training group (H, n = 7) or a normoxic (FiO2 = 20.9%) training group (N, n = 7). They completed resistance training two times per week for 8 weeks (a total of 16 sessions). The resistance training consisted of seven types of whole-body weight resistance training focusing on eccentric muscle contraction. Knee and elbow extension / flection strength (isometric strength, isokinetic strength, and muscular endurance), muscle thickness (rectus femoris and biceps brachii) and circumference (thigh and upper arm) were measured before and after training. During training session, SpO2 (all of sessions) and hart rate were monitored. Also, we measured growth hormone and cortisol at 10 training session. Each parameter was statistical analyzed by Wilcoxon signed rank tests were completed to identify any significant between-groups (p < 0.05). RESULTS: Elbow and Knee isometric and isokinetic strength tended to increase after training in both groups. But there was no significant difference in isometric and isokinetic strength between H and N groups. The % change of total work capacity in knee muscular endurance of H group tended to higher than that of N group. And, the % change of total work capacity in elbow of H group (108.8 ± 10.2%) was significantly higher than that of N group (96.0 ± 8.5%) (P < 0.05). The biceps brachii muscle thickness was significantly increased after training in the H group (110.2 ± 4.7%) compare with the N group (102.6 ± 3.3%) (P < 0.01). Also, rectus femoris muscle thickness, of H group tended to increase in compare with N group. CONCLUSIONS: It was suggested that body weight resistance training in hypoxia for 8 weeks increased muscle strength as well as traditional resistance training and would be improved muscular endurance and promoted muscle hypertrophy.