Voluntary Muscle Activation Research Articles

The single-leg heel raise does not predict maximal plantar flexion strength in healthy males and females.

IntroductionThe single-leg heel raise test (SLHR) is commonly used in clinical settings to approximate plantar flexor strength, yet this is neither validated nor supported physiologically. The purposes of this study were to: determine (1) associations between SLHR repetitions, maximal plantar flexor strength, and reductions in strength; and (2) whether sex differences exist in performance of the SLHR.MethodsTwenty-eight young, healthy participants (14 males,14 females, 19–30 years) performed repeated single-leg heel raises to task failure. Pre- and post-task measures included maximal voluntary isometric contractions (MVIC), and voluntary activation and contractile properties of the plantar flexor muscles, assessed using peripheral electrical stimulation of the tibial nerve. Surface electromyography was recorded for the medial and lateral gastrocnemius, soleus, and anterior tibialis muscles.ResultsThe SLHR resulted in 20.5% reductions in MVIC torque (p<0.001). However, the number of SLHR repetitions was not correlated with either the baseline MVIC (maximal strength; p = 0.979) or the reduction in MVIC following the SLHR (p = 0.23). There were no sex differences in either the number of SLHR repetitions (p = 0.14), baseline MVIC torque (p = 0.198), or the reduction of MVIC (p = 0.14). MVIC decline was positively associated with the reduction in voluntary activation (r = 0.841, p<0.001), but was not associated with the change in twitch amplitude (p = 0.597).ConclusionsThe SLHR was similar in young males and females yet was a poor predictor of maximal plantar flexor strength but evaluates performance fatigability of the lower extremity specific to dynamic contractions. The reduction in maximal strength at task failure was explained by reduced neural drive to the plantar flexor muscles in both males and females.Impact statementSLHR performance is not a clinical assessment of plantar flexor strength but assesses dynamic lower extremity fatigability that is similar in males and females. Alternate clinical measures for maximal plantar flexion strength need to be developed.

Residual force enhancement in humans: Is there a true non-responder?

When an active muscle is stretched and kept isometrically active, the resulting force is enhanced compared to a purely isometric reference contraction at the same muscle length and activity; a generally accepted muscle property called residual force enhancement (rFE). Interestingly, studies on voluntary muscle action regularly identify a significant number of participants not showing rFE. Therefore, the aim was to unmask possible confounders for this non‐responsive behavior. Ten participants performed maximum voluntary isometric plantarflexion contractions with and without preceding stretch. Contractions were accompanied by the assessment of voluntary activation using the twitch‐interpolation technique. The same test protocol was repeated four additional times with a least on day rest in‐between. Additionally, at the first and fifth sessions, a submaximal tetanic muscle‐stimulation condition was added. At both muscle‐stimulation sessions mean rFE higher 10% (p < 0.028) was found. In contrast, during voluntary muscle action, individual participants showed inconsistent rFE across sessions and only one session (#3) had significant rFE (5%; p = 0.023) in group means. As all participants clearly had rFE in electrical stimulation conditions, structural deficits cannot explain the missing rFE in voluntary muscle action. However, we also did not find variability in voluntary activation levels or muscle activity as the confounding characteristics of “non‐responders.”

Atlas of voluntary facial muscle activation: Visualization of surface electromyographic activities of facial muscles during mimic exercises.

Complex facial muscle movements are essential for many motoric and emotional functions. Facial muscles are unique in the musculoskeletal system as they are interwoven, so that the contraction of one muscle influences the contractility characteristic of other mimic muscles. The facial muscles act more as a whole than as single facial muscle movements. The standard for clinical and psychosocial experiments to detect these complex interactions is surface electromyography (sEMG). What is missing, is an atlas showing which facial muscles are activated during specific tasks. Based on high-resolution sEMG data of 10 facial muscles of both sides of the face simultaneously recorded during 29 different facial muscle tasks, an atlas visualizing voluntary facial muscle activation was developed. For each task, the mean normalized EMG amplitudes of the examined facial muscles were visualized by colors. The colors were spread between the lowest and highest EMG activity. Gray shades represent no to very low EMG activities, light and dark brown shades represent low to medium EMG activities and red shades represent high to very high EMG activities relatively with respect to each task. The present atlas should become a helpful tool to design sEMG experiments not only for clinical trials and psychological experiments, but also for speech therapy and orofacial rehabilitation studies.

Workshop 6: Single-Fiber EMG WS6.1. Voluntary SFEMG: Principles and Parameters

SFEMG is a selective recording technique that identifies action potentials (APs) from individual muscle fibers. Selectivity results from the 25 µm diameter recording surface that exits on the side of the electrode, 3 mm from the tip, and is further enhanced by using a 500Hz high pass filter. SFEMG measures fiber density and neuromuscular jitter. Fiber density is measured during slight voluntary muscle activation. Position the electrode to record with maximum amplitude the AP from one muscle fiber, which triggers the display, and count the number of time-locked acceptable APs (amplitude >200 μV, rise time <300 μs). The FD is the mean number of APs, including the triggering AP, counted at 20 sites throughout the muscle. The FD differs among different muscles and increases with age, especially after age 70 and in distal limb muscles. Jitter is measured either during axonal stimulation or voluntary activation. Stimulate facial nerve branches proximal to their entry into the muscle or anterior to the ear. In limb muscles, stimulate intramuscular axons via a monopolar needle electrode inserted near the endplate zone. Stimulate at 2 to 10 Hz (10 Hz is preferred) and adjust the stimulus intensity to produce a slight twitch. Measure jitter between the stimulus and individual APs. Analyze at least 50 stimuli for each AP and aim to measure at least 30 APs at different sites throughout the muscle. Jitter measured during voluntary activation is less subject to technical problems. Position the electrode to record at least two time-locked acceptable APs. Aim to measure jitter from 20 AP pairs from different sites throughout the muscle. Calculate jitter as the Mean value of Consecutive Differences (MCD) of successive interpotential intervals. A study is abnormal if the mean MCD exceeds the muscle upper limit, or if more than 10% of AP pairs or endplates have increased jitter. With more pronounced disturbances, individual muscle fibers fail to respond to nerve activation, blocking. Jitter can be measured with small concentric needle electrodes if careful attention is given to signal quality and appropriate reference values are used. Fiber density can only be measured with SFEMG electrodes.

Faster intrinsic rate of torque development in elbow flexors than knee extensors: Effect of muscle architecture?

We studied the effect of pennate vs. fusiform muscle architecture on the rate of torque development (RTD) by examining the predominately fusiform elbow flexors (EF) and highly-pennate knee extensors (KE). Seventeen male volunteers (28.4 ± 6.2 years) performed explosive isometric EF and KE contractions (MVCs). Biceps brachii and vastus lateralis fascicle angles were measured to confirm their architecture, and both the rate of voluntary muscle activation (root-mean-square EMG in the 50 ms before contraction onset; EMG-50) and electromechanical delay (EMD; depicting muscle-tendon series elasticity) were assessed as control variables to account for their influence on RTD. MVC torque, early (RTD50) and late (RTD200) RTDs were calculated and expressed as absolute and normalized values. Absolute MVC torque (+412%), RTD50 (+215%), and RTD200 (+427%) were significantly (p < 0.001) higher in KE than EF. However, EF RTD50 was faster (+178%) than KE after normalization (p = 0.02). EMG-50 and EMD did not differ between muscle groups. The results suggest that the faster absolute RTD in KE is largely associated with its higher maximal torque capacity, however in the absence of differences in rates of muscle activation, fiber type, and EMD the fusiform architecture of EF may be considered a factor allowing its faster early RTD relative to strength capacity.

Acute Capsaicin and Exercise Performance in Humans: Potential Neuromuscular Mechanisms

The pungent bioactive ingredient in peppers (Capsaicin; CAP) has been widely investigated for its activation of the transient receptor potential vanilloid 1 (TRPV1) channel on sensory neurons. It has been shown to improve mitochondrial biogenesis, adenosine triphosphate (ATP) production and vascular function. In animal models has been demonstrated that increases exercise performance and decreases fatigue development. However, whether acute oral CAP improves endurance performance and the potential underlying mechanisms remains elusive. This study aimed to evaluate the potential ergogenic and anti-fatigue effects of acute oral CAP supplementation in healthy humans. In a double-blind, placebo-controlled, cross-over design, 10 young healthy males performed constant-load cycling exercise (294±55W; 85% of peak power output) to exhaustion, after acute ingestion of placebo (PL; 1000mg fiber pill) and CAP (780mg pill) capsules. Fatigue was assessed on the dominant quadriceps with the interpolated twitch technique, via changes in supramaximal electrical stimulation pre- vs. post-exercise, during isometric maximal voluntary contractions (MVC) and at rest. Cardiopulmonary parameters (heart rate, cardiac output, oxygen consumption, ventilation) were assessed throughout the exercise. No statistically significant differences were detected in the muscle contractile functions, despite a trend (P=0.07) for a decreased time to exhaustion during CAP (PL: 369±85 vs. CAP: 296±64 sec). All the values (except muscle voluntary activation (%VMA)) significantly decreased from pre- to post-exercise in both conditions. The exercise-induced attenuation of the intrinsic muscle contractile properties (Maximal rate of force development (MRFD) and Maximal relaxation rate (MRR) of the resting twitch force) were mitigated, in part, by CAP. Notably, in the PL condition MRR was seemingly reduced by 47±33%, while only of 29±68% in CAP; contrarily, MRFD decreased similarly of 47±23% and of 40±27% in PL and CAP, respectively. In 9 participants, the resting twitch (estimate of peripheral muscle fatigue) pre- vs. post-exercise decreased less with CAP (PL: 44±17 vs. CAP: 37±13%). CAP did not influence the MVC nor %VMA. The cardiopulmonary responses were similar between the conditions (P>0.05). In contrast to prior work, acute oral capsaicin did not improve endurance performance in the present study. CAP did elicit a tendency for faster relaxation rate, which might suggest an enhanced activation of the sarcoendoplasmic reticulum calcium ATPase (SERCA) pumps, thereby increasing the rate of Ca2+ reuptake and relaxation. However, this altered Ca2+ handling might also increase ATP demand. The tendency for CAP to attenuate the exercise-induced reduction in muscle function, or fatigue, might provide a mechanistic basis for the previously demonstrated beneficial effects of CAP. Further work is needed in larger samples, to further determine the optimal dosing and loading strategies, to better understand the potential ergogenic effects of capsaicin.

Dr. Physiological study of doshas in dincharya and ritucharya w.s.r biological clock

According to ayurveda biological clock organizes your entire day as per the Ayurvedic clock. Every day, human body cycles through three doshas-Vata, Pitta and Kapha. One dosha is dominant at one particular time. Thus, tuning the body as per the qualities and timings of doshas can ensure harmony in life. According to Ayurvedic concepts, body is made up of three types of Doshas, viz. Vata, Pitta, Kapha. Balancing between Doshas leads to health whereas the imbalance leads to disease condition. At specific time in each day, or seasons or at given age the balance between Tridosha is in constant flux. Balancing of Doshas is possible with ‘Dinacharya’ and ‘Rutucharya’, which will lead to syncing of the inner biological clock. Thus, the lifestyle disorders could be managed with changes in the lifestyle with least medical intervention. Rhythmicity is a ubiquitous phenomenon. Rhythmic temporal patterns are considered and important factor in therapeutics as effective treatments should work in conjunction with body’s clocks. Te concept of chronobiology is well evidenced by the cyclic alterations of dosas in the body. The Ayurvedic way of living as well as healing has been developed keeping in mind these biological clocks so as to maintain a balanced state of dosas in the present paper an attempt is made to review the ayurvedic concept of chronobiology and chronotherapy. Circadian rhythm is the cyclical 24-hour period of human biological activity. Within the circadian (24-hour) cycle, a person usually sleeps approximately 8 hours and stays awake for 16 hours. During the wakeful hours, mental and physical functions are most active and tissue cell growth increases. During sleep, voluntary muscle activities nearly disappear and there is a decrease in metabolic rate, respiration, heart rate, body temperature, and blood pressure. In Ayurveda, this concept is based on three Doshas- Vata, Pitta, Kapha - which predominantly govern our daily routine life. These Doshas maintain the integrity of our body by creating, assimilating &amp; diffusing strength. In this article, efforts will be made to correlate the Doshic influence which affects the human body.

Reliability of isokinetic tests of velocity‐ and contraction intensity‐dependent plantar flexor mechanical properties

“Flexibility” tests are traditionally performed voluntarily relaxed by rotating a joint slowly; however, functional activities are performed rapidly with voluntary/reflexive muscle activity. Here, we describe the reliabilities and differences in maximum ankle range of motion (ROMmax) and plantar flexor mechanical properties at several velocities and levels of voluntary force from a new test protocol on a commercially available dynamometer. Fifteen participants had their ankle joint dorsiflexed at 5, 30, and 60° s−1 in two conditions: voluntarily relaxed and while producing 40% and 60% of maximal eccentric torque. Commonly reported variables describing ROMmax and resistance to stretch were subsequently calculated from torque and angle data. Absolute (coefficient of variation (CV%) and typical error) and relative (ICC2,1) reliabilities were determined across two testing days (≥72 h). ROMmax relative reliability was good in voluntarily relaxed tests at 30 and 60° s−1 and moderate at 5° s−1, despite CVs ≤ 10% for all velocities. Tests performed with voluntary muscle activity were only reliable when performed at 5° s−1, and ROMmax reliability was moderate and CV ≤ 8%. For most variables, the rank order of participants differed between the slow‐velocity, relaxed test, and those performed at faster speeds or with voluntary activation, indicating different information. A person's flexibility status during voluntarily relaxed fast or active stretches tended to differ from their status in the traditional voluntarily relaxed, slow‐velocity test. Thus, “flexibility” tests should be completed under conditions of different stretch velocity and levels of muscle force production, and clinicians and researchers should consider the slightly larger between‐day variability from slow‐velocity voluntarily relaxed tests.

Electrically induced quadriceps fatigue in the contralateral leg impairs ipsilateral knee extensors performance.

Muscle fatigue induced by voluntary exercise, which requires central motor drive, causes central fatigue that impairs endurance performance of a different, nonfatigued muscle. This study investigated the impact of quadriceps fatigue induced by electrically induced (no central motor drive) contractions on single-leg knee-extension (KE) performance of the subsequently exercising ipsilateral quadriceps. On two separate occasions, eight males completed constant-load (85% of maximal power-output) KE exercise to exhaustion. In a counterbalanced manner, subjects performed the KE exercise with no pre-existing quadriceps fatigue in the contralateral leg on one day (No-PreF), whereas on the other day, the same KE exercise was repeated following electrically induced quadriceps fatigue in the contralateral leg (PreF). Quadriceps fatigue was assessed by evaluating pre- to postexercise changes in potentiated twitch force (ΔQtw,pot; peripheral fatigue), and voluntary muscle activation (ΔVA; central fatigue). As reflected by the 57 ± 11% reduction in electrically evoked pulse force, the electrically induced fatigue protocol caused significant knee-extensors fatigue. KE endurance time to exhaustion was shorter during PreF compared with No-PreF (4.6 ± 1.2 vs 7.7 ± 2.4 min; P < 0.01). Although ΔQtw,pot was significantly larger in No-PreF compared with PreF (-60% vs -52%, P < 0.05), ΔVA was greater in PreF (-14% vs -10%, P < 0.05). Taken together, electrically induced quadriceps fatigue in the contralateral leg limits KE endurance performance and the development of peripheral fatigue in the ipsilateral leg. These findings support the hypothesis that the crossover effect of central fatigue is mainly mediated by group III/IV muscle afferent feedback and suggest that impairments associated with central motor drive may only play a minor role in this phenomenon.

Estimation of maximal muscle electromyographic activity from the relationship between muscle activity and voluntary activation.

Maximal muscle activity recorded with surface electromyography (EMG) is an important neurophysiological measure. It is frequently used to normalize EMG activity recorded during passive or active movement. However, the true maximal muscle activity cannot be determined in people with impaired capacity to voluntarily activate their muscles. Here, we determined whether maximal muscle activity can be estimated from muscle activity produced during submaximal voluntary activation. Twenty-five able-bodied adults (18 males, mean age 29 yr, range 19-64 yr) participated in the study. Participants were seated with the knee flexed 90° and the ankle in 5° of dorsiflexion from neutral. Participants performed isometric voluntary ankle plantarflexion contractions at target torques, in random order: 1, 5, 10, 15, 25, 50, 75, 90, 95, and 100% of maximal voluntary torque. Ankle torque, muscle activity in soleus, medial and lateral gastrocnemius muscles, and voluntary muscle activation determined using twitch interpolation were recorded. There was a strong loge-linear relationship between measures of muscle activation and muscle activity in all three muscles tested. Linear mixed models were fitted to muscle activation and loge-transformed EMG data. Each 1% increase in muscle activation increased muscle activity by a mean of 0.027 ln(mV) [95% confidence interval (CI) 0.025 to 0.029 ln(mV)] in soleus, 0.025 ln(mV) [0.022 to 0.028 ln(mV)] in medial gastrocnemius, and 0.028 ln(mV) [0.026 to 0.030 ln(mV)] in lateral gastrocnemius. The relationship between voluntary muscle activation and muscle activity can be described with simple mathematical functions. In future, it should be possible to normalize recorded muscle activity using these types of functions.NEW & NOTEWORTHY Muscle activity is often normalized to maximal muscle activity; however, it is difficult to obtain accurate measures of maximal muscle activity in people with impaired voluntary neural drive. We determined the relationship between voluntary muscle activation and plantarflexor muscle activity across a broad range of muscle activation values in able-bodied people. The relationship between voluntary muscle activation and muscle activity can be described with simple mathematical functions capable of estimating maximal muscle activity.

Reliability of Tibialis Anterior Muscle Voluntary Activation Using the Interpolated Twitch Technique and the Central Activation Ratio in People with Stroke.

Voluntary activation (VA) is measured by applying supramaximal electrical stimulation to a muscle during a maximal voluntary contraction (MVC). The amplitude of the evoked muscle twitch is used to determine any VA deficit, and indicates incomplete central neural drive to the motor units. People with stroke experience VA deficits and greater levels of central fatigue, which is the decrease in VA that occurs following exercise. This study investigated the between-session reliability of VA and central fatigue of the tibialis anterior muscle (TA) in people with chronic stroke (n = 12), using the interpolated twitch technique (ITT), adjusted-ITT, and central activation ratio (CAR) methods. On two separate sessions, supramaximal electrical stimulation was applied to the TA when it was at rest and maximally activated, at the start and end of a 30-s isometric dorsiflexor MVC. The most reliable measures of VA were obtained using the CAR calculation on transformed data, which produced an ICC of 0.92, and a lower bound confidence interval in the good range (95% CI 0.77 to 0.98). Reliability was lower for the CAR calculation on non-transformed data (ICC 0.82, 95% CI 0.63 to 0.91) and the ITT and adjusted-ITT calculations on transformed data (ICCs 0.82, 95% CIs 0.51 to 0.94), which had lower bound confidence intervals in the moderate range. The two ITT calculations on non-transformed data demonstrated the poorest reliability (ICCs 0.62, 95% CI 0.25 to 0.74). Central fatigue measures demonstrated very poor reliability. Thus, the reliability for VA in people with chronic stroke ranged from good to poor, depending on the calculation method and statistical analysis method, whereas the reliability for central fatigue was very poor.

Effect of proprioceptive neuromuscular facilitation stretching on physical fitness: A Critical Analysis

Background: PNF stretching is a reputed exercise for the development of physical exercise and sports performance. However, there was no review study on PNF stretching and physical fitness. Aim: The aim of the study was to identify the effect of PNF stretching on physical fitness in the perspective of positive effect, negative effect and no effect. Method: 28 articles fulfilling the criteria for made this review study after inclusion and exclusion were done. All articles were collected through online scientific data sources. Discussion: Interpretation was made on the following three areas: PNF and positive effect on physical fitness; PNF and negative effect on physical fitness; PNF and no effect on physical fitness. Conclusion: It may be conclude that PNF stretching has some positive effect for the development of physical fitness, i.e flexibility, strength, balance, endurance, sprinting performance. Researchers reported some adverse effect on muscle activation and strength. Some researchers also reported that there was no effect on isometric maximal voluntary contraction and muscle activity.

Acute effects of dynamic stretching on neuromechanical properties: an interaction between stretching, contraction, and movement.

The present study aimed to investigate the acute effects of dynamic stretching on neurophysiological and mechanical properties of plantar flexor muscles and to test the hypothesis that dynamic stretching resulted from an interaction between stretching, movement, and contraction. The dynamic stretching conditioning activity (DS) was compared to static stretching (SS), passive cyclic stretching (PCS), isometric contractions (IC), static stretching followed by isometric contractions (SSIC), and control (CO) conditions. Stretching amplitude (DS, SS, PCS and SSIC), contraction intensity (DS, IC and SSIC) and duration (all 6 conditions) were matched. Thirteen volunteers were included. Passive torque, fascicle length, and stiffness were evaluated from a dynamometer and ultrasonography during passive dorsiflexion. Neuromuscular electrical stimulation was used to investigate contractile properties [peak twitch torque (PTT), and rate of torque development (RTD)] and muscle voluntary activation (%VA). Gastrocnemius lateralis electromyographic activity (GL EMG/Mwave) was obtained during maximal voluntary contraction. All of these parameters were measured immediately before and 10s after each experimental condition. Peak twitch torque, RTD, %VA, GL EMG/Mwave remained unaltered, while passive torque was significantly reduced after DS (- 8.14 ± 2.21%). SS decreased GL EMG/Mwave (- 7.83 ± 12.01%) and passive torque (- 2.16 ± 7.25%). PCS decreased PTT (- 3.40 ± 6.03%), RTD (- 2.96 ± 5.16%), and passive torque (- 2.16 ± 2.05%). IC decreased passive torque (- 7.72 ± 1.97%) and enhanced PTT (+ 5.77 ± 5.19%) and RTD (+ 7.36 ± 8.35%). However, SSIC attenuated PTT and RTD improvements as compared to IC. These results suggested that dynamic stretching is multi-component and would result from an interaction between stretching, contraction, and movement.

Fatigue following mild traumatic brain injury relates to visual processing and effort perception in the context of motor performance

IntroductionFollowing mild traumatic brain injury (mTBI), a substantial number of patients experience disabling fatigue for months after the initial injury. To date, the underlying mechanisms of fatigue remain unclear. Recently, it was shown that mTBI patients with persistent fatigue do not demonstrate increased performance fatigability (i.e., objective performance decline) during a sustained motor task. However, it is not known whether the neural activation required to sustain this performance is altered after mTBI. MethodsBlood oxygen level-dependent (BOLD) fMRI data were acquired from 19 mTBI patients (>3 months post-injury) and 19 control participants during two motor tasks. Force was recorded from the index finger abductors of both hands during submaximal contractions and a 2-minute maximal voluntary contraction (MVC) with the right hand. Voluntary muscle activation (i.e., CNS drive) was indexed during the sustained MVC using peripheral nerve stimulation. Fatigue was quantified using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS). Questionnaire, task, and BOLD data were compared across groups, and linear regression was used to evaluate the relationship between BOLD-activity and fatigue in the mTBI group. ResultsThe mTBI patients reported significantly higher levels of fatigue (FSS: 5.3 vs. 2.6, p < 0.001). Both mTBI- and control groups demonstrated significant performance fatigability during the sustained MVC, but no significant differences in task performance or BOLD-activity were observed between groups. However, mTBI patients reporting higher FSS scores showed increased BOLD-activity in the bilateral visual cortices (mainly extrastriate) and the left midcingulate gyrus. Furthermore, across all participants mean voluntary muscle activation during the sustained MVC correlated with long lasting post-contraction BOLD-activation in the right insula and midcingulate cortex. ConclusionThe fMRI findings suggest that self-reported fatigue in mTBI may relate to visual processing and effort perception. Long lasting activation associated with high levels of CNS drive might be related to changes in cortical homeostasis in the context of high effort.

Training-Induced Acute Neuromuscular Responses to Military Specific Test during a Six-Month Military Operation.

Limited data are available regarding strength and endurance training adaptations to occupational physical performance during deployment. This study assessed acute training-induced changes in neuromuscular (electromyography; EMG) and metabolic (blood lactate, BLa) responses during a high-intensity military simulation test (MST), performed in the beginning (PRE) and at the end (POST) of a six-month crisis-management operation. MST time shortened (145 ± 21 vs. 129 ± 16 s, −10 ± 7%, p < 0.001) during the operation. Normalized muscle activity increased from PRE to POST in the hamstring muscles by 87 ± 146% (116 ± 52 vs. 195 ± 139%EMGMVC, p < 0.001) and in the quadriceps by 54 ± 81% (26 ± 8 vs. 40 ± 20%EMGMVC, p < 0.001). In addition, higher acute BLa values were measured after MST during POST. Changes in BLa and EMG suggested an increased neural input and metabolic rate during POST MST, likely leading to faster performance times at the end of the operation. High EMG values throughout the different phases of MST suggested that despite the anaerobic nature of the test, the soldiers were able to maintain their voluntary muscle activation level until the end of the test. This indicates only limited neural fatigue during the two-minute high-intensity military specific performance. While learning effect may explain some part of the improvement in the MST performance times, combined strength and endurance training three times per week may improve neuromuscular performance in occupationally relevant tasks.

Functional Resistance Training to Improve Knee Strength and Function After Acute Anterior Cruciate Ligament Reconstruction: A Case Study

Background: Thigh muscle weakness after anterior cruciate ligament reconstruction (ACLR) can persist after returning to activity. While resistance training can improve muscle function, “nonfunctional” training methods are not optimal for inducing transfer of benefits to activities such as walking. Here, we tested the feasibility of a novel functional resistance training (FRT) approach to restore strength and function in an individual with ACLR. Hypothesis: FRT would improve knee strength and function after ACLR. Study Design: Case report. Level of Evidence: Level 5. Methods: A 15-year-old male patient volunteered for an 8-week intervention where he performed 30 minutes of treadmill walking, 3 times per week, while wearing a custom-designed knee brace that provided resistance to the thigh muscles of his ACLR leg. Thigh strength, gait mechanics, and corticospinal and spinal excitability were assessed before and immediately after the 8-week intervention. Voluntary muscle activation was evaluated immediately after the intervention. Results: Knee extensor and flexor strength increased in the ACLR leg from pre- to posttraining (130 to 225 N·m [+74%] and 44 to 88 N·m [+99%], respectively) and increases in between-limb extensor and flexor strength symmetry (45% to 92% [+74%] and 47% to 72% [+65%], respectively) were also noted. After the intervention, voluntary muscle activation in the ACLR leg was 72%, compared with the non-ACLR leg at 75%. Knee angle and moment during late stance phase decreased (ie, improved) in the ACLR leg and appeared more similar to the non-ACLR leg after FRT training (18° to 14° [−23.4] and 0.07 to −0.02 N·m·kg−1·m−1 [−122.8%], respectively). Corticospinal and spinal excitability in the ACLR leg decreased (3511 to 2511 [−28.5%] and 0.42 to 0.24 [−43.7%], respectively) from pre- to posttraining. Conclusion: A full 8 weeks of FRT that targeted both quadriceps and hamstring muscles lead to improvements in strength and gait, suggesting that FRT may constitute a promising and practical alternative to traditional methods of resistance training. Clinical Relevance: FRT may serve as a viable approach to improve knee strength and function after ACL reconstruction.

Voluntary activation of knee extensor muscles with transcranial magnetic stimulation.

We examined if transcranial magnetic stimulation (TMS) is a valid tool for assessment of voluntary activation of the knee extensors in healthy individuals. Maximal M-waves (Mmax) of vastus lateralis (VL) were evoked with electrical stimulation of femoral nerve (FNS); Mmax of medial hamstrings (HS) was evoked with electrical stimulation of sciatic nerve branches; motor evoked potentials (MEPs) of VL and HS were evoked with TMS; superimposed twitches (SIT) of knee extensors were evoked with FNS and TMS. In study 1, TMS intensity [69% output (SD: 5)] was optimized for MEP sizes, but guidelines for test validity could not be met. Agonist VL MEPs were too small [51.4% Mmax (SD: 11.9); guideline ≥70% Mmax] and antagonist HS MEPs were too big [16.5% Mmax (SD: 10.3); guideline <10% Mmax]. Consequently, the TMS estimated resting twitch [99.1 N (SD: 37.2)] and FNS resting twitch [142.4 N (SD: 41.8)] were different. In study 2, SITs at 90% maximal voluntary contraction (MVC) were similar between TMS [16.1 N (SD: 10.3)] and FNS [20.9 N (SD: 16.7)], when TMS intensity was optimized for this purpose, suggesting a procedure that combines TMS SITs with FNS resting twitches could be valid. In study 3, which tested the TMS intensity [56% output (SD: 18)] that evoked the largest SIT at 90% MVC, voluntary activation from TMS [87.3% (SD: 7.1)] and FNS [84.5% (SD: 7.6)] was different. In sum, the contemporary procedure for TMS-based voluntary activation of the knee extensors is invalid. A modified procedure improves validity but only in individuals who meet rigorous inclusion criteria for SITs and MEPs.NEW & NOTEWORTHY We discovered that the contemporary procedure for assessing voluntary activation of the knee extensor muscles with transcranial magnetic stimulation (TMS) is invalid. TMS activates too few agonist quadriceps motoneurons and too many antagonist hamstrings motoneurons to estimate the resting twitch accurately. A modified procedure, in which TMS-evoked superimposed twitches are considered together with the resting twitch from femoral nerve stimulation, is valid but only in select individuals who meet rigorous eligibility criteria.

Branched-chain amino acid supplementation improves cycling performance in untrained cyclists

ObjectivesTo investigate the effects of acute branched-chain amino acid (BCAA) supplementation on cycling performance and neuromuscular fatigue during a prolonged, self-paced cycling time-trial. DesignRandomised double-blind counterbalanced crossover. MethodsEighteen recreationally active men (mean±SD; age: 24.7±4.8 years old; body-weight, BW: 67.1±6.1kg; height: 171.7±4.9cm) performed a cycling time-trial on an electromagnetically-braked cycle ergometer. Participants were instructed to complete the individualised total work in the shortest time possible, while ingesting either BCAAs (pre-exercise: 0.084gkg−1 BW; during exercise: 0.056gkg−1h−1) or a non-caloric placebo solution. Rating of perceived exertion, power, cadence and heart rate were recorded throughout, while maximal voluntary contraction, muscle voluntary activation level and electrically evoked torque using single and doublet stimulations were assessed at baseline, immediately post-exercise and 20-min post-exercise. ResultsSupplementation with BCAA reduced (287.9±549.7s; p=0.04) time-to-completion and ratings of perceived exertion (p≤0.01), while concomitantly increasing heart rate (p=0.02). There were no between-group differences (BCAA vs placebo) in any of the neuromuscular parameters, but significant decreases (All p≤0.01) in maximal voluntary contraction, muscle voluntary activation level and electrically evoked torque (single and doublet stimulations) were recorded immediately following the trial, and these did not recover to pre-exercise values by the 20min recovery time-point. ConclusionsCompared to a non-caloric placebo, acute BCAA supplementation significantly improved performance in cycling time-trial among recreationally active individuals without any notable changes in either central or peripheral factors. This improved performance with acute BCAA supplementation was associated with a reduced rating of perceived exertion.

Mechanisms of Modulation of Automatic Scapulothoracic Muscle Contraction Timings

Erected posture provides humans a large shoulder mobility that requires complex automatic muscle synergies to accomplish joint stability needs. This is evident in shoulder abduction, wherein the voluntary activation of glenohumeral muscles is coupled with an automatic recruitment of scapulothoracic muscles. Here, we investigated whether volitional modification of the scapular position, and dynamic scapular elevation, modulate the contraction timing of five shoulder muscles (middle deltoid, upper, middle and lower fiber of the trapezius, serratus anterior) during shoulder abduction. The results show matched contraction timings of the deltoid and upper trapezius across the scapular positions, whereas the contraction timings of the middle and lower fibers of the trapezius change secondary to the scapular position. These results might reflect different central strategies to coordinate the automatic sequences of contraction of the scapulothoracic muscles. This suggest a flexible and adaptable predisposition of the motor control system in exploring alternative solutions to accomplish the functional movement needs, such as the fulfillment of unconstrained movements. Intriguingly, the shoulder abduction may represent a powerful, non-invasive, and straightforward tool to deepen the understanding of the neural basis underlying the voluntary motor command modulation of the out-of-volition automatic muscle contractions.

Time course of neuromuscular responses to acute hypoxia during voluntary contractions.

What is the central question of this study? How does acute hypoxia alter central and peripheral fatigue during brief and sustained maximal voluntary muscle contractions? What is the main finding and its importance? Perception of fatigue during muscle contractions was increased progressively for 2 h after hypoxic exposure. However, an increase in motor cortex excitability and a decrease in voluntary activation of skeletal muscle were observed across the entire protocol when performing brief (3 s) maximal contractions. These adaptations were abolished if the brief contraction was held for a duration of 20 s, which was presumably attributable to a successful redistribution of blood to overcome the reduced oxygen content. Few studies have examined the time course of changes in the motor system after acute exposure to hypoxia. Thus, the purpose of this study was to examine how acute hypoxia affects corticospinal excitability, voluntary activation (VA) and the perception of fatigue during brief (3s) and sustained (20s) maximal voluntary contractions (MVCs). Fourteen healthy individuals (23±2.2years of age; four female) were exposed to hypoxia and sham conditions. During hypoxia, peripheral blood oxygen saturation was titrated over a 15min period and remained at 80% during testing. Corticospinal excitability and VA were assessed before titration (Pre), 0, 1 and 2 h after. At each time point, the brief and sustained elbow flexion MVCs were performed. Motor evoked potentials (MEPs) were obtained using transcranial magnetic stimulation. Superimposed and resting twitches were obtained from motor point stimulation of biceps brachii to calculate the level of VA, and ratings of perceived fatigue were obtained with a modified CR-10 Borg scale. A condition-by-time interaction was detected for the CR-10 Borg scale, whereby perception of fatigue increased progressively throughout the hypoxia protocol. However, main effects of MEP area and VA indicated that corticospinal excitability increased, and VA of the biceps brachii decreased, throughout the hypoxia protocol. Given that these changes in MEP area and VA were seen only when performing the brief MVCs (and not during the sustained MVCs), performing longer contractions might overcome reduced oxygen content by redirecting blood flow to active areas of the motor system.