Voluntary Muscle Activation Research Articles

Muscle Fatigability After Hex-Bar Deadlift Exercise Performed With Fast or Slow Tempo.

To examine the differences in muscle fatigability after resistance exercise performed with fast tempo (FT) compared with slow tempo (ST). A total of 8 resistance-trained males completed FT and ST hexagonal-barbell deadlifts, consisting of 8 sets of 6 repetitions at 60% 3-repetition maximum, using a randomized crossover design. Each FT repetition was performed with maximal velocity, while each repetition during ST was performed with a 3-1-3 (eccentric/isometric/concentric) tempo (measured in seconds). Isometric maximal voluntary contraction, voluntary muscle activation, and evoked potentiated twitch torque of the knee extensors were determined using twitch interpolation before, during (set 4), and after exercise. Displacement-time data were measured during the protocols. The mean bar velocity and total concentric work were higher for FT compared with ST (995 [166] W vs 233 [52]W; 0.87 [0.05]m/s vs 0.19 [0.05]m/s; 4.8 [0.8]kJ vs 3.7 [1.1]kJ). Maximal voluntary contraction torque, potentiated twitch, and voluntary muscle activation were significantly reduced after FT (-7.8% [9.2%]; -5.2% [9.2%], -8.7% [12.2%]) and ST (-11.2% [8.4%], -13.3% [8.1%], -1.8% [3.6%]). The decline in maximal voluntary force after both the FT and ST hexagonal-barbell deadlifts exercise was accompanied by a similar decline in contractile force and voluntary muscle activation.

Caffeine increases strength and power performance in resistance-trained females during early follicular phase.

The effects of 4mg·kg-1 caffeine ingestion on strength and power were investigated for the first time, in resistance-trained females during the early follicular phase utilizing a randomized, double-blind, placebo-controlled, crossover design. Fifteen females (29.8±4.0years, 63.8±5.5kg [mean±SD]) ingested caffeine or placebo 60minutes before completing a test battery separated by 72hours. One-repetition maximum (1RM), repetitions to failure (RTF) at 60% of 1RM, was assessed in the squat and bench press. Maximal voluntary contraction torque (MVC) and rate of force development (RFD) were measured during isometric knee extensions, while utilizing interpolated twitch technique to measure voluntary muscle activation. Maximal power and jump height were assessed during countermovement jumps (CMJ). Caffeine metabolites were measured in plasma. Adverse effects were registered after each trial. Caffeine significantly improved squat (4.5±1.9%, effect size [ES]: 0.25) and bench press 1RM (3.3±1.4%, ES: 0.20), and squat (15.9±17.9%, ES: 0.31) and bench press RTF (9.8±13.6%, ES: 0.31), compared to placebo. MVC torque (4.6±7.3%, ES: 0.26), CMJ height (7.6±4.0%, ES: 0.50), and power (3.8±2.2%, ES: 0.24) were also significantly increased with caffeine. There were no differences in RFD or muscle activation. Plasma [caffeine] was significantly increased throughout the protocol, and mild side effects of caffeine were experienced by only 3 participants. This study demonstrated that 4mg·kg-1 caffeine ingestion enhanced maximal strength, power, and muscular endurance in resistance-trained and caffeine-habituated females during the early follicular phase, with few adverse effects. Female strength and power athletes may consider using this dose pre-competition and -training as an effective ergogenic aid.

Residual Innervation of the Pelvic Floor Muscles in People with Motor-Complete Spinal Cord Injury.

Individuals classified clinically as having a motor-complete spinal cord injury (mcSCI) should lack voluntary motor function below their injury level. Neurophysiological assessments using electromyography (EMG) and transcranial magnetic stimulation (TMS), however, have demonstrated that persons with mcSCI retain limited cortical descending innervation and voluntary activation of muscles below their level of injury, including muscles of the trunk and lower limb. We explored the possibility of whether there is also preserved innervation of the pelvic floor muscles (PFM) in persons with mcSCI. The PFM are controlled by widespread cortical and subcortical areas and typically coactivated with trunk and gluteal muscles to maintain continence and regulate intra-abdominal pressure. Nine mcSCI and eight control subjects participated in this cross-sectional study. Surface EMG was used to record activity in the PFM. Data were recorded while participants attempted various maneuvers of the trunk and pelvis. We also applied TMS at incrementing levels of intensity over the primary motor cortex area to record motor evoked potentials (MEPs) in the PFM. When performing the maneuvers, activation of the PFM was possible in all controls and the majority of SCI participants. However, the PFM were only activated in the SCI participants during maneuvers that engaged other trunk muscles, however. MEP responses in the PFM were also elicited in all controls and SCI participants, but MEP response characteristics were significantly altered in the SCI group. Our results suggest that persons with mcSCI retain some residual innervation of the PFM after injury, possibly via indirect cortical descending pathways.

Effect of exercise on pain processing and motor output in people with knee osteoarthritis: a systematic review and meta-analysis

Guidelines recommend exercise as a core treatment for knee osteoarthritis. However, it is unclear how exercise affects measures of pain processing and motor function. The aim was to evaluate the effect of exercise on measures of pain processing and motor function in people with knee osteoarthritis. We searched five electronic databases (MEDLINE, EMBASE, CINAHL, SCOPUS and Cochrane Central Register of Controlled Trials) for studies on knee osteoarthritis, of any design, evaluating pain processing and motor function before and after exercise. Data were pooled with random-effects meta-analysis. Study quality was assessed using the Downs and Black and quality of evidence was assessed using the GRADE. Eighteen studies were eligible and 16 were included. Following acute exercise, pressure pain threshold increased local to the study limb (standardised mean difference [95% confidence interval (CI)] 0.26, [0.02, 0.51], n=159 from 5 studies), but there was no statistically significant change remote from the study limb (0.09, [-0.11, 0.29], n=90 from 4 studies). Following an exercise program (range 5-12 weeks) there were no statistically significant changes in pressure pain threshold (local 0.23, [-0.01, 0.47], n=218 from 8 studies; remote 0.33 [-0.13, 0.79], n=76 from 4 studies), temporal pain summation (0.38 [-0.08, 0.85], n=122 from 3 studies) or voluntary quadriceps muscle activation (4.23% [-1.84 to 10.30], n=139 from 4 studies). Very-low quality evidence suggests that pressure pain threshold increases following acute exercise. Very-low quality evidence suggests that pressure pain threshold, temporal pain summation or voluntary quadriceps activation do not change statistically significantly following exercise programs.

Transcutaneous spinal direct current stimulation increases corticospinal transmission and enhances voluntary motor output in humans.

Optimization of motor performance is of importance in daily life, in relation to recovery following injury as well as for elite sports performance. The present study investigated whether transcutaneous spinal direct current stimulation (tsDCS) may enhance voluntary ballistic activation of ankle muscles and descending activation of spinal motor neurons in able‐bodied adults. Forty‐one adults (21 men; 24.0 ± 3.2 years) participated in the study. The effect of tsDCS on ballistic motor performance and plantar flexor muscle activation was assessed in a double‐blinded sham‐controlled cross‐over experiment. In separate experiments, the underlying changes in excitability of corticospinal and spinal pathways were probed by evaluating soleus (SOL) motor evoked potentials (MEPs) following single‐pulse transcranial magnetic stimulation (TMS) over the primary motor cortex, SOL H‐reflexes elicited by tibial nerve stimulation and TMS‐conditioning of SOL H‐reflexes. Measures were obtained before and after cathodal tsDCS over the thoracic spine (T11‐T12) for 10 min at 2.5 mA. We found that cathodal tsDCS transiently facilitated peak acceleration in the ballistic motor task compared to sham tsDCS. Following tsDCS, SOL MEPs were increased without changes in H‐reflex amplitudes. The short‐latency facilitation of the H‐reflex by subthreshold TMS, which is assumed to be mediated by the fast conducting monosynaptic corticomotoneuronal pathway, was also enhanced by tsDCS. We argue that tsDCS briefly facilitates voluntary motor output by increasing descending drive from corticospinal neurones to spinal plantar flexor motor neurons. tsDCS can thus transiently promote within‐session CNS function and voluntary motor output and holds potential as a technique in the rehabilitation of motor function following central nervous lesions.

Precise quantification of the time course of voluntary activation capacity following Botulinum toxin injections in the biceps brachii muscles of chronic stroke survivors

BackgroundSpasticity is a key motor impairment that affects many hemispheric stroke survivors. Intramuscular botulinum toxin (BT) injections are used widely to clinically manage spasticity-related symptoms in stroke survivors by chemically denervating muscle fibers from their associated motor neurons. In this study, we sought to understand how BT affects muscle activation, motor unit composition and voluntary force generating capacity over a time period of 3 months. Our purpose was to characterize the time course of functional changes in voluntary muscle activity in stroke survivors who are undergoing BT therapy as part of their physician-prescribed clinical plan.MethodOur assessment of the effects of BT was based on the quantification of surface electromyogram (sEMG) recordings in the biceps brachii (BB), an upper arm muscle and of voluntary contraction force. We report here on voluntary force and sEMG responses during isometric elbow contractions across consecutive recording sessions, spread over 12 weeks in three segments, starting with a preliminary session performed just prior to the BT injection. At predetermined time points, we conducted additional clinical assessments and we also recorded from the contralateral limbs of our stroke cohort. Eight subjects were studied for approximately 86 experimental recording sessions on both stroke-affected and contralateral sides.ResultsWe recorded an initial reduction in force and sEMG in all subjects, followed by a trajectory with a progressive return to baseline over a maximum of 12 weeks, although the minimum sEMG and minimum force were not always recorded at the same time point. Three participants were able to complete only one to two segments. Slope values of the sEMG-force relations were also found to vary across the different time segments. While sEMG-force slopes provide assessments of force generation capacity of the BT injected muscle, amplitude histograms from novel sEMG recordings during the voluntary tasks provide additional insights about differential actions of BT on the overall motor unit (MU) population over time.ConclusionsThe results of our study indicate that there are potential short term as well as long term decrements in muscle control and activation properties after BT administration on the affected side of chronic stroke survivors. Muscle activation levels as recorded using sEMG, did not routinely return to baseline even at three months’ post injection. The concurrent clinical measures also did not follow the same time course, nor did they provide the same resolution as our experimental measures. It follows that even 12 weeks after intramuscular BT injections muscle recovery may not be complete, and may thereby contribute to pre-existing paresis.

Vastus Lateralis Muscle Oxygenation Measured By Near-infrared Spectroscopy During Voluntary Isometric Leg Extension Muscle Actions

Vastus Lateralis Muscle Oxygenation Measured By Near-infrared Spectroscopy During Voluntary Isometric Leg Extension Muscle Actions

Reduced Neuromuscular Performance in Night Shift Orthopedic Nurses: New Insights From a Combined Electromyographic and Force Signals Approach.

The effect of sleep–wake rhythm disruption on neuromuscular control and muscle fatigue has received little attention. Because nurse shift work is so varied, including overnight duty, rotating shift schedules, early awakening, and interrupted nocturnal sleep, it offers an interesting model to study this paradigm. It has been investigated so far using only subjective markers. A combined approach based on the simultaneous analysis of surface electromyographic (sEMG) and force signals can objectively detect possible deficits in neuromuscular control and muscle fatigue. With this study we investigated neuromuscular activation and muscle contraction capacity at submaximum and maximum level in nurses working two night-shift schedules and compared them to levels in nurses working entirely in day shifts. Sleep quality and activity levels were also assessed. The study sample was 71 nurses grouped by their shift work schedule: night shift for 5 days (NS5, n = 46), night shift for 10 days (NS10, n = 9), and only day/swing shift (DS, n = 16). Before and after the shift-work cycle, maximum voluntary contraction (MVC) force and muscle activation, neuromuscular control, and muscle fatigability were measured in the finger flexor muscles. Activity level and sleep quality during the shift-work cycle were recorded with a wrist actigraph. After the shift-work cycles, MVC force and muscle activation were decreased (−11 ± 3% and −33 ± 3%, p < 0.001) as was neuromuscular control (−36 ± 8%, p = 0.007), whereas muscle fatigability was increased (+ 19 ± 9%, p = 0.006) in the NS5 and the NS10 group. Sleep quality was lower in the NS5 and the NS10 group (−8 ± 1.8% and −15%3, respectively, p < 0.001), while the activity level for the three groups was similar. There was a clear reduction in neuromuscular control and an increase in muscle fatigue in the nurses working the night shift. These findings may inform of work schedule planning or recommendations for devising new recovery strategies to counteract neuromuscular alterations in night shift nurses.

Neurophysiological impairments in multiple sclerosis-Central and peripheral motor pathways.

A systematic review of the literature was conducted comparing neurophysiological outcomes in persons with multiple sclerosis (PwMS) to healthy controls (HC), in studies of the central nervous system (CNS) function comprising motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) and in studies of the peripheral nervous system (PNS) function comprising electroneuronography (ENG) outcomes elicited by peripheral nerve stimulation. Studies comparing neuromuscular function, assessed during maximal voluntary contraction (MVC) of muscle, were included if they reported muscle strength along with muscle activation by use of electromyography (EMG) and/or interpolated twitch technique (ITT). Studies investigating CNS function showed prolonged central motor conduction times, asymmetry of nerve conduction motor pathways, and prolonged latencies in PwMS when compared to HC. Resting motor threshold, amplitude, and cortical silent periods showed conflicting results. CNS findings generally correlated with disabilities. Studies of PNS function showed near significant prolongation in motor latency of the median nerve, reduced nerve conduction velocities in the tibial and peroneal nerves, and decreased compound muscle action potential amplitudes of the tibial nerve in PwMS. ENG findings did not correlate with clinical severity of disabilities. Studies of neuromuscular function showed lower voluntary muscle activation and increased central fatigue in PwMS, whereas EMG showed divergent muscle activation (ie, EMG amplitude) during MVC. When comparing the existing literature on neurophysiological motor examinations in PwMS and HC, consistent and substantial impairments of CNS function were seen in PwMS, whereas impairments of the PNS were less pronounced and inconsistent. In addition, impairments in muscle activation were observed in PwMS.

Enhancement of knee extension voluntary and electrically-evoked strength with the body tilted backward

BACKGROUND: While extreme changes in body position (e.g., standing vs. sitting) have been shown to affect knee extensor strength, little is known regarding how less extreme changes in body position affect knee extensor strength and activation. OBJECTIVE: This study evaluated the effect of four seat ed positions on the maximum voluntary isometric contraction (MVIC) and electrically-evoked isometric strengths of the knee extensors. METHODS: Forty healthy subjects participated. MVIC strength, electrically-evoked strength, and voluntary activation of the quadriceps muscles were measured under four seated positions: 1) 22.5–25∘ forward tilt, 2) 0∘ tilt, 3) 22.5–25∘ backward tilt, and 4) 45–50∘ backward tilt. The effect of seated position on each dependent variable was assessed using a one-way repeated measures ANOVA with linear contrasts. RESULTS: MVIC and electrically-evoked strengths increased (P⩽ 0.037) by 5–11% as the body was moved from the 22.5–25∘ forward-tilted to 45–50∘ backward-tilted position. However, voluntary muscle activation and EMG amplitudes of the knee extensors during MVIC did not change. CONCLUSIONS: Knee extensor MVIC and electrically-evoked strengths were modestly enhanced as the body was tilted backwards. The use of a semi-reclined position may assist in obtaining a more forceful contraction of the knee extensors, thereby potentially resulting in better strength training outcomes.

Acute and chronic neuromuscular electrical stimulation and postural balance: a review

Electro-induced (EI) muscle actions are largely used in healthy subjects to improve motor performance, in frail/older subjects to limit sarcopenia and mobility loss, and in pathological subjects to restore functional abilities after injury and/or surgical operation. Their effects on motor output (e.g., muscle strength and power, and motor performance) are relatively well known, but their effects on postural balance are not. However, postural balance turns out to be a determining factor for motor skills in terms of motor performance and prevention of falls (especially in older/frail and pathological subjects). Hence, this review addresses the acute and chronic effects of EI muscle actions on postural balance, comparing them to the effects of voluntary (VOL) muscle actions. Narrative review. In acute, fatigue-generating application, EI muscle actions impair postural balance but less than VOL muscle actions. In chronic application, EI muscle actions induce beneficial effects on postural balance in pathological and aged (or frail) subjects. However, they have no or very little impact on healthy and young subjects. In aged (and probably pathological) subjects, EI muscle actions alone or superimposed onto voluntary contractions (EI + VOL) are less efficient than VOL muscle actions in improving postural balance. In practice, as part of populations too frail/fragile or unable (sarcopenic or pathological persons) to regularly undertake VOL motor tasks required to efficiently struggle against the loss of mobility and the risk of fall, the EI muscle actions turn out to be particularly relevant to implement.

P35 Differences between voluntary and involuntary muscle activation in Parkinsonian patients

P35 Differences between voluntary and involuntary muscle activation in Parkinsonian patients

Effects of caffeine on neuromuscular function in a non-fatigued state and during fatiguing exercise.

What is the central question of the study? What are the effects of caffeine on neuromuscular function in a non-fatigued state and during fatiguing exercise? What is the main finding and its importance? In a non-fatigued state, caffeine decreased the duration of the silent period evoked by transcranial magnetic stimulation. Caffeine-induced reduction of inhibitory mechanisms in the central nervous system before exercise was associated with an increased performance. Individuals who benefit from caffeine ingestion may experience lower perception of effort during exercise and an accelerated recovery of M-wave amplitude postfatigue. This study elucidates the mechanisms of action of caffeine and demonstrates that inter-individual variability of its effects on neuromuscular function is a fruitful area for further work. Caffeine enhances exercise performance, but its mechanisms of action remain unclear. In this study, we investigated its effects on neuromuscular function in a non-fatigued state and during fatiguing exercise. Eighteen men participated in this randomized, double-blind, placebo-controlled crossover trial. Baseline measures included plantarflexion force, drop jump, squat jump, voluntary activation of triceps surae muscle, soleus muscle contractile properties, M-wave, α-motoneuron excitability (H-reflex), corticospinal excitability, short-interval intracortical inhibition, intracortical facilitation, silent period evoked by transcranial magnetic stimulation (SP) and plasma potassium and caffeine concentrations. Immediately after baseline testing, participants ingested caffeine (6mg·kg-1 ) or placebo. After a 1-h rest, baseline measures were repeated, followed by a fatiguing stretch-shortening cycle exercise (sets of 40 bilateral rebound jumps on a sledge apparatus) until task failure. Neuromuscular testing was carried out throughout the fatigue protocol and afterwards. Caffeine enhanced drop jump height (by 4.2%) and decreased the SP (by 12.6%) in a non-fatigued state. A caffeine-related decrease in SP and short-interval intracortical inhibition before the fatiguing activity was associated with an increased time to task failure. The participants who benefitted from an improved performance on the caffeine day reported a significantly lower sense of effort during exercise and had an accelerated postexercise recovery of M-wave amplitude. Caffeine modulates inhibitory mechanisms of the CNS, recovery of M-wave amplitude and perception of effort. This study lays the groundwork for future examinations of differences in caffeine-induced neuromuscular changes between those who are deemed to benefit from caffeine ingestion and those who are not.

Effects of enhanced cutaneous sensory input on interlimb strength transfer of the wrist extensors.

The relative contribution of cutaneous sensory feedback to interlimb strength transfer remains unexplored. Therefore, this study aimed to determine the relative contribution of cutaneous afferent pathways as a substrate for cross‐education by directly assessing how “enhanced” cutaneous stimulation alters ipsilateral and contralateral strength gains in the forearm. Twenty‐seven right‐handed participants were randomly assigned to 1‐of‐3 training groups and completed 6 sets of 8 repetitions 3x/week for 5 weeks. Voluntary training (TRAIN) included unilateral maximal voluntary contractions (MVCs) of the wrist extensors. Cutaneous stimulation (STIM), a sham training condition, included cutaneous stimulation (2x radiating threshold; 3sec; 50Hz) of the superficial radial (SR) nerve at the wrist. TRAIN + STIM training included MVCs of the wrist extensors with simultaneous SR stimulation. Two pre‐ and one posttraining session assessed the relative increase in force output during MVCs of isometric wrist extension, wrist flexion, and handgrip. Maximal voluntary muscle activation was simultaneously recorded from the flexor and extensor carpi radialis. Cutaneous reflex pathways were evaluated through stimulation of the SR nerve during graded ipsilateral contractions. Results indicate TRAIN increased force output compared with STIM in both trained (85.0 ± 6.2 Nm vs. 59.8 ± 6.1 Nm) and untrained wrist extensors (73.9 ± 3.5 Nm vs. 58.8 Nm). Providing ‘enhanced’ sensory input during training (TRAIN + STIM) also led to increases in strength in the trained limb compared with STIM (79.3 ± 6.3 Nm vs. 59.8 ± 6.1 Nm). However, in the untrained limb no difference occurred between TRAIN + STIM and STIM (63.0 ± 3.7 Nm vs. 58.8 Nm). This suggests when ‘enhanced’ input was provided independent of timing with active muscle contraction, interlimb strength transfer to the untrained wrist extensors was blocked. This indicates that the sensory volley may have interfered with the integration of appropriate sensorimotor cues required to facilitate an interlimb transfer, highlighting the importance of appropriately timed cutaneous feedback.

Eccentric, but not concentric blood flow restriction resistance training increases muscle strength in the untrained limb

ObjectivesLittle is known regarding the variables or mechanisms mediating cross-education as a result of resistance training. Therefore, the purpose of the present study was to examine the effects of low-load eccentric-only blood flow restriction (Ecc-BFR) and low-load concentric-only BFR (Con-BFR) on indices of cross-education. DesignThirty-six women were randomly assigned to 4-wks of unilateral resistance training with Ecc-BFR (n = 12), Con-BFR (n = 12) or control (no intervention, n = 12) group. Eccentric peak torque, concentric peak torque, maximal voluntary isometric contraction torque, muscle thickness, and muscle activation were assessed from the contralateral, untrained arm. ResultsMuscle strength (collapsed across mode) increased from 0-wk to 2-wks (4.9%) and 4-wks (13.0%) for Ecc-BFR only. There were increases in muscle activation (collapsed across mode and group) regardless of training modality, but there were no changes in muscle size for any of the conditions. ConclusionsThe findings of the present study indicated that low-load Ecc-BFR increased muscle strength. The increases in muscle strength as a result of Ecc-BFR were not mode-specific. Thus, low-load Ecc-BFR provides a unique alternative to maintain muscle function in an untrained limb that may have application during limb immobilization and rehabilitation practices.

Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists

Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological disorders. The tremor occurred only in the resting jaw position, with 10 episodes per day on an average, and lasted from 10 minutes to hours. It disappeared with any voluntary activation of the masseter muscle and did not change (in amplitude or frequency) with distraction maneuvers. The remainder of neurologic examination was unremarkable. The patient underwent extensive testing, including contrast-enhanced brain magnetic resonance imaging, blood tests and neuropsychiatric evaluation by two different neuropsychiatrists which failed to reveal the underlying cause. The needle electromyography examination revealed involuntary, intermittent, and synchronized muscular contractions in both masseter muscles, at a frequency of 13 to 14 Hz. No changes were discovered in the other muscles. He was treated with propranolol, primidone, valproic acid, diazepam, and amitriptyline, but the response was not significant. Injection of 25 units of botulinum toxin type A in the masseter muscle on both sides of the fac was effective five days after the injection. No adverse effects or masseter weakness were observed.

Rightward shift of optimal fascicle length with decreasing voluntary activity level in the soleus and lateral gastrocnemius muscles.

Much of our understanding of in vivo skeletal muscle properties is based on studies performed under maximal activation, which is problematic because muscles are rarely activated maximally during movements such as walking. Currently, force-length properties of the human triceps surae at submaximal voluntary muscle activity levels are not characterized. We therefore evaluated plantar flexor torque- and force-ankle angle, and torque- and force-fascicle length properties of the soleus and lateral gastrocnemius muscles during voluntary contractions at three activity levels: 100, 30 and 22% of maximal voluntary contraction. Soleus activity levels were controlled by participants via real-time electromyography feedback and contractions were performed at ankle angles ranging from 10 deg plantar flexion to 35 deg dorsiflexion. Using dynamometry and ultrasound imaging, torque-fascicle length curves of the soleus and lateral gastrocnemius muscles were constructed. The results indicate that small muscle activity reductions shift the torque- and force-angle, and torque- and force-fascicle length curves of these muscles to more dorsiflexed ankle angles and longer fascicle lengths (from 3 to 20% optimal fascicle length, depending on ankle angle). The shift in the torque- and force-fascicle length curves during submaximal voluntary contraction have potential implications for human locomotion (e.g. walking) as the operating range of fascicles shifts to the ascending limb, where muscle force capacity is reduced by at least 15%. These data demonstrate the need to match activity levels during construction of the torque- and force-fascicle length curves to activity levels achieved during movement to better characterize the lengths that muscles operate at relative to their optimum during a specific task.

Greater Lower Limb Fatigability in People with Prediabetes than Controls.

The study purpose was to compare perceived fatigability and performance fatigability after high-velocity contractions with knee extensor muscles between people with prediabetes, people with type 2 diabetes (T2D), and controls without diabetes matched for age, body mass index, and physical activity. Twenty people with prediabetes (11 men, 9 women: 63.1 ± 6.0 yr, 26.9 ± 4.2 kg·m, 8030 ± 3110 steps per day), 39 with T2D (23 men, 16 women: 61.2 ± 8.5 yr, 29.4 ± 6.4 kg·m, 8440 ± 4220 steps per day), and 27 controls (13 men, 14 women: 58.1 ± 9.4 yr, 27.3 ± 4.3 kg·m, 8400 ± 3000 steps per day) completed the Fatigue Impact Scale as a measure of perceived fatigability and a fatigue protocol including 120 maximal-effort, high-velocity concentric contractions (MVCC; 1 contraction/3 s) with the knee extensors using a submaximal load (30% maximum) to quantify performance fatigability. Electrical stimulation was used to assess voluntary activation and contractile function of the knee extensor muscles before and after the fatigue protocol. Fatigue Impact Scale scores were not different between people with prediabetes, people with T2D, and controls (12.5 ± 15.1, 18.3 ± 22.7, and 12.6 ± 18.6, respectively; P = 0.517). However, people with prediabetes had greater reductions in MVCC power during the fatigue protocol than did controls (31.8% ± 22.6% vs 22.1% ± 21.1%, P < 0.001), and both groups had lesser reductions than the T2D group (44.8% ± 21.9%, P < 0.001). Similarly, the prediabetes group had larger reductions in electrically evoked twitch amplitude than the control group (32.5% ± 24.9% vs 21.3% ± 33.0%, P < 0.001), but lesser reductions than those with T2D (44.0% ± 23.4%, P < 0.001). For all three groups, a greater decline in MVCC power was associated with larger reductions of twitch amplitude (r = 0.350, P < 0.001). People with prediabetes have greater performance fatigability of the knee extensors due to contractile mechanisms compared with controls, although less performance fatigability than that of people with T2D.

Preprocessing surface EMG data removes voluntary muscle activity and enhances SPiQE fasciculation analysis

ObjectivesFasciculations are a clinical hallmark of amyotrophic lateral sclerosis (ALS). The Surface Potential Quantification Engine (SPiQE) is a novel analytical tool to identify fasciculation potentials from high-density surface electromyography (HDSEMG). This method was accurate on relaxed recordings amidst fluctuating noise levels. To avoid time-consuming manual exclusion of voluntary muscle activity, we developed a method capable of rapidly excluding voluntary potentials and integrating with the established SPiQE pipeline. MethodsSix ALS patients, one patient with benign fasciculation syndrome and one patient with multifocal motor neuropathy underwent monthly thirty-minute HDSEMG from biceps and gastrocnemius. In MATLAB, we developed and compared the performance of four Active Voluntary IDentification (AVID) strategies, producing a decision aid for optimal selection. ResultsAssessment of 601 one-minute recordings permitted the development of sensitive, specific and screening strategies to exclude voluntary potentials. Exclusion times (0.2–13.1 minutes), processing times (10.7–49.5 seconds) and fasciculation frequencies (27.4–71.1 per minute) for 165 thirty-minute recordings were compared. The overall median fasciculation frequency was 40.5 per minute (10.6–79.4 IQR). ConclusionWe hereby introduce AVID as a flexible, targeted approach to exclude voluntary muscle activity from HDSEMG recordings. SignificanceLongitudinal quantification of fasciculations in ALS could provide unique insight into motor neuron health.

Corticospinal excitability modulation by pairing peripheral nerve stimulation with cortical states of movement initiation.

We compare the effects on corticospinal excitability of repeatedly delivering peripheral nerve stimulation at three time points (-30ms, 0ms, +50ms) relative to muscle onset in a cue-guided task. Plastic changes in excitability are only observed when stimuli are delivered immediately before the time when muscles activate, while stimuli delivered at muscle onset or shortly later (0, +50ms) have no effect. Plastic effects are abolished if there is ongoing volitional electromyogram activity in the muscles prior to the onset of the phasic contraction. The plastic effects induced by timing peripheral stimulation relative to electromyographic markers of muscle activation are as effective as those that occur if stimulation is timed relative to electroencephalographic markers of motor cortical activation. We provide a simple alternative protocol to induce plasticity in people in whom electroencephalogram recording is difficult. Plastic changes in corticospinal excitability (CSE) and motor function can be induced in a targeted and long-term manner if afferent volleys evoked by peripheral nerve stimulation are repeatedly associated with the peak of premovement brain activity assessed with an electroencephalogram (EEG). The present study investigated whether other factors might also characterize this optimal brain state for plasticity induction. In healthy human volunteers (n=24), we found that the same reliable changes in CSE can be induced by timing peripheral afferent stimulation relative to the onset of electromyogram (EMG) activity rather than using the EEG peak. Specifically, we observed an increase in CSE when peripheral stimulation activated the cortex just before movement initiation. By contrast, there was no effect on CSE if the afferent input reached the cortex at the same time or after EMG onset, consistent with the idea that the temporal order of synaptic activation from afferent input and voluntary movement is important for production of plasticity. Finally, in 14 volunteers, we found that background voluntary muscle activity prior to movement also abolished the effect on CSE. One possible explanation is that the intervention strengthens synapses that are inactive at rest but change their activity in anticipation of movement, and that the intervention fails when the synapses are tonically active during background EMG activity. Overall, we demonstrate that, in individuals with voluntary control of muscles targeted by our intervention, EMG signals are a suitable alternative to an EEG for inducing plasticity by coupling movement-related brain states with peripheral afferent input.