Greater cross education following training with muscle lengthening than shortening

Corticospinal responses of resistance-trained and un-trained males during dynamic muscle contractions

Little is known regarding the modulation and the plasticity of the neural pathway interconnecting elements of the central nervous system and skeletal muscle in resistant-trained individuals. The aim of the study was to compare corticospinal and spinal responses measured during dynamic muscle contractions of the tibialis anterior in resistance trained (RT) and un-trained (UT) males. Nine UT and 10 RT male volunteers reported to the laboratory 24h following a familiarisation session. Motor evoked potentials (MEPs) and the cortical silent period were evoked using transcranial magnetic stimulation at a range of contraction intensities and was delivered as the ankle passed 90° during shortening and lengthening contractions. The Hoffmann reflex (H-reflex) and V-waves were evoked with peripheral nerve stimulation. Despite the RT group being significantly stronger during shortening (28%; P=0.023: CI=1.27-15.1Nm), lengthening (25%; P=0.041: CI=0.27-17.0Nm) and isometric muscle actions (20%; P=0.041; CI=0.77-14.9Nm), no differences between the groups existed for corticospinal or spinal variables. Lack of detectable differences between RT and UT individuals may be linked to minimal exposure to task specific, isolated high intensity resistance training of the TA muscle.

Changes in brain activation patterns according to cross-training effect in serial reaction time task: An functional MRI study

Cross-training is a phenomenon related to motor learning, where motor performance of the untrained limb shows improvement in strength and skill execution following unilateral training of the homologous contralateral limb. We used functional MRI to investigate whether motor performance of the untrained limb could be improved using a serial reaction time task according to motor sequential learning of the trained limb, and whether these skill acquisitions led to changes in brain activation patterns. We recruited 20 right-handed healthy subjects, who were randomly allocated into training and control groups. The training group was trained in performance of a serial reaction time task using their non-dominant left hand, 40 minutes per day, for 10 days, over a period of 2 weeks. The control group did not receive training. Measurements of response time and percentile of response accuracy were performed twice during pre- and post-training, while brain functional MRI was scanned during performance of the serial reaction time task using the untrained right hand. In the training group, prominent changes in response time and percentile of response accuracy were observed in both the untrained right hand and the trained left hand between pre- and post-training. The control group showed no significant changes in the untrained hand between pre- and post-training. In the training group, the activated volume of the cortical areas related to motor function (i.e., primary motor cortex, premotor area, posterior parietal cortex) showed a gradual decrease, and enhanced cerebellar activation of the vermis and the newly activated ipsilateral dentate nucleus were observed during performance of the serial reaction time task using the untrained right hand, accompanied by the cross-motor learning effect. However, no significant changes were observed in the control group. Our findings indicate that motor skills learned over the 2-week training using the trained limb were transferred to the opposite homologous limb, and motor skill acquisition of the untrained limb led to changes in brain activation patterns in the cerebral cortex and cerebellum.

At-home resistance tubing strength training increases shoulder strength in the trained and untrained limb

The purpose was to determine if an at-home resistance tubing strength training program on one shoulder (that is commonly used in rehabilitation settings) would produce increases in strength in the trained and untrained shoulders via cross-education. Twenty-three participants were randomized to TRAIN (strength-trained one shoulder; n = 13) or CONTROL (no intervention; n = 10). Strength training was completed at home using resistance tubing and consisted of maximal shoulder external rotation, internal rotation, scaption, retraction, and flexion 3 days/week for 4 weeks. Strength was measured via handheld dynamometry and muscle size measured via ultrasound. For external rotation strength, the trained (10.9 ± 10.9%) and untrained (12.7 ± 9.6%) arm of TRAIN was significantly different than CONTROL (1.6 ± 13.2%; -2.7 ± 12.3%; pooled across arm; P < 0.05). For internal rotation strength, the trained (14.8 ± 11.3%) and untrained (14.6 ± 10.1%) arm of TRAIN was significantly different than CONTROL (6.4 ± 11.2%; 5.1 ± 8.8%; pooled across arm; P < 0.05). There were no significant differences for scaption strength (P = 0.056). TRAIN significantly increased muscle size in the training arm of the supraspinatus (1.90 ± 0.32 to 1.99 ± 0.31 cm), and the anterior deltoid (1.08 ± 0.37 to 1.21 ± 0.39 cm; P < 0.05). This study suggests that an at-home resistance tubing training program on one limb can produce increases in strength in both limbs, and has implications for rehabilitation after unilateral shoulder injuries.

Eccentric Versus Concentric Resistance Training to Enhance Neuromuscular Activation and Walking Speed Following Stroke

Background. Impaired voluntary neuromuscular activation of agonist muscles is a primary determinant of weakness and motor dysfunction following stroke. Objective. To determine whether eccentric resistance training (ECC) resistance training is superior to concentric resistance training (CON) resistance training to enhance neuromuscular activation, strength, and walking speed after stroke. Methods. A total of 34 adults poststroke participated in a staged intervention comprising (1) either CON-only or ECC-only resistance training of the paretic leg followed by (2) gait training. Changes in voluntary neuromuscular activation and power were assessed for both the trained paretic and untrained nonparetic legs. Self-selected and fast walking speeds were also assessed. Results. In response to resistance training, the ECC group experienced larger improvements in neuromuscular activation of paretic leg muscles, rectus femoris and vastus medialis ( P < .005), and the largest gains in paretic leg power (+74% for ECC contractions, P < .0001). ECC also had greater cross-education of increased power to the untrained nonparetic leg (12%-14%, P = .006). Over the course of gait training, much of the gain in paretic leg activation in the ECC group was lost, such that the net change in agonist activation was comparable between the CON and ECC groups when the full intervention was completed. Nevertheless, improvement in walking speed postintervention was more prevalent in the ECC than CON group. Conclusion. ECC resistance training was more effective for improving bilateral neuromuscular activation, strength, and walking speed following stroke. Future research should assess whether a longer duration ECC training program can provide further benefit.

Moderate-Intensity Exercise Improves Body Composition and Improves Physiological Markers of Stress in HIV-Infected Men

HIV/AIDS and its treatment often alter body composition and result in poorer physical functioning. The aim of this study was to determine the effects of a moderate-intensity exercise program on body composition and the hormones and cytokines associated with adverse health outcomes. HIV-infected males (N = 111) were randomized to an exercise group (EX) who completed 6 weeks of moderate-intensity exercise training, or to a nonintervention control group (CON). In pre- and postintervention, body composition was estimated via DXA, peak strength was assessed, and resting blood samples were obtained. There was a decrease in salivary cortisol at wake (P = 0.025) in the EX and a trend (P = 0.07) for a decrease 1 hour after waking. The EX had a significant increase in lean tissue mass (LTM) (P < 0.001) following the intervention. Those in the EX below median body fat (20%) increased LTM (P = 0.014) only, while those above 20% decreased fat mass (P = 0.02), total fat (N = 0.009), and trunk fat (P = 0.001), while also increasing LTM (P = 0.027). Peak strength increased between 14% and 28% on all exercises in the EX group. These data indicate that 6 weeks of moderate-intensity exercise training can decrease salivary cortisol levels, improve physical performance, and improve body composition in HIV-infected men.

The effects of whole-body vibration on the cross-transfer of strength

This study investigated whether the use of superimposed whole-body vibration (WBV) during cross-education strength training would optimise strength transfer compared to conventional cross-education strength training. Twenty-one healthy, dominant right leg volunteers (21 ± 3 years) were allocated to a strength training (ST, m = 3, f = 4), a strength training with WBV (ST + V, m = 3, f = 4), or a control group (no training, m = 3, f = 4). Training groups performed 9 sessions over 3 weeks, involving unilateral squats for the right leg, with or without WBV (35 Hz; 2.5 mm amplitude). All groups underwent dynamic single leg maximum strength testing (1RM) and single and paired pulse transcranial magnetic stimulation (TMS) prior to and following training. Strength increased in the trained limb for the ST (41%; ES = 1.14) and ST + V (55%; ES = 1.03) groups, which resulted in a 35% (ES = 0.99) strength transfer to the untrained left leg for the ST group and a 52% (ES = 0.97) strength transfer to the untrained leg for the ST + V group, when compared to the control group. No differences in strength transfer between training groups were observed (P = 0.15). For the untrained leg, no differences in the peak height of recruitment curves or SICI were observed between ST and ST + V groups (P = 1.00). Strength training with WBV does not appear to modulate the cross-transfer of strength to a greater magnitude when compared to conventional cross-education strength training.

Transcranial magnetic stimulation in sport science: a commentary

The aim of this commentary is to provide a brief overview of transcranial magnetic stimulation (TMS) and highlight how this technique can be used to investigate the acute and chronic responses of the central nervous system to exercise. We characterise the neuromuscular responses to TMS and discuss how these measures can be used to investigate the mechanisms of fatigue in response to locomotor exercise. We also discuss how TMS might be used to study the corticospinal adaptations to resistance exercise training, with particular emphasis on the responses to shortening/lengthening contractions and contralateral training. The limited data to date suggest that TMS is a valuable technique for exploring the mechanisms of central fatigue and neural adaptation.

Do dominant and non-dominant arms respond similarly to maximal eccentric exercise of the elbow flexors?

OBJECTIVES

Two common models to investigate the effect of interventions on muscle damage include using two groups in which one group receives an intervention while the other acts as control, and using contralateral limbs of one group. The latter model is based on the assumption that changes in markers of muscle damage are similar between limbs, but this has not been examined systematically.

DESIGN

This study compared changes in muscle damage markers between dominant and non-dominant arms following maximal eccentric exercise of the elbow flexors.

METHODS

Eighteen men performed 60 maximal eccentric elbow flexions of each arm separated by 4 weeks with the order of testing between arms randomised. Maximal voluntary isometric torque, range of motion, upper arm circumference, plasma creatine kinase (CK) activity and muscle soreness before and for 7 days following exercise were compared between arms using two-way repeated measures ANOVA.

RESULTS

No significant differences between arms were evident for any of the markers, but significant (P<0.05) differences between first and second bouts were evident for changes in strength, circumference and CK with smaller changes following the second bout. A poor correlation was found for the magnitude of changes in the markers between dominant and non-dominant arms, suggesting that responses to eccentric exercise were not necessarily the same between arms.

CONCLUSIONS

These results show that the order affected the responses of dominant and non-dominant arms to the eccentric exercise; however, the contralateral limb design appears to be usable if bout order is counterbalanced and randomised among participants.

Progressive resistance exercise and Parkinson's disease: a review of potential mechanisms

This paper reviews the therapeutically beneficial effects of progressive resistance exercise (PRE) on Parkinson's disease (PD). First, this paper discusses the rationale for PRE in PD. Within the first section, the review discusses the central mechanisms that underlie bradykinesia and muscle weakness, highlights findings related to the central changes that accompany PRE in healthy individuals, and extends these findings to individuals with PD. It then illustrates the hypothesized positive effects of PRE on nigro-striatal-thalamo-cortical activation and connectivity. Second, it reviews recent findings of the use of PRE in individuals with PD. Finally, knowledge gaps of using PRE on individuals with PD are discussed along with suggestions for future research.

Interhemispheric plasticity in humans

INTRODUCTION

Chronic unimanual motor practice increases the motor output not only in the trained but also in the nonexercised homologous muscle in the opposite limb. We examined the hypothesis that adaptations in motor cortical excitability of the nontrained primary motor cortex (iM1) and in interhemispheric inhibition from the trained to the nontrained M1 mediate this interlimb cross education.

METHODS

Healthy, young volunteers (n=12) performed 1000 submaximal voluntary contractions (MVC) of the right first dorsal interosseus (FDI) at 80% MVC during 20 sessions.

RESULTS

Trained FDI's MVC increased 49.9%, and the untrained FDI's MVC increased 28.1%. Although corticospinal excitability in iM1, measured with transcranial magnetic stimulation (TMS) before and after every fifth session, increased 6% at rest, these changes, as those in intracortical inhibition and facilitation, did not correlate with cross education. When weak and strong TMS of iM1 were delivered on a background of a weak and strong muscle contraction, respectively, of the right FDI, excitability of iM1 increased dramatically after 20 sessions. Interhemispheric inhibition decreased 8.9% acutely within sessions and 30.9% chronically during 20 sessions and these chronic reductions progressively became more strongly associated with cross education. There were no changes in force or TMS measures in the trained group's left abductor minimi digiti and there were no changes in the nonexercising control group (n=8).

CONCLUSIONS

The findings provide the first evidence for plasticity of interhemispheric connections to mediate cross education produced by a simple motor task.

Effects of electromyostimulation on knee extensors and flexors strength and steadiness in older adults

It is known that electromyostimulation (EMS) alone or superimposed over voluntary contraction (EV) can effectively improve muscle strength. However, the effect of this type of training on the ability to control force production at submaximal levels is unknown. The authors examined the effects of EV training on steadiness in force production of knee extensors and flexors in older adults. Forty participants, including 20 men and 20 women, 60-77 years of age, were randomly allocated into a control group (CG) and an electromyostimulation superimposed over voluntary contraction (EVG) group. The EVG performed 30 bilateral isometric knee extension and flexion contractions per session, 3 training sessions per week, for 6 weeks. The variations in force production, expressed in absolute (standard deviation [SD]) and relative (coefficient of variation [CV]) terms, were assessed in isometric contractions at 5%, 15% and 25% maximal voluntary contraction (MVC) levels. Results indicated that MVC increased in knee extension and flexion in EVG (p < .05) after the training; steadiness CV also improved at 15% MVC in knee flexion (p < .05) but no significant changes were found in knee extension and steadiness SD. The training-induced changes in MVC were not correlated to steadiness CV that might indicate different mechanisms underlying these adaptations.

Effect of eccentric exercise velocity on akt/mtor/p70(s6k) signaling in human skeletal muscle

It has been suggested that muscle tension plays a major role in the activation of intracellular pathways for skeletal muscle hypertrophy via an increase in mechano growth factor (MGF) and other downstream targets. Eccentric exercise (EE) imposes a greater amount of tension on the active muscle. In particular, high-speed EE seems to exert an additional effect on muscle tension and, thus, on muscle hypertrophy. However, little is known about the effect of EE velocity on hypertrophy signaling. This study investigated the effect of acute EE-velocity manipulation on the Akt/mTORCI/p70(S6K) hypertrophy pathway. Twenty subjects were assigned to either a slow (20°·s(-1); ES) or fast EE (210°·s(-1); EF) group. Biopsies were taken from vastus lateralis at baseline (B), immediately after (T1), and 2 h after (T2) the completion of 5 sets of 8 repetitions of eccentric knee extensions. Akt, mTOR, and p70(S6K) total protein were similar between groups, and did not change postintervention. Further, Akt and p70(S6K) protein phosphorylation were higher at T2 than at B for ES and EF. MGF messenger RNA was similar between groups, and only significantly higher at T2 than at B in ES. The acute manipulation of EE velocity does not seem to differently influence intracellular hypertrophy signaling through the Akt/mTORCI/p70S6K pathway.

Cross-education of muscle strength: cross-training effects are not confined to untrained contralateral homologous muscle

The aim of this study was to evaluate whether electrical muscle stimulation (EMS) on dominant wrist flexors causes an increase in the muscle strength of the contralateral wrist extensors. Twenty-three healthy, young, adult men were included in this prospective, double-blind, controlled study. Participants were randomly allocated to the EMS group or Control group. Electrodes were placed over the flexor aspect of the right forearm in both groups. In the EMS group, passive wrist extension and (EMS) that caused powerful muscle contraction were simultaneously applied. In the Control group, a conventional mode of transcutaneous electrical nerve stimulation was applied without causing any contraction. A group effect (P=0.0001) and group-by-time interaction were found (P=0.0001) for both the wrist flexor and extensor muscles, but not group-by-time-by-arm interactions. This implies that the effect of the interventions was similar in both arms, but that the response was significantly larger in the EMS than in the Control group. The results of the current study suggest that cross-education is not confined to the untrained contralateral wrist flexors and that the strength increase may also be observed in the contralateral wrist extensors.

Enhancement of parkinsonian rigidity with contralateral hand activation

OBJECTIVE

Quantify the enhancement of parkinsonian rigidity associated with a contralateral activation maneuver.

METHODS

Twelve subjects with PD and eight controls participated in the study protocol. Subjects' tested hand was displaced by a servo-motor throughout wrist flexion and extension motions of 60° without and with a concurrent gripping activation in the contralateral hand, referred to as Passive and Active conditions, respectively. Subjects with PD were tested in both OFF-MED and ON-MED states. Rigidity was quantified by integrating torque with position during both flexion and extension (torque resistance). ANOVA was performed to assess the effect of contralateral activation on rigidity.

RESULTS

PD patients had significantly (0.038) enhanced torque resistance in OFF-MED compared to healthy controls and ON-MED. In the Active condition, differences in torque resistance were magnified (p=0.002). Medication substantially reduced differences in torque resistance between controls and PD patients in the Passive and Active conditions.

CONCLUSIONS

A contralateral activation maneuver substantially increases rigidity in patients with PD, specifically the OFF-MED state. Rigidity is reduced with the application of dopaminergic medication, even with the presence of a contralateral activation maneuver.

SIGNIFICANCE

These data support the use of a contralateral activation maneuver as a tool in the diagnosis of PD.

Ipsilateral motor cortical responses to TMS during lengthening and shortening of the contralateral wrist flexors

Unilateral lengthening contractions provide a greater stimulus for neuromuscular adaptation than shortening contractions in the active and non-active contralateral homologous muscle, although little is known of the potential mechanism. Here we examined the possibility that corticospinal and spinal excitability vary in a contraction-specific manner in the relaxed right flexor carpi radialis (FCR) when humans perform unilateral lengthening and shortening contractions of the left wrist flexors at the same absolute force. Corticospinal excitability in the relaxed right FCR increased more during lengthening than shortening at 80% and 100% of maximum voluntary contraction (MVC). Short-interval intracortical inhibition diminished during shortening contractions, and it became nearly abolished during lengthening. Intracortical facilitation lessened during shortening but increased during lengthening. Interhemispheric inhibition to the 'non-active' motor cortex diminished during shortening, and became nearly abolished during lengthening at 90% MVC. The amplitude of the Hoffman reflex in the relaxed right FCR decreased during and remained depressed for 20 s after lengthening and shortening of the left wrist flexors. We discuss the possibility that instead of the increased afferent input, differences in the descending motor command and activation of brain areas that link function of the motor cortices during muscle lengthening vs. shortening may cause the contraction-specific modulation of ipsilateral motor cortical output. In conclusion, ipsilateral motor cortex responses to transcranial magnetic stimulation are contraction-specific; unilateral lengthening and shortening contractions reduced contralateral spinal excitability, but uniquely modulated ipsilateral corticospinal excitability and the networks involved in intracortical and interhemispheric connections, which may have clinical implications.

Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe

The purpose of this study was to apply cross-education during 4 wk of unilateral limb immobilization using a shoulder sling and swathe to investigate the effects on muscle strength, muscle size, and muscle activation. Twenty-five right-handed participants were assigned to one of three groups as follows: the Immob + Train group wore a sling and swathe and strength trained (n = 8), the Immob group wore a sling and swathe and did not strength train (n = 8), and the Control group received no treatment (n = 9). Immobilization was applied to the nondominant (left) arm. Strength training consisted of maximal isometric elbow flexion and extension of the dominant (right) arm 3 days/wk. Torque (dynamometer), muscle thickness (ultrasound), maximal voluntary activation (interpolated twitch), and electromyography (EMG) were measured. The change in right biceps and triceps brachii muscle thickness [7.0 ± 1.9 and 7.1 ± 2.2% (SE), respectively] was greater for Immob + Train than Immob (0.4 ± 1.2 and -1.9 ± 1.7%) and Control (0.8 ± 0.5 and 0.0 ± 1.1%, P < 0.05). Left biceps and triceps brachii muscle thickness for Immob + Train (2.2 ± 0.7 and 3.4 ± 2.1%, respectively) was significantly different from Immob (-2.8 ± 1.1 and -5.2 ± 2.7%, respectively, P < 0.05). Right elbow flexion strength for Immob + Train (18.9 ± 5.5%) was significantly different from Immob (-1.6 ± 4.0%, P < 0.05). Right and left elbow extension strength for Immob + Train (68.1 ± 25.9 and 32.2 ± 9.0%, respectively) was significantly different from the respective limb of Immob (1.3 ± 7.7 and -6.1 ± 7.8%) and Control (4.7 ± 4.7 and -0.2 ± 4.5%, P < 0.05). Immobilization in a sling and swathe decreased strength and muscle size but had no effect on maximal voluntary activation or EMG. The cross-education effect on the immobilized limb was greater after elbow extension training. This study suggests that strength training the nonimmobilized limb benefits the immobilized limb for muscle size and strength.

Effect of cross exercise on quadriceps acceleration reaction time and subjective scores (Lysholm questionnaire) following anterior cruciate ligament reconstruction

BACKGROUND

Anterior cruciate ligament (ACL) injury or reconstruction can cause knee impairments and disability. Knee impairments are related to quadriceps performance - accelerated reaction time (ART) - and disability to performance of daily living activities which is assessed by questionnaires such as the Lysholm knee score. The purposes of this study were to investigate the effect of cross exercise, as supplementary rehabilitation to the early phase of ACL reconstruction: a) on quadriceps ART at the angles 45 degrees , 60 degrees and 90 degrees of knee flexion and, b) on the subjective scores of disability in ACL reconstructed patients.

METHODS

42 patients who underwent ACL reconstruction were randomly divided into 3 groups, two experimental and one control. All groups followed the same rehabilitation program. The experimental groups followed 8 weeks of cross eccentric exercise (CEE) on the uninjured knee; 3 d/w, and 5 d/w respectively.Quadriceps ART was measured at 45 degrees , 60 degrees and 90 degrees of knee flexion pre and nine weeks post-operatively using an isokinetic dynamometer. Patients also completed pre and post operatively the Lysholm questionnaire whereby subjective scores were recorded.

RESULTS

Two factor ANOVA showed significant differences in ART at 90 degrees among the groups (F = 4.29, p = 0.02, p < 0.05). Post hoc Tukey HSD analysis determined that the significant results arose from the first experimental group in comparison to the control (D = -0.83, p = 0.01). No significant differences were revealed at 45 degrees and 60 degrees .Significant differences were also found in the Lysholm score among the groups (F = 4.75, p = 0.01, p < 0.05). Post hoc analysis determined that the above significant results arose from the first experimental group in comparison with the control (D = 7.5, p < 0.01) and from the second experimental in comparison with the control (D = 3.78, p = 0.03).

CONCLUSION

CEE showed improvements on quadriceps ART at 90 degrees at a sequence of 3 d/w and in the Lysholm score at a sequence of 3 d/w and 5 d/w respectively on ACL reconstructed patients.

Strength training the free limb attenuates strength loss during unilateral immobilization

The objective was to determine if strength training the free limb during a 3-wk period of unilateral immobilization attenuates strength loss in the immobilized limb through cross-education. Thirty right-handed participants were assigned to three groups. One group (n = 10) wore a cast and trained the free arm (Cast-Train). A second group (n = 10) wore a cast and did not train (Cast). A third group (n = 10) received no treatment (control). Casts were applied to the nondominant (left) wrist and hand by a physician. Strength training was maximal isometric ulnar deviation (right hand) 5 days/wk. Peak torque (dynamometer), electromyography (EMG), and muscle thickness (ultrasound) were assessed in both arms before and after the intervention. Cast-Train improved right arm strength [14.3 (SD 5.0) to 17.7 (SD 4.8) N x m; P < 0.05] with no significant muscle hypertrophy [3.73 (SD 0.43) to 3.84 (SD 0.52) cm; P = 0.09]. The immobilized arm of Cast-Train did not change in strength [13.9 (SD 4.3) to 14.2 (SD 4.6) N x m] or muscle thickness [3.61 (SD 0.51) to 3.57 (SD 0.43) cm]. The immobilized arm of Cast decreased in strength [12.2 (SD 3.8) to 10.4 (SD 2.5) N x m; P < 0.05] and muscle thickness [3.47 (SD 0.59) to 3.32 (SD 0.55) cm; P < 0.05]. Control showed no changes in the right arm [strength: 15.3 (SD 6.1) to 14.3 (SD 5.8) N x m; muscle thickness: 3.57 (SD 0.68) to 3.52 (SD 0.75) cm] or left arm [strength: 14.5 (SD 5.3) to 13.7 (SD 6.1) N x m; muscle thickness: 3.55 (SD 0.77) to 3.51 (SD 0.70) cm]. Agonist muscle activation remained unchanged after the intervention for both arms [right: 302 (SD 188) to 314 (SD 176) microV; left: 261 (SD 139) to 288 (SD 151) microV] with no group differences. Strength training of the free limb attenuated strength loss in the immobilized limb during unilateral immobilization. Strength training may have prevented muscle atrophy in the immobilized limb.

Cross-transfer effects of resistance training with blood flow restriction

PURPOSE

This study investigated whether muscle hypertrophy-promoting effects are cross-transferred in resistance training with blood flow restriction, which has been shown to evoke strong endocrine activation.

METHODS

Fifteen untrained men were randomly assigned into the occlusive training group (OCC, N = 8) and the normal training group (NOR, N = 7). Both groups performed the same unilateral arm exercise (arm curl) at 50% of one-repetition maximum (1RM) without occlusion (three sets, 10 repetitions). Either the dominant or nondominant arm was randomly chosen to be trained (OCC-T, NOR-T) or to serve as a control (OCC-C, NOR-C). After the arm exercise, OCC performed leg exercise with blood flow restriction (30% of 1RM, three sets, 15-30 repetitions), whereas NOR performed the same leg exercise without occlusion. The training session was performed twice a week for 10 wk. In a separate set of experiments, acute changes in blood hormone concentrations were measured after the same leg exercises with (N = 5) and without (N = 5) occlusion.

RESULTS

Cross-sectional area (CSA) and isometric torque of elbow flexor muscles increased significantly in OCC-T, whereas no significant changes were observed in OCC-C, NOR-T, and NOR-C. CSA and isometric torque of thigh muscles increased significantly in OCC, whereas no significant changes were observed in NOR. Noradrenaline concentration showed a significantly larger increase after leg exercise with occlusion than after exercises without occlusion, though growth hormone and testosterone concentrations did not show significant differences between these two types of exercises.

CONCLUSION

The results indicate that low-intensity resistance training increases muscular size and strength when combined with resistance exercise with blood flow restriction for other muscle groups. It was suggested that any circulating factor(s) was involved in this remote effect of exercise on muscular size.

Neuromuscular adaptations and correlates of knee functionality following ACL reconstruction

The objective of this research was to examine the dynamic restraint mechanism by establishing the neuromuscular characteristics of lower extremity muscles in anterior cruciate ligament reconstruction (ACLR) subjects. This study also investigated neuromuscular variables that relate to post-ACLR functional outcome. Thirteen patients having undergone ACLR using the bone patella tendon bone graft at least 6 months prior participated in this study. Knee functionality (0- to 100-point scale) was rated using the Cincinnati Knee Rating System. The median frequency of the electromyographic (EMG) recordings from the vastus medialis (VM) and vastus lateralis (VL) muscles together with the isokinetic quadriceps torque generated in 10 degrees intervals between 80 degrees and 10 degrees knee flexion was determined for the noninvolved and involved limbs. Lower limb musculotendinous stiffness was also assessed for the noninvolved and involved limbs. Limb symmetry indexes were calculated for each of the physiological measures. Compared to the noninvolved limb, the median frequency of the EMG from the involved limb VM and VL muscles was significantly lower as was the quadriceps torque generated at the seven knee flexion intervals. In contrast, musculotendinous stiffness was significantly higher in the involved lower limb compared to the noninvolved limb. Significant, moderate correlations were identified between knee functionality and symmetry indexes for all variables except for the isokinetic quadriceps torque produced between 80 degrees -70 degrees and 20 degrees -10 degrees knee flexion. More functional ACLR subjects demonstrated enhanced motor unit recruitment reflective of less quadriceps muscle fiber atrophy together with increased quadriceps strength and musculotendinous stiffness of the lower limb musculature.

Evidence of a contralateral repeated bout effect after maximal eccentric contractions

The aim of this investigation was firstly, to examine whether a contralateral repeated bout effect is manifested after a single bout of maximal eccentric muscle actions and secondly, to compare the magnitude of any such protection to an ipsilateral control. Sixteen male subjects undertook 45 repetitions of maximal eccentric contractions of the elbow flexors. The ipsilateral group (IL, N=8) repeated the exercise using the same arm and the contralateral group (CL, N=8) repeated the exercise using the contralateral arm 14 days later. Serum creatine kinase (CK), muscle soreness, maximal voluntary contraction (MVC) and range of motion (ROM) were significantly attenuated in the repeated bout for IL. CL also showed a significant reduction in the repeated bout for CK, muscle soreness and MVC. Despite the significant attenuation of dependent variables in both groups the magnitude of change was less in CL compared to IL for CK, soreness, MVC and ROM. The findings demonstrate a repeated bout effect in the contralateral limb after a single bout of maximal eccentric exercise; however, the magnitude of protection in the contralateral limb is less than that manifested in the ipsilateral limb. The apparent contralateral repeated bout effect observed in this investigation is thought to be predominantly mediated by neural mechanisms, although further research is required to elucidate this possibility.

Cross Education

Resistance training can be defined as the act of repeated voluntary muscle contractions against a resistance greater than those normally encountered in activities of daily living. Training of this kind is known to increase strength via adaptations in both the muscular and nervous systems. While the physiology of muscular adaptations following resistance training is well understood, the nature of neural adaptations is less clear. One piece of indirect evidence to indicate that neural adaptations accompany resistance training comes from the phenomenon of 'cross education', which describes the strength gain in the opposite, untrained limb following unilateral resistance training. Since its discovery in 1894, subsequent studies have confirmed the existence of cross education in contexts involving voluntary, imagined and electrically stimulated contractions. The cross-education effect is specific to the contralateral homologous muscle but not restricted to particular muscle groups, ages or genders. A recent meta-analysis determined that the magnitude of cross education is approximately equal to 7.8% of the initial strength of the untrained limb. While many features of cross education have been established, the underlying mechanisms are unknown. This article provides an overview of cross education and presents plausible hypotheses for its mechanisms. Two hypotheses are outlined that represent the most viable explanations for cross education. These hypotheses are distinct but not necessarily mutually exclusive. They are derived from evidence that high-force, unilateral, voluntary contractions can have an acute and potent effect on the efficacy of neural elements controlling the opposite limb. It is possible that with training, long-lasting adaptations may be induced in neural circuits mediating these crossed effects. The first hypothesis suggests that unilateral resistance training may activate neural circuits that chronically modify the efficacy of motor pathways that project to the opposite untrained limb. This may subsequently lead to an increased capacity to drive the untrained muscles and thus result in increased strength. A number of spinal and cortical circuits that exhibit the potential for this type of adaptation are considered. The second hypothesis suggests that unilateral resistance training induces adaptations in motor areas that are primarily involved in the control of movements of the trained limb. The opposite untrained limb may access these modified neural circuits during maximal voluntary contractions in ways that are analogous to motor learning. A better understanding of the mechanisms underlying cross education may potentially contribute to more effective use of resistance training protocols that exploit these cross-limb effects to improve the recovery of patients with movement disorders that predominantly affect one side of the body.

Contralateral effects of unilateral strength training: evidence and possible mechanisms

If exercises are performed to increase muscle strength on one side of the body, voluntary strength can increase on the contralateral side. This effect, termed the contralateral strength training effect, is usually measured in homologous muscles. Although known for over a century, most studies have not been designed well enough to show a definitive transfer of strength that could not be explained by factors such as familiarity with the testing. However, an updated meta-analysis of 16 properly controlled studies (range 15–48 training sessions) shows that the size of the contralateral strength training effect is ∼8% of initial strength or about half the increase in strength of the trained side. This estimate is similar to results of a large, randomized controlled study of training for the elbow flexors (contralateral effect of 7% initial strength or one-quarter of the effect on the trained side). This is likely to reflect increased motoneuron output rather than muscular adaptations, although most methods are insufficiently sensitive to detect small muscle contributions. Two classes of central mechanism are identified. One involves a “spillover” to the control system for the contralateral limb, and the other involves adaptations in the control system for the trained limb that can be accessed by the untrained limb. Cortical, subcortical and spinal levels are all likely to be involved in the “transfer,” and none can be excluded with current data. Although the size of the effect is small and may not be clinically significant, study of the phenomenon provides insight into neural mechanisms associated with exercise and training.

Oestrogen status in relation to the early training responses in human thumb adductor muscles

AIMS

The aims of this study were to identify the mechanisms for the early response to training in women of different oestrogen status and to determine whether any oestrogen and exercise effects on these would be additive.

METHODS

We monitored training (ten 5-s contractions per day for 12 weeks)-induced changes in the size, strength, voluntary activation capacity and index of crossbridge force state (i.e. rapid stretch to isometric torque ratio), in the thumb adductor muscles of postmenopausal [eight who had never used, and 14 who were using, hormone replacement therapy (HRT)] and seven premenopausal eumenorrhoeic women. The contralateral untrained muscle was used as a control.

RESULTS

There was a significant effect of oestrogen status on the magnitude of training-induced strength increment, with the non-HRT postmenopausal group exhibiting the greatest benefits (28 +/- 6%, P = 0.024) from training. There were no significant or commensurate changes in either cross-sectional area or voluntary activation capacity. The index of crossbridge force state improved most in the no-HRT group (19 +/- 7%, P < 0.05).

CONCLUSIONS

Presence, rather than absence of oestrogen, is associated with relatively higher muscle function which limits the potential for any further training-induced increments in muscle performance, as would be expected if the muscle strengthening actions of training and oestrogen share a common, partially saturable physiological pathway. The mechanism that is involved in the early training-induced strength increment in the three differing oestrogen groups cannot be due to increased size or recruitment. It would appear instead that increased motor unit firing frequency is involved.

Neural Adaptations to Resistive Exercise

It is generally accepted that neural factors play an important role in muscle strength gains. This article reviews the neural adaptations in strength, with the goal of laying the foundations for practical applications in sports medicine and rehabilitation. An increase in muscular strength without noticeable hypertrophy is the first line of evidence for neural involvement in acquisition of muscular strength. The use of surface electromyographic (SEMG) techniques reveal that strength gains in the early phase of a training regimen are associated with an increase in the amplitude of SEMG activity. This has been interpreted as an increase in neural drive, which denotes the magnitude of efferent neural output from the CNS to active muscle fibres. However, SEMG activity is a global measure of muscle activity. Underlying alterations in SEMG activity are changes in motor unit firing patterns as measured by indwelling (wire or needle) electrodes. Some studies have reported a transient increase in motor unit firing rate. Training-related increases in the rate of tension development have also been linked with an increased probability of doublet firing in individual motor units. A doublet is a very short interspike interval in a motor unit train, and usually occurs at the onset of a muscular contraction. Motor unit synchronisation is another possible mechanism for increases in muscle strength, but has yet to be definitely demonstrated. There are several lines of evidence for central control of training-related adaptation to resistive exercise. Mental practice using imagined contractions has been shown to increase the excitability of the cortical areas involved in movement and motion planning. However, training using imagined contractions is unlikely to be as effective as physical training, and it may be more applicable to rehabilitation. Retention of strength gains after dissipation of physiological effects demonstrates a strong practice effect. Bilateral contractions are associated with lower SEMG and strength compared with unilateral contractions of the same muscle group. SEMG magnitude is lower for eccentric contractions than for concentric contractions. However, resistive training can reverse these trends. The last line of evidence presented involves the notion that unilateral resistive exercise of a specific limb will also result in training effects in the unexercised contralateral limb (cross-transfer or cross-education). Peripheral involvement in training-related strength increases is much more uncertain. Changes in the sensory receptors (i.e. Golgi tendon organs) may lead to disinhibition and an increased expression of muscular force. Agonist muscle activity results in limb movement in the desired direction, while antagonist activity opposes that motion. Both decreases and increases in co-activation of the antagonist have been demonstrated. A reduction in antagonist co-activation would allow increased expression of agonist muscle force, while an increase in antagonist co-activation is important for maintaining the integrity of the joint. Thus far, it is not clear what the CNS will optimise: force production or joint integrity. The following recommendations are made by the authors based on the existing literature. Motor learning theory and imagined contractions should be incorporated into strength-training practice. Static contractions at greater muscle lengths will transfer across more joint angles. Submaximal eccentric contractions should be used when there are issues of muscle pain, detraining or limb immobilisation. The reversal of antagonists (antagonist-to-agonist) proprioceptive neuromuscular facilitation contraction pattern would be useful to increase the rate of tension development in older adults, thus serving as an important prophylactic in preventing falls. When evaluating the neural changes induced by strength training using EMG recording, antagonist EMG activity should always be measured and evaluated.