Neural Adaptations to Resistive Exercise

Bilateral movement therapy post-stroke: underlying mechanisms and review

Aims

Up to 66% of individuals with stroke never regain functional use of their upper extremities. Bilateral movement training (BMT) is a task-specific rehabilitation technique that has recently been investigated for its influence on upper extremity recovery in individuals post-stroke. BMT is thought to affect the hemiparetic upper extremity by a phenomenon referred to as cross education, or the cross transfer effect.

Methods

This article reviews the theoretical accounts underlying the cross transfer effect and explain the means by which BMT may facilitate recovery of function in the hemiparetic arm. The current research evidence supporting the use of BMT as a therapeutic approach to stroke rehabilitation is discussed, and implications for clinical practice and recommendations for further research are presented.

Findings

Evidence is emerging that BMT improves impairments and function in people with hemiparesis after stroke. The main limitations of existing research on BMT include small sample sizes, varying initial impairment levels, and lack of control groups.

Conclusions

Future research needs to establish which individuals are most likely to benefi tfrom BMT, as well as the optimal dose of BMT, and whether BMT can be used as an adjunct to existing rehabilitation approaches for upper extremity rehabilitation.

Influence of motor unit synchronization on amplitude characteristics of surface and intramuscularly recorded EMG signals

The increase in muscle strength without noticeable hypertrophic adaptations is very important in some sports. Motor unit (MU) synchronisation and higher rate of MU activation are proposed as possible mechanisms for such a strength and electromyogram (EMG) increase in the early phase of a training regimen. Root mean square and/or integrated EMG are amplitude measures commonly used to estimate the adaptive changes in efferent neural drive. EMG amplitude characteristics could change also because of alteration in intracellular action potential (IAP) spatial profile. We simulated MUs synchronization under different length of the IAP profile. Different synchronization was simulated by variation of the percent of discharges in a referent MU, to which a variable percent of remaining MUs was synchronized. Population synchrony index estimated the degree of MU synchronization in EMG signals. We demonstrate that the increase in amplitude characteristics due to MU synchronization is stronger in surface than in intramuscularly detected EMG signals. However, the effect of IAP profile lengthening on surface detected EMG signals could be much stronger than that of MU synchronization. Thus, changes in amplitude characteristics of surface detected EMG signals with progressive strength training could hardly be used as an indicator of changes in neural drive without testing possible changes in IAPs.

Força muscular versus pressão arterial de repouso: uma revisão baseada no treinamento com pesos

INTRODUÇÃO: O exercício com pesos é atualmente recomendado para diferentes grupos de indivíduos. Seu principal objetivo é o aumento na força muscular, mas podem ocorrer outros resultados , como a redução na pressão arterial (PA) de repouso. Contudo, é pouco abordada a relação entre prescrição do treinamento com pesos, aumento da força e comportamento da PA de repouso em humanos. OBJETIVO: Analisar a PA após uma sessão aguda de exercícios com pesos e após um período de treinamento com pesos, em indivíduos normotensos e hipertensos, em estudos publicados na literatura internacional. MÉTODOS: As referências foram selecionadas de três formas distintas: 1) para compor as sugestões de treinamento de pesos foi utilizado um estudo meta-analítico e um posicionamento oficial de uma reconhecida entidade de pesquisa; 2) para os dados do exercício com pesos e PA de repouso nos momentos pós-exercício, foram pesquisados estudos na base Medline publicados em inglês que acompanharam a PA por pelo menos 60 min; 3) as referências sobre treinamento com pesos em longo prazo e PA de repouso foram resgatadas do último estudo meta-analítico sobre o tema, adicionadas dos experimentos publicados até julho de 2008. RESULTADOS: Após analisar as referências, a prescrição do treinamento com pesos, na maioria dos estudos, seguiu sugestões atuais. Porém, somente em poucos estudos a PA de repouso foi reduzida, tanto em normotensos quanto em hipertensos. CONCLUSÕES: Mesmo com certa variação na prescrição, o treinamento com pesos parece ser suficiente para aumentar a força muscular. Contudo, ainda faltam pesquisas para inferir sobre sua relação com a PA de repouso de normotensos e hipertensos.

Elderly women have blunted response to resistance training despite reduced antagonist coactivation

PURPOSE

To test the ability of a combination high-velocity/high-resistance training program to enhance knee extensor muscle strength, power, nervous activation of muscle, and muscle activation time in inactive women and compare the response to training between young and old women.

METHODS

The study involved 49 inactive women, with young (18-33 yr, n = 25) and old (65-84 yr, n = 24) distributed to training and control groups using blocked randomization. Electrically evoked muscle twitches were measured for the knee extensors; then maximal, voluntary, isometric knee extensions were performed in a visually cued reaction time (RT) task, followed by 8 wk of explosive resistance training.

RESULTS

Training increased peak torque (+12%, P = 0.03) and reduced antagonist coactivation (-13%, P = 0.02) similarly for both age groups. Young training group increased the rate of torque development by 34% compared to young controls (-7%), old training (+9%), and old controls (+8%) (P = 0.002). Young training group increased impulse by 53%, which was greater than young controls (-11%), old training (+12%), and old controls (+9%) (P = 0.001). Resistance training did not change electrically evoked twitch, RT (premotor time, motor time, or reaction time), or nervous activation measures (onset EMG amplitude or rate of EMG rise).

CONCLUSIONS

Explosive force training was ineffective at enhancing muscle twitch characteristics, neural drive, or RT in young or old women. It did enhance peak muscle force in both young and old, modulated through a reduction in antagonist coactivation. Older participants showed less of an improvement in the rate of torque development and contractile impulse than young, indicating either that this sample of older women had a reduced capacity to develop muscle power or that the 8-wk isokinetic resistance training program used in this study was not a sufficient stimulus for adaptation.

The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study

OBJECTIVES

To study the effect of additional strengthening of hip abductor and lateral rotator muscles in a strengthening quadriceps exercise rehabilitation programme for patients with the patellofemoral pain syndrome.

DESIGN

Randomized controlled pilot trial.

SETTING

Clinical setting with home programme.

PARTICIPANTS

Fourteen patients with patellofemoral pain syndrome.

INTERVENTION

The subjects were randomly assigned to the intervention group (strengthening of quadriceps plus strengthening of hip abductor and lateral rotator muscles) or to the control group (strengthening of quadriceps). Both groups participated in a six-week home exercise protocol.

MAIN OUTCOME MEASURES

The perceived pain symptoms, isokinetic eccentric knee extensor, hip abductor and lateral rotator torques and the gluteus medius electromyographic activity were assessed before and after treatment. Parametric and non-parametric tests were used to compare the groups before and after treatment with alpha=0.05.

RESULTS

Only the intervention group improved perceived pain symptoms during functional activities (P=0.02-0.04) and also increased their gluteus medius electromyographic activity during isometric voluntary contraction (P=0.03). Eccentric knee extensors torque increased in both groups (P=0.04 and P=0.02). There was no statistically significant difference in the hip muscles torque in either group.

CONCLUSION

Supplementation of strengthening of hip abductor and lateral rotator muscles in a strengthening quadriceps exercise programme provided additional benefits with respect to the perceived pain symptoms during functional activities in patients with patellofemoral pain syndrome after six weeks of treatment.

Interpretation of EMG integral or RMS and estimates of "neuromuscular efficiency" can be misleading in fatiguing contraction

In occupational and sports physiology, reduction of neuromuscular efficiency (NME) and elevation of amplitude characteristics, such as root mean square (RMS) or integral of surface electromyographic (EMG) signals detected during fatiguing submaximal contraction are often related to changes in neural drive. However, there is data showing changes in the EMG integral (I(EMG)) and RMS due to peripheral factors. Causes for these changes are not fully understood. On the basis of computer simulation, we demonstrate that lengthening of intracellular action potential (IAP) profile typical for fatiguing contraction could affect EMG amplitude characteristics stronger than alteration in neural drive (central factors) defined by number of active motor units (MUs) and their firing rates. Thus, relation of these EMG amplitude characteristics only to central mechanisms can be misleading. It was also found that to discriminate between changes in RMS or I(EMG) due to alterations in neural drive from changes due to alterations in peripheral factors it is better to normalize RMS of EMG signals to the RMS of M-wave. In massive muscles, such normalization is more appropriate than normalization to either peak-to-peak amplitude or area of M-wave proposed in literature.

(Over)training effects on quantitative electromyography and muscle enzyme activities in standardbred horses

Too intensive training may lead to overreaching or overtraining. To study whether quantitative needle electromyography (QEMG) is more sensitive to detect training (mal)adaptation than muscle enzyme activities, 12 standardbred geldings trained for 32 wk in age-, breed-, and sex-matched fixed pairs. After a habituation and normal training (NT) phase ( phases 1 and 2, 4 and 18 wk, respectively), with increasing intensity and duration and frequency of training sessions, an intensified training (IT) group ( phase 3, 6 wk) and a control group (which continued training as in the last week of phase 2) were formed. Thereafter, all horses entered a reduced training phase ( phase 4, 4 wk). One hour before a standardized exercise test (SET; treadmill), QEMG analysis and biochemical enzyme activity were performed in muscle or in biopsies from vastus lateralis and pectoralis descendens muscle in order to identify causes of changes in exercise performance and eventual (mal)adaptation in skeletal muscle. NT resulted in a significant adaptation of QEMG parameters, whereas in muscle biopsies hexokinase activity was significantly decreased. Compared with NT controls, IT induced a stronger adaptation (e.g., higher amplitude, shorter duration, and fewer turns) in QEMG variables resembling potentially synchronization of individual motor unit fiber action potentials. Despite a 19% decrease in performance of the SET after IT, enzyme activities of 3-hydroxyacyl dehydrogenase and citrate synthase displayed similar increases in control and IT animals. We conclude that 1) QEMG analysis is a more sensitive tool to monitor training adaptation than muscle enzyme activities but does not discriminate between overreaching and normal training adaptations at this training level and 2) the decreased performance as noted in this study after IT originates most likely from a central (brain) rather than peripheral level.

Chronic low-frequency rTMS of primary motor cortex diminishes exercise training-induced gains in maximal voluntary force in humans

Although there is consensus that the central nervous system mediates the increases in maximal voluntary force (maximal voluntary contraction, MVC) produced by resistance exercise, the involvement of the primary motor cortex (M1) in these processes remains controversial. We hypothesized that 1-Hz repetitive transcranial magnetic stimulation (rTMS) of M1 during resistance training would diminish strength gains. Forty subjects were divided equally into five groups. Subjects voluntarily (Vol) abducted the first dorsal interosseus (FDI) (5 bouts x 10 repetitions, 10 sessions, 4 wk) at 70-80% MVC. Another group also exercised but in the 1-min-long interbout rest intervals they received rTMS [Vol+rTMS, 1 Hz, FDI motor area, 300 pulses/session, 120% of the resting motor threshold (rMT)]. The third group also exercised and received sham rTMS (Vol+Sham). The fourth group received only rTMS (rTMS_only). The 37.5% and 33.3% gains in MVC in Vol and Vol+Sham groups, respectively, were greater (P = 0.001) than the 18.9% gain in Vol+rTMS, 1.9% in rTMS_only, and 2.6% in unexercised control subjects who received no stimulation. Acutely, within sessions 5 and 10, single-pulse TMS revealed that motor-evoked potential size and recruitment curve slopes were reduced in Vol+rTMS and rTMS_only groups and accumulated to chronic reductions by session 10. There were no changes in rMT, maximum compound action potential amplitude (M(max)), and peripherally evoked twitch forces in the trained FDI and the untrained abductor digiti minimi. Although contributions from spinal sources cannot be excluded, the data suggest that M1 may play a role in mediating neural adaptations to strength training.

Detraining and retraining in older adults following long-term muscle power or muscle strength specific training

BACKGROUND

Training cessation among older adults is associated with the loss of functional ability. However, exercise programs undertaken prior to activity cessation may offer functional protection. In the present study, the residual effects of muscle power or muscle strength training were investigated following extended detraining and subsequent retraining.

METHODS

Thirty-eight healthy independent older adults (65-84 years) entered a 24-week detraining period subsequent to 24 weeks of training. Following detraining, participants recommenced training using either the high-velocity muscle power (HV) or muscle strength (ST) protocol, as undertaken during the initial training period, twice weekly for 12 weeks. Isometric and dynamic muscle strength, muscle power, movement velocity, muscle endurance, electromyographic activity, and the results of a battery of functional performance tasks were assessed.

RESULTS

Muscle function and functional performance increased following initial training, however, no group differences were observed. Detraining resulted in similar declines in muscle power and muscle strength for both groups (p <.05) (power, HV 17.8 +/- 1.8%, ST 15.5 +/- 2.2%; and strength, HV 17.1 +/- 2.2%, ST 16.5 +/- 1.8%), with comparable accrual following retraining. No significant changes in functional ability were observed following detraining (average change; HV 3.1 +/- 3.5% and ST 2.1 +/- 3.5%) or retraining. No group differences emerged in this study.

CONCLUSION

Cessation of training resulted in only a modest loss of muscle power and strength that was recouped following 12 weeks of retraining. Importantly, training-induced gains in functional performance were preserved during detraining. The residual effects of power or strength training appear comparable, and both may be suitable exercise modes prior to a period of activity cessation to promote physical independence.

The effects of PNF training on the facial profile

Although orthodontic treatment improves dentoalveolar problems, the facial profile seldom changes because the perioral muscles do not easily adapt to the new morphological circumstances. We employed proprioceptive neuromuscular facilitation (PNF), which is training with added resisted movement to motions such as lifting the upper lip, lowering the lower lip, and sticking out the tongue, to adapt the perioral muscles to the new morphological circumstances. The subjects were 40 adults with an average age of 29.6 years. A series of PNF exercises was performed three times per day for 1 month. Lateral facial photographs were taken using a digital camera before training (T(0)), after training (T(1)), and 1 month after the end of training (T(2)). The nasolabial (NL), mentolabial (ML), and mentocervical (MC) angles were measured, and linear measurements were taken to verify the change of each measurement point. In the test group, the NL and ML angles significantly increased (P < 0.05), and the MC angle significantly decreased after the PNF exercise. From T(1) to T(2), the NL and ML angles decreased significantly, while the MC angle increased significantly. No significant differences were observed in these angles when the values measured at T(0) and T(2) were compared. Although the training appeared to be effective for sharpening the mouth and submandibular region, continued training is necessary to avoid relapse.

Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial

OBJECTIVE

To assess pain, function, quality of life, and muscle strength in patients with shoulder impingement syndrome who participated in muscle strengthening exercises.

METHODS

A total of 60 patients diagnosed with shoulder impingement syndrome were selected from the clinics of the Federal University of São Paulo and randomly distributed into experimental and control groups. Patients were evaluated regarding pain, function, quality of life, muscle strength, and the number of antiinflammatory drugs and analgesics taken. Patients then participated in the progressive resistance training program for the musculature of the shoulder, which was held twice a week for 2 months, while the control group remained on a waiting list.

RESULTS

Sixty patients were randomly allocated to the experimental group (21 women and 9 men, mean age 56.3 years) and control group (25 women and 5 men, mean age 54.8 years). Patients from the experimental group showed an improvement from 4.2 cm to 2.4 cm on a 10-cm visual analog scale (P < 0.001) regarding pain at rest and from 7.4 cm to 5.2 cm (P < 0.001) regarding pain during movement. Function went from 44.0 to 33.2 (P < 0.007) using the Disabilities of the Arm, Shoulder, and Hand assessment and domains from the Short Form 36. There was a statistically significant difference in improvement in pain and function between patients in the experimental group and those in the control group (P < 0.05).

CONCLUSION

The progressive resistance training program for the musculature of the shoulder in patients with shoulder impingement syndrome was effective in reducing pain and improving function and quality of life.

The effect of increasing resistance on trunk muscle activity during extension and flexion exercises on training devices

Although progressive resistance training of trunk muscles on devices is very common, today, the effects of increasing resistance on trunk muscle activity during dynamic extension and flexion movements on training devices have not been reported yet. Thirty healthy subjects participated in maximal isometric and submaximal dynamic (at 30%, 50% and 70% of maximum mean torque (MMT)) extension and flexion exercises on Tergumed lumbar training devices. The normalized (as a percentage of maximal voluntary isometric contractions (MVIC)) electromyographic activity of 16 abdominal and back muscles was investigated. The results of the present study indicated that in general, with increasing resistance from 30% MMT to 50% MMT and 70% MMT, the activity of all back muscles during the extension exercises and the activity of all abdominal muscles during the flexion exercises increased significantly. To train strength (>60% of MVIC), low intensities (30% and 50% MMT) appeared sufficient to affect the back muscles, but for the abdominals higher resistance (70% MMT) was required. In contrast to the other back muscles, the lumbar multifidus demonstrated high activity levels during both the extension and the flexion exercises. As the lumbar multifidus is demonstrated to be an important muscle in segmental stabilization of the lumbar spine, this finding may help in understanding the efficacy of rehabilitation programs using specific training devices.

The sympathetic skin response habituation in sedentary subjects and sportsmen

The aim of the present study was to investigate the habituation rates of the sympathetic skin response (SSR) in sedentary subjects and trained sportsmen. A total of 52 voluntary male students (30 sedentary subjects and 22 trained sportsmen) participated in the experiment. SSR was recorded with the contralateral electrical stimulation of the ulnar nerve (of the upper extremities). In order to initiate the SSRs, 16 square-wave consecutive electrical shock stimuli were presented to each subject over the left ulnar nerve. In 52 subjects, 16 stimuli were applied at random time intervals (20-50 s). In sedentary subjects, the mean amplitude of the SSRs decreased from 4.83 +/- 0.36 mV at the first stimulus, to 0.80 +/- 0.12 mV at the 16th stimulus. In trained sportsmen, the mean amplitude of the SSRs decreased from 3.95 +/- 0.51 mV at the first stimulus, to 0.80 +/- 0.17 mV at the 16th stimulus. In the sedentary subjects, at the S1-S9 stimuli, the mean amplitudes of SSRs were higher than those of trained sportsmen. Depending upon these findings we can say that the trained sportsmen showed a more rapid habituation than sedentary subjects. In these processes, changes of amplitude and latency values reflect changes in amount of neuronal activation. Amplitude reflects the amount of neuronal activation, which is concerned with number of neuronal populations. Neuroplasticity, known as the habituation of the brain, is the adaptation of autonomic nervous system, which can be reflected by SSRs.

Parkinson's disease and resistive exercise: rationale, review, and recommendations

Individuals with Parkinson's disease (PD) are not only burdened with disease-specific symptoms (i.e., bradykinesia, rigidity, and tremor), but are also confronted with age-associated progressive loss of physical function, perhaps to a greater extent than neurologically normal adults. Suggestions for the inclusion of resistive exercise into treatment to attenuate these symptoms were made over 10 years ago, yet very few well controlled investigations are available. The objective of this review is to establish a clear rationale for the efficacy of resistance training in individuals with PD. Specifically, we highlight musculoskeletal weakness and its relationship to function as well as potential training-induced adaptive alterations in the neuromuscular system. We also review the few resistance training interventions currently available, but limit this review to those investigations that provide a quantitative exercise prescription. Finally, we recommend future lines of inquiry warranting further attention and call to question the rationale behind current exercise prescriptions. The absence of reports contraindicating resistive exercise, the potential for positive adaptation, and the noted benefits of resistance training in other populations may provide support for its inclusion into a treatment approach to PD.

Translating principles of neural plasticity into research on speech motor control recovery and rehabilitation

PURPOSE

To review the principles of neural plasticity and make recommendations for research on the neural bases for rehabilitation of neurogenic speech disorders.

METHOD

A working group in speech motor control and disorders developed this report, which examines the potential relevance of basic research on the brain mechanisms involved in neural plasticity and discusses possible similarities and differences for application to speech motor control disorders. The possible involvement of neural plasticity in changes in speech production in normalcy, development, aging, and neurological diseases and disorders was considered. This report focuses on the appropriate use of functional and structural neuroimaging and the design of feasibility studies aimed at understanding how brain mechanisms are altered by environmental manipulations such as training and stimulation and how these changes might enhance the future development of rehabilitative methods for persons with speech motor control disorders.

CONCLUSIONS

Increased collaboration with neuroscientists working in clinical research centers addressing human communication disorders might foster research in this area. It is hoped that this article will encourage future research on speech motor control disorders to address the principles of neural plasticity and their application for rehabilitation.

Effects of robot-aided bilateral force-induced isokinetic arm training combined with conventional rehabilitation on arm motor function in patients with chronic stroke

OBJECTIVE

To analyze the effects of conventional rehabilitation combined with bilateral force-induced isokinetic arm movement training on paretic upper-limb motor recovery in patients with chronic stroke.

DESIGN

Single-cohort, pre- and postretention design.

SETTING

Rehabilitation department at a medical university.

PARTICIPANTS

Twenty subjects who had unilateral strokes at least 6 months before enrolling in the study.

INTERVENTION

A training program (40min/session, 3 sessions/wk for 8wk) consisting of 10 minutes of conventional rehabilitation and 30 minutes of robot-aided, bilateral force-induced, isokinetic arm movement training to improve paretic upper-limb motor function.

MAIN OUTCOME MEASURES

The interval of pretest, post-test, and retention test was set at 8 weeks. Clinical arm motor function (Fugl-Meyer Assessment [FMA], upper-limb motor function, Frenchay Arm Test, Modified Ashworth Scale), paretic upper-limb strength (grip strength, arm push and pull strength), and reaching kinematics analysis (peak velocity, percentage of time to peak velocity, movement time, normalized jerk score) were used as outcome measures.

RESULTS

After comparing the sets of scores, we found that the post-test and retention test in arm motor function significantly improved in terms of grip (P=.009), push (P=.001), and pull (P=.001) strengths, and FMA upper-limb scale (P<.001). Reaching kinematics significantly improved in terms of movement time (P=.015), peak velocity (P=.035), percentage of time to peak velocity (P=.004), and normalized jerk score (P=.008). Improvement in reaching ability was not sustained in the retention test.

CONCLUSIONS

Preliminary results showed that conventional rehabilitation combined with robot-aided, bilateral force-induced, isokinetic arm training might enhance the recovery of strength and motor control ability in the paretic upper limb of patients with chronic stroke.

Influence of concurrent exercise or nutrition countermeasures on thigh and calf muscle size and function during 60 days of bed rest in women

AIM

The goal of this investigation was to test specific exercise and nutrition countermeasures to lower limb skeletal muscle volume and strength losses during 60 days of simulated weightlessness (6 degrees head-down-tilt bed rest).

METHODS

Twenty-four women underwent bed rest only (BR, n = 8), bed rest and a concurrent exercise training countermeasure (thigh and calf resistance training and aerobic treadmill training; BRE, n = 8), or bed rest and a nutrition countermeasure (a leucine-enriched high protein diet; BRN, n = 8).

RESULTS

Thigh (quadriceps femoris) muscle volume was decreased (P < 0.05) in BR (-21 +/- 1%) and BRN (-24 +/- 2%), with BRN losing more (P < 0.05) than BR. BRE maintained (P > 0.05) thigh muscle volume. Calf (triceps surae) muscle volume was decreased (P < 0.05) to a similar extent (P > 0.05) in BR (-29 +/- 1%) and BRN (-28 +/- 1%), and this decrease was attenuated (P < 0.05) in BRE (-8 +/- 2%). BR and BRN experienced large (P < 0.05) and similar (P > 0.05) decreases in isometric and dynamic (concentric force, eccentric force, power and work) muscle strength for supine squat (-19 to -33%) and calf press (-26 to -46%). BRE maintained (P > 0.05) or increased (P < 0.05) all measures of muscle strength.

CONCLUSION

The nutrition countermeasure was not effective in offsetting lower limb muscle volume or strength loss, and actually promoted thigh muscle volume loss. The concurrent aerobic and resistance exercise protocol was effective at preventing thigh muscle volume loss, and thigh and calf muscle strength loss. While the exercise protocol offset approximately 75% of the calf muscle volume loss, modification of this regimen is needed.

Changes in Antagonist Muscles' Coactivation in Response to Strength Training in Older Women

BACKGROUND

The purpose of this study was to assess changes in neuromuscular function of the plantarflexor and dorsiflexor muscles after 1 year of strength training of these muscles in elderly women. Twelve participants were assigned to a training (74.2 +/- 3.1 years) group and eight to a nontraining group (73.6 +/- 4.3 years).

METHODS

Isometric maximum voluntary contractions (MVC) and muscle activation based on surface electromyography (EMG) were recorded before and after the 12-month training program at six different joint angles.

RESULTS

After training (in the training group), (a) plantarflexion (PF) MVC increased on average by 14.4% (p <.05) across ankle joint angles from -20 degrees dorsiflexion (DF) to +30 degrees PF, (b) DF MVC decreased by 5.7% (p <.05), (c) PF EMG root mean square increased on average by 22.3% (p <.05), and (d) PF antagonists' coactivation increased on average by 7.5% across the tested joint angles. No changes were observed in the nontraining group.

CONCLUSIONS

The present results show a significant increase in antagonist muscle coactivation with strength training in older women. The hypothesis is put forward that with a training-induced gain in agonist muscles' torque, stabilization of the ankle joint by increasing antagonist coactivation is needed because of a changed ratio of maximal PF torque to maximal DF torque.

Strength training reduces freely chosen pedal rate during submaximal cycling

The freely chosen pedal rate is relatively high and energetically inefficient during submaximal cycling, which is a paradox since the rate of energy expenditure is considered important for voluntary motor behavior in other cyclical activities as, e.g., running. For example, it has been suggested that subjects pedal fast to reduce the perception of force. In this study, we investigated the hypothesis that strength training would cause subjects to pedal at a slower rate during low to moderate submaximal cycling. Fourteen healthy subjects performed supervised heavy (2-12 RM) strength training 4 days/week for 12 weeks, including 2 days/week with leg-extensor and knee-flexor exercises. Seven healthy subjects formed the control group. The training group increased strength (one repetition maximum, 1 RM) in both squat [20%(3), mean (SEM)] and leg curl [12%(1)] exercises from the beginning to the end of the study period (p<0.01). At the same time, freely chosen pedal rate was reduced by 8 (2) and 10 (2) rpm, respectively, during cycling at 37 and 57% of maximal power output (Wmax) (p<0.01). In addition, rate of energy expenditure is 3% (2) lower at 37% of Wmax (p<0.05) and tended to be lower at 57% Wmax (p=0.07) at the end of the study. Values for strength, freely chosen pedal rate, and rate of energy expenditure, were unchanged for the control group from the beginning to the end of the study. In conclusion, strength training caused subjects to choose an approximately 9 rpm lower pedal rate during submaximal cycling. This was accompanied by a approximately 3% lower rate of energy expenditure.

Effects of training programs for spinal cord injury

INTRODUCTION

Endurance exercise training programs in patients with spinal cord injury (SCI) were largely studied to determine different types of adaptations. The aim of specific rehabilitation is to obtain maximal gains in quality-of-life (QoL) after SCI.

OBJECTIVE

To review the literature on the efficiency of training programs for SCI.

METHODS

We searched the MEDline database with the keywords SCI, paraplegia and quadriplegia and synonyms, then combined them with one of the following terms: rehabilitation, training, exercise conditioning, physical fitness, exercise prescription, adaptation, effect, or benefit. We found 65 articles related to the physiological and psychological effects of training programmes on patients with SCI.

RESULTS AND DISCUSSION

Training programs after SCI offer reconditioning cardiorespiratory, cardiovascular, cardiac, metabolic, bone, biomechanical, muscle adaptation, and QoL benefits. Reconditioning training increases VO2 max, reverses leg vascular resistance in the paralyzed legs and has possible cardiac and neural adaptations, favorable catecholamine responses and effects on platelet aggregation. Reconditioning can also modify lipid profile, reduce risk for cardiovascular diseases, prevent osteoporosis and increase maximal upper-extremity muscle strength, sprint power output and maximal power output. This effect allows for considerable improvement in mechanical efficiency and wheelchair propulsion technique.

CONCLUSIONS

Reconditioning training programs after SCI have a direct impact on function and QoL, permitting participation in physical activities in addition to daily living activities in subjects with SCI.

Enhanced H-reflex with resistance training is related to increased rate of force development

Parallel increases in strength and rate of force development (RFD) are well-known outcomes from the initial phase of resistance training. However, it is unknown whether neural adaptations with training contribute to improvements of both factors. The aim of this study was to examine whether changes in H-reflex amplitude with resistance training can explain the gain in strength or rather be associated with RFD. Twelve subjects carried out 3 weeks of isometric maximal plantarflexion training, whereas 12 subjects functioned as controls. H-reflexes were elicited in the soleus muscle during rest and sub-maximal contractions at 20 and 60% of maximal voluntary contraction (MVC). In addition, surface electromyography (sEMG) was recorded from the soleus, gastrocnemius and tibialis anterior muscles during MVC. The resistance training provided increases in maximal force of 18%, RFD of 28% and H-reflex amplitude during voluntary contractions of 17 and 15% while no changes occurred in the control group. In contrast, the maximal M-wave, the maximal H-reflex to maximal M-wave ratio during rest and sEMG during MVC did not change with training. There was a positive correlation between percentage changes in H-reflex amplitude and RFD with training (r = 0.59), while significant association between percentage changes in H-reflex amplitude and maximal force was not found. These findings indicate the occurrence of changed motoneuron excitability or presynaptic inhibition during the initial phase of resistance training. This is the first study to document that increased RFD with resistance training is associated with changes in reflex excitability.

Changes in muscle coordination with training

Three core concepts, activity-dependent coupling, the composition of muscle synergies, and Hebbian adaptation, are discussed with a view to illustrating the nature of the constraints imposed by the organization of the central nervous system on the changes in muscle coordination induced by training. It is argued that training invoked variations in the efficiency with which motor actions can be generated influence the stability of coordination by altering the potential for activity-dependent coupling between the cortical representations of the focal muscles recruited in a movement task and brain circuits that do not contribute directly to the required behavior. The behaviors that can be generated during training are also constrained by the composition of existing intrinsic muscle synergies. In circumstances in which attempts to produce forceful or high velocity movements would otherwise result in the generation of inappropriate actions, training designed to promote the development of control strategies specific to the desired movement outcome may be necessary to compensate for protogenic muscle recruitment patterns. Hebbian adaptation refers to processes whereby, for neurons that release action potentials at the same time, there is an increased probability that synaptic connections will be formed. Neural connectivity induced by the repetition of specific muscle recruitment patterns during training may, however, inhibit the subsequent acquisition of new skills. Consideration is given to the possibility that, in the presence of the appropriate sensory guidance, it is possible to gate Hebbian plasticity and to promote greater subsequent flexibility in the recruitment of the trained muscles in other task contexts.