1
|
Davico G, Labanca L, Gennarelli I, Benedetti MG, Viceconti M. Towards a comprehensive biomechanical assessment of the elderly combining in vivo data and in silico methods. Front Bioeng Biotechnol 2024; 12:1356417. [PMID: 38770274 PMCID: PMC11102974 DOI: 10.3389/fbioe.2024.1356417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
The aging process is commonly accompanied by a general or specific loss of muscle mass, force and/or function that inevitably impact on a person's quality of life. To date, various clinical tests and assessments are routinely performed to evaluate the biomechanical status of an individual, to support and inform the clinical management and decision-making process (e.g., to design a tailored rehabilitation program). However, these assessments (e.g., gait analysis or strength measures on a dynamometer) are typically conducted independently from one another or at different time points, providing clinicians with valuable yet fragmented information. We hereby describe a comprehensive protocol that combines both in vivo measurements (maximal voluntary isometric contraction test, superimposed neuromuscular electrical stimulation, electromyography, gait analysis, magnetic resonance imaging, and clinical measures) and in silico methods (musculoskeletal modeling and simulations) to enable the full characterization of an individual from the biomechanical standpoint. The protocol, which requires approximately 4 h and 30 min to be completed in all its parts, was tested on twenty healthy young participants and five elderlies, as a proof of concept. The implemented data processing and elaboration procedures allowing for the extraction of several biomechanical parameters (including muscle volumes and cross-sectional areas, muscle activation and co-contraction levels) are thoroughly described to enable replication. The main parameters extracted are reported as mean and standard deviation across the two populations, to highlight the potential of the proposed approach and show some preliminary findings (which were in agreement with previous literature).
Collapse
Affiliation(s)
- Giorgio Davico
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Irene Gennarelli
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| |
Collapse
|
2
|
Gaemelke T, Laustsen C, Feys P, Folkestad L, Andersen MS, Jørgensen NR, Jørgensen ML, Jespersen SN, Ringgaard S, Eskildsen SF, Dalgas U, Hvid LG. Effects of power training in older patients with multiple sclerosis on neurodegeneration, neuromuscular function, and physical function. A study protocol for the "power training in older multiple sclerosis patients (PoTOMS) randomized control trial. Contemp Clin Trials Commun 2024; 38:101279. [PMID: 38444875 PMCID: PMC10912361 DOI: 10.1016/j.conctc.2024.101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/24/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Approximately one-third of all persons with multiple sclerosis (pwMS) are older, i.e., having an age ≥60 years. Whilst ageing and MS separately elicit deteriorating effects on brain morphology, neuromuscular function, and physical function, the combination of ageing and MS may pose a particular challenge. To counteract such detrimental changes, power training (i.e., a type of resistance exercise focusing on moderate-to-high loading at maximal intended movement velocity) presents itself as a viable and highly effective solution. Power training is known to positively impact physical function, neuromuscular function, as well as brain morphology. Existing evidence is promising but limited to young and middle-aged pwMS, with the effects of power training remaining to be elucidated in older pwMS. Methods The presented 'Power Training in Older MS patients (PoTOMS)' trial is a national, multi-center, parallel-group, randomized controlled trial. The trial compares 24 weeks of usual care(n = 30) to 24 weeks of usual care and power training (n = 30). The primary outcome is whole brain atrophy rate. The secondary outcomes include changes in brain micro and macro structures, neuromuscular function, physical function, cognitive function, bone health, and patient-reported outcomes. Ethics and dissemination The presented study is approved by The Regional Ethics Committee (reference number 1-10-72-222-20) and registered at the Danish Data Protection Agency (reference number 2016-051-000001). All study findings will be published in scientific peer-reviewed journals and presented at relevant scientific conferences independent of the results. The www.clinicaltrials.gov identifier is NCT04762342.
Collapse
Affiliation(s)
- Tobias Gaemelke
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peter Feys
- REVAL, Rehabilitation Research Center, BIOMED, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | | | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Sune Nørhøj Jespersen
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Ringgaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Simon F. Eskildsen
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars G. Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
| |
Collapse
|
3
|
Collimore AN, Alvarez JT, Sherman DA, Gerez LF, Barrow N, Choe DK, Binder-Macleod S, Walsh CJ, Awad LN. A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive. Bioengineering (Basel) 2024; 11:137. [PMID: 38391623 PMCID: PMC10885982 DOI: 10.3390/bioengineering11020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/15/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Plantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC2,1) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS' measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS' measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, p < 0.001). CEDRS' measurements also showed the expected between-limb differences (p's < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, p < 0.001) and distance-induced changes in speed (r = 0.61, p = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability.
Collapse
Affiliation(s)
- Ashley N Collimore
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Jonathan T Alvarez
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - David A Sherman
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
- Section of Rheumatology, Boston University, Boston, MA 02215, USA
| | - Lucas F Gerez
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Noah Barrow
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Dabin K Choe
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | | | - Conor J Walsh
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Louis N Awad
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| |
Collapse
|
4
|
Gaemelke T, Jørgensen MLK, Riemenschneider M, Dalgas U, Hvid LG. The combined deleterious effects of multiple sclerosis and ageing on neuromuscular function. Exp Gerontol 2023; 184:112339. [PMID: 38029888 DOI: 10.1016/j.exger.2023.112339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/03/2023] [Accepted: 11/26/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND The prevalence of older (>60 years) people with multiple sclerosis (pwMS) is increasing. This introduces numerous challenges, as both MS and ageing independently contribute to the deterioration of neuromuscular function. AIM The aim was to compare the neuromuscular function in pwMS and healthy controls (HC) across three age groups: young, middle-aged, and old. METHODS Using a cross-sectional study design, the maximal muscle strength (Fmax) and rate of force development (RFD) of the knee extensors (KE) and plantar flexors (PF) were assessed using an isokinetic dynamometer. In addition, voluntary activation (VA) and resting twitch (RT) were measured using the interpolated twitch technique. RESULTS The Fmax, RFD, and VA of the KE were reduced in pwMS compared to HC across age groups. In pwMS, reductions were observed in PF Fmax, RFD, and RT, predominantly in the middle-aged and old age groups. Reductions increased with age in KE for both groups (except for VA) but in PF only for pwMS. The "trajectory" differed between pwMS and HC, as pwMS showed reductions from young to middle age, while HC showed reductions from middle to old age in KE. CONCLUSION The combined negative effects of MS and ageing on neuromuscular function were especially present in the PF but also substantial in the KE. RFD showed large deficits for pwMS compared to HC across age groups. The findings can partly be explained by a reduction in VA and RT, but further investigations of neural regulation are needed to explain large RFD deficits.
Collapse
Affiliation(s)
- Tobias Gaemelke
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark.
| | | | | | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars G Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark; The Danish MS Hospitals, Ry and Haslev, Denmark
| |
Collapse
|
5
|
Wrucke DJ, Kuplic A, Adam M, Hunter SK, Sundberg CW. Neural and muscular contributions to the age-related loss in power of the knee extensors in men and women. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.24.563851. [PMID: 37961177 PMCID: PMC10634815 DOI: 10.1101/2023.10.24.563851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The mechanisms for the loss in limb muscle power in old (60-79 years) and very old (≥80 years) adults and whether the mechanisms differ between men and women are not well-understood. We compared maximal power of the knee extensor muscles between young, old, and very old men and women and identified the neural and muscular factors contributing to the age-related loss of power. 31 young (22.9±3.0 years, 15 women), 83 old (70.4±4.9 years, 39 women), and 16 very old adults (85.8±4.2 years, 9 women) performed maximal isokinetic contractions at 14 different velocities (30-450°/s) to identify peak power. Voluntary activation (VA) and contractile properties were assessed with transcranial magnetic stimulation to the motor cortex and electrical stimulation of the femoral nerve. The age-related loss in power was ~6.5 W·year-1 for men (R2=0.62, p<0.001), which was a greater rate of decline (p=0.002) than the ~4.2 W·year-1 for women (R2=0.77, p<0.001). Contractile properties were the most closely associated variables with power output for both sexes, such as the rate of torque development of the potentiated twitch (men: R2=0.69, p<0.001; women: R2=0.57, p<0.001). VA was weakly associated with power in women (R2=0.13, p=0.012) but not men (p=0.191), whereas neuromuscular activation (EMG amplitude) during the maximal power contraction was not associated with power in men (p=0.347) or women (p=0.106). These data suggest that the age-related loss in power of the knee extensor muscles is due primarily to factors within the muscle for both sexes, although neural factors may play a minor role in older women.
Collapse
Affiliation(s)
- David J. Wrucke
- Exercise and Rehabilitation Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Andrew Kuplic
- Exercise and Rehabilitation Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Mitchell Adam
- Exercise and Rehabilitation Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Sandra K. Hunter
- Exercise and Rehabilitation Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
- Athletic and Human Performance Research Center, Marquette University, Milwaukee, WI, USA
| | - Christopher W. Sundberg
- Exercise and Rehabilitation Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
- Athletic and Human Performance Research Center, Marquette University, Milwaukee, WI, USA
| |
Collapse
|
6
|
Sara LK, Gutsch SB, Bement MH, Hunter SK. Plantar Flexor Weakness and Pain Sensitivity Cannot Be Assumed in Midportion Achilles Tendinopathy. EXERCISE, SPORT, & MOVEMENT 2023; 1:1-7. [PMID: 38222444 PMCID: PMC10786321 DOI: 10.1249/esm.0000000000000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Introduction/Purpose The purpose of this study was to determine the following in persons with midportion Achilles tendinopathy (AT): 1) maximal strength and power; 2) neural drive during maximal contractions and contractile function during electrically evoked resting contractions; and 3) whether pain, neural drive, and contractile mechanisms contribute to differences in maximal strength. Methods Twenty-eight volunteers (14 AT, 14 controls) completed isometric, concentric, and eccentric maximal voluntary contractions (MVCs) of the plantar flexors in a Biodex™ dynamometer. Supramaximal electrical stimulation of the tibial nerve was performed to quantify neural drive and contractile properties of the plantar flexors. Pain sensitivity was quantified as the pressure-pain thresholds of the Achilles tendon, medial gastrocnemius, and upper trapezius. Results There were no differences in plantar flexion strength or power between AT and controls (isometric MVC: P = 0.95; dynamic MVC: P = 0.99; power: P = 0.98), nor were there differences in neural drive and contractile function (P = 0.55 and P = 0.06, respectively). However, the mechanisms predicting maximal strength differed between groups: neural drive predicted maximal strength in controls (P = 0.02) and contractile function predicted maximal strength in AT (P = 0.001). Although pain did not mediate these relationships (i.e., between maximal strength and its contributing mechanisms), pressure-pain thresholds at the upper trapezius were higher in AT (P = 0.02), despite being similar at the calf (P = 0.24) and Achilles tendon (P = 0.40). Conclusions There were no deficits in plantar flexion strength or power in persons with AT, whether evaluated isometrically, concentrically, or eccentrically. However, the mechanisms predicting maximal plantar flexor strength differed between groups, and systemic pain sensitivity was diminished in AT.
Collapse
Affiliation(s)
- Lauren K Sara
- Harvard Medical School, Cambridge, MA, USA
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Savannah B Gutsch
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | | | - Sandra K Hunter
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| |
Collapse
|
7
|
Varesco G, Luneau E, Millet GY, Féasson L, Lapole T, Rozand V. Age-Related Differences between Old and Very Old Men in Performance and Fatigability Are Evident after Cycling but Not Isometric or Concentric Single-Limb Tasks. Med Sci Sports Exerc 2023; 55:1641-1650. [PMID: 37580874 DOI: 10.1249/mss.0000000000003181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
PURPOSE This study aimed to compare performance and fatigability between young (n = 13; 18-30 yr), old (n = 13; 60-80 yr), and very old (n = 12; >80 yr) men during a single-joint isometric (ISO) and concentric (CON) task performed on an isokinetic dynamometer and a cycling (BIKE) task. METHODS Participants randomly performed incremental tasks consisting of stages of 75 contractions (i.e., 120 s, 0.8 s on/0.8 s off) for ISO and CON and 120 s at 37.5 rpm (similar duty cycle) for BIKE. Increments were set as a percentage of body weight. Knee extensor maximal force, voluntary activation, and twitch amplitude were measured at baseline, after each stage, and at task failure (five out of eight contractions below the target force or 6 s in a row at a cadence <37.5 rpm). RESULTS Compared with young men, performance (number of stages) was 24% and 40% lower in old and very old men in ISO, 54% and 59% lower in CON, and 36% and 60% lower in BIKE (all P < 0.05). Performance of old and very old differed only in BIKE (P < 0.01). For the last common stages performed, compared with young, force loss was greater for very old men in ISO and for old and very old men in BIKE (all P < 0.05). Overall, for the last common stage performed and task failure, old and very old men presented similar force loss, alterations in voluntary activation, and twitch amplitude. CONCLUSIONS Our findings reveal that, with workloads relative to body weight, differences in performance between old and very old men could only be observed during BIKE (i.e., the more ecologically valid task). Results from isometric or concentric conditions might not be transferable to dynamic exercise with large muscle masses.
Collapse
Affiliation(s)
- Giorgio Varesco
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | - Eric Luneau
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | | | | | - Thomas Lapole
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | - Vianney Rozand
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| |
Collapse
|
8
|
Lim CL, Keong NLS, Yap MMC, Tan AWK, Tan CH, Lim WS. The effects of community-based exercise modalities and volume on musculoskeletal health and functions in elderly people. Front Physiol 2023; 14:1227502. [PMID: 37492640 PMCID: PMC10363600 DOI: 10.3389/fphys.2023.1227502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
The effects of different muscle loading exercise (MLEX) modes and volume on musculoskeletal health is not well-studied in older populations. Aim: Therefore, this study aimed to compare the effects of community-based MLEX modalities and volume on musculoskeletal health in elderly people. Methods: Elderly men (n = 86) and women (n = 170), age 50-82 years old, were assigned to the sedentary (SE, n = 60), muscle strengthening exercise (MSE, n = 71), aerobic exercise (AE, n = 62) and Tai Chi exercise (TCE, n = 63) groups, based on > 2 years of exercise history. Exercise volume was compared between "Minimum" ("Min" < 60 min/week), "Low" (60-120 min/week). "Moderate" (121-239 min/week) and "High" (240-720 min/week) volumes. Results: All three modes of MLEX were associated with lower percentage of body fat (BF%) and higher percentage of lean body mass (LBM%, p = 0.003 main effect of group, and p = 0.002 main effect of volume for both BF% and LBM%), but not with higher bone mineral density (BMD, total body, lumbar spine, total hip and neck of femur), than SE. TCE had a distinct advantage in trunk flexibility (p = 0.007 with MSE, p = 0.02 with AE, and p = 0.01 with SE), and both TCE (p = 0.03) and AE (p = 0.03) performed better than SE in the one-leg stand balance test. Isometric strength and throwing speed and peak power with a 2 kg power ball were higher in the MLEX than SE groups (p = 0.01), in the ranking order of MSE, AE and TCE. However, there was no difference in handgrip strength performance between the MLEX groups, which performed better than the SE participants. Accumulating >120 min/week of MLEX can promote body composition health and muscle functions, but 60 min/week of MSE alone may have equal or better outcomes in these parameters. Conclusion: Community-based MLEX classes may be used to mitigate age-related chronic disease that are associated with body composition and muscular functions.
Collapse
Affiliation(s)
- Chin Leong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Margaret Mei Chan Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Alvin Wai Kit Tan
- Department of Endocrinology, Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore
| | - Cher Heng Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore
| | - Wee Shiong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
| |
Collapse
|
9
|
Maffiuletti NA, Dirks ML, Stevens-Lapsley J, McNeil CJ. Electrical stimulation for investigating and improving neuromuscular function in vivo: Historical perspective and major advances. J Biomech 2023; 152:111582. [PMID: 37088030 DOI: 10.1016/j.jbiomech.2023.111582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
This historical review summarizes the major advances - particularly from the last 50 years - in transcutaneous motor-level electrical stimulation, which can be used either as a tool to investigate neuromuscular function and its determinants (electrical stimulation for testing; EST) or as a therapeutic/training modality to improve neuromuscular and physical function (neuromuscular electrical stimulation; NMES). We focus on some of the most important applications of electrical stimulation in research and clinical settings, such as the investigation of acute changes, chronic adaptations and pathological alterations of neuromuscular function with EST, as well as the enhancement, preservation and restoration of muscle strength and mass with NMES treatment programs in various populations. For both EST and NMES, several major advances converge around understanding and optimizing motor unit recruitment during electrically-evoked contractions, also taking into account the influence of stimulation site (e.g., muscle belly vs nerve trunk) and type (e.g., pulse duration, frequency, and intensity). This information is equally important both in the context of mechanistic research of neuromuscular function as well as for clinicians who believe that improvements in neuromuscular function are required to provide health-related benefits to their patients.
Collapse
Affiliation(s)
| | - Marlou L Dirks
- Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Jennifer Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, USA
| | - Chris J McNeil
- Integrated Neuromuscular Physiology Laboratory, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| |
Collapse
|
10
|
Orssatto LBR, Rodrigues P, Mackay K, Blazevich AJ, Borg DN, Souza TRD, Sakugawa RL, Shield AJ, Trajano GS. Intrinsic motor neuron excitability is increased after resistance training in older adults. J Neurophysiol 2023; 129:635-650. [PMID: 36752407 DOI: 10.1152/jn.00462.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
This study investigated the effects of high-intensity resistance training on estimates of the motor neuron persistent inward current (PIC) in older adults. Seventeen participants (68.5 ± 2.8 yr) completed a 2-wk nonexercise control period followed by 6 wk of resistance training. Surface electromyographic signals were collected with two 32-channel electrodes placed over soleus to investigate motor unit discharge rates. Paired motor unit analysis was used to calculate delta frequency (ΔF) as an estimate of PIC amplitudes during 1) triangular-shaped contractions to 20% of maximum torque capacity and 2) trapezoidal- and triangular-shaped contractions to 20% and 40% of maximum torque capacity, respectively, to understand their ability to modulate PICs as contraction intensity increases. Maximal strength and functional capacity tests were also assessed. For the 20% triangular-shaped contractions, ΔF [0.58-0.87 peaks per second (pps); P ≤ 0.015] and peak discharge rates (0.78-0.99 pps; P ≤ 0.005) increased after training, indicating increased PIC amplitude. PIC modulation also improved after training. During the control period, mean ΔF differences between 20% trapezoidal-shaped and 40% triangular-shaped contractions were 0.09-0.18 pps (P = 0.448 and 0.109, respectively), which increased to 0.44 pps (P < 0.001) after training. Also, changes in ΔF showed moderate to very large correlations (r = 0.39-0.82) with changes in peak discharge rates and broad measures of motor function. Our findings indicate that increased motor neuron excitability is a potential mechanism underpinning training-induced improvements in motor neuron discharge rate, strength, and motor function in older adults. This increased excitability is likely mediated by enhanced PIC amplitudes, which are larger at higher contraction intensities.NEW & NOTEWORTHY Resistance training elicited important alterations in soleus intrinsic motor neuronal excitability, likely mediated by enhanced persistent inward current (PIC) amplitude, in older adults. Estimates of PICs increased after the training period, accompanied by an enhanced ability to increase PIC amplitudes at higher contraction intensities. Our data also suggest that changes in PIC contribution to self-sustained discharging may contribute to increases in motor neuron discharge rates, maximal strength, and functional capacity in older adults after resistance training.
Collapse
Affiliation(s)
- Lucas B R Orssatto
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Patrick Rodrigues
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen Mackay
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David N Borg
- Australian Centre for Health Services Innovation (AusHSI), School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tiago Rosa de Souza
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Raphael L Sakugawa
- Department of Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
11
|
Liu XJ, Ge S, Cordova A, Yaghi Z, Jiang BY, Yue GH, Yao WX. Elderly may benefit more from motor imagery training in gaining muscle strength than young adults: A systematic review and meta-analysis. Front Psychol 2023; 13:1052826. [PMID: 36687842 PMCID: PMC9845905 DOI: 10.3389/fpsyg.2022.1052826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Objective The current review was aimed to determine the effectiveness of mental imagery training (MIT) on the enhancement of maximum voluntary muscle contraction (MVC) force for healthy young and old adults. Data sources Six electronic databases were searched from July 2021 to March 2022. Search terms included: "motor imagery training," "motor imagery practice," "mental practice," "mental training," "movement imagery," "cognitive training," "strength," "force," "muscle strength," "performance," "enhancement," "improvement," "development," and "healthy adults." Study selection and data extraction Randomized controlled trials of MIT in enhancing muscle strength with healthy adults were selected. The decision on whether a study met the inclusion criteria of the review was made by two reviewers independently. Any disagreements between the two reviewers were first resolved by discussion between the two reviewers. If consensus could not be reached, then it would be arbitrated by a third reviewer. Data synthesis Twenty-five studies including both internal MIT and external MIT were included in meta-analysis for determining the efficacy of MIT on enhancing muscle strength and 22 internal MIT were used for subgroup analysis for examining dose-response relationship of MIT on MVC. Results MIT demonstrated significant benefit on enhancing muscle strength when compared with no exercise, Effect Size (ES), 1.10, 95% confidence interval (CI), 0.89-1.30, favoring MIT, but was inferior to physical training (PT), ES, 0.38, 95% CI, 0.15-0.62, favoring PT. Subgroup analysis demonstrated that MIT was more effective for older adults (ES, 2.17, 95% CI, 1.57-2.76) than young adults (ES, 0.95, 95% CI, 0.74-1.17), p = 0.0002, and for small finger muscles (ES, 1.64, 95% CI, 1.06-2.22) than large upper extremity muscles (ES, 0.86, 95% CI, 0.56-1.16), p = 0.02. No significant difference was found in the comparison of small finger muscles and large lower extremity muscles, p = 0.19 although the ES of the former (ES, 1.64, 95% CI, 1.06-2.22) was greater than that of the later (ES, 1.20, 95%, 0.88-1.52). Conclusion This review demonstrates that MIT has better estimated effects on enhancing MVC force compared to no exercise, but is inferior to PT. The combination of MIT and PT is equivalent to PT alone in enhancing muscle strength. The subgroup group analysis further suggests that older adults and small finger muscles may benefit more from MIT than young adults and larger muscles.
Collapse
Affiliation(s)
- Xiao J. Liu
- College of Art, Beijing Sport University, Beijing, China
| | - Sha Ge
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Alberto Cordova
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Zayd Yaghi
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Bo Y. Jiang
- School of Public Health, Jilin Medical University, Jilin, China
| | - Guang H. Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Wan X. Yao
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| |
Collapse
|
12
|
Grosicki GJ, Zepeda CS, Sundberg CW. Single muscle fibre contractile function with ageing. J Physiol 2022; 600:5005-5026. [PMID: 36268622 PMCID: PMC9722590 DOI: 10.1113/jp282298] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/07/2022] [Indexed: 01/05/2023] Open
Abstract
Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas for future research. Surprisingly, most studies observe that the size and contractile function of fibres expressing slow myosin heavy chain (MHC) I are well-preserved with ageing. In contrast, there are profound age-related decrements in the size and contractile function of the fibres expressing the MHC II isoforms. Notably, lifelong aerobic exercise training is unable to prevent most of the decrements in fast fibre contractile function, which have been implicated as a primary mechanism for the age-related loss in whole-muscle power output. These findings reveal a critical need to investigate the effectiveness of other nutritional, pharmaceutical or exercise strategies, such as lifelong resistance training, to preserve fast fibre size and function with ageing. Moreover, integrating single fibre contractile mechanics with the molecular profile and other parameters important to contractile function (e.g. phosphorylation of regulatory proteins, innervation status, mitochondrial function, fibre economy) is necessary to comprehensively understand the ageing skeletal muscle phenotype.
Collapse
Affiliation(s)
- Gregory J. Grosicki
- Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, USA
| | - Carlos S. Zepeda
- Exercise and Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA
| | - Christopher W. Sundberg
- Exercise and Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA
- Athletic and Human Performance Research Center, Marquette University, Milwaukee, Wisconsin, USA
| |
Collapse
|
13
|
Zambolin F, Duro-Ocana P, Faisal A, Bagley L, Gregory WJ, Jones AW, McPhee JS. Fibromyalgia and Chronic Fatigue Syndromes: A systematic review and meta-analysis of cardiorespiratory fitness and neuromuscular function compared with healthy individuals. PLoS One 2022; 17:e0276009. [PMID: 36264901 PMCID: PMC9584387 DOI: 10.1371/journal.pone.0276009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine cardiorespiratory fitness and neuromuscular function of people with CFS and FMS compared to healthy individuals. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Medline, CINAHL, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), and PEDro from inception to June 2022. ELIGIBLE CRITERIA FOR SELECTING STUDIES Studies were included if presenting baseline data on cardiorespiratory fitness and/or neuromuscular function from observational or interventional studies of patients diagnosed with FMS or CFS. Participants were aged 18 years or older, with results also provided for healthy controls. Risk of bias assessment was conducted using the Quality Assessment Tool for Quantitative Studies (EPHPP). RESULTS 99 studies including 9853 participants (5808 patients; 4405 healthy controls) met our eligibility criteria. Random effects meta-analysis showed lower cardiorespiratory fitness (VO2max, anaerobic threshold, peak lactate) and neuromuscular function (MVC, fatigability, voluntary activation, muscle volume, muscle mass, rate of perceived exertion) in CFS and FMS compared to controls: all with moderate to high effect sizes. DISCUSSION Our results demonstrate lower cardiorespiratory fitness and muscle function in those living with FMS or CFS when compared to controls. There were indications of dysregulated neuro-muscular interactions including heightened perceptions of effort, reduced ability to activate the available musculature during exercise and reduced tolerance of exercise. TRAIL REGISTRATION PROSPERO registration number: (CRD42020184108).
Collapse
Affiliation(s)
- Fabio Zambolin
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- * E-mail:
| | - Pablo Duro-Ocana
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Anaesthesia, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Azmy Faisal
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- Faculty of Physical Education for Men, Alexandria University, Alexandria, Egypt
| | - Liam Bagley
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Anaesthesia, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - William J. Gregory
- Rheumatology Department, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Arwel W. Jones
- Respiratory Research@Alfred, Monash University, Melbourne, Australia
| | - Jamie S. McPhee
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
| |
Collapse
|
14
|
Single skeletal muscle fiber mechanical properties: a muscle quality biomarker of human aging. Eur J Appl Physiol 2022; 122:1383-1395. [DOI: 10.1007/s00421-022-04924-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/23/2022] [Indexed: 12/25/2022]
|
15
|
Varesco G, Luneau E, Féasson L, Lapole T, Rozand V. Very old adults show impaired fatigue resistance compared to old adults independently of sex during a knee-extensors isometric test. Exp Gerontol 2022; 161:111732. [DOI: 10.1016/j.exger.2022.111732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
|
16
|
Ha PL, Dalton BE, Alesi MG, Smith TM, VanDusseldorp TA, Feito Y, Hester GM. No sex differences in evoked contractile properties after fatiguing isometric and isotonic exercise for the plantar flexors. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2022; 22:504-513. [PMID: 36458388 PMCID: PMC9716306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Females tend to fatigue less than males after isometric exercise, but less is clear for isotonic exercise. Further, there have been relatively few sex comparisons for fatigability of the plantar flexors (PFs). We sought to investigate potential sex differences in contractile properties after a sustained maximal voluntary isometric contraction (MVIC) and isotonic contractions. METHODS Twenty-seven physically active males (n=14; 22±2 yrs) and females (n=13; 21±2 yrs) randomly performed a 2 min MVIC and 120 concentric isotonic (30% MVIC) contractions for the PFs on separate visits. Before and after each fatiguing task, muscle activation was obtained from brief MVICs, which was followed (~2 sec) by tibial nerve stimulation at rest. Contractile properties including peak twitch, absolute and normalized time to peak twitch, and half relaxation time were calculated. RESULTS No sex differences existed for fatigue-induced changes in muscle activation (p=0.09-0.41; d=0.33-0.69) or contractile properties (p=0.19-0.96; d=0.06-0.94). CONCLUSIONS Peripheral fatigue, as indicated by contractile parameters, did not differ between sexes after isometric or isotonic exercise. The PFs similar fiber type proportions between sexes or greater fiber type heterogeneity may explain why sex differences in fatigability, though common in other muscle groups (e.g., knee extensors), were not expressed in this muscle group.
Collapse
Affiliation(s)
- Phuong L. Ha
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Benjamin E. Dalton
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Michaela G. Alesi
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Tyler M. Smith
- Department of Molecular and Cellular Biology, Kennesaw State University, Kennesaw, GA, USA
| | - Trisha A. VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,Bonafide Health, LLC, Research and Development, Harrison, NY, USA
| | - Yuri Feito
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,American College of Sports Medicine, Indianapolis, IN, USA
| | - Garrett M. Hester
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,Corresponding author: Garrett M. Hester, Kennesaw State University, 520 Parliament Garden Way NW, Kennesaw, GA 30144, USA E-mail:
| |
Collapse
|
17
|
Frontera WR. Rehabilitation of Older Adults with Sarcopenia: From Cell to Functioning. Prog Rehabil Med 2022; 7:20220044. [PMID: 36118146 PMCID: PMC9437741 DOI: 10.2490/prm.20220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022] Open
Abstract
The 20th and 21st centuries have witnessed a substantial increase in human life
expectancy and in the number of men and women aged 60 years and older. Aging is associated
with a large number of health conditions, including sarcopenia, which has been the subject
of important research in the past 30 years. Sarcopenia is characterized by an age-related
loss of muscle mass, weakness, and impaired physical performance. The condition can be
diagnosed with a combination of measurements of these three elements. The precise
definition of sarcopenia and the selection of optimal assessment methods have changed
significantly in the past 20 years; nonetheless, the prevalence of sarcopenia in the
general older population is in the range of 5–15%. Molecular and cellular events at the
muscle cell level impact the size and quality of muscles (force adjusted for size). The
active and passive mechanical properties of single muscle fibers are altered by changes in
the structure and function of various cellular elements. Systemic factors such as
inflammation, loss of hormonal influence, and deleterious lifestyle choices also
contribute to sarcopenia. The consequences of sarcopenia include many adverse effects such
as impairments in activities of daily living, falls, loss of independence, and increased
mortality. Several rehabilitative interventions have been tested, and the safest and most
effective is the use of progressive resistance exercise. An increase in dietary protein
intake has synergistic effects. Future research should focus on a consensus definition of
sarcopenia, identification of the best assessment methods, understanding of biological
mechanisms, and testing of innovative interventions.
Collapse
Affiliation(s)
- Walter R. Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine/Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA
| |
Collapse
|
18
|
Orssatto LBR, Borg DN, Blazevich AJ, Sakugawa RL, Shield AJ, Trajano GS. Intrinsic motoneuron excitability is reduced in soleus and tibialis anterior of older adults. GeroScience 2021; 43:2719-2735. [PMID: 34716899 PMCID: PMC8556797 DOI: 10.1007/s11357-021-00478-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022] Open
Abstract
Age-related deterioration within both motoneuron and monoaminergic systems should theoretically reduce neuromodulation by weakening motoneuronal persistent inward current (PIC) amplitude. However, this assumption remains untested. Surface electromyographic signals were collected using two 32-channel electrode matrices placed on soleus and tibialis anterior of 25 older adults (70 ± 4 years) and 17 young adults (29 ± 5 years) to investigate motor unit discharge behaviors. Participants performed triangular-shaped plantar and dorsiflexion contractions to 20% of maximum torque at a rise-decline rate of 2%/s of each participant's maximal torque. Pairwise and composite paired-motor unit analyses were adopted to calculate delta frequency (ΔF), which has been used to differentiate between the effects of synaptic excitation and intrinsic motoneuronal properties and is assumed to be proportional to PIC amplitude. Soleus and tibialis anterior motor units in older adults had lower ΔFs calculated with either the pairwise [-0.99 and -1.46 pps; -35.4 and -33.5%, respectively] or composite (-1.18 and -2.28 pps; -32.1 and -45.2%, respectively) methods. Their motor units also had lower peak discharge rates (-2.14 and -2.03 pps; -19.7 and -13.9%, respectively) and recruitment thresholds (-1.50 and -2.06% of maximum, respectively) than young adults. These results demonstrate reduced intrinsic motoneuron excitability during low-force contractions in older adults, likely mediated by decreases in the amplitude of persistent inward currents. Our findings might be explained by deterioration in the motoneuron or monoaminergic systems and could contribute to the decline in motor function during aging; these assumptions should be explicitly tested in future investigations.
Collapse
Affiliation(s)
- Lucas B. R. Orssatto
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - David N. Borg
- Menzies Health Institute Queensland, The Hopkins Centre, Griffith University, Brisbane, Australia
| | | | - Raphael L. Sakugawa
- Biomechanics Laboratory, Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Anthony J. Shield
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Gabriel S. Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| |
Collapse
|
19
|
Sara LK, Gutsch SB, Hunter SK. The single-leg heel raise does not predict maximal plantar flexion strength in healthy males and females. PLoS One 2021; 16:e0253276. [PMID: 34415915 PMCID: PMC8378718 DOI: 10.1371/journal.pone.0253276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/01/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction The single-leg heel raise test (SLHR) is commonly used in clinical settings to approximate plantar flexor strength, yet this is neither validated nor supported physiologically. The purposes of this study were to: determine (1) associations between SLHR repetitions, maximal plantar flexor strength, and reductions in strength; and (2) whether sex differences exist in performance of the SLHR. Methods Twenty-eight young, healthy participants (14 males,14 females, 19–30 years) performed repeated single-leg heel raises to task failure. Pre- and post-task measures included maximal voluntary isometric contractions (MVIC), and voluntary activation and contractile properties of the plantar flexor muscles, assessed using peripheral electrical stimulation of the tibial nerve. Surface electromyography was recorded for the medial and lateral gastrocnemius, soleus, and anterior tibialis muscles. Results The SLHR resulted in 20.5% reductions in MVIC torque (p<0.001). However, the number of SLHR repetitions was not correlated with either the baseline MVIC (maximal strength; p = 0.979) or the reduction in MVIC following the SLHR (p = 0.23). There were no sex differences in either the number of SLHR repetitions (p = 0.14), baseline MVIC torque (p = 0.198), or the reduction of MVIC (p = 0.14). MVIC decline was positively associated with the reduction in voluntary activation (r = 0.841, p<0.001), but was not associated with the change in twitch amplitude (p = 0.597). Conclusions The SLHR was similar in young males and females yet was a poor predictor of maximal plantar flexor strength but evaluates performance fatigability of the lower extremity specific to dynamic contractions. The reduction in maximal strength at task failure was explained by reduced neural drive to the plantar flexor muscles in both males and females. Impact statement SLHR performance is not a clinical assessment of plantar flexor strength but assesses dynamic lower extremity fatigability that is similar in males and females. Alternate clinical measures for maximal plantar flexion strength need to be developed.
Collapse
Affiliation(s)
- Lauren K. Sara
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States of America
- * E-mail:
| | - Savannah B. Gutsch
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States of America
| | - Sandra K. Hunter
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States of America
| |
Collapse
|
20
|
Varesco G, Hunter SK, Rozand V. Physical activity and aging research: opportunities abound. Appl Physiol Nutr Metab 2021; 46:1004-1006. [PMID: 33951404 DOI: 10.1139/apnm-2020-1062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aging is associated with large between-subjects variability in motor function among older adults, which can compromise identifying the mechanisms for age-related reductions in motor performance. This variability is in part explained by differences among older adults in habitual physical activity. Quantifying and accounting for physical activity levels of the participants in aging studies will help differentiate those changes in motor function associated with biological aging rather than those induced by inactivity. Novelty: Quantification of physical activity levels in studies with older participants will help differentiate the effects of aging rather than physical inactivity.
Collapse
Affiliation(s)
- G Varesco
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Lyon, UJM-Saint-Etienne, EA 7424, Saint-Etienne F-42023, France
| | - S K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI 53201, USA
| | - V Rozand
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Lyon, UJM-Saint-Etienne, EA 7424, Saint-Etienne F-42023, France
| |
Collapse
|
21
|
Oranchuk DJ, Hopkins WG, Nelson AR, Storey AG, Cronin JB. The effect of regional quadriceps anatomical parameters on angle-specific isometric torque expression. Appl Physiol Nutr Metab 2021; 46:368-378. [DOI: 10.1139/apnm-2020-0565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The length–tension relationship affects knee extension performance; however, whether anatomical variations in different quadriceps regions affect this relationship is unknown. Regional (proximal, middle, distal) quadriceps thickness (MT), pennation angle, and fascicle length of 24 males (48 limbs) were assessed via ultrasonography. Participants also performed maximal voluntary isometric torque (MVIT) assessments at 40°, 70°, and 100° of knee flexion. Measures were recorded on 3 separate occasions. Linear regression models predicting angle-specific torque from regional anatomy provided adjusted simple and multiple correlations (√adjR2) with bootstrapped compatibility limits to assess magnitude. Middle vastus lateralis MT and MVIT at 100° (√adjR2 = 0.64) was the largest single correlation, with distal vastus lateralis MT having the greatest mean correlations regardless of angle (√adjR2 = 0.61 ± 0.05, mean ± SD). Lateral distal MT and architecture had larger (Δ√adjR2 = 0.01 to 0.43) single and multiple correlations with MVIT than the lateral proximal (√adjR2 = 0.15 to 0.69 vs −0.08 to 0.65). Conversely, middle anterior MT had greater (Δ√adjR2 = 0.08 to 0.38) single and multiple correlations than proximal MT (√adjR2 = 0.09 to 0.49 vs −0.21 to 0.14). The length–tension relationship was trivially affected by regional quadriceps architecture. The middle and distal quadriceps were the strongest predictors of MVIT at all joint angles. Therefore, researchers may wish to focus on middle and distal lateral quadriceps anatomy when performing ultrasonographic evaluations. Novelty: The length–tension relationship is minimally affected by regional quadriceps anatomical parameters. Middle and distal vastus lateralis and lateral vastus intermedius anatomy were consistently the best predictors of torque. Practitioners may focus their assessments on the middle and distal regions of the lateral quadriceps’ musculature.
Collapse
Affiliation(s)
- Dustin J. Oranchuk
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland 0632, New Zealand
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - William G. Hopkins
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - André R. Nelson
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Adam G. Storey
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland 0632, New Zealand
| | - John B. Cronin
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland 0632, New Zealand
| |
Collapse
|
22
|
Reliability of Tibialis Anterior Muscle Voluntary Activation Using the Interpolated Twitch Technique and the Central Activation Ratio in People with Stroke. Brain Sci 2021; 11:brainsci11020176. [PMID: 33535411 PMCID: PMC7912757 DOI: 10.3390/brainsci11020176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 12/04/2022] Open
Abstract
Voluntary activation (VA) is measured by applying supramaximal electrical stimulation to a muscle during a maximal voluntary contraction (MVC). The amplitude of the evoked muscle twitch is used to determine any VA deficit, and indicates incomplete central neural drive to the motor units. People with stroke experience VA deficits and greater levels of central fatigue, which is the decrease in VA that occurs following exercise. This study investigated the between-session reliability of VA and central fatigue of the tibialis anterior muscle (TA) in people with chronic stroke (n = 12), using the interpolated twitch technique (ITT), adjusted-ITT, and central activation ratio (CAR) methods. On two separate sessions, supramaximal electrical stimulation was applied to the TA when it was at rest and maximally activated, at the start and end of a 30-s isometric dorsiflexor MVC. The most reliable measures of VA were obtained using the CAR calculation on transformed data, which produced an ICC of 0.92, and a lower bound confidence interval in the good range (95% CI 0.77 to 0.98). Reliability was lower for the CAR calculation on non-transformed data (ICC 0.82, 95% CI 0.63 to 0.91) and the ITT and adjusted-ITT calculations on transformed data (ICCs 0.82, 95% CIs 0.51 to 0.94), which had lower bound confidence intervals in the moderate range. The two ITT calculations on non-transformed data demonstrated the poorest reliability (ICCs 0.62, 95% CI 0.25 to 0.74). Central fatigue measures demonstrated very poor reliability. Thus, the reliability for VA in people with chronic stroke ranged from good to poor, depending on the calculation method and statistical analysis method, whereas the reliability for central fatigue was very poor.
Collapse
|
23
|
Banks NF, Rogers EM, Jenkins NDM. Electromyographic amplitude versus torque relationships are different in young versus postmenopausal females and are related to muscle mass after controlling for bodyweight. Eur J Appl Physiol 2020; 121:479-488. [PMID: 33123807 DOI: 10.1007/s00421-020-04532-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine differences in the electromyographic vs torque (EMG-T) relationship, as well as muscle strength and indicators of muscle mass and quality between young versus postmenopausal females, and explore whether the potential differences in the EMG-T relationships could be explained by differences in muscle mass. METHODS Thirty young (age = 20.7 ± 2.8 y) and 30 postmenopausal (age = 56.3 ± 4.7 y) females completed maximal isometric strength testing (MVIT) and isometric ramp contractions at 40% and 70% MVIT, during which electromyographic signals were collected to quantify the slopes (Slope40; Slope70) and intercepts (Intercept40; Intercept70) of the EMG-T relationships. Muscle mass and quality measurements were also completed. RESULTS Postmenopausal females exhibited lower skeletal muscle mass (- 2.3 ± 1.5 kg), fat-free mass index (- 1.1 ± 0.7 kg·m-2), MVIT (- 17.1 ± 16.3 Nm), phase angle (- 0.5 ± 0.0°), muscle cross-sectional area (- 5.5 ± 1.1 cm2), muscle quality (- 0.1 ± 0.0 a.u), Slope40 (- 0.0003 ± 0.0002 mV·%MVIT-1), Slope70 (- 0.0003 ± 0.0002 mV·%MVIT-1), and had a higher echo intensity (+ 9.8 ± 2.8 a.u), Intercept40 (+ 0.001 ± 0.001 mV), and Intercept70 (+ 0.004 ± 0.003 mV) (p ≤ 0.001-0.04) than the young females. The EMG-T relationship variables were correlated with both muscle mass and quality after controlling for bodyweight. When controlling for muscle mass and bodyweight, group differences in the slopes of the EMG-T relationship and muscle strength were eliminated. CONCLUSION Muscle mass and quality are primary contributors to the decrements in neuromuscular function observed in postmenopausal versus young females, and the preservation of muscle mass should be prioritized in the years leading up to, during, and immediately after menopause.
Collapse
Affiliation(s)
- Nile F Banks
- Kinesiology, Applied Health and Recreation, Department of Nutritional Sciences, Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, 74078, USA.,Laboratory for Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, OK, USA
| | - Emily M Rogers
- Kinesiology, Applied Health and Recreation, Department of Nutritional Sciences, Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, 74078, USA.,Laboratory for Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, OK, USA
| | - Nathaniel D M Jenkins
- Kinesiology, Applied Health and Recreation, Department of Nutritional Sciences, Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, 74078, USA. .,Laboratory for Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, OK, USA.
| |
Collapse
|
24
|
Sieljacks PS, Søberg CA, Michelsen AS, Dalgas U, Hvid LG. Lower extremity muscle strength across the adult lifespan in multiple sclerosis: Implications for walking and stair climbing capacity. Exp Gerontol 2020; 139:111025. [DOI: 10.1016/j.exger.2020.111025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 01/22/2023]
|
25
|
Zarzissi S, Bouzid MA, Zghal F, Rebai H, Hureau TJ. Aging reduces the maximal level of peripheral fatigue tolerable and impairs exercise capacity. Am J Physiol Regul Integr Comp Physiol 2020; 319:R617-R625. [PMID: 32966120 DOI: 10.1152/ajpregu.00151.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The aim of the present study was to determine the magnitude of the maximal level of peripheral fatigue attainable (fatigue threshold) during an all-out intermittent isometric knee-extensor protocol in both younger (24 ± 1 yr, n = 12) and older (60 ± 2 yr, n = 12) participants to provide new insights into the effects of aging on neuromuscular function. Participants performed two experimental sessions, in which they performed 60 maximal voluntary contractions (MVCs; 3 s of contraction, 2 s of relaxation). One trial was performed in the unfatigued state (CTRL) and one other following fatiguing neuromuscular electrical stimulation of the quadriceps (FNMES). Peripheral fatigue was quantified via pre/postexercise decrease in quadriceps twitch force (∆Ptw). Critical force (CF) was determined as the mean force output of the last 12 contractions, whereas W' was calculated as the area above CF. Although FNMES led to a significant decrease in Ptw before performing the 60-MVCs protocol (P = 0.024), ∆Ptw was not different between CTRL and FNMES for both the young group (P = 0.491) and the old group (P = 0.523). However, this peripheral fatigue threshold was significantly greater in young versus old participants (∆Ptw = -48 ± 10% vs. -29 ± 13%, respectively, P = 0.028). In CTRL, W' was 55 ± 13% lower in the old group than in the young group (P < 0.001), but CF was similar (326 ± 10 N vs. 322 ± 12 N, respectively, P = 0.941). ∆Ptw was correlated with W', independently of age (r2 = 0.84, P < 0.001). Exercise performance decreases with aging consequent to a lower tolerance to peripheral fatigue. However, the peripheral fatigue threshold mechanism persists with healthy aging and continues to play a protective role in preserving locomotor muscle function during exercise.
Collapse
Affiliation(s)
- Slim Zarzissi
- Education, Motor Skills, Sport and Health Laboratory, High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Mohamed Amine Bouzid
- Education, Motor Skills, Sport and Health Laboratory, High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Firas Zghal
- Education, Motor Skills, Sport and Health Laboratory, High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Education, Motor Skills, Sport and Health Laboratory, High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Thomas J Hureau
- Mitochondria, Oxidative Stress and Muscular Protection Laboratory (UR 3072), Faculty of Medicine, University of Strasbourg, Strasbourg, France.,European Centre for Education, Research and Innovation in Exercise Physiology (CEERIPE), Faculty of Sport Sciences, University of Strasbourg, Strasbourg, France
| |
Collapse
|
26
|
Kwon M, Senefeld JW, Hunter SK. Attenuated activation of knee extensor muscles during fast contractions in older men and women. Eur J Appl Physiol 2020; 120:2289-2299. [PMID: 32789699 DOI: 10.1007/s00421-020-04451-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/30/2020] [Indexed: 01/07/2023]
Abstract
AIM Reduced physical function and increased risk of falls in older adults are accompanied by age-related reductions in torque development of leg muscles, although the mechanisms and potential sex differences are not understood. PURPOSE To determine the mechanistic origins (neural vs. muscular) for the age-related reduction in torque development, we compared the peak rates of torque development (RTD) during electrically-evoked and fast voluntary contractions of the knee extensors between young and older men and women. METHODS Sets of single- and double-pulse electrical stimulations evoked contractions of the knee extensor muscles in 20 young (23.0 ± 0.8 years; 10 women) and 20 older adults (78.2 ± 1.5 years; 10 women), followed by voluntary isometric knee extension contractions with torque development as fast as possible that matched the torque during electrically-evoked contraction (10-40% maximal torque). RESULTS Peak RTD during fast-voluntary contractions was 41% less than electrically-evoked contractions (p < 0.001), but more so for older adults (44%) than young (38%, p = 0.04), with no sex differences. Peak RTD during fast-voluntary contractions was more variable between contractions for the older than young adults (77%MVC s-1 vs. 47%MVC s-1, p < 0.001). Additionally, older women exhibited greater variability than older men (81%MVC s-1 vs. 72%MVC s-1, p = 0.04) with no sex-related differences within the young adults. CONCLUSION Older adults had slower and more variable RTD during voluntary contractions than young adults, particularly older women. The limited age-related differences in electrically-evoked RTD suggest the primary mechanism for the slower torque development of the knee extensor muscles in older men and women involve reduced neural activation.
Collapse
Affiliation(s)
- MinHyuk Kwon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA.,Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA
| | - Jonathon W Senefeld
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA.,Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, USA.
| |
Collapse
|