Acute muscle swelling effects of a knee rehabilitation exercise performed with and without blood flow restriction

This study assessed the acute effect of adding blood flow restriction (BFR) to quad sets on muscle-cross sectional area (mCSA), muscle thickness (MT), echo intensity (EI), and subcutaneous fat-normalized EI (EINORM) of the superficial quadriceps muscles. Twelve males and 12 females (mean±SD; age (yrs): 21.4±2.9; stature (m): 1.76±0.1; body mass (kg): 77.7±2.9) performed 70 repetitions (one set of 30, three sets of 15 repetitions) of bodyweight quad sets separately on each leg, with or without BFR (CON) applied. Rating of perceived exertion was recorded following each set. Panoramic ultrasound images of the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) were captured prior to (PRE), immediately after (IMM-POST), 30- (30-POST), and 60-minutes after (60-POST) after exercise. Sex x condition x time repeated measures ANOVAs assessed differences at p<0.05 for each muscle and dependent variable separately. Although males had larger VM and VL mCSA and VL MT (p<0.05), there were no acute changes from PRE to IMM-POST (p>0.05). There was a 3-way interaction in VL mCSA (p = 0.025) which indicated BFR was greater than CON at IMM-POST by 7.6% (p = 0.019) for males only. Females had greater EI in the VM and VL than males (p<0.05), yet males had greater EINORM for each muscle (p>0.05) and EINORM did not change over time or treatment (p>0.05). The lack of changes in MT, EI, and EINORM indicate that unloaded quad sets do not provide a stimulus to promote fluid shifts or acute changes in muscle size with the exception of IMM-POST in the VL for males. Future research should attempt to elucidate the acute muscular responses of BFR application for lightly loaded rehabilitation exercises in the clinical populations for which they are prescribed.

Non-uniform excitation of pectoralis major induced by changes in bench press inclination leads to uneven variations in the cross-sectional area measured by panoramic ultrasonography

This study combined surface electromyography with panoramic ultrasound imaging to investigate whether non-uniform excitation could lead to acute localized variations in cross-sectional area and muscle thickness of the clavicular and sternocostal heads of pectoralis major (PM). Bipolar surface electromyograms (EMGs) were acquired from both PM heads, while 13 men performed four sets of the flat and 45° inclined bench press exercises. Before and immediately after exercise, panoramic ultrasound images were collected transversely to the fibers. Normalized root mean square (RMS) amplitude and variations in the cross-sectional area and muscle thickness were calculated separately for each PM head. For all sets of the inclined bench press, the normalized RMS amplitude was greater for the clavicular head than the sternocostal head (P < 0.001), and the opposite was observed during the flat bench press (P < 0.001). Similarly, while greater increases in cross-sectional area were observed in the clavicular than in the sternocostal head after the inclined bench press (P < 0.001), greater increases were quantified in the sternocostal than in the clavicular head after the flat bench press exercise (P = 0.046). Therefore, our results suggest that the PM regional excitation induced by changes in bench press inclination leads to acute, uneven responses of muscle architecture following the exercise.

Human skeletal muscle size with ultrasound imaging: a comprehensive review

Skeletal muscle size is an important factor in assessing adaptation to exercise training and detraining, athletic performance, age-associated atrophy and mobility decline, clinical conditions associated with cachexia, and overall skeletal muscle health. Magnetic resonance (MR) imaging and computed tomography (CT) are widely accepted as the gold standard methods for skeletal muscle size quantification. However, it is not always feasible to use these methods (e.g., field studies, bedside studies, large cohort studies). Ultrasound has been available for skeletal muscle examination for more than 50 years and the development, utility, and validity of ultrasound imaging are underappreciated. It is now possible to use ultrasound in situations where MR and CT imaging are not suitable. This review provides a comprehensive summary of ultrasound imaging and human skeletal muscle size assessment. Since the first study in 1968, more than 600 articles have used ultrasound to examine the cross-sectional area and/or volume of 107 different skeletal muscles in more than 27,500 subjects of various ages, health status, and fitness conditions. Data from these studies, supported by decades of technological developments, collectively show that ultrasonography is a valid tool for skeletal muscle size quantification. Considering the wide-ranging connections between human health and function and skeletal muscle mass, the utility of ultrasound imaging will allow it to be employed in research investigations and clinical practice in ways not previously appreciated or considered.

Acute Inflammatory, Cortisol, and Soreness Responses to Supramaximal Accentuated Eccentric Loading

ABSTRACT

Merrigan, JJ and Jones, MT. Acute inflammatory, cortisol, and soreness responses to supramaximal accentuated eccentric loading. J Strength Cond Res 35(2S): S107-S113, 2021-The purpose was to determine differences in time under tension, cortisol, inflammation, and perceived soreness between accentuated eccentric (AEL) and traditional loading (TRA) resistance exercise protocols. Resistance-trained men (n = 21) completed the AEL and TRA protocols in a random order, separated by 48 hours (sets × reps at eccentric/concentric) as follows: AEL65, 3 × 5 at 120/65% 1 repetition maximum (RM); AEL80, 3 × 3 at 120/80% 1RM; TRA65, 3 × 5 at 65/65% 1RM; and TRA80, 3 × 3 at 80/80% 1RM. Four linear position transducers measured eccentric time under tension (ETUT) and total time under tension (TTUT). Ultrasonography measured vastus lateralis muscle thickness and echo intensity at baseline and immediately post-exercise. Salivary cortisol was assessed at baseline, 0-, 15-, 30-, and 60-minute post-exercise. Perceived soreness was assessed at baseline, 24-, and 48-hours post-exercise. During rep 1, AEL65 and AEL80 had longer ETUT and TTUT than TRA65 (p ≤ 0.002) and TRA80 (p ≤ 0.008), respectively. However, AEL65 had shorter ETUT (reps 3-5) and TTUT (reps 3-5) than TRA65 (p ≤ 0.043). Similarly, ETUT (reps 2-3) and TTUT (rep 3) was shorter in AEL80 than TRA80 (p ≤ 0.045). However, there was no protocol effect for ETUT and TTUT (p > 0.05). Muscle thickness changes were trivial after each protocol (AEL80, d = 0.19; TRA80, d = 0.15; AEL65, d = 0.24; TRA65, d = 0.23), but changes in echo intensity were moderate (AEL80, d = 0.61; TRA80, d = 0.61; AEL65, d = 0.61; TRA65, d = 0.76). Salivary cortisol decreased below baseline at 30- and 60-minute post-exercise (p ≤ 0.006). Perceived soreness elevated from baseline to 24 hours for AEL80 (p = 0.006). The inflammatory, cortisol, and soreness responses after AEL were either low or similar to TRA, indicating similar recovery patterns between protocols.

Acute effect of multiple sets of fatiguing resistance exercise on muscle thickness, echo intensity, and extracellular-to-intracellular water ratio

Resistance exercise (RE) causes an acute increase of the muscle thickness (MT) considered to relate to an increase in tissue water content. Segmental bioelectrical impedance spectroscopy (S-BIS) is a tool used to noninvasively assess intra- and extra-cellular water (ICW and ECW, respectively) of a given limb segment. The purpose of the present study was to examine the change of MT, ultrasound echo intensity (EI), ICW, and ECW after 3 sets of exhaustive RE. Eighteen untrained young males (age, 25.4 ± 4.1 years) performed RE consisting of 3 sets of knee extension concentric and eccentric contractions with 80% of 1-repetition maximum to failure. The MT and EI of the quadriceps measured by ultrasonography, and ECW/ICW ratio of the thigh assessed by S-BIS before (baseline) and after each set of RE (PostEx1, 2, and 3). The changes (Δ) in MT, EI, and ECW/ICW ratio were calculated as values of PostEx minus baseline values. The values of MT, EI, and ECW/ICW ratio at PostEx3 were significantly higher than baseline (effect size: MT, 1.11; EI, 0.47; and ECW/ICW ratio, 0.45). In addition, ΔMT was significantly and moderately correlated with ΔECW/ICW ratio (r = 0.61). Integrated data showed weak but significant correlation between ΔEI and ΔECW/ICW ratio as well (r = 0.31). The present results suggest multiple sets of exhaustive knee extension RE induce the acute increase of EI and ECW/ICW ratio as well as MT. The acute increase of muscle size after exercise can be at least partly explained by relative ECW increase.

Exercise induced changes in echo intensity within the muscle: a brief review

Echo intensity is the mean pixel intensity of a specific region of interest from an ultrasound image. This variable has been increasingly used in the literature as a physiological marker. Although there has been an increased interest in reporting changes in echo intensity in response to exercise, little consensus exists as to what a change in echo intensity represents physiologically. The purpose of this paper is to review some of the earliest, as well as the most up to date literature regarding the changes in echo intensity in response to exercise. Echo intensity has been used to measure muscle quality, muscle damage, acute swelling, and intramuscular glycogen. The changes in echo intensity, however, are not consistent throughout the literature and often times lead to conclusions that seem contrary to the physiologic effects of exercise. For example, echo intensity increases in conjunction with increases in strength, contrary to what would be expected if echo intensity was a marker of muscle quality/muscle damage. It is conceivable that a change in echo intensity represents a range of physiologic effects at different time points. We recommend that these effects should be determined experimentally in order to rule out what echo intensity might and might not represent. Until this is done, caution should be employed when interpreting changes in echo intensity with acute and chronic exercise.