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Objective: Muscle strength is a critical clinical hallmark in both health and disease. The current study introduces a novel portable device prototype (MyoQuad) for assessing and monitoring maximal voluntary isometric knee extension torque (MVIT)., Approach: Fifty-six patients with inclusion body myositis were studied. Knee extension weakness is a key feature in this inflammatory muscle disease. Cross-validation with an isokinetic dynamometer (Biodex System 3 Pro) was performed. Between-day reproducibility and ability to monitor changes in muscle strength over time compared to the gold standard method as a reference, were also investigated., Main Results: The measurement was feasible even in the weakest patients. Agreement between methods was excellent (standard error of measurement (SEM) was 3.8 Nm and intra-class correlation coefficient (ICC) was 0.973). Least significant difference (LSD) was 4.9 and 5.3 Nm for the MyoQuad and the Biodex, respectively Measurements using the MyoQuad exhibited excellent between-day reproducibility (SEM was 2.4 Nm and ICC was 0.989 versus 2.6 Nm and 0.988 using the Biodex). Changes in MVIT at 6 and 12 months were similar between methods (timepoint  ×  method interaction was not significant; all p   >  0.19); strength changes classified according to LSD at 6 and 12 months were consistent between methods (>70% consistent classification))., Significance: The measurement of MVIT using the MyoQuad offers a cost-effective, portable and immediate alternative for the routine measurement of maximal voluntary isometric strength of the quadriceps. The MyoQuad offers a comfort and stability that cannot be provided by standard hand-held dynamometers. These results support quantitative muscle strength assessment using fixed yet flexible dynamometry within clinical routine and multicenter trials.

Objectives: To (i) evaluate the feasibility and the reliability of a test assessing quadriceps strength, endurance and fatigue in patients with fascioscapulohumeral dystrophy (FSHD) and Charcot-Marie-Tooth disease (CMT), (ii) compare quadriceps function between patients and healthy controls., Methods: Controls performed the test once and patients twice on two separate visits. It involved progressive sets of 10 isometric contractions each followed by neuromuscular assessments with FNMS., Results: Volitional assessment of muscle strength, endurance and fatigue appeared to be reliable in FSHD and CMT patients. Supramaximal FNMS was achieved in ∼70% of FSHD patients and in no CMT patients. In FSHD patients, Femoral nerve magnetic stimulation (FNMS) provided reliable assessment of central (typical error as a coefficient of variation (CVTE)<8% for voluntary activation) and peripheral (CVTE<10% and intraclass coefficient correlation >0.85 for evoked responses) function. Patients and controls had similar reductions in evoked quadriceps responses, voluntary activation and similar endurance., Conclusions: This test provides reliable evaluation but FNMS exhibits limitations due to insufficient stimulation intensity particularly in neurogenic conditions. It showed similar central and peripheral quadriceps fatigability in patients and controls., Significance: This test may be a valuable tool for patient follow-up although further development of magnetic stimulation devices is needed to extend its applicability., (Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Purpose: The potential ergogenic effects of therapeutic inhaled salbutamol doses in endurance athletes have been controversially discussed for decades. We hypothesized that salbutamol inhalation may increase peripheral muscle contractility, reduce fatigability, and improve force recovery after a localized exercise in endurance athletes., Methods: Eleven healthy, nonasthmatic male athletes with high aerobic capacities were recruited to be compared in a double-blinded, randomized crossover study of two dose levels of salbutamol (200 and 800 μg) and a placebo administered by inhalation before a quadriceps fatigue test. Subjects performed an incremental exercise protocol consisting in sets of 10 intermittent isometric contractions starting at 20% of maximum voluntary contraction (MVC) with 10% MVC increment until exhaustion. Femoral nerve magnetic stimulation was used during and after MVC to evaluate neuromuscular fatigue after each set, at task failure, and after 10 and 30 min of recovery., Results: Initial MVC and evoked muscular responses were not modified with salbutamol (P > 0.05). The total number of submaximal contractions until task failure significantly differed between treatments (placebo, 72 ± 7; 200 µg, 78 ± 8; and 800 µg, 82 ± 7; P < 0.01). MVC and evoked muscular responses were similarly reduced with all treatments during the fatiguing task (all P > 0.05). Voluntary activation was unaffected by the fatiguing task and treatments (P > 0.05)., Conclusion: Supratherapeutic inhaled doses of β2-agonists increased quadriceps endurance during an incremental and localized fatiguing task in healthy endurance-trained athletes without significant effect on neuromuscular fatigue. Further studies are needed to clarify the underlying mechanisms.

We investigated the reliability of a test assessing quadriceps strength, endurance and fatigability in a single session. We used femoral nerve magnetic stimulation (FMNS) to distinguish central and peripheral factors of neuromuscular fatigue. We used a progressive incremental loading with multiple assessments to limit the influence of subject's cooperation and motivation. Twenty healthy subjects (10 men and 10 women) performed the test on two different days. Maximal voluntary strength and evoked quadriceps responses via FMNS were measured before, after each set of 10 submaximal isometric contractions (5-s on/5-s off; starting at 10% of maximal voluntary strength with 10% increments), immediately and 30min after task failure. The test induced progressive peripheral (41±13% reduction in single twitch at task failure) and central fatigue (3±7% reduction in voluntary activation at task failure). Good inter-day reliability was found for the total number of submaximal contractions achieved (i.e. endurance index: ICC=0.83), for reductions in maximal voluntary strength (ICC>0.81) and evoked muscular responses (i.e. fatigue index: ICC>0.85). Significant sex-differences were also detected. This test shows good reliability for strength, endurance and fatigability assessments. Further studies should be conducted to evaluate its feasibility and reliability in patients., (Copyright © 2012 Elsevier Ltd. All rights reserved.)