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Patients palliated with Total Cavopulmonary Connection have a lower muscle mass and a lower exercise capacity. We assessed calf muscle oxidative metabolism during and after heel raise exercise to exhaustion in young patients with TCPC compared to healthy peers. Near-infrared spectroscopy was used for measuring oxygen metabolism in the medial portion of the gastrocnemius muscle. Forty-three patients with TCPC, aged 6-18 years, were compared with 43 age and sex-matched healthy control subjects. Subgroups were formed to include children (6-12 years) and adolescents (13-18 years) to determine if these age groups influenced the results. During exercise, for the patients compared to controls there was a lower increase in deoxygenated hemoglobin (oxygen extraction) (5.13 ± 2.99au vs. 7.75 ± 4.15au, p = 0.001) and a slower rate of change in total hemoglobin (blood volume) (0.004 ± 0.015au vs 0.016 ± 0.01au, p = 0.001). Following exercise, patients exhibited a slower initial increase in tissue oxygenation saturation index (0.144 ± 0.11au vs 0.249 ± 0.226au, p = 0.007) and a longer half-time to maximum hyperemia (23.7 ± 11.4 s vs 16.8 ± 7.5 s, p = 0.001). On the subgroup level, the adolescents differed compared to healthy peers, whereas the children did not. Young patients with TCPC had impaired oxidative metabolism during exercise and required a longer time to recover. In that the differences were seen in the adolescent group and not in the children group may indicate a declining function with age., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Patients with CHD exhibit reduced isometric muscle strength and muscle mass; however, little is known how these parameters relate. Therefore, the aim was to investigate the relation between isometric limb muscle strength and muscle mass for patients in comparison to age- and sex-matched control subjects., Methods: Seventy-four patients (35.6 ± 14.3 years, women n = 22) and 74 matched controls were included. Isometric muscle strength in elbow flexion, knee extension, and hand grip was assessed using dynamometers. Lean mass, reflecting skeletal muscle mass, in the arms and legs was assessed with dual-energy x-ray absorptiometry., Results: Compared to controls, patients had lower muscle strength in elbow flexion, knee extension, and hand grip, and lower muscle mass in the arms (6.6 ± 1.8 kg versus 5.8 ± 1.7 kg, p < 0.001) and legs (18.4 ± 3.5 kg versus 15.9 ± 3.2 kg, p < 0.001). There was no difference in achieved muscle force per unit muscle mass in patients compared to controls (elbow flexion 0.03 ± 0.004 versus 0.03 ± 0.005 N/g, p = 0.5; grip strength 0.008 ± 0.001 versus 0.008 ± 0.001 N/g, p = 0.7; knee extension 0.027 ± 0.06 versus 0.028 ± 0.06 N/g, p = 0.5). For both groups, muscle mass in the arms correlated strongly with muscle strength in elbow flexion (patients r = 0.86, controls, r = 0.89), hand grip (patients, r = 0.84, controls, r = 0.81), and muscle mass in the leg to knee extension (patients r = 0.64, controls r = 0.68)., Conclusion: The relationship between isometric muscle strength and limb muscle mass in adults with CHD indicates that the skeletal muscles have the same efficiency as in healthy controls.

Background: Adults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise., Methods: Seventy-four patients with complex CHD (mean age 35.6 ± 14.3 years, female n = 22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery., Results: The patients with CHD performed fewer shoulder flexions (40 ± 17 vs 69 ± 40; P < 0.001), had lower muscle oxygen saturation (StO 2 ) at rest (58 ± 18% vs 69 ± 18%; P < 0.001), slower desaturation rate at exercise onset (-9.7 ± 5.9 vs -15.1 ± 6.5% StO 2  × 3.5 s -1 , P <0.001), and slower resaturation rate post exercise (4.0 ± 2.7 vs 5.4 ± 3.6% StO 2  × 3.5 s -1 ; P = 0.009) compared with the controls., Conclusions: In comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population., (Copyright © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Background: Type 1 diabetic patients and non-diabetic patients were referred for evaluation for chronic exertional compartment syndrome (CECS) based on clinical examination and complaints of activity-related leg pain in the region of the tibialis anterior muscle. Previous studies using near-infrared spectroscopy (NIRS) showed greater deoxygenation during exercise for CECS patients versus healthy controls; however, this comparison has not been done for diabetic CECS patients., Methods: We used NIRS to test for differences in oxygenation kinetics for Type 1 diabetic patients diagnosed with (CECS-diabetics, n = 9) versus diabetic patients without (CON-diabetics, n = 10) leg anterior chronic exertional compartment syndrome. Comparisons were also made between non-diabetic CECS patients (n = 11) and healthy controls (CON, n = 10). The experimental protocol consisted of thigh arterial cuff occlusion (AO, 1-minute duration), and treadmill running to reproduce symptoms. NIRS variables generated were resting StO2%, and oxygen recovery following AO. Also, during and following treadmill running the magnitude of deoxygenation and oxygen recovery, respectively, were determined., Results: There was no difference in resting StO2% between CECS-diabetics (78.2±12.6%) vs. CON-diabetics (69.1±20.8%), or between CECS (69.3±16.2) vs. CON (75.9±11.2%). However, oxygen recovery following AO was significantly slower for CECS (1.8±0.8%/sec) vs. CON (3.8±1.7%/sec) (P = 0.002); these data were not different between the diabetic groups. StO2% during exercise was lower (greater deoxygenation) for CECS-diabetics (6.3±8.6%) vs. CON-diabetics (40.4±22.0%), and for CECS (11.3±16.8%) vs. CON (34.1±21.2%) (P<0.05 for both). The rate of oxygen recovery post exercise was faster for CECS-diabetics (3.5±2.6%/sec) vs. CON-diabetics (1.4±0.8%/sec) (P = 0.04), and there was a tendency of difference for CECS (3.1±1.4%/sec) vs. CON (1.9±1.3%/sec) (P = 0.05)., Conclusion: The greater deoxygenation during treadmill running for the CECS-diabetics group (vs. CON-diabetics) is in line with previous studies (and with the present study) that compared non-diabetic CECS patients with healthy controls. Our findings could suggest that NIRS may be useful as a diagnostic tool for assessing Type 1 diabetic patients suspected of CECS.

Background: This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?, Methods: PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies., Results: Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity., Conclusions: Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.

Objective: This study systematically summarizes biochemical biomarker research in non-traumatic musculoskeletal disorders (MSD). Two research questions guided the review: (i) Are there biochemical markers associated with neck and upper-extremity MSD? and (ii) Are there biochemical markers associated with the severity of neck and upper-extremity MSD?, Methods: A literature search was conducted in PubMed and SCOPUS, and 87 studies met primary inclusion criteria. Following a quality screen, data were extracted from 44 articles of sufficient quality., Results: Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. A response rate was explicitly stated in only 11 (13%) studies. Less than half of the studies controlled for potential confounding through restriction or in the analysis. Most sufficient-quality studies were conducted in older populations (mean age in one or more analysis group >50 years). In sufficient-quality articles, 82% demonstrated at least one statistically significant association between the MSD and biomarker(s) studied. Evidence suggested that: (i) the collagen-repair marker TIMP-1 is decreased in fibro proliferative disorders, (ii) 5-HT (serotonin) is increased in trapezius myalgia, and (iii) triglycerides are increased in a variety of MSD. Only 5 studies showed an association between a biochemical marker and MSD severity., Conclusion: While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration), and insufficient attention to comorbid conditions. A list of recommendations for future studies is provided.

Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC)--sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO2%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P<0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO2% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics.

Purpose: The mechanisms behind trapezius myalgia are unclear. Many hypotheses have been presented suggesting an altered metabolism in the muscle. Here, muscle microdialysate from healthy and myalgic muscle is analysed using metabolomics. Metabolomics analyse a vast number of metabolites, enabling a comprehensive explorative screening of the cellular processes in the muscle., Methods: Microdialysate samples were obtained from the shoulder muscle of healthy and myalgic subjects that performed a work and stress test. Samples from the baseline period and from the recovery period were analysed using gas chromatography—mass spectrometry (GC–MS) together with multivariate analysis to detect differences in extracellular content of metabolites between groups. Systematic differences in metabolites between groups were identified using multivariate analysis and orthogonal partial least square discriminate analysis (OPLS-DA). A complementary Mann–Whitney U test of group difference in individual metabolites was also performed., Results: A large number of metabolites were detected and identified in this screening study. At baseline, no systematic differences between groups were observed according to the OPLS-DA. However, two metabolites, l-leucine and pyroglutamic acid, were significantly more abundant in the myalgic muscle compared to the healthy muscle. In the recovery period, systematic difference in metabolites between the groups was observed according to the OPLS-DA. The groups differed in amino acids, fatty acids and carbohydrates. Myristic acid and putrescine were significantly more abundant and beta-d-glucopyranose was significantly less abundant in the myalgic muscle., Conclusion: This study provides important information regarding the metabolite content, thereby presenting new clues regarding the pathophysiology of the myalgic muscle.

We tested hypotheses of (a) reduced oxygen usage, oxygen recovery, blood flow and oxygen consumption; and (b) increased muscle activity for patients diagnosed with work-related muscle pain (WRMP) in comparison to healthy controls. Oxygenation was measured with near infrared spectroscopy (NIRS), and muscle activity with EMG for the extensor carpi radialis (ECR) and trapezius descendens (TD) muscles. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determining an individual's maximum voluntary contraction (MVC) force, short-term (20 s) isometric contractions for the ECR and TD of 10, 30, 50 and 70 % MVC generated ∆StO₂ and StO₂% recovery (Rslope) from NIRS, and RMS%max from EMG signals. In addition, upper arm venous (VO) and arterial (AO) occlusions generated slopes of total hemoglobin (HbTslope) and deoxyhemoglobin (HHbslope) for the resting ECR as surrogates of blood flow and oxygen consumption, respectively. Mixed model analyses, t tests, and Mann-Whitney test were used to assess differences between groups. There was no significant difference in MVC between groups for either muscle. Also, ∆StO₂%, Rslope for either muscle, and ECR-HbTslope were not different between groups, thus our hypotheses of reduced oxygen use, recovery, and blood flow for patients were not confirmed. However, patients had a significantly lower ECR-HHbslope confirming our hypothesis of reduced consumption. Further, there was no difference in RMS%max during contractions meaning that the hypothesis of increased activity for patients was not confirmed. When taking into account the number of NIRS variables studied, differences we found between our patient group and healthy controls (i.e., in forearm oxygen consumption and shoulder oxygen saturation level) may be considered modest. Overall our findings may have been impacted by the fact that our patients and controls were similar in muscle strength, which is in contrast to previous studies.

Introduction: The goal was to investigate the effect of acute moderate hypobaric exposure on the physiological responses to sustained contractions (local) and light to moderate dynamic exercise (systemic) for cabin attendants (CAB) and a matched control group (CON)., Method: There were 14 CAB and 13 CON who participated. The experimental protocol was designed as a 2 x 2 randomized crossover study for which subjects performed a forearm isometric test and a cycling test in normobaric (NORM) and hypobaric [HYPO; 574 mmHg approximately 8000 ft (2440 m) above sea level (ASL)] conditions. Oxygen saturation (StO2%) was measured in the extensor carpi radialis muscle at rest and during an isometric wrist extension (20% MVC). Heart rate (HR), ventilation (V(E)), and oxygen uptake (VO2) were measured at rest, during cycling exercise at intensities of 50 W and 100 W, and during recovery. Blood samples were collected and analyzed for hemoglobin concentrations., Results: Local response: There was a significant effect of HYPO for both CAB and CON with a decrease in StO2% of 6.5% both at rest and during contraction. Systemic response: there was no general effect of HYPO on HR, VE, or VO2. No differences were found between groups in either the local or systemic response or in the blood parameters., Conclusion: This study shows an effect of moderate hypobaric exposure on local muscle oxygenation during rest and sustained contraction. Whether this has an impact on fatigue development during work among cabin attendants is discussed.

This study determined the day-to-day reliability of NIRS-derived oxygenation responses (∆StO(2)%) for isometric contractions and for cuff occlusion. Twenty-four subjects (12 males and 12 females) were tested for 2 days (4-6 days interval). Variables generated were: (1) ∆StO(2)% for isometric contractions (10, 30, 50 and 70% MVC) for descending trapezius (TD) and extensor carpi radialis (ECR) muscles; (2) slope changes in total haemoglobin (HbTslope) and deoxyhaemoglobin (HHbslope) for the ECR using upper arm venous (VO, 50 mmHg) and arterial occlusion (AO, 250 mmHg); (3) recovery slopes (Rslope) for oxygen saturation (StO(2)) following isometric contractions and AO. For each variable, an intraclass correlation (ICC) was calculated to assess the ability to differentiate between subjects, and limits of agreement (LOA) were computed to assess day-to-day consistency of the measurement. ICCs for ΔStO(2)% were lowest at 10% MVC for both ECR (0.58) and TD (0.55), and highest at 30% MVC for ECR (0.95) and at 70% MVC for TD (0.79). For both muscles, LOA for ΔStO(2)% was lowest at 10% and highest at 50 and 70% MVC. ICC for HbTslope was 0.17. For HHbslope ICC was higher for AO (0.83) than for VO (0.73), and LOA was lower for AO. For the ECR Rslope ICCs ranged from 0.88 to 0.90 for contraction, but was lower for AO (0.33); LOA was lowest at 70% MVC. For trapezius Rslope ICCs ranged from 0.63 to 0.73 and LOA was lowest at 30% MVC. For this study, establishing reliability data for the ECR and TD and including variables commonly reported are expected to have meaning for future NIRS studies of work-related upper-extremity pain as well as for other NIRS research and clinical applications.

The aim was to investigate the relationship between oxygen saturation (StO(2)%) measured with near-infrared spectroscopy (NIRS) and myoelectric activity (root mean square, RMS) for the extensor carpi radialis (ECR) and trapezius muscles. In addition, gender differences were examined for submaximal (10-70% MVC) and sustained (10% MVC for 5 min) isometric contractions. Thirteen males and 15 females participated. Changes in StO(2)% (∆StO(2)%) and RMS, expressed as percentages of maximum, were calculated for each submaximal contraction. A good correlation between ∆StO(2)% and RMS was seen for the ECR (r = -0.53) and a moderate correlation seen for the trapezius muscle (r = -0.44). The ANOVA showed a significant decrease in ECR-∆StO(2)% over force with females demonstrating a tendency for larger changes than males. ECR-RMS increased over force with no impact of gender. For the trapezius, ∆StO(2)% decreased over force but was not gender dependent. Trapezius-RMS increased over force with females demonstrating a tendency for greater change than males. For the sustained contraction, ECR-StO(2)% changed over time but was not gender dependent. ECR-RMS increased over time with females showing a greater response than males. Trapezius-StO(2)% changed over time and differed between genders, i.e., males increased while females decreased. RMS increased over time similarly for both genders. In conclusion, our data show that the ECR and trapezius aerobic demands during isometric contractions are negatively correlated to electromyography (EMG) RMS. The present study also suggests some gender specificity for forearm and shoulder myoelectric activity and oxygenation for submaximal and sustained contractions.

Muscle oxygenation responses are reportedly greater in the distal muscle region than in the proximal muscle region. We combined near infrared spectroscopy and electromyography (EMG) to determine whether regional differences in oxygenation are associated with differences in (1) muscle activation and/or (2) fatigue development. Nine males performed 2-min sustained isometric knee extensions at 15% and 30% maximum voluntary contraction during which oxygenation and EMG were recorded simultaneously from proximal and distal locations of the vastus lateralis muscle. Near infrared spectroscopy variables for oxygen saturation (StO(2)%) were initial slope at contraction onset, peak drop, and recovery slope at contraction end. Electromyography produced the root mean square to indicate muscle activation and mean power frequency changes over time (decreasing slope) to indicate fatigue development. For StO(2)%, significantly greater peak drop and steeper recovery slope were found for the distal muscle region than for the proximal muscle region. Root mean square, however, was not different between locations. Mean power frequency decreased throughout the contractions but changes were not different between locations. Our results indicate that for modest submaximal contractions, regional differences in oxygenation are not associated with differences in muscle activation or with fatigue development (as interpreted by changes in mean power frequency over time).

Objective: The present study aimed to elucidate possible physiological mechanisms behind impaired endurance during chewing as previously reported in WAD. We tested the hypothesis of a stronger autonomic reaction in WAD than in healthy subjects in response to dynamic loading of the jaw-neck motor system., Design: Cardiovascular reactivity, muscle fatigue indicies of EMG, and perceptions of fatigue, exhaustion and pain were assessed during standardised chewing. Twenty-one WAD subjects and a gender/age matched control group participated. Baseline recordings were followed by two sessions of alternating unilateral chewing of a bolus of gum with each session followed by a rest period., Results: More than half of the WAD subjects terminated the test prematurely due to exhaustion and pain. In line with our hypothesis the chewing evoked an increased autonomic response in WAD exhibited as a higher increase in heart rate as compared to controls. Furthermore, we saw consistently higher values of arterial blood pressure for WAD than for controls across all stages of the experiment. Masseter EMG did not indicate muscle fatigue nor were there group differences in amplitude and mean power frequency. Pain in the WAD group increased during the first session and remained increased, whereas no pain was reported for the controls., Conclusion: More intense response to chewing in WAD might indicate pronounced vulnerability to dynamic loading of the jaw-neck motor system with increased autonomic reactivity to the test. Premature termination and autonomic involvement without EMG signs of muscle fatigue may indicate central mechanisms behind insufficient endurance during chewing., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Epidemiological research provides strong evidence for a link between repetitive work (RW) and the development of chronic trapezius myalgia (TM). The aims were to further elucidate if an accumulation of sensitising substances or impaired oxygenation is evident in painful muscles during RW. Females with TM (n = 14) were studied during rest, 30 minutes RW and 60 minutes recovery. Microdialysate samples were obtained to determine changes in intramuscular microdialysate (IMMD) [glutamate], [PGE(2)], [lactate], and [pyruvate] (i.e., [concentration]) relative to work. Muscle oxygenation (%StO(2)) was assessed using near-infrared spectroscopy. During work, all investigated substances, except PGE(2), increased significantly: [glutamate] (54%, P < .0001), [lactate] (26%, P < .005), [pyruvate] (19%, P < .0001), while the %StO(2) decreased (P < .05). During recovery [PGE(2)] decreased (P < .005), [lactate] remained increased (P < .001), [pyruvate] increased progressively (P < .0001), and %StO(2) had returned to baseline. Changes in substance concentrations and oxygenation in response to work indicate normal increase in metabolism but no ongoing inflammation in subjects with TM.

Context: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. Design: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. Methods: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. Results: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. Conclusions: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise. [ABSTRACT FROM AUTHOR]

Both physical as well as mental demands result in an increased activity in the sympathetic nervous system (SNS) with changes in blood-pressure and heart-rate. Through local release of catecholamines, e.g. noradrenaline (NAd) SNS exerts various actions at the muscle level. The aims of this study were to investigate the effects of low-load repetitive work alone and in combination with mental demands on local muscle interstitial noradrenaline concentration [NAd](i), muscle activity and oxygenation, assessed with microdialysis, surface electromyography, and near-infrared spectroscopy, respectively. Healthy females (n = 15) were exposed to (1) 30 min repetitive work (RW) and (2) 30 min repetitive work with superimposed mental load (RWML) on two different occasions. Muscle [NAd](i) and muscle activity increased significantly in response to RW, but did not increase further during RWML. For RW, [NAd](i) was found to be inversely correlated to muscle activity. Oxygenation decreased significantly during work, independently of occasion. Our findings indicate that low-load work causes significantly increased trapezius muscle [NAd](i) in healthy females, and short periods of superimposed mental load do not add to this increase and further, that both muscle activity and oxygenation were unaffected by the superimposed mental load.

In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

During sustained or repeated maximal voluntary efforts, muscle fatigue (acute strength loss) is not linear. After a large initial decrease, muscle strength plateaus at approximately 40% of baseline. This plateau, which likely reflects muscle strength preservation, has been observed in sustained maximal isometric and repeated maximal isokinetic contractions. Whether this pattern of fatigue occurs with traditional resistance exercise repetitions with free weights and weight stack machines has not been overviewed. Here, the aim was to determine whether the number of repetitions completed across 4 or more consecutive repetitions-to-failure tests exhibits the same nonlinear pattern of muscle fatigue. A secondary analysis was applied to data extracted as part of a recent meta-analysis on repetitions-to-failure tests. Studies were eligible if they reported mean number of repetitions completed in 4-6 consecutive repetitions-to-failure tests at a given relative load. Twenty-nine studies were included. Overall, the results show that the number of repetitions completed in consecutive repetitions-to-failure tests at a given load generally decreases curvilinearly. The numbers of repetitions completed in sets 2, 3, 4, 5, and 6 were equal to approximately 70, 55, 50, 45, and 45% of the number of repetitions completed in set 1, respectively. Longer interset rest intervals typically attenuated repetition loss, but the curvilinear pattern remained. From the results, a chart was created to predict the number of repetitions across 6 sets of resistance exercise taken to failure based on the number of repetitions completed in set 1. The chart is a general guide and educational tool. It should be used cautiously. More data from a variety of exercises, relative loads, and interset rest intervals are needed for more precise estimates of number of repetitions completed during repeated sets of fatiguing resistance exercise. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors that induce strong contractions during repetitive peripheral magnetic stimulation (rPMS) and compare the muscle torque induced by two stimulators (Stim A and Stim B) with different coil properties. Methods: rPMS was applied to the right vastus lateralis of 30 healthy young adults. Stim A contained a 10.1 cm2 rectangular iron core coil, while Stim B contained a 191 cm2 round coil. The knee extensor torque (KET) induced by rPMS at 30 Hz was measured isometrically and divided by the maximum voluntary contraction (MVC) to obtain a relative value of MVC (%MVC). KET at 100% intensity of Stim A (A100%, 1.08 T) was compared to those at 100% or 70% intensity of Stim B (B100%, 1.47 T vs. B70%, 1.07 T). Additionally, we conducted a comprehensive literature search for studies that measured the KET during rPMS. Results: Both the mean values of %MVC using B100% and B70% were significantly greater than that using A100%. Furthermore, the KET induced by Stim B was found to be larger than that described in previous reports, unless booster units were used to directly stimulate the main trunk of the femoral nerve. Conclusion: Stim B induced a stronger muscle contraction force than Stim A did. This may be because the larger the coil area, the wider the area that can be stimulated. Additionally, a circular coil allows for deeper stimulation. [ABSTRACT FROM AUTHOR]

Context: Stretching is common among athletes as a potential method for injury prevention. Stretching-induced changes in the muscle spindle properties are a suggested mechanism, which may imply reduced proprioception after stretching; however, little is known of this association., Objective: To evaluate whether acute stretching of the shoulder muscles affects position sense., Design: A crossover design with subjects randomized to 3 groups., Setting: A university human research laboratory., Patients or Other Participants: Nine male (age = 24 +/- 3 years) and 9 female (age = 21 +/- 2 years) healthy volunteers., Intervention(s): Stretching of shoulder (1) agonists or (2) antagonists or (3) nonstretching control., Main Outcome Measure(s): We determined position sense acuity of the right shoulder before and after the interventions by having subjects attempt to reproduce arm positions of 15 degrees and 30 degrees (shoulder adduction) while starting at 45 degrees to the sagittal plane. The outcome variables were response variability (variable error) and overall accuracy (absolute error)., Results: The relative change in variable error (ie, variable error after/variable error before) was not significantly different between the interventions ( P = .38). Similarly, no change in absolute error was found ( P = .76). Furthermore, no differences were noted regarding test sequence or the interaction of intervention x sequence for either variable error ( P = .73 and .53, respectively) or absolute error ( P = .71 and .67, respectively)., Conclusions: We found no effect on shoulder position sense after an acute bout of stretching of either agonist or antagonist shoulder muscles.

The aim of this study was to investigate the effects of duration of low-load repetitive work on intramuscular lactate, pyruvate, glutamate and prostaglandin E(2) (PGE(2)), and oxygen saturation in the trapezius muscle. Twenty healthy females were studied during baseline rest, during low-load repetitive work for either 30 (REP 30) or 60 min (REP 60) and 60 min recovery. Intramuscular microdialysate (IMMD) samples were obtained, and local muscle tissue oxygenation (%StO(2)) assessed with near-infrared spectroscopy (NIRS). Subjects rated their perceived exertion (Borg CR-10 scale) and capillary blood was sampled for lactate analysis. The results showed a significant increase in IMMD lactate in response to both REP 30 and REP 60 (P < 0.05 and P < 0.01, respectively) and glutamate (P < 0.0001), but no progressive increase with increasing work duration. Both IMMD pyruvate and lactate tended to be significantly increased during the recovery period. No corresponding increase in blood lactate was found. Local muscle %StO(2) did not change significantly in response to work and was not correlated to the IMMD lactate concentration. The ratings of perceived exertion increased in response to work, and remained increased after recovery for REP 60. In conclusion, the results of this study show significantly increased IMMD lactate and, glutamate concentrations in the trapezius muscle of healthy females in response to low-load work, but no progressive increase with increased work duration. Further, they do not indicate that the increased IMMD lactate concentration was caused by a locally decreased or insufficient muscle tissue oxygenation.

We investigated the effects of active versus passive pauses implemented during computer mouse work on muscle oxygenation and EMG of the forearm extensor carpi radialis muscle, and on wrist position sense. Fifteen healthy female subjects (age: 19-24 years) performed a 60-min mouse-operated computer task, divided into three 20 min periods, on two occasions separated by 3-6 days. On one occasion a passive pause (subjects resting) was implemented at the end of each 20-min period, and on another occasion an active pause (subjects performed a number of high intensity extensions of the forearm) was implemented. Also at the end of each 20-min period, test contractions were conducted and subjective ratings of fatigue and stress were obtained. Another parameter of interest was total haemoglobin calculated as the summation of oxy-and deoxy-haemoglobin, since it reflects blood volume changes. The most interesting findings were an overall increasing trend in total haemoglobin throughout the mouse work (P<0.001), and that this trend was greater for the active pause as compared to the passive pause (P<0.01). These data were accompanied by an overall increase in oxygen saturation (P<0.001), with a tendency, albeit not significant, toward a higher increase for the active pause (P=0.13). EMG amplitude and median frequency tended to decrease (P=0.08 and 0.05, respectively) during the mouse work but was not different between pause types. Borg ratings of forearm fatigue showed an overall increase during the activity (P<0.001), but the perceptions of stress did not change. Position sense did not change due to the mouse work for either pause type. While increasing trends were found for both pause types, the present study lends support to the hypothesis of an enhancement in oxygenation and blood volume for computer mouse work implemented with active pauses. However, a presumption of an association between this enhancement and attenuated fatigue during the mouse work was not supported.

Much is still unknown concerning the mechanisms underlying the development of chronic muscle pain. The presence and magnitude of inflammatory substances and neurotransmitters in chronic painful conditions is not clear. The aims of the present study were to determine, with the use of microdialysis, the interstitial concentrations and the equilibration times for PGE2 and glutamate in the trapezius muscles of nine female subjects with chronic muscle pain, and nine pain-free age-matched controls. A microdialysis probe was implanted in the upper part of the trapezius muscle and perfused with Ringer-acetate solution at a flow rate of 0.3 microL/min. Samples were obtained every 30 min, during a 4-h rest period. At equilibration, the mean concentrations (+/-SE) of PGE2 were 0.71 (+/-0.11) ng/mL for the pain-group and 0.97 (+/-0.35) ng/mL for the controls. For glutamate the mean concentrations for the pain-group were 66.3 (+/-13.3) micromol/L and 60.6 (+/-22.9) micromol/L for the controls. For the pain group and the control group, respectively, equilibration for PGE2 was reached at 180 and 150 min, and for glutamate at 150 and 120 min. The present study showed no differences between groups in the concentrations of PGE2 and glutamate in the trapezius muscle. Further, it revealed that when using the slow-flow method, a period of at least 2.0-2.5 h is needed, after probe insertion, to reach steady state for glutamate and PGE2.

The present study investigated the effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense in the upper extremity. Twenty-four healthy subjects (12 males and 12 females) performed a 45-min standardized mouse-operated computer task on two occasions. The task consisted of painting rectangles that were presented on the screen. On one occasion, time pressure and precision demands were imposed (more demanding task, MDT), whereas, on the other occasion, no such restraints were added (less demanding task, LDT). The order of the two task versions was randomized. Tissue oxygen saturation in the trapezius and extensor carpi radialis muscles was recorded throughout, and the position-matching ability of the wrist was measured before and after the tasks. In addition, measurements of autonomic nervous system reactivity and subjective ratings of tenseness and physical fatigue were obtained. Performance was measured in terms of the number of rectangles that were painted during the task. During MDT, oxygen saturation in extensor carpi radialis decreased (P < 0.05) compared to LDT. These data were paralleled by increased electrodermal activity (P < 0.05), skin blood flow (P < 0.05), ratings of tenseness and fatigue (P < 0.01), and increased performance (P < 0.01) during MDT. Females exhibited lower oxygen saturation than males, during rest as well as during the computer tasks (P < 0.01). Wrist repositioning error increased following LDT as compared to MDT (P < 0.05). In conclusion, computer mouse work under time pressure and precision demands caused a decrease in forearm muscle oxygenation, but did not affect wrist position sense accuracy. We attribute our changes in oxygenation more to increased oxygen consumption as a result of enhanced performance, than to vasoconstriction.

Objective: To study the effects of a muscle stretching regimen for the rectus femoris muscle on subjective stretch sensation and range of motion (ROM)., Design: A 2 x 2 crossover design comprising 2 treatments and 2 intervention periods., Setting: A military base in Sweden., Participants: A volunteer sample of 29 male military conscripts divided into 2 groups, with each group subjected to both experimental and control treatments at different time periods., Intervention: Two weeks of supervised stretching (4 times/wk) of the rectus femoris muscle (experimental treatment) and the calf muscles (control treatment)., Main Outcome Measures: Subjective rating of the stretch sensation for the anterior aspect of the thigh determined on a category ratio scale. Passive knee flexion ROM determined on each test with the same applied torque, specific for each subject., Results: An additive analysis of variance revealed that the stretch sensation after the experimental treatment was decreased, compared with the control treatment (p <.01). The knee flexion, however, remained the same regardless of the treatment., Conclusion: Sensory adaptation seems to be an important mechanistic factor in the effect stretching has on ROM changes. The lack of change in knee flexion suggests that the stretching, as performed in this study, did not influence stiffness of the rectus femoris muscle. Sensory adaptation may also be an underlying mechanism in the alleviating effect of stretching when applied to tired, tender, and painful muscles.

The purpose of the study was to investigate changes in intramuscular pressure (IMP) (maximal during contraction - peak IMP, and between contraction, relaxation IMP - RxIMP) and surface electromyographic activity (EMG) parameters [mean frequency of the power spectrum (fmean), and signal amplitude, root mean square (RMS)] throughout 100 repetitive isokinetic contractions for six healthy subjects. Parameters were recorded simultaneously from the vastus lateralis muscle during maximal knee extension. Regression analyses revealed significant decreases for peak IMP and fmean, and an increase in RxIMP; RMS, however, did not change. All parameters demonstrated trends of change throughout the contractions that were non-linear. Details and inter relations for RxIMP and fmean were highlighted to express intramuscular fluid accumulation and fatigue development, respectively. Individual regression analyses for RxIMP revealed significant positive correlations for all subjects (range of r=0.62 to 0.89). At group level, mean RxIMP increased from 6.0 mmHg for the 1st contraction to 14.0 mmHg for the 100th contraction. For fmean, individual regressions were significantly negative for all subjects (r=-0.75 to -0.89). Fmean decreased from 89.2 Hz for the 1st contraction to 63.3 Hz for the 100th contraction. When the data were delineated between the fatigue (contractions 1-40) and endurance phases (41-100), the slopes of increase for RxIMP, and of decrease for fmean were significantly greater during the fatigue phase. RxIMP throughout the 100 contractions correlated negatively with fmean for each subject (r=-0.54 to -0.78); when delineated, the correlation between parameters was significantly greater for the fatigue as compared with the endurance phase. Relaxation IMP trends are mainly attributed to intramuscular water accumulations during repetitive contractions. In spite of consistent correlations between RxIMP and fmean a causal association could not be established. It may be suggested that a common factor occurring during the fatiguing process governs changes in RxIMP and fmean.

Objective: To assess the effect of starting position, target position, and various types of limb displacement on repositioning tests commonly used for clinical evaluation of rehabilitation., Setting: Controlled laboratory environment., Participants: Sixteen healthy volunteer subjects., Main Outcome Measure: Absolute error, ie, the absolute difference between target and replicate positions., Design: Each subject performed four testing procedures consisting of different types of limb displacement (active, passive, and passive during antagonist muscle contraction). For each procedure, horizontal movements were performed ipsilaterally about the right glenohumeral joint from one intermediate starting position (40 degrees ) and two extreme starting positions (0 degrees and 80 degrees ). Four fixed target positions (16 degrees , 32 degrees, 48 degrees , 64 degrees ) were presented for each starting position. The subjects were required to replicate target position after returning to the respective starting position., Results: Lower repositioning errors occurred with active displacement procedures compared with passive, and with the intermediate starting position compared with the extreme. Target position, however, had no effect on repositioning errors., Conclusions: Starting position and type of displacement should be considered in interpretations and comparisons of data from clinical studies.

Repetitive work to fatigue is soundly associated with work-related musculoskeletal disorders (WMSD), although the underlying mechanisms are poorly understood. In the present study, we tested the hypothesis that fatiguing work leads to proprioceptive deficits, which can be an initiating factor for the occurrence of WMSD. Thus, the position sense of the shoulder was determined for 13 males and 13 females before and after performing repetitive low-intensity arm work to fatigue in a simulated occupational setting. From a starting position of 45 degrees to the sagittal plane, position sense tests consisted of subjects attempting to actively reproduce target positions of horizontal movements to 15 degrees and 30 degrees (shoulder adduction) and to 60 degrees and 75 degrees (shoulder abduction). An analysis of variance revealed that the absolute error was significantly increased following fatigue for the subjects as a group (P < 0.001). Furthermore, females had an overall higher error than males (P < 0.01). No difference in error was detected for the shorter movements versus the longer movements. However, the overall absolute error for adduction was significantly higher than for abduction (P < 0.001). The results of the present study support the hypothesis of diminished proprioceptive acuity following low-intensity work to fatigue. A reduction in position sense acuity could lead to impairment in motor control, which would further impact on position sense. Thus, a vicious cycle may be activated that might result in WMSD. The poorer position sense acuity observed for females may contribute to the explanation of why females demonstrate a higher incidence of WMSD than males.

Position sense testing has increased as a tool for augmenting evaluation of joint injury. In the present study, we investigated the inter-day reliability for four different types of position sense tests using a fully automated system. The tests included (1) passive presentation/active replication, (2) passive presentation/passive replication, (3) semi-passive presentation/semi-passive replication (where semi-passive denotes passive movement during antagonist muscle contraction), and (4) active presentation/active replication. The absolute difference between presented target and replicated position was used as a measure of position sense accuracy. Ten healthy subjects who were blindfolded and seated with the arm in a moveable rig performed the tests on two occasions, separated by 3-4 days. For each type of position sense test, horizontal abduction from a starting position of 0 degrees (relative to the sagittal plane) to target positions of 32 degrees and 64 degrees, and horizontal adduction from a starting position of 80 degrees to 48 degrees and 16 degrees were conducted. A two-way ANOVA revealed no differences in absolute error between days or between testing procedures. However, intra-class correlations (ICC), which are most often used to express test-retest reliability, were moderate at best, ranging from 0.40 to 0.61 for the four types of position sense tests. Hence, the present study indicates that the ability of repositioning tests to detect alterations in proprioceptive function is limited, suggesting that their use in clinical evaluation be approached with prudence.

This study is an investigation of the relationship between muscle morphology and surface electromyographic (EMG) parameters [mean frequency of the power spectrum (MNF), signal amplitude (root mean square, RMS) and the signal amplitude ratio (SAR; i.e. the ratio between the RMS level during the passive part of the contraction cycle and the RMS level during the active part of the contraction cycle)] during 100 maximal dynamic knee extensions at 90 degrees. s(-1). Each contraction cycle comprised of 1 s of active knee extension and 1 s of passive knee flexion. The surface EMG was recorded from the vastus lateralis muscle. Twenty clinically healthy subjects participated in the study, and muscle biopsy samples of the vastus lateralis were obtained from 19 of those subjects. The relationships between muscle morphology and EMG were investigated at three stages of the test: initially, during the fatigue phase (initial 40 contractions), and at the endurance level (the final 50 contractions). Major findings on correlations are that SAR and MNF tended to correlate positively with the proportion of type 1 fibres, and RMS correlated positively with the proportion of type 2 muscle fibres. The muscle fibre areas showed little correlation with the EMG variables under investigation. The results of the present study showed that the three EMG variables of a dynamic endurance test that were investigated (RMS, MNF and SAR) were clearly correlated with the proportions of the different fibre types, but only to a small extent with fibre areas. These findings contradict some of the theoretical models of the EMG, especially for parameters in the frequency domain.

The effect of pre-anaesthetic ketamine on ensemble coding of different stimuli consisting of muscle stretches of various amplitudes was studied for ensembles of simultaneously recorded primary muscle spindle afferents (MSAs). The experiments were conducted on 8 alpha-chloralose anaesthetised cats. Three of the cats received a pre-anaesthetic dose of ketamine (25 mg/kg) injected subcutaneously (ketamine group), while the remaining five animals did not (non-ketamine group). Data for ensemble coding were collected both before and after cutting the ventral root. A method based on principal component analysis and algorithms was used to quantify stimulus discrimination and an ANOVA tested differences between groups as well as differences due to ventral root cutting. When the fusimotor supply was intact, a general trend of an increase in the ability to discriminate stimuli with increasing ensemble size was observed for both groups, however, this trend was significantly greater for the non-ketamine group as compared to the ketamine group. When the ventral root was cut, the discrimination pattern for the non-ketamine group decreased significantly (as compared to before ventral root cutting), however, no change occurred for the ketamine group. Consequently, no difference in discrimination pattern was detected between groups after ventral root cutting. The reduction in information transmitted by ensembles of primary MSAs when ketamine is used as a pre-anaesthetic may suggest that ketamine elicits an adverse affect on the fusimotor system.

Negative external pressure has been used previously in experiments on the blood circulation in humans and is currently being considered as a counter-measure to the musculoskeletal deconditioning which occurs during the exposure to microgravity. Intramuscular pressure (IMP) measurement is an important tool for determining the effectiveness of the transmission of negative pressure. Therefore two IMP techniques, a fibre optic transducer-tipped catheter and a fluid-filled teflon catheter with side holes, were evaluated using laboratory and human tests for measuring negative pressures. For the laboratory tests, both catheters were placed inside a lower leg negative pressure (LLNP) chamber and pressures of 0, -20, -50, -80, -100 and back to 0 mmHg were applied. Both catheters measured pressures equally and remained stable over 1 min at all pressure levels. When the teflon catheter was infused at rates commonly used for IMP recordings at normal atmospheric pressures, the drip rate at the catheter tip increased inversely with the magnitude of negative pressure. The cables and pressure tubings of the catheters within the LLNP chamber were not affected by the negative pressures. For tests in humans, the catheters were inserted side by side in the tibialis anterior muscle in eight legs of four human volunteers. The leg was placed in the LLNP chamber and pressures of 0, -20, -50, -80 and back to 0 mmHg were applied. The teflon catheter was used without infusion. Both catheters measured IMP similarly at rest and both remained stable over 1 min at all pressure levels; also the IMP during muscle contractions and immediately following contractions was similarly recorded by both catheters. We concluded that both catheter systems are suitable for recording negative pressures over a wide range. As is the case with recordings at normal atmospheric pressures, the fibre optic transducer-tipped catheter system may be preferred when recording IMP in a negative pressure environment when complex limb movements are involved.

This study investigated changes in intramuscular pressure (IMP) and surface electromyographic (EMG) parameters (mean frequency of the power spectrum, f(mean); and signal amplitude denoted as root mean square, RMS) during contractions to fatigue at 25 and 70% of maximal voluntary contraction (MVC). Parameters were recorded simultaneously from the vastus lateralis muscle during knee extension. A significant decrease in f(mean) occurred with time at both contraction levels; however, the rate of decline (slope) was greater at 70% MVC. RMS increased throughout the contractions at both levels, with the relative increase being significantly greater for 25% MVC. IMP increased during 25% MVC but did not change during the 70% MVC contraction. IMP at rest was significantly higher post-contractions than it was pre-contractions at 25% MVC (21.1 vs. 8.0 mmHg, P < 0.01) and 70% MVC (13.7 vs. 8.6 mmHg, P < 0.01). Consequently, post-contraction IMP was higher at 25% MVC than at 70% MVC (P < 0.01). IMP changes throughout the fatiguing contractions correlated negatively with f(mean) and positively with RMS at both MVC levels; however, these correlations were better at 25% MVC. The extent of intramuscular water accumulation is discussed as a major cause of the difference in IMP changes between 25% and 70% MVC. Significant differences in the rate of change for all parameters between high vs. low contraction levels may suggest a common mechanism governing changes in IMP and EMG fatigue indicators.

This study investigated the relationship between muscle morphology and surface electromyographic parameters (mean frequency, f(mean); and signal amplitude, RMS) during sustained static knee extension to exhaustion at 25% maximal voluntary contraction (MVC) and at 70% MVC. Twenty clinically healthy subjects participated. EMGs were registered from the quadriceps. Muscle forces during knee extension at a 90 degree joint angle were maintained at the respective levels throughout the measurement periods. A biopsy was obtained of the vastus lateralis muscle. The total time to exhaustion was normalized for each subject. By means of regression analysis, the intercept (i) (i.e. the unfatigued state) and the regression coefficient (k) were determined for each EMG parameter. The endurance time increased with decreasing force level. A significantly higher perception of fatigue was found at 25% MVC than at 70% MVC. From principal component analyses it was concluded that RMS-k at 25% MVC mainly correlated with the type 2 muscle fibre proportions (%), and at 70% MVC mainly with the areas of type 2 muscle fibre. At 25% MVC, f(mean)-k correlated with the areas of type 2A, 2B and 2C fibres, and at 70% MVC negatively with the proportion of type 2B and to some extent with areas of type 2A, 2B and 2C fibres. f(mean)-i at 25% MVC correlated with fibre type proportions (%); f(mean)-i at 70% MVC correlated with the areas of type 2A, 2B and 2C. The present study indicates relationships between surface EMG and muscle morphology, which is contrary to presented models of the EMG.

The objectives of this study were to determine whether the occurrence of delayed onset muscle soreness (DOMS) for the vastus lateralis muscle was associated with elevated intramuscular pressure (IMP); and to assess, whether high eccentric forces occurred at an increased muscle length (as determined by joint angle). Therefore, peak knee extension torque, peak IMP of the vastus lateralis muscle, and the joint angle at which peak torque (JAPT) occurred were determined in eight male subjects during repetitive eccentric and concentric activities until fatigue occurred. Peak torque was significantly higher for eccentric compared to concentric activity (P < 0.01) and declined significantly for both activities (P < 0.01) throughout the protocols. When comparing the start (prior to fatigue) to the end (fatigue state), mean torque for eccentric activity declined from 191 to 147 (N.m) and for concentric activity declined from 166 to 104 (N.m). In contrast, peak IMP was not significantly different between the types of activity and did not change significantly with time. At the start and the end, the mean IMP remained constant for eccentric activity at 54 mmHg (7.2 kPa) but for concentric activity was 78 mmHg (10.4 kPa) and 96 mmHg (12.8 kPa), respectively. All the subjects, however, experienced DOMS of the vastus lateralis muscle exclusively for the eccentric activity leg. The JAPT was not different between activity types and did not change significantly with time; however, a significant interaction between activity type and time was observed (P = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

This study investigated changes in intramuscular fluid pressure (IMP), torque and swelling related to delayed onset muscle soreness (DOMS) of the vastus lateralis muscle. IMP was measured via catheterization in the unstretched (0 degree, full extension) and stretched (90 degrees of knee flexion) muscle at rest; then IMP and knee extension torque were determined during maximal contractions pre and 2 d after (post) repetitive eccentric activity in one leg for eight male subjects. DOMS of the vastus lateralis muscle was associated with a significant elevation in IMP at rest as indicated by pre (0 degree: 5.4 mmHg, 90 degrees: 80 mmHg) and post (0 degree: 8.4 mmHg, 90 degrees: 13.2 mmHg) comparisons (P = 0.02). Soreness symptoms were aggravated when the muscle was stretched and this was accompanied by a significantly higher post IMP at 90 degrees vs. 0 degree (P = 0.01). During maximal contractions, peak torque declined by 15% relative to pre and peak IMP declined by 26%; DOMS symptoms, however, were most severe during this manoeuvre. Biopsies from the sore vastus lateralis muscle revealed significantly larger fibre areas for all fibre types as compared with contralateral controls (P < 0.01); however, no differences were detected for extracellular volume percent comparisons. This study shows that DOMS of the vastus lateralis muscle is associated with extensive intracellular swelling and with elevated IMP. In line with previous studies, fibre swelling may be a common subsequence to repetitive eccentric activity; the ability of IMP measurements to detect this swelling at rest and during various manoeuvres for other muscles may depend on compartmental compliance.

A direct method for measuring force production of specific muscles during dynamic exercise is presently unavailable. Previous studies indicate that both intramuscular pressure (IMP) and electromyography (EMG) correlate linearly with muscle contraction force during isometric exercise. The objective of this study was to compare IMP and EMG as linear assessors of muscle contraction force during dynamic exercise. IMP and surface EMG activity were recorded during concentric and eccentric isokinetic plantarflexion and dorsiflexion of the ankle joint from the tibialis anterior (TA) and soleus (SOL) muscles of nine male volunteers (28-54 yr). Ankle torque was measured using a dynamometer, and IMP was measured via catheterization. IMP exhibited better linear correlation than EMG with ankle joint torque during concentric contractions of the SOL (IMP R2 = 0.97, EMG R2 = 0.81) and the TA (IMP R2 = 0.97, EMG R2 = 0.90), as well as during eccentric contractions (SOL: IMP R2 = 0.91, EMG R2 = 0.51; TA: IMP R2 = 0.94, EMG R2 = 0.73). IMP provides a better index of muscle contraction force than EMG during concentric and eccentric exercise through the entire range of torque. IMP reflects intrinsic mechanical properties of individual muscles, such as length-tension relationships, which EMG is unable to assess.

The effect of lower body negative pressure (LBNP) on transcapillary fluid balance is unknown. Therefore, our objective was to assess leg interstitial fluid pressures (IFP), leg circumference, plasma volume (PV), and net whole body transcapillary fluid transport (TFT) during and after supine LBNP and to evaluate the addition of oral saline ingestion on transcapillary exchange. Six healthy men 23-41 yr old underwent 4 h of 30 mmHg LBNP, followed by 50 min of supine recovery on two separate occasions, once with and once without ingestion of 1 liter of isotonic saline. IFP was measured continuously in subcutis as well as superficial and deep regions of the tibialis anterior muscle by slit catheters. TFT was calculated by subtracting urine production and calculated insensible fluid loss from changes in PV. During exposure to LBNP, IFP decreased in parallel with chamber pressure, foot venous pressure did not change, leg circumference increased by 3 +/- 0.35% (SE) (P < 0.05), and PV decreased by 14 +/- 2.3%. IFP returned to near control levels after LBNP. At the end of minute 50 of recovery, PV remained decreased (by 7.5 +/- 5.2%) and leg circumference remained elevated (by 1 +/- 0.37%). LBNP alone produced significant movement of fluid into the lower body but no net TFT (-7 +/- 12 ml/h). During LBNP with saline ingestion, 72 +/- 4% of the ingested fluid volume filtered out of the vascular space (TFT = 145 +/- 10 ml/h), and PV decreased by 6 +/- 3%.(ABSTRACT TRUNCATED AT 250 WORDS)

A scintigraphic technique employing technetium pyrophosphate uptake was used to identify the area of skeletal muscle damage in the lower leg of four runners 24 h after an ultramarathon footrace (160 km). Most of the race had been run downhill which incorporated an extensive amount of eccentric work. Soreness was diffuse throughout the posterior region of the lower leg. In order to interpret what increased technetium uptake reflects and to express extreme endurance related damages, a biopsy was taken from the 3-D position of abnormal uptake. In addition, intramuscular pressures were determined in the deep posterior compartment. Scintigraphs revealed increased technetium pyrophosphate uptake in the medial portion of the gastrocnemius muscle. For 3698 fibres analysed, 33 fibres (1%) were necrotic, while a few other fibres were either atrophic or irregular shaped. A cluster of necrotic fibres occurred at the fascicular periphery for one subject and fibre type grouping occurred for another. Ultrastructural analysis revealed Z-line streaming near many capillaries and variously altered subsarcolemmal mitochondria including some with paracrystalline inclusions. The majority of the capillaries included thickened and irregular shaped endothelial cells. Intramuscular pressures of the deep posterior compartment were slightly elevated (12-15 mmHg) for three of the four subjects. Increased technetium uptake following extreme endurance running does not just reflect muscle necrosis but also subtle fibre abnormalities. Collectively, these pathological findings are attributed to relative ischaemia occurring during the race and during pre-race training, whereas, intramuscular pressure elevations associated with muscle soreness are attributed to mechanical stress caused by extensive eccentric work during the race.

The efficacy of a modified fibre optic transducer-tipped catheter system for measuring intramuscular pressures during exercise was determined. A microcapillary infusion technique using a catheter was employed as the standard of comparison due to its established dynamic properties. Pressures were measured in the tibialis anterior muscle of six healthy adults at rest before exercise, during isometric and concentric exercise, and at rest after exercise. The fibre optic system measured contraction pressures equal to the microcapillary infusion technique during all phases of the exercise protocols but recorded a lower relaxation pressure during isometric exercise and a lower rest pressure following 20 min of concentric exercise. Negative relaxation pressures were recorded by the fibre optic system for two subjects during continuous concentric exercise. It is hypothesized that a piston effect, due to the sliding of muscle fibres at the catheter tip following a contraction, rendered falsely low pressures during relaxation and that this artefact was reflected in the subsequent rest pressure following exercise. The larger volume (157 mm3) and area (3.49 mm2) of the fibre optic catheter in the muscle made it more prone to this effect than the conventional catheter (39 mm3 and 0.87 mm2, respectively). The fibre optic system may be preferred when recording the muscle contraction pressures during complex limb movements but should not be used when assessing the relaxation pressures or the pressure at rest following exercise.

Biopsies from the medial gastrocnemius muscle of three experienced endurance runners who had completed an ultramarathon run (160 km) the previous day were assessed for their oxidative characteristics (fibre types, capillarization and mitochondria content). Also, a regional comparison was made for fibres located centrally (completely surrounded by other fibres) versus fibres located peripherally (next to the interfascicular space) and the capillarization of these peripheral fibres was determined. Subsarcolemmal mitochondria were abundant and 'compartmentalized' close to the capillaries. The number of capillaries around fibres ranged from 5.8 to 8.5 and 5.7 to 8.5, and the number of capillaries.mm-2 ranged from 665 to 810 and 727 to 762, for type I (slow twitch) and type II (fast twitch) fibres, respectively. Central fibres contained a greater number of capillaries and more capillaries.mm-2 than their peripheral counterparts. Peripheral fibres contained more capillaries.micron-1 between fibres than at the interfascicular space. Type I fibres were more distributed (63%-78%) and larger than type II fibres. An abundance of subsarcolemmal mitochondria located close to the capillaries, efficient capillary proliferation between fibres where sharing can occur and greater relative distribution and size of type I fibres are, collectively, efficient characteristics of extreme endurance training.

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