Serum creatine kinase activity following forearm flexion isometric exercise

The purpose of this study was to compare serum creatine kinase (CK) activity following two forearm flexion isometric exercise regimens differing in work to rest ratio, and examine the CK response to a repeated bout of isometric exercise. Eleven males were tested on two sessions (bouts) spaced 1 week apart. For bout 1, five subjects (group A) performed a forearm flexion isometric exercise consisting of 40 10-s maximal contractions with 20-s inter-trial rests (10:20), while six (group B) performed 40 maximal 10-s contractions with 5-s inter-trial rests (10:5). The increase in serum CK activity following the 10:20 exercise (143%) was significantly greater than that following the 10:5 exercise (52%). The 10:20 exercise was also associated with greater tension generation over trials. One week later, both groups performed a bout of 10:20 exercise. A substantial reduction in the serum CK response was found following this second bout. The data suggest that for bout 1 the isometric exercise associated with the greater overall tension levels resulted in the greater CK response. However, when the 10:20 exercise was repeated 1 week later, a substantial reduction in the CK response was found which was unrelated to the tension generated.     

Break point of serum creatine kinase release after endurance exercise.

We investigated whether there is a break point of creatine kinase (CK) release after daily endurance exercise and whether CK response depends on individual physical characteristics. Fifteen healthy young men performed 90 min of bicycle exercise for 3 consecutive days. Body composition, properties of the quadriceps femoris muscle (QFM), and aerobic and anaerobic capacities were estimated before the test. Blood samples were obtained 22 times during the experimental period. Endurance exercise significantly elevated serum CK from 3 h after the first exercise session (P < 0.05) and gradually increased thereafter. Subjects were classified into two groups according to their peak CK values: high responders (HR; >500 IU/l of CK) and low responders (LR; <300 IU/l of CK). Peak CK values during the experimental period correlated (P < 0.01) with workload/cross-sectional area of the QFM (r = 0.658), workload/volume of the QFM (r = 0.648), and knee extensor strength/body mass (r = -0.634); however, the HR and LR groups were separated in each variable. Thus the break point of CK release after endurance exercise under these conditions is 300-500 IU/l, two or three times higher than in the resting condition, and is associated with properties of the QFM.     

Serum creatine kinase activity following repeated bouts of isometric exercise with different muscle groups

The purpose of this study was to examine the relationship between the muscle mass involved in exercise and post-exercise serum creatine kinase (CK) elevation. Twelve untrained college-aged men completed three isometric exercises: one arm flexion (OAF), two arm flexion (TAF) and one leg knee extension (OLE). These exercises were balanced over subjects and days and separated by two week intervals. Each exercise consisted of 40 maximal isometric concentrations lasting for 10 s with a 20 s rest between contractions. Relative increases in serum CK for OAF, TAF, and OLE were 181 +/- 70% (SD), 222 +/- 69% and 297 +/- 67%, respectively. An ANOVA using a latin square design for analysis of carry over effects showed that these CK increases were not significantly different (p greater than 0.05). However, the increase in serum CK following the first exercise (379 +/- 90%), regardless of what it was (OAF, TAF, or OLE), was significantly greater (p less than 0.05) than those following bouts 2 and 3 (155 +/- 29%; 167 +/- 54%). Regression analysis indicated that post-exercise serum CK elevation was not related to the amount of muscle mass involved in the exercise (r = 0.30, p greater than 0.05) nor to muscle tension developed (r = 0.28, p greater than 0.05). We conclude that post-exercise serum CK elevation is not necessarily related to the muscle mass involved in the exercise. Because each exercise involved the use of different muscle groups, factors outside the exercising muscle may contribute to post-exercise serum enzyme activity.     

Facilitated diffusion of myoglobin and creatine kinase and reaction-diffusion constraints of aerobic metabolism under steady-state conditions in skeletal muscle

The roles of creatine kinase (CK) and myoglobin (Mb) on steady-state facilitated diffusion and temporal buffering of ATP and oxygen, respectively, are assessed within the context of a reaction-diffusion model of muscle energetics. Comparison of the reaction-diffusion model with experimental data from a wide range of muscle fibers shows that the experimentally observed skeletal muscle fibers are generally not limited by diffusion, and the model further indicates that while some muscle fibers operate near the edge of diffusion limitation, no detectable effects of Mb and CK on the effectiveness factor, a measure of diffusion constraints, are observed under steady-state conditions. However, CK had a significant effect on average ATP concentration over a wide range of rates and length scales within the reaction limited regime. The facilitated diffusion functions of Mb and CK become observable in the model for larger size cells with low mitochondrial volume fraction and for low boundary O(2) concentration and high ATP demand, where the fibers may be limited by diffusion. From the transient analysis it may be concluded that CK primarily functions to temporally buffer ATP as opposed to facilitating diffusion while Mb has a small temporal buffering effect on oxygen but does not play any significant role in steady-state facilitated diffusion in skeletal muscle fibers under most physiologically relevant regions.     

Capillary and venous samples of total creatine kinase are similar after eccentric exercise

Circulating creatine kinase (CK) levels are often monitored as an indirect biomarker of muscle damage after resistive exercise. The purpose of the present investigation was to evaluate whether capillary whole-blood sampling, a simpler and less invasive method for obtaining a venous blood sample, would allow for a reliable measurement of total CK compared to venipuncture. Fifteen untrained subjects performed 50 maximal eccentric elbow extensions to induce muscle damage of the biceps brachii. Capillary (fingerstick) and venous whole-blood samples were collected contemporaneously at baseline and again at 24, 48, 72, and 96 hours post-exercise. Using a commercial CK analysis kit with a protocol modification to account for a reduced sample size, total CK activity of the capillary and venous samples was analyzed concurrently via spectrophotometry. Results indicated a 0.997 correlation between sampling sites for total CK, with disagreement between the venous and capillary samples estimated at <12% across the range of CK values. These findings indicate capillary sampling for total CK activity provides a valid alternative to venipuncture and should be considered by researchers, clinicians, and strength and conditioning specialists as an alternate sampling technique when indirectly evaluating muscle damage after exercise.     

Absence of myofibrillar creatine kinase and diaphragm isometric function during repetitive activation

Creatine kinase(CK) provides ATP buffering in skeletal muscle and is expressed as1) cytosolic myofibrillar CK (M-CK)and 2) sarcomeric mitochondrial CK(ScCKmit) isoforms that differ in their subcellular localization. Wecompared the isometric contractile and fatigue properties of1) control CK-sufficient (Ctl),2) M-CK-deficient (M-CK[/]), and3) combined M-CK/ScCKmit-deficientnull mutant (CK[/]) diaphragm (Dia) todetermine the effect of the absence of M-CK activity on Dia performancein vitro. Baseline contractile properties were comparable across groupsexcept for specific force, which was ~16% lower inCK[/] Dia compared withM-CK[/] and Ctl Dia. During repetitiveactivation (40 Hz, duty cycle), force declined in all threegroups. This decline was significantly greater inCK[/] Dia compared with Ctl and M-CK[/] Dia. The pattern of forcedecline did not differ between M-CK[/] andCtl Dia. We conclude that Dia isometric muscle function is notabsolutely dependent on the presence of M-CK, whereas the completeabsence of CK acutely impairs isometric force generation duringrepetitive activation.

     

Effect of dibunol and isoptin on the creatine kinase and myoglobin content of the blood serum in dogs undergoing postischemic coronary reperfusion

The effect of an antioxidant dibunol and calcium antagonist verapamil on postperfusion release of myoglobin (Mb) and MB-creatine kinase (MB-CK) has been assessed in 30 dogs with experimental coronary occlusive myocardial infarction. It has been shown that reperfusion after 3-hour ischemia does not only accelerate the release of intracellular proteins, but also leads to pronounced myoglobinemia and blood enzymes. In postischemic blood flow recovery with combined dibunol and verapamil preliminary injections, an almost threefold decrease in MB-CK and Mb blood content, as compared to "reperfusion" indexes, was observed by the 10th minute of reperfusion.     

Regulation of creatine kinase during steady-state isometric twitch contraction in rat skeletal muscle

In vivo 31P-NMR saturation transfer measurements of the creatine kinase exchange flux in the direction creatine phosphate----ATP were made in the gastrocnemius muscle of rats at rest and during steady-state isometric twitch contraction at frequencies from 0.25 to 2 Hz. There was no correlation between creatine kinase exchange flux and either free [ADP] or oxygen consumption, both of which increase with stimulation frequency. The flux was found to be nearly constant over all conditions at about 16 mM X s-1, 10-times greater than the highest estimated ATP turnover in this study. The kinetic properties of skeletal muscle creatine kinase in vivo are similar to, but not completely predictable from, the equilibrium exchange fluxes measured on the isolated enzyme. These results are not consistent with strong functional coupling between ATP synthesis and mitochondrial creatine kinase.     

Changes in serum creatine phosphokinase during submaximal exercise testing

The changes in creatine phosphokinase with exercise were studied in 70 subjects who had a submaximal exercise electrocardiogram carried out as part of their routine medical investigation. A significantly greater proportion of the subjects with a positive exercise ECG had a rise in CPK following exercise than did the subjects with a negative exercise ECG. The former had significantly lower initial CPK values, and this difference could be related to the different alteration of CPK with exercise in the two groups, for example by indicating a lower level of physical fitness in the group with positive exercise ECGs. However, the most likely explanation for the greater tendency of subjects with a positive exercise ECG to show a rise in CPK following exercise is greater CPK efflux from their ischemic myocardium.With refinements, measurement of CPK before and after exercise could be useful in helping to evaluate the diagnostic significance of the exercise ECG.     

Roles of the creatine kinase system and myoglobin in maintaining energetic state in the working heart

Background  

The heart is capable of maintaining contractile function despite a transient decrease in blood flow and increase in cardiac ATP demand during systole. This study analyzes a previously developed model of cardiac energetics and oxygen transport to understand the roles of the creatine kinase system and myoglobin in maintaining the ATP hydrolysis potential during beat-to-beat transient changes in blood flow and ATP hydrolysis rate.     

Creatine kinase equilibrium and lactate content compared with muscle pH in tissue samples obtained after isometric exercise

Muscle biopsies taken from the musculus quadriceps femoris of man were analysed for pH, ATP, ADP, AMP, creatine phosphate, creatine, lactate and pyruvate. Biopsies were taken at rest, after circulatory occlusion and after isometric contraction. Muscle pH decreased from 7.09 at rest to 6.56 after isometric exercise to fatigue. Decrease in muscle pH was linearly related to accumulation of lactate plus pyruvate. An increase of 22mumol of lactate plus pyruvate per g of muscle resulted in a fall of 0.5pH unit. The apparent equilibrium constant of the creatine kinase reaction (apparent K(CK)) increased after isometric contraction and a linear relationship between log(apparent K(CK)) and muscle pH was obtained. The low content of creatine phosphate in muscle after contraction as analysed from needle-biopsy samples is believed to be a consequence of an altered equilibrium state of the creatine kinase reaction. This in turn is attributed mainly to a change in intracellular pH.     

Post-exercise hyperemia after ischemic and non-ischemic isometric handgrip exercise

Post-exercise related time course of muscle oxygenation during recovery provides valuable information on peripheral vascular disease. The purpose of the present study was to examine post-exercise hyperemia (forearm blood flow; FBF, Doppler ultrasound) assessed by peak FBF, excess FBF and the time constant for FBF (FBF(Tc)) following isometric handgrip exercise (IHE). Post-exercise hyperemia was assessed in an ischemic and non-ischemic state at different exercise intensities and durations. Peak FBF and excess FBF were defined as the maximum FBF during recovery, and the total amount of FBF volume, respectively. FBF(Tc) represents the time to reach approximately 37% of the change in FBF between peak FBF and resting FBF (delta peak FBF). Ten subjects performed IHE at "10% and 30% maximum voluntary contraction (MVC)" for 2 min with or without arterial occlusion (AO), followed by 2 min of AO alone (Study I). In Study II, six subjects performed 30%MVC-IHE with AO for "100%, 66%, 33% and 10% of the exhausted exercise duration" (time to exhaustion). In Study I, although peak FBF and excess FBF were significantly higher in ischemic than non-ischemic IHE for both 10% and 30%MVC (p<0.05), FBF(Tc) was similar in the ischemic and non-ischemic conditions. The peak FBF, excess FBF and FBF(Tc) were all significantly higher at 30% than at 10%MVC (p<0.05). In Study II, the peak FBF and excess FBF increased linearly compared to the absolute and relative exercise durations for ischemic IHE. FBF(Tc) increased exponentially when compared to the absolute and relative exercise durations. These data suggest the ischemic exercise has a larger hyperemic response compared to the non-ischemic exercise. In conclusion, the peak FBF, excess FBF and FBF(Tc) seen during post-exercise hyperemia are closely correlated with exercise intensity and duration, not only in non-ischemic, but also in the ischemic exercise. In combination with the ischemic exercise, these parameters could potentially prove to be valuable indicators of peripheral vascular disease.     

Skeletal muscle creatine kinase MB alterations in women marathon runners

Total creatine kinase (CK) and CK MB activities were determined in gastrocnemius muscle and serum obtained from 14 female marathon runners. The level of CK MB in muscle increased significantly (p less than 0.05) after chronic exercise training from 5.3% to 10.5% of the total CK activity, but not after acute exercise (post-marathon 8.9%). No significant differences in total CK activities were detected. However, the total CK activity in the muscles were significantly (p less than 0.05) less than those previously reported from the muscle of men runners (1800 U/g, 3000 U/g respectively). No significant correlation existed between fiber type and muscle CK MB activity. Additionally, trace amounts of mitochondrial CK and CK BB were present in muscle homogenates. A significant correlation was observed in the increase in mean serum total CK (597 UL-1) and CK MB (23 UL-1) activities 24 h after the race (r = 0.97, p less than 0.05). These results suggest that gastrocnemius muscle in women adapts to training with increased CK MB activities and imply that skeletal muscle is the major source of elevated serum CK MB activities in women marathon runners.     

Radioimmunoassay of serum creatine kinase BB as index of brain damage after head injury.

Brain-type creatine kinase isoenzymes (CK-BB) was measured by radioimmunoassay in the serum of 54 patients with head injuries. CK-BB was not detectable in 476 out of 1006 controls, the remaining 530 normal samples containing a mean of 1.5 +/- SD0.75 microgram/l. The mean CK-BB concentrations in patients with mild, moderate, and fatal head injuries were all significantly higher than the control value (p < 0.01 in each instance). Patients with serious head injury had serum concentrations many times the normal value, in two cases within 30 minutes after impact. Fatally injured patients continued to have high serum concentrations several days after injury. In less serious cases values approached normal within two or three days. Every patient with evidence of cerebral laceration, bruising, or swelling had a serum CK-BB concentration above normal. Raised concentrations were found in 14 out of 22 patients with concussion only. The serum CK-BB concentration appears to be a sensitive index of brain damage and may prove useful in the management and follow-up of head-injured patients.     

Activation of shoulder muscles in healthy men and women under isometric conditions

Purpose: Due to the low osseous lead of the shoulder joint a large portion of the shoulder muscles, in addition to executing movements, deals with stabilising tasks. This requires a permanent readjustment of the intermuscular co-ordination of all involved muscles. The aim of the study was to verify the existence of gender dependent differences in intramuscular co-ordination patterns of shoulder muscles.

Method: Fifteen healthy men and nine healthy women, who executed 24 isometric exercises in sagittal, frontal and horizontal planes with a loading of 50% of their individual isometric maximum force, were investigated. In every plane, four angular positions were chosen and both opposite force directions were measured, respectively. SEMG was taken from 13 muscles of the shoulder and the upper arm. Due to inter-individual differences SEMG amplitudes were normalised. Results: Gender specific differences of functional intermuscular co-ordination patterns could be proven systematically. Women showed less activation of muscles acting in the main force direction. In addition, those muscles less necessary for the actual force production were more activated in women than in men.

Conclusions: Functionally comparable shoulder function showed a gender dependency in terms of functional intermuscular co-ordination.     

Contractile adaptations in the human triceps surae after isometric exercise

Ultrastructural and twitch contractile characteristics of the human triceps surae were determined in seven healthy but very sedentary subjects before and after 16 wk of unilateral isometric training at 100% maximal voluntary contraction. After training, twitch contraction time decreased by approximately 20%. One-half relaxation time, peak twitch torque, and percent fiber type in any of the muscles of the triceps surae complex were not changed by training. Type I and type II fiber areas increased in the soleus by approximately 30%, but only type II fibers showed an increased in area in the lateral gastrocnemius (40%). Despite such changes in fiber area, the volume density of the sarcoplasmic reticulum-transverse tubular (SR) network averaged 3.2 +/- 0.6 and 5.9 +/- 0.9% in type I and type II fibers, respectively, before and after training in the two heads of the gastrocnemius. Type I SR fraction increased to 3.5 +/- 1.2% after training in the soleus; however, correlations were not significant between the change in the volume density of SR and the change in twitch contraction time (R = 0.46, P = 0.45) or the change in one-half relaxation time (R = -0.68, P = 0.08). The results demonstrate that isometric training at 100% maximal voluntary contraction induced changes in twitch contraction time that were not directly related to changes in the volume density of SR in fibers of the triceps surae.     

Total serum creatine kinase and isozyme concentrations in the owl monkey.

Serum samples from 62 owl monkeys were analyzed to determine concentrations of creatine kinase activity and isozymes. Fifty monkeys were determined to be clinically normal, while twelve had cardiac disease. Findings showed that the data had a non-normal distribution. Based on nonparametric tests, significant differences were not observed between sexes or animals with and without cardiac disease, indicating that CK activity and isozymes are not reliable indicators of myocardial disease in the owl monkey. Reference values presented are only intended as a guide. Each laboratory should determine its own reference values.