The differential effects of fatigue on reflex response timing and amplitude in males and females.

We examined the effects of fatigue on patellar tendon reflex responses in males and females. A spring-loaded reflex hammer elicited a standardized tendon tap with the knee positioned in an isokinetic dynamometer and flexed to 85 degrees. We recorded vastus lateralis activity (SEMG) and knee extension force production at the distal tibia (force transducer). Reflex trials were performed before and after (immediate, 2, 4, and 6 min) an isokinetic fatigue protocol to 50% MVC (90 degrees /s). For each event, pre-motor time (PMT), electromechanical delay (EMD), and total motor time (TMT) were obtained, as well as EMG amplitude (EMG(amp)), time to peak EMG (EMG(tpk)), peak force amplitude (F(amp)), time to peak force (F(tpk)), EMG:force ratio (E:F), and rate of force production (F(rate)=N/ms). TMT increased significantly in females following fatigue, while males showed no change. The increased TMT was due to an increased EMD with fatigue, while PMT was unaffected. EMG(amp) and F(amp) were somewhat diminished in females yet significantly augmented in males following fatigue, likely accounting for the differential changes in EMD noted. Results suggest males and females may respond differently to isokinetic fatigue, with males having a greater capacity to compensate for contraction force failure when responding to mechanical perturbations.     

Faster intrinsic rate of torque development in elbow flexors than knee extensors: Effect of muscle architecture?

We studied the effect of pennate vs. fusiform muscle architecture on the rate of torque development (RTD) by examining the predominately fusiform elbow flexors (EF) and highly-pennate knee extensors (KE). Seventeen male volunteers (28.4 ± 6.2 years) performed explosive isometric EF and KE contractions (MVCs). Biceps brachii and vastus lateralis fascicle angles were measured to confirm their architecture, and both the rate of voluntary muscle activation (root-mean-square EMG in the 50 ms before contraction onset; EMG_-50) and electromechanical delay (EMD; depicting muscle-tendon series elasticity) were assessed as control variables to account for their influence on RTD. MVC torque, early (RTD₅₀) and late (RTD₂₀₀) RTDs were calculated and expressed as absolute and normalized values. Absolute MVC torque (+412%), RTD₅₀ (+215%), and RTD₂₀₀ (+427%) were significantly (p < 0.001) higher in KE than EF. However, EF RTD₅₀ was faster (+178%) than KE after normalization (p = 0.02). EMG_-50 and EMD did not differ between muscle groups. The results suggest that the faster absolute RTD in KE is largely associated with its higher maximal torque capacity, however in the absence of differences in rates of muscle activation, fiber type, and EMD the fusiform architecture of EF may be considered a factor allowing its faster early RTD relative to strength capacity.     

Knee joint laxity affects muscle activation patterns in the healthy knee.

This study investigated the effects of anterior knee joint laxity on muscle activation patterns prior to and following a lower extremity perturbation. Participants were subjected to a forward and either internal (IR) or external (ER) rotation perturbation of the trunk and thigh on the weight-bearing shank. Pre-activity (%MVIC) before the perturbation, and reflex time (ms) and mean reflex amplitude (%MVIC) following the perturbation were recorded via surface electromyography (sEMG) in the medial and lateral gastrocnemius, hamstring and quadriceps muscles. Twenty-one NCAA DI intercollegiate female athletes with below average anterior knee laxity (3-5 mm) were compared to 21 with above average anterior knee laxity (7-14 mm) as measured by a standard knee arthrometer. Groups differed in reflex timing by muscle (P = 0.013), with females with above average knee laxity (KT((>7 mm))) demonstrating a 16 ms greater delay in biceps femoris reflex timing compared to females with below average knee laxity (KT((<5 mm))). Groups also differed in muscle activation amplitude by response, muscle and direction of rotation (i.e. a 4-way interaction; P = 0.027). The magnitude of change from pre to post perturbation was significantly less in KT((>7 mm)) vs. KT((<5 mm)) for the medial (MG) and lateral (LG) gastrocnemius muscles, primarily due to higher levels of muscle preactivity while awaiting the perturbation (MG = 20% vs. 12% MVIC, P = 0.05; LG = 33% vs. 21% MVIC, P = 0.11). Further, KT((>7 mm)) demonstrated higher activation levels in the biceps femoris than KT((<5 mm)) (47% vs. 27% MVIC; P = 0.025) regardless of response (pre vs. post perturbation) or direction of rotation. These findings suggest females with increased knee laxity may be less sensitive to joint displacement or loading (delayed reflex), and are more reliant on active control of the gastrocnemius and biceps femoris muscles to potentially compensate for reduced passive joint stability.     

Effect of time-of-day-specific strength training on serum hormone concentrations and isometric strength in men

A time-of-day influence on the neuromuscular response to strength training has been previously reported. However, no scientific study has examined the influence of the time of day when strength training is performed on hormonal adaptations. Therefore, the primary purpose of this study was to examine the effects of time-of-day-specific strength training on resting serum concentrations and diurnal patterns of testosterone (T) and cortisol (CORT) as well as maximum isometric strength of knee extensors. Thirty eight diurnally active healthy, previously untrained men (age 20-45 yrs) underwent a ten-week preparatory strength training period when sessions were conducted between 17:00-19:00 h. Thereafter, these subjects were randomized into either a morning (n=20, training times 07:00-09:00 h) or afternoon (n=18, 7:00-19:00 h) training group for another ten-week period of time-of-day-specific training (TST). Isometric unilateral knee extension peak torque (MVC) was measured at 07:00, 12:00, 17:00, and 20:30 h over two consecutive days (Day 1 & Day 2) before and after TST. Blood samples were obtained before each clock-time measurement to assess resting serum T and CORT concentrations. A matched control group (n=11) did not train but participated in the tests. Serum T and CORT concentrations significantly declined from 07:00 to 20:30 h on all test days (Time effect, p<.001). Serum CORT at 07:00 h was significantly higher on Day 1 than Day 2 in the control and afternoon group, both in Pre and Post conditions (Day x Time interaction, p<.01). In the morning group, a similar day-to-day difference was present in the Pre but not Post conditions (Time x Group interaction, p<.05). MVC significantly increased after TST in both the morning and afternoon groups (Pre to Post effect, p<.001). In both groups, a typical diurnal variation in MVC (Time effect, p<.001) was found, especially on Day 2 in the Pre condition, and this feature persisted from Pre to Post in the afternoon group. In the morning group, however, diurnal variation was reduced after TST on both Day 1 and Day 2 (Pre to PostxDay x TimexGroup interaction, p<.05). In conclusion, 10 weeks of morning time-of-day-specific strength training resulted in reduced morning resting CORT concentrations, presumably as a result of decreased masking effects of anticipatory psychological stress prior to the morning testing. The typical diurnal pattern of maximum isometric strength was blunted by the TST period in the morning but not the afternoon group. However, the TST period had no significant effect on the resting total T concentration and its diurnal pattern and on the absolute increase in maximum strength.     

Muscle fiber type-specific response of Hsp70 expression in human quadriceps following acute isometric exercise.

To investigate the time course of fiber type-specific heat shock protein 70 (Hsp70) expression in human skeletal muscle after acute exercise, 10 untrained male volunteers performed single-legged isometric knee extensor exercise at 60% of their maximal voluntary contraction (MVC) with a 50% duty cycle (5-s contraction and 5-s relaxation) for 30 min. Muscle biopsies were collected from the vastus lateralis before (Pre) exercise in the rested control leg (C) and immediately after exercise (Post) in the exercised leg (E) only and on recovery days 1 (R1), 2 (R2), 3 (R3), and 6 (R6) from both legs. As demonstrated by Western blot analysis, whole muscle Hsp70 content was unchanged (P > 0.05) immediately after exercise (Pre vs. Post), was increased (P < 0.05) by approximately 43% at R1, and remained elevated throughout the entire recovery period in E only. Hsp70 expression was also assessed in individual muscle fiber types I, IIA, and IIAX/IIX by immunohistochemistry. There were no fiber type differences (P > 0.05) in basal Hsp70 expression. Immediately after exercise, Hsp70 expression was increased (P < 0.05) in type I fibers by approximately 87% but was unchanged (P > 0.05) in type II fibers (Pre vs. Post). At R1 and throughout recovery, Hsp70 content in E was increased above basal levels (P < 0.05) in all fiber types, but Hsp70 expression was always highest (P < 0.05) in type I fibers. Hsp70 content in C was not different from Pre at any time throughout recovery. Glycogen depletion was observed at Post in all type II, but not type I, fibers, suggesting that the fiber type differences in exercise-induced Hsp70 expression were not related to glycogen availability. These results demonstrate that the time course of exercise-induced Hsp70 expression in human skeletal muscle is fiber type specific.     

Comparison of hamstring neuromechanical properties between healthy males and females and the influence of musculotendinous stiffness

The hamstrings limit anterior cruciate ligament (ACL) loading, and neuromuscular control of these muscles is crucial for dynamic knee joint stability. Sex differences in electromechanical delay (EMD) and rate of force production (RFP) have been reported previously, and attributed to differences in musculotendinous stiffness (MTS). These characteristics define the neuromechanical response to joint perturbation, and sex differences in these characteristics may contribute to the greater female ACL injury risk. However, it is unclear if these differences exist in the hamstrings, and the relationship between MTS and neuromechanical function has not been assessed directly. Hamstring MTS, EMD, the time required to produce 50% peak force (Time50%), and RFP were assessed in 20 males and 20 females with no history of ACL injury. EMD did not differ significantly across sex (p = 0.788). However, MTS (p < 0.001) and RFP (p = 0.003) were greater in males, Time50% (p = 0.013) was shorter in males, and Time50% was negatively correlated with MTS (r = −0.332, p = 0.039). These results suggest that neuromechanical hamstring function in females may limit dynamic knee joint stability, potentially contributing to the greater female ACL injury risk. However, future research is necessary to determine the direct influences of MTS and neuromechanical function on dynamic knee joint stability and ACL injury risk.     

The coupled motion of the femur and patella during in vivo weightbearing knee flexion

The movement of the knee joint consists of a coupled motion between the tibiofemoral and patellofemoral articulations. This study measured the six degrees-of-freedom kinematics of the tibia, femur, and patella using dual-orthogonal fluoroscopy and magnetic resonance imaging. Ten normal knees from ten living subjects were investigated during weightbearing flexion from full extension to maximum flexion. The femoral and the patellar motions were measured relative to the tibia. The femur externally rotated by 12.9 deg and the patella tilted laterally by 16.3 deg during the full range of knee flexion. Knee flexion was strongly correlated with patellar flexion (R(2)=0.91), posterior femoral translation was strongly correlated to the posterior patellar translation (R(2)=0.87), and internal-external rotation of the femur was correlated to patellar tilt (R(2)=0.73) and medial-lateral patellar translation (R(2)=0.63). These data quantitatively indicate a kinematic coupling between the tibia, femur, and patella, and provide base line information on normal knee joint kinematics throughout the full range of weightbearing flexion. The data also suggest that the kinematic coupling of tibia, femur, and patella should be considered when investigating patellar pathologies and when developing surgical techniques to treat knee joint diseases.     

Effect of Time‐of‐Day‐Specific Strength Training on Serum Hormone Concentrations and Isometric Strength in Men

A time‐of‐day influence on the neuromuscular response to strength training has been previously reported. However, no scientific study has examined the influence of the time of day when strength training is performed on hormonal adaptations. Therefore, the primary purpose of this study was to examine the effects of time‐of‐day‐specific strength training on resting serum concentrations and diurnal patterns of testosterone (T) and cortisol (CORT) as well as maximum isometric strength of knee extensors. Thirty eight diurnally active healthy, previously untrained men (age 20–45 yrs) underwent a ten‐week preparatory strength training period when sessions were conducted between 17:00–19:00 h. Thereafter, these subjects were randomized into either a morning (n=20, training times 07:00–09:00 h) or afternoon (n=18, 7:00–19:00 h) training group for another ten‐week period of time‐of‐day‐specific training (TST). Isometric unilateral knee extension peak torque (MVC) was measured at 07:00, 12:00, 17:00, and 20:30 h over two consecutive days (Day 1 & Day 2) before and after TST. Blood samples were obtained before each clock‐time measurement to assess resting serum T and CORT concentrations. A matched control group (n=11) did not train but participated in the tests. Serum T and CORT concentrations significantly declined from 07:00 to 20:30 h on all test days (Time effect, p<.001). Serum CORT at 07:00 h was significantly higher on Day 1 than Day 2 in the control and afternoon group, both in Pre and Post conditions (Day×Time interaction, p<.01). In the morning group, a similar day‐to‐day difference was present in the Pre but not Post conditions (Time×Group interaction, p<.05). MVC significantly increased after TST in both the morning and afternoon groups (Pre to Post effect, p<.001). In both groups, a typical diurnal variation in MVC (Time effect, p<.001) was found, especially on Day 2 in the Pre condition, and this feature persisted from Pre to Post in the afternoon group. In the morning group, however, diurnal variation was reduced after TST on both Day 1 and Day 2 (Pre to Post×Day×Time×Group interaction, p<.05). In conclusion, 10 weeks of morning time‐of‐day‐specific strength training resulted in reduced morning resting CORT concentrations, presumably as a result of decreased masking effects of anticipatory psychological stress prior to the morning testing. The typical diurnal pattern of maximum isometric strength was blunted by the TST period in the morning but not the afternoon group. However, the TST period had no significant effect on the resting total T concentration and its diurnal pattern and on the absolute increase in maximum strength.     

Electromechanical delay in isometric muscle contractions evoked by voluntary, reflex and electrical stimulation

Electromechanical delay (EMD) in isometric contractions of knee extensors evoked by voluntary, tendon reflex (TR) and electrical stimulation (ES) was investigated in 21 healthy young subjects. The subject performed voluntary knee extensions with maximum effort (maximal voluntary contraction, MVC), and at 30%, 60% and 80% MVC. Patellar tendon reflexes were evoked with the reflex hammer being dropped from 60°, 75° and 90° positions. In the percutaneous ES evoked contractions, single switches were triggered with pulses of duration 1.0 ms and of intensities 90, 120 and 150 V. Electromyograms of the vastus lateralis and rectus femoris muscles were recorded using surface electrodes. The isometric knee extension force was recorded using a load cell force transducer connected to the subject's lower leg. The major finding of this study was that EMD of the involuntary contractions [e.g. mean 22.1 (SEM 1.32) ms in TR 90°; mean 17.2 (SEM 0.62) ms in ES 150 V] was significantly shorter than that of the voluntary contractions [e.g. mean 38.7 (SEM 1.18) ms in MVC,P < 0.05]. The relationships between EMD, muscle contractile properties and muscle fibre conduction velocity were also investigated. Further study is needed to explain fully the EMD differences found between the voluntary and involuntary contractions.     

Muscle sarcoplasmic reticulum calcium regulation in humans during consecutive days of exercise and recovery.

The study investigated the hypothesis that three consecutive days of prolonged cycle exercise would result in a sustained reduction in the Ca(2+)-cycling properties of the vastus lateralis in the absence of changes in the sarcoplasmic (endoplasmic) reticulum Ca(2+)-ATPase (SERCA) protein. Tissue samples were obtained at preexercise (Pre) and postexercise (Post) on day 1 (E1) and day 3 (E3) and during recovery day 1 (R1), day 2 (R2), and day 3 (R3) in 12 active but untrained volunteers (age 19.2 +/- 0.27 yr; mean +/- SE) and analyzed for changes (nmol.mg protein(-1).min(-1)) in maximal Ca(2+)-ATPase activity (V(max)), Ca(2+) uptake and Ca(2+) release (phase 1 and phase 2), and SERCA isoform expression (SERCA1a and SERCA2a). At E1, reductions (P < 0.05) from Pre to Post in V(max) (150 +/- 7 vs. 121 +/- 7), Ca(2+) uptake (7.79 +/- 0.28 vs. 5.71 +/- 0.33), and both phases of Ca(2+) release (phase 1, 20.3 +/- 1.3 vs. 15.2 +/- 1.1; phase 2, 7.70 +/- 0.60 vs. 4.99 +/- 0.48) were found. In contrast to V(max), which recovered at Pre E3 and then remained stable at Post E3 and throughout recovery, Ca(2+) uptake remained depressed (P < 0.05) at E3 Pre and Post and at R1 as did phase 2 of Ca(2+) release. Exercise resulted in an increase (P < 0.05) in SERCA1a (14% at R2) but not SERCA2a. It is concluded that rapidly adapting mechanisms protect V(max) following the onset of regular exercise but not Ca(2+) uptake and Ca(2+) release.     

Computational modelling of mobile bearing TKA anterior–posterior dislocation

Anterior–posterior stability in an unconstrained mobile-bearing total knee arthroplasty (TKA) and one with rotational constraints is compared in a computational model based on an ASTM test. Both TKA designs dislocate at loads greater than reported maximum in vivo forces. The posterior drawer forces (mean: 3027 N vs. 1817 N) needed to induce subluxation increase with a greater anterior jump distance (12 mm vs. 7 mm; refers to the vertical height of the anterior or posterior border of the tibial insert's articulating surface). The posterior jump distance for both tested TKA differed by 1.5 mm and had minimal effect on the magnitude of the anterior drawer forces at dislocation in mid-flexion (unconstrained vs. constrained: 445 N vs. 412 N). The unconstrained insert dislocated by means of spin-out whereas in the constrained TKA the femur dislocated from the bearing during posterior drawer and the bearing from the baseplate during anterior drawer. MCL function is an important consideration during ligament balancing since a ± 10% variation in MCL tension affects dislocation forces by ± 20%. The simulation platform provided the means to investigate TKA designs in terms of anterior–posterior stability as a function of knee flexion, collateral ligament function and mechanical morphology.     

Aldosterone impairs baroreflex sensitivity in healthy adults

Animal studies suggest that acute and chronic aldosterone administration impairs baroreceptor/baroreflex responses. We tested the hypothesis that aldosterone impairs baroreflex control of cardiac period [cardiovagal baroreflex sensitivity (BRS)] and muscle sympathetic nerve activity (MSNA, sympathetic BRS) in humans. Twenty-six young (25 +/- 1 yr old, mean +/- SE) adults were examined in this study. BRS was determined by using the modified Oxford technique (bolus infusion of nitroprusside, followed 60 s later by bolus infusion of phenylephrine) in triplicate before (Pre) and 30-min after (Post) beginning aldosterone (experimental, 12 pmol.kg(-1).min(-1); n = 10 subjects) or saline infusion (control; n = 10). BRS was quantified from the R-R interval-systolic blood pressure (BP) (cardiovagal BRS) and MSNA-diastolic BP (sympathetic BRS) relations. Aldosterone infusion increased serum aldosterone levels approximately fourfold (P < 0.05) and decreased (P < 0.05) cardiovagal (19.0 +/- 2.3 vs. 15.6 +/- 1.7 ms/mmHg Pre and Post, respectively) and sympathetic BRS [-4.4 +/- 0.4 vs. -3.0 +/- 0.4 arbitrary units (AU).beat(-1).mmHg(-1)]. In contrast, neither cardiovagal (19.3 +/- 3.3 vs. 20.2 +/- 3.3 ms/mmHg) nor sympathetic BRS (-3.8 +/- 0.5 vs. -3.6 +/- 0.5 AU.beat(-1).mmHg(-1)) were altered (Pre vs. Post) in the control group. BP, heart rate, and MSNA at rest were similar in experimental and control subjects before and after the intervention. Additionally, neural and cardiovascular responses to a cold pressor test and isometric handgrip to fatigue were unaffected by aldosterone infusion (n = 6 subjects). These data provide direct experimental support for the concept that aldosterone impairs baroreflex function (cardiovagal and sympathetic BRS) in humans. Therefore, aldosterone may be an important determinant/modulator of baroreflex function in humans.     

Gravitational force modulates muscle activity during mechanical oscillation of the tibia in humans

Mechanical oscillation (vibration) is an osteogenic stimulus for bone in animal models and may hold promise as an anti-osteoporosis measure in humans with spinal cord injury (SCI). However, the level of reflex induced muscle contractions associated with various loads (g force) during limb segment oscillation is uncertain. The purpose of this study was to determine whether certain gravitational loads (g forces) at a fixed oscillation frequency (30 Hz) increases muscle reflex activity in individuals with and without SCI. Nine healthy subjects and two individuals with SCI sat with their hip and knee joints at 90° and the foot secured on an oscillation platform. Vertical mechanical oscillations were introduced at 0.3, 0.6, 1.2, 3 and 5g force for 20 s at 30 Hz. Non-SCI subjects received the oscillation with and without a 5% MVC background contraction. Peak soleus and tibialis anterior (TA) EMG were normalized to M-max. Soleus and TA EMG were <2.5% of M-max in both SCI and non-SCI subjects. The greatest EMG occurred at the highest acceleration (5g). Low magnitude mechanical oscillation, shown to enhance bone anabolism in animal models, did not elicit high levels of reflex muscle activity in individuals with and without SCI. These findings support the g force modulated background muscle activity during fixed frequency vibration. The magnitude of muscle activity was low and likely does not influence the load during fixed frequency oscillation of the tibia.     

Excessive compression of the human tibio-femoral joint causes ACL rupture

The knee is one of the most frequently injured joints in the human body. A recent study suggests that axial compressive loads on the knee may play a role in injury to the anterior cruciate ligament (ACL) for the flexed knee, because of an approximate 10 degrees posterior tilt in the tibial plateau (J. Orthop. Res. 16 (1998) 122-127). The hypothesis of the current study was that excessive axial compressive loads in the human tibio-femoral (TF) joint would cause relative displacement and rotation of the tibia with respect to the femur, and result in isolated injury to the ACL when the knee is flexed to 60 degrees , 90 degrees or 120 degrees . Sixteen isolated knees from eleven fresh cadaver donors (74.3+/-10.5 yr) were exposed to repetitive TF compressive loads increasing in intensity until catastrophic injury. ACL rupture was documented in 14/16 cases. The maximum TF joint compressive force for ACL failure was 5.1+/-2.1 kN for all flexion angles combined. For the 90 degrees flexed knee, the injury occurred with a relative anterior displacement of 5.4+/-3.8mm, a lateral displacement of 4.1+/-1.4mm, and a 7.8+/-7.0 degrees internal rotation of the tibia with respect to the femur.     

Influence of sodium bicarbonate ingestion on plasma ammonia accumulation during incremental exercise in man

This investigation evaluated the influence of metabolic alkalosis on plasma ammonia (NH₃) accumulation during incremental exercise. On two occasions separated by at least 6 days, six healthy men cycled at 70, 80, and 90%g of maximum oxygen consumption ( ) for 5 min; each exercise period was followed by 5 min of seated recovery. Exercise was then performed at 100% until exhaustion. Beginning 3 h prior to exercise, subjects ingested 3.6 mmol · kg body mass^– NaHCO₃ (test, T) or 3.0 mmol · kg body mass^–1 CaCO₃ (placebo, P) (both equivalent to 0.3 g · kg^–1) over a 2-h period. Trials were performed after an overnight fast and the order of treatments was randomized. Arterialized venous blood samples for the determination of acid-base status, blood lactate and plasma NH₃ concentrations were obtained at rest before treatment, 15 s prior to each exercise bout (Pre 70%, Pre 80%, Pre 90%, and Pre 100%), and at 0, 5 (5Post), and 10 (10'Post) min after exhaustion. Additional samples for blood lactate and plasma NH₃ determination were obtained immediately after each exercise bout (Post 70%, Post 80%, Post 90%) and at 15 min after exercise (15Post). Time to exhaustion at 100% of was not significantly different between treatments [mean (SE): 173 (42) s and 184 (44) s for T and P respectively]. A significant treatment effect was observed for plasma pH with values being significantly higher on T than on P Pre 70% [7.461 (0.007) vs 7.398 (0.008)], Pre 90% [7.410 (0.010) vs 7.340 (0.016)], and 10'Post [7.317 (0.032) vs 7.242 (0.036)]. The change in plasma pH was significantly greater following the 90%g bout (Pre 100% Pre 90%) for T [–0.09 (0.02)] than for P [–0.06 (0.01)]. Blood base excess and plasma bicarbonate concentrations were significantly higher for T than P before each exercise bout but not at the point of exhaustion. During recovery, base excess was higher for T than P at 5Post and 10Post while the bicarbonate concentration was higher for T than P at 10Post. A significant treatment effect was observed for the blood lactate concentration with T on the average being higher than P [7.0 (1.0) and 6.3 (1.1) mmol · l^–1 for T and P averaged across the 12 sampling times]. Plasma NH₃ accumulation was not different between treatments at any point in time. In addition, no differences were observed between treatments in blood alanine accumulation. The results suggest that under the conditions of the present investigation metabolic alkalosis does not influence plasma NH₃ accumulation or endurance capacity during intense incremental exercise.     

A comparison of the influence of global functional loads vs. local contact anatomy on articular cartilage thickness at the knee

Cartilage contact geometry, along with joint loading, can play an important role in determining local articular cartilage tissue stress. Thus individual variations in cartilage thickness can be associated with both individual variations in joint loading associated with activities of daily living as well as individual differences in the anatomy of the contacting surfaces of the joint. The purpose of this study was to isolate the relationship between cartilage thickness predicted by individual variations in contact surface geometry based on the radii of the femur and tibia vs. cartilage thickness predicted by individual variations in joint loading. Knee magnetic resonance (MR) images and the peak knee adduction moments during walking were obtained from 11 young healthy male subjects (age 30.5+/-5.1 years). The cartilage thicknesses and surface radii of the femoral and tibial cartilage were measured in the weight-bearing regions of the medial and lateral compartments of three-dimensional models from the MR images. The ratio of contact pressure between the medial and lateral compartments was calculated from the radii of tibiofemoral contact surface geometries. The results showed that the medial to lateral pressure ratios were not correlated with the medial to lateral cartilage thickness ratios. However, in general, pressure was higher in the lateral than medial compartments and cartilage was thicker in the lateral than medial compartments. The peak knee adduction moment showed a significant positive linear correlation with medial to lateral thickness ratio in both femur (R(2)=0.43,P<0.01) and tibia (R(2)=0.32,P<0.01). The results of this study suggest that the dynamics of walking is an important factor to describe individual differences in cartilage thickness for normal subjects.     

In vivo measurement of translational stiffness of rabbit knees

This paper describes the design, evaluation, and preliminary results of a specialized testing device and surgical protocol to determine translational stiffness of a rabbit knee, replicating the clinical anterior drawer test. Coronal-plane transverse pins are inserted through the rabbit leg, two in the tibia and one in the distal femur, to hold and reproducibly position the leg in the device for tests at multiple time points. A linear stepper motor draws the tibia upward then returns to the home position, and a load cell measures the resisting force; force-displacement knee stiffness is then calculated. Initial evaluation of this testing device determined the effects of preconditioning, intra-operator repeatability, rabbit-to-rabbit variability, knee flexion angle (90 degrees vs. 135 degrees ), and anterior cruciate ligament (ACL) sectioning (0%, 25%, 50%, 75%, 100%). Knee stiffness generally decreased as ACL sectioning increased. This testing device and surgical protocol provide an objective and efficient method of determining translational rabbit knee stiffness in vivo, and are being used in an ongoing study to evaluate the effect of knee instability (via partial to complete ACL sectioning) on the development of post-traumatic osteoarthritis.     

Age-related fatigability in knee extensors and knee flexors during dynamic fatiguing contractions

This study investigated the effects of dynamic knee extension and flexion fatiguing task on torque and neuromuscular responses in young and older individuals. Eighteen young (8 males; 25.1 ± 3.2 years) and 17 older (8 males; 69.7 ± 3.7 years) volunteered. Following a maximal voluntary isometric contraction test, participants performed a fatiguing task involving 22 maximal isokinetic (concentric) knee extension and flexion contractions at 60°/s, while surface EMG was recorded simultaneously from the knee extensors (KE) and flexors (KF). Fatigue-induced relative torque reductions were similar between age groups for KE (peak torque decrease: 25.15% vs 26.81%); however, KF torque was less affected in older individuals (young vs older peak torque decrease: 27.6% vs 11.5%; p < 0.001) and this was associated with greater increase in hamstring EMG amplitude (p < 0.001) and hamstrings/quadriceps peak torque ratio (p < 0.01). Furthermore, KE was more fatigable than KF only among older individuals (peak torque decrease: 26.8% vs 11.5%; p < 0.001). These findings showed that the age-related fatigue induced by a dynamic task was greater for the KE, with greater age-related decline in KE compared to KF.     

"Effect of transcranial magnetic stimulation to motor cortex on pain perception and nociceptive reflex"

"Noxious stimulation over the foot can evoke a nociceptive flexor reflex (NR) in the lower limb especially for tibialis anterior muscle (TA). Components of NR include the monosynaptic fast latency NRII, and the polysynaptic slow latency NRIII, supposedly a spinal segmental reflex influenced by the supraspinal control. Pain perception is quantified by visual analogous scale (VAS) and has been reported to be related to NRIII. Previous papers have reported the long lasting effect of transcranial magnetic stimulation (TMS), as well as TMS suppressing pain perception. The purpose of this study was to investigate the immediate and prolonged effect of a single-pulse TMS to suppress NR and pain. NRIII was provoked at right TA by a train of electrical stimulation on the right toe in 10 healthy subjects. TMS was delivered over the vertex area to evoke right anterior tibialis muscle activity. A sham TMS from different directions of the coil was performed on the next day. The NRIII amplitude and VAS were measured. As a result, the amplitude of NRIII was significantly decreased than the control 50 ms pre-stimulation (0.20 ± 0.13 mA vs . 0.65 ± 0.42 mV, P = 0.016), 100 ms pre-stimulation (0.10 ± 0.10 mA vs . 0.65 ± 0.42 mV, P = 0.001), 15 min post-stimulation (0.12 ± 0.09 mA vs . 0.65 ± 0.42 mV, P = 0.004), and 30 min post-stimulation (0.41 ± 0.21 mA vs . 0.65 ± 0.42 mV, P = 0.046). VAS was diminished compared with the control 50 ms pre-stimulation (3.3 ± 0.9 vs . 5.4 ± 1.3, P = 0.002), 100 ms pre-stimulation (2.6 ± 0.5 vs . 5.4 ± 1.3, P < 0.001) and 15 min post-stimulation (3.5 ± 0.9 vs . 5.4 ± 1.3, P = 0.046). The NRIII amplitude was well correlated with VAS in reduction during the TMS condition and 15 min after electrical stimulation (P < 0.001). The sham TMS did not suppress NRIII or VAS. In conclusion, our results indicate that NRIII and the nociception can be inhibited by one single pulse TMS and such an effect can last for a period of time."     

The effects of knee motion and external loading on the length of the anterior cruciate ligament (ACL): a kinematic study

A six-degrees-of-freedom mechanical linkage device was designed and used to study the unconstrained motion of ten intact human cadaver knees. The knees were subjected to externally applied varus and valgus (V-V) moments up to 14 N-m as well as anterior and posterior (A-P) loads up to 100 N. Tests were done at four knee flexion angles; 0, 30, 45, and 90 deg. Significant coupled axial tibial rotation was found, up to 21.0 deg for V-V loading (at 90 deg of flexion) and 14.2 deg for A-P loading (at 45 deg of flexion). Subsequently, the knees were dissected and the locations of the insertion sites to the femur and tibia for the anteromedial (AM), posterolateral (PL), and intermediate (IM) portions of the ACL were identified. The distances between the insertion sites for all external loading conditions were calculated. In the case when the external load was zero, the AM portion of the ACL lengthened with knee flexion, while the PL portion shortened and the intermediate (IM) portion did not change in length. With the application of 14 N-m valgus moment, the PL and IM portions of the ACL lengthened significantly more than the AM portion (p less than 0.001). With the application of 100 N anterior load, the AM portion lengthened slightly less than the PL portion, which lengthened slightly less than the IM portion (p less than 0.005). In general, the amount of lengthening of the three portions of the ACL during valgus and anterior loading was observed to increase with knee flexion angle (p less than 0.001).