Biomechanics of human quadriceps muscles during electrical stimulation

The quadriceps muscles of neurologically intact and spinal cord injured (SCI) human subjects were stimulated with constant current pulses. Up to three, separately adjustable stimulating electrodes over the motor points for vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) muscles were used to maximize torque generation while minimizing discomfort. The torque generated by stimulation increased as the knee was slowly flexed to about 1 rad (50-60 degrees) and decreased beyond that point (a 'negative slope' on a torque-angle curve). Despite this region of negative slope the force generated by small oscillations remained positively correlated to the angle changes. When the knee was slowly extended again from a flexed position, the torque continued to decline and therefore showed a large degree of 'hysteresis'. Of the three heads studied, only stimulation of RF muscle generally produced this behavior. VL and VM had torques that increased monotonically with knee flexion over the range studied. The torques generated with electrical stimulation of normal subjects represented up to about 30% of maximum voluntary contraction. When subjects generated similar torques voluntarily, the negative slope region and substantial hysteresis were not observed. Thus, SCI subjects may be adversely affected by hysteresis during electrically-induced transitions from sitting to standing and vice versa, while normal subjects are not.     

A comparative histochemical study of intrinsic laryngeal muscles of ungulates and carnivores

The intrinsic laryngeal muscles of the horse, donkey, sheep, ox, pig, dog and cat were examined for myosin ATPase, following acid and alkali pre-incubation, SDH and M-alphaGPDH activities. In all laryngeal muscles two fibre types, betaR and alphaR, belonging to slow and fast-contracting, fatigue-resistant motor units (types S and FR) were present in different proportions. The alphaW fibre type, belonging to fast-contracting and fatigue-resistant motor units was absent (type FF). The alphaR fibres of the dog and the cat were subdivided into groups by the various degrees of acid stable myosin ATPase, oxidative and glycolytic activities. In the ox and pig laryngeal muscles, the same fibres showed an atypical myosin ATPase activity, as high as the fast-contracting fibres but acid-resistant like the slow-twitch fibres. The most uniform muscle was the CAD, which was formed of a higher percentage of slow-twitch fibres than the other laryngeal muscles of the same species. Also the VE muscle was very uniform in the dog, horse and donkey but the fast-twitch fibres were by far the most numerous, the highest in fact among all the laryngeal muscles. In the TA muscle of the cat, sheep and ox, the percentage of fast-twitch fibres was very high in the rostral portion decreasing gradually towards the caudal portion. Thus it was possible to separate histochemically the TA muscle in the rostral (pars ventricularis) and caudal (pars vocalis) portions which are related to the VE and the VO muscles of the dog, horse and donkey. In the VO muscle the slow-twitch fibres are more numerous than in the VE. The two portions of the TA were not detected by histochemical methods in the pig. However, this muscle has the highest percentage of fast-twitch fibres. The qualitative and quantitative data presented in this paper together with the data reported in the literature, enable us to correlate morphological and functional aspects of fibre composition among the species.     

Functional relationship between the foot intrinsic and extrinsic muscles in walking

The intrinsic and extrinsic muscles are considered to stabilize the foot and contribute to propulsion during walking. This study aimed to clarify the functional relationship between intrinsic and extrinsic muscles during walking. Thirteen healthy men participated in this study. The muscle activities of the intrinsic muscles (quadratus plantae and abductor hallucis), and the extrinsic muscles (flexor hallucis longus, flexor digitorum longus, and tibialis posterior) were measured using fine-wire and surface electromyography during walking. The muscle onset timing after foot contact was calculated and compared among muscles using the one-way ANOVA. The stance phase was divided into early and late braking, and early and late propulsion phases. Muscle activity among phases was compared using repeated-measures ANOVA. The onset time of the abductor hallucis was significantly earlier than those of the flexor digitorum longus and tibialis posterior. The quadratus plantae demonstrated significantly earlier onset than that of the tibialis posterior. In the late propulsion phase, the activity of extrinsic muscles decreased, whereas intrinsic muscles were continuously active. Early activation of the intrinsic muscles may stabilize the foot for efficient torque production by the extrinsic muscles. Furthermore, the intrinsic muscles may contribute to the final push-off after the deactivation of extrinsic muscles.     

Chronic electrical stimulation of nongrafted and grafted skeletal muscles in rats

Our purpose was to determine the effects of chronic electrical stimulation on the structure and function of neve-intact grafts in rats. Fourteen days after grafting, extensor digitorum longus (EDL) grafts (n = 6) and nongrafted EDL muscles (n = 4) were stimulated 8 h/day at 10 Hz for 26 days. Measurements were made subsequently of cytochrome c concentration, capillary density, contraction and relaxation times, developed tension, and the resistance to fatigue. Compared with contralateral nonstimulated grafts, chronically stimulated grafts demonstrated a 65% greater cytochrome c concentration, 45% greater number of capillaries per millimeter squared, 30% greater resistance to fatigue, 35% longer contraction time, 30% longer relaxation time, and 30% lower maximum tetanic tension. The differences that resulted from the stimulation of nongrafted EDL muscles were significant but of less magnitude. Chronic stimulation of 8 h/day provided a mixed stimulus for adaptation that enhanced the metabolic and endurance characteristics of fibers in muscles and grafts, but decreased the total fiber cross-sectional area and development of force.     

Effects of chronic electrical stimulation on paralyzed expiratory muscles.

Following spinal cord injury, the expiratory muscles develop significant disuse atrophy characterized by reductions in their weight, fiber cross-sectional area, and force-generating capacity. We determined the extent to which these physiological alterations can be prevented with electrical stimulation. Because a critical function of the expiratory muscles is cough generation, an important goal was the maintenance of maximal force production. In a cat model of spinal cord injury, short periods of high-frequency lower thoracic electrical spinal cord stimulation (SCS) at the T(10) level (50 Hz, 15 min, twice/day, 5 days/wk) were initiated 2 wk following spinalization and continued for a 6-mo period. Airway pressure (P)-generating capacity was determined by SCS. Five acute, spinalized animals served as controls. Compared with controls, initial P fell from 43.9 +/- 1.0 to 41.8 +/- 0.7 cmH(2)O (not significant) in the chronic animals. There were small reductions in the weight of the external oblique, internal oblique, transverses abdominis, internal intercostal, and rectus abdominis muscles (not significant for each). There were no significant changes in the population of fast muscle fibers. Because prior studies (Kowalski KE, Romaniuk JR, DiMarco AF. J Appl Physiol 102: 1422-1428, 2007) have demonstrated significant atrophy following spinalization in this model, these results indicate that expiratory muscle atrophy can be prevented by the application of short periods of daily high-frequency stimulation. Because the frequency of stimulation is similar to the expected pattern of clinical use for cough generation, the daily application of electrical stimulation could potentially serve the dual purpose of maintenance of expiratory muscle function and airway clearance.     

Significance of the pattern of motor innervation of the intrinsic laryngeal muscles of cat.

Simple and compound forms of motor endings, showing a particular distribution, were found in the intrinsic laryngeal muscles of the cat. The muscles carrying compound and multiple endings were stained densely black with Sudan black B; while the muscles with simple and single endings showed black and pale fibres. A probable relationship is suggested between the contraction properties and the pattern of motor innervation of intrinsic laryngeal muscles of the cat.     

Effect of electrical stimulation of antagonist muscles for voluntary motor drive

Voluntary motor drive is an important central command that descends via the corticospinal tract to initiate muscle contraction. When electrical stimulation (ES) is applied to an antagonist or agonist muscle, it changes the agonist muscle’s representative motor cortex and thus its voluntary motor drive. In this study, we used a reaction time task to compare the effects of weak and strong ES of the antagonist or agonist muscle during the premotor period of a wrist extension. We recorded motor evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS) that was applied to the extensor carpi radialis (ECR; agonist) and flexor carpi radialis (FCR; antagonist). When stronger ES intensities were applied to the antagonist, the MEP control ratio in the ECR significantly increased during the premotor time. Furthermore, the MEP control ratio with stronger antagonist ES intensity was significantly larger than that in the agonist for the same ES intensity. In the FCR, the MEP control ratio was also significantly greater at the strong ES intensity than at the weak ES intensity. Furthermore, the MEP control ratio in the antagonist with a strong ES intensity was significantly larger than that in the agonist with the same ES intensity. These results suggest that agonist corticomotor excitability might be enhanced by ES of the antagonist, which in turn strongly activates the descending motor system in the preparation of agonist contraction.     

Epinephrine inhibits exogenous glucose utilization in exercising horses.

This study examined the effects of preexercise glucose administration, with and without epinephrine infusion, on carbohydrate metabolism in horses during exercise. Six horses completed 60 min of treadmill exercise at 55 +/- 1% maximum O(2) uptake 1) 1 h after oral administration of glucose (2 g/kg; G trial); 2) 1 h after oral glucose and with an intravenous infusion of epinephrine (0.2 micromol. kg(-1). min(-1); GE trial) during exercise, and 3) 1 h after water only (F trial). Glucose administration (G and GE) caused hyperinsulinemia and hyperglycemia ( approximately 8 mM). In GE, plasma epinephrine concentrations were three- to fourfold higher than in the other trials. Compared with F, the glucose rate of appearance was approximately 50% and approximately 33% higher in G and GE, respectively, during exercise. The glucose rate of disappearance was approximately 100% higher in G than in F, but epinephrine infusion completely inhibited the increase in glucose uptake associated with glucose administration. Muscle glycogen utilization was higher in GE [349 +/- 44 mmol/kg dry muscle (dm)] than in F (218 +/- 28 mmol/kg dm) and G (201 +/- 35 mmol/kg dm). We conclude that 1) preexercise glucose augments utilization of plasma glucose in horses during moderate-intensity exercise but does not alter muscle glycogen usage and 2) increased circulating epinephrine inhibits the increase in glucose rate of disappearance associated with preexercise glucose administration and increases reliance on muscle glycogen for energy transduction.     

A model for nonexercising hindlimb muscles in exercising animals

Nonexercising muscles appear to be metabolically active during exercise. Animal models for this purpose have not been established. However, we have been able to teach animals to run on their forelimbs while their hindlimbs are suspended above the treadmill with no visible limb movement. To document that indeed this mode of exercise does not provoke additional muscle activity, we have compared the levels of neural activation of the soleus and plantaris muscles using a computer analysis of the electromyographic interference pattern, recorded from bipolar fine wire electrodes implanted across each muscle. Via computer analyses of the electromyographic interference patterns the frequencies and amplitudes of motor unit action potentials were obtained. The data were sampled during 20 s of every minute of observation. Comparisons were made in four conditions: (i) resting on the treadmill while bearing weight on the hindlimbs (normal rest), (ii) running on the treadmill (15 m/min, 8% grade) on all four limbs (normal exercise), (iii) resting while the hindlimbs were suspended in a harness above the treadmill (suspended rest), and (iv) exercising with the forelimbs (15 m/min, 8% grade) while the hindlimbs were suspended above the treadmill (suspended exercise). All four experimental conditions were carried out for 90 min each and were performed by each animal. The results clearly show that muscle activities (frequencies and amplitudes), when the hindlimbs are suspended above the treadmill, at rest or during exercise, are lower than the activities in these same muscles when the animals are at rest, supporting only their body weight. Activities in the same muscles during exercise were from 300 to 2000% greater than during hindlimb suspension.(ABSTRACT TRUNCATED AT 250 WORDS)     

Neuromuscular electrical stimulation attenuates thigh skeletal muscles atrophy but not trunk muscles after spinal cord injury

The current study examined the effects of 12 weeks of surface neuromuscular electrical stimulation (NMES) and ankle weights on the cross-sectional areas (CSAs) of three thigh [Gracilis (Gra), Sartorious (Sar) and Adductor (Add)] as well as two trunk [hip flexor (HF) and back extensor (BE)] muscle groups in men with spinal cord injury (SCI). Seven individuals with chronic motor complete SCI were randomly assigned into a resistance training + diet (RT + diet; n = 4) or diet control (n = 3) groups. The RT + diet group underwent twice weekly training with surface NMES and ankle weights for 12 weeks. Training composed of four sets of 10 repetitions of leg extension exercise while sitting in their wheelchairs. Both groups were asked to monitor their dietary intake. Magnetic resonance images were captured before and after 12 weeks of interventions. Gra muscle CSA showed no change before and after interventions. A significant interaction (P = 0.001) was noted between both groups as result of 9% increase and 10% decrease in the Gra muscle CSA of the RT + diet and diet groups, respectively. Sar muscle CSA increased [1.7 ± 0.4–2.5 ± 0.5 cm²; P = 0.029] in the RT + diet group with no change [2.9 ± 1.4–2.6 ± 1.3 cm²] in the diet group; with interaction noted between both groups (P = 0.002). Analysis of covariance indicated that Add muscle CSA was 38% greater in the RT + diet compared to the diet group (P = 0.025) after 12 weeks; a trend of interaction was also noted between both groups (P = 0.06). HF and BE muscle groups showed no apparent changes in CSA in both groups. The results suggested that surface NMES can delay the process of progressive skeletal muscle atrophy after chronic SCI. However, the effects are localized to the trained thigh muscles and do not extend to the proximal trunk muscles.     

Optimal electrode placement for noninvasive electrical stimulation of human abdominal muscles.

Abdominal muscles are the most important expiratory muscles for coughing. Spinal cord-injured patients have respiratory complications because of abdominal muscle weakness and paralysis and impaired ability to cough. We aimed to determine the optimal positioning of stimulating electrodes on the trunk for the noninvasive electrical activation of the abdominal muscles. In six healthy subjects, we compared twitch pressures produced by a single electrical pulse through surface electrodes placed either posterolaterally or anteriorly on the trunk with twitch pressures produced by magnetic stimulation of nerve roots at the T(10) level. A gastroesophageal catheter measured gastric pressure (Pga) and esophageal pressure (Pes). Twitches were recorded at increasing stimulus intensities at functional residual capacity (FRC) in the seated posture. The maximal intensity used was also delivered at total lung capacity (TLC). At FRC, twitch pressures were greatest with electrical stimulation posterolaterally and magnetic stimulation at T(10) and smallest at the anterior site (Pga, 30 +/- 3 and 33 +/- 6 cm H(2)O vs. 12 +/- 3 cm H(2)O; Pes 8 +/- 2 and 11 +/- 3 cm H(2)O vs. 5 +/- 1 cm H(2)O; means +/- SE). At TLC, twitch pressures were larger. The values for posterolateral electrical stimulation were comparable to those evoked by thoracic magnetic stimulation. The posterolateral stimulation site is the optimal site for generating gastric and esophageal twitch pressures with electrical stimulation.     

Attempts to optimise functional electrical stimulation of antagonistic muscles by mathematical modelling

The mathematical relationship between the kinetic data of joint motion and the functional electrical stimulation (FES) voltage of the corresponding antagonistic pair of muscles is given on the basis of a dynamic ankle joint model. The mathematical model is solved with the aid of state variables, while the resulting electrical stimulation voltage is found as a solution of the Volterra integral equation. The calculated stimulation voltage was applied to the plantar and dorsiflexors of the ankle joint of a hemiplegic patient. The measured ground reaction forces and goniograms during walking with and without electrical stimulation showed a significant improvement of the patient's gait. The problems of low saturation muscle force during FES, the need for individual determination of model parameters, nonlinearities of the system and the variability of gait are discussed.