Effects of activation pattern on nonisometric human skeletal muscle performance.

During volitional muscle activation, motor units often fire with varying discharge patterns that include brief, high-frequency bursts of activity. These variations in the activation rate allow the central nervous system to precisely control the forces produced by the muscle. The present study explores how varying the instantaneous frequency of stimulation pulses within a train affects nonisometric muscle performance. The peak excursion produced in response to each stimulation train was considered as the primary measure of muscle performance. The results showed that at each frequency tested between 10 and 50 Hz, variable-frequency trains that took advantage of the catchlike property of skeletal muscle produced greater excursions than constant-frequency trains. In addition, variable-frequency trains that could achieve targeted trajectories with fewer pulses than constant-frequency trains were identified. These findings suggest that similar to voluntary muscle activation patterns, varying the instantaneous frequency within a train of pulses can be used to improve muscle performance during functional electrical stimulation.     

Catchlike-inducing train activation of human muscle during isotonic contractions: burst modulation.

Stimulation trains that exploit the catchlike property [catchlike-inducing trains (CITs)] produce greater forces and rates of rise of force than do constant-frequency trains (CFTs) during isometric contractions and isovelocity movements. This study examined the effect of CITs during isotonic contractions in healthy subjects. Knee extension was electrically elicited against a load of 10% of maximum voluntary isometric contraction. The stimulation intensity was set to produce 20% of maximum voluntary isometric contraction. The muscle was tested before and after fatigue with a 6-pulse CFT and 6-pulse CITs that contained an initial doublet, triplet, or quadruplet. For prefatigue responses, the greatest isotonic performance was produced by CITs with initial doublets. When the muscles were fatigued, triplet CITs were best. CITs produce greater excursion, work, peak power, and average power than do CFTs, because CITs produced more rapid rates of rise of force. Faster rates of rise of force enabled the preload on the muscle to be exceeded earlier during the stimulation train.     

Catchlike property of rat diaphragm: subsequent train frequency effects in variable-train stimulation.

A high-frequency burst of pulses at the onset of a subtetanic train of stimulation allows skeletal muscle to hold force at a higher level than expected from the extra pulses alone because of the catchlike property of muscle. The present study tested the hypothesis that the presence and degree of force increase induced by a high-frequency burst are strongly modulated by the subsequent train frequency. Rat diaphragm muscle strips (studied in vitro at 37 degrees C) underwent two-, three-, or four-pulse bursts [interpulse interval (IPI) of 5 or 10 ms] at the onset of 10- to 50-Hz subtetanic trains. Force was quantified during the train with respect to its peak value (F(peak)), mean value (F(mean)), and force-time integral (F(area)), and it was compared with that produced during subtetanic trains of an equal number of pulses without preceding pulse bursts (Diff-F(peak), Diff-F(mean), Diff-F(area)). F(peak) and F(mean) increased with two-, three-, and four-pulse bursts, and Diff-F(peak) and Diff-F(mean) increased progressively with decreasing frequency of the subtetanic train. F(area), the best reflection of catchlike force augmentation, was increased mainly by the four-pulse bursts with an IPI of 10 ms, and Diff-F(area) was maximal at subsequent train frequencies of 15-25 Hz. The use of incorrect patterns of burst stimulation could also precipitate F(area) decreases, which were observed with the four-pulse, 5-ms IPI paradigm. The time required to reach 80% of maximal force (T(80%)) became shorter for each of the pulse burst stimulation patterns, with maximal reduction of Diff-T(80%) occurring at a subsequent train frequency of 20 Hz in all cases. These data indicate that extra-pulse burst stimulation paradigms need to incorporate the optimal combinations of extra-pulse number, IPI, and the frequency of the subsequent subtetanic train to take greatest advantage of the catchlike property of muscle.     

Activation of human quadriceps femoris muscle during dynamic contractions: effects of load on fatigue.

Muscle fatigue is both multifactorial and task dependent. Electrical stimulation may assist individuals with paralysis to perform functional activities [functional electrical stimulation (FES), e.g., standing or walking], but muscle fatigue is a limiting factor. One method of optimizing force is to use stimulation patterns that exploit the catchlike property of skeletal muscle [catchlike-inducing trains (CITs)]. Although nonisometric (dynamic) contractions are important parts of both normal physiological activation of skeletal muscles and FES, no previous studies have attempted to identify the effect that the load being lifted by a muscle has on the fatigue produced. This study examined the effects of load on fatigue during dynamic contractions and the augmentation produced by CITs as a function of load. Knee extension in healthy subjects was electrically elicited against three different loads. The highest load produced the least excursion, work, and average power, but it produced the greatest fatigue. CIT augmentation was greatest at the highest load and increased with fatigue. Because CITs were effective during shortening contractions for a variety of loads, they may be of benefit during FES applications.     

Nonlinear stiffness--force relationships in whole mammalian skeletal muscles

Small, sinusoidal length changes were superimposed on isometric contractions of fast- and slow-twitch mouse muscles, which were stimulated maximally via their nerves. Stiffness increased with increasing frequency of sinusoidal stimulation, but the relative time course of force and stiffness changes during twitch, tetanic, or partially fused contractions was quite invariant over a range of frequencies in both muscles. Typically, stiffness increases more rapidly than force during contraction and decreases less rapidly during relaxation. This pattern was observed at various temperatures and with various numbers of stimuli. It can be described by a nonlinear relation between stiffness and force with some hysteresis. The presence in the muscle of parallel and series elastic elements, whose stiffness varies with force, may account for the nonlinear relation. This nonlinearity can be used to relate the patterns for summation of force and stiffness observed with brief trains of stimuli under a variety of conditions.     

Mathematical models for fatigue minimization during functional electrical stimulation

We previously reported the development of a force- and fatigue-model system that predicted accurately forces during repetitive fatiguing activation of human skeletal muscles using brief duration (six-pulse) stimulation trains. The model system was tested in the present study using force responses produced by longer duration stimulation trains, containing up to 50 pulses. Our results showed that our model successfully predicted the peak forces produced when the muscle was repetitively activated with stimulation trains of frequencies ranging from 20 to 40 Hz, train durations ranging from 0.5 to 1 s, and varied pulse patterns. The predicted peak forces throughout each protocol matched the experimental peak forces with r² values above 0.9 and predicted successfully the forces at the end of each protocol with <15% error for all protocols tested. The success of our model system further supports its potential use for the design of optimal stimulation patterns for individual users during functional electrical stimulation.     

Tetanic depression in fast motor units of the cat gastrocnemius muscle.

Ability of muscle fibers to generate force is decreased when higher frequency of stimulation of motor units immediately follows lower frequency. This phenomenon called tetanic depression was found in rat medial gastrocnemius. However, it was not clear whether tetanic depression occurred only in rat muscle or it concerns all mammals. This study was conducted on motor units of cat medial gastrocnemius. Analyses were made at three successive trains of stimulation: 30 Hz, 20 and 30 Hz and again 30 Hz (the first pattern) or 40 Hz, 25 and 40 Hz and 40 Hz (the second pattern). In all fast units force generated within the middle tetanus was lower than force generated at the same, but constant frequency of stimulation applied earlier or later. The mean tetanic depression in 30 Hz tetani amounted to 10.9% for fast fatigable (FF) and 15.9% for fast resistant (FR) motor units, whereas in 40 Hz tetani mean values were 5.6% and 7.3% for FF and FR motor units, respectively. In slow motor units tetanic depression was not observed. These results proved the existence of tetanic depression in the feline muscle and indicated that its intensity depends on the fusion of tetanus. It has been concluded, that the tetanic depression is a general property of fast motor units in mammals.     

Effects of stimulation frequency versus pulse duration modulation on muscle fatigue.

During functional electrical stimulation (FES), both the frequency and intensity can be increased to increase muscle force output and counteract the effects of muscle fatigue. Most current FES systems, however, deliver a constant frequency and only vary the stimulation intensity to control muscle force. This study compared muscle performance and fatigue produced during repetitive electrical stimulation using three different strategies: (1) constant pulse-duration and stepwise increases in frequency (frequency-modulation); (2) constant frequency and stepwise increases in pulse-duration (pulse-duration-modulation); and (3) constant frequency and pulse-duration (no-modulation). Surface electrical stimulation was delivered to the quadriceps femoris muscles of 12 healthy individuals and isometric forces were recorded. Muscle performance was assessed by measuring the percent changes in the peak forces and force-time integrals between the first and the last fatiguing trains. Muscle fatigue was assessed by measuring percent declines in peak force between the 60Hz pre- and post-fatigue testing trains. The results showed that frequency-modulation showed better performance for both peak forces and force-time integrals in response to the fatiguing trains than pulse-duration-modulation, while producing similar levels of muscle fatigue. Although frequency-modulation is not commonly used during FES, clinicians should consider this strategy to improve muscle performance.     

Differences between properties of male and female motor units in the rat medial gastrocnemius muscle.

Differences between motor units in hindlimb locomotor muscles of male and female Wistar rats were studied. The contractile and action potential properties of various types of motor units as well as proportions of these units in the medial gastrocnemius muscle were analyzed. Experiments were based on functional isolation and electrical stimulation of axons of single motor units. Composition of motor units was different for male and female subjects, with higher number of the fast fatigable and lower number of slow type units in male animals. The contraction and the half-relaxation times were significantly longer in male motor units, what might be due to differences in muscle size. Slower contraction of male motor units likely corresponds to lower firing rates of their motoneurons. On the other hand, no significant differences between sexes were observed with respect to force parameters of motor units (the twitch and the maximum tetanus forces), except the fast resistant units (higher force values in male muscles). The mass of the muscle was approximately 1.5 time bigger in male rats. However, the mean ratio of motor unit tetanus force to the muscle mass was almost twice smaller in this group, what indirectly suggests that muscles of male rats are composed of higher number of motor units. Finally, female muscles appeared to have higher fatigue resistance as the effect of higher proportion of resistant units (slow and fast resistant) and higher values of the fatigue index in respective motor unit types. The motor unit action potentials in female rats had slightly lower amplitudes and shorter time parameters although this difference was significant only for fast resistant units.     

Motor unit composition has little effect on the short-range stiffness of feline medial gastrocnemius muscle.

Studies on skinned fibers and single motor units have indicated that slow-twitch fibers are stiffer than fast-twitch fibers. This suggests that skeletal muscles with different motor unit compositions may have different short-range stiffness (SRS) properties. Furthermore, the natural recruitment of slow before fast motor units may result in an SRS-force profile that is different from electrical stimulation. However, muscle architecture and the mechanical properties of surrounding tissues also contribute to the net SRS of a muscle, and it remains unclear how these structural features each contribute to the SRS of a muscle. In this study, the SRS-force characteristics of cat medial gastrocnemius muscle were measured during natural activation using the crossed-extension reflex, which activates slow before fast motor units, and during electrical activation, in which all motor units are activated synchronously. Short, rapid, isovelocity stretches were applied using a linear puller to measure SRS across the range of muscle forces. Data were collected from eight animals. Although there was a trend toward greater stiffness during natural activation, this trend was small and not statistically significant across the population of animals tested. A simple model, in which the slow-twitch fibers were assumed to be 30% stiffer than the fast-twitch fibers, was used to simulate the experimental results. Experimental and simulated results show that motor unit composition or firing rate has little effect on the SRS property of the cat MG muscle, suggesting that architectural features may be the primary determinant of SRS.     

Interspecies differences in the force-frequency relationship of the medial gastrocnemius motor units.

Single, functionally isolated motor units were studied in the medial gastrocnemius (MG) muscle of cats and rats. Axons of their motoneurons were stimulated with trains of pulses at frequencies increasing from 1 to 150 Hz and forces developed by muscle fibers were measured and force-frequency curves were compared between species. The following observations were made: (1) the most steep parts of curves (related to unfused tetani of motor units) begun at lower frequencies of stimulations in all types of feline motor units, (2) for fast motor units, the same relative values of force of unfused tetani were achieved at significantly lower frequencies of stimulations in the cat than in the rat. Twitch time parameters of both species influenced the course of force-frequency curves. It was showed that the contraction times of feline units varied in the wide range (21-81 ms), and these units reached 60% of the maximum force at stimulation frequencies between 10 and 38 Hz. On the other hand, contraction times of rat units ranged from 10 to 34 ms, whereas stimulation frequencies necessary to reach 60% of the maximum force varied considerably, from 12 to 65 Hz. The correlations between the above parameters were found for motor units of each species. However, the regression lines drown for the collected population of cat and rat units did not form linear continuity. Thus it seems that interspecies differences in the twitch contraction times do not fully explain different force-frequency relationships in mammalian skeletal muscles.     

Recruitment,force and fatigue characteristics of quadriceps muscles of paraplegics isometrically activated by surface functional electrical stimulation

This study deals with the recruitment characteristics of unfatigued electrically stimulated quadriceps muscles of paraplegic subjects and with the time-dependent force output of these muscles under sustained stimulation conditions. Both these aspects of the performance of paralysed stimulated muscles were studied under isometric conditions and at different muscle lengths. The forces in the knee joint resulting from stimulation of the quadriceps were also calculated. Recruitment force curves due to a ramp-like stimulation function indicated a strong dependence on muscle length and demonstrated a sigmoid-shaped curve with three distinct regions: negligible force up to threshold stimulation intensity; rapid force increase; and levelling-off of the curve after which the force remains constant even though intensity is further increased. When normalized to the maximal force, recruitment was found to be independent of muscle length, generating a typical recruitment curve for every patient, under isometric stimulation. The peak forces were obtained at the same flexion angles previously published for normal subjects, but with much lower values. Muscle fatigue in tetanic isometric conditions, defined as the decrease in force due to sustained stimulation with fixed parameters, was found to be length dependent and to have a double exponential decay. The first is the acute force loss and is the more significant for functional purposes; the second is the more moderate and asymptotic region, in which partial force receovery in the form of bursts is observed.     

Direct evidence that stomatogastric (Panulirus interruptus) muscle passive responses are not due to background actomyosin cross-bridges

Muscles respond to imposed length changes with rapid, large force changes followed by slow relaxations to new steady-state forces. These responses were originally believed to arise from background levels of actomyosin binding. Discovery of giant sarcomere-spanning proteins suggested muscle passive responses could arise from length changes of elastic domains present in these proteins. However, direct evidence that actomyosin plays little role in passive muscle force responses to imposed length changes has not been provided. We show here that a poison of actomyosin interaction, thiourea, does not alter initial force changes or subsequent relaxations of lobster stomatogastric muscles. These data provide direct evidence that background actomyosin cross-bridge formation likely plays, at most, a small role in muscle passive responses to length changes. Thiourea does not alter lobster muscle electrical responses to motor nerve stimulation, although in this species it does cause tonic motor nerve firing. This firing limits the utility of thiourea to study lobster muscle electrical responses to motor nerve stimulation. However, it is unclear whether thiourea induces such motor nerve firing in other animals. Thiourea may therefore provide a convenient technique to measure muscle electrical responses to motor nerve input without the confounding difficulties caused by muscle contraction.     

Trans-spinal direct current enhances corticospinal output and stimulation-evoked release of glutamate analog, D-2,3-³H-aspartic acid

Trans-spinal direct current (tsDC) stimulation is a modulator of spinal excitability and can influence cortically elicited muscle contraction in a polarity-dependent fashion. When combined with low-frequency repetitive cortical stimulation, cathodal tsDC [tsDC(-)] produces a long-term facilitation of cortically elicited muscle actions. We investigated the ability of this combined stimulation paradigm to facilitate cortically elicited muscle actions in spinal cord-injured and noninjured animals. The effect of tsDC-applied alone or in combination with repetitive spinal stimulation (rSS) on the release of the glutamate analog, D-2,3-(3)H-aspartate (D-Asp), from spinal cord preparations in vitro-was also tested. In noninjured animals, tsDC (-2 mA) reproducibly potentiated cortically elicited contractions of contralateral and ipsilateral muscles tested at various levels of baseline muscle contraction forces. Cortically elicited muscle responses in animals with contusive and hemisectioned spinal cord injuries (SCIs) were similarly potentiated. The combined paradigm of stimulation caused long-lasting potentiation of cortically elicited bilateral muscle contraction in injured and noninjured animals. Additional analysis suggests that at higher baseline forces, tsDC(-) application does not increase the rising slope of the muscle contraction but causes repeated firing of the same motor units. Both cathodal and anodal stimulations induced a significant increase of D-Asp release in vitro. The effect of the combined paradigm of stimulation (tsDC and rSS) on the concentration of extracellular D-Asp was polarity dependent. These results indicate that tsDC can powerfully modulate the responsiveness of spinal cord neurons. The results obtained from the in vitro preparation suggest that the changes in neuronal excitability were correlated with an increased concentration of extracellular glutamate. The combined paradigm of stimulation, used in our experiments, could be noninvasively applied to restore motor control in humans with SCI.     

Length-dependent [Ca2+] sensitivity adds stiffness to muscle

It is well documented that muscle fibers become more sensitive for [Ca2+] with increasing sarcomere length. In mechanical terms this length-dependent [Ca2+] sensitivity (LDCS) adds to the stiffness of muscle fibers, because muscle force, normalized for the force-length relationship at maximal stimulation, increases with contractile element (CE) length. Although LDCS is well-documented in the physiological literature, it is ignored in most motor control studies. The aim of the present study was to investigate the importance of LDCS as a contributor to the stiffness of a muscle. Comparison of experimental data with predictions derived from the model of activation dynamics proposed by Hatze (Myocybernetic Control Models of Skeletal Muscle, University of South Africa, Pretoria, 1981, pp. 31-42) indicated that this model captures the main characteristics of LDCS well. It was shown that LDCS accounts for the experimentally observed shifts in optimum length at sub-maximal stimulation levels. Furthermore, it was shown that in conditions with low-to-medium muscle stimulation, the contribution of LDCS to the total amount of stiffness provided by the muscle is substantial. It was concluded that LDCS is an important muscle property and should be taken into account in studies concerning motor control.     

Changes in the time course of potentiated and fatigued contractions of fast motor units in rat muscle

The contraction and relaxation times of the twitches and the last contractions within 32 unfused tetani of FF and 27 unfused tetani of FR motor units in the rat medial gastrocnemius muscle were studied during prolonged activity. The pattern of the MU stimulation included single pulses (to evoke twitches) and series of three trains of stimuli at 40, 50 and 60 Hz (to evoke unfused tetani), repeated 30 times. The analysis concerned changes of force and time parameters at the beginning of activity, during the potentiation and then during the fatigue. It was found that changes of force during the potentiation and the fatigue were mainly accompanied by changes in the course of relaxation. The significant prolongation of the half-relaxation time during the potentiation of either twitches or unfused tetani was revealed in both types of fast MU. The twitch contraction time did not change markedly, whereas significantly shortened in the last contractions of unfused tetani during the potentiation. These changes of time parameters correlated to the increase of the fusion degree. During the fatigue, the time parameters shortened, however, changes of the half-relaxation times were remarkably higher. The shortening of relaxation was responsible for the decrease of the fusion degree. Changes of the fusion index exceeding 0.75 during the potentiation or decreasing below this value during the fatigue, were accompanied by respective appearance or disappearance of the biphasic relaxation.     

A muscle activation model of variable stimulation frequency response and stimulation history, based on positive feedback in calcium dynamics

 Muscle fiber response to a train of variable-frequency pulses includes the potentiation and catch-like effect. For better understanding of these phenomena, we built an activation model with emphasis on the calcium liberation from and re-sequestration into the sarcoplasmic reticulum, including calcium-induced calcium release. The model had two stable equilibrium points in the calcium concentration. Changes from the low to the high equilibrium point could be produced by high-frequency trains of pulses and would account for the potentiation. The model also showed a catch-like effect, as a long-lasting increment of muscle force after the application of a single extra pulse. The increase in force appeared in resting muscle, disappeared when the muscle was potentiated, and reappeared briefly if the stimulation was continued for long periods. Received: 31 January 2000 / Accepted in revised form: 2 August 2000     

Relationship between force and stiffness in muscle fibers after stretch.

The purpose of this study was to evaluate the relationship between force and stiffness after stretch of activated fibers, while simultaneously changing contractility by interfering with the cross-bridge kinetics and muscle activation. Single fibers dissected from lumbrical muscles of frogs were placed at a length 20% longer than the plateau of the force-length relationship, activated, and stretched by 5 and 10% of fiber length (speed: 40% fiber length/s). Experiments were conducted with maximal and submaximal stimulation in Ringer solution and with the addition of 2 and 5 mM of the myosin inhibitor 2,3-butanedione monoxime (BDM) to the solution. The steady-state force after stretch of an activated fiber was higher than the isometric force produced at the corresponding length in all conditions investigated. Lowering the frequency of stimulation decreased the force and stiffness during isometric contractions, but it did not change force enhancement and stiffness enhancement after stretch. Administration of BDM decreased the force and stiffness during isometric contractions, but it increased the force enhancement and stiffness enhancement after stretch. The relationship between force enhancement and stiffness suggests that the increase in force after stretch may be caused by an increase in the proportion of cross bridges attached to actin. Because BDM places cross bridges in a weakly bound, pre-powerstroke state, our results further suggest that force enhancement is partially associated with a recruitment of weakly bound cross bridges into a strongly bound state.     

Single motor unit and fiber action potentials during fatigue

Muscle fatigue is defined as a loss of tension development during constant stimulation. Although the relationship is not well documented, muscle fatigue has been inferred from electromyogram (EMG) signals. The purpose of this study was to determine the relationship between the amplitude and duration of single motor unit action potentials (MUAPs) and the loss of tension development (fatigue) in the medial gastrocnemius muscles of cats. Single motor units were fatigued by continuous stimulation at 10 or 80 Hz or with trains of 40-Hz stimuli. When motor units were stimulated at 10 Hz and with trains at 40 Hz (low frequency), tension declined and remained depressed during recovery. The changes in the MUAP correlated poorly with changes in tension. During and after stimulation at 80 Hz (high frequency), changes in the amplitude and duration of MUAPs correlated highly with changes in tension development. Since the EMG signal is dependent on a summation and cancellation of individual MUAPs, the EMG provides a reasonable estimate of high-frequency fatigue but an unreliable measure of low-frequency fatigue.