The effect of age on the maximum moments of strength of the muscles of the lower extremities in patients with lumbar disc hernia

The maximum contractility of the muscles of the lower extremities was studied in patients with lumbar disc hernia in different age periods. Characteristics of the age-related changes in the muscle function of the patients were analyzed in comparison with the parameters of men with physiologically normal aging. It is shown that the maximum strength of muscles of the lower extremities (lower leg extensors and flexors and plantar flexors of the foot) in patients with lumbar disc hernia is 46–50% lower than in healthy subjects. This value is characterized by a negative correlation with age. The percentage of the age-specific decrease in the strength of three groups of muscles (lower leg extensors and flexors and plantar flexors of the foot) is 14% higher than in healthy men. The age-related decrease in the muscle strength of the lower extremities begins 30 years earlier.     

Investigation of muscle tone in patients with Parkinson’s disease in unloading conditions

Parkinson’s disease (PD) is a progressive neurodegenerative disorder, the main symptoms of which are hypertonicity and difficulties emerging during performance of stepping movements due to increased muscle stiffness. Biomechanical (stiffness) and electrophysiological (shortening reaction, SR) characteristics of hip and shank muscles were examined in 25 patients with mild and moderate stages of PD (1 to 3 of Hoehn and Yahr Rating Scale, 61 ± 9 years) and 22 age-matched healthy controls in unloading leg conditions during passive flexion/extension of hip, knee, and ankle joints, as well as the changes in the tonic state of muscles under the influence of levodopa. The data obtained were compared with similar findings in healthy subjects. Essentially greater stiffness in all leg muscle groups (except foot extensors) was observed in patients with PD as compared to the healthy subjects. In patients with PD, SR values in hip and shank extensors as well as in foot flexors and extensors were essentially greater then in the healthy subjects. The medicine essentially reduced the stiffness of hip flexors and knee flexors and extensors. The SR persisted, although the frequency of its occurrence decreased in half of studied muscles, and a significant decrease in the SR value was observed in foot extensors. The medicine had no marked effect on the SR in the proximal muscles. Thus, the increased muscle stiffness in patients with PD manifests itself as distorted reactions to external disturbances and increased reflectory reactions of muscles.     

Morphological and mechanical properties of muscle and tendon in highly trained sprinters

The purpose of this study was to investigate muscle and tendon properties in highly trained sprinters and their relations to running performance. Fifteen sprinters and 15 untrained subjects participated in this study. Muscle thickness and tendon stiffness of knee extensors and plantar flexors were measured. Sprinter muscle thickness was significantly greater than that of the untrained subjects for plantar flexors, but not for knee extensors (except for the medial side). Sprinter tendon stiffness was significantly lower than that of the untrained subjects for knee extensors, but not for plantar flexors. The best official record of a 100-m race was significantly correlated to the muscle thickness of the medial side for knee extensors. In conclusion, the tendon structures of highly trained sprinters are more compliant than those of untrained subjects for knee extensors, but not for plantar flexors. Furthermore, a thicker medial side of knee extensors was associated with greater sprinting performance.     

The influence of task and angle on torque production and muscle activity at the elbow

This study investigated the effect of changing internal mechanical variables and task demands on muscle activity and torque production during high effort isometric contractions of the elbow flexors. The effect of adding a 50% maximal voluntary contraction (MVC) of supination to an MVC of elbow flexion was studied over a range of angles from 30° to 110° of elbow flexion. Surface EMGs were recorded from the biceps brachii (BIC), brachioradialis (BRAD) and triceps brachii (TRI) of 10 healthy subjects. BIC was the only muscle to show a consistent trend of increasing root mean square (rms) EMG with increasing elbow flexion angle. BIC activity also remained constant or increased with the addition of the supination task at all angles. In contrast, BRAD showed decreased activity when supination was added at several angular positions. Maximal flexion torque was reduced when the second task of submaximal supination was added. This torque reduction was statistically significant at all angles except 70° and appeared related to the decreased contribution from BRAD. In a small subset of subjects, however, BRAD activity did not decrease when the second degrees of freedom (df) task was added. These subjects exhibited higher flexion torques averaged over task than the majority, at all angles except 30°. These data support the view that internal mechanical considerations influence the manner in which the central nervous system (CNS) distributes activity to muscular synergists in response to altered task demands. Further, subject-specific patterns exist which must be recognized if these findings are to be incorporated in training or rehabilitation programmes.     

Wide-pulse-width, high-frequency neuromuscular stimulation: implications for functional electrical stimulation.

Electrical stimulation (1-ms pulses, 100 Hz) produces more torque than expected from motor axon activation (extra contractions). This experiment investigates the most effective method of delivering this stimulation for neuromuscular electrical stimulation. Surface stimulation (1-ms pulses; 20 Hz for 2 s, 100 Hz for 2 s, 20 Hz for 3 s) was delivered to triceps surae and wrist flexors (muscle stimulation) and to median and tibial nerves (nerve stimulation) at two intensities. Contractions were evaluated for amplitude, consistency, and stability. Surface electromyograph was collected to assess how H-reflexes and M-waves contribute. In the triceps surae, muscle stimulation produced the largest absolute contractions (23% maximal voluntary contraction), evoked the largest extra contractions as torque increased by 412% after the 100-Hz stimulation, and was more consistent and stable compared with tibial nerve stimulation. Absolute and extra contraction amplitude, consistency, and stability of evoked wrist flexor torques were similar between stimulation types: torques reached 11% maximal voluntary contraction, and extra contractions increased torque by 161%. Extra contractions were 10 times larger in plantar flexors compared with wrist flexors with muscle stimulation but were similar with nerve stimulation. For triceps surae, H reflexes were 3.4 times larger than M waves during nerve stimulation, yet M waves were 15 times larger than H reflexes during muscle stimulation. M waves in the wrist flexors were larger than H reflexes during nerve (8.5 times) and muscle (18.5 times) stimulation. This is an initial step toward utilizing extra contractions for neuromuscular electrical stimulation and the first to demonstrate their presence in the wrist flexors.     

Muscle architecture and force-velocity relationships in humans

The in vivo torque-velocity relationships of the knee extensors (KE), knee flexors (KF), ankle plantarflexors (PF), and ankle dorsiflexors (DF) were determined in 12 untrained subjects using an isokinetic testing device (Cybex II). These data were then matched to the predicted maximum forces and shortening velocities derived from muscle architectural determinations made on three hemipelvectomies (36). The torque-velocity curves of all muscle groups resembled that predicted by Hill's (19, 20) equation except at the higher forces and lower velocities. The peak torques occurred at mean velocities ranging from 41-62 rad X s-1 for the KE, KF, and PF. Although the peak torque of the DF occurred at the isometric loading condition, it was also lower than that predicted by Hill's equation. The muscle fiber length and physiological cross-sectional area measurements indicate that the architecture of the human leg musculature has a major influence on the torque-velocity characteristics. These data corroborate previous findings (24) that some neural inhibitory mechanism exists in the control of the leg musculature, which limits the maximum forces that could be produced under optimal stimulating conditions.     

Muscle activities of the lower limb during level and uphill running

This study aimed to compare the muscle activities of the lower limb during overground level running (LR) and uphill running (UR) by using a musculoskeletal model. Six male distance runners ran at three running speeds (slow: 3.3 m/s; medium: 4.2 m/s; and high: 5.0 m/s) on a level runway and a slope of 9.1% grade in which force platforms were mounted. A musculoskeletal leg model and optimization were used to estimate the muscle activation and muscle torque from the joint torque of the lower limb calculated by the inverse dynamics approach. At high speed, the activation and muscle torque of the muscle groups surrounding the hip joints, such as the hamstrings and iliopsoas, during the recovery phase were significantly greater during UR than during LR. At all the running speeds, the knee extension torque by the vasti during the support phase was significantly smaller during UR. Further, the hip flexion and knee extension torques by the rectus femoris during UR were significantly greater than those during LR at all the speeds; this would play a role in compensating for the decrease in the knee extension torque by the vasti and in maintaining the trunk in a forward-leaning position. These results revealed that the activation and muscle torque of the hip extensors and flexors were augmented during UR at the high speed.     

Ageing and isokinetic plantar flexion

Isokinetic torques (Cybex II) of the plantar flexors in 25 healthy men were compared at 5 angular velocities (30, 60, 90, 120 and 180 degrees X s-1). The purposes were to compare plantar flexion torques in young and old subjects, and to determine whether the expected decrease was significantly associated with age, physical activity, or aerobic fitness. Four groups were studied: young (21.7 +/- 2.0 years) and older (63.3 +/- 2.8 years), active and sedentary. Measurements of height, weight, % body fat, VO2max, and daily leisure energy expenditure (questionnaire) were determined for each subject. Statistical measures of analysis of variance were used to determine significant differences among groups; product moment correlation and stepwise regression analysis were used to describe the degree of association between the dependent variable of plantar flexion torque and the independent variables at each velocity. A decline in torque was observed as the isokinetic velocity of angular motion increased. Age alone was a significant determinant of plantar flexion torque, whereas at the slowest speed, when VO2max was used as an explanatory variable, age was not a significant determinant of torque. At 30 degrees X s-1 47% of the variance in torque was explained by VO2max while at 180 degrees X s-1 49% of the variance was explained by age.     

Evidence of changes in load sharing during isometric elbow flexion with ramped torque

This study aimed to: (1) test the repeatability of Supersonic Shear Imaging measures of muscle shear elastic modulus of four elbow flexor muscles during isometric elbow flexion with ramped torque; (2) determine the relationship between muscle shear elastic modulus and elbow torque for the four elbow flexor muscles, and (3) investigate changes in load sharing between synergist elbow flexor muscles with increases in elbow flexor torque. Ten subjects performed ten isometric elbow flexions consisting of linear torque ramps of 30-s from 0 to 40% of maximal voluntary contraction. The shear elastic modulus of each elbow flexor muscle (biceps brachii long head [BB(LH)], biceps brachii short head [BB(SH)], brachialis [BA], and brachoradialis [BR]) and of triceps brachii long head [TB] was measured twice with individual muscles recorded in separate trials in random order. A good repeatability of the shape of the changes in shear elastic modulus as a function of torque was found for each elbow flexor muscle (r-values: 0.85 to 0.94). Relationships between the shear elastic modulus and torque were best explained by a second order polynomial, except BA where a higher polynomial was required. Statistical analysis showed that BB(SH) and BB(LH) had an initial slow change at low torques followed by an increasing rate of increase in modulus with higher torques. In contrast, the BA shear elastic modulus increased rapidly at low forces, but plateaued at higher forces. These results suggest that changes in load sharing between synergist elbow flexors could partly explain the non-linear EMG-torque relationship classically reported for BB during isometric efforts.     

Voluntary control of lengthened and intact limbs muscles tension under different force load ranges

The data are presented which supporting the hypothesis of the presence of isometric force load zone, within which the subjects tested organize the voluntary muscle tension controlling with maximal accuracy and minimal specific power expenses, estimated indirectly, by the ratio of the surface electromyogram (EMG) area (integral of EMG) to force moment impulse. The asymmetries of the integral values of visual-and-motor tracking have been analyzed as well using isometric control organs in 23 patients at the age of 15-35 years (6 - males and 17 - females) in different periods after surgical elimination of lower limb length discrepancies. Poorly marked zone of minimization of integral discrete visual-and-motor tracking estimates, manifesting itself within 25-35% of the maximal force of the muscle group tested (foot dorsal flexors) has been noted in tested healthy subjects (26 normal males at the age of 19-39 years) and orthopedic patients (intact limb). The zone of "optimal' loads is marked more clearly on patients' lengthening side with the tendency towards its shift to the area of weaker forces.     

Voluntary control of muscle tension in lengthened and intact limbs in different ranges of force load

Data confirming the hypothesis that there is a range of isometric loads where subjects organize voluntary control of muscle tension with the maximum precision and minimum specific energy expenditure are presented, the energy expenditure being estimated indirectly by the ratio of the area (integral) of the summary electromyogram (EMG) to the force momentum impulse. The asymmetries of the integrated estimates of visuomotor tracking with the use of isometric control organs have been analyzed in 23 patients (6 men and 17 women) aged 15–35 years in different periods, after surgical elimination of the difference between the lengths of their lower extremities. A slightly distinct zone of minimization of the integrated estimates of discrete visuomotor tracking in the range of 25–35% of the maximum force of the muscle group tested (foot dorsal flexors) has been found in healthy subjects (26 healthy men aged 19–39 years) and orthopedic patients (the intact extremity). The zone of optimal loads is more distinct in patents on the side of lengthening; this zone tends to shift towards the region of weaker forces.     

Relationship between work and electromyographic activity during repeated leg muscle contractions in orienteers

Contraction work (CW) was recorded for each of 200 repetitive isokinetic plantar flexions (1.05 rad.s-1) and knee extensions (1.57 rad.s-1) in 14 elite male orienteers. Simultaneous recordings of integrated electromyograms (iEMG) were obtained from the 3 parts of triceps surae and from 3 superficial portions of quadriceps femoris. CW in both muscle groups decreased significantly during the first 30 contractions (the fatigue phase), followed by a steady state level. The relative steady state level was higher for the plantar flexors (70 +/- 17%) than for the knee extensors (56 +/- 12%). For quadriceps a significant increase in iEMG occurred during the first 10 contractions followed by a decrease, whereas the iEMG of the plantar flexors showed a gradual decrease to the steady state level, which was similar for the two muscle groups (71-72%). The chosen expression of output/input balance (CW/iEMG) was constant throughout the plantarflexion test but decreased during the initial 20 knee extensions down to 82%. Thus, the fatigue phase of the knee extensions appeared to be divided into two; the first part had decreases in both CW and CW/iEMG and the second part with a decrease in CW alone. In contrast the plantar flexors only showed the characteristics of the second part.     

Effects of aging on force, velocity, and power in the elbow flexors of males

The effect of aging on muscular power development was investigated by determining the force-velocity relationship. The muscle cross-sectional area (CSA) was estimated by the thickness of the elbow flexors. The subjects were 19 elderly males aged 69.1+/-3.7 years old (G-70 group), 15 middle-aged males aged 50.9+/-3.5 years old (G-50), and 19 young males aged 21.2+/-1.3 years old (G-20). The G-70 group had the slowest shortening velocities under various load conditions, resulting in the lowest force-velocity relationship. The maximum values for force (Fmax), velocity (Vmax), power (Pmax), dynamic constants (a, b), and the a/Fmax ratio were determined using Hill's equation. The a/Fmax ratio determines the degree of concavity in the force-velocity curve. The a/Fmax ratio was greatest in G-70, followed by those in G-50 and G-20, while the maximum values for force (Fmax), velocity (Vmax), and power (Pmax) were significantly lower in G-70 than in the other groups. Fmax and Pmax per CSA were lowest in G-70, and Vmax per unit muscle length was also lowest in G-70 as compared to the other age groups. The ratio of G-70/G-20 was greatest in Pmax (69.6%), followed by Fmax (75.3%) and Vmax (83.4%). However, there were no significant differences in CSA among the 3 age groups. Our findings suggest that muscle force and shortening velocity may decline gradually in the process of aging attributed to declining muscle function rather than CSA.     

Effects of 20 days of bed rest on physiological cross-sectional area of human thigh and leg muscles evaluated by magnetic resonance imaging

The present study was to investigate the effects of 20 days of bed rest on morphological characteristics of lower limb skeletal muscles. Ten sedentary volunteers (5 males and 5 females) were participating in this study. Magnetic resonance imaging techniques were used to measure the physiological cross-sectional areas (PCSAs) of the major muscles and muscle groups of the lower limb. Consecutive images were taken from the right thigh and leg of subjects, and muscle volumes (MV), muscle length, and fiber length were calculated. PCSA of each muscle was determined as MV times the cosine of the angle of fiber pennation divided by fiber length. PCSA of knee extensor and flexor muscles were significant reduced during and after bed rest. MV and PCSA of individual muscles in the knee extensors decreased by -5.1 % to -8.0%. In knee flexors, MV and PCSA in biceps femoris (long head), semitendinosus, semimembranosus, and sartorius decreased during and after bed rest. MV and PCSA in medial and lateralis [correction of andateralis] gastrocnemius, and soleus were remarkably reduced by -9.4 to -10.3% after bed rest. The results suggest that there is a great variability of muscle atrophy in the lower limb muscle groups or individual muscle after bed rest and that the plantar flexors primarily affected.     

The linear co-variance between joint muscle torques is not a generalized principle

In 1996, Gottlieb et al. [Gottlieb GL, Song Q, Hong D, Almeida GL, Corcos DM. Coordinating movement at two joints: A principle of linear covariance. J Neurophysiol 1996;75(4):1760–4] identified a linear co-variance between the joint muscle torques generated at two connected joints. The joint muscle torques changed directions and magnitudes in a synchronized and linear fashion and called it the principle of linear co-variance. Here we showed that this principle cannot hold for some class of movements. Neurologically normal subjects performed multijoint movements involving elbow and shoulder with reversal towards three targets in the sagittal plane without any constraints. The movement kinematics was calculated using the X and Y coordinates of the markers positioned over the joints. Inverse dynamics was used to calculate the joint muscle, interaction and net torques. We found that for the class of voluntary movements analyzed, the joint muscle torques of the elbow and the shoulder were not linearly correlated. The same was observed for the interaction torques. But, the net torques at both joints, i.e., the sum of the interaction and the joint muscle torques were linearly correlated. We showed that by decoupling the joint muscle torques, but keeping the net torques linearly correlated, the CNS was able to generate fast and accurate movements with straight fingertip paths. The movement paths were typical of the ones in which the joint muscle torques were linearly correlated.     

Skeletal muscle responses to lower limb suspension in humans.

Eight subjects participated in a 6-wk unilateral lower limb suspension (ULLS) study to determine the influence of reduced weight bearing on human skeletal muscle morphology. The right shoe was outfitted with a platform sole that prevented the left foot from bearing weight while walking with crutches, yet it allowed freedom of movement about the ankle, knee, and hip. Magnetic resonance images pre- and post-ULLS showed that thigh muscle cross-sectional area (CSA) decreased (P less than 0.05) 12% in the suspended left lower limb, whereas right thigh muscle CSA did not change. Likewise, magnetic resonance images collected post-ULLS showed that muscle CSA was 14% smaller (P less than 0.05) in the left than in the right leg. The decrease in muscle CSA of the thigh was due to a twofold greater response of the knee extensors (-16%, P less than 0.05) than knee flexors (-7%, P less than 0.05). The rectus femoris muscle of the knee extensors showed no change in CSA, whereas the three vastus muscles showed similar decreases of approximately 16% (P less than 0.05). The apparent atrophy in the leg was due mainly to reductions in CSA of the soleus (-17%) and gastrocnemius muscles (-26%). Biopsies of the left vastus lateralis pre- and post-ULLS showed a 14% decrease (P less than 0.05) in average fiber CSA. The decrease was evident in both type I (-12%) and II (-15%) fibers. The number of capillaries surrounding the different fiber types was unchanged after ULLS.(ABSTRACT TRUNCATED AT 250 WORDS)     

Variables during swing associated with decreased impact peak and loading rate in running

When the foot impacts the ground in running, large forces and loading rates can arise that may contribute to the development of overuse injuries. Investigating which biomechanical factors contribute to these impact loads and loading rates in running could assist clinicians in developing strategies to reduce these loads. Therefore, the goals of our work were to determine variables that predict the magnitude of the impact peak and loading rate during running, as well as to investigate how modulation of knee and hip muscle activity affects these variables. Instrumented gait analysis was conducted on 48 healthy subjects running at 3.3 m/s on a treadmill. The top four predictors of loading rate and impact peak were determined using a stepwise multiple linear regression model. Forward dynamics was performed using a whole body musculoskeletal model to determine how increased muscle activity of the knee flexors, knee extensors, hip flexors, and hip extensors during swing altered the predictors of loading rate and impact peak. A smaller impact peak was associated with a larger downward acceleration of the foot, a higher positioned foot, and a decreased downward velocity of the shank at mid-swing while a lower loading rate was associated with a higher positioned thigh at mid-swing. Our results suggest that an alternative to forefoot striking may be increased hip flexor activity during swing to alter these mid-swing kinematics and ultimately decrease the leg's velocity at landing. The decreased velocity would decrease the downward momentum of the leg and hence require a smaller force at impact.     

A probabilistic finger biodynamic model better depicts the roles of the flexors during unloaded flexion

Previous deterministic finger biomechanical models predicted that the flexor digitorum superficialis (FDS) was silent and the flexor digitorum profundus (FDP) was the only active flexor during finger flexion. Experimental studies in vivo, however, recorded activities of both flexors. In this study, in an attempt to elucidate the roles of the flexors, a probabilistic biodynamic model of the index finger was constructed to estimate the muscle–tendon forces during an experimentally measured index finger flexion movement.A Monte-Carlo simulation was performed with four model parameters, including moment arms, physiological cross sectional areas (PCSA), passive torques, and anthropometric measures as independent random variables. The muscle-tendon forces at each time point were determined using a nonlinear optimization technique. The model predicted that both FDS and FDP contributed to sustaining the movement and the FDS was not necessarily silent. The two distinct force patterns observed in vivo in experimental studies were also corroborated by the simulation. These findings, contrary to previous deterministic models’ predictions but in agreement with experimental measurements, explained the observed coactivation of FDS and FDP, and resolved the controversy regarding the roles of the flexors in finger movement dynamics.     

Patellar reflex: I. Studies in healthy subjects

The reflex activity of the flexors and extensors of the knee joint in response to a tap with a percussion hammer at a patellar tendon has been studied in healthy subjects. The studies were performed while the subjects were in a relaxed state at rest or during reinforcement using Jendrassik’s method. The contribution of muscle receptors to the reflex is discussed. It has been demonstrated that the initial burst of activity in the flexors is a “hum” of potentials generated by the quadriceps muscle of the thigh.     

The relationship between preseason range of motion and muscle strain injury in elite soccer players

The purpose of the study was to determine the influence of preseason lower-extremity range of motion (ROM) on the risk of muscle strain injury during a competitive season for elite soccer players. Thirty-six elite male soccer players (age, 25.6 +/- 4.7 years) had maximum static ROM for 6 movements of the lower extremity measured prior to the 2003-2004 English Premier League season. Player age, body size, dominant limb, and playing position were documented also. All lower-extremity muscle strain injuries were recorded prospectively during the competitive season, as was the total amount of time spent in training and games for each player. Soccer players sustaining a muscle strain injury in the hip flexors or knee flexors had lower preseason ROM (p < 0.05) in these muscle groups compared with uninjured players. Similar trends were observed for the remaining muscle groups, but all failed to reach statistical significance (p > 0.05). Most significantly, soccer players with lower preseason ROM in the hip flexors and knee flexors had a statistically higher risk for a muscle strain injury to these muscle groups during a competitive season. Age, body size, limb dominance, and playing position were not significant intrinsic risk factors for the development of muscle strain injuries. Screening of flexibility for soccer players should be conducted during preseason, and flexibility training should be prescribed to players with reduced ROM to lower the risk of developing a muscle strain injury.