Neuromuscular fatigue after maximal exercise in patients with cystic fibrosis.

The aim of this study was to determine whether patients with cystic fibrosis (CF), despite their ventilatory limitation, would develop neuromuscular fatigue of quadriceps muscles following a maximal cycling exercise. Eleven adults with CF (age=26.8±6.9years; forced expiratory volume in 1s=54.1±12.8% predicted) and 11 age-matched healthy subjects performed a maximal incremental cycle test with respiratory gas exchange measurements. Maximal voluntary contraction (MVC) and electromyographic (EMG) activity of the vastus medialis muscle were recorded before and after exercise. Neural and contractile properties of the quadriceps were also investigated using femoral nerve electrical stimulation. Patients had lower exercise capacity, peak oxygen uptake and MVC than controls. MVC fell significantly postexercise in both groups (CF: -20±10%, controls: -19±6%; p<0.01). EMG root mean square values, M-wave amplitude and duration were unchanged in both groups. Peak twitch (-46.9±13.8%), maximal rate of twitch torque development (-50.3±13.8%) and relaxation (-35.2±19.5%) were all reduced after exercise in CF patients. The control group followed the same pattern (-38.4±14.4%, -42.1±14.7% and -15±20.4%) but the statistical significance was not reached for the maximal rate of twitch torque relaxation. In conclusion, CF patients demonstrated lower limb fatigue following symptom-limited cycle exercise, which was comparable to that exhibited by healthy controls. This fatigue may be due to contractile impairments and not to transmission failure. Further studies should be conducted in a larger sample to confirm these preliminary results.

Whole body vibration does not enhance muscle activation.

Whether a whole body vibration session can enhance muscle voluntary activation remains debated. This pilot study thus investigated the acute effects of an intervention with whole body vibration versus a "sham" intervention on the voluntary activation of knee extensor muscles. Ten healthy subjects volunteered to participate in two interventions, vibration and sham, in randomized order. Knee extensor muscle voluntary activation, contractile properties and maximal voluntary isometric contraction were assessed before and immediately after each intervention. No significant differences were found for any of the variables. After both interventions, muscle activation remained unchanged, whereas maximal voluntary isometric contraction was significantly reduced (p<0.05). In conclusion, the two interventions induced the same adaptations in the knee extensors. These findings can be useful in conceiving whole body vibration protocols, although future research is warranted to address the influence of vibration on neural adaptation.

Soleus T reflex modulation in response to spinal and tendinous adaptations to unilateral lower limb suspension in humans.

AIM: To investigate the influence of tendinous and synaptic changes induced by unilateral lower limb suspension (ULLS) on the tendon tap reflex. METHODS: Eight young men underwent a 23-day period of ULLS. Muscle cross-sectional area (CSA), torque and electromyographic (EMG) activity of the plantar flexor muscles (normalized to the M wave), Achilles tendon-aponeurosis mechanical properties, soleus (SOL) H and T reflexes and associated peak twitch torques were measured at baseline, after 14 and 23 days of ULLS, and 1 week after resuming ambulatory activity. RESULTS: Significant decreases in muscle CSA (-9%), in maximal voluntary torque (-10%) and in the associated SOL EMG activity (-16%) were found after ULLS (P < 0.05). In addition to a 36% (P < 0.01) decrease in tendon-aponeurosis stiffness, normalized H reflex increased by 35% (P < 0.05). An increase in the slope (28%, P < 0.05) and intercept (85%, P < 0.05) of the T reflex recruitment curve pointed to an increase in the gain and to a decrease in the sensitivity of this reflex, possibly resulting from the decrease in the tendon-aponeurosis stiffness at low forces. Following ULLS, changes in tendinous stiffness correlated with changes in neuromuscular efficiency (peak twitch torque to reflex ratio) at higher tendon tap forces. CONCLUSION: These findings point out the dual and antagonistic influences of spinal and tendinous adaptations upon the tendon tap reflex in humans under conditions of chronic unloading. These observations have potential implications for the sensitivity of the short-latency Ia stretch response involved in rapid compensatory contractions to unexpected postural perturbations.

Time course of mechanical and neuromuscular characteristics of cyclists and triathletes during a fatiguing exercise.

This study examined the impact of sport specificity on the time course of fatigue during maximal voluntary eccentric, concentric and isometric torque production following a submaximal isokinetic fatiguing exercise. Seven cyclists and seven triathletes performed a fatiguing exercise consisting of nine sets of 31 isokinetic concentric knee extensions at 1.05 rad . s (-1). Fatigue was assessed pre-exercise, after three and six sets, and post-exercise. The maximal knee extension torque associated with electromyographic (EMG) activity was recorded during voluntary contractions and electrically induced contractions (single and paired twitches). The maximal voluntary eccentric torque production declined in cyclists (18 +/- 3.5 %, p < 0.05) and was not significantly affected in triathletes (5 +/- 2.5 %, p > 0.05). The decrease in cyclists was associated with an increase in the sum of the normalized EMG (nRMS) values of the three agonist muscles (p < 0.01). Although no significant difference was observed between groups, the two-way repeated-measure analysis of variance revealed a time effect on maximal concentric and isometric torque, twitch contractile and electrophysiological response (M (max)) properties. No modification in the activation and coactivation levels was observed. In conclusion, these results indicate that the time course of fatigue, especially during eccentric contractions, is mediated by sport-specific adaptations likely due to the mode of muscle contraction used in the activity.

[Neuromuscular function in patients with cystic fibrosis]. / Etude de la fonction neuromusculaire chez des patients atteints de mucoviscidose.

INTRODUCTION: In patients with cystic fibrosis impaired exercise tolerance and the reasons for this dysfunction are now well documented. This decrease in performance is mainly related to respiratory and nutritional problems but also to impaired muscle function. The aim of this study was to determine whether there is a specific neuromuscular disorder in this population that could explain the decreased muscular performance. METHODS: Nine male subjects with forced expiratory volume (FEV1) values ranging from 40% to 80% of predicted values and taking regular nutritional supplements were included in this study. Ten untrained healthy subjects were used as a control group. The neuromuscular properties of the quadriceps were evaluated by voluntary maximal isometric force (VMIF) and EMG values (spectral analysis) before, and immediately after, maximal incremental cycling exercise to exhaustion. RESULTS: At rest the subjects with cystic fibrosis had, significantly lower values of VMIF than the control group (-26%; p<0.05), with no difference in EMG. After fatigue a similar decrease in VMIF was observed in the two groups (cystic fibrosis -20%; controls -19.4%). Furthermore no significant difference in the decrease of EMG values (mean power frequency) was observed between the two groups. CONCLUSION: An identical decrease in maximal isometric force and EMG parameters was observed in both populations after exhausting exercise. Therefore, no specific alteration of muscular function seems to exist in subjects with cystic fibrosis with FEV1 values above 40% of maximal predicted values and taking adapted nutritional supplementation.

Effect of voluntary contraction intensity on the H-reflex and V-wave responses.

This study examined the evolution of H-reflex and V-wave responses of soleus muscle during maximal voluntary plantar-flexor contraction. We also investigated the relationship between the V response and force level and between V-wave during maximal voluntary contraction (MVC) and the maximal H reflex at rest. The H-reflex and the V-wave responses are measures of motoneuron excitability and also reflect the magnitude of presynaptic inhibition on Ia afferents and the magnitude of descending motor drive. Both may be influenced by postsynaptic inhibition. Twenty male subjects participated in the study and were assigned to one of two groups. The maximal M wave (Mmax) was evoked at rest in the 20 subjects, who then performed 10 maximal voluntary contraction. During MCV performance, a stimulus was delivered at supra-maximal intensity, which allowed us to record the superimposed M wave (Msup) and V wave of the soleus muscle. These parameters were also recorded during sub-maximal contractions (20, 40, 60, 80% of one MVC) in 10 subjects. The maximal H reflex (Hmax), was evoked at rest in the other 10 subjects. These subjects then performed 10 MVC and the Hsup (superimposed H, evoked by means of stimulus at Hmax intensity) was recorded. The results show that the amplitude of maximal M wave increased during MVC (gain 44.52 +/- 10.71%). No significant difference between Hmax/Mmax at rest and the Hsup/Msup ratios during MVC was observed, while an effect of force level on the V/Msup ratio was found. V/Msup and Hmax/Mmax were linearly correlated (r2 = 0.81), but V/Msup was significantly lower (P < 0.01) than Hmax/Mmax. In conclusion, the present study shows that maximal voluntary contractions potentiate some reflex responses. The V wave, which reflects motoneuron excitability presynaptic inhibition of Ia afferents and the magnitude of descending central motor drive to spinal motoneurons, may be a relatively simple method to analyse the modulation adaptive neural alterations at spinal and supraspinal level during voluntary contractions.

Effect of ageing on the electrical and mechanical properties of human soleus motor units activated by the H reflex and M wave.

This study was designed to investigate the effect of ageing on the mechanical and electromyographic (EMG) characteristics of the soleus motor units (MUs) activated by the maximal Hoffmann reflex (Hmax) and by the direct muscle compound action potential (Mmax). Eleven young (mean age 25 +/- 4 years) and ten elderly (mean age 73 +/- 5 years) males took part in this investigation. The senior group presented lower amplitudes of Mmax (-57 %, P < 0.001) and Hmax (-68 %, P < 0.001) waves compared to the younger population. These were associated with a depression of relative twitch torque of the plantar flexors. The average values of the Hmax/Mmax ratio did not statistically differ between the two populations, despite a tendency for lower values (~23 %) in the senior group. However, the older adults showed a greater relative amplitude of the sub-maximal M wave evoked at Hmax (MatHmax) than did the younger males (young 5 % vs. elderly 29 % of the Mmax, P < 0.01). This finding suggests an increased homogeneity between the excitability threshold of sensory and motor axons. The twitch torque at Hmax (PtH-M) was subsequently calculated by subtraction from the total twitch torque of the mechanical contamination associated with MatHmax. The resulting PtH-M was significantly lower in the elderly (-59 %, P < 0.001). Despite a discrepancy of 20 % between the two groups, the mechanical ratio (PtH-M/PtM; PtM, twitch tension related to the Mmax compound action potential), like the EMG ratio, did not statistically differ between the young and older individuals. Nevertheless, the senior subjects exhibited a higher twitch/EMG ratio for the reflexively activated MUs (PtH-M/Hmax) than the younger individuals (+40 %, P < 0.05). This finding suggests an on-going neuromuscular remodelling, resulting in an increased innervation ratio. The neural rearrangement may be viewed as a compensatory adaptation of the motor system to preserve the mechanical efficiency of the surviving MUs, despite the age-related impairment of the segmental reflex system. This phenomenon is confirmed by the maintenance, with senescence, of the approximately constant values of the twitch/EMG ratio for the entire motor pool (PtM/Mmax).

Central versus peripheral adaptations following eccentric resistance training.

Aim of the present investigation was to study the effects of an eccentric training on the neuromuscular properties of the plantar-flexor muscles. The experiment was carried out on 14 males divided into two groups (eccentric and control). Eccentric training consisted of six sets of six eccentric contractions at 120 % of one maximal concentric repetition and it was performed four times a week during four weeks. Before and after the 4-wk period, the plantar-flexor torque and the associated electromyographic activity were recorded during voluntary contractions (isometric, concentric and eccentric) and electrically induced contractions (twitch and tetanus), in order to distinguish central from peripheral adaptations. For the eccentric group, voluntary torque significantly increased after training independent of the action mode (relative gains 14 - 30 %, p < 0.05). This was associated with an increase in agonist EMG activity during isometric action and a decrease in antagonist coactivation in concentric (-27 %) and eccentric actions (-22 %) (p < 0.05). Voluntary activation level significantly increased from 80 +/- 5 % to 91 +/- 2 % (p < 0.05). Some of the twitch contractile properties (peak torque and maximal rate of twitch tension relaxation) were significantly modified (p < 0.05), but no changes were observed for the tetanus characteristics. These results allowed to conclude that the torque gains observed after the present training were more likely associated to central adaptations, affecting both agonist and antagonist muscles.

Electrical and mechanical H(max)-to-M(max) ratio in power- and endurance-trained athletes.

The aim of this study was to compare the mechanical and electromyographic (EMG) characteristics of soleus motor units activated during maximal H reflex and direct M response among subjects with different histories of physical activity. Power-trained athletes produced stronger twitches, with a higher rate of twitch tension buildup and relaxation, than their endurance counterparts for both maximal H-reflex and maximal M-wave responses. The maximal H-reflex-to-maximal M-wave ratios for both force output (twitch) and EMG wave amplitude were significantly lower in power-trained than endurance-trained athletes. However, power-trained athletes exhibited a significantly greater twitch-to-EMG ratio for the reflexly activated motor units with respect to the entire motor pool, whereas endurance-trained athletes had comparable twitch-to-EMG ratios for both reflexly and directly activated units. Power training increases the force output of the whole ensemble of the motor units, thereby compensating for the lower efficacy of the reflex transmission between Ia spindle afferent input and soleus alpha-motoneuron. On the other hand, the lower level of force evoked by the reflexly activated units in endurance-trained athletes is associated with a greater motor pool reflex excitability. Therefore, endurance-trained athletes produce the necessary force by recruitment of more slow-twitch units than do other subjects for comparable levels of force and type of task.