Impact of repeated bouts of eccentric exercise on sarcolemma disruption in human skeletal muscle.

In animal models, unaccustomed eccentric exercise (EE) has been widely related to muscle fiber membrane (sarcolemma) damage. On the contrary, studies in humans reported that sarcolemma was not susceptible to damage following a single bout of EE. We hypothesized that the single bout of EE used by those studies was not sufficient to induce sarcolemma damage, in humans. In this study we examined muscle biopsies from untrained males who either performed six sets of 15 reps of maximum voluntary eccentric contractions (n=9), for six consecutive days, or served as control-group (n=6). Blood and biopsy samples were obtained one week prior to exercise, immediately after bout 3, and 24h after the last training session. In addition to standard haematoxylin-eosin staining, all biopsies were stained immunohistochemically using antibodies specific for fibronectin and desmin antigens. In the exercise-group, no biopsies taken at pre-exercise or post-exercise level showed evidence of sarcolemma damage as stained by anti-fibronectin antibody in eight of nine subjects. Serum creatine kinase (CK) and lactate dehydrogenase (LDH) activities increased significantly throughout the study despite the lack of sarcolemma damage.We suggest that in humans, repeated bouts of EE do not cause gross sarcolemma damage in the mid-belly of Vastus Lateralis.

[Limiting factors of aerobic capacity]. / Az aerob funkciós rendszer korlátai.

High aerobic capacity is necessary to maintain high intensity, wholebody physical exercise for several minutes. Any steps in the chain of the oxygen delivery and mitochondrial consumption can be a rate-limiting factor of the aerobic functional system. Many examples in the field of the pathology and of the performance physiology demonstrate limiting functions in the elements of this function. Central factors (cardiac output, gas exchange in the lungs, oxygen transport capacity of the blood) and the oxidative capability of the muscle play a probably well integrated role in functioning of the system. A couple of interventions--increase by training, adaptation to the circumstances, medicaments etc are available to restore the failing functions which serve as the physiologic basis of the rehabilitation.

[Threshold parameters in clinical practice]. / "Küszöbértékek" haszna a klinikumban.

Certain parameters above a given intensity of an incremental exercise load are diverging from the linearity of the load and oxygen uptake. This intensity in Watts, speed or percent of the maximal oxygen uptake is called as "anaerobic threshold". The not fully understood events can reflect a relative local oxygen deficiency, levelling off the elimination of lactic acid, consecutive changes in ventilation, levelling off of the stroke volume and/or the macroerg phosphate turnover, uprising of the sympathoadrenal activation, changes in the activation of motor units etc. Empirically the "threshold" has been effectively applied by the performance physiologist and a growing body supports its use in the clinical diagnostics and (cardiac) rehabilitation. Some of the "threshold" parameters (acid-base status, lactic acid level, heart rate deflection) were easily available. Connected to the (spiro)ergometry, "thresholds" offer a valid, objective measure for fitness assessment and for monitoring of the effects of medicaments. It is rational to standardise certain diagnostic parameters to the "threshold" load.

[Training program for rehabilitation of patients with internal diseases]. / Rehabilitációs edzésprogramok belbetegségekben.

Physical training for patients with internal diseases differs in many points to the physical activity recommended for health maintenance. Cardiac patients are usually limited by symptoms (angina, ECG abnormalities, anaerobic threshold) therefore the intensity of the training (monitored by heart rate or ECG) must be setted by an ergometer exercise testing. Patients with obliterative peripheral artery disease may surpass the local anaerobic threshold during interval-type loads. Blood pressure limits the training intensity of the hypertensive patients if not an organ lesion. COPD patients use the rest periods of an interval training for expectoration and for restitution of their blood gas values. In insulin dependent diabetes the vascular complications can be avoided by a proper insulin regime, training and diet. Day-to-day training by an even energy need acts like the insulin therefore it must be carefully dosed. In NIDDM also the carbohydrate metabolism can improve significantly. In anxiety and depression the training and the social milieu offers a physiological trigger for the improvement. Other rehabilitative interactions (psychology, dietetics, behavioral modalities etc.) are built up in the basis of exercise training.

Exhaled carbon monoxide concentration increases after exercise in children with cystic fibrosis.

Oxidative stress and hypoxia, which may occur in cystic fibrosis patients (CF) at rest and may be worsened by exercise, induce the expression of heme oxygenase (HO)-1, resulting in increased carbon monoxide (CO) formation. We tested that exhaled CO level (eCO) was higher in CF patients than in healthy subjects, and that exercise increased CO production. Exhaled CO was measured electrochemically in 15 CF patients and 15 control subjects at rest (T0), immediately (T1) and 60 minutes after a symptom-limited incremental bicycle exercise test (T60). Arterial oxygen saturation (TcO2) was monitored transcutaneously. Data are given as mean+/-SEM. Baseline eCO was 1.90+/-0.26 ppm in the control and 1.93+/-0.27 ppm in the CF group. In both groups eCO was lower at T1 than at rest. In the control group eCO was also low at T60, but in the CF group it was increased compared to baseline level at this timepoint. Exercise caused oxyhemoglobin desaturation in CF patients which was related to the increase in eCO measured at T60 (r=0.67, p<0.01). Our findings suggest that exercise modulates the level of exhaled CO partly by worsening oxygenation in CF patients.

[Myofibrosis in childhood. Differential diagnosis in chest pain]. / Myofibrosis a gyermekkorban. A mellkasi fájdalmak differenciáldiagnosztikája.

It is emphasised in connection with the differential diagnosis of chest complaints that after excluded the serious and urgent conditions, a searching for painful muscle bundles and trigger points at the characteristic locations in the muscles can explain the origin of the complaints. By finding of myofibrosis, other expensive or invasive diagnostic tests can be omitted and the patient gets rid off his or her claims.

Specific tension of human elbow flexor muscles.

Human muscle has a specific tension that is similar to that of other mammalian skeletal muscle. Further, it appears that with the appropriate application of present imaging capabilities, the specific tension of human muscle can be defined more precisely.

[Technology of fitness testing]. / A fittségi vizsgálat technológiája.

The aim of the fitness testing is to measure the aerobic working capacity of the subject, to reveal the health-threatening risk factors, and to detect the positive and negative features of his/her life-style, with the purpose of advising an individually tailored exercise program, diet and behavioral pattern to promote the subjects health. Technology of the resting and exercise tests are summarized. The recommended calculations and the "normal values" are also reported.

Skeletal muscle biopsy studies of cardiac patients.

Eleven patients diagnosed and treated for congestive cardiomyopathy (COCM) of unknown aetiology, and another 10 patients, with congestive alcoholic heart muscle disease (ACOCM) were studied. Muscle biopsy samples were obtained from the vastus lateralis (VL) and the gastrocnemius (G) muscles. In part of the sample muscle the fibre pattern was classified by means of ATPase activity staining, a technique based on the pH lability of the fibres concerned. Fibre typing and area measurements were carried out by light microscope. The other part of the sample was used as muscle homogenate of which the Ca2+-activated ATPase activity as well as citrate synthetase (CS) and aldolase activities were measured. No significant difference was found in these enzyme activities between the two groups of patients. The proportion of the slow twitch (ST) fibres in the VL, mainly in the patients with ACOCM, was lower as compared to data for healthy subjects. A similar tendency was revealed for G. In both muscles tested, the area of ST fibres was smaller in the ACOCM group. The fast twitch (FT) fibre area proved to be slightly different in the two groups of subjects tested. Occurrence of degenerative signs in the histological tests was higher in the ACOCM than in the COCM group. It was concluded that differences in the skeletal muscles of patients with ACOCM and COCM may primarily account for the alcoholism. The disease of the heart muscle has little effect on the function of skeletal muscle. Even so, a low amount or lack of physical activity may have an unfavourable influence on the skeletal muscles of patients with heart muscle disease.

The effect of fatigue on store and re-use of elastic energy in slow and fast types of human skeletal muscle.

Stretch-shortening exercises are characterized by enhancement of performance when compared to the work output performed in shortening conditions. There is evidence that fast subjects are unable to re-use great amounts of elastic energy during stretch-shortening cycles performed with slow stretching speed and large stretching length. In the present study, 14 subjects possessing different fibre types in m. vastus lateralis performed vertical jumps with and without preliminary countermovement and with large angular displacement and slow stretching speed The jumping tests were executed before and immediately after fatigue induced by short intense exercises (60 s of continuous rebound jumping). The results indicated that the percentage of re-use of elastic energy was more pronounced in slow subjects compared to fast ones during the test performed before fatigue (28.3% vs. 22.8%). In contrast fast subjects demonstrated a greater percentage re-use of elastic energy than slow ones after fatigue (32% vs. 22.5%). Similarly, the negative relationship observed before fatigue, between the percentage of re-use of elastic energy and percentage of fast twitch fibres (r = 0.50, n = 14, P less than 0.05), was reversed after fatigue (r = 0.55, n = 14, P less than 0.05). The results can be interpreted through differences in sarcomere cross-bridges life-times between fast and slow twitch muscle fibres. The slow twitch-type muscle fibre may be able to retain the cross-bridge attachment for a longer period of time during no fatigued conditions, and therefore it may utilize elastic energy better in slow type ballistic motion. On the other hand, fast twitch type muscle fibres are more affected by fatigue, which might have induced a remarkable decrease of the cross-bridge attachment detachment cycle. Decrease of the cross-bridge rate cycle might allow fast twitch-type muscle fibres to retain longer the elastic energy stored during the stretching phase and then re-use it during positive phase.

Metabolic enzyme activity patterns in muscle biopsy samples in different athletes.

Citrate synthase (CS) and aldolase (ALD) activities and muscle fiber composition were compared in the muscles of high jumpers, sprinters, race walkers, middle distance runners and untrained men. Muscle biopsy samples were taken from vastus lateralis (VL) and gastrocnemius (G) in each group. Oxidative enzyme activity (CS, IU X g-1 ww) was highest (24.64 and 15.0 in G and VL, respectively) in endurance-trained top race walkers, followed in order by the middle distance runners (G: 17.28, VL: 12.29), untrained controls (G: 11.17, VL:8.10) and the high jumpers (G: 11.51, VL: 8.89). All athletes performing intense endurance exercise with the leg musculature displayed 30 to 60% higher CS activity and 20 to 40% higher ST% in G than in VL. Glycolytic enzyme activity (ALD approximately 28 IU X g-1 ww) was highest in both muscles in the sprinters, followed by the high jumpers (23 IU X g-1 ww). Novice runners had 30 to 50% lower ALD and CS activity than experienced sportsmen. The differences arise not only from age, but also from the periods of regular exercise and adaptation to training in elite sportsmen. It was concluded that the more intensive the sporting activity of a muscle, the higher its enzyme activity (as with oxidative or glycolytic metabolism). The correlations between fiber composition and enzyme activities differed in VL and G in the same sportsmen. Thus, the degree of adaptation due to training also differed.

Mechanical power test and fiber composition of human leg extensor muscles.

The present study was undertaken to assess the relationship between the mechanical power developed during new anaerobic power test and muscular fiber distribution. Ten track and field male athletes were used as subjects, whose muscle fiber composition (m. vastus lateralis) varied from 25 to 58 fast twitch (FT) fibers. The test consisted of measuring the flight time with a special timer during 60 s continuous jumping. A formula was derived to allow the calculation of mechanical power during a certain period of time (e.g., in the present study every 15 s during 60 s of jumping performance). The relationship between the mechanical power for the first 15 s period correlated best with fast twitch (FT) fiber distribution (r = 0.86, p less than 0.005). However, the power output during the successive 15 s periods demonstrated lower correlation with FT, and this relationship became statistically non-significant after 30 s of work. The sensitivity to fatigue of the test was supported by the relationship observed between the decrease of power during 60 s jumping performance and the percentage of FT fibers (r = 0.73, p less than 0.01). Thus, the present findings suggest that muscular performance, as determined by the new jumping test, is influenced by skeletal muscle fiber composition. The new test, which primarily evaluates maximal short term muscular power, also proved sensitive in assessing fatigue patterns during 60 s of strenuous work.

Store and recoil of elastic energy in slow and fast types of human skeletal muscles.

Stretch-shortening cycle refers to the mechanical condition in which store and recoil of elastic energy occur in the skeletal muscle. This leads to a greater work output when compared to a simple shortening contraction. The subjects performed vertical jumps with and without preliminary counter-movement and with small and large knee angular displacement. The results indicated that those subjects who had more fast twitch (FT) fibers benefited more from the stretching phase performed with high speed and short angular displacement. The amounts of elastic energy stored in this phase were 30 and 26 N X kgBW-1, respectively, for FT and slow twitch (ST) type subjects. The recoil of elastic energy was proportional to the amount of energy storage. In large amplitude jumps where transient period between stretch and shortening is long the both types of subjects demonstrated similar amount of storage of elastic energy (17 and 16 N X kgBW-1, respectively). However, the re-use of this elastic energy was greater in ST group (24%) as compared to the FT group (17%). The results can be interpreted through differences in sarcomere crossbridge life times between fast and slow muscle fibers. The slow type muscle may be able to retain the cross-bridge attachment for a longer period of time and therefore it may utilize elastic energy better in a slow type ballistic motion.

Force-velocity-power characteristics and fiber composition in human knee extensor muscles.

To investigate the influence of skeletal muscle fiber composition on the mechanical characteristics of human skeletal muscle under isometric and dynamic conditions, ten well-trained track athletes with different muscle compositions (m. vastus lateralis) were used. The subjects were instructed to perform maximum isometric and dynamic knee extensions at maximal speed against increasing load. To determine the mechanical properties of the knee extensors a special dynamometer was used. The load was increased by adding weight discs to the electromagnetic part of the dynamometer. The load increased from 0.33-2.33 kg2 moment of inertia in six stages. The data were handled on the basis of Hill's characteristic equation. The subjects were divided into two equal groups, one with more and one with less than 50% of fast twitch fibers. The force-velocity curve was found to be different in the two groups, the subjects with a predominance of fast twitch fibers being able to develop higher power output at a given load. Significant correlations between percentage of fast twitch fiber and power, as well as velocity, were found at the four greater loads only. However, when the percentage of fast twitch fiber and fast twitch fiber cross-sectional areas were combined, significant correlations were also found between this combined parameter and power output at the two lowest loads.

Data on muscle fibre conversion and fibre splitting in man.

A high proportion of the "intermediate" muscle fibres, which are semi-dark after both acidic and alkaline preincubation in ATP-ase staining, was found in the thigh with heart failure. Characteristic patterns of fibre splitting were found mostly in jumpers' muscles. Possibilities of fibre subgroup transformation and fibre hyperplasia due to training are discussed.