Effects of electrically induced fatigue on the twitch and tetanus of paralyzed soleus muscle in humans.

We analyzed the twitch and summated torque (tetanus) during repetitive activation and recovery of the human soleus muscle in individuals with spinal cord injury. Thirteen individuals with complete paralysis (9 chronic, 4 acute) had the tibial nerve activated every 1,500 ms with a 20-Hz train (7 stimuli) for 300 ms and a single pulse at 1,100 ms. The stimulation protocol lasted 3 min and included 120 twitches and 120 tetani. Minimal changes were found for the acute group. The chronic group showed a significant reduction in the torque and a significant slowing of the contractile speeds of both the twitch and tetanus. The decrease in the peak twitch torque was significantly greater than the decrease in the peak tetanus torque early during the fatigue protocol for the chronic group. The twitch time to peak and half relaxation time were prolonged during fatigue, which was associated with improved fusion of the tetanus torque. At the end of the fatigue protocol, the decrease in the peak twitch torque was not significantly different from the decrease in the peak tetanus torque. After 5 min of rest, the contractile speeds recovered causing the tetanus to become unfused, but the tetanus torque became less depressed than the twitch torque. The differential responses for the twitch and the tetanus suggest an interplay between optimal fusion created from contractile speed slowing and excitation contraction coupling compromise. These issues make the optimal design of functional electrical stimulation systems a formidable task.

Clinical norms for amplitude of accommodation in Chinese.

Amplitude of accommodation was measured in 121 Hong Kong Chinese subjects between the ages of 11 and 65 years, using the 'push-up' method and the results compared with those previously obtained for Caucasian subjects. The results confirm and quantify clinical experience that Chinese people have lower amplitudes of accommodation than Caucasians. If presbyopia is considered to commence when the amplitude of accommodation declines to less than 5 D, then presbyopia in the Chinese race occurs between the ages of 36 and 40 years. By early in the second decade of life the amplitude of accommodation in the Chinese is already lower than that of Caucasians. This suggests that reduced amplitude of accommodation may be due, at least in part, to factors other than longterm environmental effects.