Effects of electrical stimulation-induced leg training on skeletal muscle adaptability in spinal cord injury.

Neuromuscular electrical stimulation has grown in popularity as a therapeutic device for training and an ambulation aid to human paralyzed muscle. Despite its current clinical use, few studies have attempted to concurrently investigate the functional and intramuscular adaptations which occur after electrical stimulation training. Six individuals with a spinal cord injury performed 10 weeks of electrical stimulation leg cycle training (30 min d(-1), 3 d week(-1)). The paralyzed vastus lateralis muscle showed significant alterations in skeletal muscle characteristics after the training, indicated by an improvement in total work output (52-112 kJ; P < 0.05), an increase in fiber cross-sectional area (18 to 41 x 10(2) microm(2); P < 0.05), a reduction in the percentage of type IIX fibers (75% to 12%; P < 0.05), a decrease in myosin heavy chain IIx (68% to 44%; P < 0.05), an increase in capillary density (2-3.5 capillaries around fiber; P < 0.05) and increases in activity levels of citrate synthase (7-16 mU mg(-1) protein) and hexokinase (1.2-2.4 mU mg(-1) protein). This study showed that 10 weeks of electrical stimulation training of human paralyzed muscle induces concurrent improvements in functional capacity and oxidative metabolism.

Skeletal muscle metabolic and ionic adaptations during intense exercise following sprint training in humans.

The effects of sprint training on muscle metabolism and ion regulation during intense exercise remain controversial. We employed a rigorous methodological approach, contrasting these responses during exercise to exhaustion and during identical work before and after training. Seven untrained men undertook 7 wk of sprint training. Subjects cycled to exhaustion at 130% pretraining peak oxygen uptake before (PreExh) and after training (PostExh), as well as performing another posttraining test identical to PreExh (PostMatch). Biopsies were taken at rest and immediately postexercise. After training in PostMatch, muscle and plasma lactate (Lac(-)) and H(+) concentrations, anaerobic ATP production rate, glycogen and ATP degradation, IMP accumulation, and peak plasma K(+) and norepinephrine concentrations were reduced (P<0.05). In PostExh, time to exhaustion was 21% greater than PreExh (P<0.001); however, muscle Lac(-) accumulation was unchanged; muscle H(+) concentration, ATP degradation, IMP accumulation, and anaerobic ATP production rate were reduced; and plasma Lac(-), norepinephrine, and H(+) concentrations were higher (P<0.05). Sprint training resulted in reduced anaerobic ATP generation during intense exercise, suggesting that aerobic metabolism was enhanced, which may allow increased time to fatigue.

Effects of electrical stimulation leg training during the acute phase of spinal cord injury: a pilot study.

Four individuals with a spinal cord injury underwent 16 weeks of isometric electrical stimulation training to both legs for 60 min, five times per week during the first 5 months after injury, while two SCI individuals remained untrained. A baseline biopsy sample of the vastus lateralis muscle was obtained within 1 month of injury, and another biopsy sample was taken after a further 16 weeks. The untrained, paralyzed skeletal muscle displayed a reduction in (1) type I fibers (from 50% to 9%), (2) myosin heavy chain (MHC) I (from 27% to 6%), and (3) fiber cross-sectional area of type I, type IIA and type IIX fibers (-62%, -68%, and -55%, respectively) when compared to the baseline sample of muscle taken within 1 month of injury. In contrast, the trained group showed smaller alterations in type I fibers (from 49% to 40%) and MHC I composition (from 39% to 25%), while fiber cross-sectional area was similar to baseline levels for type I, type IIA and type IIX fibers (-3%, -8%, and -4%, respectively). In conclusion, electrical stimulation training can largely prevent the adverse effects of a spinal cord injury upon paralyzed human skeletal muscle if applied soon after the injury.

Cardiorespiratory responses to arm cranking and electrical stimulation leg cycling in people with paraplegia.

PURPOSE: The purpose of this study was to assess the cardiorespiratory responses during arm exercise with and without concurrent electrical stimulation-induced leg cycling in people with paraplegia. METHODS: On separate days, 10 subjects with spinal cord injuries (T5-T12) performed either arm cranking (ACE), or simultaneous arm cranking + electrical stimulation-induced leg cycling (ACE+ES-LCE) graded exercise tests. RESULTS: During submaximal, steady-state exercise, ACE+ES-LCE elicited significantly higher VO2, (by 0.25-0.28 L x min(-1)) stroke volume (by 13 mL), and VE(BTPS) (by 9.4 L x min(-1)) compared with ACE alone. In contrast, there were no significant differences of submaximal HR, cardiac output, or power output between the exercise modes. At maximal exercise, ACE+ES-LCE elicited significantly higher VO2 (by 0.23 L x min(-1)) compared with ACE alone, but there were no differences in power output, HR, or VE(BTPS). CONCLUSIONS: These results demonstrate that during submaximal or maximal exercise there was a greater metabolic stress elicited during ACE+ES-LCE compared with during ACE alone. The higher stroke volume observed during submaximal ACE+ES-LCE, in the absence of any difference in HR, implied a reduced venous pooling and higher cardiac volume loading during ACE+ES-LCE. These results suggest that training incorporating ACE+ES-LCE may be more effective in improving aerobic fitness in people with paraplegia than ACE alone.

Evaluation of supported upper limb exercise capacity in patients with cystic fibrosis.

Physiological responses to upper limb exercise have not been well documented in patients with cystic fibrosis (CF). This is the first study to quantify ventilatory responses to supported incremental upper limb exercise in this patient group. Twenty-four subjects with CF, with a wide range of pulmonary impairment, and ten normal control subjects were studied. Subjects performed pulmonary function tests and incremental arm and leg exercise to peak work capacity on an arm crank and bicycle ergometer. All subjects performed less work with the arms than legs. At an equivalent oxygen consumption, ventilation was higher for arm work than leg work. This higher ventilation was achieved mainly through a higher frequency of breathing. Only CF subjects with severe pulmonary impairment (FEV1 < 40% predicted, FEF25-75% < 20% predicted) had a reduced arm work capacity compared with control subjects. At peak arm work, these subjects had a mean ventilation to maximum voluntary ventilation ratio (VE/MVV) of 106% +/- 25, while maximum heart rate was less than 80% predicted. Despite the high ventilatory requirement for arm exercise, arm work capacity was well maintained in subjects with CF until severe lung disease impaired the ability to further increase ventilation.

Oxygen uptake and heart rate responses during arm vs combined arm/electrically stimulated leg exercise in people with paraplegia.

The purpose of this study was to compare the oxygen uptake and heart rate responses during submaximal arm cranking to combined arm cranking + electrical stimulation (ES)-induced leg cycling in individuals with spinal cord injury (SCI). Seven subjects with paraplegia (T4-T12) performed combined arm and leg cycling exercise for 5 min, followed by arm cranking alone at the same power output for a further 5 min. During both exercise conditions, steady state oxygen consumption (VO2), carbon dioxide output (VCO2), expired ventilation (VE) and heart rate (HR) were determined. The respiratory exchange ratio (RER) and oxygen pulse were calculated from the measured variables. During combined arm + electrical stimulation-induced leg cycling exercise, the VO2 was 25% higher (1.58 l min-1 vs 1.26 l min-1), but the HR was 13% lower (132 b min-1 vs 149 b min-1), than during arm cranking exercise alone. Oxygen pulse and VCO2 were also significantly higher (by 42% and 25%, respectively) during combined arm + ES-induced leg exercise, but there were no differences between the two exercise conditions for VE or RER. These data suggest that the absence of the leg 'muscle pump' and a reduced venous return of blood to the heart elevate exercise heart rates during submaximal arm cranking. Conversely, combined arm cranking + ES-induced leg cycling exercise provides the body with a greater metabolic stress than arm cranking alone, while reducing the cardiac stress. The mechanism explaining the heart rate response, however, remains unclear, but may have been influenced by the blood pressure variations across the range of lesions. The findings from this study may have implications for the relative benefit of combined arm + ES-induced leg cycling training for people with paraplegia.

Impaired calcium pump function does not slow relaxation in human skeletal muscle after prolonged exercise.

This study examined the effects of prolonged exercise on human quadriceps muscle contractile function and homogenate sarcoplasmic reticulum Ca2+ uptake and Ca2+-adenosinetriphosphatase activity. Ten untrained men cycled at 75 +/- 2% (SE) peak oxygen consumption until exhaustion. Biopsies were taken from the right vastus lateralis muscle at rest, exhaustion, and 20 and 60 min postexercise. Peak tension and half relaxation time of the left quadriceps muscle were measured during electrically evoked twitch and tetanic contractions and a maximal voluntary isometric contraction at rest, exhaustion, and 10, 20, and 60 min postexercise. At exhaustion, homogenate Ca2+ uptake and Ca2+ adenosinetriphosphatase activity were reduced by 17 +/- 4 and 21 +/- 5%, respectively, and remained depressed after 60 min recovery (P

Effect of acute plasma volume expansion on substrate turnover during prolonged low-intensity exercise.

We investigated the effect of acute, graded increases in plasma volume (PV) by use of dextran on substrate turnover and oxidation during exercise. Eight untrained males [peak aerobic power (VO2peak) = 45.2 +/- 2.2 (SE) ml.kg-1.min-1] performed 2 h of cycle ergometry at 46 +/- 4% of VO2peak on three occasions in a randomized order: 0% PV expansion (CON) and after 14% (LOW) and 21% (HIGH) PV expansion. Glucose and glycerol turnover were measured using primed continuous infusions of [6,6-2H2]glucose and [2H5]glycerol, respectively. Glycerol rate of appearance (Ra) was taken as a relative index of whole body lipolysis. Increases in PV had no effect on glucose Ra or disappearance (Rd) either at rest or during exercise. At the onset of exercise, both glucose Ra and Rd increased approximately 100% (P < 0.01). Glucose Ra and Rd continued to increase with exercise duration (P < 0.05) so that, at 120 min of exercise, they were > 330% higher than at rest (P < 0.01). Glycerol Ra also increased with exercise duration (P < 0.05). Total lipolysis during exercise, calculated as the area under the glycerol Ra vs. time curve, was reduced during LOW vs. CON (P < 0.01). Further expansion of PV (HIGH) had no additional effect on whole body lipolysis. No effect of hypervolemia was observed on whole body fat or carbohydrate oxidation. These results indicate that acute PV expansion can alter whole body lipolysis, possibly via a reduction in catecholamine secretion.

Necrobiotic palisading suture granulomas involving bone and joint: report of two cases.

Biomaterial used in surgery is relatively inert and non-toxic; however, adverse reactions may follow implantation of such foreign material. We describe the first two cases of bone and joint destruction by necrobiotic palisading suture granulomas. The hypersensitivity reaction occurred years after shoulder repair using silk sutures. One patient received chemotherapy for a mistaken diagnosis of tuberculous arthritis. Although very rare, foreign material should be included in the differential diagnosis of necrotizing granulomas. A history of surgery and microscopic examination with polarized light should allow recognition of this entity.

Plasma concentrations of beta-endorphin in trained eumenorrheic and amenorrheic women.

OBJECTIVE: To characterize the pattern of plasma beta-endorphin throughout the normal menstrual cycle and test the hypothesis that beta-endorphin concentrations are elevated in trained women with amenorrhea compared with trained and sedentary eumenorrheic women. DESIGN: Cohort analytic study. SETTING: Academic research environment. PARTICIPANTS: Healthy female volunteers: 10 eumenorrheic sedentary, 11 eumenorrheic trained, and 11 amenorrheic trained women. INTERVENTIONS: Blood samples were collected three times per week for either one complete menstrual cycle (eumenorrheic sedentary and trained subjects) or for a 4-week period (amenorrheic trained subjects). MAIN OUTCOME MEASURE: Plasma beta-endorphin concentrations. RESULTS: beta-Endorphin levels varied considerably across the sampling period and were not associated with menstrual status, gonadotropin, or gonadal steroid concentrations. Average beta-endorphin levels were not different between the follicular and luteal phases for menstruating subjects, but were greater in the eumenorrheic athletes. Compared with eumenorrheic sedentary subjects, plasma beta-endorphin levels were higher in the athletic groups, regardless of menstrual status. CONCLUSION: There were no cycle-related beta-endorphin changes. Eumenorrheic and amenorrheic athletes have higher beta-endorphin concentrations that may reflect adaptations to intense training and not exercise-associated amenorrhea.

Effects of acute expansion of plasma volume on cardiovascular and thermal function during prolonged exercise.

To investigate the hypothesis that an increase in plasma volume (PV) is obligatory in reducing the cardiovascular drift that is associated with prolonged exercise following training, a plasma expander (Macrodex) was used to acutely elevate PV. Eight untrained volunteers [maximal oxygen consumption; VO2max 45.2 (2.2) ml x kg(-1) x min(-1), mean (SE)] cycled for 2 h [at 46 (4)% VO2max] in ambient conditions either with no PV expansion (CON) or following PV expansions of either 14% (LOW) or 21% (HIGH). During CON, heart rate (HR) increased (P < 0.05) from 147 (2.4) beats x min(-1) to 173 (3.6) beats x min(-1) from 15 to 120 min of exercise. Both LOW and HIGH conditions depressed (P < 0.05) HR, an effect that was manifested following 15 min of exercise. In contrast, stroke volume (SV) was elevated following PV expansion, with values (ml) of 89.6 (6.8), 97.8 (5.9) and 104 (4.6) noted by 15 min of exercise for CON, LOW and HIGH conditions, respectively. Acute PV expansion, regardless of magnitude, also resulted in elevations in cardiac output (Qc). These differences between conditions persisted throughout the exercise, as did the elevation in Qc that was noted with LOW and HIGH conditions. No difference between Qc, HR or SV was found between LOW and HIGH. In addition, neither LOW nor HIGH conditions altered the change in rectal temperature that was observed during exercise. These results demonstrate that, at least for moderate exercise performed in ambient conditions, PV expansion serves only to alter cardiac function (Qc, HR, SV) early in exercise, and not to attenuate the drift that occurs as the exercise is prolonged.

Cardiovascular and metabolic responses to electrical stimulation-induced leg exercise in spinal cord injury.

Electrical stimulation-induced leg muscle contractions provide a useful model for examining the role of leg muscle neural afferents during low-intensity exercise in persons with spinal cord-injury and their able-bodied cohorts. Eight persons with paraplegia (SCI) and 8 non-disabled subjects (CONTROL) performed passive knee flexion/extension (PAS), electrical stimulation-induced knee flexion/extension (ES) and voluntary knee flexion/extension (VOL) on an isokinetic dynamometer. In CONTROLs, exercise heart rate was significantly increased during ES (94 +/- 6 bpm) and VOL (85 +/- 4 bpm) over PAS (69 +/- 4 bpm), but no changes were observed in SCI individuals. Stroke volume was significantly augmented in SCI during ES (59 +/- 5 ml) compared to PAS (46 +/- 4 ml). The results of this study suggest that, in able-bodied humans, Group III and IV leg muscle afferents contribute to increased cardiac output during exercise primarily via augmented heart rate. In contrast, SCI achieve raised cardiac output during ES leg exercise via increased venous return in the absence of any change in heart rate.

Reduced muscle lactate during prolonged exercise following induced plasma volume expansion.

To examine the effects of a dilutional mediated decrease in arterial O2 content on muscle metabolic and substrate behaviour during exercise, plasma volume was acutely expanded by either 14% (LOW) or 21% (HIGH) using a 6% dextran solution dissolved in saline (Macrodex) and compared with a control (CON) condition. The exercise protocol, performed by eight untrained males (VO2max = 45.2 +/- 2.2 mL.kg-1.min-1, X +/- SE) and with the conditions randomized, was conducted for 120 min at 46 +/- 4% VO2max. The content of inosine monophosphate determined on muscle tissue extracted from the vastus lateralis increased (p < 0.05) by 120 min of exercise (0.119 +/- 0.02 vs 0.493 +/- 0.19 mmol/kg dry weight) in CON. No effect of either LOW or HIGH expansion of plasma volume was found. Similarly, phosphocreatine content (mmol/kg dry weight), although reduced (p < 0.05) with exercise, was not different between the conditions at either 3 min (61.9 +/- 3.5, 66.2 +/- 3.5, 64.3 +/- 2.1) or 120 min (52.5 +/- 6.3, 53.8 +/- 5.8, 59.4 +/- 5.5) of exercise. In contrast, both pyruvate and lactate were reduced (p < 0.05) by 3 min of exercise in both LOW and HIGH compared with CON. The reduction in these metabolites with plasma volume expansion was not accompanied by an alteration in glycogen depletion rates. Steady-state VO2 was unaffected by acute hypervolemia. These results suggest that moderate exercise following an approximate 10% reduction in arterial O2 content can be performed without increasing the imbalance between ATP production and utilization rates. Since high energy phosphate transfer and glycolysis appeared not to be increased, mitochondrial respiration was apparently preserved by mechanisms as yet undetermined.

Fluid and electrolyte hormonal responses to exercise and acute plasma volume expansion.

To investigate the effect of acute graded increases in plasma volume (PV) on fluid and regulatory hormone levels, eight untrained men (peak aerobic power 45.2 +/- 2.2 ml.kg-1.min-1) performed prolonged cycle exercise (46 +/- 4% maximal aerobic power on three occasions, namely, with no PV expansion (Con) and after 14% (Low) and 21% (High) expansions, respectively. The exercise plasma levels of aldosterone (Aldo), arginine vasopressin (AVP), and atrial natriuretic peptide (ANP) were all altered by acute PV increases. A pronounced blunting (P < 0.05) of the Aldo response during exercise was observed, the magnitude of which was directly related to the amount of hypervolemia (Con < Low < High). At 120 min of exercise, Aldo concentrations were 660 +/- 71, 490 +/- 85, and 365 +/- 78 pg/ml for Con, Low, and High conditions, respectively. In contrast, the lower AVP and the higher ANP observed during exercise appeared to be due to the effect of PV expansion on resting concentrations. Because osmolality did not vary among conditions, the results indicate that PV represents an important primary stimulus in the response of Aldo to exercise. The lower exercise blood concentrations of both epinephrine and norepinephrine observed with PV expansion would suggest that a lower sympathetic drive may be implicated at least in the lower Aldo responses.

Interrelationships between muscle morphology, insulin action, and adiposity.

There is evidence that insulin resistance and obesity are associated with relative increases in the proportion of glycolytic type IIb muscle fibers and decreases in the proportion of oxidative type I fibers. Futhermore, insulin resistance and obesity are associated with the fatty acid (FA) profile of structural membrane lipids. The present study was undertaken to define interrelationships between muscle fiber type and oxidative capacity, muscle membrane FA composition, and insulin action and obesity. Muscle morphology, insulin action, and body fat content were measured in 48 male nondiabetic Pima Indians. Percent body fat (pFAT, determined by hydrodensitometry) correlated negatively with percentage of type I fibers (r = -0.44, P = 0.002) and positively with percentage of type IIb fibers (r = 0.40, P = 0.005). Consistent with this finding, pFAT was also significantly related to oxidative capacity of muscle, as assessed by NADH staining (r = -0.47, P = 0.0007) and citrate synthase (CS) activity (r = -0.43, P = 0.008). Insulin action was correlated with oxidative capacity (CS; r = 0.41, P = 0.01) and weakly correlated with percentage of type IIb fibers (r = -0.29, P = 0.05). In addition, relationships were shown between muscle fiber type and FA composition (e.g., percentage of type I fibers related to n-3 FA; r = 0.37, P = 0.01). Thus leaness and insulin sensitivity are associated with increased oxidative capacity and unsaturation of membranes in skeletal muscle. Present studies support the hypothesis that muscle oxidative capacity and fiber type may play a genetically determined or an environmentally modified role in development of obesity and insulin resistance.

Altitude and beta-blockade augment glucose utilization during submaximal exercise.

To test the hypothesis that altitude exposure increases glucose utilization and that this increment is mediated by a beta-adrenergic mechanism, the effects of hypobaric hypoxia and beta-blockade on glucose rates of appearance (Ra), disappearance (Rd), oxidation (Rox), and leg uptake [G = 2(arteriovenous glucose difference)(1 - leg blood flow)] were measured during rest and a given submaximal exercise task. We studied six healthy beta-blocked (beta) men [26.7 +/- 1.2 (SE) yr, 74.0 +/- 6.6 kg] and five matched controls (C; 26 +/- 1.2 yr, 69.3 +/- 2.6 kg) in energy and nitrogen balance during rest and leg cycle-ergometer exercise at sea level, on acute altitude exposure to 4,300 m (barometric pressure = 463 Torr), and after 3 wk of habituation. Subjects received a primed continuous infusion of [6,6-2H]- and [1-13C]glucose, rested for > or = 90 min, and then immediately exercised for 45 min at 89 W, which elicited 49% of sea-level peak O2 consumption (VO2peak; 65% of altitude VO2peak). At sea level, resting Ra was 1.47 +/- 0.19 and 1.66 +/- 0.16 mg x kg-1 x min-1 for C and beta, respectively, and increased to 3.04 +/- 0.25 and 3.56 +/- 0.27 mg x kg-1 x min-1, respectively, during exercise. Thus glucose Ra was significantly increased by beta-blockade during rest and exercise at sea level. At sea level, beta-blockade increased leg G, which accounted for 49 and 69% of glucose disposal during exercise in C and beta, respectively. On acute altitude exposure, glucose Ra rose significantly during rest and exercise relative to sea level, whereas blockade continued to augment this increment. During exercise on acute exposure, G increased more than at sea level and accounted for a greater percentage (80 and 97%, respectively) of Rd in C and beta during exercise. Similarly, Rox values, particularly during exercise, were increased significantly at altitude relative to sea level, and beta-blockade potentiated this effect. During a given submaximal exercise task after acclimatization, glucose Ra, Rox, and G were increased relative to sea level, but these increments were less than those in response to exercise measured on acute exposure. We conclude that altitude exposure increases glucose use during rest and a given submaximal exercise bout and beta-blockade exaggerates the response.

Dynamics of periodic breathing and arousal during sleep at extreme altitude.

To determine whether nocturnal periodic breathing (PB) at altitude is due primarily to unstable control of ventilation or the inability to maintain stable sleep states, we performed visual and computer analyses of the electroencephalographic and respiratory records of healthy volunteers at simulated altitudes of 4572, 6100 and 7620 m. Transient arousals were associated with < 52% of the apneas identified; thus, the PB cycle was not always associated with transient arousal. Following the termination of oxygen breathing, the reinitiation of PB was not dependent on the occurrence of arousal as the primary event. The transition from apnea to breathing preceded the appearance of arousal by approximately 1 to 4 sec. Ventilatory drive in the breaths immediately following arousal was significantly larger than corresponding control breaths, matched for SaO2. Our findings suggest that altitude-induced PB is unlikely to result from primary fluctuations in state. Arousals promote the development of PB with apnea and help to sustain these episodes, but are not necessary for their initiation.

Smaller alveolar-arterial O2 gradients in Tibetan than Han residents of Lhasa (3658 m).

Previous studies have indicated that native Tibetans have a larger lung capacity and better maintain arterial O2 saturation during exercise than Han ("Chinese") acclimatized lowlanders. To test if differences in ventilation or alveolar-arterial O2 gradient (A-aDO2) were responsible, we compared 10 lifelong Tibetan and 9 Han acclimatized newcomer residents of Lhasa (3658 m) at rest and during progressive exercise. Resting blood gas tensions and arterial O2 saturation in the two groups were similar. During exercise the Tibetans had lower total ventilation and higher arterial CO2 tensions than the Han (both P < 0.01) and markedly lower A-aDO2 (7 +/- 1 vs. 11 +/- 1, 13 +/- 1 vs. 18 +/- 1, and 14 +/- 1 vs. 20 +/- 1 mmHg at light, medium, and heavy workloads respectively, all P < 0.01). The Tibetans' narrower A-aDO2 compensated for their lower exercise ventilation such that arterial O2 tension and saturation were raised above acclimatized newcomer values and better maintained during exercise. We concluded that the Tibetans exhibited more efficient pulmonary gas exchange which compensated for reduced ventilation and lessened respiratory effort.

Pedal forces produced during neuromuscular electrical stimulation cycling in paraplegics.

This study investigated forces applied to the pedal of a cycle ergometer by paraplegic subjects undergoing neuromuscular electrical-stimulation-induced leg exercise. The patterns of force application were compared with those of able-bodied subjects cycling under voluntary muscle control in order to investigate the effectiveness of the muscle stimulation parameters. Results show that paraplegic subjects applied significantly larger peak forces than the able-bodied subjects because of the short duration of neuromuscular stimulation. Able-bodied subjects were able to achieve the same average workload by applying smaller forces over a greater percentage of each crank revolution. It is suggested that the large forces produced by paraplegic subjects contribute to the low efficiency reported by previous studies, and that increasing the range of angles over which muscles are stimulated may provide a means to increase the efficiency of cycling for paraplegic individuals.

Relationships between muscle membrane lipids, fiber type, and enzyme activities in sedentary and exercised rats.

Insulin resistance in skeletal muscle is associated with 1) relative increases in the proportion of glycolytic and fast-twitch muscle fibers and decreases in the proportion of more oxidative fibers and 2) a higher proportion of the saturated fatty acids in membrane structural lipids. Exercise is known to improve insulin action. The aims of the current studies were 1) to investigate the relationship between muscle fiber type and membrane fatty acid composition and 2) to determine how voluntary exercise might influence both variables. In sedentary Wistar rats in experiment 1, increased amounts of unsaturated fatty acids were found in the more oxidative insulin-sensitive red quadriceps and soleus muscles, whereas reduced levels of polyunsaturated fatty acids were found in primarily glycolytic white quadriceps muscles. In experiment 2, voluntary running-wheel exercise by adult female rats over 45 days resulted in reduced proportions of type IIb fibers (P = 0.01) and increased proportions of type IIa/IIx fibers (P = 0.03) in extensor digitorum longus muscle. The magnitude of these changes was related to the distance run (r = -0.73, P = 0.04; r = 0.79, P = 0.02, respectively). Exercise significantly increased oxidative capacity, as assessed by the proportion of intensely NADH-stained fibers (P = 0.0004) and citrate synthase (P = 0.003) and hexokinase (P = 0.04) activities. Citrate synthase activity was also increased by exercise in soleus muscle, where, as expected, no fiber type changes were detected. No significant differences in the fatty acid profile of soleus and extensor digitorum longus were found between groups.(ABSTRACT TRUNCATED AT 250 WORDS)