Facilitation-inhibition control of motor neuronal persistent inward currents in young and older adults.

A well-coordinated facilitation-inhibition control of motor neuronal persistent inward currents (PICs) via diffuse neuromodulation and local inhibition is essential to ensure motor units discharge at required times and frequencies. Present best estimates indicate that PICs are reduced in older adults; however, it is not yet known whether PIC facilitation-inhibition control is also altered with ageing. We investigated the responses of PICs to (i) a remote handgrip contraction, which is believed to diffusely increase serotonergic input onto motor neurones, and (ii) tendon vibration of the antagonist muscle, which elicits reciprocal inhibition, in young and older adults. High-density surface electromyograms were collected from soleus and tibialis anterior of 18 young and 26 older adults during triangular-shaped plantar and dorsiflexion contractions to 20% (handgrip experiments) and 30% (vibration experiments) of maximum torque (rise-decline rate of 2%/s). A paired-motor-unit analysis was used to calculate ∆F, which is assumed to be proportional to PIC strength. ΔF increased in both soleus (0.55 peaks per second (pps), 16.0%) and tibialis anterior (0.42 pps, 11.4%) after the handgrip contraction independent of age. Although antagonist tendon vibration reduced ΔF in soleus (0.28 pps, 12.6%) independent of age, less reduction was observed in older (0.42 pps, 10.7%) than young adults (0.72 pps, 17.8%) in tibialis anterior. Our data indicate a preserved ability of older adults to amplify PICs following a remote handgrip contraction, during which increased serotonergic input onto the motor neurones is expected, in both lower leg muscles. However, PIC deactivation in response to reciprocal inhibition was impaired with ageing in tibialis anterior despite being preserved in soleus. KEY POINTS: Motor neuronal persistent inward currents (PICs) are facilitated via diffuse neuromodulation and deactivated by local inhibition to ensure motor units discharge at required times and frequencies, allowing normal motor behaviour. PIC amplitudes appear to be reduced with ageing; however, it is not known whether PIC facilitation-inhibition control is also altered. Remote handgrip contraction, which should diffusely increase serotonergic input onto motor neurones, facilitated PICs similarly in both soleus and tibialis anterior of young and older adults. Antagonist tendon vibration, which induces reciprocal inhibition, reduced PICs in soleus in both young and older adults but had less effect in tibialis anterior in older adults. Data from lower-threshold motor units during low-force contractions suggest that PIC facilitation is preserved with ageing in soleus and tibialis anterior. However, the effect of reciprocal inhibition on the contribution of PICs to motor neurone discharge seems reduced in tibialis anterior but preserved in soleus.

Anatomical and Neuromuscular Determinants of Strength Change in Previously Untrained Men Following Heavy Strength Training.

This study examined whether changes in strength following a moderate-duration strength training program were associated with changes in specific combinations of anatomical and neuromuscular variables. 36 men (18-40 y) completed 10 weeks of lower-limb heavy resistance (6-RM) strength training. Measurements included cross-sectional area (CSA), fascicle length (lf) and fascicle angle (θf) from proximal, middle and distal regions of the four quadriceps components; agonist (EMG:M), antagonist (EMG) muscle activities and percent voluntary quadriceps activation (%VA; interpolated twitch technique); patellar tendon moment arm distance; and maximal isometric, concentric and eccentric (60° s-1) torque. Multiple regression models were developed to quantify the relationship between the change in maximum torque and the changes in combinations of anatomical and neuromuscular variables. The best model for each contraction mode was determined using Akaike's Information Criterion (AICc), an information-theoretic approach for model selection. Strength increased significantly following training (mean range = 12.5-17.2%), and moderate relationships were observed between modeled data (using best-fit prediction models) and the change in torque for each contraction mode. The change in isometric torque was best (although weakly) predicted by the linear combination of the change in proximal-region vastus lateralis (VL) CSA and fascicle angle (R 2 = 0.27, p < 0.05; AICc wi = 0.52, i.e., the probability the model would be selected as the "best model"). The models best predicting the change in concentric and eccentric torque both included the combination of the change in quadriceps (i.e., mean of all muscles) EMG:M and the change in vastus intermedius fascicle angle combined with either a change in proximal-region VL (R 2 = 0.40, p < 0.001; AICc wi = 0.15) or whole quadriceps (R 2 = 0.41, p < 0.001; AICc wi = 0.30) CSA (concentric and eccentric, respectively). Models incorporating the change in proximal CSA typically received substantial support (AICC < 2) for concentric torque prediction models, and the change in % VA and pre-training moment arm distance had substantial support for use in eccentric torque prediction models. In conclusion, adaptations varied between individuals, however strength training programs targeted to improve a group of variables that particularly includes agonist muscle activation might yield the greatest improvements in concentric and eccentric knee extension strength, whereas proximal muscle size and fascicle angle appear most important for isometric torque improvements.

The effects of flexibility training on exercise-induced muscle damage in young men with limited hamstrings flexibility.

Adaptations to 6 weeks of supervised hamstring stretching training and its potential impact on symptoms of eccentric exercise-induced muscle damage (EIMD) were studied in 10 young, untrained men with limited hamstrings flexibility. Participants performed unilateral flexibility training (experimental leg; EL) on an isokinetic dynamometer, while the contralateral limb acted as control (CL). Hip range of motion (ROM), passive, isometric, and concentric torques, active optimum angle, and biceps femoris and semitendinosus muscle thickness and ultrasound echo intensity were assessed both before and after the training. Additionally, muscle soreness was assessed before and after an acute eccentric exercise bout in both legs (EL and CL) at post-training only. Hip ROM increased (P < .001) only in EL after the training (EL = 10.6° vs CL = 1.6°), but no changes (P > .05) in other criterion measurements were observed. After a bout of eccentric exercise at the end of the program, isometric and dynamic peak torques and muscle soreness ratings were significantly altered at all time points equally in EL and CL. Also, active optimum angle was reduced immediately, 48 and 72 hours post-exercise, and hip ROM was reduced at 48 and 72 hours equally in EL and CL. Finally, biceps femoris muscle thickness was significantly increased at all time points, and semitendinosus thickness and echo intensity significantly increased at 72 hours, with no significant differences between legs. The stretching training protocol significantly increased hip ROM; however, it did not induce a protective effect on EIMD in men with tight hamstrings.

Change in knee flexor torque after fatiguing exercise identifies previous hamstring injury in football players.

Muscular fatigue and interlimb strength asymmetry are factors known to influence hamstring injury risk; however, limb-specific exacerbation of knee flexor (hamstrings) torque production after fatiguing exercise has previously been ignored. To investigate changes in muscular force production before and after sport-specific (repeated-sprint) and non-specific (knee extension-flexion) fatiguing exercise, and explore the sensitivity and specificity of isokinetic endurance (ie, muscle-specific) and single-leg vertical jump (ie, whole limb) tests to identify previous hamstring injury. Twenty Western Australia State League footballers with previous unilateral hamstring injury and 20 players without participated. Peak concentric knee extensor and flexor (180°âˆ™s-1 ) torques were assessed throughout an isokinetic endurance test, which was then repeated alongside a single-leg vertical jump test before and after maximal repeated-sprint exercise. Greater reductions in isokinetic knee flexor torque (-16%) and the concentric hamstring:quadriceps peak torque ratio (-15%) were observed after repeated-sprint running only in the injured (kicking) leg and only in the previously injured subjects. Changes in (1) peak knee flexor torque after repeated-sprint exercise, and (2) the decline in knee flexor torque during the isokinetic endurance test measured after repeated-sprint exercise, correctly identified the injured legs (N = 20) within the cohort (N = 80) with 100% specificity and sensitivity. Decreases in peak knee flexor torque and the knee flexor torque during an isokinetic endurance test after repeated-sprint exercise identified previous hamstring injury with 100% accuracy. Changes in knee flexor torque, but not SLVJ, should be tested to determine its prospective ability to predict hamstring injury in competitive football players.

Vastus intermedius vs vastus lateralis fascicle behaviors during maximal concentric and eccentric contractions.

Vastus intermedius (VI) plays a major role in knee extension, but its fascicle behaviors during dynamic contractions are not well understood. This study aimed to compare VI and vastus lateralis (VL) fascicle behaviors during singular maximal concentric and eccentric contractions. Thirteen men (27.1 ± 3.4 years) performed maximal isokinetic concentric contractions through knee joint angles of 105° to 35° (0° = full extension) and eccentric contractions from 35° to 105° at an angular velocity of 30°/s. Longitudinal VI and VL sonographic images were simultaneously recorded at 30 Hz, and muscle fascicle lengths at the knee joint angles of 40° and 100° were measured to compare the magnitudes of fascicle length change between the muscles. During concentric contractions, VI and VL fascicle lengths at 100° were 108 ± 12 mm and 104 ± 12 mm, respectively, and shortened by 36 ± 12 mm for VI and 28 ± 13 mm for VL (not statistically different; P = .13) at 40°. During eccentric contractions, VI and VL fascicle lengths at 40° were 72 ± 7 mm and 75 ± 8 mm, respectively, but lengthened by 35 ± 9 mm for VI and 24 ± 5 mm for VL at 100°, with a significant difference between the muscles (P = .01). These results indicate that VI fascicles are lengthened 1.4 times more than VL fascicles during eccentric contractions, whereas VI and VL fascicles shorten similarly during concentric contractions. This suggests a possibility that a greater mechanical strain is imposed to VI than VL during eccentric contractions.

Effects of resistance training using known vs unknown loads on eccentric-phase adaptations and concentric velocity.

The aims of this study were to compare both eccentric- and concentric-phase adaptations in highly trained handball players to 4 weeks of twice-weekly rebound bench press throw training with varying loads (30%, 50% and 70% of one-repetition maximum [1-RM]) using either known (KL) or unknown (UL) loads and to examine the relationship between changes in eccentric- and concentric-phase performance. Twenty-eight junior team handball players were divided into two experimental groups (KL or UL) and a control group. KL subjects were told the load prior each repetition, while UL were blinded. For each repetition, the load was dropped and then a rebound bench press at maximum velocity was immediately performed. Both concentric and eccentric velocity as well as eccentric kinetic energy and musculo-articular stiffness prior to the eccentric-concentric transition were measured. Results showed similar increases in both eccentric velocity and kinetic energy under the 30% 1-RM but greater improvements under 50% and 70% 1-RM loads for UL than KL. UL increased stiffness under all loads (with greater magnitude of changes). KL improved concentric velocity only under the 30% 1-RM load while UL also improved under 50% and 70% 1-RM loads. Improvements in concentric movement velocity were moderately explained by changes in eccentric velocity (R2 =.23-.62). Thus, UL led to greater improvements in concentric velocity, and the improvement is potentially explained by increases in the speed (as well as stiffness and kinetic energy) of the eccentric phase. Unknown load training appears to have significant practical use for the improvement of multijoint stretch-shortening cycle movements.

Hamstring-to-quadriceps fatigue ratio offers new and different muscle function information than the conventional non-fatigued ratio.

Commonly used injury risk prediction tests such as the hamstring-to-quadriceps (H:Q) strength ratio appear to be poor predictors of non-contact injury. However, these tests are typically performed in a non-fatigued state, despite accumulated fatigue being an important risk factor for both hamstring strain (HS) and anterior cruciate ligament (ACL) injuries in professional soccer players. After the effect of different H:Q calculation methods were compared and contrasted, the influence of neuromuscular fatigue on the H:Q strength ratio and the association between fatigued and non-fatigued ratio scores were examined. Thirty-five professional soccer players performed a 30-repetition isokinetic fatigue test protocol. Peak knee joint moments were computed for each repetition, and the H:Q conventional ratio (H:QCR ) was calculated using several different, previously published, methods. Knee extensor and flexor moments were statistically decreased by the sixth repetition and continued to decrease until the end of the protocol. However, the H:Q ratio was statistically decreased at the end of the test due to a significant reduction in knee flexor moment (correlation between change in knee flexor moment and change in H:Q, r≈.80; P<.01). Moreover, H:Q measured in fatigue (ie, H:QFatigue ) at the end of the test was greater than H:QCR (1.25-1.38 vs 0.70, P<.01), these variables were weakly correlated (r=.39, P=.02), and subject rankings within the cohort based on H:QCR and H:QFatigue were different (rs =0.25, P=.15). The present data suggest that H:Q ratio measurement during a fatiguing test (H:QFatigue ) provides different outcomes to the traditional H:QCR . The observed significant hamstring fatigue and the difference, and weak correlation, between H:QCR and H:QFatigue indicate that useful information might be obtained with respect to the prediction of HS and ACL injury risk. The potential predictive value of H:QFatigue warrants validation in future prospective trials.

Anatomical and neuromuscular variables strongly predict maximum knee extension torque in healthy men.

PURPOSE: This study examined the relative influence of anatomical and neuromuscular variables on maximal isometric and concentric knee extensor torque and provided a comparative dataset for healthy young males. METHODS: Quadriceps cross-sectional area (CSA) and fascicle length (l f) and angle (θ f) from the four quadriceps components; agonist (EMG:M) and antagonist muscle activity, and percent voluntary activation (%VA); patellar tendon moment arm distance (MA) and maximal voluntary isometric and concentric (60° s(-1)) torques, were measured in 56 men. Linear regression models predicting maximum torque were ranked using Akaike's Information Criterion (AICc), and Pearson's correlation coefficients assessed relationships between variables. RESULTS: The best-fit models explained up to 72 % of the variance in maximal voluntary knee extension torque. The combination of 'CSA + Î¸ f + EMG:M + %VA' best predicted maximum isometric torque (R (2) = 72 %, AICc weight = 0.38) and 'CSA + Î¸ f + MA' (R (2) = 65 %, AICc weight = 0.21) best predicted maximum concentric torque. CONCLUSION: Proximal quadriceps CSA was included in all models rather than the traditionally used mid-muscle CSA. Fascicle angle appeared consistently in all models despite its weak correlation with maximum torque in isolation, emphasising the importance of examining interactions among variables. While muscle activity was important for torque prediction in both contraction modes, MA only strongly influenced maximal concentric torque. These models identify the main sources of inter-individual differences strongly influencing maximal knee extension torque production in healthy men. The comparative dataset allows the identification of potential variables to target (i.e. weaknesses) in individuals.

Load knowledge reduces rapid force production and muscle activation during maximal-effort concentric lifts.

PURPOSE: Rapid force development is a key factor influencing performance and injury risk in movements where little time is available for force production; thus there is a need to develop interventions that enhance this ability. In the present study, the influence of load knowledge on mechanical output [rate of force development; (RFD) and power] and muscle activation [electromyographic (EMG) responses] in the concentric-only bench press throw exercise was studied. METHODS: Fifteen strength-trained individuals performed 6 sets of 6 maximal explosive repetitions in a single test session after extensive familiarization. In three of these sets the subjects were given knowledge about the load before each repetition (known condition; KC), whereas in the other three sets they were given no information (unknown condition; UC). In both conditions the loads were 30, 50 and 70 % of maximum, but condition and load orders were randomized. RESULTS: RFD (24-50 %) and power output (20-39 %) were significantly higher in UC in the early time intervals from movement onset (<150 ms). In addition, UC elicited greater EMG amplitudes in anterior deltoid both prior to movement onset (pre50-0 ms) and in the early time intervals (<100 ms) after movement onset, and in pectoralis major after movement onset (<100 ms). CONCLUSIONS: UC resulted in a greater initial activation of the muscles and both a higher RFD and mechanical power output in the early phase of the movement under all loading conditions (30-70 % of maximum). UC appears to offer a novel neuromuscular stimulus, and further research on the effects of continued exposure is warranted.

Influence of Strength, Sprint Running, and Combined Strength and Sprint Running Training on Short Sprint Performance in Young Adults.

The purpose of this study was to assess the degree of transference of 6 weeks of full squat vs. full squat plus sprint running training to short (ranged from 0-10 to 0-30 m) sprint running performance in non-athletes. We hypothesized that a speed-full-squat training regimen could enhance squat strength and power with simultaneous improvements in short sprint performance. 122 physically active adults (age: 20.5±2.5 years; body mass: 65.8±6.1 kg; height: 1.71±0.08 m) were randomly divided into 4 groups: full squat training (n=36), combined full squat and sprint training (n=32), speed training only (n=34) and non-training control group (n=20). Each training group completed 2 sessions per week over 6 weeks, while the control group performed only their normal physical activity. Sprint performance was improved after sprint running or full squat training alone (1.7% and 1.8% P<0.05, respectively), however larger enhancements (2.3%; P<0.01) were observed after the combined full squat plus sprint training intervention. These results suggest that in recreationally active adults, combined full squat and sprint training provides a greater stimulus for improving sprint performance than either modality alone.

Effects of resistance training on tendon mechanical properties and rapid force production in prepubertal children.

Children develop lower levels of muscle force, and at slower rates, than adults. Although strength training in children is expected to reduce this differential, a synchronous adaptation in the tendon must be achieved to ensure forces continue to be transmitted to the skeleton with efficiency while minimizing the risk of strain-related tendon injury. We hypothesized that resistance training (RT) would alter tendon mechanical properties in children concomitantly with changes in force production characteristics. Twenty prepubertal children (age 8.9 ± 0.3 yr) were equally divided into control (nontraining) and experimental (training) groups. The training group completed a 10-wk RT intervention consisting of 2-3 sets of 8-15 plantar flexion contractions performed twice weekly on a recumbent calf-raise machine. Achilles tendon properties (cross-sectional area, elongation, stress, strain, stiffness, and Young's modulus), electromechanical delay (EMD; time between the onset of muscle activity and force), rate of force development (RFD; slope of the force-time curve), and rate of electromyographic (EMG) increase (REI; slope of the EMG time curve) were measured before and after RT. Tendon stiffness and Young's modulus increased significantly after RT in the experimental group only (∼29% and ∼25%, respectively); all other tendon properties were not significantly altered, although there were mean decreases in both peak tendon strain and strain at a given force level (14% and 24%, respectively; not significant) which may have implications for tendon injury risk and muscle fiber mechanics. A decrease of ∼13% in EMD was found after RT for the experimental group, which paralleled the increase in tendon stiffness (r = -0.59); however, RFD and REI were unchanged. The present data show that the Achilles tendon adapts to RT in prepubertal children and is paralleled by a change in EMD, although the magnitude of this change did not appear to be sufficient to influence RFD. These findings are of importance within the context of the efficiency and execution of movement.

Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans.

The neuromuscular adaptations in response to muscle stretch training have not been clearly described. In the present study, changes in muscle (at fascicular and whole muscle levels) and tendon mechanics, muscle activity, and spinal motoneuron excitability were examined during standardized plantar flexor stretches after 3 wk of twice daily stretch training (4 × 30 s). No changes were observed in a nonexercising control group (n = 9), however stretch training elicited a 19.9% increase in dorsiflexion range of motion (ROM) and a 28% increase in passive joint moment at end ROM (n = 12). Only a trend toward a decrease in passive plantar flexor moment during stretch (-9.9%; P = 0.15) was observed, and no changes in electromyographic amplitudes during ROM or at end ROM were detected. Decreases in H(max):M(max) (tibial nerve stimulation) were observed at plantar flexed (gastrocnemius medialis and soleus) and neutral (soleus only) joint angles, but not with the ankle dorsiflexed. Muscle and fascicle strain increased (12 vs. 23%) along with a decrease in muscle stiffness (-18%) during stretch to a constant target joint angle. Muscle length at end ROM increased (13%) without a change in fascicle length, fascicle rotation, tendon elongation, or tendon stiffness following training. A lack of change in maximum voluntary contraction moment and rate of force development at any joint angle was taken to indicate a lack of change in series compliance of the muscle-tendon unit. Thus, increases in end ROM were underpinned by increases in maximum tolerable passive joint moment (stretch tolerance) and both muscle and fascicle elongation rather than changes in volitional muscle activation or motoneuron pool excitability.

The effects of two weeks of recombinant growth hormone administration on the response of IGF-I and N-terminal pro-peptide of collagen type III (P-III-NP) during a single bout of high resistance exercise in resistance trained young men.

OBJECTIVE: Recombinant human growth hormone (rhGH) is used by some athletes and body builders with the aim of enhancing performance, building muscle and improving physique. Detection of the misuse of rhGH has proved difficult for a number of reasons. One of these is the effect of preceding exercise. In this randomised, double blind placebo-controlled study, we determined the effects of rhGH administration in male amateur athletes on two candidate markers of rhGH abuse, IGF-I and N-terminal pro-peptide of collagen type III (P-III-NP), following a bout of weightlifting exercise. DESIGN: Sixteen men entered a four-week general weight training programme to homogenise their activity profile. They then undertook repeated bouts of standardised leg press weightlifting exercise (AHRET-acute heavy resistance exercise test). Blood samples were taken before and up to one hour after the AHRET. After the first laboratory visit (Test 1), the subjects were randomly assigned to receive daily injections of either rhGH (0.1 IU kg(-1) day(-1)) or placebo for two weeks. The AHRET was repeated after the two-week dosing period (Test 2) and a further test was undertaken following a one-week washout (Test 3). RESULTS: There was no effect of exercise on either IGF-I or P-III-NP in any test. Both markers were markedly elevated at Test 2 (p<0.001), with P-III-NP remaining elevated at Test 3 in the GH administration group (p<0.05). Application of the GH-2000 discriminant function positively identified GH administration in 17 of 40 blood samples taken at Test 2 from the rhGH group and none from the placebo group. CONCLUSION: The data show that rhGH results in elevated levels of IGF-I and P-III-NP in well-trained individuals and that leg press weightlifting exercise does not affect these markers. The GH-2000 discriminant function identified four of eight subjects taking rhGH with no false positive results.

Neuromuscular factors influencing the maximum stretch limit of the human plantar flexors.

Maximum joint range of motion is an important parameter influencing functional performance and musculoskeletal injury risk. Nonetheless, a complete description of the muscle architectural and tendon changes that occur during stretch and the factors influencing maximum range of motion is lacking. We measured muscle-tendon elongation and fascicle lengthening and rotation sonographically during maximal plantar flexor stretches in 21 healthy men. Electromyogram (EMG) recordings were obtained synchronously with ultrasound and joint moment data, and H-reflex measurements were made with the ankle at neutral (0°) and dorsiflexed (50% maximal passive joint moment) positions; the maximum H amplitude (normalized to maximum M-wave amplitude; M(max)) and H-amplitude elicited at a stimulation intensity that evoked 10% M(max) were obtained. Maximal stretch was accomplished through significant muscle (14.9%; 30 mm) and tendon lengthening (8.4%; 22 mm). There were similar relative changes in fascicle length and angle, but planimetric modeling indicated that the contribution of fascicle rotation to muscle lengthening was small (<4 mm). Subjects with a greater range of motion showed less resistance to stretch and a greater passive joint moment at stretch termination than less flexible subjects (i.e., greater stretch tolerance). Also, greater fascicle rotation accompanied muscle elongation (9.7 vs. 5.9%) and there was a greater tendon length at stretch termination in more flexible subjects. Finally, a moderate correlation between the angle of EMG onset and maximum range of motion was obtained (r = 0.60, P < 0.05), despite there being no difference in H-reflex magnitudes between the groups. Thus clear differences in the neuromuscular responses to stretch were observed between "flexible" and "inflexible" subjects.

Plantarflexor stretch training increases reciprocal inhibition measured during voluntary dorsiflexion.

Agonist-mediated reciprocal inhibition (RI) in distal skeletal muscles is an important neurophysiological phenomenon leading to improved movement coordination and efficiency. It has been shown to be reduced in aged and clinical populations, so the development of interventions augmenting RI is an important research goal. We examined the efficacy of using chronic passive muscle stretching to augment RI. The influence of 3 wk of plantarflexor stretching (4 × 30 s, two times/day) on RI of soleus and gastrocnemius initiated by tonic, voluntary dorsiflexion contractions [20% of maximum voluntary contraction (MVC)] was examined in 11 healthy men who performed stretch training and in nine nontraining controls. Hoffmann's reflexes (H-reflexes) were elicited by tibial nerve stimulation during both weak isometric (2% MVC) plantarflexions and dorsiflexion contractions at 20% MVC. Changes were examined at three joint angles, normalized to each subject's range of motion (ROM; plantarflexed = 10 ± 0°, neutral = -3.3 ± 2.9°, dorsiflexed = -16.5 ± 5.6°). No changes were detected in controls. A 20% increase in ROM in the stretch subjects was associated with a significant decrease in maximum H-reflex (H(max)): maximum evoked potential (M(max)), measured during 2% plantarflexion at the plantarflexed and neutral angles in soleus and at the plantarflexed angle in gastrocnemius (P < 0.05-0.01). By contrast, decreases in H(max):M(max) during 20% dorsiflexion contract were also seen at each angle in soleus and at the dorsiflexed angle in gastrocnemius. However, a greater decrease in H(max):M(max) measured during voluntary dorsiflexion rather than during plantarflexion, which indicates a specific change in RI, was detected only at the dorsiflexed angle (-30.7 ± 9.4% and -35.8 ± 6.8% for soleus and gastrocnemius, respectively). These results demonstrate the efficacy of soleus-gastrocnemius stretch training in increasing agonist-mediated RI from tibialis anterior onto soleus-gastrocnemius in young, healthy individuals at dorsiflexed, but not plantarflexed, joint angles.

Age-related changes in mechanical properties of the Achilles tendon.

The stiffness of a tendon, which influences muscular force transfer to the skeleton and increases during childhood, is dependent on its material properties and dimensions, both of which are influenced by chronic loading. The aims of this study were to: (i) determine the independent contributions of body mass, force production capabilities and tendon dimensions to tendon stiffness during childhood; and (ii) descriptively document age-related changes in tendon mechanical properties and dimensions. Achilles tendon mechanical and material properties were determined in 52 children (5-12 years) and 19 adults. Tendon stiffness and Young's modulus (YM) were calculated as the slopes of the force-elongation and stress-strain curves, respectively. Relationships between stiffness vs. age, mass and force, and between YM vs. age, mass and stress were determined by means of polynomial fits and multiple regression analyses. Mass was found to be the best predictor of stiffness, whilst stress was best related to YM (< 75 and 51% explained variance, respectively). Combined, mass and force accounted for up to 78% of stiffness variation. Up to 61% of YM variability could be explained using a combination of mass, stress and age. These results demonstrate that age-related increases in tendon stiffness are largely attributable to increased tendon loading from weight-bearing tasks and increased plantarflexor force production, as well as tendon growth. Moreover, our results suggest that chronic increases in tendon loading during childhood result in microstructural changes which increase the tendon's YM. Regarding the second aim, peak stress increased from childhood to adulthood due to greater increases in strength than tendon cross-sectional area. Peak strain remained constant as a result of parallel increases in tendon length and peak elongation. The differences in Achilles tendon properties found between adults and children are likely to influence force production, and ultimately movement characteristics, which should be explicitly examined in future research.

Can Achilles tendon moment arm be predicted from anthropometric measures in pre-pubescent children?

Muscle-tendon moment arm magnitudes are essential variables for accurately calculating muscle forces from joint moments. Their measurement requires specialist knowledge and expensive resources. Research has shown that the patellar tendon moment arm length is related to leg anthropometry in children. Here, we asked whether the Achilles tendon moment arm (MA(AT)) can be accurately predicted in pre-pubescent children from surface anthropometry. Age, standing height, mass, foot length, inter-malleolar ankle width, antero-posterior ankle depth, tibial length, lower leg circumference, and distances from the calcaneus to the distal head of the 1st metatarsal and medial malleolus were determined in 49 pre-pubescent children. MA(AT) was calculated at three different ankle positions (neutral, 10° plantarflexion, and 10° dorsiflexion) by differentiating tendon excursion, measured via ultrasonography, with respect to ankle angle change using seven different differentiation techniques. Backwards stepwise regression analyses were performed to identify predictors of MA(AT.) When all variables were included, the regression analysis accounted for a maximum of 49% of MA(AT) variance at the neutral ankle angle when a third-order polynomial was used to differentiate tendon excursion with respect to ankle angle. For this condition, foot length and the distance between calcaneus and 1st metatarsal were the only significant predictors, accounting for 47% of the variance (p<0.05). The absolute error associated with this regression model was 3.8±4.4 mm, which would result in significant error (mean=14.5%) when estimating muscle forces from joint moments. We conclude that MA(AT) cannot be accurately predicted from anthropometric measures in children.

In vivo assessment of muscle fascicle length by extended field-of-view ultrasonography.

The present study examined the reliability and validity of in vivo vastus lateralis (VL) fascicle length (L(f)) assessment by extended field-of-view ultrasonography (EFOV US). Intraexperimenter and intersession reliability of EFOV US were tested. Further, L(f) measured from EFOV US images were compared to L(f) measured from static US images (6-cm FOV) where out-of-field fascicle portions were trigonometrically estimated (linear extrapolation). Finally, spatial accuracy of the EFOV technique was assessed by comparing L(f) measured on swine VL by EFOV US to actual measurements from digital photographs. The difference between repeated VL L(f) measurements by the same experimenter was 2.1 ± 1.7% with an intraclass correlation (ICC) of 0.99 [95% confidence interval (CI) = 0.95-1.00]. In terms of intersession reliability, no difference (P = 0.48) was observed between L(f) measured on two different occasions, with ICC = 0.95 (CI = 0.80-0.99). The average absolute difference between L(f) measured by EFOV US and using linear extrapolation was 12.6 ± 8.1% [ICC = 0.76 (CI = -0.20-0.94)]; EFOV L(f) was always longer than extrapolated L(f). The relative error of measurement between L(f) measured by EFOV US and by dissective assessment (digital photographs) in isolated swine VL was 0.84% ± 2.6% with an ICC of 0.99 (CI = 0.94-1.00). These results show that EFOV US is a reliable and valid method for the measurement of long muscle fascicle in vivo. Thus EFOV US analysis was proven more accurate for the assessment of skeletal muscle fascicle length than conventional extrapolation methods.

Assessment of quadriceps muscle cross-sectional area by ultrasound extended-field-of-view imaging.

This study aimed to test the validity and reliability of an extended-field-of-view ultrasonography (EFOV) method for quadriceps muscle cross-sectional area (CSA) assessment. The CSA was measured at 10, 20, 30, 40 and 50% of the distance from the superior border of the patella to the medial aspect of anterior superior iliac spine by EFOV imaging and compared to the CSA measured by computed tomography (CT). Validity was tested by intra-class correlation (ICC) between the two methods and intra- and inter-experimenter and inter-day reliability were also examined. The ICC computed between the two techniques ranged between 0.951 and 0.998 (P < 0.000), but the 95% confidence intervals of the ICCs were in the acceptable range only for 30, 40 and 50% sections (0.842-0.999, 0.943-0.997 and 0.992-0.999, respectively). The standard error of the EFOV technique when compared to CT was 2.4, 4.3, 1.2, 1.2 and 0.6%, for 10, 20, 30, 40 and 50% sections, respectively. The coefficient of variation, showing intra- and inter-experimenter reliability, ranged from 0.6 to 2.7%. ICCs computed to assess the inter-day reliability were between 0.982 and 0.998 (95% confidence interval 0.892-1). When CSA was compared between sections statistically significant differences were found between them, regardless of the imaging technique used. Small standard errors of the measurement and high ICCs with the small confidence intervals suggest that, at proximal and mid-thigh sections, EFOV is a valid and reliable method to measure quadriceps muscle size.

High-throughput ultra-high-performance liquid chromatography/tandem mass spectrometry quantitation of insulin-like growth factor-I and leucine-rich alpha-2-glycoprotein in serum as biomarkers of recombinant human growth hormone administration.

Insulin-like growth factor-I (IGF-I) is a known biomarker of recombinant human growth hormone (rhGH) abuse, and is also used clinically to confirm acromegaly. The protein leucine-rich alpha-2-glycoprotein (LRG) was recently identified as a putative biomarker of rhGH administration. The combination of an ACN depletion method and a 5-min ultra-high-performance liquid chromatography/tandem mass spectrometry (uHPLC/MS/MS)-based selected reaction monitoring (SRM) assay detected both IGF-I and LRG at endogenous concentrations. Four eight-point standard addition curves of IGF-I (16-2000 ng/mL) demonstrated good linearity (r(2) = 0.9991 and coefficients of variance (CVs) <13%). Serum samples from two rhGH administrations were extracted and their uHPLC/MS/MS-derived IGF-I concentrations correlated well against immunochemistry-derived values. Combining IGF-I and LRG data improved the separation of treated and placebo states compared with IGF-I alone, further strengthening the hypothesis that LRG is a biomarker of rhGH administration. Artificial neural networks (ANNs) analysis of the LRG and IGF-I data demonstrated an improved model over that developed using IGF-I alone, with a predictive accuracy of 97%, specificity of 96% and sensitivity of 100%. Receiver operator characteristic (ROC) analysis gave an AUC value of 0.98. This study demonstrates the first large scale and high throughput uHPLC/MS/MS-based quantitation of a medium abundance protein (IGF-I) in human serum. Furthermore, the data we have presented for the quantitative analysis of IGF-I suggest that, in this case, monitoring a single SRM transition to a trypsin peptide surrogate is a valid approach to protein quantitation by LC/MS/MS.