Heat transfer to deep tissue: the effect of body fat and heating modality.

The purpose of this study was to quantify the thermal transfer characteristics of the skin in relation to body composition as assessed by the ability of water immersion and hot and cold packs with different thicknesses of towels layers to heat or cool deep tissue. Two sets of experiments were conducted to determine the interrelationships between body fat content and muscle temperature after immersion of the limb in water or the application of hot and cold packs. In the first series of experiments, subjects immersed their lower body in water at 42, 37, 34, 27, 24 and 0 degrees C for 20 minutes. Muscle temperature was measured in the skin above and in the belly of the quadriceps and medial gastrocnemius muscles by a thermistor on the skin and one implanted with a 20-gauge needle 25 mm below and perpendicular to the skin. To see the effect of circulation, a series was conducted with the circulation occluded. In the second series, hot or cold packs were used with different thicknesses of towel layers. The muscle temperature after immersion in water approached that of the packs within approximately 20 minutes. In contrast, when hot and cold packs were used with various thickness of towels ranging from 2 to 10 mm in thickness, the change in muscle temperature was much less and it was still changing at the end of a 20 minute period. Subjects with high body fat changed their deep tissue temperatures much more slowly with a time constant nearly double that of the thin subjects with all modalities. Even after water immersion, if the body fat exceeded 25% of the subject's weight, 20 min of immersion was not enough to either warm the muscle or cool it down substantially. Cold packs and hot packs were very ineffective in changing muscle temperature under these same conditions. Body fat plays a major role, as did limb blood flow in controlling the movement of heat across the limb.

The transfer of current through skin and muscle during electrical stimulation with sine, square, Russian and interferential waveforms.

Electrical stimulation is a commonly used modality for both athletic training and physical therapy. However, there are limited objective data available to determine the waveform which provides the maximum muscle strength as well as minimizing pain. In the present investigation, two groups of subjects were examined. Group 1 was composed of six males and four females and group 2 was composed of three male and three female subjects. The first series of experiments investigated muscle strength with stimulation at currents of 20, 40 and 60 milliamps using sine, square, Russian and interferential waveforms evaluating strength production and pain as outcomes. The second phase of experiments compared the effect of the different waveforms on current dispersion in surface versus deep muscle electrodes with these same waveforms. The results of the experiments showed that sine wave stimulation produced significantly greater muscle strength and significantly less pain than square wave, Russian or interferential stimulation at that same current. The most painful stimulation was square wave. Strength production was greatest with sine wave and least with Russian and interferential. An explanation of these findings may be the filtering effect of the fat layer separating skin from muscle. The highly conductive muscle and skin dermal layers would form the plates of a capacitor separated by the subcutaneous fat layer providing an RC filter. This filtering effect, while allowing sine wave stimulation to pass to the muscle, reduced power transfer in square wave, Russian and interferential stimulation is observed.

Joint acceleration during gait in relation to age.

Forty-four male and female subjects with no history of falling and whose ages ranged from 10 to 68 years participated in a series of experiments to assess movement at the joints during gait while walking in a straight line, in pivot turns and in turns of 0.33 and 0.66 m diameter. Acceleration at the joints in the forward and side-to-side direction was measured by dual-axis accelerometers placed at the ankles, knees, hips, shoulders, and on the head. Eye movement was assessed from electrodes placed on the sides of the eyes. The results of the experiments showed that for people whose age was above 40 years, significant increases in the forward-back and side-to-side movements occurred at all joints and progressively increased with age. By age 60, adverse movement of the joints as much as quadrupled in many subjects when compared to people whose age was 20-30 years. The increase in joint acceleration occurred equally in the front-back and side-to-side planes. The mechanism of the increased joint movement may be due to tendon laxness, peripheral neuropathy or loss of central control of gait due to age. Accelerometry may be a much more sensitive technique to analyze abnormalities in gait than standard video or observational gait analysis. Results are given as mean (SD) unless otherwise stated.

The relationship between exercise work intervals and duration of exercise on lower extremity training induced by electrical stimulation in humans with spinal cord injuries.

A group of 90 male paraplegics were studied to determine the optimal training protocol for isokinetic exercise induced by functional electrical stimulation of the quadriceps muscles. The parameters that were varied were the number of training sessions a week, the length of the training sessions each day, and the work-rest intervals in each training session. Training for 3 days a week for 30 min a day with 6 s of exercise and 6 s of rest proved the optimal protocol. Training for 5 days or for 1 day a week was not as effective in training strength or endurance. A combination of 50% work and 50% rest produced a much greater gain in strength and endurance than work:rest ratios of 66%:33% or 25%:75%. When training was conducted for 5 min, 15 min or 30 min each day, the greatest increase was found when the muscles were exercised for 30 min each day. While more variables need to be examined, this study has provided some initial guidelines for isokinetic training of humans using electrical stimulation.

Blood pressure and heart rate responses during a fatiguing isometric exercise in paraplegic men with hypertension.

A group of 45 male subjects were examined in a cross-sectional study to compare the blood pressure response that occurs during isometric exercise maintained to fatigue among control subjects and paraplegic patients with (PH) and without essential hypertension (PN). Two muscle groups were examined: the handgrip muscles (voluntary effort) and the quadriceps muscles. The tension chosen for the contraction was 40% of the muscles maximum strength for both muscle groups. While the paraplegic groups had more strength in their handgrip muscles than that found for the controls, the control subjects had more strength in their quadriceps muscles than either of the paraplegic groups. During the fatiguing isometric contractions, the rate of rise and absolute systolic blood pressure was higher in the PH than the other groups of subjects. The diastolic pressure of the PH group, while elevated during exercise, was only elevated to the same degree as the increase in resting diastolic pressure above normal. Heart rate changes during exercise was the same in all groups of subjects for handgrip contractions. The controls had the same heart rate response to handgrip as to leg exercise. The paraplegic groups showed no heart rate change during fatiguing contractions of their quadriceps muscles. The PH group actually showed a reduction in heart rate during the leg exercise.