Methodical approaches to determine the rate of radial muscle displacement using tensiomyography: A scoping review and new reporting guideline.

Tensiomyography is a non-invasive method to assess skeletal muscle contractile properties from the stimulated radial displacement. Many studies have used the rate of displacement (Vc) as an indirect measure of muscle contraction velocity. However, no standardised methodical approach exists to measure displacement and determine Vc. This review aimed to provide an overview of concepts to determine Vc and measurement protocols to foster the development of a standardised methodical approach. This review followed the Preferred Reporting Items for Systematic Reviews and meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Systematic searches were performed within five electronic databases and additional sources. The included 62 studies reported 10 different concepts to determine Vc, which we summarised in three groups. The determination concepts differed mainly regarding time intervals during the contraction phase considered and criteria used to define these intervals. Essential information on the equipment and raters, measurement setup, electrical stimulation procedure, and data analysis were frequently not reported. In conclusion, no consensus on how to determine Vc existed. Incomplete reporting of measurement protocols hindered study comparison, which obstructs developing a standardised approach. Therefore, we propose a new guideline for reporting measurement protocols, which covers the 1) equipment and rater, 2) measurement setup, including positioning of the subject, sensor and electrodes, 3) electrical stimulation, including initial stimulation amplitude, increment, and endpoint, and 4) data analysis, including selection criteria and number of analysed signals and a definition of derived parameters.

Appropriateness of surgical antimicrobial prophylaxis in Japanese university hospitals.

BACKGROUND: Surgical antimicrobial prophylaxis (SAP) is one of the major purposes of antimicrobial use. AIM: To determine the adherence to the Japanese SAP guidelines in Japanese university hospitals. METHODS: This was a retrospective cohort study including 15 general hospitals and one dental university hospital. Up to three cases of 18 designated surgeries were evaluated regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as 'appropriate'. FINDINGS: In total, 688 cases (22-45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.6% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.9%, 116/688, respectively), compared to the guideline. CONCLUSIONS: Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multi-centre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections.

Global status of Toxoplasma gondii infection: systematic review and prevalence snapshots.

Our group sought to determine the global status of T. gondii infection and to evaluate any continental and geographical trends by systematically examining the currently available epidemiological data on the prevalence of T. gondii infection. A comprehensive literature search was conducted from 10 electronic databases (Google Scholar, Science Direct, Embase, PubMed, PLOS ONE, Web of Knowledge, SciELO, MyAIS, Free Medical Journals, and Scopus) without date or language restrictions. Specific medical subject heading terms were used to search for human T. gondii seroprevalence studies that recruited subjects from general apparently healthy populations. The data were collated and analysed for both continental and global trends. The search identified 152 published studies that examined a total of 648,010 subjects. From these, 166,255 were seropositive for T. gondii infection indicating an average global seroprevalence rate of 25.7% (95% CI: 25.6 - 25.8%). The overall range of seroprevalence was determined to be 0.5 - 87.7%. African countries had the highest average seroprevalence rate of 61.4%, followed by Oceania with 38.5%, South America with 31.2%, Europe with 29.6%, USA/Canada with 17.5%, and Asia with 16.4%. Numerous environmental and human factors affect the differences in T. gondii seroprevalence rates observed between the various countries and continents. Monitoring the source and transmission may assist public health authorities to clarify the risk factors involved, as well as focus on implementing optimal state-specific health policies targeting T. gondii transmission control.

Global status of Toxoplasma gondii infection: systematic review and prevalence snapshots

@#Our group sought to determine the global status of T. gondii infection and to evaluate any continental and geographical trends by systematically examining the currently available epidemiological data on the prevalence of T. gondii infection. A comprehensive literature search was conducted from 10 electronic databases (Google Scholar, Science Direct, Embase, PubMed, PLOS ONE, Web of Knowledge, SciELO, MyAIS, Free Medical Journals, and Scopus) without date or language restrictions. Specific medical subject heading terms were used to search for human T. gondii seroprevalence studies that recruited subjects from general apparently healthy populations. The data were collated and analysed for both continental and global trends. The search identified 152 published studies that examined a total of 648,010 subjects. From these, 166,255 were seropositive for T. gondii infection indicating an average global seroprevalence rate of 25.7% (95% CI: 25.6 – 25.8%). The overall range of seroprevalence was determined to be 0.5 – 87.7%. African countries had the highest average seroprevalence rate of 61.4%, followed by Oceania with 38.5%, South America with 31.2%, Europe with 29.6%, USA/Canada with 17.5%, and Asia with 16.4%. Numerous environmental and human factors affect the differences in T. gondii seroprevalence rates observed between the various countries and continents. Monitoring the source and transmission may assist public health authorities to clarify the risk factors involved, as well as focus on implementing optimal state-specific health policies targeting T. gondii transmission control.

Muscle damage protective effect by two maximal isometric contractions on maximal eccentric exercise of the elbow flexors of the contralateral arm.

Muscle damage after 30 maximal eccentric contractions of the elbow flexors (30MVEC) is reduced when the same exercise is performed by the opposite arm, and when two maximal voluntary isometric contractions at a long muscle length (2MVIC) are performed prior to 30MVEC by the same arm. This study investigated the hypothesis that 2MVIC would attenuate muscle damage after 30MVEC performed by the opposite arm. Untrained young (20-25 years) men were placed into 1 of 4 experimental groups that performed 2MVIC at 1 (1d), 2 (2d), 4 (4d), or 7 days (7d) before 30MVEC by the opposite arm, or one control group that performed 30MVEC only (n = 13/group). Changes in indirect muscle damage markers after 30MVEC were compared among the groups by mixed-design two-way ANOVA. Maximal voluntary concentric contraction torque, range of motion, plasma creatine kinase activity, and muscle soreness did not change significantly after 2MVIC. Changes in these variables after 30MVEC were smaller (P < .05) for 1d (eg, peak soreness: 45 ± 21 mm) and 2d groups (46 ± 20 mm) than control group (66 ± 18 mm), without significant differences between 1d and 2d groups. No significant differences in the changes were found among 4d, 7d, and control groups, except for soreness showing smaller (P < .05) increases for 4d group (54 ± 19 mm) than 7d (62 ± 17 mm) and control groups. These results supported the hypothesis and showed that muscle damage induced by 30MVEC was reduced by 2MVIC performed 1-2 days prior to 30MVIC by the contralateral arm.

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.

Muscular mechanical hyperalgesia after lengthening contractions in rats depends on stretch velocity and range of motion.

BACKGROUND: The current study investigated stretch variables and mechanical factors of lengthening contractions (LC) in the processes leading to muscular mechanical hyperalgesia in rats to understand mechanisms underpinning delayed onset muscle soreness (DOMS). METHODS: Under isoflurane anaesthesia, ankle extensor muscles were loaded with repetitive LC with angular stretch velocities (50°, 100°, 200° and 400°/s) at a fixed range of motion (ROM) of 90°, and with ROMs (30°, 60°, 90° and 120°) at a fixed velocity of 200°/s. RESULTS: Mechanical hyperalgesia was observed in a velocity- and ROM-dependent manner. Under the fixed ROM, integrated torque generated during LC (iTq[max] ) was inversely correlated with the velocity, but the rate of torque increase during LC (rTq[max] ) was positively and significantly correlated with the velocity, and the magnitude of hyperalgesia was correlated with rTq[max] (p < 0.001). When the velocity was fixed, iTq[max] was significantly correlated with ROM, and the magnitude of hyperalgesia was correlated with iTq[max] (p < 0.01). Necrotic myofibres were observed only sparsely (<0.8%) after any of the LC protocols tested. Up-regulation of nerve growth factor and glial cell line-derived neurotrophic factor mRNA in the muscle was positively correlated with the increases in the LC velocity and ROM (p < 0.05~0.001). CONCLUSIONS: Both velocity and ROM are pivotal variables determining the initiation of mechanical hyperalgesia. Neurotrophic factor-mediated peripheral mechanisms, but apparently not inflammatory changes caused by myofibre damage, are responsible for the mechanical hyperalgesia. SIGNIFICANCE: Mechanical hyperalgesia appears after LC in a stretch velocity- and range of motion-dependent manner. The rate of torque increase and integrated torque are the crucial factors. Neurotrophic factor-mediated peripheral pain mechanisms without robust inflammatory changes caused by myofibre damage were required for this mechanical hyperalgesia.

Susceptibility to Exercise-Induced Muscle Damage: a Cluster Analysis with a Large Sample.

We investigated the responses of indirect markers of exercise-induced muscle damage (EIMD) among a large number of young men (N=286) stratified in clusters based on the largest decrease in maximal voluntary contraction torque (MVC) after an unaccustomed maximal eccentric exercise bout of the elbow flexors. Changes in MVC, muscle soreness (SOR), creatine kinase (CK) activity, range of motion (ROM) and upper-arm circumference (CIR) before and for several days after exercise were compared between 3 clusters established based on MVC decrease (low, moderate, and high responders; LR, MR and HR). Participants were allocated to LR (n=61), MR (n=152) and HR (n=73) clusters, which depicted significantly different cluster centers of 82%, 61% and 42% of baseline MVC, respectively. Once stratified by MVC decrease, all muscle damage markers were significantly different between clusters following the same pattern: small changes for LR, larger changes for MR, and the largest changes for HR. Stratification of individuals based on the magnitude of MVC decrease post-exercise greatly increases the precision in estimating changes in EIMD by proxy markers such as SOR, CK activity, ROM and CIR. This indicates that the most commonly used markers are valid and MVC orchestrates their responses, consolidating the role of MVC as the best EIMD indirect marker.

EFFECTS OF COMPRESSION ON LYMPHEDEMA DURING RESISTANCE EXERCISE IN WOMEN WITH BREAST CANCER-RELATED LYMPHEDEMA: A RANDOMIZED, CROSS-OVER TRIAL.

The use of compression garments during exercise is recommended for women with breast cancer-related lymphedema, but the evidence behind this clinical recommendation is unclear. The aim of this randomized, cross-over trial was to compare the acute effects of wearing versus not wearing compression during a single bout of moderate-load resistance exercise on lymphedema status and its associated symptoms in women with breast cancer-related lymphedema (BCRL). Twenty-five women with clinically diagnosed, stable unilateral breast cancer-related lymphedema completed two resistance exercise sessions, one with compression and one without, in a randomized order separated by a minimum 6 day wash-out period. The resistance exercise session consisted of six upper-body exercises, with each exercise performed for three sets at a moderate-load (10-12 repetition maximum). Primary outcome was lymphedema, assessed using bioimpedance spectroscopy (L-Dex score). Secondary outcomes were lymphedema as assessed by arm circumferences (percent inter-limb difference and sum-of-circumferences), and symptom severity for pain, heaviness and tightness, measured using visual analogue scales. Measurements were taken pre-, immediately post- and 24 hours post-exercise. There was no difference in lymphedema status (i.e., L-Dex scores) pre- and post-exercise sessions or between the compression and non-compression condition [Mean (SD) for compression pre-, immediately post- and 24 hours post-exercise: 17.7 (21.5), 12.7 (16.2) and 14.1 (16.7), respectively; no compression: 15.3 (18.3), 15.3 (17.8), and 13.4 (16.1), respectively]. Circumference values and symptom severity were stable across time and treatment condition. An acute bout of moderate-load, upper-body resistance exercise performed in the absence of compression does not exacerbate lymphedema in women with BCRL.

Rate of force development as a measure of muscle damage.

This study tested the hypothesis that rate of force development (RFD) would be a more sensitive indirect marker of muscle damage than maximum voluntary isometric contraction (MVC) peak torque. Ten men performed one concentric cycling and two eccentric cycling (ECC1, ECC2) bouts for 30 min at 60% of maximal concentric power output with 2 weeks between bouts. MVC peak torque, RFD, and vastus lateralis electromyogram amplitude and mean frequency were measured during a knee extensor MVC before, immediately after and 1-2 days after each bout. The magnitude of decrease in MVC peak torque after exercise was greater (P < 0.05) for ECC1 (11-25%) than concentric cycling (2-12%) and ECC2 (0-16%). Peak RFD and RFD from 0-30 ms, 0-50 ms, 0-100 ms, to 0-200 ms decreased (P < 0.05) immediately after all cycling bouts without significant differences between bouts, but RFD at 100-200 ms interval (RFD(100-200)) decreased (P < 0.05) at all time points after ECC1 (24-32%) and immediately after ECC2 (23%), but did not change after CONC. The magnitude of decrease in RFD(100-200) was 7-19% greater than that of MVC peak torque after ECC1 (P < 0.05). It is concluded that RFD(100-200) is a more specific and sensitive indirect marker of eccentric exercise-induced muscle damage than MVC peak torque.

Muscle damage after low-intensity eccentric contractions with blood flow restriction.

Discrepancies exist whether blood flow restriction (BFR) exacerbates exercise-induced muscle damage (EIMD). This study compared low-intensity eccentric contractions of the elbow flexors with and without BFR for changes in indirect markers of muscle damage. Nine untrained young men (18-26 y) performed low-intensity (30% 1RM) eccentric contractions (2-s) of the elbow flexors with one arm assigned to BFR and the other arm without BFR. EIMD markers of maximum voluntary isometric contraction (MVC) torque, range of motion (ROM), upper arm circumference, muscle thickness and muscle soreness were measured before, immediately after, 1, 2, 3, and 4 days after exercise. Electromyography (EMG) amplitude of the biceps brachii and brachioradialis were recorded during exercise. EMG amplitude was not significantly different between arms and did not significantly change from set 1 to set 4 for the biceps brachii but increased for the brachioradialis (p ≤ 0.05, 12.0% to 14.5%) when the conditions were combined. No significant differences in the changes in any variables were found between arms. MVC torque decreased 7% immediately post-exercise (p ≤ 0.05), but no significant changes in ROM, circumference, muscle thickness and muscle soreness were found. These results show that BFR does not affect EIMD by low-intensity eccentric contractions.

Changes in muscle damage markers in female basketball players.

The aim of the present study was to investigate changes in muscle soreness, blood muscle damage markers, muscle strength and agility following an official basketball match. Eleven elite female professional basketball players (27.4 ± 4.8 years, 179.5 ± 5.5 cm, 72.0 ± 7.8 kg) of a team participated in this study. The official match was the seventh match of the season in the first phase of the Brazilian National Female Basketball Championship. Muscle soreness, plasma creatine kinase activity (CK), and myoglobin concentration (Mb) were determined before and after the match (post-match, 24 and 48 hours after the match). The 1RM strength for bench press and leg press, and the agility T test were assessed before and at 24 and 48 hours after the match. Significant increases in muscle soreness, CK and Mb were observed at 24 and 48 hours post-match (p<0.05). No significant changes in the 1RM strength and T test were detected during recovery (24 and 48 hours after the match). These results suggest that a basketball match induced limited muscle damage with minimal effect on performance during recovery. The small increase in muscle damage markers following a basketball match did not affect strength and agility performance.

Muscle damage after a tennis match in young players.

The present study investigated changes in indirect markers of muscle damage following a simulated tennis match play using nationally ranked young (17.6 ± 1.4 years) male tennis players. Ten young athletes played a 3-hour simulated match play on outdoor red clay courts following the International Tennis Federation rules. Muscle soreness, plasma creatine kinase activity (CK), serum myoglobin concentration (Mb), one repetition maximum (1RM) squat strength, and squat jump (SJ) and counter movement jump (CMJ) heights were assessed before, immediately after, and 24 and 48 h after the simulated match play. All parameters were also evaluated in a non-exercised group (control group). A small increase in the indirect markers of muscle damage (muscle soreness, CK and Mb) was detected at 24-48 hours post-match (p < 0.05). A marked acute decrement in neuromuscular performance (1RM squat strength: -35.2 ± 10.4%, SJ: -7.0 ± 6.0%, CMJ: -10.0 ± 6.3%) was observed immediately post-match (p < 0.05). At 24 h post-match, the 1RM strength and jump heights were not significantly different from the baseline values. However, several players showed a decrease of these measures at 24 h after the match play. The simulated tennis match play induced mild muscle damage in young players. Coaches could monitor changes in the indirect markers of muscle damage to assess athletes' recovery status during training and competition.

PDK1 inhibition is a novel therapeutic target in multiple myeloma.

BACKGROUND: Cancer cells utilise the glycolytic pathway even when adequate oxygen is present, a phenomenon known as the Warburg effect. We examined whether this system is operative in multiple myeloma (MM) cells and whether glycolysis inhibition is a potential therapeutic modality. METHODS: The MM cells were purified from 59 patients using CD138-immunomagnetic beads. The expression levels of genes associated with glycolysis, c-MYC, GLUT1, LDHA, HIF1A and pyruvate dehydrogenase kinase-1 (PDK1) were determined by real-time PCR. Glucose consumption and lactate production by MM cell lines were analysed. Oxamate, an LDH inhibitor, and dichloroacetate (DCA), a PDK1 inhibitor, were employed. Inhibition of PDK1 expression was achieved using a siRNA. RESULTS: High LDHA expression was found to be an indicator of poor prognosis. It was also positively correlated with the expression of PDK1, c-MYC and GLUT1. Greater glucose consumption and lactate production in MM cells was associated with higher LDHA expression. All the glycolysis inhibitors (oxamate, DCA and PDK1 siRNA) induced apoptosis in MM cells. DCA combined with bortezomib showed additive cytotoxic effects. CONCLUSION: The present data suggest that the Warburg effect is operative in MM cells. As PDK1 is not overexpressed in normal tissues, PDK1 inhibition could serve as a novel therapeutic approach.

Changes in serum fast and slow skeletal troponin I concentration following maximal eccentric contractions.

OBJECTIVES: We tested the hypothesis that fast skeletal muscle troponin I (fsTnI) concentration in serum would increase more than those of slow skeletal muscle troponin I (ssTnI) after eccentric exercise of the elbow flexors using a sensitive blood marker to track fibre specific muscle damage. DESIGN: Observational comparison of response in a single experimental group. METHODS: Eight young men (26.4±6.2 years) performed 210 (35 sets of 6) eccentric contractions of the elbow flexors on an isokinetic dynamometer with one arm. Changes in serum fsTnI and ssTnI concentrations, serum creatine kinase (CK) activity, and maximal voluntary isometric contraction torque (MVIC) before and 1, 2, 3, 4 and 14 days following exercise were analysed by a Student-Newman-Keuls multiple comparison test. The relationship between serum CK activity and fsTnI or ssTnI concentrations was determined using a Pearson's product moment correlation. RESULTS: Significant (P<0.05) decreases in MVIC and increases in serum CK activity and fsTnI were evident after exercise, but ssTnI did not change. The time course of changes in fsTnI was similar to that of CK, peaking at 4 days post-exercise, and the two were highly correlated (r=0.8). CONCLUSIONS: Increases in serum fsTnI concentrations reflect muscle damage, and it seems likely that only fast twitch fibres were damaged by eccentric contractions.

Monitoring training loads, stress, immune-endocrine responses and performance in tennis players.

The study aim was to investigate the effect of a periodised pre-season training plan on internal training load and subsequent stress tolerance, immune-endocrine responses and physical performance in tennis players. Well-trained young tennis players (n = 10) were monitored across the pre-season period, which was divided into 4 weeks of progressive overloading training and a 1-week tapering period. Weekly measures of internal training load, training monotony and stress tolerance (sources and symptoms of stress) were taken, along with salivary testosterone, cortisol and immunoglobulin A. One repetition maximum strength, running endurance, jump height and agility were assessed before and after training. The periodised training plan led to significant weekly changes in training loads (i.e. increasing in weeks 3 and 4, decreasing in week 5) and post-training improvements in strength, endurance and agility (P < 0.05). Cortisol concentration and the symptoms of stress also increased in weeks 3 and/or 4, before returning to baseline in week 5 (P < 0.05). Conversely, the testosterone to cortisol ratio decreased in weeks 3 and 4, before returning to baseline in week 5 (P < 0.05). In conclusion, the training plan evoked adaptive changes in stress tolerance and hormonal responses, which may have mediated the improvements in physical performance.

Effects of set-repetition configuration in eccentric exercise on muscle damage and the repeated bout effect.

The number of eccentric contractions is a factor affecting the magnitude of muscle damage; however, it is unknown whether set-repetition configurations for the same total number of eccentric contractions affect the muscle damage. The present study investigated whether different set-repetition configurations would result in different force output during eccentric exercise and different magnitude of muscle damage following the first and second exercise bouts. Ten non-resistance-trained men (26.1 ± 4.1 years) performed two bouts of eccentric exercise of the elbow flexors of each arm (4 bouts in total). One arm performed 3 sets of 10 maximal eccentric contractions (3 × 10) and the contralateral arm performed 10 sets of 3 maximal eccentric contractions (10 × 3), and each arm performed 20 sets of 3 maximal eccentric contractions (20 × 3) 4 weeks after the first bout. The order of the exercise (3 × 10, 10 × 3) and the use of arm (dominant, non-dominant) were counterbalanced amongst subjects. The torque produced over 30 eccentric contractions was similar between 3 × 10 and 10 × 3, and the changes in torque during 20 × 3 were similar between arms. Maximal voluntary contraction strength, range of motion, biceps brachii cross-sectional area and muscle soreness changed significantly (P < 0.05) following the exercise without significant differences between 3 × 10 and 10 × 3, and changes in the measures following 20 × 3 were similar between arms, except for range of motion (ROM). No significant difference in the changes in any measures except ROM was evident when compared between the first and second bouts. These results showed that changing the set-repetition configuration had little effect on muscle damage.

Pulmonary epithelioid hemangioendothelioma with PlGF expression: report of a case.

Pulmonary epithelioid hemangioendothelioma (PEH) is a relatively uncommon neoplasm of vascular origin with a low or intermediate grade of malignancy. We present a case of a 28-year-old female with multiple pulmonary nodules which were diagnosed as PEH by video-assisted thoracoscopic surgery (VATS) biopsy. In addition, we performed an immunohistochemical analysis for placenta growth factor (PlGF) and a strong positivity for PlGF observed, suggesting that the PlGF may play some role in the tumorigenesis of PEH.

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.

Effect of a 5-min cold-water immersion recovery on exercise performance in the heat.

BACKGROUND: This study examined the effect of a 5-min cold-water immersion (14 degrees C) recovery intervention on repeated cycling performance in the heat. METHODS: 10 male cyclists performed two bouts of a 25-min constant-paced (254 (22) W) cycling session followed by a 4-km time trial in hot conditions (35 degrees C, 40% relative humidity). The two bouts were separated by either 15 min of seated recovery in the heat (control) or the same condition with 5-min cold-water immersion (5th-10th minute), using a counterbalanced cross-over design (CP(1)TT(1) --> CWI or CON --> CP(2)TT(2)). Rectal temperature was measured immediately before and after both the constant-paced sessions and 4-km timed trials. Cycling economy and Vo(2) were measured during the constant-paced sessions, and the average power output and completion times were recorded for each time trial. RESULTS: Compared with control, rectal temperature was significantly lower (0.5 (0.4) degrees C) in cold-water immersion before CP(2) until the end of the second 4-km timed trial. However, the increase in rectal temperature (0.5 (0.2) degrees C) during CP(2) was not significantly different between conditions. During the second 4-km timed trial, power output was significantly greater in cold-water immersion (327.9 (55.7) W) compared with control (288.0 (58.8) W), leading to a faster completion time in cold-water immersion (6.1 (0.3) min) compared with control (6.4 (0.5) min). Economy and Vo(2) were not influenced by the cold-water immersion recovery intervention. CONCLUSION: 5-min cold-water immersion recovery significantly lowered rectal temperature and maintained endurance performance during subsequent high-intensity exercise. These data indicate that repeated exercise performance in heat may be improved when a short period of cold-water immersion is applied during the recovery period.