Central effects of mouth rinses on endurance and strength performance.

Rinsing the mouth with a carbohydrate (CHO) solution has been shown to enhance exercise performance while reducing neuromuscular fatigue. This effect is thought to be mediated through the stimulation of oral receptors, which activate brain areas associated with reward, motivation, and motor control. Consequently, corticomotor responsiveness is increased, leading to sustained levels of neuromuscular activity prior to fatigue. In the context of endurance performance, the evidence regarding the central involvement of mouth rinse (MR) in performance improvement is not conclusive. Peripheral mechanisms should not be disregarded, particularly considering factors such as low exercise volume, the participant's fasting state, and the frequency of rinsing. These factors may influence central activations. On the other hand, for strength-related activities, changes in motor evoked potential (MEP) and electromyography (EMG) have been observed, indicating increased corticospinal responsiveness and neuromuscular drive during isometric and isokinetic contractions in both fresh and fatigued muscles. However, it is important to note that in many studies, MEP data were not normalised, making it difficult to exclude peripheral contributions. Voluntary activation (VA), another central measure, often exhibits a lack of changes, mainly due to its high variability, particularly in fatigued muscles. Based on the evidence, MR can attenuate neuromuscular fatigue and improve endurance and strength performance via similar underlying mechanisms. However, the evidence supporting central contribution is weak due to the lack of neurophysiological measures, inaccurate data treatment (normalisation), limited generalisation between exercise modes, methodological biases (ignoring peripheral contribution), and high measurement variability.Trial registration: PROSPERO ID: CRD42021261714.

Interaction of hand orientations during familiarization of a goal-directed aiming task.

The purpose of the present study was to examine errors for an isometric goal-directed aiming task during familiarization at different hand orientation. Interaction between neutral and pronated hand orientations with and without directional feedback would provide insights into short-term adaptations and the nature of control. In this study, 30 healthy right-handed adults (age, 22.7 ± 3.1 years; weight, 69.4 ± 16.6 kg; height, 166.7 ± 7.9 cm) were randomly assigned to neutral or pronated hand orientation conditions. To assess familiarization, participants performed ten sets (16 targets/set) of goal-directed aiming task with continuous visual feedback towards targets symmetrically distributed about the origin. Following familiarization, participants then completed eight sets; four sets with and four sets without directional feedback, in an alternated order. For both hand orientations, directional errors were reduced in the first two sets (p < 0.05), suggesting only three sets were required for familiarization. Additionally, the learning rate was also similar for both hand orientations. Following familiarization, aiming errors without feedback were significantly higher than with feedback while no change between sets was observed, regardless of hand orientation. Aiming errors were reduced in the early phase with and without visual feedback, however, in the late phase, errors were corrected when visual feedback was provided. It suggests that hand orientation does not affect familiarization, and mechanisms similar to rapid learning may be involved. It is probable that learning is consolidated during familiarization along with feedforward input to maintain performance. In addition, proprioceptive feedback plays a role in reducing errors early, while the online visual feedback plays a role in reducing errors later, independent of hand orientation.

Contralateral Effects of Eccentric Exercise and DOMS of the Plantar Flexors: Evidence of Central Involvement.

Purpose: Peripheral and central factors play important roles in the reduction of motor performance following damaging eccentric exercise and delayed onset muscle soreness (DOMS). Following this regime, contralateral limbs could also be affected; however, the factors involved remain inconclusive. The purpose of this study was to distinguish the peripheral and central factors following eccentric contraction and DOMS of the plantar flexors in treated and contralateral homologous limbs. Methods: Ten males (BMI = 25.08 ± 1.69kgm-2; age = 28.70 ± 4.24 years) were randomly assigned to experimental (DOM) or control (CON) groups. The DOM group performed a damaging eccentric exercise, while the CON group rested. Plasma creatine kinase (CK), pain rating scale (PRS), muscle stiffness, maximal voluntary contraction (MVC), and neural voluntary activation (VA) were measured before, after 10 min, and after 24, 48, and 72 hr on treated and contralateral limbs. Results: Following exercise, CK increased until after 48 hr, while PRS increased until after 72 hr compared to the CON group. Importantly, MVC was reduced at all time points, with the greatest reduction observed after 24 hr (-16%), while VA was affected until after 48 hr, with the greatest reduction at after 10 min (-7%). Interestingly, a "cross-over effect" was observed in contralateral limbs when PRS, MVC, and VA were negatively affected following the same pattern (time line) as treated limbs (-13% peak MVC reduction; -3.5% peak VA reduction). Conclusion: These findings suggest a substantial central contribution to the reduction in force immediately following eccentric exercise and to a lesser extent during the latter part of DOMS in both treated and contralateral limbs.

Prevalence, patterns and factors associated with injury: comparison between elite Malaysian able-bodied and para-badminton players.

OBJECTIVES: This study aimed to determine and compare the prevalence, patterns and factors associated with injury between elite Malaysian able-bodied and para-badminton players. METHODS: Medical records from July 2007 to December 2017 were reviewed. RESULTS: Among 209 able-bodied players, 1010 injuries were reported. The injuries affected the lower limb (67.2%), sustained during training (94.2%), overuse in nature (38.7%), and involving mostly junior players (62.4%). The injury rate was 94/year, lower than previously reported. Patellar tendinopathy and muscle strain to the upper limb and torso were the commonest. Age, sex and history of injury were predictors of injury. Lower limb injury was a predictor of upper limb and torso injuries, while history of injury to the upper limb and/or torso was a predictor of lower limb injury. Meanwhile, among 18 para-badminton players, 62 injuries were reported from July 2014 to December 2017, which involved the lower limb (45.2%), sustained during training (87.1%), overuse in nature (54.8%), and involved mostly standing-class players (77.8%). The injury rate was 10/year. Patellar tendinopathy, rotator cuff tendinopathy and back muscle strain were the commonest. The patterns of injury (site, occasion and nature) were similar between groups, except for the shoulder where nature was overuse in para-badminton players compared to acute in able-bodied players. CONCLUSIONS: All players are susceptible to training-related injuries, particularly to the lower limb. Over the last decade, an increase in the injury index for the lower limb and a shift from chronic to acute for the upper limb were observed among able-bodied players. Age, sex and history of injury expose able-bodied players to greater risk. Meanwhile, for para-badminton players, overuse shoulder and knee injuries are commonest. These findings necessitate a comprehensive injury prevention program that encompasses all body regions with an emphasis on the lower limb among elite Malaysian able-bodied and para-badminton players.

Evaluation of Shoulder and Knee Isokinetic Strength Profile Among Elite Adolescent Badminton Players.

CONTEXT: Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered. OBJECTIVE: To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively). MAIN OUTCOME MEASURE(S): Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured. RESULTS: Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups. CONCLUSIONS: For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.

Effect of glucose and sodium chloride mouth rinses on neuromuscular fatigue: a preliminary study.

Carbohydrate (CHO) mouth rinse has been shown to improve endurance performance and maintain the central drive of contracting muscles. Salt (NaCl) mouth rinse solution, often used in dentistry to desensitise the oral cavity to pain, could also activate cortical areas of the brain. Hence, the objective of this preliminary study was to investigate whether CHO (glucose) and NaCl mouth rinses could attenuate the reduction in maximum voluntary contraction (MVC) and sustained MVC (sMVC) following an endurance exercise (30-minute cycling at 70% VO2max). Ten subjects (male, age: 22 ± 1 years, weight: 65.3 ± 12.4 kg, height: 164.5 ± 7.5 cm, VO2max: 48.3 ± 6.1 mL kg-1 min-1) completed three trials of 30-minute cycling exercise. In a randomised cross-over study, in each trial, the participants rinsed using either water, 6% glucose, or 6% NaCl solution for 5 s immediately prior to and every 10 min during the cycling exercise. The MVC and sMVC were measured pre and post cycling. Analysis of variance showed significant interaction and time effects for MVC, while for sMVC there was a significant interaction with time and group effects. Both MVC and sMVC were higher post cycling in the glucose and NaCl groups compared to the water group, which suggests that activation of glucose and NaCl oral receptors could better preserve post-exercise force production. This is the first study to show that NaCl mouth rinse can produce a comparable effect on glucose. Hence, mouth rinses may be able to activate other distinct pathways that could attenuate fatigue.

Maximum isokinetic familiarization of the knee: Implication on bilateral assessment.

PURPOSE: Familiarization is necessary for an accurate strength assessment as it reduces confounding factors such as learning and training effects. However, the number of contractions required for familiarization and whether cross-limb transfer during familiarization could affect bilateral assessment are unknown. This study aimed at identifying the number of maximum contractions required for isokinetic knee extension and flexion familiarization in both dominant (D) and non-dominant limb (ND). METHODS: Twenty-eight right-limb dominant males (age: 22.64 ± 2.60 years, BMI: 23.82 ± 2.85 kg/m2) performed a total of 6 sets (each consisted of 5 continuous maximum contractions) at 60o/s for each limb. RESULTS: The number of sets required for familiarization is determined when the average peak torque achieved stabilization from the series of contractions of each limb. For knee extension, 3 sets (15 contractions) were required for familiarization, whereas 2 sets (10 contractions) for knee flexion in both limbs. Interestingly, for knee extension in ND, the number of sets required for familiarization was reduced to 2 following contralateral contractions in D, however, for knee extension in D, there was no difference in the number of sets required for familiarization following contralateral contractions in ND. While for knee flexion, no cross-limb transfer was observed. These observations suggest the presence of cross-limb transfer from D to ND during familiarization which implies the involvement of the central nervous system. CONCLUSIONS: Practically, familiarization for bilateral isokinetic strength assessment for knee extension and flexion at 60o/s should begin with the dominant limb for 3 sets to obtain accurate and reliable measurements.

Associations between Perceptual Fatigue and Accuracy of Estimated Repetitions to Failure during Resistance Exercises.

The ability to accurately identify proximity to momentary failure during a set of resistance exercise might be important to maximise training adaptations. This study examined the association between perceptual fatigue and the accuracy of the estimated repetitions to failure (ERF). Twenty-seven males and eleven females performed sets of 10 repetitions at specific loads for the chest press and leg-press. Following the completion of 10 repetitions, participants rated their fatigue and ERF and then proceeded to concentric failure (actual repetitions to failure) to determine the ERF accuracy (i.e., error-ERF). Small correlations were found between perceptual fatigue and error-ERF for the chest-press (r = -0.26, p = 0.001) and the leg-press (r = -0.18, p = 0.013). For actual repetitions to failure and error-ERF, a strong correlation was found for the chest-press (r = 0.68, p < 0.001) and a very strong correlation was foundfor the leg-press (r = 0.73, p < 0.001). Moderate correlations were found between perceptual fatigue and actual repetitions to failure for the chest-press (r = -0.42, p < 0.001) and leg-press (r = -0.40, p < 0.001). Overall, findings suggest that the accuracy of the estimated repetitions to failure is more strongly associated with proximity to task repetition failure rather than subjective feelings of fatigue.

Effect of quantity and quality of pre-exercise carbohydrate meals on central fatigue.

Both the quantity and quality of pre-exercise carbohydrate (CHO) meals have been shown to improve endurance performance. However, their role in attenuating central fatigue (CF) is inconclusive. The use of neurophysiological techniques, such as voluntary activation (VA) and the central activation ratio (CAR), alongside maximum voluntary contraction (MVC) and sustained MVC (sMVC) can provide information on CF. Hence, the objective of this study was to investigate the effects of isocaloric pre-exercise meals: 1) a high versus low quantity of CHO and 2) a high quantity of CHO with a high versus low glycemic index (GI) on MVC, VA, and CAR following a 90-min run. The high and low quantity of CHO was 1.5 and 0.8 g/kg body wt, respectively, and high and low GI was ~75 and ~40, respectively. Blood insulin, serotonin, tryptophan, and gaseous exchange were also measured. High CHO preserved sMVC, VA, CAR, and serotonin postrunning with greater CHO oxidation and insulin response, whereas in low CHO, greater reductions in sMVC, VA, and CAR were accompanied by higher serotonin and fat oxidation with lower insulin response. These observations indicate central involvements. Meanwhile, high GI CHO better preserved force (sMVC), CAR, and tryptophan with greater CHO oxidation and insulin response compared with low GI. The findings of this study suggest that pre-exercise meals with varying quantity and quality of CHO can have an effect on CF, where greater CHO oxidation and insulin response found in both high CHO and high GI lead to attenuation of CF. NEW & NOTEWORTHY This paper examined the effects of carbohydrate interventions (high and low: quantity and quality wise) on central activity during prolonged exercise using mainly neurophysiological techniques along with gaseous exchange and blood insulin, serotonin, and tryptophan data.

Strength Training Biases Goal-Directed Aiming.

PURPOSE: Goal-directed movements tend to resemble the characteristics of previously executed actions. Here we investigated whether a single bout of strength training, which typically involves stereotyped actions requiring strong neural drive, can bias subsequent aiming behavior toward the direction of trained forces. METHODS: In experiment 1 (n = 10), we tested the direction of force exerted in an isometric aiming task before and after 40 repetitions of 2-s maximal-force ballistic contractions toward a single directional target. In experiment 2 (n = 12), each participant completed three training conditions in a counterbalanced crossover design. In two conditions, both the aiming task and the training were conducted in the same (neutral) forearm posture. In one of these conditions, the training involved weak forces to determine whether the level of neural drive during training influences the degree of bias. In the third condition, high-force training contractions were performed in a 90° pronated forearm posture, whereas the low-force aiming task was performed in a neutral forearm posture. This dissociated the extrinsic training direction from the pulling direction of the trained muscles during the aiming task. RESULTS: In experiment 1, we found that aiming direction was biased toward the training direction across a large area of the work space (approximately ±135°; tested for 16 targets spaced 22.5° apart), whereas in experiment 2, we found systematic bias in aiming toward the training direction defined in extrinsic space, but only immediately after high-force contractions. CONCLUSION: Our findings suggest that bias effects of training involving strong neural drive generalize broadly to untrained movement directions and are expressed according to extrinsic rather than muscle-based coordinates.

A systematic method to quantify the presence of cross-talk in stimulus-evoked EMG responses: implications for TMS studies.

Surface electromyography (EMG) responses to noninvasive nerve and brain stimulation are routinely used to provide insight into neural function in humans. However, this could lead to erroneous conclusions if evoked EMG responses contain significant contributions from neighboring muscles (i.e., due to "cross-talk"). We addressed this issue with a simple nerve stimulation method to provide quantitative information regarding the size of EMG cross-talk between muscles of the forearm and hand. Peak to peak amplitude of EMG responses to electrical stimulation of the radial, median, and ulnar nerves (i.e., M-waves) were plotted against stimulation intensity for four wrist muscles and two hand muscles (n = 12). Since electrical stimulation can selectively activate specific groups of muscles, the method can differentiate between evoked EMG arising from target muscles and EMG cross-talk arising from nontarget muscles. Intramuscular EMG responses to nerve stimulation and root mean square EMG produced during maximal voluntary contractions (MVC) of the wrist were recorded for comparison. Cross-talk was present in evoked surface EMG responses recorded from all nontarget wrist (5.05-39.38% Mmax) and hand muscles (1.50-24.25% Mmax) and to a lesser degree in intramuscular EMG signals (∼3.7% Mmax). The degree of cross-talk was comparable for stimulus-evoked responses and voluntary activity recorded during MVC. Since cross-talk can make a considerable contribution to EMG responses in forearm and hand muscles, care is required to avoid misinterpretation of EMG data. The multiple nerve stimulation method described here can be used to quantify the potential contribution of EMG cross-talk in transcranial magnetic stimulation and reflex studies.

Early neural responses to strength training.

The neural adaptations that accompany strength training have yet to be fully determined. Here we sought to address this topic by testing the idea that strength training might share similar mechanisms with some forms of motor learning. Since ballistic motor learning is accompanied by a shift in muscle twitches induced by transcranial magnetic stimulation (TMS) toward the training direction, we sought to investigate if these changes also occur after single isometric strength training sessions with various contraction duration and rate of force development characteristics (i.e., brief or sustained ballistic contractions or slow, sustained contractions). Twitch force resultant vectors and motor-evoked potentials (MEPs) induced by TMS were measured before and after single sessions of strength training involving the forearm muscles. Participants (n = 12) each performed three training protocols (each consisting of 4 sets of 10 repetitions) and served as their own control in a counterbalanced order. All three training protocols caused a significant (P < 0.05) shift in TMS-induced twitch force resultant vectors toward the training direction, followed by a gradual shift back toward the pretraining direction. The strongest effect was found when training involved both ballistic and sustained force components. There were no large or consistent changes in the direction of twitches evoked by motor nerve stimulation for any of the three training protocols. We suggest that these early neural responses to strength training, which share similar corticospinal changes to motor learning, might reflect an important process that precedes more long-term neural adaptation that ultimately enhance strength.