Influence of transducer pressure and examiner experience on muscle active shear modulus measured by shear wave elastography.

INTRODUCTION: This study examined the effects of ultrasound transducer pressure and examiner experience on the biceps femoris long head and semitendinosus muscle active shear modulus in healthy individuals (n = 28). METHODS: Active shear modulus was assessed using shear wave elastography at 20% of knee flexor maximal voluntary isometric contraction. Examiners with different experience levels measured the muscles' shear modulus with three pressure levels: mild, moderate, and hard. RESULTS: A main effect of transducer pressure was found for both biceps femoris long head (p < 0.001; η2p = 0.314) and semitendinosus muscles (p < 0.001; η2p = 0.280), whereas differences were found between mild-moderate (biceps femoris long head: p = 0.013, d = 0.23; semitendinosus: p = 0.024, d = 0.25), and mild-hard pressures (biceps femoris long head: p = 0.001, d = 0.47; semitendinosus: p = 0.002, d = 0.47). Examiners performed similar shear modulus measurements in the biceps femoris long head (p = 0.299; η2p = 0.041) and semitendinosus (p = 0.177; η2p = 0.066), although the experienced examiner showed a higher measurement repeatability (biceps femoris long head: ICC = 0.86-0.95, semitendinosus: ICC = 0.89-0.96; vs. biceps femoris long head: ICC = 0.78-0.87, semitendinosus: ICC = 0.66-0.87). CONCLUSION: Transducer pressure influences the active shear modulus measurement between mild and moderate or hard pressures. Additionally, examiner experience seems to have no influence on muscle active shear modulus measurement when assessed at the same site (using casts). IMPLICATIONS FOR PRACTICE: Future studies assessing active muscle shear modulus should use mild transducer pressure and having experienced examiners in order to improve measurement reliability.

Synchronization performance affects gait variability measures during cued walking.

BACKGROUND: Incorporating variability within gait rehabilitation offers a promising approach to restore functional capacity. However, it's success requires adequate synchronization, a parameter that lacks report in most of the literature regarding cued gait training. RESEARCH QUESTION: How changes to synchronization performance during fractal-like and isochronous cueing impacts gait variability measures? METHODS: We asked twelve young male participants to walk in synchronization to two different temporally structure cueing (isochronous [ISO] and fractal [FRC]). We have also manipulated the cueing's tempo by increasing and decreasing it by 5% to manipulate synchronization, resulting in six conditions (stimuli [ISO,FRC] x tempo [SLOW, NORMAL, FAST]). The normal condition was set from an uncued trial through the participant's self-paced stride time. Synchronization performance (ASYNC) and gait variability (fractal scaling and coefficient of variation) were calculated from stride time data ( -ISIs,CV-ISIs). Repeated measures analysis of variance or Aligned Rank Transform were conducted to determine significant differences between metronome tempo and stimuli for the dependent variables RESULTS: Our results showed a FAST tempo decreases synchronization performance (ASYNC) and leads to lower -ISIs, for both ISO and FRC stimuli. This indicates that when an individual exhibits poor synchronization during cued gait training, his/her gait variability patterns will not follow the temporal structure of the presented metronome. Specifically, if the individual poorly synchronizes to the cues, the gait patterns become more random, a condition typically observed in older adults and neurological patients, which runs contrary to the hypothesis when using fractal-like metronomes. SIGNIFICANCE: This study provides supporting evidence that measuring synchronization performance in cued training is fundamental for a proper clinical interpretation of its effects. This is particularly relevant for the recent and ongoing clinical research using fractal-like metronomes since the expected gait patterns are dependent on the synchronization performance. Randomized control trials must incorporate synchronization performance related measures.

Fatigue Evaluation through Machine Learning and a Global Fatigue Descriptor.

Research in physiology and sports science has shown that fatigue, a complex psychophysiological phenomenon, has a relevant impact in performance and in the correct functioning of our motricity system, potentially being a cause of damage to the human organism. Fatigue can be seen as a subjective or objective phenomenon. Subjective fatigue corresponds to a mental and cognitive event, while fatigue referred as objective is a physical phenomenon. Despite the fact that subjective fatigue is often undervalued, only a physically and mentally healthy athlete is able to achieve top performance in a discipline. Therefore, we argue that physical training programs should address the preventive assessment of both subjective and objective fatigue mechanisms in order to minimize the risk of injuries. In this context, our paper presents a machine-learning system capable of extracting individual fatigue descriptors (IFDs) from electromyographic (EMG) and heart rate variability (HRV) measurements. Our novel approach, using two types of biosignals so that a global (mental and physical) fatigue assessment is taken into account, reflects the onset of fatigue by implementing a combination of a dimensionless (0-1) global fatigue descriptor (GFD) and a support vector machine (SVM) classifier. The system, based on 9 main combined features, achieves fatigue regime classification performances of 0.82 ± 0.24, ensuring a successful preventive assessment when dangerous fatigue levels are reached. Training data were acquired in a constant work rate test (executed by 14 subjects using a cycloergometry device), where the variable under study (fatigue) gradually increased until the volunteer reached an objective exhaustion state.

Stretching Effects: High-intensity & Moderate-duration vs. Low-intensity & Long-duration.

This study examined whether a high-intensity, moderate-duration bout of stretching would produce the same acute effects as a low-intensity, long-duration bout of stretching. 17 volunteers performed 2 knee-flexor stretching protocols: a high-intensity stretch (i. e., 100% of maximum tolerable passive torque) with a moderate duration (243.5 ± 69.5-s); and a low-intensity stretch (50% of tolerable passive torque) with a long duration (900-s). Passive torque at a given sub-maximal angle, peak passive torque, maximal range of motion (ROM), and muscle activity were assessed before and after each stretching protocol (at intervals of 1, 30 and 60 min). The maximal ROM and tolerable passive torque increased for all time points following the high-intensity stretching (p<0.05), but not after the low-intensity protocol (p>0.05). 1 min post-stretching, the passive torque decreased in both protocols, but to a greater extent in the low-intensity protocol. 30 min post-test, torque returned to baseline for the low-intensity protocol and had increased above the baseline for the high-intensity stretches. The following can be concluded: 1) High-intensity stretching increases the maximal ROM and peak passive torque compared to low-intensity stretching; 2) low-intensity, long-duration stretching is the best way to acutely decrease passive torque; and 3) high-intensity, moderate-duration stretching increases passive torque above the baseline 30 min after stretching.

Effects of Walking with Blood Flow Restriction on Excess Post-exercise Oxygen Consumption.

This study determined the influence of walking with blood flow restriction (BFR) on the excess post-exercise oxygen consumption (EPOC) of healthy young men. 17 healthy young men (22.1±2.9 years) performed graded treadmill exercise to assess VO2peak. In a randomized fashion, each participant performed 5 sets of 3-min treadmill exercise at their optimal walking speed with 1-min interval either with or without BFR. Participants were then seated in a chair and remained there for 30 min of recovery. Expired gases were continuously monitored during exercise and recovery. BFR increased the O2 cost of walking as well as its relative intensity and cumulative O2 deficit (p<0.05). The EPOC magnitude after walking with BFR was greater than in the non-BFR condition (p<0.05). No differences between conditions were seen for the duration of EPOC. The EPOC magnitude was no longer different between conditions after controlling for the differences in relative intensity and in the cumulative O2 deficit (p>0.05). These data indicate that walking with BFR increases the magnitude of EPOC. Moreover, they also demonstrate that such increment in EPOC is likely explained by the effects of BFR on walking relative intensity and cumulative O2 deficit.

Provocative mechanical tests of the peripheral nervous system affect the joint torque-angle during passive knee motion.

This study aimed to determine the influence of the head, upper trunk, and foot position on the passive knee extension (PKE) torque-angle response. PKE tests were performed in 10 healthy subjects using an isokinetic dynamometer at 2°/s. Subjects lay in the supine position with their hips flexed to 90°. The knee angle, passive torque, surface electromyography (EMG) of the semitendinosus and quadriceps vastus medialis, and stretch discomfort were recorded in six body positions during PKE. The different maximal active positions of the cervical spine (neutral; flexion; extension), thoracic spine (neutral; flexion), and ankle (neutral; dorsiflexion) were passively combined for the tests. Visual analog scale scores and EMG were unaffected by body segment positioning. An effect of the ankle joint was verified on the peak torque and knee maximum angle when the ankle was in the dorsiflexion position (P < 0.05). Upper trunk positioning had an effect on the knee submaximal torque (P < 0.05), observed as an increase in the knee passive submaximal torque when the cervical and thoracic spines were flexed (P < 0.05). In conclusion, other apparently mechanical unrelated body segments influence torque-angle response since different positions of head, upper trunk, and foot induce dissimilar knee mechanical responses during passive extension.