Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances.

Robot-assisted bilateral arm training has demonstrated its effectiveness in improving motor function in individuals post-stroke, showing significant enhancements with increased repetitions. However, prolonged training sessions may lead to both mental and muscle fatigue. We conducted two types of robot-assisted bimanual wrist exercises on 16 healthy adults, separated by one week: long-duration, low-resistance workouts and short-duration, high-resistance exercises. Various measures, including surface electromyograms, near-infrared spectroscopy, heart rate, and the Borg Rating of Perceived Exertion scale, were employed to assess fatigue levels and the impacts of exercise intensity. High-resistance exercise resulted in a more pronounced decline in electromyogram median frequency and recruited a greater amount of hemoglobin, indicating increased muscle fatigue and a higher metabolic demand to cope with the intensified workload. Additionally, high-resistance exercise led to increased sympathetic activation and a greater sense of exertion. Conversely, engaging in low-resistance exercises proved beneficial for reducing post-exercise muscle stiffness and enhancing muscle elasticity. Choosing a low-resistance setting for robot-assisted wrist movements offers advantages by alleviating mental and physiological loads. The reduced training intensity can be further optimized by enabling extended exercise periods while maintaining an approximate dosage compared to high-resistance exercises.

Partial-body cryostimulation does not impact peripheral microvascular responsiveness but reduces muscular metabolic O2 consumption (mV˙O2) at rest.

This study aimed to investigate the effect of partial-body cryostimulation (PBC) on microvascular responsiveness and muscular metabolic O2 consumption rate (mV˙O2). Twenty healthy young adults (ten males and ten females) underwent a post-occlusive reactive hyperemia (PORH) test at the flexor digitorum superficialis area before and after a 3-min PBC session and a 3-min control session. Using near-infrared spectroscopy, occlusion and reperfusion slopes were calculated: oxyhemoglobin ([HbO2]) decrease rate ([HbO2] slope 1), deoxyhaemoglobin ([HHb]) increase rate ([HHb] slope 1), [HbO2] increase rate ([HbO2] slope 2), and [HHb] increase rate ([HHb] slope 2. Using HbO2 kinetics during the occlusion, mV˙O2 was also calculated to characterize myocytes' metabolic O2 consumption. HbO2 slope 1 value was lower after PBC than before PBC (-0.15 ± 0.08 vs -0.24 ± 0.11 s-1; respectively; P < 0.05) in male participants only. A lower [HHb] slope 1 was also observed after PBC compared to before PBC (0.18 ± 0.10 vs 0.24 ± 0.16 s-1; P < 0.05) with no interaction for sex categories. mV˙O2 was significantly lower after PBC than before (pre values 14.75 ± 3.94 vs 18.47 ± 5.73 µMO2Hb.s-1; respectively; P < 0.01) with no interaction between sex categories. No changes in the calculated slope 2 were observed. These findings suggest that a single session of PBC reduces the muscular metabolic O2 needs at rest; however, it does not alter the vascular ability to provide O2 to the myocytes.

Acute Effects of Cocoa Flavanols on Blood Pressure and Peripheral Vascular Reactivity in Type 2 Diabetes Mellitus and Essential Hypertension: A Protocol for an Acute, Randomized, Double-Blinded, Placebo-Controlled Cross-Over Trial.

Introduction: Patients with type 2 diabetes mellitus are at high risk to develop vascular complications resulting in high morbidity and mortality. Cocoa flavanols are promising nutraceuticals with possible beneficial vascular effects in humans. However, limited research is currently available on the vascular effects in a diabetic population with inconsistent results. Possible reasons for this inconsistency might be heterogeneity in the given intervention (dose per time and day, single dose vs. split-dose, placebo formula) and the studied population (blood pressure at baseline, duration of diabetes, use of vasoactive antihypertensive and antidiabetic drugs, sex). Therefore, we aimed to develop a randomized, double-blinded, placebo-controlled cross-over trial to investigate whether cocoa flavanols have an acute impact on blood pressure and vascular reactivity in patients with type 2 diabetes with and without arterial hypertension. Methods and Analysis: We will include participants in four groups: (i) patients with type 2 diabetes without arterial hypertension, (ii) patients with type 2 diabetes with arterial hypertension and 1 antihypertensive drug, (iii) non-diabetic participants with essential hypertension and 1 antihypertensive drug, and (iv) healthy controls. All participants will complete the same protocol on both testing days, consuming high-flavanol cocoa extract (790 mg flavanols) or placebo. Macrovascular endothelial function (flow-mediated dilation) and blood pressure will be measured before and after capsule ingestion. Forearm muscle vasoreactivity (near-infrared spectroscopy) and brachial artery blood flow (echo-doppler) will be assessed in response to a dynamic handgrip exercise test after capsule ingestion. Data will be analyzed with a random intercept model in mixed models. Clinical Trial Registration: www.Clinicaltrials.gov, identifier: NCT03722199.

Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study.

Since there is merit in noninvasive monitoring of muscular oxidative metabolism for near-infrared spectroscopy in a wide range of clinical scenarios, the present study attempted to evaluate the clinical usability for featuring the modulatory strategies of sternocleidomastoid muscular oxygenation using near-infrared spectroscopy in mild nonspecific neck pain patients. The muscular oxygenation variables of the dominant or affected sternocleidomastoid muscles of interest were extracted at 25% of the maximum voluntary isometric contraction from ten patients (5 males and 5 females, 23.6 ± 4.2 years) and asymptomatic individuals (6 males and 4 females, 24.0 ± 5.1 years) using near-infrared spectroscopy. Only a shorter half-deoxygenation time of oxygen saturation during a sternocleidomastoid isometric contraction was noted in patients compared to asymptomatic individuals (10.43 ± 1.79 s vs. 13.82 ± 1.42 s, p < 0.001). Even though the lack of statically significant differences in most of the muscular oxygenation variables failed to refine the definite pathogenic mechanisms underlying nonspecific neck pain, the findings of modulatory strategies of faster deoxygenation implied that near-infrared spectroscopy appears to have practical potential to provide relevant physiological information regarding muscular oxidative metabolism and constituted convincing preliminary evidences of the adaptive manipulations rather than pathological responses of oxidative metabolism capacity of sternocleidomastoid muscles in nonspecific neck patients with mild disability.

Increased oxygenation in the non-contracting forearm muscle during contralateral skilful hand movement.

NEW FINDINGS: What is the central question of this study? When performing skilful hand movement, motor command descends especially towards distal arm muscles. Does central command evoke a vascular response selectively in the distal arm muscles during skilful hand movement? What is the main finding and its importance? We found, using near-infrared spectroscopy, that unilateral skilful hand movement evoked a greater increase in oxygenation of the contralateral forearm muscle compared with that of the upper arm muscles. Mental imagery of the hand movement also increased oxygenation of the forearm muscle. These findings suggest that central command might contribute to the vasodilator response in the non-contracting forearm muscle during contralateral skilful hand movement. ABSTRACT: The human hand is a special organ to perform skilful movement in daily life. To meet metabolic demands of the working distal arm muscles, central command might evoke neurogenic vasodilatation in the muscles. Based on our previous demonstration that a centrally generated vasodilator signal is transmitted bilaterally to skeletal muscles during exercise, centrally induced vasodilatation might occur in the non-contracting distal arm muscles during contralateral skilful hand movement. To examine this possibility, we used near-infrared spectroscopy to measure the relative concentrations of oxygenated haemoglobin (Oxy-Hb; as an index of regional blood flow) in the non-contracting arm muscles during skilful hand movement (two-ball rotation) in 22 subjects. Two-ball rotation increased Oxy-Hb of both forearm and upper arm muscles, with little changes in perfusion pressure and cardiac output. The increased Oxy-Hb was greater in the forearm muscle than in the upper arm muscles. The increased Oxy-Hb of the forearm muscle during two-ball rotation was greater than that during one-armed cranking performed with no load. Mental imagery of two-ball rotation increased Oxy-Hb of the forearm and biceps muscles. The increases in Oxy-Hb of both forearm and upper arm muscles during two-ball rotation were reduced by decreasing the level of task difficulty. Intravenous administration of atropine attenuated the increases in Oxy-Hb of the arm muscles during two-ball rotation. It is likely that contralateral skilful hand movement evokes a selective increase in Oxy-Hb of the non-contracting forearm muscle via a sympathetic cholinergic mechanism and that the increase in oxygenation might be mediated, at least in part, by central command.

Evaluación del trabajo respiratorio mediante oxigenación muscular / Assessment of work of breathing using muscle oxygenation

RESUMEN El aumento del trabajo respiratorio (work of breathing, WOB) es uno de los problemas kinesiológicos frecuentes en el quehacer clínico. Un desafío profesional es contar con valores de variables fisiológicas que permitan objetivar el WOB facilitando así su interpretación entre los diferentes profesionales de la salud. El uso de dispositivos portátiles que registran la longitud de onda cercana al rango infrarrojo (680- 820 nm, Near Infrared Spectroscopy (NIRS)) en músculos superficiales permite obtener valores de hemoglobina total unida a oxígeno (tHb) y oxigenación muscular local (SmO2), variables relacionadas al trabajo muscular pues reportan el flujo sanguíneo en la microcirculación y consumo de oxígeno local, respectivamente. Estos dispositivos situados en musculatura intercostal nos informan el WOB asociado a la respiración. Para evaluar esto, se analizó el comportamiento de tHb y SmO2 en m. intercostal en 20 corredores de maratón durante la valoración de consumo de oxígeno máximo (VO2- max), instancia que implica aumento sostenido e incremental de la ventilación pulmonar (��E), y por tanto de la actividad muscular respiratoria. El aumento de V E en 128,4 L·min-1 ( ��E (máximo-reposo)) implicó una disminución en SmO2- m.intercostal del 34% ( SmO2 (reposo-máximo)), sin cambios en tHb (p=0,805). La tuvo una correlación inversa con SmO2-m.intercostal (rho=-0.565; p=0,001). Se concluye que la valoración de SmO2-m.intercostal es una forma novedosa de objetivar el WOB en sujetos sanos. Conocer la aplicabilidad clínica requiere de otros estudios que evalúen esta herramienta en pacientes con disfunciones cardiorrespiratorias, lo que permitiría incorporar su uso en nuestro desarrollo clínico profesional.

The work of breathing (WOB) increased is a commonkinesiological problems at the clinical practice. A professional challenge is to have values of physiological variables that allows to objective the WOB, thus facilitating its interpretation among different health professionals. The use of portable devices that measure by spectroscopy the near-infrared wavelength (680-820 nm) atsuperficial muscles allows to obtain values of total hemoglobin linked to oxygen (tHb) and local muscle oxygenation (SmO2), variables related to muscle work because give information of the blood flow at the microcirculation and local oxygen consumption, respectively. These devices located at the m.intercostal could give information about the WOB associated to breathing. To evaluate this, the tHb and SmO2 of the m.intercostal in 20 marathon runners were analyzed while they doing the maximum oxygen consumption test (VO2-max), an exercise that increase the pulmonary ventilation and the respiratory muscle activity. The increase of V E (128,4 L·min-1((max-rest)) implied a decrease in SmO2- m.intercostal (34% ( SmO2 (max-rest)), without changes in tHb (p=0.805). The showedan negative correlation to SmO2-m.intercostal (rho= -0.565; p=0.001). It is concluded that the assessment of SmO2-m.intercostal is a novel way to measure the WOB in healthy subjects. Their clinical applicability requires more studies that applied this tool in patients with cardiorespiratory dysfunctions, facilitating their incorporation in the professional clinical practice.

Methods of estimating the muscle oxygenation curve by near-infraredspectroscopy(NIRS) during ramp exercise. Reproducibility and specificity / 体力科学

The purpose of this study was to confirm both the reproducibility of indices (NIRS slope, NT2, %NIRS fall) and the specificity obtained by analyzing the muscle oxygenation curve measured by near-infrared spectroscopy (NIRS) during ramp exercise. Ten healthy men participated in this study. The NIRS probe was placed on the vastus lateralis muscle. An increase in oxygenation was observed from rest to warm-up at 0 watts (Δ NIRS) . Oxygenation began to decrease lineally as the workload increased (NIRS slope) . In the latter phase of exercise, the oxygenation curve flattened out despite an increasing workload, and as a result, an inflection point was formed (NT2) . The minimum value of oxygenation during ramp exercise was indicated as“%NIRS fall.”<BR>Protocol 1. After a warm-up period of 3 min at 0 watts, a ramp exercise (20 watt/min) test was performed until volitional fatigue. The test was performed for each subject twice (test-1, test-2) with a 1-week interval. Protocol 2. A test was performed with three consecutive ramp exercises (lOwatt/min·20watt/min·30watt/min) up to120watt each with sufficient rest between the exercises.<BR>NT2 was observed in 7 of 10 subjects. Test-1 and test-2 mean values of ANIRS, NIRS slope, watts at NT2 (NT2) and %NIRS fall were not significantly different, and the correlations between test-1 and test-2 were highly significant (r=0.94, P<0.0001: ANIRS, r=0.99, P<0.0001: NIRS slope, r=0.91, P<0.002: NT2 and r=0.78, P<0.005 : %NIRS fall) . The regression lines obtained for correlations of results of test-1 and test-2 were y=-5.89+1.38X (Δ NIRS), y=0.02+ 1.03X (NIRS slope), y=31.52+0.83X (NT2), and y=19.91+0.61X (%NIRS fall) . No significant differences in both intercept and coefficient between the regression line and identity line were found in the NIRS slope and NT2. The rate of decrease in the oxygenation curve became steeper with an increase in work-load from 10 watts/min to 20 watts/min and to 30 watts/min. However, the mean values of the NIRS slope, modified by watts, were 0.29±0.06%/watt, 0.29±0.07%/watt and 0.29±0.07%/watt, respectively. There were no significant differences of the NIRS slopes among these exercises. The results indicate constancy of the rate of decrease in oxygenation per workload.<BR>In conclusion, these findings demonstrate the reproducibility of the NIRS slope and the appearance of NT2 during ramp exercise, and the specific way in which the decrease in muscle oxygenation reflects workload. They suggest that analysis of the muscle oxygenation curve can be used to estimate muscular metabolism and indices of training effects.

EVALUATION OF THE MUSCLE OXYGENATION CURVE BY NEAR-INFRARED SPECTROSCOPY (NIRS) DURING RAMP EXERCISE / 体力科学

A study was conducted to establish a method for quantitative evaluation of both the rate and degree of muscle oxygenation during ramp exercise using Near Infrared Spectroscopy (NIRS), and to determine the relationship of the indices to body composition and physical fitness. The subjects were 13 healthy men. After a warm-up period of 3 min at 20-W, the ramp exercise test was conducted. The exercise consisted of an increasing work rate at a slope of 20 W/min on a cycle ergometer performed until volitional fatigue. The NIRS probe used in the cycling exercise was placed on the vastus lateralis muscle. After 30 min of exercise, calibration was performed by cuff occlusion for 10 min with a pressure of 260 mmHg for quantitative determination of the NIRS curve. The oxygenation curve measured by NIRS during the exercise initially exhibited a linear decrease as the work rate increased. This rate of decrease in oxygenation was indicated by the NIRS slope (%/W) obtained from the calibration curve. In later stages of the exercise, the NIRS curve became flattened with increased work rate. The breaking point between the sloping phase and the flat phase was named the “NIRS Threshold 2, NT 2”. In addition, the rate of decrease in oxygenation at the end of exercise per maximal NIRS decrease obtained from the calibration curve was indicated as the %NIRS fall. The mean NIRS slope and %NIRS fall were 0.3±0.1%/W (range, 0.13 to 0.50%/W) and 29.9±11.8% (range, 12.0 to 50.0%), respectively. NT 2 was observed in 8 of the 13 subjects. The subjects were divided into two groups (NT 2 (+) and NT 2 (-) ) based on the appearance of NT 2. Both the NIRS slope and %NIRS fall in the NT 2 (+) group were significantly higher than those in the NT 2 (-) group. The NIRS slope was significantly correlated with VO<SUB>2</SUB>/wt at VT (r=0.73, p<0.05) and wattage at VT (r=0.86, p<0.0001) . The %NIRS fall was significantly correlated with VO<SUB>2</SUB>/wt at peak (r=0.80, P<0.001) . The NIRS slope and %NIRS fall were not significantly correlated with body mass index, %fat or thigh circumference.<BR>These findings suggest that the NIRS slope indicates the efficiency of oxygen exchange in muscles activated during incremental exercise, and that the %NIRS fall indicates the ability to utilize Oxy-Hb+Mb against maximal oxygenation capacity in muscles. The NIRS slope and %NIRS fall can therefore be used as indices of muscular limitation during exercise, and as indices of muscular adaptation during exercise.